The diagnosis,treatment,and prognosis evaluation of cervical spondylosis are challenging in clinic.Machine learning(ML)models can improve the accuracy and efficiency of cervical spondylosis diagnosis by processing complex clinical data,assist in selecting more precise treatment plans,and evaluate prognosis.Through the domestic and foreign literature review on the application of ML models in cervical spondylosis in recent years,the study classifies and summarizes the relevant models applied in the diagnosis,treatment,and prognosis evaluation of cervical spondylosis,introduces classic algorithms such as random forest,as well as new algorithms such as convolutional neural networks,deep neural networks and long short-term memory networks,aiming to provide reference ML solutions for various stages of cervical spondylosis diagnosis and treatment.

Objective: To analyze the association between alcohol consumption and lumbar disc herniation (LDH), so as to provide a reference for the development of prevention and treatment strategies for LDH. Methods: From May to July 2022, permanent residents aged ≥18 years from eight counties (cities/districts) in Gansu Province were selected using a multistage stratified random sampling method. Data on basic characteristics, alcohol consumption in the past 30 days, hypertension, and diabetes mellitus were collected through questionnaire surveys. LDH was determined based on imaging findings, combined with disease history or clinical symptoms. Multivariable logistic regression model was used to analyze the association between alcohol consumption and LDH, with subgroup analyses conducted by gender, age, ethnicity, and altitude of residence. Propensity score matching (PSM) was utilized for sensitivity analysis. Results: A total of 4 545 individuals were surveyed. There were 2 026 (44.58%) males and 2 519 (55.42%) females. The mean age was (44.82±15.33) years. The study participants were predominantly of Han ethnicity, with 2 598 persons accounting for 57.17%. The altitude of residence was mainly above 3 500 m, with 1 941 persons accounting for 42.71%. There were 574 alcohol drinkers, accounting for 12.63%. LDH was detected in 1 035 cases, with a detection rate of 22.77%. Multivariable logistic regression analysis showed that after adjusting for gender, age, physical activity, and hypertension, compared to non-drinking residents, alcohol-consuming residents exhibited a 27.6% reduction in the risk of LDH (OR=0.724, 95%CI: 0.544-0.963). No significant interaction effects on LDH risk were observed between alcohol consumption and gender, age, ethnicity, or altitude of residence (all Pfor interaction >0.05). The results of the sensitivity analysis indicated that compared to non-drinking residents, alcohol-consuming residents exhibited a 38.8% reduction in the risk of LDH (OR=0.612, 95%CI: 0.382-0.976). Conclusion Alcohol consumption was statistically associated with a lower risk of LDH.

Objective:To explore the risk factors for osteoporosis in postmenopausal patients with rheumatoid arthritis and establish a prediction model for early identification.Methods:A retrospective analysis was conducted on the clinical data of 128 postmenopausal patients with rheumatoid arthritis who visited Northwest Women′s and Children′s Hospital from May 2021 to December 2023. According to their bone mineral density, the patients were divided into the osteoporosis group (T-score ≤-2.5, n=16) and the non-osteoporosis group (T-score >-2.5, n=112). Clinical data of the two groups were compared. Pearson correlation analysis was used to analyze the correlation of various indicators. Multivariate logistic regression analysis was applied to screen the influencing factors for osteoporosis in postmenopausal patients with rheumatoid arthritis, and a Nomogram model for predicting the risk of osteoporosis in such patients was established. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive efficacy of the model. Results:The age, Disease Activity Score 28 based on Erythrocyte Sedimentation Rate (DAS28-ESR), β-cross-linked C-telopeptide of type I collagen (β-CTX), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) in the osteoporosis group were higher than those in the non-osteoporosis group, while the bone mineral density of lumbar vertebrae t1-4, left hip, right hip, serum calcium, and estradiol (E 2) levels were lower (all P<0.05). Pearson correlation analysis showed that DAS28-ESR was negatively correlated with bone mineral density of lumbar vertebrae t1-4 ( r=-3.026, P=0.002), left hip ( r=-3.409, P<0.001), and right hip ( r=-4.125, P<0.001). Multivariate logistic regression analysis showed that age ( OR=4.697, 95% CI: 2.509-8.795), DAS28-ESR ( OR=4.889, 95% CI: 2.611-9.154), β-CTX ( OR=4.816, 95% CI: 2.572-9.018), LH ( OR=4.998, 95% CI: 2.669-9.357), and FSH ( OR=4.802, 95% CI: 2.565-8.991) were risk factors for osteoporosis in postmenopausal women with rheumatoid arthritis (all P<0.05); bone mineral density of lumbar vertebrae t1-4 ( OR=0.203, 95% CI: 0.108-0.381), left hip ( OR=0.214, 95% CI: 0.114-0.401), right hip ( OR=0.211, 95% CI: 0.113-0.396), serum calcium ( OR=0.199, 95% CI: 0.106-0.372), and E 2 ( OR=0.210, 95% CI: 0.112-0.383) were protective factors (all P<0.05). The Nomogram model for predicting osteoporosis in postmenopausal patients with rheumatoid arthritis had a sensitivity of 0.86(95% CI: 0.73-0.92), a specificity of 0.83(95% CI: 0.72-0.95), and an area under the curve of 0.918(95% CI: 0.865-0.973). Conclusions:Age, DAS28-ESR, β-CTX, LH, FSH, bone mineral density of lumbar vertebrae t1-4, left hip, right hip, serum calcium, and E 2 are related to osteoporosis in postmenopausal patients with rheumatoid arthritis. The established prediction model is helpful for early identification of the risk of osteoporosis.

The diagnosis,treatment,and prognosis evaluation of cervical spondylosis are challenging in clinic.Machine learning(ML)models can improve the accuracy and efficiency of cervical spondylosis diagnosis by processing complex clinical data,assist in selecting more precise treatment plans,and evaluate prognosis.Through the domestic and foreign literature review on the application of ML models in cervical spondylosis in recent years,the study classifies and summarizes the relevant models applied in the diagnosis,treatment,and prognosis evaluation of cervical spondylosis,introduces classic algorithms such as random forest,as well as new algorithms such as convolutional neural networks,deep neural networks and long short-term memory networks,aiming to provide reference ML solutions for various stages of cervical spondylosis diagnosis and treatment.

Objective:To explore the risk factors for osteoporosis in postmenopausal patients with rheumatoid arthritis and establish a prediction model for early identification.Methods:A retrospective analysis was conducted on the clinical data of 128 postmenopausal patients with rheumatoid arthritis who visited Northwest Women′s and Children′s Hospital from May 2021 to December 2023. According to their bone mineral density, the patients were divided into the osteoporosis group (T-score ≤-2.5, n=16) and the non-osteoporosis group (T-score >-2.5, n=112). Clinical data of the two groups were compared. Pearson correlation analysis was used to analyze the correlation of various indicators. Multivariate logistic regression analysis was applied to screen the influencing factors for osteoporosis in postmenopausal patients with rheumatoid arthritis, and a Nomogram model for predicting the risk of osteoporosis in such patients was established. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive efficacy of the model. Results:The age, Disease Activity Score 28 based on Erythrocyte Sedimentation Rate (DAS28-ESR), β-cross-linked C-telopeptide of type I collagen (β-CTX), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) in the osteoporosis group were higher than those in the non-osteoporosis group, while the bone mineral density of lumbar vertebrae t1-4, left hip, right hip, serum calcium, and estradiol (E 2) levels were lower (all P<0.05). Pearson correlation analysis showed that DAS28-ESR was negatively correlated with bone mineral density of lumbar vertebrae t1-4 ( r=-3.026, P=0.002), left hip ( r=-3.409, P<0.001), and right hip ( r=-4.125, P<0.001). Multivariate logistic regression analysis showed that age ( OR=4.697, 95% CI: 2.509-8.795), DAS28-ESR ( OR=4.889, 95% CI: 2.611-9.154), β-CTX ( OR=4.816, 95% CI: 2.572-9.018), LH ( OR=4.998, 95% CI: 2.669-9.357), and FSH ( OR=4.802, 95% CI: 2.565-8.991) were risk factors for osteoporosis in postmenopausal women with rheumatoid arthritis (all P<0.05); bone mineral density of lumbar vertebrae t1-4 ( OR=0.203, 95% CI: 0.108-0.381), left hip ( OR=0.214, 95% CI: 0.114-0.401), right hip ( OR=0.211, 95% CI: 0.113-0.396), serum calcium ( OR=0.199, 95% CI: 0.106-0.372), and E 2 ( OR=0.210, 95% CI: 0.112-0.383) were protective factors (all P<0.05). The Nomogram model for predicting osteoporosis in postmenopausal patients with rheumatoid arthritis had a sensitivity of 0.86(95% CI: 0.73-0.92), a specificity of 0.83(95% CI: 0.72-0.95), and an area under the curve of 0.918(95% CI: 0.865-0.973). Conclusions:Age, DAS28-ESR, β-CTX, LH, FSH, bone mineral density of lumbar vertebrae t1-4, left hip, right hip, serum calcium, and E 2 are related to osteoporosis in postmenopausal patients with rheumatoid arthritis. The established prediction model is helpful for early identification of the risk of osteoporosis.

Transient receptor potential vanilloid 1 is a non-selective cation channel, which is sensitive to heat, acidic environment and capsaicin. It is widely expressed in sensory neurons and various other tissues, and is closely associated with the development of several orthopedic disorders. Knee osteoarthritis (KOA) is a common degenerative joint disease characterized by articular cartilage degeneration, synovial inflammation and subchondral bone remodeling. In recent years, with the deepening of research, it has been found that Transient receptor potential vanilloid receptor 1 (TRPV1) plays an important role in the pathophysiological process of KOA, affecting the progression of the disease by regulating pain transmission, inflammatory response, ferroptosis of chondrocytes, bone homeostasis and other mechanisms. In recent years, by targeting the TRPV1 channel to maintain the homeostasis of the joint environment, certain breakthroughs have been made in the relief of symptoms and the prevention and treatment of KOA, showing a good application prospect. This review outlines the mechanisms and regulatory pathways of TRPV1 and discusses its roles in chondrocytes, synovial tissue, and subchondral bone, as well as its pathological relevance in the development of KOA. It further summarizes current strategies for targeting TRPV1 in KOA therapy and the progress of related therapeutic interventions. The aim of this study is to expand the treatment of knee osteoarthritis and provide new treatment ideas and strategies for KOA patients.

BACKGROUND:Intervertebral disk degeneration is a pathological change caused by a series of complex molecular mechanisms that result in the aging and damage of intervertebral discs,ultimately leading to severe clinical symptoms.Traditional Chinese medicine has unique advantages in the treatment of intervertebral disk degeneration due to its low cost,non-addictive nature,multi-target effects,minimally toxic and side effects,and high patient acceptance. OBJECTIVE:To review the latest research results of traditional Chinese medicine monomer intervention-related signaling pathways in the treatment of intervertebral disk degeneration,describe and analyze the action mechanism of traditional Chinese medicine monomer on intervertebral disk degeneration,and provide a new approach and theoretical basis for future basic research and clinical treatment. METHODS:The first author searched for relevant literature from January 2018 to February 2023 in CNKI,PubMed,VIP,and WanFang using the search terms"intervertebral disc,signal pathway".The articles that did not meet the criteria were excluded after preliminary screening of the titles and abstracts.Finally,72 articles were selected for review and analysis. RESULTS AND CONCLUSION:Traditional Chinese medicine monomers can regulate multiple classical signaling pathways such as Wnt/β-catenin,PI3K/Akt,mTOR,NF-κB,and MAPK.They achieve this by regulating oxidative stress,adjusting the expression of pro/anti-apoptotic proteins in cells,stimulating cellular autophagy function,reducing stimulation of cell inflammatory factors,increasing the expression of extracellular matrix markers,reducing the production of matrix-degrading enzymes,maintaining the synthesis and stability of extracellular matrix,inducing differentiation of mesenchymal stem cells in the nucleus pulposus into nucleus pulposus cells,promoting endogenous repair and reconstruction,controlling apoptosis and aging of nucleus pulposus cells,and increasing the activity of nucleus pulposus cells.These actions improve the microenvironment within the intervertebral disc,maintain the normal physiological function of the intervertebral disc,and delay intervertebral disc degeneration.

BACKGROUND:At present,bone marrow mesenchymal stem cells are the main seed cells used in cell therapy for the treatment of intervertebral disc degeneration.However,the use of bone marrow mesenchymal stem cells as seed cells for the regeneration of fibrous rings is at risk of heterotopic ossification and teratoma at the repair site.Therefore,it is of great economic and social significance to find a new kind of seed cells for tissue engineering of annulus fibrosus for the treatment of intervertebral disc degeneration. OBJECTIVE:To isolate and purify rat annulus fibrosus-derived stem cells by adherent method combined with fibronectin differential adhesion screening method,and to observe its purification effect and biological characteristics. METHODS:Annulus fibrosus tissue was obtained from a SD rat intervertebral disc.Primary annulus fibrosus-derived stem cells were obtained by the mechanical-enzymatic digestion method.Annulus fibronectin differential adhesion method was used to purify annulus fibrosus-derived stem cells.Morphological changes and proliferation of cells were observed through a microscope.The expression levels of stem cell markers were detected by immunofluorescence technique and qPCR.The screened cells were subjected to multi-lineage cell differentiation and characteristic gene detection. RESULTS AND CONCLUSION:(1)The purified cells grew well,and most of them were angular and star-shaped multi-process cells,which had good proliferation ability.(2)Cells were positive for cell membrane surface antigens CD73,CD90 and CD105,while negative for CD45 and CD34.(3)After specific induction,cells could successfully differentiate into osteoblasts,chondroblasts and lipoblasts.(4)Collagen-I,Runx-2 after osteogenic induction,Collagen Ⅱ,Sox-9 after chondrogenic induction,and PPAR-γ and LPL after lipogenic induction were highly expressed in cells,and the difference was significant compared with that before induction(P<0.05).(5)These findings confirm that the adherent method combined with fibronectin differential adhesion method is effective enough to screen,isolate and purify rat annulus fibrosus-derived stem cells,and has good cell biological properties,good proliferation ability and multiple differentiation potential.

Objective To investigate the differences in blood pressure phenotypes,renal pathological changes,and related pathogenic pathways in genetically diverse hypertensive mice obtained from 13 strains.Methods The genotypes of Cckbr+/+,Cckbr+/-and Cckbr-/-were obtained by hybridization of 13 strains of genetically diverse mice with Cckbr-/-mice.Blood pressure was measured with a noninvasive blood pressure analysis system(BP-2000).The expression of CCKBR protein in mouse kidney tissue was detected by Western Blot,and the pathological changes in mouse kidney tissue were detected by hematoxylin-eosin(HE)staining and immunohistochemistry(IHC).The pathogenic pathways related to essential hypertension were screened by RNA sequencing.Results In three specific mouse strains(A/J,LOT,and FIM),the systolic blood pressure(SBP)was significantly different between the Cckbr-/-and Cckbr+/+groups.HE staining and IHC showed that hypertension caused a certain degree of renal injury in the mice.Gene Ontology(GO)and pathway enrichment analysis showed that differentially expressed genes were enriched in metabolic processes and circadian rhythm regulation.Conclusions Genetically diverse mice can effectively simulate the genetic background of the population and provide a new resource for studying the pathogenic genes related to essential hypertension.

Intervertebral disc degeneration(IDD) is the pathological basis of spinal diseases. With the development and change of working and living style, IDD gradually presents the trend of younger in recent years. The effective prevention and treatment of IDD has become a hotspot in clinical research. Recent studies have shown that oxidative stress plays an important role in IDD. The disruption of reactive oxygen species balance in cells or the body leads to changes in extracellular matrix and intervertebral disc cell phenotype, which induces oxidative stress of intervertebral disc and leads to IDD. Oxidative stress can affect the development of IDD through apoptosis, autophagy, senescence and extracellular matrix of intervertebral disc. Currently, opioids and drugs for promoting blood circulation and pain relief are commonly used in clinical treatment of IDD, which can alleviate some symptoms to a certain extent, but is easy to induce gastrointestinal and other adverse reactions. Meanwhile, due to the long treatment cycle and poor patient compliance to a certain extent, which brings great difficulties to the treatment. At the same time, traditional Chinese medicine plays an important role in the treatment of IDD due to its advantages of low cost and fewer adverse reactions. With the in-depth research of modern technologies such as molecular biology and network pharmacology, it has been found that traditional Chinese medicine can intervene in the expression of oxidative stress-related functions, namely, slowing down apoptosis, autophagy and degradation of extracellular matrix, etc, to play a role in the treatment of IDD. In this paper, the role of oxidative stress in IDD and the research results on the intervention of traditional Chinese medicine in oxidative stress will be expounded, in order to provide reference for the prevention and treatment of IDD by traditional Chinese medicine.