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Abstract Background Bone defects and nonunion following initial treatment remain significant clinical challenges. The Ilizarov method constitutes a fundamental approach for addressing bone defects, and its integration with adjunctive techniques, such as the accordion maneuver, antibiotic spacers, or internal fixation, has become increasingly widespread. Despite this, limited research exists on the clinical outcomes specifically related to the use of the Ilizarov method combined with the accordion technique for treating long bone defects in the lower limbs. Objective This study seeks to systematically review the application of the Ilizarov method in combination with the accordion technique for addressing long bone deficiencies in the lower limbs. Study Design Systematic review; Level of evidence, 4. Methods A systematic review was performed in alignment with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), involving searches of Medline, Embase, Web of Science, and the Cochrane Library, with the search process concluding on August 20, 2024. The study population consisted of patients with bone defects who underwent treatment using the Ilizarov method in conjunction with the accordion technique. The methodological quality of the included studies was evaluated using the MINORS (Methodological Index for Non-Randomized Studies) scoring system. This study recorded and analyzed the participant count for each study that met the inclusion criteria, along with the number of patients who achieved bone healing, the bone and functional outcomes, and complications such as pin infections, pain, and refracture. Results Drawing from eight studies involving 80 patients with bone defects treated through the Ilizarov method combined with the accordion technique, this systematic review evaluated the method’s impact on bone regeneration. Of these patients, 24% presented with femoral defects, while 76% had tibial defects. The mean patient age was 32.8 years, with an average follow-up of 25.2 months. The accordion technique involved daily distraction and compression adjustments ranging from 0.25 to 1 mm, typically in more than two cycles, effectively promoting bone healing. The bone healing rate was high, with the majority of patients rated as having excellent or good functional recovery, according to standards such as ASAMI and Paley. Common complications included superficial pin tract infections (33.75%) and deep pin tract infections (6.25%), both of which were generally manageable with routine treatment. The accordion technique showed promising results in shortening healing time and enhancing the quality of bone healing. Conclusion This systematic review demonstrates that despite variations in parameter settings across studies, the Ilizarov method combined with the accordion technique consistently shows strong efficacy and safety in promoting bone regeneration and functional recovery. While some complications may arise, they are generally well-managed with standard care. This approach represents a reliable option for complex bone reconstruction, with future research needed to optimize parameters and further enhance clinical outcomes.

Abstract Purpose This study aimed to evaluate the clinical and radiological outcomes of modified suture-bridge technique fixation for anterior cruciate ligament (ACL) tibial avulsion fracture. Method Minors who underwent arthroscopic reduction and modified suture bridge fixation of ACL tibial avulsion fracture between January 2018 and January 2022 were retrospectively analyzed. Postoperative MRI and X-ray examinations were performed to evaluate the presence of epiphyseal plate injury and fracture healing. Moreover, KT-1000 side-to-side difference, Lachman test, range of motion (ROM), the subjective Knee score of the International Knee Documentation Committee (IKDC), Lysholm Knee score, and Tegner activity grade score were evaluated preoperatively and at the minimum 1-year follow-up visit. Results A total of 16 participants met the inclusion criteria. They had a mean age of 12.6 years (range, 9–16 years); mean time to surgery, 6.9 days (range, 2–13 days) and had a minimum of 12 months clinical follow-up (mean, 25.4 months; range, 12–36 months) after surgery. Postoperative radiographs and MRI showed no injury to the epiphyseal plate, optimal reduction immediately after the operation, and bone union within three months in all patients. All of the following showed significant improvements (pre- vs. postoperatively): mean KT-1000 side-to-side difference (8.6 vs. 1.5; p

The study examined the impact of adding cattle manure to the composting process of Agaricus bisporus mushroom substrate on compost humification. A control group CK comprised entirely of Agaricus bisporus mushroom substrate, while the experimental group CD (70 percent Agaricus bisporus mushroom substrate and 30 percent cattle manure) comprised the two composting treatments that were established. The study determined that the addition of cow dung has promoted the formation of humus components. Particularly, humic substance (HS-C) and humic acid (HA) increased by 41.3 and 74.7%, respectively, and the ratio of humic acid to fulvic acid (HA/FA) also increased by 2.78. It showed that the addition of cow dung accelerated the synthesis and decomposition of precursors, such as polysaccharides, polyphenols, and reducing sugars. Thereby promoting the formation of humic acid. Network analysis revealed that adding cow dung promoted microbial interactions increased the complexity and stability of the bacterial and fungal symbiotic network, enhanced cooperation and reciprocity among microbes, and assisted in transforming fulvic acid (FA) components. Structural equation modeling (SEM) is a multivariate data analysis method for analyzing complex relationships among constructs and core indicators. SEM illustrated that introducing cattle manure into the composting process resulted in alterations to the correlation between physicochemical parameters and the microbial community, in addition to humus formation. Polysaccharides are the primary precursors for polymerization to form HA, which is an essential prerequisite for the conversion of fulvic acid to humic acid. Additionally, microbes affected the formation of humus, with bacteria substantially more influential than fungi. These findings provide new ideas for regulating the degree of humification in the composting process and have important practical implications for optimizing mushroom cultivation and composting techniques today.

Objective: Investigation of the trait improvement impact of royal jelly enzymatic products (royal jelly peptides) on Alzheimer's disease (AD) model zebrafishes. Methods: 150 wild-type AB strain zebrafishes (4 days after fertilization, 4 dpf) were randomly divided into normal group, model control group, donepezil hydrochloride positive control group (3.33 μg/mL), royal jelly enzymatic digest lyophilized powder-1 group (LPR-1, 1000 μg/mL) and royal jelly enzymatic digest lyophilized powder-2 group (LPR-2, 1000 μg/mL), and these groups were added in 6-well plates, respectively. The volume of each well was 3 mL, and 30 tails of zebrafishes were employed in each group. Except for the normal group, zebrafishes in other groups were treated with aluminum chloride hexahydrate (180 μmol/L) to establish AD models. The efficacy of recovery of motor dysfunction, improvement of responsiveness, inhibition of acetylcholinesterase (AchE) and inhibition of apoptosis were evaluated for each experimental group after treated with corresponding drugs simultaneously for 24 h. The relative expressions of TNF-α, caspase-3 and BDNF genes were also calculated and their effects on related genes were analyzed. Results: Compared to the model control group, the LPR-1 and LPR-2 administration groups zebrafishes showed prolonged total locomotor distance (highly significant, P

Abstract Pulmonary arterial hypertension‐targeted therapies in portopulmonary hypertension (PoPH) are scarce, let alone for patients with chronic liver failure (CLF) and hepatopulmonary syndrome (HPS). A 48‐year male was admitted to the hospital because of cirrhosis for 18 years, systemic oedema, and chest distress after exercise for 1 week. He was diagnosed with CLF, PoPH, and HPS. After 7 weeks of macitentan treatment, the patient's activity tolerance, pulmonary artery systolic pressure, arterial partial pressure of oxygen (PaO2), cTNI, and NT‐proBNP changes indicated gradual recovery, without hepatic safety concerns. This case indicated that administering macitentan in patients diagnosed as PoPH (with CLF and HPS) may be efficient and safe enough in a clinical setting.

BackgroundThe two geriatric diseases, sarcopenia and cardiovascular disease (CVD), often coexist, yet the causal relationship is unclear. However, few studies focus on the effect of muscle mass on CVD. This comprehensive study is dedicated to unearthing the potential connection between sarcopenia-related traits and CVD at the genetic level.MethodA two-sample bi-directional Mendelian randomization (MR) study was conducted. In the first stage, we performed MR analysis regarding coronary heart disease (CHD), stroke, and myocardial infarction (MI) as exposure factors to reveal their effect on appendicular lean mass (ALM) and hand grip strength. In the second stage, we reverse the position of exposures and outcomes. The inverse variance weighted (IVW) method was used as the primary approach to reveal the potential causation between the exposure and outcome.ResultsThe results of the IVW method revealed a negative causal effect of ALM on CHD (OR = 0.848, 95% CI = 0.804 to 0.894, p = 8.200E-10), stroke (OR = 0.931, 95% CI = 0.890 to 0.975, p = 2.220E-03), and MI (OR = 0.810, 95% CI = 0.694 to 0.901, p = 1.266E-13). Additionally, the left-hand grip strength is a significant protective factor for CHD (OR = 0.737, 95% CI = 0.601 to 0.904, p = 3.353E-03) and MI (OR = 0.631, 95% CI = 0.515 to 0.765, p = 2.575E-06), but is not causally linked to the stroke (OR = 0.971, 95% CI =0.829 to 1.139, p = 0.720). Meanwhile, the same conclusion about the effect of right-hand grip strength on CHD (OR = 0.681, 95% CI = 0.558 to 0.832, p = 1.702E-05), MI (OR = 0.634, 95% CI = 0.518 to 0.776, p = 9.069E-06), and stroke (OR = 1.041, 95% CI = 0.896 to 1.209, p = 0.604) was obtained. However, no significant causal effect of CVD (CHD, stroke, MI) on sarcopenia-related traits (ALM, handgrip strength) was found.ConclusionThere is a unidirectional causal relationship between sarcopenia and CVD. The loss of muscle mass and strength has a significant causal role in promoting the occurrence and development of CVD, providing a reference for the prevention and treatment of comorbidities in older people.

Abstract Studies on 3D-printed porous bone scaffolds mostly focus on materials or structural parameters, while the repair of large femoral defects needs to select appropriate structural parameters according to the needs of different parts. In this paper, a kind of stiffness gradient scaffold design idea is proposed. Different structures are selected according to the different functions of different parts of the scaffold. At the same time, an integrated fixation device is designed to fix the scaffold. Finite element method was used to analyze the stress and strain of homogeneous scaffolds and the stiffness gradient scaffolds, and the relative displacement and stress between stiffness gradient scaffolds and bone in the case of integrated fixation and steel plate fixation. The results showed that the stress distribution of the stiffness gradient scaffolds was more uniform, and the strain of host bone tissue was changed greatly, which was beneficial to the growth of bone tissue. The integrated fixation method is more stable, less stress and evenly distributed. Therefore, the integrated fixation device combined with the design of stiffness gradient can repair the large femoral bone defect well.

Abstract Background Anteromedial tibial plateau fracture with posterolateral corner (PLC) injury is a relatively rare combined injury in the clinic. In addition, there is no unified treatment scheme for this combined injury. The purpose of this study was to evaluate the clinical and imaging results of single-stage arthroscopic-assisted surgery for anteromedial tibial plateau fracture with PLC injury, and to explore the advantages of this surgical technique. Method In this retrospective study, a total of 9 patients (7 males and 2 females) were included, aged 24–64 years (average 40.7 years), treated in our Department of Orthopedics from January 2016 to January 2021. In the preoperative evaluations, there were 9 cases of anteromedial tibial plateau fractures with PLC injuries, 6 cases of concomitant PCL injuries, 6 cases of concomitant medial or lateral meniscus injuries, and 2 cases of concomitant fibular head avulsion fractures. All patients underwent single-stage arthroscopic-assisted surgery. Results All patients were followed up, and the average follow-up period was 15.2 months (range 12–18 months). The average operation time was 135.6 min (range 100–160 min), and the average surgical blood loss was 87.2 ml (range 60–110 ml). The anatomical reduction was achieved in 9 cases, and the anatomical reduction rate was 100%. The average fracture healing time was 13.1 weeks (range 12–16 weeks). At the last follow-up, the average VAS score was 1 (range 0–2); the average Lysholm function score was 90.7 (range 86–95), and the average IKDC score was 91.4 (range 88–95); the average knee extension angle of all patients was 0° and the average knee flexion angle was 128.3° (average 120–135°); The posterior drawer test, the Lachman test and the dial test were negative for all cases. None of the patients had operation-related complications. Conclusion Single-stage arthroscopy-assisted surgery in the treatment of anteromedial tibial plateau fracture with PLC injury can achieve good clinical outcomes, restore the stability of the knee joint, and reduce the risk of severe lower extremity dysfunction.

Abstract Background The purpose of this study was to evaluate the clinical and radiographic outcomes after medial patellofemoral ligament (MPFL) reconstruction combined with supracondylar biplanar femoral derotation osteotomy (FDO) in recurrent patellar dislocation (RPD) with increased femoral anteversion angle (FAA) and genu valgum. Methods Between January 2017 to December 2020, a total of 13 consecutive patients (13 knees, 4 males and 9 females, mean age 18.7 (range, 15–29 years) with RPD with increased FAA (FAA > 25°) and genu valgum (mechanical axis deformity of ≥5°) who underwent supracondylar biplanar FDO using a Tomofix-locking plate combined with MPFL reconstruction in our institution were included. Preoperative full-leg standing radiographs, lateral views, and hip-knee-ankle computed tomography (CT) scans were used to evaluate the mechanical lateral distal femoral angle (mLDFA), anatomical femorotibial angle (aFTA), mechanical axis, patellar height, tibial tubercle-trochlear groove (TT-TG) distance, and torsional angle of the tibial and femoral in the axial plane. Patient reported outcomes were evaluated using the International Knee Documentation Committee (IKDC) score, Kujala score, Lysholm score, visual analog scale (VAS), and Tegner score preoperatively and postoperatively. Postoperative CT scans were used to evaluate the changes of FAA and TT-TG, and full-leg standing radiographs was used to evaluate the changes of mLDFA, aFTA, and mechanical axis. Results A total of 13 patients (13 knees) were included with an average follow-up period of 26.7 months (range 24–33). No cases developed wound infection, soft tissue irritation, and recurrent patellar dislocation during the follow-up period after surgery. Bone healing at the osteotomy site was achieved in all cases, and all patients regained full extension and flexion. Clinical outcomes (VAS, Kujala, IKDC, Lysholom, and Tegner scores) improved significantly at the final follow-up after surgery (p 0.05). Conclusion MPFL reconstruction combined with supracondylar biplanar FDO showed satisfactory clinical outcomes and radiographic results in the short-term follow-up period.

In this study, a femtosecond laser with a wavelength of 800 nm was used to modify the surface of a titanium alloy bone scaffold created via selective laser melting (SLM). The outcomes demonstrated that the surface morphology of the bone scaffold after femtosecond laser treatment was micro-nano morphology. The hydrophobic structure of the scaffold was changed into a super-hydrophilic structure, improving the surface roughness, which was highly helpful for osteoblast adhesion and differentiation. The femtosecond laser surface treatment in vitro samples produced a thick layer of hydroxyapatite (HAP) with improved surface bioactivity. The effectiveness of osseointegration and interstitial growth of the specimens treated with the femtosecond laser surface were found to be better when bone scaffolds were implanted into the epiphysis of the tibia of rabbits. As a result, femtosecond laser therapy dramatically enhanced the surface activity of bone scaffolds and their capacity to integrate with the surrounding bone tissues, serving as a trustworthy benchmark for future biological scaffold research.

Abstract The microstructure of porous scaffolds plays a vital role in bone regeneration, but its optimal shape is still unclear. In this study, four kinds of porous titanium alloy scaffolds with similar porosities (65%) and pore sizes (650 μm) and different structures were prepared by selective laser melting. Four scaffolds were implanted into the distal femur of rabbits to evaluate bone tissue growth in vivo. Micro-CT and hard tissue section analyses were performed 6 and 12 weeks after the operation to reveal the bone growth of the porous scaffold. The results show that diamond lattice unit (DIA) bone growth is the best of the four topological scaffolds. Through computational fluid dynamics (CFD) analysis, the permeability, velocity and flow trajectory inside the scaffold structure were calculated. The internal fluid velocity difference of the DIA structure is the smallest, and the trajectory of fluid flow inside the scaffold is the longest, which is beneficial for blood vessel growth, nutrient transport and bone formation. In this study, the mechanism of bone growth in different structures was revealed by in vivo experiments combined with CFD, providing a new theoretical basis for the design of bone scaffolds in the future.

The geometry of porous bone scaffolds has an important effect on its bone ingrowth, but there is still a lack of in-depth research on this aspect. This study establishes a curved structure and a strut structure with a porosity of 65% and a pore size of 650 μm. The rabbit femoral condyle implants were used to assess the bone ingrowth. The pressure cloud chart and the velocity streamline inside the scaffold structure were calculated by computational fluid dynamics (CFD). The results show that the osteogenic property of a curved structure is better than that of a strut structure, but the mechanical property is not as good as that of the strut structure. The velocity streamline and velocity difference inside the scaffold structure has a great influence on bone ingrowth. Under the same condition, the smaller the fluid velocity difference inside the scaffold structure, the larger the fluid flow area, and the better the bone tissue growth. Studies have shown that the geometry of the bone scaffold can be optimized according to different implantation sites to meet the requirements of different implantation sites.

Abstract Background Due to atypical clinical symptoms, it is difficult to diagnose joint tuberculosis infection, which often results in misdiagnosis and missed diagnosis. It is easy to cause joint disability. And there are few reports of using arthroscopy to diagnose and treat shoulder tuberculosis. This case series aims to introduce the clinical outcomes of arthroscopic treatment of shoulder tuberculosis. Methods Twenty-nine patients with shoulder tuberculosis from September 2013 to February 2019 were included (10 males, 19 females; age range from 22 to 69; the average age is 37.6 years). All patients underwent arthroscopic lesion debridement, with preoperative and postoperative regular use of isoniazid, rifampicin, pyrazinamide, and streptomycin quadruple anti-tuberculosis drugs. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were recorded before and at the last follow-up. The shoulder function was evaluated according to the visual analogue scoring method (visual analogue scale, VAS) pain score and Constant score. Results Twenty-nine patients were followed up from 12 months to 2 years, and the average follow-up time was 15.7 months. The pathological diagnosis of all patients after surgery was shoulder tuberculosis. No serious complications were found at the last follow-up, and the incision healed well. VAS pain score, Constant score, ESR, and CRP at the last follow-up were significantly improved compared with those before treatment (P < 0.05). Conclusion On the basis of the standard use of anti-tuberculosis drugs before and after surgery, shoulder arthroscopy is used to treat early and mid-term shoulder tuberculosis, which can be diagnosed by direct observation under the arthroscope and postoperative pathological examination. It has the advantages of thorough lesion removal, minimal invasiveness, rapid recovery, and reliable clinical effect.

To improve the bearing capacity of existing angle steel structures, a new and cost-effective reinforcement method for increasing the load-bearing capacity is proposed. This method uses steel pipes as auxiliary materials and clamps the reinforced angle steel and the auxiliary materials through fixtures to ensure that they are deformed together. The influence of the fixture spacing, the size of the reinforced angle steel member, the slenderness ratio of the members, the size of the auxiliary steel pipe, and other parameters on the reinforcement effect is studied. The results show that the smaller the fixture spacing is, the more obvious the improvement of the bearing capacity is, and the reasonable fixture spacing is related to the angle steel leg width. The larger the slenderness ratio of the member is, the more obvious the reinforcement effect of the scheme is. The steel pipe size has a significant impact on the reinforcement effect of the scheme.

The WHO’s “Global tuberculosis report 2020” lists tuberculosis (TB) as one of the leading causes of death globally. Existing anti-TB therapy strategies are far from adequate to meet the End TB Strategy goals set for 2035. Therefore, novel anti-TB therapy protocols are urgently needed. Here, we proposed an allogeneic Vγ9Vδ2 T-cell-based immunotherapy strategy and clinically evaluated its safety and efficacy in patients with multidrug-resistant TB (MDR-TB). Eight patients with MDR-TB were recruited in this open-label, single-arm pilot clinical study. Seven of these patients received allogeneic Vγ9Vδ2 T-cell therapy adjunct with anti-TB drugs in all therapy courses. Cells (1 × 108) were infused per treatment every 2 weeks, with 12 courses of cell therapy conducted for each patient, who were then followed up for 6 months to evaluate the safety and efficacy of cell therapy. The eighth patient initially received four courses of cell infusions, followed by eight courses of cell therapy plus anti-MDR-TB drugs. Clinical examinations, including clinical response, routine blood tests and biochemical indicators, chest CT imaging, immune cell surface markers, body weight, and sputum Mycobacterium tuberculosis testing, were conducted. Our study revealed that allogeneic Vγ9Vδ2 T cells are clinically safe for TB therapy. These cells exhibited clinical efficacy in multiple aspects, including promoting the repair of pulmonary lesions, partially improving host immunity, and alleviating M. tuberculosis load in vivo, regardless of their application in the presence or absence of anti-TB drugs. This pilot study opens a new avenue for anti-TB treatment and exhibits allogeneic Vγ9Vδ2 T cells as promising candidates for developing a novel cell drug for TB immunotherapy.Clinical Trial Registration(https://clinicaltrials.gov/ct2/results?cond=&term=NCT03575299&cntry=&state=&city=&dist=) ( NCT03575299).

In this paper, two groups of titanium alloy and biodegradable ceramic scaffolds with the same pore structure were designed, and the cell proliferation and bone tissue growth of the two groups were studied by cell proliferation experiment and animal experiment. The results show that the biological properties of biodegradable ceramic scaffolds are obviously better than those of titanium alloy scaffolds. The cell proliferation experiment in vitro showed that with the passage of time, the number of cell proliferation and the activity of ALP in biodegradable ceramic scaffolds were higher than those in titanium alloy scaffolds. The results of animal implantation experiments show that the amount of bone tissue in the ceramic scaffold is several times than that of titanium alloy in the same implantation time, indicating that the ceramic scaffold has great research and application potential in the field of bone tissue engineering.

In the task of image instance segmentation, semi-supervised instance segmentation algorithms have received constant research attention over recent years. Among these algorithms, algorithms based on transfer learning are better than algorithms based on pseudo-label generation in terms of segmentation performance, but they can not make full use of the relevant characteristics of source tasks. To improve the accuracy of these algorithms, this work proposes a semi-supervised instance segmentation model AFT-Mask (attention-based feature transfer Mask R-CNN) based on category attention. The AFT-Mask model takes the result of object-classification prediction as “attention” to improve the performance of the feature-transfer module. In detail, we designed a migration-optimization module for connecting feature migration and classification prediction to enhance segmentation-prediction accuracy. To verify the validity of the AFT-Mask model, experiments were conducted on two types of datasets. Experimental results show that the AFT-Mask model can achieve effective knowledge transfer and improve the performance of the benchmark model on semi-supervised instance segmentation.

In this paper, the results of the study on the performance of four groups of different honeycomb structures show that the application of honeycomb structure in the design of biomimetic bone scaffold is feasible and promising. In terms of static properties, the elastic modulus (1.6–3 GPa) of the four scaffolds matched the elastic modulus of human cancellous bone (0.1–4.5 GPa), and the yield strength (88–146 MPa) was much higher than that of the femoral neck (0.56–3.71 MPa). In terms of permeability, except for the excessive permeability of SU scaffold, the permeability of the other three groups of scaffolds (1.5*10−8–4.8*10−8 m2) are all in the range of cancellous bone permeability (0.5*10−8–5.0*10−8 m2). In terms of the distribution of wall shear stress, the wall shear stress of the four groups of scaffolds ranged from 2.8 to 42.8 MPa, which could stimulate cells to deposit mineralized extracellular matrix (0.55–30 MPa) in the 3D scaffold, which was conducive to bone tissue regeneration.

Although customized three-dimensional tantalum implants have been used to treat a large variety of diseases, few reports have described the application of such implants to reconstruct large pelvic bone defects after the removal of massive tumors. We herein describe a 30-year-old woman with a 9-year history of a massive low-grade chondrosarcoma in the pelvic bone. After removal of a solid 12- × 8- × 6-cm tumor with clear margins, we used a customized three-dimensional printed tantalum implant to fill the large pelvic bone defect and performed hip arthroplasty in a one-step surgery. The patient’s postoperative recovery was uneventful. She started walking 1 month after surgery, and she developed no tumor recurrence, instrumentation failure, or implant loosening during the 12-month follow-up period. This report describes the successful application of a customized three-dimensional printed implant to reconstruct a massive pelvic bone defect. Satisfactory functional recovery was achieved with no apparent complications. The methodology of the current case may benefit orthopedic and oncologic surgeons in designing treatment strategies for similar cases.

Background Three-dimensional (3D) reconstruction has been used for various diseases, but few reports have described its application in pelvic reconstruction after removal of giant chondrosarcoma. Case reports describing the clinical application of personalized 3D-printed titanium implants are needed for future clinical reference. Case presentation: We herein describe a 29-year-old woman with a giant chondrosarcoma treated with a personalized 3D titanium implant. The surgery was successful, and the patient recovered with significant pain relief and good functional recovery after the surgery. No implant-related complications occurred during the 12-month follow-up. The current case represents successful application of 3D printing technology to the treatment of a massive bone defect due to the removal of a giant osteoporotic tumor. Conclusions Personalized 3D titanium implants can be used in the reconstruction of massive bone defects after the removal of giant pelvic sarcomas. The methodology and results described in the current case report can be a used as reference in the treatment of similar cases in future.

Background/Aims: With the aging population increases, senile osteoporosis has become a global public health problem. Previous evidence has shown that miR-124 has important effects on the occurrence and development of osteoporosis. However, the role of miR-124 in the process of osteoclastogenesis is still obscure. Methods: First of all, we measured the expression level of miR-124 in bone marrow monocytes (BMMs) of osteoporotic mice (ovariectomized mice: OVX). Next, we evaluated the alteration of miR-124 during osteoclast differentiation of BMMs. Then, BMMs were transfected with miR-124 mimics or inhibitors to explore the influences of miR-124 on osteoclast differentiation of BMMs in vitro. Furthermore, bioinformatics analysis and luciferase reporter assay were performed for prediction and identification of the target of miR-124. Results: BMMs from OVX mice exhibited lower expression of miR-124 compared with Sham mice. Additionally, miR-124 was down-regulated when BMMs differentiated into osteoclasts. In addition, inhibition of miR-124 promoted BMMs differentiated into osteoclasts in vitro, whereas overexpression of miR-124 attenuated this procedure, demonstrated by increased expression of osteoclast specific genes and TRAP staining. Furthermore, Rab27a was confirmed to be the direct target of miR-124 by bioinformatics, Western blot and luciferase reporter assay analysis. Conclusion: Our findings revealed that miR-124 has an important role in osteoclastogenesis via targeting Rab27a. Thus, targeting miR-124 promises a therapeutic potential in the treatment of osteoporosis.

Aim To observe the efficacy of modified lamellar keratoplasty (LK) and immunosuppressive therapy guided by in vivo confocal microscopy (IVCM) for perforated Mooren's ulcer. Methods 25 patients (31 eyes) with perforated Mooren's ulcer underwent modified LK. The perforated hole was patched with a thin, fresh posterior cornea containing the endothelium, before a glycerin-preserved lamellar graft shaped like the defect was placed. Immunosuppressants and corticosteroids were used and their dosages adjusted following the density of dendritic cells in the corneal graft postoperatively as detected by IVCM. The anatomical recovery, visual acuity, surgical complications, and recurrence were followed up for 24 months. Results Favourable anatomical recovery was achieved in 27 eyes (87.1%). The vision was significantly improved in all eyes ( p<0.05). Four eyes (12.9%) had leakage at the graft-host interface. No allograft autolysis or immunological rejection was observed. A large number of dendritic cells existed in the peripheral and central graft at 1 week postoperatively, with a mean density of 359.47±97.21 cells/mm2 and 216.93 ±57.86 cells/mm2, respectively, which significantly decreased to 93.83±31.07 cells/mm2 and 43.65 ±28.43 cells/mm2 at 2 months. Accordingly, the dosage of medication was gradually reduced during this period. At 6 months, if no dendritic cells were found in the graft, use of the topical drug was stopped. The disease recurrence rate was 9.7%. Conclusions Modified LK, combined with immunosuppressive therapy, can effectively treat perforated Mooren's ulcer, with few complications. The use of corticosteroids and immunosuppressants guided by IVCM may reduce the disease recurrence. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to evaluate the value of tumor M2 pyruvate kinase (tumor M2-PK) in the diagnosis of nonsmall cell lung cancer. Methods: The diagnosis clinical studies of tumor M2-PK in the diagnosis of nonsmall cell lung cancer were electronic researched in the Medline, EMBASE, WANFANG, and CNIK databases. The data of true positive, false positive, false negative, and true negative were extracted from each of the individual studies. We use Stata11.0 (http://www.stata.com; Stata Corporation, College Station, TX) and MetaDiSc 1.4 software to pool the diagnostic sensitivity, specificity, and diagnostic area under the receiver operating characteristic (ROC). Results: Eleven diagnostic clinical studies with 1294 subjects were included in this diagnostic meta-analysis. The combined sensitivity, specificity, positive likely hood ratio, negative likely hood ratio were 0.69 (0.65-0.72), 0.92 (0.89-0.94), 7.84 (5.92-10.38), 0.36 (0.32-0.40). And the area under the ROC curve was 0.92 (0.90-0.94). Conclusion: Serum tumor M2-PK can be a potential biomarker for diagnosis of nonsmall cell lung cancer. [ABSTRACT FROM AUTHOR]

As people age, geriatric syndromes characterized by frailty significantly impact both clinical practice and public health. Aging weakens people's immune functions, leading to chronic lowgrade inflammation that ultimately contributes to the development of frailty. Effectively managing geriatric syndromes and frailty can help alleviate the economic burden of an aging population. This review delves into the intricate relationship among aging, infection-induced inflammation, chronic inflammation, and frailty. In addition, it analyzes various approaches and interventions to address frailty, such as smart rehabilitation programs and stem-cell treatments, offering promising solutions in this new era. Given the importance of this topic, further research into the mechanisms of frailty is crucial. Equally essential is the devising of relevant measures to delay its onset and the formulation of comprehensive clinical, research, and public health strategies to enhance the quality of life for elderly individuals. [ABSTRACT FROM AUTHOR]