OBJECTIVE: To investigate the short-term clinical effect of closed reduction single arm external fixator combined with percutaneous needle fixation in the treatment of C1 distal radius fracture in elderly patients. METHODS: Between December 2022 and December 2023, a total of 60 elderly patients diagnosed with type C1 distal radius fractures were treated, comprising 9 males and 51 females. The age ranged from 65 to 84 years old, with an average of (72.69±8.14) years old. Among them, there were 18 cases on the left side and 42 cases on the right side. There were 55 cases of falling injury and 5 cases of traffic accident injury. According to the different surgical methods, the patients were divided into observation group and control group, with 30 cases in each group. The control group underwent manual reduction and unilateral external fixator fixation, consisting of 4 males and 26 females. The mean age was (72.54±8.67) years old. The body mass index (BMI) was (20.61±2.17) kg·m^-2. There were 10 cases on the left side and 20 cases on the right side. Among them, there were 27 cases of falling injury and 3 cases of traffic accident injury. The observation group was treated with manual reduction and unilateral external fixator combined with percutaneous Kirschner wire fixation, including 5 males and 25 females. The mean age was (72.76±7.23) years old. BMI (20.82±2.03) kg·m^-2. The left side was involved in 8 cases and the right side in 22 cases. There were 28 cases of falling injury and 2 cases of traffic accident injury. The changes in radial height, ulnar declination, palmar inclination angle parameters and patient-rated wrist evaluation (PRWE) were assessed on X-ray films before surgery, 2 days after surgery, and 12 weeks after surgery between the two groups. RESULTS: All surgical procedures were successfully completed in both groups without any significant complications. All patients were followed up for a duration from 12 to 20 weeks with an average of(14.50±2.78) weeks. The two groups exhibited significant differences in radial height, palmar inclination angle, and ulnar deviation angle at 2 days and 12 weeks post-operation (P<0.05). However, there was no statistically significant difference observed in radial height, palmar inclination, and ulnar deviation between the two groups at 2 days after the operation (P>0.05). There were significant differences in radial height, palmar inclination angle, and ulnar deviation between the two groups at 12 weeks after operation (P<0.05). At 2 days and 12 weeks after the operation, there were significant differences in PRWE scores of the two groups compared with preoperative scores(P<0.05). At 2 days after the operation, there was no significant difference in PRWE score between the two groups (P>0.05). The PRWE score showed a significant difference between the two groups at 12 weeks post-operation(P<0.05). CONCLUSION The combination of closed reduction and unilateral external fixator, along with percutaneous pin fixation provides move stable fixation for type C1 distal radius fractures. Gradual removal of external fixator further facilitatse the recovery of wrist joint function.
Humans ; Male ; Female ; Radius Fractures/surgery* ; External Fixators ; Aged ; Aged, 80 and over ; Bone Wires ; Fracture Fixation/instrumentation* ; Wrist Fractures

Autophagy is an essential cellular metabolic process that involves clearance of damaged organelles and protein aggregates in cells through lysosomes,providing energy for cells,and maintaining cellular tissue homeostasis.Impaired autophagy is closely related to the pathophysiology of a variety of diseases.In the pathogenesis of atherosclerosis(AS),the dysfunction of autophagy of vascular cells plays a crucial role in the formation and progression of AS.The functional status,survival or death of vascular cells,including endothelial cells,vascular smooth muscle cells and macrophages,can influence the formation and stability of plaques,thereby affecting the progression of AS.This review summarizes the relationship between autophagy and AS,and details the impact of autophagy dysfunction on vascular cell function in the process of AS,as well as the role of mitophagy and inflammasome in the development of AS,aiming to provide novel insights for the prevention and treatment of AS.

Objective To investigate the radiographic anatomical relationship between tibial plateau and distal femur and evaluate the impact of reset tibial plateau of various widths after reduction of the Schatzker Ⅳ-C tibial plateau fractures on postoperative outcomes.Methods We collected and reviewed the X-ray images of the normal knees of 207 standard neutrally-positioned adults(non-fracture group)and pre-and post-operative immediate anterior-posterior X-ray images of the knees of 60 patients with Schatzker Ⅳ-C fractures(fracture group)in our hospital from August 2012 to August 2022.We measured the proximal tibial joint width(TAW),distal femoral width(DFW),and distal femoral joint width(FAW)in both groups and calculated the TAW/DFW and TAW/FAW ratios.In the fracture group,the cases with TAW between FAW and DFW were assigned to the well-reduced group,while those with TAW outside this range between FAW and DFW to the poorly-reduced group.Both groups were assessed using the Hospital for Special Surgery knee score(HSS)one year after operation.Results In the non-fracture group,there were no significant differences in gender or affected side in terms of TAW/DFW and TAW/FAW ratios(P＞0.05),while in the fracture group,there were statistically significant differences in the TAW/DFW and TAW/FAW ratios compared to the non-fracture group(P＜0.05).There was a statistically signifi-cant difference in the one-year postoperative HSS scores between the well-reduced and poorly-reduced groups in the fracture group(P＜0.05).Conclusion The radiographic anatomical relationship between the tibial plateau and distal femur in normal adults is relatively constant,providing a radiological reference for resetting the tibial plateau to a satisfactory width during reduction of Schatzker Ⅳ-C fractures.TAW/DFW＞1 or TAW/FAW＜1 indicates a poor reduction of the fracture and predicts poor postoperative recovery of knee joint function.

Oligonucleotide drugs have experienced accelerated development in the past 10 years, and some of them have been used in clinical treatment. Because of its convenient design, flexible sequence, and high specificity, it is expected to solve the “undruggable” challenge of many targets which are difficult in drug development. Moreover, its clinical transformation period and cost are relatively low, which makes oligonucleotide drug become the frontier of emerging biotechnology drug discovery. Brain diseases include a series of incurable diseases, such as neurodegenerative diseases, glioma, and motor neuron diseases. Many of them are age-related and regarded as aging-associated brain diseases. Due to the complex etiology, many targets are difficult to be drugged. At the same time, the existence of the barrier system “blood-brain barrier” in the brain makes most drugs unable to achieve effective accumulation at brain lesions, and many small molecule drugs have failed in clinical transformation. The specificity and sequence flexibility of oligonucleotide acid drugs provide new possibilities for drug development, but they also face the challenge of brain delivery. Although a variety of oligonucleotide drugs have been used in the medical market, brain-targeted oligonucleotide drugs are still extremely rare. This article reviewed recent advances and discussed key topics and clinical transformation challenges in this field, such as clinical approval cases, bottlenecks of brain-targeted delivery and current strategies, as well as potential targets for aging-related brain diseases.

Objective To investigate the influence of volatile oil from Acori graminei Rhizoma (VOA) on expressions of glial fibrillary acidic protein (GFAP), c-Jun N-terminal protein kainse (JNK) and tumour necrosis factor-α (TNF-α) in the spinal cord dorsal horn of imflammatory pain rats. Methods Totally 36 male SD rats were randomly divided into control group (control), sham-operated group (sham), complete Freund' s adjuvant group (CFA), 5 g/(kg·d) low dose VOA+CFA group (VOA-L+CFA), 10 g/(kg·d) medium dose VOA + CFA group (VOA-M+CFA) and 20 g/(kg·d) high dose VOA + CFA group (VOA-H+CFA). All animals were sacrificed immediately after continuous gavage administration for 22 days. The expressions of GFAP, JNK and TNF-α in the spinal cord dorsal horn of rats in each group were detected by immunofluorescence and Western blotting methods. Results The present results showed that the positive expressions of GFAP, JNK and TNF-α in the spinal cord dorsal horn of rats increased significantly in the CFA group, when compared to the control and sham groups (P < 0. 01). The expressions of GFAP, JNK and TNF-α in the spinal cord dorsal horn of rats with VOA treatment reduced in the dose-dependent manner, when compared to the CFA group, the positive expressions of GFAP, JNK and TNF-α reduced significantly in the dorsal horn of the spinal cord of the VOA-H+CFA group (P<0. 05, P<0. 01). Conclusion VOA reduces the expressions of GFAP, JNK and TNF-α in the spinal cord dorsal horn of rats of CFA-induced inflammatory pain.

ObjectiveTo investigate the effect of Astragalin （AST） on apoptosis of cerebral cortex neurons in APP/PS1 transgenic mice. MethodsEighteen six-month-old male APP/PS1 transgenic mice were randomly divided into APP/PS1 group， APP/PS1+ 40 mg/kg AST group and APP/PS1+ 20 mg/kg Donepezil （DNP） group， with six mice in each group. At the same time， six male C57BL/6 mice were selected as the normal control group. After intraperitoneal injection of AST once a day and continuous administration for one month， we used Tunel staining to detect the apoptosis of neurons in the cerebral cortex of APP/PS1 mice； immunofluorescent staining to examine the expression of apoptosis-related proteins Bax， Bcl-2， Caspase9 and Cleaved-Caspase3 in the cerebral cortex neurons of APP/PS1 mice； Western blot method to evaluate the changes of the expression of Bax， Bcl-2， Caspase9 and Caspase3. ResultsTunel staining showed that 40 mg/kg AST and 20 mg/kg DNP both reduced the apoptosis of neurons in the cerebral cortex of APP/PS1 mice， AST with more significant inhibition effect. Immunofluorescent staining revealed that 40 mg/kg AST and 20 mg/kg DNP both inhibited the expression of Bax， Caspase9， and Cleaved-Caspase3， and icreased the expression of Bcl-2 in the cerebral cortex neurons of APP/PS1 mice. Western blot results further confirmed that 40 mg/kg AST and 20 mg/kg DNP both down-regulated the expression of Bax （P < 0.05， P < 0.05）， Caspase9 （P < 0.005， P < 0.05） and Caspase3 （P < 0.0001， P < 0.0001） ， and up-regulated the expresstion of Bcl-2 （P < 0.05， P < 0.05） in the cerebral cortex neurons of APP/PS1 mice. ConclusionsAST can inhibit the apoptosis of cerebral cortex neurons in APP/PS1 mice.

OBJECTIVE: To derive the Chinese medicine (CM) syndrome classification and subgroup syndrome characteristics of ischemic stroke patients. METHODS: By extracting the CM clinical electronic medical records (EMRs) of 7,170 hospitalized patients with ischemic stroke from 2016 to 2018 at Weifang Hospital of Traditional Chinese Medicine, Shandong Province, China, a patient similarity network (PSN) was constructed based on the symptomatic phenotype of the patients. Thereafter the efficient community detection method BGLL was used to identify subgroups of patients. Finally, subgroups with a large number of cases were selected to analyze the specific manifestations of clinical symptoms and CM syndromes in each subgroup. RESULTS: Seven main subgroups of patients with specific symptom characteristics were identified, including M3, M2, M1, M5, M0, M29 and M4. M3 and M0 subgroups had prominent posterior circulatory symptoms, while M3 was associated with autonomic disorders, and M4 manifested as anxiety; M2 and M4 had motor and motor coordination disorders; M1 had sensory disorders; M5 had more obvious lung infections; M29 had a disorder of consciousness. The specificity of CM syndromes of each subgroup was as follows. M3, M2, M1, M0, M29 and M4 all had the same syndrome as wind phlegm pattern; M3 and M0 both showed hyperactivity of Gan (Liver) yang pattern; M2 and M29 had similar syndromes, which corresponded to intertwined phlegm and blood stasis pattern and phlegm-stasis obstructing meridians pattern, respectively. The manifestations of CM syndromes often appeared in a combination of 2 or more syndrome elements. The most common combination of these 7 subgroups was wind-phlegm. The 7 subgroups of CM syndrome elements were specifically manifested as pathogenic wind, pathogenic phlegm, and deficiency pathogens. CONCLUSIONS There were 7 main symptom similarity-based subgroups in ischemic stroke patients, and their specific characteristics were obvious. The main syndromes were wind phlegm pattern and hyperactivity of Gan yang pattern.
Humans ; Syndrome ; Ischemic Stroke ; Medicine, Chinese Traditional ; Liver ; Phenotype

Objective:The purpose of this study was to investigate the effect of voice therapy via telepractice on voice function in laryngopharyngeal reflux disease (LPRD) patients.Methods:The prospective study included 120 patients from January 2021 to July 2022 with dyspnea and LPRD diagnosed at the department of otolaryngology head and neck surgery of the First Hospital of Shanxi Medical University. These patients were then randomly divided into standard treatment group (group A), combined face-to-face voice therapy group (group B) and combined telepractice voice therapy group (group C). We collected and compared data on curative effect in patients with LPRD at the 8th week(Stage 1) and the 12th week of treatment(Stage 2) and the 6th week post-treatment(Stage 3). Statistical analysis was performed using SPSS 22.0.Results:One hundred and twenty patients with LPRD and dyspnea were included in the study (63 men, 57 women, 18-65 years old). At stage 1, there were statistically significant differences among the three groups in Voice Handicap Index(VHI), Reflux Symptom Index (RSI) and Reflux Finding Score(RFS) ( F=13.72, P<0.05; F=62.50, P<0.05; F=3.78, P<0.05). VHI and RSI in group B and C were significantly smaller than those in group A, VHI and RSI in group C were significantly smaller than those in group B, and RFS in group C was significantly smaller than that in group A and B. At stage 2, there were statistically significant differences between the three groups in Maximum Phonation Time(MPT), Dysphonia Severity Index(DSI), VHI, RSI and RFS( F=8.49, P<0.05; F=3.24, P<0.05; F=8.55, P<0.05; F=19.92, P<0.05; F=12.19, P<0.05). MPT and DSI in group B and C were significantly larger than those in group A. The scores of VHI, RSI and RFS in group B and C were significantly smaller than those in group A, and RFS in group C was significantly smaller than that in group B. At stage 3, there were statistically significant differences among the three groups in Jitter, MPT, DSI, VHI( F=3.19, P<0.05; F=19.37, P<0.05; F=43.56, P<0.05; F=11.05, P<0.05), and there were statistically significant differences among the three groups in RSI and RFS( F=25.58, P<0.05; F=11.82, P<0.05). MPT and DSI in group B and C were significantly larger than those in group A. The scores of VHI and RSI in group B and C were significantly smaller than those in group A, and RFS in group C was significantly smaller than those in group A and B. Conclusion:Telepractice can be used in patients with LPRD and dyspnea as an alternative to face-to-face voice therapy with better long-term outcomes.

ObjectiveTo explore the effect of astragalin （AST） on neurons and Aβ plaques in the cortex of APP/PS1 transgenic mice. MethodsTwenty-four 8-month-old male APP/PS1 transgenic mice were randomly divided into APP/PS1 group， 10 mg/kg AST （APP/PS1+AST 10） group， and 20 mg/kg AST （APP/PS1+AST 20） group， 40 mg/kg AST （APP/PS1+AST 40） group， with 6 mice in each group. Six C57BL/6 male mice of the same age served as the control group （WT group）. AST drugs were continuously injected intraperitoneally for one month. Then Immunofluorescent staining was used to observe the deposition of Aβ plaques in the cortex. Nissl staining was used to observe the number and morphological changes of neurons in the cortex， and immunofluorescent multiple staining methods were used to observe the co-expression of LC3B， p62 and NeuN in the cortex. Then the expressions of NeuN， LC3B， and p62 protein were detected by Western blot method. ResultsImmunofluorescent staining results showed 20 mg/kg and 40 mg/kg AST reduced Aβ plaques deposition in the cortex of APP/PS1 mice （P < 0.000 1； P < 0.000 1）. Western blot analysis showed both 20 and 40 mg/kg AST increased the expression of NeuN protein in the cortex of APP/PS1 mice （P = 0.012 1； P < 0.000 1）. Immunofluorescent multiplex staining showed co-expression of LC3B， p62， and NeuN in the cortex of APP/PS1 mice. Western blot analysis showed AST increased the expression of LC3B （P = 0.007， P < 0.000 1） and decreased the expression of p62 （P < 0.000 1， P < 0.000 1） in the cortex of APP/PS1 mice. ConclusionsAST reduces neuronal damage and Aβ plaques deposition in the cortex of APP/PS1 mice by activating autophagy.

A new rapid, quality control method based on quantitative water tests has been established for the quality evaluation of Indigo Naturalis. The Turbiscan stability index (TSI) of 26 batches of Indigo Naturalis was measured by a stability analyzer. The parameters, including the method by which the ingredients are added, their particle size, amount, and the testing temperature, were systematically optimized and the methodological indexes such as repeatability and stability were determined. The content of indigo and indirubin in 26 batches of Indigo Naturalis was determined by high performance liquid chromatography and the total ash was measured. The correlation analysis between the active ingredients, total ash content and TSI value of Indigo Naturalis was determined by SPSS 26.0 and Origin 2021. This research shows that the best way to prepare samples for testing is to add 0.2 g of Indigo Naturalis powder which has passed through a No. 7 sieve but failed to pass through a No. 9 sieve to a glass bottle containing 20 mL pure water by a funnel and scan at 25 ℃ with a stability analyzer. Consistency analysis showed that the content ranking of indigo and indirubin is opposite to the TSI value, and the content ranking of total ash is generally consistent with the TSI value. Correlation analysis showed that the correlation coefficients of indigo and indirubin content and TSI value were -0.850 and -0.801, respectively, and R² was 0.72 and 0.64. The correlation coefficient between total ash content and TSI value was 0.724, R² was 0.52. Using the change in TSI value of Indigo Naturalis powder in water, this study establishes the range of classification of Indigo Naturalis decoction pieces and the content of relevant components, which can be used to authenticate Indigo Naturalis and evaluate its quality.