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Abstract Background The modified Dunn procedure has rapidly gained popularity as a treatment for slipped capital femoral epiphysis (SCFE) during the past few years. However, there is limited information regarding its safety and efficacy in severe slips with this procedure. The purpose of this study is to present clinical results and incidence of complications associated with the modified Dunn osteotomy in a consecutive series of severe SCFE cohort. Patients and methods We retrospectively assessed the outcomes of all twenty patients who had been treated with the modified Dunn procedure in our tertiary-care institution. According to the Loder and Fahey criteria, all cases were classified as severe slips; nineteen cases were stable, and one case was an unstable slip. All surgical procedures were performed by one senior orthopedic surgeon who had specific training in the modified Dunn procedure. Operative reports, outpatient records, follow-up radiographs, and the intraoperative findings were reviewed to determine the demographic information, type of fixation, final slip angle, presence of avascular necrosis (AVN), and any additional complications. The mean age of the patients was 13.2 ± 1.6 years (range, 10 to 17 years). Twenty patients (twenty-one hips) with a mean of 31.2 ± 14 months (range, 12 to 57 months) follow-up met the inclusion criteria. Pain and function were assessed by the modified Harris score and WOMAC score. Radiographic anatomy was measured using the slip angle and α-angle. The radiographic findings related to the anatomy of the femoral head-neck junction, as well as signs of early-onset of osteoarthritis (OA) and AVN, were evaluated pre- and postoperatively. Results Overall, nineteen patients had excellent clinical and radiographic outcomes with respect to hip function and radiographic parameters. One patient (5%) who developed implant failure at 3 months postoperatively had a poor outcome. The mean preoperative slip angle was corrected from 63.2 ± 8.1° (range, 51 to 84°) to a normal value of 7.5 ± 3.5° (range, 2 to 15°) (p < 0.01). The mean α-angle was improved from an average of 94.5 ± 21.1° (range, 61 to 123°) to postoperative 42 ± 6.4° (range, 25 to 55°) (p < 0.01). The mean modified Harris hip and WOMAC scores postoperatively were 96.7 ± 13.4 (range, 40 to 100) and 95.4 ± 10.6 (range, 38 to 100), respectively. There were no cases of the development of femoroacetabular impingement (FAI) and the progression of OA. We did not record any case of AVN, closure of the growth plate, heterotopic ossification (HO), trochanteric nonunion, or limb length discrepancy that occurred postoperatively either at the most recent follow-up. Conclusions Our series of severe SCFEs treated with the modified Dunn osteotomy demonstrated that the procedure is safe and capable of restoring more normal proximal femoral anatomy by maximum correction of the slip angle, minimizing probability of secondary FAI and early onset of OA. However, despite its lower surgical complication rate compared with alternative treatment described in the literature for SCFE, AVN can and do occur postoperatively which should always be concerned in every hip.

Abstract Aliphatic allylic amines are common in natural products and pharmaceuticals. The oxidative intermolecular amination of C(sp3)-H bonds represents one of the most straightforward strategies to construct these motifs. However, the utilization of widely internal alkenes with amines in this transformation remains a synthetic challenge due to the inefficient coordination of metals to internal alkenes and excessive coordination with aliphatic and aromatic amines, resulting in decreasing the reactivity of the catalyst. Here, we present a regioselective Cu-catalyzed oxidative allylic C(sp3)-H amination of internal olefins with azodiformates to these problems. A removable bidentate directing group is used to control the regiochemistry and stabilize the π-allyl-metal intermediate. Noteworthy is the dual role of azodiformates as both a nitrogen source and an electrophilic oxidant for the allylic C-H activation. This protocol features simple conditions, remarkable scope and functional group tolerance as evidenced by >40 examples and exhibits high regioselectivity and excellent E/Z selectivity.

Background: Insomnia is a high-incidence complication in patients undergoing maintenance hemodialysis (MHD). Auricular therapy can effectively improve sleep with few adverse effects. Acupoint selection affects the impact of auricular therapy. However, there is currently a lack of analysis on the standards of acupoint selection. Our study used data mining technology to investigate the acupoint selection principles and characteristics of auricular therapy for the treatment of MHD-related insomnia. Objective: The objective of the study is to explore the standards of acupoint selection in auricular therapy for the treatment of MHD-related insomnia through data mining technology. Materials and Methods: We searched three English (PubMed, WOS, and Embase) and four Chinese (CNKI, VIP, Wangfang, and CBM) databases for studies on auricular therapy for MHD-related insomnia from self-establishment to November 14, 2022. Results: Eighty-one publications were involved, which included 33 acupoints. The most common auricular points in patients with MHD-related insomnia were the Shenmen, heart, and kidney points. More applications involved the visceral, nervous system, and specific acupoints. Five effective clusters and two clusters were obtained through cluster analysis, including specific auricular points for insomnia, such as the multi-dream area, neurasthenia area, deep sleep point, and anterior ear lobe. Complex network analysis showed that the core auricular acupoint combinations for the intervention of MHD-related insomnia were Shenmen with kidney, Shenmen with heart, heart with kidney, heart with Shenmen, and heart and Shenmen with subcortex. Conclusions: The selection of auricular points for the treatment of MHD-related insomnia was guided by the heart theory of traditional Chinese medicine. Clinical treatment attaches importance to the use of the multi-dream area, neurasthenia area, and other acupoints.

Abstract Background Lung salivary-type tumors originating from bronchial submucosal glands are rare, only four types of salivary gland-type tumors are listed in 2015 WHO classification of lung tumors. Here, we report a rare case of oncocytic carcinoma (OC) in the right main bronchus. Case presentation A 34-year-old man presented to our hospital with a two-month history of recurrent hemoptysis and with one month of inspiratory dyspnea. Pulmonary function tests showed mild restrictive ventilatory dysfunction and severe diffusion dysfunction. Furthermore, the flow volume loop showed a variable extra-thoracic obstruction. Computed tomography (CT) of the chest revealed that a polypiform nodule of 13 mm in diameter was at the proximal right main bronchus. Testing for purified protein derivative was positive (category 2). The nodule was resected under bronchoscopy. The bronchial aspirate was negative for mycobacterium tuberculosis and tumor cells. The biopsy sample showed a solid and acinar predominant pattern with abundant eosinophilic cytoplasm. The bronchial mucosa was destroyed and replaced by tumor cells. The loose edematous stromal reaction could be seen in a local area. Immunohistochemically, tumor cells were positive for CK, EMA, Vimentin, CD117, CK7, S100, Mammaglobin and SOX10. Only scattered tumor cells were stained by basal cell markers, including CK5/6, P40 and P63. Electron microscopy revealed numerous swelling mitochondria with lacking mitochondrial cristae in tumor cells. Fluorescence in situ hybridization (FISH) testing for MAML2 and ETV6 rearrangement were negative. Next-generation sequencing analysis of 520 genes in the tissue biopsy specimen showed no somatic mutation. The diagnosis of OC was made. Subsequently, the patient underwent a right upper lobectomy with sleeve resection of the main bronchus and lymph dissection. No recurrent evidence was seen during two years of chest CT follow-up. Conclusions To our knowledge, this is the first case of primary OC in the bronchus. This patient has no recurrence during two years of follow-up, indicating that primary OC in the bronchus has the same favorable prognosis as in salivary glands. Moreover, complete excision and thorough sampling to know the invasive growth pattern is important to reach the correct diagnosis.

Abstract To investigate whether the combination scheme of deep learning score (DL-score) and radiomics can improve preoperative diagnosis in the presence of micropapillary/solid (MPP/SOL) patterns in lung adenocarcinoma (ADC). A retrospective cohort of 514 confirmed pathologically lung ADC in 512 patients after surgery was enrolled. The clinicoradiographic model (model 1) and radiomics model (model 2) were developed with logistic regression. The deep learning model (model 3) was constructed based on the deep learning score (DL-score). The combine model (model 4) was based on DL-score and R-score and clinicoradiographic variables. The performance of these models was evaluated with area under the receiver operating characteristic curve (AUC) and compared using DeLong's test internally and externally. The prediction nomogram was plotted, and clinical utility depicted with decision curve. The performance of model 1, model 2, model 3 and model 4 was supported by AUCs of 0.848, 0.896, 0.906, 0.921 in the Internal validation set, that of 0.700, 0.801, 0.730, 0.827 in external validation set, respectively. These models existed statistical significance in internal validation (model 4 vs model 3, P = 0.016; model 4 vs model 1, P = 0.009, respectively) and external validation (model 4 vs model 2, P = 0.036; model 4 vs model 3, P = 0.047; model 4 vs model 1, P = 0.016, respectively). The decision curve analysis (DCA) demonstrated that model 4 predicting the lung ADC with MPP/SOL structure would be more beneficial than the model 1and model 3 but comparable with the model 2. The combined model can improve preoperative diagnosis in the presence of MPP/SOL pattern in lung ADC in clinical practice.

Objective: To explore the regulatory mechanism of competitive endogenous RNAs (ceRNA) in gastric cancer (GC) and to predict the prognosis of GC. Materials and Methods: Expression profiles of long noncoding RNAs (lncRNAs), microRNAs (miRNAs), and mRNAs were obtained from The Cancer Genome Atlas platform. Differentially expressed RNAs (DERNAs) were screened to construct a lncRNA-miRNA-mRNA ceRNA network. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses were performed on the ceRNA network-related differentially expressed mRNAs (DEmRNAs). Next, the DERNAs were subjected to Cox regression and survival analyses to identify crucial prognostic factors for patients with GC. Results: We detected 1029 differentially expressed lncRNAs, 104 differentially expressed miRNAs, and 1659 DEmRNAs in patients with GC. Next, we performed bioinformatic analysis to construct the lncRNA-miRNA-mRNA ceRNA network, which included 10 miRNAs, 65 lncRNAs, and 10 mRNAs. Subsequently, KaplanMeier (K-M) analysis showed that the survival rate of the high-risk group was significantly lower than that of the low-risk group, and the area under the curve value of the receiver operating characteristic curve revealed that the polygenic model had good predictive ability. The results indicated that ADAMTS9-AS1, ATAD2, and CADM2 might be potential therapeutic targets and prognostic biomarkers for GC. Conclusions: Our study has implications for predicting prognosis and monitoring surveillance of GC and provides a new theoretical and experimental basis for the clinical prognosis of GC.

Abstract. Background:. Autologous fat grafting has gained popularity in breast augmentation. Various methods can be used to estimate the volume retention rate. This systematic review aimed to establish whether the type of method used for measuring breast volume is a factor that influences the reported volume retention rate. Methods:. Studies were identified using the electronic databases PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science from inception of the database up to February 2019. Articles describing autologous fat grafting for breast augmentation were selected based on pre-determined inclusion and exclusion criteria. The characteristics of the included studies were summarized, and the reported volume retention rate from the studies was compared. A quality assessment of all included articles was performed using the methodological index for non-randomized studies criteria. Results:. A total of 618 articles were identified, of which 12 studies, with a total of 1337 cases, were eligible. The retention rate of injected adipose tissue varied when the method of fat grafting and volume analysis used were both the same, as well as when the method of fat grafting was the same but the method of volumetric evaluation used was different. Conclusions:. Currently, the tools available for estimating the volume retention rate come with limitations. In order to objectively evaluate the percentage of graft retention, a standard protocol that applies to the different methods should be established in the future.

In order to solve the problem of poor antiimpact ability of hydraulic support under rock bursting, a kind of thin-walled cylinder crushing component used in the composite spiral antiimpact device was developed, and different structural models were proposed and simulated. On this basis, the model was verified by experiments. The results show that the arrangement of the hollow structure can restrain the ring mode deformation and Euler instability of the tube member in the crushing yield and can carry out the buckling deformation according to the expected crushing force during the compression deformation process and effectively reduce the initial peak force. The arrangement of guide grooves can make the buckling deformation more stable and regular, which can effectively reduce the initial peak force and elastic displacement. With the smaller wall thickness and the smaller wall thickness of the induced groove, the effective deformation yield stroke of the crushing member increases, and the initial peak force, total energy absorption, average reaction force, and elastic displacement decrease. The simulation results are consistent with the experimental results which will be used in the future works.

Osteoarthritis (OA) is a common and dynamic disease of the joints, including the articular cartilage, underlying bones and synovium. In particular, OA is considered as the degeneration of the cartilage. Tectorigenin (Tec) is known to affect many biological processes; however, its effects on articular chondrocytes remain unclear. This study aimed to assess the effects of Tec on articular cartilage. In vitro, Tec inhibited the expression levels of type X collagen, cyclooxigenase-2, matrix metalloproteinase (MMP)-3 and MMP-13, but enhanced the expression of Runx1, type II collagen and aggrecan in the presence of IL-1β. Meanwhile, Tec inhibited apoptosis through the Bax/Bcl-2/caspase-3 pathway, upregulating p-Bad, downregulating the Bax/Bcl-2 ratio, and activating caspase-3 compared with IL-1β treatment only. Moreover, this process was partially regulated by NF-κB P65. In vivo, the chondroprotective effects of Tec were assessed by establishing a model of surgically induced OA. Tec-treated joints exhibited fewer osteoarthritic changes than saline-treated joints. Meanwhile, 1.5 μg/kg Tec treatment produced a greater protective effect than 0.75 μg/kg Tec. The Osteoarthritis Research Society International (OARSI) scoring system, employed to assess histopathological grading of the models, as well immunohistochemistry for Aggrecan Neoepitope and MMP-3, further confirmed the results. In conclusion, this study showed that Tec plays a chondroprotective role in the OA process by preventing articular cartilage degeneration and chondrocyte apoptosis via the NF-κB P65 pathway.

Abstract Buckwheat is a nutritional and economically crop belonging to Polygonaceae, Fagopyrum. To better understand the mutation patterns and evolution trend in the chloroplast (cp) genome of buckwheat, and found sufficient number of variable regions to explore the phylogenetic relationships of this genus, two complete cp genomes of buckwheat including Fagopyrum dibotrys (F. dibotrys) and Fagopyrum luojishanense (F. luojishanense) were sequenced, and other two Fagopyrum cp genomes were used for comparative analysis. After morphological analysis, the main difference among these buckwheat were height, leaf shape, seeds and flower type. F. luojishanense was distinguishable from the cultivated species easily. Although the F. dibotrys and two cultivated species has some similarity, they different in habit and component contents. The cp genome of F. dibotrys was 159,320 bp while the F. luojishanense was 159,265 bp. 48 and 61 SSRs were found in F. dibotrys and F. luojishanense respectively. Meanwhile, 10 highly variable regions among these buckwheat species were located precisely. The phylogenetic relationships among four Fagopyrum species based on complete cp genomes was showed. The results suggested that F. dibotrys is more closely related to Fagopyrum tataricum. These data provided valuable genetic information for Fagopyrum species identification, taxonomy, phylogenetic study and molecular breeding.

In order to achieve the high efficiency and stable cushioning effect under the uncertain impacting situation, a digital hydraulic damper is developed which can adjust the whole buffering capacity so as to be adaptable to the impacting load on time during the buffering process. In the paper, the mechanism of energy dissipation in the digital hydraulic damper and the whole damping process are studied. The relationship between the energy dissipation process and the control process is given. Firstly, the energy dissipation process of the digital throttling unit is studied, and the mathematical model of energy losses of the digital hydraulic damper unit and the energy dissipation model of the whole digital damper are established. The energy dissipation model of the digital hydraulic buffer is proposed. Secondly, the effect on energy losses caused by the three elements of the digital damper, which are the sudden extension of cross section, form of orifice, and form of cone valve port, is analyzed. Finally, based on the energy dissipation model, the control model of the energy dissipation process is given, which lays a theoretical foundation for detailed structural design and control optimization.

To study the load transfer characteristics of a two-legged shield powered support, a numerical simulation model of the support was established using the multibody dynamics software ADAMS. The model took full account of the hydraulic-elastic deformation characteristics of the support, as a series spring-damper system was used to replace the leg and the equilibrium jack. The canopy, goaf shield, lemniscate bars, and equilibrium jack are equivalent to flexible bodies. The setting force of the leg was provided by the preload of the equivalent spring, the static roof load was simulated using a slope signal, and the impact load was simulated using a step signal. Using the model, the impact and excitation effects of each hinge joint of the support were analyzed under different impact load conditions across the canopy. The results show that the location of the impact load affects the force transmissions of all hinge points of the support. Both the impact effect and the excitation effect are at a minimum when the impact force is located near the leg action line. These results are useful for the adaptive control and structural design optimization of the support.

Kidney governing bone theory plays an important role in treating bone metabolic disease such as osteoporosis, and many tonifying kidney prescriptions/herbs are widely used in Traditional Chinese Medicine (TCM). However, the exact biological basis of kidney governing bone theory in the context of new advances in biology is still not fully established. In this paper, the content of kidney governing bone theory in biology has been fully demonstrated from different aspects. We first propose that bone and kidney mutually affect each other in pathology and physiology, particularly through homeostasis of calcium, phosphorus and fibroblast growth factor-23(FGF-23). Next, we identify that tonifying kidney prescriptions/herbs exert bone protective effects, thus treating osteoporosis by regulating bone formation and bone resorption. Furthermore, the exact molecular mechanisms of tonifying kidney prescriptions, herbs and their effective components in treating osteoporosis have been systematically reviewed. Finally, we come into the conclusion that kidney regulating bone mineral homeostasis, bone protective effects of tonifying kidney herbs and regulatory effects on bone homeostasis are all the manifestations of kidney governing bone theory. Therefore, the new insights into kidney governing bone theory in biology will promote the development of clinical practices, and drugs discovery in treating osteoporosis.