19 cinnamamide/ester-triazole compounds were designed, synthesized and evaluated for their anti-Alzheimer's disease (AD) activity. Among them, compound 4f displayed excellent anti-β-amyloid protein (Aβ)-mediated cytotoxicity (EC₅₀ = 2.03 ± 2.45 μmol·L^-1) in APPswe cells and acetylcholinesterase inhibiton (IC₅₀ = 4.88 ± 4.70 μmol·L^-1). Further study indicated that, at dosages of (1, 5 and 25 mg·kg^-1), compound 4f was effective in improving spatial learning and memory deficits in Aβ_1-42-impaired mice, which was achieved by promoting the nonamyloidogenic signaling and inhibiting the amyloidogenic pathway, along with the suppression of Aβ-induced Tau phosphorylation. All animal experiments in this study were approved by the Experimental Animal Care and Use Committee of the Institute of Medicinal Biotechnology (IMB-20220908D701). In conclusion, compound 4f holds promise as a lead candidate for AD treatment, and the present study lays the foundation for its subsequent development.

Objective:To investigate the surgical techniques and clinical efficacy of arthroscopic-assisted posterior malleolus reduction for the management of ankle fracture-dislocation.Methods:A retrospective analysis was performed on the clinical data of 27 patients who underwent arthroscopy-assisted posterior malleolar reduction via the posterior approach for the surgical management of ankle fracture-dislocation at the Third Affiliated Hospital of Nanjing Medical University (Changzhou No.2 People's Hospital) between January 2022 and June 2023. The cohort comprised 17 males and 10 females, with a mean age of 43.67±9.56 years (range, 25-63 years). Based on the Bartonícek and Rammelt classification, there were 15 type II cases, 9 type III cases, and 3 type IV cases. The operation time, posterior ankle arthroscopy duration, and postoperative complications, such as neurovascular injury, wound infection, or skin necrosis, were recorded. X-ray and 3D CT imaging were utilized to assess joint surface reduction quality, tibiofibular matching and fracture healing status. The ankle plantarflexion, dorsiflexion and hallux flexion contractures were recorded at the last follow-up. Functional outcomes were measured using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the Olerud-Molander ankle score (OMAS), while pain was evaluated using the visual analogue scale (VAS).Results:All 27 patients were followed up postoperatively, with a mean follow-up duration of 14.30±1.38 months (range, 12-18 months). Postoperatively, one patient experienced wound exudation, while another developed intermuscular venous thrombosis in the calf. No cases of neurovascular injury, wound infection, skin necrosis, or hallux flexion contracture occurred, and no reduction loss was observed. The mean operation time was 96.11±11.55 min (range, 80-120 min), and the posterior ankle arthroscopy duration was 35.74±5.67 min (range, 30-45 min). Postoperative X-ray evaluations demonstrated no loss of fracture reduction, and all fractures achieved bony union. The mean fracture healing time was 3.78±0.75 months (range, 3-5 months). Postoperative CT evaluations showed no joint surface malalignment, and distal tibiofibular matching was satisfactory. At the final follow-up, mean ankle plantarflexion was 46.74°±4.73° (range, 33°-50°), and dorsiflexion was 20.96°±3.29° (range, 14°-26°). There was no hallux flexion contracture occurred. The mean AOFAS ankle-hindfoot score was 92.11±7.19 (range, 74-100), with 20 excellent, 5 good, and 2 fair, yielding an excellent-good rate of 93%. The mean OMAS score was 94.44±7.25 (range, 75-100), comprising 20 excellent and 7 good results, yielding an excellent-good rate of 100%. The mean VAS score was 0.70±0.95 (range, 0-3).Conclusion:Arthroscopy-assisted posterior malleolar reduction in ankle fracture-dislocation surgery provides optimal soft tissue protection and ensures precise fracture reduction and fixation.

OBJECTIVE: To investigate the effectiveness of nickel-titanium shape memory staples in treating multiple metatarsal fractures. METHODS: The clinical data of 27 patients with multiple metatarsal fractures who were treated between January 2022 and June 2023 and met the selection criteria were retrospectively analysed. The cohort consisted of 16 males and 11 females, aged 33-65 years (mean, 47.44 years). The causes of injury included heavy object impact in 11 cases, traffic accidents in 9 cases, and crush in 7 cases. Simultaneous fractures of 2, 3, 4, and 5 bones occurred in 6, 6, 4, and 8 cases, respectively, with tarsometatarsal joint injury in 3 cases. Fixation was performed using staples for 16, 22, and 9 fractures in the metatarsal neck, shaft, and the base, respectively, and 5 tarsometatarsal joint injuries. Preoperative soft tissue injuries were identified in 8 cases and classified according to the Tscherne-Oestern closed soft tissue injury classification as type Ⅰ in 5 cases and type Ⅱ in 3 cases. One case of type Ⅱexhibited preoperative skin necrosis. The patients were treated with fixation using nickel-titanium shape memory staples. Complications and fracture healing were documented. At last follow-up, the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was used to evaluate the function, and the visual analogue scale (VAS) score was used to evaluate the pain. RESULTS: The 27 patients were followed up 9-19 months (mean, 12.4 months). Postoperative X-ray films revealed no loss of fracture reduction, and all fractures achieved bony union. No internal fixator loosening, breakage, or other mechanical failures was observed. The mean fracture healing time was 3.13 months (range, 3-4 months). Postoperatively, 4 cases (2 of Tscherne-Oestern type Ⅰ, 2 of type Ⅱ) developed superficial skin necrosis, which resolved with dressing changes. No infection was observed in the remaining patients, and all wounds healed. At last follow-up, the AOFAS forefoot score ranged from 70 to 95, with an average of 86.6, of which 19 cases were excellent, 6 cases were good, and 2 cases were fair, with an excellent and good rate of 92.6%; the VAS score ranged from 0 to 3, with an average of 0.9, of which 24 cases were excellent, and 3 cases were good, with an excellent and good rate of 100%. CONCLUSION The use of nickel-titanium shape memory staples in the treatment of multiple metatarsal fractures can effectively protect local skin and soft tissues and minimize secondary damage associated with internal fixator insertion. It is a viable surgical option for management of multiple metatarsal fractures.
Humans ; Male ; Female ; Middle Aged ; Adult ; Titanium ; Nickel ; Retrospective Studies ; Fracture Fixation, Internal/instrumentation* ; Aged ; Metatarsal Bones/surgery* ; Fractures, Bone/surgery* ; Treatment Outcome ; Sutures ; Fractures, Multiple/surgery*

OBJECTIVE: To explore the improvement effect of rehabilitation nursing based on information-knowledge-belief-behavior (IKAP) theory on urinary incontinence patients after radical prostatectomy. METHODS Sixty-six patients with urinary incontinence who received robot-assisted laparoscopic radical prostatectomy in General Hospital of Eastern Theater Command from January 2021 to January 2023 were selected and divided into control group (n=33) and observation group (n=33) according to random number table method. The patients in the control group were treated with rehabilitation nursing. The patients in the observation group were treated with rehabilitation nursing guided by IKAP theory. The recovery of urinary incontinence, duration of urinary incontinence, subjective well-being, quality of life, psychological and emotional indexes of patients in the two groups were compared. Results： The total effective rate of urinary incontinence recovery in the observation group was significantly higher than that in the control group (90.91% vs 60.61%，P<0.05). The duration of urinary incontinence in the observation group was significantly shorter than that in the control group (［3.36±1.54］d vs ［4.15±1.36］d，P<0.05). And the subjective well-being score in observation group was significantly higher than that in the control group (［19.36±2.69］points vs ［11.65±2.65］points， P<0.05). There was no significant difference in preoperative physical function, social function，and mental health scores between the two groups (P>0.05). And all scores in the observation group were significantly higher than those in the control group after surgery (P<0.05). There was no significant difference in the preoperative SAS and SDS scores between the two groups of patients (P>0.05). And the scores of SAS and SDS in observation group were lower than those of the control group after the operation (P<0.05). Conclusion： Rehabilitation nursing based on IKAP theory can significantly improve urinary incontinence in patients with prostate cancer after surgery, which promotes the recovery of urinary incontinence, shortens the time of urinary incontinence, and improves the subjective well-being and quality of life, as well as reduces the negative impact of negative emotions. Therefore, it can be widely promoted and implemented in clinical practice.
Humans ; Prostatectomy/adverse effects* ; Urinary Incontinence/etiology* ; Male ; Quality of Life ; Rehabilitation Nursing ; Middle Aged ; Aged

Since May 2022, a severe global Mpox epidemic has underscored the urgent need for a preventative vaccine. On September 16, 2022, the mainland of China reported its first case of imported Mpox, which was subsequently followed by a significant rise in domestic infections commencing from June 2023. This alarming trend has escalated the likelihood of localized outbreaks and covert transmission, posing a heightened risk to public health. Notably, the United States, many European countries, and Japan have approved the use of smallpox vaccines for Mpox prevention and emergency vaccination post-exposure, based on their cross-protection efficacy. In recent years, virology research has broadened its scope to include investigations into various novel vaccine approaches, such as nucleic acid-based vaccines, protein subunit vaccines, and epitope peptide vaccines, and other related methodologies. This review offers a thorough examination of the current global landscape of Mpox prevalence, delves into the advancements in Mpox vaccine development, and highlights the progress achieved in Mpox vaccine research, serving as a valuable resource and providing technical insights essential for the effective prevention and control of Mpox.
Humans ; Vaccine Development ; Smallpox Vaccine ; Smallpox/epidemiology* ; Mpox, Monkeypox

OBJECTIVE: Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection frequently develop central nervous system damage, yet the mechanisms driving this pathology remain unclear. This study investigated the primary pathways and key factors underlying brain tissue damage induced by the SARS-CoV-2 beta variant (lineage B.1.351). METHODS: K18-hACE2 and C57BL/6 mice were intranasally infected with the SARS-CoV-2 beta variant. Viral replication, pathological phenotypes, and brain transcriptomes were analyzed. Gene Ontology (GO) analysis was performed to identify altered pathways. Expression changes of host genes were verified using reverse transcription-quantitative polymerase chain reaction and Western blot. RESULTS: Pathological alterations were observed in the lungs of both mouse strains. However, only K18-hACE2 mice exhibited elevated viral RNA loads and infectious titers in the brain at 3 days post-infection, accompanied by neuropathological injury and weight loss. GO analysis of infected K18-hACE2 brain tissue revealed significant dysregulation of genes associated with innate immunity and antiviral defense responses, including type I interferons, pro-inflammatory cytokines, Toll-like receptor signaling components, and interferon-stimulated genes. Neuroinflammation was evident, alongside activation of apoptotic and pyroptotic pathways. Furthermore, altered neural cell marker expression suggested viral-induced neuroglial activation, resulting in caspase 4 and lipocalin 2 release and disruption of neuronal molecular networks. CONCLUSION These findings elucidate mechanisms of neuropathogenicity associated with the SARS-CoV-2 beta variant and highlight therapeutic targets to mitigate COVID-19-related neurological dysfunction.
Animals ; COVID-19/genetics* ; Mice ; Brain/metabolism* ; Apoptosis ; Mice, Inbred C57BL ; SARS-CoV-2/physiology* ; Pyroptosis ; Gene Expression Profiling ; Transcriptome ; Male ; Female

In this study,a sensitive lateral flow immunoassay(LFIA)platform based on carbon dots-mesoporous silica nanocomposite(CD-MSNs)fluorescent probes was constructed for high-performance detection of inflammatory marker interleukin-6(IL-6).Green fluorescent carbon dots(CDs)were prepared by hydrothermal method with 3,9-perylenic acid and 3-aminopropyltriethoxysilane(APTES)as raw materials,and highly fluorescent CD-MSNs composites were then constructed by encapsulating the prepared CDs in mesoporous silica nanoparticles(MSNs).Fluorescent probes were prepared by covalent coupling of CD-MSNs with IL-6 antibody.Fluorescent immunochromatographic test strips were constructed by spraying IL-6 capture antibody and goat anti-mouse IgG on nitrocellulose membrane as detection line(T-line)and quality control line(C-line),respectively.The fluorescence immunoassay analyzer was used to quantitatively detect the fluorescence intensity of T-line,and the experimental results showed that the LFIA platform based on this probe had a good linear relationship in IL-6 concentration range of 102-106 pg/mL,and the detection limit was 64 pg/mL,which was two orders of magnitude more sensitive than that of the traditional colloidal gold test strips.This method effectively solved the issue of insufficient sensitivity of traditional LFIA technique,and provided a rapid and highly sensitive detection method for early diagnosis of inflammatory diseases.

Objective:To investigate the surgical techniques and clinical efficacy of arthroscopic-assisted posterior malleolus reduction for the management of ankle fracture-dislocation.Methods:A retrospective analysis was performed on the clinical data of 27 patients who underwent arthroscopy-assisted posterior malleolar reduction via the posterior approach for the surgical management of ankle fracture-dislocation at the Third Affiliated Hospital of Nanjing Medical University (Changzhou No.2 People's Hospital) between January 2022 and June 2023. The cohort comprised 17 males and 10 females, with a mean age of 43.67±9.56 years (range, 25-63 years). Based on the Bartonícek and Rammelt classification, there were 15 type II cases, 9 type III cases, and 3 type IV cases. The operation time, posterior ankle arthroscopy duration, and postoperative complications, such as neurovascular injury, wound infection, or skin necrosis, were recorded. X-ray and 3D CT imaging were utilized to assess joint surface reduction quality, tibiofibular matching and fracture healing status. The ankle plantarflexion, dorsiflexion and hallux flexion contractures were recorded at the last follow-up. Functional outcomes were measured using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the Olerud-Molander ankle score (OMAS), while pain was evaluated using the visual analogue scale (VAS).Results:All 27 patients were followed up postoperatively, with a mean follow-up duration of 14.30±1.38 months (range, 12-18 months). Postoperatively, one patient experienced wound exudation, while another developed intermuscular venous thrombosis in the calf. No cases of neurovascular injury, wound infection, skin necrosis, or hallux flexion contracture occurred, and no reduction loss was observed. The mean operation time was 96.11±11.55 min (range, 80-120 min), and the posterior ankle arthroscopy duration was 35.74±5.67 min (range, 30-45 min). Postoperative X-ray evaluations demonstrated no loss of fracture reduction, and all fractures achieved bony union. The mean fracture healing time was 3.78±0.75 months (range, 3-5 months). Postoperative CT evaluations showed no joint surface malalignment, and distal tibiofibular matching was satisfactory. At the final follow-up, mean ankle plantarflexion was 46.74°±4.73° (range, 33°-50°), and dorsiflexion was 20.96°±3.29° (range, 14°-26°). There was no hallux flexion contracture occurred. The mean AOFAS ankle-hindfoot score was 92.11±7.19 (range, 74-100), with 20 excellent, 5 good, and 2 fair, yielding an excellent-good rate of 93%. The mean OMAS score was 94.44±7.25 (range, 75-100), comprising 20 excellent and 7 good results, yielding an excellent-good rate of 100%. The mean VAS score was 0.70±0.95 (range, 0-3).Conclusion:Arthroscopy-assisted posterior malleolar reduction in ankle fracture-dislocation surgery provides optimal soft tissue protection and ensures precise fracture reduction and fixation.

Objective:To analyze the independent risk factors for pneumothorax in older adult patients with chronic obstructive pulmonary disease (COPD), construct and validate a prediction model of pneumothorax risk in patients with COPD.Methods:A total of 500 patients with COPD who received treatment at the Department of Emergency, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to December 2021 were selected using the convenience sampling method and included in this study. Chest CT scan or chest X-ray film findings were used as diagnostic criteria. These patients were divided into a pneumothorax group and a control group according to whether they developed pneumothorax. Taking whether patients develop pneumothorax as a dependent variable and predictive risk factors as independent variables, univariate and multivariate logistic regression analyses of the included risk factors were performed to identify the independent influential factors for developing pneumothorax in patients with COPD. Subsequently, a prediction model for predicting the risk of pneumothorax was constructed and evaluated. A decision curve analysis was conducted to evaluate its clinical practicality.Results:Among 500 patients with COPD, 104 developed pneumothorax, with an incidence of 20.80%. Binary logistic regression analysis showed that long duration of COPD, C-reactive protein, and mechanical ventilation were independent risk factors for the development of pneumothorax in these patients. The percentage of forced expiratory volume in one second (FEV 1%), the FEV 1/forced vital capacity ratio (FEV 1/FVC), and serum albumin are protective factors for the development of pneumothorax in patients with COPD. A prediction model for the risk of developing pneumothorax was constructed. Finally, we obtained the formula: Logit( P) = 12.427 + 2.241 × COPD duration + 0.899 × smoking + 7.715 × CRP + 0.208 × mechanical ventilation history -0.514 × albumin -0.243 × FEV 1%-0.286 FEV 1/FVC. Receiver operating characteristic curve analysis results showed that the area under the curve was 0.815 and the C-Index was 0.781 (95% CI: 0.856-0.891), indicating that the constructed prediction model can better distinguish between patients with and without pneumothorax among those with COPD. Conclusion:C-reactive protein, albumin, FEV 1%, FEV 1/FVC, smoking history, and mechanical ventilation history are all risk factors for the development of pneumothorax. A prediction model has been successfully constructed based on these risk factors, which can effectively predict the risk of pneumothorax. This constructed risk prediction model provides good guidance in taking preventive treatment and nursing measures by medical staff.

Parkinson’s disease (PD) is a neurodegenerative disorder characterized by muscle rigidity, resting tremor, and postural instability, which severely impair the quality of life in middle-aged and elderly individuals. PD’s pathogenesis is complex, involving oxidative stress, immune inflammation, and genetic factors. Despite extensive research, precise therapeutic targets for PD remain elusive, necessitating further investigation into its underlying mechanisms. Recent studies highlight the pivotal role of regional brain iron overload, oxidative stress, and lipid peroxidation in PD’s pathogenesis. Ferroptosis, a form of regulated cell death driven by iron dependency and lipid peroxidation, has emerged as a critical factor in PD pathology. This review examines the relationship between ferroptosis and PD and explores the potential of exercise as a therapeutic intervention to modulate ferroptosis and alleviate PD symptoms. Ferroptosis, distinct from other forms of cell death such as necrosis, autophagy, pyroptosis, and apoptosis, is characterized by mitochondrial shrinkage, reduced cristae, and membrane collapse, without nuclear fragmentation, DNA cleavage, or caspase activation. It is induced by the accumulation of intracellular Fe²⁺, which enhances lipid peroxidation and reactive oxygen species (ROS) generation, ultimately leading to cell death. Studies show disrupted iron metabolism in PD patients, with elevated iron levels in dopaminergic neurons of the substantia nigra correlating with disease severity. Iron chelation therapy has shown promise in alleviating PD symptoms by reducing brain iron levels, highlighting the significance of iron metabolism in PD pathogenesis. Lipid peroxidation, a hallmark of ferroptosis, involves the oxidation of polyunsaturated fatty acids (PUFAs) in cell membranes, compromising membrane integrity and increasing permeability. Elevated lipid peroxidation in the substantia nigra contributes to neuronal damage in PD. Enzymes such as ACSL4 and LPCAT3, crucial in PUFA metabolism, play significant roles in ferroptosis. Exercise has been shown to modulate these enzymes, potentially reducing lipid peroxidation and preventing ferroptosis in PD. Glutathione (GSH) metabolism is another crucial factor in ferroptosis regulation. GSH depletion impairs ROS detoxification, exacerbating oxidative stress and lipid peroxidation. PD patients exhibit reduced GSH levels in the substantia nigra, making dopaminergic neurons more vulnerable to oxidative damage. Exercise enhances GSH synthesis and activity, mitigating oxidative stress and ferroptosis in PD. α-Synuclein aggregation, a hallmark of PD, is closely linked to iron metabolism and oxidative stress. Excessive α‑synuclein binds to iron, promoting its aggregation and inducing ferroptosis. Exercise has been found to reduceα-synuclein accumulation and its pathological phosphorylation, potentially through the upregulation of neuroprotective proteins like DJ-1 and Irisin. These proteins enhance antioxidant defenses and facilitate α‑synuclein degradation, providing a protective effect against PD progression. Additionally, glutamate excitotoxicity, driven by dysregulated glutamate metabolism and receptor activity, contributes to ferroptosis in PD. Exercise modulates glutamate levels and receptor expression, reducing excitotoxicity and iron-induced neuronal damage. In conclusion, emerging research suggests that exercise may inhibit ferroptosis through multiple mechanisms, including regulation of iron metabolism, enhancement of antioxidant defenses, reduction of α-synuclein aggregation, and modulation of glutamate metabolism. These findings highlight the potential of exercise as a non-pharmacological intervention in the prevention and treatment of PD. Further research is needed to elucidate precise mechanisms and optimize exercise protocols for maximum therapeutic benefit.