BACKGROUND In an era leaning toward a personalized alignment of total knee arthroplasty,coronal plane alignment of the knee(CPAK)phenotypes for each population are studied;furthermore,other possible variables affectin...BACKGROUND In an era leaning toward a personalized alignment of total knee arthroplasty,coronal plane alignment of the knee(CPAK)phenotypes for each population are studied;furthermore,other possible variables affecting the alignment,such as ankle joint alignment,should be considered.AIM To determine CPAK distribution in the North African(Egyptian)population with knee osteoarthritis and to assess ankle joint line orientation(AJLO)adaptations across different CPAK types.METHODS A cross-sectional study was conducted on patients with primary knee osteoarthritis and normal ankle joints.Radiographic parameters included the mechanical lateral distal femoral angle,medial proximal tibial angle,and the derived calculations of joint line obliquity(JLO)and arithmetic hip-knee-ankle angle(aHKA).The tibial plafond horizontal angle(TPHA)was used for AJLO assessment,where 0°is neutral(type N),<0°is varus(type A),and>0°is valgus(type B).The nine CPAK types were further divided into 27 subtypes after incorporating the three AJLO types.RESULTS A total of 527 patients(1054 knees)were included for CPAK classification,and 435 patients(870 knees and ankles)for AJLO assessment.The mean age was 57.2±7.8 years,with 79.5%females.Most knees(76.4%)demonstrated varus alignment(mean aHKA was-5.51°±4.84°)and apex distal JLO(55.3%)(mean JLO was 176.43°±4.53°).CPAK types I(44.3%),IV(28.6%),and II(10%)were the most common.Regarding AJLO,70.2%of ankles exhibited varus orientation(mean TPHA was-5.21°±6.45°).The most frequent combined subtypes were CPAK type I-A(33.7%),IV-A(21.5%),and I-N(6.9%).A significant positive correlation was found between the TPHA and aHKA(r=0.40,P<0.001).CONCLUSION In this North African cohort,varus knee alignment with apex distal JLO and varus AJLO predominated.CPAK types I,IV,and II were the most common types,while subtypes I-A,IV-A,and I-N were commonly occurring after incorporating AJLO types;furthermore,the AJLO was significantly correlated to aHKA.展开更多
BACKGROUND The optimal surgical approach for patients with primary glenohumeral osteoarthritis(GHOA)and an intact rotator cuff remains debated.While anatomic total shoulder arthroplasty(TSA)has traditionally been favo...BACKGROUND The optimal surgical approach for patients with primary glenohumeral osteoarthritis(GHOA)and an intact rotator cuff remains debated.While anatomic total shoulder arthroplasty(TSA)has traditionally been favoured,reverse TSA(RTSA)is increasingly utilized.AIM To systematically compare the outcomes of RTSA and TSA in this specific patient population.METHODS A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines.Retrospective comparative studies evaluating RTSA and TSA in patients with GHOA and intact rotator cuff were included.Key outcomes assessed included complication and reoperation rates,patient-reported outcome measures(PROMs),and range of motion.Risk of bias was assessed using the Risk of Bias in Non-randomized Studies of Interventions tool.RESULTS Twelve studies encompassing 1608 patients(580 RTSA,1028 TSA)met inclusion criteria.RTSA was associated with a lower reoperation rate compared to TSA[odds ratio=0.37;95%confidence interval(CI):0.14-0.94;P value=0.04],while no significant difference in overall complication rates was observed(odds ratio=0.47;95%CI:0.19-1.16;P value=0.10).RTSA patients showed superior outcomes in University of California Los Angeles,Simple Shoulder Test,and Shoulder Pain and Disability Index scores;however,the differences did not exceed the minimal clinically important difference.TSA patients had significantly better external rotation(mean difference=-9.0°;95%CI:-13.21 to-5.02;P value<0.0001).No significant differences were found in other range of motion measures or satisfaction scores.The overall methodological quality of included studies was moderate to serious.CONCLUSION In patients with GHOA and an intact rotator cuff,RTSA may offer comparable or improved outcomes to TSA with lower reoperation rates and similar complication profiles.Functional outcomes favour RTSA in certain patientreported outcome measures,while TSA retains an advantage in external rotation.Surgical decision-making should remain individualized based on patient characteristics and functional demands.展开更多
Musculoskeletal injuries are among the most common causes of disability worldwide,with early detection and appropriate intervention critical to minimizing long-term complications.Infrared thermography(IRT)has emerged ...Musculoskeletal injuries are among the most common causes of disability worldwide,with early detection and appropriate intervention critical to minimizing long-term complications.Infrared thermography(IRT)has emerged as a noninvasive,real-time imaging modality that captures superficial temperature changes reflecting underlying physiological processes such as inflammation and vascular alterations.This review explores the fundamental principles of medical thermography,differentiates between passive and active approaches,and outlines key technological advancements including artificial intelligence integration.The clinical utility of IRT is discussed in various contexts–ranging from acute soft tissue injuries and overuse syndromes to chronic pain and rehabilitation monitoring.Comparative insights with conventional imaging techniques such as ultrasound and magnetic resonance imaging are also presented.While IRT offers functional imaging capabilities with advantages in portability,safety,and speed,its limitations–such as lack of deep-tissue penetration and protocol standardization–remain significant barriers to broader adoption.Future directions include the integration of IRT with other imaging modalities and digital health platforms to enhance musculoskeletal assessment and injury prevention strategies.展开更多
BACKGROUND Orthobiologics-biological substances like platelet-rich plasma(PRP),bone marrow aspirate concentrate,and stem cells-are increasingly used in musculoskeletal care to promote tissue repair and reduce reliance...BACKGROUND Orthobiologics-biological substances like platelet-rich plasma(PRP),bone marrow aspirate concentrate,and stem cells-are increasingly used in musculoskeletal care to promote tissue repair and reduce reliance on invasive surgery.Despite global momentum,India's clinical adoption remains underexplored.AIM To inform education,policy,and resource allocation for the safe and effective adoption of orthobiologics in musculoskeletal care.METHODS A cross-sectional electronic survey was conducted from January to March 2025 among orthopaedic surgeons,academicians,and trainees across India.The questionnaire assessed demographics,knowledge of orthobiologics,attitudes toward training and subspecialization,usage trends,regulatory awareness,and perceived barriers.Data were analyzed using descriptive statistics andχ2/Fisher’s exact tests,with P<0.05 considered significant.RESULTS A total of 1280 valid responses were collected.Awareness of orthobiologics was high(97%),with PRP being the most familiar and widely used(80%).Formal training was reported by only 31%,though 85%showed interest in structured education,and 68%supported orthobiologics as a subspecialty.Satisfaction with clinical outcomes averaged 6.5±2.3 out of 10 points.Barriers included high treatment cost(64%),poor patient awareness(90%),and limited access to biologics labs(18%).Regulatory understanding was moderate,with academic-affiliated clinicians more informed about stem cell guidelines.CONCLUSION Indian orthopaedic professionals demonstrate strong awareness and optimism toward orthobiologics,but widespread gaps in training,infrastructure,and regulation hinder broader adoption.Strategic investments in education,standardized protocols,and accessible facilities are essential to support safe and evidence-driven integration of regenerative therapies into clinical practice.展开更多
Objectives:Photodynamic therapy(PDT)is a minimally invasive method used in the treatment of various cancers and skin diseases,but it is not widely used in bone cancer,where the current therapy is often not effective a...Objectives:Photodynamic therapy(PDT)is a minimally invasive method used in the treatment of various cancers and skin diseases,but it is not widely used in bone cancer,where the current therapy is often not effective and accompanied by side effects.Alternative and more effective therapies like PDT are needed.In this in-vitro study,the effect of the photosensitizer(PS)chlorin e6(Ce6)on cancerous bone tumor cells using PDT was examined.Methods:A total of 27 tissue specimens from patients with primary bone cancers or bone metastases of different origins were genetically characterized and treated with PDT.Following a 24-h incubation,cell viability was determined,and the effect of PDT on cell migration was analyzed over 48 h.Results:We could demonstrate that the effect on proliferation of PDT in combination with the PS Ce6 was best in cells isolated from primary osteosarcoma and in bone metastases from mammary carcinomas.Besides proliferation,PDT was also effective in inhibiting the migration of these cells.A statistically significant correlation between the PDT effect and CD164 gene expression was detected,indicating that a high expression of this gene could result in a higher effectiveness of the photodynamic treatment.Conclusion:This study analyzes for the first time the effect of PDT in bone cancers and metastases and shows the potential of treating these cancer types with Ce6 PDT.展开更多
Background:Skeletal tuberculosis(TB)remains a persistent clinical and research chal-lenge due to its chronic course,osteolytic destruction,and the limitations of existing animal models,which often require high-level b...Background:Skeletal tuberculosis(TB)remains a persistent clinical and research chal-lenge due to its chronic course,osteolytic destruction,and the limitations of existing animal models,which often require high-level biosafety containment or fail to repli-cate human skeletal pathology.Methods:This study developed a biosafe,accessible,and versatile murine model of skeletal TB using Mycobacterium smegmatis,a fast-growing,nonpathogenic myco-bacterial species with high genomic homology to Mycobacterium tuberculosis.Three infection routes-subperiosteal calvarial injection,intratibial injection,and intra-cardiac inoculation-were systematically evaluated for their ability to induce lo-calized versus disseminated bone infection under standard biosafety level(BSL)-1 conditions.Results:Subperiosteal calvarial and intratibial injection of M.smegmatis induced local-ized bone lesions characterized by osteolysis,sequestrum formation,granulomatous inflammation,and increased osteoclast activity.Intratibial infection additionally trig-gered compartment-specific immune responses,including neutrophil and macrophage expansion,transient B-cell depletion,and activation of interferon-γ^(+)(IFN-γ^(+))T cells,reflecting active immune remodeling at the infection site.Systemic dissemination via intracardiac injection reproducibly generated progressive vertebral and tibial bone destruction with organized granuloma formation and immune cell infiltration but without prominent sequestrum formation.Compared to intratibial infection,intracar-diac delivery exhibited lower intragroup variability and more closely recapitulated the diffuse progression of extrapulmonary skeletal tuberculosis.Conclusions:This M.smegmatis-based murine model provides a straightforward,reliable,and immunopathologically relevant platform for exploring host-pathogen dynamics,immune-driven bone destruction,and early-stage therapeutic testing in skeletal TB,all within standard BSL-1 laboratories.This model fills a critical gap by enabling BSL-1 research into skeletal TB mechanisms and drug development.展开更多
To enhance the mechanical reliability of dental prostheses under long-term service conditions,this study aimed to evaluate the fracture behavior and energy dissipation characteristics of three commonly used prosthetic...To enhance the mechanical reliability of dental prostheses under long-term service conditions,this study aimed to evaluate the fracture behavior and energy dissipation characteristics of three commonly used prosthetic materials,namely,zirconia ceramics(ZrO_(2)),cobalt-chromium alloy(Co-Cr),and titanium-zirconium alloy(Ti-13Zr),under various crack configurations.A three-dimensional finite element model of a single-crown prosthesis incorporating predefined cracks was established,and both axial and oblique multidirectional loads were applied.Using LS-DYNA software,the deformation patterns,principal stress distribution,and energy release characteristics during crack propagation were systematically analyzed.The experimental results indicate that Ti-13Zr alloy exhibited the highest crack resistance,making it particularly suitable for patients with insufficient bone volume or limited implant space.Co-Cr alloy demonstrated favorable structural stability and mechanical performance under high-load conditions.In contrast,due to its inherent brittleness,ZrO_(2)was more prone to rapid fracture propagation in long-span or high-stress scenarios,although it remains a preferred option for anterior esthetic zones and patients with metal sensitivities.Furthermore,the simulation outcomes were theoretically validated using Griffith's energy-based fracture criterion,reinforcing the accuracy of failure predictions based on principal stress analysis.This study elucidates the differences in clinical applicability among prosthetic materials and reveals their distinct fracture mechanisms,thereby providing a theoretical foundation for optimizing material selection and structural design.The findings contribute to improving the long-term safety and functional stability of implant-supported dental restorations.展开更多
Mitochondrial dysfunction and oxidative stress are widely regarded as primary drivers of aging and are associated with several neurodegenerative diseases.The degeneration of motor neurons during aging is a critical pa...Mitochondrial dysfunction and oxidative stress are widely regarded as primary drivers of aging and are associated with several neurodegenerative diseases.The degeneration of motor neurons during aging is a critical pathological factor contributing to the progression of sarcopenia.However,the morphological and functional changes in mitochondria and their interplay in the degeneration of the neuromuscular junction during aging remain poorly understood.A defined systematic search of the Pub Med,Web of Science and Embase databases(last accessed on October 30,2024)was conducted with search terms including'mitochondria','aging'and'NMJ'.Clinical and preclinical studies of mitochondrial dysfunction and neuromuscular junction degeneration during aging.Twentyseven studies were included in this systematic review.This systematic review provides a summary of morphological,functional and biological changes in neuromuscular junction,mitochondrial morphology,biosynthesis,respiratory chain function,and mitophagy during aging.We focus on the interactions and mechanisms underlying the relationship between mitochondria and neuromuscular junctions during aging.Aging is characterized by significant reductions in mitochondrial fusion/fission cycles,biosynthesis,and mitochondrial quality control,which may lead to neuromuscular junction dysfunction,denervation and poor physical performance.Motor nerve terminals that exhibit redox sensitivity are among the first to exhibit abnormalities,ultimately leading to an early decline in muscle strength through impaired neuromuscular junction transmission function.Parg coactivator 1 alpha is a crucial molecule that regulates mitochondrial biogenesis and modulates various pathways,including the mitochondrial respiratory chain,energy deficiency,oxidative stress,and inflammation.Mitochondrial dysfunction is correlated with neuromuscular junction denervation and acetylcholine receptor fragmentation,resulting in muscle atrophy and a decrease in strength during aging.Physical therapy,pharmacotherapy,and gene therapy can alleviate the structural degeneration and functional deterioration of neuromuscular junction by restoring mitochondrial function.Therefore,mitochondria are considered potential targets for preserving neuromuscular junction morphology and function during aging to treat sarcopenia.展开更多
BACKGROUND Glenohumeral dislocation is a common injury that may predispose patients to chronic pain and instability.However,there is a paucity of current data available regarding the epidemiological trends of this inj...BACKGROUND Glenohumeral dislocation is a common injury that may predispose patients to chronic pain and instability.However,there is a paucity of current data available regarding the epidemiological trends of this injury.AIM To provide an updated,comparative assessment of the epidemiology of shoulder dislocations presenting to emergency departments in the United States.We also sought to analyze patient demographic risk factors and consumer products associated with dislocation events.METHODS Data were obtained from the national electronic injury surveillance system database for glenohumeral dislocations between 2012 and 2021.Incidence,age,sex,and injury characteristics were analyzed using weighted population statistics as well as incidence rates and 95%confidence intervals(CI).RESULTS In total,an estimated 773039 shoulder dislocations(CI:640598-905481)presented to emergency rooms across the United States during the study period.The annual incidence rate was 23.96 per 100000 persons and the average patient age at the time of injury was 37.1 years.Significantly more male patients sustained dislocations than female patients(537189,69.5%,vs 235834,30.5%,P<0.001).With regard to associated consumer products,sports and recreation equipment were involved in the highest proportion of incidents(44.31%),followed by home structures and construction materials(21.22%),and home furnishings,fixtures,and accessories(21.21%).Regarding product sub-groups,stairs,ramps,landings,floors was cited in the greatest number of cases(131745).CONCLUSION The national annual incidence rate of glenohumeral dislocations throughout the study period was approximately 23.92 per 100000 persons.Male adolescents sustained the highest proportion of dislocations,with a peak incidence in age group 15-20 years,predominantly secondary to participation in sporting and recreational activities.Conversely,women experienced a relatively consistent incidence of dislocation throughout their lifespan.After age 63,the incidence rate of dislocations in females was found to surpass that observed in males.展开更多
The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a pati...The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.展开更多
Background: Surgical wound drainage is practiced routinely by many orthopaedic surgeons despite studies that challenge the practice. Among proponents, the advantages of drainage include prevention of haematoma and/or ...Background: Surgical wound drainage is practiced routinely by many orthopaedic surgeons despite studies that challenge the practice. Among proponents, the advantages of drainage include prevention of haematoma and/or seroma formation which potentially reduces the chances for infection, prevention of wound swelling, prevention of compartment syndrome and improvement of the local wound environment. Opponents argue that prophylactic wound drainage confers no significant advantages, increases the risk of infection and the need for blood transfusion with the attendant risks of this therapy. Aim: To ascertain if prophylactic drainage of clean orthopaedic wounds confer any significant advantages by evaluating wound and systemic factors in two treatment groups. Patients and Methods: A prospective analysis of 62 patients was undergoing clean orthopaedic procedures. The patients were randomly assigned to a “No drain” (study) group and a “drain” (control) group. Each group had 31 patients. Surgeons were blinded to the randomization process and the evaluation of clinical outcomes. The parameters assessed included pain, superficial wound infection, the need for post-operative transfusion, wound leakage, dressing changes and the surgery-discharge interval. Data was analysed using SPSS statistics version 20 (IBM Corp., New York). Results: There were no significant differences in the demographic data. Femoral fractures were the commonest indication for surgery (43.55%), and plate and screw osteosynthesis was the commonest procedure (48.4% in the drain group and 67.7% in the no-drain group). There was a significantly higher need for post-operative transfusion in the drain group (22.6% against 0%) as well as a significantly prolonged capillary refill time (2.39 + 0.56 secs versus 2.03 + 0.41 secs). Although not statistically significant, there were four cases (12.8%) of superficial wound infection in the drain group and 1 case (3.2%) in the no-drain group. Conclusion: Prophylactic wound drainage confers no significant advantages over no drainage and may contribute to increased treatment costs through an increased post-operative transfusion requirements.展开更多
Over the past 200 years, there has been significant advancements in the fields of bioengineering and orthopaedics. Investigators, clinicians and manufactures are learning that the success of implant systems is not lim...Over the past 200 years, there has been significant advancements in the fields of bioengineering and orthopaedics. Investigators, clinicians and manufactures are learning that the success of implant systems is not limited to a single factor, but a combination of variables that must work in unison to provide stability and high survivorship. Innovations continue to advance these fields and include: biomimetic alterations, three-dimensional, patient-specific reconstructions and novel coatings to mitigate aseptic loosening or other pathologies. However, implant systems continue to fail in clinical practice since they do not adhere to key fundamental principles. Therefore, this article is intended to highlight 5 hallmarks of biomaterials that should be considered during design, surgery, and post-operative rehabilitation.展开更多
Objective: To explore the practice and application of infection prevention and control strategies in risk departments during the COVID-19 epidemic, and to formulate the infection prevention and control measures to pro...Objective: To explore the practice and application of infection prevention and control strategies in risk departments during the COVID-19 epidemic, and to formulate the infection prevention and control measures to provide advice and guidance in risk departments. Methods: According to the latest plan of diagnosis and treatment, prevention and control issued by the National Health Commission, expert advice and consensus, combined with the actual situation in our hospital, a series of infection prevention and control measures of COVID-19 in risk department was formulated. Results: During the epidemic period, the prevention and control measures of nine risk departments including emergency operation, anesthesiology, endoscopy center, blood purification center, otolaryngology, stomatology, medical imaging department, medical cosmetology department and pulmonary function room were established from six aspects, including pre-examination and screening, medical technology control, personnel management, personal protection, environmental disinfection, medical waste disposal, etc. Conclusion: During the epidemic period, the infection prevention and control strategy of risk departments is one of the key links to control the spread of the epidemic, and risk departments must pay attention to and strictly implement various infection prevention and control measures.展开更多
Gut microbiota(GM)exerts an indispensable effect in human health,especially in metabolism regulation.^(1)Recent studies have identified a potential association with osteoporosis.^(2–5)At the same time,GM intervention...Gut microbiota(GM)exerts an indispensable effect in human health,especially in metabolism regulation.^(1)Recent studies have identified a potential association with osteoporosis.^(2–5)At the same time,GM intervention,such as antibiotic treatment,^(6)fecal microbiota transplantation(FMT),^(7–8)supplement of probiotics^(9–10)and other means,will also subsequently affect bone metabolism.Further,GM dysbiosis was also mentioned as one of pathophysiological mechanism of osteoporosis,even written in the clinical diagnosis and treatment guidelines^(11)[Fig.1,based on Guidelines for the diagnosis and treatment of primary osteoporosis in China(2022)].展开更多
Rheumatoid arthritis(RA)is a prevalent and debilitating inflammatory disease that significantly impairs functional capacity and quality of life.RA accelerates musculoskeletal aging,leading to complications such as mus...Rheumatoid arthritis(RA)is a prevalent and debilitating inflammatory disease that significantly impairs functional capacity and quality of life.RA accelerates musculoskeletal aging,leading to complications such as muscle degeneration and sarcopenia.Recent research has identified myopenia as a condition of significant muscle loss associated with illness,distinct from the muscle wasting seen in other chronic diseases like cancer cachexia or heart failure.In RA,myopenia is characterized by muscle depletion without concurrent significant fat loss,and it can affect individuals of all ages.While inflammation plays a central role,it is not the sole factor contributing to the high incidence of muscle wasting in RA.In subsequent discussions,secondary sarcopenia will be considered alongside myopenia,as both involve muscle wasting decline primarily due to disease.This review summarizes recent findings on the impact of RA-related myopenia and secondary sarcopenia on functional capacity,explores its underlying mechanisms,and discusses contemporary strategies to mitigate the process of musculoskeletal aging in RA patients.展开更多
Intervertebral disc degeneration is a degenerative disease where inflammation and immune responses play significant roles.Macrophages,as key immune cells,critically regulate inflammation through polarization into diff...Intervertebral disc degeneration is a degenerative disease where inflammation and immune responses play significant roles.Macrophages,as key immune cells,critically regulate inflammation through polarization into different phenotypes.In recent years,the role of macrophages in inflammation-related degenerative diseases,such as intervertebral disc degeneration,has been increasingly recognized.Macrophages construct the inflammatory microenvironment of the intervertebral disc and are involved in regulating intervertebral disc cell activities,extracellular matrix metabolism,intervertebral disc vascularization,and innervation,profoundly influencing the progression of disc degeneration.To gain a deeper understanding of the inflammatory microenvironment of intervertebral disc degeneration,this review will summarize the role of macrophages in the pathological process of intervertebral disc degeneration,analyze the regulatory mechanisms involving macrophages,and review therapeutic strategies targeting macrophage modulation for the treatment of intervertebral disc degeneration.These insights will be valuable for the treatment and research directions of intervertebral disc degeneration.展开更多
The intricate interplay between natural compounds like curcumin and the gut microbiome has gained significant attention in recent years due to their potential therapeutic implications in various health conditions.Curc...The intricate interplay between natural compounds like curcumin and the gut microbiome has gained significant attention in recent years due to their potential therapeutic implications in various health conditions.Curcumin,a polyphenolic compound derived from turmeric,exhibits diverse pharmacological properties,including anti-inflammatory,antioxidant,and anticancer effects.Understanding how curcumin modulates gut microbiota composition and function is crucial for elucidating its therapeutic mechanisms.This review examines the current literature on the interactions between curcumin and the gut microbiome.A systematic search of relevant databases was conducted to identify studies investigating the effects of curcumin on gut microbial diversity and abundance.Key findings from studies exploring curcumin's efficacy in neurological disorders,gastrointestinal diseases,and metabolic dysfunction are synthesized and discussed.Studies have demonstrated that curcumin supplementation can modulate gut microbiota composition and function,leading to beneficial effects on gut health and homeostasis.Mechanisms underlying curcumin's therapeutic effects include immune modulation,neuroprotection,and inflammation regulation.However,challenges such as poor bioavailability and safety concerns remain significant hurdles to overcome.The interactions between curcumin and the gut microbiome hold promise for therapeutic interventions in a diverse range of health conditions.Further research is needed to optimize curcumin formulations,improve bioavailability,and address safety concerns.展开更多
Current modifications of Ti-based materials with porous scaffolds for achieving biological fixation often decrease corrosion fatigue strength(σ_(cf))of the resultant implants,thereby shortening their service lifes-pa...Current modifications of Ti-based materials with porous scaffolds for achieving biological fixation often decrease corrosion fatigue strength(σ_(cf))of the resultant implants,thereby shortening their service lifes-pan.To resolve this issue,in the present,a step-wise graded porous Ti-6Al-7Nb scaffold was additively manufactured on optimally surface mechanical attrition treated(SMATed)Ti-6Al-7Nb(specifically de-noted as S-Ti6Al7Nb)using laser powder bed fusion(PBF)technology.The microstructure,bond strength,residual stress distribution,and corrosion fatigue behavior of porous scaffolds modified S-Ti6Al7Nb were investigated and compared with those of mechanically polished Ti-6Al-7Nb(P-Ti6Al7Nb),S-Ti6Al7Nb,and porous scaffolds modified P-Ti6Al7Nb.Results showed that corrosion fatigue of porous scaffolds modi-fied Ti-6Al-7Nb was propagation controlled.Moreover,the crack propagation behavior in the PBF scaf-fold’s fusion zone(FZ)and heat-affected zone(HAZ),exhibiting insensitivity to the microstructural con-figurations characterized by columnar prior-βgrain(PBG)boundaries and acicularα''martensites,cou-pled with the PBF-induced residual tensile stresses in these regions,resulted in a considerable decrease inσ_(cf) for porous scaffolds modified P-Ti6Al7Nb compared to P-Ti6Al7Nb.In contrast,step-wise graded porous scaffold-modified S-Ti6Al7Nb demonstrated an improvedσ_(cf) which was even higher than that of P-Ti6Al7Nb.Such an advancement in corrosion fatigue strength is primarily attributed to the presence of residual compressive stresses within the underlying S-Ti6Al7Nb substrate,extending beyond FZ and HAZ.These stresses increased the crack propagation threshold,leading to crack deflection/branching and increased crack-path tortuosity,thereby synergistically markedly enhancing the crack propagation resis-tance of porous scaffolds modified S-Ti6Al7Nb.展开更多
The current artificial bone is unable to accurately replicate the inhomogeneity and anisotropy of human cancellous bone.To address this issue,we proposed a personalized approach based on clinical CT images to design m...The current artificial bone is unable to accurately replicate the inhomogeneity and anisotropy of human cancellous bone.To address this issue,we proposed a personalized approach based on clinical CT images to design mechanical equivalent porous structures for artificial femoral heads.Firstly,supported by Micro and clinical CT scans of 21 bone specimens,the anisotropic mechanical parameters of human cancellous bone in the femoral head were characterized using clinical CT values(Hounsfield unit).After that,the equivalent porous structure of cancellous bone was designed based on the gyroid surface,the influence of its degree of anisotropy and volume fraction on the macroscopic mechanical parameters was investigated by finite element analysis.Furthermore,a mapping relationship between CT values and the porous structure was established by jointly solving the mechanical parameters of the porous structure and human cancellous bone,allowing the design of personalized gradient porous structures based on clinical CT images.Finally,to verify the mechanical equivalence,implant press-in tests were conducted on 3D-printed artificial femoral heads and human femoral heads,the influence of the porous structure’s cell size in bone-implant interaction problems was also explored.Results showed that the minimum deviations of press-in stiffness(<15%)and peak load(<5%)both occurred when the cell size was 20%to 30%of the implant diameter.In conclusion,the designed porous structure can replicate the human cancellous bone-implant interaction at a high level,indicating its effectiveness in optimizing the mechanical performance of 3D-printed artificial femoral head.展开更多
基金approved by Institutional Review Board of Faculty of Medicine in Assiut University,No.04-2024-300470.
文摘BACKGROUND In an era leaning toward a personalized alignment of total knee arthroplasty,coronal plane alignment of the knee(CPAK)phenotypes for each population are studied;furthermore,other possible variables affecting the alignment,such as ankle joint alignment,should be considered.AIM To determine CPAK distribution in the North African(Egyptian)population with knee osteoarthritis and to assess ankle joint line orientation(AJLO)adaptations across different CPAK types.METHODS A cross-sectional study was conducted on patients with primary knee osteoarthritis and normal ankle joints.Radiographic parameters included the mechanical lateral distal femoral angle,medial proximal tibial angle,and the derived calculations of joint line obliquity(JLO)and arithmetic hip-knee-ankle angle(aHKA).The tibial plafond horizontal angle(TPHA)was used for AJLO assessment,where 0°is neutral(type N),<0°is varus(type A),and>0°is valgus(type B).The nine CPAK types were further divided into 27 subtypes after incorporating the three AJLO types.RESULTS A total of 527 patients(1054 knees)were included for CPAK classification,and 435 patients(870 knees and ankles)for AJLO assessment.The mean age was 57.2±7.8 years,with 79.5%females.Most knees(76.4%)demonstrated varus alignment(mean aHKA was-5.51°±4.84°)and apex distal JLO(55.3%)(mean JLO was 176.43°±4.53°).CPAK types I(44.3%),IV(28.6%),and II(10%)were the most common.Regarding AJLO,70.2%of ankles exhibited varus orientation(mean TPHA was-5.21°±6.45°).The most frequent combined subtypes were CPAK type I-A(33.7%),IV-A(21.5%),and I-N(6.9%).A significant positive correlation was found between the TPHA and aHKA(r=0.40,P<0.001).CONCLUSION In this North African cohort,varus knee alignment with apex distal JLO and varus AJLO predominated.CPAK types I,IV,and II were the most common types,while subtypes I-A,IV-A,and I-N were commonly occurring after incorporating AJLO types;furthermore,the AJLO was significantly correlated to aHKA.
文摘BACKGROUND The optimal surgical approach for patients with primary glenohumeral osteoarthritis(GHOA)and an intact rotator cuff remains debated.While anatomic total shoulder arthroplasty(TSA)has traditionally been favoured,reverse TSA(RTSA)is increasingly utilized.AIM To systematically compare the outcomes of RTSA and TSA in this specific patient population.METHODS A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines.Retrospective comparative studies evaluating RTSA and TSA in patients with GHOA and intact rotator cuff were included.Key outcomes assessed included complication and reoperation rates,patient-reported outcome measures(PROMs),and range of motion.Risk of bias was assessed using the Risk of Bias in Non-randomized Studies of Interventions tool.RESULTS Twelve studies encompassing 1608 patients(580 RTSA,1028 TSA)met inclusion criteria.RTSA was associated with a lower reoperation rate compared to TSA[odds ratio=0.37;95%confidence interval(CI):0.14-0.94;P value=0.04],while no significant difference in overall complication rates was observed(odds ratio=0.47;95%CI:0.19-1.16;P value=0.10).RTSA patients showed superior outcomes in University of California Los Angeles,Simple Shoulder Test,and Shoulder Pain and Disability Index scores;however,the differences did not exceed the minimal clinically important difference.TSA patients had significantly better external rotation(mean difference=-9.0°;95%CI:-13.21 to-5.02;P value<0.0001).No significant differences were found in other range of motion measures or satisfaction scores.The overall methodological quality of included studies was moderate to serious.CONCLUSION In patients with GHOA and an intact rotator cuff,RTSA may offer comparable or improved outcomes to TSA with lower reoperation rates and similar complication profiles.Functional outcomes favour RTSA in certain patientreported outcome measures,while TSA retains an advantage in external rotation.Surgical decision-making should remain individualized based on patient characteristics and functional demands.
文摘Musculoskeletal injuries are among the most common causes of disability worldwide,with early detection and appropriate intervention critical to minimizing long-term complications.Infrared thermography(IRT)has emerged as a noninvasive,real-time imaging modality that captures superficial temperature changes reflecting underlying physiological processes such as inflammation and vascular alterations.This review explores the fundamental principles of medical thermography,differentiates between passive and active approaches,and outlines key technological advancements including artificial intelligence integration.The clinical utility of IRT is discussed in various contexts–ranging from acute soft tissue injuries and overuse syndromes to chronic pain and rehabilitation monitoring.Comparative insights with conventional imaging techniques such as ultrasound and magnetic resonance imaging are also presented.While IRT offers functional imaging capabilities with advantages in portability,safety,and speed,its limitations–such as lack of deep-tissue penetration and protocol standardization–remain significant barriers to broader adoption.Future directions include the integration of IRT with other imaging modalities and digital health platforms to enhance musculoskeletal assessment and injury prevention strategies.
文摘BACKGROUND Orthobiologics-biological substances like platelet-rich plasma(PRP),bone marrow aspirate concentrate,and stem cells-are increasingly used in musculoskeletal care to promote tissue repair and reduce reliance on invasive surgery.Despite global momentum,India's clinical adoption remains underexplored.AIM To inform education,policy,and resource allocation for the safe and effective adoption of orthobiologics in musculoskeletal care.METHODS A cross-sectional electronic survey was conducted from January to March 2025 among orthopaedic surgeons,academicians,and trainees across India.The questionnaire assessed demographics,knowledge of orthobiologics,attitudes toward training and subspecialization,usage trends,regulatory awareness,and perceived barriers.Data were analyzed using descriptive statistics andχ2/Fisher’s exact tests,with P<0.05 considered significant.RESULTS A total of 1280 valid responses were collected.Awareness of orthobiologics was high(97%),with PRP being the most familiar and widely used(80%).Formal training was reported by only 31%,though 85%showed interest in structured education,and 68%supported orthobiologics as a subspecialty.Satisfaction with clinical outcomes averaged 6.5±2.3 out of 10 points.Barriers included high treatment cost(64%),poor patient awareness(90%),and limited access to biologics labs(18%).Regulatory understanding was moderate,with academic-affiliated clinicians more informed about stem cell guidelines.CONCLUSION Indian orthopaedic professionals demonstrate strong awareness and optimism toward orthobiologics,but widespread gaps in training,infrastructure,and regulation hinder broader adoption.Strategic investments in education,standardized protocols,and accessible facilities are essential to support safe and evidence-driven integration of regenerative therapies into clinical practice.
文摘Objectives:Photodynamic therapy(PDT)is a minimally invasive method used in the treatment of various cancers and skin diseases,but it is not widely used in bone cancer,where the current therapy is often not effective and accompanied by side effects.Alternative and more effective therapies like PDT are needed.In this in-vitro study,the effect of the photosensitizer(PS)chlorin e6(Ce6)on cancerous bone tumor cells using PDT was examined.Methods:A total of 27 tissue specimens from patients with primary bone cancers or bone metastases of different origins were genetically characterized and treated with PDT.Following a 24-h incubation,cell viability was determined,and the effect of PDT on cell migration was analyzed over 48 h.Results:We could demonstrate that the effect on proliferation of PDT in combination with the PS Ce6 was best in cells isolated from primary osteosarcoma and in bone metastases from mammary carcinomas.Besides proliferation,PDT was also effective in inhibiting the migration of these cells.A statistically significant correlation between the PDT effect and CD164 gene expression was detected,indicating that a high expression of this gene could result in a higher effectiveness of the photodynamic treatment.Conclusion:This study analyzes for the first time the effect of PDT in bone cancers and metastases and shows the potential of treating these cancer types with Ce6 PDT.
基金Southwest Hospital Boqing Innovation Fund,Grant/Award Number:2024BQCXJJ-9Fundings for Young Investigators of PLA,Grant/Award Number:2022-JCJQ-QT-004+3 种基金NSFC Key Projects of the Regional Innovation and Development Joint Fund,Grant/Award Number:U23A20413China Postdoctoral Science Foundation,Grant/Award Number:2023M744280National Natural Science Foundation of China,Grant/Award Number:82103778,82172449 and 82172489Southwest Hospital Postdoctoral Starting Fund,Grant/Award Number:5175ZA36BP。
文摘Background:Skeletal tuberculosis(TB)remains a persistent clinical and research chal-lenge due to its chronic course,osteolytic destruction,and the limitations of existing animal models,which often require high-level biosafety containment or fail to repli-cate human skeletal pathology.Methods:This study developed a biosafe,accessible,and versatile murine model of skeletal TB using Mycobacterium smegmatis,a fast-growing,nonpathogenic myco-bacterial species with high genomic homology to Mycobacterium tuberculosis.Three infection routes-subperiosteal calvarial injection,intratibial injection,and intra-cardiac inoculation-were systematically evaluated for their ability to induce lo-calized versus disseminated bone infection under standard biosafety level(BSL)-1 conditions.Results:Subperiosteal calvarial and intratibial injection of M.smegmatis induced local-ized bone lesions characterized by osteolysis,sequestrum formation,granulomatous inflammation,and increased osteoclast activity.Intratibial infection additionally trig-gered compartment-specific immune responses,including neutrophil and macrophage expansion,transient B-cell depletion,and activation of interferon-γ^(+)(IFN-γ^(+))T cells,reflecting active immune remodeling at the infection site.Systemic dissemination via intracardiac injection reproducibly generated progressive vertebral and tibial bone destruction with organized granuloma formation and immune cell infiltration but without prominent sequestrum formation.Compared to intratibial infection,intracar-diac delivery exhibited lower intragroup variability and more closely recapitulated the diffuse progression of extrapulmonary skeletal tuberculosis.Conclusions:This M.smegmatis-based murine model provides a straightforward,reliable,and immunopathologically relevant platform for exploring host-pathogen dynamics,immune-driven bone destruction,and early-stage therapeutic testing in skeletal TB,all within standard BSL-1 laboratories.This model fills a critical gap by enabling BSL-1 research into skeletal TB mechanisms and drug development.
基金Funded by the National Key R&D Program of China(No.2023YFC2412300)the Technology Development Project of Shan-dong Weigao Orthopedic Materials Co.,Ltd.(No.20221h0074)the Independent Innovation Research Fund of Wuhan University of Technology(No.104972024ZHZXhp0027)。
文摘To enhance the mechanical reliability of dental prostheses under long-term service conditions,this study aimed to evaluate the fracture behavior and energy dissipation characteristics of three commonly used prosthetic materials,namely,zirconia ceramics(ZrO_(2)),cobalt-chromium alloy(Co-Cr),and titanium-zirconium alloy(Ti-13Zr),under various crack configurations.A three-dimensional finite element model of a single-crown prosthesis incorporating predefined cracks was established,and both axial and oblique multidirectional loads were applied.Using LS-DYNA software,the deformation patterns,principal stress distribution,and energy release characteristics during crack propagation were systematically analyzed.The experimental results indicate that Ti-13Zr alloy exhibited the highest crack resistance,making it particularly suitable for patients with insufficient bone volume or limited implant space.Co-Cr alloy demonstrated favorable structural stability and mechanical performance under high-load conditions.In contrast,due to its inherent brittleness,ZrO_(2)was more prone to rapid fracture propagation in long-span or high-stress scenarios,although it remains a preferred option for anterior esthetic zones and patients with metal sensitivities.Furthermore,the simulation outcomes were theoretically validated using Griffith's energy-based fracture criterion,reinforcing the accuracy of failure predictions based on principal stress analysis.This study elucidates the differences in clinical applicability among prosthetic materials and reveals their distinct fracture mechanisms,thereby providing a theoretical foundation for optimizing material selection and structural design.The findings contribute to improving the long-term safety and functional stability of implant-supported dental restorations.
基金supported by grants from Collaborative Research Fund(Ref:C4032-21GF)General Research Grant(Ref:14114822)+1 种基金Group Research Scheme(Ref:3110146)Area of Excellence(Ref:Ao E/M-402/20)。
文摘Mitochondrial dysfunction and oxidative stress are widely regarded as primary drivers of aging and are associated with several neurodegenerative diseases.The degeneration of motor neurons during aging is a critical pathological factor contributing to the progression of sarcopenia.However,the morphological and functional changes in mitochondria and their interplay in the degeneration of the neuromuscular junction during aging remain poorly understood.A defined systematic search of the Pub Med,Web of Science and Embase databases(last accessed on October 30,2024)was conducted with search terms including'mitochondria','aging'and'NMJ'.Clinical and preclinical studies of mitochondrial dysfunction and neuromuscular junction degeneration during aging.Twentyseven studies were included in this systematic review.This systematic review provides a summary of morphological,functional and biological changes in neuromuscular junction,mitochondrial morphology,biosynthesis,respiratory chain function,and mitophagy during aging.We focus on the interactions and mechanisms underlying the relationship between mitochondria and neuromuscular junctions during aging.Aging is characterized by significant reductions in mitochondrial fusion/fission cycles,biosynthesis,and mitochondrial quality control,which may lead to neuromuscular junction dysfunction,denervation and poor physical performance.Motor nerve terminals that exhibit redox sensitivity are among the first to exhibit abnormalities,ultimately leading to an early decline in muscle strength through impaired neuromuscular junction transmission function.Parg coactivator 1 alpha is a crucial molecule that regulates mitochondrial biogenesis and modulates various pathways,including the mitochondrial respiratory chain,energy deficiency,oxidative stress,and inflammation.Mitochondrial dysfunction is correlated with neuromuscular junction denervation and acetylcholine receptor fragmentation,resulting in muscle atrophy and a decrease in strength during aging.Physical therapy,pharmacotherapy,and gene therapy can alleviate the structural degeneration and functional deterioration of neuromuscular junction by restoring mitochondrial function.Therefore,mitochondria are considered potential targets for preserving neuromuscular junction morphology and function during aging to treat sarcopenia.
基金supported by Health and Medical Research Fund(18190481)Research Impact Fund(R4034-23F)+6 种基金Areas of Excellence(AoE/M-402/20)General Research Fund(14120924)Co-funding Mechanism on Joint Laboratories with the CAS(JLFS/M-401/24)the Knowledge Transfer Project Fund(KPF24GWP05)the IdeaBooster Fund(IDBF25MED07)Natural Science Foundation of Guangdong Province(Guangdong 2021A15150112042021A1515011285).
文摘Magnesium(Mg)-based biomaterials transform inherent limitations—rapid degradation and suboptimal strength—into therapeutic advantages for orthopedic regeneration.Contrary to industrial perceptions,the moderate corrosion rate and bone-mimetic stiffness(~30 GPa)of Mg synergistically support tissue repair:degradation products activate multiple pathways to enhance functional bone regeneration.Clinical translation milestones include China’s first NMPA-approved Mg-based 3D-printed scaffold.Future advancement hinges on three pillars:biomimetic structural design,material refinement,and smart implants.By redefining the“shortcomings”of Mg as regenerative assets,this paradigm accelerates functional bone reconstruction across orthopedic scenarios.
文摘BACKGROUND Glenohumeral dislocation is a common injury that may predispose patients to chronic pain and instability.However,there is a paucity of current data available regarding the epidemiological trends of this injury.AIM To provide an updated,comparative assessment of the epidemiology of shoulder dislocations presenting to emergency departments in the United States.We also sought to analyze patient demographic risk factors and consumer products associated with dislocation events.METHODS Data were obtained from the national electronic injury surveillance system database for glenohumeral dislocations between 2012 and 2021.Incidence,age,sex,and injury characteristics were analyzed using weighted population statistics as well as incidence rates and 95%confidence intervals(CI).RESULTS In total,an estimated 773039 shoulder dislocations(CI:640598-905481)presented to emergency rooms across the United States during the study period.The annual incidence rate was 23.96 per 100000 persons and the average patient age at the time of injury was 37.1 years.Significantly more male patients sustained dislocations than female patients(537189,69.5%,vs 235834,30.5%,P<0.001).With regard to associated consumer products,sports and recreation equipment were involved in the highest proportion of incidents(44.31%),followed by home structures and construction materials(21.22%),and home furnishings,fixtures,and accessories(21.21%).Regarding product sub-groups,stairs,ramps,landings,floors was cited in the greatest number of cases(131745).CONCLUSION The national annual incidence rate of glenohumeral dislocations throughout the study period was approximately 23.92 per 100000 persons.Male adolescents sustained the highest proportion of dislocations,with a peak incidence in age group 15-20 years,predominantly secondary to participation in sporting and recreational activities.Conversely,women experienced a relatively consistent incidence of dislocation throughout their lifespan.After age 63,the incidence rate of dislocations in females was found to surpass that observed in males.
文摘The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.
文摘Background: Surgical wound drainage is practiced routinely by many orthopaedic surgeons despite studies that challenge the practice. Among proponents, the advantages of drainage include prevention of haematoma and/or seroma formation which potentially reduces the chances for infection, prevention of wound swelling, prevention of compartment syndrome and improvement of the local wound environment. Opponents argue that prophylactic wound drainage confers no significant advantages, increases the risk of infection and the need for blood transfusion with the attendant risks of this therapy. Aim: To ascertain if prophylactic drainage of clean orthopaedic wounds confer any significant advantages by evaluating wound and systemic factors in two treatment groups. Patients and Methods: A prospective analysis of 62 patients was undergoing clean orthopaedic procedures. The patients were randomly assigned to a “No drain” (study) group and a “drain” (control) group. Each group had 31 patients. Surgeons were blinded to the randomization process and the evaluation of clinical outcomes. The parameters assessed included pain, superficial wound infection, the need for post-operative transfusion, wound leakage, dressing changes and the surgery-discharge interval. Data was analysed using SPSS statistics version 20 (IBM Corp., New York). Results: There were no significant differences in the demographic data. Femoral fractures were the commonest indication for surgery (43.55%), and plate and screw osteosynthesis was the commonest procedure (48.4% in the drain group and 67.7% in the no-drain group). There was a significantly higher need for post-operative transfusion in the drain group (22.6% against 0%) as well as a significantly prolonged capillary refill time (2.39 + 0.56 secs versus 2.03 + 0.41 secs). Although not statistically significant, there were four cases (12.8%) of superficial wound infection in the drain group and 1 case (3.2%) in the no-drain group. Conclusion: Prophylactic wound drainage confers no significant advantages over no drainage and may contribute to increased treatment costs through an increased post-operative transfusion requirements.
文摘Over the past 200 years, there has been significant advancements in the fields of bioengineering and orthopaedics. Investigators, clinicians and manufactures are learning that the success of implant systems is not limited to a single factor, but a combination of variables that must work in unison to provide stability and high survivorship. Innovations continue to advance these fields and include: biomimetic alterations, three-dimensional, patient-specific reconstructions and novel coatings to mitigate aseptic loosening or other pathologies. However, implant systems continue to fail in clinical practice since they do not adhere to key fundamental principles. Therefore, this article is intended to highlight 5 hallmarks of biomaterials that should be considered during design, surgery, and post-operative rehabilitation.
文摘Objective: To explore the practice and application of infection prevention and control strategies in risk departments during the COVID-19 epidemic, and to formulate the infection prevention and control measures to provide advice and guidance in risk departments. Methods: According to the latest plan of diagnosis and treatment, prevention and control issued by the National Health Commission, expert advice and consensus, combined with the actual situation in our hospital, a series of infection prevention and control measures of COVID-19 in risk department was formulated. Results: During the epidemic period, the prevention and control measures of nine risk departments including emergency operation, anesthesiology, endoscopy center, blood purification center, otolaryngology, stomatology, medical imaging department, medical cosmetology department and pulmonary function room were established from six aspects, including pre-examination and screening, medical technology control, personnel management, personal protection, environmental disinfection, medical waste disposal, etc. Conclusion: During the epidemic period, the infection prevention and control strategy of risk departments is one of the key links to control the spread of the epidemic, and risk departments must pay attention to and strictly implement various infection prevention and control measures.
基金supported by the National Key Research and Development Program(2021YFC2501700)the National Natural Science Foundation of China(82330078,82272554)Beijing Natural Science Foundation(7232214,L241067)。
文摘Gut microbiota(GM)exerts an indispensable effect in human health,especially in metabolism regulation.^(1)Recent studies have identified a potential association with osteoporosis.^(2–5)At the same time,GM intervention,such as antibiotic treatment,^(6)fecal microbiota transplantation(FMT),^(7–8)supplement of probiotics^(9–10)and other means,will also subsequently affect bone metabolism.Further,GM dysbiosis was also mentioned as one of pathophysiological mechanism of osteoporosis,even written in the clinical diagnosis and treatment guidelines^(11)[Fig.1,based on Guidelines for the diagnosis and treatment of primary osteoporosis in China(2022)].
基金supported in part by the National Natural Science Foundation of China(Grant No.82350710800,82374470,82202757)Shenzhen Medical Research Fund B2302005,and NHMRC,APP1163933.
文摘Rheumatoid arthritis(RA)is a prevalent and debilitating inflammatory disease that significantly impairs functional capacity and quality of life.RA accelerates musculoskeletal aging,leading to complications such as muscle degeneration and sarcopenia.Recent research has identified myopenia as a condition of significant muscle loss associated with illness,distinct from the muscle wasting seen in other chronic diseases like cancer cachexia or heart failure.In RA,myopenia is characterized by muscle depletion without concurrent significant fat loss,and it can affect individuals of all ages.While inflammation plays a central role,it is not the sole factor contributing to the high incidence of muscle wasting in RA.In subsequent discussions,secondary sarcopenia will be considered alongside myopenia,as both involve muscle wasting decline primarily due to disease.This review summarizes recent findings on the impact of RA-related myopenia and secondary sarcopenia on functional capacity,explores its underlying mechanisms,and discusses contemporary strategies to mitigate the process of musculoskeletal aging in RA patients.
基金National Natural Science Foundation of China(U24A20670,82372419,82072435)Tianjin Science and Technology Plan Project“Unveiling and Directing”Major Project(21ZXJBSY00130)Beijing-Tianjin-Hebei Basic Research Cooperation Project(J230020)。
文摘Intervertebral disc degeneration is a degenerative disease where inflammation and immune responses play significant roles.Macrophages,as key immune cells,critically regulate inflammation through polarization into different phenotypes.In recent years,the role of macrophages in inflammation-related degenerative diseases,such as intervertebral disc degeneration,has been increasingly recognized.Macrophages construct the inflammatory microenvironment of the intervertebral disc and are involved in regulating intervertebral disc cell activities,extracellular matrix metabolism,intervertebral disc vascularization,and innervation,profoundly influencing the progression of disc degeneration.To gain a deeper understanding of the inflammatory microenvironment of intervertebral disc degeneration,this review will summarize the role of macrophages in the pathological process of intervertebral disc degeneration,analyze the regulatory mechanisms involving macrophages,and review therapeutic strategies targeting macrophage modulation for the treatment of intervertebral disc degeneration.These insights will be valuable for the treatment and research directions of intervertebral disc degeneration.
文摘The intricate interplay between natural compounds like curcumin and the gut microbiome has gained significant attention in recent years due to their potential therapeutic implications in various health conditions.Curcumin,a polyphenolic compound derived from turmeric,exhibits diverse pharmacological properties,including anti-inflammatory,antioxidant,and anticancer effects.Understanding how curcumin modulates gut microbiota composition and function is crucial for elucidating its therapeutic mechanisms.This review examines the current literature on the interactions between curcumin and the gut microbiome.A systematic search of relevant databases was conducted to identify studies investigating the effects of curcumin on gut microbial diversity and abundance.Key findings from studies exploring curcumin's efficacy in neurological disorders,gastrointestinal diseases,and metabolic dysfunction are synthesized and discussed.Studies have demonstrated that curcumin supplementation can modulate gut microbiota composition and function,leading to beneficial effects on gut health and homeostasis.Mechanisms underlying curcumin's therapeutic effects include immune modulation,neuroprotection,and inflammation regulation.However,challenges such as poor bioavailability and safety concerns remain significant hurdles to overcome.The interactions between curcumin and the gut microbiome hold promise for therapeutic interventions in a diverse range of health conditions.Further research is needed to optimize curcumin formulations,improve bioavailability,and address safety concerns.
基金the National Key Research and Development Program of China(Grant No.2023YFC2412600)the National Natural Science Foundation of China(Grant No.51971171)for financially supporting this work.
文摘Current modifications of Ti-based materials with porous scaffolds for achieving biological fixation often decrease corrosion fatigue strength(σ_(cf))of the resultant implants,thereby shortening their service lifes-pan.To resolve this issue,in the present,a step-wise graded porous Ti-6Al-7Nb scaffold was additively manufactured on optimally surface mechanical attrition treated(SMATed)Ti-6Al-7Nb(specifically de-noted as S-Ti6Al7Nb)using laser powder bed fusion(PBF)technology.The microstructure,bond strength,residual stress distribution,and corrosion fatigue behavior of porous scaffolds modified S-Ti6Al7Nb were investigated and compared with those of mechanically polished Ti-6Al-7Nb(P-Ti6Al7Nb),S-Ti6Al7Nb,and porous scaffolds modified P-Ti6Al7Nb.Results showed that corrosion fatigue of porous scaffolds modi-fied Ti-6Al-7Nb was propagation controlled.Moreover,the crack propagation behavior in the PBF scaf-fold’s fusion zone(FZ)and heat-affected zone(HAZ),exhibiting insensitivity to the microstructural con-figurations characterized by columnar prior-βgrain(PBG)boundaries and acicularα''martensites,cou-pled with the PBF-induced residual tensile stresses in these regions,resulted in a considerable decrease inσ_(cf) for porous scaffolds modified P-Ti6Al7Nb compared to P-Ti6Al7Nb.In contrast,step-wise graded porous scaffold-modified S-Ti6Al7Nb demonstrated an improvedσ_(cf) which was even higher than that of P-Ti6Al7Nb.Such an advancement in corrosion fatigue strength is primarily attributed to the presence of residual compressive stresses within the underlying S-Ti6Al7Nb substrate,extending beyond FZ and HAZ.These stresses increased the crack propagation threshold,leading to crack deflection/branching and increased crack-path tortuosity,thereby synergistically markedly enhancing the crack propagation resis-tance of porous scaffolds modified S-Ti6Al7Nb.
基金supported by the National Key R&D Program of China(Grant No.2021YFC2501700).
文摘The current artificial bone is unable to accurately replicate the inhomogeneity and anisotropy of human cancellous bone.To address this issue,we proposed a personalized approach based on clinical CT images to design mechanical equivalent porous structures for artificial femoral heads.Firstly,supported by Micro and clinical CT scans of 21 bone specimens,the anisotropic mechanical parameters of human cancellous bone in the femoral head were characterized using clinical CT values(Hounsfield unit).After that,the equivalent porous structure of cancellous bone was designed based on the gyroid surface,the influence of its degree of anisotropy and volume fraction on the macroscopic mechanical parameters was investigated by finite element analysis.Furthermore,a mapping relationship between CT values and the porous structure was established by jointly solving the mechanical parameters of the porous structure and human cancellous bone,allowing the design of personalized gradient porous structures based on clinical CT images.Finally,to verify the mechanical equivalence,implant press-in tests were conducted on 3D-printed artificial femoral heads and human femoral heads,the influence of the porous structure’s cell size in bone-implant interaction problems was also explored.Results showed that the minimum deviations of press-in stiffness(<15%)and peak load(<5%)both occurred when the cell size was 20%to 30%of the implant diameter.In conclusion,the designed porous structure can replicate the human cancellous bone-implant interaction at a high level,indicating its effectiveness in optimizing the mechanical performance of 3D-printed artificial femoral head.
