BACKGROUND:Bone marrow mesenchymal stem cells play a crucial role in treatment of diseases,such as femoral head necrosis,and the therapeutic efficacy is closely related to the quality of the cells.The empowerment of cells has become a research focus.OBJECTIVE:To investigate the effects of hypoxia mimetic dimethylglyoxal glycine pretreatment on mitophagy and differentiation capacity of human bone marrow mesenchymal stem cells.METHODS:Bone marrow mesenchymal stem cells were extracted from the bone marrow of patients' iliac crest and cultured in vitro to the third passage.The cells were treated with dimethylglyoxal glycine at 0,10,50,and 100 μmol/Lfor 24 hours,followed by the replacement with an osteogenic induction differentiation medium,which constituted the pretreatment group.The continuous treatment group was cultured directly in osteogenic induction medium containing 0,10,50,and 100 μmol/L dimethylglyoxal glycine after cell adhesion.After 7 days of induction,alkaline phosphatase staining was performed to select the most favorable conditions for osteogenic differentiation for subsequent experiments,with normally cultured bone marrow mesenchymal stem cells serving as the control group.Alkaline phosphatase staining,alkaline phosphatase activity,oil red O staining,and related RT-qPCR were used to evaluate the osteogenic and adipogenic differentiation differences of bone marrow mesenchymal stem cells between the two groups.MitoSox staining was used to detect mitochondrial reactive oxygen species levels.Mito-tracker and Lyso-tracker staining were used to detect the co-localization of mitochondria and lysosomes.The fluorescent probe JC-1 was used to measure mitochondrial membrane potential.RESULTS AND CONCLUSION:Alkaline phosphatase staining indicated that the most beneficial treatment for bone marrow mesenchymal stem cell osteogenesis was pretreatment with 10 μmol/L dimethylglyoxal glycine for 24 hours.Compared with the control group,the experimental group showed enhanced alkaline phosphatase staining expression,increased alkaline phosphatase activity and osteogenic gene expression,reduced lipid droplet formation and adipogenic gene expression as indicated by oil red O staining,decreased mitochondrial reactive oxygen species production,increased co-localization of mitochondria and lysosomes,and elevated mitochondrial membrane potential.The results suggest that 10 μmol/L dimethylglyoxal glycine pretreatment can promote osteogenic differentiation of bone marrow mesenchymal stem cells,inhibit adipogenic differentiation,and enhance mitophagy.

BACKGROUND:Bone marrow mesenchymal stem cells play a crucial role in treatment of diseases,such as femoral head necrosis,and the therapeutic efficacy is closely related to the quality of the cells.The empowerment of cells has become a research focus.OBJECTIVE:To investigate the effects of hypoxia mimetic dimethylglyoxal glycine pretreatment on mitophagy and differentiation capacity of human bone marrow mesenchymal stem cells.METHODS:Bone marrow mesenchymal stem cells were extracted from the bone marrow of patients' iliac crest and cultured in vitro to the third passage.The cells were treated with dimethylglyoxal glycine at 0,10,50,and 100 μmol/Lfor 24 hours,followed by the replacement with an osteogenic induction differentiation medium,which constituted the pretreatment group.The continuous treatment group was cultured directly in osteogenic induction medium containing 0,10,50,and 100 μmol/L dimethylglyoxal glycine after cell adhesion.After 7 days of induction,alkaline phosphatase staining was performed to select the most favorable conditions for osteogenic differentiation for subsequent experiments,with normally cultured bone marrow mesenchymal stem cells serving as the control group.Alkaline phosphatase staining,alkaline phosphatase activity,oil red O staining,and related RT-qPCR were used to evaluate the osteogenic and adipogenic differentiation differences of bone marrow mesenchymal stem cells between the two groups.MitoSox staining was used to detect mitochondrial reactive oxygen species levels.Mito-tracker and Lyso-tracker staining were used to detect the co-localization of mitochondria and lysosomes.The fluorescent probe JC-1 was used to measure mitochondrial membrane potential.RESULTS AND CONCLUSION:Alkaline phosphatase staining indicated that the most beneficial treatment for bone marrow mesenchymal stem cell osteogenesis was pretreatment with 10 μmol/L dimethylglyoxal glycine for 24 hours.Compared with the control group,the experimental group showed enhanced alkaline phosphatase staining expression,increased alkaline phosphatase activity and osteogenic gene expression,reduced lipid droplet formation and adipogenic gene expression as indicated by oil red O staining,decreased mitochondrial reactive oxygen species production,increased co-localization of mitochondria and lysosomes,and elevated mitochondrial membrane potential.The results suggest that 10 μmol/L dimethylglyoxal glycine pretreatment can promote osteogenic differentiation of bone marrow mesenchymal stem cells,inhibit adipogenic differentiation,and enhance mitophagy.

Robotic joint surgery (RJS) has demonstrated high precision and reproducibility in total hip and knee arthroplasty,the integration of artificial intelligence(AI) has further enhanced the intelligence level of key processes,including surgical planning,registration,surgical manipulator control,and robot autonomy. AI-powered surgical planning improves implant positioning accuracy through deep learning,while AI-powered registration overcomes the limitations of traditional methods in precision and efficiency. Additionally,reinforcement learning and neural networks have optimized surgical manipulator control,improving operational accuracy and human-robot interaction. As AI continues to advance,RJS is expected to make significant strides in automation,multimodal sensing,and human-robot collaboration,driving arthroplasty surgeries toward higher levels of intelligence and individual treatment.

Robotic joint surgery (RJS) has demonstrated high precision and reproducibility in total hip and knee arthroplasty,the integration of artificial intelligence(AI) has further enhanced the intelligence level of key processes,including surgical planning,registration,surgical manipulator control,and robot autonomy. AI-powered surgical planning improves implant positioning accuracy through deep learning,while AI-powered registration overcomes the limitations of traditional methods in precision and efficiency. Additionally,reinforcement learning and neural networks have optimized surgical manipulator control,improving operational accuracy and human-robot interaction. As AI continues to advance,RJS is expected to make significant strides in automation,multimodal sensing,and human-robot collaboration,driving arthroplasty surgeries toward higher levels of intelligence and individual treatment.

Objective:To explore and practice the construction of an innovative ecosystem that integrates innovation in the National Clinical Research Center for Orthopedics and Sports Rehabilitation, providing references and insights for driving high-quality development of medical care.Methods:Guided by a national policy framework and Industry-Academia-Research-Government-Enterprise Collaborative Innovation, the Center had established six innovation platforms and three systemic pillars. The study analyzed its integrated strategy, which encompassed ecosystem design, platform-enabled empowerment, comprehensive system support, end-to-end coverage, a folded innovation approach, and a standardization-driven mechanism.Results:The Center had built a highly integrated innovation ecosystem, creating a powerful driver for technological advancement and commercialization in orthopedics and sports rehabilitation, accelerating the industrialization of key technologies like surgical robots and 3D-printed implants.Conclusions:Guided by the principle of ″simplifying complex surgeries and standardizing common procedures″, the Center will leverage digital intelligence throughout clinical care, aiming to bridge gaps in healthcare quality so that patients can receive top-tier treatment for major diseases within their home provinces. This commitment to homogenized, high-quality care presents a ″China Model″ for global health and advance the national ″Healthy China″ initiative.

Objective To explore the clinical effectiveness of full endoscopic lamina fenestration discec-tomy(Endo-LOVE)in combination with nerve root pulsed radiofrequency(NR-PRF)in the treatment of lumbar degenerative disease(LDD),along with the amelioration of postoperative residual symptoms.Methods A retro-spective analysis was performed on 102 patients with LDD who were treated in our hospital between January 2022 and June 2023.Among them,53 cases were assigned to the observation group(receiving Endo-LOVE combined with NR-PRF),and 49 cases were included in the control group(undergoing Endo-LOVE alone).The mean follow-up period was 15.05±1.15 months.The general data of the two groups were compared.Observations were carried out at preoperative,1-day,7-day,1-month,3-month,6-month,and final follow-up time points postopera-tively.The perioperative data and follow-up outcomes of the two groups were compared.Results Prior to surgery,no significant disparities were detected in the general conditions and clinical observation indicators(VAS,M-JOA,and ODI scores)between the two groups.Postoperatively,both groups exhibited a notable improvement in clinical indicators when compared to the preoperative levels(P<0.05).Within three months after surgery,the observation group showed significantly more pronounced improvement in all clinical indicators than the control group(P<0.05).At six months postoperatively and during the final follow-up,no statistically significant differences in clinical indi-cators were found between the two groups.Moreover,at the final follow-up,there was no statistically significant difference in the Macnab scores between the two groups(P>0.05).Conclusion Endoscopic decompression for the treatment of LDD exhibits high safety and reliability.When combined with endoscopic NR-PRF,it enhances the clinical efficacy,reduces the incidence of postoperative residual symptoms,and facilitates rapid postoperative recovery.This complementary combination presents a novel therapeutic strategy for LDD.

The landscape of modern warfare is undergoing profound transformation. With the large-scale, clustered application of high-kinetic weapon systems and intelligent munitions, combat trauma has exhibited distinct characteristics: diversified injury patterns, a significant increase in the proportion of complex injuries, a drastically shortened golden window for treatment, more stringent time-critical requirements, and highly fragmented allocation of medical resources. These emerging trends pose systemic challenges to traditional combat trauma care systems, highlighting deficiencies including delayed injury assessment, experience-dependent medical decision-making, and low efficiency in multi-link coordination. Intelligent technologies for combat trauma care, underpinned by artificial intelligence, the Internet of Things, robotics, and brain-computer interfaces, offer new pathways to address the limitations of traditional care systems. Starting from the new challenges in modern combat trauma care, the author elaborated on the application of intelligent orthopedics across key stages including pre-hospital, in-hospital, and post-hospital care, identified potential issues and countermeasures, aiming to provide theoretical and practical references for the development of an intelligent combat trauma care system.

Objective To investigate the role of the ROS/NLRP3/Caspase-1 pyroptosis signaling pathway in mediating the inflammatory response of nerve roots in a rabbit model of lumbar disc herniation(LDH)following acupotomy intervention.Methods Forty New Zealand white rabbits were randomly assigned to four groups:a blank control group(10 rabbits),a model control group(10 rabbits),an electroacupuncture intervention group(positive control group,10 rabbits),and an acupotomy intervention group(10 rabbits).The LDH nerve root inflammatory response model was established in the model control group,electroacupuncture intervention group,and acupotomy intervention group using the classical autologous nucleus pulposus transplantation method.Following successful model establishment,corresponding interventions were administered.Dorsal root ganglion tissues were then collected for analysis.Reactive oxygen species levels were assessed using fluorescent probe staining.The expression of NLRP3 inflammasome-related proteins(NLRP3,ASC,GSDMD-N,and Caspase-1)was evaluated by Western blot.Mitochondrial permeability transition pore opening was assessed via Calcein AM staining.Results The comparison of relative fluorescence intensity of reactive oxygen species in dorsal root ganglion tissue among the groups indicated that the model control group exhibited significantly higher levels compared to the blank control group(P＜0.05).Both the electroacupuncture intervention group and the acupotomy intervention group demon-strated significantly lower levels than the model control group(P＜0.05).Western blot analysis revealed that the expression levels of NLRP3,ASC,GSDMD-N,and Caspase-1 in the model control group were significantly elevated compared to those in the blank control group(P＜0.05).Both intervention groups showed markedly reduced expression of these proteins compared to the model control group(P＜0.05).Additionally,the assessment of mito-chondrial permeability transition pore activity based on relative fluorescence intensity showed a significant increase in the model control group compared to the blank control group(P＜0.05),with both intervention groups exhibiting significantly lower levels than the model control group(P＜0.05).Conclusions Acupotomy therapy modulates the ROS/NLRP3/Caspase-1 signaling pathway,thereby inhibiting pyroptosis and attenuating the inflammatory response in nerve roots.This elucidates the potential molecular mechanism underlying the therapeutic effects of acupotomy on LDH through the regulation of ROS/NLRP3/Caspase-1-mediated downstream signaling cascades.

Objective To investigate the role of the ROS/NLRP3/Caspase-1 pyroptosis signaling pathway in mediating the inflammatory response of nerve roots in a rabbit model of lumbar disc herniation(LDH)following acupotomy intervention.Methods Forty New Zealand white rabbits were randomly assigned to four groups:a blank control group(10 rabbits),a model control group(10 rabbits),an electroacupuncture intervention group(positive control group,10 rabbits),and an acupotomy intervention group(10 rabbits).The LDH nerve root inflammatory response model was established in the model control group,electroacupuncture intervention group,and acupotomy intervention group using the classical autologous nucleus pulposus transplantation method.Following successful model establishment,corresponding interventions were administered.Dorsal root ganglion tissues were then collected for analysis.Reactive oxygen species levels were assessed using fluorescent probe staining.The expression of NLRP3 inflammasome-related proteins(NLRP3,ASC,GSDMD-N,and Caspase-1)was evaluated by Western blot.Mitochondrial permeability transition pore opening was assessed via Calcein AM staining.Results The comparison of relative fluorescence intensity of reactive oxygen species in dorsal root ganglion tissue among the groups indicated that the model control group exhibited significantly higher levels compared to the blank control group(P＜0.05).Both the electroacupuncture intervention group and the acupotomy intervention group demon-strated significantly lower levels than the model control group(P＜0.05).Western blot analysis revealed that the expression levels of NLRP3,ASC,GSDMD-N,and Caspase-1 in the model control group were significantly elevated compared to those in the blank control group(P＜0.05).Both intervention groups showed markedly reduced expression of these proteins compared to the model control group(P＜0.05).Additionally,the assessment of mito-chondrial permeability transition pore activity based on relative fluorescence intensity showed a significant increase in the model control group compared to the blank control group(P＜0.05),with both intervention groups exhibiting significantly lower levels than the model control group(P＜0.05).Conclusions Acupotomy therapy modulates the ROS/NLRP3/Caspase-1 signaling pathway,thereby inhibiting pyroptosis and attenuating the inflammatory response in nerve roots.This elucidates the potential molecular mechanism underlying the therapeutic effects of acupotomy on LDH through the regulation of ROS/NLRP3/Caspase-1-mediated downstream signaling cascades.

BACKGROUND:The development of calcium phosphate bone cement is limited due to its poor mechanical properties and weak osteogenic ability.Silicate bioactive glass is highly favored due to its excellent biological activity and osteogenic ability.Simultaneously,fiber structures can enhance the mechanical strength of materials.OBJECTIVE:To investigate the mechanical properties,biocompatibility,and osteogenic effect of silicate bioactive glass fiber composite calcium phosphate bone cement.METHODS:Different mass percentages(0％,10％,and 20％)of silicate bioactive glass fiber were added to the solid phase of calcium phosphate bone cement,mixed with the liquid phase and cured for 48 hours to obtain silicate bioactive glass fiber composite calcium phosphate bone cement.The mechanical properties,setting time,and ion precipitation of the cement were characterized.The three groups of bone cement extracts were co-cultured with MC3T3-E1 cells.The cell compatibility of the materials was evaluated by CCK-8 assay,live/dead staining,and phalloidin staining.After osteogenic induction,the osteogenic induction ability of the materials was evaluated by alkaline phosphatase staining,alizarin red staining,RUNX2 immunofluorescence staining,and RT-PCR.RESULTS AND CONCLUSION:(1)With the increase of silicate bioactive glass fiber content,the compressive strength and flexural strength of bone cement increased,and the setting time was prolonged.When bone cement was immersed in simulated body fluid,the precipitation of silicon ions,calcium ions,and phosphorus ions could be detected.Moreover,with the increase of silicate bioactive glass fiber content,the mass concentration of silicon ions and phosphorus ions released by bone cement increased,and the mass concentration of calcium ions decreased.(2)Live/dead staining and phalloidin staining results exhibited that silicate bioactive glass fiber composite calcium phosphate bone cement had no toxic effect on MC3T3-E1 cells.CCK-8 assay results showed that silicate bioactive glass fiber composite calcium phosphate bone cement could promote the proliferation of MC3T3-E1 cells.(3)With the increase of silicate bioactive glass fiber content in bone cement,the alkaline phosphatase activity and extracellular calcium deposition of MC3T3-E1 cells increased,the expression of RUNX2 protein increased,and the expression of alkaline phosphatase,osteocalcin,osteopontin,and RUNX2 mRNA expression increased.(4)The results indicate that silicate bioactive glass fibers can enhance the mechanical properties and osteogenic induction ability of calcium phosphate bone cement,among which 20％silicate bioactive glass fibers have a more obvious effect.