Exploring melatonin's multifaceted role in female reproductive health: From follicular development to lactation and its therapeutic potential in obstetric syndromes.

BACKGROUND: Melatonin is mainly secreted by the pineal gland during darkness and regulates biological rhythms through its receptors in the suprachiasmatic nucleus of the hypothalamus. In addition, it also plays a role in the reproductive system by affecting the function of the hypothalamic-pituitary-gonadal axis, and by acting as a free radical scavenger thus contributing to the maintenance of the optimal physiological state of the gonads. Besides, melatonin can freely cross the placenta to influence fetal development. However, there is still a lack of overall understanding of the role of melatonin in the reproductive cycle of female mammals. AIM OF REVIEW: Here we focus the role of melatonin in female reproduction from follicular development to delivery as well as the relationship between melatonin and lactation. We further summarize the potential role of melatonin in the treatment of preeclampsia, polycystic ovary syndrome, endometriosis, and ovarian aging. KEY SCIENTIFIC CONCEPTS OF REVIEW: Understanding the physiological role of melatonin in female reproductive processes will contribute to the advancement of human fertility and reproductive medicine research.

A robust multi-scale feature extraction framework with dual memory module for multivariate time series anomaly detection.

Although existing reconstruction-based multivariate time series anomaly detection (MTSAD) methods have shown advanced performance, most assume the training data is clean. When faced with noise or contamination in training data, they can also reconstruct the anomaly well, weakening the distinction between normal and anomaly. Some probabilistic generation-based methods have been used to address this issue because of their implicit robust structure to noise, but the training process and suppression of anomalous generalization are not stable. The recently proposed explicit method based on the memory module would also sacrifice the reconstruction effect of normal patterns, resulting in limited performance improvement. Moreover, most existing MTSAD methods use a single fixed-length window for input, which weakens their ability to extract long-term dependency. This paper proposes a robust multi-scale feature extraction framework with the dual memory module to comprehensively extract features fusing different levels of semantic information and lengths of temporal dependency. First, this paper designs consecutive neighboring windows as inputs to allow the model to extract local and long-term dependency information. Secondly, a dual memory-augmented encoder is proposed to extract global typical patterns and local common features. It ensures the reconstruction ability of normal data while suppressing the generalization of the anomaly. Finally, this paper proposes a multi-scale fusion module to fuse latent variables representing different levels of semantic information and uses the reconstructed latent variables to reconstruct samples for anomaly detection. Experimental results on five datasets from diverse domains show that the proposed method outperforms 16 typical baseline methods.

The causal associations of circulating lipids with Barrett's Esophagus and Esophageal Cancer: a bi-directional, two sample mendelian randomization analysis.

OBJECTIVE: The causal associations of circulating lipids with Barrett's Esophagus (BE) and Esophageal Cancer (EC) has been a topic of debate. This study sought to elucidate the causality between circulating lipids and the risk of BE and EC. METHODS: We conducted two-sample Mendelian randomization (MR) analyses using single nucleotide polymorphisms (SNPs) of circulating lipids (n = 94,595 - 431,167 individuals), BE (218,792 individuals), and EC (190,190 individuals) obtained from the publicly available IEU OpenGWAS database. The robustness and reliability of the results were ensured by employing inverse-variance weighted (IVW), weighted median, MR-Egger, and MR-PRESSO methods. The presence of horizontal pleiotropy, heterogeneities, and stability of instrumental variables were assessed through MR-Egger intercept test, Cochran's Q test, and leave-one-out sensitivity analysis. Additionally, bidirectional MR and multivariable MR (MVMR) were performed to explore reverse causality and adjust for known confounders, respectively. RESULTS: None of the testing methods revealed statistically significant horizontal pleiotropy, directional pleiotropy, or heterogeneity. Univariate MR analyses using IVW indicated a robust causal relationship between increased triglycerides and BE (odds ratio [OR] = 1.79, p-value = 0.009), while no significant association with EC was observed. Inverse MR analysis indicated no evidence of reverse causality in the aforementioned outcomes. In MVMR analyses, elevated triglycerides (TRG) were significantly and positively associated with BE risk (OR = 1.79, p-value = 0.041). CONCLUSION: This MR study suggested that genetically increased triglycerides were closely related to an elevated risk of BE, potentially serving as a biomarker for the diagnosis of BE in the future.

Nutritional strategies to reduce intestinal cell apoptosis by alleviating oxidative stress.

The gut barrier is the first line of defense against harmful substances and pathogens in the intestinal tract. The balance of proliferation and apoptosis of intestinal epithelial cells (IECs) is crucial for maintaining the integrity of the intestinal mucosa and its function. However, oxidative stress and inflammation can cause DNA damage and abnormal apoptosis of the IECs, leading to the disruption of the intestinal epithelial barrier. This, in turn, can directly or indirectly cause various acute and chronic intestinal diseases. In recent years, there has been a growing understanding of the vital role of dietary ingredients in gut health. Studies have shown that certain amino acids, fibers, vitamins, and polyphenols in the diet can protect IECs from excessive apoptosis caused by oxidative stress, and limit intestinal inflammation. This review aims to describe the molecular mechanism of apoptosis and its relationship with intestinal function, and to discuss the modulation of IECs' physiological function, the intestinal epithelial barrier, and gut health by various nutrients. The findings of this review may provide a theoretical basis for the use of nutritional interventions in clinical intestinal disease research and animal production, ultimately leading to improved human and animal intestinal health.

A filter-augmented auto-encoder with learnable normalization for robust multivariate time series anomaly detection.

While existing reconstruction-based multivariate time series (MTS) anomaly detection methods demonstrate advanced performance on many challenging real-world datasets, they generally assume the data only consists of normal samples when training models. However, real-world MTS data may contain significant noise and even be contaminated by anomalies. As a result, most existing approaches easily capture the pattern of the contaminated data, making identifying anomalies more difficult. Although a few studies have aimed to mitigate the interference of the noise and anomalies by introducing various regularizations, they still employ the objective of fully reconstructing the input data, impeding the model from learning an accurate profile of the MTS's normal pattern. Moreover, it is difficult for existing methods to apply the most appropriate normalization schemes for each dataset in various complex scenarios, particularly for mixed-feature MTS. This paper proposes a filter-augmented auto-encoder with learnable normalization (NormFAAE) for robust MTS anomaly detection. Firstly, NormFAAE designs a deep hybrid normalization module. It is trained with the backbone end-to-end in the current training task to perform the optimal normalization scheme. Meanwhile, it integrates two learnable normalization sub-modules to deal with the mixed-feature MTS effectively. Secondly, NormFAAE proposes a filter-augmented auto-encoder with a dual-phase task. It separates the noise and anomalies from the input data by a deep filter module, which facilitates the model to only reconstruct the normal data, achieving a more robust latent representation of MTS. Experimental results demonstrate that NormFAAE outperforms 17 typical baselines on five real-world industrial datasets from diverse fields.

Extracorporeal shock wave therapy inhibits osteoclast differentiation by targeting NF-κB signaling pathway.

BACKGROUND: Extracorporeal shock wave therapy (ESWT) has been reported to promote osteoblast differentiation. However, the role of ESWT on osteoclast differentiation is still elusive. METHODS: This study analyzed the differentiation of osteoclasts in the shock wave group and the control group in vitro, and TRAP staining, RT-PCR, WB assays, and MTT assays were assessed between the two groups. Furthermore, we analyzed the bone formation in these two groups in vivo and micro-CT and trap staining were assessed between the two groups. RESULTS: We found that ESWT inhibited osteoclast maturation in vitro and ESW treatment of femur promoted bone formation in vivo. Mechanically, osteoclast differentiation was inhibited as the number of impulses increased and ESWT decreased endogenous levels of NTAFc1 and P65 protein. CONCLUSIONS: ESWT may be a potential therapy of osteoporosis through NF-κB signaling pathway.

Maternal sodium acetate supplementation promotes lactation performance of sows and their offspring growth performance.

Milk yield and composition are critical determining factors for the early growth and development of neonates. The objective of this experiment was to comprehensively evaluate the effects of dietary sodium acetate (SA) supplementation on the milk yield and composition of sows and the growth performance of their offspring. A total of 80 sows (Landrace × Yorkshire, 3 to 6 parity) were randomly assigned to 2 groups (with or without 0.1% SA) from d 85 of gestation to d 21 of lactation. The result shows that maternal 0.1% SA supplementation significantly increased sows milk yield, milk fat, immunoglobulin A (IgA) and IgG content in milk (P < 0.05), with the up-regulation of short-chain fatty acids receptors (GPR41 and GPR43) expression and the activation of mammalian target of rapamycin complex C1 (mTORC1) signaling pathway. Consistently, in our in vitro experiment, SA also activated mTORC1 signaling in porcine mammary epithelial cells (P < 0.05). Furthermore, the improvement of milk quality and quantity caused by maternal SA supplementation led to the increase in body weight (BW) and average daily weight gain (ADG) of weaning piglets, with the improvement of gut health and colonization of the beneficial bacteria (P < 0.05). In conclusion, maternal supplementation of 0.1% SA improved the lactation performance (milk yield and milk fat) of sows, possibly with the activation of GPR41/GPR43-mTORC1 signaling. Furthermore, enhanced milk quality improved growth performance, gut health and the colonization of beneficial microbial flora of their piglets.

Exploring the Benefits of Probiotics in Gut Inflammation and Diarrhea-From an Antioxidant Perspective.

Inflammatory bowel disease (IBD), characterized by an abnormal immune response, includes two distinct types: Crohn's disease (CD) and ulcerative colitis (UC). Extensive research has revealed that the pathogeny of IBD encompasses genetic factors, environmental factors, immune dysfunction, dysbiosis, and lifestyle choices. Furthermore, patients with IBD exhibit both local and systemic oxidative damage caused by the excessive presence of reactive oxygen species. This oxidative damage exacerbates immune response imbalances, intestinal mucosal damage, and dysbiosis in IBD patients. Meanwhile, the weaning period represents a crucial phase for pigs, during which they experience pronounced intestinal immune and inflammatory responses, leading to severe diarrhea and increased mortality rates. Pigs are highly similar to humans in terms of physiology and anatomy, making them a potential choice for simulating human IBD. Although the exact mechanism behind IBD and post-weaning diarrhea remains unclear, the oxidative damage, in its progression and pathogenesis, is well acknowledged. Besides conventional anti-inflammatory drugs, certain probiotics, particularly Lactobacillus and Bifidobacteria strains, have been found to possess antioxidant properties. These include the scavenging of reactive oxygen species, chelating metal ions to inhibit the Fenton reaction, and the regulation of host antioxidant enzymes. Consequently, numerous studies in the last two decades have committed to exploring the role of probiotics in alleviating IBD. Here, we sequentially discuss the oxidative damage in IBD and post-weaning diarrhea pathogenesis, the negative consequences of oxidative stress on IBD, the effectiveness of probiotics in IBD treatment, the application of probiotics in weaned piglets, and the potential antioxidant mechanisms of probiotics.

First Report of Cercospora citrullina Causing Spot Disease on Watermelon in China.

Watermelon [Citrullus lanatus (Thunb.) Matsum. and Nakai], Cucurbitaceae family, is an important vegetable crop. It is believed to be native to Africa and is cultivated in the temperate regions of Africa, central Asia, Americas and the Mediterranean (Chomicki & Renner 2015). China is the largest producer and consumer of watermelon, with an annual production of about 60.25 million tons in 2020 (https://www.fao.org/faostat/en/#home). In May 2022, a new fungal disease was observed on the leaves, vines and fruits of watermelon (cv. Heimeiren, 8424, Qilin) with an incidence of up to 75% in greenhouses, in Gudi Industrial Park, Hanting district, Weifang City, Shandong Province, China. The symptomatic leaves, vines and fruits showed small circular black spots. The disease caused the leaves and vines to desiccate rapidly, and severely affected the fruit quality. Symptomatic leaves, vines and fruits were randomly collected, and isolations were performed from infected tissues. The edges of necrotic lesions were cut into small pieces (about 5 mm), surface sterilized with 2% NaClO for 2 min, followed by 75% ethanol for 30 s, rinsed three times in sterile distilled water and placed in Petri dishes on potato dextrose agar (PDA). The same fungus was isolated from all tissue pieces and formed colonies white fluffy on the surface, and dark gray on the reverse side after 7 days incubation at 25oC. Colonies were subcultured on PDA and Corn Meal Agar (CMA), respectively, and grew slowly (the diameter was approximately 2 cm in 10 days) on PDA showing a white edge, but they grew more rapidly on CMA (approximately 3.5 cm in diameter after 10 days incubation) showing an orange halo. Hyphae were branched, brown and smooth. Conidiophores were fasciculate, brown, straight, unbranched and measured 20.03 to 304.08 × 3.41 to 6.41 µm. Conidia were needle-shaped to clavate, colorless, erect or curved and measured 22.53 to 243.97 × 3.16 to 7.02 µm. According to these morphological characteristics, the fungus was tentatively identified as Cercospora spp. (Chupp 1954). To determine the species of the fungus, three representative isolates, UNL090101, UNL090102 and UNL090103 obtained from symptomatic leaves, vines and fruits, respectively, were characterized. The genomic DNA was extracted to amplify the nuclear ribosomal internal transcribed spacer (ITS) region, translation elongation factor 1-α (TEF-1), histone H3 (HIS), and actin (ACT) genes, using the following primer pairs ITS1/ITS4 (White et al. 1990), EF1-728F/EF1-986R (Carbone & Kohn 1999), CYLH3F/CYLH3R (Crous et al. 2004), ACT-512F/ACT-783R (Carbone & Kohn 1999), respectively. The ITS, EF-1, HIS, and ACT gene sequences were blasted and deposited in GenBank (accession numbers ON849061/OQ102622/OQ102623, ON890306/OQ108278/OQ108281, ON890307/OQ108279/OQ108282 and ON890308/OQ108280/OQ108283, respectively). A phylogenetic tree based on concatenated sequences of ITS-CAT-TEF-H3 from the genus Cerospora was constructed using the maximum likelihood method. Isolates from watermelon and C. citrullina formed a monophyletic group with 100% bootstrap support, which was in accordance with BLAST results. Therefore, the fungus associated to watermelon spot disease was identified as C. citrullina. To fulfill the Koch's postulates, each of the three isolates was artificially inoculated onto watermelon (cv. Qilin) detached expanded leaves, vines and fruits. Three wounds were made with sterilized entomological needles on each leaf, vine and fruit, and each wound was inoculated with 6 mm CMA medium with the fungus, and without fungus as control. All the experiments were conducted for three times. All the inoculated and control leaves were placed in an incubator and incubated at 28oC and 85% relative humidity, with a 12 h photoperiod. Three days after inoculation, the inoculated leaves showed similar symptoms to those observed on naturally infected plants, while the control leaves remained asymptomatic. C. citrullina was re-isolated from symptomatic artificially inoculated leaves and identified by microscopy and re-sequencing, thus fulfilling Koch's postulates. C. citrullina has been reported on several Cucurbitaceae plants worldwide, eg. on watermelon in South Carolina (Rennberger et al. 2019) and on Burcucumber (Sicyos angulatus L.) in Korea (Hong et al. 2014), but, to our knowledge, this is the first report of C. citrullina causing spot disease on watermelon in China.

Prevalence of osteoporosis in spinal surgery patients older than 50 years: A systematic review and meta-analysis.

INTRODUCTION: In spine surgery, poor bone condition is associated with several complications like adjacent segment fractures, proximal junctional kyphosis, and screw loosening. Our study explored the prevalence of osteoporosis in spinal surgery patients older than 50 years through a systematic review and meta-analysis. METHODS: This systematic review and meta-analysis were conducted according to the PRISMA criteria. Three electronic databases, including PubMed, EMBASE, and Web of Science, were searched from inception to August 2022. We used the random-effects model to calculate the overall estimates, and the heterogeneity was measured using Cochran's Q and I2 tests. Meta-regression and subgroup analyses were used to determine the source of the heterogeneity. RESULTS: Based on the inclusion and criteria, we chose ten studies with 2958 individuals for our analysis. The prevalence of osteoporosis, osteopenia, and osteoporosis/osteopenia in the spinal surgery patients was 34.2% (95%CI: 24.5%-44.6%), 43.5% (95%CI: 39.8%-47.2%), and 78.7% (95%CI: 69.0%-87.0%), respectively. Regarding different diagnoses, the prevalence was highest in patients with lumbar scoliosis (55.8%; 95%CI: 46.8%-64.7%) and the lowest in patients with cervical disc herniation (12.9%; 95%CI: 8.1%-18.7%). In age groups 50-59, 50-69,70-79, the prevalence was 27.8%, 60.4%, 75.4% in females, and 18.9%, 17.4%, 26.1% in males. CONCLUSIONS: This study showed a high prevalence of osteoporosis in patients undergoing spine surgery, especially in females, people of older age, and patients who received degenerative scoliosis and compression fractures. Current osteoporosis screening standards for patients undergoing spine surgery may not be adequate. Orthopedic specialists should make more efforts regarding preoperative osteoporosis screening and treatment.

Development and Determinants of Topsoil Bacterial and Fungal Communities of Afforestation by Aerial Sowing in Tengger Desert, China.

It was previously reported that afforestation in the desert can help improve soil texture, carbon accumulation, and nutrient status. However, the effects of afforestation on soil microbial composition, diversity, and microbial interactions with soil physicochemical properties have been rarely evaluated quantitatively. Using the method of space-for-time substitutions, we assessed the development and determinants of topsoil bacterial and fungal communities over nearly 40 years of successive afforestation by aerial sowing in Tengger Desert, China. The results showed that afforestation by aerial sowing comprised a considerable proportion of Chloroflexi and Acidobacteria in the bacterial community in addition to the ubiquitous phyla found in desert but had fewer effects on the dominant phyla of the fungal community. At the phylum level, the bacterial community was clearly clustered into two groups. However, it was difficult to differentiate the constituents of the fungal community based on principal coordinate analysis. The richness of the bacterial and fungal communities was significantly higher after five years than at zero years and three years. Additionally, the bacterial community varied parabolically and reached its largest size at twenty years, while the fungal community increased exponentially. Soil physicochemical properties were found to have divergent effects on the abundance and diversity of bacterial and fungal communities, among which salt- and carbon-associated properties (e.g., electrical conductivity, calcium, magnesium, total carbon, and organic carbon) were closely related with the abundance of bacterial-dominant phyla and the diversity of bacteria and fungi, but nutrient-associated properties (e.g., total phosphorus and available phosphorus) were not. The results indicate that afforestation through the salt secretions of plants leaves and carbon inputs from litter promote the development of topsoil bacterial and fungal communities in the desert.

Mechanistic insights into CDCP1 clustering on non-small-cell lung cancer membranes revealed by super-resolution fluorescent imaging.

CDCP1 is a transmembrane protein that is involved in a variety of important biological processes and upregulated in a variety of human solid malignancies; however, its spatial distribution and variation at the molecular level remain unclear. To solve this problem, we first analyzed its expression level and prognostic implications in lung cancer. Then, we used super-resolution microscopy to reveal the spatial organization of CDCP1 at different levels, and found that cancer cells generated more and larger CDCP1 clusters than normal cells. Furthermore, we found that CDCP1 can be integrated into larger and denser clusters as functional domains upon activation. Our findings elucidated the significant differences of CDCP1 clustering characteristics between cancer and normal cells, and revealed the relationship between its distribution and function, which will contribute to a comprehensive understanding of its oncogenic mechanism, and will be of great help for the development of CDCP1-targeted drugs for lung cancer.

Erratum: Mechanistic insights into CDCP1 clustering on non-small-cell lung cancer membranes revealed by super-resolution fluorescent imaging.

[This corrects the article DOI: 10.1016/j.isci.2023.106103.].

A retrospective review of non­intestinal­type adenocarcinoma of nasal cavity and paranasal sinus.

Non-intestinal adenocarcinoma of nasal cavity and paranasal sinuses (n-ITAC) is a heterogeneous tumor, which has rarely been reported in previous studies. Most high-grade n-ITAC has poor prognosis and there is a lack of classic therapeutic strategy. The present study examined using the PACS system of Nanfang Hospital of Southern Medical University between January 2000 and June 2020. It searched the keyword 'n-ITAC' and selected pathology. A total of 15 consecutive patients were searched. Finally, the present study analyzed a total of 12 n-ITAC patients. The follow-up time was 47 months on average. For low-grade (G1) tumors, 1 and 3-year overall survival (OS) rate were 100 and 85.7% respectively, while for high-grade (G3) tumors, 1 and 3-year OS rates were 80.0 and 20.0% respectively. Pathological grade may be an adverse prognostic factor (P=0.077). The OS of the surgery group was significantly superior to that of the non-surgery group (3-year OS was 63.6 vs. 0%, P=0.0009). Surgery is an indispensable means of treatment. The OS of patients with positive incisal margin was lower compared with that of patients with negative margin (P=0.186), suggesting that complete resection may be one of the prognostic factors. Patients with high risk factors received radiotherapy. The radiation dose was 66-70 Gy/33F for patients with positive margin or non-operation and was 60 Gy/28F for those with negative margin. Most of the patients received prophylactic irradiation of cervical area. Therefore, the prognosis of pathological high-grade n-ITAC is poor. Surgery is the most effective and an indispensable treatment for n-ITAC. For patients with high risk factors, surgery combined with radiotherapy may be a reasonable treatment. With regard to the cover range of radiotherapy, the primary tumor combined with lymph node drainage area is often used in Nanfang Hospital of Southern Medical University and the total dose of radiotherapy can be reduced if the surgical margin is negative.

Experimental Study on the Modular Vertical Greening Shading in Summer.

Previous studies have shown that vertical greening has a significant cooling and energy-saving effect, most of which are applied to opaque walls. However, windows are the critical factor contributing to the indoor thermal environment. This study developed a modular vertical greening shading device (MVGSD), and introduces its detailed structure: water supply mode, plant selection, and substrate preparation. To investigate the thermal performance of MVGSD, a structural model test was carried out. The results show that MVGSD has a noticeable effect on indoor temperature. Specifically, the greatest indoor temperature can be reduced by 4 °C and effectively low the concentration of CO2 (The CO2 absorption rate is 53.1%). In addition, the characteristics of the louver shading and MVGSD were compared, and it was found that the indoor temperature by using MVGSD is 2.6 °C lower than the louver. It is also worth mentioning that indoor humidity is improved by MVGSD, which has a beneficial effect on the thermal comfort of human beings.

The clinical outcomes of surgical treatment for chronic ankle instability by anatomical reconstruction of the anterior talofibular ligament with autologous half-bundle peroneal longus tendon: A retrospective study.

The anterior talofibular ligament is the weakest and most vulnerable lateral ligament to be injured, and it can replace anatomical position through anatomical reconstruction. The purpose of this study is to evaluate clinical outcomes after an autologous half-bundle peroneus longus tendon anatomical reconstruction. We conducted a retrospective analysis by enrolling 34 patients [22 male and 12 female, median age 21 (range 19-26) years] with anterior talofibular ligament injury from January 2018 to March 2020. All patients underwent a ligament anatomical reconstruction operation with autologous half-bundle peroneus longus tendon and followed up with an average time of 16.21 ± 3.20 (range 12-24) months, with no loss of patients to follow-up during the study period. The American Orthopedic Foot, Ankle Society Score (AOFAS), Visual Analogue Score (VAS), and Anterior Tibiotalar Translation were used to assess the curative effect. All the indexes were compared between the preoperative and at the final follow-up to discover the related statistical differences. The AOFAS score improved significantly from an average preoperative score of 56.91 ± 3.79 to 94.12 ± 2.51 at the final followed-up (p < 0.001). Meanwhile, the pre-operation VAS pain score decreased from 5.94 ± 1.32 to 1.71 ± 0.87 (p < 0.001). Additionally, the Anterior tibiotalar translation decreased from 16.40 ± 1.85 to 5.20 ± 0.57 mm at the final followed-up (p < 0.001). The anterior drawer test was negative for all patients after the operation. Considering the outcomes, we concluded that anatomical reconstruction of the anterior talofibular ligament with autologous half-bundle peroneal longus tendon was a proper and safe procedure for chronic lateral ankle instability, and it had good clinical results and minimal complications.

The effect of anteromedial support plate with three cannulated screws in the treatment of Pauwels type III femoral neck fracture in young adults.

PURPOSE: This study is aimed to evaluate the clinical effects of anteromedial support plate combined with three cannulated screws on Pauwels type III femoral neck fractures in young adults. METHODS: We conducted a retrospective study of 27 patients with Pauwels type III femoral neck fracture treated by anteromedial support plate combined with three cannulated screws. The results of fracture healing and complications for all patients were assessed by postoperative imaging examination. The Harris hip score was used to evaluate the functional outcome of the hip at the last follow-up. RESULTS: The fracture union was achieved in 25 patients (92.6%). However, two patients required reoperation (two for nonunion). Early implant failure occurred in one patient, neck shortening in one patient and coxa vara in one patient. The excellent or good outcome of the Harris hip score was 96% for the 25 patients with satisfactory fracture union. CONCLUSION: Our preliminary results indicate that anteromedial support plate combined with three cannulated screws is a good alternative in the treatment of Pauwels type III femoral neck fractures in young adults with high union rate and low incidence of complications including nonunion and avascular necrosis of the femoral head.

The study of distance changes between lumbar bi-cortical pedicle screws and anterior large vessels in patients with lumbar spondylolisthesis.

OBJECTIVE: This paper was a anatomical radiographic study of distance between lumbar bi-cortical pedicle screws (BPSs) and anterior large vessels (ALVs) in patients with lumbar spondylolisthesis, and to provide clinical basis for evaluating the safety of bi-cortical pedicle screw implantation during lumbar spondylolisthesis. METHODS: Complete Computed tomography (CT) data of 104 patients with grade I lumbar spondylolisthesis (L4 52 and L5 52) and 107 non-spondylolisthesis patients (control group) were collected in this study. The distances between lumbar 4,5(L4,5) and sacrum 1(S1) BPSs and ALVs (abdominal aorta, inferior vena cava, left and right common iliac artery, internal and external iliac artery) were respectively measured at different transverse screw angles (TSAs) (L4:5°,10°; L5:10°,15°; S1:0°,5°,10°) and analyzed by SPSS (v25.0). There were three types of distances from the anterior vertebral cortex (AVC) to the ALVs (DAVC-ALV): DAVC-ALV N, DAVC-ALV ≥ 0.50 cm, and DAVC-ALV < 0.50 cm; these different distances represented non-contact, distant and close ALV respectively. RESULTS: We calculated the incidences of screw tip contacting large vessels at different TSAs and provided the appropriate angle of screw implantation. In non-spondylolisthesis group, in L4, the appropriate left TSA was 5°, and the incidence of the close ALV was 4.62%. In S1, the appropriate left TSA was 0° and the incidence of the close ALV was 22.4%, while the appropriate right TSA was 10° and the incidence of the close ALV was 17.8%. In L4 spondylolisthesis group, in L4, the appropriate left TSA was 5°, and the incidence of the close ALV was 3.8%. In L5 spondylolisthesis group, in S1, the appropriate left TSA was 0° and the incidence of the close ALV was 19.2%, while the appropriate right TSA was 10° and the incidence of the close ALV was 21.2%. The use of BPS was not appropriate on the right side of L4 or on the either side of L5 both in spondylolisthesis and control group. In patients with lumbar 4 spondylolisthesis, the incidences of screw tip contacting large vessels were less than the control group in both L4 and 5. In patients with lumbar 5 spondylolisthesis, the incidences of screw tip contacting large vessels were less than the control group in L5, while there were no significant difference in S1. CONCLUSION: It is very important that considering the anatomical relationship between the AVC and the ALVs while planning BPSs. The use of BPS does not apply to every lumbar vertebra. In patients with lumbar spondylolisthesis and non-spondylolisthesis patients, the incidences of screw tip contacting large vessels are different.

Extracorporeal Shock Wave Therapy Promotes Osteogenic Differentiation in a Rabbit Osteoporosis Model.

Extracorporeal shock wave therapy (ESWT) has been identified to accelerate bone formation. However, detailed mechanism has not been fully explained. In this study, we found that ESWT promoted osteoblast formation in vitro. Local ESW treatment of femur increased bone formation in vivo. Furthermore, changing the density or frequency of energy, there was no statistical difference in osteogenic differentiation. Therapeutically, local ESW therapy relieved bone loss and increased the number of bone trabecular in a rabbit osteoporosis model and promoted endogenous levels of SMAD2 protein expression. Thus, ESWT may be a potential therapy by promoting osteoblast maturation through TGF-ß/SMAD2 pathway.

The traditional experience strategy (TES) and combined ultrasonography examination (CUE) for the treatment of lateral compression type 1 pelvic fractures: a historical control study.

BACKGROUND: It is difficult to judge the stability of lateral compression type-1 (LC-1) pelvic fracture, as it is often based on static images of the pelvis. Compared with the traditional experience strategy, ultrasonography examination may be able to distinguish operative and conservative patients before definitive treatment. However, in previous studies, we have not compared the outcomes between traditional experience strategy (TES group) and combined ultrasonography examination (CUE group). Thus, the aim of the study is comparing the differences between TES and CUE strategy, to identify the value of ultrasonography examination. METHODS: Medical records system for patients with LC-1 pelvic fractures who were treated with TES and CUE strategy were included. Patients' baseline characteristics, treatment strategy, and function were recorded at follow-up. Functional outcomes were evaluated using the Majeed grading system. RESULTS: In total, 77 patients with LC-1 pelvic fractures were included in the study. There were 42 and 35 patients in TES and CUE group, respectively. Compared to TES group (69 %), there were less proportion patients chosen the operative treatment in CUE group (43 %, P = 0.021). The volume of intraoperative blood loss in CUE operative group was more than TES operative group (P = 0.037). There were more patients with complete sacral fracture in CUE operative group than TES operative group (P = 0.002). The Majeed scores in CUE conservative group was higher than TES conservative group (P = 0.008). The overall Majeed scores in CUE group was higher than that in TES group (P = 0.039). CONCLUSIONS: The ultrasonography examination could relatively accurately identify the unstable LC-1 pelvis than the traditional experience strategy, the operative rate could be reduced and the overall function of LC-1 patients could be improved under the ultrasonography examination. LEVEL OF EVIDENCE: Level III.