Objective To investigate the efficiency and safety of articulating spacer for severe infected knee arthroplasty in patients with medical comorbidities and local sinus tracts. Methods Ten consecutive patients with medical comorbidities (rheumatoid arthritis, diabetes mellitus, etc) or local sinus tracts,who were complicated with late infected TKA, were included in the study. All the patients underwent twostage revision using articulating spacers. All of the patients were debridement thoroughly and followed by implantation of an antibiotic-loaded cement articulated spacer. Two-stage revisions were not followed untill the infection were controlled. The hospital for special surgery (HSS) knee scoring system and range of motion were used to evaluate the outcomes. Results One patient underwent knee fusion because the infection was not controlled after first-stage surgery. The other 9 patients had no evidence of infection. The mean follow-up was 50 months (range, 24-90 months), no recurrent infection developed for these 9 patients. The mean modified HSS score had improved from 48 points (range, 32-63) before the resection surgery to 79 points (range,62-91) at the end of the spacer period. At the latest follow-up, the modified HSS score averaged 89 points (range, 74-95). The good and excellent rate was 0, 80% and 100%, respectively. The average range of motion had increased from 13°-70° preoperatively to 8°-93° prior to the revision. And at the latest follow-up, the range of motion averaged 3° to 110°. Conclusion The delayed two-stage revision using an articulating spacer is effective in the treatment of chronically infected TKA characterized by simple, good reproducible, high rate of infection control, better joint function after surgeries

Objective To measure the femoral head-neck ratio among Chinese adults in Nanjing to explore its clinical significance. Methods 468 Chinese without hip symptoms were chosen randomly. There were 313 males and 155 females. 13 cases were less than 20 years old, 88 cases were from 21 to 30 years old, 123 cases were from 31 to 40 years old, 104 cases were from 41 to 50 years old, 102 cases were from 51 to 60 years old, 24 cases were from 61 to 70 years old, 14 cases were more than 71 years old. The mean age was 42.4 years old (ranged from 17 to 82 years old). The maximum diameter of the femoral head and the minimum vertical diameter of femoral neck length on both sides were measured by Digimizer software in the standard anteroposterior pelvis film. The femoral head-neck ratio (FHNR) was calculated and compared with that of the western. Results The normal FHNR of Chinese in Nanjing was 1.48 ± 0.09 (1.33-1.69). FHNR was 1.46±0.09 in Chinese aged less than 20 years old. It was 1.48±0.09 in Chinese aged from 21 to 30 years, and 1.47±0.10 in those aged 31-40 years, 1.46±0.09 in 41-50 years, 1.49±0.10 in 51-60 years,1.48±0.08 in 61-70 years, 1.49±0.10 in those more than 71 years. There was no difference between male and female, the left and right side or the different age groups. There was no difference between the western and Chinese in Nanjing. Conclusion FHNR measurement has not variation with regard to sex, age and side. It may be useful to understand some kind of the hip diseases.

OBJECTIVEThis study was to investigate the mechanical properties of thermodynamic nickel-titanium (NiTi) archwires of different brands under controlled temperature and in artificial saliva to provide some reference for its clinical application.

METHODSUsing a modified partial dental arch bending system, four types of thermodynamic NiTi archwires were tested under controlled temperature (25, 33, 37, 60 degrees C) and in artificial saliva. An Instron Universal Testing Machine was used to apply 3 mm deflections of archwires in the lateral incisor area. The load-deflection curves were determined from the passive position to deflections of 3 mm. The following variables from unloading curves were calculated: Stiffness between 2.5 mm UDP (unloading deflection point) to 0.5 mm UDP after unloading. Any statistically significant differences in these variables for the different brands, temperature and moments levels were analyzed using one-way analysis of variance.

RESULTSUnloading values of four types thermodynamic nickel-titanium archwires increased with controlled temperature rising. The unloading stiffness of the same brand archwires were approximate at 25, 33, 37 degrees C, while their unloading stiffness increased obviously at 60 degrees C.

CONCLUSIONDifferent brands thermodynamic NiTi archwires demonstrated different mechanical behaviours, but all of them exhibited super elasticity and practical shape memory effect. The four thermodynamic NiTi archwires displayed temperature sensitivity at the four test temperatures.

Dental Alloys ; Dental Stress Analysis ; Elasticity ; Humans ; In Vitro Techniques ; Materials Testing ; Nickel ; Orthodontic Wires ; Temperature ; Titanium

Objective To investigate prevalence of metabolic syndrome (MS) in population at high-risk for diabetes in Changfeng community of Shanghai. Methods Totally, 982 persons aged 40-79 years without previous history of diabetes, but with risk factors for diabetes from Changfeng community in Shanghai were screened by questionnaire, physical examinations, lipid profile and oral glucose tolerance test. Prevalence of MS and its clinical characteristic were observed. Results Overall prevalence of MS was 44. 6% (438/982) in Changfeng community, significantly higher in women of 48.6% (341/701) than that in men of 34. 5% (97/281) (P<0.01). Prevalence of MS increased with age in women (P <0. 01 ), but not in men (P>0.05). Components of MS ranking from high to low were hypertension of 66. 5% (653/982), abdominal obesity of 62.8% (617/982), decreased high-density lipoprotein-cholesterol (HDL-C) of 49. 4% (485/982), increased triglyceride (TG) of 46. 0% (452/982) and increased fasting glucose of 35.7% (351/982). There were 55.9% (245/438) of MS patients with three or more MS components in addition to abdominal obesity. Conclusions Prevalence of MS is higher in community population at high-risk for diabetes and more than half of the MS patients have three or more risk factors for cardiovascular disease.

Objective:To analyze the research on airway clearance technology, explore the trends, and research hotspots for airway clearance technology.Methods:The literature on airway clearance technology was searched in the Web of Science core database. The search period was from January 1, 2000, to August 31, 2023. Origin 2022, Scimago Graphica, VOSviewer 1.6.18, and CiteSpace 6.2.4 software were used for visualization analysis.Results:A total of 2 553 articles were included, and the number of articles on airway clearance technology showed a fluctuating upward trend from 2000 to 2023. The United States ranked first in the world in terms of publication volume. Chang was the author with the highest number of publications. Research institutions were mainly concentrated in universities in countries such as the United States, China, and Australia, with the University of Sydney having the highest publication volume. The research hotspots mainly focused on types of airway clearance disorders, types of airway clearance techniques, key populations and implementation sites for airway clearance.Conclusions:The number of publications on airway clearance technology continues to increase. It is necessary to strengthen interdisciplinary and cross-regional exchanges and enhance the depth and breadth of research by Chinese scholars.

Objective To analyze the factors that influence the articular function after open reduction and internal fixation for ankle fractures.Methods From July 2014 to January 2016,111 ankle fractures received surgery in our hospital.There were 54 males and 57 fenales,with a mean age of 43.5 years (frown 18 to 75 years).By the Broos & Bisschop classification,there were 43 unimalleolar,38 bimalleolar and 30 trimalleolar fractures.The postoperative articular function was evaluated according to the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring at the final follow-up.Comparisons were made between the patients with excellent functional scores and those with lower than excellent functional scores.The potential influencing factors were analyzed,including age,gender,body mass index,smoking history,primary hypertension history,diabetes history,injured side,fracture cause,Broos & Bisschop classification,combined presence of obvious inferior tibiofibular separation,combined presence of ankle dislocation,combined presence of other injury,time from injury to surgery,physical status classification by the American Society of Anesthesiologists system,operation time,early functional exercise,removal of internal fixation and postoperative complications.The influencing factors were identified using univariate analysis and logistic regression analysis.Results The average follow-up period was 15.5 months (from 8 to 25 months).The clinical union time of the fractures averaged 3.2 months (from 3 to 5 months).The ankle function at the final follow-up was excellent in 58 cases,good in 48,fair in 5 and poor in 0,with an excellent and good rate of 95.5％.Removal of internal fixation (P =0.001),early functional exercise (P =0.002),and postoperative complications (P =0.049) were identified as the independent risk factors influencing the articular function after surgery for ankle fractures.Conclusion For patients with ankle fracture,enhancing intraoperative procedures,reducing postoperative complications,encouraging the patients to do early functional exercise,and removing internal fixation after firacture union can effectively improve their ankle function.

Objective:To explore the efficacy of long intramedullary nails versus short intramedullary nails in the treatment of AO/OTA 31-A3 intertrochanteric fractures.Methods:A retrospective analysis was conducted on 60 patients with AO/OTA 31-A3 intertrochanteric femur fractures treated between March 2019 and August 2022. The patients were randomly divided into two groups (the long nail group and the short nail group). Thirty-four patients were treated with long intramedullary nails, including 16 males and 18 females, aged 68.41±17.84 years old (range 31-96 years). Twenty-six patients were treated with short intramedullary nails, including 13 males and 13 females, aged 72.23±13.97 years old (range 31-90 years). The causes of injury, fracture classification (AO/OTA classification), intraoperative blood loss, operation time, fracture healing time, imaging indexes (fracture reduction quality, postoperative neck trunk angle, and medial support), Harris score of the hip joint at the last follow-up, one-year mortality rates and complications were compared between the two groups.Results:The follow-up time was 24.26±6.67 months in the long nail group and 24.31±5.60 months in the short nail group, and the general information of the two groups were comparable. Between the long nail and short nail group, the intraoperative blood loss was 281.47±235.28 ml vs. 121.92±84.14 ml and the operation time was 110.44±24.63 min vs. 81.15±28.54 min with significant differences ( P<0.05). While the length of hospital stay was 12.35±4.81 d vs. 10.89±4.30 d, the good rate of fracture reduction was 55.9% vs. 61.53%, the fracture healing time was 120.44±16.43 d vs. 128.07±18.33 d, the presence rate of medial support was 67.6% vs. 79.4%, and the excellent rate of Harris score was 65.4% vs. 65.4% with no significant difference between the two groups ( P>0.05). One-year mortality rates was 5.3% vs. 7.1% and complications was 11.7% vs. 15.4% with no significant difference between the two groups ( P>0.05). Conclusion:Both long intramedullary nails and short intramedullary nails are effective in the treatment of AO/OTA 31-A3 intertrochanteric femur fractures. However, surgical time and intraoperative blood loss was less in the short nail group.

Perilla (Perilla frutescens L.) is an important edible-medicinal oil crop, with its seed containing 46%-58% oil. Of perilla seed oil, α-linolenic acid (C18:3) accounts for more than 60%. Lysophosphatidic acid acyltransferase (LPAT) is one of the key enzymes responsible for triacylglycerol assembly in plant seeds, controlling the metabolic flow from lysophosphatidic acid to phosphatidic acid. In this study, the LPAT2 gene from the developing seeds of perilla was cloned and designated as PfLPAT2. The expression profile of PfLPAT2 gene was examined in various tissues and different seed development stages of perilla (10, 20, 30, and 40 days after flowering, DAF) by quantitative real-time PCR (qRT-PCR). In order to detect the subcellular localization of PfLPAT2 protein, a fusion expression vector containing PfLPAT2 and GFP was constructed and transformed into Nicotiana benthamiana leaves by Agrobacterium-mediated infiltration. In order to explore the enzymatic activity and biological function of PfLPAT2 protein, an E. coli expression vector, a yeast expression vector and a constitutive plant overexpression vector were constructed and transformed into an E. coli mutant SM2-1, a wild-type Saccharomyces cerevisiae strain INVSc1, and a common tobacco (Nicotiana tabacum, variety: Sumsun NN, SNN), respectively. The results showed that the PfLPAT2 open reading frame (ORF) sequence was 1 155 bp in length, encoding 384 amino acid residues. Functional structure domain prediction showed that PfLPAT2 protein has a typical conserved domain of lysophosphatidic acid acyltransferase. qRT-PCR analysis indicated that PfLPAT2 gene was expressed in all tissues tested, with the peak level in seed of 20 DAF of perilla. Subcellular localization prediction showed that PfLPAT2 protein is localized in cytoplasm. Functional complementation assay of PfLPAT2 in E. coli LPAAT mutant (SM2-1) showed that PfLPAT2 could restore the lipid biosynthesis of SM2-1 cell membrane and possess LPAT enzyme activity. The total oil content in the PfLPAT2 transgenic yeast was significantly increased, and the content of each fatty acid component changed compared with that of the non-transgenic control strain. Particularly, oleic acid (C18:1) in the transgenic yeast significantly increased, indicating that PfLPAT2 has a higher substrate preference for C18:1. Importantly, total fatty acid content in the transgenic tobacco leaves increased by about 0.42 times compared to that of the controls, with the C18:1 content doubled. The increased total oil content and the altered fatty acid composition in transgenic tobacco lines demonstrated that the heterologous expression of PfLPAT2 could promote host oil biosynthesis and the accumulation of health-promoting fatty acids (C18:1 and C18:3). This study will provide a theoretical basis and genetic elements for in-depth analysis of the molecular regulation mechanism of perilla oil, especially the synthesis of unsaturated fatty acids, which is beneficial to the genetic improvement of oil quality of oil crops.
Acyltransferases ; Cloning, Molecular ; Escherichia coli/metabolism* ; Fatty Acids ; Perilla frutescens/metabolism* ; Plant Oils ; Plant Proteins/metabolism* ; Saccharomyces cerevisiae/metabolism* ; Seeds/chemistry* ; Tobacco/genetics*