Although exosome therapy has been recognized as a promising strategy in the treatment of rheumatoid arthritis (RA), sustained modulation on RA specific pathogenesis and desirable protective effects for attenuating joint destruction still remain challenges. Here, silk fibroin hydrogel encapsulated with olfactory ecto-mesenchymal stem cell-derived exosomes (Exos@SFMA) was photo-crosslinked in situ to yield long-lasting therapeutic effect on modulating the immune microenvironment in RA. This in situ hydrogel system exhibited flexible mechanical properties and excellent biocompatibility for protecting tissue surfaces in joint. Moreover, the promising PD-L1 expression was identified on the exosomes, which potently suppressed Tfh cell polarization via inhibiting the PI3K/AKT pathway. Importantly, Exos@SFMA effectively relieved synovial inflammation and joint destruction by significantly reducing T follicular helper (Tfh) cell response and further suppressing the differentiation of germinal center (GC) B cells into plasma cells. Taken together, this exosome enhanced silk fibroin hydrogel provides an effective strategy for the treatment of RA and other autoimmune diseases.

OBJECTIVE: To investigate the epidemiological characteristics and changing trends of distal radius fractures during 5 years, which gains insight into the incidence of the disease in the region. METHODS: Utilizing the medical imaging computer system (PACS), 1954 clinical records of radial radius fractures from patients treated at the affiliated hospital of Jiangsu University from January 2017 to December 2021 were collected and analyzed for age, gender, side, osteoporosis status, and incidence of the season. RESULTS: there were a total of 1954 distal radius fractures, with 731 (37.4%) being male and 1223 (62.6%) being female (ratio 0.59:1), and the highest proportion was female. The median age was 56 years (range 1-102 years) with an average of 50.48 years, 1033 (52.7%) on the left side, 885 (45.1%) on the right side, and 36 (1.8%) on both sides, the left side being the highest. The age distribution was highest in the 61-70 year old group (23.9%, 467/1954), and the highest proportion in males was in the 11-20 year old group (23.8%, 174/731), and in females was in the 61-70 year old group (30.83%, 377/1223). In the 50 years and older group, there were 276 males and 991 females (ratio 1:3.59), with osteoporosis in 536 cases, accounting for 42.03% of the older fractures. The seasonal distribution was highest in summer and autumn (55.1%, 1076/1954). CONCLUSION: In east China, distal radius fractures were predominantly female and left-sided, with the highest proportion in the age group of 61-70 years and in summer and autumn（rainy season）.

Objective To investigate the characteristics and seasonal patterns of distal radius fractures (DRFs) over the preceding five years, with the aim of establishing a clinical foundation for the prevention and management of such fractures within this region. Methods Utilizing the Picture Archiving and Communication Systems (PACS), the clinical records of 1954 patients diagnosed with DRFs and admitted to the Affiliated Hospital of Jiangsu University between January 2017 and December 2021 were compiled. The analysis encompassed factors such as age, gender, visitation timing, fracture side, and presence of osteoporosis. Results Out of the total 1954 distal radius fractures, 731 were males (37.4%) and the male to female ratio was 0.59:1. The median age of patients with DRFs was 56 years, with the 25th percentile being 38 years and the 75th percentile being 67 years. The average age was 50 years (standard deviation 23.3) and 1033 cases (52.7%) occurred on the left side, 885 cases (45.1%) on the right side, and 36 cases (1.8%) were bilateral, with the left side being the most frequently affected. The age group of 61–70 years (23.9%, 467/1954) exhibited the highest proportion, and the most prominent age group for males was 11–20 years (23.8%, 174/731), whereas for females it was 61–70 years (30.83%, 377/1223). In the 50 years and older group, there were 276 males and 991 females (ratio 1:3.59), with osteoporosis in 536 cases, accounting for 42.03% of the group. In terms of seasonal distribution, the highest incidence occurred during the summer and autumn months (55.1%, 1076/1954) and there were gender differences in different seasons. Conclusion In east China, DRFs were predominantly female and left-sided, with the highest proportion in the age group of 61–70 years and in summer and autumn. Furthermore, gender differences were observed between the warm and cold seasons.