BACKGROUND Hip fracture in elderly patients,particularly those with comorbid post-traumatic stress disorder(PTSD),presents a significant clinical challenge.In addition to the physiological stress of surgery,these pati...BACKGROUND Hip fracture in elderly patients,particularly those with comorbid post-traumatic stress disorder(PTSD),presents a significant clinical challenge.In addition to the physiological stress of surgery,these patients often endure psychological burdens that may adversely affect postoperative recovery.The potential benefits of targeted perioperative psychological interventions have not been fully elucidated in this special population.This study hypothesized that a structured perioperative psychological program would improve recovery outcomes,including postoperative pain,functional outcomes,and mental well-being.AIM To evaluate the impact of perioperative psychological intervention on postoperative outcomes among elderly patients with PTSD undergoing hip fracture surgery.METHODS Between January 1,2022,and December 31,2024,medical records of 50 elderly hip fracture patients(age≥65)with PTSD who underwent surgical fixation at our center were retrospectively reviewed.Patients were divided into an intervention(n=25;standardized psychological care)and control(n=25;usual care)groups.Data collected included demographics,fracture type,PTSD severity,and anesthesia details.The intervention comprised preoperative counseling,relaxation training,and postoperative coping sessions.Postoperative outcomes compared included pain,PTSD severity,activities of daily living scores,complications,length of stay,mental health,and functional recovery.RESULTS The groups had comparable demographic and clinical characteristics.The intervention group demonstrated significantly lower pain scores on postoperative days 3 and 7(P<0.01),fewer moderate-to-severe depressive symptoms(P<0.05),and a greater reduction in PTSD severity(P<0.01)compared with the control group.Furthermore,the intervention group exhibited improved activities of daily living scores at 4 weeks post-surgery and a lower postoperative complication rate(16%vs 32%,P=0.14).The average length of hospital stay was shorter in the intervention group(11.5±2.0 days vs 13.1±2.6 days,P<0.05).CONCLUSION In elderly hip fractures patients with comorbid PTSD,perioperative psychological interventions improved pain control,functional recovery,and PTSD symptoms,supporting its value in holistic perioperative management and outcome enhancement.展开更多
Myeloid-derived suppressor cells （MDSCs） play a crucial role in T cell dysfunction, which is related to poor outcome in patients with severe trauma. Cyclooxygenase-2 （Cox-2） contributes to immune disorder in traum...Myeloid-derived suppressor cells （MDSCs） play a crucial role in T cell dysfunction, which is related to poor outcome in patients with severe trauma. Cyclooxygenase-2 （Cox-2） contributes to immune disorder in trauma and infection via production of prostaglandin E2. However, the role of Cox-2 in the accumulation and function of MDSCs after traumatic stress has not been fully elucidated. In the present study, we treated murine trauma model with NS398, a selective Cox-2 inhibitor. Then the percentages of CD1 lb＋/Gr-l＋ cells, proliferation and apoptosis of CD4＋ T cells were determined. Ar- ginase activity and arginase-1 （Arg-1） protein expression of splenic CDllb＋/Gr-I＋ cells, and de- layed-type hypersensitivity （DTH） response were analyzed. The results showed that Cox-2 blockade significantly decreased the percentages of CD1 lb＋/Gr-l＋ cells in the spleen and bone marrow 48 and 72 h after traumatic stress. NS398 inhibited arginase activity and down-regulated the Arg-1 expression of splenic CD1 lb＋/Gr-l＋ ceils. Moreover, NS398 could promote proliferation and inhibit apoptosis of CD4＋ T cells. It also restored DTH response of traumatic mice. Taken together, our data revealed that Cox-2 might play a pivotal role in the accumulation and function of MDSC after traumatic stress.展开更多
Objective After traumatic injury in pregnant women,providing timely and appropriate management for high-risk patients is crucial for both pregnant women and fetuses.This study aimed to identify risk factors that predi...Objective After traumatic injury in pregnant women,providing timely and appropriate management for high-risk patients is crucial for both pregnant women and fetuses.This study aimed to identify risk factors that predict adverse pregnancy outcomes after traumatic injury.Methods A retrospective cohort study including 317 pregnant patients who experienced trauma was conducted.The collected data included general demographics,injury mechanisms and adverse pregnancy outcomes.Patients were divided into two subgroups based on the absence or presence of trauma-related adverse pregnancy outcomes.Univariate and multivariate logistic regressions were conducted to estimate the associations between clinical variables and adverse pregnancy outcomes.Results A total of 41(12.93%)patients experienced adverse pregnancy outcomes within the first 24 h post-trauma.This study revealed that age>35 years(OR=14.995,95%CI:5.024–44.755,P<0.001),third trimester trauma(OR=3.878,95%CI:1.343–11.204,P=0.012),abdominal pain(OR=3.032,95%CI:1.221–7.527,P=0.017),vaginal bleeding(OR=3.226,95%CI:1.093–9.523,P=0.034),positive scan in focused assessment with sonography for trauma(FAST)positive(OR=8.496,95%CI:2.825–25.555,P<0.001),9≤injury severity score(ISS)<16(OR=3.039,95%CI:1.046–8.835,P=0.041)and ISS≥16(OR=5.553,95%CI:1.387–22.225,P=0.015)increased the probability of posttraumatic adverse pregnancy outcomes.Maternal age,gestational age at delivery,vaginal bleeding and positive FAST results were risk factors for abnormal delivery.Conclusion Advanced maternal age,third trimester,and positive FAST results should alert multidisciplinary trauma teams to closely monitor patients to prevent adverse pregnancy outcomes.展开更多
Objective To compare the clinical outcomes of retrograde pubic ramus intramedullary nail(RPRIN)and percutaneous cannulated screw(PCS)in the treatment of anterior pelvic ring fractures(APRFs).Methods This retrospective...Objective To compare the clinical outcomes of retrograde pubic ramus intramedullary nail(RPRIN)and percutaneous cannulated screw(PCS)in the treatment of anterior pelvic ring fractures(APRFs).Methods This retrospective cohort study included 45 patients with APRFs treated between February 2019 and October 2022 in our trauma center.Patients were divided into two groups based on the surgical method:20 received RPRIN fixation,and 25 received PCS fixation.Key variables including operation time,fluoroscopic time,blood loss,and postoperative complications were analyzed.Fracture reduction quality was assessed using the Matta score system,and pelvic functional recovery was evaluated using the Majeed score system at the final follow-up.Quantitative variables were compared using the independent sample t test,while categorical variables were analyzed using Chisquare and Fisher’s exact tests.Results The RPRIN group had significantly shorter operation time(36.3±5.6 min vs.49.5±6.9 min,P<0.01),fluoroscopic time(32.0±2.8 s vs.48.4±3.6 s,P<0.01),and less blood loss(20.4±7.6 mL vs.34.0±5.7 mL,P<0.01)than the PCS group.Fracture reduction quality(Matta outcome)and pelvic functional recovery(Majeed outcome)were comparable between the two groups(P>0.05).No significant complications were reported in either group.Conclusions Both RPRIN and PCS are effective for treating APRFs.However,RPRIN offers distinct advantages by reducing operation time,fluoroscopic time,and blood loss,making it a more efficient and less invasive option.Further multicenter studies and biomechanical analyses are warranted to confirm these findings.展开更多
Objective Close reduction and internal fixation have gained popularity for the treatment of pelvic fractures.However,the closed reduction of bilateral displaced posterior pelvic ring disruption is a great challenge ev...Objective Close reduction and internal fixation have gained popularity for the treatment of pelvic fractures.However,the closed reduction of bilateral displaced posterior pelvic ring disruption is a great challenge even for the most experienced surgeon.In this study,we describe in detail a novel unlocking closed reduction technique(UCRT)frame that allows strong traction for bilateral posterior pelvic ring displacement and presents preliminary clinical outcomes.Methods We retrospectively reviewed 32 patients with bilateral displaced posterior pelvic ring disruptions(AO/OTA 61-C2 and C3)who were initially treated with this technique between July 2017 and July 2022.According to the AO/OTA clas-sification,there were 9 cases(28.12%)of 61-C2,and 23 cases(71.88%)of 61-C3.There were 11 males,21 females,with an average age of 38.1 years.The interval from injury to operation was 4-27 days,with a cut-off of 12.5 days(receiver operat-ing characteristic curve).Operative time,blood loss,and postoperative radiographic findings were recorded.The functional outcomes and complications were followed.Results A total of 30(93.8%)patients achieved successful closed reduction,whereas 2 required open reduction.The success-ful closed reduction rate was 95.5%(21/22)in patients whose injury-to-operation time was less than 12.5 days.The vertical displacement percent correction of the obviously displaced hemipelvis was 70.20%±16.79%on average.The average degree of pelvic deformity correction was 64.86%±17.71%.Thirty patients were followed up for at least 12 months(12-36 months),and no complications of nonunion or redisplacement were observed.The Matta-Tornetta scoring standard revealed that the excellent(25/30)and good(4/30)rate was 96.7%.The Majeed clinical efficacy score revealed that the overall excellent and good rate was 100%.One patient had INFIX-related infection,and 2 reported numbness in the lateral thigh.The numbness was improved after INFIX removal.Conclusions This study presents an updated technique for closed reduction using a UCRT frame for bilateral posterior pelvic ring disruption,which has been shown to be effective,as indicated by excellent surgical and functional outcomes.展开更多
BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental heal...BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental health problems.In recent years,the new transrectus lateral approach has favorably treated pelvic fractures and possibly preserved patients'physiological and psychological conditions.There-fore,investigating its clinical efficacy for treating pelvic fractures plus lum-bosacral plexus injuries is of great clinical significance.AIM To investigate the clinical effect of the transrectus lateral approach on pelvic fractures complicated by lumbosacral plexus injuries as well as anxiety and depression.METHODS Data of 136 patients with pelvic fractures complicated by lumbosacral plexus injuries treated by the transrectus lateral approach(January 2011 to May 2024)were retrospectively analyzed.The patients'general data were collected via questionnaire.The Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to assess anxiety and depression,respectively.We adopted a numerical rating scale(NRS)to evaluate pain degree,the Pittsburgh Sleep Quality Index(PSQI)to assess sleep quality,and Medical Research Council(MRC)Scale for Muscle Strength to evaluate treatment efficacy and complications.RESULTS The 136 included patients(92 male,44 female)were a mean 48.02±15.72 years old.The mean SAS score was 66.36±5.15 preoperatively vs 42.15±4.36 postoperatively,while the mean SDS score was 65.61±5.02 preoperatively vs 43.83±4.54 postoperatively,showing statistically significant differences(P<0.05).The mean NRS and PSQI scores were significantly lower pre-vs postoperatively(P<0.05).Postoperatively,67 patients with fresh pelvic fractures plus nerve injuries achieved an MRC of M5,22 achieved an M1-M4,and four achieved an M0.Postoperative motor function improved by a mean 4.20 grades(scale,0-5).Among the patients with old pelvic fractures and nerve injuries,19 achieved an M5,16 achieved an M1-M4,and eight achieved an M0.Motor function improved significantly by a mean 3.30 grades(scale,0-5;P<0.05).No serious postoperative complications occurred.CONCLUSION The transrectus lateral approach to treating pelvic fractures plus lumbosacral plexus injuries can safely alleviate anxiety and depression,relieve pain,improve sleep quality,reduce intraoperative blood loss,and improve postoperative recovery.展开更多
BACKGROUND High-grade serous ovarian carcinoma(HGSOC)is among the most lethal gynecological malignancies,characterized by late-stage diagnosis,extensive peritoneal dissemination,and limited treatment options,resulting...BACKGROUND High-grade serous ovarian carcinoma(HGSOC)is among the most lethal gynecological malignancies,characterized by late-stage diagnosis,extensive peritoneal dissemination,and limited treatment options,resulting in poor survival outcomes.The tumor microenvironment plays a critical role in disease progression and therapy resistance,with CD4+T cells exhibiting significant plasticity and functional heterogeneity.Regulatory T cells(Tregs)are particularly implicated in immune suppression and tumor evasion.However,the spatial distribution,functional states,and prognostic significance of CD4+T cell subtypes in HGSOC remain poorly understood.AIM To characterize the functional heterogeneity and tissue-specific distributions of CD4+T cell subtypes in HGSOC and identify biomarkers for therapy.METHODS We analyzed single-cell RNA sequencing(scRNA-seq)data from 42 HGSOC patients,examining samples collected from adnexal tissues and ascites.CD4+T cells were identified and classified into subtypes using unsupervised clustering and marker gene analysis.Functional profiling was performed using pathway enrichment,differential expression analysis,and functional signature scoring.Kaplan-Meier survival and Cox proportional hazards modeling were conducted to evaluate the prognostic value of CD4+T cell subtypes.RESULTS Distinct distributions of CD4+T cell subtypes were identified between adnexal tissues and ascites.Naive CD4+T cells were predominant in ascites,while Tregs and CXCL13-expressing CD4+T cells were enriched in adnexal tissues.Tregs were further categorized into four subtypes(Treg1,Treg2,Treg3,and TISG),each exhibiting unique molecular signatures and tissue-specific adaptations.Treg3 cells,enriched in adnexal tissues,were characterized by high levels of activation and exhaustion markers,correlating with poor clinical outcomes in HGSOC patients.CONCLUSION Treg3 cells drive immune suppression and tumor progression in HGSOC,making them a key immunotherapy target.Their adnexal enrichment highlights the need for tissue-specific immune profiling in precision treatment.展开更多
Essex-Lopresti injury is characterized by a radial head fracture accompanied by dislocation of the distal radioulnar joint and rupture of the interosseous membrane(IOM).This type of injury typically results from high-...Essex-Lopresti injury is characterized by a radial head fracture accompanied by dislocation of the distal radioulnar joint and rupture of the interosseous membrane(IOM).This type of injury typically results from high-energy axial forces transmitted through the wrist to the elbow,leading to tears in the IOM,fractures of the radial head,injuries to the distal radioulnar joint,and disruption of the triangular fibrocartilage complex,ultimately causing axial instability of the radioulnar joint.Due to its complexity,this injury is often overlooked in clinical settings,with a reported misdiagnosis rate as high as 60%.In pediatric cases,the misdiagnosis rate is even higher due to children's limited ability to articulate symptoms,the presence of substantial cartilaginous structures that have not fully ossified,and less typical radiographic findings compared to adults.This review aims to provide a comprehensive overview of the injury mechanism,clinical presentation,diagnosis,and treatment of Essex-Lopresti injuries in children,emphasizing the importance for pediatric orthopedists to recognize and manage this condition accurately to prevent misdiagnosis and inappropriate treatment.展开更多
Osteoporotic fractures often exhibit delayed healing and repair difficulties in which the bone immune microenvironment may play a critical role,but direct evidence remains elusive.Recently,magnesium(Mg)-based alloys h...Osteoporotic fractures often exhibit delayed healing and repair difficulties in which the bone immune microenvironment may play a critical role,but direct evidence remains elusive.Recently,magnesium(Mg)-based alloys have emerged as promising biodegradable materials capable of promoting fracture healing.Herein,we performed internal fixation of high-purity Mg implants for osteoporotic fractures and used single-cell studies to investigate and elucidate the cellular heterogeneity and dynamic changes that occurred during osteoporotic fracture repair.We observed an early increase in immature neutrophil numbers,together with anti-inflammatory changes in lymphocytes and macrophages.A cluster of macrophages exhibited pro-angiogenic capabilities activated via the TRPM7/S100A4 pathway.These findings provide new theoretical insights into the biological effects of Mg-based materials on the healing of osteoporotic fractures.展开更多
Studies have shown that gut microbiota metabolites can enter the central nervous system via the blood-spinal cord barrier and cause neuroinflammation, thus constituting secondary injury after spinal cord injury. To in...Studies have shown that gut microbiota metabolites can enter the central nervous system via the blood-spinal cord barrier and cause neuroinflammation, thus constituting secondary injury after spinal cord injury. To investigate the correlation between gut microbiota and metabolites and the possible mechanism underlying the effects of gut microbiota on secondary injury after spinal cord injury, in this study, we established mouse models of T8–T10 traumatic spinal cord injury. We used 16 S rRNA gene amplicon sequencing and metabolomics to reveal the changes in gut microbiota and metabolites in fecal samples from the mouse model. Results showed a severe gut microbiota disturbance after spinal cord injury, which included marked increases in pro-inflammatory bacteria, such as Shigella, Bacteroides, Rikenella, Staphylococcus, and Mucispirillum and decreases in anti-inflammatory bacteria, such as Lactobacillus, Allobaculum, and Sutterella. Meanwhile, we identified 27 metabolites that decreased and 320 metabolites that increased in the injured spinal cord. Combined with pathway enrichment analysis, five markedly differential amino acids(L-leucine, L-methionine, L-phenylalanine, L-isoleucine and L-valine) were screened out, which play a pivotal role in activating oxidative stress and inflammatory responses following spinal cord injury. Integrated correlation analysis indicated that the alteration of gut microbiota was related to the differences in amino acids, which suggests that disturbances in gut microbiota might participate in the secondary injury through the accumulation of partial metabolites that activate oxidative stress and inflammatory responses. Findings from this study provide a new theoretical basis for improving the secondary injury after spinal cord injury through fecal microbial transplantation.展开更多
The effect of high-frequency repetitive transcranial magnetic stimulation（r TMS） on potassium-chloride cotransporter-2（KCC2） protein expression following spinal cord injury（SCI） and the action mechanism were inv...The effect of high-frequency repetitive transcranial magnetic stimulation（r TMS） on potassium-chloride cotransporter-2（KCC2） protein expression following spinal cord injury（SCI） and the action mechanism were investigated. SCI models were established in SD rats. Five groups were set up randomly： normal control group, SCI 7-day（7 D） model group, SCI 14-day（14 D） model group, SCI-7 DrTMS group and SCI-14 DrTMS group（n=5 each）. The rats in SCI rTMS groups were treated with 10 Hz rTMS from 8 th day and 15 th day after SCI respectively, once every day, 5 days every week, a total of 4 weeks. After the model establishment, motor recovery and spasticity alleviation were evaluated with BBB scale once a week till the end of treatment. Finally, different parts of tissues were dissected out for detection of variations of KCC2 protein using Western blotting and polymerase chain reaction（PCR） technique. The results showed that the BBS scores after treatment were significantly higher in SCI-7 DrTMS group than in SCI-14 DrTMS group（P〈0.05）. As compared with normal control groups, The KCC2 protein in SCI model groups was down-regulated after SCI, and the decrease was much more significant in SCI-14 D model group than in SCI-7 D group（P〈0.05）. As compared with SCI model groups, KCC2 protein in rTMS groups was up-regulated after the treatment（P〈0.05）. The up-regulation of KCC2 protein content and expression was more obvious in SCI-7 DrTMS group than in SCI-14 DrTMS group（P〈0.05）. It was concluded that 10 Hz rTMS can alleviate spasticity in rats with SCI, which might be attributed to the up-regulation of KCC2 protein. It was also suggested that the high-frequency rTMS treatment after SCI at early stage might achieve more satisfactory curative effectiveness.展开更多
Summary：To compare the expression level of metastasis associated-1 （MTA 1 ） gene in high and low metastatic： human osteosarcoma cell lines and examine the relationship of MTA 1 expression and the metastasis potent...Summary：To compare the expression level of metastasis associated-1 （MTA 1 ） gene in high and low metastatic： human osteosarcoma cell lines and examine the relationship of MTA 1 expression and the metastasis potentiality of osteosarcoma cells, the expression of MTA 1 in MC-63 osteosarcoma cell lines with high and low metastasis potential was detected by semiquantitative TR-PCR. Boyden chamber invasion assay was used to evaluate the invasive capacity in vitro in two osteosarcoma cell lines, The low metastasis MG-63 cells were transfected with MTA 1 full-length cDNA expression plasmid by lipofectamine and the changes of MTA 1 expression and in vitro invasion potential were examined after the transfection. Our results showed that MG63 cell line with high metastasis potential expressed significantly higher MTA 1 than that of MG63 cells with low metastasis as reavealed by RT-PCR The invasion potential of low metastasis MG63 cell line was increased after MTA 1 gene transfection. It is concluded that there may be a relationship between MTA 1 and invasive potentiality of human osteosarcoma cells, and the mechanism of MTA 1 in osteosarcoma metastasis and its possible role in associated gene therapy deserve further study.展开更多
Background:Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients,this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in ...Background:Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients,this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in the China trauma care training(CTCT)program in addition to their post-course test results to provide support for the development of trauma care training programs and trauma systems in China.Methods:A cross-sectional study was conducted by collecting demographic information,hospital-related information and trauma knowledge of the trainees from 19 regions in China.All participants were assessed by questionnaires collecting the socio-demographic data,the trauma care knowledge levels and the information of the hospitals.Results:There were 955 males(78.9%)and 256 females(21.1%)enrolled.Among them,854 were physicians(70.5%),357 were registered nurses(29.5%).In addition,64 of them also played an administrative role in the hospitals(5.3%).The score of the trainees who were members of the emergency department staff(72.59±14.13)was the highest among the scores of all the personnel surveyed,followed by those of the trainees from the intensive care unit(ICU)(71.17±12.72),trauma surgery department(67.26±13.81),orthopedics department(70.36±14.48),general surgery department(69.91±14.79)and other departments(69.93±16.91),P=0.031.The score of the professors(73.09±15.05)was higher than those of the associate professors(72.40±14.71),lecturers(70.07±14.25)and teaching assistants(67.58±15.16),P<0.0001.The score of the individuals who attended experts’trauma lectures(72.22±14.45)was higher than that of individuals who did not attend the lectures(69.33±15.17),P=0.001.The mean scores before and after the training were 71.02±14.82 and 84.24±13.77,respectively,P<0.001.The mean score of trauma knowledge after the training of trainees from different provinces and with different educational backgrounds was higher than that before the training,with a statistically significant difference(P<0.05).Conclusions:The level of trauma knowledge of trauma care providers was associated with their department,professional position and previous participation in related academic conferences.Trauma care experience and participation in academic lectures and training program including CTCT may effectively improve individuals’level of trauma knowledge.展开更多
BACKGROUND Older people are more likely to experience pelvic fractures than younger people.Multi-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can c...BACKGROUND Older people are more likely to experience pelvic fractures than younger people.Multi-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can clearly demonstrate the 3D space of fractures and detect fractures at a higher rate.AIM To investigate the clinical value of multi-slice spiral CT 3D reconstruction in the diagnosis of unstable pelvic fractures in the elderly as well as the effect of less invasive stabilization.METHODS A total of 86 patients with unstable pelvic fractures treated between March 2016 and March 2019 underwent femoral supracondylar bone traction before surgery.Pelvic radiography and multi-row spiral CT were performed successively once the patient’s vital signs and hemodynamic indices were stable.Secondary processing of the original data was performed to obtain 3D reconstruction images and determine the vertical displacement of the pelvis.After basic or complete reduction,minimally invasive internal fixation using hollow lag screws was performed.The detection rates of fracture location and classification by X-ray and CT reconstruction were compared.Patients were divided into two groups according to the presence or absence of preoperative 3D reconstruction to compare postoperative reduction,wound healing time,fracture healing time,hospitalization time,visual analog scale(VAS)score,poor internal fixation,and functional recovery.RESULTS The diagnostic coincidence rates of X-rays for pubic symphysis,ilium wing,sacroiliac periarticular,and sacral fractures were lower than those of CT reconstruction.The coincidence rate of CT reconstruction in the clinical classification of pelvic fractures was 100%,whereas 11 cases were misdiagnosed by X-ray;the total coincidence rate was 87.21%.The total excellent and good rates of postoperative reduction were significantly higher in the study group than in the control group(P<0.05).The wound healing,fracture healing,and hospitalization times were significantly shorter in the study group than in the control group(P<0.05).The VAS scores decreased in both groups postoperatively and were lower in the study group than in the control group(P<0.05).The total incidence of poor postoperative internal fixation was significantly lower in the study group than in the control group(P<0.05).The overall rate of postoperative functional recovery was significantly higher in the study group than in the control group(P<0.05).CONCLUSION Multi-slice spiral CT has high guiding significance for the diagnosis,classification,and treatment of unstable pelvic fractures in the elderly.Preoperative 3D reconstruction can effectively shorten the operation time and promote fracture healing,while minimally invasive internal fixation can effectively reduce pain and promote functional recovery of fracture sites,making it worthy of clinical application.展开更多
Research has been carried out to look for safe and effective anti-inflammation drugs from traditional Chinese herbal medicine. As a powerful research technology of life science, molecular biology has entered many area...Research has been carried out to look for safe and effective anti-inflammation drugs from traditional Chinese herbal medicine. As a powerful research technology of life science, molecular biology has entered many areas of traditional Chinese medicine.This study aimed to investigate the effect of triptolide on tumor necrosis factor-α （TNF-α） and interleukin-8 （IL-8） of peritoneal macrophages activated by lipopolysaccharide （LPS） in mice. Peritoneal elicited macrophages were separated, purified and activated by LPS in mice, then cultured in vitro with triptolide at different concentrations. The activity of TNF-a and the level of IL-8 of cellular supernatants were determined by MTT colorimetric assay and ELISA, respectively. The activity of TNF-a in macrophages was significantly inhibited （P〈0.01） by triptolide （10^-1-10^1μg/ml） during 4-24 hours in a time- and dose-dependent manner. The level of IL-8 in macrophages was significantly inhibited （P〈0.01） by triptolide （10^-1-10^1g/ml） in 12 hours in a dose- dependent manner. Triptolide could inhibit the activity of TNF-a and the level of IL-8 in macrophages activated by LPS.展开更多
The inhibitory effects of diallyl sulfide(DAS) derived from allicin on in vitro and in vivo proliferation of human osteosarcoma MG-63 cells and the action mechanism,and the influence of DAS on invasive capability of M...The inhibitory effects of diallyl sulfide(DAS) derived from allicin on in vitro and in vivo proliferation of human osteosarcoma MG-63 cells and the action mechanism,and the influence of DAS on invasive capability of MG-63 cells were investigated in order to search for the novel medicines for osteosarcoma.In the in vitro experiment,MG-63 cells were treated with different concentrations of DSA,and the morphological changes of MG-63 cells were observed under an inverted phase microscope.MTT method was used to assay the proliferation of MG-63 cells.Semi-quantitative reverse transcription polymerase chain reaction(RT-PCR) was used to detect the VEGF mRNA expression level in MG-63 cells.By using Transwell invasion assay,the influence of DAS on invasive ability of MG-63 cells was tested.In the in vivo experiment,the nude mice MG-63 cells tumor-bearing model was established,and different concentrations of DAS were injected beside the tumor.Twenty-one days after treatment,the mice were killed,the tumor size and tumor inhibition rate were calculated.The microvessel density(MVD) was determined by using immunohistochemistry.In the in vitro experiment,different concentrations of DAS could obviously inhibit proliferation of MG-63 cells in a time-and concentration-dependent manner.RT-PCR revealed that the expression levels of VEGF mRNA in DSA groups(different concentrations) were significant reduced as compared with those in control group(all P<0.05).Transwell invasion assay indicated that in 20 and 40 μg/mL DAS groups,the number of migratory cells was 91.4±8.3 and 81.8±7.4 respectively,which was significantly declined as compared with that in control group(150.4±14.7,both P<0.05).In the in vivo experiment,DAS could significantly suppress the growth of MG-63 tumor-bearing tissue.Immunohistochemistry demonstrated that different concentrations(20 and 40 μg/mL) of DAS could significantly decrease MVD of MG-63 tumor-bearing tissue(all P<0.05).It was suggested that DAS could inhibit the growth of MG-63 cells probably by suppressing the expression of VEGF mRNA.展开更多
Osteosarcoma is the most common primary malignant bone tumor in childhood,and it maintains a high level of recurrence.Matrix metalloproteinase-1(MMP-1)was found to contribute to cancer progression.The present study wa...Osteosarcoma is the most common primary malignant bone tumor in childhood,and it maintains a high level of recurrence.Matrix metalloproteinase-1(MMP-1)was found to contribute to cancer progression.The present study was to investigate the in vitro effects of MMP-1 over-expression on the proliferation,invasion,metastasis and stem-like properties of osteosarcoma MG-63 cells.The MG-63 cells were cultured and had a full length MMP-1 cDNA inserted by the tentiviral vector (MG-63^MMP-1+).MG-63 negative control and MG-63 blank control groups were established as well.MMP-1 expression was detected in MG-63^MMP-1+,MG-63 negative control and MG-63 blank control cells using qPCR,Western blotting and immunofluorescence after 24h of culture. The cell proliferation assay was performed with a camera attached to a bioreactor,which was programmed to photograph five regions of each well every 10 min over a period of 48 h.The cell invasion assay was conducted with Matrigel to assess the invasive potential,of MG-63 cells over 24h,the qPCR analysis to measure stem cell markers,including Oct4, Sox-2,Nanog,and Pax-7,and Western blot analysis to detect invasive and metastatic potential markers TIMP-1,VEGF and BMP2/4,after 24h of culture.Immunofluorescence was used to investigate the presence of the stem cell marker Pax-7 after 24-h culture. The results showed that over-expression of MMP-1 after transfection could significantly increase minor cell proliferation and invasion (P<0.05,MG-63^MMP-1+ versus controls).Pax-7 was highly expressed in MG-63^MMP-1+ cells,with no significant changes of Oct-4,Sox-2, and Nanog observed (P<0.05).MG-63^MMP-1+ cells showed higher expression of VEGF and BMP 2/4 proteins and lower expression of TIMP-1 protein than controls (P<0.05).It was concluded that MMP-1 over-expression in MG-63 cells contributed to the proliferation, invasion,metastasis and stem-like properties of osteosarcoma cells.Future studies should focus on in vivo effects of MMP-1 over-expression and the application of MMP-1 and Pax-7 inhibition in vivo to osteosarcoma theraoies.展开更多
Ischemic preconditioning or postconditioning has been shown to have neuroprotective effect on cerebral ischemia, but it has not been studied in peripheral nerve injury. In this study, a rat model of sciatic nerve tran...Ischemic preconditioning or postconditioning has been shown to have neuroprotective effect on cerebral ischemia, but it has not been studied in peripheral nerve injury. In this study, a rat model of sciatic nerve transection was established, and subjected to three cycles of ischemia for 10 minutes ＋ reperfusion for 10 minutes, once a day. After ischemic postconditioning, serum insulin-like growth factor 1 expression increased; sciatic nerve Schwann cell myelination increased; sensory function and motor function were restored. These findings indicate that ischemic postconditioning can effectively protect injured sciatic nerve. The protective effect is possibly associated with upregulation of insulin-like growth factor 1.展开更多
Although primary gastrointestinal lymphoma is a rare malignancy, it can cause an intussusception in adults and can be a clinically challenging condition to manage. Intussusception could progress to lifethreatening com...Although primary gastrointestinal lymphoma is a rare malignancy, it can cause an intussusception in adults and can be a clinically challenging condition to manage. Intussusception could progress to lifethreatening complications if left untreated or could delay chemotherapy if inappropriate surgical management is used. We report a 31-year-old man diagnosed with human immunodeficiency virus who was being treated with antiretroviral therapy. He presented with nausea, vomiting, poor appetite, and intermittent, cramping abdominal pain for over 1 wk. Abdominal computed tomography revealed a well-defined homogeneous mass in the mesenteric root region, together with a long segmental wall thickening in the ileum with ileocolic-type intussusception, which was suspected to be caused by a lymphoma. The intussusception was successfully laparoscopically reduced, and the tumor involvement of the appendix was confirmedby appendectomy with intraoperative frozen section. Systemic chemotherapy was immediately initiated after surgery without the need for bowel resection.展开更多
This study examined the effects of ω-3 polyunsaturated fatty acid（ω-3PUFA） on the expression of toll-like receptor 2（TLR2）,toll-like receptor 4（TLR4） and some related inflammatory factors in peripheral blood m...This study examined the effects of ω-3 polyunsaturated fatty acid（ω-3PUFA） on the expression of toll-like receptor 2（TLR2）,toll-like receptor 4（TLR4） and some related inflammatory factors in peripheral blood mononuclear cells（PBMCs） of patients with early-stage severe multiple trauma.Thirty-two patients who were admitted to the Department of Traumatic Surgery,Tongji Hospital（Wuhan,China） between May 2010 and November 2010,and diagnosed as having severe multiple trauma with a injury severity score（ISS） no less than 16,were enrolled in the study and divided into two groups at random（n=16 in each）：ω-3PUFA group and control group in which routine parenteral nutrition supplemented with ω-3PUFA or not was administered to the patients in two groups for consecutive 7 days.Peripheral blood from these patients was collected within 2 h of admission（day 0）,and 1,3,5 and 7 days after the nutritional support.PBMCs were isolated and used for detection of the mRNA and protein expression of TLR2 and TLR4 by using real-time PCR and flow cytometry respectively,the levels of NF-κB by quantum dots-based immunofluorescence assay,the levels of TNF-α,IL-2,IL-6 and COX-2 by ELISA,respectively.The results showed that the mRNA and protein expression of TLR2 and TLR4 in PBMCs was significantly lower in ω-3PUFA group than in control group 5 and 7 days after nutrition support（both P0.05）.The levels of TNF-α,IL-2,IL-6 and COX-2 were found to be substantially decreased in PBMCs in ω-3PUFA group as compared with control group at 5th and 7th day（P0.05 for all）.It was concluded that ω-3PUFA can remarkably decrease the expression of TLR2,TLR4 and some related inflammatory factors in NF-κB signaling pathway in PBMCs of patients with severe multiple trauma,which suggests that ω-3PUFA may suppress the excessive inflammatory response meditated by the TLRs/NF-κB signaling pathway.展开更多
基金Supported by the Shandong Province Medical and Health Science and Technology Development Program Project,No.202204070354.
文摘BACKGROUND Hip fracture in elderly patients,particularly those with comorbid post-traumatic stress disorder(PTSD),presents a significant clinical challenge.In addition to the physiological stress of surgery,these patients often endure psychological burdens that may adversely affect postoperative recovery.The potential benefits of targeted perioperative psychological interventions have not been fully elucidated in this special population.This study hypothesized that a structured perioperative psychological program would improve recovery outcomes,including postoperative pain,functional outcomes,and mental well-being.AIM To evaluate the impact of perioperative psychological intervention on postoperative outcomes among elderly patients with PTSD undergoing hip fracture surgery.METHODS Between January 1,2022,and December 31,2024,medical records of 50 elderly hip fracture patients(age≥65)with PTSD who underwent surgical fixation at our center were retrospectively reviewed.Patients were divided into an intervention(n=25;standardized psychological care)and control(n=25;usual care)groups.Data collected included demographics,fracture type,PTSD severity,and anesthesia details.The intervention comprised preoperative counseling,relaxation training,and postoperative coping sessions.Postoperative outcomes compared included pain,PTSD severity,activities of daily living scores,complications,length of stay,mental health,and functional recovery.RESULTS The groups had comparable demographic and clinical characteristics.The intervention group demonstrated significantly lower pain scores on postoperative days 3 and 7(P<0.01),fewer moderate-to-severe depressive symptoms(P<0.05),and a greater reduction in PTSD severity(P<0.01)compared with the control group.Furthermore,the intervention group exhibited improved activities of daily living scores at 4 weeks post-surgery and a lower postoperative complication rate(16%vs 32%,P=0.14).The average length of hospital stay was shorter in the intervention group(11.5±2.0 days vs 13.1±2.6 days,P<0.05).CONCLUSION In elderly hip fractures patients with comorbid PTSD,perioperative psychological interventions improved pain control,functional recovery,and PTSD symptoms,supporting its value in holistic perioperative management and outcome enhancement.
基金supported by grants from the Foundation of Science and Technology of Wuhan City(No.201161038339)Health Department of Hubei Province of China(No.QJX2010-4)+1 种基金Natural Science Foundation of Hubei Province of China(No.2011CDB205)National"Twelfth Five-Year"Plan for Science&Technology Support(No.2012BAI11B00)
文摘Myeloid-derived suppressor cells （MDSCs） play a crucial role in T cell dysfunction, which is related to poor outcome in patients with severe trauma. Cyclooxygenase-2 （Cox-2） contributes to immune disorder in trauma and infection via production of prostaglandin E2. However, the role of Cox-2 in the accumulation and function of MDSCs after traumatic stress has not been fully elucidated. In the present study, we treated murine trauma model with NS398, a selective Cox-2 inhibitor. Then the percentages of CD1 lb＋/Gr-l＋ cells, proliferation and apoptosis of CD4＋ T cells were determined. Ar- ginase activity and arginase-1 （Arg-1） protein expression of splenic CDllb＋/Gr-I＋ cells, and de- layed-type hypersensitivity （DTH） response were analyzed. The results showed that Cox-2 blockade significantly decreased the percentages of CD1 lb＋/Gr-l＋ cells in the spleen and bone marrow 48 and 72 h after traumatic stress. NS398 inhibited arginase activity and down-regulated the Arg-1 expression of splenic CD1 lb＋/Gr-l＋ ceils. Moreover, NS398 could promote proliferation and inhibit apoptosis of CD4＋ T cells. It also restored DTH response of traumatic mice. Taken together, our data revealed that Cox-2 might play a pivotal role in the accumulation and function of MDSC after traumatic stress.
文摘Objective After traumatic injury in pregnant women,providing timely and appropriate management for high-risk patients is crucial for both pregnant women and fetuses.This study aimed to identify risk factors that predict adverse pregnancy outcomes after traumatic injury.Methods A retrospective cohort study including 317 pregnant patients who experienced trauma was conducted.The collected data included general demographics,injury mechanisms and adverse pregnancy outcomes.Patients were divided into two subgroups based on the absence or presence of trauma-related adverse pregnancy outcomes.Univariate and multivariate logistic regressions were conducted to estimate the associations between clinical variables and adverse pregnancy outcomes.Results A total of 41(12.93%)patients experienced adverse pregnancy outcomes within the first 24 h post-trauma.This study revealed that age>35 years(OR=14.995,95%CI:5.024–44.755,P<0.001),third trimester trauma(OR=3.878,95%CI:1.343–11.204,P=0.012),abdominal pain(OR=3.032,95%CI:1.221–7.527,P=0.017),vaginal bleeding(OR=3.226,95%CI:1.093–9.523,P=0.034),positive scan in focused assessment with sonography for trauma(FAST)positive(OR=8.496,95%CI:2.825–25.555,P<0.001),9≤injury severity score(ISS)<16(OR=3.039,95%CI:1.046–8.835,P=0.041)and ISS≥16(OR=5.553,95%CI:1.387–22.225,P=0.015)increased the probability of posttraumatic adverse pregnancy outcomes.Maternal age,gestational age at delivery,vaginal bleeding and positive FAST results were risk factors for abnormal delivery.Conclusion Advanced maternal age,third trimester,and positive FAST results should alert multidisciplinary trauma teams to closely monitor patients to prevent adverse pregnancy outcomes.
基金supported by Clinical Application-oriented Medical Innovation Foundation from National Clinical Research Center for Orthopedics,Sports Medicine&Rehabilitation and Jiangsu China-Israel Industrial Technical Research Institute Foundation(No.2021-NCRC-CXJJ-ZH-24)National Key R&D Plan of the 14th Five-Year Plan(No.2022YFC2504303).
文摘Objective To compare the clinical outcomes of retrograde pubic ramus intramedullary nail(RPRIN)and percutaneous cannulated screw(PCS)in the treatment of anterior pelvic ring fractures(APRFs).Methods This retrospective cohort study included 45 patients with APRFs treated between February 2019 and October 2022 in our trauma center.Patients were divided into two groups based on the surgical method:20 received RPRIN fixation,and 25 received PCS fixation.Key variables including operation time,fluoroscopic time,blood loss,and postoperative complications were analyzed.Fracture reduction quality was assessed using the Matta score system,and pelvic functional recovery was evaluated using the Majeed score system at the final follow-up.Quantitative variables were compared using the independent sample t test,while categorical variables were analyzed using Chisquare and Fisher’s exact tests.Results The RPRIN group had significantly shorter operation time(36.3±5.6 min vs.49.5±6.9 min,P<0.01),fluoroscopic time(32.0±2.8 s vs.48.4±3.6 s,P<0.01),and less blood loss(20.4±7.6 mL vs.34.0±5.7 mL,P<0.01)than the PCS group.Fracture reduction quality(Matta outcome)and pelvic functional recovery(Majeed outcome)were comparable between the two groups(P>0.05).No significant complications were reported in either group.Conclusions Both RPRIN and PCS are effective for treating APRFs.However,RPRIN offers distinct advantages by reducing operation time,fluoroscopic time,and blood loss,making it a more efficient and less invasive option.Further multicenter studies and biomechanical analyses are warranted to confirm these findings.
基金supported by the National Key Research and Development Program of China(2022YFC2504303)Innovation Foundation of National Clinical Research Center for Orthopaedics,Sports Medicine&Rehabilitation(2021-NCRC-CXJJ-ZH-24)Medical Innovation and Transformation Incubation Project of Tongji Hospital(2022ZHFY10).
文摘Objective Close reduction and internal fixation have gained popularity for the treatment of pelvic fractures.However,the closed reduction of bilateral displaced posterior pelvic ring disruption is a great challenge even for the most experienced surgeon.In this study,we describe in detail a novel unlocking closed reduction technique(UCRT)frame that allows strong traction for bilateral posterior pelvic ring displacement and presents preliminary clinical outcomes.Methods We retrospectively reviewed 32 patients with bilateral displaced posterior pelvic ring disruptions(AO/OTA 61-C2 and C3)who were initially treated with this technique between July 2017 and July 2022.According to the AO/OTA clas-sification,there were 9 cases(28.12%)of 61-C2,and 23 cases(71.88%)of 61-C3.There were 11 males,21 females,with an average age of 38.1 years.The interval from injury to operation was 4-27 days,with a cut-off of 12.5 days(receiver operat-ing characteristic curve).Operative time,blood loss,and postoperative radiographic findings were recorded.The functional outcomes and complications were followed.Results A total of 30(93.8%)patients achieved successful closed reduction,whereas 2 required open reduction.The success-ful closed reduction rate was 95.5%(21/22)in patients whose injury-to-operation time was less than 12.5 days.The vertical displacement percent correction of the obviously displaced hemipelvis was 70.20%±16.79%on average.The average degree of pelvic deformity correction was 64.86%±17.71%.Thirty patients were followed up for at least 12 months(12-36 months),and no complications of nonunion or redisplacement were observed.The Matta-Tornetta scoring standard revealed that the excellent(25/30)and good(4/30)rate was 96.7%.The Majeed clinical efficacy score revealed that the overall excellent and good rate was 100%.One patient had INFIX-related infection,and 2 reported numbness in the lateral thigh.The numbness was improved after INFIX removal.Conclusions This study presents an updated technique for closed reduction using a UCRT frame for bilateral posterior pelvic ring disruption,which has been shown to be effective,as indicated by excellent surgical and functional outcomes.
基金Supported by National Key Research and Development Plan,No.2022YFC2504303National Natural Science Foundation of China,No.82072411+1 种基金Guangzhou Area Clinical High-tech and Major Technology Projects,No.2024PL-GX11Internal Medicine Research Fund Project of Huadu District People's Hospital,Guangzhou(Excellent Youth Project),No.2020B06.
文摘BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental health problems.In recent years,the new transrectus lateral approach has favorably treated pelvic fractures and possibly preserved patients'physiological and psychological conditions.There-fore,investigating its clinical efficacy for treating pelvic fractures plus lum-bosacral plexus injuries is of great clinical significance.AIM To investigate the clinical effect of the transrectus lateral approach on pelvic fractures complicated by lumbosacral plexus injuries as well as anxiety and depression.METHODS Data of 136 patients with pelvic fractures complicated by lumbosacral plexus injuries treated by the transrectus lateral approach(January 2011 to May 2024)were retrospectively analyzed.The patients'general data were collected via questionnaire.The Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to assess anxiety and depression,respectively.We adopted a numerical rating scale(NRS)to evaluate pain degree,the Pittsburgh Sleep Quality Index(PSQI)to assess sleep quality,and Medical Research Council(MRC)Scale for Muscle Strength to evaluate treatment efficacy and complications.RESULTS The 136 included patients(92 male,44 female)were a mean 48.02±15.72 years old.The mean SAS score was 66.36±5.15 preoperatively vs 42.15±4.36 postoperatively,while the mean SDS score was 65.61±5.02 preoperatively vs 43.83±4.54 postoperatively,showing statistically significant differences(P<0.05).The mean NRS and PSQI scores were significantly lower pre-vs postoperatively(P<0.05).Postoperatively,67 patients with fresh pelvic fractures plus nerve injuries achieved an MRC of M5,22 achieved an M1-M4,and four achieved an M0.Postoperative motor function improved by a mean 4.20 grades(scale,0-5).Among the patients with old pelvic fractures and nerve injuries,19 achieved an M5,16 achieved an M1-M4,and eight achieved an M0.Motor function improved significantly by a mean 3.30 grades(scale,0-5;P<0.05).No serious postoperative complications occurred.CONCLUSION The transrectus lateral approach to treating pelvic fractures plus lumbosacral plexus injuries can safely alleviate anxiety and depression,relieve pain,improve sleep quality,reduce intraoperative blood loss,and improve postoperative recovery.
基金Supported by The Natural Science Foundation of Hunan Province,China,No.2022JJ30329.
文摘BACKGROUND High-grade serous ovarian carcinoma(HGSOC)is among the most lethal gynecological malignancies,characterized by late-stage diagnosis,extensive peritoneal dissemination,and limited treatment options,resulting in poor survival outcomes.The tumor microenvironment plays a critical role in disease progression and therapy resistance,with CD4+T cells exhibiting significant plasticity and functional heterogeneity.Regulatory T cells(Tregs)are particularly implicated in immune suppression and tumor evasion.However,the spatial distribution,functional states,and prognostic significance of CD4+T cell subtypes in HGSOC remain poorly understood.AIM To characterize the functional heterogeneity and tissue-specific distributions of CD4+T cell subtypes in HGSOC and identify biomarkers for therapy.METHODS We analyzed single-cell RNA sequencing(scRNA-seq)data from 42 HGSOC patients,examining samples collected from adnexal tissues and ascites.CD4+T cells were identified and classified into subtypes using unsupervised clustering and marker gene analysis.Functional profiling was performed using pathway enrichment,differential expression analysis,and functional signature scoring.Kaplan-Meier survival and Cox proportional hazards modeling were conducted to evaluate the prognostic value of CD4+T cell subtypes.RESULTS Distinct distributions of CD4+T cell subtypes were identified between adnexal tissues and ascites.Naive CD4+T cells were predominant in ascites,while Tregs and CXCL13-expressing CD4+T cells were enriched in adnexal tissues.Tregs were further categorized into four subtypes(Treg1,Treg2,Treg3,and TISG),each exhibiting unique molecular signatures and tissue-specific adaptations.Treg3 cells,enriched in adnexal tissues,were characterized by high levels of activation and exhaustion markers,correlating with poor clinical outcomes in HGSOC patients.CONCLUSION Treg3 cells drive immune suppression and tumor progression in HGSOC,making them a key immunotherapy target.Their adnexal enrichment highlights the need for tissue-specific immune profiling in precision treatment.
基金Supported by Science Project of Hunan Provincial Healthy Commission,No.20230844Science Project of Hunan Natural Science Foundation,No.2025JJ81181.
文摘Essex-Lopresti injury is characterized by a radial head fracture accompanied by dislocation of the distal radioulnar joint and rupture of the interosseous membrane(IOM).This type of injury typically results from high-energy axial forces transmitted through the wrist to the elbow,leading to tears in the IOM,fractures of the radial head,injuries to the distal radioulnar joint,and disruption of the triangular fibrocartilage complex,ultimately causing axial instability of the radioulnar joint.Due to its complexity,this injury is often overlooked in clinical settings,with a reported misdiagnosis rate as high as 60%.In pediatric cases,the misdiagnosis rate is even higher due to children's limited ability to articulate symptoms,the presence of substantial cartilaginous structures that have not fully ossified,and less typical radiographic findings compared to adults.This review aims to provide a comprehensive overview of the injury mechanism,clinical presentation,diagnosis,and treatment of Essex-Lopresti injuries in children,emphasizing the importance for pediatric orthopedists to recognize and manage this condition accurately to prevent misdiagnosis and inappropriate treatment.
基金financially supported by the National Natural Science Foundation of China(Nos.81871742 and 82102538)Shanghai Sailing Program(No.21YF1405800)+2 种基金Shanghai Pudong Science and Technology Development Funding(No.PKJ2020-Y44)the Featured Clinical Discipline Project of Shanghai Pudong New District(No.Pwyts2021-03)the support of the National Engineering Research Center of Light Alloy Net Forming,Shanghai Jiao Tong University
文摘Osteoporotic fractures often exhibit delayed healing and repair difficulties in which the bone immune microenvironment may play a critical role,but direct evidence remains elusive.Recently,magnesium(Mg)-based alloys have emerged as promising biodegradable materials capable of promoting fracture healing.Herein,we performed internal fixation of high-purity Mg implants for osteoporotic fractures and used single-cell studies to investigate and elucidate the cellular heterogeneity and dynamic changes that occurred during osteoporotic fracture repair.We observed an early increase in immature neutrophil numbers,together with anti-inflammatory changes in lymphocytes and macrophages.A cluster of macrophages exhibited pro-angiogenic capabilities activated via the TRPM7/S100A4 pathway.These findings provide new theoretical insights into the biological effects of Mg-based materials on the healing of osteoporotic fractures.
基金supported by the National Natural Science Foundation of China,Nos. 81771346, 82071383the Natural Science Foundation of Shandong Province (Key Project),No. ZR2020KH007+3 种基金the Taishan Scholar Youth Program of Shandong Province,No. tsqn201812156Academic Promotion Program of Shandong First Medical University,Nos. 2019QL025, 2019RC021Spring Industry Leader Talent Support Plan,No. 201984Rongxiang Regenerative Medicine Fund,No. 2019SDRX-23 (all to BN)。
文摘Studies have shown that gut microbiota metabolites can enter the central nervous system via the blood-spinal cord barrier and cause neuroinflammation, thus constituting secondary injury after spinal cord injury. To investigate the correlation between gut microbiota and metabolites and the possible mechanism underlying the effects of gut microbiota on secondary injury after spinal cord injury, in this study, we established mouse models of T8–T10 traumatic spinal cord injury. We used 16 S rRNA gene amplicon sequencing and metabolomics to reveal the changes in gut microbiota and metabolites in fecal samples from the mouse model. Results showed a severe gut microbiota disturbance after spinal cord injury, which included marked increases in pro-inflammatory bacteria, such as Shigella, Bacteroides, Rikenella, Staphylococcus, and Mucispirillum and decreases in anti-inflammatory bacteria, such as Lactobacillus, Allobaculum, and Sutterella. Meanwhile, we identified 27 metabolites that decreased and 320 metabolites that increased in the injured spinal cord. Combined with pathway enrichment analysis, five markedly differential amino acids(L-leucine, L-methionine, L-phenylalanine, L-isoleucine and L-valine) were screened out, which play a pivotal role in activating oxidative stress and inflammatory responses following spinal cord injury. Integrated correlation analysis indicated that the alteration of gut microbiota was related to the differences in amino acids, which suggests that disturbances in gut microbiota might participate in the secondary injury through the accumulation of partial metabolites that activate oxidative stress and inflammatory responses. Findings from this study provide a new theoretical basis for improving the secondary injury after spinal cord injury through fecal microbial transplantation.
基金supported by the National Natural Science Foundation of China(No.81101458)
文摘The effect of high-frequency repetitive transcranial magnetic stimulation（r TMS） on potassium-chloride cotransporter-2（KCC2） protein expression following spinal cord injury（SCI） and the action mechanism were investigated. SCI models were established in SD rats. Five groups were set up randomly： normal control group, SCI 7-day（7 D） model group, SCI 14-day（14 D） model group, SCI-7 DrTMS group and SCI-14 DrTMS group（n=5 each）. The rats in SCI rTMS groups were treated with 10 Hz rTMS from 8 th day and 15 th day after SCI respectively, once every day, 5 days every week, a total of 4 weeks. After the model establishment, motor recovery and spasticity alleviation were evaluated with BBB scale once a week till the end of treatment. Finally, different parts of tissues were dissected out for detection of variations of KCC2 protein using Western blotting and polymerase chain reaction（PCR） technique. The results showed that the BBS scores after treatment were significantly higher in SCI-7 DrTMS group than in SCI-14 DrTMS group（P〈0.05）. As compared with normal control groups, The KCC2 protein in SCI model groups was down-regulated after SCI, and the decrease was much more significant in SCI-14 D model group than in SCI-7 D group（P〈0.05）. As compared with SCI model groups, KCC2 protein in rTMS groups was up-regulated after the treatment（P〈0.05）. The up-regulation of KCC2 protein content and expression was more obvious in SCI-7 DrTMS group than in SCI-14 DrTMS group（P〈0.05）. It was concluded that 10 Hz rTMS can alleviate spasticity in rats with SCI, which might be attributed to the up-regulation of KCC2 protein. It was also suggested that the high-frequency rTMS treatment after SCI at early stage might achieve more satisfactory curative effectiveness.
文摘Summary：To compare the expression level of metastasis associated-1 （MTA 1 ） gene in high and low metastatic： human osteosarcoma cell lines and examine the relationship of MTA 1 expression and the metastasis potentiality of osteosarcoma cells, the expression of MTA 1 in MC-63 osteosarcoma cell lines with high and low metastasis potential was detected by semiquantitative TR-PCR. Boyden chamber invasion assay was used to evaluate the invasive capacity in vitro in two osteosarcoma cell lines, The low metastasis MG-63 cells were transfected with MTA 1 full-length cDNA expression plasmid by lipofectamine and the changes of MTA 1 expression and in vitro invasion potential were examined after the transfection. Our results showed that MG63 cell line with high metastasis potential expressed significantly higher MTA 1 than that of MG63 cells with low metastasis as reavealed by RT-PCR The invasion potential of low metastasis MG63 cell line was increased after MTA 1 gene transfection. It is concluded that there may be a relationship between MTA 1 and invasive potentiality of human osteosarcoma cells, and the mechanism of MTA 1 in osteosarcoma metastasis and its possible role in associated gene therapy deserve further study.
基金support by grants from the“Chongqing Science and Technology Benefiting project”(cstc2016kjhmpt1001)research project from the State Key Laboratory of Trauma,Burns and Combined Injury(SKLZZ201603)。
文摘Background:Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients,this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in the China trauma care training(CTCT)program in addition to their post-course test results to provide support for the development of trauma care training programs and trauma systems in China.Methods:A cross-sectional study was conducted by collecting demographic information,hospital-related information and trauma knowledge of the trainees from 19 regions in China.All participants were assessed by questionnaires collecting the socio-demographic data,the trauma care knowledge levels and the information of the hospitals.Results:There were 955 males(78.9%)and 256 females(21.1%)enrolled.Among them,854 were physicians(70.5%),357 were registered nurses(29.5%).In addition,64 of them also played an administrative role in the hospitals(5.3%).The score of the trainees who were members of the emergency department staff(72.59±14.13)was the highest among the scores of all the personnel surveyed,followed by those of the trainees from the intensive care unit(ICU)(71.17±12.72),trauma surgery department(67.26±13.81),orthopedics department(70.36±14.48),general surgery department(69.91±14.79)and other departments(69.93±16.91),P=0.031.The score of the professors(73.09±15.05)was higher than those of the associate professors(72.40±14.71),lecturers(70.07±14.25)and teaching assistants(67.58±15.16),P<0.0001.The score of the individuals who attended experts’trauma lectures(72.22±14.45)was higher than that of individuals who did not attend the lectures(69.33±15.17),P=0.001.The mean scores before and after the training were 71.02±14.82 and 84.24±13.77,respectively,P<0.001.The mean score of trauma knowledge after the training of trainees from different provinces and with different educational backgrounds was higher than that before the training,with a statistically significant difference(P<0.05).Conclusions:The level of trauma knowledge of trauma care providers was associated with their department,professional position and previous participation in related academic conferences.Trauma care experience and participation in academic lectures and training program including CTCT may effectively improve individuals’level of trauma knowledge.
文摘BACKGROUND Older people are more likely to experience pelvic fractures than younger people.Multi-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can clearly demonstrate the 3D space of fractures and detect fractures at a higher rate.AIM To investigate the clinical value of multi-slice spiral CT 3D reconstruction in the diagnosis of unstable pelvic fractures in the elderly as well as the effect of less invasive stabilization.METHODS A total of 86 patients with unstable pelvic fractures treated between March 2016 and March 2019 underwent femoral supracondylar bone traction before surgery.Pelvic radiography and multi-row spiral CT were performed successively once the patient’s vital signs and hemodynamic indices were stable.Secondary processing of the original data was performed to obtain 3D reconstruction images and determine the vertical displacement of the pelvis.After basic or complete reduction,minimally invasive internal fixation using hollow lag screws was performed.The detection rates of fracture location and classification by X-ray and CT reconstruction were compared.Patients were divided into two groups according to the presence or absence of preoperative 3D reconstruction to compare postoperative reduction,wound healing time,fracture healing time,hospitalization time,visual analog scale(VAS)score,poor internal fixation,and functional recovery.RESULTS The diagnostic coincidence rates of X-rays for pubic symphysis,ilium wing,sacroiliac periarticular,and sacral fractures were lower than those of CT reconstruction.The coincidence rate of CT reconstruction in the clinical classification of pelvic fractures was 100%,whereas 11 cases were misdiagnosed by X-ray;the total coincidence rate was 87.21%.The total excellent and good rates of postoperative reduction were significantly higher in the study group than in the control group(P<0.05).The wound healing,fracture healing,and hospitalization times were significantly shorter in the study group than in the control group(P<0.05).The VAS scores decreased in both groups postoperatively and were lower in the study group than in the control group(P<0.05).The total incidence of poor postoperative internal fixation was significantly lower in the study group than in the control group(P<0.05).The overall rate of postoperative functional recovery was significantly higher in the study group than in the control group(P<0.05).CONCLUSION Multi-slice spiral CT has high guiding significance for the diagnosis,classification,and treatment of unstable pelvic fractures in the elderly.Preoperative 3D reconstruction can effectively shorten the operation time and promote fracture healing,while minimally invasive internal fixation can effectively reduce pain and promote functional recovery of fracture sites,making it worthy of clinical application.
文摘Research has been carried out to look for safe and effective anti-inflammation drugs from traditional Chinese herbal medicine. As a powerful research technology of life science, molecular biology has entered many areas of traditional Chinese medicine.This study aimed to investigate the effect of triptolide on tumor necrosis factor-α （TNF-α） and interleukin-8 （IL-8） of peritoneal macrophages activated by lipopolysaccharide （LPS） in mice. Peritoneal elicited macrophages were separated, purified and activated by LPS in mice, then cultured in vitro with triptolide at different concentrations. The activity of TNF-a and the level of IL-8 of cellular supernatants were determined by MTT colorimetric assay and ELISA, respectively. The activity of TNF-a in macrophages was significantly inhibited （P〈0.01） by triptolide （10^-1-10^1μg/ml） during 4-24 hours in a time- and dose-dependent manner. The level of IL-8 in macrophages was significantly inhibited （P〈0.01） by triptolide （10^-1-10^1g/ml） in 12 hours in a dose- dependent manner. Triptolide could inhibit the activity of TNF-a and the level of IL-8 in macrophages activated by LPS.
基金supported by a grant from Natural Science Foundation of Hubei Province of China (No. 2008CBD112)
文摘The inhibitory effects of diallyl sulfide(DAS) derived from allicin on in vitro and in vivo proliferation of human osteosarcoma MG-63 cells and the action mechanism,and the influence of DAS on invasive capability of MG-63 cells were investigated in order to search for the novel medicines for osteosarcoma.In the in vitro experiment,MG-63 cells were treated with different concentrations of DSA,and the morphological changes of MG-63 cells were observed under an inverted phase microscope.MTT method was used to assay the proliferation of MG-63 cells.Semi-quantitative reverse transcription polymerase chain reaction(RT-PCR) was used to detect the VEGF mRNA expression level in MG-63 cells.By using Transwell invasion assay,the influence of DAS on invasive ability of MG-63 cells was tested.In the in vivo experiment,the nude mice MG-63 cells tumor-bearing model was established,and different concentrations of DAS were injected beside the tumor.Twenty-one days after treatment,the mice were killed,the tumor size and tumor inhibition rate were calculated.The microvessel density(MVD) was determined by using immunohistochemistry.In the in vitro experiment,different concentrations of DAS could obviously inhibit proliferation of MG-63 cells in a time-and concentration-dependent manner.RT-PCR revealed that the expression levels of VEGF mRNA in DSA groups(different concentrations) were significant reduced as compared with those in control group(all P<0.05).Transwell invasion assay indicated that in 20 and 40 μg/mL DAS groups,the number of migratory cells was 91.4±8.3 and 81.8±7.4 respectively,which was significantly declined as compared with that in control group(150.4±14.7,both P<0.05).In the in vivo experiment,DAS could significantly suppress the growth of MG-63 tumor-bearing tissue.Immunohistochemistry demonstrated that different concentrations(20 and 40 μg/mL) of DAS could significantly decrease MVD of MG-63 tumor-bearing tissue(all P<0.05).It was suggested that DAS could inhibit the growth of MG-63 cells probably by suppressing the expression of VEGF mRNA.
文摘Osteosarcoma is the most common primary malignant bone tumor in childhood,and it maintains a high level of recurrence.Matrix metalloproteinase-1(MMP-1)was found to contribute to cancer progression.The present study was to investigate the in vitro effects of MMP-1 over-expression on the proliferation,invasion,metastasis and stem-like properties of osteosarcoma MG-63 cells.The MG-63 cells were cultured and had a full length MMP-1 cDNA inserted by the tentiviral vector (MG-63^MMP-1+).MG-63 negative control and MG-63 blank control groups were established as well.MMP-1 expression was detected in MG-63^MMP-1+,MG-63 negative control and MG-63 blank control cells using qPCR,Western blotting and immunofluorescence after 24h of culture. The cell proliferation assay was performed with a camera attached to a bioreactor,which was programmed to photograph five regions of each well every 10 min over a period of 48 h.The cell invasion assay was conducted with Matrigel to assess the invasive potential,of MG-63 cells over 24h,the qPCR analysis to measure stem cell markers,including Oct4, Sox-2,Nanog,and Pax-7,and Western blot analysis to detect invasive and metastatic potential markers TIMP-1,VEGF and BMP2/4,after 24h of culture.Immunofluorescence was used to investigate the presence of the stem cell marker Pax-7 after 24-h culture. The results showed that over-expression of MMP-1 after transfection could significantly increase minor cell proliferation and invasion (P<0.05,MG-63^MMP-1+ versus controls).Pax-7 was highly expressed in MG-63^MMP-1+ cells,with no significant changes of Oct-4,Sox-2, and Nanog observed (P<0.05).MG-63^MMP-1+ cells showed higher expression of VEGF and BMP 2/4 proteins and lower expression of TIMP-1 protein than controls (P<0.05).It was concluded that MMP-1 over-expression in MG-63 cells contributed to the proliferation, invasion,metastasis and stem-like properties of osteosarcoma cells.Future studies should focus on in vivo effects of MMP-1 over-expression and the application of MMP-1 and Pax-7 inhibition in vivo to osteosarcoma theraoies.
基金supported by the 2016 Beijing Municipal Natural Science Foundation(CN),No.71520061Beijing Municipal Science and Technology Commission,China,No.Z161100000116080
文摘Ischemic preconditioning or postconditioning has been shown to have neuroprotective effect on cerebral ischemia, but it has not been studied in peripheral nerve injury. In this study, a rat model of sciatic nerve transection was established, and subjected to three cycles of ischemia for 10 minutes ＋ reperfusion for 10 minutes, once a day. After ischemic postconditioning, serum insulin-like growth factor 1 expression increased; sciatic nerve Schwann cell myelination increased; sensory function and motor function were restored. These findings indicate that ischemic postconditioning can effectively protect injured sciatic nerve. The protective effect is possibly associated with upregulation of insulin-like growth factor 1.
基金Supported by National Defense Medical Center,Tri-Service General Hospital,Neihu 114,Taipei,Taiwan
文摘Although primary gastrointestinal lymphoma is a rare malignancy, it can cause an intussusception in adults and can be a clinically challenging condition to manage. Intussusception could progress to lifethreatening complications if left untreated or could delay chemotherapy if inappropriate surgical management is used. We report a 31-year-old man diagnosed with human immunodeficiency virus who was being treated with antiretroviral therapy. He presented with nausea, vomiting, poor appetite, and intermittent, cramping abdominal pain for over 1 wk. Abdominal computed tomography revealed a well-defined homogeneous mass in the mesenteric root region, together with a long segmental wall thickening in the ileum with ileocolic-type intussusception, which was suspected to be caused by a lymphoma. The intussusception was successfully laparoscopically reduced, and the tumor involvement of the appendix was confirmedby appendectomy with intraoperative frozen section. Systemic chemotherapy was immediately initiated after surgery without the need for bowel resection.
基金supported by a grant from the Scientific Research Foundation for the Returned Overseas Chinese Scholars,State Education Ministry of China (No. 2009-1001)
文摘This study examined the effects of ω-3 polyunsaturated fatty acid（ω-3PUFA） on the expression of toll-like receptor 2（TLR2）,toll-like receptor 4（TLR4） and some related inflammatory factors in peripheral blood mononuclear cells（PBMCs） of patients with early-stage severe multiple trauma.Thirty-two patients who were admitted to the Department of Traumatic Surgery,Tongji Hospital（Wuhan,China） between May 2010 and November 2010,and diagnosed as having severe multiple trauma with a injury severity score（ISS） no less than 16,were enrolled in the study and divided into two groups at random（n=16 in each）：ω-3PUFA group and control group in which routine parenteral nutrition supplemented with ω-3PUFA or not was administered to the patients in two groups for consecutive 7 days.Peripheral blood from these patients was collected within 2 h of admission（day 0）,and 1,3,5 and 7 days after the nutritional support.PBMCs were isolated and used for detection of the mRNA and protein expression of TLR2 and TLR4 by using real-time PCR and flow cytometry respectively,the levels of NF-κB by quantum dots-based immunofluorescence assay,the levels of TNF-α,IL-2,IL-6 and COX-2 by ELISA,respectively.The results showed that the mRNA and protein expression of TLR2 and TLR4 in PBMCs was significantly lower in ω-3PUFA group than in control group 5 and 7 days after nutrition support（both P0.05）.The levels of TNF-α,IL-2,IL-6 and COX-2 were found to be substantially decreased in PBMCs in ω-3PUFA group as compared with control group at 5th and 7th day（P0.05 for all）.It was concluded that ω-3PUFA can remarkably decrease the expression of TLR2,TLR4 and some related inflammatory factors in NF-κB signaling pathway in PBMCs of patients with severe multiple trauma,which suggests that ω-3PUFA may suppress the excessive inflammatory response meditated by the TLRs/NF-κB signaling pathway.
