Effect of knee osteoarthritis on the postoperative outcome of proximal femoral nail anti-rotation in the treatment of intertrochanteric fractures in the elderly: a retrospective analysis.

BACKGROUND: The proximal femoral nail anti-rotation (PFNA) is a commonly used internal fixation system for intertrochanteric fractures (IFs) in older adults. Knee osteoarthritis (KOA) is a degenerative lower extremity disease that occurs most frequently in the elderly. Some patients have already had KOA before the IFs. However, whether KOA impacts the postoperative outcome of IFs has not been reported. OBJECTIVE: This study aimed to investigate the effect of KOA on the fracture side on the outcome after PFNA for IFs in the elderly. METHODS: Between January 2016 and November 2021, 297 elderly patients treated with PFNA for IFs were enrolled in this study. They were divided into two groups according to the American Rheumatism Association KOA clinical and radiographic criteria: the control group and the KOA group. Intraoperative bleeding, operative time, length of hospital stay, postoperative time out of bed, fracture healing time, postoperative complications, postoperative Harris hip function score, and Barthel ability to daily living Score were compared between the two groups. Follow-up was routinely scheduled at 1, 3, 6, and 12 months postoperatively. RESULTS: Based on the exclusion criteria, 254 patients who met the requirements were left to be included in this study, including the control group (n = 133) and the KOA group (n = 121). Patients were followed up for a mean of 17.5 months (12-24 months). There was no significant difference between the two groups in preoperative demographic data, intraoperative blood loss, operation time, and length of stay in the hospital. The control group was statistically significant compared to the KOA group in terms of postoperative time out of bed (17.8 ± 4.0 days vs. 19.1 ± 5.8 days), fracture healing time (13.7 ± 2.2 weeks vs. 14.6 ± 3.7 weeks), and postoperative complications (12.8 vs. 23.1%). The Harris hip function score and Barthel ability to daily living score were higher in the control group than in the KOA group at 1, 3, 6, and 12 months postoperatively (the control group: 63.8 ± 10.9, 71.8 ± 10.3, 81.5 ± 8.7, and 91.6 ± 6.3 vs. The KOA group 61.0 ± 10.4, 68.6 ± 9.1, 79.0 ± 9.2, and 88.5 ± 5.9). CONCLUSIONS: In elderly patients with IFs combined with KOA of the fracture side treated with PFNA internal fixation, KOA increases the incidence of postoperative complications of the fracture, prolongs postoperative time out of bed and fracture healing, and reduces postoperative hip function and ability to daily living. Therefore, treating KOA on the fractured side needs to be considered when treating IFs in the elderly.

Antibacterial constituents of Fructus Chebulae Immaturus and their mechanisms of action.

BACKGROUND: To extract, purify, and identify the effective constituents of aqueous extract of Fructus Chebulae Immaturus, and analyze the bactericidal effects of total tannins. METHODS: Preparative thin layer chromatography and semi-preparative high performance liquid chromatography were used to isolate and purify the total tannin fraction. (1)H- and (13)C- NMR spectroscopy were used to elucidate compound structures. The antibacterial activities of total tannins and ethyl gallate on Klebsiella pneumoniae (KP) and Staphylococcus aureus (SA) were determined through minimum inhibitory concentration and minimum bactericidal concentration assays. Their antibacterial mechanisms of action were explored by transmission electron microscopy and scanning electron microscopy. RESULTS: Five compounds were isolated: ellagic acid, ethyl gallate, arjugenin, ß-sitosterol, and tri-n-butyl chebulate. Tri-n-butyl chebulate is a newly-reported compound. Total tannins and ethyl gallate both had favorable bactericidal effects against KP and SA. CONCLUSION: In vivo and in vitro pharmacodynamic experiment demonstrated that the effective components of Fructus Chebulae Immaturus possessed significant antibacterial effects, and were nontoxic and safe. TRIAL REGISTRATION: No results of a health care intervention on human participants.

Analysis of association among clinical features and shorter leukocyte telomere length in mitochondrial diabetes with m.3243A>G mitochondrial DNA mutation.

BACKGROUND: Mitochondrial diabetes is a kind of rare diabetes caused by monogenic mutation in mitochondria. The study aimed to summarize the clinical phenotype profiles in mitochondrial diabetes with m.3243 A>G mitochondrial DNA mutation and to investigate the mechanism in this kind of diabetes by analyzing the relationship among clinical phenotypes and peripheral leukocyte DNA telomere length. METHODS: Fifteen patients with maternally inherited diabetes in five families were confirmed as carrying the m.3243 A>G mitochondrial DNA mutation. One hundred patients with type 2 diabetes and one hundred healthy control subjects were recruited to participate in the study. Sanger sequencing was used to detect the m.3243 A>G mitochondrial DNA mutation. The peak height G/A ratio in the sequence diagram was calculated. Real-time polymerase chain reaction (PCR) was used to measure telomere length. RESULTS: The patients with mitochondrial diabetes all had definite maternally inherited history, normal BMI (19.5 ± 2.36 kg/m(2)), early onset of diabetes (35.0 ± 14.6 years) and deafness. The peak height G/A ratio correlated significantly and negatively with the age at onset of diabetes (≦ 25 years, 61.6 ± 20.17%; 25-45 years, 16.59 ± 8.64%; >45 years, 6.37 ± 0.59%; p = 0.000). Telomere length was significantly shorter among patients with mitochondrial diabetes and type 2 diabetes than in the control group (1.28 ± 0.54 vs. 1.14 ± 0.43 vs. 1.63 ± 0.61; p = 0.000). However, there was no significant difference between patients with mitochondrial diabetes and those with type 2 diabetes. There was no correlation between telomere length and the peak height G/A ratio. CONCLUSION: Deafness with definite maternal inheritance and normal BMI, associated with elevated blood lactic acid and encephalomyopathy, for the most part, suggest the diagnosis of mitochondrial diabetes . The peak height G/A ratio could reflect the spectrum of age at onset of the disease. Telomere length was shorter in patients with mitochondrial diabetes and those with type 2 diabetes, which suggests that the shorter telomere length is likely involved in the pathogenesis of diabetes but is not specific for this kind of diabetes.

[Research and realization of signal processing algorithms based on FPGA in digital ophthalmic ultrasonography imaging].

OBJECTIVE: To design and improve signal processing algorithms of ophthalmic ultrasonography based on FPGA. METHODS: Achieved three signal processing modules: full parallel distributed dynamic filter, digital quadrature demodulation, logarithmic compression, using Verilog HDL hardware language in Quartus II. RESULTS: Compared to the original system, the hardware cost is reduced, the whole image shows clearer and more information of the deep eyeball contained in the image, the depth of detection increases from 5 cm to 6 cm. CONCLUSION: The new algorithms meet the design requirements and achieve the system's optimization that they can effectively improve the image quality of existing equipment.

[The research of skin imaging technology with high frequency ultrasound].

OBJECTIVE: Developing a high-frequency ultrasonic skin imaging system to obtain the high resolution ultrasonic image of the skin. And further analyzing the ultrasonic images of skin to explore the imaging characteristics of skin structure and then explore the value of high-frequency imaging in the application of skin diagnosis. METHODS: 50 MHz single element ultrasonic transducer, mechanic linear scanning method is used in the imaging system. The resolution and the ability of recognize the skin issue is verified by linear target scanning and clinical trials. RESULTS: Both the axial and lateral resolution of the system reaches 50 microm. The subtle structure of normal skin tissue is clearly visible. Some diseases have obvious appearance in the image. CONCLUSIONS: 50 MHz ultrasonic skin imaging system is of high resolution and is valuable to skin structure detect and disease diagnosis.

Integration of serum metabolomics and network pharmacology reveals the immunoenhancing mechanisms of Qishenbuqi capsules.

Introduction: Qishenbuqi capsule (QSBQC), a listed Chinese patent prescription, comprises of 4 herbs. Clinically, it has been shown to improve immune functions. Methods: Subjects with Qi deficiency and non-Qi deficiency were recruited, who then took QSBQC for 4 weeks. Traditional Chinese medicine (TCM) syndrome scores and the levels of white blood cells, CD3+ T cells (CD3+), CD4+ T cells (CD3+CD4+), CD8+ T cells (CD3+CD8+), and CD4+/CD8+ were determined. Serum metabolomics was used to explore the metabolic mechanisms of QSBQC on improving immunity. Meanwhile, the potential active ingredients, targets, and pathways of QSBQC on enhancing immunity were screened by network pharmacology. Results: QSBQC significantly improved TCM syndrome scores and increased the number of CD8+ T cells of both Qi deficiency and non-Qi deficiency subjects. Serum metabolomics revealed that QSBQC regulated 18 differential metabolites and 8 metabolic pathways of Qi deficiency, and 12 differential metabolites and 7 metabolic pathways of non-Qi deficiency subjects. The "herbs-compounds-pathways" diagram showed that PQ-2, cimifugin, and divaricatol were the main active components. Pathways in cancer and arginine and proline metabolism could be the most important pathways. Conclusion: Our research revealed the immunoenhancing mechanisms of QSBQC and improved the combination of TCM theory and modern western medicine theory.

Research on Golay-coded excitation in real-time imaging of high frequency ultrasound biomicroscopy.

High frequency ultrasonic imaging provides clinicians with high-resolution diagnostic images and more accurate measurement results. The technique is now widely used in ophthalmology, dermatology, and small animal imaging. However, since ultrasonic attenuation in tissue increases rapidly with increasing frequency, the depth of detection of high frequency ultrasound in tissue is limited to a few millimeters. In this paper, a novel method of using Golay-coded excitation as a replacement for conventional single-pulse excitation in high frequency ultrasound biomicroscopy was proposed, and real-time imaging was realized. While maintaining the transmission voltage and image resolution unchanged, the detection depth can be effectively improved. The ultrasonic transmission frequency is 30 MHz and the transmission voltage is ± 60 V p-p. In this study, 4-bit, 8-bit, and 16-bit coding sequences and decoding compression were used. To verify the effectiveness of the coding sequence in real-time imaging of ultrasound biomicroscopy, we designed a 10-µm diameter line target echo experiment, an ultrasound phantom experiment, and an in vitro porcine eye experiment. The experimental results show that the code/decode method of signal processing can not only maintain a resolution consistent with that of single-pulse transmission, but can also improve the detection depth and signal-to-noise ratio.

[Development of a transmitting and echo receiving system for high frequency ultrasonic imaging].

A transmitting and receiving system used in high frequency ultrasound imaging is introduced and has been used for image collection of 10MHz, 20MHz and 50MHz HF ultrasonic imaging equipment. Its experimental results show that this transmitting and receiving system is capable of obtaining a better quality of medical images.

The study of sclareol in inhibiting proliferation of osteosarcoma cells by apoptotic induction and loss of mitochondrial membrane potential.

Sclareol (sclarcol) is an organic compound extracted from sage clary plants. Recent study has showed its anti-tumor effects against breast cancer, gastric carcinoma, osteosarcoma and colorectal cancer. However, its exact mechanisms in inhibiting tumor growth remain unknown. This study thus observed the effect of sclareol on the proliferation of osteosarcoma cells, in an attempt to investigate the role of sclarcol on osteosarcoma growth. MG63 osteosarcoma cell was treated with different concentrations of sclarcol. CCK8 assay was used to test its effect on cell proliferation. LC50 value was then determined to obtain optimal treatment dose. MG63 cells were then divided into control and drug treated group, for measuring apoptosis and mitochondrial membrane potential by flow cytometry, and the expression of cytochrome c, Bax and Bcl-2 by western blot. CCK8 analysis showed that sclareol inhibited MG63 cell proliferation, with an LC50 value at 11.0 µM. Flow cytometry results showed the apoptotic cell ratio was 13.8%, 24.1% and 37.3% after treated with 2.0 µM, 4.0 µM and 8.0 µM sclareol respectively. Compared to control group, sclareol significantly depressed mitochondrial membrane potential of MG63 cells, increased the expression of cytochrome c and Bax, but decreased Bcl-2 expression. In conclusion, Sclareol can inhibit the proliferation of MG63 cells, and induce cell apoptosis and decrease mitochondrial membrane potential suggesting the inhibition of osteosarcoma cells by sclareol might be via both apoptosis induction and decreasing mitochondrial membrane potential.

[Role of intestinal lymphatic pathway in pathogenesis of intestine-derived bacteria/endotoxin translocation in rats in shock].

OBJECTIVE: To observe the changes of toxic substances in mesenteric lymph and portal vein blood of rats in hemorrhagic shock, and the influence of mesenteric lymph duct ligation on level of endotoxin (ET) in organs and bacterial contents in mesenteric lymph nodes (MLN) and spleen in rats with hemorrhagic shock, and to evaluate the role of lymphatic pathway in pathogenesis of intestine-derived bacteria/endotoxin translocation (BET) in rats with shock. METHODS: Twenty-four male Wistar rats were randomly divided into the shock group and control group. A model of serious hemorrhagic shock was reproduced by blood shedding to maintain the blood pressure at 40 mm Hg (1 mm Hg=0.133 kPa) for 90 minutes under aseptic condition, and MLN and portal vein blood were harvested. The specimens were also obtained in control group. The contents of ET, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were determined in them. Thirty male Wistar rats were randomly divided into the sham operation group, shock group and lymphatic duct ligation group. Mesenteric lymph ducts were ligated after resuscitation. All rats were sacrificed, and lung, liver, heart and kidney were removed and homogenized for determination of the content of ET. MLN and spleen homogenates were subjected to bacterial culture. RESULTS: The contents of ET, TNF-alpha and IL-6 in lymph were significantly higher than those of plasma in shock group, and also higher than that in normal plasma and normal lymph (all P<0.01). In shock group the contents of ET in lung, liver, heart and renal homogenate 3 and 6 hours after transfusion and resuscitation were significantly higher than those of sham operation group and ligation group (P<0.05 or P<0.01). Bacterial culture of MLN and spleen in shock group rats 3 and 6 hours after transfusion and resuscitation was positive, but it was not in ligation group. CONCLUSION: The results demonstrate that the intestinal lymphatic pathway plays an important role after compromise of gut barrier function in carrying out BET after hemorrhagic shock.

Genetic source tracking of an anthrax outbreak in Shaanxi province, China.

BACKGROUND: Anthrax is an acute zoonotic infectious disease caused by the bacterium known as Bacillus anthracis. From 26 July to 8 August 2015, an outbreak with 20 suspected cutaneous anthrax cases was reported in Ganquan County, Shaanxi province in China. The genetic source tracking analysis of the anthrax outbreak was performed by molecular epidemiological methods in this study. METHODS: Three molecular typing methods, namely canonical single nucleotide polymorphisms (canSNP), multiple-locus variable-number tandem repeat analysis (MLVA), and single nucleotide repeat (SNR) analysis, were used to investigate the possible source of transmission and identify the genetic relationship among the strains isolated from human cases and diseased animals during the outbreak. RESULTS: Five strains isolated from diseased mules were clustered together with patients' isolates using canSNP typing and MLVA. The causative B. anthracis lineages in this outbreak belonged to the A.Br.001/002 canSNP subgroup and the MLVA15-31 genotype (the 31 genotype in MLVA15 scheme). Because nine isolates from another four provinces in China were clustered together with outbreak-related strains by the canSNP (A.Br.001/002 subgroup) and MLVA15 method (MLVA15-31 genotype), still another SNR analysis (CL10, CL12, CL33, and CL35) was used to source track the outbreak, and the results suggesting that these patients in the anthrax outbreak were probably infected by the same pathogen clone. CONCLUSIONS: It was deduced that the anthrax outbreak occurred in Shaanxi province, China in 2015 was a local occurrence.

[Research progress on tranexamic acid application strategy in total knee arthroplasty].

Tranexamic acid(TXA) as an antifibrinolytic drugs used to reduce the total knee arthroplasty(TKA) postoperative blood loss is a hot issue in recent years. Such as blood loss, hemoglobin, transfusion rate and other relevant indexs effected by the impact of total knee replacement have been studied and investigated by many scholars. There is no a gold standard about how to safely and effectively apply the TXA. Depending on the dose, TXA may be used by body weight or using 1.5 g or 3.0 g directly. Depending on the different route of administration, TXA may be intravenous infusion, topical application and oral medication. Depending on the using opportunity, TXA can be used preoperative, intraoperative, postoperative or combined application with different times. Without any increase in the chances of thrombosis after TKA, choosing the more scientific instructions to play the greatest utility TXA is a hot issue recently.

Caveolin-1 Mediates Low-Intensity Ultrasound-Induced Apoptosis via Downregulation of Signal Transducer and Activator of Transcription 3 Phosphorylation in Laryngeal Carcinoma Cells.

Low-intensity ultrasound therapy has been found to be a potential tool in the management of malignant tumors in recent years. However, the molecular mechanism underlying low-intensity ultrasound-induced apoptosis is still not clear. In this study, we investigated the effects of low-intensity ultrasound-induced apoptosis in HEp-2 cells. We found that low-intensity ultrasound significantly induced apoptosis, and the expression level of caveolin-1 (Cav-1) was dramatically increased after ultrasound treatment of HEp-2 cells. After inhibiting the expression level of Cav-1 using siRNA transfection, we found that the cellular apoptosis induced by low-intensity ultrasound was significantly suppressed. In addition, inhibition of Cav-1 expression promoted phosphorylation of signal transducer and activator of transcription 3 (STAT3), suggesting that the STAT3 signaling pathway was involved in low-intensity ultrasound-induced apoptosis via Cav-1 regulation. Our results indicate that Cav-1/STAT3 signaling pathway may mediate low-intensity ultrasound-induced apoptosis, and this technology could potentially be used clinically for the treatment of cancers.

Barker-coded excitation in ophthalmological ultrasound imaging.

High-frequency ultrasound is an attractive means to obtain fine-resolution images of biological tissues for ophthalmologic imaging. To solve the tradeoff between axial resolution and detection depth, existing in the conventional single-pulse excitation, this study develops a new method which uses 13-bit Barker-coded excitation and a mismatched filter for high-frequency ophthalmologic imaging. A novel imaging platform has been designed after trying out various encoding methods. The simulation and experiment result show that the mismatched filter can achieve a much higher out signal main to side lobe which is 9.7 times of the matched one. The coded excitation method has significant advantages over the single-pulse excitation system in terms of a lower MI, a higher resolution, and a deeper detection depth, which improve the quality of ophthalmic tissue imaging. Therefore, this method has great values in scientific application and medical market.

Quercetin: a potential natural drug for adjuvant treatment of rheumatoid arthritis.

Rheumatoid arthritis (RA) is the rheumatism mainly manifested as disabling joint disease and mainly involves hands, wrists, feet and other small joints. Recurrent arthritis attacks, synovial cell hypertrophy and hyperplasia and bone and cartilage damages eventually lead to joint dysfunction and other complications, and there is no cure. Quercetin (QU) is a kind of natural flavonoids, with lipid-lowering, anti-inflammatory and other pharmacological activities, and minor toxic side effects. Thus, we assume that QU may be an adjuvant natural drug for treatment of RA. The possible mechanism is through regulation of NF-κB, to inhibit the transcription of joint synovitis factors, hinder the generation of inflammatory factors, and inhibit the inflammatory reaction; through inhibiting the activities of VEGF, bFGF, MMP-2 and other cytokines, to inhibit angiogenesis in multiple links and inhibit synovial pannus formation. QU may be an adjuvant natural drug for treatment of RA.

[Clinical experience of treatment of 275 mandible fractures].

OBJECTIVE: To evaluate the treatment effect of mandible fractures. METHODS: Clinical data of 275 mandibular fracture patients of Tongchuan people's hospital were analysed. RESULTS: (1) The systemic health of 27 non-surgery cases were influenced during the intermaxillary ligation and 3 cases of them had deformity of maxillofacial region. (2) In the surgery group, 5 of 73 cases fixed by steel wire had disorder of occlusion, 6 of 169 cases fixed by titanium mini plate accepted secondary operation of removing the plates, and 6 cases fixed by bioabsorbable mini plate had better effect. CONCLUSION: The internal rigid fixation is an appropriate and effective method for the mandible fractures.

[Correlation between point mutation frequency of MBL gene exon I and plasma MBL concentration in healthy Mongolians].

AIM: To investigate the point mutation at codon 54 of mannose binding lectin (MBL) gene, detect the plasma MBL level, and analyze the correlation between the gene mutation frequency and plasma MBL concentration. METHODS: A method for detecting MBL gene point mutation (PCR-RFLP) was established with self-designed primers according to MBL genomic sequence. The plasma MBL concentration was detected by MBL Oliger ELISA kit. RESULTS: The PCR-RFLP for detecting the point mutation at codon 54 of MBL gene was established. Frequency of point mutation at codon 54 of MBL gene in healthy Mongolians was 0.18. The plasma MBL concentration was (2.53+/-1.96)mg/L. There was negative correlation between plasma MBL concentration and MBL gene mutation frequency in Mongolians (r = -0.641). CONCLUSION: The established method of PCR-RFLP was proved to have high specificity, excellent reproducibility and high sensitivity. The relationship between frequency of mutation at codon 54 of MBL gene and the plasma MBL concentration in healthy Mongolians is negatively correlated.