BACKGROUND:Delayed healing and nonunion of fractures are common clinical issues.Clinical observations have shown that patients with limb fractures combined with traumatic brain injury experience significantly faster fracture healing compared with those without brain injury.The potential mechanisms behind this phenomenon have become a crucial focus of current research.Recent studies indicate that traumatic brain injury significantly accelerates callus formation and fracture healing processes by regulating cytokines,hormones,neural signals,and stem cell mechanisms.OBJECTIVE:To summarize the latest research progress in the mechanisms by which traumatic brain injury promotes callus formation and fracture healing,thereby providing a theoretical basis for clinical applications.METHODS:The first author conducted a search of CNKI,WanFang,VIP,PubMed,Embase,Web of Science,and Cochrane Library databases for literature published from January 2013 to October 2024,with some references traced back up to 20 years.The search terms used were"traumatic brain injury,callus,fracture healing,inflammatory response,cytokines,hormones,neuropeptides,genes,stem cells"in Chinese and English.A total of 83 articles meeting the inclusion criteria were ultimately selected.RESULTS AND CONCLUSION:The mechanism by which traumatic brain injury promotes callus formation and fracture healing is highly complex,involving multiple regulatory pathways such as cytokines,hormones,the nervous system,and stem cells.However,the precise mechanisms are still not fully understood and require further investigation.Current research suggests that traumatic brain injury accelerates bone callus formation and bone tissue regeneration by promoting the release of cytokines(e.g.,insulin-like growth factor-1)and hormones(e.g.,growth hormone and leptin),regulating the nervous system,and promoting stem cell proliferation and differentiation.Additionally,traumatic brain injury triggers a series of immune responses,including the release of inflammatory factors and activation of immune cells,which modulate fracture healing.These responses improve local blood flow,cell migration,and fibroblast activation,supporting various stages of bone healing.Stem cell activation induced by traumatic brain injury is also crucial,as activated stem cells differentiate into osteoblasts,chondrocytes,and adipocytes,facilitating bone tissue regeneration and repair.Therefore,traumatic brain injury-induced immune responses and stem cell activation work together to accelerate fracture healing,providing essential support for the process.These mechanisms significantly shorten the healing time and improve patient outcomes.In conclusion,traumatic brain injury promotes callus formation and fracture healing through multiple mechanisms,highlighting its importance in bone repair.Future research should focus on the signaling pathways and regulatory factors influenced by traumatic brain injury to further understand its mechanisms.These findings will provide a foundation for developing targeted therapies,stem cell treatments,and neural regulation therapies,with potential clinical value in shortening healing time,optimizing recovery protocols,and improving prognosis.Exploring traumatic brain injury-induced biological effects will open new avenues for fracture treatment.

BACKGROUND:Delayed healing and nonunion of fractures are common clinical issues.Clinical observations have shown that patients with limb fractures combined with traumatic brain injury experience significantly faster fracture healing compared with those without brain injury.The potential mechanisms behind this phenomenon have become a crucial focus of current research.Recent studies indicate that traumatic brain injury significantly accelerates callus formation and fracture healing processes by regulating cytokines,hormones,neural signals,and stem cell mechanisms.OBJECTIVE:To summarize the latest research progress in the mechanisms by which traumatic brain injury promotes callus formation and fracture healing,thereby providing a theoretical basis for clinical applications.METHODS:The first author conducted a search of CNKI,WanFang,VIP,PubMed,Embase,Web of Science,and Cochrane Library databases for literature published from January 2013 to October 2024,with some references traced back up to 20 years.The search terms used were"traumatic brain injury,callus,fracture healing,inflammatory response,cytokines,hormones,neuropeptides,genes,stem cells"in Chinese and English.A total of 83 articles meeting the inclusion criteria were ultimately selected.RESULTS AND CONCLUSION:The mechanism by which traumatic brain injury promotes callus formation and fracture healing is highly complex,involving multiple regulatory pathways such as cytokines,hormones,the nervous system,and stem cells.However,the precise mechanisms are still not fully understood and require further investigation.Current research suggests that traumatic brain injury accelerates bone callus formation and bone tissue regeneration by promoting the release of cytokines(e.g.,insulin-like growth factor-1)and hormones(e.g.,growth hormone and leptin),regulating the nervous system,and promoting stem cell proliferation and differentiation.Additionally,traumatic brain injury triggers a series of immune responses,including the release of inflammatory factors and activation of immune cells,which modulate fracture healing.These responses improve local blood flow,cell migration,and fibroblast activation,supporting various stages of bone healing.Stem cell activation induced by traumatic brain injury is also crucial,as activated stem cells differentiate into osteoblasts,chondrocytes,and adipocytes,facilitating bone tissue regeneration and repair.Therefore,traumatic brain injury-induced immune responses and stem cell activation work together to accelerate fracture healing,providing essential support for the process.These mechanisms significantly shorten the healing time and improve patient outcomes.In conclusion,traumatic brain injury promotes callus formation and fracture healing through multiple mechanisms,highlighting its importance in bone repair.Future research should focus on the signaling pathways and regulatory factors influenced by traumatic brain injury to further understand its mechanisms.These findings will provide a foundation for developing targeted therapies,stem cell treatments,and neural regulation therapies,with potential clinical value in shortening healing time,optimizing recovery protocols,and improving prognosis.Exploring traumatic brain injury-induced biological effects will open new avenues for fracture treatment.

Gastric cancer is a common malignant tumor with complex pathological mechanisms， a low early diagnosis rate， and a high mortality rate. However， surgical treatment， targeted therapy， and chemotherapy have their treatment limitations and toxic side effects. Therefore， exploring the pathogenesis and mechanism of gastric cancer and finding effective treatment methods are important. At present， researches has found that tumor epithelial cells exhibit individual differences in molecular characteristics and exhibit metabolic heterogeneity that affects cell phenotype and function. The interaction between metabolites and cytokines can inhibit the formation of the tumor immune microenvironment and promote malignant progression. Therefore， metabolic reprogramming is regarded as a key feature of tumors and plays an important role in the process of tumor occurrence and development. However， the continuous deterioration of gastric cancer may be closely related to changes in the energy metabolism of cancer cells. Gastric cancer cells may regulate the dysregulation of synthesis or decomposition pathways such as glucose metabolism， amino acid metabolism， lipid metabolism， and nucleotide metabolism and activate associated signaling pathways， key proteins， and genes， leading to proliferation， invasion， and metastasis of cancer cells. In recent years， there has been a close relationship between the effective intervention by traditional Chinese medicine in gastric cancer and the regulation of metabolic reprogramming. There has been some progress in the intervention research on effective ingredients and formulas of traditional Chinese medicine for cancer. This article summarized existing Chinese and foreign literature on how gastric cancer cells affect disease progression by regulating their related metabolic networks， such as glucose metabolism， amino acid metabolism， lipid metabolism， and nucleotide metabolism， as well as how effective ingredients and formulas of traditional Chinese medicine enhance anti-tumor effects through targeted metabolism. It reviewed metabolic reprogramming intervention in gastric cancer， providing a reference for research on metabolic reprogramming regulation by traditional Chinese medicine and new targets and strategies for the treatment and prognosis of gastric cancer.

Objective:To investigate the filial piety value level and the influencing factors of filial piety among children whose parents were diagnosed as advanced cancer.Methods:A convenient sampling method was used to recruit 383 participants in Tumor Hospital, Tianjin Medical University.Results:The total score of Filial Piety Value Scale among children whose parents were advanced cancer patients was (66.50±4.10) . The age of the patient, the number of hospitalization and the degree of awareness of the condition, the age of the children, whether the child was the-only-child, whether the child was living with the patient, and the average daily care time influenced the filial piety values of children whose parents were advanced cancer patients ( Z=16.64-62.94, U=2.04-4.27, P<0.05). Conclusion:Children whose parents were with advanced cancer have a better understanding of filial piety. Nurses understand the values of filial piety of children in the context of traditional filial piety and family care mode in China, which can enhance the experience of filial piety and filial piety of both children and parents, also improve the mental health problems of patients, and finally improve the quality of life of patients with advanced cancer.

Objective To investigate the effect of spine disease on pelvic sagittal alignment and hip biomechanics in total hip arthroplasty (THA) patients. Methods The clinical data of 120 THA patients who had normal lumbar spine (control group) and 40 THA patients who had lumbar disease (lumbar disease group) between January 2013 and September 2015 in Shenzhen Longhua District People′s Hospital were analyzed. Radiographical parameters, like lumbar lordosis (LL), pelvic incidence(PI), pelvic tilt (PT) and sacralslope (SS) were collected and compared. Normal and pathological musculoskeletal simulation model was established based on standing and sitting X-ray pelvic alignment. Hip contact force, moment and muscle forces in standing posture and sitting to standing posture were calculated. Results The value of LL in lumbar disease group was shorter than that in control group:(34.23 ± 12.81)°vs. (47.26 ± 14.67)°, P＜0.05. Butthe value of PI in two groups had no significant difference (P>0.05). The value of PT and SS in two groups had significant differences: (17.51 ± 2.31)°vs. (8.31 ± 1.34)°,(27.61 ± 1.72)°vs. (38.01 ± 1.92)°, P＜0.05. At standing position and sitting moment position, the joint force and moment value between disease model and control model had significant differences (P＜0.05), and the differences were mainly in sagittal and vertical axis (P＜0.05). At standing position and the moment of sitting up, the extorsion muscle activation was at lower level and had no significant difference (P＞0.05). Conclusions Pelvic sagittal alignment pathology could change hip biomechanical situation, making threats to hip stability.

Objective To investigate the efficacy and safety of surgical treatment for internal carotid artery atheromatous pseudo-occlusion (APO).Methods Clinical data of patients with carotid artery stenosis treated by carotid endarterectomy from Dec.,2011 to Jun.,2016 in Zhongshan Hospital Affiliated to Fudan University were analyzed retrospectively.Carotid endarterectomy were performed in 32 patients with pseudo-occlusion of the internal carotid artery (APO group).And 124 patients with traditional severe stenosis (70％-99％) served as control group.Perioperative major and minor complications,recurrence rate of ipsilateral ischemic stroke,restenosisrate and mortality in follow-up were compared between the two groups.Results Perioperative major complications:one patient (3.1 ％) developed myocardial infarction in the APO group,no ischemic stroke,cerebral hemorrhage and death cases;2 (1.4％) ischemic stroke cases,6 (4.2％) myocardial infarction cases and 1 (0.7％)death case was found in control group.Perioperative minor complications:1 (3.1％) incision bleeding case,2 (6.3％) pulmonary infection cases,2 (6.3％) cerebral hyperperfusion syndrome cases were found in APO group;3 (2.1％) incision bleeding cases,2 (1.4％) incision infection cases,4 (2.8％)pulmonary infection cases,2 (1.4％) cranial nerve injury cases,2 (1.4％) cerebral hyperperfusion syndrome cases were found in control group.Patients were followed up for 6-60 months,with mean follow-up period of (35.3 ± 17.5) months.During follow-up,1 (3.1％) ipsilateral ischemic stroke recurrence case,4 (12.5％) restenosis cases,and 3 (9.4％) death cases were found in the APO group.And 8 (5.6％) ipsilateral ischemic stroke recurrence cases,9 (6.3％) restenosis cases,8 (5.6％)death cases were found in control group.There were no significant differences in perioperative major and minor complications,recurrence rate of ipsilateral ischemic stroke,restenosis rate and mortality between the two groups.Conclusions Surgical treatment for atheromatous pseudo-occlusion of the internal carotid artery is safe and effective.Perioperative and follow-up results are satisfactory.

Objective To explore the treatment effect and failure patterns associated with different clinical target volume on patients with esophageal carcinoma treated with 5-filed intensity modulated radiotherapy (IMRT), and to determine whether involved field irradiation (IFI) is practicable in these patients. Methods A total of 88 patients with esophageal carcinoma between January 2012 to June 2014 underwent IMRT in our hospital, were divided into IFI group and elective nodal irradiation(ENI) group according to the CTV range for a concurrent control study. Results One-year and two-year survival rate in IFI group and ENI group were 75.0%, 45.5% and 70.5%, 43.2% respectively (P > 0.05). Local failure rate in IFI and ENI groups was 27.3% and 22.7% respectively, distant metastasis failure rates 22.7% and 18.2% respectively and regional failure rate outside the radiation field 11.4% and 4.5%, which showed no statistical difference (P > 0.05). Subgroup analysis indicated failure outside the radiation field tended to increase for primary lesion located in the up thoracic or clinical stageⅠ in IFI group. The volume dose histogram of lung V5, V20, V30 and mean lung dose of ENI group were greater than that of IFI group, while V5 of lung and the mean lung dose had statistical difference. Conclusions The survival rate and local control rate have no significant differencein IFI group and ENI group, so IFI is feasible for some esophageal carcinoma, but it should be cautious to choose IFI for those primary lesion located in the up thoracic or clinical stageⅠ.

BACKGROUND:There are many methods in the clinic to treat pelvic fractures, mainly conservative treatment, internal fixation and external fixation. Conservative treatment often causes complications due to poor reduction after fractures. Fixation has good effects on repair of unstable fractures, but fixation is seldom used for pelvic fractures.
OBJECTIVE:To observe the effects of internal fixation on unstable pelvic fractures, and compare with conservative treatment and external fixation.
METHODS:126 cases of unstable pelvic fractures from Longhua District People’s Hospital of Shenzhen City from January 2008 to June 2014 were divided into three groups:conservative treatment group, external fixation group and internal fixation group (n=42). After treatment, patients received X-ray examination. Lindahl imaging criteria were used as evidence. The quality of fracture reduction was evaluated. Patients were regularly fol owed up after treatment. The recovery of limb function was evaluated according to Majeed standard. Repair effects, the excel ent and good rates of fracture healing and cal us growth were evaluated in the last fol ow-up.
RESULTS AND CONCLUSION:During the last fol ow-up, the total efficiency was 81%in the internal fixation group, 69%in the conservative treatment group, and 71%in the external fixation group, and results were significantly better in the internal fixation group than in the other two groups (P<0.05). The Lindahl and Majeed scores were significantly higher in the internal fixation group than in the other two groups (P<0.05). These results suggest that internal fixation for unstable pelvic fracture obtained better recovery effects and efficiency than conservative treatment and external fixation. Thus, the internal fixation is more suitable for patients with unstable pelvic fractures.

OBJECTIVETo investigate the value of serum IgA/C3 ratio in the diagnosis of IgA nephropathy and explore its relationship with the clinicopathological features of the patients.

METHODSSixty-six patients with IgA nephropathy, 111 with other glomerular diseases, and 40 healthy control subjects without kidney disease were tested for serum IgA and C3 levels using CRM470 adjusted standardized immune turbidimetric method, and the IgA/C3 ratio was calculated. According to Oxford and Lee's classification criteria, we analyzed the pathological grades of the renal biopsy samples from patients with IgA nephropathy. The ROC curve was used to assess the value of serum IgA and IgA/C3 ratio in predicting IgA nephropathy.

RESULTSPatients with IgA nephropathy had an elevated serum IgA/C3 ratio than those with other glomerular diseases and the control subjects, with an area under the ROC curve of 0.776. An elevated serum IgA/C3 ratio was not found to significantly correlate with the pathological grade of renal biopsy samples in patients with IgA nephropathy.

CONCLUSIONIn the absence of renal biopsy findings, serum IgA/C3 ratio can help in the diagnosis of IgA nephropathy.

Biopsy ; Case-Control Studies ; Complement C3 ; analysis ; Glomerulonephritis, IGA ; blood ; diagnosis ; Humans ; Immunoglobulin A ; blood ; Kidney ; pathology

OBJECTIVETo analyze the quantity and size distribution of 24-hour urinary extracellular vesicles (uEVs) from healthy adults.

METHODSThe 24-hour uEVs from 9 healthy adults were isolated by hydrostatic filtration dialysis (HFD). The effectiveness of uEVs enrichment was evaluated using Western blotting and transmission electron microscopy (TEM). The quantity and size distribution of the uEVs was analyzed with BCA protein quantification, TEM, and nanoparticle tracking analysis (NTA).

RESULTSuEVs with different sizes and morphologies were observed under TEM. Western blotting confirmed the expression of TSG101 in all the uEV fractions from the 9 donors, ranging from 132.50 to 760.70 ng/mL. NTA results showed that the number of 24-hour uEVs amount ranged from 3.56 × 10¹² particles to 5.12 × 10¹² particles, with a CV of 14.23%. The proportion of the vesicles with a diameter <40 nm was 0.04%-0.69% with a number range of (1.80-26.49)× 10⁹ particles; the proportion of vesicles with a diameter of 40-100 nm (which is consistent with the size of exosomes)was 22.07%-42.08% with a number range of (1.00-1.77)× 10¹² particles. The proportion of vesicles with a diameter of 100-1000 nm (consistent with the size of microvesicles) was 57.88%-77.85% with a number range of (2.09-3.86)× 10¹² particles.

CONCLUSIONThe established HFD method allows efficient and convenient isolation of uEVs from a large amount of urine samples. The 24-hour uEVs from healthy adults show narrow differences between individuals and thus can be an ideal source of samples for relevant studies.

Adult ; Blotting, Western ; Cell-Derived Microparticles ; Exosomes ; Extracellular Vesicles ; Humans ; Microscopy, Electron, Transmission ; Nanoparticles ; Urine