BACKGROUND:There are more literature reports about the floating shoulder injury in recent years, but there stil have obvious controversies about the treatment of the floating shoulder injury. Whether choose the conservative treatment or operative treatment is an important issue in face of every clinician. OBJECTIVE:To review the clinical features and present treatment situation of the floating shoulder injury. METHODS: A computer-based online search was performed in the PubMed and the China National Knowledge Infrastructure database for the clinical research papers on the treatment methods of the floating shoulder injury from January 1975 to August 2015. The key words were floating shoulder injury, diagnose, treatment method. The articles published earlier and repetitive researches were excluded. Finaly, 33 articles were included for further analysis. RESULTS AND CONCLUSION:(1) Floating shoulder injury is a kind of severe shoulder injury which is caused by high energy and violence. It is often complicated with severe systemic injury, which should be paid more attention in clinic. (2) The treatment of floating shoulder injury has been controversial, and there is no standard treatment guideline. Conservative treatment and operative treatment can get good outcomes. There are less reports about conservative treatment of the floating shoulder injury in recent years. The outcome of operative treatment may better than conservative treatment. (3) Conservative or simple clavicle fixation can be used for fractures without displacement or with smal displacement. Obviously displaced fractures can be treated with simple clavicle fixation or double fixation of clavicle and scapula, which may have good repair effects.

With the increasing incidence rate of nonalcoholic fatty liver disease (NAFLD) in Western developed countries and rich regions of China year by year, the treatment methods for NAFLD have been constantly improved and NAFLD has become a research hotspot. As an important physiological structure of the liver, liver sinus endothelial cells (LSECs) play an important role in the development and progression of NAFLD. This article summarizes the mechanism of action of LSECs in the pathogenesis of NAFLD, which included the following aspects: LSEC capillarization occurs in nonalcoholic fatty liver and promotes steatosis; meanwhile, LSECs contribute to oxidative stress in nonalcoholic steatohepatitis (NASH) and is a major effector of liver inflammation in NASH, thus promoting liver fibrosis; in addition, angiogenesis is highly stimulated and promotes NAFLD-related hepatocellular carcinoma in NAFLD. However, the role of LSECs in NASH-associated liver cirrhosis has not been validated, which needs to be further clarified to provide new ideas and directions for treatment.

The preservation of anal sphincter function is an urgent demand for patients with distal rectal carcinoma who expect a good quality of life, especially for aged patients intolerant to surgery due to their poor physical conditions, always posing clinical challenges. Although the clinical complete response (cCR) rates of 24%-49% achieved by neoadjuvant chemoradiotherapy or total neoadjuvant therapy (TNT) allow partial patients to avoid or delay anal resection by adopting a wait-and-see strategy, they still face the risk of local recurrence. Studies have confirmed a dose-response relationship in radiotherapy for rectal cancer, with local doses ranging from 72 to 92 Gy potentially achieving a cCR rate of 50%. In contrast, the tolerated doses for conventional external beam radiotherapy (EBRT) vary between 45 and 54 Gy, while higher doses may cause severe damage to normal organs or tissues. Endorectal brachytherapy, characterized by direct irradiation of tumors, a short irradiation range, and rapid dose fall-off, increases local exposure dose while protecting surrounding organs and even the contralateral normal rectal mucosa. Two main modalities of endorectal brachytherapy are available: 50 kV contact X-ray therapy (CXB) and high-dose-rate brachytherapy (HDR-BT). This review summarizes and analyzes the latest advances in research on endorectal brachytherapy, demonstrating its association with higher cCR rates, long-term local control rates, and lower adverse reaction rates. Therefore, endorectal brachytherapy is a more beneficial alternative for aged patients with distal rectal carcinoma who are intolerant to surgery due to their poor physical conditions and require anal sphincter preservation.

Objective To identify and validate co-expressed genes associated with myocardial ischemia/reperfusion injury(MI/RI)and necrotic apoptosis by bioinformatics analysis.Methods Gene expression profile data for MI/RI were obtained by GSE67308 and GSE19875 datasets from the Gene Expression Omnibus(GEO)database.Differential expression analysis was conducted on the GSE67308 dataset to identify differentially expressed genes(DEGs),followed by gene set enrichment analysis and biological pathway analysis.More-over,immune cell infiltration analysis was performed on the GSE67308 dataset.Necrotic apoptosis-related genes were retrieved from the Molecular Signatures Database and the Kyoto Encyclopedia of Genes and Genomes(KEGG).A protein-protein interaction(PPI)network was constructed by overlapping DEGs with these necrotic apoptosis-related genes to identify key genes.Furthermore,the expression pat-terns of these key genes across various cardiac cell types were analyzed using a single-cell sequencing analysis platform,and validation of key gene expression was performed using the GSE19875 dataset.Results A total of 1054 DEGs were identified,comprising 363 upregu-lated and 691 downregulated genes.Gene enrichment analysis revealed that DEGs were primarily associated with processes related to apoptosis,immune responses,and intracellular signaling regulation.Moreover,biological pathway analysis demonstrated that DEGs were predominantly involved in the regulation of signaling pathways such as tumor necrosis factor(TNF)and NF-κB.Immune infiltration anal-ysis indicated a high degree of immune infiltration,particularly with natural killer cells and monocytes,in MI/RI myocardial tissue.PPI network analysis identified Il1b,TNF,Birc3,and Ripk1as crucial genes in the context of necrotic apoptosis.Single-cell sequencing anal-ysis showed the elevated expression of key genes within white blood cells.In comparison to the control group,the MI/RI model group in the GSE19875 dataset exhibited significantly increased expression of Il1b,TNF,Birc3,and Ripk1(P<0.01).Conclusion MI/RI is strongly correlated with the TNF signaling pathway and the NF-κB signaling pathway,both of which play pivotal roles in regulating necrotic apop-tosis.Il1b,TNF,Birc3,and Ripk1emerge as key genes that concurrently regulate both MI/RI and necrotic apoptosis.It is plausible that IL-1b,TNF,Birc3,and Ripk1 may serve as critical regulatory factors in the context of necrotic apoptosis during MI/RI.

Objective To establish a rapid detection method for invasive candidiasis based on droplet digital polymerase chain reaction(ddPCR).Methods We developed an assay system using a microtitre-based digital PCR platform and designed primer probes specific for four Candida species,namely Candida albicans,Candida smoothii,Candida near-smoothii,and Candida tropicalis.(1)The Limit of Blank(LOB)range and positive judg-ment value were determined by analyzing No Template Control(NTC)samples.(2)The Limit of Detection(LOD)range was determined by diluting positive samples with 10 replicate extractions at each concentration gradient.(3)The Linear Limit of Quantitation(LOQ)range was determined by repetitive testing of diluted samples.(4)The linear range limit was determined through gradient dilution of the positive samples.(5)The coefficient of variation(CV),calculated from the logarithmic values of the resultant concentrations,was assessed by extracting and test-ing positive samples in 12 repetitions at both high and low concentrations.(6)Method reliability was evaluated by calculating the CV from the logarithmic values of the resultant concentrations obtained from clinical samples with fungal culture results.Results The ddPCR assay detected Candida LOB at a range of 0～81 copies/mL,with a positive threshold set at≥3 positive microdroplets.The LOD and LOQ were determined to be 3×102 copies/mL.The linear range for detecting different concentration gradients was found to be between 3×102 and 3×107 copies/mL,with high correlation coefficients observed for Candida albicans(R2=0.999 5),Candida smoothii(R2=0.998 9),Candida near-smoothii(R2=0.999 4),and Candida tropicalis(R2=0.999).Additionally,the coefficient of variation for the resultant concentration logarithmic values was less than 5%,meeting precision requirements.Furthermore,preliminary validation using clinical specimens demonstrated consistent results compared to clinical culture findings.Conclusion ddPCR exhibits rapidity,high sensitivity,good repeatability,and high specificity in detecting inva-sive candidiasis in critically ill patients.This study highlights the potential value of droplet digital PCR as a diag-nostic tool for invasive candidiasis.

Objective:To determine the content of albiflorin, paeoniflorin, benzoylpaeoniflorin, sophoricoside, prim-O-glucosylcimifugin, cimifugin, 5-O-methylvisammioside and sec-O-glucosylhamaudol in Huaiqin Salve with high performance liquid chromatography-quantitative analysis of multi-components by single-marker (HPLC-QAMS) method. Methods:The samples were separated with ZORBAX Eclipse XDB-C18 column by a gradient elution using methanol-acetonitrile (1:2) (A)-0.1% phosphoric acid solution (B) as mobile phase and the flow rate was 1.0 ml/min. The detection wavelength was 230 nm for albiflorin, paeoniflorin and benzoylpaeoniflorin, and 254 nm for sophoricoside, prim-O-glucosylcimifugin, cimifugin, 5-O-methylvisammioside and sec-O-glucosylhamaudol. The column temperature was 30 ℃. Using sophoricoside as an internal standard, the relative correction factors (RCFs) of albiflorin, paeoniflorin, benzoylpaeoniflorin, prim-O-glucosylcimifugin, cimifugin, 5-O-methylvisammioside and sec-O-glucosylhamaudol were calculated. The method was validated by comparison of the quantitative results between external standard method (ESM) and HPLC-QAMS method.Results:Albiflorin, paeoniflorin, benzoylpaeoniflorin, sophoricoside, prim-O-glucosylcimifugin, cimifugin, 5-O-methylvisammioside and sec-O-glucosylhamaudol showed good linear relationship within the range of 0.034 7-0.867 5, 0.063 6-1.590 0, 0.006 9-0.172 5, 0.198 6-4.965 0, 0.092 8-2.320 0, 0.026 6-0.665 0, 0.042 7-1.067 5, 0.020 9-0.522 5 μg ( r ≥ 0.999 1); whose average recoveries ( RSDs) were 98.85% (1.02%), 100.04% (0.67%), 96.92% (1.14%), 100.06% (0.85%), 99.31% (1.39%), 99.16% (1.22%), 98.59% (1.33%) and 97.58% (1.41%), respectively. No significant differences were found in the quantitative analysis of the components with ESM and HPLC-QAMS method. Conclusion:The HPLC-QAMS method could provide the reference for themulti-index component evaluation for Huaiqin Salve.

OBJECTIVE To analyze the effects of centralized volume-based procurement policy （hereinafter referred to as “centralized procurement”） on the use of anti-tumor drugs in medical institutions. METHODS The interrupted time series model was used to analyze the changes in the monthly purchase volume and purchase amount of docetaxel， gemcitabine and pemetrexed disodium in a third-grade class-A cancer hospital in Shanxi province from January 2018 to December 2021. RESULTS & CONCLUSIONS After the implementation of the centralized procurement policy， both the selected drugs and the non-selected drugs had different degrees of price reduction， and the price reduction of the selected drugs was far greater than that of the non- selected drugs； average monthly purchase volume and amount of docetaxel decreased significantly in that month after the implementation of the policy， while those of gemcitabine and pemetrexed disodium increased significantly （P＜0.05 or P＜0.01）. After the implementation of the policy， the average monthly purchase volume and amount of gemcitabine showed a downward trend， while those of docetaxel and pemetrexed disodium showed an upward trend （P＜0.05 or P＜0.01）. It is suggested that hospitals should strengthen pharmaceutical administration， and avoid adopting a “one size fits all” approach to non-selected drugs； relevant departments should further expand the collection range of anti-tumor drugs or carry out special collection of anti-tumor drugs， so as to save medical insurance funds and reduce medical expenses.

Humans ; COVID-19/genetics* ; SARS-CoV-2/genetics* ; Clustered Regularly Interspaced Short Palindromic Repeats/genetics* ; CRISPR-Cas Systems/genetics* ; RNA, Viral/genetics*