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Introduction: Patient satisfaction after arthroscopic rotator cuff repair (RCR) is commonly assessed with patient-reported outcome measures (PROMs), and there is an increased need to establish clinical relevance within these measures. The purpose of this study was to (1) define minimal clinically important difference (MCID), patient acceptable symptomatic state (PASS), and substantial clinical benefit (SCB) for the visual analog scale (VAS) pain score in patients undergoing arthroscopic RCR, and (2) identify preoperative predictors of achieving each of these threshold values., Methods: Data from consecutive patients who underwent primary arthroscopic rotator cuff repair study between 2010 and 2016 were prospectively collected. Baseline data and VAS pain scores were collected preoperatively and at 1 year and 2 years postoperatively. MCID, PASS and SCB were determined using an anchor-based approach, with anchor questions assessing postoperative satisfaction and expectation fulfillment. Multivariate logistic regression analysis was also used to identify preoperative predictors for achieving MCID, PASS, and SCB., Results: A total of 286 patients were included in the final analysis, with an average age of 60.2 ​± ​10.4 and the majority being female (61.2%). The values for the VAS pain score identified to represent MCID, PASS, and SCB, respectively, at 1-year postoperatively were: 5, 2, and 1. The rates of achieving clinically significant improvement based on VAS were 60.5%, 63.3%, and 57.2%, respectively. A higher preoperative VAS was predictive for achieving MCID (odds ratio [OR], 1.84; P ​< ​0.01)., Conclusion: This study identified threshold VAS pain scores of 5, 2, and 1 for achieving MCID, PASS, and SCB, respectively, at 1-year follow-up after arthroscopic rotator cuff repair. A higher preoperative VAS pain score was also identified as a statistically significant predictor of attaining MCID after arthroscopic rotator cuff repair., Level of Evidence: II., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: There is paucity of literature on the impact of patients' gender on recovery and treatment success after arthroscopic rotator cuff repair. This study investigates the effect of gender on patient-reported outcomes preoperatively and postoperatively (minimum 2 years), and to determine if gender affects the attainment of patient-acceptable symptomatic state (PASS) thresholds., Methods: 266 patients (117 males, 149 females), who underwent primary arthroscopic rotator cuff repair for atraumatic, full-thickness tears, were included. Functional outcomes and pain scores were collected preoperatively and postoperatively. Percentage of attainment of PASS for the various outcome scores was calculated and compared between males and females., Results: Women had statistically significantly poorer functional outcome and pain scores preoperatively and at 1 and 2 years postoperatively (P ​< ​0.01). They also experienced less improvement in outcome scores throughout the postoperative period. Women had statistically significantly lower rates of PASS attainment at 2 years postoperatively., Conclusion: Women experience greater pain and poorer shoulder function compared with men preoperatively, and up to 2 years postoperatively. Women are less likely to achieve PASS thresholds postoperatively, compared to their male counterparts., Study Design: Retrospective Cohort Study., Level of Evidence: III., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Reverse shoulder arthroplasty is typically indicated for patients with severe shoulder osteoarthritis, rotator cuff tear arthropathy, or proximal humerus fractures that have failed to heal properly. The primary goal of reverse shoulder arthroplasty is to improve shoulder function and reduce pain, while also restoring the ability to perform daily activities. There is a growing body of evidence supporting the effectiveness of reverse shoulder arthroplasty in improving shoulder function and reducing pain in patients with severe shoulder osteoarthritis or rotator cuff tear arthropathy. Reverse shoulder arthroplasty is associated with significant improvements in shoulder function and pain reduction compared to non-surgical treatments. This paper aims to summarize current knowledge, practices and present a summary of the long-term effects of reverse shoulder arthroplasty (RSA) on patient outcomes, including how these outcomes are defined and what measures are typically used to assess them. It will also cover newer definitions of outcomes for RSA that have been developed in recent years in order to better understand the long-term effects of the procedure on patient-reported outcomes and functional ability, as well as information on revision surgery and implant survivorship, and the future of RSA (3D-navigation, patient-specific instrumentation, robotics and artificial intelligence) and its effects on outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Study Design: Retrospective review of prospective data., Objectives: Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) may be beneficial for elderly patients due to decreased surgical morbidity and faster postoperative recovery. This study compared the clinical and radiological outcomes of MIS-TLIF in elderly patients and younger controls at minimum 5-year follow-up., Methods: There were 120 patients who underwent single-level MIS-TLIF for degenerative spondylolisthesis. Elderly patients (≥70 years; n = 30) and controls (<70 years; n = 90) were matched 1:3 for demographics, comorbidities and preoperative patient-reported outcomes (PROs). The Oswestry Disability Index (ODI), 36-Item Short-Form Physical (SF-36 PCS) and Mental Component Summary (SF-36 MCS), Visual Analogue Scale (VAS) back pain, and VAS leg pain were compared at 6 months, 2 years and 5 years. Radiographic fusion, adjacent segment degeneration (ASD) and revision rates were assessed at mean 7.2 ± 2.0 years., Results: Elderly patients had longer length of stay (4.7 ± 5.8 vs 3.3 ± 1.4 days, P = .035) and more readmissions (10% vs 1%, P = .019), but there was no difference in operative time, transfusions, complications or discharge disposition. All PROs were comparable at 5 years and satisfaction rates were similar (93% elderly vs 91% controls, P = .703). The rates of radiographic fusion in the control group and elderly group were similar (94% vs 97%, P = .605), as were the rates of ASD (40% vs 33%, P = .503). There were 3 revisions (3.3%) in the control group (2 for ASD, 1 for screw loosening) but none in the elderly group ( P = .311)., Conclusions: Elderly patients undergoing MIS-TLIF achieved similar improvements in pain, disability and quality of life that were sustained at 5 years. Level of Evidence: Level III, retrospective cohort study., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Current literature lacks consensus regarding the impact of obesity on clinical outcomes of total hip arthroplasty (THA). The variability of results may reflect the lack of minimal clinically important difference (MCID) analysis, which helps to standardise the interpretation of patient-reported outcome measures (PROMs). We compared the PROMs, patient satisfaction and survivorship between obese and non-obese patients after THA., Methods: Prospectively collected registry data of 192 obese patients and 192 propensity score-matched controls who underwent primary THA at a single institution were reviewed. Clinical outcomes and satisfaction rates were assessed at 6 months and 2 years. Reoperations for surgical complications and revision rates were analysed., Results: Obese patients had a significantly poorer Oxford Hip Score (OHS) at 6 months and WOMAC-Function at 2 years. However, there was no difference in overall WOMAC, WOMAC-Pain, WOMAC-stiffness, SF-36 mental and physical component summary (PCS). A similar proportion of patients in each group achieved the MCID for OHS, WOMAC and SF-36 PCS. At 2 years, 90.3% of obese patients and 91.7% of controls were satisfied ( p  = 0.755). At a mean follow-up of 9 years, there were 5 reoperations (2.6%) for surgical complications in the obese group and 1 (0.5%) in the control group; whereas 12 revisions (6.3%) were recorded in the obese group and 3 (1.6%) in the control group ( p  = 0.021)., Conclusions: Despite a higher revision rate, obese patients undergoing THA may experience a similar level of clinical meaningful improvement and satisfaction as their non-obese counterparts. This study provides valuable prognostic information for obese patients and guides preoperative counselling.

Case: A 55-year-old man with Down syndrome (DS) suffered from chronic irreducible right patellar dislocation. Imaging studies showed an attenuated appearance of the medial patellar retinaculum, and the tibial tubercle to trochlear groove distance measured 1.6 cm. Right medial patellofemoral ligament reconstruction (MPFLR) and lateral lengthening (LL) with proximalization of the tibial tubercle (PTT) were performed with good surgical outcomes., Conclusion: The combination of MPFLR, LL, and PTT is a viable option for treating a skeletally mature DS patient with patellofemoral instability causing recurrent patellar dislocation., Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B842)., (Copyright © 2022 by The Journal of Bone and Joint Surgery, Incorporated.)

Background: The literature on minimal clinically important differences (MCIDs) for patient-reported outcome measures assessing shoulder instability is limited, with none addressing the Oxford Shoulder Instability Score (OSIS). The OSIS was developed to provide a standardized method for assessing shoulder function after surgery for shoulder instability, and previous studies have demonstrated its high reliability, low interrater variability, and ease of administration., Purpose: To identify the MCID for the OSIS after arthroscopic Bankart repair for recurrent shoulder instability., Study Design: Case series; Level of evidence, 4., Methods: A longitudinally maintained institutional registry was queried for patients who underwent arthroscopic Bankart repair from 2010 to 2016 for recurrent shoulder instability secondary to a Bankart lesion without significant glenoid bone loss. The OSIS was completed preoperatively and at 1 year postoperatively. Patients were categorized into "expectations met" and "expectations unmet" groups using a questionnaire evaluating expectation fulfilment. The MCID of the OSIS at 1 year was calculated using 3 anchor-based approaches and a distribution-based approach. The 3 anchor-based approaches comprised (1) simple linear regression analysis, (2) receiver operating characteristic curve analysis, and (3) calculation of mean differences in change for the OSIS between the "expectations met" and "expectations unmet" groups., Results: The study cohort comprised 68 men and 11 women aged 29.9 ± 12.7 years (mean ± SD). Duration of follow-up for all patients exceeded 1 year. The MCIDs for the OSIS based on the 4 calculation approaches yielded a narrow range of values, ranging from 7.7 to 8.5 for the anchor-based methods and 8.6 for the distribution-based method., Conclusion: Study results indicated that patients with recurrent shoulder instability without significant bone loss who undergo primary arthroscopic Bankart repair and have at least 8.6 points of improvement on their OSIS experience a clinically significant change at 1 year postoperatively., Competing Interests: The authors have declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2022.)

Background: Despite the expanding indications for unicompartmental knee arthroplasty (UKA), the classic indication that limits flexion contracture to <5° in fixed bearing UKA excludes most patients with arthritic knees and has not been challenged in modern literature. This study compared the clinical outcomes between patients with severe flexion contracture and controls undergoing UKA., Methods: Eighty seven medial fixed bearing UKAs performed in patients with severe (≥15°) flexion contracture were matched 1:1 with 87 controls without flexion or recurvatum deformity (-5°

Background: Parkinson's disease (PD) may negatively influence the rehabilitative course after total knee arthroplasty (TKA). However, functional outcomes in this select group remain poorly defined. We compared complication, mortality and revision rates, as well as patient-reported outcomes, and satisfaction between patients with PD and controls after TKA., Methods: Patients with PD who underwent primary unilateral TKA were identified and matched 1:1 with a control group using propensity scores adjusting for age, sex, body mass index, Charlson Comorbidity Index, baseline range of motion, Knee Society Knee Score, Knee Society Function Score, Oxford Knee Score, and 36-item Short-Form Health Survey Mental and Physical Component Summary. Functional outcomes and patient satisfaction were assessed at 6 months and 2 years. Complications, survivorship, and all-cause mortality were analyzed., Results: In total, 114 patients were included. Majority of PD patients had Hoehn and Yahr stage 1 or 2 disease. Overall complication rate was 26.3% in the PD group and 10.5% in the control group (P = .030). There was no difference in transfusions, length of stay, and discharge to rehabilitation or readmissions. Patients with PD had more flexion contractures, poorer Knee Society Function Score and Oxford Knee Score at 2 years, and poorer 36-item Short-Form Health Survey Physical Component Summary at 6 months. 80.4% of patients with PD were satisfied compared with 85.5% of controls (P = .476). At follow-up of 8.5 ± 2.7 years, one TKA was revised in each group. All-cause mortality was higher in the PD group (15.8% vs 5.3%, P = .067)., Conclusion: Although patients with PD had relatively poorer knee function and quality of life, these patients still experienced significant functional gains compared with their preoperative status, and high satisfaction was achieved., Level of Evidence: III., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Some studies have suggested that women have poorer short-term outcomes after unicompartmental knee arthroplasty (UKA) due to a higher incidence of implant overhang. This study aimed to compare patient-reported outcome measures (PROMs) between men and women after UKA at a minimum follow-up of 10 years., Methods: Patients who underwent medial fixed-bearing UKA by two arthroplasty surgeons were identified from an institutional joint registry. Men and women were matched for age, body mass index, Charlson Comorbidity Index, American Society of Anesthesiologists class, range-of-motion and baseline PROMs using propensity scores. PROMs were compared at 2 and 10 years. Patients also completed a satisfaction questionnaire during these visits. Radiographic outliers were defined as > 2 mm of overhang., Results: A total of 128 patients were included. There was no difference in complications, length of stay or readmissions. Women had poorer Knee Society functional scores, Short-Form 36 physical and mental component scores (SF-36 MCS) at 2 years. No difference in PROMs was found at 10 years, except for poorer SF-36 MCS in women (P = 0.041). At 10 years, 96% of women and 92% of men were satisfied (P = 0.243). Fifteen-year survivorship free from any revision was 96% in each group. There were more medial-tibial outliers in women (9%) compared with men (5%) (P = 0.018). However, no association between outliers and outcomes or survivorship was found on multivariate analyses., Conclusion: There was nodifference in clinical outcomes between men and women undergoing UKA at a minimum follow-up of 10 years. While women had a higher incidence of medial tibial overhang, this was not associated with long-term outcomes or survivorship., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Scapulothoracic bursitis is a significant clinical condition that limits day-to-day function. Arthroscopic scapular debridement and resection have provided satisfactory outcomes; however, techniques, approaches, and recommendations remain varied. Novel bony parameters have also gained increasing interest owing to their value in preoperative planning., Purpose: To assess midterm clinical outcomes after the arthroscopic management of scapulothoracic bursitis and to identify and measure novel bony parameters on preoperative magnetic resonance imaging., Study Design: Case series; Level of evidence, 4., Methods: A total of 8 patients underwent arthroscopic scapular debridement and bursectomy; 5 of the 8 patients underwent additional medial scapulectomy. There were 5 male (62.5%) and 3 female (37.5%) patients with a mean age of 30.1 ± 12.3 years (range, 19-58 years). Inclusion criteria for surgery were patients with symptomatic scapulothoracic bursitis for whom extensive nonoperative modalities had been utilized for at least 6 months but failed. Outcome measures included the Oxford Shoulder Score (OSS), University of California Los Angeles (UCLA) shoulder rating scale, Constant Shoulder Score (CSS), and visual analog scale (VAS) for pain. The bony parameters included scapular shape, anterior offset, costomedial angle, and medial scapular corpus angle (MSCA)., Results: The follow-up duration was at least 2 years for all patients (mean follow-up, 25.0 ± 4.1 months [range, 24-35 months]). The majority of patients had a concave-shaped scapula (62.5%). The mean anterior offset was 24.3 ± 3.4 mm, and the mean costomedial angle was 132.3° ± 9.6°. Half the patients had a positive MSCA, while the other half had a negative MSCA. A statistically significant improvement was observed in the OSS, UCLA, CSS, and VAS scores from preoperatively to 2-year follow-up ( P < .001 for all). No complications were observed., Conclusion: Arthroscopic scapular debridement and resection provided satisfactory midterm clinical outcomes for the treatment of scapulothoracic bursitis., Competing Interests: The authors declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2021.)

Secret sharing is a widely-used security protocol and cryptographic primitive in which all people cooperate to restore encrypted information. The characteristics of a quantum field guarantee the security of information; therefore, many researchers are interested in quantum cryptography and quantum secret sharing (QSS) is an important research topic. However, most traditional QSS methods are complex and difficult to implement. In addition, most traditional QSS schemes share classical information, not quantum information which makes them inefficient to transfer and share information. In a weighted threshold QSS method, each participant has each own weight, but assigning weights usually costs multiple quantum states. Quantum state consumption will therefore increase with the weight. It is inefficient and difficult, and therefore not able to successfully build a suitable agreement. The proposed method is the first attempt to build multiparty weighted threshold QSS method using single quantum particles combine with the Chinese remainder theorem (CRT) and phase shift operation. The proposed scheme allows each participant has its own weight and the dealer can encode a quantum state with the phase shift operation. The dividing and recovery characteristics of CRT offer a simple approach to distribute partial keys. The reversibility of phase shift operation can encode and decode the secret. The proposed weighted threshold QSS scheme presents the security analysis of external attacks and internal attacks. Furthermore, the efficiency analysis shows that our method is more efficient, flexible, and simpler to implement than traditional methods.

Background: Parkinson's disease (PD) adversely affects physical function after joint replacement. The biomechanical advantages of unicompartmental knee arthroplasty (UKA) may be particularly beneficial for these patients who suffer from gait and kinetic abnormalities. We aimed to describe the functional outcomes, complications and survivorship after UKA in patients with PD., Methods: Ten patients (11 knees) undergoing primary fixed-bearing UKA for medial osteoarthritis were studied. Knee Society Knee (KSKS) and Function Scores (KSFS), as well as the Short-Form-36 (SF-36) Mental (MCS) and Physical Component Scores (PCS) were assessed preoperatively, at six months and at two years postoperatively. Complications, survivorship and all-cause mortality were analyzed., Results: No perioperative complications occurred. Length of stay was 5 ± 2 days and no patients were discharged to rehabilitation or readmitted. Nine of 11 knees had a flexion contracture preoperatively and this remained unchanged at two years. KSKS and SF-36 PCS improved significantly. However, there was no improvement in KSFS or SF-36 MCS. All patients achieved minimal clinically important difference for KSKS, six of 11 for KSFS and nine of 11 for SF-36 PCS. At mean 10 ± 5 years, there was one revision for progression of osteoarthritis. Seven of 10 patients progressed in Hoehn and Yahr stage and only three were able to ambulate independently at last follow-up., Conclusions: Patients suffering from osteoarthritis and PD can experience a substantial improvement in knee pain with low morbidity after UKA. However, the improved kinematics of UKA did not translate to an improved range of motion or knee function postoperatively., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Although the influence of psychological distress on the outcomes of total knee arthroplasty has been described extensively, its effect on unicompartmental knee arthroplasty (UKA) is poorly defined. Furthermore, most studies in arthroplasty literature had short follow-ups of ≤1 year. We investigated the influence of psychological distress on long-term patient-reported outcomes and analyzed the change in mental health after UKA in a cohort with minimum 10 years of follow-up., Methods: Prospectively collected data of 269 patients undergoing UKA in 2004-2007 were reviewed. Patients were stratified into those with psychological distress (36-item Short-Form health survey [SF-36] Mental Component Summary [MCS] <50, n = 111) and those without (SF-36 MCS ≥50, n = 158). Clinical outcomes were obtained preoperatively, at 2 years, and 10 years. Multiple regression was used to control for age, gender, body mass index, Charlson Comorbidity Index, American Society of Anesthesiologists class, and baseline scores. The rate of expectation fulfillment and satisfaction was compared., Results: Psychologically distressed patients had poorer Knee Society Knee Score, Function Score, Oxford Knee Score, and SF-36 Physical Component Summary preoperatively, at 2 years, and 10 years. However, an equal proportion in each group attained the minimal clinically important difference for each score. Distressed patients had a comparable rate of satisfaction (91% vs 95%, P = .136) but lower fulfillment of expectations (89% vs 95%, P = .048). The percentage of distressed patients declined from 41% to 35% at follow-up. The mean SF-36 MCS improved by 6.9 points., Conclusion: Although psychologically distressed patients had relatively greater pain and poorer function preoperatively and up to 10 years after UKA, a similar proportion of them experienced a clinically meaningful improvement in patient-reported outcomes., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: Venous thromboembolism (VTE), comprising either deep vein thrombosis (DVT) and pulmonary embolism (PE), is one of the most significant complications after Total Hip Arthroplasty (THA). The incidence of VTE after Direct Anterior Approach (DAA) hip arthroplasty is not known. Preceding studies have shown that internal femoral rotation used in the posterior approach leads to "scissoring" of the femoral vein and complete occlusion of flow. In contrast, external femoral rotation, utilized in an anterior approach, does not lead to any limitation in venous flow. We hypothesize that the rate of VTE post-operatively after DAA THA is comparable, if not lower, to other conventional approaches., Methods: Retrospective analysis of medical records was examined to identify the incidence of symptomatic DVT within 6 months post-surgery, yielding 196 cases of elective primary DAA after THAs between 2015 and 2019. Aspirin was administered post-operatively. Corresponding imaging was performed for cases with high clinical suspicion of either DVT or PE based on Well's criteria., Results: There were no cases of symptomatic DVT or fatal PE within 1 year of THA. There was 1 case of non-fatal subsegmental pulmonary embolism, treated with warfarin, which made an uneventful recovery. The overall incidence of symptomatic DVT and PE after DAA THA was 0% and 0.5% respectively in our study population., Conclusion: Cumulative rate of symptomatic DVT and PE was less than 1%, demonstrating that incidence of VTE after DAA THA is low. DAA is a viable approach in Asian patients undergoing THA, in view of lower incidence of post-operative VTE compared values cited in other conventional surgical approaches. Further large scale studies involving use of routine post-operative venography for assessment will further validate our results., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.)

This research proposes the first one-out-of-two quantum oblivious transfer (QOT) scheme that does not have a two-level structure and is not subject to Lo's no-go theorem. Instead, the proposed scheme is a simple and efficient approach based on nonorthogonal states. The nonorthogonality causes one of a pair of messages to be unable to be measured to achieve the irreversible goal of discarding a message, resulting in a one-out-of-two selection effect. The proposed QOT protocol is therefore built directly on quantum resources rather than on a two-level structure in which two classical keys must first be created using quantum resources (all-or-nothing QOT) and then a one-out-of-two protocol is built from there. Furthermore, the proposed protocol allows Alice and Bob to test each other's loyalty by comparing measurement results. In addition, the relationship with the no-go theorem is discussed in detail; this relationship is often overlooked in other studies. A security analysis demonstrates that the proposed protocol is secure against both external and internal attacks. In addition, an efficiency analysis shows that the proposed protocol is more efficient than other, two-level-structured protocols.

This paper presents a novel dynamic group multi-party Quantum Key Agreement (DGMQKA) protocol, achieved by a multicast transmission method. The proposed method is able to achieve arbitrary number of groups and members under the same resources. In addition, it can be dynamically adjusted by joining a new member, combining two groups into one group, revoking an old member and dividing one group into two groups, for different and complex situations. Furthermore, the proposed protocol can be of help to research into Quantum Secret Sharing (QSS), which it complements. The security analysis shows that the proposed protocol can resist both external and internal attacks. In consumption comparison, the proposed protocol using the multicast transmission method is more effective than other current MQKA protocols.

For many malignancies, inflammation-based scores correlate with survival. The neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI) are immunonutritional indices associated with postoperative outcomes in patients with hepatocellular carcinoma (HCC). We evaluated whether a combined preoperative NLR and PNI score was prognostically superior to either index alone in 793 patients with unresectable HCC after transarterial chemoembolization. Patient demographic, clinical, and pathological data were also collected and analysed. A receiver-operating characteristic (ROC) analysis was used to classify patients as follows: NLR-PNI 0 group (NLR ≤ 2.2 and PNI > 46), NLR-PNI 1 group (NLR > 2.2 or PNI ≤ 46) and NLR-PNI 2 group (NLR > 2.2 and PNI ≤ 46). Regarding 1-, 3-, and 5-year survival, the NLR-PNI score had superior discriminative abilities (i.e., higher area under the ROC curve), compared with either the NLR or PNI alone, and patients in the NLR-PNI 0, 1, and 2 groups had median survival times of 33 (95% confidence interval: 22.8-43.2), 14 (10.9-17.1), and 6 (9.9-14.1) months, respectively. In multivariate analyses, the Barcelona Clinic Liver Cancer, total bilirubin, vascular invasion, and NLR-PNI score adversely affected overall survival. In conclusion, the NLR-PNI score can improve the accuracy of prognoses for patients with unresectable HCC.

Ammonium nitrogen (NH 4 + -N) at high concentrations is toxic to plants. In order to explore the NH 4 + -N tolerance of Myriophyllum aquaticum ( M. aquaticum ) and its ability of nitrogen (N) and phosphorus (P) uptake, this study used a nutrient solution with three NH 4 + -N levels (70, 210, 420 mg·L -1 ) to incubate M. aquaticum for 21 d. The characteristics of plant physiology and N and P uptake of M. aquaticum were measured. At NH 4 + -N of 70 mg·L -1 , M. aquaticum grew healthily, and shoot height and biomass linearly increased with the increase incubation time. Relative shoot height and biomass of M. aquaticum were 40.56 cm and 17.82 g·hole -1 on day 21, respectively. Compared to the control with 70 mg·L -1 ammonium, malondialdehyde (MDA) content of M. aquaticum was significantly increased; chlorophyll and soluble sugar contents were also high at NH 4 + -N of 210 mg·L -1 . M. aquaticum suffered from the NH 4 + -N stress. However, the stress of 210 mg·L -1 NH 4 + -N did not affect its normal growth and there was no significant difference in the relative growth rate of the shoot height and biomass compared with the control. At NH 4 + -N of 420 mg·L -1 , MDA contents of M. aquaticum doubled and the shoot height and biomass growth rate were only 27.4% and 17.9% of those for 70 mg·L -1 NH 4 + -N, indicating that M. aquaticum was subjected to serious stress that caused unhealthy growth or even death. At three NH 4 + -N levels, the ranges of N and P content of M. aquaticum were 30.7-53.4 mg·g -1 and 3.8-7.7 mg·g -1 , respectively, which indicated that M. aquaticum had a high uptake capacity of N and P. M. aquaticum is an ideal wetland plant that has a good application prospect for constructed wetlands in biological treatment of high-ammonia wastewater.

Prostate cancer (PC) is one of the most common cancers in males. MicroRNAs (miRNAs) are demonstrated to be involved in prostate cancer development and progression. Recently, miR-96 was identified to play a tumor promoting role in several tumors including PC, however, the underlying function of miR-96 in PC still need to be known. In the study, our results demonstrated that miR-96 was higher in prostate cancer tissues compared with adjacent normal tissues. Higher miR-96 was association with higher PSA level, lymph node metastasis, pathologic stage and distant metastasis in prostate cancer patients. Lose-of-function studies showed that down-regulated expression of miR-96 inhibited cell proliferation and cell cycle by regulating down-regulating CyclinA1, CDK2 and CDK4 expression in PC cells. Furthermore, we found that FOXF2 was a target of miR-96 in PC cells and miR-96 promoted cell proliferation by suppressing FOXF2 expression. Thus, these results showed that inhibition of miR-96 may be a target for prostate cancer treatment., Competing Interests: None., (IJCEP Copyright © 2017.)

Ammonia (NH 3 ) is the most abundant alkaline gas in the ambient air, and it is also one of the important precursors for the ammonium salts in aerosol and rainwater. Though the emission intensities of NH 3 and acidic gases are high, the concentrations and deposition rates of atmospheric ammonia-nitrogen (NH 3 -N), particulate ammonium-nitrogen (NH 4 + -N p ) and rainwater ammonium-nitrogen (NH 4 + -N r ) in double rice regions in subtropical China are still less known. In this study, atmospheric concentrations of NH 3 -N, NH 4 + -N p in PM 10 and NH 4 + -N r and related meteorological parameters were observed simultaneously in a typical double rice region in the subtropical hilly region of China, with the aim to clarify the characteristics and influencing factors of atmospheric NH 3 /NH 4 + -N concentrations and to quantify the wet and dry deposition rates of atmospheric NH 3 /NH 4 + -N. The results showed that the annual mean concentrations of nitrogen in NH 3 -N, NH 4 + -N p and NH 4 + -N r were 5.7 μg·m -3 , 12.8 μg·m -3 and 0.8 mg·L -1 , respectively, and their deposition rates were 8.38, 5.61 and 9.07 kg·(hm 2 ·a) -1 , respectively. The NH 3 -N concentration was significantly increased after application of nitrogen fertilizer in the paddy field, and had a significant positive correlation with the air temperature. The NH 4 + -N p concentration did not show significant correlation with NH 3 -N concentration, indicating that atmospheric NH 3 -N concentration was not the main limiting factor for the NH 4 + -N p pollution in the studied region. The NH 4 + -N r concentration was positively correlated with the NH 4 + -N p concentration but negatively correlated with precipitation. The high concentrations and deposition rates of atmospheric NH 3 -N/NH 4 + -N in the studied region indicated that the atmospheric NH 3 /NH 4 + -N pollution was serious, and atmospheric deposition of NH 3 /NH 4 + -N was an important nitrogen source in paddy fields, which should be considered in cropland nitrogen nutrient management.

Taking an example of Qianjiang City in Jianghan Plain, the distribution and dynamics of soil organic carbon (SOC) in croplands was studied in present study. The cropland included both paddy field and dry land. SOC contents were analyzed by taking soil samples of topsoil (0-20 cm) in 2011 according to land uses and soil types, and then compared with the initial SOC conducted in the period of the second soil survey (1983). The results showed that SOC density and storage in 2011 was 30.50 t . hm-2and 452. 82 x 10(4) t, respectively. During the past 28 years, the cropland SOC density was decreased at a rate of 0. 10 t . (hm2.a)-1, and SOC storage was reduced by 9% with the decreasing rate of 1. 53 t.a-1. SOC density and storage in paddy field was about 1. 6 and 1. 3 times over that in dry land in the two selected periods. However, the dynamics of SOC in paddy field and dry land were quite the opposite. In paddy field, SOC was lost by 16% (52. 83 x 10(4) t), with a decreasing rate of 0. 23 t . (hm2.a)-1; whereas in dry land, SOC was increased by 5% (8. 57 x 10(4) t), with an increasing rate of 0. 05 t . (hm2.a)-1. The loss of SOC in paddy field was mainly resulted from gleyed paddy soil, which suffered a fast decrease of SOC density and accounted for 80% of SOC lost in paddy field. In addition, Hydromorphic paddy soil, accounting for 50% of the area of paddy field, tended to loss another 15% of SOC in paddy field. While in dry land, the minor SOC storage increased was dominantly attributed to grey fluvo aquic soil, which accounted for 96% of the area of dry land. Thus, the dynamics of cropland SOC in Jianghan Plain was dominantly controlled by SOC changes in paddy field. Our findings suggest that effective management should be considered to enhance the capacity of SOC accumulation and sequestration in the low-yield paddy field and the types of soils that are large in area.

Objective: To compare the middle and long term results of two internal iliac artery exclusionmethods (with or without coils) in endovascular aorta repair (EVAR)., Methods: Clinical data of patients who underwent EVAR from January 2006 to December 2013 were analyzed retrospectively. The participants were divided into two group: coils were not used in Group A, but were used in Group B. The patients were followed up from June 2006 to June 2014., Results: A total of 137 patients (74 in Group A, 63 in Group B) were included in this study, with a mean age of 71. 6 years. The majority (124) of participants were men. Postoperative 30-day mortality of the participants was 0. 73%. None of the participants developed pelvic and spinal ischemia. Claudication appeared in 9 patients (3 in Group A and 6 in Group B). Ischemia in lower extremity happened in 5 patients (2 in Group A and 3 in Group B). Gluteal sore was reported by 5 patients (1 in Group A and 4 in Group B). One patient from Group B developed gluteal skin necrosis. No statistical difference in ischemia and stent occlusion was found between the two groups (P=0. 301, P=0. 108). However, patients in Group B stayed in hospitals longer (P<0. 001) than those in group A. One patient in Group B developed severe ischemic complication: skin and gluteus necrosis., Conclusion: Internal iliac artery exclusions with and without coilsresult in similar middle and long term outcomes measured by ischemic complications.

We propose a novel protocol for controlled bidirectional quantum secure communication based on a nonlocal swap gate scheme. Our proposed protocol would be applied to a system in which a controller (supervisor/Charlie) controls the bidirectional communication with quantum information or secret messages between legitimate users (Alice and Bob). In this system, the legitimate users must obtain permission from the controller in order to exchange their respective quantum information or secret messages simultaneously; the controller is unable to obtain any quantum information or secret messages from the decoding process. Moreover, the presence of the controller also avoids the problem of one legitimate user receiving the quantum information or secret message before the other, and then refusing to help the other user decode the quantum information or secret message. Our proposed protocol is aimed at protecting against external and participant attacks on such a system, and the cost of transmitting quantum bits using our protocol is less than that achieved in other studies. Based on the nonlocal swap gate scheme, the legitimate users exchange their quantum information or secret messages without transmission in a public channel, thus protecting against eavesdroppers stealing the secret messages.

Objective: To investigate the clinical and pathological characteristics and surgical treatment of carotid body tumor with endocrine activity (CBT)., Methods: Records of seven CBT patients with endocrine activity (Jan, 1991-Aug, 2011) who underwent surgical excision of tumor were retrospectively reviewed. The operations were performed with the careful peroperative preparation on the control of blood pressure, serum potassium and catecholamine. All the tumors were studied with the methods of HE staining, immunohistochemistry of chromogranin A (CgA) and S-100., Results: All the operations were successfully accomplished and the patients recovered quickly. It was confirmed with pathological examination that all the tumors were CBT, coming from paraganglioma. Tumor cells and sertoli cells were found in HE staining, and all were positive of CgA and S-100. All patients were followed up for 12-60 months and no recurrence was found during the follow up., Conclusion: CBT with endocrine activity presents with identifiable clinical and pathological characteristics. The recommended treatment is surgical resection, careful perioperative preparation and care is important to avoid the severe complication due to the endocrine activity of tumor.

Objective: A multivariate logistic regression analysis model for predicting ectopic pregnancy in women with pregnancy of unknown location was designed and evaluated clinically., Methods: Endometrial thickness, symmetry, resonance, pattern of echogenicity, helicine artery blood flow and blood flow resistance index (RI) in 129 patients with suspected early ectopic pregnancy were assessed by transvaginal power Doppler ultrasonography. Variables significant in univariate logistic regression analysis were included in a multivariate predictive logistic regression analysis model., Results: The final predictive model included three factors: endometrial thickness≤9 mm; a multilayered endometrial echogenicity pattern with prominent outer and midline hyperechogenic lines and an inner hypoechogenic region; and visible endometrial arterial blood flow. The area under the receiver operating characteristic curve of the model was 0.980. When RI was >0.65 and the predictive probability>0.50, diagnostic accuracy was high. The model correctly diagnosed 52/55 (94.5%) clinically confirmed ectopic pregnancy cases., Conclusion: This multivariate predictive logistic regression analysis model has clinical value for the differential diagnosis of early ectopic pregnancy when the pregnancy location is unknown.

In order to identify the proteomic changes of apple (Malus domestica Borkh.) during the vegetative phase change and the floral transition, leaf protein of juvenile, adult vegetative and reproductive phase in a seedling ('Jonathan' × 'Golden Delicious') was extracted and analyzed by 2-D electrophoresis and Matrix-assisted laser desorption/ionization-time of flight mass spectrometry. Seventy two gel spots with significant expression differences between ontogenetic phases were obtained. Five protein spots were only detected in leaves of juvenile phase and 11 were not; 17 spots were found exclusively in adult vegetative leaves; and only one spot solely appeared in reproductive leaves while 12 did not. Twenty six of the differentially expressed proteins identified were involved in photosynthesis. Seven enzymes were related to respiration and carbohydrate metabolism. Fifteen other proteins also presented qualitative or quantitative differences among developmental phases. The spatial distribution of one differentially expressed protein, serine hydroxymethyltransferase, was confirmed by enzyme linked immunosorbent assay and immunohistochemistry. These results strongly support the idea that the vegetative phase change and the floral transition are regulated independently during developmental process.

Objective: To investigate the effects of ischemic postconditioning(IPo) on cellular apoptosis in acute renal ischemic-reperfusion injury (IRI) in rats., Methods: Model of acute renal ischemic-reperfusion injury (IRI) was constructed using Wistar rats. Forty healthy male rats were divided into 4 groups randomly,including group C,group IRI, group IPo and group Ado. Rats of group C received right nephronectomy and separation of left renal vessels. Before reperfusion, group IPo was perfused for 10 s, following ischemic reperfusion for another 10 s with 6 cycles. Group Ado was infused with adenosine intravenously 10 min before ischemia. Cellular apoptosis was determined with TUNEL (TdT-mediated dUTP Nick End Labelling), flowcytometry and histopathological staining., Results: Compared with group C, the apoptotic index increased predominatly in group IRI (P<0.05), whereas, apoptosis index decreased obviousely in group IPo, Ado (P<0.05). In addition, the apoptosis index between group IPo and Ado was not statistically different., Conclusion: Ischemic postconditioning could decrease cellular apoptosis induced by IRI in rat kidney.

Aim: To prepare the human hepatocellular carcinoma-(HCC)-targeted liposome microbubbles and to investigate their immunological properties., Methods: Human hepatocarcinoma specific monoclonal antibody HAb18 was attached to the surface of home-made liposome microbubbles by static attraction to prepare the targeted liposome microbubbles. The combination of HAb18 with liposome microbubbles was confirmed by the slide agglutination test and immunofluorescent assay. Their immunological activity was measured by ELISA. Rosette formation test, rosette formation blocking test and immun-ofluorescent assay were used to identify the specific binding of targeted liposome microbubbles to SMMC-7721 hepatoma cells, and cytotoxicity assay was used to detect their effect on human hepatocytes., Results: The targeted liposome microbubbles were positive in the slide agglutination test and immunofluorescent assay. ELISA indicated that the immunological activity of HAb18 on the liposome microbubbles was similar to that of free HAb18. SMMC-7721 cells were surrounded by the targeting liposome microbubbles to form rosettes, while the control SGC-7901 gastric cancer cells were not. Proliferation of SMMC-7721 cells and normal human hepatocytes was not influenced by the targeted liposome microbubbles., Conclusion: The targeted liposome microbubbles with a high specific biological activity have been successfully prepared, which specifically bind to human hepatocarcinoma cells, and are non-cytotoxic to hepatocytes. These results indicate that the liposome microbubbles can be used as a HCC-targeted ultrasound contrast agent that may enhance ultrasound images and thus improve the diagnosis of HCC, especially at the early stage.

Polysaccharide sulphate (PSS) is a new heparinoid drug. The therapeutic effect and laboratory findings in the treatment of 282 cases with ischemic cerebrovascular disease by PSS were analysed in this study. In treating patients with acute cerebral infarction, the effective rate (93.2%) and highly effective rate (62.9%) were both significantly higher in comparison with controls. Excellent results were also obtained in treating patients with cerebral infarction at late and sequela stage and patients with transient ischemic attack. Laboratory observations and animal experiments showed that PSS has anticoagulative and vasodilatory effects. It can also reduce blood viscosity and serum lipids. So PSS is an effective drug for the prevention and treatment of ischemic cerebrovascular diseases.