Jun Zou

Bacterial colonization and insufficient osseointegration remain major challenges for titanium‐based orthopedic and dental implants. Here, we developed a bioinspired mechano‐chemical titanium interface by combining an anodization‐derived micro‐/nano‐pitted topography with a polydopamine–citric acid–quercetin (PCQ) functional layer. Inspired by dragonfly‐wing micro‐/nanostructures, the resulting OPT@PCQ interface exhibited hierarchical topography, enhanced hydrophilicity, and preserved overall mechanical response. OPT@PCQ showed favorable cytocompatibility and significantly promoted osteogenic differentiation of bone marrow‐derived mesenchymal stromal cells, with increased alkaline phosphatase activity, matrix mineralization, and RUNX2, COL1A1, and OCN expression. It also displayed pronounced antibacterial activity against Staphylococcus aureus and Escherichia coli , accompanied by bacterial morphological deformation and reduced viability. Transcriptomic analysis of S. aureus revealed broad perturbation of central carbon metabolism, glycolysis/gluconeogenesis, ribosome‐associated processes, and stress‐response pathways. In vivo, OPT@PCQ promoted wound closure and markedly enhanced new bone formation and trabecular reconstruction in a noninfected rat femoral defect model. Qualitative hemolysis assessment and major‐organ histology provided preliminary evidence of hemocompatibility and systemic biosafety under the tested conditions. Collectively, these findings support OPT@PCQ as a multifunctional titanium interface with potential for infection‐resistant osseointegration; however, direct validation in an infected bone‐defect model remains necessary.

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Diabetic bone repair is impaired by a microenvironment characterized by heightened susceptibility to infection and persistent inflammation. This study presents a dissolvable, dual‐responsive (to glutathione and gelatinase) microneedle patch (CGF/PP@MN) for spatiotemporally controlled therapy. The system features a GelMA hydrogel matrix encapsulating Concentrated Growth Factors (CGF) within its core, while its surface is functionalized with a glutathione‐reactive anti‐inflammatory peptide (pro‐AIP) and a gelatinase‐cleavable antimicrobial peptide (pro‐AMP). This spatial design enables a sequential, pathology‐triggered release cascade: upon insertion, pro‐AMPs are first cleaved in the presence of bacterial gelatinase to eradicate biofilms; subsequently, the elevated glutathione concentration activates pro‐AIPs to mitigate inflammation and promote M2 macrophage polarization, thereby remodeling the hostile immune niche. Finally, the sustained release of CGF from the hydrogel core drives vascularization and osteogenesis. This platform demonstrates precise temporal alignment with endogenous healing, excellent biocompatibility, and robust bioactivity in vitro. In a diabetic bone defect model, it significantly enhanced wound healing, attenuated inflammation, promoted robust bone regeneration, and improved overall repair outcomes. This work provides a novel combinatorial strategy for immunomodulation and regenerative repair of diabetic bone defects.

Purpose To investigate the influence of facet tropism (FT) on spinal parameters and clinical symptoms of degenerative lumbar spondylolisthesis (DLS) after posterior lumbar intervertebral fusion (PLIF). Methods A total of 108 patients with DLS who received PLIF surgery from June 2016 to June 2020 were retrospectively analyzed and divided into non-facet tropism (NFT) group and FT group according to bilateral facet joint angle (FJA) difference of more than 10°. Pre-postoperative clinical data compared between groups. Correlation analysis was performed between imaging parameter changes and symptom score changes. Groups were divided by preoperative FT segments to compare imaging parameters and symptom score changes with the NFT group. Results Overall, 54 patients were included in NFT group and 54 patients were included in FT group. The FT group had a lower lumbar range of motion (ROM) than the NFT group, with similar preoperative clinical data. Both groups showed improved imaging parameters and symptom scores after PLIF compared to preoperative levels. The ROM in the FT group was lower than those in the NFT group (P < 0.01). Both groups showed similar symptom improvements, but the FT group had significantly higher VAS and ODI scores at follow-up than the NFT group (P < 0.05). Improvements in VAS and ODI were significantly correlated with changes in imaging parameters and ROM in both groups. Conclusion PLIF improves DLS symptoms and lumbar curvature but restricts postoperative ROM. FT compromises correction efficacy, necessitating preoperative FT evaluation for optimal surgical planning.

The treatment of osteoporosis and related bone defects remains challenging. This study identifies pyroptosis-driven inflammation as a key disruptor of bone homeostasis. To address this, we develop a magnesium-gelatin composite microsphere scaffold (GelMa/Mg/DMF MS) that exploit pyroptosis blockade and hydrogen-mediated inflammation regulation for osteoporosis treatment. This porous microsphere scaffold is implanted into bone defects to achieve the sustained release of hydrogen gas, magnesium ions (Mg²⁺), and dimethyl fumarate (DMF). DMF act by activating the nuclear factor erythroid-related factor 2 to prevent osteoblast pyroptosis, and combine with the antioxidant effects of hydrogen, effectively remodel the inflammatory microenvironment and create favorable conditions for the restoration of bone homeostasis. Mg²⁺ further expedite bone tissue repair. These results demonstrate that the GelMa/Mg/DMF MS effectively reverse inflammatory microenvironments both in vivo and in vitro, resulting in significant tissue repair. These results suggest the combination of hydrogen therapy and pyroptosis blockade as a potential therapeutic strategy.

Background: Intervertebral disc degeneration (IVDD) is a leading cause of low back pain, yet current therapies fail to reverse the degenerative process or restore disc function. Ferroptosis, a form of iron-dependent cell death characterized by lipid peroxidation, has been implicated in IVDD progression.

Background Diffuse idiopathic skeletal hyperostosis (DISH) is a metabolic disease that is prevalent in elderly patients and is characterized by spinal ankylosis. Traditional surgical treatment requires open long-segment internal fixation. Percutaneous kyphoplasty (PKP), as a minimally invasive spinal surgery technology, can accurately relieve pain and improve quality of life. The objective of this study was to evaluate the efficacy and reliability of PKP in treating vertebral fractures with DISH. Methods We retrospectively investigated 209 patients with thoracic or lumbar fractures receiving PKP between January 2019 and December 2020. The patients were divided into 2 groups according to the diagnostic criteria. The anterior and posterior vertebral height restoration ratio and the local kyphotic angle (LKA) were used to evaluate the radiographic results. The visual analog scale score and the Oswestry Disability Index questionnaire were used for the assessment of the clinical function. Results The average age of the DISH group was significantly older than that of the non-DISH group (P < 0.05). The perioperative prognostic nutritional index measured in the DISH group was significantly worse than that in the non-DISH group (P < 0.05). PKP in DISH patients achieved a significant restoration in the anterior and posterior vertebral height restoration ratio between pre- and postoperative measurements (P < 0.05). The postoperative LKA was significantly corrected at 1 day, 1 month, and the last follow-up (P < 0.05). Significant reductions in visual analog scale and Oswestry Disability Index scores were obtained during follow-up (P < 0.05). Conclusion For vertebral fractures in elderly DISH patients, PKP may be effective and feasible, which restores the vertebral height, corrects the LKA, and achieves pain relief and satisfactory functional improvement. Level of Evidence 3.

Chordoma presents a formidable therapeutic challenge due to its distinct anatomical location, thus complicating its complete surgical resection coupled with marked resistance to both radiotherapy and chemotherapy. Currently, effective systemic therapies remain unavailable, contributing to a poor prognosis for patients. To address this critical unmet need, we have developed a targeted drug delivery system tailored to the tumor biology of chordoma. This system encapsulates the CDK7 inhibitor THZ1 within nanoparticles featuring diselenide bonds as dual-responsive release triggers. Upon exposure to low-dose X-ray irradiation (e.g., 2 Gy) and to the elevated reactive oxygen species (ROS) level in the tumor microenvironment, these diselenide bonds are cleaved and transformed into selenic acid (RSeOOH), which subsequently initiates rapid carrier disassembly and drug release. The synergy between RSeOOH and THZ1 enhances radiotherapy efficacy by modulating p53 signaling, inducing apoptosis, and promoting G2/M phase cell cycle arrest in U-CH1 cells, thereby overcoming the radiotherapy resistance commonly seen in chordoma. To further improve tumor-specificity, we functionalize the carrier with the EGFR-targeting GE11 peptide, which drives selective drug accumulation at tumor sites. In murine models, this delivery system has demonstrated substantial efficacy in combination with radiochemotherapy and yet produces minimal toxicity. Molecular dynamics simulations have further elucidated carrier self-assembly mechanisms, guiding the rational design of this nanoplatform.

Study Design.: A real-world, multicenter retrospective study. Objective.: To identify independent risk factors for cage subsidence following Posterior Lumbar Interbody Fusion (PLIF) and develop an interpretable machine learning model for risk prediction. Materials and Methods.: Patients with degenerative lumbar disease who underwent single-level PLIF (January 2018–October 2023) were retrospectively included. A training set (n=620) came from the First Affiliated Hospital of Soochow University, and a validation set (n=100) from the Second Affiliated Hospital. Cage subsidence (≥2 mm intervertebral height loss) was assessed radiographically. Parameters included paraspinal muscle indices (Psoas Muscle Index [PMI], Multifidus Muscle Index [MM]), Fat Infiltration [FI]), bone density markers (Hounsfield Unit [HU] value, Vertebral Bone Quality [VBQ], Endplate Bone Quality [EBQ]), cage position, and postoperative alignment. Multivariate logistic regression identified risk factors; multiple machine learning models were developed and evaluated. A web-based tool was created for clinical deployment. Results.: Multivariate analysis identified PMI, FI, HU value, VBQ, cage position, cage height, postoperative Intervertebral Height (IH), corrected IH, and corrected SA as independent risk factors for cage subsidence. Light Gradient Boosting Machine (LightGBM) outperformed other models, achieving the highest AUC (0.9752), accuracy (0.92), and F1-score (0.9216), with the lowest Brier score (0.0660). After excluding indicators related to paravertebral muscle function from the prediction model, the predictive accuracy of the model decreased substantially. (SHapley Additive exPlanations) SHAP analysis confirmed VBQ, PMI, BMI, and EBQ as the most influential predictors. The final model was deployed as a web-based tool for real-time clinical risk assessment. Conclusions.: Key risk factors for PLIF cage subsidence were identified, and a validated machine learning model was developed. The high-performance LightGBM model, deployed in a user-friendly web application, enables spine surgeons to optimize surgical planning and reduce subsidence risk.