Inferring Mycobacterium Tuberculosis Drug Resistance and Transmission using Whole-genome Sequencing in a High TB-burden Setting in China.

Objective: China is among the 30 countries with a high burden of tuberculosis (TB) worldwide, and TB remains a public health concern. Kashgar Prefecture in the southern Xinjiang Autonomous Region is considered as one of the highest TB burden regions in China. However, molecular epidemiological studies of Kashgar are lacking. Methods: A population-based retrospective study was conducted using whole-genome sequencing (WGS) to determine the characteristics of drug resistance and the transmission patterns. Results: A total of 1,668 isolates collected in 2020 were classified into lineages 2 (46.0%), 3 (27.5%), and 4 (26.5%). The drug resistance rates revealed by WGS showed that the top three drugs in terms of the resistance rate were isoniazid (7.4%, 124/1,668), streptomycin (6.0%, 100/1,668), and rifampicin (3.3%, 55/1,668). The rate of rifampicin resistance was 1.8% (23/1,290) in the new cases and 9.4% (32/340) in the previously treated cases. Known resistance mutations were detected more frequently in lineage 2 strains than in lineage 3 or 4 strains, respectively: 18.6% vs. 8.7 or 9%, P < 0.001. The estimated proportion of recent transmissions was 25.9% (432/1,668). Multivariate logistic analyses indicated that sex, age, occupation, lineage, and drug resistance were the risk factors for recent transmission. Despite the low rate of drug resistance, drug-resistant strains had a higher risk of recent transmission than the susceptible strains (adjusted odds ratio, 1.414; 95% CI, 1.023-1.954; P = 0.036). Among all patients with drug-resistant tuberculosis (DR-TB), 78.4% (171/218) were attributed to the transmission of DR-TB strains. Conclusion: Our results suggest that drug-resistant strains are more transmissible than susceptible strains and that transmission is the major driving force of the current DR-TB epidemic in Kashgar.

Relationship between the methylenetetrahydrofolate reductase (MTHFR) rs1801133 SNP and serum homocysteine levels of Zhuang hypertensive patients in the central region of Guangxi.

BACKGROUND: The relationship between the methylenetetrahydrofolate reductase (MTHFR) single nucleotide polymorphism (SNP) and serum homocysteine (Hcy) levels or H-type hypertension in different populations is inconsistent. This study aimed to explore the association between the MTHFR rs1801133 SNP and serum Hcy levels of Zhuang hypertensive patients in the central region of Guangxi. METHODS: A total of 606 Zhuang inpatients with essential hypertension were recruited in our hospital from August 2016 to December 2018. The patients were divided into H-type hypertension (Hcy > 10 µmol/L, n = 528) and non-H-type hypertension (Hcy ≤ 10 µmol/L, n = 78) groups. At the same time, an age- and sex-matched group of 379 subjects with normal physical examination in our hospital were selected as the control group. Blood biochemical measurements and genotyping of the MTHFR rs1801133 SNP were performed. RESULTS: The prevalence of H-type hypertension was 87.13%. The levels of serum Hcy in patients with hypertension were higher than those in control group (14.20 ± 5.78 µmol/L vs. 11.97 ± 5.39 µmol/L, P < 0.001), especially in patients with H-type hypertension (15.08 ± 5.65 µmol/L, P < 0.001). The frequencies of TT genotype (22.73%) and T allele (46.21%) in patients with H-type hypertension were significantly higher than those in control group (11.35% and 30.47%, respectively) and non-H-type hypertension group (10.26% and 28.85%, respectively; P < 0.001 for all). Multivariate linear regression analysis showed that serum Hcy levels were significantly correlated with creatinine, low-density lipoprotein cholesterol, endogenous creatinine clearance rate, and the MTHFR rs1801133 genotypes in control group, while serum Hcy levels were significantly correlated with creatinine, triglyceride, low-density lipoprotein cholesterol, endogenous creatinine clearance rate, glycosylated hemoglobin, and the MTHFR rs1801133 genotypes in H-type hypertension group (P < 0.05-0.001). Serum Hcy levels in the T allele carriers were higher than those in the T allele noncarriers in both H-type hypertension and control groups. CONCLUSIONS: There was closely related between the MTHFR rs1801133 SNP and serum Hcy levels in Zhuang patients with H-type hypertension in the central region of Guangxi. The MTHFR SNP may be an important reason for the increase of serum Hcy levels in Zhuang patients with H-type hypertension in this region.

ZIP14 is involved in iron deposition and triggers ferroptosis in diabetic nephropathy.

Ferroptosis is caused by lipid peroxidation and iron accumulation and can cause cell death. Abnormally expressed iron transporters are involved in ferroptosis in a variety of diseases. ZRT/IRT-like protein 14 (ZIP14) is a transport protein that can mediate cellular uptake of iron, zinc, and manganese. Herein, we have tested the hypothesis that the divalent metal transporter ZIP14 is involved in the initiation of ferroptosis in diabetic nephropathy (DN). DN was induced in 8-week-old male rats by streptozotocin before analysis of the degree of renal tubular injury. In addition, an in vitro model of DN in human kidney proximal tubular cell line was used. We showed that ZIP14 was up-regulated and ferrous iron (Fe2+) levels increased both in vivo and in vitro. Expression of glutathione peroxidase 4 and the level of glutathione were reduced, whereas that of malondialdehyde (MDA) increased. Ferrostatin-1 (Fer-1) treatment reduced the expression of ZIP14 and the levels of Fe2+ and MDA, which is consistent with ferroptosis. Fer-1 improved kidney function in DN rats. This was characterized by urine levels of protein-to-creatinine ratio, α1-microglobulin, and N-acetyl-ß-D-glucosaminidase. Our study demonstrates a novel role for ZIP14 in diabetic kidney injury mediated by ferroptosis, and suggests a potential new therapeutic approach for the treatment of diabetic nephropathy.

[ß-Thalassemia among Newborns in Wuhan Region and Its Influence Factors].

OBJECTIVE: To investigate the screening of ß-thalassemia among newborns in Wuhan region, so as to explore the influencing factors of Hb A in dried blood spot. METHODS: Concentrations of Hb A,Hb A2,Hb F in the dried blood spots collected from 99 275 neonates in Wuhan region were analyzed by Sebia capillary electrophoresis. The screening result of ß-thalassemia was interpretated accroding to the ratio of each group, the suspicious ß-thalassemia newborns were recalled and the gene of thalassemia in those newborns was checked. RESULTS: Among 99 275 newborns, 1 408 positive patients were found, and the positive rate of screening was 1.41%. A total of 350 patients with gene mutation were found among 709 ß-thalassemia suspicious patients. There were significantly statistical differences of positive predictive value among Hb A levels in different groups and there were also significantly statistical differences of positive predictive values among gestational weeks in different groups. No significantly statistical differences were observed among different genetic defects and phenotypes of heterozygous ß-thalassemia in Hb A concentrations. Postnatal day and gestational age were significantly and positively associated with Hb A concentrations. CONCLUSION: The capillary electrophoresis is an effective screening method for ß-thalassemia of full-term neonate. Postnatal day and gestational age is associated with the pencentage of Hb A.

Human Microfibrillar-Associated Protein 4 (MFAP4) Gene Promoter: A TATA-Less Promoter That Is Regulated by Retinol and Coenzyme Q10 in Human Fibroblast Cells.

Elastic fibers are one of the major structural components of the extracellular matrix (ECM) in human connective tissues. Among these fibers, microfibrillar-associated protein 4 (MFAP4) is one of the most important microfibril-associated glycoproteins. MFAP4 has been found to bind with elastin microfibrils and interact directly with fibrillin-1, and then aid in elastic fiber formation. However, the regulations of the human MFAP4 gene are not so clear. Therefore, in this study, we firstly aimed to analyze and identify the promoter region of the human MFAP4 gene. The results indicate that the human MFAP4 promoter is a TATA-less promoter with tissue- and species-specific properties. Moreover, the promoter can be up-regulated by retinol and coenzyme Q10 (coQ10) in Detroit 551 cells.

Effect of Gestational Weight Gain on Associations Between Maternal Thyroid Hormones and Birth Outcomes.

Purpose: The aim was to investigate the associations between maternal thyroid parameters within the normal ranges during early pregnancy and birth outcomes, and further to examine whether the associations were modified by gestational weight gain (GWG). Methods: Maternal serum thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) concentrations within the normal ranges during early pregnancy were measured from 8,107 pregnant women in Wuhan, China. The associations between maternal thyroid parameters and birth outcomes (birth weight, birth length, and low birth weight) were analyzed using multivariable adjusted regression models, and effect modification by pre-pregnancy body mass index (BMI) category and GWG were further evaluated. Results: Maternal TSH and FT4 concentrations were negatively associated with birth weight, and the latter only occurred in normal weigh women with inadequate and excessive GWG, as well as in both underweight and overweight women with excessive GWG (e.g., ß = -359.33 g, 95% CI: -700.95, -17.72 in underweight women with excessive GWG for per unit increase of FT4 concentrations). Moreover, maternal FT4 and FT3 concentrations were associated with increased risk for low birth weight, and the latter only occurred in normal weigh women with inadequate GWG (OR = 2.52, 95% CI: 1.00, 6.36 for per unit increase of FT3 concentrations). These associations still persist when maternal thyroid parameters were modeled as quintiles. Main conclusion: Maternal normal thyroid function during early pregnancy with excessive and inadequate GWG may adversely influence fetal growth.

Comparison in enantioseparation performance of chiral stationary phases prepared from chitosans of different sources and molecular weights.

The aim of the present study was to compare the enantioseparation performance of chiral stationary phases (CSPs) which were derived from chitosans of different sources and molecular weights. Therefore, chitosans of shrimp and crab shells were prepared. The viscosity-average molecular weights of the chitosans both prepared from shrimp and crab shells were 2.8 × 105 and 1.4 × 105. The chitosans were isobutyrylated yielding isopropylcarbonyl chitosans which were then derivatized with 4-methylphenyl isocyanate to provide chitosan 3,6-bis(4-methylphenylcarbamate)-2-(isobutyrylamide)s. The chitosan 3,6-bis(4-methylphenylcarbamate)-2-(isobutyrylamide)s were used as chiral selectors (CSs) with which the corresponding CSPs were prepared. With the same chiral analytes and under the same mobile phase conditions, the enantioseparation capability of the CSPs was evaluated by high-performance liquid chromatography. In two CSs prepared from the same source, the one with higher molecular weight showed better enantioseparation capability; in two CSs prepared with the chitosans of the same molecular weight, the one derived from shrimp shell exhibited better performance. With regard to the two shrimp chitosan CSs, most of chiral analytes interacted more strongly with the one with lower molecular weight, and an opposite trend was found for the two crab chitosan CSs. Based on the results observed in the present study and in previous work, we believe that the influence of molecular weight on CSP enantioseparation performance is related to the substituent introduced in the CS molecule.

[Genetic Analysis and Prenatal Diagnosis for Thalassemia of Pregnant Women in Wuhan Area of China].

OBJECTIVE: To investigate the common genotypes of thalassemia of the pregnant woman in Wuhan area of China, and to make the prenantal gentic diagnosis for the fetus at high risk of thalassemia. METHODS: A total of 357 pregnant woman with the primary positive screening in Wuhan area were included in this study. Genotypes were measured with PCR-flow cytometry, and fluorescence hybridization was used for detecting thalassmia gene. The husbands of the pregnant women with thalassmia were recalled for genetic analysis of thalassemia, and 9 cases of fetuses with high risk of thalassemia were detected by amniocontesis after genetic counseling. RESULTS: In 357 cases of the pregnant women in Wuhan area, the 214 cases were diagnosed as thalassemia, 80 cases were diagnosed as alpha thalassemia (up to 90%), whose genotypes were determind as --SEA/αα (78.75%) and -α3.7/αα (15.00%), while 133 cases were determind with genotype of IVS-2-654/N (43.61%), CD41-42/N (20.30%) and CD17/N (19.55%) in beta thalassemia (up to 80%). 9 prenatal diagnosis continued pregnancy included 1case of -α3.7/--SEA, 1 case of -α3.7/αα, 2 cases of --SEA/αα, 2 cases of IVS-2-654/N and 3 cases of normal, however, the pregnancy in prenatal diagnosis of -α3.7/--SEA voluntarily was terminated after genetic counseling. Follow-up results after delivery were consistent with prenatal diagnosis. CONCLUSION: Minor and static thalassemia were very common in Wuhan area. Genetic detection after primary screening, genetic counseling and prenatal diagnosis in pregnant women could provide a theoretical basis for the development of regional specific prevention of intermedius and critical thalassemia which is meaning for rearing and bearing better children.

The CXCL12 SNPs and their haplotypes are associated with serum lipid traits.

The relationship among the single nucleotide polymorphisms (SNPs) of the C-X-C motif chemokine ligand 12 gene (CXCL12) and the serum lipid profiles in the Chinese population has rarely been described, especially in somewhat old-fashioned and isolated Maonan minority. The goal of the current study was to elucidate the connection among the CXCL12 rs501120 and rs1746048 SNPs, haplotypes, several environmental factors and serum lipid traits in the Maonan as well as Han populations. Genotyping of the two SNPs, gel electrophoresis and direct sequencing were accomplished in 1,494 distinct subjects (Maonan, 750 and Han, 744) using polymerase chain reaction and restriction fragment length polymorphism. The frequencies of genotypes as well as alleles of the two SNPs were not similar between the two ethnic groups. The rs501120 SNP was related with serum total cholesterol levels, while the rs1746048 SNP was related with serum apolipoprotein (Apo) B levels. Four haplotypes were identified, of which the rs501120A-rs1746048C haplotype was the most common. The haplotypes of rs501120A-rs1746048T increased and rs501120G-rs1746048C decreased the risk of hyperlipidemia (P < 0.001 for each), showing consistent association with the levels of serum triglyceride, ApoA1 and ApoB. These outcomes specify that the CXCL12 SNPs as well as their haplotypes are related to serum lipid levels. Different serum lipid levels between both populations may partially be related to the CXCL12 SNPs, their haplotypes along with several environmental factors.

Are paediatric clinical practice guidelines trustworthy?

AIM: To assess the methodological and reporting quality of paediatric clinical practice guidelines (CPGs) in National Guideline Clearinghouse (NGC) using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument and Reporting Items for Practice Guidelines in Healthcare (RIGHT) standard. METHODS: We identified all published CPGs through the NGC, and search records were screened in duplicate for inclusion. Two researchers evaluated the methodological and reporting quality of paediatric CPGs using the AGREE II instrument and RIGHT standard. STATA version 12.0 and SPSS version 22.0 software were used to analyse the related data. RESULTS: A total of 50 paediatric CPGs were included. The scores for all six domains by AGREE II instrument were presented as follows: scope and purpose (85.6 ± 9.59), stakeholder involvement (69.15 ± 19.32), rigour of development (73.19 ± 17.18), clarity of presentation (78.51 ± 14.36), applicability (54.61 ± 22.63) and editorial independence (68.42 ± 13.06). In the seven domains of the RIGHT standard, the reporting rate of the recommendation domain was the lowest (52.86%).The highest reporting rate was the other information domain, which was 68%.There was a high correlation between reporting the completeness of CPGs using the AGREE II instrument and RIGHT standard (r = 0.77, P < 0.001). CONCLUSIONS: The paediatric CPGs from NGC have good quality. There was a high correlation in the completeness of reporting for paediatric CPGs using the AGREE II instrument and RIGHT standard. It could be concluded that the CPGs of good methodological quality have good reporting quality. Maybe the researcher should effectively combine the AGREE II instrument and RIGHT standard in the development process of CPGs.

A novel lncRNA-miRNA-mRNA triple network identifies lncRNA TWF1 as an important regulator of miRNA and gene expression in coronary artery disease.

BACKGROUND: Long non-coding RNAs (lncRNAs) are involved in numerous physiological functions. Yet, their mechanisms in coronary artery disease (CAD) are not well understood. METHODS: The expression profile of genes associated to CAD was reannotated into the lncRNA-mRNA biphasic profile. The target microRNA data were used to design a global CAD triple network. Thereafter, we conducted a functional enrichment analysis and clustering using the triple network from the level of topology analyses. The expression of four non-coding RNAs (ncRNAs) was measured by qRT-PCR and the risk of CAD was calculated by nomogram. The prognostic value of three ncRNAs was evaluated using receiver operating characteristic (ROC) curve. RESULTS: A CAD lncRNA-miRNA-mRNA network was constructed which included 15 mRNAs, 3 miRNAs, 19 edges and one lncRNA. Nomogram showed that four ncRNAs were the risk of CAD. After RT-PCR validation in four ncRNAs between CAD and non-CAD samples, only three ncRNAs had significant meaning for further analysis. ROC curve showed that TWF1 presented an area under curve (AUC) of 0.862, the AUC of hsa -miR-142-3p was 0.856 and hsa -miR126-5p was 0.822. After the pairwise comparison, we found that TWF1 had significant statistical significance (P TWF1-142 < 0.05 and P TWF1-126 < 0.01). The results of functional enrichment analysis of interacting gene and microRNA showed that the shared lncRNA TWF1 may be a new factor for CAD. CONCLUSIONS: This investigation on the regulatory networks of lncRNA-miRNA-mRNA in CAD suggests that a novel lncRNA, lncRNA TWF1 is a risk factor for CAD, and expands our understanding into the mechanisms involved in the pathogenesis of CAD.

Different effects of ozone and aqueous ammonia in a combined pretreatment method on rice straw and dairy manure fiber for enhancing biomethane production.

Low digestibility of lignocellulosic feedstock is the most important limitation for biogas production. The synergistic effects of ozone and aqueous ammonia (OSAA) on different types of lignocelluloses including rice straw and dairy manure fiber were investigated. OSAA significantly increased biogas production of rice straw by 114.2%-172.8% when compared with using ozonation alone, while increased by 6.2%-8.8% with manure fiber. OSAA pretreatment increased biogas production of manure fiber by 55.3%-103.6% when compared with soaking aqueous ammonia (SAA) alone, while by 28.8%-39.9% with rice straw. The specific effects of pretreatment time on anaerobic digestion of manure fiber differed noticeably from those on rice straw. Ozonation time had a major function for pretreatment of manure fiber via the OSAA process, but SAA pretreatment time was more important than that for rice straw.

Integrated DNA methylation and gene expression analysis in the pathogenesis of coronary artery disease.

To evaluate DNA methylation sites and gene expression associated with coronary artery disease (CAD) and the possible pathological mechanism involved, we performed (1) genome-wide DNA methylation and mRNA expression profiling in peripheral blood datasets from the Gene Expression Omnibus repository of CAD samples and controls; (2) functional enrichment analysis and differential methylation gene regulatory network construction; (3) validation tests of 11 differential methylation positions of interest and the corresponding gene expression; and (4) correlation analysis for DNA methylation and mRNA expression data. A total of 669 differentially expressed mRNAs were matched to differentially methylated genes. After disease ontology, Kyoto Encyclopedia of Genes and Genomes pathway, gene ontology, protein-protein interaction and network construction and module analyses, 11 differentially methylated positions (DMPs) corresponding to 11 unique genes were observed: BDNF - cg26949694, BTRC - cg24381155, CDH5 - cg02223351, CXCL12 - cg11267527, EGFR - cg27637738, IL-6 - cg13104385, ITGB1 - cg20545410, PDGFRB - cg25613180, PIK3R1- cg00559992, PLCB1 - cg27178677 and PTPRC - cg09247619. After validation tests of 11 DMPs of interest and the corresponding gene expression, we found that CXCL12 was less hypomethylated in the CAD group, whereas the relative expression of ITGB1, PDGFRB and PIK3R1 was lower in CAD samples, and CXCL12 and ITGB1 methylation was negatively correlated with their expression. This study identified the correlation between DNA methylation and gene expression and highlighted the importance of CXCL12 in CAD pathogenesis.

Structure screening and performance restoration of chiral separation materials based on chitosan derivatives.

In order to screen chiral selector structure and find structure-property relationship, ten chitosan 3,6-bis(phenylcarbamate)-2-(cyclopropylformamide)s were synthesized from which corresponding chiral stationary phases were prepared. Enantioseparation capability and mobile phase tolerability of the chiral stationary phases were evaluated. The chiral selectors with 3-chloro-4-methylphenyl, 4-chlorophenyl, 3-chlorophenyl, 3,5-dichlorophenyl and 4-trifluoromethoxyphenyl groups demonstrated powerful enantioseparation capability. Enantioseparation capability was found to be dependent on a match between the substituent at C2 and the one attached to phenyl group at C3/C6 of glucose unit in the chitosan derivatives. Moreover, the tolerability tests revealed that the developed chiral stationary phases were highly tolerable to pure ethyl acetate, pure acetone and n-hexane/tetrahydrofuran of various ratios. In addition, n-hexane/tetrahydrofuran was found to be a modifier to adjust suprastructure of the chitosan derivatives, resulting in an improvement or restoration in enantioseparation. This observation implies n-hexane/tetrahydrofuran may make a damaged chiral selector restore its enantioseparation capability.

[Prevalence and Genetic Analysis of ß-Thalassemia in Neonates in Wuhan Area of China].

OBJECTIVE: To investigate the ß-thalassemia genotypes in neonates in Wuhan area of China and their characteristics of molecular epidemiology. METHODS: A total of 2721 neonates in Wuhan who were positive in primary screening for ß-thalassemia were included in this study. Genotypes of ß-thalassemia gene were determined with PCR-flow cytometry and fluorescence hybridization assay. RESULTS: There were 537 cases of ß-thalassemia with over 15 kinds of genotypes, and 19 cases of α-composite ß-thalassemia with 8 genotypes. Thalassemia minor appeared mostly in ß-thalassemia, including 229 cases of IVS-2-654/N (42.64%), 121 cases of CD41-42/N (22.53%), 76 cases of CD17/N.(14.15%), 39 cases of CD26/N (7.26%) and 27 cases of CD27-28/N (5.03%) and the total ratio reached to 91.62%, however, 1 case of thalassemia intermediate was -29/IVS-2-654, and the genotype of 2 cases of thalassemia major was CD27-28/IVS-2-654 and CD41-42/IVS-2-654. The mutation frequency of IVS-2-654, CD41-42 and CD17 was higher in ß-thalassemia, as follows: 42.93%, 22.36% and 14.13%, respectively. CONCLUSION: ß-Thalassemia minor is the majority of the neonants thalassemia in Wuhan area. The gene frequency of deletion type, such as IVS-2-654/N, CD41-42/N and CD17/N, is higher.

An Ultrasensitive Colorimetric Strategy for Detection of Cadmium Based on the Peroxidase-like Activity of G-Quadruplex-Cd(II) Specific Aptamer.

We rationally designed an ultrasensitive and label-free sensing platform for determination of cadmium (Cd). The sensing platform contains G-quadruplex-Cd(II) specific aptamer (GCDSA) constructed by incorporating G-rich sequence at the end of 5' and the critical domain of the Cd-4 aptamer. GCDSA designed act as both a special recognition sequence for Cd2+ and a signal DNAzyme. In absence of Cd2+, GCDSA may mainly exist in a random coil sequence. Upon addition of Cd2+, GCDSA could probably be induced to fold into a G-quadruplex structure. The generation of plentiful active G-quadruplex interacts with hemin to form a peroxidase-like DNAzyme, leading to increased absorbance signal of the sensing system. ΔA was directly proportional to the two segments of concentrations for Cd2+, with the detection of limit of 0.15 nM. The proposed method avoids the labeled oligonucleotides and allows directly quantitative analysis of the samples by cheap instruments, with an excellent dynamic range.

Identification of ß-Sitosterol as in Vitro Anti-Inflammatory Constituent in Moringa oleifera.

ß-Sitosterol is a well known phytosterol in plants, but owing to its poor solubility in typical media, determining its cellular mechanisms has been proven to be difficult. In this study, we investigated the anti-inflammatory activity of ß-sitosterol (BSS) isolated from Moringa oleifera in two cell lines. Over a dose range of 7.5 to 30 µM, BSS dispersed well in the medium as nanoparticles with diameters of 50 ± 5 nm and suppressed the secretion of inflammatory factors from keratinocytes and macrophages induced by PGN, TNF-α, or LPS, such as TNF-α, IL-1ß, IL-6, IL-8, and ROS, separately. In addition, BSS significantly reduced the expression of NLRP3, a key component of NLRP3 inflammasomes, and inhibited the activation of caspase-1. There was partial inhibition of NF-κB in macrophages. This is the first study to report an increase in the solubility of nearly water-insoluble phytosterols via the formation of nanoparticles and to delineate the formulation's capacity to inhibit the signal transduction pathways of inflammation in macrophages.

Delayed total hip arthroplasty after failed treatment of acetabular fractures: an 8- to 17-year follow-up study.

BACKGROUND: Delayed total hip arthroplasty (THA) is a reliable procedure following failed treatment of acetabular fractures. The aim of the present study was to evaluate the influence of the type of fracture treatment and modern ceramic bearing on the clinical outcomes of delayed THA. METHODS: Between January 1997 and January 2008, 33 patients (33 hips) underwent cementless THA after failed acetabular fractures. Twenty-one were initially treated by open reduction internal fixation (ORIF) and 12 had non-ORIF. Joint articulation was either conventional metal-on-polyethylene (MOP) or ceramic-on-ceramic (COC). Intraoperative measures and preoperative and follow-up clinical, radiological, and functional outcomes were compared between the ORIF and non-ORIF groups. RESULTS: Surgery duration, blood loss, and transfusion requirement were greater in the ORIF group than in the non-ORIF group (p < 0.05). Significant improvement in Harris Hip Scores was seen post-surgery in both groups. However, a significant difference in the mean Harris Hip Score was not observed between the two groups (p = 0.57). Six patients in the ORIF group required acetabular reconstructive procedures to address bony defects compared to seven patients in the non-ORIF group (p = 0.09). The rate of anatomical restoration was 58.3% (7/12) in the non-ORIF group and 42.9% (9/21) in the ORIF group (p = 0.12). Radiolucent lines were observed in the MOP group and none in the COC group. Overall survival rate was similar in both groups (p = 0.85): 89.3% in the ORIF group and 87.5% in the non-ORIF group. CONCLUSION: Delayed THA with previous acetabular fractures is a challenging procedure. Initial fracture treatment does not influence the outcome of delayed THA, and modern ceramic bearing has promising results in the long-term follow-up.

Novel combined method of biosorption and chemical precipitation for recovery of Pb2+ from wastewater.

A novel combined biosorption-precipitation process has been designed and applied to recycle Pb2+ from low concentration lead containing wastewater. Pb2+ was firstly removed selectively from wastewater by pyromellitic dianhydride (PMDA) modified sugarcane bagasse (SB) fixed-bed column, and then, it was desorbed into the concentrated eluate and recycled by adding chemical precipitant. Adsorption performance of the column and optimum desorption and precipitation condition for Pb2+ were investigated in detail. Results showed that the as-prepared column could efficiently remove Pb2+ from aqueous solution and optimum condition for Pb2+ precipitation in eluate was at pH 3.0 and molar ratio of precipitant to Pb2+ of 5:1 by using Na3PO4 as precipitant. Recovery experiment illustrated that Pb2+ was selectively removed from wastewater containing ions of Pb2+, Zn2+, Cd2+, Ca2+, K+, and Na+ through competitive substitution adsorption on the modified SB, and mass ratio of the five metal ions in eluate was 96.8:0.7:0.7:0.7:0.5:0.5. Pb2+ in this concentrated and purified eluate solution was recycled efficiently by adding Na3PO4. The combined method had great potential in application of heavy metal recovery from wastewater.