The Association between Vitamin D Deficiency and the Risk of Mortality after Hip Fractures: A Systematic Review and Meta-Analysis.

Prevalence of hip fractures is on the rise and is associated with high mortality, especially in aging patients. Vitamin D is routinely recommended for bone health in general population. Our study explores the potential association between low levels (≤20 ng/mL) of vitamin D and mortality in hip fracture patients. Systematic search was done for studies that were published from inception until May 10, 2023, and that report a possible correlation between low vitamin D levels and mortality in patients with hip fractures. A random-effects model was used to assess the effects of normal vitamin D levels on mortality, subgroup analyses were conducted to assess the link between low levels of vitamin D and geographic location of the study and its impact on the recovery process. In 575 identified studies, 18 met the inclusion criteria. A strong connection between low serum levels of vitamin D (<20 ng/mL) and mortality (hazard ratio (HR): 2.29, p<0.001). Further analysis indicated that insufficient (20 to 30 ng/mL) and sufficient (>30 ng/mL) levels of vitamin D levels did not have a significant association with the mortality (HR: 1.10, p=0.12), and (HR: 1.04, p=0.50). As shown by subgroup analysis vitamin D deficiency significantly correlated with mortality in studies conducted in Europe (HR: 2.4). Our results clearly demonstrate that vitamin D deficiency is associated with higher risk of mortality in hip fracture patients. Additional analyses demonstrate that insufficient and sufficient levels of vitamin D were not significantly associated with mortality outcomes in hip fracture patients.

Research progress on KIF3B and related diseases.

Kinesins constitute a protein superfamily that belongs to the motor protein group. Kinesins move along microtubules to exert their various functions, which include intracellular transportation, mitosis, and cell formation. Kinesins are responsible for the transport of various membrane organelles, protein complexes, mRNA and other material, as well as the regulation of intracellular molecular signal pathways. Cumulative studies have also indicated that kinesins are related to the development of a variety of human diseases. At present, there are 14 subfamilies of the kinesin superfamily (KIFs), comprising 45 members. KIF3 is the most common expression in KIFs. KIF3 is a complex composed of a KIF3A/3B heterodimer and a kinesin-related protein, known as KAP3. These complexes are organelles and protein complexes involved in membrane binding in various tissues and transport within cells (nerve cells, melanocytes, epithelial cells, etc.). As a member of the KIF3 subfamily, KIF3B is an essential protein that can regulate cell migration, and proliferation and has critical biological functions. During mitosis, KIF3B is responsible for vesicle transport and membrane expansion, thus regulating cell migration. In recent years, more and more attention has been paid to the relationship between KIF3B and the occurrence and development of diseases. This article reviews the recent advances in the study of KIF3B and its related diseases.

Protective role of ß-carotene against oxidative stress and neuroinflammation in a rat model of spinal cord injury.

Acute spinal cord injury (SCI) results in long-lasting functional impairments through both mechanical damage as well as secondary mechanisms, with limited available therapeutic options. ß-Carotene has been demonstrated to exert biological and pharmacological activities. We aimed to examine the protective effects of ß-carotene in a SCI rat model. We tested the hind-limb locomotor function, neuro-inflammation, oxidative stress, astrocyte activation and nuclear factor-κB (NF-κB) pathway activation of SCI rats, with or without ß-carotene treatment. ß-Carotene substantially improved locomotion that was reduced by SCI. ß-Carotene also relieved SCI-induced oxidative stress via regulation of reactive oxygen species, malondialdehyde, nitric oxide, and superoxide dismutase, as well as restored SCI-suppressed protein expressions of Nrf2 and HO-1. Additionally, ß-carotene decreased the generation of pro-inflammatory cytokines, including tumor necrosis factor-α, interleukin-1ß, interleukin-18 and cyclooxygenase-2, and inhibited the activation of astrocyte in the spinal cord. Furthermore, ß-carotene treatment markedly inhibited the NF-κB pathway activation. Our findings demonstrated that ß-carotene effectively reduced the progression of secondary injury events following SCI through preventing NF-κB pathway activation. Therefore, ß-carotene may be an effective candidate for treating SCI.

[Analysis of the characteristics and clinical diagnosis and treatment of avulsion fracture of the lateral edge of tibial plateau].

OBJECTIVE: To investigate the characteristics and clinical treatment of avulsion fracture of the lateral edge of tibial plateau(segond fracture) in knee joint injuries. METHODS: From January 2011 and December 2015, 29 patients with Segond fracture were treated with minimally invasive arthroscopy technology in intra-articular injuries combined with double anchor nail fixation in avulsion fracture of the lateral edge of tibial plateau, including 17 males and 12 females with an average age of 41 years old ranging from 27 to 62 years old. Among them, there were 20 cases of anterior cruciate ligament rupture (ACL rupture) involving the anterior cruciate ligament tibial eminence avulsion fracture included, 3 cases of posterior cruciate ligament rupture (PCL rupture), 1 case of ACL rupture combined with PCL rupture, 3 cases of medial collateral ligament tear, and 2 cases combined fractures of tibial plateau (1 case of the medial platform fractures and 1 cases of lateral fracture). All the patients were confirmed by X-rays, CT and MRI. The procedures were performed at 5 to 14 days after the injury(means 7 days). Lysholm scores were used to assess the knee function before and after the operation. RESULTS: The operation time was 40 to 125 minutes (means 85 minutes), the intraoperative blood loss was 10 to 30 ml (means 15 ml). All paients were followed up for 12 to 18 months(means 14 months). The Lysholm scores were significantly improved from preoperative 52.0±4.2 to 91.9±1.4(t=-49.24, P<0.05). The results of drawer test, Lachman test and lateral stress test were negative in all 29 cases, all the fractures of 29 patients were bony union. CONCLUSIONS: The avulsion fracture of the lateral tibial plateau suggests that there are knee joint static and stable structures(joint ligament, joint capsule, meniscus, et al) and even intra articular fractures. Therefore, besides conventional imaging examinations, arthroscopic exploration was also necessary to avoid misdiagnose and provide comprehensive assessments and treatment. This can create favorable conditions for the knee joint function restore maximum.