D-dimer-albumin ratio (DAR) as a new biomarker for predicting preoperative deep vein thrombosis after geriatric hip fracture patients.

PURPOSE: Hip fractures in the elderly are complicated by preoperative deep vein thrombosis (DVT). The objective of this study is to determine the usefulness of blood-based biomarkers, particularly the D-dimer-albumin ratio (DAR), in predicting preoperative DVT. METHODS: A retrospective observational study was carried out on 1149 patients from a single hospital, and subsequently validated on an additional 626 patients from a separate hospital. The aim was to evaluate the prognostic and predictive value of 10 biomarkers, with a specific emphasis on DAR, in both cohorts. The primary measure of interest was the occurrence of preoperative DVT. RESULTS: The ratio of D-dimer to albumin demonstrated superior predictive capability for preoperative DVT in older patients with hip fractures compared to other biomarkers (AUC = 0.677). Using the optimal cutoff point of 0.24, high DAR was significantly associated with preoperative DVT (OR 3.45, 95% CI 2.00-5.95). Notably, all the DAR definitions detailed above were successfully validated in an external, independent cohort. CONCLUSIONS: DAR may be a valuable biomarker for predicting preoperative DVT in elderly patients with hip fractures.

The minimally invasive spinal surgery in the treatment of posterior edge separation.

BACKGROUND: Posterior edge separation of the vertebral body is an uncommon but non-rare orthopedic disease, the traditional treatment is posterior open surgery. Recently, a lot of attempts in minimally invasive treatment of lumbar posterior edge fracture have been made. We set to discover the value of minimally invasive surgery in the treatment of posterior edge separation, we designed this retrospective study. METHODS: Eighteen patients (10 males and 8 females) with posterior edge separation were included between September 2015 and May 2019. The mean age of the patients were 49.9 years. Patients that we included were divided into two groups: people in team A were treated with percutaneous endoscopic lumbar discectomy (PELD), while the other group (team B) were carried the minimally invasive spinal surgery-transforaminal lumbar interbody fusion (MISS-TLIF). The intraoperative/postoperative complications and index were recorded respectively. Visual analogue scale (VAS) and Oswestry disability index (ODI) were applied as evaluation parameters to evaluate the effect of the procedure. RESULTS: The mean operation time and notch length in PELD group were 71 min and 6.8 mm, while these date in the other group were 105 min and 31.2 mm. In PELD group, the blood loss during the operation were 5 mL and the time lying in bed after the surgery 24 h, the data in corresponding group were 101 mL and 96 h. People included in our trial (excluding 1 defaulters) had a mean follow-up of 9 months (range, 3-12 months). The VAS and ODI score before and after the surgery had insignificant difference between the two groups (P>0.05). Compared with the data before the operation, the VAS and ODI score had significantly improved after the surgery in two groups (P<0.05). CONCLUSIONS: The MISS-TLIF and PELD were all effective methods in the treatment of posterior edge separation.

Discovery of 3,6-diaryl-1H-pyrazolo[3,4-b]pyridines as potent anaplastic lymphoma kinase (ALK) inhibitors.

A new series of 3,6-diaryl-1H-pyrazolo[3,4-b]pyridine compounds have been discovered as potent anaplastic lymphoma kinase (ALK) inhibitors. The 4-hydroxyphenyl in the 6-position of 1H-pyrazolo[3,4-b]pyridine were crucial and a fluorine atom substitution could give promising inhibitory activity. The IC50 of compound 9v against ALK was up to 1.58 nM and a binding mechanism was proposed.