Knee osteoarthritis(KOA)and osteoporosis(OP)"co-morbidity"is a chronic progressive disease,the incidence of which is higher in recent years.Exosomes have intercellular messenger functions,which play an important role in the development of KOA and OP"co-morbidity".This article recognized the"co-morbidity"between KOA and OP from the perspective of modern medicine and the"tendon","bone","liver"and"kidney"in TCM theories,systematically reviewed the indirect regulation of KOA and OP"co-morbidity"through exosomes,and explored the possible mechanisms of exosome-based treatment of KOA and OP"co-morbidity"through Chinese materia medica in terms of inflammation,MAPK pathway,bone remodeling and cartilage metabolism,and mitochondrial autophagy,with the aim to investigate the possible mechanisms of KOA and OP"co-morbidity",and provide new ideas for the treatment of KOA and OP"co-morbidity".

Knee osteoarthritis(KOA)and osteoporosis(OP)"co-morbidity"is a chronic progressive disease,the incidence of which is higher in recent years.Exosomes have intercellular messenger functions,which play an important role in the development of KOA and OP"co-morbidity".This article recognized the"co-morbidity"between KOA and OP from the perspective of modern medicine and the"tendon","bone","liver"and"kidney"in TCM theories,systematically reviewed the indirect regulation of KOA and OP"co-morbidity"through exosomes,and explored the possible mechanisms of exosome-based treatment of KOA and OP"co-morbidity"through Chinese materia medica in terms of inflammation,MAPK pathway,bone remodeling and cartilage metabolism,and mitochondrial autophagy,with the aim to investigate the possible mechanisms of KOA and OP"co-morbidity",and provide new ideas for the treatment of KOA and OP"co-morbidity".

Objective:To compare Jefferson-fracture reduction plate (JeRP) and micro titanium plate in the transoral single-segment fixation of unstable atlas fractures.Methods:From January 2008 to December 2020, 45 patients with unstable atlas fracture were treated by single-segment fixation through an oral approach with a JeRP or a micro titanium plate at Department of Orthopedic Surgery, General Hospital of Southern Theatre Command. They were 24 males and 21 females, aged from 15 to 67 years. By the Gehweiler classification, 11 atlas fractures were type Ⅰ and 34 type Ⅲ; by the American Spinal Injury Association (ASIA) classification, the spinal cord injury was grade D in 7 cases and grade E in 38 cases; by the Dickman classification, the atlas transverse ligament injury was type Ⅰ in 4 cases and type Ⅱ in 11 cases. Of the patients, 26 were treated by transoral single-segment fixation with a JeRP and 19 by transoral single-segment fixation with a micro titanium plate. The 2 groups were compared in terms of baseline data, operation time, blood loss, hospital stay, visual analog scale (VAS) for neck pain and atlas lateral mass displacement (LMD) before operation and at the last follow-up, and intraoperative and postoperative complications.Results:The 2 groups were comparable because there was no significant difference between them in the preoperative general data ( P>0.05). All patients were followed up for 12 to 55 months (mean, 21.8 months). Wound dehiscence or infection was observed in none of the patients after operation. About 12 months after operation, all fractures achieved bony union, neck pain basically disappeared, and neck movement had no obvious limitation. The hospital stay was (13.9±2.2) d for the JeRP group and (14.2±2.9) d for the micro titanium plate group, showing no significant difference between the 2 groups ( P>0.05). The operation time was (203.5±173.4) min and the blood loss (167.3±138.6) mL in the JeRP group, significantly more than those in the micro titanium plate group [(121.5±50.5) min and (98.4±57.2) mL] ( P<0.05). In the JeRP group, the preoperative LMD was (6.7±1.7) mm and the preoperative VAS score (6.8±1.0) points, significantly higher than the last follow-up values [(0.7±0.6) mm and (0.7±0.6) points] ( P<0.05). In the micro titanium plate group, the preoperative LMD was (6.6±1.5) mm and the preoperative VAS score (6.7±0.9) points, significantly higher than the last follow-up values [(0.9±0.6) mm and (0.8±0.7) points] ( P<0.05). However, there was no significant difference in the preoperative or the last follow-up comparison between the 2 groups ( P>0.05). Implant loosening was observed in one patient in the JeRP group while foreign body sensation in the throat was reported in one patient after operation in the micro titanium plate group. Conclusions:Both JeRP and micro titanium plate in the transoral single-segment fixation can lead to effective treatment of unstable atlas fractures. Compared with JeRP, the micro titanium plate can effectively shorten operation time and reduce blood loss due to its smaller size and lower incision.

Objective To design and synthesize an antitubercular compound,24-ketoarguesterol.Methods The target compound was synthesized via 8 steps,including methyl esterification,grignard isopropylation,deportation,etc.,using hyodeoxycholic acid as the starting material.3?-tert-butyldimethylsilyoxyl-5?-hydroxyl-6?-di-me-thoxylmethyl-24-keto-B-norcholanate was the key intermediate and grignard isopropylation as the key step.Results The target compound was synthesized in a total yield of 42% and identified by mass spectrometry(MS),proton magnetic resonance spectroscopy(1HNMR),carbon magnetic resonance spectroscopy,(13CNMR)and infrared spectroscopy(IR).Conclusion The synthetic route is characterized by atomic economy and high efficiency and laid the foundation for development of novel antituberculous drugs.