BACKGROUND:Macrophages exhibit distinct pro-inflammatory and anti-inflammatory phenotypes.Through tissue engineering techniques,their phenotype transition has made them one of the most studied immune cells in bone injury repair.Recent studies have found that neutrophils also play a significant role in bone injury repair processes,but there is currently no such review available.OBJECTIVE:To summarize the current role of neutrophils in fracture healing and interventions targeting neutrophils to promote fracture healing.METHODS:We searched the Web of Science,PubMed,WanFang Data,and CNKI databases from January 2000 to February 2024 with the key words of"neutrophil,fracture healing,bone damage,bone repair,bone remodeling"in Chinese and English.Literature screening was conducted based on inclusion and exclusion criteria,resulting in a final selection of 72 articles for review.RESULTS AND CONCLUSION:(1)The history of neutrophils has been long,with their importance initially overlooked due to a lack of staining techniques.In 1900,Paul Ehrlich's invention of triacid staining distinguished neutrophils,marking the beginning of research in this field.(2)Under normal conditions,neutrophils migrate to various organs to assist in their physiological functions.In pathological states,neutrophils exert their antimicrobial effects through phagocytosis,degranulation,and the formation of neutrophil extracellular traps.(3)Neutrophils primarily participate in the early hematoma inflammation stage of fracture healing by releasing cytokines to recruit other immune cells and mesenchymal stem cells.They also produce fibrinogen to promote hematoma formation and establish a local microenvironment.(4)Neutrophils transform into two distinct subtypes,N1 and N2,at different stages of fracture healing,coordinating with each other to promote bone repair.(5)Neutrophils recruited to the fracture site participate in the healing process by secreting cytokines such as tumor necrosis factor-alpha,interleukin-6,interleukin-10,fibroblast growth factor-2,monocyte chemoattractant protein-1,and platelet-derived growth factor.(6)Neutrophils regulate osteogenesis/osteolysis balance through interactions with the main cellular components involved in different stages of fracture healing.(7)Similar to the widespread research and application of tissue engineering techniques in modulating macrophage polarization in fracture healing,interventions targeting neutrophils to promote fracture healing hold promising prospects for the future.

Artificial intelligence (AI) has been widely used in all walks of life, including healthcare, and has shown great application value in the auxiliary diagnosis of pulmonary nodules in the medical field. In the face of a large amount of lung imaging data, clinicians use AI tools to identify lesions more quickly and accurately, improving work efficiency, but there are still many problems in this field, such as the high false positive rate of recognition, and the difficulty in identifying special types of nodules. Researchers and clinicians are actively developing and using AI tools to promote their continuous evolution and make them better serve human health. This article reviews the clinical application and research progress of AI-assisted diagnosis of pulmonary nodules.

BACKGROUND:Macrophages exhibit distinct pro-inflammatory and anti-inflammatory phenotypes.Through tissue engineering techniques,their phenotype transition has made them one of the most studied immune cells in bone injury repair.Recent studies have found that neutrophils also play a significant role in bone injury repair processes,but there is currently no such review available.OBJECTIVE:To summarize the current role of neutrophils in fracture healing and interventions targeting neutrophils to promote fracture healing.METHODS:We searched the Web of Science,PubMed,WanFang Data,and CNKI databases from January 2000 to February 2024 with the key words of"neutrophil,fracture healing,bone damage,bone repair,bone remodeling"in Chinese and English.Literature screening was conducted based on inclusion and exclusion criteria,resulting in a final selection of 72 articles for review.RESULTS AND CONCLUSION:(1)The history of neutrophils has been long,with their importance initially overlooked due to a lack of staining techniques.In 1900,Paul Ehrlich's invention of triacid staining distinguished neutrophils,marking the beginning of research in this field.(2)Under normal conditions,neutrophils migrate to various organs to assist in their physiological functions.In pathological states,neutrophils exert their antimicrobial effects through phagocytosis,degranulation,and the formation of neutrophil extracellular traps.(3)Neutrophils primarily participate in the early hematoma inflammation stage of fracture healing by releasing cytokines to recruit other immune cells and mesenchymal stem cells.They also produce fibrinogen to promote hematoma formation and establish a local microenvironment.(4)Neutrophils transform into two distinct subtypes,N1 and N2,at different stages of fracture healing,coordinating with each other to promote bone repair.(5)Neutrophils recruited to the fracture site participate in the healing process by secreting cytokines such as tumor necrosis factor-alpha,interleukin-6,interleukin-10,fibroblast growth factor-2,monocyte chemoattractant protein-1,and platelet-derived growth factor.(6)Neutrophils regulate osteogenesis/osteolysis balance through interactions with the main cellular components involved in different stages of fracture healing.(7)Similar to the widespread research and application of tissue engineering techniques in modulating macrophage polarization in fracture healing,interventions targeting neutrophils to promote fracture healing hold promising prospects for the future.

Objective To explore the impact of peptidylarginine deiminase 2(Padi2)-knockout on depressive-like behaviors in socially isolated mice.Methods Using CRISPR/Cas9 technology,a Padi2-knockout(Padi2-/-)mouse model with a C57BL/6J background was established,and the effect of Padi2 knockout was identified by genotyping and RT-qPCR detection.Six-week-old male Padi2-/- mice and wild-type C57BL/6J mice were selected and divided into normal rearing and social isolation groups,with 15 mice per group.The normal rearing group mice were housed with 5 mice per cage,and the social isolation group was housed with 1 mouse per cage,and weighed once a week.After 4 weeks,forced swimming and open field tests were conducted.After the behavioral experiments,brain tissues were taken from mice in each group,and changes in microglia in the brains were detected by immunofluorescence.Results We successfully established Padi2-/- mice.There was no difference in behavior between Padi2-/- mice and C57BL/6J mice in the normal rearing group.After social isolation,compared with C57BL/6J mice,Padi2-/- mice showed a significant increase in depressive symptoms,obvious weight gain,and a significant increase in the number of microglia in brain tissue.Conclusions Padi2 knockout exacerbated depressive-like behaviors and obesity in socially isolated mice,indicating that Padi2 is involved in the progression of depression and may be an effective target for the prevention and treatment of depression.

Objective To explore the impact of peptidylarginine deiminase 2(Padi2)-knockout on depressive-like behaviors in socially isolated mice.Methods Using CRISPR/Cas9 technology,a Padi2-knockout(Padi2-/-)mouse model with a C57BL/6J background was established,and the effect of Padi2 knockout was identified by genotyping and RT-qPCR detection.Six-week-old male Padi2-/- mice and wild-type C57BL/6J mice were selected and divided into normal rearing and social isolation groups,with 15 mice per group.The normal rearing group mice were housed with 5 mice per cage,and the social isolation group was housed with 1 mouse per cage,and weighed once a week.After 4 weeks,forced swimming and open field tests were conducted.After the behavioral experiments,brain tissues were taken from mice in each group,and changes in microglia in the brains were detected by immunofluorescence.Results We successfully established Padi2-/- mice.There was no difference in behavior between Padi2-/- mice and C57BL/6J mice in the normal rearing group.After social isolation,compared with C57BL/6J mice,Padi2-/- mice showed a significant increase in depressive symptoms,obvious weight gain,and a significant increase in the number of microglia in brain tissue.Conclusions Padi2 knockout exacerbated depressive-like behaviors and obesity in socially isolated mice,indicating that Padi2 is involved in the progression of depression and may be an effective target for the prevention and treatment of depression.

Bone metabolism includes the processes of bone formation and bone resorption, both of which maintain bone metabolic homeostasis in the body. Adipose browning is a biological process that converts energy-storing white fat into thermogenic brown fat, which is induced by environment, exercise, nutrients, and signaling molecules. Adipose browning regulates bone metabolism in vivo and affects osteogenic and osteoblastic capacity through the secretion of adipokines such as fibroblast growth factor-21, adiponectin, insulin-like growth factor-1, and bone morphogenetic proteins. Adipose browning can also affect bone metabolism through immune pathways mediated by the gut microbiota. The browning ability of fat decreases in the aging body, which is related to the imbalance of bone metabolism in the state of osteoporosis. In children and adolescents, fat browning is active and bone metabolism is maintained in a healthy state. Exercise and supplementation of nutrients (capsaicin, resveratrol, quercetin, etc.) can promote the browning of adipose tissue and maintain brown adipose tissue, which plays a positive role in bone metabolism. In the future, it is of great significance to clarify the specific regulatory mode between adipose browning and bone metabolism for the treatment of bone metabolism-related diseases by intervening adipose browning.

BACKGROUND:There is controversy regarding the need for marrow reaming in intertrochanteric fractures of the femur.Some believe that unreaming shortens operative time,reduces bleeding,and decreases intraoperative risk in elderly patients,but there is no basis for whether this move reduces the effectiveness of intramedullary nail support.Others believe that reaming allows for the selection of thicker diameter intramedullary nails for better mechanical support,but basic studies have shown that this approach carries risks such as fat embolism and destruction of bone(especially in elderly patients with osteoporosis). OBJECTIVE:To analyze the mechanical distribution characteristics of reamed and unreamed proximal femoral nail antirotation-Ⅱ in the treatment of type 31-A3 intertrochanteric fractures by finite element analysis. METHODS:A healthy volunteer was included,and CT scans of his femur were obtained in DICOM format,and the files were sequentially imported into Mimics,Geomagic Wrap,SolidWorks,Hypermesh,and Ansys software for processing.The A3.1,A3.2,and A3.3 intertrochanteric fracture models were obtained and assembled with 9 mm,11 mm diameter,and 170 mm length intramedullary nails,respectively,followed by assigning material properties,setting the interaction relationship of each contact surface and defining the load and boundary conditions,and then solved.The femoral stress distribution,internal fixation stress distribution,femoral displacement,and internal fixation displacement were observed in different models. RESULTS AND CONCLUSION:(1)The femoral stress was less than that of unreamed intramedullary nail fixation for each type of fracture,and the maximum stress value of the femur for A3.3 fracture was greater than that of A3.1 and A3.2.(2)The internal fixation stress was greater than that of unreamed intramedullary nail fixation for each type of fracture,and the maximum stress value of internal fixation for A3.3 fracture was greater than that of A3.1.(3)Reamed versus unreamed intramedullary nailing has less effect on femoral and internal fixation displacement and more effect on stress.(4)It is indicated that the use of reamed intramedullary nail fixation results in a reduction in femoral stress,an increase in the stress borne by the internal fixation as a whole,and a reduction in the stress borne by the distal locking nail.The use of reamed intramedullary nail fixation may provide better treatment results compared to unreamed intramedullary nail fixation.

Objective To evaluate the validity of the Patient Health Questionnaire(PHQ-9)and the Generalized Anxiety Disorder Scale(GAD-7)in measuring depression and anxiety among employees.Methods A stratified random sample of 1117 employees from various departments of an enterprise was included in the study.The item analysis was performed using the Grade Response Model in IRT to assess the dimensionality,discrimination,difficulty coefficient and average information of each item.The model fit and differential item functioning were also assessed.Results The study population consisted of 661(59.2%)employees under the age of 45 and 456(40.8%)employees aged 45 and above;802(71.8%)were male and 315(28.2%)were female.The Cronbach's α coefficients for the PHQ-9 and GAD-7 were 0.923 and 0.951,and the split-half reliability coefficients were 0.863 and 0.940.The ratio of the first characteristic root to the second characteristic root of both the PHQ-9 and GAD-7 scales was＞3,in line with the hypothesis of unidimensionality.The discrimination of the PHQ-9 items ranged from 2.362 to 3.618,the difficulty coefficient from-0.949 to 2.639,and the average information from 0.772 to 1.935.The discrimination of the GAD-7 items ranged from 3.631 to 5.580,the difficulty coefficient from-0.469 to 2.044,and the average information from 1.880 to 3.547.Differential item functioning indicated that age and gender did not influence the screening of the two scales.Conclusion The PHQ-9 and GAD-7 scales can be used as psychometric tools to assess depression and generalized anxiety disorder in corporate employees.

Salt-processed Alismatis Rhizoma (SAR) is extensively used in clinical practice and exhibits a more robust urination-promoting effect than Alismatis Rhizoma (AR). This study employed ultra-performance liquid chromatography–quadrupole-time-of-flight mass spectrometry (UPLC-Q-TOF-MS) and pattern analysis to compare the terpenoids between AR and SAR. Additionally, this study compared the effects of AR and SAR on the gene expression in the kidneys of the rat model of edema (syndrome of kidney Yin deficiency) by transcriptomics to decipher the mechanism of salt processing. Materials and methods: AR and SAR were extracted by ultrasonication, and data were collected by UPLC-Q-TOF-MS in the positive ionmode. Transcriptome sequencing was employed to determine the gene expression levels of the ratmodel treated with AR and SAR, and the differentially expressed genes (DEGs) were obtained. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment was performed for the DEGs. The protein-protein interaction (PPI) network was built, on the basis of which the core targets were screened out. Finally, real-time quantitative polymerase chain reaction (RT-PCR) was conducted to verify the core targets. Results: A total of 63 terpenoids were detected in AR and SAR, and salt processing had a significant effect on the content of terpenoids. AR and SAR mainly participated in the regulation of inflammation and immune responses, and SAR regulated more DEGs than AR. Additionally, SAR exerted more extensive regulatory effects on the targets than AR. Conclusion: Salt processing mainly changes the content of chemical compounds in AR, which may indirectly optimize the proportion of the main compounds to enhance the therapeutic effect while reducing the toxicity. AR and SAR mainly ameliorate the edema due to kidney Yin deficiency by reducing inflammation and improving immunity. Finally, SAR regulates more genes and signaling pathways and exerts more extensive regulatory effects than AR.

Objective To compare the efficacies of unilateral biportal endoscopic(UBE)technique and percutaneous transforaminal endoscopic discectomy(PTED)in the treatment of lumbar spinal stenosis.Methods Forty patients who were diagnosed with lumbar spinal stenosis in Chashan Hospital of Dongguan from January 2019 to January 2023 were enrolled in this retrospective study.They were divided into PTED group(n=20)and UBE group(n=20).Perioperative data(operation time,intraoperative bleeding,postoperative hospital stay,degree of decompression and complications)were compared between the two groups.Visual analogue scale(VAS)score and Oswestry dysfunction index(ODI)were collected before surgery and on 3 days,1 month and 6 months after surgery.Results There were no significant differences in the operation time,intraoperative bleeding,or hospitalization time between the two groups(all P>0.05).The incidence of postoperative complications in the UBE group was significantly lower than that in the PTED group(P=0.001).VAS score and ODI of the low back and leg pains in the UBE group were superior to the PTED group at each postoperative time point(all P<0.05).One month after surgery,the UBE group had a more significant increase in the dural sac cross-sectional area and intervertebral foramen area than the PTED group(t=3.842,P=0.003;t=2.469,P=0.006).Conclusion Compared with PTED,UBE has better clinical outcomes,higher degree of decompression,and lower incidence of complications.UBE is a safe and feasible surgical method for the treatment of lumbar spinal stenosis.