Bacterial cellulose-based hydrogel with regulated rehydration and enhanced antibacterial activity for wound healing

Bacterial cellulose (BC) hydrogels are promising medical biomaterials that have been widely used for tissue repair, wound healing and cartilage engineering. However, the high water content of BC hydrogels increases the difficulty of storage and transportation. Moreover, they will lose their original hydrogel structure after dehydration, which severely limits their practical applications. Introducing the bio-based polyelectrolytes is expected to solve this problem. Here, we modified BC and combined it with quaternized chitosan (QCS) via a chemical reaction to obtain a dehydrated dialdehyde bacterial cellulose/quaternized chitosan (DBC/QCS) hydrogel with repeated swelling behavior and good antibacterial properties. The hydrogel can recover the initial state on the macro scale with a swelling ratio over 1000 % and possesses excellent antimicrobial properties against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) with a killing rate of 80.8 % and 81.3 %, respectively. In addition, the hydrogel has excellent biocompatibility, which is conducive to the stretching of L929 cells. After 14 d of in vivo wound modeling in rats, it was found that the hydrogel loaded with pirfenidone (PFD) could promote collagen deposition and accelerate wound healing with scar prevention. This rehydratable hydrogel can be stored and transported under dry conditions, which is promising for practical applications.

Constructing Heptazine-COF@TiO2 Heterojunction Photocatalysts for Efficient Photodegradation of Acetaminophen under Visible Light

Constructing heterojunction photocatalysts are widely applied to boost the photocatalytic activity of materials. Here, a novel covalent organic framework (COF) material with heptazine units was developed and hybridized with TiO2 nano particles (NPs) to fabricate the Heptazine-COF@TiO2 photocatalysts for acetaminophen (AAP) photodegradation. The successfully assembled heptazine unit endows the Heptazine-COF with outstanding semiconductor property (optical bandgap is 2.53 eV). The synthesized Heptazine-COF@TiO2 hybrids is proved to have the heterojunction structure with high visible light activity and fast charge-carrier mobility, and exhibits better performance in photodegradation of AAP under visible light. The excellent photodegradation efficiency (rate constant: 0.758 min-1 ) and high reusability (rate constant: 0.452 min-1 in the 6th  cycles) of the optimized sample outperform the traditional inorganic photocatalysts and other heterojunction photocatalysts. In addition, these photocatalysts present universal degradation activity for other dyes and antibiotics.

Highly Sensitive Fiber Crossbar Sensors Enabled by Second-Order Synergistic Effect of Air Capacitance and Equipotential Body

Fiber crossbars, an emerging electronic device, have become the most promising basic unit for advanced smart textiles. The demand for highly sensitive fiber crossbar sensors (FCSs) in wearable electronics is increased. However, the unique structure of FCSs presents challenges in replicating existing sensitivity enhancement strategies. Aiming at the sensitivity of fiber crossbar sensors, a second-order synergistic strategy is proposed that combines air capacitance and equipotential bodies, resulting in a remarkable sensitivity enhancement of over 20 times for FCSs. This strategy offers a promising avenue for the design and fabrication of FCSs that do not depend on intricate microstructures. Furthermore, the integrative structure of core-sheath fibers ensures a robust interface, leading to a low hysteresis of only 2.33% and exceptional stability. The outstanding capacitive response performance of FCSs allows them to effectively capture weak signals such as pulses and sounds. This capability opens up possibilities for the application of FCSs in personalized health management, as demonstrated by wireless monitoring systems based on pulse signals.

Bacterial cellulose-based film with self-floating hierarchical porous structure for efficient solar-driven interfacial evaporation

Interface solar water evaporation is a mean of rapidly evaporating water using solar energy. However, it is still a challenge to obtain solar evaporators with simple assembly, durability and high photothermal performance. Here, we demonstrated an effective post foaming strategy for treating nitrogen-doped reduced graphene oxide/bacterial cellulose film (F-NRGO@BC) prepared by a simple in situ culture method. The composite film contains hierarchical porous structure and bubbles on the film, achieving an integrated self-floating interface evaporator with excellent light absorption (96.5 %) and high toughness (200.18 kJ m-3). Porous structure and low enthalpy of F-NRGO@BC make a high evaporation rate of 1.68 kg m-2 h-1 and a low thermal conductivity of 0.644 W m-1 K-1 to ensure effective energy efficiency and heat insulation. This design of controlling surface morphology and internal structure provides a novel way for large-scale preparation and high-performance evaporator.

Highly Sensitive Capacitive Fiber Pressure Sensors Enabled by Electrode and Dielectric Layer Regulation

Capacitive pressure sensors play an important role in the field of flexible electronics. Despite significant advances in two-dimensional (2D) soft pressure sensors, one-dimensional (1D) fiber electronics are still struggling. Due to differences in structure, the theoretical research of 2D sensors has difficulty guiding the design of 1D sensors. The multiple response factors of 1D sensors and the capacitive response mechanism have not been explored. Fiber sensors urgently need a tailor-made theoretical research and development path. In this regard, we established a fiber pressure-sensing platform using a coaxial wet spinning process. Aiming at the two problems of the soft electrode modulus and dielectric layer thickness, the conclusions are drawn from three aspects: model analysis, experimental verification, and formula derivation. It makes up some theoretical blanks of capacitive fiber pressure sensors. Through the self-regulation of these two factors without a complex structural design, the sensitivity can be significantly improved. This provides a great reference for the design and development of fiber pressure sensors. Besides, taking advantage of the scalability and easy integration of 1D electronics, multipoint sensors prepared by fibers have verified their application potential in health monitoring, human-machine interface, and motion behavior analysis.

Highly Sensitive Fiber Pressure Sensors over a Wide Pressure Range Enabled by Resistive-Capacitive Hybrid Response

Soft capacitive pressure sensors with high performance are becoming increasingly in demand in the emerging flexible wearable field. While capacitive fiber pressure sensors have achieved high sensitivity, their sensitivity range is limited to low-pressure levels. As fiber sensors typically require preloading and fixation, this narrow range of high sensitivity poses a challenge for practical applications. To overcome this limitation, the study proposes resistive-capacitive hybrid response fiber pressure sensors (HFPSs) with three-layer core-sheath structures. The trigger and sensitivity enhancement mechanisms of the hybrid response are determined through model analysis and experimental verification. By adjustment of the sensitivity enhancement range of the hybrid response, the sensitivity attenuation of HFPSs is alleviated significantly. The obtained results demonstrate that HFPSs have excellent characteristics such as fast response, low hysteresis, wide response frequency, small signal drift, and good durability. The hybrid response enhances the practical sensitivity of HFPSs for various applications. With enhanced sensitivity, HFPSs can effectively monitor pulse signals at preloads ranging from 0 to 22.7 kPa. This wide range of preloads improves the fault tolerance of pulse monitoring and expands the potential application scenarios of fiber pressure sensors.

μPESI-MS/MS System for Screening and Quantitating Drugs in Plasma Samples

Recently, we developed a novel microprobe electrospray ionization (μPESI) source and its coupled MS (μPESI-MS/MS) system. Here, we aimed to widely validate the μPESI-MS/MS method for quantitative analysis of drugs in plasma samples. Furthermore, the relationship between the quantitative performance of the μPESI-MS/MS method and the physicochemical properties of target drugs was analyzed. The μPESI-MS/MS methods for quantitative analysis of 5 representative drugs with a relatively wide range of molecular weight, pK_a, and log P values were developed and validated. The results showed that the linearity, accuracy, and precision of these methods met the requirements of the European Medicines Agency (EMA) guidance. Then a total of 75 drugs from plasma samples were primarily detected using the μPESI-MS/MS methods, among which 48 drugs could be quantitatively measured. Logistics regression suggested that drugs with significantly greater log P and physiological charge had better quantitative performance using the μPESI-MS/MS method. Collectively, these results clearly demonstrate the practical application of the μPESI-MS/MS system as a rapid approach to the quantitative analysis of drugs in plasma samples.

Bacterial cellulose-based hydrogel with antibacterial activity and vascularization for wound healing

Skin wounds need an appropriate wound dressing to help prevent bacterial infection and accelerate wound closure. Bacterial cellulose (BC) with a three-dimensional (3D) network structure is an important commercial dressing. However, how to effectively load antibacterial agents and balance the antibacterial activity is a lingering issue. Herein, this study aims to develop a functional BC hydrogel containing silver-loaded zeolitic imidazolate framework-8 (ZIF-8) antibacterial agent. The tensile strength of the prepared biopolymer dressing is >1 MPa, the swelling property is over 3000 %, the temperature can reach 50 °C in 5 min with near-infrared (NIR) and the release of Ag⁺ and Zn²⁺ is stable. In vitro investigation shows that the hydrogel displays enhanced antibacterial activity, and the bacteria survival ratios are only 0.85 % and 0.39 % against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). In vitro cell experiments present that BC/polydopamine/ZIF-8/Ag (BC/PDA/ZIF-8/Ag) shows satisfactory biocompatibility and promising angiogenic ability. In vivo study, the full-thickness skin defect on rats demonstrates remarkably wound healing ability and accelerated skin re-epithelialization. This work presents a competitive functional dressing with effective antibacterial properties and accelerative angiogenesis activities for wound repair.

[Proposal and thoughts on establishing and improving multi-level dental insurance in China]

Oral diseases are highly prevalent in China, while oral health services are generally underutilized and public health resources are wasted. Lacking oral insurance may be one of the leading causes. The basic medical insurance of China does not cover dental care in most cities, which is worthy to further discuss. To better understand the experience of dental insurance from international dental care practice, the dental coverage scope, content, co-pay ratio, and effects of oral insurance on oral health improvement from the abroad countries with typical health insurance systems were summarized by using scoping review. Then, we discussed the coverage scope for dental health of basic medical insurance and private insurance in China. We also analyzed the current issues of dental care coverage and cost-share. At last, we proposed thoughts and suggestions to establish and improve a multi-level oral health insurance system with Chinese characteristics under the basic medical insurance frame. In particular, we gave suggestions on increasing the coverage for high dental care xpenditure by ebasic medical insurance, supplying children and teenagers with preventive dental care, and encouraging private insurance companies to cover dental care expenditure.

Acrylamide-induced meiotic arrest of spermatocytes in adolescent mice by triggering excessive DNA strand breaks: Potential therapeutic effects of resveratrol

Background: Baked carbohydrate-rich foods are the main source of acrylamide (AA) in the general population and are widely consumed by teenagers. Considering the crucial development of the reproductive system during puberty, the health risks posed by AA in adolescent males have raised public concern.Methods: In this study, we exposed 3-week-old male pubertal mice to AA for 4 weeks to evaluate its effect on spermatogenesis using computer-assisted sperm analysis (CASA) and historical analysis. Flow cytometric analysis and meiocyte spreading assay were conducted to assess meiosis in mice. The expression of meiosis-related proteins and double-strand break (DSB) proteins were evaluated by immunoblot analyses. Additionally, isolated spermatocytes were used to explore the role of resveratrol in AA-induced damages of meiosis.Results: Our results showed that AA decreased the testicular and epididymal indexes, reduced sperm count and motility, and induced morphological disruption of the testes in pubertal mice. Subsequent meiotic analysis revealed that AA increased the proportion of 4C spermatocytes and decreased the proportion of 1C spermatids. The expression levels of meiosis-related proteins (SYCP3, Cyclin A1 and CDK2) were downregulated, and signaling proteins (γH2AX, p-CHK2 and p-ATM) expression levels were upregulated in AA-treated mice testes. Similar expression patterns were observed in primary spermatocytes treated with AA and these effects were reversed significantly by resveratrol.Conclusions: Our results indicate that AA induces meiotic arrest via persistent activation of DSBs, which may contribute to AA-compromised spermatogenesis. Resveratrol could serve as a potential therapeutic agent against AA-induced meiotic toxicity. These data highlight the importance of natural product supplementation for treating AA-related reproductive toxicity.

Resectability of bilobar liver tumours after simultaneous portal and hepatic vein embolization versus portal vein embolization alone: meta-analysis

BACKGROUND

Many patients with bi-lobar liver tumours are not eligible for liver resection due to an insufficient future liver remnant (FLR). To reduce the risk of posthepatectomy liver failure and the primary cause of death, regenerative procedures intent to increase the FLR before surgery. The aim of this systematic review is to provide an overview of the available literature and outcomes on the effectiveness of simultaneous portal and hepatic vein embolization (PVE/HVE) versus portal vein embolization (PVE) alone.

METHODS

A systematic literature search was conducted in PubMed, Web of Science, and Embase up to September 2022. The primary outcome was resectability and the secondary outcome was the FLR volume increase.

RESULTS

Eight studies comparing PVE/HVE with PVE and six retrospective PVE/HVE case series were included. Pooled resectability within the comparative studies was 75 per cent in the PVE group (n = 252) versus 87 per cent in the PVE/HVE group (n = 166, OR 1.92 (95% c.i., 1.13-3.25)) favouring PVE/HVE (P = 0.015). After PVE, FLR hypertrophy between 12 per cent and 48 per cent (after a median of 21-30 days) was observed, whereas growth between 36 per cent and 67 per cent was reported after PVE/HVE (after a median of 17-31 days). In the comparative studies, 90-day primary cause of death was similar between groups (2.5 per cent after PVE versus 2.2 per cent after PVE/HVE), but a higher 90-day primary cause of death was reported in single-arm PVE/HVE cohort studies (6.9 per cent, 12 of 175 patients).

CONCLUSION

Based on moderate/weak evidence, PVE/HVE seems to increase resectability of bi-lobar liver tumours with a comparable safety profile. Additionally, PVE/HVE resulted in faster and more pronounced hypertrophy compared with PVE alone.

The economic impact of porcine reproductive and respiratory syndrome outbreak in four Chinese farms: Based on cost and revenue analysis

The economic impact after the outbreak of porcine reproductive and respiratory syndrome (PRRS) has been proven to be tremendous for pig production worldwide. However, the economic impact of the disease is not well understood in China. In our previous study, we acquired and analyzed the main production data (the number of weaned piglets, health costs, delayed marketing age, etc.) from the management system before and after the PRRS outbreaks occurring in November 2014, March 2015, December 2016, and February 2017. This study aimed to analyze and quantify the economic losses of the four PRRS outbreaks in Chinese herds. A straightforward approach was used to calculate additional costs and decreased revenues based on the PRRS-induced production deficiencies by average cost-of-production indices calculated from annual estimates of costs between 2014 and 2017. The results showed that economic losses varied between ¥668.14 and ¥1004.43 per sow in breeding herds from the outbreaks to regain the basic performance, with an average of ¥822.75 per sow, and the mean costs in the fattening herds (including nursery pigs) were ¥601.62 per sow, ranging from ¥318.64 to ¥937.14. Overall, the economic impact of PRRS on the whole herd was ¥1424.37 per sow. The majority of the losses were due to the reduction in the number of weaned piglets for breeding herds, and the increased feed cost (occupying 44.88%) was the primary source of loss for fattening herds. Our study fills the gap in knowledge of PRRS economics in China, enriches the data for veterinary economics, and re-stresses the necessity for producers and veterinarians to control PRRS effectively.

Anti-Fouling, Adhesive Polyzwitterionic Hydrogel Electrodes Toughened Using a Tannic Acid Nanoflower

Conductive polyzwitterionic hydrogels with good adhesion properties show potential prospect in implantable electrodes and electronic devices. Adhesive property of polyzwitterionic hydrogels in humid environments can be improved by the introduction of catechol groups. However, common catechol modifiers can usually quench free radicals, resulting in a contradiction between long-term tissue adhesion and hydrogel toughness. By adding tannic acid (TA) to the dispersion of clay nanosheets and nanofibers, we designed TA-coated nanoflowers and nanofibers as the reinforcing phase to prepare polyzwitterionic hydrogels with adhesion properties. The hydrogel combines the mussel-like and zwitterionic co-adhesive mechanism to maintain long-term adhesion in underwater environments. In particular, the noncovalent cross-linking provided by the nanoflower structure effectively compensates for the defects caused by free-radical quenching so that the hydrogel obtained a high stretchability of over 2900% and a toughness of 1.16 J/m³. The hydrogel also has excellent anti-biofouling property and shows resistance to bacteria and cells. In addition, the hydrogel possesses a low modulus (<10 kPa) and ionic conductivity (0.25 S/m), making it an ideal material for the preparation of implantable electrodes.

Dragon 1 Protocol Manuscript: Training, Accreditation, Implementation and Safety Evaluation of Portal and Hepatic Vein Embolization (PVE/HVE) to Accelerate Future Liver Remnant (FLR) Hypertrophy

STUDY PURPOSE

The DRAGON 1 trial aims to assess training, implementation, safety and feasibility of combined portal- and hepatic-vein embolization (PVE/HVE) to accelerate future liver remnant (FLR) hypertrophy in patients with borderline resectable colorectal cancer liver metastases.

METHODS

The DRAGON 1 trial is a worldwide multicenter prospective single arm trial. The primary endpoint is a composite of the safety of PVE/HVE, 90-day mortality, and one year accrual monitoring of each participating center. Secondary endpoints include: feasibility of resection, the used PVE and HVE techniques, FLR-hypertrophy, liver function (subset of centers), overall survival, and disease-free survival. All complications after the PVE/HVE procedure are documented. Liver volumes will be measured at week 1 and if applicable at week 3 and 6 after PVE/HVE and follow-up visits will be held at 1, 3, 6, and 12 months after the resection.

RESULTS

Not applicable.

CONCLUSION

DRAGON 1 is a prospective trial to assess the safety and feasibility of PVE/HVE. Participating study centers will be trained, and procedures standardized using Work Instructions (WI) to prepare for the DRAGON 2 randomized controlled trial. Outcomes should reveal the accrual potential of centers, safety profile of combined PVE/HVE and the effect of FLR-hypertrophy induction by PVE/HVE in patients with CRLM and a small FLR.

TRIAL REGISTRATION

Clinicaltrials.gov: NCT04272931 (February 17, 2020). Toestingonline.nl: NL71535.068.19 (September 20, 2019).

Crack-Based Core-Sheath Fiber Strain Sensors with an Ultralow Detection Limit and an Ultrawide Working Range

With the booming development of flexible wearable sensing devices, flexible stretchable strain sensors with crack structure and high sensitivity have been widely concerned. However, the narrow sensing range has been hindering the development of crack-based strain sensors. In addition, the existence of the crack structure may reduce the interface compatibility between the elastic matrix and the sensing material. Herein, to overcome these problems, integrated core-sheath fibers were prepared by coaxial wet spinning with partially added carbon nanotube sensing materials in thermoplastic polyurethane elastic materials. Due to the superior interface compatibility and the change in the conductive path during stretching, the fiber strain sensor exhibits excellent durability (5000 tensile cycles), high sensitivity (>10⁴), large stretchability (500%), a low detection limit (0.01%), and a fast response time of ∼60 ms. Based on these outstanding strain sensing performances, the fiber sensor is demonstrated to detect subtle strain changes (e.g., pulse wave and swallowing) and large strain changes (e.g., finger joint and wrist movement) in real time. Moreover, the fabric sensor woven with the core-sheath fibers has an excellent performance in wrist bending angle detection, and the smart gloves based on the fabric sensors also show exceptional recognition ability as a wireless sign language translation device. This integrated strategy may provide prospective opportunities to develop highly sensitive strain sensors with durable deformation and a wide detection range.

Production Performance of Four Pig Herds Infected With Porcine Reproductive and Respiratory Syndrome Using the “Load-Close-Exposure” Approach in China

Porcine reproductive and respiratory syndrome (PRRS) is one of the most important swine diseases causing enormous losses to pig producers all over the world. The intervention measure of “load-close-exposure” [interrupting the introduction of replacement pigs combined with whole-herd exposure to live PRRS virus (PRRSV)] has been widely used in North America and has shown wonderful outcomes in controlling PRRS in the field. In the present study, we performed analyses of the production performance of four herds acutely infected with PRRSV by adopting this measure for the first time in China. Our results showed that the development rate of gilts decreased by a mean of 8.56%, the farrowing rate of breeding sows decreased from 86.18 to 77.61%, the number of piglets born alive per sow decreased by a mean of 0.73 pigs, and the pre-weaning and post-weaning mortality of piglets increased by a mean of 2.74–4.97% compared to the parameters of 6 months before an outbreak. The time to PRRSV stability (TTS), defined as the time in weeks it took to produce PRRSV-negative pigs at weaning, is an important indicator of successful control of PRRSV. The median TTS among herds A, C, and D was 21.8 weeks (21.6 22.1 weeks). In herd B, TTS was 42.3 weeks, which could be explained by the double introduction of gilts. Our study suggests that the “load-close-exposure” strategy may be a good alternative for Chinese producers and veterinaries to control PRRS in the field.

Long-Term Genome Monitoring Retraces the Evolution of Novel Emerging Porcine Reproductive and Respiratory Syndrome Viruses

Porcine reproductive and respiratory syndrome virus (PRRSV) causes tremendous economic losses to the swine industry worldwide. In China, novel PRRSVs have frequently emerged in recent years, but the evolutionary relationship among these viruses has remained unclear. In the present study, a 4-year PRRSV genome-monitoring study was performed on samples from a pig farm. We observed that NADC30-like PRRSVs with higher mutation rates replaced HP-PRRSVs as the epidemic strains. We monitored the variation in the same PRRSV strain evolved in a pig herd over 2 years and observed that the low genomic similarity of NADC30-like PRRSVs results from rapid mutation. We also showed that recombination events between NADC30-like and QYYZ-like PRRSVs resulted in the complex recombination patterns of PRRSVs, which have formed gradually over time. Furthermore, recombination of the same strain can occur at different locations and increase the diversity of recombination events. Overall, these findings interpret the evolutionary patterns of novel and emerging PRRSVs, information that is crucial for PRRSV control.

[Prevalence and frequencies of human papilloma virus types in adenocarcinoma in situ of the uterine cervix]

Objective: To examine the prevalence and frequencies of human papillomavirus (HPV) genotypes in cervical adenocarcinoma in situ (AIS). Methods: The cases of cervical AIS with concurrent tests of cytology and HPV typing from January 2007 to February 2020 in the Obstetrics and Gynecology Hospital of Fudan University were collected and analyzed. Results: A total of 478 cases of cervical AIS were obtained. The average age of the patients was 39.4 years (range, 19-81 years). The largest age group was 30-39 years (44.8%), followed by 40-49 years (34.7%). Among the 478 patients, 355 underwent high-risk HPV (hrHPV) testing and had a hrHPV-positive rate of 93.8%. Of the 355 patients, 277 also underwent HPV typing and were mostly positive for either or both HPV16 and HPV18 (93.1%), with 55.6% positive for HPV18 and 48.7% positive for HPV16. Among the 478 cases, 266 cases (55.6%) were diagnosed with both AIS and squamous intraepithelial lesion (SIL), while 212 cases (44.4%) were diagnosed with only AIS. Patients infected with HPV16 in the AIS and SIL group significantly outnumbered those in the AIS alone group (P<0.05). Moreover, the rate of positive cytology was 55.9% (167/299 cases), while that of negative cytology was 44.1% (132/299). Among the 109 patients with negative cytology results and co-tested hrHPV, there were 101 HPV-positive cases (92.7%), of which 88 cases were subject to HPV typing and showed an HPV16/18 positive rate of 94.3% (83/88 cases). Conclusions: The combination of HPV typing and cytological screening can maximize the detection rate of cervical AIS, and should continue to be utilized, ideally on a larger scale, in the future.

Hierarchically Designed Three-Dimensional Composite Structure on a Cellulose-Based Solar Steam Generator

The emerging water purification technology represented by solar water evaporation has developed rapidly in recent years and is widely used in seawater desalination. However, the high reflectivity of sunlight and low efficiency of photothermal conversion greatly hinder its application prospects. In this paper, the hierarchical structure of the film was designed and optimized by the addition of carbon materials in the process of bacterial cellulose culture. A cellulose-based composite film material with a microporous structure was obtained, which can improve the photothermal evaporation rate and photothermal conversion efficiency from the structural principle to improve the stability of floating on the water. Bacterial cellulose (BC) as a three-dimensional carrier was combined with one-dimensional and two-dimensional (1D/2D) compounds of carbon nanotubes (CNT) and reduced graphene oxide (RGO) to form composite films for solar evaporation. By the addition of CNT-RGO (21.8 wt %), the composite showed prominent photothermal evaporation rate and photothermal conversion efficiency properties. Through in situ culture of BC, not only a tight structure can be obtained but also the surface of BC contains a large number of hydroxyl groups, which have many active sites to load photothermal materials. BC nanofibers, CNT, and RGO cooperate to form a porous network structure, which provides continuous double channels for the rapid transmission of water molecules and light paths, so as to form an excellent photothermal layer. The photothermal conversion efficiency is 90.2%, and the photothermal evaporation rate is 1.85 kg m^-2 h^-1 to achieve efficient solar interface evaporation. This is a high level of photothermal properties in a cellulose-based solar steam generator. The superior photothermal performance of this hybrid film possesses scalability and desalination ability.

Transcription Factor Specificity Protein 1 Regulates Inflammation and Fibrin Deposition in Nasal Polyps Via the Regulation of microRNA-125b and the Wnt/β-catenin Signaling Pathway

Nasal polyps (NPs) are multifactorial soft growths inside the nasal passages and are associated with chronic inflammation that originate from the nasal and paranasal sinus mucosae. This study focused on the role of microRNA (miR)-125b and the molecules associated with NP development. Differentially expressed miRNAs between nasal tissues from patients with chronic rhinosinusitis (CRS) with NP (CRSwNP) and CRS without NP (CRSsNP) were screened using microarray analysis. A murine model of CRSwNP was established. The expression of miR-125b in murine tissues was examined using reverse transcription quantitative polymerase chain reaction. Candidate upstream regulators of miR-125b were predicted using bioinformatics tools, and the binding relationship between specificity protein 1 (Sp1) and miR-125b was validated using luciferase and chromatin immunoprecipitation assays. Altered expression of Sp1 and miR-125b was induced to evaluate their relevance to the progression of NPs. miR-125b expression was significantly upregulated in NP tissues from patients with CRSwNP. Sp1 was confirmed as an upstream regulator that promotes miR-125b transcription in NPs. Overexpression of Sp1 reduced levels of d-dimer (an indicator of fibrinogen degradation products) and tissue-type plasminogen activator (t-PA) but increased eosinophil cationic protein and peroxidase levels, as well as the levels of inflammatory factors interleukin-5 (IL-5) and IL-8 in murine NP tissues. However, these trends were reversed after miR-125b downregulation. Sp1 and miR-125b were found to activate the Wnt/β-catenin signaling pathway in NPs. This study demonstrated that Sp1, an upstream transcription factor of miR-125b, accumulates on the miR-125b promoter to activate its transcription, which induces inflammation and fibrin deposition in NP by activating the Wnt/β-catenin axis.

Effects of Preoperative Pyloric Stenosis on Outcomes and Nutritional Status in 73 Patients Following Curative Gastrectomy for Gastric Cancer: A Retrospective Study from a Single Center

Background

The aim of this study was to explore the potential impact of pyloric stenosis (PS) on the nutritional status, the incidence of postoperative complications, and the long-term prognosis of distal gastric cancer (GC) patients after curative resection.

Material/Methods

We retrospectively analyzed the data of 343 GC patients who underwent curative gastrectomy for gastric cancer between January 2010 and December 2013. All patients were divided into 2 groups according to the status of PS. Their clinical and pathological features, nutritional indicators, and incidence of postoperative complications were compared and potential prognostic factors were analyzed using the propensity score matching analysis (PSM).

Results

Seventy-four (21.6%) patients had PS. Patients with PS had worse survival outcomes than those without PS (χ²=21.369, P<0.001). Multivariate survival analysis demonstrated that PS, depth of invasion, and lymph node metastasis (all P<0.05) were the independent predictors of overall survival (OS). Patients with PS had significantly higher lymph node metastasis in No. 3, 4sb, 4d, 6, 8a, 9, and 14v lymph nodes. Patients with PS had significantly lower preoperative BMI, more weight loss, and lower prealbumin than those without PS. There were no significant differences between the 2 groups in postoperative complications, morbidity, or mortality.

Conclusions

Distal GC patients with PS have poor clinicopathological and nutritional status and poor prognosis. However, PS does not increase surgery-related morbidity and mortality.

Therapeutic analysis of Herbert screw fixation for capitellar fractures via the anterior approach in adolescent patients

Objective

The aim of this study is to analyze the efficacy of open reduction and Herbert screw fixation for coronal fractures of the capitellum via the anterior approach in adolescents.

Methods

We retrospectively analyzed the clinical and imaging data of 15 adolescents with capitellar fractures who were admitted to our hospital from May 2014 to May 2019. The fracture was reduced through the cubital crease incision via the anterior approach and was internally fixated with Herbert screws. A follow-up was conducted after the operation to examine fracture healing and elbow function. The postoperative functional recovery of patients was evaluated with the Mayo Elbow Performance index (MEPI) and the Broberg-Morrey rating system.

Results

Patients underwent surgery 3.7 days after injury on average. Intraoperative fracture reduction was satisfactory. No vascular injury or nerve injury occurred. Bony union occurred in an average of 6 weeks after the operation. All adolescents completed a 12- to 36-month follow-up. At the last follow-up, the Mayo Elbow Performance index was considered excellent in 12 patients and good in three patients. The Broberg-Morrey score was considered excellent in 12 patients, good in two patients, and fair in one patient.

Conclusion

Open reduction with Herbert screw fixation via the anterior approach is a feasible surgical method for the treatment of coronal fractures of the capitellum in adolescents.

Levels of evidence

Therapeutic, retrospective study-Level IV

The protective effect of hesperidin against renal ischemia-reperfusion injury involves the TLR-4/NF-κB/iNOS pathway in rats

Renal injury is reported to have a high mortality rate. Additionally, there are several limitations to current conventional treatments that are used to manage it. This study evaluated the protective effect of hesperidin against ischemia/reperfusion (I/R)-induced kidney injury in rats. Renal injury was induced by generating I/R in kidney tissues. Rats were then treated with hesperidin at a dose of 10 or 20 mg/kg intravenously 1 day after surgery for a period of 14 days. The effect of hesperidin on renal function, serum mediators of inflammation, and levels of oxidative stress in renal tissues were observed in rat kidney tissues after I/R-induced kidney injury. Moreover, protein expression and mRNA expression in kidney tissues were determined using Western blotting and RT-PCR. Hematoxylin and eosin (H&E) staining was done for histopathological observation of kidney tissues. The data suggest that the levels of blood urea nitrogen (BUN) and creatinine in the serum of hesperidin-treated rats were lower than in the I/R group. Treatment with hesperidin also ameliorated the altered level of inflammatory mediators and oxidative stress in I/R-induced renal-injured rats. The expression of p-IκBα, caspase-3, NF-κB p65, Toll-like receptor 4 (TLR-4) protein, TLR-4 mRNA, and inducible nitric oxide synthase (iNOS) was significantly reduced in the renal tissues of hesperidin-treated rats. Histopathological findings also revealed that treatment with hesperidin attenuated the renal injury in I/R kidney-injured rats. In conclusion, our results suggest that hesperidin protects against renal injury induced by I/R by involving TLR-4/NF-κB/iNOS signaling.

[Clinical application of single-port inflatable endoscopic nipple sparing mastectomy with immediate reconstruction using prosthesis implantation]

Objective: To examine the clinical application value of single-port inflatable endoscopic nipple sparing mastectomy with immediate reconstruction using prosthesis implantation in the treatment of early breast cancer. Methods: From February 2014 to July 2019, the clinic-pathological data of 34 early breast cancer patients received single-port inflatable endoscopic nipple sparing mastectomy with immediate reconstruction using prosthesis implantation at Department of General Surgery, Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed and followed up. All the patients were female, with an age of 46(11) years (M(Q_R)) (range: 26 to 64 years). The radical cure degree of operation, cosmetic effect after operation were evaluated. The satisfaction to operation and personal quality of life after operation was accessed by BREAST-Q scale. Results: All surgical procedures were successfully completed. The operation time was (313.4±11.7) minutes (range: 200 to 485 minutes). The blooding-liquid was (33.8±3.3) ml (range: 10 to 100 ml). There were 5 cases (14.7%) of nipple areola necrosis after operation, of which 1 patient received taking the prosthesis out because of prosthesis exposure. There was no capsular contracture or postoperative bleeding case. The follow-up time was 35(17) months (range: 12 to 77 months), and there was one case suffering local recurrence and metastasis, and another suffering metastasis. The scores of postoperative breast satisfaction, psychosocial status, chest wall status and sexual health were 78.32±2.57 (range: 55 to 100), 89.12±2.30 (range: 82 to 100), 91.47±1.33 (range: 43 to 100), and 78.50±2.68 (range: 39 to 100). Conclusion: Single-port inflatable endoscopic nipple sparing mastectomy with immediate reconstruction using prosthesis implantation in the treatment of early breast cancer can achieve provided curative and cosmetic effect on patients with breast cancer, with good patients' postoperative quality of life and satisfaction.

A Bulk-Heterostructure Nanocomposite Electrolyte of Ce0.8Sm0.2O2-δ-SrTiO3 for Low-Temperature Solid Oxide Fuel Cells

Since colossal ionic conductivity was detected in the planar heterostructures consisting of fluorite and perovskite, heterostructures have drawn great research interest as potential electrolytes for solid oxide fuel cells (SOFCs). However, so far, the practical uses of such promising material have failed to materialize in SOFCs due to the short circuit risk caused by SrTiO₃. In this study, a series of fluorite/perovskite heterostructures made of Sm-doped CeO₂ and SrTiO₃ (SDC-STO) are developed in a new bulk-heterostructure form and evaluated as electrolytes. The prepared cells exhibit a peak power density of 892 mW cm^-2 along with open circuit voltage of 1.1 V at 550 °C for the optimal composition of 4SDC-6STO. Further electrical studies reveal a high ionic conductivity of 0.05-0.14 S cm^-1 at 450-550 °C, which shows remarkable enhancement compared to that of simplex SDC. Via AC impedance analysis, it has been shown that the small grain-boundary and electrode polarization resistances play the major roles in resulting in the superior performance. Furthermore, a Schottky junction effect is proposed by considering the work functions and electronic affinities to interpret the avoidance of short circuit in the SDC-STO cell. Our findings thus indicate a new insight to design electrolytes for low-temperature SOFCs.

Magnetic transfection with superparamagnetic chitosan-loaded IGFBP5 nanoparticles and their in vitro biosafety

We prepared the superparamagnetic chitosan nanoparticles (SPCIONPs) to study the application of them as gene vectors using a magnetic transfection system for the targeted treatment of lung metastasis of osteosarcoma. The SPCIONPs were characterized by transmission electron microscopy, Fourier transform infrared spectrometry, superconducting quantum interference device and atomic force microscopy. Their biosafety was determined by cell counting kit-8 (CCK8) and live-dead staining assays. The transfection in vitro was detected by laser confocal microscopy. SPCIONPs, which can bind closely to plasmids and protect them from DNA enzyme degradation, were prepared with an average particle size of approximately 22 nm and zeta potential of 11.3 mV. The results of the CCK8 and live-dead staining assays showed that superparamagnetic chitosan nanoparticles loaded with insulin-like growth factor-binding protein 5 (SPCIONPs/pIGFBP5) induced no significant cytotoxicity compared to the control group. The result of transfection in vitro suggested that pIGFBP5 emitted a greater amount of red fluorescence in the SPCIONPs/pIGFBP5 group than that in the chitosan-loaded IGFBP5 (CS/pIGFBP5) group. In conclusion, the prepared SPCIONPs had good biosafety and could be effectively used to transfer pIGFBP5 into 143B cells, and they thus have good application prospects for the treatment of lung metastasis of osteosarcoma.

Closed Reduction and Percutaneous Pinning in the Treatment of Humeral Distal Metaphyseal-Diaphyseal Junction Fractures in Children: A Technique Note and Preliminary Results

Objective: The metaphyseal-diaphyseal junction (MDJ) fracture is an uncommon but problematic type of fracture occurring at the distal humerus in children. Closed reduction and fixation are challenging and may not be possible with the conventional reduction maneuver utilized in supracondylar fractures. The purpose of this study was to evaluate a novel closed reduction and percutaneous pinning (CRPP) technique for the treatment of these fractures. Methods: We retrospectively evaluated 14 children (8 boys and 6 girls) who underwent closed reduction and percutaneous fixation for the treatment of MDJ fractures. Six children who underwent treatment with a novel CRPP technique were enrolled as Group A. Eight children underwent the conventional reduction maneuver utilized in supracondylar fracture and were enrolled as Group B. Clinical and radiographic outcomes in the two groups were then compared. Results: In Group A, all six MDJ fractures were treated successfully with the novel CRPP technique without the need for open procedures or re-operation. No complications such as pin-site infection or iatrogenic nerve injury were found in this group. In group B, five of the eight fractures were treated successfully with the conventional CRPP technique; three fractures needed open reduction, and one of them had further surgery because of the loss of fixation. Children with successful CRPP in each group were included to compare the efficacy of the novel CRPP technique. The average duration of the surgery in Group A was significantly shorter than that in Group B (p < 0.001). At last follow-up, both groups obtained satisfactory clinical and radiographic outcomes. Conclusion: MDJ fractures can be reduced successfully and fixed stably via a novel CRPP technique, and laborious and frustrating attempts at closed reduction and further open reduction can be avoided.

Whole genome expression microarray reveals novel roles for Kif4 in monocyte/macrophage cells

OBJECTIVE

Kinesin superfamily member 4 (Kif4), a conventional kinesin, is a microtubule-dependent molecular motor. The active movement of Kif4 participates in several cellular functions, including DNA repair, mitosis, the transport of macromolecules, survival of neurons and even tumorigenesis and progression. However, the role of Kif4 in monocyte/macrophage cells has not been reported. Our work aimed to increase understanding and further investigations of Kif4 in monocyte/macrophage cells.

MATERIALS AND METHODS

RAW264.7 cells were transfected with Kif4 small interfering RNA (siRNA), and whole genome expression microarray analysis was employed to analyze gene expression after cells treatment with or without Kif4 siRNA.

RESULTS

Our data found multiple differentially expressed genes which were enriched in the top 5 biological processes about innate immune response, immune response, response to interferon-beta, immune system process and cellular response to interferon-beta. 23 most significant pathways had been identified and enriched pathways indicated enrichment in peroxisome, lysosome, fatty acid metabolism, cell adhesion molecules and so on.

CONCLUSIONS

Our work may help understand the roles of Kif4 in monocyte/macrophage cells and would give useful information on basic research and the function of monocyte/macrophage cells.

Efficacy of closed reduction for developmental dysplasia of the hip: midterm outcomes and risk factors associated with treatment failure and avascular necrosis

BACKGROUND

The purpose of this study was to evaluate the efficacy of closed reduction (CR) in the treatment of developmental dysplasia of the hip (DDH) and to investigate risk factors associated with CR failure and avascular necrosis (AVN) occurrence in follow-ups.

METHODS

The study retrospectively included 110 patients and 138 hips with DDH diagnosis that underwent closed reduction between February 2012 and November 2015 in our single tertiary medical institution. The failure rate of CR and the underlying risk factors were evaluated. Meanwhile, the incidence of AVN and the related risk factors among the successful CR cases were assessed.

RESULTS

The overall failure rate of DDH treated by CR in the present study was 31.16% (43/138). Risk factors for the CR failure were older age at the time of CR (≥ 18.35 month), large medical interval before CR (≥ 35.35 mm), and severer dislocation of the affected hip (IDHI grades III and IV). The incidence of AVN was 8.33% (6/72) in patients with successful CR at the last follow-up. No significant risk factors had been established in the present study that associated with the AVN occurrence.

CONCLUSIONS

For the treatment of DDH with CR, patients with younger age might achieve better outcomes; early diagnosis and early treatment might be the key point in the DDH treatment.

Ultrasonography-guided closed reduction in the treatment of displaced transphyseal fracture of the distal humerus

Background

To evaluate the clinical and radiographic outcomes of ultrasonography-guided closed reduction in the treatment of displaced transphyseal fracture of the distal humerus (TFDH).

Methods

Twenty-seven patients with displaced TFDH were successfully treated by the ultrasonography-guided closed reduction during January 2012 to December 2016 and were retrospectively reviewed. After the mean follow-up of 34.88 months, the clinical and radiographic outcomes of patients were evaluated. The cubitus varus of the affected elbows was also assessed at the latest follow-up.

Results

The successful rate of ultrasonography-guided closed reduction in the treatment of displaced TFDH was 84% (27/32). The twenty-seven patients with successful reduction were included for the following analysis. There were 20 males and 7 females included in the study, and the mean age at treatment was 15.39 ± 3.10 months; seventeen fractures occurred in the right side elbow and ten in the left side. At the last follow-up, there were significant decreases in the elbow flexion (3°, P = 0.027) and range of motion (5°, P = 0.003) between the injured and uninjured elbow, respectively, whereas no difference in elbow extension was detected (P = 0.110). Flynn’s criteria assessment showed that all the patients achieved excellent or good outcomes both in the functional and cosmetic categories. The clinical and radiographic carrying angles at the last follow-up were 11.67 ± 3.11° and 10.46 ± 3.88°, respectively. And the incidence of cubitus varus after treatment was 7.4% at the last follow-up.

Conclusion

The ultrasonography-guided closed reduction in the treatment of displaced TFDH is an effective procedure; the adequate fracture reduction can be acquired with the advantages of real-time, non-radioactive, and simple utilization. With the percutaneous pining fixation, satisfactory clinical and radiographic outcomes can be achieved with a low incidence of postoperative cubitus varus.

Fasciotomy through multiple small skin incisions for the treatment of early acute osteofascial compartment syndrome in children

BACKGROUND

The purpose of the present study is to investigate the therapeutic effect of fasciotomy through multiple small skin incisions for the treatment of early osteofascial compartment syndrome in children.

METHODS

From January 2009 to May 2017, 56 pediatric patients with early osteofascial compartment syndrome in their limbs were admitted into our department and treated with multiple small skin incisions for decompression at the early stage. The skin incisions, function, and sensation of the limbs were followed up.

RESULTS

The osteofascial compartment syndrome was diagnosed at 7.4 ± 2.1 h after injury, and then fasciotomy was performed at 1.4 ± 0.4 h later. The average procedure time of fasciotomy was 12.7 ± 4.8 min. No postoperative incision infections or neurovascular injuries were observed in all the patients. The incisions completely healed in 7-10 days with an average healing time of 8 days without secondary suture. The patients were followed up for an average of 5.1 years. No Volkmann's contractures in the injured limbs were found. The appearance, electromyography, and nerve conduction velocity of the affected limbs were not significantly different from that of the contralateral limbs. All the patients were free of symptoms and were fully recovered of sensation and function, being an "excellent" outcome at the latest follow-up.

CONCLUSION

Fasciotomy through multiple small skin incisions, which can be useful to decompress the compartment pressure with fewer complications, is a simple and effective strategy for the treatment of early osteofascial compartment syndrome in children.

Correction to: Evolutionary and recombination analysis of porcine reproductive and respiratory syndrome isolates in China

The original version of this article unfortunately contained an error in GenBank Accession Number.

Signal Drift in Liquid Chromatography Tandem Mass Spectrometry and Its Internal Standard Calibration Strategy for Quantitative Analysis

The present project studied the signal drift in liquid chromatography tandem mass spectrometry (LC-MS/MS) and proposed a strategy for compensating such drift. In the study, four 4-component groups were repeatedly run on different LC-MS/MS systems for over 12 h to investigate the dependence of signal drift on time and hardware systems. The 4-component groups each consisted of (1) an analyte, (2) a stable isotope labeled analyte, (3) a compound with similar structure to the analyte, and (4) a compound with dissimilar structure. All of the species showed significant signal drift, generally more than 25% over 12 h. The analyte and its stable isotope labeled analog always have the same drifting pattern including the trends and direction from one LC-MS/MS system to another. Signal drift was also found to be concentration dependent. Our experiments further proved that a conventional stable isotope labeled internal standard in LC-MS/MS quantification would not compensate the variations caused by concentration-dependent signal drift. An ideal internal standard for LC-MS/MS has both identical structure and similar concentration to the analyte. For that, we proposed a new internal standard strategy, pseudo internal standard (Pseudo IS), for LC-MS/MS quantification. Pseudo IS could effectively compensate signal drift in spite of its significant time, system, and concentration dependencies.

RNA interference-mediated knockdown of the transcription factor Krüppel homologue 1 suppresses vitellogenesis in Chilo suppressalis

Vitellogenesis in holometabolous insects involves the production and secretion of vitellogenin (Vg) and other yolk protein precursors in developing oocyte by the fat body, all of which is predominantly orchestrated by juvenile hormone (JH). Krüppel homologue 1 (Kr-h1) is a zinc finger transcription factor that has been demonstrated to be a JH-early inducible gene and to contribute to reproduction. However, the exact molecular function of Kr-h1 in insect reproduction is poorly understood. In the current study, we used the notorious pest Chilo suppressalis as a model system to investigate the role of Kr-h1 in female reproduction. Cloning and sequencing C. suppressalis Kr-h1 revealed that it shares high identity with its homologues from other lepidopteran insects. Moreover, RNA interference-mediated knockdown of CsKr-h1 substantially reduced the transcription of Vg in the fat body, dramatically decreased yolk protein deposition and also impaired oocyte maturation and ovarian development, indicating that Kr-h1 is indispensable for normal vitellogenesis in C. suppressalis. Based on these results, we conclude that Kr-h1 is crucial to reproduction in insects and that targeting this gene could potentially be a new way to suppress rice pests.

Evolutionary and recombination analysis of porcine reproductive and respiratory syndrome isolates in China

Seven strains of porcine reproductive and respiratory syndrome virus (PRRSV) were isolated from 2014 to 2017 in the Shandong province of China and their genomes were sequenced and analyzed. Results showed that all seven of the isolates belong to PRRSV 2, and are clustered into four lineages (lineage 1, 3, 5 and 8) based on comparisons of the ORF5 gene. Comparative analysis of genomes and specific amino acid sites revealed that three of the strains (SDwh1402, SDwh1602 and SDwh1701) have evolved directly from modified live virus (MLV) JXA1-P80, TJM-F92 and IngelvacPRRS. Further recombination analysis revealed that two of the strains (SDyt1401 and SDwh1601) were the result of a recombination event between MLVs JXA1-P80 and NADC30 while two other strains (SDwh1403 and SDqd1501) were the result of recombination between MLVs IngelvacPRRS and NADC30 and HP-PRRSV and QYYZ, respectively. Our results add to the data on MLV evolution and PRRSV recombination and provide a better understanding of the epidemiology of PRRSV in China.

Molecular cloning, characterisation, and expression analysis of adipocyte fatty acid binding protein gene in Xupu goose (Anser cygnoides domesticus)

1. Adipocyte fatty acid binding protein (A-FABP) plays a key role in fatty acid uptake and intracellular transport. The objective of the present study was to identify and characterise the A-FABP gene in Xupu goose.2. The full-length cDNA of goose A-FABP gene was cloned from the liver tissue using reverse transcription polymerase chain reaction (RT-PCR) and rapid amplification of cDNA ends (RACE). The distribution of the goose A-FABP in different tissues was determined by quantitative real-time PCR (qRT-PCR).3. The results showed that the full-length cDNA sequence of goose A-FABP was 657 bp, containing a 5'-UTR of 52 bp, a 3'-UTR of 206 bp and an open reading frame (ORF) of 399 bp, which encoded a polypeptide of 132 amino acids (AA).4. The AA sequence of goose A-FABP showed 76.52%, 75.00%, 93.18% and 99.24% identities with previously described homologues from humans (Homo sapiens), mouse (Mus musculus), chicken (Gallus gallus), and duck (Anas platyrhynchos), respectively, and phylogenetic analysis revealed a close relationship among them. The transcript of Xupu goose A-FABP was ubiquitously expressed in all tested tissues, and showed a high-level expression in abdominal fat, sebum and liver.5. A significant positive correlation was identified between A-FABP mRNA abundance in the three adipose tissues and liver weight, ratio of liver to body weight, TG content, and VLDL concentration in the plasma of Xupu goose. A significant negative correlation was observed between the mRNA level of A-FABP and HDL concentration in the plasma of Xupu goose.6. These findings provide a foundation for further research on the function and mechanism of A-FABP in the fat deposition process.

Early life famine exposure to the Great Chinese Famine in 1959-1961 and subsequent pregnancy loss: a population-based study

OBJECTIVE

To explore the relation between famine exposure in early life and subsequent pregnancy loss, including stillbirth, and spontaneous abortion in adulthood.

DESIGN

A population-based, partly ecological study.

SETTING AND POPULATION

Individual data of 58 601 females born around the time of the Great Chinese Famine in 1959-1961.

METHODS

Associations between the famine exposure in early life and pregnancy loss (stillbirth and spontaneous abortion) in adulthood were analysed using negative binomial regression, with the non-exposure group as reference, adjusting for region, highest education, monthly income, alcohol consumption, tobacco use, body mass index in 25-year-olds and metabolic equivalent. Further analyses were stratified by rural versus urban region.

MAIN OUTCOME MEASURES

Continuous variables of times of stillbirths and spontaneous abortions were used according to the individual self-reported reproductive history.

RESULTS

No association was found between famine exposure and spontaneous abortion. In contrast, females experiencing the famine during their prenatal period (incidence rate ratio = 1.15, 95% CI 1.00-1.33) or infant period (incidence rate ratio = 1.27, 95% CI 1.12-1.44) were more likely to report stillbirth in later adult life. Such an association appeared stronger in women living in rural regions.

CONCLUSIONS

Early life exposure of famine was associated with an increased risk of stillbirth but not spontaneous abortion in adulthood. The strength of such an association appeared stronger in rural areas. Given the high potential for unmeasured confounding, these associations must be interpreted with caution. Regarding the potential implication that undernutrition in the fetal period is related to reproductive outcome in adulthood, fetal nutritional supply may play an important role in human reproduction.

TWEETABLE ABSTRACT

Exposure to famine in early life was associated with increased pregnancy loss in adulthood.

Cannulated screw and Kirschner fixation for the treatment of medial and lateral malleolar epiphyseal fractures in children: a retrospective study of 36 cases

BACKGROUND

Percutaneous fixation with cannulated screws is an effective method for treating medial malleolar epiphyseal fractures, which comprise a portion of bimalleolar and trimalleolar fractures. Lateral malleolar fractures also need to be fixed to achieve anatomical reduction and absolute stable fixation of the ankle. However, there are no individual studies in the literature on this topic.

METHODS

Thirty-six children (22 boys and 14 girls) aged 8 to 15 years (average, 11.3 years) with medial and lateral epiphyseal fractures were treated by cannulated screw and Kirschner fixation after closed reduction from January 2010 to December 2015 in our hospital. The patients were examined each month postoperatively. Ankle function was assessed using the Baird-Jackson ankle score.

RESULTS

The 36 patients were followed up for 18 to 29 months (average, 25 months). No cases of fracture non-union or secondary displacement were observed, and the healing time was 2.8 ± 1.1 months (range, 2-4 months). At the last follow-up visit, the Baird-Jackson ankle score ranged from 83 to 100 (average, 94), including an "excellent" score in 13 cases, a "good" score in 19 cases, a "fair" score in 4 cases, and a "poor" score in 0 cases. The ankle recovered to the pre-injury level of function within 3.5 ± 1.6 months (range, 2-5 months). Dysfunction, pain, instability, and premature epiphyseal closure were not observed during the follow-up of the 36 patients.

CONCLUSIONS

Cannulated screw and Kirschner fixation after closed reduction is an effective and readily available method for the treatment of medial and lateral malleolar epiphyseal fractures in children.