ObjectiveTo compare the effectiveness of flexible fixation and rigid fixation in the treatment of ankle pronation-external rotation fractures with distal tibiofibular syndesmosis.MethodsA retrospective analysis was made on the clinical data of 50 patients with ankle pronation-external rotation fractures and distal tibiofibular syndesmosis treated between January 2013 and December 2015. Suture-button fixation was used in 23 patients (flexible fixation group) and cortical screw fixation in 27 patients (rigid fixation group). There was no significant difference in age, gender, weight, side, fracture type, and time from trauma to surgery between 2 groups (P>0.05). The operation time, medial clear space (MCS), tibiofibular clear space (TFCS), tibiofibular overlap (TFO), American Orthopaedic Foot and Ankle Society (AOFAS) score, and Foot and Ankle Disability Index (FADI) score were compared between 2 groups.ResultsThe operation time was (83.0±9.1) minutes in the flexible fixation group and was (79.6±13.1) minutes in the rigid fixation group, showing no significant difference (t=1.052, P=0.265). All patients achieved healing of incision by first intention. The patients were followed up 12-20 months (mean, 14 months). The X-ray films showed good healing of fracture in 2 groups. There was no screw fracture, delayed union or nounion. The fracture healing time was (12.1±2.5) months in the flexible fixation group and was (11.3±3.2) months in the rigid fixation group, showing no significant difference between 2 groups (t=1.024, P=0.192). Reduction loss occurred after removal of screw in 2 cases of the rigid fixation group. At last follow-up, there was no significant difference in MCS, TFCS, TFO, AOFAS score and FADI score between 2 groups (P>0.05).ConclusionSuture-button fixation has similar effectiveness to screw fixation in ankle function and imaging findings, and flexible fixation has lower risk of reduction loss of distal tibiofibular syndesmosis than rigid fixation.
Objective To explore depression-related biomarkers and potential therapeutic drugs in order to alleviate depression symptoms and improve patients’ quality of life. Methods From November 2022 to January 2024, gene expression profiles of depression patients and healthy volunteers were downloaded from the Gene Expression Omnibus database. Differential expression analysis was performed to identify differentially expressed genes. Enrichment analysis of these genes was conducted, followed by the construction of a protein-protein interaction network. Finally, Cytoscape software with the Cytohubba plugin was used to identify potential key genes, and drug prediction was performed. Results Through differential expression analysis, a total of 110 differentially expressed genes (74 upregulated and 36 downregulated) were identified. Protein-protein interaction network identified 10 key genes, and differential expression analysis showed that 8 of these genes (CPA3, HDC, IL3RA, ENPP3, PTGDR2, VTN, SPP1, and SERPINE1) exhibited significant differences in expression levels between healthy volunteers and patients with depression (P<0.05). Enrichment analysis revealed that the upregulated genes were significantly enriched in pathways related to circadian rhythm, niacin and nicotinamide metabolism, and pyrimidine metabolism, while the downregulated genes were primarily enriched in extracellular matrix-receptor interaction and interleukin-17 signaling pathways. Six overlapping verification genes (SALL2, AKAP12, GCSAML, CPA3, FCRL3, and MS4A3) were obtained across two datasets using the Wayn diagram. Single-cell sequencing analysis indicated that these genes were significantly expressed in astrocytes and neurons. Mendelian randomization analysis suggested that the FCRL3 gene might play a critical role in the development of depression. Drug prediction analysis revealed several potential antidepressant agents, such as cefotiam, harmol, lincomycin, and ribavirin. Conclusions Circadian rhythm, nicotinate and nicotinamide metabolism, and pyrimidine metabolism pathways may represent potential pathogenic mechanisms in depression. Harmol may be a potential therapeutic drug for the treatment of depression.
Objective To study the clinical and CT findings of bronchiolar adenoma. Methods Patients diagnosed with bronchiolar adenoma confirmed by surgical pathology at Linyi People's Hospital and Yantai Yuhuangding Hospital from 2016 to 2021 were collected. Their clinical and CT imaging features were retrospectively analyzed. ResultsFinally, 25 patients were collected, including 6 males and 19 females, aged 32-73 (58.6±10.1) years. The immunohistochemical Ki-67 (MIB1) of all lesions was <5%. The lesions were located in the upper and middle lobe of both lungs in 9 patients, lower lobes in 16 patients, extrapulmonary zone in 22 patients, intrapulmonary middle zone in 3 patients, round in 11 patients, irregular in 14 patients, well-defined in 22 patients, pure ground-glass/mixed ground-glass nodules in 6 patients, solid nodules in 19 patients. There were 11 patients with central small cavity, 18 patients with single bronchioles sign, 19 patients without adhesion with adjacent pleura, and 24 patients without mediastinal lymph node enlargement. ConclusionBronchiolar adenomas usually occur in the middle-aged and elderly, mostly in the lower lobe of both lungs and the distribution of the peripheral lung field, most of the patients do not have any clinical symptoms, and the postoperative prognosis is good. CT may show large nodules or masses, pure ground-glass/mixed ground-glass nodules, irregular solid nodules and central small cavities. Irregular stellate nodules, central small cavity shadow, and single bronchiolar vascular bundle connected with the lesions are relatively specific imaging findings of bronchiolar adenoma.