BACKGROUND:Pearl powder is rich in many active ingredients,which can promote the proliferation and migration of fibroblasts,thus promoting wound healing and skin tissue regeneration.However,the effect of nano-pearl powder water-soluble matrix on proliferation,migration and apoptosis of mouse fibroblasts L929 has not been reported.OBJECTIVE:To investigate the effect of nano-pearl powder water-soluble matrix on the proliferation,migration and apoptosis of mouse fibroblasts L929.METHODS:Passage 6 L929 cells were divided into five groups.The negative control group did not add any material;the positive control group added PBS,and the low,medium and high mass concentration groups of water-soluble matrix were added with 10,25 and 40 μg/mL of nano-pearl powder water-soluble matrix,respectively.The proliferation of L929 cells was detected by MTT assay.The migration ability of L929 cells was detected by Transwell.The apoptosis rate of L929 cells was detected by flow cytometry.The expressions of apoptosis-related proteins Bax,Bcl-2,and Caspase-1 were detected by western blot assay.RESULTS AND CONCLUSION:(1)The results of MTT assay and Transwell chamber experiment showed that the water-soluble matrix of nano-pearl powder could promote the proliferation and migration of L929 cells,and it was concentration dependent.(2)Flow cytometry and western blot assay results showed that the water-soluble matrix of nano-pearl powder could reduce the apoptosis rate of L929 cells and the protein expression of Bax and Caspase-1,and increase the expression of Bcl-2 protein,and it was concentration dependent.(3)These findings exhibited that the water-soluble matrix of nano-pearl powder could inhibit cell apoptosis under high mass concentration treatment.The results show that the water-soluble matrix of nano-pearl powder can promote the proliferation and migration of fibroblasts and inhibit the apoptosis of fibroblasts.

BACKGROUND:Pearl powder is rich in many active ingredients,which can promote the proliferation and migration of fibroblasts,thus promoting wound healing and skin tissue regeneration.However,the effect of nano-pearl powder water-soluble matrix on proliferation,migration and apoptosis of mouse fibroblasts L929 has not been reported.OBJECTIVE:To investigate the effect of nano-pearl powder water-soluble matrix on the proliferation,migration and apoptosis of mouse fibroblasts L929.METHODS:Passage 6 L929 cells were divided into five groups.The negative control group did not add any material;the positive control group added PBS,and the low,medium and high mass concentration groups of water-soluble matrix were added with 10,25 and 40 μg/mL of nano-pearl powder water-soluble matrix,respectively.The proliferation of L929 cells was detected by MTT assay.The migration ability of L929 cells was detected by Transwell.The apoptosis rate of L929 cells was detected by flow cytometry.The expressions of apoptosis-related proteins Bax,Bcl-2,and Caspase-1 were detected by western blot assay.RESULTS AND CONCLUSION:(1)The results of MTT assay and Transwell chamber experiment showed that the water-soluble matrix of nano-pearl powder could promote the proliferation and migration of L929 cells,and it was concentration dependent.(2)Flow cytometry and western blot assay results showed that the water-soluble matrix of nano-pearl powder could reduce the apoptosis rate of L929 cells and the protein expression of Bax and Caspase-1,and increase the expression of Bcl-2 protein,and it was concentration dependent.(3)These findings exhibited that the water-soluble matrix of nano-pearl powder could inhibit cell apoptosis under high mass concentration treatment.The results show that the water-soluble matrix of nano-pearl powder can promote the proliferation and migration of fibroblasts and inhibit the apoptosis of fibroblasts.

OBJECTIVE: To investigate the effectiveness of Youngswick-Akin osteotomy in the treatment of moderate hallux valgus combined with mild to moderate hallux rigidus. METHODS: The clinical data of 43 patients with moderate hallux valgus combined with mild to moderate hallux rigidus who were admitted between August 2019 and August 2022 and met the selection criteria were retrospectively analyzed. There were 8 males and 35 females. The age ranged from 28 to 77 years, with an average age of 59.0 years. The disease duration ranged from 10 to 35 months, with an average of 20 months. The degree of hallux rigidus included 2 cases of CoughlinⅠ degree, 29 cases of Ⅱ degree, 12 cases of Ⅲ degree. The preoperative hallux valgus angle ranged from 25° to 40°, with an average of 32°. All patients were treated with Youngswick-Akin osteotomy. The first metatarsophalangeal joint space was compared before operation and at 6 months after operation. The American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS) score were used to evaluate the functional recovery and pain relief of the patients before operation and at 6 and 24 months after operation. According to the severity of hallux rigidus, the patients were divided into mild group (Ⅰ, Ⅱ degree) and moderate group (Ⅲ degree) to compare the prognosis, including the changes of AOFAS score, VAS score, and the first metatarsophalangeal joint space. RESULTS: The operation time was 60-75 minutes (mean, 65 minutes). The intraoperative blood loss was 10-30 mL (mean, 20 mL). Two cases had superficial infection of the incision margin after operation, and healed well after dressing change and antibiotic treatment. The incisions of the other patients healed by first intention, and no medial cutaneous nerve injury of the great toe occurred. All patients were followed up 24-31 months, with an average of 25.8 months. The patient's hallux valgus deformity was corrected without recurrence; no complication such as osteomyelitis and hallux varus occurred. The AOFAS score, VAS score, and the first metatarsophalangeal joint space after operation significantly improved when compared with those before operation, the AOFAS score and VAS score at 24 months after operation further improved when compared with those at 6 months after operation, and the differences were significant ( P<0.05). The change of VAS score in mild group was significantly better than that in moderate group ( P<0.05); but there was no significant difference in the changes of AOFAS score and the first metatarsophalangeal joint space between the two groups ( P>0.05). CONCLUSION Youngswick-Akin osteotomy for moderate valgus deformity with mild to moderate hallux rigidus can achieve good functional recovery, pain relief, and joint space improvement.
Humans ; Osteotomy/methods* ; Hallux Valgus/diagnostic imaging* ; Male ; Female ; Middle Aged ; Hallux Rigidus/diagnostic imaging* ; Retrospective Studies ; Adult ; Aged ; Treatment Outcome ; Metatarsophalangeal Joint/surgery*

Objective:To investigate the correlation between the ratio of apolipoprotein B to apolipoprotein A-I (ApoB/ApoA-I) and unstable carotid plaque in a neurologically healthy population receiving health check-ups.Methods:This cross-sectional study consecutively enrolled 1 149 neurologically healthy individuals who underwent physical examinations at the Health Management Centre of Beijing Tiantan Hospital, Capital Medical University, from October 2021 to September 2022. All eligible participants completed standardized questionnaires, physical examinations and laboratory tests. Laboratory tests of lipid metabolism-related biomarkers included total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), ApoA-I, and ApoB; non-high-density lipoprotein cholesterol and the ApoB/ApoA-I ratio were subsequently calculated. The carotid plaque stability was evaluated using superb microvascular imaging technology. The participants were classified into unstable plaque group (341 cases) and stable plaque group (808 cases) according to the presence or absence of intraplaque neovascularization. The univariate and multivariate logistic regression analyses were used to explore the correlation between the ApoB/ApoA-I ratio and unstable carotid plaques.Results:The study enrolled 1 149 participants totally, with a median age of 57 (49-63) years, including 771 males (67.10%) and 378 females (32.90%), and 341 cases (29.68%) were found with unstable carotid plaques. The unstable plaque group had a higher proportion of males, smoking history, diabetes history, along with higher waist-to-hip ratio and ApoB/ApoA-I ratio compared to the stable plaque group [76.54% vs 63.12%, 33.43% vs 22.77%, 19.06% vs 13.37%, 0.91 (0.85, 0.94) vs 0.89 (0.84, 0.93), 0.64 (0.51, 0.76) vs 0.59 (0.48, 0.72)], while HDL-C and ApoA-I levels were lower [1.39 (1.19, 1.63) vs 1.44 (1.24, 1.66) mmol/L, 1.43 (1.29, 1.60) vs 1.51 (1.36, 1.68) g/L] (all P<0.05). An elevated ApoB/ApoA-I ratio was positively associated with the risk of unstable carotid plaque ( OR=1.61, 95% CI: 1.13-2.29, P=0.008; P for trend<0.001). After adjusting for age, gender, waist-to-hip ratio, history of hypertension, history of diabetes, dyslipidemia, cardiovascular disease, history of smoking and estimated glomerular filtration rate, the positive association between elevated ApoB/ApoA-I ratio and the risk of unstable carotid plaque remained significant ( OR=1.48, 95% CI: 1.01-2.16, P=0.044; P for trend=0.004). Conclusion:In a neurologically healthy population receiving health check-ups, an elevated ApoB/ApoA-I ratio may increase the risk of unstable carotid plaque.

Objective:To study the risk factors for acute kidney injury (AKI) following one-stage revision surgery combined with intra-articular antibiotics infusion for periprosthetic joint infection (PJI) of the hip joint.Methods:A retrospective analysis was conducted on the data of 168 patients with hip PJI who underwent one-stage revision surgery combined with intra-articular antibiotics infusion in the Department of Joint Surgery, the First Affiliated Hospital of Xinjiang Medical University, from May 1, 2010 to April 30, 2024. There were 87 males and 81 females with an average age of 60.1±14.6 years (range: 21-89 years). The body mass index (BMI) was 24.9±4.6 kg/m 2 (range: 17-41 kg/m 2). PJI was diagnosed according to the criteria of Musculoskeletal Infection Society (MSIS) in 2011. AKI was diagnosed and classified according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. For AKI group and non-AKI group, risk factors were screened by univariate analysis on their age, gender, BMI, BMI≥30 kg/m 2 (yes/no), American Society of Anesthesiologists (ASA) score (II/III), hypertension, diabetes, chronic kidney disease (CKD), surgical side (left/right), duration of intravenous antibiotic use, duration of intra-articular antibiotic use, preoperative blood transfusion, postoperative blood transfusion, baseline hemoglobin value, anemia grade (none/mild/moderate), baseline serum creatinine value, baseline serum creatinine grade (normal/below normal range/above normal range). Variables with P<0.10 were included in the multivariate logistic regression model to identify independent risk factors. Results:The overall incidence of AKI was 9.52%(16/168), among which 50%(8 cases) were stage I AKI, transient and requiring no special treatment. 12.5% (2 cases) were stage II AKI and did not undergo dialysis. 37.5%(6 cases) were stage III AKI. One case needed temporary hemodialysis, and there was no patient requiring long-term dialysis. There were significant differences in age, diabetes, chronic kidney disease and ASA score between AKI group and non-AKI group ( P<0.05). The univariate logistic regression analysis revealed that there were significant differences in age ( P=0.005), BMI ( P=0.078), ASA score level Ⅲ ( P=0.037), diabetes ( P=0.025), CKD ( P=0.003), and low baseline serum creatinine level ( P=0.056). Multivariate logistic regression analysis showed that age, CKD and low baseline serum creatinine level were independent risk factors for AKI ( P<0.05). Conclusions:The incidence of AKI after one-stage revision surgery combined with local antibiotic use in the joint cavity was relatively low in the treatment of PJI after total hip arthroplasty. Hower elderly patients with a history of CKD, or a low baseline serum creatinine level before surgery were at higher risk of developing AKI.

Objective:To compare the clinical and radiological outcomes between the ankle dislocation exposure versus the traditional posterolateral approach exposure in the treatment of complex posterior ankle malunion.Methods:This retrospective study analyzed the 50 patients (50 feet) with posterior ankle malunion who had been treated at Department of Foot and Ankle Orthopedics, Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from May 2015 to June 2023. This cohort included 18 males and 32 females, with an age of (46.2±12.0) years. The duration from injury to surgery averaged 7.0 (4.0, 12.2) months. The patients were divided into 2 groups based on the surgical exposure methods: an ankle dislocation group (22 cases) in which the posterior ankle malunion was exposed by ankle dislocation before reduction and fixation, and a traditional posterolateral approach group (28 cases) in which the posterior ankle malunion was exposed by the traditional posterolateral approach before reduction and fixation. Evaluation indices included operative time, ankle arthritis grading, incidence of complications, as well as pre-operative and last follow-up recordings of distal tibial articular angle and joint step-off, visual analogue scale (VAS) pain score, and ankle-hindfoot score of American Orthopaedic Foot and Ankle society (AOFAS).Results:There was no significant difference in the baseline data between the 2 groups, indicating comparability ( P>0.05). The average follow-up was (39.4±17.9) months. The operative time in the dislocation group [(95.8±9.9) min] was significantly shorter than that in the posterolateral approach group [(121.9±14.3) min] ( P<0.05). The step-off on the distal tibial articular surface at the last follow-up in the dislocation group [0.3 (0.0, 0.9) mm] was significantly lower than that in the posterolateral approach group [1.0 (0.3, 1.1) mm] ( P<0.05). The grading of ankle arthritis was significantly worse in the posterolateral approach group than that in the dislocation group ( P<0.05). There were no differences in distal tibial articular angle, VAS pain score, AOFAS ankle-hindfoot score, or postoperative complications between the 2 groups at the last follow-up ( P>0.05). Conclusions:Both ankle dislocation exposure and traditional posterolateral approach exposure yield satisfactory clinical and radiological outcomes in patients with complex posterior ankle malunion. However, the ankle dislocation exposure offers a novel method for direct visualization of the malunion on multiple planes, which is more advantageous for restoration of the anatomical consistency of the distal tibial articular surface.

Objective:To investigate the short-term efficacy of metaphyseal sleeves or metal tantalum cones in the treatment of low-position periprosthetic fractures of the distal femur (types Su Ⅱ and Ⅲ) after total knee arthroplasty (TKA).Methods:A retrospective study was conducted to analyze the data of the 14 patients who had been treated at Department of Joint surgery, The First Hospital Affiliated to Xinjiang Medical University for low-position periprosthetic fractures of the distal femur (types Su Ⅱ and Ⅲ) after TKA from January 2021 to December 2023. The cohort included 8 males and 6 females with an age of (73.3±4.0) years. The median time from the TKA to the low-position periprosthetic fracture was 37.5 (15.0, 62.3) months. The patients were treated with either a metaphyseal sleeve (8 cases) or a tantalum metal cone (6 cases). The following parameters were recorded for each patient: operative time, complications during follow-up, and assessments at the final follow-up including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS) for pain, American Knee Society Score (KSS), maximum extension angle, and maximum flexion angle.Results:The operative time for this group was 93 (87, 101) min. The 14 patients were followed up for 10.0 (8.0, 12.0) months postoperatively. At the final follow-up, the WOMAC score [(11.01±2.67) points] and VAS pain score [1.00 (0.75, 1.05) points] for the 14 patients were significantly lower than their preoperative values [(44.49±2.64) points and 7.55 (7.00, 8.00) points], while their KSS functional score and joint score [(64.93±2.69) points and (86.73±4.61) points] were significantly higher than their preoperative values [(15.20±2.27) points and (19.59±3.33) points] ( P<0.05). Their maximum flexion angle (91.92°±2.55°) was significantly greater than the preoperative one (67.60°±7.76°) ( P<0.05). However, there was no statistically significant difference in the maximum extension angle between preoperation and postoperation ( P>0.05). Postoperatively, 2 patients developed intermuscular vein thrombosis and 3 deep venous thrombosis, but standardized thromboprophylaxis and treatment led to complete resolution of the thrombi with no adverse events. No patients experienced such complications as infection, fixation loosening, or non-union at the fracture site. Conclusion:In the treatment of low-position periprosthetic fractures of the distal femur (types Su Ⅱ and Ⅲ) after TKA, the metaphyseal sleeve and tantalum cone techniques significantly improve knee joint function, alleviate pain severity, and enhance patients' quality of life, demonstrating satisfactory short-term efficacy.

Objective:To compare the efficacy of drug-coated balloon (DCB) angioplasty and self-expanding stenting in symptomatic middle cerebral artery stenosis (MCAS).Methods:A retrospective study was performed. Patients with symptomatic MCAS admitted to Department of Cerebrovascular Diseases, Interventional Center, He'nan Provincial People's Hospital from January 2020 to December 2022 were chosen from their prospective study database. They were divided into a DCB group and a stent group based on approaches. Baseline data differences between the two groups were eliminated using 1: 1 propensity score matching (PSM). Then, the technical success rate, immediate restenosis rate, and 6-month restenosis rate, and clinical outcomes within 30 days and 1 year of procedure were compared between the two groups.Results:After PSM, 58 patients were included, with 29 in the stent group and 29 in the DCB group. Technical success rate was 93.1% (27/29) in the DCB group and 96.6% (28/29) in the stent group, without significant difference ( P>0.05). The immediate restenosis rate was 6.9% (2/29) in the DCB group and 3.4% (1/29) in the stent group, without significant difference ( P>0.05). In terms of safety, no stroke or death events were noted in the two groups within 30 days of procedure; ischemic stroke incidence in the offending vessel areas within 1 year of procedure in the DCB group and stent group was 3.7% (1/27) and 11.5% (3/26), without significant difference ( P>0.05); no hemorrhagic stroke or death were noted in the two groups within 1 year of procedure. In terms of efficacy, the modified Rankin scale score of the two groups was both 0 (0, 0) at 1 year of follow-up, without significant difference ( P>0.05); 46 patients in the DCB group and stent group had imaging followe-up for 6 months: the restenosis rate was 8.0% (2/25) and 23.8% (5/21), respectively, without significant difference ( P>0.05). Conclusion:DCB angioplasty is comparable in efficacy and safety with self-expanding stenting in symptomatic MCAS.

Objective Cheng's Juanbi Decoction(CSJBD)is a classic traditional Chinese medicine formula for treating rheumatoid arthritis(RA),exhibiting significant clinical efficacy,but the underlying mechanisms remain unclear.We investigated whether CSJBD inhibited RA pathology by blocking the WTAP-Wnt7b-Wnt/β-catenin signaling axis using a collagen-induced arthritis(CIA)mouse model and fibroblast-like synoviocytes(FLSs)derived from RA patients(RA FLSs)and examined the underlying mechanisms.Methods We conducted in vivo experiments.Male C57BL/6 mice weighing 17 to 20 g were used to establish the CIA model.The mice were assigned to 6 groups,including the normal group,the model(CIA)group,the model+CSJBD-L(8.1 g/kg)group,the model+CSJBD-M(16.2 g/kg)group,the model+CSJBD-H(32.4 g/kg)group,and the model+leflunomide(LEF)(0.05 mg/10 g)group,with 10 mice in each group.CSJBD was administered twice daily via gastric gavage,while LEF was administered once daily via gastric gavage,for a duration of 28 days.We also conducted in vitro experiments.RA FLSs were assigned to 4 groups,including the RA FLSs+CSJBDS-L group receiving 10%CSJBDS-containing serum,the RA FLSs+CSJBDS-M group receiving 15%CSJBDS-containing serum,the RA FLSs+CSJBDS-H group receiving 20%CSJBDS-containing serum,and the RA FLSs+NC group(negative control).To study whether WTAP regulated Wnt7b,RA FLSs were divided into the RA FLSs group,the RA FLSs+si-WTAP#3 group,the RA FLSs+si-WTAP#3+Wnt7b-OE group,and the RA FLSs+si-WTAP#3+Wnt7b-NC group.To study the underlying mechanism by which CSJBT affected RA FLSs,RA FLSs were divided into the RA FLSs group,the RA FLSs+CSJBDS-M group,the RA FLSs+CSJBDS-M+Wnt7b-OE group,and the RA FLSs+CSJBDS-M+NC group.We used ultra-high performance liquid chromatography(UPLC)to identify and quantify key monomer compounds from CSJBD as quality criteria for CSJBD preparation.Bioinformatics,CCK-8,RT-qPCR,Western blot,immunofluorescence,and related methods were employed to assess the therapeutic efficacy and underlying mechanisms of CSJBD in treating RA.Results According to the UPLC analysis,ferulic acid,osthole,mulberroside A,notopterol,and gentiopicroside were identified as quality control standards for the preparation of CSJBD formula.CSJBD improved RA pathology in CIA mice,reduced the levels of interleukin(IL)-6,IL-1β,IL-8,and tumor necrosis factor-α(TNF-α)in their serum,and decreased the expression of RA pathological genes MMP3 and fibronectin,with the difference between groups being statistically significant.Bioinformatics analysis suggested that CSJBD might inhibit RA pathology by suppressing the Wnt/β-catenin signaling pathway through Wnt7b.Experimental results showed that the expression of WTAP and Wnt7b was significantly increased in RA.After knocking down WTAP,the expression of Wnt7b was significantly reduced,and the Wnt/β-catenin signaling pathway was also inhibited,with the difference between groups being statistically significant(P<0.05),confirming that WTAP regulated the pathway via Wnt7b.According to experimental verification,CSJBD significantly inhibited the Wnt/β-catenin signaling pathway and the proliferation of RA FLSs.Wnt7b overexpression reversed the inhibitory effect of CSJBD on the Wnt/β-catenin signaling pathway and the proliferation of RA FLSs,indicating that Wnt7b is the direct target of CSJBD.Conclusion CSJBD inhibits RA pathology by blocking the WTAP-Wnt7b-Wnt/β-catenin signaling axis,with Wnt7b identified as a direct therapeutic target of CSJBD.