Iron overload (IO) was considered to be a risk factor for cartilage degradation in knee osteoarthritis (KOA) advancement. However, few drugs were found to improve cartilage degeneration by alleviating multiple cell death induced by the impaired iron level of the knee joints. We aimed to elucidate that Arctiin (ARC) plays a role in managing KOA caused by accumulated iron levels by restoring chondrocyte apoptosis and ferroptosis. Single-cell RNA sequencing analysis was used to discover the disparities in chondrocytes between KOA patients and non-KOA individuals. CCK-8 assay was performed to detect chondrocyte viability. Annexin V-FITC/PI staining determined the cell apoptosis rate. The fluorescence density reflected the iron content, ROS, lipid-ROS, and mitochondrial membrane potential. Q-RTPCR and Western Blotting were used to detect the expression levels of genes and proteins expression. Micro-CT and Safranin O-Fast Green staining were used to detect the phenotype of the knee joints. ARC increased cell viability and inhibited chondrocyte apoptosis. Further, ARC acts as an anti-ferroptosis effect by reducing the intracellular iron, ROS, and lipid-ROS content and restoring mitochondrial damage. Based on the results of scRNA-seq, we found that ARC can play a role by activating AKT/NRF2/HO-1 signaling pathway. In vivo, ARC can significantly improve the severity of KOA caused by IO. ARC alleviates oxidative stress in chondrocytes via the AKT/NRF2/HO-1 signaling pathway, suggesting the potential application of ARC in KOA.

Objective: This study aimed to compare the clinical outcomes of conventional retrograde intrarenal surgery (RIRS) and RIRS with intelligent pressure control, as well as to identify factors influencing the stone-free rate (SFR). Materials and methods: We conducted a retrospective review of 101 patients treated with either conventional RIRS or RIRS with intelligent pressure control from September 2023 to September 2024. Clinical and stone-related parameters were collected for comparison between the two methods, and factors affecting SFR were examined using univariate and multivariate logistic regression analyses. Results: The SFR was significantly higher in the intelligent pressure control group compared to the conventional RIRS group (89.8% vs. 73.1%, p = 0.032). No statistically significant differences were found between the two groups regarding operative time or post-operative hospital stays. The incidence of post-operative fever was lower in the intelligent pressure control group than in the conventional RIRS group (2.0% vs. 9.8%), although this difference did not reach statistical significance (p = 0.205). Univariate analysis identified stone size, stone density, number, location, and surgical method as factors associated with SFR. Multivariate analysis further confirmed that stone size, density, and surgical method significantly impacted SFR. Conclusion: RIRS with intelligent pressure control significantly improves the stone-free rate compared to conventional RIRS, without increasing complications, hospitalization duration, or operative time. Additionally, stone size and density were influential factors for SFR.