Burden of Child Anemia Attributable to Fine Particulate Matters Brought by Sand Dusts in Low- and Middle-Income Countries.

Addressing environmental factors has recently been recommended to curb the growing trend of anemia in low- and middle-income countries (LMICs). Fine particulate matter (PM2.5) generated by dust storms were concentrated in place with a high prevalence of anemia. In a multicounty, multicenter study, we analyzed the association between anemia and life-course averaged exposure to dust PM2.5 among children aged <5 years based on 0.65 million records from 47 LMICs. In the fully adjusted mixed effects model, each 10 µg/m3 increase in life-course averaged exposure to dust PM2.5 was associated with a 9.3% increase in the odds of anemia. The estimated exposure-response association was nonlinear, with a greater effect of dust PM2.5 exposure seen at low concentrations. Applying this association, we found that, in 2017, among all children aged <5 years in the 125 LMICs, dust PM2.5 contributed to 37.98 million cases of anemia. Results indicated that dust PM2.5 contributed a heavier burden than all of the well-identified risk factors did, except for iron deficiency. Our study revealed that long-term exposure to dust PM2.5 can be a novel risk factor, pronouncedly contributed to the burden of child anemia in LMICs, affected by land degradations or arid climate.

Microarray analysis of tRNA-derived small RNA (tsRNA) in LPS-challenged macrophages treated with metformin.

Metformin, a widely used anti-diabetic drug, has demonstrated its efficacy in addressing various inflammatory conditions. tRNA-derived small RNA (tsRNA), a novel type of small non-coding RNA, exhibits diverse regulatory functions and holds promise as both a diagnostic biomarker and a therapeutic target for various diseases. The purpose of this study is to investigate whether the abundance of tsRNAs changed in LPS versus LPS + metformin-treated cells, utilizing microarray technology. Firstly, we established an in vitro lipopolysaccharide (LPS)-induced inflammation model using RAW264.7 macrophages and assessed the protective effects of metformin against inflammatory damage. Subsequently, we extracted total RNA from both LPS-treated and metformin + LPS-treated cell samples for microarray analysis to identify differentially abundant tsRNAs (DA-tsRNAs). Furthermore, we conducted bioinformatics analysis to predict target genes for validated DA-tsRNAs and explore the biological functions and signaling pathways associated with DA-tsRNAs. Notably, metformin was found to inhibit the inflammatory response in RAW264.7 macrophages. The microarray results revealed a total of 247 DA-tsRNAs, with 58 upregulated and 189 downregulated tsRNAs in the Met + LPS group compared to the LPS group. The tsRNA-mRNA network was visualized, shedding light on potential interactions. The results of bioinformatics analysis suggested that these potential targets of specific tsRNAs were mainly related to inflammation and immunity. Our study provides compelling evidence that metformin exerts anti-inflammatory effects and modulates the abundance of tsRNAs in LPS-treated RAW264.7 macrophages. These findings establish a valuable foundation for using tsRNAs as potential biomarkers for metformin in the treatment of inflammatory conditions.

Treatment for locally resectable stage IIIC1r cervical cancer: surgery or chemoradiotherapy?

OBJECTIVE: The aim of this study was to compare the therapeutic value and treatment-related complications of radical hysterectomy with those of concurrent chemoradiotherapy (CCRT) for locally resectable (T1a2-T2a1) stage IIIC1r cervical cancer. METHODS: A total of 213 patients with locally resectable stage IIIC1r cervical cancer who had been treated at Jiangxi Maternal and Child Health Care Hospital between January 2013 and December 2021 were included in the study and classified into two groups: surgery (148 patients) and CCRT (65 patients). The disease-free survival (DFS) rate, overall survival (OS) rate, side effects, and economic costs associated with the two groups were compared. RESULTS: 43.9% (65/148) patients in the surgical group had no pelvic lymph node metastasis, and 21of them did not require supplementary treatment after surgery due to a low risk of postoperative pathology. The median follow-up time was 46 months (range: 7-108 months). The five-year DFS and OS rates of the surgery group were slightly higher than those of the CCRT group (80.7% vs. 75.1% and 81.6% vs. 80.6%, respectively; p > 0.05). The incidences of grade III-IV gastrointestinal reactions in the surgery and CCRT groups were 5.5% and 9.2%, respectively (p = 0.332). Grade III-IV myelosuppression was identified in 27.6% of the surgery group and 26.2% of the CCRT group (p = 0.836). The per capita treatment cost was higher for the surgery group than for the CCRT group (RMB 123, 918.6 0 vs. RMB 101, 880.90, p = 0.001). CONCLUSION: The therapeutic effects and treatment-related complications of hysterectomy and CCRT are equivalent in patients with locally resectable stage IIIC1r cervical cancer, but surgery can provide accurate lymph node information and benefit patients with unnecessary radiation.

Kynureninase knockdown inhibits cisplatin resistance in vivo and in vitro and impacts the prognosis of cervical adenocarcinoma.

BACKGROUND: Chemotherapy resistance is a leading cause of treatment failure in cases of cervical adenocarcinoma (ADC), and no effective treatment approach has yet been found. We previously identified the differentially expressed kynureninase (KYNU) mRNA in cervical adenocarcinoma cells (HeLa) and cervical adenocarcinoma cisplatin resistance cells (HeLa/DDP) using gene chips. However, the role and potential mechanism of KYNU in the cisplatin resistance of cervical adenocarcinoma remain unclear. METHODS: We verified the expression of KYNU in the cells and tissues of ADC patients and analyzed its correlation with patient prognosis. A stable HeLa/DDP cell line with KYNU mRNA knockdown was constructed. We then used a CCK8 assay to detect cell survival, a transwell assay to evaluate cell migration and proliferation and flow cytometry to measure apoptosis. The effect of KYNU silence on cisplatin sensitivity was evaluated in an orthotopic model of metastatic ADC. Immunohistochemistry was performed to determine the changes in relevant drug resistance-associated protein expression, aiming to explore the underlying mechanism of KYNU-mediated drug resistance. RESULTS: KYNU is overexpressed in HeLa/DDP cells and tissues and is associated with the poor prognoses of patients with ADC. After KYNU mRNA knockdown, the invasion, migration, and proliferation of HeLa/DDP cells in the cisplatin environment significantly reduced, while the apoptosis rate of HeLa/DDP cells significantly increased. Meanwhile, KYNU knockdown improved the DDP sensitivity of ADC in vivo. Furthermore, silencing KYNU decreased the expressions of CD34 and the drug-resistance related proteins P-gp, MRP1, and GST-π and increased the level of the proapoptotic regulatory protein Bax. CONCLUSION: KYNU deficiency enhanced DDP sensitivity by suppressing cell proliferation, migration, and invasion and promoting apoptosis in DDP-resistant ADC cells in vitro. Furthermore, KYNU knockdown improved the drug sensitivity of ADC in vivo. The results showed that KYNU is involved in the chemotherapy resistance of cervical adenocarcinoma.

MDFF-Net: A multi-dimensional feature fusion network for breast histopathology image classification.

Breast cancer is a common malignancy and early detection and treatment of it is crucial. Computer-aided diagnosis (CAD) based on deep learning has significantly advanced medical diagnostics, enhancing accuracy and efficiency in recent years. Despite the convenience, this technology also has certain limitations. When the morphological characteristics of the patient's pathological section are not evident or complex, certain small lesions or cells deep within the lesion cannot be recognized, and misdiagnosis is prone to occur. As a result, MDFF-Net, a CNN-based multidimensional feature fusion network, is proposed. The model consists of a one-dimensional feature extraction network, a two-dimensional feature extraction network, and a feature fusion classification network. The basic part of the two-dimensional feature extraction network is stacked by modules integrated with multi-scale channel shuffling networks and channel attention modules. Furthermore, inspired by natural language processing, this model integrates a one-dimensional feature extraction network to extract detailed information in the image to avoid misdiagnosis caused by insufficient information extraction such as cell morphological characteristics and differentiation degree. Finally, the extracted one-dimensional and two-dimensional features are fused in the feature fusion network and employed for the final classification. The effectiveness of MDFF-Net and classical classification models were evaluated on the BreakHis and the BACH datasets. According to experimental results, MDFF-Net achieves an accuracy of 98.86% on the BreakHis and 86.25% on the BACH dataset. Furthermore, to further assess the effectiveness of the model in other classification tasks, the colon cancer and the lung cancer datasets were employed for additional experiments, achieving a classification accuracy of 100% in both cases.

The Therapeutic Value of Adjuvant Chemotherapy after Concurrent Chemoradiotherapy for Locally Advanced Cervical Cancer.

OBJECTIVE: The aim of this study was to evaluate the therapeutic value and treatment-related complications of adjuvant chemotherapy after concurrent chemoradiotherapy (CCRT) for locally advanced cervical cancer (LACC). DESIGN: The medical records of LACC patients who underwent CCRT were reviewed retrospectively. METHODS: A total of 1,138 patients with LACC who had been treated at our hospital between January 2013 and December 2017 were included in the study and classified into two groups: the CCRT group, comprising 726 patients who had received only CCRT, and the CCRT + adjuvant chemotherapy (ACT) group, comprising 412 patients who had received three cycles of adjuvant chemotherapy after CCRT. 39 patients in the CCRT group and 50 patients in the CCRT + ACT group had undergone lymphadenectomy, which revealed pathology-positive lymph nodes in 22 patients and 35 patients, respectively. Progression-free survival (PFS), overall survival (OS), and adverse events were compared. RESULTS: The median follow-up time was 61 months (range: 2-96 months). No significant differences in PFS and OS were found between the two groups (p > 0.05), but more grade 3-4 acute hematologic toxicities were observed in the CCRT + ACT group than in the CCRT group (24.8% vs. 31.8%, p = 0.01). A subgroup analysis of patients with pathology-positive lymph nodes showed that the 5-year PFS and OS rates were 76.5% and 74.9%, respectively, for the CCRT + ACT group and 45.0% and 49.2%, respectively, for the CCRT group; the differences were statistically significant (p = 0.015 and 0.042, respectively). LIMITATIONS: First, the sample size of the subgroup of patients with pathology-positive lymph nodes was too small for a confirmative conclusion. The heterogeneous population and the selection bias resulting from the retrospective design were the other flaws of our study. CONCLUSION: The application of adjuvant chemotherapy after CCRT may be worth investigating further for women with LACC and pathology-positive lymph nodes, but this approach is associated with an increase in acute hematology toxicities.

The impact of COVID-19 on global health journals: an analysis of impact factor and publication trends.

BACKGROUND: COVID-19 has affected research productivity across all areas of knowledge. Current evidence suggests that COVID-19 has had a blockbuster effect on journal impact factors (JIFs) and publication trends, while little is known on global health journals. METHODS: Twenty global health journals were included to analyse the impact of COVID-19 on their JIFs and publication trends. Indicator data, including numbers of publications, citations, articles with different types, etc, were extracted from journal websites and Web of Science Core Collection database. The JIFs from 2019 to 2021 were simulated for longitudinal and cross-sectional analyses. Interrupted time-series analysis and non-parametric tests were applied to assess whether COVID-19 had decreased non-COVID-19 publications from January 2018 to June 2022. RESULTS: In 2020, 615 out of 3223 publications were COVID-19 related, accounting for 19.08%. The simulated JIFs of 17 out of 20 journals in 2021 were higher than those in 2019 and 2020. Notably, 18 out of 20 journals had a decrease in their simulated JIFs after excluding COVID-19-related publications. Moreover, 10 out of 20 journals decreased their monthly numbers of non-COVID-19 publications after the COVID-19 outbreak. For all the 20 journals as a whole, after the COVID-19 outbreak in February 2020, the total number of non-COVID-19 publications significantly decreased by 14.2 compared with the previous month (p=0.013), and since then, on average, the publications had decreased by 0.6 per month until June 2022 (p<0.001). CONCLUSIONS: COVID-19 has impacted the structure of COVID-19-related publications, the JIFs of global health journals and their numbers of non-COVID-19 publications. Although journals may benefit from increased JIFs, global health journals should avoid relying on a single metric. More follow-up studies including more years of data with a combination of metrics should be conducted to generate more robust evidence.

Morphological feature recognition of different differentiation stages of induced ADSCs based on deep learning.

In order to accurately identify the morphological features of different differentiation stages of induced Adipose Derived Stem Cells (ADSCs) and judge the differentiation types of induced ADSCs, a morphological feature recognition method of different differentiation stages of induced ADSCs based on deep learning is proposed. Using the super-resolution image acquisition method of ADSCs differentiation based on stimulated emission depletion imaging, after obtaining the super-resolution images at different stages of inducing ADSCs differentiation, the noise of the obtained image is removed and the image quality is optimized through the ADSCs differentiation image denoising model based on low rank nonlocal sparse representation; The denoised image is taken as the recognition target of the morphological feature recognition method for ADSCs differentiation image based on the improved Visual Geometry Group (VGG-19) convolutional neural network. Through the improved VGG-19 convolutional neural network and class activation mapping method, the morphological feature recognition and visual display of the recognition results at different stages of inducing ADSCs differentiation are realized. After testing, this method can accurately identify the morphological features of different differentiation stages of induced ADSCs, and is available.

Research on PBFT consensus algorithm for grouping based on feature trust.

The consensus mechanism is the core of the blockchain system, which plays an important role in the performance and security of the blockchain system . The Practical Byzantine Fault Tolerance (PBFT) algorithm is a widely used consensus algorithm, but the PBFT algorithm also suffers from high consensus latency, low throughput and performance. In this paper, we propose a grouped PBFT consensus algorithm (GPBFT) based on feature trust. First, the algorithm evaluates the trust degree of nodes in the transaction process through the EigenTrust trust model, and uses the trust degree of nodes as the basis for electing master nodes and proxy nodes. Then, the algorithm divides the nodes in the blockchain system into multiple groups, and the consensus within each independent group does not affect the other groups, which greatly reduces the communication overhead of the consensus process when the number of nodes in the system is large. Finally, we demonstrate through theoretical and experimental analysis that the GPBFT algorithm has a significant improvement in security and performance.

Risk factors on healthcare-associated infections among tuberculosis hospitalized patients in China from 2001 to 2020: a systematic review and meta-analysis.

BACKGROUND: China has been still suffering from high burden attributable to tuberculosis (TB) and healthcare-associated infections (HAIs). TB patients are at high risk to get HAIs. Evidence-based guidelines or regulations to constrain the rising HAIs among TB hospitalized patients are needed in China. The aim of this systematic review and meta-analysis is to investigate the risk factors associated with HAIs among TB hospitalized patients in Chinese hospitals. METHODS: Medline, EMBASE and Chinese Journals Online databases were searched. The search was limited to studies published from January 1st 2001 to December 31st 2020. Meta-analyses of ORs of the risk factors between patients with HAIs and patients without HAIs among TB hospitalized patients were estimated. Heterogeneity among studies was assessed based on the [Formula: see text]2 and I2 statistics to select the meta-analysis model. Review Manager 5.3 was employed and P < 0.05 was considered as statistical significance. RESULTS: 851 records were filtered from the databases, of which 11 studies were included in the quantitative meta-analysis. A total of 11,922 TB patients were included in the systematic review and meta-analysis, of which 1133 were diagnosed as having HAIs. Age older than 60 years (OR: 2.89 [2.01-4.15]), complications (OR: 3.28 [2.10-5.13]), diabetes mellitus (OR: 1.63 [1.22-2.19]), invasive procedure (OR: 3.80 [2.25-6.42]), longer than 15 hospitalization days (OR: 2.09 [1.64-2.64]), secondary tuberculosis (OR: 2.25 [1.48-3.42]), smoking (OR: 1.40[1.02-1.93]), underlying disease (OR: 2.66 [1.53-4.62]), and use of antibiotics (OR: 2.77 [2.35-3.27]) were the main risk factors associated with HAIs among TB hospitalized patients with a statistical significance (P < 0.05). CONCLUSIONS: Age older than 60 years, presence of complications, presence of diabetes mellitus, invasive procedure, longer than 15 hospitalization days, secondary tuberculosis, smoking, presence of underlying disease, and use of antibiotics were the main risk factors which had a negative impact on HAIs among TB hospitalized patients in Chinese hospitals. These findings provided evidence for policy makers and hospital managers to make effective infection prevention and control measures to constrain the rising HAIs. It is also required that more cost-effective infection prevention and control measures should be widely applied in routinely medical treatment and clinical management to reduce the occurrence of HAIs among TB hospitalized patients.

The best postoperative adjuvant therapy for patients with early stage cervical adenosquamous carcinoma.

BACKGROUND: Cervical adenosquamous carcinoma (ASC) was previously thought to be a subtype of cervical adenocarcinoma, but recent studies have found that the clinical features of the two diseases are different. Moreover, the pathological characteristics, survival, prognosis, and optimal ASC therapy remain unknown. This study aims to retrospectively analyze the postoperative survival of patients with early-stage ASC and to evaluate their condition after treatment with postoperative concurrent chemoradiotherapy (CCRT) and prophylactic irradiation of the para-aortic lymphatic drainage area. METHODS: This study enrolled 131 patients with pathologically confirmed ASC screened from 3502 patients with confirmed stage I-II cervical cancer diagnosis who had completed surgical treatments in our hospital. Among the 131 enrolled patients, 75 patients received CCRT, 33 patients received chemotherapy (CT), and 23 patients did not receive adjuvant treatment (named surgery alone (S alone). Of the 75 patients CCRT, 43 patients received prophylactic irradiation of the para-aortic lymphatic drainage area. The efficacy of the postoperative treatments of patients among groups (CCRT, CT, and S alone) was compared. RESULTS: The median follow-up time, age, and overall survival (OS) were 76 months, 43 years, and 74 months, respectively. The 3- and 5-year survival rates were 82% and 71.4%, respectively. The median disease-free survival (DFS) was 64 months. Cox regression analysis showed that postoperative adjuvant treatment modalities and positive lymph node metastases were associated with OS and DFS. Patients who received CCRT treatment had higher OS and DFS than those with CT and S alone. Prophylactic irradiation of the para-aortic lymphatic drainage area did not improve the OS and DFS of patients with CCRT treatment. However, further subgroup analysis suggested that it might improve survival rates in patients who had positive pelvic lymph nodes as confirmed by postoperative pathology. CONCLUSION: Postoperative CCRT improved the survival rates in patients with early-stage ASC. The value of prophylactic irradiation of the para-aortic lymphatic drainage area remains debatable, but it may benefit patients with pelvic lymph node involvement.

Bi-layered nanofibrous membrane with osteogenic and antibacterial functions for periodontal tissue regeneration.

Guided tissue regeneration (GTR) membranes have great potential to promote periodontal tissue regeneration and reestablishment. However, the regeneration potential and microbial infection resistance of current GTR membranes still need to be improved. Here, a bi-layered nanofibrous membrane on the basis of poly (lactic-co-glycolic acid) (PLGA)/gelatin with osteogenic and antibacterial functions was fabricated for periodontal tissue regeneration. The antimicrobial layer (AL) of the bi-layered nanofibrous membrane was composed of nanofibrous PLGA/gelatin nanofibers loaded with nano-silver (nAg), while the osteoconductive layer (OL) of the nanofibrous membrane consisted of PLGA/gelatin nanofibers loaded with nano-hydroxyapatite (nHA). The bi-layered nanofibrous membrane was examined by scanning electron microscopy (SEM), energy dispersive spectrometer (EDS), transmission electron microscope (TEM), Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectrometry (XPS) and X-ray diffractometry (XRD). The results showed that nHA and nAg particles were well evenly loaded or embedded in PLGA/gelatin nanofibers. The cell culture experiments suggested that the bi-layered nanofibrous membrane possessed good cytocompatibility and the OL of the bi-layered nanofibrous membrane possessed an enhanced osteogenic capacity for human osteoblast-like cells (MG63), which was verified by the good cell viability and the increased alkaline phosphatase (ALP) activity, respectively. The results of in vitro antimicrobial study displayed that the AL of the bi-layered nanofibrous membrane possessed an effective antibacterial capability. In conclusion, the prepared bi-layered nanofibrous membrane with osteogenic and antibacterial functions may have great potential for periodontal tissue regeneration and reestablishment.[Formula: see text].

In-Situ Isothermal Crystallization of Poly(l-lactide).

The isothermal crystallization of poly(l-lactide) (PLLA) has been investigated by in-situ wide angle X-ray diffraction (WAXD) and polarized optical microscopes (POM) equipped with a hot-stage accessory. Results showed that the spherulites of PLLA were formed at high temperature, whereas irregular morphology was observed under a low temperature. This can be attributed to the varying rates of crystallization of PLLA at different temperatures. At low temperatures, the nucleation rate is fast and hence the chains diffuse very slow, resulting in the formation of imperfect crystals. On the other hand, at high temperatures, the nucleation rate is slow and the chains diffuse fast, leading to the formation of perfect crystals. The change in the value of the Avrami exponent with temperature further verifies the varying trend in the morphological feature of the crystals.

Assessment of retroperitoneal lymph node status in locally advanced cervical cancer.

BACKGROUND: The assessment of retroperitoneal lymph node status in patients with locally advanced cervical cancer is still a problem. This study aimed to explore the choice of these assessment methods. METHODS: Laparoscopic retroperitoneal lymphadenectomy was performed in 96 patients with advanced cervical cancer. The positive rates of lymph node metastasis were analyzed. The values of computed tomography lymph node minimum axial diameter (MAD) and squamous cell carcinoma antigen (SCC-Ag), and their combination in predicting retroperitoneal lymph node metastasis were compared. High-risk factors for common iliac lymph node (CILN) and/or para-aortic lymph node (PALN) metastasis were analyzed. RESULTS: The lymph node metastasis rate was 62.50% and the CILN and/or PALN metastasis rate was 31.25%. Overall, 96 patients had 172 visible lymph nodes. The positive rate of lymph node metastasis was significantly higher in the MAD ≥1.0 cm group (83.33%) than in the 0.5 cm ≤ MAD < 1.0 cm group (26.82%). The critical values of MAD and SCC-Ag in determining lymph node metastasis were 1.0 cm and 5.2 ng/mL, respectively. The accuracy, specificity, and Youden index of MAD ≥1.0 cm combined with SCC-Ag ≥ 5.2 ng/mL for evaluating lymph node metastasis were 75.71%, 100%, and 0.59, respectively, and were significantly different from the values for the MAD ≥1.0 cm (72.09%, 80.56%, and 0.47, respectively) and SCC-Ag ≥ 5.2 ng/mL (71.43%, 68.97%, and 0.42, respectively) groups. Correlation analysis showed that non-squamous cell carcinoma, pelvic lymph node (PLN) MAD ≥1.0 cm plus number ≥ 2, and 1 PLN MAD ≥1.0 cm with CILN and/or PALN MAD 0.5-1.0 cm were risk factors for CILN and/or PALN metastasis. CONCLUSION: Patients with MAD ≥1.0 cm and SCC-Ag ≥ 5.2 ng/mL, as well as high risk factors for CILN and/or PALN metastasis, should undergo resection of enlarged lymph nodes below the common iliac gland and lymphadenectomy of CILN/PALN to reduce tumor burden and to clarify lymph node metastasis status for accurate guidance in follow-up treatment. Patients with MAD < 1.0 cm and SCC-Ag < 5.2 ng/mL may be treated with chemoradiotherapy directly based on imaging, given the low lymph node metastasis rate.

Flammulina velutipes polysaccharide improves C57BL/6 mice gut health through regulation of intestine microbial metabolic activity.

Flammulina velutipes polysaccharides (FVP) can improve gut health through gut microbiota and metabolism regulation. In this study, the 28-days fed experiment was used to investigate gut microbime and metabolic profiling induced by FVP. After treatment, intestinal tissue section showed the higher villus height and villus height/crypt depth (V/C) value in FVP-treated group. The 16 s rRNA gene sequencing revealed microbiota composition alteration caused by FVP, as the Firmicutes phylum increased while Bacteroidetes phylum slightly decreased. The metabolic profiling was detected by LC/MS and results showed 56 and 99 compounds were dramatically changed after FVP treatment in positive and negative ion mode, respectively. Annotation in Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways displayed the adjustment of energy metabolism, amino acid metabolism, nucleotide metabolism and other related basic pathways after FVP treatment. Our study suggested that FVP can be developed as a dietary supplement for intestine health promotion.

Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity.

BACKGROUND: Cubitus varus deformity is a common sequela of elbow fractures in children. Cubitus varus deformity treatment is tending toward 3D correction, which is challenging for orthopedic surgeons. This study aims to explore whether individualized 3D-printed navigation templates can assist with accurate and effective corrective treatment of children with cubitus varus deformity. METHODS: Thirty-five patients were treated for cubitus varus deformity from June 2015 to April 2017, including 21 boys and 14 girls, aged 4.6-13.2 years (average, 7.5 years). Of these cases, 17 deformities were on the left side and 18 were on the right side. All were treated with wedge osteotomy of the lateral distal humerus. 3D-printed navigation templates were used in 16 cases, while traditional surgery was used in 19 cases. All patients underwent computed tomography scans before surgery. Computer software was used to analyze the measurements and design and print individualized navigation templates. The navigation templates were matched, and surgery was initially simulated. Intraoperative individualized navigation templates were used to assist with accurate osteotomy and Kirschner wire fixation. Operation times were recorded in all cases, the carrying angles before and after surgery were assessed by computer, and postoperative elbow joint function was evaluated using Bellemore criteria. All measurement data were presented as means ± SD, and Student's t test was used to examine differences between groups. All count data between both groups were compared using the chi-square test or Fisher's exact test analysis. RESULTS: All individualized navigation templates matched well with the corresponding anatomical markers and were consistent with preoperative planning, simulated surgery, and intraoperative procedures. Average operation times from clear exposure to fixed Kirschner wire were 11.69 min (9.6-13.5 min) for the individualized navigation template group and 22.89 min (17.7-26.8 min) for the traditional operation group (p < 0.001). Average differences in postoperation carrying angles between affected and healthy sides were 1.13° (0-2.0°) and 4.21° (0-7.5°), respectively (p < 0.001). Follow-up 6-12 months postoperation showed that elbow function did not differ significantly between groups using the Bellemore criteria (p > 0.05). CONCLUSIONS: Individualized navigation templates simplify procedures, reduce operation time, and improve accuracy when used in orthopedic surgery to treat children with cubitus varus deformity.

A facile approach for engineering tissue constructs with vessel-like channels by cell-laden hydrogel fibers.

Vascularization is of great importance in the successful translation of tissue engineered constructs into clinically relevant application. The lack of a general approach to rapidly construct vascular networks in engineered constructs remains a major challenge. Herein, an adhesive hydrogel-based tissue construct, in which cell-affinitive domains and interconnected channels were concurrently constructed, was put forward to enhance vascularization. Hydrogel matrix was modified with Arg-Gly-Asp (RGD) peptide to supply cell adhesion sites. Collagen fibers were added into the hydrogel matrix to produce interconnected vessel-like channels via enzyme mediated degradation. In a bone-like model, the successful outspread morphology and intensive function expression of osteo-like cells and the formation of endothelial cells-lined channels were observed, suggesting it's flexible to functionalize extracellular matrix with vessel-like channels via the introduction of endothelial cells-laden fibers. Our approach furnishes a particular strategy to build vascular architecture and is especially attractive in the bioengineering of rich vascularized tissues.

A Modification of Laparoscopic Type C1 Hysterectomy to Reduce Postoperative Bladder Dysfunction: A Retrospective Study.

OBJECTIVE: To investigate the feasibility of a modified type C1 hysterectomy, using the deep uterine vein (DUV) and its branches as an anatomical landmark, to reduce postoperative bladder dysfunction in cervical cancer patients. METHODS: One hundred fifty-two stage IA2-IIB cervical cancer patients were enrolled to undergo a laparoscopic hysterectomy. According to the operation methods, 93 or 59 of the patients were assigned to a type C1 hysterectomy (group 1), using the DUV and its branches as an anatomical landmark, and a type C2 hysterectomy (group 2), respectively. The baseline data, operation time, blood loss, hospitalization time, survival rate, and bladder dysfunction of both groups were compared. RESULTS: The patients in group 1 experienced shorter overall and postoperative hospitalization time, less blood loss, and shorter catheterization time, as compared to those in group 2. There were no statistically significant differences in intraoperative damage, postoperative complications, numbers of dissected lymph nodes, and rates of positive resection margins between two groups. The incidences of long-term overall bladder dysfunction, urinary retention, and bladder-emptying difficulties were lower in group 1 than those in group 2. There was no statistically significant difference in bladder storage dysfunction, such as urinary incontinence and frequent urination, between two groups. The 3-year disease-free survival rates and 3-year overall survival rates in the two groups were both similar. CONCLUSION: Compared to type C2 hysterectomies, type C1 hysterectomies, using the DUV and its branches as an anatomical landmark, resulted in shorter hospitalization time, less blood loss, reduced bladder dysfunction, and uncompromised radicality.

Automated fabrication of hydrogel microfibers with tunable diameters for controlled cell alignment.

A newly designed spinning device was utilized to produce continuous hydrogel microfibers with tunable diameters. It was found that the diameter of the microfiber was dependent on perfusion speed and coagulation wheel rotation rate. Their correlation was finally described by a mathematical expression, which proved to be useful for a size-tunable spinning technique. Based on the controllable fabrication of hydrogel microfibers with desired size, microfiber/cell-size-dependent cellular orientated spreading was studied by using PC12 and L929 as model cells. By further demonstrating the assembly of fibrous tissue-like grafts using the spun hydrogel microfibers, the wet spinning protocol was proved to be instructive for manufacturing size-tunable hydrogel microfibers, as well as two-dimensional or three-dimensional scaffolds with varied micro-structure for tissue engineering.