International Journal of Molecular Medicine

Article	Citations
Towards effective COVID‑19 vaccines: Updates, perspectives and challenges (Review)	215
Sensitivity assessment of droplet digital PCR for SARS-CoV-2 detection	171
Role of m6A RNA methylation in cardiovascular disease (Review)	153
Neuronal injuries in cerebral infarction and ischemic stroke: From mechanisms to treatment (Review)	114
Current and innovative methods for the diagnosis of COVID‑19 infection (Review)	102
Comprehensive analysis of drugs to treat SARS‑CoV‑2 infection: Mechanistic insights into current COVID‑19 therapies (Review)	94
Neutrophil extracellular traps promote gastric cancer metastasis by inducing epithelial‑mesenchymal transition	82
Recent advances on the mechanisms of kidney stone formation (Review)	82
TGF‑β1: Gentlemanly orchestrator in idiopathic pulmonary fibrosis (Review)	74
Carthamin yellow improves cerebral ischemia‑reperfusion injury by attenuating inflammation and ferroptosis in rats	71
Mitochondria as a therapeutic target for cardiac ischemia‑reperfusion injury (Review)	68
Entangling COVID-19 associated thrombosis into a secondary antiphospholipid antibody syndrome: Diagnostic and therapeutic perspectives (Review)	67
The role of the Golgi apparatus in disease (Review)	65
Pathophysiology and mechanisms of primary sarcopenia (Review)	65
Antioxidant and anti‑inflammatory mechanisms of action of astaxanthin in cardiovascular diseases (Review)	58
Emerging trends in colorectal cancer: Dysregulated signaling pathways (Review)	56
Exosomal microRNA‑146a derived from mesenchymal stem cells increases the sensitivity of ovarian cancer cells to docetaxel and taxane via a LAMC2‑mediated PI3K/Akt axis	53
MicroRNA‑34a‑5p expression in the plasma and in its extracellular vesicle fractions in subjects with Parkinson's disease: An exploratory study	52
Nosocomial infection of COVID‑19: A new challenge for healthcare professionals (Review)	51
Role and clinical significance of TGF‑β1 and TGF‑βR1 in malignant tumors (Review)	51
Inhibition of aerobic glycolysis alleviates sepsis‑induced acute kidney injury by promoting lactate/Sirtuin 3/AMPK‑regulated autophagy	50
BCL2‑regulated apoptotic process in myocardial ischemia‑reperfusion injury (Review)	49
Molecular mechanisms of astragaloside‑IV in cancer therapy (Review)	48
Placental exosomes isolated from urine of patients with gestational diabetes exhibit a differential profile expression of microRNAs across gestation	47
COVID‑19 and ischemic stroke: Mechanisms of hypercoagulability (Review)	46

TGF‑β1‑induced autophagy activates hepatic stellate cells via the ERK and JNK signaling pathways	45
An update on genetic basis of generalized pustular psoriasis (Review)	43
lncRNA NEAT1 ameliorates LPS‑induced inflammation in MG63 cells by activating autophagy and suppressing the NLRP3 inflammasome	43
Approaches towards fighting the COVID‑19 pandemic (Review)	43
miR‑335 promotes ferroptosis by targeting ferritin heavy chain 1 in in vivo and in vitro models of Parkinson's disease	37
Mechanism overview and target mining of atherosclerosis: Endothelial cell injury in atherosclerosis is regulated by glycolysis (Review)	37
Zinc and SARS‑CoV‑2: A molecular modeling study of Zn interactions with RNA‑dependent RNA‑polymerase and 3C‑like proteinase enzymes	37
Formononetin protects against cisplatin‑induced acute kidney injury through activation of the PPARα/Nrf2/HO‑1/NQO1 pathway	36
Selenium attenuates ischemia/reperfusion injury‑induced damage to the blood‑brain barrier in hyperglycemia through PI3K/AKT/mTOR pathway‑mediated autophagy inhibition	35
Role of ferroptosis induced by a high concentration of calcium oxalate in the formation and development of urolithiasis	34
Dendritic cell‑derived exosomal miR‑494‑3p promotes angiogenesis following myocardial infarction	34
Oxymatrine attenuates oxidized low‑density lipoprotein‑induced HUVEC injury by inhibiting NLRP3 inflammasome‑mediated pyroptosis via the activation of the SIRT1/Nrf2 signaling pathway	33
Atrial fibrosis underlying atrial fibrillation (Review)	33
Clinical and genetic heterogeneity of primary ciliopathies (Review)	33
Resveratrol contributes to the inhibition of liver fibrosis by inducing autophagy via the microRNA‑20a‑mediated activation of the PTEN/PI3K/AKT signaling pathway	32
Critical role of mass spectrometry proteomics in tear biomarker discovery for multifactorial ocular diseases (Review)	32
Epigallocatechin‑3‑gallate inhibits self‑renewal ability of lung cancer stem‑like cells through inhibition of CLOCK	32
A dissection of SARS‑CoV2 with clinical implications (Review)	32
MicroRNA‑126 suppresses the proliferation and migration of endothelial cells in experimental diabetic retinopathy by targeting polo‑like kinase 4	31
Co‑expression of peripheral olfactory receptors with SARS‑CoV‑2 infection mediators: Potential implications beyond loss of smell as a COVID‑19 symptom	31
Resveratrol inhibits the progression of cervical cancer by suppressing the transcription and expression of HPV E6 and E7 genes	31
Herceptin induces ferroptosis and mitochondrial dysfunction in H9c2 cells	30
Reversal of brain aging by targeting telomerase: A nutraceutical approach	30
Transcription factor PU.1 and immune cell differentiation (Review)	30
Astragaloside IV ameliorates diabetic nephropathy in db/db mice by inhibiting NLRP3 inflammasome‑mediated inflammation	28
Insight into the roles of melatonin in bone tissue and bone‑related diseases (Review)	28
Downregulation of hsa_circ_0026123 suppresses ovarian cancer cell metastasis and proliferation through the miR‑124‑3p/EZH2 signaling pathway	28
Update on current views and advances on RSV infection (Review)	28
Gut microbiota metabolites as integral mediators in cardiovascular diseases (Review)	27
Quercetin reverses TNF‑α induced osteogenic damage to human periodontal ligament stem cells by suppressing the NF‑κB/NLRP3 inflammasome pathway	27
In vitro biocompatibility and bioactivity of calcium silicate‑based bioceramics in endodontics (Review)	26
MicroRNA‑199a‑3p suppresses high glucose‑induced apoptosis and inflammation by regulating the IKKβ/NF‑κB signaling pathway in renal tubular epithelial cells	26
Oral cancer cell‑derived exosomes modulate natural killer cell activity by regulating the receptors on these cells	25
Knockdown of lncRNA MIR4435‑2HG and ST8SIA1 expression inhibits the proliferation, invasion and migration of prostate cancer cells in vitro and in vivo by blocking the activation of the	25
Gypenoside XVII protects against spinal cord injury in mice by regulating the microRNA‑21‑mediated PTEN/AKT/mTOR pathway	25
Hypoxia‑induced circCCDC66 promotes the tumorigenesis of colorectal cancer via the miR‑3140/autophagy pathway	25
Echinacea polysaccharide attenuates lipopolysaccharide‑induced acute kidney injury via inhibiting inflammation, oxidative stress and the MAPK signaling pathway	25
Role of the central renin‑angiotensin system in hypertension (Review)	25
Estrogen disorders: Interpreting the abnormal regulation of aromatase in granulosa cells (Review)	24
Molecular pathways associated with oxidative stress and their potential applications in radiotherapy (Review)	24
Semaglutide attenuates seizure severity and ameliorates cognitive dysfunction by blocking the NLR family pyrin domain containing 3 inflammasome in pentylenetetrazole‑kindled mice	24
Fibroblast‑derived exosomal microRNA‑369 potentiates migration and invasion of lung squamous cell carcinoma cells via NF1‑mediated MAPK signaling pathway	23
lncRNA‑SNHG7‑003 inhibits the proliferation, migration and invasion of vascular smooth muscle cells by targeting the miR‑1306‑5p/SIRT7 signaling pathway	23
Therapeutic strategies targeting Wnt/β‑catenin signaling for colorectal cancer (Review)	23
The potential role of necroptosis in clinical diseases (Review)	23
FGD5‑AS1 promotes cisplatin resistance of human lung adenocarcinoma cell via the miR‑142‑5p/PD‑L1 axis	23
Doxorubicin‑induced oxidative and nitrosative stress: Mitochondrial connexin 43 is at the crossroads	23
Toll‑like receptor 4 activates the NLRP3 inflammasome pathway and periodontal inflammaging by inhibiting Bmi‑1 expression	23
Ginsenoside Rg3 ameliorates acute pancreatitis by activating the NRF2/HO‑1‑mediated ferroptosis pathway	22
miR‑589‑3p sponged by the lncRNA TINCR inhibits the proliferation, migration and invasion and promotes the apoptosis of breast cancer cells by suppressing the Akt pathway via IGF1R	22

Inhibitors of the NLRP3 inflammasome pathway as promising therapeutic candidates for inflammatory diseases (Review)	22
Rosmarinic acid inhibits cell proliferation, migration, and invasion and induces apoptosis in human glioma cells	22
Inhibition of miR‑101‑3p protects against sepsis‑induced myocardial injury by inhibiting MAPK and NF‑κB pathway activation via the upregulation of DUSP1	22
CircRNAs open a new era in the study of cardiovascular disease (Review)	22
[Comment] COVID‑19 vaccine safety	22
Role of 2‑series prostaglandins in the pathogenesis of type 2 diabetes mellitus and non‑alcoholic fatty liver disease (Review)	22
Inhibition of miRNA‑135a‑5p ameliorates TGF‑β1‑induced human renal fibrosis by targeting SIRT1 in diabetic nephropathy	22
Astragaloside IV blocks monocrotaline‑induced pulmonary arterial hypertension by improving inflammation and pulmonary artery remodeling	21
Astragaloside IV attenuates cerebral ischemia‑reperfusion injury in rats through the inhibition of calcium‑sensing receptor‑mediated apoptosis	21
Pineal hormone melatonin as an adjuvant treatment for COVID‑19 (Review)	21
COVID‑19 and SARS‑CoV‑2 host cell entry mediators: Expression profiling of TMRSS4 in health and disease	21
Extracellular matrix grafts: From preparation to application (Review)	21
Advance genome editing technologies in the treatment of human diseases: CRISPR therapy (Review)	20
Puerarin improves graft bone defect through microRNA‑155‑3p‑mediated p53/TNF‑α/STAT1 signaling pathway	20
Inhibition of chondrocyte apoptosis in a rat model of osteoarthritis by exosomes derived from miR‑140‑5p‑overexpressing human dental pulp stem cells	20
KLF5/LINC00346/miR‑148a‑3p axis regulates inflammation and endothelial cell injury in atherosclerosis	20
Interleukin‑6 signalling as a valuable cornerstone for molecular medicine (Review)	20
miR‑29b promotes the osteogenic differentiation of mesenchymal stem cells derived from human adipose tissue via the PTEN/AKT/β‑catenin signaling pathway	20
Potential immunomodulatory effects of vitamin D in the prevention of severe coronavirus disease 2019: An ally for Latin America (Review)	20
MicroRNA‑93 contributes to the suppression of lung inflammatory responses in LPS‑induced acute lung injury in mice via the TLR4/MyD88/NF‑κB signaling pathway	20
miR‑148a‑3p regulates alcoholic liver fibrosis through targeting ERBB3	19
Carvacrol may alleviate vascular inflammation in diabetic db/db mice	19
Therapeutic potential of curcumin in diabetic retinopathy (Review)	19
Circular RNA derived from TIMP2 functions as a competitive endogenous RNA and regulates intervertebral disc degeneration by targeting miR‑185‑5p and matrix metalloproteinase 2	19
Knockdown of mesenchymal stem cell‑derived exosomal LOC100129516 suppresses the symptoms of atherosclerosis via upregulation of the PPARγ/LXRα/ABCA1 signaling pathway	19
[Editorial] COVID‑19: Post‑lockdown guidelines	19
Long non‑coding RNA KCNQ1OT1 promotes nasopharyngeal carcinoma cell cisplatin resistance via the miR‑454/USP47 axis	19
Ursolic acid protects against cisplatin‑induced ototoxicity by inhibiting oxidative stress and TRPV1‑mediated Ca2+‑signaling	19
Long non‑coding RNA MKLN1‑AS aggravates hepatocellular carcinoma progression by functioning as a molecular sponge for miR‑654‑3p, thereby promoting hepatoma‑derived growth factor expression	19
lncRNA TUG1 promotes the brown remodeling of white adipose tissue by regulating miR‑204‑targeted SIRT1 in diabetic mice	18
Role of emerging vitamin K‑dependent proteins: Growth arrest‑specific protein 6, Gla‑rich protein and periostin (Review)	18
Ingenuity pathway analysis of differentially expressed genes involved in signaling pathways and molecular networks in RhoE gene‑edited cardiomyocytes	18
circNRIP1 facilitates keloid progression via FXR1‑mediated upregulation of miR‑503‑3p and miR‑503‑5p	18
Astragaloside IV alleviates silica‑induced pulmonary fibrosis via inactivation of the TGF‑β1/Smad2/3 signaling pathway	18
ASK1/p38‑mediated NLRP3 inflammasome signaling pathway contributes to aberrant retinal angiogenesis in diabetic retinopathy	18
Platelet‑to‑lymphocyte ratio, neutrophil‑to‑lymphocyte ratio and monocyte‑to‑HDL cholesterol ratio as markers of peripheral artery disease in elderly patients	18
CircRNA: A novel potential strategy to treat thyroid cancer (Review)	18
Paeonol exerts anti‑tumor activity against colorectal cancer cells by inducing G0/G1 phase arrest and cell apoptosis via inhibiting the Wnt/β‑catenin signaling pathway	18
Focus on the role of mitochondria in NLRP3 inflammasome activation: A prospective target for the treatment of ischemic stroke (Review)	18
CircUSP36 knockdown alleviates oxidized low‑density lipoprotein‑induced cell injury and inflammatory responses in human umbilical vein endothelial cells via the miR‑20a‑5p/ROCK2 axis	18
Myricetin induces apoptosis through the MAPK pathway and regulates JNK‑mediated autophagy in SK‑BR‑3 cells	18
LINC00473 contributes to the radioresistance of esophageal squamous cell carcinoma by regulating microRNA‑497‑5p and cell division cycle 25A	18
Transcriptomic landscaping of core genes and pathways of mild and severe psoriasis vulgaris	17
Transcription factor EB‑mediated autophagy promotes dermal fibroblast differentiation and collagen production by regulating endoplasmic reticulum stress and autophagy‑dependent secretion	17
Nanobodies targeting immune checkpoint molecules for tumor immunotherapy and immunoimaging (Review)	17
SphK1 promotes development of non‑small cell lung cancer through activation of STAT3	17
PCSK9 mediates the oxidative low‑density lipoprotein‑induced pyroptosis of vascular endothelial cells via the UQCRC1/ROS pathway	17
Neferine promotes the apoptosis of HNSCC through the accumulation of p62/SQSTM1 caused by autophagic flux inhibition	17
Autologous cell therapy in diabetes‑associated critical limb ischemia: From basic studies to clinical outcomes (Review)	17
Paris saponin H inhibits the proliferation of glioma cells through the A1 and A3 adenosine receptor‑mediated pathway	17
ELK1‑mediated upregulation of lncRNA LBX2‑AS1 facilitates cell proliferation and invasion via regulating miR‑491‑5p/S100A11 axis in colorectal cancer	17
lncRNA DGCR 5/miR‑27a‑3p/BNIP3 promotes cell apoptosis in pancreatic cancer by regulating the p38 MAPK pathway	17
Protective role of wogonin following traumatic brain injury by reducing oxidative stress and apoptosis via the PI3K/Nrf2/HO‑1 pathway	17
Exogenous spermine attenuates diabetic kidney injury in rats by inhibiting AMPK/mTOR signaling pathway	17
Rotenone restrains colon cancer cell viability, motility and epithelial‑mesenchymal transition and tumorigenesis in nude mice via the PI3K/AKT pathway	16
CDK4/6 inhibitor resistance mechanisms and treatment strategies (Review)	16
Damage to the blood‑brain barrier and activation of neuroinflammation by focal cerebral ischemia under hyperglycemic condition	16
Dihydroartemisinin attenuates osteoarthritis by inhibiting abnormal bone remodeling and angiogenesis in subchondral bone	16
Multifaceted regulation and functions of 53BP1 in NHEJ‑mediated DSB repair (Review)	16
Transcriptomic analysis of COVID‑19 lungs and bronchoalveolar lavage fluid samples reveals predominant B cell activation responses to infection	16
Taxifolin suppresses the malignant progression of gastric cancer by regulating the AhR/CYP1A1 signaling pathway	16
IRF1 regulates the progression of colorectal cancer via interferon‑induced proteins	16
MicroRNA‑103 modulates tumor progression by targeting KLF7 in non‑small cell lung cancer	16
miR‑144‑3p inhibits tumor cell growth and invasion in oral squamous cell carcinoma through the downregulation of the oncogenic gene, EZH2	16
Exosomal microRNAs in colorectal cancer: Overcoming barriers of the metastatic cascade (Review)	16
Peptide Szeto‑Schiller 31 ameliorates doxorubicin‑induced cardiotoxicity by inhibiting the activation of the p38 MAPK signaling pathway	16
Circular RNA circ_0010283 regulates the viability and migration of oxidized low‑density lipoprotein‑induced vascular smooth muscle cells via an miR‑370‑3p/HMGB1 axis in atherosclerosis	16
Tanshinone‑IIA inhibits myocardial infarct via decreasing of the mitochondrial apoptotic signaling pathway in myocardiocytes	16
Sonic Hedgehog signaling pathway in gynecological and genitourinary cancer (Review)	16
BAY61‑3606 attenuates neuroinflammation and neurofunctional damage by inhibiting microglial Mincle/Syk signaling response after traumatic brain injury	16
Downregulation of LINC00707 promotes osteogenic differentiation of human bone marrow‑derived mesenchymal stem cells by regulating DKK1 via targeting miR‑103a‑3p	16
Bufalin exerts antitumor effects in neuroblastoma via the induction of reactive oxygen species‑mediated apoptosis by targeting the electron transport chain	16
Caffeic acid phenethyl ester attenuates osteoarthritis progression by activating NRF2/HO‑1 and inhibiting the NF‑κB signaling pathway	16
Host cell entry mediators implicated in the cellular tropism of SARS‑CoV‑2, the pathophysiology of COVID‑19 and the identification of microRNAs that can modulate the expression of these mediators (Rev	15
Schizandrin A can inhibit non‑small cell lung cancer cell proliferation by inducing cell cycle arrest, apoptosis and autophagy	15
FXII regulates the formation of deep vein thrombosis via the PI3K/AKT signaling pathway in mice	15
Silencing of ISLR inhibits tumour progression and glycolysis by inactivating the IL‑6/JAK/STAT3 pathway in non‑small cell lung cancer	15
YAP and Wnt3a independently promote AECIIs proliferation and differentiation by increasing nuclear β‑catenin expression in experimental bronchopulmonary dysplasia	15
Talin‑1 interaction network in cellular mechanotransduction (Review)	15
CAPN3: A muscle‑specific calpain with an important role in the pathogenesis of diseases (Review)	15

An integrative look at SARS‑CoV‑2 (Review)	15
MicroRNA‑133b alleviates doxorubicin‑induced cardiomyocyte apoptosis and cardiac fibrosis by targeting PTBP1 and TAGLN2	15
FGF21 attenuates hypoxia‑induced dysfunction and inflammation in HPAECs via the microRNA‑27b‑mediated PPARγ pathway	15
KCNQ1OT1 contributes to sorafenib resistance and programmed death‑ligand‑1‑mediated immune escape via sponging miR‑506 in hepatocellular carcinoma cells	15
Immune response (IgG) following full inoculation with BNT162b2 COVID‑19 mRNA among healthcare professionals	15
The impact of diet upon mitochondrial physiology (Review)	15
MicroRNA‑1 regulates the development of osteoarthritis in a Col2a1‑Cre‑ERT2/GFPfl/fl‑RFP‑miR‑1 mouse model of osteoarthritis through the downregulation of Indian hedgehog expression	15
Hesperidin administration suppresses the proliferation of lung cancer cells by promoting apoptosis via targeting the miR‑132/ZEB2 signalling pathway	14
Transforming growth factor‑β family and stem cell‑derived exosome therapeutic treatment in osteoarthritis (Review)	14
PTH(1‑34) activates the migration and adhesion of BMSCs through the rictor/mTORC2 pathway	14
IL‑18 knockout alleviates atopic dermatitis‑like skin lesions induced by MC903 in a mouse model	14
Insights regarding mitochondrial DNA copy number alterations in human cancer (Review)	14
Isoquercitrin protects HUVECs against high glucose‑induced apoptosis through regulating p53 proteasomal degradation	14
Unraveling the roles of vitamin D status and melanin during Covid‑19 (Review)	14
Astragaloside regulates lncRNA LOC100912373 and the miR‑17‑5p/PDK1 axis to inhibit the proliferation of fibroblast‑like synoviocytes in rats with rheumatoid arthritis	14
Knockdown of long non‑coding RNA DLEU2 suppresses idiopathic pulmonary fibrosis by regulating the microRNA‑369‑3p/TRIM2 axis	14
Roles of long non‑coding RNA in osteoarthritis (Review)	14
Pathophysiology of stress granules: An emerging link to diseases (Review)	14
Antitumor activities of a defucosylated anti‑EpCAM monoclonal antibody in colorectal carcinoma xenograft models	14
Dihydroartemisinin attenuates osteoclast formation and bone resorption via inhibiting the NF‑κB, MAPK and NFATc1 signaling pathways and alleviates osteoarthritis	14
Melatonin inhibits RANKL‑induced osteoclastogenesis through the miR‑882/Rev‑erbα axis in Raw264.7 cells	14
Prostaglandin E2 serves a dual role in regulating the migration of dendritic cells	14
Role of long non‑coding RNAs and related epigenetic mechanisms in liver fibrosis (Review)	14
Propofol maintains Th17/Treg cell balance and reduces inflammation in rats with traumatic brain injury via the miR‑145‑3p/NFATc2/NF‑κB axis	14
Inhibitory effects of brusatol delivered using glycosaminoglycan‑placental chondroitin sulfate A‑modified nanoparticles on the proliferation, migration and invasion of cancer cells	14
Tumor necrosis factor‑α in systemic lupus erythematosus: Structure, function and therapeutic implications (Review)	13
Macrophage‑derived exosomal miRNA‑155 promotes tubular injury in ischemia‑induced acute kidney injury	13
Autophagy inhibition enhances the inhibitory�effects of ursolic acid on lung cancer cells	13
Downregulation of microRNA‑25‑3p inhibits the proliferation and promotes the apoptosis of multiple myeloma cells via targeting the PTEN/PI3K/AKT signaling pathway	13
Starvation mediates pancreatic cancer cell sensitivity to ferroptosis via ERK1/2, JNK and changes in the cell mesenchymal state	13
Morusin inhibits the growth of human colorectal cancer HCT116‑derived sphere‑forming cells via the inactivation of Akt pathway	13
Radiation induces primary osteocyte senescence phenotype and affects osteoclastogenesis in vitro	13
Expression levels of sonic hedgehog pathway genes and their targets are upregulated in early clear cell renal cell carcinoma	13
Long non‑coding RNA SNHG3 promotes the development of non‑small cell lung cancer via the miR‑1343‑3p/NFIX pathway	13
Chrysin induces autophagy through the inactivation of the ROS‑mediated Akt/mTOR signaling pathway in endometrial cancer	13
Extracellular vesicles derived from human placental mesenchymal stem cells alleviate experimental colitis in�mice by inhibiting inflammation and oxidative stress	13
Sulforaphane suppresses the viability and metastasis, and promotes the apoptosis of bladder cancer cells by inhibiting the expression of FAT‑1	13
SETD7 regulates chondrocyte differentiation and glycolysis via the Hippo signaling pathway and HIF‑1α	13
Banxia xiexin decoction affects drug sensitivity in gastric cancer cells by regulating MGMT expression via IL‑6/JAK/STAT3‑mediated PD‑L1 activity	13
Lipoxin A4 protects against paraquat‑induced acute lung injury by inhibiting the TLR4/MyD88‑mediated activation of the NF‑κB and PI3K/AKT pathways	13
Protective effects of Lycium barbarum polysaccharide on ovariectomy‑induced cognition reduction in aging mice	13
Bruton's tyrosine kinase regulates macrophage‑induced inflammation in the diabetic kidney via NLRP3 inflammasome activation	13
Promotion of liver regeneration and anti‑fibrotic effects of the TGF‑β receptor kinase inhibitor galunisertib in CCl4‑treated mice	13
Calcium chelator BAPTA‑AM protects against iron overload‑induced chondrocyte mitochondrial dysfunction and cartilage degeneration	13