Photochromic Uranyl-Based Coordination Polymer for Quantitative and On-Site Detection of UV Radiation Dose.

A highly sensitive detection of ultraviolet (UV) radiation is required in a broad range of scientific research, chemical industries, and health-related applications. Traditional UV photodetectors fabricated by direct wide-band-gap inorganic semiconductors often suffer from several disadvantages such as complicated manufacturing procedures, requiring multiple operations and high-cost instruments to obtain a readout. Searching for new materials or simple strategies to develop UV dosimeters for quantitative, accurate, and on-site detection of UV radiation dose is still highly desirable. Herein, a photochromic uranyl-based coordination polymer [(UO2)(PBPCA)·DMF]·DMF (PBPCA = pyridine-3,5-bis(phenyl-4-carboxylate), DMF = N,N'-dimethylformamide, denoted as SXU-1) with highly radiolytic and chemical stabilities was successfully synthesized via the solvothermal method at 100 °C. Surprisingly, the fresh samples of SXU-1 underwent an ultra-fast UV-induced (365 nm, 2 mW) color variation from yellow to orange in less than 1 s, and then the color changed further from orange to brick red after the subsequent irradiation, inspiring us to develop a colorimetric dosimeter based on red-green-blue (RGB) parameters. The mechanism of radical-induced photochromism was intensively investigated by UV-vis absorption spectra, EPR analysis, and SC-XRD data. Furthermore, SXU-1 was incorporated into an optoelectronic device to fabricate a novel dosimeter for convenient, quantitative, and on-site detection of UV radiation dose.

Anthropometry of the medial femoral condyle in the Chinese population: the morphometric analysis to design unicomparmental knee component.

BACKGROUND: This study aimed to assess the radii of the distal and posterior articular surfaces of the medial femoral condyle in a Chinese population and provide detailed parameters of the knee joint for the future design of UKA components. METHODS: This study included 500 consecutive Chinese patients who underwent knee MRI from Jan 2019 to Jan 2020. The two most appropriate circles were used to reveal the distal and posterior joint surfaces in the sagittal plane of the MRI images. The radius of the circle representing the distal articular surface in the sagittal plane was measured as R1, and the radius of the posterior articular surface was measured as R2. The distance between the centers of the two rotation circles was recorded as d. An independent t test was used to compare the differences between men and women. The Pearson correlation coefficient was calculated to analyze the correlation between R1 and R2. SPSS v19.0 software was used for statistical analysis. RESULTS: The average values of R1, R2, R1/R2 and d were calculated. Scatter plots were constructed to show the trend of changes in the radius of the distal and posterior articular surfaces of the femoral condyle. R1, R2 and d differed significantly between men and women (p < 0.05). Correlation analysis showed that R1 was positively correlated with R2 (r = 0.61, p < 0.05). CONCLUSIONS: The data of the radii of the distal and posterior articular surfaces of the medial femoral condyle were provided. In the UKA design, the relationships between the radii of the distal and posterior articular surfaces should be taken into account.

Decreased angiogenic and increased apoptotic activities of bone microvascular endothelial cells in patients with glucocorticoid-induced osteonecrosis of the femoral head.

BACKGROUND: Glucocorticoid-induced osteonecrosis of the femoral head (ONFH) is closely associated with the dysfunction of the bone microvascular endothelial cells (BMECs). The present study investigated the angiogenic and apoptotic activity of the BMECs in glucocorticoid-induced ONFH. METHODS: This study enrolled a total of 12 patients, six of whom were assigned to the ONFH group whereas the other six served as the control group. The ONFH group was composed of patients with glucocorticoid-induced ONFH while the control group had femoral neck fractures. BMECs were isolated from the subchondral region of the femoral head. Cell proliferation, cell viability, tube formation assay, Transwell assay, TUNEL assay, and Western blot analysis were performed. RESULTS: BMECs of the two groups were successfully isolated and identified. No significant differences were noticed in BMECs proliferation between the two groups. However, compared to the control, cell viability, tube formation, and migration of BMECs were significantly decreased and the number of TUNEL positive cells was markedly increased in the ONFH group. In the ONFH group, it was also noted that the amount of Bax and cleaved-caspase3 was elevated while that of Bcl-2 was reduced. CONCLUSION: The findings of our study revealed that BMECs obtained from the glucocorticoid-induced ONFH patients had decreased angiogenic and increased apoptotic activities, which could explain the pathogenesis and progression of glucocorticoid-induced ONFH.

Anthropometry of the medial tibial plateau in the Chinese population: the morphometric analysis and adaptability with Oxford Phase III tibial components.

PURPOSE: The objective of this study was to measure resected surfaces of the medial tibial plateau and to provide accurate anatomical parameters for the Chinese population and improve the unicompartmental knee arthroplasty (UKA) component design in the future. METHODS: This study measured different dimensions of the medial tibial plateau on MRIs of 1000 consecutive healthy Chinese people without knee deformity. The anteroposterior (AP) dimension and mediolateral dimensions at defined points (recorded as WA, WB, WC) of the medial tibial plateau were measured. The aspect ratio (WB/AP, recorded as AR) was also recorded. The measured results were grouped to compare with the dimensions of the Oxford Phase III tibial component. An independent t test was used to compare the differences between the males and females. RESULTS: The Oxford Phase III tibial component showed mediolateral overhang or undersize for the whole range of measured anteroposterior dimensions of the resected medial tibial plateau. A total of 71.3% patients' resected surface did not match the Oxford Phase III tibial component well. The study also found a decrease in the aspect ratio (WB/AP) with an increase in the AP dimension in the medial tibial plateau. CONCLUSIONS: There is a difference between the morphology of the Chinese knee joint and the configuration of the Oxford Phase III tibial components. The results of this study provided accurate anatomical parameters for Chinese and guidelines for designing UKA components suitable for the Chinese population. LEVEL OF EVIDENCE: Retrospective comparative study, Level III.

Progesterone modulates CD4+ CD25+ FoxP3+ regulatory T Cells and TGF-ß1 in the maternal-fetal interface of the late pregnant mouse.

OBJECTIVE: Progesterone supplementation is recommended to prevent spontaneous preterm birth (sPTB) in clinical practice. However, the exact mechanism is still unclear. This study aims to better understand the mechanisms that progesterone can prevent PTB. METHODS: Late pregnant mice were given various doses of progesterone receptor antagonist mifepristone, and pregnancy outcomes were observed. Then, non-pregnant and pregnant mice were given a subcutaneous injection of 40 mg/kg progesterone and 5 mg/kg mifepristone, respectively. CD4+ CD25+ FoxP3+ Treg cells in peripheral blood and decidua basalis were detected by FACS. Expressions of FoxP3 and TGF-ß1 in the decidua basalis were detected. RESULTS: Mifepristone induced preterm birth, and an obvious dose-response was found. Proportions of CD4+ CD25+ FoxP3+ Treg cells in the peripheral blood of non-pregnant mice increased significantly after progesterone injection. CD4+ CD25+ FoxP3+ Treg cells in the peripheral blood of pregnant mice increased significantly compared with those of non-pregnant mice. In pregnant mice, mifepristone significantly decreased the proportions of CD4+ CD25+ FoxP3+ Treg cells in peripheral blood, and reduced proportions of Treg cells at the maternal-fetal interface and expressions of FoxP3 and TGF-ß1 in the maternal-fetal interface. Total 40 mg/kg of progesterone did not increase CD4+ CD25+ FoxP3+ Treg in the peripheral blood of pregnant mice, but increased proportions of Treg cells at the maternal-fetal interface and up-regulated FoxP3 and TGF-ß1 expressions in the maternal-fetal interface. CONCLUSION: Progesterone promotes pregnancy immune homeostasis by up-regulating Treg cells and TGF-ß1 expression in the maternal-fetal interface. It may be one of the mechanisms of progesterone in preventing sPTB.

What is the ideal route of administration of tranexamic acid in total knee arthroplasty? A meta-analysis based on randomized controlled trials.

BACKGROUND: Tranexamic acid (TXA) was conducive in total knee arthroplasty (TKA) to reduce blood loss and transfusion demand. The purpose of this meta-analysis was to assess the efficacy and safety of different administration of TXA in primary TKA. METHODS: Database PubMed, Medline, Web of Science and Embase were searched. The relative risks (RRs) with 95% confidence intervals (CIs) were calculated to analysis dichotomous outcomes. The mean differences (MD) with 95% CIs were calculated to analysis dichotomous outcomes. Data was analyzed using RevMan 5.3. RESULTS: Twenty-eight randomized controlled trials (RCTs) studies were included in this meta-analysis involving a total of 4,200 participants. There were no obvious differences between oral, intravenous or topical TXA group in total blood loss (intravenous vs. topical: MD =11.55, 95% CI, -10.23 to 33.34, oral vs. intravenous or topical: MD =-52.25, 95% CI, -121.28 to 16.78), transfusion rate (intravenous vs. topical: RR =1.04, 95%CI, 0.64 to 1.69, oral vs. intravenous or topical: RR =0.75, 95% CI, 0.36 to 1.54), incidence of venous thrombotic events (VTE) (intravenous vs. topical: RR =1.43, 95% CI, 0.81 to 2.54). The topical TXA administration had significantly increased postoperative hemoglobin (HB) level compared with the intravenous TXA administration (MD =-0.37, 95% CIs, -0.47 to -0.26). In the combined group, the total blood loss (MD =-119.58, 95% CI, -181.68 to -57.49) and postoperative HB level (MD =0.54, 95% CI, 0.45 to 0.64) were more acceptable than the single-route group. CONCLUSIONS: Combined administration of TXA can reduce total blood loss, postoperative HB drop compared with intravenous, topical or oral TXA alone. Oral administration of TXA is similar to intravenous or topical TXA use alone.

Bearing dislocation of mobile bearing unicompartmental knee arthroplasty in East Asian countries: a systematic review with meta-analysis.

BACKGROUND: Bearing dislocation is a common postoperative complication of mobile-bearing unicompartmental knee arthroplasty, and East Asian patients tend to be at higher risk. However, whether this high dislocation rate is common in all East Asian populations remains unclear. This meta-analysis was performed to explore this issue and describe various features of dislocation in East Asians, including the onset time, dislocation direction, and re-dislocation rate. METHODS: The literature was searched in PubMed, Embase, Ovid, and Cochrane Library up to May 2020. Studies were scrutinized by two independent authors, and the bearing dislocation rate, onset time, direction, and re-dislocation rate were specifically analyzed. RevMan 5.3 was used for the statistical analysis. RESULTS: Seven case series from Korea, China, and Japan were included. The pooled analysis showed that the total dislocation rate was 2.37%, while the subgroup analysis showed that the dislocation rate in Korea and other countries was 4.50% and 0.74%, respectively (P < 0.01). Another subgroup analysis of the onset time showed a significant difference before and after the first 5 years postoperatively (P < 0.01). Anterior and posterior dislocations were more frequent than medial and lateral dislocations (P < 0.01). The average re-dislocation rate was 32.45%, which was approximately seven times higher than the primary dislocation rate (P < 0.01). CONCLUSION: Our meta-analysis demonstrated that Korea had a higher bearing dislocation rate among East Asian countries, especially in the first 5 years after primary UKA. Anterior and posterior dislocations were common. The most important finding is that the re-dislocation rate can be much higher than the initial dislocation rate.

Robotic-assisted unicompartmental knee arthroplasty: a review.

PURPOSE: Presented here is an up-to-date review concerning robotic-assisted unicompartmental knee arthroplasty (rUKA), including its rationale, operative system, pros and cons. METHODS: We did a systematic research in electronic databases, including PubMed, Cochrane Library, Web of Science, and Embase up to March 30, 2020 to retrieve literature pertaining to rUKA. The search strategies "(robotic* AND knee arthroplasty OR knee replacement)" and "(knee arthroplasty OR knee replacement NOT total)" were used. Studies describing rUKA and clinical trials, dry bone or cadaveric researches regarding technologies, positioning, alignment, function, or survivorship of implants were included in this review. All retrieved studies were first browsed for eligibility on the basis of title and abstract, and the selected studies were further evaluated by reading full text for final inclusion. RESULTS: Robotic-assisted technology has been found to increase the accuracy of bone preparation and implant placement, reduce technical variability and outliers, and enhance reproduction of limb alignment. Additionally, early clinical outcomes were excellent, but mid-term follow-up showed no superiority in component survivorship. The potential drawbacks of the robotic-assisted technology include relatively-low time- and cost-effectiveness, development of some rUKA-related complications, and lack of support by high-quality literature. CONCLUSION: This review shows that rUKA can decrease the number of outliers concerning the optimal implant positioning and limb alignment. However, due to absence of extensive studies on clinical outcomes and long-term results, it remains unclear whether the improved component positioning translates to better clinical outcomes or long-term survivorship of the implant. Nevertheless, since an accurate implant position is presumably beneficial, robotic-assisted technology is worth recommendation in UKA.

Does patellofemoral osteoarthritis affect functional outcomes and survivorship after medial unicompartmental knee arthroplasty? A meta-analysis.

PURPOSE: The argument that patellofemoral osteoarthritis (PFOA) is a contraindication to unicompartmental knee arthroplasty (UKA) remains to be resolved. The purpose of this study was to perform a meta-analysis to determine whether PFOA affects functional outcomes and survivorship after medial UKA. METHODS: A literature search was performed in PubMed, Medline, Cochrane Library and Web of science to identify studies published in English (the last search was updated on June 1, 2020). The primary outcome measure was the Oxford Knee Score (OKS), whereas the secondary outcomes included range of motion (ROM) and the revision rate. Patients with patellofemoral joint narrowing or cartilage lesions as assessed intraoperatively or by radiography were assigned to the PFOA group. RESULTS: A total of 8 studies involving 3504 patients and 3975 knees were included in this meta-analysis. No patients had a severe lateral patellar groove. The results showed that there was no significant difference in the OKS, revision rate and ROM between PFOA patients and patients without PFOA. CONCLUSIONS: No significant difference in functional outcomes and survivorship was found between patients with and without PFOA. Patients with PFOA assessed by radiographs or intraoperatively but without a lateral patellar groove should be considered candidates for medial UKA.

Association between the polymorphism of IL-17A and IL-17F gene with knee osteoarthritis risk: a meta-analysis based on case-control studies.

BACKGROUND: Knee osteoarthritis is a joint disease which is characterized by degeneration of articular cartilage and subsequent subchondral bone changes. Polymorphisms of IL-17A/F gene were the recognized candidate genes associated with knee osteoarthritis risk although the results were conflicting. The aim of this study was to determine whether IL-17A(rs2275913) and IL-17F(rs763780) polymorphisms confer susceptibility to knee osteoarthritis. METHOD: Literature search was performed in PubMed, Medline, Cochrane Library, Web of science, Embase, and Google Scholar (last search was updated on June 20, 2019), and assessing this association was performed by calculating odds ratios with 95% confidence intervals. Statistical heterogeneity was quantitatively evaluated by using the Q statistic with its p value and I2 statistic. RESULT: Six case-control based studies were included involving IL-17A(rs2275913) (2134 cases and 2306 controls) and IL-17F(rs763780) (2134 cases and 2426 controls). The overall analysis suggested that the A allele of the rs2275913 polymorphism, and the C allele of the rs763780 polymorphism in the IL-17 gene may increase the risk of OA. However, subgroup analysis revealed that no association between IL-17A(rs2275913) gene and knee OA risk was found in Caucasian population. CONCLUSIONS: This meta-analysis revealed that the IL-17A(rs2275913) gene polymorphisms may increase the risk of knee OA in Asians, and the IL-17F(rs763780) gene polymorphisms may increase the risk of knee OA both in Asians and Caucasians. However, because of the limitations of the present study, additional larger studies are needed to confirm our findings in the future.

Should synovectomy be performed in primary total knee arthroplasty for osteoarthritis? A meta-analysis of randomized controlled trials.

BACKGROUND: During primary total knee arthroplasty (TKA), synovectomy as a part of the procedure has been recommended to relieve pain and inflammation of the synovium, but there is a controversy about it due to increased bleeding. In this meta-analysis, the aim is to answer whether synovectomy should be performed routinely during TKA for symptomatic knee osteoarthritis (KOA). METHODS: Relevant randomized controlled trials (RCTs) on synovectomy were retrieved through database searches of PubMed, Embase, Web of Science, and Cochrane Library up to February 2019. Studies that compared postoperative pain, clinical Knee Society Score (KSS), functional KSS, range of motion (ROM), drainage, pre- and postoperative hemoglobin difference, transfusion rate, operative time, and/or complications were included in the meta-analysis. Review Manager 5.3.0 was used for meta-analysis. RESULTS: We included 5 RCTs with 542 knees. Pooled results indicated that the synovectomy group was associated with more blood loss via drainage (WMD = - 99.41, 95% CI - 153.75 to - 45.08, P = 0.0003) and pre- and postoperative hemoglobin difference (WMD = - 0.93, 95% CI - 1.33 to - 0.5, P < 0.00001), compared with the non-synovectomy group. No statistically significant differences were demonstrated between both groups in postoperative pain, clinical KSS, functional KSS, ROM, transfusion rate, or complications (P > 0.05). CONCLUSIONS: The current evidence demonstrates that performing synovectomy in primary TKA for symptomatic KOA does not have any clinical benefit. It increases postsurgical blood loss. Surgeons routinely undertaking synovectomy should deliberate whether this is clinically indicated and consider limiting resection, if possible.