BACKGROUND:With the development of the aging trend of society,the incidence of femoral neck fractures is increasing.Currently,the preferred surgical treatment is cannulated screw internal fixation.However,post-surgical femoral neck shortening occurs in some cases,resulting in impaired hip functionality.OBJECTIVE:To investigate the incidence of femoral neck shortening following the use of half-threaded cannulated screws for internal fixation in patients with femoral neck fractures,to analyze the effect on hip function,and to identify factors contributing to neck shortening.METHODS:A retrospective analysis was conducted on the medical records of 102 patients treated with half-threaded cannulated screws in an inverted triangle setup for femoral neck fractures at Affiliated Hai'an Hospital of Nantong University from January 2016 to January 2021.This group included 36 males and 66 females at the mean age of(57.2±7.7)years,with 34 cases of Garden type Ⅰ and Ⅱ fractures and 68 of Garden type Ⅲ and Ⅳ fractures.The mean bone mineral density value T was-2.8 SD.The Harris score was used to evaluate the hip function.During the follow-up period,the occurrence of femoral neck shortening was determined using X-ray imagery,and the factors influencing this shortening were examined using both univariate and multivariate regression analyses.RESULTS AND CONCLUSION:(1)Among the 102 patients with femoral neck fractures,30 patients developed femoral neck shortening,accounting for 29.4％.72 patients had no femoral neck shortening(70.6％).(2)The Harris score for patients experiencing neck shortening was significantly lower than that for patients without shortening(P＜0.05).(3)The study identified several factors associated with femoral neck shortening following the internal fixation of femoral neck fractures included age,gender,bone mineral density value T,preoperative Garden classification,and quality of reduction.These factors not only affect the shortening of the femoral neck after surgery,but are also directly related to the functional performance of the patient's hip joint.(4)Femoral neck shortening after surgery for femoral neck fracture is associated with various clinical parameters,especially the patient's age,gender,bone mineral density,preoperative classification,and accuracy of reduction during surgery.

BACKGROUND:With the development of the aging trend of society,the incidence of femoral neck fractures is increasing.Currently,the preferred surgical treatment is cannulated screw internal fixation.However,post-surgical femoral neck shortening occurs in some cases,resulting in impaired hip functionality.OBJECTIVE:To investigate the incidence of femoral neck shortening following the use of half-threaded cannulated screws for internal fixation in patients with femoral neck fractures,to analyze the effect on hip function,and to identify factors contributing to neck shortening.METHODS:A retrospective analysis was conducted on the medical records of 102 patients treated with half-threaded cannulated screws in an inverted triangle setup for femoral neck fractures at Affiliated Hai'an Hospital of Nantong University from January 2016 to January 2021.This group included 36 males and 66 females at the mean age of(57.2±7.7)years,with 34 cases of Garden type Ⅰ and Ⅱ fractures and 68 of Garden type Ⅲ and Ⅳ fractures.The mean bone mineral density value T was-2.8 SD.The Harris score was used to evaluate the hip function.During the follow-up period,the occurrence of femoral neck shortening was determined using X-ray imagery,and the factors influencing this shortening were examined using both univariate and multivariate regression analyses.RESULTS AND CONCLUSION:(1)Among the 102 patients with femoral neck fractures,30 patients developed femoral neck shortening,accounting for 29.4％.72 patients had no femoral neck shortening(70.6％).(2)The Harris score for patients experiencing neck shortening was significantly lower than that for patients without shortening(P＜0.05).(3)The study identified several factors associated with femoral neck shortening following the internal fixation of femoral neck fractures included age,gender,bone mineral density value T,preoperative Garden classification,and quality of reduction.These factors not only affect the shortening of the femoral neck after surgery,but are also directly related to the functional performance of the patient's hip joint.(4)Femoral neck shortening after surgery for femoral neck fracture is associated with various clinical parameters,especially the patient's age,gender,bone mineral density,preoperative classification,and accuracy of reduction during surgery.

Diabetic nephropathy （DN） is one of the most common and severe microvascular complications of diabetes， with a complex pathogenesis involving immune inflammatory responses， oxidative stress， apoptosis， glomerulosclerosis， renal interstitial fibrosis， and other pathological processes. In recent years， numerous animal or cell model experiments have revealed that the transforming growth factor-β （TGF-β）/mothers against decapentaplegic homolog （Smad）， phosphoinositide 3-kinase （PI3K）/ protein kinase B （Akt）/mammalian target of rapamycin （mTOR）， mitogen-activated protein kinase （MAPK）， AMP-activated protein kinase （AMPK）， nuclear factor-κB （NF-κB）， Janus kinase （JAK）/signal transducer and activator of transcription （STAT）， neurogenic locus notch homolog protein （Notch）， nuclear factor E₂-related factor 2 （Nrf2）， secretory glycoprotein （Wnt）/β-catenin， and other classical signaling pathways play important roles in the occurrence and development of DN. Traditional Chinese medicines， as natural drugs， possess characteristics such as multiple components， multiple targets， and few adverse reactions， demonstrating unique advantages in regulating the aforementioned signaling pathways and improving renal pathological changes. This review summarized recent research progress on the intervention of DN through the regulation of the aforementioned signaling pathways by single compounds and formulas of traditional Chinese medicine， focusing on their mechanisms of action in regulating immune inflammatory responses， inhibiting renal fibrosis， oxidative stress， improving metabolic disorders， and other aspects. The aim is to provide theoretical references for a deeper understanding of the modern pharmacological basis and clinical application of traditional Chinese medicine in the treatment of DN.

ObjectiveTo explore the effects of mechanical pressure regulation on the migration and bone-promoting ability of suture dural cells （S-DCs） and non-suture dural cells （NS-DCs）. MethodsDural cells （S-DCs）， non-cranial suture dural cells （NS-DCs） and cranial suture mesenchymal stem cells （CS-MSCs） of 5-day-old SD rats were isolated and cultured. Four experimental conditions， namely S-DCs-Normal， S-DCs-Stress， NS-DCs-Normal and NS-DCs-Stress， were set according to the source of the cells and whether mechanical pressure （1.07 kPa， 24 hours） was applied. The migration ability of dural cells was detected by cell scratch test. Four experimental condition culture media were collected and co-cultured with CS-MSCs for osteogenic induction. Calcium salt deposition was detected by alizarin red staining， and the expression of osteogenesis-related proteins was detected by Western blot. ResultsCompared with the Normal group， the migration abilities of both S-DCs and NS-DCs decreased after Stress treatment （P<0.05）. Compared with S-DCs， NS-DCs has a weaker migration ability under the same processing conditions （P<0.05）. The conditioned medium experiment showed that Stress treatment reduced the osteogenic ability of CS-MSCs （P<0.05）， and the osteogenic effect of the conditioned medium derived from NS-DCs was weaker than that of S-DCs （P<0.05）. The Western blot results were consistent with the trend of alizarin red staining. Both Stress treatment and NS-DCs sources could down-regulate the expression of osteogenesis-related proteins （P<0.05）. ConclusionMechanical stress can significantly inhibit the migration of dural cells and the osteogenic differentiation process of CS-MSCs mediated by it. The mechanical tolerance and osteogenic regulation ability of S-DCs are significantly better than those of NS-DCs.

Objective:To analyze the efficacy of enzyme replacement therapy and anti-drug antibody production in children with Fabry disease.Methods:The clinical data of 7 children with Fabry disease treated with enzyme replacement therapy for more than 1 year at Children′s Hospital of Zhejiang University School of Medicine from July 2021 to June 2024 were retrospectively analyzed. The basic information and the changes of related clinical indicators before and after treatment were collected. Paired sample t test was used to compare renal function, left heart mass index, pain score and other related indexes before and after treatment. The anti-drug antibodies were detected by enzyme-linked immunosorbent assay. Results:A total of 6 boys and 1 girl were included. The age of diagnosis was (12.2±1.8) years. After 1 year of enzyme replacement therapy, the abnormal substrate globotriaosylsphingosine and brief pain inventory scores of all children were significantly lower than those before treatment ((16±11) vs. (63±42) μg/L, 22±19 vs. 45±29, t=3.88, 3.43, both P<0.05). There were no significant differences in glomerular filtration rate, urinary microalbumin to creatinine and left heart mass index before and after treatment ((124±35) vs. (136±26) ml/(min·1.73 m 2), (9.3±8.3) vs. (3.8±2.5) mg/g, (38±9) vs. (33±6) g/m 2.7, t=1.33, 1.74, 1.19, all P>0.05). Patients 4, 5 and 6 developed anti-drug antibodies at 1 month, 4 months and 1 month after medication, respectively. Patient 4 had persistently high anti-drug antibody titers (absorbance 3.65-3.73) accompanied by urticaria, elevated globotriaosylsphingosine and worsening clinical symptoms. Conclusions:The enzyme replacement therapy can effectively improve the clinical symptoms and reduce the level of globotriaosylsphingosine in children with Fabry disease. The anti-drug antibody is common in patients after long-term enzyme replacement therapy and may diminish the efficacy, which needs dynamic monitoring.

This article reported a case of a newborn with congenital absence of the penis. The prenatal examinations were unremarkable. Physical examination of the newborn revealed abnormal external genitalia, with well-developed scrotum and fully descended testicle in normal size, but without the penis. Postnatal ultrasound showed no obvious signals of uterus and ovaries in pelvis and had normal bilateral testicles and urinary system. The diagnosis was congenital absence of the penis.

Objective:To explore the clinical risk factors and pregnancy outcomes in women with hyperglycemia in pregnancy (HIP) complicated with hypertensive disorders of pregnancy (HDP).Methods:This retrospective cohort study included 43 973 singleton live births delivered at the Obstetrics and Gynecology Hospital of Fudan University between September 2017 and December 2022. Participants were categorized into four groups: HH group (HIP with HDP, n=1 011), HIP group ( n=5 469), HDP group ( n=3 486), and control group ( n=34 007). Baseline characteristics and perinatal outcomes were compared using the Chi-square test (or Fisher's exact test). Logistic regression identified risk factors and adverse outcome risks and analyze the impact of HH on neonatal weight. Results:HH accounted for 15.6% (1 011/6 480) of HIP cases, with an overall incidence of 2.3% (1 011/43 973). HIP and HDP were strongly correlated [ OR=1.803, 95% CI: 1.672-1.945]. Advanced maternal age (≥35 years at estimated due date), primiparity, and pre-pregnancy overweight/obesity (body mass index ≥24 kg/m2) were independent risk factors for HH [ OR (95% CI): 1.305 (1.113-1.529), 1.845 (1.545-2.203), and 2.316 (1.981-2.718), respectively]. Compared to the HIP group, the HH group had significantly higher risks of preterm birth [10.3% (104/1 011) vs. 6.3% (344/5 469), OR=1.627 (95% CI:1.280-2.068)], cesarean delivery [57.0% (576/1 011) vs. 41.9% (2 289/5 469), OR=1.701 (95% CI:1.474-1.963)], and neonatal birth weight < P10 [13.9% (141/1 011) vs. 9.0% (494/5 469), OR=1.668 (95% CI:1.336-2.083)]. Stratified analysis revealed a 73.4% increased risk of birth weight < P10 in the gestational diabetes mellitus A1 with HDP subgroup ( aOR=1.734, 95% CI: 1.416-2.125). Conclusions:Advanced age, pre-pregnancy overweight/obesity, and primiparity are risk factors for HH. Compared to isolated HIP, HH is associated with elevated risks of preterm birth, cesarean delivery, and abnormal neonatal birth weight, though the impact on birth weight may vary by HIP subtype.

Objective To evaluate the effects of the method of blood-cooling and blood stasis-resolving on heart function and prognosis in patients with sepsis-induced myocardial dysfunction(SIMD).Methods Sixty patients with SIMD admitted to the department of critical care medicine of Affiliated Hospital of Nanjing University of Chinese Medicine from June 2022 to October 2024 were enrolled as study subjects.The patients were divided into treatment group and control group according to random number table,with 30 patients in each group.All patients received conventional treatments,the patients in the treatment group were given Taohe Chengqi decoction(Persicae Semen 12 g,Chinese rhubarb 12 g,Cinnamon twig 6 g,Licorice root 6 g and Sodium Sulfate 6 g),the decoction was concentrated to 200 mL and taken in 2 divided doses in the morning and evening,one dose daily;and the patients in the control group were given the same amount of warm water.The total course of treatment lasts for 7 days.The differences in indicators of cardiac function[brain natriuretic peptide(BNP),cardiac troponin I(cTnI),MB isoenzyme of creatine kinase(CK-MB),aspartate aminotransferase(AST)]and echocardiographic parameters[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),mitral orifice early/late diastolic blood flow velocity ratio(E/A ratio),E/mitral and tricuspid valve ostia and the peak early diastolic velocity(E/e')]at admission,at 1st and 7th day after treatment,and prognosis indexes[mechanical ventilation time,intensive care unit(ICU)length of stay,total hospital stay,28-day survival rate]were compared between two groups.Draw the Kaplan-Meier survival curve and compare the difference in the 28-day cumulative survival rate between the two groups of patients.Results After 7 days therapy,LVEF of the treatment group was significantly higher than that the control(0.524±0.132 vs.0.458±0.118,P<0.05)and E/e'ratio of the treatment group was significantly lower than the control group[11.17(9.57,12.04)vs.11.82(11.28,13.72),P<0.05].There were no significant differences in the 28-day mortality and total hospital stay time between the two groups,but mechanical ventilation time[days:7.00(0.00,11.00)vs.12.50(3.50,21.75),P<0.05]and stay time of ICU[days:14.50(7.75,25.00)vs.21.00(14.25,31.50),P<0.05]in the treatment group were shorter than those in the control group.The Kaplan-Meier survival showed that the cumulative 28-day survival rate was similar between two groups(Log-Rank:χ2=1.448,P=0.229).Conclusion The method of blood-cooling and blood stasis-resolving could decrease mechanical ventilation time and length of stay in ICU of SIMD patients and could increase LVEF in the treatment group.

Objective To investigate the effect and mechanism of lentivirus-mediated overexpression of suppressors of cytokine sig-naling 3(SOCS3)on the heart of rats with experimental autoimmune myocarditis(EAM).Methods Thirty Lewis rats were randomly di-vided into a control group,EAM group and EAM+SOCS3 group.The EAM rat model was established by subcutaneous injection of cardiac myosin.On day 0 of the experiment,the EAM+SOCS3 group was injected with lentivirus overexpressing SOCS3 via the tail vein,and the EAM group was injected with an equal amount of empty vector lentivirus.On day 21 of the experiment,all rats underwent echocardio-graphy to evaluate cardiac function and were then euthanized.Hematoxylin-eosin(HE)staining was used to observe the pathological changes of myocardial tissue.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of serum cardiac troponin T,creatine kinase-myocardial band,B-type natriuretic peptide,and myocardial interleukin-6,interleukin-1 β and tumor necrosis fac-tor-α.Immunohistochemistry,real-time quantitative PCR(RT-qPCR)and Western blot(WB)were used to detect the expressions of SOCS3,Janus kinase 2(JAK2),signal transducer and activator of transcription 3(STAT3),monocyte chemoattractant protein-1(MCP-1),and transforming growth factor-β(TGF-β)in myocardial tissue.Results The myocardial pathological score,serum lev-els of cardiac troponin T,creatine kinase-myocardial band,B-type natriuretic peptide,and myocardial levels of interleukin-6,inter-leukin-1β,and tumor necrosis factor-α in the EAM group were significantly higher than those in the control group(P＜0.05).The cardiac function of the EAM group was significantly lower than that of the control group(P＜0.05).The mRNA and protein expressions of myocardial JAK2,STAT3,MCP-1 and TGF-β in the EAM group were significantly higher than those in the control group(P＜0.05).These indexes in the EAM+SOCS3 group were significantly restored compared with those in the EAM group(P＜0.05).The mRNA and protein expressions of SOCS3 in the myocardial tissue of the EAM+SOCS3 group were significantly higher than those in the EAM group(P＜0.05).Conclusion Overexpression of SOCS3 may ameliorates the inflammatory response of the myocardium in EAM rats and im-prove cardiac function by inhibiting the JAK2/STAT3 signaling pathway and downregulating the expressions of MCP-1 and TGF-β.

Objective:To investigate the dynamic imaging characteristics of hepatocellular carcinoma (HCC) following Yttrium-90 selective internal radiation therapy ( 90Y-SIRT) and to compare these with imaging findings after transarterial chemoembolization (TACE). Methods:This retrospective case-control study included 24 HCC patients who received 90Y-SIRT at Zhongda Hospital, Southeast University, and West China Hospital, Sichuan University, between September 2021 and June 2023, establishing the 90Y-SIRT group. Additionally, 45 HCC patients who underwent their first TACE treatment at Zhongda Hospital, Southeast University during the same period were included as the TACE group. Patients underwent MRI and/or CT follow-ups at 1-3 months (first follow-up) and 3-6 months (second follow-up) after treatment. The analyzed imaging features included tumor characteristics, peritumoral features, and measurements of tumor and liver volumes, with postoperative change rates calculated. Imaging differences between the 90Y-SIRT and TACE groups were statistically compared using the Mann-Whitney U test or χ2 test. Results:At the first follow-up, compared to baseline, a higher proportion of lesions in the 90Y-SIRT group exhibited a reduction in arterial phase enhancement in the viable region (10/13) than in the TACE group (10/29), with a statistically significant difference ( P=0.040). The necrotic region of the tumor on T 1WI showed significantly lower signal intensity in the 90Y-SIRT group than in the TACE group ( Z=2.98, P=0.006). The change in the apparent diffusion coefficient value in the viable region compared to baseline was 157.0×10 -3(-62.0×10 -3, 311.5×10 -3) mm2/s in the 90Y-SIRT group and -56.0×10 -3 (-216.8×10 -3, 110.0×10 -3) mm2/s in the TACE group, with a statistically significant difference ( Z=-2.71, P=0.008). At the first and second follow-up, the contralateral liver lobe volume increased significantly in the 90Y-SIRT group, with a statistically significant difference from the TACE group ( Z=-3.21, -3.78, both P=0.001). Regarding peritumoral imaging characteristics, a statistically significant difference was observed between the two groups in the low signal intensity of the liver lobe or segment where the tumor waslocated during the hepatobiliary phase ( P=0.020, 0.040). Both HCC groups exhibited progressive tumor volume reduction after treatment. In the 90Y-SIRT group, the change rates of lesion volume relative to baseline at the two follow-ups were -23.0% (-45.6%, 7.9%) and -68.7% (-82.7%, -28.5%), respectively. In the TACE group, the values were -29.8% (-53.6%, -2.7%) and -38.0% (-65.3%, -10.7%). The differences between the two groups were not statistically significant ( Z=-0.52, P=0.605; Z=-1.79, P=0.073). Conclusion:There is a statistically significant difference in the tumor imaging features and peritumoral imaging characteristics between 90Y-SIRT and TACE. 90Y-SIRT demonstrates a notable advantage in promoting contralateral liver lobe regeneration while also contributing to tumor size reduction.