Suture Bridge Technique with 5-Ethibond: A Promising Approach for Infrapatellar Pole Fracture Treatment.

Purpose: Infrapatellar pole fractures are challenging injuries that require appropriate treatment to ensure optimal functional outcomes. This study aimed to introduce the application of the Suture Bridge technique using the 5-Ethibond for the treatment of infrapatellar patella fracture. Methods: Five cases of infrapatellar pole fracture that were treated at our institution between February 2020 and September 2021. The patients included one male and four females, with an average age of 66 years (range: 60-77 years). All patients were treated with the Suture Bridge technique using the 5-Ethibond to preserve the infrapatellar pole. Results: The average operative time was 64 min (range: 50-80 min). The average blood loss during surgery was 51 mL (range: 40-60 mL). All cases demonstrated fracture healing at an average of 10 weeks (range 8-12) after surgery. The patients were followed up for an average period of 14.8 months (8-22). No wound infection or second displacement of fracture fragment was found. Full range of motion was restored in all patients within 12-14 weeks after surgery. None of the patients complained of anterior knee pain. Conclusions: Based on the findings of the study, it appears that the Suture Bridge technique using 5-Ethibond is a promising and viable option for the treatment of infrapatellar pole fractures.

Parental Psychological Control and Adolescent Academic Achievement: The Mediating Role of Achievement Goal Orientation.

This study examined the multiple mediating roles of achievement goal orientation between three parental psychological control (PPC) strategies and adolescents' academic achievement. The study sample consisted of 2613 Chinese middle school adolescents (52.6% boys) who were followed for one and a half years; they completed questionnaires on PPC (including love withdrawal, guilt induction, and authority assertion), achievement goal orientation (involving the mastery approach, the performance approach, and performance-avoidance goals), and academic achievement. We found that (1) the direct effects of the three strategies on academic performance differed, with love withdrawal directly and negatively predicting adolescents' academic achievement and guilt induction and authority assertion not being significant direct predictors. (2) The mediating role of achievement goal orientations differed across the psychological control strategies. Specifically, love withdrawal led to adolescents' academic achievement through their performance-approach goal orientation, performance-avoidance goal orientation, and mastery goal orientation. Moreover, guilt induction and authority assertion had impacts only on adolescents' performance-approach and performance-avoidance goal orientations. This study highlights the negative impact of love withdrawal on adolescents' internal motivation and academic achievement by warning parents not to use this strategy to influence their children's thoughts and feelings.

Effect of Cooling Rate on the Microstructure and Mechanical Property of Nickel-Based Superalloy MAR-M247.

Heat treatment is an important process for optimizing the microstructures of superalloys, and the cooling rate after solid solution treatment is one of the most critical parameters. In this work, we treated solid solution MAR-M247 alloys with water quenching, air cooling, and furnace cooling. Microstructure characterization, hardness, and room temperature tensile tests were conducted to investigate the effect of cooling rate on the microstructure and mechanical properties of MAR-M247 alloys. The results showed that the cooling rate after solid solution treatment mainly affected the precipitation behavior of the secondary γ' phase, but it had few effects on other microstructure characterizations, including grain size, γ/γ' eutectic, and MC carbide. The water-quenched sample had the highest cooling rate (400 °C/s) and hardness (400 HV) but suffered from premature fracture because of quenching cracks. A further decrease in cooling rate from 1.5 °C/s to 0.1 °C/s deteriorated hardness (384 HV to 364 HV) and yield strength (960 MPa to 771 MPa) but increased elongation (8.5% to 13.5%). Moreover, the deformation mechanism was transformed from dislocation shearing to Orowan bypassing. The decreased yield strength was mainly due to the weakened precipitation strengthening resulting from γ'-phase coarsening. The improved elongation was attributed to not only the higher work-hardening index caused by interface dislocation networks but also the more uniform deformation, which delayed necking.

Effect of Deformation Conditions on Strain-Induced Precipitation of 7Mo Super-Austenitic Stainless Steel.

Strain-induced precipitation (SIP) behaviors of 7Mo super-austenitic stainless steel (SASS) under various deformation conditions were studied by stress relaxation tests. The research demonstrates that sigma phases are the primary SIP phases of 7Mo SASS. Generally, SIP is mainly distributed in granular shape at the boundaries of deformed grains or recrystallized grains, as well as around the deformed microstructure, such as deformation twin layers/matrix interfaces. The variation of deformation parameters can lead to changes in microstructure, therefore influencing the distribution of SIP. For instance, with the temperature increases, the SIP distribution gradually evolves from deformed grain boundaries to recrystallized grain boundaries. The average size of SIP increases with increasing temperature and strain, as well as decreasing strain rate. The SIP content also increases with increasing strain and decreasing strain rate, while exhibiting an initial rise followed by a decline with increasing temperature, reaching its maximum value at 850 °C. The presence of SIP can promote recrystallization by particle-induced nucleation (PSN) mechanism during the hot deformation process. Moreover, the boundaries of these recrystallized grains can also serve as nucleation sites for SIP, therefore promoting SIP. This process can be simplified as SIP→PSNRecrystallization→Nucleation sitesSIP. With the increase in holding time and the consumption of stored energy, the process gradually slows down, leading to the formation of a multi-layer structure, namely SIPs/Recrystallized grains/SIPs structure. Moreover, SIP at recrystallized grain boundaries can hinder the growth of recrystallized grains. Through this study, a comprehensive understanding of the SIP behaviors in 7Mo SASS under different deformation conditions has been achieved, as well as the interaction between SIP and recrystallization. This finding provides valuable insights for effective control or regulation of SIP and optimizing the hot working processes of 7Mo SASS.

Non-Lethal Doses of RSL3 Impair Microvascular Endothelial Barrier through Degradation of Sphingosie-1-Phosphate Receptor 1 and Cytoskeletal Arrangement in A Ferroptosis-Independent Manner.

The excess microvascular endothelial permeability is a hallmark of acute inflammatory diseases. Maintenance of microvascular integrity is critical to preventing leakage of vascular components into the surrounding tissues. Sphingosine-1-phosphate (S1P) is an active lysophospholipid that enhances the endothelial cell (EC) barrier via activation of its receptor S1PR1. Here, we delineate the effect of non-lethal doses of RSL3, an inhibitor of glutathione peroxidase 4 (GPX4), on EC barrier function. Low doses of RSL3 (50-100 nM) attenuated S1P-induced human lung microvascular barrier enhancement and the phosphorylation of AKT. To investigate the molecular mechanisms by which RSL3 attenuates S1P's effect, we examined the S1PR1 levels. RSL3 treatment reduced S1PR1 levels in 1 h, whereas the effect was attenuated by the proteasome and lysosome inhibitors as well as a lipid raft inhibitor. Immunofluorescence staining showed that RSL3 induced S1PR1 internalization from the plasma membrane into the cytoplasm. Furthermore, we found that RSL3 (100 and 200 nM) increased EC barrier permeability and cytoskeletal rearrangement without altering cell viability. Taken together, our data delineates that non-lethal doses of RSL3 impair EC barrier function via two mechanisms. RSL3 attenuates S1P1-induced EC barrier enhancement and disrupts EC barrier integrity through the generation of 4-hydroxynonena (4HNE). All these effects are independent of ferroptosis.

Case report: Unusual cause of refractory hypoxemia after pacemaker lead extraction.

A 59-year-old woman with a history of a pacemaker implanted for III-degree atrioventricular block was admitted due to pocket infection. The atrial and ventricular leads were removed via the right femoral vein using a needle's eye snare. Hypoxemia was observed immediately after the removal of the lead. It was refractory to oxygen therapy. The pulse oxygen saturation (SpO2) showed 89% in the supine position and 77% in the upright position. However, the CTPA and pulmonary perfusion SPECT/CT imaging did not reveal any signs of pulmonary embolism. Pulmonary function tests and chest CT showed normal results. Transthoracic contrast echocardiography revealed a patent foramen ovale (PFO) and a right-to-left intracardiac shunt, no significant tricuspid regurgitation, without any signs of elevated right heart pressure or pulmonary hypertension. Hypoxemia was considered to be associated with the right-to-left shunt through PFO. The condition was relieved by percutaneous closure of the PFO. Refractory hypoxemia resulting from an intracardiac right-to-left shunt following pacemaker lead extraction is a rare but serious complication. Transthoracic contrast echocardiography helps in diagnosis. If the right-to-left intracardiac shunt through PFO persists irreversibly and the associated hypoxemic symptoms are significant, closure of the PFO is necessary. Transesophageal echocardiography also revealed the presence of a left-to-right shunt through PFO during cardiac systole. The closure of the PFO is also necessary to avoid long-term complications, such as chronic pulmonary hypertension and right heart failure.

USP13 regulates cell senescence through mediating MDM2 stability.

AIMS: Lung aging results in altered lung function, reduced lung remodeling and regenerative capacity, and increased susceptibility to acute and chronic lung diseases. The molecular and physiological underlying mechanisms of lung aging remain unclear. Mounting evidence suggests that deubiquitinating enzymes (DUBs) play a critical role in tissue aging and diseases through regulation of cellular signaling pathways. Here we investigate the role of Ubiquitin-Specific Protease 13 (USP13) in cell senescence and lung aging and its underlying mechanisms. MAIN METHODS: Protein levels of USP13 and MDM2 in lung tissues from aged and young mice were compared. Gene silencing and overexpression of USP13 in human cell lines were performed. MDM2 levels were examined by Quantitative Real-Time PCR and Western blotting analysis. The cell senescence levels of human cells were checked by the ß-galactosidase staining. KEY FINDINGS: Lung tissues from aged mice showed higher levels of USP13 compared to younger mice. We found a negative correlation between USP13 and MDM2 expression in lung tissues of aged mice. The increased protein levels of MDM2 were detected in lung tissues of USP13 deficient mice. Furthermore, overexpression of USP13 promoted cell senescence. Knockdown of USP13 increased MDM2 levels in lung cells, while overexpression of USP13 reduced it. The degradation of MDM2 caused by USP13 was prevented by the proteasome inhibitor MG132. Furthermore, we showed that USP13 targeted and reduced K63-linked polyubiquitination of MDM2. These results demonstrate that USP13 is involved in the aging signaling pathway in lungs through regulation of MDM2.

The Optimized Homogenization Process of Cast 7Mo Super Austenitic Stainless Steel.

Super austenitic stainless steels are expected to replace expensive alloys in harsh environments due to their superior corrosion resistance and mechanical properties. However, the ultra-high alloy contents drive serious segregation in cast steels, where the σ phase is difficult to eliminate. In this study, the microstructural evolution of 7Mo super austenitic stainless steels under different homogenization methods was investigated. The results showed that after isothermal treatment for 30 h at 1250 °C, the σ phase in steels dissolved, while the remelting morphologies appeared at the phase boundaries. Therefore, the stepped solution heat treatment was further conducted to optimize the homogenized microstructure. The samples were heated up to 1220 °C, 1235 °C and 1250 °C with a slow heating rate, and held at these temperatures for 2 h, respectively. The elemental segregation was greatly reduced without incipient remelting and the σ phase was eventually reduced to less than 0.6%. A prolonged incubation below the dissolution temperature will lead to a spontaneous compositional adjustment of the eutectic σ phase, resulting in uphill diffusion of Cr and Mn, and reducing the homogenization efficiency of ISHT, which is avoided by SSHT. The hardness reduced from 228~236 Hv to 220~232 Hv by adopting the cooling process of "furnace cooling + water quench". In addition, the study noticed that increasing the Ce content or decreasing the Mn content can both refine the homogenized grain size and accelerate diffusion processes. This study provides a theoretical and experimental basis for the process and composition optimization of super austenitic stainless steels.

ISGylation of NF-κBp65 by SCFFBXL19 E3 Ligase Diminishes Endothelial Inflammation.

BACKGROUND: NF-κB (nuclear factor kappa B) plays a pivotal role in endothelial cell (EC) inflammation. Protein ISGylation is regulated by E3 ISG15 (interferon-stimulated gene 15) ligases; however, ISGylation of NF-κBp65 and its role in EC functions have not been investigated. Here, we investigate whether p65 is ISGylated and the role of its ISGylation in endothelial functions. METHODS: In vitro ISGylation assay and EC inflammation were performed. EC-specific transgenic mice were utilized in a murine model of acute lung injury. RESULTS: We find that NF-κBp65 is ISGylated in resting ECs and that the posttranslational modification is reversible. TNFα (tumor necrosis factor alpha) and endotoxin stimulation of EC reduce p65 ISGylation, promoting its serine phosphorylation through reducing its association with a phosphatase WIP1 (wild-type p53-induced phosphatase 1). Mechanistically, an SCF (Skp1-Cul1-F-box) protein E3 ligase SCFFBXL19 is identified as a new ISG15 E3 ligase that targets and catalyzes ISGylation of p65. Depletion of FBXL19 (F-box and leucine-rich repeat protein 19) increases p65 phosphorylation and EC inflammation, suggesting a negative correlation between p65 ISGylation and phosphorylation. Moreover, EC-specific FBXL19 overexpressing humanized transgenic mice exhibit reduced lung inflammation and severity of experimental acute lung injury. CONCLUSIONS: Together, our data reveal a new posttranslational modification of p65 catalyzed by a previously unrecognized role of SCFFBXL19 as an ISG15 E3 ligase that modulates EC inflammation.

Predictors for adverse events during cardiac lead extraction - Experience from a large single centre.

BACKGROUND: As the use of cardiac implantable electronic devices (CIED) has increased in recent years, the need for transvenous lead extraction (TLE) has also steadily increased. However, the TLE procedure could lead to serious complications and even death. Clinical decision-making tools are necessary for predicting these adverse events, but the appropriate tools have not yet been developed. OBJECTIVE: To explore the possible predictors and develop a clinical model to predict TLE related adverse events. METHODS: All the patients who were admitted to our cardiac center for TLE from January 2014 to January 2021 were included in this study. The patient information, device baseline characteristics, procedure-related information, complications and outcomes were recorded. Independent predictors of TLE related adverse events were identified by univariate, LASSO and multivariate analysis. A nomogram for predicting these adverse events was developed based on these independent predictors. Calibration and decision curve analysis were conducted to evaluate the nomogram. RESULTS: One thousand and one hundred patients were included in this study, 778 (70.7%) were male and the median age was 68 years old. A total of 2,208 leads were extracted and 2.01±0.74 leads were extracted per procedure. Fifty-five patients (5%) developed adverse events including minor complications (2.4%), major complications (2.3%) and death (0.27%). Seven independent predictors for TLE related adverse events were identified and selected to establish the nomogram including BMI, female gender, hypoalbuminemia, number of extracted leads>3, longest dwell time of the extracted leads and manual traction. The area under the receiver operating characteristic (ROC) curve (AUC) for the prediction model was 0.774. Calibration curve and decision curve analysis showed that the nomogram had good prediction performance. CONCLUSION: TLE related adverse events are some of the key issues that concern clinicians. We have identified seven independent factors and established a predictive model that may help clinicians identify at-risk patients and create better plans for lead extraction.

Cardiovascular adverse events in chronic myeloid leukemia patients treated with nilotinib or imatinib: A systematic review, meta-analysis and integrative bioinformatics analysis.

Objective: The aim of this article is to assess the risk and potential mechanisms of cardiovascular adverse events in patients treated with nilotinib or imatinib by conducting a systematic review, meta-analysis and integrative bioinformatics analysis. Materials and methods: Three databases were systematically searched for studies published from inception to May 29, 2022. Differential expression analysis and weighted gene coexpression network analysis (WGCNA) were performed to search for modules of genes most associated with cardiotoxicity. Protein-protein interaction (PPI) network analysis was then performed to identify hub genes for the cardiotoxicity of nilotinib. Molecular docking was used to analyze the effects of rosuvastatin and aspirin on these targets. Results: Patients treated with nilotinib as first-line treatment were associated with a higher risk of CAE (OR = 3.43 [95% CI 2.77-4.25]), CAD (OR = 5.30 [95% CI 3.85-7.29]), ACS (OR 2.7 [95% CI 1.60-4.54]), CVA (OR 5.76 [95% CI 2.84-11.28]), PAOD (OR 5.57 [95% CI 3.26-9.50]) and arrhythmia (OR 2.34 [1.17,4.67]) than those treated with imatinib, while no significant difference was found in the risk of HF (OR 1.40 [95% CI 0.42-4.69]) between the two groups. Patients who were treated with more than 600 mg daily dosage of nilotinib or followed up for more than 5 years had a higher risk of ACS and CVA. IL6, CXCL8, CCL2, SOD2, NFKBIA, and BIRC3 were identified as the top 6 hub genes in the magenta module (human cardiomyocyte samples) and were mainly enriched in the NOD-like receptor signaling pathway, IL-17 signaling pathway, TNF signaling pathway, lipid and atherosclerosis signaling pathway. TYROBP and CSF1R were identified as hub genes in the turquoise module (liver samples from Mus musculus). GSEA results showed that type II diabetes mellitus, B-cell receptor, apoptosis, insulin, natural killer cell mediated cytotoxicity,mTOR, chemokine, and T-cell receptor signaling pathways were related to the higher risk of atherosclerosis caused by nilotinib. Rosuvastatin can effectively bind to most of the hub targets and proteins enriched in the inflammatory pathways above. Conclusion: CML patients who start with nilotinib have a higher risk of CAE than those with imatinib. Atherosclerosis caused by the inflammatory response and glycolipid metabolism disorder is the key mechanism of nilotinib cardiotoxicity. Rosuvastatin may be an effective treatment for the cardiotoxicity of nilotinib.

Prediction of Creep Curves Based on Back Propagation Neural Networks for Superalloys.

Creep deformation is one of the main failure forms for superalloys during service and predicting their creep life and curves is important to evaluate their safety. In this paper, we proposed a back propagation neural networks (BPNN) model to predict the creep curves of MarM247LC superalloy under different conditions. It was found that the prediction errors for the creep curves were within ±20% after using six creep curves for training. Compared with the θ projection model, the maximum error was reduced by 30%. In addition, it is validated that this method is applicable to the prediction of creep curves for other superalloys such as DZ125 and CMSX-4, indicating that the model has a wide range of applicability.

Application of one-third tubular steel plates and screws for fixation of medial column in pilon fractures.

Background: The present study sought to explore the efficacy of one-third tubular steel plates and screws for the treatment of medial column of pilon fractures. Methods: The present retrospective study comprised 40 subjects with Rüedi-Allgöwer type III pilon fractures that attended Northern Jiangsu People's Hospital from April 2016 to April 2019. Patients were assigned to 2 groups based on reconstruction and fixation components used on the medial column. The medial column of participants in the control group (n=20) was anchored using screws. The medial column for subjects in the treatment group (n=20) was reconstructed using a one-third tubular steel plate. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score at 1, 2, 3, 6, 12 and 24 months after operation, intraoperative blood loss, fracture healing time, preoperative detumescence duration, operation time, postoperative weightbearing duration, and postoperative Burwell-Charnley radiological score of the 2 groups were compared. Results: The findings showed that intraoperative blood loss, preoperative detumescence time, and operation time for the treatment group were not statistically different relative to the control group (P>0.05). The fracture healing time and postoperative weightbearing time in the treatment group were 15.07±0.98 weeks and 6.91±0.61 weeks, respectively, while those in the control group were 15.84±0.59 weeks and 8.60±0.53 weeks, respectively (P<0.05). Patients in the treatment group showed markedly higher AOFAS scores relative to the AOFAS scores of subjects in the control group at month 1, 2, and 3 post-operation (P<0.05). AOFAS scores for the 2 groups were not significantly different at month 6, 12 and 24 post-operation. Subjects in the control group had a significantly lower Burwell-Charnley number radiology score relative to that of subjects in the treatment group (P<0.05). Conclusions: The present findings show that the medial column of subjects with Rüedi-Allgöwer type III pilon fracture can be repaired using a one-third tubular steel plate. Compared with simple screw fixation, the use of a one-third tubular steel plate allows earlier postoperative weightbearing, decreases the rate of postoperative reduction loss, and leads to better clinical effects and prognosis.

The safety and efficiency of fluoroless site-specific transseptal puncture guided by three-dimensional intracardiac echocardiography.

BACKGROUND: Although fluoroless transseptal puncture (TSP) guided by intracardiac echocardiography (ICE) has been used for many years, there are no reports of an accurate site-specific method for TSP in detail, especially about the safety and efficiency of the method. This study aimed to compare the efficacy and safety of TSP guided by three-dimensional ICE using a fluoroless site-specific method with that of the conventional fluoroless method in patients with atrial fibrillation (AF). METHODS: This prospective study included 60 patients with AF scheduled for radiofrequency ablation who were assigned to undergo modified fluoroless site-specific TSP (SS-ICE group, n = 30) or conventional fluoroless TSP (C-ICE group, n = 30). TSP was guided by three-dimensional ICE in both study groups. RESULTS: All fluoroless TSP were performed successfully in both groups. There were no significant differences in patient characteristics, Pre-TSP time (11.3 ± 1.7 min vs. 11.1 ± 1.6 min, P = 0.822) and TSP time (3.4 ± 0.9 min vs. 3.5 ± 1.1 min, P = 0.772) between the SS-ICE group and the C-ICE group. The distance between the actual traversing point and the presetting point in the fossa ovalis was less than 5 mm in 87% of patients (26/30, 3.1 ± 1.2 mm) in the SS-ICE group. There were no TSP-related complications in either group. CONCLUSION: SS-ICE method is a simple, safe, and effective approach for fluoroless site-specific TSP.

Initial Experience in Transvenous Implantation of a Left Ventricular Lead With a Novel Venogram Balloon Catheter.

Aim: The most challenging and time-consuming stage of cardiac resynchronization therapy (CRT) device implantation is coronary sinus (CS) cannulation and left ventricular epicardial electrode implantation. This paper reports the initial clinical experience of CS cannulation and left ventricular lead implantation guided by a novel venogram balloon catheter (Lee's venogram balloon catheter). Methods and Results: Consecutive patients eligible for CRT were deemed suitable for this novel venogram balloon catheter. Parameters such as left ventricular lead implantation time, procedure time, and fluoroscopy time were recorded. CS cannulation with LV lead implantation guided by Lee's venogram balloon catheter was successful in all 5 patients, including 4 challenging cases. The total fluoroscopy and procedural durations were 5.0 ± 3.0 and 57.4 ± 12.5 min, respectively. No adverse catheter-related events occurred during the procedures. Conclusion: This initial study of an innovative venogram balloon catheter demonstrated that it greatly facilitated CS cannulation and successful LV lead placement in all patients undergoing CRT system implantation. This significantly shortened the learning curve and showed a decrease in left ventricular lead implantation time, procedure time, and fluoroscopy time.

Research Progress on Natural Products' Therapeutic Effects on Atrial Fibrillation by Regulating Ion Channels.

Antiarrhythmic drugs (AADs) have a therapeutic effect on atrial fibrillation (AF) by regulating the function of ion channels. However, several adverse effects and high recurrence rates after drug withdrawal seriously affect patients' medication compliance and clinical prognosis. Thus, safer and more effective drugs are urgently needed. Active components extracted from natural products are potential choices for AF therapy. Natural products like Panax notoginseng (Burk.) F.H. Chen, Sophora flavescens Ait., Stephania tetrandra S. Moore., Pueraria lobata (Willd.) Ohwi var. thomsonii (Benth.) Vaniot der Maesen., and Coptis chinensis Franch. have a long history in the treatment of arrhythmia, myocardial infarction, stroke, and heart failure in China. Based on the classification of chemical structures, this article discussed the natural product components' therapeutic effects on atrial fibrillation by regulating ion channels, connexins, and expression of related genes, in order to provide a reference for development of therapeutic drugs for atrial fibrillation.

Bridge pacemaker with an externalized active fixation lead for pacemaker-dependent patients with device infection.

BACKGROUND: The risk of Cardiac Implantable Electronic Device (CIED) infection has been increasing in recent years. For pacemaker-dependent patients, a temporary pacemaker is needed before a new device can be implanted. The aim of this study is to evaluate the safety and efficacy of using a temporary pacing device with an externalized active fixation lead (bridge pacemaker) before a new device can be implanted in pacemaker-dependent patients with device infection. METHODS: All patients who were admitted to our cardiac center with CIED infection and in need of bridge pacemaker implantation from April 2013 to August 2020 were prospectively enrolled in this observational study. The medical records of all patients were collected and evaluated. All procedure-related complications were also collected. Long-term outcomes, including reinfection and death within 1 year after hospital discharge, were collected through telephone follow-ups. RESULTS: During the study period, 1050 patients underwent CIED extraction, of which 312 pacemaker-dependent patients underwent bridge pacemaker implantation. The mean age of the extracted leads was 44 ± 38.7 months. The bridge pacemakers were in use for a mean duration of 6 days. Nine patients developed procedure-related complications including pericardial tamponade, pneumothorax, peripheral venous thrombosis, and pulmonary embolism. Three patients developed complications that were related to their bridge pacemakers, including lead dislodgement, over-sensing and elevated pacing threshold. During the 1-year follow-up, it was found that four patients had developed CIED reinfection and three patients had died due to cardiac-related reasons. CONCLUSIONS: A bridge pacemaker with an externalized active fixation lead is safe and efficacious for pacemaker-dependent patients with device infection.

LINC01119 negatively regulates osteogenic differentiation of mesenchymal stem cells via the Wnt pathway by targeting FZD4.

BACKGROUND: Mesenchymal stem cells (MSCs) can differentiate into diverse cell types under specific conditions. Dysfunction in the osteogenic differentiation of MSCs can result in bone metabolism-related diseases, including osteoporosis. Accumulating evidence has revealed that long non-coding RNA (lncRNAs) play critical regulatory roles during MSC differentiation. METHODS: In the present study, we identified an evolutionarily conserved lncRNA expressed during the osteogenic differentiation of MSCs, which we termed LINC01119. We first identified LINC01119 as a negative regulator of the osteogenic differentiation of MSCs. RESULTS: LINC01119 knockdown markedly induced calcium deposition in bone marrow MSCs and promoted the osteogenic differentiation of MSCs. More importantly, we demonstrated the underlying molecular basis through which LINC01119 regulates osteogenesis via the Wnt pathway by targeting FZD4. Furthermore, we observed that transcription factor EBF3 could directly bind the promoter site of LINC01119. CONCLUSIONS: We first explored the molecular regulatory mechanism of LINC01119 during the osteogenic differentiation of MSCs and revealed that LINC01119 negatively regulates osteogenesis through the Wnt pathway by targeting FZD4.

Clinical application of Kirschner wires combined with 5-Ethibond fixation for patella fractures.

Background: Patella fractures that require surgery are conventionally treated using Kirschner wires (K-wires) and stainless steel wires. In recent years, the nonabsorbable polyester has been reported to have excellent outcomes clinically. Therefore, the goal of our study was to evaluate the effects of Kirschner wires combined with 5-Ethibond on treating patellar fractures. Methods: From July 2018 to January 2022, 22 patella fracture patients were treated with Kirschner wires combined with 5-Ethibond. Radiographs of the knees were used to evaluate fracture healing and hardware complications. The clinical results were evaluated through the functional score, knee joint range of motion (ROM), and Bostman patella fracture functional score. Results: The average age of patients was 57.4 ± 11.9 (range 33-74) years. The mean follow-up time was 15.2 ± 7.6 (range 4-36) months. The mean operation time was 56.8 ± 8.7 (range 45-80) min. The entire patients had bony union at an average of 10.5 ± 1.9 (range 8-14) weeks. At the final follow-up, the mean range of postoperative ROM was 123.4° ± 14.6° (range 95°-140°), and the functional score was 28.7 ± 1.2 (range 26-30) points. No patient exhibited internal fixation failure, and no symptomatic implants or skin complications were recorded. Conclusions: The fixation approach using K-wires combined with 5-Ethibond has a lower complication rate and delivers superior clinical results. This research reveals that such technology is a safe and prospective substitute for conventional metal fixation approaches.

Antibacterial Effect of Copper Sulfide Nanoparticles on Infected Wound Healing.

Background: It is widely acknowledged that pathogenic germs delay wound healing to some extent. To explore factors influencing the wound healing process, the current study was conducted to evaluate the antibacterial effect of topical application of copper sulfide nanoparticles (CuS NPs) in vitro and on infected wound healing process in the rat model. Materials and Methods: In this study, the morphology and size of CuS NPs were detected. Staphylococcus aureus and Escherichia coli were used so that the antibacterial ability of CuS NPs could be evaluated better. In addition, a 2-cm circular full-thickness wound infected with a solution of 107 colony forming units (CFU) Staphylococcus aureus was created on the back of each rat. The rats were divided into four groups including the control group, the 100 mcg/mL CuS NPs group, the 250 mcg/mL CuS NPs group, and the 500 mcg/mL CuS NPs group. Tissue bacterial count and histologic assessment were evaluated. Results: The results indicated that CuS NPs had antibacterial activity against Staphylococcus aureus and Escherichia coli. Moreover, they could decrease the incidence of bacterial colonization and promote wound healing through re-epithelialization and collagen deposition. Furthermore, CuS NPs could maintain Cu2+ continuous release and inhibit the viability of Staphylococcus aureus through lipid peroxidation. Conclusions: This study found that CuS NPs have fine antibacterial properties, and particularly, the 500 mcg/mL CuS NPs had better effects, without increase of side effects. They could promote infected wound healing, the prospective clinical application of which was further confirmed in the treatment of wound infection.