Identification and functional characterization of annexin A2 in half-smooth tongue sole (Cynoglossus semilaevis).

Annexin A2 (AnxA2), belonging to the annexin family, plays a crucial role in immune responses. In this study, the cDNA of the AnxA2 gene was identified in half-smooth tongue sole, Cynoglossus semilaevis. The transcript of AnxA2 gene in C. semilaevis (CsAnxA2) showed broad tissue distribution, with the highest expression level observed in the gut. CsAnxA2 expression was significantly up-regulated in the intestine, spleen, and kidney tissues following exposure to Shewanella algae. Immunohistochemical staining revealed that CsAnxA2 was predominantly expressed in epithelial cells and significantly elevated after S. algae challenge. Subcellular localization showed that CsAnxA2 was primarily localized in the cytoplasmic compartment. Moreover, proinflammatory cytokines (IL-6, IL-8 and IL-1ß) exhibited significant upregulation after CsAnxA2 was overexpressed in vivo. One hundred and fifty-eight CsAnxA2-interacting proteins were captured in the intestinal tissue, showing the top two normalized abundance observed for actin beta (ACTB) and protein S100-A10 (p11). Fifty-four high abundance CsAnxA2-interacting proteins (HIPs) were primary enriched in ten pathways, with the top three significantly enriched pathways being Salmonella infection, glycolysis/gluconeogenesis, and peroxisome proliferator-activated receptor (PPAR) signaling pathway. These results provide valuable information for further investigation into the functional mechanism of AnxA2 in C. semilaevis.

A High-Reliability RF MEMS Metal-Contact Switch Based on Al-Sc Alloy.

This paper presents a new metal-contact RF MEMS switch based on an Al-Sc alloy. The use of an Al-Sc alloy is intended to replace the traditional Au-Au contact, which can greatly improve the hardness of the contact, and thus improve the reliability of the switch. The multi-layer stack structure is adopted to achieve the low switch line resistance and hard contact surface. The polyimide sacrificial layer process is developed and optimized, and the RF switches are fabricated and tested for pull-in voltage, S-parameters, and switching time. The switch shows high isolation of more than 24 dB and a low insertion loss of less than 0.9 dB in the frequency range of 0.1-6 GHz.

Effects of Mask Material on Lateral Undercut of Silicon Dry Etching.

The silicon etching process is a core component of production in the semiconductor industry. Undercut is a nonideal effect in silicon dry etching. A reduced undercut is desired when preparing structures that demand a good sidewall morphology, while an enlarged undercut is conducive to the fabrication of microstructure tips. Undercut is related to not only the production parameters but also the mask materials. In this study, five mask materials-Cr, Al, ITO, SiNx, and SiO2-are chosen to compare the undercut effect caused by the isotropic etching process and the Bosch process. In the Bosch process, the SiNx mask causes the largest undercut, and the SiO2 mask causes the smallest undercut. In the isotropic process, the results are reversed. The effect of charges in the mask layer is found to produce this result, and the effect of electrons accumulating during the process is found to be negligible. The undercut effect can be enhanced or suppressed by selecting appropriate mask materials, which is helpful in the MEMS process. Finally, using an Al mask, a tapered silicon tip with a top diameter of 119.3 nm is fabricated using the isotropic etching process.

Super tiny quartz-tuning-fork-based light-induced thermoelastic spectroscopy sensing.

In this Letter, a sensitive light-induced thermoelastic spectroscopy (LITES)-based trace gas sensor by exploiting a super tiny quartz tuning fork (QTF) was demonstrated. The prong length and width of this QTF are 3500 µm and 90 µm, respectively, which determines a resonant frequency of 6.5 kHz. The low resonant frequency is beneficial to increase the energy accumulation time in a LITES sensor. The geometric dimension of QTF on the micrometer scale is advantageous to obtain a great thermal expansion and thus can produce a strong piezoelectric signal. The temperature gradient distribution of the super tiny QTF was simulated based on the finite element analysis and is higher than that of the commercial QTF with 32.768 kHz. Acetylene (C2H2) was used as the analyte. Under the same conditions, the use of the super tiny QTF achieved a 1.64-times signal improvement compared with the commercial QTF. The system shows excellent long-term stability according to the Allan deviation analysis, and a minimum detection limit (MDL) would reach 190 ppb with an integration time of 220 s.

Design and Fabrication of a Novel Poly-Si Microhotplate with Heat Compensation Structure.

I Microhotplates are critical devices in various MEMS sensors that could provide appropriate operating temperatures. In this paper, a novel design of poly-Si membrane microhotplates with a heat compensation structure was reported. The main objective of this work was to design and fabricate the poly-Si microhotplate, and the thermal and electrical performance of the microhotplates were also investigated. The poly-Si resistive heater was deposited by LPCVD, and phosphorous doping was applied by in situ doping process to reduce the resistance of poly-Si. In order to obtain a uniform temperature distribution, a series of S-shaped compensation structures were fabricated at the edge of the resistive heater. LPCVD SiNx layers deposited on both sides of poly-Si were used as both the mechanical supporting layer and the electrical isolation layer. The Pt electrode was fabricated on the top of the microhotplate for temperature detection. The area of the heating membrane was 1 mm × 1 mm. Various parameters of the different size devices were simulated and measured, including temperature distribution, power consumption, thermal expansion and response time. The simulation and electrical-thermal measurement results were reported. For microhotplates with a heat compensation structure, the membrane temperature reached 811.7 °C when the applied voltage was 5.5 V at a heating power of 148.3 mW. A 3.8 V DC voltage was applied to measure the temperature distribution; the maximum temperature was 397.6 °C, and the area where the temperature reached 90% covered about 73.8% when the applied voltage was 3.8 V at a heating power of 70.8 mW. The heating response time was 17 ms while the microhotplate was heated to 400 °C from room temperature, and the cooling response time was 32 ms while the device was recovered to room temperature. This microhotplate has many advantages, such as uniform temperature distribution, low power consumption and fast response, which are suitable for MEMS gas sensors, humidity sensors, gas flow sensors, etc.

A Novel Packaged Ultra-High Q Silicon MEMS Butterfly Vibratory Gyroscope.

A novel three-dimensional (3D) wafer-level sandwich packaging technology is here applied in the dual mass MEMS butterfly vibratory gyroscope (BFVG) to achieve ultra-high Q factor. A GIS (glass in silicon) composite substrate with glass as the main body and low-resistance silicon column as the vertical lead is processed by glass reflow technology, which effectively avoids air leakage caused by thermal stress mismatch. Sputter getter material is used on the glass cap to further improve the vacuum degree. The Silicon-On-Insulator (SOI) gyroscope structure is sandwiched between the composite substrate and glass cap to realize vertical electrical interconnection by high-vacuum anodic bonding. The Q factors of drive and sense modes in BFVG measured by the self-developed double closed-loop circuit system are significantly improved to 8.628 times and 2.779 times higher than those of the traditional ceramic shell package. The experimental results of the processed gyroscope also demonstrate a high resolution of 0.1°/s, the scale factor of 1.302 mV/(°/s), and nonlinearity of 558 ppm in the full-scale range of ±1800°/s. By calculating the Allen variance, we obtained the angular random walk (ARW) of 1.281°/√h and low bias instability (BI) of 9.789°/h. The process error makes the actual drive and sense frequency of the gyroscope deviate by 8.989% and 5.367% compared with the simulation.

Highly sensitive HF detection based on absorption enhanced light-induced thermoelastic spectroscopy with a quartz tuning fork of receive and shallow neural network fitting.

Due to its advantages of non-contact measurement and high sensitivity, light-induced thermoelastic spectroscopy (LITES) is one of the most promising methods for corrosive gas detection. In this manuscript, a highly sensitive hydrogen fluoride (HF) sensor based on LITES technique is reported for the first time. With simple structure and strong robustness, a shallow neural network (SNN) fitting algorithm is introduced into the field of spectroscopy data processing to achieve denoising. This algorithm provides an end-to-end approach that takes in the raw input data without any pre-processing and extracts features automatically. A continuous wave (CW) distributed feedback diode (DFB) laser with an emission wavelength of 1.27 µm was used as the excitation source. A Herriott multi-pass cell (MPC) with an optical length of 10.1 m was selected to enhance the laser absorption. A quartz tuning fork (QTF) with resonance frequency of 32,767.52 Hz was adopted as the thermoelastic detector. An Allan variance analysis was performed to demonstrate the system stability. When the integration time was 110 s, the minimum detection limit (MDL) was found to be 71 ppb. After the SNN fitting algorithm was used, the signal-to-noise ratio (SNR) of the HF-LITES sensor was improved by a factor of 2.0, which verified the effectiveness of this fitting algorithm for spectroscopy data processing.

A High-Performance MEMS Accelerometer with an Improved TGV Process of Low Cost.

High-performance MEMS accelerometers usually use a pendulum structure with a larger mass. Although the performance of the device is guaranteed, the manufacturing cost is high. This paper proposes a method of fabricating high-performance MEMS accelerometers with a TGV process, which can reduce the manufacturing cost and ensure the low-noise characteristics of the device. The TGV processing relies on laser drilling, the metal filling in the hole is based on the casting mold and CMP, and the packaging adopts the three-layer anodic bonding process. Moreover, for the first time, the casting mold process is introduced to the preparation of MEMS devices. In terms of structural design, the stopper uses distributed comb electrodes for overload displacement suppression, and the gas released by the packaging method provides excellent mechanical damping characteristics. The prepared accelerometer has an anti-overload capability of 10,000 g, the noise density is less than 0.001°/√Hz, and it has ultra-high performance in tilt measurement.

Adoption of Compound Echocardiography under Artificial Intelligence Algorithm in Fetal Congenial Heart Disease Screening during Gestation.

This research was aimed at exploring the diagnostic and screening effect of composite echocardiography based on the artificial intelligence (AI) segmentation algorithm on fetal congenital heart disease (CHD) during pregnancy, so as to reduce the birth rate of newborns with CHD. A total of 204 fetuses with abnormal heart conditions were divided into group II, group C (optimized with the AI algorithm), and group W (not optimized with the AI algorithm). In addition, 9,453 fetuses with normal heart conditions were included in group I. The abnormal distribution of fetal heart and the difference of cardiac Z score between group II and group I were analyzed, and the diagnostic value of group C and group W for CHD was compared. The results showed that the segmentation details of the proposed algorithm were better than those of the convolutional neural network (CNN), and the Dice coefficient, precision, and recall values were higher than those of the CNN. In fetal CHD, the incidence of abnormal ultrasonic manifestations was ventricular septal defect (98/48.04%), abnormal right subclavian artery (29/14.22%), and persistent left superior vena cava (25/12.25%). The diagnostic sensitivity (75.0% vs. 51.5%), specificity (99.6% vs. 99.2%), accuracy (99.0% vs. 98.2%), negative predictive value (88.5% vs. 78.5%), and positive predictive value (99% vs. 57.7%) of echocardiography segmentation in group C were significantly higher than those in group W. To sum up, echocardiography segmented by the AI algorithm could obviously improve the diagnostic efficiency of fetal CHD during gestation. Cardiac ultrasound parameters of children with CHD changed greatly.

[Study on the mechanism of paeonol in improving low-density lipoprotein-induced human vascular endothelial cell injury].

OBJECTIVE: To investigate the effects of paeonol on low-density lipoprotein-induced human vascular endothelial cell injury and its molecular mechanisms. METHODS: Human umbilical vein endothelial cells (HUVECs) were divided into 9 groups, normal control (NC) group, ox-LDL group (100 ng/L ox-LDL), low, medium, and high-dose paeonol groups (60 µmol/L, 120 µmol/L, 240 µmol/L paeonol+100 ng/L ox-LDL), ox-LDL+small interfering RNA negative control (si-NC) group, ox-LDL+circ_0003204 small interfering RNA (si-circ_0003204) group, middle dose group+ox-LDL+circ_0003204 overexpression negative control (pcDNA-NC) group, middle dose group+ox-LDL+circ_0003204 overexpression (pcDNA-circ_0003204) group, three replicate wells in each group. MTT flow cytometry, and Western blot were used to detect cell proliferation, apoptosis and protein (CDK2, Bcl2, p27, Bax) expressions, respectively. Malondialdehyde (MDA) and superoxide dismutase (SOD) kit were used to detect MDA content and SOD activity; real-time quantitative PCR (RT-qPCR) was used to detect the expression of circ_0003204. RESULTS: Compared with the NC group, the proliferation activity, protein expressions of CDK2 and Bcl2, and SOD activity of HUVECs in the ox-LDL group were decreased significantly (P＜0.05), and the apoptosis rate, protein expressions of p27 and Bax, MDA content, and circ_0003204 expression were increased significantly (P＜ 0.05). Compared with the ox-LDL group, the proliferation activity, protein (CDK2, Bcl2) expressions and SOD activity of HUVECs in the low, medium and high dose paeonol groups were increased significantly (P＜0.05), and the apoptosis rate, protein (p27, Bax) expressions, MDA content And circ_0003204 expression were decreased significantly (P＜ 0.05). Compared with ox-LDL+si-NC group, the proliferation activity, protein (CDK2, Bcl2) expressions, SOD activity of HUVECs in ox-LDL+si-circ_0003204 group were increased significantly (P＜0.05), the apoptosis rate, protein (p27, Bax) expressions, and the content of MDA were decreased significantly (P＜0.05). Compared with the middle-dose+ox-LDL+pcDNA-NC group, the HUVECs proliferation activity, protein (CDK2, Bcl2) expressions, and SOD activity in the middle-dose+ox-LDL+pcDNA-circ_0003204 group were decreased significantly (P＜0.05), and the levels of circ_0003204, apoptosis rate, protein (p27, Bax) expressions and MDA content were increased significantly (P＜0.05). CONCLUSION: Paeonol can inhibit ox-LDL-induced apoptosis and oxidative stress of human umbilical vein endothelial cells, and alleviate human umbilical vein endothelial cell injury. The mechanism of action may be related to the down-regulation of circ_0003204 expression.

ZRO Drift Reduction of MEMS Gyroscopes via Internal and Packaging Stress Release.

Zero-rate output (ZRO) drift induces deteriorated micro-electromechanical system (MEMS) gyroscope performances, severely limiting its practical applications. Hence, it is vital to explore an effective method toward ZRO drift reduction. In this work, we conduct an elaborate investigation on the impacts of the internal and packaging stresses on the ZRO drift at the thermal start-up stage and propose a temperature-induced stress release method to reduce the duration and magnitude of ZRO drift. Self-developed high-Q dual-mass tuning fork gyroscopes (TFGs) are adopted to study the correlations between temperature, frequency, and ZRO drift. Furthermore, a rigorous finite element simulation model is built based on the actual device and packaging structure, revealing the temperature and stresses distribution inside TFGs. Meanwhile, the relationship between temperature and stresses are deeply explored. Moreover, we introduce a temperature-induced stress release process to generate thermal stresses and reduce the temperature-related device sensitivity. By this way, the ZRO drift duration is drastically reduced from ~2000 s to ~890 s, and the drift magnitude decreases from ~0.4 °/s to ~0.23 °/s. The optimized device achieves a small bias instability (BI) of 7.903 °/h and a low angle random walk (ARW) of 0.792 °/√ h, and its long-term bias performance is significantly improved.

A Novel High-Q Dual-Mass MEMS Tuning Fork Gyroscope Based on 3D Wafer-Level Packaging.

Tuning fork gyroscopes (TFGs) are promising for potential high-precision applications. This work proposes and experimentally demonstrates a novel high-Q dual-mass tuning fork microelectromechanical system (MEMS) gyroscope utilizing three-dimensional (3D) packaging techniques. Except for two symmetrically decoupled proof masses (PM) with synchronization structures, a symmetrically decoupled lever structure is designed to force the antiparallel, antiphase drive mode motion and eliminate low frequency spurious modes. Thermoelastic damping (TED) and anchor loss are greatly reduced by the linearly coupled, momentum- and torque-balanced antiphase sense mode. Moreover, a novel 3D packaging technique is used to realize high Q-factors. A composite substrate encapsulation cap, fabricated by through-silicon-via (TSV) and glass-in-silicon (GIS) reflow processes, is anodically bonded to the wafer-scale sensing structures. A self-developed control circuit is adopted to realize loop control and characterize gyroscope performances. It is shown that a high-reliability electrical connection, together with a high air impermeability package, can be fulfilled with this 3D packaging technique. Furthermore, the Q-factors of the drive and sense modes reach up to 51,947 and 49,249, respectively. This TFG realizes a wide measurement range of ±1800 °/s and a high resolution of 0.1°/s with a scale factor nonlinearity of 720 ppm after automatic mode matching. In addition, long-term zero-rate output (ZRO) drift can be effectively suppressed by temperature compensation, inducing a small angle random walk (ARW) of 0.923°/√h and a low bias instability (BI) of 9.270°/h.

A Real-Time Circuit Phase Delay Correction System for MEMS Vibratory Gyroscopes.

With the development of the designing and manufacturing level for micro-electromechanical system (MEMS) gyroscopes, the control circuit system has become a key point to determine their internal performance. Nevertheless, the phase delay of electronic components may result in some serious hazards. This study described a real-time circuit phase delay correction system for MEMS vibratory gyroscopes. A detailed theoretical analysis was provided to clarify the influence of circuit phase delay on the in-phase and quadrature (IQ) coupling characteristics and the zero-rate output (ZRO) utilizing a force-to-rebalance (FTR) closed-loop detection and quadrature correction system. By deducing the relationship between the amplitude-frequency, the phase-frequency of the MEMS gyroscope, and the phase relationship of the whole control loop, a real-time correction system was proposed to automatically adjust the phase reference value of the phase-locked loop (PLL) and thus compensate for the real-time circuit phase delay. The experimental results showed that the correction system can accurately measure and compensate the circuit phase delay in real time. Furthermore, the unwanted IQ coupling can be eliminated and the ZRO was decreased by 755% to 0.095°/s. This correction system realized a small angle random walk of 0.978°/√h and a low bias instability of 9.458°/h together with a scale factor nonlinearity of 255 ppm at room temperature. The thermal drift of the ZRO was reduced to 0.0034°/s/°C at a temperature range from -20 to 70 °C.

Revision of failed metal-on-metal total hip arthroplasty using cemented arthroplasty: a mean 10-year follow-up of 157 consecutive patients.

OBJECTIVE: This study was performed to assess the outcomes of Asian patients who underwent conversion from metal-on-metal total hip arthroplasty (MoM-THA) to cemented THA (CTHA). METHODS: One hundred and fifty-seven consecutive patients (157 hips) who underwent CTHA following primary MoM-THA from January 2005 to February 2015 were retrospectively analysed. The primary endpoints were the clinical outcomes. Follow-ups occurred at 3 months, 6 months, 1 year, 2 years, and then every 2 years following revision of MoM-THA. RESULTS: The mean follow-up after conversion was 10 years (range, 5-14 years). Statistically significant improvements in the mean Harris hip score were observed between the preoperative and final follow-up evaluations (62.71 ± 13.85 vs. 84.03 ± 16.21, respectively). The major orthopaedic complication rate was 16.5% (26/157). Six (3.8%) patients underwent revision at a mean of 3.5 ± 1.3 years after conversion, predominantly because of prosthesis loosening or recurrent dislocation. Nine (5.7%) patients developed prosthesis loosening at a mean of 2.6 ± 1.1 years following conversion, two of whom requested revision surgery. Eleven (7.0%) patients developed prosthesis dislocation, four of whom requested revision surgery. CONCLUSION: CTHA may yield favourable functional outcomes and a reduced rate of major orthopaedic complications.

A Novel Fabrication Method for a Capacitive MEMS Accelerometer Based on Glass-Silicon Composite Wafers.

In this paper, we report a novel teeter-totter type accelerometer based on glass-silicon composite wafers. Unlike the ordinary micro-electro-mechanical systems (MEMS) accelerometers, the entire structure of the accelerometer, includes the mass, the springs, and the composite wafer. The composite wafer is expected to serve as the electrical feedthrough and the fixed capacitance plate at the same time, to simplify the fabrication process, and to save on chip area. It is manufactured by filling melted borosilicate glass into an etched silicon wafer and polishing the wafer flat. A sensitivity of 51.622 mV/g in the range of ±5 g (g = 9.8 m/s2), a zero-bias stability under 0.2 mg, and the noise floor with 11.28 µg/√Hz were obtained, which meet the needs of most acceleration detecting applications. The micromachining solution is beneficial for vertical interconnection and miniaturization of MEMS devices.

Conversion from a failed proximal femoral nail anti-rotation to a cemented or uncemented total hip arthroplasty device: a retrospective review of 198 hips with previous intertrochanteric femur fractures.

BACKGROUND: At present, it is unclear which device (uncemented or cemented total hip arthroplasty [UTA or CTA, respectively]) is more suitable for the conversion of a failed proximal femoral nail anti-rotation (PFNA). The aim of this review was to assess the outcomes of failed PFNAs converted to a UTA or CTA device in elderly individuals with intertrochanteric femoral fractures (IFFs). METHODS: Two hundred fifty-eight elderly individuals (258 hips) with IFFs who underwent a conversion to a UTA or CTA device following failed PFNAs during 2007-2017 were retrospectively identified from the China Southern Medical Centre (CSMC) database. The primary endpoint was the Harris Hip Score (HHS); secondary endpoint was the key orthopaedic complication rate. RESULTS: The median follow-up was 65 months (60-69 months). Significant distinctions were observed (87.26 ± 16.62 for UTA vs. 89.32 ± 16.08 for CTA, p = 0.021; 86.61 ± 12.24 for symptomatic UTA vs. 88.68 ± 13.30 for symptomatic CTA, p = 0.026). A significant difference in the overall key orthopaedic complication rate was detected (40.8% [40/98] vs. 19.0% [19/100], p = 0.001). Apparent distinctions were detected in terms of the rate of revision, loosening, and periprosthetic fracture (11.2% for UTA vs 3.0% for CTA, p = 0.025; 13.2% for UTA vs 5.0% for CTA, p = 0.043; 10.2% for UTA vs 3.0% for CTA, p = 0.041, respectively). CONCLUSION: For elderly individuals with IFFs who suffered a failed PFNA, CTA devices may have a noteworthy advantage in regard to the revision rate and the rate of key orthopaedic complications compared with UTA devices, and CTA revision should be performed as soon as possible, regardless of whether these individuals have symptoms.

Favourable clinical outcomes following cemented arthroplasty after metal-on-metal total hip replacement: a retrospective study with a mean follow-up of 10 years.

BACKGROUND: Given the unexpected high rate of failure following metal-on-metal total hip replacement (MoM-THR), it is expected that more MoM-THR patients will experience revision. The long-term outcomes regarding the primary MoM-THR revised to cemented THR (CTHR) remain controversial. The purpose of this retrospective review was to evaluate the long-term outcomes of patients who underwent conversion from MoM-THR to CTHR. METHODS: A total of 220 patients (220 hips) who underwent a conversion of primary MoM-THR to CTHR from March 2006 to October 2016 were retrospectively reviewed. The primary outcomes were the functional outcomes assessed using the Harris hip scores (HHS) and major radiographic outcomes. Follow-ups occurred at 3 months, 6 months, 1 year, 2 years, and then every two years after revision. RESULTS: Mean follow-up was 10.1 years (5-13 years). Distinct improvements were detected in the mean HHS between the preoperative and last follow-up analysis (62.35[±8.49] vs. 84.70[±14.68], respectively, p < 0.001). The key orthopaedic complication rate was 18.2% (27/148). Seven (4.7%) cases experienced a CTHR failure at a mean of 3.4 (±1.2) years after revision MoM-THR, mostly attributed to recurrent dislocation. CONCLUSION: CTHR might yield an acceptable functional score and a low rate of the key orthopaedic complications.

Cemented versus uncemented total hip replacement for femoral neck fractures in elderly patients: a retrospective, multicentre study with a mean 5-year follow-up.

BACKGROUND: Cemented or uncemented total hip replacement (CTR or UTR) for femoral neck fractures (AO/OTA type 31B/C) is a relatively common procedure in elderly individuals. The recent literature is limited regarding long-term outcomes following CTR versus UTR in the Asian population. METHODS: Using our institutional database, we performed long-term outcome analysis on 268 patients with femoral neck fractures (AO/OTA type 31B/C) who had undergone a primary UTR or CTR (CTR: n = 132, mean age, 67.43 ± 6.51 years; UTR: n = 136, mean age, 67.65 ± 6.13 years) during 2007-2014, and these patients were followed until 2019. Follow-up occurred 1, 3, 6, and 12 months postoperatively and yearly thereafter. The primary endpoint was the Harris hip score (HHS); the secondary endpoint was the incidence of orthopaedic complications. RESULTS: The mean follow-up time was 62.5 months (range, 50.1-76.1 months). At the final follow-up, the HHS was 79.39 ± 16.92 vs 74.18 ± 17.55 (CTR vs UTR, respectively, p = 0.011). Between-group significant differences were observed regarding the incidence of prosthesis revision, prosthesis loosening, and periprosthetic fracture (7.6% [95% CI, 6.4-8.2] for CTR vs 16.9% [95% CI, 14.7-17.3] for UTR, p = 0.020; 9.8% [95% CI, 8.3-10.7] for CTR vs 19.9% [95% CI, 18.2-20.9] for UTR, p = 0.022; 5.3% [95% CI, 4.4-6.7] for CTR vs 13.2% [95% CI, 12.1-13.8] for UTR, p = 0.026, respectively). CONCLUSION: CTR showed superiority to UTR by improving the HHS and decreasing the incidence of orthopaedic complications. Our findings need to be confirmed in a prospective, randomized controlled study to verify whether they can be applicable to a broader population.

Cetuximab versus bevacizumab maintenance following prior 8-cycle modified FOLFOXIRI plus cetuximab in Asian postmenopausal women with treatment-naive KRAS and BRAF wild-type metastatic colorectal cancer.

OBJECTIVE: To assess the efficacy and safety of cetuximab (CE) versus bevacizumab (BE) maintenance treatment after prior 8-cycle modified 5-fluorouracil, folinate, oxaliplatin, and irinotecan (FOLFOXIRI) plus CE induction therapy in treatment-naive KRAS and BRAF wild-type (wt) metastatic colorectal cancer (mCRC). METHODS: From 2012 to 2017, prospectively maintained databases were reviewed to assess Asian postmenopausal women with treatment-naive KRAS and BRAF wt mCRC who underwent modified FOLFOXIRI plus CE induction therapy, followed by CE or BE maintenance until disease progression or death. Co-primary clinical endpoints were progression-free survival (PFS) and overall survival (OS). RESULTS: A total of 222 women were included (CE n = 110 and BE n = 112). At a median follow-up of 27.0 months (interquartile range, 6.5-38.6 months), median PFS was 21.9 months (95% confidence interval [CI] 16.4-24.4) and 17.7 months (95% CI 11.3-19.0) for CE and BE groups, respectively (hazard ratio [HR] 0.31, 95% CI 0.15-0.46); median OS was 26.0 months (95% CI 23.4-28.7) and 22.7 months (95% CI 21.2-24.3) for CE and BE groups, respectively (HR 0.22, 95% CI 0.11-0.37). CONCLUSIONS: CE maintenance treatment is more poorly tolerated but has a slightly more modest survival benefit compared with BE maintenance treatment in mCRC.

Conversion to hemi-shoulder arthroplasty or reverse total shoulder arthroplasty after failed plate osteosynthesis of proximal humerus fractures: a retrospective study.

OBJECTIVE: To assess the clinical outcomes of hemi-shoulder arthroplasty (HSA) versus reverse total shoulder arthroplasty (RTSA) following failed plate osteosynthesis of proximal humerus fractures in elderly patients. METHODS: This retrospective study identified all patients that had a documented failed plate osteosynthesis of proximal humeral fractures treated with revision HSA or RTSA. Follow-up occurred at 1, 3, 6 and 12 months after surgery and every year thereafter. The primary outcomes were the American Shoulder and Elbow Surgeons (ASES) scores, Simple Shoulder Test (SST) scores, visual analogue scale (VAS) pain scores and the University of California, Los Angeles Shoulder Rating Scale (UCLA SRS) scores. The secondary outcome was the rate of major complications. RESULTS: A total of 126 patients (126 shoulders) were enrolled in the study. At the final follow-up, the RTSA group had significantly greater improvements in ASES, SST and UCLA SRS scores than the HSA group. The RTSA group had significantly larger decreases in the VAS pain score compared with the HSA group. The rate of major complications was significantly higher in the HSA group than in the RTSA group (44.4% versus 27.5%, respectively). CONCLUSION: RTSA provided superior functional outcomes compared with HSA, with a lower rate of major complications after a follow-up period of at least 5 years.