Scientific publications on orthopedic surgery from three major East Asian countries(2012-2021)

BACKGROUND East Asia is the most dynamic region in the world and includes three major countries:Japan,South Korea and China.Due to rapid economic growth,orthopedics research in East Asia has achieved great advances during the past 10 years.However,the current status of orthopedic research in Japan,South Korea and China is still unclear.AIM To understand the current status of orthopedic research in Japan,South Korea,and China.METHODS Journals listed in the“Orthopedics”category of Science Citation Index Expanded subject categories were included.The PubMed and Web of Knowledge electronic databases were searched to identify scientific publications from the selected journals written by researchers from Japan,South Korea and China.A systematic analysis was conducted to analyze orthopedic research articles published in the three countries based on the number of articles,study design,impact factors(IFs)and citations.Furthermore,we also ranked the top 10 countries worldwide with the highest publications in the past 10 years.Additionally,we ranked the top 10 countries with the highest number of publications in the world in the past 10 years.Statistical analyses were performed using SPSS 20.0 software(SPSS Inc.,Chicago,IL,United States),and statistical results are given in Tables and Figures.The Kruskal-Wallis test and the Mann-Whitney test were used to detect differences between countries.The tendency regarding the number of articles was analyzed by curvilinear regression.A two-tailed P<0.05 was considered significant.RESULTS From 2012-2021,a total of 144518 articles were published in the 86 selected orthopedic journals.During this period,the number of worldwide published orthopedic articles has shown an annual increasing trend.A total of 27164 orthopedic research articles were published by Japan,South Korea and China during the past 10 years;44.32%were from China,32.98%were from Japan,and 22.70%were from South Korea.From 2012 to 2021,the annual number of articles markedly increased in each of the three countries.Over time,the worldwide share of articles increased substantially in South Korea(3.37%to 6.53%,P<0.001)and China(5.29%to 9.61%,P<0.001).However,the worldwide share of articles significantly decreased in Japan(5.22%to 3.80%,P<0.001).The annual total IFs of articles from China were well above those of articles from Japan and South Korea(36597.69 vs 27244.48 vs 20657.83,P<0.05).There was no significant difference among the articles in the top 10 high-IF orthopedics journals published from those three countries[South Korea(800)>China(787)>Japan(646),P>0.05].CONCLUSION Over the past 10 years,China’s scientific publications in orthopedic journals have shown an increasing trend.Considering the relative scale of the populations,Japan and South Korea have outpaced China with respect to quality.

Upregulation of β-catenin signaling represents a single common pathway leading to the various phenotypes of spinal degeneration and pain

Spine degeneration is an aging-related disease,but its molecular mechanisms remain unknown,although elevatedβ-catenin signaling has been reported to be involved in intervertebral disc degeneration.Here,we determined the role ofβ-catenin signaling in spinal degeneration and in the homeostasis of the functional spinal unit(FSU),which includes the intervertebral disc,vertebra and facet joint and is the smallest physiological motion unit of the spine.We showed that pain sensitivity in patients with spinal degeneration is highly correlated withβ-catenin protein levels.We then generated a mouse model of spinal degeneration by transgenic expression of constitutively activeβ-catenin in Col2^(+) cells.We found thatβ-catenin-TCF7 activated the transcription of CCL2,a known critical factor in osteoarthritic pain.Using a lumbar spine instability model,we showed that aβ-catenin inhibitor relieved low back pain.Our study indicates thatβ-catenin plays a critical role in maintaining spine tissue homeostasis,its abnormal upregulation leads to severe spinal degeneration,and its targeting could be an avenue to treat this condition.

Biomechanical Study of Vertebral Compression Fracture Using Finite Element Analysis

This research aimed to mechanically analyze vertebral stress concentration in one healthy subject and one subject with osteoporotic first lumbar (L1) vertebral compression fracture by using finite element analysis (FEA). We constructed three-dimensional image-based finite element (FE) models (Th12L2) by using computed tomographic (CT) digital imaging and communications in medicine (DICOM) for each patient and then conducted exercise stress simulations on the spine models. The loadings on the 12th thoracic vertebra (Th12) due to compression, flexion, extension, lateral bending, and axial rotation were examined within the virtual space for both spine models. The healthy and vertebral compression fracture models were then compared based on the application of equivalent vertebral stress. The comparison showed that vertebral stress concentration increased with all stresses in the vertebral compression fracture models. In particular, compression and axial rotation caused remarkable increases in stress concentration in the vertebral compression fracture models. These results suggest that secondary vertebral compression fractures are caused not only by bone fragility but possibly also by the increase in vertebral stress concentration around the site of the initial

Biomechanical Study of the Effects of Balloon Kyphoplasty on the Adjacent Vertebrae

We used the finite element method (FEM) to investigate the stress profiles of vertebrae in patients who underwent balloon kyphoplasty (BKP) for vertebral fracture. BKP is often performed for persistent pain after vertebral fractures. However, fractures are frequently reported in the adjacent vertebrae after BKP. The purpose was to clarify the mechanism of fractures that occur in the adjacent vertebrae after BKP. The subjects were two patients (first case: 74-year-old woman;second case: 88-year-old woman) who had BKP for osteoporotic vertebral fractures (L1). A bone analysis software program, Mechanical Finder, was used to construct three-dimensional finite element models (T11-L3) from computed tomographic (CT) digital imaging and communications in medicine (DICOM) data. Moment loadings were examined to evaluate stress concentrations on the vertebrae. Young’s moduli were lower in the second case than in the first case at all vertebral levels. Maximum Drucker-Prager stresses after BKP were larger in the second case than in the first case for compression, flexion, extension, and axial rotation. Strain energy density decreased in L1 and increased in the adjacent ver-tebrae. Our results suggest that post-BKP fractures of the adjacent vertebrae not only are due to bone fragility, but also can be caused by increased rigidity in the vertebrae filled with bone cement, which increases stress concentration on the adjacent verte-brae and raises the likelihood of fracture.

Controlled release and biocompatibility of polymer/titania nanotube array system on titanium implants

Bacterial infection and tissue inflammation are the major causes of early failure of titanium-based orthopedic implants;thus,surgical implants with tunable drug releasing properties represent an appealing way to address some of these problems of bacterial infection and tissue inflammation in early age of orthopedic implants.In this work,a hybrid surface system composed of biodegradable poly(lactic-coglycolic acid)(PLGA)and titania nanotubes(TNTs)has been successfully constructed on Ti implants with the aim of preventing bacterial infection via long-term drug release.By varying the size of the TNTs and the thickness of the polymer film,the drug release profile can be tuned to achieve the optimal therapeutic action throughout the treatment time.The size of TNTs plays a dominant role in the drug loading dose of TNTs/PLGA hybrid coatings.In this work,TNTs with an average size of 80 nm can achieve the largest loading dose.Depending on the polymer thickness,significant improvement in the drug release characteristics is attained,for instance,reduced burst release(from 84%to 27%)and overall release time extended from 5 to over 40 days.In addition,the PLGA layers may favor the proliferation and osteogenesis of MC3T3-E1 mouse cells at an earlier stage.Therefore,this TNT/PLGA hybrid surface system can be employed as an effective bioplatform for improving both self-antibacterial performance and biocompatibility of Ti-based biomaterials.

A Bibliometric Analysis and Visualization of Current Research Trends in Chinese Medicine for Osteosarcoma

Background:To illustrate the research framework,overall knowledge structure,and development trends of Chinese medicine(CM)treatment for osteosarcoma(OS)by using a bibliometric analysis and newly developed visualization tools.Methods:Research datasets were acquired from the Web of Science(WOS)database from January 1,1980 to September 30,2019.VOS viewer and Citespace software was used to analyze the data and generate visualization knowledge maps.Annual trends of publications,distribution of institutes,distribution of journals,citation and H-index status,co-authorship status,research hotspots and co-citation status were analyzed.Results:A total of 223 publications in the WOS database met the requirement.The number of published articles showed a rise but the citation frequency and the H-index of China were relatively low.The cooperation between the countries,institutes and authors were relatively weak.Most publications were basic researches.Most of the previous researches focused on basic mechanisms of CM in treating OS,and therapy and improvement of dosage form may become a frontier in this research field.Conclusions:Compared with other fields,the field of CM treatment for osteosarcome is still in infancy.The distribution of researches is imbalanced and cooperation between countries,institutions and authors remains to be strengthened.Furthermore,basic research occupies an absolute dominant position,and the exploration of the molecular mechanism of CM in preventing and treating OS may become a key point in the future.

Unbiased transcriptomic analyses reveal distinet effects of immune deficiency in CNS function with and without injury

The mammalian central nervous system (CNS) is considered an immune privileged system as it is separated from the periphery by the blood brain barrier (BBB). Yet, immune functions have been postulated to heavily influence the functional state of the CNS, especially after injury or during neurodegeneration. There is controversy regarding whether adaptive immune responses are beneficial or detrimental to CNS injury repair. In this study, we utilized immunocompromised SCID mice and subjected them to spinal cord injury (SCI). We analyzed motor function, electrophysiology, histochemistry, and performed unbiased RNA-sequencing. SCID mice displayed improved CNS functional recovery compared to WT mice after SCI. Weighted gene-coexpression network analysis (WGCNA) of spinal cord transcriptomes revealed that SCID mice had reduced expression of immune function-related genes and heightened expression of neural transmission-related genes after SCI, which was confirmed by immunohistochemical analysis and was consistent with better functional recovery. Transcriptomic analyses also indicated heightened expression of neurotransmission-related genes before injury in SCID mice, suggesting that a steady state of immune-deficiency potentially led to CNS hyper-connectivity. Consequently, SCID mice without injury demonstrated worse performance in Morris water maze test. Taken together, not only reduced inflammation after injury but also dampened steady-state immune function without injury heightened the neurotransmission program, resulting in better or worse behavioral outcomes respectively. This study revealed the intricate relationship between immune and nervous systems, raising the possibility for therapeutic manipulation of neural function via immune modulation.

The modulation of stem cell behaviors by functionalized nanoceramic coatings on Ti-based implants

Nanoceramic coating on the surface of Ti-based metallic implants is a clinical potential option in orthopedic surgery.Stem cells have been found to have osteogenic capabilities.It is necessary to study the influences of functionalized nanoceramic coatings on the differentiation and proliferation of stem cells in vitro or in vivo.In this paper,we summarized the recent advance on the modulation of stem cells behaviors through controlling the properties of nanoceramic coatings,including surface chemistry,surface roughness and microporosity.In addition,mechanotransduction pathways have also been discussed to reveal the interaction mechanisms between the stem cells and ceramic coatings on Ti-based metals.In the final part,the osteoinduction and osteoconduction of ceramic coating have been also presented when it was used as carrier of BMPs in new bone formation.

Ultrasound-triggered piezocatalytic composite hydrogels for promoting bacterial-infected wound healing

Wound healing has become one of the basic issues faced by the medical community because of the susceptibility of skin wounds to bacterial infection.As such,it is highly desired to design a nanocomposite hydrogel with excellent antibacterial activity to achieve high wound closure effectiveness.Here,based on ultrasound-triggered piezocatalytic therapy,a multifunctional hydrogel is designed to promote bacteria-infected wound healing.Under ultrasonic vibration,the surface of barium titanate(BaTiO_(3),BT)nanoparticles embedded in the hydrogel rapidly generate reactive oxygen species(ROS)owing to the established strong built-in electric field,endowing the hydrogel with superior antibacterial efficacy.This modality shows intriguing advantages over conventional photodynamic therapy,such as prominent soft tissue penetration ability and the avoidance of serious skin phototoxicity after systemic administration of photosensitizers.Moreover,the hydrogel based on N-[tris(hydroxymethyl)methyl]acrylamide(THM),N-(3-aminopropyl)methacrylamide hydrochloride(APMH)and oxidized hyaluronic acid(OHA)exhibits outstanding self-healing and bioadhesive properties able to accelerate full-thickness skin wound healing.Notably,compared with the widely reported mussel-inspired adhesive hydrogels,OHA/THM-APMH hydrogel due to the multiple hydrogen bonds from unique tri-hydroxyl structure overcomes the shortage that catechol groups are easily oxidized,giving it long-term and repeatable adhesion performance.Importantly,this hybrid hydrogel confines BT nanoparticles to wound area and locally induced piezoelectric catalysis under ultrasound to eradicate bacteria,markedly improving the therapeutic biosafety and exhibits great potential for harmless treatment of bacteria-infected tissues.

Spinal cord conduits for spinal cord injury regeneration

Spinal cord injury(SCI),which causes irreversible damage in both sensory and motor function,is considered an insurmountable challenge in the field of medicine.The previous researchers have developed many kinds of biomaterials for SCI,and spinal cord conduits(SCCs)are an important classification for bridging spinal cord tissues while performing their corresponding functions.In this review,we first describe the original sources of the different polymers that determine the properties of the different SCCs.Afterwards,we focus on the different types of crosslinking methods used for preparing SCCs.Then,various practical applications and therapeutic effects of SCCs are summarized and discussed.Finally,we conclude the existing limitations of current SCCs.We hope that this paper will serve as a further inspiration for the development of SCCs in future.

Comments on ‘FNIP1 regulates adipocyte browning and systemic glucose homeostasis in mice by shaping intracellular calcium dynamics'

Owing to its remarkable benefits on metabolic health and its demonstrated presence in adult humans,beige or‘brite'adipocytes holdgreatpromiseto combat obesity and metabolic diseases.Delineation of the mechanisms involved inadipocyte‘beiging'or‘browning'is thus of particular interest.