Canjun Zeng

Arthroscopic anterior talofibular ligament repair (AATFLR) has been shown to restore ankle function effectively and to provide favourable clinical outcomes in chronic lateral ankle instability (CLAI). The present study was designed to identify variables associated with suboptimal postoperative sports-related functional recovery in patients with CLAI. Patients who underwent AATFLR between December 2021 and February 2024 were included. Baseline characteristics including age, sex, body mass index, serum uric acid, concomitant avulsion/free bone fragments and osteochondral lesion of the talus were collected. Postoperative outcomes were assessed using the Foot and Ankle Ability Measure-Activities of Daily Living (FAAM-ADL), the FAAM-Sport score, the Karlsson score, the numeric rating scale pain score, and the Tegner score. Multivariable linear regression and ordinal logistic regression analyses were performed to identify variables associated with postoperative functional recovery. Regression coefficients are reported as β. A total of 197 patients were included, with a mean follow-up of 30.0 months. All functional outcomes improved significantly postoperatively (p < 0.001). Multivariate regression analyses demonstrated that increasing age was associated with lower postoperative FAAM-Sport score (β = - 0.51, 95% CI [- 0.78; -0.23], p < 0.001). However, no association was observed between age and the FAAM-ADL score (β = - 0.07, 95% CI [- 0.26; 0.12], p = 0.471). Increasing age significantly reduced odds of achieving higher postoperative Tegner activity levels (OR = 0.947, 95% CI [0.92-0.98], p = 0.002). Female sex was associated with lower postoperative Karlsson score (β = - 6.56, 95% CI [- 10.92; - 2.21], p = 0.003), which did not achieve the minimal clinically important difference. The overall complication rate was 31.0%, consisting predominantly of minor complications. AATFLR significantly improved ankle function and reduced pain in patients with CLAI. Increasing age may be associated with poorer postoperative sports-related functional recovery after AATFLR. However, it may not affect activities of daily living. Sex may not be associated with postoperative functional recovery. Older patients with high athletic demands should be provided with more comprehensive preoperative risk counselling. Level of evidence Level III, retrospective cohort study.

Peripheral nerve injury leads to progressive neuromuscular junction (NMJ) destabilization and acetylcholine receptor (AChR) degradation, which are critical drivers of denervation-induced muscle atrophy and impaired motor recovery. However, the post-transcriptional mechanisms regulating AChR stability during denervation remain poorly understood. Here, we investigated the role of miR-206-3p in NMJ maintenance and muscle preservation after denervation, with a focus on its interaction with the RNA-binding protein cytoplasmic polyadenylation element binding protein 1 (Cpeb1). Using C2C12 myoblasts and a sciatic nerve transection mouse model, we demonstrate that miR-206-3p promotes myogenic differentiation, enhances AChR clustering, and preserves postsynaptic AChR morphology. miR-206-3p directly targets the 3′ untranslated region of Cpeb1, suppressing its expression, as confirmed by dual-luciferase reporter assays. In vivo, adeno-associated virus–mediated overexpression of miR-206-3p delayed denervation-induced AChR fragmentation, attenuated muscle atrophy, and significantly improved motor function recovery. Conversely, Cpeb1 overexpression accelerated AChR degradation and muscle wasting, whereas co-overexpression of miR-206-3p mitigated these detrimental effects, indicating that Cpeb1 is a key downstream effector of miR-206-3p. Collectively, our findings identify the miR-206-3p/Cpeb1 axis as a previously unrecognized regulator of NMJ stability and muscle integrity after denervation, providing mechanistic insight and a potential therapeutic target for preserving neuromuscular function during prolonged denervation. Graphical Abstract

Subtalar arthroereisis (STA) is a commonly used surgical approach for treating pediatric flatfoot. It remains unclear whether STA combined with spring liga

Osteosarcoma lacks effective molecular targets, and the biological role of MAT2A in this disease remains unclear. Here we show that MAT2A drives osteosarcoma progression by increasing the transcription of the downstream gene PARN. MAT2A interacts with the transcription factor SRF, promotes its SUMO-dependent stabilization in the nucleus, and enhances its ability to activate PARN. A catalytically inactive MAT2A mutant retains this function, indicating a SAM-independent mechanism. MAT2A also elevates aerobic glycolysis in osteosarcoma cells through the PARN–PI3K–AKT pathway, while pharmacological inhibition of MAT2A reduces glycolysis, SRF and PARN expression, and tumor growth in vitro and in vivo. These findings identify a previously unrecognized regulatory mechanism linking MAT2A to transcriptional control and metabolic reprogramming, and highlight MAT2A as a promising therapeutic target for osteosarcoma.

Background: This study aimed to evaluate the efficacy and safety of an accelerated postoperative rehabilitation protocol (APRP), which emphasizes immediate full weightbearing (FWB), muscle strength and balance training as early as possible, after arthroscopic anterior talofibular ligament (ATFL) repair for chronic lateral ankle instability (CLAI). Methods: Patients with CLAI who underwent modified ATFL lasso-loop repair procedures between December 2019 and November 2022 were retrospectively screened. Based on their postoperative rehabilitation protocols, subjects were divided into the APRP group and the conventional postoperative rehabilitation protocol (CPRP) group using 1:2 propensity score matching. Clinical outcome measures comprised the Karlsson score, visual analog scale (VAS) for pain, Tegner score, anterior drawer test findings, complications, and magnetic resonance imaging–based ATFL Quality Score (ATFLQS). A receiver operating characteristic curve analysis was employed to investigate the association between preoperative ATFLQS and clinical outcomes in the APRP group. Results: The APRP group demonstrated comparable improvements in Karlsson score (31.8 ± 17.6 vs 36.0 ± 13.4, P = .267) and Tegner score (2 [−1 to 6] vs 2 [0 to 5], P = .168) to the CPRP group. Although the APRP group showed statistically superior VAS pain score improvement (3.5 ± 2.3 vs 2.2 ± 0.7, P < .001), the clinical significance of this 1.3-point difference remains uncertain given the lack of validated minimal clinically important difference thresholds for VAS pain in ankle ligament surgery populations. The overall complication rates between the 2 groups showed no statistically significant difference (10/54 vs 7/28, P = .492). Comparable ATFL quality was also found between the 2 groups based on the ATFLQS. The optimal ATFLQS threshold value for predicting functional outcomes was determined to be 2.5, based on the maximal Youden index, demonstrating a sensitivity of 82.4% and specificity of 83.3%. Conclusion: Comparable outcomes between the 2 groups were found following arthroscopic ATFL repair for CLAI, with no recurrence observed. FWB, muscle strength, and balance training as early as possible demonstrates both efficacy and safety after surgery. However, patients with preoperative ATFLQS <2.5 receiving APRP may have a significantly increased risk for suboptimal functional recovery.

The management of osteochondral lesions of the talus (OLT) remains a challenging clinical issue. With advances in theory and technology, treatment options for OLT have expanded significantly. This review examines recent progress in the clinical treatment of OLT, focusing on studies published from 2021 to 2023. We searched PubMed, Embase, and Cochrane databases to identify relevant clinical treatments, including both nonsurgical and surgical approaches. Surgical advancements have primarily centered on microfracture, bone transplantation, cartilage transplantation, combined cell therapy, and biomaterials. Among these, some innovative methods, such as autologous costal cartilage transplantation and biological scaffolds, have yielded promising clinical outcomes. However, high‐quality clinical studies are still lacking, particularly those exploring nonsurgical treatments and physical therapy. Future research may increasingly focus on integrating biomaterials with physical therapy, which holds potential for improving patient outcomes.

Background: Diabetic polyneuropathy (DPN) is a common diabetes complication with limited treatment options. We aimed to identify circulating plasma proteins as potential therapeutic targets for DPN using Mendelian Randomization (MR). Methods: The protein quantitative trait loci (pQTLs) utilized in this study were derived from seven previously published genome-wide association studies (GWASs) on plasma proteomics. The DPN data were obtained from the IEU OpenGWAS project. This study employed two-sample MR using MR-Egger and inverse-variance weighted methods to evaluate the causal relationship between plasma proteins and DPN risk, with Cochran’s Q test, and I² statistics, among other methods, used to validate the robustness of the results. Results: Using cis-pQTLs as genetic instruments, we identified 62 proteins associated with DPN, with 33 increasing the risk and 29 decreasing the risk of DPN. Using cis-pQTLs + trans-pQTLs, we identified 116 proteins associated with DPN, with 44 increasing the risk and 72 decreasing the risk of DPN. Steiger directionality tests indicated that the causal relationships between circulating plasma proteins and DPN were consistent with expected directions. Conclusion: This study identified 96 circulating plasma proteins with genetically determined levels that affect the risk of DPN, providing new potential targets for DPN drug development, particularly ITM2B, CREG1, CD14, and PLXNA4.