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Objective: To explore the effect of calcitriol combined with zoledronic acid in posterior cruciate ligament tibial avulsion fractures of the knee joint in patients with diabetic osteoporosis. Methods: Between January 2020 and January 2022, 60 patients with diabetic osteoporosis treated in our hospital were included. All patients underwent knee joint posterior cruciate ligament tibial avulsion fractures, and they were randomized (1 : 1) into the observation group (calcitriol combined with zoledronic acid) and control group (calcitriol). The two groups were compared with respect to the improvement of bone mineral density and bone metabolism indexes, the pain degree (VAS) and knee joint function (Lysholm), and the incidence of refracture. Results: Both groups showed an increasing bone mineral density after treatment, and significant increase was observed in the observation group vs. control group (all p < 0.05). After treatment, VAS scores decreased in the two groups, and Lysholm scores increased compared to the corresponding values before treatment (all p < 0.05), with more notable changes in the observation group versus control group (all p < 0.05). The observation group had fewer cases of refractures than the control group (2 cases vs. 8 cases) (p < 0.05). Conclusion: Calcitriol combined with zoledronic acid used in patients with diabetic osteoporosis after the posterior cruciate ligament tibial attachment avulsion fracture of the knee joint yields a promising result in enhancing bone mineral density and bone metabolism indicators, relieving pain, improving knee joint function, and reducing the risk of refracture.

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Background: Tetralogy of Fallot (TOF) belongs to cyanotic heart damage, which is the most common in clinic. In the chronic myocardial hypoxia injury related to TOF, the potential molecular mechanism of cardiac energy metabolism remains unclear. Materials and methods: In our study, microarray transcriptome analysis and metabonomics methods were used to explore the energy metabolism pathway during chronic hypoxia injury. The gene expression omnibus (GEO) dataset GSE132176 was obtained for analyzing the metabolic pathways. The clinical samples (right atrial tissues) of atrial septal defect (ASD) and TOF were analyzed by metabonomics. Next, we screened important pathways and important differential metabolites related to energy metabolism to explore the pathogenesis of TOF. Results: Gene set enrichment analysis (GSEA) indicated that fructose 6-phosphate metabolic process, triglyceride metabolic process, and et al. were significantly enriched. Gene set variation analysis (GSVA) results showed that significant difference of ASD group and TOF group existed in terpenoid metabolic process and positive regulation of triglyceride metabolic process. Pathways with significant enrichment (impact > 0.1) in TOF were caffeine metabolism (impact = 0.69), sphingolipid metabolism (impact = 0.46), glycerophospholipid metabolism (impact = 0.26), tryptophan metabolism (impact = 0.24), galactose metabolism (impact = 0.11). Pathways with significant enrichment (impact > 0.1) in ASD are caffeine metabolism (impact = 0.69), riboflavin metabolism (impact = 0.5), alanine, aspartate and glutamate metabolism (impact = 0.35), histidine metabolism (impact = 0.34) and et al. Conclusion: Disturbed energy metabolism occurs in patients with TOF or ASD, and further investigation was needed to further clarify mechanism.

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Background: Ulinastatin has been prescribed to treat sepsis. However, there is doubt regarding the extent of any improvement in outcomes to guide future decision making. Objectives: To evaluate the effects of ulinastatin on mortality and related outcomes in sepsis patients. Methods: Thirteen randomized controlled trials and two prospective studies published before September 1, 2018, that included 1358 patients with sepsis, severe sepsis, or septic shock were evaluated. The electronic databases searched in this study were PubMed, Medline, Embase, and China National Knowledge Infrastructure (CNKI) for Chinese Technical Periodicals. Results: Ulinastatin significantly decreased the all-cause mortality {odds ratio (OR) = 0.48, 95% confidence interval (CI) [0.35-0.66], p < 0.00001, I2 = 13%}, Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) score {mean difference (MD) = -2.40, 95% CI [-4.37, -0.44], p = 0.02, I2 = 66%}, and reduced the incidence of multiple organ dysfunction syndrome (MODS) (OR = 0.3, 95% CI [0.18, 0.49], p < 0.00001, I2 = 0%). Ulinastatin also decreased the serum levels of IL-6 (MD = -88.5, 95% CI [-123.97, -53.04], p < 0.00001), TNF-α (MD = -56.22, 95% CI [-72.11, -40.33], p < 0.00001), and increased the serum levels of IL-10 (MD = 37.73, 95% CI [16.92, 58.54], p = 0.0004). Ulinastatin administration did not lead to any difference in the occurrence of adverse events. Conclusions: Ulinastatin improved all-cause mortality and other related outcomes in patients with sepsis or septic shock. The results of this meta-analysis suggest that ulinastatin may be an effective treatment for sepsis and septic shock.

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[This corrects the article DOI: 10.3389/fphar.2019.01370.].