1.Ameliorating Effect of Yifei Tongluo Prescription on Bleomycin-induced Pulmonary Fibrosis in Rats via Regulating NLRP3/Caspase-1/GSDMD Signaling Pathway and Epithelial-mesenchymal Transition
Bowen ZHOU ; Zefeng LI ; Xian MA ; Xuannian LI ; Jingwen WANG ; Fei XU ; Huaman LIU ; Xinhua JIA
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):150-159
ObjectiveTo observe the effects of Yifei Tongluo prescription on the NOD-like receptor protein 3 (NLRP3)/Caspase-1/gasdermin D (GSDMD) pathway and epithelial-mesenchymal transition (EMT) in rats with pulmonary fibrosis. MethodsTracheal instillation of bleomycin was conducted to establish a rat model of pulmonary fibrosis. Thirty Sprague-Dawley (SD) rats were randomly divided into a blank group, a model group, a prednisone acetate group (1.17 mg·kg-1), and low- and high-dose Yifei Tongluo prescription groups (10.62 and 21.24 g·kg-1, respectively). Administration started on the 7th day after modeling, once a day for 28 consecutive days. The lung coefficient of each group was calculated. The pathological changes of lung tissues in each group were observed by hematoxylin-eosin (HE) staining and Masson staining. The expression of α-smooth muscle actin (α-SMA) and vimentin in rat lung tissues was detected by immunohistochemistry. The expression of NLRP3 inflammasome, E-cadherin (E-cad), and typeⅠ collagen (ColⅠ) in lung tissues was detected by immunofluorescence. The content of hydroxyproline (HYP), tumor necrosis factor (TNF)-α, interleukin (IL)-18, and IL-1β in rat serum was detected by enzyme-linked immunosorbent assay (ELISA). The mRNA expression levels of NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), IL-1β, and transforming growth factor (TGF)-β1 in rat lung tissues were determined by real-time quantitative polymerase chain reaction (Real-time PCR). The protein expression levels of NLRP3, GSDMD, ASC, and Caspase-1 in rat lung tissues were determined by Western blot. ResultsCompared with the blank group, the model group exhibited a significantly increased lung coefficient (P<0.01) and significantly increased range of pulmonary interstitial inflammation and collagen deposition. In addition, the levels of α-SMA, Vimentin, E-cad, and ColⅠ in lung tissues were significantly increased (P<0.01). The levels of fibrosis- and inflammation-related factors HYP, TNF-α, IL-18, and IL-1β in serum were significantly upregulated (P<0.01). The levels of factors related to the activation of NLRP3 inflammasome in lung tissues, including NLRP3, GSDMD, ASC, Caspase-1, IL-1β, and TGF-β1, were significantly upregulated (P<0.01). Compared with the model group, the Yifei Tongluo prescription groups showed improved lung coefficients. Additionally, the extent of lung inflammation and collagen deposition was significantly reduced. The expression of α-SMA, Vimentin, E-cad, and ColⅠ in lung tissue was significantly decreased (P<0.01). The levels of HYP, TNF-α, IL-18, and IL-1β in serum were significantly reduced (P<0.01). The expression levels of NLRP3, GSDMD, ASC, Caspase-1, IL-1β, and TGF-β1 in lung tissue were also significantly decreased (P<0.01). ConclusionYifei Tongluo prescription can regulate the NLRP3/Caspase-1/GSDMD pathway, down-regulate release of pro-inflammatory and pro-fibrotic cytokines, alleviate NLRP3 inflammasome-mediated pyroptosis and EMT, and thereby improve pulmonary fibrosis in rats.
2.Mechanisms of Anemarrhenae Rhizoma Water Extract in Ameliorating Neuroinflammation in Alzheimer's Disease Model Rats via SIRT1/HMGB1/NF-κB Signaling Pathway
Fei WU ; Yuexia LI ; Qi HUANG ; Tianshi LI ; Chuanshan JIN ; Kai MA
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):230-240
ObjectiveTo investigate the therapeutic effects of the Anemarrhenae Rhizoma water extract (AR) on Alzheimer's disease (AD) model rats and to explore its potential underlying mechanisms. MethodsMale rats were intraperitoneally injected with D-galactose (100 mg·kg-1) for 42 days, and on day 14, 1 μL of β-amyloid (Aβ25-35, 2 g·L-1) solution was injected into the hippocampus. Rats were randomly divided into a model group, low-dose AR (0.6 g·kg-1), medium-dose AR (1.2 g·kg-1), high-dose AR (2.4 g·kg-1), and a positive control group (donepezil, 5 mg·kg-1). Healthy rats receiving only a hippocampal injection of 1 μL of sterile saline served as the sham-operated group. From day 21, rats in the treatment groups were administered the corresponding drugs by gavage once daily for 21 consecutive days, while the blank control and model groups received an equal volume of saline. Learning and memory abilities were assessed using the Morris water maze. Brain tissue damage was observed by hematoxylin and eosin (HE) staining, and neuronal apoptosis was evaluated by terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) staining. Levels of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and interleukin-10 (IL-10) in brain tissues were measured by enzyme-linked immunosorbent assay (ELISA). BV2 microglial cells were co-cultured with Aβ25-35 (40 μmol·L-1) for 2 h, and cell viability was determined by the CCK-8 assay to screen the optimal concentration of AR-containing serum (S-AR). Cells were divided into blank control, Aβ25-35, S-AR, EX527 [silent information regulator 1 (SIRT1) inhibitor], and S-AR+EX527 groups. Immunofluorescence staining was used to detect the expression of CD16, CD206, and high-mobility group box 1 (HMGB1). Western blot analysis was performed to measure the protein expression of CD16, inducible nitric oxide synthase (iNOS), CD206, arginase (Arg), and proteins related to the SIRT1/HMGB1/nuclear factor-κB (NF-κB) signaling pathway. ResultsIn vivo experiments showed that, compared with the sham-operated group, the model group exhibited reduced platform crossings and time spent in the target quadrant (P<0.01), prolonged escape latency, increased hippocampal neuronal apoptosis (P<0.01), and obvious hippocampal damage. The expression levels of IL-6, TNF-α, IL-10, CD16, and iNOS in brain tissues were significantly elevated (P<0.01), while CD206 and Arg protein expression showed an increasing trend without statistical significance. Compared with the model group, all AR-treated groups significantly increased platform crossings and target quadrant time (P<0.05, P<0.01), alleviated hippocampal damage, reduced escape latency and neuronal apoptosis, downregulated the expression of TNF-α, IL-6, CD16, and iNOS (P<0.05, P<0.01), and upregulated the expression of IL-10, CD206 and Arg (P<0.05, P<0.01). In vitro experiments demonstrated that, compared with the blank control group, the Aβ25-35 group showed increased fluorescence intensity of CD206, CD16, and HMGB1, as well as elevated protein expression of iNOS and CD16 (P<0.01), while CD206 and Arg protein expression exhibited an increasing trend without statistical significance. After S-AR intervention, CD206 fluorescence intensity and the protein expression of Arg and CD206 were significantly increased (P<0.01), whereas the fluorescence intensity of CD16 and HMGB1 and the protein expression of iNOS and CD16 were significantly decreased (P<0.01). These effects were reversed by EX527 (P<0.05, P<0.01). Furthermore, compared with the blank control group, the Aβ25-35 group showed significantly increased cytoplasmic HMGB1 expression and p-p65/p65 ratio (P<0.01), along with significantly decreased SIRT1 and nuclear HMGB1 expression (P<0.01). In contrast, the S-AR group exhibited opposite trends compared with the Aβ25-35 group, and the regulatory effects of S-AR on these proteins were reversed by EX527 (P<0.01). ConclusionAR exerts neuroprotective effects in AD model rats by regulating microglial polarization and alleviating neuroinflammation, potentially through modulation of the SIRT1/HMGB1/NF-κB signaling pathway.
3.Relevant Mechanism of Traditional Chinese Medicine in Treatment of Hyperandrogenism in Polycystic Ovary Syndrome: A Review
Wenchen FAN ; Hui MA ; Yongfen DING ; Haotian MA ; Fei GAO ; Qiuyu LIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):306-317
Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder among women of reproductive age. Hyperandrogenism (HA), one of its core pathological features, is closely associated with the clinical manifestations and metabolic complications of the disease. Current western medical treatments for PCOS-HA mainly include anti-androgen therapy and ovulation induction, such as short-acting oral contraceptives like Diane-35 and Yasmin. However, long-term use of these medications may result in adverse reactions like increasing the risk of liver dysfunction and exacerbating lipid metabolism disorders, with unsatisfactory long-term efficacy when used alone. Traditional Chinese medicine offers unique advantages in the treatment of PCOS-HA due to its holistic approach and multi-target regulatory mechanisms. In the view of traditional Chinese medicine, PCOS-HA is classified under the categories such as "delayed menstruation", "amenorrhea", and "infertility", with kidney deficiency as the root, as well as liver stagnation and spleen deficiency as the manifestations. Phlegm and blood stasis are considered to be intertwined throughout the disease course. Modern studies have shown that traditional Chinese medicine is significantly effective in improving the androgen levels, restoring ovulation, and improving insulin resistance in PCOS-HA patients. Representative prescriptions, such as Erxian Tang, Jiawei Xiaoyaosan, Guizhi Fulingwan, and Cangfu Daotantang, exert therapeutic effects through various mechanisms including regulation of the hypothalamic-pituitary-ovarian axis, reduction of ovarian androgen synthase activity, improvement of insulin signaling pathways, and inhibition of inflammation and oxidative stress, which demonstrates the characteristics of comprehensive treatment with traditional Chinese medicine. Based on the perspectives of etiology and pathogenesis of traditional Chinese medicine, modern medical cognition, typical prescriptions, and action mechanisms, this paper reviewed the research progress of traditional Chinese medicine in the treatment of PCOS-HA, aiming to provide a reference for in-depth research and clinical applications in this field.
4.Relevant Mechanism of Traditional Chinese Medicine in Treatment of Hyperandrogenism in Polycystic Ovary Syndrome: A Review
Wenchen FAN ; Hui MA ; Yongfen DING ; Haotian MA ; Fei GAO ; Qiuyu LIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):306-317
Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder among women of reproductive age. Hyperandrogenism (HA), one of its core pathological features, is closely associated with the clinical manifestations and metabolic complications of the disease. Current western medical treatments for PCOS-HA mainly include anti-androgen therapy and ovulation induction, such as short-acting oral contraceptives like Diane-35 and Yasmin. However, long-term use of these medications may result in adverse reactions like increasing the risk of liver dysfunction and exacerbating lipid metabolism disorders, with unsatisfactory long-term efficacy when used alone. Traditional Chinese medicine offers unique advantages in the treatment of PCOS-HA due to its holistic approach and multi-target regulatory mechanisms. In the view of traditional Chinese medicine, PCOS-HA is classified under the categories such as "delayed menstruation", "amenorrhea", and "infertility", with kidney deficiency as the root, as well as liver stagnation and spleen deficiency as the manifestations. Phlegm and blood stasis are considered to be intertwined throughout the disease course. Modern studies have shown that traditional Chinese medicine is significantly effective in improving the androgen levels, restoring ovulation, and improving insulin resistance in PCOS-HA patients. Representative prescriptions, such as Erxian Tang, Jiawei Xiaoyaosan, Guizhi Fulingwan, and Cangfu Daotantang, exert therapeutic effects through various mechanisms including regulation of the hypothalamic-pituitary-ovarian axis, reduction of ovarian androgen synthase activity, improvement of insulin signaling pathways, and inhibition of inflammation and oxidative stress, which demonstrates the characteristics of comprehensive treatment with traditional Chinese medicine. Based on the perspectives of etiology and pathogenesis of traditional Chinese medicine, modern medical cognition, typical prescriptions, and action mechanisms, this paper reviewed the research progress of traditional Chinese medicine in the treatment of PCOS-HA, aiming to provide a reference for in-depth research and clinical applications in this field.
5.Effect of different exercise interventions on patients with metabolic dysfunction-associated fatty liver disease: A systematic review and network Meta-analysis
Guodong MA ; Zhuojing SUN ; Song HU ; Zijun YE ; Mingchen MA ; Fei CUI ; Jiaju ZHU
Journal of Clinical Hepatology 2026;42(2):326-344
ObjectiveTo investigate the effect of different exercise interventions on metabolism and liver parameters in patients with metabolic dysfunction-associated fatty liver disease (MAFLD), and to provide evidence-based recommendations for clinical exercise rehabilitation. MethodsThis study was conducted according to the PRISMA guidelines, and the protocol was registered on the PROSPERO platform, with a registration number of CRD42025641717. PubMed, Web of Science, Scopus, Wiley Online Library, CNKI, Wanfang Data, and VIP were searched for related articles published up to September 2024. The Cochrane tool for assessing risk of bias was used to assess the quality of articles, and Stata MP 17.0 was used to perform the network meta-analysis. ResultsA total of 57 articles were included, involving 2 648 patients. The results showed that aerobic exercise combined with resistance exercise had the best effect in improving body mass index (mean difference [WMD]=-0.97, 95% confidence interval [CI]: -1.66 to -0.28], P<0.05, surface under the cumulative ranking curve [SUCRA]=85.4) and triglycerides (WMD=-29.6, 95%CI: -46.66 to 12.54, P<0.05, SUCRA=87.3); resistance exercise was the optimal intervention method for improving total cholesterol (WMD=-15.99, 95%CI: -24.19 to -7.79, P<0.05, SUCRA=79.9) and glutamine transaminase (WMD=-8.08, 95%CI: -12.13 to -4.02, P<0.05, SUCRA=87.3); low-intensity aerobic exercise had the best effect in improving aspartate aminotransferase (WMD=-4.3, 95%CI: -8.45 to -0.15, P<0.05, SUCRA=73.5), gamma-glutamyl transpeptidase (GGT) (WMD=-3.26, 95%CI: -7.79 to 1.27, P>0.05, SUCRA=82.3), and glycated hemoglobin (HbA1c) (WMD=-0.6, 95%CI: -2.02 to 0.82, P>0.05, SUCRA=78.8); moderate-intensity aerobic exercise was the optimal intervention modality to improve Homeostasis Model Assessment of Insulin Resistance (WMD=-0.92, 95%CI: -1.51 to -0.33, P<0.05, SUCRA=69.4). It should be noted that there were no significant differences in HbA1c and GGT across different exercise interventions (all P>0.05), suggesting that there was currently no sufficient statistical evidence to support that exercise could improve these two indicators. ConclusionBased on the comprehensive league table and cumulative probability ranking, aerobic exercise combined with resistance exercise, resistance exercise, and low- and moderate-intensity aerobic exercise may be the best exercise modality for improving key indicators in MAFLD patients, and targeted exercise modalities should be selected for intervention against different indicators; however, due to limitations of the original studies, further studies are needed for validation and exploration.
6.Analysis of risk factors for sodium valproate-induced hyperammonemia in neurocritical patients and construction of risk prediction model
Wan XU ; Jin WU ; Jiaojiao MAO ; Jingjing MA ; Yao FEI
China Pharmacy 2026;37(8):1039-1044
OBJECTIVE To investigate the risk factors for sodium valproate (VPA)-induced hyperammonemia in neurocritical patients, and to construct a risk prediction model. METHODS Clinical data were retrospectively collected from 172 neurocritical patients who received VPA treatment in the Department of Critical Care Medicine, the Fourth Affiliated Hospital of Soochow University from January 2022 to June 2025. Patients were divided into the hyperammonemia group (73 cases) and the normal group (99 cases) based on their blood ammonia levels. Univariate analysis and LASSO regression analysis were used to screen for predictive variables. Independent factors were identified through multivariate Logistic regression analysis, and a nomogram was constructed accordingly. The performance of the model was evaluated using receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). RESULTS Combination of univariate analysis and LASSO regression analysis screened out seven predictive variables: body mass index (BMI)≥24.0 kg/m 2 , concomitant use of benzodiazepines, VPA blood concentration, hemoglobin, serum urea, average daily VPA dose, and albumin. Multivariate Logistic regression analysis showed that concomitant use of benzodiazepines, BMI≥24.0 kg/m 2 , VPA blood concentration, albumin and serum urea level (with odds ratios of 1.615, 1.538, 1.623, 1.942 and 0.637, respectively; 95% confidence intervals of 1.128-2.359, 1.059-2.251, 1.112-2.431, 1.106-3.598 and 0.402-0.980, respectively) were all significantly associated with VPA-induced hyperammonemia in neurocritical patients ( P <0.05). The nomogram prediction model constructed based on these variables was evaluated, showing that the area under the ROC curve was 0.810 for the test set and 0.844 for the validation set. The calibration curves closely approximated t he actual curves, and the application of this model could improve the clinical net benefit. CONCLUSIONS Concomitant use of benzodiazepines, BMI≥24.0 kg/m 2 , high VPA blood concentration and high albumin level are independent risk factors for VPA-induced hyperammonemia in neurocritical patients, while high serum urea level is an independent protective factor. The risk prediction model constructed based on these factors exhibits good discrimination, consistency, and clinical applicability, making it applicable for predicting the risk of VPA-induced hyperammonemia in neurocritical patients.
7.Exploring CRISPR/Cas9 Technology for The Modernization of Traditional Chinese Medicine
Shu-Xian WANG ; Fei-Fei GUO ; Guang-Qiang MA
Progress in Biochemistry and Biophysics 2026;53(4):1000-1014
The clustered regularly interspaced short palindromic repeats (CRISPR)/associated protein 9 (CRISPR /Cas9) immune system is an adaptive immune system widely distributed in bacteria and archaea. It precisely defends against invasion by exogenous phages, viruses, and plasmids through sequence-specific endogenous immune response mechanisms. As the most prominent member of this family, the CRISPR/Cas9 system has evolved into the most widely applied, flexible, and efficient technical platform in the field of genome engineering due to its exceptional genome modification capabilities. Within the CRISPR/Cas9 system, the Cas9 protein, precisely guided by a single-stranded guide RNA (gRNA), can specifically recognize target DNA sequences and induce double-strand breaks. This activates the cell’s DNA repair mechanisms, enabling gene knockout, knock-in, or modification. Demonstrating significant advantages in specificity, flexibility, and operability, CRISPR/Cas9 technology has shown immense potential in the medical field, opening new avenues for modernizing traditional Chinese medicine (TCM) research. On one hand, this technology can be used to construct precise disease models and tailor personalized treatment plans. It enables in-depth elucidation of the molecular mechanisms underlying the action targets and signaling pathways of TCM formulas and active components, thereby unraveling the scientific secrets of their complex mechanisms of action. On the other hand, it demonstrates powerful tool value in improving TCM germplasm resources, identifying and screening superior varieties, evaluating the controllability of TCM quality, and producing innovative drugs, providing technical support for the standardization and precision of TCM. Simultaneously, the high-throughput omics data generated by CRISPR technology is driving artificial intelligence (AI) to construct virtual disease models and drug prediction systems. This empowers the intelligent screening of effective TCM components, the precise prediction of potential targets, and the exploration of “reducing toxicity while enhancing efficacy” through formula combinations. This synergistic innovation between CRISPR and AI aligns perfectly with precision medicine’s urgent demand for personalized, efficient drug development, injecting new momentum into the modernization and transformation of TCM. This paper first systematically reviews and explains the developmental trajectory, structural basis, and action mechanisms of the CRISPR/Cas9 system, tracing its scientific evolution from a bacterial immune system to a gene-editing tool. It then comprehensively outlines the current state of convergence between precision medicine concepts and modernization research in TCM, analyzing the synergistic points and potential spaces for their integration. Against the backdrop of rapid precision medicine advancement, this paper emphasizes how CRISPR/Cas9 gene editing technology empowers in-depth analysis of TCM mechanisms—including specific applications in disease model construction, therapeutic target validation, and multi-target network regulation studies. It further elaborates on its multidimensional practical contributions to modernizing TCM, spanning key domains such as germplasm resource innovation, bioactive compound biosynthesis, quality standardization control, and novel TCM drug development. Finally, this paper envisions the future landscape of deep integration between CRISPR technology and AI: from data-driven intelligent drug screening to high-throughput precision discovery of effective TCM components, and further to intelligent model construction based on “reducing toxicity while enhancing efficacy” mechanisms. The synergistic convergence of these multidimensional technologies will pioneer new scientific paradigms and translational pathways for TCM modernization, propelling TCM toward leapfrogging development in the era of precision medicine.
8.Correlation Between the Spinopelvic Parameters and Morphological Characteristics of Pedicle-Facet Joints in Different Lumbar Spondylolisthesis
Baoqiang HE ; Yebo LENG ; Shicai XU ; Yang LI ; Jiajun ZHOU ; Min KANG ; Yehui LIAO ; Minghao TIAN ; Qiang TANG ; Fei MA ; Qing WANG ; Chao TANG ; Dejun ZHONG
Neurospine 2025;22(1):231-242
Objective:
Based on spinopelvic parameters and biomechanical principles, the pedicle-facet joint (PFJ) morphological characteristics of isthmic and degenerative spondylolisthesis were analyzed, and the mechanism of their onset and progression was discussed.
Methods:
This retrospective cross-sectional study included 194 patients with L5 spondylolysis or L5–S1 low-grade isthmic spondylolisthesis (IS group), 172 patients with L4–5 degenerative spondylolisthesis (DS group), and 366 patients with nonlumbar spondylolysis (NL group). The spinopelvic parameters and PFJ morphological parameters of the patients were measured, the differences in these parameters among and within the 3 groups were compared, and the correlations were analyzed.
Results:
Sacral slope (SS) and lumbar lordosis (LL) were the highest in the IS group, the second highest in the DS group, and the lowest in the NL group. Among the 3 groups, the L4 facet joint angle (FJA) was the largest in the IS group, the second largest in the NL group, and the smallest in the DS group. The L4 pedicle-facet joint angle (PFA) was the largest in the DS group, the second largest in the IS group, and the smallest in the NL group. Pearson correlation analysis showed that within each group, SS and LL were negatively correlated with FJA and positively correlated with PFA.
Conclusion
This study found a correlation between the PFJ morphological characteristics of patients with lumbar spondylolisthesis and spinopelvic parameters, suggesting that the morphological characteristics of PFJs may be caused by varying stresses under different spinopelvic morphologies.
9.Arthroscopic one-stage direct suture technique for treating anterior cruciate ligament injury combined with anterior meniscus root injury.
Wentao XIONG ; Fei ZHANG ; Yang LIU ; Jipeng MA ; Qiang ZHANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(10):1276-1284
OBJECTIVE:
To investigate the effectiveness of one-stage direct suture technique under arthroscopy for the treatment of anterior cruciate ligament (ACL) injury combined with anterior meniscus root injury.
METHODS:
The clinical data of 9 patients with ACL injury or tibial intercondylar eminence fracture combined with anterior meniscus root injury who were admitted between September 2017 and September 2024 and met the selection criteria were retrospectively analyzed. There were 3 males and 6 females, aged 21-62 years, with an average age of 37.1 years. The time from injury to surgery ranged from 5 days to 5 years, with a median time of 40 days. Among them, 5 cases had ACL injury, including 4 cases of type 1 and 1 case of type 2 according to modified Sherman classification; 4 cases had tibial intercondylar eminence fracture, including 3 cases of type 3 and 1 case of type 2 according to Meyers-McKeever classification. There were 7 cases of anterior root injury of lateral meniscus and 2 cases of anterior root injury of medial meniscus. The preoperative International Knee Documentation Committee (IKDC) score was 45.0±12.3, and Lysholm score was 49.2±12.4. Preoperatively, 7 cases were positive in anterior drawer test, Lachman test, and McMurray test, while 2 cases could not complete the test due to pain limitation. Preoperatively and at last follow-up, IKDC score and Lysholm score were used to evaluate knee joint function, anterior drawer test and Lachman test were used to evaluate knee joint stability, and McMurray test was used to evaluate meniscus condition.
RESULTS:
The operation time was 30-100 minutes, with an average of 64.2 minutes; the total hospital stay was 2-12 days, with an average of 4.5 days; the postoperative hospital stay was 1-4 days, with an average of 1.8 days. All incisions healed by first intention without surgery-related complications. All 9 patients were followed up 2-30 months, with an average of 18.8 months. No internal fixation-related complications occurred during follow-up. At last follow-up, MRI review showed good ligament tension, and CT showed good fracture healing. The results of anterior drawer test and Lachman test were all negative. McMurray test was negative in all cases. The IKDC score was 88.3±5.1, and Lysholm score was 88.3±5.6, both showing significant improvement compared to preoperative scores ( t=14.001, P<0.001; t=10.192, P<0.001).
CONCLUSION
One-stage direct suture technique under arthroscopy for repairing ACL injury or tibial intercondylar eminence fracture combined with anterior meniscus root injury can achieve good effectiveness without fixation device-related complications.
Humans
;
Adult
;
Male
;
Female
;
Arthroscopy/methods*
;
Middle Aged
;
Anterior Cruciate Ligament Injuries/surgery*
;
Tibial Meniscus Injuries/surgery*
;
Retrospective Studies
;
Suture Techniques
;
Young Adult
;
Treatment Outcome
;
Tibial Fractures/surgery*
;
Anterior Cruciate Ligament Reconstruction/methods*
;
Menisci, Tibial/surgery*
10.Analysis of risk factors, pathogenic bacteria characteristics, and drug resistance of postoperative surgical site infection in adults with limb fractures.
Yan-Jun WANG ; Zi-Hou ZHAO ; Shuai-Kun LU ; Guo-Liang WANG ; Shan-Jin MA ; Lin-Hu WANG ; Hao GAO ; Jun REN ; Zhong-Wei AN ; Cong-Xiao FU ; Yong ZHANG ; Wen LUO ; Yun-Fei ZHANG
Chinese Journal of Traumatology 2025;28(4):241-251
PURPOSE:
We carried out the study aiming to explore and analyze the risk factors, the distribution of pathogenic bacteria, and their antibiotic-resistance characteristics influencing the occurrence of surgical site infection (SSI), to provide valuable assistance for reducing the incidence of SSI after traumatic fracture surgery.
METHODS:
A retrospective case-control study enrolling 3978 participants from January 2015 to December 2019 receiving surgical treatment for traumatic fractures was conducted at Tangdu Hospital of Air Force Medical University. Baseline data, demographic characteristics, lifestyles, variables related to surgical treatment, and pathogen culture were harvested and analyzed. Univariate analyses and multivariate logistic regression analyses were used to reveal the independent risk factors of SSI. A bacterial distribution histogram and drug-sensitive heat map were drawn to describe the pathogenic characteristics.
RESULTS:
Included 3978 patients 138 of them developed SSI with an incidence rate of 3.47% postoperatively. By logistic regression analysis, we found that variables such as gender (males) (odds ratio (OR) = 2.012, 95% confidence interval (CI): 1.235 - 3.278, p = 0.005), diabetes mellitus (OR = 5.848, 95% CI: 3.513 - 9.736, p < 0.001), hypoproteinemia (OR = 3.400, 95% CI: 1.280 - 9.031, p = 0.014), underlying disease (OR = 5.398, 95% CI: 2.343 - 12.438, p < 0.001), hormonotherapy (OR = 11.718, 95% CI: 6.269 - 21.903, p < 0.001), open fracture (OR = 29.377, 95% CI: 9.944 - 86.784, p < 0.001), and intraoperative transfusion (OR = 2.664, 95% CI: 1.572 - 4.515, p < 0.001) were independent risk factors for SSI, while, aged over 59 years (OR = 0.132, 95% CI: 0.059 - 0.296, p < 0.001), prophylactic antibiotics use (OR = 0.082, 95% CI: 0.042 - 0.164, p < 0.001) and vacuum sealing drainage use (OR = 0.036, 95% CI: 0.010 - 0.129, p < 0.001) were protective factors. Pathogens results showed that 301 strains of 38 species of bacteria were harvested, among which 178 (59.1%) strains were Gram-positive bacteria, and 123 (40.9%) strains were Gram-negative bacteria. Staphylococcus aureus (108, 60.7%) and Enterobacter cloacae (38, 30.9%) accounted for the largest proportion. The susceptibility of Gram-positive bacteria to Vancomycin and Linezolid was almost 100%. The susceptibility of Gram-negative bacteria to Imipenem, Amikacin, and Meropenem exceeded 73%.
CONCLUSION
Orthopedic surgeons need to develop appropriate surgical plans based on the risk factors and protective factors associated with postoperative SSI to reduce its occurrence. Meanwhile, it is recommended to strengthen blood glucose control in the early stage of admission and for surgeons to be cautious and scientific when choosing antibiotic therapy in clinical practice.
Humans
;
Surgical Wound Infection/epidemiology*
;
Male
;
Female
;
Risk Factors
;
Retrospective Studies
;
Middle Aged
;
Adult
;
Case-Control Studies
;
Fractures, Bone/surgery*
;
Aged
;
Drug Resistance, Bacterial
;
Logistic Models
;
Anti-Bacterial Agents/therapeutic use*
;
Incidence
;
Bacteria/drug effects*

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