Efficacy and safety of Osteoking on fracture healing: a systematic review and meta-analysis.

Background: Osteoking (OK) is prescribed in traditional Chinese medicine to accelerate fracture healing. Although some studies suggest the potential efficacy of OK for fracture healing, the evidence remains inconclusive. Aim: To systematically evaluate the safety of OK and its effect on fracture healing. Methods: Relevant authoritative databases were searched until 25 August 2023. Randomized controlled trials (RCTs) of patients with fractures treated with Osteoking were included. We evaluated the risk of bias using the Cochrane tool and performed a meta-analysis using the Review Manager 5.4 software package. Results: 13 studies involving 1123 participants were included. This meta-analysis showed that compared with observations in the control group, the OK group showed a shortened fracture healing time, increased fracture healing rate, reduced swelling regression time and ecchymosis regression time, and improved bone metabolism. In addition, the included studies did not report any serious side effects associated with the use of OK, and the mild side effects resolved without treatment. Conclusion: OK therapy is beneficial and safe for accelerating fracture healing, reducing swelling, eliminating ecchymosis, and improving bone metabolism. However, the meta-analysis results do not support OK treatment for improving the fracture healing rate at all fracture sites and reducing pain across all fracture sites. Further original, high-quality studies are needed to validate these findings.Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=452430, identifier CRD42023452430.

[Cystic fibrosis primarily presenting with pseudo-Bartter syndrome: a report of three cases and literature review]. / 以假性Bartter综合征为主要表现的囊性纤维化患儿3ä¾‹å¹¶æ–‡çŒ®å¤ä¹ .

OBJECTIVES: To summarize the clinical characteristics and genetic variations in children with cystic fibrosis (CF) primarily presenting with pseudo-Bartter syndrome (CF-PBS), with the aim to enhance understanding of this disorder. METHODS: A retrospective analysis was performed on the clinical data of three children who were diagnosed with CF-PBS in Hunan Children's Hospital from January 2018 to August 2023, and a literature review was performed. RESULTS: All three children had the onset of the disease in infancy. Tests after admission showed hyponatremia, hypokalemia, hypochloremia, and metabolic alkalosis, and genetic testing showed the presence of compound heterozygous mutation in the CFTR gene. All three children were diagnosed with CF. Literature review obtained 33 Chinese children with CF-PBS, with an age of onset of 1-36 months and an age of diagnosis of 3-144 months. Among these children, there were 29 children with recurrent respiratory infection or persistent pneumonia (88%), 26 with malnutrition (79%), 23 with developmental retardation (70%), and 18 with pancreatitis or extrapancreatic insufficiency (55%). Genetic testing showed that c.2909G>A was the most common mutation site of the CFTR gene, with a frequency of allelic variation of 23% (15/66). CONCLUSIONS: CF may have no typical respiratory symptoms in the early stage. The possibility of CF-PBS should be considered for infants with recurrent hyponatremia, hypokalemia, hypochloremia, and metabolic alkalosis, especially those with malnutrition and developmental retardation. CFTR genetic testing should be performed as soon as possible to help with the diagnosis of CF.

Beam dynamics optimization design of Rhodotron electron accelerator based on genetic algorithm and sensitivity analysis.

The beam dynamics optimization study of Rhodotron electron accelerator for irradiation sterilization is introduced in this paper. The Rhodotron accelerator acceleration principle and the RF field distribution in the coaxial resonant cavity are described in detail. Beam dynamics in the Rhodotron accelerator are analyzed from both transverse and longitudinal directions. Beam dynamics of two kinds of Rhodotron electron accelerators with maximum beam energy of 10 MeV and 40 MeV were optimized based on multi-objective genetic algorithm. The key parameters of Rhodotron accelerators are determined, and the influence of some parameters on the overall acceleration effect is quantitatively analyzed. This paper provides some references for the research, manufacture, installation, and commissioning of this type of accelerator.

GLRA2 gene mutations cause high myopia in humans and mice.

BACKGROUND: High myopia (HM) is a leading cause of blindness that has a strong genetic predisposition. However, its genetic and pathogenic mechanisms remain largely unknown. Thus, this study aims to determine the genetic profile of individuals from two large Chinese families with HM and 200 patients with familial/sporadic HM. We also explored the pathogenic mechanism of HM using HEK293 cells and a mouse model. METHODS: The participants underwent genome-wide linkage analysis and exome sequencing. Visual acuity, electroretinogram response, refractive error, optical parameters and retinal rod cell genesis were measured in knockout mice. Immunofluorescent staining, biotin-labelled membrane protein isolation and electrophysiological characterisation were conducted in cells transfected with overexpression plasmids. RESULTS: A novel HM locus on Xp22.2-p11.4 was identified. Variant c.539C>T (p.Pro180Leu) in GLRA2 gene was co-segregated with HM in the two families. Another variant, c.458G>A (p.Arg153Gln), was identified in a sporadic sample. The Glra2 knockout mice showed myopia-related phenotypes, decreased electroretinogram responses and impaired retinal rod cell genesis. Variants c.458G>A and c.539C>T altered the localisation of GlyRα2 on the cell membrane and decreased agonist sensitivity. CONCLUSION: GLRA2 was identified as a novel HM-causing gene. Its variants would cause HM through altered visual experience by impairing photoperception and visual transmission.

Recent Advances in Enhancement Techniques for Blood Fingerprints.

The blood fingerprint enhancement is not so eye-catching as latent fingerprint development in forensic community, but it is indeed an important piece of evidence for personal identification, forensic analysis and even reconstruction of crime scenes. In over past ten years, novel reagents, advanced materials and emerging techniques have growingly participated in blood fingerprint enhancement, which not only leads to a higher level of developing sensitivity, selectivity and contrast, but also endows blood impressions with more forensic significance. This review summarizes recent advances in conventional chemical reagents targeting at heme, protein and amino acid as well as emerging enhancement techniques based on advanced materials, new equipment or methods. Some critical issues in forensic science are also discussed, including partial blood fingerprint enhancement, false positive of developing reagents, the compatibility of blood enhancement technique and DNA, fingerprint age determination, and so on. Finally, we have proposed several urgent problems to be solved and the prospects of some promising techniques were proposed in the field of blood fingerprint enhancement in future work.

Experimental observation of the electron beam focusing effect induced by plasma currents with opposite directions.

We report on the experimental observation of the focusing effect of a 50MeV accelerator electron beam in a gas-discharge plasma target. The plasma is generated by igniting an electric discharge in two collinear quartz tubes, with the currents up to 1.5kA flowing in opposite directions in either of the two tubes. In such plasma current configuration, the electron beam is defocused in the first discharge tube and focused with a stronger force in the second one. With symmetric plasma currents, asymmetric effects are, however, induced on the beam transport process and the beam radius is reduced by a factor of 2.6 compared to the case of plasma discharge off. Experimental results are supported by two-dimensional particle-in-cell simulations.

De novo variants in genes regulating stress granule assembly associate with neurodevelopmental disorders.

Stress granules (SGs) are cytoplasmic assemblies in response to a variety of stressors. We report a new neurodevelopmental disorder (NDD) with common features of language problems, intellectual disability, and behavioral issues caused by de novo likely gene-disruptive variants in UBAP2L, which encodes an essential regulator of SG assembly. Ubap2l haploinsufficiency in mouse led to social and cognitive impairments accompanied by disrupted neurogenesis and reduced SG formation during early brain development. On the basis of data from 40,853 individuals with NDDs, we report a nominally significant excess of de novo variants within 29 genes that are not implicated in NDDs, including 3 essential genes (G3BP1, G3BP2, and UBAP2L) in the core SG interaction network. We validated that NDD-related de novo variants in newly implicated and known NDD genes, such as CAPRIN1, disrupt the interaction of the core SG network and interfere with SG formation. Together, our findings suggest the common SG pathology in NDDs.

Imaging and Pathological Characteristics of Port-Wine Stain Patients with Tissue Hypertrophy Before Laser Therapy: Retrospective Data.

Background: Port-wine stain (PWS) patients may simultaneously have accompanied soft tissue hypertrophy. The outcome of laser therapy can be poor. Objective: To study the imaging and histopathological characteristics of PWS patients with facial overgrowth. Materials and methods: We retrospectively assessed the effect of therapy on a subset of PWS patients with facial overgrowth. The degree of hypertrophy and the density of enhanced signals on T1-weighted magnetic resonance imaging (MRI) were independently graded by two radiologists using a quartile scale. Biopsies/resection of tissue deep to the facial muscle was reviewed and compared with flat PWS. Results: Thirty-two PWS patients with facial hypertrophy and 15 patients with flat PWS were included. MRI revealed a statistically significant correlation between the degree of hypertrophy and the density of enhanced signals (3.02 ± 0.92 vs. 2.47 ± 0.69; p < 0.01). Histological features of a subset of patients showed that vascular malformations existed in the dermis and also in the subcutaneous fat and muscle with much larger vessel diameters (fat, 0.048 vs. 0.020; muscle, 0.035 vs. 0.017) and thicker vessel walls (fat, 0.014 vs. 0.006; muscle, 0.010 vs. 0.006) (both p < 0.05). Conclusions: The imaging and pathological findings indicate that capillary malformation in subcutaneous tissue might be a major cause of poor therapeutic effect of laser therapy for PWS. Clinical trial registration no.: ChiCTR1800014278.

Value of Dynamic Contrast-Enhanced (DCE) MRI in Predicting Response to Foam Sclerotherapy of Venous Malformations.

BACKGROUND: Preoperative imaging assessment of venous malformations (VMs) and prediction of foam sclerotherapy efficacy might be achievable by DCE-MRI but elaborate quantitive analysis was absent. PURPOSE: To evaluate the value of DCE-MRI in predicting the effectiveness of foam sclerotherapy in VMs. STUDY TYPE: Retrospective. POPULATION: Fifty-five patients (M:F = 17:38; mean age ± SD, 15.4 ± 13.0 years) with VMs. FIELD STRENGTH/SEQUENCE: Three Tesla MRI with 3D T1 -weighted volume interpolated body examination. ASSESSMENT: Patients who underwent pretreatment DCE-MRI were divided into "effective" and "ineffective" groups according to the response to foam sclerotherapy. Clinical characteristics and morphologic features were assessed. The semiquantitative parameters, such as maximum intensity time ratio (MITR), enhancement ratio (ER), and Slope, were obtained from ROI and volume of interest (VOI). The quartile and mean values of these parameters were acquired from VOI, while mean values denoted as Mean# were acquired from ROI. Establishment of two predictive models was based on ROI and VOI respectively. Model 1 was based on morphologic parameters and ROI semiquantitative parameters, while model 2 was based on morphologic parameters and VOI semiquantitative parameters. STATISTICAL ANALYSIS: Mann-Whitney U-test, Cohen's kappa, multivariate logistic regression analysis (backward stepwise), and ROC analyses. RESULTS: The lesion classification, presence of phlebolith, semiquantitative parameters of VOI (quartile and mean of MITR), and semiquantitative parameters of ROI (Slopemean# , MITRmean# ) were significantly different between two groups. Lesion classification (P = 0.002) and MITRmean# (P = 0.027) were independent predictors for poor efficacy in model 1 as determined by multivariate binary logistic regression analysis. For model 2, lesion classification (P = 0.006) and MITR25 (P = 0.001) were independent predictors. The predictive model based on VOI (AUC = 0.961) performed better than that based on ROI (AUC = 0.909) in predicting therapeutic response. DATA CONCLUSION: DCE-MRI is promising in predicting the response to foam sclerotherapy for VMs. The whole lesion VOI-based model showed better performance and could instruct surgical approach in the future. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 4.

Multiparametric Magnetic Resonance Imaging Features That Predict Treatment Response to Endovascular Sclerotherapy in Craniofacial Venous Malformations.

PURPOSE: Craniofacial venous malformations (VMs) cause severe psychological and physiological burden to patients, and treatment is meaningful only when the benefits of treatment outweigh the risks. Therefore, it is very important to predict the treatment response before treatment. This study was performed to explore the value of multiparametric magnetic resonance imaging for predicting treatment response to endovascular sclerotherapy in VMs. MATERIALS AND METHODS: We designed and implemented a case-control study and enrolled a sample from patients with VM treated by endovascular sclerotherapy at our hospital from January 2014 to January 2018. The primary predictor variables were pretreatment volume (prevolume), lesion classification, phleboliths, initial slope of increase (ISI), gender, age, and sclerosants. The primary outcome variable was treatment response (positive response or negative response). Descriptive, univariate and multivariate binary logistic regressions, and Firth's penalized maximum likelihood estimate were computed to measure the association between predictor variables and treatment response. The level of statistical significance was set at a P value less than or equal to .05. RESULTS: The sample was composed of 42 patients with a median age of 17.50 years, and 33.3% were males. There were 27 and 15 patients in the positive and negative response groups, respectively. There were significant differences between the 2 groups for ISI (adjusted odds ratio [OR], 2.184; P = .0268; 95% confidence interval [95% CI], 1.094 to 4.360), lesion classification (adjusted OR, 9.072; P = .0226; 95% CI, 1.363 to 60.400), and prevolume (adjusted OR, 1.020; P = .0268; 95% CI, 1.002 to 1.038). The cutoff point for prevolume and ISI was 40.42 cm3 and 2.61. CONCLUSIONS: Multiparametric magnetic resonance imaging could provide an approach for predicting treatment response in craniofacial VMs. When the prevolume was greater than 40.42 cm3, ISI was greater than 2.61, and the classification was infiltrating type, the response to sclerotherapy was negative.

Ultrasonography and magnetic resonance imaging features of kaposiform hemangioendothelioma and tufted angioma.

Kaposiform hemangioendothelioma (KHE) and tufted angioma (TA) primarily occurring in infants are difficult to distinguish. This study evaluated ultrasonography (US) and magnetic resonance imaging (MRI) features of KHE and TA. Pathologically proven TA (n = 21) and KHE (n = 40 [11 KHE + Kasabach-Merritt phenomenon [KMP]]) occurring between January 2015 and December 2017 were reviewed. US (n = 61) and MRI (n = 50) findings were retrospectively evaluated. On US, KHE and TA lesions were subcutaneous, while 40% of KHE exhibited an infiltrative pattern extending into adjacent muscles. Of TA lesions, 42.9% were hyperechoic and 96.15% of KHE lesions exhibited mixed echogenicity. Of TA lesions, 76.2% exhibited well-defined margins and all KHE lesions exhibited ill-defined margins. The depth and vascular density of KHE and KHE + KMP were significantly increased compared with TA. The arterial peak systolic blood flow velocity of KHE + KMP was significantly higher than that in TA and KHE. KHE and KHE + KMP were significantly harder than TA on elastography. 3-D color Doppler revealed branch-shape blood flow for KHE and KHE + KMP lesions; for TA, it revealed a dot-like and striped pattern. Considering MRI findings, KHE and KHE + KMP were more likely to exhibit diffuse heterogeneous enhancement after contrast than TA. KHE was infiltrative and more likely to be thick, hypoechoic, ill-defined, richly vascular and hard than TA on US. KHE lesions were subcutaneous and reticular, with heterogeneous enhancement on MRI. Awareness of these features should prompt radiologists in the differential diagnosis of pediatric masses.

Midterm and long-term results of ethanol embolization of auricular arteriovenous malformations as first-line therapy.

OBJECTIVE: The objective of this study was to assess the midterm and long-term results of patients with auricular arteriovenous malformations (AVMs) treated by ethanol embolization. METHODS: Medical records of 35 patients (20 male, 15 female; age range, 10-59 years) with auricular AVMs between 2006 and 2016 were reviewed. The short-term results of 4 of the 35 patients were reported in 2009. They were included in this study with updated follow-up data. The data from the 31 new included patients have not been reported previously. Ethanol embolization was performed with a direct puncture approach. The nidus was eradicated by bolus injection of ethanol with manual compression whenever possible. Treatment outcomes were classified into four categories by assessing the resolution of symptoms as well as the degree of nidus devascularization between the baseline and follow-up angiography studies. RESULTS: A total of 86 embolization sessions were performed in 35 patients (mean, 2.5 ± 1.3 sessions). The dosage of ethanol used per single session was 12.0 ± 4.5 mL (range, 6.0-24 mL). All patients received post-treatment clinical follow-up (mean, 40.7 ± 25.8 months), and 28 patients received post-treatment imaging follow-up (mean, 34.3 ± 25.5 months). Ethanol embolotherapy was effective in all patients. Control was achieved in 16 patients (45.7%), and improvement was achieved in 18 patients (51.4%). One patient experienced recurrence. A total of 13 minor complications and 2 major complications occurred in 12 patients during the 86 treatment sessions (12/35 [34.2%]; 15/86 [17.4%]). All the complications resolved spontaneously. CONCLUSIONS: The midterm and long-term results of this study demonstrate that ethanol embolization alone is an effective option for auricular AVMs as first-line therapy with a mild risk of minor and major complications.