Closed reduction and posterior percutaneous internal fixation for simple displaced talar neck fracture: a retrospective comparative study.

PURPOSE: Open reduction and internal fixation (ORIF) is the most commonly used surgical technique for talar neck fracture, but there are high risks for complications and poor functional outcomes. In this study, we reported the closed reduction and percutaneous internal fixation (CRPIF) technique of the bilateral approach of the Achilles tendon for simple displaced talar neck fracture, in comparison with ORIF. METHODS: Data of 15 patients in the CRPIF group and 22 in the ORIF group were included. The American Orthopaedic Foot and Ankle Society (AOFAS) score, Visual Analog Scale (VAS) score, 12-item Short-Form Survey (SF-12) score, range of motion (ROM), complications, and radiographic results were recorded and compared. RESULTS: The mean follow-up in the CRPIF group was 33.9 months. Complications included two cases of avascular necrosis (AVN) and two cases of osteoarthritis. All patients achieved bony union and recovered their pre-operative mobility. The mean follow-up in the ORIF group was 39 months. Complications included two cases of bony nonunion, nine AVN, and seven cases of osteoarthritis. Moreover, the mobility of the ORIF group was significantly lower than the CRPIF group post-operatively. The AOFAS score, VAS score, and SF-12 physical component score (PCS) for the CRPIF group were better improved than those for the ORIF group (ALL, P < 0.05). CONCLUSIONS: The CRPIF technique of the bilateral approach of the Achilles tendon was an effective method for the treatment of simple displaced talar neck fractures. Compared with the ORIF, the limited blood supply of the talus was protected, provide better functional outcomes and biomechanical fixation, and lower incidence of resurgery and complication in the CRPIF.

Can local environmental constraints improve enterprise's green innovation quality? Evidence from Chinese-listed firms.

The target responsibility system of environmental protection is one of the vital channels to achieve a win-win situation for both economic development and environmental protection. Comprehensively investigating how local environmental target constraints drive enterprises to improve their green innovation quality is of enormous theoretical and practical significance for optimizing the implementation effect of environmental target constraints policies and boosting enterprises' green and high-quality development. We empirically examine the mechanism of the impact of the intensity of different types of local environmental target constraints on the quality of corporate green innovation and the nonlinear relationship between them through innovatively constructing indicators of local environmental target constraint intensity and utilizing the knowledge width of green patents of listed companies as a proxy variable for enterprise green innovation quality. First, the strength of indirect environmental target constraints has a significant positive effect on the quality of green innovation, but further nonlinear characteristics reveal a significant inverse U-shaped relationship between them. Second, indirect environmental target constraint intensity has an inverted U-shaped trend in increasing the intensity of environmental regulation and influencing the digitalization of enterprises, which in turn forms an inverted U-shaped relationship with the quality of green innovation. Third, indirect environmental target constraint intensity works better in areas with policies prioritizing city over province, with mayors less than 57 years old, and for enterprises in technology-intensive industries.

Evaluation of the Rapid Antigen Detection Test for Diagnosing SARS-CoV-2 during the COVID-19 Pandemic: Experience from a Centralized Isolation Site in Shanghai, China.

Rapid and reliable diagnosis is important for the management of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The rapid antigen detection test (RADT) is a rapid, inexpensive, and easy method. Several studies have reported that RADTs performed well in many countries; however, very few studies have been reported in China. In this study, we assessed the performance of the RADT (Ediagnosis COVID-19 antigen test kit). This study was conducted in a centralized isolation site in Shanghai and enrolled 716 patients with COVID-19 and 203 noninfected participants. Nasopharyngeal swabs from all participants were collected on the same day and tested using the RADT and real-time reverse transcription-PCR (RT-PCR). The performance of the RADT was evaluated in different scenarios, such as threshold cycle (CT) values, symptomatic phase, and symptoms on the day of testing. The results demonstrated that the sensitivity for patients with CT values lower than 20 was 96.55% (95% confidence interval [CI], 87.05 to 99.4). The sensitivities were 78.4% (95% CI, 69.96 to 85.05) for participants within 5 days after the first RT-PCR-positive result and 90.77% (95% CI, 80.34 to 96.19) within 5 days after symptom onset. Moreover, the sensitivity of the RADT was more than 80% for patients with symptoms on the day of testing, including fever (89.29%), cough (86.84%), stuffy nose (92.59%), runny nose (92%), sore throat (81.25%), and muscle pain (80.77%), especially for those with upper respiratory tract symptoms. The specificity of the RADT was good in all scenarios. During the SARS-CoV-2 epidemic, Ediagnosis performed excellently in individuals with a higher viral load (evidenced by lower CT values), individuals in the early symptomatic phase, and especially those with upper respiratory tract symptoms. IMPORTANCE RADTs have demonstrated excellent performance in many counties for screening SARS-CoV-2 infection, but very few studies have been conducted in China. The performance of RADTs is largely related to different real-life scenarios. In our study, the performance of the RADT was evaluated in different scenarios, such as CT values, symptomatic phase, and symptoms on the day of testing. The results demonstrated that Ediagnosis (an RADT made in China) performed excellently for individuals with a higher viral load (evidenced by lower CT values), individuals in the early symptomatic phase, and especially those with upper respiratory tract symptoms.

Phenylalanine promotes alveolar macrophage pyroptosis via the activation of CaSR in ARDS.

Acute respiratory distress syndrome (ARDS) is associated with high mortality rates in patients admitted to the intensive care unit (ICU) patients with overwhelming inflammation considered to be an internal cause. The authors' previous study indicated a potential correlation between phenylalanine levels and lung injury. Phenylalanine induces inflammation by enhancing the innate immune response and the release of pro-inflammatory cytokines. Alveolar macrophages (AMs) can respond to stimuli via synthesis and release of inflammatory mediators through pyroptosis, one form of programmed cell death acting through the nucleotide-binging oligomerization domain-like receptors protein 3 (NLRP3) signaling pathway, resulting in the cleavage of caspase-1 and gasdermin D (GSDMD) and the release of interleukin (IL) -1ß and IL-18, aggravating lung inflammation and injury in ARDS. In this study, phenylalanine promoted pyroptosis of AMs, which exacerbated lung inflammation and ARDS lethality in mice. Furthermore, phenylalanine initiated the NLRP3 pathway by activating the calcium-sensing receptor (CaSR). These findings uncovered a critical mechanism of action of phenylalanine in the context of ARDS and may be a new treatment target for ARDS.

[Progress in diagnosis and treatment of fibular fracture in ankle fracture].

OBJECTIVE: To summarize the diagnosis and treatment of fibular fracture in ankle fracture. METHODS: Relevant literature at home and abroad in recent years was widely consulted, and various types of fractures were discussed and summarized according to Danis-Weber classification. RESULTS: Conservative treatment is not an ideal treatment for type A avulsion fracture. The operation method should be determined according to the position and size of bone mass. For simple type B fracture, both conservative treatment and surgical treatment can achieve good results. When the position of type C fracture is high and does not affect the stability of ankle joint, it can be treated conservatively, while when the position is low and affects the stability of ankle joint, it needs surgical treatment. CONCLUSION: First of all, whether the fibular fracture in the ankle fracture is stable or not should be determined. Whether it is treated surgically or not, the purpose is to restore the tibiofibular syndesmosis and restore the motor function of the ankle.

The Effect of Environmental Policy Uncertainty on Enterprises' Pollution Emissions: Evidence from Chinese Industrial Enterprise.

In response to the global call for emission reduction, China has assumed international responsibility for energy conservation and emission reduction by enacting several environmental policies to save energy and reduce consumption. However, it is debatable whether the increased uncertainty in environmental policies negatively affects firms' emission reduction. Few studies have examined this relationship based on micro-level data. Therefore, this study constructs a theoretical framework of environmental policy uncertainty affecting firms' pollution emissions. Based on comprehensive data from the Chinese Industrial Enterprise Database, the Chinese Industrial Enterprise Pollution Emission Database, and the Chinese Patent Database from 2002 to 2014, we empirically analyzed the impact of environmental policy uncertainty on firms' pollution emissions. The results show that (1) environmental policy uncertainty significantly aggravates the pollution emission intensity of industrial enterprises; (2) environmental policy uncertainty inhibits the improvement of enterprises' innovation capacity, reduces their human capital stock and foreign investment, and aggravates their pollution emission; (3) environmental policy uncertainty has significant heterogeneity on enterprise pollution emissions, that is, environmental policy uncertainty has a greater impact on non-export enterprises, large enterprises, young enterprises, capital-intensive enterprises, state-owned enterprises, and enterprises in polluting industries and central regions. This study provides a useful reference for the improvement of environmental policy and the green transformation of enterprises.

Effect of input servitization on carbon mitigation: evidence from China's manufacturing industry.

Manufacturing servitization, a new industrial form that integrates manufacturing and service, promotes not only high-quality economic development but also carbon mitigation. By employing the panel data of 14 manufacturing sectors and 17 service sectors from 1995 to 2009 in China, this study sheds light on the effect of manufacturing input servitization on carbon reduction. Results show that input servitization reduces carbon intensity. In terms of the manufacturing heterogeneity, the carbon abatement effect of input servitization in pollution-intensive sectors is greater than that in non-pollution sectors; with respect to the service heterogeneity, more emphasis shall be placed on transportation and business services among all manufacturing industries to curb carbon emissions. Furthermore, the mechanism analysis demonstrates that input servitization reduces carbon intensity by substituting energy elements, promoting technological innovation, and optimizing structure. These conclusions reveal that increasing the level of input servitization helps to coordinate manufacturing industry's development with carbon abatement commitment in China.

Effects of 4-DAMP on allergic rhinitis in guinea pigs and its potential mechanism.

Background: Allergic rhinitis (AR) is a non-infectious chronic inflammatory disease of the nasal mucosa mainly mediated by immunoglobulin E (IgE), which seriously affects the life quality of affected patients. This study aimed to observe the effects of 1,1-dimethyl-4-diphenylacetoxypiperidinium iodide (4-DAMP; a selective M3 receptor antagonist) on ovalbumin (OVA)-induced AR guinea pigs, and to explore its potential mechanism of involvement. Methods: An AR model was established by inducing male guinea pigs (4-6 weeks of age) with OVA. AR guinea pigs were randomly divided into a model group, 0.6 mg/kg ipratropium bromide (IB) group, 0.12 and 0.6 mg/kg 4-DAMP group (n=18). The 0.6 mg/kg IB group, 0.12 and 0.6 mg/kg 4-DAMP group animals were treated with IB (0.6 mg/kg) and 4-DAMP (0.12 or 0.6 mg/kg) by intranasal instillation per nostril daily. Animals in the model group and normal group were treated with saline as control. The AR symptom scores were counted and nasal secretion weights were measured. Histopathological methods were used to observe nasal mucosa. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of histamine and cytokines. Western blot and quantitative real-time polymerase chain reaction (qRT-PCR) were used to detect the expressions of mucin 5AC (MUC5AC), matrix metalloproteinase 9 (MMP9), and epidermal growth factor receptor (EGFR). Results: Compared with model group animals, the AR symptom scores and nasal secretion weights of animals treated with 4-DAMP were reduced significantly, goblet cell metaplasia was reversed, and eosinophil infiltration was visibly alleviated. The levels of histamine and cytokines in nasal lavage fluid (NLF) were decreased, and the protein and messenger RNA (mRNA) expressions of MUC5AC, MMP9, and EGFR were inhibited. Conclusions: Treatment with 4-DAMP has a certain effect on AR, especially for mucus hypersecretion, which provides a new idea for clinical treatment of AR.

The spillover effects of China's regional environmental markets to local listed firms: a risk Granger causality approach.

Using the quantile GARCH model estimators to gauge the bidirectional risk magnitude and the Granger causality test in risk distributions to detect the existence of risk spillovers, this paper explores the extreme risk spillovers of China's regional carbon markets to local listed firm's stock returns. From the perspectives of macro region level and micro firm level, the findings are outlined as follows. First, among the top three active carbon trading pilots (Hubei, Guangdong, and Shenzhen), Hubei pilot exhibits significant "low risk and high profit" features. Second, the predominant risk spillover effects to local listed firms are heterogeneous across pilots. Specifically, Hubei pilot is dominated by "up-to-down" effect, and Guangdong pilot is dominated by "down-to-down" effect, while Shenzhen pilot has no predominant effect. The heterogeneous risk spillover performance may be caused by the regional divergence in economic development, industry structure, and cap setting concerning each pilot. Third, the risk transmission performance from carbon allowance price to local listed firm's stock returns depends on the firm's belonging sector. That is, environment-related firms, either environment-friendly firms or pollution-intensive firms, are more susceptible to carbon markets' risks compared with environment-unrelated firms. This paper supplies novel information on the risk transmission from carbon markets to local economic entities, which proves valuable not only for firms to improve risk aversion ability but also for policy-makers to perfect carbon markets' mechanism.