Acute kidney injury (AKI) is one of the most common functional injuries observed in trauma patients. However, certain trauma medications may exacerbate renal injury. Therefore, the early detection of trauma-related AKI holds paramount importance in improving trauma prognosis.
Methods
Qualified datasets were selected from public databases, and common differentially expressed genes related to trauma-induced AKI and hub genes were identified through enrichment analysis and the establishment of protein-protein interaction (PPI) networks. Additionally, the specificity of these hub genes was investigated using the sepsis dataset and conducted a comprehensive literature review to assess their plausibility. The raw data from both datasets were downloaded using R software (version 4.2.1) and processed with the "affy" package19 for correction and normalization.
Results
Our analysis revealed 585 upregulated and 629 downregulated differentially expressed genes in the AKI dataset, along with 586 upregulated and 948 downregulated differentially expressed genes in the trauma dataset. Concurrently, the establishment of the PPI network and subsequent topological analysis highlighted key hub genes, including CD44, CD163, TIMP metallopeptidase inhibitor 1, cytochrome b-245 beta chain, versican, membrane spanning 4-domains A4A, mitogen-activated protein kinase 14, and early growth response 1. Notably, their receiver operating characteristic curves displayed areas exceeding 75%, indicating good diagnostic performance. Moreover, our findings postulated a unique molecular mechanism underlying trauma-related AKI.
Conclusion
This study presents an alternative strategy for the early diagnosis and treatment of trauma-related AKI, based on the identification of potential biomarkers and therapeutic targets. Additionally, this study provides theoretical references for elucidating the mechanisms of trauma-related AKI.
目的急性肾损伤（AKI）是创伤患者最常见的功能性损伤之一。然而，某些创伤药物可能会加重肾损伤。方法从公共数据库中筛选出合格的数据集，通过富集分析和建立蛋白-蛋白相互作用（PPI）网络，确定与创伤诱导的 AKI 相关的常见差异表达基因和枢纽基因。此外，还利用败血症数据集研究了这些中心基因的特异性，并进行了全面的文献综述以评估其合理性。我们使用 R 软件（4.2.1 版）下载了这两个数据集的原始数据，并使用 "affy "软件包19 对其进行了校正和归一化处理。结果我们的分析发现，在 AKI 数据集中有 585 个上调和 629 个下调的差异表达基因，在创伤数据集中有 586 个上调和 948 个下调的差异表达基因。同时，PPI 网络的建立和随后的拓扑分析突出显示了关键的枢纽基因，包括 CD44、CD163、TIMP 金属肽酶抑制剂 1、细胞色素 b-245 beta 链、versican、膜跨越 4 域 A4A、丝裂原活化蛋白激酶 14 和早期生长应答 1。值得注意的是，它们的接收者操作特征曲线显示面积超过 75%，表明诊断性能良好。此外，我们的研究结果还推测了创伤相关性 AKI 的独特分子机制。此外，本研究还为阐明创伤相关性 AKI 的机制提供了理论参考。
{"title":"Exploration of potential biomarkers and therapeutic targets for trauma-related acute kidney injury","authors":"Peng Qi , Meng-Jie Huang , Wei Wu , Xue-Wen Ren , Yong-Zhi Zhai , Chen Qiu , Hai-Yan Zhu","doi":"10.1016/j.cjtee.2024.01.002","DOIUrl":"10.1016/j.cjtee.2024.01.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Acute kidney injury <strong>(</strong>AKI) is one of the most common functional injuries observed in trauma patients. However, certain trauma medications may exacerbate renal injury. Therefore, the early detection of trauma-related AKI holds paramount importance in improving trauma prognosis.</p></div><div><h3>Methods</h3><p>Qualified datasets were selected from public databases, and common differentially expressed genes related to trauma-induced AKI and hub genes were identified through enrichment analysis and the establishment of protein-protein interaction (PPI) networks. Additionally, the specificity of these hub genes was investigated using the sepsis dataset and conducted a comprehensive literature review to assess their plausibility. The raw data from both datasets were downloaded using R software (version 4.2.1) and processed with the \"affy\" package19 for correction and normalization.</p></div><div><h3>Results</h3><p>Our analysis revealed 585 upregulated and 629 downregulated differentially expressed genes in the AKI dataset, along with 586 upregulated and 948 downregulated differentially expressed genes in the trauma dataset. Concurrently, the establishment of the PPI network and subsequent topological analysis highlighted key hub genes, including CD44, CD163, TIMP metallopeptidase inhibitor 1, cytochrome <em>b</em>-245 beta chain, versican, membrane spanning 4-domains A4A, mitogen-activated protein kinase 14, and early growth response 1. Notably, their receiver operating characteristic curves displayed areas exceeding 75%, indicating good diagnostic performance. Moreover, our findings postulated a unique molecular mechanism underlying trauma-related AKI.</p></div><div><h3>Conclusion</h3><p>This study presents an alternative strategy for the early diagnosis and treatment of trauma-related AKI, based on the identification of potential biomarkers and therapeutic targets. Additionally, this study provides theoretical references for elucidating the mechanisms of trauma-related AKI.</p></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 2","pages":"Pages 97-106"},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127524000026/pdfft?md5=e48979840bbd6107eda4617d09a207ba&pid=1-s2.0-S1008127524000026-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139631335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.cjtee.2024.01.004
Hui-Dan Jing , Jun-Ying Tian , Wei Li , Bing-Ling He , Hong-Chao Li , Fu-Xia Jian , Cui Shang , Feng Shen
Purpose
To assess the value of the driving pressure variation rate (ΔP%) in predicting the outcome of weaning from invasive mechanical ventilation in patients with acute respiratory distress syndrome.
Methods
In this case-control study, a total of 35 patients with moderate-severe acute respiratory distress syndrome were admitted to the intensive care unit between January 2022 and December 2022 and received invasive mechanical ventilation for at least 48 h were enrolled. Patients were divided into successful weaning group and failed weaning group depending on whether they could be removed from ventilator support within 14 days. Outcome measures including driving pressure, PaO2:FiO2, and positive end-expiratory pressure, etc. were assessed every 24 h from day 0 to day 14 until successful weaning was achieved. The measurement data of non-normal distribution were presented as median (Q1, Q3), and the differences between groups were compared by Wilcoxon rank sum test. And categorical data use the Chi-square test or Fisher's exact test to compare. The predictive value of ΔP% in predicting the outcome of weaning from the ventilator was analyzed using receiver operating characteristic curves.
Results
Of the total 35 patients included in the study, 17 were successful vs. 18 failed in weaning from a ventilator after 14 days of mechanical ventilation. The cut-off values of the median ΔP% measured by Operator 1 vs. Operator 2 in the first 4 days were ≥ 4.17% and 4.55%, respectively (p < 0.001), with the area under curve of 0.804 (sensitivity of 88.2%, specificity of 64.7%) and 0.770 (sensitivity of 88.2%, specificity of 64.7%), respectively. There was a significant difference in mechanical ventilation duration between the successful weaning group and the failure weaning group (8 (6, 13) vs. 12 (7.5, 17.3), p = 0.043). The incidence of ventilator-associated pneumonia in the successful weaning group was significantly lower than in the failed weaning group (0.2‰ vs. 2.3‰, p = 0.001). There was a significant difference noted between these 2 groups in the 28-day mortality (11.8% vs. 66.7%, p = 0.003).
Conclusion
The median ΔP% in the first 4 days of mechanical ventilation showed good predictive performance in predicting the outcome of weaning from mechanical ventilation within 14 days. Further study is needed to confirm this finding.
{"title":"Predictive performance of the variation rate of the driving pressure on the outcome of invasive mechanical ventilation in patients with acute respiratory distress syndrome","authors":"Hui-Dan Jing , Jun-Ying Tian , Wei Li , Bing-Ling He , Hong-Chao Li , Fu-Xia Jian , Cui Shang , Feng Shen","doi":"10.1016/j.cjtee.2024.01.004","DOIUrl":"10.1016/j.cjtee.2024.01.004","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess the value of the driving pressure variation rate (ΔP%) in predicting the outcome of weaning from invasive mechanical ventilation in patients with acute respiratory distress syndrome.</p></div><div><h3>Methods</h3><p>In this case-control study, a total of 35 patients with moderate-severe acute respiratory distress syndrome were admitted to the intensive care unit between January 2022 and December 2022 and received invasive mechanical ventilation for at least 48 h were enrolled. Patients were divided into successful weaning group and failed weaning group depending on whether they could be removed from ventilator support within 14 days. Outcome measures including driving pressure, PaO<sub>2</sub>:FiO<sub>2</sub>, and positive end-expiratory pressure, etc. were assessed every 24 h from day 0 to day 14 until successful weaning was achieved. The measurement data of non-normal distribution were presented as median (Q<sub>1</sub>, Q<sub>3</sub>), and the differences between groups were compared by Wilcoxon rank sum test. And categorical data use the Chi-square test or Fisher's exact test to compare. The predictive value of ΔP% in predicting the outcome of weaning from the ventilator was analyzed using receiver operating characteristic curves.</p></div><div><h3>Results</h3><p>Of the total 35 patients included in the study, 17 were successful <em>vs.</em> 18 failed in weaning from a ventilator after 14 days of mechanical ventilation. The cut-off values of the median ΔP% measured by Operator 1 <em>vs.</em> Operator 2 in the first 4 days were ≥ 4.17% and 4.55%, respectively (<em>p</em> < 0.001), with the area under curve of 0.804 (sensitivity of 88.2%, specificity of 64.7%) and 0.770 (sensitivity of 88.2%, specificity of 64.7%), respectively. There was a significant difference in mechanical ventilation duration between the successful weaning group and the failure weaning group (8 (6, 13) <em>vs.</em> 12 (7.5, 17.3), <em>p</em> = 0.043). The incidence of ventilator-associated pneumonia in the successful weaning group was significantly lower than in the failed weaning group (0.2‰ <em>vs.</em> 2.3‰, <em>p</em> = 0.001). There was a significant difference noted between these 2 groups in the 28-day mortality (11.8% <em>vs.</em> 66.7%, <em>p</em> = 0.003).</p></div><div><h3>Conclusion</h3><p>The median ΔP% in the first 4 days of mechanical ventilation showed good predictive performance in predicting the outcome of weaning from mechanical ventilation within 14 days. Further study is needed to confirm this finding.</p></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 2","pages":"Pages 107-113"},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S100812752400004X/pdfft?md5=c449e3403731415fcd104e0ede5c7eb7&pid=1-s2.0-S100812752400004X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139637237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.cjtee.2023.05.005
Sheng-Feng Chen , Bo-Yao Yang , Tie-Yuan Zhang , Xiang-Yu Song , Zhi-Bo Jia , Lei-Jia Chen , Meng-Yi Cui , Wen-Jing Xu , Jiang Peng
Purpose
Ischemia and hypoxia are the main factors limiting limb replantation and transplantation. Static cold storage (SCS), a common preservation method for tissues and organs, can only prolong limb ischemia time to 4 – 6 h. The normothermic machine perfusion (NMP) is a promising method for the preservation of tissues and organs, which can extend the preservation time in vitro by providing continuous oxygen and nutrients. This study aimed to evaluate the difference in the efficacy of the 2 limb preservation methods.
Methods
The 6 forelimbs from beagle dogs were divided into 2 groups. In the SCS group (n = 3), the limbs were preserved in a sterile refrigerator at 4 °C for 24 h, and in the NMP group (n = 3), the perfusate prepared with autologous blood was used for the oxygenated machine perfusion at physiological temperature for 24 h, and the solution was changed every 6 h. The effects of limb storage were evaluated by weight gain, perfusate biochemical analysis, enzyme-linked immunosorbent assay, and histological analysis. All statistical analyses and graphs were performed using GraphPad Prism 9.0 one-way or two-way analysis of variance. The p value of less than 0.05 was considered to indicate statistical significance.
Results
In the NMP group, the weight gained percentage was 11.72% ± 4.06%; the hypoxia-inducible factor-1α contents showed no significant changes; the shape of muscle fibers was normal; the gap between muscle fibers slightly increased, showing the intercellular distance of (30.19 ± 2.83) μm; and the vascular α-smooth muscle actin (α-SMA) contents were lower than those in the normal blood vessels. The creatine kinase level in the perfusate of the NMP group increased from the beginning of perfusion, decreased after each perfusate change, and remained stable at the end of perfusion showing a peak level of 4097.6 U/L. The lactate dehydrogenase level of the NMP group increased near the end of perfusion and reached the peak level of 374.4 U/L. In the SCS group, the percentage of weight gain was 0.18% ± 0.10%, and the contents of hypoxia-inducible factor-1α increased gradually and reached the maximum level of (164.85 ± 20.75) pg/mL at the end of the experiment. The muscle fibers lost their normal shape and the gap between muscle fibers increased, showing an intercellular distance of (41.66 ± 5.38) μm. The contents of vascular α-SMA were much lower in the SCS group as compared to normal blood vessels.
Conclusions
NMP caused lesser muscle damage and contained more vascular α-SMA as compared to SCS. This study demonstrated that NMP of the amputated limb with perfusate solution based on autologous blood could maintain the physiological activities of the limb for at least 24 h.
{"title":"Study on the preservation effects of the amputated forelimb by machine perfusion at physiological temperature","authors":"Sheng-Feng Chen , Bo-Yao Yang , Tie-Yuan Zhang , Xiang-Yu Song , Zhi-Bo Jia , Lei-Jia Chen , Meng-Yi Cui , Wen-Jing Xu , Jiang Peng","doi":"10.1016/j.cjtee.2023.05.005","DOIUrl":"10.1016/j.cjtee.2023.05.005","url":null,"abstract":"<div><h3>Purpose</h3><p>Ischemia and hypoxia are the main factors limiting limb replantation and transplantation. Static cold storage (SCS), a common preservation method for tissues and organs, can only prolong limb ischemia time to 4 – 6 h. The normothermic machine perfusion (NMP) is a promising method for the preservation of tissues and organs, which can extend the preservation time <em>in vitro</em> by providing continuous oxygen and nutrients. This study aimed to evaluate the difference in the efficacy of the 2 limb preservation methods.</p></div><div><h3>Methods</h3><p>The 6 forelimbs from beagle dogs were divided into 2 groups. In the SCS group (<em>n</em> = 3), the limbs were preserved in a sterile refrigerator at 4 °C for 24 h, and in the NMP group (<em>n</em> = 3), the perfusate prepared with autologous blood was used for the oxygenated machine perfusion at physiological temperature for 24 h, and the solution was changed every 6 h. The effects of limb storage were evaluated by weight gain, perfusate biochemical analysis, enzyme-linked immunosorbent assay, and histological analysis. All statistical analyses and graphs were performed using GraphPad Prism 9.0 one-way or two-way analysis of variance. The <em>p</em> value of less than 0.05 was considered to indicate statistical significance.</p></div><div><h3>Results</h3><p>In the NMP group, the weight gained percentage was 11.72% ± 4.06%; the hypoxia-inducible factor-1α contents showed no significant changes; the shape of muscle fibers was normal; the gap between muscle fibers slightly increased, showing the intercellular distance of (30.19 ± 2.83) μm; and the vascular α-smooth muscle actin (α-SMA) contents were lower than those in the normal blood vessels. The creatine kinase level in the perfusate of the NMP group increased from the beginning of perfusion, decreased after each perfusate change, and remained stable at the end of perfusion showing a peak level of 4097.6 U/L. The lactate dehydrogenase level of the NMP group increased near the end of perfusion and reached the peak level of 374.4 U/L. In the SCS group, the percentage of weight gain was 0.18% ± 0.10%, and the contents of hypoxia-inducible factor-1α increased gradually and reached the maximum level of (164.85 ± 20.75) pg/mL at the end of the experiment. The muscle fibers lost their normal shape and the gap between muscle fibers increased, showing an intercellular distance of (41.66 ± 5.38) μm. The contents of vascular α-SMA were much lower in the SCS group as compared to normal blood vessels.</p></div><div><h3>Conclusions</h3><p>NMP caused lesser muscle damage and contained more vascular α-SMA as compared to SCS. This study demonstrated that NMP of the amputated limb with perfusate solution based on autologous blood could maintain the physiological activities of the limb for at least 24 h.</p></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 2","pages":"Pages 114-120"},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127523000470/pdfft?md5=1e4d8f9f54ffd8d7b219abc24710316e&pid=1-s2.0-S1008127523000470-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9982937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Hoffa fracture is a femoral condyle fracture in the coronal plane. The lateral condyle is more commonly involved. The diagnosis is often difficult to detect with routine radiographs. Conservative management in this type of fracture resulted in nonunion, malunion, and other complications, such as stiff knee. Therefore, surgical management is mandatory in displaced fractures. Previous studies suggest only application of cancellous screw fixation, but these are not enough to counter vertical shear stress. Therefore, this study will evaluate the clinical outcomes of open reduction and internal fixation of Letenneur type I Hoffa fracture using cancellous screws with posterior buttressing plate.
Method: This was a prospective cohort study conducted from March 2017 to July 2022 in orthopaedics department of tertiary care center after approval of institutional ethical committee. The study included 36 patients with Letenneur type I fractures treated by open reduction and internal fixation using posterior buttress plate and cancellous screws. Radiographs and clinical outcomes, range of movement (ROM), bone union, and knee society score (KSS) of patients were assessed at the end of 4 and 12 months in the follow-ups. All statistical analysis was done using Epi info version 7.2.1.0.
Results: In the 36 patients with Letenneur type I fracture, the majority belong to younger age group between 25 and 54 years with 22 males and 14 females. The modes of injury were road traffic accidents in 25 patients and fall from height in 11 patients. The right knee was involved in 21 cases and left was involved in 15 cases. Lateral condyle involvement was seen in 27 cases and medial condyle in 9 cases. All 36 patients with Letenneur type I Hoffa fracture were evaluated 4 months after surgical intervention. The notable improvements were observed in terms of ROM 120.4° ± 5.0° and KSS 85.0 ± 4.2. At the 12-month follow-up, considerably better outcomes were maintained regarding ROM 128.1° ± 5.2° and KSS 89.3 ± 4.8 with p < 0.05 which was statistically significant. At the final follow-up, all patients had routine fracture healing with a union time of (3.2 ± 3.4) months.
Conclusions: Fixation of Letenneur type I Hoffa fracture with cancellous screws and posterior buttress plate is effective, reliable and capable of providing adequate stability. Buttress plate assisted fixation is a valuable enhancement of the conventional technique of lag screw fixation of Hoffa fractures.
目的：Hoffa 骨折是冠状面上的股骨髁骨折。外侧髁更常受累。常规X光片往往难以诊断。保守治疗会导致骨折不愈合、错位和其他并发症，如膝关节僵硬。因此，对于移位骨折必须进行手术治疗。以往的研究建议仅应用松质骨螺钉固定，但这不足以对抗垂直剪切应力。因此，本研究将评估使用松质骨螺钉与后托板对Letenneur I型Hoffa骨折进行切开复位内固定的临床效果：这是一项前瞻性队列研究，经机构伦理委员会批准后，于2017年3月至2022年7月在三级医疗中心骨科开展。研究共纳入36例Letenneur I型骨折患者，均采用后托钢板和松质骨螺钉进行切开复位内固定治疗。随访4个月和12个月后，对患者的X光片和临床疗效、活动范围（ROM）、骨结合情况和膝关节社会评分（KSS）进行评估。所有统计分析均使用 Epi info 7.2.1.0 版进行：在36名Letenneur I型骨折患者中，大多数年龄在25至54岁之间，其中男性22人，女性14人。受伤方式为道路交通事故（25 例）和高空坠落（11 例）。21例患者右膝受累，15例患者左膝受累。外侧髁受累 27 例，内侧髁受累 9 例。所有 36 例 Letenneur I 型霍法骨折患者均在手术治疗 4 个月后接受了评估。患者的活动度（ROM）为120.4°±5.0°，KSS为85.0±4.2，均有明显改善。在 12 个月的随访中，在 ROM 128.1° ± 5.2°和 KSS 89.3 ± 4.8（P）方面保持了更好的结果：用松质骨螺钉和后托板固定 Letenneur I 型 Hoffa 骨折是有效、可靠的，并能提供足够的稳定性。对接钢板辅助固定是对传统的 Hoffa 骨折滞后螺钉固定技术的重要改进。
{"title":"Novel approach of plate assisted buttressing in Hoffa fracture.","authors":"Amit Singh, Nirottam Singh, Gaurav Siwach, Mohit Bansal, Hemant Jain, Kishore Raichandani","doi":"10.1016/j.cjtee.2024.02.003","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.02.003","url":null,"abstract":"<p><strong>Purpose: </strong>Hoffa fracture is a femoral condyle fracture in the coronal plane. The lateral condyle is more commonly involved. The diagnosis is often difficult to detect with routine radiographs. Conservative management in this type of fracture resulted in nonunion, malunion, and other complications, such as stiff knee. Therefore, surgical management is mandatory in displaced fractures. Previous studies suggest only application of cancellous screw fixation, but these are not enough to counter vertical shear stress. Therefore, this study will evaluate the clinical outcomes of open reduction and internal fixation of Letenneur type I Hoffa fracture using cancellous screws with posterior buttressing plate.</p><p><strong>Method: </strong>This was a prospective cohort study conducted from March 2017 to July 2022 in orthopaedics department of tertiary care center after approval of institutional ethical committee. The study included 36 patients with Letenneur type I fractures treated by open reduction and internal fixation using posterior buttress plate and cancellous screws. Radiographs and clinical outcomes, range of movement (ROM), bone union, and knee society score (KSS) of patients were assessed at the end of 4 and 12 months in the follow-ups. All statistical analysis was done using Epi info version 7.2.1.0.</p><p><strong>Results: </strong>In the 36 patients with Letenneur type I fracture, the majority belong to younger age group between 25 and 54 years with 22 males and 14 females. The modes of injury were road traffic accidents in 25 patients and fall from height in 11 patients. The right knee was involved in 21 cases and left was involved in 15 cases. Lateral condyle involvement was seen in 27 cases and medial condyle in 9 cases. All 36 patients with Letenneur type I Hoffa fracture were evaluated 4 months after surgical intervention. The notable improvements were observed in terms of ROM 120.4° ± 5.0° and KSS 85.0 ± 4.2. At the 12-month follow-up, considerably better outcomes were maintained regarding ROM 128.1° ± 5.2° and KSS 89.3 ± 4.8 with p < 0.05 which was statistically significant. At the final follow-up, all patients had routine fracture healing with a union time of (3.2 ± 3.4) months.</p><p><strong>Conclusions: </strong>Fixation of Letenneur type I Hoffa fracture with cancellous screws and posterior buttress plate is effective, reliable and capable of providing adequate stability. Buttress plate assisted fixation is a valuable enhancement of the conventional technique of lag screw fixation of Hoffa fractures.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.1016/j.cjtee.2024.01.006
Xiang-Ping Luo, Jian Peng, Ling Zhou, Hao Liao, Xiao-Chun Jiang, Xiong Tang, Dun Tang, Chao Liu, Jian-Hui Liu
Purpose: Intertrochanteric fractures undergoing proximal femoral nail antirotation (PFNA) surgery are associated with significant hidden blood loss. This study aimed to explore whether intramedullary administration of tranexamic acid (TXA) can reduce bleeding in PFNA surgery for intertrochanteric fractures in elderly individuals.
Methods: A randomized controlled trial was conducted from January 2019 to December 2022. Patients aged over 60 years with intertrochanteric fractures who underwent intramedullary fixation surgery with PFNA were eligible for inclusion and grouped according to random numbers. A total of 249 patients were initially enrolled, of which 83 were randomly allocated to the TXA group and 82 were allocated to the saline group. The TXA group received intramedullary perfusion of TXA after the bone marrow was reamed. The primary outcomes were total peri-operative blood loss and post-operative transfusion rate. The occurrence of adverse events was also recorded. Continuous data was analyzed by unpaired t-test or Mann-Whitney U test, and categorical data was analyzed by Pearson Chi-square test.
Results: The total peri-operative blood loss (mL) in the TXA group was significantly lower than that in the saline group (577.23 ± 358.02 vs. 716.89 ± 420.30, p = 0.031). The post-operative transfusion rate was 30.67 % in the TXA group and 47.95 % in the saline group (p = 0.031). The extent of post-operative deep venous thrombosis and the 3-month mortality rate were similar between the 2 groups.
Conclusion: We observed that intramedullary administration of TXA in PFNA surgery for intertrochanteric fractures in elderly individuals resulted in less peri-operative blood loss and decreased transfusion rate, without any adverse effects, and is, thus, recommended.
目的：接受股骨近端钉抗旋转（PFNA）手术的转子间骨折与大量隐性失血有关。本研究旨在探讨髓内注射氨甲环酸（TXA）能否减少老年人股骨转子间骨折 PFNA 手术中的出血量：方法：2019年1月至2022年12月进行了一项随机对照试验。年龄在60岁以上、接受PFNA髓内固定手术的转子间骨折患者均符合纳入条件，并根据随机编号进行分组。共有249名患者被初步纳入，其中83人被随机分配到TXA组，82人被分配到生理盐水组。TXA组在骨髓扩孔后接受髓内TXA灌注。主要结果是围手术期总失血量和术后输血率。此外，还记录了不良事件的发生情况。连续数据采用非配对 t 检验或 Mann-Whitney U 检验，分类数据采用 Pearson Chi-square 检验：TXA组的围手术期总失血量（毫升）明显低于生理盐水组（577.23 ± 358.02 vs. 716.89 ± 420.30，P = 0.031）。TXA 组的术后输血率为 30.67%，生理盐水组为 47.95%（P = 0.031）。两组的术后深静脉血栓形成程度和 3 个月死亡率相似：我们观察到，在老年转子间骨折的 PFNA 手术中，髓内注射 TXA 可减少围手术期失血，降低输血率，且无任何不良反应，因此值得推荐。
{"title":"Intramedullary administration of tranexamic acid reduces bleeding in proximal femoral nail antirotation surgery for intertrochanteric fractures in elderly individuals: A randomized controlled trial.","authors":"Xiang-Ping Luo, Jian Peng, Ling Zhou, Hao Liao, Xiao-Chun Jiang, Xiong Tang, Dun Tang, Chao Liu, Jian-Hui Liu","doi":"10.1016/j.cjtee.2024.01.006","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.01.006","url":null,"abstract":"<p><strong>Purpose: </strong>Intertrochanteric fractures undergoing proximal femoral nail antirotation (PFNA) surgery are associated with significant hidden blood loss. This study aimed to explore whether intramedullary administration of tranexamic acid (TXA) can reduce bleeding in PFNA surgery for intertrochanteric fractures in elderly individuals.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted from January 2019 to December 2022. Patients aged over 60 years with intertrochanteric fractures who underwent intramedullary fixation surgery with PFNA were eligible for inclusion and grouped according to random numbers. A total of 249 patients were initially enrolled, of which 83 were randomly allocated to the TXA group and 82 were allocated to the saline group. The TXA group received intramedullary perfusion of TXA after the bone marrow was reamed. The primary outcomes were total peri-operative blood loss and post-operative transfusion rate. The occurrence of adverse events was also recorded. Continuous data was analyzed by unpaired t-test or Mann-Whitney U test, and categorical data was analyzed by Pearson Chi-square test.</p><p><strong>Results: </strong>The total peri-operative blood loss (mL) in the TXA group was significantly lower than that in the saline group (577.23 ± 358.02 vs. 716.89 ± 420.30, p = 0.031). The post-operative transfusion rate was 30.67 % in the TXA group and 47.95 % in the saline group (p = 0.031). The extent of post-operative deep venous thrombosis and the 3-month mortality rate were similar between the 2 groups.</p><p><strong>Conclusion: </strong>We observed that intramedullary administration of TXA in PFNA surgery for intertrochanteric fractures in elderly individuals resulted in less peri-operative blood loss and decreased transfusion rate, without any adverse effects, and is, thus, recommended.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Purpose</h3><div>To explore the clinical characteristics of pediatric pelvic fracturs caused by traffic accidents and to analyze the accompanying injuries and complications.</div></div><div><h3>Methods</h3><div>A total of 222 cases involved traffic accidents was enrolled in this case-control study. The data of children with pelvic fractures caused by traffic accidents who were admitted to our hospital from January 2006 to December 2021 were analyzed retrospectively. Sex, age, Tile classification, abbreviated injury scale score, injury severity score, mortality, and accompanying injuries were studied. The ANOVA was used for measurement data, and the non-parametric rank sum test was used for non-normally distributed data. The Fisher's exact probability method was used for the count data.</div></div><div><h3>Results</h3><div>Of all enrolled cases, 140 are boys and 82 are girls, including 144 cases aged < 6 years, 65 aged between 6 and 12 years, and 13 aged > 12 years. Depending on the injury mechanism, there are 15 cases involving pedestrians <em>vs</em>. motorcycles (PVM), 91 cases involving pedestrians <em>vs</em>. passenger cars (PVC), 78 cases involving pedestrians <em>vs</em>. commercial vehicles (PVV), and 38 cases involving motor vehicles <em>vs</em>. motor vehicles (MVM). Associated injuries are reported in 198 cases (89.2%), primarily involving the abdomen injury in 144 cases (64.9%), and lower limb injury in 99 cases (44.6%). PVV injury involves longer hospital stay (<em>p</em> = 0.004). Intensive care unit admission rate is significantly higher in the MVM group than in other groups (<em>p</em> = 0.004). Head injury (<em>p</em> = 0.001) and face injury (<em>p</em> = 0.037) are more common in the MVM group, whereas abdominal injury (<em>p</em> = 0.048) and lower limb injury (<em>p</em> = 0.037) are more common in the PVV group. In the MVM group, the brain injury (<em>p</em> = 0.004) and femoral neck injury (<em>p</em> = 0.044) are more common. In the PVM group, the mediastinum (<em>p</em> = 0.004), ear (<em>p</em> = 0.009), lumbar vertebrae (<em>p</em> = 0.008), and spinal cord (<em>p</em> = 0.011) are the most vulnerable regions, while in the PVV group, the perineum (<em>p</em> < 0.001), urethra (<em>p</em> = 0.001), rectum (<em>p</em> = 0.006), anus (<em>p</em> = 0.004), and lower limb soft tissues (<em>p</em> = 0.024) are the most vulnerable regions. Children aged > 12 years have higher pelvic abbreviated injury scale scores (<em>p</em> = 0.019). There are significant differences in the classification of pelvic fractures among children < 6, 6 – 12, and > 12 years of age, with Tile C being more likely to occur in children > 12 years of age (<em>p</em> = 0.033). Children aged > 12 years are more likely to sustain injuries to the spleen (<em>p</em> = 0.022), kidneys (<em>p</em> = 0.019), pancreas (<em>p</em> < 0.001), lumbar vertebrae (<em>p</em> = 0.013), and sacrum (<em>p</em> = 0.024). The MVM group ha
{"title":"Comparison of pediatric pelvic fractures and associated injuries caused by different types of road traffic accidents","authors":"Bao-Jian Song, Qiang Wang, Wei Feng, Dan-Jiang Zhu, Xue-Jun Zhang","doi":"10.1016/j.cjtee.2024.01.005","DOIUrl":"10.1016/j.cjtee.2024.01.005","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the clinical characteristics of pediatric pelvic fracturs caused by traffic accidents and to analyze the accompanying injuries and complications.</div></div><div><h3>Methods</h3><div>A total of 222 cases involved traffic accidents was enrolled in this case-control study. The data of children with pelvic fractures caused by traffic accidents who were admitted to our hospital from January 2006 to December 2021 were analyzed retrospectively. Sex, age, Tile classification, abbreviated injury scale score, injury severity score, mortality, and accompanying injuries were studied. The ANOVA was used for measurement data, and the non-parametric rank sum test was used for non-normally distributed data. The Fisher's exact probability method was used for the count data.</div></div><div><h3>Results</h3><div>Of all enrolled cases, 140 are boys and 82 are girls, including 144 cases aged < 6 years, 65 aged between 6 and 12 years, and 13 aged > 12 years. Depending on the injury mechanism, there are 15 cases involving pedestrians <em>vs</em>. motorcycles (PVM), 91 cases involving pedestrians <em>vs</em>. passenger cars (PVC), 78 cases involving pedestrians <em>vs</em>. commercial vehicles (PVV), and 38 cases involving motor vehicles <em>vs</em>. motor vehicles (MVM). Associated injuries are reported in 198 cases (89.2%), primarily involving the abdomen injury in 144 cases (64.9%), and lower limb injury in 99 cases (44.6%). PVV injury involves longer hospital stay (<em>p</em> = 0.004). Intensive care unit admission rate is significantly higher in the MVM group than in other groups (<em>p</em> = 0.004). Head injury (<em>p</em> = 0.001) and face injury (<em>p</em> = 0.037) are more common in the MVM group, whereas abdominal injury (<em>p</em> = 0.048) and lower limb injury (<em>p</em> = 0.037) are more common in the PVV group. In the MVM group, the brain injury (<em>p</em> = 0.004) and femoral neck injury (<em>p</em> = 0.044) are more common. In the PVM group, the mediastinum (<em>p</em> = 0.004), ear (<em>p</em> = 0.009), lumbar vertebrae (<em>p</em> = 0.008), and spinal cord (<em>p</em> = 0.011) are the most vulnerable regions, while in the PVV group, the perineum (<em>p</em> < 0.001), urethra (<em>p</em> = 0.001), rectum (<em>p</em> = 0.006), anus (<em>p</em> = 0.004), and lower limb soft tissues (<em>p</em> = 0.024) are the most vulnerable regions. Children aged > 12 years have higher pelvic abbreviated injury scale scores (<em>p</em> = 0.019). There are significant differences in the classification of pelvic fractures among children < 6, 6 – 12, and > 12 years of age, with Tile C being more likely to occur in children > 12 years of age (<em>p</em> = 0.033). Children aged > 12 years are more likely to sustain injuries to the spleen (<em>p</em> = 0.022), kidneys (<em>p</em> = 0.019), pancreas (<em>p</em> < 0.001), lumbar vertebrae (<em>p</em> = 0.013), and sacrum (<em>p</em> = 0.024). The MVM group ha","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 6","pages":"Pages 372-379"},"PeriodicalIF":1.8,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139631302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The treatment strategy for blast injuries is closely linked to the clinical outcome of blast injury casualties. However, the application of military surgery experience to blast injuries caused by production safety accidents is relatively uncommon. In this study, the authors present 2 cases of blast injuries caused by one gas explosion, both cases involved individuals of the same age and gender and experienced similar degree of injury. The authors highlight the importance of using a military surgery treatment strategy, specifically emphasizing the need to understand the concept of damage control and disposal. It is recommended that relevant training in this area should be strengthened to improve the clinical treatment of such injuries. This study provides a valuable reference for healthcare professionals dealing with blast injuries.
{"title":"Blast injuries with contrasting outcomes treated by military surgery strategies: A case report","authors":"Di-You Chen , Xi-Yan Zhu , Wei Ma , Shi-Feng Shao , Liang Zhang , Jing-Ru Xie , Yao-Li Wang , Hui Zhao","doi":"10.1016/j.cjtee.2024.01.003","DOIUrl":"10.1016/j.cjtee.2024.01.003","url":null,"abstract":"<div><div>The treatment strategy for blast injuries is closely linked to the clinical outcome of blast injury casualties. However, the application of military surgery experience to blast injuries caused by production safety accidents is relatively uncommon. In this study, the authors present 2 cases of blast injuries caused by one gas explosion, both cases involved individuals of the same age and gender and experienced similar degree of injury. The authors highlight the importance of using a military surgery treatment strategy, specifically emphasizing the need to understand the concept of damage control and disposal. It is recommended that relevant training in this area should be strengthened to improve the clinical treatment of such injuries. This study provides a valuable reference for healthcare professionals dealing with blast injuries.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 6","pages":"Pages 414-419"},"PeriodicalIF":1.8,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139636306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.cjtee.2023.09.004
Soliudeen Adebayo Arojuraye , Ibrahim Abolaji Alabi , Ibrahim Usman Mustapha
Purpose
Many techniques have been described for the reconstruction of chronic lateral collateral ligament (LCL) rupture with different autograft options. The advantages of percutaneous LCL reconstruction include small incisions, minimal soft tissue disruption, less postoperative pain, and speedy rehabilitation and recovery. The aim of this study was to report the functional outcome of percutaneous LCL reconstruction and overall patient satisfaction in Africans.
Methods
This prospective and interventional study involving 51 patients with chronic LCL rupture who had percutaneous LCL reconstruction using peroneus longus autograft was conducted between January 2021 and December 2022 in National Orthopaedic Hospital, Dala-Kano, Nigeria. The inclusion criteria were patients between the ages of 18 and 45 years with chronic isolated LCL and not more than 1 injury of knee ligament. Exclusion criteria were active infection, and multi-ligament knee injury requiring 2-staged surgery. The knee functions were assessed preoperatively, 3 months, 6 months, and 12 months postoperatively using the Lysholm scoring system. Patient satisfaction with the outcome of the treatment was assessed using a 5-point Likert scale. Relevant information was recorded into Microsoft Excel sheet and data was analyzed using SPSS version 23.0 for windows. The paired samples t-test was used to compare the clinical outcomes as continuous variables. Statistical significance was considered at p < 0.05.
Results
The mean age of the patients was (30.10 ± 5.90) years. The median time from injury to surgery was 7 months (ranging from 3 to 28 months). The mean follow-up period was (14.07 ± 3.13) months. The mean preoperative and 1-year postoperative Lysholm scores were 44.33 ± 12.97 and 97.96 ± 1.23, respectively.
Conclusion
Percutaneous LCL reconstruction using peroneus longus autograft significantly improves patient knee function and results in excellent patient satisfaction.
目的：已经描述了多种不同自体移植方案重建慢性外侧副韧带（LCL）断裂的技术。经皮LCL重建的优点包括切口小、软组织破坏小、术后疼痛少、康复和恢复快。本研究的目的是报告非洲人经皮LCL重建的功能结果和患者的总体满意度，达拉卡诺，尼日利亚。纳入标准为年龄在18至45岁之间患有慢性孤立性LCL且膝关节韧带损伤不超过一次的患者。排除标准为活动性感染和需要两阶段手术的膝关节多韧带损伤。使用Lysholm评分系统对术前、术后3个月、6个月和12个月的膝关节功能进行评估。使用5分Likert量表评估患者对治疗结果的满意度。将相关信息记录在Microsoft Excel表格中，并使用SPSS 23.0 for windows对数据进行分析。配对样本t检验用于比较作为连续变量的临床结果。结果：患者平均年龄为（30.10±5.90）岁。从受伤到手术的中位时间为7个月（从3个月到28个月不等）。平均随访时间为（14.07±3.13）个月。术前和术后1年的平均Lysholm评分分别为44.33±12.97和97.96±1.23。结论：自体腓骨长肌经皮LCL重建术可显著改善患者膝关节功能，患者满意度高。
{"title":"Outcome of percutaneous reconstruction of chronic lateral collateral ligament rupture","authors":"Soliudeen Adebayo Arojuraye , Ibrahim Abolaji Alabi , Ibrahim Usman Mustapha","doi":"10.1016/j.cjtee.2023.09.004","DOIUrl":"10.1016/j.cjtee.2023.09.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Many techniques have been described for the reconstruction of chronic lateral collateral ligament (LCL) rupture with different autograft options. The advantages of percutaneous LCL reconstruction include small incisions, minimal soft tissue disruption, less postoperative pain, and speedy rehabilitation and recovery. The aim of this study was to report the functional outcome of percutaneous LCL reconstruction and overall patient satisfaction in Africans.</p></div><div><h3>Methods</h3><p>This prospective and interventional study involving 51 patients with chronic LCL rupture who had percutaneous LCL reconstruction using peroneus longus autograft was conducted between January 2021 and December 2022 in National Orthopaedic Hospital, Dala-Kano, Nigeria. The inclusion criteria were patients between the ages of 18 and 45 years with chronic isolated LCL and not more than 1 injury of knee ligament. Exclusion criteria were active infection, and multi-ligament knee injury requiring 2-staged surgery. The knee functions were assessed preoperatively, 3 months, 6 months, and 12 months postoperatively using the Lysholm scoring system. Patient satisfaction with the outcome of the treatment was assessed using a 5-point Likert scale. Relevant information was recorded into Microsoft Excel sheet and data was analyzed using SPSS version 23.0 for windows. The paired samples <em>t</em>-test was used to compare the clinical outcomes as continuous variables. Statistical significance was considered at <em>p</em> < 0.05.</p></div><div><h3>Results</h3><p>The mean age of the patients was (30.10 ± 5.90) years. The median time from injury to surgery was 7 months (ranging from 3 to 28 months). The mean follow-up period was (14.07 ± 3.13) months. The mean preoperative and 1-year postoperative Lysholm scores were 44.33 ± 12.97 and 97.96 ± 1.23, respectively.</p></div><div><h3>Conclusion</h3><p>Percutaneous LCL reconstruction using peroneus longus autograft significantly improves patient knee function and results in excellent patient satisfaction.</p></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 1","pages":"Pages 58-62"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127523000949/pdfft?md5=ab40746fad263be19999dc18424017a5&pid=1-s2.0-S1008127523000949-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.cjtee.2023.10.004
Hai-Zhen Duan , Xin Zhou , Quan Hu , Meng-Long Liu , Shu-Hong Wang , Ji Zhang , Xu-Heng Jiang , Tian-Xi Zhang , An-Yong Yu
<div><h3>Purpose</h3><p>Mannitol is one of the first-line drugs for reducing cerebral edema through increasing the extracellular osmotic pressure. However, long-term administration of mannitol in the treatment of cerebral edema triggers damage to neurons and astrocytes. Given that neural stem cell (NSC) is a subpopulation of main regenerative cells in the central nervous system after injury, the effect of mannitol on NSC is still elusive. The present study aims to elucidate the role of mannitol in NSC proliferation.</p></div><div><h3>Methods</h3><p>C57 mice were derived from the animal house of Zunyi Medical University. A total of 15 pregnant mice were employed for the purpose of isolating NSCs in this investigation. Initially, mouse primary NSCs were isolated from the embryonic cortex of mice and subsequently identified through immunofluorescence staining. In order to investigate the impact of mannitol on NSC proliferation, both cell counting kit-8 assays and neurospheres formation assays were conducted. The <em>in vitro</em> effects of mannitol were examined at various doses and time points. In order to elucidate the role of Aquaporin 4 (AQP4) in the suppressive effect of mannitol on NSC proliferation, various assays including reverse transcription polymerase chain reaction, western blotting, and immunocytochemistry were conducted on control and mannitol-treated groups. Additionally, the phosphorylated p38 (p-p38) was examined to explore the potential mechanism underlying the inhibitory effect of mannitol on NSC proliferation. Finally, to further confirm the involvement of the p38 mitogen-activated protein kinase-dependent (MAPK) signaling pathway in the observed inhibition of NSC proliferation by mannitol, SB203580 was employed. All data were analyzed using SPSS 20.0 software (SPSS, Inc., Chicago, IL). The statistical analysis among multiple comparisons was performed using one-way analysis of variance (ANOVA), followed by Turkey's post hoc test in case of the data following a normal distribution using a Shapiro-Wilk normality test. Comparisons between 2 groups were determined using Student's <em>t</em>-test, if the data exhibited a normal distribution using a Shapiro-Wilk normality test. Meanwhile, data were shown as median and interquartile range and analyzed using the Mann-Whitney <em>U</em> test, if the data failed the normality test. A <em>p</em> < 0.05 was considered as significant difference.</p></div><div><h3>Results</h3><p>Primary NSC were isolated from the mice, and the characteristics were identified using immunostaining analysis. Thereafter, the results indicated that mannitol held the capability of inhibiting NSC proliferation in a dose-dependent and time-dependent manner using cell counting kit-8, neurospheres formation, and immunostaining of Nestin and Ki67 assays. During the process of mannitol suppressing NSC proliferation, the expression of AQP4 mRNA and protein was downregulated, while the gene expression of p-p38 was elev
{"title":"Mannitol inhibits the proliferation of neural stem cell by a p38 mitogen-activated protein kinase-dependent signaling pathway","authors":"Hai-Zhen Duan , Xin Zhou , Quan Hu , Meng-Long Liu , Shu-Hong Wang , Ji Zhang , Xu-Heng Jiang , Tian-Xi Zhang , An-Yong Yu","doi":"10.1016/j.cjtee.2023.10.004","DOIUrl":"10.1016/j.cjtee.2023.10.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Mannitol is one of the first-line drugs for reducing cerebral edema through increasing the extracellular osmotic pressure. However, long-term administration of mannitol in the treatment of cerebral edema triggers damage to neurons and astrocytes. Given that neural stem cell (NSC) is a subpopulation of main regenerative cells in the central nervous system after injury, the effect of mannitol on NSC is still elusive. The present study aims to elucidate the role of mannitol in NSC proliferation.</p></div><div><h3>Methods</h3><p>C57 mice were derived from the animal house of Zunyi Medical University. A total of 15 pregnant mice were employed for the purpose of isolating NSCs in this investigation. Initially, mouse primary NSCs were isolated from the embryonic cortex of mice and subsequently identified through immunofluorescence staining. In order to investigate the impact of mannitol on NSC proliferation, both cell counting kit-8 assays and neurospheres formation assays were conducted. The <em>in vitro</em> effects of mannitol were examined at various doses and time points. In order to elucidate the role of Aquaporin 4 (AQP4) in the suppressive effect of mannitol on NSC proliferation, various assays including reverse transcription polymerase chain reaction, western blotting, and immunocytochemistry were conducted on control and mannitol-treated groups. Additionally, the phosphorylated p38 (p-p38) was examined to explore the potential mechanism underlying the inhibitory effect of mannitol on NSC proliferation. Finally, to further confirm the involvement of the p38 mitogen-activated protein kinase-dependent (MAPK) signaling pathway in the observed inhibition of NSC proliferation by mannitol, SB203580 was employed. All data were analyzed using SPSS 20.0 software (SPSS, Inc., Chicago, IL). The statistical analysis among multiple comparisons was performed using one-way analysis of variance (ANOVA), followed by Turkey's post hoc test in case of the data following a normal distribution using a Shapiro-Wilk normality test. Comparisons between 2 groups were determined using Student's <em>t</em>-test, if the data exhibited a normal distribution using a Shapiro-Wilk normality test. Meanwhile, data were shown as median and interquartile range and analyzed using the Mann-Whitney <em>U</em> test, if the data failed the normality test. A <em>p</em> < 0.05 was considered as significant difference.</p></div><div><h3>Results</h3><p>Primary NSC were isolated from the mice, and the characteristics were identified using immunostaining analysis. Thereafter, the results indicated that mannitol held the capability of inhibiting NSC proliferation in a dose-dependent and time-dependent manner using cell counting kit-8, neurospheres formation, and immunostaining of Nestin and Ki67 assays. During the process of mannitol suppressing NSC proliferation, the expression of AQP4 mRNA and protein was downregulated, while the gene expression of p-p38 was elev","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 1","pages":"Pages 42-52"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127523001025/pdfft?md5=231c4a072c3c931c9dcc26d80cf983e2&pid=1-s2.0-S1008127523001025-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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