The Chinese consensus for surgical treatment of traumatic rib fractures 2021 (C-STTRF 2021).

Rib fracture is the most common injury in chest trauma. Most of patients with rib fractures were treated conservatively, but up to 50% of patients, especially those with combined injury such as flail chest, presented chronic pain or chest wall deformities, and more than 30% had long-term disabilities, unable to retain a full-time job. In the past two decades, surgery for rib fractures has achieving good outcomes. However, in clinic, there are still some problems including inconsistency in surgical indications and quality control in medical services. Before the year of 2018, there were 3 guidelines on the management of regional traumatic rib fractures were published at home and abroad, focusing on the guidance of the overall treatment decisions and plans; another clinical guideline about the surgical treatment of rib fractures lacks recent related progress in surgical treatment of rib fractures. The Chinese Society of Traumatology, Chinese Medical Association, and the Chinese College of Trauma Surgeons, Chinese Medical Doctor Association organized experts from cardiothoracic surgery, trauma surgery, acute care surgery, orthopedics and other disciplines to participate together, following the principle of evidence-based medicine and in line with the scientific nature and practicality, formulated the Chinese consensus for surgical treatment of traumatic rib fractures (STTRF 2021). This expert consensus put forward some clear, applicable, and graded recommendations from seven aspects: preoperative imaging evaluation, surgical indications, timing of surgery, surgical methods, rib fracture sites for surgical fixation, internal fixation method and material selection, treatment of combined injuries in rib fractures, in order to provide guidance and reference for surgical treatment of traumatic rib fractures.

Constructing a Risk Prediction Model for Lung Cancer Recurrence by Using Gene Function Clustering and Machine Learning.

OBJECTIVE: A significant proportion of patients with early non-small cell lung cancer (NSCLC) can be cured by surgery. The distant metastasis of tumors is the most common cause of treatment failure. Precisely predicting the likelihood that a patient develops distant metastatic risk will help identify patients who can further intervene, such as conventional adjuvant chemotherapy or experimental drugs. METHODS: Current molecular biology techniques enable the whole genome screening of differentially expressed genes, and rapid development of a large number of bioinformatics methods to improve prognosis. RESULTS: The genes associated with metastasis do not necessarily play a role in the pathogenesis of the disease, but rather reflect the activation of specific signal transduction pathways associated with enhanced migration and invasiveness. CONCLUSION: In this study, we discovered several genes related to lung cancer resistance and established a risk model to predict high-risk patients.

Effects of Xiaoding Ointment on COX-2/PGE2/cAMP signal pathway expression in fracture healing / 中成药

AIM To study the effects and action mechnism of Xiaoding Ointment (Pyrolusite,Catechu,Rhei Radix et Rhizoma,etc.) on rabbits' fracture healing in terms of cyclooxygenase-2 (COX-2),prostaglandin E2 (PGE2),cyclic adenosine monophosphate (cAMP) expressions at different time points.METHODS One hundred and twenty-eight New Zealand white rabbits were randomly divided into blank group,model group,Qingpeng Ointment (Oxytropis Falcatae Herba,Rhei lhasaense Radix et Rhizoma,Terminalia chebula Fructus,etc.) group and Xiaoding Ointment group.All the other groups,except the blank group,were made with ulna 3 mm bone defect,after which external fixation was applied to both the blank group and the model group.On the 3rd,7th,14th and 28th days after the medications,eight rabbits randomly selected from various groups had their callus morphopathology changes observed under optical microscope,their callus tissue COX-2 mRNA expression levels were detected by realtime fluorescence quantitative polymerase chain reaction (qRT-PCR),and their callus tissue PGE2 and cAMP protein expressions were determined by immunohistochemistry.RESULTS Compared with the model group and the Qingpeng Ointment group,the Xiaoding Ointment group exhibited significantly better formation of callus and collagen fibers.The mRNA expression of COX-2,and the protein expressions of PGE2 and cAMP in the Xiaoding Ointment group were remarkably enhanced as revealed on the 7th and 14th days' postoperative check (P ＜ 0.05),and the peak values arrived around the 14th day after the operation.CONCLUSION Xiaoding Ointment's obvious effect on promoting fracture healing may associate with its impact on COX-2/PGE2/cAMP signaling pathway.