Extramedullary versus intramedullary tibial alignment technique in total knee arthroplasty: A meta-analysis of randomized controlled trials

The aim of this study was to establish whether the use of an extramedullary or intramedullary tibial cutting guide leads to superior mechanical leg axis and implant positioning. A meta-analysis of six randomized controlled trials including 350 knees was performed. For the mechanical axis, frontal tibial component angle and tibial slope, there were no significant differences in the mean values or the number of outliers (±3°) between the extramedullary and intramedullary groups. A reduced tourniquet time was associated with the intramedullary guide. No significant difference in the complication rate was noted between the two groups. Neither extramedullary nor intramedullary tibial alignment was more accurate in facilitating the tibial cut. Use of an intramedullary guide results in a shorter tourniquet time and exhibits a similar complication rate as the extramedullary guide

Green-light p-n Junction Particle Inhomogeneous Phase Enhancement of MgB2 Smart Meta-Superconductor

Improving the critical temperature (TC), critical magnetic field (HC), and critical current (JC) of superconducting materials has always been one of the most significant challenges in the field of superconductivity, but progress has been slow over the years. Based on the concept of injecting energy to enhance electron pairing states, in this study, we have employed a solid-state sintering method to fabricate a series of smart meta-superconductors (SMSCs) consisting of p-n junction nanostructures with a wavelength of 550 nm, doped within an MgB2 matrix. Experimental results demonstrate that compared to pure MgB2 samples, the critical transition temperature (TC) has increased by 1.2 K, the critical current (JC) has increased by 52.8%, and the Meissner effect (HC) shows significant improvement in its diamagnetic properties. This phenomenon of enhanced superconducting performance can be explained by the coupling between superconducting electrons and evanescent waves

Mediastinal Lymph Node Metastases in Thyroid Cancer: Characteristics, Predictive Factors, and Prognosis

Background. Mediastinal lymph node metastases (MLNM) have not been extensively studied. The aim of this study is to investigate the characteristics, predictive factors, and prognosis of MLNM in thyroid cancer. Methods. This is a retrospective study based on the thyroid cancer patients with MLNM at our institution from 2008 to 2015. Results. In total, 73 thyroid cancer patients with positive MLNM were included in this study. It contained sixty patients (82.2%) with papillary thyroid carcinoma (PTC), twelve (16.4%) with medullary thyroid carcinoma, and one (1.4%) with anaplastic thyroid carcinoma. Forty-eight patients had the surgery as initial treatment. Fifty-three (72.6%) patients remained disease-free, and fifteen (20.5%) developed a regional recurrence. Distant metastases occurred in four (5.5%) patients and five (6.8%) patients died. Five-year overall survival rate and disease-free survival (DFS) rate of the PTC patients for initial treatment are 95.4% and 77.2%, respectively. Extrathyroidal extension and multiple lymph nodes involved were associated with DFS in PTC patients. Conclusions. Initial therapeutic control is very important for the thyroid cancer patients. Extrathyroidal extension and multiple mediastinal lymph nodes involved were the influence factors of prognosis in the thyroid cancer patients with MLNM

Analysis of AMB-FUBINACA Biotransformation Pathways in Human Liver Microsome and Zebrafish Systems by Liquid Chromatography-High Resolution Mass Spectrometry

In this study, the metabolic profiles of a new illicit drug AMB-FUBINACA were investigated using both human liver microsome and zebrafish models. Liquid chromatography Q Extractive HF Hybrid Quadrupole-Orbitrap mass spectrometry (LC-QE-HF-MS) was employed to analyze the metabolic sites and pathways. AMB-FUBINACA was added to the in vitro liver microsome incubation model to simulate the metabolic processes in human body. The results showed that a total of 17 metabolites were generated in the human liver microsome model; the main metabolic pathways of the phase I metabolism included ester hydrolysis, methylation, ester hydrolysis combined with decarboxylation, hydroxylation, ester hydrolysis combined with indazole ring hydroxylation, etc. while glucuronidation served as the main metabolic pathway of the phase II metabolism. The zebrafish system produced a similar result with 16 of the same 17 metabolites identified. The phase I metabolites M3.1 (ester hydrolysis), M1.2 (alkyl chain hydrolysis) and the phase II metabolite M3.2 (M3.1 glucuronide) were recommended to be the potential poisoning markers

Zwitterionically modified alginates mitigate cellular overgrowth for cell encapsulation

Foreign body reaction (FBR) to implanted biomaterials and medical devices is common and can compromise the function of implants or cause complications. For example, in cell encapsulation, cellular overgrowth (CO) and fibrosis around the cellular constructs can reduce the mass transfer of oxygen, nutrients and metabolic wastes, undermining cell function and leading to transplant failure. Therefore, materials that mitigate FBR or CO will have broad applications in biomedicine. Here we report a group of zwitterionic, sulfobetaine (SB) and carboxybetaine (CB) modifications of alginates that reproducibly mitigate the CO of implanted alginate microcapsules in mice, dogs and pigs. Using the modified alginates (SB-alginates), we also demonstrate improved outcome of islet encapsulation in a chemically-induced diabetic mouse model. These zwitterion-modified alginates may contribute to the development of cell encapsulation therapies for type 1 diabetes and other hormone-deficient diseases