Mechanically induced biological responses in bone cells involve a complex biophysical process. Although various mechanosensors have been identified, the precise mechanotransduction pathway remains poorly understood. PIEZO1 is a newly discovered mechanically activated ion channel in bone cells. This study aimed to explore the involvement of PIEZO1 in mechanical loading (fluid shear stress)‐induced signaling cascades that control osteogenesis. The results showed that fluid shear stress increased PIEZO1 expression in MC3T3‐E1 cells. The fluid shear stress elicited the key osteoblastic gene Runx‐2 expression; however, PIEZO1 silencing using small interference RNA blocked these effects. The AKT/GSK‐3β/β‐catenin pathway was activated in this process. PIEZO1 silencing impaired mechanically induced activation of the AKT/GSK‐3β/β‐catenin pathway. Therefore, the results demonstrated that MC3T3‐E1 osteoblasts required PIEZO1 to adapt to the external mechanical fluid shear stress, thereby inducing osteoblastic Runx‐2 gene expression, partly through the AKT/GSK‐3β/β‐catenin pathway.

Full-length lower limb x-rays are used to diagnose and plan surgical procedures, such as Total Knee Arthroplasty (TKA) and High Tibial Osteotomy (HTO). Due to the size limitation of digital radiography (DR), panoramic x-ray images cannot be obtained in a single exposure, necessitating multiple exposures and image stitching. In favor of manually constructing full-length x-ray images, we propose a new feature-based automated method for stitching together x-ray images. This new method is based on Canny algorithm, which detects and aligns bone edges before fusing them using a Wavelet form domain. Twenty-eight sets of lower limb x-ray images obtained from our hospital have been stitched and evaluated. The hip, knee, and ankle (HKA) angle was computed in two different ways then compared to manually stitched x-ray images by an expert. The stitching time was only three seconds, and the P-value was P = 0.974, and an accuracy rate of 100% was found. This method demonstrated greater precision and speed than both manually stitched x-ray images and previously published methods.

Background : At present, more and more clinicians in China are partaking in case discussions using WeChat groups for the purposes of communication, diagnosis, treatment planning, and information sharing. However, the reliability of discussions using WeChat groups remains debatable. This study aimed to analyze case discussions in WeChat groups and evaluate their significance. Methods : By taking screenshots of the chat records from the most-used WeChat groups by orthopedic surgeons, all of the data related to the cases were collected from June to August in 2019. We analyzed the purpose, participation, and completeness of each case. Furthermore, we analyzed whether the conclusion reached in each case discussion, which was supported by the majority of members, was consistent with the opinion of three experts after evaluating all of the data from the case records. Results : Seven WeChat groups and 60 cases were included. WeChat group members often discussed cases to show surgical results (40.0%), to obtain treatment advice (39.0%), and to seek diagnostic advice (9%). The rate of ‘likes’ for ‘surgical results show’ was greater than the rate of ‘likes’ for alternative purposes (P<0.05). The percentage of complete, relatively complete and incomplete cases was 23%, 32%, and 45%, respectively. The relatively complete cases received more effective comments than the other cases (P<0.05). The cases for diagnostic purposes were more complete than those for other purposes (P<0.05). Among 60 cases, only 29 cases led to the same conclusions being reached among the three experts and WeChat group members. The consistency rate of conclusions relating to treatment was higher than that associated with the other purposes (P<0.05). The consistency rate of the complete cases was higher than that of the relatively complete and incomplete cases (P<0.05). Conclusions : Clinicians should treat discussions in WeChat groups for clinical decision-making with caution. Online discussions using WeChat groups should be standardized in respect to the cases presented and the comments that are generated.

Background: With the vigorous development of social media networks, an increasing number of orthopedists in China are taking part in case discussions using WeChat groups. The case discussion process using WeChat is quick, convenient and not limited by time or space, but this kind of case discussion is also chaotic and unconstrained. This study is aimed to observe and analyze the purpose, participation, case completeness, opinion consistency of orthopedic case discussions using WeChat groups.Methods: We collected data related to the case discussions of three orthopedic surgeons by taking screenshots of the chat records in the most-used WeChat groups from June to August 2019, and analyzed the purpose, participation, completeness and the opinion consistency between the majority of members and experts in related fields.Results: The common purposes of orthopedic case discussions were showing surgical results and obtaining treatment advice. The number of likes received for cases showing surgical results was significantly higher than those for cases requesting diagnostic advice and obtaining treatment advice. The complete and relatively complete cases attracted more participants and received more effective comments than the incomplete cases. The opinion consistency rate of the complete cases was higher than that of the relatively complete and incomplete cases.Conclusions: The case discussions using WeChat groups among orthopedists was mainly to show surgical results and request for diagnostic advice. Incomplete cases had low discussion participation and low opinion consistency. Online discussions using WeChat groups should be standardized with respect to the completeness of cases.