Effects of dexmedetomidine on renal function, inflammatory markers, and cognitive functioning in elderly patients undergoing hip replacement surgery.

OBJECTIVE: To investigate the effects of dexmedetomidine on renal function, inflammatory markers, and cognitive outcome, and to identify factors influencing early postoperative cognitive dysfunction (POCD) in elderly patients undergoing hip replacement surgery. METHODS: A retrospective analysis was conducted on 162 elderly patients who underwent hip replacement surgery at Cangzhou Central Hospital from March 2022 to May 2023. Patients were divided into a control group (without dexmedetomidine) and an experimental group (with dexmedetomidine). Measurements included creatinine (Cr), blood urea nitrogen (BUN), interleukin 1ß (IL-1ß), tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), Montreal Cognitive Assessment (MoCA) score, and the incidence of POCD seven days postoperatively. Univariate and logistic regression analyses were employed to investigate the predictors of early POCD. RESULTS: Significant differences were observed between the groups in terms of renal function, inflammatory markers, and cognitive outcome (Cr, BUN, IL-1ß, TNF-α, IL-6 and MoCA scores) (all P<0.05). The experimental group showed a significantly lower incidence of POCD at seven days post-surgery (P<0.05). Logistic regression identified having a neuron-specific enolase (NSE) level seven days post-surgery ≥7.0 pg/ml as a risk factor for early POCD (P=0.001, OR=3.987, 95% CI: 1.789-8.886), whereas intraoperative use of dexmedetomidine was a protective factor (P=0.041, OR=0.424, 95% CI: 0.187-0.964). CONCLUSION: The use of dexmedetomidine in hip replacement surgery can mitigate postoperative renal injury and inflammatory response, enhance cognitive outcome, and significantly reduce the incidence and risk of early POCD in elderly patients.

Comparative efficacy and safety of anlotinib and topotecan as second-line treatment in small cell lung cancer: a retrospective cohort study.

Background: Small cell lung cancer (SCLC) presents considerable challenges regarding the availability of second-line treatment options, which remain limited. The paucity of effective therapeutic choices at this setting emphasizes the urgent requirement for rigorous research and investigation into novel treatment strategies. To address this clinical gap, the current study aimed to compare the efficacy and safety of anlotinib with the standard second-line treatment, topotecan, in patients with relapsed SCLC. Methods: This retrospective collected data from SCLC patients who received either anlotinib or topotecan as second-line treatment. The primary endpoints were progression-free survival (PFS), while the secondary endpoints included the overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety assessment. Results: The study included 46 SCLC patients, with 20 receiving anlotinib and 26 receiving topotecan as second-line treatment. The anlotinib group showed a significantly longer median PFS compared to the topotecan group [5.6 vs. 2.2 months; hazard ratio (HR) =0.50; 95% confidence interval (CI): 0.27-0.92; P=0.02]. However, there was no statistically significant difference in OS between the two groups (9.1 vs. 7.7 months; HR =0.88; 95% CI: 0.46-1.70; P=0.71). The ORRs were 20.0% and 7.7% (P=0.48), and the DCRs were 70.0% and 23.1% (P=0.007) for the anlotinib and topotecan groups, respectively. Treatment-related adverse events (TRAEs) occurred in 13 patients (65.0%) in the anlotinib group and 20 (76.9%) in the topotecan group (P=0.49). Conclusions: Anlotinib shows the potential to extend PFS and manageable adverse events (AEs) compared to topotecan in the second-line setting for relapsed SCLC.

The Efficacy and Safety of Minocycline-Containing Quadruple Therapies Against Helicobacter pylori Infection: A Retrospective Cohort Study.

Background: Minocycline, a derivative of tetracycline, has anti-Helicobacter pylori (H. pylori) properties and can be used to treat H. pylori infection. However, only a few randomized controlled trials (RCTs) have investigated the efficacy of minocycline-containing quadruple therapy (MCQT) in treating H. pylori infection. This study aimed to determine the efficacy and safety of MCQT and investigate the factors influencing both aspects. Methods: This was a retrospective cohort study. Patients diagnosed with H. pylori infection between January 1, 2022, and July 31, 2023 at. The primary outcome was the eradication rate of H. pylori, and the secondary outcome was the number and type of adverse events. Results: A total of 828 patients were included in this study. The overall H. pylori eradication rate among the included patients at 95% confidence interval (CI) (Range 0.864 to 0.907) was 88.53%. The H. pylori eradication rate for patients who received MCQT regimen as the primary therapy was 92.28% (95% CI: 0.901-0.945), significantly higher than that of patients who received MCQT as rescue therapy (80.81%; 95% CI: 0.761-0.855, P=0.003). Adverse events, including dizziness, abdominal distension, diarrhea, nausea, abdominal discomfort, constipation, headache, rash, sleep disorder, palpitation, backache, and anorexia, occurred in 185 (22.34%) patients, with dizziness being the most common (75/828, 9.06%). Compliance with MCQT therapy was an independent factor influencing H. pylori eradication in patients receiving MCQT as a primary therapy. Compliance and presence or absence of H. pylori infection symptoms at the time of screening were independent factors influencing H. Pylori eradication in patients receiving MCQT as rescue therapy. Factors that influenced the occurrence of adverse events included reasons for H. pylori infection screening, residence, treatment compliance, and the use of acid-suppressant regimens. Conclusion: MCQT regimens were effective in H. pylori infection eradication, and the treatment resulted only in fewer adverse events when used as primary or rescue therapies for H. pylori infection treatment. Future prospective studies with larger sample sizes and more comprehensive data are needed to validate our findings.

Ionizable Lipids from Click Reactions for Lipid Nanoparticle Assembling and mRNA Delivery.

Ionizable lipid-containing lipid nanoparticles (LNPs) are regarded as promising nonviral vectors for gene therapy delivery systems. Rationale design of the ionizable lipid structure based on initial screening of ionizable lipid molecule libraries combined with systematic comparison and analysis on the physical chemical parameters related to delivery efficiency greatly accelerated the discovery of novel LNP candidates for delivering various nucleic acid therapeutics like mRNAs (mRNAs). Based on the copper-catalyzed azide-alkyne click reaction, which is highly efficient and biocompatible, we were able to obtain the lipid molecule library containing a common triazole moiety between different lipid tails and various substituents as hydrophilic head groups. Herein, we systematically investigated the change of pKa values of different ionizable lipid molecules with different substituents as head groups in the click-based lipid library, mapping the pKa value change to different steps in the process of the LNP assembly and mRNA delivery. Systematic analyses on the data including the pKa value of the ionized lipids and the encapsulation and delivery efficiency of mRNA in LNPs with these ionized lipids provided the possibility of rational design on the head and tail structure for the triazole containing ionized lipids to realize highly efficient delivery of different mRNAs.

[Inhibitory Effect of Metformin and Arsenic Trioxide on KG1a Cell Proliferation].

OBJECTIVE: To investigate the effect of metformin and arsenic trioxide on KG1a cells proliferation of acute myeloid leukemia and its possible mechanism. METHODS: CCK-8 method was used to detect the killing effect of metformin, arsenic trioxide and combined application on KG1a cells. Annexin V-FITC/PI Dual Stain Flow Cytometry was used to detect the effect of combined application on apoptosis of KG1a cells. Western blot was used to detect the expression of intracellular apoptosis-,autophagy-related protein. RESULTS: Metformin and arsenic trioxide alone or in combination could inhibit the proliferation of KG1a cells and induce apoptosis of KG1a cells, and the proliferation inhibition rate and apoptosis rate in the combined drug group were higher than those in the drug group alone(P <0.05). The combination of drugs induced upregulation of Caspase 8 protein and P62 protein expression and was higher than that in the drug group alone(P <0.05). CONCLUSION: Metformin can synergize with arsenic trioxide to kill KG1a cells, and its mechanism of action may be related to inducing apoptosis and enhancing autophagy.

Physiological and transcriptomic analyses of response of walnuts (Juglans regia) to Pantoea agglomerans infection.

Introduction: Walnut blight is a serious bacterial disease that affects the yield and quality of walnuts. Pantoea agglomerans is one of the main causative agents of walnut blight. However, there have been few studies on the response of walnuts to P. agglomerans infection. Methods: In this study, the soluble sugar, photosynthesis, antioxidant enzyme activities, and secondary metabolites were measured, and the transcriptomic analysis was performed to determine the response of walnut tissue cultures to P. agglomerans infection. Results: After pathogen inoculation, the soluble sugar content decreased, and photosynthesis was inhibited. Antioxidant enzyme (superoxide dismutase and peroxidase) activities and secondary metabolites (phenol and flavonoid) contents increased, especially in the early stages of inoculation. Transcriptomic analysis revealed that the phenylpropanoid biosynthesis pathway is induced after infection, and pathogen infection promotes ABA and ethylene signal transduction and inhibits auxin signaling. In addition, SA and JA-related gene expression was altered after inoculation with P. agglomerans, and the FLS- and calcium-mediated disease resistance signaling pathways were activated. Furthermore, our results suggested an involvement of the R-protein RPM-mediated disease resistance pathway in the response of walnuts to bacterial infections. Discussion: Our findings indicated that phenylpropanoid biosynthesis, hormone signal transduction, and plant-pathogen interaction have key roles in pathogenic inoculation, which provide insights into the molecular mechanisms in the response of walnuts to P. agglomerans infection.

C-N Axially Chiral Heterobiaryl Isoquinolinone Skeletons Construction via Cobalt-Catalyzed Atroposelective C-H Activation/Annulation.

Herein, the atroposelective construction of isoquinolinones bearing a C-N chiral axis has been successfully developed via a Co-catalyzed C-H bond activation and annulation process. This conversion can be effectively carried out in an environmentally friendly oxygen atmosphere to generate the target C-N axially chiral frameworks with excellent reactivities and enantioselectivities (up to >99% ee) in the absence of any additives. Additionally, the current protocol has proved to be an alternative approach for the C-N axial architectures fabrication under electrochemical conditions for cobalt/Salox catalysis, and this strategy allowed the efficient and atom-economical synthesis of various axially chiral isoquinolinones under mild reaction conditions.

Cobalt-catalyzed enantioselective C-H/N-H annulation of aryl sulfonamides with allenes or alkynes: facile access to C-N axially chiral sultams.

Herein we report a cobalt-catalyzed enantioselective C-H/N-H annulation of aryl sulfonamides with allenes and alkynes, using either chemical or electrochemical oxidation. By using O2 as the oxidant, the annulation with allenes proceeds efficiently with a low catalyst/ligand loading of 5 mol% and tolerates a wide range of allenes, including 2,3-butadienoate, allenylphosphonate, and phenylallene, resulting in C-N axially chiral sultams with high enantio-, regio-, and position selectivities. The annulation with alkynes also exhibits excellent enantiocontrol (up to >99% ee) with a variety of functional aryl sulfonamides, and internal and terminal alkynes. Furthermore, electrochemical oxidative C-H/N-H annulation with alkynes is achieved in a simple undivided cell, demonstrating the versatility and robustness of the cobalt/Salox system. The gram-scale synthesis and asymmetric catalysis further highlight the practical utility of this method.

C-N Axially Chiral Heterobiaryl Skeletons Construction via Cobalt-Catalyzed Atroposelective Annulation.

Herein, the atroposelective construction of five-six heterobiaryl skeleton-based C-N chiral axis has been successfully accomplished via a Co-catalyzed C-H bond activation and annulation process, in which the isonitrile was employed as the C1 source and the 8-aminoquinoline moiety served as both directing group and integral part of C-N atropisomers, respectively. This conversion can be effectively carried out in an environmentally friendly oxygen atmosphere, generating the target axial heterobiaryls with excellent reactivities and enantioselectivities (up to >99% ee) in the absence of any additives, and the obtained 3-iminoisoindolinone products with a five membered N-heterocycle exhibit high atropostability. Additionally, the C-N axially chiral monophosphine backbones derived from this protocol possess the potential to become an alternative ligand platform.

[Mechanism of heat-clearing prescriptions in alleviating type 2 diabetes mellitus:a review].

Type 2 diabetes mellitus(T2DM), a common chronic metabolic disease, is often accompanied by internal heat syndrome. Heat-clearing prescriptions are widely used to treat different heat syndromes of T2DM from the aspects of clearing stagnant heat, excess heat, damp heat, phlegm heat, and heat toxin, demonstrating remarkable effects. The mechanism of blood sugar-lowering agents has always been a hotspot of research. Recently, the basic studies of heat-clearing prescriptions from different perspectives have been increasing year by year. To clarify the mechanisms of heat-clearing prescriptions and find specific mechanisms, we systematically reviewed the basic studies of heat-clearing prescriptions commonly used for the treatment of T2DM in the past decade, intending to provide a reference for related research.

Ionizable Lipids with Triazole Moiety from Click Reaction for LNP-Based mRNA Delivery.

Ionizable lipid-containing lipid nanoparticles (LNPs) as a non-viral vector with good safety and potency have been considered as an ideal delivery system for gene therapy. The screening of ionizable lipid libraries with common features but diverse structures holds the promise of finding new candidates for LNPs to deliver different nucleic acid drugs such as messenger RNAs (mRNAs). Chemical strategies for the facile construction of ionizable lipid libraries with diverse structure are in high demand. Here, we report on the ionizable lipids containing the triazole moiety prepared by the copper-catalyzed alkyne-azide click reaction (CuAAC). We demonstrated that these lipids served well as the major component of LNPs, in order to encapsulate mRNA using luciferase mRNA as the model system. Thus, this study shows the potential of click chemistry in the preparation of lipid libraries for LNP assembly and mRNA delivery.

A sensitive fluorescence nanoplatform for monitoring benzoyl peroxide in food using carbon dots coupled with glutathione capped gold nanoparticles as FRET probe.

Herein, a sensitive fluorescence nanoplatform for benzoyl peroxide (BPO) detection is constructed from carbon dots (CDs) and glutathione capped gold nanoparticles (GSH-AuNPs). The fluorescence of CDs is first quenched due to the fluorescence resonance energy transfer (FRET) effect in the presence of GSH-AuNPs, and then effectively recovered when adding BPO. The detection mechanism lies in the aggregation of AuNPs in a high salt background due to oxidation of GSH caused by BPO, thus the amount of BPO is reflected by the variations of the recovered signals. The linear range and detection limit in this detection system is found to be 0.05-200 µM (R2 = 0.994) and 0.1 µg g-1 (3σ/K), respectively. Several possible interferents with high concentration show little influence on BPO detection. The proposed assay exhibits good performance for BPO determination in wheat flour and noodles, demonstrating its applicability for facile monitoring BPO additive amount in real foods.

Differences of injury characteristics of medial patellofemoral ligament in acute lateral patellar dislocation and multiligament knee injuries.

BACKGROUND: The injury characteristics of medial patellofemoral ligament (MPFL) in multiligament knee injuries (MLKIs) and the differences of injury patterns of MPFL in MLKIs and acute lateral patellar dislocation (LPD) remain unclear. PURPOSE: To explore the differences of injury characteristics of MPFL after acute LPD and MLKIs. METHODS: Magnetic resonance images were prospectively analyzed in 219 patients after acute LPD or MLKIs. Statistical analyses of the injury patterns of MPFL were performed between LPD and MLKIs. RESULTS: The incidence of partial tear and complete MPFL tear in adolescent LPD and MLKIs were 40.3% and 48.4%, and 27.9% and 16.3%, respectively. Compared with LPD, MLKIs showed lower incidence rates of partial and complete MPFL tears (both P = 0). The MLKI subgroup showed lower incidence rates of MPFL tear at the patellar insertion (PAT), femoral attachment (FEM), and multiple-site of the MPFL (COM) (9.3%, 20.9%, and 14%) when compared with the LPD subgroup (45.2%, 24.2%, and 16.1%) (all P < 0.01). The incidence of partial tear and complete MPFL tear in adult LPD and MLKIs were 41.5% and 47.2%, and 24.6% and 16.4%, respectively. Compared with LPD, MLKIs showed lower incidence rates of partial and complete MPFL tears (both P = 0). The MLKI subgroup showed lower incidence rates of MPFL tear at PAT, FEM, and COM (8.2%, 18%, and 14.8%) when compared with the LPD subgroup (20.8%, 34%, and 30.2%) (all P = 0). CONCLUSION: Compared with LPD, MPFL tears are relatively uncommon in MLKIs. Even if MPFL tears occur, partial tears and femoral-sided tears are relatively more common.

Effects of Spermidine on Mouse Gut Morphology, Metabolites, and Microbial Diversity.

Spermidine is a class of biologically active organic small molecules that play an important role in maintaining intestinal homeostasis. The specific objective of this study was to explore the effects of spermidine on intestinal morphology, metabolites, and microbial diversity in mice. We showed that 0.3 mmol/L of spermidine significantly promoted the growth of ileal villi (p < 0.05), and 3.0 mmol/L of spermidine significantly increased the body weight of mice and promoted the growth of jejunum villi (p < 0.05). The 16S rDNA sequencing results indicated that 3.0 mmol/L of spermidine affected the balance of the intestinal flora by increasing the abundance of intestinal Lactic acid bacteria and reducing the abundance of harmful bacteria (Turicibacter and Alistipes). Additionally, spermidine affects the levels of microbial metabolites such as succinic acid and Pantetheine. In summary, spermidine affects intestinal morphology and regulates intestinal flora and metabolites, and this study has provided a new understanding of spermidine's effects on the intestinal tract.

A novel DNA damage repair-related signature for predicting prognositc and treatment response in non-small lung cancer.

DNA damage repair (DDR) is essential for maintaining genome integrity and modulating cancer risk, progression, and therapeutic response. DDR defects are common among non-small lung cancer (NSCLC), resulting in new challenge and promise for NSCLC treatment. Thus, a thorough understanding of the molecular characteristics of DDR in NSCLC is helpful for NSCLC treatment and management. Here, we systematically analyzed the relationship between DDR alterations and NSCLC prognosis, and successfully established and validated a six-DDR gene prognostic model via LASSO Cox regression analysis based on the expression of prognostic related DDR genes, CDC25C, NEIL3, H2AFX, NBN, XRCC5, RAD1. According to this model, NSCLC patients were classified into high-risk subtype and low-risk subtype, each of which has significant differences between the two subtypes in clinical features, molecular features, immune cell components, gene mutations, DDR pathway activation status and clinical outcomes. The high-risk patients was characterized with worse prognosis, lower proportion and number of DDR mutations, unique immune profile and responsive to immunetherapy. And the low-risk patients tend to have superior survival, while being less responsive to immunotherapy and more sensitive to treatment with DNA-damaging chemotherapy drugs. Overall, this molecular classification based on DDR expression profile enables hierarchical management of patients and personalized clinical treatment, and provides potential therapeutic targets for NSCLC.

Different patterns of exosomal α-synuclein between Parkinson's disease and probable rapid eye movement sleep behavior disorder.

BACKGROUND AND PURPOSE: The insidious onset of Parkinson's disease (PD) makes early diagnosis difficult. Notably, idiopathic rapid eye movement sleep behavior disorder (iRBD) was reported as a prodrome of PD, which may represent a breakthrough for the early diagnosis of PD. However, currently there is no reliable biomarker for PD diagnosis. Considering that α-synuclein (α-Syn) and neuroinflammation are known to develop prior to the onset of clinical symptoms in PD, it was hypothesized that plasma total exosomal α-Syn (t-exo α-Syn), neural-derived exosomal α-Syn (n-exo α-Syn) and exosomal apoptosis-associated speck-like protein containing a caspase activation and recruitment domain (ASC) may be potential biomarkers of PD. METHODS: In this study, 78 PD patients, 153 probable iRBD patients (pRBD) and 63 healthy controls (HCs) were recruited. α-Syn concentrations were measured using a one-step paramagnetic particle-based chemiluminescence immunoassay, and ASC levels were measured using the Ella system. RESULTS: It was found that t-exo α-Syn was significantly increased in the PD group compared to the pRBD and HC groups (p < 0.0001), whilst n-exo α-Syn levels were significantly increased in both the PD and pRBD groups compared to HCs (p < 0.0001). Furthermore, although no difference was found in ASC levels between the PD and pRBD groups, there was a positive correlation between ASC and α-Syn in exosomes. CONCLUSIONS: Our results suggest that both t-exo α-Syn and n-exo α-Syn were elevated in the PD group, whilst only n-exo α-Syn was elevated in the pRBD group. Additionally, the adaptor protein of inflammasome ASC is correlated with α-Syn and may facilitate synucleinopathy.

Identification and genetic diversity analysis of Rickettsia in Dermacentor nuttalli within inner Mongolia, China.

BACKGROUND: The genus Rickettsia contains the lineages spotted fever group (SFG), typhus group (TG), and transitional group (TRG). The spotted fever group Rickettsia (SFGR) is transmitted by ticks. The tick species Dermacentor nuttalli is considered the main vector carrying SFGR in Inner Mongolia. Studying the genetic diversity and population structure of Rickettsia is essential for developing effective control strategies and predicting evolutionary trends of Rickettsia. METHODS: In 2019 we collected 408 D. nuttalli in the Inner Mongolia Autonomous Region, detected the percentage of Rickettsia-positive specimens, and characterized the haplotypes. From the Rickettsia-positive ticks, the gltA and ompA genes were extracted, amplified, and sequenced. RESULTS: Ten haplotypes of the gltA gene and 22 haplotypes of the ompA gene were obtained. The phylogenetic analysis showed that the haplotypes G1-G7 and G9 of the gltA gene cluster with Rickettsia raoultii, while G8 and G10 cluster with Rickettsia sibirica. Haplotypes O1-O15, O18 and O20-O22 of the ompA gene cluster with R. raoultii, while O16 and O19 cluster with R. sibirica. The average haplotype diversity was 0.3 for gltA and 0.7 for ompA. The average nucleotide diversity was greater than 0.05. Neutrality tests were nonsignificant for Tajima's D results and Fu's Fs results. The fixation index values (FST) showed that the degree of genetic differentiation between most sampled populations was small (FST < 0.05), whereas some populations showed a medium (FST > 0.05) or large (FST > 0.15) degree of differentiation. Analysis of molecular variance (AMOVA) revealed that the variation within populations was greater than that between populations. The mismatch analysis of Rickettsia showed double peaks. CONCLUSIONS: We found two Rickettsia spp. (R. raoultii and R. sibirica). The high genetic disparity of Rickettsia allows for easy adaption to different environments. Genetic differentiation between populations is small, and Rickettsia populations do not show a geographically differentiated structure. The high rates of retention and infection of Rickettsia in D. nuttalli together with the animal husbandry exchange in Inner Mongolia gradually led to the harmonization of genetic characteristics of Rickettsia across various regions. Overall, the significant genetic diversity and geographical structure of Rickettsia in D. nuttalli are critical for SFGR control.

Potential Chemoprevention of Paeoniflorin in Colitis-Associated Colorectal Cancer by Network Pharmacology, Molecular Docking, and In Vivo Experiment.

Chronic inflammation plays a positive role in the development and progression of colitis-associated colorectal cancer (CAC). Medicinal plants and their extracts with anti-inflammatory and immunoregulatory properties may be an effective treatment and prevention strategy for CAC. This research aimed to explore the potential chemoprevention of paeoniflorin (PF) for CAC by network pharmacology, molecular docking technology, and in vivo experiments. The results showed that interleukin-6 (IL-6) is a key target of PF against CAC. In the CAC mouse model, PF increased the survival rate of mice and decreased the number and size of colon tumors. Moreover, reduced histological score of colitis and expression of Ki-67 and PCNA were observed in PF-treated mice. In addition, the chemoprevention mechanisms of PF in CAC may be associated with suppression of the IL-6/STAT3 signaling pathway and the IL-17 level. This research provides experimental evidence of potential chemoprevention strategies for CAC treatment.

Factors associated with acute articular cartilage lesions of the patella and lateral femoral condyle in acute first-time lateral patellar dislocation: A prospective magnetic resonance imaging study.

OBJECTIVES: To identify risk factors of acute articular cartilage lesions of the patella and lateral femoral condyle in acute first-time lateral patellar dislocation (LPD). METHODS: Magnetic resonance images were prospectively analyzed in 115 patients in an acute first-time LPD. Factors included gender, skeletal maturity, trochlear dysplasia, patellar height, and tibial tuberosity-trochlear groove (TT-TG) distance. Binary logistic regression analysis was carried out to identify the independent risk factors for the incidence of acute articular cartilage lesions of the patella and lateral femoral condyle in acute first-time LPD. RESULTS: The incidence of acute articular cartilage lesion of the patella and lateral femoral condyle were 46.1% and 27% in acute first-time LPD, respectively. Univariate analysis revealed significantly higher incidence rate of acute articular cartilage lesion of the patella in male (P = 0.027), skeletally mature (P = 0.035), normal TT-TG distance (P = 0.043) and normal femoral trochlea (P = 0.031). Risk factors for the incidence of acute articular cartilage lesion of the patella were skeletally mature (odds ratio (OR): 2.324), normal TT-TG distance (OR: 2.824) and normal femoral trochlea (OR: 3.835). Univariate analysis revealed significantly higher incidence rate of acute articular cartilage lesion of the lateral femoral condyle in skeletally mature (P = 0.027) and normal femoral trochlea (P = 0.031). Risk factor for the incidence of acute articular cartilage lesion of the lateral femoral condyle was normal femoral trochlea (OR: 3.347). CONCLUSIONS: For patients in acute first-time LPD, compared with other parameters, the normal femoral trochlea, normal TT-TG distance and skeletally mature are independent risk factors for the incidence of acute articular cartilage lesion of the patella, and the normal femoral trochlea is an independent risk factor for the incidence of acute articular cartilage lesion of the lateral femoral condyle.

Nickel-Catalyzed anti-Markovnikov Hydrodifluoroalkylation of Unactivated Alkenes.

An efficient Ni-catalyzed hydrodifluoroalkylation of unactivated alkenes with bromodifluoroacetate by using PhSiH3 as hydride source was developed. The transformation affords aliphatic difluorides with anti-Markovnikov regioselectivity. A wide range of highly remote alkenes, simple alkenes, drug molecules, commercially available CF2 precursors, and even nonfluorinated substrates are competent in this reaction under mild conditions, demonstrating the practicability of the strategy. Moreover, mechanistic studies indicated that the difluoroalkyl radical might be a key intermediate to this transformation.