The association between admission mean corpuscular volume and preoperative deep venous thrombosis in geriatrics hip fracture: a retrospective study.

OBJECTIVE: This study evaluated the association between admission MCV and preoperative deep vein thrombosis (DVT) in geriatric hip fractures. METHODS: Older adult patients with hip fractures were screened between January 2015 and September 2019. The demographic and clinical characteristics of the patients were collected at the largest trauma center in northwest China. MCV was measured at admission and converted into a categorical variable according to the quartile. Multivariate binary logistic regression and generalized additive model were used to identify the linear and nonlinear association between MCV and preoperative DVT. Analyses were performed using EmpowerStats and the R software. RESULTS: A total of 1840 patients who met the criteria were finally enrolled and divided into four groups according to their MCV levels. The mean MCV was 93.82 ± 6.49 (80.96 to 105.91 fL), and 587 patients (31.9%) were diagnosed with preoperative DVT. When MCV was a continuous variable, the incidence of preoperative DVT increased with mean corpuscular volume. In the fully adjusted model, admission MCV was positively correlated with the incidence of preoperative DVT (OR: 1.03; 95% CI: 1.01-1.05; P = 0.0013). After excluding the effect of other factors, each additional 1fL of MCV increased the prevalence of preoperative DVT by 1.03 times as a continuous variable. CONCLUSION: MCV was linearly associated with preoperative DVT in geriatric patients with hip fractures and could be considered a predictor of DVT risk. The MCV may contribute to risk assessment and preventing adverse outcomes in the elderly. STUDY REGISTRATION: This study is registered on the website of the Chinese Clinical Trial Registry (ChiCTR: ChiCTR2200057323).

Association between Neutrophil Levels on Admission and All-Cause Mortality in Geriatric Patients with Hip Fractures: A Prospective Cohort Study of 2,589 Patients.

Objective: To evaluate the association between neutrophil levels and all-cause mortality in geriatric hip fractures. Methods: Elderly patients with hip fractures were screened between January 2015 and September 2019. Demographic and clinical characteristics of the patients were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between neutrophil levels and mortality. Analyses were performed using Empower Stats and R software. Results: A total of 2,589 patients were included in this study. The mean follow-up period was 38.95 months. During the study period, 875 (33.80%) patients died due to various causes. Linear multivariate Cox regression models showed that neutrophil levels were associated with mortality after adjusting for confounding factors, when neutrophil concentration increased by 1∗109/L, the mortality risk increased by 3% (HR = 1.03, 95% CI: 1.00-1.06, and P=0210). Neutrophil concentration was used as a categorical variable; we only found statistically significant differences when neutrophil levels were high (HR = 1.27, 95% CI:1.05-1.52, and P=0.0122). In addition, the results are stable in P for trend and propensity score matching sensitivity analysis. Conclusions: Neutrophil levels are associated with mortality in geriatric hip fractures and could be considered a predictor of death risk in the long-term. This study is registered with the Chinese Clinical Trial Registry (ChiCTR) as number ChiCTR2200057323.

Rescue of cardiac failing and remodelling by inhibition of protein phosphatase 1γ is associated with suppression of the alternative splicing factor-mediated splicing of Ca2+/calmodulin-dependent protein kinase δ.

Our previous studies showed that protein phosphatase 1γ (PP1γ) exacerbates cardiomyocyte apoptosis through promotion of Ca(2+)/calmodulin-dependent protein kinase δ (CaMKIIδ) splicing. Here we determine the role of PP1γ in abdominal aorta constriction-induced hypertrophy and remodelling in rat hearts. Systolic blood pressure and echocardiographic measurements were used to evaluate the model of cardiac hypertrophy. Sirius red staining and invasive haemodynamic/cardiac index measurements were used to evaluate the effects of PP1γ or inhibitor 1 of PP1 transfection. Western blot, reverse transcription polymerase chain reaction and co-immunoprecipitation were applied to investigate the molecular mechanisms. Transfection of PP1γ increased the value of the heart mass index, left ventricular mass index and cardiac fibrosis, and simultaneously decreased the value of maximal left ventricular pressure increase and decline rate, ejection fraction, fractional shortening, and left ventricular end-diastolic pressure, as well as left ventricular systolic pressure. Transfection of inhibitor 1 of PP1, however, showed opposite effects on the aforementioned indexes. Overexpression of PP1γ potentiated CaMKIIδC production and decreased CaMKIIδB production in the hypertrophic heart. In contrast, inhibition of PP1γ re-balanced the CaMKIIδ splicing. Furthermore, CaMKII activity was found to be augmented or attenuated by PP1γ overexpression or inhibition, respectively. Further mechanistic studies showed that abdominal aorta constriction stress specifically increased the association of alternative splicing factor with PP1γ, but not with PP1ß. Overexpression of PP1γ, but not inhibitor 1 of PP1, further potentiated this association. These results suggest that PP1γ alters the cardiac hypertrophy and remodelling likely through promotion of the alternative splicing factor-mediated splicing of CaMKIIδ.

The Effect of Hematocrit on All-Cause Mortality in Geriatric Patients with Hip Fractures: A Prospective Cohort Study.

OBJECTIVE: The present study aimed to evaluate the association between hematocrit (HCT) levels and all-cause mortality in geriatric hip fractures. METHODS: Older adult patients with hip fractures were screened between January 2015 and September 2019. The demographic and clinical characteristics of these patients were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between HCT levels and mortality. Analyses were performed using EmpowerStats and the R software. RESULTS: A total of 2589 patients were included in this study. The mean follow-up period was 38.94 months. Eight hundred and seventy-five (33.8%) patients died due to all-cause mortality. Linear multivariate Cox regression models showed that HCT level was associated with mortality (hazard ratio [HR] = 0.97, 95% confidence interval [CI]: 0.96-0.99, p = 0.0002) after adjusting for confounding factors. However, the linear association was unstable and nonlinearity was identified. A HCT level of 28% was the inflection point for prediction. A HCT level of <28% was associated with mortality (HR = 0.91, 95% CI: 0.87-0.95, p < 0.0001), whereas a HCT level > 28% was not a risk factor for mortality (HR = 0.99, 95% CI: 0.97-1.01, p = 0.3792). We found that the nonlinear association was very stable in the propensity score-matching sensitivity analysis. CONCLUSIONS: The HCT level was nonlinearly associated with mortality in geriatric hip fracture patients and could be considered a predictor of mortality in these patients. REGISTRATION: ChiCTR2200057323.

Association between total cholesterol and all-cause mortality in geriatric patients with hip fractures: A prospective cohort study with 339 patients.

BACKGROUND: Total cholesterol (TC) levels represent the comprehensive level of human cholesterol metabolism, which is closely related to the nutritional status, metabolic level, disease development, and aging of the human body. Total cholesterol plays an important role in the maintenance of bodily functions, regulation of sexual function, immune regulation, and in the development of organisms. Abnormal TC levels are an important risk factor for cardiovascular disease (CVD), and TC is closely related to the development of many diseases, and is used as an important indicator of human blood lipid levels and overall health status. However, the relationship between serum TC levels and the prognosis of patients with hip fractures remains unclear. OBJECTIVES: To evaluate the association between TC levels and all-cause mortality in patients with geriatric hip fractures. MATERIAL AND METHODS: Elderly patients with hip fractures were screened between January 2015 and September 2019. Patient demographic and clinical characteristics were recorded. Linear multivariate Cox regression models were used to identify the association between TC levels and all-cause mortality. Analyses were performed using Empower Stats and R software. RESULTS: Three hundred and thirty-nine patients were enrolled. The mean follow-up period was 34.18 months. There were 99 (29.20%) cases of all-cause mortality. Total cholesterol levels after hip fracture were linearly associated with all-cause mortality in the elderly. Linear multivariate Cox regression models showed that TC levels were associated with mortality (hazard ratio (HR) = 0.67; 95% confidence interval (95% CI): 0.53-0.85; p = 0.001 after adjusting for confounding factors). Each 1 mmol/L increase in TC levels was associated with a 33% reduction in morbidity and mortality. Compared with the low-TC group, mortality was significantly lower in the middle-TC group (HR = 0.58; 95% CI: 0.35-0.94; p = 0.027) and high-TC group (HR = 0.45; 95% CI: 0.27-0.75; p = 0.002). CONCLUSIONS: Total cholesterol levels were associated with mortality in geriatric hip fracture patients and could be considered a protective factor for all-cause mortality.

Alkaloids, sesquiterpenoids and hybrids of terpenoid with p-hydroxycinnamic acid from Ganoderma sinensis and their biological evaluation.

The fruiting bodies of Ganoderma sinensis are used as food raw materials of marketed healthcare products. To gain an insight into the chemical and biological profling of G. sinensis, twenty-five compounds including eleven undescribed ones (ganodermasines A‒K) and fourteen known ones were isolated. Among them, ganodermasines A‒D are undescribed diketopiperazine alkaloids, ganodermasines E and F are alkaloids containing a pyridine. The structures of undescribed compounds were identified by spectroscopic, computational, and crystallographic methods. The results of acetylcholinesterase (AchE) inhibitory activity show that ganodermasines I and J could inhibit AchE with IC50 values of 26.05 and 20.40 µM, respectively. In addition, neurotrophic assay in PC-12 cells showed that (+)-ganodermasine E, (-)-ganodermasine E, and ganodermasine I could stimulate neurite outgrowth at 10 µM, while the other isolates are inactive. The present findings will lend a hand for further utilization of G. sinensis.

The morphological mapping of lateral compression type 1 pelvic fracture and pelvic ring stability classification: a finite element analysis.

PURPOSE: This finite element analysis assessed lateral compression (LC-1) fracture stability using machine learning for morphological mapping and classification of pelvic ring stability. METHODS: Computed tomography (CT) files of LC-1 pelvic fractures were collected. After morphological mapping and producing matrix data, we used K-means clustering in unsupervised machine learning to classify the fractures. Based on these subtypes, we manually added fracture lines in ANSYS software. Finally, we performed a finite element analysis of a normal pelvis and eight fracture subtypes based on von Mises stress and total deformation changes. RESULTS: A total of 218 consecutive cases were analyzed. According to the three main factors-zone of sacral injury and completion, pubic ramus injury side, and the sagittal rotation of the injured hemipelvis-the LC-1 injuries were classified into eight subtypes (I-VIII). No significant differences in stress or deformation were observed between unilateral and bilateral public ramus fractures. Subtypes VI and VIII showed the maximum stress while subtypes V-VIII showed the maximum deformation in the total pelvis and sacrum. The subtypes did not differ in superior public ramus deformation. CONCLUSIONS: Complete fracture of sacrum zones 2/3 may be a feature of unstable LC-1 fractures. Surgeons should give surgical strategies for subtypes V-VIII.

Zizhines G-O, AchE inhibitory meroterpenoids from Ganoderma sinensis.

Zizhines G-O (1-9), nine new meroterpenoids, and seven known analogs (10-16) were isolated from the dried fruiting bodies of Ganoderma sinensis. Their structures were identified by using spectroscopic data and CD curve comparison. The inhibitory activities of the selected new meroterpenoids toward AchE were assessed in vitro. Compounds 1-6 and 10-14 were found to exhibit AchE inhibitory activities at the concentration of 50 µM.

Meroterpenoid enantiomers from Ganoderma sinensis.

Zizhines A-F (1-6), six pairs of new meroterpenoid enantiomers and a known meroterpenoid (7) were isolated from the fruiting bodies of Ganoderma sinensis. The structures and absolute configurations of the new substances were assigned by spectroscopic and computational methods. All the compounds apart from 7 were evaluated for their inhibition on extracellular matrix component (fibronectin) generation by using TGF-ß1-induced rat kidney tubular epithelial cells. Although none of them was found to be active in these cells, the present findings add new facets for the chemistry of Ganoderma.