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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.

Abstract Clinical work and research on diabetic wound repair remain challenging globally. Although various conventional wound dressings have been continuously developed, the efficacy is unsatisfactory. The effect of drug delivery is limited by the depth of penetration. The sustained release of biomolecules from biological wound dressings is a promising treatment approach to wound healing. An assortment of cell-derived exosomes (exos) have been proved to be instrumental in tissue regeneration, and researchers are dedicated to developing biomolecules carriers with unique properties. Herein, we reported a methacrylate gelatin (GelMA) microneedles (MNs) patch to achieve transdermal and controlled release of exos and tazarotene. Our MNs patch comprising GelMA/PEGDA hydrogel has distinctive biological features that maintain the biological activity of exos and drugs in vitro. Additionally, its unique physical structure prevents it from being tightly attached to the skin of the wound, it promotes cell migration, angiogenesis by slowly releasing exos and tazarotene in the deep layer of the skin. The full-thickness cutaneous wound on a diabetic mouse model was carried out to demonstrate the therapeutic effects of GelMA/PEGDA@T + exos MNs patch. As a result, our GelMA/PEGDA@T + exos MNs patch presents a potentially valuable method for repairing diabetic wound in clinical applications. Graphic Abstract

Introduction: Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer with low 5-year survival rate. Cellular senescence, characterized by permanent and irreversible cell proliferation arrest, plays an important role in tumorigenesis and development. This study aims to develop a cellular senescence-based stratified model, and a multivariable-based nomogram for guiding clinical therapy for HCC.Materials and methods: The mRNAs expression data of HCC patients and cellular senescence-related genes were obtained from TCGA and CellAge database, respectively. Through multiple analysis, a four cellular senescence-related genes-based prognostic stratified model was constructed and its predictive performance was validated through various methods. Then, a nomogram based on the model was constructed and HCC patients stratified by the model were analyzed for tumor mutation burden, tumor microenvironment, immune infiltration, drug sensitivity and immune checkpoint. Functional enrichment analysis was performed to explore potential biological pathways. Finally, we verified this model by siRNA transfection, scratch assay and Transwell Assay.Results: We established an cellular senescence-related genes-based stratified model, and a multivariable-based nomogram, which could accurately predict the prognosis of HCC patients in the ICGC database. The low and high risk score HCC patients stratified by the model showed different tumor mutation burden, tumor microenvironment, immune infiltration, drug sensitivity and immune checkpoint expressions. Functional enrichment analysis suggested several biological pathways related to the process and prognosis of HCC. Scratch assay and transwell assay indicated the promotion effects of the four cellular senescence-related genes (EZH2, G6PD, CBX8, and NDRG1) on the migraiton and invasion of HCC.Conclusion: We established a cellular senescence-based stratified model, and a multivariable-based nomogram, which could predict the survival of HCC patients and guide clinical treatment.

In this paper, we investigated the mechanisms, kinetics, and toxicity evaluation of the OH-initiated reaction of coniferyl alcohol (4-(3-hydroxy-1-propenyl)-2-methoxyphenol) in the atmosphere using theoretical calculations. The initial reaction of coniferyl alcohol with OH radicals had two pathways, H-abstraction and OH-addition reactions. The total reaction rate constants were 2.32 × 10−9 cm3 molecule−1 s−1 (in gas-phase) and 9.44 × 109 s−1 M−1 (in liquid-phase) for the preliminary reactions of coniferyl alcohol with OH radicals at 298 K, respectively, and the half-lives of the total reaction (including all initial H-abstraction and OH-addition reactions) of coniferyl alcohol with OH radical in the atmosphere, urban and remote clouds were 8.3 × 10−2 h, 5.83 × 103 h and 9.27 × 102 h, respectively. The temperature had a strong and positive influence on the initial reaction rate constant. The branching ratios of H-abstraction and OH-addition reactions were 3.68% and 97.69%, respectively, making the OH-addition reactions become dominant reactions. The ecotoxicity evaluation revealed that the toxicity levels of coniferyl alcohol and its products were similar and non-toxic. However, all these products have developmental toxicity, with most of them having no mutagenicity. Therefore, further attention should be paid to the oxidation process and product toxicity evaluation of coniferyl alcohol in the atmosphere.

In the present work, volatile organic compounds (VOCs) from vehicle exhaust and cooking fumes were investigated via simulation experiments, which covered engine emissions produced during gasoline direct injection (GDI) using two kinds of fuels and cooking emissions produced by preparing three domestic dishes. The distinct characteristics of VOCs emitted during the two processes were identified. Alkanes (73% mass fraction on average) and aromatics (15% on average) dominated the vehicle VOCs, while oxygenated VOCs (49%) and alkanes (29%) dominated the cooking VOCs. Isopentane (22%) was the most abundant species among the vehicle VOCs. N-hexanal (20%) dominated the cooking VOCs. The n-hexanal-to-n-pentanal ratio (3.68 ± 0.64) was utilized to identify cooking VOCs in ambient air. The ozone formation potential produced by cooking VOCs was from 1.39 to 1.93 times higher than that produced by vehicle VOCs, which indicates the significant potential contribution of cooking VOCs to atmospheric ozone. With the equivalent photochemical age increasing from 0 h to 72 h, the secondary organic aerosol formation by vehicle VOCs was from 3% to 38% higher than that of cooking VOCs. Controlling cooking emissions can reduce SOA pollution in a short time due to its higher SOA formation rate than that of vehicle VOCs within the first 30 h. However, after 30 h of oxidation, the amount of SOAs formed by vehicle exhaust emissions exceeded the amount of SOAs produced by cooking activities, implying that reducing vehicle emissions will benefit particle pollution for a longer time. Our results highlight the importance of VOCs produced by cooking fumes, which has not been given much attention before. Further, our study suggested that more research on semi-volatile organic compounds produced by cooking emissions should be conducted in the future.

A highly virulent porcine epidemic diarrhea virus (PEDV) appeared in China and spread rapidly to neighbor countries, which have led to great economic losses to the pig industry. In the present study, we isolated a PEDV using Vero cells and serially propagated 100 passages. PEDV SDSX16 was characterized in vitro and in vivo. The viral titers increased to 107.6 TCID50/mL (100th) by serial passages. The spike (S) gene and the whole gene of the SDSX16 virus was fully sequenced to assess the genetic stability and relatedness to previously identified PEDV. Along with successive passage in vitro, there were 18 nucleotides (nt) deletion occurred in the spike (S) gene resulting in a deletion of six amino acids when the SDSX16 strain was passaged to the 64th generation, and this deletion was stable until the P100. However, the ORF1a/b, M, N, E, and ORF3 genes had only a few point mutations in amino acids and no deletions. According to growth kinetics experiments, the SDSX16 deletion strain significantly enhanced its replication in Vero cells since it was passaged to the 64th generation. The animal studies showed that PEDV SDSX16-P10 caused more severe diarrhea and vomiting, fecal shedding, and acute atrophic enteritis than SDSX16-P75, indicating that SDSX16-P10 is enteropathogenic in the natural host, and the pathogenicity of SDSX16 decreased with successive passage in vitro. However, SDSX16-P10 was found to cause lower levels of cytokine expression than SDSX16-P75 using real-time PCR and flow cytometry, such as IL1β, IL6, IFN-β, TNF-α, indicating that SDSX16-P10 might inhibit the expression of cytokines. Our data indicated that successive passage in vitro resulted in virulent attenuation in vivo of the PEDV variant strain SDSX16.