Background Arsenic is an environmentally harmful substance that causes hepatic insulin resistance and liver damage, increasing the risk of type 2 diabetes mellitus. Objective To explore whether the insulin-like growth factor 2 mRNA binding protein 2 (IGF2BP2) is involved in insulin resistance in HepG2 cells after arsenic exposure through the peroxisome-proliferator-activated receptor γ (PPAR-γ) / glucose transporter 4 (GLUT4) pathway. Methods Cell viability was determined using cell counting kit 8 (CCK8) and an appropriate NaAsO₂ infection dose was determined. A cellular arsenic exposure model of HepG2 cells was established by four concentrations of NaAsO₂ solution for 24 h (the experiment was divided into four groups: 0, 2, 4, and 8 μmol·L⁻¹); HepG2 cells were firstly treated with pcDNA3.1-IGF2BP2 and pcDNA3.1-NC respectively for 6 h, then with 8 μmol·L⁻¹ NaAsO₂ for 24 h to establish a IGF2BP2 overexpression cell model (the experiment was divided into 4 groups: control, NaAsO₂, NaAsO₂+pcDNA3.1-IGF2BP2, and NaAsO₂+pcDNA3.1-NC); finally the cells were subject to 100 nmol·L⁻¹ insulin stimulation for 30 min. Glycogen and glucose in HepG2 cells were determined by glycogen and glucose assay kits; mRNA expression levels of IGF2BP2 were measured by quantitative real-time PCR; protein expression levels of IGF2BP2, PPAR-γ, and GLUT4 in HepG2 were detected by Western blot (WB); and the binding of IGF2BP2 to PPAR-γ and PPAR-γ to GLUT4 was verified by co-immunoprecipitation (CO-IP) experiment. Results The results of CCK8 experiment showed a dose-effect relationship between NaAsO₂ concentration and cell viability. When the concentration of NaAsO₂ was ≥4 μmol·L⁻¹ , the cell viabilities were lower than that of the control group (P <0.05). With the increasing dose of NaAsO₂ infection, reduced glucose consumption and glycogen levels in HepG2 cells were found in the 2, 4, and 8 μmol·L⁻¹ NaAsO₂ treatment groups compared to the control group (P <0.05). The difference between the mRNA expression level of IGF2BP2 in the HepG2 cells treated with 4 or 8 μmol L⁻¹ NaAsO₂ and the control group was significant (P <0.05). In the IGF2BP2 overexpression cell model, compared with the control group, glucose consumption and glycogen levels were lowered in the NaAsO₂ group (P <0.05), the mRNA expression level of IGF2BP2 and the protein expression levels of IGF2BP2, PPAR-γ, and GLUT4 in the cell membrane were all decreased (P <0.05). Compared with the NaAsO₂ group, the glucose consumption and glycogen levels were increased in the NaAsO₂+pcDNA3.1-IGF2BP2 group (P <0.05), and the mRNA expression level of IGF2BP2 and the protein expression levels of IGF2BP2, PPAR-γ, and GLUT4 in the cell membrane were all increased (P <0.05). The results of CO-IP experiments showed that IGF2BP2 interacted with PPAR-γ as well as PPAR-γ with GLUT4 protein. Conclusion IGF2BP2 is involved in arsenic exposure-induced insulin resistance in HepG2 cells by acting on the PPAR-γ/GLUT4 pathway.

OBJECTIVE To study the effects of Phellodendron amurense polysaccharides （PAP） on improving gouty nephropathy （GN） in rats， and to investigate its mechanism primarily by interfering the p38 mitogen-activated protein kinase （p38 MAPK）/nuclear factor-κB（NF-κB）/tumor necrosis factor-α（TNF-α）. METHODS Sixty rats were randomly divided into normal group （water）， model group （water）， allopurinol group （positive control， 20 mg/kg）， PAP high-dose， medium-dose and low-dose groups （100， 50， 25 mg/kg， by raw material） after being stratified by body weight， with 10 rats in each group. Except for the normal group， the other groups were induced to construct GN model by giving 1 500 mg/kg potassium oxazinate and 100 mg/kg adenine intragastrically for 14 days. After modeling， the rats in each group were given relevant medicine/water intragastrically， once a day， for consecutive 28 days. After the last medication， the levels of biochemical parameters related to renal function [uric acid， creatinine （Cr）， blood urea nitrogen （BUN）， xanthine oxidase （XOD）] were detected in rats， and the histopathological changes in the rat kidney were observed. The protein expressions of monocyte chemoattractant protein-1（MCP-1），TNF-α and interleukin-6（IL-6） as well as the phosphorylation levels of p38 MAPK and NF-κB p65 protein were determined in renal tissue of rats. RESULTS Compared with the normal group， the model group suffered from the dilatation of renal tubules， structural damage to glomeruli， accompanied by inflammatory infiltration and fibrosis； the contents of uric acid， Cr， BUN and XOD， the protein expressions of MCP-1，TNF-α and IL-6 and the phosphorylation levels of p38 MAPK and NF-κB p65 protein were all increased significantly （P＜0.05 or P＜0.01）. Compared with the model group， the pathological symptoms of renal tissue in rats had been improved to varying degrees in different dose groups of PAP； the contents of uric acid， Cr， BUN and XOD， protein expressions of MCP-1， TNF-α and IL-6， the phosphorylation levels of p38 MAPK and NF-κB p65 protein in PAP high-dose and PAP medium-dose groups were all decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS PAP exhibits an anti-GN effect， the mechanism of which may be associated with inhibiting the p38 MAPK/NF-κB/TNF-α signaling pathway.

OBJECTIVE: To investigate the effectiveness of sagittal top compression reduction technique in the treatment of thoracolumbar vertebral fractures. METHODS: A retrospective analysis was conducted on the clinical data of 59 patients with thoracolumbar vertebral fractures who met the selection criteria and were admitted between November 2018 and January 2022. Among them, 34 patients were treated with sagittal top compression reduction technique (top pressure group), and 25 patients were treated with traditional reduction technique (traditional group). There was no significant difference in baseline data between the two groups ( P>0.05), including gender, age, fracture segment, cause of injury, AO classification of thoracolumbar vertebral fractures, thoracolumbar injury classification and severity (TLICS) score, American Spinal Injury Association (ASIA) grading, surgical approach, preoperative vertebral body index, height ratio of the anterior margin of injured vertebra, injured vertebra angle, segmental kyphosis angle, visual analogue scale (VAS) score, and Oswestry disability index (ODI). The operation time, intraoperative blood loss, and incidence of complications between the two groups were recorded and compared. After operation, VAS score and ODI were used to evaluate effectiveness, and X-ray and CT examinations were performed to measure imaging indicators such as vertebral body index, height ratio of the anterior margin of injured vertebra, injured vertebra angle, and segmental kyphosis angle. RESULTS: There was no significant difference in operation time and intraoperative blood loss between the two groups ( P>0.05). No complication such as dural sac, nerve root, or vascular injury was found during operation, and all incisions healed by first intention. Patients in both groups were followed up 6-48 months, with an average of 20.6 months. No loosening, breakage, or failure of internal fixation occurred during follow-up. The imaging indicators, VAS score, and ODI of the two groups significantly improved at 1 week and last follow-up when compared to preoperative ones ( P<0.05). At last follow-up, the VAS score and ODI further significantly improved when compared to 1 week after operation ( P<0.05). At 1 week after operation and last follow-up, the vertebral body index, segmental kyphosis angle, injured vertebra angle, and ODI in the top pressure group were significantly better than those in the traditional group ( P<0.05). There was no significant difference in VAS score and height ratio of the anterior margin of injured vertebra between the two groups at 1 week after operation ( P>0.05), but the two indicators in the top pressure group were significantly better than those in the traditional group at last follow-up ( P<0.05). CONCLUSION The treatment of thoracolumbar vertebral fractures with sagittal top compression reduction technique can significantly improve the quality of vertebral reduction, and is superior to traditional reduction techniques in relieving pain and improving spinal function.
Humans ; Thoracic Vertebrae/injuries* ; Lumbar Vertebrae/injuries* ; Retrospective Studies ; Blood Loss, Surgical ; Treatment Outcome ; Pedicle Screws ; Spinal Fractures/surgery* ; Kyphosis ; Fracture Fixation, Internal ; Fractures, Compression/surgery*

Objective To investigate the prevalence and risk factors of hookworm infections among vegetable growers in Anhui Province, so as to provide the evidence for formulating the control strategy and interventions for hookworm human infections.. Methods A total of 1 179 vegetable growers were randomly sampled from 7 counties in Anhui province according to the natural ecological function areas in 2018 and 2019, and the basic features and risk factors of hookworm infections were collected from all subjects using a self-designed questionnaire, including living environment, vegetable planting and fertilization, type of household crops, animal feeding, hygiene and labor habits. In addition, stool samples were collected from all participants, and each stool sample was subjected to twice tests with the Kato-Katz technique. The risk factors of hookworm infections were identified among vegetable growers with the Bayesian log-binomial regression model. Results The prevalence of hookworm infection was 3.90% among the 1 179 vegetable growers. The prevalence of hookworm infection was 10.07% (15/149) among unemployed subjects, 5.32% (31/583) among farmers, and 0 among full-time vegetable growers (0/377) and subjects with other occupations (0/70), and there was a significant difference among subjects in terms of occupation (χ²=36.37, P < 0.01). Bayesian log-binomial regression analysis showed that fertilization with human feces [relative risk (RR)=18.25, 95% confidence interval (CI): (4.31, 77.17)], barefoot labor in vegetable fields [RR=2.86, 95% CI: (1.43, 5.70)], and living in plain ecological areas along the middle and lower reaches of the Yangtze River [RR=4.19, 95% CI: (1.19, 14.81)] were independent risk factors of hookworm infections among vegetable growers. Stratified analysis showed that fertilization with human feces, barefoot labor in vegetable fields, drinking well water or mountain spring, and living in plain ecological areas along the middle and lower reaches of the Yangtze River were independent risk factors of hookw, orm infection among farmers, and living in plain ecological areas along the middle and lower reaches of the Yangtze River and growing rice were independent risk factors of hookw, orm infection among unemployed individuals. Conclusions The prevalence of hookworm infection is high among vegetable growers in Anhui Province, and fertilization with human feces, barefoot labor in vegetable fields and living in plain ecological areas along the middle and lower reaches of the Yangtze River are risk factors of hookw, orm infections among vegetable growers.

Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

During pandemic of corona virus disease 2019 (COVID-19), emergency orthopedic trauma is commonly seen. It is particularly important to ensure the emergency treatment quality of orthopedic trauma but avoid cross-infection between doctors and patients. The double-buffered diagnosis and treatment mode refers to the model of patients first undergoing medical observation in the comprehensive buffer ward and the inpatient buffer rooms of various disciplines after admission to confirm the exclusion of COVID-19 and then receiving specialist diagnosis and treatment. The authors summarize the experiences of using the double-buffered diagnosis and treatment model in the Department of Orthopedics, Renmin Hospital of Wuhan University during the prevention and control of COVID-19 pandemic so as to provide a reference for treatment of orthopedic patients.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.

Objective To investigate the effect of tissue engineered cartilage on the repair of artic ular cartilage defects in rabbits with calcium alginate gel (CAG) loaded transforming growth factor beta 3 (TGF-β3) and compounded with adipose mesenchymal stem cells (ADSCs).Methods The ADSCs were separated and cultured in subcutaneous fat of New Zealand white rabbits.The full-thickness articular cartilage defect model was made at the patellar groove by exposure of the femoral ankle joint.ADSCs were implanted into calcium alginate scaffolds loaded with TGF-β3 to construct tissue-engineered cartilage and transplanted into rabbit articular cartilage defects.The animals were divided into four groups:control group (injected with sterile isotonic saline),CAG group (injected with CAG),ADSCs + CAG group (injected with CAG loaded with ADSCs),TGF-β3 + CAG group (injected with CAG loaded with TGF-β3) and TGF-β3 + ADSCs + CAG group (injected with CAG loaded with TGF-β3 and ADSCs).At the end of 12 weeks,the repair of articular cartilage defects was observed by gross observation,hematoxylin-eosin (HE) staining,immunohistochemical staining of safranin-O and type Ⅱ] collagen,and the scoring method developed by In ternational Association of Cartilage Repair (ICRS) Histological score.Results The cartilage repair effect of TGF-β3 + ADSCs + CAG group was better than that of other groups,not only the neonatal tissue and the surrounding normal tissue closely,but also the secretion of extracellular matrix and normal tissue similar.The ICRS scores of each group were (7.06 ±+ 0.18) score,(7.15 + 0.23) score,(7.45 + 0.25) score,(7.47 + 0.24) score and (15.78 ±+ 0.24) score.That of TGF-β3 + ADSCs + CAG group was better than that of other groups,the difference was significant (P ＜ 0.05).Conclusions CAG loaded with TGF-β3 and combined with ADSCs has a good effect in repairing articular cartilage defects in rabbits,and is a structural repair.

Objective To detect the inhibitory effect of siliver nanoparticles loaded titanium nanotubes on staphylococcus aureus, and provide a theoretical basis for implant local application. Methods Orderly arrangement of titania nanotubes produced by anodic oxidation, loaded silver nanoparticals by situ replacement. Scanning electron microscopy (SEM) and transmission electron microscopy(TEM) were used to detect the morphology topology of silver nanoparticals, titanium nanotubes and siliver particals loaded titanium nanotubes. The minimum inhibitory concentration of silver nanoparticles was calculated. The antibacterial of planktonic bacteria was detected 1 day, 3 days and 5 days after culturing staphylococcus aureus on siliver particals loaded titanium nanotubes. The inhibitory bacterial adhesion properties were detected by scanning electron microscopy. Results The uniform and orderly diameter of 80～120 nm TiO2 nanotubes were prepared under 18 V voltage, loaded diameter of 20 nm silver nanoparticals, which effectively inhibited adhesion and proliferation of staphylococcus aureus. Conclusion Titanium nanotubes produced by 18 V have a stronger drug loading capacity. The 100 mmol/L silver nanopartical solution loaded nanotubes can effectively inhibit staphylococcus aureus adhesion and proliferation within three days.