Correlation between tibial valgus deformity and aspect ratio of resected tibial surface in female Chinese patients undergoing total knee arthroplasty

BackgroundMorphology of the resected tibial surface is the reference for tibial component design, selection, and implantation in total knee arthroplasty (TKA). This comparative study sought to answer whether valgus deformity of the tibia would affect the morphology of the resected tibial surface in TKA.MethodsThirty-one female Chinese patients with valgus tibias were retrospectively and consecutively identified from a single-center registration database. Thirty-one patients with well-aligned tibias were matched in terms of gender, height, and weight. Weight-bearing full-length radiographs and computed tomography images of the whole lower limb were obtained for every case. Tibial resection was mimicked perpendicular to the mechanical axis of the tibia in the frontal plane with 3° of posterior slope and a cut level individualized by the actual intraoperative cut. On the resected surface, mediolateral dimension (MLD), medial anteroposterior dimensions (mAPD), and lateral anteroposterior dimensions (lAPD) were measured, and aspect ratios (AR) were calculated. We compared the AR between the two groups.ResultsThe aspect ratio of resected tibial surface positively correlated with tibial valgus alignment. Patients with valgus tibias had significantly smaller AR (MLD/mAPD) for the medial plateau (1.50 ± 0.06 vs. 1.54 ± 0.07, P = 0.032). However, the AR for the lateral plateau was similar between the two groups (1.63 ± 0.08 vs. 1.65 ± 0.07, P = 0.328).ConclusionThis difference in morphology of resected tibial surface between valgus and well-aligned tibias should be considered in tibial component design, as well as in the selection and placement of TKA implants for knees with valgus tibias

The influence of adjunctive traditional Chinese medicine therapy on survival in primary liver cancer: a real-world study based on electronic medical records

Background: Traditional Chinese medicine (TCM) effectively improves the survival rate and quality of life of primary liver cancer patients, but high-level evidence is lacking.Patients and methods: Patients were selected from 5 tertiary hospitals in Henan Province, China. Two thousand sixty-seven patients with primary liver cancer were included in the study. The electronic medical records (EMRs) of the patients were collected. Patients who received adjunctive TCM treatment and underwent treatment cumulative time for more than 1 month were classified as the TCM intervention cohort. Patients who did not receive adjunctive TCM treatment or underwent treatment cumulative time for less than 1 month were classified as the non-TCM intervention cohort. The main outcome indicators were the survival rate and overall survival time. The propensity score inverse probability weighting method was used to balance the differences between the groups.Results: The primary cohort comprised 2,067 patients, including 462 patients who received adjunctive TCM treatment and 1,605 patients who did not receive adjunctive TCM treatment. The results of the Kaplan‒Meier survival curve indicated that the survival rate and median survival time of the exposure group before and after propensity score weighting were greater than those of the control group (p < 0.0001). Univariate Cox regression analysis after propensity score weighting showed that adjunctive TCM treatment was an independent protective factor for survival [regression coefficient = −0.215, hazard ratio (HR) = 0.8066, 95% confidence interval (CI) (0.6609–0.9844)].Conclusion: Adjuvant treatment with TCM has a protective effect on the prognosis of patients with primary liver cancer; it can reduce the mortality and prolong the survival time

Secondary Production of Gaseous Nitrated Phenols in Polluted Urban Environments

Nitrated phenols (NPs) are important atmospheric pollutants that affect air quality, radiation, and health. The recent development of the time-of-flight chemical ionization mass spectrometer (ToF-CIMS) allows quantitative online measurements of NPs for a better understanding of their sources and environmental impacts. Herein, we deployed nitrate ions as reagent ions in the ToF-CIMS and quantified six classes of gaseous NPs in Beijing. The concentrations of NPs are in the range of 1 to 520 ng m(-3). Nitrophenol (NPh) has the greatest mean concentration. Dinitrophenol (DNP) shows the greatest haze-to-clean concentration ratio, which may be associated with aqueous production. The high concentrations and distinct diurnal profiles of NPs indicate a strong secondary formation to overweigh losses, driven by high emissions of precursors, strong oxidative capacity, and high NOx levels. The budget analysis on the basis of our measurements and box-model calculations suggest a minor role of the photolysis of NPs (Peer reviewe

ER stress mediates Angiotensin II-augmented innate immunity memory and facilitates distinct susceptibilities of thoracic from abdominal aorta to aneurysm development

To determine the roles of endoplasmic reticulum (ER) stress and trained immunity, we performed transcriptome analyses on the thoracic aorta (TA) and abdominal aorta (AA) from the angiotensin II (Ang II)-HFD-ApoE-KO aneurysm model and made significant findings: 1) Ang II bypassed HFD-induced metabolic reprogramming and induced stronger inflammation in AA than in TA; 2) Ang II and HFD upregulated 890 genes in AA versus TA and induced cytokine signaling; 3) Ang II AA and TA upregulated 73 and 68 cytokines, scRNA-Seq identified markers of macrophages and immune cells, cell death regulators, respectively; transdifferentiation markers of neuron, glial, and squamous epithelial cells were upregulated by Ang II-AA and TA; and pyroptosis signaling with IL-1β and caspase-4 were more upregulated in Ang II-AA than in TA; 4) Six upregulated transcriptomes in patients with AAA, Ang II AA, Ang II TA, additional aneurysm models, PPE-AAA and BAPN-Ang II-AAA, were partially overlapped with 10 lists of new ER stress gene sets including 3 interaction protein lists of ER stress regulators ATF6, PERK, and IRE1, HPA ER localization genes, KEGG signal genes, XBP1 transcription targets, ATF4 (PERK) targets, ATF6 targets, thapsigargin ER stress genes, tunicamycin-ER stress genes, respectively; 5) Ang II-AA and TA upregulated ROS regulators, MitoCarta genes, trained immunity genes, and glycolysis genes; and 6) Gene KO transcriptomes indicated that ATF6 and PERK played more significant roles than IRE1 in promoting AAA and trained immunity whereas antioxidant NRF2 inhibited them. Our unprecedented ER-focused transcriptomic analyses have provided novel insights on the roles of ER as an immune organelle in sensing various DAMPs and initiating ER stress that triggers Ang II-accelerated trained immunity and differs susceptibilities of thoracic and abdominal aortas to diseases

Innate immunity of vascular smooth muscle cells contributes to two-wave inflammation in atherosclerosis, twin-peak inflammation in aortic aneurysms and trans-differentiation potential into 25 cell types

IntroductionVascular smooth muscle cells (VSMCs) are the predominant cell type in the medial layer of the aorta, which plays a critical role in aortic diseases. Innate immunity is the main driving force for cardiovascular diseases. MethodsTo determine the roles of innate immunity in VSMC and aortic pathologies, we performed transcriptome analyses on aortas from ApoE–/– angiotensin II (Ang II)-induced aortic aneurysm (AAA) time course, and ApoE–/– atherosclerosis time course, as well as VSMCs stimulated with danger-associated molecular patterns (DAMPs).ResultsWe made significant findings: 1) 95% and 45% of the upregulated innate immune pathways (UIIPs, based on data of 1226 innate immune genes) in ApoE–/– Ang II-induced AAA at 7 days were different from that of 14 and 28 days, respectively; and AAA showed twin peaks of UIIPs with a major peak at 7 days and a minor peak at 28 days; 2) all the UIIPs in ApoE–/– atherosclerosis at 6 weeks were different from that of 32 and 78 weeks (two waves); 3) analyses of additional 12 lists of innate immune-related genes with 1325 cytokine and chemokine genes, 2022 plasma membrane protein genes, 373 clusters of differentiation (CD) marker genes, 280 nuclear membrane protein genes, 1425 nucleoli protein genes, 6750 nucleoplasm protein genes, 1496 transcription factors (TFs) including 15 pioneer TFs, 164 histone modification enzymes, 102 oxidative cell death genes, 68 necrotic cell death genes, and 47 efferocytosis genes confirmed two-wave inflammation in atherosclerosis and twin-peak inflammation in AAA; 4) DAMPs-stimulated VSMCs were innate immune cells as judged by the upregulation of innate immune genes and genes from 12 additional lists; 5) DAMPs-stimulated VSMCs increased trans-differentiation potential by upregulating not only some of 82 markers of 7 VSMC-plastic cell types, including fibroblast, osteogenic, myofibroblast, macrophage, adipocyte, foam cell, and mesenchymal cell, but also 18 new cell types (out of 79 human cell types with 8065 cell markers); 6) analysis of gene deficient transcriptomes indicated that the antioxidant transcription factor NRF2 suppresses, however, the other five inflammatory transcription factors and master regulators, including AHR, NF-KB, NOX (ROS enzyme), PERK, and SET7 promote the upregulation of twelve lists of innate immune genes in atherosclerosis, AAA, and DAMP-stimulated VSMCs; and 7) both SET7 and trained tolerance-promoting metabolite itaconate contributed to twin-peak upregulation of cytokines in AAA. DiscussionOur findings have provided novel insights on the roles of innate immune responses and nuclear stresses in the development of AAA, atherosclerosis, and VSMC immunology and provided novel therapeutic targets for treating those significant cardiovascular and cerebrovascular diseases

An improved Bergeron differential protection for half-wavelength AC transmission line

Half-wavelength AC transmission line has the characteristics of long transmission distance and high voltage level, and its fault characteristics are significantly different from conventional transmission line. In order to reduce the interference of distributed capacitive current on half-wavelength AC transmission line on the calculation of current differential protection, this paper proposes a new current differential protection scheme based on Bergeron model. In order to solve the problem of small differential current located at the midpoint when a short circuit fault occurs, a solution using different methods to calculate setting value in different areas is proposed. The protection can move quickly near the terminal and delay to act in the middle area. After simulation and verification on the PSCAD experimental platform, it is found that when there is a fault at both terminals of the line, the protection can quickly operate in about 10 ms; when fault occurs in the middle area, the protection can delay its operation. The experimental results show that the various actions and performance of the protection device can meet the requirements of safe operation of half-wavelength transmission line

The Effects of Controlled Drainage on N Concentration and Loss in Paddy Field

To relieve the situation of the agricultural nonpoint pollution (NPS) in south and east China, paddy field controlled drainage (PFCD) is applied as an important and efficient approach to agricultural water management. A series of PFCD tests at four major growth stages of rice were conducted by use of 18 lysimeters. Concentration of ammonia nitrogen (NH4+-N) and nitrate nitrogen (NO3--N) in surface and subsurface paddy water was observed. The results indicated that the concentration of NH4+-N and NO3--N in paddy water declined with the persistence of a waterlogged condition. Compared to traditional drainage, PFCD reduced N loss in surface water by 95.6%, 78.7%, 59.6%, and 87.4% at the stage of tillering, jointing-booting, heading-flowering, and milking, respectively. It should be noted that loads of N losses in surface water increased on the fourth day after waterlogging at the jointing-booting and milking stage, and surface water exhibited higher N concentration on the first day after waterlogging at each stage. Therefore, paddy field surface water drainage should be avoided in these periods

Analysis of integrated uses of dockless bike sharing and ridesourcing with metros: A case study of Shanghai, China

To enhance the last-mile connectivity of metros, transport managers are experimenting with the integration of shared mobility modes, such as dockless bike sharing (DBS) and ridesourcing. To provide theoretical guidance for transport managers, it is imperative to deepen knowledge of the differences between the integration of DBS and ridesourcing with metros. A three-level structure was developed in this study to identify integrated DBS and ridesourcing trips using observed data from DiDi and Mobike in Shanghai, China. The travel characteristics of two identified integrated shared mobility modes were then compared. Finally, negative binomial regression models were built to investigate the factors influencing these two integrated uses. Comparative analysis shows that the travel distance intervals with the highest proportions are 0.5–1.0 km for DBS and 1.0–1.5 km for ridesourcing. In terms of temporal distribution, morning peaks of integrated DBS trips are higher and earlier than those of ridesourcing. In the spatial dimension, integrated DBS and ridesourcing trips are mainly concentrated in the central urban area and suburban areas, respectively. Further examination indicates that the built environment has different impacts on these two integrated uses. These results provide an improved understanding of the seamless integration of shared mobility modes with metros