Objective:To compare the efficacy of the horizontal plate plus raft screws above the acetabulum and fixation with screws only for acetabular fractures combined with dome impaction in the aged patients.Methods:A retrospective cohort study was conducted to analyze the clinical data of 20 aged patients with acetabular fractures combined with dome impaction, who were admitted to Tianjin hospital between May 2013 and January 2023, including 5 males and 15 females, aged 61-84 years [(72.2±7.3)years]. According to Letournel and Judet classification, 13 patients had anterior column fracture, 5 anterior column fracture combined with posterior transverse fracture and 2 two-column fracture. All the patients underwent open reduction and internal fixation through an anterior approach. Of them, 11 patients were treated with the fixation with the horizonal plate plus raft screws above the acetabulum (plate plus raft screw group) and 9 with the screws only (screw only group). The operative time, intraoperative blood loss, and intraoperative fluoroscopy times were compared between the two groups. The quality of fracture reduction was evaluated with the Matta′s radiographic criteria at 3 days after surgery and the function of the hip joint was assessed with Merle D′Aubigné and Postel scoring system at 3 months after surgery and at the last follow-up as well as the excellent and good rate at te last follow-up. The occurrence of postoperative complications was observed.Results:All the patients were followed up for 6-18 months [(13.1±3.1)months]. There were no significant differences in the operative time, intraoperative blood loss or intraoperative fluoroscopy times between the two groups ( P>0.05). According to the Matta′s radiographic criteria at 3 days after surgery, patients with anatomical reduction and satisfactory reduction accounted 6 and 5 in the plate plus raft screw group, compared to 5 and 4 respectively in the screw only group ( P>0.05). The values of Merle D′Aubigné and Postel score at 3 months after surgery and at the last follow-up were (14.0±2.4)points and (15.8±2.2)points in the plate plus raft screw group, which were higher than those in the screw only group [(11.0±2.6)points and (13.0±3.1)points] ( P<0.01). The values of Merle D′Aubigné and Postel score at the last follow-up of both groups were further enhanced from those at 3 months after surgery ( P<0.01). At the last follow-up, 3 patients were rated excellent, 6 good, 1 fair and 1 poor in the plate plus raft screw group, with an excellent and good rate of 81.8%, while in the screw only group, 3 were rated good, 2 fair and 4 poor, with an excellent and good rate of 33.3% ( P<0.05). One patient in the plate plus raft screw group and 5 in the screw only group had displacement of the dome impaction fragment combined with traumatic arthritis after surgery ( P<0.05). Conclusion:For acetabular fractures combined with dome impaction in the aged patients, the horizontal plate plus raft screw above the acetabulum can effectively improve the function restoration of the hip joint and reduce the occurrence of the displacement of the dome impaction fragment and traumatic arthritis after surgery compared to the fixation with screws only.

Nitroxide radicals are a kind of stable organic free radicals.Due to the presence of N-O·and unpaired electrons in its structure,it has many characteristics,and thus can be used as a spin marker to explore the mechanism of biological reactions;with its magnetic properties,it can be used for the development of multifunctional magnetic molecular materials and used as a polymerization inhibitor and catalyst in organic reactions.More importantly,it has a variety of biological activities such as anti-oxidation and anti-tumor,and so has attracted much attention in the research and development of new drugs.For example,the spin labeling of nitroxide radicals on anticancer drug podophyllotoxin can enhance the efficacy and reduce the toxicity,and can be easily to be absorbed by the body,thus obtaining a new anti-cancer drug 4-[4″-(2″,2″,6″,6″-tetramethyl-1″-piperidinyloxy nitroxide radical)amino]-4′-demethyl epipodophyllotoxin(GP-7).It is an effective way to seek new drugs by introducing pharmacophore to modify nitroxide radicals or it can be spin-labeled on active natural products to obtain new compounds with high efficiency and low toxicity.The research progress of derivatives and its biological activitives of nitroxide radicals are summarized,aiming to provide theoretical basis for the developing and utilizing of nitroxide radicals and searching for new drugs.

Objective This study was to develop a"Spleen Deficiency Certificate Scale for County Residents"and test its reliability.It was then developed as an objective tool for Chinese medicine evidence and symptoms for the prevention and control of chronic diseases among county residents.Methods The scale was compiled based on the team's previous foundation.The reliability of the scale was evaluated using internal consistency reliability and split-half reliability,while its validity was evaluated using structural validity,content validity,calibration validity,and discriminant validity.Results The study included 213 adults from Lanxi,of whom 155 were tested for intestinal flora.Seven scale entries were identified:Fatigue,fear of cold,bland mouth,loss of appetite,diarrhea,weak bowel movements,and tooth-marked tongue.In the reliability test,Cronbach's alpha coefficient was 0.828 and McDonald's ω coefficient was 0.825.The"stomach pain"and"bloating"entries did not meet the inclusion requirements and were recommended to be deleted.The Spearman-Brown coefficient was 0.839.The exploratory factor analysis of the two common factors explained 61.6%of the cumulative variance.The calibration validity indicated that the ratio of salivary amylase activity before and after acid stimulation was 0.826±0.253 in the group with spleen deficiency.Significant differences(P<0.05)in the genera Dialister,Shigella,Leuconostoc,Photobacterium,Trabulsiella,and Parvimonas between the spleen deficiency group and the non-spleen deficiency group.Conclusion The Spleen Deficiency Scale for County Residents demonstrates good reliability and validity.

The surgical reduction and fixation of subtrochanteric femoral fractures are challenging due to its particular anatomical and biomechanical characteristics. Intramedullary nailing is the golden standard for its treatment, but postoperative bone nonunion is a common complication, resulting in limb pain and decreased mobility, which requires a second operation and greatly affects the patients′ life quality. At present, there are many studies on the risk factors of bone nonunion after intramedullary nail fixation, but the risk factors with strong correlation remain unclear and the subsequent treatment plans are diverse, without consensus. Further identification of risk factors can help to select treatment plans. To this end, the authors reviewed the research progress in the risk factors and treatment methods of bone nonunion after intramedullary nailing of subtrochanteric femoral fractures to provide references for its clinical treatment.

Objective: : Kinesin family member C1 (KIFC1), a non-essential kinesin-like motor protein, has been found to serve a crucial role in supernumerary centrosome clustering and the progression of several human cancer types. However, the role of KIFC1 in glioma has been rarely reported. Thus, the present study aimed to investigate the role of KIFC1 in glioma progression. Methods: : Online bioinformatics analysis was performed to determine the association between KIFC1 expression and clinical outcomes in glioma. Immunohistochemical staining was conducted to analyze the expression levels of KIFC1 in glioma and normal brain tissues. Furthermore, KIFC1 expression was knocked in the glioma cell lines, U251 and U87MG, and the functional roles of KIFC1 in cell proliferation, invasion and migration were analyzed using cell multiplication, wound healing and Transwell invasion assays, respectively. The autophagic flux and expression levels matrix metalloproteinase-2 (MMP2) were also determined using imaging flow cytometry, western blotting and a gelation zymography assay. Results: : The results revealed that KIFC1 expression levels were significantly upregulated in glioma tissues compared with normal brain tissues, and the expression levels were positively associated with tumor grade. Patients with glioma with low KIFC1 expression levels had a more favorable prognosis compared with patients with high KIFC1 expression levels. In vitro, KIFC1 knockdown not only inhibited the proliferation, migration and invasion of glioma cells, but also increased the autophagic flux and downregulated the expression levels of MMP2. Conclusion : Upregulation of KIFC1 expression may promote glioma progression and KIFC1 may serve as a potential prognostic biomarker and possible therapeutic target for glioma.

Humans ; Female ; Breast Neoplasms/genetics* ; Prognosis ; Gene Expression Profiling ; Biomarkers, Tumor/genetics* ; Gene Expression Regulation, Neoplastic/genetics* ; Receptor, ErbB-2/metabolism* ; Gene Regulatory Networks/genetics*

Objective To observe the clinical effect of arthroscopic repair of isolated degenerative medi-al meniscus injury in patients over 45 years old and to evaluate the healing after more than two years of fol-low-up through MRI.Methods A retrospective study was conducted on the clinical effects of 51 patients with isolated degenerative medial meniscus injury who underwent arthroscopic repair from January 2016 to Decem-ber 2020.The meniscus was sutured by total internal suture or total internal suture combined with internal-to-external technique.IKDC score,Tegner score and Lysholm score were recorded before operation and at the last follow-up(at least 24 months).The type and location of meniscus injury during operation,and the microscopic classification and location of cartilage injury were recorded.At the same time,MRI was used to observe the healing of meniscus and ICRS cartilage injury grading.On MRI,0-2 degree injury was defined as meniscus healing,and 3 degree injury was defined as nonunion.The clinical repair failure was judged according to the Barrett evaluation criteria.Results The average age of the patients was(57.3±8.4)years,and the average follow-up time was(55.0±15.3)months.There were 47.1％complex fissures,31.3％horizontal fissures and 21.6％other types.The Lysholm score increased from 53.5±6.4 preoperative to 87.6±7.9 postoperative,the IKDC score increased from 33.6±4.7 preoperative to 72.8±5.3 postoperative,and the Tegner score increased from 1.0±0.1 preoperative to 4.0±0.5 postoperative.Three patients were judged as clinical repair failure,and five patients had progressed cartilage injury after surgery.At the last follow-up,the meniscus healing was observed on MRI:0 degree in two cases(3.9％),1 degree in 17 cases(33.3％),2 degree in 11 cases(21.6％),3 degree in 21 cases(41.2％).Conclusion For middle-aged and elderly patients with isolated de-generative medial meniscus injury,if conservative treatment is not effective or there are mechanical obstruc-tion factors,arthroscopic meniscus repair can achieve good clinical results and low clinical repair failure rate.

Objective:To design a motor impairment rehabilitation monitoring aid for the assessment of motor impairment in patients who do not have or have difficulty walking independently.Methods:An assistive device vehicle was designed, equipped with an accelerometer and a six-dimensional force sensor. The normal walking (NW) group and abnormal walking group were set up, in which the abnormal walking group included moderate abnormal walking (MA) group, moderate abnormal walking with the aid of the assistive vehicle (MA-V) group, severe abnormal walking (SA) group, and severe abnormal walking with the aid of the assistive vehicle (SA-V) group. In the MA-V group, the range of knee movement was adjusted from 0 to 30°, and in the SA group, the knee joint was completely unbending. The gait cycles, peak and mean acceleration values of the right and left legs were evaluated by accelerometers, and changes in the upper limb forces were assessed by six-dimensional force transducers.Results:For the moderate impairment group, the difference in gait cycle between the MA and MA-V groups was not statistically significant ( P>0.05), and the gait cycle in the MA-V group was slightly greater than that in the MA group. For the severe injury group, the gait cycle of the SA-V group was lower than that of the SA group, and the difference was statistically significant ( P<0.01). For all abnormal groups, the mean and peak acceleration of the left leg were greater than that of the right leg, and the difference between the peak acceleration of the left leg and that of the right leg was statistically significant ( P<0.05). In the abnormal walking pattern, the mean (absolute) value of the left hand force was greater than that of the right hand, especially in the Z-axis. The standard deviations of the combined forces on the left side for the NW, MA-V, and SA-V groups were 2.759, 8.297, and 13.118 N, respectively. The SA-V group had the highest dispersion in the force scatter plot, while the NW group had a better concentration. Conclusions:An assistive vehicle equipped with an accelerometer and a six-dimensional force sensor was designed to help physicians in the assessment and rehabilitation of motor disorders.

Objective:To explore the effectiveness and safety of robot-aided percutaneous anterior column screw combined with posterior plate fixtation treatment for transverse acetabular fractures with posterior wall.Methods:A retrospective analysis was conducted on the data of 13 patients with transverse acetabular fractures and posterior wall fractures treated by robot-aided percutaneous anterior column screws combined with posterior plate in Tianjin Hospital from May 2016 to May 2021. There were 9 males and 4 females, aged 49.1±8.5 years (range, 25-65 years), 9 cases of vehicle accidents, 2 cases of falling injuries, 2 cases of impact injuries, 7 cases of combined posterior hip dislocations, and 1 case of sciatic nerve injury. Apply Kocher-Langenbeck approach for reduction and fixation of the posterior wall and the posterior column and indirect reduction of the anterior column. Use robot navigation for percutaneous anterior column screw fixation, and record the time of inserting anterior column screws, incision length, and complications. The quality of fracture reduction was evaluated using Matta imaging, and the degree of ectopic ossification was evaluated using Brooker classification. The Matta modified Postel Merle D'Aobigne score was used to evaluate the function at 3, 6 months after surgery and at the last follow-up.Results:All 13 patients successfully completed the surgery. The insertion time of the anterior column screw was 19.4±4.0 min (range, 17-23 min), and the incision length was 8.0±1.4 mm (range, 6-10 mm). Postoperative imaging examination showed that all anterior column screws were located within the bone canal, with a screw length of 108.3±11.2 mm (range, 90-130 mm), and no complications such as nerve or vascular injury or incision infection occurred. All 13 patients were followed up for a period of 12-36 months, with an average of 18.6 months; All fractures healed, with a healing time of 2-6 months, average 3.4 months. According to the Matta imaging evaluation method, 11 of 13 patients had anatomical reduction of fractures, and 2 were evaluated as incomplete reduction due to a 1-2 mm gap in the anterior column. The anatomical reduction rate was 84%. At postoperative 3, 6 months and the last follow-up, the modified Postel Merle D'Aobigne scores were 13.4±1.1, 15.8±1.5, and 17.0±1.7, respectively, with statistically significant differences ( F=7.78, P=0.007). The difference between the last follow-up and postoperative 3 months was statistically significant ( P=0.002), and there was no statistically significant difference compared to postoperative 6 months ( P=0.222). At the last follow-up, 8 cases were excellent, 4 cases were good, and 1 case was fair, with an excellent and good rate of 92%. There was no occurrence of ectopic ossification, traumatic arthritis, or necrosis of the femoral head. Conclusion:Robot-aided percutaneous anterior column screw combined with posterior plate treatment for transverse acetabular fractures with posterior wall is safe and effective, and is worthy of clinical promotion.

Objective:To evaluate the clinical outcome of Robot-assisted sacroiliac screw fixation in the treatment of fragility fracture of the sacrum in the elderly.Methods:From March 2016 to June 2022, a retrospective analysis was performed on 30 patients with fragility fractures of the sacrum in the elderly who accepted robot-assisted sacroiliac screw to treat fragility fractures of the sacrum in our hospital. There were 12 males and 18 females with average age 71.03±8.25 years (range, 60-89 years). According to the classification of fragility fractures of the pelvis (FFP) in the elderly, there were 22 patients with FFP II, 2 patients with FFP III, and 6 patients with FFP IV. Surgical planning was based on the average CT value of S 1 channel and whether there is a transsacral screw channel. Robot-assisted sacroiliac screw fixation was performed during surgery. The pain of pre-operation and post-operation was evaluated using the visual analogue scale (VAS), the position of sacroiliac screws was evaluated by Gras grading, and the degree of functional recovery after surgery was evaluated using the Majeed function score. Results:All 30 patients successfully completed the operation. The mean operation time was 27.00±6.68 min (range, 18-35 min), the mean fluoroscopy times were 27.13±5.16 (range, 18-34), and the mean blood loss was 30.53±6.61 ml (range, 23-38 ml). All patients were followed up, and the mean follow-up time was 19.03±7.8 months (range, 8-25 months). The VAS was 5(5, 6), 4(3, 4), 3(2, 3), 0(0, 1) points before surgery, 1 week, 2 months and 6 months after surgery, respectively, and the difference was statistically significant ( H=103.26, P<0.001). After the surgery of 2 months, 6 months and the last follow-up time, the Majeed function scores were 88(83, 90), 91(87, 92), 92(90, 93) points, respectively, and the difference was statistically significant ( H=19.59, P<0.001). Screw position was evaluated according to Gras grading at 3 days after surgery, including 28 cases of level I, 2 cases of level II, and no screw penetrated the cortical bone or entered the sacral canal or sacral foramen. No vascular or nerve injury occured during the operation. 28 patients with FFS met the fracture healing criteria, and the healing time was 4.54±1.57 months (range, 3-7 months). Two patients had bone nonunion, one of whom underwent anterior ring plate removal due to infection of the pelvic anterior wound, and one month later, pelvic CT scan revealed loosening of the sacroiliac screw; the other one is considered to be related to too early weight bearing. Conclusion:For fragility fractures of the sacrum in elderly, Robot-assisted sacroiliac screw is an effective minimally invasive treatment, with high accuracy of screw placement, effective pain reduction, improved fracture healing rate, and achieve the satisfactory clinical efficacy.