OBJECTIVE: To investigate short-term effectiveness of using expert adolescent lateral femoral nail (EALFN) in treating femoral shaft fractures in older children and adolescents. METHODS: A retrospective analysis was conducted on the clinical data of 17 patients with femoral shaft fractures who met the inclusion criteria and were admitted between July 2020 and June 2024. All fractures were fixed with EALFN after reduction. There were 11 males and 6 females, with a mean age of 13.3 years (range, 11-16 years). The average body weight was 51.2 kg (range, 40-84 kg), and the average height was 162.1 cm (range, 150-172 cm). The causes of injury included traffic accidents ( n=9), falling from height ( n=1), and simple falls ( n=7). One patient had an open fracture treated with an external fixator and experienced delayed fracture healing. The remaining patients were closed fractures, with an average time from injury to operation of 5.8 days (range, 2-10 days). Operation time and postoperative hospital stay were documented. During follow-up, X-ray films were taken to observe the fracture healing, and the bilateral femoral length, femoral neck-shaft angle, widest femoral neck diameter (FND), and articular trochanteric distance (ATD) were measured at last follow-up. Hip function was assessed using the Harris score. The differences in the all indicators between the healthy and affected sides were compared. RESULTS: The operation time ranged from 65 to 130 minutes (mean, 94.1 minutes). Postoperative hospital stay ranged from 5 to 40 days (mean, 16.7 days). All patients were followed up 7-36 months (mean, 14.4 months). One patient exhibited delayed fracture healing during follow-up. The distal locking nail was removed at 6 months after operation, and partial weight-bearing was initiated following dynamic fracture stabilization. The fracture healing was achieved, and the intramedullary nail was removed at 24 months after operation. The other fractures healed with the healing time of 6-20 months (mean, 9.6 months), and the intramedullary nails were removed. During follow-up, no femoral fracture, abnormal development of the greater trochanter, or ischemic necrosis of the femoral head occurred. At last follow-up, there was no significant difference in femoral length, femoral neck-shaft angle, FND, ATD, or Harris score between the affected and healthy sides ( P>0.05). CONCLUSION For older children and adolescents with femoral neck fractures, the application of EALFN fixation aligns more closely with the principles of intramedullary central fixation and rapid rehabilitation. This approach is associated with fewer complications and superior short-term effectiveness.
Humans ; Male ; Femoral Fractures/surgery* ; Female ; Child ; Adolescent ; Retrospective Studies ; Bone Nails ; Fracture Fixation, Intramedullary/instrumentation* ; Fracture Healing ; Treatment Outcome

Objective To evaluate the value of risk score model based on clinical and multimodal ultrasound features for differentiating benign and malignant breast imaging reporting and data system(BI-RADS)4A lesions in breast.Methods Totally 177 patients with BI-RADS 4A lesions detected by multimodal breast ultrasound were prospectively enrolled,and the patients were divided into training set(n=123)and test set(n=54)at the ratio of 7∶3.Univariate and multivariate logistic regression analyses were used to analyze patients'clinical,gray-scale ultrasound,CDFI and elastography ultrasound parameters of lesions,and the independent risk factors for differentiating benign and malignant BI-RADS 4A lesions in breast were screened,so as a risk score model was constructed.Based on the results of sungical pathology or follow-up,the cut-off value of the model for differentiating benign and malignant BI-RADS 4A lesions in breast was obtained by receiver operating characteristic(ROC)curve,and the patients were divided into high-risk and low-risk subgroups according to the cut-off value,and the efficacy of the model was evaluated.Results Among 177 cases,39 were with benign lesions and 138 were with malignant lesions.Patients'age＞58 years,diameter of lesion＞15.1 mm,lesions with irregular shape,lesions with grade 1 or 2 of blood flow and standard deviation of sound touch elastography of a 2 mm circular area around the lesion(shell)(shell-STESD)＞16.33 kPa were all independent risk factors of malignant BI-RADS 4A lesions in breast.The cut-off value of risk score model for differential diagnosis was 6.5 points,and its sensitivity was 84.69%(83/98)and specificity was 88.00%(22/25)in distinguishing high-risk and low-risk subgroups in training set,while its sensitivity was 77.50%(31/40)and specificity was 71.43%(10/14)in test set.Conclusion Risk score model based on clinical and multimodal ultrasound features could effectively differentiate benign and malignant BI-RADS 4A lesions in breast.

Objective:To understand the mental problem in elderly male prisoners and its related factors.Methods:A total of 289 elderly male prisoners from five prisons in Sichuan Province were selected.They were assessed with the self-compiled general situation questionnaire,12-item General Health Questionnaire(GHQ-12,with a total score ≥ 3 indicating a tendency towards mental problem),short-form UCLA Loneliness Scale(ULS-8)and Insomnia Severity Index-Chinese Version(ISI-C).Results:The detection rate of mental problem was 41.52％.Multiple factor logistic regression analysis indicated that having a remaining sentence of≥5 years,educa-tional levels of primary school and below,high school or technical secondary school and above,involvement in drug-related crimes,property crimes,violent crimes,good and poor relationships with spouses,average relationships with fellow inmates,self-assessed blood pressure levels that were low and high,and having insomnia were risk fac-tors for mental problem(OR=9.55,11.75,13.88,82.24,33.96,363.52,5.77,113.27,2.33,1.87,3.80,42.89).Conclusion:The mental problem among elderly male prisoners are related to their sentence,education lev-el,crime type,relationship with spouse and cellmates,self-rated blood pressure and sleep status.

Objective:To understand the mental problem in elderly male prisoners and its related factors.Methods:A total of 289 elderly male prisoners from five prisons in Sichuan Province were selected.They were assessed with the self-compiled general situation questionnaire,12-item General Health Questionnaire(GHQ-12,with a total score ≥ 3 indicating a tendency towards mental problem),short-form UCLA Loneliness Scale(ULS-8)and Insomnia Severity Index-Chinese Version(ISI-C).Results:The detection rate of mental problem was 41.52％.Multiple factor logistic regression analysis indicated that having a remaining sentence of≥5 years,educa-tional levels of primary school and below,high school or technical secondary school and above,involvement in drug-related crimes,property crimes,violent crimes,good and poor relationships with spouses,average relationships with fellow inmates,self-assessed blood pressure levels that were low and high,and having insomnia were risk fac-tors for mental problem(OR=9.55,11.75,13.88,82.24,33.96,363.52,5.77,113.27,2.33,1.87,3.80,42.89).Conclusion:The mental problem among elderly male prisoners are related to their sentence,education lev-el,crime type,relationship with spouse and cellmates,self-rated blood pressure and sleep status.

Objective To evaluate the value of risk score model based on clinical and multimodal ultrasound features for differentiating benign and malignant breast imaging reporting and data system(BI-RADS)4A lesions in breast.Methods Totally 177 patients with BI-RADS 4A lesions detected by multimodal breast ultrasound were prospectively enrolled,and the patients were divided into training set(n=123)and test set(n=54)at the ratio of 7∶3.Univariate and multivariate logistic regression analyses were used to analyze patients'clinical,gray-scale ultrasound,CDFI and elastography ultrasound parameters of lesions,and the independent risk factors for differentiating benign and malignant BI-RADS 4A lesions in breast were screened,so as a risk score model was constructed.Based on the results of sungical pathology or follow-up,the cut-off value of the model for differentiating benign and malignant BI-RADS 4A lesions in breast was obtained by receiver operating characteristic(ROC)curve,and the patients were divided into high-risk and low-risk subgroups according to the cut-off value,and the efficacy of the model was evaluated.Results Among 177 cases,39 were with benign lesions and 138 were with malignant lesions.Patients'age＞58 years,diameter of lesion＞15.1 mm,lesions with irregular shape,lesions with grade 1 or 2 of blood flow and standard deviation of sound touch elastography of a 2 mm circular area around the lesion(shell)(shell-STESD)＞16.33 kPa were all independent risk factors of malignant BI-RADS 4A lesions in breast.The cut-off value of risk score model for differential diagnosis was 6.5 points,and its sensitivity was 84.69%(83/98)and specificity was 88.00%(22/25)in distinguishing high-risk and low-risk subgroups in training set,while its sensitivity was 77.50%(31/40)and specificity was 71.43%(10/14)in test set.Conclusion Risk score model based on clinical and multimodal ultrasound features could effectively differentiate benign and malignant BI-RADS 4A lesions in breast.

BACKGROUND:Cryopreservation can better ensure the integrity of the vascular structure.How to reduce its immunogenicity to improve rejection after transplantation has attracted more and more attention. OBJECTIVE:To review the research progress of freezing treatment to reduce vascular immunogenicity after allogeneic vascular transplantation in order to provide a reference for clinical research. METHODS:A systematic search of Chinese and English databases CNKI,WanFang and PubMed,as well as online websites Baidu and Google Scholar since the establishment of the database has published literature on reducing vascular immunogenicity after allogeneic vascular transplantation.Keywords were"cardiovascular disease,endothelial cells,cryopreservation,blood vessel transplantation or vascular graft,immunogenicity,immune rejection,allograft or allogeneic transplantation or allograft transplantation and cryoprotectant".A total of 68 articles were included according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION:(1)The review found that the rejection of allogeneic vascular transplantation can be reduced by improving the existing freezing technology,which mainly involves the selection of freezing and thawing methods and cryoprotectants.(2)The existing research suggests that the freeze-drying method is superior to the low-temperature cryopreservation,but due to the limited conditions,it is still dominated by low-temperature cryopreservation.Among them,vitrification cryopreservation,slow rewarming and the use of stainless steel and even silver-containing materials are better than programmed cryopreservation and rapid rewarming.(3)The combined selection of permeable and non-permeable cryoprotectants can further reduce the occurrence of rejection while reducing their toxicity.

Thioredoxin-interacting protein (TXNIP), which mainly regulates glucose homeostasis in pancreatic β cells, is a novel target in the treatment of diabetes.In this study, 4-hydroxybenzopyrimidine was used as the raw material, four nitrogen-containing rings (imidazole, methylpiperazine, pyrazole, morpholine) were introduced, benzopyrimidine skeleton with nitrogen-containing rings derivatives targeting TXNIP was designed and synthesized, and the protective effect of compounds on palmitic acid-stimulated islet β cells was investigated.A total of 20 benzopyrimidine derivatives were designed and synthesized, and the structures were confirmed by 1H NMR and ESI-MS.Pharmacological studies showed that most of the compounds exhibited protective effects on islet β cells, with better axtivity for compounds C-1, C-2, C-4 and D-2 (cell survival rate > 70%) compared with PA model group (38.3%), Among the four compounds, D-2 had the highest activity of 87.2%, so it could become a potential new anti-diabetic chemical entity.

Objective:To investigate the transcriptomic mechanisms and clinical efficacy of D-CAG regimen for the treatment of acute myeloid leukemia (AML) after failure to initial induction of remission.Methods:The transcriptome data of AML cells before and after the use of dexitabine before August 28, 2021 was searched in Gene Expression Omnibus (GEO) database with "decitabine" as the search term. The R language package was used for differential expression analysis and Kyoto encyclopedia of genes and genomes (KEGG) and gene ontology (GO) enrichment analysis of the data. Protein-protein interaction network (PPI) analysis was conducted on the STRING online analysis website. The accurate treatment prediction platform designed based on logistic omics theory (EpiMed) was used to make drug-disease-target correlation analysis. The clinical data of 18 AML patients treated with D-CAG regimen after failure to induction of remission with standard anthracycline and cytarabine regimen ("3+7" regimen) in the 305th Hospital of Chinese PLA from October 8, 2015 to July 9, 2018 were searched and analyzed, and the curative effect was evaluated. The effects of the dose and duration of each drug on the efficacy were analyzed.Results:The transcriptome data of AML cells before and after the use of decitabine in GSE40442 dataset of the GPL5188 platform were finally selected, updated on July 10, 2014. A total of 366 differentially expressed genes were screened, including 201 up-regulated genes and 165 down-regulated genes. The differential genes were mainly related to cell cycle regulation, bone marrow leukocyte migration and differentiation, transcriptional regulation, bone marrow hematopoiesis and other signaling pathways. Ten core genes such as ANXA5, IL-10, THBS1, TLR4, JUN and CXCL12 were screened by PPI analysis. Drug-disease-target analysis showed that dexitabine had a potential therapeutic effect on various blood diseases such as diffuse large B-cell lymphoma, thrombocytopenia, T-cell acute lymphocytic leukemia, aplastic anemia, and AML. Of the 18 patients, after initial induction of remission, 7 (38.8%) patients achieved partial remission (PR), and 11 (61.2%) patients had no response (NR); after one cycle of re-induction remission therapy, 9 patients had complete remission (CR), 5 patients had PR, 4 patients had NR, and the overall response rate (ORR) was 77.8% (14/18). Compared with patients with NR, the CR rate was higher in patients with PR after initial induction therapy, which were 85.7% (6/7) and 27.3% (3/11), and the difference was statistically significant ( χ2=5.84, P = 0.025). The median duration of cytarabine in CR patients was longer than that in NR patients [10 d (7-14 d) vs. 5 d (2-8 d), Z = 3.89, P = 0.002] and the median ratio of the number of bone marrow blast cells to the duration cytarabine was lower in CR patients than that in NR patients [2.29 (0.89-9.10) vs. 8.10 (3.00-38.50), Z = -2.19, P = 0.006]; the median dose of cytarabine in CR patients was lower than NR patients, which were 50 mg·m -2·d -1 (30-150 mg·m -2·d -1) and 100 mg·m -2·d -1 (50-500 mg·m -2·d -1), and the difference was not statistically significant ( Z = -1.80, P = 0.074). Conclusions:AML patients with PR after initial induction and failure to initial induction of remission may be more likely to achieve CR after the treatment of D-CAG regimen, and this change may be related to the epigenetic regulation of decitabine.

OBJECTI VE To establish the high performan ce liquid c hromatography（HPLC）fingerprint of carotenoid in Lycium barbarum，and to investigate the spectrum-effect relationship between its common peak and antioxidant activity. METHODS HPLC method was adopted. The fingerprints of carotenoid in 34 batches of L. barbarum from different producing areas were established by Similarity Evaluation System of TCM Fingerprint （2012 edition），and similarity evaluation and common peak identification were carried out. Taking scavenging rate of DPPH free radical as index ，in vitro antioxidant activity of carotenoid in L. barbarum was investigated. The spectrum-effect relationship between the common peaks of carotenoids in L. barbarum and antioxidant activity was analyzed by grey correlation method. RESULTS There were 4 common peaks in the fingerprints of carotenoids in 34 batches of L. barbarum ，and the similarity was not less than 0.903. Peak 1 was identified as zeaxanthin ，and peak 4 as zeaxanthin dipalmitate. The scavenging rates of them to DPPH free radical were 1.792％-3.160％. The common peaks of carotenoids in L. barbarum were positively correlated with scavenging rate of DPPH free radical ，and the correlation degree was greater than 0.6；the correlation degree of peak 2 and peak 4（zeaxanthin dipalmitate ）with scavenging rate of DPPH free radical was greater than 0.8. According to the correlation degree ，the contribution of each common peak to scavenging rate of DPPH free radical was determined as peak 2＞ peak 4（zeaxanthin dipalmitate ）＞peak 1（zeaxanthin）＞peak 3. CONCLUSIONS In this study ，HPLC fingerprint of carotenoid in L. barbarum is successfully established ，and two common peaks are identified. The chemical components represented by peak 2 and zeaxanthin palmitate may be the material basis of antioxidant activity of carotenoid in L. barbarum .