Emerging diabetes therapies: Regenerating pancreatic ß cells.

The incidence of diabetes mellitus (DM) is steadily increasing annually, with 537 million diabetic patients as of 2021. Restoring diminished ß cell mass or impaired islet function is crucial in treating DM, particularly type 1 diabetes mellitus (T1DM). However, the regenerative capacity of islet ß cells, which primarily produce insulin, is severely limited, and natural regeneration is only observed in young rodents or children. Hence, there is an urgent need to develop advanced therapeutic approaches that can regenerate endogenous ß cells or replace them with stem cell (SC)-derived or engineered ß-like cells. Current strategies for treating insulin-dependent DM mainly include promoting the self-replication of endogenous ß cells, inducing SC differentiation, reprogramming non-ß cells into ß-like cells, and generating pancreatic-like organoids through cell-based intervention. In this Review, we discuss the current state of the art in these approaches, describe associated challenges, propose potential solutions, and highlight ongoing efforts to optimize ß cell or islet transplantation and related clinical trials. These effective cell-based therapies will generate a sustainable source of functional ß cells for transplantation and lay strong foundations for future curative treatments for DM.

In-situ generation of iron activated percarbonate for sustainable sludge dewatering.

Effective dewatering of sewage sludge could potentially address the issues of high energy consumption and large carbon footprint inherent in the sludge treatment process, advancing toward carbon neutrality in environmental remediation. Yet, the surface hydrophilic characteristics and water-holding interfacial affinity in sludge led to dwindled sludge-water separation performance. Here, the integration of in-situ generation of iron from zero-valent scrap iron (ZVSI) and sodium percarbonate (SPC) was attempted to attenuate the water-retaining interfacial affinity within sludge, thus achieving superior sludge dewatering performance. Results showed that under the optimal conditions, the ZVSI + SPC system led to a remarkable decline of 76.09 % in the specific resistance to filtration of the sludge, accompanied by a notable decline of 34.96 % in the water content. Moreover, the utilization of ZVSI + SPC system could be a viable alternative to the traditional strategies in terms of enhanced sludge dewaterability, offering application potential with stable operating performance, economic feasibility, and reduced carbon emissions. Investigation into dewatering mechanism revealed that ZVSI could maintain the Fe3+/Fe2+ in a stable dynamic cycle and continuously in-situ generate Fe2+, thereby efficaciously fostering the SPC activation for the ceaseless yield of reactive oxygen species. The predominant •OH and 1O2 efficiently decomposed the hydrophilic biopolymers, therefore minimizing the hydrophilic protein secondary structures, along with the hydrogen and disulfide bonds within proteins. Subsequently, the water-holding interfacial affinity was profoundly diminished, leading to intensified hydrophobicity, self-flocculation, and dewaterability. These findings have important implications for the advancement of efficacious ZVSI + SPC conditioning techniques toward sustainable energy and low-carbon prospects.

Genetic liability to frailty in relation to functional outcome after ischemic stroke.

BACKGROUND: Frailty appears to be associated with unfavorable prognosis after stroke in observational studies, but the causality remains largely unknown. AIMS: The aim of this study is to investigate the potential causal effect of frailty on functional outcome at 3 months after ischemic stroke using the Mendelian randomization (MR) framework. METHODS: Genetic instruments for frailty index were identified in a genome-wide association study meta-analysis including 175,226 individuals of European descent. Corresponding genetic association estimates for functional outcome after ischemic stroke at 90 days were taken from the Genetic of Ischemic Stroke Functional Outcome (GISCOME) network of 6021 patients. We performed inverse-variance weighted MR as the main analyses, followed by several alternate methods and sensitivity analyses. RESULTS: In univariable MR, we found evidence that genetically predicted higher frailty index (odds ratio (OR) = 5.12; 95% confidence interval (CI) = 1.31-20.09; p = 0.019) was associated with worse functional outcome (modified Rankin Scale score ⩾3) after ischemic stroke. In further multivariable MR adjusting for potential confounding traits including body mass index, C-reactive protein, inflammatory bowel disease, and smoking initiation, the overall patterns between genetic liability to frailty and poor functional outcome status remained. Sensitivity analyses with complementary methods and with model unadjusted for baseline stroke severity (OR = 4.19; 95% CI = 1.26-13.90; p = 0.019) yielded broadly concordant results. CONCLUSIONS: The present MR study suggested a possible causal effect of frailty on poor functional outcome after ischemic stroke. Frailty might represent a potential target for intervention to improve recovery after ischemic stroke.

Iron-rich digestate biochar toward sustainable peroxymonosulfate activation for efficient anaerobic digestate dewaterability.

In this study, a suite of Fe-rich biochars derived from Fenton-like treated digestate (Fe-BC) were fabricated under different pyrolysis temperatures (300, 500, and 800 °C), which were firstly utilized as peroxymonosulfate (PMS) activators for promoting digestate dewaterability with wide applicability. Results showed that compared to the Fe-BC300/Fe-BC500 + PMS treatments, Fe-BC800 + PMS process performed superior digestate dewaterability in which specific resistance to filtration reduction and water content reduction improved by > 12.5% and > 130%, respectively, under the optimal conditions. Mechanistic results demonstrated that in Fe-BC800 + PMS system, HO• and SO4•- oxidation played a pivotal role on promoted digestate dewaterability, while HO• and 1O2 oxidation was dominated in Fe-BC300/Fe-BC500 + PMS treatments. Fe-BC800 containing higher Fe and CO contents could efficiently interact with PMS to generate numerous HO• and SO4•- via iron cycle. These highly reactive oxygen species proficiently reduced the hydrophilic biopolymers, protein molecules, and amino acids in extracellular polymeric substances, leading to remarkable decrease in particle size, hydrophilicity, adhesion, network strength, and bound water of digestate. Consequently, the flowability and dewaterability of digestate could be significantly enhanced. The cost-benefit result indicated the Fe-BC + PMS treatment possessed desirable reusability, applicability, and economic viability. Collectively, the Fe-BC + PMS is a high-performance and eco-friendly technique for digestate dewatering, which opens a new horizon towards a closed-loop of digestate reutilization.

Impact of total solids content on biochar amended co-digestion of food waste and sludge: Microbial community dynamics, methane production and digestate quality assessment.

This study evaluates the impact of biochar addition on the performance of anaerobic co-digestion of food waste (FW) and sewage sludge at different total solids (TS) contents (2.5 %, 5.0 %, and 7.5 %). Biochar co-digestion improved hydrolysis and acidogenesis by neutralizing volatile fatty acids (VFAs) reducing its inhibitions (2.6-fold removal), which elevated the soluble chemical oxygen demand (sCOD) degradation by 2.5 folds leading to a higher cumulative methane production compared to the control. This increase corresponded to an improvement of methane yields by ∼21 %-33 % (242-340 mL/gVSadd) at different TS contents. The biochar surface area offered substantial support for direct interspecies electron transfer (DIET) activity, and biofilm-mediated growth of methanogens i.e., Methanosarcina, Methanosata, and Methanobrevibacter. The biochar-enriched digestate improved the seed germination index, and bioavailability of plant nutrients such as N, P, K, and NH4+-N. This study reports an improved biochar-mediated anaerobic co-digestion for efficient and sustainable FW valorization.

Protrudent electron transfer channels on kaolinite modified iron oxide QDs/N vacancy graphitic carbon nitride driving superior catalytic oxidation.

Optimizing electron transfer channels and sufficiently exposing active sites to trigger an efficient Fenton-like reaction are vital for manipulating catalytic properties of water treatment. Herein, Fe2O3 quantum dots were prepared and integrated with composites of g-C3N4 and kaolinite with nitrogen (N) vacancies (FONGK-10) for bisphenol A (BPA) removal in a peroxymonosulfate (PMS)/visible light (Vis) system. X-ray absorption near-edge structures and extended X-ray absorption fine structures demonstrated interface's combined properties. In particular, the tight interfacial contact and introduction of N vacancies resulted in the formation of effective electron channels, which caused more effective separation of electron-hole pairs and an extended response time of 1.5 × 10-4 s. Furthermore, the introduction of kaolinite reduced the Fe2O3 particle size and accelerated PMS consumption. The k value in FONGK-10/PMS/Vis system was 4.5 times that of the FONGK-10/PMS and 27.5 times that of the FONGK-10/Vis system, and the synergetic system exhibited superior consecutive catalytic performance in a fluidized-bed catalytic unit, degrading ~100% of BPA in 200 min. The exposed electron channels significantly maintained the Fe(III)/Fe(II) stable dynamic cycle, thereby enhancing the activation of PMS and photocatalysis performance.

Iron-based advanced oxidation processes for enhancing sludge dewaterability: State of the art, challenges, and sludge reuse.

The increasing amount of sewage sludge produced in wastewater treatment plants (WWTPs) poses a great challenge to both environment and economy globally. As a requisite process during sludge treatment, sludge dewatering can significantly minimize the sludge volume and lower the operational cost for downstream transportation and disposal. Iron-based advanced oxidation process (AOP), a robust and cost-effective technique with relatively low technical barriers for high-level sludge dewatering, has been widely explored in the past 20 years. The development was mainly driven by the demands of efficient and sustainable sludge conditioning technology and the flexible sludge management approaches. The application of iron-based AOPs in sludge dewatering process attracts more and more attention. In this work, we discussed the current application of iron-based AOPs technology in the sludge dewatering processes in a holistic manner, summarized the factors affecting the sludge dewaterability in the treatment processes, and analyzed the mechanisms of iron-based AOPs to improve dewatering processes. Furthermore, we elaborated potential advantages, limitations, and challenges associated with implementing iron-based AOPs in the full-scale plants and shared the opportunities for sludge reutilization. This review aims to contribute to the development of highly efficient iron-based AOPs for sludge dewatering and offer perspectives and directions towards the new-generation of WWTPs with the sustainable and eco-friendly benefits.

High-efficiency treatment of electroless nickel plating effluent using core-shell MnFe2O4-C@Al2O3 combined with ozonation: Performance and mechanism.

Heterogeneous catalytic ozonation (HCO) has been widely applied for the treatment of wastewater. In order to maintain the structural stability and surface catalytic activity of heterogeneous catalysts during the HCO treatment of electroless nickel plating effluent (ENPE), a MnFe2O4-C@Al2O3 catalyst with a core-shell structure was synthesized. MnFe2O4-C@Al2O3 was characterized and applied in the removal of total nickel (TNi) and organic contaminants from actual ENPE, using a coupled system of HCO combined with a magnetic dithiocarbamate chelating resin (MnFe2O4-C@Al2O3/O3-MDCR). Results show that embedding Al2O3 with C and MnFe2O4 significantly increased the TNi removal efficiency (99.3%), enhanced the O3-utilization efficiency and improved the generation of reactive oxygen species (ROS). The reaction rate (k = 0.7641 min-1) and O3-utilization efficiency established for TNi removal (ΔTNi/ΔO3 =0.221) by the MnFe2O4-C@Al2O3/O3-MDCR system, were 220% and 140% higher than the Al2O3/O3-MDCR system, respectively. Catalytic mechanism analysis demonstrated that surface hydroxyl groups, oxygen vacancy, metals, the carbon surface and its functional groups, can all potentially serve as catalytic active sites, with 1O2 and •OH considered to the predominant ROS. Overall, these findings verify that the synthesized MnFe2O4-C@Al2O3 catalyst possesses excellent catalytic capabilities and outstanding structural stability, making it suitable for practical application in the treatment of wastewater effluent.

Feasibility of reduced iron species for promoting Li and Co recovery from spent LiCoO2 batteries using a mixed-culture bioleaching process.

The recovery of metals from spent LiCoO2 batteries (SLBs) is essential to avoid resource wastage and the production of hazardous waste. However, the major challenge in regard to recovering metals from SLBs using traditional bioleaching is the low Co yield. To overcome this issue, a mixed culture of Acidithiobacillus caldus and Sulfobacillus thermosulfidooxidans was designed for use in SLBs leaching in this study. With the assistance of Fe2+ as a reductant, 99% of Co and 100% of Li were leached using the above mixed-culture bioleaching (MCB) process, thus solving the problem of low metal leaching efficiency from SLBs. Analysis of the underlying mechanism revealed that the effective extraction of metals from SLBs by the Fe2+-MCB process relied on Fe2+-releasing electrons to reduce refractory Co(III) to Co(II) that can be easily bioleached. Finally, the hazardous SLBs was transformed into a non-toxic material after treatment utilizing the Fe2+-MCB process. However, effective SLBs leaching was not achieved by the addition of Fe0 to the MCB system. Only 25% Co and 31% Li yields were obtained, as the addition of Fe0 caused acid consumption and bacterial apoptosis. Overall, this study revealed that reductants that cause acid consumption and harm bacteria should be ruled out for use in reductant-assisted bioleaching processes for extracting metals from SLBs.

Boosting Nitrogen Reduction to Ammonia on FeN4 Sites by Atomic Spin Regulation.

Understanding the relationship between the electronic state of active sites and N2 reduction reaction (NRR) performance is essential to explore efficient electrocatalysts. Herein, atomically dispersed Fe and Mo sites are designed and achieved in the form of well-defined FeN4 and MoN4 coordination in polyphthalocyanine (PPc) organic framework to investigate the influence of the spin state of FeN4 on NRR behavior. The neighboring MoN4 can regulate the spin state of Fe center in FeN4 from high-spin (dxy 2 dyz 1 dxz 1 d z 2 1 d x 2 - y 2 1 ) to medium-spin (dxy 2 dyz 2 dxz 1 d z 2 1 ), where the empty d orbitals and separate d electron favor the overlap of Fe 3d with the N 2p orbitals, more effectively activating N≡N triple bond. Theoretical modeling suggests that the NRR preferably takes place on FeN4 instead of MoN4 , and the transition of Fe spin state significantly lowers the energy barrier of the potential determining step, which is conducive to the first hydrogenation of N2 . As a result, FeMoPPc with medium-spin FeN4 exhibits 2.0 and 9.0 times higher Faradaic efficiency and 2.0 and 17.2 times higher NH3 yields for NRR than FePPc with high-spin FeN4 and MoPPc with MoN4 , respectively. These new insights may open up opportunities for exploiting efficient NRR electrocatalysts by atomically regulating the spin state of metal centers.

Promoting anaerobic co-digestion of sewage sludge and food waste with different types of conductive materials: Performance, stability, and underlying mechanism.

In this research, we investigated and compared the effects of three widely used conductive materials, e.g., zero-valent iron (Fe0), magnetite (Fe3O4), and biochar on the performance, stability, and in-depth mechanism during the anaerobic co-digestion process of sewage sludge and food waste. Among the three conductive materials, Fe0 could achieve the highest cumulative methane production of 394.0 mL/g volatile solids (VS) added, which was 1.24-fold and 1.17-fold higher than that receiving Fe3O4 and biochar. The mechanistic studies indicated that compared to the Fe3O4 and biochar groups, Fe0 could significantly enhance the release of soluble protein, polysaccharide, and dissolved organic matters, the degradation of volatile fatty acids and VS, and the activities of key enzymes and direct interspecies electron transfer (DIET). Consequently, the methane yield and digestate dewaterability were notably improved. Collectively, these findings will offer suggestions of the preferable conductive materials in the anaerobic co-digestion process for decision makers.

Bioleaching for detoxification of waste flotation tailings: Relationship between EPS substances and bioleaching behavior.

The production of large volumes of waste flotation tailings results in environmental pollution and presents a major ecological and environmental risk. This study investigates bioleaching of waste flotation tailings using Acidithiobacillus ferrooxidans. The experiments were performed with 5.00% solid concentration, pH 2.0 with 100 mL medium for 25 d in the lab. The pH, OPR, metal concentration, dissolved organic matter (DOM) in leachate and extracellular polymeric substances (EPS) were recorded. Bioleaching tailing materials were finally characterized. Results showed that microorganisms, acclimating with mine tailings, effectively accelerated the bioleaching process, achieving maximum Zn and Fe extraction efficiencies of 95.45% and 83.98%, respectively, after 25 days. Compared with raw mine tailings, bioleaching could reduce 96.36% and 95.84% leachable Zn and Pb, and Pb presented a low risk (4.13%), while Zn, Cu, and Cr posed no risk (0.34%, 0.64%, and 0%). Toxicity and environmental risk analysis revealed bioleaching process significantly reduced the environmental risk associated with mine tailings. EPS analysis indicated that the loosely-bound EPS (LB-EPS) and tightly-bound EPS (TB-EPS) fractions contained different organic substances, which played different roles in the bioleaching process. Pearson correlation analysis revealed that EPS was highly correlated with bioleaching behavior (p < 0.05), and EPS was the main factor affecting the bioleaching process, promoting bioleaching in the LB-EPS and TB-EPS fractions.

Effects of delayed hip replacement on postoperative hip function and quality of life in elderly patients with femoral neck fracture.

BACKGROUND: For various reasons, some elderly patients with femoral neck fracture undergo delayed surgical treatment. There is little information about the effect of delayed treatment on postoperative hip function and quality of life. The aim of this study was to investigate the effect of delayed hip arthroplasty on hip function, quality of life, and satisfaction in patients with femoral neck fractures. METHODS: Forty-seven patients with femoral neck fracture and hip replacement delayed over 21 days served as the delayed group (D group). Patients with femoral neck fracture, matched 1:1 for age and sex, and hip replacement within 7 days served as the control group (C group). The Harris hip score (HHS) and health-related quality of life (HRQoL) were assessed before surgery and 3 months, 6 months and 1 year postoperatively. The satisfaction questionnaires were completed by the patients themselves at the last follow-up. RESULTS: The HHS in the C group was lower than that in the D group (32.64 ± 9.11 vs. 46.32 ± 9.88, P < 0.05) before surgery but recovered faster after surgery. The HHS in the D group was lower than that in the C group 1 year postoperatively (85.2 ± 3.80 vs. 89.8 ± 3.33, P < 0.05). The patients' quality of life changed similarly to their HHS. The HHS 1 year after surgery was related to the preoperative HHS in group D (rs = 0.521, P < 0.01). Patients in the D group showed significantly higher satisfaction scores than those in the C group (P < 0.05). CONCLUSIONS: Hip function in patients with femoral neck fracture surgery delayed over 21 days recovered more slowly than that in those who underwent surgery within 7 days. However, they were more satisfied with the surgery. Moderate hip movement to ameliorate the lower limb muscle atrophy was recommended for patients facing a temporary inability to undergo surgery.

Genetic correlations and causal inferences in ischemic stroke.

BACKGROUND AND PURPOSE: Considerable studies have reported inconsistent relationships between ischemic stroke and a large number of factors. These uncertainties may reflect the susceptibility to confounding in observational studies. We aimed to assess genetic correlations and causal relationships between ischemic stroke and diverse phenotypes. METHODS: Summary-level data for ischemic stroke (34,217 cases and 406,111 controls) from the MEGASTROKE consortium were used as the outcome. Exposures were derived from two GWAS statistics curated databases. We explored the genetic correlations and causalities between hundreds of traits and ischemic stroke, using linkage disequilibrium score regression and Mendelian randomization (MR), respectively. Multiple sensitivity analyses were also performed. RESULTS: Genetic correlation analyses reflected genetic overlaps between ischemic stroke and physical activity, cardiometabolic factors, smoking, and lung function. Applying MR, we found suggestive evidence that genetic predisposition to higher concentration of low-density lipoprotein particles (LDL.P) and cholesterol carried in different sizes of LDL.P (LDL.C) were associated with higher risk of ischemic stroke, particular large artery stroke. The strongest effect was observed for small LDL.P in large artery stroke (OR 1.31, 95% CI 1.09-1.56, p = 0.003). The results were overall robust for sensitivity analyses. We further observed significant positive associations of genetically predicted LDL.P and LDL.C with coronary artery disease and myocardial infarction. CONCLUSIONS: Shared genetic overlaps might exist between ischemic stroke and physical activity, cardiometabolic factors, smoking, and lung function. We provided suggestive evidence for a potential causal role of LDL.P and LDL.C in ischemic stroke, particularly in large artery stroke. Future researches are required to confirm these findings.

High-level waste activated sludge dewaterability using Fenton-like process based on pretreated zero valent scrap iron as an in-situ cycle iron donator.

A novel, recyclable, and rapid pre-ultrasound-thermal-acid-washed zero valent scrap iron/hydrogen peroxide (UTA-ZVSI/H2O2) method has been developed to effectively enhance waste activated sludge (WAS) dewaterability. The effects of UTA ultrasound densities, UTA temperature, newly generated iron solution, H2O2 concentrations, and WAS conditioning time on the WAS dewaterability were investigated using a bench-scale system. Results indicated that the UTA-ZVSI/H2O2 treatment significantly improved the WAS dewaterability. The water content of the dewatered cake decreased to 44.15 ± 0.98 wt% during optimal operational conditions, which was significantly lower than that achieved using Fenton-based processes. Based on this outcome, a three-step treatment mechanism involving UTA-ZVSI/H2O2 has been developed, including iron flocculation, hydroxyl radical oxidation, and skeleton building. The dewatering efficiencies of three types of representative WAS were consistently effective in the UTA-ZVSI/H2O2 reactor for up to 15 cycles. Efficiencies levels were significantly higher than those achieved with Fenton-based processes. Economic analysis illustrated that the developed UTA-ZVSI/H2O2 system was the most cost-effective among other WAS dewatering treatments. In addition, the treatment system significantly alleviated toxicity of heavy metals and phytotoxicity in the dewatered sludge. This supported subsequent agricultural use. In summary, this study provided a comprehensive and useful basis for improving WAS dewatering and subsequent disposal.

Mechanism of zero valent iron and anaerobic mesophilic digestion combined with hydrogen peroxide pretreatment to enhance sludge dewaterability: Relationship between soluble EPS and rheological behavior.

This study proposed a novel two-step conditioning strategy to enhance activated sludge (AS) dewatering performance. The method involved a zero valent iron (ZVI), anaerobic mesophilic digestion (AMD) process, and hydrogen peroxide (H2O2) oxidation. Response surface methodology (RSM) was applied to achieve optimum dewatering conditions. After the combined conditioning, dewatering was significantly better in the treated sludge compared to the raw AS. The specific resistance of filtration (SRF) of the treated sludge decreased to 2.48 × 1011 m/kg; this SRF level was 93.60% lower compared to the raw AS. The bound water content (BWC) decreased to 1.19 g/g dry solid (DS); this BWC level was 15.2% lower compared to the raw AS. The water content of the treated sludge cake decreased to 44.18 ± 0.46%. An economic analysis shows that ZVI-AMD-H2O2 can be used in real-world settings. Investigations of the underlying mechanisms showed that small block structures were formed after conditioning; viscosity and the colloidal forces of the sludge decreased; and organic matter and BWC were released from inner extracellular polymeric substances (EPS) layers to form soluble (SB)-EPS. This study illuminated the relationship between SB-EPS and the rheological behavior of AS. There is a high correlation coefficient between rheological parameter τy and N-containing substances in SB-EPS (R = -0.993, p < 0.05). The ZVI-AMD-H2O2 process effectively changed the EPS content, especially protein materials. This led to a decrease in AS viscosity and an increase in sludge dewaterability.

[Effect of pneumatic tourniquet on perioperative blood loss in total knee arthroplasty].

OBJECTIVE: To evaluate the effect of pneumatic tourniquet on perioperative period of total knee arthroplasty (TKA). METHODS: The perioperative period data of 116 patients over 60 years old with severe knee osteoarthritis treated with TKA between January 2018 and January 2019 were retrospectively analyzed. According to whether pneumatic tourniquet was used during operation, the patients were divided into trial group (49 cases, pneumatic tourniquet was not used during operation) and control group (67 cases, pneumatic tourniquet was used during operation). There was no significant difference in gender, age, body mass index, lesion side, disease duration, and preoperative hemoglobin between the two groups ( P>0.05). The operation time, actual total blood loss, overt blood loss, hidden blood loss, and percentage of hidden blood loss, knee swelling at 3 days after operation, and range of motion of knee at 2 weeks after operation were recorded and compared between the two groups. RESULTS: The operation time of the trial group was significantly longer than that of the control group ( t=14.013, P=0.000). The actual total blood loss, hidden blood loss, and percentage of hidden blood loss in the trial group were significantly lower than those in the control group ( P<0.05); there was no significant difference in the overt blood loss between the two groups ( t=-1.293, P=0.200). The knee swelling degree in the trial group was significantly slighter than that in the control group at 3 days after operation, and the range of motion of knee in the trial group was significantly better than that in the control group at 2 weeks after operation ( P<0.05). CONCLUSION: Pneumatic tourniquet can reduce the operation time of TKA significantly. However, it may increase the hidden blood loss and knee swelling, and negatively impact the recovery of knee function in the early postoperative stage of TKA.

[Effectiveness of open wedge high tibial osteotomy on medial unicompartmental knee osteoarthritis].

Objective: To evaluate the effectiveness of open wedge high tibial osteotomy (OWHTO) in treatment of medial unicompartmental knee osteoarthritis (MUKOA). Methods: A clinical data of 61 cases with MUKOA who were treated with OWHTO between January 2015 and January 2017 were retrospectively analyzed. There are 14 males and 47 females with an average age of 52.8 years (mean, 44-60 years). The body mass index ranged from 19.1 to 34.7 kg/m 2 (mean, 25.3 kg/m 2). Twenty-seven cases were left side and 34 cases were right side. The disease duration was 1-9 years (mean, 5.3 years). The MUKOA was rated as stage Ⅱ in 33 cases and stage Ⅲ in 28 cases. Preoperative Hospital for Special Surgery (HSS) score was 56.0±3.7. Walking visual analogue scale (VAS) score was 4.6±1.0. Results: The operation time was 49-85 minutes (mean, 66.5 minutes). The length of incision was 10-13 cm (mean, 11.0 cm). The total overt blood loss was 80-210 mL (mean, 139.1 mL). The postoperative bed-rest time was 1-10 days (mean, 4.7 days). All patients were followed up 12-24 months (mean, 17.3 months). The bearing area of tibial platform at 3 months after operation was 60.3%-66.8%, with an average of 63.4%. At 3 and 6 months after operation, the HSS score was 79.1±4.2 and 85.3±3.1 respectively, and the VAS score was 1.7±0.7 and 0.6±0.5 respectively, all showing significant differences ( P<0.05). Conclusion: OWHTO is an ideal choice for treating MUKOA with less postoperative complications. The force line could be corrected by OWHTO. However, the preoperative preparations are very important, especially that the open angle should be measured accurately.

Interleukin 1ß attenuates vascular α1 adrenergic receptors expression following lipopolysaccharide-induced endotoxemia in rabbits: involvement of JAK2-STAT3 pathway.

BACKGROUND: Studies have shown that interleukin 1ß (IL-1ß) participates in the down-regulation of vascular reactivity via both nitric oxide-dependent and nitric oxide-independent mechanisms during shock. However, the precise mechanisms of nitric oxide-independent pathway remain to be established. METHODS: The effect of IL-1ß on the expression of α1 adrenergic receptors (α1AR) and the relationship with Janus kinase 2-signal transducer and activator of transcription 3 (JAK2-STAT3) pathway were observed using a rabbit model of lipopolysaccharide (LPS)-induced endotoxemia and superior mesenteric arteries (SMAs) in vivo and in vitro, respectively. RESULTS: The vascular reactivity of SMAs to α1AR agonist (phenylephrine) displayed a biphasic change after LPS (significantly increased at 0.5 hour following LPS and then markedly decreased after 2 hours), the α1A, α1B and α1DAR messenger RNA (mRNA) and protein expression seemed a time-dependent decrease following LPS administration, α1A and α1DAR decreased more obviously than α1BAR. IL-1ra (4 µg/mL) partly reversed LPS-induced the decrease of vascular reactivity and down-regulation of α1AR expression. In vitro incubation with IL-1ß (12.5-50 ng/mL) significantly decreased the vascular reactivity of SMA to phenylephrine and the expression of α1AR mRNA and protein and elevated the DNA binding ability of STAT3. AG490 (10 µmol/L), an inhibitor of JAK2, partly reversed the IL-1ß-induced down-regulation of vascular reactivity and α1AR mRNA and protein expression and suppressed the DNA binding ability of STAT3. CONCLUSION: IL-1ß participates in the regulation of vascular hyporeactivity following endotoxemia in rabbit. The mechanism is related to the down-regulation of α1AR expression through activating the JAK2-STAT3 pathway.