[Revision rate of periprosthetic joint infection post total hip or knee arthroplasty of 34 hospitals in China between 2015 and 2017: a multi-center survey].

Objective: To investigate the rate of periprosthetic joint infection (PJI) revision surgeries and clinical information of hip-/knee- PJI cases nationwide from 2015 to 2017 in China. Methods: An epidemiological investigation. A self-designed questionnaire and convenience sampling were used to survey 41 regional joint replacement centers nationwide from November 2018 to December 2019 in China. The PJI was diagnosed according to the Musculoskeletal Infection Association criteria. Data of PJI patients were obtained by searching the inpatient database of each hospital. Questionnaire entries were extracted from the clinical records by specialist. Then the differences in rate of PJI revision surgery between hip- and knee- PJI revision cases were calculated and compared. Results: Total of 36 hospitals (87.8%) nationwide reported data on 99 791 hip and knee arthroplasties performed from 2015 to 2017, with 946 revisions due to PJI (0.96%). The overall hip-PJI revision rate was 0.99% (481/48 574), and it was 0.97% (135/13 963), 0.97% (153/15 730) and 1.07% (193/17 881) in of 2015, 2016, 2017, respectively. The overall knee-PJI revision rate was 0.91% (465/51 271), and it was 0.90% (131/14 650), 0.88% (155/17 693) and 0.94% (179/18 982) in 2015, 2016, 2017, respectively. Heilongjiang (2.2%, 40/1 805), Fujian (2.2%, 45/2 017), Jiangsu (2.1%, 85/3 899), Gansu (2.1%, 29/1 377), Chongqing (1.8%, 64/3 523) reported relatively high revision rates. Conclusions: The overall PJI revision rate in 34 hospitals nationwide from 2015 to 2017 is 0.96%. The hip-PJI revision rate is slightly higher than that in the knee-PJI. There are differences in revision rates among hospitals in different regions.

Meta-analysis of the association between primary tumour location and prognosis after surgical resection of colorectal liver metastases.

BACKGROUND: Primary tumour location is emerging as an important prognostic factor in localized and metastatic colorectal cancers. However, its prognostic role in colorectal liver metastasis (CRLM) after hepatectomy remains controversial. A systematic review and meta-analysis was undertaken to evaluate its prognostic value. METHODS: References were identified through searches of PubMed, Embase, Web of Science and the Cochrane Library comparing overall or disease-free survival after hepatic resection between patients with CRLM originating from right- or left-sided colorectal cancers. Data were pooled using hazard ratios (HRs) and 95 per cent confidence intervals according to a random-effects model. Meta-regression and subgroup analyses were conducted to assess the effect of underlying confounding factors on HR estimates and to adjust for this. RESULTS: The final analysis included 21 953 patients from 45 study cohorts. Compared with left-sided primary tumour location, right-sided location was associated with worse overall survival (HR 1·39, 95 per cent c.i. 1·28 to 1·51; P < 0·001; prediction interval 1·00 to 1·93), and also tended to have a negative impact on disease-free survival (HR 1·18, 1·06 to 1·32; P = 0·004; prediction interval 0·79 to 1·75). Subgroup analysis showed that the negative effect of right-sided primary tumour location on overall survival was more prominent in the non-Asian population (HR 1·47, 1·33 to 1·62) than the Asian population (HR 1·18, 1·05 to 1·32) (P for interaction <0·01). CONCLUSION: This study demonstrated a prognostic role for primary tumour location in patients with CRLM receiving hepatectomy, especially regarding overall survival. Adding primary tumour location may provide important optimization of prognosis prediction models for CRLM in current use.

ANTECEDENTES: La ubicación del tumor primario (primary tumor location, PTL) ha surgido como un factor pronóstico importante en los cánceres colorrectales (colorectal cancers, CRCs) localizados y metastásicos. Sin embargo, todavía se discute su relevancia como factor pronóstico tras la resección de metástasis hepáticas de cáncer colorrectal (colorectal liver metastases, CRLM). Se realizó una revisión sistemática y un metaanálisis para determinar su valor pronóstico. MÉTODOS: En PubMed, EMBASE, Web of Science y la Biblioteca Cochrane se identificaron los trabajos que compararon la supervivencia global (overall survival, OS) y la supervivencia libre de enfermedad (disease-free survival, DFS) tras la resección hepática de CRLM cuyo CRCs estuviese situado en el lado derecho o izquierdo. Los datos se expresaron en forma del cociente de riesgos instantáneos (hazard ratio, HR) e intervalos de confianza del 95% (i.c. del 95%) de acuerdo con un modelo de efectos aleatorios. Se efectuaron análisis de metarregresión y de subgrupos para evaluar el efecto de los factors de confusión existentes en las estimaciones de HR, ajustando por los mismos. RESULTADOS: El análisis final incluyó 21.953 pacientes de cohortes de 45 estudios. La PTL en el lado derecho en comparación con el lado izquierdo se asoció con una peor supervivencia global (HR 1,39; i.c. del 95% 1,28-1,51; P < 0,001; intervalo de predicción 1,00-1,93) y una tendencia a un impacto negativo en la DFS (HR 1,18; i.c. del 95% 1,06-1,32; P = 0,004; intervalo de predicción 0,79-1,75). El análisis de subgrupos mostró que el efecto negativo de la PTL del lado derecho en la OS fue más prominente en la población no asiática (HR 1,47; i.c. del 95% 1,33-1,62) que en la asiática (HR 1,18; i.c. del 95% 1,05-1,32; Pinteracción < 0,01). CONCLUSIÓN: Este estudio demostró que la PTL tiene un papel pronóstico tras la hepatectomía de las CRLM, especialmente respecto a la OS. La adición de la PTL proporcionaría una optimización importante en los modelos actuales de predicción pronóstica de CRLM.

[Spatial-temporal analysis on the human immunodeficiency virus/acquired immunodeficiency syndrome among permanent residence and migrants in Shanghai, 2005-2015].

Objective: To describe the spatial and temporal characteristics of human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS) in permanent residents and migrants in Shanghai during 2005 to 2015 and provide suggestions for the HIV/AIDS prevention. Methods: The data of HIV/AIDS was collected from the National HIV/AIDS Comprehensive Information Management System based on report date. The population data was collected from the statistical yearbook of Shanghai. Spatial analysis was conducted using the hotspots model in ArcGIS. SaTScan software was employed to determine the distribution of HIV clusters in space, time or both. Results: During 2005 to 2015, a total of 13 498 cases of HIV/AIDS were reported in Shanghai. The prevalence of HIV increased from 0.025/10(5) (450 cases) to 0.093/10(5) (2 236 cases). The prevalence of AIDS increased from 0.002/10(5) (32 cases) to 0.028/10(5) (683 cases). Hotspot analysis showed that the hot spot of incidence of migrants had moved from Hongkou (2005) (Z=2.96, P=0.003) to Changning (2006-2015) (all Z>1.96, P<0.05); whereas the hot spot of incidence of permanent residents had moving from Jinshan (2005-2007) (all Z>2.58, P<0.01) to downtown area (2006-2015) (all Z>1.96, P<0.05). The spatial high clusters of HIV and AIDS were same, including Huangpu, Xuhui, Changning, Jingan, Putuo, Hongkou and Yangpu; The temporal high clusters of HIV cases among permanent residents were 2011 to 2015, and the spatial clusters were Huangpu, Xuhui, Changning, Jingan. The temporal high clusters of HIV cases among migrants were 2014 to 2015, and the spatial clusters was Xuhui, Changning, Jingan. Conclusion: The total HIV/AIDS incidence in Shanghai was clustered in downtown area. The cluster of the incidence of the permanent residents had moving towards that of migrants, indicating the cluster area deserves a close surveillance.

[Epidemiologic and spatio-temporal characteristics of hepatitis E in China, 2004-2014].

Objective: To describe and analyze the epidemiologic and spatio-temporal characteristics of hepatitis E in China from 2004 to 2014. Methods: Data on the incidence of hepatitis E in 31 provinces (municipality and autonomous region) from 2004 to 2014, were collected. Empirical Mode Decomposition (EMD) was applied to decompose the time-series data to accurately describe the trend of hepatitis E incidence. Mathematic model was used to estimate the annual change of incidence in each age group and the whole province. Software ArcGIS 10.1 and SaTScan 9.01 were used to analyze the spatio-temporal clusters. Results: During 2004-2014, a total of 245 414 hepatitis E cases were reported in China. The overall incidence showed a slight increase (OR=1.05, 95%CI: 1.03-1.10). Incidence rates on hepatitis E were discovered different across the provinces, with significant increase appearing in the southern, central and northwestern areas. The highest increase was seen in the elderly, especially in the 65-69 and 70-74 year-olds. Results from the Local spatial autocorrelation analysis showed that the "high-high cluster" was moving from the north to the south and the "low-low cluster" disappeared as time went by. Data from Spatio-temporal scanning showed that there were five spatio-temporal clustering areas across the country. Conclusion: The overall incidence of hepatitis E was on the rise from 2004 to 2014, in China, but with differences seen across the areas and age groups.

Osteogenesis of umbilical mesenchymal stem cells is enhanced in absence of DNA methyltransferase 3B (DNMT3B) through upregulating Runx2 expression.

OBJECTIVE: Umbilical mesenchymal stem cells (UMSCs) is one of most popular regenerative medical source of bone replacement therapy in both clinical and scientific researches. However, it is still low effective to induce the osteogenesis of hUMSCs. In this study, we aimed to elucidate the roles of DNA methyltransferase 3B (DNMT3B) in the osteogenesis of hUMSCs. MATERIALS AND METHODS: Knockdown DNMT3B in hUMSCs was gained via RNA interference technology. After confirming the decrease of DNMT3B in mutant hUMSCs by immunostaining and qPCR, osteogenesis differentiation was carried out. To identify the phenotype of osteogenesis in both bone formation ability and function of bone, immunostaining, qPCR and functional test was performed, compared to wildtype hUMSCs. RESULTS: Real-time Quantitative PCR (qPCR) and immunostaining results indicated that lacking of DNTM3B the osteogenesis related genes were significantly downregulated. Meanwhile, the functional test was also consistent with the downregulated differentiation result. CONCLUSIONS: The osteogenesis differentiation of hUMSCs is impaired in the absence of DNMT3B.

Computer navigation did not improve alignment in a lower-volume total knee practice.

UNLABELLED: Postoperative alignment of the implanted prosthesis in computer-navigated TKA has been reported to be superior to that using the conventional technique. There is an assumption that use of computer navigation techniques can make an inexperienced or occasional TKA surgeon perform more like an expert TKA surgeon. To assess improved accuracy in recreation of mechanical alignment in TKA performed using computer navigation, a retrospective review of the experience of one of the authors (WPY) before and after using computer navigation was performed. We reviewed the radiographic results of 104 TKAs (52 computer navigation, 52 conventional technique) and found the accuracy of postoperative radiographic alignment of the implanted prosthesis was not improved by using computer navigation as judged by (1) overall limb alignment (case: varus 1.3 degrees ; control: varus 0.3 degrees ); (2) femoral component alignment (case: 90.3 degrees ; control: 90.3 degrees ); and (3) tibial component alignment (case: 89 degrees ; control: 90 degrees ). Significant factors that affected postoperative overall mechanical alignment in the current navigation series included severity of the preoperative deformity, amount of error in making bone cuts, and experience of the surgeon in using the computer navigation system. LEVEL OF EVIDENCE: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

A mixed-valence manganese(III)-manganese(IV) di-mu-oxo complex, [(cyclam)MnO]2(ClO4)2(NO3).

The title dinuclear di-mu-oxo-bis[(1,4,8,11-tetraazacyclotetradecane-kappa(4)N)manganese(III,IV)] diperchlorate nitrate complex, [Mn(2)O(2)(C(10)H(24)N(4))(2)](ClO(4))(2)(NO(3)) or [(cyclam)MnO](2)(ClO(4))(2)(NO(3)), was self-assembled by the reaction of Mn(2+) with 1,4,8,11-tetraazacyclotetradecane in aqueous media. The structure of this compound consists of a centrosymmetric binuclear [(cyclam)MnO](3+) unit, two perchlorate anions and one nitrate anion. While the low-temperature electron paramagnetic resonance spectra show a typical 16-line signal for a di-mu-oxo Mn(III)/Mn(IV) dimer, the magnetic susceptibility studies also confirm a characteristic antiferromagnetic coupling between the electronic spins of the Mn(IV) and Mn(III) ions.

A convenient route to synthesize the fully conjugated bimetallic complex (Bu4N)2[tto[Ni(dmit)2]] (tto = tetrathiooxalate, C2S4(2-), and dmit = 1,3-dithiole-2-thione-4,5-dithiolate, C3S5(2-) and the crystal structure of a new crystal form.

A novel route for the conversion of (Bu4N)2[Ni(dmit)2] to (Bu4N)2[tto[Ni(dmit)2]] is reported here. This provides a much more efficient way of synthesizing (Bu4N)2[tto[Ni(dmit)2]] than the literature method. During the process, the conversion of dmit2- to tto2- was realized for the first time. This new synthesis should facilitate further research on the conducting bimetallic complexes [C]x[tto[Ni(dmit)2]]. In addition, a new crystal form of (Bu4N)2[tto[Ni(dmit)2]]. In addition, a new crystal form of (Bu4N)2[tto[Ni(dmit)2]] was determined by X-ray crystallographic analysis.