Is conventional magnetic resonance imaging superior to radiography in the functional integrity evaluation of anterior cruciate ligament in patients with knee osteoarthritis?

BACKGROUND: The functional integrity of the anterior cruciate ligament (ACL) influences surgical decision-making in patients with knee osteoarthritis (KOA). This study aimed to compare the diagnostic value of radiography and magnetic resonance imaging (MRI) in determining the functional status of ACL. METHODS: We analyzed 306 knees retrospectively using preoperative hip-to-ankle anteroposterior standing (APS) radiographs, anteroposterior (AP) and lateral knee radiographs, AP valgus stress (VS) force radiographs, and standard orthogonal MRI. Based on the intraoperative visualization, the knees were grouped into ACL functionally-intact and ACL functionally-deficient (ACLD) groups. The diagnostic validity and reliability were calculated based on the radiograph parameters such as hip-knee-ankle angle (HKA), medial proximal tibial angle (MPTA), lateral distal femoral angle (LDFA), posterior tibial slope (PTS), sagittal tibiofemoral subluxation (STFS), coronal tibiofemoral subluxation (CTFS), joint line convergence angle (JLCA), the maximum wear point of the proximal tibia plateau (MWPPT%), and MRI parameters including ACL grades and MWPPT%. RESULTS: HKA, MPTA, PTS, STFS, JLCA, and CTFS on APS and AP radiographs, and MWPPT% on radiographs and MRI showed a significant diagnostic value (P < 0.05). There were no statistically significant differences in the single parameters from radiographs and MRI. After constructing the logistic regression models, MRI showed higher sensitivity, specificity, and accuracy, reaching 96.8%, 79.9%, and 83.3%, respectively (P < 0.001). CONCLUSIONS: In patients with KOA, the diagnostic value of single radiographic or MRI parameter in assessing the functional integrity of the ACL are equivalent. However, by constructing predictive models, MRI could significantly improve diagnostic validity compared with radiography.

Factors that impact the patellofemoral contact stress in the TKA: a review.

Abnormal retro patellar stress is believed to contribute to patellofemoral complications after total knee arthroplasty (TKA), but the causal link between TKA and patellofemoral contact stress remains unclear. By reviewing the relevant studies, we found that both TKA implantation and additional patellar resurfacing increase retro patellar pressure. The rotation and size of the femoral component, thickness and position of the patellar component, installation of the tibial component, prosthesis design and soft tissue balance further influence patellofemoral stress. Specific measures can be applied to reduce stress, including the installation of the femoral prosthesis with an appropriate external rotation angle, placing the tibial component at a more posterior position and the patellar button at a more medial position, avoiding over-sized femoral and patellar components, selecting posterior-stabilized design rather than cruciate-retaining design, using gender-specific prosthesis or mobile-bearing TKA system, and releasing the lateral retinaculum or performing partial lateral facetectomy. Despite these measures, the principle of individualization should be followed to optimize the patellofemoral biomechanics.

Pressure Attenuation Law of Low-Frequency Pulse Pressure Flooding and Its Influence on Oil Recovery.

Pulse water injection is widely used in tertiary oil recovery. This study aims to reduce the pulse frequency, control the pulse frequency at 0.033∼0.1 Hz, simulate the pressure change in the formation at 0.1 Hz and 100 mD through COMSOL, and combine the core displacement experiment to determine the frequency. The effect of permeability change on the recovery factor of the water cut agent is summarized as follows: when the pulse frequency is 0.033∼0.066 Hz, the recovery factor of 100, 300, and 500 mD increases by 0.25, 0.34, and 0.39 percentage points, respectively, and these data can be of low frequency. The method proposed in this paper can provide certain theoretical basis and basic experimental data for tertiary oil recovery.

Relationship between patellofemoral finite helical axis and femoral trans-epicondylar axis using a static magnetic resonance-based methodology.

BACKGROUND: To manage patellofemoral joint disorders, a complete understanding of the in vivo patellofemoral kinematics is critical. However, as one of the parameters of joint kinematics, the location and orientation of the patellofemoral finite helical axis (FHA) remains unclear. The purpose of this study is to quantify the location and orientation of the patellar FHA, both in vivo and non-invasively at various flexion angles, and evaluate the relationship of the FHA and the trans-epicondylar axis (TEA). METHODS: The magnetic resonance (MR) images of 18 unilateral knees were collected at full extension, 30°, 60°, 90°, and maximum angle of knee flexion. Three-dimensional models of the knee joint at different flexion angles were created using the MR images, and then used to calculate the patellar tracking and FHA with a spline interpolation algorithm. By using a coordinate system based on the TEA, the FHA tracking was quantified. Six parameters concerning the location and orientation of the patellar FHA were analysed. RESULTS: The average patellar FHA drew an L-shaped tracking on the midsagittal plane moving from the posteroinferior to the anterosuperior side of the TEA with knee flexion. Before 90° flexion, the patellar rotational radius decreased slightly, with an average value of 5.65 ± 1.09 cm. During 20° to 90° knee flexion, the average angle between the patellar FHA and the TEA was approximately 10° and that between the FHA and the coronal plane was maintained at about 0°, while that between the FHA and the level plane fluctuated between - 10° and 10°. CONCLUSIONS: This study quantitatively reported the continuous location and direction of the patellar FHA during knee flexion. The patellar FHA was close to but not coincident with the femoral TEA both in location and orientation, and the patellar rotational radius decreased slightly with knee flexion. These findings could provide a clear direction for further studies on the difference in patellofemoral FHA among various types of patellofemoral disorders, and provide a foundation for the application of FHA in surgical evaluation, preoperative planning and prosthesis design, thereby assisting in the diagnosis and treatment of patellofemoral disorders.

Correlation between femorotibial pressure and joint gap in osteoarthritis patients with varus deformity: an intraoperative measurement using sensor device in primary posterior-stabilized total knee arthroplasty.

BACKGROUND: The normal femorotibial pressure and its variation under different gap values remain unknown. Thus, for the purpose of improving soft-tissue balancing in total knee arthroplasty (TKA), a load-sensor device was used to measure femorotibial pressures. More specifically, the aim of this study was to analyze the trend in pressure changes. METHODS: Twenty TKAs were first balanced by conventional techniques, and then femorotibial pressure was measured using the sensor. After this, the difference in pressure among different joint gaps was calculated to analyze the trend. A repeated measure of analysis of variance and a Tukey's honestly significant difference (HSD) test were used to analyze the data. RESULTS: The medial gap pressure was significantly increased at extension and flexion as the thickness of the sensor increased in most patients, while the lateral gap pressure changed without a specific trend. The average medial gap pressure was significantly larger than the average lateral gap pressure at both the full extension and 90° flexion positions. The average extension gap pressure was larger than the average flexion gap pressure at both the medial and lateral gaps. CONCLUSIONS: The tension of the soft tissue around the knee joint changes with the joint gap. The tension at the medial side is higher than that on the lateral side, and that of the extension position is higher than that of the flexion position. The use of the pressure sensor insert has a better auxiliary effect on the operation using the gap-balancing technique.

Surface Functional Nanofiber Membrane for Ultrasensitive and Naked-Eye Visualization of Bacterial Concentration.

Bacterial contamination in water is a serious health risk to human beings, so it is very important to realize the point-of-care (POC) bacterial detection in water. However, the traditional bacterial detection methods are time-consuming, professional- and equipment-dependent, and do not meet the needs of POC detection. There is a pressing need to develop a platform for POC bacterial detection to defeat the increasing risk of bacterial infections. Herein, a surface functional nanofiber membrane (NFM) is prepared by layer-by-layer (LBL) self-assembly as a platform for POC detection of bacterial concentration; it is naked-eye visualization and ultrasensitive. The platform shows obvious bacterial responsiveness, which allows naked-eye visualization of bacterial concentration (102-106 CFU/mL) within 30 min and can quantitatively detect the bacterial concentration (101-106 CFU/mL) by fluorescence within 5 min. The platform not only exhibits high efficiency but also has a low threshold for bacterial concentration detection. Furthermore, the platform shows good consistency with traditional methods in the detection of bacteria in practical water samples, and has the potential for use in detecting bacterial concentrations in water supplies to protect human beings from health hazards. This work also provides useful reference for research on bacterial detection, taking advantage of the surface characteristics of bacteria and the high sensitivity of NFM.

Research Methods and Progress of Patellofemoral Joint Kinematics: A Review.

Patellofemoral pain syndrome has a high morbidity, and its pathology is closely associated with patellofemoral joint kinematics. A series of in vivo and in vitro studies have been conducted to explore patellofemoral kinematics, and the findings are relevant to the diagnosis, classification, and management of patellofemoral diseases and even the whole knee joint. However, no definite conclusion on normal patellofemoral kinematics has been established. In this study, the measurement methodologies of patellofemoral kinematics (including data collection methods, loading conditions, and coordinate system) as well as their advantages and limitations were reviewed. Motion characteristics of the patella were analyzed. During knee flexion, the patellar flexion angle lagged by 30-40% compared to the tibiofemoral joint flexion. The patella tilts, rotates, and shifts medially in the initial stage of knee flexion and subsequently tilts, rotates, and shifts laterally. The finite patellar helical axis fluctuates near the femoral transepicondylar axis or posterior condylar axis. Moreover, factors affecting kinematics, such as morphology of the trochlear groove, soft tissue balance, and tibiofemoral motion, were analyzed. At the initial period of flexion, soft tissues play a vital role in adjusting patellar tracking, and during further flexion, the status of the patella is determined by the morphology of the trochlear groove and patellar facet. Our findings could increase our understanding of patellofemoral kinematics and can help to guide the operation plan for patients with patellofemoral pain syndrome.

Dynamic layer-by-layer films on nanofiber membrane: a platform for ultra-sensitive bacterial concentration detection.

Herein, a new platform was established for ultra-sensitive bacterial concentration detection. The sensing system had a linear relationship with the logarithm of bacterial concentration from 1 × 101 to 1 × 105 CFU mL-1 within 5 min. Moreover, the platform showed excellent consistency compared with the traditional standard method against practical samples.

Local autoantigen expression as essential gatekeeper of memory T-cell recruitment to islet grafts in diabetic hosts.

It is generally believed that inflammatory cues can attract noncognate, "bystander" T-cell specificities to sites of inflammation. We have shown that recruitment of naive and in vitro activated autoreactive CD8⁺ T cells into endogenous islets requires local autoantigen expression. Here, we demonstrate that absence of an autoantigen in syngeneic extrapancreatic islet grafts in diabetic hosts renders the grafts "invisible" to cognate memory (and naive) T cells. We monitored the recruitment of islet-specific glucose-6-phosphatase catalytic subunit-related protein (IGRP)206₋214-reactive CD8⁺ T cells into IGRP206₋214-competent and IGRP206₋214-deficient islet grafts in diabetic wild-type or IGRP206₋214(-/-) nonobese diabetic hosts (harboring either naive and memory T cells or only naive IGRP206₋214-specific T-cells, respectively). All four host-donor combinations had development of recurrent diabetes within 2 weeks. Wild-type hosts recruited IGRP206₋214-specific T cells into IGRP206₋214(+/+) but not IGRP206₋214(-/-) grafts. In IGRP206₋214(-/-) hosts, there was no recruitment of IGRP206₋214-specific T cells, regardless of donor type. Graft-derived IGRP206₋214 activated naive IGRP206₋214-specific T cells, but graft destruction invariably predated their recruitment. These results indicate that recurrent diabetes is exclusively driven by autoreactive T cells primed during the primary autoimmune response, and demonstrate that local antigen expression is a sine qua non requirement for accumulation of memory T cells into islet grafts. These findings underscore the importance of tackling autoreactive T-cell memory after ß-cell replacement therapy.

Microbial community of granules in expanded granular sludge bed reactor for simultaneous biological removal of sulfate, nitrate and lactate.

This study studied the cultivation of granules from an expanded granular sludge bed reactor that simultaneously transforms sulfates, nitrates, and oxygen to elementary sulfur, nitrogen gas, and carbon dioxides, respectively. The living cells accumulate at the granule outer layers, as revealed by the multicolor staining and confocal laser scanning microscope technique. The microbial community comprises sulfate-reducing bacteria (SRB, Desulfomicrobium sp.), heterotrophic (Pseudomonas aeruginosa and Sulfurospirillum sp.), and autotrophic denitrifiers (Sulfurovum sp. and Paracoccus denitrificans) whose population dynamics at different sulfate and nitrate loading rates are monitored with the single-strand conformation polymorphism and denaturing gradient gel electrophoresis technique. The Desulfomicrobium sp. presents one of the dominating strains following reactor startup. At high sulfate and nitrate loading rates, the heterotrophic denitrifiers overcompete autotrophic denitrifiers to reduce SRB activities. Conversely, suddenly reducing nitrate loading rates completely removes the heterotrophic denitrifier Sulfurospirillum sp. from the granules and activates the autotrophic denitrifiers. The physical fixation of different groups of functional strains in granules fine-tunes the strains' activities, and hence the reactor performance.

Simultaneous biological removal of sulfur, nitrogen and carbon using EGSB reactor.

High-rate biological conversion of sulfide and nitrate in synthetic wastewater to, respectively, elemental sulfur (S(0)) and nitrogen-containing gas (such as N(2)) was achieved in an expanded granular sludge bed (EGSB) reactor. A novel strategy was adopted to first cultivate mature granules using anaerobic sludge as seed sludge in sulfate-laden medium. The cultivated granules were then incubated in sulfide-laden medium to acclimate autotrophic denitrifiers. The incubated granules converted sulfide, nitrate, and acetate simultaneously in the same EGSB reactor to S(0), N-containing gases and CO(2) at loading rates of 3.0 kg S m(-3) d(-1), 1.45 kg N m(-3) d(-1), and 2.77 kg Ac m(-1) d(-1), respectively, and was not inhibited by sulfide concentrations up to 800 mg l(-1). Effects of the C/N ratio on granule performance were identified. The granules cultivated in the sulfide-laden medium have Pseudomonas spp. and Azoarcus sp. presenting the heterotrophs and autotrophs that co-work in the high-rate EGSB-SDD (simultaneous desulfurization and denitrification) reactor.

Surfactant as an airway smooth muscle relaxant.

A variety of clinical and experimental evidence indicates that surfactant may be important in the pathogenesis and treatment of asthma. The purpose of this study was to determine the pharmacologic effect of pulmonary surfactant and its major lipid and protein constituents on bronchial smooth muscle. First-generation bronchi from male Sprague-Dawley rats were contracted with methacholine and exposed to two kinds of surfactant: whole rat surfactant and two bovine surfactant extracts in clinical use. The latter lack the hydrophilic surfactant-associated proteins (SP)-A and SP-D. All the surfactants relaxed the rat bronchi in a concentration-dependent manner; however, whole rat surfactant was more potent than the bovine extracts. Both surfactant lipids and SP-A contributed to the bronchial relaxation. The relaxation response produced by the highest concentration (0.5 mg/ml) of whole rat surfactant was equivalent to that caused by substance P (5 microM) and approximately half of that caused by 1 microM isoproterenol. The relaxation response was epithelium-dependent and blocked by indomethacin but not by N-omega-nitro-L-arginine methyl ester. We conclude that surfactant can relax airway smooth muscle directly via a prostanoid-mediated, epithelium-dependent process that does not involve nitric oxide synthase.