Immobilization of a broad host range phage on the peroxidase-like Fe-MOF for colorimetric determination of multiple Salmonella enterica strains in food.

A broad host range phage-based nanozyme (Fe-MOF@SalmpYZU47) was prepared for colorimetric detection of multiple Salmonella enterica strains. The isolation of a broad host range phage (SalmpYZU47) capable of infecting multiple S. enterica strains was achieved. Then, it was directly immobilized onto the Fe-MOF to prepare Fe-MOF@SalmpYZU47, exhibiting peroxidase-like activity. The peroxidase-like activity can be specifically inhibited by multiple S. enterica strains, benefiting from the broad host range capture ability of Fe-MOF@SalmpYZU47. Based on it, a colorimetric detection approach was developed for S. enterica in the range from 1.0 × 102 to 1.0 × 108 CFU mL-1, achieving a low limit of detection (LOD) of 11 CFU mL-1. The Fe-MOF@SalmpYZU47 was utilized for detecting S. enterica in authentic food samples, achieving recoveries ranging from 91.88 to 105.34%. Hence, our proposed broad host range phage-based nanozyme exhibits significant potential for application in the colorimetric detection of pathogenic bacteria.

Biomechanical investigation of a customized interspinous spacer system in the treatment of degenerative disc diseases: A finite element analysis.

BACKGROUND: A novel interspinous fixation system based on anatomical parameters and incorporating transfacetopedicular screws, was developed to treat degenerative disc diseases. The biomechanical characteristics of the novel system were evaluated using finite element analysis in comparison to other classical interspinous spacers. METHODS: The L1-S1 lumbar spine finite element models were surgically implanted with the novel system, Coflex and DIAM devices at the L4/L5 segment to assess the range of motion, the pression distribution of intervertebral disc, the peak stresses on the spinous process and implant during various motions. FINDINGS: Range of motions of the L4/L5 surgical segment were reduced by 29.13%, 61.27%, 77.35%, 33.33%, and the peak stresses of intervertebral disc were decreased by 36.82%, 67.31%, 73.00%, 69.57% for the novel system in flexion, extension, lateral bending, and axial rotation when compared with the Coflex, and they were declined by 34.53%, 57.86%, 75.81%, 25.21%; 36.22%, 67.31%, 75.01%, 71.40% compared with DIAM. The maximum stresses of the spinous process were 29.93 MPa, 24.66 MPa, 14.45 MPa, 24.37 MPa in the novel system, and those of Coflex and DIAM were 165.3 MPa, 109 MPa, 84.79 MPa, 47.66 MPa and 52.59 MPa, 48.78 MPa, 50.27 MPa, 44.16 MPa during the same condition. INTERPRETATION: Compared to other interspinous spacer devices, the novel interspinous fixation system demonstrated excellent stability, effectively distributing load on the intervertebral disc, and reducing the risk of spinous process fractures. The personalized design of the novel interspinous fixation system could be a viable option for treating degenerative disc diseases.

Coffee and the risk of osteoarthritis: a two-sample, two-step multivariable Mendelian randomization study.

Purpose: To investigate the potential causal relationship between coffee consumption and osteoarthritis (OA), and to disentangle whether body mass index (BMI) and Bone mineral density (BMD) mediate this relationship. Methods: We performed two-sample and two-step Mendelian randomization (MR) analyses utilizing publicly available genome-wide association studies (GWAS) summary statistics to estimate the association between coffee intake and OA risk (including knee OA, hip OA, knee or hip OA, and total OA), as well as the possible mediating effects of BMI and BMD. In addition, data of different coffee types (decaffeinated coffee, instant coffee, ground coffee-including espresso, filter, etc., and other coffee types) were used to explore the effect of coffee type on the risk of OA. Results: In two-sample MR, coffee intake increased the risk of OA in various sites, with the most significant impact observed in knee osteoarthritis (KOA) (odds ratio [OR] 2.03, 95% confidence interval [CI] 1.57-2.61, p < 0.001). The effect on self-reported OA was minimal (OR 1.03, 95% CI 1.01-1.05, p = 0.006). Further analysis of different types of coffee revealed that only decaffeinated coffee was causally associated with both KOA (OR 4.40, 95% CI 1.71-11.33, p = 0.002) and self-reported OA (OR 1.13, 95% CI 1.02-1.26, p = 0.022). In two-step MR, BMI explained over half of the coffee intake-all OA risk association, while BMD accounted for less than 5% of the mediation effect. Conclusion: Our study suggests that coffee intake increase the risk of OA, with BMI playing a significant mediating role. Decaffeinated coffee appears to have the greatest impact on OA risk compared to other types of coffee. Therefore, managing BMI and selecting appropriate types of coffee should be included in the health management of individuals who frequently consume coffee.

Insights into PM2.5 pollution of four small and medium-sized cities in Chinese representative regions: Chemical compositions, sources and health risks.

Fine particles (PM2.5) pollution is still a severe issue in some cities in China, where the chemical characteristics of PM2.5 remain unclear due to limited studies there. Herein, we focused on PM2.5 pollution in small and medium-sized cities in key urban agglomerations and conducted a comprehensive study on the PM2.5 chemical characteristics, sources, and health risks. In the autumn and winter of 2019-2020, PM2.5 samples were collected simultaneously in four small and medium-sized cities in four key regions: Dingzhou (Beijing-Tianjin-Hebei region), Weinan (Fenwei Plain region), Fukang (Northern Slope of the Tianshan Mountain region), and Bozhou (Yangtze River Delta region). The results showed that secondary inorganic ions (43.1 %-67.0 %) and organic matter (OM, 8.6 %-36.4 %) were the main components of PM2.5 in all the cities. Specifically, Fukang with the most severe PM2.5 pollution had the highest proportion of SO42- (31.2 %), while the dominant components in other cities were NO3- and OM. The Multilinear Engine 2 (ME2) analysis identified five sources of PM2.5 in these cities. Coal combustion contributed most to PM2.5 in Fukang, but secondary sources in other cities. Combined with chemical characteristics and ME2 analysis, it was preliminarily determined that the primary emission of coal combustion had an important contribution to high SO42- in Fukang. Potential source contribution function (PSCF) analysis results showed that regional transport played an important role in PM2.5 in Dingzhou, Weinan and Bozhou, while PM2.5 in Fukang was mainly affected by short-range transport from surrounding areas. Finally, the health risk assessment indicated Mn was the dominant contributor to the total non-carcinogenic risks and Cr had higher carcinogenic risks in all cities. The findings provide a scientific basis for formulating more effective abatement strategies for PM2.5 pollution.

The impact of thyroid function on total spine bone mineral density in postmenopausal women.

PURPOSE: Osteoporosis has been a widespread concern for older women, especially postmenopausal women. Thyroid function is crucial for bone metabolism. However, the relationship between thyroid function variation within thyroxine reference range and bone mineral density (BMD) remains ambiguous. The objective of this study was to evaluate the effect of subclinical hypothyroidism or hyperthyroidism on total spinal BMD in postmenopausal women. METHODS: Based on data from the National Health and Nutrition Examination Survey (NHANES) 2007-2010, multivariable weighted logistic regression was used to evaluate the relationships between total spine BMD and TSH among postmenopausal women aged ≥50. RESULTS: After accounting for a number of variables, this study discovered that the middle TSH tertile was associated with a decreased probability of osteoporosis. Additionally, the subgroup analysis revealed that postmenopausal women over the age of 65 or people with an overweight BMI had a clearer relationship between total spine BMD and TSH. CONCLUSION: The total spinal BMD had a positive relationship with thyroid stimulating hormone in postmenopausal women, and that appropriate TSH level (1.38-2.32 mIU/L) was accompanied by higher total spinal BMD.

Enhanced osteogenicity of the demineralized bone-dermal matrix composite by the optimal partial demineralization for sustained release of bioactive molecules.

Allogenic demineralized bone matrix (DBM), processed to expose bioactive proteins imbedded by calcium salts, is widely used for bone repair and regeneration as an alternative to the autologous bone graft. However, demineralized bone matrices from tissue banks vary significantly in residual calcium content and osteogenicity for clinical bone regeneration. The present study produced DBM with various residual calcium contents by partial demineralization using ethylenediaminetetraacetic acid disodium (EDTA) and hydrochloric acid. Compositional analysis reveals that, as the percent weight loss of bone materials increases from 0% to 74.9% during demineralization, the residual calcium content of DBM decreases from 24.8% to 0.2% and collagen content increases from 29.7% to 92.6%. Calorimetrical analysis and Fourier transform infrared (FTIR) analysis demonstrated that demineralization to the residual calcium content of <4% enables the complete exposure and/or release of bone collagen fibers and other bioactive molecules. In order to evaluate the relationship between the extent of demineralization and the osteogenicity of DBM, DBM particles were fabricated with the aid of acellular dermal matrix (ADM) microfibers to form flexible foam-like DBM/ADM composites. Proteomic analysis identified various type collagens and bone formation-related bioactive molecules in both ADM and DBM. Using the rat bilateral Φ = 5 mm calvarium defect repair model, the study had shown that the DBM/ADM composite with ~20% DBM residual calcium (e.g., ~40% calcium being removed) maximized the osteogenicity for bone defect repair after 4 and 8 weeks. DBM with ~40% calcium removal had the maximal osteogenicity presumably through the sustained release of bioactive molecules during the process of bone regeneration.

CO Oxidation Promoted by NO Adsorption on RhMn2O3- Cluster Anions.

CO oxidation represents an important model reaction in the gas phase to provide a clear structure-reactivity relationship in related heterogeneous catalysis. Herein, in combination with mass spectrometry experiments and quantum-chemical calculations, we identified that the RhMn2O3- cluster cannot oxidize CO into gas-phase CO2 at room temperature, while the NO preadsorbed products RhMn2O3-[(NO)1,2] are highly reactive in CO oxidation. This discovery is helpful to get a fundamental understanding on the reaction behavior in real-world three-way catalytic conditions where different kinds of reactants coexist. Theoretical calculations were performed to rationalize the crucial roles of preadsorbed NO where the strongly attached NO on the Rh atom can greatly stabilize the products RhMn2O2-[(NO)1,2] during CO oxidation and at the same time works together with the Rh atom to store electrons that stay originally in the attached CO2- unit. The leading result is that the desorption of CO2, which is the rate-determining step of CO oxidation by RhMn2O3-, can be greatly facilitated on the reactions of RhMn2O3-[(NO)1,2] with CO.

Development and validation of a semi-supervised deep learning model for automatic retinopathy of prematurity staging.

Retinopathy of prematurity (ROP) is currently one of the leading causes of infant blindness worldwide. Recently significant progress has been made in deep learning-based computer-aided diagnostic methods. However, deep learning often requires a large amount of annotated data for model optimization, but this requires long hours of effort by experienced doctors in clinical scenarios. In contrast, a large number of unlabeled images are relatively easy to obtain. In this paper, we propose a new semi-supervised learning framework to reduce annotation costs for automatic ROP staging. We design two consistency regularization strategies, prediction consistency loss and semantic structure consistency loss, which can help the model mine useful discriminative information from unlabeled data, thus improving the generalization performance of the classification model. Extensive experiments on a real clinical dataset show that the proposed method promises to greatly reduce the labeling requirements in clinical scenarios while achieving good classification performance.

Physiochemistry and sources of individual particles in response to intensified controls during the 2022 Winter Olympics in Beijing.

To investigate the particle sources before, during, and after the 2022 Beijing Winter Olympic and Paralympic (WOP) in Beijing, ambient particles were passively collected from January to March 2022. The physicochemical properties including morphology, size, shape parameters, and elemental compositions were analyzed by the IntelliSEM EPAS (an advanced computer-controlled scanning electron microscopy [CCSEM] system). Using the user-defined classification rules, 37,174 individual particles were automatically classified into 27 major groups and further attributed to seven major sources based on the source-associated characteristics, including mineral dust, secondary aerosol, combustion/industry, carbonaceous particles, salt-related particles, biological particles, and fiber particles. Our results showed that mineral dust (66.5%), combustion/industry (12.6%), and secondary aerosol (6.3%) were the three major sources in a wide size range of 0.2-42.8 µm. During the Winter Olympic Games period, low emission of anthropogenic particles and favorable meteorological conditions contributed to significantly improved air quality. During the Winter Paralympic Games period, more particles sourced from the dust storm, secondary formed particles, and the adverse meteorological conditions resulted in relatively worse air quality. The secondary aerosol all decreased during the competition period, while increased during the non-competition period. Sulfate-related particles had explosive growth and further aggravate the pollution degree during the non-competition period, especially under adverse meteorological conditions. These results provide microscopic evidence revealing variations of physicochemical properties and sources in response to the control measures and meteorological conditions.

Effect of vault on predicting postoperative refractive error for posterior chamber phakic intraocular lens based on a machine learning model.

PURPOSE: To investigate how vault and other biometric variations affect postoperative refractive error of implantable collamer lenses (ICLs) by integrating artificial intelligence and modified vergence formula. SETTING: Eye and ENT Hospital of Fudan University, Shanghai, China. DESIGN: Artificial intelligence and big data-based prediction model. METHODS: 2845 eyes that underwent uneventful spherical ICL or toric ICL implantation and with manifest refraction results 1 month postoperatively were included. 1 eye of each patient was randomly included. Random forest was used to calculate the postoperative sphere, cylinder, and spherical equivalent by inputting variable ocular parameters. The influence of predicted vault and modified Holladay formula on predicting postoperative refractive error was analyzed. Subgroup analysis of ideal vault (0.25 to 0.75 mm) and extreme vault (<0.25 mm or >0.75 mm) was performed. RESULTS: In the test set of both ICLs, all the random forest-based models significantly improved the accuracy of predicting postoperative sphere compared with the Online Calculation & Ordering System calculator ( P < .001). For ideal vault, the combination of modified Holladay formula in spherical ICL exhibited highest accuracy ( R = 0.606). For extreme vault, the combination of predicted vault in spherical ICL enhanced R values ( R = 0.864). The combination of predicted vault and modified Holladay formula was most optimal for toric ICL in all ranges of vault (ideal vault: R = 0.516, extreme vault: R = 0.334). CONCLUSIONS: The random forest-based calculator, considering vault and variable ocular parameters, illustrated superiority over the existing calculator on the study datasets. Choosing an appropriate lens size to control the vault within the ideal range was helpful to avoid refractive surprises.

Biomechanical effects of osteoporosis severity on the occurrence of proximal junctional kyphosis following long-segment posterior thoracolumbar fusion.

BACKGROUND: Proximal junctional kyphosis is a common long-term complication in adult spinal deformity surgery that involves long-segment posterior spinal fusion. However, the underlying biomechanical mechanisms of the impact of osteoporosis on proximal junctional kyphosis remain unclear. The present study was to evaluate adjacent segment degeneration and spine mechanical instability in osteoporotic patients who underwent long-segment posterior thoracolumbar fusion. METHODS: Finite element models of the thoracolumbar spine T1-L5 with posterior long-segment T8-L5 fusion under different degrees of osteoporosis were constructed to analyze intervertebral disc stress characterization, vertebrae mechanical transfer, and pedicle screw system loads during various motions. FINDINGS: Compared with normal bone mass, the maximum von Mises stresses of T7 and T8 were increased by 20.32%, 22.38%, 44.69%, 4.49% and 29.48%, 17.84%, 40.95%, 3.20% during flexion, extension, lateral bending, and axial rotation in the mild osteoporosis model, and by 21.21%, 18.32%, 88.28%, 2.94% and 37.76%, 15.09%, 61.47%, -0.04% in severe osteoporosis model. The peak stresses among T6/T7, T7/T8, and T8/T9 discs were 14.77 MPa, 11.55 MPa, and 2.39 MPa under lateral bending conditions for the severe osteoporosis model, respectively. As the severity of osteoporosis increased, stress levels on SCR8 and SCR9 intensified during various movements. INTERPRETATION: Osteoporosis had an adverse effect on proximal junctional kyphosis. The stress levels in cortical bone, intervertebral discs and screws were increased with bone mass loss, which can easily lead to intervertebral disc degeneration, bone destruction as well as screw pullout. These factors have significantly affected or accelerated the occurrence of proximal junctional kyphosis.

Strategies for the coordinated control of particulate matter and carbon dioxide under multiple combined pollution conditions.

Air pollutants represented by fine particulate matter (PM2.5) and the greenhouse effect caused by carbon dioxide (CO2), are both urgent threats to public health. Tackling the synergistic reduction of PM2.5 and CO2 is critical to achieving improvements in clean air worldwide. A persistent issue is the identification of their common sources and integrated impacts under different environmental conditions. In this study, we investigated the characteristics of the pollution types captured by combined analysis through a comprehensive observational dataset for 2017-2020, and applied machine learning algorithms to quantify the effects of drivers on air pollutants and CO2 formation. More importantly, detailed conclusions were drawn for the joint control of PM2.5-CO2 in multiple pollution types by using ensemble traceability technique. We demonstrated that reducing coal combustion emissions was an effective measure to maximize the benefits of PM2.5-CO2 in weather with low CO2 levels and no PM2.5 pollution. Correspondingly, on days with severe PM2.5 episodes, prioritizing control of vehicle emissions can simultaneously mitigate PM2.5 and CO2. Similar conclusions were found at high CO2 levels, accompanied by a more extensive role of vehicle emissions. Furthermore, a comparison of the differences in source impacts between PM2.5-CO2 and individual species suggests that focusing only on the sources that contribute significantly to one species may result in an underestimation or overestimation of PM2.5-CO2 source impacts. One such implication, as evidenced by our findings, is that synergistic controlling common sources of pollutants should be efficient. Thereby, common source management targeting PM2.5-CO2 under multiple pollution types is a more workable solution to alleviate environmental pollution.

Association between physical activity and bone mineral density in postmenopausal women: a cross-sectional study from the NHANES 2007-2018.

BACKGROUND: Physical activity (PA) is generally encouraged for the treatment of osteoporosis. However, epidemiological statistics on the level of physical activity required for bone health are scarce. The purpose of this research was to analyze the association between PA and total spine bone mineral density (BMD) in postmenopausal women. METHODS: The research study included postmenopausal women aged ≥ 50 from the National Health and Nutrition Examination Survey. The metabolic equivalent (MET), weekly frequency, and duration of each activity were used to calculate PA. Furthermore, the correlations between BMD and PA were investigated by multivariable weighted logistic regression. RESULTS: Eventually, 1681 postmenopausal women were included, with a weighted mean age of 62.27 ± 8.18 years. This study found that performing ≥ 38MET-h/wk was linked to a lower risk of osteoporosis after controlling for several covariates. Furthermore, the subgroup analysis revealed that the connection between total spine BMD and moderate-to-vigorous PA was more obvious among postmenopausal women aged < 65 years or individuals with normal BMI (< 25 kg/m2). CONCLUSION: Physical activity ranging from moderate to vigorous was linked to higher total spine BMD in postmenopausal women.

[Short- and mid-term effectiveness of unicompartmental knee arthroplasty for post-traumatic arthritis of knee].

Objective: To investigate the short- and mid-term effectiveness of unicompartmental knee arthroplasty (UKA) for post-traumatic arthritis (PTA) of knee. Methods: The clinical data of 30 patients with PTA of unilateral knee between March 2014 and September 2021 was retrospectively analyzed. There were 14 males and 16 females with an average of 64.5 years (range, 33-81 years). The average body mass index was 26.7 kg/m 2 (range, 19.8-35.6 kg/m 2). The types of injuries that caused PTA included intra-articular fracture in 16 cases, extra-articular fracture in 8 cases, and soft tissue injury in 6 cases. The initial injuries were treated by conservative therapy in 12 cases and by surgical therapy in 18 cases. Ten cases were medial compartment osteoarthritis and 20 cases were lateral compartment osteoarthritis. According to Kellgren-Lawrence staging, there were 19 cases of grade Ⅲ and 11 cases of grade Ⅳ. The operative time, the length of hospital stay, complications, and subjective satisfaction were recorded. The Oxford Knee Function Score (OKS), Hospital for Special Surgery (HSS) score, and knee range of motion (ROM) were used to evaluate knee function. Weight-bearing X-ray films were taken to measure the femoro-tibial angle (FTA) and to assess alignment correction of the lower limb. Results: The operative time ranged from 50 to 95 minutes (mean, 63.7 minutes), the length of hospital stay ranged from 3 to 8 days (mean, 6.9 days). Superficial infection occurred in 2 patients, while the remaining incisions healed by first intention. There was no deep vein thrombosis or neurovascular injury. All patients were followed up 17-109 months (median, 70 months). At last follow-up, OKS score, HSS score, and ROM in 30 cases significantly improved when compared with those before operation (P<0.05). Lower limb alignment was significantly corrected and there was significant difference in FTA of the varus and valgus knees between pre- and post-operation ( P<0.05). The patient satisfaction rate was 86.7% (26/30). Two cases developed contralateral osteoarthritis progression during follow-up. No bearing dislocation, prosthesis loosening or sinking occurred and none required further revision. Conclusion: For patients with PTA of knee, UKA can obtain definite short- and mid-term effectiveness with high patient satisfaction.

Molecular and clinical features of papillary thyroid cancer in adult patients with a non-classical phenotype.

Purpose: Genotyping is fundamental in papillary thyroid cancer (PTC) and helps to enhance diagnosis and prognosis and determine appropriate treatments. The phenotype-genotype association in PTC was previously studied, with BRAF V600E characterizing classic PTC and tall-cell PTC and RAS mutations characterizing follicular-variant PTC. In clinic, some non-classical histological subtypes of PTC were also identified, however, their genotype remains unclear. In this study, we collected samples of these non-classical PTC after the exclusion of classic phenotypes and examined their phenotypes, genotype and the relationship between phenotype and genotype. Methods: We screened out non-classical PTC by excluding classical PTC from 1,059 different thyroid samples, and a total of 24 cases was obtained and described from the morphological features, which is rare in differentiated PTC. DNA/RNA sequencing was performed using 18 available samples to describe the genetic features. Results: PTC with the non-classical phenotype were characterized cuboidal to low columnar tumor cells with subtle nuclear features of PTC and without discernible nuclear elongation, concurrently with dense microfollicles, delicate papillae or solid nodules with delicate fibrovascular cores. They were associated with lymphatic vessel invasion (P<0.001) but not with a worse prognosis (P=0.791). Gene fusions were identified in 14 of 18 (77.8%) cases, including eight fusions of NTRK and six fusions of RET. The high percentage of fusions in this papillary thyroid cancer subgroup suggested a correlation of gene fusions with the phenotype that does not belong to the BRAF V600E-mutant or RAS-mutant group. Conclusions: Our study retrospectively screened a large cohort of different thyroid tissue samples, and presented the histopathological and genetic features of a non-classical phenotype of PTC from 24 patients. It may contribute to diagnose in PTC, and patients of these non-classical phenotype may benefit from targeted therapy, compared to a natural patient cohort without selection.

Catalytic NO Reduction by Noble-Metal-Free Vanadium-Aluminum Oxide Cluster Anions.

By using state-of-the-art mass spectrometry and guided by the newly discovered single-electron mechanism (SEM; e.g., Ti3+ + 2NO → Ti4+-O•- + N2O), we determined experimentally that the vanadium-aluminum oxide clusters V4-xAlxO10-x- (x = 1-3) can catalyze the reduction of NO by CO and substantiated theoretically that the SEM still prevails in driving the catalysis. This finding marks an important step in cluster science in which a noble metal had been demonstrated to be indispensable in NO activation mediated by heteronuclear metal clusters. The results provide new insights into the SEM in which active V-Al cooperative communication favors the transfer of an unpaired electron from the V atom to NO attached to the Al atom on which the reduction reaction actually takes place. This study provides a clear picture for improving our understanding of related heterogeneous catalysis, and the electron hopping behavior induced by NO adsorption could be a fundamental chemistry for driving NO reduction.

Diane-35 and metformin therapy in rats with endometrial lesions induced by dihydrotestosterone exposure.

Background: Cotreatment with metformin and Diane-35 is conventionally used in the clinic to ameliorate ovulatory dysfunction and insulin resistance in women with polycystic ovary syndrome (PCOS). We previously showed that this combination treatment could reverse endometrial hyperplasia and endometrial cancer (EC) in patients with PCOS. Here, we aimed to investigate the influence of dihydrotestosterone (DHT) and this cotreatment on the endometrium, along with the related mechanisms. Methods: We treated a DHT-exposed rat model with Diane-35 or metformin alone or their combination and investigated the 3-dimensional (3D) endometrial structure to determine the role of these treatments in reversing endometrial lesions and to clarify the underlying mechanisms. Uterine segments were made transparent with clear, unobstructed brain/body imaging cocktails and a computational analysis protocol and then labeled with 4',6-diamidino-2-phenylindole (DAPI), antiandrogen receptor (AR) antibody, and antiglucose transportation protein 4 (GLUT4) antibody. We visualized and analyzed the endometrial structure, AR expression, and GLUT4 expression under 3D conditions using light sheet microscopy and Imaris software (Bitplane, Zurich, Switzerland). Results: Long-term DHT treatment contributed to hyperandrogenism and insulin resistance in female Wistar rats. After DHT treatment, rats exhibited other PCOS-like characteristics, such as polycystic ovary morphology, hypothalamic-pituitary-ovarian axis disorder, and relative endometrial hyperplasia. After metformin and Diane-35 treatment, the PCOS-like characteristics and endometrial hyperplasia were alleviated. Conclusions: Hyperandrogenism and insulin resistance likely play important roles in the pathophysiological changes of PCOS and lead to PCOS-like characteristics as well as endometrial lesions. Hypoandrogenic and insulin sensitization therapy can alleviate DHT-induced endometrial hyperplasia by regulating AR and GLUT4 expression.

A standardized technique for lateral unicompartmental knee arthroplasty.

OBJECTIVES: We developed a new standardized procedure for lateral unicompartmental knee arthroplasty (UKA) to maximize the benefits and minimize the risks of surgery in patients with osteoarthritis (OA). METHODS: This retrospective study recruited patients who underwent lateral UKA at our hospital between January 2014 and January 2016. Demographic characteristics and preoperative and postoperative American Knee Society (AKS) clinical scores (including pain, clinical, and knee mobility scores) were collected. RESULTS: A total of 158 patients (35 male and 123 female) who underwent 160 lateral UKAs were analyzed. Their AKS clinical scores (0-100 points) improved from 53.1 ± 4.1 (range 45-62) preoperatively to 97.0 ± 1.7 (range 92-99) (p < 0.001) postoperatively with additional improvements of 9.1 ± 1.8 (range 3-14) to 47.3 ± 1.5 (range 45-49) (p < 0.001) for pain, 49.7 ± 9.7 (range 35-70) to 97.1 ± 4.1 (range 90-100) (p < 0.001) for function, and 105.0 ± 4.4° (equivalent to ∼100-115°) to 125.5 ± 5.3° (∼110-135°) (p < 0.001) for a range of motion (ROM). No patients required reoperations or revisions. Two patients were readmitted within 60 days due to severe knee swelling. CONCLUSION: The lateral UKA protocol was reproducible and the patients had a good postoperative outcomes. Yet, large-scale, multi-center, prospective studies are needed to further confirm our findings.