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Objective: To investigate the efficacy of pars plana vitrectomy (PPV) without intraocular tamponade in the treatment of high myopic eyes with myopic foveoschisis (MF) accompanied by foveal detachment (FD). Methods: A retrospective case series study was conducted. The medical records of patients diagnosed with unilateral MF accompanied by FD at the Eye & ENT Hospital of Fudan University between May 2018 and December 2021 were collected. All patients underwent 23-gauge PPV with posterior vitreous cortex clearance, and no intraocular tamponade was applied. The cases were divided into groups based on whether the internal limiting membrane was peeled during surgery or retained. Follow-up was conducted for at least 12 months. The main outcome measures included postoperative best-corrected visual acuity (BCVA, converted to logarithm of the minimum angle of resolution), central foveal thickness (CFT), MF resolution, and complications. Statistical analyses were performed using t-tests, chi-square tests, Fisher's exact tests, and univariate and multivariate linear regression. Results: A total of 40 patients (40 eyes) with MF and FD were included in the study, with 30.0% being male and 70.0% female. The mean age was (56.9±11.7) years, and the axial length of the eyes was (29.1±1.9) mm. At 12 months postoperatively, BCVA improved from baseline 1.15±0.58 to 0.73±0.39 (t=6.11, P<0.001), and CFT decreased from baseline (610.1±207.2) µm to (155.9±104.1) µm (t=13.47, P<0.001). Complete resolution of MF with foveal reattachment was observed in 80.0% of eyes, with a median time of 6 (5, 8) months. There was no significant difference in BCVA and CFT between the internal limiting membrane peeled group and retained group [0.68±0.39 vs. 0.79±0.40, t=0.85, P=0.403; (148.3±63.8)vs.(164.3±137.2)um,t=0.48, P=0.634]. One eye experienced macular hole and another eye developed retinal detachment postoperatively. Correlation analysis showed a positive correlation between BCVA at 12 months postoperatively and baseline BCVA (ß=0.433, P<0.001). Conclusions: Pars plana vitrectomy without intraocular tamponade is effective in treating MF accompanied by FD. The choice between internal limiting membrane peeling and retention does not significantly affect visual prognosis.
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Miopia Degenerativa , Descolamento Retiniano , Perfurações Retinianas , Retinosquise , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Vitrectomia , Miopia Degenerativa/cirurgia , Miopia Degenerativa/complicações , Estudos Retrospectivos , Retinosquise/cirurgia , Retinosquise/diagnóstico , Retinosquise/etiologia , Tomografia de Coerência Óptica , Membrana Basal/cirurgia , Acuidade Visual , Descolamento Retiniano/cirurgia , Perfurações Retinianas/cirurgiaRESUMO
Electron delocalization has an important impact on the physical properties of condensed materials. However, the L-electron delocalization in inorganic, especially nitrogen, compounds needs exploitation to improve the energy efficiency, safety, and environmental sustainability of high-energy-density materials (HEDMs). This Letter presents an intriguing N8 molecule, ingeniously utilizing nitrogen's L-electron delocalization. The molecule, exhibiting a unique lollipop-shaped conformation, can fold at various angles with very low energy barriers, self-assembling into environmentally stable, all-nitrogen crystals. These crystals demonstrate unparalleled stability, high energy density, low mechanical sensitivity, and optimal electronic thermal conductivity, outperforming existing HEDMs. The remarkable properties of these designed materials are attributed to two distinct delocalized systems within nitrogen's L-shell: π- and lone pair σ-electrons, which not only stabilize the molecular structure but also facilitate interconnected 3D networks of intermolecular nonbonding interactions. This work might pave the way to the experimental synthesis of environmentally stable all-nitrogen solids.
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BACKGROUND: Live attenuated vaccines alter immune functions and are associated with beneficial outcomes. We previously demonstrated that live attenuated yellow fever virus (YFV) vaccine (LA-YF-Vax) dampens T-cell receptor (TCR) signaling in vitro via an RNA-based mechanism. We examined study participants before and after LA-YF-Vax to assess TCR-mediated functions in vivo. METHODS: Serum samples and peripheral blood mononuclear cells (PBMCs) were obtained before and after LA-YF-Vax (with or without additional vaccines) or quadrivalent influenza vaccine. TCR-mediated activation was determined by interleukin 2 release or phosphorylation of the lymphocyte-specific Src kinase. TCR-regulating phosphatase (protein tyrosine phosphatase receptor type E [PTPRE]) expression was also measured. RESULTS: Compared with prevaccination findings, LA-YF-Vax recipient PBMCs demonstrated transient reduction in interleukin 2 release after TCR stimulation and PTPRE levels, unlike in control participants who received quadrivalent influenza vaccine. YFV was detected in 8 of 14 participants after LA-YF-Vax. After incubation of healthy donor PBMCs in serum-derived extracellular vesicles prepared from LA-YF-Vax recipients, TCR signaling and PTPRE levels were reduced after vaccination, even in participants without detectable YFV RNA. CONCLUSIONS: LA-YF-Vax reduces TCR functions and PTPRE levels after vaccination. Extracellular vesicles from serum recapitulated this effect in healthy cells. This likely contributes to the reduced immunogenicity for heterologous vaccines after LA-YF-Vax administration. Identification of specific immune mechanisms related to vaccines should contribute to understanding of the "off-target," beneficial effects of live vaccines.
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Vacinas contra Influenza , Vacina contra Febre Amarela , Humanos , Interleucina-2 , Leucócitos Mononucleares , Anticorpos Antivirais , Vírus da Febre Amarela , Antígenos Virais , Vacinas Combinadas , Receptores de Antígenos de Linfócitos T , RNA , Vacinas AtenuadasRESUMO
Molecular interactions in energetic materials form the key not only to the "structure stability, energy storage, ignition, and detonation" dynamics but also to the sensitivity to the loading of perturbation and the power intensity of radiation for the energetic substance, with the nature of the interactions remaining elusive. With the aid of perturbative Raman spectroscopy and the pressure-resolved density functional theory, we uncovered that the H-N bond of the intermolecular O:H-N bonds for LLM-105 shares the same negative compressibility and thermal expansivity of the H-O bond for the coupling O:H-O bond of water [Phys. Rep. 2023, 998, 1-68]. In contrast, the dangling H-N bond vibrating at a 3440 cm-1 high frequency does otherwise due to the absence of coupling interaction and the undercoordination-driven bond contraction. These findings should deepen our insight into interactions involving electron lone pairs and offer an efficient means for discriminating the performance of individual bonds.
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Objective: To explore the related factors of lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) metastasis in papillary thyroid carcinoma (PTC) and establish a nomogram model for evaluating LN-prRLN metastasis. Methods: The clinical data of patients with PTC who underwent surgery in the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2021 were retrospectively analyzed. Multivariate logistic regression was used to analyze the related factors of LN-prRLN metastasis and construct a nomogram model for evaluating LN-prRLN metastasis. Meanwhile, the data of 120 patients from January to June 2022 were also collected for external verification. Results: A total of 466 patients with PTC were enrolled, including 106 males and 360 females, and aged 44 (33, 53) years. There were 280 cases in the training group and 186 cases in the internal validation group, respectively. Multivariate logistic regression analysis showed that age (OR=0.966, 95%CI: 0.938-0.996, P=0.027), tumor size (OR=1.048, 95%CI: 1.001-1.098, P=0.043), multifocality (OR=2.459, 95%CI: 1.268-4.767, P=0.008), right central lymph node metastasis reported by ultrasound (OR=3.099, 95%CI: 1.255-7.651, P=0.014), extrathyroid extension (OR=3.561, 95%CI: 1.255-10.102, P=0.017) and serum thyroglobulin level (OR=1.010, 95%CI: 1.001-1.018, P=0.032) were related factors for LN-prRLN metastasis. The area under the curve (AUC) values of receiver operating characteristic (ROC) curves of the training group, internal validation group and external validation group were 0.765 (95%CI: 0.691-0.840), 0.747 (95%CI: 0.657-0.837) and 0.754 (95%CI: 0.639-0.869), respectively. Conclusion: Dissection of the LN-prRLN is recommended for young PTC patients with large tumor size, multifocality, right central lymph node metastasis reported by ultrasound, extrathyroid extension and high serum thyroglobulin level.
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Carcinoma Papilar , Carcinoma , Neoplasias da Glândula Tireoide , Feminino , Humanos , Masculino , Linfonodos , Metástase Linfática/patologia , Nomogramas , Nervo Laríngeo Recorrente/patologia , Estudos Retrospectivos , Fatores de Risco , Tireoglobulina , Câncer Papilífero da Tireoide , Adulto , Pessoa de Meia-IdadeRESUMO
A 62-year-old female patient presented with binocular vision loss for 10 days. Fundus photography and optical coherence tomography showed bilateral optic disc edema. Fundus fluorescein angiography showed hypofluorescence of the optic disc in the early stage, but irregular filling defects and segmental hyperfluorescence in the late stage. The diagnosis of bilateral simultaneous non-arteritic anterior ischemic optic neuropathy was made. The patient's visual acuity and visual field were improved after the use of megadose corticosteroids and comprehensive treatment. The prognosis of the patient was stable during the follow-up period.
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Disco Óptico , Neuropatia Óptica Isquêmica , Papiledema , Feminino , Humanos , Pessoa de Meia-Idade , Neuropatia Óptica Isquêmica/etiologia , Papiledema/complicações , Campos Visuais , AngiofluoresceinografiaRESUMO
The formation of the Ontong Java Nui super oceanic plateau (OJN), which is based on the model that the submarine Ontong Java Plateau (OJP), Manihiki Plateau (MP), and Hikurangi Plateau (HP) were once its contiguous fragments, could have been the largest globally consequential volcanic event in Earth's history. This OJN hypothesis has been debated given the paucity of evidence, for example, the differences in crustal thickness, the compositional gap between MP and OJP basalts and the apparent older age of both plateaus relative to HP remain unresolved. Here we investigate the geochemical and 40Ar-39Ar ages of dredged rocks recovered from the OJP's eastern margin. Volcanic rocks having compositions that match the low-Ti MP basalts are reported for the first time on the OJP and new ~ 96-116 Ma and 67-68 Ma 40Ar-39Ar age data bridge the temporal gap between OJP and HP. These results provide new evidence for the Ontong Java Nui hypothesis and a framework for an integrated tectonomagmatic evolution of the OJP, MP, and HP. The isotopic data imply four mantle components in the source of OJN that are also expressed in present-day Pacific hotspots sources, indicating origin from (and longevity of) the Pacific Large Low Shear-wave Velocity Province.
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Mitochondria are hubs where bioenergetics, redox homeostasis, and anabolic metabolism pathways integrate through a tightly coordinated flux of metabolites. The contributions of mitochondrial metabolism to tumor growth and therapy resistance are evident, but drugs targeting mitochondrial metabolism have repeatedly failed in the clinic. Our study in pancreatic ductal adenocarcinoma (PDAC) finds that cellular and mitochondrial lipid composition influence cancer cell sensitivity to pharmacological inhibition of electron transport chain complex I. Profiling of patient-derived PDAC models revealed that monounsaturated fatty acids (MUFAs) and MUFA-linked ether phospholipids play a critical role in maintaining ROS homeostasis. We show that ether phospholipids support mitochondrial supercomplex assembly and ROS production; accordingly, blocking de novo ether phospholipid biosynthesis sensitized PDAC cells to complex I inhibition by inducing mitochondrial ROS and lipid peroxidation. These data identify ether phospholipids as a regulator of mitochondrial redox control that contributes to the sensitivity of PDAC cells to complex I inhibition.
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Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Humanos , Espécies Reativas de Oxigênio/metabolismo , Éteres Fosfolipídicos/metabolismo , Mitocôndrias/metabolismo , Fosfolipídeos/metabolismo , Neoplasias Pancreáticas/patologia , Carcinoma Ductal Pancreático/metabolismo , HomeostaseRESUMO
AIM: To compare the performance of T2∗ imaging and apparent diffusion coefficient (ADC) in differentiating normal placentas from those complicated by fetal growth restriction (FGR). MATERIALS AND METHODS: This prospective study included 28 control and 30 FGR placentas. Gradient-echo magnetic resonance imaging (MRI) at 16 different echo times and diffusion-weighted imaging (b-value of 0 and 800 s/mm2) were performed on all pregnant women using a 3 T MRI system. RESULTS: Both T2∗ imaging Z-score and ADC were significantly lower in the FGR placentas (ADC, (1.69 ± 0.19) × 10-3 versus (1.42 ± 0.28) × 10-3 mm2/s, p<0.001; T2∗ imaging Z-score, -0.004 ± 0.95 versus -2.441 ± 1.48, p<0.001). The area under the curve for T2∗ imaging Z-score and ADC was 0.917 (95% confidence interval [CI] = 0.842-0.991) and 0.788 (95% CI = 0.655-0.887), respectively. The performance of T2∗ imaging in differentiating FGR placentas was significantly better than that of ADC (Z = 2.043, p=0.041). CONCLUSION: Placental T2∗ imaging was found to be more reliable than ADC in differentiating between normal and FGR placentas.
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Retardo do Crescimento Fetal , Placenta , Humanos , Feminino , Gravidez , Placenta/diagnóstico por imagem , Retardo do Crescimento Fetal/diagnóstico por imagem , Estudos Prospectivos , Imagem de Difusão por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/métodosRESUMO
Objective: To study the relationship between the Chinese dietary guidelines compliance index for pregnant women (CDGCI_PW) and congenital heart disease (CHD) in offspring. Methods: In a hospital-based case-control study conducted in Xi'an, Shaanxi province, semi-quantitative food frequency questionnaires were used to investigate the diets of pregnant women throughout pregnancy. The modified CDGCI_PW score was used to evaluate dietary quality during pregnancy, logistic regression was applied to analyze the relationship between CDGCI_PW score and offspring CHD, and the ROC curve was adopted to construct the prediction model of CDGCI_PW for offspring CHD. Results: A total of 1 422 subjects were enrolled, including 474 in the case group and 948 in the control group. The CDGCI_PW score in the case group M (Q1, Q3) was 46.0 (26.0, 65.0) lower than that in the control group, which was 60.0 (40.0, 77.0). The difference between the two groups was significant (P<0.001). Compared with those in the Q1 of CDGCI_PW, the offspring in the Q2, Q3, and Q4 of CDGCI_PW had a lower risk of total CHD (OR=0.60, 95%CI: 0.43-0.83; OR=0.64, 95%CI: 0.45-0.89; OR=0.29, 95%CI: 0.19-0.44), with the trend test P<0.001. The risk of total CHD was reduced by 17% (OR=0.83, 95%CI: 0.79-0.88) when 10 points increased the CDGCI_PW score. The area under curve predicted by constructing the ROC curve was 0.793 (95%CI: 0.768-0.818), and at the maximum of the Youden index, the sensitivity was 0.740, and the specificity was 0.725. Conclusion: This study suggests that improving dietary quality during pregnancy may reduce the risk of CHD in offspring.
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Cardiopatias Congênitas , Gestantes , Gravidez , Feminino , Humanos , Estudos de Casos e Controles , População do Leste Asiático , Modelos Logísticos , Fatores de RiscoRESUMO
Perturbation Raman spectroscopy has underscored the hydrogen bond (O:H-O or HB) cooperativity and polarizability (HBCP) for water, which offers a proper parameter space for the performance of the HB and electrons in the energy-space-time domains. The OO repulsive coupling drives the O:H-O segmental length and energy to relax cooperatively upon perturbation. Mechanical compression shortens and stiffens the O:H nonbond while lengthens and softens the HO bond associated with polarization. However, electrification by an electric field or charge injection, or molecular undercoordination at a surface, relaxes the O:H-O in a contrasting way to the compression with derivation of the supersolid phase that is viscoelastic, less dense, thermally diffusive, and mechanically and thermally more stable. The HO bond exhibits negative thermal expansivity in the liquid and the ice-I phase while its length responds in proportional to temperature in the quasisolid phase. The O:H-O relaxation modifies the mass densities, phase boundaries, critical temperatures and the polarization endows the slipperiness of ice and superfluidity of water at the nanometer scale. Protons injection by acid solvation creates the HâH anti-HB and introduction of electron lone pairs derives the O:â:O super-HB into the solutions of base or H2O2 hydrogen-peroxide. The repulsive HâH and O:â:O interactions lengthen the solvent HO bond while the solute HO bond contracts because its bond order loss. Differential phonon spectroscopy quantifies the abundance, structure order, and stiffness of the bonds transiting from the mode of pristine water to the perturbed states. The HBCP and the perturbative spectroscopy have enabled the dynamic potentials for the relaxing O:H-O bond. Findings not only amplified the power of the Raman spectroscopy but also substantiated the understanding of anomalies of water subjecting to perturbation.
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Objective: To analyze the clinical characteristics of patients with Möbius syndrome (MBS) and to explore likely pathogenic genes. Methods: Cross-sectional study. The study enrolled 18 sporadic MBS patients who visited the Eye Center of Beijing Tongren Hospital Affiliated to Capital Medical University from July 2018 to December 2021. All patients completed the general information questionnaire and underwent detailed ophthalmic examinations and general physical examinations. Seventeen patients received MRI examination of cranial nerves and the orbit. The peripheral venous blood of all patients and their nuclear family members was collected, the genomic DNA was extracted, and the pathogenic gene variations that may lead to MBS were identified by whole exome sequencing and bioinformatics analysis. Results: Among the 18 patients, there were 8 males and 10 females, and the age was (4.5±4.0) years (range, 8 months to 17 years). All patients showed congenital, bilateral or unilateral abduction deficit and facial weakness, which met the minimum diagnostic criteria of MBS. Among them, bilateral abduction deficit (16/18) and bilateral facial weakness (15/18) were more common. Nine patients were orthotopic in primary position, eight presented with esotropia, and one showed hypotropia. All patients had ametropia, of which 4 patients were diagnosed as amblyopia. Fifteen patients were also accompanied by other multiple congenital malformations, mainly characterized by abnormal development of glossopharynx (14/18) and limbs (5/18), and 7 patients were also accompanied by motor retardation. In addition, 9 patients had intrauterine exposure to adverse factors. Among the 17 patients who underwent MRI, 15 patients had bilateral hypoplasia of the abducens nerve, two had unilateral hypoplasia of the abducens nerve, 14 showed bilateral hypoplasia of the facial nerve, and three showed hypoplasia of the left facial nerve. Besides, some patients were also accompanied by hypoplasia of other cranial nerves, mainly the glossopharyngeal nerve and the hypoglossal nerve. No definite pathogenic variations were found by whole exome sequencing and bioinformatics analysis. Conclusions: The main clinical features of MBS were congenital abduction deficit and facial weakness, with complicated manifestations and variable severity. MRI showed absence or thinning of the abducens nerve and the facial nerve. The results of MRI can be used as a supplement to the diagnostic criteria of MBS. The mutation detection rate of MBS was low, and half of patients had exposure to adverse factors during pregnancy, suggesting that there was a multifactorial pathogenic mechanism in MBS.
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Paralisia Facial , Síndrome de Möbius , Estrabismo , Estudos Transversais , Paralisia Facial/congênito , Feminino , Humanos , Lactente , Masculino , Síndrome de Möbius/genética , Sequenciamento do ExomaRESUMO
AIM: To analyse the clinicopathological features and ultrasound findings of the diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) and compare differences between children/adolescents (CAs) and adults. MATERIALS AND METHODS: Medical records and ultrasound images of 97 consecutive DSV-PTC patients were reviewed and comparison was made between CAs and adults. RESULTS: The average age was 31.2 ± 12.4 years old and 16.5% patients were CAs. Unilateral lobe was involved in 40.2% patients and 69.1% combined with Hashimoto's thyroiditis. Up to 95.9% patients had lymph node metastasis (LNM). CAs had more contralateral central LNM (CCLNM) and contralateral lateral LNM (CLLNM) than adults (p=0.047, p=0.025). Lung metastasis was also more common in CAs (p=0.002). Involved lobes mostly appeared as diffuse heterogeneous echogenicity on ultrasonography with isoechogenicity as the most common predominant echo (48.4%). Diffuse microcalcifications were observed frequently with grade 2-3 accounting for 52.3%. Lesions involving the whole gland lobe (diffuse type) occurred in 63.9%. Blood flow was poor in 71.6% (with grade 0-1). Microcalcifications of both lobes and metastatic lymph nodes and lesions involving (diffuse type) were more common in CAs (p=0.038, 0.002; 0.011). Of 39 patients with unilateral lobe involvement, ultrasonic sensitivity for CCLNM and CLLNM was only 50% and 66.7% respectively. CONCLUSION: DSV-PTC has characteristic ultrasonographic findings. DSV-PTC of CAs may be more aggressive than that of adults. Ultrasonic sensitivity for LNM of contralateral compartments was not satisfactory and diagnostic methods with good efficacy are required.
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Calcinose , Carcinoma Papilar , Neoplasias da Glândula Tireoide , Adolescente , Adulto , Carcinoma Papilar/diagnóstico por imagem , Criança , Humanos , Metástase Linfática/diagnóstico por imagem , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Adulto JovemRESUMO
Objective: To explore the effect of neoadjuvant immunotherapy on pulmonary function and the efficacy in patients with resectable non-small cell lung cancer. Methods: Data of 30 patients with non-small cell lung cancer (NSCLC) who received neoadjuvant immunotherapy before surgery in the Chest Hospital of Shanghai Jiaotong University from March 2018 to September 2021 were retrospectively collect. The efficacy and safety of neoadjuvant immunotherapy in the perioperative period and changes in pulmonary function of patients before and after neoadjuvant treatment were valuated. Results: The patients were all-male with age of (61±8)years old, The major pathological response (MPR) rate of patients receiving neoadjuvant immunotherapy was 43%(13 cases), the pathologic complete response (pCR) rate was 37% (11 cases), disease control rate (DCR) was 97% (29 cases), objective response rate (ORR) was 67% (20 cases). The forced expiratory volume in one second (FEV1) after treatment was (2.59±0.63) L, and the ratio of FEV1 to the predicted value (FEV1%pred) was 85.27%±15.86%, which were significantly higher than those before treatment [(2.48±0.59)L, 81.73%±15.94%, respectively] (P=0.013, 0.022, respectively). Forced vital capacity (FVC) after treatment was (3.59±0.77) L, which was also significantly higher than before [(3.47±0.76) L,P=0.036]; while there were no statistical difference in FEV1/FVC and FVC accounted for the proportion of predicted values (FVC%pred) between before and after treatment (P=0.084, 0.344, respectively). The ratio of carbon monoxide dispersion (DLCO) to the predicted value (DLCO%pred) decreased from 83.61%±13.10% to 78.69%±13.85% after treatment (P=0.023). There was no significant difference in the incidence of postoperative complications between the DLCO%pred decreased group and the non-decreased group (3/18 vs 0/6; P=0.546). Conclusions: Neoadjuvant immunotherapy can increase the rate of MPR and PCR, significantly increase FEV1 and FEV1%pred, but also lead to a decrease in DLCO%pred; neoadjuvant immunotherapy does not increase the incidence of postoperative complications.
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Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Idoso , Carcinoma Pulmonar de Células não Pequenas/terapia , China , Volume Expiratório Forçado , Humanos , Imunoterapia , Pulmão , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estudos RetrospectivosRESUMO
Objective: To investigate the influence of correction degree on the clinical effect of valgus knee after total knee arthroplasty(TKA). Methods: Clinical data of 91 patients with unilateral valgus knee who underwent TKA from January 2015 to December 2018 at Department of Orthopaedic Surgery,Zhongda Hospital,Southeast University were retrospectively analyzed. According to postoperative hip-knee-ankle angle(HKA),these patients were divided into neutral group (-3°≤HKA≤3°) and residual valgus group(HKA>3°). There were 70 patients in the neutral group,with a median age of 71.5 years(range:57 to 91 years),and 21 patients in the residual valgus group,with a median age of 71.5 years(range:60 to 85 years). The postoperative clinical indicators,including the range of motion (ROM),American Knee Society score(KSS),Western Ontario and McMaster University(WOMAC) osteoarthritis index,forgotten joint score (FJS-12) were collected. Meanwhile,the imaging indexes of femoral angle,tibial angle,femoral prosthesis flexion angle,tibial prosthesis posterior slope angle,patella tilt angle,congruence angle were also collected. Additionally,postoperative complications were recorded. The clinical data were analyzed by independent sample t test,Mann-Whitney U test or χ2 test. Results: There were no differences between the two groups in postoperative ROM (122.5°±8.5° vs. 119.4°±7.1°,t=1.534,P=0.128),KSS(159.8±8.9 vs. 150.0±8.9,t=-0.103,P=0.918),WOMAC osteoarthritis index(10.0(3.0) vs. 9.0(5.0),Z=-0.733,P=0.464),FJS-12(52.1(8.4) vs. 50.1(7.5),Z=-0.594,P=0.553)and femoral angle(94.0°(4.0°) vs. 94.0°(5.0°),Z=-0.209,P=0.835),tibial angle(90.0°(3.0°) vs. 91.0°(2.5°),Z=-1.226,P=0.220),femoral prosthesis flexion angle(3.0°(1.0°) vs. 3.0°(1.0°),Z=-0.652,P=0.514),tibial prosthesis posterior slope angle(4.0°(2.0°) vs. 4.0°(2.0°),Z=-0.763,P=0.445),patella tilt angle(9.0°(3.0°) vs. 9.0°(3.5°),Z=-1.429,P=0.153),congruence angle(14.0°(4.0°) vs. 15.0°(4.0°),Z=-1.690,P=0.091). However,abnormal proportions of patella tilt angle(33.3% vs.11.4%,χ²=5.630,P=0.018) and congruence angle(38.1% vs.17.1%,χ²=4.136,P=0.042) were apparent in the residual valgus group. The patients were follow-up for (32.1±5.2) months(range:24 to 40 months). Six weeks after operation,one case of joint stiffness occurred in the residual valgus group, which was improved after manual relaxation and rehabilitation exercises. At the last follow-up,two cases in the residual valgus group suffered patella instability which were fixed by patella braces and strengthening of the medial femoral muscles. There were no cases requiring reoperation for dislocation of patella,joint instability and aseptic loosening of the prosthesis in both groups. Conclusions: Residual valgus after TKA for valgus knee has no significant effect on the short-term clinical outcome,but it is more likely to cause abnormal proportions of patella tilt angle and congruence angle which may induce the risk of postoperative patella instability. The mid-and long-term outcomes need to be further investigated.
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Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Idoso , Idoso de 80 Anos ou mais , Humanos , Articulação do Joelho/cirurgia , Pessoa de Meia-Idade , Osteoartrite do Joelho/cirurgia , Amplitude de Movimento Articular , Estudos RetrospectivosRESUMO
The theoretical prediction of the catalytic activity is very beneficial for the design of highly efficient catalysts. At present, most theoretical descriptors focus on estimating the catalytic activity and understanding the enhancement mechanism of catalysts, while it is also quite important to find a factor to correlate the descriptors with preparation methods. In this work, a correlation factor, the d electron density of transition metal ions, was developed to correlate the d band center values of transition metal ions with the preparation methods of amorphization and Al introduction. According to the results of theoretical simulations, the correlation factor not only exhibited favorable linear relationships with the theoretical overpotentials of (CoFeAlx)3O4 and (CoFeAlx)3O4 + (CoFeAlx)OOH systems but also correlated with two preparation methods by altering the volume of systems. Based on theoretical guidance, the electrocatalytic activities of the prepared (CoFeAlx)3O4 specimens were gradually improved by the preparation methods of amorphization and Al introduction, and the Am-CoFeAl-2-10h specimen exhibited a low kinetic barrier of 268 mV, fast charge transfer rate, and stable electrocatalytic activity. This strategy could be applied to design highly efficient catalysts by adjusting the correlation factor of the active site with suitable preparation methods.
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The long-standing performance-stability contradiction issue of high energy density materials (HEDMs) is of extremely complex and multi-parameter nature. Herein, machine learning was employed to handle 28 feature descriptors and 5 properties of detonation and stability of 153 HEDMs, wherein all 21,648 data used were obtained through high-throughput crystal-level quantum mechanics calculations on supercomputers. Among five models, namely, extreme gradient boosting regression tree (XGBoost), adaptive boosting, random forest, multi-layer perceptron, and kernel ridge regression, were respectively trained and evaluated by stratified sampling and 5-fold cross-validation method. Among them, XGBoost model produced the best scoring metrics in predicting the detonation velocity, detonation pressure, heat of explosion, decomposition temperature, and lattice energy of HEDMs, and XGBoost predictions agreed best with the 1,383 experimental data collected from massive literatures. Feature importance analysis was conducted to obtain data-driven insight into the causality of the performance-stability contradiction and delivered the optimal range of key features for more efficient rational design of advanced HEDMs.