Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

The current organ allocation rules prioritize elderly and urgent patients on the lung transplantation (LT) waiting list. A steady increase in the threshold at which age is taken into consideration for LT has been observed. This retrospective cohort study recruited 166 lung transplant recipients aged ≽ 65 years between January 2016 and October 2020 in the largest LT center in China. In the cohort, subgroups of patients aged 65-70 years (111 recipients, group 65-70) and ≽ 70 years (55 recipients, group ≽ 70) were included. Group D restrictive lung disease was the main indication of a lung transplant in recipients over 65 years. A significantly higher percentage of coronary artery stenosis was observed in the group ≽ 70 (30.9% vs. 14.4% in group 65-70, P = 0.014). ECMO bridging to LT was performed in 5.4% (group 65-70) and 7.3% (group ≽ 70) of patients. Kaplan-Meier estimates showed that recipients with cardiac abnormalities had a significantly increased risk of mortality. After adjusting for potential confounders, cardiac abnormality was shown to be independently associated with the increased risk of post-LT mortality (HR 6.37, P = 0.0060). Our result showed that LT can be performed in candidates with an advanced age and can provide life-extending benefits.
Aged ; Humans ; East Asian People ; Heart Diseases/etiology* ; Lung Transplantation/adverse effects* ; Retrospective Studies

Objective: To investigate the prevalence of depression of middle school students in Liaoning Province in 2019 and analyze its influencing factors, to provide corresponding strategies and measures for depression prevention and control. Methods: By using the method of multi-stage stratified random cluster sampling, the 32 909 students of grade 1-3 of junior middle school, senior high school and vocational high school were selected from 14 cities in Liaoning province, and were investigated with Center for Epidermiologic Studies Depression Scale (CES-D) psychological scale. Results: The depression score of middle school students in Liaoning Province was (12.66±9.53), and the incidence of depression was 19.5%. Analysis of variance and multiple regression analysis showed that the main factors influencing the occurrence of depression were grade, bullying on campus, internet addiction, being beaten and scolded by parents, drinking, gender, Leave of absence from school, smoking, serious injury and economic classification (P<0.05). Conclusion Depression of middle school students in Liaoning Province is not optimistic. Effective prevention and control measures should be developed and implemented to the occurrence of adverse factors, so as to reduce the occurrence of depression symptoms.

Objective:To investigate the efficacy of internal fixation of Pipkin types I and II femoral head fractures through the modified Smith-Petersen (S-P) approach.Methods:A retrospective case control study was conducted to analyze the clinical data of 33 patients with Pipkin types I and II femoral head fractures admitted to Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from June 2015 to September 2019. There were 22 males and 11 females, aged 20-40 years (mean, 29.5 years). There were 15 patients with Pipkin type I fractures and 18 with Pipkin type II fractures. A total of 22 patients were treated using the modified S-P approach via the sartorius and tensor fascia lata space (modified S-P group) and 11 patients were treated using the modified K-L approach via the posterior superior iliac spine and gluteus maximus (modified K-L group). The operation duration, intraoperative blood loss, postoperative drainage volume, length of hospital stay, numeric rating scales (NRS) for pain assessment at postoperative 15 days, bone healing time, Harris hip joint score at postoperative one month, and complication rate were compared between the two groups.Results:All patients were followed up for 1-24 months (mean, 6.5 months). The operation duration, blood loss, drainage rate and length of hospital stay in modified S-P group were better than those in modified K-L group [(71.7±7.3)minutes vs. (112.1±6.7)minutes, (55.9±6.2)ml vs. (99.4±8.7)ml, (91.2±5.9)ml vs. (121.3±7.0)ml, (6.0±1.5)days vs. (10.5±1.6)days] ( P<0.01). There were no significant differences between two groups in terms of NRS, bone healing time and Harris score ( P>0.05). The incidence of complications was similar between the two groups, including femoral head ischemia necrosis, traumatic arthritis, and heterogenous ossification ( P>0.05). Conclusion:For Pipkin types I and II femoral head fractures, the modified modified S-P approach is superior to modified K-L approach in aspects of operative time, intraoperative blood loss, postoperative drainage and length of hospital stay.

Objective To evaluate the individualized 3D) printed drilling guide we developed and used for placement of C1/2 pedicle screws in the clinical treatment of fracture and dislocation of the atlantoaxial joint.Methods From January 2014 to June 2016,we treated a total of 17 patients with fracture and dislocation of the atlantoaxial joint.All the cervical CT data of the patients were imported into the digital orthopaedic workstation for 3D reconstruction,data modeling and 3D printing to design and manufacture individualized atlantoaxial vertebral guide templates.Intraoperatively,C1 and C2 pedicle screws were placed under the guide of individualized 3D printed drilling template.Cervical short-segment fixation and fusion were conducted for the patients.Postoperatively,regular clinical and radiographic follow-ups were carried out.Results No serious complications like injury to spinal cord and vertebral artery happened due to failed placement of C1/2 pedicle screws.The operation time ranged from 136 to 222 min (average,168.0 rmin);the intraoperative blood loss ranged from 260 to 556 mL (average,356.0 mL).The 17 patients were followed up for 6 to 36 months (average,13.5 months).The patients obtained bony union after 4 to 6 months (average,4.8 months).At the final follow-up,according to ASIA92 scoring system,the average sensory score was improved significantly from preoperative 7.4 + 3.2 to postoperative 13.1 + 5.9,and the average motor score was improved significantly from preoperative 5.3 + 3.1 to postoperative 11.7 + 5.1 (P ＜ 0.05).No such complications as infection or implant failure occurred after operation.Conclusion Individualized 3D printed drilling guide for implantation of atlantoaxial pedicle screws can make the complicate and risky placement become accurate,safe and simple.

Objective To investigate the role of long noncoding RNA nuclear paraspeckle assembly transcript 1 (NEA T1) in regulating the activation of microglias.Methods (1) Microglias BV2 were routinely cultured in vitro and NEA T1 mRNA expression was detected by real-time PCR (RT-PCR) after 0,0.1,0.5 and 1 μg/mL lipopolysaccharide (LPS) stimulation for 6 h;NEAT1 mRNA expression was detected by RT-PCR after 1 μg/mL LPS stimulation for 0,6,12 and 24 h.(2) NEAT1 siRNA (NEA T1-si) was transfected into BV2,and RT-PCR and Western blotting were employed to detect the LC3 mRNA and protein expressions.(3) The BV2 cells were divided into control group,NEAT1-si group,LPS group and NEAT1-si+LPS group;RT-PCR was used to detect the tumor necrosis factor-α (TNF-oα) and inducible nitric oxide synthase (iNOS) mRNA expressions;morphological changes of BV2 cells were observed under inverted microscope.(4) The BV2 cells were divided into control group,negative control+Torin-1 group and NEAT1-si+Torin-1 group;Western blotting was used to detect the LC3 protein expression and LC3,TNF-α and iNOS mRNA expressions were detected by RT-PCR.Results (1) NEA T1 was significantly up-regulated in LPS-stimulated BV2 cells in dose-and time-d ependent manners;significant differences were noted between each two groups (P＜0.05).(2) The LC3-Ⅱ mRNA expression in the NEAT1-si group was significantly decreased as compared with that in the control group (P＜0.05);LC3-Ⅱ/Ⅰ protein ratio (0.7) in the NEAT1-si group was significantly lower than that in the control group (1.03,P＜0.05).(3) As compared with those in the control group,the TNF-α and iNOS mRNA expressions in the NEAT1-si group were decreased;As compared with those in the LPS group,the TNF-oα and iNOS mRNA expressions in the NEA T1-si+LPS group were significantly decreased (P＜0.05).(4) LC3-Ⅱ/Ⅰ protein ratio in the control group,Torin-1 group and Torin-l+NEAT1-si group were 0.7,1.14 and 0.97,respectively;LC3-Ⅱ,TNF-α and iNOS mRNA expressions in the Torin-1 group were significantly higher than those in the control group (P＜0.05);LC3-Ⅱ,TNF-α and iNOS mRNA expressions in the NEAT1-si+Torin-1 group were significantly higher than those in the Torin-1 group (P＜0.05).Conclusion Knockdown of long noncoding RNA NEA T1 could attenuate microglia activation through inhibiting autophagy,and NEA T1 maybe the key molecule for the mitigation and cure of the neuroinflammation related diseases.

Objective To investigate the role of micro RNA-124 (miR-124) in regulating activation of microglias and secretion of pro-inflammation cytokines and its potential mechanism.Methods (1) BV-2 cells were exposed to different concentration oflipopolysaccharide (LPS) for different durations;relative expression level of miR-124 was detected by real time-quantitative PCR (RT-qPCR).(2) The BV-2 cells were divided into four groups:PBS group,LPS group,LPS+ctrl-simulant group and LPS+miR-124 simulant group.Protein and mRNA expressions of inflammatory factors (tumor necrosis factor [TNF]-α and interleukin [IL] 1-β) were evaluated by RT-qPCR and ELISA.Expressions of p38α,phosphorylated (p)-p38α,ERK and p-ERK were detected by Western blotting.(3) Besides the above groups,four groups were added:LPS+VX702 group,LPS+miR-124 inhibitor group,LPS+VX702+miR-124 simulant group and LPS+VX702+miR-124 inhibitor group;pretreatment with p38α specific inhibitor VX702 was given to the BV-2 cells,the latter two groups were given miR-124 simulant or miR-124 inhibitor,and LPS was used to activate the cells;the expressions of TNF-α and IL-1β were evaluated by ELISA.Results (1) As compared with control group,miR-124 was significantly down-regulated in LPS-stimulated BV-2 cells (P＜0.05),in a dose-and time-dependent manner.(2) As compared with cells in the LPS+ctrl-simulant group,cells in the LPS+miR-124 simulant group had significantly decreased TNF-α and IL-lβ mRNA and protein expressions,and p38α and p-p38α levels (P＜0.05);the ERK and p-ERK levels showed no significant difference between the two groups (P＞0.05).(3) The TNF-α and IL-1β levels between LPS+VX702 group and LPS+VX702+miR-124 simulant group were not significantly different (P＞0.05);those between the LPS+VX702+miR-124 inhibitor group and the LPS+VX702 group were not significantly different (P＞0.05).Conclusion The miR-124 is down-regulated in LPS-activated BV-2 cells and miR-124 could suppress the secretion of pro-inflammatory mediators by targeting to p38α.

Objective: To explore the relationship between the changes of plasma levels of resistin with the contemporary body weigh changes in the same population. Methods: The community based epidemiological surveys were carried out in the same population in Shijingshan district of Beijing at the year of 2005 and year of 2010. A total of 943 subjects with the entire information of cardiovascular related risk factors were enrolled including 316 male with the mean age of (58.2 ± 8.5) years and 627 female with the mean age of (59.3 ± 7.5) years. Plasma levels of resistin in both year of 2005 and year of 2010 in all subjects were recorded, and the subjects were divided into 4 groups based on the quartile levels of resistin. Group①, the subjects with plasma level of resistin ≤ (-0.66) mmol/L,n=239, Group②, resistin level (from -0.67 to 0.25) mmol/L,n=233, Group③, resistin level (0.26-1.24) mmol/L, n=235 and Group④, resistin level ≥1.25 mmol/L,n=236. Pearson correlation study with uni- and multi- regression analysis were conducted to investigate the relationship between the changes of plasma levels of resistin with the contemporary body weight changes in the same population.Results: The uni-variate analysis showed that in female subjects, plasma levels of resistin were obviously related to the percentage (%) of body weight changes (correlation coefifcient: 0.1173), body weight index (kg/m2) changes (0.1521), the% of body weight index changes (0.1412), the waist circumference (cm) changes (0.1228) and the % of waist circumference changes (0.1057) respectively, allP<0.05; while the above changes in male subjects were not signiifcant, allP>0.05. Multi-regression analysis indicated that with adjusted baseline variables, in female subjects, the plasma levels of resistin were obviously related to body weight (kg) changes and the % of body weight changes (regression coefifcient: 0.0261 and 0.2916), body weight index (kg/m2) changes and % of body weight index changes (0.2157 and 0.3072), the waist circumference (cm) changes and the% of waist circumference changes (0.0532 and 0.2738) respectively, allP<0.05; while the above changes in male subjects were not signiifcant, allP>0.05. Conclusion: The changes of plasma levels of resistin are signiifcantly related to contemporary body weight changes in female subjects, but not in male subjects.

OBJECTIVETo assess the association of neural development-related genes LIS1and TSNAX with bipolar disorder in a Chinese Han population.

METHODSThree hundred and eight five patients (including 188 males and 197 females) from Guangzhou Brain Hospital with bipolar disorder meeting the Diagnostic and Statistic Manual of Bipolar Disorder (BDI) (Fourth Edition) criteria and 475 healthy controls from the local community were recruited. Ten single nucleotide polymorphisms (SNPs) of the LIS1 and TSNAX genes were genotyped by GoldenGate genotyping assay on an Illumina Beadstation 500 machine. Association analyses of SNPs and haplotypes were performed with Plink 1.07 software.

RESULTSAnalysis of the total sample has failed to find any association of SNP or haplotype of the two genes with BDI (P> 0.05). When patients were divided into subgroups with or without psychotic symptom, no significant association of the two genes was found with psychotic BDI or non-psychotic BDI (P> 0.05). No significant association was found between any SNP and haplotype of two genes and female BDI or male BDI, nor were significant association found between age of onset and LIS1 and TSNAX gene polymorphisms.

CONCLUSIONOur results indicated that LIS1 and TSNAX genes are not associated with susceptibility to bipolar I disorder in Chinese Han population.

1-Alkyl-2-acetylglycerophosphocholine Esterase ; genetics ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; ethnology ; genetics ; Bipolar Disorder ; ethnology ; genetics ; Case-Control Studies ; DNA-Binding Proteins ; genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Microtubule-Associated Proteins ; genetics ; Middle Aged ; Polymorphism, Single Nucleotide ; Young Adult