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Bone metabolism includes the processes of bone formation and bone resorption, both of which maintain bone metabolic homeostasis in the body. Adipose browning is a biological process that converts energy-storing white fat into thermogenic brown fat, which is induced by environment, exercise, nutrients, and signaling molecules. Adipose browning regulates bone metabolism in vivo and affects osteogenic and osteoblastic capacity through the secretion of adipokines such as fibroblast growth factor-21, adiponectin, insulin-like growth factor-1, and bone morphogenetic proteins. Adipose browning can also affect bone metabolism through immune pathways mediated by the gut microbiota. The browning ability of fat decreases in the aging body, which is related to the imbalance of bone metabolism in the state of osteoporosis. In children and adolescents, fat browning is active and bone metabolism is maintained in a healthy state. Exercise and supplementation of nutrients (capsaicin, resveratrol, quercetin, etc.) can promote the browning of adipose tissue and maintain brown adipose tissue, which plays a positive role in bone metabolism. In the future, it is of great significance to clarify the specific regulatory mode between adipose browning and bone metabolism for the treatment of bone metabolism-related diseases by intervening adipose browning.
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BACKGROUND:There is controversy regarding the need for marrow reaming in intertrochanteric fractures of the femur.Some believe that unreaming shortens operative time,reduces bleeding,and decreases intraoperative risk in elderly patients,but there is no basis for whether this move reduces the effectiveness of intramedullary nail support.Others believe that reaming allows for the selection of thicker diameter intramedullary nails for better mechanical support,but basic studies have shown that this approach carries risks such as fat embolism and destruction of bone(especially in elderly patients with osteoporosis). OBJECTIVE:To analyze the mechanical distribution characteristics of reamed and unreamed proximal femoral nail antirotation-Ⅱ in the treatment of type 31-A3 intertrochanteric fractures by finite element analysis. METHODS:A healthy volunteer was included,and CT scans of his femur were obtained in DICOM format,and the files were sequentially imported into Mimics,Geomagic Wrap,SolidWorks,Hypermesh,and Ansys software for processing.The A3.1,A3.2,and A3.3 intertrochanteric fracture models were obtained and assembled with 9 mm,11 mm diameter,and 170 mm length intramedullary nails,respectively,followed by assigning material properties,setting the interaction relationship of each contact surface and defining the load and boundary conditions,and then solved.The femoral stress distribution,internal fixation stress distribution,femoral displacement,and internal fixation displacement were observed in different models. RESULTS AND CONCLUSION:(1)The femoral stress was less than that of unreamed intramedullary nail fixation for each type of fracture,and the maximum stress value of the femur for A3.3 fracture was greater than that of A3.1 and A3.2.(2)The internal fixation stress was greater than that of unreamed intramedullary nail fixation for each type of fracture,and the maximum stress value of internal fixation for A3.3 fracture was greater than that of A3.1.(3)Reamed versus unreamed intramedullary nailing has less effect on femoral and internal fixation displacement and more effect on stress.(4)It is indicated that the use of reamed intramedullary nail fixation results in a reduction in femoral stress,an increase in the stress borne by the internal fixation as a whole,and a reduction in the stress borne by the distal locking nail.The use of reamed intramedullary nail fixation may provide better treatment results compared to unreamed intramedullary nail fixation.
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Objective:To investigate the spectrum, drug resistance and risk factors of multidrug resistant organism (MDRO) in chronic osteomyelitis.Methods:A retrospective study was conducted by cluster sampling to analyze the 414 patients with chronic osteomyelitis who had been admitted to Department of Orthopaedics, The Second Hospital Affiliated to Shanxi Medical University, Department of Orthopaedics, The People's Hospital of Shanxi Province, Department of Traumatology, Yuncheng City Hospital, and Department of Orthopaedics, Linfen City Hospital from January 2016 to December 2021. The patients were assigned into 2 groups according to whether MDRO had been detected or not. In the MDRO infection group of 150 cases, there were 118 males and 32 females with an age of (48.8±16.2) years; in the non-MDRO infection group of 264 cases, there were 194 males and 70 females with an age of (46.0±17.8) years. The characteristics of bacterial spectrum and drug resistance in MDRO infection were described and analyzed. The 2 groups were compared in terms of clinical data like gender, age, course of disease, body mass index, history of antibiotic use before admission, combined internal diseases, combined trauma, and length of hospital stay. The items with P<0.05 were included in a multivariate logistic regression model to explore the risk factors for MDRO infection. Results:Pathogenic bacteria (331 strains) were detected in 286 of the 414 patients with chronic osteomyelitis, and infection with 168 strains of MDRO was detected in 150 of the 286 patients, yielding a detection rate of 50.8% (168/331). Of the 168 strains of MDR, 129 (76.8%, 129/168) were Gram-positive and 39 (23.2%, 39/168) Gram-negative. Staphylococcus aureus was the most frequently detected species of Gram-positive bacteria (58.1%, 75/129) and the most frequently detected pathogen (44.6%, 75/168) in this study. The resistance of Gram-positive bacteria to peptides and oxazolidinones was low (less than 10%). Multivariate logistic regression analysis showed that age ≥45 years ( OR=6.991, 95% CI: 3.525 to 13.865, P<0.001), essential hypertension ( OR=4.191, 95% CI: 2.070 to 8.485, P<0.001), trauma ( OR=4.232, 95% CI: 2.409 to 7.435, P<0.001) and length of hospital stay ( OR=1.015, 95% CI: 1.001 to 1.029, P=0.030) were the risk factors for MDRO infection in patients with chronic osteomyelitis. Conclusions:The detection rate of MDRO is at a medium to high level. Gram positive bacteria are the main pathogens and resistant to most antibiotics. Antibiotic therapy guided by bacterial culture is of great significance for patients with chronic osteomyelitis. Age≥45 years, essential hypertension, trauma, and long hospital stay are risk factors for MDRO infection in patients with chronic osteomyelitis.
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Diagnosis and treatment of Hill-Sachs combined with Bankart lesions in anterior dislocation of shoulder joint is a major clinical challenge in orthopedics, because it likely leads to a high recurrence rate of redislocation of shoulder joint, a serious damage to the shoulder joint, recurrent shoulder injury and dramatically disturbed quality of daily life. Although various means of clinical diagnosis and treatment are available for the lesions, they all have their own advantages and disadvantages. However, arthroscopic surgery of shoulder has achieved superior curative effects, gradually becoming the first choice and a mainstream treatment. This article reviews the current research progress in pathogenesis, diagnosis and arthroscopic treatment of Hill-Sachs combined with Bankart lesions in anterior dislocation of shoulder joint.
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@#Objective To investigate the changes and clinical significance of serum caspase-cleaved cytokeratin-18 (CCCK-18) and complement 1q tumor necrosis factor-related protein 3 (CTRP3) levels in patients with acute ischemic stroke (AIS).Methods A total of 163 AIS patients were selected as the AIS group.According to the National Institutes of Health Stroke Scale (NIHSS),the patients were divided into the mild defect group (49 cases),moderate defect group (76 cases),severe defect group (38 cases),after 3 months of treatment,patients were divided into poor prognosis group (66 cases) and good prognosis group (97 cases) according to the modified Rankin scale (mRS),in addition,72 healthy individuals who had physical examination during the same period were selected as the control group.Enzyme-linked immunosorbent assay was used to determine serum CCCK-18 and CTRP3 levels.Results The serum CCCK-18 level in the AIS group was significantly higher than that in the control group,and the CTRP3 level was significantly lower than that in the control group (P＜0.05).The serum CCCK-18 level in the mild,moderate,and severe defect groups gradually increased,and the CTRP3 level gradually decreased (P＜0.05).The serum CCCK-18 level was positively correlated with NIHSS score,and CTRP3 level was negatively correlated with NIHSS score (P＜0.05).Multivariate logistic regression analysis showed that large area infarction,high NIHSS score,high CCCK-18 level were an independent risk factor for poor prognosis in AIS patients,and high CTRP3 level was an independent protective factor (P＜0.05).The ROC curve showed that the AUC of CCCK-18 combined CTRP3 predicting poor prognosis of AIS patients was significantly greater than that of CCCK-18,CTRP3 alone predicted(P＜0.05),the sensitivity and specificity were 86.36% and 81.44%.Conclusion The serum CCCK-18 level in AIS patients is up-regulated,and the CTRP3 level is down-regulated,which is related to the severity of the disease and poor prognosis.Combined detection of the two can improve the predictive value of poor prognosis.
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Abstract@#On the basis of combing the working mechanism of infectious disease prevention and control in French, British and American primary and secondary schools, this paper summarizes the typical models, specific practices and the enlightenment to carry out school infectious disease prevention and control work in China. In view of the problems existing in school health and infectious disease prevention and control work, it proposes to strengthen the relevant legislation on prevention and control of public health emergencies in schools, and to clarify the countermeasures and applicable conditions in each stage of the epidemic development; to establish and improve school public health system top-level design, and to bring school health into the key area of national public health system construction; what s more the school public health professional and technical personnel training, access, employment, treatment, evaluation and incentive should be improved.
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BACKGROUND: Early prevention of hip fracture can effectively reduce the risk of hip fracture in a high-risk population. Epidemiological studies can provide guidance for the clinical prevention and treatment of such patients. OBJECTIVE: To retrospectively analyze the epidemiological distribution characteristics of patients with hip fracture admitted to the Second Hospital of Shanxi Medical University from January 1, 2016 to December 31, 2018. METHODS: To collect the patient’s age, sex, fracture type, territorial, season for injury, causes, surgical procedure, intraoperative situation, blood clots, length of hospital stay, cost, and admission to operation time, body mass index, complications, SPSS 26.0 software was used for data processing to analyze the epidemiology of hip fracture distribution characteristics in 2342 patients. RESULTS AND CONCLUSION: The average age of patients with hip fracture was (73.90±13.43) years, and hip fracture mostly occurred in the 80-90 group, accounting for 29.97%. Hip fractures were common in winter, and there was a significant difference in the seasonal distribution of femoral neck and intertrochanteric fractures. Falls resulted in the most hip fractures, accounting for 88.13%. Among the 2 108 patients with hip fractures who underwent surgical treatment, hip replacement was the major choice for femoral neck fractures, accounting for 60.03%; intramedullary fixation was the main choice for intertrochanteric fractures, accounting for 92.04%. Among the 2097 patients with hip fracture who underwent color Doppler ultrasonography, 32.38% (679/2 097) of the patients had arteriovenous thrombosis of the lower extremities, and 28.71% (195/679) of the patients had inferior vena cava filter implantation. The average hospitalization time of patients with hip fracture was (10.49±7.06) days, and the average hospitalization cost was (4.63±3.14) thousand yuan. The average hospitalization cost, average blood loss and average operation time of femoral neck fractures were significantly less than those of intertrochanteric fractures. Patients with intertrochanteric fractures were generally thinner than those with femoral neck fractures. The 44.41% of patients with hip fracture had cardiovascular and cerebrovascular diseases. These results indicate that hip fractures are mainly developed in the older adults, especially in elderly women. With the increase of age, the proportion of intertrochanteric fractures increases gradually. Falls are the main cause of hip fractures in the older adults. Surgical treatment is the main choice for hip fracture. Preoperative blood preparation and perioperative thrombosis prevention can improve the prognosis of patients.
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Abstract@#To thoroughly implement General Secretary Xi Jinping’s important instructions on preventing and controlling myopia in children, the Ministry of Education together in collaboration with relevant eight departments jointly issued and implemented a plan to tackle and prevent myopia among children and young students. This article focuses on strengthening organizational leadership, optimizing system design, ensuring responsibilities of implerentation, uniting prevention and control efforts, highlighting pilot drive, strengthening demonstration guidance, promoting integration of teaching and medicine, playing the role of experts, insisting on scientific prevention and control, regularly monitoring and early warning, and reducing academic burden. Strengthen physical training, strengthen hardware construction, improve the visual environment, collaborative family-school relationship, comprehensively overcome difficulties, strengthen market supervision, standardize industry behavior, strengthen team building, strengthen professional training, support professional construction, provide intellectual support, increase financial investment, ensure the implementation of funds, strengthen publicity and education, highlight the function of educating people, improve the assessment mechanism, and be accountable according to regulations and laws. This paper summarizes the phased progress made in the comprehensive prevention and control of myopia among children and adolescents in provinces (cities, districts) across China over the past year through the solid implementation of the Plan. A number of phased achievements have been achieved, providing important supports for the construction of a healthy China.
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Abstract@#To deeply implement important instructions given by General Secretary Xi Jinping on childhood myopia prevention and control, eight departments including the Ministry of Education jointly issued the implementation. This editorial summarized current progress in preventing and controlling myopia in children and adolescents in organizational leadership, key performance indicators, team building, professional support, scientific research, financial input, publicity and education, standardized management of myopia, as well as supervision and evaluation, all of which provided important support for the building of a healthy China.
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Objective To study the anti-tumor activity of quercetin in NB4 leukemia cells and the roles of PI3K/Akt,bcl-2,and Bax on the quercetin-induced apoptosis,and to investigate the potential underlying mechanism.Methods MTT assay was used to monitor cell proliferation,Hoechst 33258 fluorescent staining and flow cytometry were employed to detect apoptosis in NB4 cells.Western blot was used to detect the expression changes of related proteins in quercetin treated NB4 cells.Confocal laser microscopy was used to test the distributional variation of Akt between cytoplasm and nucleus.Results Quercetin significantly inhibited the NB4 cell proliferation in a dose-and time-dependent manner (20-160 μ mol/L).In addition,treated by 20,40 80 μmol/L quercetin,the rates of apoptosis were (9.25±0.11) ％,(20.83±2.10) ％and (41.43±2.90) ％,there were statistical difference compared with blank cells (t were 4.14,6.56 and 7.02,all P ＜ 0.05).This was concentration dependent and accompanied by morphological changes characteristic of apoptosis.Further,quercetin induced a G~M arrest,which might account for its cytotoxic effects.Quercetin decreased PI3k/Akt expression and caused an inhibition of the anti-apoptotic protein bcl-2,while increasing the expression of Bax.Quercetin had no effects on total Akt,but it promoted Akt translocation from cell nucleus to the cytoplasm (F =15.12,P ＜ 0.05).Conclusion Quercetin induces the leukemia NB4 cell apoptosis by affecting multiple signal pathways and plays a strong anti-leukemia effect.In addition,our results suggest that PI3K/Akt pathway could be a novel target for the leukemia chemotherapy.