Purpose: This meta-analysis compared the efficacy and safety of Proximal Femoral Nail Antirotation (PFNA) and InterTan Nail in the treatment of intertrochanteric fractures. Given the high incidence of femoral intertrochanteric fractures in the elderly population and its impact on quality of life, choosing the most effective and safest surgical option is crucial. PFNA and InterTan are currently two commonly used techniques, but there is a lack of systematic evaluation comparing their safety and effectiveness. This study aims to fill this knowledge gap through Meta-analysis, providing clinicians with evidence-based treatment recommendations.Materials and methods: A computer search was used to search for published literature on PFNA and InterTan in the treatment of intertrochanteric fractures in PubMed (Medline), Web of Science, Embase, Cochrane Library (CENTRAL), Cinahl, CBM, and CNKI.A total of 853 related literatures were retrieved, and 15 literatures were finally included. Newcastle-Ottawa-Scale and Cochrane systematic review methodologies were used to assess the quality of the literature. Meta-analysis was performed using Review Manager 5.4 software, following data extraction.Results: The comparison found that during the surgical treatment of intertrochanteric fractures, the operation time, fluoroscopy time, and blood loss in the PFNA group were significantly shorter than those in the InterTan group, and the difference was statistically significant. In terms of postoperative complication rates, the InterTan group had a significant advantage over the PFNA group. Shaft fracture, varus collapse, cut out, screw migration, and pain of hip and thigh were the most likely to occur in the PFNA group, and the differences were all statistically significant. In terms of postoperative efficacy, the results of the PFNA group and the InterTan group were comparable, and there was no significant differences.Conclusions: When selecting surgical techniques for the treatment of femoral intertrochanteric fractures, it is necessary to conduct individualized assessments based on the patient’s overall health status, surgical tolerance, and post-operative recovery needs. For patients who cannot tolerate long-term surgery or are in poor physical condition, PFNA may be more appropriate. While for patients who can tolerate long-term surgery or have more complex conditions, InterTan may be more suitable.

Objective: To elucidate potential molecular mechanisms differentiating osteoarthritis (OA) and rheumatoid arthritis (RA) through a bioinformatics analysis of differentially expressed genes (DEGs) in patient synovial cells, aiming to provide new insights for clinical treatment strategies. Materials and methods: Gene expression datasets GSE1919, GSE82107, and GSE77298 were downloaded from the Gene Expression Omnibus (GEO) database to serve as the training groups, with GSE55235 being used as the validation dataset. The OA and RA data from the GSE1919 dataset were merged with the standardized data from GSE82107 and GSE77298, followed by batch effect removal to obtain the merged datasets of differential expressed genes (DEGs) for OA and RA. Intersection analysis was conducted on the DEGs between the two conditions to identify commonly upregulated and downregulated DEGs. Enrichment analysis was then performed on these common co-expressed DEGs, and a protein-protein interaction (PPI) network was constructed to identify hub genes. These hub genes were further analyzed using the GENEMANIA online platform and subjected to enrichment analysis. Subsequent validation analysis was conducted using the GSE55235 dataset. Results: The analysis of differentially expressed genes in the synovial cells from patients with Osteoarthritis (OA) and Rheumatoid Arthritis (RA), compared to a control group (individuals without OA or RA), revealed significant changes in gene expression patterns. Specifically, the genes APOD, FASN, and SCD were observed to have lower expression levels in the synovial cells of both OA and RA patients, indicating downregulation within the pathological context of these diseases. In contrast, the SDC1 gene was found to be upregulated, displaying higher expression levels in the synovial cells of OA and RA patients compared to normal controls.Additionally, a noteworthy observation was the downregulation of the transcription factor PPARG in the synovial cells of patients with OA and RA. The decrease in expression levels of PPARG further validates the alteration in lipid metabolism and inflammatory processes associated with the pathogenesis of OA and RA. These findings underscore the significance of these genes and the transcription factor not only as biomarkers for differential diagnosis between OA and RA but also as potential targets for therapeutic interventions aimed at modulating their expression to counteract disease progression. Conclusion: The outcomes of this investigation reveal the existence of potentially shared molecular mechanisms within Osteoarthritis (OA) and Rheumatoid Arthritis (RA). The identification of APOD, FASN, SDC1, TNFSF11 as key target genes, along with their downstream transcription factor PPARG, highlights common potential factors implicated in both diseases. A deeper examination and exploration of these findings could pave the way for new candidate targets and directions in therapeutic research aimed at treating both OA and RA. This study underscores the significance of leveraging bioinformatics approaches to unravel complex disease mechanisms, offering a promising avenue for the development of more effective and targeted treatments.

This bioinformatics investigation systematically interrogates leukemia stem cell (LSC) transcriptomes from acute myeloid leukemia (AML) patients, focusing on exosome-related biomarkers to delineate their mechanistic involvement and therapeutic potential in AML pathogenesis. We curated two LSC gene expression datasets (GSE17054, GSE24395) from GEO, implementing rigorous normalization and batch effect correction using R-based bioinformatics pipelines (ComBat algorithm via sva package). Harmonized datasets underwent differential expression analysis through empirical Bayes moderated t-tests (limma package), cross-referenced with exosome-associated genes from GeneCards to identify AML-specific candidates. Subsequent DAVID functional annotation revealed critical enrichment in vesicle-mediated transport (FDR<0.05) and ferroptosis pathways (p=3.2×10⁻⁴). STRING database analysis coupled with network topology analysis in Cytoscape identified six hub genes (ANXA2, TNFRSF1A, THY1, CD63, IDH1, S100A11) exhibiting significant connectivity (degree centrality ≥8), including membrane trafficking regulators (ANXA2, CD63) and metabolic modulators (IDH1). These findings establish an exosome-related gene signature with therapeutic implications, particularly highlighting IDH1's dual role in 2-hydroxyglutarate metabolism and extracellular vesicle biogenesis. Our multi-omics integration strategy provides a novel framework for understanding AML pathogenesis through the exosome-LSC axis, serving as potential diagnostic biomarkers and therapeutic targets, ultimately advancing therapeutic development for AML.

Rationale: Tension viscerothorax is a severe condition characterized by significant increases in thoracic pressure due to the herniation of abdominal organs into the thoracic cavity. It is commonly observed in children with congenital diaphragmatic hernias or as a postoperative complication, while tension viscerothorax resulting from blunt trauma is rare. Patient concerns: A 48-year-old male was urgently admitted to the emergency department with dyspnea following a fall from a height of 15 m. Diagnoses: The patient, presenting in shock and based on clinical signs, was initially diagnosed with a tension pneumothorax (TPT). Bedside point-of-care ultrasound (POCUS) revealed substantial parenchymal echo abnormalities in the left thoracic cavity and cardiac displacement to the right, suggesting a left-sided tension viscerothorax. Thoracic and abdominal computed tomography confirmed the diagnosis of a rare left-sided tension viscerothorax. Interventions: Due to the delayed diagnosis, the patient experienced a cardiac arrest. Following cardiopulmonary resuscitation and advanced life support, the patient regained spontaneous circulation and underwent an emergency laparotomy to reduce abdominal organs and repair a diaphragmatic hernia. Postoperatively, the patient received comprehensive medical care. Outcomes: The patient recovered well postsurgery and was discharged after an 18-day hospital stay. Follow-up over 2 years revealed no significant complications. Lessons: Blunt trauma-induced tension viscerothorax is rare and can easily be confused with TPT, leading to misdiagnosis. Early use of bedside POCUS is recommended for suspected cases to expedite identification and management, thereby improving survival rates.

Background/Objectives: Andersson lesions are uncommon discovertebral complications of ankylosing spondylitis and may be overlooked when a new mechanical pain pattern is attributed to chronic inflammatory disease. This report describes the diagnostic reasoning, operative decision-making, and short-term outcome of a severe lumbar lesion with three-column instability. Methods: A 38-year-old woman with a 15-year history of ankylosing spondylitis presented with progressive low-back pain, left L5 radiculopathy, and marked functional decline without major trauma. Radiographs, computed tomography, and magnetic resonance imaging were used to characterize the lesion and assess spinal instability and neural compression. A Cawley type E Andersson lesion at L4/5 with severe three-column instability was diagnosed. The patient underwent single-stage posterior–anterior circumferential reconstruction consisting of L4/5 decompression, long-segment L2-S2 fixation, anterior debridement, and tricortical iliac crest grafting. Results: A postoperative gastrocnemius intramuscular venous thrombosis was detected and treated with anticoagulation. At 3 months, the activity-related visual analog scale score improved from 8 to 1, the Oswestry Disability Index improved from 68% to 18%, independent ambulation was restored, and imaging showed stable instrumentation with progressive osseous bridging. At the latest 9-month telephone follow-up, the patient reported maintained pain relief, mobility, and daily function; no new imaging was available. Conclusions: A change from inflammatory to mechanical pain or the development of neurologic findings in ankylosing spondylitis should prompt targeted imaging for an Andersson lesion. In carefully selected patients with severe three-column instability and substantial anterior column deficiency, circumferential reconstruction may provide effective short-term stabilization and functional recovery. Because radiographic follow-up was limited to 3 months, definitive fusion and long-term construct durability cannot be established.

Objective: This study employs bioinformatics analysis with the objective of identifying commonly differentially expressed genes (DEGs) in ulcerative colitis (UC) and rheumatoid arthritis (RA), as well as exploring their underlying molecular mechanisms. By doing so, it aims to provide a theoretical basis for investigating the potential associations between these two diseases and developing novel therapeutic strategies. Materials and methods: We downloaded multiple gene expression datasets for Rheumatoid Arthritis (RA) and Ulcerative Colitis (UC) from the Gene Expression Omnibus (GEO) database. For RA, GSE77298, GSE12021, and GSE55457 were selected as the training sets, with GSE89408 serving as the validation set. For UC, GSE36807, GSE87473, and GSE92415 were chosen as the training sets, and GSE13367 as the validation set.During data processing, we first merged the RA and UC data from each training set with standardized data, eliminated batch effects, and obtained combined datasets of differentially expressed genes (DEGs). Subsequently, we conducted a cross-analysis of the DEGs from RA and UC to identify commonly up-regulated and down-regulated genes. To gain a deeper understanding of these DEGs, we constructed a protein-protein interaction (PPI) network and identified hub genes.For further analysis of these hub genes, we utilized the GENEMANIA platform to obtain functional annotations and interaction information. Finally, we validated our analysis results using the GSE89408 and GSE13367 datasets. Results: After a thorough analysis of the differentially expressed genes in the cells of patients with rheumatoid arthritis (RA) and ulcerative colitis (UC) we found that genes such as CCR7, CD19, CXCL13, CXCR4, and SELL were significantly up-regulated, suggesting their crucial roles in the pathology of both diseases. This discovery not only underscores the importance of these genes as biomarkers for the differential diagnosis of RA and UC, but also highlights key nodes worthy of further validation. In the future, it may be possible to slow or halt disease progression by modulating the expression of these genes. Conclusion: The results of this study reveal potential common molecular mechanisms underlying rheumatoid arthritis (RA) and ulcerative colitis (UC). The key target genes CCR7, CD19, CXCL13, CXCR4, and SELL highlight common underlying factors associated with both diseases. Further investigation and exploration of these findings can pave the way for new candidate targets and directions in therapeutic research aimed at treating RA and UC. This study emphasizes the importance of utilizing bioinformatics approaches to uncover the mechanisms of complex diseases, providing a promising pathway for the development of more effective and targeted treatments.