[Advances in study of surgical approaches and MRI evaluation of total hip arthroplasty].

Objective: To review the research on different surgical approaches and MRI evaluation of total hip arthroplasty (THA), to clarify the possible muscle damage caused by different approaches, and to help clinicians avoid intraoperative muscle damage and identify the causes of certain muscle-related complications after operation. Methods: The research literature on different surgical approaches and MRI evaluation of THA at home and abroad was extensively reviewed to summarize the MRI performance of the posterior approach, modified direct lateral approach, direct anterior approach, and minimally invasive anterolateral approach (also called Orthopadische Chirurgie Munchen approach). Results: The traditional posterior approach mainly damages the short external rotator muscle group and increases the incidence of postoperative dislocation; the piriformis-keeping posterior approach significantly improves the quality of the pyriformis tendon in the postoperative period, but it may lead to damage to the intrapelvic portion of the piriformis muscle. The modified direct lateral approach mainly damages the gluteus medius muscle, which increases the risk of postoperative claudication. The direct anterior approach mainly damages the vastus tensoris muscle and may result in damage to the short external rotator muscle group and the muscles around the incision. The minimally invasive anterolateral approach primarily damages the superior gluteal nerve, which subsequently leads to denervation of the broad fascial tensor fasciae latae, and this approach may also result in injury to the gluteus medius and gluteus minimus muscles. The muscle damage status significantly affects prognosis, and the minimally invasive approach is more suitable for elderly patients. Conclusion: MRI can clarify the different types of muscle damage caused by different surgical approaches. Minimally invasive approaches can reduce muscle damage and improve postoperative function compared with traditional approaches, and can benefit elderly patients more, but due to the small field, forcing to expand the surgical field will lead to unintended muscle damage and reduce postoperative function.

Advancing Ultrasonic Defect Detection in High-Speed Wheels via UT-YOLO.

In the context of defect detection in high-speed railway train wheels, particularly in ultrasonic-testing B-scan images characterized by their small size and complexity, the need for a robust solution is paramount. The proposed algorithm, UT-YOLO, was meticulously designed to address the specific challenges presented by these images. UT-YOLO enhances its learning capacity, accuracy in detecting small targets, and overall processing speed by adopting optimized convolutional layers, a special layer design, and an attention mechanism. This algorithm exhibits superior performance on high-speed railway wheel UT datasets, indicating its potential. Crucially, UT-YOLO meets real-time processing requirements, positioning it as a practical solution for the dynamic and high-speed environment of railway inspections. In experimental evaluations, UT-YOLO exhibited good performance in best recall, mAP@0.5 and mAP@0.5:0.95 increased by 37%, 36%, and 43%, respectively; and its speed also met the needs of real-time performance. Moreover, an ultrasonic defect detection data set based on real wheels was created, and this research has been applied in actual scenarios and has helped to greatly improve manual detection efficiency.

Artificial intelligence-assisted system for the assessment of Forrest classification of peptic ulcer bleeding: a multicenter diagnostic study.

BACKGROUND: Inaccurate Forrest classification may significantly affect clinical outcomes, especially in high risk patients. Therefore, this study aimed to develop a real-time deep convolutional neural network (DCNN) system to assess the Forrest classification of peptic ulcer bleeding (PUB). METHODS: A training dataset (3868 endoscopic images) and an internal validation dataset (834 images) were retrospectively collected from the 900th Hospital, Fuzhou, China. In addition, 521 images collected from four other hospitals were used for external validation. Finally, 46 endoscopic videos were prospectively collected to assess the real-time diagnostic performance of the DCNN system, whose diagnostic performance was also prospectively compared with that of three senior and three junior endoscopists. RESULTS: The DCNN system had a satisfactory diagnostic performance in the assessment of Forrest classification, with an accuracy of 91.2% (95%CI 89.5%-92.6%) and a macro-average area under the receiver operating characteristic curve of 0.80 in the validation dataset. Moreover, the DCNN system could judge suspicious regions automatically using Forrest classification in real-time videos, with an accuracy of 92.0% (95%CI 80.8%-97.8%). The DCNN system showed more accurate and stable diagnostic performance than endoscopists in the prospective clinical comparison test. This system helped to slightly improve the diagnostic performance of senior endoscopists and considerably enhance that of junior endoscopists. CONCLUSION: The DCNN system for the assessment of the Forrest classification of PUB showed satisfactory diagnostic performance, which was slightly superior to that of senior endoscopists. It could therefore effectively assist junior endoscopists in making such diagnoses during gastroscopy.

[Influencing factors on effectiveness of reverse total shoulder arthroplasty].

Objective: To summarize the influencing factors on the effectiveness of reverse total shoulder arthroplasty (RTSA), so as to provide reference for clinical treatment. Methods: The related research literature of RTSA at home and abroad was extensively consulted, and the factors that may affect the effectiveness were summarized from the aspects of surgical technique, muscle condition, general condition of patients, psychological expectation, and lifestyle. Results: For surgical techniques, different surgical approaches have their own advantages. The glenoid notch, poor bone ingrowth, increased bone resorption, and infection would lead to the loosening of glenoid prosthesis. In addition, the neck shaft angle and inclination angle of humeral prosthesis affect the occurrence of glenoid notch and the range of motion of joint internal/external rotation after operation, respectively. For muscle condition, the quality of teres minor and deltoid muscle has an important influence on joint stability after operation. Moderate increase of deltoid muscle tension can improve joint mobility after operation, and suture repair of subscapular tendon during operation can relieve joint pain and improve function, range of motion, and strength. For the general condition of patients, gender, age, and body mass index are all related to postoperative joint function and complications, and different occupations and postoperative exercise levels affect the recovery. The patients with severe degenerative diseases, poor preoperative function, and long disease duration have lower expectations and higher satisfaction with the effectiveness, and bad lifestyle has a negative impact on the effectiveness. Conclusion: The effectiveness of RTSA is related to surgical technique, muscle condition, general condition of patients, psychological expectation, and lifestyle. In order to avoid the loosening of glenoid prosthesis, the operator should choose humeral prosthesis with small neck shaft angle and large glenoid ball and put them down and inclined inferiorly during operation, and choose appropriate approach to eliminate space with drainage to reduce the risk of infection. After operation, patients should avoid activities that generate high anterior and posterior shear forces. In addition, the humeral prosthesis with a inclination angle of 10°-20° can achieve the best balance between the range of internal rotation and external rotation after operation. Proper deltoid tension can maintain joint stability and good range of motion. Suture of subscapular tendon is recommended.

International comparison and insights on sustainable competitiveness of water industry management models: evidences from France and China.

The sustainability of water industry management model is one of the essential means to achieve sustainable utilization of water resources. Based on existing research on the sustainability of water industry, this study explores the factors affecting the sustainable competitiveness of water industry management model. It constructs a more complete sustainable competitiveness evaluation indicator system. Evidences taken from France and China were selected as the references for the study, and the principal component analysis was used to evaluate the overall sustainable competitiveness and main component dimensions. It is found through this study that the overall competitiveness indicator in the sustainable water industry management model and the sub-dimensional competitiveness indicators in resource support, development base, and environmental impact of water industry of France are better than those of China. China is more competitive in social inclusion, technological innovation, and sustainability of water industry. Based on the research results, this study provides insights into solving the existing issues in the sustainable development of China's water industry to support how China can adjust its water industry management model to improve its sustainable competitiveness.

Catalpol ameliorates dexamethasone-induced osteoporosis by promoting osteogenic differentiation of bone marrow mesenchymal stem cells via the activation of PKD1 promoter.

OBJECTIVE: To investigate the effects of CA on glucocorticoid-induced osteoporosis (GIOP) and lucubrate the underlying mechanism of CA via the activation of polycystic kidney disease-1(PKD1) in bone marrow mesenchymal stem cells (BMSCs). METHODS: In vivo, a GIOP model in mice treated with dexamethasone (Dex) was established. Biomechanical, micro-CT, immunofluorescence staining of OCN, ALP and PKD1 and others were severally determined. qRT-PCR and Western blot methods were adopted to elucidate the particular mechanisms of CA on GIOP. In addition, BMSCs cultured in vitro were also induced by Dex to verify the effects of CA. Finally, siRNA and luciferase activity assays were performed to confirm the mechanisms. RESULTS: We found that CA could restore the destroyed bone microarchitecture and increase the bone mass in GIOP mice. CA could also upregulate PKD1 protein expression, reduce oxidative stress, and promote mRNA expression of bone formation-associated markers in GIOP mice. Furthermore, it was also observed that CA reduced oxidative stress and promoted osteogenic differentiation in Dex-induced BMSCs. Mechanically, CA could promote protein expression via increasing the activity of PKD1 promoter. CONCLUSION: This study provides important evidences for CA in the further clinical treatment of GIOP, reveals the activation of PKD1 promoter as the underlying mechanism.

The potential role of synovial cells in the progression and treatment of osteoarthritis.

Osteoarthritis (OA), the commonest arthritis, is characterized by the progressive destruction of cartilage, leading to disability. The Current early clinical treatment strategy for OA often centers on anti-inflammatory or analgesia medication, weight loss, improved muscular function and articular cartilage repair. Although these treatments can relieve symptoms, OA tends to be progressive, and most patients require arthroplasty at the terminal stages of OA. Recent studies have shown a close correlation between joint pain, inflammation, cartilage destruction and synovial cells. Consequently, understanding the potential mechanisms associated with the action of synovial cells in OA could be beneficial for the clinical management of OA. Therefore, this review comprehensively describes the biological functions of synovial cells, the synovium, together with the pathological changes of synovial cells in OA, and the interaction between the cartilage and synovium, which is lacking in the present literature. Additionally, therapeutic approaches based on synovial cells for OA treatment are further discussed from a clinical perspective, highlighting a new direction in the treatment of OA.

Modified Technique for Labral Reconstruction of Hip Joint Using Autologous Iliotibial Band (ITB)-Make Labral Reconstruction Stress-Free.

Current treatments for labral tear include surgical debridement, arthroscopic repair, and labral reconstruction. Although labral debridement and labral suture repair are suitable for most patients, labral reconstruction is the first treatment option when there is extensive labral degeneration or defect. Often, however, the labral degeneration or defect is only detected intraoperatively; therefore, the surgeon should always have a backup plan. The current labral reconstruction technique has shortcomings such as long operation time, difficult autograft harvesting, cumbersome graft preparation, and the need for a large surgical incision and re-sterilization and draping. To address these problems, we developed a modified technique for draping and surgery. This technique ensures preparedness for labral reconstruction during each hip arthroscopic surgery. The method also simplifies the steps for autologous iliotibial band graft harvesting and shortens operative time. We have achieved satisfactory clinical results with use of this technique over the past 2 years. In this Technical Note, we describe our technique. This modified labral reconstruction technique greatly improves surgical efficiency and could be a promising surgical technique for hip labral reconstruction.

Disaster response strategies of governments and social organizations: From the perspective of infrastructure damage and asymmetric resource dependence.

Natural disaster response is commonly regarded as a dynamic process that reflects intricate relationships between physical and social factors. The resilience of physical infrastructure impacts the availability of emergency resources, while asymmetric resource dependence among emergency cooperation organizations influences the effectiveness of the coordinated emergency response. This study has formulated differential game encompassing three emergency response models: autonomous participation, government-led, and collaborative response. These models have been designed to account for scenarios involving infrastructure damage and asymmetric resource dependence scenarios to compute the optimal level of emergency response efforts by both government and social organizations, the government cost-sharing ratio, the optimal level of emergency resource availability, and disaster response performance. The results indicated that, under specific conditions, government cost-sharing can motivate social organizations to actively engage in disaster response, leading to improvement in disaster response performance. The collaborative emergency response model outperformed the other models regarding optimal emergency response strategy and disaster response performance. Notably, infrastructure damage and asymmetric resource dependence lead to a reduction in the optimal level of emergency response efforts and system disaster response performance for both parties. Furthermore, the impact of infrastructure damage on disaster response performance and the optimization of emergency resource availability levels are shown to be more substantial than the effects of asymmetric resource dependence. This research provided theoretical support for strategic decision-making in natural disaster response and is more aligned with disaster response.

Influence of respondents' Differentiation of subjective response on water knowledge stock test scale: Evaluation based on two-parameter-multidimensional IRT model.

Insufficient awareness of water issues is a crucial bottleneck restricting the sustainable utilization of water resources. To accurately measure citizens' water knowledge stock and overcome the differences between scales and respondents' characteristic levels on test results, the research focuses on developing and evaluating water knowledge stock test scales. The mechanism for identifying indicators is designed based on the grounded theory, and as a result, the water knowledge stock test indicator system is derived. The data was collected by the form of survey questionnaire developed with the test indicator system. A two-parameter multidimensional item response theoretical model is constructed based on item parameter estimation, data model fitting, and item information function. The survey data and optimization model are used to optimize the water knowledge stock test scale and verify the fitting degree with the characteristics of the respondents. The test information function and standard error function indicate that the scale is most informative for individuals with characteristic levels ranging from -2 to 3, resulting in a highly reliable test effect. The research has established a measurement indicator system, methodology, and presented results that serve as a foundation for measuring the stock of water knowledge.

Portal Selection for Suture Anchor Placement During Hip Arthroscopic Labral Repair: A Study Based on 3-Dimensional Model Reconstruction.

Background: Arthroscopic suture repair is the main treatment option for hip labral tears; however, anchor insertion and placement from arthroscopic portals is difficult. Purpose: To quantitatively evaluate the safety of various arthroscopic portals for suture anchor placement during hip labral repair. Study Design: Descriptive laboratory study. Methods: The computed tomography scans of 20 patients with normally developed hip joints were used to create 3-dimensional models. The distances from the anchor to the articular cartilage (DAC) and from the acetabular insertion point to the cortical bone (DCB) were measured in the anterolateral portal (AL), posterolateral portal (PL), midanterior portal (MAP), medial MAP, and 3 distal anterolateral accessory portals (DALAs): DALA-proximal, DALA-middle, and DALA-distal. Labral tears were divided into anterior (4, 3, and 2 o'clock), lateral (1, 12, and 11 o'clock), and posterior (10, 9, and 8 o'clock) acetabular zones, and the Kruskal-Wallis and Mann-Whitney U test were used to compare DAC and DCB in the zones. The success rate was defined as anchors placed with DAC ≥1 mm and DCB ≥15 mm. Results: The DAC was significantly smaller in the AL at 1 o'clock (0.68 ± 0.32 mm; P < .001) and 12 o'clock (0.37 ± 0.30 mm; P < .001), and in the PL at 12 o'clock (-0.35 ± 0.38 mm; P < .001) and 11 o'clock (0.60 ± 0.24 mm; P < .001). The DCB was significantly smaller in the DALA-P at 3 o'clock (8.93 ± 2.12 mm; P < .001) and 11 o'clock (9.59 ± 2.84 mm; P < .001), the MAP at 12 o'clock (13.76 ± 3.89 mm; P < .001) and 11 o'clock (0.27 ± 0.27 mm; P < .001), and the MMA at 12 o'clock (5.96 ± 2.31 mm; P < .001) and 11 o'clock (0 mm; P < .001). Success rates were high for MAP and MMA between 4 o'clock and 1 o'clock, for DALA-proximal at 12 o'clock, for AL at 11 o'clock, and for PL between 10 o'clock and 8-o'clock. Conclusion: There were significant differences in the success rate of anchor placement using different portals during hip arthroscopic labral repair. Clinical Relevance: MAP is recommended for labral repair between 4 o'clock and 1 o'clock, DALA-P is recommended between 2 o'clock and 12 o'clock, AL is suitable at 11 o'clock, and PL is suitable between 10 o'clock and 8 o'clock.

Current Knowledge and Future Perspectives of Exosomes as Nanocarriers in Diagnosis and Treatment of Diseases.

Exosomes, as natural nanocarriers, characterized with low immunogenicity, non-cytotoxicity and targeted delivery capability, which have advantages over synthetic nanocarriers. Recently, exosomes have shown great potential as diagnostic markers for diseases and are also considered as a promising cell-free therapy. Engineered exosomes have significantly enhanced the efficacy and precision of delivering therapeutic agents, and are currently being extensively employed in targeted therapeutic investigations for various ailments, including oncology, inflammatory disorders, and degenerative conditions. Particularly, engineered exosomes enable therapeutic agent loading, targeted modification, evasion of MPS phagocytosis, intelligent control, and bioimaging, and have been developed as multifunctional nano-delivery platforms in recent years. The utilization of bioactive scaffolds that are loaded with exosome delivery has been shown to substantially augment retention, extend exosome release, and enhance efficacy. This approach has advanced from conventional hydrogels to nanocomposite hydrogels, nanofiber hydrogels, and 3D printing, resulting in superior physical and biological properties that effectively address the limitations of natural scaffolds. Additionally, plant-derived exosomes, which can participate in gut flora remodeling via oral administration, are considered as an ideal delivery platform for the treatment of intestinal diseases. Consequently, there is great interest in exosomes and exosomes as nanocarriers for therapeutic and diagnostic applications. This comprehensive review provides an overview of the biogenesis, composition, and isolation methods of exosomes. Additionally, it examines the pathological and diagnostic mechanisms of exosomes in various diseases, including tumors, degenerative disorders, and inflammatory conditions. Furthermore, this review highlights the significance of gut microbial-derived exosomes. Strategies and specific applications of engineered exosomes and bioactive scaffold-loaded exosome delivery are further summarized, especially some new techniques such as large-scale loading technique, macromolecular loading technique, development of multifunctional nano-delivery platforms and nano-scaffold-loaded exosome delivery. The potential benefits of using plant-derived exosomes for the treatment of gut-related diseases are also discussed. Additionally, the challenges, opportunities, and prospects of exosome-based nanocarriers for disease diagnosis and treatment are summarized from both preclinical and clinical viewpoints.

[Research Progress and Prospect of Herbicide Residue Characteristics in Black Soil Region of China].

Food security is the top priority of a country. As an important granary in China, the northeast black land is a "ballast" to ensure national food security. However, the long-term and high-intensity application of herbicides in black land farmland has led to the accumulation and migration of herbicides in the soil, which affects soil quality, crop yield, and quality and hinders sustainable agricultural development in the black soil. To solve the problem of herbicide residues in black land farmland, it is necessary to control the application of herbicides from the source, as well as to elucidate the current situation, spatial and temporal evolution, and driving factors of herbicide residues, in order to achieve scientific prevention and control and precise policy implementation. The main contents of this study were as follows:1systematically summarize the application status and problems of herbicides in the farmland of black soil in China, suggesting that there are currently problems such as irregular application and insufficient product innovation of herbicides in the farmland of black soil; 2 comprehensively analyze the current status of herbicide residues, identify the deficiencies in recent studies on herbicide residue characteristics, spatial distribution, and pollution diagnosis in the farmland of black soil, and clarify the gaps in the research on the residue characteristics of herbicides in the farmland of black soil; and 3 propose the research prospect and key orientation for the herbicide residue diagnosis and risk management in the farmland of the black soil region of China. The results of this study can provide science and technology support for guaranteeing soil health, food security, and ecosystem security of black land farmland in China.

Effects of atmospheric deposition on heavy metals accumulation in agricultural soils: Evidence from field monitoring and Pb isotope analysis.

Atmospheric deposition is an essential pathway of heavy metals (HMs) from the atmosphere to soils, while few studies assess the effects and contributions of atmospheric deposition on HMs accumulations in agricultural soils from the field and regional scales. In this study, eleven representative field monitoring sites from industrial areas, agricultural areas, and reference site in a typical rapid industrial development region were selected to determine the effects of atmospheric deposition on soil HMs accumulation. Industrial activities significantly increased the deposited particles flux from atmospheric deposition, with annual particles fluxes in industrial areas being 1.83 and 1.90 times higher than in agricultural areas and reference site, respectively. Although the HMs deposition fluxes had decreased significantly with time by literature comparison, the deposition fluxes of Cd and Pb were still at high levels in this study area. Precipitation was the key factor affecting seasonal variations of atmospheric HMs deposition. Lead isotope analysis indicated that atmospheric Pb originated from coal combustion, and atmospheric deposition was the primary source of Pb contamination in agricultural soil adjacent to industries. This study provided insight into the effects of atmospheric deposition on agricultural soil HMs accumulations at the regional scale and an important theoretical basis for source-preventing soil HMs contamination in industrial developed and other similar areas.

Arthroscopic Capsular Suture-Lifting Technique for Treating Femoroacetabular Impingement Patients With a High Risk of Postoperative Anterior Instability.

With the increasing popularity of hip arthroscopy, postoperative iatrogenic instability due to bony and soft-tissue issues has been noted by more orthopaedic surgeons. Although there is a low risk of serious complications in patients with normal hip joint development even without suturing of the joint capsule, for patients with a preoperative high risk of anterior instability-including those with excessive anteversion of the acetabulum or femur, borderline dysplasia of the hip, and hip arthroscopic revision surgery with an anterior defect of the joint capsule-capsulotomy without repair will result in postoperative anterior instability of the hip joint and related symptoms. Capsular suturing techniques that provide anterior stabilization will be of great help for these high-risk patients and reduce the possibility of postoperative anterior instability. In this Technical Note, we introduce the arthroscopic capsular suture-lifting technique for treating femoroacetabular impingement (FAI) patients with a high risk of postoperative hip instability. In the past 2 years, the capsular suture-lifting technique has been used to treat FAI patients with borderline dysplasia of the hip and excessive femoral neck anteversion, and clinical results have shown that the suture-lifting technique provides a reliable and effective solution for FAI patients with a high risk of postoperative anterior hip instability.