Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.

OBJECTIVE To explore the possible molecular mechanism through which amygdala cell adhesion molecule-1(CADM1)is involved in acute sleep deprivation-induced anxiety.METHODS Sixteen 8-week-old C57BL/6J mice were randomly divided into the control group and para-chlorophe-nylalanine(PCPA)-induced acute sleep deprivation experimental group.The PCPA mice were intraperi-toneally injected with PCPA suspension(at a dose of 300 mg?kg-1)between 8∶00 and 9∶00 am for 2 consecutive days while the control mice were injected with the same dose of normal saline.The sleep latency and sleep duration of mice were detected via the righting reflex test.Anxiety-like behaviors were detected by the open field test and elevated plus maze test.The expression level of CADM1 in the mouse amygdala was detected by Western Blot and Immunofluorescence staining.The GeneNet-work database was used to analyze the association between Cadm1 genes and other genes in the mouse amygdala.The key candidate regulatory genes were screened,and the Cadm1-anxiety behavior phenotype network was constructed.The mRNA expression levels of the key candidate regulatory genes were analyzed via qPCR analysis.RESULTS Compared with the control mice,the sleep latency of PCPA mice was significantly prolonged(P<0.01)while the sleep duration was significantly shortened(P<0.01).The activity time and distance of PCPA mice in the open field center were significantly shorter than those of the control group(P<0.05).The elevated plus maze experiment showed that the percentage of the number of times PCPA mice entered the open arm and the percentage of residence time in the open arm were significantly lower than those of the control group(P<0.05).Western Blot and immuno-fluorescence staining showed that the expression of CADM1 protein in the amygdala from PCPA mice was down-regulated compared with the control mice(P<0.05).Based on gene-behavioral association network analysis,Cadm1 was significantly associated with 25 anxiety-like behavior-related genes.The enrichment analysis of Cadm1 co-expression genes showed that Cadm1 was associated with γ-amino-butyric acid GABAergic synaptic pathway(P=4.31e-09),and that the key genes were huntingtin associ-ated protein 1(Hap1)(r=0.705,P=1.09e-08)、inositol 1,4,5-triphosphate receptor type 1(Itpr1)(r=-0.751,P=3.34e-10)、gamma-aminobutyric acid type A receptor subunit delta(Gabrd)(r=-0.836,P=3.93e-14)、γ-aminobutyric acid A receptor β1 subunit gene(Gabrb1)(r=0.732,P=1.50e-09)and adrenoceptor alpha 2A(Adra2a)(r=0.759,P=1.73e-10).The results of qPCR analysis showed that the mRNA levels of Hap1(P<0.05)、Gabrb1 and Adra2a were significantly up-regulated(P<0.01)while those of Itpr1 and Gabrd were significantly down-regulated(P<0.01).CONCLUSION Acute sleep deprivation leads to down-regulation of Cadm1 expression in the amygdala,and induces anxiety-like behaviors by affecting the expression of GABAergic synaptic signaling pathways Hap1,Gabrb1,Adra2a,Itpr1 and Gabrd.

OBJECTIVE To explore the possible molecular mechanism through which amygdala cell adhesion molecule-1(CADM1)is involved in acute sleep deprivation-induced anxiety.METHODS Sixteen 8-week-old C57BL/6J mice were randomly divided into the control group and para-chlorophe-nylalanine(PCPA)-induced acute sleep deprivation experimental group.The PCPA mice were intraperi-toneally injected with PCPA suspension(at a dose of 300 mg?kg-1)between 8∶00 and 9∶00 am for 2 consecutive days while the control mice were injected with the same dose of normal saline.The sleep latency and sleep duration of mice were detected via the righting reflex test.Anxiety-like behaviors were detected by the open field test and elevated plus maze test.The expression level of CADM1 in the mouse amygdala was detected by Western Blot and Immunofluorescence staining.The GeneNet-work database was used to analyze the association between Cadm1 genes and other genes in the mouse amygdala.The key candidate regulatory genes were screened,and the Cadm1-anxiety behavior phenotype network was constructed.The mRNA expression levels of the key candidate regulatory genes were analyzed via qPCR analysis.RESULTS Compared with the control mice,the sleep latency of PCPA mice was significantly prolonged(P<0.01)while the sleep duration was significantly shortened(P<0.01).The activity time and distance of PCPA mice in the open field center were significantly shorter than those of the control group(P<0.05).The elevated plus maze experiment showed that the percentage of the number of times PCPA mice entered the open arm and the percentage of residence time in the open arm were significantly lower than those of the control group(P<0.05).Western Blot and immuno-fluorescence staining showed that the expression of CADM1 protein in the amygdala from PCPA mice was down-regulated compared with the control mice(P<0.05).Based on gene-behavioral association network analysis,Cadm1 was significantly associated with 25 anxiety-like behavior-related genes.The enrichment analysis of Cadm1 co-expression genes showed that Cadm1 was associated with γ-amino-butyric acid GABAergic synaptic pathway(P=4.31e-09),and that the key genes were huntingtin associ-ated protein 1(Hap1)(r=0.705,P=1.09e-08)、inositol 1,4,5-triphosphate receptor type 1(Itpr1)(r=-0.751,P=3.34e-10)、gamma-aminobutyric acid type A receptor subunit delta(Gabrd)(r=-0.836,P=3.93e-14)、γ-aminobutyric acid A receptor β1 subunit gene(Gabrb1)(r=0.732,P=1.50e-09)and adrenoceptor alpha 2A(Adra2a)(r=0.759,P=1.73e-10).The results of qPCR analysis showed that the mRNA levels of Hap1(P<0.05)、Gabrb1 and Adra2a were significantly up-regulated(P<0.01)while those of Itpr1 and Gabrd were significantly down-regulated(P<0.01).CONCLUSION Acute sleep deprivation leads to down-regulation of Cadm1 expression in the amygdala,and induces anxiety-like behaviors by affecting the expression of GABAergic synaptic signaling pathways Hap1,Gabrb1,Adra2a,Itpr1 and Gabrd.

Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.

OBJECTIVE:To study the inhibitory effects of recombinant adenovirus Ad-GFP-C197, which prepared by adenovirus vector system-loading human telomerase reverse transcriptase(hTERT)C fragment(C197),on the proliferation of 3 kinds of tumor cells in vitro. METHODS:Ad-GFP-C197 was amplified and purified with HEK293 cells. Human gastric cancer cells SGC7901,human breast cancer cells MCF7 and human colorectal cancer cells CaCO2 were infected by Ad-GFP-C197 respectively. Using blank adenovirus carrier (Ad-GFP) as reference,the protein expression of C197 in 3 kinds of tumor cells infected by Ad-GFP-C197 was detected by Western blot assay. The inhibitory effects of Ad-GFP-C197 on 3 kinds of tumor cells were detected by MTT assay. The cell proliferation curve was drawn and the proliferation inhibition rate was calculated. RESULTS:The protein expression of C197 was not detected in 3 kinds of tumor cells infected by Ad-GFP,while significant protein expression of C197 was found in above cells infected by Ad-GFP-C197. The proliferation curves of the 3 kinds of tumor cells infected by Ad-GFP-C197 were significantly inhibited with the time extended,and the proliferation inhibitory rate reached 37.31%-41.42%. CONCLUSIONS:Ad-GFP-C197 shows significant inhibitory effects on the proliferation of SGC7901,MCF7 and CaCO2 cells, which is rapid to make up for the slow effect of other telomerase inhibitors.

In order to study the effect of nitric oxide (NO) on the expression of hypoxia-inducible factor-1 alpha (HIF-1alpha) mRNA in hypoxic pulmonary hypertension (HPH) rats, 30 healthy male Wistar rats were randomly divided into normoxic control group, chronic hypoxic group and hypoxia plus L-arginine (L-Arg) group. The animal model of HPH was developed. The mean pulmonary arterial pressure (mPAP) was measured by inserting a microcatheter into the pulmonary artery. The HIF-1alpha mRNA expression levels were detected by in situ hybridization (ISH) and semiquantitative RT-PCR. It was found that after 14 days hypoxia, the mPAP in normoxic control group (17.6 +/- 2.7 mmHg, 1 mmHg=0.133 kPa) was significantly lower than that in chronic hypoxic group (35.8 +/- 6.1 mmHg, t=0.2918, P<0.05) and mPAP in chronic hypoxic group was higher than that in hypoxia plus L-arginine group (24.4 +/- 3.8 mmHg, t=0.2563, P<0.05). ISH showed that the expression of HIF-1alpha mRNA in the intraacinar pulmonary arteriolae (IAPA) in normoxic control group (0.1076 +/- 0.0205) was markedly weaker than that in chronic hypoxic group (0.3317 +/- 0.0683, t=3.125, P<0.05) and that in chronic hypoxic group was stronger than that in hypoxia plus L-arginine group (0.1928 +/- 0.0381, t=2.844, P<0.05). RT-PCR showed that the content of HIF-1alpha mRNA in chronic hypoxic group (2.5395 +/- 0.6449) was 2.16 times and 1.75 times higher than that in normoxic control group (1.1781 +/- 0.3628) and hypoxia plus L-arginine group (1.4511 +/- 0.3981), respectively. It is concluded that NO can reduce the mPAP by the inhibition of the expression of HIF-1alpha mRNA, which may be one of the mechanisms through which NO affects the pathogenesis of HPH.
Animals ; Arginine ; pharmacology ; Hypertension, Pulmonary ; metabolism ; Hypoxia ; metabolism ; Hypoxia-Inducible Factor 1, alpha Subunit ; Male ; Nitric Oxide ; pharmacology ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Wistar ; Reverse Transcriptase Polymerase Chain Reaction ; Transcription Factors ; biosynthesis ; genetics

In order to study the effect of nitric oxide (NO) on the expression of hypoxia-inducible factor-1 alpha (HIF-1alpha) mRNA in hypoxic pulmonary hypertension (HPH) rats, 30 healthy male Wistar rats were randomly divided into normoxic control group, chronic hypoxic group and hypoxia plus L-arginine (L-Arg) group. The animal model of HPH was developed. The mean pulmonary arterial pressure (mPAP) was measured by inserting a microcatheter into the pulmonary artery. The HIF-1alpha mRNA expression levels were detected by in situ hybridization (ISH) and semiquantitative RT-PCR. It was found that after 14 days hypoxia, the mPAP in normoxic control group (17.6 +/- 2.7 mmHg, 1 mmHg=0.133 kPa) was significantly lower than that in chronic hypoxic group (35.8 +/- 6.1 mmHg, t=0.2918, P<0.05) and mPAP in chronic hypoxic group was higher than that in hypoxia plus L-arginine group (24.4 +/- 3.8 mmHg, t=0.2563, P<0.05). ISH showed that the expression of HIF-1alpha mRNA in the intraacinar pulmonary arteriolae (IAPA) in normoxic control group (0.1076 +/- 0.0205) was markedly weaker than that in chronic hypoxic group (0.3317 +/- 0.0683, t=3.125, P<0.05) and that in chronic hypoxic group was stronger than that in hypoxia plus L-arginine group (0.1928 +/- 0.0381, t=2.844, P<0.05). RT-PCR showed that the content of HIF-1alpha mRNA in chronic hypoxic group (2.5395 +/- 0.6449) was 2.16 times and 1.75 times higher than that in normoxic control group (1.1781 +/- 0.3628) and hypoxia plus L-arginine group (1.4511 +/- 0.3981), respectively. It is concluded that NO can reduce the mPAP by the inhibition of the expression of HIF-1alpha mRNA, which may be one of the mechanisms through which NO affects the pathogenesis of HPH.
Anoxia/metabolism ; Arginine/pharmacology ; Hypertension, Pulmonary/*metabolism ; Hypoxia-Inducible Factor 1, alpha Subunit ; Nitric Oxide/*pharmacology ; RNA, Messenger/biosynthesis ; RNA, Messenger/genetics ; Random Allocation ; Rats, Wistar ; Reverse Transcriptase Polymerase Chain Reaction ; Transcription Factors/*biosynthesis ; Transcription Factors/genetics

OBJECTIVETo find out the relationship between the opacity in lens and the contents of 2,6-dinitro-4-amino-toluene(DNAT) in the urine of exposed workers.

METHODSTesting the exposed worker's lens and measuring the contents of DNAT in the urine after work.

RESULTSWhen the opacity of the lens occurred, the contents of DNAT in the urine(2.38 mg/L) of workers exposed to TNT were significantly higher than those without opacity in lens(1.44 mg/L) (P < 0.05).

CONCLUSIONThe severity of opacity of lens increased with the contents of DNAT raised in the urine. The threshold value suggested by ILO is not applicable to Chinese occupational population, which recommends the contents of DNAT(30 mg/L) in the urine for the workers exposed to TNT as biological occupational exposed limits.

Aniline Compounds ; urine ; Cataract ; chemically induced ; Environmental Monitoring ; Humans ; Occupational Exposure ; adverse effects ; Trinitrotoluene ; metabolism