The distance between the anterior and posterior edges of the fibula at a lateral internal rotation of 15° is associated with postoperative malreduction in patients with an ankle joint fracture combined with a lower tibiofibular syndesmosis injury.

BACKGROUND: Malreduction remains a problem in patients with an ankle joint fracture combined with a lower tibiofibular syndesmosis injury. Current methods of malreduction evaluation have many limitations, and novel techniques are required. OBJECTIVES: The aim of the study was to investigate the association between the distance between the anterior and posterior edges of the fibula at a 15° lateral internal rotation and postoperative malreduction in patients with an ankle joint fracture combined with a lower tibiofibular syndesmosis injury. MATERIAL AND METHODS: This prospective observational cohort study enrolled 187 patients diagnosed with an ankle joint fracture combined with a lower tibiofibular syndesmosis injury between January 2020 and January 2022. The patients were divided into 2 groups according to their postoperative malreduction condition: the malreduction group and the non-malreduction group. After tibiofibular syndesmosis reduction, a computed tomography (CT) scan was used to measure the distance between the anterior and posterior edges of the fibula at a standard lateral position and a position with a lateral internal rotation of 15°. Demographic data and basic clinical characteristics were recorded for all patients. RESULTS: The mean distance between the anterior and posterior edges of the fibula was longer in malreduction patients than non-malreduction patients at the standard lateral and 15° lateral internal rotation positions. At a lateral internal rotation of 15°, the distance between the anterior and posterior edges correlated negatively with the postoperative Mazur and American Orthopaedic Foot and Ankle Society (AOFAS) scores, and correlated positively with the length of hospitalization and fracture healing time. Receiver operating characteristic (ROC) curves revealed the potential postoperative malreduction diagnostic value of fibular anterior-posterior edge distance using an internal rotation of 15°. Postoperative AOFAS score, length of hospitalization, fracture healing time, and the distance between the anterior and posterior edges of the fibula at a lateral internal rotation of 15° were independent risk factors of malreduction. CONCLUSIONS: The fibular anterior-posterior edge distance at an internal rotation of 15° is associated with postoperative ankle joint function and the occurrence of malreduction.

Lean management of nursing human resources during COVID-19 pandemic.

AIM: To find a rapid, scientific, rational and accurate method of allocating nursing human resources during the COVID-19 pandemic. DESIGN: A longitudinal prospective study. METHODS: Lean management tool is used to implement four-level scheduling of nursing human resources, which is departmental level, district level, hospital level and city level, according to the daily reporting data of the whole hospital, such as Lianfan scheduling data, Dingding sensitive data and Hospital Information System daily report data. RESULTS: Fifty batches of nursing manpower, 294 nurses and 3813 working days were deployed during the pandemic, and the nursing human resources allocation mathematical models of the hospital and all departments were constructed. Since COVID-19 occurred, the infection rate of nurses with novel coronavirus and the mortality rate of critical patients have been keeping 0%, and the cure rate of common patients has been 100%. CONCLUSION: The use of lean management tool to allocate nursing human resources plays a positive role in ensuring zero infection of nurses, improving the cure rate of common patients and reducing the mortality rate of critically ill patients with COVID-19.

LncRNA NBR2 inhibits epithelial-mesenchymal transition by regulating Notch1 signaling in osteosarcoma cells.

Long noncoding RNAs (lncRNAs) have been identified to have increasingly important roles in tumorigenesis, and they may serve as novel biomarkers for cancer therapy. Recent studies have demonstrated that lncRNA NBR2 (neighbor of BRCA1 gene 2), a novel identified lncRNA, is decreased in several cancers; however, the role of NBR2 in the development of osteosarcoma has not been elucidated. In our study, we found that NBR2 expression was downregulated in osteosarcoma tissues, and osteosarcoma cases with lower NBR2 expression exhibited a shorter overall survival time compared with those with higher NBR2 expression. NBR2 overexpression inhibited osteosarcoma cell proliferation, invasion, and migration but did not increase apoptosis. Furthermore, RNA-binding protein immunoprecipitation assays confirmed that NBR2 directly binds to Notch1 protein. Furthermore, overexpression of Notch1 in NBR2-overexpressing osteosarcoma cells reversed the effects of NBR2 on cell proliferation, invasion, migration, and epithelial-mesenchymal transition. The in vivo results showed that NBR2 overexpression inhibited tumor growth in nude mice that were inoculated with osteosarcoma cells. NBR2 overexpression also suppressed the messenger RNA (mRNA) expression of Notch1, N-cadherin, and vimentin and increased the mRNA expression of E-cadherin in the tumor tissues. These data indicated that NBR2 served as a tumor suppressor gene in osteosarcoma and inhibited osteosarcoma cell proliferation, invasion, and migration. The current study provides a novel insight and treatment strategy for osteosarcoma.

Peroxiredoxin-1 promotes cell proliferation and metastasis through enhancing Akt/mTOR in human osteosarcoma cells.

Osteosarcoma is characterized by high propensity for metastasis, especially to the lung, which is the main cause of death. Peroxiredoxin-1 (PRDX1) plays significant roles in multiple processes of initiation and progression of tumorogenesis. However, whether PRDX1 participates in metastasis of osteosarcoma remains unknown. Here, we demonstrate that PRDX1 overexpressed in osteosarcoma tissues comparing to adjacent non-tumor tissues. Two independent cohorts of patients showed high level of PRDX1 correlated with clinicopathological features such as larger tumor size and advanced tumor metastasis stage. While patients with high PRDX1 level have poor prognosis. Notably, expression level of PRDX1 especially increased in lung lesion of osteosarcoma patients, indicating that PRDX1 may promote lung metastasis. Ectopic expression of PRDX1 promotes osteosarcoma cell migration and metastasis in vitro and in vivo, whereas knockdown of PRDX1 expression suppresses cell metastatic behaviors such as invasion and migration. Furthermore, we found that PRDX1 promotes cells metastasis through enhancing Akt/mTOR signal pathway. Taken together, our findings prove the important role of PRDX1 in the molecular etiology of osteosarcoma and suggest that PRDX1 may be a novel prognostic biomarker and therapeutic target for osteosarcoma.

Inhibiting ROS-TFEB-Dependent Autophagy Enhances Salidroside-Induced Apoptosis in Human Chondrosarcoma Cells.

BACKGROUND/AIMS: Autophagy modulation has been considered a potential therapeutic strategy for human chondrosarcoma, and a previous study indicated that salidroside exhibits significant anti-carcinogenic activity. However, the ability of salidroside to induce autophagy and its role in human chondrosarcoma cell death remains unclear. METHODS: We exposed SW1353 cells to different concentrations of salidroside (0.5, 1 and 2 mM) for 24 h. RT-PCR, Western-blotting, Immunocytofluorescence, and Luciferase Reporter Assays were used to evaluate whether salidroside activated the TFEB-dependent autophagy. RESULTS: We show that salidroside induced significant apoptosis in the human chondrosarcoma cell line SW1353. In addition, we demonstrate that salidroside-induced an autophagic response in SW1353 cells, as evidenced by the upregulation of LC3-II and downregulation of P62. Moreover, pharmacological or genetic blocking of autophagy enhanced salidroside -induced apoptosis, indicating the cytoprotective role of autophagy in salidroside-treated SW1353 cells. Salidroside also induced TFEB (Ser142) dephosphorylation, subsequently to activated TFEB nuclear translocation and increase of TFEB reporter activity, which contributed to lysosomal biogenesis and the expression of autophagy-related genes. Importantly, we found that salidroside triggered the generation of ROS in SW1353 cells. Furthermore, NAC, a ROS scavenger, abrogated the effects of salidroside on TFEB-dependent autophagy. CONCLUSIONS: These data demonstrate that salidroside increased TFEB-dependent autophagy by activating ROS signaling pathways in human chondrosarcoma cells. These data also suggest that blocking ROS-TFEB-dependent autophagy to enhance the activity of salidroside warrants further attention in treatment of human chondrosarcoma cells.

Real-world cost-effectiveness of infliximab for moderate-to-severe rheumatoid arthritis in a medium-sized city of China.

AIM: To assess the cost-effectiveness of infliximab-containing therapy (ICT) for moderate-to-severe rheumatoid arthritis (RA) in a medium-sized Chinese city. METHODS: A Chinese prospective cohort study comparing ICT (25 patients) versus conventional disease-modified antirheumatic drugs (24 patients) for RA was used to assess the cost-effectiveness of ICT. RESULTS: The cohort study observed significantly reduced disease activity score of 28 joints (coefficient -2.718, p < 0.001), improved EQ-5D (coefficient 0.453, p < 0.001) and increased medical costs (coefficient 1.289, p < 0.001) associated with ICT. The incremental cost-effectiveness ratio per gained quality-adjusted life year for ICT versus disease-modified antirheumatic drugs was 1.897-times of the local gross domestic product per capita. CONCLUSION: Infliximab was a favorable cost-effective alternative option for moderate-to-severe RA in a medium-sized city of China.