Portable and simultaneous detection of four respiratory pathogens through a microfluidic LAMP and real-time fluorescence assay.

Respiratory pathogen infections are seasonally prevalent and are likely to cause co-infections or serial infections during peak periods of infection. Since they often cause similar symptoms, simultaneous and on-site detection of respiratory pathogens is essential for accurate diagnosis and efficient treatment of these infectious diseases. However, molecular diagnostic techniques for multiple pathogens in this field are lacking. Herein, we developed a microfluidic LAMP and real-time fluorescence assay for rapid detection of multiple respiratory pathogens using a ten-channel microfluidic chip with pathogen primers pre-embedded in the chip reaction well. The microfluidic chip provided a closed reaction environment, effectively preventing aerosol contamination and improving the accuracy of the detection results. Its corresponding detection instrument could automatically collect and display the fluorescence curve in real time, which was more conducive to the interpretation of results. The results showed that the developed method could specifically recognize the nucleic acid of influenza A(H1N1), Mycoplasma pneumoniae, respiratory syncytial virus type A, and SARS-CoV-2 with low detection limits of 104 copies per mL or 103 copies per mL. The test results on clinical samples demonstrated that the developed method has high sensitivity (92.00%) and high specificity (100.00%) and even has the capability to differentiate mixed-infection samples. With simple operation and high detection efficiency, the present portable and simultaneous detection assay could significantly improve the efficiency of on-site detection of respiratory infectious diseases and promote the accurate treatment, efficient prevention and control of the diseases.

An optimized back propagation neural network on small samples spectral data to predict nitrite in water.

Accurate detection of pollutant levels in water bodies using fusion algorithms combined with spectral data has become a critical issue for water conservation. However, the number of samples is too small and the model is unstable, which often leads to poor prediction and fails to achieve the measurement goal well. To address these challenges, this paper proposes a practical and effective method to precisely predict the concentrations of nitrite pollution in aquatic environments. The proposed method consists of three steps. Firstly, the dimension of the spectral data is reduced using Kernel Principal Component Analysis (KPCA), followed by sample augmentation using Generative Adversarial Network (GAN) to reduce calculation cost and increase the diversity and scale of the data. Secondly, several improvement strategies, including multi-cluster competitive and adaptive parameter updating, are introduced to enhance the capability of the Particle Swarm Optimization (PSO) algorithm. The improved PSO algorithm is then applied to optimize the initialization weights and biases of the Back Propagation neural network, thereby improving the model fitting and training performance. Finally, the developed prediction model is employed to predict the test set samples. The result suggests that the R2, RMSE, and MAE values are 0.976290, 0.008626, and 0.006617, which outperform the state-of-the-art and provided a promising model for the prediction of nitrite concentration in water.

Single-cell transcriptomic survey of cell diversity and functional changes in yak hearts at different altitude.

The yak (Bos grunniens) is a species adapted to the hypoxic environment in the plateau area. The heart is a hypoxia-sensitive organ involved in this adaptation. Herein, we used single-cell RNA-seq technology and clustering to determine the presence of 11 cell populations in the yak heart. We analyzed gene expression differences and expression patterns in each cell subpopulation at different altitudes. The cells related to altitude changes are mainly smooth muscle cells and vascular endothelial cells. Of the four transcription factors (TFs, MEF2B, FOXP4, ARID5A, and HES4) found in smooth muscle cells, only MEF2B was specifically expressed in vascular smooth muscle cells. Three key TFs (HNF1B, DMRTA1, and ARNTL2) were also found in the cardiomyocyte module. Compared with data extracted from low-altitude yak, we observed that the high altitude yak has enhanced contraction and relaxation of vascular smooth muscle cells and an increased metabolic level of cardiomyocytes. These may be strategies for the yak to adapt to high-altitude hypoxia environments.

Solvent-Responsive Reversible and Controllable Conversion between a Polyimine Membrane and an Organic Molecule Cage.

Adaptive bionic self-correcting behavior offers an attractive property for chemical systems. Here, based on the dynamic feature of imine formation, we propose a solvent-responsive strategy for smart switching between an amorphous ionic polyimine membrane and a crystalline organic molecule cage without the addition of other building blocks. To adapt to solvent environmental constraints, the aldehyde and amine components undergo self-correction to form a polymer network or a molecular cage. Studies have shown that the amorphous film can be switched in acetonitrile to generate a discrete cage with bright birefringence under polarized light. Conversely, the membrane from the cage crystal conversion can be regained in ethanol. Such a membrane-cage interconversion can be cycled continuously at least 5 times by switching the two solvents. This work builds a bridge between the polymer network and crystalline molecules and offers prospects for smart dynamic materials.

Boost of Gas Adsorption Kinetics of Covalent Organic Frameworks via Ionic Liquid Solution Process.

Adsorption, storage, and conversion of gases (e.g., carbon dioxide, hydrogen, and iodine) are the three critical topics in the field of clean energy and environmental mediation. Exploring new methods to prepare high-performance materials to improve gas adsorption is one of the most concerning topics in recent years. In this work, an ionic liquid solution process (ILSP), which can greatly improve the adsorption kinetic performance of covalent organic framework (COF) materials for gaseous iodine, is explored. Anionic COF TpPaSO3 H is modified by amino-triazolium cation through the ILSP method, which successfully makes the iodine adsorption kinetic performance (K80% rate) of ionic liquid (IL) modified COF AC4 tirmTpPaSO3 quintuple compared with the original COF. A series of experimental characterization and theoretical calculation results show that the improvement of adsorption kinetics is benefited from the increased weak interaction between the COF and iodine, due to the local charge separation of the COF skeleton caused by the substitution of protons by the bulky cations of ILs. This ILSP strategy has competitive help for COF materials in the field of gas adsorption, separation, or conversion, and is expected to expand and improve the application of COF materials in energy and environmental science.

Controlling the directional excitation of surface plasmon polaritons using tunable non-Hermitian metasurfaces.

In this work, we propose an efficient approach to controlling the directional excitation of surface plasmon polaritons (SPPs) by dynamically modulating the real-part perturbation in a passive parity-time symmetric metasurface. This non-Hermitian system can experience two exceptional points that can induce two unidirectional excitation states of SPPs along opposite directions. Empowered by its superior modulation depth, the energy ratio and energy intensities of two excited SPP states can be effectively manipulated by this non-Hermitian metasurface. To demonstrate these findings, we design and numerically verify non-Hermitian metasurfaces integrated with an Sb2Se3 phase-change material. Our work provides a promising platform for the controllable engineering of SPP excitations, holding significant potential for the development of new plasmonic devices, including on-chip SPP sources, routers and sorters, and integrated optical circuits.

Modulating oxidative stress counteracts specific antigen-induced regulatory T-cell apoptosis in mice.

Treg are known to have a central role in orchestrating immune responses, but less is known about the destiny of Treg after being activated by specific Ags. This study aimed to investigate the role of superoxide dismutase, an active molecule in the regulation of oxidative stress in the body, in the prevention of Treg apoptosis induced by specific Ags. Ag-specific Tregs were isolated from the DO11.10 mouse intestine. A food allergy mouse model was developed with ovalbumin as the specific Ag and here, we observed that exposure to specific Ag induced Treg apoptosis through converting the precursor of TGF-ß to its mature form inside the Tregs. Oxidative stress was induced in Tregs upon exposure to specific Ags, in which Smad3 bound the latency-associated peptide to induce its degradation, converting the TGF-ß precursor to its mature form, TGF-ß. Suppressing oxidative stress in Tregs alleviated the specific Ag-induced Treg apoptosis in in vitro experiments and suppressed experimental food allergy by preventing the specific Ag-induced Treg apoptosis in the intestine. In conclusion, exposure to specific Ags induces Treg apoptosis and it can be prevented by upregulating superoxide dismutase or suppressing reactive oxidative species in Tregs.

Management of Palatal Fistula Using Superficial Circumflex Iliac Artery Perforator Flap With Intraoral Anastomosis and Supermicrosurgery Techniques.

ABSTRACT: Postoperative palatal fistula following primary cleft palate repair, especially wide and recurrent defects, presents significant challenges to management. When the fistula is surrounded by limited and scarred regional tissues, vascularized free flaps are recommended. The authors propose a novel method to repair a wide and recurrent palatal fistula resulting in excellent aesthetics and minor donor-site complications. The superficial circumflex iliac artery perforator flap was transferred with the application of intraoral anastomosis and supermicrosurgery techniques for palatal fistula closure.

A fully automated microfluidic PCR-array system for rapid detection of multiple respiratory tract infection pathogens.

Rapid and accurate identification of respiratory tract infection pathogens is of utmost importance for clinical diagnosis and treatment, as well as prevention of pathogen transmission. To meet this demand, a microfluidic chip-based PCR-array system, Onestart, was developed. The Onestart system uses a microfluidic chip packaged with all the reagents required, and the waste liquid is also collected and stored on the chip. This ready-to-use system can complete the detection of 21 pathogens in a fully integrated manner, with sample lysis, nucleic acid extraction/purification, and real-time PCR sequentially implemented on the same chip. The entire analysis process is completed within 1.5 h, and the system automatically generates a test report. The lower limit-of-detection (LOD) of the Onestart assay was determined to be 1.0 × 103 copies·mL-1. The inter-batch variation of cycle threshold (Ct) values ranged from 0.08% to 0.69%, and the intra-batch variation ranged from 0.9% to 2.66%. Analytical results of the reference sample mix showed a 100% specificity of the Onestart assay. The analysis of batched clinical samples showed consistency of the Onestart assay with real-time PCR. With its ability to provide rapid, sensitive, and specific detection of respiratory tract infection pathogens, application of the Onestart system will facilitate timely clinical management of respiratory tract infections and effective prevention of pathogen transmission. Onestart, a ready-to-use system, can detect 21 pathogens in a fully integrated manner on a microchip within 1.5 h.

LncRNA-HNF1A-AS1 functions as a competing endogenous RNA to activate PI3K/AKT signalling pathway by sponging miR-30b-3p in gastric cancer.

BACKGROUND: Accumulating evidence demonstrated that long noncoding RNAs (lncRNAs) played important regulatory roles in many cancer types. However, the role of lncRNAs in gastric cancer (GC) progression remains unclear. METHODS: RT-qPCR assay was performed to detect the expression of HNF1A-AS1 in gastric cancer tissues and the non-tumourous gastric mucosa. Overexpression and RNA interference approaches were used to investigate the effects of HNF1A-AS1 on GC cells. Insight into competitive endogenous RNA (ceRNA) mechanisms was gained via bioinformatics analysis, luciferase assays and an RNA-binding protein immunoprecipitation (RIP) assay, RNA-FISH co-localisation analysis combined with microRNA (miRNA)-pulldown assay. RESULTS: This study displayed that revealed expression of HNF1A-AS1 was associated with positive lymph node metastasis in GC. Moreover, HNF1A-AS1 significantly promoted gastric cancer invasion, metastasis, angiogenesis and lymphangiogenesis in vitro and in vivo. In addition, HNF1A-AS1 was demonstrated to function as a ceRNA for miR-30b-3p. HNF1A-AS1 abolished the function of the miRNA-30b-3p and resulted in the derepression of its target, PIK3CD, which is a core oncogene involved in the progression of GC. CONCLUSION: This study demonstrated that HNF1A-AS1 worked as a ceRNA and promoted PI3K/AKT signalling pathway-mediated GC metastasis by sponging miR-30b-3p, offering novel insights of the metastasis mechanism in GC.

Self-Assembled Biomimetic Capsules for Self-Preservation.

The inorganic semiconductor is an attractive material in sewage disposal and solar power generation. The main challenges associated with environment-sensitive semiconductors are structural degradation and deactivation caused by the unfavorable environment. Here, inspired by the pomegranate, a self-protection strategy based on the self-assembly of silver chloride (AgCl) particles is reported. The distributed photosensitive AgCl particles can be encapsulated by themselves through mixing aqueous silver nitrate and protic ionic liquids (PILs). A probable assembling mechanism is proposed based on the electrostatic potential investigation of PILs cations. The AgCl particles inside the shell maintain their morphology and structure well after 6 months light-treatment. Moreover, they exhibit excellent photocatalytic activity, same as newly prepared AgCl particles, for degradation of methyl orange (MO), neutral red (NR), bromocresol green (BG), rhodamine B (RhB), Congo red (CR), and crystal violet (CV).

iso-µmGene: an isothermal amplification-based portable microfluidic system for simple, reliable and flexibly multiplexed genetic identification and quantification.

Simple, reliable and flexibly multiplexed genetic identification and quantification of microbial pathogens is in urgent need for early disease diagnosis and timely treatment. This study presented an isothermal amplification-based portable microfluidic system (iso-µmGene) with features of multi-well chips for convenient filling and reliable sealing, flexible detection throughput, and a stand-alone and well-performing point of care (POC) genetic testing device. Using disposable chips with two kinds of reaction wells (eighteen and ten wells) and a device prototype with independent four chip holders, the iso-µmGene enables on-demand analysis of different target genes in one sample per chip and one to four samples (chips) per run, requiring only a single pipetting step for dispensing per chip with dehydrated primers. To completely seal the loop-mediated isothermal amplification (LAMP) reaction system to minimize the risk of amplicon escape, a dedicated plastic shell is used to assemble the array-type chip and reliably close its openings. Meanwhile, to enhance the precision for flexibly multiplexed detection and decrease the size and cost of the device, we designed a thermoelectric cooler (TEC)-based temperature-control module including two separate units and a CCD-based fluorescence imaging module containing a linear translation stage for real-time LAMP assay. This work demonstrated applications for the parallel detection of 2-2000 CFU (colony forming units) per reaction well with good intra- and inter-chip reproducibility using the crude lysates of two aquaculture pathogens Edwardsiella tarda and Vibrio harveyi. Overall, the iso-µmGene presented here possesses both a sophisticated instrument's functionality and performance and POC device's portability and cost.

Biocompatible Ionic Liquid Based on Curcumin as Fluorescence Probe for Detecting Benzoyl Peroxide without the Interference of H2O2.

Accurate estimation of the level of benzoyl peroxide (BPO) is of considerable significance because of its threat to humanity and environment. Several research efforts have been devoted to the detection of BPO by fluorescent method with high sensitivity and selectivity. However, it remains challenging to eliminate the interference of H2O2 due to its similar properties to BPO. In this work, the first demonstration of fluorescent and colorimetric probe for specific detection of BPO without the disturbance of H2O2 was achieved by curcumin-based ionic liquid (CIL) that possesses simple fabrication, good biocompatibility, and low cost. The fluorescence quenches and emission peak blue-shifts once the probe selectively interacts with BPO, whereas the other possible interfering agents, including H2O2, do not have this phenomenon. The probe CIL exhibits prominent sensitivity for BPO sensing and enables the detection limit at levels as ultralow as 10 nM. The local detection of BPO in practical samples is realized by visualization using a portable device derived from CIL-based liquid atomizer.

Investigation of Acoustic Injection on the MPU6050 Accelerometer.

Acoustic injection is one of the most dangerous ways of causing micro-electro-mechanical systems (MEMS) failures. In this paper, the failure mechanism of acoustic injection on the microprocessor unit 6050 (MPU6050) accelerometer is investigated by both experiment and simulation. A testing system was built to analyze the performance of the MPU6050 accelerometer under acoustic injection. A MEMS disassembly method was adopted and a MATLAB program was developed to establish the geometric model of MPU6050. Subsequently, a finite element model of MPU6050 was established. Then, the acoustic impacts on the sensor layer of MPU6050 were studied by acoustic-solid coupling simulations. The effects of sound frequencies, pressures and directions were analyzed. Simulation results are well agreed with the experiments which indicate that MPU6050 is most likely to fail under the sounds of 11,566 Hz. The failure mechanism of MPU6050 under acoustic injection is the relative shift of the capacitor flats caused by acoustic-solid resonance that make the sensor detect false signal and output error data. The stress is focused on the center linkage. MPU6050 can be reliable when the sound pressure is lower than 100 dB.

Mandibular growth in survivors of pediatric parotid gland carcinoma treated with interstitial brachytherapy.

BACKGROUND: The aim of the study was to present long-term results of mandibular growth in pediatric parotid gland carcinoma survivors treated with interstitial brachytherapy. PROCEDURE: Twenty-five survivors of pediatric parotid gland carcinoma treated with iodine-125 seed interstitial brachytherapy were included for quantitative analysis, including three dimensional (3D) cephalometry and measurement of mandibular volume. RESULTS: 3D cephalometry showed that the median fore-and-aft increments of the lengths of the condyle, the ramus, and the body of the mandible were 1.23, 0.19, and 1.66 mm for the affected side, respectively, and were 1.37, 1.95, and 3.42 mm for the unaffected side, respectively. The difference in increments of the ramus was statistically significant between the affected side and the unaffected side (P = 0.003; P < 0.05). Moreover, mandibular volume measurements showed that the median fore-and-aft increments of the volumes of the condyle, the ramus, and the body of the mandible were 290.62, 220.14, and 1706.40 mm3 for the affected side, respectively, and were 269.15, 370.40, and 1469.86 mm3 for the unaffected side, respectively. The difference in increments was statistically significant between the affected side and the unaffected side for the ramus (P = 0.005; P < 0.05) and the body (P = 0.043; P < .05). CONCLUSION: Mandibular growth was affected by interstitial brachytherapy, especially for the ramus, in pediatric parotid gland carcinoma survivors treated with interstitial brachytherapy. Nevertheless, the impact was mild in these survivors.

Performance Analysis of NDT-based Graph SLAM for Autonomous Vehicle in Diverse Typical Driving Scenarios of Hong Kong.

Robust and lane-level positioning is essential for autonomous vehicles. As an irreplaceable sensor, Light detection and ranging (LiDAR) can provide continuous and high-frequency pose estimation by means of mapping, on condition that enough environment features are available. The error of mapping can accumulate over time. Therefore, LiDAR is usually integrated with other sensors. In diverse urban scenarios, the environment feature availability relies heavily on the traffic (moving and static objects) and the degree of urbanization. Common LiDAR-based simultaneous localization and mapping (SLAM) demonstrations tend to be studied in light traffic and less urbanized area. However, its performance can be severely challenged in deep urbanized cities, such as Hong Kong, Tokyo, and New York with dense traffic and tall buildings. This paper proposes to analyze the performance of standalone NDT-based graph SLAM and its reliability estimation in diverse urban scenarios to further evaluate the relationship between the performance of LiDAR-based SLAM and scenario conditions. The normal distribution transform (NDT) is employed to calculate the transformation between frames of point clouds. Then, the LiDAR odometry is performed based on the calculated continuous transformation. The state-of-the-art graph-based optimization is used to integrate the LiDAR odometry measurements to implement optimization. The 3D building models are generated and the definition of the degree of urbanization based on Skyplot is proposed. Experiments are implemented in different scenarios with different degrees of urbanization and traffic conditions. The results show that the performance of the LiDAR-based SLAM using NDT is strongly related to the traffic condition and degree of urbanization. The best performance is achieved in the sparse area with normal traffic and the worse performance is obtained in dense urban area with 3D positioning error (summation of horizontal and vertical) gradients of 0.024 m/s and 0.189 m/s, respectively. The analyzed results can be a comprehensive benchmark for evaluating the performance of standalone NDT-based graph SLAM in diverse scenarios which is significant for multi-sensor fusion of autonomous vehicle.

ENIGMA-Viewer: interactive visualization strategies for conveying effect sizes in meta-analysis.

BACKGROUND: Global scale brain research collaborations such as the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) consortium are beginning to collect data in large quantity and to conduct meta-analyses using uniformed protocols. It becomes strategically important that the results can be communicated among brain scientists effectively. Traditional graphs and charts failed to convey the complex shapes of brain structures which are essential to the understanding of the result statistics from the analyses. These problems could be addressed using interactive visualization strategies that can link those statistics with brain structures in order to provide a better interface to understand brain research results. RESULTS: We present ENIGMA-Viewer, an interactive web-based visualization tool for brain scientists to compare statistics such as effect sizes from meta-analysis results on standardized ROIs (regions-of-interest) across multiple studies. The tool incorporates visualization design principles such as focus+context and visual data fusion to enable users to better understand the statistics on brain structures. To demonstrate the usability of the tool, three examples using recent research data are discussed via case studies. CONCLUSIONS: ENIGMA-Viewer supports presentations and communications of brain research results through effective visualization designs. By linking visualizations of both statistics and structures, users can gain more insights into the presented data that are otherwise difficult to obtain. ENIGMA-Viewer is an open-source tool, the source code and sample data are publicly accessible through the NITRC website ( http://www.nitrc.org/projects/enigmaviewer_20 ). The tool can also be directly accessed online ( http://enigma-viewer.org ).

Heterochronicity of white matter development and aging explains regional patient control differences in schizophrenia.

BACKGROUND: Altered brain connectivity is implicated in the development and clinical burden of schizophrenia. Relative to matched controls, schizophrenia patients show (1) a global and regional reduction in the integrity of the brain's white matter (WM), assessed using diffusion tensor imaging (DTI) fractional anisotropy (FA), and (2) accelerated age-related decline in FA values. In the largest mega-analysis to date, we tested if differences in the trajectories of WM tract development influenced patient-control differences in FA. We also assessed if specific tracts showed exacerbated decline with aging. METHODS: Three cohorts of schizophrenia patients (total n = 177) and controls (total n = 249; age = 18-61 years) were ascertained with three 3T Siemens MRI scanners. Whole-brain and regional FA values were extracted using ENIGMA-DTI protocols. Statistics were evaluated using mega- and meta-analyses to detect effects of diagnosis and age-by-diagnosis interactions. RESULTS: In mega-analysis of whole-brain averaged FA, schizophrenia patients had lower FA (P = 10-11 ) and faster age-related decline in FA (P = 0.02) compared with controls. Tract-specific heterochronicity measures, that is, abnormal rates of adolescent maturation and aging explained approximately 50% of the regional variance effects of diagnosis and age-by-diagnosis interaction in patients. Interactive, three-dimensional visualization of the results is available at www.enigma-viewer.org. CONCLUSION: WM tracts that mature later in life appeared more sensitive to the pathophysiology of schizophrenia and were more susceptible to faster age-related decline in FA values. Hum Brain Mapp 37:4673-4688, 2016. © 2016 Wiley Periodicals, Inc.

Effects of thermal stress on lipid peroxidation and antioxidant enzyme activities of the predatory mite, Neoseiulus cucumeris (Acari: Phytoseiidae).

Changes in temperature are known to cause a variety of physiological stress responses in insects and mites. Thermal stress responses are usually associated with the increased generation of reactive oxygen species (ROS), resulting in oxidative damage. In this study, we examined the time-related effect (durations for 1, 2, 3, and 5 h) of thermal stress conditions-i.e., relatively low (0, 5, 10, and 15 °C) or high (35, 38, 41, and 44 °C) temperatures-on the activities of antioxidant enzymes including catalase (CAT), superoxide dismutase (SOD), peroxidase (POX), glutathione S-transferases (GSTs), and total antioxidant capacity (T-AOC) of the predatory mite Neoseiulus cucumeris. Also the lipid peroxidation (LPO) levels of the predatory mite were measured under thermal stress conditions. The results confirmed that thermal stress results in a condition of so-called oxidative stress and the four antioxidant enzymes play an important role in combating the accumulation of ROS in N. cucumeris. CAT and POX activity changed significantly when the mites were exposed to cold and heat shock, respectively. The elevated levels of SOD and GSTs activity, expressed in a time-dependent manner, may have an important role in the process of antioxidant response to thermal stress. However, the levels of LPO in N. cucumeris were high, serving as an important signal that these antioxidant enzyme-based defense mechanisms were not always adequate to counteract the surplus ROS. Thus, we hypothesize that thermal stress, especially extreme temperatures, may contribute much to the generation of ROS in N. cucumeris, and eventually to its death.

Effect of patellofemoral joint overstuffing following total knee arthroplasty without patella resurfacing on clinical efficacy and related factors analysis.

OBJECTIVE: To analyze the influencing factors for patellofemoral joint (PFJ) overstuffing following total knee arthroplasty (TKA) without patella resurfacing, and explore the effect of PFJ overstuffing on clinical efficacy. METHODS: A retrospective analysis was conducted on 168 patients with end-stage knee osteoarthritis who underwent TKA without patella resurfacing at our hospital between Match 2019 and September 2021. The clinical data of these patients were retrospectively analyzed. In this study, PFJ overstuffing was defined as a postoperative PFJ distance greater than 1 mm compared to the preoperative measurement. The occurrence of postoperative PFJ overstuffing was counted. The patients were divided into the overstuffing group (n = 109) and the non-overstuffing group (n = 59) to count the patellar thickness and thickness of femoral anterior condyle in all patients before and after surgery, and analyze the influencing factors for postoperative PFJ overstuffing in such patients. Patients were followed up for 2 years to compare the recovery time of postoperative pain, score of visual analogue scale (VAS) and flexion activity between the two groups. RESULTS: There was no significant difference in patellar thickness between preoperative and postoperative measurements of the patients (P > 0.05). However, the thickness of the femoral anterior condyle and the PFJ distance after surgery increased significantly compared with those before surgery (P < 0.05). Among the 168 patients, 109 cases (64.88%) experienced PFJ overstuffing. The risk of PFJ overstuffing was higher in female patients than in male (P < 0.05). The preoperative thickness of the femoral anterior condyle in the overstuffing group was significantly smaller compared to the non-overstuffing group (P < 0.001). Compared with the non-overstuffing group, the overstuffing group had longer recovery time of postoperative pain (P < 0.05), and had lower flexion activity at 2 years after surgery (P < 0.001). However, no significant difference was found in VAS score between the overstuffing group and the non-overstuffing group at 2 years after surgery (P > 0.05). Spearman rank correlation analysis indicated females tend to have a lower preoperative thickness of the femoral anterior condyle (r=-0.424, P < 0.001), as well as a positive postoperative PFJ overstuffing (r = 0.237, P < 0.05). Furthermore, there was a negative correlation between preoperative thickness of the femoral anterior condyle and postoperative PFJ overstuffing (r=-0.540, P < 0.001). CONCLUSION: Following TKA without patella resurfacing, there is a high risk of PFJ overstuffing, particularly among female patients and those with a small thickness of the femoral anterior condyle. Therefore, special attention should be given to these high-risk groups during clinical treatment.