Risk factors for surgical site infection after closed proximal humerus fractures.

Proximal humerus fractures are common in clinical practice, and there are relatively a few studies on postoperative incision infections of such fractures. The purpose of this study was to explore the risk factors for surgical site infection (SSI) after internal fixation in patients with closed proximal humerus fractures. Patients with closed proximal humerus fractures who underwent surgery from January 2016 to January 2022 were retrospectively analysed. Cases with superficial or deep infections within 3 months after surgery were in the infection group and the remaining cases were in the non-infection group. The types of pathogenic bacteria in the infection group were analysed. The potential risk factors for SSI in all patients were recorded: (1) patient-related factors: gender, age, body mass index (BMI), smoking, comorbidities; (2) trauma-related factors: mechanism of injury, Injury Severity Score, visual analogue scale, fracture type, soft tissue condition and combined dislocation; (3) laboratory-related indexes: haemoglobin, albumin; (4) surgery-related factors: time from injury to surgery, American Society of Anesthesiologists anaesthesia classification, surgical time, fixation mode, intraoperative blood loss, suture method, bone graft and postoperative drainage. The risk factors for the occurrence of SSI were analysed using univariate analysis and multivariate logistic regression. The incidence of SSI was 15.7%. The most common bacterium in the infection group was Staphylococcus aureus. High BMI (p = 0.033), smoking (p = 0.030), an increase in mean time from injury to definitive surgery (p = 0.013), and prolonged surgical time (p = 0.044) were independent risk factors for the development of SSI after closed proximal humeral fractures. In patients with closed proximal humerus fractures, weight loss, perioperative smoking cessation, avoidance of delayed surgery, and shorter surgical time may be beneficial in reducing the incidence of SSI.

[Long-term outcomes of lateral femoral notch after early anterior cruciate ligament reconstruction].

OBJECTIVE: To investigate the outcome of lateral femoral notch (LFN) after early anterior cruciate ligament (ACL) reconstruction and evaluate the recovery of knee joint function after the operation. METHODS: The clinical data of 32 patients who underwent early ACL reconstruction from December 2015 to December 2019 were retrospectively analyzed. The study included 18 males and 14 females, aged 16 to 54 years old, with an average age of (25.39±2.82) years. The body mass index (BMI) of the patients ranged from 20 to 30 kg/cm2, with an average of (26.15±3.09) kg/cm2. Among them, 6 cases were caused by traffic accidents, 19 by exercise, and 7 by the crush of heavy objects. MRI of all patients showed LFN depth was more than 1.5 mm after injury, and no intervention for LFN was performed during surgery. Preoperative and postoperative depth, area, and volume of LFN defects were observed by MRI data. International Cartilage Repair Society (ICRS) score, Lysholm score, Tegner activity levels, and knee injury and osteoarthritis outcome score (KOOS) were analyzed before and after the operation. RESULTS: All patients were followed up from 2 to 6 years with an average of (3.28±1.12) years. There was no significant difference in the defect depth of LFN from (2.31±0.67) mm before the operation to (2.53±0.50) mm at follow-up (P=0.136). The defect area of LFN was decreased from (207.55±81.01)mm2 to (171.36±52.69)mm2 (P=0.038), and the defect volume of LFN was decreased from (426.32±176.54) mm3 to (340.86±151.54)mm3 (P=0.042). The ICRS score increased from (1.51±0.34) to (2.92±0.33) (P<0.001), the Lysholm score increased from (35.37±10.54) to (94.46±8.45) (P<0.001), and the Tegner motor score increased from (3.45±0.94) to (7.56±1.28), which was significantly higher than that of the preoperative data (P<0.001). The KOOS score of the final follow-up was 90.42±16.35. CONCLUSION: With the increase of recovery time after anterior cruciate ligament reconstruction, the defect area and volume of LFN decreased gradually, but the defect depth remained unchanged. The knee joint function of the patients significantly improved. The cartilage of the LFN defect improved, but the repair effect was not good.

Total knee arthroplasty in patients with Parkinson's disease: A systematic review and meta-analysis protocol.

BACKGROUND: Parkinson's disease (PD) patients have been shown to have various musculoskeletal problems, the postoperative outcomes of total knee arthroplasty procedure might be less predictable if performed on a patient who has PD. We conducted a protocol for systematic review and meta-analysis to evaluate the functional outcomes, activity levels, mortalities, implant survival rates, and complications of total knee arthroplasty in patients with PD. METHODS: This study follows the guideline of the preferred reporting items for systematic reviews and meta-analyses protocols and has been registered on the International Prospective Register of Systematic Reviews with CRD42022375885. Two independent reviewers will search for databases including PubMed, Embase, Cochrane Library website, ClinicalTrials.gov databases, Chinese National Knowledge Infrastructure Database, Wanfang database, and VIP database using the search strategies recommended by the Cochrane Back Review Group. The RevMan 5.3 software (Cochrane Collaboration, Oxford, UK) will be used to conduct the meta-analyses. RESULTS: The results of this systematic review will be published in a peer-reviewed journal. CONCLUSION: This study may provide evidence for the clinical application of total knee arthroplasty in patients with PD.

Combination of Two Colorless Fluorophores for Full-Color Red-Green-Blue Luminescence.

Herein, a molecular pixel system for full-color luminescence reproduction is achieved by adjusting the colorless mixtures of two matching fluorophores, i.e., polarity-insensitive 9,14-diphenyl-9,14-dihydrodibenzo[a,c]phenazine (DPAC) as the fixed red primary color and polarity-sensitive dansylamide (DSA) as dynamic blue to green primary colors. DPAC and DSA possess independent emission properties free from electron and energy transfer crosstalk between them because of their close frontier molecular orbitals as well as similar absorptions below 400 nm. According to the additive color theory, under diverse mixing ratios and various polarities, a smooth emission color change is realized in the triangle surrounded by the luminophores in the chromaticity diagram with accurate prediction and expedient reproduction. The principle of this system may open an innovative route for the development of powerful full-color luminescent materials, for example, ratiometric fluorescent polarity sensors and invisible fluorescent crayons.

Saponin from Periploca forrestii Schltr Mitigates Oxazolone-Induced Atopic Dermatitis via Modulating Macrophage Activation.

Atopic dermatitis (AD) is a relapsing, acute, and chronic skin disease featured by intractable itching, eczematous skin. Conventional therapies based on immunosuppression such as corticosteroids are associated with multiple adverse reactions. Periploca forrestii Schltr saponin (PFS) was shown to potently inhibit murine arthritis by protecting bone and cartilage injury and suppressing NF-κB activation. However, its therapeutic effect on oxazolone-induced atopic dermatitis (AD) and the underlying mechanisms on macrophage are still unclear. The AD-like dermatitis was induced by repeated oxazolone challenge to the skin of BALB/c mice in vivo. Blood and ears were biochemically or histologically processed. RT-PCR, western blotting, and ELISA were conducted to evaluate the expression of macrophage factors. Mouse bone marrow-derived macrophages (BMDMs) stimulated with lipopolysaccharide (LPS) were used as a model in vitro. PFS treatment inhibited AD-like dermatitis development. PFS downregulated epidermis thickness and cell infiltration, with histological analysis of the skin lesion. PFS alleviated plasma immunoglobulin (Ig) E, IgG2a, and IgG1 levels. PFS downregulated the expression of M1 macrophage factors, tumor necrosis factor- (TNF-) α, interleukin- (IL-) 6, monocyte chemotactic protein-1 (MCP-1), and nitric oxide synthase2 (NOS2), and M2 macrophage factors, IL-4, arginase1 (Arg1) and CD163 in AD-like skin, which were confirmed by western blot and ELISA analysis. In addition, PFS inhibited LPS-induced macrophage polarization via the inhibition of the phosphorylation of signal transducer and activator of transcription 3 (STAT3) and nuclear translocation of NF-κB p65. These results suggest that PFS exerted an antidermatitis effect against oxazolone by modulating macrophage activation. PFS administration might be useful in the treatment of AD and inflammatory skin diseases.

The endeavor of vibration-induced emission (VIE) for dynamic emissions.

Organic chromophores with large Stokes shifts and dual emissions are fascinating because of their fundamental and applied interest. Vibration-induced emission (VIE) refers to a tunable multiple fluorescence exhibited by saddle-shaped N,N'-disubstituted-dihydribenzo[a,c]phenazines (DHPs), which involves photo-induced configuration vibrations from bent to planar form along the N-N axis. VIE-active molecules show intrinsic long-wavelength emissions in the unconstrained state (planar state) but bright short-wavelength emissions in the constrained state (bent state). The emission response for VIE-active luminogens is highly sensitive to steric hindrance encountered during the planarization process such that a tiny structural variation can induce an evident change in fluorescence. This can often be achieved by tuning the intensity ratio of short- and long-wavelength bands. In some special cases, the alterations in the emission wavelength of VIE fluorophores can be achieved step by step by harnessing the degree of bending angle motion in the excited state. In this perspective, we summarize the latest progress in the field of VIE research. New bent heterocyclic structures, as novel types of VIE molecules, are being developed, and the general features of the chemical structures are also being proposed. Technologically, novel emission color-tuning approaches and VIE-based probes for visualizing biological activity are presented to demonstrate how the dynamic VIE effect can be exploited for cutting-edge applications.

Diversified Excited-State Relaxation Pathways of Donor-Linker-Acceptor Dyads Controlled by a Bent-to-Planar Motion of the Donor.

Herein, we introduce the cyclic 8π-electron (C8π) molecule N,N'-diaryl-dihydrodibenzo[a,c]phenazine (DPAC) as a dual-functional donor to establish a series of new donor-linker-acceptor (D-L-A) dyads DLA1-DLA5. The excited-state bent-to-planar dynamics of DPAC regulate the energy gap of the donor, while the acceptors A1-A5 are endowed with different energy gaps and HOMO/LUMO levels. As a result, the rate and efficiency of the excited-state electron transfer vs. energy transfer can be finely harnessed, which is verified via steady-state spectroscopy and time-resolved emission measurements. This comprehensive approach demonstrates, for the first time, the manifold of excited-state properties governed by bifunctional donor-based D-L-A dyads, including bent-to-planar, photoinduced electron transfer (PET) from excited donor to acceptor (oxidative-PET), fluorescence resonance energy transfer (FRET), bent-to-planar followed by electron transfer (PFET), and PET from donor to excited acceptor (reductive-PET).

Supramolecular Assembly-Driven Color-Tuning and White-Light Emission Based on Crown-Ether-Functionalized Dihydrophenazine.

The development of color-tunable white-light-emitting systems is significant for artificial smart materials. Recently, a set of conformational dependent fluorophores N,N'-diaryl-dihydrodibenzo[a,c]phenazines (DPACs) have been developed with unique photoluminescence mechanism vibration-induced emission (VIE). DPACs can emit intrinsical blue emission at a bent excited state and abnormal orange-red emission at a planar excited state, which are due to the varied π-conjugation via excited-state configuration transformation along the N-N' axis from bent to planar form. Herein, a novel VIE-active compound DPAC-[B15C5]2 is designed and synthesized with two wings of benzo-15-crown-5. The excited-state vibration of the DPAC moiety can be modulated by tuning the supramolecular assembly and disassembly via chelation competition of K+ between 15-crown-5 and 18-crown-6, and hence, a wide-color-tuning emission is achieved from blue to orange-red including white. Dynamic light scattering and transmission electron microscopy experiments were conducted to exhibit the supramolecular assembling process. Additionally, the moisture detection in organic solvents is realized since the water could dissociate the supramolecular assembly.

Flemingia philippinensis Flavonoids Relieve Bone Erosion and Inflammatory Mediators in CIA Mice by Downregulating NF-κB and MAPK Pathways.

BACKGROUND: The dry root of Flemingia philippinensis has been widely used in the treatment of rheumatism, arthropathy, and osteoporosis in traditional Chinese medicine; the therapeutic effects of Flemingia philippinensis are associated with antiarthritis in traditional Chinese medicine theory. This study was undertaken to investigate the mechanism of bone erosion protection and anti-inflammatory effect of Flemingia philippinensis flavonoids (FPF) in collagen-induced arthritis (CIA) in mice. METHODS: Flavonoids were extracted from the dry root of Flemingia philippinensis. Collagen-induced arthritis in C57BL/6 mice was used as a rheumatoid arthritis model, and the mice were orally fed with FPF prior to induction to mimic clinical prophylactic therapy for a total of 39 days. After treatment, histology and immunohistochemistry staining were performed, and the levels of anti-collagen type II (CII) antibody and inflammatory mediators, as well as the key proteins of nuclear factor kappa-B (NF-κB) and mitogen-activated protein kinase (MAPK) pathways, were detected in the samples taken from ankle joints, plasma, and paws. RESULTS: FPF administration significantly suppressed the paw swelling and arthritic score in CIA mice. FPF reduced inflammatory infiltration and pannus formation, articular cartilage destruction and osteoclast infiltration, and the expression of MMP-9 and cathepsin K in the ankle joint. FPF inhibited plasma anti-CII antibody levels and the production of inflammatory cytokines and chemokines in CIA paws. FPF treatment suppressed the activation of NF-κB as indicated by downregulating the phosphorylation of NF-κB p65 and mitogen-activated protein kinases in CIA paws. Additionally, FPF significantly inhibited inflammation signaling by suppressing the activation of activator protein-1 subset and signal transducers and activators of transcription 3 (STAT3). CONCLUSIONS: Our data suggest that FPF might be an active therapeutic agent for rheumatoid arthritis and the preventive effect of FPF on arthritis is attributable to an anti-inflammatory effect on CIA by preventing bone destruction, regulating inflammatory mediators, and suppressing NF-κB and MAPK signaling pathways.

Ratiometric Indicator Based on Vibration-Induced Emission for in Situ and Real-Time Monitoring of Gelation Processes.

Monitoring specific processes such as gelation in a ratiometric and visual manner is of scientific value and has practical implications but remains challenging. Herein, an innovative fluorescent low-molecular-weight gelator (DPAC-CHOL) capable of revealing and self-revealing the gelation processes in situ and in real time via the ratiometric fluorescence change from orange-red to blue has been developed. By virtue of its vibration-induced emission attribute, the gelation point, critical gelation concentration, and the internal stiffness of the gel networks of DPAC-CHOL and other gelation systems could be facilely evaluated in a ratiometric and naked-eye-observable fashion. Noteworthily, the DPAC-CHOL-doped gelation system Ph-CHOL can quantitatively identify the environmental temperature in a daily-concerned range (i.e., 20-55 °C). This work not only provides a versatile advanced material but also opens up a new avenue for the investigation of gelation systems.

Periploca forrestii saponin ameliorates CIA via suppressing proinflammatory cytokines and nuclear factor kappa-B pathways.

OBJECTIVE: Periploca forrestii Schltr has been used as a Chinese folk medicine for the treatment of rheumatism, arthralgia and fractures. However, the anti-arthritic activity of Periploca forrestii saponin (PFS) and the active compound has still not been revealed. This study aimed to investigate the protective effects and mechanisms of PFS on collagen type II (CII) collagen-induced arthritis (CIA) mice. We sought to investigate whether PFS and Periplocin could regulate osteoclastogenesis, and if so, further investigation on its mechanism of action. METHODS: Arthritis was induced in female BALB/c mice by CIA method. PFS was administered at a dose of 50 mg/kg body weight once daily for five weeks. The effects of treatment in mice were assessed by histological and biochemical evaluation in sera and paws. Anti-osteoclastogenic action of PFS and Periplocin was identified using an osteoclast formation model induced by RANKL. RESULTS: PFS ameliorated paw erythema and swelling, inhibited bone erosion in ankle joint histopathological examination. PFS treatment resulted in decreased IgG2a, and increased IgG1 levels in the serum of CIA mice. Decreased TNF-α, and increased interleukin (IL)-4 and IL-22 levels were also found in PFS-treated mice. PFS inhibited the I-κBα phosphorylation, blocked nuclear factor (NF)-κB/p65 phosphorylation and abrogated AP-1/c-Fos activity. PFS downregulated toll-like receptor (TLR) 4, STAT3 and MMP-9 expression in CIA mice and RANKL-induced osteoclastogenesis. PFS and Periplocin inhibited RANKL-induced osteoclast formation in a dose dependent manner within nongrowth inhibitory concentration, and PFS decreased osteoclastogenesis-related marker expression, including cathepsin K and MMP-9. CONCLUSION: This study revealed that the protective mechanism of PFS on CIA was associated with regulatory effects on proinflammatory factors and further on the crosstalk between NF-κB and c-Fos/AP-1 in vivo and in vitro. Therefore, PFS is a promising therapeutic alternative for the treatment of RA, evidencing the need to conduct further studies that can identify their active components in treating and preventing RA.

Periploca forrestii Saponin Ameliorates Murine CFA-Induced Arthritis by Suppressing Cytokine Production.

Periploca forrestii Schltr. has been used as a Chinese folk medicine due to its versatile pharmacological effects such as promoting wounds and rheumatoid arthritis. However, the antiarthritic activity of Periploca forrestii saponin (PFS) and its active compound Periplocin has still not been demonstrated. Here, we evaluated the antiarthritic effects of PFS in adjuvant-induced arthritis (AIA) rats by intragastric administration at a dose of 50 mg/kg. The anti-inflammatory activities of Periplocin were also examined in LPS-induced AIA splenocytes and synoviocytes. PFS significantly ameliorated joint swelling; inhibited bone erosion in joints; lowered levels of IL-6 and TGF-ß1 in AIA rat splenocyte; and reduced joint protein expression levels of phospho-STAT3 and IKKα. Using LPS-induced AIA splenocytes, we demonstrate that Periplocin suppressed the key proinflammatory cytokines levels of IL-6, IFN-γ, TGF-ß1, and IL-13 and IL-22 and transcription factor levels of T-bet, GATA3, and C-Jun genes. Periplocin also suppressed LPS-induced cytokine secretion from synoviocytes. Our study highlights the antiarthritic activity of PFS and its derived Periplocin and the underlying mechanisms. These results provide a strong rationale for further testing and validation of the use of Periploca forrestii Schltr. as an alternative modality for the treatment of RA.

Tumor necrosis factor-α, monocyte chemoattractant protein-1 and intercellular adhesion molecule-1 increase during the development of a 2,4-dinitrofluorobenzene-induced immediate-type dermatitis in rats.

BACKGROUND: Due to the steadily increasing incidence of atopic dermatitis, there is a great medical need for new therapies and improved animal models. OBJECTIVE: To provide more detailed analysis of a Sprague-Dawley rat dermatitis model. METHODS: Sprague-Dawley rats were actively sensitized by intraperitoneal injections of dinitrophenylated ovalbumin (DNP-OVA) plus alum. Skin reactions were elicited by repeated epicutaneous challenge with 2,4-dinitrofluorobenzene (DNFB). RESULTS: The ear thickness exhibited a significant increase from the first challenge. A relatively steep increase in ear thickness was observed at the fifth DNFB application. After the fifth DNFB application, total serum immunoglobulin (Ig) E and IgG1 levels reached a plateau at 1 h compared with the normal group. The peak production of tumor necrosis factor (TNF)-α and monocyte chemoattractant protein (MCP)-1 was found at 1 h, while that of intercellular adhesion molecule (ICAM)-1 was found at 24 h. Infiltration of CD4+ T cells, CD8+ T cells, eosinophils and mast cells increased in the skin lesion. CONCLUSIONS: The indices such as thickness and inflammatory cell infiltration in the lesional skin were increased by repeated hapten application; TNF-α, MCP-1 and ICAM-1 increased with the development of the dermatitis.

Immunomodulatory effect of Eriobotrya japonica seed extract on allergic dermatitis rats.

We examined the immunomodulatory effect of Eriobotrya japonica seed extract (ESE) on rat allergic dermatitis elicited by repeated dinitrofluorobenzene (DNFB) application on the ear. Oral administration of ESE significantly inhibited development of allergic dermatitis based on lower ear thickness and serum immunoglobulin E (IgE) levels. Th1 cytokine interferon-gamma (IFN-gamma) and interleukin-2 (IL-2), Th2 cytokine interleukin-4 (IL-4) and interleukin-10 (IL-10) in the lesional skin were determined. Oral administration of ESE significantly decreased IL-4 while significantly increasing IL-10 in lesional skin, and the lower levels of IFN-gamma and IL-2 were reversed by oral administration of ESE. The infiltration of eosinophils in the lesional skin was decreased by oral administration of ESE. These results suggested that ESE exerts anti-allergic actions by improving the balance of Th1/Th2 in allergic dermatitis.

Protective effects of Flos lonicera extract on acute liver injury by dimethylnitrosamine-induced in rats.

The aim of this study is to investigate effects of Flos lonicera extract (FLE) on acute liver injury model rats which induced by 35 mg/kg dimethylnitrosamine (DMN). Model rats were divided into hepatic injury control group (administrated with water), FLE group (administrated with FLE) and silymarin group (administrated with silymarin which is hepatotherapeutic drug) as positive control. They were examined including ALT, AST, ALP, gamma-GT, ALB and TP levels in serum, and MDA, GPx levels in liver tissue. In addition, pathologic changes, particularly fibrosis, were examined by Azan staining. The results revealed that the ALT, AST, ALP, gamma-GT, MDA GPx and liver fibrosis degree in the LJE group were lower than the silymarin group and control group, ALB and TP were higher than the silymarin group and control group. These results suggested that LJE may help in inhibiting of acute liver injury greater than silymarin.

Animal studies supporting the inhibition of mast cell activation by Eriobotrya japonica seed extract.

OBJECTIVES: The potent antioxidant activity of Eriobotrya japonica seed extract (ESE) and its usefulness in the prevention and treatment of various disorders has been reported previously. Its antioxidant activity associated with beta-sitosterol and polyphenols contained in the extract was also validated. In this study, anti-allergic activity of Eriobotrya japonica seed extract was investigated. METHODS: The inhibition of histamine release-mediated type 1 allergy by Eriobotrya japonica seed extract was used as an index. KEY FINDINGS: The administration of this extract inhibited histamine release from rat mast cells, suggesting its usefulness in allergic disease treatment. In an experiment using a guinea-pig allergic rhinitis model, this extract reduced the frequency of sneezing and nose-scratching. CONCLUSIONS: These results suggest that Eriobotrya japonica seed extract may contribute to the relief of allergic disease-related symptoms.

Effect of orally administered Eriobotrya japonica seed extract on allergic contact dermatitis in rats.

The anti-allergic activity of Eriobotrya japonica seeds extract (ESE) was investigated. Oral administration of ESE dramatically inhibited ear swelling due to allergic contact dermatitis caused by repeated application of two antigens, 4-ethoxymethylene-2-phenyl-2-oxazolin-5-one (oxazolone) and dinitrofluorobenzene (DNFB), respectively. The increase of histamine content in inflamed ear tissue induced by oxazolone and DNFB was significantly antagonized by orally administered ESE. Eosinophil peroxidase and myeloperoxidase activity in both models was suppressed by orally administered ESE. Tumour necrosis factor-alpha in the inflamed region caused by repeated application of DNFB was also significantly suppressed. The findings suggest that ESE may be effective for treating allergic contact dermatitis.