Relationship between preoperative psychological stress and short-term prognosis in elderly patients with femoral neck fracture.

BACKGROUND: Older adults are at high risk of femoral neck fractures (FNFs). Elderly patients face and adapt to significant psychological burdens, resulting in different degrees of psychological stress response. Total hip replacement is the preferred treatment for FNF in elderly patients; however, some patients have poor postoperative prognoses, and the underlying mechanism is unknown. We speculated that the postoperative prognosis of elderly patients with FNF may be related to preoperative psychological stress. AIM: To explore the relationship between preoperative psychological stress and the short-term prognosis of elderly patients with FNF. METHODS: In this retrospective analysis, the baseline data, preoperative 90-item Symptom Checklist score, and Harris score within 6 months of surgery of 120 elderly patients with FNF who underwent total hip arthroplasty were collected. We analyzed the indicators of poor short-term postoperative prognosis and the ability of the indicators to predict poor prognosis and compared the correlation between the indicators and the Harris score. RESULTS: Anxiety, depression, garden classification of FNF, cause of fracture, FNF reduction quality, and length of hospital stay were independent influencing factors for poor short-term postoperative prognoses in elderly patients with FNF (P < 0.05). The areas under the curve for anxiety, depression, and length of hospital stay were 0.742, 0.854, and 0.749, respectively. The sensitivities of anxiety, depression, garden classification of FNF, and prediction of the cause of fracture were 0.857, 0.786, 0.821, and 0.821, respectively. The specificities of depression, FNF quality reduction, and length of hospital stay were the highest at 0.880, 0.783, and 0.761, respectively. Anxiety, depression, and somatization scores correlated moderately with Harris scores (r = -0.523, -0.625, and -0.554; all P < 0.001). CONCLUSION: Preoperative anxiety, depression, and somatization are correlated with poor short-term prognosis in elderly patients with FNF and warrant consideration.

Effects of Different Running Intensity on Serum Levels of IL-6 and TNF-α in Patients with Early Knee Osteoarthritis.

OBJECTIVE: To investigate the effects of different running intensities on interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in patients with early knee osteoarthritis (KOA). STUDY DESIGN: Clinical comparative study. PLACE AND DURATION OF STUDY: Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Fujian, China, from January 2019 to January 2021. METHODOLOGY: A total of 131 patients with early KOA admitted to Longyan First Hospital Affiliated to Fujian Medical University from January 2019 to January 2021 were selected and randomly divided into four groups using the random number table method: Group A (static control group, 34 cases), Group B (walking group, 32 cases), Group C (brisk walking group, 32 cases), and Group D (jogging group, 33 cases), and the training duration of the four groups was 6 months. Moreover, the levels of IL-6 and TNF-α, the activity of daily living (ADL), Fugl-Meyer assessment scale (FMA) scores, and adverse events before and after training were compared between the four groups. RESULTS: No statistical significance was observed in the differences of TNF-α, IL-6, ADL-advanced ability, ADL-basic ability, FMA-upper limb, and FMA-lower limb among the four groups before training (p>0.05). After training, the levels of TNF-α and IL-6 of the four groups were decreased, while the scores of FMA and ADL were increased. Group C had the highest FMA-upper limb and FMA-lower limb scores, ADL- advanced ability and ADL-basic ability after training, which were higher than those in groups A, B, and D (p<0.05). No statistical significance could be observed in the difference in the adverse event rate among the four groups during training (X2=3.339, p>0.05). CONCLUSION: Exercise training of different intensities, such as slow walking, brisk walking, and jogging, is touted to enhance the overall recovery of patients with early KOA. The exercise intensity of brisk walking training is moderate, and the activity of daily living and exercise ability of patients are significantly improved after training, while the levels of TNF-α and IL-6 are obviously decreased. KEY WORDS: Knee osteoarthritis, Interleukin-6, Exercise training, Exercise intensity, Tumor necrosis factor α.

Efficacy of Intramedullary Nailing in the Treatment of Comminuted Proximal Humeral Fractures and Its Influence on Shoulder Joint Function Recovery.

In this paper, we have aimed to elucidate the therapeutic effect of intramedullary nailing (IMN) in treating comminuted proximal humeral fractures (CPHFs) and its influence on the recovery of shoulder joint function. For this purpose, 60 cases with CPHFs were selected, particularly from January 2020 to October 2021. In these cases, 28 cases were treated with a locking proximal humeral plate (LPHP) and assigned to the control (Con) group and the remaining 32 patients were treated with IMN and included in the research (Res) group. The therapeutic effect, surgical indicators, total complications, visual analogue scale (VAS) score, and postoperative shoulder joint function score were compared between the two arms. We observed that compared with the Con group, the effective rate in the Res group was higher while the operation time, intraoperative blood loss, and fracture healing time were shorter, the overall complication rate and VAS score were lower, and the postoperative shoulder joint function score was higher, all with statistical significance. The above results indicate that IMN is effective and safe in the treatment of CPHFs, which can validly reduce the discomfort of patients and facilitate the recovery of shoulder joint function.

The pro-survival function of DLEC1 and its protection of cancer cells against 5-FU-induced apoptosis through up-regulation of BCL-XL.

The tumor suppressor DLEC1 has been shown to promote cell proliferation when AP-2α2 is down-regulated in HCT116 stable clones, suggesting its pro-survival nature. However, the pro-survival function of DLEC1 has not been confirmed in other cells and its underlying mechanisms remain elusive. Therefore, we knocked down DLEC1 in a panel of cell lines and found that DLEC1 depletion caused various extents of cell death through intrinsic pathway. DLEC1 overexpression promoted cell survival and reduced cell death in cancer cells after 5-FU treatment, while DLEC1 down-regulation sensitized cancer cells to 5-FU. Further studies demonstrated that DLEC1 attenuated the increase in cleaved PARP, caspase-3 and caspase-7, the activity of caspase-9 and the diffusion of cytosolic cytochrome c from mitochondria. Our data also showed that BCL-XL was up-regulated by DLEC1 in stable clones after 5-FU treatment. Altogether, these results indicated that DLEC1 protects cells against cell death induced by 5-FU through the attenuation of active proteins in caspase cascade and the up-regulation of BCL-XL. Therefore, DLEC1 can be a pro-survival protein under certain circumstances and a potential therapeutic target for increasing sensitivity of cancer cells to 5-FU.