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Objective To explore the effect of skeletal muscle mass on the outcomes of early joint function in patients undergoing total hip arthroplasty. Methods A prospective study was performed on 107 patients who planned to undergo hip arthroplasty for the first time from November 2020 to December 2021 in Army Medical Center of PLA. The demographic data was collected, and nutritional status and pain status were assessed. Skeletal muscle mass was measured by bioelectrical impedance analysis (BIA), and was corrected to the skeletal muscle mass index (SMI) with their height. With follow-up call, the joint function was assessed with Harris Hip Score Scale, and daily living activities was investigated with Activities of Daily Living(ADL) Scale at 1, 3 and 6 months after surgery. The effect of SMI on early rehabilitation after hip arthroplasty was analyzed. According to the diagnostic criteria of the Asian Sarcopenia Working Group 2019, the patients were divided into normal SMI group and reduced SMI group, and postoperative rehabilitation was compared between the 2 groups. Results Pearson correlation analysis showed that SMI was positively correlated with postoperative Harris score and ADL score. Multivariate linear regression model showed that SMI was an influencing factor of Harris score and of ADL score in different periods after surgery, with a standardized regression coefficient of 0.394~0.436 and 0.391~0.461 (P < 0.01), respectively. The incidence of SMI reduction in total hip arthroplasty was 32.71%. The SMI reduction group had significantly larger ratio of needing walk aid instrument for 30 d, but lower postoperative Harris scores and ADL scores when compared with the normal SMI group (all P < 0.01). Conclusion The preoperative SMI of patients undergoing hip arthroplasty independently affects the outcomes of early joint function, and the patients with reduced SMI are the focus population of clinical rehabilitation care.

Objective To investigate the incidence of preoperative skeletal muscle mass (SM) loss and related influencing factors in patients with hip or knee replacement. Methods A cross-sectional survey was performed on 267 patients who planned to undergo hip or knee replacement for first time from August 2020 to June 2021 in Army Medical Center. The demographic data, disease history and laboratory indicators were collected. Nutritional risk screening 2002 (NRS2002) scale was used to assess nutritional status, and chair test, 3-m reentry test and 6-min walking test were employed to evaluate lower extremity muscle strength and joint functional mobility. According to the screening criteria for bioelectrical impedance analysis (BIA) recommended by 2019 Consensus of Asian Working Group for Sarcopenia, the patients were divided into muscle mass reduction group (n=94) and normal muscle mass group (n=173). The related factors of muscle mass loss were analyzed. Results The detection rate of muscle mass loss was 35.21%. Statistical significances were seen in lower extremity joint function performance between the 2 groups by 3-m reentry test (Z=-4.744, P < 0.001) and 6-min walking test (Z=-4.889, P < 0.001). There were significant differences in age, BMI, results of nutritional risk screening, usage of walking aid, lymphocyte count, and levels of hemoglobin, serum albumin, serum prealbumin, and C-reactive protein between the 2 groups (P < 0.05). Multivariate logistic regression analysis showed that BMI (OR=0.640, 95%CI: 0.557~0.734) was an independent protective factor for muscle mass loss, and age (OR=1.093, 95%CI: 1.057~1.132) and usage of walking aid (OR=2.956, 95%CI: 1.179~7.410) were risk factors. Multiple linear regression analysis indicated that the influencing factors of muscle mass were sex (muscle mass of men larger than that of women, β=0.846, P < 0.001), age (β=-0.245, P < 0.001), history of smoking (β=-0.170, P=0.024), and hemoglobin (β=0.149, P=0.017), and age and smoking were negatively and hemoglobin was positively correlated with muscle mass. Conclusion Loss of muscle mass is more common in patients who choose hip or knee arthroplasty. Age, BMI, and use of walking aids may be related to the occurrence of muscle mass loss in them, and gender, age, and hemoglobin content may be used as predictors of preoperative skeletal muscle mass.

The basement membrane zone is the interface between the epidermis and dermis, and it is disrupted in several skin conditions. Here, we report the results of a comprehensive investigation into the structural and molecular factors of the basement membrane zone in vitiligo, a dermatological disorder characterised by depigmented patches on the skin. Using electron microscopy and immunofluorescence staining, we confirmed abnormal basement membrane zone morphology and disrupted basement membrane zone architecture in human vitiliginous skin. Furthermore, we identified elevated expression of matrix metalloproteinase 2 (MMP2) in human dermal fibroblasts as a key factor responsible for basement membrane zone matrix degradation. In our in vitro and ex vivo models, overexpression of MMP2 in fibroblasts led to basement membrane zone disruption and melanocyte disappearance. Importantly, we reveal that the loss of melanocytes in vitiligo is primarily linked to their weakened adhesion to the basement membrane, mediated by binding between integrin β1 and laminin and discoidin domain receptor 1 and collagen IV. Finally, inhibition of matrix metalloproteinase 2 expression reversed depigmentation in a mouse model of vitiligo. In conclusion, our research shows the importance of basement membrane zone integrity in melanocyte residence and offers new avenues for therapeutic interventions to address this challenging skin condition. © 2024 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland. [ABSTRACT FROM AUTHOR]

Aims Background Methods Results Conclusions Relevance to Clinical Practice Impact Reporting Method Patient or Public Contributions To investigate the independent and combined effects of physical activity (PA) and depressive symptoms on the risk of frailty in community‐dwelling older adults.Older adults face a high risk of frailty which is commonly used to predict adverse health outcomes in older patients. Engaging in PA and without depressive symptoms are crucial factors to prevent frailty. It is essential to investigate the independent and combined effects of these two variables on the risk of frailty.We included 3392 community‐dwelling older adults. The FRAIL Scale was used to assess older adults' frail status (robust, prefrail and frail). Multiple logistic regression was utilized to examine the independent and combined effects of PA and depressive symptoms on the risk of prefrailty and frailty. The combined effects were visualized by marginal plots.The prevalence of prefrailty and frailty in older adults were 42.16% and 10.58%. Compared with the group of “Light physical activity and With depressive symptoms”, “Vigorous physical activity and Without depressive symptoms” had the lowest risk of prefrailty and frailty.Older adults who do not engage in PA or have depressive symptoms increased the risk of frailty, but older adults with depressive symptoms could lower the risk of frailty through PA.It is effective to reduce the risk of frailty by directing older adults to do moderate physical activity, although they have depressive symptoms. The focus should also be on older adults with depressive symptoms, who have at least more than twice and fourfold risk of prefrailty and frailty compared to those without.This study offers insights for future interventions aimed at preventing frailty in older adults.This study adhered to the STROBE checklist.Older adults participated in this study and completed questionnaires. [ABSTRACT FROM AUTHOR]

Epidermal melanin unit integrity is crucial for skin homeostasis and pigmentation. Epidermal growth factor (EGF) receptor (EGFR) is a pivotal player in cell growth, wound healing, and maintaining skin homeostasis. However, its influence on skin pigmentation is relatively unexplored. This study investigates the impact and underlying mechanisms of EGFR inhibitors on skin pigmentation. We evaluated EGF and EGFR expression in various skin cells using quantitative real‐time PCR, Western blot, and immunofluorescence. EGF and EGFR were predominantly expressed in epidermal keratinocytes, and treatment with the EGFR tyrosine kinase inhibitors (EGFR‐TKIs) gefitinib and PD153035 significantly increased stem cell factor (SCF) and endothelin‐1 (ET‐1) expression in cultured keratinocytes. Enhanced melanocyte migration and proliferation were observed in co‐culture, as evidenced by time‐lapse live imaging and single‐cell tracking assays. Furthermore, topical application of gefitinib to guinea pig dorsal skin induced increased pigmentation and demonstrated efficacy in mitigating rhododendrol‐induced leukoderma. Suppression of EGF signaling indirectly enhanced skin pigmentation by upregulating SCF and ET‐1 in epidermal keratinocytes. This novel mechanism highlights the pivotal role of EGF signaling in regulating skin pigmentation, and topical EGFR‐TKI therapy at an appropriate dose may be a promising approach for depigmentation disorder management. [ABSTRACT FROM AUTHOR]

Objective To investigate the functional mobility of the knee joint after unilateral total knee replacement (TKA), and explore the factors affecting the difference of mobility. Methods A retrospective analysis was performed on 110 patients who received unilateral TKA for the first time from January to December 2019 in the orthopedics department of a Grade A hospital in Chongqing by telephone follow-up. Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index was adopted to evaluate the knee joint function. And the general information of patients and their knee functional activities were subsequently analyzed. Results Standing and walking were the easiest and most satisfying activities for the patients after TKA, but 83% of them still had problems in going up and down stairs or slopes, and 41.8% were expected to be able to squat or use a squat toilet. Among them, 88.2% continued to exercise after discharge to train muscle strength and joint mobility, and only 13.4% had added special training for knee joint function. There were no differences between the patients taking exercise at home and at special rehabilitation centers. The results of rank sum test showed that age, pain, postoperative months, post-discharge exercise, functional training, and home environment had significantly different effects on WOMAC function score (P < 0.05). And stepwise multiple linear regression model indicated that pain (B=13.924, P=0.000) was positively correlated with WOMAC functional score, while persistent exercise (B=-19.889, P=0.002) and functional training (B=-14.671, P=0.011) after discharge were negatively correlated with the score, in an order of strong influencing significance of post-discharge exercise, functional training, and pain. For the patients having post-discharge exercise, functional training was negatively correlated with the WOMAC function score (B=-10.694, P=0.044), whose effect was only second to pain. Conclusion TKA surgery can improve the knee function of patients with knee osteoarthritis, however, pain is still the main factor affecting postoperative functional mobility. Keeping exercise after discharge combined with functional training in addition is helpful to further improve the knee functional joint mobility.