Xiang Wang

Chronic osteomyelitis (COM) is a persistent bone infection that is difficult to treat with conventional antibiotics due to issues such as drug resistance and adverse side effects. To address this challenge, we have developed a novel smart structural color hydrogel patch (CPG) for both the diagnosis and treatment of COM. The patch combines methylacrylated chitosan modified with phenylboronic acid (CSMA-PBA) as a scaffold, temperature-responsive GelMA hydrogel as filler, and salicylic acid (SA) for drug delivery. Characterization showed excellent mechanical properties and adhesive strength. Drug release experiments confirmed that CPG effectively responds to pH changes, enabling controlled drug release. CPG also serves as a diagnostic tool by detecting pH and temperature changes at the infection site, assisting in postoperative recovery. Antimicrobial tests showed significant inhibition of bacterial growth, and in vitro experiments demonstrated CPG's ability to promote vascular endothelial growth factor expression while reducing inflammatory markers. The study highlights the multifunctional capabilities of the hydrogel patch, including antimicrobial, anti-inflammatory, and pro-vascular effects, positioning it a promising therapeutic option for chronic osteomyelitis.

Chronic osteomyelitis (COM) is a persistent bone infection that is difficult to treat with conventional antibiotics due to issues such as drug resistance and adverse side effects. To address this challenge, we have developed a novel smart structural color hydrogel patch (CPG) for both the diagnosis and treatment of COM. The patch combines methylacrylated chitosan modified with phenylboronic acid (CSMA-PBA) as a scaffold, temperature-responsive GelMA hydrogel as filler, and salicylic acid (SA) for drug delivery. Characterization showed excellent mechanical properties and adhesive strength. Drug release experiments confirmed that CPG effectively responds to pH changes, enabling controlled drug release. CPG also serves as a diagnostic tool by detecting pH and temperature changes at the infection site, assisting in postoperative recovery. Antimicrobial tests showed significant inhibition of bacterial growth, and in vitro experiments demonstrated CPG's ability to promote vascular endothelial growth factor expression while reducing inflammatory markers. The study highlights the multifunctional capabilities of the hydrogel patch, including antimicrobial, anti-inflammatory, and pro-vascular effects, positioning it a promising therapeutic option for chronic osteomyelitis.

Background: Osteomyelitis (OM) is a serious infection of the bone, often resulting from diabetic foot ulcers, trauma, or surgical interventions. Given its complex pathophysiology and recurrent nature, identifying reliable risk factors is essential for early diagnosis and intervention. This study identifies independent OM risk factors through a systematic review and meta-analysis method. Methods: A search was conducted across several databases up to January 2025. Data were extracted independently, and study quality was assessed using the Newcastle–Ottawa Scale. Statistical analysis was performed with RevMan 5.3 and Stata 15.0 software, using univariate and multivariate analyses. Heterogeneity was assessed by methods of subgroup analysis and sensitive analysis, and publication bias was evaluated with Egger’s test and funnel plots. Results: A total of 4019 potential articles were systematically reviewed, with 27 studies (n = 11 941 participants) were included. These studies were analyzed to identify risk factors across five categories: demographic features, medical history, clinical features, laboratory findings, and bacterial characteristics. Medical history factors, such as history of foot ulcers/foot disease (OR = 2.520), operation duration time (>3 hours, OR = 1.740), and incision length >10 cm (OR = 6.530), were significant. Clinical features including inflamed ulcer (OR = 6.200), fever (OR = 2.200), and ulcer size >4/5 cm ² (OR = 2.740) also increased OM risk. Laboratory findings such as elevated HbA1c (OR = 1.140), hypoalbuminemia (OR = 1.740), anemia (OR = 1.540), and microbiological perspective such as polymicrobial infections (OR = 2.580) were also recognized as independent risk factors of OM. Subgroup analysis accounted for heterogeneity arising from the type of OM and different risk factor characteristics. Sensitivity analysis confirmed the reliability of the results. Additionally, both funnel plots and Egger tests showed no evidence of publication bias. Conclusions: This is the first meta-analysis to integrate univariate and multivariate evidence on OM risk factors. It establishes clinically preventable risk factors across OM subtypes, enabling early targeted interventions to reduce amputations and healthcare burdens.

Objective: This study aimed to evaluate the effectiveness of intravenous versus oral antibiotic treatments in managing bone infections, particularly osteomyelitis, using a rat tibial infection model.Methods: A tibial bone infection model was established in twelve-week-old Wistar rats via injection of Staphylococcus aureus at a cortical defect site. After six weeks, rats were treated with vancomycin (intravenous), cefazolin (intravenous), ciprofloxacin (oral), or ciprofloxacin combined with rifampin (oral). Microbial analysis, blood analysis for pro-inflammatory cytokines, micro-computed tomography (μCT), histological analysis, and osteoclast activity were used to assess the efficacy of each treatment.Results: Blood analysis showed significant reductions in white blood cell count and pro-inflammatory cytokines in the intravenous treatment groups, especially with vancomycin. μCT imaging revealed better preservation of bone structure in intravenous treatment groups, while oral treatments resulted in more pronounced structural deterioration. Microbial analysis confirmed a lower bacterial load in the intravenous groups, particularly vancomycin, compared to oral treatments. Histological analysis revealed reduced inflammation, lower fibrosis, and minimal bacterial presence in intravenous groups. Osteoclast activity was notably reduced in the vancomycin and cefazolin groups, indicating better control of bone resorption.Conclusion: Intravenous administration of vancomycin demonstrated superior efficacy in controlling bone infection, reducing inflammation, and preserving bone structure compared to oral treatments. While ciprofloxacin and the ciprofloxacin-rifampin combination showed some efficacy, they were less effective than intravenous vancomycin, likely due to lower bioavailability and insufficient drug penetration in bone tissue.

Background: During the new coronavirus disease 2019 (COVID-19) pandemic, there are numerous symptoms in the skeletal muscular system, such as decreased skeletal muscle mass, strength, and muscle function, which are the main manifestations of sarcopenia. To investigate the impact of the COVID-19 pandemic on sarcopenia from the perspectives of COVID-19 pandemic lockdown and COVID-19 infection, we conducted this study. Methods: We searched for literature related to COVID-19 and sarcopenia published in PubMed, Embase, Cochrane Library, and Web of Science. Two researchers independently searched and screened the articles, extracted data, and assessed the quality of the final included literature. RevMan 5.4 was used for meta-analysis. Results: A total of 8 articles with a total of 1145 patients were included. There was a significant difference in SARC-F scores (MD = 0.67, 95%CI = [0.41, 0.93], Z = 5.00, P < .00001), handgrip (MD = ‐1.57, 95%CI = [‐2.41, ‐0.73], Z = 3.66, P = .0002), body weight (MD = ‐1.87, 95%CI = [‐3.69, ‐0.05], Z = 2.01, P = .04), and skeletal muscle mass index (MD = ‐0.28, 95%CI = [‐0.54, ‐0.02], Z = 2.13, P = .03) between the time before the COVID-19 pandemic and during the COVID-19 pandemic. However, the results showed that there was no significant difference in muscle mass between the 2 groups (MD = ‐1.72, 95%CI = [‐4.39, 0.94], Z = 1.27, P = .21). Conclusion: The COVID-19 pandemic has had an impact on sarcopenia. Both infection with COVID-19 and lockdown during the COVID-19 pandemic increase the risk of sarcopenia. Research should pay more attention to this disease during the COVID-19 pandemic and adopt effective interventions to minimize adverse outcomes.

To explore whether season is a risk factor of periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) and explain it with the theory of traditional Chinese medicine. This was a retrospective cohort study. Only patients who suffered from PJI within 1 month after TJA were included in the study. Occurrence of PJI was the outcome of this study. Chi-squared test and t test was used to assess differences for baseline characteristics. Chi-square test was used to analyze whether season was related to the occurrence of PJI. Logistic regression was used to evaluate the association between season and occurrence of PJI. The incidence of PJI in summer is significantly higher than that in winter, whether after total knee arthroplasty (Chi-square value = 6.455, P = .011) or total hip arthroplasty (Chi-square value = 6.141, P = .013). Summer was an independent risk factor for PJI (OR = 4.373, 95% confidence interval = 1.899–10.673, P = .004). To be more exact, compared to nonlate summer (19.51%), and PJI is mainly concentrated in late summer (80.49%). Late summer was an independent risk factor of PJI after TJA. The infection rate of PJI after TJA in late summer is higher than other seasons. A more thorough preoperative disinfection procedure is needed in late summer.

Background: Obesity is considered one of the biggest public health problems, especially in the background of the coronavirus disease 2019 (COVID-19) lockdown. It is urgent to find interventions to control and improve it. We performed this systematic review and meta-analysis to summarize the effect of traditional Chinese exercise on obesity.Methods: We searched PubMed, Embase, Cochrane Library, the China National Knowledge Infrastructure (CNKI), the Chinese Scientific Journal Database (VIP), the Chinese Biomedical Literature Database (CBM), and WanFang database for updated articles published from the inception of each database to June 2022. Randomized controlled trials (RCTs) on traditional Chinese exercise in weight reduction were included, and related data were extracted. The random-effects model was used to adjust for the heterogeneity of the included studies, and funnel plots were used to examine publication bias.Results: A total of 701 participants were included in the 10 studies. Compared with the control group, the outcome of body weight [mean difference (MD) = −6.10; 95% CI = -8.79, -3.42], body mass index (MD = −2.03; 95% CI = -2.66, -1.41), body fat mass (MD = −3.12; 95% CI = -4.49, -1.75), waist circumference (MD = −3.46; 95% CI = -4.67, -2.24), hip circumference (MD = −2.94; 95% CI = -4.75, -1.30), and waist-to-hip ratio (MD = −0.04; 95% CI = -0.06, -0.03) in the intervention group had significant differences. Egger’s test and funnel plots showed that the potential publication bias of the included studies was slight (p = 0.249).Conclusion: Traditional Chinese exercise is an effective treatment for obesity; people under the COVID-19 lockdown could do these exercises to control weight. However, a precise and comprehensive conclusion calls for RCTs on a larger scale with more rigorous designs considering the inferior methodological quality and limited retrieved articles.Systematic review registration: www.crd.york.ac.uk/PROSPERO/, identifier CRD42021270015.

Background. Hidden blood loss (HBL) after total hip arthroplasty (THA) would lead to many undesirable consequences. Traditional Chinese medicine (TCM) is now increasingly used for hidden blood loss. We performed this systematic review and meta-analysis to summarize the effect and safety of TCM treatment of HBL after THA. Methods. We searched PubMed, Embase, Cochrane Library, CNKI, VIP, WanFang, and CBM for the updated articles published from the inception of each database to May, 2022, among which results such as abstracts, comments, letters, reviews, and case reports were excluded. The efficacy and safety of TCM treatment of HBL after THA were synthesized and discussed by the outcomes of total blood loss (TBL), hidden blood loss (HBL), hemoglobin (Hb), and hematocrit (HCT), and the incidence of adverse reactions. Results. A total of 12 articles and 881 patients were included. There were 441 cases in the intervention group and 440 cases in the control group. Compared with the control group, the intervention group had more advantages in TBL (MD = −251.68, 95% CI = [−378.36, −125]; Z = 3.89, ), HBL (MD = −159.64, 95% CI = [−252.56, −66.71]; Z = 3.37, ), Hb (MD = 11.39, 95% CI = [7.35, 15.43]; Z = 5.53, ), and HCT (MD = 2.87, 95% CI = [0.97, 4.78]; Z = 2.95, ), and had less incidence of adverse reactions (OR = −0.20, 95% CI = [−0.35, −0.05]; Z = 2.64, ). Conclusion. TCM has advantages in the efficacy and safety of treating hidden blood loss after THA. The strength of the evidence of the research results is limited by the quality of the included literature, and more high-quality RCTs are needed to confirm.