OBJECTIVE: To explore the effectiveness of the modified Lemaire procedure in anterior cruciate ligament reconstruction (ACLR) in patients with a highly positive pivot shift test. METHODS: The clinical data of 18 patients with anterior cruciate ligament (ACL) rupture and highly positive pivot shift test between April 2020 and September 2022 were retrospectively analyzed. There were 13 males and 5 females with an average age of 28.3 years (range, 17-41 years). Causes of injury included 11 cases of direct violence injury, including 6 cases of traffic accident injury, 4 cases of sports injury, 1 case of falling injury; 7 cases of indirect violence injury, all sports injury. All patients had complete ACL rupture, including 15 acute injuries and 3 old injuries. The preoperative pivot shift test was grade Ⅱ in 9 cases and grade Ⅲ in 9 cases. All patients were treated with ACLR combined with modified Lemaire procedure. The International Knee Documentation Committee (IKDC) score and Lysholm score were used to evaluate the effectiveness before operation and at 3, 6, 12 months after operation. KT-2000 arthrometer was used to measure the anterior stability of the knee joint, and the difference between the healthy and affected sides was recorded. Pivot shift test was used to evaluate the rotational stability of the knee joint. During the follow-up, X-ray films were taken to observe the bone tunnel and internal fixation, and MRI was used to examine the healing of ACL, anterolateral collateral ligament and fibular collateral ligament grafts. RESULTS: All patients completed the operation successfully without complications such as knee joint infection, vascular and nerve injury. All patients were followed up 12-19 months (mean, 13.2 months). After operation, the rotational stability of the knee joint recovered satisfactorily, and there was no adverse symptom such as knee instability and locking at last follow-up. X-ray film and MRI showed that the bone tunnel was anatomically located and healed well, the internal fixation was in good position, and the reconstructed ACL and iliotibial band were continuous and in good tension. The IKDC score, Lysholm score, and the difference of KT-2000 between the healthy and the affected sides significantly improved at 3, 6, and 12 months after operation ( P<0.05). All the indicators further improved with time after operation, except that there was no significant difference in IKDC score between 3 and 6 months after operation and in the difference of KT-2000 between 3 months and 6, 12 months after operation ( P>0.05), and there were significant differences in other indicators between different time points ( P<0.05). Pivot shift test was negative immediately after operation and at last follow-up. CONCLUSION In ACL injuries with a highly positive pivot shift test, ACLR combined with the modified Lemaire procedure can effectively restore anterolateral knee stability, leading to satisfactory knee stability and function in the early postoperative period.
Humans ; Anterior Cruciate Ligament Reconstruction/methods* ; Male ; Female ; Anterior Cruciate Ligament Injuries/physiopathology* ; Adult ; Adolescent ; Retrospective Studies ; Young Adult ; Anterior Cruciate Ligament/surgery* ; Treatment Outcome ; Joint Instability/surgery* ; Knee Joint/physiopathology* ; Range of Motion, Articular

Cardiac fibrosis is characterized by an elevated amount of extracellular matrix (ECM) within the heart. However, the persistence of cardiac fibrosis ultimately diminishes contractility and precipitates cardiac dysfunction. Circular RNAs (circRNAs) are emerging as important regulators of cardiac fibrosis. Here, we elucidate the functional role of a specific circular RNA CELF1 in cardiac fibrosis and delineate a novel feedback loop mechanism. Functionally, circ-CELF1 was involved in enhancing fibrosis-related markers' expression and promoting the proliferation of cardiac fibroblasts (CFs), thereby exacerbating cardiac fibrosis. Mechanistically, circ-CELF1 reduced the ubiquitination-degradation rate of BRPF3, leading to an elevation of BRPF3 protein levels. Additionally, BRPF3 acted as a modular scaffold for the recruitment of histone acetyltransferase KAT7 to facilitate the induction of H3K14 acetylation within the promoters of the Celf1 gene. Thus, the transcription of Celf1 was dramatically activated, thereby inhibiting the subsequent response of their downstream target gene Smad7 expression to promote cardiac fibrosis. Moreover, Celf1 further promoted Celf1 pre-mRNA transcription and back-splicing, thereby establishing a feedback loop for circ-CELF1 production. Consequently, a novel feedback loop involving CELF1/circ-CELF1/BRPF3/KAT7 was established, suggesting that circ-CELF1 may serve as a potential novel therapeutic target for cardiac fibrosis.

Objective:To establish a high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method for the fast determination of maduramicin ammonium (MAD) in rat serum.Methods:In February 2024, rat serum samples were selected and directly injected after extraction and purification with methanol: acetonitrile (1: 1), separated on a C18 chromatographic column, and gradient-eluted using 0.1% formic acid aqueous solution -0.1% formic acid methanol solution as the mobile phase. Under optimized instrument conditions, electrospray positive ion multiple reaction monitoring (MRM) mode was employed for quantification using the external standard method, followed by methodological validation of the established approach.Results:The linearity of MAD in serum was good in the concentration range of 0.5-100 μg/L, and the correlation coefficient was 0.9997. The mean recoveries of MAD from spiked samples were 86.0%-109.6%, with the relative standard deviations were less than 10%. The limit of detection was 0.23 μg/L, The limit of detection was 0.75 μg/L.Conclusion:This method is high sensitive and reliable, which is suitable for the determination of MAD in in mouse serum.

Objective:To establish a high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method for the fast determination of maduramicin ammonium (MAD) in rat serum.Methods:In February 2024, rat serum samples were selected and directly injected after extraction and purification with methanol: acetonitrile (1: 1), separated on a C18 chromatographic column, and gradient-eluted using 0.1% formic acid aqueous solution -0.1% formic acid methanol solution as the mobile phase. Under optimized instrument conditions, electrospray positive ion multiple reaction monitoring (MRM) mode was employed for quantification using the external standard method, followed by methodological validation of the established approach.Results:The linearity of MAD in serum was good in the concentration range of 0.5-100 μg/L, and the correlation coefficient was 0.9997. The mean recoveries of MAD from spiked samples were 86.0%-109.6%, with the relative standard deviations were less than 10%. The limit of detection was 0.23 μg/L, The limit of detection was 0.75 μg/L.Conclusion:This method is high sensitive and reliable, which is suitable for the determination of MAD in in mouse serum.

Objective:To investigate the risk of developing pulmonary hypertension (PH) in children with bronchopulmonary dysplasia (BPD) exposed to hemodynamically significant patent ductus arteriosus (hsPDA) and the correlation between PH and exposure to hsPDA.Methods:Retrospective case-control study.The clinical data of extremely premature infants (gestational age <32 weeks) admitted to the Department of Neonatology, Shanghai Children′s Hospital from January 2018 to December 2022 were retrospectively analyzed.All the very premature infants had a corrected gestational age≥36 weeks, required respiratory support, and were diagnosed with BPD.Their echocardiograms were evaluated by a team of physicians specialized in ultrasound.The patients were divided into a non-PH group and a PH group based on whether they were complicated by PH.The risk factors of PH in infant with BPD were analyzed by univariate and multivariate analyses.The influence of hsPDA on the outcome of PH in infant with BPD was analyzed by a Logistic model, whose performance was evaluated by the receiver-operating characteristic (ROC) curve.Results:(1)A total of 147 infants with BPD were included, with 74 cases in the non-PH group and 73 cases in the PH group.There was no significant difference in gestational age[(204.5±11.8) days vs.(201.6±11.5) days] and birth weight[(1 222±273) g vs.(1 153±237) g] between the non-PH and PH groups(all P>0.05).(2)Univariate ANOVA showed the development of PH in children with BPD was significantly related to postnatal positive pressure ventilation resuscitation ( P=0.036), invasive respiratory support ( P=0.002), prenatal glucocorticoids ( P=0.043), intravenous hormones ( P=0.003), liquid restriction ( P<0.001), hypercapnia ( P=0.004), PDA ( P=0.010), and hsPDA ( P<0.001).(3)The Logistic regression analysis suggested that exposure to hsPDA ( OR=5.414, 95% CI: 1.852-15.824, P=0.002) was an independent risk factor for PH development in children with BPD.The ROC curve is plotted through the prediction probability of the model, which has an optimal cut-off value of 42.9% (sensitivity=83.6%, specificity=63.5%, area under the ROC curve=0.794, and Youden index=0.471). Conclusions:Exposure to hsPDA increases the risk and is an independent risk factor of PH development in infants with BPD.

Objective:To investigate the risk of developing pulmonary hypertension (PH) in children with bronchopulmonary dysplasia (BPD) exposed to hemodynamically significant patent ductus arteriosus (hsPDA) and the correlation between PH and exposure to hsPDA.Methods:Retrospective case-control study.The clinical data of extremely premature infants (gestational age <32 weeks) admitted to the Department of Neonatology, Shanghai Children′s Hospital from January 2018 to December 2022 were retrospectively analyzed.All the very premature infants had a corrected gestational age≥36 weeks, required respiratory support, and were diagnosed with BPD.Their echocardiograms were evaluated by a team of physicians specialized in ultrasound.The patients were divided into a non-PH group and a PH group based on whether they were complicated by PH.The risk factors of PH in infant with BPD were analyzed by univariate and multivariate analyses.The influence of hsPDA on the outcome of PH in infant with BPD was analyzed by a Logistic model, whose performance was evaluated by the receiver-operating characteristic (ROC) curve.Results:(1)A total of 147 infants with BPD were included, with 74 cases in the non-PH group and 73 cases in the PH group.There was no significant difference in gestational age[(204.5±11.8) days vs.(201.6±11.5) days] and birth weight[(1 222±273) g vs.(1 153±237) g] between the non-PH and PH groups(all P>0.05).(2)Univariate ANOVA showed the development of PH in children with BPD was significantly related to postnatal positive pressure ventilation resuscitation ( P=0.036), invasive respiratory support ( P=0.002), prenatal glucocorticoids ( P=0.043), intravenous hormones ( P=0.003), liquid restriction ( P<0.001), hypercapnia ( P=0.004), PDA ( P=0.010), and hsPDA ( P<0.001).(3)The Logistic regression analysis suggested that exposure to hsPDA ( OR=5.414, 95% CI: 1.852-15.824, P=0.002) was an independent risk factor for PH development in children with BPD.The ROC curve is plotted through the prediction probability of the model, which has an optimal cut-off value of 42.9% (sensitivity=83.6%, specificity=63.5%, area under the ROC curve=0.794, and Youden index=0.471). Conclusions:Exposure to hsPDA increases the risk and is an independent risk factor of PH development in infants with BPD.

Objective To investigate the diagnostic efficiency of patients with human epidermal growth factor receptor-2(HER-2)over expressed breast cancer via combining the dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)perfusion parameters,apparent diffusion coefficient(ADC)value and clinical feature model.Methods A total of 197 breast cancer patients who underwent DCE-MRI and diffusion weighted imaging(DWI)scans were analyzed retrospectively,including 47 breast cancer patients with HER-2 over expressed and 150 breast cancer patients with non-HER-2 over expressed.The t-test or chi-square test was used to compare the DCE-MRI perfusion parameters[Ktrans,Kep,Ve,W-in,W-out,and time to peak(TTP)],ADC value,and clinical feature between the two groups.The diagnostic efficiency of the models were analyzed via receiver operating characteristic(ROC)curves.Results There were significant difference in the maximum tumor diameter,minimum tumor diameter,T stage,N stage,Kep,W-in,and ADC value between HER-2 over expressed breast cancer and non-HER-2 over expressed breast cancer groups(P＜0.05).The proposed combined model,which included the combined maximum tumor diameter,minimum tumor diameter,T stage,N stage,Kep,W-in,and ADC value,showed a better diagnostic efficiency with area under the curve(AUC)(AUC=0.763)than the clinical model(AUC=0.634)based on the combined maximum tumor diameter,minimum tumor diameter,T stage,and N stage,and the imaging model(AUC=0.715)based on the combined Kep,W-in and ADC value.Conclusion The maximum tumor diameter,minimum tumor diameter,T stage,N stage,Kep,W-in,and ADC value may be associated with HER-2 over expressed breast cancer.Combining all above parameters can improve the diagnostic ability of breast cancer patients with HER-2 over expressed.

Objective To investigate the therapeutic effect of segmental decompression combined with corrective short-segment fusion surgery for the treatment of degenerative lumbar scoliosis.Methods In total,124 patients with degenerative lumbar scoliosis were selected and divided into short-and long-segment fusion groups using the random number table method,with 62 patients in each group.Posterior short-segment decompression,fixation,and fusion were performed in the short-segment fusion group;the fusion segment was the adjacent lumbar vertebra.Posterior long-segment decompression,fixation,and fusion were performed in the long-segment fusion group;the fusion segments included multiple adjacent lumbar vertebrae.At the 6th month after surgery,the coronal Cobb angle of lumbar convexity,sagittal Cobb angle of lumbar lordosis,intervertebral foramen height,intervertebral space height,intervertebral foramen area,spinal canal area,spinal canal diameter,Japanese Orthopedic Association(JOA)score,Oswestry Disability Index(ODI),degree of pain in the lower back and lower limbs,and postoperative complications were compared between the groups.Results The Cobb angle of the coronal lumbar scoliosis in the short-and long-segment fusion groups was significantly higher than that before surgery(P<0.05).At the 6th month after surgery,the intervertebral foramen height,intervertebral space height,intervertebral foramen area,spinal canal area,and spinal canal diameter in both groups increased,and those in the short-segment fusion group were higher than those in the long-segment fusion group(P<0.05);at the 6th month after the operation,the JOA scores of the short-segment and long-segment fusion groups were higher than those before surgery,and the JOA score of the short-segment fusion group was higher than that of the long-segment fusion group(P<0.05).The ODI score was lower than that before surgery in the short-and long-segment fusion groups,and the ODI score in the short-segment fusion group was lower than that in the long-segment fusion group(P<0.05).At the 6th month after surgery,the pain scores of the lower back and lower limbs in the short-and long-segment fusion groups were significantly higher than those before surgery(P<0.05).There were two cases of dural tears during decompression caused by lamina dura adhesion in the long-segment fusion group,and no serious complications were observed in the short-segment fusion group.Conclusions Both short-and long-segment decompression fixation fusion using a posterior approach can achieve good therapeutic effects for treating degenerative lumbar scoliosis.However,compared to the long-segment fusion group,the short-segment fusion group undergoing short-segment decompression fixation fusion through a posterior approach had a shorter surgical period,lower intraoperative blood loss,better recovery of lumbar function,and a lower risk of postoperative complications.

Objective To explore the mechanobiological mechanism of fluid shear force(FSF)on the protection,injury,and destruction of the structure and function of the blood-brain barrier(BBB)under normal physiological conditions,ischemic hypoperfusion,and postoperative hyperperfusion conditions.BBB is mainly composed of brain microvascular endothelial cells.Rat brain microvascular endothelial cells(rBMECs)were used as model cells to conduct the investigation.Methods rBMECs were seeded at a density of 1×105 cells/cm2 and incubated for 48 h.FSF was applied to the rBMECs at 0.5,2,and 20 dyn/cm2,respectively,simulating the stress BBB incurs under low perfusion,normal physiological conditions,and high FSF after bypass grafting when there is cerebral vascular stenosis.In addition,a rBMECs static culture group was set up as the control(no force was applied).Light microscope,scanning electron microscope(SEM),and laser confocal microscope(LSCM)were used to observe the changes in cell morphology and cytoskeleton.Transmission electron microscope(TEM)was used to observe the tight junctions.Immunofluorescence assay was performed to determine changes in the distribution of tight junction-associated proteins claudin-5,occludin,and ZO-1 and adherens junction-associated proteins VE-cadherin and PECAM-1.Western blot was performed to determine the expression levels of tight junction-associated proteins claudin-5,ZO-1,and JAM4,adherens junction-associated protein VE-cadherin,and key proteins in Rho GTPases signaling(Rac1,Cdc42,and RhoA)under FSF at different intensities.Results Microscopic observation showed that the cytoskeleton exhibited disorderly arrangement and irregular orientation under static culture and low shear force(0.5 dyn/cm2).Under normal physiological shear force(2 dyn/cm2),the cytoskeleton was rearranged in the orientation of the FSF and an effective tight junction structure was observed between cells.Under high shear force(20 dyn/cm2),the intercellular space was enlarged and no effective tight junction structure was observed.Immunofluorescence results showed that,under low shear force,the gap between the cells decreased,but there was also decreased distribution of tight junction-associated proteins and adherens junction-associated proteins at the intercellular junctions.Under normal physiological conditions,the cells were tightly connected and most of the tight junction-associated proteins were concentrated at the intercellular junctions.Under high shear force,the gap between the cells increased significantly and the tight junction and adherens junction structures were disrupted.According to the Western blot results,under low shear force,the expression levels of claudin-5,ZO-1,and VE-cadherin were significantly up-regulated compared with those of the control group(P<0.05).Under normal physiological shear force,claudin-5,ZO-1,JAM4,and VE-cadherin were highly expressed compared with those of the control group(P<0.05).Under high shear force,the expressions of claudin-5,ZO-1,JAM4,and VE-cadherin were significantly down-regulated compared with those of the normal physiological shear force group(P<0.05).Under normal physiological shear force,intercellular expressions of Rho GTPases proteins(Rac1,Cdc42,and RhoA)were up-regulated and were higher than those of the other experimental groups(P<0.05).The expressions of Rho GTPases under low and high shear forces were down-regulated compared with that of the normal physiological shear force group(P<0.05).Conclusion Under normal physiological conditions,FSF helps maintain the integrity of the BBB structure,while low or high shear force can damage or destroy the BBB structure.The regulation of BBB by FSF is closely related to the expression and distribution of tight junction-associated proteins and adherens junction-associated proteins.

Bronchopulmonary dysplasia(BPD), a common respiratory disease in premature infants, leads to poor long-term prognosis.The crosstalk between the gut and lung which can be mediated by microbiota is known as the gut-lung axis.Recently, an increasing amount of evidence has indicated that the gut microbiota is closely related to the pathogenesis of many respiratory diseases.The gut-lung axis affects the occurrence and development of BPD through microbiota translocation and regulation of immune pathways.At present, the relationship between the gut-lung axis and BPD is still in the research stage and exploring the potential association may help to search early markers and new therapies for BPD.In order to provide insights into preventing and treating BPD, this review describes the relationship between the gut-lung axis and BPD.