Gentianine alleviates dextran sulfate sodium-induced ulcerative colitis via inhibition of TLR4/NLRP3-mediated pyroptosis.

OBJECTIVES: Ulcerative colitis (UC) is a common inflammatory bowel disorder. Gentiana scabra Bunge is a traditional medicinal plant that is used to treat a variety of diseases. Studies have shown that gentianine (GTN) from Gentiana scabra inhibits the development of inflammatory diseases. The purpose of this study was to investigate the effect and possible mechanism of action of GTN on UC in mice. METHODS: An animal model of UC was established using dextran sulfate sodium (DSS). Mice were administered intraperitoneally with GTN (12.5, 25, or 50 mg/kg/day) for seven days. Body weight and disease activity index (DAI) were monitored daily during GTN administration. Colon length, pathological changes, and myeloperoxidase (MPO) activity were measured following GTN administration. The signalling pathways regulated by GTN were analysed using machine learning. HT-29 cells were used to verify the effect and mechanism of action of GTN on UC in vitro. RESULTS: GTN suppressed weight loss, shortened colon length, alleviated colon injury, and reduced the DAI score and MPO activity of mice with UC in a dose-dependent manner. Further analysis showed that GTN inhibited the NOD-like receptor (NLR) signalling pathway. GTN markedly decreased the levels of NLR signalling pathway-related proteins. Moreover, GTN decreased the levels of pyroptosis-related proteins, IL-1ß and IL-18. The in vitro data were consistent with those of animal experiments. Furthermore, TLR4 and NLRP3 overexpression eliminated the protective effects of GTN in HT-29 cells. CONCLUSION: Gentianine alleviated DSS-induced UC by inhibiting TLR4/NLRP3-mediated pyroptosis.

Perioperative Protocol of Ankle Fracture and Distal Radius Fracture Based on Enhanced Recovery after Surgery Program: A Multicenter Prospective Clinical Controlled study.

Background: The enhanced recovery after surgery (ERAS) program is aimed to shorten patients' recovery process and improve clinical outcomes. This study aimed to compare the outcomes between the ERAS program and the traditional pathway among patients with ankle fracture and distal radius fracture. Methods: This is a multicenter prospective clinical controlled study consisting of 323 consecutive adults with ankle fracture from 12 centers and 323 consecutive adults with distal radial fracture from 13 centers scheduled for open reduction and internal fixation between January 2017 and December 2018. According to the perioperative protocol, patients were divided into two groups: the ERAS group and the traditional group. The primary outcome was the patients' satisfaction of the whole treatment on discharge and at 6 months postoperatively. The secondary outcomes include delapsed time between admission and surgery, length of hospital stay, postoperative complications, functional score, and the MOS item short form health survey-36. Results: Data describing 772 patients with ankle fracture and 658 patients with distal radius fracture were collected, of which 323 patients with ankle fracture and 323 patients with distal radial fracture were included for analysis. The patients in the ERAS group showed higher satisfaction levels on discharge and at 6 months postoperatively than in the traditional group (P < 0.001). In the subgroup analysis, patients with distal radial fracture in the ERAS group were more satisfied with the treatment (P=0.001). Furthermore, patients with ankle fracture had less time in bed (P < 0.001) and shorter hospital stay (P < 0.001) and patients with distal radial fracture received surgery quickly after being admitted into the ward in the ERAS group than in the traditional group (P=0.001). Conclusions: Perioperative protocol based on the ERAS program was associated with high satisfaction levels, less time in bed, and short hospital stay without increased complication rate and decreased functional outcomes.

Anterior Subcutaneous Transposition of the Ulnar Nerve Affects Elbow Range of Motion: A Mean 13.5 Years of Follow-up.

BACKGROUND: Surgical decompression of the ulnar nerve is effective for cubital tunnel syndrome. However, deep approaches may result in iatrogenic elbow stiffness. This long-term study was to evaluate the range of motion (ROM) of the elbow and functional outcomes after anterior subcutaneous transposition. METHODS: A total of 115 patients (78 male and 37 female; mean age: 46.6 years) who underwent anterior subcutaneous transposition of the ulnar nerve between 2001 and 2005 were evaluated retrospectively; mean follow-up was 13.5 years. Elbow ROM was measured as flexion arc, flexion, and extension preoperatively and at the final follow-up, and compared via a mixed analysis of variance adjusting for age. Neuropathy was assessed preoperatively using a modified McGowan neuropathy grade and postoperatively using modified Wilson-Krout criteria. An ordinal logistic regression analysis used postoperative modified Wilson-Krout criteria as the outcome and preoperative factors as predictors. RESULTS: Preoperative McGowan grades were Grade 1 in 14 patients (12.2%), Grade 2A in 28 (24.3%), Grade 2B in 53 (46.1%), and Grade 3 in 20 (17.4%) patients. Postoperatively, 66 patients (57.4%) had excellent results, 26 (22.6%) had good results, 16 (13.9%) had fair results, and 7 (6.1%) had poor results at the final follow-up, as per the Wilson-Krout criteria. There were no complications. Pre- and postoperative elbow ROM was significantly decreased in patients with previous trauma or surgery of the elbow compared with those without (P < 0.05). Anterior subcutaneous transposition of the ulnar nerve did not significantly affect elbow ROM regardless of previous trauma or surgical history nor preoperative ROM (P > 0.05), after adjusting for age. Patients with prolonged symptoms prior to surgery and worse neuropathy tended to have less satisfactory functional outcomes (P < 0.05), after adjusting for covariates. CONCLUSIONS: Anterior subcutaneous transposition of the ulnar nerve is an effective and reliable treatment of cubital tunnel syndrome with satisfactory outcomes and minimal effect on elbow ROM.

Demonstration of a fully integrated superconducting receiver with a 2.7 THz quantum cascade laser.

We demonstrate for the first time the integration of a superconducting hot electron bolometer (HEB) mixer and a quantum cascade laser (QCL) on the same 4-K stage of a single cryostat, which is of particular interest for terahertz (THz) HEB/QCL integrated heterodyne receivers for practical applications. Two key issues are addressed. Firstly, a low power consumption QCL is adopted for preventing its heat dissipation from destroying the HEB's superconductivity. Secondly, a simple spherical lens located on the same 4-K stage is introduced to optimize the coupling between the HEB and the QCL, which has relatively limited output power owing to low input direct current (DC) power. Note that simulation techniques are used to design the HEB/QCL integrated heterodyne receiver to avoid the need for mechanical tuning. The integrated HEB/QCL receiver shows an uncorrected noise temperature of 1500 K at 2.7 THz, which is better than the performance of the same receiver with all the components not integrated.

[The in vitro observational investigation of antibiotic coating on implants].

OBJECTIVES: To investigate the characteristics of antibiotic poly (D, L-lactide) (PDLLA) coating of implants, including its quantity, mechanical stability, sterility and antibiotic release in vitro. METHODS: The weight of the total coating mass was determined with an electronic semimicro balance before and after coating. Thickness of the coating was documented by scanning electronic microscopy. The stability and the loss of coating mass after implantation and extraction into the intramedullary canal was measured by electronic semimicro balance and the regularity and possible damage of the coating was examined by scanning electronic microscopy. Sterility of the coating procedure was tested by bacteria incubation. A group of coated implants were incubated in PBS to test the coating decrease and the release of gentamicin at different time points. RESULTS: The quantification of the total coating mass was (7.2 +/- 0.9) mg and the thickness of coating was (13.5 +/- 1.7) microm. After explantation of the coated implants from the tibia medullary, the mean loss of coating mass was (3.5 +/- 1.3)%. Scanning electronic microscopy confirmed no defects of the coating layer extending to the metallic surface in any implant. None of the tested samples presented bacterial growth after incubation on blood agar and tryptic soy broth. The PDLLA depicted a weight reduction of about 6.4% after 6 weeks. Within the first 4 h, the release of gentamicin experienced an initial peak period, then a constant and gradual release was found for at least 6 weeks. CONCLUSIONS: The antibiotic PDLLA coating on implants can meet the demands of the mechanical stability and sterility, and gentamicin releases quickly in the first hour and the release can last at least 6 weeks. These characteristics undoubtedly justify the feasibility of the coating usage in clinics.

[Evaluation of stability of distal radius fracture after conservative treatment].

OBJECTIVES: To evaluate the effect of conservative treatment on stability of different types of distal radius fracture so as to help select the optimal treatment of different distal radius fracture and verify the exact time when the patient need careful. METHODS: During the period of one year 103 consecutive patients of distal radius fracture were treated by closed reduction and below-elbow cast immobilization and standard PA in the emergency room and were followed up 1, 2, and 4 weeks after the initial visit until the casts were removed. Lateral radiographic examination was conducted before and after reduction and during the reexamination. All the images were saved in a working server in hospital. The patients were classified according to the Cooney classification system, then the displacement, palmar tilt, radial inclination and radial shortening in every film were measured accurately and involvement of radiocarpal joint surface was noted. Combined with the assessment by the Lindstrom grading system, the radiographic results were divided into 2 groups: accepted and unaccepted. Finally, Pearson Chi-square test, likelihood ratio test, and Kendall correlation analysis were used to testify the radiographic results of different Cooney types. RESULTS: Fractures of Cooney type 1, 2 and 3 achieved good results after non-operative treatment with the rates of accepted results of 90%, 88.5%, and 88.9% respectively. Only 28.1% of the type 4 fractures reached the accepted criteria. The general rate of accepted results among the 103 fracture patients was 69.9%. The general rate of accepted results of the 103 patients was 69.9%. The rates of accepted results of the Cooney type 1, 2, 3, and 4 fractures were 90.0%, 88.5%, 88.9%, and 28.1% respectively. The radiographic result was significantly correlated with the Cooney classification with a large Kendall coefficient. Displacement after closed reduction was found in 36.5% of the type 2 fractures and 65.6% of the type 4 fractures and a large majority of them displayed instability within a week after the closed reduction and cast immobilization. CONCLUSION: A large majority of the distal radius fractures can achieve good results after treatment by closed reduction and cast immobilization, especially those of type 1, 2, and 3, for which conservative treatment should be the first choice. However, type 4 fracture is extremely unstable and a large percentage of it fails to get satisfactory result by non-operative treatment, so operative treatment is better for it. Reexamination 1 - 2 weeks after the manipulation should be emphasized so as to adopt effective treatment in time.

[The role of CT in the diagnosis and treatment of distal radius fracture].

OBJECTIVES: To investigate and discuss the role of CT in the diagnosis and treatment of comminutive distal radius fractures. METHODS: One hundred and eleven consecutive patients (118 cases of fractures) who were admitted to Jishuitan hospital from January 2003 to January 2005 were included in this study. These patients all need operative treatment and accepted CT scans for better understandings of these injuries and helping to make operation plans. RESULTS: after comparing the results of X planes and CT scans, considerable differences existing between the two examinations were found in the measurements of articular compression and step-off, gapping, comminution degree and subdislocation. This difference was manifested not only in the alteration of quantity but also in the change of quality. CONCLUSIONS: Computed tomography can provide more vivid and detailed information of fractures for practitioners. Undoubtedly, CT is especially valuable in the evaluation of severity degree and stability of comminutive distal radius fractures, thus it helps us to determine whether operation is obligatory and choose the best method and approach of operation. Moreover, CT can also clearly show the important parts of fractures which need special attention in the process of operation. At the same time, practitioners are required to understand the indications of CT examination completely and know how to choose scan planes properly.