Estradiol reduced 5-HT reuptake by downregulating the gene expression of Plasma Membrane Monoamine Transporter (PMAT, Slc29a4) through estrogen receptor ß and the MAPK/ERK signaling pathway.

Estrogen deficiency-induced female depression is closely related to 5-hydroxytriptamine (5-HT) deficiency. Estradiol (17ß-estradiol, E2) regulates the monoamine transporters and acts as an antidepressant by affecting 5-HT clearance through estrogen receptors and related signaling pathways at the genomic level, although the specific mechanisms require further exploration. The brain expresses higher levels of plasma membrane monoamine transporter (PMAT, involved in 5-HT reuptake of the uptake 2 system) than other uptake transporters. In this study, we found that estrogen-deficient ovariectomized (OVX) rats had high PMAT mRNA and protein expression levels in the hippocampus and estradiol significantly reduced these levels. Furthermore, estradiol inhibited PMAT expression and reduced 5-HT reuptake in neurons and astrocytes and estradiol regulated the PMAT expression mainly by affecting estrogen receptor ß (ERß) at the genomic level in astrocytes. Further experiments showed that estradiol also regulated PMAT expression through the MAPK/ERK signaling pathway and not through the PI3K/AKT signaling pathway. In conclusion, estradiol inhibited 5-HT reuptake by regulating PMAT expression at the genomic level through ERß and the MAPK/ERK signaling pathway, highlighting the importance of PMAT in the antidepressant effects of estradiol through 5-HT clearance reduction.

A Hybrid Repair Technique Combining Single-Bundle Reconstruction and Primary Repair With Internal Brace Augmentation for Anterior Cruciate Ligament Injury.

Recently, favorable outcomes of primary anterior cruciate ligament (ACL) repair have been reported in patients with proximal tears and good tissue quality. If the tear involves the midsubstance of the ACL fibers or Sherman type II or III injury, independent primary repair will cause a higher failure rate at long-term follow-up. For these cases, we conduct primary repair and apply an internal brace and single-bundle reconstruction as hybrid augmentation. This hybrid repair technique encourages natural healing of the primary ligament by the internal brace and single-bundle graft as a provisional scaffold during the healing phase, as well as early mobilization. We describe our ACL hybrid repair technique, using a video and illustrations.

Correlation Analysis of Magnetic Resonance Imaging-Based Graft Maturity and Outcomes After Anterior Cruciate Ligament Reconstruction Using International Knee Documentation Committee Score.

OBJECTIVE: The correlation between the signal/noise quotient values of an anterior cruciate ligament graft and the International Knee Documentation Committee Subjective Knee Form 2000 scores after anterior cruciate ligament reconstruction was evaluated. DESIGN: Magnetic resonance imaging and clinical evaluation using International Knee Documentation Committee scores were used to calculate the signal intensity of the graft maturity at the 6-mo and 12-mo follow-up points postoperatively. The associations between the signal/noise quotient values at the 6-mo follow-up point and International Knee Documentation Committee scores at the 12-mo follow-up point were evaluated. RESULTS: A total of 42 male patients completed our trial and returned to normal activity level before the surgery. The mean ± SD age of these patients was 29.07 ± 8.11 yrs (range, 17-47 yrs). The mean ± SD body mass index was 26.00 ± 2.59 kg/m. Notably, the Pearson correlation analysis showed that the International Knee Documentation Committee scores obtained at 12 mos were significantly associated with the signal/noise quotient values measured in the sixth month and twelfth month, respectively (r = -0.454, P = 0.003; r = -0.478, P = 0.001). CONCLUSIONS: According to this study, early measurement of graft maturity might predict the clinical outcome afterward. The sensitive predictive value of signal/noise quotient could be used to maximize the patient outcomes.

A Pilot Study on Using Forcemyography to Record Upper-limb Movements for Human-machine Interactive Control.

Forcemyography (FMG) is a useful method to record real-time body motions, which has application potentials for human-machine interactive control. The FMG registers the change of force distribution in the normal direction on muscle surface during limb movements, and the body motions can be recognized by decoding the FMG patterns. In this study, we used FMG to record upper-limb movements and evaluated the influence of different configurations of signal channel and feature on motion classification performances. A four-channel wearable FMG acquisition system was developed to record seven upper-limb movements on each of six able-bodied subjects. The preliminary results showed that the signal channel number has significant influence on motion classification performance; however, the influence of signal feature number on motion classification was insignificant. In addition, the influence of channel combination and feature combination were also discussed in this paper. This work would support the application potential of FMG for body motion recording and may provide useful instructions for the application of FMG in human-machine interactive control.

Spatially distributed sequential array stimulation of tibial anterior muscle for foot drop correction.

Electrode arrays for the ease of electrode placement in the correction of foot drop with surface electrical stimulation have been developed in recent years. However, the configuration and identification of optimal stimulation sites with regard to time efficiency, stimulation comfort, and fatigue resistance is yet to be solved. In this study, the candidate stimulation sites were ranked and selected according to the motor thresholds induced by 1 Hz stimulation trains. Then based on the selected sites, a new stimulation configuration method termed spatially distributed sequential stimulation was tested and compared with traditional single electrode stimulation for foot drop correction in two normal subjects. The preliminary results demonstrated that the motor threshold of spatially distributed sequential stimulation was equal or less than motor thresholds of each stimulus sites. Besides, with the same stimulation parameters, the spatially distributed sequential stimulation induced larger dorsiflexion motion compared with traditional single electrode stimulation. These findings suggest that spatially distributed sequential stimulation on the selected sites might be an effective electrode array configuration method for correcting foot drop with electrical stimulation.

C-reactive protein levels after 4 types of arthroplasty.

BACKGROUND AND PURPOSE: Postoperative C-reactive protein (CRP) levels in serum appear to reflect surgical trauma. We examined CRP levels after 4 types of arthroplasty. MATERIAL AND METHODS: We investigated 102 patients who had total knee arthroplasty (TKA), computer navigation-assisted total knee arthroplasty (NAV-TKA), hip resurfacing arthroplasty (metal on metal, MMSA) and total hip arthroplasty (THA), respectively. CRP levels were estimated before surgery and postoperatively at 2 and 7 days. RESULTS: Postoperatively, the peak CRP levels were highest on the second day after surgery in each of the groups. The peak CPR levels after hip resurfacing were lower than those after conventional primary THA. The peak CRP levels after computer navigation-assisted TKA were lower than those after conventional primary TKA. INTERPRETATION: The extent of bone and bone marrow injury rather than the region of surgery or the amount of soft tissue damage appears to determine the extent of the postoperative CRP response.