Increased risk of periprosthetic joint infection after traumatic injury in joint revision patients.

BACKGROUND: Periprosthetic joint infection (PJI) is a serious complication after total joint arthroplasty (TJA). Although some risk factors of PJI were well studied, the association between trauma and PJI remains unknown in revision patients. MATERIALS AND METHODS: Between 2015 and 2018, a total of 71 patients with trauma history before revisions (trauma cohort) were propensity score matched (PSM) at a ratio of 1 to 5 with a control cohort of revision patients without a history of trauma. Then, the cumulative incidence rate of PJI within 3 years after operation between the two groups was compared. The secondary endpoints were aseptic revisions within 3 postoperative years, complications up to 30 postoperative days, and readmission up to 90 days. During a minimal 3-year follow-up, the survival was comparatively analyzed between the trauma cohort and the control cohort. RESULTS: The cumulative incidence of PJI was 40.85% in patients with trauma history against 27.04% in the controls (P = 0.02). Correspondingly, the cumulative incidence of aseptic re-revisions was 12.68% in patients with trauma history compared with 5.07% in the control cohort (P = 0.028). Cox regression revealed that trauma history was a risk factor of PJI (HR, 1.533 [95%CI, (1.019,2.306)]; P = 0.04) and aseptic re-revisions (HR, 3.285 [95%CI, (1.790,6.028)]; P < 0.0001). CONCLUSIONS: Our study demonstrated that revision patients with trauma history carried a higher risk of PJI compared to those without trauma history. Moreover, after revisions, the trauma patients were still at higher risk for treatment failure due to PJI, periprosthetic joint fracture, and mechanical complications.

Rolling circle transcription: A new system to produce RNA microspheres for improving RNAi efficiency in an agriculturally important lepidopteran pest (Mythimna separate).

We applied a new RNA interference (RNAi) system using rolling circle transcription (RCT) technology to generate RNA microspheres (RMS) for targeting two key chitin synthetic pathway genes [chitin synthase A (CHSA), chitin synthase B (CHSB)] in the larvae of the oriental armyworm (Mythimna separate), a RNAi-unsusceptible agriculturally important lepidopteran pest. Feeding the third-instar larvae with the RMS-CHSA- or RMS-CHSB-treated corn leaf discs suppressed the expression of CHSA by 81.7% or CHSB by 88.1%, respectively, at 72 h. The silencing of CHSA consequently affected the larval development, including the reduced body weight (54.0%) and length (41.3%), as evaluated on the 7th day, and caused significant larval mortalities (51.1%) as evaluated on the 14th day. Similar results were obtained with the larvae fed RMS-CHSB. We also compared RNAi efficiencies among different strategies: 1) two multi-target RMS [i.e., RMS-(CHSA + CHSB), RMS-CHSA + RMS-CHSB], and 2) multi-target RMS and single-target RMS (i.e., either RMS-CHSA or RMS-CHSB) and found no significant differences in RNAi efficiency. By using Cy3-labeled RMS, we confirmed that RMS can be rapidly internalized into Sf9 cells (<6 h). The rapid cellular uptake of RMS accompanied with significant RNAi efficiency through larval feeding suggests that the RCT-based RNAi system can be readily applied to study the gene functions and further developed as bio-pesticides for insect pest management. Additionally, our new RNAi system takes the advantage of the microRNA (miRNA)-mediated RNAi pathway using miRNA duplexes generated in vivo from the RMS by the target insect. The system can be used for RNAi in a wide range of insect species, including lepidopteran insects which often exhibit extremely low RNAi efficiency using other RNAi approaches.

Status of robot-assisted artificial total joint arthroplasty in China: a cross-sectional survey of joint surgeons.

PURPOSE: The purpose of this study is to report on the use of Robotic-assisted total joint arthroplasty (RA-TJA) in China as well as the experience and expectations of Chinese doctors regarding this technology. METHOD: A self-administered questionnaire was used to assess the current status of RA-TJA in China, the practical experience and suggestions for improvement of the technology by joint surgeons who have performed RA-TJA, and the interest and expectations of orthopaedic surgeons who have not used RA-TJA. The questionnaire was administered to all the physicians of the Chinese Association of Orthopedic Surgeons (CAOS). RESULT: A total of 372 qualified questionnaires were generated, among which 28% (n = 104) of the respondents had performed RA-TJA, among those who had performed RA-TJA. When asked how helpful the joint replacement robot was actually/expected to be, there was no significant difference between the expected and actual experience of nonusers and users (p ≥ 0.05); the biggest disadvantage of the current development of RA-TJA was perceived as additional charges to the patient by those who had used it, while those who had not used it perceived it as a limitation of their hospital, both of which were significant differences. Most respondents in both groups (used: 94.2%; not used: 91.4%) were confident in the clinical development of the joint replacement robot. CONCLUSION: This survey provides cross-sectional data on the current status of Chinese joint surgeons using or not using robots in their daily clinical practice. Improving surgical precision was the consensus of most respondents, while high surgical costs and limitations of hospital conditions were barriers to its development in China.

Early Clinical and Radiographic Outcomes of Robot-Assisted Versus Conventional Manual Total Knee Arthroplasty: A Randomized Controlled Study.

OBJECTIVE: Robot-assisted surgery has been promoted worldwide in recent years. The development of a domestic orthopaedic robot and its clinical application are therefore of great significance. This study aimed to compare the early clinical and radiographic outcomes of domestic robot-assisted total knee arthroplasty (RA-TKA) with conventional manual total knee arthroplasty (CM-TKA). METHODS: A total of 77 patients who underwent primary single-sided TKA from June to December 2020 were prospectively enrolled; resulting in the inclusion of 72 patients. The patients were randomly divided into the RA-TKA group (37 cases, with TKA being assisted by the Yuanhua Orthopaedic Robotic System) and the CM-TKA group (35 cases, with TKA being performed using conventional tools). Knee function was evaluated by the knee range of motion (ROM), the American Knee Society Score (KSS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Postoperative radiographic results were evaluated by full-length weight-bearing X-rays of the lower limb and anteroposterior and lateral X-rays of the knee were obtained preoperatively and at 90 days postoperative. The operative duration, blood loss, postoperative knee function, radiographic outcomes, and incidence of complications were compared by Student's t-test, Mann-Whitney U test, or chi-square test. Serum levels of inflammatory markers before the operation and 1, 3, and 30 days after the operation were recorded and compared between the two groups. RESULTS: The operation was significantly longer in the RA-TKA group than in the CM-TKA group (154.3 vs 115.2 min, p < 0.001). There was no significant difference in blood loss (933 vs 863 ml, p = 0.519) between the two groups. The knee ROM, KSS, and WOMAC were significantly improved in both groups 90 days after the operation compared with before the operation (p < 0.05), but there were no significant differences between the two groups (p > 0.05). The incidence of postoperative deep vein thrombosis was not statistically different between the two groups. In the radiographic findings at 90 days postoperatively we found the frequency of lateral tibial component (LTC) angle outliers was significantly lower in the RA-TKA group (3.0% vs 29.4%, p = 0.003). The neutrophil-to-lymphocyte ratio (NLR) was significantly lower in the RA-TKA group than in the CM-TKA group on day 1 after surgery (9.9 vs 12.7, p = 0.024). CONCLUSIONS: RA-TKA requires more time than CM-TKA, which may be related to the learning curve and intraoperative registration. The short-term postoperative knee functional outcomes had no differences between the two groups, and RA-TKA improved the accuracy of tibial component alignment. Further follow-up studies are required to investigate the long-term outcomes.

Fallow Land Enhances Carbon Sequestration in Glomalin and Soil Aggregates Through Regulating Diversity and Network Complexity of Arbuscular Mycorrhizal Fungi Under Climate Change in Relatively High-Latitude Regions.

Soil aggregation and aggregate-associated carbon (C) play an essential function in soil health and C sequestration. Arbuscular mycorrhizal fungi (AMF) are considered to be primary soil aggregators due to the combined effect of extraradical hyphae and glomalin-related soil proteins (GRSPs). However, the effects of diversity and network complexity of AMF community on stability of soil aggregates and their associated C under long-term climate change (CC) and land-use conversion (LUC) in relatively high-latitude regions are largely unexplored. Therefore, an 8-year soil plot (with a 30-year cropping history) transplantation experiment was conducted to simulate CC and LUC from cropland to fallow land. The results showed that Glomus, Paraglomus, and Archaeospora were the most abundant genera. The diversity of AMF community in fallow land was higher than cropland and increased with increasing of mean annual temperature (MAT) and mean annual precipitation (MAP). Fallow land enhanced the network complexity of AMF community. The abundance families (Glomeraceae and Paraglomeraceae) exhibited higher values of topological features and were more often located in central ecological positions. Long-term fallow land had a significantly higher hyphal length density, GRSP, mean weight diameter (MWD), geometric mean diameter (GMD), and C concentration of GRSP (C-GRSP) than the cropland. The soil aggregate associated soil organic carbon (SOC) was 16.8, 18.6, and 13.8% higher under fallow land compared to that under cropland at HLJ, JL, and LN study sites, respectively. The structural equation model and random forest regression revealed that AMF diversity, network complexity, and their secreted GRSP mediate the effects of CC and LUC on C-GRSP and aggregate-associated SOC. This study elucidates the climate sensitivity of C within GRSP and soil aggregates which response symmetry to LUC and highlights the potential importance of AMF in C sequestration and climate change mitigation.

Arbuscular Mycorrhizal Fungi and Glomalin Play a Crucial Role in Soil Aggregate Stability in Pb-Contaminated Soil.

With the rapid development of industrialization and urbanization, soil contamination with heavy metal (HM) has gradually become a global environmental problem. Lead (Pb) is one of the most abundant toxic metals in soil and high concentrations of Pb can inhibit plant growth, harm human health, and damage soil properties, including quality and stability. Arbuscular mycorrhizal fungi (AMF) are a type of obligate symbiotic soil microorganism forming symbiotic associations with most terrestrial plants, which play an essential role in the remediation of HM-polluted soils. In this study, we investigated the effects of AMF on the stability of soil aggregates under Pb stress in a pot experiment. The results showed that the hyphal density (HLD) and spore density (SPD) of the AMF in the soil were significantly reduced at Pb stress levels of 1000 mg kg−1 and 2000 mg kg−1. AMF inoculation strongly improved the concentration of glomalin-related soil protein (GRSP). The percentage of soil particles >2 mm and 2−1 mm in the AMF-inoculation treatment was higher than that in the non-AMF-inoculation treatment, while the Pb stress increased the percentage of soil particles <0.053 mm and 0.25−0.53 mm. HLD, total glomalin-related soil protein (T-GRSP), and easily extractable glomalin-related soil protein (EE-GRSP) were the three dominant factors regulating the stability of the soil aggregates, based on the random forest model analysis. Furthermore, the structural equation modeling analysis indicated that the Pb stress exerted an indirect effect on the soil-aggregate stability by regulating the HLD or the GRSP, while only the GRSP had a direct effect on the mean weight diameter (MWD) and geometric mean diameter (GMD). The current study increases the understanding of the mechanism through which soil degradation is caused by Pb stress, and emphasizes the crucial importance of glomalin in maintaining the soil-aggregate stability in HM-contaminated ecosystems.

Comparison of serum inflammatory indicators and radiographic results in MAKO robotic-assisted versus conventional total knee arthroplasty for knee osteoarthritis: a retrospective study of Chinese patients.

BACKGROUND: The purpose of this study was to compare the serum inflammatory indicators and radiographic results of conventional manual total knee arthroplasty (CM-TKA) with those of MAKO-robotic assisted total knee arthroplasty (MA-TKA). METHODS: We retrospectively analysed 65 patients with knee osteoarthritis who underwent unilateral TKA from December 2020 to November 2021 in our department, which included 34 patients who underwent MA-TKA and 31 patients who underwent CM-TKA. The tourniquet time and estimated blood loss (EBL) were compared between the two groups. Knee function was evaluated using range of motion (ROM), functional score and pain score. Leukocytes, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), creatine kinase (CK), and neutrophil-to-lymphocyte ratio (NLR) were recorded at 3 time points (preoperative, and on the first and third postoperative days). The hip-knee-ankle angle (HKA) and the femoral and tibial component angles in the coronal and sagittal planes were used for postoperative radiographic evaluation. RESULTS: The postoperative MA-TKA group had less EBL (496.9 ± 257.8 vs. 773.0 ± 301.3 ml, p < 0.001). There was no significant difference in knee function scores at 6 weeks postoperatively (p > 0.05). IL-6 levels were significantly lower in the MA-TKA group on the 1st postoperative day (11.4 (5.2, 21.0) vs. 24.6 (86.3, 170.8), p = 0.031). This difference in inflammatory indices became more pronounced at 72 hours after the operation because CRP, ESR, IL-6, and CK values were significantly lower in the MA-TKA group on the 3rd postoperative day (72 h) (p < 0.05). Postoperative radiographic examinations performed 2 days after the MA-TKA group suggested that only 2 cases of HKA had outlier values, which was remarkably better than the 12 cases found in the CM-TKA group (5.9% vs. 38.7%, p < 0.001). The frontal femoral component was significantly closer to the expected value of 90° in the MA-TKA group (90.9 (90.5, 92.3) vs. 92.4 (91.3, 93.7), p = 0.031). The remaining imaging evaluation parameters were not significantly different between the two groups (p > 0.05). CONCLUSIONS: In Chinese patients with OA, there was a milder systemic inflammatory response in the early postoperative period after MA-TKA compared to that of CM-TKA, as well as better radiographic outcomes. However, the tourniquet time was prolonged, and no advantages were observed in terms of functional score or pain score in the short-term follow-up.

Characterization of Agarolytic Pathway in a Terrestrial Bacterium Cohnella sp. LGH.

Previously, we have reported that an endo-type ß-agarase AgaW was responsible for the hydrolysis of agarose into the major product neoagarotetraose in a terrestrial agar-degrading bacterium Cohnella sp. LGH. Here, we identify and characterize the following depolymerization pathway in strain LGH through the genomic and enzymatic analysis. In the pathway, neoagarotetraose was depolymerized by a novel α-neoagarooligosaccharide (NAOS) hydrolase CL5012 into 3,6-anhydro-α-L-galactose (L-AHG) and agarotriose; Agarotriose was further depolymerized by a novel agarolytic ß-galactosidase CL4994 into D-galactose and neoagarobiose; Neoagarobiose was finally depolymerized by CL5012 into L-AHG and D-galactose. Although α-agarase has not been identified in strain LGH, the combined action of CL5012 and CL4994 unexpectedly plays a critical role in the depolymerization of agarotetraose, one theoretical product of α-agarase hydrolysis of agarose. In this pathway, agarotetraose was depolymerized by CL4994 into D-galactose and neoagarotriose; Neoagarotriose was then depolymerized by CL5012 into L-AHG and agarobiose. Furthermore, another novel endo-type ß-agarase CL5055 was identified as an isozyme of AgaW with different pH preference in the hydrolysis of agarose into α-NAOSs. Strain LGH seemed to lack a common exo-type ß-agarase responsible for the direct depolymerization of agarose or neoagarooligosaccharide into neoagarobiose. These results highlight the diversity of agarolytic manner in bacteria and provide a novel insight on the diversity of agarolytic pathways.

Heavy metal domestication enhances beneficial effects of arbuscular mycorrhizal fungi on lead (Pb) phytoremediation efficiency of Bidens parviflora through improving plant growth and root Pb accumulation.

Native arbuscular mycorrhizal fungi (AMF) generally provide more effective assistance for phytoremediation to remove heavy metal (HM) from polluted soils than non-native AMF. Nevertheless, it is a time-consuming work to isolate, identify, and propagate AMF inoculum for practical application. This study aims to explore an alternative method to improve the phytoremediation efficiency of Bidens parviflora using domesticated AMF under HM stress condition for a certain period of time. Our results showed that Funneliformis mosseae inoculation alleviated oxidative damage to plant membranes by enhancing activities of superoxide dismutase, catalase, ascorbate peroxidase, and glutathione reductase. Furthermore, mycorrhizal plants had higher chlorophyll concentration, photosynthesis efficiency, and root Pb content to protect the aerial parts from damage. These protective mechanisms were found to be more efficient in domesticated AMF inoculation compared with non-domesticated AMF inoculation. Overall, this study suggests that F. mosseae domesticated for 12 months could greatly enhance plant root Pb accumulation and plant growth mainly through strengthening antioxidant defenses as well as the photosynthesis efficiency under Pb stress conditions. Plants inoculated with pre-domesticated AMF provided a promising new strategy to enhance phytoremediation of Pb-contaminated soils.

Synthesis and Biological Activity of Novel Antifungal Leads: 3,5-Dichlorobenzyl Ester Derivatives.

Succinate dehydrogenase (SDH) is one of the most important molecular targets for the development of new fungicides. Carboxamide fungicides are a class of SDH inhibitors widely used to inhibit highly destructive plant pathogens. Although cases of resistance have been found in fungal pathogens due to the unrestricted use in recent years, there is still demand for new compounds with improved fungicidal activity. Therefore, a series of ester compounds were designed to investigate potential novel antifungal molecules. First, the antifungal activity of different benzyl alcohol compounds (A1-A21) was tested, and a highly active fragment (3,5-dichlorobenzyl alcohol) was found. Subsequently, various compounds were synthesized by esterification between different acids and 3,5-dichlorobenzyl alcohol, among which compound 5 exhibited remarkable antifungal activity against Botrytis cinerea and Rhizoctonia solani with EC50 values of 6.60 and 1.61 mg/L, respectively, which were comparable to those of commercial fungicide boscalid (EC50 = 1.24 and 1.01 mg/L). In vivo testing further demonstrated that compound 5 was effective in suppressing B. cinerea (200 mg/L, 50.9%). Moreover, SDH inhibition assays, fluorescence quenching analysis, and determination of mitochondrial membrane potential revealed that compound 5 has similar effects to boscalid. Furthermore, the fungicidal activity of target compounds can be maintained by modifying the amide bond to an ester bond. These results will provide basis for the development of novel fungicides.