Effectiveness and Biomechanical Analysis of the Ortho-Bridge System on Femoral Fracture Healing: A Retrospective Analysis

BackgroundAmong the surgical methods for femoral fractures, the Ortho-Bridge System (OBS) appears to heal fractures via an uncommon process. We compared its effectiveness and biomechanical aspects to those of a locking compression plate (LCP) and explained the healing process demonstrated by the OBS.MethodsEleven femoral shaft fracture cases treated with OBS between July 2017 and May 2020 were retrospectively reviewed. Clinical and radiographic data were collected during regular postoperative follow-up visits and assessed via the Harris Hip Score and Knee Society Score. We performed biomechanical experiments of OBS. We simulated different fracture conditions and selected appropriate screw holes at the fracture’s far and near segments. The OBS module was placed according to the position of LCP’s locking hole at both ends of the fracture; then, a static three-point bending test was performed.ResultsAll patients had contralateral callus growth with secondary fracture healing. Healing time was 3–5 months with excellent hip and knee function. When the key screw distance was 22–34 mm, the OBS was significantly less stiff than the LCP (P < 0.05). The stiffness of LCP and OBS decreased significantly when the key screw distance was 49–82 mm, with the LCP being slightly stronger (P < 0.05).ConclusionsFemoral shaft fracture treatment with OBS demonstrated secondary healing. When the distance between the key screws was 20–40 mm, the elasticity was higher in OBS than in LCP, possibly producing axial micro-motion to stimulate callus formation and promote fracture healing, which differ from the plate’s primary healing process.     

Mechanisms of Sodium/Iodide Symporter-Mediated Mammary Gland Iodine Compensation during Lactation

This research aimed to investigate the compensation mechanism of iodine deficiency and excess in the mammary gland during lactation. Female rats were divided into the low iodine group (LI), the normal iodine group (NI), the 10-fold high iodine group (10HI) and the 50-fold high iodine group (50HI). We measured the iodine levels in the urine, blood, milk, and mammary gland. The protein expression of sodium/iodide symporter (NIS), DPAGT1, and valosin-containing protein (VCP) in the mammary gland was also studied. The 24-hour urinary iodine concentration, serum total iodine concentration, serum non-protein-bound iodine concentration, breast milk iodine concentration, and mammary gland iodine content in the 50HI group were significantly higher than those in the NI group (p < 0.05). Compared with the NI group, NIS expression in the 50HI group significantly decreased (p < 0.05). DAPGT1 expression was significantly higher in the LI group than in the NI group (p < 0.05). The expression level of VCP was significantly increased in the 10HI and 50HI groups. In conclusion, milk iodine concentration is positively correlated with iodine intake, and the lactating mammary gland regulates the glycosylation and degradation of NIS by regulating DPAGT1 and VCP, thus regulating milk iodine level. However, the mammary gland has a limited role in compensating for iodine deficiency and excess.     

Does Regular Physical Activity Improve Personal Income? Empirical Evidence from China

A lack of adequate exercise threatens human health, weakening human capital accumulation. The relationship between exercise and income has become the focus of attention in health economics. In terms of reducing body weight and improving physical fitness, diet and physical exercise are intertwined and become effective ways to shape a healthy state. Based on individual-level survey data from China, this study quantified the economic returns of habitual exercise behavior by using an endogenous switching regression model (ESRM) to eliminate selection bias. The study shows that (1) participants in the group with regular exercise behavior increased their income by 3.79% compared with those not exercising regularly; (2) for the group with no regular exercise behavior, regular exercise increased their income by 13.36% compared with those not exercising regularly. Additionally, empirical evidence shows that both drinking and smoking can significantly increase individual income, despite unhealthy habits. These results suggest that the habit of regular physical activity plays a vital role in increasing individual income and improving overall national health, and the effect of individual behavior on income is affected by national culture. The outcomes are empirical evidence for the Chinese government to promote Healthy China Action and support developing countries worldwide to enable habitual exercise, stimulating a policy of exercise behavior.     

Do Individuals Use Nutrition Labels on Food Packages to Make Healthy Choices? Testing the Dual-Process Model in Two Laboratory-Based Experiments

Nutrition labels on food packages are designed to assist consumers in making healthy decisions. Based on the model of a dual-process system, the current study examined how people might be affected by nutrition labels and consuming contexts when making choices about healthy foods. Using four types of nutrition labels (i.e., the NuVal label, 5-Color nutrition label, traffic light label, and daily value label), participants were instructed to choose the healthier foods with or without time constraints in two experiments. In Experiment 1, participants were presented with pairs of foods accompanied by the same type of nutrition labels to measure the efficiency of their health evaluation. In Experiment 2, two types of labels with inconsistent nutritional information were presented to participants simultaneously to measure their preference regarding the nutrition labels. Findings of the current study support the notion that the traffic light label is advantageous in terms of both the efficiency of, and preferences regarding, nutrition judgment, especially with time constraints. When there was only one type of nutrition label, participants made decisions fastest and most accurately when observing the NuVal label, regardless of time constraints. Overall, the reliable interactions between the time constraints and patterns of nutrition labels have theoretical implications for the appeal-based heuristics and rational-based processing when making health-related food decisions.     

CCN1/Integrin α5β1 Instigates Free Fatty Acid-Induced Hepatocyte Lipid Accumulation and Pyroptosis through NLRP3 Inflammasome Activation

Hyperlipidemia with high blood levels of free fatty acids (FFA) is the leading cause of non-alcoholic steatohepatitis. CCN1 is a secreted matricellular protein that drives various cellular functions, including proliferation, migration, and differentiation. However, its role in mediating FFA-induced pro-inflammatory cell death and its underlying molecular mechanisms have not been characterized. In this study, we demonstrated that CCN1 was upregulated in the livers of obese mice. The increase in FFA-induced CCN1 was evaluated in vitro by treating hepatocytes with a combination of oleic acid and palmitic acid (2:1). Gene silencing using specific small interfering RNAs (siRNA) revealed that CCN1 participated in FFA-induced intracellular lipid accumulation, caspase-1 activation, and hepatocyte pyroptosis. Next, we identified integrin α₅β₁ as a potential receptor of CCN1. Co-immunoprecipitation demonstrated that the binding between CCN1 and integrin α₅β₁ increased in hepatocytes upon FFA stimulation in the livers of obese mice. Similarly, the protein levels of integrin α₅ and β₁ were increased in vitro and in vivo. Experiments with specific siRNAs confirmed that integrin α₅β₁ played a part in FFA-induced intracellular lipid accumulation, NLRP3 inflammasome activation, and pyroptosis in hepatocytes. In conclusion, these results provide novel evidence that the CCN1/integrin α₅β₁ is a novel mediator that drives hepatic lipotoxicity via NLRP3-dependent pyroptosis.     

Preliminary validation study of the WHO quality of life (WHOQOL) scales for people with spinal cord injury in Mainland China

ObjectiveTo validate the WHOQOL Scales (WHOQOL-BREF and WHOQOL-DIS module) for people with spinal cord injury in Mainland China.DesignCross-sectional study.SettingShanghai Sunshine Rehabilitation Center.Participants249 adults with SCI who were admitted to a rehabilitation training program between 2017 and 2019.InterventionsNot applicable.MethodsQuestionnaires about personal and injury characteristics, the WHOQOL Scales, global QOL, Zung Self-Rating Anxiety/Depression Scale (SAS/SDS), and Community Integration Questionnaire (CIQ) were administrated. Floor and ceiling effects, reliability, and validity analyses were tested.ResultsThe 8 domains of the WHOQOL Scales showed no floor or ceiling effects. Cronbach alpha values of the WHOQOL-BREF and the WHOQOL-DIS were 0.93 and 0.78, respectively. Test-retest reliability was good for the WHOQOL Scales. Satisfactory criterion-related validity was shown by the correlation analysis among the WHOQOL Scales, SAS/SDS, CIQ, and global QOL. Good item-domain correlations (>0.50) were found for 38 items of the 39-item WHOQOL Scales, excepting the “impact of disability” (0.48) of the WHOQOL-DIS. Confirmatory Factor Analysis (CFA) supported a construct of the WHOQOL-DIS as made of four domains: autonomy, social inclusion, social activities, and discrimination. CFI and RMSEA values were 0.91 and 0.07, respectively, for the four-domain structure WHOQOL-DIS, with a higher-order factor. WHOQOL-BREF domains and WHOQOL-DIS scores showed the predicted pattern among a priori known groups.ConclusionThe WHOQOL Scales are valid and reliable, and they can be used to measure QOL in people with SCI in China. We suggest the WHOQOL-DIS be analyzed as one general item constituting a single 12-item domain.     

Breast Augmentation with Autologous Fat Grafting Immediately after Removal of Polyacrylamide Hydrogel and Fibrotic Capsule in 162 Patients

ObjectiveIn this study, we investigated the feasibility and efficacy of immediate breast augmentation with autologous fat grafting after removal of polyacrylamide hydrogel (PAAG) and fibrotic capsule.MethodsA retrospective study was conducted on 162 female patients who underwent removal of breast filler PAAG and the fibrotic capsule which produced after injection of PAAG via areola omega-shaped incision. Then autologous fat grafting was immediately performed evenly and radially around the areola via the same incision into different layers (subcutaneous, submammary tissue, pectoralis major intramuscular, and inferior pectoralis major space) except the empty cavity. The cavity left by removal of PAAG and fibrous capsule was closed with negative pressure drainage tube and slight external pressure.ResultsAll patients recovered well without severe complications. The average score of postoperative satisfaction with physical well-being: chest was 99.83 (total score: 100) compared with the average satisfaction score of 71.69 (total score: 100) preoperatively by means of BREAST-Q™ evaluation (p < 0.01). All patients were satisfied with their postoperative breast shape.ConclusionsRemoving as much as possible is critical for patients who underwent the PAAG injection. Our experience in immediate breast augmentation with autologous fat grafting after removal of PAAG and fibrotic capsule proved useful and effective to maintain the balance between removing the PAAG as much as possible and retaining soft tissue to reshape breasts.Level of EvidenceIV.     

Intra‐Articular Biomechanical Changes of the Meniscus and Ligaments During Stance Phase of Gait Circle after Different Anterior Cruciate Ligament Reconstruction Surgical Procedures: A Finite Element Analysis

ObjectiveThe debate on the superiority of single‐ or double‐bundle for anterior cruciate ligament reconstruction has not ceased. The comparative studies on intra‐articular biomechanics after different surgical reconstructions are rare. This study is to evaluate the biomechanical stress distribution intra‐knee after single‐ and double‐bundle anterior cruciate ligament reconstruction by three‐dimensional finite element analysis, and to observe the change of stress concentration under the condition of vertical gradient loads.MethodsIn this study, magnetic resonance imaging data were extracted from patients and healthy controls for biomechanical analysis. Patients included in the three models were matched in age and sex. The strength and distribution of induced stresses were analyzed in two frequently used procedures, anatomical single‐bundle anterior cruciate ligament reconstruction and anatomical double‐bundle anterior cruciate ligament reconstruction, using femoral‐graft‐tibial system under different loads, to mimic a post‐operation mechanical motion. The three‐dimensional finite‐element models for normal ligament and two surgical methods were applied. A vertical force simulating daily walking was performed on the models to assess the interfacial stresses and displacements of intra‐articular tissues and ligaments. The evaluation results mainly included the stress of each part of ligament and meniscus. The stress values of different parts of three models were extracted and compared.ResultsThe stress of ligament/graft at femoral side of three finite‐element models was significantly higher than at tibial side, while the highest level was observed in single‐bundle reconstruction finite‐element model. With the increase of force, the maximum stress in the medial (7.1–7.1 MPa) and lateral (4.9–7.4 MPa) meniscus of single‐bundle reconstruction finite‐element model shifted from the anterior horn to the central area (p = 0.0161, 0.0479, respectively). The stress was shown to be at a lower level at femoral side and posterior cruciate ligament of intra‐knee in two reconstruction finite‐element models than that in normal finite‐element models, while presented higher level at the tibial side than normal knee (p = 0.3528). The displacement of the femoral side and intra‐knee areas in reconstruction finite‐element models was greater than that in normal finite‐element model (p = 0.0855).ConclusionCompared with the single‐bundle technique, the graft of double‐bundle anterior cruciate ligament reconstruction has better stress dissipation effect and can prevent postoperative meniscus tear more effectively.     

Research Status and Hotspots of Chronic Osteomyelitis: A Bibliometric and Visualized Analysis

ObjectiveThe treatment of chronic osteomyelitis (COM) is extremely challenging for physicians and patients. It is of great significance to explore the research status, development trend and future research hotspots in the field of COM to promote the development of this field. This study is aimed to explore the global research status of COM and predict its future research hotspots based on bibliometric and visualized analysis.MethodsWeb of Science core collection database was used to search the related literature of COM from 1994 to 2020. All data were imported into Microsoft Excel 2019 for collation. Additionally, the literature quality of countries, authors, journals, and institutions is evaluated. The VOS viewer software was used for conducting co‐analysis, co‐citation analysis, and keyword co‐occurrence analysis of literature to analyze the global status and predict the future hotspots of the COM field.ResultsA total of 726 articles were retrieved in this study. The number of global publications shows a trend of wave growth, but the increase is not significant. It is expected that the number of COM articles will remain at more than 50 per year in the next decade. The COM literature published in the United States (Publications = 160, H index = 37, average citations per item = 28.63) is of the highest quality. Girschick HJ (Publications = 16, H index = 14, average citations per item = 52.25) is the most contributed scholar in the field of COM. UNIV IOWA (Publications = 15, H index = 11, average citations per item = 57.27) and UNIV WURZBURG (Publications = 18, H index = 15, average citations per item = 47.5) are influential institutions in the field of COM. The results of co‐occurrence analysis show that the field of COM can be roughly divided into the following five modules: COM surgical research, COM basic research, COM diagnosis‐related research, chronic recurrent multifocal osteomyelitis (CRMO)‐related research, risk factors of COM. Risk factors of COM are the module with the highest concentration of hot words.ConclusionCOM‐related research will continue to develop further in the next decade. The diagnosis research and risk factors of COM are the most popular research modules in recent years. Some controversial or troubled issues including the efficacy of perforator flap and fascia flap covering soft tissue, searching exclusive detection methods for the diagnosis of COM and bisphosphonates and biological agents in the treatment of CRMO may lead to the development of the COM field.