Is unicompartmental knee arthroplasty a better choice than total knee arthroplasty for unicompartmental osteoarthritis? A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: The choice of unicompartmental knee arthroplasty (UKA) vs. total knee arthroplasty (TKA) in the surgical treatment of knee osteoarthritis (KOA) remains controversial. This study aimed to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the clinical results of UKA and TKA for treating unicompartmental KOA. METHODS: PubMed, Embase, and the Cochrane Library were systematically searched for articles published up to January 2, 2023. The literature was rigorously screened to include only RCTs comparing UKA and TKA for unicompartmental KOA. A systematic review and meta-analysis were performed to calculate the mean difference (MD), relative risk (RR), and 95% confidence interval (CI) according to the Cochrane standards. RESULTS: Thirteen publications involving 683 UKAs and 683 TKAs were analyzed. Except for one study with a follow-up period of 15 years, all outcome measures reported were within 5 years of follow-up. Meta-analysis showed better knee recovery (MD: 1.23; 95% CI: 1.01-1.45; P <0.00001), greater knee function (MD: 1.78; 95% CI: 0.34-3.22; P = 0.02), less pain (MD: 0.75; 95% CI: 0.43-1.06; P <0.00001), and better health status (MD: 3.75; 95% CI: 0.81-6.69; P = 0.01) after UKA than TKA. However, considering the minimal clinically important difference values for these variables, the findings were not clinically relevant. Moreover, UKA patients had fewer complications (RR: 0.59; 95% CI: 0.45-0.78; P = 0.0002) and shorter hospital stays (MD: -0.89; 95% CI: -1.57 to -0.22; P = 0.009) than did TKA patients. There were no statistically significant differences in terms of postoperative range of movement, revision, failure, operation time, and patient satisfaction. CONCLUSIONS: In terms of clinical efficacy, there was no obvious advantage of UKA over TKA in the surgical treatment of knee OA when considering the minimal clinically important difference. The main advantage of UKA over TKA is that it leads to fewer complications and a shorter length of hospital stay. It is ideal to perform prospective studies with longer follow-up periods to fully evaluate the long-term efficacy and safety of the two procedures in the future.

Characterization and functional analysis of a novel C-type lectin in blunt snout bream (Megalobrama amblycephala).

C-type lectins, one of the pattern recognition receptors (PRRs), play significant roles in innate immune responses through binding to the pathogen-associated molecular patterns (PAMPs) presented on surfaces of microorganisms. Here, a novel C-type lectin (named as MaCTL) from blunt snout bream (Megalobrama amblycephala) was cloned and characterized. The open reading frame (ORF) of MaCTL is 573 bp long encoding a putative protein of 190 amino acids (aa), which contains a typical feature of signal peptide at 1-23 aa, a characteristic CRD domain at 45-178 aa and a WND/EPN motif that is required for carbohydrates-binding specificity. Phylogenetic analysis indicated that MaCTL is a novel member of CTL family and possessed the highest similarity to that of grass carp (92.11%). The qRT-PCR analysis revealed that MaCTL expressed widely in all examined normal tissues, including heart, liver, spleen, kidney, head-kidney, gill, intestine and muscle, with the higher expression in the spleen, liver and muscle. The expression of MaCTL in spleen was significantly elevated, peaking at 9 h and 6 h after LPS stimulation and Aeromonas hydrophila challenge, respectively, suggesting its association with involvement in innate immune response. The recombinant MaCTL protein (rMaCTL) agglutinated markedly both Gram-positive (Staphylococcus aureus) and Gram-negative bacteria, including Escherichia coli, Vibrio anguillarum, Vibrio vulnificus and Aeromonas hydrophila, in a Ca2+-dependent manner. Meanwhile, rMaCTL showed the binding effects on the five bacteria and four carbohydrates, such as glucose, surose, LPS and PGN. Moreover, rMaCTL could remarkably inhibit the growth of three types of bacteria in vitro. Overall, the results obtained above demonstrated firmly that MaCTL binds to carbohydrates on the surface of diverse pathogens as a PRR and elicits antimicrobial responses, which shed new light on a better understanding of antibacterial functions of CTLs in teleost fish.

Functions of circular RNAs and their potential applications in gastric cancer (Review).

As the fifth most common cancer and the fourth leading cause of cancer-related death in the world, gastric cancer (GC) poses a potential threat to human health. However, there is still a lack of effective means for the early screening and treatment of GC, and therefore, GC remains a difficult disease to overcome. With the continuous in-depth research on circular RNAs (circRNAs), an increasing body of evidence indicates that circRNAs play an important role in a wide variety of diseases, particularly cancer. Proliferation, invasion and metastatic spread of cancer cells are strongly associated with abnormal circRNA expression. Hence, circRNAs are considered a candidate biomarker for GC diagnosis and prognosis, and a target for cancer treatment. The focus has been on the association of GC with circRNAs, thus it is necessary to briefly review and summarize the relevant research to provide the research findings across the area to researchers, and to indicate the direction for future research. The present review provides an overview on the biogenesis and functions of circRNAs in GC, predicting their possible clinical application as ideal biomarkers and potential targets of treatment in GC.

Toll-interacting protein negatively regulated innate immune response via NF-κB signal pathway in blunt snout bream, Megalobrama amblycephala.

Toll-interacting protein (Tollip) is an important negative regulator of Toll-like receptor-mediated innate immunity by preventing excessive proinflammatory responses. The structure and function of Tollip have been well identified in mammals, but the piscine Tollip remains poorly understood. In the present study, a homologue of Tollip was identified and characterized from blunt snout bream (named MaTollip), which was composed of an 831 bp open reading frame encoding a protein of 276 amino acids. Phylogenetic analysis indicated that MaTollip is a novel member of Tollip family and possessed the highest similarity to that of grass carp (99.28%). Multiple alignment of amino acid sequence showed that MaTOLLIP shared a high degree of structural conservation, including a TBD domain, a C2 domain and a CUE domain, with its counterparts from other vertebrates. With regard to tissue-specific expression without immune challenge, MaTollip was constitutively expressed in a wide range of normal tissues, with the highest in the head-kidney and the lowest in the intestine. MaTollip expression in the head-kidney was strongly upregulated upon LPS stimulation and A. hydrophila infection. Fluorescence microscopic analysis revealed that the green fluorescent protein-TOLLIP was localized predominantly in the cytoplasm of EPC cells in a dot-like state. When MaTollip was overexpressed in HEK-293T and EPC cells, it could significantly inhibit the activity of nuclear factor-κB (NF-κB) promoter in a dose dependent manner. MaTollip overexpression in MAF cells lowered drastically the transcriptional expression level of lipopolysaccharide-induced proinflammatory cytokines (IL-1ß, IL-6 and IL-8), whereas they were dramatically promoted by MaTollip knock down with siRNA. Taken together, this study demonstrated that MaTollip played a pivotal role in mediating host innate immune response to pathogen invasion, and unveiled the involvement of MaTollip in NF-κB-mediated transcription of inflammation genes, which paved the way for further studies of immune negative regulation mechanisms mediated by Tollip in fish.