Objective:To compare the therapeutic efficacy of the dual anteromedial and anterolateral approaches versus that of the anterior midline approach in the treatment of Wahlquist type C medial tibial plateau fractures accompanied by posterior column collapse.Methods:A retrospective study was conducted to analyze the 21 patients who had been treated for Wahlquist type C medial tibial plateau fractures plus posterior column collapse at The Fourth Orthopedic Ward, The 72nd Group Army Hospital of PLA between January 2019 and August 2023. The cohort included 13 males and 8 females, with an age of (43.3±6.7) years. The left side was involved in 14 fractures and the right side in 7 ones. The patients were divided into 2 groups based on their surgical approaches: a dual-approach group ( n=13) undergoing fixation via the dual anteromedial and anterolateral approaches, and a single-approach group ( n=8) undergoing fixation via the anterior midline approach. Comparative parameters included operative time, intraoperative blood loss, fracture healing time, quality of fracture reduction, medial proximal tibial angle (MPTA), incision complications, postoperative bone mass reduction quality (evaluated according to the Rasmussen anatomical criteria for tibial condyle fracture reduction), lateral tibial plateau instability, incidence of genu varum, and post-traumatic arthritis. Functional recovery of the lower limb joints was assessed at the final follow-up using the Merchant criteria. Results:No statistically significant differences were observed in the baseline characteristics between the 2 groups preoperatively, indicating comparability ( P>0.05). All patients were followed up for a mean duration of (38.1±11.3) months. The postoperative MPTA in the dual-approach group (86.8°±0.8°) was significantly larger than that in the single-approach group (85.5°±0.9°) ( P<0.05). Genu varum occurred in 1 patient in the dual-approach group and in 4 patients in the single-approach group, while lateral tibial plateau instability was observed in 1 patient in the dual-approach group and in 4 patients in the single-approach group, showing statistically significant differences between the 2 groups ( P<0.05). No statistically significant differences were found between the 2 groups regarding operative time, intraoperative blood loss, fracture healing time, quality of fracture reduction, incidence of incision complications, or incidence of post-traumatic arthritis ( P>0.05). At the final follow-up, no statistically significant difference was observed in the functional recovery of the lower limb joints assessed by the Merchant criteria between the 2 groups ( P>0.05). Conclusion:In the treatment of Wahlquist type C medial tibial plateau fractures accompanied by posterior column collapse, compared with the single anterior midline approach, the dual anteromedial and anterolateral approaches can restore more effectively the MPTA, and reduce the incidences of genu varum and lateral tibial plateau instability.

Objective To explore the clinical efficacy and safety of single-port laparoscopic ovarian cyst removal surgery.Methods A total of 145 patients who underwent laparoscopic surgery for ovarian cyst in Wenzhou People's Hospital from January 2023 to June 2024.Among them,single-port laparoscopic ovarian cystectomy+oophoroplasty was performed in 67 cases as single-port group,and traditional multi-port laparoscopic ovarian cystectomy+oophoroplasty was performed in 78 cases as multi-port group.Clinical indicators during and after surgery in two groups were recorded and compared.Results There were significant difference the operation time and pain scores at 1 day after surgery between two groups(P＜0.05).There was no significant difference in intraoperative bleeding,postoperative exhaust time and postoperative hospitalization time between two groups(P＞0.05).Neither of two groups had intraoperative vascular or nerve damage in the abdominal wall,and there were no postoperative complications such as incision infection,intestinal obstruction,or lower limb venous thrombosis,and the incision healed well.Continuing the follow-up for 3 months after discharge,both surgical procedures had no significant effect on menstruation,and there was no short-term recurrence of ovarian cyst in either case.Conclusion The single-port laparoscopic technique for the treatment of ovarian cyst incision is concealed and beautiful,the postoperative pain is lighter.No obvious effect on menstruation,and the curative effect is definite and safe.

Objective:To investigate impact of farrerol(Far)on LPS-induced microglial inflammatory injury by regulating cyclic guanosine monophosphate-adenosine monophosphate synthase(cGAS)-stimulator of interferon genes(STING)signal pathway.Methods:Mice BV2 microglial cell lines were grouped into control group(normal culture),LPS group(1 μg/ml),Far low,medium and high doses groups(1,5,10 μmol/L),activator group(10 μmol/L Far+75 μg/ml cGAS-STING signal pathway activator DMX-AA);proliferation and apoptosis of BV2 cells were detected by MTT,plate cloning assay and flow cytometry;qRT-PCR and ELISA were applied to detect levels of IL-6,IL-1β and TNF-α in cells and supernatants;NO content in cell supernatant was detected by nitrate reductase method;Western blot was applied to detect expressions of proliferating cell nuclear antigen(PCNA),Bcl-2 associated X protein(Bax),anti-apoptotic factor B cell lymphoma protein-2(Bcl-2)and cGAS-STING pathway protein in BV2 cells.Results:Compared with control group,A490 of BV2 cells,number of cloned cells,expressions of PCNA and Bcl-2 proteins in LPS group were decreased,apoptosis rate,mRNA expressions of IL-6,IL-1β,TNF-α,contents of IL-6,IL-1β,TNF-α,NO,and protein expres-sions of Bax,cGAS and STING were increased(P<0.05);compared with LPS group,A490 of BV2 cells,number of cloned cells,expressions of PCNA and Bcl-2 proteins in Far low,medium and high dose groups were increased,apoptosis rate,mRNA expressions of IL-6, IL-1β, TNF-α, contents of IL-6, IL-1β, TNF-α, NO, and protein expressions of Bax, cGAS and STING were decreased (P<0.05); compared with Far high-dose group, A490 of BV2 cells, number of cloned cells, expressions of PCNA and Bcl-2 proteins in activator group were decreased, apoptosis rate, mRNA expressions of IL-6, IL-1β, TNF-α, contents of IL-6, IL-1β, TNF-α, NO, and protein expressions of Bax, cGAS and STING were increased (P<0.05).Conclusion:Far may inhibit apoptosis and inflammatory injury of BV2 cells and promote proliferation of BV2 cells by inhibiting cGAS-STING pathway, and thus alleviate inflammatory injury of BV2 cells induced by LPS.

Objective:To investigate impact of farrerol(Far)on LPS-induced microglial inflammatory injury by regulating cyclic guanosine monophosphate-adenosine monophosphate synthase(cGAS)-stimulator of interferon genes(STING)signal pathway.Methods:Mice BV2 microglial cell lines were grouped into control group(normal culture),LPS group(1 μg/ml),Far low,medium and high doses groups(1,5,10 μmol/L),activator group(10 μmol/L Far+75 μg/ml cGAS-STING signal pathway activator DMX-AA);proliferation and apoptosis of BV2 cells were detected by MTT,plate cloning assay and flow cytometry;qRT-PCR and ELISA were applied to detect levels of IL-6,IL-1β and TNF-α in cells and supernatants;NO content in cell supernatant was detected by nitrate reductase method;Western blot was applied to detect expressions of proliferating cell nuclear antigen(PCNA),Bcl-2 associated X protein(Bax),anti-apoptotic factor B cell lymphoma protein-2(Bcl-2)and cGAS-STING pathway protein in BV2 cells.Results:Compared with control group,A490 of BV2 cells,number of cloned cells,expressions of PCNA and Bcl-2 proteins in LPS group were decreased,apoptosis rate,mRNA expressions of IL-6,IL-1β,TNF-α,contents of IL-6,IL-1β,TNF-α,NO,and protein expres-sions of Bax,cGAS and STING were increased(P<0.05);compared with LPS group,A490 of BV2 cells,number of cloned cells,expressions of PCNA and Bcl-2 proteins in Far low,medium and high dose groups were increased,apoptosis rate,mRNA expressions of IL-6, IL-1β, TNF-α, contents of IL-6, IL-1β, TNF-α, NO, and protein expressions of Bax, cGAS and STING were decreased (P<0.05); compared with Far high-dose group, A490 of BV2 cells, number of cloned cells, expressions of PCNA and Bcl-2 proteins in activator group were decreased, apoptosis rate, mRNA expressions of IL-6, IL-1β, TNF-α, contents of IL-6, IL-1β, TNF-α, NO, and protein expressions of Bax, cGAS and STING were increased (P<0.05).Conclusion:Far may inhibit apoptosis and inflammatory injury of BV2 cells and promote proliferation of BV2 cells by inhibiting cGAS-STING pathway, and thus alleviate inflammatory injury of BV2 cells induced by LPS.

Objective To explore the clinical efficacy and safety of single-port laparoscopic ovarian cyst removal surgery.Methods A total of 145 patients who underwent laparoscopic surgery for ovarian cyst in Wenzhou People's Hospital from January 2023 to June 2024.Among them,single-port laparoscopic ovarian cystectomy+oophoroplasty was performed in 67 cases as single-port group,and traditional multi-port laparoscopic ovarian cystectomy+oophoroplasty was performed in 78 cases as multi-port group.Clinical indicators during and after surgery in two groups were recorded and compared.Results There were significant difference the operation time and pain scores at 1 day after surgery between two groups(P＜0.05).There was no significant difference in intraoperative bleeding,postoperative exhaust time and postoperative hospitalization time between two groups(P＞0.05).Neither of two groups had intraoperative vascular or nerve damage in the abdominal wall,and there were no postoperative complications such as incision infection,intestinal obstruction,or lower limb venous thrombosis,and the incision healed well.Continuing the follow-up for 3 months after discharge,both surgical procedures had no significant effect on menstruation,and there was no short-term recurrence of ovarian cyst in either case.Conclusion The single-port laparoscopic technique for the treatment of ovarian cyst incision is concealed and beautiful,the postoperative pain is lighter.No obvious effect on menstruation,and the curative effect is definite and safe.

Objective:To compare the therapeutic efficacy of the dual anteromedial and anterolateral approaches versus that of the anterior midline approach in the treatment of Wahlquist type C medial tibial plateau fractures accompanied by posterior column collapse.Methods:A retrospective study was conducted to analyze the 21 patients who had been treated for Wahlquist type C medial tibial plateau fractures plus posterior column collapse at The Fourth Orthopedic Ward, The 72nd Group Army Hospital of PLA between January 2019 and August 2023. The cohort included 13 males and 8 females, with an age of (43.3±6.7) years. The left side was involved in 14 fractures and the right side in 7 ones. The patients were divided into 2 groups based on their surgical approaches: a dual-approach group ( n=13) undergoing fixation via the dual anteromedial and anterolateral approaches, and a single-approach group ( n=8) undergoing fixation via the anterior midline approach. Comparative parameters included operative time, intraoperative blood loss, fracture healing time, quality of fracture reduction, medial proximal tibial angle (MPTA), incision complications, postoperative bone mass reduction quality (evaluated according to the Rasmussen anatomical criteria for tibial condyle fracture reduction), lateral tibial plateau instability, incidence of genu varum, and post-traumatic arthritis. Functional recovery of the lower limb joints was assessed at the final follow-up using the Merchant criteria. Results:No statistically significant differences were observed in the baseline characteristics between the 2 groups preoperatively, indicating comparability ( P>0.05). All patients were followed up for a mean duration of (38.1±11.3) months. The postoperative MPTA in the dual-approach group (86.8°±0.8°) was significantly larger than that in the single-approach group (85.5°±0.9°) ( P<0.05). Genu varum occurred in 1 patient in the dual-approach group and in 4 patients in the single-approach group, while lateral tibial plateau instability was observed in 1 patient in the dual-approach group and in 4 patients in the single-approach group, showing statistically significant differences between the 2 groups ( P<0.05). No statistically significant differences were found between the 2 groups regarding operative time, intraoperative blood loss, fracture healing time, quality of fracture reduction, incidence of incision complications, or incidence of post-traumatic arthritis ( P>0.05). At the final follow-up, no statistically significant difference was observed in the functional recovery of the lower limb joints assessed by the Merchant criteria between the 2 groups ( P>0.05). Conclusion:In the treatment of Wahlquist type C medial tibial plateau fractures accompanied by posterior column collapse, compared with the single anterior midline approach, the dual anteromedial and anterolateral approaches can restore more effectively the MPTA, and reduce the incidences of genu varum and lateral tibial plateau instability.

Objective:To investigate whether quercetin reduces neuroinflammation in epileptic rats by regulating high mobility group protein B1(HMGB1),receptor for advanced glycation end products(RAGE)and nuclear factor kappa-B(NF-κB),and to explore the possibility of HMGB1/RAGE/NF-κB pathway as a new target of quercetin.Methods:Twelve SD rats were randomly selected from 60 SD rats as healthy group,and the remaining rats were used to construct experimental models of epilepsy rats.Rats that were successfully modeled were divided into model group,high-dose quercetin group,low-dose quercetin group,quercetin+pathway activator group,with 12 rats in each group.Pathological changes of hippocampal tissue of rats were observed;neurobehavioral function of rats was evaluated;levels of tumor necrosis factor-α(TNF-α),IL-6 and IL-1β,and mRNA and protein expression levels of HMGB1,RAGE,NF-κB in hippocampal tissue of rats were detected.Results:Structure of hippocampus of rats in healthy group was complete;compared with healthy group,structure of hippocampal tissue of rats in model group was scattered,the number of surviving neurons was observably reduced,apoptotic index was observably increased,the Racine grade was observably increased,TNF-α,IL-1β,IL-6 contents and mRNA and protein expression levels of HMGB1,RAGE,NF-κB in hippocampal tissue were significantly increased;com-pared with model group,structure of hippocampal tissue of rats in low-and high-dose quercetin groups was relatively complete,the number of surviving neurons was observably increased,apoptotic index was observably decreased,the Racine grade was significantly decreased,TNF-α,IL-1β,IL-6 contents and mRNA and protein expression levels of HMGB1,RAGE,NF-κB were significantly re-duced,and the improvement effect of high-dose quercetin group was better;compared with high-dose quercetin group,the number of surviving neurons in quercetin+pathway activator group was significantly reduced,apoptotic index was significantly increased,the Ra-cine grade was significantly increased,TNF-α,IL-1β,IL-6 contents and mRNA and protein expression levels of HMGB1,RAGE,NF-κB in hippocampal tissue were significantly increased.Conclusion:Quercetin can effectively reduce neuroinflammation in epilep-tic rats by inhibiting the HMGB1/RAGE/NF-κB pathway and reducing the mRNA and protein expressions of related genes.

Model informed precision dosing (MIPD) is a new concept to guide precision dosing for individual patient by modeling and simulation based on the available information about the individual patient, medications and the disease. Compared to the empirical dosing, MIPD could improve the efficacy, safety, economics and adherence of the pharmacotherapy according to the individual's pathophysiology, genotyping and disease progression. This consensus report provides a brief account of the concept, methodology and implementation of MIPD as well as clinical decision supporting systems for MIPD. The status and future advancing of MIPD was also discussed to facilitate the appropriate application and development of MIPD in China.

OBJECTIVETo explore the value of baseline serum alkaline phosphatase (ALP) for predicting 2-year fracture in patients with chronic kidney disease (CKD) on maintenance dialysis.

METHODSA total of 139 patients with CKD undergoing maintenance dialysis in our hospital were enrolled in this study. According to the median serum ALP level, the patients were divided into high ALP and low ALP groups. The demographic and clinical data of the patients including dialysis duration, serum calcium level, serum phosphorus level, and serum intact parathyroid hormone level were recorded, and their bone mineral density of the femur and the lumbar spine was measured using dual energy X-ray absorptiometry. The patients were followed up for 2 years and fracture events were recorded. The risk factors of fracture were analyzed using logistic regression analysis, and their predictive value for fracture was analyzed using receiver-operating characteristic (ROC) curve.

RESULTSThe mean baseline serum ALP level was 132.55±167.68 U/L in these patients, significantly higher than that in the normal population (=2.816, =0.006). Baseline serum ALP level was negatively correlated with the bone mineral density of the lumbar spine (=-0.203, =0.006) and the femur (=-0.196, =0.021). Fractures occurred in 21 (15.1%) of the patients during the 2-year follow-up, and the fracture rate was significantly higher in patients with high ALP levels. Logistic regression analysis identified serum ALP level as an independent risk factor of fracture (OR: 1.010, =0.001, 95%CI: 1.004-1.016). The areas under the ROC curve were 0.900 and 0.768 for serum ALP level and intact parathyroid hormone level in predicting 2-year fractures, respectively.

CONCLUSIONSSerum ALP may serve as a good indicator for predicting 2-year fractures in patients with CKD on maintenance dialysis.

Objective To explore the role and mechanism of microRNA-15b in the regulation of epithelial-mesenchymal transition (EMT) of human peritoneal mesothelial cells (HPMCs).Methods PCR assay was used to determine the expression of microRNA-15b in the HMrSV5 induced by 138mmol/L high glucose for 24 h.MicmRNA-15b mimic or inhibitor was transfected into human peritoneal mesothelial cells (HMrSV5) to over-express or down-regulate microRNA-15b.The cells were then incubated with 138 mmol/L high glucose for 24 h,and the expressions of E-cadherin(E-Cad),Vimentin (VIM),Fibronectin(FN) and Smad7 were detected by real-time PCR and Western blotting respectively.Results microRNA-15b in the HMrSV5 ceils was over-expressed and down-regulated.Increased level of microRNA-15b was obtained in HMrSV5 cells treated with high glucose.In vitro,high glucose led to the up-regulation of vimentin as well as fibronectin and the down-regulation of E-cadherin in HMrSV5 cells (all P ＜ 0.05),which indicated EMT and fibrosis.Suppression of microRNA-15b by transfection with microRNA-15b inhibitor partially reversed the EMT and fibrosis changes (P ＜ 0.05),while over-expression of microRNA-15b by transfection with microRNA-15b mimic obviously enhanced the EMT and fibrosis changes (P ＜ 0.05).Conclusions MicroRNA-15b mediates high glucose induced EMT in human peritoneal mesothelial cells by the inhibition of Smad7 possibly.MicroRNA-15b maybe a new target for the prevention and treatment of peritoneal fibrosis during peritoneal dialysis (PD).