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Abstract Background A comprehensive understanding of the anatomy of the anterolateral ankle joint and its interrelationships is essential for advancing the development of minimally invasive Broström–Gould procedure, thereby enhancing surgical efficacy and minimizing postoperative complications. Methods Ten fresh human ankle specimens were dissected to observe the shape and trajectory of the lateral bundle of the inferior extensor retinaculum (IER) and its relationship with the deep fascia. To observe the relationship between the ankle capsule and the anterior talofibular ligament (ATFL). The center of the insertion point of ATFL at the lateral malleolus was used as the reference point. The vertical distance from the reference point to the fibula tip, the horizontal distance from the reference point to the lateral branch of the superficial peroneal nerve, the shortest distance from the reference point to IER, the narrowest width of the IER, the angle between the line connecting the shortest distance from the reference point to the IER and the longitudinal axis of the fibula were measured. The tension and elasticity of ATFL was understood. To describe the minimally invasive Broström–Gould procedure according to the anatomical characteristics of the anterolateral ankle joint. Results Among the 10 cases, 8 cases (80%) had double bundles of ATFL, 2 cases (20%) had single bundle of ATFL, and no outer superior oblique bundle was observed in IER. The vertical distance from the reference point to the fibula tip was 1.2 ± 0.3 (range 1.1–1.3) mm. The shortest distance from the reference point to the level of the superficial peroneal branch was 28.2 ± 4.3 (range 24.5–32.4) mm. The shortest distance from the reference point to IER was 12.5 ± 0.6 (range 12.1–12.9) mm, and the width of IER at this point was 7.2 ± 0.3 (range 7.0–7.6) mm. The angle between the line connecting the shortest distance from the reference point to the IER and the longitudinal axis of the fibula was about 60° ± 2.8° (range 58.1°–62.1°) mm. The space between the anterolateral deep fascia of the ankle joint and the ankle capsule is very small, and only a few fat granules are separated between them. The ATFL is largely fused to the ankle capsule. The ATFL exhibited high tension and poor elasticity after traction with the probe hook. Conclusions The results showed that in the minimally invasive Broström–Gould technique for lateral ankle stabilization, the Broström procedure actually sutured the insertion of the ATFL together with the ankle capsule to the anterior edge of the lateral malleolus. In the Gould procedure, the deep fascia was mostly reinforced with the ankle capsule. The minimum suture span was obtained when the Gould suture needle direction was at an Angle of 60° to the longitudinal axis of the fibula.

Purpose: There are various surgical interventions available for the management of Chronic lateral ankle instability (CLAI). The Broström-Gould procedure has gained widespread recognition among foot and ankle specialists for its favorable surgical outcomes. However, with advancements in anatomical understanding and medical technology, further enhancements to the effectiveness of the Gould procedure are warranted. This study introduces a all-inside modified “outside-in” Broström -Gould procedure as an alternative approach for addressing lateral ankle instability. Methods: From August 2020 to October 2022, 40 patients with lateral ankle instability who underwent arthroscopic repair of the modified “outside-in” Broström-Gould procedure were retrospectively analyzed. All patients received standard non-surgical treatment before surgery for more than 6 months without symptom relief. Visual Analogue Scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) and Karlsson-Peterson score were used to evaluate the postoperative effect. Results: All patients were followed up for (14.62 ± 2.04) months. One year after operation, all patients could walk normally, ankle instability sensation disappeared, varus stress test and anterior drawer test were negative. The VAS , AOFAS and Karlsson-Peterson scores of all patients were significantly better compared with those before operation, and the difference between before and after operation was statistically significant. Conclusions: The modified “outside-in” Broström-Gould procedure can effectively treat CLAI, which can obtain satisfactory results. The procedure is straightforward, the impact is minimal, and the aesthetics are pleasing.

AbstractContext Panax ginseng C. A. Meyer (Araliaceae) is a tonic herb used in ancient Asia.Objective This study investigated the antifatigue effect of P. ginseng on chronic fatigue rats.Materials and methods Sprague-Dawley rats were divided into control, model and EEP (ethanol extraction of P. ginseng roots) (50, 100 and 200 mg/kg) groups (n = 8). The rats were subcutaneously handled with loaded swimming once daily for 26 days, except for the control group. The animals were intragastrically treated with EEP from the 15th day. On day 30, serum, liver and muscles were collected, and the PI3K/Akt/mTOR signalling pathway was evaluated.Results The swimming times to exhaust of the rats with EEP were significantly longer than that without it. EEP spared the amount of muscle glycogen, hepatic glycogen and blood sugar under the chronic state. In addition, EEP significantly (p

Abstract Objectives This study aimed to analyze the possible causes of changes in cardiac function and investigate the feasibility of clinical assessment of gastrointestinal cancer in patients with or without acute kidney injury (AKI) assessed using a non-invasive impedance cardiography (ICG, Bioz. Cardio Dynamics, USA) to identify independent risk factors. Methods Patients admitted to the Fourth Hospital of Hebei Medical University, China, between May 1, 2019, and February 15, 2022, were included in this study. A total of 51 patients with gastrointestinal cancer (31 men and 20 women, mean age 61.1 ± 10.9 years) with or without AKI were evaluated for ICG. A total of 19 patients underwent ultrasound cardiography (UCG) and ICG evaluations. Result There was a significant positive correlation between cardiac output (CO), cardiac index (CI), stroke volume (SV), left cardiac work index (LCWI), and ejection fraction (EF) measured using UCG and ICG. The relationship was observed between COICG and COUCG (r = 0.707, P = 0.001), CIICG and CIUCG (r = 0.718, P = 0.001), SVICG and SVUCG (r = 0.837, P

Abstract Background Senescent adipose-derived stem cells (ASCs) exhibit reduced therapeutic efficacy during wound healing. Transcriptional regulation factors including long noncoding RNAs (lncRNAs) reportedly have essential roles in stem cell aging. However, the mechanisms of which lncRNAs influence mesenchymal stem cell aging and how it works need further investigation. Methods The expression patterns of lncRNA senescence-associated noncoding RNA (SAN) and miR-143-3p in ASCs obtained from old and young volunteer donors were detected by quantitative polymerase chain reaction. ASCs with overexpression or knockdown of SAN and γ-adducin (ADD3) were constructed by lentiviral transduction. Mimic and inhibitor were used to manipulate the cellular level of miR-143-3p in ASCs. The effects of these RNAs on ASCs proliferation, migration and cellular senescence were examined by EdU, transwell and senescence-activated β-galactosidase (SA-β-gal) staining assays. Wound scratch and tube formation assays were conducted to evaluate the capacities of ASCs in promoting fibroblasts migration and endothelial cells angiogenesis. Furthermore, dual-luciferase assays and rescue experiments were performed to identify the RNA interactions. Finally, the therapeutic effects of SAN-depleted aged ASCs were evaluated in a skin injury model. Results The lncRNA SAN (NONHSAT035482.2) was upregulated in aged ASCs; it controlled cellular senescence in ASCs. lncRNA SAN knockdown in ASCs led to ASC functional enhancement and the inhibition of cellular senescence; it also promoted the effects of conditioned medium (CM) on endothelial cell tube formation and fibroblast migration. Mechanistic analysis showed that SAN serves as a sponge for miR-143-3p, thereby regulating the expression of ADD3. The application of SAN-depleted aged ASCs increased re-epithelialization, collagen deposition, neovascularization and led to accelerated skin wound closure, compared with transplantation of aged ASCs. Conclusion The lncRNA SAN mediates ASC senescence by regulating the miR-143-3p/ADD3 pathway, providing a potential target for rejuvenation of senescent ASCs and enhancement of wound repair.

Objective: To explore the effect of understory Panax ginseng extract (UGPE) on depression-like behavior and hypothalamic-pituitary-adrenal (HPA) axis of chronic unpredictable mild stress (CUMS) model mice. Methods: Ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) were used to detect the contents of ginsenosides. Totally 60 male Kunming mice were randomly divided into four groups: Control, model, positive venlafaxine (10 mg·kg−1 Ven) and UGPE group (100 mg·kg−1 UPGE). The depression model was induced by CUMS in mice except for those in the control group, they were received corresponding drug by intragastric administration for 21 days. The sucrose preference test, open field test and Morris water maze experiments were conducted to analyze their behavioral changes. The contents of corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH) and corticosterone (CORT) in plasma were measured by enzyme linked immunosorbent assay (ELISA). Hematoxylin-Eosin (HE) staining was used to investigate the pathological changes of neurons in the CA1 and CA3 area of hippocampus. The apoptosis of hippocampal neurons was observed by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) method. Results: UPGE contained 16 ginsenosides. Compared with the model group, the UPGE group significantly improved sugar-water preference (P

Carposina coreana is an important pest of Cornus officinalis, distributed in China, Korea, and Japan. In recent years, its damage to C. officinalis has become increasingly serious, causing enormous economic losses in China. This study and prediction of current and future suitable habitats for C. coreana in China can provide an important reference for the monitoring, early warning, prevention, and control of the pest. In this study, the potential distributions of C. coreana in China under current climate and future climate models were predicted using the maximum entropy (MaxEnt) model with ArcGIS software. The distribution point data of C. coreana were screened using the buffer screening method. Nineteen environmental variables were screened using the knife-cut method and variable correlation analysis. The parameters of the MaxEnt model were optimized using the kuenm package in R software. The MaxEnt model, combined with key environmental variables, was used to predict the distribution range of the suitable area for C. coreana under the current (1971–2000) and four future scenarios. The buffer screening method screened data from 41 distribution points that could be used for modeling. The main factors affecting the distribution of C. coreana were precipitation in the driest month (Bio14), precipitation in the warmest quarter (Bio18), precipitation in the coldest quarter (Bio19), the standard deviation of seasonal variation of temperature (Bio4), minimum temperature in the coldest month (Bio6), and average temperature in the coldest quarter (Bio11). The feature class (FC) after the kuenm package optimization was a Q-quadratic T-threshold combination, and the regularization multiplier (RM) was 0.8. The suitable areas for C. coreana under the current climate model were mainly distributed in central China, and the highly suitable areas were distributed in southern Shaanxi, southwestern Henan, and northwestern Hubei. The lowest temperature in the coldest month (Bio6), the average temperature in the coldest quarter (Bio11), and the precipitation in the warmest quarter (Bio18) all had good predictive ability. In future climate scenarios, the boundary of the suitable area for C. coreana in China is expected to shift northward, and thus, most of the future climate scenarios would shift northward.

ObjectivesIn order to improve the fault diagnosis level of marine power systems, this paper studies the real-time fault diagnosis of a marine supercharged boiler based on a convolutional neural network (CNN).MethodsFirst, the simulation program of the marine supercharged boiler is developed based on the GSE platform, and the simulation fault data is obtained. The fault diagnosis model of the boiler is then established using the CNN method. Next, through the change trends of temperature, flow and other parameters, combined with a priori knowledge and the machine learning method, fault identification is carried out. Lastly, the performance of the method is evaluated against criteria such as confusion matrix and accuracy.ResultsAccording to the comparison results between the feature extracted dataset and the original dataset, the stability of the model output results and the generalization ability of the model are optimized and improved, with an overall fault classification accuracy reaching 99.53%.ConclusionThe results of this study can provide valuable references for the intelligent monitoring of marine power systems.

The refractory diabetic wound has remained a worldwide challenge as one of the major health problems. The impaired angiogenesis phase during diabetic wound healing partly contributes to the pathological process. MicroRNA (miRNA) is an essential regulator of gene expression in crucial biological processes and is a promising nucleic acid drug in therapeutic fields of the diabetic wound. However, miRNA therapies have limitations due to lacking an effective delivery system. In the present study, we found a significant reduction of miR-31-5p expression in the full-thickness wounds of diabetic mice compared to normal mice. Further, miR-31-5p has been proven to promote the proliferation, migration, and angiogenesis of endothelial cells. Thus, we conceived the idea of exogenously supplementing miR-31-5p mimics to treat the diabetic wound. We used milk-derived exosomes as a novel system for miR-31-5p delivery and successfully encapsulated miR-31-5p mimics into milk exosomes through electroporation. Then, we proved that the miR-31-5p loaded in exosomes achieved higher cell uptake and was able to resist degradation. Moreover, our miRNA-exosomal formulation demonstrated dramatically improved endothelial cell functions in vitro, together with the promotion of angiogenesis and enhanced diabetic wound healing in vivo. Collectively, our data showed the feasibility of milk exosomes as a scalable, biocompatible, and cost-effective delivery system to enhance the bioavailability and efficacy of miRNAs.

In this work, the numerical simulation study of the hydrothermal flow and heat transfer process in the porous rock under 30 MPa pressure was developed. The flow and heat transfer characteristics of hydrothermal in rocks with different porosities are studied by changing the porosity of the rock. The simulation results show that the average flow velocity decreases and the average temperature increases when the porosity decreases. The velocity field and temperature field are coupled due to the nonlinear thermophysical properties of hydrothermal. The velocity field and temperature field have strongly interacted in the range of 400–450 ℃ and the effect of temperature on velocity is gradually diminishing outside the range. Most of the fluid will be "squeezed" into the crevice and the average velocity is almost three times the no-creviced case when a crevice is present. The existence of the crevice makes the total heat flux decrease from an overall perspective, and the crevice makes a large temperature gradient at the entrance and export of the crevice from a local perspective. These results provide theoretical support for the utilization of submarine hydrothermal fluid shallow circulation heat energy.

To satisfy the requirements of low fuel consumption, low emission, and high efficiency of the shipping industry, marine diesel engines are developing in the direction of automation and energy-saving, which increases the possibility and complexity of marine diesel engine failures. A one-dimension thermodynamic model for the marine diesel engine is built with AVL Boost software. The model is applied to a low-speed two-stroke 6S50MC diesel engine, and the error between the main performance parameters obtained by simulation and the test bench data is less than 3% under 100% and 75% load. Based on the model, 6 typical single faults and many typical double faults concomitant phenomena of diesel are reproduced. Based on the second law of thermodynamics, the exergy flow among the components and the external environment is analyzed. The thermoeconomic model of a marine diesel engine is established where the "fuel" and "product" of the components are defined according to their function. The fault diagnosis results show that the effects of faults generally propagate through the diesel engine system and affect the behavior of several components, resulting in induced malfunction in normal components. Therefore the malfunction MFi of each component is the superposition of the intrinsic malfunction and the induced malfunction according to the malfunction and dysfunction analysis. The thermoeconomic fault diagnosis method can be used to narrow the search range of abnormal components though it cannot accurately locate the fault.

ObjectivesIn the process of the emergency deceleration and reversing operations of marine steam power systems, back-steam control technology is an effective means of alleviating the problem of boiler drum overpressure，so it is necessary to study its influence on the system. MethodsThis paper establishes a steam power system simulation model of a supercharged boiler, main steam turbine and propeller, and carries out the simulation and comparative analysis of the characteristics of back-steam control in the process of the emergency deceleration and reversing of large ships under the three working conditions of quick closing valve with/without back-steam and slow closing valve without back-steam. ResultsThe simulation results show that the steam return control technology can effectively prevent boiler drum overpressure in the process of emergency deceleration and reversing, and the system stability time is shortened by about 3 mins and 1 min respectively. ConclusionThe results of this study can provide references for ship maneuverability and safety design.

With the proportion of wind power in the grid increasing, the monitoring and maintenance of wind turbines is becoming more and more important for the reliability of the grid. In this study, a data-driven modelling framework based on deep convolutional neural networks is constructed for wind turbines condition monitoring (CM) and performance forecasting (PF). For CM, a robust denoising autoencoder (DAE) model is introduced to output the reconstruction error (RE) of raw signals. The RE is processed to a state indicator by exponentially weighted moving average (EWMA) and monitored on a control chart. For PF, two multi-steps ahead forecasting models are constructed for the forecasting of generator bearing and transformer temperature. To prevent overfitting caused by abundant features, the marginal effect analysis based on random forests is implemented to measure the importance of features. Besides, novel residual attention module (RAM) and training strategies are used improve their representation power of DAE and PF models. Experiments on a real wind turbine dataset prove the effectiveness of the proposed models and methods.

We aimed to investigate whether the use of intravenous paracetamol (IVP) preoperatively in intertrochanteric fracture (IF) patients aged 65 years or over receiving intramedullary fixation had significantly benefits on the pain score at discharge, delirium incidence, length of hospital stay (LOS), functional outcomes, and mortality. A retrospective analysis of all surgically treated patients presenting with IF was conducted at a single Level I trauma center in China between Jan. 2016 and Jan. 2020. The data concerning patients’ demographics, injury-related data, surgery-related data, operation-related data, in-hospital data, and postoperative outcomes were extracted. To minimize potential confounding and selection bias, the propensity score matching (PSM) method was performed via the caliper matching method by using a 1 : 1 ratio. After PSM, McNemar’s chi-square tests were used to examine the association of using IVP with outcome analyses. The Spearman correlations of IVP using, pain scores, and the factors which may influence them were also computed. After screening 2963 consecutive patients, 2166 were included finally, including 1576 in the non-IVP group and 590 in the IVP group. After PSM, 531 remained in each group. The pain scores at discharge were significantly between the two groups before and after matching (all p

Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications in diabetes. Previous studies have shown that chronic neuroinflammation was associated with DPN. However, further research is needed to investigate the exact immune molecular mechanism underlying the pathogenesis of DPN. Expression profiles were downloaded from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were screened by R software. After functional enrichment analysis of DEGs, a protein–protein interaction (PPI) network analysis was performed. The CIBERSORT algorithm was used to evaluate the infiltration of immune cells in DPN. Next, the least absolute shrinkage and selection operator (LASSO) logistic regression and support vector machine-recursive feature elimination (SVM-RFE) algorithms were applied to identify potential DPN diagnostic markers. Finally, the results were further validated by qRT-PCR. A total of 1308 DEGs were screened in this study. Enrichment analysis identified that DEGs were significantly enriched in immune-related biological functions and pathways. Immune cell infiltration analysis found that M1 and M2 macrophages, monocytes, resting mast cells, resting CD4 memory T cells and follicular helper T cells were involved in the development of DPN. LTBP2 and GPNMB were identified as diagnostic markers of DPN. qRT-PCR results showed that 15 mRNAs, including LTBP2 and GPNMB, were differentially expressed, consistent with the microarray results. In conclusion, LTBP2 and GPNMB can be used as novel candidate molecular diagnostic markers for DPN. Furthermore, the infiltration of immune cells plays an important role in the progression of DPN.

Introduction One of the crucial mechanisms following spinal cord injury is mitochondria-associated cell death. Minocycline, an anti-inflammatory drug, is well known to impede mitochondrial cell death. However, there has been no study on the effect of minocycline linking Fas cell surface death receptor (FAS)-mediated cell death and hypoxia inducible factor (HIF-1α), the targets involved in mitochondrial cell death. Material and methods Male Sprague Dawley rats (N = 15, divided into three groups) were subjected to traumatic spinal cord injury and were injected with minocycline (n = 5) (90 mg/kg and later a 45 mg/kg dose twice a day (every 12 h)). Injection with sterile PBS in injured animals served as the vehicle (n = 5) and another group comprised healthy animals (n = 5). TUNEL assay was used to quantify cell death. The release of Smac/Diablo, cytochrome-c (cyt-c), HIF-1α, FAS ligand (FASL) and tumour necrosis factor-α (TNF-α) was measured using ELISA. Expression of HIF-1α, FASL and other cell death associated factors was quantified at the mRNA and protein level and confirmed with immunohistochemistry. Results There was a marked reduction in the HIF-1α and FASL expression levels in the minocycline-treated group compared to the vehicle. The reduction of HIF-1α and FASL was associated with other factors linked to cell death (Smac/Diablo, cyt-c, TNF-α, p53, caspase-8 and BH3 interacting domain death agonist (BID)) (p < 0.5; *p < 0.05 vs. vehicle group, **p < 0.01 vs. vehicle group). Conclusions The present study focuses on the investigation of minocycline in inhibiting mitochondria-associated cell death by modulating FASL and HIF-1α expression, which are seemingly interlinked mechanisms contributing to cell death.

This work aimed at improving the water solubility of Ginsenoside (G)-Re by forming an inclusion complex. The solubility parameters of G-Re in alpha (α), beta (β), and gamma (γ) cyclodextrin (CD) were investigated. The phase solubility profiles were all classified as AL-type that indicated the 1:1 stoichiometric relationship with the stability constants Ks which were 22 M−1 (α-CD), 612 M−1 (β-CD), and 14,410 M−1 (γ-CD), respectively. Molecular docking studies confirmed the results of phase solubility with the binding energy of −4.7 (α-CD), −5.10 (β-CD), and −6.70 (γ-CD) kcal/mol, respectively. The inclusion complex (IC) of G-Re was prepared with γ-CD via the water-stirring method followed by freeze-drying. The successful preparation of IC was confirmed by powder X-ray diffraction (XRD), Fourier transform-infrared spectroscopy (FT-IR), differential scanning calorimetry (DSC), and scanning electron microscopy (SEM). In-vivo absorption studies were carried out by LC-MS/MS. Dissolution rate of G-Re was increased 9.27 times after inclusion, and the peak blood concentration was 2.7-fold higher than that of pure G-Re powder. The relative bioavailability calculated from the ratio of Area under the curve AUC0–∞ of the inclusion to pure G-Re powder was 171%. This study offers the first report that describes G-Re’s inclusion into γ-CD, and explored the inclusion complex’s mechanism at the molecular level. The results indicated that the solubility could be significantly improved as well as the bioavailability, implying γ-CD was a very suitable inclusion host for complex preparation of G-Re.

Through anatomical observations, the anatomical characteristics of the inferior extensor retinaculum of ankle (IER) of the ankle joint were elucidated, and its potential applications in treating lateral ankle instability or other conditions were discussed. A total of 12 adult foot specimens were dissected to expose the inferior extensor retinaculum of ankle, and a standard model was established. The pre-experimental scheme guided the recording of general findings, adjacent structures, lateral attachment in the tarsal sinus region, and influence on movement of inferior tendons. 1, attachment mean width: lateral band of IER 6.6±1.38 mm, oblique superomedial band of IER (32.3±3.97 mm), oblique inferomedial band of IER (30.0±5.30 mm) ; 2, mean length:lateral band of IER (78.1±4.20 mm), oblique superomedial band of IER (14.2±0.80 mm), oblique inferomedial band of IER (71.8±2.61 mm); 3, maximum mean thickness: lateral band of IER (1.52±0.03 mm), oblique superomedial band of IER (0.89±0.05 mm), oblique inferomedial band of IER (0.73±0.16 mm); 4, the closest distance between IER and the tip of lateral malleolus: 23.9±0.83 mm; 5, mean width of the fiber tunnel:lateral fiber tunnel (11.9±1.16 mm), intermedium fiber tunnel (6.8±1.24 mm), medial fiber tunnel (8.6±0.79 mm); 6, mean distance from tunnel midpoint to lateral malleolar tip: lateral fiber tunnel (38.0±3.74 mm), intermedium fiber tunnel (69.8±4.15 mm), medial fiber tunnel (181.1±6.00 mm); 7, the distance between medial dorsal cutaneous nerve and the tip of lateral malleolus on the level of the IER (79.2±8.3 mm) the distance between intermediate cutaneous nerve of dorsum and the tip of lateral malleolus on the level of the IER (57.9±1.02 mm). The inferior extensor retinaculum of ankle is a crucial restraint unit of the anterior ankle tendon, and a comprehensive understanding of its anatomical characteristics holds significant implications for treating chronic ankle instability and exploring potential clinical applications. [ABSTRACT FROM AUTHOR]