A nomogram model based on the combination of the systemic immune-inflammation index, body mass index, and neutrophil/lymphocyte ratio to predict the risk of preoperative deep venous thrombosis in elderly patients with intertrochanteric femoral fracture: a retrospective cohort study.

OBJECTIVES: Deep vein thrombosis (DVT) has been considered as a frequent and serious consequence of intertrochanteric femoral fractures in the elderly. Several negative repercussions of DVT can be considerably mitigated by its timely recognition and treatment. The current work was aimed at exploring the factors independently predicting DVT among cases suffering from intertrochanteric femoral fractures and validate their predictive usefulness in diagnosing DVT. METHODS: Between April 2017 and July 2022, clinical information from 209 cases showing preoperative DVT for femoral intertrochanteric fractures were retrospectively evaluated. In patients with femoral intertrochanteric fractures, logistic regression analysis with a backward stepwise method was adopted for detecting independent predictors for the diagnosis of preoperative DVT. Using multivariate logistic regression, a nomogram prediction model was developed and verified with the testing group. RESULTS: According to multivariate logistic regression model, body mass index (BMI) (OR 0.79, 95% CI 0.63-0.99, P = 0.042), neutrophil/lymphocyte ratio (NLR) (OR 7.29, 95% CI 1.53, 34.64, P = 0.0012), and systemic immune-inflammation index (SII) (OR 6.61, 95% CI 2.35, 18.59, P = 0.001) were independent predictors for DVT before surgery among cases developing intertrochanteric femoral fracture. AUC values were 0.862 and 0.767 for training and testing groups, separately, while their mean errors in the calibration curve were 0.027 and 0.038 separately. Decision curve analysis (DCA) curve revealed a high value of clinical application for both groups. CONCLUSION: Upon admission, BMI, NLR, and SII are independent predictors of DVT before surgery among cases developing intertrochanteric femoral fractures. Additionally, the nomogram based on the BMI, NLR, and SII can assist clinicians in determining if preventive and symptomatic therapies are required to improve DVT prognosis and reduce its associated mortality.

Study on Flavonoids and Bioactivity Features of Pericarp of Citrus reticulata "Chachi" at Different Harvest Periods.

Dry mature pericarp of Citrus reticulata "Chachi" (PCR), Pericarpium Citri Reticulatae Chachiensis, is a traditional Chinese medicine that displays characteristics of different usage at different harvest times in clinical use. The corresponding changes in the bioactive components in PCR from different harvest times remain unclear. Therefore, in this study, broadly targeted metabolomics technology was used to compare the differences in bioactive components among pericarps of PCR, which are the raw material of PCR at different growth stages. In the results, 210 kinds of flavonoid metabolites were detected. The content of hesperidin in red PCR harvested in December was higher than that in Citri Reticulatae Pericarpium Viride (CRPV) and reddish PCR harvested from July to November. Furthermore, the content of nobiletin, tangeretin, and 3,3',4',5,6,7,8-heptamethoxyflavone in CRPV from July to September was higher than that in the PCR harvested at other times. In addition, the result of cluster analysis and PCA showed that CRPV harvested from July to September had an obvious grouping pattern with the reddish PCR and the red PCR harvested from October to December. Differential metabolites in six comparison groups (A1 vs. A6, A1 vs. A2, A2 vs. A3, A3 vs. A4, A4 vs. A5, A5 vs. A6) were 67, 48, 14, 51, 42, and 40, respectively. The common differential metabolite of four comparison groups was 3',4',7-trihydroxyflavone (A1 vs. A2, A2 vs. A3, A3 vs. A4, A4 vs. A5). All the flavonoid differential metabolites screened were enriched in 16 metabolic pathways. Moreover, the results of the evaluation of the total antioxidant capacity indicated that CRPV in August was a suitable raw material for the production of antioxidants. Through molecular docking, the content of potential anti-SARS-CoV-2 components in the PCR in October was higher than that in the PCR in other periods. These results further proved that PCR at different harvest times was endowed with different efficacy and usage due to the difference in the accumulation of bioactive components.

Decreased serum CXCL12/SDF-1 concentrations may reflect disease severity of non-traumatic osteonecrosis of femoral head.

OBJECTIVE: The current study was performed to investigate the potential association of serum CXCL12 with disease severity in non-traumatic ONFH. METHODS: This study enrolled 182 patients with non-traumatic ONFH and 182 age- and gender-matched healthy controls. The CXCL12 levels in serum were measured by enzyme-linked immunosorbent assay. Meanwhile, serum levels of procollagen type I (PINP) and Interleukin-33(IL-33) were also detected. The radiographic severity was determined by FICAT grade. Clinical severity was evaluated by visual analogue scale (VAS), Harris Hip Score (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Among the non-traumatic ONFH, 90 patients ONFH received total hip arthroplasty, the localization and expression of the CXCL12 protein and mRNA were detected by immunohistochemistry, Western blot analysis, RT-PCR and in necrotic area and adjacent non-necrotic area from lesioned femoral neck from ONFH patients and healthy femoral head from femoral neck fracture patients. Receiver operating characteristic (ROC) curve analysis was carried out to confirm the diagnostic value serum CXCL12, PINP and IL-33 with regard to the FICAT grade. RESULTS: Serum CXCL12 levels were significantly lower in non-traumatic ONFH patients compared with healthy controls. CXCL12 mRNA and protein expressions were both significantly decreased in necrotic area in comparison with non-necrotic area and healthy femoral head. Serum CXCL12 concentrations were drastically reduced in patients with FICAT stage 4 compared with stage 3, and CXCL12 concentrations in patients with stage 3 were markedly lower than stage 2. Serum CXCL12 levels were negatively related to FICAT grading. In addition, Serum CXCL12 concentrations were also negatively related to VAS, WOMAC scores and positively correlated with HHS scores. Meanwhile, serum CXCL12 levels were positively correlated with serum PINP and negatively correlated with IL-33 levels. ROC curve analysis implicated that decrease CXCL12 in serum may act as a favorable marker for FICAT grade. CONCLUSIONS: Decreased serum CXCL12 concentrations may reflect disease severity of non-traumatic ONFH.

Blastosporiumpersicolor gen. et sp. nov., a new helotialean fungus.

A new genus and species, Blastosporiumpersicolor, is described and illustrated from leaves of mildewed tobacco. It is characterised by branched, septate hyphae from which arise macronematous, unbranched or spaced branched conidiophores and mono- or polyblastic conidiogenous cells that produced solitary and blastocatenate, obovoid, oblong, ellipsoidal, allantoid, broad fusiform to irregular, unicellular, hyaline conidia. The phylogenetic analyses, based on the combined sequence data from the small and large nuclear subunit ribosomal DNA (SSU and LSU), placed B.persicolor in the Leotiomycetes class, Helotiales order.