OBJECTIVE: To analyze the disease burden of pelvic fractures at the global, regional, and national levels from 1990 to 2023 using data from the 2023 Global Burden of Disease Study (GBD), and to predict the disease burden through 2050. METHODS: Leveraging data from the GBD 2023, this study investigated the disease burden of pelvic fractures across 204 countries and regions. Assessment indicators included incidence rate, prevalence rate, and years lived with disability (YLDs). The Joinpoint regression model was employed to analyze trends in pelvic fracture burden from 1990 to 2023, while the average annual percentage change (AAPC) was used to quantify this temporal trend. The relationship between the socio-demographic index and pelvic fracture burden was evaluated. Furthermore, the long short-term memory (LSTM) model was applied to predict trends in pelvic fracture burden through 2050. RESULTS: In 2023, the estimated number of new pelvic fracture cases globally was 7 479 884 [95% uncertainty interval ( UI): 5 293 401-10 611 876], representing a 42.74% increase from 1990. In the same year, the number of prevalent pelvic fracture cases and YLDs were 23 007 508 (95% UI: 21 021 518-25 327 165) and 3 909 228 person-years (95% UI: 2 725 498-5 194 385), respectively. Additionally, age-standardized rates exhibited an opposing downward trend. Significant disparities in the disease burden of pelvic fractures were identified across different age groups, genders, and social contexts. According to predictions from the LSTM model, the global age-standardized incidence rate (ASIR) of pelvic fractures will be approximately 88.44 per 100 000 persons by 2050, while the total number of incident cases will rise to 8 547 095. CONCLUSION Although the overall incidence rate, prevalence rate, and YLDs of pelvic fractures have exhibited an upward trend over the past three decades, the ASIR, age-standardized prevalence rate (ASPR), and age-standardized years of life lost rate (ASYR) have shown a downward trend. It is predicted that over the upcoming 26-year period, the age-standardized rate of disease burden due to pelvic fractures will further decrease, while the number of incident cases and prevalent cases will continue to exhibit an upward trend. Formulating more targeted disease prevention strategies is critical to addressing disparities across genders, regions, and other dimensions, and to mitigating the burden of pelvic fractures.
Humans ; Fractures, Bone/epidemiology* ; Pelvic Bones/injuries* ; Male ; Female ; Middle Aged ; Adult ; Incidence ; Prevalence ; Aged ; Global Burden of Disease/trends* ; Global Health ; Adolescent ; Cost of Illness ; Young Adult ; Forecasting ; Disability-Adjusted Life Years ; Memory, Short-Term

Objective:To investigate the correlation between plasma Dickkopf-1 (DKK1) and post-stroke cognitive impairment (PSCI) in patients with acute ischemic stroke.Methods:Consecutive patients with first-ever acute ischemic stroke admitted to the Department of Neurology, Nanjing Jiangbei Hospital from March 2023 to February 2024 were included prospectively. Enzyme-linked immunosorbent assay was used to detect plasma DKK1 within 24 hours of onset. The Montreal Cognitive Assessment Scale was used to evaluate cognitive function at 3 months after onset. A score ≤22 was defined as PSCI. Multivariate logistic regression analysis was used to determine the correlation between DKK1 and PSCI. The relationship between DKK1 and PSCI risks was evaluated through restrictive cubic spline analysis. Results:A total of 205 patients with acute ischemic stroke were enrolled, including 106 males (51.7%), aged 67.0±9.4 years; 61 patients (29.8%) experienced PSCI. Multivariate logistic regression analysis showed that after adjusting for age, gender, education level, and other confounding factors, there was a significant independent correlation between higher plasma DKK1 and PSCI (odds ratio 1.778, 95% confidence interval 1.313-2.408; P=0.001). Subgroup analysis showed that age, gender, etiological classification of stroke, and education level had no significant effect on the above correlation. Restrictive cubic spline analysis showed plasma DKK1 had a linear relationship with the risk of PSCI ( P=0.003). Conclusion:Higher plasma DKK1 level is significantly correlated with PSCI in patients with acute ischemic stroke at 90 days after onset.

Objective:To investigate the pathways involved in bisphenol S(BPS)and bisphenol F(BPF)induced male reproductive injury by bioinformatics methods and experimental verification.Methods:Bioinformatics analysis was conducted to screen the genes related to male reproductive system diseases associated with BPF and BPS from the Comparative Toxicogenomics Database(CTD).Functional enrichment using Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were performed to predict potential signaling pathways and key genes.Cell counting kit-8(CCK-8)method was used to assess the cell viability in various groups treated with different concentrations of BPS and BPF(1×10-3,1×10-2,1×10-1,1×100,1×101,and 1×102 μmol·L-1).TM3 cells were divided into control group(0.1％DMSO),different doses of BPS groups,and different doses of BPF groups.The cells were treated with 20,40,and 80 μmol·L-1 of BPS and BPF for 72 h,respectively.Real-time fluorescence quantitative PCR(RT-qPCR)and Western blotting method were used to detect the expression levels of key genes mRNA and proteins in various groups.Results:The bioinformatics analysis results revealed that 507 and 447 male systemic disease genes related to BPS and BPF were screened by CTD,respectively.The GO enrichment analysis results showed that the selected genes were primarily enriched in biological processes(BP)such as reproductive system development and reproductive structure development.The KEGG pathway analysis results indicated that these genes were significantly enriched in signaling pathways such as phosphatidylinositol 3-kinase/protein kinase B(PI3K/AKT),hypoxia-inducible factor-1(HIF-1),and cellular senescence(P＜0.001).The CCK-8 method results showed that compared with control group,the cell viabilities in 1× 102 μmol·L-1 BPF and BPS groups were significantly decreased(P＜0.05),while the viabilities of TM3 cells in other groups had no significant changes(P＞0.05).After BPS treatment,compared with control group,the expression levels of PI3K,AKT,hypoxia-inducible factor-1α(HIF-1α),and CREB-binding protein(CBP)mRNA in low,medium,and high doses of BPS groups were decreased(P＜0.05),the expression levels of PI3K protein were decreased(P＜0.05),the expression levels of B-cell lymphoma-2-associated X protein(Bax)protein were increased(P＜0.05),and the expression levels of serine protease inhibitor clade B,member 10(SERPINB10)mRNA were increased(P＜0.01);the expression levels of Bax and intraflagellar transport 80 homolog(IFT80)mRNA in the cells in medium and high doses of BPS groups were increased(P＜0.05);the expression levels of B-cell lymphoma-2(Bcl-2)mRNA and protein in low and high doses of BPS groups were decreased(P＜0.05);the expression levels of additional sex combs like 2(ASXL2)mRNA in low and medium doses of BPS groups were decreased(P＜0.01).After BPF treatment,compared with control group,the expression levels of Bcl-2,HIF-1α,and structural maintenance of chromosomes protein 1B(SMC1B)mRNA in low,medium,and high doses of BPF groups were decreased(P＜0.05),and the expression levels of IFT80 mRNA(P＜0.01)and Bax protein(P＜0.01)were increased;the expression levels of PI3K,AKT,and ring finger protein 130(RNF130)mRNA in low and high doses of BPF groups were decreased(P＜0.05);the expression level of CBP mRNA in medium dose of BPF group was decreased(P＜0.05),while the expression level of RNF130 mRNA was increased(P＜0.05);the expression levels of PI3K and Bcl-2 proteins in high dose of BPF group were decreased(P＜0.05).Conclusion:BPF and BPS may cause cell cytotoxicity and impair male reproductive health through PI3K/AKT and HIF-1 signaling pathways.RNF130 and SMC1B may be important targets for their induction of male reproductive toxicity.

Objective To retrospectively analyze the efficacy and safety of combined hetrombopag in the treatment of cancer therapy induced thrombocytopenia(CTIT)after chemotherapy for germ cell tumors.Methods The data of patients with CTIT ≥ grade Ⅲcombined with chemotherapy for intracranial germ cell tumors admitted from January 2021 to March 2024 were collected and analyzed,and 33 patients met the enrollment criteria.The patients in the study group were treated with oral hetrombopag combined with subcutaneous injections of recombinant human thrombopoietin(rhTPO)or interleukin-11(IL-11),and those in the control group were treated with subcutaneous injections of rhTPO or IL-11.The differences of the two groups of patients in platelet counts,platelet-raising response rate,mean onset of action time,and prolongation of the next cycle of treatment before and after the treatment were compared to each other,and the adverse reactions of the two groups were also counted.Results The platelet counts of patients in both groups were improved post-treatment,with no statistical significance between the two groups for platelet count elevation on days d1,d2,and d3 of the medication(P＞0.05).The platelet elevation counts of the study group were significantly elevated on day d(7±3)after the medication compared with the control group,with a statistically significant difference(P＜0.05),and the rate of platelet elevation response increased with time prolongation.The mean time to onset of drug administration was 3(3,5)in the study group and 4(3,7)in the control group,with no statistically significant difference(P＞0.05).The incidence of prolongation of the time to the next cycle of treatment was 54.5％in the study group and 81.8％in the control group,and the difference between the two groups was not statistically significant(P＞0.05).Two patients in the study group developed mild reversible liver function abnormalities.Conclusion The efficacy of hetrombopag combined with subcutaneous injection of t rhTPO or IL-11 in the treatment of thrombocytopenia after chemotherapy for intracranial germ cell tumors is reliable,and it can significantly elevate platelet counts with tolerable adverse effects.

Neutrophils are the most abundant white blood cells in the human body and play different roles in various diseases.The studies have shown that inflammation is closely related to the occurrence and development of tumors.As an important component of the tumor microenvironment(TME),neutrophils play a crucial role in tumors and have a dual effect of promoting and inhibiting tumor growth.This article deeply discusses the recruitment and subtypes of neutrophils,as well their dual effects on tumors.Meanwhile,it illustrates the role and clinical significance of neutrophils in gliomas.The therapeutic approach of targeting neutrophils in tumors provides a new direction for subsequent tumor treatment.Especially for central nervous system tumors,neutrophils as carriers can transport chemotherapeutic drugs across the blood-brain barrier to reach the tumor tissue,offering new hope for the subsequent treatment of brain tumors.

Objective Objective To investigate the expression levels of long non-coding RNA HCG11(LncHCG11)and miR-214-5p in pancreatic cancer tissues and their potential molecular regulatory mechanisms.Methods Ten patients with pancreatic cancer admitted between January 2022 and January 2025 were included,and post-operative cancer tissue and paired adjacent tissue samples were collected.Real-time quantitative PCR technology was used to detect the transcription levels of LncHCG11 and miR-214-5p,and the expression level of sirtuin 2(SIRT2)protein was measured by Western blot.The relationship of miR-214-5p with LncHCG11 and SIRT2 was predicted through a biological database.Results Compared with the adjacent non-cancerous tissues,the expression of LncHCG11 and SIRT2 was significantly reduced in pancreatic cancer tissues,while the level of miR-214-5p was significantly increased(P<0.01).In vitro experiments showed that overexpression of LncHCG11 in the Panc1 cell line could upregulate the expression of SIRT2 protein and simultaneously inhibit the proliferative activity of Panc1 cells(P<0.05).Both miR-214-5p and LncHCG11,SIRT2 had binding sites.Conclusion LncHCG11 may act as a competing endogenous RNA to sponge miR-214-5p,releasing its transcriptional inhibition on SIRT2,thereby inhibiting the progression of pancreatic cancer.

Objective Objective To investigate the expression levels of long non-coding RNA HCG11(LncHCG11)and miR-214-5p in pancreatic cancer tissues and their potential molecular regulatory mechanisms.Methods Ten patients with pancreatic cancer admitted between January 2022 and January 2025 were included,and post-operative cancer tissue and paired adjacent tissue samples were collected.Real-time quantitative PCR technology was used to detect the transcription levels of LncHCG11 and miR-214-5p,and the expression level of sirtuin 2(SIRT2)protein was measured by Western blot.The relationship of miR-214-5p with LncHCG11 and SIRT2 was predicted through a biological database.Results Compared with the adjacent non-cancerous tissues,the expression of LncHCG11 and SIRT2 was significantly reduced in pancreatic cancer tissues,while the level of miR-214-5p was significantly increased(P<0.01).In vitro experiments showed that overexpression of LncHCG11 in the Panc1 cell line could upregulate the expression of SIRT2 protein and simultaneously inhibit the proliferative activity of Panc1 cells(P<0.05).Both miR-214-5p and LncHCG11,SIRT2 had binding sites.Conclusion LncHCG11 may act as a competing endogenous RNA to sponge miR-214-5p,releasing its transcriptional inhibition on SIRT2,thereby inhibiting the progression of pancreatic cancer.

Objective To retrospectively analyze the efficacy and safety of combined hetrombopag in the treatment of cancer therapy induced thrombocytopenia(CTIT)after chemotherapy for germ cell tumors.Methods The data of patients with CTIT ≥ grade Ⅲcombined with chemotherapy for intracranial germ cell tumors admitted from January 2021 to March 2024 were collected and analyzed,and 33 patients met the enrollment criteria.The patients in the study group were treated with oral hetrombopag combined with subcutaneous injections of recombinant human thrombopoietin(rhTPO)or interleukin-11(IL-11),and those in the control group were treated with subcutaneous injections of rhTPO or IL-11.The differences of the two groups of patients in platelet counts,platelet-raising response rate,mean onset of action time,and prolongation of the next cycle of treatment before and after the treatment were compared to each other,and the adverse reactions of the two groups were also counted.Results The platelet counts of patients in both groups were improved post-treatment,with no statistical significance between the two groups for platelet count elevation on days d1,d2,and d3 of the medication(P＞0.05).The platelet elevation counts of the study group were significantly elevated on day d(7±3)after the medication compared with the control group,with a statistically significant difference(P＜0.05),and the rate of platelet elevation response increased with time prolongation.The mean time to onset of drug administration was 3(3,5)in the study group and 4(3,7)in the control group,with no statistically significant difference(P＞0.05).The incidence of prolongation of the time to the next cycle of treatment was 54.5％in the study group and 81.8％in the control group,and the difference between the two groups was not statistically significant(P＞0.05).Two patients in the study group developed mild reversible liver function abnormalities.Conclusion The efficacy of hetrombopag combined with subcutaneous injection of t rhTPO or IL-11 in the treatment of thrombocytopenia after chemotherapy for intracranial germ cell tumors is reliable,and it can significantly elevate platelet counts with tolerable adverse effects.

Neutrophils are the most abundant white blood cells in the human body and play different roles in various diseases.The studies have shown that inflammation is closely related to the occurrence and development of tumors.As an important component of the tumor microenvironment(TME),neutrophils play a crucial role in tumors and have a dual effect of promoting and inhibiting tumor growth.This article deeply discusses the recruitment and subtypes of neutrophils,as well their dual effects on tumors.Meanwhile,it illustrates the role and clinical significance of neutrophils in gliomas.The therapeutic approach of targeting neutrophils in tumors provides a new direction for subsequent tumor treatment.Especially for central nervous system tumors,neutrophils as carriers can transport chemotherapeutic drugs across the blood-brain barrier to reach the tumor tissue,offering new hope for the subsequent treatment of brain tumors.

OBJECTIVE To prepare nanoparticle-based targeting preparation loaded with triptolide(TP),and evaluate its quality,targeting ability and cytotoxic effects.METHODS Polymer nanoparticles carrying TP-targeted folic acid(FA)receptor(TP@PLGA-PEG-FA)were fabricated using poly(lactic-co-glycolic acid)/polyethylene glycol/FA(PLGA-PEG-FA)as the carrier by emulsion and volatilization technique.The morphology and distribution were observed,and their particle size,Zeta potential,polydispersity index(PDI),drug loading capacity and encapsulation efficiency were measured.Their stability,blood compatibility,in vitro drug release,uptake by RAW264.7 cells(localization with fluorescent dye Cy3.5),and in vitro cytotoxicity were evaluated.RESULTS TP@PLGA-PEG-FA exhibited spherical shape and uniform distribution,with particle size of(122.60±0.02)nm,Zeta potential of(-17.6±0.6)mV,and PDI of 0.26±0.02;drug loading capacity and encapsulation efficiency of TP were measured to be(7.78±0.05)%and(68.62±0.03)%,respectively.The hemolysis rates of 100,200,300,400 μg/mL TP@PLGA-PEG-FA were 0.77%,0.92%,1.34%and 1.63%,respectively.There were no significant changes in particle size,PDI and Zeta potential when TP@PLGA-PEG-FA were placed in 4℃water for 14 days and in DMEM culture medium containing 10%fetal bovine serum at 37℃for 12 h.The cumulative release rate of TP@PLGA-PEG-FA was(84.83±0.29)%in phosphate buffer at pH5.5 for 72 h,which was significantly higher than the cumulative release rates in phosphate buffer solutions at pH7.4 and 6.5 for 72 h[(42.37±0.35)%and(63.83±0.29)%,respectively](P＜0.05).Activated RAW264.7 cells took up significantly more Cy3.5@PLGA-PEG-FA than they took up Cy3.5@PLGA-PEG-FA+free FA and Cy3.5@PLGA-PEG.When the mass concentration of TP was≥15.63 ng/mL,the survival rates of activated cells in the TP@PLGA-PEG-FA groups were significantly lower than those of the same mass concentration of free TP groups(P＜0.05).CONCLUSIONS The prepared TP@PLGA-PEG-FA has high stability,good blood compatibility,active targeting and cytotoxicity to inflammatory cells.