Objective:To evaluate the clinical efficacy of the V-shaped bone tunnel technique at the base of the distal phalanx for treating tendinous mallet finger.Methods:A retrospective analysis was conducted on clinical data from patients with tendinous mallet finger treated in the Department of Hand and Foot Surgery at Linyi People’s Hospital between August 2022 and November 2023. Two oblique bone tunnels were created in a V-shaped configuration at the dorsal base of the distal phalanx, adjacent to the extensor tendon insertion, using a 0.8 mm Kirschner wire. A 4-0 double-needle monofilament tendon suture was passed through the tunnels to secure the ruptured extensor tendon to the base of the distal phalanx, followed by fixation of the distal interphalangeal (DIP) joint with a 1.0 mm Kirschner wire. The Kirschner wire was removed at 4 weeks postoperatively to initiate functional exercises. Regular follow-up was conducted to monitor wound healing and functional recovery of the DIP joint. At the final follow-up, the range of flexion and extension of the DIP joint was measured, and treatment outcomes were evaluated using Crawford’s mallet finger evaluation criteria, which classified results into four grades: excellent, good, fair, and poor.Results:Fifteen patients (16 fingers) were included, comprising 11 males and 4 females, with a mean age of 44.5 years (range: 17-65 years). The injured fingers included 2 index, 4 middle, 5 ring, and 5 little fingers, all presenting with DIP joint flexion deformity and limited active extension. Postoperative follow-up ranged from 6 to 28 months (mean: 17 months). All wounds healed primarily without complications such as infection or skin necrosis, and no cases of tendon re-rupture occurred. At the final follow-up, the measurement results of flexion and extension range of motion of the affected fingers at the DIP joint were as follows: the maximum flexion angle of all 16 fingers was 45°, among which 7 fingers had an extension angle of 0°, 8 fingers had limited extension ranging from 1° to 10°, and 1 finger had limited extension of 15°. Among the 16 fingers, 7 fingers were rated as excellent, 8 fingers as good and 1 finger as fair.Conclusion:The V-shaped bone tunnel technique for tendon-to-bone reattachment of the extensor tendon insertion is a simple and effective method for treating tendinous mallet finger. It provides satisfactory functional recovery, improves finger appearance, and is associated with minimal complications.

Objective:To explore the reliability of intraoperative fluoroscopy at lateral 10° and 30° Brodén views in addition to the standard lateral and axial calcaneal views in the lateral decubitus position to assess the quality of articular reduction in calcaneal fractures of Sanders types Ⅱ and Ⅲ.Methods:A retrospective study was conducted to analyze the clinical data of the 74 patients who had been treated at Department of Foot and Ankle Surgery, The People’s Hospital of Linyi for unilateral closed calcaneal fractures of Sanders type Ⅱ or Ⅲ from January 2024, to August 2024. According to the different methods of intraoperative fluoroscopy, the patients were divided into a precision group and a conventional group. In the precision group of 39 cases, intraoperative fluoroscopy was conducted at lateral 10° and 30° Brodén views in the surgery for calcaneal fractures in addition to the standard lateral and axial calcaneal views in the lateral decubitus position; in the conventional group of 35 cases, intraoperative fluoroscopy was conducted only in the standard lateral and axial calcaneal views in the surgery for calcaneal fractures. All patients were treated by traction assisted by external fixation, minimally invasive prying reduction through the tarsal sinus incision, and three-dimensional framework internal fixation. The 2 groups were compared in terms of frequency of intraoperative fluoroscopy; preoperative and postoperative B?hler angles, Gissane angles, and calcaneal varus angles; screw protrusions (more than 2 mm beyond the medial cortex) of the posterior articular surface screw, sustentaculum tali screw, and anterior tuberosity screw; skin irritation symptoms due to the main nail tail (protruding cortex > 1 mm); step-off of the posterior articular surface (more than 2 mm) and wide gap of the posterior articular surface (more than 2 mm).Results:There were no statistically significant differences in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). Both groups showed significant postoperative improvements in X-ray B?hler angle, Gissane angle, and calcaneal varus angle compared with the preoperative values ( P<0.05). There were no statistically significant differences in postoperative X-ray B?hler angle, Gissane angle, or calcaneal varus angle between the 2 groups ( P>0.05). There was no statistically significant difference in the frequency of intraoperative fluoroscopy between the 2 groups either ( P>0.05). The precision group had significantly fewer cases of screw protrusion (more than 2 mm beyond the medial cortex) of the posterior articular surface screw, sustentaculum tali screw, and anterior tuberosity screw, skin irritation symptoms due to the main screw tail (protruding cortex>1 mm), step-off of the posterior articular surface (more than 2 mm), and wide gap of the posterior articular surface (more than 2 mm) on the postoperative CT three-dimensional reconstruction compared with the conventional group ( P<0.05). Conclusion:In surgery for calcaneal fractures of Sanders types Ⅱ and Ⅲ, intraoperative fluoroscopy at lateral 10° and 30° Brodén views in addition to the standard lateral and axial calcaneal views in the lateral decubitus position provides stable and reliable intraoperative monitoring of B?hler angle, Gissane angle, calcaneal varus angle, reduction of the posterior articular surface of the calcaneus and the positions and lengths of implants.

Acute respiratory distress syndrome (ARDS) is the leading cause of respiratory failure with high morbidity and mortality. Pulmonary surfactant (PS)-based complementary therapies have exhibited potential for ARDS healing and applied as an adjunctive therapy strategy. Coacervate (Coac) has the characteristics of softness, deformability and excellent molecular enrichment properties, and has attracted extensive attention in the biomedical field. Here PS and coacervate were combined for the potential ARDS treatment. The Coac, fabricated from polyallylamine hydrochloride (PAH) and adenosine triphosphate (ATP) by simple mixing, exhibited soft droplet property and high enrichment for dexamethasone sodium phosphate (DSP). To avoid the fusion effect of membraneless coacervate and endow it with biological functions of PS, liposomes with PS-biomimetic lipid components (PS-lipo) were further introduced to construct PS-biomimetic membranized coacervate (DSP@PS-Coac). The DSP@PS-Coac demonstrated high lung targeting effect and significant penetration efficiency after intravenous injection. Furthermore, PS-lipo replenished the endogenous PS pool and facilitated the distribution of DSP in inflammatory cells in the lung. In the ARDS mouse model, PS-Coac and DSP exerted synergetic anti-inflammatory functions, via reducing the recruitment of inflammatory neutrophils and modulating macrophages into anti-inflammatory phenotype. The overall results confirmed that DSP@PS-Coac may provide a promising delivery option for the treatment of ARDS.

Objective:To explore the relationship between life events, anxiety, depression, and behavior problems in adolescents.Methods:From September to October 2022, the cluster sampling method was used to select 5 341 adolescents from 4 middle schools in Xinxiang urban area.The subjects and their parents were investigated by the adolescent self-rating life events check list (ASLEC), generalized anxiety disorder scale (GAD-7), patient health questionnaire (PHQ-9), and child behavior checklist (CBCL). SPSS 27.0 software was used for Spearman correlation analysis, and AMOS 28.0 software was used to construct the structural equation model.Results:The scores of anxiety, depression, and behavioral problems were 1 (0, 4), 1 (0, 4), and 3 (0, 10). The total score of life events was 5 (1, 13), and the dimensions scored as follows: interpersonal conflict 1 (0, 4), academic pressure 2 (0, 5), punishment 0 (0, 2), loss 0 (0, 0), health and adaptation problem 0 (0, 1), and others 0 (0, 2). There were positive correlations between life events and its dimensions, depression, anxiety and behavioral problems ( r=0.28-0.69, all P<0.01). In the overall population, anxiety and depression played parallel mediating roles in the impact of life events on behavior problems. Life events could positively predict anxiety ( β=0.68, P<0.01), and anxiety could positively predict behavior problems ( β=0.04, P=0.02). Life events could positively predict depression ( β=0.77, P<0.01), and depression could positively predict behavior problems ( β=0.18, P<0.01). The standardized total effect size of the impact of life events on behavioral problems was 0.622 (95% CI=0.564-0.675). The standardized direct effect size and indirect effect size were 0.460 (95% CI=0.374-0.539) and 0.162 (95% CI=0.108-0.218), accounting for 74.0% and 26.0%of the total effect, respectively. After stratification by gender, the results for male adolescents were consistent with the overall population, while the mediating effect of anxiety was not significant in the female adolescents. Conclusion:Life events can lead to anxiety and depression in adolescents, thereby increasing the risk of behavior problems.

This report summarises the experience of nursing care for a patient with compression of the inferior vena cava caused by a huge liver abscess of fusobacterium necrophorum infection.The nursing measures included the care of blood shunting,care of pus liquefaction and drainage,management of fluid therapy and continuous renal replacement therapy,as well as observation and nursing of the drug therapy.With meticulous in treatment and care,the patient recovered and discharged from the hospital after a 19-day hospital stay.

Objective:To explore the relationship between life events, anxiety, depression, and behavior problems in adolescents.Methods:From September to October 2022, the cluster sampling method was used to select 5 341 adolescents from 4 middle schools in Xinxiang urban area.The subjects and their parents were investigated by the adolescent self-rating life events check list (ASLEC), generalized anxiety disorder scale (GAD-7), patient health questionnaire (PHQ-9), and child behavior checklist (CBCL). SPSS 27.0 software was used for Spearman correlation analysis, and AMOS 28.0 software was used to construct the structural equation model.Results:The scores of anxiety, depression, and behavioral problems were 1 (0, 4), 1 (0, 4), and 3 (0, 10). The total score of life events was 5 (1, 13), and the dimensions scored as follows: interpersonal conflict 1 (0, 4), academic pressure 2 (0, 5), punishment 0 (0, 2), loss 0 (0, 0), health and adaptation problem 0 (0, 1), and others 0 (0, 2). There were positive correlations between life events and its dimensions, depression, anxiety and behavioral problems ( r=0.28-0.69, all P<0.01). In the overall population, anxiety and depression played parallel mediating roles in the impact of life events on behavior problems. Life events could positively predict anxiety ( β=0.68, P<0.01), and anxiety could positively predict behavior problems ( β=0.04, P=0.02). Life events could positively predict depression ( β=0.77, P<0.01), and depression could positively predict behavior problems ( β=0.18, P<0.01). The standardized total effect size of the impact of life events on behavioral problems was 0.622 (95% CI=0.564-0.675). The standardized direct effect size and indirect effect size were 0.460 (95% CI=0.374-0.539) and 0.162 (95% CI=0.108-0.218), accounting for 74.0% and 26.0%of the total effect, respectively. After stratification by gender, the results for male adolescents were consistent with the overall population, while the mediating effect of anxiety was not significant in the female adolescents. Conclusion:Life events can lead to anxiety and depression in adolescents, thereby increasing the risk of behavior problems.

Objective:To evaluate the clinical efficacy of the V-shaped bone tunnel technique at the base of the distal phalanx for treating tendinous mallet finger.Methods:A retrospective analysis was conducted on clinical data from patients with tendinous mallet finger treated in the Department of Hand and Foot Surgery at Linyi People’s Hospital between August 2022 and November 2023. Two oblique bone tunnels were created in a V-shaped configuration at the dorsal base of the distal phalanx, adjacent to the extensor tendon insertion, using a 0.8 mm Kirschner wire. A 4-0 double-needle monofilament tendon suture was passed through the tunnels to secure the ruptured extensor tendon to the base of the distal phalanx, followed by fixation of the distal interphalangeal (DIP) joint with a 1.0 mm Kirschner wire. The Kirschner wire was removed at 4 weeks postoperatively to initiate functional exercises. Regular follow-up was conducted to monitor wound healing and functional recovery of the DIP joint. At the final follow-up, the range of flexion and extension of the DIP joint was measured, and treatment outcomes were evaluated using Crawford’s mallet finger evaluation criteria, which classified results into four grades: excellent, good, fair, and poor.Results:Fifteen patients (16 fingers) were included, comprising 11 males and 4 females, with a mean age of 44.5 years (range: 17-65 years). The injured fingers included 2 index, 4 middle, 5 ring, and 5 little fingers, all presenting with DIP joint flexion deformity and limited active extension. Postoperative follow-up ranged from 6 to 28 months (mean: 17 months). All wounds healed primarily without complications such as infection or skin necrosis, and no cases of tendon re-rupture occurred. At the final follow-up, the measurement results of flexion and extension range of motion of the affected fingers at the DIP joint were as follows: the maximum flexion angle of all 16 fingers was 45°, among which 7 fingers had an extension angle of 0°, 8 fingers had limited extension ranging from 1° to 10°, and 1 finger had limited extension of 15°. Among the 16 fingers, 7 fingers were rated as excellent, 8 fingers as good and 1 finger as fair.Conclusion:The V-shaped bone tunnel technique for tendon-to-bone reattachment of the extensor tendon insertion is a simple and effective method for treating tendinous mallet finger. It provides satisfactory functional recovery, improves finger appearance, and is associated with minimal complications.

This report summarises the experience of nursing care for a patient with compression of the inferior vena cava caused by a huge liver abscess of fusobacterium necrophorum infection.The nursing measures included the care of blood shunting,care of pus liquefaction and drainage,management of fluid therapy and continuous renal replacement therapy,as well as observation and nursing of the drug therapy.With meticulous in treatment and care,the patient recovered and discharged from the hospital after a 19-day hospital stay.

Objective:To explore the reliability of intraoperative fluoroscopy at lateral 10° and 30° Brodén views in addition to the standard lateral and axial calcaneal views in the lateral decubitus position to assess the quality of articular reduction in calcaneal fractures of Sanders types Ⅱ and Ⅲ.Methods:A retrospective study was conducted to analyze the clinical data of the 74 patients who had been treated at Department of Foot and Ankle Surgery, The People’s Hospital of Linyi for unilateral closed calcaneal fractures of Sanders type Ⅱ or Ⅲ from January 2024, to August 2024. According to the different methods of intraoperative fluoroscopy, the patients were divided into a precision group and a conventional group. In the precision group of 39 cases, intraoperative fluoroscopy was conducted at lateral 10° and 30° Brodén views in the surgery for calcaneal fractures in addition to the standard lateral and axial calcaneal views in the lateral decubitus position; in the conventional group of 35 cases, intraoperative fluoroscopy was conducted only in the standard lateral and axial calcaneal views in the surgery for calcaneal fractures. All patients were treated by traction assisted by external fixation, minimally invasive prying reduction through the tarsal sinus incision, and three-dimensional framework internal fixation. The 2 groups were compared in terms of frequency of intraoperative fluoroscopy; preoperative and postoperative B?hler angles, Gissane angles, and calcaneal varus angles; screw protrusions (more than 2 mm beyond the medial cortex) of the posterior articular surface screw, sustentaculum tali screw, and anterior tuberosity screw; skin irritation symptoms due to the main nail tail (protruding cortex > 1 mm); step-off of the posterior articular surface (more than 2 mm) and wide gap of the posterior articular surface (more than 2 mm).Results:There were no statistically significant differences in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). Both groups showed significant postoperative improvements in X-ray B?hler angle, Gissane angle, and calcaneal varus angle compared with the preoperative values ( P<0.05). There were no statistically significant differences in postoperative X-ray B?hler angle, Gissane angle, or calcaneal varus angle between the 2 groups ( P>0.05). There was no statistically significant difference in the frequency of intraoperative fluoroscopy between the 2 groups either ( P>0.05). The precision group had significantly fewer cases of screw protrusion (more than 2 mm beyond the medial cortex) of the posterior articular surface screw, sustentaculum tali screw, and anterior tuberosity screw, skin irritation symptoms due to the main screw tail (protruding cortex>1 mm), step-off of the posterior articular surface (more than 2 mm), and wide gap of the posterior articular surface (more than 2 mm) on the postoperative CT three-dimensional reconstruction compared with the conventional group ( P<0.05). Conclusion:In surgery for calcaneal fractures of Sanders types Ⅱ and Ⅲ, intraoperative fluoroscopy at lateral 10° and 30° Brodén views in addition to the standard lateral and axial calcaneal views in the lateral decubitus position provides stable and reliable intraoperative monitoring of B?hler angle, Gissane angle, calcaneal varus angle, reduction of the posterior articular surface of the calcaneus and the positions and lengths of implants.

The mesencephalic astrocyte-derived neurotrophic factor (MANF) has been recently identified as a neurotrophic factor, but its role in hepatic fibrosis is unknown. Here, we found that MANF was upregulated in the fibrotic liver tissues of the patients with chronic liver diseases and of mice treated with CCl₄. MANF deficiency in either hepatocytes or hepatic mono-macrophages, particularly in hepatic mono-macrophages, clearly exacerbated hepatic fibrosis. Myeloid-specific MANF knockout increased the population of hepatic Ly6C^high macrophages and promoted HSCs activation. Furthermore, MANF-sufficient macrophages (from WT mice) transfusion ameliorated CCl₄-induced hepatic fibrosis in myeloid cells-specific MANF knockout (MKO) mice. Mechanistically, MANF interacted with S100A8 to competitively block S100A8/A9 heterodimer formation and inhibited S100A8/A9-mediated TLR4-NF-κB signal activation. Pharmacologically, systemic administration of recombinant human MANF significantly alleviated CCl₄-induced hepatic fibrosis in both WT and hepatocytes-specific MANF knockout (HKO) mice. This study reveals a mechanism by which MANF targets S100A8/A9-TLR4 as a "brake" on the upstream of NF-κB pathway, which exerts an impact on macrophage differentiation and shed light on hepatic fibrosis treatment.