Total glucosides of paeony alleviates cGAS-STING-mediated diseases by blocking the STING-IRF3 interaction.

In the realm of autoimmune and inflammatory diseases, the cyclic GMP-AMP synthase (cGAS) stimulator of interferon genes (STING) signaling pathway has been thoroughly investigated and established. Despite this, the clinical approval of drugs targeting the cGAS-STING pathway has been limited. The Total glucosides of paeony (TGP) is highly anti-inflammatory and is commonly used in the treatment of rheumatoid arthritis (RA), emerged as a subject of our study. We found that the TGP markedly reduced the activation of the cGAS-STING signaling pathway, triggered by various cGAS-STING agonists, in mouse bone marrow-derived macrophages (BMDMs) and Tohoku Hospital Pediatrics-1 (THP-1) cells. This inhibition was noted alongside the suppression of interferon regulatory factor 3 (IRF3) phosphorylation and the expression of interferon-beta (IFN-ß), C-X-C motif chemokine ligand 10 (CXCL10), and inflammatory mediators such as tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6). The mechanism of action appeared to involve the TGP's attenuation of the STING-IRF3 interaction, without affecting STING oligomerization, thereby inhibiting the activation of downstream signaling pathways. In vivo, the TGP hindered the initiation of the cGAS-STING pathway by the STING agonist dimethylxanthenone-4-acetic acid (DMXAA) and exhibited promising therapeutic effects in a model of acute liver injury induced by lipopolysaccharide (LPS) and D-galactosamine (D-GalN). Our findings underscore the potential of the TGP as an effective inhibitor of the cGAS-STING pathway, offering a new treatment avenue for inflammatory and autoimmune diseases mediated by this pathway.

The important role of EPS in mediated biosynthesis of CdS QDs: Comparative study of EPS-intact and EPS-free.

In this study, we investigated the adsorption of Cd(II) and the biosynthesis of CdS quantum dots (QDs) mediated by cells of sulfate-reducing bacteria before and after the removal of EPS to determine whether EPS or the cell wall plays a major role. Potentiometric titration revealed that the concentration of proton-active binding sites on cells with EPS (EPS-intact) was notably higher than that on cells without EPS (EPS-free) and that the sites were predominantly carboxyl, phosphoryl, hydroxyl, and amine groups. The protein content in EPS-intact cells was higher, and thus the Cd(II) adsorption capacity was stronger. The CdS QDs biosynthesized using EPS-intact possessed better properties, including uniform size distribution, good crystallinity, small particle size, high fluorescence, and strong antimicrobial activity, and the yields were significantly higher than those of EPS-free by a factor of about 1.5-3.7. Further studies revealed that alkaline amino acids in EPS play a major role and serve as templates in the biosynthesis of QDs, whereas they were rarely detected in the cell wall. This study emphasizes the important role of EPS in the bacterial binding of metals and efficient recycling of hazardous waste in water.

Ion-Concentration-Hopping Heterolayer Gel for Ultrahigh Gradient Energy Conversion.

Conventional solid ion channel systems relying on single one- or two-dimensional confined nanochannels enabled selective and ultrafast convective ion transport. However, due to intrinsic solid channel stacking, these systems often face pore-pore polarization and ion concentration blockage, thereby restricting their efficiency in macroscale ion transport. Here, we constructed a soft heterolayer-gel system that integrated an ion-selective hydrogel layer with a water-barrier organogel layer, achieving ultrahigh cation selectivity and flux and effectively providing high-efficiency gradient energy conversion on a macroscale order of magnitude. Specifically, the hydrogel layer featured an unconfined 3D network, where the fluctuations of highly hydrated polyelectrolyte chains driven by thermal dynamics enhanced cation selectivity and mitigated transfer energy barriers. Such chain fluctuation mechanisms facilitated ion-cluster internal transmission, thereby enhancing ion concentration hopping for more efficient ion-selective transport. Compared to the existing rigid nanochannel-based gradient energy conversion systems, such a heterogel-based power generator exhibited a record power density of 192.90 and 1.07 W/m2 at the square micrometer scale and square centimeter scale, respectively (under a 500-fold artificial solution). We anticipate that such heterolayer gels would be a promising candidate for energy separation and storage applications.

Low-Power Perovskite Neuromorphic Synapse with Enhanced Photon Efficiency for Directional Motion Perception.

The advancement of artificial intelligent vision systems heavily relies on the development of fast and accurate optical imaging detection, identification, and tracking. Framed by restricted response speeds and low computational efficiency, traditional optoelectronic information devices are facing challenges in real-time optical imaging tasks and their ability to efficiently process complex visual data. To address the limitations of current optoelectronic information devices, this study introduces a novel photomemristor utilizing halide perovskite thin films. The fabrication process involves adjusting the iodide proportion to enhance the quality of the halide perovskite films and minimize the dark current. The photomemristor exhibits a high external quantum efficiency of over 85%, which leads to a low energy consumption of 0.6 nJ. The spike timing-dependent plasticity characteristics of the device are leveraged to construct a spiking neural network and achieve a 99.1% accuracy rate of directional perception for moving objects. The notable results offer a promising hardware solution for efficient optoneuromorphic and edge computing applications.

Bicontinuous vitrimer heterogels with wide-span switchable stiffness-gated iontronic coordination.

Currently, it remains challenging to balance intrinsic stiffness with programmability in most vitrimers. Simultaneously, coordinating materials with gel-like iontronic properties for intrinsic ion transmission while maintaining vitrimer programmable features remains underexplored. Here, we introduce a phase-engineering strategy to fabricate bicontinuous vitrimer heterogel (VHG) materials. Such VHGs exhibited high mechanical strength, with an elastic modulus of up to 116 MPa, a high strain performance exceeding 1000%, and a switchable stiffness ratio surpassing 5 × 103. Moreover, highly programmable reprocessing and shape memory morphing were realized owing to the ion liquid-enhanced VHG network reconfiguration. Derived from the ion transmission pathway in the ILgel, which responded to the wide-span switchable mechanics, the VHG iontronics had a unique bidirectional stiffness-gated piezoresistivity, coordinating both positive and negative piezoresistive properties. Our findings indicate that the VHG system can act as a foundational material in various promising applications, including smart sensors, soft machines, and bioelectronics.

Removal efficiency of antibiotic residues, antibiotic resistant bacteria, and genes across parallel secondary settling tank and membrane bioreactor treatment trains in a water reclamation plant.

Antimicrobial resistance is recognized as a potent threat to human health. Wastewater treatment facilities are viewed as hotspots for the spread of antimicrobial resistance. This study provides comprehensive data on the occurrences of 3 different antibiotic resistant opportunistic pathogens (with resistance to up to 5 antibiotics), 13 antibiotic resistant genes and intI1, and 22 different antimicrobial residues in a large water reclamation plant (176 million gallons per day) that runs a conventional Modified Ludzack-Ettinger (MLE) reactor followed by a secondary settling tank (SST) and membrane bioreactor (MBR) in parallel. All the antibiotic resistant bacteria and most of the antibiotic resistance genes were present in the raw influent, ranging from 2.5 × 102-3.7 × 106 CFU/mL and 1.2× 10-1-6.5 × 1010 GCN/mL, respectively. MBR outperformed the SST system in terms of ARB removal as the ARB targets were largely undetected in MBR effluent, with log removals ranging from 2.7 to 6.8, while SST only had log removals ranging from 0.27 to 4.6. Most of the ARG concentrations were found to have significantly higher in SST effluent than MBR permeate, and MBR had significantly higher removal efficiency for most targets (p < 0.05) except for sul1, sul2, blaOXA48, intI1 and 16S rRNA genes (p > 0.05). As for the antibiotic residues (AR), there was no significant removal from the start to the end of the treatment process, although MBR had higher removal efficiencies for azithromycin, chloramphenicol, erythromycin, erythromycin-H2O, lincomycin, sulfamethoxazole and triclosan, compared to the SST system. In conclusion, MBR outperformed SST in terms of ARB and ARGs removal. However low removal efficiencies of most AR targets were apparent.

The combination of Schisandrin C and Luteolin synergistically attenuates hepatitis B virus infection via repressing HBV replication and promoting cGAS-STING pathway activation in macrophages.

BACKGROUND: HBV infection can result in severe liver diseases and is one of the primary causes of liver cell carcinoma-related mortality. Liuwei Wuling tablet (LWWL) is a traditional Chinese medicine formula, with a protecting liver and decreasing enzyme activity, usually used to treat chronic hepatitis B with NAs in clinic. However, its main active ingredients and mechanism of action have not been fully investigated. Hence, we aimed to screen the active ingredient and effective ingredient combinations from Liuwei Wuling tablet to explore the anti-herpatitis B virus activity and mechanism. METHODS: Analysis and screening of effective antiviral components in LWWL by network pharmacology, luteolin (Lut) may be a compound with significant antiviral activity. The mechanism of antiviral action of Lut was also found by real-time PCR detection and western blotting. Meanwhile, we established a co-culture model to investigate the antiviral mechanism of Schisandrin C (SC), one of the main active components of Schisandra chinensis fructus (the sovereign drug of LWWL). Next, HBV-infected mice were established by tail vein injection of pAAV-HBV1.2 plasmid and administered continuously for 20 days. And their antiviral capacity was evaluated by checking serum levels of HBsAg, HBeAg, levels of HBV DNA, and liver levels of HBcAg. RESULTS: In this study, we conducted network pharmacology analysis on LWWL, and through in vitro experimental validation and data analysis, we found that luteolin (Lut) possessed obviously anti-HBV activity, inhibiting HBV replication by downregulating hepatocyte nuclear factor 4α (HNF4α) via the ERK pathway. Additionally, we established a co-culture system and proved that SC promoted activation of cGAS-STINIG pathway and IFN-ß production in THP-1 cells to inhibit HBV replication in HepG2.2.15 cells. Moreover, we found the combination of SC and Lut shows a greater effect in inhibiting HBV compared to SC or Lut alone in HBV-infected mice. CONCLUSION: Taken together, our study suggests that combination of SC and Lut may be potential candidate drug for the prevention and treatment of chronic hepatitis B.

Machine learning based peri-surgical risk calculator for abdominal related emergency general surgery: a multicenter retrospective study.

BACKGROUND: Currently, there is a lack of ideal risk prediction tools in the field of emergency general surgery (EGS). The American Association for the Surgery of Trauma recommends developing risk assessment tools specifically for EGS-related diseases. In this study, we sought to utilize machine learning (ML) algorithms to explore and develop a web-based calculator for predicting five perioperative risk events of eight common operations in EGS. METHOD: This study focused on patients with EGS and utilized electronic medical record systems to obtain data retrospectively from five centers in China. Five ML algorithms, including Random Forest (RF), Support Vector Machine, Naive Bayes, XGBoost, and Logistic Regression, were employed to construct predictive models for postoperative mortality, pneumonia, surgical site infection, thrombosis, and mechanical ventilation >48 h. The optimal models for each outcome event were determined based on metrics, including the value of the Area Under the Curve, F1 score, and sensitivity. A comparative analysis was conducted between the optimal models and Emergency Surgery Score (ESS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and American Society of Anesthesiologists (ASA) classification. A web-based calculator was developed to determine corresponding risk probabilities. RESULT: Based on 10,993 patients with EGS, we determined the optimal RF model. The RF model also exhibited strong predictive performance compared with the ESS, APACHE II score, and ASA classification. Using this optimal model, we developed an online calculator with a questionnaire-guided interactive interface, catering to both the preoperative and postoperative application scenarios. CONCLUSIONS: We successfully developed an ML-based calculator for predicting the risk of postoperative adverse events in patients with EGS. This calculator accurately predicted the occurrence risk of five outcome events, providing quantified risk probabilities for clinical diagnosis and treatment.

A Self-Oscillated Organic Synapse for In-Memory Two-Factor Authentication.

Entering the era of AI 2.0, bio-inspired target recognition facilitates life. However, target recognition may suffer from some risks when the target is hijacked. Therefore, it is significantly important to provide an encryption process prior to neuromorphic computing. In this work, enlightened from time-varied synaptic rule, an in-memory asymmetric encryption as pre-authentication is utilized with subsequent convolutional neural network (ConvNet) for target recognition, achieving in-memory two-factor authentication (IM-2FA). The unipolar self-oscillated synaptic behavior is adopted to function as in-memory asymmetric encryption, which can greatly decrease the complexity of the peripheral circuit compared to bipolar stimulation. Results show that without passing the encryption process with suitable weights at the correct time, the ConvNet for target recognition will not work properly with an extremely low accuracy lower than 0.86%, thus effectively blocking out the potential risks of involuntary access. When a set of correct weights is evolved at a suitable time, a recognition rate as high as 99.82% can be implemented for target recognition, which verifies the effectiveness of the IM-2FA strategy.

Tissue accumulation of microplastics and potential health risks in human.

Microplastics have become ubiquitous throughout the environment. Humans constantly ingest and inhale microplastics, increasing concerns about the health risks of microplastic exposure. However, limited data impedes a full understanding of the internal exposure to microplastics. Herein, to evaluate microplastic exposure via the respiratory and digestive systems, we used laser direct infrared spectroscopy to identify microplastics >20 µm in size in different human tissues. Consequently, 20-100 µm microplastics were concentrated in all tissues, with polyvinyl chloride (PVC) being the dominant polymer. The highest abundance of microplastics was detected in lung tissue with an average of 14.19 ± 14.57 particles/g, followed by that in the small intestine, large intestine, and tonsil (9.45 ± 13.13, 7.91 ± 7.00, and 6.03 ± 7.37 particles/g, respectively). The abundance of microplastics was also significantly greater in females than in males (p < 0.05). Despite significant diversity, our estimation showed that the lungs accumulated the highest amounts of microplastic. Moreover, PVC particles may cause potential health risks because of their high polymer hazard index and maximal risk level. This study provides evidence regarding the occurrence of microplastics in humans and empirical data to support assessments of the health risks posed by microplastics.

An ultrasmall organic synapse for neuromorphic computing.

High-performance organic neuromorphic devices with miniaturized device size and computing capability are essential elements for developing brain-inspired humanoid intelligence technique. However, due to the structural inhomogeneity of most organic materials, downscaling of such devices to nanoscale and their high-density integration into compact matrices with reliable device performance remain challenging at the moment. Herein, based on the design of a semicrystalline polymer PBFCL10 with ordered structure to regulate dense and uniform formation of conductive nanofilaments, we realize an organic synapse with the smallest device dimension of 50 nm and highest integration size of 1 Kb reported thus far. The as-fabricated PBFCL10 synapses can switch between 32 conductance states linearly with a high cycle-to-cycle uniformity of 98.89% and device-to-device uniformity of 99.71%, which are the best results of organic devices. A mixed-signal neuromorphic hardware system based on the organic neuromatrix and FPGA controller is implemented to execute spiking-plasticity-related algorithm for decision-making tasks.

Study on inflammation and fibrogenesis in MAFLD from 2000 to 2022: a bibliometric analysis.

Chronic inflammation and fibrosis are significant factors in the pathogenesis of metabolic-associated fatty liver disease (MAFLD). In this study, we conducted a bibliometric analysis of publications on inflammation and fibrogenesis in MAFLD, with a focus on reporting publication trends. Our findings indicate that the USA and China are the most productive countries in the field, with the University of California San Diego being the most productive institution. Over the past 23 years, Prof. Diehl AM has published 25 articles that significantly contributed to the research community. Notably, the research focus of the field has shifted from morbid obesity and adiponectin to metabolic syndrome, genetics, and microbiome. Our study provides a comprehensive and objective summary of the historical characteristics of research on inflammation and fibrogenesis in MAFLD, which will be of interest to scientific researchers in this field.

A Bilayered Wood-Poly(3,4-ethylenedioxythiophene):Polystyrene Sulfonate Hydrogel Interfacial Evaporator for Sustainable Solar-Driven Sewage Purification and Desalination.

Solar-driven interfacial evaporation and purification is a promising solar energy conversion technology to produce clean water or solve water scarcity. Although wood-based photothermal materials have attracted particular interest in solar water purification and desalination due to their rapid water supply and great heat localization, challenges exist given their complicated processing methods and relatively poor stability. Herein, we propose a facile approach for fabricating a bilayered wood-poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (wood-PEDOT:PSS) hydrogel interfacial evaporator by direct drop-casting and dry-annealing. Benefiting from the unique combined merits of the wood-PEDOT:PSS hydrogel evaporator, i.e., excellent light absorption (~99.9%) and efficient photothermal conversion of nanofibrous PEDOT:PSS and the strong hydrophilicity and fast water transport from wood, the as-fabricated bilayered wood-PEDOT:PSS hydrogel evaporator demonstrates a remarkably high evaporation rate (~1.47 kg m-2 h-1) and high energy efficiency (~75.76%) at 1 kW m-2. We further demonstrate the practical applications of such an evaporator for sewage purification and desalination, showing outstanding performance stability and partial salt barrier capability against a continuous 10-day test in simulated seawater and an ultrahigh ion removal rate of 99.9% for metal ion-containing sewage. The design and fabrication of such novel, efficient wood-based interfacial evaporators pave the way for large-scale applications in solar water purification.

Hmga1-overexpressing lentivirus protects against osteoporosis by activating the Wnt/ß-catenin pathway in the osteogenic differentiation of BMSCs.

Postmenopausal osteoporosis is associated with bone formation inhibition mediated by the impaired osteogenic differentiation potential of bone marrow mesenchymal stem cells (BMSCs). However, identifying and confirming the essential genes in the osteogenic differentiation of BMSCs and osteoporosis remain challenging. The study aimed at revealing the key gene that regulated osteogenic differentiation of BMSCs and led to osteoporosis, thus exploring its therapeutic effect in osteoporosis. In the present study, six essential genes related to the osteogenic differentiation of BMSCs and osteoporosis were identified, namely, fibrillin 2 (Fbn2), leucine-rich repeat-containing 17 (Lrrc17), heat shock protein b7 (Hspb7), high mobility group AT-hook 1 (Hmga1), nexilin F-actin-binding protein (Nexn), and endothelial cell-specific molecule 1 (Esm1). Furthermore, the in vivo and in vitro experiments showed that Hmga1 expression was increased during the osteogenic differentiation of rat BMSCs, while Hmga1 expression was decreased in the bone tissue of ovariectomized (OVX) rats. Moreover, the expression of osteogenic differentiation-related genes, the activity of alkaline phosphatase (ALP), and the number of mineralized nodules were increased after Hmga1 overexpression, which was partially reversed by a Wnt signaling inhibitor (DKK1). In addition, after injecting Hmga1-overexpressing lentivirus into the bone marrow cavity of OVX rats, the bone loss, and osteogenic differentiation inhibition of BMSCs in OVX rats were partially reversed, while osteoclast differentiation promotion of BMSCs in OVX rats was unaffected. Taken together, the present study confirms that Hmga1 prevents OVX-induced bone loss by the Wnt signaling pathway and reveals that Hmga1 is a potential gene therapeutic target for postmenopausal osteoporosis.

Using model texts as a type of feedback in EFL writing.

Recent work has established that model texts could be employed as a useful feedback technique. However, few studies have employed argumentative writing tasks and analyzed draft quality, and little is known about the role played by the language analytic ability in using model texts. The current study aimed to investigate what Chinese EFL learners (n = 60) noticed at the composition and comparison (comparing their texts with model texts) processes in a four-stage argumentative writing task and explore to what degree model texts can enhance the learners' subsequent writing. The four stages were: (1) writing (pre-test); (2) comparing (treatment); (3) rewriting (immediate post-test); (4) delayed writing (delayed post-test). The findings showed that learners primarily noticed lexical features in the composition and comparison stages. Higher language analytic ability (LAA) learners and guided noticing learners could notice and elicit more information from the model texts. Overall, the use of model texts was effective in improving learners' writing by providing alternative elements associated with lexis, grammar, content, and organization. In addition, the beneficial effect of model texts on writing could be maintained after 1 week. Some pedagogical implications are put forward to help teachers make better use of model texts to improve learners' writing. This study also provides new insights into how language analytic ability affects the effectiveness of using models and provides more information on the type of learner most likely to benefit from model texts.

Mediated biosynthesis of CdS QDs by EPS from Desulfovibrio desulfuricans sub sp. under carbon source-induced reinforcement.

This paper describes a unique molecular mechanism for the EPS-mediated synthesis of CdS QDs by sulfate-reducing bacteria (SRB) under carbon source-induced reinforcement. Under the induced by carbon sources (HCOONa, CH3COONa and C6H12O6), there was a significant increase in EPS production of SRB, particularly in protein, and the capacity of Cd(II) adsorption was further enhanced. CdS QDs were extracellularly synthesized by adding S2- after Cd(II) adsorption. The results showed that CdS QDs were wrapped or adhered by EPS, and the most significant increase in Arg and Lys among basic amino acids in EPS after HCOONa-induced was 133.34% and 63.89%, respectively. This may serve as a biological template for QD synthesis, producing protein gels with a large number of microcavities and controlling the nucleation of CdS QDs. The highest yield of HCOONa-CdS was achieved after induction, with 23.59 g/g biomass per unit strain, which was 447.34% higher than that before induction and was at a high level in previous studies. The synthesized CdS QDs were uniform in size distribution and had higher luminescence activity and a larger specific surface area than those synthesized by the chemical synthesis route, provides a new idea for EPS treatment of heavy metal wastewater and metal biorecovery.

Inhibition of miR-6215 rescued low subchondral bone mass caused by maternal exposure to dexamethasone in female offspring rats.

Osteoporotic osteoarthritis is primarily associated with low subchondral bone mass. However, the mechanisms and therapeutic targets of osteoporotic osteoarthritis caused by prenatal dexamethasone exposure (PDE) in offspring remain unclear. In this study, pregnant Wistar rats were injected with dexamethasone to obtain bone tissue from fetal and postnatal rat offspring for analysis. Bone marrow mesenchymal stem cells (BMSCs) were isolated in vitro to elucidate the underlying molecular mechanisms. We determined in vivo that PDE reduced subchondral bone mass in adult female rat offspring, which originated from dysplasia of the subchondral bone. PDE led to a continuous increase in miR-6215 expression, accompanied by a decrease in FERM domain-containing protein 6 (FRMD6) expression. In vitro, dexamethasone upregulated miR-6215 expression through the glucocorticoid receptor, thereby inhibiting FRMD6 expression, promoting the translocation of yes-associated protein 1 (YAP1) into the nucleus of BMSCs, and downregulating downstream osteogenic marker genes. Finally, the rAAV-miR-6215 inhibitor rescued the low subchondral bone mass and osteoarthritis susceptibility caused by PDE in rat offspring. In conclusion, increased expression of miR-6215 mediates low subchondral bone mass caused by PDE through FRMD6/YAP1 signaling. Therefore, miR-6215 is a promising therapeutic target for PDE-induced low subchondral bone mass in offspring.

Microplastics transferring from abiotic to biotic in aquatic ecosystem: A mini review.

Microplastics have been detected in global aquatic ecosystems, so it is vital to understand the bioaccumulation and biomagnification of microplastics for ecological risk assessment. However, variability between studies, including sampling, pretreatment processes, and polymer identification methods have made it difficult to draw definitive conclusions. Alternatively, the compilation and statistical analysis of available experimental and investigation data provides insight into the fates of microplastics in an aquatic ecosystem. To reduce bias, we performed a systematic literature retrieval and compiled these reports on microplastic abundance in the natural aquatic environment. Our results indicate that microplastics are more abundant in sediments than in water, mussels, and fish. There is a significant correlation between mussels and sediments, but not between water and mussels or between water/sediment and fish. Bioaccumulation of microplastics appears to occur through water, but the route of biomagnification is unclear. More sound evidence is required to fully understand the biomagnification of microplastics in aquatic environments.

[Treatment of femoral neck fractures with closed reduction assisted by joystick technique and cannulated screw fixation].

Objective: To investigate the effectiveness of joystick technique assisted closed reduction and cannulated screw fixation in the treatment of femoral neck fracture. Methods: Seventy-four patients with fresh femoral neck fractures who met the selection criteria between April 2017 and December 2018 were selected and divided into observation group (36 cases with closed reduction assisted by joystick technique) and control group (38 cases with closed manual reduction). There was no significant difference in gender, age, fracture side, cause of injury, Garden classification, Pauwels classification, time from injury to operation, and complications (except for hypertension) between the two groups ( P>0.05). The operation time, intraoperative infusion volume, complications, and femoral neck shortening were recorded and compared between the two groups. Garden reduction index was used to evaluate the effect of fracture reduction, and score of fracture reduction (SFR) was designed and was used to evaluate the subtle reduction effect of joystick technique. Results: The operation was successfully completed in both groups. There was no significant difference in operation time and intraoperative infusion volume between the two groups ( P>0.05). All patients were followed up 17-38 months, with an average of 27.7 months. Two patients in the observation group received joint replacement due to failure of internal fixation during the follow-up, and the other patients had fracture healing. Within 1 week after operation, the Garden reduxtion index of the observation group was better than the control group; the SFR score of the observation group was also higher than that of the control group; the proportion of femoral neck shortening within 1 week after operation and at 1 year after operation in the observation group were lower than those in the control group. The differences of the above indexes between the two groups were significant ( P<0.05). Conclusion: The joystick technique can improve the effectiveness of closed reduction of femoral neck fractures and reduce the incidence of femoral neck shortening. The designed SFR score can directly and objectively evaluate the reduction effect of femoral neck fracture.

Comparative efficacy of aromatase inhibitors and gonadotropin-releasing hormone analogue in increasing final height of idiopathic short stature boys: a network meta-analysis.

Objective: To investigate the efficacy of monotherapy with AIs or GnRHa in improving the height of boys with idiopathic short stature (ISS). Method: We performed a systematic search in Pubmed, The Cochrane Library, Chinese National Knowledge Infrastructure databases, and Wanfang Database for eligible studies. The network meta-analysis was conducted using STATA software. Results: We identified a total of four studies that included 136 individuals. We used FAH/PAH as the main outcome of final height. The results revealed a statistically higher final height after treatment with AI or GnRHa in idiopathic short stature children(MD= 4.63, 95% CI[3.29,5.96]). In network meta-analysis, the direct and indirect comparison between AI and GnRHa was presented in the forest plot. Compared with control group, both AI and GnRHa were effective in increasing the final height, with the mean effect of 4.91(95%CI:1.10,8.17) and 5.55(95%CI:1.12,9.98) respectively. However, there was no statistical difference between the GnRHa and AI treatment, of which the mean effect was 0.65(95%CI: -4.30,5.60). Conclusion: Both AIs and GnRHa monotherapy were effective in augmenting the final height of boys with idiopathic short stature when compared to placebo groups. However, there was no statistical difference between the GnRHa and AI treatments.