BACKGROUND:Studies have shown that there is a close relationship between pyroptosis,inflammatory factors and osteoporosis.OBJECTIVE:To review the effects of pyroptosis and inflammatory factors on the pathogenesis of osteoporosis from the perspectives of osteogenic differentiation and osteoclastic differentiation,based on an overview of pyroptosis in relation to the interaction of relevant inflammatory factors.METHODS:The first author used the computer to search the literature published by each database until 2024,and searched CNKI,WanFang,VIP and PubMed databases with the search terms of"pyroptosis,inflammatory factors,osteoporosis,osteoblast,osteoclast,bone metabolism,signaling pathway,review"in Chinese and English.A total of 79 papers were finally included according to the inclusion criteria.RESULTS AND CONCLUSION:The progression of osteoporosis is closely related to inflammation,in which pyroptosis plays a key role.Immune cells induce pyroptosis through apoptosis pathway,promote the secretion of inflammatory factors such as interleukin-18,interleukin-1β and NLRP3,build an inflammatory immune microenvironment,and regulate bone metabolism through complex signaling pathways,resulting in enhanced bone absorption and reduced bone formation,thereby leading to osteoporosis.Previous studies have shown that inhibiting pyroptosis is anti-inflammatory and slows the progression of osteoporosis,and it has been shown to improve inflammatory bone loss in vitro and in animal models.At present,research on pyroptosis and osteoporosis is limited.On the one hand,the exact mechanism of osteoporosis and the pathogenesis of pyroptosis are unknown,and the specific pathways and regulatory mechanisms remain to be understood.On the other hand,therapeutic strategies targeting pyroptosis are still theoretical,not clinically proven,and drug side effects are unknown.In the future,the research focus is to further explore the pathogenesis,especially the mechanism of pyroptosis,identify potential therapeutic targets,further study the pyroptosis signaling pathway and Gasdermin protein,and develop new drugs to improve the therapeutic effect in patients with osteoporosis.

BACKGROUND:Studies have shown that there is a close relationship between pyroptosis,inflammatory factors and osteoporosis.OBJECTIVE:To review the effects of pyroptosis and inflammatory factors on the pathogenesis of osteoporosis from the perspectives of osteogenic differentiation and osteoclastic differentiation,based on an overview of pyroptosis in relation to the interaction of relevant inflammatory factors.METHODS:The first author used the computer to search the literature published by each database until 2024,and searched CNKI,WanFang,VIP and PubMed databases with the search terms of"pyroptosis,inflammatory factors,osteoporosis,osteoblast,osteoclast,bone metabolism,signaling pathway,review"in Chinese and English.A total of 79 papers were finally included according to the inclusion criteria.RESULTS AND CONCLUSION:The progression of osteoporosis is closely related to inflammation,in which pyroptosis plays a key role.Immune cells induce pyroptosis through apoptosis pathway,promote the secretion of inflammatory factors such as interleukin-18,interleukin-1β and NLRP3,build an inflammatory immune microenvironment,and regulate bone metabolism through complex signaling pathways,resulting in enhanced bone absorption and reduced bone formation,thereby leading to osteoporosis.Previous studies have shown that inhibiting pyroptosis is anti-inflammatory and slows the progression of osteoporosis,and it has been shown to improve inflammatory bone loss in vitro and in animal models.At present,research on pyroptosis and osteoporosis is limited.On the one hand,the exact mechanism of osteoporosis and the pathogenesis of pyroptosis are unknown,and the specific pathways and regulatory mechanisms remain to be understood.On the other hand,therapeutic strategies targeting pyroptosis are still theoretical,not clinically proven,and drug side effects are unknown.In the future,the research focus is to further explore the pathogenesis,especially the mechanism of pyroptosis,identify potential therapeutic targets,further study the pyroptosis signaling pathway and Gasdermin protein,and develop new drugs to improve the therapeutic effect in patients with osteoporosis.

Tibial shaft fractures are clinically common, mostly caused by traffic accidents, heavy object impacts, and other injuries. Treatment methods include open reduction and internal fixation, minimally invasive plate osteosynthesis, external fixators, and intramedullary nails. Among these, intramedullary fixation is the gold standard, as it can protect soft tissues and blood supply. Traditional intramedullary nails are inserted through an infrapatellar incision at the anterior knee, which has shortcomings such as the need for knee flexion during operation and difficulty in reduction. In recent years, suprapatellar approach nail placement in the semi-extended knee position has been widely applied. This review focuses on recent studies, comparing the suprapatellar and infrapatellar approaches of tibial intramedullary nailing for tibial fractures in terms of surgical operation, therapeutic efficacy, and complications. It aims to provide literature support for clinical decision-making and help doctors better select appropriate treatment plans.

BACKGROUND:We have successfully isolated and cultured neonatal mouse cerebrospinal fluid-contacting neurons in vitro,but there is no study that reports an effective method for isolating and culturing high-purity adult mouse cerebrospinal fluid-contacting neurons.There is no study on whether the self-renewal ability of cerebrospinal fluid-contacting neurons changes with age.OBJECTIVE:To establish a method for isolating and culturing high-purity adult mouse cerebrospinal fluid-contacting neurons in vitro,and to characterize the self-renewal ability of adult mouse cerebrospinal fluid-contacting neurons and neonatal mouse cerebrospinal fluid-contacting neurons in vitro.METHODS:Primary cells containing cerebrospinal fluid-contacting neurons were isolated from the cervical medulla of adult mouse (3 months of age) in adherent culture and transfected with lentivirus fused with multimodal imaging genes.High-purity adult mouse cerebrospinal fluid-contacting neurons were obtained by puromycin screening in suspension culture in complete medium.The expression of neural stem cell markers Nestin and SOX2 was detected by immunofluorescence in adult mouse cerebrospinal fluid-contacting neurons,and the ability of adult mouse cerebrospinal fluid-contacting neurons to form spheres and pass on in vitro was observed.An equal number (5×103/mL) of passage 3 adult mouse and neonatal mouse cerebrospinal fluid-contacting neurons were divided into two groups under the same conditions and inoculated into ultra-low adhesion plates containing complete medium in suspension culture at 5％ CO2,37℃ thermostat,respectively.The self-renewal capacity of adult mouse and neonatal mouse cerebrospinal fluid-contacting neurons was characterized by in vitro spheroid formation,CCK8 assay,qPCR,and western blot assay.RESULTS AND CONCLUSION:(1) High-purity cerebrospinal fluid-contacting neurons were successfully isolated from adult mouse,which expressed Nestin and SOX2 in vitro,and were able to form neurospheres and pass on continuously.(2) The in vitro self-renewal ability of cerebrospinal fluid-contacting neurons in adult mouse was significantly weaker than that of neonatal mouse,and the neurospheres formed by day 4 of cell culture in neonatal mouse were about 150 μm in diameter,whereas the neurospheres formed by adult mouse tactile neurons were only 40 μm in diameter (P<0.0001).(3) CCK8 proliferation assay showed that the proliferative activity of adult mouse cerebrospinal fluid-contacting neurons was significantly weaker than that of neonatal mouse at all time points after culture (P<0.0001).(4) qPCR and western blot assay revealed that the mRNA (P<0.0001) and protein expression levels (P<0.01) of Nestin and SOX2 in cerebrospinal fluid-contacting neurons of adult mouse were significantly decreased compared with those of neonatal mouse.(5) The above results indicated that the self-renewal ability of cerebrospinal fluid-contacting neurons in adult mouse was significantly weaker than that of neonatal mouse in vitro.

BACKGROUND:Studies have indicated that long noncoding RNAs play a crucial role in the pathogenesis and progression of osteoporosis.Thus,it is essential to comprehend the current research status,hotspots,and developmental trajectories of long noncoding RNAs in the field of osteoporosis research.OBJECTIVE:To explore the research status,development trends,and hotspots in the field of osteoporosis-related long noncoding RNAs by conducting bibliometric statistics and visualization analysis of the relevant literature.METHODS:Using the search string"(TS=(Osteoporosis OR Osteoporoses)AND TS=(Long non coding RNA OR LncRNA OR Lnc RNA OR Long noncoding RNA)),"a subject term search was conducted in the Web of Science Core Collection database for articles published from January 2015 to September 2024.After manual filtering of the obtained raw data,visualization analysis of authors,institutions,countries,and keywords was performed using Cite Space 6.2.R4 software and Microsoft 365(Office).RESULTS AND CONCLUSION:A total of 265 articles were included from the Web of Science Core Collection database.Since 2015,there has been an overall upward trend in the number of publications in this field,with China being the leading country in terms of publication volume and research centrality,while Beihang University holds the highest institutional centrality.After keywords directly related to the article's theme were excluded,the terms"osteogenic differentiation,""expression,""bone formation,"and"mesenchymal stem cells"emerged as core topics based on co-occurrence frequency and centrality.A comprehensive analysis of the keyword cluster map,keyword burst map,and keyword timeline map reveals that investigating the mechanisms by which long non-coding RNAs influence the formation and differentiation of osteoblasts,as well as the differentiation of osteoclasts and bone resorption,constitutes both a current research hotspot and a future research trend in this field.

BACKGROUND:It has also been confirmed that ferroptosis is closely related to a variety of musculoskeletal diseases,such as rheumatoid arthritis,osteosarcoma,and osteoporosis.The pathophysiological mechanisms of ferroptosis and osteoporosis need to be further studied and elucidated to broaden our understanding of iron metabolism and osteoporosis.It will provide research ideas for the future elucidation of new mechanisms of osteoporosis and the development of new technologies and drugs for the treatment of osteoporosis. OBJECTIVE:To provide an overview of the current status of research on ferroptosis in osteoporosis,to provide a new direction for future research on the specific molecular mechanisms of osteoporosis,and to provide more effective and better options for osteoporosis treatment strategies. METHODS:The first author used the computer to search the literature published from 2000 to 2024 in CNKI,WanFang,VIP,and PubMed databases with search terms"ferroptosis,iron metabolism,osteoporosis,osteoblast,osteoclast,bone metabolism,signal pathway,musculoskeletal,review"in Chinese and English.A total of 68 articles were finally included according to the selection criteria. RESULTS AND CONCLUSION:(1)Ferroptosis is a new type of cell death discovered in recent years,which is usually accompanied by a large amount of iron accumulation and lipid peroxidation during cell death,and its occurrence is iron-dependent.This is distinctly different from several types of cell death that are currently being hotly studied(e.g.,cellular pyroptosis,necrotic apoptosis,cuproptosis,and autophagy).(2)Intracellular iron homeostasis is manifested as a balance between iron uptake,export,utilization,and storage.The body's iron regulatory system includes systemic and intracellular regulation.The main factor of systemic regulation is hepcidin produced by hepatic secretion,and cellular regulation depends on the iron regulatory protein/iron response element system.Of course,intracellular iron homeostasis can be controlled by other factors,such as hypoxia,cytokines,and hormones.(3)Lipid peroxidation causes oxidative damage to biological membranes(plasma membrane and internal organelle membranes),lipoproteins,and other lipid-containing molecules.Polyunsaturated fatty acid-containing phospholipids are important targets of lipid peroxidation.Free polyunsaturated fatty acid is an important substrate for lipid oxidation and can bind to the phospholipid bilayer,leading to over-oxidation and thus triggering lipid apoptosis.(4)Several studies have shown that osteoblasts are overloaded with iron in different ways,resulting in the accumulation of unstable ferrous iron and the generation of reactive oxygen species and lipid peroxides,causing ferroptosis of osteoblasts and ultimately a decrease in bone formation,affecting bone homeostasis and the development of osteoporosis.(5)Osteoclasts are large multinucleated cells formed by the fusion of mononuclear macrophage cell lines or bone marrow mesenchymal stem cells induced by nuclear factor-κB ligand receptor activator,and they have the function of bone resorption.Iron ions can promote osteoclast differentiation and bone resorption through the production of intracellular lipid reactive oxygen species,while iron chelators can inhibit osteoclast formation in vitro and thus affect the occurrence and development of osteoporosis.

Objective To investigate the effect of the Nogo receptor antagonist NEP1-40,administered via an exogenous route,on axonal regeneration in rats with spinal cord injury(SCI),and to explore its mecha-nism of action in the process of neural repair.Methods SD rats were divided into a sham surgery group(Group A),an injury group(Group B),and an injury+NEP1-40 treatment group(Group C).In Group A,only laminectomy was performed without spinal cord injury.Groups B and C were subjected to a clip-type SCI model.Group C received treatment with NEP1-40 based on the established SCI model.Hindlimb motor func-tion in the three groups was assessed using the BBB score at 1,3,7,and 14 days post-surgery.Real-time quan-titative PCR(qPCR)and Western blot were used to detect changes in gene and protein expression levels of growth-associated protein-43(GAP-43)and microtubule-associated protein-2(MAP-2),characteristic markers of axonal and dendritic regeneration.Immunofluorescence was employed to analyze NF-200 and BrdU double-labeling,and changes in the number of double-labeled positive cells were observed and analyzed.Results In group A rats,the BBB scores at various time points after surgery showed no significant change compared with preoperative scores.In groups B and C,the BBB scores on postoperative day 1 were obviously lower than pre-operative scores.From days 3 to 14 after surgery,the BBB scores partially recovered compared with postopera-tive day 1,though they remained lower than those in group A.However,on postoperative days 3,7,and 14,the BBB scores in group C were higher than those in group B(P<0.05).qPCR and Western blot results showed that compared with preoperative levels,GAP-43 and MAP-2 mRNA and protein expression in groups B and C at postoperative days 3,7,and 14 showed a trend of first decreasing and then increasing,and the expression in group C was consistently higher than in group B(P<0.05).The expression level of NogoA in group C showed an opposite trend to GAP-43 and MAP-2.Compared with preoperative levels,NogoA mRNA and pro-tein expression in group B rats decreased on postoperative days 1 and 3(P<0.05)and increased on days 7 and 14(P<0.05).Compared with preoperative levels,NogoA mRNA and protein expression in groups B and C also showed a trend of first decreasing and then increasing,but in group C,at all postoperative time points except day 1,it was lower than in group B(P<0.05).Immunofluorescence results showed that over time,the number of cells double-labeled with BrdU and NF-200 gradually increased,with the highest number observed in group C on postoperative day 14.Conclusion NEP1-40 promotes neurological repair in SCI,providing a new approach for SCI repair treatment.

Objective To compare the safety and efficacy of balloon-occluded retrograde transvenous obliteration(BRTO),endoscopic ultrasound(EUS)-guided coil embolization combined with endoscopic injection of cyanoacrylate,and titanium clip-assisted endoscopic cyanoacrylate injection(CLIP-ECI)in the treatment of gastric varices based on a network meta-analysis.Methods A computerized retrieval of randomized controlled trials(RCT)and retrospective studies concerning the"balloon-occluded retrograde transvenous obliteration""EUS-guided coil embolization combined with endoscopic injection of cyanoacrylate"and"titanium clip-assisted endoscopic cyanoacrylate injection"from the databases of PubMed,Web of Science,Cochrane Library,Embase,CNKI,Wanfang Medical Network,and CBM was conducted.The retrieval time period was from the establishment of the database to July 1,2024.Studies were selected based on inclusion and exclusion criteria,and data were processed using a random-effects model with STATA14.0 software for network meta-analysis.Results A total of 22 articles,including 7 RCTs and 15 retrospective studies,were included in this analysis,with a total sample size of 2 122 patients.The network meta-analysis showed that in terms of rebleeding prevention,the BRTO group(SUCRA 93.5)had the lowest rebleeding rate,followed by the EUS group(SUCRA 72.0);in terms of mortality,the CLIP-ECI group(SUCRA 82.1)had the lowest overall mortality,followed by the BRTO group(SUCRA 75.5);in terms of ectopic embolism rate,the BRTO group(SUCRA 68.7)had the smallest likelihood of ectopic embolism,while the ECI group(SUCRA 23.8)had the highest likelihood;in terms of gastric variceal eradication,the BRTO group(SUCRA 95.4)had the highest variceal eradication rate,followed by the EUS group(SUCRA 60.7).Conclusion Compared with endoscopic therapy,BRTOcan reduce the rebleeding rate of gastric varices and increase the eradication rate,with lower rates of ectopic embolization and mortality.Therefore,BRTO is an effective and safe means for the treatment of gastric varices.

Objective:To clarify the effect of methotrexate on blood uric acid levels and the incidence of hyperuricemia in patients with rheumatic and musculoskeletal diseases (RMDs).Methods:The clinical data were collected from 349 patients with RMDs who took methotrexate for more than 52 weeks and 429 patients with RMDs who did not take methotrexate, who were treated at Anqing Medical Center of Auhui Medical University from June 1, 2022 to June 30, 2024, to compare the differences in serum uric acid concentration and the incidence of hyperuricemia before and after 24 weeks of methotrexate administration in the two groups of patients with RMDs. The changes in serum uric acid concentration and serum creatinine value in the MTX na?ve patients who had taking MTX for 0, 24 and 52 weeks were compared. The relationship between serum uric acid concentration and methotrexate dosage was analyzed. Measurement data were compared using t-test or ANOVA, repeated measures analysis of variance, and count data were compared using χ2 test. Results:①At week 0, there was no significant difference in serum uric acid concentration [(300±63)μmol/L vs. (306±64)μmol/L, t=-1.416, P=0.157] and the incidence of hyperuricemia [9.3%(40/429) vs. 10.3%(36/349) , χ2=0.215, P=0.643] between the two groups. At week24, the serum uric acid concentration (307±70)μmol/L vs. (246±89)μmol/L was statistically significantly ( t=10.909, P<0.001) different. The incidence of hyperuricemia (11.0%, 47/429) vs. (4.6%, 16/349), was statistically significantly different ( χ2=10.497, P<0.001). There was a statistically significant difference in serum uric acid concentration between week 0 and week 24 in the methotrexate group ( t=10.237, P<0.001), and there was a statistically significant difference in the incidence of hyperuricemia ( χ2=8.312, P=0.004). ②The overall serum uric acid concentrations at week 0, weeks 24, and weeks 52 were (306±64)μmol/L, (246±89)μmol/L, and (247±66)μmol/L, respectively. The difference in overall serum uric acid concentration was statistically significant ( F= 29.506, P<0.001). There was no significant difference in serum uric acid concentration between weeks 24 and 52 ( P=1.000). There were significant differences in serum creatinine levels between weeks 0, 24 and 52 ( P<0.001). There was no significant difference in serum creatinine levels between weeks 0 ,52, weeks 24 and 52 ( P=0.077, P=1.000). There were statistically significant differences in the overall serum uric acid concentration and serum creatinine value at weeks 0, 24 and 52 of medication ( P<0.001).③ There was no significant difference in serum uric acid concentration before and after taking hydroxychloroquine, cyclosporine, tripterygium wilfordii, mycophenolate mofetil, tofacitinib, etanercept and adalimumab alone for weeks 0 and 24(all P>0.05). ④There was no significant difference in serum uric acid concentration between patients taking different doses of methotrexate (7.5 mg once weekly, 10 mg once weekly, 12.5 mg once weekly, 15 mg once weekly) at weeks 0 and 24 weeks(all P>0.05). Conclusion:MTX, as an anti-rheumatic drug, reduces the serum uric acid level and the incidence of hyperuricemia in patients with RMDs during the treatment.

Pituitary metastasis(PM), a rare metastatic complication of malignant tumors most commonly seen in lung and breast cancers, exhibits subtle and nonspecific clinical manifestations that complicate its differentiation from other sellar lesions. Symptom development correlates with anatomical involvement: tumors often initially destroy the posterior pituitary, causing diabetes insipidus; subsequently, pituitary stalk compression may trigger hyperprolactinemia, while progressive anterior pituitary destruction ultimately leads to hormonal deficiencies. Additionally, mass effects from the tumor can result in optic chiasm compression, with specific neurological manifestations dependent on the invasion site. Nonspecific symptoms such as fatigue and headache are frequently observed. Pituitary MRI serves as a critical diagnostic tool for distinguishing sellar pathologies. As a distant metastatic event, PM portends a poor overall prognosis. This study presents two cases of lung adenocarcinoma with PM, supplemented by a comprehensive literature review, to summarize clinical characteristics and diagnostic/therapeutic strategies.