OBJECTIVE: To compare clinical effects of external fixation and minimally invasive percutaneous plate osteosynthesis (MIPPO) after external fixation in treating open fractures of tibial shaft. METHODS: From January 2020 to June 2022, 151 patients with open fracture of tibial shaft treated with external fixation stenting were divided into external fixation group and combined group according to different surgical methods. There were 81 patients in external fixation group, including 48 males and 33 females, aged from 21 to 68 years old with an average of (42.58±7.44) years old;according to Gustilo classification, 49 patients with typeⅡ, 32 patients with type ⅢA;the time from injury to treatment ranged from 2.5 to 10 h with an average of (4.25±0.74) h;external fixed stenting was performed. There were 70 patients in combined group, including 42 males and 28 females, aged from 20 to 69 years old with an average of (41.39±7.02) years old;35 patients with type Ⅱ and 35 patients with type ⅢA according to Gustilo classification;the time from injury to treatment ranged from 3 to 9 h with an average of (4.31±0.85) h;MIPPO treatment was performed after external fixed stenting. The time of callus formation, fracture healing and complications were compared between two groups. Rasmussen score and Hospital for Special Surgery (HSS) score were used to evaluate functional recovery of knee joint at 6 months after operation. RESULTS: Both groups were followed up for 6 to 13 months with an average of (10.17±2.33) months. The time of callus formation and fracture healing were (13.98±4.02) d and (70.26±12.15) d in combined group, and (18.56±4.37) d and (79.87±15.41) d in external fixation group, respectively. Combined group was better than external fixation group in the time of callus formation and fracture healing (P<0.05). At six months after operation, Rasmussen and HSS scores in combined group were (26.79±3.11) and (83.36±9.44), which were higher than those in external fixation group (24.51±4.63) and (79.63±8.46) (P<0.05). In external fixation group, there were 2 patients with incision infection, 2 patients with nail tract infection, 1 patient with stent loosening, fracture displacement, delayed union and malunion, and 1 patient with biocompatibility reaction in combined group, with statistical significance between two groups (P<0.05). CONCLUSION MIPPO could accelerate callus formation and fracture healing, improve knee function, improve clinical effects and reduce complications in patients with open tibial shaft fractures after external and external fixation.
Humans ; Male ; Female ; Middle Aged ; Adult ; Aged ; Tibial Fractures/physiopathology* ; Fracture Fixation, Internal/methods* ; Retrospective Studies ; Bone Plates ; External Fixators ; Fractures, Open/physiopathology* ; Stents ; Young Adult

Objective:To implement evidence-based practice for eye management in ICU patients undergoing prone position ventilation and evaluate the effectiveness of applying the best evidence for eye management in this setting.Methods:Through literature retrieval, screening, and evaluation, the best evidence for eye management in ICU patients undergoing prone position ventilation was summarized and compiled into evidence review indicators. From March to June 2024, convenience sampling was used to select 29 ICU prone position ventilation patients and 30 ICU nurses at Shanghai Changzheng Hospital for baseline review to identify obstacles in clinical practice of evidence and develop action strategies based on these obstacles. From July to October 2024, 29 ICU prone position ventilation patients and 29 ICU nurses were selected for evidence-based practice to compare the implementation rates of review indicators before and after evidence-based practice, ICU nurses' knowledge, attitude and practice regarding eye management for prone position ventilation patients, as well as the intraocular pressure during prone position ventilation and the incidence of eye complications within the first week of ICU admission.Results:After evidence-based practice, the implementation rates of all 16 review indicators by ICU nurses were higher than those before evidence-based practice, and the differences were statistically significant ( P<0.05). The total score, knowledge dimension score, and practice dimension score on the Knowledge, Attitude and Practice Questionnaire on Eye Management during Prone Position Ventilation for ICU nurses were higher than those before evidence-based practice, with statistically significant differences ( P<0.05). After evidence-based practice, the intraocular pressure of ICU patients in prone position ventilation for 8 hours and at the end improved, and the differences were statistically significant ( P<0.05). The overall incidence of eye complications within one week of ICU admission decreased from 27.6% to 6.9%, with a statistically significant difference ( P<0.05) . Conclusions:Implementing evidence-based practices for eye management in ICU patients undergoing prone position ventilation can effectively increase nurses' implementation rates of review indicators, enhance their knowledge, attitude, and practice regarding eye management, and reduce the incidence of eye complications in patients.

Background::The increasing incidence of inflammatory bowel disease (IBD) presents significant medical and societal challenges. A well-designed IBD database is crucial for both epidemiological studies and clinical management. However, inconsistencies between regional databases hinder cross-institutional and international research, especially between Eastern and Western societies.Methods::We developed a new IBD database, the 301 IBD database, integrating the IBD clinical characteristics from the Penn IBD database (USA) and the latest IBD guidelines and consensus and clinical practices of the Chinese PLA General Hospital (PLAGH). We applied this database to analyze clinical data of IBD inpatients at PLAGH from 2008 to 2023.Results::The 301 IBD database contains 490 items in 6 sections including demographic characteristics, personal history, clinical phenotype, disease activity, laboratory tests and examinations, and treatment. Features of the 301 IBD database include inpatient focus, biochemical indicators and opportunistic infection focus, and more about ulcerative colitis (UC)-associated complications. Single-center analysis revealed an increasing hospitalization trend, from 2.35% in 2008 to 3.94% in 2023. We found that the clinical characteristics of our UC inpatients are predominantly male (62.5%), extensive lesions (55.1%), low usage of biologics (4.1%), and a high incidence of UC-CRC (3.0%). The clinical characteristics of CD inpatients included male predominance (68.39%), early onset age (35.43 ± 14.75-year-old), and high rate of surgery (25.81%).Conclusion::The 301 IBD database, integrating Eastern and Western clinical data, provides a valuable tool for IBD clinical research. Future international, multicenter collaborations are expected to further enhance its utility.

Pyroptosis is an identified programmed cell death that has been highly linked to endoplasmic reticulum (ER) dynamics. However, the crucial proteins for modulating dynamic ER membrane curvature change that trigger pyroptosis are currently not well understood. In this study, a biotin-labeled chemical probe of potent pyroptosis inducer α-mangostin (α-MG) was synthesized. Through protein microarray analysis, reticulon-4 (RTN4/Nogo), a crucial regulator of ER membrane curvature, was identified as a target of α-MG. We observed that chemically induced proteasome degradation of RTN4 by α-MG through recruiting E3 ligase UBR5 significantly enhances the pyroptosis phenotype in cancer cells. Interestingly, the downregulation of RTN4 expression significantly facilitated a dynamic remodeling of ER membrane curvature through a transition from tubules to sheets, consequently leading to rapid fusion of the ER with the cell plasma membrane. In particular, the ER-to-plasma membrane fusion process is supported by the observed translocation of several crucial ER markers to the "bubble" structures of pyroptotic cells. Furthermore, α-MG-induced RTN4 knockdown leads to pyruvate kinase M2 (PKM2)-dependent conventional caspase-3/gasdermin E (GSDME) cleavages for pyroptosis progression. In vivo, we observed that chemical or genetic RTN4 knockdown significantly inhibited cancer cells growth, which further exhibited an antitumor immune response with anti-programmed death-1 (anti-PD-1). In translational research, RTN4 high expression was closely correlated with the tumor metastasis and death of patients. Taken together, RTN4 plays a fundamental role in inducing pyroptosis through the modulation of ER membrane curvature remodeling, thus representing a prospective druggable target for anticancer immunotherapy.
Pyroptosis/immunology* ; Humans ; Endoplasmic Reticulum/immunology* ; Animals ; Nogo Proteins/antagonists & inhibitors* ; Mice ; Cell Line, Tumor ; Xanthones/pharmacology* ; Neoplasms/pathology* ; Mice, Nude

Genetics,which provides important theoretical knowledge for the cultivation of students majo-ring in biology,is a discipline that studies the law of biological heredity and variation.In the era of high-ly advanced information technology,the blended online and offline teaching model has progressively been integrated into university classrooms,which seamlessly merges offline teaching with"Internet+"and greatly improves the outcomes and effectiveness of student learning and teacher instruction.Taking the genetics course as a platform,this paper first examines the complementary features of online and offline teaching methods.Then,the genetic teaching model that was carried out through various online platforms and resources were designed and optimized from purely online instruction and blended online-offline in-struction respectively.The assessment and evaluation methodologies were also enhanced.The findings of the investigation on the impact of teaching practices showed that a notable enhancement in students'en-thusiasm for learning genetic courses was achieved.This was reflected in the fact that an increasing num-ber of students selected genetic-related topics in science and innovation competitions.Meanwhile,com-pared with the non-implementation of blended teaching reform,students'academic performance in genet-ics courses has also been significantly improved,with a total score of about 5-6 points.The implementa-tion of the innovative blended teaching model will further enhance the efficiency of classroom teaching in-novation and talent training.

Objective To investigate the value of MRI of the sternal end of clavicle in bone age assessment in Chinese population,especially its applicability in the determination of criminal responsible age.Methods A total of 431 patients aged from 10.00 to 29.99 years with neck or chest MRI were retrospectively collected.According to the Schmeling grading method,the epiphyseal development of the clavicle MRI was divided into five grades.The consistency of methods was evaluated.The correlation and general descriptive analysis between MRI grades and age was analyzed.The sex difference was analyzed.Curve fitting was used to establish a nonlinear model between age and grades.Results The grades of clavicle MRI showed a significant age-related trend(Figure 2),and the correlation was 0.861(0.887 in males and 0.840 in females).Except for grade 1,there was no significant difference between males and females in other grades.The minimum age of male grade 3 was greater than 14 years old,and the minimum age of female grade 3 was greater than 16 years old.The minimum age in grade 4 and grade 5 was over 18 years old in both sexes.The best curve fitting model was cubic model for both sexes(R2=0.805 for men and 0.722 for women).Conclusion Clavicle MRI can be used for the assessment of bone age in Chinese population.Complete epiphyseal plate closure can be used as a reliable indicator for the determination of age at 18 years old,and it is expected to achieve radiation-free forensic bone age assessment.

Objective:To implement evidence-based practice for eye management in ICU patients undergoing prone position ventilation and evaluate the effectiveness of applying the best evidence for eye management in this setting.Methods:Through literature retrieval, screening, and evaluation, the best evidence for eye management in ICU patients undergoing prone position ventilation was summarized and compiled into evidence review indicators. From March to June 2024, convenience sampling was used to select 29 ICU prone position ventilation patients and 30 ICU nurses at Shanghai Changzheng Hospital for baseline review to identify obstacles in clinical practice of evidence and develop action strategies based on these obstacles. From July to October 2024, 29 ICU prone position ventilation patients and 29 ICU nurses were selected for evidence-based practice to compare the implementation rates of review indicators before and after evidence-based practice, ICU nurses' knowledge, attitude and practice regarding eye management for prone position ventilation patients, as well as the intraocular pressure during prone position ventilation and the incidence of eye complications within the first week of ICU admission.Results:After evidence-based practice, the implementation rates of all 16 review indicators by ICU nurses were higher than those before evidence-based practice, and the differences were statistically significant ( P<0.05). The total score, knowledge dimension score, and practice dimension score on the Knowledge, Attitude and Practice Questionnaire on Eye Management during Prone Position Ventilation for ICU nurses were higher than those before evidence-based practice, with statistically significant differences ( P<0.05). After evidence-based practice, the intraocular pressure of ICU patients in prone position ventilation for 8 hours and at the end improved, and the differences were statistically significant ( P<0.05). The overall incidence of eye complications within one week of ICU admission decreased from 27.6% to 6.9%, with a statistically significant difference ( P<0.05) . Conclusions:Implementing evidence-based practices for eye management in ICU patients undergoing prone position ventilation can effectively increase nurses' implementation rates of review indicators, enhance their knowledge, attitude, and practice regarding eye management, and reduce the incidence of eye complications in patients.

Background::The increasing incidence of inflammatory bowel disease (IBD) presents significant medical and societal challenges. A well-designed IBD database is crucial for both epidemiological studies and clinical management. However, inconsistencies between regional databases hinder cross-institutional and international research, especially between Eastern and Western societies.Methods::We developed a new IBD database, the 301 IBD database, integrating the IBD clinical characteristics from the Penn IBD database (USA) and the latest IBD guidelines and consensus and clinical practices of the Chinese PLA General Hospital (PLAGH). We applied this database to analyze clinical data of IBD inpatients at PLAGH from 2008 to 2023.Results::The 301 IBD database contains 490 items in 6 sections including demographic characteristics, personal history, clinical phenotype, disease activity, laboratory tests and examinations, and treatment. Features of the 301 IBD database include inpatient focus, biochemical indicators and opportunistic infection focus, and more about ulcerative colitis (UC)-associated complications. Single-center analysis revealed an increasing hospitalization trend, from 2.35% in 2008 to 3.94% in 2023. We found that the clinical characteristics of our UC inpatients are predominantly male (62.5%), extensive lesions (55.1%), low usage of biologics (4.1%), and a high incidence of UC-CRC (3.0%). The clinical characteristics of CD inpatients included male predominance (68.39%), early onset age (35.43 ± 14.75-year-old), and high rate of surgery (25.81%).Conclusion::The 301 IBD database, integrating Eastern and Western clinical data, provides a valuable tool for IBD clinical research. Future international, multicenter collaborations are expected to further enhance its utility.

Subunit 5B of constitutively photomorphogenic 9 signalosome(CSN5B)is an inhibitory factor for the biosynthesis of vitamin C in the L-galactose synthesis pathway in plants.To create mutants with richer vitamin C in tomato fruits,a dual-target vector of pKSE402-SlCSN5Bwas constructed and trans-formed into the breeding parent of 1912.Based on the molecular biological assay and DNA sequencing,17 transgenic positive lines were determined,and 6 lines of them were genetically mutated at the target site of SlCSN5B,with an editing efficiency of 35.3％.Among the mutants,2 lines were homozygous mu-tants,csn5b-6 with 180 bp deletion and csn5b-8 with 3 bp deletion.The biological traits of two types of deficiency homozygotes without exogenous T-DNA insertion derived from the T1 generation were observed,and there were no significant differences in phenotypes of the plant and fruit.Through physiological tes-ting of red-ripe fruits from T,generation lines of csn5b-6,the GMPase activity and the vitamin C content significantly increased by 43％and 37.8％,respectively,the content of hydrogen peroxide significantly decreased by 25.9％,and the content of soluble solids did not obviously change,compared with the wild type.There were no significant differences in plant traits and physiological characteristics between T1 gen-eration lines of csn5b-8 and the wild type.Based on gene expression analysis and protein structure predic-tion,the results showed that the gene of SlCSN5B normally transcribed,and the loss of large peptide seg-ments of CSN5B encoded by SlCSN5B caused changes in its structure to affect functioning,which led to an increase of vitamin C content in the line of csn5b-6-1 1.The findings suggest that the vitamin C content of tomato fruit can be improved by CRISPR/Cas9-mediated SlCSN5B gene editing,which provides the valuable resources for high-quality breeding in tomato.