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Objective This study aimed to explore the epidemiological and microbiological characteristics of fracture-related infection (FRI), analyze the drug resistance characteristics of major pathogens, and provide timely and relatively complete clinical and microbiological data for antimicrobial treatment of FRI. Methods The clinical and microbiological data of patients with FRI from January 1, 2011, to December 31, 2020, were collected from three tertiary hospitals in Northeast China. The automatic microbial analysis system was used for strain identification and drug susceptibility testing, and the drug susceptibility results were determined in accordance with the latest Clinical and Laboratory Standards Institute (CLSI) criteria (as applicable each year). Results A total of 744 patients with FRI were enrolled. The incidence of FRI was about 1.5%, and 81.7% were male patients, with an average age of 48.98 ± 16.01 years. Open fractures accounted for 64.8%. Motor crush (32.8%) and falling (29.8%) were the main causes of injuries. The common sites of infection were the tibia and fibula (47.6%), femur (11.8%), foot (11.8%), and hand (11.6%). A total of 566 pathogenic bacteria were cultured in 378 patients with positive bacterial cultures, of which 53.0% were Gram-positive bacteria and 47.0% were Gram-negative bacteria. The most common pathogen at all sites of infection is Staphylococcus aureus . Staphylococcus aureus had a high resistance rate to penicillin (PEN), erythromycin (ERY), and clindamycin (CLI), exceeding 50%. Methicillin-resistant Staphylococcus aureus (MRSA) was more than 80% resistant to CLI and ERY. Conclusions The incidence of FRI in Northeast China was at a low level among major medical centers nationwide. Staphylococcus aureus was still the main pathogen causing bone infections, and the proportion of MRSA was lower than reported abroad, but we have observed an increase in the proportion of infections. Enterobacteriaceae have a higher resistance rate to third-generation cephalosporins and quinolones. For Enterobacteriaceae , other sensitive treatment drugs should be selected clinically.

Background Early diagnosis and early delivery are the main strategies for the treatment of premature ovarian insufficiency (POI). However, POI warning markers, especially those that can be detected through noninvasive methods, are very limited; therefore, the identification of noninvasive markers for POI is urgent. Methods We acquired POI GWAS summary statistics from the FinnGen database. The metabolome, circulating plasma proteins, gut microbiota, immunophenotypes, circulating microRNAs (miRNAs), and two proteomes were obtained for two-sample Mendelian randomization (MR). Specifically, we employed inverse variance weighted (IVW) as the main method to calculate the MR effect estimates. eQTL data (from the eQTLGen Consortium) were employed for SMR. Hub genes were identified using the String database and Cytoscape software. Potential mechanisms of POI were identified via pathway enrichment analysis of the identified genes and miRNAs. Results Three metabolites (sphinganine-1-phosphate levels, X-23636 levels, 4-methyl-2-oxopentanoate levels), two circulating plasma proteins (fibroblast growth factor 23 levels, neurotrophin-3 levels), one gut microbiota (faecalibacterium abundance), one immunophenotype (HVEM on naive CD8 + T cells), 23 miRNAs (miR-500a-3p, miR-555, miR-584-5p, miR-642a-5p, miR-671-3p, miR-1324, miR-6870-3p, miR-1468-5p, miR-146a-3p, miR-221-3p, miR-3121-5p, miR-3184-3p, miR-3185, miR-335-5p, miR-4302, miR-4506, miR-6808-5p, miR-6894-5p, miR-145-5p, miR-149-3p, miR-23a-3p, miR-3141, and miR-374b-5p), and three hub genes ( ESR1 , ERBB2 , and GART ) serve as warning markers for POI. Enrichment analysis indicated that pathways such as glutathione metabolism and the PI3 kinase pathway may be involved in mechanisms regulating POI. Conclusion Our results are the first to identify noninvasive predictors for POI via MR, providing contributions for early warning and fertility guidance for clinical POI patients.

Objective We examined the clinical characteristics and outcomes of patients with recurrent trigeminal neuralgia (TN) and assessed the long-term efficacy and safety of microvascular decompression (MVD) to treat typical recurrent TN. Methods We identified 3024 patients who underwent MVD for treatment of TN at the China-Japan Friendship Hospital from March 2009 to December 2020. We retrospectively analyzed the data and outcomes of 137 patients who underwent redo-MVD and 74 patients who did not undergo redo-MVD as the control group. These outcomes were evaluated using the Barrow Neurological Institute scoring system. Results Recurrence in 68 of the 137 patients was due to incomplete or absent decompression or new responsible vessels. To ensure thorough pain relief, redo-MVD should include decompression of both the trigeminal root entry zone and the peripheral nerve segments, where blood vessels can cause symptoms. Factors associated with reduced effectiveness of redo-MVD were no period of initial pain relief after the first MVD and a longer duration of symptoms before the first MVD. Conclusions Redo-MVD should not be excluded as a treatment option for patients with refractory TN who develop recurrent pain after a first MVD procedure.

Purpose Infection after fracture fixation (IAFF) is a severe complication. There are few multicenter studies targeting IAFF. This paper identifies independent risk factors associated with IAFF by analyzing multicenter clinical data. Appropriate interventions should be implemented to reduce the risk of IAFF. Methods This is a multicenter retrospective cohort study. This study screened medical records of patients who underwent internal fixation for fractures at participating medical institutions from January 1, 2011, to December 31, 2020. Data extraction included demographic characteristics, disease features, surgical variables, and laboratory indicators. Logistic regression analysis was employed to identify the relationship between relevant risk factors and IAFF. Research data were sourced from the hospital's electronic medical record system and self‐constructed databases. Results In our study, 202 patients who underwent internal fixation for fractures experienced postoperative infections, which corresponds to an overall incidence rate of approximately 1.7%. The predominant pathogen identified in these infections was Staphylococcus aureus. A multifactorial analysis indicated that several factors were independently associated with the occurrence of IAFF. These factors included BMI ranges of 24.0–27.9 and 28.0–31.9, smoking, a high ASA score, high‐energy trauma, diabetes, open fracture, seasonal timing of the surgery (summer), bone grafting, drainage duration, surgical duration ≥ 180 min, and A/G ratio < 1.2. Conclusions We strongly recommend that orthopedic surgeons perform comprehensive preoperative assessments on fracture patients to identify factors that may increase the risk of infection. Through the implementation of targeted interventions and beneficial modifications to these modifiable risk factors, it is possible to lower the incidence of IAFF. Additionally, proactive screening, risk stratification, and thorough patient education should be prioritized for patients with high risk but nonmodifiable factors. Internal fixation surgery is the most prevalent procedure in traumatic orthopedics, widely utilized for fractures occurring throughout the body. With a long history and proven efficacy, this surgical approach is well‐established. However, inevitable postoperative complications exist, with the most severe being postoperative infections. According to relevant studies, the incidence of postoperative infections after fractures ranges from approximately 0.4% to 16.1%. Specifically, the incidence for closed fractures is around 1%, while for open fractures, it exceeds 15%. The outcomes associated with IAFF are disastrous. This complication can lead to permanent loss of limb function, and in severe cases, necessitate amputation, resulting in a significant decline in the patient's quality of life. Managing the infection usually entails multiple surgeries, rendering the treatment process complex, lengthy, and often characterized by a poor prognosis. In the end, amputation or even death may be inevitable. Moreover, infections impose significant psychological and economic burdens on patients and their families, and entail substantial healthcare system expenditures. Although the incidence of IAFF has decreased with advancements in medical technology and healthcare environments, the rapid progress in modern industry and transportation is expected to lead to a substantial increase in the number of fracture patients, consequently resulting in a corresponding rise in IAFF cases. Identifying the high‐risk factors that are associated with IAFF, implementing targeted interventions, and modulating these factors beneficially can effectively reduce the incidence of IAFF. However, to date, a few studies have investigated the risk factors linked to postoperative infection in Orthopedics, but most of them relied on prosthetic joint infection (PJI) or surgical site infection (SSI) as the definition of infection. These definitions are inadequate for fracture patients, as they do not take into account the presence of fracture, soft tissue injury, and internal fixation. Moreover, the cases included in the studies are mostly limited to single fracture sites or specific age groups, which may introduce bias in the research results. In view of the above limitations, we conducted this multicenter cohort study to investigate the incidence and characteristics of IAFF, to identify the independent risk factors associated with IAFF, and to screen the risk factors that can be used for infection prevention.

Most of the existing masonry bridges have been in service for a significant duration, and as a result of construction limitations, these structures often exhibit intricate geometric defects. Furthermore, under prolonged loading conditions, the rheological behavior of rock can induce deformation in masonry bridges, leading to a continuously evolving stress state. Employing an idealized model for safety assessment frequently results in an overestimation of their load-bearing capacity. To accurately evaluate the load-bearing performance and remaining service life of masonry bridges, as well as to prevent safety incidents, this study employs a parametric approach to establish a two-phase numerical model of masonry bridges. In this model, cohesive elements are introduced to simulate the bonding relationship, while the distribution pattern of geometric initial defects is determined based on the theory of conditional random fields. Additionally, the rheological behavior of rock is incorporated through a custom-written Abaqus user subroutine. Building upon this foundation, the probability distribution of the load-bearing capacity of masonry bridges is reconstructed using the maximum entropy method with fractional moment constraints. The resulting outcomes are compared and validated against those obtained using the decomposition conditional correlation matrix. Finally, the effectiveness and applicability of the proposed method are demonstrated through numerical simulations and field measurements conducted on an actual bridge. The findings reveal that the method introduced in this paper adequately accounts for the stochastic nature of geometric initial defects, objectively reflects the operational performance of masonry bridges, and effectively simulates the complete failure process of such structures. Consequently, this method provides a solid basis for the safety assessment of masonry bridges.

Background Oral squamous cell carcinoma (OSCC) is one of the most common malignancies in Southern and Southeastern Asia, and in the Hunan region of China, where betel nut chewing is prevalent. The prognosis of OSCC with oral submucous fibrosis (OSF), caused by areca nut use, remains debated. This study aimed to determine whether OSCC associated with OSF exhibits distinct tumor biological behaviors compared to OSCC without OSF, and to explore the tumor immune microenvironment, specifically focusing on the expression of Th17/Treg cells and the PD-1/PD-L1 axis. Methods OSCC patients with and without OSF (Jan 2013–Oct 2023) were recruited from Xiangya Stomatological Hospital, grouped by history and clinical features. Patients were followed every 3 months for recurrence and complications. SPSS 27 was used for descriptive and inferential statistics (Kaplan–Meier, Cox regression, χ 2 -test); survival/log survival/hazard functions were plotted to compare survival probabilities, stratified by sex, age, tumor location, stage (early/advanced, TNM), and habits (betel quid, smoking, alcohol). A subgroup of 88 patients (44 each) had immunohistochemical analysis for Th17/Treg and PD-1/PD-L1 expression. Results OSCC with OSF primarily affected the tongue and buccal mucosa, occurring in younger patients (median age 48 vs. 55 years). Recurrence was higher in OSF-associated OSCC (27.56% vs. 19.73%). Overall Survival (OS) rates for OSCC with OSF were 94.25% (1-year OS), 49.82% (3-year OS), and 41.23% (5-year OS), compared to 94.82% (1-year OS), 56.58% (3-year OS), and 47.92% (5-year OS) in non-OSF cases. A subgroup of 88 patients (44 each) had immunohistochemical analysis for the expression of IL-17 (a marker of Th17 cells) and Foxp3 (a marker of Treg cells), as well as PD-1/PD-L. Immune profiling showed elevated IL-17, Treg cells, PD-L1, and PD-1 in OSF-associated OSCC. Conclusion OSCC with OSF displays more aggressive tumor biological behavior and worse prognosis, which contributed by a more suppressive immune microenvironment marked by elevated levels of IL-17, Treg cells, and PD-1/PD-L1 expression. These results highlight the need for tailored treatment approaches in managing OSCC in patients with OSF.

BackgroundThe role of tumor-infiltrating lymphocytes (TILs) in the immune remodeling of tumor microenvironments (TME) in oral squamous cell carcinoma (OSCC) remains controversial. In this study, we pursued a comprehensive characterization of the repertoire of TILs and then analyzed its clinical significance and potential prognostic value.MethodsFresh tumor tissue samples and peripheral blood from 83 OSCC patients were collected to comprehensively characterize the phenotypes and frequencies of TILs by flow cytometry. Archived paraffin-embedded tissues derived from 159 OSCC patients were analyzed by immunohistochemistry to further assess the TIL repertoire. The clinical significance of TILs and their potential prognostic value were further analyzed.ResultsA series of unique features of TILs were observed. IL-17 was highly expressed in betel nut chewers, and CD20 was abundantly expressed in patients who did not drink alcohol; high expression of CD138, PD-L1, and Foxp3 was associated with poor prognosis. The Th17/Treg ratio was an independent prognostic factor for patient survival with greater predictive accuracy for overall survival.ConclusionsOur results suggest an antigen-driven immune response; however, the immune dysfunction within the microenvironment in OSCC and the Th17/Treg balance may play important roles in the modulation of antitumor immunity.

It is widely accepted that oral squamous cell carcinoma (OSCC) is a major contributor to the incidence and mortality of neck and head cancer. Tropomyosin-1 (TPM1), which is expressed at a low level, has been considered a prominent tumor-suppressing gene in a variety of solid tumors, although the precise mechanism of the TPM1 gene in OSCC progression remains unknown. We found that TPM1 expression levels decreased in OSCC patients and OSCC cell lines. The overall and cancer-specific survival of patients who exhibited low TPM1 levels were inferior to those of patients who had high TPM1 levels. It was also found that OSCC patients who suffered from disease stageⅠ-Ⅱ were more likely to have an up-regulated TPM1 expression level, and OSCC patients with lymph node metastasis had a higher probability of exhibiting reduced TPM1 expression. We show that overexpression of TPM1 can promote cell apoptosis and inhibit migration. Our results suggest that TPM1 can suppress tumors in OSCC, and the TPM1 expression level is related to OSCC patient prognosis.

Ferroptosis is a newly identified form of regulated cell death that is associated with iron metabolism and oxidative stress. As a physiological mechanism, ferroptosis selectively removes cancer cells by regulating the expression of vital chemical molecules. Current findings on regulation of ferroptosis have largely focused on the function of non-coding RNAs (ncRNAs), especially microRNAs (miRNAs), in mediating ferroptotic cell death, while the sponging effect of circular RNAs (circRNAs) has not been widely studied. In this review, we discuss the molecular regulation of ferroptosis and highlight the value of circRNAs in controlling ferroptosis and carcinogenesis. Herein, we deliberate future role of this emerging form of regulated cell death in cancer therapeutics and predict the progression and prognosis of oncogenesis in future clinical therapy.

This study aimed to investigate whether endometrial thickness (EmT) change prognosticates the ongoing pregnancy rate (OPR) in hormonally prepared frozen-thawed embryo transfers (FETs) in women with treated intrauterine adhesion (IUA). We prospectively examined 261 FET cycles in women with IUA. Ultimately, 156 patients were included in the final analysis. The primary outcome was OPR. The association between the EmT change ratio and OPR, as well as the relationship between the EmT change and serum hormone concentration, was analyzed. The intraclass correlation coefficient for repeated EmT measurements was 0.944 (95% CI: 0.933-0.954, P < 0.001). Subdividing by the expansion cutoff from 5% to 15%, the 10% expansion group had the highest OPR with optimal sensitivity and specificity. Regarding the baseline characteristics, there were no statistically significant differences between the two groups. Nevertheless, the OPR increased significantly in cycles with endometrial expansion ≥ 10% compared to those with no expansion (55.3% vs 26.3%, P=0.001). The difference was still significant after adjustment between the two groups (adjusted OR, 3.74; 95% CI 1.68-8.34, P=0.001). No correlation was found between the EmT change and serum hormone concentrations. Endometrial expansion was significantly correlated with higher OPR in women with treated IUA in the hormonal protocol for FET.