Musculoskeletal disorders (MSDs) are characterized by extensive pathological involvement and high prevalence and cause a significant disease burden. Long-term drug administration often causes by adverse effects with poor therapeutic efficacy. Low-intensity pulsed ultrasound (LIPUS), as a specialized therapeutic modality, delivers acoustic energy at a low intensity in a pulsed wave mode, thus ensuring stable energy transmission to the target tissues while minimizing thermal effects. This non-invasive approach has demonstrated significant potential for MSD treatment by delivering effective physical stimulations. Extensive animal and clinical studies have demonstrated the efficacy of LIPUS for accelerating the healing process of fresh fractures and nonunions, promoting soft tissue regeneration and suppressing inflammatory responses. Emerging evidence suggests promising applications of LIPUS in skeletal muscle injury treatment and promoting tissue regeneration and repair. This review outlines the recent advancements and mechanistic studies of LIPUS for treatment of common MSDs including fractures, nonunions, muscle injuries, and osteoarthritis, addressing also the technical parameters of commercially available LIPUS devices, current therapeutic approaches, the existing challenges, and future research directions.
Humans ; Ultrasonic Therapy/methods* ; Musculoskeletal Diseases/therapy* ; Ultrasonic Waves ; Osteoarthritis/therapy* ; Muscle, Skeletal/injuries*

The extracellular matrix is an important component of articular cartilage,and in previous stud-ies it was more commonly recognized as a scaffolding structure supporting chondrocytes that provides protection from mechanical loading and elastic compression.As research continues to progress,a large body of literature sug-gests that the extracellular matrix is dynamic in nature.It degrades,deposits,and releases components in response to changes in its local microenvironment,which in turn dynamically regulates chondrocyte function and fate.There-fore,this review outlines the impact of matrix-chondrocyte interactions on chondrocyte behavior and joint homeosta-sis in osteoarthritis.It is hoped that the systematic elucidation of matrix-cell reciprocal relationships will provide new insights into the pathological mechanisms of osteoarthritis and the design and construction of cartilage tissue engineering.Specifically,we first summarize the typical molecular components that make up the extracellular matrix and the mechanical properties they confer in the matrix and the mechanotransduction functions they exert in chondrocytes.Next,we discuss the negative impact of chondrocytes on the synthesis and breakdown of matrix com-ponents during the osteoarthritic process in response to abnormal mechanical loading in the local microenvironment or disturbance by trauma.Finally,we focus on the impact of an abnormally remodeled extracellular matrix on chon-drocyte signaling and the pathological progression of osteoarthritis by mediating the generation of bioactive catabolic fragments,modulating cytokine release,and altering mechanical properties.

The extracellular matrix is an important component of articular cartilage,and in previous stud-ies it was more commonly recognized as a scaffolding structure supporting chondrocytes that provides protection from mechanical loading and elastic compression.As research continues to progress,a large body of literature sug-gests that the extracellular matrix is dynamic in nature.It degrades,deposits,and releases components in response to changes in its local microenvironment,which in turn dynamically regulates chondrocyte function and fate.There-fore,this review outlines the impact of matrix-chondrocyte interactions on chondrocyte behavior and joint homeosta-sis in osteoarthritis.It is hoped that the systematic elucidation of matrix-cell reciprocal relationships will provide new insights into the pathological mechanisms of osteoarthritis and the design and construction of cartilage tissue engineering.Specifically,we first summarize the typical molecular components that make up the extracellular matrix and the mechanical properties they confer in the matrix and the mechanotransduction functions they exert in chondrocytes.Next,we discuss the negative impact of chondrocytes on the synthesis and breakdown of matrix com-ponents during the osteoarthritic process in response to abnormal mechanical loading in the local microenvironment or disturbance by trauma.Finally,we focus on the impact of an abnormally remodeled extracellular matrix on chon-drocyte signaling and the pathological progression of osteoarthritis by mediating the generation of bioactive catabolic fragments,modulating cytokine release,and altering mechanical properties.

Objective: To evaluate the change of tooth root volume and length after rapid maxillary expansion by CBCT three dimensional reconstruction method. Methods: 33 patients underwent rapid maxillary expansion were examined by CBCT before and after treatment. The CBCT images of the first,second premolars and the first molars were segmented and reconstructed by Mimics image processing software for the analysis of the changes of root volume and length. All data were analyzed by SPSS software statistically. Results: After maxillary expansion,all root volumes were reduced(P ＜ 0. 05),more reduction was observed in anchorage teeth than in non-anchorage teeth(P ＜ 0. 05). The length of most teeth roots was not decreased(P＞ 0. 05) except the buccal and distal roots of the first molars(P ＜ 0. 05). Conclusion: Rapid maxillary expansion may result in root resorption and this resorption is mainly based on the volume decrease.

Objective:To evaluate the effects of maxillary protraction with or without rapid maxillary expansion in the treatment of Class Ⅲ malocclusion by Meta-Analysis.Methods:The randomized controlled trail,quasi-randomized controlled trail and the clinical controlled trail about the treatment of Class Ⅲ malocclusion by protraction with or without expansion were searched in the database of Cochrane Library,Embase,PubMed,Medline,CBM,Wan Fang,CNKI,VIP.2 authors qualified and extracted the data independently.Then the Meta-analysis was performed by using the RevMan 5.3 software.Results:7 studies with 228 cases were included,114 cases were treated by maxillary protraction with expansion and the other 114 cases by maxillary protraction without expansion.The Meta-analysis showed that:there was no significant difference in SNA,SNB,ANB and SN-PP except ANS-Me,U1-NA,SN-MP.A favorable improvement of the sagittal relationship between maxillary and mandibular was observed by using protraction whether with expansion or not.The expansion did not shorten the course of treatment,but it lowered the inclination of upper incisors,resulting in more clockwise rotation of mandibular plane and increase of the facial vertical dimension.Conclusion:Maxillary protraction with rapid maxillary expansion can be used in the treatment of class Ⅲ malocclusion with incisor labioclination.

Objective:To study the dental and skeletal changes after orthodontic treatment for malocclusion patients with rapid maxil-lary and mandibular expansion companied with fixed appliance.Methods:36 patients underwent the treatment with rapid maxillary and mandibular expansion companied with straight wire appliance.Pre-and post-treatment dental casts and lateral cephalometric radiographs were measured and compared.Results:After treatment,the maxillary and mandibular arch width perimeters increased(P <0.05).The anterior arch depths decreased(P <0.05).No significant differences were found in vertical skeletal variables(P >0.05).U1-SN and U1-NA decreased,L1-MP and L1-NB increased(P <0.05).Conclusion:Dental crowding can be solved effectively and occlusion re-lationship can be kept well with rapid maxillary and mandibular expansion companied with straight wire appliance without influence on the vertical skeletal relationship.

Objective:To investigate efficacy of modified expander in the treatment of non-extraction patients with Angel Ⅰ maloccul-sion.Methods:1 4 Angel Ⅰcases aged 1 0 -1 4 years treated by non-extraction and fixed rapid expander.Jaw bones of the cases were laser scanned before(T1 )and after treatment(T2).The differences of arch width and length between T1 and T2 were analyzed.The In-dex of treatment complexity,outcome and need(ICON)was used to assess the pre-treatment and post-treatment study models.Data were statistically analysed with SPSS1 3.0 software.Results:The arch width increased significantly from T1 to T2.Good occlusal rela-tionship and soft tissue profiles were achieved in all cases.All cases were evaluated as greatly improved by ICON.Conclusion:AngelⅠ malocclusion can be treated successfully by increasing arch width with fixed rapid expander technique without tooth extraction.

Objective To compare dental and skeletal changes after rapid maxillary expansion in patients with different bone ages.Methods Thirty-seven patients in different growth period were divided into three groups according to cervical vertebral maturation (CVM).There were 13 patients in the growth acceleration group,13 patients in growth peak group,and 11 patients in growth deceleration group.Conebeam computed tomography(CBCT) images were segmented and reconstructed using Mimics image processing software to assess the change of palatal morphology before and after treatment.Statistical analysis was carried out using SPSS 17.0 software.Results After the expansion the posterior teeth and alveolar bone were tilted and the mid-palatal suture was opened in all three groups.The first molar angle in the three groups decreased by 2.66°±1.04°,3.53°±0.81° and 12.32°± 1.64°,respectively and no significant difference was found between the acceleration group and the peak group (P ＞ 0.05),but the changes in the acceleration group and the peak groups were significantly less than that in the deceleration group (P＜0.05).The palatal angle in the three groups increased by 6.01°±2.06°,4.79°± 1.31° and 6.73°± 1.71°,respectively and no significant difference was found between the acceleration group and the deceleration group (P ＞ 0.05),but the changes in the acceleration group and the deceleration group were significantly greater than that in the peak group (P ＜ 0.05).The palatal cemento-enamel junction (CEJ) width,the middle palate width and the mid-palatal suture width in the three groups increased by (7.37± 1.31),(6.68± 0.72) and (5.13± 1.42) mm;(5.72±1.68),(4.82± 1.66) and (3.42± 1.15) mm;(3.14±0.45),(2.98±0.51) and (0.96±0.83) mm,respectively and no significant difference was found between the acceleration group and the peak group (P ＞ 0.05),but the changes in the acceleration group and the peak group were significantly greater than that in the deceleration group (P ＜ 0.05).Conclusions The mid-palatal suture could be opened in patients in different CVM period.More skeletal and less dental effects were found in patients in the growth acceleration and peek group than in those in the growth deceleration group and the inclination of the alveolar bone could be avoided to a greater degree in patients in the growth peek group.

Among several intraoral distalizing devices,the pendulum appliance is one of the most commonly used noncompliance appli-ances.It is widely used to correct Class Ⅱ molar relationship.More healthy teeth can be preserved with the using of pendulum appliance in the tooth extraction of borderline cases.The pendulum appliance was modified and used in clinic.Long-term observasion showed that the modified pendulum appliace is effective in orthodontic treatment.