OBJECTIVE:External fixators and plate internal fixation are commonly used treatments for comminuted distal radius fractures,each with its own advantages and disadvantages in clinical practice. To systematically evaluate the clinical efficacy and safety of external fixator and plate internal fixation in the treatment of comminuted distal radius fractures,and to provide a basis for the development of guidelines for the diagnosis and treatment of distal radius fractures with integrated traditional Chinese and Western medicine. METHODS:PubMed,Web of Science,Embase,Cochrane Library,China National Knowledge Infrastructure,China Biomedical Literature Database,VIP,andWanFang databases were systematically searched to include randomized controlled trials on external fixators and internal plate fixation for the treatment of comminuted distal radial fractures published from October 2013 to October 2023. The literature was screened according to the inclusion and exclusion criteria. Review Manager was used for literature quality evaluation and meta-analysis.RESULTS:(1) Eight articles were included,including 4 in Chinese and 4 in English,with a total sample size of 648 cases,including 328 cases in the external fixation stent group and 320 cases in the internal fixation plate group. (2) At 3 months after operation,the internal fixation plate group was superior to the external fixation stent group in the range of dorsal extension,palmar flexion and supination. At 12 months after operation,the grip strength,palmar inclination,palmar flexion,pronation and supination in the internal fixation plate group were better than those in the external fixation stent group. The postoperative infection in the internal fixation plate group was better than that in the external fixation stent group,and there was no statistical difference in other outcome indicators.CONCLUSION:Eight evidences showed that in the choice of treatment for comminuted distal radius fracture,both external fixation stent and incision plate internal fixation had good therapeutic effect,and plate internal fixation was better than other factors. However,for some special patients with highly severe comminuted distal radius fractures,poor bone quality,severely contaminated open fractures,and soft tissue swelling that did not allow incision surgery,external fixation was the first choice. The results of this study have limitations,and more high-quality,large-sample,multi-center randomized controlled trials are needed in the future,emphasizing the observation of long-term efficacy and other secondary indicators,and supplementing and optimizing the current research results.

OBJECTIVE:External fixators and plate internal fixation are commonly used treatments for comminuted distal radius fractures,each with its own advantages and disadvantages in clinical practice. To systematically evaluate the clinical efficacy and safety of external fixator and plate internal fixation in the treatment of comminuted distal radius fractures,and to provide a basis for the development of guidelines for the diagnosis and treatment of distal radius fractures with integrated traditional Chinese and Western medicine. METHODS:PubMed,Web of Science,Embase,Cochrane Library,China National Knowledge Infrastructure,China Biomedical Literature Database,VIP,andWanFang databases were systematically searched to include randomized controlled trials on external fixators and internal plate fixation for the treatment of comminuted distal radial fractures published from October 2013 to October 2023. The literature was screened according to the inclusion and exclusion criteria. Review Manager was used for literature quality evaluation and meta-analysis.RESULTS:(1) Eight articles were included,including 4 in Chinese and 4 in English,with a total sample size of 648 cases,including 328 cases in the external fixation stent group and 320 cases in the internal fixation plate group. (2) At 3 months after operation,the internal fixation plate group was superior to the external fixation stent group in the range of dorsal extension,palmar flexion and supination. At 12 months after operation,the grip strength,palmar inclination,palmar flexion,pronation and supination in the internal fixation plate group were better than those in the external fixation stent group. The postoperative infection in the internal fixation plate group was better than that in the external fixation stent group,and there was no statistical difference in other outcome indicators.CONCLUSION:Eight evidences showed that in the choice of treatment for comminuted distal radius fracture,both external fixation stent and incision plate internal fixation had good therapeutic effect,and plate internal fixation was better than other factors. However,for some special patients with highly severe comminuted distal radius fractures,poor bone quality,severely contaminated open fractures,and soft tissue swelling that did not allow incision surgery,external fixation was the first choice. The results of this study have limitations,and more high-quality,large-sample,multi-center randomized controlled trials are needed in the future,emphasizing the observation of long-term efficacy and other secondary indicators,and supplementing and optimizing the current research results.

Objective:To investigate the efficacy of fixation through dual minimally invasive incisions and dual osseous channels with a loop titanium plate combined with a Dog-Bone titanium plate for acute Rockwood Ⅲ acromioclavicular dislocation in comparison with open reduction and fixation with a clavicular hook plate.Methods:A retrospective study was conducted to analyze the data of the 60 patients with acute type Ⅲ acromioclavicular dislocation who had been treated at Department of Orthopedics, Liaocheng People's Hospital from February 2019 to May 2022. There were 35 males and 25 females with an age of (43.2±8.0) years, and 34 left sides and 26 right sides affected. According to different surgical methods, they were divided into a double titanium plates group of 32 cases who had been treated by fixation through dual minimally invasive incisions and dual osseous channels with a loop titanium plate combined with a Dog Bone titanium plate and a hook plate group of 28 cases who had been treated by open reduction and internal fixation with a clavicle hook plate. The time from injury to operation was (2.1±1.3) d. The 2 groups were compared in terms of incision length, operation time, intraoperative bleeding, and visual analogue scale (VAS) pain score, Constant-Murley shoulder function score and the coracoclavicular distance on the affected side which were recorded preoperatively and at the last follow-up. Complications such as infection, loosening of internal fixation or secondary fracture were observed.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, indicating comparability ( P > 0.05). All patients were followed up for (11.2±2.1) months. The incision length in the double titanium plates group [(3.5±0.3) cm] was significantly shorter than that in the hook plate group [(6.2±0.7) cm], and the intraoperative bleeding [(45.3±7.5) mL] in the former was significantly less than that in the latter [(64.1±6.2) mL] ( P < 0.05). However, there was no statistically significant difference in the operation time between the 2 groups ( P > 0.05). The VAS score [0.5 (0, 1.0) points] and Constant-Murley shoulder function score [(95.1±2.1) points] in the double titanium plates group were significantly better than those in the hook plate group [0.8 (0, 1.0) points, (86.0±4.4) points] at the last follow-up ( P < 0.05). However, there was no statistically significant difference between the 2 groups in the coracoclavicular distance on the affected side ( P > 0.05). Good acromioclavicular joint repositioning and fixation were achieved in all patients. There were no surgery-related complications except for sinus tract formation in one patient in the double titanium plates group. Conclusion:In the treatment of acute Rockwood Ⅲ acromioclavicular dislocation, fixation through dual minimally invasive incisions and dual osseous channels with a loop titanium plate combined with a Dog-Bone titanium plate is superior to open reduction and internal fixation with a clavicular hook plate, showing advantages of minimal invasion, better safety, less intraoperative bleeding, and faster joint function recovery.

Objective: To investigate the implementation of GBZ/T 201.3-2014 Radiation Shielding Specification for Radiotherapy Room--Part 3: Radiotherapy Room of γ-ray Sources (hereinafter referred to GBZ/T 201.3-2014). Methods: A total of 129 personnels, who were involved in the approval and supervision of radiation diagnosis and treatment construction projects in 19 provincial administrative agencies, engaged in radiation protection testing and evaluation of γ-ray radiotherapy rooms in radiation health technology service institutions, and used GBZ/T 201.3-2014 in other institutions (environmental impact assessment, education and scientific research), were selected as the participants using a stratified random sampling method. A questionnaire survey was conducted to assess their awareness and application of the standard. Results: The participants' awareness of GBZ/T 201.3-2014 was ≥63.6%, but the training rate was only 9.1% to 50.0%. The familiarity with the various chapters of the standard was over 86.4%. And 42.6% of the participants reported using the standard at least once a year. Regarding the applicability of the standard, all of the participants believed that the standard meets the needs of approval, supervision, testing, or evaluation, and adapts to the updated development of radiotherapy equipment and technology. And 94.6% of the participants believed that the use of the standard could improve the level of protection design and management, and 92.2% believed that the standard was widely applied. Regarding the adequacy of the standard, 97.7% of the participants believed that the standard's reference for ambient dose equivalent rate was reasonable, while 34.1% believed that the standard needs revision. Conclusion: The participants are satisfied with the standard and believe its applicability. They have a good level of awareness of the standard, but there is a room for improvement in their familiarity with the shielding calculation related content of the standard. The promotion, training, and practicality of the standard need to be strengthened.

Objective To optimize the extraction process parameters of digestive Funing decoction.Methods Taking fingerprint similarity index(C,A),the total content of multiple components and extract yield as indexes,the extraction process parameters of Xiaohua Funing Tang were optimized by central composite design response surface methodology(RSCCD).Results The extraction times had a significant effect on the comprehensive score.The optimum extraction parameters were adding 9 times of water,decocting for 1.5 hour and extracting for 3 times.Under this condition,the predicted value of the comprehensive score was 100.333,and the verified mean value was 96.75,which was not significantly different from the predicted value.Conclusion The extraction process of Xiaohua Funing Tang determined in this paper is scientific,reasonable,stable and feasible.It lays a foundation for the research and development of later preparations.

Glioma is a primary aggressive brain tumor with high recurrence rate. The poor efficiency of chemotherapeutic drugs crossing the blood‒brain barrier (BBB) is well-known as one of the main challenges for anti-glioma therapy. Moreover, massive infiltrated tumor-associated macrophages (TAMs) in glioma further thwart the drug efficacy. Herein, a therapeutic nanosystem (SPP-ARV-825) is constructed by incorporating the BRD4-degrading proteolytic targeting chimera (PROTAC) ARV-825 into the complex micelle (SPP) composed of substance P (SP) peptide-modified poly(ethylene glycol)-poly(d,l-lactic acid)(SP-PEG-PDLLA) and methoxy poly(ethylene glycol)-poly(d,l-lactic acid) (mPEG-PDLLA, PP), which could penetrate BBB and target brain tumor. Subsequently, released drug engenders antitumor effect via attenuating cells proliferation, inducing cells apoptosis and suppressing M2 macrophages polarization through the inhibition of IRF4 promoter transcription and phosphorylation of STAT6, STAT3 and AKT. Taken together, our work demonstrates the versatile role and therapeutic efficacy of SPP-ARV-825 micelle against glioma, which may provide a novel strategy for glioma therapy in future.

Tropheryma whipplei (TW) is an opportunistic pathogen that can cause Whipple′s disease (WD). Recently, the biomedical field is concerned about whether the bacteria cause pneumonia. When BALF was detected by PCR, the TW positive rate was about 6.1%. Etiology status is generally described as “associated” or “probable”. Immunocompromised status is the susceptible factor; Different species of the same genus have been reported. The current method may have missed detection. All relevant information needs further study. This article reviews the acute pneumonia caused by TW and the detection technology.

Presepsin(sCD14-ST), is an soluble leukocyte differentiation antigen 14 subtype. It is a glycoprotein fragment and a marker of acute phase reaction. For diagnosis of adult sepsis, bacteremia and bacterial DNAaemia, the area under of ROC is 0.88,0.78 and 0.79, respectively. The levels of Presepsin increase earlier than procalcitonin, and have better clinical value for early diagnosis of sepsis. It is significantly correlated with disease severity and can be used to predict prognosis. One study mentioned that in the absence of organ dysfunction, the value was 235.0 (172.0-340.3) pg/ml, and for one, two, three or more organ dysfunction, were 403.5 (275.8-587.3) pg / ml, 844.5 (559.8-1259.5) pg / ml, 1412.5 (893.0-2675.8) pg/ml (P<0.01), respectively. Another study mentioned that Presepsin is an independent risk factor for 30-day death of sepsis, and it is effective to evaluate poor prognosis with a threshold of >927.5 pg/ml. Presepsin also has clinical value for neonatal and child sepsis. The Greece meta-analysis showed that the AUC for neonatal sepsis diagnosis was 0.9751, which was higher and more sensitive than that of CRP and procalcitonin. Turkish study on children showed a significant increase in sCD14-ST in sepsis patients compared with healthy controls. Its AUC was 0.98, the best threshold was 990 pg/ml. The reference range of this value was been studied, showing that 75％ and 95％ percentiles of full-term infants are 791 and 1178 pg/ml. Adults do not exceed 200 pg/ml of all age groups. It is affected by renal function. Prospective trials are expected to further clarify its diagnostic value, more therapeutic research to elaborate its therapeutic value, and corresponding clinical practice guideline.

Objective To investigate the feasibility of manual reduction with inverse shift for pronation-extorsion trimalleolar fracture by applying the finite element method combined with clinical experience. Methods Based on CT images and anatomical features of bone, ligaments and other tissues as well as material parameters, a normal ankle model with completed muscles and bones for a Chinese young male was established. According to the related characteristics of the pronation-extorsion trimalleolar fractures, fracture was simulated in the proper position to make osteotomy model. The finite element model of pronation-extorsion trimalleolar fractures was thus established and then applied with mechanical loading to simulate manual reduction with inverse shift. Results The established finite element model of pronation-extorsion trimalleolar fractures was effectively restored by the displacement loading. Conclusions The finite element analysis on pronation-extorsion trimalleolar fractures by inverse shift maneuver could further prove the feasibility, effectiveness and scientificity of manual reduction with inverse shift based on clinical experience.

Objective: The effect of total flavonoids of litchi (TFL) on nuclear translocation of nuclear factor-kappa B (NF- kappa B) in rat hepatic stellate cell line (HSC-T6) induced by transforming growth factor - beta 1 (TGF- beta 1) in vitro was studied to explore the mechanism of action of anti-hepatic fibrosis drugs. Methods: HSC-T6 was cultured in vitro, induced by TGFβ1 for 24 h, and then treated with TFL at 125, 250 and 500 μg/ml for 48 h. The effect of TFL on NF-κB nuclear translocation in HSC-T6 was observed by confocal laser microscopy. The effects of TFL on the expression of TLR4, p-IκB ɑ, p-NF-κB p65, NF-κB and Collagen I protein were detected by western blot. The expressions of TLR4 and p-NF-κB p65 were detected by immunofluorescence. Data were presented as mean±SEM. Homogeneity test of variance was performed and then followed by one-way analysis of variance (ANOVA). The multiple comparisons between groups were performed by LSD test. P < 0.05 was considered statistically significant. Results: Confocal laser scanning microscopy showed TFL inhibited the nuclear translocation of NF-κB in activated HSC-T6 in a concentration-dependent manner and TFL down regulated the protein expression levels of TLR4, p-IκB ɑ, p-NF-κB p65, NF-κB and collagen I protein in HSC-T6 in a concentration-dependent manner. Conclusion The mechanism of TFL against hepatic fibrosis may be related to the inhibition of nuclear translocation of NF-κb in the activated HSC-T6 and the expression of TLR4, P-iκbɑ, P-nf-κb p65, NF-κb and collagen I protein in HSC-T6.