Effectiveness, cost, and safety of four regimens recommended by WHO for RR/MDR-TB treatment: a cohort study in Eastern China.

BACKGROUND: To compare the effectiveness, cost, and safety of four regimens recommended by the World Health Organization (WHO) for rifampicin resistance/multidrug-resistance tuberculosis (RR/MDR-TB) Treatment in Eastern China. METHODS: We performed a cohort study among patients with RR/MDR between 2020 and 2022 in Jiangsu Province. The treatment success rate, cost, and drug adverse reaction rate were compared. RESULTS: Between 2020 and 2022, 253 RR/MDR-TB patients were enrolled in the study. 37 (14.62%), 76 (30.04%), 74 (29.25%), and 66 (26.09%) patients had the short-term regimens, the new long-term oral regimens, the new long-term injectable regimens, and the traditional long-term regimens, respectively. The treatment success rate was the highest among patients treated with the short-term regimen (75.68%) and was the lowest among patients treated with the traditional long-term regimens (60.61%). The estimated mean cost per favorable outcome was 142.61 thousand Chinese Yuan (CNY), and the short-term regimens showed the lowest cost in the four regimes (88.51 thousand CNY vs. 174.24 thousand CNY, 144.00 thousand CNY, and 134.98 thousand CNY). Incremental cost-effectiveness ratios of the short-term regimens, the new long-term oral regimen, and the new long-term injectable regimens were -3083.04, 6040.09, and 819.68 CNY compared to the traditional long-term regimens. CONCLUSIONS: For RR/MDR-TB patients in China who meet the criteria for short-term regimens, the short-term regimens were proven to be the most cost-effective of the four regimens recommended by WHO. For RR/MDR-TB patients in China who don't meet the criteria for short-term regimens, the new long-term injectable regimens are more cost-effective than the remaining two regimens.

This is the first study to evaluate the effectiveness, cost, and safety of four regimens recommended by the WHO for RR/MDR-TB treatment in China.For RR/MDR-TB patients in China who meet the criteria for the short-term regimens, the short-term regimens were proven to be the most cost-effective of the four regimens recommended by WHO.

Recent strategies, progress, and prospects of two-dimensional metal carbides (MXenes) materials in wastewater purification: A review.

With the rapid development of industrialization, water pollution directly leads to the serious shortage of fresh water. As reported by the World Water Council, nearly 3.8 billion people will face water scarcity by 2030. Therefore, developing advanced nanomaterials to realize wastewater purification is a major challenge. Two-dimensional (2D) transition metal carbides (MXenes), as the emerging 2D layered nanomaterials, have been investigated for the applications of water purification treatment since first reported in 2011. Over 40 different MXenes have been developed for environmental remediation, and dozens more structures and properties are theoretically predicted. Here, we review the advances from the aspects of synthesis strategies for MXenes, purification mechanism, and their applications in wastewater treatment processes. The major points are 1) the synthesis and modification approaches for MXenes such as multi-layered stacked MXenes and delaminated MXenes 2) a discussion of current water remediation over MXene-based materials, 3) a brief introduction for removal behaviors and deep interaction mechanisms, 4) optimization strategies and key points for boosting the remediation performance of MXenes.

Engineering the Surface Properties of DNA Nanostructures by Tuning the Valency of Assembling Species for Biomedical Applications.

Self-assembled DNA nanostructures hold great potentials in biomedical applications. Nevertheless, the negatively charged DNA backbone and susceptivity to enzyme degradation pose challenges to this regard. Engineering the surface properties of DNA nanostructures by assembling DNA with guest molecules in magnesium-free system is promising to solve these issues. In this study, the polyamines-mediated DNA self-assembly with an emphasis on the valency of polyamines is investigated. Both spermine, spermidine, and putrescine can assemble DNA tetrahedron under appropriate concentrations. The cytotoxicity and cellular uptake efficiencies vary with the polyamine valency. Compared with magnesium-assembled DNA tetrahedron, polyamine-assembled DNA tetrahedron exhibits higher cellular uptake efficiency and serum stability. Circular dichroism spectrum results indicate that polyamines induce DNA conformation slightly shifting from B form to A form. The improved performances of polyamine-assembled DNA tetrahedrons under physiological settings are attributed to the surface properties that altered by guest molecules polyamine. The current study suggests that engineering the surface properties of DNA nanostructures by assembling them with guest cationic species is promising to further their biomedical applications.

A renewable electrochemical sensor based on a self-assembled framework of chiral molecules for efficient identification of tryptophan isomers.

Molecular self-assembly provides a reasonably effective strategy for the design and construction of chiral sensors. Here, Cu2+ was connected to ß-cyclodextrin (ß-CD) through coordination to synthesize Cu2-ß-CD, subsequently assembled with ammoniated chitosan-MWCNTs (NH2-CS-MWCNTs) by the effect of coordination driver to form a chiral sensing interface Cu2-ß-CD/NH2-CS-MWCNTs. Using the electrochemical method, the valid recognition of tryptophan (Trp) isomers was achieved on the self-assembly interface. Under the optimal experimental conditions, the developed sensor exhibited good linearity and satisfactorily renewable ability. Cu2-ß-CD/NH2-CS-MWCNTs/GCE showed the capacity to predict the ratio of D-Trp and L-Trp in racemic mixtures and the possibility of qualitative and quantitative determination for Trp isomers. Finally, the electrochemical sensor was used to detect the Trp enantiomers in rat serum, further verifying the feasibility of the sensor in the determination of actual samples. Therefore, the electrochemical chiral sensor not only is used for the recognition of Trp enantiomers but shows great potential in practical applications.

Integrative effects based on behavior, physiology and gene expression of tritiated water on zebrafish.

Tritium is a water-soluble hydrogen isotope that releases beta rays during decay. In nature, tritium primarily exists as tritiated water (HTO), and its main source is nuclear power/processing plants. In recent decades, with the development of nuclear power industry, it is necessary to evaluate the impact of tritium on organisms. In this study, fertilized zebrafish embryos are treated with different HTO concentrations (3.7 × 103 Bq/ml, 3.7 × 104 Bq/ml, 3.7 × 105 Bq/ml). After treatment with HTO, the zebrafish embryos developed without evident morphological changes. Nevertheless, the heart rate increased and locomotor activity decreased significantly. In addition, RNA-sequencing shows that HTO can affect gene expressions. The differentially expressed genes are enriched through many physiological processes and intracellular signaling pathways, including cardiac, cardiovascular, and nervous system development and the metabolism of xenobiotics by cytochrome P450. Moreover, the concentrations of thyroid hormones in the zebrafish decrease and the expression of thyroid hormone-related genes is disordered after HTO treatment. Our results suggest that exposure to HTO may affect the physiology and behaviors of zebrafish through physiological processes and intracellular signaling pathways and provide a theoretical basis for ecological risk assessment of tritium.

Efficient organic solar cells with superior stability based on PM6:BTP-eC9 blend and AZO/Al cathode.

Although efficiency over 18% has been achieved, the real application of organic solar cells is still impeded by inferior stability because of degradation and limited studies. Here we report efficient normal structure organic solar cells delivering promising stability under different conditions, based on PM6:BTP-eC9 blend and AZO/Al cathode. The impact of cathode on device stability is systematically studied by screening the leading electron transporting layers i.e., AZO, PFN-Br, PDINN, and metal electrodes (Al and Ag). Strong correlation between cathode and stability is demonstrated. The optimal AZO/Al-cathode device delivers the best efficiency of 15.76%, with shelf-stability of T83 > 1,200 h, thermal stability of T60 > 300 h, and MPP operational stability of T87 > 500 h. As far as we know, this is the best stability achieved for PM6:Y6/derivative cells in literature so far, based on well-studied simple cathode system and without any tailoring/dopant for the active blend.

Exploring the role of monocyte chemoattractant protein-1 in fibroblast-like synovial cells in rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease with persistent synovitis. In the present study, the impact of monocyte chemoattractant protein-1 (MCP-1) was explored to determine methods for the diagnosis and treatment of RA. METHODS: First, fibroblast-like synoviocytes (FLSs) were obtained from a collagen-induced rat RA model. Next, MCP-1-overexpression plasmid and small interfering RNA were transfected into human and rat FLSs. Cell Counting Kit-8 (CCK-8), Transwell migration and flow cytometry assays were used to analyze cell proliferation, migration and apoptosis of FLSs following MCP-1 transfections, respectively. Furthermore, western blotting was used to analyze the expression levels of p-P38, p-PI3K, PI3K, CD31, VEGF, TNF-α and IL-ß in FLSs following MCP-1 transfection. In addition, reverse transcription-quantitative PCR and ELISAs were used to analyze the expression levels of C-reactive protein (CRP), estrogen receptor, MCP-1 and pentraxin-3 in patients with clinical RA, followed by correlation analysis of clinical data. Finally, expression validation, diagnostic and protein-protein interaction (PPI) network analysis of MCP-1 were performed. RESULTS: MCP-1 promoted FLS proliferation and migration, and affected the apoptosis of FLSs. In addition, the expression levels of p-P38, p-PI3K, PI3K, CD31, VEGF, TNF-α and IL-ß were also affected by MCP-1. In patients with clinical RA, the expression level of MCP-1 was increased. Moreover, CRP expression level was significantly up-regulated in RA. Clinically, MCP-1 was strongly correlated with tender joint count, swollen joint count, visual analog scale for general health and disease activity score 28 (DAS28)-MCP-1, and was moderately correlated with DAS28 and DAS28-CRP. PPI analysis showed that MCP-1 mainly interacted with other inflammatory cytokines. CONCLUSION: In conclusion, MCP-1 may play a significant regulatory role in RA, and could be used as a measurement index of clinical RA activity.

microRNA-145-5p Inhibits Migration, Invasion, and Metastasis in Hepatocellular Carcinoma by Inhibiting ARF6.

PURPOSE: Hepatocellular carcinoma (HCC) has the fourth highest rate of mortality among the different types of cancer worldwide. This study aimed to investigate the functions of microRNA-145-5p and AFR6 on migration, invasion and metastasis in HCC. METHODS: A total of 150 pairs of tumor and their matched adjacent nontumor liver tissues were collected from HCC patients. Expressions of microRNA-145-5p and AFR6 were measured by real-time PCR in HCC tissues and in HCC cell lines. The correlations between microRNA-145-5p and HCC prognosis were investigated. The proliferation, migration, invasion, cell cycle progression, and apoptosis of HCCLM3 cells were evaluated with CCK8, wound healing, transwell, and flow cytometric experiments. RESULTS: The expression of miR-145-5p was confirmed to be downregulated not only in HCC tissues but also in several HCC cell lines compared with normal controls. A low expression level of miR-145-5p was notably associated with poor prognosis in patients with HCC and certain characteristics of metastatic tumors. In vitro, miR-145-5p negatively regulated cell proliferation, migration, and invasion and induced apoptosis in HCCLM3 cells. Subsequent experiments further verified that ARF6 is a novel target of miR-145-5p and is significantly overexpressed in HCC tissues. Overexpression of ARF6 circumvented the effects of miR-145-5p in HCCLM3 cells. CONCLUSION: miR-145-5p may play a pivotal role in HCC metastasis via regulating ARF6, and these findings may both provide further insights into the key factors of HCC metastasis and prove to be useful in the development of novel treatment options for HCC.

Controlled growth factor delivery system with osteogenic-angiogenic coupling effect for bone regeneration.

OBJECTIVE: Bone regeneration involves a coordinated cascade of events that are regulated by several cytokines and growth factors, among which bone morphogenic protein-2 (BMP-2), vascular endothelial growth factor (VEGF) and fibroblast growth factor-2 (FGF-2) play important roles. In this study, we investigated the effects of dual release of the three growth factors on bone regeneration in femur defects. METHODS: A composite consisting of Gelatin microparticles loaded with VEGF/FGF-2 and poly(lactic-co-glycolic acid)-poly(ethylene glycol)-carboxyl (PLGA-PEG-COOH) microparticles loaded with BMP-2 encapsulated in a nano hydroxyapatite-poly actic-co-glycolic acid (nHA-PLGA) scaffold was prepared for the dual release of the growth factors. RESULTS: On the 14th day, decreased release rate of BMP-2 compared with FGF-2 and VEGF was observed. However, after 14 days, compared to FGF-2 and VEGF, BMP-2 showed an increased release rate. Controlled dual release of BMP-2 and VEGF, FGF-2 resulted in a significant osteogenic differentiation of bone mesenchymal stem cells (BMSCs). Moreover, effects of the composite scaffold on functional connection of osteoblast-vascular cells during bone development were evaluated. The synergistic effects of dual delivery of growth factors were shown to promote the expression of VEGF in BMSCs. Increased secretion of VEGF from BMSCs promoted the proliferation and angiogenic differentiation of human umbilical vein endothelial cells (HUVECs) in the co-culture system. At 12 weeks after implantation, blood vessel and bone formation were analyzed by micro-CT and histology. The composite scaffold significantly promoted the formation of blood vessels and new bone in femur defects. CONCLUSIONS: These findings demonstrate that dual delivery of angiogenic factors and osteogenic factors from Gelatin and PLGA-PEG-COOH microparticles-based composite scaffolds exerted an osteogenic-angiogenic coupling effect on bone regeneration. This approach will inform on the development of appropriate designs of high-performance bioscaffolds for bone tissue engineering.

Acute and chronic traumatic diaphragmatic hernia: 10 years' experience.

Controversy persists regarding many aspects of traumatic diaphragmatic hernia (TDH). We aimed to understand why some traumatic diaphragmatic injuries present with chronic hernia and to evaluate diagnosis and treatment options. Fifty acute and 19 chronic TDH patients were diagnosed and treated at our institution over a 10-year period. Clinical data from these two groups were analyzed statistically and compared. Chronic TDH patients had a significantly lower Injury Severity Score than acute TDH patients (10.26 ± 2.68 vs. 26.92 ± 4.79, P < 0.001). The most common surgical approach for acute and chronic TDH was thoracotomy and laparotomy, respectively. The length of the diaphragmatic rupture was significantly shorter in chronic TDH patients than acute TDH patients (6.00 ± 1.94 cm vs. 10.71 ± 3.30 cm, P < 0.001). The mean length of hospital stay was significantly longer for acute TDH patients than chronic TDH patients (41.18 ± 31.02 days vs. 16.65 ± 9.61 days, P = 0.002). In conclusion, milder trauma and a smaller diaphragmatic rupture were associated with delayed diagnosis. A thoraco-abdominal computed tomography scan is needed for patients with periphrenic injuries to avoid delayed diagnosis of TDH. Improved awareness and understanding of diaphragmatic injuries will increase the rate of early diagnosis and improve prognosis.

Functionalization of carbon nanomaterials by means of phytic acid for uranium enrichment.

A promising strategy for radionuclides immobilization on the functionalized carbon-based materials is a pursuing issue. Here, we developed phosphorylated hydrothermal carbon spheres (HCSs@PO4) through chemical-grafted method using phytic acid as a phosphorus source. When served as U(VI) scavenger from simulated environmental wastewater, the resulting HCSs@PO4 showed excellent adsorption capacity toward U(VI) (552.49 mg·g-1 at pH 5.0 and T = 298 K), outperforming that of HCSs (32.06 mg·g-1) and state-of the-art materials. A weak ionic strength-dependence of U(VI) enrichment with HCSs@PO4 was investigated by a series of pH experiments, indicating an inner-sphere surface complexation. Through thermodynamic study, high temperature promoted the adsorptive ability of HCSs@PO4 toward U(VI), revealing the endothermic and spontaneous nature. Additional selective adsorption applications were conducted to evaluate the ability of HCSs@PO4 to capture uranium fission byproducts and other radioactive ions. Analyses of characteristic means (FT-IR and XPS) revealed enhanced uptake performance of HCSs@PO4 originated from grafting abundant phosphate groups, which exhibited the stronger surface complexation toward U(VI) than sluggish hydroxyl and carboxyl groups. The findings herein highlighted a facile and powerful technique for the manufacture of phosphorylated carbon-based materials of radioactive wastewater remediation.

Efficient elimination of Cr(VI) from aqueous solutions using sodium dodecyl sulfate intercalated molybdenum disulfide.

In recent years, the heavy metal ions have been immoderately released into the ecological system and result in potential hazardous to public health. Herein, the sodium dodecyl sulfate intercalated molybdenum disulfide (SDS-MoS2) was synthesized for the adsorption of Cr(VI). The SDS molecule was flat and vertically intercalated into the interlayer of MoS2, which was further evidenced by density functional theory calculations. The capture of Cr(VI) on the sphere-like SDS-MoS2 relied on solution pH. The retention of Cr(VI) on SDS-MoS2 attained 63.92 mg/g, and the removal process was endothermic, spontaneous and increased with temperature increasing. The main removal mechanism of Cr(VI) onto SDS-MoS2 was Cr(VI) fixing on the surface of the composites by chemisorption involving possible Cr-S coordination bonding. More importantly, Cr(VI) passed into the increased interlamination and reacted at the interlamination of SDS-MoS2, which was further proved at molecular level. The results can provide critical information for the application of SDS-MoS2 in Cr(VI) elimination or other kinds of pollutants removal in natural aquatic environment.

Two-dimensional MAX-derived titanate nanostructures for efficient removal of Pb(ii).

Two-dimensional (2D) nanomaterials have been identified as one of the promising materials due to their great promise for waste treatment. Currently, the investigation of wastewater remediation is highly imperative and still remains challenging. Here, a novel class of 2D MAX@titanate nanocomposites was fabricated by a simple oxidation and alkalization method, and they exhibited different morphologies and impressive elimination performance. The Pb(ii) uptake processes were dramatically affected by the solution pH and reached equilibrium quickly. Abundant functional groups and enhanced specific surface areas endowed T-NTO nanofibers with outstanding adsorption capacity of 328.9 mg g-1 at pH = 5.0 and T = 298 K, which was much higher than that of T-KTO nanoribbons. Moreover, the possible mechanism was expounded with the aid of Raman, FT-IR, XRD and XPS analyses, in which the synergistic effect of surface complexation and ion exchange significantly contributed to the adsorption performance. On the basis of above analyses, this study not only presents a novel and facile strategy for preparing T-NTO and T-KTO nanostructures with superior adsorption capacity, but also broadens the prospective applications of other functional MAX-derived nanostructures in environmental cleanup.

Comparative Pharmacokinetic Study of Mangiferin in Normal and Alloxan-Induced Diabetic Rats after Oral and Intravenous Administration by UPLC-MS/MS.

BACKGROUNDS: Diabetes mellitus (DM)-induced morphological and/or functional complications may alter the pharmacokinetic profiles of mangiferin. This study aims to compare pharmacokinetic profiles of mangiferin in normal and alloxan-induced diabetic rats after oral and intravenous administration. METHODS: Mangiferin was administered orally (10 mg/kg) and intravenously (2 mg/kg) to normal and alloxan-induced diabetic Sprague-Dawley (SD) rats (n = 8). Blood samples were collected at different time points post-dose. Mangiferin and esculentoside (internal standard)  were analyzed by Waters Acquity ultra-performance liquid chromatography system and TSQ Quantum Ultra triple quadrupole mass spectrometer (UPLC-MS/MS). RESULTS: Mangiferin in normal and alloxan-induced diabetic rats experienced serious first-pass effect, which resulted in 1.71 and 0.80% of oral bioavailability respectively. Meanwhile, mangiferin was predominantly restricted to blood but not extensively distributed to organ tissues after intravenous administration. Compared with normal rats, the diabetic condition induced 53.26 and 50.90% decreases in Cmax and AUC0-t, respectively, for mangiferin after oral administration, and 63.08% decreases in Cmax after intravenous administration. CONCLUSIONS: Compared to normal rats, pharmacokinetic parameters of mangiferin were altered in diabetic condition induced by alloxan. The findings might help to provide useful evidence for modeling of diabetic rats and the clinical applications of mangiferin.

Simultaneous adsorption and oxidative degradation of Bisphenol A by zero-valent iron/iron carbide nanoparticles encapsulated in N-doped carbon matrix.

The increased release and accumulation of Bisphenol A (BPA) in contaminated wastewater has resulted in the world wide concerns because of its potential negative effects on human health and aquatic ecosystems. Starting with metal-organic frameworks, we present a simple method to synthesize magnetic porous microcubes (N-doped Fe0/Fe3C@C) with graphitized shell and highly dispersed active kernel via the pyrolysis process under N2 atmosphere. Batch adsorption experimental results showed that N-doped Fe0/Fe3C@C had high adsorption capacity for BPA (∼138 mg g-1 at pH = 7 and 298 K). Degradation of BPA adsorbed on N-doped Fe0/Fe3C@C was further investigated as a function of BPA concentration, persulfate amount, temperature and solution pH. It was found that potassium peroxodisulfate could be activated by N-doped Fe0/Fe3C@C, and a large number of free radicals were generated which was crucial for the degradation of BPA. The concentration of BPA was barely changed in the individual persulfate system. BPA (10 mg L-1) was almost completely degraded within 60 min in the presence of N-doped Fe0/Fe3C@C (∼0.2 g L-1). When the BPA content increased to 25 mg L-1, the removal efficiency of BPA achieved to 98.4% after 150 min. From the XRD, Raman, and XPS analysis, the main adsorption mechanism of BPA was π-π interactions between the π orbital on the carbon basal planes and the electronic density in the BPA aromatic rings. While the superior degradation was attributed to the radical generation and evolution in phenol oxidation. This work not only proved the potential application of N-doped Fe0/Fe3C@C in the adsorption and degradation of BPA, but also opened the new possibilities to eliminate organic pollutants using this kind of magnetic materials in organic pollutants' cleanup.

A novel magnetite nanorod-decorated Si-Schiff base complex for efficient immobilization of U(vi) and Pb(ii) from water solutions.

A novel silicon Schiff base complex (Si-SBC) and magnetite nanorod-decorated Si-SBC (M/SiO2-Si-SBC) were synthesized and well characterized in detail. The synthesized materials were applied for the removal of U(vi) and Pb(ii) from water solutions under various experimental conditions. The monolayer maximum adsorption capacities of M/SiO2-Si-SBC (6.45 × 10-4 mol g-1 for Pb(ii) and 4.82 × 10-4 mol g-1 for U(vi)) obtained from the Langmuir model at 25 °C and pH = 5.00 ± 0.05 were higher than those of Si-SBC (5.18 × 10-4 mol g-1 for Pb(ii) and 3.70 × 10-4 mol g-1 for U(vi)). Moreover, DFT calculations showed that the high adsorption energies (Ead) of 7.61 kcal mol-1 for Pb2+-(Si-SBC) and 2.72 kcal mol-1 for UO22+-(Si-SBC) are mainly attributed to stronger electrostatic interactions. The results revealed that the Si-SBC and M/SiO2-Si-SBC could be used as efficient adsorbents for the effective elimination of U(vi) and Pb(ii) from contaminated wastewater. High sorption capacity and reusability indicated the practical applications of the synthesized materials in environmental pollution cleanup.

The Effect of Cartilage Fragments on Femoral Tunnel Widening After Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Controlled Study.

PURPOSE: To analyze the effect of cartilage fragments on tunnel widening and tendon-bone integration at 2 years' follow-up after anterior cruciate ligament reconstruction (ACLR). METHODS: A prospective randomized controlled study was performed in 116 patients who underwent ACLR with autologous hamstring tendons augmented with cartilage fragments (study group, n = 56) or without any augmentation (control group, n = 60). All patients were followed up for 25.6 months (range, 24-28 months), and the International Knee Documentation Committee score, Lysholm score, and visual analog scale score were determined. Computed tomography scans of all patients were obtained 2 years after surgery to evaluate the diameter of the femoral tunnel and thereby assess the amount of tunnel widening. Magnetic resonance imaging evaluation was performed 2 years postoperatively to evaluate the status of the graft in the femoral tunnel. In addition, 5 patients underwent biopsy of the tendon-bone interface at 24 months postoperatively with histologic assessment and transmission electron microscopy. RESULTS: A total of 107 patients completed the follow-up. There were no significant differences between the 2 groups in terms of International Knee Documentation Committee score (P = .07), Lysholm score (P = .10), and visual analog scale score (P = .57) at 24 months' follow-up. The femoral tunnel diameter and the tunnel widening percentage in the study group were significantly smaller than those in the control group (P < .001). The signal-noise quotient value of the graft in the femoral tunnel was 10.4 ± 7.0 in the study group, which was significantly lower than that in the control group (19.5 ± 9.2, P < .001). Histologic studies of the tendon-bone interface showed that there were more bone formations containing chondroid cells with aligned connective tissue in the study group compared with the control group; in addition, the diameter of the collagen fibrils in the study group was considerably thicker than that in the control group (P < .05). CONCLUSIONS: The use of cartilage fragments was effective in preventing femoral tunnel widening and seemed to promote the tendon-bone integration process after ACLR. LEVEL OF EVIDENCE: Level II, prospective randomized controlled study.

Recent advances in layered double hydroxide-based nanomaterials for the removal of radionuclides from aqueous solution.

Layered double hydroxides (LDHs), one of the most important two-dimensional layered compounds, have enabled massive developments in effective pollution treatments. Their derivative materials have also attracted multidisciplinary attention owing to the intrinsic advantages of their moderate chemiostability, low cost and nontoxicity. Over the past few decades, significant advances have been made in the synthesis of novel LDH-based composites and the optimization of characterization techniques. In this review, we give an overview of the recent advances in LDH-based nanomaterials, from a brief introduction to their preparation and modification methods to an overview of their application in the removal of radionuclides and an exploration of their underlying adsorption mechanisms. In the end, a summary and outlook are also briefly addressed. This review intends to provide deep insight into the design of high-performance LDH-based materials for the potential elimination of radionuclides from aqueous solutions during environmental pollution cleanup.

Arthroscopic Rotator Cuff Repair With Graft Augmentation of 3-Dimensional Biological Collagen for Moderate to Large Tears: A Randomized Controlled Study.

BACKGROUND: Due to the highly organized tissue and avascular nature of the rotator cuff, rotator cuff tears have limited ability to heal after the tendon is reinserted directly on the greater tubercle of the humerus. Consequently, retears are among the most common complications after rotator cuff repair. Augmentation of rotator cuff repairs with patches has been an active area of research in recent years to reduce retear rate. HYPOTHESIS: Graft augmentation with 3D collagen could prevent retears of the repaired tendon and improve tendon-bone healing in moderate to large rotator cuff tears. STUDY DESIGN: Randomized controlled study; Level of evidence, 2. METHODS: A prospective, randomized controlled study was performed in a consecutive series of 112 patients age 50 to 85 years who underwent rotator cuff repair with the suture-bridge technique (58 patients, control group) or the suture-bridge technique augmented with 3-dimensional (3D) collagen (54 patients, study group). All patients were followed for 28.2 months (range, 24-36 months). Visual analog scale score for pain, University of California Los Angeles (UCLA) shoulder score, and Constant score were determined. Magnetic resonance imaging was performed pre- and postoperatively (at a minimum of 24 months) to evaluate the integrity of the rotator cuff and the retear rate of the repaired tendon. Three patients in each group had biopsies at nearly 24 months after surgery with histological assessment and transmission electron microscopy. RESULTS: A total of 104 patients completed the final follow-up. At the 12-month follow-up, the UCLA shoulder score was 28.1 ± 1.9 in the study group, which was significantly better than that in the control group (26.9 ± 2.1, P = .002). The Constant score was also significantly better in the study group (87.1 ± 3.2) than in the control group (84.9 ± 4.2, P = .003). However, at the final follow-up, no significant differences were found in the UCLA shoulder scores (29.4 ± 1.9 in the control group and 30.0 ± 1.6 in the study group, P = .052) or Constant scores (89.9 ± 3.2 in the control group and 90.8 ± 3.5 in the study group, P = .18). In terms of structural integrity, more patients in the study group had a favorable type I retear grade (18/51) than in the control group (10/53) ( P = .06). The postoperative retear rate was 34.0% in the control group and 13.7% in the study group, thus indicating a significantly lower retear rate in the study group ( P = .02). Biopsy specimens of the tendon-bone interface in 6 patients revealed more bone formation and more aligned fibers with larger diameters in the study group than in the control group. No intraoperative or postoperative complications were noted in either group. CONCLUSION: 3D collagen augmentation could provide effective treatment of moderate to large rotator cuff tears, providing substantial functional improvement, and could reduce the retear rate. This technique could also promote new tendon-bone formation, thus exerting a prominent effect on tendon-bone healing.