OBJECTIVE: To investigate the effectiveness of nickel-titanium shape memory staples in treating multiple metatarsal fractures. METHODS: The clinical data of 27 patients with multiple metatarsal fractures who were treated between January 2022 and June 2023 and met the selection criteria were retrospectively analysed. The cohort consisted of 16 males and 11 females, aged 33-65 years (mean, 47.44 years). The causes of injury included heavy object impact in 11 cases, traffic accidents in 9 cases, and crush in 7 cases. Simultaneous fractures of 2, 3, 4, and 5 bones occurred in 6, 6, 4, and 8 cases, respectively, with tarsometatarsal joint injury in 3 cases. Fixation was performed using staples for 16, 22, and 9 fractures in the metatarsal neck, shaft, and the base, respectively, and 5 tarsometatarsal joint injuries. Preoperative soft tissue injuries were identified in 8 cases and classified according to the Tscherne-Oestern closed soft tissue injury classification as type Ⅰ in 5 cases and type Ⅱ in 3 cases. One case of type Ⅱexhibited preoperative skin necrosis. The patients were treated with fixation using nickel-titanium shape memory staples. Complications and fracture healing were documented. At last follow-up, the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was used to evaluate the function, and the visual analogue scale (VAS) score was used to evaluate the pain. RESULTS: The 27 patients were followed up 9-19 months (mean, 12.4 months). Postoperative X-ray films revealed no loss of fracture reduction, and all fractures achieved bony union. No internal fixator loosening, breakage, or other mechanical failures was observed. The mean fracture healing time was 3.13 months (range, 3-4 months). Postoperatively, 4 cases (2 of Tscherne-Oestern type Ⅰ, 2 of type Ⅱ) developed superficial skin necrosis, which resolved with dressing changes. No infection was observed in the remaining patients, and all wounds healed. At last follow-up, the AOFAS forefoot score ranged from 70 to 95, with an average of 86.6, of which 19 cases were excellent, 6 cases were good, and 2 cases were fair, with an excellent and good rate of 92.6%; the VAS score ranged from 0 to 3, with an average of 0.9, of which 24 cases were excellent, and 3 cases were good, with an excellent and good rate of 100%. CONCLUSION The use of nickel-titanium shape memory staples in the treatment of multiple metatarsal fractures can effectively protect local skin and soft tissues and minimize secondary damage associated with internal fixator insertion. It is a viable surgical option for management of multiple metatarsal fractures.
Humans ; Male ; Female ; Middle Aged ; Adult ; Titanium ; Nickel ; Retrospective Studies ; Fracture Fixation, Internal/instrumentation* ; Aged ; Metatarsal Bones/surgery* ; Fractures, Bone/surgery* ; Treatment Outcome ; Sutures ; Fractures, Multiple/surgery*

As the brain's resident immune cells, microglia perform crucial functions such as phagocytosis, neuronal network maintenance, and injury restoration by adopting various phenotypes. Dynamic imaging of these phenotypes is essential for accessing brain diseases and therapeutic responses. Although numerous probes are available for imaging pro-inflammatory microglia, no PET tracers have been developed specifically to visualize anti-inflammatory microglia. In this study, we present an ¹⁸F-labeled PET tracer (QTFT) that targets the P2Y₁₂, a receptor highly expressed on anti-inflammatory microglia. [¹⁸F]QTFT exhibited high binding affinity to the P2Y₁₂ (14.43 nmol/L) and superior blood-brain barrier permeability compared to other candidates. Micro-PET imaging in IL-4-induced neuroinflammation models showed higher [¹⁸F]QTFT uptake in lesions compared to the contralateral normal brain tissues. Importantly, this specific uptake could be blocked by QTFT or a P2Y₁₂ antagonist. Furthermore, [¹⁸F]QTFT visualized brain lesions in mouse models of epilepsy, glioma, and aging by targeting the aberrantly expressed P2Y₁₂ in anti-inflammatory microglia. In a pilot clinical study, [¹⁸F]QTFT successfully located epileptic foci, showing enhanced radioactive signals in a patient with epilepsy. Collectively, these studies suggest that [¹⁸F]QTFT could serve as a valuable diagnostic tool for imaging various brain disorders by targeting P2Y₁₂ overexpressed in anti-inflammatory microglia.

Objective:To compare the efficacy of reduction and internal fixation of flexion-inversion tibial plateau fractures with a modified two-window and conventional single-window posteromedial inverted L-shaped approach.Methods:A retrospective cohort study was used to analyze the clinical data of 44 patients with flexion-inversion tibial plateau fractures admitted to the Affiliated Changzhou No.2 People′s Hospital of Nanjing Medical University from January 2018 to December 2022, including 22 males and 22 females, aged 31-58 years [(44.4±9.1)years]. Among them, 25 patients were injured on the left side and 19 on the right. A total of 23 patients were treated with the conventional single-window posteromedial inverted L-shaped approach (conventional single-window approach group), while the other 21 with the modified two-window posteromedial inverted L-shaped approach (modified two-window approach group). The length of surgical incision, operation time, intraoperative blood loss, postoperative drainage volume, and postoperative hospital stay were compared between the two groups. The articular step-offs, medial tibial plateau angles (mTPA), tibial posterior slope angles (PSA), and Rasmussen radiological scores at 3 days, 3 months after surgery and at the last follow-up were evaluated in the two groups. The visual analogue scale (VAS) scores before surgery, at 7 days and 3 months after surgery, data of extension-flexion motion of the knee joint at 7 days after surgery and Hospital for Special Surgery (HSS) knee function scores at 3 and 6 months after surgery and at the last follow-up were compared between the two groups. At the last follow-up, the fracture healing was observed. The postoperative incidence of complications such as thrombosis and poor wound healing was compared between the two groups.Results:All the patients were followed up for 12-18 months [(15.7±3.2)months]. The operation time of the modified two-window approach group was (121.6±19.2)minutes, significantly shorter than (149.5±22.4)minutes of the conventional single-window approach group ( P<0.01). There were no statistically significant differences in the length of surgical incision, intraoperative blood loss, postoperative drainage volume, or postoperative hospital stay between the two groups ( P>0.05). At 3 days, 3 months after surgery and at the last follow-up, the articular step-offs of the modified two-window approach group were 0.7(0.5, 0.9)mm, 1.0(0.8, 1.1)mm and 0.9(0.8, 1.0)mm respectively, significantly shorter than 1.0(0.7, 1.2)mm, 1.1(1.0, 1.3)mm and 1.1(0.9, 1.2)mm of the conventional single-window approach group ( P<0.05 or 0.01); the mTPA of the modified two-window approach group was 87.0(86.0, 87.0)°, 87.0(86.0, 87.0)° and 86.0(85.5, 87.0)° respectively, significantly larger than 85.0(84.0, 86.0)°, 85.0(84.0, 86.0)°and 85.0(84.0, 86.0)°of the conventional single-window approach group ( P<0.01); the Rasmussen radiological scores of the modified two-window approach group were (17.0±0.9)points, 16.0(15.0, 17.0)points and 16.0(15.0, 16.0)points respectively, significantly higher than (16.4±1.1)points, 13.0(13.0, 15.0)points and 14.0(13.0, 15.0)points of the conventional single-window approach group ( P<0.05 or 0.01); no significant differences in the PSA were found between the two groups ( P>0.05). There were no significant differences in VAS scores between the two groups before surgery and at 3 months after surgery ( P>0.05), while the VAS score at 7 days after surgery was 3.0(3.0, 3.0)points in the modified two-window approach group, significantly lower than 3.0(3.0, 4.0)points of the conventional single-window approach group ( P<0.05). There was no significant difference in the VAS score at 3 months after surgery between the two groups ( P>0.05). The extension-flexion motion of the knee joint at 7 days after surgery was 90.0(85.0, 95.0)° in the modified two-window approach group, higher than 80.0(75.0, 85.0)° of the conventional single-window approach group ( P<0.01). The HSS knee function score at 3 months after surgery was (67.9±2.8)points in the modified two-window approach group, higher than (66.1±2.7)points of the conventional one-window approach group ( P<0.05). There were no significant differences in the HSS knee function scores at 6 months after surgery and at the last follow-up between the two groups ( P>0.05). At the last follow-up, bone union was observed in both groups. One patient in the conventional single-window approach group developed partial popliteal vein thrombosis, with a complication rate of 4.4% (1/23); while one patient in the modified two-window approach group had poor healing of the incision postoperatively, with a complication rate of 4.8%(1/21) ( P>0.05). Conclusion:Compared with the conventional single-window approach, the modified two-window posteromedial inverted L-shaped approach has the advantages of shorter operation time, better reduction quality, early pain relief, and better restoration of knee joint extension-flexion motion and joint function in the reduction and internal fixation of flexion-inversion tibial plateau fractures.

OBJECTIVE： To prepare Zingiber officinale oil microcapsules and to evaluate its quality. METHODS： Z. officinale oil microcapsules were prepared by spray drying method with sodium starch octenyl succinate as capsule material. The preparation technology was optimized by orthogonal test with mixing temperature of capsule material and capsule core， mass ratio of capsule material and capsule core， stirring speed as factors， using encapsulation efficiency as index. The drug loading， encapsulation efficiency， appearance， particle size distribution and stability of light， heat and humidity （using iodine value and peroxide value as indexes） were evaluated. RESULTS： The optimal preparation technology of Z. officinale oil microcapsules was that the mixing temperature of capsule material and core was 60 ℃； mass ratio of capsule material and capsule core was 10 ∶ 1； stirring speed was 12 000 r/min. Average drug-loading amount and encapsulation efficiency of Z. officinale oil microcapsules prepared by optimal technology were 17.97％ and 73.57％ （n＝3）. The morphology of Z. officinale oil microcapsules was round， smooth， non-sticky and uniform in size distribution. The average diameter of microcapsules was （6.30±0.27） μm. Under light， heat and humidity conditions， the iodine value and peroxide value of Z. officinale oil microcapsules changed slightly. CONCLUSIONS： The optimal preparation technology of Z. officinale oil microcapsules is simple and reproducible. The prepared microcapsules have good encapsulation efficiency， high drug loading amount and good stability.

Antimicrobial resistance is on the rise while the number of antibiotics being brought to market continues to drop. Drug-resistant genes and drug-resistant bacteria infection have seriously threatened human health. Therefore, antimicrobial resistance presents an ongoing challenge that requires multifaceted approaches including: biomedical innovation; improved surveillance of antibiotic consumption and antimicrobial resistance generated rates; prevention of health-care-associated infections and transmission of multidrug-resistant bacteria and environmental dissemination; rapid microbiological diagnosis; and curtailed clinical and veterinary misuse. Fortunately, combating antimicrobial resistance has been highly valued and supported by the government, scientists and entrepreneurs of various countries. With the continuous introduction of new technologies, new products, and new management measures, the problem of antimicrobial resistance must be controlled and alleviated.

Objective To investigate the clinical value of PET-CT in aiding CT guided percutaneous puncture biopsy for lung mas-ses.Methods The retrospective data were analyzed including 5 7 patients with lung masses who underwent CT guided percutaneous puncture biopsy combined with PET-CT (regarded as a research group)and other 75 similar patients with single CT-guided biopsy (control group).In two groups,it was divided with malignant,suspicious malignant,can not be diagnosed,inflammatory,benign by pathological findings,and was contrasted with the surgical pathology or final clinical results.To calculate sensitivity,specificity and accuracy of diagnosis for cancer through two puncture method.Recorded complication for pneumothorax and bleeding in two groups .Be compared analysis using the 2 test.Results In study group,it was higher for the diagnosis of malignancy sensitivity, specificity,accuracy.There were 96.3% (52/54),100.0%(3/3)and 96.5%(55/57)in research group,while those were 88.4%(61/69),83.3% (5/6)and 88.0% (66/75)in the control group,respectively.And no statistically significant.Between research and the control group,there was a significantly statistical difference in the rate of twice punctures in one mass (χ2= 10.122,P=0.001).Between the two groups,there was no statistically significant difference in the pneumothorax rate and the hemorrhage rate. Conclusion PET-CT in aiding CT-guided lung biopsy improves the sensitivity,specificity and accuracy of diagnosis.

Objective To investigate focal cerebral ischemia on cell proliferation and expression of glial fibrillary acidic protein(GFAP) in caveolin-1 knockout mice.Methods Focal cerebral ischemia was induced by middle cerebral artery occlusion(MCAO) to caveolin-1-knockout mice and homologous C57 wild-mice.Expression of BrdU and GFAP in the brain were detected using immunohistochemistry in the postoperative 7d.Results The number of BrdU( (29.04 ± 1.68 )/mm2 ; (24.13 ±- 1.57 )/mm2 ) and GFAP-positive cells ( ( 10.75 ± 2.32 )/mm2 ; ( 18.14 ± 1.95 )/mm2 ) were increased in wild-type and caveolin-1 -knockout mice after ischemia,and there was significant difference compared with sham group (BRDU( 6.15 ± 1.09 )/mm2,(6.23 ± 1.05 )/mm2 ; GFAP (2.31 ±0.98)/mm2,(2.07 ± 1.01 )/mm2 ) (P＜0.05).Expression of BMU in knockout mice was less than that in wild mice,but expression GFAP in knockout mice was stronger than that in wild mice,and the difference was statistically significant (P ＜ 0.05 ).Conclusion Cerebral ischemia can promote cell proliferation and glial activation in brain,loss of caveolin-1 reduced cell proliferation and enhanced glial activation early stage of brain ischemia.

The mechanical properties of natural and synthetic extracellular matrices affect cellular processes and regulate tissue formation. In order to explore the optimal environment for chondrocytes growth in vitro, we investigated the relationship between the mechanical properties of the alginate beads and the ability of chondrocyte proliferation in this study. We measured the compressive properties of alginate with different concentrations by INSTRON 3365,and found that compressive moduli significantly increased with increasing alginate concentration. The rabbit chondrocytes were encapsulated in 1%, 2% and 3% (w/v) alginate beads at high (1 x 10(7)/ml) density. After 4 week's culturing, all the three groups resulted in the limited proliferation of the chondrocytes and the formation of cell clusters resembling cartilaginous tissues. Chondrocytes proliferation was more rapid on lower concentrate gels (1%, 2%) than on the higher concentrate gels (3%). These results suggested that the mechanical properties of scaffold architecture had certain effect on chondrocytes proliferation.
Alginates ; pharmacology ; Animals ; Cartilage, Articular ; cytology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Chondrocytes ; cytology ; Compressive Strength ; drug effects ; Glucuronic Acid ; pharmacology ; Hexuronic Acids ; pharmacology ; Hydrogels ; pharmacology ; Rabbits

OBJECTIVETo observe the effect of C-reactive protein (CRP) on the expressions of Notch pathway components in human peripheral blood endothelial progenitor cells (EPC) in vitro.

METHODSMononuclear cells isolated by density gradient centrifugation of human peripheral blood mixed with 6% hydroxyethyl starch (Hes) were plated on fibronectin-coated 6-well culture dishes. After 7 days, the adherent cells were cultured in the presence of 10 and 20 mg/L CRP for 48 h, and the proliferation, migration, and adhesion abilities of the cells were observed. The mRNA expressions of Notch-1 and its ligand Jagged-1 in the EPCs were measured by RT-PCR, and their protein expressions by Western blotting.

RESULTSCRP at 10 and 20 mg/L caused a significant reduction in the number of viable EPCs (61∓3 and 54∓3, respectively) as compared with PBS (71∓4, P<0.05). CRP also resulted in a significant suppression of the proliferation, migration and adhesion capacities of the EPCs. The mRNA and protein expressions of Jagged-1 and Notch-1 in the EPCs significantly increased following CRP exposure in comparison with PBS treatment.

CONCLUSIONCRP can suppress the proliferation, migration and adhesion capacities of the EPCs probably by affecting the expressions of the Notch-1 pathway components.

C-Reactive Protein ; pharmacology ; Calcium-Binding Proteins ; genetics ; metabolism ; Cell Adhesion ; Cell Movement ; Cell Proliferation ; Cells, Cultured ; Endothelial Cells ; cytology ; metabolism ; Humans ; Intercellular Signaling Peptides and Proteins ; genetics ; metabolism ; Jagged-1 Protein ; Leukocytes, Mononuclear ; cytology ; metabolism ; Membrane Proteins ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Receptor, Notch1 ; genetics ; metabolism ; Serrate-Jagged Proteins ; Signal Transduction ; drug effects ; Stem Cells ; cytology ; metabolism

Objective To analyze the clinical characteristics of pneumomediastinum in patients with dermatomyositis and polymyositis for demonstrating its pathogenesis and for predicting its prognosis. Methods The clinical records of 96 patients with PM/DM were reviewed, focusing on for perdicting its pneumomediastinum. Five patients with pneumomediastinum are described in detail. Case reports of pneumomediastinum in PM/DM in English publications are reviewed. Results Five DM cases complicated by pneumomediastinum all had lung infections. Twenty-nine cases (including our five cases) of DM/PM with pneumomediastinum have taken methylprednisolone, four cases alive, and six died. Nine cases have taken CsA,seven cases alive and two died. Conclusion The infections was strongly suspected as being responsible for the pneumomediastinum. Methylprednisolone has poor effect. CsA can be an effective therapeutic agent in PM/DM.