BACKGROUND:Degenerative diseases caused by bone and muscle degeneration are major reasons for the decline in physical function and mobility,increased fragility fractures,and high mortality rates in the elderly,significantly affecting their health and quality of life.OBJECTIVE:To review the research progress in the mechanisms of muscle-bone interaction and the etiology,prevention,and treatment of related diseases.METHODS:CNKI,WanFang and PubMed databases were searched for relevant literature published from 2014 to 2024.The search terms were"muscle-bone crosstalk,musculoskeletal system,inter-tissue communication,myokines,osteokines,osteosarcopenia,sarcopenia,osteoporosis,bone regeneration,fibro-adipogenic progenitors"in Chinese and English.By reading the articles,we eliminated irrelevant,outdated,and poorly focused literature,and finally 94 articles were included for review.RESULTS AND CONCLUSION:Mechanical interaction,secretion factor interaction,and stem cell interaction between muscle and bone are crucial for the metabolism and regeneration regulation of the musculoskeletal system.Systemic interventions targeting biochemical signals of muscle factors(such as myostatin and irisin)and bone factors(such as nuclear factor-κB receptor-activating factor ligand and sclerostin)can improve the quality and function of skeletal muscle and bone,and have positive effects on fracture healing.In recent years,it has been found that related stem cells in the musculoskeletal system can interact,with the activation of muscle progenitor cells(such as fibro-adipogenic progenitors)having a significant impact on bone growth,repair,and regeneration.Research on the mechanisms of muscle-bone interaction can provide insights into the etiology,prevention,and treatment of related diseases.However,there are currently no effective clinical treatments for muscle-bone comorbidities,with most research still at the cellular and animal experiment stage.Therefore,extensive research is needed in the future to gradually move from experiments to clinical applications,developing more targeted therapies and drugs to better serve clinical needs.

BACKGROUND:At present,there is a main kind of operation,which is represented by the proximal femoral nail antirotation,to treat femoral intertrochanteric fractures,but some sequelae still occur such as internal fixation loosening,failure,and nail withdrawal.We designed a new femoral neck spiral blade system to solve this problem,so we analyze the mechanical structure by the finite element method that can be regard as the theoretical basis for the system.OBJECTIVE:To compare the mechanical properties of the new femoral neck spiral blade system and the proximal femoral nail antirotation in the treatment of femoral intertrochanteric fracture by the finite element method.METHODS:Based on the finite element model of the femur,the A1.2 and A2.2 femoral intertrochanteric fracture models were established according to the AO fracture classification principle of 2018 edition.The models were fixed with the proximal femoral nail antirotation and the new internal fixation system,applying an axial load of 700,1 400,and 2 100 N above the femoral head.The mechanical characteristics of the two internal fixation methods were respectively compared and analyzed by observing the maximum equivalent stress and the maximum deformation of each group.RESULTS AND CONCLUSION:(1)The maximum equivalent stress of the new internal fixation group under different compressive loads was smaller than that of the proximal femoral nail antirotation group.(2)In the A1.2 fracture model,under different compression loads,the deformation of the new internal fixation system was smaller than that of the proximal femoral nail antirotation group,and the average value of difference between the two was 1.113 mm;the result of the A2.2 type fracture model was the same as that in the A1.1 with an average value of difference of 2.017 mm between the two.(3)In the A1.2 fracture model,under different compressive loads,the maximum deformation of the spiral blade fixed by the new internal fixation system was smaller than that of the proximal femoral nail antirotation group,and the average value of difference between the two was 1.062 mm;the result of the A2.2 type fracture model was the same as that in the A1.1 with an average value of difference of 1.891 mm between the two.(4)The results indicate that the new femoral neck spiral blade system has a lower internal fixation stress value compared to the proximal femoral nail antirotation,and a smaller displacement value of the femur after fixation and internal fixation.It can more effectively fix fractures and prevent the spiral blade from retracting or cutting out in the femoral neck.

BACKGROUND:Degenerative diseases caused by bone and muscle degeneration are major reasons for the decline in physical function and mobility,increased fragility fractures,and high mortality rates in the elderly,significantly affecting their health and quality of life.OBJECTIVE:To review the research progress in the mechanisms of muscle-bone interaction and the etiology,prevention,and treatment of related diseases.METHODS:CNKI,WanFang and PubMed databases were searched for relevant literature published from 2014 to 2024.The search terms were"muscle-bone crosstalk,musculoskeletal system,inter-tissue communication,myokines,osteokines,osteosarcopenia,sarcopenia,osteoporosis,bone regeneration,fibro-adipogenic progenitors"in Chinese and English.By reading the articles,we eliminated irrelevant,outdated,and poorly focused literature,and finally 94 articles were included for review.RESULTS AND CONCLUSION:Mechanical interaction,secretion factor interaction,and stem cell interaction between muscle and bone are crucial for the metabolism and regeneration regulation of the musculoskeletal system.Systemic interventions targeting biochemical signals of muscle factors(such as myostatin and irisin)and bone factors(such as nuclear factor-κB receptor-activating factor ligand and sclerostin)can improve the quality and function of skeletal muscle and bone,and have positive effects on fracture healing.In recent years,it has been found that related stem cells in the musculoskeletal system can interact,with the activation of muscle progenitor cells(such as fibro-adipogenic progenitors)having a significant impact on bone growth,repair,and regeneration.Research on the mechanisms of muscle-bone interaction can provide insights into the etiology,prevention,and treatment of related diseases.However,there are currently no effective clinical treatments for muscle-bone comorbidities,with most research still at the cellular and animal experiment stage.Therefore,extensive research is needed in the future to gradually move from experiments to clinical applications,developing more targeted therapies and drugs to better serve clinical needs.

BACKGROUND:At present,there is a main kind of operation,which is represented by the proximal femoral nail antirotation,to treat femoral intertrochanteric fractures,but some sequelae still occur such as internal fixation loosening,failure,and nail withdrawal.We designed a new femoral neck spiral blade system to solve this problem,so we analyze the mechanical structure by the finite element method that can be regard as the theoretical basis for the system.OBJECTIVE:To compare the mechanical properties of the new femoral neck spiral blade system and the proximal femoral nail antirotation in the treatment of femoral intertrochanteric fracture by the finite element method.METHODS:Based on the finite element model of the femur,the A1.2 and A2.2 femoral intertrochanteric fracture models were established according to the AO fracture classification principle of 2018 edition.The models were fixed with the proximal femoral nail antirotation and the new internal fixation system,applying an axial load of 700,1 400,and 2 100 N above the femoral head.The mechanical characteristics of the two internal fixation methods were respectively compared and analyzed by observing the maximum equivalent stress and the maximum deformation of each group.RESULTS AND CONCLUSION:(1)The maximum equivalent stress of the new internal fixation group under different compressive loads was smaller than that of the proximal femoral nail antirotation group.(2)In the A1.2 fracture model,under different compression loads,the deformation of the new internal fixation system was smaller than that of the proximal femoral nail antirotation group,and the average value of difference between the two was 1.113 mm;the result of the A2.2 type fracture model was the same as that in the A1.1 with an average value of difference of 2.017 mm between the two.(3)In the A1.2 fracture model,under different compressive loads,the maximum deformation of the spiral blade fixed by the new internal fixation system was smaller than that of the proximal femoral nail antirotation group,and the average value of difference between the two was 1.062 mm;the result of the A2.2 type fracture model was the same as that in the A1.1 with an average value of difference of 1.891 mm between the two.(4)The results indicate that the new femoral neck spiral blade system has a lower internal fixation stress value compared to the proximal femoral nail antirotation,and a smaller displacement value of the femur after fixation and internal fixation.It can more effectively fix fractures and prevent the spiral blade from retracting or cutting out in the femoral neck.

The mortality rate of liver cancer patients in China is increasing constantly, which greatly threatens human health, and therefore, it is urgent to explore more effective treatment methods to prolong the survival time of patients. Because of its special physiological structure, the liver plays an immunoregulatory role, and thus immunotherapy for liver cancer gradually shows its clinical advantages and has become the fourth-generation therapy for liver cancer after surgical resection, chemotherapy, and radiotherapy. Adoptive cell transfer immunotherapy has been developed rapidly in the treatment of hepatocellular carcinoma (HCC) in recent years. CIK, NK, DC-CIK, TIL, and CAR-T cells are immune cells used for adoptive cell transfer immunotherapy. This article briefly summarizes the research advances in these immune cells in the treatment of HCC.

Objective: To further observe the efficacy of combined transplantation of islet and bone marrow mesenchymal stem cells (BMSC) in diabetic rats, PET-CT was used to trace cells in vivo to determine the homing and distribution of cells in vivo. Methods: Streptozotocin (STZ)was used to construct a rat model of diabetes mellitus. BMSC could be isolated and cultured by full adherence method; islets were isolated by collagenase; Islets and BMSC were labeled with 18F-FDG in vitro. Diabetic rats were randomly divided into 4 groups, 15 rats in each group: A, Control group; B, Stem cell transplantation group; C, Islet Transplantation group; D, Combined transplantation group, a total of four groups, all transplanted through portal vein, PET-CT tracing the distribution of cells transplanted into the body.7 days after transplantation, the livers of each group were taken, and the homing and distribution of transplanted cells were detected by immunofluorescent staining.The SUV was calculated by the analysis of variance of random block, and the difference between groups was compared by t-test. Results: PET-CT results showed that BMSC were mainly distributed uniformly in the right liver, and the islets of the pancreas were mainly clustered in terminal branches of hepatic portal vein, and BMSC were around the islets of pancreas, but there was no obvious development in the liver of the control group. Conclusions PET-CT can directly reveal the distribution of islets and BMSC in liver after transplantation through portal vein.

Objective To investigate the CT features of hepatic focal nodular hyperplasia (FNH) in children.Methods Thirteen patients with FNH,which was confirmed by postoperative pathology,were enrolled retrospectively.Plain and contrast CT were performed on all patients before operation.The CT imaging features of FNH including size,shape,density,style of contrast were analyzed retrospectively and compared with pathology.Results There were 13 patients with 16 lesions,8 lesions were found in the right lobe,5 lesions in the left lobe and 3 lesions involving both lobes.The tumor size ranged from 5.5 cm to 11.5 cm (media size 7.5 cm) in diameter.Histologically,2 cases were typical type,11 cases were atypical type.The lesions were regular morphology in 12 cases and 1 case with capsule.On plain CT,the lesions were isodensity (n=1) or slightly low-density (n=12).In 2 typical type lesions,there were slit-like,stellate-shaped low density central scars.Arterial phase demonstrated that 12 cases were significantly enhanced and 1 case showed mild enhancement.The central scar was not enhanced.In 12 cases,thickened and torturous arteries were seen.The enhancement was reduced at the portal venous phase in all the lesions,with 10 cases showing slightly higher density,2cases isodensity and 1 case low-density.Two cases showed mild enhancement of the central scar.The enhancement of the solid portion in all lesions decreased at the delay phase,with 12 cases showing isodensity and 1 case slightly low density.Two cases with central scar showed delayed enhancement with slightly higher density.Conclusion The CT features of FNH in children are diversified but distinctive which are related with postoperative pathological findings.Combining with clinical symptoms and CT features can be helpful for the early diagnosis of FNH in children.

OBJECTIVETo investigate whether transplantation of autologous peripheral blood CD34+ stem cells is a viable approach for treating patients with advanced cirrhosis,which is currently hindered by a shortage in liver donors.

METHODSA total of 100 patients with advanced cirrhosis and who had failed to respond to conservative therapy were recruited for transplantation of autologous peripheral blood CD34+ stem cells.The success of transplantation was investigated 6-and 12-months later by measuring markers of liver biosynthesis function (coagulation,albumin level,indocyanine green clearance,Child-Pugh score) and assessing pathological changes (Knodell score) and morphologic changes in the liver tissue.Complications were also recorded during follow-up.

RESULTSThe 1-year cumulative survival rate was 100%. Fifty-two patients with massive ascites showed gradual reduction and disappearance of the ascites.Four patients experienced upper gastrointestinal bleeding and three patients developed with hepatic encephalopathy (I-II degree) at 3 months post-transplantation.All patients showed significantly improved liver biosynthesis function,liver elasticity and Knodell score after transplantation (P less than 0.05).

CONCLUSIONAutologous peripheral blood CD34+ stem cell transplantation is a safe and effective treatment for advanced cirrhosis,and has high cost-benefit since it improves liver function,liver histology,and quality of life.

Objective To investigate the CT features of hepatic mesenchymal hamartoma (HMH)in children.Methods Nine patients with HMH confirmed by postoperative pathology were enrolled,including 4 were males and 5 were females.Their age ranged from 3 days to 9 years 5 months (the median age was 7 months).All patients admitted due to palpable abdominal mass without jaundice.All patients were examed by contrast-enhanced CT before the operation.Results All the 9 cases showed solitary hepatic mass,among which 6 were in the right lobe,2 were in the left lobe and 1 involved in both lobes.The tumor size ranged from 7.0 to 22.5 cm (mean size was 13.5 cm) in diameter.The CT manifestations of HMH was related to the proportion and distribution of component in the masses.The masses were cystic (n =1),cystic-solid mixed (n =6) and solid (n =3).After contrast administration,the solid component and the septa of the mass showed enhancement while cystic component was not enhanced.Calcification was seen inside the tumor in one case.Conclusions The CT features of HMH in children are multitudinous which are related to postoperative pathological findings.With the clinical history,it is easy to distinguish HMH from the other hepatic tumors.

ObjectiveTo compare the CT features of retroperitoneal ganglioneuroblastoma (GNB) and neuroblastoma (NB) in children,and summarize the differentiations between them.Methods From November 2007 to November 2011,19 patients with GNB and 21 patients with NB proven pathologically were enrolled in the study.The CT data of GNB and NB were analyzed retrospectively.These tumor parameters in CT included lesion location,size,shape,margin,calcification,across central line,style of contrast enhancement,degree of contrast enhancement,presence of small vessels in or around the tumor arranged in clumps or in line,tumor embolus,adjacent organs invasion or metastasis,lymph node metastasis,and relationship between tumor and surrounding great vessels.These parameters of both groups were compared by x2 and t test.ResultsIn GNB group,11 patients were located in adrenal gland and 8 patients in the retroperitoneal sympathetic chain; however,in NB group,18 patients were located in adrenal gland and 3 patients in the retroperitoneal sympathetic chain. The difference were statistical significances in the incidence rate of regular morphology,clear border,vessel encased by tumor,vessels displaced,presence of small vessels in /around the tumor arranged in clumps or in line,adjacent organs invasion or viscera metastasis,lymph node metastasis between NB (6/21,7/21,14/21,7/21,11/21,10/21,and 11/21,respectively) and GNB ( 12/19,13/19,6/19,13/19,4/19,3/19 and 4/19,respectively) ( P ＜ 0.05 ).However,there was no statistical significance in size,calcification,across central line,contrast enhancement type,contrast enhancement degree between them ( P ＞ 0.05 ).ConclusionsNB are more likely located at adrenal gland and presented a higher incidence rate of presence of small vessels in or around the tumor which arranged in clumps or in line,vessel encased by tumor,adjacent organs invasion or metastasis and lymph node metastasis.Regular morphology,clear border and vessels displaced are more frequently observed in GNB.