Guidance for dysmorphic sacrum fixation with upper sacroiliac screw based on imaging anatomy study: techniques and indications.

OBJECTIVE: This study aimed to investigate the techniques and indications of upper sacroiliac screw fixation for the dysmorphic sacrum. METHODS: The dysmorphic sacra were selected from 267 three-dimensional pelvic models. The dysmorphic sacra which couldn't accommodate a 7.3 mm upper trans ilio-sacroiliac screw were classified as the main dysmorphic sacra. Then, the size of the bone corridor, the length of the screw in the corridor, and the orientation of the screw were measured. The insertion point on the sacrum was identified by two bone landmarks. RESULTS: totally, 30.3% of sacra were identified as the main dysmorphic sacra. The inclinations of the screw oriented from posterior to anterior were (21.80 ± 3.56)° for males and (19.97 ± 3.02)° for females (p < 0.001), and from caudal to cranial were (29.97 ± 5.38)° for males and (28.15 ± 6.21)° for females (p = 0.047). The min diameters of the corridor were (16.31 ± 2.40) mm for males and (15.07 ± 1.58) mm for females (p < 0.001). The lengths of the screw in the Denis III zone were (14.41 ± 4.40) mm for males and (14.09 ± 5.04) mm for females (p = 0.665), and in the Denis II+III zones were (36.25 ± 3.40) mm for males and (38.04 ± 4.60) mm for females (p = 0.005). The rates of LP-PSIS/LAIIS-PSIS were (0.36 ± 0.04) for males and (0.32 ± 0.03) for females (t = 4.943, p < 0.001). The lengths of LPM were (8.81 ± 5.88) for males and (-4.13 ± 6.33) for females (t = 13.434, p < 0.001). CONCLUSION: When the sacrum has the features of "sacrum not recessed" and/or "acute alar slope", the conventional trans ilio-sacroiliac screw couldn't be placed safely. The inclination oriented from posterior to anterior and from caudal to cranial are approximately 20° and 30°, respectively. The bone insertion point locates in the rear third of the anterior inferior iliac spine to the posterior superior iliac spine. The sacroiliac screw is not recommended to fix the fractures in Denis III zone.

Early neurological deterioration in patients with minor ischemic stroke caused by large vessel occlusion: risk factors and the impact of rescue endovascular thromboectomy on outcomes at discharge / 国际脑血管病杂志

Objective:To investigate the risk factors of early neurological deterioration (END) in patients with minor ischemic stroke caused by large vessel occlusion (LVO) and the impact of rescue endovascular thromboectomy (REVT) on clinical outcomes of patients with END at discharge.Methods:Consecutive patients with acute minor ischemic stroke caused by LVO within 24 h of onset in the Third Affiliated Hospital, Soochow University from January 2021 to March 2023 were retrospectively enrolled. Minor ischemic stroke was defined as baseline National Institute of Health Stroke Scale (NIHSS) score ≤5 at admission. END was defined as an increase of ≥4 in the NIHSS score within 24 h after the best medical management. The modified Rankin Scale was used to evaluate the clinical outcomes of patients with END at discharge. 0-2 was defined as a good outcome. Multivariate logistic regression analysis was used to identify the independent risk factors for END and the impact of REVT on clinical outcomes in patients with END. Results:A total of 75 patients with minor ischemic stroke caused by LVO were included, of which 31 (41.3%) developed END and 13 (41.9%) underwent REVT after END. Multivariate logistic regression analysis showed that internal carotid artery occlusion was an independent risk factor for END (odds ratio 4.304, 95% confidence interval 1.213-15.270; P=0.024), and REVT was an independent protective factor for good outcomes in patients with END (odds ratio 0.068, 95% confidence interval 0.006-0.774; P=0.030). Conclusions:The incidence of END is higher in patients with minor ischemic stroke caused by LVO, and internal carotid artery occlusion is an independent risk factor for the occurrence of END. Providing REVT after END may improve the clinical outcomes of patients with END at discharge.

Peroxidase from foxtail millet bran exerts anti-colorectal cancer activity via targeting cell-surface GRP78 to inactivate STAT3 pathway

Molecular targeted therapy has become an emerging promising strategy in cancer treatment, and screening the agents targeting at cancer cell specific targets is very desirable for cancer treatment. Our previous study firstly found that a secretory peroxidase of class III derived from foxtail millet bran (FMBP) exhibited excellent targeting anti-colorectal cancer (CRC) activity in vivo and in vitro, whereas its underlying target remains unclear. The highlight of present study focuses on the finding that cell surface glucose-regulated protein 78 (csGRP78) abnormally located on CRC is positively correlated with the anti-CRC effects of FMBP, indicating it serves as a potential target of FMBP against CRC. Further, we demonstrated that the combination of FMBP with the nucleotide binding domain (NBD) of csGRP78 interfered with the downstream activation of signal transducer and activator of transcription 3 (STAT3) in CRC cells, thus promoting the intracellular accumulation of reactive oxygen species (ROS) and cell grown inhibition. These phenomena were further confirmed in nude mice tumor model. Collectively, our study highlights csGRP78 acts as an underlying target of FMBP against CRC, uncovering the clinical potential of FMBP as a targeted agent for CRC in the future.

Mechanism of epithelial-mesenchymal transition / 中国药理学通报

Epithelial-mesenchymal transition (EMT) is a process by which the epithelial cells change to a mesenchymal phenotype.The highly conserved and fundamental process is integral in development, wound healing and contributes pathologically to fibrosis and cancer progression.The process can be activated by many transcription factors, growth factors or protein molecules, which involves complex molecular mechanism and signal transduction pathways.This paper reviews the development of molecular mechanisms of epithelial-mesenchymal transition and briefly summarizes the research progress of natural compounds targeting the EMT.

Self-management capability of patients with PICC and influencing factors / 现代临床护理

Objective To explore the current situations in self-management of cancer patients over peripherally inserted central catheter (PICC) and the influencing factors. Method Self-designed general demographic data form, disease-related questionnaire and PICC self-management ability for cancer patients were used to investigate 98 tumor patients with PICC. Results The total score on self-management ability of the cancer patient with PICC was (150.85 ± 17.35). The influencing factors of their self-management of PICC included education level, economic condition, presence or absence of long-term caregivers and cognitive disorders, all contributive to the prediction of 28.60%total variance for the patients′self-management capability. Conclusions Cancer patients have a better ability in managing PICC, but a few patients failed to grasp self-management skills, which was resulted from many factors. Nurses should pay more attention to those with less education, under poorer economic conditions and without long-term caregivers, and provide them with more care and education so as to comprehensively improve their self-management skills.

ANTIINFLAMMATORY, ANALGESIC AND ANTIPYRETIC EFFECTS OF DEOXYACONITINE / 中国药理学通报

Deoxyaconitine (DAC), an extract from the tuber of Aconitum flavum Hand-Mazz, was assayed comparatively with the other previously studied alkaloid 3-Acetylaconitine(3AAC)with respect to their antiinflammatory, analgesic and anti-pyretic effects in laboratory animals. DACO.Smg /kg ip markedly inhibited the croton oil induced ear edema in micei 0.2 mg/kg ip or sc showed significant inhibiton on the hind-paw edema in rats induced by carrageenin or formalin,and on the increase of vascular permeability induced by intradermic injection of histam-ine in rats or acetic acid ip in mice. With the model of carrageenin induced hind-paw edema in rats, the antiinflammatory therapeutic index of DAC ip (6.38) was slightly higher than that of 3AAC (5.92 ) . The sc analgesic ED50 of DAC measured with acetic acid twisting test in mice was 0.22+ 0.06mg/kg and that measured with hotplate method by ip was 0.41+0.10 mg/kg.In the latter case, the analgesic therapeutic index of DAC (6.37) was higher than that of 3-AAC(4.60) . DAC 0.24mg/kg ip showed marked anti-pyretic effect on the rabbit fever induced by typho-paratyphoid vaccine.