RGS2 attenuates alveolar macrophage damage by inhibiting the Gq/11-Ca2+ pathway during cowshed PM2.5 exposure, and aberrant RGS2 expression is associated with TLR2/4 activation.

Staff and animals in livestock buildings are constantly exposed to fine particulate matter (PM2.5), which affects their respiratory health. However, its exact pathogenic mechanism remains unclear. Regulator of G-protein signaling 2 (RGS2) has been reported to play a regulatory role in pneumonia. The aim of this study was to explore the therapeutic potential of RGS2 in cowshed PM2.5-induced respiratory damage. PM2.5 was collected from a cattle farm, and the alveolar macrophages (NR8383) of the model animal rat were stimulated with different treatment conditions of cowshed PM2.5. The RGS2 overexpression vector was constructed and transfected it into cells. Compared with the control group, cowshed PM2.5 significantly induced a decrease in cell viability and increased the levels of apoptosis and proinflammatory factor expression. Overexpression of RGS2 ameliorated the above-mentioned cellular changes induced by cowshed PM2.5. In addition, PM2.5 has significantly induced intracellular Ca2+ dysregulation. Affinity inhibition of Gq/11 by RGS2 attenuated the cytosolic calcium signaling pathway mediated by PLCß/IP3R. To further investigate the causes and mechanisms of action of differential RGS2 expression, the possible effects of oxidative stress and TLR2/4 activation were investigated. The results have shown that RGS2 expression was not only regulated by oxidative stress-induced nitric oxide during cowshed PM2.5 cells stimulation but the activation of TLR2/4 had also an important inhibitory effect on its protein expression. The present study demonstrates the intracellular Ca2+ regulatory role of RGS2 during cellular injury, which could be a potential target for the prevention and treatment of PM2.5-induced respiratory injury.

Low-density lipoprotein cholesterol-to-lymphocyte count ratio (LLR) is a promising novel predictor of postoperative new-onset deep vein thrombosis following open wedge high tibial osteotomy: a propensity score-matched analysis.

BACKGROUND: The association of low-density lipoprotein cholesterol (LDL-C) and lymphocyte counts with the development of deep vein thrombosis (DVT) has been demonstrated in many fields but remains lacking in open wedge high tibial osteotomy (OWHTO). This study aimed to assess the predictive value of LDL-C to lymphocyte count ratio (LLR) in screening for postoperative new-onset DVT. METHODS: Clinical data were retrospectively collected from patients who underwent OWHTO between June 2018 and May 2023. The limited restricted cubic spline (RCS) was conducted to evaluate the nonlinear relationship between LLR and the risk of postoperative new-onset DVT. The receiver operating characteristic (ROC) curves were plotted and the predictive value of biomarkers was assessed. After adjusting for intergroup confounders by propensity score matching, the univariate logistic regression was applied to assess the association between LLR and DVT. RESULTS: 1293 eligible patients were included. RCS analysis showed a linear positive correlation between LLR and the risk of DVT (P for overall = 0.008). We identified LLR had an area under the curve of 0.607, accuracy of 74.3%, sensitivity of 38.5%, and specificity of 80.7%, and LLR > 1.75 was independently associated with a 1.45-fold risk of DVT (95% CI: 1.01-2.08, P = 0.045). Furthermore, significant heterogeneities were observed in the subgroups of age, BMI, diabetes mellitus, hypertension, Kellgren-Lawrence grade, the American Society of Anesthesiologists (ASA) score, and intraoperative osteotomy correction size. CONCLUSION: LLR is a valuable biomarker for predicting postoperative new-onset DVT in patients with OWHTO, and routine screening is expected to yield positive benefits.

A quantum-chemical insight into SOMO-HOMO conversion in phosphorus-boron cation radicals.

Organic radicals exhibiting SOMO-HOMO conversion (SHC) electronic configurations have recently garnered increasing attention due to their exceptional stability and photophysical properties. In this study, we investigate two series of phosphorus-boron cation radicals based on 1,3,5-trimethylphenyl units substituted with P and B atoms, varying numbers of P-B moieties, and π-conjugation linkers. We perform quantum-chemical calculations to systematically assess the influence of chemical substituents on the SHC electronic structural features. Our computational results demonstrate that the SHC electronic configurations of the studied complexes are primarily determined by the number of P-B moieties, specifically, phosphorus-boron cation radicals with two P-B moieties as terminal groups in π-conjugation linkers, which efficiently arrange electrons to increase HOMO energies compared to corresponding radicals with only one P-B unit. Furthermore, spin density distributions change as the size of π-conjugation linkers increases. Natural bond orbital (NBO) and atoms-in-molecules (AIM) analyses reveal strong intramolecular charge transfer between P and B atoms along with other stabilized donor-acceptor interactions and significant covalent bonds between P and B atoms. Moreover, synergistic effects resulting from 1,3,5-trimethylphenyl substitutions and enlarged π-conjugation linkers containing P-B units confer excellent photophysical properties upon these studied radicals, making them potential stable radicals in optoelectronic applications.

The Time-Effect Relationship between Time to Surgery and In-Hospital Postoperative Pneumonia in Older Patients with Hip Fracture.

INTRODUCTION: Pneumonia is a common and devastating complication following hip fracture surgery in older patients. Time to surgery is a potentially modifiable factor associated with improved prognosis, and we aim to quantify the time-effect relationship between time to surgery and in-hospital postoperative pneumonia (IHPOP) and identify the effect of delayed surgery on the risk of IHPOP. METHODS: We analyzed clinical data of older hip fracture patients (≥60 years) undergoing surgical treatments at a tertiary referral trauma center between 2015 and 2020. Restricted cubic spline (RCS) was used to fit the time-effect relationship between time to surgery and IHPOP. Based on the results of RCS, we divided patients into two groups of "early surgery" and "delayed surgery." A 1:1 propensity score matching (PSM) analysis and multivariate conditional logistic regression analysis were performed to minimize the selection bias and determine the association magnitude. Subgroup analysis was conducted to assess potential interaction effects between delayed surgery and common risk factors for IHPOP. RESULTS: 3,118 eligible patients were included. The RCS curve showed an inverse S-shape trend and the relative risk of IHPOP decreased in the range of days 2-3 and increased on day 1 and day 3 or more post-injury, with the lowest point on day 3. PSM yielded 1,870 matched patients and delayed surgery (>3 days) was identified to be independently associated with IHPOP (relative ratio, 1.66; 95% confidence interval, 1.12-2.46; p value, 0.011). We observed positive interaction effects between delayed surgery and age of 80 years or more, female gender, COPD, heart disease, ASA score ≥3, anemia, and hypoproteinemia. CONCLUSION: The relative risk of IHPOP decreased in the range of 2-3 days and increased on day 1 and day 3 or more post-injury. Delayed surgery (>3 days) was identified to be independently associated with a 1.66-fold increased risk of IHPOP.

Clinical outcome after open-wedge high tibial osteotomy: comparison of double-triangle locking compression plate (DT-LCP) and T-shaped locking compression plate (T-LCP).

BACKGROUND: The objective of this study was to compare the clinical outcomes of two internal fixation methods for high tibial osteotomy (HTO): double-triangle locking compression plate (DT-LCP) and T-shaped locking compression plate (T-LCP). METHODS: 202 adult patients in our hospital between January 2018 and December 2021 were included and followed up for at least one year: group 1(DT-LCP, 98 patients) and group 2 (T-LCP, 104 patients). Detailed information on demographics, preoperative and postoperative follow-up, surgical procedures, and complications were collected. The information of the International Knee Documentation Committee Knee Evaluation Form (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were collected before surgery and at the last follow-up. RESULTS: A total of 202 patients were included in the per-protocol analysis. No significant difference was found in terms of demographic data between groups, except for age and BMI. Clinically relevant improvements in knee pain were reached up to last follow-up after the operation in both groups. The mean pain scores (KOOS, WOMAC) at the final follow-up were significantly higher among group 1 compared to group 2 (P = 0.040 and P = 0.023). Furthermore, the DT-LCP internal fixation exerted more excellent effects on other symptoms, function and quality of life than T-LCP internal fixation. CONCLUSIONS: Our study demonstrated that DT-LCP provided better clinical performance due to its implant irritant pain, compared with T-LCP. Thus, DT-LCP is a feasible alternative for the fixation of OW-HTO.

Risk factors of preoperative deep vein thrombosis in patients with non-traumatic osteonecrosis of the femoral head.

PURPOSE: This study aims to identify independent risk factors for preoperative lower extremity deep venous thrombosis (DVT) in patients with non-traumatic osteonecrosis of the femoral head (NONFH), and to develop a prediction nomogram. METHODS: Retrospective analysis of prospectively collected data on patients presenting with non-traumatic osteonecrosis of the femoral head between October 2014 and April 2019 was conducted. Duplex ultrasonography (DUS) was routinely used to screen for preoperative DVT of bilateral lower extremities. Data on demographics, chronic comorbidities, preoperative characteristics, and laboratory biomarkers were collected. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors associated with DVT which were combined and transformed into a nomogram model. RESULT: Among 2824 eligible patients included, 35 (1.24%) had preoperative DVT, including 15 cases of proximal thrombosis, and 20 cases of distal thrombosis. Six independent risk factors were identified to be associated with DVT, including Sodium ≤ 137 mmol/L (OR = 2.116, 95% confidence interval [CI]: 1.036-4.322; P = 0.040), AGE ≥ 49 years (OR = 7.598, 95%CI: 1.763-32.735; P = 0.008), D-Dimer > 0.18 mg/L (OR = 2.351, 95%CI: 1.070-5.163; P = 0.033), AT III ≤ 91.5% (OR = 2.796, 95%CI: 1.387-5.634; P = 0.006), PLT ≥ 220.4*109 /L (OR = 7.408, 95%CI: 3.434-15.981; P = 0.001) and ALB < 39 g/L (OR = 3.607, 95%CI: 1.084-12.696; P = 0.042). For the nomogram model, AUC was 0.845 (95%CI: 0.785-0.906), and C-index was 0.847 with the corrected value of 0.829 after 1000 bootstrapping validations. Moreover, the calibration curve and DCA exhibited the tool's good prediction consistency and clinical practicability. CONCLUSION: These epidemiologic data and the nomogram may be conducive to the individualized assessment, risk stratification, and development of targeted prevention programs for preoperative DVT in patients with NONFH.

Outcomes after ORIF are similar in young and elderly patients with tibial plateau fractures: A minimum 2-year follow-up study.

BACKGROUND: This study aimed to compare the outcomes of open reduction internal fixation in young and elderly patients with tibial plateau fractures. METHODS: A total of 224 patients with tibial plateau fractures treated with open reduction internal fixation at a level I trauma center from 2014 to 2019 were reviewed. The patients with a minimum follow-up of 2 years were divided into two groups, with those aged 60 years and older divided into the elderly group and those under 60 years divided into the young group. The mean follow-up time was 55 months (range: 24-80), and the primary outcomes were quality of reduction and function. The secondary outcomes included complications, fracture healing time, and conversion to total knee arthroplasty. RESULTS: The elderly group had a higher proportion of women than the young group (61.1% vs. 23.9%, p < 0.001). Diabetes was more prevalent in the elderly cohort than in the young cohort (18.9% vs. 9.0%, p = 0.030). The rate of bone grafts was higher in the elderly group (57.8% vs. 41.8%, p = 0.019), but no significant differences were found between the groups regarding fracture characteristics, the operative time or intraoperative blood loss. The reduction quality, knee function, postoperative complications, healing time, and total knee arthroplasty conversion rate were not significantly different (p > 0.05) between the groups. CONCLUSIONS: Open reduction internal fixation remains a satisfactory technique to treat tibial plateau fractures in the elderly. Although the rate of bone grafts is higher in elderly patients, they had comparable outcomes compared with their younger counterparts.

Severe medial osteoarthritis predicts patient dissatisfaction after proximal fibular osteotomy: a mid- to long-term follow-up study.

PURPOSE: This study aimed to investigate postoperative patient satisfaction at mid- to long-term follow-up after proximal fibular osteotomy and to identify risk factors for patient dissatisfaction. METHODS: This was a retrospective cross-sectional study that included 252 knees from 160 osteoarthritis (OA) patients who underwent proximal fibular osteotomy with a follow-up of four to eight years. Patients were categorized into a satisfied group (satisfaction score ≥ 20) or a dissatisfied group (satisfaction score < 20) based on the New Knee Society Score (New KSS). Patient demographics, preoperative pain visual analogue scale (VAS) score, preoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Kellgren-Lawrence (K-L) grade, preoperative hip-knee-ankle (HKA) angle, and preoperative medial proximal tibial angle (MPTA) were compared between the two groups. Multiple logistic regression analysis was used to identify risk factors for patient dissatisfaction. RESULTS: Of the 203 knees, 130 (64.0%) were satisfied with their results. Multiple logistic regression analysis demonstrated that severe medial OA (K-L grade = IV) was an independent risk factor for patient dissatisfaction after proximal fibular osteotomy (OR 8.334, 95% CI 3.815-18.206, P < 0.001). CONCLUSION: Our study confirmed that proximal fibular osteotomy was a simple and effective treatment for medial OA patients, and majority of our patients obtained a higher satisfaction rate within mid- to long-term follow-up after surgery. Severe medial OA, however, was an independent risk factor for dissatisfaction.

Long-term surgical outcomes of open reduction and internal fixation (ORIF) in patients with Hoffa-like tibial plateau fractures: a clinical study and analysis.

PURPOSE: The Hoffa-like tibial plateau fracture is a rare intra-articular fracture and few studies have investigated its curative effect after treatment. We aimed to focus on patients with Hoffa-like tibial plateau fractures based on a large sample population and to evaluate their long-term surgical outcomes treated with open reduction and internal fixation (ORIF). METHOD: Between August 2017 and September 2020, a period in which 3256 tibial plateau fractures were treated in five trauma centres. Among them, patients with Hoffa-like tibial plateau fractures who treated with ORIF were retrospectively reviewed. Baseline characteristics, operative information, imaging findings, functional scores and any complications were accurately recorded. Each patient was followed for at least three years. RESULTS: Hoffa-like tibial plateau fractures account for approximately 0.9% (29/3256) of all tibial plateau fractures, including 19 males and ten females with a mean age of 45.8 years. After surgery, all patients obtained anatomical reduction of the fractures and none experienced reduction loss. The final Hospital for Special Surgery score (HSS) was improved compared to one year postoperatively (92.76 ± 3.52 versus 89.03 ± 3.81, P < 0.01). No significant differences (P > 0.05) were found in VAS pain score, Rasmussen score, tibial plateau angle (TPA), and posterior slope angle (PSA) between one year and final follow-up. No serious postoperative complications occurred during the treatment and follow-up. CONCLUSION: Long-term follow-up results showed that patients with Hoffa-like tibial plateau fractures can achieve stable fracture fixation, low postoperative complications, excellent radiographic findings and good functional recovery with ORIF.

The effect of distal locking mode on postoperative mechanical complications in intertrochanteric fractures: a retrospective cohort study of five hundred and seven patients.

PURPOSE: The optimal choice of distal locking modes remains a subject due to limited available data, and therefore, this study aims to investigate the relationship between distal locking mode and postoperative mechanical complications in an intertrochanteric fracture (ITF) population who underwent closed reduction and intramedullary fixation with a PFNA-II. METHODS: Patients aged 65 years or older who underwent surgery with PFNA-II fixation in a university teaching hospital between January 2020 and December 2021 were potentially eligible. Based on the distal locking mode, patients were classified into static, dynamic, and limited dynamic groups, among which the differences were tested using univariate analysis. Multivariate logistic regression was used to examine whether the distal locking mode was independently associated with the risk of postoperative one year mechanical complications, adjusting for covariates and potential confounders. Subgroup analyses were performed to evaluate the robustness of the findings. RESULT: Among 507 eligible patients, 33 (6.5%) developed postoperative mechanical complications. In the univariate analysis, sex (P = 0.007), fracture type (P = 0.020), LAT Parker ratio (P = 0.023), and lateral femoral (P = 0.003) wall showed that the differences were significant. Compared to the static group, the limited dynamic group and the dynamic group showed higher odds of postoperative mechanical complications (OR = 3.314, 95% CI: 1.215-9.041; and OR = 3.652, 95% CI: 1.451-9.191, respectively). These associations were robust across a series of analyses, including adjusting for confounders and subgroup analyses. CONCLUSION: Using a distal non-static locking mode significantly increases the risk of postoperative mechanical complications, and static locking could be a preferable option when treating an intertrochanteric fracture.

Preparation, purification, and biochemical of fat-degrading bacterial enzymes from pig carcass compost and its application.

BACKGROUND: A lot of kitchen waste oil is produced every day worldwide, leading to serious environmental pollution. As one of the environmental protection methods, microorganisms are widely used treating of various wastes. Lipase, as one of the cleaning agents can effectively degrade kitchen waste oil. The composting process of pig carcasses produces many lipase producing microorganisms, rendering compost products an excellent source for isolating lipase producing microorganisms. To our knowledge, there are no reports isolating of lipase producing strains from the high temperature phase of pig carcass compost. METHODOLOGY: Lipase producing strains were isolated using a triglyceride medium and identified by 16S rRNA gene sequencing. The optimal fermentation conditions for maximum lipase yield were gradually optimized by single-factor tests. The extracellular lipase was purified by ammonium sulfate precipitation and Sephadex G-75 gel isolation chromatography. Amino acid sequence analysis, structure prediction, and molecular docking of the purified protein were performed. The pure lipase's enzymatic properties and application potential were evaluated by characterizing its biochemical properties. RESULTS: In this study, a lipase producing strain of Bacillus sp. ZF2 was isolated from pig carcass compost products, the optimal fermentation conditions of lipase: sucrose 3 g/L, ammonium sulfate 7 g/L, Mn2+ 1.0 mmol/L, initial pH 6, inoculum 5%, temperature 25 ℃, and fermentation time 48 h. After purification, the specific activity of the purified lipase reached 317.59 U/mg, a 9.78-fold improvement. Lipase had the highest similarity to the GH family 46 chitosanase and molecular docking showed that lipase binds to fat via two hydrogen bonds at Gln146 (A) and Glu203 (A). Under different conditions (temperature, metal ions, organic solvents, and surfactants), lipase can maintain enzymatic activity. Under different types of kitchen oils, lipase has low activity only for 'chicken oil', in treating other substrates, the enzyme activity can exceed 50%. CONCLUSIONS: This study reveals the potential of lipase for waste oil removal, and future research will be devoted to the application of lipase.

Transcriptome-wide identification and characterization of genes exhibit allele-specific imprinting in maize embryo and endosperm.

BACKGROUND: Genomic imprinting refers to a subset of genes that are expressed from only one parental allele during seed development in plants. Studies on genomic imprinting have revealed that intraspecific variations in genomic imprinting expression exist in naturally genetic varieties. However, there have been few studies on the functional analysis of allele-specific imprinted genes. RESULTS: Here, we generated three reciprocal crosses among the B73, Mo17 and CAU5 inbred lines. Based on the transcriptome-wide analysis of allele-specific expression using RNA sequencing technology, 305 allele-specific imprinting genes (ASIGs) were identified in embryos, and 655 ASIGs were identified in endosperms from three maize F1 hybrids. Of these ASIGs, most did not show consistent maternal or paternal bias between the same tissue from different hybrids or different tissues from one hybrid cross. By gene ontology (GO) analysis, five and eight categories of GO exhibited significantly higher functional enrichments for ASIGs identified in embryo and endosperm, respectively. These functional categories indicated that ASIGs are involved in intercellular nutrient transport, signaling pathways, and transcriptional regulation of kernel development. Finally, the mutation and overexpression of one ASIG (Zm305) affected the length and width of the kernel. CONCLUSION: In this study, our data will be helpful in gaining further knowledge of genes exhibiting allele-specific imprinting patterns in seeds. The gain- and loss-of-function phenotypes of ASIGs associated with agronomically important seed traits provide compelling evidence for ASIGs as crucial targets to optimize seed traits in crop plants.

Effects of Cryptosporidium parvum infection on intestinal fungal microbiota in yaks (Bos grunniens).

During the last decade, researchers had started to focus on the relationship between intestinal parasitic infection and variation of intestinal microflora. Cryptosporidium is a widely known opportunistic and zoonotic pathogen. Several studies have shown that Cryptosporidium infection has impact to alter the gut microflora. However, there are only few studies referring to the fungal microflora changes in response to Cryptosporidium infection in highland ruminants. Therefore, the present study was performed for exploring the alternations of intestinal fungal microbiota in yaks after exposure to Cryptosporidium infection. In present study, Amplicon sequencing of ITS regions was used to study the variations of fungal microflora in yaks. After filtering the raw data, over 45 000 and 62 000 clean data were obtained in uninfected and infected yaks, respectively. By using alpha diversity analysis, it was found that there is no significant difference in the richness and evenness when positive samples were compared with negative ones, whereas intestinal fungal communities in different taxa in yaks were changed. The results of present study depicted that 2-phyla and 21-genera in the infected animals had significantly (P < 0.05) changed. These genera were Septoria, Coniothyrium, Cleistothelebolus, Bensingtonia, Cystobasidium, Filobasidium, Coprotus, Carex, Blumeria, Coprinellus, Leucosporidium, Phialophora, Isolepis, Ascobolus, Thecaphora, Mortierella, Urocystis, Symmetrospora and Lasiobolus. In addition, we found variations in 28 enzymes suggesting that the function of microbiota was also affected. It is concluded that there are drastic changes in the fungal microflora and microbiota functions after exposure to Cryptosporidium infection in yak. Our results help to focus on the prompt way for the development of new therapies to control Cryptosporidiosis.

Characterization of 17ß-estradiol-degrading enzyme from Microbacterium sp. MZT7 and its function on E2 biodegradation in wastewater.

BACKGROUND: 17ß-estradiol (E2) residues exhibit harmful effects both for human and animals and have got global attention of the scientific community. Microbial enzymes are considered as one of the effective strategies having great potential for removal E2 residues from the environment. However, limited literature is available on the removal of E2 from wastewater using short-chain dehydrogenase. RESULTS: In this study, 17ß-estradiol degrading enzyme (17ß-HSD-0095) was expressed and purified from Microbacterium sp. MZT7. The optimal pH and temperature for reaction was 7 and 40 °C, respectively. Molecular docking studies have shown that the ARG215 residue form a hydrogen bond with oxygen atom of the substrate E2. Likewise, the point mutation results have revealed that the ARG215 residue play an important role in the E2 degradation by 17ß-HSD-0095. In addition, 17ß-HSD-0095 could remediate E2 contamination in synthetic livestock wastewater. CONCLUSIONS: These findings offer some fresh perspectives on the molecular process of E2 degradation and the creation of enzyme preparations that can degrade E2.

Transcriptome profiling of Microbacterium resistens MZT7 reveals mechanisms of 17ß-estradiol response and biotransformation.

17ß-estradiol (E2) pollution has attracted much attention, and the existence of E2 poses certain risks to the environment and human health. However, the mechanism of microbial degradation of E2 remains unclear. In this study, the location of E2-degrading enzymes was investigated, and transcriptome analysis of Microbacterium resistens MZT7 (M. resistens MZT7) exposed to E2. The degradation of E2 by M. resistens MZT7 was via the biological action of E2-induced intracellular enzymes. With the RNA sequencing, we found 1109 differentially expressed genes (DEGs). Among them, 773 genes were up-regulated and 336 genes were down-regulated. The results of the RNA sequencing indicated the DEGs were related to transport, metabolism, and stress response. Genes for transport, transmembrane transport, oxidoreductase activity, ATPase activity, transporter activity and quorum sensing were up-regulated. Genes for the tricarboxylic acid cycle, ribosome, oxidative phosphorylation and carbon metabolism were down-regulated. In addition, heterologous expression of one enzymes efficiently degraded E2. These findings provide some new insights into the molecular mechanism of biotransformation of E2 by M. resistens MZT7.

One-year unplanned readmission after total hip arthroplasty in patients with osteonecrosis of the femoral head: rate, causes, and risk factors.

BACKGROUND: The primary objectives of this study were to focus on one - year unplanned readmissions after THA in ONFH patients and to investigate rates, causes, and independent risk factors. METHODS: Between October 2014 and April 2019, eligible patients undergoing THA were enrolled and divided into unplanned readmission within one year and no readmission in this study. All unplanned readmissions within 1 year of discharge were reviewed for causes and the rate of unplanned readmissions was calculated. Demographic information, ONFH characteristics, and treatment-related variables of both groups were compared and analysed. RESULTS: Finally, 41 out of 876 patients experienced unplanned readmission. The readmission rate was 1.83% in 30 days 2.63% in 90 days, and 4.68% in 1 year. Prosthesis dislocation was always the most common cause at all time points studied within a year. The final logistic regression model revealed that higher risks of unplanned readmission were associated with age > 60 years (P = 0.001), urban residence (P = 0.001), ARCO stage IV (P = 0.025), and smoking (P = 0.033). CONCLUSIONS: We recommend the introduction of a strict smoking cessation program prior to surgery and the development of comprehensive management strategies, especially for the elderly and end-stage ONFH patients, and pay more attention to preventing prosthesis dislocation in the early days after surgery.

Development and validation of a nomogram for predicting the risk of immediate postoperative deep vein thrombosis after open wedge high tibial osteotomy.

PURPOSE: This study aimed to identify independent risk factors for immediate postoperative deep vein thrombosis (DVT) in patients with open wedge high tibial osteotomy (OWHTO) and to develop and validate a predictive nomogram. METHODS: Patients who underwent OWHTO for knee osteoarthritis (KOA) from June 2017 to December 2021 were retrospectively analyzed. Baseline data and laboratory test results were collected, and the occurrence of DVT in the immediate postoperative period was regarded as the study outcome event. Multivariable logistic regression identified independent risk factors associated with a higher incidence of immediate postoperative DVT. The predictive nomogram was constructed based on the analysis results. The stability of the model was further assessed in this study using patients from January to September 2022 as an external validation set. RESULTS: 741 patients were enrolled in the study, of which 547 were used in the training cohort and the other 194 for the validation cohort. Multivariate analysis revealed a higher Kellgren-Lawrence (K-L) grade (III vs. I-II OR 3.09, 95% CI 0.93-10.23. IV vs. I-II OR 5.23, 95% CI 1.27-21.48.), platelet to hemoglobin ratio (PHR) > 2.25 (OR 6.10, 95% CI 2.43-15.33), Low levels of albumin (ALB) (OR 0.79, 95% CI 0.70-0.90), LDL-C > 3.40 (OR 3.06, 95% CI 1.22-7.65), D-dimer > 1.26 (OR 2.83, 95% CI 1.16-6.87) and BMI ≥ 28 (OR 2.57, 95% CI 1.02-6.50) were the independent risk factors of immediate postoperative DVT. The concordance index (C-index) and Brier score of the nomogram were 0.832 and 0.036 in the training set, and the corrected values after internal validation were 0.795 and 0.038, respectively. The receiver-operating characteristic (ROC) curve, the calibration curve, the Hosmer-Lemeshow test, and the decision curve analysis (DCA) performed well in both the training and validation cohorts. CONCLUSION: This study developed a personalized predictive nomogram with six predictors, which allows surgeons to stratify risk and recommended immediate ultrasound scans for patients with any of these factors. LEVEL OF EVIDENCE: III.

Proximal tibia osteotomy with absorbable spacer combined with fibular osteotomy versus high tibial osteotomy for medial compartmental knee osteoarthritis.

PURPOSE: The study aimed to compare the perioperative complications, short-term clinical outcomes, patient-reported outcomes, and radiographic parameters of tibiofibular proximal osteotomy combined with absorbable spacer insertion (TPOASI) and open-wedge high tibial osteotomy (OWHTO) in a two year postoperative time period. METHODS: A total of 160 patients with Kellgren-Lawrence classification grade 3 medial compartmental knee OA were randomized to receive either TPOASI (n = 82) or OWHTO (n = 78). The primary and secondary outcomes were measured preoperatively, postoperatively, and at each follow-up examination. The primary outcomes were the between-group change in the Western Ontario and McMaster Universities Global score (WOMAC). Secondary measures included visual analog scale (VAS), radiographic parameters, American Knee Society Score (KSS), operation time, blood loss, length of incision, hospital stay, and relevant complications. Postoperative radiographic parameters, including the femorotibial angle (FTA), varus angle (VA), and joint line convergence angle (JLCA), were measured to evaluate the correction of varus deformity. RESULTS: No significant differences were found in the baseline data between the two groups. Both methods improved functional status and pain postoperatively. For primary outcomes of both groups, statistical difference was observed in WOMAC scores at the 6-month follow-up (P < 0.001). For secondary outcomes, no statistical difference was observed between the groups during the 2-year follow-up (P > 0.05). For TPOASI vs. OWHTO, the mean hospital stay (6.6 ± 1.3 days vs. 7.8 ± 2.1 days) was shorter (P < 0.001), and both blood loss (70.56 ± 35.58 vs. 174.00 ± 66.33 mL) and complication rate (3.7% vs. 12.8%) were significantly lower (P < 0.005 for both). CONCLUSIONS: Both approaches showed satisfactory functional outcomes and alleviated pain. However, TPOASI is a simple, feasible method with few complications, and it could be widely used.

New Classification Based on CT and Its Value Evaluation for Fractures of the Lateral Process of the Talus.

This study aimed to develop a comprehensive classification system for fractures of the lateral process of the talus (LPTF) based on CT, and to evaluate its prognostic value, reliability and reproducibility. We retrospectively reviewed 42 patients involving LPTF with an average follow-up of 35.9 months for clinical and radiographic evaluations. In order to develop a comprehensive classification, a panel of experienced orthopedic surgeons discussed the cases. All fractures were classified according to Hawkins, McCrory-Bladin and new proposed classifications by 6 observers. The analysis of interobserver and intraobserver agreements was measured using kappa statistics. The new classification included 2 types based on presence of concomitant injuries or not, with type I consisting of 3 subtypes and type II of 5 subtypes. Average AOFAS score was 91.5 in the type Ia of new classification, 86 in type Ib, 90.5 in type Ic, 89 in type IIa, 76.7 in type IIb, 76.6 in type IIc, 91.3 in type IId, and 83.5 in type IIe. Interobserver and intraobserver reliability of the new classification system were almost perfect (κ = 0.776 and 0.837, respectively), showing a higher interobserver and intraobserver reliability compared to the Hawkins classification (κ 0.572 and 0.649, respectively) as well as McCrory-Bladin classification (κ = 0.582 and 0.685, respectively). The new classification system is a comprehensive one that takes into account concomitant injuries and shows good prognostic value with clinical outcomes. It is more reliable and reproducible and could be a useful tool for decision-making on treatment options for LPTF.

Genome-wide identification and characterization of lncRNAs in sunflower endosperm.

BACKGROUND: Long non-coding RNAs (lncRNAs), as important regulators, play important roles in plant growth and development. The expression and epigenetic regulation of lncRNAs remain uncharacterized generally in plant seeds, especially in the transient endosperm of the dicotyledons. RESULTS: In this study, we identified 11,840 candidate lncRNAs in 12 day-after-pollination sunflower endosperm by analyzing RNA-seq data. These lncRNAs were evenly distributed in all chromosomes and had specific features that were distinct from mRNAs including tissue-specificity expression, shorter and fewer exons. By GO analysis of protein coding genes showing strong correlation with the lncRNAs, we revealed that these lncRNAs potential function in many biological processes of seed development. Additionally, genome-wide DNA methylation analyses revealed that the level of DNA methylation at the transcription start sites was negatively correlated with gene expression levels in lncRNAs. Finally, 36 imprinted lncRNAs were identified including 32 maternally expressed lncRNAs and four paternally expressed lncRNAs. In CG and CHG context, DNA methylation levels of imprinted lncRNAs in the upstream and gene body regions were slightly lower in the endosperm than that in embryo tissues, which indicated that the maternal demethylation potentially induce the paternally bias expression of imprinted lncRNAs in sunflower endosperm. CONCLUSION: Our findings not only identified and characterized lncRNAs on a genome-wide scale in the development of sunflower endosperm, but also provide novel insights into the parental effects and epigenetic regulation of lncRNAs in dicotyledonous seeds.