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Background: We did this study to better clarify the correlations of methylenetetrahydrofolate dehydrogenase 1 (MTHFD1)-G1958A (rs2236225) gene polymorphism with the risk of congenital heart diseases (CHD) and its subgroups., Methods: Relevant articles were searched in PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP database and Wanfang DATA until October 2023. We will use odds ratios (ORs) and 95% confidence intervals (CIs) to examine the potential associations of MTHFD1- G1958A gene polymorphism with CHD and its subgroups., Results: We included a total of 9 eligible studies, encompassing 1917 children with CHD, 1863 healthy children, 1717 mothers of the children with CHD and 1666 mothers of healthy children. In our study, the meta-analysis of fetal group revealed no significant association between any of the five genetic models for the MTHFD1-G1958A polymorphism and the risk of CHD. Subgroup analysis showed that associations between the MTHFD1-G1958A polymorphism and Tetralogy of Fallot (TOF) risk in the homozygote model (AA vs. GG, OR = 2.82, 95%CI [1.16, 6.86], P = 0.02) and recessive model (AA vs. GG + GA, OR = 3.09, 95%CI [1.36, 7.03], P = 0.007). In addition, the MTHFD1-G1958A polymorphism was associated with the risk of CHD in racial subgroup, increasing the risk of CHD in Caucasians. In maternal analysis, 2 genetic models of MTHFD1-G1958A polymorphism increased the risk of CHD: the heterozygote model (GA vs. GG, OR = 1.22, 95%CI [1.04, 1.42], P = 0.01), and the dominance model (GA + AA vs. GG, OR = 1.17, 95%CI [1.01, 1.34], P = 0.03)., Conclusions: The fetal MTHFD1-G1958A (rs2236225) gene polymorphism increase their risk of TOF. The maternal MTHFD1-G1958A polymorphism has a strong correlation with the risk of CHD, and there are racial differences in this correlation. Compared with GG genotype, the GA genotype increases the risk of CHD., Competing Interests: Declarations. Ethical approval: As a systematic review, there is no ethical approval is required. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

H. longicornis is used as an experimental animal model for the study of three-host ticks due to its special life cycle and easy maintenance in the laboratory and in its reproduction. The life cycle of H. longicornis goes through a tightly regulated life cycle to adapt to the changing host and environment, and these stages of transition are also accompanied by proteome changes in the body. Here, we used the isobaric tags for a relative and absolute quantification (iTRAQ) technique to systematically describe and analyze the dynamic expression of the protein and the molecular basis of the proteome of H. longicornis in seven differential developmental stages (eggs, unfed larvae, engorged larvae, unfed nymphs, engorged nymphs unfed adults, and engorged adults). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of the differentially expressed proteins (DEPs) were used. In our study, A total of 2044 proteins were identified, and their expression profiles were classified at different developmental stages. In addition, it was found that tissue and organ development-related proteins and metabolism-related proteins were involved in different physiological processes throughout the life cycle through the GO and KEGG analysis of DEPs. More importantly, we found that the up-regulated proteins of engorged adult ticks were mainly related to yolk absorption, degradation, and ovarian development-related proteins. The abundance of the cuticle proteins in the unfed stages was significantly higher compared with those of the engorged ticks in the previous stages. We believe that our study has made a significant contribution to the research on H. longicornis , which is an important vector of SFTSV. In this study, we identified changes in the proteome throughout the H. longicornis development, and functional analysis highlighted the important roles of many key proteins in developmental events (ovarian development, the molting process, the development of midgut, the development and degeneration of salivary glands, etc.). The revelation of this data will provide a reference proteome for future research on tick functional proteins and candidate targets for elucidating H. longicornis development and developing new tick control strategies.

Background: Lumbar disc herniation (LDH) is one of the most common diseases and is a global medical and socioeconomic problem characterized by leg or back pain, weakness in the lower extremities and paresthesia., Objectives: A multicenter, randomized, double-blinded, parallel, positive-controlled clinical trial was conducted to evaluate the efficacy and safety of Yaobitong capsules (YBT) for LDH., Material and Methods: Patients (n = 479) were recruited and randomized into YBT and Jingyaokang capsule (JYK) groups (the positive control), and received YBT or JYK at a dose of 3 capsules 3 times per day after a meal for 30 days. The primary efficacy outcome was the Oswestry Disability Index (ODI), with the visual analogue scale (VAS) used as the secondary efficacy outcome. The adverse events and adverse reactions were also evaluated., Results: There was no significant difference in baseline characteristics between YBT (n = 358) and JYK groups (n = 120), and no difference was observed between groups for mean ODI score at day 0 (p = 0.064) or day 7 (p = 0.196), but there were differences at days 14, 21 and 30 (p < 0.001). The YBT showed more decline from baseline, and the decreased ODI score was substantially different from JYK (p < 0.001). The differences in decreased VAS scores between YBT and JYK were also significant at each time point (days 7, 14, 21, and 30), with better scores in the YBT group than in the JYK group (p < 0.001). In terms of safety, there was no obvious disparity in adverse events or adverse reactions between the 2 groups (p > 0.05)., Conclusions: Yaobitong was better than JYK for LDH treatment, with no significant difference in safety. The study suggests that YBT is a promising and effective treatment for LDH.

In this paper we update the knowledge on the species of Sericini occurring in the Nanling Mountains, China. This includes new records of 19 known species. Furthermore, six new species are described: Maladera paradaanensis Liu, Ahrens, Li & Yang, new species, M. tianqiae Liu, Ahrens, Li & Yang, new species, Neoserica (s. str.) parajingangshanica Liu, Ahrens, Li & Yang, new species, Tetraserica dabuensis Liu, Ahrens, Li & Yang, new species, Trioserica shimen Liu, Ahrens, Li & Yang, new species, and Lasioserica siyuanae Liu, Ahrens, Li & Yang, new species. The habitus and male genitalia of the new species are illustrated, and a map shows the distribution of the new species.

Here we present updates on the taxonomy and distribution of the genera Pachyserica Brenske, 1898 and Serica MacLeay, 1819 from East Asia. Thirty eight new species are desribed from China, Myanmar, South Korea, and Vietnam: Pachyserica chenchangchini Ahrens, Zhao, Pham & Liu, new species, P. dieuthuyae Ahrens, Zhao, Pham & Liu, new species, P. hoabinhensis Ahrens, Zhao, Pham & Liu, new species, P. motuo Ahrens, Zhao, Pham & Liu, new species, P. natmatoung Ahrens, Zhao, Pham & Liu, new species, P. sanqingshanensis Ahrens, Zhao, Pham & Liu, new species, P. sunfengyii Ahrens, Zhao, Pham & Liu, new species, P. tayyentu Ahrens, Zhao, Pham & Liu, new species, P. tianxuani Ahrens, Zhao, Pham & Liu, new species, P. wangzizhaoi Ahrens, Zhao, Pham & Liu, new species, P. yaonani Ahrens, Zhao, Pham & Liu, new species, P. yinhengi Ahrens, Zhao, Pham & Liu, new species, P. zhanbaoxiangi Ahrens, Zhao, Pham & Liu, new species, Serica (s. l.) anhua Ahrens, Zhao, Pham & Liu, new species, S. (s. l.) camura Ahrens, Zhao, Pham & Liu, new species, S. (s. l.) fengxue Ahrens, Zhao, Pham & Liu, new species, S. (s. l.) nhiae Ahrens, Zhao, Pham & Liu, new species, S. (s. l.) paracallosericoides Ahrens, Zhao, Pham & Liu, new species, S. (s. l.) taythien Ahrens, Zhao, Pham & Liu, new species, S. (s. l.) wuyishan Ahrens, Zhao, Pham & Liu, new species, S. (s. l.) yuechengling Ahrens, Zhao, Pham & Liu, new species, S. (Serica) assingi Ahrens, Zhao, Pham & Liu, new species, S. (S.) bomi Ahrens, Zhao, Pham & Liu, new species, S. (S.) christophreuteri Ahrens, Zhao, Pham & Liu, Ahrens, Zhao, Pham & Liu, new species, S. (S.) cuona Ahrens, Zhao, Pham & Liu, new species, S. (S.) fansipan Ahrens, Zhao, Pham & Liu, new species, S. (S.) gongtonggouensis Ahrens, Zhao, Pham & Liu, new species, S. (S.) guangxiensis Ahrens, Zhao, Pham & Liu, new species, S. (S.) gwangjuensis Ahrens, Zhao, Pham & Liu, new species, S. (S.) hongyii Ahrens, Zhao, Pham & Liu, new species, S. (S.) jiangda Ahrens, Zhao, Pham & Liu, new species, S. (S.) jiulaoci Ahrens, Zhao, Pham & Liu, new species, S. (S.) lushui Ahrens, Zhao, Pham & Liu, new species, S. (S.) liyitengi Ahrens, Zhao, Pham & Liu, new species, S. (S.) qizhihaoi Ahrens, Zhao, Pham & Liu, new species, S. (S.) xizang Ahrens, Zhao, Pham & Liu, new species, S. (S.) zhamu Ahrens, Zhao, Pham & Liu, new species, and S. (Taiwanoserica) yexiaohani Ahrens, Zhao, Pham & Liu, new species. The lectotype of Pachyserica scalaris Arrow, 1946 is designated and its male genitalia is illustrated. Additional records of 66 other species are provided.

Proximal gracilis tear is a rare sports-related injury that can easily lead to misdiagnosis and underdiagnosis. Clinical manifestations are dominated by localized pain, tenderness, and dysfunction. Here, we report a therapy of proximal segmental tear of the gracilis and demonstrate its treatment process and clinical outcome. This Technical Note describes in detail the minimally invasive distal gracilis resection technique for the treatment of chronic proximal gracilis ruptures, focusing on the most important technical aspects and thus attempting to introduce this procedure and make it more widely used in the treatment of similar muscle injuries., Competing Interests: The authors report the following potential conflicts of interest or sources of funding: This research was supported by Science Foundation of The Second Hospital of Shandong University (2023JX15). All authors (Q-H.J., Y.L., X-Y.Y., X-G.Z., W-G.L., Q-F.Y.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Full ICMJE author disclosure forms are available for this article online, as supplementary material., (© 2024 The Authors.)

Femoral head fractures are relatively uncommon high-energy injuries and usually associated with traumatic hip dislocation. Pipkin classified these fractures into 4 types according to the location of the head fragment related to the fovea and associated lesions on the femoral neck or acetabulum. Traditional open reduction and internal fixation for femoral head fracture has been proven to be effective, but it could be associated with significant complications. Arthroscopic fixation with screws is a less-invasive alternative to open reduction and internal fixation that offers several advantages. However, technical challenges could be encountered during the procedure and catastrophic consequences could occur in cases of fixation failure. Therefore, we propose an effective arthroscopic technique for Pipkin type I (small fracture caudal to the fovea capitis) femoral head fractures that uses an absorbable suture anchors. The anchors provide initial stability to the fracture fragments, and then the sutures are tied in a double-pulley fashion to further secure the fracture. Finally, a triangular suture bridge ("letter V") is created, which supplies a convenient and stable fixation for proper femoral head fracture., Competing Interests: All authors (X.-Y.Y., Y.L., W.-G.L., Q.-F.Y.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The study is supported by Science Foundation of The Second Hospital of Shandong University (2023JX15)., (© 2024 The Authors.)

Objectives: To establish a method for the simultaneous quantitative analysis of etomidate and its metabolite etomidate acid in blood, and to discuss its application value in actual cases., Methods: Acetonitrile precipitate protein method was used, and C 18 column was selected. Gradient elution was performed with acetonitrile and 5 mmol/L ammonium acetate within 6 min. Electrospray ionization source in positive ion mode was used. The internal standard etomidate acid-d 5 was obtained by etomidate-d 5 alkaline hydrolysis reaction. Ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was used for quantitative analysis. The methodological verification was conducted., Results: Etomidate and etomidate acid in blood showed good linear relationship in the quantitative linear range ( r >0.999), with the lower limit of quantification was 2.5 ng/mL and 7.5 ng/mL, respectively. The accuracy, precision, recovery rate, and matrix effect of the method met the professional verification standards. The practical application results showed that etomidate and etomidate acid could be detected in the blood of the abusers, and their mass concentrations ranged from 17.24 to 379.93 ng/mL., Conclusions: The method established in this study can simultaneously quantify etomidate and etomidate acid in blood, which is simple and convenient to operate with accuracy. It can meet the detection needs of actual cases and provide technical support for law enforcement to crack down on etomidate abuse.

Objective: To explore relationship between intramuscular fat content of quadriceps femoris and clinical severity of knee osteoarthritis (KOA)., Methods: Totally 30 KOA patients were selected from February 2021 to June 2021, including 6 males and 24 females, aged with an average of (64.20±9.19) years old, and body mass index (BMI) was (24.92±3.35) kg·m-2. Patients were divided into relative severe leg (RSL) and relative moderate leg (RML) according to severity of pain on visual analogue scale(VAS). Musculoskeletal ultrasound was used to collect muscle images of quadriceps muscles on both sides of the patient, and Image J was used to analyze echo intensity (EI) of each muscle. Both VAS and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to assess pain and function. Quadriceps muscle EI on both sides of patients was compared. Pearson correlation analysis was conducted to analyze correlation between quadriceps muscle EI value between RSL and RML, and linear regression was used to analyze relationship between each muscle EI and VAS and WOMA scores of patients., Results: The EI of RSL lateral vastus lateralis (VL) was 123.78±36.25 and RSL vastus medialis (VM) was 109.46±30.36 which were significantly higher than those of 108.03±31.34 and 93.32±26.04 of RML ( P <0.05), but there was no statistical significance in EI values of rectus femoris (RF) on both sides ( P >0.05). EI values of VL and VM on both sides were significantly correlated ( P <0.05). There was a significant positive correlation between VM EI value and VAS score in RSL and RML ( P <0.05). VM EI values in RSL were positively correlated with total WOMAC ( P <0.05), and VM VL EI values in RML were positively correlated with total WOMAC score ( P <0.05)., Conclusion: Intramuscular fat content of quadriceps is closely related to severity of clinical symptoms in KOA patients, and the most obvious one is VM. Therefore, the intramuscular fat content of quadriceps may be an objective indicator to evaluate severity of KOA patients. At the same time, reducing intramuscular fat content of the quadriceps muscle of KOA patients may be a new direction for the prevention and treatment of KOA.

In this paper we update the knowledge on the species of Serica McLeay, 1819 (sensu lato) occurring in Yunnan, Sichuan, and Shaanxi provinces, China. Three new species are described: Sericaallonanhua Liu, Ahrens, Li & Su, sp. nov. , S.breviantennalis Liu, Ahrens, Li & Su, sp. nov. , and S.fengensis Liu, Ahrens, Li & Su, sp. nov. The key to the species groups and species is updated. The habitus and male genitalia of the new species are illustrated, and a map showing their distribution is provided. New distributional data are given for four species., Competing Interests: The authors have declared that no competing interests exist., (Xie Su, Wei Li, Wan-Gang Liu, Dirk Ahrens, Ying-Juan Zheng, Yang Liu.)

Populus euphratica Oliv., a dominant species of arid desert community, grows heteromorphic leaves at different crown positions. Whether heteromorphic leaves are a strategy of plant adaptation to drought stress is rarely reported. This study sequenced the transcriptome of three typical heteromorphic leaves (lanceolate, ovate and broad-ovate leaves) of P. euphratica , and measured their drought stress. We wanted to reveal the molecular mechanisms underlying the formation of heteromorphic leaves. Drought stress was increased significantly from lanceolate to ovate to broad-ovate leaves. Gene ontology (GO) and KEGG enrichment analysis showed that the MADs-box gene regulated the expression of peroxidase (POD) in the phenylpropane biosynthetic pathway. The up-regulated expression of the chalcone synthase (CHS) gene in broad-ovate leaves significantly activated the flavonoid biosynthetic pathway. In the process of leaf shape change, the different expressions of homeodomain leucine zipper (HD-ZIP) among the three heteromorphic leaves had potential interactions on the AUX and ABA pathways. The expression of Sucrose phosphate synthase (SPS) and sucrose synthase (SUS) increased from lanceolate to broad-ovate leaves, resulting in a consistent change in starch and sucrose content. We concluded that these resistance-related pathways are expressed in parallel with leaf formation genes, thereby inducing the formation of heteromorphic leaves. Our work provided a new insights for desert plants to adapt to drought stress., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Xu, Liu, Huang, Li, Dai and Yang.)

To achieve high frame rates and continuous streaming simultaneously, we propose a compressed spatio-temporal imaging framework implemented by combining time-delay-integration sensors and coded exposure. Without additional optical coding elements and subsequent calibration required, this electronic-domain modulation enables a more compact and robust hardware structure, compared to the existing imaging modalities. By exploiting the intra-line charge transfer mechanism, we achieve a super-resolution in both temporal and spatial domains, thus multiplying the frame rate to millions of frames-per-second. In addition, the forward model with post-tunable coefficients, and two reconstruction strategies proposed therefrom, facilitate a flexible voxels post-interpretation. Finally, the effectiveness of the proposed framework is demonstrated by both numerical simulations and proof-of-concept experiments. With the prominent advantages of prolonged time window and flexible voxels post-interpretation, the proposed system will be suitable for imaging random, non-repetitive, or long-term events.

Objectives: This study aims to investigate the efficacy of a computer-aided diagnosis (CAD) system in distinguishing between benign and malignant thyroid nodules in the context of Hashimoto's thyroiditis (HT) and to evaluate the role of the CAD system in reducing unnecessary biopsies of benign lesions., Methods: We included a total of 137 nodules from 137 consecutive patients (mean age, 43.5 ± 11.8 years) who were histopathologically diagnosed with HT. The two-dimensional ultrasound images and videos of all thyroid nodules were analyzed by the CAD system and two radiologists with different experiences according to ACR TI-RADS. The diagnostic cutoff values of ACR TI-RADS were divided into two categories (TR4 and TR5), and then the sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of the CAD system and the junior and senior radiologists were compared in both cases. Moreover, ACR TI-RADS classification was revised according to the results of the CAD system, and the efficacy of recommended fine-needle aspiration (FNA) was evaluated by comparing the unnecessary biopsy rate and the malignant rate of punctured nodules., Results: The accuracy, sensitivity, specificity, PPV, and NPV of the CAD system were 0.876, 0.905, 0.830, 0.894, and 0.846, respectively. With TR4 as the cutoff value, the AUCs of the CAD system and the junior and senior radiologists were 0.867, 0.628, and 0.722, respectively, and the CAD system had the highest AUC ( P < 0.0001). With TR5 as the cutoff value, the AUCs of the CAD system and the junior and senior radiologists were 0.867, 0.654, and 0.812, respectively, and the CAD system had a higher AUC than the junior radiologist ( P < 0.0001) but comparable to the senior radiologist ( P = 0.0709). With the assistance of the CAD system, the number of TR4 nodules was decreased by both junior and senior radiologists, the malignant rate of punctured nodules increased by 30% and 22%, and the unnecessary biopsies of benign lesions were both reduced by nearly half., Conclusions: The CAD system based on deep learning can improve the diagnostic performance of radiologists in identifying benign and malignant thyroid nodules in the context of Hashimoto's thyroiditis and can play a role in FNA recommendations to reduce unnecessary biopsy rates., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Gong, Zhou, Li and Liu.)

Macroscopic electric motors continue to have a large impact on almost every aspect of modern society. Consequently, the effort towards developing molecular motors 1-3 that can be driven by electricity could not be more timely. Here we describe an electric molecular motor based on a [3]catenane 4,5 , in which two cyclobis(paraquat-p-phenylene) 6 (CBPQT 4+ ) rings are powered by electricity in solution to circumrotate unidirectionally around a 50-membered loop. The constitution of the loop ensures that both rings undergo highly (85%) unidirectional movement under the guidance of a flashing energy ratchet 7,8 , whereas the interactions between the two rings give rise to a two-dimensional potential energy surface (PES) similar to that shown by F O F 1 ATP synthase 9 . The unidirectionality is powered by an oscillating 10 voltage 11,12 or external modulation of the redox potential 13 . Initially, we focused our attention on the homologous [2]catenane, only to find that the kinetic asymmetry was insufficient to support unidirectional movement of the sole ring. Accordingly, we incorporated a second CBPQT 4+ ring to provide further symmetry breaking by interactions between the two mobile rings. This demonstration of electrically driven continual circumrotatory motion of two rings around a loop in a [3]catenane is free from the production of waste products and represents an important step towards surface-bound 14 electric molecular motors., (© 2023. The Author(s).)

Objective: To observe the clinical effect of acupotomy combined with warm needling on cervical spondylotic radiculopathy (CSR) of qi and blood stagnation syndrome., Methods: A total of 90 CSR patients were randomly divided into an acupotomy group, a warm needling group and a combined treatment group, with 30 cases in each group. The patients in the acupotomy group were treated with acupotomy, once every 7 days, consecutively for 3 times. The patients in the warm needling group received warm needling, once daily, at the interval of 2 days after consecutive treatments for 5 days, 7 days as one session of treatment and 3 consecutive sessions were required. The patients in the combined treatment group were treated with acupotomy and warm needling, and the methods and the treatment session were same as the the previous two groups. Before and after the treatment, the pain rating index (PRI) of McGill pain questionnaire (MPQ) and the 20-point scale of CSR developed by Yasuhisa Tanaka (CSR20) were adopted in the assessment. The changes of clinical symptoms and functions of patients were observed and the clinical efficacy was assessed in each group., Results: After the treatment, the PRI score was decreased ( P <0.05) and the CSR20 score was increased ( P <0.05) in the 3 treatment groups when compared with those before the treatment. After the treatment, compared with the acupotomy group and the warm needling group, the PRI score was decreased ( P <0.05) and the CSR20 score was increased ( P <0.05) in the combined treatment group. The total effective rate was 83.3% (25/30) in the acupotomy group, 76.7% (23/30) in the warm needling group and 93.3% (28/30) in the combined treatment group. The total effective rate in the combined treatment group was higher than those in the acupotomy group and the warm needling group ( P <0.05)., Conclusion: The combined treatment with acupotomy and warm needling may obviously improve the clinical symptoms and physical signs, e.g. pain and numbness in the patients with CSR of qi and blood stagnation syndrome. Its efficacy is remarkably higher than that of the simple application of acupotomy or warm needling.

Objective: To explore the mortality of patients with fragile hip fractures and assess the death-associated risk factors., Methods: A total of 690 patients with osteoporotic hip fractures (age, 50-103 years) that were treated from January 2010 to December 2015 were enrolled and followed-up in this study and the clinical data were retrospectively collected. Three months, 1 year, and the total mortality were measured. Mortality-related risk factors were assessed including age, gender, surgery, the duration from injury to operation, pulmonary infection, and the number and type of complications. The mortality of each group was compared by chi-square test or corrected chi-square test for univariate analysis, and the factors with statistically significant mortality difference confirmed by univariate analysis were analyzed by binary logistic multivariate analysis., Results: The 3-month mortality was 7.69%, the 1-year mortality was 15.60%, and the total mortality of the follow-up time was 24.06%. The 1-year and total mortality during the follow-up of the patients were higher in the >75-year-old group than those in the ≤75-year-old group (p = 0.000, respectively); were higher in the male patients than that in the female patients (p = 0.042; p = 0.017, respectively); were significantly lower in the operation group than that in the non-operation group (p = 0.000, respectively); were significantly lower in the patients that underwent the operation in ≤5 days than the patients that underwent the operation within >5 days (p = 0.008; p = 0.000, respectively); were significantly lower in patients with >2 kinds of combined medical diseases than those with ≥2 kinds of chronic diseases (p = 0.000, respectively); were significantly lower in patients receiving anti-osteoporosis treatment than in patients not receiving anti-osteoporosis treatment (p = 0.000, p = 0.002, respectively). Binary logistic regression analysis showed that the independent risk factors affecting mortality included advanced age >75-years-old (OR = 5.653, p = 0.000), male (OR = 1.998, p = 0.001), non-surgical treatment (OR = 9.909, p = 0.000), the number of combined medical diseases ≥2 (OR = 1.522, p = 0.042), and non-anti-osteoporosis treatment (OR = 1.796, p = 0.002)., Conclusion: Age, whether or not surgical treatment was performed, the number of medical diseases, and whether or not anti-osteoporosis treatment was performed were independent risk factors for 3-month and 1-year mortality in patients with fragile hip fractures., (© 2022 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)

Objective: The efficacy and safety of ultrasound-guided percutaneous laser ablation (PLA) for treating recurrent papillary thyroid cancer nodules (RPTCNs)., Methods: A retrospective study was conducted in 43 patients with single recurrent thyroid cancer which was diagnosed by fine needle aspiration biopsy (FNAB). The extent of ablation was assessed by contrast-enhanced ultrasound (CEUS) 24h after PLA. At baseline (before ablation), 6, and 12 months, and every 6 months thereafter, the following were recorded: nodule maximum diameter, volume reduction rate (VRR), complications, and side effects., Result: All 43 patients were successfully treated with PLA without serious complications. All patients underwent CEUS 24 hours after PLA treatment, and all achieved complete ablation. The success rate of single ablation was 100%. The average follow-up time was 23.47 ± 6.50 months, 12 ~ 36 months. At the last follow-up, 32 (74.4%) ablation lesions disappeared completely and 11 (25.6%) ablation lesions showed scar-like changes. No lymph node metastasis was found during follow-up. The maximum diameter and volume of nodules decreased from 5.1 ± 1.4 mm, 86.22 ± 20.46 mm 3 before operation to 0.73 ± 1.1 mm, 1.02 ± 1.92 mm 3 at the end of observation ( P < 0.01). The average volume reduction rates (VRR) at 6, 12, 18, 24, 30 and 36 months after ablation were 11.92%, 60.64%, 82.26%, 90.96%, 93.7% and 97.79% respectively. No regrowth of treated nodule and distant metastases were detected. One patient (2.3%) had local recurrence and was treated with PLA again., Conclusion: Ultrasound-guided PLA appears to be effective and safe for treating unifocal RPTCNs in selected patients who are ineligible for surgery, which is suitable for clinical application and promotion., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Yong-ping, Juan, Li, Qi, Liu, Zhao, Liu, Zhang and Zhou.)

Objectives: To reconstruct the cases of acceleration craniocerebral injury caused by blunt in forensic cases by finite element method (FEM), and to study the biomechanical mechanism and quantitative evaluation method of blunt craniocerebral injury., Methods: Based on the established and validated finite element head model of Chinese people, the finite element model of common injury tool was established with reference to practical cases in the forensic identification, and the blunt craniocerebral injury cases were reconstructed by simulation software. The cases were evaluated quantitatively by analyzing the biomechanical parameters such as intracranial pressure, von Mises stress and the maximum principal strain of brain tissue., Results: In case 1, when the left temporal parietal was hit with a round wooden stick for the first time, the maximum intracranial pressure was 359 kPa; the maximum von Mises stress of brain tissue was 3.03 kPa at the left temporal parietal; the maximum principal strain of brain tissue was 0.016 at the left temporal parietal. When the right temporal was hit with a square wooden stick for the second time, the maximum intracranial pressure was 890 kPa; the maximum von Mises stress of brain tissue was 14.79 kPa at the bottom of right temporal lobe; the maximum principal strain of brain tissue was 0.103 at the bottom of the right temporal lobe. The linear fractures occurred at the right temporal parietal skull and the right middle cranial fossa. In case 2, when the forehead and left temporal parietal were hit with a round wooden stick, the maximum intracranial pressure was 370 kPa and 1 241 kPa respectively, the maximum von Mises stress of brain tissue was 3.66 kPa and 26.73 kPa respectively at the frontal lobe and left temporal parietal lobe, and the maximum principal strain of brain tissue was 0.021 and 0.116 respectively at the frontal lobe and left temporal parietal lobe. The linear fracture occurred at the left posterior skull of the coronary suture. The damage evaluation indicators of the simulation results of the two cases exceeded their damage threshold, and the predicted craniocerebral injury sites and fractures were basically consistent with the results of the autopsy., Conclusions: The FEM can quantitatively evaluate the degree of blunt craniocerebral injury. The FEM combined with traditional method will become a powerful tool in forensic craniocerebral injury identification and will also become an effective means to realize the visualization of forensic evidence in court.

Os acetabuli is a bone fragment with unknown origin and isolated at the acetabular rim that may be associated with cam-type femoroacetabular impingement. If this bone fragment is too large and threatens the stability of the hip joint after resection, fixation would be recommended. However, conventional rigid fixation with metal screws has some disadvantages. We describe an arthroscopic suture fixation of the Os acetabulum with absorbable anchors penetrating the bone fragment and secured by tying knots in a double-pulley fashion simultaneously. This technique provides a new feasible solution for the fixation of Os acetabuli, avoiding any metal implants and potential damage to the joint., (© 2022 The Authors.)

Objective: To observe the clinical efficacy of balance acupotomy combined with warm needling in treatment of cervical spondylopathy of vertebral artery type (CSA)., Methods: Ninety patients were randomly divided into a warm needling group, a balance acupotomy group and a combined treatment group, 30 cases in each one. In the warm needling group, warm needling was given, once daily, for 5 days consecutively, with the interval of 2 days every week, and the treatment was conducted for 3 weeks. In the combined treatment group, on the base of the treatment as the warm needling group, the balance acupotomy was exerted, for consecutive 3 weeks. In the balance acupotomy group, the balance acupotomy was adopted, once a week, for 3 weeks consecutively. Clinical efficacy, the mean blood flow velocity of left vertebral artery (LVA), right vertebral artery (RVA) and basilar artery (BA), the pulse index (PI) and the resistance index (RI) were observed in 3 groups separately. The score of vertigo symptom and function was compared before and after treatment in 3 groups., Results: In comparison with before treatment, the score of evaluation scale for cervical vertigo (ESCV) and the mean blood flow velocity of LVA, RVA and BA were all increased ( P <0.05). while PI and RI reduced ( P <0.05) in each group after treatment. In comparison with those in the warm needling group and the balance acupotomy group, ESCV score and the mean blood flow velocity of LVA, RVA and BA were increased ( P <0.05), while PI and RI decreased ( P <0.05) in the combined treatment group after treatment. Compared with the balance acupotomy group, the mean blood flow velocity of LVA, RVA and BA was increased ( P <0.05), and PI and RI reduced ( P <0.05) in the warm needling group after treatment. The total effective rate was 73.3% (22/30) in the warm needling group, 70.0% (21/30) in the balance acupotomy group and 93.3% (28/30) in the combined treatment group respectively. The total effective rate in the combined treatment group was higher than that either in the warm needling group or in the balance acupotomy group ( P <0.05)., Conclusion: Balance acupotomy combined with warm needling may restore the mechanical equilibrium state of the neck, and effectively improve the change of vertebral-basilar artery blood flow and relieve vertigo symptoms in patient with of cervical spondylosis of vertebral artery type.

Objective: Therapeutic inertia threatens the potential long-term benefits of achieving early glycemic control after type 2 diabetes diagnosis. We evaluated temporal trends in second-line diabetes medication initiation among individuals initially treated with metformin., Research Design and Methods: We included data from 199,042 adults with type 2 diabetes in the U.S. Department of Veterans Affairs health care system initially treated with metformin monotherapy from 2005 to 2013. We used multivariable Cox proportional hazards and linear regression to estimate associations of year of metformin monotherapy initiation with time to second-line diabetes treatment over 5 years of follow-up (primary outcome) and with hemoglobin A1c (HbA1c) at the time of second-line diabetes treatment initiation (secondary outcome)., Results: The cumulative 5-year incidence of second-line medication initiation declined from 47% among metformin initiators in 2005 to 36% in 2013 counterparts (P < 0.0001) despite a gradual increase in mean HbA1c at the end of follow-up (from 6.94 ± 1.28% to 7.09 ± 1.42%, Ptrend < 0.0001). In comparisons with metformin monotherapy initiators in 2005, adjusted hazard ratios for 5-year initiation of second-line diabetes treatment ranged from 0.90 (95% CI 0.87, 0.92) for 2006 metformin initiators to 0.68 (0.66, 0.70) for 2013 counterparts. Among those receiving second-line treatment within 5 years of metformin initiation, HbA1c at second-line medication initiation increased from 7.74 ± 1.66% in 2005 metformin initiators to 8.55 ± 1.92% in 2013 counterparts (Ptrend < 0.0001)., Conclusions: We observed progressive delays in diabetes treatment intensification consistent with therapeutic inertia. Process-of-care interventions early in the diabetes disease course may be needed to reverse adverse temporal trends in diabetes care., (© 2022 by the American Diabetes Association.)

Objective: To analyze the efficacy of percutaneous vertebroplasty for osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom., Methods: A retrospective analysis was performed on 37 patients with osteoporotic vertebral compression fractures treated from January 2015 to January 2021, all of whom had spin-derived abdominal pain as the main symptom, and were divided into surgery group(21 cases) and conservative group (16 cases) according to different treatment methods. Patients in the surgery group were treated with percutaneous vertebroplasty, including 7 males and 14 females, with an average age of (75.95±6.84) years old and an average course of disease of (5.26±3.79) days. The conservative group received non-surgical treatment, including 5 males and 11 females, with an average age of (75.50±8.07) years old and an average course of disease of (4.28±3.42) days. Two groups of patients with preoperative mainly characterized by abdominal pain, abdominal distension and constipation, have no obvious chest waist back pain symptoms, the thoracolumbar MRI diagnosed as fresh osteoporotic vertebral compression fractures, record its postoperative abdominal pain visual analogue scale (VAS), medical outcomes study short form-36 (SF-36) score, defecation interval after treatment, etc., Results: Thirty-seven patients were followed up for (14.90±14.11) months in surgery group and( 21.42±17.53) months in conservative group. Compared with before treatment, the VAS of surgery group at each time period after treatment, VAS of conservative group at 1 month after treatment and SF-36 score between two groups at 3 months after treatment were all improved( P <0.05), while VAS of conservative group at 3 days after treatment showed no statistically significant difference( P >0.05). Compared between two groups, there were no significant differences in VAS and SF-36 scores at 1 day before treatment( P >0.05), but VAS at 3 days after treatment in surgery group, life vitality and social function score at 3 months after treatment, and defecation time after treatment in surgery group were better than those in conservative group( P <0.05). There were no significant differences in other indexes( P >0.05). The incision healing of patients in surgery group was good, and no serious complications occurred in both groups., Conclusion: Percutaneous vertebroplasty is an effective method for the treatment of osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom. Compared with conservative treatment, percutaneous vertebroplasty has more advantages in early relief of abdominal pain and constipation, recovery of vitality and social function.

Background: Thrombotic thrombocytopenic purpura (TTP) is a life-threatening but treatable disorder. Acute pancreatitis is a well-described consequence of TTP, but TTP as a consequence of acute pancreatitis is rare., Case Summary: A 32-year-old male developed acute pancreatitis due to a fatty diet and suffered splenectomy 3 years ago due to trauma. From day 4 of his onset of pain the blood examination showed the platelet extremely reduced, bilirubin elevated and creatinine increased. High clinical suspicion of TTP was made and prompt initiation of plasma exchange was given followed intravenous drip methylprednisolone. After 7 sessions of plasm exchange and the laboratory parameters were back to normal and the patient was discharged from the hospital on the 13 th day of admission., Conclusion: Patients develop acute pancreatitis with no apparent causes for hemolytic anemia and thrombocytopenia, the possibility of TTP should be considered. Treatments for TTP including plasm exchange should be evaluated as soon as a diagnosis is made., Competing Interests: Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported., (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)

Numerous results have revealed an association between inhibited function of excitatory amino acid transporter 3 (EAAT3) and several neurodegenerative diseases. This was also corroborated by our previous studies which showed that the EAAT3 function was intimately linked to learning and memory. With this premise, we examined the role of EAAT3 in post-operative cognitive dysfunction (POCD) and explored the potential benefit of riluzole in countering POCD in the present study. We first established a recombinant adeno-associated-viral (rAAV)-mediated shRNA to knockdown SLC1A1 /EAAT3 expression in the hippocampus of adult male mice. The mice then received an intracerebroventricular microinjection of 2 μg lipopolysaccharide (LPS) to construct the POCD model. In addition, for old male mice, 4 mg/kg of riluzole was intraperitoneally injected for three consecutive days, with the last injection administered 2 h before the LPS microinjection. Cognitive function was assessed using the Morris water maze 24 h following the LPS microinjection. Animal behavioral tests, as well as pathological and biochemical assays, were performed to clarify the role of EAAT3 function in POCD and evaluate the effect of activating the EAAT3 function by riluzole. In the present study, we established a mouse model with hippocampal SLC1A1 /EAAT3 knockdown and found that hippocampal SLC1A1 /EAAT3 knockdown aggravated LPS-induced learning and memory deficits in adult male mice. Meanwhile, LPS significantly inhibited the expression of EAAT3 membrane protein and the phosphorylation level of GluA1 protein in the hippocampus of adult male mice. Moreover, riluzole pretreatment significantly increased the expression of hippocampal EAAT3 membrane protein and also ameliorated LPS-induced cognitive impairment in elderly male mice. Taken together, our results demonstrated that the dysfunction of EAAT3 is an important risk factor for POCD susceptibility and therefore, it may become a promising target for POCD treatment.

Molecular recognition 1-4 and supramolecular assembly 5-8 cover a broad spectrum 9-11 of non-covalently orchestrated phenomena between molecules. Catalysis 12 of such processes, however, unlike that for the formation of covalent bonds, is limited to approaches 13-16 that rely on sophisticated catalyst design. Here we establish a simple and versatile strategy to facilitate molecular recognition by extending electron catalysis 17 , which is widely applied 18-21 in synthetic covalent chemistry, into the realm of supramolecular non-covalent chemistry. As a proof of principle, we show that the formation of a trisradical complex 22 between a macrocyclic host and a dumbbell-shaped guest-a molecular recognition process that is kinetically forbidden under ambient conditions-can be accelerated substantially on the addition of catalytic amounts of a chemical electron source. It is, therefore, electrochemically possible to control 23 the molecular recognition temporally and produce a nearly arbitrary molar ratio between the substrates and complexes ranging between zero and the equilibrium value. Such kinetically stable supramolecular systems 24 are difficult to obtain precisely by other means. The use of the electron as a catalyst in molecular recognition will inspire chemists and biologists to explore strategies that can be used to fine-tune non-covalent events, control assembly at different length scales 25-27 and ultimately create new forms of complex matter 28-30 ., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

The films of vinylidene fluoride and trifluoroethylene (P(VDF-TrFE)) are widely used in piezoelectric tactile sensors, vibration energy harvesters, optical frequency conversion materials and organic photo-voltaic devices because of high electroactive, good optical and nonlinear optical properties, respectively. In this work, the multilayer structured ultrathin films were fabricated by the Langmuir-Blodgett technique, and the thickness per layer can be controlled accurately. It was found that as the collapse pressure of P(VDF-TrFE) (25:75) and the optimal dipping value are 60~70 mN/m and 15 mN/m, respectively, a high-density film can be obtained due to the compression of molecules. The surface topography and optical properties of the LB films were characterized by X-ray diffraction, white light interferometer and variable-angle spectrum ellipsometer. It was observed that the films are transparent in the visible region and IR-band, but show a high absorption in the UV band. Besides, the transmittance of the films ranges from 50% to 85% in the visible region, and it linearly decreases with the number of monolayers. The average thickness of per deposition layer is 2.447 nm, 2.688 nm and 2.072 nm, respectively, under three measurement methods. The calculated refractive index ranged from 1.443 to 1.598 (600~650 nm) by the Cauchy-model.

Opioid analgesics are widely used to treat acute, postoperative, and chronic pain. However, opioid receptor activation can result in severe respiratory depression. In this study, we demonstrated that Tandospirone (TS), a selective serotonin-1A receptor partial agonist, is effective against opioid-induced respiratory depression. Fentanyl was used to establish a respiratory depression model in rodents. We observed the effects of TS on respiratory depression in rats by using plethysmographic recordings and arterial oxygen saturation. In addition, we evaluated the effects of TS on fentanyl-induced sedation and analgesia by using the loss of righting reflex (LORR) and hot-plate tests, respectively. Rats (n = 5) were treated with TS or saline 5 min prior to fentanyl administration. TS [2 mg/kg, intravenous (i.v.)] dose-dependently attenuated fentanyl-induced respiratory depression versus saline + fentanyl group. Furthermore, pre-treatment with TS (2 mg/kg, i.v.) increased arterial oxygen saturation to 76.5 ± 2.0% at 5 min after fentanyl injection, compared with 35.9 ± 2.5% in saline pre-treated rats (P < 0.001), whereas the time to induction of LORR (P > 0.99) and duration of LORR (P = 0.95) did not differ between the "TS + fentanyl" and "saline + fentanyl" group. The antinociceptive effect of fentanyl was not affected by the administration of TS (P = 0.99) in mice (n = 10). In conclusion, we found that TS, a novel non-benzodiazepine anxiolytic/antidepressant drug, could attenuate severe fentanyl-induced respiratory depression and did not affect the analgesic/sedative effect of fentanyl. The clinical application of TS could significantly improve pain management., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Resveratrol (RES) is a novel dietary phenol compound derived from plants and has been studied extensively for its health benefit and medical potential including osteoporosis. The purpose of this study is to investigate the role of resveratrol in osteoporosis in vivo and in vitro and explore the mechanism of osteogenic differentiation of BMSCs. RT-qPCR, ELISA, and Western blot were used to measure the expression level of miR-193a, SIRT7, and osteogenic markers proteins. The interaction between miR-193a and SIRT7 was validated by dual-luciferase reporter assay. Moreover, MTT assay was conducted to detect cell viability. Alizarin red s staining was used to examine bone formation and calcium deposits. The ovariectomized rat model was set up successfully and HE staining was used to examine femoral trabeculae tissue. Our results showed that miR-193a was overexpressed, while SIRT7 was downregulated in osteoporosis. RES suppressed miR-193a to promote osteogenic differentiation. Mechanically, miR-193a targeted and negative regulated SIRT7. Additionally, it was confirmed that SIRT7 promoted osteogenic differentiation of BMSCs through NF-κB signaling pathway. Further study indicated that RES exerted its beneficial function through miR-193a/SIRT7-mediated NF-κB signaling to alleviate osteoporosis in vivo. Our research suggested that the RES-modulated miR-193a inhibition is responsible for the activation of SIRT7/NF-κB signaling pathway in the process of osteogenic differentiation, providing a novel insight into diagnosis and treatment of osteoporosis., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: To evaluate the molecular mechanism underlying the beneficial effect of Bushen Qiangjin capsule (BSQJ), a Traditional Chinese Medicine, on knee osteoarthritis (KOA)., Methods: In the present study, 32 female Sprague-Dawley rats were randomly divided into four groups: control, KOA, high-dose BSQJ (H-BSQJ), and low-dose BSQJ (L-BSQJ). After successfully establishing the KOA model by intra-articular injection of papain, H-BSQJ and L-BSQJ groups were intragastrically administered 0.243 and 0.122 g/kg BSQJ, respectively, daily for 6 weeks. At the end of the experiment, knee articular cartilage tissues of rats were collected for evaluation by hematoxylin and eosin staining, Safranin O-Fast Green staining, and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay. Serum interleukin-1α and tumor necrosis factor-α levels of rats were detected with an enzyme-linked immunosorbent assay method. Gene expression of Wnt-4, α-catenin, Frizzled-2, glycogen synthase kinase-3β (GSK-3β), cysteinyl aspartate-specific proteinases 3 and 9 (caspases 3 and 9), collagen type II alpha 1 (Col2a1), and matrix metalloproteinases 1 and 13 (MMP-1 and MMP-3) of rat knee articular cartilage was quantified by reverse transcription-quantitative polymerase chain reaction analysis. Wnt-4, α-catenin, Frizzled-2, GSK-3β, cleaved caspase-3, and cleaved caspase-9 protein expression in rat knee articular cartilage was determined by western blot analysis., Results: BSQJ obviously reduced pathological damage and matrix degradation of articular cartilage in KOA rats. Compared with the KOA group, H-BSQJ rats exhibited downregulated mRNA and protein expression of Wnt-4, β-catenin, Frizzled-2,and caspase-3, as well as upregulated mRNA and protein expression of GSK-3α. In addition, H-BSQJ significantly increased mRNA expression of Col2a1 and decreased mRNA expression of MMP-1 and MMP-13., Conclusion: BSQJ exerted a beneficial effect on KOA by a mechanism involving downregulation of the Wnt/α-catenin pathway, which inhibited both cartilage extracellular matrix degradation and chondrocyte apoptosis to ameliorate KOA in rats.

Toxoplasma gondii is an obligate intracellular protozoan parasite, which has a worldwide distribution and can infect a large number of warm-blooded animals and humans. T. gondii must colonize and proliferate inside the host cells in order to maintain its own survival by securing essential nutrients for the development of the newly generated tachyzoites. The type II fatty acid biosynthesis pathway (FASII) in the apicoplast is essential for the growth and survival of T. gondii . We investigated whether deletion of genes in the FASII pathway influences the in vitro growth and in vivo virulence of T. gondii . We focused on beta-hydroxyacyl-acyl carrier protein dehydratase (FabZ) and oxidoreductase, short chain dehydrogenase/reductase family proteins ODSCI and ODSCII. We constructed T. gondii strains deficient in FabZ, ODSCI , and ODSCII using CRISPR-Cas9 gene editing technology. The results of immunofluorescence assay, plaque assay, proliferation assay and egress assay showed that in RHΔ FabZ strain the apicoplast was partly lost and the growth ability of the parasite in vitro was significantly inhibited, while for RHΔ ODSCI and RHΔ ODSCII mutant strains no similar changes were detected. RHΔ FabZ exhibited reduced virulence for mice compared with RHΔ ODSCI and RHΔ ODSCII , as shown by the improved survival rate. Deletion of FabZ in the PRU strain significantly decreased the brain cyst burden in mice compared with PRUΔ ODSCI and PRUΔ ODSCII . Collectively, these findings suggest that FabZ contributes to the growth and virulence of T. gondii , while ODSCI and ODSCII do not contribute to these traits., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Xu, Elsheikha, Liu, Zhang, Sun, Liang, Song and Zhu.)

Objective: To evaluate the correlation between culprit vessel/tirofiban and reperfusion bradyarrhythmia in patients with ST-segment elevation myocardial infarction (STEMI) after emergency percutaneous coronary intervention (PCI)., Patients and Methods: A total of 123 STEMI patients undergoing emergency PCI in our hospital from September 2018 to September 2019 were selected and divided into the reperfusion arrhythmias (RA) group (50 cases) and non-RA group (NRA, 73 cases) according to whether RA occurring during PCI. The baseline data such as age and underlying disease were statistically analyzed. Then, the differences were compared between the two groups. According to whether reperfusion bradyarrhythmia (RB) occurring during PCI, 123 STEMI patients were divided into the RB group (63 cases) and non-RB group (60 cases). The relation between culprit vessel/tirofiban and RB was analyzed. ROC curves analysis and multivariate logistic regression were conducted for the risk factors of RA and RB., Results: Among 123 patients with STEMI after PCI treatment, 73 patients had RA (59.35%), including RB 63 cases and tachyarrhythmia 10 cases. Results of single factor analysis showed that there was statistical significance in 3 factors including the patient age, infarction area and vascular blood flow TIMI classification between RA group and NRA group (p<0.05). ROC curve analysis indicated that the continuous variable patent ages had predictive value in the prevalence of RA, which resulting in an AUC 0.624 and a cut-off pointed age 57 (sensitivity 72.60, specificity 52.00). Multivariate regression analysis showed that the patient age (>57 years old), infarction area in inferior wall and grade 0 lesion vascular blood flow TIMI classification in RA group was significantly higher than that in NRA group (p<0.05). Tirofiban was not associated with RB in STEMI patients treated with emergency PCI, while culprit vessel was statistically significant between RB group and NRB group (p<0.05). Multivariate regression analysis indicated that culprit vessel of the right coronary artery and grade 0 lesions vascular blood flowed TIMI classification was independent risk factors to occurring RB in the STEMI patients with emergency PCI., Conclusions: Tirofiban was not associated with RB in STEMI patients treated with emergency PCI. However, it may increase the risk of RB development when the culprit vessel is the right coronary artery. Therefore, timely corresponding treatments and reduction of reperfusion damage are of great significance for those patients.

The development of chiral ligands with privileged scaffolds plays an important role in transition-metal-catalyzed asymmetric reactions. Herein we present anthracene-photodimer-derived chiral monophosphine ligand 1 , which features dual chirality and a rigid scaffold. This ligand exhibits remarkable efficiency in Pd-catalyzed desymmetric intermolecular C-N coupling under mild conditions with excellent chemo- and enantioselectivity.

Currently available antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), generally require weeks to months to produce a therapeutic response, but the mechanism of action underlying the delayed onset of antidepressant-like action remains to be elucidated. The balance between excitatory glutamatergic pyramidal neurons and inhibitory γ-aminobutyric acid (GABA) interneurons, i.e., the excitation:inhibition functional (E:I) balance, in the medial prefrontal cortex (mPFC) is critical in regulating several behaviors and might play an important mediating role in the mechanism of rapid antidepressant-like action reported by several studies. In the present study, the multichannel electrophysiological technique was used to record the firing activities of pyramidal neurons and interneurons and investigate the effects of a single dose of fluoxetine and ketamine (both 10 mg/kg, i.p.) on the E:I functional balance in the rat mPFC after 90 min or 24 h, and the forced swimming test (FST) was used to evaluate the antidepressant-like effects of fluoxetine and ketamine. The present study also explored the effects of chronic treatment with fluoxetine (10 mg/kg, i.g.) for 7 d or 21 d on the E:I functional balance in the mPFC. The present results suggested that a single dose of ketamine could both significantly increase the firing activities of pyramidal neurons and significantly decrease the firing activities of interneurons in the mPFC and exerted significant antidepressant-like action on the FST after 90 min and 24 h, but fluoxetine had no such effects under the same conditions. However, chronic treatment with fluoxetine for 21 d (but not 7 d) could significantly affect the firing activities of pyramidal neurons and interneurons in the mPFC. Taken together, the present results indicated that rapid regulation of the E:I functional balance in the mPFC might be an important common mechanism of rapid-acting antidepressants and the delayed onset of SSRIs might be partly attributed to their inability to rapidly regulate the E:I functional balance in the mPFC. The present study provided a new entry point to the development of rapid-acting antidepressants., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objectives: To investigate the cup survivorship, patient satisfaction level, clinical function, and radiographic outcomes of patients who underwent total hip arthroplasty (THA) using electron beam melting (EBM)-produced porous coated titanium cups at mid-term follow up., Methods: A total of 32 patients (32 hips) from five hospitals in China who underwent primary THA using EBM-produced trabecular titanium cups between May and December 2012 were retrospectively reviewed. The inclusion criteria were: (i) patients who underwent THA with the use of EBM-produced cups with possible 7-year follow up; and (ii) patients with follow-up information, including the cup survivorship, patient satisfaction level, and clinical outcomes such as Harris hip score. The exclusion criteria were: (i) patients with neuropathic diseases; and (ii) patients who underwent THA due to neoplastic disease. Five (15.6%) patients were lost to follow up before the 7-year follow-up and, thus, were excluded; none of these patients died due to disease associated with the THA or had undergone removal of their cups as of our last evaluation. The mean age and body mass index of the patients were 59.37 (range: 38.00-69.00) years and 24.51 (range: 16.50-34.10) kg/m 2 , respectively. Thirteen (48.1%) of the patients were female., Results: The average duration of follow-up was 93.48 (range: 89.00-99.00) months. The median Harris hip score improved from 42.00 (interquartile range: 37.00-49.00) to 97.00 (interquartile range: 92.00-97.00) at the latest follow up (P < 0.001). A total of 18 (66.7%) patients rated their satisfaction level as very satisfied, 6 (22.2%) as satisfied, 2 (7.4%) as neutral and 1 (3.7%) as dissatisfied. No intraoperative or postoperative complications were identified. At the latest follow up, all cups were considered to have achieved osteointegration fixation, with three or more of the five signs evident in the most recent X-ray. However, three cups revealed radiolucent lines with a width of less than 1 mm. The median vertical and horizontal distances between the latest postoperative center of rotation relative to the anatomic center of rotation were 2.50 (interquartile range: -3.10, 6.94) mm superiorly and 3.26 (interquartile range: -8.12, 2.38) mm medially, respectively, at the most recent postoperative follow up. Kaplan-Meier survivorship analysis of cups, with the endpoint defined as postoperative radiolucent lines of less than 1 mm in width in at least two zones, reveals that the 8.25-year survival was 96.3% (95% confidence interval: 76.49%-99.47%)., Conclusion: The mid-term follow-up of patients who underwent primary THA using EBM-produced porous coated titanium cups demonstrated favorable patient satisfaction, good clinical function, excellent survivorship, and adequate biological fixation., (© 2021 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.)

The thyrotroph embryonic factor gene is a circadian clock-controlled gene. The rs738499 polymorphism of this gene has been suggested to be associated with depression and sleep disturbance in Parkinson's disease in previous cross-sectional studies. We aimed to investigate whether this single nucleotide polymorphism is associated with the progression rates of various motor and non-motor symptoms in patients with Parkinson's disease. We recruited 186 patients with Parkinson's disease for a longitudinal study. Motor and non-motor symptoms were assessed at baseline and follow-up, and 170 Parkinson's disease patients completed the clinical evaluation twice with an average follow-up period of 3.3 ± 1.1 years. A stepwise linear regression model was used to validate factors associated with Parkinson's disease symptoms' annual progression rates. Faster annual worsening rates of sleep quality and Hoehn-Yahr stage were found in carriers with the homozygous dominant (TT). After adjustment for related clinical factors, the rs738499 polymorphism showed a contribution of 3.1% to the annual decline rate on the Parkinson's Disease Sleep Scale score and a contribution of 5.5% to the annual increase rate of the Hoehn-Yahr stage. Additionally, anxiety and axial symptoms predicted the progression of sleep disturbances and motor staging. The TT genotype of rs738499 might be a potential predictor of rapid deterioration in sleep quality and Hoehn-Yahr stage in patients with Parkinson's disease and may advance the understanding of the genetic contributions to Parkinson's disease., Competing Interests: The authors declare no competing interests., (© 2021 The Authors. Published by IMR Press.)

Objective: To explore the clinical effect of "Jin's three-needle" therapy and motor relearning regime for the recovery of upper limb motor function in the patients with ischemic stroke., Methods: A total of 60 patients with ischemic stroke were randomly divided into an experiment group (30 cases) and a control group (30 cases). In the control group, the routine rehabilitation regimen was adopted. In the experimental group, on the base of the treatment regimen as the control group, the "Jin's three-needle" therapy was supplemented. The neurological function deficit score was used to assess the neurological function. The modified Fugel-Meyer assessment for upper extremities (FMA) and motor assessment scale (MAS) were adopted to assess the upper limb motor function in patients. The modified Barthel Index (MBI) was used to evaluate the activity of daily living (ADL) in patients., Results: After treatment, the neurological function deficit score, the upper limb motor function (FMA and MAS) and ADL (MBI) were all improved obviously as compared with those before treatment ( P <0.05). In the experimental group, the reducing range of neurological function deficit score (difference value) was larger than that in the control group ( P <0.05). The increases of FMA score (upper arm function), the total score of MAS, the score for hand movement in MAS and the score for advanced hand activities of MAS, as well as MBI score in the experimental group were significantly larger than those in the control group successively ( P <0.05)., Conclusion: "Jin's three-needle" therapy combined with exercise relearning regimen effectively reduces the degree of neurological deficit and improve the upper limb motor function and ADL in patients with ischemic stroke.

Posttraumatic stress disorder (PTSD) is a debilitating trauma and stressor-related disorder that has become a major neuropsychiatric problem, leading to substantial disruptions in individual health and societal costs. Our previous studies have demonstrated that hypidone hydrochloride (YL-0919), a novel combined selective 5-HT reuptake inhibitor/5-HT 1A receptor partial agonist/5-HT 6 receptor full agonist, exerts notable antidepressant- and anxiolytic-like as well as procognitive effects. However, whether YL-0919 exerts anti-PTSD effects and its underlying mechanisms are still unclear. In the present study, we showed that repeated treatment with YL-0919 caused significant suppression of contextual fear, enhanced anxiety and cognitive dysfunction induced by the time-dependent sensitization (TDS) procedure in rats and by inescapable electric foot-shock in a mouse model of PTSD. Furthermore, we found that repeated treatment with YL-0919 significantly reversed the accompanying decreased expression of the brain-derived neurotrophic factor (BDNF) and the synaptic proteins (synapsin1 and GluA1), and ameliorated the neuroplasticity disruption in the prefrontal cortex (PFC), including the dendritic complexity and spine density of pyramidal neurons. Taken together, the current study indicated that YL-0919 exerts clear anti-PTSD effects, which might be partially mediated by ameliorating the structural neuroplasticity by increasing the expression of BDNF and the formation of synaptic proteins in the PFC., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Liu, Zhang, Yao, Yin, Zhang, Li and Cao.)

In the present monograph, the taxonomy of the species of the genus Maladera Mulsant Rey, 1871 from China is revised. We recorded 224 valid species for China, including 152 species new to science: Maladera allonitens Ahrens, Fabrizi Liu, sp. n., M. anhuiensis Ahrens, Fabrizi Liu, sp. n., M. apicalis Ahrens, Fabrizi Liu, sp. n., M. aptera Ahrens, Fabrizi Liu, sp. n., M. baii Ahrens, Fabrizi Liu, sp. n., M. baishaoensis Ahrens, Fabrizi Liu, sp. n., M. bansongchana Ahrens, Fabrizi Liu, sp. n., M. baoxingensis Ahrens, Fabrizi Liu, sp. n., M. bawanglingana Ahrens, Fabrizi Liu, sp. n., M. bawanglingensis Ahrens, Fabrizi Liu, sp. n., M. beibengensis Ahrens, Fabrizi Liu, sp. n., M. beidouensis Ahrens, Fabrizi Liu, sp. n., M. bikouensis Ahrens, Fabrizi Liu, sp. n., M. breviclava Ahrens, Fabrizi Liu, sp. n., M. bubengensis Ahrens, Fabrizi Liu, sp. n., M. businskyorum Ahrens, Fabrizi Liu, sp. n., M. chenzhouana Ahrens, Fabrizi Liu, sp. n., M. constellata Ahrens, Fabrizi Liu, sp. n., M. crenatotibialis Ahrens, Fabrizi Liu, sp. n., M. crenolatipes Ahrens, Fabrizi Liu, sp. n., M. daanensis Ahrens, Fabrizi Liu, sp. n., M. dadongshanica Ahrens, Fabrizi Liu, sp. n., M. dahongshanica Ahrens, Fabrizi Liu, sp. n., M. dajuensis Ahrens, Fabrizi Liu, sp. n., M. danfengensis Ahrens, Fabrizi Liu, sp. n., M. dayaoshanica Ahrens, Fabrizi Liu, sp. n., M. diaolinensis Ahrens, Fabrizi Liu, sp. n., M. emeifengensis Ahrens, Fabrizi Liu, sp. n., M. enigma Ahrens, Fabrizi Liu, sp. n., M. erlangshanica Ahrens, Fabrizi Liu, sp. n., M. eshanensis Ahrens, Fabrizi Liu, sp. n., M. excisilabrata Ahrens, Fabrizi Liu, sp. n., M. fangana Ahrens, Fabrizi Liu, sp. n., M. fangchengensis Ahrens, Fabrizi Liu, sp. n., M. fencli Ahrens, Fabrizi Liu, sp. n., M. fengyangshanica Ahrens, Fabrizi Liu, sp. n., M. fereobscurata Ahrens, Fabrizi Liu, sp. n., M. filigraniforceps Ahrens, Fabrizi Liu, sp. n., M. flavipennis Ahrens, Fabrizi Liu, sp. n., M. fuanensis Ahrens, Fabrizi Liu, sp. n., M. guangdongana Ahrens, Fabrizi Liu, sp. n., M. guangzhaishanica Ahrens, Fabrizi Liu, sp. n., M. guanxianensis Ahrens, Fabrizi Liu, sp. n., M. guanxiensis Ahrens, Fabrizi Liu, sp. n., M. guomenshanensis Ahrens, Fabrizi Liu, sp. n., M. guomenshanica Ahrens, Fabrizi Liu, sp. n., M. gusakovi Ahrens, Fabrizi Liu, sp. n., M. haba Ahrens, Fabrizi Liu, sp. n., M. habashanensis Ahrens, Fabrizi Liu, sp. n., M. hajeki Ahrens, Fabrizi Liu, sp. n., M. hansmalickyi Ahrens, Fabrizi Liu, sp. n., M. hongyuanensis Ahrens, Fabrizi Liu, sp. n., M. houzhenziensis Ahrens, Fabrizi Liu, sp. n., M. hsui Ahrens, Fabrizi Liu, sp. n., M. huanianensis Ahrens, Fabrizi Liu, sp. n., M. hubeiensis Ahrens, Fabrizi Liu, sp. n., M. hui Ahrens, Fabrizi Liu, sp. n., M. hunanensis Ahrens, Fabrizi Liu, sp. n., M. hunuguensis Ahrens, Fabrizi Liu, sp. n., M. hutiaoensis Ahrens, Fabrizi Liu, sp. n., M. jaroslavi Ahrens, Fabrizi Liu, sp. n., M. jatuai Ahrens, Fabrizi Liu, sp. n., M. jiangi Ahrens, Fabrizi Liu, sp. n., M. jingdongensis Ahrens, Fabrizi Liu, sp. n., M. jinggangshanica Ahrens, Fabrizi Liu, sp. n., M. jinghongensis Ahrens, Fabrizi Liu, sp. n., M. jiucailingensis Ahrens, Fabrizi Liu, sp. n., M. jizuana Ahrens, Fabrizi Liu, sp. n., M. juntongi Ahrens, Fabrizi Liu, sp. n., M. juxianensis Ahrens, Fabrizi Liu, sp. n., M. kalawensis Ahrens, Fabrizi Liu, sp. n., M. kryschanowskii Ahrens, Fabrizi Liu, sp. n., M. kubeceki Ahrens, Fabrizi Liu, sp. n., M. laocaiensis Ahrens, Fabrizi Liu, sp. n., M. lianxianensis Ahrens, Fabrizi Liu, sp. n., M. liaochengensis Ahrens, Fabrizi Liu, sp. n., M. liwenzhui Ahrens, Fabrizi Liu, sp. n., M. longruiensis Ahrens, Fabrizi Liu, sp. n., M. luoxiangensis Ahrens, Fabrizi Liu, sp. n., M. lushanensis Ahrens, Fabrizi Liu, sp. n., M. lushuiensis Ahrens, Fabrizi Liu, sp. n., M. maguanensis Ahrens, Fabrizi Liu, sp. n., M. maoershana Ahrens, Fabrizi Liu, sp. n., M. mupingensis Ahrens, Fabrizi Liu, sp. n., M. nabanensis Ahrens, Fabrizi Liu, sp. n., M. nanlingensis Ahrens, Fabrizi Liu, sp. n., M. nanpingensis Ahrens, Fabrizi Liu, sp. n., M. ninglangensis Ahrens, Fabrizi Liu, sp. n., M. panyuensis Ahrens, Fabrizi Liu, sp. n., M. parabrunnescens Ahrens, Fabrizi Liu, sp. n., M. paradetersa Ahrens, Fabrizi Liu, sp. n., M. paranitens Ahrens, Fabrizi Liu, sp. n., M. paraserripes Ahrens, Fabrizi Liu, sp. n., M. parobscurata Ahrens, Fabrizi Liu, sp. n., M. peregoi Ahrens, Fabrizi Liu, sp. n., M. pieli Ahrens, Fabrizi Liu, sp. n., M. pingchuanensis Ahrens, Fabrizi Liu, sp. n., M. pseudoconsularis Ahrens, Fabrizi Liu, sp. n., M. pseudoegregia Ahrens, Fabrizi Liu, sp. n., M. pseudoexima Ahrens, Fabrizi Liu, sp. n., M. pseudofuscipes Ahrens, Fabrizi Liu, sp. n., M. pseudonitens Ahrens, Fabrizi Liu, sp. n., M. pseudosenta Ahrens, Fabrizi Liu, sp. n., M. pui Ahrens, Fabrizi Liu, sp. n., M. putaodiensis Ahrens, Fabrizi Liu, sp. n., M. qianqingtangensis Ahrens, Fabrizi Liu, sp. n., M. queinneci Ahrens, Fabrizi Liu, sp. n., M. riberai Ahrens, Fabrizi Liu, sp. n., M. robustula Ahrens, Fabrizi Liu, sp. n., M. rubriventris Ahrens, Fabrizi Liu, sp. n., M. rufonitida Ahrens, Fabrizi Liu, sp. n., M. rufopaca Ahrens, Fabrizi Liu, sp. n., M. sanqingshanica Ahrens, Fabrizi Liu, sp. n., M. serratiforceps Ahrens, Fabrizi Liu, sp. n., M. shaluishanica Ahrens, Fabrizi Liu, sp. n., M. shangraoensis Ahrens, Fabrizi Liu, sp. n., M. shaowuensis Ahrens, Fabrizi Liu, sp. n., M. shenglongi Ahrens, Fabrizi Liu, sp. n., M. shengqiaoae Ahrens, Fabrizi Liu, sp. n., M. shiniushanensis Ahrens, Fabrizi Liu, sp. n., M. shiruguanensis Ahrens, Fabrizi Liu, sp. n., M. shiwandashanensis Ahrens, Fabrizi Liu, sp. n., M. shoumanensis Ahrens, Fabrizi Liu, sp. n., M. sinobiloba Ahrens, Fabrizi Liu, sp. n., M. snizeki Ahrens, Fabrizi Liu, sp. n., M. songi Ahrens, Fabrizi Liu, sp. n., M. taiyangheensis Ahrens, Fabrizi Liu, sp. n., M. tengchongensis Ahrens, Fabrizi Liu, sp. n., M. tiachiensis Ahrens, Fabrizi Liu, sp. n., M. tiammushanica Ahrens, Fabrizi Liu, sp. n., M. tiani Ahrens, Fabrizi Liu, sp. n., M. tianzushanica Ahrens, Fabrizi Liu, sp. n., M. tongzhongensis Ahrens, Fabrizi Liu, sp. n., M. trifidiforceps Ahrens, Fabrizi Liu, sp. n., M. uncipenis Ahrens, Fabrizi Liu, sp. n., M. wandingana Ahrens, Fabrizi Liu, sp. n., M. weni Ahrens, Fabrizi Liu, sp. n., M. wipfleri Ahrens, Fabrizi Liu, sp. n., M. wulaoshanica Ahrens, Fabrizi Liu, sp. n., M. wuliangshanensis Ahrens, Fabrizi Liu, sp. n., M. wupingensis Ahrens, Fabrizi Liu, sp. n., M. xingkei Ahrens, Fabrizi Liu, sp. n., M. xingkeyangi Ahrens, Fabrizi Liu, sp. n., M. xinqiaoensis Ahrens, Fabrizi Liu, sp. n., M. xuezhongi Ahrens, Fabrizi Liu, sp. n., M. yakouensis Ahrens, Fabrizi Liu, sp. n., M. yangi Ahrens, Fabrizi Liu, sp. n., M. yibini Ahrens, Fabrizi Liu, sp. n., M. yipinglangensis Ahrens, Fabrizi Liu, sp. n., M. yongrenensis Ahrens, Fabrizi Liu, sp. n., M. yunnanica Ahrens, Fabrizi Liu, sp. n., M. zhejiangensis Ahrens, Fabrizi Liu, sp. n. The work also resulted in nine new combinations and 17 new synonyms: Maladera (subgenus Omaladera Reitter, 1896) (= Cephaloserica Brenske, 1900, syn. n.; = Coronoserica Brenske, 1902, syn. n.); Maladera formosae (Brenske, 1898) (= Autoserica castanea Arrow, 1913, syn. n.; = Serica korgei Petrovitz, 1967, syn. n.); Maladera motschulskyi (Brenske, 1897) (= Autoserica furcillata Brenske, 1897, syn. n.; Serica schoenfeldti Murayama, 1937, syn. n.); Maladera pallida (Burmeister, 1855) comb. n. (= Maladera ludipennis Miyake, Yamaguchi Aoki 2002, syn. n.); Maladera renardi (Ballion, 1870) (= Serica delicta Brenske, 1897, syn. n.); Maladera secreta (Brenske, 1897) (= Autoserica cruralis Frey, 1972, syn. n.); Maladera verticalis (Fairmaire, 1888) (= Autoserica hiekei Frey, 1972, syn. n.); Maladera futschauana (Brenske, 1897) (= Autoserica atavana Brenske, 1902, syn. n.; = Autoserica montivaga Moser, 1915, syn. n.); Maladera aureola (Murayama, 1938) (= Maladera liotibia Nomura, 1974, syn. n.); Maladera brunnescens (Frey, 1972) comb. n., Maladera exima (Arrow, 1946) comb. n., Maladera gansuensis (Miyake Yamaya, 2001) comb. n., Maladera nigrobrunnea (Moser, 1926) comb. n., Maladera orientalis (Motschulsky, 1858) (= Serica salebrosa Brenske, 1897, syn. n.; =Autoserica davidis Brenske, 1898, syn. n.; = Serica mirabilis Brenske, 1894, syn. n.), Maladera punctulata (Frey, 1972) comb. n., Maladera rotunda (Arrow, 1946) comb. n., Maladera serripes (Moser, 1915) comb. n., Maladera senta (Brenske, 1897) (= Autoserica subspinosa Brenske, 1898, syn n.); Maladera spissigrada (Brenske, 1897) (= Serica nakayamai Murayama, 1938, syn. n.); Maladera tibialis (Brenske, 1898) comb. n. The lectotypes of the following species were designated: Autoserica furcillata Brenske, 1897, A. cariniceps Moser, 1915, A. diversipes Moser, 1915, A. flammea Brenske, 1898, A. fuscipes Moser, 1915, A. gibbiventris Brenske, 1897, A. hongkongica Brenske, 1898, A. obscurata Moser, 1915, A. piceola Moser, 1915, Serica delicta Brenske, 1897, S. exigua Brenske, 1894, S. nigrobrunnea Moser, 1926, S. orientalis Motschulsky, 1858, S. pallida Burmeister, 1855, S. salebrosa Brenske, 1897, and S. sibirica Brenske, 1897. Keys to the subgenera and species groups of Maladera, as well as a key to the species within each species-group are provided. Furthermore, we provide maps of the species distribution, as well as illustrations of the habitus and male genitalia.

Objective: To investigate the application of treatment modalities for patients with osteonecrosis of the femoral head (ONFH) in mainland China., Methods: This cross-sectional study was based on the online application of China Osteonecrosis of the Femoral Head Database (CONFHD). Between July 2016 to December 2018, the CONFHD program planned to recruit ONFH patients from 12 administrative areas across mainland China. Real-world medical records of treatment regimens for these patients, including surgeries and prescriptions, were approved to upload to the CONFHD application for further analysis. The surgeries performed on these patients were classified into total hip arthroplasty and hip-preserving procedures, and the latter was further classified into core decompression, bone grafting, and tantalum rod implantation. Prescription medications were classified into chemical medicine and Chinese herbal medicine (CHM); chemical medicine was further classified according to their chemical compounds, and CHM was classified according to therapeutic functions based on traditional Chinese medicine theory. Descriptive analysis was performed to summarize the application of different treatment regimens on the overall sample., Results: A total of 1491 patients (2381 hips) who fulfilled the protocol criteria were included. There were 1039 males and 452 females with a mean age of 47.29 ± 12.69 years. The causes of ONFH were alcoholism in 642 patients (43%), corticosteroid in 439 patients (29%), trauma in 239 patients (16%), and idiopathic ONFH in 171 patients (11%). Operative treatments (including total hip arthroplasty and hip-preserving procedures) were performed on 49% of patients (43% of hips), chemical medicine therapy (including bisphosphonate, statins, and prostacyclin) was given to 37% of patients (37% of hips), and CHM was administrated to 72% of patients (75% of hips). The aforementioned interventions were not always used alone, since 47% of patients (52% of hips) received combined regimens with multiple interventions. Among hips treated by surgery, all hips with ARCO stage IV ONFH received THA (305 hips), and THA was also performed on 63 hips with stage II ONFH. Over half of hips with stage I (81%), II (91%), and III (92%) ONFH had received pharmacological treatments. Prostacyclin and bisphosphonate were the top two most prescribed medicines used alone. CHM therapies with multiple CHM functions were more commonly prescribed., Conclusion: Current treatment modalities for ONFH patients in mainland China include operative treatment, chemical medicine, and CHM. Combined regimens with different treatment modalities are common in real-world clinical practices., (© 2020 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.)

Objective: To study the distribution and drug resistance of pathogens causing periprosthetic infections after hip and knee arthroplasty, and to formulate prevention and treatment strategies for drug-resistant bacteria., Methods: The data of 146 cases of periprosthetic infection after primary hip and knee arthroplasty from 2010 to 2015 were collected, including 111 cases of periprosthetic infection after hip arthroplasty and 35 cases of periprosthetic infection after knee arthroplasty. The culture positive rate, pathogenic bacteria composition and drug resistance rate were counted over the years, and the change trend of pathogen distribution and drug resistance was analyzed., Results: One hundredand eight strains of pathogenic bacteria were detected in 146 cases, and the positive rate of culture was 73.97%. Gram positive bacteria accounted for 55.48%, Staphylococcus epidermidis and Staphylococcus aureus accounted for 25.34% and 15.07% respectively. Gram negative bacteria accounted for 13.01%, including Enterobacter cloacae, Pseudomonas aeruginosa and Escherichia coli. There were 4 cases of Mycobacterium tuberculosis infection and mixed infection. The results of culture over the years showed that the constituent ratio of Gram positive bacteria had an increasing trend, fluctuating from 39.13% to 76.47%. The results of drug sensitivity showed that the pathogens were highly resistant to β-lactams, quinolones, clindamycin and gentamicin, and the drug resistance rate was increasing, but it was still sensitive to rifampicin, nitrofurantoin, tigecycline, linezolid and vancomycin., Conclusion: Gram positive bacteria are the main pathogens of periprosthetic infection, and the proportion is increasing gradually.The pathogens have high resistance to many kinds of antibiotics, and the resistance rate is still increasing. To strengthen the monitoring of the distribution and drug resistance of pathogenic bacteria is helpful to grasp its change trend and formulate targeted prevention and control strategies.

MicroRNAs are reportedly involved in the pathogenesis of neurodegenerative diseases, including Parkinson's disease and multiple system atrophy. We previously identified 7 differentially expressed microRNAs in Parkinson's disease patients and control sera (miR-30c, miR-31, miR-141, miR-146b-5p, miR-181c, miR-214, and miR-193a-3p). To investigate the expression levels of the 7 serum microRNAs in Parkinson's disease and multiple system atrophy, 23 early Parkinson's disease patients (who did not take any anti- Parkinson's disease drugs), 23 multiple system atrophy patients, and 24 normal controls were recruited at outpatient visits in this study. The expression levels of the 7 microRNAs in serum were detected using quantitative real-time polymerase chain reaction. A receiver operating characteristic curve was used to evaluate whether microRNAs can differentially diagnose Parkinson's disease and multiple system atrophy. Clinical scales were used to analyze the correlations between serum microRNAs and clinical features. The results indicated that miR-214 could distinguish Parkinson's disease from the controls, and another 3 microRNAs could differentiate multiple system atrophy from the controls (miR-141, miR-193a-3p, and miR-30c). The expression of miR-31, miR-141, miR-181c, miR-193a-3p, and miR-214 were lower in multiple system atrophy than in Parkinson's disease (all P < 0.05). Combinations of microRNAs accurately discriminated Parkinson's disease from multiple system atrophy (area under the receiver operating characteristic curve = 0.951). For the correlation analysis, negative correlations were discovered between the expression of miR-214 and the Hamilton Anxiety Scale and Parkinson's Disease Non-Motor Symptom scores (all P < 0.05). Our results demonstrate that the distinctive characteristics of microRNAs differentiate Parkinson's disease and multiple system atrophy patients from healthy controls and may be used for the early diagnosis of Parkinson's disease and multiple system atrophy., Competing Interests: All authors declare no conflicts of interest., (© 2020 Yan et al. Published by IMR press.)

Background: The present study explored the role and mechanism of microRNA-874-3p (miR-874-3p) in the migration of the osteosarcoma cell line, U-2 OS., Methods: The expression profile of osteosarcoma (OS) microRNA (GSE65071) datasets was downloaded from the Gene Expression Omnibus (GEO) database (https://www.ncbi.nlm.nih.gov/geo) to identify differentially expressed miRNAs in OS and its biological functions. A quantitative reverse transcription-polymerase chain reaction was performed to detect the expression of miR-874-3p and its target gene regulator of G protein 4 (RGS4) in human osteosarcoma cells U-2 OS and normal osteoblast hFOB1.19. Plasmid overexpression miR-874-3p and pcDNA-RGS4 were transfected into U-2 OS using Lipofectamine 2000 (Thermo Fisher, Waltham, MA, USA). Cell migration was measured using Transwell migration assays. Bioinformatic analysis and luciferase reporter assay were conducted to search for the target gene of miR-874-3p., Results: In total, 167 differentially expressed miRNAs were detected after the analysis of GSE65071; of which 78 were up-regulated genes and 89 were down-regulated. miR-874-3p was down-regulated and selected for further analysis. The expression level of miR-874-3p in U-2 OS cells was significantly decreased compared to the hFOB1.19 cell line (p < 0.05). Overexpression of miR-874-3p significantly inhibited the proliferation and migration of U-2 OS cells and overexpression of RGS4 reversed the inhibitory effect of miR-874-3p on U-2 OS cells. Through luciferase report analyses and bioinformatic analysis, RGS4 may be the candidate target gene of miR-874-3p., Conclusions: In conclusion, overexpression of miR-874-3p suppressed OS cell proliferation and migration. Thus, miR-874-3p might present a therapeutic agent for the treatment of OS., (© 2020 John Wiley & Sons, Ltd.)

Background: The relationship between risk factor or biomarker trajectories and contemporaneous short-term clinical outcomes is poorly understood. In diabetes patients, it is unknown whether hemoglobin A1c (HbA1c) trajectories are associated with clinical outcomes and can inform care in scenarios in which a single HbA1c is uninformative, for example, after a diagnosis of coronary artery disease (CAD)., Objective: To compare associations of HbA1c trajectories and single HbA1c values with short-term mortality in diabetes patients evaluated for CAD DESIGN: Retrospective observational cohort study PARTICIPANTS: Diabetes patients (n = 7780) with and without angiographically defined CAD MAIN MEASURES: We used joint latent class mixed models to simultaneously fit HbA1c trajectories and estimate association with 2-year mortality after cardiac catheterization, adjusting for clinical and demographic covariates., Key Results: Three HBA1c trajectory classes were identified: individuals with stable glycemia (class A; n = 6934 [89%]; mean baseline HbA1c 6.9%), with declining HbA1c (class B; n = 364 [4.7%]; mean baseline HbA1c 11.6%), and with increasing HbA1c (class C; n = 482 [6.2%]; mean baseline HbA1c 8.5%). HbA1c trajectory class was associated with adjusted 2-year mortality (3.0% [95% CI 2.8, 3.2] for class A, 3.1% [2.1, 4.2] for class B, and 4.2% [3.4, 4.9] for class C; global P = 0.047, P = 0.03 comparing classes A and C, P > 0.05 for other pairwise comparisons). Baseline HbA1c was not associated with 2-year mortality (P = 0.85; hazard ratios 1.01 [0.96, 1.06] and 1.02 [0.95, 1.10] for HbA1c 7-9% and ≥ 9%, respectively, relative to HbA1c < 7%). The association between HbA1c trajectories and mortality did not differ between those with and without CAD (interaction P = 0.1)., Conclusions: In clinical settings where single HbA1c measurements provide limited information, HbA1c trajectories may help stratify risk of complications in diabetes patients. Joint latent class modeling provides a generalizable approach to examining relationships between biomarker trajectories and clinical outcomes in the era of near-universal adoption of electronic health records.

We report how the nanoconfined environment, introduced by the mechanical bonds within an electrochemically switchable bistable [2]rotaxane, controls the rotation of a fluorescent molecular rotor, namely, an 8-phenyl-substituted boron dipyrromethene (BODIPY). The electrochemical switching of the bistable [2]rotaxane induces changes in the ground-state coconformation and in the corresponding excited-state properties of the BODIPY rotor. In the starting redox state, when no external potential is applied, the cyclobis(paraquat- p -phenylene) (CBPQT 4+ ) ring component encircles the tetrathiafulvalene (TTF) unit on the dumbbell component, leaving the BODIPY rotor unhindered and exhibiting low fluorescence. Upon oxidation of the TTF unit to a TTF 2+ dication, the CBPQT 4+ ring is forced toward the molecular rotor, leading to an increased energy barrier for the excited state to rotate the rotor into the state with a high nonradiative rate constant, resulting in an overall 3.4-fold fluorescence enhancement. On the other hand, when the solvent polarity is high enough to stabilize the excited charge-transfer state between the BODIPY rotor and the CBPQT 4+ ring, movement of the ring toward the BODIPY rotor produces an unexpectedly strong fluorescence signal decrease as the result of photoinduced electron transfer from the BODIPY rotor to the CBPQT 4+ ring. The nanoconfinement effect introduced by mechanical bonding can effectively lead to modulation of the physicochemical properties as observed in this bistable [2]rotaxane. On account of the straightforward synthetic strategy and the facile modulation of switchable electrochromic behavior, our approach could pave the way for the development of new stimuli-responsive materials based on mechanically interlocked molecules for future electro-optical applications, such as sensors, molecular memories, and molecular logic gates.

Objective: To evaluate the efficacy and safety of Tongning Gel (TNG) compared to placebo-controlled (PC) for knee osteoarthritis (KOA)., Methods: A multicentre, randomized, double-blinded, parallel, placebo-controlled, clinical trial was performed in 576 patients (432 patients in the TNG group, 144 patients in the PC group), and 1 in the experimental group withdrew due to nonuse of drug. Patients were randomized to receive TNG or PC applied to knee skin at 3g per time, 2 times per day, which lasted for 3 weeks. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score was used to evaluate the primary efficacy of TNG and WOMAC stiffness and physical function and total scores were used to evaluate the secondary efficacy of TNG. All participants who received at least one dose of study drug were included in the safety analysis. This trial has been registered in Chinese Clinical Trial Registry (no. CTR20131276)., Results: Primary efficiency outcome: there were significant differences in the decreased value of WOMAC pain score between two groups ( P < 0.05), and the decreased value of WOMAC pain score in the TNG group were better than those in the PC group ( P < 0.05). Secondary efficiency outcome: the WOMAC total score, WOMAC stiffness score, WOMAC physical function score, and the decrease of the above indexes of the two groups of patients after treatment were statistically significant ( P < 0.05), and the improvement of the above indexes in the TNG group was better than that of the PC group ( P < 0.05). Safety Evaluation . A total of 42 adverse events were reported by 29 patients: 25 adverse events reported by 16 patients (3.71%) in the experimental group and 17 adverse events were reported by 13 patients (9.03%) in the control group. And 8 adverse reactions were reported by 6 patients including 2 adverse reactions by 2 patients (0.46%) in the experimental group and 6 adverse reactions by 4 patients (2.78%) in the control group. Two cases of significant adverse events occurred in the experimental group. Both groups had one serious adverse event, respectively, which were not relevant to the intervention., Conclusion: These results of the trial demonstrate that TNG is superior to placebo in the treatment of patients with KOA, and TNG can improve other symptoms of KOA, such as stiffness and physical function. TNG is safe for the treatment of knee osteoarthritis as a whole., Competing Interests: There are no conflicts of interest regarding the publication of this paper., (Copyright © 2020 Ye Zhao et al.)

Successful completion of the molting process requires new epidermal growth and ecdysis of the old cuticle in Haemaphysalis longicornis ( H. longicornis ). MicroRNAs (miRNAs) participate in the development of organisms by inhibiting the expression of their target mRNAs. In this study, a novel tick-specific miRNA was identified and denoted hlo-miR-2 that serves as a novel regulator of molting events in H. longicornis nymphs by targeting a cuticular protein. The full length of this cuticular protein was first obtained and named it CPR1. A qRT-PCR analysis showed that hlo-miR-2 and CPR1 exhibit significant tissue and temporal specificity and that their transcription levels are negatively correlated during the molting process. CPR1, as a direct target of hlo-miR-2, was identified by a luciferase reporter assay in vitro . Agomir treatment indicated that the overexpression of hlo-miR-2 significantly reduced the protein expression level of CPR1, decreased the molting rate and delayed the molting time point in H. longicornis nymphs. RNA interference (RNAi) experiments demonstrated that CPR1 was significantly associated with the molting process in H. longicornis nymphs. Phenotypic rescue experiments convincingly showed that hlo-miR-2 participated in molting events by targeting CPR1 in H. longicornis nymphs. In summary, we present evidence demonstrating that miRNAs constitute a novel important regulator of molting events in addition to hormones. The described functional evidence implicating CPR1 in molting events contributes to an improved understanding of the distinct functions of the CPR family in ticks and will aid the development of a promising application of cuticular protein RNAi in tick control., (Copyright © 2020 Liu, Luo, Ren, Qu, Lin, Xu, Ni, Xiao, Chen, Rashid, Wu, Tan, Qiu, Luo, Yin, Wang, Yang, Xiao and Liu.)