A Robust Anti-Thermal-Quenching Phosphor Based on Zero-Dimensional Metal Halide Rb3InCl6:xSb3.

High-power phosphor-converted white light-emitting diodes (hp-WLEDs) have been widely involved in modern society as outdoor lighting sources. In these devices, due to the Joule effect, the high applied currents cause high operation temperatures (>500 K). Under these conditions, most phosphors lose their emission, an effect known as thermal quenching (TQ). Here, we introduce a zero-dimensional (0D) metal halide, Rb3InCl6:xSb3+, as a suitable anti-TQ phosphor offering robust anti-TQ behavior up to 500 K. We ascribe this behavior of the metal halide to two factors: (1) a compensation process via thermally activated energy transfer from structural defects to emissive centers and (2) an intrinsic structural rigidity of the isolated octahedra in the 0D structure. The anti-TQ phosphor-based WLEDs can stably work at a current of 2000 mA. The low synthesis cost and nontoxic composition reported here can herald a new generation of anti-TQ phosphors for hp-WLED.

A Luminescent Hybrid Bimetallic Halide Family with Solvent-Coordinated Rare Earth and Alkaline Earth Metals.

Hybrid metal halides are an extraordinary class of optoelectronic materials with extensive applications. To further diversify and study the in-depth structure-property relations, we report here a new family of 21 zero-dimensional hybrid bimetallic chlorides with the general formula A(L)n[BClm] (A=rare earth (RE), alkaline earth metals and Mn; L=solvent ligand; and B=Sb, Bi and Te). The RE(DMSO)8[BCl6] (RE=La, Ce, Sm, Eu, Tb, and Dy; DMSO=dimethyl sulfoxide) series shows broadband emission attributed to triplet radiative recombination from Sb and Bi, incorporating the characteristic emission of RE metals, where Eu(DMSO)8[BiCl6] shows a staggering PL quantum yield of 94 %. The pseudo-octahedral [SbCl5] with Cl vacancy in AII(DMSO)6[SbCl5] (AII=Mg, Ca and Mn) and the square pyramidal [SbCl5] in AII(TMSO)6[SbCl5] (TMSO=tetramethylene sulfoxide) enhance the stereoactive expression of the 5 s2 lone pairs of Sb3+, giving rise to the observation of dual-band emission of singlet and triplet emission, respectively. A series of Te(IV) analogues have been characterized, showing blue-light-excitable single-band emission. This work expands the materials space for hybrid bimetallic halides with an emphasis on harnessing the RE elements, and provides important insights into designing new emitters and regulating their properties.

One-Dimensional Organic-Inorganic Lead Bromide Hybrids with Excitation-Dependent White-Light Emission Templated by Pyridinium Derivatives.

Organic-inorganic hybrid metal halides have attracted widespread attention due to their excellent tunability and versatility. Here, we have selected pyridinium derivatives with different substituent groups or substitution positions as the organic templating cations and obtained six 1D chain-like structures. They are divided into three types: type I (single chain), type II (double chain), and type III (triple chain), with tunable optical band gaps and emission properties. Among them, only (2,4-LD)PbBr3 (2,4-LD = 2,4-lutidine) shows an exciton-dependent emission phenomenon, ranging from strong yellow-white to weak red-white light. By comparing its photoluminescence spectrum with that of its bromate (2,4-LD)Br, it is found that the strong yellow-white emission at 534 nm mainly came from the organic component. Furthermore, through a comparison of the fluorescence spectra and lifetimes of (2,4-LD)PbBr3 and (2-MP)PbBr3 (2-MP = 2-methylpyridine) with similar structures at different temperatures, we confirm that the tunable emission of (2,4-LD)PbBr3 comes from different photoluminescent sources corresponding to organic cations and self-trapped excitons. Density functional theory calculations further reveal that (2,4-LD)PbBr3 has a stronger interaction between organic and inorganic components compared to (2-MP)PbBr3. This work highlights the importance of organic templating cations in hybrid metal halides and the new functionalities associated with them.

IL2RB affects Th1/Th2 and Th17 responses of peripheral blood mononuclear cells from septic patients.

BACKGROUND: Immune dysfunction is a common and serious complication of sepsis. This study finds key genes linked to immunity in sepsis. METHODS: The "Limma package" was used to analyze GSE154918 datasets for differentially expressed genes. The differentially expressed genes were then enriched for Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway, and interleukin 2 receptor subunit Beta (IL2RB) protein coding gene was chosen for investigation. IL2RB expression in peripheral blood mononuclear cells (PBMC) was assessed by polymerase chain reaction. White blood cells of septic patients and healthy controls were collected from hospitals and linked with acute physiology and chronic health evaluation (APACHE) II, sequential organ failure assessment (SOFA), C-reactive protein (CRP), and procalcitonin (PCT) of septic patients using Pearson's correlation analysis. PBMC cells were transfected with IL2RB, and the effect of transfection was observed on cellular interferon gamma (IFN-γ), interleukin (IL)-12, IL-4, IL-10, and IL-17A. RESULTS: A total of 686 differential genes, comprising 446 upregulated and 240 down regulated genes, were identified. The enrichment of KEGG pathway revealed that the majority of differential genes were enriched in the T helper (Th1)/Th2 cell and Th17 cell differentiation pathways. In patients with sepsis, correlation analysis revealed a negative correlation between IL2RB and APACHE II score, SOFA score, CRP, and PCT. IFN-γ and IL-12 levels were elevated in PBMC of septic patients after IL2RB transfection, but IL-4, IL-10, and IL-17A levels were lowered. CONCLUSION: Sepsis-induced immunological dysfunction is improved by IL2RB, which also balances Th1/Th2 responses and prevents Th17 activation. © 2023 Codon Publications. Published by Codon Publications.

Hybrid Double Perovskite Derived Halides Based on Bi and Alkali Metals (K, Rb): Diverse Structures, Tunable Optical Properties and Second Harmonic Generation Responses.

Double perovskites (DP) have attracted extensive attention due to their rich structures and wide application prospects in the field of optoelectronics. Here, we report 15 new Bi-based double perovskite derived halides with the general formula of A2 BBiX6 (A=organic cationic ligand, B=K or Rb, X=Br or I). These materials are synthesized using organic ligands to coordinate with metal ions with a sp3 oxygen, and diverse structure types have been obtained with distinct dimensionalities and connectivity modes. The optical band gaps of these phases can be tuned by changing the halide, the organic ligand and the alkali metal, varying from 2.0 to 2.9 eV. The bromide phases exhibit increasing photoluminescence (PL) intensity with decreasing temperature, while the PL intensity of iodide phases changes nonmonotonically with temperature. Because the majority of these phases are non-centrosymmetric, second harmonic generation (SHG) responses are also measured for selected non-centrosymmetric materials, showing different particle-size-dependent trends. Our findings give rise to a series of new structural types to the DP family, and provide a powerful synthetic handle for symmetry breaking.

The interplay between ABA/ethylene and NAC TFs in tomato fruit ripening: a review.

KEY MESSAGE: This review contains functional roles of NAC transcription factors in the transcriptional regulation of ripening in tomato fruit, describes the interplay between ABA/ethylene and NAC TFs in tomato fruit ripening. Fruit ripening is regulated by a complex network of transcription factors (TFs) and genetic regulators in response to endogenous hormones and external signals. Studying the regulation of fruit ripening has important significance for controlling fruit quality, enhancing nutritional value, improving storage conditions and extending shelf-life. Plant-specific NAC (named after no apical meristem (NAM), Arabidopsis transcription activator factor 1/2 (ATAF1/2) and Cup-shaped cotyledon (CUC2)) TFs play essential roles in plant development, ripening and stress responses. In this review, we summarize the recent progress on the regulation of NAC TFs in fruit ripening, discuss the interactions between NAC and other factors in controlling fruit development and ripening, and emphasize how NAC TFs are involved in tomato fruit ripening through the ethylene and abscisic acid (ABA) pathways. The signaling network regulating ripening is complex, and both hormones and individual TFs can affect the status or activity of other network participants, which can alter the overall ripening network regulation, including response signals and fruit ripening. Our review helps in the systematic understanding of the regulation of NAC TFs involved in fruit ripening and provides a basis for the development or establishment of complex ripening regulatory network models.

Physiological and metabolic analysis of winter jujube after postharvest treatment with calcium chloride and a composite film.

BACKGROUND: Ziziphus jujuba Miller cv. Dongzao is extremely susceptible to reddening, browning, nutritional loss, and perishability after harvest. In this study, we evaluated the mechanisms of calcium chloride and chitosan/nano-silica composite film treatments on the quality, especially in reddening, by physiological and metabolomic assays. RESULTS: The treatment delayed the decline of phenylalanine ammonia-lyase (PAL), chalcone synthase (CHS), and chalcone isomerase (CHI) activities. Meanwhile, the treated groups retarded the increases in anthocyanin and quercetin contents by inhibiting the gene expressions of flavonol synthase (ZjFLS), dihydroflavonol 4-reductase (ZjDFR), and anthocyanidin synthase (ZjANS), while promoting leucoanthocyanidin reductase (ZjLAR) expression, which leads to retardation of fruit reddening. Anthocyanins were found to be responsible for post-harvest winter jujube reddening through principal component analysis. Results from the technique for order preference by similarity to an ideal solution indicated that the treated group delayed the decline of the quality of 'Dongzao' and extended its shelf life. CONCLUSION: The treatment induced the heightening of flavonoids metabolism. They enhanced the nutritional value and the ability to resist stress by delaying the decline of PAL, CHS, and CHI activities. Meanwhile, the treated groups retarded the increase in anthocyanin and quercetin contents by inhibiting the gene expressions of ZjFLS, ZjDFR, and ZjANS and promoting ZjLAR expression, which leads to retardation of fruit reddening. Anthocyanins are responsible for post-harvest winter jujube reddening. Coating treatment effectively delayed the decline of winter jujube quality. © 2020 Society of Chemical Industry.

Efficacy and safety of dexmedetomidine versus propofol for the sedation of tube-retention after oral maxillofacial surgery.

PURPOSE: To compare the safety and efficacy of sedation induced by dexmedetomidine and propofol after oral and maxillofacial surgery. MATERIALS AND METHODS: In this trial, 66 patients 18 to 50 years old received oral and maxillofacial surgery and required postoperative nasal endotracheal intubation under overnight sedation with dexmedetomidine or propofol. The dexmedetomidine group (group D) received dexmedetomidine 1.0 µg/kg intravenously for 10 minutes after entering the recovery room. The dose was maintained by giving an intravenous injection of dexmedetomidine 0.4 µg/kg. The injection rate could be modulated from 0.2 to 0.7 µg/kg/hour in the intensive care unit (ICU). If the Ramsay score was lower than 2 and involuntary limb movement occurred, other sedatives were used. The propofol group (group P) was given propofol 0.1 mg/kg intravenously for 10 minutes after entering the recovery room and then maintained with intravenous injections of propofol 1 to 2 mg/kg/hour in the recovery room and ICU. RESULTS: The oxygen desaturation of group P was higher than that of group D (at the first sedation time of 30 minutes), but the mean blood pressure of group P was significantly lower than that of group D at the 10-minute time point. The Ramsay score was higher in group D after the first 3 hours of sedation than in group P (P < .05). CONCLUSION: Dexmedetomidine showed similar safety and efficacy as propofol and could be used for tube-retaining sedation after oral and maxillofacial surgery.

Biomechanical analysis of the calcaneocuboid joint pressure after sequential lengthening of the lateral column.

BACKGROUND: Lengthening of the lateral column by means of the Evans osteotomy is commonly used for reconstruction of adult and pediatric flatfoot. However, some reports have shown that the Evans osteotomy is linked with increased calcaneocuboid joint pressures and an increased risk of arthritis in the joint. The purpose of this study was to measure the pressure across the calcaneocuboid joint and demonstrate the changing trends of the pressure within the calcaneocuboid joint after sequential lengthening of the lateral column. METHODS: Six cadaver specimens were physiologically loaded and the peak pressure of the calcaneocuboid joint was measured under the following conditions: (1) normal foot, (2) flatfoot, and (3) sequential lengthening of the lateral column by means of the Evans procedure (from 4 mm to 12 mm, in 2 mm increments). RESULTS: Peak pressures across the joint increased significantly from baseline in the flatfoot (P < .05). In the corrected foot, with the increment of the graft, the peak pressure decreased initially and then increased. The pressure reached its minimum value (11.04 ± 1.15 kg/cm(2)) with 8 mm lengthening of the lateral column. The differences were significant compared to the flatfoot (P < .05) and corrected foot with the other sizes of grafts (P < .05), but differences were not significant compared to the intact foot (P = .143). CONCLUSIONS: Lateral column lengthening within a certain extent will decrease the pressure in calcaneocuboid joint with a flatfoot deformity. CLINICAL RELEVANCE: Performing the procedure with an 8 mm lengthening may reduce the risk of the secondary calcaneocuboid osteoarthritis.

Treating open tibular fracture (Type gustillo IIIA) with medullary nail assisted by cortex screws: A case report.

BACKGROUND: Open fractures of the tibia are mostly caused by high-energy injuries, accompanied by severe soft tissue injuries. Staged operations are reported performing better prognosis in these cases. CASE SUMMARY: The author reports a case of open comminuted fracture of the left tibia (GustilloIIIA) and discusses its clinical features and treatment experience with the literature. The patient was admitted to our hospital by an ambulance for half an hour due to pain in her left leg caused by a car collision on an electric bike. During hospitalization, external fixation and an intramedullary nail were sequential used. CONCLUSION: The case report suggests that cortex screws are likely benefit the prognosis of severe open tibial fracture.

Na, K-ATPase α1 cooperates with its endogenous ligand to reprogram immune microenvironment of lung carcinoma and promotes immune escape.

Dysregulated endocrine hormones (EHs) contribute to tumorigenesis, but how EHs affect the tumor immune microenvironment (TIM) and the immunotherapy of non-small cell lung cancer (NSCLC) is still unclear. Here, endogenous ouabain (EO), an adrenergic hormone, is elevated in patients with NSCLC and closely related to tumor pathological stage, metastasis, and survival. EO promotes the suppression of TIM in vivo by modulating the expression of immune checkpoint proteins, in which programmed cell death protein ligand 1 (PD-L1) plays a major role. EO increases PD-L1 transcription; however, the EO receptor Na- and K-dependent adenosine triphosphatase (Na, K-ATPase) α1 interacts with PD-L1 to trigger the endocytic degradation of PD-L1. This seemingly contradictory result led us to discover the mechanism whereby EO cooperates with Na, K-ATPase α1 to finely control PD-L1 expression and dampen tumoral immunity. In conclusion, the Na, K-ATPase α1/EO signaling facilitates immune escape in lung cancer, and manipulation of this signaling shows great promise in improving immunotherapy for lung adenocarcinoma.

Fusion of talonavicular and naviculocuneiform joints for the treatment of Müller-Weiss disease.

Müller-Weiss disease is a rare spontaneous osteonecrosis of the tarsal and navicular bones in adults. From April 2008 to April 2011, we treated 7 patients with Müller-Weiss disease by surgical fusion of the talonavicular and naviculocuneiform joints with tricortical autologous iliac crest block fixated by screws and plate. Preoperative and postoperative clinical outcomes were evaluated with the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale. The median follow-up time was 22 (range 3 to 38) months. All of the operated feet fused solidly. The median time for solid fusion was 13 (range 12 to 16) weeks. The median American Orthopaedic Foot and Ankle Society ankle-hindfoot score improved from 49 (range 15 to 66) points preoperatively to 82 (range 68 to 87) points at last follow-up. The results suggest that this type of fusion is an effective surgical treatment for Müller-Weiss disease.

Nutcracker fracture of the cuboid: management and results.

Nutcracker fractures of the cuboid are rare and often missed at an initial visit. They can be difficult to manage and convey a high risk of long-term pain in the foot. During the last six years, 6 recent cuboid fractures in 6 patients were treated at our hospital by open reduction, allogeneic bone grafting (where necessary) and internal fixation. Shortening of the lateral column of the foot existed in all these fractures. At the time of follow-up the results concerning pain and function were good in 2 and fair in 4 patients. We recommend open treatment for cuboid fractures with shortening of the lateral column of the foot or articular displacement of more than 1 mm.

[Surgical treatment for Müller-Weiss disease].

OBJECTIVE: To discuss operative methods and effects for Müller-Weiss disease. METHODS: From March 2005 to May 2011, 15 patients were operated. There were 2 males and 13 females, with an average age of 51.8 years (range, 26 to 62 years). The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was (42 ± 13) points. According to the Maceira Staging system, 1 foot was grade 2, 6 feet were grade 3, 4 feet were grade 4, and 4 feet were grade 5. The technique consisted of arthrodesis of the talonaviculocuneiform joints with plate, arthrodesis of the talonavicular joint and arthrorisis of naviculocuneiform joint with plate, or triple arthrodesis with screws, according to the preoperative evaluation. RESULTS: Ten feet were treated with arthrodesis of the talonaviculocuneiform joints, 3 feet were treated with arthrodesis of the talonavicular joint and arthrorisis of naviculocuneiform joint and 2 feet were treated with triple arthrodesis. Two patients were lost to follow-up. The average follow-up after operation was 19.2 months (range, 9 to 38 months). All feet were solid fusion and the average duration of union was 13.3 weeks (range, 12-16 weeks). The AOFAS ankle-hindfoot score at the last follow-up was (83 ± 6) points. Two feet were excellent, 10 feet were good, and 1 foot was fair. The length of feet was (14.2 ± 1.0) cm before surgery and (15.7 ± 0.9) cm at the last follow-up (t = 11.570, P < 0.05). The Meary's angle was -6.1° ± 13.1°before surgery and 1.1° ± 3.0° at the last follow-up (t = 2.248, P < 0.05). The talocalcaneal angle was 4.5° ± 2.2° before surgery and 18.0° ± 4.0° at the last follow-up (t = 11.700, P < 0.05). One foot had breakage of the plate and screws at arthrorisis of naviculocuneiform joint and none had complications related to the incision. CONCLUSION: Operations for Müller-Weiss disease, according to concrete conditions using different therapeutic program, may achieve a satisfactory outcome.

Regulating Thermogalvanic Effect and Mechanical Robustness via Redox Ions for Flexible Quasi-Solid-State Thermocells.

The design of power supply systems for wearable applications requires both flexibility and durability. Thermoelectrochemical cells (TECs) with large Seebeck coefficient can efficiently convert low-grade heat into electricity, thus having attracted considerable attention in recent years. Utilizing hydrogel electrolyte essentially addresses the electrolyte leakage and complicated packaging issues existing in conventional liquid-based TECs, which well satisfies the need for flexibility. Whereas, the concern of mechanical robustness to ensure stable energy output remains yet to be addressed. Herein, a flexible quasi-solid-state TEC is proposed based on the rational design of a hydrogel electrolyte, of which the thermogalvanic effect and mechanical robustness are simultaneously regulated via the multivalent ions of a redox couple. The introduced redox ions not only endow the hydrogel with excellent heat-to-electricity conversion capability, but also act as ionic crosslinks to afford a dual-crosslinked structure, resulting in reversible bonds for effective energy dissipation. The optimized TEC exhibits a high Seebeck coefficient of 1.43 mV K-1 and a significantly improved fracture toughness of 3555 J m-2, thereby can maintain a stable thermoelectrochemical performance against various harsh mechanical stimuli. This study reveals the high potential of the quasi-solid-state TEC as a flexible and durable energy supply system for wearable applications.

A systematic review of outcome and failure rate of uncemented Scandinavian total ankle replacement.

PURPOSE: The purpose of this study was to provide cumulative data about the intermediate to long-term outcome of Scandinavian total ankle replacement (STAR) in the literature and to provide a summary of survival rate, implant failure rate and reasons. METHODS: A comprehensive search for all relevant articles published in English and German from January 1995 to May 2011 was conducted. Two reviewers evaluated each study to determine whether it was eligible for inclusion and, if so, collected data of interest. The intermediate to long-term outcomes were determined. Evidence-based meta-analytic pooling of results across studies was performed to determine survival and failure rates. RESULTS: Sixteen primary studies with 2,088 implants were identified. The mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 77.8 points, and the mean Kofoed ankle score was 76.4 points. The pooled mean five year survival rate was 85.9% [95% confidence interval (CI) 80.9-90.3], and the pooled mean ten year survival rate was 71.1% (95% CI 60.9-81.5). Pooled failure rate was 11.1% (95% CI 7.6 -14.9), with a mean follow-up time of 52 months; 41% failed within one year of initial operation. The first three reasons associated with implant failure were aseptic loosening (5.2%), malalignment (1.7%) and deep infection (1.0%). CONCLUSIONS: We found that STAR prosthesis achieved encouraging results in terms of intermediate to long-term outcome. The five and ten year survival rates were acceptable. However, the failure rate was still high. The major reasons for implant failure were aseptic loosening and malalignment. Maybe the increase of surgeons' experience and patient selection could improve outcomes and decrease failure rate.

[Surgical treatment of flatfoot resulting from calcaneal fractures malunion].

OBJECTIVE: To explore the operative approach and efficacy of flatfoot after calcaneal fractures malunion. METHODS: A total of 116 flatfoot patients after old calcaneal fractures were treated from January 1998 to January 2008. There were 94 males and 22 females with an average age of 33.5 years old (range: 16 - 46). They included unilateral flatfoot after old calcaneal fractures (n = 110) and bilateral flatfoot after old calcaneal fractures (n = 6). The surgical treatments included open reduction, calcaneal osteotomy without subtalar fusion or a reconstruction of calcaneal thalamus and subtalar arthrodesis. RESULTS: A total of 101 patients were followed up for an average of 14 months (range: 12 - 24). No wound healing problem or infection was observed. Solid union was obtained without redislocation in all patients. The mean time of bone union was 12 weeks (range: 10 - 14). The mean time of complete weight loading was 13 weeks (range: 11 - 15 weeks). The height of foot arch increased from 4.2 mm ± 1.7 mm to 14.1 mm ± 4.1 mm (P < 0.05). Calcaneal inclination angle increased from 11.2° ± 2.5° to 19.1° ± 4.4° (P < 0.05). Bohler angle increased from 5.4° ± 3.5° to 25.8° ± 5.2° (P < 0.05). Meary angle recovered from 22.2° ± 4.4° to 5.1° ± 3.2° (P < 0.05). The mean AOFAS Ankle and Hindfoot score increased from 33.4 (range: 27 - 43) to 85.8 (range: 78 - 98). CONCLUSION: As to flatfoot after old calcaneal fractures, surgical treatment has a favorable efficacy. A customized operative approach may achieve a satisfactory outcome.

[Characteristics and surgical treatment of combined calcaneal fractures].

OBJECTIVE: To discuss the characteristics and experience for surgical treatment of combined calcaneal fracture. METHODS: Between February 2004 and September 2007, 17 feet of 13 patients with combined calcaneal fractures underwent surgical operations. Among 17 calcaneal fractures, 8 combined with ipsilateral talus fractures, 5 combined with trimalleolar fractures, 4 combined with Pilon fractures. Firstly, fractures of hinder foot were treatment with open reduction and internal fixation according to the principle. Of all, 15 fractures were treated with screws or titanic plate plus open reduction and internal fixation, the rest 2 fractures were treated with subtalar arthrodesis. Postoperative X-ray assessed the internal fixation and union of fractures. The foot function was evaluated by the Maryland Foot Score. RESULTS: A total of 13 patients were all followed up for 16.0 - 33.0 months (average 26.5 months), superficial infection was found in a patient with open wound 10 d after surgery. All the bone fractures united after surgery from 4 to 6 months. Morphous improvement of the calcaneal were proved by X-ray films and there here was no plates and screws' breakage, loosening. Mild osteoarthritis in Subtalar and ankle joints were found by X-ray after surgery from 9 months to last follow-up. Cystic degeneration and necrosis were found in 5 and 2 cases of talus fractures respectively. According to Maryland Foot Score, excellent was in 3 feet, good in 6 feet, fare in 5 feet and poor in 3 feet, with excellence rate of 52.9%. CONCLUSIONS: Combined calcaneal is a calcaneus-based concomitant ankle and foot fractures after a high-energy injury. Good deal of soft tissue and correct design of operation pre-operatively, restoration of form and power lines of calcaneal, effective bone graft, right place of simple internal fixation or subtalar arthrodesis and good reduction and internal fixation of other fracture in hinder feet intra-operatively and correct function postoperatively are key points to have a relatively satisfied treating effect of combined calcaneal fractures.

[Surgical treatment of malunited or nonunited talus fractures].

OBJECTIVE: To explore the operative methods of malunited or nonunited talus fractures. METHODS: Twenty-two patients of malunions or nonunions after displaced talar fractures were treated from January 2000 to January 2008. There were 17 males and 5 females with an average age of 34 years (ranged from 15 to 52 years). According to classification of posttraumatic talar deformities (Zwipp 2003), there were 10 cases of type I (malunion and/or joint displacement), 8 cases of type II (nonunion with joint displacement), 4 cases of type III (type I/II with partial AVN). The surgical treatments included open reduction, osteotomy, correction and internal fixation with plate, screw or K-wire, or the ankle, subtalar arthrodesis. RESULTS: Seventeen patients were followed up for 14 months in average (ranged from 12 to 24 months). No wound healing problems or infections were observed. Solid union was obtained without redislocation in all patients. The mean time of bone union was 14 weeks (ranged from 12 to 18 weeks). The mean time of completely weight loading was 14 weeks (ranged from 12 to 18 weeks). The mean AOFAS ankle and hindfoot score increased from 35.4 (ranged from 28.0 to 41.0) to 86.6 (ranged from 78.0 to 98.0). CONCLUSIONS: As to posttraumatic talar deformities, surgical treatment can lead to a favorable outcome. According to concrete status of malunions or nonunions after displaced talar fractures, suitable surgical treatment should be applied to obtain satisfactory outcome.

Angiotensin II contributes to intratumoral immunosuppressionvia induction of PD-L1 expression in non-small cell lung carcinoma.

The formation of an immunosuppressive microenvironment and up-regulation of PD-L1 protein are the main causes of tumor immune escape. Previous reports suggest that Angiotensin II (Ang II) can modulate the immune status of tumor microenvironment in non-small cell lung cancer (NSCLC), but the underlying mechanism remains not fully understood. Here we demonstrated that AngII treatment causes the reduction of intratumoral infiltrating CD4 T lymphocytes in tumor-bearing mice, increases the accumulation of immunosuppressive granulocytes and TAMs in tumor tissue, and upregulates the expression levels of immunosuppressive marker genes. In addition, AngII/AGTR1 axis triggers cell PD-L1 expression through a mechanism involving increases in PD-L1 mRNA stability by human antigen R (HuR), an AU-rich element (ARE)-binding protein. Collectively, AngII/AGTR1 signaling promotes the tumor immunosuppressive microenvironment by upregulating PD-L1 in NSCLC, the mechanism of which is largely accounted by HuR-mediated PD-L1 mRNA stabilization.