Epidemiological characteristics and distribution of pediatric supracondylar fractures in South China: a retrospective analysis of 760 cases

To evaluate demographic characteristics and distribution of pediatric supracondylar fractures (SCFs) at a tertiary hospital in South China. A retrospective observational study was conducted on children aged 15 years or younger with a diagnosis of SCFs during the period from January 2016 to December 2018. Patients' medical records and radiographs were retrospectively analyzed for age at the time of injury, sex, site and mechanism of traumatic injury. A total of 760 patients with 761 SCFs were reviewed (453 males, 59.6%, and 307 females, 40.4%). There were 748 extension-type fractures (98.3%) and 13 flexion-type fractures (1.7%). Associated injuries were identified in 30/760 (3.9%) patients: associated fracture ( n  = 15; 2%), nerve injury ( n  = 12; 1.6%), open fracture ( n  = 2; 0.2%) and compartment syndrome ( n  = 1; 0.1%). Age at the time of fracture has a bimodal pattern with a first peak around the age of 1 year and a second peak around the age of 4-5 years. The fractures occurred mostly around 11 a.m. and between 4 and 9 p.m. in the evening. Most fractures occurred at home (50.7%), and falling down (62.2%) was the most frequent mechanism of injury. SCFs occurred most frequently in children aged 1 and 4-5 years, and during daylight hours. In about 96% of cases, these were isolated injuries, and falling down was found to be the most frequent traumatic mechanism. Based on our findings, targeted educational efforts and interventions can be set up in order to prevent the occurrence of SCFs in South China. Level of evidence: III.

[Associations of cardiometabolic multimorbidity with grip strength and gait speed among older Chinese adults]

Objective: To investigate the associations of cardiometabolic multimorbidity (CMM) with grip strength and gait speed among older Chinese adults. Methods: This study included participants aged ≥60 years from the China Health and Retirement Longitudinal Survey during 2011-2015. Generalized estimating equation models were employed to estimate the associations of CMM with grip strength and gait speed. Results: A total of 6 357 participants were included to measure grip strength and 6 250 participants to measure gait speed. Compared with no cardiometabolic disease, participants with 1 (β=-0.018, 95%CI: -0.026--0.010), 2 (β=-0.029, 95%CI: -0.041- -0.018), and ≥3 (β=-0.050, 95%CI: -0.063- -0.037) cardiometabolic diseases were associated with a decreased grip strength. The associations between cardiometabolic disease counts (1: β=-0.052, 95%CI: -0.326-0.222; 2: β=-0.083, 95%CI: -0.506-0.340; ≥3: β=-0.186, 95%CI: -0.730-0.358) and gait speed were not statistically significant. The predictive value of gait speed of the participants with 0, 1, 2, and ≥3 cardiometabolic diseases were found to be 1.98 (95%CI: 1.38-2.58), 1.93 (95%CI: 1.34-2.51), 1.89 (95%CI: 1.18-2.61), and 1.79 (95%CI: 1.10-2.48) m/s respectively, which was clinically significant for the magnitude of the decrease. Cardiometabolic combinations with a higher risk of decreased grip strength and gait speed mainly seen in diabetes. Conclusions: Cardiometabolic disease counts and combinations were associated with grip strength and gait speed. Grip strength and gait speed can be used to measure CMM severity.

[Comparative study of unilateral biportal endoscopy and coaxial large channel endoscopy for lumbar spinal stenosis]

Objective: To compare the efficacy of unilateral biportal endoscopy (UBE) and coaxial large channel endoscopy for lumbar spinal stenosis. Methods: A total of 176 patients with lumbar spinal stenosis treated in Tianjin Hospital from March 2015 to October 2021 were included in this study. Of the patients, 110 cases were treated with UBE, including 52 males and 58 females, with a mean age of (75.1±10.4) years; while 66 cases were treated with coaxial large channel endoscopy, including 31 males and 35 females, with an average age of (77.2±13.1) years. The visual analogue scale (VAS) score of pain and Oswestry disability index (ODI) were compared before and after surgery between the two groups, with the improvement rate calculated. The operation time, intraoperative blood loss, perioperative conditions and complications were compared. The operation efficacy was evaluated according to MacNab scale and was compared between the two groups. Results: There was no significant differences in age, gender, disease course, VAS of pain, ODI and index levels between the two groups before operation (all P>0.05). The operation time and postoperative drainage in UBE group and coaxial large channel endoscopy group were comparable [(60.1±12.4)min, (62.5±13.2)min and (103.8±20.7)ml, (98.5±22.1)ml, respectively, both P>0.05]. After the operation, the VAS score of low back pain, VAS score of leg pain and ODI of the two groups were all lower than those before operation, and decreased continuously during follow-up; and under the repeated measures analysis of variance, significant differences were found between different time points (all P<0.05), no significant difference was found between the two groups (all P>0.05), nor interaction between groups and time points was detected (all P>0.05). The patients were followed-up for (18.0±4.2) months (6 to 30 months). There was no significant difference in VAS and ODI improvement rates and excellent rate of efficacy between the two groups at the last follow-up (all P>0.05). Conclusions: Both UBE and coaxial large channel endoscopy can provide excellent results for lumbar spinal stenosis. UBE has sufficient decompression and is convenient to explore and remove the herniated disc.

[Relationship between obesity and death by multi-morbidity status in older adults in China]

Objective: To explore the relationship between obesity status and death stratified by different multi-morbidity status in older adults in China. Methods: Data for older Chinese adults aged ≥65 years were from Chinese Longitudinal Healthy Longevity Survey (CLHLS). Multi-morbidity patterns based on 13 chronic conditions were explored using exploratory factor analysis. Cox models were used to examine relationships between obesity status and death stratified by disease count and multi-morbidity patterns at baseline, respectively. Besides, obesity status was defined by baseline body mass index and waist circumference. Results: A total of 6 272 participants were included in the analyses. Multi-morbidity including cardio-metabolic, sensory perception and other patterns were identified. For those without any chronic condition, compared with those without central obesity, central obesity was associated with a higher risk for death (HR=1.66, 95%CI:1.04-2.66). For those only with one chronic condition, compared with normal weight, underweight was associated with a higher risk for death (HR=1.41, 95%CI: 1.10-1.80). For those with multi-morbidity, compared with normal weight, underweight increased the risk for death (HR=1.19, 95%CI:1.05-1.34). Compared with those without central obesity, central obesity decreased the risk for death (HR=0.88, 95%CI:0.78-0.99). Conclusions: Relationships between obesity status and death varied by multi-morbidity status in older adults in China. Underweight and non-central obesity were associated with increased risks for death in older adults with only one chronic disease or multi-morbidity. Therefore, it is necessary to pay attention to multi-morbidity status in the management of obesity in older adults and provide effective targeted body weight management plan.

Molecular dynamics study of three amino acids as corrosion inhibitor for copper in hydrochloric acid solution

Molecular dynamics (MD) simulation is used to study the corrosion inhibition mechanism of cysteine (Cys), glutamic (Glu) and glycine (Gly) for copper in hydrochloric acid solution. The adsorption energy and radial distribution function results show that all three amino acids can spontaneously adsorb on Cu (111) surface by chemical adsorption. The absolute value of adsorption energy and intensity is Cys > Glu > Gly. The diffusion coefficient and relative concentration curve show that all the three amino acids can inhibit the diffusion and aggregation ability of corrosion particles, so the three amino acids not only can slow down the aggregation of corrosive particles, but also effectively repel corrosive particles to protect the substrate. The inhibition ability obtained by the MD simulation shows the trend of Cys > Glu > Gly, which is consistent with the experimental results. The inhibition efficiency is determined by both the adsorption strength on the substrate surface and inhibition ability for the diffusion and aggregation ability of corrosion particles.

Neuroprotection effect of interleukin (IL)-17 secreted by reactive astrocytes is emerged from a high-level IL-17-containing environment during acute neuroinflammation

An increase in interleukin (IL)-17A-producing cells, particularly at sites of tissue inflammation, is observed frequently, yet the mechanism is not fully understood. This study aims to dissect the role of IL-17 in autoimmunity-mediated neuroinflammation. The cytokine milieu containing elevated IL-17, which often appears in active states of autoimmunity, was mimicked in vitro by a supernatant obtained from rat peripheral blood monocytes stimulated with phorbol mystistate acetate (PMA)/ionomycin. The application of such inflammatory media on only primary cultured cerebellar granule neurones resulted in significant apoptosis, but the presence of astrocytes largely prevented the effect. The supernatants of the stimulated astrocytes, especially those that contained the highest level of IL-17, achieved the best protection, and this effect could be blocked by anti-IL-17 antibodies. Protein IL-17 inhibited intracellular calcium increase and protected the neurones under inflammatory attack from apoptosis. IL-17, but not interferon (IFN)-γ, in the inflammatory media contributed to astrocyte secretion of IL-17, which depended on the Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathway activation. The astrocytes that were treated with IL-17 alone or with prolonged treatment of the inflammatory media failed to produce sufficient levels of IL-17. Moreover, confirmatory data were obtained in vivo in a monophasic experimental autoimmune uveitis (EAU) in Lewis rats; in this preparation, the high-level IL-17-containing the cytokine milieu was demonstrated, along with IL-17 secretion by the resident neural cells. The antagonism of IL-17 at a late stage disturbed the disease resolution and resulted in significant neural apoptosis. Our data show a dynamic role of IL-17 in the maintenance of homeostasis and neuroprotection in active neuroinflammation.

The relationship of plumage colours with MC1R (Melanocortin 1 Receptor) and ASIP (Agouti Signaling Protein) in Japanese quail (Coturnix coturnix japonica)

1. The relationship of polymorphisms in the Melanocortin 1 Receptor (MC1R) and Agouti Signalling Protein (ASIP) genes with plumage colour in Japanese quail was investigated by cloning and sequencing the entire coding regions from black, white and maroon Japanese quail embryos at 12 d of incubation. 2. Three SNPs were identified in the MC1R coding region by multiple alignment of sequences from individuals with different plumage colours. A missense C/T mutation located at 169 bp within the Open Reading Frame caused a Ile57Val mutation in the amino acid sequence, and had a significant relationship with the black colour. 3. The expression of MC1R was higher in black plumage quails than that in maroon plumage quails, whereas the expression of ASIP was higher in maroon plumage quails than that in black plumage quails. 4. It is concluded that the black plumage colour in Japanese quails may be caused by either increased production of MC1R or decreased production of ASIP.

Screening for intracranial aneurysm in 355 patients with autosomal-dominant polycystic kidney disease

BACKGROUND AND PURPOSE

the association of autosomal-dominant polycystic kidney disease (ADPKD) with intracranial aneurysm (ICAN) is well known but little is known about the characteristics of ICAN in ADPKD. The purpose of this study was to investigate the prevalence and characteristics of ICAN in ADPKD.

METHODS

we screened 355 patients with ADPKD (mean age, 46.5 ± 13.2 years; range, 7 to 87 years) with 3-dimensional time-of-flight MR angiography. Size, location, and morphology of aneurysms were assessed. The prevalence and characteristics of ICAN in patients with ADPKD were evaluated. Patients with ICAN found by MR angiography and moderate renal function subsequently were recommended to undergo digital subtraction angiography for comparison.

RESULTS

the prevalence of ICAN in ADPKD was 12.4% (95% CI, 8.95% to 15.82%) with an equal gender distribution. The prevalence increased as age increased, reaching a peak value of 23.3% (95% CI, 16.85 to 29.75%) in the 60- to 69-year age group. The prevalence of ICAN in patients with ADPKD with a positive family history of hemorrhagic stroke or ICAN was higher than patients with ADPKD lacking such family history (relative risk, 1.968; 95% CI, 1.57 to 2.67). The mean diameter of ICAN was 3.85 ± 3.25 mm. The most frequent site of ICAN was the internal carotid artery. The result of digital subtraction angiography of 15 patients with 18 ICANs and moderate renal function corresponded to the detection of MR angiography.

CONCLUSIONS

the characteristics of ICAN in patients with ADPKD were different from some previous reports. Systematic screening of ICAN with 3-dimensional time-of-flight MR angiography is recommended for patients with ADPKD, particularly for adult patients (≧30 years) or patients with a positive family history of hemorrhagic stroke or ICAN.

Modification of 15-akylidene andrographolide derivatives as alpha-glucosidase inhibitor

15-Alkylidene andrographolide derivatives were specific alpha-glucosidase inhibitors. Semi-synthetic studies of these derivatives led to new alpha-glucosidase inhibitors. Their alpha-glucosidase inhibitory activity was evaluated. Bioactivity results indicated that most of the derivatives were excellent alpha-glucosidase inhibitors. Among them, 6c displayed the best alpha-glucosidase inhibitory bioactivity with an <span lang="EN-US">IC(50) value of 8.3 </span><span lang="EN-US" style="font-size: 10.5pt; font-family: Symbol;">m</span><span lang="EN-US">M.</span>

Rats made congenic for Oia3 on chromosome 10 become susceptible to squalene-induced arthritis

Several quantitative trait loci (QTLs) regulating the risk of experimental arthritis have been identified by genome-wide linkage analyses, but only the MHC has thus far been reported to transfer arthritis susceptibility in congenic animals. We have produced a congenic strain for Oia3, a genetic factor originally identified as an oil-induced arthritis (OIA) QTL in arthritis-prone DA rats. A 46 cM telomeric region of chromosome 10 encompassing Oia3 was transferred from DA rats to MHC-identical but minutely arthritis-susceptible LEW.1AV1 rats by selective breeding. Arthritis development was provoked in Oia3-congenic rats by intradermal injection of different adjuvant oils. One successful arthritis trigger was squalene, which is approved for vaccinations in humans and has been implicated in Gulf War syndrome. The endogenous cholesterol precursor squalene induced T cell infiltration into joints and macroscopic arthritis in Oia3-congenic rats and DA rats, whereas LEW.1AV1 rats were almost resistant. Arthritis onset, approximately 14 days post-injection, coincided with arrested body-weight gain and increased plasma levels of the inflammation markers fibrinogen and alpha 1-acid glycoprotein. Congenic rats displayed intermediate phenotypes compared with the two parental strains, and similar to rheumatoid arthritis in humans, female preponderance was observed in Oia3-congenic rats. Finally, recombinant rat strains were constructed and were used to map a susceptibility gene(s) in females to a telomeric 4--19 cM Oia3 subregion. The experimental system described allows transformation of multifactorial arthritis susceptibility into dichotomous phenotypes.

Effects of AP-V and bicuculline on somatostatin-positive neurons in hypothalamus of rats subjected to acute hypobaric hypoxia

AIM

To investigate the effects of 2-amino-5-phosphonovalerate-pharmacology (AP-V) and bicuculline on somatostatin (SST)-positive neurons in hypothalamus of rats subjected to acute hypobaric hypoxia.

METHODS

SST-immunoreactivity (IR) and somatostatin mRNA (SS mRNA)-positive neurons were measured by immunohistochemistry and in situ hybridization methods.

RESULTS

Compared with control rats, SST-IR and SS mRNA-positive neurons in hypothalamic periventricular nucleus (PeV), paraventricular nucleus (PVN), and arcuate nucleus (ARC) increased after acute hypobaric hypoxia for 6 h (P < 0.01), and these effects were markedly inhibited by AP-V (10 microg, icv), a highly selective N-methyl-D-aspartate (NMDA) receptor antagonist, whereas were strongly enhanced by bicuculline (1.5 mg/kg, ip), a gamma-aminobutyric acid (GABAA) receptor antagonist.

CONCLUSION

SST possibly participates in acute hypoxic reaction in hypothalamus, furthermore, glutamate and GABA can affect somatostatin release and synthesis in hypothalamus through NMDA and GABAA receptors respectively.

Effects of corticotrophin on pain behavior and BDNF, CRF levels in frontal cortex of rats suffering from chronic pain

AIM

To investigate the effects of corticotrophin (Cor) on corticotropin-releasing factor (CRF), brain-derived neurotrophic factor (BDNF), and its functional receptor trkB in the frontal cortex of complete Freud's adjuvant (CFA)-induced arthritic rats.

METHODS

The chronic pain rat model was modified and pain behaviour scores were assessed. BDNF-immunoreactivity (IR), trkB-IR, and CRF mRNA-positive neurons were measured by immunohistochemistry and in situ hybridization methods.

RESULTS

Compared with control rats, pain behavior scores, BDNF-IR, CRF mRNA-positive, trkB-IR, and BDNF/CRF mRNA double-labeling neurons in the contralateral frontal cortex of the arthritic rats increased significantly at 24 h after injection of CFA (P < 0.05), and these effects were decreased markedly by i.p. injection of Cor (P < 0.05). The decrease in pain behavior and BDNF-IR, CRF mRNA levels in frontal cortex of arthritic rats due to Cor were partly prevented by adrenalectomy (ADX).

CONCLUSION

The increment in BDNF and CRF levels in the contralateral frontal cortex of arthritic rats may be inhibited by corticotrophin.

[Relationship between insulin resistance and clustering of risk factors of cerebrovascular disease]

OBJECTIVE

To study the relationship between insulin resistance and clustering of risk factors of cerebrovascular disease.

METHODS

The serum concentrations of fasting glucose, insulin, lipids, the activities of tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor-1(PAI-1), and the level of blood pressure were measured in 159 patients with stroke and 40 healthy control subjects.

RESULTS

All subjects were divided into 4 groups in the light of number of risk factors of cerebrovascular disease. As the number of risk factors increased, the insulin sensitivity index (ISI) in four groups gradually decreased. The ISI in the patients with cerebrovascular disease was negatively associated with increased levels of SBP, DBP, TG, APOB, and PAI-1 activity (P < 0.01) and positively with decreased level of HDL (P < 0.01).

CONCLUSION

Insulin resistance is associated with clustering of risk factors of cerebrovascular disease, the more resistant, the more clustered.

[A genetic epidemiologic study on HBsAg chronic carriers]

375 Individuals from 23 HBsAg positive families were investigated in the study. The results showed that HBsAg carrier rate among blood relatives was significantly higher than non-blood relatives (P < 0.01); HBsAg carrier rate decreased with the order of the first, second and third degree relatives (P < 0.01); and the rate in the individuals living together with the probands was higher than those living apart (P < 0.01). However, the other two markers of HBV infectivity, anti-HBs and anti-HBc, did not show any differences mentioned above. The results analysed by means of dichotomy and Logistic regression model, showed that blood relationship played an important role in HBsAg carrier state. In addition, the history of sharing living facilities was related to HBsAg carrier state. The average heritability in the first, second and third degree relatives was 79.68%. The analysis of genetic model showed that HBsAg carrier state was corresponded to the characteristic of multifactorial genetic disease, excluding the possibility of genetic disease due to single gene.

[Comprehensive evaluation of inheritance and environmental factors in the etiology of primary liver cancer]

A1:1 matched case-control study was carried out in 152 cases with primary liver cancer (PLC) and 152 controls to identify the risk factors associated with it and its cumulative mortality in their second- and third-degree relatives. Results showed cumulative mortality of PLC in the relatives of the cases (0.46%) was significantly higher than that of controls (0.07%). Cumulative mortality of PLC in consanguineous relatives of the cases (0.55%) was significantly higher than that in non-consanguineous ones (0.08%). Cumulative mortality of PLC decreased regularly with family relation (consanguinity) drifting apart. Genetic factors still played an important role independently in the etiology of PLC with multiple regression and stratification analyses studying genetic and environmental factors as a whole. This laid a theoretical basis to study further the association between genetic factors and PLC incidence.

[The use of decision making analysis for evaluating hepatitis B inoculation strategy]

Using quality adjusted life year (QALY) as an evaluation measure of cost-effectiveness for assessing hepatitis B inoculation strategy in China, through the decision tree model. The result showed that for hepatitis B inoculation, priority should be given to neonates and infants aged 0-3 years; and the age of vaccination subjects be extended to, adults older than 25 yrs. The result also indicated: that the net cost for each QALY gained due to vaccination was very high, so that the ultimate control of hepatitis B epidemic not only depended on the development of highly effective and inexpensive vaccine, but also on the improvement of economic level and sanitary status.

Dexamethasone prevents autoimmune nephritis and reduces renal expression of Ia but not costimulatory signals

Although glucocorticoids are a conventional treatment for lupus nephritis, the cellular and molecular mechanisms responsible for preventing renal injury are unknown. MRL-lpr mice develop an aggressive autoimmune nephritis. As these mice become nephritic, there is an increase in the renal expression of molecules that permit or facilitate immune interactions, including MHC class II (Ia) antigens, intercellular adhesion molecule-1 (ICAM-1), and pro-inflammatory cytokines. Because dexamethasone (Dex) alters Ia antigen expression and suppresses cytokine generation, the authors prophylactically treated MRL-lpr mice and investigated the relative importance of these molecules in inducing renal injury. MRL-lpr mice given Dex (0.4 mg/kg/d) from age 6 weeks were killed 4, 8, and 16 weeks after the initiation of therapy, and tissue was removed for histology and extraction of total RNA. Dex prevented lymphadenopathy and renal injury. DEX eliminated the marked Thy 1.2+ lymphocytic infiltrates within the kidney and preserved normal renal histology and urinary protein levels. Northern blot analysis of steady-state mRNA transcripts indicated Dex suppressed a four-fold increase in kidney major histo-compatibility complex class II (Ia) molecule antigen mRNA seen by age 22 weeks (Ia/beta-actin ratios = 0.64 +/- 0.50 versus 2.32 +/- 0.48, P less than 0.01), but did not alter the costimulatory molecules ICAM-1 or tumor necrosis factor alpha (TNF alpha). Although all of these molecules are important mediators of inflammation, autoimmune nephritis was ameliorated without alteration of TNF alpha gene transcription or ICAM-1 transcription and surface expression. This study suggests that the benefit of steroids in nephritis stems from preventing lymphocyte infiltration into the kidney and decreasing immune interactions by limiting Ia expression.

Clustering of genes necessary for hydrogen oxidation in Rhodobacter capsulatus

Three cosmids previously shown to contain information necessary for the expression of uptake of hydrogenase in Rhodobacter capsulatus were found to be present in a cluster on the chromosome. Earlier genetic experiments suggested the presence of at least six genes essential for hydrogenase activity that are now shown to be in a region of approximately 18 kb that includes the structural genes for the enzyme. A potential response regulator gene was sequenced as a part of the hup gene region.

A simple method for the preparation of chromosomal DNA from cell culture

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Hepatitis B surface antigen (HBsAg) in feces of convalescent hepatitis B patients

In 1983, 13 subjects were selected from a factory where an outbreak of viral hepatitis B occurred in October 1982. About 5-7 months later, 13 patients with viral hepatitis B were studied by RPHA and ELISA for HBsAg in feces. Presence of HBsAg was confirmed by specific blocking procedure. HBsAg was found in feces in 69% (9/13) of patients and 30.2% (26/86) of samples collected. 14 fecal specimens found to be positive for HBsAg by RPHA or ELISA examined by immune electron microscopy. Small aggregates of 20-28 nm HBsAg spherical particles were found in three fecal samples. 40-50 nm Dane's-like particles were also observed in one sample. The results suggested that in convalescent period of viral hepatitis B the HBsAg might be excreted through feces.

[Multiple pathogenic factors analysis on primary liver cancer the role of HBV infection combined with other risk factors in the occurrence of PLC]

To assess the roles of some suspected etiological factors in the pathogenic course of primary liver cancer (PLC), a casecontrol and seroepidemiologic study was conducted in 102 cases of PLC patients and two control groups. The result provides further data to support the hypothesis that PLC is closely associated with HBV infection. The study also shows that psychic trauma and habitual drinking may be regarded as the risk factors for PLC. Moreover, it is noticeable that a significant synergic effect is observed when some factors work together. This probably indicates that many other factors also play an important part in the pathogenic course of PLC.

Identification and isolation of genes essential for H2 oxidation in Rhodobacter capsulatus

Mutants of Rhodobacter capsulatus unable to grow photoautotrophically with H2 and CO2 were isolated. Those lacking uptake hydrogenase activity as measured by H2-dependent methylene blue reduction were analyzed genetically and used in complementation studies for the isolation of the wild-type genes. Results of further subcloning and transposon Tn5 mutagenesis suggest the involvement of a minimum of five genes. Hybridization to the 2.2-kilobase-pair SstI fragment that lies within the coding region for the large and small subunits of Bradyrhizobium japonicum uptake hydrogenase showed one region of strong homology among the R. capsulatus fragments isolated, which we interpret to mean that one or both structural genes were among the genes isolated.