Treatment of irreducible femoral intertrochanteric fractures using a wire-guided device

Purpose:Treatment of irreducible femoral intertrochanteric fractures often requires open reduction.However,the technique unavoidably causes patients to suffer greater trauma.As such,minimally invasive techniques should be employed to reduce the surgical-related trauma on these patients and maintain a stable reduction of the fractures.Herein,a minimally invasive wire introducer was designed and used for the treatment of femoral intertrochanteric fractures.The effectiveness of using a wireguided device to treat irreducible femoral intertrochanteric fractures was evaluated.Methods:Between 2013 and 2018,patients with femoral intertrochanteric fractures who were initially treated by intramedullary nail fixation but had difficult reduction using the traction beds were retrospectively reviewed.Decision for an additional surgery was based on the displacement of the fracture.The patients were then divided into two groups:those in the control group received an open reduction surgery while those in the observation group received a closed reduction surgery using a minimally invasive wire introducer to guide the wire that could assist in fracture reduction.The operation time,blood loss,visual analogue scale scores,angulation,reduction,neck-shaft angle,re-displacement,limb length discrepancy,and union time were then recorded and analyzed to determine the efficiency of the wire introducer technique.Categorical variables were analyzed by using Chi-square test,while continuous variables by independent t-test and the Mann-Whitney test accordingly.Results:There were 92 patients included in this study:61 in the control group and 31 in the observation group.There were no significant differences in baseline demographic factors between the two groups.All surgeries were successful with no deaths within the perioperative period.The average follow-up time for the patients was 23.8 months.However,the observation group had a significantly shorter operation time,lower visual analogue scale score,less intraoperative bleeding,and shorter fracture healing time.There were no significant differences in the angulation,reduction,neck-shaft angle,and limb length discrepancy between the two groups.Conclusion:The minimally invasive wire guide achieved a similar effect to that of open reduction in the treatment of intertrochanteric fractures with difficult reduction.Moreover,the minimally invasive wire introducer is a good technology that accurately guides the wire during reduction.Indeed,it is an effective technique and achieves good clinical outcomes in restoration of irreducible femoral intertrochanteric fractures.

Identification of micro RNAs and their target genes in Alport syndrome using deep sequencing of iPSCs samples

MicroRNAs （miRNAs） are a class of small RNA molecules that are implicated in post-transcriptional reg- ulation of gene expression during development. The discovery and understanding of miRNAs has revolutionized the traditional view of gene expression. Alport syndrome （AS） is an inherited disorder of type IV collagen, which most commonly leads to glomerulonephritis and kidney failure. Patients with AS inevitably reach end-stage renal disease and require renal replacement therapy, starting in young adulthood. In this study, Solexa sequencing was used to identify and quantitatively profile small RNAs from an AS family. We identified 30 known miRNAs that showed a sig- nificant change in expression between two individuals. Nineteen miRNAs were up-regulated and eleven were down-regulated. Forty-nine novel miRNAs showed significantly different levels of expression between two individuals. Gene target predictions for the miRNAs revealed that high ranking target genes were implicated in cell, cell part and cellular process categories. The purine metabolism pathway and mitogen-activated protein kinase （MAPK） signaling pathway were enriched by the largest number of target genes. These results strengthen the notion that miRNAs and their target genes are involved in AS and the data advance our understanding of miRNA function in the patho- genesis of AS.