Risk factors and predictive models for frozen shoulder.

This study aims to explore the risk factors associated with frozen shoulder (FS) and develop a predictive model for diagnosing FS, in order to facilitate early detection of the condition. A total of 103 patients diagnosed with FS and admitted to the Department of Joint Surgery at Suining Central Hospital between October 2021 and October 2023 were consecutively included in the study. Additionally, 309 individuals without shoulder joint diseases, matched for age and gender, who visited the department during the same time, were included as the control group.The complete recording of clinical data for all patients was followed by the utilization of statistical tests such as the Mann-Whitney U test, sample t test, and chi-square test to compare different groups. Additionally, multivariate binary logistic regression analysis was employed to identify risk factors associated with the occurrence of FS in patients, leading to the establishment of a prediction model and derivation of a simplified equation. The diagnostic effectiveness of individual indicators and prediction models was assessed through the use of receiver operating characteristic (ROC) curve analysis. In the sample of 103 individuals, 35 were identified as male and 68 as female, with an average age range of 40-70 years (mean age: 54.20 ± 6.82 years). The analysis conducted between different groups revealed that individuals with a low body mass index (BMI), in conjunction with other factors such as diabetes, cervical spondylosis, atherosclerosis, and hyperlipidemia, were more susceptible to developing FS. Logistic regression analysis further indicated that low BMI, diabetes, cervical spondylosis, and hyperlipidemia were significant risk factors for the occurrence of FS. These variables were subsequently incorporated into a predictive model, resulting in the creation of a simplified equation.The ROC curve demonstrated that the combined indicators in the predictive model exhibited superior diagnostic efficacy compared to single indicators, as evidenced by an area under the curve of 0.787, sensitivity of 62.1%, and specificity of 82.2%. Low BMI, diabetes, cervical spondylosis, and hyperlipidemia are significant risk factors associated with the occurrence of FS. Moreover, the utilization of a prediction model has demonstrated superior capability in forecasting the likelihood of FS compared to relying solely on individual indicators. This finding holds potential in offering valuable insights for the early diagnosis of FS.

Enhancement of triclocarban biodegradation: Metabolic division of labor in co-culture of Rhodococcus sp. BX2 and Pseudomonas sp. LY-1.

Triclocarban (TCC) and its metabolite, 3,4-dichloroaniline (DCA), are classified as emerging organic contaminants (EOCs). Significant concerns arise from water and soil contamination with TCC and its metabolites. These concerns are especially pronounced at high concentrations of up to approximately 20 mg/kg dry weight, as observed in wastewater treatment plants (WWTPs). Here, a TCC-degrading co-culture system comprising Rhodococcus rhodochrous BX2 and Pseudomonas sp. LY-1 was utilized to degrade TCC (14.5 mg/L) by 85.9% in 7 days, showing improved degradation efficiency compared with monocultures. A combination of high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS), genome sequencing, transcriptomic analysis, and quantitative reverse transcription-PCR (qRT-PCR) was performed. Meanwhile, through the combination of further experiments involving heterologous expression and gene knockout, we proposed three TCC metabolic pathways and identified four key genes (tccG, tccS, phB, phL) involved in the TCC degradation process. Moreover, we revealed the internal labor division patterns and connections in the co-culture system, indicating that TCC hydrolysis products were exchanged between co-cultured strains. Additionally, mutualistic cooperation between BX2 and LY-1 enhances TCC degradation efficiency. Finally, phytotoxicity assays confirmed a significant reduction in the plant toxicity of TCC following synergistic degradation by two strains. The in-depth understanding of the TCC biotransformation mechanisms and microbial interactions provides useful information for elucidating the mechanism of the collaborative biodegradation of various contaminants.

Synergistic detoxification efficiency and mechanism of triclocarban degradation by a bacterial consortium in the liver-gut-microbiota axis of zebrafish (Danio rerio).

Triclocarban (TCC), an emerging organic contaminant, poses a potential threat to human health with long-term exposure. Here, Rhodococcus rhodochrous BX2 and Pseudomonas sp. LY-1 were utilized to degrade TCC at environmental related concentrations for enhancing TCC biodegradation and investigating whether the toxicity of intermediate metabolites is lower than that of the parent compound. The results demonstrated that the bacterial consortium could degrade TCC by 82.0% within 7 days. The calculated 96 h LC50 for TCC, as well as its main degradation product 3,4-Dichloroaniline (DCA) were 0.134 mg/L and 1.318 mg/L respectively. Biodegradation also alleviated histopathological lesions induced by TCC in zebrafish liver and gut tissues. Liver transcriptome analysis revealed that biodegradation weakened differential expression of genes involved in disrupted immune regulation and lipid metabolism caused by TCC, verified through RT-qPCR analysis and measurement of related enzyme activities and protein contents. 16 S rRNA sequencing indicated that exposure to TCC led to gut microbial dysbiosis, which was efficiently improved through TCC biodegradation, resulting in decreased relative abundances of major pathogens. Overall, this study evaluated potential environmental risks associated with biodegradation of TCC and explored possible biodetoxification mechanisms, providing a theoretical foundation for efficient and harmless bioremediation of environmental pollutants.

Biomechanical study of posterior cruciate ligament tibial arrest avulsion fracture fixation with triple tibial channel net sutures.

To investigate the biomechanical properties of posterior cruciate ligament avulsion fractures of the tibia fixed using four different methods, including triple tibial channel net suture fixation. In 40 porcine knees, a standardized bony avulsion of the posterior cruciate ligament was generated. Double tibial bone channel suture fixation was performed in group A, double-head hollow compression screw fixation was performed in group B, triple tibial bone channel net suture fixation was performed in group C, and cortical suspension EndoButton fixation was performed in group D. The constructs were cyclically loaded 500 times (10 to 100 N) to measure the initial displacement and stiffness values. Subsequently, loading to failure was performed, and the yield load and peak load were measured. The results were analysed by one-way ANOVA, with significance set at P < 0.05. The initial displacement in group D (1.00 ± 0.20 mm) was lower than that in group C (1.46 ± 0.33 mm, P = 0.000), group B (1.91 ± 1.71 mm, P = 0.000) and group A (3.91 ± 0.79 mm, P = 0.000), but there was no significant difference between groups B and C (P = 0.055). The initial stiffness in group A (50.59 ± 6.89 N/mm) was lower than that in group C (67.21 ± 12.80 N/mm, P = 0.001), group D (71.18 ± 9.20 N/mm, P = 0.000) and group B (78.67 ± 5.91 N/mm, P = 0.000). However, there was no significant difference between groups B and D or between groups C and D (P = 0.111 and P = 0.391). The yield load in group A (554.86 ± 71.43 N) was lower than that in group C (767.00 ± 34.53 N, P = 0.000), group D (777.62 ± 73.03 N, P = 0.000) and group B (837.50 ± 55.73 N, P = 0.000). There was no significant difference between groups C and D (P = 0.729). The peak load in group A (667.38 ± 61.54 N) was lower than that in group C (842.00 ± 26.20 N, P = 0.000), group D (867.63 ± 63.42 N, P = 0.000) and group B (901.25 ± 54.38 N, P = 0.000). There was no significant difference between groups C and D (P = 0.346). Different failure modes were found among the four groups. The triple tibial bone channel suture fixation group showed better initial stability and fixation strength, which was comparable to that in the cortical suspension EndoButton fixation group and double-head hollow compression screw fixation group and significantly stronger than that in the double tibial bone channel suture fixation group. This study analysed the dynamic and static indexes of posterior cruciate ligament tibial avulsion fractures fixed by four different fixation methods under cyclic loading tests and single failure loading tests, providing a theoretical basis for clinical treatment.

Arthroscopic treatment of deep gluteal syndrome and the application value of high-frequency ultrasound.

PURPOSE: This study aimed to evaluate the efficacy of arthroscopic sciatic neurolysis for treating deep gluteal syndrome (DGS) and to analyse the application value of high-frequency ultrasound during perioperative period. METHODS: Between June 2020 and February 2022, 30 patients with DGS who underwent failed conservative treatment were retrospectively analysed. Lateral arthroscopic exploration of the deep gluteal space and sciatic neurolysis were performed. In addition to pelvic X-ray, lumbar disc and hip magnetic resonance imaging (MRI), ultrasonography of the sciatic nerve was also performed in all patients. The visual analogue scale pain score (VAS), modified Harris hip score (mHHS) and Benson symptom-rating scale were used to evaluate the clinical efficacy. The correlation between preoperative sciatic nerve ultrasound and arthroscopic findings was analysed. RESULTS: The median follow-up for these patients was 13 months (range,12-21 months). Preoperative ultrasonography showed precise morphological changes in 26 sciatic nerves of patients. The VAS score decreased from 5.0 (4.0, 6.0) preoperatively to 0.5 (0, 1.0) postoperatively (p < 0.001), and the mHHS increased from 64.0 (57.0, 67.0) preoperatively to 95.0 (93.0, 97.0) postoperatively (p < 0.001). The Benson symptom score was excellent in 15 cases, good in 12 cases, fair in 2 cases, poor in 1 case; thus, the score was excellent or good in 90% of the cases. Preoperative ultrasound diagnosis and intra-operative findings matched up in all cases. There were four cases of transient numbness in the posterior thigh. CONCLUSIONS: Arthroscopic sciatic neurolysis is a safe and effective treatment option for DGS patients who fail conservative treatment. Ultrasound diagnosis matched the arthroscopic findings perfectly. Preoperative Doppler ultrasound can assist surgical decision-making, guide intraoperative release.

Enhanced bioremediation of triclocarban-contaminated soil by Rhodococcus rhodochrous BX2 and Pseudomonas sp. LY-1 immobilized on biochar and microbial community response.

Triclocarban (TCC), an emerging organic contaminant (EOC), has become a severe threat to soil microbial communities and ecological security. Here, the TCC-degrading strain Rhodococcus rhodochrous BX2 and DCA-degrading strain Pseudomonas sp. LY-1 (together referred to as TC1) were immobilized on biochar to remove TCC and its intermediates in TCC-contaminated soil. High-throughput sequencing was used to investigate the microbial community structure in TCC-contaminated soil. Analysis of co-occurrence networks was used to explore the mutual relationships among soil microbiome members. The results showed that the immobilized TC1 significantly increased the removal efficiency of TCC from 84.7 to 92.7% compared to CK (no TC1 cells on biochar) in 10 mg/L TCC liquid medium. The utilization of immobilized TC1 also significantly accelerated the removal of TCC from contaminated soil. Microbial community analysis revealed the crucial microorganisms and their functional enzymes participating in TCC degradation in soil. Moreover, the internal labor division patterns and connections of TCC-degrading microbes, with a focus on strains BX2 and LY-1, were unraveled by co-occurrence networks analysis. This work provides a promising strategy to facilitate the bioremediation of TCC in soil, which has potential application value for sustainable biobased economies.

The posterior cruciate ligament index as a reliable indirect sign of anterior cruciate ligament rupture is associated with the course of knee joint injury.

PURPOSE: The objective of this study was to clarify the clinical value of the posterior cruciate ligament index (PCLI) in anterior cruciate ligament (ACL) rupture, to explore the relationship between the PCLI and course of disease, and to identify the influencing factors of the PCLI. METHODS: The PCLI was defined a quotient of the X (the tibial and femoral PCL attachments) and the Y (the maximum perpendicular distance from X to the PCL). A total of 858 patients were enrolled in this case-control study, including 433 patients with ACL ruptures who were assigned to the experimental group and 425 patients with meniscal tears (MTs) who were allocated to the control group. Some patients in the experimental group have collateral ligament rupture (CLR). Information, such as the patient's age, sex, and course of disease, was recorded. All patients underwent magnetic resonance imaging (MRI) preoperatively, and the diagnosis was confirmed with the aid of arthroscopy. The PCLI and the depth of the lateral femoral notch sign (LFNS) were calculated based on the MRI findings, and the characteristics of the PCLI were explored. RESULTS: The PCLI in the experimental group (5.1 ± 1.6) was significantly smaller than that in the control group (5.8 ± 1.6) (P < 0.05). The PCLI gradually decreased with time and was only 4.8 ± 1.4 in patients in the chronic phase (P < 0.05). This change was not due to the decrease in X but rather the increase in Y. The results also showed that the PCLI was not related to the depth of the LFNS or injuries of other structures in the knee joint. Furthermore, when the optimal cut-off point of the PCLI was 5.2 (area under the curve = 71%), the specificity and the sensitivity were 84% and 67%, respectively, but the Youden index was just 0.3 (P < 0.05). CONCLUSION: The PCLI decreases due to the increase in Y instead of the decrease in X with time, especially in the chronic phase. The change in X in this process may be offset during imaging. In addition, there are fewer influencing factors that lead to changes in the PCLI. Therefore, it can be used as a reliable indirect sign of ACL rupture. However, it is difficult to quantify the diagnostic criteria of the PCLI in clinical practice. Thus, the PCLI as a reliable indirect sign of ACL rupture is associated with the course of knee joint injury, and it can be used to describe the instability of the knee joint. LEVELS OF EVIDENCE: III.

A Novel Estrone Degradation Gene Cluster and Catabolic Mechanism in Microbacterium oxydans ML-6.

Global-scale estrone (E1) contamination of soil and aquatic environments results from the widespread use of animal manure as fertilizer, threatening both human health and environmental security. A detailed understanding of the degradation of E1 by microorganisms and the associated catabolic mechanism remains a key challenge for the bioremediation of E1-contaminated soil. Here, Microbacterium oxydans ML-6, isolated from estrogen-contaminated soil, was shown to efficiently degrade E1. A complete catabolic pathway for E1 was proposed via liquid chromatography-tandem mass spectrometry (LC-MS/MS), genome sequencing, transcriptomic analysis, and quantitative reverse transcription-PCR (qRT-PCR). In particular, a novel gene cluster (moc) associated with E1 catabolism was predicted. The combination of heterologous expression, gene knockout, and complementation experiments demonstrated that the 3-hydroxybenzoate 4-monooxygenase (MocA; a single-component flavoprotein monooxygenase) encoded by the mocA gene was responsible for the initial hydroxylation of E1. Furthermore, to demonstrate the detoxification of E1 by strain ML-6, phytotoxicity tests were performed. Overall, our findings provide new insight into the molecular mechanism underlying the diversity of E1 catabolism in microorganisms and suggest that M. oxydans ML-6 and its enzymes have potential applications in E1 bioremediation to reduce or eliminate E1-related environmental pollution. IMPORTANCE Steroidal estrogens (SEs) are mainly produced by animals, while bacteria are major consumers of SEs in the biosphere. However, the understanding of the gene clusters that participate in E1 degradation is still limited, and the enzymes involved in the biodegradation of E1 have not been well characterized. The present study reports that M. oxydans ML-6 has effective SE degradation capacity, which facilitates the development of strain ML-6 as a broad-spectrum biocatalyst for the production of certain desired compounds. A novel gene cluster (moc) associated with E1 catabolism was predicted. The 3-hydroxybenzoate 4-monooxygenase (MocA; a single-component flavoprotein monooxygenase) identified in the moc cluster was found to be necessary and specific for the initial hydroxylation of E1 to generate 4-OHE1, providing new insight into the biological role of flavoprotein monooxygenase.

An amidase and a novel phenol hydroxylase catalyze the degradation of the antibacterial agent triclocarban by Rhodococcus rhodochrous.

Triclocarban (TCC) is an emerging and intractable environmental contaminant due to its hydrophobicity and chemical stability. However, the antibacterial property of TCC limits its biodegradation, and only the functional enzyme TccA involved in TCC degradation has been characterized to date. In this study, we report a highly efficient TCC-degrading bacterium, Rhodococcus rhodochrous BX2, that could degrade and mineralize TCC (10 mg/L) by 76.8% and 56.5%, respectively, within 5 days. Subsequently, the TCC biodegradation pathway was predicted based on the detection of metabolites using modern mass spectrometry techniques. Furthermore, an amidase (TccS) and a novel phenol hydroxylase (PHIND) encoded by the tccS and PHIND genes, respectively, were identified by genomic and transcriptomic analyses of strain BX2, and these enzymes were further unequivocally proven to be the key enzymes responsible for the metabolism of TCC and its intermediate 4-chloroaniline (4-CA) by using a combination of heterologous expression and gene knockout. Our results shed new light on the mechanism of TCC biodegradation and better utilization of microbes to remediate TCC contamination.

Direct Anterior Approach in Lateral Decubitus Position Versus Supine Position for Unilateral Total Hip Arthroplasty: A Comparative Study.

OBJECTIVE: To compare the clinical efficacy of the direct anterior approach in lateral decubitus position (L-DAA) and supine position (S-DAA) for unilateral total hip arthroplasty. METHODS: A retrospective study was conducted on 89 patients who underwent primary unilateral total hip arthroplasty in our department between August 2016 and December 2017. There were 46 patients who underwent L-DAA and 43 patients who underwent S-DAA. The body mass index (BMI), operation time, blood loss, preoperative Hb, first day and third day postoperative Hb, incision length, hospital stay, preoperative and postoperative Harris score, preoperative and postoperative visual analogue scale (VAS) score, radiological evaluation, intraoperative and postoperative complication, postoperative absolute length difference of lower extremity were recorded and analyzed. P < 0.05 was set as the significant difference. RESULTS: All patients were followed up for 8-23 months, with an average of 15.6 months. No significant differences were found in preoperative and postoperative Harris scores, preoperative Hb, incision lengths, radiological evaluations, preoperative and postoperative VAS scores, and hospital stay (P > 0.05). However, significant differences were detected in BMI, blood loss, first day and third day postoperative Hb, and operation time (P < 0.05). There were no postoperative complications in the L-DAA and S-DAA groups. During the operation, two cases of proximal femoral fracture occurred in the L-DAA group, four in the S-DAA group, and the difference was statistically significant. There were significant differences found in the postoperative absolute length difference of lower extremity between the two groups. CONCLUSION: Compared with the S-DAA approach, the L-DAA approach had the advantages of shorter operation time and less blood loss. Compared with S-DAA, it was easier to expose the proximal femur, and lower BMI was required in L-DAA. However, it was more difficult to compare the length of both lower extremities in the L-DAA approach than in the S-DAA approach.

Risk factors for femoral fracture in lateral decubitus direct anterior approach total hip arthroplasty using conventional stems: a retrospective analysis.

OBJECTIVE: To provide guidelines for surgery and reduce the incidence of fracture, this study analyzed the relationship between femoral fracture and related factors in direct anterior approach (DAA) total hip arthroplasty (THA) in the lateral decubitus position. METHOD: A retrospective series of 273 consecutive patients who underwent THA with the DAA in the lateral decubitus position was analyzed. Each surgery was performed by the same surgeon with a conventional operation bed and femoral stem. The correlations between the incidence of fracture and sex, age, body mass index (BMI), height, osteoporosis, the anterior superior iliac spine-greater trochanter distance (ASIS-GTD), and hip joint disease were analyzed by univariate analysis and logistic regression analysis. RESULTS: Among all hip arthroplasty procedures, 35 hips had femoral fractures, including 30 greater trochanter fractures, 4 proximal femoral splits, and 1 femoral perforation. The incidence of fracture was 12.82%. Univariate analysis showed no significant difference in the incidence of fracture by sex, BMI, or age. However, osteoporosis caused an increase in the incidence of fracture, while the incidence of fracture decreased as height and the ASIS-GTD increased. The incidence of femoral neck fracture was lower in cases of osteonecrosis of the femoral head than in cases of other diseases. Logistic regression showed a significant correlation between osteoporosis, the ASIS-GTD, and fractures. Patients with osteoporosis had a high possibility of fracture (OR = 2.414); the possibility of fracture decreased with increasing ASIS-GTD (OR = 0.938). CONCLUSION: Lateral decubitus DAA THA can be successfully performed using a conventional operation bed and stem, effectively saving medical resources. Osteoporosis and a shorter ASIS-GTD were independent risk factors for femoral fracture.

Diagnostic value of miR-193a-3p in Alzheimer's disease and miR-193a-3p attenuates amyloid-ß induced neurotoxicity by targeting PTEN.

OBJECTIVE: Many microRNAs (miRNAs) have been reported to be aberrantly expressed in Alzheimer's disease (AD) patients. The present study aimed to explore the diagnostic value and neuroprotective role of miR-193a-3p in AD. METHODS: 108 sporadic AD patients and 93 healthy controls were included. An Aß25-35 insult cellular AD model of PC12 and SH-SY5Y was established. The relative expression levels of miR-193a-3p were calculated using qRT-PCR. Receiver operating characteristic (ROC) curve was applied to evaluate the usefulness of miR-193a-3p for detecting AD. Cell viability and apoptotic rates were calculated. Luciferase reporter assay was performed to confirm the interaction between miR-193a-3p and PTEN. RESULTS: miR-193a-3p expression was downregulated in both AD patients and the cellular AD model (all P < 0.001). Remarkable positive association was detected between serum miR-193a-3p level and MMSE score in AD patients (r = 0.5889, P < 0.0001). The diagnostic sensitivity and specificity were 89.8% and 77.4%, respectively, and the area under the curve (AUC) was 0.914. Overexpression of miR-193a-3p weakened Aß25-35 induced cell viability inhibition, and reduced Aß25-35 induced cell apoptosis in PC12 cells (all P < 0.01). Downregulation of miR-193a-3p intensified the effect of Aß25-35 PTEN was proved to be the target gene of miR-193a-3p. CONCLUSION: MiR-193a-3p could be a novel biomarker for AD diagnosis, and may protect against neurotoxicity in AD by targeting PTEN.

Comparison of early complications between the use of a cannulated screw locking plate and multiple cancellous screws in the treatment of displaced intracapsular hip fractures in young adults: a randomized controlled clinical trial.

BACKGROUND: The incidence of early postoperative complications of displaced intracapsular hip fractures is high. The purpose of this study was to compare the early postoperative complications and assess the incidence of femoral neck shortening on using a newly designed proximal femoral cannulated screw locking plate (CSLP) versus multiple cancellous screws (MCS) in the treatment of displaced intracapsular hip fractures in young adults. METHODS: Sixty-eight young adult patients with displaced intracapsular hip fractures were randomly assigned to either the CSLP group or the MCS group and treated routinely by internal fixation with either the CSLP or the MCS. Harris Hip Score, nonunion, failure of fixation, overall complications, and femoral neck shortening were recorded and compared. RESULTS: Two patients (5.88%) in the CSLP group and eight (23.53%) in the MCS group had postoperative nonunion (P < 0.05). There was one case (2.94%) of fixation failure in the CSLP group and three cases (8.82%) in the MCS group (P > 0.05). Three patients (8.82%) in the CSLP group and 11 (32.35%) in the MCS group had overall complications (P < 0.05). Mean femoral neck shortening was 5.10 mm in the vertical plane and 5.11 mm in the horizontal plane in the CSLP group and 11.14 mm in the vertical plane and 10.51 mm in the horizontal plane in the MCS group. Severe femoral neck shortening (≥ 10 mm) did not occur in either the vertical or the horizontal plane in any patient of the CSLP group but occurred in 10 patients (28.57%) in the vertical plane and in 8 (22.86%) patients in the horizontal plane in the MCS group. CONCLUSIONS: Compared with MCS, the use of CSLP in the treatment of displaced intracapsular hip fractures in young adults can reduce the rates of postoperative nonunion and overall complications and minimize femoral neck shortening. TRIAL REGISTRATION: ChiCTR1800016032 . Registered 8 May 2018. Retrospectively registered.