Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

tRNA-derived small RNAs (tsRNAs) are novel non-coding RNAs that are involved in the occurrence and progression of diverse diseases. However, their exact presence and function in hepatocellular carcinoma (HCC) remain unclear. Here, differentially expressed tsRNAs in HCC were profiled. A novel tsRNA, tRNA^Gln-TTG derived 5'-tiRNA-Gln, is significantly downregulated, and its expression level is correlated with progression in patients. In HCC cells, 5'-tiRNA-Gln overexpression impaired the proliferation, migration, and invasion in vitro and in vivo, while 5'-tiRNA-Gln knockdown yielded opposite results. 5'-tiRNA-Gln exerted its function by binding eukaryotic initiation factor 4A-I (EIF4A1), which unwinds complex RNA secondary structures during translation initiation, causing the partial inhibition of translation. The suppressed downregulated proteins include ARAF, MEK1/2 and STAT3, causing the impaired signaling pathway related to HCC progression. Furthermore, based on the construction of a mutant 5'-tiRNA-Gln, the sequence of forming intramolecular G-quadruplex structure is crucial for 5'-tiRNA-Gln to strongly bind EIF4A1 and repress translation. Clinically, 5'-tiRNA-Gln expression level is negatively correlated with ARAF, MEK1/2, and STAT3 in HCC tissues. Collectively, these findings reveal that 5'-tiRJNA-Gln interacts with EIF4A1 to reduce related mRNA binding through the intramolecular G-quadruplex structure, and this process partially inhibits translation and HCC progression.
Humans ; Carcinoma, Hepatocellular/pathology* ; Liver Neoplasms/pathology* ; Eukaryotic Initiation Factor-4A/genetics* ; Cell Line ; RNA, Transfer/metabolism* ; RNA ; Cell Proliferation

BACKGROUND: The prevalence of hypertension is high among Chinese adults, thus, identifying non-hypertensive individuals at high risk for intervention will help to improve the efficiency of primary prevention strategies. METHODS: The cross-sectional data on 9699 participants aged 20 to 80 years were collected from the China National Health Survey in Gansu and Hebei provinces in 2016 to 2017, and they were nonrandomly split into the training set and validation set based on location. Multivariable logistic regression analysis was performed to develop the diagnostic prediction model, which was presented as a nomogram and a website with risk classification. Predictive performances of the model were evaluated using discrimination and calibration, and were further compared with a previously published model. Decision curve analysis was used to calculate the standardized net benefit for assessing the clinical usefulness of the model. RESULTS: The Lasso regression analysis identified the significant predictors of hypertension in the training set, and a diagnostic model was developed using logistic regression. A nomogram with risk classification was constructed to visualize the model, and a website ( https://chris-yu.shinyapps.io/hypertension_risk_prediction/ ) was developed to calculate the exact probabilities of hypertension. The model showed good discrimination and calibration, with the C-index of 0.789 (95% confidence interval [CI]: 0.768, 0.810) through internal validation and 0.829 (95% CI: 0.816, 0.842) through external validation. Decision curve analysis demonstrated that the model was clinically useful. The model had a higher area under receiver operating characteristic curves in training and validation sets compared with a previously published diagnostic model based on Northern China population. CONCLUSION This study developed and validated a diagnostic model for hypertension prediction in Gansu Province. A nomogram and a website were developed to make the model conveniently used to facilitate the individualized prediction of hypertension in the general population of Han and Yugur.
Adult ; Humans ; Asian People ; China/epidemiology* ; Cross-Sectional Studies ; Health Surveys ; Hypertension/epidemiology* ; Nomograms ; Ethnicity

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Objective Evaluation the effect to improve the eight-year program medical students` comprehensive ability between standard of PBL mode and complex scenarios PBL mode.Methods To comparative improved teaching quality between complex scenarios PBL teaching mode and standard of the PBL teaching mode by final exam scores and DREEM scale.Results The complex scenarios PBL teaching mode improve the ability of problem solving score significantly higher than the standard scores of PBL teaching mode at the start of analyzing questions and help students to stimulate interest, increase self-confidence, (P<0.05).Comparative analysis shows the comprehensive thinking ability of medical students has improved significantly.ConclusionsComplex scenarios PBL teaching mode can improve the ability of handling the students` study enthusiasm, comprehensive ability and strain capacity more effectively than that of standard PBL teaching mode.The obvious effect is worth promoting.

Objective To investigate the correlation between serum procalcitonin (PCT) levels and infection sites,as well as between PCT and bacterial species in gram negative (G-) bacteria induced sepsis,so as to provide rationale for therapeutic strategy of using antibiotic in sepsis.Methods The data of patients with sepsis admitted in Emergency Department and ICU from January 2014 to June 2015 were retrospectively analyzed.The blood culture of G-bacteria and PCT detection were carried out simultaneously within 24 hours after admission.The clinical data was analyzed to find out the correlation between PCT levels and infection sites,as well as between PCT levels and pathogenic bacterial species.Results A total of 187 specimens (came from 162 patients) were enrolled in the study with a median age of 70 years old and a median sequential organ failure assessment (SOFA) score of 4.PCT levels were found to be associated with bacterial species.PCT level caused by Escherichia coli bacteremia infection was higher than that caused by Acinetobacter baumannii bacteremia and Burkholderia cepacia bacteremia infection (4.62 ng/mL vs.2.44 ng/mL;4.62 ng/mL vs.0.81 ng/mL;P ＜ 0.05).Receiver operating characteristic (ROC) analysis showed an area under the curve (AUC) for PCT was 0.61 to discriminate Escherichia coli infection from Acinetobacter baumannii infection and an AUC was 0.66 to discriminate Escherichia coli infection from Burkholderia cepacia infection.When the cutoff point of PCT was 30.32 ng/mL,it could predict Escherichia coli infection rather than Acinetobacter baumannii infection with 94.10％ specificity,90.00％ positive predictive value and positive likelihood ratio for 4.24.When the cutoff point of PCT was 8.01 ng/mL,it could predict Escherichia coli infection rather than Burkholderia cepacia infection with 85.70％ specificity,93.94％ positive predictive value,and positive likelihood ratio for 3.01.When PCT cutoff value reached 47.31 ng/mL,the specificity and positive predictive value were both 100.00％.PCT level caused by urinary tract infection was higher than that caused by pulmonary infection (11.58 ng/mL vs.2.07 ng/mL,P ＜ 0.05),and the AUC was 0.69.When the cutoff point of PCT was 32.11 ng/mL,it could predict Escherichia coli infection rather than Acinetobacter baumannii infection with 90.60％ specificity,86.18％ negative predictive value and positive likelihood ratio for 3.68.Conclusions PCT elevation in G-bacteria induced sepsis might be associated with infection sites and bacterial species.

Objective To investigate the value of early trophic feeding on maintenance of the integrity of intestinal mucosa barrier in severe traumatic patients.Methods The seriously traumatic patients were eligible for enrollment to this study from January 1st,2014 to March 31st,2015 in the intensive care unit of Xiangcheng People's Hospital.All patients were randomly divided into early enteral nutrition (EEN)group and the control group.Within 12 to 24 hours after ICU admission,all patients were fed on enteral nutrition.In the EEN group,the nutrient was reached to 25％ of target nutrient amount [104.6 kJ/ (kg · d)],and in the control group,the nutrition was reached to 60％ of the target nutrient amount.Comparisons of feeding intolerance,incidence of newly developed lung infection,the total length of hospital stay,ICU medical costs,and the markers of mucosa barrier function including lactulose/mannitol ratios (L/M),serum lactic acid level,and diamine oxidase (the first day,the third day and the seventh day) between two groups were carried out.Results Of them,56 patients were treated with early enteral nutrition.Early enteral feeding intolerance and ICU associated infection complications were significantly lower in EEN group than those in control group (P =0.012,P =0.046).There were no significant differences in ICU associated infection complications,the length of ICU stay,the length of hospital stay,ICU medical costs,L/M ratios,D-lactic acid level and diamine oxidase concentration between the two groups (P=0.135,P=0.126,P =0.223,P =0.235).Conclusions Under the seriously traumatic stress,the significantly increased intestinal mucosal permeability will be occurred early.In patients with early trophic feeding,the intestinal mucous membrane barrier function can be improved,thus decreasing ICU associated infection complications and incidence of feeding intolerance.

ObjectiveTo study the effect of group interpersonal psychotherapy (IPT-G) on depression disorder of college students abused in childhood.Methods 28 college students meeting criteria of DSM-Ⅳ for depression disorder were divided into two groups:the treatment group( 14 patients)and the control group (14 patients).The treatment group was treated with IPT-G.Depression Symptom Checklist and Global Assessment Function(GAF) were measured in two groups before and after treatment.Results ①Patients in treatment group had better efficacy than those in control group( 100％ vs 57.1％,x2 =7.636,P ＜ 0.01 ).②The treatment factor and time factor had main effect to depression symptom and GAF(F =4.23 ～ 184.93,P ＜ 0.05 ),also had interaction effect(F=15.87 ～82.36,P ＜ 0.01 ).Time factor and abuse factor had main effect to depression symptom and GAF(F =7.44 ～ 183.9,P ＜ 0.05 ),but no interaction effect (F =0.01 ～ 4.72,P ＞ 0.05 ).③IPT-G,depression symptom and quality of life before treatment,age and only children had remarkable predictable functions on depression symptom(P ＜ 0.05).IPT-G had striking predictable functions on GAF (P ＜ 0.01 ).ConclusionIPT-G can improve depression symptom,mental and Social Function,while childhood abuse has no effect.

Objective To discuss the metabolic characteristics and significance of peripheral blood cell and T lymphocyte subgroup in patients with air condition disease.Methods Thirty-six patients diagnosed as air condition diseases with fever and 30 patients diagnosed as non-fever patients enrolled this study as observation group(fever group and non-fever group respectively),and 30 health population were used as control.The changes of peripheral blood cell and T lymphocyte was measured using regular blood examination and flow cytometry.Results(1)No significant diffence on white blood cell was found between the three groups(F =1.89,P =0.134);(2)The percentage of neutrophils was(68.13 ±5.67)％,(53.24 ±8.36)％ and(61.25 ±6.31)％ respectively in the fever,non-fever and control group,respectively.Compared to the non-fever and control group,the percentage of neutrophils were significantly higher(t =6.64,9.13; P =0.018,0.027 respectively).No signiciant difference in the percentage of neutrophils was found between the non-fever group and control group(P =0.356,0.125).The percentage of lymphocyte percentage was(31.66 ±7.11)％,in the fever group,which was significantly higher than those of(43.67 ±8.17)％ and(30.98 ± 8.76)％ in the nonfever and control group(t =5.59,4.98 ; P =0.022,0.021 respectively).(3)The percentage of CD4 + was (36.351 ± 6.531)％,(42.676 ± 5.169)％ and(39.253 ± 5.461)％ in the fever,non-fever and control group,respectively.The percentage of CD4 + in the fever group was significantly lower than that in the non-fever group(t =1.28,P =0.039),whereas the percentage of CD4 + in the non-fever group was significantly higher than that in the control group(t =3.80,P =0.048).The percentage of CD8 + was(28.084 ± 7.344)％,(21.186 ± 6.331)％ and(24.607 ± 7.108)％,respectively.Compared to nonfever group,the percentage of CD8+ was significantly higher(t =3.17,P =0.016).(4)The ratio of CD4 +/CD8 + was(1.629 ±0.554)％、(2.380 ± 0.391)％,and(2.079 ± 0.659)％.Compared to the non-fever and control group,the ration in the fever group was siginificantly lower(t =19.21,P ＜ 0.001 ; t =6.98 ; P =0.006),whereas compared to the control group,the ratio in the non-fever group was significantly higher(t =8.68,P =0.031).Conclusion The changes of T subgroup show the unbalance immunity function network in patients with air condition disease.

A new technique was developed to fabricate PDLLA and PDLLA/PELA composite scaffolds by thermally induced phase separation in combination, with particulate-leaching. Effects of PDLLA/PELA ratio, PEG/PLA ratio and PEG molecular weight on properties of mechanics, degradation behavior and cell toxicity as well as morphological properties were investigated. As the result showed, by thermally induced phase separation/ particulate-leaching, a unique morphology that macropores (100-250 microm) and micropores (5-40 microm)coexisted in the scaffold was obtained. An increase of PEG content or a decrease of PEG molecular weight raised the porosity of the scaffold. A decrease of PDLLA/PELA ratio or an increase of PEG/PLA ratio weakened mechanical properties and accelerated the degradation of the scaffold. PDLLA and PDLLA/PELA scaffolds didn't show cell toxicity. When PDLLA/PELA ratio was 3:1 and PEG5000/PLA ratio was 25:75, the scaffold got a regular, highly interconnected, macro-co-micro porous structure.
Biocompatible Materials ; chemistry ; Lactates ; chemistry ; Lactic Acid ; chemistry ; Polyesters ; Polyethylene Glycols ; chemistry ; Polyglycolic Acid ; chemistry ; Polymers ; chemistry ; Porosity ; Surface Properties ; Tissue Engineering ; methods ; Tissue Scaffolds ; chemistry ; Water ; chemistry