BACKGROUND:In recent years,it has been found that physical interventions play a significant role in influencing proliferation,differentiation,and migration of bone marrow mesenchymal stem cells.However,the current physical intervention still exists such as basic research data to be strengthened,unified parameter standards need to be further improved and other shortcomings.OBJECTIVE:To review the effects of physical interventions on the differentiation of bone marrow mesenchymal stem cells.METHODS:PubMed and CNKI databases were searched for relevant articles using"bone marrow mesenchymal stem cells(BMSC),bone marrow stromal cells,osteogenesis differentiation,chondrocytes differentiation,electrical stimulation,mechanical stimulation,hypoxia,electromagnetic fields,low intensity pulsed ultrasound"as English and Chinese search terms.A total of 58 articles were selected for review.RESULTS AND CONCLUSION:(1)Physical interventions have been applied to regulate the proliferation and differentiation of bone marrow mesenchymal stem cells by altering specific microenvironments,but the parameters have not yet been unified.The future investigation should further optimize and explore the best parameters and conditions of action of the relevant physical factors on the role of bone marrow mesenchymal stem cell proliferation and differentiation.(2)It is difficult to carry out the application of certain special physical environmental conditions through low-cost conventional means,pending subsequent research and development to further reduce the difficulty of constructing special physical conditions.(3)The use of physical factors to rationally intervene in differentiation and proliferation of bone marrow mesenchymal stem cells has not yet been widely applied in the clinic,and further research is needed to promote clinical translation in the future.

Objective To evaluate the clinical efficacy of robot-assisted navigation with percutaneous lag screw treatment for Hangman's fracture.Methods We retrospectively analyzed the clinical data of 5 patients treated with robot-assisted C2 percutaneous lag screw for Hangman's fracture in our hospital from September 2021 to August 2023.Patients were positioned with moderate head-neck flexion in a Mayfield head clamp.After closed reduction with manual traction under general anesthesia,the C2 percutaneous lag screws were implanted under TINAVI orthopedic surgical robot assistance.Postoperative cervical CT scans were used to assess screw placement accuracy and fracture healing quality.Clinical efficacy was evaluated by the Odom grading system.Results All the 5 patients were operated successfully without vertebral artery injury or neurological complications.A total of 10 screws were implanted.According to the Gertzbein-Robbins standard,9 screws belonged to the grade A,and 1 belonged to the grade B,with an accuracy of 90％(9/10)and an excellent rate of 100％(10/10).The neck incision length ranged 20-30 mm(mean,27 mm).The operation time was 86-160 min(mean,112.8 min).The intraoperative blood loss was 10-50 ml(mean,30 ml).The postoperative hospitalization was5-18 d(mean,8 d).The patients were followed up for 12-34 months(mean,23.6 months).All fractures healed without screw breakage or loosening.According to the Odom grading,4 cases were excellent,and 1 case was good.Conclusion Robot-assisted navigation C2 percutaneous lag screw treatment for Hangman's fracture is accurate and minimally invasive,safe and effective.

BACKGROUND:In recent years,it has been found that physical interventions play a significant role in influencing proliferation,differentiation,and migration of bone marrow mesenchymal stem cells.However,the current physical intervention still exists such as basic research data to be strengthened,unified parameter standards need to be further improved and other shortcomings.OBJECTIVE:To review the effects of physical interventions on the differentiation of bone marrow mesenchymal stem cells.METHODS:PubMed and CNKI databases were searched for relevant articles using"bone marrow mesenchymal stem cells(BMSC),bone marrow stromal cells,osteogenesis differentiation,chondrocytes differentiation,electrical stimulation,mechanical stimulation,hypoxia,electromagnetic fields,low intensity pulsed ultrasound"as English and Chinese search terms.A total of 58 articles were selected for review.RESULTS AND CONCLUSION:(1)Physical interventions have been applied to regulate the proliferation and differentiation of bone marrow mesenchymal stem cells by altering specific microenvironments,but the parameters have not yet been unified.The future investigation should further optimize and explore the best parameters and conditions of action of the relevant physical factors on the role of bone marrow mesenchymal stem cell proliferation and differentiation.(2)It is difficult to carry out the application of certain special physical environmental conditions through low-cost conventional means,pending subsequent research and development to further reduce the difficulty of constructing special physical conditions.(3)The use of physical factors to rationally intervene in differentiation and proliferation of bone marrow mesenchymal stem cells has not yet been widely applied in the clinic,and further research is needed to promote clinical translation in the future.

Objective To evaluate the clinical efficacy of robot-assisted navigation with percutaneous lag screw treatment for Hangman's fracture.Methods We retrospectively analyzed the clinical data of 5 patients treated with robot-assisted C2 percutaneous lag screw for Hangman's fracture in our hospital from September 2021 to August 2023.Patients were positioned with moderate head-neck flexion in a Mayfield head clamp.After closed reduction with manual traction under general anesthesia,the C2 percutaneous lag screws were implanted under TINAVI orthopedic surgical robot assistance.Postoperative cervical CT scans were used to assess screw placement accuracy and fracture healing quality.Clinical efficacy was evaluated by the Odom grading system.Results All the 5 patients were operated successfully without vertebral artery injury or neurological complications.A total of 10 screws were implanted.According to the Gertzbein-Robbins standard,9 screws belonged to the grade A,and 1 belonged to the grade B,with an accuracy of 90％(9/10)and an excellent rate of 100％(10/10).The neck incision length ranged 20-30 mm(mean,27 mm).The operation time was 86-160 min(mean,112.8 min).The intraoperative blood loss was 10-50 ml(mean,30 ml).The postoperative hospitalization was5-18 d(mean,8 d).The patients were followed up for 12-34 months(mean,23.6 months).All fractures healed without screw breakage or loosening.According to the Odom grading,4 cases were excellent,and 1 case was good.Conclusion Robot-assisted navigation C2 percutaneous lag screw treatment for Hangman's fracture is accurate and minimally invasive,safe and effective.

Objective To summarize the diagnosis and treatment experience of surgical site infection(SSI)after percutaneous endoscopic lumbar discectomy(PELD).Methods A retrospective analysis was made on 11 cases of postoperative SSI after PELD from January 2016 to December 2022.After PELD surgery,severe lower back or lower limb pain occurred in all the patients,with a Visual Analog Scale(VAS)score of 7-9(average,8.1).The erythrocyte sedimentation rate(ESR)was 17-114 mm/h(average,54.4 mm/h),and the level of C-reactive protein(CRP)was 8-151 mg/L(average,56.5 mg/L).The MRI showed changes of inflammatory signals in the intervertebral space of the surgical area.The SSI was diagnosed at 2-17 d(average,9.5 d)after PELD surgery.All the cases were treated with antibiotics(4 cases with empiric antibiotic therapy and 7 cases with sensitive antibiotic treatment),8 of which underwent combined surgery,including percutaneous endoscopic lesion removal,catheter irrigation and drainage in 4 cases,posterior lesion removal in 2 cases,and posterior lesion removal combined with internal fixation in 2 cases.Results The patients were followed up for 14-75 months(average,36.8 months).According to the modified MacNab criteria,5 cases were excellent,4 cases were good,and 2 cases were fair.Conclusions SSI after PELD is characterized by acute onset,recurrent severe lower back or lower limb pain,elevated inflammatory markers,and characteristic imaging features.Standardized antibiotic treatment combined with surgery can achieve good therapeutic effects.

In recent years， with the changes of population structure and the aggravation of aging， the prevalence of osteoporosis is increasing year by year. Osteoporosis poses great impacts on the body and family life of the patients and increases the burden on the society. Therefore， the research on osteoporosis is urgent and significant. The imbalance between osteoblasts， osteocytes， and osteoclasts causes abnormal bone metabolism， which destroys the fine structure of bone and increases bone fragility， thus increasing the risk of fracture. Although the pathogenesis of osteoporosis is complex， researchers have confirmed that the imbalance of the endocrine system directly or indirectly promotes the occurrence and development of osteoporosis. Traditional Chinese medicine （TCM） is a treasure of Chinese traditional culture and plays a key role in safeguarding the public health. With unique therapeutic effects and advantages， TCM has been widely accepted. Chinese medicines， moxibustion， acupuncture and other TCM therapies have play a unique role in the treatment of osteoporosis. Particularly， TCM prevention and treatment of osteoporosis by regulating the endocrine system has received extensive attention. By reviewing relevant literature， this paper introduces the research progress in the TCM modulation of bone metabolism and alleviation of bone loss by regulating estrogen， calcitonin， and parathyroid hormone in the endocrine system and affecting the hypothalamus capable of regulating these hormones， aiming to provide ideas for the TCM treatment of osteoporosis.

With the aging of population， osteoporosis has become one of the main diseases endangering the health of the elderly in China. Therefore， the research on osteoporosis has become a hot spot. Since Chinese medicines demonstrate significant therapeutic effects on osteoporosis， this issue is attracting increasing attention from researchers， especially in the deciphering of the molecular mechanism. This paper introduces the mechanism of the prevention and treatment of osteoporosis by Chinese medicines via the mitogen-activated protein kinase （MAPK） signaling pathway， aiming to provide a theoretical basis for deciphering the mechanism of Chinese medicines in the treatment of osteoporosis and promoting their clinical application. MAPK signaling pathway mainly involves p38 MAPK， extracellular signal-regulated kinase 1/2 （ERK1/2）， c-Jun N-terminal kinase （JNK）， and extracellular signal-regulated kinase 5 （ERK5）. Studies have shown that these proteins play a role in the progression of osteoporosis by regulating cell proliferation， differentiation， and apoptosis. Chinese medicines as a unique therapy with Chinese characteristics has definite efficacy， high safety， and mild side effects. Researchers have proved by experiments that the extracts or compounds of Chinese medicines can significantly mitigate osteoporosis by regulating the proteins involved in the MAPK signaling pathway. Therefore， this article reviews the relevant studies with focus on these proteins.

Objective To investigate the developmental characteristics of static visual acuity (SVA) and kinetic visual acuity (KVA) and the correlation between the for children. Methods From April to June, 2018, SVA and KVA of 715 children aged 6 to 10 years in Suzhou were tested with logarithmic visual chart and KVA meter. Results KVA and SVA increased with age within 6 to 9 years old, and decreased then. KVA was higher in boys than in girls (t = 4.604, P < 0.001), but not significantly different for SVA (t = 1.822, P > 0.05). There was a moderate positive correlation between KVA and SVA (r = 0.552, P < 0.01). KVA can predicted SVA (B = 0.617, P < 0.001). Conclusion KVA and SVA develop for children aged 6 to 9, and moderately positive correlate with each other. It means SVA may be improved via training of KVA.