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    08 December 2026, Volume 30 Issue 34 Previous Issue   
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    Mechanism of glucocorticoid-induced mitochondrial dysfunction in osteoblasts in steroid-induced osteonecrosis of the femoral head
    Ma Runqiu, Yang Huixia, Li Xuer, Bai Zhigang, Li Guizhong, Hao Yinju, Ma Shengchao, Jiang Yideng
    2026, 30 (34):  8845-8851.  doi: 10.12307/2026.872
    Abstract ( 69 )   PDF (18874KB) ( 54 )   Save
    BACKGROUND: The pathogenesis of steroid-induced osteonecrosis of the femoral head remains unclear; however, it is closely associated with mitochondrial damage in osteoblasts.
    OBJECTIVE: To explore the impact of dexamethasone on mitochondrial dysfunction in osteoblasts following steroid-induced osteonecrosis of the femoral head and to analyze its regulatory roles in osteoblast apoptosis and autophagy. 
    METHODS: MC3T3-E1 cells were cultured in vitro and divided into control group (no treatment) and dexamethasone group (1 μmol/L dexamethasone treatment for 24 hours). Osteoblast differentiation capacity was assessed by alizarin red staining and qRT-PCR. Mitochondrial morphology was examined using transmission electron microscopy, MitoTracker Red fluorescent staining, and flow cytometry. Mitochondrial membrane potential and energy metabolism were evaluated via JC-1 fluorescent staining and ATP content measurement. Mitochondrial superoxide levels were quantified using MitoSOX™ Red fluorescent probe combined and flow cytometry. Intracellular total reactive oxygen species and glutathione levels were simultaneously measured to evaluate oxidative stress status. Additionally, western blot and qRT-PCR assays were performed to examine Bax/Bcl-2 (apoptosis) and LC3B/p62 (autophagy) expression. Flow cytometric analysis was performed to assess apoptotic rates. Autophagic flux was assessed using mRFP-GFP-LC3 adenovirus transfection followed by confocal microscopy analysis. 
    RESULTS AND CONCLUSION: (1) Compared with the control group, dexamethasone-treated MC3T3-E1 cells exhibited significantly impaired osteogenic differentiation capacity (P < 0.05), accompanied by mitochondrial structural abnormalities (including swelling and cristae disruption), decreased membrane potential, reduced glutathione synthesis, elevated mitochondrial superoxide and total reactive oxygen species levels, as well as increased glutathione depletion. (2) Western blot analysis revealed that dexamethasone treatment significantly upregulated Bax (P < 0.01) while downregulating Bcl-2 (P < 0.01), concurrently increasing the LC3B-II/I ratio (P < 0.01) and decreasing p62 levels (P < 0.01). Flow cytometry analysis further confirmed that dexamethasone treatment significantly increased the apoptotic rate (P < 0.01). (3) mRFP-GFP-LC3 adenovirus tracer detection demonstrated a marked enhancement in the formation of both autophagosomes and autolysosomes. To conclude, dexamethasone regulates the apoptosis and autophagy processes of MC3T3-E1 cells in a coordinated manner by inducing mitochondrial dysfunction and oxidative stress response, and thereby impairs bone formation and repair functions. This mechanism may be the key pathological basis for the pathogenesis of steroid-induced osteonecrosis of the femoral head.
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    Role of myeloid-derived suppressor cells in osteoclast differentiation in primary osteoporosis
    Cheng Xinyi, Chen Yida, Wang Yi, Liu Daihui, Zheng Yi, Shi Qin
    2026, 30 (34):  8852-8859.  doi: 10.12307/2026.889
    Abstract ( 41 )   PDF (2476KB) ( 23 )   Save
    BACKGROUND: Recent studies have found that immune cells play an important role in bone metabolism. Myeloid-derived suppressor cells, as a type of immunosuppressive cell, play a significant role in tumor development, but their role in primary osteoporosis remains unclear.
    OBJECTIVE: To investigate the osteoclastogenic potential of myeloid-derived suppressor cells in naturally aged and ovariectomy-induced osteoporosis mouse models.
    METHODS: (1) Myeloid-derived suppressor cells and bone marrow-derived macrophages were isolated from 6-8-week-old female C57BL/6 mice. Both cell types were induced for osteoclast differentiation. After 5 days of induction, osteoclast formation was detected by tartrate-resistant acid phosphatase staining. After 3 days of induction, mRNA expression of nuclear factor of activated T-cells 1 and osteoclast-associated immunoglobulin-like receptor was detected by qRT-PCR. (2) 6-8-week-old female C57BL/6 mice (young group, n=6) and 18-month-old female C57BL/6 mice (naturally aged group, n=6) were taken. Bone microstructure of the distal femur was analyzed by Micro-CT. Bone marrow cells were collected from both groups, and the proportion of myeloid-derived suppressor cells was detected by flow cytometry. Myeloid-derived suppressor cells were isolated from both groups and induced for osteoclast differentiation. After 5 days of induction, osteoclast formation was detected by tartrate-resistant acid phosphatase staining. After 3 days of induction, mRNA expression of nuclear factor of activated T-cells 1 and osteoclast-associated immunoglobulin-like receptor was detected by qRT-PCR. (3) 6-8-week-old female C57BL/6 mice were randomly divided into a sham-operated group (n=6) and an ovariectomized group (n=6). Eight weeks after ovariectomy, bone microstructure of the distal femur was analyzed by Micro-CT. Bone marrow cells were collected from both groups, and the proportion of myeloid-derived suppressor cells was detected by flow cytometry. Serum levels of tumor necrosis factor-α and interleukin-6 were detected by ELISA. Myeloid-derived suppressor cells were isolated from both groups and induced for osteoclast differentiation. After 5 days of induction, osteoclast formation was detected by tartrate-resistant acid phosphatase staining. After 3 days of induction, mRNA expression of nuclear factor of activated T-cells 1 and osteoclast-associated immunoglobulin-like receptor was detected by qRT-PCR.
    RESULTS AND CONCLUSION: (1) Tartrate-resistant acid phosphatase staining and qRT-PCR showed that the osteoclastogenic potential of myeloid-derived suppressor cells was stronger than that of bone marrow-derived macrophages. (2) Micro-CT analysis showed that compared with the young group, the naturally aged group had a lower bone mineral density, bone volume fraction, and trabecular number (P < 0.05), and higher trabecular separation (P < 0.05). The proportion of myeloid-derived suppressor cells in the naturally aged group was higher than that in the young group (P < 0.05). Tartrate-resistant acid phosphatase staining and qRT-PCR showed that the osteoclastogenic potential of myeloid-derived suppressor cells in the naturally aged group was stronger than that in the young group. (3) Micro-CT analysis showed that compared with the sham-operated group, the ovariectomized group had lower bone mineral density, bone volume fraction, and trabecular number (P < 0.05), and higher trabecular separation (P < 0.05). The proportion of myeloid-derived suppressor cells and the serum levels of tumor necrosis factor-α and interleukin-6 in the ovariectomized group were higher than those in the sham-operated group (P < 0.05). Tartrate-resistant acid phosphatase staining and qRT-PCR showed that the osteoclastogenic potential of myeloid-derived suppressor cells in the ovariectomized group was stronger than that in the sham-operated group. These findings indicate that the increased proportion and enhanced osteoclastogenic potential of myeloid-derived suppressor cells under natural aging and estrogen-deficient conditions may be involved in the occurrence and development of osteoporosis.
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    Mechanism by which Hernandezine alleviates osteoporosis through macrophage polarization and osteoclast activation
    Xia Wenyu, Zhang Wei, Li Wenhao, Jiang Kunlong, Wu Zebin, Yang Huilin
    2026, 30 (34):  8860-8867.  doi: 10.12307/2026.846
    Abstract ( 40 )   PDF (11364KB) ( 14 )   Save
    BACKGROUND: Hernandezine has shown promising therapeutic effects due to its anti-inflammatory bioactivity in diseases such as suppression of tumors, antiplatelet agglutination and diabetes. However, there are no basic studies on the effects and molecular mechanism of Hernandezine on macrophage phenotype and osteoclast activation.
    OBJECTIVE: To investigate the role of Hernandezine on the regulation of macrophage polarization, osteoclast activation and osteoporosis.
    METHODS: (1) Cellular experiments: RAW264.7 was used as macrophage model and divided into four groups: Control group, lipopolysaccharide group, lipopolysaccharide + 2.5 μmol/L Hernandezine group, lipopolysaccharide + 5 μmol/L Hernandezine group. Macrophage polarization was induced in the latter three groups using a complete medium supplemented with lipopolysaccharide. The two drug-treated groups received 2.5 and 5 μmol/L Hernandezine, respectively. RAW264.7 cells were induced toward osteoclast differentiation using a complete medium supplemented with nuclear factor κB receptor activator ligand. Macrophage polarization was assessed via qRT-PCR and immunofluorescence for inflammatory cytokine expression. The effects of Hernandezine on osteoclast differentiation were evaluated using qRT-PCR, tartrate-resistant acid phosphatase staining, and F-actin staining. (2) In vivo experiments: Twenty-four 8-week-old female C57BL/6J mice were randomly divided into four groups: sham-operated group, ovarian extirpation group, 5 mg/kg Hernandezine group and 10 mg/kg Hernandezine group. Bilateral ovariectomy was performed to establish an osteoporosis mouse model in the latter three groups. Hernandezine at the dose of 5 and 10 mg/kg was intraperitoneally injected in the two drug-treated groups every 2 days after the operation. Femurs were collected after 8 weeks of modeling for Micro-CT scanning, bone parameter analysis and hematoxylin-eosin staining to assess bone loss.
    RESULTS AND CONCLUSION: (1) Hernandezine could inhibit the expression of pro-inflammatory related genes induced by lipopolysaccharide, and exerted anti-inflammatory effects by down-regulating the transcription level of genes related to Toll-like receptor 4/nuclear factor-κB signaling pathway in a concentration-dependent manner. 5 μmol/L Hernandezine exhibited a more pronounced inhibitory effect. (2) Hernandezine could inhibit the expression of genes related to osteoclast activation and bone resorption, and inhibit osteoclast activation in vitro, also in a concentration-dependent manner. (3) Hernandezine could reduce bone loss in estrogen-deficient induced osteoporosis mice, and the recovery effect was more significant in the 10 mg/kg group. In conclusion, we confirmed that Hernandezine inhibits the conversion process of macrophage pro-inflammatory phenotype and osteoclast activation, and exerts anti-inflammatory effects by down-regulating the Toll-like receptor 4/nuclear factor-κB signaling pathway. Hernandezine has also been confirmed to attenuate excessive bone loss in estrogen-deficient osteoporosis.  

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    Mechanism by which luteolin regulates macrophage polarization in the treatment of knee osteoarthritis
    Zhao Canbin, Zeng Ping, Shi Weiqi, Liu Jinfu, Ding Qiang, Guo Liang, Wang Weiwei, Tao Hongcheng, Guo Yafeng, Qin Ying
    2026, 30 (34):  8868-8877.  doi: 10.12307/2026.893
    Abstract ( 42 )   PDF (7696KB) ( 12 )   Save
    BACKGROUND: The polarization state of macrophages is closely related to the occurrence and development of knee osteoarthritis. Luteolin can regulate the nuclear transcription factor κB (NF-κB) signaling pathway to affect the polarization process of macrophages, but the specific mechanism remains unclear. 
    OBJECTIVE: To investigate the mechanism of luteolin in the treatment of knee osteoarthritis. 
    METHODS: (1) Intersectional targets of luteolin, macrophage polarization, and knee osteoarthritis were retrieved via network pharmacology. A protein-protein interaction network was constructed, followed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses, and molecular docking. (2) After knocking out nuclear factor κB-light-chain-enhancer of activated B cells p65 subunit (NF-κB p65), RAW264.7 cells were induced to polarize toward M1 and M2 phenotypes, and polarization trends were detected by flow cytometry. Different concentrations of luteolin were applied to RAW264.7 cells, and the suitable concentration for subsequent experiments was selected using the cell counting kit-8 assay. RAW264.7 cells were induced to polarize toward M1 and M2 phenotypes with simultaneous luteolin intervention, and polarization trends were detected by flow cytometry. RAW264.7 cells were induced toward M1 polarization with simultaneous luteolin intervention. The levels of tumor necrosis factor-α, interleukin-6, and interleukin-10 in the cell supernatant were measured by ELISA. Nuclear translocation of NF-κB p65/p50 was detected by immunofluorescence staining. The expression and phosphorylation of NF-κB p65 and NF-κB inhibitor α (IκBα) were detected by western blot.
    RESULTS AND CONCLUSION: (1) A total of 137 intersection genes were screened, among which 135 target genes participated in the construction of the protein-protein interaction network. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses showed that the NF-κB complex was enriched in the protein-protein interaction network. Molecular docking indicated that luteolin bound well to IκBα, NF-κB p50, and NF-κB p65 proteins. (2) After NF-κB p65 knockout, the tendency of RAW264.7 cells to polarize toward the M1 phenotype was inhibited, and spontaneous polarization toward the M2 phenotype occurred. Luteolin intervention inhibited RAW264.7 cell polarization toward the M1 phenotype and promoted polarization toward the M2 phenotype. During the induction of RAW264.7 cells toward M1 polarization, luteolin intervention inhibited the release of pro-inflammatory factors and promoted the release of anti-inflammatory factors, suppressed nuclear translocation of NF-κB p65/p50, promoted IκBα expression while inhibiting its phosphorylation, and inhibited NF-κB p65 expression and its phosphorylation. These findings indicate that luteolin can regulate macrophage polarization through the NF-κB signaling pathway, showing potential therapeutic effects on knee osteoarthritis.
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    Therapeutic targets for knee osteoarthritis: identification via a bioinformatics approach
    Chen Cai, Hong Zhongyuan, Deng Huaidong, Zeng Qin, Chen Jiancong
    2026, 30 (34):  8878-8888.  doi: 10.12307/2026.890
    Abstract ( 39 )   PDF (57131KB) ( 18 )   Save
    BACKGROUND: The etiology of knee osteoarthritis is complex and its mechanisms are not fully understood. Research on candidate target genes for knee osteoarthritis will help further clarify the pathogenesis of the disease and provide a basis for precision treatment.
    OBJECTIVE: To identify therapeutic targets for knee osteoarthritis based on summary data using Mendelian randomization combined with bioinformatics methods, followed by cellular validation.
    METHODS: Gene expression profiles GSE46750, GSE55235, GSE82107, and GSE206848 were downloaded from the Gene Expression Omnibus database. Differentially expressed genes were obtained using R software with screening criteria of |log2FC| > 0.585 and adjusted P < 0.05. Module genes with the highest correlation were acquired using the Weighted Gene Co-expression Network Analysis algorithm and intersected with differentially expressed genes. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed on the intersecting genes. Genetic genes significantly associated with knee osteoarthritis were obtained from the eQTLGen database using summary-data-based Mendelian randomization analysis. Genes jointly identified by both bioinformatics and summary-data-based Mendelian randomization analysis were defined as core genes. The binding of celecoxib to core genes was evaluated via molecular docking and dynamics simulations. Immune infiltration analysis of core genes was performed using the CIBERSORT algorithm. Human chondrocytes were divided into a normal group and an experimental group (interleukin-1β-induced osteoarthritis cell models). The mRNA expression of adrenomedullin, human osteopontin, and lysosomal membrane protein 5 was detected by qPCR.
    RESULTS AND CONCLUSION: Bioinformatics analysis identified 229 differentially expressed genes. Gene Ontology enrichment analysis showed that these genes were mainly associated with biological functions such as inflammatory response, positive regulation of response to external stimulus, regulation of cell activation, and chemotaxis. Kyoto Encyclopedia of Genes and Genomes enrichment analysis revealed significant enrichment in pathways including phagosome, osteoclast differentiation, complement and coagulation cascades, and interleukin-17 signaling pathway. Summary-data-based Mendelian randomization analysis identified 76 significantly associated genetic genes (P < 0.05, FDR < 0.05, HEIDI test P > 0.05). Adrenomedullin, human osteopontin, and lysosomal membrane protein 5 were identified as core genes. Human osteopontin and lysosomal membrane protein 5 were negatively correlated with the progression of knee osteoarthritis, while adrenomedullin was positively correlated with the progression of knee osteoarthritis. Molecular docking and molecular dynamics simulations confirmed favorable structure-activity relationships between the core genes and celecoxib. Immune infiltration analysis suggested that adrenomedullin, human osteopontin, and lysosomal membrane protein 5 were correlated with multiple immune cell types. qPCR detection showed that the mRNA expression of human osteopontin and lysosomal membrane protein 5 in the experimental group was lower than that in the normal group (P < 0.001), while the mRNA expression of adrenomedullin was higher than that in the normal group (P < 0.001). These findings indicate that adrenomedullin, human osteopontin, and lysosomal membrane protein 5 are key genes in the progression of knee osteoarthritis and may serve as promising novel targets for its prevention and treatment.
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    Weighted gene co-expression network analysis combined with machine learning identifies autophagy and senescence signature genes in osteoarthritis chondrocytes
    Yang Huaqun, Abudouainijiang·Abulimiti, Wang Fazheng, Maimaitishawutiaji·Maimaiti, Li Simi, Muhetaer·Maimaitirexiati
    2026, 30 (34):  8889-8898.  doi: 10.12307/2026.894
    Abstract ( 55 )   PDF (7319KB) ( 13 )   Save
    BACKGROUND: Autophagy and senescence are considered important factors in the pathogenesis of osteoarthritis, but their specific regulatory mechanisms remain unclear.  
    OBJECTIVE: To screen autophagy- and senescence-related genes in osteoarthritis through bioinformatics analysis combined with machine learning methods, providing new molecular targets for early diagnosis and treatment of osteoarthritis.  
    METHODS: Osteoarthritis-related datasets (including GSE51588, GSE169077, and GSE114007) were downloaded from the GEO database. Differential expression analysis, weighted gene co-expression network analysis, and functional enrichment analysis were performed to identify autophagy- and senescence-related genes in osteoarthritis. Subsequently, potential biomarkers were further screened using machine learning methods such as LASSO regression, Random Forest, and Support Vector Machine, and their diagnostic value was evaluated using receiver operating characteristic curves. Based on the GSE51588 dataset, the proportions of immune cell types such as T-cell subsets, B cells, and macrophages in osteoarthritis and healthy control knee cartilage samples were analyzed using the CIBERSORT algorithm. The expression of ubiquitin-conjugating enzyme E2I (UBE2I), ribosomal protein S6 kinase 1 (RPS6KB1), interleukin-2 receptor β chain (IL2RB), YEATS domain-containing protein 4 (YEATS4), histone H4 variant (H4C1), and Toll-like receptor 3 (TLR3) was detected in osteoarthritis samples and healthy controls in the external validation dataset GSE114007. Clinical samples, including five osteoarthritis knee cartilage specimens and five healthy control knee cartilage specimens, were collected. The mRNA expression of UBE2I, RPS6KB1, IL2RB, YEATS4, H4C1, and TLR3 was measured by RT-qPCR.  
    RESULTS AND CONCLUSION: (1) A total of 26 differentially expressed genes related to autophagy and senescence in osteoarthritis were identified. Functional enrichment analysis showed that these genes were mainly involved in biological processes such as cellular homeostasis, immune regulation, and cell death, and played important roles in multiple signaling pathways. Six key genes were screened using machine learning methods: UBE2I, RPS6KB1, IL2RB, YEATS4, H4C1, and TLR3. The area under the receiver operating characteristic curve for these genes was all greater than 0.8, indicating high diagnostic performance. Immune infiltration analysis revealed that in the osteoarthritis group, the infiltration of plasma cells, resting CD4 memory T cells, resting NK cells, monocytes, M2 macrophages, eosinophils, and neutrophils was significantly reduced, while the infiltration of follicular helper T cells, γδ T cells, activated NK cells, M1 macrophages, and resting dendritic cells was significantly increased. (2) In the external validation dataset, the expression of UBE2I, IL2RB, and TLR3 was higher in the osteoarthritis group than the healthy control group (P < 0.05), while there was no significant difference in the expression of H4C1, YEATS4, and RPS6KB1 between the two groups (P > 0.05). In clinical samples, the mRNA expression of RPS6KB1, IL2RB, YEATS4, H4C1, and TLR3 was higher in the osteoarthritis group than the healthy control group (P < 0.05), while there was no significant difference in UBE2I mRNA expression between the two groups (P > 0.05). Overall, these findings indicate that TLR3 and IL2RB may serve as key genes for autophagy and senescence in osteoarthritis chondrocytes and potentially be used as diagnostic molecular markers and therapeutic targets for osteoarthritis.  

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    Functional characterization of Caspr2 in a mouse model of sciatic nerve injury
    Liu Chenglong, Wei Shanwen, Zhou Liyu, Li Di, Zou Mingming, Ma Yanxia
    2026, 30 (34):  8899-8905.  doi: 10.12307/2026.881
    Abstract ( 29 )   PDF (1783KB) ( 25 )   Save
    BACKGROUND: The intrinsic molecular mechanisms and regulatory networks underlying peripheral nerve injury still require systematic investigation. Contactin-associated protein-like 2 (Caspr2), a cell adhesion molecule specifically expressed on the axonal surface, plays a crucial role in nerve fiber myelination. However, its dynamic regulatory mechanisms in peripheral nerve regeneration remain unclear. 
    OBJECTIVE: To focus on characterizing the functional role of Caspr2 in a sciatic nerve injury model and to elucidate its molecular mechanisms in regulating axonal regeneration in dorsal root ganglion neurons, thereby providing new insights for developing precise repair strategies for peripheral nerve injuries.
    METHODS: A sciatic nerve crush injury model was established in ICR mice. qRT-PCR and western blot were used to analyze the transcriptional and protein expression profiles of Caspr2 in dorsal root ganglion tissues. Immunofluorescence staining was employed to detect Caspr2 expression in dorsal root ganglion neurons. A primary dorsal root ganglion neuron culture system was used to construct intervention models: Caspr2 siRNA negative control group, Caspr2 siRNA treatment group, Caspr2 overexpression group, and Caspr2 empty vector control group. Tuj1 immunofluorescence staining and AxioVision image analysis were performed to quantitatively assess axonal regeneration dynamics.
    RESULTS AND CONCLUSION: (1) Injury response characteristics: On day 3 post-injury, both mRNA and protein levels of Caspr2 in dorsal root ganglion tissues decreased, with further reduction by day 7. Additionally, Caspr2 expression in dorsal root ganglion neurons was significantly reduced by day 7 post-injury. (2) Loss-of-function effect: Caspr2 siRNA treatment significantly promoted neuronal axon growth. (3) Overexpression effect: Caspr2 overexpression markedly inhibited axonal elongation. These findings indicate that Caspr2 acts as a key inhibitory factor in peripheral nerve regeneration, bidirectionally regulating axonal regenerative capacity and participating in nerve repair.
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    Interleukin-10 alleviates inflammatory responses after acute tendon injury
    Jiang Li, Peng Guoqiang, Li Sen
    2026, 30 (34):  8906-8913.  doi: 10.12307/2026.842
    Abstract ( 30 )   PDF (3964KB) ( 23 )   Save
    BACKGROUND: During the repair process following tendon injury, an excessive inflammatory response can cause tendon cell apoptosis, thereby leading to a reduction in the biomechanical properties of the tendon. Meanwhile, a persistent inflammatory response can also trigger tissue fibrosis and adhesion. Studies have confirmed that interleukin-10 exerts an inflammatory regulatory role in connective tissue cells such as fibroblasts and can block inflammatory responses produced in various models.
    OBJECTIVE: To explore the effect of interleukin-10 against inflammatory responses following acute tendon injury. 
    METHODS: Forty-two Sprague-Dawley rats were randomly divided into a normal group (n=6), model group (n=12), control group (n=12), and intervention group (n=12). Except for the normal group, the other three groups underwent acute Achilles tendon injury modeling via intra-tendinous injection of type I collagenase solution (the model was successfully established after 3 days). On the day of modeling, the control and intervention groups were subjected to daily injections of PBS and interleukin-10 protein solution, respectively, at the 1 cm points on both sides of the intersection between the line connecting the hind limbs and the midline of the abdomen, once daily for 4 consecutive days. Ultrasound examination of the Achilles tendon was performed on day 3 after successful modeling. Tissue samples were collected on days 3 and 7 after successful modeling. Hematoxylin-eosin staining was used to observe pathological changes in the Achilles tendon, while immunohistochemical staining was used to detect the expression of phosphorylated nuclear factor κB and tumor necrosis factor α proteins in the Achilles tendon. RT-PCR was used to detect mRNA expression of nuclear factor κB, tumor necrosis factor α, and cyclooxygenase-2 in Achilles tendon tissue. Western blot analysis was performed to detect protein expression of phosphorylated nuclear factor κB, tumor necrosis factor α, and cyclooxygenase-2 in Achilles tendon tissue.
    RESULTS AND CONCLUSION: (1) Ultrasound examination revealed that in the model group, the Achilles tendon tissue had a blurred boundary and increased thickness, whereas in the intervention group, the Achilles tendon tissue exhibited a clearer boundary and tissue thickness close to that of the normal group. (2) Hematoxylin-eosin staining demonstrated that on day 3 after successful modeling, in the model and control groups, the collagen fibers of the Achilles tendon arranged irregularly, with extensive infiltration of inflammatory cells, and the nuclei exhibited a round, concentrated distribution. In the intervention group, the disorganization of collagen fiber alignment was alleviated, with minimal infiltration of inflammatory cells, and a higher number of long spindle-shaped tendon cells. On day 7 after successful modeling, the model and control groups showed significantly improved collagen fiber alignment and reduced inflammatory cell infiltration in the Achilles tendon. Tendon cells exhibited a transition from round to spindle-shaped morphology. Most nuclei were neatly arranged and evenly distributed. In the intervention group, the collagen fibers of the Achilles tendon were arranged in parallel and orderly, tending toward normal. Infiltration of inflammatory cells was further reduced, and tendon cells predominantly exhibited a long spindle shape. (3) Immunohistochemical staining showed that on days 3 and 7 after successful modeling, the protein expression levels of phosphorylated nuclear factor κB and tumor necrosis factor-α) in the Achilles tendon of the model group were higher than those in the normal group and the intervention group (P < 0.05). RT-PCR detection showed that on days 3 and 7 after successful modeling, the mRNA expression levels of phosphorylated nuclear factor κB, tumor necrosis factor-α, and cyclooxygenase-2 in the Achilles tendon of the model group were higher than those in the normal group and the intervention group (P < 0.05). (4) Western blot analysis indicated that on days 3 and 7 after successful modeling, the protein and mRNA expression levels of phosphorylated nuclear factor κB, tumor necrosis factor-α, and cyclooxygenase-2 in the Achilles tendon of the model group were higher than those in the normal group (P < 0.05). On day 3 after successful modeling, the intervention group exhibited lower protein expression of phosphorylated nuclear transcription factor κB, tumor necrosis factor α, and cyclooxygenase-2 in the Achilles tendon compared with the model group (P < 0.05). To conclude, administration of interleukin-10 can effectively attenuate inflammatory responses during the repair of acute tendon injury.

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    Effects of different frequency electroacupuncture on mitochondrial function and oxidative stress injury in quadriceps femoris muscle of rabbits with anterior cruciate ligament injury
    Zhang Pengyi, Huang Yongyuan, Su Hong, Xu Zhaolin, Wang Chenxi, Li Jiaying, Yang Xuejie
    2026, 30 (34):  8914-8920.  doi: 10.12307/2026.877
    Abstract ( 29 )   PDF (1562KB) ( 10 )   Save
    BACKGROUND: Oxidative stress is one of the potential factors contributing to muscle atrophy following anterior cruciate ligament injury. Alleviating skeletal muscle fatigue facilitates proprioceptive recovery, thereby accelerating rehabilitation after anterior cruciate ligament injury. Improving mitochondrial function helps mitigate skeletal muscle fatigue-related damage.
    OBJECTIVE: To verify that electroacupuncture at different frequencies alleviates skeletal muscle oxidative stress damage and improves mitochondrial function in rabbits, thereby reducing skeletal muscle fatigue, restoring proprioceptive function, and accelerating rehabilitation following anterior cruciate ligament injury.
    METHODS: Twenty-four healthy New Zealand rabbits were randomly divided into blank group, model group, low-frequency electroacupuncture group and high-frequency electroacupuncture group, with six rabbits in each group. The model group, low-frequency electroacupuncture group and high-frequency electroacupuncture group were used to establish the anterior cruciate ligament injury model of the knee joint. The low-frequency electroacupuncture group and high-frequency electroacupuncture group were treated with electroacupuncture at the Xuehai and Liangqiu acupoints on the injured side of the knee joint 7 days after modeling, while the blank and model groups were only grasped and fixed without electroacupuncture intervention. The treatment was continued for 21 days. After the intervention, the contents of superoxide dismutase, succinate dehydrogenase, malondialdehyde in the quadriceps femoris were detected by ELISA; the expression levels of silent information regulator 2-related enzyme 1, peroxisome proliferator-activated receptor gamma coactivator 1α, and mitochondrial transcription factor A proteins in the skeletal muscle tissue of rabbits and the mRNA expression levels of silent information regulator 2-related enzyme 1, peroxisome proliferator-activated receptor gamma coactivator 1α, nuclear respiratory factor 1, and mitochondrial transcription factor A were detected by western blot assay.
    RESULTS AND CONCLUSION: After anterior cruciate ligament injury, the expression level of superoxide dismutase in the quadriceps femoris of rabbits increased, the expression level of succinate dehydrogenase decreased, and the expression level of malondialdehyde increased; the expression levels of silent information regulator 2-related enzyme 1, peroxisome proliferator-activated receptor gamma coactivator 1α, and mitochondrial transcription factor A proteins decreased; the mRNA expression levels of silent information regulator 2-related enzyme 1, peroxisome proliferator-activated receptor gamma coactivator 1α, nuclear respiratory factor 1, and mitochondrial transcription factor A were significantly down-regulated. After electroacupuncture intervention, the expression of malondialdehyde in the quadriceps femoris on the injured side decreased, the activities of superoxide dismutase and succinate dehydrogenase increased, the expression levels of silent information regulator 2-related enzyme 1, peroxisome proliferator-activated receptor gamma coactivator 1α, and mitochondrial transcription factor A proteins increased; the mRNA expression levels of silent information regulator 2-related enzyme 1, peroxisome proliferator-activated receptor gamma coactivator 1α, nuclear respiratory factor 1, and mitochondrial transcription factor A, which are related to mitochondrial biogenesis, increased, and the low-frequency electroacupuncture group was superior to the high-frequency electroacupuncture group. To conclude, electroacupuncture can reduce oxidative stress damage in skeletal muscle after anterior cruciate ligament injury by increasing the levels of superoxide dismutase and succinate dehydrogenase and reducing the content of malondialdehyde; and improve mitochondrial function by regulating the expression of silent information regulator 2-related enzyme 1/peroxisome proliferator-activated receptor gamma coactivator 1α signaling pathway-related proteins and regulating the mRNA expression levels of genes related to mitochondrial biogenesis, thereby accelerating the recovery after anterior cruciate ligament injury.

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    Effects of Gushukang Granules on the expression of myogenic and osteogenic factors in the muscles and bones of sarcopenic osteoporosis rats
    Wei Wei, Wang Deyu, Yu Zhitong, Qiao Chunlin, Cui Xiangran, Liu Hongfei, Wang Chengbo, Wang Shixuan, Teng Hai
    2026, 30 (34):  8921-8929.  doi: 10.12307/2026.896
    Abstract ( 27 )   PDF (4080KB) ( 9 )   Save
    BACKGROUND: In sarcopenic osteoporosis, muscle loss and osteoporosis often coexist, leading to a significant increase in the risk of falls and fractures. Gushukang Granules are clinically used for the treatment of osteoporosis; however, the mechanism of action on myogenic and osteogenic factors in muscle and bone remains unclear.
    OBJECTIVE: To investigate the effects of Gushukang Granules on myogenic and osteogenic factors in the muscles and bones of rats.
    METHODS: Thirty-six healthy Sprague-Dawley rats were randomly divided into a control group, a model group, and a Gushukang Granules group, with 12 rats in each group. Osteoporosis was induced in the latter two groups via ovariectomy. Four weeks after surgery, drug administration began. The Gushukang Granules group was given 1.05 mL/kg of Gushukang Granules solution by gavage daily, while the other groups received an equal volume of normal saline, once a day for 12 consecutive weeks. General conditions of the rats in each group were observed. Hematoxylin-eosin staining was used to examine morphological changes in the bone and muscle tissues. Real-time quantitative polymerase chain reaction was performed to measure mRNA expression levels of interleukin-6, tumor necrosis factor-α, osteocalcin, and insulin-like growth factor-1 in the muscle tissues. Immunohistochemistry was used to observe the expression of interleukin-6, tumor necrosis factor-α, insulin-like growth-1, and osteocalcin in the muscle and bone tissues. Western blot was used to detect the protein expression levels of interleukin-6, tumor necrosis factor-α, insulin-like growth 1, and osteocalcin in the muscle and bone tissues. 
    RESULTS AND CONCLUSION: (1) Compared with the control group, the model group exhibited typical sarcopenic osteoporosis phenotypes: In muscle tissue, muscle fibers were sparsely and disorderly arranged with widened spacing, accompanied by significant atrophy. In bone tissue, the number of trabeculae decreased, with sparse arrangement, widened spacing, visible fractures, and poor connectivity. mRNA and protein expression of interleukin-6 and tumor necrosis factor-α were significantly increased (P < 0.01), while mRNA and protein expression of insulin-like growth 1 and osteocalcin were significantly decreased (P < 0.01) in both muscle and bone tissues. (2) Compared with the model group, the Gushukang Granules group showed significant improvements in the above indicators: In muscle tissue, the arrangement of muscle fibers tended to be more orderly, with obvious interstitial fibrosis. In bone tissue, the number of trabeculae increased, and connectivity improved (though still relatively loose). mRNA and protein expression of interleukin-6 and tumor necrosis factor-α were significantly decreased (P < 0.01), while mRNA and protein expression of insulin-like growth-1 and osteocalcin were significantly increased (P < 0.01) in both muscle and bone tissues. (3) Western blot results were consistent with the immunohistochemistry trends. Overall, these findings suggest that Gushukang Granules can improve muscle atrophy and trabecular sparseness in ovariectomized rats by downregulating the abnormally high expression of interleukin-6 and tumor necrosis factor-α and upregulating the expression of insulin-like growth-1 and osteocalcin in muscle and bone tissues. Its effects may be related to regulating the muscle-bone interaction signaling pathway and balancing inflammatory and growth-promoting factors, providing experimental support for the clinical application of Gushukang Granules in sarcopenic osteoporosis. 

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    Mechanism of epothilone B improving spinal cord microcirculation after spinal cord injury in rats
    Yin Haoran, Wang Fangyong
    2026, 30 (34):  8930-8938.  doi: 10.12307/2026.880
    Abstract ( 35 )   PDF (3480KB) ( 9 )   Save
    BACKGROUND: Animal experiments have found that epothilone B can remodel blood microcirculation and reduce tissue scar formation after spinal cord injury, but the specific mechanism remains unclear.  
    OBJECTIVE: To clarify the mechanism by which epothilone B improves spinal cord microcirculation after spinal cord injury.  
    METHODS: Fifty Sprague-Dawley rats were randomly divided into a sham-operated group (n=10), a spinal cord injury group (n=20), and an epothilone B group (n=20). The sham-operated group underwent only laminectomy at T10, while the other two groups were subjected to laminectomy at T10 followed by spinal cord contusion. Immediately after modeling, the epothilone B group received intraperitoneal injections of Epothilone B solution, while the other two groups received corresponding solvents. At corresponding time points post-modeling, Basso-Beattie-Bresnahan scores, inclined plane tests, and open field tests were used to assess motor function. Laser speckle contrast imaging was employed to measure blood flow recovery in the posterior median spinal vessels. Hematoxylin-eosin staining was used to evaluate overall spinal tissue conditions. Western blot was performed to detect Toll-like receptor 4 and nuclear factor κB protein expression. Immunofluorescence staining was used to assess vascular endothelial growth factor receptor 2 and Toll-like receptor 4 expression in spinal cord injury tissues.  
    RESULTS AND CONCLUSION: At 14 and 28 days post-modeling, the Basso-Beattie-Bresnahan scores in the Epothilone B group were higher than those in the spinal cord injury group (P < 0.05). At 28 days post-modeling, the inclined plane test angle was greater in the epothilone B group than the spinal cord injury group (P < 0.05). At 14 and 28 days post-modeling, the movement distance in the open field test was greater in the epothilone B group than in the spinal cord injury group (P < 0.05), indicating that epothilone B improved motor function in rats with spinal cord injury. Laser speckle contrast imaging at 28 days post-modeling showed that epothilone B enhanced blood flow recovery in rats with spinal cord injury. Hematoxylin-eosin staining at 28 days post-modeling revealed that the spinal cavity area was smaller in the epothilone B group than in the spinal cord injury group (P < 0.05). Western blot analysis at 5 days post-modeling showed that Toll-like receptor 4 and nuclear factor κB protein expression was higher in the spinal cord injury group than in the sham-operated and epothilone B groups (P < 0.05). Immunofluorescence staining at 5 days post-modeling demonstrated that vascular endothelial growth factor receptor 2 expression was lower in the spinal cord injury group than in the sham-operated and Epothilone B groups (P < 0.05), while Toll-like receptor 4 expression was higher in the spinal cord injury group than in the sham-operated and epothilone B groups (P < 0.05). These findings suggest that Epothilone B may alleviate local inflammation after spinal cord injury by regulating the Toll-like receptor 4 and nuclear factor κB pathways, thereby ensuring vascular endothelial cell regeneration within the spinal tissue and promoting the reconstruction of blood microcirculation.
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    Application of tissue clearing technology in a rat model of chronic spinal cord injury
    Wang Zhizhuang, Xu Bo, Ma Guoliang, Zhang Dan, Qin Xiaokuan, Feng Minshan, Chen Xin, Yang Kexin, Yang Bowen, Yin He
    2026, 30 (34):  8939-8945.  doi: 10.12307/2026.888
    Abstract ( 32 )   PDF (1412KB) ( 11 )   Save
    BACKGROUND: Studies have shown that tissue clearing technology enables the three-dimensional (3D) visualization of neurons in the spinal cord injury area, clearly presenting morphological changes of neurons, including soma atrophy, dendrite fragmentation, and axonal degeneration.
    OBJECTIVE: To systematically evaluate the application potential of tissue clearing technology in a rat model of chronic spinal cord injury.
    METHODS: Thirty-six female Sprague-Dawley rats were randomly and equally divided into a normal group (n=12), a sham surgery group (n=12), and a surgery group (n=12). The normal group received no treatment. The sham group underwent implantation and immediate removal of a poly(vinyl alcohol)/polyacrylamide interpenetrating network hydrogel into the C5-C7 spinal canal. The surgery group received implantation of the hydrogel to compress the spinal cord at C5-C7 to establish a chronic spinal cord injury model. Motor function was assessed using the Basso-Beattie-Bresnahan score and the modified Rivlin inclined plane test on postoperative days 1, 3, 7, and 14. On day 14, spinal cord tissue was harvested. Hematoxylin-eosin staining was used to observe tissue morphology. Tissue clearing combined with immunofluorescence labeling for neuron-specific nuclear protein (NeuN) was performed for 3D reconstruction analysis and cross-sectional view analysis of the spinal cord.
    RESULTS AND CONCLUSION: (1) The Basso-Beattie-Bresnahan scores and inclined plane angles in the surgery group on postoperative days 1, 3, 7, and 14 were significantly lower than those in the normal and sham groups (P < 0.001). (2) Hematoxylin-eosin staining revealed significant spinal cord injury in the surgery group: neurons in the gray matter showed swelling and disruption, the white matter structure lost uniformity and stability, some nuclei disappeared, cell numbers decreased, extensive glial cell proliferation and aggregation occurred in the compression area, white matter structure was disordered, and numerous cavities formed. (3) 3D reconstruction and cross-sectional analyses of the spinal cord tissue showed that the spinal cord appeared continuous and full with uniformly distributed NeuN red fluorescence signal in the normal and sham groups. Neurons in the ventral horn of the gray matter were densely arranged in layers, and white matter fiber tracts were intact. In the surgery group, the spinal cord appeared sunken or even interrupted. NeuN fluorescence intensity was markedly weakened in the compressed segments, the layered structure of gray matter neurons was disrupted, and regional fluorescence interruption was observed. These findings indicate that tissue clearing technology can effectively reveal the structural changes of spinal cord tissue after injury, providing strong support for research into the pathological mechanisms of spinal cord injury.
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    Immunological mechanisms of Xuling Jiangu Formula in intervening osteoporosis model rats
    Huang Jingwen, Li Shengqiang, Jiang Hong, Chen Xuan, Ye Yunjin, Ge Jirong
    2026, 30 (34):  8946-8952.  doi: 10.12307/2026.895
    Abstract ( 31 )   PDF (2046KB) ( 6 )   Save
    BACKGROUND: Osteoporosis is not only a metabolic disease, but also an inflammatory or autoimmune disease. Immune cells Treg and Th17 have a mutually antagonistic effect on the differentiation and maturation of osteoclasts, and the maintenance of cell balance between the two is the basis for ensuring normal bone metabolism
    OBJECTIVE: To explore the immunomodulatory mechanism of Xuling Jiangu Formula on osteoporosis and its relationship with the balance of Treg/Th17 cells.
    METHODS: Sprague-Dawley rats were randomly divided into a sham operation group, a model group, and a drug group, with eight rats in each group. The latter two groups underwent bilateral ovariectomy to establish the animal model; the sham operation group underwent the same procedure except for ovary removal. Four weeks after modeling, bone mineral density was measured using dual-energy X-ray absorptiometry to evaluate whether the modeling was successful. Drug intervention started 4 weeks after surgery: the Xuling Jiangu Formula group was administered Xuling Jiangu Formula by gavage once daily at 10 mL/kg for 16 consecutive weeks; the model group and sham operation group were given an equal volume of physiological saline by gavage. After 16 weeks of drug administration, samples were collected. Bone mineral density and routine blood indicators were measured; bone tissue morphology was observed by hematoxylineosin staining; serum immune factor levels were detected by ELISA; gene and protein expression of osteoprotegerin, receptor activator of nuclear factor κB ligand, retinoic acidrelated orphan receptor γT, and forkhead transcription factor 3 were measured by quantitative PCR and western blot assays; and the number of regulatory T (Treg) cells and Th 17 cells was detected by flow cytometry.
    RESULTS AND CONCLUSION: (1) After 16 weeks of drug administration, compared with the model group, the bone mineral density of rats in the Xuling Jiangu Formula group significantly increased (P < 0.05). The serum levels of immune cytokines interleukin10 and transforming growth factor β increased but without significant difference, while the levels of interleukin 17 and interleukin 6 significantly decreased (P < 0.05). (2) After 16 weeks of drug administration, the gene and protein expression of osteoprotegerin and the Treg cell marker gene forkhead transcription factor 3 in the Xuling Jiangu Formula group were significantly higher than those in the model group (P < 0.05), whereas the gene and protein expression of the Th17 cell marker gene retinoic acidrelated orphan receptor γT significantly decreased (P < 0.05). The protein expression of receptor activator of nuclear factorκB ligand significantly decreased (P < 0.05), while its gene expression showed a decreasing trend without significant difference. (3) Flow cytometry results showed that the number of Treg cells in the Xuling Jiangu Formula group significantly increased (P < 0.05), while the number of Th17 cells decreased but without statistical significance. These findings suggest that the immune mechanism of Xuling Jiangu Formula in treating osteoporosis involves increasing the number of Treg cells to influence the Treg/Th17 balance, subsequently reducing the secretion of interleukin17 and interleukin6, promoting upregulation of forkhead transcription factor 3 and downregulation of retinoic acidrelated orphan receptor γT, thereby altering the osteoprotegerin/receptor activator of nuclear factor κB ligand ratio and further inhibiting osteoclast differentiation.

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    Mechanisms by which mangiferin alleviates pain in osteoarthritis: integration of microarray data analysis, network pharmacology, and experimental validation in a rat model
    Jing Kun, Wang Yulu, Liang Hao, Huo Yuhang, Cong Longxu,
    2026, 30 (34):  8953- 8961.  doi: 10.12307/2026.850
    Abstract ( 38 )   PDF (12152KB) ( 10 )   Save
    BACKGROUND: Mangiferin, a major bioactive compound derived from mango trees, is widely present in various traditional Chinese medicinal herbs and exhibits multiple biological functions including antibacterial, cholesterol-lowering, and anti-allergic effects. Existing studies have suggested that mangiferin may prevent and treat osteoarthritis pain. However, its specific mechanism of action remains unclear to date.
    OBJECTIVE: To systematically investigate the key targets and potential mechanisms of mangiferin in the treatment of osteoarthritis by integrating gene expression omnibus (GEO) microarray data analysis, network pharmacology, and molecular docking techniques, and to validate the findings through animal experiments.
    METHODS: First, potential therapeutic targets for osteoarthritis were mined using GEO microarray data. Next, the therapeutic targets of mangiferin were predicted by combining professional databases, and disease targets related to osteoarthritis were collected. A Venn diagram was generated using the EVenn platform, and a protein-protein interaction network was constructed using the STRING database. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed. A drug-target-pathway-disease network diagram was generated using Cytoscape 3.8.0 software, and molecular docking analyses and visualizations were conducted via the CBDOCK2 online platform. The osteoarthritis rat model was established using the anterior cruciate ligament transection method, followed by intervention with different concentrations of mangiferin, and the therapeutic effects were observed and recorded.
    RESULTS AND CONCLUSION: (1) A total of 144 potential targets for mangiferin were identified from multiple databases. (2) Protein-protein interaction network analysis revealed key targets such as interleukin 6, tumor necrosis factor, and nuclear factor κB1. (3) Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis indicated that mangiferin may be involved in 235 signaling pathways, including those related to lipids, atherosclerosis, advanced glycation end product-receptor of advanced glycation end product, hypoxia-inducible factor 1, and estrogen, all of which are closely associated with inflammation. (4) In animal experiments, after 4 weeks of treatment with 40 μmol/L mangiferin, there was no significant difference in weight-bearing of the hind limbs between the treatment and sham surgery groups. Overall, mangiferin may exert therapeutic effects on osteoarthritis through a multi-target and multi-pathway mode of action, providing new potential strategies and theoretical foundations for the treatment of osteoarthritis.
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    Mazdutide improves cognitive function in APP/PS1/Tau triple transgenic mice
    Yuan Jingjing, Zhang Xiaomin, Du Pengyang, Wang Weifeng
    2026, 30 (34):  8962-8969.  doi: 10.12307/2026.897
    Abstract ( 39 )   PDF (3019KB) ( 16 )   Save
    BACKGROUND: The pathological process of Alzheimer's disease is closely related to β-amyloid/Tau deposition and cerebrovascular dysfunction, and existing therapies are difficult to effectively intervene. In recent years, research on glucagon-like peptide-1 receptor agonists for the treatment of Alzheimer's disease has gained increasing popularity. As a novel dual agonist of the glucagon-like peptide-1 receptor and glucagon receptor, the therapeutic mechanism of Mazdutide in Alzheimer’s disease remains to be elucidated.  
    OBJECTIVE: To systematically explore the mechanism by which Mazdutide improves cognitive function in Alzheimer’s disease using a strategy combining network pharmacology and experimental validation, and to identify its potential core molecular targets, providing a theoretical basis for developing new treatment strategies for this disease.  
    METHODS: A multi-omics integration strategy was employed: Alzheimer’s disease-Mazdutide co-localization targets were screened based on the DisGeNET and SEA databases; protein-protein interaction networks were constructed via STRING, and core hub genes were identified through Cytoscape topology analysis; in APP/PS1/Tau triple transgenic Alzheimer’s disease mice, cognitive function was assessed following intraperitoneal injection of mazdutide (30 nmol/kg) using the Morris water maze, novel object recognition, and Y-maze tests. Western blot was used to detect hippocampal Aβ (6E10), p-Tau181, and endothelin receptor A expression.  
    RESULTS AND CONCLUSION: (1) Fifty-two co-localized targets were identified, with endothelin receptor A ranking as the top hub gene. (2) Mazdutide significantly improved cognition in 3xTg mice: spatial memory latency was shortened, episodic memory recognition index was enhanced, spontaneous alternation accuracy in working memory was increased, hippocampal pathological load was reduced, p-Tau181 levels were decreased, and EDNRA overexpression was suppressed. (3) Gene Ontology/Kyoto Encyclopedia of Genes and Genomes enrichment analyses revealed core pathways: in biological processes, the most significantly enriched terms included regulation of blood pressure and regulation of amine transport; cellular component analysis showed primary enrichment in symmetric synapses, sperm head, and pseudopodium structures; in molecular function, G protein-coupled peptide receptor activity, peptide receptor activity, and neuropeptide receptor activity dominated; in Kyoto Encyclopedia of Genes and Genomes pathway analysis, neuroactive ligand-receptor interaction, calcium signaling pathway, and hormone signaling were the three most significant pathways. (4) This study confirmed that Mazdutide may alleviate neuronal pathological damage and multi-dimensionally reverse cognitive impairment in Alzheimer’s disease by targeting and inhibiting EDNRA overexpression. The discovery of EDNRA provides a novel therapeutic target for Alzheimer’s disease.  
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    Establishment and identification of a patient-derived organoid model for esophagogastric junction adenocarcinoma
    Gao Zhendong, Zhang Li, Chen Pan, Yin Xiyao, Li Jiayi, Yang Pingjuan, Zhang Min, Liao Shuxin, Shi Linlin, Gao Shegan
    2026, 30 (34):  8970-8977.  doi: 10.12307/2026.891
    Abstract ( 35 )   PDF (4443KB) ( 10 )   Save
    BACKGROUND: Traditional cell culture models exhibit substantial limitations in accurately recapitulating the complex biological characteristics of tumors. In contrast, organoid, which maintains the essential biological features of primary tumors, offers a highly effective platform for comprehensive investigation into the pathogenesis of adenocarcinoma of the esophagogastric junction and the advancement of precision diagnostics and targeted therapeutic strategies.
    OBJECTIVE: To Establish patient-derived organoid models of gastroesophageal junction adenocarcinoma, evaluate their fidelity in representing the biological characteristics of primary tumors, and provide a standardized in vitro model for investigating the pathogenesis of gastroesophageal junction adenocarcinoma and advancing precision medicine.
    METHODS: Fifty surgical resection specimens were obtained from patients with adenocarcinoma of the esophagogastric junction and used for tissue dissociation, culture, and the establishment of organoid models. Cell viability in the constructed organoid models was evaluated using fluorescence co-localization staining. Hematoxylin-eosin staining was performed to compare structural morphological features between patient-derived organoid models of esophagogastric junction adenocarcinoma and their corresponding primary tumor tissues. Periodic Acid-Schiff staining was carried out to detect mucin-secreting phenotypes in the patient-derived organoid models. Immunohistochemistry was conducted to assess histopathological consistency between the organoid models and the original tumor tissues. The chi-square test and univariate logistic regression analysis were utilized to explore potential associations between the success rate of organoid model establishment and the clinicopathological characteristics as well as tissue features of the patients.
    RESULTS AND CONCLUSION: In the patient-derived organoid models of esophagogastric junction adenocarcinoma established in this study, the primary culture success rate was 86.0% (43/50). The organoids exhibited a typical three-dimensional structure, progressively developing from cell aggregates into glandular lumen-like spherical formations. Stable subculturing was achieved within 7-10 days after primary culture, with no significant phenotypic changes observed across multiple passages. Furthermore, the organoids maintained a stable proliferative capacity after cryopreservation and subsequent thawing. Fluorescence co-localization staining confirmed that the patient-derived organoid models of esophagogastric junction adenocarcinoma maintained high cell viability across all stages of culture. Hematoxylin-eosin staining revealed that both the patient-derived organoid models and the corresponding primary tumor tissues exhibited dysplastic glandular architecture and an increased nuclear-to-cytoplasmic ratio. Periodic Acid-Schiff staining demonstrated consistent mucin secretion positivity. Immunohistochemistry analysis revealed a high degree of concordance in the positive expression rates of Ki67, CEA, CK7, and Cadherin17 between the organoids and the corresponding primary tumor tissues. Moreover, chi-square test and logistic regression analyses indicated that poorly differentiated tumor tissues (P=0.02), major pathological response to neoadjuvant chemotherapy in patients with adenocarcinoma of the esophagogastric junction (P=0.007), ex vivo duration of tumor tissues (P=0.006), and tumor tissue weight (P=0.006) were significantly associated with the success rate of organoid model establishment.

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    Lentivirus-mediated gene therapy in a beta-thalassemia mouse model 
    Liu Hongwei, Chang Lungji
    2026, 30 (34):  8978-8985.  doi: 10.12307/2026.771
    Abstract ( 39 )   PDF (4184KB) ( 8 )   Save
    BACKGROUND: Lentiviral vector (LV)-mediated autologous hematopoietic stem cell gene therapy is expected to be a novel curative treatment for β-thalassemia. The LV serves as a core agent of gene therapy, directly influencing future clinical efficacy and treatment costs. Therefore, the primary task is to develop high-performance lentiviral vectors.
    OBJECTIVE: To explore the feasibility of an ex vivo gene therapy and assess the activity and functionality of the β-globin-LV in thalassemic mice.
    METHODS: A novel lentiviral vector, HS40-LV, carrying the human β-globin gene cassette, was constructed. 7.5 Gy-conditioned Hbbth3/+ mice were subjected to HS40-LV-modified hematopoietic stem cell transplantation. Normal mice and untreated thalassemic mice served as controls. Peripheral blood samples were collected from mice at 2, 4, 6, 8, and 10 months post-treatment. The integrated proviral DNA in the individual sample was detected by using qPCR. The proportion of red blood cells expressing human β-globin was detected by fluorescence-activated cell sorting. Fresh whole blood was collected for blood smears, which were used for Giemsa staining, reticulocyte staining, and fully automated blood cell analysis. At 10 months post-treatment, the liver, spleen, and bone marrow tissues were sampled from all three groups to prepare single-cell suspensions and extract genomic DNA. qPCR was used to detect the labeling ratio of the LV. Flow cytometry was used to determine the proportion of cells expressing transgenic β-globin. Portions of spleen and liver tissues were fixed, embedded, sectioned, and subsequently stained with hematoxylin-eosin and Prussian blue.
    RESULTS AND DISCUSSION: (1) The HS40-LV achieved a 50% transduction efficiency in hematopoietic stem cells. (2) Over the 10-month follow-up period, the proportion of vector-marked cells and β-globin-expressing cells in the peripheral blood of treated mice exhibited a sustained increase, reaching up to 50% marking efficiency and 70% β-globin-positive red blood cells. (3) The presence of the HS40-LV proviral DNA and transgenic β-globin was detected in the liver, spleen, and bone marrow. (4) Gene therapy achieved hematological correction in thalassemic mice, manifested by a significant reduction in poikilocytes, reticulocytes, and cellular debris, along with a marked increase in total hemoglobin levels. (5) Histopathological remission was also observed, including decreased iron deposition in the spleen and liver and ameliorated extramedullary hematopoiesis. These findings demonstrate that the novel HS40 LV vector achieves stable expression in vivo, and the modified cells partially relieve symptoms in thalassemia mice.

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    Mitochondrial kinetic mechanism by which triptolide alleviates hydrogen peroxide-induced apoptosis in SH-SY5Y cells
    Mu Bingtao, Guo Minfang, Hu Fenqi, Liu Qiyuan, Jia Hui, Xu Mingyuan, Chen Jiayuan, Zhang Huiyu, Meng Tao, Yu Jiezhong
    2026, 30 (34):  8986-8993.  doi: 10.12307/2026.892
    Abstract ( 32 )   PDF (17216KB) ( 26 )   Save
    BACKGROUND: Previous studies from our group have shown that triptolide exerts protective effects on nerve cells and alleviates symptoms of neurodegenerative diseases. However, whether it acts by improving mitochondrial dynamic abnormalities requires further investigation.
    OBJECTIVE: To explore the effect and mechanism of triptolide in regulating the mitochondrial fusion-fission balance to mitigate hydrogen peroxide (H₂O₂)-induced apoptosis in SH-SY5Y cells.
    METHODS: Human neuroblastoma SH-SY5Y cells were cultured and divided into three groups: control group, model group (200 μmol/L H₂O₂), and triptolide group (2.5 nmol/L triptolide + 200 μmol/L H₂O₂). After 24 hours of intervention, oxidative stress markers (superoxide dismutase activity and malondialdehyde levels), mitochondrial membrane potential, and apoptotic rate were measured. Western blot was used to detect the expression of apoptosis-related proteins, mitochondrial dynamics-related proteins, and respiratory chain-related proteins. Immunofluorescence staining was used to detect the expression of phospho-dynamin-related protein 1, optic atrophy protein 1, cytochrome c oxidase 1, and ATP synthase F1 subunit α.
    RESULTS AND CONCLUSION: Compared with the control group, the model group showed significantly decreased superoxide dismutase activity, mitochondrial membrane potential, and expression levels of anti-apoptotic protein Bcl-2, mitochondrial fusion protein 1, mitochondrial fusion protein 2, optic atrophy protein 1, and ubiquinone oxidoreductase subunit B8, panthenol-cytochrome C reductase core protein 2, cytochrome C oxidase 1, succinate dehydrogenase B, and ATP synthase F1 subunit α (P < 0.05). In contrast, malondialdehyde levels, expression of pro-apoptotic proteins (Bax, Caspase-3) and mitochondrial fission protein 1 and phospho-p161, and apoptotic rate were significantly increased (P < 0.05). Compared with the model group, triptolide intervention reduced malondialdehyde levels, increased superoxide dismutase activity and mitochondrial membrane potential, promoted the expression of fusion proteins, suppressed the expression of fission proteins, elevated the levels of oxidative phosphorylated complex protein, and decreased the apoptotic rate (P < 0.05). These results confirm that triptolide can alleviate H₂O₂-induced apoptosis in SH-SY5Y cells by regulating mitochondrial dynamic imbalance.
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    Eight-week aerobic exercise and aerobic exercise combined with full-body vibration training improve the microcirculation function of obese college students
    Wen Fan, Zhu Huan, Hu Qinghua, Tuo Yanfang, Zhou Shufeng, Hu Jiangping, Wang Kangfeng
    2026, 30 (34):  8994-9001.  doi: 10.12307/2026.835
    Abstract ( 95 )   PDF (1500KB) ( 13 )   Save
    BACKGROUND: The occurrence and development of obesity are closely related to microcirculation dysfunction. Improving microcirculation dysfunction is of great significance to obese people. Studies have shown that both aerobic exercise and full-body vibration training can improve microcirculation dysfunction. However, most existing research focuses on single exercise modalities, with insufficient exploration of combined intervention studies.
    OBJECTIVE: To compare the effects of 8-week aerobic exercise and aerobic exercise combined with full-body vibration training on the microcirculation function of obese college students. 
    METHODS: Sixty obese college students (with a body fat percentage of ≥ 28% for females and ≥ 20% for males) were recruited and divided into three groups using the matching grouping method: The control group (n=20) did not undergo systematic exercise training; the aerobic exercise group (n=20) received 8 weeks of aerobic jogging (4 times a week, 60 minutes each session), and the combined exercise group (n=20) received 8 weeks of aerobic exercise combined with full-body vibration training (4 times a week, 60 minutes each session, including 51 minutes of aerobic jogging and 9 minutes of full-body vibration training). Before and after exercise, microvascular reactivity, transcutaneous partial pressure of oxygen, muscle oxygen saturation, as well as the levels of serum nitric oxide, endothelial nitric oxide synthase and endothelin-1 were detected in the three groups of subjects.
    RESULTS AND CONCLUSION: (1) After exercise, microvascular perfusion heat value, blood cell concentration heat value, blood cell migration velocity heat value, transcutaneous oxygen partial pressure, and muscle oxygen saturation in the aerobic exercise group and the combined exercise group were all higher than those in the control group (P < 0.05), and those in the combined exercise group were all higher than those in the aerobic exercise group (P < 0.05). The basal values of microvascular blood perfusion volume and blood cell migration velocity in the combined exercise group after exercise were higher than those before exercise (P < 0.05). The heated values of microvascular blood perfusion volume, blood cell concentration, and blood cell movement speed, transcutaneous oxygen partial pressure and muscle oxygen saturation after exercise in the aerobic exercise group and the combined exercise group were all higher than those before exercise (P < 0.05, P < 0.01). (2) After exercise, the levels of serum nitric oxide, endogenous nitric oxide synthase and nitric oxide/endothelin 1 in the aerobic exercise group and the combined exercise group were all higher than those in the control group (P < 0.05), while the levels of serum endothelin 1 were both lower than that in the control group (P < 0.05). The levels of serum nitric oxide, endogenous nitric oxide synthase and nitric oxide/endothelin in the combined exercise group were higher than those in the aerobic exercise group (P < 0.05), while the level of serum endothelin 1 was lower than that in the aerobic exercise group (P < 0.05). The levels of serum nitric oxide, endogenous nitric oxide synthase and nitric oxide/endothelin-1 after exercise in the aerobic exercise group and the combined exercise group were all higher than those before exercise (P < 0.05). These findings indicate that both 8-week aerobic exercise and aerobic exercise combined with full-body vibration training can improve the microcirculation function of obese subjects, and the intervention effect of aerobic exercise combined with full-body vibration training is better. Promoting endogenous nitric oxide release and increasing nitric oxide/endothelin-1 levels may be the potential mechanism by which exercise improves microcirculation function.
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    Correlation between body mass index and early recovery outcomes after kidney transplantation
    Zhong Xiaoping, Chen Dan, Xie Nianhua
    2026, 30 (34):  9002-9007.  doi: 10.12307/2026.871
    Abstract ( 32 )   PDF (1288KB) ( 8 )   Save
    BACKGROUND: The proportion of obesity in the Chinese population has increased year by year, but its impact on early renal function recovery after kidney transplantation has not been systematically elucidated, and localized research is urgently needed to provide evidence-based basis.
    OBJECTIVE: To investigate the effect of different body mass indexes on early renal function recovery in renal transplant recipients after surgery, to analyze the association between body mass index and postoperative creatinine, urine volume and hospital stay, and to propose clinical recommendations for individualized management.
    METHODS: The clinical data of 495 renal transplant recipients in the Second Xiangya Hospital of Central South University from 2019 to 2020 were retrospectively analyzed. According to the Chinese obesity standard, they were divided into a lean group (body mass index < 18.5 kg/m2, n=78), a normal group (18.5 ≤ body mass index < 24 kg/m2, n=273), an overweight group (24 kg/m2 ≤ body mass index < 28 kg/m2, n=119), and an obese group (body mass index ≥ 28 kg/m2, n=25). The baseline characteristics, postoperative creatinine, urine volume, and hospital stay were compared among the groups. Multivariate regression analysis was used to analyze the independent effect of body mass index on postoperative recovery. 
    RESULTS AND CONCLUSION: (1) The age of the obese group was significantly higher than that of the other groups (P < 0.001), and the proportion of living donors was the lowest (0%, P=0.015). The creatinine level on the 1st day after surgery and hospitalization days were the highest (P < 0.001), and the urine volume was the lowest (P < 0.001). (2) Multivariate regression showed that for every 1 kg/m2 increase in body mass index, the creatinine level on the 1st day after surgery increased by 38 μmol/L (β=0.38, P < 0.001) and the urine volume decreased by 32 mL (β=-0.41, P < 0.001). These findings suggest that increased body mass index is an independent risk factor for slow early renal function recovery and prolonged hospital stay after kidney transplantation. Based on the Chinese obesity standard (body mass index ≥ 28 kg/m²), it is recommended to strengthen perioperative monitoring, optimize immunosuppression regimens, and develop individualized fluid management strategies for obese recipients to improve prognosis. This study provides evidence-based basis for the stratified management of body mass index tailored to local populations.

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    Regional specificity of brain organoids and their application in ischemic stroke modeling and drug development 
    2026, 30 (34):  9008-9016.  doi: 10.12307/2026.857
    Abstract ( 48 )   PDF (1488KB) ( 19 )   Save
    BACKGROUND: The construction of brain organoid technology and its application in ischemic stroke are new research hotspots in recent years. The anatomy and functional organization of the brain of rodents are significantly different from those of the human brain, which determines that they cannot fully mimic the physiological, pathological and anatomical characteristics of the human brain. At the same time, there are ethical issues in obtaining brain tissue samples from patients in clinical practice, so the importance of brain organoids in ischemic stroke research is that they can replace clinical brain tissue and animal models to build in vitro research models that are more suitable for human brain tissue, which is of great value in disease mechanism modeling and drug development.
    OBJECTIVE: To review and summarize the current regional-specific studies on brain organoids are presented, providing new technical means and research strategies for the application of brain organoids in ischemic stroke modeling and drug development.
    METHODS: A literature search on organoids and ischemic stroke was conducted using the CNKI and PubMed databases. The retrieval period spanned from the inception of each database up to May 2025. Search terms included: “ischemic stroke, stroke, organoid, ischemia-reperfusion injury, glucose-oxygen deprivation/reoxygenation, forebrain organoid, hippocampal organoid, thalamic organoid, midbrain organoid” in Chinese and “ischemic stroke, stroke, organoids, oxygen-glucose deprivation/reoxygenation, middle cerebral artery occlusion, forebrain organoids, hippocampal organoids, thalamic organoids, midbrain organoids” in English. All the retrieved documents were original research articles and relevant reviews. A total of 98 articles were screened for analysis and summary.
    RESULTS AND CONCLUSION: (1) The dorsal anterior brain organoids simulate the cortical neuroepithelium and differentiate into astrocytes, excitatory neurons, and oligodendrocytes, etc. The ventral anterior brain organoids mimic the ganglion protrusions and develop into basal ganglia and striatum, showing extensive neuronal migration and maintaining GABAergic characteristics. (2) The transplantation of hippocampal organoids generated from human-induced pluripotent stem cells can integrate with the neural circuit function of the mouse hippocampus, receive excitatory input, and form a neuronal grid with synaptic connections. (3) The thalamus/hypothalamus organoids simulate the development, cell diversity, and exploration of dopamine neuron specificity of the human hypothalamic arcuate nucleus. (4) Midbrain organoids are widely used in the study of Parkinson’s disease modeling, gene editing, and drug development. (5) Oxygen-glucose deprivation induces brain organoids to simulate ischemic stroke in vitro, and to study neurological damage involved through death pathways such as apoptosis, necroptosis, autophagy, and ferroptosis. The expression profile of brain organoid genes changed significantly after oxygen-glucose deprivation treatment. The application of neuroprotective drugs such as carnooxalic acid or the transplantation of brain organoids in middle cerebral artery occlusion rats can improve the neurological function damage of rats, reduce the volume of infarction, and play an important role in the field of transplantation regenerative medicine.


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    The functions and underlying molecular mechanisms of PIEZO channels in nervous system diseases
    Liu Yuxiao, Huang Sijing, Geng Longyu, Gao Beiyao, Yang Guang, Ge Ruidong, Gao Qi
    2026, 30 (34):  9017-9023.  doi: 10.12307/2026.870
    Abstract ( 58 )   PDF (1701KB) ( 25 )   Save
    BACKGROUND: Recent studies have demonstrated that mechanotransduction plays a critical role in the pathological processes of neurological disorders. PIEZO channels, as key mechanosensitive ion channels, serve as core mediators in sensing and transducing mechanical signals. However, a systematic review of their specific roles across various neurological diseases is relatively lacking.
    OBJECTIVE: To explore the roles and molecular mechanisms ofPIEZO1 and PIEZO2 channels in central and peripheral nervous system diseases, and to evaluate their potential as therapeutic targets.
    METHODS: A literature search was conducted in PubMed, Web of Science, CNKI, WanFang, and VIP databases from January 2010 to May 2025. English search terms were “central nervous system diseases,” “central nervous system disorder,” “cns disease,” “cns diseases,” “central nervous system disorders,” “neurodegenerative disease,” “autonomic nervous system diseases,” “brain diseases,” “central nervous system infections,” “high pressure neurological syndrome,” “spinal cord diseases,” “PIEZO1 channel,” “PIEZO2 channel,” and “PIEZO channel.” Chinese search terms included “nervous system diseases,” “central nervous system diseases,” “PIEZO1,” “PIEZO2,” and “PIEZO.” A combination of subject headings and free-text terms was employed in the search strategy. Based on predefined inclusion and exclusion criteria, 60 English-language articles were selected for systematic analysis, with mechanisms categorized by disease types.
    RESULTS AND CONCLUSION: (1) PIEZO1 ion channels are highly expressed in gliomas and correlate with malignancy and poor prognosis, while calcium channels drive tumor progression through dual mechanisms: promoting tumor proliferation and remodeling microenvironment stiffness. (2) Intracerebral hemorrhage activates neuronal PIEZO2 ion channels, promoting iron transporter expression and increasing intracellular iron accumulation, thereby inducing ferroptosis and exacerbating secondary brain injury. Meanwhile, dysfunction of PIEZO1 ion channels disrupts cerebral vascular integrity and the blood-brain barrier. (3) Upregulation of PIEZO2 in traumatic brain injury exacerbates neuronal death and promotes the release of inflammatory factors. (4) Activation of PIEZO1 promotes the drainage of fluid in the brain and thereby alleviates hydrocephalus. (5) PIEZO1 dysfunction underlies amyloid-β toxicity, glial activation, vascular impairment, and metabolic abnormalities in Alzheimer’s disease. (6) PIEZO1 inhibits myelination and modulates immune responses in multiple sclerosis. (7) PIEZO1 mediates pulsatile pain in migraines induced by blood flow pulsations. (8) Elevated intraocular pressure upregulates PIEZO1 and PIEZO2 ion channels, leading to retinal ganglion cell hyperexcitability and metabolic stress-induced damage. (9) PIEZO ion channels regulate neuronal excitability in amyotrophic lateral sclerosis, as well as proprioceptive and baroreflex abnormalities, representing a potential therapeutic target.

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    Role and mechanism of exercise-regulated miRNAs in cardiac remodeling after acute myocardial infarction
    Luan Chuankai, Zhu Lei
    2026, 30 (34):  9024-9031.  doi: 10.12307/2026.814
    Abstract ( 38 )   PDF (1549KB) ( 14 )   Save
    BACKGROUND: The pathological manifestations of acute myocardial infarction primarily include cardiomyocyte apoptosis, fibrosis, impaired angiogenesis, calcium dyshomeostasis, and cardiac hypertrophy. MicroRNAs (miRNAs) are key regulators of gene expression and play significant roles in the progression of acute myocardial infarction. Exercise has been shown to improve cardiac function after acute myocardial infarction by modulating miRNA expression, although the underlying mechanisms remain incompletely understood. 
    OBJECTIVE: To summarize the roles of miRNAs in the pathological features of acute myocardial infarction and discuss the molecular mechanisms through which exercise regulates miRNAs to treat acute myocardial infarction, thereby providing a theoretical reference for precise therapeutic interventions. 
    METHODS: Literature published between 2000 and 2025 was retrieved from databases such as PubMed, Web of Science, CNKI, and WanFang, focusing on miRNAs and their association with acute myocardial infarction-related pathological features (e.g., fibrosis, angiogenesis, calcium homeostasis, and cardiac hypertrophy) as well as exercise-induced regulatory mechanisms. Inclusion criteria encompassed experimental studies, clinical research, and review articles. Chinese and English search terms were “acute myocardial infarction, cardiac remodeling, micrornas, myocardial cell apoptosis, myocardial fibrosis, angiogenesis, calcium homeostasis, cardiac hypertrophy, exercise.” Ultimately, 92 articles were included in the analysis. 
    RESULTS AND CONCLUSION: miRNAs (miR-1, miR-133a, miR-21, and miR-29 family) contribute to cardiac remodeling post-acute myocardial infarction by regulating signaling pathways associated with apoptosis, fibrosis, angiogenesis, and calcium homeostasis. Exercise upregulates miR-126 to enhance angiogenesis, miR-29 to suppress myocardial fibrosis, miR-214-3p to restore calcium homeostasis, and miR-222 to promote physiological cardiac hypertrophy, thereby improving cardiac function after acute myocardial infarction. Combining exercise with pharmacological agents (e.g., trifluoromethoxyphenyl-3-(1-propionylpiperidin-4-yl)urea) or nutrients (e.g., vitamin D3) may synergistically modulate miRNA-mediated therapeutic effects. Future research should focus on spatiotemporal and familial variations among miRNAs to develop precise targeted interventions, establish personalized exercise regimens based on miRNA expression profiles combined with artificial intelligence for efficacy prediction, and explore the integration of exercise intervention with gene editing or exosome delivery technologies to precisely regulate miRNA expression, thereby promoting cardiac repair and functional recovery. 
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    Synovial fluid exosome-mediated crosstalk between synoviocytes and chondrocytes in development and progression of knee osteoarthritis
    Wang Yanfei, Jin Lianhai, Li Qingya, Fu Yuanfei, Tan Huangsheng, Deng Pengwei, Gao Kun
    2026, 30 (34):  9032-9040.  doi: 10.12307/2026.832
    Abstract ( 42 )   PDF (5282KB) ( 18 )   Save
    BACKGROUND: Increasing evidence has demonstrated the crucial role of synovial cell-chondrocyte signaling crosstalk mediated by synovial fluid exosomes in knee osteoarthritis. The signaling interaction between synovial cells and chondrocytes reveals, at the molecular level, the bidirectional regulatory role of synovial fluid exosomes in the progression of knee osteoarthritis. 
    OBJECTIVE: To comprehensively interpret the interactions between synoviocytes and chondrocytes mediated by synovial fluid exosomes from multiple perspectives and levels to provide new insights and directions for research and clinical applications in the related field. 
    METHODS: A literature search was conducted in PubMed for publications from January 2001 to June 2025 using the keywords “osteoarthritis*, exosomes, synovial cells, chondrocytes.” All relevant original studies, reviews, and clinical trials published from January 2001 to June 2025 were included, while irrelevant mechanisms and studies with low relevance to the topic were excluded. A total of 93 articles were ultimately included for comprehensive analysis.
    RESULTS AND CONCLUSION: During the onset and progression of knee osteoarthritis, synoviocytes and chondrocytes establish close signal communication through synovial fluid exosomes. This interaction significantly affects knee osteoarthritis progression, not only exacerbating cartilage degeneration and synovial inflammation, but also potentially exerting protective and regulatory effects under certain conditions. Therefore, the dual role of this mechanism highlights the necessity of precise intervention. Targeting the key molecules in exosome-mediated intercellular signaling pathways may provide novel therapeutic strategies and targets for knee osteoarthritis.

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    Key role of m6A methylation in sarcopenia
    Li Jiatong, Liang Songlin, Liu Runjia, Li Nianhu
    2026, 30 (34):  9041-9047.  doi: 10.12307/2026.819
    Abstract ( 38 )   PDF (3498KB) ( 12 )   Save
    BACKGROUND: The role of epigenetic regulatory mechanisms, especially N6 methyladenine (m6A) RNA modification, in muscle cell proliferation, differentiation, and disease development is increasingly being studied. However, the multidimensional mechanism of m6A methylation in sarcopenia still needs to be systematically integrated.
    OBJECTIVE: To explore the key role of m6A methylation in the occurrence and development of sarcopenia, and to review the latest research progress on the involvement of m6A related regulatory factors in the pathological process of sarcopenia. 
    METHODS: Using “m6A methylation, N6 methyladenine, sarcopenia, muscle atrophy, muscle regeneration, muscle, skeletal muscle” as Chinese keywords, and “m6A RNA methylation, sarcopenia, skeletal muscle, muscle mass loss”, as English keywords, CNKI and PubMed were searched to screen high-quality literature in recent years, and the mechanism of action and related signaling pathways of m6A methylation in sarcopenia were summarized. 
    RESULTS AND CONCLUSION: m6A methylation participated in the pathological process of sarcopenia through a dynamically reversible regulatory network (N6-adenosine-methyltransferase 70 kDa subunit (METTL3)/METTL14, fat mass and obesity associated protein FTO/ AlkB homolog 5, RNA demethylase ALKBH5, YTH N6-methyladenosine RNA binding protein C1 (YTHDC1)/YTHDF2). m6A methylation affected the proliferation and differentiation of skeletal muscle cells by regulating mechanisms such as satellite cells, ubiquitin proteasome system, and non-coding RNA. Most studies are based on cell models or animal experiments, with limited research on clinical sample validation and translational applications. The feasibility of m6A-related factors as diagnostic markers or therapeutic targets for sarcopenia needs further validation.  

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    Molecular mechanisms and therapeutic targets of mechanical stress regulating osteoarthritis
    Zhang Yirui, Gu Ye, Qian Zhengtao, Wu Zerui, Xie Heng, Tang Yihan, Gu Yingchu, Fang Tao, Wang Qiufei, Peng Yuqin, Geng Dechun, Xu Yaozeng
    2026, 30 (34):  9048-9055.  doi: 10.12307/2026.824
    Abstract ( 46 )   PDF (1515KB) ( 21 )   Save
    BACKGROUND:  Piezo-type mechanosensitive ion channel components (PIEZO) play a crucial role in cartilage degeneration, inflammation, and pain in osteoarthritis by sensing mechanical stimulation and regulating calcium signaling, potentially serving as an important therapeutic target for osteoarthritis.
    OBJECTIVE: To systematically review the role of PIEZO ion channels in the pathological mechanisms of osteoarthritis and evaluate their potential as a novel therapeutic target.
    METHODS: The first author searched CNKI and PubMed databases using Chinese keywords such as “mechanical stress, Piezo, osteoarthritis, chondrocytes, osteoblast, osteoclasts, synovial cells, immune cells,” and English keywords such as “Piezo1, osteoarthritis, chondrocyte, osteoblast, osteoclast, synovial membrane, immune cell, GsMTx4.” Articles published between 2000 and 2025 were selected, and 102 articles were ultimately included in this review. 
    RESULTS AND CONCLUSION: Mechanical stress plays a central role in the degenerative changes of articular cartilage and surrounding tissues. Prolonged excessive mechanical stress or uneven loading can cause chondrocyte damage, apoptosis, and inflammatory responses, thereby accelerating the progression of osteoarthritis. Currently known mechanoreceptors include the transient receptor potential channel family, the two-pore potassium channel family, the degenerative factor/epithelial sodium channel family, and the integrin family. The PIEZO family is the first group of mechanosensitive cation channel porins discovered in mammalian cells. Widely distributed in human cells, they control Ca2+ influx by sensing changes in environmental pressure, thus affecting cell function. PIEZO ion channels regulate Ca2+ influx by sensing mechanical stimulation of the cell membrane, thereby affecting chondrocytes, osteoblasts, synovial cells, immune cells, and pain perception. Inhibiting PIEZO ion channels may be an effective method for treating arthritis.
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    Different physical factor therapies for knee osteoarthritis: a network meta-analysis of efficacy and safety
    Wu Ruiqi, Dong Panfeng, Zhang Hongrui, Lyu Yongbin, Peng Qinglin, Zhuo Yinghong, Chen Yueping
    2026, 30 (34):  9056-9066.  doi: 10.12307/2026.868
    Abstract ( 46 )   PDF (73811KB) ( 20 )   Save
    OBJECTIVE: The therapeutic modalities of physical factor interventions for knee osteoarthritis have been increasingly diversified; however, comprehensive comparative evaluations of their efficacy remain limited. This study aims to compare the efficacy and safety of various physical factor therapies for knee osteoarthritis through a network meta-analysis.
    METHODS: Randomized controlled trials on physical factor therapy for knee osteoarthritis were retrieved from PubMed, Web of Science, Cochrane Library, EMbase, CNKI, VIP, WanFang, and SinoMed databases from inception to July 25, 2025. Eligible studies were screened, and data were extracted. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias tool. Statistical analyses were performed with Stata 16.0 and RevMan 5.4.1.
    RESULTS: (1) A total of 65 randomized controlled trials involving 3 418 patients were included, with 1 726 in the intervention group and 1 692 in the control group, covering 7 types of physical factor-based rehabilitation regimens. (2) For overall clinical response rate, the top three interventions ranked by the surface under the cumulative ranking curve were pulsed electromagnetic field therapy > ultrasound therapy > transcutaneous electrical stimulation, each combined with conventional rehabilitation. For reduction in knee pain assessed by the visual analogue scale, the top three interventions ranked by the surface under the cumulative ranking curve were transcutaneous electrical stimulation > extracorporeal shock wave therapy > ultrasound, each combined with conventional rehabilitation. For improvement in total Western Ontario and McMaster Universities Arthritis Index scores, the top three interventions ranked by the surface under the cumulative ranking curve were ultrasound > pulsed electromagnetic field therapy > ultrasound plus transcutaneous electrical stimulation, each combined with conventional rehabilitation. For reduction in Western Ontario and McMaster Universities Arthritis Index stiffness subscale scores, the top three interventions ranked by the surface under the cumulative ranking curve were transcutaneous electrical stimulation > ultrasound > ultrasound plus transcutaneous electrical stimulation, each combined with conventional rehabilitation. For improvement in 36-Item Short Form Survey quality-of-life scores, the top three interventions ranked by the surface under the cumulative ranking curve were pulsed electromagnetic field therapy > extracorporeal shock wave therapy > ultrasound, each combined with conventional rehabilitation. For improvement in Lysholm knee scores, the top three interventions ranked by the surface under the cumulative ranking curve were ultrasound > ultrasound plus transcutaneous electrical stimulation > extracorporeal shock wave therapy, each combined with conventional rehabilitation. No serious adverse events were reported across the included studies; most trials only documented mild skin irritation or allergic reactions.
    CONCLUSION: Based on the surface under the cumulative ranking curve and the results of the network meta-analysis, transcutaneous electrical nerve stimulation combined with conventional rehabilitation therapy demonstrated a relatively higher probability of benefit in improving visual analogue scale scores and Western Ontario and McMaster Universities Arthritis Index stiffness scores in patients with knee osteoarthritis; ultrasound therapy combined with conventional rehabilitation therapy showed comparatively better performance in improving Lysholm knee scores and total Western Ontario and McMaster Universities Arthritis Index scores; pulsed electromagnetic field therapy combined with conventional rehabilitation therapy exhibited a potential advantage in enhancing overall quality of life in patients with knee osteoarthritis. Each physical factor possesses its unique advantages; however, given the limitations in the quality and quantity of the included studies, these findings require further verification through high-quality, multicenter, large-sample randomized controlled trials.

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    Different doses of aquatic exercise for improving muscle strength in older adults: a meta-analysis
    Wang Yifei, Zhao Jing, Gao Mingchen, Wu Xiaobin
    2026, 30 (34):  9067-9074.  doi: 10.12307/2026.859
    Abstract ( 44 )   PDF (4225KB) ( 19 )   Save
    OBJECTIVE: To systematically evaluate and quantify the effects of different doses of aquatic exercise on muscle strength in healthy older adults using a Bayesian model–based dose–response meta-analysis, thereby determining the optimal exercise regimen and providing evidence-based recommendations for precise exercise prescription.
    METHODS: A systematic search was conducted in both English and Chinese databases, including PubMed, Embase, Web of Science, CNKI, and WanFang, to identify randomized controlled trials published up to March 2025 that investigated the effects of aquatic exercise on muscle strength in older adults. Data analysis was performed using R 4.5.0. A conventional meta-analysis was first conducted to estimate the overall effect, followed by a Bayesian model-based dose-response meta-analysis to quantify the nonlinear relationships between different exercise dose dimensions and improvements in muscle strength. The standardized mean difference (SMD) and its 95% confidence interval (CI) were used as the effect measures.
    RESULTS: (1) A total of 13 randomized controlled trials involving 531 participants were included. (2) The overall meta-analysis showed that aquatic exercise significantly improved muscle strength in older adults compared with control groups (SMD=0.56, 95% CI: 0.39–0.74, P < 0.000 1). (3) Dose-response analyses indicated cumulative effects with increasing training duration, frequency, and total weekly time: the peak effect was observed at 24 weeks of training (SMD=0.65, 95% CI: 0.40–0.66); a frequency of twice per week already yielded significant benefits (SMD=0.56, 95% CI: 0.22–0.58), with a slight increase at three sessions per week (SMD=0.62, 95% CI: 0.24–0.62); total weekly training time showed a significant effect at 100 minutes (SMD=0.58, 95% CI: 0.34–0.60), reaching a plateau beyond 200 minutes. (4) In contrast, session duration and intensity exhibited inverted U-shaped relationships: the peak effect for session duration occurred at 40 minutes (SMD=0.62, 95% CI: 0.32–0.82), with an optimal range of 30–45 minutes; the optimal intensity range was Borg RPE 10–12 (SMD=0.45, 95% CI: 0.18–0.46), beyond which benefits declined.
    CONCLUSION: Aquatic exercise is an effective strategy to enhance muscle strength in healthy older adults. It is recommended that older adults engage in aquatic exercise two to three times per week, for approximately 40 minutes per session, at a moderately high intensity (Borg RPE 10–12), which should be maintained as a long-term strategy.

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    Correlation between skeletal muscle mass and Chinese healthy eating index in older adults
    Chen Simin, Song Rui, Peng Xing, Wang Jie, Jing Zhaohang, Parhati Nasr, Abdunabi Wupu, He Qi, Yang Lei
    2026, 30 (34):  9075-9080.  doi: 10.12307/2026.851
    Abstract ( 43 )   PDF (1966KB) ( 9 )   Save
    BACKGROUND: With the deepening of China’s aging population, low skeletal muscle mass has become a serious public health problem. Diet is closely linked to muscle mass; however, existing research has mostly focused on the effects of a single nutrient, and there is still a lack of systematic exploration of the relationship between China’s overall dietary pattern and skeletal muscle quality. 
    OBJECTIVE: To analyze the correlation between the Chinese healthy eating index and skeletal muscle mass in older adults, thereby providing scientific evidence for optimizing diets for the elderly and preventing low skeletal muscle mass.
    METHODS: Based on the data from the 2018 China Longitudinal Healthy Longevity Survey (CLHLS), 8 114 study subjects were included. The Chinese healthy eating index was used to evaluate the dietary quality of older adults, and skeletal muscle mass index was used to calculate the skeletal muscle mass of older adults. Low skeletal muscle mass was diagnosed according to the 2019 Asian Musculosis Working Group criteria. Multiple Logistic regression analysis was used to explore the association between China’s Healthy Diet Index and low skeletal muscle mass. 
    RESULTS AND CONCLUSION: (1) Univariate analysis showed that the highest quartile (Q4) group of the overall Chinese healthy eating index [odds ratio (OR)=0.52, 95% confidence interval (CI): 0.46-0.59], animal-based Chinese healthy eating index (OR=0.85, 95% CI: 0.75-0.97), and plant-based Chinese healthy eating index (OR=0.43, 95% CI: 0.38-0.49) was significantly associated with low skeletal muscle mass (P < 0.001). (2) Multivariate logistic regression showed that compared with the lowest quartile (Q1) group, the highest quartile (Q4) group of overall Chinese healthy eating index, animal-based Chinese healthy eating index, and plant-based Chinese healthy eating index had a 30% (OR=0.70, 95% CI: 0.60-0.83, P < 0.05), 20% (OR=0.80, 95% CI: 0.68-0.94, P < 0.05), and 20% (OR=0.80, 95% CI: 0.69-0.94, P < 0.05) reduction in low skeletal muscle mass risk, respectively. Trend testing further indicated that higher dietary quality was significantly associated with lower risk of low skeletal muscle mass (P_trend < 0.001). (3) Subgroup analysis showed that in female study subjects, compared with the lowest quartile (Q1), the highest quartile (Q4) group had a 43% (OR=0.57, 95% CI: 0.45-0.72, P < 0.05), 29% (OR=0.71, 95% CI: 0.56-0.88, P < 0.001), and 33% (OR=0.67, 95% CI: 0.54-0.83, P < 0.001) reduction in the risk of low skeletal muscle mass for the overall Chinese healthy eating index, animal-based Chinese healthy eating index, and plant-based Chinese healthy eating index, respectively. No correlation was found among males. These findings indicate that a higher Chinese healthy eating index is significantly associated with a reduced risk of low skeletal muscle mass in older adults. Adopting a healthy diet is an economically effective intervention to prevent a decrease in skeletal muscle mass.

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    Medication patterns for traditional Chinese medicine in children with cerebral palsy: an analysis based on medical records and literature
    Zou Yuxiong, Liu Ying, Liu Xiaomeng, Gu Nan, Zhu Yue, Zhu Jintai, Li Shuming, Ao Meiying, Liu Qian, He Yuan
    2026, 30 (34):  9081-9087.  doi: 10.12307/2026.852
    Abstract ( 38 )   PDF (3394KB) ( 12 )   Save
    BACKGROUND: Jiangxi University of Chinese Medicine Affiliated Hospital has over 20 years of experience in treating cerebral palsy in children with traditional Chinese medicine (TCM). To date, no systematic analysis of TCM medication patterns has been conducted.
    OBJECTIVE: To analyze the TCM syndrome types of children with cerebral palsy based on medical records and literature, and to explore TCM treatment approaches and medication patterns for children with cerebral palsy.
    METHODS: Evidence-based search strategies were employed to retrieve and manage relevant literature and medical records of TCM treatment for children with cerebral palsy. Bibliometric techniques were utilized to mine and analyze various data features. VOSviewer software was utilized to generate visual knowledge maps. Association rule analysis of TCM was conducted using IBM SPSS Modeler software. Radar diagrams were applied to analyze the four natures and five flavors of Chinese materia medica.
    RESULTS AND CONCLUSION: (1) A total of 503 medical records and 90 articles were included in the study. (2) The analysis of TCM syndrome types revealed that the primary feature among children with cerebral palsy was a deficiency in the liver and kidney. (3) Analysis of intervention measures demonstrated that external treatments were the most frequently employed in medical records and the literature. In contrast, internal drug treatments, specifically those drugs that nourish the liver and kidneys, were most prevalent. (4) The analysis of medication rules indicated that among the top 20 medicines utilized in medical records and literature, the duplication rate for high-frequency medicines (n=12) was 60%. Additionally, the support degree levels for the two pairs of Dioscorea opposita Thunb. and Poria cocos (Schw.) Wolf, and Rehmanniae Radix Praeparata and Poria cocos(Schw.) Wolf exceeded 82.50%, suggesting a significant correlation between these two pairs of herbs. The majority of Chinese medicines prescribed for children with cerebral palsy exhibited warm properties, followed by flat and cold; they were primarily sweet, followed by bitter and spicy; the liver and kidney meridians were the most significant meridians, followed by spleen, heart, and lung meridians; and all of them were basically non-toxic. These findings indicate that children with cerebral palsy mainly exhibit liver and kidney deficiency. Most of the prescriptions used in TCM clinical practice and related clinical studies in TCM are aimed at tonifying the liver and kidneys. Among these, Liuwei Dihuang Pills and its derivatives are the most frequently prescribed. Notably, the combinations of Rehmanniae Radix Praeparata with Faria cocos(Schw.) Wolf and Dioscorea opposita Thunb. with Faria cocos(Schw.) Wolf are the most commonly used and reliable pairs. The herbs primarily exhibit warm and sweet properties and target the liver and kidney meridians.

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    Future medical research on brain organoids: interdisciplinary training, bioengineering technologies, and optimized model maturity
    He Renda, Ma Wei, Sun Yongsi, Mo Xueni
    2026, 30 (34):  9088-9094.  doi: 10.12307/2026.865
    Abstract ( 30 )   PDF (3250KB) ( 12 )   Save
    BACKGROUND: In recent years, brain organoids have rapidly emerged as a hotspot in neuroscience research; however, no comprehensive analysis of knowledge graphs related to medical research on brain organoid has been conducted.
    OBJECTIVE: To conduct a bibliometric analysis of brain organoid medical research and systematically collate research hotspots, emerging trends, and developmental trajectories in this field, thereby providing scholars with a rapid and systematic overview of the current landscape. 
    METHODS: Relevant publications on brain organoids from January 1, 2014 to December 31, 2024 were retrieved and analyzed using the Web of Science Core Collection. CiteSpace, Microsoft Office, and Origin software were employed to quantify annual publication volume, country distributions, institutional contributions, author productivity, highly cited literature, and keyword co-occurrence networks. 
    RESULTS AND CONCLUSION: The annual publication volume in brain organoid medicine research has demonstrated a rapid growth trajectory. The United States dominated both output and academic influence, with the University of California System emerging as the most prolific institution. While extensive collaborative networks were observed among institutions and intra-team collaborations remained close-knit, inter-team partnerships were limited. The highest-output author was Knoblich J. Since 2021, research hotspots entered an intensive growth phase. Persistent themes included pluripotent stem cells, in vitro models, and culture techniques, while recent frontiers shifted toward choroid plexus, human cortical organoids, and microglia. To conclude, medical research on brain organoids has entered a phase of accelerated innovation characterized by thematic diversity. The establishment of in vitro three-dimensional models remains a central priority. Future research will focus on interdisciplinary integration of organoid culture with bioengineering technologies to optimize model maturity, thereby advancing precision platforms for investigations on regenerative medicine, neurological disorder treatment, and neurophysiological mechanisms.
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    Triangular fibrocartilage complex injuries: a visualization analysis of treatment hotspots and frontiers
    Bu Fanchen, Hua Zhen, , Li Xiaolong, Lyu Jinye, Man Hao, Wang Jianwei,
    2026, 30 (34):  9095-9102.  doi: 10.12307/2026.869
    Abstract ( 41 )   PDF (22616KB) ( 13 )   Save
    BACKGROUND: As a common condition of the musculoskeletal system, triangular fibrocartilage complex injury necessitates effective treatment strategies to improve patients’ quality of life and functional recovery. However, there is a lack of systematic integration of global research trends and core hotspots.
    OBJECTIVE: To conduct a bibliometric analysis of the literature on triangular fibrocartilage complex injury treatment, aiming to explore the current research status, hotspots, and trends in this field.
    METHODS: Relevant literature in the field of triangular fibrocartilage complex injury treatment published between 2001 and 2024 was retrieved from the Web of Science Core Collection. Citespace software was utilized for visual analysis of countries, authors, institutions, co-cited references, and keywords.
    RESULTS AND CONCLUSION: (1) After screening, 352 articles were included, with an increasing trend in the annual publication volume. The United States was the leading contributing country, and Mayo Clinic (USA) was the most prolific institution. (2) The top five most frequent keywords were triangular fibrocartilage complex, wrist, distal radioulnar joint, anatomy, and tear. Anatomy had the highest centrality, indicating it as a core research focus. (3) Timeline analysis revealed that early research (pre-2010) primarily focused on the anatomical basis and diagnostic methods of wrist injuries. Starting around 2010, the research emphasis shifted towards arthroscopic techniques, postoperative complications, and long-term outcomes. Recent studies have demonstrated the characteristics of precision, standardization, and interdisciplinary integration. (4) Future research hotspots are anticipated to concentrate on innovative multidisciplinary approaches, building upon precise anatomy, intelligent diagnosis/treatment, and biomaterial applications.

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    Global analysis and hotspot exploration of acne scarring: a bibliometric visualization approach
    Liu Yi, Fu Yuping, Cheng Qiannan
    2026, 30 (34):  9103-9112.  doi: 10.12307/2026.858
    Abstract ( 37 )   PDF (7125KB) ( 8 )   Save
    BACKGROUND: As societal attention to acne scarring has increased, the number of emerging studies in this field has risen markedly. However, traditional reviews and meta-analyses are limited in their ability to accurately predict future development trends. Therefore, bibliometric methods are needed to clarify the research landscape and trajectory within this domain.
    OBJECTIVE: To analyze the research status and future trends of acne scars from 2000 to 2025 using bibliometric methods.
    METHODS: The relevant papers and reviews on the research of acne scars from 2000 to 2025 were retrieved using the Web of Science Core Collection. And Excel, CiteSpace, VOSviewer and BibliomeTools (R-Tool of R-Studio) were used to analyze the citation frequency, countries/institutions, authors/co-cited authors, journals/co-cited journals, keywords and co-cited references.
    RESULTS AND CONCLUSION: From January 1, 2000 to February 28, 2025, both the annual publication volume and the number of citations in the field of acne scars showed an upward trend. Among them, the annual publication volume reached a peak of 114 articles in 2022; the number of citations reached the highest value of 3 933 times in 2024. The analysis of countries/regions shows that the United States is in a leading position globally in this field, with the highest publication volume and the number of citations. Among the authors, the French author Dreno, Brigitte and the American author Alster, Ts rank first in terms of publication volume and co-citation times respectively, and they are authoritative authors in this field. The institution with the largest number of publications is the Tehran University of Medical Sciences in Iran, and more than half of the institutions with a high number of citations are from the United States, represented by Harvard University. Dermatologic Surgery has published the largest number of articles in this field and is also the journal with the highest number of co-citations. The most common keyword is “acne scar,” which appeared 275 times. Keywords such as “microneedling,” “atrophic scar,” and “subcision” have received more attention in the past few years. The most concerned article is Acne vulgaris written by Williams, HC et al., which has been cited 814 times as of February 28, 2025. The study employed bibliometric methods to reveal that acne scar treatment, particularly laser therapy, has been a current research hotspot and represents a future trend in this field. 

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