Objective To compare the outcomes of traumatic flail chest with multiple injuries treated by operative fixation versus conservative approach. Methods The clinical data of 60 patients with traumatic flail chest with multiple injuries were retrospectively analysed, and the outcomes between operation group (treated by operative fixation, n=32)and non-operation group (treated by conservative approach, n=28) were compared. Results The mean time of hospital stay, ICU stay and mechanical ventilation was significantly shorter, and the prevalences of chest wall deformity, pulmonary infection, pulmonary atelectasis and respiratory failure were significantly lower in operation group than those in non-operation group (P<0.05). Six months after discharge, the pulmonary function parameters such as inspiratory capacity, forced vital capacity, forced expiratory volume in one second, peak expiratory flow, total lung capacity and maximal midexpiratory flow were significantly higher in operation group than those in non-operation group (P<0.05). Conclusion Traumatic flail chest with multiple injuries treated by operative fixation may lead to less flail chest associated complications. Operative fixation has short- and long-term benefits to flail chest.

BACKGROUND: At present, the materials that are successful y applied in rib fracture internal fixation mainly include titanium, nitinol rib encircling bone bonding plate, imported poly-L-lactic acid absorbable rib nails and anatomical plate.
OBJECTIVE: To study the biomechanical characteristics of new magnesium al oy absorbable rib intramedul ary nail in the rib fracture fixation, and to compare with imported poly-L-lactic acid absorbable rib intramedul ary nail in order to provide scientific basis for clinical application.
METHODS: Thirty fresh adult fifth rib specimens were col ected, and the specimens were used to make models for the middle rib fractures. The specimens were fixed with AZ31B magnesium al oy absorbable rib intramedul ary nail (magnesium al oy group) and poly-L-lactic acid absorbable rib intramedul ary nail (poly-L-lactic acid group), and the normal rib specimen group was set as control. The biomechanical characteristics of the nails in each group were tested with stress analysis.
RESULTS AND CONCLUSION: Three-point bending strength measurement results showed that the bending strength in the magnesium alloy group was close to the normal value of the specimen (P > 0.05), and there was significant difference in the bending strength between magnesium alloy group and the poly-L-lactic acid group (P < 0.05). Torsional strength measurement showed that there was no significant difference in torsional strength between magnesium alloy group and the normal specimens, and the results showed that the magnesium alloy was better than poly-L-lactic acid in fixation (P < 0.05). Tensile tests showed that the tensile strength and anti-pulling force of the magnesium alloy fixation were better than those of poly-L-lactic acid fixation (P < 0.05). The results indicate that the magnesium alloy absorbable rib intramedullary nail is better than poly-L-lactic acid absorbable rib intramedullary nail in strength and tensile strength, which is the ideal fixation material for rib fixation.

BACKGROUND: Circular RNAs (circRNAs) are considered to be important regulators in cancer biology. In this study, we focused on the effect of circRNA baculoviral inhibitor of apoptosis protein (IAP) repeat containing 6 (circBIRC6) on non-small cell lung cancer (NSCLC) progression. METHODS: The NSCLC and adjacent non-tumor tissues were collected at Shanghai Ninth People's Hospital. Quantitative real-time polymerase chain reaction was conducted for assessing the levels of circBIRC6, amyloid beta precursor protein binding protein 2 (APPBP2) messenger RNA (mRNA), baculoviral IAP repeat containing 6 mRNA (BIRC6), and microRNA-217 (miR-217). Western blot assay was adopted for measuring the protein levels of APPBP2, E-cadherin, N-cadherin, and vimentin. Colony formation assay, transwell assay, and flow cytometry analysis were utilized for evaluating cell colony formation, metastasis, and apoptosis. Dualluciferase reporter assay and RNA immunoprecipitation assay were carried out to determine the interaction between miR-217 and circBIRC6 and APPBP2 in NSCLC tissues. The murine xenograft model assay was used to investigate the function of circBIRC6 in tumor formation in vivo. Differences were analyzed via Student's t test or one-way analysis of variance. Pearson's correlation coefficient analysis was used to analyze linear correlation. RESULTS: CircBIRC6 was overexpressed in NSCLC tissues and cells. Knockdown of circBIRC6 repressed the colony formation and metastasis and facilitated apoptosis of NSCLC cells in vitro and restrained tumorigenesis in vivo. Mechanically, circBIRC6 functioned as miR-217 sponge to promote APPBP2 expression in NSCLC cells. MiR-217 inhibition rescued circBIRC6 knockdown-mediated effects on NSCLC cell colony formation, metastasis, and apoptosis. Overexpression of miR-217 inhibited the malignant phenotypes of NSCLC cells, while the effects were abrogated by elevating APPBP2. CONCLUSIONS CircBIRC6 aggravated NSCLC cell progression by elevating APPBP2 via sponging miR-217, which might provide a fresh perspective on NSCLC therapy.
Amyloid beta-Peptides/metabolism* ; Amyloid beta-Protein Precursor/metabolism* ; Animals ; Carcinoma, Non-Small-Cell Lung/pathology* ; Cell Movement/genetics* ; Cell Proliferation/genetics* ; China ; Gene Expression Regulation, Neoplastic/genetics* ; Humans ; Lung Neoplasms/pathology* ; Mice ; MicroRNAs/metabolism* ; RNA, Circular/genetics* ; RNA, Messenger