Expression of scrum CYR61 mRNA and protein in patients with tibial fracture and its relationship with prognosis

Objective: To explore the relationship between the expression of serum CYR61 mRNA and protein and prognosis in patients with tibial fracture. Methods: Eighty-six patients with tibiofibular fractures (fracture group) admitted to Xi'an Central Hospital from July 2016 to July 2018 and 84 healthy controls (control group) who underwent physical examination in our hospital were selected as the study subjects. The imaging healing score (RUST) and prognosis were divided into two subgroups, 74 in the normal healing group and 10 in the abnormal healing group. The serum CYR61 mRNA and protein expression levels were compared and the relationship between serum CYR61 mRNA and protein expression levels and fracture prognosis was analyzed. Result: The relative expression levels of CYR61 mRNA and protein in the normal healing group were (2.35±0.49) and (0.33±0.10), respectively (2.0210.29) and (0.23±0.07) in the abnormal healing group and 1.8810.37 in the control group.), (0.26±0.06), the difference between the three groups was statistically significant (P<0.05), and the serum CYR61 mRNA and CYR61 protein in the normal healing group were significantly higher than the control group (P<0.05), and the serum CYR61 mRNA in the abnormal healing group. CYR61 protein was significantly lower than the normal healing group (P<0.05). The RUST of the normal healing group was (11.3511.51), which was higher than that of the abnormal healing group (7.1710.95), and the difference was statistically significant (P<0.05). Serum CYR61 mRNA and protein expression levels were significantly positively correlated with prognosis (P<0.05). ROC curve analysis showed that the AUC of serum CYR61 mRNA and protein were 0.735 and 0.778, respectively, and the Cut-off values were 2.363 and 0.338, respectively. The sensitivities were 60.80% and 54.10%, respectively, and the specificities were 80.00% and 90.00%, respectively. They were 0.408 and 0.441, respectively, thus indicating that serum CYR61 mRNA and protein expression levels have predictive value for prognosis. Conclusion: The higher the mRNA and protein expression levels of serum CYR61 in early stage, the better the prognosis of fracture healing in patients with tibiofibular fractures. To a certain extent, serum CYR61 can be used as a reference for predicting the prognosis of tibiofibular fractures.

Baseline MMP expression in periapical granuloma and its relationship with periapical wound healing after surgical endodontic treatment

Background Matrix metalloproteinases (MMPs) catalyzes the degradation of the extracellular matrix components and have a major role in many physiological processes including wound healing. In the current study, we examined the correlation of baseline MMPs 1, 2, 7, and 9 expressions with periapical wound healing after surgical endodontic treatment. Methods 27 patients aged between 15–57 years presenting with chronic apical periodontitis or chronic apical abscess of an anterior tooth with previously attempted or failed root canal treatment were included in this study. During surgical endodontic treatment, tissue from the periapical lesion sample was collected and used for gross histopathological analysis as well as mRNA expression analysis of MMPs 1, 2, 7, and 9. Patients were recalled for follow-up after 6 and 12 months to evaluate the healing status both clinically and radiographically and healing was correlated with baseline MMP expression. Results Out of 27 patients, healing was observed in 15 patients at the end of 6 months, and patients after 12 months. Six patients showed no healing even after 12 months. Analysis of baseline MMP 1, 2, 7, and 9 expression levels with healing status showed the mean relative expression of MMP2 and MMP9 to be considerably increased in the non-healing group as compared to the healing group. Conclusion Overexpression of MMP2 and MMP9 may be considered as a potential prognostic biomarker for periapical wound healing after surgical endodontic treatment. However, further studies are desirable to establish its precise relationship with periapical wound healing.

Individualized Modeling Differential Ratio Method for Judging the Degree of Lower Extremity Long Bone Healing

Background:There are no recognized quantitative diagnostic criteria, which is one of the difficulties faced in trauma orthopedics. The purpose of this study is to quantitatively evaluate the degree of bone healing after internal fracture fixation with the individualized differential ratio method.Methods:Patients with a lower limb fracture treated at the Orthopedics Department of our hospital were recruited. At the time of follow-up, the degree of bone healing was evaluated by two orthopedic physicians and one imaging physician. Patients were divided into the bone healing group (group A), the poor bone healing group (group B), and the nonunion group (group C). Three-dimensional geometric models of the unaffected limb and the affected limb after simulated removal of the internal fixation were established, corresponding to the basic phase and the simulated phase, respectively, and the average CT gray value (average CT value) was obtained. Wall thickness analysis was performed to obtain the median wall thickness after meshing. R2 (median wall thickness ratio), R4 (CT value ratio), and R5 (healing index ratio) were obtained by calculating the ratio of each value in the simulated phase to that in the basic phase. Results:A total of 79 patients were included in the study, and 112 CT scans were performed. The frequency of categorization in groups A, B, and C was 49, 37 and 26, respectively. The correlation coefficient between the degree of bone healing and R2, R4 and R5 was 0.654, 0.060 and 0.542, respectively. The median R2 in groups A, B, and C was 0.91, 0.80, and 0.67, respectively. On ROC curve analysis, R2 was more effective in evaluating bone healing and nonunion than R5. The best cutoff point for R2 in predicting bone healing was 0.84, and the best cutoff point in predicting bone nonunion was 0.74.The individualized differential ratio method can be used to quantitatively evaluate the fracture healing state, with the median wall thickness ratio as a more intuitive and reliable judgment index.

The Comparison of the IFN-ɤ, TNF-α and IL-10 Cytokines in Healing and Non-healing Cutaneous Leishmaniasis

Background: Leishmaniasis is one of the main vectors borne and neglected tropical parasitic diseases. T cell cytokine responses are highly important in the presentations of disease such as control or progression, and understanding of the host immunological response is valuable in diagnosis, follow-up, and vaccine designs. In the current study, the profile of IFN-ɤ, TNF-α, and IL-10 cytokines was investigated through the ELISA technique in PBMCs isolated from antimony resistance and susceptible patients. Methods: In this experimental study, 54 patients with healing (n=27) or non-healing (n=27) CL were recruited. Lesion samples were collected to determine the genotype of Leishmania spp. and peripheral blood mononuclear cells (PBMCs) were obtained to evaluate the cytokines profiles using soluble Leishmania antigen (SLA) and phytohaemagglutinin (PHA) mitogen. Cytokines were assessed by the ELISA technique Results: The IFN-ɤ and TNF-α cytokines were significantly increased in the healing group treated with both SLA antigen and PHA mitogen (P<0.001). The level of IL-10 was significantly increased in non-healing and significantly declined in healing groups (P<0.001). Conclusion: The profile of IFN-ɤ, TNF-α, and IL-10 cytokines are crucially associated with the response of treatment.

Factors influencing sternal healing and comparison of different sternal closure methods: a retrospective analysis

Background We determined the factors affecting sternum healing after a median sternotomy based on a retrospective analysis; additionally, we compared the stability of different sternal closure techniques. Methods We collected information involving patients who underwent a median sternotomy in Changzhou First People's Hospital from 2014–2019 and who had chest CT examinations at 1–24 months post-operation. The main outcome included the average sternal healing score at the five specific anatomic levels and adverse events of transverse displacement of the sternum. Results In the short-term healing group, the sternal score was only correlated with postoperative time (HR = 0.18, 95% CI: 0.135–0.225, p < 0.001). In the long-term healing group, older people had a higher risk of poor sternal healing than young people (age, HR=-0.028, 95% CI: -0.05–0.006, p = 0.013). Patients with left internal mammary artery dissociation (LIMA-d) had a high risk of poor sternal healing (HR=-0.444, 95% CI: -0.869-0.019, p = 0.045). The binary logistic regression showed that steel wire fixation was a favorable factor for preventing transverse displacement of the sternum (HR = 0.122, 95% CI: 0.007–0.651, p = 0.047). Conclusion In summary, advanced age and internal mammary artery interception are risk factors that affect sternal healing, based on the imaging findings. This new method of sternal closure provides an effective way of ensuring sternal stability of both sternal plates and reduces the risk for complications after cardiac surgery in high-risk patients.

Influence Factors of Sternal Healing and Comparison of Different Sternal Closure Methods：A Retrospective Analysis

Background We determined the factors affecting sternum healing after a median sternotomy based on a retrospective analysis and compared the stability of different sternal closure techniques. Methods We collected information involving patients who underwent a median sternotomy in Changzhou First Hospital from 2014–2019 and had chest CT examinations 1–24 months postoperative, Main outcome includes the average of sternal healing score at the five specific anatomic levels and the adverse event of transverse displacement of sternum. Results In the short term healing group, Sternal score was only correlated with postoperative time (HR = 0.18, 95%CI:0.135–0.225, p < 0.001). In the long term healing group,old people had a higher risk of poor sternal healing than young (Age, HR=-0.028,95%CI:-0.05,-0.006, p = 0.013). Patients with left internal mammary artery grafting (LIMAG) had a high risk of poor sternal healing (HR=-0.444, CI:-0.869-0.019, p = 0.045).By binary logistic regression, It could be found that steel wire fixation was a favorable factor to prevent the transverse displacement of sternum (HR = 0.122, 95%CI:0.007–0.651, p = 0.047). Conclusion In summary, advanced age and internal mammary artery interception are risk factors that affect sternal healing based on imaging findings. this new method of sternal closure provides an effective way of ensuring sternal stability of both sternal plates and reduces the risk for complication after cardiac surgery in high-risk patients.

Self-Healing Group Key Distribution Facilitating Source Authentication Using Block Codes

Secure group key distribution is essential for many group-oriented applications such as sensor networks, multimedia broadcast services, and Internet of Things (IoT) scenarios. There are several challenges and requirements in designing secure group key distribution. Among them, computational efficiency, communication efficiency, adaptability to dynamic group membership change, robustness to various security threats, self-healing capacities, and source authentication are desirable. It is very challenging to design an efficient group distribution that satisfies all the requirements and challenges. Based on block codes, we propose an efficient self-healing group key distribution that facilitates both message source authentication and secure group key distribution, where the source identification and authentication can facilitate intrusion detection and identification. Both the privacy of the group key and the authentication of message sources are computationally secure. To the best of our knowledge, it is the first codes-based scheme that satisfies all the above requirements and facilitates message source authentication. The merits of the proposed scheme include the following: (1) it is highly efficient in terms of computation and communication, (2) it provides self-healing capacities for unstable environments, (3) it is very robust to various security threats and attacks, (4) it facilitates both message source authentication and secure group key distribution, and (5) it greatly improves the communication performance, compared to the state-of-the-art schemes. The security properties are analyzed, and the performance evaluations confirm its efficiency and practicality.

The success of laser ablation of fistula tract (laft) technique in anal fistula treatment: Early results of a tertiary center

Laser Ablation of the Fistula Tract (LAFT) is a newly defined technique for anal fistula treatment. Our aim in this study is to evaluate the effectiveness of the LAFT technique and to discuss the precise indications and limitations of the technique by sharing our own truths and mistakes over our early results. All patients with anal fistulas who were treated LAFT tecnique by same team from April 2019 until March 2020 at the our center, were evaluated in this study, retrospectively. While the patients who failed LAFT were included in the "Reccurrence after LAFT" group, the patients with successful LAFT were included in the "Healing" group. Differences between the groups were investigated. LAFT technique was applied to 19 patients in the specified period. Twelve (63%) of the cases were male and 7 (37%) were female, and the mean age was 45±14.5. The mean postoperative follow-up time was 13±3.4 months. Eleven cases had undergone surgery at least once with the diagnosis of anal fistula. Loose seton was applied in only 4 (25%) cases. It was observed that only 7 (37%) patients recovered with the LAFT technique (Table 1). LAFT was found to be more successful in patients who had never been operated before (p = 0.048, Table 2). In conclusion, LAFT technique is more successful in primary anal fistula cases and this technique should definitely be among the surgical options for anal fistula treatment.

Evaluation of Anterolateral Ligament Healing After Anatomic Anterior Cruciate Ligament Reconstruction

Background: Few studies have reported the healing process of anterolateral ligament (ALL) injuries. Purpose/Hypothesis: This study investigated the healing status of ALL injuries after primary anterior cruciate ligament (ACL) reconstruction (ACLR). Additionally, we investigated the association between the healing status of ALL injuries and associated lesions such as osseous lesions and meniscal tears occurring at the time of an ACL rupture. We hypothesized that acute ALL injuries show a high rate (more than two-thirds) of healing at the 1-year follow-up after ACLR and that concomitant lesions observed at the time of an ACL rupture affect the healing status of the ALL. Study Design: Case-control study; Level of evidence, 3. Methods: We retrospectively investigated patients with ALL injuries who underwent primary ACLR between March 2015 and February 2017. Using magnetic resonance imaging (MRI), we evaluated the features of ALL injuries and concomitant lesions, and MRI was performed at the 1-year follow-up to assess the healing status of the ALL. We investigated the association between the healing status of the ALL and concomitant lesions observed at the time of an ACL rupture. A subjective assessment was performed using the Lysholm score, International Knee Documentation Committee subjective score, and Tegner activity scale. Objective tests included an isokinetic strength assessment and functional performance testing. Results: With respect to the severity of ALL injuries, of 54 patients, a complete rupture occurred in 16 (29.6%) of the 54 patients and a partial rupture in 38 (70%). A significant association was observed between the severity of ALL injuries and bone contusions (lateral tibial plateau and medial tibial plateau [MTP]) and meniscus ramp lesions (Fisher exact test: P = .023, .012, and .023, respectively). Good and partial healing of the ALL occurred in 16 (29.6%) and 23 (42.6%) of 54 patients, respectively. Scar formation occurred in 12 (22.2%), and nonvisualization of the ALL was observed in 3 (5.6%) of 54 patients. Poor healing of the ALL was associated with preoperative MTP bone contusions and a high-grade pivot shift. Multivariate analysis showed that an MTP bone contusion was an independent risk factor associated with poor healing of the ALL. Among the functional tests performed, significant differences were observed between the good and poor healing groups with respect to the carioca test ( P = .039). The good healing group (n = 16) showed a negative pivot shift at the last follow-up, whereas 5 (13.2%) of the patients from the poor healing group (n = 38) showed a positive pivot shift, including 2 (5.3%) with a high-grade pivot shift. Conclusion: Approximately 70% of acute ALL injuries showed poor healing at the 1-year follow-up. Poor healing of ALL injuries was significantly associated with preoperative MTP bone contusions and a high-grade pivot shift. Therefore, a careful assessment of posteromedial bone contusions at the time of an ACL rupture is warranted, particularly in patients with a high-grade pivot shift.