Exosomes(Exos)are extracellular vesicles secreted by cells and serve as crucial mediators of intercellular communication.They play a pivotal role in the pathogenesis and progression of various diseases and offer promi...Exosomes(Exos)are extracellular vesicles secreted by cells and serve as crucial mediators of intercellular communication.They play a pivotal role in the pathogenesis and progression of various diseases and offer promising avenues for therapeutic interventions.Exos derived from mesenchymal stem cells(MSCs)have significant immunomodulatory properties.They effectively regulate immune responses by modulating both innate and adaptive immunity.These Exos can inhibit excessive inflammatory responses and promote tissue repair.Moreover,they participate in antigen presentation,which is essential for activating immune responses.The cargo of these Exos,including ligands,proteins,and microRNAs,can suppress T cell activity or enhance the population of immunosuppressive cells to dampen the immune response.By inhibiting lymphocyte proliferation,acting on macrophages,and increasing the population of regulatory T cells,these Exos contribute to maintaining immune and metabolic homeostasis.Furthermore,they can activate immune-related signaling pathways or serve as vehicles to deliver microRNAs and other bioactive substances to target tumor cells,which holds potential for immunotherapy applications.Given the immense therapeutic potential of MSC-derived Exos,this review comprehensively explores their mechanisms of immune regulation and therapeutic applications in areas such as infection control,tumor suppression,and autoimmune disease management.This article aims to provide valuable insights into the mechanisms behind the actions of MSC-derived Exos,offering theoretical references for their future clinical utilization as cell-free drug preparations.展开更多
Hepatocellular carcinoma(HCC)is the predominant form of primary liver cancer,accounting for 90%of all cases.Currently,early diagnosis of HCC can be achieved through serum alpha-fetoprotein detection,B-ultrasound,and c...Hepatocellular carcinoma(HCC)is the predominant form of primary liver cancer,accounting for 90%of all cases.Currently,early diagnosis of HCC can be achieved through serum alpha-fetoprotein detection,B-ultrasound,and computed tomography scanning;however,their specificity and sensitivity are suboptimal.Despite significant advancements in HCC biomarker detection,the prognosis for patients with HCC remains unfavorable due to tumor heterogeneity and limited understanding of its pathogenesis.Therefore,it is crucial to explore more sensitive HCC biomarkers for improved diagnosis,monitoring,and management of the disease.Long non-coding RNA(lncRNA)serves as an auxiliary carrier of genetic information and also plays diverse intricate regulatory roles that greatly contribute to genome complexity.Moreover,investigating gene expression regulation networks from the perspective of lncRNA may provide insights into the diagnosis and prognosis of HCC.We searched the PubMed database for literature,comprehensively classified regulated cell death mechanisms and systematically reviewed research progress on lncRNA-mediated cell death pathways in HCC cells.Furthermore,we prospectively summarize its potential implications in diagnosing and treating HCC.展开更多
Children presenting with partial physeal arrest and significant remaining growth may benefit from physeal bar resection,although the operation is a technique demanding procedure.This study evaluates the treatment of p...Children presenting with partial physeal arrest and significant remaining growth may benefit from physeal bar resection,although the operation is a technique demanding procedure.This study evaluates the treatment of post-traumatic pediatric ankle varus deformity using physeal bar resection and hemi-epiphysiodesis with the assistance of two operative methods.Forty-five patients presenting with a distal tibial medial physeal bridge as well as ankle varus deformity following traumatic ankle physeal injury between 2009 and 2017 were followed.These patients were treated w让h physeal bar resection and hemi-epiphysiodesis,with the assistance of either fluoroscopy (10 cases) or intraoperative three-dimensional navigation (35 cases).Of the 45 cases,the median age was 9.0 years (range:3-14 years) with 28 male and 17 female patients.The median of pre-operation ankle varus angle was 20 degrees (IQR 15-25) and 5 degrees (IQR 0-20) at the time of final follow up,representing a statistically significant difference (P<0.05).No differences were observed with regards to age,gender,and surgical history between effective group and ineffective group (P>0.05).The median of pre-operative ankle varus angles of the navigation and fluoroscopy groups were both 20 degrees (P>0.05).The median correction angle of the navigation and fluoroscopy groups was 10 and 15 degrees,respectively (P>0.05).Our results indicate that physeal bar resection and hemiepiphysiodesis are effective treatments for correcting ankle varus deformity due to traumatic medial physeal arrest of the distal tibia.We observe no difference in outcome between fluoroscopy group and three-dimensional navigation group during the procedures.展开更多
Combined femoral and acetabular anteversion is the sum of femoral and acetabular anteversion,representing their morphological relationship in the axial plane.Along with the increasing understanding of hip dysplasia in...Combined femoral and acetabular anteversion is the sum of femoral and acetabular anteversion,representing their morphological relationship in the axial plane.Along with the increasing understanding of hip dysplasia in recent years,numerous scholars have confirmed the role of combined femoral and acetabular anteversion in the pathological changes of hip dysplasia.At present,the reconstructive surgery for hip dysplasia includes total hip replacement and redirectional hip preservation surgery.As an important surgery index,combined femoral and acetabular anteversion have a crucial role in these surgeries.Herein,we discuss the role of combined femoral and acetabular anteversion in pathological changes of hip dysplasia,total hip replacement,and redirectional hip preservation surgery.展开更多
In children with asymmetric growth on the medial and lateral side of limbs,if there still remains growth potential,the guided growth technique of hemiepiphysiodesis on one side of the epiphysis is recognized as a safe...In children with asymmetric growth on the medial and lateral side of limbs,if there still remains growth potential,the guided growth technique of hemiepiphysiodesis on one side of the epiphysis is recognized as a safe and effective method.However,when the hemi-epiphysiodesis start to correct the deformities,how many degrees could hemi-epiphysiodesis bring every month and when to remove the hemi-epiphysiodesis implant without rebound phenomenon are still on debate.This article reviews the current studies focus on the effective time,correction speed and termination time of hemi-epiphysiodesis.展开更多
Rhabdoid tumors (RTs) are a well-defined entity in the kidney or central nervous system of infants or children. However, soft-tissue involvement is uncommon. It’s an exceptional neonatal tumor of soft tissue. The ima...Rhabdoid tumors (RTs) are a well-defined entity in the kidney or central nervous system of infants or children. However, soft-tissue involvement is uncommon. It’s an exceptional neonatal tumor of soft tissue. The imaging characteristics of this tumor are not specific. Biopsy allows diagnosis;the histomorphological characteristics of rhabdoid tumors, their immunoreactivity to epithelial markers and vimentin, and the INI-1 loss are important tools for diagnosis. RT tumors are aggressive and have a rapidly fatal clinical course in most cases. Despite multidisciplinary therapy, the survival rate is very low. We report a rare case occurring in a male neonate who presents at birth with a voluminous right axillary mass. A CT scan showed a well-limited tumor mass with lobulated contours. An ultrasound-guided biopsy was performed on day 8, showing the morphology and immunoprofile of RT. The mass showed rapid growth. The child was admitted for respiratory distress at 3 weeks. A thoraco-abdominal CT showed an increase in the size of the mass with the appearance of multiple lymph nodes and pleural, hepatic, and renal metastases. The child died two days later.展开更多
OBJECTIVE: To clarify the role of midkine (MK) in vulvar carcinogenesis though examination of its expression in vulvar lesions including vulvar condyloma acuminata (VCA), vulvar intraepithelial neoplasia (VIN) and vul...OBJECTIVE: To clarify the role of midkine (MK) in vulvar carcinogenesis though examination of its expression in vulvar lesions including vulvar condyloma acuminata (VCA), vulvar intraepithelial neoplasia (VIN) and vulvar squamous cell carcinomas (VSCC), and to analyze the relationship between MK expression and human papilloma virus (HPV) infection. METHODS: Thirty VSCC, 15 VIN and 10 VCA patients were studied by streptavidin-biotin-immunoperoxidase method. MK expression was compared with clinicopathologic features of vulvar tumors. RESULTS: MK was expressed in 26 of 30 VSCC (87%), 3 of 5 VIN III and all VCA samples, whereas no MK expression was detected in the VIN I-II samples or in normal epithelium. The difference of MK expression between VIN III and VSCC was statistically significant (P展开更多
BACKGROUND Rosai-Dorfman disease(RDD),or sinus histiocytosis with massive lymphadenopathy,is a benign histiocytic disorder.Extranodal involvement is common,occurring in>40%of patients,but bone involvement occurs in...BACKGROUND Rosai-Dorfman disease(RDD),or sinus histiocytosis with massive lymphadenopathy,is a benign histiocytic disorder.Extranodal involvement is common,occurring in>40%of patients,but bone involvement occurs in<10%of cases.In addition,primary bone RDD is extremely rare.The majority of patients are adolescents and young adults,and the mean age at onset is 20-years-old.CASE SUMMARY We report an 8-year-old Chinese girl who presented to our hospital with an insidious onset of swelling and pain in the middle shaft of her right tibia for 4 mo.We performed total surgical resection of the right tibia lesion and allograft transplantation.A good prognosis was confirmed at the 6 mo follow-up.Pain and swelling symptoms were totally relieved,range of motion of her right knee and ankle returned to normal,and there was no clinical evidence of lesion recurrence at last follow up.Our case is the second reported case of osseous RDD without lymphadenopathy in the shaft of the tibia of a child.CONCLUSION Extranodal RDD is a rare disease and can be misdiagnosed easily.Lesion resection and allograft transplantation are an option to treat extranodal RDD in children with good short term result.Pediatric orthopedist should be aware of this rare disease,especially extranodal involvement.展开更多
BACKGROUND Synovial chondromatosis(SC)is a rare benign lesion first reported by Ambrose Pare in 1558.It is most common in the knee joint,followed by the hip joint and elbow joint.It is characterized by the presence of...BACKGROUND Synovial chondromatosis(SC)is a rare benign lesion first reported by Ambrose Pare in 1558.It is most common in the knee joint,followed by the hip joint and elbow joint.It is characterized by the presence of multiple pearl-like osteochondral bodies in the joint.The incidence in children is extremely low.CASE SUMMARY We report a 6-year-old Chinese boy who presented to our hospital with left hip joint pain and claudication for more than one year.We performed total surgical resection of SC tissue in the left hip.A good prognosis was confirmed at the 6-wk follow-up.Pain and swelling symptoms were totally relieved,range of motion of his left hip returned to normal,and there was no clinical evidence of lesion recurrence at last follow-up.Our case is the youngest reported patient with SC occurring in the hip.CONCLUSION SC is a rare disease and can be easily misdiagnosed.When we encounter children with hip pain and claudication,increased vigilance and a comprehensive physical examination and imaging examination should be considered,in order to avoid misdiagnosis and delayed treatment in patients.展开更多
AIM: To confirm the rarity of this disorder and then to evaluate the effects of antibiotic treatment alone and assess whether this could produce a complete remission of symptoms in children and adolescents.METHODS: We...AIM: To confirm the rarity of this disorder and then to evaluate the effects of antibiotic treatment alone and assess whether this could produce a complete remission of symptoms in children and adolescents.METHODS: We made a retrospective review of all cases of condensing osteitis of the clavicle in children and adolescents between January 2007 and January 2016. Outpatient and inpatient medical records, with radiographs, magnetic resonance imaging, triphasic bone scan and computed tomography scans were retrospectively reviewed. All the patients underwent biopsy of the affected clavicle and were treated with intra venous(IV) antibiotics followed by oral antibiotics.RESULTS: Seven cases of condensing osteitis of the clavicle were identified. All the patients presented with swelling of the medial end of the clavicle, and 5 out of 7 reported persisting pain. The patients' mean age at presentation was 11.5 years(range 10.5-13). Biopsy confirmed the diagnosis in all cases. All the patients completed the treatment with IV and oral antibiotics. At last follow-up visit none of the patients complained of residual pain; all had a clinically evident reduction in the swelling of the medial end of the affected clavicle. The mean follow-up was 4 years(range 2-7).CONCLUSION: Our findings show that condensing osteitis of the clavicle is a rare condition. Biopsy is needed to confirm diagnosis. The condition should be managed with IV and oral antibiotics. Aggressive surgery should be avoided.展开更多
BACKGROUND The effectiveness of Platelet-Rich Plasma(PRP)in the treatment of patients with Achilles tendon rupture(ATR)and Achilles tendinopathy(AT)has been controversial.AIM To assess PRP injections’effectiveness in...BACKGROUND The effectiveness of Platelet-Rich Plasma(PRP)in the treatment of patients with Achilles tendon rupture(ATR)and Achilles tendinopathy(AT)has been controversial.AIM To assess PRP injections’effectiveness in treating ATR and AT.METHODS A comprehensive review of relevant literature was conducted utilizing multiple databases such as Cochrane Library,PubMed,Web of Science,Chinese Science and Technology Journal,EMBASE,and China Biomedical CD-ROM.The present investigation integrated randomized controlled trials that assessed the effectiveness of platelet-rich plasma injections in managing individuals with Achilles tendon rupture and tendinopathy.The eligibility criteria for the trials encompassed publications that were published within the timeframe of January 1,1966 to December 2022.The statistical analysis was performed utilizing the Review Manager 5.4.1,the visual analogue scale(VAS),Victorian Institute Ankle Function Scale(VISA-A),and Achilles Tendon Thickness were used to assess outcomes.RESULTS This meta-analysis included 13 randomized controlled trials,8 of which were randomized controlled trials of PRP for AT and 5 of which were randomized controlled trials of PRP for ATR.PRP for AT at 6 wk[weighted mean difference(WMD)=1.92,95%CI:-0.54 to 4.38,I2=34%],at 3 mo[WMD=0.20,95%CI:-2.65 to 3.05,I2=60%],and 6 mo[WMD=2.75,95%CI:-2.76 to 8.26,I2=87%)after which there was no significant difference in VISA-A scores between the PRP and control groups.There was no significant difference in VAS scores between the PRP group and the control group after 6 wk[WMD=6.75,95%CI:-6.12 to 19.62,I2=69%]and 6 mo[WMD=10.46,95%CI:-2.44 to 23.37,I2=69%]of treatment,and at mid-treatment at 3 mo[WMD=11.30,95%CI:7.33 to 15.27,I2=0%]after mid-treatment,the PRP group demonstrated better outcomes than the control group.Post-treatment patient satisfaction[WMD=1.07,95%CI:0.84 to 1.35,I2=0%],Achilles tendon thickness[WMD=0.34,95%CI:-0.04 to 0.71,I2=61%]and return to sport[WMD=1.11,95%CI:0.87 to 1.42,I2=0%]were not significantly different between the PRP and control groups.The study did not find any statistically significant distinction between the groups that received PRP treatment and those that did not,regarding the Victorian Institute of Sport Assessment-Achilles scores at 3 mo[WMD=-1.49,95%CI:-5.24 to 2.25,I2=0%],6 mo[WMD=-0.24,95%CI:-3.80 to 3.32,I2=0%],and 12 mo[WMD=-2.02,95%CI:-5.34 to 1.29,I2=87%]for ATR patients.Additionally,no significant difference was observed between the PRP and the control groups in improving Heel lift height respectively at 6 mo[WMD=-3.96,95%CI:-8.61 to 0.69,I2=0%]and 12 mo[WMD=-1.66,95%CI:-11.15 to 7.83,I2=0%]for ATR patients.There was no significant difference in calf circumference between the PRP group and the control group after 6 mo[WMD=1.01,95%CI:-0.78 to 2.80,I2=54%]and 12 mo[WMD=-0.55,95%CI:-2.2 to 1.09,I2=0%]of treatment.There was no significant difference in ankle mobility between the PRP and control groups at 6 mo of treatment[WMD=-0.38,95%CI:-2.34 to 1.58,I2=82%]and after 12 mo of treatment[WMD=-0.98,95%CI:-1.41 to-0.56,I2=10%]there was a significant improvement in ankle mobility between the PRP and control groups.There was no significant difference in the rate of return to exercise after treatment[WMD=1.20,95%CI:0.77 to 1.87,I2=0%]and the rate of adverse events[WMD=0.85,95%CI:0.50 to 1.45,I2=0%]between the PRP group and the control group.CONCLUSION The use of PRP for AT improved the patient’s immediate VAS scores but not VISA-A scores,changes in Achilles tendon thickness,patient satisfaction,or return to sport.Treatment of ATR with PRP injections alone improved long-term ankle mobility but had no significant effect on VISA-A scores,single heel lift height,calf circumference or return to sport.Additional research employing more extensive sampling sizes,more strict experimental methods,and standard methodologies may be necessary to yield more dependable and precise findings.展开更多
Traumatic painful neuroma is an intractable clinical disease characterized by improper extracellular matrix(ECM)deposition around the injury site.Studies have shown that the microstructure of natural nerves provides a...Traumatic painful neuroma is an intractable clinical disease characterized by improper extracellular matrix(ECM)deposition around the injury site.Studies have shown that the microstructure of natural nerves provides a suitable microenvironment for the nerve end to avoid abnormal hyperplasia and neuroma formation.In this study,we used a decellularized nerve matrix scaffold(DNM-S)to prevent against the formation of painful neuroma after sciatic nerve transection in rats.Our results showed that the DNM-S effectively reduced abnormal deposition of ECM,guided the regeneration and orderly arrangement of axon,and decreased the density of regenerated axons.The epineurium-perilemma barrier prevented the invasion of vascular muscular scar tissue,greatly reduced the invasion ofα-smooth muscle actin-positive myofibroblasts into nerve stumps,effectively inhibited scar formation,which guided nerve stumps to gradually transform into a benign tissue and reduced pain and autotomy behaviors in animals.These findings suggest that DNM-S-optimized neuroma microenvironment by ECM remodeling may be a promising strategy to prevent painful traumatic neuromas.展开更多
Developmental dysplasia of hip seriously affects the health of children,and pelvic osteotomy is an important part of surgical treatment.Improving the shape of the acetabulum,preventing or delaying the progression of o...Developmental dysplasia of hip seriously affects the health of children,and pelvic osteotomy is an important part of surgical treatment.Improving the shape of the acetabulum,preventing or delaying the progression of osteoarthritis is the ultimate goal of pelvic osteotomies.Re-directional osteotomies,reshaping osteotomies and salvage osteotomies are the three most common types of pelvic osteotomy.The influence of different pelvic osteotomy on acetabular morphology is different,and the acetabular morphology after osteotomy is closely related to the prognosis of the patients.But there lacks comparison of acetabular morphology between different pelvic osteotomies,on the basis of retrospective analysis and measurable imaging indicators,this study predicted the acetabular shape after developmental dysplasia of the hip pelvic osteotomy in order to help clinicians make reasonable and correct decisions and improve the planning and performance of pelvic osteotomy.展开更多
Chronic osteomyelitis is a painful and serious disease caused by infected surgical prostheses or infected fractures.Traditional treatment includes surgical debridement followed by prolonged systemic antibiotics.Howeve...Chronic osteomyelitis is a painful and serious disease caused by infected surgical prostheses or infected fractures.Traditional treatment includes surgical debridement followed by prolonged systemic antibiotics.However,excessive antibiotic use has been inducing rapid emergence of antibiotic-resistant bacteria worldwide.Additionally,it is difficult for antibiotics to penetrate internal sites of infection such as bone,thus limiting their efficacy.New approaches to treat chronic osteomyelitis remain a major challenge for orthopedic surgeons.Luckily,the development of nanotechnology has brought new antimicrobial options with high specificity to infection sites,offering a possible way to address these challenges.Substantial progress has been made in constructing antibacterial nanomaterials for treatment of chronic osteomyelitis.Here,we review some current strategies for treatment of chronic osteomyelitis and their underlying mechanisms.展开更多
<b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Ver...<b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Scoliosis is among interventions with high postoperative com</span><span><span style="font-family:Verdana;">plication rates due to the characteristics of the surgery, where blood los</span><span style="font-family:Verdana;"></span><span style="font-family:Verdana;">s,</span></span><span style="font-family:Verdana;"> transfusion and fluid requirements can be increased. A monocentric retrospective observational study was undertaken earlier to determine predictors of intraoperative and postoperative outcomes in surgical patients. In this initial cohort, there were patients who underwent scoliosis surgery, and a secondary </span><span style="font-family:Verdana;">analysis to describe outcomes in these patients was realized and presented</span> <span><span style="font-family:Verdana;">here. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To describe intraoperative and postoperative outcomes in</span></span><span style="font-family:Verdana;"> patients under 18 years old in scoliosis surgery included in the initial study and </span><span style="font-family:Verdana;">to propose improvement </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">and </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">implementation measures. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A sec</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ondary analysis of patients undergoing scoliosis surgery </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">from</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> 1 January 2014 to </span><span style="font-family:Verdana;">17 May 2017 was undertaken in our institution—Necker Enfants Malades</span> <span style="font-family:Verdana;">uni</span><span style="font-family:Verdana;">ver</span><span><span style="font-family:Verdana;">sity hospital. The study was approved by the Ethics Committee. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> There </span></span><span style="font-family:Verdana;">were 116 patients with a mean age of 147.5 ± 40.2 months. Twenty-eight pa</span><span style="font-family:Verdana;">tients </span><span style="font-family:Verdana;">(24.1%) presented intraoperative and/or postoperative complications. The most</span> <span style="font-family:Verdana;">common intraoperative complication was hemorrhagic shock in 3 patients </span><span style="font-family:Verdana;">(2.6%). The most common postoperative organ failure was neuro</span><span style="font-family:Verdana;">logic in seven patients (6%), respiratory in 3 patients (2.6%), car</span><span style="font-family:Verdana;">dio-circulatory in 2 patients (1.7%) and renal failure in </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">1</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patient (0.9%). The most common postoperative infection was surgical wound sepsis in 8 patients (6.9%), urinary sepsis in </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">3</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patients (2.6%), and abdominal sepsis and septicemia in </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">2</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patients (1.7%). </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">12</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> patients (10.3%) had reoperations. Fif</span><span style="font-family:Verdana;">ty-six patients (48.3%) had </span><span><span style="font-family:Verdana;">intraoperative transfusion. There was no in-hospital mortality. </span><b><span style="font-family:Verdana;">Conclusion:</span></b></span><span style="font-family:Verdana;"> The </span><span style="font-family:Verdana;">portion of patients with intraoperative and or postoperative complications </span><span style="font-family:Verdana;">was 24.1%, integrating goal-directed therapies in this surgical setting could improve postoperative outcomes.展开更多
Breast cancer is the most common malignancy in women worldwide.Triplenegative breast cancer(TNBC),refers breast cancer negative for estrogen receptor,progesterone receptor and human epidermal growth factor receptor 2,...Breast cancer is the most common malignancy in women worldwide.Triplenegative breast cancer(TNBC),refers breast cancer negative for estrogen receptor,progesterone receptor and human epidermal growth factor receptor 2,characterized by high drug resistance,high metastasis and high recurrence,treatment of which is a difficult problem in the clinical treatment of breast cancer.In order to better treat TNBC clinically,it is a very urgent task to explore the mechanism of TNBC resistance in basic breast cancer research.Pregnane X receptor(PXR)is a nuclear receptor whose main biological function is to participate in the metabolism,transport and clearance of allobiological agents in PXR.PXR plays an important role in drug metabolism and clearance,and PXR is highly expressed in tumor tissues of TNBC patients,which is related to the prognosis of breast cancer patients.This reviews synthesized the important role of PXR in the process of high drug resistance to TNBC chemotherapeutic drugs and related research progress.展开更多
BACKGROUND Neonatal distal humeral physeal fractures are rare and difficult to diagnose.Thus,missed diagnoses and delayed healing are possible.Few studies have reported surgical treatment,because a callus may develop ...BACKGROUND Neonatal distal humeral physeal fractures are rare and difficult to diagnose.Thus,missed diagnoses and delayed healing are possible.Few studies have reported surgical treatment,because a callus may develop at the fracture site 5 d after the fracture,resulting in difficult reduction,and reduction of the limb may cause further physeal injury.Other surgical challenges include the provision of adequate anesthesia and complexity of the operation.However,without appropriate reduction and fixation,a varus elbow deformity may develop.Manual reduction and percutaneous pin fixation are ideal treatment options.CASE SUMMARY A 4-day-old neonate with left elbow pain accompanied by limited movement for 4 d was admitted,and diagnosed with delayed physeal fracture of the distal humerus based on physical examination,ultrasonography,and magnetic resonance imaging.The patient was treated by manual reduction combined with percutaneous pin fixation under arthrography.Postoperatively,the reduction was successful.The upper limbs could have been lifted and the fingers could have been moved freely on the second day after the operation.CONCLUSION The techniques of manual reduction and percutaneous pin fixation,to treat neonatal distal humeral physeal fractures,are safe and reliable.展开更多
BACKGROUND Heterotopic ossification(HO)refers to the formation of new bone in non-skeletal tissues such as muscles,tendons or other soft tissues.Severe muscle and soft tissue injury often lead to the formation of HO.H...BACKGROUND Heterotopic ossification(HO)refers to the formation of new bone in non-skeletal tissues such as muscles,tendons or other soft tissues.Severe muscle and soft tissue injury often lead to the formation of HO.However,anterior HO of the ankle is rarely reported.CASE SUMMARY We report a patient with massive HO in front of the ankle joint for 23 years.In 1998,the patient was injured by a falling object on the right lower extremity,which gradually formed a massive heterotopic bone change in the right calf and dorsum of the foot.The patient did not develop gradual ankle function limitations until nearly 36 mo ago,and underwent resection of HO.Even after 23 years and resection of HO,the ankle joint was still able to move.CONCLUSION It is recommended that the orthopedist should be aware of HO and distinguish it from bone tumor.展开更多
Developing novel cancer therapies that exploit programmed cell death pathways holds promise for advancing cancer treatment.According to a recently published study in Science,copper death(cuproptosis)occurs when intrac...Developing novel cancer therapies that exploit programmed cell death pathways holds promise for advancing cancer treatment.According to a recently published study in Science,copper death(cuproptosis)occurs when intracellular copper is overloaded,triggering aggregation of lipidated mitochondrial proteins and Fe–S cluster proteins.This intriguing phenomenon is triggered by the instability of copper ions.Understanding the molecular mechanisms behind cuproptosis and its associated genes,as identified by Tsvetkov,including ferredoxin 1,lipoic acid synthase,lipoyltransferase 1,dihydrolipid amide dehydrogenase,dihydrolipoamide transacetylase,pyruvate dehydrogenaseα1,pyruvate dehydrogenaseβ,metallothionein,glutaminase,and cyclin-dependent kinase inhibitor 2A,may open new avenues for cancer therapy.Here,we provide a new understanding of the role of copper death and related genes in cancer.展开更多
Objective To investigate the pathological mechanism of hip dysplasia. Methods The leftknee joints of eighteen rabbits were fixed in extending position with plaster cylinder for four weeks, but their hip joints were fl...Objective To investigate the pathological mechanism of hip dysplasia. Methods The leftknee joints of eighteen rabbits were fixed in extending position with plaster cylinder for four weeks, but their hip joints were flexed. The right side served as control. Roentgenogram was made in all animals. The changes of the x-ray films and the pathological findings between left and right hips were compared. Results Appearance of hip dysplasia was obvious at four weeks after plaster fixation. There were pathological changes, including shallow ace-tabulum and flat femoral head, increased acetabular index and decreased acetabular head index on the x-ray films. Conclusion The hip dysplasia is the result of prolonged extending position of the knee joint. Abnormal knee posture seems to be one of the important factors of hip dysplasia. This kind of deformation may be worsened with time.展开更多
基金Supported by the National Natural Science Foundation of China,No.82072537the General Project of Hunan Natural Science Foundation,No.2022JJ30412 and No.2021JJ30464.
文摘Exosomes(Exos)are extracellular vesicles secreted by cells and serve as crucial mediators of intercellular communication.They play a pivotal role in the pathogenesis and progression of various diseases and offer promising avenues for therapeutic interventions.Exos derived from mesenchymal stem cells(MSCs)have significant immunomodulatory properties.They effectively regulate immune responses by modulating both innate and adaptive immunity.These Exos can inhibit excessive inflammatory responses and promote tissue repair.Moreover,they participate in antigen presentation,which is essential for activating immune responses.The cargo of these Exos,including ligands,proteins,and microRNAs,can suppress T cell activity or enhance the population of immunosuppressive cells to dampen the immune response.By inhibiting lymphocyte proliferation,acting on macrophages,and increasing the population of regulatory T cells,these Exos contribute to maintaining immune and metabolic homeostasis.Furthermore,they can activate immune-related signaling pathways or serve as vehicles to deliver microRNAs and other bioactive substances to target tumor cells,which holds potential for immunotherapy applications.Given the immense therapeutic potential of MSC-derived Exos,this review comprehensively explores their mechanisms of immune regulation and therapeutic applications in areas such as infection control,tumor suppression,and autoimmune disease management.This article aims to provide valuable insights into the mechanisms behind the actions of MSC-derived Exos,offering theoretical references for their future clinical utilization as cell-free drug preparations.
基金Supported by Science Project of Hunan Provincial Healthy Commission,No.20230844.
文摘Hepatocellular carcinoma(HCC)is the predominant form of primary liver cancer,accounting for 90%of all cases.Currently,early diagnosis of HCC can be achieved through serum alpha-fetoprotein detection,B-ultrasound,and computed tomography scanning;however,their specificity and sensitivity are suboptimal.Despite significant advancements in HCC biomarker detection,the prognosis for patients with HCC remains unfavorable due to tumor heterogeneity and limited understanding of its pathogenesis.Therefore,it is crucial to explore more sensitive HCC biomarkers for improved diagnosis,monitoring,and management of the disease.Long non-coding RNA(lncRNA)serves as an auxiliary carrier of genetic information and also plays diverse intricate regulatory roles that greatly contribute to genome complexity.Moreover,investigating gene expression regulation networks from the perspective of lncRNA may provide insights into the diagnosis and prognosis of HCC.We searched the PubMed database for literature,comprehensively classified regulated cell death mechanisms and systematically reviewed research progress on lncRNA-mediated cell death pathways in HCC cells.Furthermore,we prospectively summarize its potential implications in diagnosing and treating HCC.
文摘Children presenting with partial physeal arrest and significant remaining growth may benefit from physeal bar resection,although the operation is a technique demanding procedure.This study evaluates the treatment of post-traumatic pediatric ankle varus deformity using physeal bar resection and hemi-epiphysiodesis with the assistance of two operative methods.Forty-five patients presenting with a distal tibial medial physeal bridge as well as ankle varus deformity following traumatic ankle physeal injury between 2009 and 2017 were followed.These patients were treated w让h physeal bar resection and hemi-epiphysiodesis,with the assistance of either fluoroscopy (10 cases) or intraoperative three-dimensional navigation (35 cases).Of the 45 cases,the median age was 9.0 years (range:3-14 years) with 28 male and 17 female patients.The median of pre-operation ankle varus angle was 20 degrees (IQR 15-25) and 5 degrees (IQR 0-20) at the time of final follow up,representing a statistically significant difference (P<0.05).No differences were observed with regards to age,gender,and surgical history between effective group and ineffective group (P>0.05).The median of pre-operative ankle varus angles of the navigation and fluoroscopy groups were both 20 degrees (P>0.05).The median correction angle of the navigation and fluoroscopy groups was 10 and 15 degrees,respectively (P>0.05).Our results indicate that physeal bar resection and hemiepiphysiodesis are effective treatments for correcting ankle varus deformity due to traumatic medial physeal arrest of the distal tibia.We observe no difference in outcome between fluoroscopy group and three-dimensional navigation group during the procedures.
基金Supported by the Science Project of Hunan Provincial Healthy Commission,No.20230844.
文摘Combined femoral and acetabular anteversion is the sum of femoral and acetabular anteversion,representing their morphological relationship in the axial plane.Along with the increasing understanding of hip dysplasia in recent years,numerous scholars have confirmed the role of combined femoral and acetabular anteversion in the pathological changes of hip dysplasia.At present,the reconstructive surgery for hip dysplasia includes total hip replacement and redirectional hip preservation surgery.As an important surgery index,combined femoral and acetabular anteversion have a crucial role in these surgeries.Herein,we discuss the role of combined femoral and acetabular anteversion in pathological changes of hip dysplasia,total hip replacement,and redirectional hip preservation surgery.
基金Supported by Science Foundation of Hunan Education Department,No.21B0075.
文摘In children with asymmetric growth on the medial and lateral side of limbs,if there still remains growth potential,the guided growth technique of hemiepiphysiodesis on one side of the epiphysis is recognized as a safe and effective method.However,when the hemi-epiphysiodesis start to correct the deformities,how many degrees could hemi-epiphysiodesis bring every month and when to remove the hemi-epiphysiodesis implant without rebound phenomenon are still on debate.This article reviews the current studies focus on the effective time,correction speed and termination time of hemi-epiphysiodesis.
文摘Rhabdoid tumors (RTs) are a well-defined entity in the kidney or central nervous system of infants or children. However, soft-tissue involvement is uncommon. It’s an exceptional neonatal tumor of soft tissue. The imaging characteristics of this tumor are not specific. Biopsy allows diagnosis;the histomorphological characteristics of rhabdoid tumors, their immunoreactivity to epithelial markers and vimentin, and the INI-1 loss are important tools for diagnosis. RT tumors are aggressive and have a rapidly fatal clinical course in most cases. Despite multidisciplinary therapy, the survival rate is very low. We report a rare case occurring in a male neonate who presents at birth with a voluminous right axillary mass. A CT scan showed a well-limited tumor mass with lobulated contours. An ultrasound-guided biopsy was performed on day 8, showing the morphology and immunoprofile of RT. The mass showed rapid growth. The child was admitted for respiratory distress at 3 weeks. A thoraco-abdominal CT showed an increase in the size of the mass with the appearance of multiple lymph nodes and pleural, hepatic, and renal metastases. The child died two days later.
文摘OBJECTIVE: To clarify the role of midkine (MK) in vulvar carcinogenesis though examination of its expression in vulvar lesions including vulvar condyloma acuminata (VCA), vulvar intraepithelial neoplasia (VIN) and vulvar squamous cell carcinomas (VSCC), and to analyze the relationship between MK expression and human papilloma virus (HPV) infection. METHODS: Thirty VSCC, 15 VIN and 10 VCA patients were studied by streptavidin-biotin-immunoperoxidase method. MK expression was compared with clinicopathologic features of vulvar tumors. RESULTS: MK was expressed in 26 of 30 VSCC (87%), 3 of 5 VIN III and all VCA samples, whereas no MK expression was detected in the VIN I-II samples or in normal epithelium. The difference of MK expression between VIN III and VSCC was statistically significant (P
基金Supported by Natural Science Foundation of Hunan Province,China,No.2019JJ50324.
文摘BACKGROUND Rosai-Dorfman disease(RDD),or sinus histiocytosis with massive lymphadenopathy,is a benign histiocytic disorder.Extranodal involvement is common,occurring in>40%of patients,but bone involvement occurs in<10%of cases.In addition,primary bone RDD is extremely rare.The majority of patients are adolescents and young adults,and the mean age at onset is 20-years-old.CASE SUMMARY We report an 8-year-old Chinese girl who presented to our hospital with an insidious onset of swelling and pain in the middle shaft of her right tibia for 4 mo.We performed total surgical resection of the right tibia lesion and allograft transplantation.A good prognosis was confirmed at the 6 mo follow-up.Pain and swelling symptoms were totally relieved,range of motion of her right knee and ankle returned to normal,and there was no clinical evidence of lesion recurrence at last follow up.Our case is the second reported case of osseous RDD without lymphadenopathy in the shaft of the tibia of a child.CONCLUSION Extranodal RDD is a rare disease and can be misdiagnosed easily.Lesion resection and allograft transplantation are an option to treat extranodal RDD in children with good short term result.Pediatric orthopedist should be aware of this rare disease,especially extranodal involvement.
基金Supported by Natural Science Foundation of Hunan Province,No.2019JJ50324.
文摘BACKGROUND Synovial chondromatosis(SC)is a rare benign lesion first reported by Ambrose Pare in 1558.It is most common in the knee joint,followed by the hip joint and elbow joint.It is characterized by the presence of multiple pearl-like osteochondral bodies in the joint.The incidence in children is extremely low.CASE SUMMARY We report a 6-year-old Chinese boy who presented to our hospital with left hip joint pain and claudication for more than one year.We performed total surgical resection of SC tissue in the left hip.A good prognosis was confirmed at the 6-wk follow-up.Pain and swelling symptoms were totally relieved,range of motion of his left hip returned to normal,and there was no clinical evidence of lesion recurrence at last follow-up.Our case is the youngest reported patient with SC occurring in the hip.CONCLUSION SC is a rare disease and can be easily misdiagnosed.When we encounter children with hip pain and claudication,increased vigilance and a comprehensive physical examination and imaging examination should be considered,in order to avoid misdiagnosis and delayed treatment in patients.
文摘AIM: To confirm the rarity of this disorder and then to evaluate the effects of antibiotic treatment alone and assess whether this could produce a complete remission of symptoms in children and adolescents.METHODS: We made a retrospective review of all cases of condensing osteitis of the clavicle in children and adolescents between January 2007 and January 2016. Outpatient and inpatient medical records, with radiographs, magnetic resonance imaging, triphasic bone scan and computed tomography scans were retrospectively reviewed. All the patients underwent biopsy of the affected clavicle and were treated with intra venous(IV) antibiotics followed by oral antibiotics.RESULTS: Seven cases of condensing osteitis of the clavicle were identified. All the patients presented with swelling of the medial end of the clavicle, and 5 out of 7 reported persisting pain. The patients' mean age at presentation was 11.5 years(range 10.5-13). Biopsy confirmed the diagnosis in all cases. All the patients completed the treatment with IV and oral antibiotics. At last follow-up visit none of the patients complained of residual pain; all had a clinically evident reduction in the swelling of the medial end of the affected clavicle. The mean follow-up was 4 years(range 2-7).CONCLUSION: Our findings show that condensing osteitis of the clavicle is a rare condition. Biopsy is needed to confirm diagnosis. The condition should be managed with IV and oral antibiotics. Aggressive surgery should be avoided.
基金Supported by Scientific Research Project of Hunan Education Department,No.21B0031 and No.21B0042
文摘BACKGROUND The effectiveness of Platelet-Rich Plasma(PRP)in the treatment of patients with Achilles tendon rupture(ATR)and Achilles tendinopathy(AT)has been controversial.AIM To assess PRP injections’effectiveness in treating ATR and AT.METHODS A comprehensive review of relevant literature was conducted utilizing multiple databases such as Cochrane Library,PubMed,Web of Science,Chinese Science and Technology Journal,EMBASE,and China Biomedical CD-ROM.The present investigation integrated randomized controlled trials that assessed the effectiveness of platelet-rich plasma injections in managing individuals with Achilles tendon rupture and tendinopathy.The eligibility criteria for the trials encompassed publications that were published within the timeframe of January 1,1966 to December 2022.The statistical analysis was performed utilizing the Review Manager 5.4.1,the visual analogue scale(VAS),Victorian Institute Ankle Function Scale(VISA-A),and Achilles Tendon Thickness were used to assess outcomes.RESULTS This meta-analysis included 13 randomized controlled trials,8 of which were randomized controlled trials of PRP for AT and 5 of which were randomized controlled trials of PRP for ATR.PRP for AT at 6 wk[weighted mean difference(WMD)=1.92,95%CI:-0.54 to 4.38,I2=34%],at 3 mo[WMD=0.20,95%CI:-2.65 to 3.05,I2=60%],and 6 mo[WMD=2.75,95%CI:-2.76 to 8.26,I2=87%)after which there was no significant difference in VISA-A scores between the PRP and control groups.There was no significant difference in VAS scores between the PRP group and the control group after 6 wk[WMD=6.75,95%CI:-6.12 to 19.62,I2=69%]and 6 mo[WMD=10.46,95%CI:-2.44 to 23.37,I2=69%]of treatment,and at mid-treatment at 3 mo[WMD=11.30,95%CI:7.33 to 15.27,I2=0%]after mid-treatment,the PRP group demonstrated better outcomes than the control group.Post-treatment patient satisfaction[WMD=1.07,95%CI:0.84 to 1.35,I2=0%],Achilles tendon thickness[WMD=0.34,95%CI:-0.04 to 0.71,I2=61%]and return to sport[WMD=1.11,95%CI:0.87 to 1.42,I2=0%]were not significantly different between the PRP and control groups.The study did not find any statistically significant distinction between the groups that received PRP treatment and those that did not,regarding the Victorian Institute of Sport Assessment-Achilles scores at 3 mo[WMD=-1.49,95%CI:-5.24 to 2.25,I2=0%],6 mo[WMD=-0.24,95%CI:-3.80 to 3.32,I2=0%],and 12 mo[WMD=-2.02,95%CI:-5.34 to 1.29,I2=87%]for ATR patients.Additionally,no significant difference was observed between the PRP and the control groups in improving Heel lift height respectively at 6 mo[WMD=-3.96,95%CI:-8.61 to 0.69,I2=0%]and 12 mo[WMD=-1.66,95%CI:-11.15 to 7.83,I2=0%]for ATR patients.There was no significant difference in calf circumference between the PRP group and the control group after 6 mo[WMD=1.01,95%CI:-0.78 to 2.80,I2=54%]and 12 mo[WMD=-0.55,95%CI:-2.2 to 1.09,I2=0%]of treatment.There was no significant difference in ankle mobility between the PRP and control groups at 6 mo of treatment[WMD=-0.38,95%CI:-2.34 to 1.58,I2=82%]and after 12 mo of treatment[WMD=-0.98,95%CI:-1.41 to-0.56,I2=10%]there was a significant improvement in ankle mobility between the PRP and control groups.There was no significant difference in the rate of return to exercise after treatment[WMD=1.20,95%CI:0.77 to 1.87,I2=0%]and the rate of adverse events[WMD=0.85,95%CI:0.50 to 1.45,I2=0%]between the PRP group and the control group.CONCLUSION The use of PRP for AT improved the patient’s immediate VAS scores but not VISA-A scores,changes in Achilles tendon thickness,patient satisfaction,or return to sport.Treatment of ATR with PRP injections alone improved long-term ankle mobility but had no significant effect on VISA-A scores,single heel lift height,calf circumference or return to sport.Additional research employing more extensive sampling sizes,more strict experimental methods,and standard methodologies may be necessary to yield more dependable and precise findings.
基金supported by the National Natural Science Foundation of China,No.82171650(to CBZ)Guangdong Province Key Research and Development Project,No.2020B1111150003(to DPQ)Guangdong Basic and Applied Basic Research Foundation,No.2020A1515011143(to CBZ)。
文摘Traumatic painful neuroma is an intractable clinical disease characterized by improper extracellular matrix(ECM)deposition around the injury site.Studies have shown that the microstructure of natural nerves provides a suitable microenvironment for the nerve end to avoid abnormal hyperplasia and neuroma formation.In this study,we used a decellularized nerve matrix scaffold(DNM-S)to prevent against the formation of painful neuroma after sciatic nerve transection in rats.Our results showed that the DNM-S effectively reduced abnormal deposition of ECM,guided the regeneration and orderly arrangement of axon,and decreased the density of regenerated axons.The epineurium-perilemma barrier prevented the invasion of vascular muscular scar tissue,greatly reduced the invasion ofα-smooth muscle actin-positive myofibroblasts into nerve stumps,effectively inhibited scar formation,which guided nerve stumps to gradually transform into a benign tissue and reduced pain and autotomy behaviors in animals.These findings suggest that DNM-S-optimized neuroma microenvironment by ECM remodeling may be a promising strategy to prevent painful traumatic neuromas.
基金Supported by Scientific Research Project of Hunan Education Department,No.21A0054.
文摘Developmental dysplasia of hip seriously affects the health of children,and pelvic osteotomy is an important part of surgical treatment.Improving the shape of the acetabulum,preventing or delaying the progression of osteoarthritis is the ultimate goal of pelvic osteotomies.Re-directional osteotomies,reshaping osteotomies and salvage osteotomies are the three most common types of pelvic osteotomy.The influence of different pelvic osteotomy on acetabular morphology is different,and the acetabular morphology after osteotomy is closely related to the prognosis of the patients.But there lacks comparison of acetabular morphology between different pelvic osteotomies,on the basis of retrospective analysis and measurable imaging indicators,this study predicted the acetabular shape after developmental dysplasia of the hip pelvic osteotomy in order to help clinicians make reasonable and correct decisions and improve the planning and performance of pelvic osteotomy.
基金Supported by the Science project of Hunan Provincial Health Commission,No.202204073347.
文摘Chronic osteomyelitis is a painful and serious disease caused by infected surgical prostheses or infected fractures.Traditional treatment includes surgical debridement followed by prolonged systemic antibiotics.However,excessive antibiotic use has been inducing rapid emergence of antibiotic-resistant bacteria worldwide.Additionally,it is difficult for antibiotics to penetrate internal sites of infection such as bone,thus limiting their efficacy.New approaches to treat chronic osteomyelitis remain a major challenge for orthopedic surgeons.Luckily,the development of nanotechnology has brought new antimicrobial options with high specificity to infection sites,offering a possible way to address these challenges.Substantial progress has been made in constructing antibacterial nanomaterials for treatment of chronic osteomyelitis.Here,we review some current strategies for treatment of chronic osteomyelitis and their underlying mechanisms.
文摘<b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Scoliosis is among interventions with high postoperative com</span><span><span style="font-family:Verdana;">plication rates due to the characteristics of the surgery, where blood los</span><span style="font-family:Verdana;"></span><span style="font-family:Verdana;">s,</span></span><span style="font-family:Verdana;"> transfusion and fluid requirements can be increased. A monocentric retrospective observational study was undertaken earlier to determine predictors of intraoperative and postoperative outcomes in surgical patients. In this initial cohort, there were patients who underwent scoliosis surgery, and a secondary </span><span style="font-family:Verdana;">analysis to describe outcomes in these patients was realized and presented</span> <span><span style="font-family:Verdana;">here. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To describe intraoperative and postoperative outcomes in</span></span><span style="font-family:Verdana;"> patients under 18 years old in scoliosis surgery included in the initial study and </span><span style="font-family:Verdana;">to propose improvement </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">and </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">implementation measures. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A sec</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ondary analysis of patients undergoing scoliosis surgery </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">from</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> 1 January 2014 to </span><span style="font-family:Verdana;">17 May 2017 was undertaken in our institution—Necker Enfants Malades</span> <span style="font-family:Verdana;">uni</span><span style="font-family:Verdana;">ver</span><span><span style="font-family:Verdana;">sity hospital. The study was approved by the Ethics Committee. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> There </span></span><span style="font-family:Verdana;">were 116 patients with a mean age of 147.5 ± 40.2 months. Twenty-eight pa</span><span style="font-family:Verdana;">tients </span><span style="font-family:Verdana;">(24.1%) presented intraoperative and/or postoperative complications. The most</span> <span style="font-family:Verdana;">common intraoperative complication was hemorrhagic shock in 3 patients </span><span style="font-family:Verdana;">(2.6%). The most common postoperative organ failure was neuro</span><span style="font-family:Verdana;">logic in seven patients (6%), respiratory in 3 patients (2.6%), car</span><span style="font-family:Verdana;">dio-circulatory in 2 patients (1.7%) and renal failure in </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">1</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patient (0.9%). The most common postoperative infection was surgical wound sepsis in 8 patients (6.9%), urinary sepsis in </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">3</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patients (2.6%), and abdominal sepsis and septicemia in </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">2</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> patients (1.7%). </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">12</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> patients (10.3%) had reoperations. Fif</span><span style="font-family:Verdana;">ty-six patients (48.3%) had </span><span><span style="font-family:Verdana;">intraoperative transfusion. There was no in-hospital mortality. </span><b><span style="font-family:Verdana;">Conclusion:</span></b></span><span style="font-family:Verdana;"> The </span><span style="font-family:Verdana;">portion of patients with intraoperative and or postoperative complications </span><span style="font-family:Verdana;">was 24.1%, integrating goal-directed therapies in this surgical setting could improve postoperative outcomes.
基金Supported by Science project of Hunan Provincial Health Commission,No.B202304089304.
文摘Breast cancer is the most common malignancy in women worldwide.Triplenegative breast cancer(TNBC),refers breast cancer negative for estrogen receptor,progesterone receptor and human epidermal growth factor receptor 2,characterized by high drug resistance,high metastasis and high recurrence,treatment of which is a difficult problem in the clinical treatment of breast cancer.In order to better treat TNBC clinically,it is a very urgent task to explore the mechanism of TNBC resistance in basic breast cancer research.Pregnane X receptor(PXR)is a nuclear receptor whose main biological function is to participate in the metabolism,transport and clearance of allobiological agents in PXR.PXR plays an important role in drug metabolism and clearance,and PXR is highly expressed in tumor tissues of TNBC patients,which is related to the prognosis of breast cancer patients.This reviews synthesized the important role of PXR in the process of high drug resistance to TNBC chemotherapeutic drugs and related research progress.
文摘BACKGROUND Neonatal distal humeral physeal fractures are rare and difficult to diagnose.Thus,missed diagnoses and delayed healing are possible.Few studies have reported surgical treatment,because a callus may develop at the fracture site 5 d after the fracture,resulting in difficult reduction,and reduction of the limb may cause further physeal injury.Other surgical challenges include the provision of adequate anesthesia and complexity of the operation.However,without appropriate reduction and fixation,a varus elbow deformity may develop.Manual reduction and percutaneous pin fixation are ideal treatment options.CASE SUMMARY A 4-day-old neonate with left elbow pain accompanied by limited movement for 4 d was admitted,and diagnosed with delayed physeal fracture of the distal humerus based on physical examination,ultrasonography,and magnetic resonance imaging.The patient was treated by manual reduction combined with percutaneous pin fixation under arthrography.Postoperatively,the reduction was successful.The upper limbs could have been lifted and the fingers could have been moved freely on the second day after the operation.CONCLUSION The techniques of manual reduction and percutaneous pin fixation,to treat neonatal distal humeral physeal fractures,are safe and reliable.
基金Supported by Scientific research project of Hunan Education Department,No.21B0075Science project of Hunan Provincial Health Commission,No.B2015-82。
文摘BACKGROUND Heterotopic ossification(HO)refers to the formation of new bone in non-skeletal tissues such as muscles,tendons or other soft tissues.Severe muscle and soft tissue injury often lead to the formation of HO.However,anterior HO of the ankle is rarely reported.CASE SUMMARY We report a patient with massive HO in front of the ankle joint for 23 years.In 1998,the patient was injured by a falling object on the right lower extremity,which gradually formed a massive heterotopic bone change in the right calf and dorsum of the foot.The patient did not develop gradual ankle function limitations until nearly 36 mo ago,and underwent resection of HO.Even after 23 years and resection of HO,the ankle joint was still able to move.CONCLUSION It is recommended that the orthopedist should be aware of HO and distinguish it from bone tumor.
基金Supported by Scientific Research Project of Hunan Education Department,No.21A0054.
文摘Developing novel cancer therapies that exploit programmed cell death pathways holds promise for advancing cancer treatment.According to a recently published study in Science,copper death(cuproptosis)occurs when intracellular copper is overloaded,triggering aggregation of lipidated mitochondrial proteins and Fe–S cluster proteins.This intriguing phenomenon is triggered by the instability of copper ions.Understanding the molecular mechanisms behind cuproptosis and its associated genes,as identified by Tsvetkov,including ferredoxin 1,lipoic acid synthase,lipoyltransferase 1,dihydrolipid amide dehydrogenase,dihydrolipoamide transacetylase,pyruvate dehydrogenaseα1,pyruvate dehydrogenaseβ,metallothionein,glutaminase,and cyclin-dependent kinase inhibitor 2A,may open new avenues for cancer therapy.Here,we provide a new understanding of the role of copper death and related genes in cancer.
文摘Objective To investigate the pathological mechanism of hip dysplasia. Methods The leftknee joints of eighteen rabbits were fixed in extending position with plaster cylinder for four weeks, but their hip joints were flexed. The right side served as control. Roentgenogram was made in all animals. The changes of the x-ray films and the pathological findings between left and right hips were compared. Results Appearance of hip dysplasia was obvious at four weeks after plaster fixation. There were pathological changes, including shallow ace-tabulum and flat femoral head, increased acetabular index and decreased acetabular head index on the x-ray films. Conclusion The hip dysplasia is the result of prolonged extending position of the knee joint. Abnormal knee posture seems to be one of the important factors of hip dysplasia. This kind of deformation may be worsened with time.
