Do the successful revision surgery for humeral nonunion solve all the effects on health-related quality of life? A retrospective cohort study.

BACKGROUND: The aim of this study is to evaluate the effects of successful revision operation on health quality of life(QoL) and functional outcome in humeral nonunion patients. METHODS: This retrospective study included 62 patients with humeral nonunion from Northwest China, who were admitted to the Department of Trauma Surgery, Honghui Hospital between March 2013 and September 2019. The following data were retrospectively evaluated: demographic data, clinical data, imaging findings, and treatment methods. The QoL assessment indicators for humeral nonunion patients included the SF-12 mental component summary (MCS) and physical component summary (PCS),brief pain inventory-severity(BPI-S) and brief pain inventory-interference (BPI-I). The mayo elbow performance score (MEPS) was used to assess the elbow function of the patients. RESULTS: Successful revision surgery significantly improved the patient's PCS, MCS, BPI-S and BPI-I scores (p<0.001). According to the MEPS criteria, the excellent and good rates were 95.16% in this study. The impact of humeral nonunion on mental health was comparable with the reported impact of stroke and type II diabetes (p>0.05).The impact of post-op on physical health was comparable with the reported impact of COPD, silicosis, hypertension, barrentt's esophagus and lower urinary tract symptoms(p>0.05). CONCLUSION: Humeral nonunion is a devastating chronic medical condition that negatively affects both physical and mental health as well as quality of life. Although the effects of pain in the body can be completely relieved by treatment, the entire medical process may cause everlasting psychological trauma to the patient.

Comparison of the effectiveness and safety of intravenous and topical regimens of tranexamic acid in complex tibial plateau fracture: a retrospective study.

BACKGROUND: Previous studies have demonstrated the effectiveness and safety of tranexamic acid (TXA) in orthopedic surgery. However, no study has investigated TXA in complex tibial plateau fracture surgery. Therefore, the purpose of this study was to confirm the safety and effectiveness of i.v. (intravenous) TXA and topical TXA. MATERIAL AND METHODS: This was a retrospective analysis of prospectively collected data. The control group received an equal amount of placebo (physiological saline solution); the i.v. group received 1.0 g TXA by intravenous injection before the tourniquet was inflated and before the surgical incision was closed, and the topical group received 3.0 g TXA in 75 mL of physiological saline solution 5 min prior to the final tourniquet release. Perioperative blood loss, vascular events, wound complications, and adverse reactions were compared among the three groups. The pain, knee function, and quality of life (QoL) assessments were based on their corresponding scoring systems. RESULTS: Baseline data were comparable for all groups. The i.v. group showed the best results for total blood loss (TBL) and hidden blood loss (HBL) (424.5 ± 49.4 mL and 219.3 ± 33.4 mL, respectively, all P values < 0.001). Patients in the i.v. group had lesser real Hb decrease than those in the control group (0.9 vs 1.5, P<0.001) and topical group (0.9 vs 1.2, P = 0.026). The blood coagulation level as measured using fibrinolysis (D-dimer) was lower in the i.v. group than in the control and topical groups on POD1 and POD3; however, this difference was not significant; the fibrin-degradation products also showed a similar trend. Patients in the topical group experienced less pain than those in the control group on POD2, POD4, and PO6W. The VAS pain score was 3.6 vs. 4.4 (POD2, P<0.05), 2.8 vs 3.3 (POD4, P<0.05), and 2.1 vs. 2.6 (PO6W, P<0.001) in the topical group vs control group, respectively. No significant differences were identified in vascular events, wound complications, adverse reactions, knee function, and QoL among the three groups. CONCLUSION: To our knowledge, this is the first study that showed both i.v. TXA and topical TXA are safe and effective for complex tibial plateau fractures. The i.v. regimen effectively reduced blood loss during the perioperative period, whereas patients under the topical regimen had less vascular events, wound complications, and a lower incidence of adverse reactions compared to those in the i.v. group. TRIAL REGISTRATION: The trial was registered in the Chinese Clinical Trial Registry ( ChiCTR-TRC-1800017754 , retrospectively registered from 2018 to 01-01).

Testicular metastasis from urothelial carcinoma: case report and literature review.

Urothelial carcinoma (UC) with testicular metastasis is extremely rare, and its modes of metastasis, prognosis, and treatment are unclear. In this report, we present an extraordinarily rare case of testicular metastasis arising from UC 8 years after surgery. The patient underwent left orchiepididymectomy and received immunotherapy postoperatively. After a 6-month follow-up, there were no signs of recurrence. Moreover, the clinical characteristics, metastasis pattern, and treatment plan were also summarized based on 14 earlier reported cases of UC with testicular metastasis.

Is the government's direct subsidy to COVID-19 effective?

With the outbreak of COVID-19, governments worldwide have provided direct subsidies to enterprises. This paper aims to identify the motivation behind these subsidies and evaluate their impact. Previous studies have overlooked the discussion of subsidy motivation, and there is still a wide divergence of views among scholars on whether subsidies have a positive effect on firm performance. To test the hypothesis, a fixed effect model is adopted. The study examines 228 Chinese A-share listed companies and confirms that subsidies are primarily attributable to the severity of the pandemic. Moreover, subsidies have a significant positive effect on social performance, particularly for small-scale enterprises. Contrary to the belief that subsidies have a positive effect on firm performance, this study disproves this viewpoint. The research findings provide a theoretical basis for subsidy policy-making during pandemics and outline the boundaries of government intervention in society and the economy.

Review on synthesis of three-dimensional graphene skeletons and their absorption performance for oily wastewater.

Water pollution is a global environmental problem that affects the ecosystem severely. Treatment of oily wastewater and organic pollutants is a major challenge that waits to be solved as soon as possible. Adsorbing is one of the most effective strategies to deal with this problem. Three-dimensional (3D) porous adsorbents made of graphene or graphene-based nanomaterials skeletons had attracted more attention in wastewater treatment because of their large surface area, high porosity, low density, high chemical/thermal stability, and steady mechanical properties, which allow different pollutants to easily access and diffuse into 3D networks of adsorbents. This work presents an extensive summarization of recent progress in the synthesis methodologies and microstructures of 3D graphene foams and 3D graphene-based foams and highlights their adsorption performance for oils and organic solvents. Advantages and disadvantages of various preparation strategies are compared and the corresponded structures of these skeletons are studied in detail. Furthermore, the effects of the structures on oil-adsorption properties are analyzed and some data and parameters of the oil-adsorption properties are listed and studied for easier comparison. At last, the future research directions and technical challenges are prospected, which is hoped that the researchers will be inspired to develop the new graphene-based adsorbents.

Epidemiological characteristics of spinal cord injury in Northwest China: a single hospital-based study.

BACKGROUND: While the cities in China in which spinal cord injury (SCI) studies have been conducted previously are at the forefront of medical care, northwest China is relatively underdeveloped economically, and the epidemiological characteristics of SCI have rarely been reported in this region. METHODS: The SCI epidemiological survey software developed was used to analyze the data of patients treated with SCI from 2014 to 2018. The sociodemographic characteristics of patients, including name, age, sex, and occupation, were recorded. The following medical record data, obtained from physical and radiographic examinations, were included in the study: data on the cause of injury, fracture location, associated injuries, and level of injury. Neurological function was evaluated using the American Spinal Injury Association (ASIA) impairment scale. In addition, the treatment and complications during hospitalization were documented. RESULTS: A total of 3487 patients with SCI with a mean age of 39.5 ± 11.2 years were identified in this study, and the male to female ratio was 2.57:1. The primary cause of SCI was falls (low falls 47.75%, high falls 37.31%), followed by traffic accidents (8.98%), and impact with falling objects (4.39%). Of all patients, 1786 patients (51.22%) had complications and other injuries. According to the ASIA impairment scale, the numbers of grade A, B, C, and D injuries were 747 (21.42%), 688 (19.73%), 618 (17.72%), and 1434 (41.12%), respectively. During the hospitalization period, a total of 1341 patients experienced complications, with a percentage of 38.46%. Among all complications, pulmonary infection was the most common (437, 32.59%), followed by hyponatremia (326, 24.31%), bedsores (219, 16.33%), urinary tract infection (168, 12.53%), deep venous thrombosis (157, 11.71%), and others (34, 2.53%). Notably, among 3487 patients with SCI, only 528 patients (15.14%) received long-term rehabilitation treatment. CONCLUSION: The incidence of SCI in northwest China was on the rise with higher proportion in males; fall and the MCVs were the primary causes of SCI. The occupations most threatened by SCI are farmers and workers. The investigation and analysis of the epidemiological characteristics of SCI in respiratory complications are important factors leading to death after SCI, especially when the SCI occurs in the cervical spinal cord. Finally, the significance of SCI rehabilitation should be addressed.

[Corrigendum] Bioinformatics analysis of differentially expressed miRNA­related mRNAs and their prognostic value in breast carcinoma.

Subsequently to the publication of this article, the authors have realized that the first of the affiliations had appeared incorrectly: 'Shying People's Hospital, Shyang Affiliated Hospital of Xuzhou Medical University, Shying' should have appeared as 'Shuyang People's Hopital, Shuyang Affiliated Hospital of Xuzhou Medical University, Shuyang'. The authors regret this error in the affiliations, and apologize for any inconvenience caused. [the original article was published in the Oncology Reports 39: 2865­2872, 2018; DOI: 10.3892/or.2018.6393].

Bioinformatics analysis of differentially expressed miRNA-related mRNAs and their prognostic value in breast carcinoma.

Breast carcinoma is one of the most common types of malignant neoplasms, and is associated with high rates of morbidity and mortality. Altered gene expression is critical in the development of breast cancer. To identify the important differentially expressed genes and microRNAs in breast carcinoma, mRNA (GSE26910, GSE42568, and GSE89116) and microRNA (GSE35412) microarray datasets were downloaded from the Gene Expression Omnibus database. The differentially expressed microRNA expression data were extracted with GEO2R online software. The DAVID online database was used to perform a function and pathway enrichment analysis of the key identified differentially expressed genes. A protein-protein interaction (PPI) network was constructed using the STRING online database, and visualized in Cytoscape software. The effect of the expression level of the key identified genes on overall survival (OS) time was analyzed by using the Kaplan-Meier Plotter online database. Furthermore, the online miRNA databases TargetScan, microT-CDS, and TarBase were used to identify the target genes of the differentially expressed miRNAs. A total of 254 differentially expressed genes were identified, which were enriched in cell adhesion, polysaccharide binding, extracellular region part and ECM-receptor interactions. The PPI network contained 250 nodes and 375 edges. Five differentially expressed genes were found to be significantly negatively correlated with the differentially expressed miRNAs, which were potentially also target genes for miRNAs. Four of the five genes, including AKAP12, SOPB, TCF7L2, COL12A1 and TXNIP were downregulated, and were associated with the OS of patients with breast carcinoma. In addition, a total of 130 differentially expressed miRNAs were identified. In conclusion, these results constitute a novel model for miRNA-mRNA differential expression patterns, and further studies may provide potential targets for diagnosing and understanding the mechanisms of breast carcinoma.

A series of water-soluble A-π-A' typological indolium derivatives with two-photon properties for rapidly detecting HSO3 -/SO3 2- in living cells.

It is believed that HSO3 - and SO3 2- play important roles in several physiological processes. However, probes with two-photon absorption to detect HSO3 - or SO3 2- in living cells are still limited. Herein, a series of novel indolium derivatives (L1-L4) with an A-π-A' structure was designed and synthesized as ratiometric probes to detect HSO3 -/SO3 2-in vitro. L3 and L4 display a colorimetric and ratiometric fluorescence dual response to HSO3 -/SO3 2- with a very fast (∼15 s) and high specificity, as well as low detection limits (∼22 nM). Furthermore, their detection is also carried out by using a two-photon excited fluorescence method. A nucleophilic addition reaction is proposed for the sensing mechanism, which is supported by MS, 1H NMR, and density functional theory (DFT) investigations. Importantly, L3 was successfully used for detecting intrinsically generated intracellular HSO3 -/SO3 2- in cancerous cells under one- and two-photon excited fluorescence imaging.

Adipokines and free fatty acids regulate insulin sensitivity by increasing microRNA-21 expression in human mature adipocytes.

Obesity is a global public health concern and may lead to a variety of complications. Previous studies have indicated that adipokines and energy­source materials contribute to obesity and obesity­associated insulin resistance. MicroRNAs (miRs) are endogenous 20­ to 25­nucleotide non­coding RNAs associated with fat metabolism. It has been indicated that miR­21 is associated with adipogenesis and metabolic syndrome. In the present study, the expression of miR­21 in human mature adipocytes was analyzed using reverse transcription quantitative­polymerase chain reaction following treatment with adipokines, including tumor necrosis factor (TNF)­α, interleukin (IL)­6, leptin, resistin and energy source materials, including free fatty acids (FFAs) and glucose. The current study demonstrated that the expression of miR­21 in human mature adipocytes was upregulated following treatment with TNF­α, IL­6, leptin, resistin and FFAs. However, low­ and high­glucose did not have an effect on miR­21 expression. These results confirmed that TNF­α, IL­6, leptin, resistin and FFAs may contribute to obesity and obesity­associated insulin resistance via upregulating miR­21 in human mature adipocytes. Therefore, miR­21 may be a key regulatory factor of obesity and obesity­associated insulin resistance, and represents a potential therapeutic target for the treatment of these disorders.

MicroRNA-100 promotes migration and invasion through mammalian target of rapamycin in esophageal squamous cell carcinoma.

Esophageal squamous cell carcinoma (ESCC) is the predominant histologic subtype of esophageal cancer and is characterized by a high mortality rate and geographic differences in incidence. microRNAs (miRNAs) are small, non-coding RNAs that play important roles in the regulation of genes associated with cancer development and progression. In the present study, we demonstrated that microRNA-100 (miR­100) demonstrated markedly lower expression in the ESCC tissues as validated by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Furthermore, we found that the downregulation of miR-100 was significantly correlated with the status of lymph node metastasis in the 34 ESCC patients. Next, we investigated the role and mechanism of miR-100 in ESCC cells and found that miR-100 modulated the migration and invasion but not the apoptosis and proliferation of ESCC cells in vitro. We further demonstrated that miR-100 directly targeted the mTOR 3'UTR and repressed the expression of mTOR, a tumor-related gene. Similarly, miR-100 has been reported as a tumor suppressor by controlling cell migration and invasion, as it can target mTOR genes. These results provide insight into the potential mechanisms of miR-100 in the pathogenesis of ESCC.

A towards-multidimensional screening approach to predict candidate genes of rheumatoid arthritis based on SNP, structural and functional annotations.

BACKGROUND: According to the Genetic Analysis Workshops (GAW), hundreds of thousands of SNPs have been tested for association with rheumatoid arthritis. Traditional genome-wide association studies (GWAS) have been developed to identify susceptibility genes using a "most significant SNPs/genes" model. However, many minor- or modest-risk genes are likely to be missed after adjustment of multiple testing. This screening process uses a strict selection of statistical thresholds that aim to identify susceptibility genes based only on statistical model, without considering multi-dimensional biological similarities in sequence arrangement, crystal structure, or functional categories/biological pathways between candidate and known disease genes. METHODS: Multidimensional screening approaches combined with traditional statistical genetics methods can consider multiple biological backgrounds of genetic mutation, structural, and functional annotations. Here we introduce a newly developed multidimensional screening approach for rheumatoid arthritis candidate genes that considers all SNPs with nominal evidence of Bayesian association (BFLn > 0), and structural and functional similarities of corresponding genes or proteins. RESULTS: Our multidimensional screening approach extracted all risk genes (BFLn > 0) by odd ratios of hypothesis H1 to H0, and determined whether a particular group of genes shared underlying biological similarities with known disease genes. Using this method, we found 6614 risk SNPs in our Bayesian screen result set. Finally, we identified 146 likely causal genes for rheumatoid arthritis, including CD4, FGFR1, and KDR, which have been reported as high risk factors by recent studies. We must denote that 790 (96.1%) of genes identified by GWAS could not easily be classified into related functional categories or biological processes associated with the disease, while our candidate genes shared underlying biological similarities (e.g. were in the same pathway or GO term) and contributed to disease etiology, but where common variations in each of these genes make modest contributions to disease risk. We also found 6141 risk SNPs that were too minor to be detected by conventional approaches, and associations between 58 candidate genes and rheumatoid arthritis were verified by literature retrieved from the NCBI PubMed module. CONCLUSIONS: Our proposed approach to the analysis of GAW16 data for rheumatoid arthritis was based on an underlying biological similarities-based method applied to candidate and known disease genes. Application of our method could identify likely causal candidate disease genes of rheumatoid arthritis, and could yield biological insights that not detected when focusing only on genes that give the strongest evidence by multiple testing. We hope that our proposed method complements the "most significant SNPs/genes" model, and provides additional insights into the pathogenesis of rheumatoid arthritis and other diseases, when searching datasets for hundreds of genetic variances.