Total body water percentage and 3rd space water are novel risk factors for training-related lower extremity muscle injuries in young males.

PURPOSE: To identify the risk factors for training-related lower extremity muscle injuries in young males by a non-invasive method of body composition analysis. METHODS: A total of 282 healthy young male volunteers aged 18 - 20 years participated in this cohort study. Injury location, degree, and injury rate were adjusted by a questionnaire based on the overuse injury assessment methods used in epidemiological studies of sports injuries. The occurrence of training injuries is monitored and diagnosed by physicians and treated accordingly. The body composition was measured using the BodyStat QuadScan 4000 multifrequency Bio-impedance system at 5, 50, 100 and 200 kHz to obtain 4 impedance values. The Shapiro-Wilk test was used to check whether the data conformed to a normal distribution. Data of normal distribution were shown as mean ± SD and analyzed by t-test, while those of non-normal distribution were shown as median (Q1, Q3) and analyzed by Wilcoxon rank sum test. The receiver operator characteristic curve and logistic regression analysis were performed to investigate risk factors for developing training-related lower extremity injuries and accuracy. RESULTS: Among the 282 subjects, 78 (27.7%) developed training injuries. Lower extremity training injuries revealed the highest incidence, accounting for 23.4% (66 cases). These patients showed higher percentages of lean body mass (p = 0.001), total body water (TBW, p = 0.006), extracellular water (p = 0.020) and intracellular water (p = 0.010) as well as a larger ratio of basal metabolic rate/total weight (p = 0.006), compared with those without lower extremity muscle injuries. On the contrary, the percentage of body fat (p = 0.001) and body fat mass index (p = 0.002) were lower. Logistic regression analysis showed that TBW percentage > 65.35% (p = 0.050, odds ratio = 3.114) and 3rd space water > 0.95% (p = 0.045, odds ratio = 2.342) were independent risk factors for lower extremity muscle injuries. CONCLUSION: TBW percentage and 3rd space water measured with bio-impedance method are potential risk factors for predicting the incidence of lower extremity muscle injuries in young males following training.

A Novel Cargo Delivery System-AnCar-ExoLaIMTS Ameliorates Arthritis via Specifically Targeting Pro-Inflammatory Macrophages.

Macrophages are heterogenic phagocytic cells that play distinct roles in physiological and pathological processes. Targeting different types of macrophages has shown potent therapeutic effects in many diseases. Although many approaches are developed to target anti-inflammatory macrophages, there are few researches on targeting pro-inflammatory macrophages, which is partially attributed to their non-s pecificity phagocytosis of extracellular substances. In this study, a novel recombinant protein is constructed that can be anchored on an exosome membrane with the purpose of targeting pro-inflammatory macrophages via antigen recognition, which is named AnCar-ExoLaIMTS . The data indicate that the phagocytosis efficiencies of pro-inflammatory macrophages for different AnCar-ExoLaIMTS show obvious differences. The AnCar-ExoLaIMTS3 has the best targeting ability for pro-inflammatory macrophages in vitro and in vivo. Mechanically, AnCar-ExoLaIMTS3 can specifically recognize the leucine-rich repeat domain of the TLR4 receptor, and then enter into pro-inflammatory macrophages via the TLR4-mediated receptor endocytosis pathway. Moreover, AnCar-ExoLaIMTS3 can efficiently deliver therapeutic cargo to pro-inflammatory macrophages and inhibit the synovial inflammatory response via downregulation of HIF-1α level, thus ameliorating the severity of arthritis in vivo. Collectively, the work established a novel gene/drug delivery system that can specifically target pro-inflammatory macrophages, which may be beneficial for the treatments of arthritis and other inflammatory diseases.

Management of non-compressible torso hemorrhage: An update.

With the widespread adoption of advanced tourniquets, the mortality rate of limb wound hemorrhage has decreased significantly, and non-compressible torso hemorrhage has gradually occupied the leading position of potentially preventable death, both in military and civilian circumstances. With the emergence of novel hemostatic devices and materials, strategies for the management of non-compressible torso hemorrhage have changed significantly. This review summarizes the current treatment strategies and types of equipment for non-compressible torso hemorrhage and suggests future research directions, hoping to provide a comprehensive review for the medical personnel and researchers engaging in this field.

Candidal periprosthetic joint infection after primary total knee arthroplasty combined with ipsilateral intertrochanteric fracture: A case report.

BACKGROUND: Candidal periprosthetic joint infection is a rare and difficult to diagnose complication of total knee arthroplasty. The treatment of such complications is inconclusive and may include prosthesis removal, debridement, arthrodesis, and extensive antifungal therapy to control the infection. CASE SUMMARY: A 62-year-old male with a history of total knee arthroplasty (TKA) in his left knee presented with ipsilateral knee pain and a sinus discharge 20 mo after TKA. The patient was previously evaluated for left knee pain, swelling, and a transient fever one month postoperatively. Prothesis removal and insertion of a cement spacer were performed in a local hospital six months prior to the current presentation. Medical therapy included rifampicin and amphotericin which were administered for 4 wk following prosthesis removal. A second debridement was performed in our hospital and Candida parapsilosis was detected in the knee joint. Fourteen weeks following the latter debridement, the patient suffered a left intertrochanteric fracture and received closed reduction and internal fixation with proximal femoral nail anterotation. Two weeks after fracture surgery, a knee arthrodesis with autograft was performed using a double-plate fixation. The patient recovered adequately and was subsequently discharged. At the two-year follow-up, the patient has a stable gait with a pain-free, fused knee. CONCLUSION: Fungal periprosthetic joint infection following TKA may be successfully and safely treated with prosthesis removal, exhaustive debridement, and arthrodesis after effective antifungal therapy. Ipsilateral intertrochanteric fractures of the affected knee can be safely fixated with internal fixation if the existing infection is clinically excluded and aided by the investigation of serum inflammatory markers.

[Generation and validation of inducible osteoblast-specific Stat3 knockout mice].

PURPOSE: Based on the Cre-Loxp gene knockout system, this study intended to construct tamoxifen-inducible STAT3 conditional knockout mice and verify the knockout efficiency. METHODS: The inducible osteoblasts-specific Stat3 knockout mice Stat3Col1ERT2 were obtained by hybridization through C57 mice of Stat3fl/fl and Col1 creERT2. Bone mesenchymal stem cells(BMSCs) of these mice were isolated and cultured with or without 4-hydroxytamoxin(4-OTH), to verify the effect of Stat3 knockout in vitro by real-time quantitative PCR and Western blotting in the level of mRNA and protein. Meanwhile, wild type and Stat3Col1ERT2 mice were both intraperitoneally injected with tamoxifen, the expression of STAT3 in the maxillary alveolar bone was observed by immunofluorescent staining to confirm the knockout effect in vivo. Statistical analysis was conducted with SPSS 24.0 software package. RESULTS: Real-time quantitative PCR and Western blotting results demonstrated that mRNA(P<0.05) and protein levels of STAT3 were significantly decreased (P<0.05) in BMSCs derived from Stat3Col1ERT2 mice by 4-OHT induced knockout in vitro. Immunofluorescent staining indicated that STAT3 expression was significantly reduced(P<0.05) in osteoblasts of the maxillary alveolar bone in Stat3Col1ERT2 mice. CONCLUSIONS: This study successfully constructed the inducible osteoblasts-specific Stat3 gene knockout mice, which helped investigators control the time and space of gene knockout, therefore providing new insights and guidance for research fields of orthodontic tooth movement, distraction osteogenesis and jaw fractures in the future.

[Expression of STAT3 in alveolar bone during orthodontic tooth movement in rats].

PURPOSE: To study the changes of expression of signal transducer and activator of transcription 3 (STAT3) during orthodontic tooth movement (OTM). METHODS: Twenty six-week-old SD rats were selected, the upper left first molars were moved by coil spring and lasted for 7 days. The maxillary tissues were obtained at 0, 1, 3, 7 d and subjected to histological study. Statistical analysis was performed using SPSS 16.0 software package. RESULTS: The main changes in alveolar bone during orthodontic tooth movement included significant increase in osteoblast number and bone formation in the tension area, and bone resorption in the pressure area. The positive cells of osteocalcin in the tension area increased during OTM. The expression of STAT3 increased in the tension area at 3 d and 7 d in comparison with that at 0 d. CONCLUSIONS: Orthodontic force can stimulate alveolar bone remolding. The expression of STAT3 in the tension area may have effects on alveolar bone remolding during orthodontic tooth movement.