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BACKGROUND: After the treatment of femoral shaft fracture with the intramedullary nail, the third fracture open reduction indications are controversial. Some scholars believe that limited open reduction can achieve anatomical reduction, conducive to fracture healing; but some scholars believe that no open reduction of the third fracture still has a high fracture healing rate. OBJECTIVE: To investigate the effect of the circumference and displacement of the third fragment on fracture healing after intramedullary nailing of femoral shaft fractures with the third fragment. METHODS: A retrospective cohort study was conducted to analyze the clinical data of 142 patients suffered a femoral shaft fracture with a third fragment admitted to the Affiliated Lianyungang Hospital of Xuzhou Medical University from February 2016 to December 2021. The fracture were classified into three types according to the circumference of the third fracture with reference to the diaphyseal circumference at the fracture site: type 1 in 71 cases, type 2 in 52 cases, and type 3 in 19 cases. Referring to the diaphyseal diameter, the fractures were classified into three degrees according to the degree of the third fragment displacement: degree I in 95 cases, degree II in 31 cases, and degree III in 16 cases. All patients were treated with femoral interlocking intramedullary nails, and no intervention was performed for the displaced third fragment during the operation. Postoperative follow-up was performed to compare the fracture healing rate, healing time, and the modified Radiographic Union Scale for Tibia at month 9 after surgery in each group. The effect of third fracture fragment circumference and degree of displacement on fracture healing was assessed. RESULTS AND CONCLUSION: (1) All 142 patients were followed up for at least 12 months, with a mean of (14.7±4.1) months, and the overall healing rate was 73.4%. (2) When the third fragment was displaced by degree I, the healing rate, healing time, and modified Radiographic Union Scale for Tibia score at month 9 were not statistically significant among the three sub-groups of circumference classification. (3) When the third fragments were displaced by degree II or III, the healing rate and healing time were not statistically significant among the three subgroups of circumference classification; the modified Radiographic Union Scale for Tibia score at month 9 in the type 1 group was higher than that in the type 2 and 3 groups (P = 0.017). (4) Logistic regression analysis showed that a greater third fragment displacement and circumference were associated with lower fracture healing rates (P < 0.05). (5) These findings indicate that in the treatment of femoral shaft fractures with third fragment by intramedullary nails, when the fracture fragment is displaced to degree I, the circumference size has little effect on fracture healing, and no intervention is required during surgery. When the third fragment is displaced to degree II or III and the circumference of which is type 1, a higher modified Radiographic Union Scale for Tibia score can still be obtained with no intervention of the third fragment. However, when the circumference is of type 2 or type 3, it significantly affects the fracture healing. Consequently, intraoperative intervention to reduce the distance of displacement of the fragment is required to lower the incidence of nonunion. The displacement of the third fracture fragments has a greater impact on fracture healing than their circumference. [ABSTRACT FROM AUTHOR]

In order to explore the content and spatial distribution of soil organic matter to implement zonal fertilization, the study took the strawberry industry in Changfeng County, Hefei City, Anhui Province, as an example, used the organic matter data from 1 986 soil sampling sites that collected by the soil testing formula project of Changfeng County and chose three prediction models of Ordinary Kriging(OK), Random Forest(RF)and Random Forest with Residual Kriging(RFRK)with six environmental covariates of terrain and vegetation related to soil formation as auxiliary information to predict the spatial distribution of soil organic matter in the study area, drew the spatial distribution map, divided the fertilization zones according to the content of organic matter and proposed different fertilization schemes for strawberry in each area. The results showed that the overall distribution trend of soil organic matter predicted by the three models was the same, with the characteristics of high distribution in the north and low distribution in the south, and the overall content of organic matter ranged from 8-30 g·kg-1 . According to the abundance and deficiency of soil organic matter, the areas with organic matter content in the range of 15-25 g·kg-1 were medium fertilizer areas and recommended to apply 45.0-52.5 t·hm-2 of farm manure. The areas with organic matter content higher than 25 g·kg-1 were low fertilizer areas, applying 37.5-45.0 t·hm-2 of farm manure. The areas with organic matter content lower than 15 g·kg-1 were high fertilization areas, applying 52.5-60.0 t·hm-2 of farm manure. Therefore, according to the predicted spatial distribution of soil organic matter, it provided the basis for strawberry fertilization zoning, made fertilization schemes, and provided guidance and reference for strawberry planting in different areas. [ABSTRACT FROM AUTHOR]

Objective To observe the effects of the insertion depth of the normal plug of modified suture-occluded method on the stability and safety of cerebral ischemia models in mice. Methods Forty SPF C57/BL6n mice were randomly divided into the groups A, B, C and D, with 10 mice in each group. In the groups B, C and D, the cerebral ischemia model was prepared by the modified suture-occluded method. The distance between the head end of each thread plug and the bifurcation of the common carotid artery was 9, 10, and 11 mm, respectively. Group A was the sham operation group. The separation procedure was the same as that of the groups B, C, and D. After the common carotid artery and the external carotid artery were separated, the surgical thread was ligated without inserting the thread plug. Hie survival and model formation of each group were counted. After the mice were fully awake (after operation) , Longa's nerve function score was used to evaluate their nerve function. After 24 h of model formation, mice in each group received magnetic resonance scanning, and the volume percentage of cerebral infarction was calculated. Results No death occurred in the group A at 24 h before magnetic resonance scanning. In the group B, 9 survived, 1 died of cerebral hernia, and 6 were successfully modeled. In the group C, 8 survived, 1 died of severe cerebral edema, 1 died of unknown cause, and 7 were successfully modeled. In the group D, 5 survived, 3 died of cerebral hemorrhage, 2 died of severe cerebral edema, and 4 were successfully modeled. No significant difference was found in the Longa's neurological function score after operation between the groups A, C and D (all P>0.05) , while that in the group B was higher than that in the group A, hut was lower than those in the groups C and D (both P >0.05 ). Before magnetic resonance scanning, no significant difference was found in the Longas neurological function score between the group C and group A (P>0.05), while the neurological function scores in the groups B and D were higher than that in group A, hut was lower than that in the group C (both P>0.05). The volume percentage of cerebral infarction in the groups C and D were larger than that in the group B (P<0.05). The infarction volume percentage in the group C was equivalent to that in the group D (P>0.05). Conclusion When the insertion depth of the thread plug in the mouse cerebral ischemia models is 10 mm, the safety and the molding rate are relatively high. [ABSTRACT FROM AUTHOR]

Objective To investigate the value of diffusion kurtosis imaging (DKI) and stretched exponential model (SEM) of magnetic resonance imaging (MRI) in the evaluation of tumor heterogeneity in an orthotopic hepatocellular carcinoma (HCC) xenograft model. Methods Twenty-five orthotopic HCC xenograft nude mouse models were established and randomly divided into five groups as group A, B, C, D and E, each group had 5 samples. Every mouse in each group underwent MRI with DKI and SEM on a 1. 5T MR scanner at 21, 28, 35, 42 and 49 days after tumor implantation. DKI and SEM parameter values including mean kurtosis (MK), mean diffusivity (MD), diffusion heterogeneity index α and distributed diffusion coefficient (DDC) at the HCC greatest dimension slice were measured, calculated and compared among different groups by using Kruskal-Wallis H test and Mann-Whitney U test. Spearman rank correlation was used to analyze correlations between DKI, SEM parameters and histopathological results including necrotic fraction (NF), micro-vessel density (MVD), Ki-67 index, standard deviation (SD) and kurtosis from HE staining and the tumor size. Results MK, MD, α and DDC values in the different groups were all statistically different (P<0.05). MK value in group D was significantly higher than group A, B and E (P<0.05), whereas α value was significantly lower than group A, B and E (P<0.05). MD and DDC values were significantly higher in group D compared with group B (P<0.05), and in group E compared with group B and C (P<0.05). Significantly good and positive correlations were found between MK and SD, kurtosis values (r=0.603 and 0.604, P<0.05) in all HCC models. Significantly good and negative correlations were found between α and SD, kurtosis values (r=-0.627 and -0.620, P<0.05) in all HCC models. From the 21st to 42nd day, moderate and positive correlations were observed between MK and NF (r=0.587, P=0.006), MVD (r=0.490, P=0.028), Ki-67 index (r=0.569, P=0.009) and tumor size (r=0.503, P=0.024), and moderate and negative correlations were observed between α and NF (r=-0.577, P=0.008), MVD (r=-0.490, P=0.028), Ki-67 index (r=-0.574, P=0.008) and tumor size (r=-0.488, P=0.029). From the 28th to 49th day, MD and DDC values were significantly positively correlated with NF (r=0.706 and 0.664, P<0.05), and moderately positively correlated with tumor size (r=0.492 and 0.525, P<0.05). Conclusions DKI and SEM parameters may be used as non-invasive imaging biomarkers for evaluating spatial and temporal heterogeneity in HCC. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and the treatment effect of iodine 131 (131Ⅰ) thyroidectomy after operation for differentiated thyroid cancer (DTC) and the predictive value of the effect of 131I thyroidectomy after DTC operation. Methods: 150 DTC patients who underwent thyroidectomy and underwent 131Ⅰ thyroidectomy after operation in Xuzhou Hospital Affiliated to Jiangsu University from March 2019 to December 2021 were selected as the study subjects, and the patients were divided into successful thyroidectomy group (107 cases) and unsuccessful thyroidectomy group (43 cases) according to the effect of 131Ⅰ thyroidectomy, neutrophil count, platelet count, lymphocyte count were obtained by blood routine examination and NLR and PLR were calculated, and the NLR and PLR were compared between the two groups. The influencing factors of 131Ⅰ thyroidectomy efficacy was analyzed by single factor and multiple factor logistic regression model, and the predictive value of NLR and PLR on the efficacy of 131Ⅰ thyroidectomy was analyzed by receiver operating characteristic curve (ROC). Results: The NLR and PLR in the successful thyroidectomy group were lower than those in the unsuccessful thyroidectomy group (P＜0.05), single factor analysis showed that the levels of thyroid stimulating hormone (TSH) was higher than that in the unsuccessful thyroidectomy group, thyroglobulin (Tg) in the successful thyroidectomy group was lower than those in the unsuccessful thyroidectomy group, and the maximum diameter of the lesion in the successful thyroidectomy was smaller than that in the unsuccessful thyroidectomy group (P＜0.05) .Multivariate logistics regression analysis showed that, high NLR, PLR and Tg were independent risk factors for failure of 131Ⅰ thyroidectomy (P＜0.05) .The area under ROC curve (AUC) of NLR, PLR and combined detection predicting the efficacy of 131Ⅰ thyroidectomy was 0.760, 0.732, 0.829respectively, and the AUC of NLR and PLR combined detection was higher than that of the two alone. Conclusion: High NLR and PLR are independent risk factors for unsuccessful 131Ⅰ thyroidectomy after DTC operation, and early detection of NLR and PLR levels has good predictive value for the efficacy of 131Ⅰ thyroidectomy after DTC operation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Due to the inherent piezoelectric properties of bone and vascular tissues, piezoelectric materials have been developed and investigated in the field of vascularized bone tissue regeneration. Therefore, the effects of piezoelectric materials on cellular response and tissue regeneration in the electrical microenvironment of bone and vascular tissues were systematically investigated so as to overcome the limitations of insufficient neovascularization in tissueengineered bone grafts, widening piezoelectric materials for their clinical applications. OBJECTIVE: To review the application and progress of piezoelectric biomaterials in the field of vascularized bone regeneration. METHODS: The key words included “piezoelectric material, bone regeneration, vascularization, angiogenesis” in Chinese and English. The articles published from 2011 to 2021 were searched on PubMed, Web of Science and CNKI. RESULTS AND CONCLUSION: Piezoelectric biomaterials possessed excellent biocompatibility and superior piezoelectricity. The electrical signals generated from the piezoelectric effect not only stimulate bone and vascular tissues but also mediate tissue regeneration. Piezoelectric biomaterials can overcome the drawbacks of inert biomaterials without the bioactivity, exhibiting the promising prospects for application in vascularized bone regeneration. Nevertheless, the mechanisms for piezoelectric materials regulating tissue repair and regeneration remain unknown. There are few comprehensive studies targeting the overall regeneration of vascularized bone. The shortcomings of the performance of piezoelectric materials, such as non-degradation properties and insufficient mechanical properties, should be further improved. [ABSTRACT FROM AUTHOR]

Objective To observe the pharmacodynamic characteristics of Danggui Buxue decoction(containing Angelica sinensis) and its separated recipes in treating liver fibrosis and angiogenesis.Methods Forty- eight Wistar rats were randomly divided into 6 groups:normal group,model group,Danggui Buxue decoction group,Astragalus membranaceus group,Angelica sinensis group,and sorafenib control group.In all groups except normal group,a rat model of liver fibrosis was established using carbon tetrachloride combined with high- fat and low-protein diet.Liver tissue inflammation was observed by HE staining,while collagen deposition by Sirius red staining.Serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and albumin(Alb) and the malondialdehyde(MDA) content,superoxide dismutase(SOD) activity,nitric oxide(NO) content,and nitricoxide synthase(NOS) activity in liver tissue were determined by a test kit.The hydroxyproline(Hyp) content in liver tissue was determined by hydrochloric acid hydrolysis.Sinusoidal endothelial fenestrae were observed by scanning electron microscope,and liver capillaries by synchrotron radiation X- ray two- dimensional imaging.Comparisons between groups were made by one- way analysis of variance;the least significant difference test was used when variances were equal,and the Tamhane's T2 test was used when variances were unequal.Results The Danggui Buxue decoction group,Astragalus membranaceus group,and Angelica sinensis group had significantly increased serum Alb levels(P 0.05) and significantly decreased serum AST levels(P 0.05);the Danggui Buxue decoction group and Astragalus membranaceus group had significantly decreased serum ALT levels(P 0.05).All treatment groups had significantly decreased liver hydroxyproline content(P 0.05).In the liver tissues of all treatment groups,the vascular texture was reduced,and the number of sinusoidal endothelial fenestrae was increased.The Danggui Buxue decoction group,Astragalus membranaceus group,and Angelica sinensis group had significantly increased SOD activity(P 0.05) and significantly decreased NOS activity(P 0.05);the Astragalus membranaceus group had significantly decreased liver MDA content(P 0.05);the Danggui Buxue decoction group and Astragalus membranaceus group had significantly decreased liver NO content(P 0.05).Conclusion Danggui Buxue decoction and its separated recipes have good efficacy in treating liver fibrosis and angiogenesis.The mechanism may involve protecting liver sinusoidal endothelial cells and reducing lipid peroxidation.Astragalus membranaceus is superior to Angelica sinensis in reducing inflammation,lipid peroxidation,and NO release. [ABSTRACT FROM AUTHOR]

目的 对比观察MRI、直肠腔内超声检查在高位肛瘘术前诊断中的应用效果。方法 高位肛瘘患者72例,术前均进行直肠腔内超声检查、MRI检查,以手术探查结果作为金标准,评价腔内超声检查、MRI检查在判断内口、主管、支管、脓腔及瘘管分型等方面的效果。结果 术前MRI及腔内超声检查全部清晰显示瘘管的主管道,准确率均为100%。MRI对内口定位与手术结果符合63例、准确率87.50%,腔内超声分别为56例、77.77%,P>0.05;MRI对支管及脓腔定位符合66例、准确率91.66%,腔内超声为38例、52.77%,P<0.05;MRI对肛瘘分型判断符合69例、准确率95.83%,腔内超声分别为33例、45.83%,P<0.01。结论高位肛瘘术前MRI、直肠腔内超声检查均能准确显示主管道,MRI检查对支管及脓腔定位、肛瘘分型的判断准确率优于直肠腔内超声检查。 [ABSTRACT FROM AUTHOR]