[Clinical study of intercondylar fossa formation to prevent intercondylar fossa impingement after high tibia osteotomy].

OBJECTIVE: To observe the clinical efficacy of intercondylar fossa plasty in preventing intercondylar fossa impingement syndrome after high tibial osteotomy. METHODS: From August 2018 to August 2020, 84 patients with inverted knee osteoarthritis were treated by arthroscopy combined with high tibial osteotomy, and were divided into two groups with 42 cases in each group according to different surgical methods. In the intercondylar fossa plasty group, there were 13 males and 29 females, age ranged from 52 to 67 years old with an average of(58.27±4.32) years old, and arthroscopic intercondylar fossa plasty was performed first, and then high tibial osteotomy. In the arthroscopic cleansing group, 16 males and 26 females, age ranged from 50 to 71 years old with an average of (59.02±5.14) years old, underwent arthroscopic cleansing and then high tibial osteotomy. Postoperative treatment was evaluated using visual analogue scale(VAS), hospital for special surgery (HSS) score for the knee, and the occurrence of intercondylar percussa impingement. RESULTS: All 84 patients were followed up, the duration ranged from 12 to 18 months with an average of (14.1±1.6) months. The VAS and HSS score of knee joint at 6, 12 and 18 months after surgery were significantly improved compared with preoperative period, and there was no significant difference between the two groups (P>0.05), but the incidence of intercondylar fossa index and intercondylar fossa impact between the two groups was significantly compared 18 months after surgery (P<0.05). CONCLUSION: Intercondylar fossa plasty can effectively prevent the incidence of intercondylar fossa impact after high tibial osteotomy, and has a more significant effect on postoperative knee pain and function improvement.

Irradiation stent with 125 I plus TACE versus sorafenib plus TACE for hepatocellular carcinoma with major portal vein tumor thrombosis: a multicenter randomized trial.

BACKGROUND AND AIM: Treatment strategy for hepatocellular carcinoma (HCC) and Vp4 [main trunk] portal vein tumor thrombosis (PVTT) remains limited due to posttreatment liver failure. We aimed to assess the efficacy of irradiation stent placement with 125 I plus transcatheter arterial chemoembolization (TACE) (ISP-TACE) compared to sorafenib plus TACE (Sora-TACE) in these patients. METHODS: In this multicenter randomized controlled trial, participants with HCC and Vp4 PVTT without extrahepatic metastases were enrolled from November 2018 to July 2021 at 16 medical centers. The primary endpoint was overall survival (OS). The secondary endpoints were hepatic function, time to symptomatic progression, patency of portal vein, disease control rate, and treatment safety. RESULTS: Of 105 randomized participants, 51 were assigned to the ISP-TACE group, and 54 were assigned to the Sora-TACE group. The median OS was 9.9 months versus 6.3 months (95% CI: 0.27-0.82; P =0.01). Incidence of acute hepatic decompensation was 16% (8 of 51) versus 33% (18 of 54) ( P =0.036). The time to symptomatic progression was 6.6 months versus 4.2 months (95% CI: 0.38-0.93; P =0.037). The median stent patency was 7.2 months (interquartile range, 4.7-9.3) in the ISP-TACE group. The disease control rate was 86% (44 of 51) versus 67% (36 of 54) ( P =0.018). Incidences of adverse events at least grade 3 were comparable between the safety populations of the two groups: 16 of 49 (33%) versus 18 of 50 (36%) ( P =0.73). CONCLUSION: Irradiation stent placement plus TACE showed superior results compared with sorafenib plus TACE in prolonging OS in patients with HCC and Vp4 PVTT.

[Characteristic of soil fungal community and the influencing factors of Pinus massoniana forests in the Three Gorges Reservoir Region]. / ä¸‰å³¡åº“åŒºé©¬å°¾æ¾æž—åœŸå£¤çœŸèŒç¾¤è½ç‰¹å¾åŠå½±å“å› ç´ .

Soil fungi are important components of belowground biodiversity and play important roles in soil carbon and nutrient cycling. We investigated fungal communities in the top soil (0-10 cm) of 22 Pinus massoniana forests in the Three Gorges Reservoir Region using high-throughput sequencing technique. We found that Ascomycota and Basidiomycota were the dominant fungi phyla, and Eurotiales, Russulales, and Tremellales were the most abundant fungi orders. The dominant functional groups in P. massoniana forests were saprophytic fungi, ectomycorrhizal fungi, and ericoid mycorrhizal fungi. Results of redundancy analysis showed that environmental variables but not spatial variables were the main drivers of soil fungal community structure across the 22 P. massoniana forests, which suggested that habitat filtering rather than dispersal limitation shaped soil fungal community structure. Aboveground biomass, soil conductivity, available phosphorus, soil bulk density, carbon to nitrogen ratio, nitrate concentration, and proportion of slit were the main factors explaining the variation in soil fungal community structure. It should be noted that the key factors influencing different fungal functional groups differed across forests.

Catalyst-Dependent Stereospecific [3,3]-Sigmatropic Rearrangement of Sulfoxide-Ynamides: Divergent Synthesis of Chiral Medium-Sized N,S-Heterocycles.

Medium-sized N,S-heterocycles have received tremendous interest due to their biological activities and potential medical applications. However, asymmetric synthesis of these compounds are extremely rare. Described herein is a catalyst-dependent [3,3]-sigmatropic rearrangement of sulfoxide-ynamides, enabling divergent and atom-economic synthesis of a series of valuable medium-sized N,S-heterocycles in moderate to good yields with broad substrate scope. Importantly, excellent enantioselectivities have been achieved via an unprecedented chirality-transfer. Moreover, theoretical calculations are employed to elucidate the origins of the catalyst-dependent stereospecific [3,3]-rearrangement.

Efficacy and Safety of Radioactive 125I Seed Implantation for Patients with Oligo-Recurrence Soft Tissue Sarcomas.

PURPOSE: To evaluate the efficacy and safety of computed tomography-guided radioactive iodine-125 (125I) seed implantation for oligo-recurrence soft tissue sarcomas following surgical resection. MATERIALS AND METHODS: Patients with oligo-recurrence soft tissue sarcomas after curative surgical resection between June 2013 and December 2020 were included. The primary outcome measure was objective response rate according to the Response Evaluation Criteria in Solid Tumors (RECIST 1.1). The secondary outcomes included progression-free survival, overall survival, and safety profiles. RESULTS: Twenty-nine patients receiving computed tomography-guided 125I seed implantation were included in the study. The objective response rates at 2-, 6- and 12-month follow-up were 48.3%, 65.5% and 40.9%, respectively. The median progression-free survival was 11.3 months. The median overall survival was 25.1 months, with a 1- and 2-year overall survival rate of 81.5% and 50.0%, respectively. No severe treatment-related adverse effects occured. CONCLUSION: 125I seed implantation has the potential to be an effective and safe treatment for oligo-recurrence soft tissue sarcomas after surgical resection.

Insertion of I-125 seed-loaded stent for inoperable hilar cholangiocarcinoma.

INTRODUCTION: Stent insertion is the most frequently used option to treat malignant biliary obstruction (MBO) patients. Hilar cholangiocarcinoma (HCCA) is the most common disease that causes hilar MBO. AIM: To assess the clinical efficacy and long-term outcomes of I-125 seed-loaded stent (ISS) insertion for HCCA patients. MATERIAL AND METHODS: Consecutive patients with HCCA underwent either normal stent (NS) or ISS insertion between January 2017 and December 2019. The baseline and treatment data of these two groups were compared. RESULTS: During the period, a total of 93 patients with inoperable HCCA were divided into either NS (n = 48) or ISS (n = 45) insertion groups at our centre. Technical success rates of the NS and ISS insertion were 91.7% and 95.6%, respectively (p = 0.733). Clinical success rates were 93.2% and 100% in the NS and ISS groups, respectively (p = 0.24). Stent dysfunction was observed in 11 and 8 patients in the NS and ISS groups, respectively (p = 0.47). The median stent patency was 143 days and 208 days in the NS and ISS groups, respectively (p < 0.001). All patients died in the follow-up period, with median survival duration of 178 days and 220 days in the NS and ISS groups, respectively (p < 0.001). ISS insertion was the only predictor of longer patency (p = 0.002) and survival (p = 0.01). CONCLUSIONS: ISS insertion might achieve longer patency and overall survival in patients with inoperable HCCA as compared with NS insertion.

A novel irradiation stent versus conventional irradiation stent for malignant dysphagia: A prospective randomized controlled trial.

AIM: To evaluate whether a novel irradiation stent (NIS) could decrease the rate of recurrent dysphagia, compared to the conventional irradiation stent (CIS) in patients with malignant dysphagia. MATERIALS AND METHODS: We performed an open-label randomized controlled trial of participants with malignant dysphagia. A total of 94 participants were parallelly allocated into the NIS group or the NIS group between April 2019 and April 2020. The primary endpoint was the rate of recurrent dysphagia. The secondary endpoints included technical success, clinical success, overall survival, and adverse events. RESULTS: The technical success rate and the clinical success rate was 100.0% (47/47) in both groups. The median follow-up period was 189 days (range 14-422 days). Recurrent dysphagia was observed in 12.8% (6/47) of patients in the NIS group and 31.9% (15/47) in the CIS group (P = 0.026). Tissue/tumor growth occurred in 4 patients (8.5%) after NIS placement and 12 (25.5%) after CIS placement (P = 0.028). Stent migration occurred in 2 patients (4.3%) after NIS placement and 3 (6.4%) after CIS placement (P = 0.646). No food obstruction was found in both groups. The median overall survival was 177 days (95% confidence interval [CI] 139-214) in the NIS group and 168 days (95% CI 153-183) in the CIS group (P = 0.932). The incidence of severe adverse events was comparable between the two groups (21.3% vs. 17.0%, P = 0.600). CONCLUSIONS: In patients with malignant dysphagia, compared with CIS, NIS could decrease the rate of tissue/tumor growth without increase the rate of stent migration and therefore decrease the rate of recurrent dysphagia.

Copper-Catalyzed Cyclization of N-Propargyl Ynamides with Borane Adducts through B-H Bond Insertion.

An efficient copper-catalyzed cyclization of N-propargyl ynamides with borane adducts through B-H bond insertion has been developed. A series of valuable organoboron compounds are constructed in generally good yields with a wide substrate scope and good functional group tolerance under mild reaction conditions. Importantly, this protocol via vinyl cation intermediates constitutes a novel way of B-H bond insertion.

Interventional Treatment for Cholangiocarcinoma.

Cholangiocarcinoma (CCA) is the second most common type of primary liver malignancy. The latest classification includes intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma, with the latter one further categorized into perihilar and distal cholangiocarcinoma. Although surgical resection is the preferred treatment for CCA, less than half of the patients are actually eligible for radical surgical resection. Interventional treatment, such as intra-arterial therapies, ablation, and brachytherapy (iodine-125 seed implantation), has become an acceptable palliative treatment for patients with unresectable CCA. For these patients, interventional treatment is helpful for locoregional control, symptom relief, and improving quality of life. Herein, in a timely and topical manner, we will review these advances and highlight future directions of research in this article.

Development of TACE Refractoriness Scores in Hepatocellular Carcinoma.

Purpose: To identify the independent risk factors for transarterial embolization (TACE) refractoriness and to develop a novel TACE refractoriness score and nomogram for predicting TACE refractoriness in patients with hepatocellular carcinoma (HCC). Methods: Between March 2006 and March 2016, HCC patients who underwent TACE monotherapy as initial treatment at two hospitals formed the study cohort and validation cohort. The criteria of TACE refractoriness followed the Japan Society of Hepatology 2014 version of TACE refractoriness. In the study cohort, the independent risk factors for TACE refractoriness were identified, and TACE refractoriness score and nomogram were then developed. The accuracy of the systems was validated externally in the validation cohort. Results: In total, 113 patients from hospital A formed the study cohort and 122 patients from hospital B formed the validation cohort. In the study cohort, 82.3% of the patients (n = 93) developed TACE refractoriness with a median overall survival (OS) of 540 days (95% CI, 400.8-679.1), and the remaining 20 patients in the TACE-non-refractory group had a median OS of 1,257 days (95% CI, 338.8-2,175.2) (p = 0.019). The median time for developing TACE refractoriness was 207 days (95% CI, 134.8-279.2), and a median number of two TACE procedures were performed after refractoriness developed. The independent risk factors for TACE refractoriness were the number of tumors and bilobular invasion of HCC. TACE refractoriness scores <3.5 indicated a lower incidence of TACE refractoriness, whereas scores >3.5 points indicated a higher incidence (p < 0.001). In the validation cohort, 77.9% of the patients (n = 95) developed TACE refractoriness with a median OS of 568 days (95% CI, 416.3-719.7), and a median OS of 1,324 days was observed in the TACE-non-refractory group (n = 27; 95% CI, 183.5-2,464.5). Conclusions: TACE refractoriness impairs the OS of HCC patients. The number of tumors and bilobular invasion status were independent risk factors for TACE refractoriness. The TACE refractoriness score can be an effective tool and easy approach to predict the risk of TACE refractoriness status.

Organocatalytic asymmetric formal [3 + 2] cycloaddition reaction of isocyanoacetates with saccharin-derived 1-azadienes.

An efficient organocatalytic diastereo- and enantioselective formal [3 + 2] cycloaddition reaction of α-isocyanoacetates with saccharin-derived 1-azadienes catalyzed by a dihydroquinine derived squaramide catalyst has been investigated, and it furnished the corresponding directly linked benzo[d]isothiazole 1,1-dioxide-dihydropyrroles with two adjacent tertiary-quaternary stereocenters in high yields (up to 98%), with moderate to excellent stereoselectivities (up to >20 : 1 dr and 97% ee) under mild conditions.

[High tibial osteotomy combined with lateral retinacular release for the treatment of knee varus osteoarthritis with lateral patellar compression syndrome].

OBJECTIVE: To investigate the clinical effect of high tibial osteotomy combined with arthroscopic lateral retinacular release in the treatment of knee varus osteoarthritis. METHODS: From October 2017 to April 2019, a retrospective analysis was performed on 43 patients with knee varus osteoarthritis and lateral patellar compression syndrome treated by high tibial osteotomy combined with arthroscopic lateral retinacular release. There were 15 males and 28 females, aged 53 to 72(62.05±5.17) years. The visual analogue scale(VAS), Lysholm, and the knee range of motion were used to evaluate knee pain and functional recovery before operation, 2 weeks, 3 months and 12 months after operation. And the congruence angle (CA), patellar tilt angle (PTA), and femala-tibial angle (FTA) were measured respectively before and 12 months after operation to evaluate the congruence of patellar joint, and the improvement of line of gravity of lower limb. RESULTS: All 43 patients were followed up for more than 12 months, with a follow-up time of 14 to 28 (19.60±4.50) months. The VAS scores decreased from 6.65±0.65 before operation to 2.16±0.95, 0.51±0.77 and 0.33±0.64 at 2 weeks, 3 months and 12 months after operation, and the difference was statistically significant (P<0.001). Lysholm score increased from 43.02±8.54 before operation to 46.84±2.81, 72.42±5.30, and 93.40±5.44 at 2 weeks, 3 months and 12 months after operation, and the difference was statistically significant (P<0.001). The knee range of motion increased from (86.97±5.02)° before operation to (99.38±3.27)°, (110.13±4.13)°, and (113.03±4.85)° at 2 weeks, 3 months and 12 months after operation, the difference was statistically significant (P<0.001). The CA decreased from (7.81±1.21)° before operation to (5.82±4.10)° at 12 months after operation, the PTA decreased from (15.87±2.89)° before operation to (13.79±4.26)° at 12 months after operation, and the FTA decreased from(182.61±2.07)° before operation to(170.89±0.89)° at 12 months after operation, and the differences were statistically significant (P<0.05). One case received proper braking and anticoagulation after operation, and was improved after 1 week. The swelling was observed in 14 patients after operation, and subsided about 2 weeks later. CONCLUSION: High tibial osteotomy combined with arthroscopic lateral retinacular release can relieve weight-bearing pain in frontal axis and improve the function of knee in sagittal axis.

Myocardial Bridge Bypass Graft: A Novel Surgical Procedure for Extensive Myocardial Bridges.

In patients with myocardial bridges (MBs) and insufficient medical management, the optimal surgical strategy remains undetermined. Based on computer simulations we developed a novel procedure, MB bypass grafting, that showed better hemodynamics compared with coronary artery bypass grafting in a simulation study. In this novel procedure the left internal mammary artery was used to connect the proximal and distal ends of the MB. For the first time we used MB bypass grafting to treat a patient with extensive MB. The patient recovered well after surgery, and the left internal mammary artery graft remained patent 3 months postoperatively.

Inhibition of Endoplasmic Reticulum Stress-Mediated Autophagy Enhances the Anticancer Effect of Iodine-125 Seed Radiation on Esophageal Squamous Cell Carcinoma.

Autophagy has been reported to play a radioresistance role in high-dose-rate irradiation. However, its mechanisms and roles in continuous low-dose-rate (CLDR) irradiation have not been clearly understood. Iodine-125 (I-125) seed brachytherapy is a modality of CLDR irradiation and has been used in the treatment of various cancers. In this study, we investigated the mechanisms and roles of autophagy induced by I-125 seed radiation in human esophageal squamous cell carcinoma (ESCC) cell lines (Eca-109 and EC-109) and a xenograft mouse model. The results of this work showed that I-125 seed radiation induced a dose-dependent increase in autophagy in both cell lines. In Eca-109 cells, I-125 seed radiation-induced endoplasmic reticulum (ER) stress, manifesting as the increased levels of intracellular Ca2+ and Grp78/BiP, and activated PERK-eIF2α, IRE1, and ATF6 pathways of the unfolded protein response. Knockdown of PERK led to the decreased expression of autophagy marker, LC3B-II. Inhibition of autophagy by chloroquine or knockdown of ATG5 enhanced I-125 seed radiation-induced cell proliferation inhibition and apoptosis. Interestingly, chloroquine did not aggravate ER stress but promoted apoptosis via the mitochondrial pathway. The animal experiment showed that inhibition of autophagy by chloroquine improved the efficacy of I-125 seed radiation. In summary, our data demonstrate that I-125 seed CLDR radiation induces ER stress-mediated autophagy in ESCC. Autophagy plays a pro-survival role in I-125 seed CLDR irradiation, and chloroquine is a potential candidate for use in combination therapy with I-125 seed radiation treatment to improve efficacy against ESCC.

[Effects of stand structure on understory biomass of the Quercus spp secondary forests in Hunan Province, China]. / æž—åˆ†ç»“æž„å¯¹æ¹–å—æ Žç±»å¤©ç„¶æ¬¡ç”Ÿæž—æž—ä¸‹æ¤è¢«ç”Ÿç‰©é‡çš„å½±å“.

We examined biomass characteristics and the potential driving factors of different forest types of Quercus spp. secondary forest in Hunan. A total of fifty plots were divided into five forest types: Castanopsis eyri - Rhododendron latoucheae mixed forest (CR), Fagus lucida - Fargesia spathacea mixed forest (FF), Lithocarpus glaber - Damnacanthus indicus + Camellia japonica mixed forest (LDC), C. eyri + Quercus serrata - R. latoucheae mixed forest (CQR), Cyclobalanopsis glauca - Camellia oleifera + R. latoucheae mixed forest (CCR). The biomass of understory vegetation was low in the five forest types, being smaller than 2.3 t·hm-2. There was no significant difference in the biomass of understory shrubs among the five forest types. The biomass of herbage layer in CR was significantly lower than that of the other four forest types. The factors affecting the biomass of understory vegetation varied in different forests types. In CR, biomass of herbaceous layer was negatively correlated with canopy and uniform angle index, whereas total understory biomass was positively correlated with opening degree index. In FF, biomass of shrub layer was negatively correlated with stand canopy density and uniform angle index, while herbaceous biomass and total understory biomass were positively correlated with stand closure. In LDC, herbaceous biomass was positively correlated with the stand aggregation index. In CQR, shrub biomass was negatively correlated with stand mingling index, while herbaceous biomass was positively related with stand density. In CCR, there was no significant correlation between stand structure and understory biomass. To adjust the understory biomass, we should first adjust the horizontal distribution pattern of stand and then adjust the degree of forest cover and tree species structure.

[Evaluation of cartilage regeneration by arthroscopy after high tibial osteotomy].

OBJECTIVE: To evaluate the cartilage regeneration in the knee joint by arthroscopy after high tibial osteotomy. METHODS: Eleven patients were included in the study who were treated with high tibial osteotomy and underwent microscopy when the internal fixation was unloaded from September 2017 to September 2019. Among them, there were 2 males and 9 females, aged from 55 to 64 years old. The internal and external compartment pictures of the knee were taken before and after surgery of removing the internal fixation and the International Cartilage Repair Society (ICRS) grading systerm was used to evaluate the degree of cartilage damage on the medial and lateral femoralcondyles and tibial plateau. The Westrn Ontarioand Mcmaster Universities osteoarthritis index (WOMAC) and the weight bearing line (WBL) were used to evaluate the function of the knee and the alignment of the lower limb. RESULTS: All 8 patients were followed up for more than 12 months, ranging from 12 to 22 months. The degenerated cartilage of the medial femoral condyle and medial tibial plateau was covered by newly regenerated cartilage. WOMAC score decreased from 102-127 to 41-52 and WBL was improved from 17%-34% to 58%-64%. All incisions healed in stageⅠ, and no complications such as internal fixation rupture and infection occurred during and after the operation. CONCLUSION: High tibial osteotomy can relieve the pain of the knee and the dysfunction by adjusting lower limb alignment, and the degenerated cartilage could be regenerated in the medial femoral condyle and medial tibial plateau.

Oligorecurrence Non-small Cell Lung Cancer After Failure of First-Line Chemotherapy: Computed Tomography-Guided 125I Seed Implantation vs. Second-Line Chemotherapy.

Purpose: To compare the efficacy and safety of computed tomography (CT)-guided 125I seed implantation with second-line chemotherapy in treatment of oligorecurrence non-small cell lung cancer after failure of first-line chemotherapy. Methods: Data of oligorecurrence non-small cell lung cancer patients after failure of first-line chemotherapy at two institutions were retrospectively reviewed from January 2013 to July 2018. A total of 53 patients who received the treatment of 125I seed implantation or second-line chemotherapy were eligible for this study. In group A, 25 patients, 84 lesions, received CT-guided permanent 125I seed implantation, whereas in group B, 28 patients, 96 lesions, received second-line chemotherapy. The outcomes were measured in terms of disease control rate, overall survival, quality of life, and complications. Results: The median follow-up period was 13 months (range, 5-42 months). Disease control rate in group A was higher than that in group B (70.8 vs. 42.3%, P = 0.042) at 6 months after treatment. The median overall survival was 12.8 months (95% confidence interval, 10.5-15.1 months) in group A and 15.2 months (95% confidence interval, 12.2-18.2 months) in group B, with no significant difference (P = 0.847). Since the fourth month, the number of patients in group A with a non-decreasing Karnofsky Performance Scale score was more than that in group B (P < 0.05). The incidence of grade 3 or higher complications especially hematologic toxicity in group A was significantly lower than that in group B (P < 0.05). Conclusion: Radioactive 125I seed implantation is safe and feasible in selected non-small cell lung cancer patients with oligorecurrence after failure of first-line chemotherapy and seems to provide a better long-term quality of life in these patients compared with second-line chemotherapy.

Iodine­125 seed radiation induces ROS­mediated apoptosis, autophagy and paraptosis in human esophageal squamous cell carcinoma cells.

Iodine­125 (125I) seed brachytherapy has been proven to be a safe and effective treatment for advanced esophageal cancer; however, the mechanisms underlying its actions are not completely understood. In the present study, the anti­cancer mechanisms of 125I seed radiation in human esophageal squamous cell carcinoma (ESCC) cells (Eca­109 and KYSE­150) were determined, with a particular focus on the mode of cell death. The results showed that 125I seed radiation significantly inhibited cell proliferation, and induced DNA damage and G2/M cell cycle arrest in both ESCC cell lines. 125I seed radiation induced cell death through both apoptosis and paraptosis. Eca­109 cells were primarily killed by inducing caspase­dependent apoptosis, with 6 Gy radiation resulting in the largest response. KYSE­150 cells were primarily killed by inducing paraptosis, which is characterized by extensive cytoplasmic vacuolation. 125I seed radiation induced autophagic flux in both ESCC cell lines, and autophagy inhibition by 3­methyladenine enhanced radiosensitivity. Furthermore 125I seed radiation induced increased production of reactive oxygen species (ROS) in both ESCC cell lines. Treatment with an ROS scavenger significantly attenuated the effects of 125I seed radiation on endoplasmic reticulum stress, autophagy, apoptosis, paraptotic vacuoles and reduced cell viability. In vivo experiments showed that 125I seed brachytherapy induced ROS generation, initiated cell apoptosis and potential paraptosis, and inhibited cell proliferation and tumor growth. In summary, the results demonstrate that in ESCC cells, 125I seed radiation induces cell death through both apoptosis and paraptosis; and at the same time initiates protective autophagy. Additionally, 125I seed radiation­induced apoptosis, paraptosis and autophagy was considerably mediated by ROS.

Copper-Catalyzed Asymmetric Reaction of Alkenyl Diynes with Styrenes by Formal [3 + 2] Cycloaddition via Cu-Containing All-Carbon 1,3-Dipoles: Access to Chiral Pyrrole-Fused Bridged [2.2.1] Skeletons.

The generation of metal-containing 1,3-dipoles from metal carbenes represents a significant advance in 1,3-dipolar cycloaddition reactions. However, these transformations have so far been limited to reactions based on diazo compounds or triazoles as precursors. Herein, we disclose a copper-catalyzed enantioselective reaction of alkenyl N-propargyl ynamides with styrene derivatives by formal [3 + 2] cycloaddition via Cu-containing all-carbon 1,3-dipoles, which constitutes a novel way for the generation of metal-containing 1,3-dipoles via metal carbenes. This protocol allows the practical and atom-economical synthesis of valuable chiral pyrrole-fused bridged [2.2.1] skeletons in moderate to good yields (up to 90% yield) with excellent diastereoselectivities (dr > 50/1) and generally excellent enantioselectivities (up to >99% ee).

[High tibial osteotomy combined with arthroscopy for elderly patients with knee osteoarthritis of medial compartment].

OBJECTIVE: To observe early clinical effect of high tibial osteotomy combined with arthroscopy for elderly patients with knee osteoarthritis of medial compartment. METHODS: Sixty-one elderly patients with medial compartment knee osteoarthritis were treated with high tibial osteotomy combined with arthroscopy from August 2017 to October 2018. Among them, including 17 males and 44 females, aged from 60 to 83 years old with an average of (67.87±6.45) years old. Weight bearing line (WBL) and femora-tibial angle (FTA) were analyzed to assess lower limb alignment before and 12 months after surgery. Visual analogue scale (VAS) score and Hospital for Special Surgery (HSS) score were used to evaluate knee pain and function before and 1, 3, 12 months after surgery. RESULTS: All patients were followed up from 12 to 19 months with an average of (14.27±4.69) months. WBL was improved from (14.79±5.61) % before operation to (59.33±7.82) % at 12 months after operation (t=2.294, P<0.05), FTA was improved from (182.14±2.19) ° before operation to (171.54±3.16) ° at 12 months after operation (t=1.827, P<0.05) . VAS score decreased from 6.14±2.21 before operation to 3.64±0.92, 2.02±0.63 and 0.93±0.61 at 1, 3 and 12 months after operation (F=458.24, P<0.001), HSS score increased from 49.66±13.79 to 58.39±9.26, 71.82±6.06 and 82.71±6.97 at 1, 3 and 12 months after operation (F=266.45, P<0.001) . Three patients had contralateral cortical fracture during surgery, whose osteotomy area healed well at 12 months after surgery. The incision healing of 4 cases was slow, while all healed at 3 to 4 weeks after surgery. CONCLUSION: High tibial osteotomy combined with arthroscopy could adjust lower limb alignment effectively, relieve knee pain and functional dysfunction, which indicated a significant short term efficacy on the elderly patients with knee osteoarthritis of medial compartment.