Effectiveness and Safety of Tourniquet Application Strategies in Total Knee Arthroplasty: a Meta-analysis.

BACKGROUND: We conducted the present meta-analysis to assess the effectiveness and safety of long-duration tourniquet and short-duration tourniquet for patients with total knee arthroplasty (TKA). METHODS: Published randomized controlled trials (RCTs) were identified from the following electronic databases: PubMed, Embase, Web of Science and Cochrane Library from inception to January 1, 2021. Studies comparing long-duration tourniquet and short-duration tourniquet in total knee arthroplasty were included. Either a random-effects model or a fixed-effects model was used for meta-analysis depending on the heterogeneity. Statistical analysis was assessed using RevMan 5.3 software. RESULTS: A total of 8 RCTs with a total of 484 patients were eligible and ultimately included in the meta-analysis. Compared with patients in the long-duration tourniquet, those in the short-duration tourniquet were significantly correlated with postoperative drainage volume (WMD = -71.85, 95% CI - 76.52 to - 67.17, P = 0.31), but an increased risk of total blood loss (WMD = 68.13, 95% CI 5.15-131.12, P = 0.03) and intraoperative blood loss (WMD = 137.13, 95% CI 69.06-205.20, P < 0.00001). Two groups showed no significant difference in operation time, visual analogue scale score of knee in early, transfusion rate and incidence of deep venous thrombosis. CONCLUSIONS: Our meta-analysis suggested that the short-duration tourniquet in TKA significantly decreased the postoperative drainage volume, increased the total blood loss and intraoperative blood loss. However, it did not marked decrease the occurrence of transfusion rate. Although the incidence of deep venous thrombosis was reduced in some study, it was not statistically significant. Additional high quality RCTs are needed to identify the hypothesis. Therefore, we recommend prolonged use of tourniquets during TKA surgery.

Incidence and Characteristics of Co-infection and Secondary Infection in Patients with COVID-19

ObjectiveThe etiology and epidemiology of co-infection and secondary infection in COVID-19 patients remain unknown. The study aims to investigate the occurrence and characteristics of co-infection and secondary infection in COVID-19 patients, mainly focusing on Streptococcus pneumoniae co-infections. MethodsThis study was a prospective, observational cohort study of the inpatients diagnosed with COVID-19 in two designated hospitals in south China enrolled between Jan 11 and Feb 22, 2020. The urine specimen was collected on admission and applied for pneumococcal urinary antigen tests (PUATs). Demographic, clinical and microbiological data of patients were recorded simultaneously. ResultA total of 146 patients with a confirm diagnosis of COVID-19 at the median age of 50.0 years (IQR 36.0-61.0) were enrolled, in which, 16 (11.0%) were classified as severe cases and 130 (89.0%) as non-severe cases. Of the enrolled patients, only 3 (2.1%) were considered to present the co-infection, in which 1 was co-infected with S.pneumoniae, 1 with B. Ovatus infection and the other one with Influenza A virus infection. Secondary infection occurred in 16 patients, with S. maltophilia as the most commonly isolated pathogen (43.8%), followed by P. aeruginosa (25.0%), E. aerogenes (25.0%), C. parapsilosis (25.0%) and A. fumigates (18.8%). ConclusionPatients with confirmed COVID-19 were rarely co-infected with Streptococcus pneumoniae or other pathogens, indicating that the application of antibiotics against CAP on admission may not be necessary in the treatment of COVID-19 cases.

Highly Selective Enamination of ß-ketoesters Catalyzed by Interlocked [Cu8 ] and [Cu18 ] Nanocages.

Interlocking cages are of great interest due to their fascinating structures and potential applications. However, the interlocking of different cages has not been previously reported. Herein, quadruply interlocked [Cu8 ] and [Cu18 ] nanocages have been constructed and structurally characterized in cationic metal-organic framework {[CuI Cu4 II (XN)4 (PTA)4 (H2 O)4 ]0.5 SO4 ⋅5 H2 O⋅EtOH}n (1). 1 can trap the anionic pollutant CrO4 2- and the radioactive-contaminant simulant ReO4 - with an uptake capacity of 83.2 and 218 mg g-1 , respectively. Catalytic investigations reveal 1 is an efficient heterogeneous catalyst for the enamination of ethyl acetoacetate with aniline and the turnover frequency (TOF) can reach a record value of 4000 h-1 . More importantly, 1 represents the first of a catalyst of enamination to exhibit excellent size selectivity on different substrates. The robust catalyst can be reused at least ten times without obvious loss in catalytic activity.

Water Stable [Tb4] Cluster-Based Metal-Organic Framework as Sensitive and Recyclable Luminescence Sensor of Quercetin.

A novel 3D metal-organic framework (MOF){[Tb3(CBA)2(HCOO)(µ3-OH)4(H2O)]·2H2O·0.5DMF} n (S-1) was synthesized by the solvothermal method. The crystal structure indicates that [Tb4O4] cubane clusters self-assemble into an infinite chain by sharing vertex, which is further linked to adjacent chains through 1,1-cyclobutanedicarboxylic acid ligand (H2CBA), resulting in a honeycomb arrayed framework. S-1 possesses excellent water stability and still retains intact structure after exposure to water for 10 weeks or boiling water for 10 weeks. Interestingly, S-1 acts as a luminescence sensor to selectively and sensitively detect quercetin with the limit of detection (LOD) as low as 0.23 ppm (7.6 × 10-7 M). The relationship between relative luminescence intensity and concentration obeys linear in the range of 0-300 ppm (0-993 µM), which allows quantitative detection of quercetin. Importantly, S-1 can be reused at least six times with almost no change in luminescent intensity. Compared with the high performance liquid chromatography-mass spectrometry (HPLC-MS) method, S-1 was used to determine the content of quercetin in onionskin and apple peel samples with satisfactory results. Furthermore, a portable S-1 test paper is also developed and expected to be applied in practice. To our knowledge, S-1 is the first example of MOFs as luminescent sensor for quercetin.

Establishment and Identification of MDS Mouse Model with Irom Overload / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To establish a MDS mouse model with iron overload and to study the effect of iron overload on MDS.</p><p><b>METHODS</b>The exogenous mutant gene RUNX1-S291fs was inserted into the mice bone marrow mononuclear cell's genome in mice by retrovirus and transplanted into C57BL/6 mice irradiated by Co γ-ray. After 8 weeks,intraperitoneal injection of iron was performed to establish an MDS mouse model with iron overload. After 24 weeks of transplantation, the peripheral blood, bone marrow, femur, liver and spleen of mice were taken, then the morphological characteristics of peripheral blood and bone marrow cells were observed by Wright's staining; the liver, spleen and bone marrow were stained with Prussian blue to observe the iron deposition. The surface antigens of bone marrow cells were detected by flow cytometry. Bone marrow mononuclear cells and spleen tissue proteins were detected by Western blot to confirm the transfection of RUNX1-S291fs gene and expression of protein. The blood routine and transplanted cell chimeric rate of mice were monitored periodically.</p><p><b>RESULTS</b>Compared with the empty plasmid control mice, levels of leukocyte and hemoglobin as well as platelet were decreased in RUNX1-S291fs mutant mice; the peripheral blood cells and bone marrow cells showed pathological hematopoiesis; the liver and spleen enlarged significantly; the tissue structure of femur, liver and spleen was abnormal; the expression of bone marrow cell surface antigens was abnormal. Bone marrow cells and spleen tissue expressed the RUNX1-S291fs protein. Compared with the controlled mice injected with normal saline, iron deposition occurred in the bone marrow, liver and spleen stained with Prussian blue in the mice injected with iron agent.</p><p><b>CONCLUSION</b>Mice engineered to carry exogenous mutant gene RUNX1-S291fs and injected with iron showed pathologic features of MDS and iron overload, resulting in establishing MDS iron overloaded mouse model successfully, which lays a foundation for studying the effect of iron overload on MDS.</p>

Baicalin alleviated rheumatoid arthritis synovitis of SD rats through TLR2-NF-κB pathway / 中国药理学通报

Aim To evaluate the effects of different doses of baicalin on rheumatoid arthritis (RA) in SD rats and explore the possible mechanism.Methods Firstly,the model of RA in SD rats was prepared and the hind foot swelling was measured;HE staining was used to observe the pathological changes of the knee joint synovial tissue;RT-qPCR was adopted to determine the mRNA expressions of TLR2 and MyD88 in synovial tissue;Western blot was used to determine the protein expressions of TLR2,MyD88 and NF-κB p65 aher intragastric administration of different doses of baicalin solution.Results Compared with the model,baicalin (60 and 30 mg · kg-1) could inhibit the proliferation of fibroblasts and inflammatory damages in synovial tissue,significantly cut down mRNA expressions of TLR2 and MyD88 (P ＜ 0.05) and markedly reduce protein expressions of TLR2,MyD88 and NF-κB p65 (P ＜ 0.01).Conclusion Baicalin has good effects on RA,which may be realized by inhibiting the activation of TLR2-NF-κB signaling pathway.

Unique (3,4,10)-Connected Lanthanide-Organic Framework as a Recyclable Chemical Sensor for Detecting Al(3.).

Three isostructural Ln-BTB frameworks (Ln = Eu (1), Dy (2), Yb (3)) were synthesized and structurally characterized, in which mononuclear and trinuclear [Ln3] units as nodes construct unprecedented (3,4,10)-connected 3D frameworks with (4·6·8)4(4·8(2))2(4·8(5))(6(2)·8(4))(4(5)·6(8)·8(26)·10(6)) point symbol. The luminescent investigations revealed that compound 1 can sensitively and selectively detect Al(3+), but comparably compound 2 could not detect Al(3+) among various cations. More importantly, 1 as an Al(3+) sensor can be reused at least five times, which represents the first recyclable metal organic framework (MOF)-supported Al(3+) sensor. Additionally, magnetic investigations on 2 also were carried out, showing a single-molecule-magnet behavior.

Structures and magnetic properties of several phenoxo-O bridged dinuclear lanthanide complexes: Dy derivatives displaying substituent dependent magnetic relaxation behavior.

Nine dinuclear Ln(iii) complexes, [Ln(dbm)2(L)]2 (Ln = Eu (), Tb (), Dy (), Ho (), Er ()) and [Ln(dbm)2(L')]2 (Ln = Tb (), Dy (), Ho (), Er ()) (dbm = 1,3-diphenyl-1,3-propanedione, HL = 2-[[(4-methoxy-phenyl)imino]methyl]-8-hydroxy-quinoline and HL' = 2-[[(4-ethoxyphenyl)imino]methyl]-8-hydroxyquinoline) have been synthesized, and structurally and magnetically characterized. The nine complexes are all phenoxo-O bridged binuclear complexes, in which Ln1 and Ln1a are in an eight-coordinated environment bridged by two phenoxido oxygen atoms of two 8-hydroxyquinoline Schiff base ligands. Although complexes and have very similar structures, magnetic studies reveal that they exhibit different magnetic relaxation behaviors with the effective barriers (ΔE/kB) of 34.5 K for and 67.6 K for . The dissimilar dynamic magnetic behaviors of and mostly result from the different electron-donating effect induced by the two alkoxy (-OCH3 and -OC2H5) of the 8-hydroxyquinoline Schiff base ligands. Meanwhile, for complexes , , and , there are no observed magnetic relaxation behaviors under a zero dc field. In addition, the luminescence properties of , and were studied.

Changes in digestive enzyme activities during larval development of Chinese loach Paramisgurnus dabryanus (Dabry de Thiersant, 1872).

The digestive physiology of Chinese loach (Paramisgurnus dabryanus) was studied by assessing the specific and total activities of different pancreatic (trypsin, chymotrypsin, amylase and lipase), gastric (pepsin) and intestinal (alkaline phosphatase and leucine-aminopeptidase) enzymes from hatching to 40 days after hatching (DAH). Larvae were reared at 24.4 ± 0.4 °C and fed with rotifers from mouth opening (4 DAH) to 15 DAH, from 10 to 35 DAH with Cladocera and from 30 to 40 DAH with compound diet. Enzyme activities for trypsin, chymotrypsin, amylase and lipase were detected before the onset of exogenous feeding, indicating that these enzymes were genetically pre-programmed. Most of the pancreatic enzyme specific activities increased until 20 DAH and decreased thereafter. The pepsin activity of Chinese loach was firstly detected at 30 DAH, indicating the appearance of functional gastric gland. Alkaline phosphatase specific activity was detected from hatching onward, showed marked increase and reached the second peak at 20 DAH, while a gradual increase in specific leucine-aminopeptidase activity was observed until the end of the experiment. Accordingly, the larvae of Chinese loach possess a functional digestive system before the onset of exogenous feeding and the digestive capacity gradually increases as development progresses. The abrupt increase in intestinal enzyme activities between 10 and 20 DAH demonstrates onset of juvenile-like digestive mode in Chinese loach larvae. The increase in pepsin activity after 30 DAH indicates the shift from alkaline to acidic digestion in Chinese loach larvae, which may be considered as the onset of weaning.

[Effects of peroxisome proliferators-activated receptor-gamma on the function of the vital organs in rats with pancreatitis].

OBJECTIVE: To observe the effects of peroxisome proliferators-activated receptor-gamma (PPARgamma) on the function of the vital organs in rats with pancreatitis. METHODS: Acute pancreatitis (AP) was induced in 30 male SD rats by ductal injection of 4% sodium taurocholate at 1.0 ml/kg. The rats received subsequent intravenously injection of 0.3 mg/kg of PPARgamma ligand (rosiglitazone, n=10), PPARgamma antagonist (GW9662, n=10) followed 10 min later by rosiglitazone administration at 0.3 mg/kg, or left untreated (AP model group, n=10). Another 10 male SD rats receiving no particular treatment served as the control group. The rats were sacrificed 6 h after the operation, and blood samples were collected for measurement of the biochemical indices of the vital organs. The histological changes of the pancreas and portal vein blood endotoxin content were examined. RESULTS: The rats in AP group and GW9662 group showed significantly higher level of the biochemical indices for the vital organs, pathological scores of the pancreas and portal vein blood endotoxin content were significantly higher in the control group and roglitazone-treated groups (P<0.05). CONCLUSION: PPARgamma ligand roglitazone can significantly ameliorate multiple organ injuries and effectively protect the functions of the organs in rats with experimental pancreatitis.

[Study on vascular endothelial injuries and inflammation related cytokines in patients with multiple organ dysfunction syndrome].

OBJECTIVE: To investigate the relationship between the circulating endothelial cell (CEC), coagulation, fibrinolysis indexes and inflammation related cytokines in patients with multiple organ dysfunction syndrome (MODS). METHODS: Thirty-five patients with MODS (MODS group) and 20 healthy individuals (control group) were enrolled for study. CECs were harvested by isopycnic centrifugation method. Plasma prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FG), D-dimer, and serum tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) were determined simultaneously. The relationship between dynamic changes in CEC, TNF-alpha, IL-6 and that in PT, APTT, FG, D-dimer was analyzed. RESULTS: Compared to the control group, CEC numbers, serum TNF-alpha, IL-6 levels and plasma D-dimer level significantly increased, PT and APTT were prolonged, and FG significantly decreased in MODS group (all P<0.05). The quantity of CEC and serum levels of TNF-alpha and IL-6 elevated with the lapse of time. Correlation analysis revealed a significant positive correlation between CEC and serum levels of TNF-alpha and IL-6 (r(1)=0.536, P(1)=0.000; r(2)=0.412, P(2)=0.002), and the same correlation between serum TNF-alpha, IL-6 levels and PT, APTT. CONCLUSION: Elevation of serum inflammation related cytokines and vascular endothelial cell damage occur in MODS patients. Serum inflammation related cytokines play an important role in endothelial damage, and an increase in CEC number may be attributed to vessel injury.

Treatment of meniscal injuries of knee joints by arthroscopy / 中国基层医药

Objective To assess the effectiveness of treatment of meniscal injuries of knee joints by arthroscopy.Methods 33 patients 35 joints were followed up and the parts,types and treatment under arthroscopy were analysed.Results 33 patients were followed up from six months to six years,the mean preoperative Lysholm score was 60.5 points,and the mean postoperative one was 86.7 points.Conclusion The advantage of treating meniscal injuries by arthroscopy was the result of correct examination and little wound of arthroscopy operation,and arthroscopic repair or partial menisectomy could effectively restore the function of the injured knee.