Chengyu Zhuang

Rotator cuff tear (RCT) is a prevalent age‐related condition whose underlying mechanisms remain poorly understood. This study employed spatial transcriptomics and multiplex immunofluorescence (mIF) to investigate gene expression and spatial heterogeneity in rotator cuff tissues from elderly RCT patients compared to age‐matched controls, aiming to uncover key molecular pathways. Tendon samples were collected from RCT patients ( n = 10) and controls ( n = 10). Five from each group underwent spatial transcriptomic sequencing for differential gene expression, functional enrichment, and cell interaction analyzes. Results were validated with mIF on the remaining samples. Compared to controls, the RCT group showed 1261 downregulated and 2789 upregulated genes. Spatial analysis revealed distinct expression gradients: COMP and CHI3L1 were upregulated in the bone region, CHI3L1 and MT1X in the mid‐tendon, and MT1X and FMOD in the tendon area—confirmed by mIF. Biological processes also varied regionally: cartilage development and extracellular matrix (ECM) organization were enriched in the bone, while ECM and collagen fibril organization dominated mid‐tendon and tendon regions. The PI3K‐AKT and ECM‐receptor interaction pathways were central to these processes. Tenogenic progenitor‐like cells (TPLCs) were significantly reduced in RCT ( p < 0.0001), whereas mesenchymal cells increased in bone and mid‐tendon areas ( p < 0.001, p < 0.01), consistent with structural gradients. These findings suggest that elderly RCT may arise from chronic inflammation, ECM dysregulation, and failed regeneration. Spatial transcriptomics identified repair‐related genes (COMP, CHI3L1, MT1X, FMOD) with region‐specific expression, providing new insights into pathology and potential therapeutic targets.

Background: The study investigates the safety and efficacy of all-suture soft anchors (ASSA) versus metal anchors (MA) in patients undergoing arthroscopic rotator cuff repair (ARCR) through a randomized controlled trial, assessing whether ASSA’s advantages – reduced bone loss and simplified deployment – can achieve non-inferior clinical outcomes compared to conventional MA. Materials and methods: We conducted a multicenter randomized controlled trial at five Chinese tertiary hospitals (Jan–Oct 2022), with final follow-up in December 2023. Eligible patients had small-to-medium full-thickness rotator cuff tears, Ellman III bursal-side tears, or Lafosse I–IV subscapularis tears. Participants were randomized 1:1 to ARCR with ASSA or MA, followed at 6 weeks, 3, 6, and 12 months. The outcome was included Constant–Murley Score (CMS), American shoulder and elbow surgeons (ASES) score, visual analog scale (VAS) pain, passive range of motion (PROM), and radiographic assessments (postoperative, 6/12 months). All adverse events were recorded. Finally, 87 patients were randomized (ASSA = 43, MA = 44) and 85 received allocated treatment (42 vs 43). Results: ASSA showed better midterm (6-month) functional recovery ( P = 0.031) and pain reduction ( P = 0.005). There was no difference in ASES, VAS, or adverse events (all P > 0.05). After 12 months, both groups showed improved CMS ( P < 0.001), with no between-group difference ( P = 0.900). No anchor dislocations observed. Conclusion: ASSA showed comparable safety and efficacy to MA in ARCR after 12 months of follow-up, with superior improvement in early functional recovery and pain alleviation in midterm (6-month) functional recovery and pain relief, supporting its use as an alternative suture anchor for ARCR.

The trace-level detection of proteins in the human body holds significant importance for health monitoring and disease prevention. To conduct real-time monitoring of the human body's health status, both wearable and implantable devices require label-free sensing. However, the signals of a considerable number of label-free electrochemical sensors originate from the signal capture medium. These signals are weak and are prone to being lost or masked by other signals. We report a Prussian blue (PB)-based self-redox aptamer sensor was developed, enabling real-time human serum albumin (HSA) detection without external redox mediators. The designed sensing interface successfully achieved the quantitative detection of HSA in PBS with a sensitivity of 124 fg mL⁻¹. In addition, to validate universality, the sensor was tested with retinol-binding protein (RBP4), showing comparable performance. This label-free electrochemical sensor can achieve one-step detection without additional reagents. This system has application potential in on-site detection, as well as wearable sensing.

Objective: To investigate the effects of warmed irrigation fluid during shoulder arthroscopy on patient temperature regulation, recovery outcomes, and cognitive function.Methods: A randomized single‐blind prospective study (Level II) and a total of 85 patients who underwent shoulder arthroscopy at our hospital from February 2022 to April 2023 were selected, all of whom signed informed consent, which was randomly divided into two groups (warmed irrigation fluid group and room temperature fluid group). Among them, there were 29 males (34.1%) and 56 females (65.9%) (male:female ratio = 1:2), with an average age of 60.80 ± 11.70 years (ranging from 19 to 79 years). There were 50 patients (58.8%) aged over 60 and 35 patients (41.2%) aged under 60. All patients were diagnosed with rotator cuff injuries. We recorded primary patient data, anesthesia duration, anesthesia method, surgery duration, intraoperative temperature protection measures, irrigation volume, intraoperative nasopharyngeal and rectal temperatures, and preoperative and postoperative Mini‐Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. Statistical analysis was performed to evaluate the impact of warmed irrigation fluid on patient temperature, recovery, and cognitive status.Results: Analysis of the data from the 85 shoulder arthroscopy patients indicated that warming the irrigation fluid effectively prevented a decrease in core body temperature (nasopharyngeal and rectal temperatures), with significant differences observed at 120 min (nasopharyngeal temperature) and 105 min (rectal temperature). Patients with warmed irrigation fluid had a shorter average anesthesia recovery time than those without warming, although this difference was not statistically significant. Analysis of MMSE and MOCA scores revealed that the areas of cognitive decline post‐surgery mainly involved cumulative memory and attention, while orientation was not affected. Education level was identified as a factor influencing cognitive decline.Conclusion: The administration of warmed irrigation fluid during shoulder arthroscopy has effectively preserved patients' core body temperature. This practice may contribute to a reduction in recovery time and complications associated with the procedure. Furthermore, minimally invasive techniques such as arthroscopy have been associated with a decreased incidence of postoperative cognitive impairment.

Recent years have witnessed a spurt of progress in the application of the encoding and decoding of neural activities to drug screening, diseases diagnosis, and brain–computer interactions. To overcome the constraints of the complexity of the brain and the ethical considerations of in vivo research, neural chip platforms integrating microfluidic devices and microelectrode arrays have been raised, which can not only customize growth paths for neurons in vitro but also monitor and modulate the specialized neural networks grown on chips. Therefore, this article reviews the developmental history of chip platforms integrating microfluidic devices and microelectrode arrays. First, we review the design and application of advanced microelectrode arrays and microfluidic devices. After, we introduce the fabrication process of neural chip platforms. Finally, we highlight the recent progress on this type of chip platform as a research tool in the field of brain science and neuroscience, focusing on neuropharmacology, neurological diseases, and simplified brain models. This is a detailed and comprehensive review of neural chip platforms. This work aims to fulfill the following three goals: (1) summarize the latest design patterns and fabrication schemes of such platforms, providing a reference for the development of other new platforms; (2) generalize several important applications of chip platforms in the field of neurology, which will attract the attention of scientists in the field; and (3) propose the developmental direction of neural chip platforms integrating microfluidic devices and microelectrode arrays.

Background: Large bone defects resulting from trauma and diseases still a great challenge for the surgeons. Exosomes modified tissue engineering scaffolds are one of the promising cell-free approach for repairing the defects. Despite extensive knowledge of the variety kinds of exosomes promote tissue regeneration, little is known of the effect and mechanism for the adipose stem cells-derived exosomes (ADSCs-Exos) on bone defect repair. This study aimed to explore whether ADSCs-Exos and ADSCs-Exos modified tissue engineering scaffold promotes bone defects repair.Material/Methods: ADSCs-Exos were isolated and identified by transmission electron microscopy nanoparticle tracking analysis, and western blot. Rat bone marrow mesenchymal stem cells (BMSCs) were exposed to ADSCs-Exos. The CCK-8 assay, scratch wound assay, alkaline phosphatase activity assay, and alizarin red staining were used to evaluate the proliferation, migration, and osteogenic differentiation of BMSCs. Subsequently, a bio-scaffold, ADSCs-Exos modified gelatin sponge/polydopamine scaffold (GS-PDA-Exos), were prepared. After characterized by scanning electron microscopy and exosomes release assay, the repair effect of the GS-PDA-Exos scaffold on BMSCs and bone defects was evaluated in vitro and in vivo.Results: The diameter of ADSCs-exos is around 122.1 nm and high expressed exosome-specific markers CD9 and CD63. ADSCs-Exos promote the proliferation migration and osteogenic differentiation of BMSCs. ADSCs-Exos was combined with gelatin sponge by polydopamine (PDA)coating and released slowly. After exposed to the GS-PDA-Exos scaffold, BMSCs have more calcium nodules with osteoinductive medium and higher expression the mRNA of osteogenic related genes compared with other groups. The quantitative analysis of all micro-CT parameters showed that GS-PDA-Exos scaffold promote new bone formed in the femur defect model in vivo and confirmed by histological analysis.Conclusion: This study demonstrates the repair efficacy of ADSCs-Exos in bone defects, ADSCs-Exos modified scaffold showing a huge potential in the treatment of large bone defects.

Objective: Fluid extravasation is a potentially dangerous complication associated with shoulder arthroscopy. Most relevant studies have involved respiratory system, while the primary purpose was to reveal the effects of the fluid extravasation on cardiovascular system and postoperative function.Methods: The clinical data of 92 patients was retrospective analyzed, in which 84 cases with rotator cuff injury, three cases with shoulder instability, three cases with fractures of the greater tuberosity of the humerus, and two cases with frozen shoulder. All the patients were undergoing shoulder arthroscopy. The relationship between the basic information of the patients and cardiac index (CI) or pulse pressure variation (PPV) were evaluated by linear regression analysis. The change of CI or PPV at different states were evaluated by the one‐way analysis of variance. The liquid retention (TR) and postoperative clinical outcomes was analyzed using linear regression.Results: The preoperative CI was affected by anesthesia status and body position, while PPV was not affected. Multivariate mixed‐effects model analysis of CI found that there was a statistically significant difference in groups of older than 55 years old and those with obesity (BMI > 24). After the operation, the retention of irrigation fluid significantly influenced the circumference of the deltoid (P < 0.001 (95%CI: [0.30, 1.00])), but not on the circumference of the deltoid, neck, and arm. The multivariate analysis of the American Shoulder and Elbow Surgery (ASES) scores at 3 and 6 months after surgery showed that the fluid retention volume was correlated with the ASES score at 3 months after surgery, especially when the retention volume was greater than 2 L (P = 0.001 (95%). %CI: [−12.49, −3.22]).Conclusion: The retention of irrigation fluid after shoulder arthroscopic surgery causes swelling of local limbs, and has an effect on peripheral blood vessels, which is mainly reflected in its influence on PPV and the postoperative function. Therefore, surgeons need to improve their surgical technique, shorten the operation time and reduce fluid retention.