Analysis of risk factors for advanced age in patients with frozen shoulder.

OBJECTIVE: To explore the risk factors of elderly patients with frozen shoulder. METHODS: 262 cases of scapulohumeral periarthritis treated in our hospital from January 2020 to December 2020 were analyzed retrospectively. According to the age of patients, patients younger than 60 years old were divided into middle-aged group (101 cases), patients between 60 and 75 years old were divided into old-aged group (91 cases), and patients ≥ 75 years old were divided into old-aged group (70 cases). The general demographic data and clinical data of the three groups were compared. Visual analogue scale (VAS) was used to evaluate the degree of pain. Finally, the dependent variable is set as whether the onset age of scapulohumeral periarthritis patients is advanced. Univariate and multivariate Logistic regression was used to analyze the risk factors of frozen shoulder patients at an advanced age. RESULTS: There were no significant differences in general demographic data, fixed position, hypertension history, smoking history, drinking history, supraspinatus muscular atrophy and physical exercise among the three groups (all P > 0.05). The course of disease, diabetes, surgical treatment, pain degree, operation time, cholecystitis, coronary heart disease, pain degree three months after operation and cervical spondylosis in the elderly group were all higher than those in the middle-aged group and the elderly group, and the differences were statistically significant (all P < 0.05). The course of scapulohumeral periarthritis, the degree of pain and the degree of pain 3 months after operation in the elderly group were higher than those in the middle-aged group, with significant differences (all P < 0.05). Univariate Logistic regression analysis showed that the risk factors of scapulohumeral periarthritis in the elderly included diabetes mellitus (OR = 3.067, 95% CI 1.881-4.587, P < 0.001), operative treatment (OR = 3.076, 95% CI 1.365-6.765, P = 0.006), VAS score (OR = 2.267, 95% CI 1.117-3.887, P = 0.013), operation time (OR = 1.537, 95% CI 1.305-2.579, P < 0.001), cholecystitis (OR = 2.143, 95% CI 1.019-4.876, P = 0.023), coronary heart disease(OR = 3.128, 95% CI 1.428-7.019, P = 0.005), VAS at 3 months after operation (OR = 1.537, 95% CI 0.786-2.635, P = 0.002), and cervical spondylosis(OR = 1.162, 95% CI 1.029-1.321, P = 0.012). Multivariate logistic regression analysis showed that the risk factors for the onset of the disease at advanced age included fatty infiltration (OR = 4.021, 95% CI 2.981-9.682, P < 0.001), surgical treatment (OR = 4.109, 95% CI 1.419-7.832, P = 0.008), VAS score (OR = 3.081, 95% CI 1.042-7.931, P = 0.046) and operation time (OR = 1.537, 95% CI 1.305-2.579, P < 0.001). CONCLUSION: Risk factors of frozen shoulder at advanced age include fat infiltration, surgical treatment, VAS score and surgical time. In clinical practice, we should refer to the above indicators to help patients with early medical intervention and prevent their onset.

The effects of tourniquet use on blood loss and perioperative complications in total knee arthroplasty.

BACKGROUND: There has been ongoing debate about the use of tourniquets in total knee arthroplasty, and their application is widely studied. A comprehensive understanding of the advantages and disadvantages of tourniquet use during the procedure is crucial for optimizing surgical outcomes. This study aimed to investigate the effectiveness of tourniquet application, with a particular focus on blood loss and perioperative complications, providing valuable insights for clinical practice. METHODS: Fifty patients who underwent total knee arthroplasty were randomized into tourniquet (n = 25) and nontourniquet (n = 25) groups. The same surgeon performed all surgical procedures. The follow-up time was 14 days after surgery. Primary outcomes were hemoglobin level changes, blood loss, operation time, and perioperative plasma D-dimer levels. Secondary outcomes were postoperative complications, including thrombotic and nonthrombotic events. RESULTS: No significant differences were found in drainage, calculated blood loss, total blood loss, postoperative hemoglobin levels, or blood transfusion between the two groups (P > 0.05). No differences in D-dimer levels were observed on postoperative Days 1, 3, and 14 between the two groups, except on postoperative Day 7, when the D-dimer level in the tourniquet group was lower than that in the nontourniquet group (P = 0.03). The incidence of local complications (thigh bruising, blisters, pain, fat liquefaction, and superficial infections) in the tourniquet group was significantly higher than that in the nontourniquet group (P = 0.03), but no significant differences were found in thromboembolic and nonthromboembolic events or overall complications (P > 0.05). CONCLUSION: We conclude that tourniquet use does not reduce the length of surgery or blood loss but does increase local complications in total knee arthroplasty.

Midterm outcomes of 18 patients with primary intra-articular diffuse tenosynovial giant cell tumor (TGCT) of the knee treated with complete arthroscopic synovectomy and postoperative low-dose radiotherapy at a mean follow-up of 68 months.

OBJECTIVE: To evaluate the long-term clinical outcome of the treatment of complete arthroscopic synovectomy combined with low-dose external radiotherapy in the knee affected by primary intra-articular diffuse tenosynovial giant cell tumor (TGCT). METHODS: From May 2009 to January 2016, 18 patients with intra-articular diffuse TGCT underwent complete arthroscopic synovectomy and low-dose external-beam radiotherapy in Zhongnan Hospital were enrolled in this retrospective study. The preoperative symptoms of patients, the complications during or after the arthroscopic procedure and the recurrence were collected and recorded. Each patient was evaluated before treatment and at the follow-up visit. Efficacy evaluation criteria were based on Ogilvie-Harris score, and the evaluation of the functional ability of knee was based on the International Knee Documentation Committee (IKDC) Score. RESULTS: The mean time from symptom onset to surgery was 9.1 ± 5.8 months (range from 3 to 29 months). The most frequent preoperative symptoms were joint effusion (100%), diffuse non-specific knee pain (66.7%), and a decreased range of motion (83.3%). Mean follow-up time was 68.0 ± 18.1 months (range from 35 to 120 months). The mean evaluation score according to the Ogilvie-Harris criteria before treatment was 3.19 ± 0.74, which corresponded to a rating of "poor". The mean score after treatment was 8.79 ± 1.57, rated as "good". The Ogilvie-Harris score was significantly increased after treatment (P = 0.003). The IKDC score of all patients increased significantly from 37.1 ± 3.8 before treatment to 83.9 ± 11.3 after treatment. The IKDC score was obviously increased after treatment (P = 0.001). No recurrence was noted at final follow-up. There were no complications during or after the arthroscopic procedure. CONCLUSION: The outcome of this study proved that complete arthroscopic synovectomy combined with low-dose external radiotherapy was appropriate for treating primary intra-articular diffuse TGCT of the knee joint. It could be safely and reliably used with minimal complications, fast postoperative recovery and satisfactory control of recurrence rates.

Autologous Dedifferentiated Osteogenic Bone Marrow Mesenchymal Stem Cells Promote Bone Formation in a Rabbit Model of Anterior Cruciate Ligament Reconstruction versus Bone Marrow Mesenchymal Stem Cells.

PURPOSE: This study aimed to verify whether transplantation of dedifferentiated osteogenic bone marrow mesenchymal stem cells (De-BMSCs) at the tendon-bone interface could result in more bone formation than BMSC transplantation in anterior cruciate ligament (ACL) reconstruction. METHODS: BMSCs from femur and tibia of New Zealand White rabbit were subjected to osteogenic induction and then cultured in osteogenic factor-free medium; the obtained cell population was termed De-BMSCs. Bilateral ACL reconstruction was performed in 48 adult rabbits. Three groups were established: control group with alginate gel injection, BMSCs group with the BMSCs injection, and De-BMSCs group with the De-BMSCs injection. At week 4 and 12 postoperatively, tendon-bone healing by histologic staining, micro-computed tomography examination, and biomechanical test were evaluated. RESULTS: The expression of α1 chain of type I collagen, osteocalcin, and osteopontin at the tendon-bone interface in the De-BMSCs group was greater than in the control or BMSCs group. The bone volume/total volume by micro-computed tomography scan was significantly greater in the De-BMSCs group than that in the control group (P = .013) or BMSCs group (P = .045) at 4 weeks, and greater than that in the control group (P = .014) or BMSCs group (P = .017) at 12 weeks. The tunnel area was significantly smaller in the De-BMSCs group than in the control group (P = .013) or BMSCs group (P = .044) at 12 weeks. The failure load and stiffness in De-BMSCs group were both significantly enhanced at 4 and 12 weeks than control group or De-BMSCs group. CONCLUSIONS: De-BMSCs transplantation can promote bone formation at the tendon-bone interface better than BMSCs transplantation in ACL reconstruction and increase the early biomechanical strength of the reconstructed ACL CLINICAL RELEVANCE: De-BMSCs transplantation is a potential choice for enhancing early bone formation in the tunnel in ACL reconstruction.

Prenatal nicotine exposure intergenerationally programs imperfect articular cartilage via histone deacetylation through maternal lineage.

Accumulating evidence has shown that the impact of prenatal environmental factors on the organs of the offspring could last until the adulthood. Here, we aimed to investigate these effects and the potential mechanism of prenatal nicotine exposure (PNE) on the female adult cartilage of the first generation (PNE-F1) and the second generation (PNE-F2). Pregnant Wistar rats were injected with 2.0 mg/kg.d nicotine from gestational day (GD) 9 to 20. Then their F1 generation at GD20 and postnatal week (PW) 12, and F2 generation at PW12 were harvested. The expression of extracellular matrix (ECM) and transforming growth factor ß (TGFß) signaling genes were analyzed by real-time quantitative PCR, and the histone acetylation was examined by chromatin immunoprecipitation assay. The results showed that PNE reduced the ECM and TGFß signaling gene expressions in both PNE-F1 and PNE-F2 female adult articular cartilage. In the F1 generation, PNE inhibited the acetylation at H3K9 of TGFß, TGFß receptor 1 (TGFßR1), SRY-type high mobility group box 9 (SOX9), a1 chain of type II collagen (COL2A1) and aggrecan (ACAN) gene promoters at both GD20 and PW12. In PNE-F2 at PW12, the obvious deacetylation at H3K9 of the TGFßR1 and COL2A1 promoters still existed. Moreover, in rat fetal chondrocytes, corticosterone rather than nicotine directly induced the hypoacetylation of H3K9 of TGFßR1 and COL2A1 genes, which might be the main cause of imperfect cartilage for PNE-F2. This study may be helpful to elucidate the developmental variability of articular cartilage quality and useful for the early prevention of articular damage.

Lipoprotein(a) accelerated the progression of atherosclerosis in patients with end-stage renal disease.

BACKGROUND: Increased plasma level of lipoprotein(a) (Lpa) is a risk factor of cardiovascular diseases. This study aimed to explore the role of Lpa in the progression of atherosclerosis in patients with end-stage renal disease (ESRD) and to investigate whether its potential mechanism is mediated by CXC chemokine ligand 16 (CXCL16) and low-density lipoprotein receptor (LDLr). METHODS: This is a retrospective clinical study. From January 2015 to April 2016, forty-six ESRD patients from Danyang First People's Hospital were investigated. The patients were grouped according to their plasma Lpa levels: control group (Lpa < 300 mg/l, n = 23) and high Lpa group (Lpa ≥ 300 mg/l, n = 23). ESRD Patients with acute infective diseases, cancer, and/or chronic active hepatitis were excluded. Biochemical indexes and lipid profiles of the patients were measured. Surgically removed tissues from the radial arteries of ESRD patients receiving arteriovenostomy were used for the preliminary evaluation of atherosclerosis. Haematoxylin-eosin (HE) and filipin staining were used to observe foam cell formation. Protein expression levels of Lpa, CXCL16, and LDLr were detected by immunohistochemistry staining and immunofluorescent staining. RESULTS: There was more foam cell formation and cholesterol accumulation in the radial arteries of the high Lpa group than in those of the control group. Furthermore, the expression levels of Lpa, CXCL16, and LDLr were significantly increased in the radial arteries of the high Lpa group. Correlation analyses showed that the protein expression levels of Lpa (r = 0.72, P < 0.01), LDLr (r = 0.54, P < 0.01), and CXCL16 (r = 0.6, P < 0.01) in the radial arteries of ESRD patients were positively correlated with the plasma Lpa levels. Further analyses showed that the co-expression of Lpa with LDLr or CXCL16 was increased in the high Lpa group. CONCLUSIONS: High plasma Lpa levels accelerated the progression of atherosclerosis in ESRD through inducing Lpa accumulation in the arteries, which was associated with LDLr and CXCL16. These two lipoproteins could both be major lipoprotein components that regulate the entry of Lpa into arterial cells.

Intrauterine low-functional programming of IGF1 by prenatal nicotine exposure mediates the susceptibility to osteoarthritis in female adult rat offspring.

This study aimed to evaluate whether female adult offspring born with intrauterine growth retardation induced by prenatal nicotine exposure (PNE) are susceptible to osteoarthritis (OA) and to explore the underlying programming mechanisms. Pregnant rats were treated with nicotine or saline at 2.0 mg/kg/d from gestational d 11 to 20. The female adult offspring with or without PNE were forced with a strenuous treadmill running for 6 wk to induce OA. Nicotine's effects on fetal articular chondrocytes were studied by exposing chondrocytes to nicotine for 10 d, and dihydro-ß-erythroidine, a selective α4ß2-nicotinic acetylcholine receptor (nAChR) inhibitor, was used to identify the change of nicotine's effect. For adult offspring, increased cartilage destruction and accelerated OA progression were observed in the PNE group with running; the expression of α1 chain of type II collagen (Col2A1), aggrecan, SRY-type high mobility group box 9 (Sox9), and IGF1 signaling molecules in the cartilage of PNE offspring were decreased. For fetuses, elevated serum corticosteroid and nicotine levels and suppressed IGF1 levels were observed; expression of Col2A1, aggrecan, Sox9, and IGF1 were reduced. The result of chondrocytes revealed that nicotine impeded the expression of Col2A1, aggrecan, and IGF1; blocking α4ß2-nAChR rescued nicotine's suppression. In conclusion, PNE increases the susceptibility of adult offspring to OA; the potential mechanism involves IGF1 low-functional programming in articular cartilage caused directly by the action of nicotine on α4ß2-nAChR.

Apo E gene polymorphism affects development of type 2 diabetic nephropathy in Asian populations, especially in East Asians: an updated meta-analysis.

BACKGROUND: Many studies have determined the correlation between the Apolipoprotein E (APO E) gene polymorphisms and diabetic nephropathy, but their results are inconclusive. MATERIAL/METHODS: With the aim to confirm this correlation, we performed a meta-analysis of 16 studies. The dichotomous data are presented as the odds ratio (OR) with a 95% confidence interval (CI). RESULTS: The results of our study indicate that APO ε2 allele among the pooled Asian populations were more likely to show high risk of DN development (2 allele vs. ε3 allele: pooled OR =1.629, 95% CI=1.010-2.628, P=0.045). For further analysis, the APO e2 allele was associated with progress of DN in the group with duration >10 years, but not in the group with duration <10 years (ε2 allele vs. ε3 allele: pooled OR=1.920, 95% CI=1.338-2.754, P<0.001). The APO e2 polymorphism increased the susceptibility to DN in Asian population compared with healthy people (ε2 allele vs. ε3 allele: pooled OR=1.629, 95% CI=1.010-2.628, P=0.045). CONCLUSIONS: Development of DN is associated with APO E polymorphisms in Asian populations, especially in East Asians.

Achieving Zero-Temperature Coefficient Point Behavior by Defect Passivation for Temperature-Immune Organic Field-Effect Transistors.

Organic field-effect transistors (OFETs) have broad prospects in biomedical, sensor, and aerospace applications. However, obtaining temperature-immune OFETs is difficult because the electrical properties of organic semiconductors (OSCs) are temperature-sensitive. The zero-temperature coefficient (ZTC) point behavior can be used to achieve a temperature-immune output current; however, it is difficult to achieve in organic devices with thermal activation characteristics, according to the existing ZTC point theory. Here, the Fermi pinning in OSCs is eliminated using the defect passivation strategy, making the Fermi level closer to the tail state at low temperatures; thus threshold voltage (VT) is negatively correlated with temperature. ZTC point behaviors in OFETs are achieved by compensation between VT and mobility at different temperatures to improve its temperature immunity. A temperature-immune output current can be realized in a variable-temperature bias voltage test over 50000 s by biasing the device at the ZTC point. This study provides an effective solution for temperature-immune OFETs and inspiration for their practical application.

Crucial role of interfacial thermal dissipation in the operational stability of organic field-effect transistors.

The operational stability becomes a key issue affecting the commercialization for organic field-effect transistors (OFETs). It is widely recognized to be closely related to the defects and traps at the interface between dielectric and organic semiconductors, but this understanding does not always effectively address operational instability, implying that the factors influencing the operational stability have not been fully understood. Here, we reveal that the self-heating effect is another crucial factor in operational stability. By using hexagonal boron nitride (hBN) to assist interfacial thermal dissipation, the dinaphtho[2,3-b:2',3'-f]thieno[3,2-b]thiophene (DNTT) FETs exhibit high mobility of 14.18 cm2 V-1 s-1 and saturated power density up to 1.8 × 104 W cm-2. The OFET can operate at a power density of 1.06 × 104 W cm-2 for 30,000 s with negligible performance degradation, showing excellent operational stability under high power density. This work deepens the understanding on operational stability and develops an effective way for ultrahigh stable devices.

Oxygen-Induced Barrier Lowering for High-Performance Organic Field-Effect Transistors.

Organic field-effect transistors (OFETs) have the advantages of low-cost, large-area processing and could be utilized in a variety of emerging applications. However, the generally large contact resistance (Rc) limits the integration and miniaturization of OFETs. The Rc is difficult to reduce due to an incompatibility between obtaining strong orbit coupling and the barrier height reduction. In this study, we developed an oxygen-induced barrier lowering strategy by introducing oxygen (O2) into the nanointerface between the electrodes and organic semiconductors layer and achieved an ultralow channel width-normalized Rc (Rc·W) of 89.8 Ω·cm and a high mobility of 11.32 cm2 V-1 s-1. This work demonstrates that O2 adsorbed at the nanointerface of metal-semiconductor contact can significantly reduce the Rc from both experiments and theoretical simulations and provides guidance for the construction of high-performance OFETs, which is conducive to the integration and miniaturization of OFETs.

Measurement of bone mineral density in the tunnel regions for anterior cruciate ligament reconstruction by dual-energy X-ray absorptiometry, computed tomography scan, and the immersion technique based on Archimedes' principle.

PURPOSE: To determine, for anterior cruciate ligament (ACL) reconstruction, whether the bone mineral density (BMD) of the femoral tunnel was higher than that of the tibial tunnel, to provide objective evidence for choosing the appropriate diameter of interference screws. METHODS: Two groups were enrolled. One group comprised 30 normal volunteers, and the other comprised 9 patients with ACL rupture. Dual-energy X-ray absorptiometry was used to measure the BMD of the femoral and tibial tunnel regions of the volunteers' right knees by choosing a circular area covering the screw fixation region. The knees were also scanned by spiral computed tomography (CT), and the 3-dimensional reconstruction technique was used to determine the circular sections passing through the longitudinal axis of the femoral and tibial tunnels. Grayscale CT values of the cross-sectional area were measured. Cylindrical cancellous bone blocks were removed from the femoral and tibial tunnels during the ACL reconstruction for the patients. The volumetric BMD of the bone blocks was measured using a standardized immersion technique according to Archimedes' principle. RESULTS: As measured by dual-energy X-ray absorptiometry, the BMD of the femoral and tibial tunnel regions was 1.162 ± 0.034 g/cm(2) and 0.814 ± 0.038 g/cm(2), respectively (P < .01). The CT value of the femoral tunnel region was 211.7 ± 11.5 Hounsfield units, and the value of the tibial tunnel region was 104.9 ± 7.4 Hounsfield units (P < .01). The volumetric BMD of the bone block from the femoral tunnel (2.80 ± 0.88 g/cm(3)) was higher than the value from the tibial tunnel (1.88 ± 0.59 g/cm(3)) (P < .01). Comparing the data between male and female patients, we found no significant difference in both femoral and tibial tunnel regions. CONCLUSIONS: For ACL reconstruction, the BMD of the femoral tunnel is higher than that of the tibial tunnel. This implies that a proportionally larger-diameter interference screw should be used for fixation in the proximal tibia than that used for fixation in the distal femur. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

Low miR-92a-3p in oocytes mediates the multigenerational and transgenerational inheritance of poor cartilage quality in rat induced by prenatal dexamethasone exposure.

An adverse environment during pregnancy leads to intrauterine programming changes in multiple generations, resulting in the multigenerational inheritance of abnormal phenotype. Here, we reported the multigenerational inheritance of poor articular cartilage quality induced by prenatal dexamethasone exposure (PDE) with 0.2 mg/kg·d dexamethasone from gestational day (GD) 9 to GD20 in Wistar rats and investigated its intrauterine epigenetic programming mechanism. For the F1 female offspring at GD20, we found that the matrix synthesis of cartilage was suppressed, the histone 3 lysine 9 acetylation (H3K9ac) level and mRNA expression of the TGFß signaling pathway were decreased, and the expression of histone deacetylase (HDAC) 2 was increased in the cartilage. Meaningfully, the similar changes were also found in the F1-F3 female adult offspring. Furthermore, PDE decreased the expression of miR-92a-3p in the oocytes of the F1-F2 offspring and in the cartilage of the F1-F3 generations. In vitro, the effect of dexamethasone on chondrocytes revealed that it inhibited the expression of miR-92a-3p through activating and binding glucocorticoid receptor, and reduced the H3K9ac level in the promoter of the TGFß signaling pathway through the increased HDAC2. In conclusion, PDE induces the multigenerational inheritance of poor articular cartilage quality in female adult offspring; the potential mechanism involves the intergenerational effect of low miR-92a-3p expression in oocytes and low functional programming of TGFß signaling pathway induced by decreased H3K9ac level via upregulating HDAC2. This study provides a new perspective to explain the multi-generation inheritance of PDE-induced organ dysplasia in adult offspring.

Prenatal smoke (Nicotine) exposure and offspring's metabolic disease susceptibility in adulthood.

Exposure to smoking (nicotine) during pregnancy not only directly affects fetal development, but also increases susceptibility to metabolic diseases in adulthood, but the mechanism of action remains unclear. Here, we review epidemiological and laboratory studies linking these relationships. In addition to the direct effect of nicotine on the fetus, intrauterine neuroendocrine-metabolic programming mediated by maternal glucocorticoid overexposure also plays an important role, involving glucocorticoid-insulin-like growth factor 1 (GC-IGF1) axis, hypothalamic-pituitary-adrenal (HPA) axis, renin-angiotensin system (RAS) and other endocrine systems. Epigenetics is involved in intrauterine neuroendocrine-metabolic programming, metabolic disease susceptibility and multigenerational inheritance. There are "two programming" and "two strikes" mechanisms for the occurrence of fetal-originated metabolic diseases in adulthood. These innovative research summaries and academic viewpoints provide experimental and theoretical basis for systematically elucidating the occurrence and development of fetal-originated metabolic diseases.

Nanog/NFATc1/Osterix signaling pathway-mediated promotion of bone formation at the tendon-bone interface after ACL reconstruction with De-BMSCs transplantation.

BACKGROUND: Bone formation plays an important role in early tendon-bone healing after anterior cruciate ligament reconstruction (ACLR). Dedifferentiated osteogenic bone marrow mesenchymal stem cells (De-BMSCs) have enhanced osteogenic potential. This study aimed to investigate the effect of De-BMSCs transplantation on the promotion of bone formation at the tendon-bone interface after ACLR and to further explore the molecular mechanism of the enhanced osteogenic potential of De-BMSCs. METHODS: BMSCs from the femurs and tibias of New Zealand white rabbits were subjected to osteogenic induction and then cultured in medium without osteogenic factors; the obtained cell population was termed De-BMSCs. De-BMSCs were induced to undergo osteo-, chondro- and adipo-differentiation in vitro to examine the characteristics of primitive stem cells. An ACLR model with a semitendinosus tendon was established in rabbits, and the animals were divided into a control group, BMSCs group, and De-BMSCs group. At 12 weeks after surgery, the rabbits in each group were sacrificed to evaluate tendon-bone healing by histologic staining, micro-computed tomography (micro-CT) examination, and biomechanical testing. During osteogenic differentiation of De-BMSCs, an siRNA targeting nuclear factor of activated T-cells 1 (NFATc1) was used to verify the molecular mechanism of the enhanced osteogenic potential of De-BMSCs. RESULTS: De-BMSCs exhibited some properties similar to BMSCs, including multiple differentiation potential and cell surface markers. Bone formation at the tendon-bone interface in the De-BMSCs group was significantly increased, and biomechanical strength was significantly improved. During the osteogenic differentiation of De-BMSCs, the expression of Nanog and NFATc1 was synergistically increased, which promoted the interaction of NFATc1 and Osterix, resulting in increased expression of osteoblast marker genes such as COL1A, OCN, and OPN. CONCLUSIONS: De-BMSCs transplantation could promote bone formation at the tendon-bone interface after ACLR and improve the biomechanical strength of the reconstruction. The Nanog/NFATc1/Osterix signaling pathway mediated the enhanced osteogenic differentiation efficiency of De-BMSCs.

Safety and Effectiveness of Orthopaedic Medical Staff in Providing Support in Combating the COVID-19 Pandemic: A Retrospective Investigation from Wuhan, China.

OBJECTIVE: To evaluate whether it is safe and effective for orthopaedic medical staff to provide support to the work against COVID-19. METHODS: One hundred and twenty-two orthopaedic medical staff from the orthopaedic center of Zhongnan Hospital of Wuhan University were included in this retrospective investigation. A total of 43 surgeons and 69 nurses provided medical support in the treatment of COVID-19 patients from 1 January 2020 to 8 April 2020 in four different hospitals in Wuhan. We collected data on the age, gender, and body temperature of orthopaedic medical staff, as well as the results for their chest CT scans, SARS-CoV-2 RNA, SARS-CoV-2 IgM and SARS-CoV-2 IgG tests, and training and examinations on COVID-19 knowledge. We also collected data on the time span of work, the number of infected staff during the support period, the number of COVID-19 patients the surgeons treated and the cure rate, the performance of the surgeons as assessed by the specialists and patients, and the number of infected staff during the pandemic. RESULTS: Among the 49 surgeons and 73 nurses, 43 surgeons and 69 nurses provided support against COVID-19. A total of 12 surgeons and 11 nurses provided support in the fields of respiration, intensive care, and emergency. A total of 34 surgeons and 58 nurses worked in the designated wards restructured for COVID-19 in the orthopaedic building. The average time span of work for the surgeons and nurses was 14.78 ± 3.64 days and 24.77 ± 7.58 days, respectively. No staff were infected during the support period. Over 1000 patients were received in the fever clinic by orthopaedic surgeons. The overall number of the treated hospitalized patients was 622. Among these patients, 226 cases were mild, 318 were mild to moderate, and 58 were severe or critical. The cure rate was 96.01%, 99.37%, and 52.00% respectively. The performance of the surgeons was scored 87.02 ± 3.17 and 90.69 ± 3.58 by the specialists and the patients, respectively. During the whole pandemic, 3 surgeons and 3 nurses who did not participate in the support work were infected in the early stages. The morbidity of all the orthopaedic staff was 4.92% during the whole pandemic, while no one was infected during the support work. CONCLUSION: Our investigation indicated that although they worked outside their specialty, it was safe and effective for the orthopaedic staff to provide medical support in the work against COVID-19 with adequate precautions and proper training.

Selective synthesis of Zn(1 - x)Mn(x)Se nanobelts and nanotubes from [Zn(1 - x)Mn(x)Se](DETA)0.5 nanbelts in solution (x = 0-0.15) and their EPR and optical properties.

Zn(1 - x)Mn(x)Se (x = 0-0.15) nanobelts and nanotubes can be synthesized via the removal of diethylenetriamine (DETA) in 1-octadecene (ODE) and ethylene glycol (EG), respectively, using [Zn(1 - x)Mn(x)Se](DETA)(0.5) nanobelts as a template. The as-prepared ZnSe nanobelts are single-crystalline and grown along the [001] direction, and the ZnSe nanotubes consist of nanoparticles assembled along the [001] direction. In addition, Mn(2+)-doped Zn(1 - x)Mn(x)Se (x = 0.05, 0.10, 0.15) nanotubes are prepared for the first time if doped [Zn(1 - x)Mn(x)Se](DETA)(0.5) nanobelts are used as the template. The formation process of Zn(1 - x)Mn(x)Se nanobelts and nanotubes has been studied, and a plausible mechanism is proposed. Photoluminescence (PL) and electron paramagnetic resonance (EPR) spectra of Zn(1 - x)Mn(x)Se nanobelts and Zn(1 - x)Mn(x)Se nanotubes have been investigated.

Aspirin attenuates podocyte injury in diabetic rats through overriding cyclooxygenase-2-mediated dysregulation of LDL receptor pathway.

AIM: This study aimed to investigate the effects of aspirin on podocyte injury and its underlying mechanisms in diabetic nephropathy (DN). METHODS: Eight-week-old male Sprague-Dawley rats were divided into three groups: non-diabetic rats (Control), streptozotocin-induced diabetic rats (DM), and diabetic rats treated with aspirin (DM + Aspirin) for 12 weeks. Intracellular lipid accumulation was evaluated by Oil Red O staining and quantitative free cholesterol assays. Podocyte injury and the levels of COX-2, inflammatory cytokines, and low-density lipoprotein receptor (LDLr) pathway-related proteins were evaluated by electron microscopy, immunohistochemical staining, and Western blotting, respectively. RESULTS: Lipid levels and urinary albumin-creatinine ratios were higher in the DM rats than in the Control rats. Periodic acid-Schiff staining showed glomerular hypertrophy and mild mesangial area widening in the DM rats. Electron microscopy showed that the podocyte foot processes were significantly flattened or absent in the DM rats. The protein expression levels of WT-1 and nephrin in the podocytes of DM rats were reduced. Interestingly, lipid accumulation in the kidneys of DM rats was significantly increased due to increased protein expression levels of LDLr, sterol regulatory element-binding protein (SREBP) cleavage-activating protein (SCAP), SREBP-2, cyclooxygenase-2 (COX-2), and inflammatory cytokines. Confocal immunofluorescent staining showed that COX-2 and WT-1 were co-expressed. Furthermore, COX-2 protein expression levels were positively correlated with LDLr protein expression levels. However, when COX-2 expression was inhibited by aspirin, these changes in the DM rats were significantly attenuated. CONCLUSION: Aspirin attenuates podocyte injury in DN, which may be through COX-2-mediated dysregulation of LDLr pathway.