All-Inside Arthroscopic Modified Broström Technique to Repair Anterior Talofibular Ligament Provides a Similar Outcome Compared With Open Broström-Gould Procedure

PurposeTo introduce an all-inside modified Broström technique to suture the anterior talofibular ligament (ATFL) and inferior extensor retinaculum (IER) under arthroscopy and to compare its outcomes with those of the conventional open procedure.MethodsAll patients who underwent arthroscopic or open repair of the ATFL between June 2014 and December 2017 were included in this study. Visual analog scale (VAS), Karlsson and Peterson (K-P), American Orthopedic Foot and Ankle Society (AOFAS) ankle/hindfoot, and Tegner activity scores, as well as manual anterior drawer test (ADT), were used to evaluate the patients preoperatively and ≥2 years after surgery. The Sefton grading system was used to assess the level of satisfaction after surgery. Detailed surgical data and intraoperative findings were documented at the time of surgery.ResultsA total of 67 patients, 31 in the arthroscopic group and 36 in the open group, were included in this study (43 men and 24 women, mean body mass index 24.00, range 19.53 to 30.03). The surgical duration in the arthroscopic group (median, 34 minutes; range, 25 to 74) was significantly shorter than that in the open group (mean, 43.08 ± 8.11 minutes; 95% confidence interval [CI] 40.34 to 45.83) (P = .007). At the last follow-up, the subjective functional scores and ADT results improved significantly in both cohorts (P < .001). However, no significant difference was found in the VAS score (1.74 ± 1.24, 95% CI 1.29 to 2.2, in the open group versus 1.58 ± 1.2, 95% CI 1.18 to 1.99, in the arthroscopic group; P = .581), AOFAS score (91.71 ± 5.46, 95% CI 89.71 to 93.71, versus 90.67 ± 5.59, 95% CI 88.78 to 92.56; P = .444), K-P score (87.52 ± 7.59, 95% CI 84.73 to 90.3, versus 88.75 ± 5.56, 95% CI 86.87 to 90.63; P = .446), and ADT evaluation (normal: 96.77% versus 94.44%, P = .557) between the arthroscopic and open groups, respectively. In addition, 28 cases (90.32%) in the arthroscopic group and 32 (88.89%) in the open group achieved satisfactory results based on the Sefton grading system (P = .736). Seventeen patients (47.2%) in the open group and 18 patients (58.1%) in the arthroscopic group underwent Tegner evaluation after surgery, which showed no significant difference (5, interquartile range [IQR] 1 in the open group versus 5, IQR 3 in the arthroscopic group; P = .883). Complications were reported in 4 (11.1%) and 2 (6.5%) patients who underwent open and arthroscopic surgeries, respectively (P = .813).ConclusionsBoth open and arthroscopic modified Broström surgeries generated favorable outcomes, with a significant improvement compared with the preoperative condition. Compared with the open Broström-Gould procedure, the all-inside arthroscopic modified Broström technique produced equivalent functional and clinical results at a minimum of 2 years after the operation, with a shorter surgical duration. Arthroscopic repair might be a safe and viable alternative to open surgery for lateral ankle stabilization.Level of EvidenceIII.     

Neutrophil-lymphocyte ratio: a controversial marker in predicting Crohn’s disease severity

Peripheral blood-derived inflammation-based scores such as the neutrophil-lymphocyte ratio (NLR) have recently been proposed as prognostic markers in ulcerative colitis. In some previous serological markers are commonly used to detect the severity of the Crohn’s disease (CD), but their sensitivity and specificity are relatively low. So we want to use simple indicators which are easy to obtain to predict disease severity. Now, we investigated and compared the capacity of NLR and other inflammatory markers in detecting CD activity and differentiating CD patients from healthy controls. These CD patients had not received corticosteroid or immunosuppressive drugs within a defined period of time. Data from our hospital between 2010 and 2012 was used. Neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cells (WBC), platelet count and albumin were measured in 44 patients with active CD, 66 patients with inactive CD, and 55 healthy blood donors. Disease activity was assessed by the Crohn’s Disease Activity Index. In the active CD group, NLR values were found to be elevated compared to inactive CD patients and controls (6.00±7.38, 5.53±6.18 and 1.84±0.85, respectively), but statistical difference was not found between active and inactive CD groups. The overall accuracy of NLR (cutoff: 2.13 fl), CRP (cutoff: 10.5 mg/dl), ESR (cutoff: 19.5 mm/hour) and WBC (cutoff: 9.2 × 10⁹/l) in differentiating CD patients from healthy controls was 80.9%, 67.3%, 71% and 60% respectively. NLR values were found to be correlated with WBC and CRP levels. NLR increased in CD patients compared with healthy subjects. NLR had the best accuracy in determination of CD patients and healthy controls. NLR did not show a discriminative value in disease activity.     

Effect of pinaverium bromide on stress-induced colonic smooth muscle contractility disorder in rats

AIM: To investigate the effect of pinaverium bromide, a L-type calcium channel blocker with selectivity for the gastrointestinal tract on contractile activity of colonic circular smooth muscle in normal or cold-restraint stressed rats and its possible mechanism. METHODS: Cold-restraint stress was conducted on rats to increase fecal pellets output. Each isolated colonic circular muscle strip was suspended in a tissue chamber containing warm oxygenated Tyrode-Ringer solution. The contractile response to ACh or KCl was measured isometrically on ink-writing recorder. Incubated muscle in different concentrations of pinaverium and the effects of pinaverium were investigated on ACh or KCl-induced contraction. Colon smooth muscle cells were cultured from rats and (Ca(2+))(i) was measured in cell suspension using the Ca(2+) fluorescent dye fura-2/AM. RESULTS: During stress, rats fecal pellet output increased 61 % (P<0.01). Stimulated with ACh or KCl, the muscle contractility was higher in stress than that in control. Pinaverium inhibited the increment of (Ca(2+))(i) and the muscle contraction in response to ACh or KCl in a dose dependent manner. A significant inhibition of pinaverium to ACh or KCl induced (Ca(2+))(i) increment was observed at 10(-6) mol/L. The IC(50) values for inhibition of ACh induced contraction for the stress and control group were 1.66X10(-6) mol/L and 0.91X10(-6) mol/L, respectively. The IC(50) values for inhibition of KCl induced contraction for the stress and control group were 8.13X10(-7) mol/L and 3.80X10(-7) mol/L, respectively. CONCLUSION: Increase in (Ca(2+))(i) of smooth muscle cells is directly related to the generation of contraction force in colon. L-type Ca(2+) channels represent the main route of Ca(2+) entry. Pinaverium inhibits the calcium influx through L-type channels; decreases the contractile response to many kinds of agonists and regulates the stress-induced colon hypermotility.     

Omega-3多不饱和脂肪酸抗心律失常作用及其机制研究进展

越来越多的研究表明,n-3多不饱和脂肪酸（n-3PUFAs）能降低心率,提高心率变异性,减少室性心律失常的发生,预防心源性猝死及减少心房颤动复发等抗心律失常作用,也有研究发现n-3PUFAs具有致心律失常的作用。本文通过分析n-3PUFAs离子通道作用特点及其抗心律失常作用机制,发现n-3PUFAs干预方式不同,作用机制不完全一样,表明n-3PUFAs在抗心律失常方面具有两面性。     

Role of Angptl4 in vascular permeability and inflammation

Background

Angptl4 is a secreted protein involved in the regulation of vascular permeability, angiogenesis, and inflammatory responses in different kinds of tissues. Increases of vascular permeability and abnormality changes in angiogenesis contribute to the pathogenesis of tumor metastasis, ischemic-reperfusion injury. Inflammatory response associated with Angptl4 also leads to minimal change glomerulonephritis, wound healing. However, the role of Angptl4 in vascular permeability, angiogenesis, and inflammation is controversy. Hence, an underlying mechanism of Angptl4 in different kind of tissues needs to be further clarified.

Methods

Keywords such as angptl4, vascular permeability, angiogenesis, inflammation, and endothelial cells were used in search tool of PUBMED, and then the literatures associated with Angptl4 were founded and read.

Results

Data have established Angptl4 as the key modulator of both vascular permeability and angiogenesis; furthermore, it may also be related to the progression of metastatic tumors, cardiovascular events, and inflammatory diseases. This view focuses on the recent advances in our understanding of the role of Angptl4 in vascular permeability, angiogenesis, inflammatory signaling and the link between Angptl4 and multiple diseases such as cancer, cardiovascular diseases, diabetic retinopathy, and kidney diseases.

Conclusions

Taken together, Angptl4 modulates vascular permeability, angiogenesis, inflammatory signaling, and associated diseases. The use of Angptl4-modulating agents such as certain drugs, food constituents (such as fatty acids), nuclear factor (such as PPARα), and bacteria may treat associated diseases such as tumor metastasis, ischemic-reperfusion injury, inflammation, and chronic low-grade inflammation. However, the diverse physiological functions of Angptl4 in different tissues can lead to potentially deleterious side effects when used as a therapeutic target. In this regard, a better understanding of the underlying mechanisms for Angptl4 in different tissues is necessary.     

慢性硬膜下血肿术后早发性癫痫的影响因素

目的 探讨钻孔引流治疗慢性硬膜下血肿术后早发性癫痫的影响因素。方法 分析2011年1月—2020年1月在龙岩市第二医院和嘉兴市第一医院采用钻孔引流治疗的230例慢性硬膜下血肿患者的临床资料,分析性别、血肿量、血肿厚度、单双侧出血、术前MGS-GCS评分、电解质异常、术后24 h血肿清除率、术后是否颅内积气和是否使用预防性抗癫痫药物与术后早发性癫痫的相关性。结果 230例患者中术后13例发生早发性癫痫,术后早发性癫痫的发生率为5.7%。多因素Logistic回归分析显示术后24 h血肿清除率≥60%（95%CI：1.009~1.092）、未使用预防性抗癫痫药物（95%CI：0.033~0.575）和颅内积气（95%CI：2.113~26.744）与早发性癫痫相关（P＜0.05）。结论 钻孔引流治疗慢性硬膜下血肿术后早发性癫痫的发生与术后24 h血肿清除率和颅内积气相关,预防性使用抗癫痫药物能预防早发性癫痫。 [国际神经病学神经外科学杂志, 2022, 49(3): 21-25.]     

Analysis of long noncoding RNA-associated competing endogenous RNA network in glucagon-like peptide-1 receptor agonist-mediated protection in β cells

BACKGROUND Long noncoding RNAs(lncRNAs) and mRNAs are widely involved in various physiological and pathological processes. The use of glucagon-like peptide-1 receptor agonists(GLP-1 RAs) is a novel therapeutic strategy that could promote insulin secretion and decrease the rate of β-cell apoptosis in type 2 diabetes mellitus(T2 DM) patients. However, the specific lncRNAs and mRNAs and their functions in these processes have not been fully identified and elucidated.AIM To identify the lncRNAs and mRNAs that are involved in the protective effect of GLP-1 RA in β cells, and their roles.METHODS Rat gene microarray was used to screen differentially expressed(DE) lncRNAs and mRNAs in β cells treated with geniposide, a GLP-1 RA. Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analyses were performed to assess the underlying functions of DE mRNAs. Hub mRNAs were filtered using the STRING database and the Cytoscape plugin, CytoHubba. In order to reveal the regulatory relationship between lncRNAs and hub mRNAs, their co-expression network was constructed based on the Pearson coefficient of DE lncRNAs and mRNAs, and competing endogenous RNA(ceRNA) mechanism was explored through miRanda and TargetScan databases.RESULTS We identified 308 DE lncRNAs and 128 DE mRNAs with a fold change filter of ≥ 1.5 and P value 0.05. GO and KEGG pathway enrichment analyses indicated that the most enriched terms were G-protein coupled receptor signaling pathway, inflammatory response, calcium signaling pathway, positive regulation of cell proliferation, and ERK1 and ERK2 cascade. Pomc, Htr2 a, and Agtr1 a were screened as hub mRNAs using the STRING database and the Cytoscape plugin, CytoHubba. This result was further verified using SwissTargetPrediction tool. Through the co-expression network and competing endogenous(ceRNA) mechanism, we identified seven lncRNAs(NONRATT027738, NONRATT027888, NONRATT030038, etc.) co-expressed with the three hub mRNAs(Pomc, Htr2 a, and Agtr1 a) based on the Pearson coefficient of the expression levels. These lncRNAs regulated hub mRNA functions by competing with six miRNAs(rno-miR-5132-3 p, rno-miR-344 g, rno-miR-3075, etc.) via the ceRNA mechanism. Further analysis indicated that lncRNA NONRATT027738 interacts with all the three hub mRNAs, suggesting that it is at a core position within the ceRNA network.CONCLUSION We have identified key lncRNAs and mRNAs, and highlighted here how they interact through the ceRNA mechanism to mediate the protective effect of GLP-1 RA in β cells.     

单项血脂及其比值与翼状胬肉的相关性研究

目的:分析单项血脂和血脂比值与翼状胬肉的关系。方法:采用回顾性病例研究。纳入2016-01/2019-02在我院眼科和体检中心确诊的翼状胬肉患者500例(翼状胬肉组)和同期进行健康体检、年龄和性别匹配的健康体检者500例(正常对照组),检测两组研究对象外周静脉血中血清甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平,计算TG/HDL、TC/HDL、LDL/HDL的比值。结果:翼状胬肉患者500例中,血脂异常者68.2%(341/500),翼状胬肉组血清TG、TC、LDL-C水平和TG/HDL、TC/HDL、LDL/HDL的比值均明显高于正常对照组(P<0.001),血清HDL水平低于正常对照组,但无差异(P>0.05)。Logistic回归分析提示,TG(OR=4.132)、TC(OR=2.194)、TG/HDL (OR=2.184)、TC/HDL (OR=2.007)均是翼状胬肉发病的影响因素(P<0.05)。结论:血脂代谢异常是翼状胬肉发病的影响因素,加强血脂管理对翼状胬肉患者的发病和治疗均具有重要的临床意义。     

Single-molecule optofluidic microsensor with interface whispering gallery modes

Label-free sensors are highly desirable for biological analysis and early-stage disease diagnosis. Optical evanescent sensors have shown extraordinary ability in label-free detection, but their potentials have not been fully exploited because of the weak evanescent field tails at the sensing surfaces. Here, we report an ultrasensitive optofluidic biosensor with interface whispering gallery modes in a microbubble cavity. The interface modes feature both the peak of electromagnetic-field intensity at the sensing surface and high-Q factors even in a small-sized cavity, enabling a detection limit as low as 0.3 pg/cm². The sample consumption can be pushed down to 10 pL due to the intrinsically integrated microfluidic channel. Furthermore, detection of single DNA with 8 kDa molecular weight is realized by the plasmonic-enhanced interface mode.

Detecting biological molecules and monitoring their dynamics are of crucial importance in biomedical analysis and disease diagnosis (1, 2). Practical applications generally involve complex biological environments, in which an engineered interface is highly desirable to enable the enrichment, detection, and analysis of specific biomolecules (3). Over the past decades, many techniques on interfacial molecular analysis have been developed, such as lateral flow immunoassay, electrochemical analytical techniques, and optical biosensors (4–7). Among them, optical evanescent microsensors, such as microspheres (8, 9), microtoroids (10–14), and nanowaveguides (15–18), have attracted considerable research interest since they can detect unlabeled molecules and monitor their interactions in real time and in situ with ultrahigh sensitivity, fast response, and miniature footprint.Despite these advantages, potentials of optical evanescent microsensors have not been fully explored. With the peak field intensity confined inside the cavity, these sensors can utilize the weak tail of the evanescent field only on the sensing surface (8, 10–12, 15, 16), thus limiting their sensitivities. Moreover, ultrasmall sample consumption is desired for high-efficiency sensing yet challenging in evanescent microsensors, since they require delicate sample delivery designs such as an additional chamber (9, 12) or a precisely aligned fluidic channel (19, 20). Therefore, an integrated microfluidic platform with ultimate sensitivity is highly demanded.In this work, we demonstrate an ultrasensitive optofluidic microbubble biosensor by exploiting the whispering gallery modes (WGMs) peaked at the interface between the optical resonator and the analyte solution, which are termed as the interface modes. Previously, the microbubble resonator has been widely used for measuring refractive index, biomolecule concentration, and single nanoparticle generally by the mode localized in the liquid core (21–29). Here, we find that the profile of the WGM field can be tuned by varying the wall thickness, and the interface mode emerges when the maximum of the field intensity is drawn onto the interface. Compared with conventional evanescent sensors, the present scheme utilizing interface modes promises maximum sensitivity for interfacial molecular analysis, pushing the detection limit down to 0.3 pg/cm². The scheme is also compatible with the widely adopted techniques to enhance signal- to-noise ratio (SNR) such as plasmonic hybridization (30–33) and frequency tracking (12, 15, 18). As a proof of concept, single-molecule detection is demonstrated with a plasmonic-enhanced interface mode. Naturally integrated into a microfluidic system, the sensor with single-molecule sensitivity exhibits ultrasmall sample consumption down to 10 pL, providing an automatic platform for biomedical analysis.