Dendritic cells (DCs) serve as the primary antigen-presenting cells in autoimmune diseases, like rheumatoid arthritis (RA), and exhibit distinct signaling profiles due to antigenic diversity. Type II collagen (CII) has been recognized as an RA-specific antigen; however, little is known about CII-stimulated DCs, limiting the development of RA-specific therapeutic interventions. In this study, we show that CII-stimulated DCs display a preferential gene expression profile associated with migration, offering a new perspective for targeting DC migration in RA treatment. Then, saikosaponin D (SSD) was identified as a compound capable of blocking CII-induced DC migration and effectively ameliorating arthritis. Optineurin (OPTN) is further revealed as a potential SSD target, with Optn deletion impairing CII-pulsed DC migration without affecting maturation. Function analyses uncover that OPTN prevents the proteasomal transport and ubiquitin-dependent degradation of C-C chemokine receptor 7 (CCR7), a pivotal chemokine receptor in DC migration. Optn-deficient DCs exhibit reduced CCR7 expression, leading to slower migration in CII-surrounded environment, thus alleviating arthritis progression. Our findings underscore the significance of antigen-specific DC activation in RA and suggest OPTN is a crucial regulator of CII-specific DC migration. OPTN emerges as a promising drug target for RA, potentially offering significant value for the therapeutic management of RA.

This study was aimed at comprehensively understanding the epidemic status of acute hemorrhagic conjunctivitis(AHC)and influencing factors related outbreak in Fujian Province,to provide valuable insights for AHC prevention and control in this region.We conducted a descriptive statistical analysis of epidemiological data for AHC cases.Additionally,clinical samples collected from a 2023 outbreak were subjected to pathogen detection,determination of full-length nucleotide sequences within the VP1 region,genotype identification,and comprehensive analysis.The peak incidence of AHC in 2023 was observed in September and accounted for a substantial proportion(86.39%,5 205/6 025)of the total cases throughout the year.The three areas with the highest incidence rates were Sanming(118.57/100 000),Longyan(53.83/100 000)and Zhangzhou(16.02/100 000).From 2011 to 2022,the inci-dence of AHC in Longyan City was the highest for consecutive 12 years.During the peak AHC outbreak period in Fujian Province in 2023,all 62 conjunctival swabs collected were identified as CVA24v,and 60 complete VP1 sequences were obtained through se-quencing.The nucleotide sequence identity among these 60 sequences ranged from 98.7%to 100%,whereas the amino acid identity ranged from 98.4%to 100%.The highest nucleotide sequence identity was observed for the 2023 strain isolated from Zhongshan,Guangdong Province(rang:99.0%～100%).The 2023 strains in Fujian Province belonged to the GIV genotype,and L16I represented a potential unique amino acid variation within the sequence.CVA24v was the causative agent responsible for this AHC epidemic,and its GIV genotype is currently the dominant type in China.Future efforts should prioritize AHC prevention and control measures cen-tered in key cities.Monitoring and early warning of AHC in the whole province should be strengthened before September each year,and the variation of pathogen nucleic should also be tracked in time.

Objective To summarize the changing prevalence of carbapenem resistance in Enterobacterales based on the data of CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021 for improving antimicrobial treatment in clinical practice.Methods Antimicrobial susceptibility testing was performed using a commercial automated susceptibility testing system according to the unified CHINET protocol.The results were interpreted according to the breakpoints of the Clinical & Laboratory Standards Institute(CLSI)M100 31st ed in 2021.Results Over the seven-year period(2015-2021),the overall prevalence of carbapenem-resistant Enterobacterales(CRE)was 9.43％(62 342/661 235).The prevalence of CRE strains in Klebsiella pneumoniae,Citrobacter freundii,and Enterobacter cloacae was 22.38％,9.73％,and 8.47％,respectively.The prevalence of CRE strains in Escherichia coli was 1.99％.A few CRE strains were also identified in Salmonella and Shigella.The CRE strains were mainly isolated from respiratory specimens(44.23±2.80)％,followed by blood(20.88±3.40)％and urine(18.40±3.45)％.Intensive care units(ICUs)were the major source of the CRE strains(27.43±5.20)％.CRE strains were resistant to all the β-lactam antibiotics tested and most non-β-lactam antimicrobial agents.The CRE strains were relatively susceptible to tigecycline and polymyxins with low resistance rates.Conclusions The prevalence of CRE strains was increasing from 2015 to 2021.CRE strains were highly resistant to most of the antibacterial drugs used in clinical practice.Clinicians should prescribe antimicrobial agents rationally.Hospitals should strengthen antibiotic stewardship in key clinical settings such as ICUs,and take effective infection control measures to curb CRE outbreak and epidemic in hospitals.

Objective: To explore the relationship between nuclear factor-kappa B subunit 1 (NFKB1) and LIM-homeobox gene 2 (LHX2) polymorphisms and esophageal cancer susceptibility, so as to provide the reference for the prevention and treatment of esophageal cancer. Methods: A total of 100 patients with primary esophageal cancer diagnosed at the Affiliated Tumor Hospital of Xinjiang Medical University from 2019 to 2023 were selected as the case group, and 100 healthy individuals undergoing physical examination during the same period of time were selected as the control group. Demographic information, disease history and lifestyle data were collected through questionnaire surveys. The single nucleotide polymorphisms at the rs28362491 and rs4648068 loci of NFKB1 gene as well as rs10760310 and rs10121751 loci of LHX2 gene were detected using multiplex high-temperature ligase detection reaction technology. The relationship between these loci and esophageal cancer susceptibility were analyzed using a multivariable conditional logistic regression, linkage disequilibrium and haplotype analysis. The impact of the interaction between the above-mentioned loci and environmental factors on esophageal cancer susceptibility using the generalized multifactor dimensionality reduction (GMDR) method. Results: The case group comprised 73 males and 27 females, with a mean age of (64.02±8.90) years. The control group included 73 males and 27 females, with a mean age of (64.54±9.43) years. The genotype distributions of rs28362491, rs4648068, rs10760310 and rs10121751, loci in both groups conformed to Hardy-Weinberg equilibrium (all P>0.05). Multivariable conditional logistic regression analysis showed that rs10760310 and rs10121751 loci of LHX2 gene were associated with the esophageal cancer susceptibility (both P<0.05). The overdominant model of rs10760310 loci of LHX2 gene had the lowest Akaike information criterion value (OR=0.22, 95%CI: 0.10-0.47). GAA haplotypes at rs4648068, rs10760310 and rs10121751 loci were associated with a lower risk of esophageal cancer susceptibility (OR=0.26, 95%CI: 0.13-0.50). GMDR analysis revealed a statistically significant interaction between rs10760310 loci and smoking on esophageal cancer susceptibility (P<0.05, cross-validation consistency coefficient: 10/10). Conclusion The rs10760310 and rs10121751 loci polymorphisms of LHX2 gene may be associated with esophageal cancer susceptibility, and there is an interaction between rs10760310 loci and smoking on the esophageal cancer susceptibility.

OBJECTIVES: This study aimed to investigate the incidence, imaging characteristics, and clinical manifestations of the eruption failure of deciduous molars using panoramic radiographs to provide a foundation for diagnosis and treatment in this population. METHODS: This study retrospectively reviewed panoramic radiographs of children aged 4-8 years obtained from Stomatology Hospital, Zhejiang University School of Medicine between January 2021 and December 2023. A total of 31 331 subjects were included for the radiographic assessment of the tooth eruption failure of deciduous molars. Incidence, radiographic characteristics, and associated complications were documented. Statistical analysis was performed using SPSS 26.0. RESULTS: The incidence of the eruption failure of deciduous molars among children aged 4-8 years was 0.94% (296/31 331). The rate was 1.55 times higher in females than in males, demonstrating a significant gender difference (P<0.001). Among the affected deciduous molars, mandibular first deciduous molars accounted for 76.4%, followed by the mandibular second deciduous molars (13.8%), and the maxillary deciduous molars collectively comprised 9.8%. The severity of eruption disorders was significantly associated with the mesial and distal tilting of adjacent teeth and elongation of the antagonist (P<0.001). CONCLUSIONS The incidence of the eruption failure of deciduous molars in children aged 4-8 years was 0.94%, with a high prevalence in females and a predilection for the mandible, particularly the mandibular first deciduous molar. For deciduous molars with severe eruption failure, early intervention is crucial to mitigate complications such as malocclusion and space loss.
Humans ; Child ; Child, Preschool ; Tooth, Deciduous/diagnostic imaging* ; Female ; Molar/physiopathology* ; Male ; Retrospective Studies ; Tooth Eruption ; Radiography, Panoramic ; Incidence

Objective:To compare the clinical efficacy of the reamer-irrigator-aspirator (RIA) technique and iliac crest bone grafting (ICBG) in the treatment of adult noninfectious long bone nonunion of the lower extremity, and to evaluate the safety and effectiveness of the RIA technique.Methods:A retrospective review was conducted of 42 adult patients with noninfectious long bone nonunion of the lower extremity treated surgically at Zhengzhou Orthopaedic Hospital from January 2021 to June 2024. The cohort included 33 men and 9 women with a mean age of 47.0±14.4 years (range, 18-62 years). Twenty-three patients had nonunion on the left side and 19 on the right. Initial surgical fixation methods included plate fixation (19 cases), intramedullary nail (16 cases), external fixator (5 cases), and combined plate-and-nail fixation (2 cases). Revision procedures included debridement and freshening of the nonunion ends, revision or adjustment of internal fixation, and autologous bone grafting. Nineteen patients underwent graft harvesting with the RIA technique (RIA group), and 23 received autograft harvested from the iliac crest (iliac group). Baseline and perioperative variables compared between the two groups included sex, age, body-mass index, preoperative comorbidities, anatomical site of the nonunion (tibial or femoral), duration from the index fracture operation to the current revision, operative time, intraoperative blood loss, volume of blood transfusion and rate of perioperative complications, nonunion fracture sites, visual analogue scale (VAS) pain score at the fracture site, donor-site morphology and functional appearance scores, and radiographic union score for tibial fractures (RUST).Results:There was no significant difference in age between the RIA and ICBG groups (45.1±14.1 vs. 48.5±14.7 years, t=0.746, P=0.449). However, intraoperative blood loss was higher in the RIA group [300 (150, 720) ml, Z=-3.072, P=0.002] and the transfusion rate was higher (14/19 vs. 8/23, χ 2=6.313, P=0.012). The harvested bone volume was very similar [40(35, 60) cm 2vs. 40(35, 40) cm 2, Z=-1.077, P=0.281]. All patients were followed for a mean of 16.5±2.8 months (range, 7-40 months). VAS scores at the surgical site showed no significant difference between groups at 3 months (3.2±1.0 vs. 3.3±1.4, t= 4.754, P=0.720) and 6 months (1.6±0.8 vs. 1.8±1.2, t=6.841, P=0.542). Donor-site morphology and functional scores were significantly better in the RIA group at 3 months [14.5(13.0, 15.5) vs. 9.0(7.0, 10.0), Z=-3.748, P<0.001] and 6 months [15.5(15.0, 16.0) vs. 11.0(10.0, 13.0), Z=-3.782, P<0.001]. At 12 months postoperatively, RUST scores did not differ significantly between groups (10.6±1.2 vs. 10.4±1.5, t=0.483, P=0.632). The incidence of perioperative complications was comparable [42%(8/19) vs. 30%(7/23), χ 2=0.617, P=0.432]. Conclusions:Both RIA and ICBG achieved favorable clinical outcomes in the treatment of adult noninfectious lower-extremity long bone nonunion. Although RIA was associated with greater intraoperative blood loss, it resulted in less donor-site morbidity and better cosmetic and functional outcomes. Bone healing capacity and overall complication rates did not differ significantly between the two groups. These findings suggest that the RIA technique is safe and effective for use in the Chinese patient population.

Objective:To evaluate the application of the reaming-irrigation-aspirator (RIA) technique in autologous bone grafting for non-union of lower limb fracture.Methods:A retrospective analysis was conducted of the data of 16 patients with non-union of lower limb fracture who had undergone autologous bone grafting using the RIA technique at Department of Lower Limb Orthopaedics Ⅰ, Zhengzhou Orthopaedic Hospital from July 2023 to March 2024. There were 12 males and 4 females with an age of (47.2±14.3) years. Sites of non-union: the femur in 14 cases and the tibia in 2 cases. Initial surgical fixation: intramedullary nail fixation in 5 cases, plate fixation in 10 cases, and intramedullary nail plus plate fixation in 1 case. The time for fracture non-union was (21.0±12.0) months. Intraoperatively, autologous bone reaming was conducted using a drill bit of RIA system, and simultaneous flushing using irrigation fluid. The bone debris carried out by the irrigation fluid was collected into a filtration device through negative pressure aspiration. After the filter was opened to squeeze out congestion, bone paste was taken out for standby. Internal fixation methods were adjusted according to the non-union condition of the fractures. Finally, the bone paste was implanted into bone defects. The time for autologous bone harvest, amount of bone harvested, intraoperative blood loss, postoperative pain at a donor site, fracture healing, functional recovery of a lower limb and occurrence of complications were recorded.Results:In 2 of the 16 patients, fracture of the RIA drill bit occurred when bone marrow was harvested from the tibia, and their operation was completed only after the drill bits were replaced. In the 16 patients, time for bone harvest was (31.4±6.1) min, bone harvest volume (42.6±9.5) mL, and intraoperative blood loss (815.6±238.6) mL. The incisions in this cohort healed primarily after operation, and 4-week follow-up revealed that no patients had pain symptoms at a donor site. The 16 patients were followed up for (8.0±2.0) months after operation. All patients achieved bone union after (4.4±0.5) months. Follow-ups showed that no patients had complications like delayed infection, donor site fracture, or loosening or fracture of an internal fixator. According to the rating scale for lower limb function at the last follow-up, the function of affected limb was evaluated as excellent in 7 cases, as good in 8 cases, and as fair in 1 case.Conclusion:Application of RIA technique for autologous bone grafting to treat non-union of lower limb fracture can lead to fine fracture healing and good lower limb function, but no long-term pain symptoms in the donor area for the patients.

Objective:To observe the clinical efficacy of posterior vertebral column resection (PVCR) combined with double row nanomimetic bone column implantation and internal fixation in the treatment of stage Ⅲ Kümmell's disease plus kyphosis.Methods:A retrospective study was conducted to analyze the clinical data of the 12 patients with stage Ⅲ Kümmell's disease plus kyphosis who had been admitted to Department of Spine Surgery, Zhengzhou Orthopedic Hospital from March 2017 to September 2023. There were 2 males and 10 females, with an age of (63.4±6.4) years and a disease duration of (8.6±5.1) months. The injured segment was T 11 in 1 patient, T 12 in 5 ones, and L 1 in 6 ones. The preoperative spinal nerve injury was graded according to American Spinal Injury Association (ASIA): grade D in 5 cases and grade E in 7 cases. All the patients were treated with PVCR combined with double row nanomimetic bone column implantation and internal fixation. The operation time, intraoperative blood loss, shortening rate of the osteotomy area, complications during follow-up, and spinal nerve recovery at the last follow-up were recorded. The visual analogue scale (VAS) pain scores, Oswestry Disability Indexes (ODIs), and local kyphosis Cobb angles were compared between pre-surgery, 2 weeks after surgery, and the last follow-up. Results:Incisions in all the 12 patients healed at the primary stage. Their operation duration was (268.4±26.5) min, intraoperative blood loss (994.9±180.4) mL, shortening rate of the osteotomy area 3.94%±7.58%, and follow-up duration (24.1±13.5) months. At 2 weeks after surgery and the last follow-up, the VAS pain scores [(3.08±0.79) points and (1.17±0.58) points] and ODIs (27.59%±6.10% and 16.67%±2.22%) were significantly lower than those before surgery [(8.08±0.79) points and 73.14%±5.64%], and the values at the last follow-up were further significantly lower than those at 2 weeks after surgery (all P<0.05). There was no statistically significant difference in the Cobb angle at the last follow-up (5.29°±1.30°) compared with 2 weeks after surgery (4.74°±1.31°) ( P>0.05), but there was a statistically significant difference compared with the preoperative value (49.41°±4.40°) ( P<0.05). At the last follow-up, the ASIA grading in all the 12 patients recovered to grade E, with good bone healing at the fixation segment. No screw loosening or fracture was found. Two patients had a biomimetic bone column sinking of 3.5 and 4.0 mm, respectively, but their Marchi's grading was still 0. During the follow-up period, one patient developed proximal junctional kyphosis, and one patient developed an osteoporotic fracture of the proximal vertebral body at the fixed level. Conclusions:In the treatment of stage Ⅲ Kümmell's disease plus kyphosis, PVCR combined with double row nanomimetic bone column implantation and internal fixation can significantly correct the kyphosis and improve clinical symptoms, leading to good clinical efficacy.

Objective:To compare the clinical efficacy of the reamer-irrigator-aspirator (RIA) technique and iliac crest bone grafting (ICBG) in the treatment of adult noninfectious long bone nonunion of the lower extremity, and to evaluate the safety and effectiveness of the RIA technique.Methods:A retrospective review was conducted of 42 adult patients with noninfectious long bone nonunion of the lower extremity treated surgically at Zhengzhou Orthopaedic Hospital from January 2021 to June 2024. The cohort included 33 men and 9 women with a mean age of 47.0±14.4 years (range, 18-62 years). Twenty-three patients had nonunion on the left side and 19 on the right. Initial surgical fixation methods included plate fixation (19 cases), intramedullary nail (16 cases), external fixator (5 cases), and combined plate-and-nail fixation (2 cases). Revision procedures included debridement and freshening of the nonunion ends, revision or adjustment of internal fixation, and autologous bone grafting. Nineteen patients underwent graft harvesting with the RIA technique (RIA group), and 23 received autograft harvested from the iliac crest (iliac group). Baseline and perioperative variables compared between the two groups included sex, age, body-mass index, preoperative comorbidities, anatomical site of the nonunion (tibial or femoral), duration from the index fracture operation to the current revision, operative time, intraoperative blood loss, volume of blood transfusion and rate of perioperative complications, nonunion fracture sites, visual analogue scale (VAS) pain score at the fracture site, donor-site morphology and functional appearance scores, and radiographic union score for tibial fractures (RUST).Results:There was no significant difference in age between the RIA and ICBG groups (45.1±14.1 vs. 48.5±14.7 years, t=0.746, P=0.449). However, intraoperative blood loss was higher in the RIA group [300 (150, 720) ml, Z=-3.072, P=0.002] and the transfusion rate was higher (14/19 vs. 8/23, χ 2=6.313, P=0.012). The harvested bone volume was very similar [40(35, 60) cm 2vs. 40(35, 40) cm 2, Z=-1.077, P=0.281]. All patients were followed for a mean of 16.5±2.8 months (range, 7-40 months). VAS scores at the surgical site showed no significant difference between groups at 3 months (3.2±1.0 vs. 3.3±1.4, t= 4.754, P=0.720) and 6 months (1.6±0.8 vs. 1.8±1.2, t=6.841, P=0.542). Donor-site morphology and functional scores were significantly better in the RIA group at 3 months [14.5(13.0, 15.5) vs. 9.0(7.0, 10.0), Z=-3.748, P<0.001] and 6 months [15.5(15.0, 16.0) vs. 11.0(10.0, 13.0), Z=-3.782, P<0.001]. At 12 months postoperatively, RUST scores did not differ significantly between groups (10.6±1.2 vs. 10.4±1.5, t=0.483, P=0.632). The incidence of perioperative complications was comparable [42%(8/19) vs. 30%(7/23), χ 2=0.617, P=0.432]. Conclusions:Both RIA and ICBG achieved favorable clinical outcomes in the treatment of adult noninfectious lower-extremity long bone nonunion. Although RIA was associated with greater intraoperative blood loss, it resulted in less donor-site morbidity and better cosmetic and functional outcomes. Bone healing capacity and overall complication rates did not differ significantly between the two groups. These findings suggest that the RIA technique is safe and effective for use in the Chinese patient population.

Objective To summarize the changing prevalence of carbapenem resistance in Enterobacterales based on the data of CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021 for improving antimicrobial treatment in clinical practice.Methods Antimicrobial susceptibility testing was performed using a commercial automated susceptibility testing system according to the unified CHINET protocol.The results were interpreted according to the breakpoints of the Clinical & Laboratory Standards Institute(CLSI)M100 31st ed in 2021.Results Over the seven-year period(2015-2021),the overall prevalence of carbapenem-resistant Enterobacterales(CRE)was 9.43％(62 342/661 235).The prevalence of CRE strains in Klebsiella pneumoniae,Citrobacter freundii,and Enterobacter cloacae was 22.38％,9.73％,and 8.47％,respectively.The prevalence of CRE strains in Escherichia coli was 1.99％.A few CRE strains were also identified in Salmonella and Shigella.The CRE strains were mainly isolated from respiratory specimens(44.23±2.80)％,followed by blood(20.88±3.40)％and urine(18.40±3.45)％.Intensive care units(ICUs)were the major source of the CRE strains(27.43±5.20)％.CRE strains were resistant to all the β-lactam antibiotics tested and most non-β-lactam antimicrobial agents.The CRE strains were relatively susceptible to tigecycline and polymyxins with low resistance rates.Conclusions The prevalence of CRE strains was increasing from 2015 to 2021.CRE strains were highly resistant to most of the antibacterial drugs used in clinical practice.Clinicians should prescribe antimicrobial agents rationally.Hospitals should strengthen antibiotic stewardship in key clinical settings such as ICUs,and take effective infection control measures to curb CRE outbreak and epidemic in hospitals.