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Objective: To investigate the effects of acupotomy on skeletal muscle fibrosis and collagen deposition in a rabbit knee osteoarthritis (KOA) model. Methods: Rabbits (n = 18) were randomly divided into control, KOA, and KOA + acupotomy (Apo) groups (n = 6). The rabbits in the KOA and Apo groups were modeled using the modified Videman's method for 6 weeks. After modeling, the Apo group was subjected to acupotomy once a week for 3 weeks on the vastus medialis, vastus lateralis, rectus femoris, biceps femoris, and anserine bursa tendons around the knee. The behavior of all animals was recorded, rectus femoris tissue was obtained, and histomorphological changes were observed using Masson staining and transmission electron microscopy. The expression of transforming growth factor-β1 (TGF-β1), Smad 3, Smad 7, fibrillar collagen types I (Col-I) and III (Col-III) was detected using Western blot and real-time polymerase chain reaction (RT-PCR). Results: Histological analysis revealed that acupotomy improved the microstructure and reduced the collagen volume fraction of rectus femoris, compared with the KOA group (P = .034). Acupotomy inhibited abnormal collagen deposition by modulating the expression of fibrosis-related proteins and mRNA, thus preventing skeletal muscle fibrosis. Western blot and RT-PCR analysis revealed that in the Apo group, Col-I, and Col-III protein levels were significantly lower than those in the KOA group (both P

Abstract Background To analyze the economic benefits of paliperidone palmitate in the treatment of schizophrenia. Methods We collected 546 patients who met the diagnostic criteria for schizophrenia according to the 《International Statistical Classification of Diseases and Related Health Problems,10th》(ICD-10). We gathered general population data such as gender, age, marital status, and education level, then initiated treatment with paliperidone palmitate. Then Follow-up evaluations were conducted at 1, 3, 6, 9, and 12 months after the start of treatment to assess clinical efficacy, adverse reactions, and injection doses. We also collected information on the economic burden before and after 12 months of treatment, as well as the number of outpatient visits and hospitalizations in the past year to analyze economic benefits. Results The baseline patients totaled 546, with 239 still receiving treatment with paliperidone palmitate 12 months later. After 12 months of treatment, the number of outpatient visits per year increased compared to before (4 (2,10) vs. 12 (4,12), Z=-5.949, P 0.05); the indirect costs of patients after 12 months of treatment (lost productivity costs for patients and families, economic costs due to destructive behavior, costs of seeking non-medical assistance) decreased compared to before (300(150,600) vs. 150(100,200), P

Abstract Advances in flexible electronics are driving the development of ferroelectric thin‐film capacitors toward flexibility and high energy storage performance. In the present work, the synergistic combination of mechanical bending and defect dipole engineering is demonstrated to significantly enhance the energy storage performance of freestanding ferroelectric thin films, achieved through the generation of a narrower and right‐shifted polarization‐electric field hysteresis loop. The recoverable energy storage density of freestanding PbZr0.52Ti0.48O3 thin films increases from 99.7 J cm−3 in the strain (defect) ‐free state to 349.6 J cm−3, marking a significant increase of 251%. The collective impact of the flexoelectric field, bending tensile strain, and defect dipoles contributes to this enhancement. The demonstrated synergistic optimization strategy has potential applicability to flexible ferroelectric thin film systems. Moreover, the energy storage properties of flexible ferroelectric thin films can be further fine‐tuned by adjusting bending angles and defect dipole concentrations, offering a versatile platform for control and performance optimization.

Introduction Mild cognitive impairment (MCI) is an intermediate phase between normal cognitive ageing and dementia and poses a serious threat to public health worldwide; however, it might be reversible, representing the best opportunity for secondary prevention against serious cognitive impairment. As a non-pharmacological intervention for those patients, interventions that combine physical exercise and cognitive training, whether delivered simultaneously or sequentially, may have superior effects on various cognitive domains, including global cognition, memory, executive function and attention. The supportive evidence remains incomplete. This study aims to assess the effectiveness of a combined exercise and cognitive intervention in Chinese older adults with mild cognitive impairment (COGITO), empowered by digital therapy and guided by the Health Action Process Model and the Theory of Planned Behaviour (HAPA-TPB theory) in a home-based setting.Methods and analysis This study is a randomised controlled, assessor-blinded multi-centre study. Four parallel groups will include a total of 160 patients, receiving either a combined exercise and cognitive intervention, an isolated exercise intervention, an isolated cognitive intervention or only health education. These interventions will be conducted at least twice a week for 50 min each session, over 3 months. All interventions will be delivered at home and remotely monitored through RehabApp and Mini-programme, along with an arm-worn heart rate telemetry device. Specifically, supervisors will receive participants’ real-time training diaries, heart rates or other online monitoring data and then provide weekly telephone calls and monthly home visits to encourage participants to complete their tasks and address any difficulties based on their training information. Eligible participants are community-dwelling patients with no regular exercise habit and diagnosed with MCI. The primary outcome is cognitive function assessed by the Alzheimer’s Disease Assessment Scale-Cognitive (ADAS-Cog) and Community Screening Instrument for Dementia (CSI-D), with baseline and three follow-up assessments. Secondary outcomes include quality of life, physical fitness, sleep quality, intrinsic capacity, frailty, social support, adherence, cost-effectiveness and cost-benefit.Ethics and dissemination The study was approved by the Institutional Review Board of Peking University. Research findings will be presented to stakeholders and published in peer-reviewed journals and at provincial, national and international conferences.Trial registration number ChiCTR2300073900.

Abstract Gastric cancer (GC), notorious for its poor prognosis, often advances to peritoneal dissemination, a crucial determinant of detrimental outcomes. This study intricately explores the role of the TGFβ-Smad-LIF axis within the tumor microenvironment in propagating peritoneal metastasis, with a specific emphasis on its molecular mechanism in instigating Neutrophil Extracellular Traps (NETs) formation and encouraging GC cellular functions. Through a blend of bioinformatics analyses, utilizing TCGA and GEO databases, and meticulous in vivo and in vitro experiments, LIF was identified as pivotally associated with GC metastasis, notably, enhancing the NETs formation through neutrophil stimulation. Mechanistically, TGF-β was substantiated to elevate LIF expression via the activation of the Smad2/3 complex, culminating in NETs formation and consequently, propelling peritoneal metastasis of GC. This revelation uncovers a novel potential therapeutic target, promising a new avenue in managing GC and mitigating its metastatic propensities.

BackgroundThe existing literature reveals several significant knowledge gaps that hinder health care providers in formulating exercise prescriptions for cognitive health. ObjectiveThis study endeavors to elucidate the relationship between the level of physical activity and cognitive function in older adults in China. Moreover, it seeks to explore the associations between distinct exercise behaviors—such as exercise types, the purpose motivating engagement in exercise, the accessibility of exercise fields, and the inclination toward exercise—and cognitive function. MethodsUsing data from the China Longitudinal Aging Social Survey (CLASS conducted in 2016, cognitive function was meticulously assessed through the modified Chinese version of the Mini-Mental State Examination, encompassing measures of orientation, memory, and calculation. Using self-report structured questionnaires, a myriad of information about physical activity during leisure time, exercise engagement, exercise intensity, primary exercise types, reasons for exercise participation, availability of sports facilities, and exercise willingness was diligently gathered. Robust ordinary least squares regression models were then used to compute coefficients along with 95% CIs. ResultsA discernible inverted U-shaped trend in cognitive scores emerged as the level of physical activity surpassed the threshold of 500 metabolic equivalents of task (MET) minutes per week. Notably, individuals with a physical activity level between 500 and 999 MET minutes per week exhibited a coefficient of 0.31 (95% CI 0.09 to 0.54), those with a physical activity level between 1000 and 1499 MET minutes per week displayed a coefficient of 0.75 (95% CI 0.52 to 0.97), and those with a physical activity level above 1500 MET minutes per week demonstrated a coefficient of 0.45 (95% CI 0.23 to 0.68). Older individuals engaging in exercise at specific MET levels showcased superior cognitive function compared to their inactive counterparts. Furthermore, individuals driven by exercise motivations aimed at enhancing physical fitness and health, as well as those using sports facilities or public spaces for exercise, exhibited notably higher cognitive function scores. ConclusionsThe findings underscore the potential of exercise as a targeted intervention for the prevention and treatment of dementia or cognitive decline associated with aging in older individuals. Leveraging these insights to formulate informed exercise recommendations holds promise in addressing a significant public health challenge linked to aging populations.

Abstract Topology created by quasi-continuous spatial variations of a local polarization direction represents an exotic state of matter, but field-driven manipulation has been hitherto limited to creation and destruction. Here we report that relatively small electric or mechanical fields can drive the non-volatile rotation of polar spirals in discretized microregions of the relaxor ferroelectric polymer poly(vinylidene fluoride-ran-trifluoroethylene). These polar spirals arise from the asymmetric Coulomb interaction between vertically aligned helical polymer chains, and can be rotated in-plane through various angles with robust retention. Given also that our manipulation of topological order can be detected via infrared absorption, our work suggests a new direction for the application of complex materials.

From the late Carboniferous to the early Permian, multiple pulses of glaciation and deglaciation have been caused by the LPIA. The Pennsylvanian period experienced phases of recovery, proliferation, and decline, ultimately forming a reef system distinctly different from that of the Mississippian period. During the late Bashkirian to Moscovian, the metazoan reef experienced a limited resurgence, with reef predominantly formed by chaetetid developing in the United States, northern China, and Japan. During the Kasimovian to Gzhelian, the phylloid algal reef dominated the global reef systems. In the late Pennsylvanian, bioconstruction cases and paleoenvironmental proxies in southern Guizhou Province were studied to investigate the composition, recovery, and evolutionary processes of the bioconstructions as well as their response to environmental variations during this period. Several bioconstructions have been reported in the Lumazhai section of Houchang Town, Guizhou Province, southern China, from the Moscovian to the Gzhelian. The upper Carboniferous strata are well-preserved and continuously exposed. The continuous strata, abundant fossils, and diverse bioconstructions provide excellent research materials for exploring the mutual constraints between organisms and their environment. This study identified ten microfacies, whose vertical evolution indicated significant changes in the depositional environment related to relative sea-level fluctuations. Skeletal grains are widely present in these facies. Among them, foraminifera, algae, bryozoans, crinoids, and Tubiphytes are the most common and exhibit distinct distribution characteristics in various environments. Quantitative statistics, CCA and theoretical ecospace have been utilized to examine and interpret environmental impact factors. Quantitative analysis of their relative abundance and distribution patterns provides insights into the complex interactions between organisms and environmental factors. The relative abundances of different organisms and factors controlling their bioconstructions are influenced by relative sea-level changes. CCA analysis reveal that hydrodynamic conditions are the primary influencing factor. Variation trends in average tiering and motility reveal the characteristics of biological communities during environmental changes in phylloid algae and microbial bioconstructions. These bioconstructions are not directly correlated with changes in environmental factors, and the biological communities in phylloid algae mounds and biostromes exhibit similar organism compositions and ecological niches across different environments.

Lygus pratensis (Linnaeus) is an important agricultural pest with a strong ability to move and spread between hosts. However, L. pratensis’ flight potential and factors affecting its flight ability are unclear. We used the insect flight information system (flight mill) to determine the effects of temperature, humidity, age, sex, and mating on L. pratensis’ flight ability in an artificial climate chamber. Temperature and relative humidity significantly affected L. pratensis’ flight ability; however, low and high temperature, as well as low humidity, were unsuitable, and the optimal flight environment was 20–28 °C and 60–75% RH. Lygus pratensis’ flying ability initially increased and then decreased with age and was highest at 10 days old (flight rate: 71.43%; total flight distance: 18.63 ± 1.89 km; total flight time: 6.84 ± 0.60 h). At 15 days old, flight speed was the highest (3.36 ± 0.18 km h−1). Sex had little effect on L. pratensis’ flying ability; it was marginally stronger for females than males, but the difference was insignificant. Mating increased female flying ability but decreased that of males, but the difference was insignificant. Overall, L. pratensis had strong flight dispersal ability, was largely unaffected by sex and mating, and optimal flight conditions were mild temperature and humidity. This knowledge provides a scientific basis for L. pratensis outbreak prediction, prevention, and control.

Abstract Solomon rings, upholding the symbol of wisdom with profound historical roots, were widely used as decorations in ancient architecture and clothing. However, it was only recently discovered that such topological structures can be formed by self-organization in biological/chemical molecules, liquid crystals, etc. Here, we report the observation of polar Solomon rings in a ferroelectric nanocrystal, which consist of two intertwined vortices and are mathematically equivalent to a $${4}_{1}^{2}$$ 4 1 2 link in topology. By combining piezoresponse force microscopy observations and phase-field simulations, we demonstrate the reversible switching between polar Solomon rings and vertex textures by an electric field. The two types of topological polar textures exhibit distinct absorption of terahertz infrared waves, which can be exploited in infrared displays with a nanoscale resolution. Our study establishes, both experimentally and computationally, the existence and electrical manipulation of polar Solomon rings, a new form of topological polar structures that may provide a simple way for fast, robust, and high-resolution optoelectronic devices.

Objective: To investigate whether acupotomy could inhibit subchondral bone remodeling in knee osteoarthritis (KOA) rabbits by regulating the activity of osteoblasts and osteoclasts. Methods: KOA rabbits were prepared by immobilization for 6 and 9 weeks by Videman method. Nine groups of rabbits (control, 6 weeks and 9 weeks model, 6 weeks and 9 weeks acupotomy, 6 weeks and 9 weeks electroacupuncture, and 6 weeks and 9 weeks drug groups) received acupotomy, electroacupuncture and risedronate sodium intervention, respectively, for 3 weeks. Results: Acupotomy can inhibit the activity of osteoclasts and osteoblasts in subchondral bone by reducing the proteins expression of cathepsin K (CK) and tartrate-resistant acid phosphatase (TRAP) and decreasing the proteins expression of osteocalcin (OCN) and alkaline phosphatase (ALP), to intercept the abnormal bone resorption and bone formation of subchondral bone in 6-week and 9-week immobilization-induced KOA rabbits. Conclusion: These findings indicated that acupotomy may be more advantageous than risedronate sodium intervention in modulating subchondral bone remodeling in KOA rabbits, especially in 9-week immobilization-induced KOA rabbits.

Abstract Wrinkled ferroelectric polymer films with out‐of‐plane deformation exhibit exotic strain fields that differ from those of conventional epitaxial film systems, offering a new path toward manipulating electrical and mechanical behaviors in ferroelectrics. However, the direct observation of the domain structure evolution in ferroelectric polymer films during continuous deformation is challenging with current experimental approaches. In this study, the strain‐induced evolution of toroidal domain structures in organic poly(vinylidene fluoride‐ran‐trifluoroethylene) (P(VDF‐TrFE)) films with concentric toroidal wrinkle patterns is comprehensively investigated using phase‐field simulations. The results reveal morphology‐ and thickness‐dependent toroidal polar topology in wrinkled P(VDF‐TrFE) films. External strain loading can modulate this ferroelectric domain, which exhibits robust coupling behavior with a mixed strain field of periodic tensile and compressive strains. It is demonstrated that toroidal wrinkled ferroelectric films provide an effective and unique flexible platform for continuously controllable strain engineering in ferroelectrics and a theoretical framework with potential applications in flexible electronic devices.

Freestanding perovskite oxides pave the way to novel flexural properties. Here, the authors observe the nanoscale strain gradient induced flexoelectric polarization with an unusual flexo-expansion/shrinkage effect in freestanding ferroelectric oxide.

Integrating ferroelectric perovskite oxides on Si is highly desired for electronic applications but challenging. Here, the authors show emergent in-plane ferroelectricity and promising nonvolatile memories based on resistive domain wall in BaTiO3/Si.

Abstract Cancer cell-derived extracellular vesicles (EVs) have extensive application in the formation of their environment, including metastasis. This study explored the ability of gastric cancer (GC) cell-derived EVs-mediated microRNA-129-5p/E2F transcription factor 7/mitogen-activated protein kinase/extracellular regulated protein kinase (miR-129-5p/E2F7/MAPK/ERK) axis to affect the peritoneal metastasis of GC by delivering lncRNA small nucleolar RNA host gene 12 (SNHG12). EV-derived lncRNA and SNHG12/miR-129-5p/E2F7 network were determined by bioinformatics analysis. The regulatory relationship among SNHG12, miR-129-5p, and E2F7 was verified using a combination of dual-luciferase reporter gene, RNA immunoprecipitation, and RNA pull-down assays. The SNHG12, miR-129-5p, and E2F7 expression was measured by RT-qPCR. After GC cell-derived EVs were isolated and co-cultured with human peritoneal mesothelial cells (HPMCs), the uptake of EVs by HPMCs was observed under laser scanning confocal microscopy. Cell viability and apoptosis were examined using cell counting kit-8 and flow cytometry, respectively. Western blot analysis was performed to measure the mesothelial–mesenchymal transition (MMT)-related protein expression. The pathological and morphological characteristics of metastatic tumors in nude mice were observed by hematoxylin–eosin staining. A high SNHG12 expression was correlated with the poor prognosis of patients with GC. GC-derived EVs led to increased HPMC apoptosis and MMT by transferring SNHG12, whereas the knockdown of SNHG12 annulled the aforementioned results. SNHG12 sponged miR-129-5p to boost E2F7 expression and activate the MAPK/ERK signaling, thus inducing HPMC apoptosis and MMT. In vivo experiments further verified that EVs derived from GC cells promoted peritoneal metastasis in nude mice. GC cell-derived EVs elevated the E2F7 expression and activated the MAPK/ERK signaling to promote peritoneal metastasis through the delivery of SNHG12.

The removal of antibiotics from wastewater to prevent their environmental accumulation is significant for human health and ecosystems. Herein, iron (Fe)-atom-doped anatase TiO2 nanofibers (Fe-TNs) were manufactured for the photocatalytic Fenton-like decomposition of tylosin (TYL) under LED illumination. Compared with the pristine TiO2 nanofibers (TNs), the optimized Fe-TNs exhibited improved visible-light-driven photocatalytic Fenton-like activity with a TYL degradation efficiency of 98.5% within 4 h. The effective TYL degradation could be attributed to the expanded optical light absorption and accelerated separation and migration of photogenerated electrons and holes after the introduction of Fe. The photogenerated electrons were highly conducive to the generation of active SO4•− radicals as they facilitated Fe(III)/Fe(II) cycles, and to oxidizing TYL. Moreover, the holes could be involved in TYL degradation. Thus, a significant enhancement in TYL degradation could be achieved. This research verifies the use of iron-doped anatase nanofibers as an effective method to synthesize novel photocatalytic Fenton-like catalysts through surface engineering for wastewater remediation.

PurposeWe designed a J-shaped external fixator (J-EF) to provide a minimally invasive, one-step surgical method for olecranon fractures. The aim of this study is to retrospectively review the method and the outcomes in 14 patients treated with J-EF fixation.MethodsBiomechanical comparative study was performed to test the tensile properties of the J-EF using a universal testing machine. Between January 2002 and December 2005, 14 patients (age range: 25–67 years) with Mayo type II olecranon fractures were treated using the external fixation technique. Follow-up was done by standard measures (radiography, range of motion, and complications monitoring) and patient-reported outcomes (Mayo Elbow Performance Score [MEPS] and Disabilities of the Arm, Shoulder, and Hand [DASH] scores) 6 months after surgery. Eight of the patients were reviewed 15 years after the surgery.ResultsResults from biomechanical studies indicate the non-inferiority of J-EF to tension-band wiring (TBW) in tensile properties. At the time of release, the mean elbow flexion arc was 132.5° and the mean forearm rotation arc was 173.6°. The mean DASH score was 14.1 points, and the mean MEPS was 93.9 points. Operative time and intraoperative blood loss were decreased by 41.3% and 64.6%, respectively, in J-EF patients than those in a comparable group treated by TBW. All eight patients are still alive after the surgery and maintaining the original outcome.ConclusionsExternal fixation using the J-EF could be considered as an alternative treatment for Mayo type II olecranon fractures as it appears to be a reliable, minimally invasive, and time-saving.Level of EvidenceTherapeutic Level IV.

A series of novel chromophores A, B, C, and D, based on the julolidinyl donor and the tricyanofuran (TCF) and CF3-tricyanofuran (CF3-Ph-TCF) acceptors, have been synthesized and systematically investigated. The 3,5-bis(trifluoromethyl)benzene derivative isolation group was introduced into the bridge in the chromophores C and D. These nonlinear optical chromophores showed good thermal stability, and their decomposition temperatures were all above 220 °C. Density functional theory (DFT) was used to calculate the energy gaps and first-order hyperpolarizability (β). The macroscopic electro-optic (EO) activity was measured using a simple reflection method. The highest EO coefficient of poled films containing 35 wt% of chromophore D doped in amorphous polycarbonate afforded values of 54 pm/V at 1310 nm. The results indicate that the 3,5-bis(trifluoromethyl)benzene isolation group can suppress the dipole–dipole interaction of chromophores. The moderate r33 value, good thermal stability, and good yield of chromophores suggest their potential use in the nonlinear optical area.

Examining the ecology quality of the Pan-Third Pole region has implications for global environmental change and sustainable development. However, spatio-temporal evolution of ecological quality in this region is still lacking. In this study, 65 countries of the Pan-Third Pole region were selected. A comprehensive evaluation index system of ecological quality was constructed using a dataset containing remote sensing, ecological environment and socio-economic data to spatially quantify the ecological quality, as well as its change from 2000 to 2020. The results displayed that the average ecological quality of the Pan-Third Pole region was at a moderate level of 0.53. Spatially, the excellent ecological quality regions were mainly concentrated in East Asian countries, while the severe quality regions were located in the Middle East. From 2000–2020, areas with improved ecological changes accounted for 38.48% of the total area, and 10.66% of the total area experienced a decline; specifically, European countries had a large proportion of improved ecological quality areas, while East Asian countries had a significantly larger proportion of declining ecological quality areas. We also found that ecosystem changes and human activities had an influence on ecological quality in the Pan-Third Pole region. This study provides an important empirical study on ecosystem services in the region.

The Qinghai–Tibet Plateau has seen decades of changes in land use/cover as a result of urbanization and regional planning policy. Research on the efficiency of social development aids in the pursuit of social and environmental sustainability. Based on CLUD and socioeconomic statistical data, this study systematically analyses the spatiotemporal evolution characteristics of urban land use in the Qinghai–Tibet Plateau and evaluates its social development efficiency from three perspectives—the holistic, the municipal, and urban hierarchy—by using indicators such as the Moran index, land use efficiency, and urban expansion speed and proportion. Results show that the urbanization rate climbed from 21.26% to 54.95%, and the area of urban lands increased from 201.93 km2 to 796.59 km2 from 1990 to 2020, with urban lands expanding from the Lanzhou–Xining City Area to the central and south of the Qinghai–Tibet Plateau. The holistic urban land use efficiency grew from 1.14 to 1.53, while the UPD decreased slightly from 1.44 to 1.31, and the UED increased steadily from 1.40 to 12.97 per decade. Moreover, we should pay attention to the rational allocation of land in human, social and ecosystem terms to comprehensively improve the quality of urbanization across the plateau.

Objective: To investigate the effect of acupotomy, on mitophagy and the Pink1-Parkin pathway in chondrocytes from rabbits with knee osteoarthritis (KOA)., Methods: A KOA model was established via the modified Videman method. Rabbits were randomly divided into a control group (CON), KOA group and KOA + acupotomy group (Acu). Rabbits in the acupotomy group were subjected to acupotomy for 4 weeks after model establishment. The behavior of the rabbits before and after intervention was recorded. Cartilage degeneration was evaluated by optical microscopy and fluorescence microscopy. The level of mitophagy was evaluated by transmission electron microscopy, immunofluorescence and enzyme-linked immunosorbent assay (ELISA). The expression of phosphatase and tensin homolog (PTEN)-induced kinase 1 (Pink1)-Parkin mitophagy pathway components was evaluated by immunofluorescence, Western blotting and real-time polymerase chain reaction., Results: In rabbits with KOA, joint pain, mobility disorders and cartilage degeneration were observed, the Mankin score was increased, collagen type Ⅱ (Col-Ⅱ) expression was significantly decreased, mitophagy was inhibited, mitochondrial function was impaired, and factors associated with the Pink1-Parkin pathway were inhibited. Acupotomy regulated the expression of Pink1-Parkin pathway-related proteins, the mitophagy-related protein microtubule-associated protein-1 light chain-3, the translocase of the outer membrane, and the inner mitochondrial membrane 23; increased the colocalization of mitochondria and autophagosomes; promoted the removal of damaged mitochondria; restored mitochondrial adenosine-triphosphate (ATP) production; and alleviated cartilage degeneration in rabbits with KOA., Conclusions: Acupotomy played a role in alleviating KOA in rabbits by activating mitophagy in chondrocytes via the regulation of proteins that are related to the Pink1-Parkin pathway.

Background and Aim: Hypoxia of the cartilage has been considered as a potential pathogenic factor in knee osteoarthritis (KOA). Studies have shown that impaired blood perfusion of joint leads to cartilage hypoxia. Electroacupuncture (EA) has proven effects on pain relief and improving microcirculation. This study aimed to explore the effect of EA on articular microcirculation and cartilage anoxic and the underlying mechanisms., Procedures: Videman's method was used for 6 weeks to establish the KOA model. EA intervention was performed in four points around the knee for 3 weeks after KOA modeling. The Lequesne MG score was used to assess ethology. We recorded the oxygen tension of synovial fluid and the synovial microcirculation in vivo. HE-staining was used to assess cartilage morphology, and immunohistochemistry (IHC), Western blotting, and RT-PCR were used to assess expression of the major glycolytic enzymes glucosetransporter1 (GLUT1), pyruvate kinase M2(PKM2), and lactate dehydrogenase A (LDHA). Enzyme-linked immunosorbent assay (Elisa) was used to detect lactate content., Results and Conclusion: There was a significant decrease in Lequesne MG score and improvement in Mankin score after EA intervention (P < 0.01), a significant increase in synovial microcirculation (P < 0.05) and synovial fluid oxygen tension (P < 0.01), and there was significant decrease in the expression of GLUT1, PKM2 and LDHA (P < 0.01) and lactate (P < 0.05). This study suggested that EA ameliorate cartilage hypoxia and regulate glycolytic metabolism in chondrocytes in KOA model rabbits by improving articular microcirculation and oxygen tension., Competing Interests: The authors report that they have no commercial or associative interest that represents a conflict of interest in connection with the work submitted., (© 2024 Center for Food and Biomolecules, National Taiwan University. Production and hosting by Elsevier Taiwan LLC.)

Knee osteoarthritis (KOA) is one of the most frequently encountered diseases in the orthopedic department, which seriously reduces the quality of life of people with KOA. Among several pathogenic factors, the biomechanical imbalance of the knee joint is one of the main causes of KOA. Acupotomology believes that restoring the mechanical balance of the knee joint is the key to treating KOA. Clinical studies have shown that acupotomy can effectively reduce pain and improve knee mobility by reducing adhesion, contracture of soft tissues, and stress concentration points in muscles and tendons around the knee joint. In this protocol, we used the modified Videman method to establish a KOA model by immobilizing the left hindlimb in a straight position. We have outlined the method of operation and the precautions related to acupotomy in detail and evaluated the efficacy of acupotomy in conjunction with the theory of "Modulating Muscles and Tendons to Treat Bone Disorders" through the detection of the mechanical properties of quadriceps femoris and tendon, as well as cartilage mechanics and morphology. The results show that acupotomy has a protective effect on cartilage by adjusting the mechanical properties of the soft tissues around the knee joint, improving the cartilage stress environment, and delaying cartilage degeneration.

Objective: To investigate the effects of acupotomy on the subchondral bone absorption and mechanical properties in rabbits with knee osteoarthritis (KOA)., Methods: The rabbits were divided into blank control, model, acupotomy and electroacupuncture (EA) groups, with 12 rabbits in each. Modified Videman's method was used to prepare KOA model. The acupotomy and EA group were given indicated intervention for 3 weeks. The behavior of rabbits in each group was recorded. Subsequently, cartilage-subchondral bone units were obtained and morphological changes were observed by optical microscope and micro computed tomography. Compression test was used to detect the mechanical properties of subchondral bone, Western blot and real-time polymerase chain reaction (RT-PCR) were applied to detect the expression of bone morphogenetic protein 2-Smad1 (BMP2-Smad1) pathway in subchondral bone., Results: Compared with the control group, rabbits in the KOA group showed lameness, knee pain, and cartilage degradation; the subchondral bone showed active resorption, the mechanical properties decreased significantly and the BMP2-Smad1 pathway downregulated significantly. Both acupotomy and EA intervention could increase the thickness of trabecular bone (Tb. Th), the bone volume fraction (BV/TV) and the thickness of subchondral bone plate, reduce the separation of trabecular bone (Tb. Sp), improve the maximum load and elastic modulus of subchondral bone, and effectively delay cartilage degeneration in KOA rabbits. This process may be achieved through upregulation the related proteins of BMP2-Smad1 pathway. The maximum load and elastic modulus of subchondral bone in the acupotomy group were slightly better than those in the EA group., Conclusions: Acupotomy could effectively protect cartilage by inhibiting abnormal bone resorption and improving mechanical properties of subchondral bone thorough the related proteins of BMP2-Smad1 pathway in KOA rabbits.

Objective: To investigate the effects of acupotomy on inhibiting abnormal formation of subchondral bone in rabbits with knee osteoarthritis (KOA)., Methods: A total of 24 New Zealand rabbits were randomly divided into four groups of 6 rabbits each [control, model, electroacupuncture (EA) and acupotomy]. Eighteen KOA model rabbits were established using a modified Videman method. Rabbits in EA and acupotomy groups received the intervention for 3 weeks. Then, the cartilage and subchondral bone unit were obtained and the histomorphological changes were recorded. Osteo-protegerin (OPG) and receptor activator of nuclear factor-κB ligand (RANKL) in subchondral bone were evaluated by Western blotting, real-time polymerase chain reaction and immunohistochemistry., Results: Compared with the model group, both the acupotomy and EA groups showed a significant decrease in the Lequesne index (both 0.01) and Mankin score ( 0.01, < 0.05). In addition, both EA and acupotomy groups had a higher expression of total articular cartilage (TAC) ( 0.05, < 0.01) and lower expression of articular calcified cartilage (ACC)/TAC ( 0.05, < 0.05) compared with the model group. The thickness of the subchondral bone plate in EA and acupotomy groups were decreased (both 0.01) compared to the model group. Moreover, trabecular bone volume (BV/TV), protein and relative expression of OPG and the ratio of OPG/RANKL in the subchondral bone of acupotomy group were decreased statistically significant, while these parameters were not significantly changed in the EA group compared with the model group., Conclusions: In the rabbit model of KOA, acupotomy inhibits aberrant formation of subchondral bone by suppressing OPG/RANKL ratio as a potential therapy for KOA.