Objective:To explore the clinical efficacy of autologous platelet-rich plasma (PRP) in the treatment of acute injury to the anterior talofibular ligament (ATFL).Methods:A retrospective study was conducted to analyze the data of 96 patients who had been admitted to Department of Orthopedic Trauma Repair, The Nanhua Hospital Affiliated to Hengyang Medical School for acute ATFL injuries of grades Ⅰ & Ⅱ from January 2022 to December 2023. They were divided into 2 groups according to their different treatments. In the PRP group subjected to local PRP injection combined with conservative treatment, there were 49 patients (28 males and 21 females), with an age of (32.5±6.5) years. In the conservative group subjected to traditional conservative treatment, there were 47 patients (24 males and 23 females), with an age of (30.5±5.3) years. The 2 groups were compared in terms of visual analog scale (VAS) pain scores, talar anterior translations, Karlsson scores, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores before and 6 months after treatment.Results:No statistically significant differences were observed in the baseline characteristics between the 2 groups before treatment, indicating comparability ( P>0.05). All patients were followed up for (9.1±1.7) months. In both groups, the VAS pain scores significantly decreased after treatment than the pre-treatment ones, the talar anterior translations significantly reduced after treatment than the pre-treatment ones, and the AOFAS and Karlsson scores significantly increased after treatment than the pre-treatment ones ( P < 0.05). After 6 months of treatment, the talar translation distance [(2.5±0.4) mm], AOFAS ankle hind foot score [(91.7 ± 4.0) points], and Karlsson score [(93.0±3.5) points] in the PRP group were significantly better than those in the conservative group [(6.1±0.9) mm, (87.1±4.3) points, (89.0±4.0) points]( P < 0.05). Conclusion:In the treatment of acute ATFL injury, PRP therapy demonstrates good clinical efficacy, for it can significantly reduce pain, promote functional recovery, and improve joint stability.

Objective:To explore the clinical efficacy of autologous platelet-rich plasma (PRP) in the treatment of acute injury to the anterior talofibular ligament (ATFL).Methods:A retrospective study was conducted to analyze the data of 96 patients who had been admitted to Department of Orthopedic Trauma Repair, The Nanhua Hospital Affiliated to Hengyang Medical School for acute ATFL injuries of grades Ⅰ & Ⅱ from January 2022 to December 2023. They were divided into 2 groups according to their different treatments. In the PRP group subjected to local PRP injection combined with conservative treatment, there were 49 patients (28 males and 21 females), with an age of (32.5±6.5) years. In the conservative group subjected to traditional conservative treatment, there were 47 patients (24 males and 23 females), with an age of (30.5±5.3) years. The 2 groups were compared in terms of visual analog scale (VAS) pain scores, talar anterior translations, Karlsson scores, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores before and 6 months after treatment.Results:No statistically significant differences were observed in the baseline characteristics between the 2 groups before treatment, indicating comparability ( P>0.05). All patients were followed up for (9.1±1.7) months. In both groups, the VAS pain scores significantly decreased after treatment than the pre-treatment ones, the talar anterior translations significantly reduced after treatment than the pre-treatment ones, and the AOFAS and Karlsson scores significantly increased after treatment than the pre-treatment ones ( P < 0.05). After 6 months of treatment, the talar translation distance [(2.5±0.4) mm], AOFAS ankle hind foot score [(91.7 ± 4.0) points], and Karlsson score [(93.0±3.5) points] in the PRP group were significantly better than those in the conservative group [(6.1±0.9) mm, (87.1±4.3) points, (89.0±4.0) points]( P < 0.05). Conclusion:In the treatment of acute ATFL injury, PRP therapy demonstrates good clinical efficacy, for it can significantly reduce pain, promote functional recovery, and improve joint stability.

Objective To investigate the risk factors of severe complications of elderly patients with pancreaticoduodenectomy (PD). Methods The clinical data of 399 elderly patients with PD and 65 years or more (65-91years) including 76 cases with 75 years or more （19.0%） in this hospital from January 2016 to December 2020, were retrospectively analyzed. Less Barthel index score was used to indicate lower activities of daily living. The risk factors of severe complications after PD were analyzed by binary Logistic regression and predictive model was established. Receiver operating characteristic (ROC) curve was used to verify the predictive efficiency of model. Results A total of 224 cases were found postoperative complications from 399 elderly PD cases with the rate 56.14% including 187 (46.87%) cases of mild complications and 37 (9.27%) cases of severe complications. Age ≥75 years (OR=2.78, P<0.05), combined with hypertension (OR=4.20, P<0.05) and less Barthel index score (OR=0.96, P<0.05) were independent risk factors for severe complications after PD in elderly patients. The risk prediction model of severe postoperative complications of PD was constructed using 6 indexes including age, hypertension, preoperative nutritional risk, operative type, Barthel index score in activities of daily living and operative time, and the fit of regression equation 0.93. ROC curve analysis showed that area under curve (AUC) was 0.76, the sensiti-vity 65%, and the specificity 76%. Conclusions Age 75 years or more, hypertension and low activities of daily living would be independent risk factors for severe complications after PD in elderly patients. The risk model constructed by age, hypertension, preoperative nutritional risk, operative type, Barthel index score in activities of daily living and operative time had certain predictive efficacy for severe complications after PD in elderly patients.

OBJECTIVE To investigate the effects and mechanism of luteolin on osteogenic repair of bone defects. METHODS The targets and potential pathways of luteolin in the treatment of bone defects were screened by network pharmacology method， and then the top 2 targets were selected by Hub gene screening for molecular docking verification， with binding energy as the evaluation standard. In vitro experiments were conducted on rat bone mesenchymal stem cells （BMSC） and rat umbilical vein endothelial cells （RUVEC）. Phenotypic validation was performed using alkaline phosphatase staining， alizarin red S staining， and in vitro angiogenesis experiments. Western blot assay was used to detect the protein expressions of phosphatidylinositol 3 kinase （PI3K） and protein kinase 1 （Akt1）， so as to validate the mechanism of luteolin on osteogenic differentiation of BMSC and angiogenesis of RUVEC in vitro. RESULTS The results of network pharmacology showed that the effects of luteolin on vascular formation and bone repair in bone defects were mainly related to Akt1， SRC， estrogen receptor 1， epidermal growth factor receptor， cyclooxygenase 2， matrix metalloproteinase 9 targets， and were closely related to PI3K-Akt signaling pathway. The results of molecular docking showed that luteolin binding to Akt1 and SRC proteins was stable. The results of in vitro experiments showed that luteolin could significantly improve the expressions and activities of alkaline phosphatase in BMSC， increased the number of calcium salt deposits and calcified nodules， and promoted calcification of BMSC. Compared with luteolin 0 μmol/L group， the angiogenesis ability of RUVEC was enhanced significantly in luteolin 1， 10 μmol/L groups， the length of blood vessels and the protein expressions of PI3K and Akt1 were significantly increased （P＜0.05 or P＜0.01）； the higherthe concentration， the better the effect. CONCLUSIONS Luteolin may play a role in promoting angiogenesis and bone repair at the fracture site by activating PI3K/Akt signaling pathway and promoting the protein expressions of PI3K and Akt1.

[摘 要] 目的：探讨甲状腺滤泡癌（FTC）组织中程序性死亡蛋白1（PD-1）和NOD样受体蛋白3（NLRP3）的表达及其与患者临床病理特征和预后的关系。方法：收集2015年1月至2020年6月福建医科大学附属第二医院手术切除的60例FTC患者的癌和配对癌旁组织标本，采用免疫组织化学染色法检测癌及癌旁组织中PD-1和NLRP3的阳性表达率，χ²检验或者Fisher精确检验法分析PD-1和NLRP3表达与FTC患者临床病理特征的关系，Pearson相关性分析PD-1与NLRP3表达的关系，Kaplan-Meier生存和Logistic回归分析PD-1和NLRP3表达与患者预后的关系。结果：在60例FTC组织中，PD-1和NLRP3均有较高的阳性表达率（46.67%与63.33%）。PD-1表达与FTC患者肿瘤分期、肿瘤大小、血管侵犯、复发与否具有显著相关性（均P<0.05），NLRP3表达与患者肿瘤大小、血管侵犯、甲状腺外浸润以及复发具有显著相关性（均P<0.05）。PD-1与NLRP3的表达成负相关，前者与患者更好的预后相关，后者是FTC复发的独立风险因素。结论：PD-1和NLRP3在FTC组织中有较高的阳性表达率，前者与患者更好的预后相关，后者是FTC复发的独立风险因素，且两者的表达呈负相关。