Traumatic proximal tibiofibular fracture and dislocation.

BACKGROUND: Traumatic proximal tibiofibular fracture and dislocation (PTFD) have been rarely studied and are easily missed in clinical practice. PTFD is considered a marker of severely traumatized knees. The purpose of this study was to retrospectively analyze the incidence and impact of PTFD in traumatized knees with vascular injury. METHODS: Patients with knee trauma and vascular injury were included from January 2022 to October 2023. X-rays and CT scans of included patients were retrospectively analyzed to determine the presence of PTFD. Patients were further divided into PTFD group and non-PTFD group for further comparative analysis. RESULTS: A total of 27 patients (28 limbs) were included. Incidence of PTFD was 39.3% (11/28) in traumatic knee with vascular injury, including 8 anterolateral dislocations and 3 posteromedial dislocations. PTFD group had significantly more limbs with open injuries compared with non-PTFD group (10/11 VS 7/17, p<0.05). Amputation rate of PTFD group was as high as 40% (4/10), compared to 23.5% (4/17) in non-PTFD group. However, the difference between two groups was not statistically significant (p>0.05). CONCLUSIONS: PTFD was easily overlooked or missed. In traumatized knees with vascular injury, incidence of PTFD was high. The presence of PTFD might indicate severe knee trauma and the possibility of open injury. Although there was no significant difference compared with non-PTFD group, PTFD group had a relatively high amputation rate of 40%.

Management of Suspected Peripheral Vascular Injuries in Orthopedic Trauma.

OBJECTIVE: In orthopedic trauma, identification of extremity trauma combined with vascular injury is challenging. Missed diagnosis may result in amputation or even death. The purpose of this study was to investigate whether physical examination combined with handheld vascular ultrasound Doppler examination could be an effective method of screening for peripheral vascular injury and to explore the characteristics of vascular injuries in orthopedic trauma patients. METHODS: Retrospective analysis of patients in the emergency department of orthopedic trauma in our hospital from January 2022 to October 2023. Physical examination combined with handheld vascular ultrasound Doppler examination was used as a screening method for suspected vascular injuries. Patients with suspected vascular injury would undergo further angiography and receive multidisciplinary treatment. Angiography was used as the gold standard for diagnosing vascular injuries. Patient demographics, mechanism of injury, location and type of injury, angiographic results, surgical notes, and early treatment outcome data were recorded. RESULTS: A total of 55 cases (58 limb injuries) with suspected vascular injury were ultimately included. Angiography revealed that 53 cases (55 limbs, positive rate 94.8%) were considered to have confirmed vascular injuries. Forty-three were male (81.1%) and 10 were female (18.9%), with mean age 44.1 ± 16.6 years. The main mechanism of injury was traffic accident (30, 56.7%). Most common site of vascular injuries was knee joint (30/55, 54.5%), and popliteal artery (23, 47.9%) was the most commonly injured blood vessel. After multidisciplinary collaborative treatment, overall patient mortality was 3.8% (2/53), and limb survival rate among surviving patients was 81.1% (43/53) in our study. CONCLUSION: In orthopedic trauma, "Hard signs" and "soft signs" combined with handheld vascular ultrasound Doppler examination were effective ways to screen for suspected vascular injuries. Most limbs had associated fractures or dislocations at the site of vascular injury. Collaboration of vascular surgery, microsurgery and orthopedic trauma may help improve patients' prognosis.

Effects of Salt Stress on Physiological and Agronomic Traits of Rice Genotypes with Contrasting Salt Tolerance.

Salinity is one of the major constraints to crop production. Rice is a main staple food and is highly sensitive to salinity. This study aimed to elucidate the effects of salt stress on physiological and agronomic traits of rice genotypes with contrasting salt tolerance. Six contrasting rice genotypes (DJWJ, JFX, NSIC, HKN, XD2H and HHZ), including three salt-tolerant and three salt-sensitive rice genotypes, were grown under two different salt concentrations (0 and 100 mmol L-1 NaCl solution). The results showed that growth, physiological and yield-related traits of both salt-sensitive and salt-tolerant rice were significantly affected by salt stress. In general, plant height, tiller number, dry weight and relative growth rate showed 15.7%, 11.2%, 25.2% and 24.6% more reduction in salt-sensitive rice than in salt-tolerant rice, respectively. On the contrary, antioxidant enzyme activity (superoxide dismutase, peroxidase, catalase), osmotic adjustment substances (proline, soluble protein, malondialdehyde (MDA)) and Na+ content were significantly increased under salt stress, and the increase was far higher in salt-tolerant rice except for MDA. Furthermore, grain yield and yield components significantly decreased under salt stress. Overall, the salt-sensitive rice genotypes showed a 15.3% greater reduction in grain yield, 5.1% reduction in spikelets per panicle, 7.4% reduction in grain-filling percentage and 6.1% reduction in grain weight compared to salt-tolerant genotypes under salt stress. However, a modest gap showed a decline in panicles (22.2% vs. 22.8%) and total spikelets (45.4% vs. 42.1%) between salt-sensitive and salt-tolerant rice under salinity conditions. This study revealed that the yield advantage of salt-tolerant rice was partially caused by more biomass accumulation, growth rate, strong antioxidant capacity and osmotic adjustment ability under salt stress, which contributed to more spikelets per panicle, high grain-filling percentage and grain weight. The results of this study could be helpful in understanding the physiological mechanism of contrasting rice genotypes' responses to salt stress and to the breeding of salt-tolerant rice.

[Orthopaedic robot assisted femoral neck dynamic cross fixation system for the treatment of femoral neck fractures].

OBJECTIVE: To explore and compare the clinical efficacy of orthopedic robot assisted femoral neck system （FNS） and traditional manual FNS in the treatment of femoral neck fractures in middle-aged and young people. METHODS: The clinical data of 62 consecutive patients with femoral neck fracture and age less than 65 years old admitted to the Intelligent Orthopaedic Department of Beijing Jishuitan Hospital from June 2021 to June 2022 were retrospectively analyzed. According to whether orthopedic robot-assisted surgery the patients were divided into two groups：30 patients aged 34 to 56 years old were treated with orthopedic robot assisted FNS internal fixation after closed or limited open reduction（experimental group）； 32 patients aged 33 to 54 years old underwent FNS internal fixation after closed or limited open reduction（control group）. The age, gender, time from injury to admission, average hospital stay, surgical duration, intraoperative bleeding volume, and intraoperative fluoroscopy frequency of two groups of patients were analyzed and compared. The hip joint function in both groups of patients was evaluated using the Harris hip joint scoring standard at 6 months after surgery. RESULTS: All 62 patients with femoral neck fractures successfully completed the surgery. There was no significant difference（P>0.05） between the experimental group and the control group in terms of baseline data such as age, gender, time from injury to admission, time from admission to surgery and the intraoperative bleeding. The surgical duration of the experimental group was significantly shorter than that of the control group [42.1（28.5, 50.7）min vs. 53.4（36.9, 62.5） min, Z=-2.338, P=0.019]. The intraoperative X-ray fluoroscopy frequency of the experimental group was significantly lower than that of the control group[8.0 （6.0, 11.0） times vs. 15.0（13.0, 17.0） times, Z=-5.960, P<0.001]. In terms of postoperative hip joint function, there was no significant difference in Harris score between the two groups of patients at 6-month follow-up（P>0.05）. CONCLUSION: Compared with manual operation of FNS, orthopedic robot assisted FNS in the treatment of femoral neck fractures can help shorten surgical time, reduce intraoperative fluoroscopy frequency, and have similar therapeutic effects on long-term hip joint function recovery.

Eco-evolutionary dynamics of gut phageome in wild gibbons (Hoolock tianxing) with seasonal diet variations.

It has been extensively studied that the gut microbiome provides animals flexibility to adapt to food variability. Yet, how gut phageome responds to diet variation of wild animals remains unexplored. Here, we analyze the eco-evolutionary dynamics of gut phageome in six wild gibbons (Hoolock tianxing) by collecting individually-resolved fresh fecal samples and parallel feeding behavior data for 15 consecutive months. Application of complementary viral and microbial metagenomics recovers 39,198 virulent and temperate phage genomes from the feces. Hierarchical cluster analyses show remarkable seasonal diet variations in gibbons. From high-fruit to high-leaf feeding period, the abundances of phage populations are seasonally fluctuated, especially driven by the increased abundance of virulent phages that kill the Lachnospiraceae hosts, and a decreased abundance of temperate phages that piggyback the Bacteroidaceae hosts. Functional profiling reveals an enrichment through horizontal gene transfers of toxin-antitoxin genes on temperate phage genomes in high-leaf season, potentially conferring benefits to their prokaryotic hosts. The phage-host ecological dynamics are driven by the coevolutionary processes which select for tail fiber and DNA primase genes on virulent and temperate phage genomes, respectively. Our results highlight complex phageome-microbiome interactions as a key feature of the gibbon gut microbial ecosystem responding to the seasonal diet.

How flare-up of small and medium enterprises intensifies carbon emissions in Asian and European regions: a panel analysis.

SMEs (small and medium enterprises) contribute substantially to the global and national economies. So, their activities can significantly affect the ecosystem; however, environmental performance is primarily targeted at larger corporations. Therefore, this study measures the SMEs' impact on environmental quality through CO2 emissions. For this purpose, data on twenty-five Asian and European economies from 2005 to 2020 is utilized, and the effect of SMEs on the environment is measured in the light of the EKC hypothesis. In order to validate and test the influence of SMEs on the environment, the pooled mean group (PMG) model with cointegration approaches is utilized. The results show that the flare-up of small and medium enterprises increases environmental pollution through high carbon emissions at micro levels. Thus, the study suggests that governments, SMEs, and other stakeholders have to create strategies and regulations targeted at SMEs to minimize their negative environmental impact.

Gut microbiome responds compositionally and functionally to the seasonal diet variations in wild gibbons.

Wild animals may encounter multiple challenges especially food shortage and altered diet composition in their suboptimal ranges. Yet, how the gut microbiome responds to dietary changes remains poorly understood. Prior studies on wild animal microbiomes have typically leaned upon relatively coarse dietary records and individually unresolved fecal samples. Here, we conducted a longitudinal study integrating 514 time-series individually recognized fecal samples with parallel fine-grained dietary data from two Skywalker hoolock gibbon (Hoolock tianxing) groups populating high-altitude mountainous forests in western Yunnan Province, China. 16S rRNA gene amplicon sequencing showed a remarkable seasonal fluctuation in the gibbons' gut microbial community structure both across individuals and between the social groups, especially driven by the relative abundances of Lanchnospiraceae and Oscillospiraceae associated with fluctuating consumption of leaf. Metagenomic functional profiling revealed that diverse metabolisms associated with cellulose degradation and short-chain fatty acids (SCFAs) production were enriched in the high-leaf periods possibly to compensate for energy intake. Genome-resolved metagenomics further enabled the resolving metabolic capacities associated with carbohydrate breakdown among community members which exhibited a high degree of functional redundancy. Our results highlight a taxonomically and functionally sensitive gut microbiome actively responding to the seasonally shifting diet, facilitating the survival and reproduction of the endangered gibbon species in their suboptimal habitats.

Early arrival did not ensure the early acquisition of intravenous thrombosis for acute ischemic stroke during the COVID-19 pandemic.

BACKGROUND: Intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) is a time-dependent treatment with a narrow therapeutic time window, in which the time delay could result from the deadline effect. METHODS: One hospital-based cohort was recruited to detect the factors contributing to the deadline effect, where patients with the deadline effect were defined as those who were presented with the onset-to-door time (ODT) in the first 50%, while the door-to-needle time (DNT) was in the last quartile. DNT (in-hospital delay) was further subdivided into several time intervals [door-to-examination time (DET), door-to-imaging time (DIT), door-to-laboratory time (DLT), and decision-making time (DMT) of the patients or their proxies. RESULTS: A total of 186 IVT cases were enrolled, of which 17.2% (32/186) suffered a delay of the deadline effect. The median age was 66 years, and 35.5% were female. Baseline characteristics were similar between the two groups (all p > .05). For the comparisons of the time intervals, DIT (26 versus 15 min, p = .001) was significantly longer in the group with deadline effect, while the differences of DET, DLT, DMT, and ONT did not reach statistical significance (all p > .05). Upon multivariable adjustment in the binary logistic regression model, longer DIT [odds ratio (OR), 1.076; 95% confidence interval (CI), 1.036-1.118; p < .001], and history of coronary heart disease (OR, 3.898; 95%CI, 1.415-10.735; p = .008) were independently associated with deadline effect in the binary logistic regression model, while admitted in the working day (OR, 0.674; 95%CI, 0.096-0.907; p = .033), and having medical insurance (OR, 0.350; 95% CI, 0.132-0.931; p = .035) were negatively associated with the deadline effect. CONCLUSIONS: A speed-safety tradeoff phenomenon from the deadline effect was observed in 17.2% of IVT cases during the COVID-19 pandemic, where longer DIT contributed a lot to this time delay. Patients without medical insurance, or admitted in official holidays were more likely to experience a delay of the deadline effect.

Osteoblasts Regulate the Expression of ADAMTS and MMPs in Chondrocytes through ERK Signaling Pathway.

OBJECTIVE: Degradative enzymes such as matrix metalloproteinase (MMP) and disintegrin metalloproteinase with platelet thrombin-sensitive protein-like motifs (ADAMTS) play a key role in the development of osteoarthritis (OA). We aimed to investigate the effects of OA subchondral osteoblasts on the expression of ADAMTS4, ADAMTS5, MMP-3, MMP-9, and MMP-13 in chondrocytes and the regulation of mitogen-activated protein kinase (MAPK) signaling pathway. METHODS: A rat knee OA model was constructed by cutting the anterior cruciate ligament of the knee joints, and normal rat articular cartilage chondrocytes (N-ACC), OA rat articular cartilage chondrocytes (O-ACC), normal subchondral bone osteoblasts (N-SBO), and OA subchondral bone osteoblasts (O-SBO) were isolated and extracted. The expressions of O-ACC and O-SBO COL1 and COL2 were detected respectively. Chondrocytes were identified by immunofluorescence of COL2 and toluidine blue staining, and osteoblasts were identified by COL1 immunofluorescence, alkaline phosphatase (ALP), and Alizarin Red staining. Gene expression of COL1, COL2, and aggrecan in normal chondrocytes and OA chondrocytes, and gene expression of osteoblast ALP and osteocalcin (OCN) were detected by RT-PCR to identify the two chondrocytes and the two osteoblast phenotypes. The constructing N-ACC group, O-ACC group, N-ACC + N-SBO group, N-ACC + O-SBO group, O-ACC + N-SBO group, O-ACC + O-SBO group, I + N-ACC + O-SBO group, and I + O-ACC + O-SBO group cell cultures, and the expression of ERK, ADAMTS4, ADAMTS5, MMP-3, MMP-9, and MMP-13 genes in chondrocytes cultured for 0, 24, 48, and 72 h were detected by RT-PCR. The protein expressions of pERK, ADAMTS4, ADAMTS5, MMP-3, MMP-9, and MMP-13 were detected by Western blot. RESULTS: · The X-ray showed that the knee joint space of the affected limb became narrow.. · The results of RT-PCR of COL2 and aggrecan gene in OA and normal chondrocytes suggest that the relative expression of COL2 in OA articular chondrocytes (0.24 ± 0.07) is significantly lower than that in normal cartilage (0.61 ± 0.07) (p < 0.05). The relative expression of AGG (0.37 ± 0.16) in OA chondrocytes was significantly lower than that of normal chondrocytes AGG (1.30 ± 0.25) (p < 0.05). The expression of COL1 was very low, and was not statistically significant.. · The results of RT-PCR of the osteoblast ALP and OCN gene indicated that gene expression of ALP (12.30 ± 1.17) and OCN (20.47 ± 4.19)was upregulated when compared with the relative expression of ALP (4.66 ± 0.71) (p < 0.05) and OCN (12.17 ± 2.76) (p < 0.05) in normal osteoblasts, indicating that osteoblasts of OA have greater osteogenic potential than normal osteoblasts.. · The expressions of ADAMTS4, ADAMTS5, MMP-3, MMP-9, and MMP-13 genes and proteins in OA chondrocytes or normal chondrocytes were basically unchanged when they were cocultured with normal osteoblasts. Indirect coculture of OA osteoblasts and chondrocytes could promote the expression of ADAMTS4, ADAMTS5, MMP-3, MMP-9, and MMP-13 genes and proteins in chondrocytes. Overexpression of ADAMTS and MMP in coculture systems can be reversed by MAPK-ERK inhibitors.. CONCLUSIONS: · OA subchondral bone osteoblasts can promote the overexpression of ADAMTS and MMPs in chondrocytes.. · The ERK signaling pathway may be involved in the regulation of the effect of subchondral bone osteoblasts on chondrocytes..

T2 mapping and readout segmentation of long variable echo-train diffusion-weighted imaging for the differentiation of parotid gland tumors.

OBJECTIVE: To investigate the diagnostic value of radial turbo-spin-echo (TSE) T2 mapping and readout segmentation of long variable echo-train diffusion-weighted imaging (RESOLVE DWI) for the differentiation of parotid gland tumors. MATERIALS AND METHODS: One hundred and fifty-four patients with histopathologically confirmed parotid gland tumors were retrospectively recruited from June 2018 to May 2021 at the First Affiliated Hospital of Zhengzhou University. There were 111 benign tumors and 43 malignant tumors. Benign tumors were further divided into pleomorphic adenomas (n = 69) and Warthin's tumors (n = 26). All patients were scanned using T2 mapping and RESOLVE DWI. T2 and ADC values and a combination of the two methods were compared and analyzed for the ability to differentiate parotid gland tumor types. RESULTS: The T2 and ADC values of benign tumors were significantly higher than those of the malignant tumors (127.97 ± 56.29 ms vs 97.53 ± 45.24 ms, 1.27 ± 0.40 × 10-3 mm2/s vs 1.00 ± 0.39 × 10-3 mm2/s, all P < 0.05). The area under the curve (AUC) of the T2 and ADC values for differentiating (1) benign and malignant parotid tumors, (2) pleomorphic adenomas and Warthin's tumors, (3) pleomorphic adenomas and malignant tumors, and (4) Warthin's tumors and malignant tumors were 0.709 and 0.715, 0.918 and 0.994, 0.748 and 0.774, and 0.665 and 0.659, respectively, with no significant differences observed between the T2 and ADC values (all P > 0.05). There were no significant differences in these values among the three tumor groups (malignant tumor, pleomorphic adenoma, and Warthin's tumor groups, all P > 0.05). CONCLUSIONS: T2 mapping and RESOLVE DWI can be used to differentiate various parotid gland tumors. T2 values are comparable to ADC values.

The Regularity of Stress Shielding in Internal Fixation Characterized by Hydromechanics.

Stress shielding is an important factor in the internal fixation of a fracture. To explore the regularity of stress shielding in internal fixation, a simplified model of a comminuted femoral shaft fracture bridged by a locking plate was established and finite element analysis was performed to analyze the load distribution between the plate and femur from the proximal end of the femur to the fracture line and investigate the stress shielding degree of the plate on the bone. The stress, deformation, and axial compressive force distribution of four internal fixation schemes under compression were obtained, and the stress shielding degrees on each section was calculated. To compare the regularity of stress shielding and flow distribution, the relationship between the compressive force increment and stress shielding degree was established. The normalized curves of compressive force increment with the plate section position were compared with the flow distribution in a Z-type manifold, a parallel pipe system similar to an internal fixation system in structure and working characteristics. For quantitative comparison, the similarity between normalized curves of the compressive force increment and simulated flow distribution was calculated. The regularity of load distribution along the section position of the plate was similar to the flow distribution in the Z-type manifold. Therefore, the flow distribution pattern of the Z-type manifold can be used to characterize the regularity of load distribution in internal fixation. This study provided a new method to characterize the stress shielding degree of a locking plate on bone.

Effect and Mechanism of TL1A Expression on Epithelial-Mesenchymal Transition during Chronic Colitis-Related Intestinal Fibrosis.

BACKGROUND AND AIMS: Recent evidences reveal that epithelial to mesenchymal transition (EMT) exacerbates the process of intestinal fibrosis. Tumor necrosis factor-like ligand 1A (TL1A) is a member of the tumor necrosis family (TNF), which can take part in the development of colonic inflammation and fibrosis by regulating immune response or inflammatory factors. The purpose of this study was to elucidate the possible contribution of TL1A in onset and progression of intestinal inflammation and fibrosis through EMT. METHODS: Colonic specimens were obtained from patients with inflammatory bowel disease (IBD) and control individuals. The expression levels of TL1A and EMT-related markers in intestinal tissues were evaluated. Furthermore, the human colorectal adenocarcinoma cell line, HT-29, was stimulated with TL1A, anti-TL1A antibody, or BMP-7 to assess EMT process. In addition, transgenic mice expressing high levels of TL1A in lymphoid cells were used to further investigate the mechanism of TL1A in intestinal fibrosis. RESULTS: High levels of TL1A expression were detected in the intestinal specimens of patients with ulcerative colitis and Crohn's disease and were negatively associated with the expression of an epithelial marker (E-cadherin), while it was positively associated with the expression of interstitial markers (FSP1 and α-SMA). Transgenic mice with high expression of TL1A were more sensitive to dextran sodium sulfate and exhibited severe intestinal inflammation and fibrosis. Additionally, the TGF-ß1/Smad3 pathway may be involved in TL1A-induced EMT, and the expression of IL-13 and EMT-related transcriptional molecules (e.g., ZEB1 and Snail1) was increased in the intestinal specimens of the transgenic mice. Furthermore, TL1A-induced EMT can be influenced by anti-TL1A antibody or BMP-7 in vitro. CONCLUSIONS: TL1A participates in the formation and process of EMT in intestinal fibrosis. This new knowledge enables us to better understand the pathogenesis of intestinal fibrosis and identify new therapeutic targets for its treatment.

Protein-Degrading Enzymes in Osteoarthritis.

OBJECTIVE: TGFß1 plays an important role in the metabolism of articular cartilage and bone; however, the pathological mechanism and targets of TGFß1 in cartilage degradation and uncoupling of subchondral bone remodeling remain unclear. Therefore, in this study, we investigated the relationship between TGFß1 and major protein-degrading enzymes, and evaluated the role of high levels of active TGFß1 in the thickening of subchondral bone and calcification of articular cartilage. MATERIALS AND METHODS: The expression of TGFß1 and protein-degrading enzymes in clinical samples of articular cartilage and subchondral bone obtained from the knee joint of patients with osteoarthritis was detected by immunohistochemistry. The expression levels of TGFß1, MMP-3, MMP-13 and IL-1ß in cartilage and subchondral bone tissues were detected by absolute real-time quantitative RT-PCR. The expression of TGFß1, nestin and osterix in subchondral bone was detected by Western blot analysis and immunohistochemistry. The degree of subchondral bone thickening was determined by micro-computed tomography (CT) imaging. RESULTS: Expression of TGFß1 and cartilage-degrading enzymes was higher in the cartilage-disrupted group than that in the intact group. Furthermore, expression of TGFß1, nestin and osterix was significantly higher in the OA group than that in the control group. Micro-CT imaging showed that in the OA group, the subchondral bone plate is thickened and the density is increased. The trabecular bone structure is thick plate-like structure, the thickness of the trabecular bone is increased and the gap is small. CONCLUSIONS: The data suggest that highly active TGFß1 activates the expression of cartilage-degrading enzymes. Abnormally activated TGFß1 may induce formation of the subchondral bone and expansion of the calcified cartilage area, eventually leading to degradation of the cartilage tissue.

Effects of cold weather on the sleeping behavior of Skywalker hoolock gibbons (Hoolock tianxing) in seasonal montane forest.

Considering the high energetic costs of maintaining constant body temperature, mammals must adjust their thermoregulatory behaviors in response to cold temperatures. Although primate daytime thermoregulation is relatively well studied, there is limited research in relation to nighttime strategies. To investigate how Skywalker hoolock gibbons (Hoolock tianxing) cope with the low temperatures found in montane forests, we collected sleep-related behavior data from one group (NA) and a single female (NB) at Nankang (characterized by extensive tsaoko plantations) between July 2010 and September 2011, and one group (BB) at Banchang (relatively well-managed reserve forest) between May 2013 and May 2015 in Mt. Gaoligong, Yunnan, China. The annual mean temperature was 13.3°C at Nankang (October 2010 to September 2011) and 13.0°C at Banchang (June 2013 to May 2015) with temperatures dropping below -2.0°C at both sites, making them the coldest known gibbon habitats. The lowest temperatures at both sites remained below 5.0°C from November to March, which we, therefore, defined as the "cold season". The hoolock gibbons remained in their sleeping trees for longer periods during the cold season compared to the warm season. Sleeping trees found at lower elevations and closer to potential feeding trees were favored during cold seasons at both sites. In addition, the gibbons were more likely to huddle together during cold seasons. Our results suggest that cold temperatures have a significant effect on the sleeping behavior of the Skywalker hoolock gibbon, highlighting the adaptability of this threatened species in response to cold climates.

Ecology and social system of northern gibbons living in cold seasonal forests.

Gibbons in China represent the northernmost margin of present day gibbon species distribution (around N25°). Compared to tropical habitats, northern gibbon habitats are characterized by low temperatures and remarkable seasonal variation in fruit abundance. How gibbons adapt to their cold and seasonal habitats and what ecological factors affect their sociality are key questions for understanding their ecology and social system evolution, the elucidation of which will contribute to the conservation of these special populations/species. According to preliminary short-term studies, northern gibbons consume more leaves and use larger home ranges than tropical gibbons. Interestingly, some Nomascus groups consist of more than one adult female. However, these preliminary results are not well understood or incorporated into current socio-ecological theories regarding gibbon species. To better understand northern gibbons, our team has systematically studied three habituated groups of Nomascus concolor, three groups of N. nasutus, and two habituated groups of Hoolock tianxing since 2002. In this paper, we stress the challenges facing gibbons living in northern habitats and summarize their behavioral adaptations to their harsh environments. We also describe the northern gibbon social system and discuss the potential relationships between their ecology and sociality. Finally, we highlight future research questions related to northern gibbons in China.

Analysis of Spino-pelvic Sagittal Alignment in Young Chinese Patients with Lumbar Disc Herniation.

OBJECTIVE: Few studies have concentrated on the sagittal alignment of lumbar disc herniation (LDH), especially the parameters of the pelvis, and controversy exists about whether pelvic morphology is involved in the pathogenesis of LDH. The present study analyzed the characteristics of the sagittal alignment in young Chinese LDH patients and explored the impact of pelvic morphology on the pathogenesis of LDH. METHODS: A retrospective analysis was conducted on 100 young patients with LDH (69 men and 31 women, aged 18-35 years), and the clinical and imaging findings met the criteria for the diagnosis of LDH. The control group included 100 asymptomatic volunteers with matching age and gender. Coronal and sagittal parameters were measured on the anteroposterior and lateral radiographs of the whole spine, including lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), thoracic kyphosis (TK), and sagittal balance (SVA). The cases were classified into four types by the apex position of lumbar lordosis (type I, L5 or the L4-5 intervertebral space; type II, bottom or middle of L4 ; type III, upper part of L4 or the intervertebral space between L3 and L4 ; type IV, L3 or more high level), and divided into three groups by PI; namely, a low PI group (PI < 40°), a medium PI group (40° ≤ PI < 50°), and a high PI group (PI ≥ 50°). The sagittal parameters, especially PI, were compared between the LDH group and the control group. Correlations between the parameters in the LDH group were analyzed. RESULTS: The PI value of the LDH group was not different from that of the control group (46.1° ± 10.0° vs 47.2° ± 8.8°, P > 0.05). The LDH group showed lower average LL, SS, and TK (P < 0.01), as well as higher PT and SVA compared with the control group (P < 0.01). The LL (34.4° ± 15.3° vs 50.8° ± 10.2°) and SVA (21.6 ± 53.6 mm vs - 18.4 ± 32.8 mm) showed a significant difference (P < 0.01); LL was correlated with PI, SS, PT, TK and SVA (P < 0.01); and SVA was also correlated with the parameters above (P < 0.01) except PI (P > 0.05), and the lordosis apex tended to be higher. The distributions of PI groups between the LDH group and the control group were not different. Pairwise correlations were found among LL, PI, SS, and PT. In addition, TK and SVA were correlated with LL, SS, and PT. CONCLUSIONS: There is no difference in PI between young Chinese patients with lumbar disc herniation and the normal population. Young LDH patients may present flat lumbar and thoracic curves, as well as lower sacral slope. The anteversion sagittal imbalance is regulated by both the spine and the pelvis.

Effect of patient position on the lordosis and scoliosis of patients with degenerative lumbar scoliosis.

This study aimed to analyze the effect of patient positions on the lordosis and scoliosis of patients with degenerative lumbar scoliosis (DLS).Seventy-seven patients with DLS were retrospectively analyzed. We measured lordosis and Cobb's angle on preoperative upright x-rays and magnetic resonance imagings in supine position. The lordosis and scoliosis of surgical segments in intraoperative prone position were measured on intraoperative radiographs of 20 patients to compare with that in standing position. Paired t tests were performed to investigate the parameters of the sample.From standing to supine position the whole lordosis increased (29.2 ±â€Š15.7 degree vs. 34.9 ±â€Š11.2 degree), and the whole scoliosis decreased (24.3 ±â€Š11.8 degree vs. 19.0 ±â€Š10.5 degree); 53 of 77 (68.8%) cases had increased lordosis, and 67 of 77 (87%) cases had decreased scoliosis. The lordosis of surgical segments in standing position had no difference with that in intraoprerative prone position. But in changing from supine/standing position to intraoprerative prone position, the scoliosis of surgical segments decreased (14.7 ±â€Š9.4 degree vs. 11.4 ±â€Š7.0 degree; 19.0 ±â€Š11.8 degree vs. 11.4 ±â€Š7.0 degree, respectively), and 18 of 20 (90%) cases had decreased scoliosis in intraoperative prone position than that in standing position.Compared with standing position in DLS patients, supine position increased lordosis and reduced scoliosis, and intraoperative prone position reduced scoliosis significantly. When evaluating the severity of DLS and making preoperative surgical plans, lumbar lordosis in supine position should also be evaluated in addition to upright x-ray, and the effects of different positions should be taken into consideration to reduce deviation.

Chorea and parkinsonism associated with autoantibodies to IgLON5 and responsive to immunotherapy.

Encephalopathy associated with autoantibodies to IgLON5 is a novel syndrome characterized by a distinct sleep disorder and brain-stem involvement. Since the initial description of this encephalopathy in 2014, only a few additional patients have been reported (Simabukuro et al., 2015). In this paper, we report a new case of anti-IgLON5 antibodies with major symptoms of chorea and parkinsonism, and responsive to immunotherapy.

Rhythmic displays of female gibbons offer insight into the origin of dance.

Dance is a universal art form practiced by all human societies and has many functions including sexual attraction, social cohesion, and the therapeutic release of energy. Dance also has been reported in a small number of non-human primate species, in particular apes. However, its function has not been systematically evaluated. We observed 357 intentional, rhythmic, and nonverbal dance displays performed by four adult female cao vit gibbons (Nomascus nasutus) residing in four polygynous groups during 3000 h of observation in Bangliang, Guangxi, China. Females used dance to solicit copulations, as well as to promote a social bond with the group's lone adult male. In addition, this display appears to represent a form of non-aggressive competition among adult females living in the same group. We found that a female who had a weaker social relationship with the breeding male increased her social and sexual access to the male by an increase in dancing frequency. Given that gibbons dance in various behavioral contexts, and appears to serve several important social and sexual functions, a greater understanding of this form of gestural communication offers an instructive model for examining the origin and evolution of dance in humans and other apes.