Hydrogels exhibit potential applications in smart wearable devices because of their exceptional sensitivity to various external stimuli.However,their applications are limited by challenges in terms of issues in biocom...Hydrogels exhibit potential applications in smart wearable devices because of their exceptional sensitivity to various external stimuli.However,their applications are limited by challenges in terms of issues in biocompatibility,custom shape,and self-healing.Herein,a conductive,stretchable,adaptable,self-healing,and biocompatible liquid metal GaInSn/Ni-based composite hydrogel is developed by incorporating a magnetic liquid metal into the hydrogel framework through crosslinking polyvinyl alcohol(PVA)with sodium tetraborate.The excellent stretchability and fast self-healing capability of the PVA/liquid metal hydrogel are derived from its abundant hydrogen binding sites and liquid metal fusion.Significantly,owing to the magnetic constituent,the PVA/liquid metal hydrogel can be guided remotely using an external magnetic field to a specific position to repair the broken wires with no need for manual operation.The composite hydrogel also exhibits sensitive deformation responses and can be used as a strain sensor to monitor various body motions.Additionally,the multifunctional hydrogel displays absorption-dominated electromagnetic interference(EMI)shielding properties.The total shielding performance of the composite hydrogel increases to~62.5 dB from~31.8 dB of the pure PVA hydrogel at the thickness of 3.0 mm.The proposed bioinspired multifunctional magnetic hydrogel demonstrates substantial application potential in the field of intelligent wearable devices.展开更多
While boron nitride(BN) is widely recognized as the most promising thermally conductive filler for rapidly developing high-power electronic devices due to its excellent thermal conductivity and dielectric properties,a...While boron nitride(BN) is widely recognized as the most promising thermally conductive filler for rapidly developing high-power electronic devices due to its excellent thermal conductivity and dielectric properties,a great challenge is the poor vertical thermal conductivity when embedded in composites owing to the poor interracial interaction causing severe phonon scattering.Here,we report a novel surface modification strategy called the "self-modified nanointerface" using BN nanocrystals(BNNCs) to efficiently link the interface between BN and the polymer matrix.Combining with ice-press assembly method,an only 25 wt% BNembedded composite film can not only possess an in-plane thermal conductivity of 20.3 W m-1K-1but also,more importantly,achieve a through-plane thermal conductivity as high as 21.3 W m-1K-1,which is more than twice the reported maximum due to the ideal phonon spectrum matching between BNNCs and BN fillers,the strong interaction between the self-modified fillers and polymer matrix,as well as ladder-structured BN skeleton.The excellent thermal conductivity has been verified by theoretical calculations and the heat dissipation of a CPU.This study provides an innovative design principle to tailor composite interfaces and opens up a new path to develop high-performance composites.展开更多
Generating sufficient strains on metal surfaces are highly challenging owing to that most metals can deform plastically to relax the strains on the surfaces.In this work,we developed a facile but highly efficient stac...Generating sufficient strains on metal surfaces are highly challenging owing to that most metals can deform plastically to relax the strains on the surfaces.In this work,we developed a facile but highly efficient stacked deposition strategy to in situ activation and reconstruction of NiO/NiOOH on Ni matrix,following with the migration of Fe ions to NiOOH.The Fe sites on the Ni/NiO/NiOOH facilitate the formation of the stable*OH oxygenated intermediates,and the Ni matrix in the catalyst provides the catalyst excellent stability.The oxygen evolution reaction(OER)performance of the stacked NiFe-5 with compressive strain displays the strengthened binding to oxygenated intermediates and superior OER activity,the ultralow overpotentials of 162 versus reversible hydrogen electrode at 10 mA cm^(-2).On the other hand,the Ni-5 without the incorporation of Fe has shown an outstanding hydrogen evolution reaction(HER)activity,affording an overpotential of 47 mV at 10 mA cm^(-2).The NiFe-5‖Ni-5 enables the overall water splitting at a voltage of 1.508 V to achieve 20 mA cm^(-2) with remarkable durability.The stacked deposition strategy improves binding strength of Ni-based catalysts to oxygenated intermediates via generating compressive strain,causing high catalytic activities on OER and HER.展开更多
Critical illness polyneuropathy and critical illness myopathy are frequent complications of severe illness that involve sensorimotor axons and skeletal muscles,respectively.Clinically,they manifest as limb and respira...Critical illness polyneuropathy and critical illness myopathy are frequent complications of severe illness that involve sensorimotor axons and skeletal muscles,respectively.Clinically,they manifest as limb and respiratory muscle weakness.Critical illness polyneuropathy/myopathy in isolation or combination increases intensive care unit morbidity via the inability or difficulty in weaning these patients off mechanical ventilation.Many patients continue to suffer from decreased exercise capacity and compromised quality of life for months to years after the acute event.Substantial progress has been made lately in the understanding of the pathophysiology of critical illness polyneuropathy and myopathy.Clinical and ancillary test results should be carefully interpreted to differentiate critical illness polyneuropathy/myopathy from similar weaknesses in this patient population.The present review is aimed at providing the latest knowledge concerning the pathophysiology of critical illness polyneuropathy/myopathy along with relevant clinical,diagnostic,differentiating,and treatment information for this debilitating neurological disease.展开更多
Zwitterion-based materials by virtue of their special physical and chemical characteristics have attracted researchers to utilize them for fabricating functional coatings. The simultaneous presence of positive and neg...Zwitterion-based materials by virtue of their special physical and chemical characteristics have attracted researchers to utilize them for fabricating functional coatings. The simultaneous presence of positive and negative charges renders the zwitterion-based materials with electrostatically induced hydration properties, which enables a high resistance towards oily pollutants, nonspecific protein adsorption, bacterial adhesion and biofilm formation. This review starts from the working mechanism of zwitterions and covers the fabrication strategies of zwitterion-based functional coatings, namely the zwitterion-bearing binder route, the zwitterion-bearing additive route and the post-generation of coatings containing zwitterionic precursors. The applications of zwitterion-based functional coatings are discussed, including medical implants, marine antifouling and oil-resistant coatings, with focus on the relevant mechanisms of the zwitterion-containing coatings for a specific performance. Finally, some comments and perspectives on the current situation and future development of zwitterion-based functional coatings are given.展开更多
Biotic stresses negatively affect canola growth and production. Flea beetle damage and Sclerotinia sclerotiorum (S. sclerotiorum) infection are two of the worst biotic stresses for canola. Auxin Repressed Proteins (AR...Biotic stresses negatively affect canola growth and production. Flea beetle damage and Sclerotinia sclerotiorum (S. sclerotiorum) infection are two of the worst biotic stresses for canola. Auxin Repressed Proteins (ARPs) responsive to several abiotic stresses have been reported. However, information about ARPs induced by Flea beetle damage and S. sclerotiorum infection, their roles in biotic stress tolerance are still lacking in canola. ESTs for an Auxin Repressed Protein 1 (BnARP1) were highly represented (expressed) in a Brassica napus subtractive library developed after leaf damage by the crucifer flea beetle (Phyllotreta cruciferae). Expression of this gene was under different developmental control in B. napus, and it was co-induced in B. napus by flea beetle feeding, S. sclerotiorum infection, drought and cold. A total of 25 BnARP genes were represented in different B. napus stress and development EST libraries and indicated larger, diversified families than known earlier. Dwarf phenotypes, primary root growth inhibition, lateral root enhancement, reduced sensitivity to 2, 4-D, and reduced PIN1 and LOX expression in transgenic Arabidopsis expression lines suggest that BnARP1 is an auxin repressor that prevents auxin transport and supports an interaction between the auxin and jasmonate signalling pathways. And the increased survival after S. sclerotiorum infection in transgenic over-expression Arabidopsis suggests that BnARP1 could play a role in S. sclerotiorum tolerance through connecting auxin and jasmonate signalling pathways.展开更多
Background:Patellofemoral joint(PFJ)degeneration has traditionally been regarded as a contraindication to unicompartmental knee arthroplasty(UKA).More recently,some researchers have proposed that PFJ degeneration can ...Background:Patellofemoral joint(PFJ)degeneration has traditionally been regarded as a contraindication to unicompartmental knee arthroplasty(UKA).More recently,some researchers have proposed that PFJ degeneration can be ignored in medial UKA,and others have proposed that this change should be reviewed in PFJ degenerative facets and severity.This study aimed to systematically evaluate the effect of PFJ degeneration on patient-reported outcome measures(PROMs)and revision rates after medial UKA.Methods:Electronic databases(PubMed,Embase,Web of Science,etc.)were searched for studies assessing the influence of PFJ degeneration on medial UKA.A random-effects meta-analysis was conducted for the Oxford knee score(OKS),Knee society score(KSS),and revision rates and stratified by PFJ degenerative facets(medial/lateral/trochlear/unspecified),severe PFJ degeneration(bone exposed),and bearing type(mobile/fixed).Heterogeneity was assessed by the Cochran Q test statistic and chi-squared tests with the I-squared statistic.Results:A total of 34 articles with 7007 knees(2267 with PFJ degeneration)were included(5762 mobile-bearing and 1145 fixed-bearing and 100 unspecified).Slight to moderate degenerative changes in the medial and trochlear facets did not decrease the OKS and KSS,and only lateral facets significantly decreased the OKS(mean difference[MD]=-2.18,P<0.01)and KSS(MD=-2.61,P<0.01).The severity degree of PFJ degeneration had no additional adverse effect on the OKS,KSS,or revision rates.For mobile-bearing UKA,only lateral PFJ degeneration significantly decreased the OKS(MD=-2.21,P<0.01)and KSS(MD=-2.44,P<0.01).For fixed-bearing UKA,no correlation was found between PROMs/revision rates and PFJ degeneration.Conclusion:For medial mobile-bearing UKA,slight to moderate degenerative changes in the PFJ,except lateral facet,did not compromise PROMs or revision rates.For medial fixed-bearing UKA,although it might not be conclusive enough,PROMs or revision rates were not adversely affected by PFJ degeneration(regardless of the facet).展开更多
Nanocatalysts are likely to contain undetected single-atom components,which may have been ignored but have significant effect in catalytic reactions.Herein,we report a catalyst composed of Mo single atoms(SAs)and MoO_...Nanocatalysts are likely to contain undetected single-atom components,which may have been ignored but have significant effect in catalytic reactions.Herein,we report a catalyst composed of Mo single atoms(SAs)and MoO_(2)nanoparticles(NPs)(MoSAs-MoO_(2)@NC),which is an exact model to understand how the SAs contribute to the nanocatalyst.Both experimental results and the density functional theory calculations reveal that Mo SAs on nitrogen-doped carbon provides the reaction zone for nitro reduction,while MoO_(2)is the active site for decomposing hydrazine hydrate to produce H*.Thanks to the synergy between Mo SAs and MoO_(2)NPs,this catalyst exhibits noble metal-like catalytic activity(100%conversion at 4 min)for the dechlorination-proof transfer hydrogenation.Additionally,the hydrogen migration on the catalyst is verified by the electrochemical tests in the absence of a hydrogen source.This work provides a model for further study on the coexistence of single atoms in nanoparticle catalysts.展开更多
Herein,we prepare the unique hierarchical polypyrrole@cobalt sulfide(PPy-hs@CoS)hollow sphere-based nanofilms as interdigitated electrodes for flexible on-chip micro-supercapacitors(MSC).Benefiting from the excellent ...Herein,we prepare the unique hierarchical polypyrrole@cobalt sulfide(PPy-hs@CoS)hollow sphere-based nanofilms as interdigitated electrodes for flexible on-chip micro-supercapacitors(MSC).Benefiting from the excellent flexibility and high electrical conductivity of PPy-hs combined with the great electrochemical activity of CoS,such PPy-hs@CoS composite material can not only inhibit the volume expansion of PPy but also promote the diffusion of the electrolyte ions.The PPy-hs@CoS filmbased electrode delivers a greatly improved specific capacitance and small resistance.Density functional theory calculations infer that OH−prefers to bind to PPy on CoS@PPy and confirms the synergistic effect of each component for enhanced reaction kinetics.A quasi-solid-state on-chip flexible asymmetric MSC based on PPy-hs@CoS and activated carbon(AC)microelectrodes exhibits large areal-specific capacitance(131.9 mF/cm2 at 0.3 mA/cm2),ultrahigh energy density(0.041 mWh/cm2@0.224 mW/cm2 and 25.6 mWh/cm3@140.6 mW/cm3),and long cycle lifespan.We demonstrate the possibility to scale up the PPy-hs@CoS nanofilm microelectrode by arranging two of our asymmetric MSC in series and parallel connections,which respectively increase the output voltage and current.A self-charging system by connecting our asymmetric MSCs with a piece of commercial solar cells is developed as a potential possible mode for future highly durable and high-voltage integrated electronics.展开更多
Background:Despite the advent of innovative knee prosthesis design,a consistent first-option knee implant design in total knee arthroplasty(TKA)remained unsettled.This study aimed to compare the clinical effects among...Background:Despite the advent of innovative knee prosthesis design,a consistent first-option knee implant design in total knee arthroplasty(TKA)remained unsettled.This study aimed to compare the clinical effects among posterior-stabilized(PS),cruciate-retaining(CR),bi-cruciate substituting(BCS),and bi-cruciate retaining designs for primary TKA.Methods:Electronic databases were systematically searched to identify eligible randomized controlled trials(RCTs)and cohort studies from inception up to July 30,2021.The primary outcomes were the range of knee motion(ROM),and the secondary outcomes were the patient-reported outcome measures(PROMs)and complication and revision rates.Confidence in evidence was assessed using Confidence in Network Meta-Analysis.The Bayesian network meta-analysis was performed for synthesis.Results:A total of 15 RCTs and 18 cohort studies involving 3520 knees were included.The heterogeneity and inconsistency were acceptable.There was a significant difference in ROM at the early follow-up when PS was compared with CR(mean difference[MD]=3.17,95%confidence interval[CI]0.07,7.18)and BCS was compared with CR(MD=9.69,95%CI 2.18,17.51).But at the long-term follow-up,there was no significant difference in ROM in any one knee implant compared with the others.No significant increase was found in the PROMs and complication and revision rates at the final follow-up time.Conclusions:At early follow-up after TKA,PS and BCS knee implants significantly outperform the CR knee implant in ROM.But in the long run,the available evidence suggests different knee prostheses could make no difference in clinical outcomes after TKA with extended follow-up.展开更多
Passive daytime radiative cooling(PDRC)is one of the promising alternatives to electrical cooling and has a significant impact on worldwide energy consumption and carbon neutrality.Toward real-world applications,howev...Passive daytime radiative cooling(PDRC)is one of the promising alternatives to electrical cooling and has a significant impact on worldwide energy consumption and carbon neutrality.Toward real-world applications,however,the parasitic heat input and heat leakage pose crucial challenges to commercial and residential buildings cooling.The integrating of radiative cooling and thermal insulation properties represents an attractive direction in renewable energy-efficient building envelope materials.Herein,we present a hierarchically porous hybrid film as a scalable and flexible thermal insulating subambient radiative cooler via a simple and inexpensive inverse high internal phase emulsion strategy.The as-prepared porous hybrid film exhibits an intrinsic combination of high solar reflectance(0.95),strong longwave infrared thermal emittance(0.97),and low thermal conductivity(31 mW/(m K)),yielding a subambient cooling temperature of~8.4℃ during the night and~6.5℃ during the hot midday with an average cooling power of~94 W/m^(2) under a solar intensity of~900 W/m^(2).Promisingly,combining the superhydrophobicity,durability,superelasticity,robust mechanical strength,and industrial applicability,the film is favorable for large-scale,sustainable and energy-saving applications in a wide variety of climates and complicated surfaces,enabling a substantial reduction of energy costs,greenhouse gas emission and associated ozone-depleting from traditional cooling systems.展开更多
Sucrose(Suc) is the major end product of photosynthesis in mesophyll cells of most vascular plants. It is loaded into phloem of mature leaves for long-distance translocation to non-photosynthetic organs where it is un...Sucrose(Suc) is the major end product of photosynthesis in mesophyll cells of most vascular plants. It is loaded into phloem of mature leaves for long-distance translocation to non-photosynthetic organs where it is unloaded for diverse uses. Clearly,Suc transport and metabolism is central to plant growth and development and the functionality of the entire vascular system. Despite vast information in the literature about the physiological roles of individual sugar metabolic enzymes and transporters,there is a lack of systematic evaluation about their molecular regulation from transcriptional to post-translational levels.Knowledge on this topic is essential for understanding and improving plant development,optimizing resource distribution and increasing crop productivity. We therefore focused our analyses on molecular control of key players in Suc metabolism and transport,including:(i) the identification of promoter elements responsive to sugars and hormones or targeted by transcription factors and microRNAs degrading transcripts of target genes; and(ii)modulation of enzyme and transporter activities through protein-protein interactions and other post-translational modifications. We have highlighted major remaining questions and discussed opportunities to exploit current understanding to gain new insights into molecular control of carbon partitioning for improving plant performance.展开更多
Maternal uterine immune cells,especially natural killer(NK)cells,are important for successful pregnancy,and an abnormal number or function of uterine NK cells is closely correlated with an impaired endometrial environ...Maternal uterine immune cells,especially natural killer(NK)cells,are important for successful pregnancy,and an abnormal number or function of uterine NK cells is closely correlated with an impaired endometrial environment and miscarriage.However,there are currently no noninvasive testing methods using reliable indicators that accurately predict uterine changes leading to miscarriage.Here,we confirmed that before implantation,menstrual blood(MB)from healthy donors had 70%CD49a^(+)tissue-resident NK(trNK)cells,the majority of which were CD49a^(+)Eomes+NK cells.Importantly,MB from patients with recurrent spontaneous abortion(RSA)had many fewer CD49a^(+)trNK cells than MB from controls.Analysis of uNK cell populations in MB may better predict an abnormal endometrial environment associated with miscarriage than peripheral blood(PB)analysis.Therefore,we suggest using MB-and CD49a-related markers as a promising noninvasive way to evaluate endometrial status.展开更多
It is well established that an abnormal tetrahydrofolate(THF)cycle causes the accumulation of hydrogen peroxide(H_(2)O_(2))and leaf senescence,however,the molecular mechanism underlying this relationship remains large...It is well established that an abnormal tetrahydrofolate(THF)cycle causes the accumulation of hydrogen peroxide(H_(2)O_(2))and leaf senescence,however,the molecular mechanism underlying this relationship remains largely unknown.Here,we reported a novel rice tetrahydrofolate cycle mutant,which exhibited H_(2)O_(2)accumulation and early leaf senescence phenotypes.Map-based cloning revealed that HPA1 encodes a tetrahydrofolate deformylase,and its deficiency led to the accumulation of tetrahydrofolate,5-formyl tetrahydrofolate and 10-formyl tetrahydrofolate,in contrast,a decrease in 5,10-methenyl-tetrahydrofolate.The expression of tetrahydrofolate cycle-associated genes encoding serine hydroxymethyl transferase,glycine decarboxylase and 5-formyl tetrahydrofolate cycloligase was significantly down-regulated.In addition,the accumulation of H_(2)O_(2)in hpa1 was not caused by elevated glycolate oxidation.Proteomics and enzyme activity analyses further revealed that mitochondria oxidative phosphorylation complex I and complex V were differentially expressed in hpa1,which was consistent with the H_(2)O_(2)accumulation in hpa1.In a further feeding assay with exogenous glutathione(GSH),a non-enzymatic antioxidant that consumes H_(2)O_(2),the H_(2)O_(2)accumulation and leaf senescence phenotypes of hpa1 were obviously compensated.Taken together,our findings suggest that the accumulation of H_(2)O_(2)in hpa1 may be mediated by an altered folate status and redox homeostasis,subsequently triggering leaf senescence.展开更多
We report that the integration of filter membrane and Ca_(2)Nb_(3)O_(10)nanosheets(FM@CNO) UV photodetector(UV PD) shows high performance and excellent flexibility. The Ca_(2)Nb_(3)O_(10)nanosheets were prepared by a ...We report that the integration of filter membrane and Ca_(2)Nb_(3)O_(10)nanosheets(FM@CNO) UV photodetector(UV PD) shows high performance and excellent flexibility. The Ca_(2)Nb_(3)O_(10)nanosheets were prepared by a facile solid-state reaction and liquid exfoliation process. The Ca_(2)Nb_(3)O_(10)nanosheets can be integrated into the pores of a filter membrane via a simple vacuum filtration method. The FM@CNO UV PD shows high performance under 300 nm light illumination at 5 V bias, including high responsivity(0.08 AW^(-1)), high detectivity(1.1 × 10^(12)Jones), high UV/visible rejection ratio(3.86 × 10^(3)) and fast speed(0.12/1.24 ms). Furthermore, the FM@CNO device exhibits excellent flexibility after many bending cycles.In addition, the FM@CNO array device was used as a pixel array detector for UV imaging. This work provides a novel approach to achieve high performance flexible PDs based on filter membrane and two dimensional materials.展开更多
The angle dependence of photonic crystals(PCs)dramatically limits their practical applications in the colorimetrical sensing of humidity and volatile organic compound(VOC)vapors.In addition,it is challenging for inver...The angle dependence of photonic crystals(PCs)dramatically limits their practical applications in the colorimetrical sensing of humidity and volatile organic compound(VOC)vapors.In addition,it is challenging for inverse opal PCs to colorimetrically distinguish between vapors with similar refractive indices.Different from the mechanism of PC-based sensors,here,we report an angle-independent polyacrylamide(PAAm)organogel structural color film based on the mechanisms of retroreflection,total internal reflection(TIR)and interference with a shape similar to a single-sided“egg waffle”.During the process of responding to humidity and VOC vapors,the color of the film remains angle-independent in the normal angle range of 0°to 45°under coaxial illumination and observation conditions.At the same time,the film can colorimetrically distinguish between vapors with similar refractive indices,such as methanol and ethanol,which is mainly due to the differences in their polarity and solubility parameters.The film shows good stability,reversibility and selectivity when exposed to vapors.A colorimetric sensor with a new response mechanism is proposed and has the potential to effectively distinguish between vapors with similar refractive indices.Furthermore,this responsive retroreflective structural color film(RRSCF)provides a universal strategy to develop targeted angle-independent structural color sensors by selecting optimized materials.展开更多
To the Editor:Femoral rotational alignment not only affects patellar tracking and alters peak contact forces,but also determines the flexion gap of the components.[1]If the angle of the external rotation is too large,...To the Editor:Femoral rotational alignment not only affects patellar tracking and alters peak contact forces,but also determines the flexion gap of the components.[1]If the angle of the external rotation is too large,it would lead to medial compartment loosing during knee flexion;if the angle is too small,it would lead to a narrowing medial compartment.A series of studies have found that the malalignment of femoral prosthesis resulted in poor outcomes after total knee arthroplasty(TKA),such as the lower Knee Society Scores,flexion instability,premature wear of the polyethylene,premature loosening of component and ongoing knee pain.It is helpful to introduce a new bony landmark to assist the femoral rotational alignment,and decrease the adverse effects caused by poor alignment of femoral rotation in TKA.The surface upon the medial trochlea,which was named as medial trochlea superior surface(MTSS)in this research,was found possibly parallel to the surgical trans-epicondylar axis(sTEA),which was usually used as a referential axis for femoral rotational alignment in TKA.Hence,MTSS might be used as a referential surface in TKA for its special anatomical position.The medial boundary of MTSS is close to the axis of the femoral shaft,and the distal end is immediately adjacent to the upper edge of the medial trochlea.The specific location of MTSS in TKA is shown in Figure 1A.展开更多
Background: Although various therapies have been developed to treat malalignment in osteoarthritic knees, the pattern of malalignment progression is still unclear. This study aimed to identify homogeneous subgroups wi...Background: Although various therapies have been developed to treat malalignment in osteoarthritic knees, the pattern of malalignment progression is still unclear. This study aimed to identify homogeneous subgroups with distinct trajectories of malalignment progression in subjects with symptomatic knee osteoarthritis (KOA) and to determine corresponding risk factors.Methods: Eight-year follow-up (from 2004 to 2012) data on 1252 participants with symptomatic KOA from the Osteoarthritis Initiative were included. Varus/valgus angle progression was characterized by group-based trajectory models. Time-varying covariates were introduced into the model to investigate how they affected trajectories. Multinomial logistic regression for trajectory group membership was applied to ascertain risk factors.Results: Five subgroups were identified. Participants in the varus worsening trajectory (n = 166) or valgus worsening trajectory (n = 118) proceeded to worsen malalignment over time. The neutral trajectory (n = 378), varus stable trajectory (n = 328), and valgus stable trajectory (n = 262) maintained close to the initial varus/valgus angle over 8 years. Higher baseline Kellgren and Lawrence grade (odds ratio [OR] = 4.35,P < 0.001 for varus;OR= 3.85,P < 0.001 for valgus) and "severe" baseline malalignment (OR = 13.57,P < 0.001 for varus;OR = 23.04,P < 0.001 for valgus) were risk factors for worsening trajectories. The cutoff point of the baseline varus/valgus angle to discriminate between stable or worsening trajectory was -4.5° for varus and 3.6° for valgus.Conclusions: This study identified the malalignment progression pattern - minor malalignment (-4.5° to +3.6°) tends to remain stable, while major baseline malalignment is likely to progress. This provides a reference for therapy to prevent malalignment from deteriorating and emphasizes the necessity of determining the trigger factors for malalignment onset.展开更多
To the Editor:Osteoarthritis(OA)is a prominent disabling disease characterized by progressive articular cartilage damage coupled with deterioration in the subchondral bone and other structures of the joint,and is rank...To the Editor:Osteoarthritis(OA)is a prominent disabling disease characterized by progressive articular cartilage damage coupled with deterioration in the subchondral bone and other structures of the joint,and is ranked as the 12th highest disease contributing to global disability.[1]The course of knee OA is considerably long and can affect three knee compartments(the patellofemoral joint[PFJ],medial tibiofemoral joint[MTFJ],and lateral tibiofemoral joint[LTFJ])alone or in combination,resulting in a large variation in the occurrence of cartilage damage in the three compartments.[2]We aimed to determine the baseline predictors associated with distinct tricompartmental trajectories of cartilage damage in knees at risk for OA.展开更多
基金the financial supports from the National Natural Science Foundation of China(52231007,51725101,11727807,22088101,52271167)the Shanghai Excellent Academic/Technological Leaders Program(19XD1400400)+4 种基金the Ministry of Science and Technology of China(973 Project Nos.2018YFA0209100 and 2021YFA1200600)the Fundamental Research Funds for the Central Universities(2022JCCXHH09)the Foundation for University Youth Key Teachers of Henan Province(2020GGJS170)the Support Program for Scientific and Technological Innovation Talents of Higher Education in Henan Province(21HASTIT004)Key Research Project of Zhejiang Lab(No.2021PE0AC02)。
文摘Hydrogels exhibit potential applications in smart wearable devices because of their exceptional sensitivity to various external stimuli.However,their applications are limited by challenges in terms of issues in biocompatibility,custom shape,and self-healing.Herein,a conductive,stretchable,adaptable,self-healing,and biocompatible liquid metal GaInSn/Ni-based composite hydrogel is developed by incorporating a magnetic liquid metal into the hydrogel framework through crosslinking polyvinyl alcohol(PVA)with sodium tetraborate.The excellent stretchability and fast self-healing capability of the PVA/liquid metal hydrogel are derived from its abundant hydrogen binding sites and liquid metal fusion.Significantly,owing to the magnetic constituent,the PVA/liquid metal hydrogel can be guided remotely using an external magnetic field to a specific position to repair the broken wires with no need for manual operation.The composite hydrogel also exhibits sensitive deformation responses and can be used as a strain sensor to monitor various body motions.Additionally,the multifunctional hydrogel displays absorption-dominated electromagnetic interference(EMI)shielding properties.The total shielding performance of the composite hydrogel increases to~62.5 dB from~31.8 dB of the pure PVA hydrogel at the thickness of 3.0 mm.The proposed bioinspired multifunctional magnetic hydrogel demonstrates substantial application potential in the field of intelligent wearable devices.
基金the National Natural Science Foundation of China(52173072,51721002 and 52033003)Natural Science Foundation of Shanghai(22ZR1403700).
文摘While boron nitride(BN) is widely recognized as the most promising thermally conductive filler for rapidly developing high-power electronic devices due to its excellent thermal conductivity and dielectric properties,a great challenge is the poor vertical thermal conductivity when embedded in composites owing to the poor interracial interaction causing severe phonon scattering.Here,we report a novel surface modification strategy called the "self-modified nanointerface" using BN nanocrystals(BNNCs) to efficiently link the interface between BN and the polymer matrix.Combining with ice-press assembly method,an only 25 wt% BNembedded composite film can not only possess an in-plane thermal conductivity of 20.3 W m-1K-1but also,more importantly,achieve a through-plane thermal conductivity as high as 21.3 W m-1K-1,which is more than twice the reported maximum due to the ideal phonon spectrum matching between BNNCs and BN fillers,the strong interaction between the self-modified fillers and polymer matrix,as well as ladder-structured BN skeleton.The excellent thermal conductivity has been verified by theoretical calculations and the heat dissipation of a CPU.This study provides an innovative design principle to tailor composite interfaces and opens up a new path to develop high-performance composites.
基金supported by the National Natural Science Foundations of China(21965024,22269016,51721002)the Inner Mongolia funding(2020JQ01,21300-5223601)the funding of Inner Mongolia University(10000-21311201/137,213005223601/003,21300-5223707)。
文摘Generating sufficient strains on metal surfaces are highly challenging owing to that most metals can deform plastically to relax the strains on the surfaces.In this work,we developed a facile but highly efficient stacked deposition strategy to in situ activation and reconstruction of NiO/NiOOH on Ni matrix,following with the migration of Fe ions to NiOOH.The Fe sites on the Ni/NiO/NiOOH facilitate the formation of the stable*OH oxygenated intermediates,and the Ni matrix in the catalyst provides the catalyst excellent stability.The oxygen evolution reaction(OER)performance of the stacked NiFe-5 with compressive strain displays the strengthened binding to oxygenated intermediates and superior OER activity,the ultralow overpotentials of 162 versus reversible hydrogen electrode at 10 mA cm^(-2).On the other hand,the Ni-5 without the incorporation of Fe has shown an outstanding hydrogen evolution reaction(HER)activity,affording an overpotential of 47 mV at 10 mA cm^(-2).The NiFe-5‖Ni-5 enables the overall water splitting at a voltage of 1.508 V to achieve 20 mA cm^(-2) with remarkable durability.The stacked deposition strategy improves binding strength of Ni-based catalysts to oxygenated intermediates via generating compressive strain,causing high catalytic activities on OER and HER.
基金supported by grants from China Scholarship Council,No.2008102056the National Natural Science Foundation of China,No.81241147
文摘Critical illness polyneuropathy and critical illness myopathy are frequent complications of severe illness that involve sensorimotor axons and skeletal muscles,respectively.Clinically,they manifest as limb and respiratory muscle weakness.Critical illness polyneuropathy/myopathy in isolation or combination increases intensive care unit morbidity via the inability or difficulty in weaning these patients off mechanical ventilation.Many patients continue to suffer from decreased exercise capacity and compromised quality of life for months to years after the acute event.Substantial progress has been made lately in the understanding of the pathophysiology of critical illness polyneuropathy and myopathy.Clinical and ancillary test results should be carefully interpreted to differentiate critical illness polyneuropathy/myopathy from similar weaknesses in this patient population.The present review is aimed at providing the latest knowledge concerning the pathophysiology of critical illness polyneuropathy/myopathy along with relevant clinical,diagnostic,differentiating,and treatment information for this debilitating neurological disease.
基金Sponsored by the National Key Research and Development Program of China(Grant No.2020YFE0100300)the National Natural Science Foundation of China(Grant No.51973036)。
文摘Zwitterion-based materials by virtue of their special physical and chemical characteristics have attracted researchers to utilize them for fabricating functional coatings. The simultaneous presence of positive and negative charges renders the zwitterion-based materials with electrostatically induced hydration properties, which enables a high resistance towards oily pollutants, nonspecific protein adsorption, bacterial adhesion and biofilm formation. This review starts from the working mechanism of zwitterions and covers the fabrication strategies of zwitterion-based functional coatings, namely the zwitterion-bearing binder route, the zwitterion-bearing additive route and the post-generation of coatings containing zwitterionic precursors. The applications of zwitterion-based functional coatings are discussed, including medical implants, marine antifouling and oil-resistant coatings, with focus on the relevant mechanisms of the zwitterion-containing coatings for a specific performance. Finally, some comments and perspectives on the current situation and future development of zwitterion-based functional coatings are given.
文摘Biotic stresses negatively affect canola growth and production. Flea beetle damage and Sclerotinia sclerotiorum (S. sclerotiorum) infection are two of the worst biotic stresses for canola. Auxin Repressed Proteins (ARPs) responsive to several abiotic stresses have been reported. However, information about ARPs induced by Flea beetle damage and S. sclerotiorum infection, their roles in biotic stress tolerance are still lacking in canola. ESTs for an Auxin Repressed Protein 1 (BnARP1) were highly represented (expressed) in a Brassica napus subtractive library developed after leaf damage by the crucifer flea beetle (Phyllotreta cruciferae). Expression of this gene was under different developmental control in B. napus, and it was co-induced in B. napus by flea beetle feeding, S. sclerotiorum infection, drought and cold. A total of 25 BnARP genes were represented in different B. napus stress and development EST libraries and indicated larger, diversified families than known earlier. Dwarf phenotypes, primary root growth inhibition, lateral root enhancement, reduced sensitivity to 2, 4-D, and reduced PIN1 and LOX expression in transgenic Arabidopsis expression lines suggest that BnARP1 is an auxin repressor that prevents auxin transport and supports an interaction between the auxin and jasmonate signalling pathways. And the increased survival after S. sclerotiorum infection in transgenic over-expression Arabidopsis suggests that BnARP1 could play a role in S. sclerotiorum tolerance through connecting auxin and jasmonate signalling pathways.
基金National Natural Science Foundation of China(81802210 and 81672219)Key Project of Sichuan Science&Technology Department(2018SZ0223 and 2018SZ0250)National Clinical Research Center for Geriatrics,West China Hospital,Sichuan University(Z20191008 and Z2018B20)
文摘Background:Patellofemoral joint(PFJ)degeneration has traditionally been regarded as a contraindication to unicompartmental knee arthroplasty(UKA).More recently,some researchers have proposed that PFJ degeneration can be ignored in medial UKA,and others have proposed that this change should be reviewed in PFJ degenerative facets and severity.This study aimed to systematically evaluate the effect of PFJ degeneration on patient-reported outcome measures(PROMs)and revision rates after medial UKA.Methods:Electronic databases(PubMed,Embase,Web of Science,etc.)were searched for studies assessing the influence of PFJ degeneration on medial UKA.A random-effects meta-analysis was conducted for the Oxford knee score(OKS),Knee society score(KSS),and revision rates and stratified by PFJ degenerative facets(medial/lateral/trochlear/unspecified),severe PFJ degeneration(bone exposed),and bearing type(mobile/fixed).Heterogeneity was assessed by the Cochran Q test statistic and chi-squared tests with the I-squared statistic.Results:A total of 34 articles with 7007 knees(2267 with PFJ degeneration)were included(5762 mobile-bearing and 1145 fixed-bearing and 100 unspecified).Slight to moderate degenerative changes in the medial and trochlear facets did not decrease the OKS and KSS,and only lateral facets significantly decreased the OKS(mean difference[MD]=-2.18,P<0.01)and KSS(MD=-2.61,P<0.01).The severity degree of PFJ degeneration had no additional adverse effect on the OKS,KSS,or revision rates.For mobile-bearing UKA,only lateral PFJ degeneration significantly decreased the OKS(MD=-2.21,P<0.01)and KSS(MD=-2.44,P<0.01).For fixed-bearing UKA,no correlation was found between PROMs/revision rates and PFJ degeneration.Conclusion:For medial mobile-bearing UKA,slight to moderate degenerative changes in the PFJ,except lateral facet,did not compromise PROMs or revision rates.For medial fixed-bearing UKA,although it might not be conclusive enough,PROMs or revision rates were not adversely affected by PFJ degeneration(regardless of the facet).
基金supported by the National Key R&D Program of China(Nos.2021YFA1502802 and 2020YFA0406101)the National Natural Science Foundation of China(Nos.21961160722,21872020,22072162,91845201,and 21701168)+3 种基金the Liaoning Revitalization Talents Program XLYC1907055Natural Science Foundation of Liaoning Province(No.2021-MS-001)Dalian National Lab for Clean Energy(DNL Cooperation Fund 202001)Dalian high level talent innovation project(No.2019RQ063).
文摘Nanocatalysts are likely to contain undetected single-atom components,which may have been ignored but have significant effect in catalytic reactions.Herein,we report a catalyst composed of Mo single atoms(SAs)and MoO_(2)nanoparticles(NPs)(MoSAs-MoO_(2)@NC),which is an exact model to understand how the SAs contribute to the nanocatalyst.Both experimental results and the density functional theory calculations reveal that Mo SAs on nitrogen-doped carbon provides the reaction zone for nitro reduction,while MoO_(2)is the active site for decomposing hydrazine hydrate to produce H*.Thanks to the synergy between Mo SAs and MoO_(2)NPs,this catalyst exhibits noble metal-like catalytic activity(100%conversion at 4 min)for the dechlorination-proof transfer hydrogenation.Additionally,the hydrogen migration on the catalyst is verified by the electrochemical tests in the absence of a hydrogen source.This work provides a model for further study on the coexistence of single atoms in nanoparticle catalysts.
基金This work was financially supported by the National Natural Science Foundation of China(No.51603092)“High level talent steed plan”of Inner Mongolia University,and the China Postdoctoral Science Foundation(No.2019T120393).
文摘Herein,we prepare the unique hierarchical polypyrrole@cobalt sulfide(PPy-hs@CoS)hollow sphere-based nanofilms as interdigitated electrodes for flexible on-chip micro-supercapacitors(MSC).Benefiting from the excellent flexibility and high electrical conductivity of PPy-hs combined with the great electrochemical activity of CoS,such PPy-hs@CoS composite material can not only inhibit the volume expansion of PPy but also promote the diffusion of the electrolyte ions.The PPy-hs@CoS filmbased electrode delivers a greatly improved specific capacitance and small resistance.Density functional theory calculations infer that OH−prefers to bind to PPy on CoS@PPy and confirms the synergistic effect of each component for enhanced reaction kinetics.A quasi-solid-state on-chip flexible asymmetric MSC based on PPy-hs@CoS and activated carbon(AC)microelectrodes exhibits large areal-specific capacitance(131.9 mF/cm2 at 0.3 mA/cm2),ultrahigh energy density(0.041 mWh/cm2@0.224 mW/cm2 and 25.6 mWh/cm3@140.6 mW/cm3),and long cycle lifespan.We demonstrate the possibility to scale up the PPy-hs@CoS nanofilm microelectrode by arranging two of our asymmetric MSC in series and parallel connections,which respectively increase the output voltage and current.A self-charging system by connecting our asymmetric MSCs with a piece of commercial solar cells is developed as a potential possible mode for future highly durable and high-voltage integrated electronics.
基金National Natural Science Foundation of China(No.81974347)Postdoctoral Science Foundation of China(No.2021M702351)Medical Science and Technology Program of Health Commission of Sichuan Province of China(No.21PJ040)
文摘Background:Despite the advent of innovative knee prosthesis design,a consistent first-option knee implant design in total knee arthroplasty(TKA)remained unsettled.This study aimed to compare the clinical effects among posterior-stabilized(PS),cruciate-retaining(CR),bi-cruciate substituting(BCS),and bi-cruciate retaining designs for primary TKA.Methods:Electronic databases were systematically searched to identify eligible randomized controlled trials(RCTs)and cohort studies from inception up to July 30,2021.The primary outcomes were the range of knee motion(ROM),and the secondary outcomes were the patient-reported outcome measures(PROMs)and complication and revision rates.Confidence in evidence was assessed using Confidence in Network Meta-Analysis.The Bayesian network meta-analysis was performed for synthesis.Results:A total of 15 RCTs and 18 cohort studies involving 3520 knees were included.The heterogeneity and inconsistency were acceptable.There was a significant difference in ROM at the early follow-up when PS was compared with CR(mean difference[MD]=3.17,95%confidence interval[CI]0.07,7.18)and BCS was compared with CR(MD=9.69,95%CI 2.18,17.51).But at the long-term follow-up,there was no significant difference in ROM in any one knee implant compared with the others.No significant increase was found in the PROMs and complication and revision rates at the final follow-up time.Conclusions:At early follow-up after TKA,PS and BCS knee implants significantly outperform the CR knee implant in ROM.But in the long run,the available evidence suggests different knee prostheses could make no difference in clinical outcomes after TKA with extended follow-up.
基金This work was supported by the National Key Research and Development Program of China(2017YFA0204600)the National Natural Science Foundation of China(51721002 and 52033003)+4 种基金Y.Z.acknowledges the support by the Program for Professor of Special Appointment(Eastern Scholar)at Shanghai Institutions of Higher Learningthe National Natural Science Foundation of China(62175154)Shanghai Pujiang Program(20PJ1411900)Shanghai Science and Technology Program(21ZR1445500)T.W.acknowledges the support of Shanghai Yangfan Program(22YF1430200).
文摘Passive daytime radiative cooling(PDRC)is one of the promising alternatives to electrical cooling and has a significant impact on worldwide energy consumption and carbon neutrality.Toward real-world applications,however,the parasitic heat input and heat leakage pose crucial challenges to commercial and residential buildings cooling.The integrating of radiative cooling and thermal insulation properties represents an attractive direction in renewable energy-efficient building envelope materials.Herein,we present a hierarchically porous hybrid film as a scalable and flexible thermal insulating subambient radiative cooler via a simple and inexpensive inverse high internal phase emulsion strategy.The as-prepared porous hybrid film exhibits an intrinsic combination of high solar reflectance(0.95),strong longwave infrared thermal emittance(0.97),and low thermal conductivity(31 mW/(m K)),yielding a subambient cooling temperature of~8.4℃ during the night and~6.5℃ during the hot midday with an average cooling power of~94 W/m^(2) under a solar intensity of~900 W/m^(2).Promisingly,combining the superhydrophobicity,durability,superelasticity,robust mechanical strength,and industrial applicability,the film is favorable for large-scale,sustainable and energy-saving applications in a wide variety of climates and complicated surfaces,enabling a substantial reduction of energy costs,greenhouse gas emission and associated ozone-depleting from traditional cooling systems.
基金This work was supported by Beijing Natural Science Foundation （grant 5182028 to L.P.）, the Agricultural Science and Technology Innovation Program, CAAS, China （to L.P.）, the National Science Foundation, USA （NSF grant lOS 0956409 to Z.R.So）, and the National Science Council, Taiwan, China （grant NSC 98-2311-B-001-001-MY3 to L.O.C.）.
基金financially supported by Australia Research Council(DP110104931,DP120104148)to YLR
文摘Sucrose(Suc) is the major end product of photosynthesis in mesophyll cells of most vascular plants. It is loaded into phloem of mature leaves for long-distance translocation to non-photosynthetic organs where it is unloaded for diverse uses. Clearly,Suc transport and metabolism is central to plant growth and development and the functionality of the entire vascular system. Despite vast information in the literature about the physiological roles of individual sugar metabolic enzymes and transporters,there is a lack of systematic evaluation about their molecular regulation from transcriptional to post-translational levels.Knowledge on this topic is essential for understanding and improving plant development,optimizing resource distribution and increasing crop productivity. We therefore focused our analyses on molecular control of key players in Suc metabolism and transport,including:(i) the identification of promoter elements responsive to sugars and hormones or targeted by transcription factors and microRNAs degrading transcripts of target genes; and(ii)modulation of enzyme and transporter activities through protein-protein interactions and other post-translational modifications. We have highlighted major remaining questions and discussed opportunities to exploit current understanding to gain new insights into molecular control of carbon partitioning for improving plant performance.
基金supported by the National Key Research&Developmental Program of China(no.2018YFC1003900 to H.W.)the National Natural Science Foundation of China(81930037 to H.W.+1 种基金31870914,81922028 to B.F.)Youth Innovation Promotion Association of Chinese Academy of Sciences(Grant 2019442 to B.F.).
文摘Maternal uterine immune cells,especially natural killer(NK)cells,are important for successful pregnancy,and an abnormal number or function of uterine NK cells is closely correlated with an impaired endometrial environment and miscarriage.However,there are currently no noninvasive testing methods using reliable indicators that accurately predict uterine changes leading to miscarriage.Here,we confirmed that before implantation,menstrual blood(MB)from healthy donors had 70%CD49a^(+)tissue-resident NK(trNK)cells,the majority of which were CD49a^(+)Eomes+NK cells.Importantly,MB from patients with recurrent spontaneous abortion(RSA)had many fewer CD49a^(+)trNK cells than MB from controls.Analysis of uNK cell populations in MB may better predict an abnormal endometrial environment associated with miscarriage than peripheral blood(PB)analysis.Therefore,we suggest using MB-and CD49a-related markers as a promising noninvasive way to evaluate endometrial status.
基金the National Key Research and Development Program of China(2016YFD0101801)the National Natural Science Foundation of China(91735303 and 91335103)+2 种基金the Natural Science Foundation of Zhejiang(LY18C130010,LY18C130009,and LY20C130004)the Science and Technology Project of Hangzhou(20180432B03,20180432B09,and 20180432B04)the Foundation of Zhejiang Education Department(Y201431296)。
文摘It is well established that an abnormal tetrahydrofolate(THF)cycle causes the accumulation of hydrogen peroxide(H_(2)O_(2))and leaf senescence,however,the molecular mechanism underlying this relationship remains largely unknown.Here,we reported a novel rice tetrahydrofolate cycle mutant,which exhibited H_(2)O_(2)accumulation and early leaf senescence phenotypes.Map-based cloning revealed that HPA1 encodes a tetrahydrofolate deformylase,and its deficiency led to the accumulation of tetrahydrofolate,5-formyl tetrahydrofolate and 10-formyl tetrahydrofolate,in contrast,a decrease in 5,10-methenyl-tetrahydrofolate.The expression of tetrahydrofolate cycle-associated genes encoding serine hydroxymethyl transferase,glycine decarboxylase and 5-formyl tetrahydrofolate cycloligase was significantly down-regulated.In addition,the accumulation of H_(2)O_(2)in hpa1 was not caused by elevated glycolate oxidation.Proteomics and enzyme activity analyses further revealed that mitochondria oxidative phosphorylation complex I and complex V were differentially expressed in hpa1,which was consistent with the H_(2)O_(2)accumulation in hpa1.In a further feeding assay with exogenous glutathione(GSH),a non-enzymatic antioxidant that consumes H_(2)O_(2),the H_(2)O_(2)accumulation and leaf senescence phenotypes of hpa1 were obviously compensated.Taken together,our findings suggest that the accumulation of H_(2)O_(2)in hpa1 may be mediated by an altered folate status and redox homeostasis,subsequently triggering leaf senescence.
基金financially supported by the National Key R&D Program of China(No.2017YFA0204600)the Inner Mongolia Talent Fund+1 种基金the National Natural Science Foundation of China(Nos.51872050 and 12061131009)the Science and Technology Commission of Shanghai Municipality(Nos.21520712600 and19520744300)。
文摘We report that the integration of filter membrane and Ca_(2)Nb_(3)O_(10)nanosheets(FM@CNO) UV photodetector(UV PD) shows high performance and excellent flexibility. The Ca_(2)Nb_(3)O_(10)nanosheets were prepared by a facile solid-state reaction and liquid exfoliation process. The Ca_(2)Nb_(3)O_(10)nanosheets can be integrated into the pores of a filter membrane via a simple vacuum filtration method. The FM@CNO UV PD shows high performance under 300 nm light illumination at 5 V bias, including high responsivity(0.08 AW^(-1)), high detectivity(1.1 × 10^(12)Jones), high UV/visible rejection ratio(3.86 × 10^(3)) and fast speed(0.12/1.24 ms). Furthermore, the FM@CNO device exhibits excellent flexibility after many bending cycles.In addition, the FM@CNO array device was used as a pixel array detector for UV imaging. This work provides a novel approach to achieve high performance flexible PDs based on filter membrane and two dimensional materials.
基金supported by National Key Research and Development Program of China(Nos.2017YFA0204600,2018YFE0201701)National Natural Science Foundation of China(No.51673041).
文摘The angle dependence of photonic crystals(PCs)dramatically limits their practical applications in the colorimetrical sensing of humidity and volatile organic compound(VOC)vapors.In addition,it is challenging for inverse opal PCs to colorimetrically distinguish between vapors with similar refractive indices.Different from the mechanism of PC-based sensors,here,we report an angle-independent polyacrylamide(PAAm)organogel structural color film based on the mechanisms of retroreflection,total internal reflection(TIR)and interference with a shape similar to a single-sided“egg waffle”.During the process of responding to humidity and VOC vapors,the color of the film remains angle-independent in the normal angle range of 0°to 45°under coaxial illumination and observation conditions.At the same time,the film can colorimetrically distinguish between vapors with similar refractive indices,such as methanol and ethanol,which is mainly due to the differences in their polarity and solubility parameters.The film shows good stability,reversibility and selectivity when exposed to vapors.A colorimetric sensor with a new response mechanism is proposed and has the potential to effectively distinguish between vapors with similar refractive indices.Furthermore,this responsive retroreflective structural color film(RRSCF)provides a universal strategy to develop targeted angle-independent structural color sensors by selecting optimized materials.
基金National Natural Science Foundation of China(No. 81974347)National Clinical Research Center for Geriatrics, West China Hospital Sichuan University(No. Z2021JC002)。
文摘To the Editor:Femoral rotational alignment not only affects patellar tracking and alters peak contact forces,but also determines the flexion gap of the components.[1]If the angle of the external rotation is too large,it would lead to medial compartment loosing during knee flexion;if the angle is too small,it would lead to a narrowing medial compartment.A series of studies have found that the malalignment of femoral prosthesis resulted in poor outcomes after total knee arthroplasty(TKA),such as the lower Knee Society Scores,flexion instability,premature wear of the polyethylene,premature loosening of component and ongoing knee pain.It is helpful to introduce a new bony landmark to assist the femoral rotational alignment,and decrease the adverse effects caused by poor alignment of femoral rotation in TKA.The surface upon the medial trochlea,which was named as medial trochlea superior surface(MTSS)in this research,was found possibly parallel to the surgical trans-epicondylar axis(sTEA),which was usually used as a referential axis for femoral rotational alignment in TKA.Hence,MTSS might be used as a referential surface in TKA for its special anatomical position.The medial boundary of MTSS is close to the axis of the femoral shaft,and the distal end is immediately adjacent to the upper edge of the medial trochlea.The specific location of MTSS in TKA is shown in Figure 1A.
基金funded by the grants from the National Natural Science Foundation of China(No.81974347)China Postdoctoral Science Foundation(No.2021M702351)+2 种基金Post-Doctor Research Project,West China Hospital,Sichuan University(No.2020HXBH081)Medical cience and Technology Project of Health Commission of Sichuan Provincial(No.21PJ040)Sichuan University Postdoctoral Interdisciplinary Innovation Fund.
文摘Background: Although various therapies have been developed to treat malalignment in osteoarthritic knees, the pattern of malalignment progression is still unclear. This study aimed to identify homogeneous subgroups with distinct trajectories of malalignment progression in subjects with symptomatic knee osteoarthritis (KOA) and to determine corresponding risk factors.Methods: Eight-year follow-up (from 2004 to 2012) data on 1252 participants with symptomatic KOA from the Osteoarthritis Initiative were included. Varus/valgus angle progression was characterized by group-based trajectory models. Time-varying covariates were introduced into the model to investigate how they affected trajectories. Multinomial logistic regression for trajectory group membership was applied to ascertain risk factors.Results: Five subgroups were identified. Participants in the varus worsening trajectory (n = 166) or valgus worsening trajectory (n = 118) proceeded to worsen malalignment over time. The neutral trajectory (n = 378), varus stable trajectory (n = 328), and valgus stable trajectory (n = 262) maintained close to the initial varus/valgus angle over 8 years. Higher baseline Kellgren and Lawrence grade (odds ratio [OR] = 4.35,P < 0.001 for varus;OR= 3.85,P < 0.001 for valgus) and "severe" baseline malalignment (OR = 13.57,P < 0.001 for varus;OR = 23.04,P < 0.001 for valgus) were risk factors for worsening trajectories. The cutoff point of the baseline varus/valgus angle to discriminate between stable or worsening trajectory was -4.5° for varus and 3.6° for valgus.Conclusions: This study identified the malalignment progression pattern - minor malalignment (-4.5° to +3.6°) tends to remain stable, while major baseline malalignment is likely to progress. This provides a reference for therapy to prevent malalignment from deteriorating and emphasizes the necessity of determining the trigger factors for malalignment onset.
基金the National Natural Science Foundation of China(No.81974347)National Clinical Research Center for Geriatrics,West China Hospital,Sichuan University(No.Z20191008)Science and Technology Foundation of Sichuan Province of China(No.2021YFH0094).
文摘To the Editor:Osteoarthritis(OA)is a prominent disabling disease characterized by progressive articular cartilage damage coupled with deterioration in the subchondral bone and other structures of the joint,and is ranked as the 12th highest disease contributing to global disability.[1]The course of knee OA is considerably long and can affect three knee compartments(the patellofemoral joint[PFJ],medial tibiofemoral joint[MTFJ],and lateral tibiofemoral joint[LTFJ])alone or in combination,resulting in a large variation in the occurrence of cartilage damage in the three compartments.[2]We aimed to determine the baseline predictors associated with distinct tricompartmental trajectories of cartilage damage in knees at risk for OA.
