Objective:To analyze the risk of re-displacement after external fixation treatment for distal radius fractures in older adult patients and establish a nomogram model.Methods:A retrospective analysis was conducted on the clinical data of 96 older adult patients with distal radius fractures who were treated with external fixation at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January to December 2022. Based on whether re-displacement of the fracture occurred, the patients were divided into an observation group (re-displacement occurred, n = 15) and a control group (no re-displacement occurred, n = 81). Univariate and logistic regression analyses were used to identify risk factors, and a nomogram model was established. Results:There were statistically significant differences between the two groups in terms of age ( t = 2.13, P = 0.036), sex ( χ2 = 4.17, P = 0.041), presence of comminution ( χ2 = 14.18, P < 0.001), fracture type ( χ2 = 49.59, P < 0.001), body mass index ( t = 3.01, P = 0.003), number of adjustments to external fixation ( χ2 = 4.17, P = 0.041), presence of bone resorption or necrosis ( χ2 = 13.96, P < 0.001), appropriateness of external fixation management ( χ2 = 21.43, P < 0.001), and reasonableness of functional exercise ( χ2 =23.67, P < 0.001). Independent risk factors for the occurrence of re-displacement after external fixation treatment for distal radius fractures in older adult patients included age ( OR = 3.07, P = 0.002), sex ( OR = 3.11, P = 0.007), presence of comminution ( OR = 2.56, P = 0.039), presence of bone resorption or necrosis ( OR = 5.70, P < 0.001), and reasonableness of functional exercise ( OR = 3.04, P < 0.001). The discrimination analysis of the nomogram model showed an area under the curve of 0.855, with a 95% CI of 0.853 to 0.927, and a critical value of 31.25% ( P < 0.001). The GiViTI calibration curve showed that the 80%-90% confidence intervals did not cross the 45° bisector in the graph ( P > 0.05). The Hosmer-Lemeshow goodness-of-fit test showed no statistically significant difference ( χ2 = 5.29, P = 0.582). The decision curve analysis indicated that when the risk of re-displacement exceeded 33.64% in older adult patients undergoing external fixation for distal radius fractures, the net benefit of intervening in these patients was maximized. Conclusions:Age, sex, presence of comminution, presence of bone resorption or necrosis, and the reasonableness of functional exercise are independent risk factors for re-displacement after external fixation treatment of distal radius fractures in older adult patients. The higher the score on the nomogram model, the greater the risk of fracture re-displacement in the patient.

Objective:To analyze the risk of re-displacement after external fixation treatment for distal radius fractures in older adult patients and establish a nomogram model.Methods:A retrospective analysis was conducted on the clinical data of 96 older adult patients with distal radius fractures who were treated with external fixation at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January to December 2022. Based on whether re-displacement of the fracture occurred, the patients were divided into an observation group (re-displacement occurred, n = 15) and a control group (no re-displacement occurred, n = 81). Univariate and logistic regression analyses were used to identify risk factors, and a nomogram model was established. Results:There were statistically significant differences between the two groups in terms of age ( t = 2.13, P = 0.036), sex ( χ2 = 4.17, P = 0.041), presence of comminution ( χ2 = 14.18, P < 0.001), fracture type ( χ2 = 49.59, P < 0.001), body mass index ( t = 3.01, P = 0.003), number of adjustments to external fixation ( χ2 = 4.17, P = 0.041), presence of bone resorption or necrosis ( χ2 = 13.96, P < 0.001), appropriateness of external fixation management ( χ2 = 21.43, P < 0.001), and reasonableness of functional exercise ( χ2 =23.67, P < 0.001). Independent risk factors for the occurrence of re-displacement after external fixation treatment for distal radius fractures in older adult patients included age ( OR = 3.07, P = 0.002), sex ( OR = 3.11, P = 0.007), presence of comminution ( OR = 2.56, P = 0.039), presence of bone resorption or necrosis ( OR = 5.70, P < 0.001), and reasonableness of functional exercise ( OR = 3.04, P < 0.001). The discrimination analysis of the nomogram model showed an area under the curve of 0.855, with a 95% CI of 0.853 to 0.927, and a critical value of 31.25% ( P < 0.001). The GiViTI calibration curve showed that the 80%-90% confidence intervals did not cross the 45° bisector in the graph ( P > 0.05). The Hosmer-Lemeshow goodness-of-fit test showed no statistically significant difference ( χ2 = 5.29, P = 0.582). The decision curve analysis indicated that when the risk of re-displacement exceeded 33.64% in older adult patients undergoing external fixation for distal radius fractures, the net benefit of intervening in these patients was maximized. Conclusions:Age, sex, presence of comminution, presence of bone resorption or necrosis, and the reasonableness of functional exercise are independent risk factors for re-displacement after external fixation treatment of distal radius fractures in older adult patients. The higher the score on the nomogram model, the greater the risk of fracture re-displacement in the patient.

C1 gases including CO, CO₂ and CH₄, are mainly derived from terrestrial biological activities, industrial waste gas and gasification syngas. Particularly, CO₂ and CH₄ are two of the most important greenhouse gases contributing to climate change. Bioconversion of C1 gases is not only a promising solution to addressing the problem of waste gases emission, but also a novel route to produce fuels or chemicals. In the past few years, C1-gas-utilizing microorganisms have drawn much attention and a variety of gene-editing technologies have been applied to improve their product yields or to expand product portfolios. This article reviewed the biological characteristics, aerobic or anaerobic metabolic pathways as well as the metabolic products of methanotrophs, autotrophic acetogens, and carboxydotrophic bacteria. In addition, gene-editing technologies (e.g. gene interruption technology using homologous recombination, group Ⅱ intron ClosTron technology, CRISPR/Cas gene editing and phage recombinase-mediated efficient integration of large DNA fragments) and their application in these C1-gas-utilizing microorganisms were also summarized.
Gene Editing ; Gases ; Carbon Dioxide ; Genetic Engineering ; Cloning, Molecular

Objective: To explore the therapeutic effect of salvianolic acid B (Sal B) on rat abdominal island flap after ischemia-reperfusion injury, and to explore the related mechanisms. Methods: Fifty-four male Sprague-Dawley rats were randomly divided into 3 groups and rat lower abdomen island flap models were established: ①Sham-operated group (Sham group): non-blocking blood vessels, intraperitoneal injection of equal volume of saline as Sal B group; ②Model group: blocking blood vessels for 8 h, intraperitoneal injection of the same volume of saline as Sal B group; ③salvianolic acid B group (Sal B group): blocking blood vessels for 8 h, intraperitoneal injection of 40 mg/Kg of Sal B per day. Seven days after continuous drug administration, the survival rate of the flaps in each group was evaluated, and then the animals from each group were sacrificed for the specimens which were used for the following tests: HE staining was performed to evaluate the microvessel density (MVD), and immunohistochemistry was used to detect the level of vascular endothelial growth factor (VEGF) and superoxide dismutase 1 (SOD1). The contents of superoxide dismutase SOD and malondialdehyde (MDA) in flap tissue were tested using the corresponding kit. Results: Seven days after flap operation, the survival rate of Sal B group flap[(65.62±13.20)%] was significantly higher than that of the model group, while HE staining showed an increase in MVD in Sal B group [(28.27±3.19)/mm² and (15.79±6.12)/mm², respectively]. The differences were statistically significant (P<0.05) . Moreover, immunohistochemistry demonstrated that the expression of VEGF and SOD1 obviously increased in Sal B group, and the content of SOD increased significantly. In addition, the expression of MDA decreased after Sal B treatment. The differences were statistically significant (P<0.05) . Conclusion Sal B is able to increase the expression of VEGF and SOD in the rat abdominal island flaps after ischemia-reperfusion injury, to reduce the content of MDA, and then to promote survival rate of rat abdominal island flap.

Objective To investigate the risk factors of perioperative heart failure in the elderly patients with femoral neck fracture treated with hip joint replacement so as to provide relevant clinical reference.Methods A retrospective case control study was conducted to analyze the clinical data of 155 elderly patients with femoral neck fractures who underwent total hip or hemiarthroplasty in Wenzhou Traditional Chinese and Western Medicine Hospital from May 2012 to August 2016.There were 62 males and 93 females,aged (75.6 ± 7.4)years.The patients were divided into heart failure group (26 patients)and non heart failure group (129 patients).Heart failure group included 10 males and 16 females,aged (78.3 ± 8.2)years.There were 52 males and 77 females in the non heart failure group,aged (74.5 ±6.7) years.Information including age,gender,history of hypertension,history of heart diseases,American Society of Anesthesiologists (ASA) physical status classification,duration from injury to surgery,preoperative renal function,perioperative fluid balance,operation method,operation time,postoperative pain score,perioperative blood loss,and constipation were collected.Univariate analysis was firstly performed on the above data,and multivariate logistic regression analysis was conducted on the significant factors generated by the univariate analysis so as to identify independent risk factors for perioperative heart failure.Results According to the univariate analysis,age,history of heart diseases,preoperative renal function,and perioperative fluid balance were statistically different between the two groups (P ＜ 0.05).Multivariate analysis results showed that the independent risk factors of perioperative heart failure included age (OR =5.351,95％ CI 1.459-19.623,P ＜ 0.01),history of heart diseases (OR =5.717,95 ％ CI 2.399-13.624,P ＜ 0.01),preoperative renal function (OR =2.670,95％ CI 1.125-6.336,P ＜ 0.05),perioperative fluid balance (OR =2.980,95％ CI 1.287-6.899,P ＜0.01).Conclusions Age,history of heart diseases,preoperative renal function,and perioperative fluid balance are the risk factors of perioperative heart failure in elderly patients with femoral neck fracture.Therefore,more attention should be paid to these risk factors and corresponding preventative measures should be taken to reduce the incidence of perioperative heart failure.