Clinical Efficacy and Safety of Ibuprofen plus Traction, Reposition, and Hip Spica Cast in the Treatment of Developmental Dysplasia of the Hip.

Objective: To assess the clinical efficacy and safety of ibuprofen plus traction, reposition, and hip spica cast in the treatment of developmental dysplasia of the hip (DDH). Methods: Between January 2019 and July 2020, 60 children with DDH treaded in department of orthopedics of our institution were assessed for eligibility and recruited. They were assigned at a ratio of 1 : 1 to receive either traction + reposition + hip spica cast plus analgesia pump (observation group) or traction + reposition + hip spica cast plus analgesia pump and oral ibuprofen (control group). The outcome measures included clinical efficacy, pain scores, unexpected pain calls, the dosage of analgesia pump, and adverse events. Results: The two groups had similar clinical efficacy (P > 0.05). The patients given oral ibuprofen were associated with significantly lower pain scores at 24 h and 72 h postoperatively versus those without oral ibuprofen (P < 0.05). Analgesics with oral ibuprofen resulted in fewer unexpected pain calls versus analgesics without oral ibuprofen within 72 h postoperatively (P < 0.05). The application of oral ibuprofen in the analgesia pump showed great improvement in lowering the dosage of analgesia pump versus the absence of ibuprofen (P < 0.05). The incidence of adverse events was similar between the two groups of patients (P > 0.05). Conclusion: Traction + reposition + hip spica cast plus analgesia pump and oral ibuprofen effectively mitigated postoperative pain in children with DDH and reduces analgesic drug dosage with a high safety profile.

Prospective comparative analysis for application and selection of FIESTA sequence and SSFSE sequence in MRI for prenatal diagnosis of placenta previa accreta.

Placenta previa accreta patients were examined using fast-imaging employing steady-state acquisition (FIESTA) and single-shot fast spin echo (SSFSE) sequence. The diagnostic value of the two sequences was compared. FIESTA was better than the SSFSE sequence in displaying outline-boundary (excellent: 82 vs. 26), signal-to-noise ratio (excellent: 75 vs. 54) for placenta and uterus. The direct signs detection rate in FIESTA was higher than SSFSE (implantable: P = .028, adhesive: P = .131, penetrating type: P = .326). The indirect signs detection rate in FIESTA was lower than SSFSE (low-signal density: P = .029, uneven-signal density: P = .328, thicker and more vascular shadow: P = 398). FIESTA combining SSFSE demonstrated higher detecting rates (100% for sensitivity, specificity, and accuracy) for all types than single sequence scanning (FIESTA/SSFSE). In conclusion, FIESTA clearly showed the situation of the placenta and uterus in placenta previa accreta patients, with excellent image quality. A combination of FIESTA and SSFSE can improve the diagnostic value of placenta previa accreta.Important statementWhat is already known on this subject? Placenta previa is the most common cause of vaginal bleeding in the third trimester of pregnancy.What do the results of this study add? FIESTA was better than the SSFSE sequence in displaying images and demonstrated higher detection rates for direct signs and lower detection rate comparing the SSFSE sequence. FIESTA combining SSFSE sequence demonstrated higher detecting rates for implantable, adhesive and penetrating types than single sequence scanning.What are the implications of these findings for clinical practice and/or further research? FIESTA sequence clearly showed the situation of placenta and uterus in placenta previa accreta patients, with excellent image quality. Combination of FIESTA and SSFSE sequences can effectively improve the diagnostic value of placenta previa accreta.

Effect of ligating dogs' arteries and veins on femoral heads.

BACKGROUND: We separately ligated the arteries and veins of dogs to establish a canine femoral head necrosis model, then compared the differences between the outcomes of the two ligation methods on canine femoral heads. METHODS: Twenty-four dogs in this experiment were randomly and evenly sorted into two groups (Group A, the arterial group; and Group B, the venous group). In dogs in Group A, the unilateral deep femoral arteries of the hips were ligated. In dogs in Group B, the unilateral deep femoral veins of the hips were ligated. Two dogs from each group were randomly selected at the 2nd, 4th, 6th, 8th, 10th, and 12th weeks postoperatively and were marked as Groups A1-A6 and B1-B6 according to the selection times. The dogs underwent X-ray (DR) and a magnetic resonance imaging (MRI) plain scan (1.5 T) on both hip joints and were then sacrificed. Bilateral femoral head specimens were soaked in formalin and then decalcified. Hematoxylin-eosin (HE) staining and histopathologic evaluation were performed on the tissue sections. RESULTS: In dogs in Group B, abnormal pathologic changes, such as adipocytes fusing into cysts, were observed at the 4th week after establishing the model. MRI scans showed abnormal signal intensity at the 6th week, and fibrocyte regrowth was demonstrated in the necrotic area of the femoral heads at the 10th week. At the same time, indicators of tissue repair and fresh granulation tissue emerged. Changes in dogs in Group A, such as interstitial haemorrhage and oedema, were not noted in pathologic sections until 6 weeks after the model was established. MRI showed abnormal signals, such as a linear low signal intensity in the weight-bearing area of the femoral heads at the 8th week. New blood vessels emerged in the necrotic area at the 12th week, while there was no proliferation of fibrocytes and tissues. CONCLUSIONS: The development and evolution of femoral head necrosis caused by ligation of the main veins of the femoral head in dogs appeared earlier than in dogs with arterial ligation, and pathologic changes, such as necrosis and repair, were more significant in dogs in the venous group than in dogs in the other group.

miR-1307-5p regulates proliferation and apoptosis of chondrocytes in osteoarthritis by specifically inhibiting transforming growth factor beta-induced gene.

OBJECTIVE: To explore the effect of miR-1307-5p which specifically inhibits transforming growth factor beta-induced gene (TGFBI) on the biologic behavior of osteoarthritis (OA) chondrocytes. METHODS: We detected miR-1307-5p and TGFBI expression in the cartilage tissue specimens of OA patients and mice, respectively. RNA22 was applied to predict the target gene of miR-1307-5p, and we further verified the relationship by performing a dual luciferase reporter experiment. Enzyme-linked immunosorbent assay was used to measure the expression of matrix metalloproteinase inhibitor-1 (TIMP-1), interleukin-1ß (IL-1ß), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in the culture medium of mouse chondrocytes. Quantitative reverse transcription-polymerase chain reaction and western blot were used to measure the expression of Bax and Bcl-2. MTT method was applied to detect the proliferation activity of chondrocytes, while flow cytometry was implemented to detect the apoptosis of chondrocytes. RESULTS: The expression of miR-1307-5p in cartilage tissue specimens of OA patients was up-regulated, while TGFBI expression was down-regulated. Compared with normal mice cartilage tissue specimens, the expression of miR-1307-5p in cartilage tissue specimens of OA mouse was increased, while TGFBI expression was decreased (both P<0.05). The results of the dual luciferase reporter experiment showed that TGFBI was a target gene of miR-1307-5p. In cell experiments, compared with the normal group, TIMP-1 and Bcl-2 expression, and cell proliferation activities in all model groups were decreased. IL-1ß, IL-6, TNF-α, Bax expression, and cell apoptosis rates were increased (all P<0.05). Compared with the blank group, TIMP-1 and Bcl-2 expression, and cell proliferation activities in the miR-1307-5p inhibitor group and the TGFBI group were increased, while IL-1ß, IL-6, TNF-α, and Bax expression, and cell apoptosis rates were decreased (all P<0.05). The changes in all indicators in the miR-1307-5p mimic group were opposite to those of the miR-1307-5p inhibitor group (all P<0.05). There were no significant differences concerning all indicators between the blank group and the NC group, and between the blank group and the miR-1307-5p mimic + TGFBI group (all P>0.05). CONCLUSION: The suppression of miR-1307-5p expression can increase TGFBI expression, promoting the proliferation of chondrocytes in OA mice, while inhibiting their apoptosis.

Recessive/dominant model: Alternative choice in case-control-based genome-wide association studies.

An additive genetic model is usually employed in case-control-based genome-wide association studies. The model usually encodes "AA", "Aa" and "aa" ("a" represents the minor allele) as three different numbers, implying the contribution of genotype "Aa" to the phenotype is different from "AA" and "aa". From the perspective of biological phenomena, the coding is reasonable since the phenotypes of lives are not "black and white". A case-control based study, however, has only two phenotypes, case and control, which means that the phenotypes are "black and white". It suggests that a recessive/dominant model may be an alternative to the additive model. In order to investigate whether the alternative is feasible, we conducted comparative experiments on several models used in those studies through chi-square test and logistic regression. Our simulation experiments demonstrate that a recessive model is better than the additive model. The area under the curve of the former has increased by 5% compared with the latter, the discrimination of identifying risk single nucleotide polymorphisms has been improved by 61%, and the precision has also reached 1.10 times that of the latter. Furthermore, the real data experiments show that the precision and area under the curve of the former are 16% and 20% higher than the latter respectively, and the area under the curve of dominant model of the former is 13% higher than the latter. The results indicate a recessive/dominant model may be an alternative to the additive model and suggest a new route for case-control-based studies.

coPLINK: A complementary tool to PLINK.

In genome-wide association studies (GWAS), a wide variety of analysis tools have been designed, leading to various formats of GWAS data. How to convert a dataset in non-PLINK format into PLINK format to use its powerful analysis performance, or to convert a dataset in PLINK format into the format of other analysis tools, is a problem that needs to be faced and solved. To address this issue, we developed a tool called coPLINK, a complementary tool to PLINK, to cooperate with PLINK to implement the conversions of GWAS data formats and to provide some additional functions, such as data files comparison. The tool can implement mutual conversions not only between an existing data format and PLINK PED/BED, but also between a user-defined data format and PLINK PED. The usage and performance of the tool are similar to PLINK. The characteristics of the conversions of existing data formats and user-defined formats make it be a good assistant to PLINK or other tools and, have good potential for GWAS studies or other works.

Density distribution of gene expression profiles and evaluation of using maximal information coefficient to identify differentially expressed genes.

The hypothesis of data probability density distributions has many effects on the design of a new statistical method. Based on the analysis of a group of real gene expression profiles, this study reveal that the primary density distributions of the real profiles are normal/log-normal and t distributions, accounting for 80% and 19% respectively. According to these distributions, we generated a series of simulation data to make a more comprehensive assessment for a novel statistical method, maximal information coefficient (MIC). The results show that MIC is not only in the top tier in the overall performance of identifying differentially expressed genes, but also exhibits a better adaptability and an excellent noise immunity in comparison with the existing methods.

Improved vacuum sealing drainage in the treatment of gas gangrene: a case report.

In this case, improved vacuum sealing drainage was used for gas gangrene treatment, which is different from traditional therapies of gas gangrene and this is the first report of using improved vacuum sealing drainage to treat gas gangrene. The patient was a 12-year-old Asian Male who was presented to the Emergency Department with a one-day history of left femoral progressing swelling, paining and fevering. Four days ago, rusty iron bars were plugged into the muscle of the left femoral when he played. Then he was taken to the local clinic and injected with tetanus antitoxin. A diagnosis of gas gangrene was made and modified vacuum sealing drainage device was used after thorough debridement. After two weeks' treatment, left femoral was kept and gas gangrene was cured successfully.