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

Alzheimer's disease (AD) is the major form of dementia in the elderly and is closely related to the toxic effects of microglia sustained activation. In AD, sustained microglial activation triggers impaired synaptic pruning, neuroinflammation, neurotoxicity, and cognitive deficits. Accumulating evidence has demonstrated that aberrant expression of deubiquitinating enzymes is associated with regulating microglia function. Here, we use RNA sequencing to identify a deubiquitinase YOD1 as a regulator of microglial function and AD pathology. Further study showed that YOD1 knockout significantly improved the migration, phagocytosis, and inflammatory response of microglia, thereby improving the cognitive impairment of AD model mice. Through LC-MS/MS analysis combined with Co-IP, we found that Myosin heavy chain 9 (MYH9), a key regulator maintaining microglia homeostasis, is an interacting protein of YOD1. Mechanistically, YOD1 binds to MYH9 and maintains its stability by removing the K48 ubiquitin chain from MYH9, thereby mediating the microglia polarization signaling pathway to mediate microglia homeostasis. Taken together, our study reveals a specific role of microglial YOD1 in mediating microglia homeostasis and AD pathology, which provides a potential strategy for targeting microglia to treat AD.

Acetaminophen (APAP) is the primary cause of drug-induced acute liver failure. Ovarian tumor deubiquitinase 6A (OTUD6A), a recently discovered deubiquitinase of the OTU family, has been primarily studied in tumor contexts. However, its role in APAP-induced liver injury (AILI) remains unclear. Therefore, this study aimed to investigate the involvement of OTUD6A in the pathogenesis of AILI. Our findings demonstrated a substantial upregulation of OTUD6A in both the liver tissue and isolated hepatocytes of mice following APAP stimulation. OTUD6A knockout exacerbated APAP-induced inflammation, hepatocyte necrosis, and liver injury, whereas OTUD6A overexpression alleviated these pathologies. Mechanistically, OTUD6A directly interacted with the enhancer of zeste homolog 2 (EZH2) and selectively removed K48-linked polyubiquitin chains from EZH2, enhancing its stability. This resulted in increased protein levels of EZH2 and H3K27me3, as well as reduced endoplasmic reticulum (ER) stress and cell death in hepatocytes. Collectively, our research uncovers a novel role for OTUD6A in mitigating APAP-induced liver injury by promoting EZH2 stabilization.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Aim To explore the mechanism of the effect of siRNA-mediated MAGE-3 silencing on intesti-nal flora,gastric mucosal PTEN expression and liver metastasis in rats with gastric cancer based on MAPK/ERK signaling pathway.Methods Thirty rats were randomly divided into the normal(CO)group,model(MO)group,and MAGE-3 silenced(SM)group,with 10 rats in each group.The model of MO group and SM group was established by MNNG gavage meth-od.After successful modeling,the SM group was intri-toneally injected with 20 μg·kg-1 shRNA MAGE-3 lentiviral vector.The number of intestinal flora in rats was detected by selective medium of intestinal flora,the expression of PTEN in gastric mucosa was detected by immunohistochemistry,liver metastasis was detected by HE staining,and the protein expression of MAPK/ERK signaling pathway was detected by Western blot.The regulatory effect of siRNA-mediated MAGE-3 si-lencing on MAPK/ERK signaling pathway was verified in vitro.Results Compared with CO group,the con-tents of Enterococcus and Escherichia coli,the protein expressions of P-MEK1,P-ERK1 and P-ELK1 in MO group increased(P＜0.05),while the contents of Lactobacillus and Bifidobacterium and the expression of PTEN decreased(P＜0.05).In SM group,the con-tents ofEnterococcus,Escherichiacoli,P-MEK1,P-ERK1 and P-ELK1 protein expressions decreased(P＜0.05),while the contents of Lactobacillus,Bifidobac-terium and PTEN expression increased(P＜0.05).Compared with group CO,the protein expressions of P-MEK1,p-ERK1 and P-ELK1 in group MO were not significantly different(P＞0.05),while the protein expressions of P-MEK1,p-ERK1 and P-ELK1 in group SM were reduced compared with group MO(P＜0.05).Conclusions siRNA-mediated MAGE-3 si-lencing can significantly improve intestinal flora,pro-mote the expression of PTEN in gastric mucosa,and inhibit liver metastasis in rats with gastric cancer.The mechanism may be related to the inhibition of MAPK/ERK signaling pathway.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Aim To explore the mechanism of the effect of siRNA-mediated MAGE-3 silencing on intesti-nal flora,gastric mucosal PTEN expression and liver metastasis in rats with gastric cancer based on MAPK/ERK signaling pathway.Methods Thirty rats were randomly divided into the normal(CO)group,model(MO)group,and MAGE-3 silenced(SM)group,with 10 rats in each group.The model of MO group and SM group was established by MNNG gavage meth-od.After successful modeling,the SM group was intri-toneally injected with 20 μg·kg-1 shRNA MAGE-3 lentiviral vector.The number of intestinal flora in rats was detected by selective medium of intestinal flora,the expression of PTEN in gastric mucosa was detected by immunohistochemistry,liver metastasis was detected by HE staining,and the protein expression of MAPK/ERK signaling pathway was detected by Western blot.The regulatory effect of siRNA-mediated MAGE-3 si-lencing on MAPK/ERK signaling pathway was verified in vitro.Results Compared with CO group,the con-tents of Enterococcus and Escherichia coli,the protein expressions of P-MEK1,P-ERK1 and P-ELK1 in MO group increased(P＜0.05),while the contents of Lactobacillus and Bifidobacterium and the expression of PTEN decreased(P＜0.05).In SM group,the con-tents ofEnterococcus,Escherichiacoli,P-MEK1,P-ERK1 and P-ELK1 protein expressions decreased(P＜0.05),while the contents of Lactobacillus,Bifidobac-terium and PTEN expression increased(P＜0.05).Compared with group CO,the protein expressions of P-MEK1,p-ERK1 and P-ELK1 in group MO were not significantly different(P＞0.05),while the protein expressions of P-MEK1,p-ERK1 and P-ELK1 in group SM were reduced compared with group MO(P＜0.05).Conclusions siRNA-mediated MAGE-3 si-lencing can significantly improve intestinal flora,pro-mote the expression of PTEN in gastric mucosa,and inhibit liver metastasis in rats with gastric cancer.The mechanism may be related to the inhibition of MAPK/ERK signaling pathway.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Traditional Chinese medicine and its active ingredients have significant advantages in treating prostate cancer(PCa),and can complement the shortcomings of Western medicine,improving the quality of life for patients.This article reviews the research progress of traditional Chinese medicine and its effective ingredients in intervening in Wnt/β-catenin pathway to treat PCa,summarizing that the main effective ingredients in traditional Chinese medicine for preventing and treating PCa through this pathway are flavonoids,terpenes,alkaloids,phenols,and other compounds;the main traditional Chinese medicine formulas include Guben Qingyuanfang,Yishen Tongpang granules,etc,and discusses the mechanisms of action of these traditional Chinese medicines and their effective ingredients in intervening in this pathway to prevent and treat PCa,in order to provide a reference for the precise treatment of PCa and the application of traditional Chinese medicine research.