OBJECTIVE: To investigate short-term effectiveness of robot-assisted fracture reduction and fixation combined with arthroscopic exploration for posterolateral depressed tibial plateau fractures. METHODS: Between January 2022 and January 2024, 8 patients with posterolateral depressed tibial plateau fractures (Schatzker type Ⅲ) were treated using robot-assisted fracture reduction and fixation combined with arthroscopic exploration, with simultaneous treatment of concomitant ligament or meniscus tears. There were 3 males and 5 females with an average age of 54.1 years (range, 42-68 years). Injury mechanisms included traffic accidents (3 cases) and falls (5 cases). The time from injury to operation ranged from 2 to 4 days (mean, 3.1 days). Operation time, intraoperative blood loss, hospital stay duration, visual analogue scale (VAS) score for pain, and complications were recorded. Fracture healing and knee Rasmussen scores were assessed radiographically, while knee function was evaluated using range of motion and Hospital for Special Surgery (HSS) scores. RESULTS: All operations were successfully completed. The operation time was 108-129 minutes (mean, 120.1 minutes). The intraoperative blood loss was 10-100 mL (mean, 41.3 mL). The hospital stay duration was 4-7 days (mean, 5.6 days). All incisions healed by first intention without complication such as peroneal nerve injury, vascular damage, or infection. All patients were followed up 32-48 weeks (mean, 40 weeks). Radiographic follow-up confirmed that the knee Rasmussen scores rated as excellent in 8 patients and all fractures healed with the healing time of 12-16 weeks (mean, 13.5 weeks). The VAS score for pain was 2-4 (mean, 2.8) at discharge and improved to 0 at 1 month after operation. The knee range of motion was 80°-110° (mean, 96.1°) at discharge and increased to 135°-140° (mean, 137.9°) at 1 month after operation. At 3 months after operation, the HSS score was 91-94 (mean, 92.8), all graded as excellent. No severe complication, including implant failure, occurred during follow-up. CONCLUSION For posterolateral depressed tibial plateau fractures, the minimally invasive approach combining robot-assisted fracture reduction and fixation with arthroscopic exploration demonstrates multiple advantages, including shorter operation time, reduced intraoperative blood loss, excellent wound healing, fewer complications, and rapid recovery of knee function. This technique achieves satisfactory short-term effectiveness, while its long-term effectiveness requires further evaluation.
Humans ; Male ; Tibial Fractures/surgery* ; Female ; Middle Aged ; Adult ; Arthroscopy/methods* ; Minimally Invasive Surgical Procedures/methods* ; Fracture Fixation, Internal/methods* ; Aged ; Treatment Outcome ; Robotic Surgical Procedures/methods* ; Operative Time ; Range of Motion, Articular ; Fracture Healing ; Length of Stay ; Tibial Plateau Fractures

[摘 要] 目的：探讨扁蒴藤素（Pris）调节Shh/Gli1信号通路对宫颈癌HeLa细胞增殖、凋亡和血管生成拟态（VM）的影响及其机制。方法：采用MTT法检测不同浓度Pris对宫颈癌HeLa细胞增殖的抑制作用，以选取合适的干预浓度。将HeLa细胞分为对照组、环巴胺组、Pris组、Pris+pc-NC组和Pris+pc-Shh组。采用MTT法、EdU法检测各组细胞的增殖能力，Transwell小室法、流式细胞术检测各组细胞的迁移及侵袭能力和细胞凋亡率，体外血管生成实验观察VM形成情况，qPCR法检测各组细胞中Shh和Gli1 mRNA表达水平，WB法检测细胞中血管内皮生长因子A（VEGF-A）、血管内皮钙黏素（VE-cadherin）、Ki-67、caspase-3及与Shh/Gli1信号通路相关蛋白表达水平。结果：0.25~2.5 mmol/L的Pris对HeLa细胞增殖均有显著抑制作用，选择1.5 mmol/L的Pris进行后续实验。对照组细胞形成良好的管腔结构，与对照组相比，环巴胺组、Pris组和Pris+pc-NC组HeLa细胞管腔结构被明显破坏，细胞增殖活力和增殖率、迁移及侵袭细胞数目、Shh和Gli1 mRNA、VEGF-A、VE-cadherin、Ki-67、Shh、Gli1蛋白表达均显著降低（均P<0.05），细胞凋亡率和caspase-3表达均显著升高（均P<0.05）；环巴胺组与Pris组HeLa细胞各项检测指标比较差异均无统计学意义（均P>0.05）；与Pris+pc-NC组相比，Pris+pc-Shh组细胞管腔结构形成明显改善，细胞增殖活力和增殖率、迁移及侵袭细胞数、Shh和Gli1 mRNA、VEGF-A、VE-cadherin、Ki-67、Shh、Gli1蛋白表达均显著升高（均P<0.05），细胞凋亡率和caspase-3表达均显著降低（均P<0.05）。结论：Pris抑制宫颈癌HeLa细胞的增殖、迁移与侵袭和VM的形成并促进细胞凋亡，可能与阻断Shh/Gli1信号通路有关。

Objective To explore the influencing factors of bone mineral density (BMD) in obese children in Qianjiang area and analyze the correlation between BMD and insulin resistance. Methods The data on pediatric cases from the outpatient department of Jianghan Oilfield General Hospital in Qianjiang from January 2018 to December 2022 were collected. A total of 183 obese children who met the inclusion and exclusion criteria were included in the study and selected in the observation group. A total of 352 children undergoing physical examination during the same period were selected as the control group. Results The body mass, waist circumference, waist to hip ratio, and BMI of obese children were significantly higher than those of the control group (P<0.001). Biochemical indexes including FBG, FINS, Home-IR, ALP, and LDL-C in obese children were significantly higher than those in the control group (P<0.05), while bone mineral density, Ca, P, sOC and HDL-C were significantly lower than those in the control group (P<0.001). The bone mineral density of obese children was significantly correlated with their exercise intensity, sunshine exposure duration, sitting time, intake of milk and dairy products, intake of sweets, supplementation of trace elements, BMI, Home-IR, and sex (all P<0.05). BMI, Home-IR, sex, exercise intensity, and sunshine exposure length were independent risk factors affecting bone mineral density of obese children (all P<0.05). Bone mineral density was negatively correlated with BMI and Home-IR (P=0.028 and0.017, respectively), and positive correlation with exercise intensity and sunlight exposure (P=0.033). Conclusion BMD of obese children in Qianjiang area is affected by gender, body mass index, diet, vitamin intake, and physical activity, and is negatively correlated with insulin resistance. Home-IR can be used as a reference for screening BMD of obese children.

BackgroundThe mental health level of the prison police is relatively low， so finding innovative ways to improve the mental health of them is of great significance for the safety of prison supervision and the implementation of peaceful China initiative. ObjectiveTo explore the relationship between perceived social support， perceived stress and psychological resilience with mental health of prison police， and to provide references for improving their mental health. MethodsIn March 2022， 424 policemen working in a male prison in a western province were selected by cluster sampling method， and investigated with the Perceived Social Support Scale （PSSS）， Chinese Perceived Stress Scale （CPSS）， Connor-Davidson Resilience Scale （CD-RISC） and General Health Questionnaire 20 （GHQ-20）， then Process 4.2 was used employed to verify the mediating role of perceived stress as well as the moderating role of psychological resilience in the relationship between perceived social support and mental health. Results①Male subjects scored higher on GHQ-20 than female subjects （t=2.095， P<0.05）. ②CPSS score was negatively correlated with PSSS and GHQ-20 scores （r=-0.670， -0.703， P<0.01）， and GHQ-20 score showed a positive correlation with PSSS and CD-RISC scores （r=0.580， 0.693， P<0.01）. ③Perceived social support positively predict mental health （β=0.154， 95% CI： 0.133~0.175， P<0.01）. ④Perceived stress played a mediating role in the relationship between perceived social support and mental health， and the mediation effect size was 0.087， accounting for 88.78% of the total effect （95% CI： 0.064~0.112， P<0.01）. ⑤Psychological resilience played a moderating role in the second half （perceived stress→mental health） of the mediating path of "perceived social support→perceived stress→mental health"（β=0.074， 95% CI： 0.046~0.102， P<0.01）. ⑥Psychological resilience also regulated the mediation effect of perceived stress on the relationship between perceived social support and mental health ［three regression coefficients tested in turn are significant： a=-0.537 （95% CI： -0.594~-0.480， P<0.01）， b1=-0.162 （95% CI： -0.197~-0.127， P<0.01）， b3=0.074 （95% CI： 0.046~0.102， P<0.01）］. ConclusionPerceived social support of prison police has an impact on their mental health both directly and indirectly through perceived stress. In addition， perceived social support of prison police has a moderated mediation effect on mental health， and it is partially moderated by psychological resilience.［ Funded by General Project of Sichuan Prison Administrative Bureau in 2022］

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

Objective To compare the value of Child-Pugh score, Model for End-Stage Liver Disease (MELD) score, MELD combined with serum sodium concentration (MELD-Na) score, CLIF Consortium Acute Decompensation (CLIF-C AD) score, and Freiburg index of post-transjugular intrahepatic portosystemic shunt (TIPS) survival (FIPS) score in predicting the survival of patients undergoing TIPS. Methods A retrospective analysis was performed for the clinical data of 447 patients with liver cirrhosis who underwent TIPS in several hospitals in southwest China, among whom there were 306 patients in the survival group and 62 in the death group. The scores of the above five models were calculated, and a survival analysis was performed based on these models. The independent samples t -test was used for comparison of normally distributed continuous data between groups, and the non-parametric Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the Pearson chi-square test was used for comparison of categorical data between groups; a multivariate Cox regression analysis was used for correction analysis of known influencing factors with statistical significance which were not included in the scoring models; the Kaplan-Meier method was used to evaluate the discriminatory ability of each model in identifying risks in the surgical population, and the log-rank test was used for analysis. The area under the receiver operating characteristic curve (AUC), C-index at different time points, and calibration curve were used to evaluate the predictive ability of each scoring model. Results Compared with the death group, the survival group had significantly lower age ( Z =2.884, P < 0.05), higher albumin ( t =3.577, P < 0.05), and Na + ( Z =-3.756, P < 0.05) and significantly lower proportion of patients with alcoholic cirrhosis ( χ 2 =22.674, P < 0.05), aspartate aminotransferase ( Z =2.141, P < 0.05), prothrombin time ( Z =2.486, P < 0.05), international normalized ratio ( Z =2.429, P < 0.05), total bilirubin ( Z =3.754, P < 0.05), severity of ascites ( χ 2 =14.186, P < 0.05), and scores of the five models (all P < 0.05). Survival analysis showed that all scoring models effectively stratified the prognostic risk of the patients undergoing TIPS. Comparison of the C-index of each scoring model at different time points showed that Child-Pugh score had the strongest ability in predicting postoperative survival, followed by MELD-Na score, MELD score, and CLIF-C AD score, and FIPS score had a relatively poor predictive ability; in addition, the prediction efficiency of each score gradually decreased over time. Child-Pugh score had the largest AUC of 0.832 in predicting 1-year survival rate after surgery, and MELD-Na score had the largest AUC of 0.726 in predicting 3-year survival rate after surgery, but FIPS score had a poor ability in predicting 1- and 3-year survival rates. Conclusion All five scoring models can predict the survival of patients with liver cirrhosis after TIPS and can provide effective stratification of prognostic risk for such patients. Child-Pugh score has a better ability in predicting short-term survival, while MELD-Na score has a better ability in predicting long-term survival, but FIPS score has a relatively poor predictive ability in predicting both short-term and long-term survival.

OBJECTIVE To study the improvement effect and possible mechanism of N-butylphthalide on inflammatory injury of bone marrow mesenchymal stem cells （BMSCs） in rats. METHODS BMSCs of rats were divided into control group， model group， N-butylphthalide low-concentration， medium-concentration and high-concentration groups （10， 20， 50 μmol/L）. BMSCs were cultured in vitro and lipopolysaccharide （the final concentration of 10 mg/L） was used to establish the inflammatory injury model. After the intervention of N-butylphthalide， the survival rate， apoptotic rate， the contents of tumor necrosis factor α （TNF- α）， interleukin 1β （IL-1β） and IL-6 in cell culture medium， the mRNA expression of nuclear factor-κB（NF-κB） p65， and the protein expressions of caspase-3， B-cell lymphoma 2 （Bcl-2）， Bcl-2 related X protein （Bax） and NF-κB p65 in cells were detected. RESULTS Compared with control group， the survival rate and protein expression of Bcl-2 were decreased significantly in model group （P＜0.05）； the apoptotic rate， contents of TNF-α， IL-1β and IL-6， the mRNA expression of NF-κB p65， and the protein expressions of caspase-3， Bax and NF-κB p65 were increased significantly （P＜0.05）. Compared with model group， above indexes were significantly reversed in all concentration groups of N-butylphthalide （P＜0.05）， in concentration-dependent manner. CONCLUSIONS N-butylphthalide can ameliorate the inflammatory injury of BMSCs induced by lipopolysaccharide， and its mechanism may be related to the inhibition of NF-κB signaling pathway.

[Abstract] Objective To investigate whether levosimendan (Lev) affects hypoxia / reoxygenation (H / R) - induced cardiomyocyte proliferation, apoptosis and fibrosis by regulating the molecular axis of long chain noncoding RNA (LncRNA) eosinophil granule ontogeny transcript (EGOT) / microRNA (miR) -641. Methods Rat cardiomyocytes H9C2 were cultured in vitro, and H / R-treated cells were used to establish cell damage models, which were randomly divided into control group, H / R group, H / R + Lev 1 μmol / L (H / R + Lev-L) group, H / R + Lev 5 μmol / L (H / R + Lev-M) group, and H / R + Lev 10 μmol / L (H / R + Lev-H) group, 9 samples per group. MTT method was used to detect cell proliferation. Flow cytometry was used to detect the apoptosis rate. Real-time P CR was used to detect the expression levels of EGOT and miR-641 mRNA. P cDNA-EGOT and EGOT small interfering RNA (si-EGOT) were transfected into H9 C2 cells respectively, and the cell proliferation and apoptosis rates were detected by the above method. The dual luciferase report experiment verified the targeting relationship between EGOT and miR-641. Western blotting was used to detect the expression levels of Bax, Bcl-2, collagen I (colI), collagen Ⅲ (col Ⅲ), tissue inhibitor of matrix metalloproteinase 2 (TIMP 2), matrix metalloproteinase-2 (MMP -2) . Results Compared with the control group, the cell survival rate of the H / R group reduced significantly (P < 0. 05), the apoptosis rate increased significantly (P < 0. 05), and the protein levels of Bax, c I, col Ⅲ, TIMP 2, and MMP -2 increased significantly (P < 0. 05), the level of Bcl-2 protein reduced significantly (P < 0. 05), the expression level of EGOT reduced significantly (P < 0. 05), the expression level of miR-641 increased significantly (P < 0. 05) . Compared with the H / R group, the cell survival rate of the H / R + Lev-L group, H / R + Lev-M group, and H / R + Lev-H group increased significantly (P < 0. 05), and the apoptosis rate decreased significant (P < 0. 05), the protein levels of Bax, colI, colⅢ, TIMP 2, MMP -2 reduced significantly (P < 0. 05), the level of Bcl-2 protein increased significantly (P < 0. 05), the expression level of EGOT increased significantly (P < 0. 05), the expression level of miR-641 reduced significantly (P < 0. 05), and each index of H / R + Lev-L group, H / R + Lev-M group, H / R + Lev-H group, the difference was statistically significant (P < 0. 05) . The dual luciferase report experiment confirmed that EGOT ccould target and bind to miR-641. The effect of transfecting pcDNA-EGOT and Lev was similar. Transfection of si-EGOT could reduce the effect of Lev on H / R-induced proliferation, apoptosis and fibrosis of H9 C2 cells. Conclusion Levosimendan may promote H / R-induced H9 C2 cell proliferation and inhibit apoptosis and fibrosis by up-regulating EGOT expression and down-regulating miR-641 expression.

【Objective】 To explore the effects of platelet-rich plasma (PRP) injection combined with pregabalin on pain and knee function in knee osteoarthritis (KOA). 【Methods】 A total of 220 patients with KOA in our hospital, between June 2020 and April 2022, were enrolled and randomly divided into observation group (n=110) and the control (n=110). The observation group was given PRP injection combined with pregabalin, while control group was given sodium hyaluronate combined with pregabalin. The clinical curative effect, osteoarthritis index (WOMAC), pain level (VAS), knee function [Lysholm-Ⅱ scale, Rasmussen scale], levels of repair-promoting factors [transforming growth factor-β1 (TGF-β1), bone morphogenetic protein 4 (BMP4), insulin growth factor 1 (IGF-1)], inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor α (TNF-α)], oxidative stress indexes [superoxide dismutase (SOD), nitric oxide (NO)] and blood routine [white blood cell count (WBC), platelet count (Plt)], and the occurrence of adverse reactions in the two groups were compared. 【Results】 The response rate of treatment was higher in observation group than control group [94.55% (104/110) vs 83.64% (92/110), P<0.05]. After treatment, scores of WOMAC and VAS were lower in observation group than the control group [points: 43.39±5.92 vs 49.40±6.18, 2.50±0.33 vs 2.87±0.39, P<0.05], and scores of Rasmussen and Lysholm-Ⅱ were higher in observation group [points 60.66±6.15 vs 55.13±5.49, 77.04±6.18 vs 72.15±7.25, P<0.05]. After treatment, levels of serum TGF-β1, BMP4 and IGF-1 were higher in observation group than control group [(944.80±54.92) ng/L vs (901.45±46.82) ng/L, (126.79±9.81) pg/mL vs (118.44±8.45) pg/mL, (96.86±5.15) μg/L vs (91.47±5.06) μg/L, P<0.05]. After treatment, levels of serum IL-6, TNF-α and NO were lower in observation group than control group [(124.92±20.58) pg/mL vs (149.10±22.91) pg/mL, (1.90±0.31) μg/L vs (2.64±0.52) μg/L, (81.05±6.83) μmol/L vs (86.22±5.84) μmol/L], while SOD was higher in observation group [(109.29±10.18) NU/mL vs (102.77±9.98) NU/mL, P<0.05)]. The levels of peripheral blood WBC and PLT in the two groups were similar after treatment (P>0.05). There was no significant difference in incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 PRP injection combined with pregabalin can effectively improve knee function, relieve pain, reduce levels of inflammatory factors and oxidative stress injury, and promote the expressions of repair-promoting factors in KOA patients.

【Objective】 To investigate the current situation concerning volume control of red blood cells in additive solution produced by blood service in Chongqing, and to lay a foundation for promoting the homogenization of preparation process of red blood cells in additive solution. 【Methods】 A questionnaire was designed to investigate the factors related to the preparation of red blood cells in additive solution. The questionnaire was sent by Chongqing Association of Blood Transfusion via E-mail to 18 blood services in the city, and the collected data was sorted, revised and analyzed by research team. 【Results】 A total of 18 blood services(including 1 blood center + 1 sub-center, 6 central blood stations and 11 central blood banks) returned the questionnaires. The results showed that there were differences among blood services across Chongqing, regarding the centrifugal parameters during preparation, the operation mode and monitoring situation of the capacity control during preparation, and the formulation of the capacity standard of red blood cells in additive solution etc. 【Conclusion】 The preparation process of red blood cells in additive solution, produced by Chongqing blood services, should be further standardized, and the capacity control method of this product in Chongqing should be gradually unified to achieve regional homogeneity and to ensure blood safety.