Demographic and radiographic factors for knee symptoms and range of motion in patients with knee osteoarthritis: a cross-sectional study in Beijing, China.

BACKGROUND: Knee osteoarthritis (KOA) causes not only pain, stiffness, and dysfunction of the knee, but also the reduction of the joint range of motion (ROM). This study explored the demographic and radiographic factors for knee symptoms and ROM in patients with symptomatic KOA. METHODS: The demographic variables, Kellgren-Lawrence (KL) grade, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) of patients with symptomatic KOA recruited in Beijing were collected. The knee ROM of all patients were also measured. We analyzed the influencing factors for WOMAC and ROM using a generalize linear model, respectively. RESULTS: This study included a total of 2034 patients with symptomatic KOA, including 530 males (26.1%) and 1504 females (73.0%), with a mean age of 59.17 (± 10.22) years. Patients with advanced age, overweight or obesity, a family history of KOA, a moderate-to-heavy manual labor job and use of nonsteroidal anti-inflammatory drugs (NSAIDs) had significantly higher WOMAC and lower ROM (all P < 0.05). The more the comorbidities, the higher the WOMAC (all P < 0.05). Patients with higher education had better ROM than those with only an elementary education(ß = 4.905, P < 0.05). Compared with those KL = 0/1, the WOMAC of patients whose KL = 4 were higher (ß = 0.069, P < 0.05), but the WOMAC of those KL = 2 were lower (ß = -0.068, P < 0.05). ROM decreased with the increase of KL grade (all P < 0.05). CONCLUSIONS: KOA patients with advanced age, overweight or obesity, a family history of KOA in first-degree relatives, a moderate-to-heavy manual labor job tended to have more severe clinical symptoms and worse ROM. Patients with more severe imaging lesions tend to have poorer ROM. Symptom management measures and regular ROM screening should be taken early to these people.

Tracking the Progression of the Simulated Bronze Disease-A Laboratory X-ray Microtomography Study.

The internal three-dimensional characteristics of X-ray microtomography (micro-CT) has great application potential in the field of bronze corrosion. This work presents a method of simulating bronze disease based on an in situ micro-CT image to study the characteristics of the oxidative hydrolysis reactions of copper(I) chloride and copper(II) chloride dihydrate. A series of high-resolution reconstruction images were obtained by carrying out micro-CT at three key points throughout the experiment. We found that the reactions of copper(I) chloride and copper(II) chloride dihydrate showed different characteristics at different stages of the simulation in the micro-CT view. The method proposed in this work specifically simulated one single type of bronze corrosion and characterized the evolution characteristics of simulated bronze disease. It provides a new perspective to investigate bronze disease and can help improve the subsequent use of micro-CT to distinguish real bronze corrosions.

Neoadjuvant endocrine therapy for strongly hormone receptor-positive and HER2-negative early breast cancer: results of a prospective multi-center study.

PURPOSE: For estrogen receptor (ER)-positive breast cancer, neoadjuvant endocrine therapy (NET) has been shown to be as effective as neoadjuvant chemotherapy (NACT). We evaluated the prognostic significance of Preoperative Endocrine Prognostic Index (PEPI). METHODS: We conducted a prospective, multi-center, non-randomized, controlled trial that enrolled postmenopausal early-stage strongly ER-positive (≥ 50%) and HER2-negative breast cancer patients. All patients were given 4-month NET before surgery. The primary objective was to investigate the 5-year recurrence-free survival (RFS) in patients who had PEPI 0-1 or pathological complete response (pCR) without chemotherapy. Patients who had PEPI 0-1 or pCR were recommended to receive adjuvant endocrine therapy only and patients had PEPI ≥ 2 may receive adjuvant chemotherapy at the discretion of the treating physician. RESULTS: A total of 410 patients were included and 352 patients constituted the per-protocol population. Overall, 9 patients (2.5%) had pCR (ypT0/is ypN0), 128 patients (36.4%) had PEPI = 0, and 56 patients (15.9%) had PEPI = 1. After a median follow-up of 60 months (4-104 months), patients who had PEPI 0-1 or pCR showed an improved 5-year RFS [99.5% (95% CI 98.5-99.9%) for PEPI 0-1 or pCR group vs. 93.7% (95% CI 89.6-97.8%) for PEPI ≥ 2 group, P = 0.028]. No survival difference was detected between patients received adjuvant chemotherapy vs. no chemotherapy among PEPI ≥ 2 cases. CONCLUSION: PEPI 0-1 or pCR may be used to define a group of ER-positive and HER2-negative postmenopausal early breast cancer patients with low relapse risk for whom adjuvant chemotherapy can be safely withheld. Studies on the identification and alternative treatment options for endocrine-resistant tumors are warranted. CLINICAL TRIAL REGISTRATION: NCT01613560.

Comparison of two techniques for the management of 2-3 cm lower pole renal calculi in obese patients.

OBJECTIVE: To compare the outcomes of mini percutaneous nephrolithotomy (mPNL) and retrograde intrarenal surgery (RIRS) for the management of 2-3 cm lower pole renal calculi (LPC) in obese patients. PATIENTS AND METHODS: 120 obese patients with 2-3 cm LPC were randomly divided into mPNL group and RIRS group. Demography, clinical characteristics, perioperative complications, and stone free rate (SFR) were recorded. Stone-free status means no stone on computed tomography 3 months after surgery, or residual fragments were less than 3 mm. RESULTS: Baseline characteristics were similar between the two groups. The mean stone burden was 585.39 ± 131.06 mm2 in the mPNL group and 548.64 ± 123.55 mm2 in the RIRS group (P = 0.125). The SFR of mPNL group was significantly better than that of RIRS group (86.2% vs 61.4%, P = 0.002). Besides, the overall complication rate was 22.4% in the mPNL group and 7% in the RIRS group (P = 0.02). Patients performed with mPNL required longer length of hospital stay than those with RIRS (P = 0.001). There were no significant differences in operative time and stone composition between the two groups. CONCLUSION: In our study, both mPNL and RIRS are safe and effective techniques for the treatment of 2-3 cm LPC in obese patients. Compared to RIRS, mPNL has better SFR at the expense of the higher incidence of complications and prolonged length of hospital stay.

Comparison of contrast-enhanced ultrasound versus conventional ultrasound-guided percutaneous nephrolithotomy in patients with nondilated collecting system: a randomized controlled trial.

OBJECTIVE: To compare the safety, effectiveness, and feasibility of contrast-enhanced ultrasound (CEUS) versus conventional ultrasound-guided percutaneous nephrolithotomy (PCNL) in patients with nondilated collecting system. METHODS: Between July 2018 and July 2020, 160 kidney stone patients with nondilated collecting system planned for PCNL were randomly assigned into two groups, CEUS with retrograde ureteral contrast injection and conventional ultrasound with retrograde ureteral normal saline injection. Patient's demographics, the success rate of puncture, success rate of a single-needle puncture, number of punctures, puncture time, perioperative outcomes, stone-free rate, and incidence of complications were compared. RESULTS: The success rate of a single-needle puncture for CEUS-guided PCNL was higher than that in the conventional ultrasound group (88.5% vs. 73.7%, p = 0.02). Patients performed with CEUS-guided PCNL required less needle passes (p = 0.02), shorter needle puncture time (p = 0.031), and shorter channel establishment time (p = 0.04) than those guided with conventional ultrasound. The postoperative hemoglobin decrease in the CEUS-guided PCNL group was less than that of the control group (p = 0.02). There was no significant difference in operating time, length of hospital stays, kidney function change, and complications between the two groups (p > 0.05). The 1-month stone-free rate was 94.9% in the CEUS group and 90.8% in the control group (p > 0.05). CONCLUSIONS: Compared with conventional ultrasound, CEUS-guided PCNL may facilitate ultrasound-guided PCNL for patients without hydronephrosis, and benefited with a higher success rate of a single-needle puncture, less needle passes, shorter puncture time, and lower postoperative Hb drop. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR1800016981 KEY POINTS: • Compared with conventional ultrasound, CEUS-guided PCNL is a safe and efficacious procedure for kidney stone patients with nondilated collecting system. • Compared with conventional ultrasound, CEUS-guided PCNL benefited with a higher success rate of a single-needle puncture, less needle passes, shorter puncture time, and lower postoperative Hb drop. • CEUS-guided PCNL associated with the more accurate needle puncture and acceptable complications.

Multi-Gaussian correlated Hankel-Bessel beam properties in anisotropic oceanic turbulence.

We introduce the model of a multi-Gaussian correlated Hankel-Bessel (MGCHB) beam generated by a multi-Gaussian Shell-model source and investigate the properties of the beam in anisotropic oceanic turbulence. Under Rytov approximation, the detection probability of the MGCHB beam and the channel capacity with MGCHB beams are derived; both the influence of oceanic turbulence and initial beam parameters on them are discussed by numerical simulations. The results show that the increase of the dissipation rate of kinetic energy per unit mass of fluid, the anisotropic coefficient, and the inner scale factor, as well as the decrease of the dissipation rate of mean-squared temperature and the temperature-salinity contribution ratio, can significantly improve the detection probability and the channel capacity. The results also indicate that the MGCHB beam is a better candidate than an Airy vortex beam for mitigating the influence of oceanic turbulence. Furthermore, smaller topological charge and larger orbital angular momentum modes number are beneficial to improve the detection probability and channel capacity, respectively. Moreover, the performance of the MGCHB beam with longer wavelength, smaller beam index, and larger transverse coherence width is conducive to enhancing the transmission quality through oceanic turbulence.

Calibration methods for VSCs measured on AS-TD-GC-SCD.

Volatile sulfur compounds (VSCs) are key odorous compounds from emissions of various odour sources because they are odorous and generally have very low odour threshold values. Identification and quantification of them through air server-thermal desorber-gas chromatography-sulfur chemiluminescence detector (AS-TD-GC-SCD) become more and more popular, although VSCs can be determined by other detectors. To find a valid, practical and quick calibration method is also an important step in their analytical processes. This study compared three different sample preparation and unity sampling methods using both gas standards (with 10 VSCs balanced in pure nitrogen gas) and liquid standards of 7 VSCs. For liquid standard sample preparation, two solvents (methanol and n-pentane) were tested and their calibration results were compared. The study revealed that the three calibration methods with both manual and dynamic dilution of VSC standard gases can achieve satisfactory calibration results with nice linear regression and correlation coefficient (r2). The dynamic dilution and loop sampling method is recommended because of its better reliability and time-saving processing. For calibration of VSCs with liquid standards, preparing the samples using dissolved VSCs in n-pentane and analysing them using the loop sampling method achieved best calibration results. For dimethyl trisulfide (DMTS), its calibration cannot obtain as good results as other sulfur compounds even using the best performance calibration method.

The role of cystoprostatectomy in management of locally advanced prostate cancer: a systematic review.

BACKGROUND: The role of cystoprostatectomy for the treatment of locally advanced prostate cancer (LAPC) was evaluated by a comprehensive review of contemporary literatures. METHODS: A systematic search of English language literatures using PubMed, EMBASE, Web of Science, and Cochrane library, from 1990 to 2018, was performed. Two independent authors reviewed abstracts as well as full-text articles and extracted data from the selected manuscripts. RESULTS: After the literature research, seven articles with a total of 211 patients were identified. Both 120 cases who received cystoprostatectomy for the primary treatment of LAPC and 91 cases for the salvage surgery after local recurrence were finally included. Overall incidence of positive surgical margins ranged from 25 to 78%. The incidence of major complications caused by the surgery during the follow-up time was limited. It had been reported that among LAPC patients who received cystoprostatectomy combined with adjuvant therapies, 5-year cancer-specific survival rate and 5-year biochemical progression-free survival was up to 87.1% and 62.2%. Moreover, symptoms such as hematuria and other urination dysfunctions, as well as patients' quality of life were significantly improved after cystoprostatectomy in LAPC patients with the bladder invasion. CONCLUSIONS: Cystoprostatectomy can serve as an alternative to the surgical step of multimodal therapy for highly selected LAPC patients with the bladder invasion, which may improve patients' symptoms and related quality of life. Therefore, cystoprostatectomy as an option for the treatment of LAPC with the bladder invasion may be feasible and safe with considerable survival outcomes.

Efficacy of pegfilgrastim to support neoadjuvant dose-dense epirubicin and cyclophosphamide chemotherapy in breast cancer.

PURPOSE: The role of long-acting hematopoietic growth factor in supporting dose-dense chemotherapy and minimizing hematologic toxicity has not been established. We investigated the efficacy and safety of once-per-cycle pegfilgrastim in breast cancer patients receiving neoadjuvant dose-dense epirubicin and cyclophosphamide (ddEC). METHODS: Newly diagnosed stage I to III breast cancer patients received four cycles of ddEC (E, 100 mg/m2 and C, 600 mg/m2 every 2 weeks) and 6 mg of subcutaneous pegfilgrastim on day 2 of each cycle. The primary endpoint was to evaluate the incidence of chemotherapy delay. Secondary endpoints include the incidences of febrile neutropenia (FN) and grade 3/4 neutropenia during the four ddEC cycles. RESULTS: A total of 240 patients were enrolled and 913 ddEC cycles were administered in the study. Chemotherapy delay occurred in 15 patients (6.3% of patients, 95% CI 3.2-9.4%) for 17 cycles (1.9% of cycles, 95% CI 1.0-2.8%). The most frequent cause of chemotherapy delay was transaminase elevation (10 patients, 12 cycles). A total of 12 patients (5.0%, 95% CI 2.2-7.8%) developed 13 episodes of FN. Of the 221 patients that completed four ddEC cycles with pegfilgrastim support, 209 patients (94.6%, 95% CI 91.6-97.6%) had a 100% relative dose intensity (RDI). A RDI ≥ 85% was achieved in 217 of 221 patients (98.2%, 95% CI 96.5-99.9%). Bone pain of any grade was recorded in 85 of 220 evaluable patients (38.6%, 95% CI 32.2-45.0%). CONCLUSIONS: Pegfilgrastim is effective and safe in facilitating four cycles of neoadjuvant ddEC, with low incidences of chemotherapy delay and febrile neutropenia.

Variations of odorous VOCs detected by different assessors via gas chromatography coupled with mass spectrometry and olfactory detection port (ODP) system.

Odorous volatile organic compounds (VOCs) were analysed via a thermal desorption gas chromatograph coupled with a mass spectrometer and olfactory detection port (TD-GC-MS/ODP) to characterize odour emissions from a wastewater treatment plant (WWTP). Three trained ODP assessors, screened according to the European dynamic olfactometry standard (EN: 13725), were used for the olfactory analysis. Their sensitivity to n-butanol varied within the acceptable limits. VOC samples from the WWTP were collected onto Tenax TA sorbent tubes in triplicate and each assessor analysed one tube in the same sample desorbing and analysing conditions. Intensities of odours detected from ODP were scaled from 1 to 4. The ODP assessors used their own odour descriptors based on their own experience as well as referenced descriptors on published compost and wastewater odour wheels. The ODP assessors detected a total of 32 different odorous VOCs; however, the intensities assigned by each assessor to particular VOCs varied. Moreover, some odorous VOCs were not detected by all assessors. For example, geosmin was detected by only two assessors. The use of a TD-GC-MS/ODP system for the analysis of odorous VOCs is valuable when analysed by different assessors, allowing a range of responses to specific odorants in a populations to be investigated.

Early prediction of pathological outcomes to neoadjuvant chemotherapy in breast cancer patients using automated breast ultrasound.

OBJECTIVE: Early assessment of response to neoadjuvant chemotherapy (NAC) for breast cancer allows therapy to be individualized. The optimal assessment method has not been established. We investigated the accuracy of automated breast ultrasound (ABUS) to predict pathological outcomes after NAC. METHODS: A total of 290 breast cancer patients were eligible for this study. Tumor response after 2 cycles of chemotherapy was assessed using the product change of two largest perpendicular diameters (PC) or the longest diameter change (LDC). PC and LDC were analyzed on the axial and the coronal planes respectively. Receiver operating characteristic (ROC) curves were used to evaluate overall performance of the prediction methods. Youden's indexes were calculated to select the optimal cut-off value for each method. Sensitivity, specificity, positive and negative predictive values (PPV and NPV) and the area under the ROC curve (AUC) were calculated accordingly. RESULTS: ypT0/is was achieved in 42 patients (14.5%) while ypT0 was achieved in 30 patients (10.3%) after NAC. All four prediction methods (PC on axial planes, LDC on axial planes, PC on coronal planes and LDC on coronal planes) displayed high AUCs (all>0.82), with the highest of 0.89 [95% confidence interval (95% CI), 0.83-0.95] when mid-treatment ABUS was used to predict final pathological complete remission (pCR). High sensitivities (85.7%-88.1%) were observed across all four prediction methods while high specificities (81.5%-85.1%) were observed in two methods used PC. The optimal cut-off values defined by our data replicate the WHO and the RECIST criteria. Lower AUCs were observed when mid-treatment ABUS was used to predict poor pathological outcomes. CONCLUSIONS: ABUS is a useful tool in early evaluation of pCR after NAC while less reliable when predicting poor pathological outcomes.

Efficacy of physical examination, ultrasound, and ultrasound combined with fine-needle aspiration for axilla staging of primary breast cancer.

The aim of this study was to compare the efficacy of physical examination (PE), ultrasound (US), and US combined with fine-needle cytology (US-FNAC) in evaluation of node status before sentinel lymph node biopsy (SLNB) for breast cancer patients. We performed a retrospective study of 3,781 breast cancer patients and calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for PE, US, and US-FNAC, respectively. A total of 3,175 cases were documented as cN0 and 606 as cN1. Abnormal axillary nodes under US were detected in 1,152 cases, among which 821 were proven to have positive nodes by FNAC. The positive FNAC results enabled 11.7% of cN0 patients (373/3,175) to avoid unnecessary SLNB. All 331 cases with abnormal US but negative FNAC results, and the 2,629 cases with normal US underwent SLNB procedure for nodal staging, and metastatic nodes were identified in 745 patients. The sensitivity of PE was 32.2%, with a specificity of 95.5%, a PPV of 83.5%, a NPV of 65%, and an accuracy of 69.3%. The sensitivity, specificity, PPV, NPV, and accuracy of axillary US alone were 58.6, 89.4, 79.6, 75.3, and 76.7%, respectively. Combining axillary US with FNAC resulted in sensitivity, specificity, PPV, NPV, and accuracy of 52.4, 100, 100, 74.8, and 80.3%, respectively. Our study demonstrated that US-FNAC is a feasible and effective triage during axillary staging for newly diagnosed breast cancer patients.

[Neoadjuvant chemotherapy using epirubicin, cyclophosphamide and fluorouracil: neutropenia and elevation of transaminase, and their management].

OBJECTIVE: To retrospectively investigate the incidence of severe neutropenia and elevation of transaminase during neoadjuvant chemotherapy using epirubicin, cyclophosphamide and fluorouracil in breast cancer patients. METHODS: From January 2011 to December 2012, 303 consecutive breast cancer patients with complete treatment data treated in our department were included in this analysis. All patients received neoadjuvant chemotherapy with equal dose of EPI (100 mg/m(2)) administered every 3 weeks for 4 cycles before surgery. RESULTS: 200 patients (66.0%) experienced at least one episode of grade 3/4 neutropenia/leukopenia, among them 176 patients experienced their first episode after the first cycle. Febrile neutropenia (FN) occurred in 13 patients for 14 episodes. Elevation of transaminase occurred in a total of 46 patients (15.2%), among them, grade 2 or higher elevation occurred in 15 patients (5.0%). Three blood test plans were adopted to monitor the patients during chemotherapy: (1) Routine blood count repeated every week; (2) Routine blood count before and on day 10 of each chemotherapy episode; (3) Routine blood count before and on day 7, 10 and 14 of each chemotherapy episode. The number of patients whose chemotherapy was delayed due to 3/4 neutropenia/leucopenia in each blood test plan was 3 (5.0%), 7 (3.9%) and 2 (3.2%), respectively. The number of patients with febrile neutropenia (FN) in each blood test plan was 2 (3.3%), 8 (4.4%) and 3 (4.8%), respectively. No statistically significant difference in treatment delay or the incidence of FN was observed among different blood test plans. No statistically significant difference in the incidence of grade 3/4 neutropenia/leukopenia or grade 2 or higher transaminase elevation was observed among different 5-Fu regimens. CONCLUSIONS: During neoadjuvant chemotherapy using FE100 C, Fci E100 C or E100 C for breast cancer patients without routine prophylactic G-CSF, the incidence of grade 3/4 neutropenia/leukopenia is 66.0%. With the patient management plan we adopted, 4.3% of patients developed febrile neutropenia. Prophylactic medication may not be necessary for patients without evident liver dysfunction.

Odour emission characteristics of 22 recreational rivers in Nanjing.

The odour emission characteristics of 22 recreational rivers in Nanjing were investigated and analysed. Eight odorous compounds (ammonia (NH3), hydrogen sulphide (H2S), sulphur dioxide (SO2), carbon disulphide (CS2), nitrobenzene (C6H5NO2), aniline (C6H5NH2), dimethylamine (C2H7N), and formaldehyde (HCHO)) were measured in odour emission samples collected using a custom-made emission flux hood chamber. The results showed that all odorants were detected in all monitoring rivers. NH3 was the main odorant, with emission rates ranging from 4.86 to 15.13 µg/min m(2). The total odour emission rate of the Nan River, at 1 427.07 OU/s, was the highest of the all investigated rivers. H2S, NH3 and nitrobenzene were three key odour emission contributors according to their contributions to the total odour emission. A correlation analysis of the pollutants showed there was a significant positive correlation between the emission rate of NH3 and the concentration of ammonia nitrogen (NH4 (+)-N) and total nitrogen (TN). The H2S and SO2 emission rates had a significant positive correlation with sulphides (S(2-)) and available sulphur (AS) in the water and sediment. The content of TN, NH4(+)-N, S(2-) and AS in the water and sediment affected the concentration of H2S, SO2 and NH3 in the emission gases. NH4(+)-N, S(2-) and AS are suggested as the key odour control indexes for reducing odours emitted from these recreational rivers. The study provides useful information for effective pollution control, especially for odour emission control for the recreational rivers of the city. It also provides a demonstrate example to show how to monitor and assess a contaminated river when odour emission and its control need to be focused on.

A rare cause of small bowel obstruction caused by duodenum-derived aggressive fibromatosis with ß-catenin T41A mutation: A case analysis.

RATIONALE: Aggressive fibromatosis (AF) is a fibroblastic/myofibroblastic tumor known for its locally aggressive properties. Intra-abdominal AF primarily occurs in the small intestine mesentery, ileocolic mesocolon, omentum, retroperitoneum, and pelvis, and rarely originates from the intestinal wall. Here, we report a rare case of small bowel obstruction caused by duodenum-derived AF with ß-catenin (CTNNB1) T41A mutation. PATIENT CONCERNS: A 35-year-old male had a 4-month history of abdominal pain, nausea, and vomiting, which gradually worsened over time. DIAGNOSES: Based on the results of CT examination, histopathology and Sanger sequencing, the patient was diagnosed with small bowel obstruction caused by duodenum-derived AF. INTERVENTIONS: Due to the extensive adhesion between the tumor and surrounding tissue, it is extremely challenging to completely remove the tumor through surgical resection with negative margins in this case. In order not to damage the function of surrounding vital organs, gastrojejunostomy was performed to relieve the symptoms of small bowel obstruction. OUTCOMES: The patient experienced a successful recovery. It is important to note that this patient is still at risk of local recurrence and requires regular follow-up. LESSONS: The best treatment should be taken based on the individual patient to relieve symptoms and improve quality of life. Moreover, histopathology plays a crucial role in diagnosing and differentiating duodenum-derived AF. The detection of mutations in exon 3 of the CTNNB1 has become strong evidence for diagnosing duodenum-derived AF.

3D Printing of a Porous Zn-1Mg-0.1Sr Alloy Scaffold: A Study on Mechanical Properties, Degradability, and Biosafety.

In recent years, the use of zinc (Zn) alloys as degradable metal materials has attracted considerable attention in the field of biomedical bone implant materials. This study investigates the fabrication of porous scaffolds using a Zn-1Mg-0.1Sr alloy through a three-dimensional (3D) printing technique, selective laser melting (SLM). The results showed that the porous Zn-1Mg-0.1Sr alloy scaffold featured a microporous structure and exhibited a compressive strength (CS) of 33.71 ± 2.51 MPa, a yield strength (YS) of 27.88 ± 1.58 MPa, and an elastic modulus (E) of 2.3 ± 0.8 GPa. During the immersion experiments, the immersion solution showed a concentration of 2.14 ± 0.82 mg/L for Zn2+ and 0.34 ± 0.14 mg/L for Sr2+, with an average pH of 7.61 ± 0.09. The porous Zn-1Mg-0.1Sr alloy demonstrated a weight loss of 12.82 ± 0.55% and a corrosion degradation rate of 0.36 ± 0.01 mm/year in 14 days. The Cell Counting Kit-8 (CCK-8) assay was used to check the viability of the cells. The results showed that the 10% and 20% extracts significantly increased the activity of osteoblast precursor cells (MC3T3-E1), with a cytotoxicity grade of 0, which indicates safety and non-toxicity. In summary, the porous Zn-1Mg-0.1Sr alloy scaffold exhibits outstanding mechanical properties, an appropriate degradation rate, and favorable biosafety, making it an ideal candidate for degradable metal bone implants.

Comparison of Alignment Accuracy and Clinical Outcomes between a CT-Based, Saw Cutting Robotic System and a CT-Free, Jig-guided Robotic System for Total Knee Arthroplasty.

OBJECTIVE: The different cutting mode of robot-assisted TKAs may influence the accuracy of alignment. The purpose of this study was to compare alignment accuracy and early clinical outcomes between a CT-based, saw cutting robotic system (MAKO) and a CT-free, jig-guided robotic system (ROSA) for total knee arthroplasty (TKA). METHODS: A total of 20 MAKO TKAs and 20 ROSA TKAs from June 2021 to June 2022 were retrospectively analyzed. Differences in the postoperative hip-knee-ankle (HKA) angle, lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), posterior tibial slope (PTS) and 3° outlier frequency of the HKA, LDFA, MPTA and PTS were studied at 3 months and 1 year of follow-up. The operative time and total blood loss (TBL) were compared between these two groups. Clinical outcomes at 1 year after surgery, including range of motion (ROM), Western Ontario McMaster University Osteoarthritis Index (WOMAC) score, and Knee Society Score-2011 (KSS-2011), were also compared between these two groups. RESULTS: The baseline characteristics of the two groups were comparable. There were no significant differences in the mean deviations of postoperative HKA, LDFA, MPTA or PTS between the two groups at 3 months or 1 year (all ps > 0.05). Moreover, there was no significant difference in the percentage of 3° outliers for HKA, LDFA, MPTA, or PTS between the two groups at 3-month or 1-year follow-up (all ps > 0.05). The mean operation time of MAKO was longer than that of ROSA (112.7 ± 12.8 min vs 94.8 ± 23.0 min, p = 0.001), but the mean TBL (1356.7 ± 648.5 mL vs 1384.5 ± 676.3 mL) and transfusion rate (15.0% vs 5.0%) were not significantly different between the two groups (all ps > 0.05). No significant differences were found in postoperative ROM, WOMAC score or KSS score at 1 year (all ps > 0.05). CONCLUSION: The MAKO and ROSA had similar accuracy and precision in TKA alignment. The clinical outcomes at 1 year after surgery were also comparable.

A Case of TKA Failure in Patient with Primary Hyperparathyroidism.

BACKGROUND: Primary hyperparathyroidism (PHPT) is an endocrine disorder with high serum calcium and parathyroid hormone (PTH) levels. Excessive secretion of PTH can cause bone loss and may have potential damage to implant fixation after total knee arthroplasty (TKA). However, there is currently no research or literature reporting prosthesis loosening after TKA associated with PHPT. CASE PRESENTATION: This case report describes a TKA failure of tibial prothesis loosening associated with PHPT. The patient faced aggravated pain and difficulty in walking 6 months after the primary TKA. Further examinations showed high serum calcium and PTH levels indicating the presence of PHPT. After the surgery of parathyroidectomy, the patient received revision TKA with 3D-printed metaphyseal cone. Knee symptoms and function were finally improved. CONCLUSION: PHPT is a risk factor for prosthesis loosening after TKA. Preoperative screening test of serum calcium and PTH levels is important to diagnose PHPT. For patients with PHPT undergoing TKA, preoperative endocrinotherapy and parathyroidectomy are recommended to improve the survival of prosthesis.

Effect of Ru on Deformation Mechanism and Microstructure Evolution of Single-Crystal Superalloys under Medium-Temperature and High-Stress Creep.

In this work, the effect of the Ru element on the γ'-phase evolution and deformation mechanism in the fourth-generation Ni-based single-crystal superalloy was investigated. Results show that the Ru element alters the distribution coefficient of other elements in the alloy to produce reverse partitioning behavior, which leads to a difference in microstructure between 0Ru and 3Ru. The addition of Ru triggered the incubation period before the beginning of the primary creep stage, which depends on the creep temperature and stress during creep deformation. TEM results revealed that Ru addition inhibits the slip system {111}<112> at medium-temperature (760-1050 °C) and high-stress (270-810 MPa) creep, which brings a considerably low creep rate and high creep life to the Ru-containing alloy.