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Abstract: While abrasions and lacerations are typically easily identified, darker pigmentation of the skin may obscure contusions. Forensic pathology literature shows a disproportionate number of illustrations of contusions on lighter skin tones compared to darker ones. Skin and soft tissue dissection is the most reliable method to confirm contusions.The authors seek to establish a correlation between skin tone and the visual identification of contusions, confirmed by soft tissue dissection. Additionally, they aim to determine the utility of specialized dissections for identifying contusions on different skin tones to identify cases that may benefit from such procedures.A review of cases from the Cook County Medical Examiner's Office from 2014 to 2024 was conducted. The office database was searched for deaths in custody, causes including "assault," and "child abuse." Autopsy photos were compiled into predissection and postdissection sets, reviewed for skin tone, visual identification of contusions, and final confirmation of soft tissue hemorrhage.Results found a negative association between skin color and accurate visual identification of contusions and determined that decedents with a skin tone of 7 or higher on the Massey-Martin scale may benefit from specialized dissections., Competing Interests: The authors report no conflict of interest., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Background: At present, the optimal treatment for posterior cruciate ligament tibial avulsion fracture (PCLTAF) combined with concomitant ipsilateral lower limb fractures remains unclear. The present study aimed to assess the preliminary outcomes of treatment for PCLTAF with concomitant ipsilateral lower limb fractures by open reduction and internal fixation (ORIF)., Materials and Methods: The medical records of patients who sustained PCLTAF with concomitant ipsilateral lower limb fractures between March 2015 and February 2019 and underwent treatment at a single institution were retrospectively reviewed. Imaging examinations performed at the time of injury were applied to identify concomitant ipsilateral lower limb fractures. We used 1:2 matching between patients with PCLTAF combined with concomitant ipsilateral lower limb fractures (combined group; n = 11) and those with isolated PCLTAF (isolated group; n = 22). Outcome data were collected, including the range of motion (ROM) and visual analogue scale (VAS), Tegner, Lysholm, and International Knee Documentation Committee (IKDC) scores. At the final follow-up, the clinical outcomes were compared between the combined and isolated groups and between patients who underwent early-stage surgery and those who underwent delayed treatment for PCLTAF., Results: Thirty-three patients (26 males, 7 females) were included in this study, with eleven patients having PCLTAF and concomitant ipsilateral lower limb fractures and a follow-up of 3.1 to 7.4 years (average, 4.8 years). Compared to patients in the isolated group, patients in the combined group demonstrated significantly worse Lysholm scores (85.7 ± 5.8 vs. 91.5 ± 3.9, p = 0.040), Tegner scores (4.4 ± 0.9 vs. 5.4 ± 0.8, p = 0.006), and IKDC scores (83.6 ± 9.3 vs. 90.5 ± 3.0, p = 0.008). Inferior outcomes were found in patients with delayed treatment., Conclusions: Inferior results were found in patients with concomitant ipsilateral lower limb fractures, while better outcomes were obtained in patients with PCLTAF through early-stage ORIF using the posteromedial approach. The present findings may help determine the prognoses of patients with PCLTAF combined with concomitant ipsilateral lower limb fractures treated through early-stage ORIF., (© 2023. The Author(s).)

The cancer chemodynamic therapy based on the Fenton reaction has been attracting more and more attention. However, the performance of the Fenton reaction is restricted by the unsuitable physiological pH value and inadequate H 2 O 2 content in the tumor microenvironment (TME). In this study, we proposed a novel method of inducing lipid peroxide (LPO) of the cancer cell membrane, whose performance is not limited by the pH value and H 2 O 2 in the TME. The activatable LPO-inducing liposomes were constructed by encapsulating Fe 3+ -containing compound ferric ammonium citrate (FC) in the unsaturated soybean phospholipids (SPC). It was found that the FC could be reduced by the overexpressed glutathione (GSH) in the TME and produce iron redox couple. The Fe 3+ /Fe 2+ mediated the peroxidation of the unsaturated SPC and induced the LPO in the cancer cells. Finally, LPO accumulation led to cancer cell death and tumor growth inhibition. Furthermore, the activatable liposomes did not damage healthy tissues because of the low GSH content in normal tissues and the GSH-triggered activation of the nanocarrier. Together, our findings revealed that FC-SPC-lipo displayed excellent anti-tumor performance and its therapeutic effects are less influenced by the TME, compared with the traditional ferroptosis., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder, which is ultimately treated by the insulin (INS). However, the subcutaneous (s. c.) injection of insulin solution faces the problems of pain and unsatisfactory patient compliance. In this study, the long-acting formulations of insulin are propsed to treat the T2DM and prevent the associated complications. The chitosan (CS) and/or branched polyethyleneimine (bPEI) nanoparticles (bPEI-INS NPs, CS-bPEI-INS NPs) were constructed to load insulin. The long -acting nanoparticles successfully achieved the sustained release of the INS in vitro and in vivo. After s. c. administration, the CS-bPEI-INS NPs greatly improved the INS bioavailability. As a result, the CS-bPEI-INS NPs produced sustained glucose-lowering effects, promising short-term and long-term hypoglycemic efficacy in the T2DM model. Furthermore, the treatment of the CS-bPEI-INS NPs greatly protected the islet in the pancreas and prevented the associated complications of the T2DM, such as cardiac fibrosis in the myocardial interstitium and the perivascular area. In a word, the CS-bPEI-INS NPs was an encouraging long-acting formulation of insulin and had great potential in the treatment of T2DM., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Mesenchymal stromal cells (MSCs) are a heterogeneous population of cells that possess multilineage differentiation potential and extensive immunomodulatory properties. In mice and rats, MSCs produce nitric oxide (NO), as immunomodulatory effector molecule that exerts an antiproliferative effect on T cells, while the role of NO in differentiation was less clear. Here, we investigated the role of NO synthase 2 (NOS2) on adipogenic and osteogenic differentiation of rat MSCs. MSCs isolated from NOS2-null (NOS2 -/- ) and wild type (WT) Sprague-Dawley (SD) rats exhibited homogenous fibroblast-like morphology and characteristic phenotypes. However, after induction, adipogenic differentiation was found significantly promoted in NOS2 -/- MSCs compared to WT MSCs, but not in osteogenic differentiation. Accordingly, qRT-PCR revealed that the adipogenesis-related genes PPAR-γ, C/EBP-α, LPL and FABP4 were markedly upregulated in NOS2 -/- MSCs, but not for osteogenic transcription factors or marker genes. Further investigations revealed that the significant enhancement of adipogenic differentiation in NOS2 -/- MSCs was due to overactivation of the STAT3 signaling pathway. Both AG490 and S3I-201, small molecule inhibitors that selectively inhibit STAT3 activation, reversed this adipogenic effect. Furthermore, after high-fat diet (HFD) feeding, knockout of NOS2 in rat MSCs resulted in significant obesity. In summary, NOS2 is involved in the regulation of rat MSC adipogenic differentiation via the STAT3 signaling pathway., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Qin, Chen, Wang, Huang, Zhang, Liang, Du, Lai, Ding, Yu and Xiang.)

Backgrounds: Surgical resection and adjunct chemotherapy or radio-therapy has been applied for the therapy of superficial malignant tumor in clinics. Whereas, there are still some problems limit its clinical use, such as severe pains and side effect. Thus, it is urgent need to develop effective, minimally invasive and low toxicity therapy stagey for superficial malignant tumor. Topical drug administration such as microneedle patches shows the advantages of reduced systemic toxicity and nimble application and, as a result, a great potential to treat superficial tumors., Methods: In this study, microneedle (MN) patches were fabricated to deliver photosensitizer IR820 and chemotherapy agent cisplatin (CDDP) for synergistic chemo-photodynamic therapy against breast cancer., Results: The MN could be completely inserted into the skin and the compounds carrying tips could be embedded within the target issue for locoregional cancer treatment. The photodynamic therapeutic effects can be precisely controlled and switched on and off on demand simply by adjusting laser. The used base material vinylpyrrolidone-vinyl acetate copolymer (PVPVA) is soluble in both ethanol and water, facilitating the load of both water-soluble and water-insoluble drugs., Conclusions: Thus, the developed MN patch offers an effective, user-friendly, controllable and low-toxicity option for patients requiring long-term and repeated cancer treatments.

Solid dispersion is a widely used method to improve the dissolution and oral bioavailability of water-insoluble drugs. However, due to the strong hydrophobicity, the drug crystallization in the release media after drug dissolution and the resulted decreased drug absorption retards the use of solid dispersions. It is widely known that the amphiphilic copolymer can encapsulate the hydrophobic compounds and help form stable nano-dispersions in water. Inspired by this, we tried to formulate the solid dispersion of nimodipine by using amphipathic copolymer as one of the carriers. Concerning the solid dispersions, there are many important points involved in these formulations, such as the miscibility between the drug and the carriers, the storage stability of solid dispersions, the dissolution enhancement and so on. In this study, a systemic method is proposed. In details, the supersaturation test and the glass transition temperature (T g ) measurement to predict the crystallization inhibition, the ratios of different components and the storage stability, the interactions among the components were investigated in detail by nuclear magnetic resonance ( 1 H NMR) and isothermal titration calorimetry (ITC) and, the final dissolution and oral bioavailability enhancement. It was found that the amphiphilic copolymer used in the solid dispersion encouraged the formation the drug loading micelles in the release media and, finally, the problem of drug crystallization in the dissolution process was successfully solved., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objective: To evaluate the application of transvaginal hydrolaparoscopy for exploration of the pelvic cavity exploration in infertile women., Study Design: A total of 510 infertile women were included in this study from May 1st, 2009 to April 30, 2012 in the clinic of the Hebei Research Institute for Family Planning., Results: In 495 of 510 of the patients (97.06%), a successful operation was achieved at the first puncture. Of these 495 patients, 286 (57.78%) showed bilateral patency. Completely normal tubo-ovarian and pelvic structures were observed only in 79 patients (15.96%): 16 patients (3.23%) had bilateral tube obstruction, 18 (3.64%) had hydrosalpinx, and 8 (1.62%) had fimbrial stenosis. Pelvic abnormalities occurred in 240 patients (44.04%), including bilateral and/or unilateral tubo-ovarian adhesions in 80 patients (16.16%) and 160 (32.32%) found with adhesions in other parts of the pelvic cavity. Pelvic endometriosis was found in 82 patients (16.57%) and 19 (3.84%) had two or more lesions in the pelvic cavity. In addition, 9 cases (1.82%) of ovarian cysts, 7 (1.41%) of bilateral vesicular appendices and 43 cases (6.69%) of a unilateral vesicular appendix were observed. In addition, convoluted tubes such as bent or twisted tubes were found in 4 cases of bilateral fallopian tube occlusion patients (0.81%) and 17 cases of unilateral tubal occlusion patients (3.43%)., Conclusions: Transvaginal hydrolaparoscopy is a feasible, safe, and cost-effective microinvasive technique. This technique can be considered as an alternative procedure for evaluating female infertility., (Copyright © 2014. Published by Elsevier Ireland Ltd.)

New type of liquid embolic agents based on a liquid crystalline material of glyceryl monooleate (GMO) was developed and evaluated in this study. Ternary phase diagram of GMO, water and ethanol was constructed and three isotropic liquids (ILs, GMO:ethanol:water=49:21:30, 60:20:20 and 72:18:10 (w/w/w)) were selected as potential liquid embolic agents, which could spontaneously form viscous gel cast when contacting with water or physiological fluid. The ILs exhibited excellent microcatheter deliverability due to low viscosity, and were proved to successfully block the saline flow when performed in a device to simulate embolization in vitro. The ILs also showed good cytocompatibility on L929 mouse fibroblast cell line. The embolization of ILs to rabbit kidneys was performed successfully under monitoring of digital subtraction angiography (DSA), and embolic degree was affected by the initial formulation composition and used volume. At 5th week after embolization, DSA and computed tomography (CT) confirmed the renal arteries embolized with IL did not recanalize in follow-up period, and an obvious atrophy of the embolized kidney was observed. Therefore, the GMO-based liquid embolic agents showed feasible and effective to embolize, and potential use in clinical interventional embolization therapy., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Embolic agents, such as microparticles, microspheres or beads used in current embolotherapy are mostly radiolucent, which means the agents are invisible under X-ray imaging during and after the process of embolization, and the fate of these particles cannot be precisely assessed. In this research, a radiopaque embolic agent was developed by encapsulating lipiodol in polyvinyl alcohol. The lipiodol-containing polyvinyl alcohol microcapsules (LPMs) were characterized and evaluated for their morphology, size distribution, lipiodol content, lipiodol release, elasticity, and deliverability through catheter. The radiopacity of LPMs in vials and in living mice was both detected by an X-ray imaging system. The biocompatibility of LPMs was investigated with L929 cells and in mice after subcutaneous injection. Embolization of LPMs to a rabbit kidney was performed under digital subtraction angiography (DSA) and the radiopacity of LPMs was verified by computed tomography (CT)., (Copyright © 2013 Elsevier B.V. All rights reserved.)

One pathogenesis of the obesity-associated complications is that consistent with increased body fat mass, the elevation of adipose tissue-derived cytokines inflicts a low-grade chronic inflammation, which ultimately leads to metabolic disorders. Adipocytes and macrophages in visceral adipose (VA) have been confirmed to contribute to the chronic inflammation; however, the role of the resident fibroblasts is still unknown. We established one VA fibroblast cell line, termed VAFC. Morphological analysis indicated that there were large numbers of pits at the cell plasma membrane. In vitro VAFC cells promoted bone marrow cells to differentiate into macrophages and protected them from apoptosis in the serum-free conditions. Additionally, they also interfered in lymphocytes proliferation. On the basis of these results, this cell line might be an in vitro model for understanding the role of adipose-derived fibroblasts in obesity-associated chronic inflammation.

Aim: To investigate the effect of berberine (Ber) on DNFB-induced delayed type hypersensitivity (DTH) and explore the mechanism of the immunosuppression effect of berberine., Methods: BALB/c mice were divided into three groups: control group, DTH group, and Ber-treated DTH group. The DTH group was sensitized to DNFB by painting the shaved abdomen with DNFB dissolved in propanone/olive oil. The Ber-treated DTH group was injected (i.p.) with berberine daily for 7 consecutive days, with the total dose of 30 mg/kg. The control group was treated with the solvent without DNFB. All mice were then challenged by painting 10 microL of 2 g/L DNFB on the left ears. The weight of right and left ears was measured at 48 h after challenge. Histological changes of mouse auricles were observed under light microscopy. Violet crystal staining was used to determine the effect of Ber on adhesion of mouse splenic lymphocytes to extracellular matrix (ECM). Annexin-V staining was used to detect the apoptotic rate of the lymphocytes in the lymph nodes., Results: The results of ear weighting showed that Ber significantly inhibited DTH reaction (P<0.05). Histological observation indicated Ber reduced markedly the infiltration of lymphocytes. The adhesion of T lymphocytes to ECM was also notably decreased by Ber treatment (P<0.05). There was no obvious difference in apoptotic rates of the lymphocytes among Ber-treated DTH group, DTH group and control group (P>0.05)., Conclusion: Ber can significantly inhibit the DNFB-induced DTH in mice. The reduced adhesion between mouse T lymphocytes and ECM may be one of the mechanisms of suppression of DTH by Ber.

Objective: The reproductive goals of married couples living in impoverished areas of China affect survival rates and quality of life of female children in those areas. The goal of this study was to collect information on parents' attitudes toward reproduction, gender preferences/prejudices, and to collect relevant socioeconomic and demographic data., Methods: Random sample families were enrolled from 3 poverty counties. Sample size included parents of 1800 children from birth to 6 years old. The children were divided into 6 age groups at one-year interval. Baseline data were collected and a questionnaire (endorsed by UNICEF) was used to evaluate reproductive expectations and gender preferences of parents., Results: (1) The success of the One Child Family program has lead to a decreased overall birthrate. (2) The gender ratio (boys:girls) of the 3 counties studied was 100:87-100:95-100:97. No gender imbalance was found in this study. (3) The "Boy Preference" was still expressed by both fathers (69.0%) and mothers (65.7%). Approximately 40% of fathers and 37% of mothers interviewed expressed that only a male child would be acceptable. (4) Approximately 65% of both fathers and mothers recognize that girls are more likely to care for aging parents., Conclusion: Government initiatives have encouraged small families, yet in this region gender ratio of newborns is still normal. More educational and social programs are needed to influence perceptions regarding gender and to eliminate the suboptimal status/poorly perceived value of girls in many societies.

Objective: To study blood Leptin level of 154 (78 male, 76 female) Chinese obese/non-obese children aged 0 - 14 years during 1999 - 2001., Methods: The gender- and age-specific distribution pattern of Leptin and its relationship with anthropometric parameters (waist circumference, waist/hip ratio, lean body mass, fat mass, body fat percentage, BMI/Kaup index etc.) and blood insulin level were recorded., Results: (1) The blood Leptin level in healthy non-obese kids ranged from 1.01 - 29.92 (ng/ml), the mean values and SD were 2.99 +/- 2.13 (ng/ml) [90% confidence interval was 1.36 - 14.21 (ng/ml) in boys and 1.74 - 21.17 (ng/ml) in girls]. There was no significant difference in the blood Leptin level between serum and plasma. (2) The blood Leptin level was higher in overweight/obese kids than that in non-obese kids (P < 0.001). (3) There was significant difference in the blood Leptin levels between boys and girls groups (P = 0.023), especially in non-obese group (P = 0.004). The multiple regression analysis showed that there was no correlation between gender and blood Leptin level when body fat factor was added (P = 0.138, 0.241, 0.990), but there was still a strong correlation between blood leptin level and BMI, FM and BF% (P < 0.001). (4) There was a correlation between blood Leptin level and age (P = 0.005), especially in overweight/obese group and in girls (P = 0.001). The blood Leptin level rose from early puberty, especially in girl group (P = 0.045). There was significant difference in blood Leptin level in different age groups (P < 0.001) (5) There were strong positive correlation between blood Leptin level and BMI, BM and FM%, a weak correlation with LBM, and no correlation with W/H ratio in boys and a positive relationship in girls. The Quatatic equation was better than the linear equation in description of the correlation mentioned above. (6) There was a correlation between blood Leptin from 0 to 7 yr and birth weight (P = 0.001), after 7 yr of age this correlation disappeared (P = 0.456). (7) A positive correlation was seen between blood Leptin level and blood insulin level (P < 0.001)., Conclusion: The blood Leptin level of 0 - 14 years old children is consistent with the level of growth of adiposity tissue and the degree of adiposity rebound.

A retrospective analysis of MRI results of knee joints of 40 patients with routine arthroscopic operation was performed by the authors. The results showed the accuracy rate of MRI for diagnosis of internal and external meniscus injury was 84.25% and 87.5%, and that for anterior and posterior cruciate ligament was 90.25% and 100.00%, respectively. Although MRI possessed good resolving capacity for soft tissue, the authors stress the attention should be paid to clinical data collection.