Three different patellar fixation techniques yield similar clinical and radiological outcomes in recurrent patellar dislocation undergoing medial patellofemoral ligament reconstruction.

PURPOSE: The purpose of this study was to evaluate and compare the clinical and radiological outcomes of three different patellar fixation techniques on medial patellofemoral ligament reconstruction (MPFLR) in the treatment of patellar dislocation (PD). METHODS: Between 2015 and 2020, 130 patients with recurrent PD who underwent surgical reconstruction were eligible for this retrospective study: 48 patients were treated with the semi-tunnel bone bridge fixation technique (Group A), 42 patients were treated with the suture anchor fixation technique (Group B) and 40 patients were treated with the transpatellar tunnel fixation technique (Group C). Clinical outcomes included functional outcomes (Kujala, Lysholm and International Knee Documentation Committee scores), activity levels (Tegner activity score and return to sports), physical examinations, patellar re-dislocation rate and complications. Radiological outcomes included patellar congruence angle, patellar tilt angle, lateral patellar translation and lateral patellar angle. RESULTS: All clinical and radiological outcomes improved significantly in all groups, without any significant difference among these three groups. At the final follow-up, no re-dislocation occurred, and all groups achieved a successful return to sports. However, the semi-tunnel bone bridge and suture anchor fixation techniques showed statistically higher Tegner activity scores (p = 0.004) and shorter time from surgery to return to sports (p = 0.007) than the transpatellar tunnel fixation technique. CONCLUSION: The three MPFLR patellar fixation techniques achieved favourable and comparable clinical and radiological outcomes in the treatment of PD. Compared with the transpatellar tunnel fixation technique, the semi-tunnel bone bridge and suture anchor fixation techniques may be more effective with higher activity levels. LEVEL OF EVIDENCE: Level III.

Decreased femoral trochlea axial orientation corrected by derotational distal femur osteotomy in patients with patellar dislocation yields satisfactory outcomes.

PURPOSE: The femoral trochlea axial orientation has been shown to be a better predictor of patellar dislocation than the femoral anteversion angle. However, no study has investigated the importance of the femoral trochlea axial orientation in the surgical treatment of patellar dislocation. It is aimed to explore the pathological threshold of the femoral trochlea axial orientation and its guiding implications for surgical interventions in the study. METHODS: Sixty-four patients with patellar dislocation and 64 controls were included for measurement of the femoral trochlea axial orientation. The ability to predict the patellar dislocation and the pathologic threshold of the femoral trochlea axial orientation were evaluated using the receiver operating characteristic curve. One hundred patients with medial patellofemoral ligament reconstruction and 25 patients with derotational distal femur osteotomy were divided into two groups based on the femoral trochlea axial orientation cut-off value and their postoperative knee functions, and patellar tilt angles were compared. RESULTS: There were significant differences in the femoral trochlea axial orientation (60.8 ± 7.9 vs. 67.8 ± 4.6, p < 0.05) between patients with patellar dislocation and the normal population. The sensitivity and specificity of the femoral trochlea axial orientation were 0.641 and 0.813, respectively, at the femoral trochlea axial orientation smaller than 63.8°. Amongst patients having had isolated medial patellofemoral ligament reconstruction with decreased femoral trochlea axial orientation, knee function was poorer after surgery. The prognosis of patients with the femoral trochlea axial orientation correction in derotational distal femur osteotomy was better than that for patients without correction. CONCLUSIONS: The femoral trochlea axial orientation had good predictive efficiency for patellar dislocation. Isolated medial patellofemoral ligament reconstruction is not sufficiently effective for patients with patellar dislocation and decreased femoral trochlea axial orientation. Patients with a decreased femoral trochlea axial orientation can have better surgical outcomes after correction by derotational distal femur osteotomy. LEVEL OF EVIDENCE: Level III.

Insight into the role of multiple signaling pathways in regulating cancer stem cells of gynecologic cancers.

Mounting evidence has demonstrated that a myriad of developmental signaling pathways, such as the Wnt, Notch, Hedgehog and Hippo, are frequently deregulated and play a critical role in regulating cancer stem cell (CSC) activity in human cancers, including gynecologic malignancies. In this review article, we describe an overview of various signaling pathways in human cancers. We further discuss the developmental roles how these pathways regulate CSCs from experimental evidences in gynecologic cancers. Moreover, we mention several compounds targeting CSCs in gynecologic cancers to enhance the treatment outcomes. Therefore, these signaling pathways might be the potential targets for developing targeted therapy in gynecologic cancers.

Age at menarche and metabolic dysfunction-associated fatty liver disease: Evidence from a large population-based epidemiological study in Southwest China.

BACKGROUND: The relationship between age at menarche and metabolic dysfunction-associated fatty liver disease remains largely not clear. The objective of this study was to examine the association between age at menarche (AAM) and metabolic dysfunction-associated fatty liver disease (MAFLD) in Chinese women and whether any observed associations were mediated by early adulthood adiposity. METHODS: The cross-sectional study included 46,873 Chinese women, aged 30-79 from baseline data of the China Multi-Ethnic Cohort study. Logistic regression models were used to evaluate the association between AAM and MAFLD. Mediation analysis was adopted to examine whether early adulthood adiposity (around 25 years) mediated the association between AAM and MAFLD. RESULTS: AAM was linearly and inversely associated with the risk of MAFLD (P for nonlinearity =0.743). In a multivariable-adjusted model, the odds ratios and 95% confidence interval (ORs (95% CI)) for MAFLD comparing menarche at <12, 12, 13, 15, 16, 17, ≥18 years to menarche at 14 years were 1.290 (1.082-1.537), 1.172 (1.068-1.285), 1.042 (0.960-1.131), 0.937 (0.861-1.020), 0.911(0.835-0.994), 0.868 (0.786-0.959), and 0.738 (0.670-0.814), respectively (P for trend <0.001). The 6.4% increased MAFLD risk was associated with each preceding year in AAM. The association between AAM and MAFLD was modified by age, ethnicity, and menopause. Early adulthood adiposity partially mediated this association. CONCLUSION: The findings of this study suggest that obesity prevention strategies are needed from young adulthood in women who undergo early menarche to reduce the risk of MAFLD.

Methane hydrate phase equilibrium considering dissolved methane concentrations and interfacial geometries from molecular simulations.

Natural gas hydrates, mainly existing in permafrost and on the seabed, are expected to be a new energy source with great potential. The exploitation technology of natural gas hydrates is one of the main focuses of hydrate-related studies. In this study, a large-size liquid aqueous solution wrapping a methane hydrate system was established and molecular dynamics simulations were used to investigate the phase equilibrium conditions of methane hydrate at different methane concentrations and interfacial geometries. It is found that the methane concentration of a solution significantly affects the phase equilibrium of methane hydrates. Different methane concentrations at the same temperature and pressure can lead to hydrate formation or decomposition. At the same temperature and pressure, in a system reaching equilibrium, the size of spherical hydrate clusters is coupled to the solution concentration, which is proportional to the Laplace pressure at the solid-liquid interface. Lower solution concentrations reduce the phase equilibrium temperature of methane hydrates at the same pressure; as the concentration increases, the phase equilibrium temperature gradually approaches the actual phase equilibrium temperature. In addition, the interfacial geometry of hydrates affects the thermodynamic stability of hydrates. The spherical hydrate particles have the highest stability for the same volume. Through this study, we provide a stronger foundation to understand the principles driving hydrate formation/dissociation relevant to the exploitation of methane hydrates.

The larger patellar tilt angle and lower intercondylar notch angle might increase posterior cruciate ligament injury risk: a retrospective comparative study.

BACKGROUND: Posterior cruciate ligament (PCL) injuries are common ligament injuries of the knee, and previous studies often focused on the associations between the morphology of the knee and PCL injuries. Studies on the correlation between PCL injuries and patellofemoral alignment are limited. METHODS: This retrospective study included 92 patients with PCL injured and 92 patients with PCL intact. Measurement parameters were compared between the two groups, including patellar tilt angle, congruence angle, patellar height, hip-knee-ankle angle, lateral trochlear inclination, femoral condyle ratio, bicondylar width, intercondylar notch width and index, notch angle, trochlear facet asymmetry, and trochlear sulcus depth and angle. Independent risk factors associated with PCL injuries were identified by logistic regression analyses. RESULTS: In the PCL injured group, the patellar tilt angle was significantly larger (13.19 ± 5.90° vs. 10.02 ± 4.95°, P = 0.04); the intercondylar notch angle was significantly lower (60.97 ± 7.83° vs. 67.01 ± 6.00°, P = 0.004); the medial and lateral femoral condyle ratio were significantly larger (0.63 ± 0.64 vs. 0.60 ± 0.56, P = 0.031; 0.65 ± 0.60 vs. 0.58 ± 0.53, P = 0.005) than in the PCL intact group. There were 11 patients with patellar dislocation in the PCL injured group, accounting for 12%. In these patients, the patellar height was higher (1.39 ± 0.17 vs. 1.09 ± 0.25, P = 0.009); the trochlear sulcus angle was larger (157.70 ± 8.7° vs. 141.80 ± 8.78°, P < 0.001); and the trochlear sulcus depth was shallower (3.10 ± 1.20mm vs. 5.11 ± 1.48mm, P = 0.003) than those in the patients without patellar dislocation. Multivariate analyses showed that patellar tilt angle (each increase 1 degree, OR = 1.14) and intercondylar notch angle (each increase 1 degree, OR = 0.90) were independent risk factors for PCL injuries. CONCLUSION: The patients with PCL injuries had larger patellar tilt angles, lower intercondylar notch angles, and longer posterior femoral condyles than patients with PCL intact. The larger patellar tilt angle and lower intercondylar notch angle might be risk factors for PCL injuries.

Predicting the Probability of Recurrence Based on Individualized Risk Factors After Primary Lateral Patellar Dislocation Treated Nonoperatively.

PURPOSE: To develop a comprehensive and effective personalized scoring system on the basis of demographic and clinical characteristics for predicting recurrence probability in patients with primary lateral patellar dislocation (LPD). METHODS: Participants included 261 primary patients with LPD with 2-year minimum follow-up from our hospital across 2013 to 2020. Demographic and clinical characteristics were collected retrospectively. The backward stepwise method was performed to identify independent predictors and construct a nomogram to predict the probability of recurrence. The predictive performance was assessed by receiver operating characteristic curves, calibration plots, and decision curve analysis. RESULTS: After variables selection, 6 independent predictors of recurrence (skeletal maturity, trochlear dysplasia, tibial tuberosity-trochlear groove distance, mechanical axis deviation, Insall-Salvati index, and patellar tilt) were enrolled in our model. Validation of this nomogram in both training and validation cohort revealed powerful predictive ability, with an area under the curve of 0.962 and 0.977, respectively. The nomogram also showed great calibration and good clinical practicability. CONCLUSIONS: Our study presented a nomogram that incorporates 6 independent risk factors (skeletal maturity, trochlear dysplasia, tibial tuberosity-trochlear groove distance, mechanical axis deviation, Insall-Salvati index, and patellar tilt), which can be conveniently used to accurately predicts the risk of recurrence after primary LPD in individual cases. LEVEL OF EVIDENCE: Level III, retrospective comparative prognostic study.

Axial orientation of the femoral trochlea is superior to femoral anteversion for predicting patellar instability.

PURPOSE: The femoral anteversion angle is considered to be the same as femoral torsion; however, the femoral anteversion angle is strongly influenced by the femoral posterior condylar morphology. It remains unclear whether the femoral anteversion angle and axial orientation of the femoral trochlea can predict patellar instability. This study aimed to redefine the femoral inherent torsion, verify whether the femoral anteversion angle reflects the femoral inherent torsion, and compare the validity and calculate the cut-off values of the femoral anteversion angle and femoral trochlear axial orientation for predicting patellar instability. METHODS: Seventy-three patients with patellar instability and 73 matched controls underwent computed tomography to measure the femoral anteversion angle, femoral inherent torsion, and femoral trochlear axial orientation. Pearson's product moment correlation coefficients and linear regression were calculated to determine correlations between measurements. Receiver operating characteristic curves and nomograms were plotted to evaluate the predictive validity of the femoral anteversion angle and femoral trochlear axial orientation for patellar instability. RESULTS: All measurements showed excellent intra- and inter-observer reliability. Compared with the control group, the patellar instability group had a significantly larger femoral anteversion angle (25.4 ± 6.4° vs. 20.2 ± 4.5°) and femoral inherent torsion (18.3 ± 6.7° vs. 15.8 ± 3.4°), and significantly smaller femoral trochlear axial orientation (58.1 ± 7.3° vs. 66.9 ± 5.1°). The femoral anteversion angle and femoral trochlear axial orientation had area under the receiver operating characteristic curve values of 79 and 84%, respectively, and cut-off values of 24.5° and 62.7°, respectively. The calibration curve and decision curve analysis showed that the femoral trochlear axial orientation performed better than the femoral anteversion angle in predicting patellar instability. There was a strong correlation between the femoral anteversion angle and femoral inherent torsion (r > 0.8). Linear regression analysis of the femoral inherent torsion with the femoral anteversion angle as the prediction variate showed moderate goodness-of-fit (adjusted R2 = 0.69). CONCLUSION: The femoral anteversion angle moderately reflects the femoral inherent torsion. The femoral trochlear axial orientation is better than the femoral anteversion in predicting patellar instability in terms of predictive efficiency, consistency with reality, and net clinical benefit. These findings warn orthopaedists against overstating the role of the femoral anteversion angle in patellar instability, and suggest that the femoral trochlear axial orientation could aid in identifying at-risk patients and developing surgical strategies for patellar instability. LEVEL OF EVIDENCE: III.

Capturing Hassles and Uplifts in Adolescents' Daily Lives: Links with Physical and Mental Well-Being.

Despite the salient impacts of daily experiences, scarce research has measured various daily minor experiences and evaluated their influences on adolescent well-being in their daily life. This study assessed the exposure to multiple aspects of daily hassles and uplifts in adolescents' daily lives, and examined the links between the level, types, and diversity of these exposures and adolescents' daily physical and mental well-being. Ninety-nine adolescents (12-17 years old, M = 14.6, 51.5% White, 53.5% female) completed a 30-day daily diary study. Multilevel modeling revealed different associations between the level and types of daily hassles and uplifts and adolescent well-being on the same day. Experiencing diverse daily hassles was linked with more emotional problems, and experiencing diverse daily uplifts was related with lower negative affect. The findings underscore the importance of including level, types, and diversity of both daily hassles and uplifts in research to better characterize adolescents' daily experiences. The findings also highlight the concurrent and potential cumulative effects of daily minor social events and mundane experiences in adolescent development in their daily lives.

Effects of ice and supercooled water on the metastability of methane hydrate: DSC analysis and MD simulations.

Methane hydrate (MH) has been viewed as a potential abundant clean energy resource worldwide. Its related technologies play important roles in applications of gas and energy storage, flow assurance of natural gas pipelines etc. Unlike the well-researched stability and decomposition of MH at temperatures above 273 K, the metastability of MH below the ice freezing point, i.e. the anomalous slow decomposition out of thermodynamically stable regions, remains to be unravelled. Studies regarding the influences of ice and supercooled water (SW) on the metastable properties of MH led to varied conclusions, i.e. the as-proposed self-preservation effect and metastable MH-SW-gas equilibrium. In this study, a series of DSC experiments were performed to investigate the thermal stability boundaries and the associated metastable behaviours of MH-ice-gas and MH-SW-gas samples in porous medium. The DSC analysis probed accurate thermal stabilities and characterized decomposition behaviors of the samples, contributing to the hypothesis of potential influences from SW and ice on the metastability of MH. MD simulations were also validated and performed. Active guest-host interactions by the SW layers between MH and gas phases were identified, suggesting probable microscopic configurations related to the metastability of the MH-SW-gas system. Indications of the DSC and MD simulation results call for future high-resolution in situ experimental validations.

A Multi-Sensor Data-Fusion Method Based on Cloud Model and Improved Evidence Theory.

The essential factors of information-aware systems are heterogeneous multi-sensory devices. Because of the ambiguity and contradicting nature of multi-sensor data, a data-fusion method based on the cloud model and improved evidence theory is proposed. To complete the conversion from quantitative to qualitative data, the cloud model is employed to construct the basic probability assignment (BPA) function of the evidence corresponding to each data source. To address the issue that traditional evidence theory produces results that do not correspond to the facts when fusing conflicting evidence, the three measures of the Jousselme distance, cosine similarity, and the Jaccard coefficient are combined to measure the similarity of the evidence. The Hellinger distance of the interval is used to calculate the credibility of the evidence. The similarity and credibility are combined to improve the evidence, and the fusion is performed according to Dempster's rule to finally obtain the results. The numerical example results show that the proposed improved evidence theory method has better convergence and focus, and the confidence in the correct proposition is up to 100%. Applying the proposed multi-sensor data-fusion method to early indoor fire detection, the method improves the accuracy by 0.9-6.4% and reduces the false alarm rate by 0.7-10.2% compared with traditional and other improved evidence theories, proving its validity and feasibility, which provides a certain reference value for multi-sensor information fusion.

Application of the health action process approach model for reducing excessive internet use behaviors among rural adolescents in China: a school-based intervention pilot study.

OBJECTIVE: There are few studies regarding Internet use behaviors of Chinese rural adolescents based on behavioral theory. The aim of this study is to examine the applicability and effectiveness of the health action process approach model (HAPA) in the intervention of excessive Internet use behaviors among rural adolescents in China. METHODS: Three hundred twenty-seven participants who met the excessive Internet use criteria were involved in this study. Four interventions based on the HAPA model were conducted during 2015-2017. The structural equation model (SEM) was applied to fit the HAPA model. RESULTS: The rate of average daily time spent online on weekends more than 4 h dropped from 57.2 to 39.1% (P < 0.001). The rate of daily game time more than 2 h decreased from 51.1 to 35.2% (P < 0.001). The result of SEM showed that both the applicability and effectiveness of the HAPA model were well in the intervention of excessive Internet use behaviors with good fitted indicators (χ2/df = 2.066, GFI = 0.889, CFI = 0.938, TLI = 0.928, IFI = 0.938, RMSEA = 0.057). The direct and indirect effects of the main pathways in the HAPA model were statistically significant (P < 0.05). The comparison analysis of HAPA model variables identified that outcome expectancy, intention, maintenance self-efficacy had been improved significantly after interventions. CONCLUSION: The intervention measures based on the HAPA model can effectively reduce excessive Internet use behaviors of Chinese rural adolescents, mainly through strengthen outcome expectancy, intention, and maintenance self-efficacy.

Deformation Assessment of the Manually Pre-Bent Titanium Miniplates in Orthognathic Surgery With Finite Element Analysis.

ABSTRACT: This study summarized the literature regarding the application of pre-bent titanium miniplates in orthognathic surgery and evaluated the extra deformation of the manually pre-bent titanium miniplates via finite element analysis for acquiring higher surgical accuracy. The literature was reviewed with a chart. Three models of titanium miniplates with different thicknesses (1.0 mm, 0.8 mm, 0.6 mm) were created using COMSOL Multiphysics software for biomechanical behavior analysis. The 3 models were virtually bent into 5 angles (15 degree, 30 degree, 45 degree, 60 degree, 80 degree). respectively to simulate the preoperative virtual bending, then to simulate the practical manual bending via finite element analysis. The stresses and displacements of these models were recorded. The models from virtual bending simulation and manual bending simulation were registered to analyze the deviations. The results showed that the maximum stress and the displacement deviations between the virtual bending models and the manual bending models increased with the thickness and bending angle of the pre-bent miniplate models. To improve the surgical accuracy, measures should be applied to the manually pre-bent titanium miniplates to reduce the extra deformation when the plate being thicker and the bending angle being larger.

Osteogenesis Differences Around Titanium Implant and in Bone Defect Between Jaw Bones and Long Bones.

The aim of this study is to evaluate the osteogenesis around titanium implant and in bone defect or fracture in jaw bones and long bones in ovariectomized (OVX) animal models. The literature on the osteogenesis around titanium implant and in bone defect or fracture in jaw bones and long bones was reviewed with charts. Fourty-eight rats were randomly divided into OVX group with ovariectomy and SHAM (sham-surgery) group with sham surgery. Titanium implants were inserted in the right mandibles and tibiae; bone defects were created in the left mandibles and tibiae. Two-week postoperatively, mandibles and tibiae of 8 rats were harvested and examined by hematoxylin and eosin staining and histological analysis; 4-week postoperatively, all mandibles and tibiae were harvested and examined by Micro-CT and histological analysis. A total of 52 articles were included in this literature review. Tibial osteogenesis around titanium implant and in bone defect in OVX group were significantly decreased compared with SHAM group. However, osteogenesis differences in the mandible both around titanium implant and in bone defect between groups were not statistically significant. OVX-induced osteoporosis suppresses osteogenesis around titanium implant and in the bone defect or fracture in long bones significantly while has less effect on that in the jaw bones.

Lidocaine sensitizes the cytotoxicity of cisplatin in breast cancer cells via up-regulation of RARß2 and RASSF1A demethylation.

It has been reported that lidocaine is toxic to various types of cells. And a recent study has confirmed that lidocaine exerts a demethylation effect and regulates the proliferation of human breast cancer cell lines. To recognize a potential anti-tumor effect of lidocaine, we evaluated the DNA demethylation by lidocaine in human breast cancer lines, MCF-7 and MDA-MB-231 cells, and determined the influence of demethylation on the toxicity to these cells of cisplatin, which is a commonly utilized anti-tumor agent for breast cancer. Results demonstrated that lidocaine promoted a significant global genomic demethylation, and particularly in the promoters of tumor suppressive genes (TSGs), RARß2 and RASSF1A. Further, the lidocaine treatment increased cisplatin-induced apoptosis and enhanced cisplatin-induced cytotoxicity. The combined treatment with both lidocaine and cisplatin promoted a significantly higher level of MCF-7 cell apoptosis than singular lidocaine or cisplatin treatment. Moreover, the abrogation of RARß2 or RASSF1A expression inhibited such apoptosis. In conclusion, the present study confirms the demethylation effect of lidocaine in breast cancer cells, and found that the demethylation of RARß2 and RASSF1A sensitized the cytotoxicity of cisplatin in breast cancer cells.

A Dynamical Systems Investigation of the Co-regulation between Perceived Daily Parental Warmth and Adolescent Attention-deficit/hyperactivity Disorder Symptoms.

Longitudinal research demonstrates that child ADHD symptoms and behaviors exhibit reciprocal associations with parenting behaviors over time. However, minimal research has investigated these associations and their dynamic links at the daily level. Intensive longitudinal data can disentangle stable between-person differences from within-person fluctuations and reveal nuanced short-term family dynamics on a micro timescale. Using 30-day daily diary data from a community sample of 86 adolescents (Mage = 14.5, 55% female, 56% White, 22% Asian) and latent differential equation modeling, this study examined the links between perceived daily parental warmth and ADHD symptoms as coupled dynamical systems. The results show that the magnitude of fluctuations in perceived daily parental warmth generally remains stable, while elevated ADHD symptoms return to their normal level over time. Perceived parental warmth is sensitive to change in ADHD symptoms such that adolescents feel that their parents will fine-tune their warmth with gradual changes when adolescents demonstrate heightened symptoms. There are substantial between-family differences in these regulating system dynamics. Among families with more baseline parental non-harsh discipline, both perceived parental warmth and ADHD symptoms tend to be more stable and fluctuate less often. Intensive longitudinal data and dynamical systems approaches offer a new lens to uncover short-term family dynamics and adolescent adjustment at a refined micro level. Future research should explore antecedents and consequences of between-family differences in these short-term family dynamics on multiple timescales.

Intelligent algorithm based on deep learning to predict the dosage for anesthesia: A study on prediction of drug efficacy based on deep learning.

Background and Aims: Anesthetic drugs play a vital role during surgery, however, due to individual differences and complex physiological mechanisms, the prediction of anesthetic drug dosage has always been a challenging problem. In this study, we propose a model for predicting the dosage of anesthetic drugs based on deep learning to help anesthesiologists better control their dosage during surgical procedures. Methods: We design a model based on the artificial neural network to predict the dosage of preoperative anesthetic, and use the SELU activation function and the loss function for weighted regularization to solve the problem of unbalanced sample. Moreover, we design a CNN-based model for the prior extraction of intraoperative features by using a 7 × 1 convolution kernel to enhance the receptive field, and combine maximum pooling and average pooling to extract key features while eliminating noise. A predictive model based on the LSTM network is designed to predict the intraoperative dosage of the anesthetic, and the bidirectional propagation-based LSTM network is used to improve the ability to learn the trend of changes in the physiological states of the patient during surgery. An attention module is added before the connection layer to appropriately attend to areas containing prominent features. Results: The results of experiments showed that the proposed method reduced values of the MAPE to 15.83% and 12.25% compared with the traditional method in predictions of the preoperative and intraoperative doses of the anesthetic, respectively, and increased the values of R2 to 0.887 and 0.915, respectively. Conclusion: The intelligent anesthesia prediction algorithm designed in this study can effectively predict the dosage of anesthetic drugs needed by patients, assist clinical judgment of anesthetic drug dose, and assist the anesthesiologists to ensure the smooth progress of the operation.

LATS1/YAP1 Axis Controls Bone Regeneration on Distraction Osteogenesis by Activating Wnt/ß-Catenin.

The Hippo signaling pathway inhibits cell growth, and its components and functions are highly conserved in mammals. LATS1 is a core component of the Hippo signaling pathway associated with lymphatic invasion, astrogliosis, apoptosis, and autophagy. Nevertheless, the role of Hippo/LATS1 in osteogenesis remains unclear. In this study, we used ribonucleic acid (RNA) lentiviruses to inhibit the expression of Lats1 in bone marrow-derived stem cells (BMSCs) and distraction osteogenic regions in rats. Increased osteogenic, proliferative, and migratory abilities of BMSCs were observed in Lats1-inhibited BMSCs, while these phenotypes were partially reversed by YAP1 inhibition. In vivo, we found that the LATS1/YAP1 axis promoted osteogenesis during distraction osteogenesis (DO). ß-catenin was positively correlated with YAP1 expression in vivo and in vitro. When YAP1 was strongly positive in the nucleus, ß-catenin expression was upregulated; when YAP1 expression was inhibited by verteporfin, ß-catenin was not expressed in the nucleus. These findings suggest that the LATS1/YAP1 signaling axis promotes DO by activating the Wnt/ß-catenin signaling pathway. This study provides insights into the molecular mechanism of osteogenesis and a potential therapeutic strategy for bone regeneration in DO by associating with LATS1/YAP1-ß-catenin.

Reliability of Tibial Tubercle-Trochlear Groove Distance for Assessing Tibial Tubercle Lateralization: A Study Comparing Different Anatomic References.

Background: The tibial tubercle-trochlear groove (TT-TG) distance is a measurement used to quantitatively assess tibial tubercle lateralization (TTL), and it has important reference value for the treatment of patellar dislocation (PD). However, TT-TG distance accuracy has been questioned, so many new parameters have been proposed. Purpose: To compare which of the TT-TG, tibial tubercle-midepicondyle (TT-ME), tibial tubercle-Roman arch (TT-RA), tibial tubercle-tibial intercondylar midpoint (TT-TIM), and tibial tubercle-mid inter-epicondyle trochlea intersection (TT-MIELTI) distances better reflect TTL in patients with PD. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: A total of 96 patients who had undergone surgery for PD and 96 patients without PD (controls) were included in the study. The patients had all undergone computed tomography examination. The TT-TG, TT-ME, TT-RA, TT-TIM, TT-MIELTI distances and the TTL distance were measured independently by 2 surgeons in a blinded and randomized fashion. The t test was used to detect whether the parameters were significantly different between the 2 groups. The TTL distance was used as a reference value for lateralization of tibial tubercle. Pearson correlation coefficients were calculated to determine correlations between the defined measurements. Results: The intra- and interobserver reliability of the defined measurements was excellent. All parameters except for TT-TIM distance were significantly larger in the PD group than the control group (P < .01 for all). There was a moderate correlation (r = 0.601) between the TT-TG distance and TTL, and other parameters were less correlated with TTL. Conclusion: Among 5 the parameters tested, the TT-TG distance still had the highest correlation with TTL and was able to reflect TTL better in patients with PD. The role of TT-TIM distance in the assessment of PD needs further study.

TP508 Promotes Bone Regeneration on Distraction Osteogenesis via the Activation of Wnt/ß-catenin Signaling Pathway.

INTRODUCTION: TP508 is a thrombin peptide that participates in the inflammatory response and wound healing. Its role in the molecular mechanism of distraction osteogenesis remains unclear. This study established a tibia distraction osteogenesis (DO) model in rats and investigated the role and mechanism of TP508 in bone regeneration during DO. METHOD: Micro-computed tomography (Micro-CT) and hematoxylin-eosin (HE) staining were used to track osteogenesis. Western blot and quantitative real-time polymerase chain reaction (qRT-PCR) were performed to measure the expression of osteoblast-related factors, Wnt/ß- catenin signaling-related proteins and genes. Immunohistochemistry was used to measure the expression of ß-catenin in the cytoplasm and nucleus. TP508 accelerated bone regeneration increased the expression of the osteoblast-related factors Alkaline phosphatase (ALP), runt-related transcription factor 2 (RUNX2), and osteocalcin (OCN). RESULTS: After the Wnt signaling was inhibited by LGK974, the expression of osteoblast-related factors was downregulated, leading to a decrease in bone regeneration ability. More importantly, TP508 upregulated ß-catenin and its target CYCLIN-D1 and could reverse the decreased osteogenic ability caused by LGK974. CONCLUSION: In conclusion, TP508 promotes bone regeneration in DO by activating the Wnt/ß- catenin signaling pathway.