BACKGROUND:Gradient artificial bone repair scaffolds can mimic unique anatomical features in musculoskeletal tissues,showing great potential for repairing injured musculoskeletal tissues. OBJECTIVE:To review the latest research advances in gradient artificial bone repair scaffolds for tissue engineering in the musculoskeletal system and describe their advantages and fabrication strategies. METHODS:The first author of the article searched the Web of Science and PubMed databases for articles published from 2000 to 2023 with search terms"gradient,bone regeneration,scaffold".Finally,76 papers were analyzed and summarized after the screening. RESULTS AND CONCLUSION:(1)As an important means of efficient and high-quality repair of skeletal system tissues,gradient artificial bone repair scaffolds are currently designed bionically for the natural gradient characteristics of bone tissue,bone-cartilage,and tendon-bone tissue.These scaffolds can mimic the extracellular matrix of native tissues to a certain extent in terms of structure and composition,thus promoting cell adhesion,migration,proliferation,differentiation,and regenerative recovery of damaged tissues to their native state.(2)Advanced manufacturing technology provides more possibilities for gradient artificial bone repair scaffold preparation:Gradient electrospun fiber scaffolds constructed by spatially differentiated fiber arrangement and loading of biologically active substances have been developed;gradient 3D printed scaffolds fabricated by layered stacking,graded porosity,and bio-3D printing technology;gradient hydrogel scaffolds fabricated by in-situ layered injections,simple layer-by-layer stacking,and freeze-drying method;and in addition,there are also scaffolds made by other modalities or multi-method coupling.These scaffolds have demonstrated good biocompatibility in vitro experiments,were able to accelerate tissue regeneration in small animal tests,and were observed to have significantly improved histological structure.(3)The currently developed gradient artificial bone repair scaffolds have problems such as mismatch of gradient scales,unclear material-tissue interactions,and side effects caused by degradation products,which need to be further optimized by combining the strengths of related disciplines and clinical needs in the future.

Objective A high sodium(HS)diet is believed to affect bone metabolism processes.Clarifying its impact on osseointegration of titanium(Ti)implants holds significant implications for postoperative dietary management of implanted patients. Methods This investigation probed the impact of sodium ions(Na+)on neovascularization and osteogenesis around Ti implants in vivo,utilizing micro-computed tomography,hematoxylin and eosin staining,and immunohistochemical analyses.Concurrently,in vitro experiments assessed the effects of varied Na+concentrations and exposure durations on human umbilical vein endothelial cells(HUVECs)and MC3T3-E1 cells. Results In vivo,increased dietary sodium(0.8%-6.0%)led to a substantial decline in CD34 positive HUVECs and new bone formation around Ti implants,alongside an increase in inflammatory cells.In vitro,an increase in Na+concentration(140-150 mmol/L)adversely affected the proliferation,angiogenesis,and migration of HUVECs,especially with prolonged exposure.While MC3T3-E1 cells initially exhibited less susceptibility to high Na+concentrations compared to HUVECs during short-term exposure,prolonged exposure to a HS environment progressively diminished their proliferation,differentiation,and osteogenic capabilities. Conclusion These findings suggest that HS diet had a negative effect on the early osseointegration of Ti implants by interfering with the process of postoperative vascularized bone regeneration.

ObjectiveTo explore the imbalance of paravertebral muscle group for patients with unilateral lumbar disc herniation. MethodsFrom January, 2022 to January, 2023, 30 patients with unilateral lumbar disc herniation (observation group) and 30 healthy people matching in general data (control group) were measured the tension and stiffness of multifidus and erector spinae with MyotonPRO, while the observation group was assessed with Visual Analogue Scale (VAS) for pain and Japanese Orthopaedic Association (JOA) score, and the time of disease was also recorded. ResultsThe mean of bilateral tension and hardness of multifidus and erector spinae was more in the observation group than in the control group (|t| > 5.407, P < 0.001), and the tension and hardness of multifidus and erector spinae of the affected side were more than those of the unaffected side in the observation group (|t| > 11.219, P < 0.001). The tension and hardness of multifidus and erector spinae of the affected side were positively correlated with VAS score (r > 0.942, P < 0.001), and negatively correlated with JOA score (|r| > 0.886, P < 0.001). ConclusionThe tension and hardness of multifidus and erector spinae of the affected side increase after unilateral lumbar disc herniation, resulting in asymmetry.

ObjectiveTo evaluate the inter-rater and test-retest reliability of echo intensity of ultrasound image for quality of quadriceps femoris in patients with knee osteoarthritis (KOA). MethodsFrom March to December, 2021, 33 patients with unilateral KOA in Guangdong Provincial Second Hospital of Traditional Chinese Medicine were included. Ultrasound was used to observe the cross sections of rectus femoris (RF), vastus medialis (VM) and vastus lateralis (VL), and the images were saved. Two independent raters analyzed the average gray value of the picture with the Image J. One of the raters repeated the measurement. The intra-class correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change (MDC) and coefficient of variation (CV) were calculated and the Bland-Altman charts were drawn. ResultsThe gray value was higher in the RF, VM and VL in the affected side than in the healthy side (t > 2.262, P < 0.05). The inter-rater reliability was excellent, with ICC 0.982 to 0.995, SEM 1.60 to 3.82, CV 1.49% to 5.90%, and MDC value 4.43 to 10.59. The test-retest reliability of the rater was excellent, with ICC 0.969 to 0.990, SEM 2.37 to 5.41, CV 2.22% to 4.84%, and MDC value 6.57 to 15.00. Bland-Altman charts analysis showed that the consistency was good. ConclusionThe quadriceps femoris muscle quality is different between the affected and the healthy sides in patients with unilateral KOA. It is reliable to evaluate muscle echo intensity by Image J.

ObjectiveTo test the inter-tester reliability and test-retest reliability of MyotonPRO for evaluating neck and shoulder muscle performance parameters in patients with unilateral chronic neck pain, observe the difference of muscle performance between the healthy and affected sides of patients with chronic neck pain, and analyze the factors that cause the imbalance of muscle performance in patients with chronic neck pain. MethodsFrom January to June, 2023, 32 patients with unilateral chronic neck pain in Guangdong Second Traditional Chinese Medicine Hospital were selected. Two testers used the same MyotonPRO equipment to measure the muscle tone, muscle hardness and muscle elasticity on both sides of the sternocleidomastoid muscle and the upper trapezius muscle in the relaxed position. Tester 1 repeated the measurement after an interval of 30 minutes, and Tester 2 was measured within the time interval between the two measurements of Tester 1. The intraclass correlation coefficient (ICC), standard error of mean (SEM) and minimum detectable change (MDC) were calculated simultaneously. The measurement results were plotted into Bland-Altman diagram and systematic bias analysis was performed. The difference in muscle characteristics between the affected side and the healthy side was compared. At the same time, the Visual Analogue Scale (VAS) score and body mass index (BMI) of the subjects were collected for correlation analysis. ResultsExcept the sternocleidomastoid muscle elasticity of the affected side (ICC = 0.697), the inter-tester reliability of all other parameters was high to very high (ICC = 0.719 to 0.952, SEM = 0.04 to 6.53, MDC = 0.12 to 18.11). The test-retest reliability of all parameters was high (ICC = 0.883 to 0.981, SEM = 0.03 to 5.72, MDC = 0.09 to 15.84). Bland-Altman plot analysis showed that the scatter distribution was consistent. The muscle tone, muscle hardness and muscle elasticity of sternocleidomastoid muscle and upper trapezius muscle were higher on the affected side than on the healthy side (t > 2.846, P < 0.05). The asymmetry index of tension, hardness and elasticity of upper trapezius muscle and sternocleidomastoid muscle was significantly positively correlated with VAS score and BMI (r > 0.385, P < 0.05). ConclusionMyotonPRO has good inter-tester reliability and retest reliability in evaluating the muscle performance of both sides of patients with chronic neck pain. The muscle tone, muscle hardness and muscle elasticity of sternocleidomastoid muscle and upper trapezius muscle on the affected side were higher than on the healthy side, and the difference of muscle performance was positively correlated with pain and BMI.

Objective:To explore the effect of combining repetitive transcranial magnetic stimulation (rTMS) with treadmill training in treating spinal cord injury (SCI).Methods:Fifty female Sprague-Dawley rats were randomly divided into a sham-operation (C) group, an SCI group, a treadmill training (TT) group, a treadmill training followed by rTMS (TR) group and an rTMS followed by treadmill training (RT) group. The C group only underwent laminectomy without spinal cord injury, while the model of T9 incomplete spinal cord injury was established in the other groups using the Louisville Injury System Apparatus impactor. One week after the operation the TT began. The TR group received rTMS immediately after the treadmill training and the RT group received it before. The treadmill′s speed started at 3.6m/min and gradually increased to 6m/min within 1 week. There was one 15min session a day, 5 days a week, for 8 weeks in total. The rTMS intensity was 30% of the maximum output intensity at 10Hz in 5s bursts with an interval of 25s. It lasted 10min, for a total of 1000 pulses. Hind limb motor functioning was evaluated using the Basso, Beattie & Bresnahan (BBB) locomotor rating scale and a grid walking test. The H max/M max ratio was used to quantify the excitability of the motor neurons. Immunohistochemistry was employed to detect the expression of 5-hydroxytryptamine (5-HT), 5-hydroxytryptamine 1A receptor (5-HT 1AR) and 5-hydroxytryptamine 2A receptor (5-HT 2AR). Results:The average BBB scores of the RT group were significantly higher than the SCI group′s averages from the 7th to 9th week after the injury. At the ninth week the average BBB score of the RT group was significantly higher than the TT group′s average. At the eighth and ninth week the average BBB scores of the TR group were significantly higher than in the SCI group. The number of drops in the RT group was significantly lower than in the SCI group at the seventh and ninth week. At the ninth week, the number of drops of the TR group was significantly lower compared with the SCI group. The H max/M max ratio of the SCI group was significantly higher than in the C and TR groups at the fifth and ninth week, while that of the TR group was significantly lower than the SCI group′s ratio at the ninth week. The expression of 5-HT, 5-HT 1AR and 5-HT 2AR in the RT and TR groups was significantly higher than in the SCI group, and the relative 5-HT 1AR density of the RT and TR groups was significantly higher than in the SCI and TT groups. Compared with the other 4 groups, the expression of 5-HT 2AR in the SCI group had increased significantly. Conclusions:Combining rTMS with treadmill training can significantly promote the recovery of locomotor function after incomplete spinal cord injury.

Objective:To learn about the employment situation of community-dwelling spinal cord injury (SCI ) survivors in Jiangsu Province and the factors which influence it, aiming to put forward suggestions which can help them return to work.Methods:This cross-sectional observational study was based on a International Spinal Cord Injury (InSCI) community survey in Jiangsu Province using a questionnaire (InSCI questionnaire) devloped with the International Classification of Functioning, Disability and Health as the framework. Data were collected using the InSCI questionnaire. Data on sociodemographics, diseases, body functions, activities and participation, environmental factors, general health, well-being and so on were collected. Descriptive statistics were computed to analyze the respondents′ employment-related information. Correlation analysis and multiple linear regression were used to analyze factors influencing the employment of these community-dwelling SCI survivors.Results:From January to December of 2018, 726 completed questionnaires were collected-541 through telephone interviews, 152 via Internet links and 33 via face-to-face interviews. Logistic regression showed that residential patterns (odds ratio, OR=0.472), whether there was someone to take care of them at home or going out ( OR=0.405), age at the onset of injury ( OR=0.949), personal factors ( OR=1.068), activity and participation ( OR=1.034), and environmental factors ( OR=1.043) all influenced the respondents′ engaging in paid work. Conclusion:The employment rate of patients with spinal cord injury living in the community is low (22.8%). Comprehensive rehabilitation programs and adequate family and social support should be implemented to help them return to work.

Objective: To evaluate the feasibility of CT angiography of pediatric complex congenital heart disease by using low radiation dose and low isotonic contrast agent dose combined with iDose⁴ iterative reconstruction technique. Methods: Prospectively, a total of 57 continuous patients with suspected congenital heart disease under or equal to 2 years old in our hospital between Mar 2016 and Jan 2017 were divided into 2 groups according to the reservation number. " double low" group included 32 patients using 80 kVp, 80 mAs, Iodixanol (270 mg I/ml) and iDose⁴ - 4iterative reconstruction algorithm; routine group included 25 patients using 100 kVp, 100 mAs, Iopromide (370 mg I/ml) and filtered back projection algorithm. Individualized injections were taken on the weight of children and the iodine intake was calculated. CT values of left atrium, left ventricle, right atrium, right ventricle, ascending and descending aorta at the level of tracheal bifurcation, midpoint of aortic arch, pulmonary trunk, left and right pulmonary artery, pectoralis major and erector spinae on both sides as well as background noise at the level of aortic arch were measured, and signal to noise ratios (SNR) and contrast to noise ratios (CNR) were calculated. The quality of all images was evaluated subjectively. Scan length (L), volume CT dose index (CTDI_vol) and dose-length-product (DLP) were recorded, and the effective dose (E) and size-specific dose estimate (SSDE) were calculated. The diagnostic coincidence rates for CTA examinations of these two groups were calculated and compared with the surgery or cardiac catheterization examination called the " gold standard" . Results: The iodine intake of " double low" group and routine group was (2.53±1.09) and (3.46±1.29)g, respectively, with statistically significant difference (t=2.976, P<0.05). No statistically significant difference existed in CT value of heart cavities, large blood vessels or CT value of muscles, background noise, SNR, CNR at the level of aortic arch or subjective evaluation for image quality between the two groups (P>0.05). The consistency of subjective evaluation for image quality of the two groups was good(Kappa=0.55, 0.76). Compared with routine group, CTDI_vol, SSDE, DLP, E of double low group descended by 57.19%, 56.71%, 56.74%, 53.33% respectively (t=54.107, 28.269, 15.338, 11.441, P<0.05). The diagnostic coincidence rates of the two groups were 96.6% and 97.1% respectively (P>0.05). Conclusions: Using 80 kVp, 80 mAs and Iodixanol (270 mg I/ml) combined with iDose⁴ iterative reconstruction technique for CT angiography of pediatric complex congenital heart disease, the image quality could meet the requirements for clinical diagnosis, and the radiation dose and the iodine dose of contrast agent could be lowered. Trial registration Chinese clinical trial registry, ChiCTR1800016576.

OBJECTIVEWe measured and analyzed the angle between the longitudinal axis of incisor crown and tooth to provide a reference for orthodontists for selecting orthodontic methods and evaluating treatment results.

METHODSA total of 120 participants were included according to the criteria of Andrews' six keys, and cephalometric radiograph under the instructions of modified natural head position acquirement method was performed. The angles of maxillary incisor crown longitudinal axis, tooth longitudinal axis, occlusion plane (OP), and true vertical (TV) plane were measured, as well as mandibular incisors.

RESULTSAs for maxillary incisors, the angle between crown longitudinal axis and TV plane, OP, and tooth longitudinal axis were 11.72°±4.71°, 73.29°±5.69°, and 20.04°±3.71°, respectively. For mandibular incisors, the angle between crown longitudinal axis and TV plane, OP, and tooth longitudinal axis were 16.03°±5.40°, 81.76°±4.81°, and 14.82°±4.01°, respectively. For the maxillary incisor, the angles between crown longitudinal axis and tooth longitudinal axis were mainly within 15° to 25°, whereas those for mandibular incisors were within 10° to 20°.

CONCLUSIONSThe longitudinal axis inclinations of the maxillary and mandibular incisor crown and of the incisor tooth need to be considered when cephalometric radiographs are used for treatment planning or for evaluating the treatment result.

Objective To investigate the constituents and analgesic and anti‐inflammatory effects of leaves essential oil in Schef fleraoctophylla .Methods SOLEO was dilated by water vapor .The mouse acetic acid‐induced twisting test and mouse auricle swelling test induced by xylene were employed to evaluate the anti‐ inflammation and analgesia effects of SOLEO . Results 55 constituents of SOLEO were identified by GC‐MS .The major constituents ,4‐terpenol ,(‐)‐spthulenol ,caryo‐phllene oxide andβ‐linalool with total percent of 51 .86% were found .The twisting number and relieve swollen auricle of mice induced by xylene were significantly reduced by SOLEO .Conclusion SOLEO was the major active components of anti‐inflam‐mation and analgesia .