Open Distal Femur Fractures Treated with Bone Cement Intramedullary Support Combined with Locked Plate Fixation.

Objective: The objective of this study was to assess the short-term clinical efficacy of the short-term clinical efficacy of bone cement intramedullary support combined with locked plate fixation in the treatment of such fractures. Methods: A retrospective study including 21 patients was reviewed at an urban level one trauma center. There were 17 males and 4 females, with a mean age of 33.9 years. Gustilo grade was II (12 cases), III-A (6 cases), III-B (2 cases), and III-C (1 case). Two fractures were AO-OTA type 33A3, 9 cases were type 33C2, and 10 cases were type 33C3. After the first stage debridement and temporary external fixation, all patients received bone cement intramedullary support combined with locked plate fixation through an anterolateral incision at the second stage.. The perioperative complications, need for bone graft, alignment, and radiographic union were recorded. At 1-year follow-up, the range of knee motion was recorded, and functional results were evaluated by the Hospital for Special Surgery (HSS) knee score. Results: All 21 patients were followed up for 12-36 months, with an average of 18.7 months. 1 case had superficial wound infection, and 2 cases had partial skin edge necrosis of the original open wound. After symptomatic dressing changes, they all healed well. 4 cases had autogenous bone grafting. 18 patients (85.7%) achieved radiographic union, with a mean union time of 6.2 months. Two patients underwent secondary operation 9 months after surgery due to nonunion and finally united after autologous bone grafting. One patient developed a deep infection 8 months after surgery and was successfully treated with Masquelet technique. Finally, bone union was achieved 7 months after surgery. The alignment was good in 17 patients (81.0%). No deep infection or hardware failure occurred during 1-year follow-up. The average range of knee extension and flexion was 5.2 ° and 106.8 °, respectively. The HSS score averaged 83.6. Conclusions: Bone cement intramedullary support combined with locked plate fixation was an effective treatment modality of open distal femur fractures with high union rate, low complication, adequate alignment and satisfactory functional outcomes.

[Characteristics and clinical significance of irreducible Pipkin type â and â ¡ femoral head fracture-dislocations].

Objective: To summarize the characteristics and clinical significance of irreducible Pipkin type Ⅰ and Ⅱ femoral head fracture-dislocations. Methods: The clinical data of 4 patients with irreducible Pipkin type Ⅰ and Ⅱ femoral head fracture-dislocations between January 2010 and December 2019 were collected. There were 2 males and 2 females and the age ranged from 24 to 41 years, with an average age of 33.5 years. The cause of injury included traffic accident in 3 cases and falling in 1 case. Pipkin classification was 2 cases of type Ⅰ and 2 cases of type Ⅱ. The time from injury to operation was 1-2 days. The clinical features were that the hip joint of the affected limb was in a locked position, and the passive range of motion was poor. The affected limb was slightly flexed at the hip joint and shortened, in a state of neutral position or slight adduction and internal rotation. The imaging data suggested that the femoral head dislocated backward and upward, and the hard cortex of the posterior edge of the acetabulum was embedded in the cancellous bone of the femoral head, and the two were compressed and incarcerated. Patients of cases 1-3 underwent closed reduction of hip dislocation 1-2 times at 3, 1, and 3 hours after injury respectively, and femoral neck fracture occurred. The injury types changed to Pipkin type Ⅲ, and open reduction and internal fixation were performed. Patient of case 4 did not undergo closed reduction, but underwent open reduction and internal fixation directly. Results: Patients of cases 1-3 were followed up 14, 17, and 12 months, respectively. They developed osteonecrosis of the femoral head at 9, 5, and 10 months after operation respectively, and all underwent total hip arthroplasty. Patient of case 4 was followed up 24 months and had no hip pain and limited mobility; the imaging data indicated that the internal fixator position was good and the fracture healed; no collapse or deformation of the femoral head was seen, and no osteonecrosis of the femoral head occurred. Conclusion: Clinicians need to improve their understanding of the unique clinical features and imaging findings of irreducible Pipkin type Ⅰ and Ⅱ femoral head fracture-dislocations. It is suggested that open reduction and simultaneous fixation of femoral head fracture should be directly used to reduce the incidence of osteonecrosis of the femoral head.

Downregulating lncRNA PVT1 Relieves Astrocyte Overactivation Induced Neuropathic Pain Through Targeting miR-186-5p/CXCL13/CXCR5 Axis.

Spinal cord injury (SCI) is one of the main causes leading to neuropathic pain. Here, we aim to explore the molecular mechanism and function of lncRNA PVT1 in neuropathic pain induced by SCI. The expression of lncRNA PVT1, microRNA (miR) - 186-5p was measured via quantitative reverse transcription PCR (qRT-PCR), and the activation of astrocytes (labeled by GFAP) was detected by immunohistochemistry. Western blot was conducted to detect the expression of chemokine ligand 13 (CXCL13), chemokine receptor 5 (CXCR5), cyclooxygenase-2 (COX2), inducible nitric oxide synthase (iNOS) and glial fibrillary acidic protein (GFAP) in spinal cord injury lesions. The levels of inflammatory cytokines (including IL-1ß and IL-6) and MDA in tissues were examined via Enzyme-linked immunosorbent assay (ELISA). In vitro experiments were also conducted in primary cultured astrocyte to explore the response of astrocyte to lipopolysaccharide (LPS). What's more, the PVT1-miR-186-5p interaction was verified via the dual luciferase activity assay and RNA immunoprecipitation (RIP) assay. The results demonstrated that the levels of PVT1, CXCL13 and CXCR5 were upregulated, while miR-186-5p were decreased in SCI rats' spinal cord and LPS-mediated astrocytes. In the SCI model, PVT1 depletion significantly alleviated neuropathic pain, astrocytic activation and reduced the expression of neuroinflammatory factors and proteins. The relevant mechanism studies confirmed that PVT1 is a competitive endogenous RNA (ceRNA) of miR-186-5p, targets and inhibits its expression and promotes the expression of CXCL13/CXCR5, while miR-186-5p targets CXCL13. In conclusion, inhibition of lncRNA PVT1 alleviates neuropathic pain in SCI rats by upregulating miR-186-5p and down-regulating CXCL13/CXCR5. The PVT1/miR-186-5p/CXCL13/CXCR5 axis can be used as a new therapeutic target for neuropathic pain.

Long-Noncoding RNA FGD5-AS1 Enhances the Viability, Migration, and Invasion of Glioblastoma Cells by Regulating the miR-103a-3p/TPD52 Axis.

PURPOSE: This study was designed to explore the functional role of FYVE, RhoGEF, and PH domain containing 5 antisense RNA 1 (FGD5-AS1) and the underlying regulatory mechanism in the progression of glioblastoma (GBM). MATERIALS AND METHODS: FGD5-AS1 expression was analyzed in The Cancer Genome Atlas (TCGA), and then detected in GBM tissues and cells by quantitative reverse-transcription polymerase chain reaction. Viability, migration, and invasion of GBM cells were assessed using the MTT, wound healing, and transwell assays, respectively. StarBase/TargetScan analysis and dual-luciferase reporter gene (DLR) assay were performed to investigate the relationship between FGD5-AS1/tumor protein D52 (TPD52) and miR-103a-3p. A xenograft tumor model was established to evaluate the role of FGD5-AS1 in GBM tumorigenesis in vivo. RESULTS: FGD5-AS1 was overexpressed in GBM tissues and cells, and silencing of FGD5-AS1 expression resulted in the inhibition of the viability, migration, and invasion of GBM cells. miR-130-3p was a target of FGD5-AS1, and its expression was negatively regulated by FGD5-AS1. Silencing miR-103a-3p expression resulted in the abrogation of the inhibitory effects of si-FGD5-AS1 on the viability, migration, and invasion of GBM cells. TPD52 was a target of miR-103a-3p and suppressed the antitumor effects of FGD5-AS1 silencing on GBM cells. In addition, FGD5-AS1 silencing inhibited the growth of xenograft tumors in vivo by modulating the miR-103a-3p/TPD52 axis. CONCLUSION: Silencing of FGD5-AS1 inhibited the viability, migration, and invasion of GBM cells by regulating the miR-103a-3p/TPD52 axis.

Endobronchial foreign body removal using fiberoptic bronchoscope together with gastroscope biopsy forceps: A case report.

RATIONALE: There are many difficult cases in the clinic because of the diversity of foreign bodies. The removal of a syringe cap is not so easy because there is always no hole at the closed end. PATIENT CONCERNS: A 54-year-old man suddenly developed dyspnea during his treatment in the hospital. DIAGNOSES: Foreign body in the left main bronchus. INTERVENTIONS: The foreign body was removed using fiberoptic bronchoscope together with gastroscope biopsy forceps. OUTCOMES: A repeat CT showed well inflation of left lung. LESSONS: The combined use of gastroscope biopsy forceps in trachea is more conducive to remove a foreign body similar to a syringe cap.

FOXK1 promotes cell growth through activating wnt/ß-catenin pathway and emerges as a novel target of miR-137 in glioma.

Glioma is the most common primary malignant brain tumor in adults. Forkhead box k1 (FOXK1) was reported to be dysregulated and play important roles in multiple human cancers. However, the expression pattern and roles of FOXK1 in glioma has never been investigated. In this study, we firstly observed that the expression of FOXK1 was significantly increased in glioma tissue samples and cell lines. Functional assays demonstrated that overexpression of FOXK1 promoted proliferation, cell cycle transition and inhibited apoptosis in glioma cell lines. On the contrary, knockdown of FOXK1 exhibited an opposite effect on glioma cells proliferation, cell cycle and apoptosis. Data of western blot indicated that FOXK1 overexpression increased while FOXK1 knockdown decreased the levels of ß-catenin, c-myc and cyclinD1 in glioma cells. Moreover, we demonstrated that FOXK1 was a novel target of miR-137 in glioma and FOXK1 restoration abolished the tumor suppressive effect of miR-137 in glioma cells. Statistical analysis showed that the mRNA level of FOXK1 was inversely correlated with miR-137 expression in glioma tissues. In conclusion, the present study demonstrated that FOXK1 promoted cell growth through activating wnt/ß-catenin pathway and is negatively regulated by miR-137 in glioma.

Statistics of extremes in oil spill risk analysis.

The Deepwater Horizon oil spill (DWH) in 2010 in the Gulf of Mexico is the largest accidental marine oil spill in the history of the petroleum industry. After DWH, key questions were asked: What is the likelihood that a similar catastrophic oil spill (with a volume over 1 million barrels) will happen again? Is DWH an extreme event or will it happen frequently in the future? The extreme value theory (EVT) has been widely used in studying rare events, including damage from hurricanes, stock market crashes, insurance claims, flooding, and earthquakes. In this paper, the EVT is applied to analyze oil spills in the U.S. outer continental shelf (OCS). Incorporating the 49 years (1964-2012) of OCS oil spill data, the EVT is capable of describing the oil spills reasonably well. The return period of a catastrophic oil spill in OCS areas is estimated to be 165 years, with a 95% confidence interval between 41 years and more than 500 years. Sensitivity tests indicate that the EVT results are relatively stable. The results of this study are very useful for oil spill risk assessment, contingency planning, and environmental impact statements on oil exploration, development, and production.

Three dimensional water quality modeling of a shallow subtropical estuary.

Knowledge of estuarine hydrodynamics and water quality comes mostly from studies of large estuarine systems. The processes affecting algae, nutrients, and dissolved oxygen (DO) in small and shallow subtropical estuaries are relatively less studied. This paper documents the development, calibration, and verification of a three dimensional (3D) water quality model for the St. Lucie Estuary (SLE), a small and shallow estuary located on the east coast of south Florida. The water quality model is calibrated and verified using two years of measured data. Statistical analyses indicate that the model is capable of reproducing key water quality characteristics of the estuary within an acceptable range of accuracy. The calibrated model is further applied to study hydrodynamic and eutrophication processes in the estuary. Modeling results reveal that high algae concentrations in the estuary are likely caused by excessive nutrient and algae supplies in freshwater inflows. While algal blooms may lead to reduced DO concentrations near the bottom of the waterbody, this study indicates that stratification and circulation induced by freshwater inflows may also contribute significantly to bottom water hypoxia in the estuary. It is also found that high freshwater inflows from one of the tributaries can change the circulation pattern and nutrient loading, thereby impacting water quality conditions of the entire estuary. Restoration plans for the SLE ecosystem need to consider both a reduction of nutrient loading and regulation of the freshwater discharge pattern.

Gene expression profiles of human osteosarcoma cell sublines with different pulmonary metastatic potentials.

AIM: to screen the pulmonary metastasis-associated molecules of Osteosarcoma and evaluate their functions concerning prognosis prediction. METHODS: cDNA microarray analysis has been applied to 2 pairs of osteosarcoma cell sublines with differential metastatic potentials to the lung. Immunohistochemistry and survival analysis have been performed to clinical samples of osteosarcoma patients. RESULT: Analysis detected 484 differentially expressed genes between the high metastatic subline, F5M2, and the low metastatic subline, F4. There were 1257 genes differentially expressed between newly established high-metastatic sublines named Saos-2M2 and its parental cell line Saos-2. Furthermore, 16 commonly up-regulated genes and 5 commonly down-regulated genes were identified by clustering analysis. EREG and CHST2, two genes not previously described in osteosarcoma, were finally seen to be differentially expressed in all examined osteosarcoma cell lines and in samples between the different prognosis sample groups. Survival analysis also confirmed these two molecules could be used to predict the outcome of OSA patients. CONCLUSION: This work represents a rationale approach to the evaluation of microarray data and will be useful to identify genes that may be causally associated with metastasis. EREG and CHST2 will be likely considered as clinical molecular markers to predict the outcome of OSA.

Expression of MDR1, HIF-1α and MRP1 in sacral chordoma and chordoma cell line CM-319.

BACKGROUND: Chordoma was a typically slow-growing tumor. The therapeutic approach to chordoma had traditionally relied mainly on surgical therapy. And the main reason for therapeutic failure was resistance to chemotherapy and radiotherapy. However the refractory mechanism was not clear. The aim of this study was to investigate the expression of three genes (MDR1, HIF-1α and MRP1) associated with resistance to chemotherapy and radiotherapy in chordoma and chordoma cell line CM-319. MATERIALS AND METHODS: Using immunohistochemical techniques, the expression of MDR1, HIF-1α and MRP1 was investigated in 50 chordoma specimen. Using RT-PCR and Western blot, the expression of MDR1, HIF-1α and MRP1 was investigated in chordoma and chordoma cell line CM-319. RESULTS: Expression of MDR1, HIF-1α and MRP1 was observed in 10%, 80% and 74% of all cases, respectively. Expression of MRP1 was correlated with HIF-1α. On the other hand, expression of MDR1 was not correlated with the expression of HIF-1α or MRP1. The expression of HIF-1α and MRP1 was observed, but MDR1 was not observed in chordoma and CM-319. CONCLUSION: Expression of HIF-1α and MRP1 was observed in most chordoma specimen and CM-319 cell line; expression of HIF-1α correlated with MRP1. HIF-1α and MRP1 may play a role in the multidrug resistance of chordoma to chemotherapy.

Use of physical sciences in support of environmental management.

Offshore drilling for oil and gas has been conducted since the early 1900s. Oil and gas under the seabed continue to be an important part of the energy resources of the United States. The need to balance the value of these resources against the potential for environmental damage is an important concern. This article explains why and how the Minerals Management Service (MMS) of the US Department of the Interior uses research in physical sciences to help fulfill its environmental goals, and it provides background information on the role of physical sciences in decision-making for Outer Continental Shelf (OCS) oil, gas, and other minerals development. Established in the 1970s, the MMS' Environmental Studies Program is a highly focused marine research program designed to provide the environmental information necessary for OCS energy and nonenergy minerals planning and development activities. The physical sciences research supported by MMS includes physical oceanography, oil-spill risk analyses, atmospheric sciences, and sand and gravel studies. Instead of giving a comprehensive review on physical sciences research in MMS, this article presents sample MMS studies and illustrates how these studies are utilized to support decision-making in environmental management.