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 study the development of conus medullaris by quantitative three-dimensional ultrasound in the second and third trimesters of pregnancy,and to analyze the value of terminal caudal vertebral ossification center count in diagnosis of closed spina bifida.Methods A total of 108 normal fetuses in the second and third trimesters of pregnancy who were admitted to Baoding No.1 Central Hospital from January 2019 to March 2024 were selected and assigned to the normal group.The distance between the fetal conus medullaris and the first sacral vertebra,the distance between the end of the conus medullaris and the end of sacrum,and the number of corresponding vertebrae were measured by three-dimensional ultrasound at different gestational weeks.Meanwhile,54 fetuses who were confirmed to have closed spina bifida after delivery were enrolled into the abnormal group.The number of ossification centers on the median sagittal section of the caudal spine was counted and compared between the two groups.The receiver operating characteristic(ROC)curve was drawn to analyze the value of ossification center count of distal caudal vertebrae in diagnosis of closed spina bifida.Results With the increase of gestational weeks,the distance between the fetal conus medullaris and the first sacral vertebra and the distance between the end of the conus medullaris and the end of the sacral bone were gradually increased.The conus medullaris of normal fetuses was mainly located in L1.5,L2 and L2.5,accounting for 85.19%(92/108).The ossification center count of distal caudal vertebra was slightly increased with the increase of gestational weeks in the normal group.At 17-20 gestational weeks,85.71%(12/14)of the ossification center count of distal caudal vertebra was 5 to 7.At 21-28 gestational weeks,100.00%(45/45)of the ossification center count was 6 and more.At week 29 and above,100.00%(45/45)of the ossification center count was more than 7.In the abnormal group,96.30%(52/54)of the fetuses had the ossification center less than 6,and 85.71%(42/49)of the ossification center count was≤5 at 21-32 gestational weeks.There were significant differences in the ossification center count between the two groups at 17-20,21-24,25-28,29-32,and 33-36 gestational weeks(P<0.05).ROC curve showed that,at 17-20,21-24,25-28,29-32,and 33-36 gestational weeks,the area under the curve(AUC)in prediction of closed spina bifida was 0.804,0.744,0.776,0.819,and 0.722 when the ossification center count of distal caudal vertebra was 5.31,4.59,4.81,4.67,and 5.49 as the cut-off value,respectively.Conclusion The conus medullaris moves upward with the increase of gestational weeks in the second and third trimesters of pregnancy.The ossification center count of the distal caudal vertebra is less than 6 in most fetuses with closed spina bifida,which is conducive to screening for closed spina bifida.

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.

Objective:To explore the correlation between bolus of different viscosity and swallowing physiological components,as well as penetration and aspiration,in patients with dysphagia after radiotherapy for nasopharyngeal carcinoma.Method:Total 67 patients with dysphagia after NPCR were evaluated by videofluoroscop.They were required to swallow 5 ml bolus per mouth,in the order of medium-low-zero-high consistency.Modified barium swal-low impairment profile(MBSImP)and penetration-aspiration scale(PAS)were used for semi-quantitative analysis.Result:Wide probability ranges(＞0.2)can be observed between different swallowing tasks for 7 physiologi-cal components:oral residue,initiation of pharyngeal swallow,laryngeal elevation,laryngeal vestibular clo-sure,pharyngeal contraction,tongue base retraction,and pharyngeal residue.The risk of penetration and aspira-tion increased with lower viscosity.There was a significant positive correlation between the penetration aspira-tion scale and epiglottic movement,laryngeal vestibular closure,bolus transpor,initiation of pharyngeal swal-low and tongue base retraction.Conclusion:The performance of swallowing physiological components in patients with dysphagia after NPCR are closely related to the viscosity of the bolus being swallowed.

Objective:To explore the correlation between bolus of different viscosity and swallowing physiological components,as well as penetration and aspiration,in patients with dysphagia after radiotherapy for nasopharyngeal carcinoma.Method:Total 67 patients with dysphagia after NPCR were evaluated by videofluoroscop.They were required to swallow 5 ml bolus per mouth,in the order of medium-low-zero-high consistency.Modified barium swal-low impairment profile(MBSImP)and penetration-aspiration scale(PAS)were used for semi-quantitative analysis.Result:Wide probability ranges(＞0.2)can be observed between different swallowing tasks for 7 physiologi-cal components:oral residue,initiation of pharyngeal swallow,laryngeal elevation,laryngeal vestibular clo-sure,pharyngeal contraction,tongue base retraction,and pharyngeal residue.The risk of penetration and aspira-tion increased with lower viscosity.There was a significant positive correlation between the penetration aspira-tion scale and epiglottic movement,laryngeal vestibular closure,bolus transpor,initiation of pharyngeal swal-low and tongue base retraction.Conclusion:The performance of swallowing physiological components in patients with dysphagia after NPCR are closely related to the viscosity of the bolus being swallowed.

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:Whether activating transcription factor 7 interacting protein(Atf7ip)is involved in the regulation in osteogenic differentiation is still controversial,and studying its impact on osteogenic differentiation and its specific mechanisms is of great significance. OBJECTIVE:To investigate the effect of Atf7ip on bone morphogenetic protein 2 promoting osteogenic differentiation of mouse embryonic osteoblast precursor cells(MC3T3-E1). METHODS:MC3T3-E1 cells cultured in vitro were divided into three groups:normal group,interference group(NC-siRNA group,Atf7ip-siRNA group),and high expression group(CMV-VC group and CMV-Atf7ip group),and were transfected for 24 hours,and then treated with 200 ng/mL bone morphogenetic protein 2 for 0,12,24,and 48 hours,respectively.qRT-PCR was used to detect the mRNA expression levels of Atf7ip,alkaline phosphatase,osteocalcin,type I collagen α1 in the cells of each group.Western blot assay was used to detect the protein expression of osteogenic differentiation markers Sp7 and Runx2,and the expression of Atf7ip binding molecule SETDB1,histone H3 and H3K9me3.Alkaline phosphatase activity was detected by alkaline phosphatase staining. RESULTS AND CONCLUSION:(1)With the increase of bone morphogenetic protein 2 treatment time,the protein and mRNA expression of Atf7ip decreased,while the protein expression of Sp7,Runx2 and the mRNA expression of osteocalcin and alkaline phosphatase increased significantly(P<0.05).There was no significant change in the protein expression of Atf7ip binding molecule SETDB1.(2)Compared with the NC-siRNA group,the protein expression of Sp7,Runx2 and the mRNA expression of osteocalcin and type I collagen α1 were significantly up-regulated(P<0.05),and alkaline phosphatase activity was significantly enhanced;and H3K9 methylation significantly decreased in the Atf7ip-siRNA group(P<0.05).(3)Compared with the CMV-VC group,the protein expression of Sp7 and Runx,as well as mRNA expression of osteocalcin,alkaline phosphatase,and type I collagen α1 was significantly downregulated(P<0.05),and the alkaline phosphatase activity was significantly reduced in the CMV-Atf7ip group,while the H3K9 methylation protein in the CMV-Atf7ip group was significantly upregulated compared to the control group(P<0.05).(4)In conclusion,Atf7ip expression was decreased during bone morphogenetic protein 2-induced osteogenic differentiation of MC3T3-E1,and osteogenic differentiation was significantly increased after knockdown of Atf7ip.Overexpression of Atf7ip significantly weakened osteogenic differentiation,indicating that Atf7ip is a negative regulatory factor of bone morphogenetic protein 2 promoting osteogenic differentiation of MC3T3-E1 cells.

Objective To explore the causal relationship between ischemic stroke and different types of epilepsy so as to provide genetic evidence for the risk of epilepsy after ischemic stroke.Methods Based on the summary data of genome-wide association study,Mendelian randomization (MR ) analysis was performed with MR-Egger regression,weighted median and inverse-variance weighting.Sensitivity analysis was conducted by using MR-Egger regression test,MR-PRESSO test and leave-one-out method.Results Two-sample MR analysis showed that there was a causal relationship between ischemic stroke and the risk of epilepsy (OR=1.10,P=0.036)and generalized epilepsy (OR=1.25,P=0.001 ),but no such relationship was observed with the risk of focal epilepsy (OR=1.06,P=0.360).In addition,diastolic blood pressure (OR=1.12,P=0.002)and BMI (OR=1.08,P=0.015)also had a causal relationship with the risk of epilepsy. After adjusting confounding factors,multivariate MR analysis revealed that only ischemic stroke (OR=1.18,P=3.770×10-6)and epilepsy risk had a causal relationship.Conclusion There is a causal relationship between ischemic stroke and the risk of generalized epilepsy,which can be used to stratify the risk of post-stroke epilepsy.

Transjugular intrahepatic portosystemic shunt （TIPS） has been recommended as a treatment method for cirrhotic portal hypertension in domestic and foreign guidelines， but there is still uncertainty in its therapeutic efficacy. More and more studies have shown that TIPS combined with collateral vessel embolization （TIPS+E） has certain advantages in the treatment of gastroesophageal variceal bleeding in liver cirrhosis. This article reviews the major studies on TIPS+E in China and globally， summarizes related recommendations in guidelines and the current status of clinical application， and proposes the issues that need to be solved， such as indication， hemodynamic criteria， and selection of materials for embolization， and large－sample multicenter randomized controlled trials are needed for further clarification.

Objective:To observe the maximum tongue pressure and study the oropharyngeal activity during swallowing of patients with nasopharyngeal carcinoma (NPC) after radiotherapy so as to correlate the maximum tongue pressure with swallowing function.Methods:The mean maximum tongue pressure of nineteen NPC patients with dysphagia was measured at the anterior (TA), middle (TM) and posterior (TP) positions, followed by video fluoroscopy. Oral transit time (OTT), upper esophageal sphincter(UES)opening time (UOT) and UES opening range (UOR) were correlated with the mean maximum tongue pressures.Results:The maximum pressure at the TM and TP positions was significantly negatively correlated with OTT, but there was no significant correlation with the anterior readings. The maximum pressures at all three tongue positions were, however, positively correlated with UOT and UOR.Conclusion:The maximum pressure at the TA, TM and TP positions is strongly correlated with the swallowing function of NPC patients.