[Research progress in surgical treatment of avascular necrosis of talus].

Objective: To summarize the surgical treatment methods for avascular necrosis of the talus. Methods: The recent domestic and international literature related to avascular necrosis of the talus was extensively conducted. The pathogenesis, surgical treatment methods, and prognosis were summarized. Results: The clinical symptoms of avascular necrosis of the talus at early stage are not obvious, and most patients have progressed to Ficat-Arlet stages Ⅲ-Ⅳ and require surgical treatment. Currently, surgical treatments for this disease include core decompression, vascularized bone flap transplantation, arthroplasty, and arthrodesis, etc. Early avascular necrosis of the talus can be treated conservatively, and if treatment fails, core decompression can be considered. Arthrodesis is a remedial surgery for patients with end-stage arthritis and collapse, and in cases of severe bone loss, tibiotalocalcaneal arthrodesis and bone grafting are required. Vascularized bone flap transplantation is effective and plays a role in all stages of avascular necrosis of the talus, but the appropriate donor area for the flap still needs further to be studied. Conclusion: The surgical treatment and the system of treatment for different stages of avascular necrosis of the talus still need to be refined.

Extracellular vesicles derived from mesenchymal stem cells mediate extracellular matrix remodeling in osteoarthritis through the transport of microRNA-29a.

BACKGROUND: Knee osteoarthritis (KOA) is a common orthopedic condition with an uncertain etiology, possibly involving genetics and biomechanics. Factors like changes in chondrocyte microenvironment, oxidative stress, inflammation, and immune responses affect KOA development. Early-stage treatment options primarily target symptom relief. Mesenchymal stem cells (MSCs) show promise for treatment, despite challenges. Recent research highlights microRNAs (miRNAs) within MSC-released extracellular vesicles that can potentially promote cartilage regeneration and hinder KOA progression. This suggests exosomes (Exos) as a promising avenue for future treatment. While these findings emphasize the need for effective KOA progression management, further safety and efficacy validation for Exos is essential. AIM: To explore miR-29a's role in KOA, we'll create miR-29a-loaded vesicles, testing for early treatment in rat models. METHODS: Extraction of bone marrow MSC-derived extracellular vesicles, preparation of engineered vesicles loaded with miR-29a using ultrasonication, and identification using quantitative reverse transcription polymerase chain reaction; after establishing a rat model of KOA, rats were randomly divided into three groups: Blank control group injected with saline, normal extracellular vesicle group injected with normal extracellular vesicle suspension, and engineered extracellular vesicle group injected with engineered extracellular vesicle suspension. The three groups were subjected to general behavioral observation analysis, imaging evaluation, gross histological observation evaluation, histological detection, and immunohistochemical detection to compare and evaluate the progress of various forms of arthritis. RESULTS: General behavioral observation results showed that the extracellular vesicle group and engineered extracellular vesicle group had better performance in all four indicators of pain, gait, joint mobility, and swelling compared to the blank control group. Additionally, the engineered extracellular vesicle group had better pain relief at 4 wk and better knee joint mobility at 8 wk compared to the normal extracellular vesicle group. Imaging examination results showed that the blank control group had the fastest progression of arthritis, the normal extracellular vesicle group had a relatively slower progression, and the engineered extracellular vesicle group had the slowest progression. Gross histological observation results showed that the blank control group had the most obvious signs of arthritis, the normal extracellular vesicle group showed signs of arthritis, and the engineered extracellular vesicle group showed no significant signs of arthritis. Using the Pelletier gross score evaluation, the engineered extracellular vesicle group had the slowest progression of arthritis. Results from two types of staining showed that the articular cartilage of rats in the normal extracellular vesicle and engineered extracellular vesicle groups was significantly better than that of the blank control group, and the engineered extracellular vesicle group had the best cartilage cell and joint surface condition. Immunohistochemical detection of type II collagen and proteoglycan showed that the extracellular matrix of cartilage cells in the normal extracellular vesicle and engineered extracellular vesicle groups was better than that of the blank control group. Compared to the normal extracellular vesicle group, the engineered extracellular vesicle group had a better regulatory effect on the extracellular matrix of cartilage cells. CONCLUSION: Engineered Exos loaded with miR-29a can exert anti-inflammatory effects and maintain extracellular matrix stability, thereby protecting articular cartilage, and slowing the progression of KOA.

Advances in the Application of Bone Transport Techniques in the Treatment of Bone Nonunion and Bone Defects.

Bone nonunion and bone defects frequently occur following high-energy open injuries or debridement surgeries, presenting complex challenges to treatment and significantly affecting patients' quality of life. At present, there are three primary treatment options available for addressing bone nonunion and bone defects: vascularized bone grafts, the Masquelet technique, and the Ilizarov technique. The Ilizarov technique, also known as distraction osteogenesis, is widely favored by orthopedic surgeons because of several advantages, including minimal soft tissue requirements, low infection risk, and short consolidation time. However, in recent years, the application of the Masquelet technique has resulted in novel treatment methods for managing post-traumatic bone infections when bone defects are present. Although these new techniques do not constitute a panacea, they continue to be the most commonly employed options for treating complex large bone nonunion and bone defects. This review evaluates the currently available research on the Ilizarov and Masquelet bone transport techniques applied at various anatomical sites. Additionally, it explores treatment durations and associated complications to establish a theoretical foundation that can guide clinical treatment decisions and surgical procedures for the management of bone nonunion and bone defects.

Cyclodextrin Incorporation into Covalent Organic Frameworks Enables Extensive Liquid and Gas Chromatographic Enantioseparations.

The separation of enantiomers using high-performance chromatography technologies represents great importance and interest. In this aspect, ß-cyclodextrin (ß-CD) and its derivatives have been extensively studied as chiral stationary phases (CSPs). Nevertheless, ß-CD that was immobilized on a traditional matrix often exhibited low stabilities and limited operating ranges. Recently, covalent organic frameworks (COFs) with highly ordered nanopores are emerging as promising CSPs for enantioseparations, but their practical applications are still hampered by the difficulty of monomer and COF synthesis. Herein, two ß-CD-driven COFs are synthesized via a fast and facile plasma-induced polymerization combined postsynthesis modification strategy. The precisely defined COF channels enhanced the accessibility of the accommodated ß-CD to the analytes and acted as robust protective barriers to safeguard the ß-CD from harsh environments. Therefore, the ß-CD-modified COFs can be potentially general CSPs for extensive enantioseparation in both gas chromatography and high-performance liquid chromatography, and a wide range of racemates were separated. Compared to the commonly employed commercial chiral columns, these COF-based columns exhibited comparable resolution capability and superior application versatility. This work integrates the advantages and overcomes the defects of COFs and ß-CD, thus advancing COFs as platforms for chiral selector modification and giving great promise for practical chromatographic enantioseparation.

Chiral derivatives of covalent organic framework TpBD (NH2 )2 used as stationary phases in gas chromatography.

Chiral covalent organic framework materials have many excellent properties, which have received much attention in the field of separation. Synthesized the covalent organic framework COF-TpBD (NH2 )2 modified, respectively, by L-valine trifluoroacetyl derivative, L-hydroxyproline, and (1S)-(+)-10-camphorsulfonyl chloride, three capillary columns of chiral covalent organic framework materials were obtained for gas chromatography. Those columns are able to separate some chiral compounds, positional isomers, n-alkanes, n-alcohols, aromatic hydrocarbon mixture, and Grob's reagents. They are complementary to other chiral capillary columns and are possible for potential applications.

[Preparation and application of chiral silica gel spheres based on L-glutamic].

Inorganic mesoporous silica gel spheres, which possess sufficient mechanical strength, thermal stability, and mobile phase endurance, are the most important and widely used materials for column packing in high performance liquid chromatography (HPLC). However, amorphous silica gel is generally reported as an inorganic chiral silica gel, and spherical all-inorganic chiral silica gel has not been reportedly used as the chiral stationary phase for HPLC. In this paper, inorganic spherical mesoporous silica gel was used in the method of polymerization-induced colloid aggregation (PICA), with silica sol as the raw material and L-glutamic acid (L-Glu) as the chiral monomer, to obtain mixed spheres of urea-formaldehyde resin and colloidal silica in a chiral environment. After high-temperature calcination (at 550 ℃) to remove the resin, inorganic mesoporous silica gel spheres based on L-Glu were prepared. Elemental analysis revealed that the prepared L-Glu chiral silica gel spheres were calcined completely, indicating that there were no organic constituents. Scanning electron microscopy (SEM) images of the silica gel spheres showed that the surface of the silica gel spheres was not smooth, with a uniform particle size of 3.0-4.5 µm. Transmission electron microscopy (TEM) images showed that the pore size distribution of the synthetic silica gel spheres was uniform due to the accumulation of pores. Nitrogen adsorption tests revealed that the specific surface area of L-Glu chiral silica gel spheres was 117.844 m2/g, the pore volume was 0.411 cm3/g, and the average pore size was 12.312 nm. All the characterizations indicated that the inorganic chiral mesoporous silicon had a regular spherical shape. The silica gel spheres possess frameworks and pore structures, providing a chiral microenvironment that is suitable as a chiral stationary phase for separating racemic compounds by HPLC. Because of the chiral pore structure and frameworks, the enantiomers were retained to different degrees and separation was achieved. The porous structure also increased the contact surface between the racemates and the active sites of the inner wall and improved the separation efficiency. Hydrogen bonding between the chiral stationary phase and the racemates, dipole interactions, and van der Waals forces were also involved in enantiomer resolution. An HPLC column was prepared with L-Glu chiral silica gel as the stationary phase and n-hexane-isopropanol (9∶1, v/v) as the mobile phase. Fifteen racemic compounds were successfully separated on the chiral HPLC column, including seven racemic compounds for baseline separation, at a flow rate of 0.1 mL/min using 254 nm as the detection wavelength at 25 ℃. The separation of 10 benzene position isomers was successfully achieved, and eight of the benzene position isomers reached baseline separation. Experimental results showed that the chiral silica gel spheres possess sufficient mechanical strength and thermal stability, along with good chiral recognition ability and the ability to separate positional isomers. Compared with ordinary silica gel, these chiral silica gel spheres afforded better chiral separation and better separation of benzene position isomers, without further modification. The preparation of this chiral stationary phase also has the advantages of being cheap, convenient, and feasible.