To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

卵圆孔未闭（PFO）是一种常见的先天性心脏病，近年来研究发现其与多种非卒中性疾病存在关联，如偏头痛、减压病、斜卧呼吸-直立性低氧血症及非脑血管周围栓塞等。本文探讨了PFO相关非卒中性疾病的流行病学特征、病理生理机制、诊断与评估方法以及治疗策略等方面的最新进展，旨在为临床诊疗提供参考，并对未来研究方向进行展望。

心房颤动（房颤）和心力衰竭（心衰）息息相关，可通过不同的机制相互引起或加重。多项研究表明，导管消融治疗房颤合并心衰不仅可改善心功能（降低脑钠肽水平及纽约心脏学会心功能分级）、提高生活质量，还能改善临床预后、降低因心衰再住院率和全因死亡率。导管消融的时机把握也同样重要，在房颤患者出现心衰症状前或在心衰早期进行导管消融，可使患者获益更多。

心力衰竭（心衰）是多种心脏疾病的严重表现形式或晚期阶段。尽管现代医学在药物及器械治疗方面取得了显著进展，患者预后有所改善，但死亡率和再住院率仍居高不下。可溶性鸟苷酸环化酶（sGC）刺激剂作为一类新型药物，通过特异性激活一氧化氮-sGC-环磷酸鸟苷信号通路，在改善心室重构、内皮功能及心肌收缩力等方面展现出独特优势。本文旨在综述sGC刺激剂在心衰中的作用机制、临床研究现状及未来发展方向。

To evaluate the causal association between occupational severe cold exposure and the risk of frozen shoulder using Mendelian randomization (MR), and to provide evidence for occupational health interventions.

A two-sample MR design was conducted using exposure data from the UK Biobank and outcome data from the FinnGen database. Genetic variants significantly associated with severe cold exposure were employed as instrumental variables. The inverse variance-weighted method was the primary approach for causal effect estimation, supplemented by sensitivity analyses to ensure robustness.

The results indicated a significant association between occasional severe cold exposure and an increased risk of frozen shoulder [odds ratio (OR) = 2.78, 95% confidence interval (CI) (1.17, 6.57), P=0.020]. No significant associations were observed for rare or frequent severe cold exposure. Sensitivity analyses confirmed the robustness of these findings.

MR study indicates causal evidence linking severe cold exposure to frozen shoulder risk, occasional exposure to severe cold environments may represent a key risk factor for frozen shoulder.

To analyze the efficacy of arthroscopic meniscoplasty and suture fixation in treating discoid lateral meniscus (DLM) injuries, identify risk factors affecting outcomes, and construct a risk prediction model to provide a reference for improving the efficacy and prognosis of DLM injury treatment.

Inclusion criteria: MRI-confirmed DLM injury with symptoms; Watanabe type I or II; unilateral involvement and first-time arthroscopic surgery; complete clinical data without chronic knee diseases. Exclusion criteria: requirement for simultaneous bilateral surgery; history of knee surgery or other knee injuries; concurrent knee infection; surgical contraindications. A single-center, self-controlled cohort study was conducted. A total of 154 patients with DLM injuries who underwent arthroscopic meniscoplasty and suture fixation at the Department of Orthopedics, Renhe Hospital Affiliated to Three Gorges University between January 2020 and January 2024 were enrolled. Lysholm knee joint score scale (LKSS) was used to evaluate efficacy at six months after operation. The patients were divided into two groups based on efficacy: the excellent/good efficacy group (score ≥70) and the poor efficacy group (score <70). Univariation analysis and multivariate logistic regression analysis were performed to identify independent risk factors affecting efficacy, and a predictive model was constructed.

LKSS scores before surgeryand six monthsafter surgery were (67±7) and (90±7) respectively, with a statistically significant difference (t=29.701, P<0.001). The overall excellent efficacy rate at six months after operation was 81.8% (126/154). Univariation analysis and multivariate logistic regression analysis revealed that age [odds ratio (OR) = 1.189], disease duration (OR=1.054), and Outerbridge classification of cartilage injury (OR=1.251) were independent risk factors affecting efficacy ( all P<0.05). A predictive model was constructed based on these independent risk factors, with an area under the receiver operating characteristic (ROC) curve of 0.894 and a critical value of 90, indicating good discriminative ability.

Age, disease duration, and Outerbridge classification of cartilage injury are independent risk factors affecting the clinical efficacy of arthroscopic meniscoplasty and suture fixation for DLM injuries. These risk factors can be used for clinical prognosis risk prediction. High-risk patients (total score >90) with advanced age, prolonged disease duration, and severe cartilage injury may benefit from individualized interventions, treatments, and develop personalized treatment plans and rehabilitation programs.

To investigate the impact of refining the clinical pathway process and management training model for artificial joint replacement on medical efficiency, treatment outcomes, and the competency enhancement of resident physicians.

A total of 258 cases undergoing artificial joint replacementat Sun Yat-sen Memorial Hospital from June 2023 to June 2024 (experimental group) were included and subjected to a refined clinical pathway management model with hierarchical progressive diagnosis and treatment. These cases were compared with 201 cases managed under the traditional clinical pathway model by the same treatment team from June 2022 to May 2023. Inclusion criteria: patients undergoing primary unilateral total hip or knee arthroplasty. Exclusion criteria: revision surgery, multiple joint replacements, active infection, severe osteoporosis, neuromuscular disorders, and incomplete data.Independent samples t test and chi square test were used to compare hospital stay duration, costs, and complication rates between groups. Resident physicians in the experimental group followed the refined clinical pathway for clinical work and training, and their clinical competency improvement was compared with that of the control group.

The experimental group exhibited significantly shorter hospital stays (t=3.061, P<0.05), lower costs (t=5.515, P<0.05), and reduced overall complication rates (χ²=6.592, P<0.05) compared to the control group. The clinical competency of resident physicians under the refined clinical pathway improved significantly (t=-17.174, P<0.001).

Refining the clinical pathway process enhances work efficiency and treatment outcomes, while also promoting the clinical competency of resident physicians.

To explore the therapeutic effect of application of orthosis after HyProCure tarsal sinus screw internal fixation on adolescent patients with flatfoot.

A retrospective study was conducted on 106 patients with flatfoot who were treated in Shangjin Hospital, West China Hospital of Sichuan University from July 2022 to July 2024. Inclusion criteria: age≤18 years old, complete clinical data, no history of surgery, imaging diagnosis of flatfoot (arch disappearance, scaphoid protrusion and heel valgus when standing) and repeated plantar/arch pain. Exclusion criteria: spinal disease, neuromuscular disease, severe osteoarthritis, immune system disease or signs of foot infection. According to the treatment methods, the enrolled patients were divided into operation group (n=52) and combination group (n=54). The operation group accepted HyProCure tarsal sinus screw internal fixation, while the combination group accepted orthosis at three weeks after HyProCure tarsal sinus screw internal fixation. The clinical efficacy as well as lower limb balance status, plantar pressure and imaging measurement indicators before and after treatment were compared between both groups by chi square test and t test.

The total clinical effective rate in the combination group was higher than that in the operation group (χ²=5.075, P<0.05). After treatment, compared with the operation group, the posterior ankle joint-hind foot function score in the combination group was higher (t=5.620, P<0.05). After treatment, the height of the first tarsometatarsal joint and calcaneal inclination angle (Pitch angle) in the combination group were higher than those in the operation group, and the first metatarsal angle (Meary angle) was smaller than that in the operation group (t=3.234, 6.666, 12.041, all P<0.05). The maximum plantar pressure and average plantar pressure in the combination group after treatment were lower than those in the operation group (t=6.568, 6.984, both P<0.05).

Orthosis application at three weeks after HyProCure tarsal sinus screw internal fixation in the treatment of adolescent flatfoot can enhance the clinical efficacy and lower limb balance, and improve the foot structure and plantar pressure of adolescent flatfoot.

To explore the effects of artesunate on wear particle-induced inflammatory osteolysis explored by in vitro and in vivo experiments.

In vitro experiments: healthy mouse embryonic osteoblast precursor cells MC3T3-E1 cells were selected and divided into four groups for culture: blank control group; Ti particle group, where titanium particles were added for osteogenic differentiation culture; artesunate group, where 10 μmol/L artesunate ester was added for osteogenic differentiation culture; combination group, where titanium particles and 10 μmol/L artesunate ester were added simultaneously for osteogenic differentiation culture. Cell activity was determined using the cell counting kit-8 (CCK-8), while apoptosis was analyzed by flow cytometry. In vivo experiments: forty C57BL/6J mice were randomly divided into four groups using a random number table. In the Ti particle group and the Ti + artesunate group, the mice’s scalps were incised and titanium was implanted to establish a mouse skull bone resorption model. In the sham group and the artesunate group, the same surgical procedures were performed without implanting titanium. After establishing the artesunate group and the titanium plus artesunate group, artesunate was administered by gavage at a dose of 50 mg/(kg·d). The mice were executed after two weeks, and hematoxylin-eosin method (HE) staining was used to observe the pathological changes of the skull; enzyme-linked immunosorbent assay (ELISA) was performed to measure the expression levels of inflammatory factors, tumor necrosis factor (TNF) α, interleukin (IL)-1β, and IL -6. Real-time quantitative polymerase chain reaction (RT-PCR) was used to assess the expression of osteogenic differentiation-related genes including alkaline phosphatase (ALP), osteocalcin (OCN), runt-related transcription factor 2 (Runx-2), and collagen type-Ⅰ (COL I). Two weeks after dosing, Micro-CT of the skull was conducted. For comparisons between groups of measurement data, independent samples t test or one-way analysis of variance was used; for multiple comparisons, LSD test was used; and for comparisons between groups of count data, chi square test was employed.

In vitro experiments: CCK8 results showed that at artesunate concentrations ≤10 μmol/L, there was no significant effect on osteoblast proliferation. Titanium particle concentrations≤0.5 mg/ml did not significantly affect the proliferation of MC3T3-E1 cells. Flow cytometry results showed that titanium particles promoted apoptosis in MC3T3-E1 cells (t=57.46, P<0.001); artesunate inhibited the effect of titanium particles (t=19.64, P<0.01). In vivo experiments: HE staining showed that the number of inflammatory cells and the degree of bone destruction in the peri-cranial tissues of the Ti granules group were significantly higher than those of the Ti+artesunate, artesunate, and Sham groups; the inflammatory response was reduced and bone destruction was significantly improved after artesunate intervention. ELISA and PCR results showed that compared to sham group, the Ti particles stimulated a significant increase in the concentration of the three inflammatory factors (t=8.872, 15.6, 18.71, all P<0.05) and a decrease in the mRNA expression of osteogenesis-related genes (t=18.31, 20.47, 23.95, 27.22, all P<0.05). In contrast, compared with the Ti particles group, the Ti + artesunate group showed different degrees of down-regulation of the expression of the three inflammatory factors (t=4.672, 4.805, 3.405, all P<0.01) and increased expression of osteogenesis-related genes (t=12.2, 15.15, 22.02, 16.99, all P<0.05). Micro-CT scans showed that titanium particles led to an increase in bone destruction and induced osteolysisaround the skull, and that the titanium particle-induced osteolysis could be mitigated by the intervention of artesunate.

Artesunate can improve titanium particles induced osteolysis and bone destruction by inhibiting inflammatory factors and up-regulating the function of osteoblasts.

To explore the effect of the combined application of transforming growth factor-β3 (TGF-β3) and stromal cell-derived factor 1α (SDF-1α) with microporous hydrogel on the repair of cartilage injury.

TGF-β3 was transfected into rat bone marrow mesenchymal stem cells (BMSCs) by adenovirus to obtain bone marrow mesenchymal stem cells carrying the TGF-β3 gene (Ad-BMSCs). Genipin crosslinked gelatin microspheres (GMs) were infiltrated into cytokine SDF-1α solution to obtain GMs containing SDF-1α (GMs-S). Then the Ad-BMSCs and BMSCs were suspending in alginate solution, respectively, and mixed with GMs-S, to obtain two groups of hydrogel microspheres (HMs) after calcium in crosslinking reaction as group S+T (containing SDF-1α and TGF-β3) and group S (containing only SDF-1α). Similarly, these two cells alginate solution mixed with GMs respectively to obtain two groups of gelatin microsphere hydrogel as group T (containing TGF-β3) and the blank group.The HMs of each group were cultured in cell incubators under the same conditions,and cell proliferation was detected by cell counting kit-8 assay (CCK-8), the release of SDF-1α and/or TGF-β3 were detected by enzyme-linked immunosorbent assay (ELISA). The gene expression of type I collagen, type Ⅱ collagen, type X collagen and aggrecan (ACAN) were detected by polymerase chain reaction assay (PCR), and expression of sex related Y-box transcription factor 9 (SOX9) protein was detected by western blotting analysis (WB). All the tests in this study were repeated for three times; the quantitative data were described as ±s, t test was used to compare the difference between two groups, and single factor variance analysis was applied for multipe groups comparison. P<0.05 indicated the difference was statistically significant.

CCK-8 data indicated that group S+T had an outstanding ability of cell growth (F=6.904, R²=0.533, P<0.05). SDF-1α (P>0.05) and TGF-β3 (P>0.05) release curves of group S+T and group S were generally consistent. Other results demonstrated that group S+T had greater expression of typeⅡcollagen (comparing the blank group and the group S with the group S+T, P<0.05) and aggrecan (comparing the blank group and the group S with the group S+T, P<0.05) and more synthesized cartilaginous extracellular matrix. Moreover, the WB analysis suggested that the expression of SOX9 protein in group S+T was the highest (each group was compared with the group S+T, P<0.05).

Synergistic effect of SDF-1α and TGF-β3 on BMSCs cultured in microcavitary hydrogel can improve the effect of chondrogenesis.

To elucidate the epigenetic regulatory mechanisms underlying acetabular cartilage dysplasia and chondrocyte degradation in patients with developmental dysplasia of hip (DDH) using single-cell assay for transposase-accessible chromatin using sequencing (scATAC-seq) technology and provide new insights into the cell-specific molecular pathology of DDH.

A total of 64 053 acetabular chondrocytes were collected from six DDH patients (those with a history of hip surgery, infection, or systemic diseases were excluded) and six patients with traumatic femoral neck fracture (TNOF) as controls in Xi’an Honghui Hospital. These cells were analyzed by scATAC-seq to construct a map of genome-wide single-cell chromatin accessibility and reveal cellular heterogeneity. The differences in the proportions of cell types between the two groups were analyzed using Mann-Whitney U test.

Six distinct cell populations in DDH cartilage were identified, such as fibrocartilage chondrocytes (FC), homeostatic chondrocytes (HomC), prehypertrophic chondrocytes (preHTC) and hypertrophic chondrocyte (HTC) as well as regulatory chondrocytes (RegC). The percentage of FC (U=35, P=0.004), HomC (U=36, P=0.002) and preHTC (U=35, P=0.004) were significantly higher in the DDH group than those in the control group. While compared to the control group, the percentage of RegC was remarkably lower in the DDH group (U=1, P=0.004). Disease associated candidate differentially accessible peaks and transcription factors (TF) were revealed, such as HINFP (log₂ FC= 2.84, P=6.31×10⁻⁴) for HomC population and runt related transcription factor 2 (RUNX2) (log₂ FC=1.02, P=1.95×10⁻⁵) for RegC population.

The identified cell types exerted different influences on the development of DDH, which may be driven by corresponding key transcription factor of differential accessible peaks. These findings may provide novel clues for understanding etiology and pathogenesis as well as therapeutic targets of DDH.

To investigate the causal relationship between sulcal morphology (specifically sulcal depth and opening distance) and osteonecrosis through Mendelian randomization analysis, thereby providing new perspectives for research on osteonecrosis pathogenesis and early screening of high-risk populations.

A two-sample Mendelian randomization design was employed, using genetic variants associated with sulcal depth as instrumental variables. Data were derived from large-scale GWAS datasets in the NHGRI-EBI and FinnGen repositories. The primary analysis was conducted using the inverse variance-weighted (IVW) method, with sensitivity analyses to validate the robustness of the findings.

Among 44 sulcal features analyzed, only the sulcal opening depth of the right anterior inferior temporal sulcus was significantly associated with osteonecrosis, showing a negative causal relationship [odds ratio (OR) =0.348, 95% confidence interval (CI) (0.143, 0.847), P=0.020]. Other sulcal features demonstrated no statistically significant associations (all P>0.05).

There might be a causal link between the sulcal depth of the right anterior inferior temporal sulcus and osteonecrosis, which suggests sulcal depth as a potential biomarker for osteonecrosis screening in at-risk population.

Articular cartilage has limited self-healing capacity due to the absence of blood vessels and nerves. Stem cell-based tissue engineering offers promising therapies for cartilage repair, but mesenchymal stem cell (MSC) sources are limited, and replicative senescence and decreased chondrogenic differentiation potential occur during in vitro expansion. Decellularized stem cell matrix (DSCM), a bioactive material, enhances MSC proliferation, chondrogenic differentiation, and resistance to replicative senescence and inflammation, making it a promising tool in cartilage tissue engineering. The regenerative efficacy of DSCM in cartilage repair is modulated by variables such as the cell source, fabrication techniques, and modes of application. Notably, its successful application in promoting cartilage regeneration in small animal models underscores its substantial potential for clinical translation. This review highlighted the impact of DSCM deposited by expanded MSCs in vitro on MSC proliferation, chondrogenic differentiation, replicative senescence, and inflammatory response, providing insights into its potential for cartilage repair through stem cell-based tissue engineering.