Senescent nucleus pulposus mesenchymal stem cells (NPMSCs) are key instigators of local chronic inflammation and disruptions in nucleus pulposus tissue repair in intervertebral disc degeneration (IVDD). This study aimed to investigate the interplay between EZH2 and NPMSCs senescence-associated inflammation. Nucleus pulposus samples were collected from IVDD patients (n = 15, F/M = 7/8, average age 47.9 (21-72) year-old). Multiplex immunohistochemistry was conducted to detect the expression of EZH2 and the cGAS/STING pathway. Subsequently, NPMSCs were isolated from 7 patients (n = 7, F/M = 4/3, average age 49.4 (36-68) year-old). After treatment with tert-butyl hydroperoxide and lentivirus-overexpression-EZH2 (Lv-OE-EZH2), real time fluorescent quantitative PCR, immunofluorescence, western blot, and ChIP were used to detect the expression of EZH2 and the cGAS/STING pathway. Micro-CT, magnetic resonance imaging, and histological staining were performed to assess the therapeutic effects of Lv-OE-EZH2 and a STING inhibitor on rat IVDD. All experiment designs were independent. In both human nucleus pulposus tissues and an in vitro cell model, EZH2 expression decreased while the cGAS/STING pathway became activated in senescent NPMSCs. ChIP assays and Lv-OE-EZH2 experiments validated that EZH2 epigenetically inhibited STING expression via H3K27me3, thereby impairing the cGAS/STING pathway and attenuating senescence-associated inflammation. Moreover, overexpression of EZH2 (Pfirrmann grade means difference -1.375, p = 0.0089) and inhibition of STING effectively attenuated rat IVDD. The decreased expression of EZH2 in senescent NPMSCs promotes senescence-associated inflammation and the progression of IVDD, possibly by relieving the transcriptional inhibition of STING and enabling the activation of the cGAS/STING pathway.

This study aimed to evaluate the impact of a cloud-based follow-up exercise prescription on knee function and quality of life in patients undergoing home-based rehabilitation following total knee arthroplasty (TKA), thereby informing the application of telemedicine in post-TKA home rehabilitation. A randomized controlled trial was conducted from February 2023 to January 2024. Patients were divided into a control group and an intervention group according to a random number table. Both groups performed rehabilitation exercises based on exercise prescriptions. After discharge, the control group received follow-up via conventional methods, while the intervention group was monitored using a cloud-based follow-up system. Independent samples t-tests were employed to compare the two patient cohorts with respect to knee function, quality of life, adherence to rehabilitation exercises, and total follow-up costs. Of the 164 patients initially enrolled, 151 completed the 12-week follow-up and functional exercises: 75 in the control group and 76 in the intervention group. At 2 and 4 weeks post-surgery, the intervention group demonstrated superior knee function and adherence to rehabilitation exercises compared to the control group (all P < 0.05). At 4 weeks post-surgery, the intervention group also exhibited a higher quality of life (P < 0.05). At 12 weeks post-surgery, no significant differences were observed between the two groups in knee function, quality of life, or adherence to rehabilitation exercises. The total follow-up cost for the intervention group was lower than that of the control group (p < 0.05). Cloud-based follow-up exercise prescriptions can improve knee function and quality of life in home-based patients in the early stages (within 4 weeks) of rehabilitation exercises after TKA, which is of clinical significance. ChiCTR2200067031, registered 23 December 2022, https://www.chictr.org.cn/bin/project/edit?pid=185737 .

Background: Older adults is characterized by an age-related decline in bone mineral density. Frailty-a distinct age-associated geriatric syndrome-further exacerbates this condition. The concomitance of osteoporosis and frailty in older adults markedly heightens the risk of functional decline, with attendant profound psychosocial sequelae. A mixed-methods study design is essential to achieve a comprehensive, patient-centered understanding of this phenomenon. Methods: This study will adopt a convergent mixed-methods design comprising three primary phases: (1) Quantitative phase: a cross-sectional survey will be conducted among older adults diagnosed with osteoporosis. Data collection will include demographic variables, scores from the Edmonton Frail Scale, Activities of Daily Living assessments, Nutritional Risk Screening assessments, and the Hospital Anxiety and Depression Scale. In addition, handgrip strength will be measured, alongside relevant laboratory parameters. Data will undergo descriptive analysis, followed by univariate analyses and multivariate binary logistic regression to identify factors associated with frailty. (2) Qualitative phase: semi-structured, face-to-face interviews will be performed with participants classified as frail according to their frailty assessment scores, enabling an in-depth exploration of their subjective perceptions and experiences of frailty within the context of osteoporosis. (3) Integration phase: key findings from both quantitative and qualitative components will be analyzed and synthesized to generate a comprehensive understanding of the phenomenon. Discussion: This study aims to explore the prevalence and clinical characteristics of frailty among older adults with osteoporosis. It also seeks to identify associated risk factors and to explore patients' subjective experiences of living with frailty in the context of osteoporosis. Clinical trial registration: This trial has been registered with the Chinese Clinical Trial Registry (ChiCTR2500097059).

Objective: To investigate the present situation of wound ostomy continence(WOC) clinic as well as to provide objective basis and expand working thoughts for carrying out WOC clinic.Method:3251 patients who visited our WOC clinic between December 2010 and March 2015 were retrospectively analyzed.Results: The patients know WOC clinic mostly (94.72%) by medical staff in our hospital. Chronic wound patients have the highest demand (63.82%). 6.51% patients with poor health and economic condition can’t stick to outpatient dressing. Most ostomy patients receive well health guidance during their hospitalization.Conclusion: The patients show great demands for WOC clincic. Next we should strengthen the propaganda, develop continuous nursing and telemedicine network.