Objective:The changes of serum inflammatory factors in patients with chronic obstructive pulmonary disease (COPD) with different traditional Chinese medicine (TCM) syndrome types were compared, and the characteristics and significance of inflammatory factors in COPD were discussed from the perspective of traditional Chinese and western medicine.Methods:A total of 100 patients with COPD who met the inclusion criteria and were admitted to Dongzhimen Hospital of Beijing University of Chinese Medicine from September 2021 to September 2022 were selected and divided into phlegm turbation obstructing lung group ( n=50) and lung and kidney qi deficiency group ( n=50) according to TCM syndrome types. Twenty healthy subjects in the same period were selected as control group. Serum levels of monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein-1α (MIP-1α), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and other inflammatory factors were compared in each group. Results:The MCP-1, IL-6, ESR, CRP, white blood cell count (WBC) and procalcitonin (PCT) of COPD patients in phlegm turbation obstructing lung group were significantly higher than those in lung and kidney qi deficiency group (all P<0.05). The WBC, MCP-1, MIP-1α, IL-6, ESR and CRP of COPD patients in the lung and kidney qi deficiency group were significantly higher than those in the control group (all P<0.05). In the phlegm turbation obstructing lung group, the MIP-1α, MCP-1, IL-6, ESR, CRP, WBC, and PCT were significantly higher than those in the control group (all P<0.05). Conclusions:Patients with COPD have inflammatory reactions, and the inflammatory reactions of patients with phlegm turbation obstructing lung syndrome are more obvious than those with lung and kidney qi deficiency syndrome. The inflammatory factors MCP-1, MIP-1α, IL-6, ESR, CRP, WBC, PCT and other indicators could be used to judge the degree of COPD inflammation, which had certain clinical guiding significance for different syndrome types of COPD patients.

Objective:To evaluate the clinical effects of adjustable traction skin stretchers used in repair of wounds at the lower leg, foot and ankle.Methods:A retrospective study was performed to analyze the clinical data of 56 patients who had been treated for skin defects at the lower leg, foot and ankle from August 2016 to September 2022 at The First Affiliated Hospital of Zhengzhou University, Honghui Hospital, Affiliated to Xi'an Jiaotong University Medical College, The First Affiliated Hospital of Henan Polytechnic University, and Yunnan Zhongde Orthopedic Hospital. There were 35 males and 21 females, aged (39.9±18.7) years. There were 43 traumatic wounds, 3 burns, 6 inflammatory wounds, 3 relief incisions due to osteofascial compartment syndrome, and 1 scar. The areas of skin defect ranged from 2.5 cm × 2.0 cm to 20.0 cm × 10.0 cm. The duration of wounds was (8.6±7.8) d. All the wounds were repaired with adjustable traction skin stretchers. The row-hook type of skin stretchers was used in 28 cases, the single-rod type in 20 cases, the single-rod type combined with an external fixator in 5 cases, and a combination of the row-hook type and the single-rod type in 3 cases.The time for wound traction closure, color of wound skin margin, skin swelling around the wound, functional recovery of affected limb and complications were recorded.Results:The time from skin stretching to wound closure was (7.8±3.8) d in the 56 patients. The color of wound skin edge after stretching was normal in 16 cases, dark red in 38 cases, and dark in 2 cases; the skin swelling around the wound was degree 1 in 21 cases, degree 2 in 33 cases, and degree 3 in 2 cases. The 56 patients were followed up for (8.9±4.1) months. Primary wound closure was achieved in 48 patients, and secondary wound closure in 8 patients after repair with an autologous skin graft. Partial skin necrosis occurred due to tension blisters after skin stretching in 2 patients, one of whom was repaired with an autologous skin graft and the other of whom by dressing change. Deep bone infection recurred in 2 patients whose wounds healed after their bone defects were repaired using Ilizarov technique of bone transfer. In the 56 patients, the muscle strength of the lower extremity beyond the wound was recovered to normal, and the range of motion of the joints adjacent to the wound also recovered to normal.Conclusion:In repair of wounds at the lower leg, foot and ankle, adjustable traction skin stretchers can lead to fine clinical effects and limited complications, because the stretchers can control the tension of skin digitally and precisely.

Objective:To investigate the application value of the Nottingham Hip Fracture Score (NHFS) in China and establish a formula specifically designed to assess the risk for 30-day mortality after surgery for hip fracture patients in China.Methods:A retrospective study was conducted to analyze the clinical data of 824 hip fracture patients who had been treated at Department of Orthopaedics, The First Hospital Affiliated to Zhengzhou University from August 2019 to May 2022. There were 312 males and 512 females with a median age of 73 (63, 82) years. The clinical data were compared between patients with different survival outcomes. The 30-day mortality was calculated by the formula according to the patients' NHFS, and compared with the actual one to validate the effectiveness of the original prediction model. The patients were divided into a training group ( n=577) and a validation group ( n=247). Binary logistic regression analysis was performed to establish a new prediction model for the patients in the training group. The discrimination, calibration, and clinical effectiveness of the predictive model were assessed in both the training and validation groups. Results:Multivariate logistic regression analysis showed that advanced age (≥86 years old) ( OR=3.775, 95% CI: 1.099 to 12.972, P=0.035), male ( OR=3.151, 95% CI: 1.574 to 6.306, P=0.001), admission hemoglobin concentration ≤100 g/L ( OR=2.402, 95% CI: 1.189 to 4.850, P=0.015), dependence on others for care before admission ( OR=2.673, 95% CI: 1.298 to 5.505, P=0.008), and comorbidities ≥2 ( OR=4.988, 95% CI: 1.874 to 13.274, P=0.001) were identified as risk factors for postoperative 30-day mortality (all P<0.05). In validation of the original prediction model, the C-index was found to be 0.764, indicating good discrimination. However, there was a significant discrepancy between the mortality forecast by the original prediction model and the actual mortality ( P<0.05), indicating poor calibration. After the prediction model was recalibrated, 30-day mortality (%) = 100/[1 + e (5.818-NHFS×0.599)]. After the new prediction model was validated in both the training and validation groups, the C-indexes were 0.762 and 0.780, indicating a good level of discrimination. The predicted 30-day mortality by the prediction model was closely aligned with the actual mortality ( P>0.05), demonstrating good calibration. When the threshold probabilities of the training and the validation groups were 0 to 26% and 0 to 35%, respectively, the patients might benefit from clinical intervention, showing clinical effectiveness of the model. Conclusions:The NHFS can predict the risk for 30-day mortality after hip fracture surgery. The new NHFS prediction model after calibration has a good predictive value for 30-day mortality after hip fracture surgery in Chinese population.

Objective:To identify the biotypes of blood culture positive Brucella in patients with acute brucellosis in Xinjiang Uygur Autonomous Region (hereinafter referred to as Xinjiang), and to learn about the clinical characteristics of these patients. Methods:Among the 30 patients diagnosed with acute brucellosis in First Affiliated Hospital, School of Medicine, Shihezi University from January 2019 to July 2021, the positive strains of blood culture Brucella of 12 patients with acute brucellosis were used to identify the biotype by AMOS-PCR. Then the general and clinical data of the 12 patients were collected, including demographic characteristics, epidemiological characteristics, clinical characteristics, laboratory tests, treatment and prognosis. Results:AMOS-PCR results showed that all 12 strains were Brucella melitensis. Among the 12 patients, 9 were males and 3 were females, all of whom had a clear history of livestock contact, and the onset time was concentrated in April to September. All 12 patients showed fever, followed by headache and dizziness (9/12), weakness (8/12), digestive symptoms (8/12), hyperhidrosis (7/12), lumbago and backache (6/12), and arthralgia (6/12). One patient was complicated with pleural effusion and pericardial effusion. One patient was complicated with pleural effusion, pelvic effusion and ascites. Only ascites occurred in 2 patients. Liver function was abnormal in 3 patients, lactate dehydrogenase increased in 6 patients, and blood creatinine decreased in 9 patients. Among the 12 patients, 10 patients were treated with rifampicin combined with doxycycline. The other 2 patients were treated with levofloxacin and doxycycline, supplemented by symptomatic treatment with hepatoprotective drugs due to impaired liver function. After discharge, the patients received out-of-hospital oral anti-infectious drugs for 1-2 courses (6 weeks each course), and all indicators returned to normal at 6 months and 12 months after discharge. Conclusions:All the 12 patients with acute brucellosis in Xinjiang are infected with Brucella melitensis. In addition to the common clinical features, patients are characterized by decreased creatinine and increased lactate dehydrogenase. The standardized anti- Brucella treatment is still the main treatment strategy.

Objective:To explore the short-term outcomes of a 3D printed trabecular block cage to assist posterior internal fixation for the treatment of patients with basilar invagination and atlantoaxial dislocation.Methods:Between June 2017 and February 2019, 12 patients with basilar invagination and atlantoaxial dislocation underwent atlantoaxial distraction and posterior internal fixation at Department of Orthopedics, The First Affiliated Hospital to Zhengzhou University. They were 5 males and 7 females, aged from 34 to 62 years (average, 45.6 years). 3D printed cages were inserted intraoperatively between the joints of the atlantoaxial lateral mass. The atlanto-dental interval interval (ADI), cervico-medullary angle (CMA) and distance from tip of the odontoid process to Chamberlain's line (DOCL) and the Japanese Orthopedic Association (JOA) scale were compared between preoperation and 12 months postoperation to observe the fusion of the joints of the atlantoaxial lateral mass.Results:Operation went on uneventfully in all the 12 patients. Operation time averaged 116.5 min (from 85 to 190 min), fluoroscopy frequency 9.4 times (from 6 to 21 times), and intraoperative bleeding 82.3 mL (from 50 to 210 mL). No such postoperative complications occurred as cerebrospinal leak, cerebral infarction, or breakage, displacement or loosening of implants. All patients were followed up for 18 to 42 months (mean, 26.3 months). Their preoperative JOA, ADI, CMA and DOCL [8.33±0.98, (8.66±1.64) mm, 119.63°±4.15° and (9.66±2.15) mm] were significantly improved to 14.17±1.03, (2.63±0.59) mm, 153.76°±7.88° and (2.07±0.69) mm ( P<0.05) at 12 months postoperation. Bony fusion was achieved in all the operative segments. Conclusion:In the treatment of patients with basilar invagination and atlantoaxial dislocation, a 3D-printed trabecular block cage can be used to assist posterior internal fixation to achieve satisfactory reduction and maintain the height of joint space, leading to satisfactory short-term outcomes.

Objective:To investigate the effects of curcumin on apoptosis and radiosensitivity of human chordoma cell line CM-319 and its mechanism.Methods:CM-319 cells were cultured in vitro and divided into curcumin 0 μmol/L group, curcumin 5 μmol/L group, curcumin 10 μmol/L group, curcumin 20 μmol/L group, si-NC group, si-UHRF1 group, curcumin+pcDNA group, curcumin+pcDNA-UHRF1 group.Flow cytometry was usedtodetect cell apoptosis, Western Blot was used to detectthe protein expression of Bcl-2, Bax, Cleaved Caspase-3 and UHRF1, qRT-PCR was used to detect the expression of UHRF1 mRNA, and clone formationexperiment was used to detect the sensitivity of CM-319 cells to radiation.Results:Compared with the curcumin 0 μmol/L group, the apoptosis rate of CM-319 cellsinthe curcumin 5 μmol/L group, curcumin 10 μmol/L group and curcumin 20 μmol/L groupincreased 12.61%±1.57%, 18.42%±1.54%, 29.37%±2.65% vs 7.24%±0.73% ( t=9.305, 19.680, 24.153; all P<0.05), and the protein expression of Bcl-2 decreased 0.62±0.06, 0.51±0.05, 0.33±0.03 vs 0.76±0.07 ( t=4.556, 8.719, 16.939; all P<0.05), while the protein expression of Bax 0.41±0.04, 0.55±0.05, 0.69±0.06 vs 0.26±0.03 ( t=9.000, 14.920, 19.230; all P<0.05) and Cleaved Caspase-3 0.37±0.04, 0.49±0.05, 0.62±0.06 vs 0.24±0.03 ( t=7.800, 12.862, 16.994; all P<0.05) increased, and the expression of UHRF1 mRNA decreased 0.82±0.08, 0.67±0.07, 0.42±0.04 vs 1.01±0.09 ( t=4.734, 8.946, 17.972; all P<0.05), the protein expression of UHRF1 decreased 0.61±0.06, 0.48±0.05, 0.31±0.03 vs 0.83±0.08 ( t=6.600, 11.130, 18.258; all P<0.05), and were dose-dependent, and the sensitization ratios were 1.433, 1.708, and 2.183, respectively. Compared with the si-NC group, the protein expression of UHRF1in CM-319 cells in the si-UHRF1 group decreased 0.35±0.04 vs 0.79±0.08 ( t=14.758, P<0.05), the apoptosis rate of CM-319 cells increased 21.49%±2.11% vs 8.24%±0.83% ( t=17.531, P<0.05), the protein expression of Bcl-2 decreased 0.34±0.03 vs 0.71±0.07 ( t=14.575, P<0.05), while the protein expression of Bax 0.62±0.06 vs 0.25±0.03 ( t=16.547, P<0.05) and Cleaved Caspase-3 0.58±0.05 vs 0.23±0.03 ( t=18.007, P<0.05) increased, and the sensitization ratio was 1.727. Compared with the curcumin+pcDNA group, the apoptosis rate of CM-319 cells in the curcumin+pcDNA-UHRF1 groupreduced 13.59%±1.25% vs 28.31%±3.01% ( t=13.549, P<0.05), the protein expression of Bcl-2 increased 0.63±0.06 vs 0.31±0.03 ( t=14.311, P<0.05), while the protein expression of Bax 0.42±0.04 vs 0.71±0.07 ( t=10.791, P<0.05) and Cleaved Caspase-3 0.38±0.04 vs 0.65±0.05 ( t=12.650, P<0.05) decreased, and the sensitization ratio was 0.539. Conclusion:Curcumin can induce apoptosis of CM-319 cells and enhance the radiosensitivity of CM-319 cells, , and the mechanism is related to the down-regulation of UHRF1 expression.

sequential treatment of advanced prostate cancer is a current research hotspot. One patient with advanced prostate cancer with multiple metastases at initial diagnosis in our institution was sequentially treated with endocrine, abiraterone, polymerase inhibitor, and enzalutamide with an overall survival of 35 months.

Objective:To evaluate the personalized 3D printed guide template used in the osteotomy for malunion of tibial fracture.Methods:A retrospective analysis was conducted of the 30 patients who had been treated for malunion of tibial fracture at Department of Orthopaedics, The First Affiliated Hospital to Zhengzhou University from January 2010 to January 2018. Of them, 15 used a personalized 3D printed guide template in the osteotomy (3D printing group). They were 9 males and 6 females, with an age of 46.3 year±8.2 years. The fracture malunion was located in the upper and middle tibia in 11 cases, in the lower tibia in 4 cases, on the left side in 6 cases and on the right side in 9 ones. There were 8 cases of varus deformity and 7 ones of valgus deformity. Their preoperative fracture deformity angle was 24.3°±5.5°. The other 15 patients were treated with conventional surgery (conventional group). They were 10 males and 5 females, with an age of 47.1 years±6.0 years. The fracture was located in the upper and middle tibia in 12 cases, in the lower tibia in 3 cases, on the left side in 5 cases and on right side in 10 cases. There were 7 cases of varus deformity and 8 ones of valgus deformity. Their preoperative fracture deformity angle was 22.5°±5.4°. The 2 groups were compared in terms of preoperative baseline data, operation time, intraoperative blood loss and postoperative recovery of the alignment of lower limb.Results:There were no significant differences in the preoperative baseline data between the 2 groups, showing comparability ( P>0.05). The 3D printing group was followed up for an average of 12 months while the conventional group for an average of 10 months. The operation time for the 3D printing group was significantly shorter than that for the conventional group(102.2 min±13.0 min versus 137.9 min ±10.5 min), the intraoperative blood loss for the former significantly less than that for the latter (77.3 mL ± 39.7 mL versus 163.3 mL ± 35.2 mL), and the postoperative malunion angle in the former significantly smaller than that in the latter (1.9°±0.4° versus 3.2°±0.9°) (all P< 0.05). The last follow-ups revealed no implant failure or re-malunion but fine healing of the osteotomy sites and good recovery of the alignment of lower limb in the 2 groups. Conclusion:A personalized 3D printed guide template used in the osteotomy for malunion of tibial fracture is an effective aid because it can facilitate precise osteotomy, reduce operation time and intraoperative blood loss and help correct the alignment of lower limb, leading to good short-term surgical outcomes.

Objective:To investigate the value of 24-hour dynamic electrocardiogram combined with cardiac troponin I (cTnI) in evaluating the radiation-induced heart disease (RIHD) in chest tumor radiotherapy.Methods:From 2015 to 2018, 128 patients with chest tumor who received radiation therapy with/without chemotherapy in the Third People′s Hospital of Linyi were selected to undergo routine ECG examination, 24-hour dynamic ECG examination, cTnI and cardiac color Doppler ultrasound before radiotherapy, 30Gy radiotherapy, 50Gy radiotherapy, after radiotherapy and 3 months after radiotherapy, respectively. The detection rates of 24-hour dynamic electrocardiogram, routine electrocardiogram, cTnI, cardiac color Doppler ultrasound and 24-hour dynamic electrocardiogram combined with cTnI for RIHD were statistically compared. The correlation between glucose level, hypertension and coronary heart disease, combined with chemotherapy, radiation dose and the irradiated area of the heart and the incidence of RIHD was analyzed.Results:The detection rates for RIHD did not significantly differ between 24-hour dynamic electrocardiogram and routine electrocardiogram ( P>0.05), whereas the detection rates for arrhythmia, atrioventricular block, bundle branch block and ST-T changes of 24-hour dynamic electrocardiogram were significantly higher than those of routine electrocardiogram (all P<0.05). The detection rate of 24-hour dynamic electrocardiogram combined with cTnI was significantly higher compared with that of 24-hour dynamic electrocardiogram, routine electrocardiogram, cTnI or cardiac color Doppler ultrasound alone (all P<0.05). There was a significant difference in RIHD before and after radiotherapy ( P<0.05). The incidence rate of RIHD in the radiation therapy combined with chemotherapy group was significantly higher than those in the cisplatin chemotherapy and radiotherapy alone groups, especially in the epirubicin+cyclophosphamide group (45%, all P<0.05). The incidence rate of RIHD was similar between radiotherapy alone and radiotherapy combined with cisplatin chemotherapy (both P>0.05). After radiation therapy, the grade of RIHD was elevated in 40 cases (31.2%). Diabetes mellitus, hypertension, coronary heart disease, radiotherapy combined with chemotherapy, cardiac D mean and cardiac V 40Gy were the independent factors for the occurrence of grade 1-4 RIHD (all P<0.05). Conclusion:The 24-hour dynamic electrocardiogram combined with cTnI is of great value in the detection of RIHD induced by radiotherapy for chest tumors with high detection rate, simple operation and low cost, which is worthy of application in clinical practice.

Objective:To investigate the effects of lncRNA cytoskeleton regulator (CYTOR) on proliferation, migration, invasion and radiosensitivity in chordoma CM-319 and U-CH1cells and uncover the underlying mechanism.Methods:The expression of CYTOR and miR-24-3p in chordoma and nucleus pulposus tissues were detected by qRT-PCR. Human chordoma cell lines CM-319 and U-CH1 were divided into si-NC group (transfected si-NC), si-CYTOR group (transfected si-CYTOR), miR-NC group (transfected miR-NC), MiR-24-3p group (transfected miR-24-3p), si-CYTOR+anti-miR-NC group (co-transfected with si-CYTOR and anti-miR-NC), si-CYTOR+anti-miR- Group 24-3p (co-transfected with si-CYTOR and anti-miR-24-3p). Western blot was applied to detect the expression levelsof proteinsrelatedtoproliferation, migration and invasion. MTT was used to measure the proliferation of CM-319 and U-CH1 cells. Transwell assay was implemented to detect the migration and invasion ability of cells. Colony formation assay was used to detect the survival fraction of CM-319 and U-CH1 cells after different doses of radiation treatment. The relationship between CYTOR and miR-24-3p was verified by dual-luciferase reporter assay system.Results:The detection of 20 samples of chordoma tissues and 20 samples of nucleus pulposus tissuesrevealed that the expression level of CYTOR in chordoma tissues was significantly higher than that in nucleus pulposus tissues ( t=19.837, P<0.05), and the expression level of miR-24-3p in chordoma tissues was significantly lower than that in nucleus pulposus tissues ( t=22.061, P<0.05). Either inhibiting CYTOR or overexpression of miR-24-3p inhibited the proliferation, migration and invasion of CM-319 and U-CH1 cells, enhanced the radiosensitivity of CM-319 and U-CH1 cells. The result of dual-luciferase reporter assay system suggested that CYTOR negatively regulated the expression of miR-24-3p. Inhibition of miR-24-3p reversed the effects of inhibiting CYTOR on the proliferation, migration, invasion and radiosensitivity of CM-319 and U-CH1 cells. Coconlusion:CYTOR inhibits the proliferation, migration, invasion and enhanceds the radiosensitivityof CM-319 and U-CH1 cells by targetingmiR-24-3p, and CYTOR is a potential molecular therapeutic target for chordoma.