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Tuberculosis (TB) is one of the infectious diseases caused by the pathogen Mycobacterium tuberculosis that continuously threatens the global human health. Bacillus Calmette-Guérin (BCG) vaccine is the only vaccine that has been used clinically to prevent tuberculosis in recent centuries, but its limitations in preventing latent infection and reactivation of tuberculosis do not provide full protection. In this study, we selected the membrane-associated antigen Rv1513 of Mycobacterium. In order to achieve stable expression and function of the target gene, the prokaryotic expression recombinant vector pET30b-Rv1513 was constructed and expressed and purified its protein. Detection of IFN- γ levels in the peripheral blood of TB patients stimulated by whole blood interferon release assay (WBIA) and multi-microsphere flow immunofluorescence luminescence (MFCIA) revealed that the induced production of cytokines, such as IFN-γ and IL-6, was significantly higher than that in the healthy group. Rv1513 combined with adjuvant DMT (adjuvant system liposomes containing dimethyldioctadecylammonium bromide (DDA), monophospholipid A (MPL), and trehalose-660-dibenzoic acid (TDB)) was used to detect serum specific antibodies, cytokine secretion from splenic suprasplenic cell supernatants, and multifunctional T-cell levels in splenocytes in immunised mice. The levels of IFN-γ, TNF-α, and IL-2 secreted by mouse splenocytes were found in the Rv1513+DMT group and the BCG+Rv1513+DMT group. The serum levels of IgG and its subclasses and the number of IFN-γ+T cells, TNF-α+T and IFN-γ+TNF-α+T cells in the induced CD4+/CD8+T cells in mice were significantly higher than those in the BCG group, and the highest levels were found in the BCG+Rv1513+DMT group. These findings suggest that Rv1513/DMT may serve as a potential subunit vaccine candidate that may be effective as a booster vaccine after the first BCG vaccination.
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Mycobacterium tuberculosis , Células Th1 , Vacinas contra a Tuberculose , Tuberculose , Animais , Mycobacterium tuberculosis/imunologia , Mycobacterium tuberculosis/genética , Camundongos , Humanos , Células Th1/imunologia , Vacinas contra a Tuberculose/imunologia , Vacinas contra a Tuberculose/genética , Vacinas contra a Tuberculose/administração & dosagem , Tuberculose/imunologia , Tuberculose/prevenção & controle , Tuberculose/microbiologia , Feminino , Antígenos de Bactérias/imunologia , Antígenos de Bactérias/genética , Citocinas/metabolismo , Citocinas/imunologia , Proteínas de Bactérias/imunologia , Proteínas de Bactérias/genética , Interferon gama/imunologia , Interferon gama/metabolismo , Camundongos Endogâmicos BALB C , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Adjuvantes Imunológicos/administração & dosagem , AdultoRESUMO
PURPOSE: The risk factors for excessive blood loss and transfusion during total knee arthroplasty (TKA) remain unclear. The present study aimed to determine the risk factors for excessive blood loss and establish a predictive model for postoperative blood transfusion. METHODS: This retrospective study included 329 patients received TKA, who were randomly assigned to a training set (n = 229) or a test set (n = 100). Univariate and multivariate linear regression analyses were used to determine risk factors for excessive blood loss. Univariate and multivariate logistic regression analyses were used to determine risk factors for blood transfusion. R software was used to establish the prediction model. The accuracy and stability of the models were evaluated using calibration curves, consistency indices, and receiver operating characteristic (ROC) curve analysis. RESULTS: Risk factors for excessive blood loss included timing of using a tourniquet, the use of drainage, preoperative ESR, fibrinogen, HCT, ALB, and free fatty acid levels. Predictors in the nomogram included timing of using a tourniquet, the use of drainage, the use of TXA, preoperative ESR, HCT, and albumin levels. The area under the ROC curve was 0.855 (95% CI, 0.800 to 0.910) for the training set and 0.824 (95% CI, 0.740 to 0.909) for the test set. The consistency index values for the training and test sets were 0.855 and 0.824, respectively. CONCLUSIONS: Risk factors for excessive blood loss during and after TKA were determined, and a satisfactory and reliable nomogram model was designed to predict the risk for postoperative blood transfusion.
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Artroplastia do Joelho , Perda Sanguínea Cirúrgica , Transfusão de Sangue , Nomogramas , Humanos , Artroplastia do Joelho/efeitos adversos , Feminino , Masculino , Estudos Retrospectivos , Fatores de Risco , Pessoa de Meia-Idade , Idoso , Transfusão de Sangue/estatística & dados numéricos , Medição de Risco , Valor Preditivo dos TestesRESUMO
BACKGROUND: The effectiveness of robot-assisted surgery remains contentious due to the lack of high-quality randomized controlled trials (RCTs) to elevate the level of evidence. We aimed to evaluate the postoperative radiographic outcomes of robot-assisted (RAS-THA) versus manual (M-THA) total hip arthroplasty. METHODS: This multicenter RCT was performed from March 1, 2021 to December 1, 2021. Patients were randomly assigned to routine M-THA or to RAS-THA that used the TRex-RS orthopedic joint surgical navigation system. The primary outcome was to compare the acetabular component orientation, femoral stem alignment, femoral canal fill ratio, and leg length discrepancy between RAS-THA and M-THA using postoperative radiography. Subgroup analyses of the two groups stratified by surgical approach, gender, and BMI were also conducted. RESULTS: Seventy-three participants were randomly allocated to the RAS-THA group, while seventy-two participants were assigned to the M-THA group. Compared to the M-THA group, the RAS-THA group exhibited less variability in the preoperative planning of the vertical center of rotation (VCOR; P < 0.001), demonstrated a significant advantage in femoral stem alignment (P = 0.004), and showed pronounced decreases in inequality and in the variability in leg length discrepancy (P < 0.001). There was no significant difference in the Lewinnek safe-zone ratio (P = 0.081) and the femoral canal fill ratio (P > 0.05) between the two groups. Further subgroup analysis also showed that the RAS-THA group had fewer horizontal center of rotation (HCOR) and leg length differences when stratified by surgical approach, gender, and overweight status. CONCLUSION: This RCT found that, regardless of the surgical approach, gender, or body mass index, RAS-THA can effectively improve the postoperative VCOR and significantly reduce the variability of leg length difference. RAS-THA should be considered an effective method to enhance surgical precision by achieving less variability in challenging patients with leg length discrepancies. TRIAL REGISTRATION: ChiCTR2100044124.
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Artroplastia de Quadril , Procedimentos Cirúrgicos Robóticos , Humanos , Masculino , Feminino , Artroplastia de Quadril/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Pessoa de Meia-Idade , Idoso , Radiografia , Desigualdade de Membros Inferiores/cirurgia , Desigualdade de Membros Inferiores/diagnóstico por imagem , Desigualdade de Membros Inferiores/etiologia , Resultado do TratamentoRESUMO
INTRODUCTION: The purpose of this article is to study whether the newly designed whole-process total hip arthroplasty (THA) robotic arm can improve the accuracy of prosthesis placement in THA. METHOD: In this study, 72 patients undergoing THA were prospectively included and randomly divided into two groups. The experimental group was treated with THA assisted by a newly designed robotic arm. The control group received THA with conventional surgical methods. The imaging data were compared after operation. RESULT: Compared with the conventional operation, the whole-process robotic arm can more accurately place the acetabular prosthesis in the anteversion safe zone of 5 ~ 25°, but in terms of the inclination angle, whether the reference is the safe zone of 30 ~ 50° or 30 ~ 45°, there is no statistical difference between the two groups. The average lower limb length discrepancy (LLLD) in the experimental group was 3.77 ± 8.31 mm longer than contralateral side, while the counterpart in the control group was 8.39 ± 9.11 mm, with significant difference (P = 0.029). The femoral prosthesis was fixed in neutral position in 35 (100%) cases in the experimental group and only 30 (83.3%) in the control group (P = 0.036). There was no significant difference in the recovery of hip offset, femoral anteversion, and canal fill ratio (CFR) between the two groups. CONCLUSION: Robotic arm can improve the accuracy of anteversion of acetabular cup, restore the consistency of the length of lower limbs, and more accurately implant the femoral prosthesis to the neutral position in the coronal position. CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR2100044124 (date of registration: 2021-3-11).
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Artroplastia de Quadril , Prótese de Quadril , Procedimentos Cirúrgicos Robóticos , Humanos , Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/métodos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Procedimentos Cirúrgicos Robóticos/métodos , Estudos Prospectivos , Acetábulo/diagnóstico por imagem , Acetábulo/cirurgiaRESUMO
OBJECTIVE: To evaluate the impact of body mass index (BMI) on the mid-term clinical outcomes and survival in patients receiving a mobile-bearing unicompartmental knee arthroplasty (UKA). METHODS: We retrospectively collected data from 355 patients who underwent UKA from June 2006 to June 2015, with a mean follow-up of 106.5 ± 22.5 months. Patients were assigned into four groups based on their BMI before surgery: normal weight group (BMI 18.5 ~ 22.9 kg/m2), overweight group (23 ~ 24.9 kg/m2), obesity group (25 ~ 29.9 kg/m2), and severe obesity group (≥ 30 kg/m2). The knee society score (KSS), knee society function score (KSFS), hospital for special surgery score (HSS), and range of motion (ROM) were assessed before the operation and at the last follow-up. The femorotibial angle (FTA) was assessed after the operation immediately and at the last follow-up. Kaplan-Meier survival analysis was performed among the four groups. RESULTS: The KSS, KSFS, and HSS in all groups were markedly improved compared with the preoperative values (p<0.001), but the ROM score was not significantly different (p>0.05). There were significant differences in KSS (p<0.001) and HSS (p = 0.004) across the four BMI groups, and these differences were due to the severe obesity group. All groups exhibited an inclination of knee varus deformity at the last follow-up (p < 0.05). Moreover, no marked difference in the implant survival rate was found among the different groups (p = 0.248), or in the survival curves (p = 0.593). CONCLUSIONS: BMI does not influence the implant survival rate. The postoperative functional and quality-of-life scores were significantly improved in all groups. Obese (BMI ≥30 kg/m2) individuals should not be excluded from UKA.
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Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Artroplastia do Joelho/efeitos adversos , Índice de Massa Corporal , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/cirurgia , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do TratamentoRESUMO
PURPOSE: The purpose of this study was to compare the early functional outcomes between robotic-arm assisted total knee arthroplasty (RATKA) and conventional manual total knee arthroplasty (TKA). METHODS: This prospective cohort study included 52 patients (26 RATKA and 26 TKA). All procedures were performed by a single experienced surgeon using identical approach and implant designs. Post-operative evaluation consisted of the risks of inflammatory and blood loss, the accuracy of mechanical alignment, post-operative pain, peri-operative and post-operative functional outcomes, and complications for 30 days after index surgery. RESULTS: There was no statistical difference in baseline characteristics of patients between two groups (p > 0.05). There was a trend that the operative time of RATKA was prolonged compared with manual TKA (p < 0.0001). However, the risks of infection and blood loss did not increase accordingly (p > 0.05). No statistical difference was found in the correction of mechanical alignment between two groups (p > 0.05). The RATKA was associated with reduced pain post-operatively in day 1 (p < 0.05). Afterwards, there was no systematic difference in VAS score from day two to three post-operatively (p > 0.05). There was no significant difference in functional recovery (p > 0.05). No complication occurred in both groups. CONCLUSION: Although the operative time was prolonged in RATKA, it did not increase the risks of infection and blood loss. There was no significant difference in radiological or functional outcomes between RATKA and conventional manual TKA. RATKA might be related to reduced pain after surgery.
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Artroplastia do Joelho , Osteoartrite do Joelho , Procedimentos Cirúrgicos Robóticos , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/métodos , Humanos , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Dor Pós-Operatória/epidemiologia , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/cirurgia , Estudos Prospectivos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Procedimentos Cirúrgicos Robóticos/métodosRESUMO
BACKGROUND: Bearing dislocation is the main complication after mobile bearing unicompartmental knee arthroplasty. The purpose of this study was to analyze the potential risk factors of bearing dislocation after Oxford phase III mobile bearing unicompartmental knee arthroplasty in Chinese patients. METHODS: We retrospectively investigated 492 patients (578 knees) who underwent Oxford phase III mobile bearing unicompartmental knee arthroplasty in our institution between February 2009 and June 2019. The patients were divided into two groups based on surgeons' annual surgical volume. Those with/ without bearing dislocation were compared based on patient, surgeon and implant factors. RESULTS: Among the 492 patients, 21 (4.3%, 4 men and 17 women) experienced bearing dislocation. Of these, 14 (4.0%) were in the high surgical volume group and 7 (5.1%) were in the low surgical volume group. Multivariate analysis revealed that trauma to the operated leg and daily life involving high knee flexion cumulatively predicted bearing dislocation (p < 0.05). CONCLUSIONS: Trauma to the operated leg and daily life involving high knee flexion were risk factors for bearing dislocation after Oxford phase III mobile bearing unicompartmental knee arthroplasty.
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Prótese do Joelho , Osteoartrite do Joelho , China/epidemiologia , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Prótese do Joelho/efeitos adversos , Masculino , Estudos Retrospectivos , Resultado do TratamentoRESUMO
CNN-based Martian rock image processing has attracted much attention in Mars missions lately, since it can help planetary rover autonomously recognize and collect high value science targets. However, due to the difficulty of Martian rock image acquisition, the accuracy of the processing model is affected. In this paper, we introduce a new dataset called "GMSRI" that is a mixture of real Mars images and synthetic counterparts which are generated by GAN. GMSRI aims to provide a set of Martian rock images sorted by the texture and spatial structure of rocks. This paper offers a detailed analysis of GMSRI in its current state: Five sub-trees with 28 leaf nodes and 30,000 images in total. We show that GMSRI is much larger in scale and diversity than the current same kinds of datasets. Constructing such a database is a challenging task, and we describe the data collection, selection and generation processes carefully in this paper. Moreover, we evaluate the effectiveness of the GMSRI by an image super-resolution task. We hope that the scale, diversity and hierarchical structure of GMSRI can offer opportunities to researchers in the Mars exploration community and beyond.
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Meio Ambiente Extraterreno , MarteRESUMO
OBJECTIVE: To investigate the differences between emergency surgery and selective surgery treatment of ankle fractures with dislocation. METHODS: In the study, 40 patients with ankle fracture and dislocation were treated and followed up from May 2013 to May 2014, and all the data were collected and analyzed. The subjects involved 29 male patients and 11 female patients. The patients were randomly separated into two groups, and the patients in group A were given surgical intervention within 6 hours after injury, while those in group B were initially given close reduction and given selective operation when the soft tissue condition got better. Group A contained 13 male patients and 7 female patients with average age of 37.10; Group B consisted of 15 male and 5 female, with average age of 37.85. RESULTS: The Baird-Jackson score was applied for assessment of the patients' outcomes. According to the score, the outcomes were classified into excellent, good, fair, and poor. In group A (emergency group), the outcomes were 13 (65.0%), 4 (20.0%), 3 (15.0%), and 0, respectively. In group B (selective group), they were 11 (55.0%), 7 (35.0%), 2 (10.0%), and 0, respectively. The numbers of the patients from excellent to poor were 24 (55.0%), 11 (27.5%), 5 (12.5%), and 0, respectively. CONCLUSION: There is no significant difference in postoperative function between the two groups, however, early surgical intervention can benefit in accomplishing anatomical reduction much easier and shortening the time of hospitalization, which is cost-saving for the patients.
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Fraturas do Tornozelo/cirurgia , Fixação Interna de Fraturas , Adulto , Tratamento de Emergência , Feminino , Humanos , Luxações Articulares , Masculino , Período Pós-OperatórioRESUMO
TSHR is a member of the glycoprotein hormone receptors, a subfamily of class A G-protein-coupled receptors and plays pivotal roles in various physiological and pathological processes, particularly in thyroid growth and hormone production. The aberrant TSHR function has been implicated in several human diseases including Graves' disease and orbitopathy, nonautoimmune hyperthyroidism, hypothyroidism, cancer, neurological disorders, and osteoporosis. Consequently, TSHR is recognized as an attractive therapeutic target, and targeting TSHR with small-molecule modulators including agonists, antagonists, and inverse agonists offers great potential for drug discovery. In this perspective, we summarize the structures and biological functions of TSHR as well as the recent advances in the development of small-molecule TSHR modulators, highlighting their chemotypes, mode of actions, structure-activity relationships, characterizations, in vitro/in vivo activities, and therapeutic potential. The challenges, new opportunities, and future directions in this area are also discussed.
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Receptores da Tireotropina , Bibliotecas de Moléculas Pequenas , Animais , Humanos , Descoberta de Drogas , Receptores da Tireotropina/metabolismo , Receptores da Tireotropina/antagonistas & inibidores , Bibliotecas de Moléculas Pequenas/química , Bibliotecas de Moléculas Pequenas/farmacologia , Bibliotecas de Moléculas Pequenas/uso terapêutico , Relação Estrutura-Atividade , Proteínas de Ligação ao GTP/química , Proteínas de Ligação ao GTP/metabolismoRESUMO
OBJECTIVE: To compare the effect of a new complete robot-assisted total hip arthroplasty (RA-THA) with that of the manual total hip arthroplasty (MTHA) and to verify the accuracy and safety of the former. METHODS: Overall, 148 patients were enroled from 3 March 2021 to 28 December 2021 in this study and classified into RA-THA ( n =74 patients) and MTHA ( n =74 patients) groups. The sex, age, operative side, BMI, diagnosis, other basic information, operative time, acetabular prosthesis anteversion and inclination, femoral prosthesis anteversion and angulation, femoral prosthesis filling rate, leg length discrepancy (LLD), Harris hip score, and visual analogue scale (VAS) score of the two groups were compared. RESULTS: No significant differences were observed in the two groups regarding sex, age, operative side, BMI, diagnosis, Harris hip score, VAS score, acetabular inclination, acetabular prosthesis anteversion, femoral prosthesis anteversion, combined anteversion, and femoral prosthesis filling rate ( P >0.05). The operative time was significantly longer in the RA-THA group than in the MTHA group (106.71±25.22 min vs. 79.42±16.16 min; t=7.30, P <0.05). The femoral angulation (1.78°±0.64°) and LLD (2.87±1.55 mm) in the RA-THA group were significantly lesser than those in the MTHA group (2.22°±1.11° and 5.81±6.27 mm, respectively; t=-2.95 and t=-3.88, P <0.05). CONCLUSION: The complete RA-THA has some advantages over the traditional procedure in restoring the lower limb length and controlling the femoral prosthesis angulation. Thus, this study verifies the accuracy and safety of the robot-assisted system.
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Artroplastia de Quadril , Procedimentos Cirúrgicos Robóticos , Humanos , Masculino , Feminino , Artroplastia de Quadril/métodos , Artroplastia de Quadril/instrumentação , Procedimentos Cirúrgicos Robóticos/métodos , Pessoa de Meia-Idade , Idoso , Duração da Cirurgia , Resultado do Tratamento , Prótese de QuadrilRESUMO
The types and morphology of sheep horns have been extensively researched, yet the genetic foundation underlying the emergence of diverse horn characteristics during the breeding of polled Tibetan sheep has remained elusive. Genome-wide association analysis (GWAS) was performed on 103 subtypes (normal large horn, scurs, and polled) differentiated from G2 (offspring (G2) of parent (G1) of polled) of the polled core herd. Six single nucleotide polymorphisms (SNPs) located on chromosome 10 of the relaxin family peptide receptor 2 (RXFP2) gene exhibited positive correlations with horn length, horn base circumference, and horn base interval. Furthermore, in genotyping 382 G2 individuals, significant variations were observed for each specific horn type. Three additional mutations were identified near the target SNP upstream of the amplification product. Finally, the RXFP2-specific haplotype associated with the horned trait effectively maintained horn length, horn base circumference, and horn base interval in Tibetan sheep, as confirmed by population validation of nine loci in a sample size of 1125 individuals. The present study offers novel insights into the genetic differentiation of the horned type during improvement breeding and evolution, thereby establishing a robust theoretical foundation for polled Tibetan sheep breeding and providing valuable guidance for practical production.
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Postoperative complications due to inaccurate prosthesis positioning are the main causes of early revision. The aim of this study was to (1) determine whether novel designed whole-process robotic assisted hip system allowed better radiographic outcomes and lower complications risk on the femoral side particularly stem subsidence compared to conventional THA, and to (2) identify the comparison of early clinical outcomes. 72 patients were initially enrolled and randomly divided into 2 groups. Finally, only 65 patients (31 RA-THAs, 34 C-THAs) were analyzed who had full 18-month follow-up data. Radiographic follow-up was performed at immediate and 6-month postoperatively, while clinical follow-up at 18-month postoperatively. Stem-related radiographic outcomes, femoral side complications and clinical scores were compared. The robotic arm allowed better radiographic outcomes of the femoral side, including a higher canal fill ratio (CFR) at B1 (P = 0.040), more neutral stem alignment (P = 0.029), lower subsidence (P = 0.023) and lower leg length discrepancy (LLD) (P = 0.010). In addition, low CFR at B1 (P = 0.001) was found the risk factor for subsidence. However, early clinical outcomes were consistent between both groups. The novel designed whole-process robotic assisted hip system covers both femoral and acetabular side operations. It allows accurate and safe manipulation of femoral side, including better stem-related radiographic outcomes and lower risk of subsidence and LLD. However, no advantage of robotic system in early clinical score was identified. Clinical trial registration number: ChiCTR2100044124.
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Artroplastia de Quadril , Prótese de Quadril , Procedimentos Cirúrgicos Robóticos , Humanos , Artroplastia de Quadril/efeitos adversos , Prótese de Quadril/efeitos adversos , Procedimentos Cirúrgicos Robóticos/métodos , Estudos Prospectivos , Resultado do Tratamento , Estudos RetrospectivosRESUMO
Acute cartilage injuries, such as intra-articular fractures and blunt impacts, frequently result in chondrocyte death and extracellular matrix (ECM) degradation, significantly elevating the risk of post-traumatic osteoarthritis (PTOA). Despite advances in treatment, no effective therapies currently exist to fully cure PTOA or halt its progression. This study explores the protective effects of the dietary fatty acid eicosapentaenoic acid (EPA) on human primary chondrocytes (HPCs) and cartilage explants exposed to mechanical overload and blunt trauma. HPCs were isolated and subjected to mechanical stretching using BioFlex six-well culture plates, while cartilage explants were subjected to impact loading via a customized drop tower. EPA was incorporated into the culture medium, followed by assays to evaluate cell viability, calcium (Ca²âº) influx, apoptosis, reactive oxygen species (ROS) levels, and collagen type II alpha (Col-2a) expression. EPA treatment markedly decreased chondrocyte mechanical sensitivity, as demonstrated by enhanced cell viability and reduced lactate dehydrogenase (LDH) release. Furthermore, EPA inhibited Piezo1 activation, leading to lower intracellular Ca²âº concentrations, decreased apoptosis, and diminished ROS levels. In cartilage explants, EPA improved chondrocyte viability, minimized structural damage, and sustained higher Col-2a expression compared to the blunt trauma group. These results indicate that EPA effectively shields chondrocytes and cartilage explants from mechanical overload-induced damage by inhibiting Piezo1 activation and mitigating Ca²âº influx, apoptosis, and oxidative stress. The findings suggest that EPA supplementation could offer a promising strategy for preventing PTOA progression following acute cartilage injuries. Further research is warranted to assess the clinical applications of EPA and confirm its efficacy in larger animal models and human trials.
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Condrócitos , Condrócitos/efeitos dos fármacos , Condrócitos/metabolismo , Humanos , Células Cultivadas , Cartilagem Articular/efeitos dos fármacos , Cartilagem Articular/metabolismo , Ácido Eicosapentaenoico/farmacologia , Sobrevivência Celular/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismo , Ácidos Graxos Ômega-3/farmacologia , Apoptose/efeitos dos fármacos , Estresse MecânicoRESUMO
BACKGROUND: With the increasing prevalence of obesity, there is growing awareness of the impact of overweight and obesity on total hip arthroplasty (THA). Research exploring the accuracy of acetabular component orientation in THA between robotic-assisted and manual techniques across different BMI categories is insufficient. METHODS: This prospective study evaluated 221 patients who underwent THA with a Robotic Interactive Orthopaedic Arm system and 252 patients who underwent manual THA between March 2022 and January 2024. The patients were divided into four groups according to their BMI. We analysed whether there were differences in the accuracy of acetabular component positioning between robotic-assisted THA and manual THA across different BMI categories. RESULTS: In the overweight group, robotic-assisted THA achieved a significantly higher rate of abductions within the target range (73/6) than manual THA (62/28) (p = 0.000). Both abductions and anteversions within the target range were also significantly more frequent in the robotic-assisted THA group (69/10) than in the manual THA group (56/34) (p = 0.000). Among the obese patients, robotic-assisted THA showed a perfect record for anteversions within the target range (29/0), markedly outperforming manual THA (39/6) (p = 0.040). CONCLUSION: In the overweight (24 kg/m² ≤ BMI < 28 kg/m²) and obese (BMI ≥ 28 kg/m²) groups, robotic-assisted THA demonstrates significantly greater accuracy in acetabular component positioning compared to manual THA. This indicates that robotic-assisted technology may provide a more precise positioning of the acetabular component in overweight and obese patients.
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Artroplastia de Quadril , Obesidade , Sobrepeso , Procedimentos Cirúrgicos Robóticos , Humanos , Artroplastia de Quadril/métodos , Estudos Prospectivos , Masculino , Feminino , Procedimentos Cirúrgicos Robóticos/métodos , Pessoa de Meia-Idade , Sobrepeso/complicações , Obesidade/cirurgia , Obesidade/complicações , Idoso , Índice de Massa Corporal , Acetábulo/cirurgia , AdultoRESUMO
Tuberculosis (TB) today remains the leading cause of global deaths due to infectious bacterial pathogens. The Bacillus Calmette-Guérin (BCG) vaccine is the only vaccine clinically used to prevent TB. However, its limitations in preventing latent infection and TB reactivation mean that it does not provide comprehensive protection. In this study, we successfully constructed and expressed the multistage fusion protein, SHR3, and used whole blood IFN-γ release assay (WBIA) with flow cytometry to detect antigen specificity, further confirmed by enzyme-linked immunosorbent assay (ELISA). SHR3 and its subfractional proteins stimulated the level of IFN-γ production by lymphocytes from M. tb-infected patients, inducing the production of single-positive and double-positive CD4+ and CD8+ T cells with IFN-γ and IL-2, at levels significantly higher than those of healthy controls. The fusion protein and complex adjuvant group (SHR3/DMT) induced mice to produce significantly higher levels of IgG antibodies and their subclasses, with IgG2a/IgG1 results showing a convergent Th1-type response; mice in the BCG + SHR3/DMT group induced secretion of the highest levels of IL-2, and TNF-α, irrespective of stimulation with purified protein derivative or SHR3. These findings suggest that SHR3/DMT could be a potential subunit vaccine candidate that may serve as an effective booster vaccine after BCG primary immunization.
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Mycobacterium tuberculosis , Vacinas contra a Tuberculose , Tuberculose , Humanos , Animais , Camundongos , Vacina BCG , Linfócitos T CD8-Positivos , Interleucina-2/metabolismo , Antígenos de Bactérias/genética , Tuberculose/prevenção & controle , Adjuvantes Imunológicos , Proteínas de Bactérias/genéticaRESUMO
Over the last 15 years, a small number of paediatric artemisinin-based combination therapy products have been marketed. These included Riamet® and Coartem® dispersible tablets, a combination of artemether and lumefantrine, co-developed by the Medicines for Malaria Venture and Novartis. Disappointingly, patient compliance, requirement for high-fat meal, and sporadic drug dissolution behaviours following administration still result in considerable challenges for these products. The first and foremost barrier that needs addressed for successful delivery of the artemether/lumefantrine combination is the poor solubility of lumefantrine within the gastrointestinal fluids. In this work, amorphous solid dispersions of lumefantrine within Soluplus®-based matrices have been manufactured using hot melt extrusion as a potential formulation strategy to achieve enhanced dissolution and apparent solubility. The drug loading capacity of Soluplus® to accommodate amorphous lumefantrine, whilst ensuring improved in-vitro dissolution performance, was investigated. The extrusion process employed a variety of processing parameters, including various temperature profiles and different production scales. The influence of variation in extrusion conditions upon the physical stability of manufactured amorphous solid dispersions was also examined. This allowed for a greater understanding of the role of extrusion processing conditions on the performance of supersaturated amorphous solid dispersions during dissolution and storage. This may allow for the design and manufacture of drug enabled formulations with lower drug dosing and thus a lower risk of adverse effects.
Assuntos
Antimaláricos , Estabilidade de Medicamentos , Lumefantrina , Polietilenoglicóis , Polivinil , Solubilidade , Lumefantrina/química , Lumefantrina/administração & dosagem , Antimaláricos/química , Antimaláricos/administração & dosagem , Polietilenoglicóis/química , Polivinil/química , Liberação Controlada de Fármacos , Tecnologia de Extrusão por Fusão a Quente , Temperatura Alta , Fluorenos/química , Fluorenos/administração & dosagem , Composição de Medicamentos/métodos , Artemisininas/química , Artemisininas/administração & dosagemRESUMO
Tibetan sheep are vital to the ecosystem and livelihood of the Tibetan Plateau; however, traditional breeding methods limit their production and growth. Modern molecular breeding techniques are required to improve these traits. This study identified a single nucleotide polymorphism (SNP) in myostatin (MSTN) and Callipyge in Tibetan sheep. The findings indicated notable associations between MSTN genotypes and growth traits including birth weight (BW), body length (BL), chest width (ChW), and chest circumference (ChC), as well as a particularly strong association with cannon circumference (CaC) at 2 months of age. Conversely, Callipyge polymorphisms did not have a significant impact on Tibetan sheep. Moreover, the analyses revealed a significant association between sex and BW or hip width (HW) at 2 months of age and ChW, ChC, and CaC at 4 months of age. Furthermore, the study's results suggested that the genotype of MSTN as a GA was associated with a notable sex effect on BW, while the genotype of Callipyge (CC) showed a significant impact of sex on CaC at 2 months of age. These results indicated that the SNP of MSTN could potentially serve as a molecular marker for early growth traits in Tibetan sheep.
Assuntos
Miostatina , Polimorfismo de Nucleotídeo Único , Animais , Miostatina/genética , Ovinos/genética , Ovinos/crescimento & desenvolvimento , Feminino , Masculino , Tibet , Genótipo , Fenótipo , Peso ao Nascer/genética , CruzamentoRESUMO
The asymmetric synthesis of thiophene-derived compounds, including catalytic asymmetric dearomatization of thiophene and atroposelective synthesis of benzothiophene derivatives, has rarely been reported. In this work, the asymmetric transformation of the thiophene motif is investigated. Through the rational design of substrates with a thiophene structure, by using the vinylidene ortho-quinone methide (VQM) intermediate as a versatile tool, axially chiral naphthyl-benzothiophene derivatives and thiophene-dearomatized chiral spiranes were obtained in high yields with excellent enantioselectivities.