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Objective To investigate the biomechanical and elution properties of meropenem‐loaded bone cement. Methods Bone cement (Palacos LV) with 5% (2 g/4 0g), 10% (4 g/40 g), and 15% (6 g/40 g) meropenem; 5% (2 g/40 g) and 10% (4 g/40 g) vancomycin; and blank bone cement were prepared in a total of six groups named A2, A4, A6, B2, B4, and A0 (antibiotic‐free). 36 cylinder specimens (6‐mm diameter and 12‐mm height) of all six groups were molded for a compression test. After the compression test, because of mechanical properties below the ISO standard requirements, groups B2, B4 were not subjected to a bending test. So a total of 24 rectangular strip specimens (10‐mm width, 75‐mm length, and 3.3‐mm thickness) for groups A2, A4, A6 and A0 were molded for the bending test. Between‐group differences of compressive strength, bending strength and bending modulus were analyzed. The meropenem standard was prepared as a series of standard solutions to calculate the standard curve. At a constant temperature of 37 °C, separately, meropenem‐loaded bone cement cylinder specimens (12 mm in diameter and 17 mm in length) of A2, A4 and A6 were serially immersed in saline solution without stirring. The eluent drug concentration at 24, 48, 72 h and 6, 12, 24 days was measured and the drug concentration‐time curve of meropenem was constructed. Results With the exception of groups B2 and B4, all cements compressive strength values were well above the minimum requirement of the ISO 5833 standard (70 MPa). The compressive strength and bending strength values of group A4 were higher than those of group A0 (P 0.05). There were no intergroup differences of bending modulus between the A0, A2, A4 and A6 groups (P > 0.05). A standard curve of meropenem was obtained and a regression equation was constructed: Y = 15.0265 X + 13.5218, r = 1.00. At 37 °C, the release of meropenem was rapid during the first 48 h for all A2, A4, A6 samples, and subsequent release continued to decrease. Conclusion When adding up to 15% (6 g/40 g) meropenem to the bone cement, the biomechanical properties were not reduced, and bone cement with 10% (4 g/40 g) meropenem had the best performance. At a constant temperature of 37°C, meropenem can be released from bone cement for up to 24 days.

Objective To investigate the risk factors for, and outcomes of, preoperative asymptomatic pulmonary embolism (PE) in patients ≥60 years old following delayed operation for hip fracture. Methods From March 2017 to December 2018, 90 patients aged ≥60 years with hip fracture who suffered a delay in surgery were recruited to this prospective study following admission to our hospital. Computed tomography pulmonary angiography (CTPA) was used to detect preoperative asymptomatic PE and calculated its incidence. Time from injury to admission, baseline characteristics, medical comorbidities, and blood biomarker levels were evaluated as potential risk factors. Logistic regression analysis was used to identify risk factors. Mortality and major bleeding events were recorded and compared between individuals with PE and without. Data were analyzed by t‐test, Mann–Whitney U test, χ2 test, Fisher's exact test, and logistic regression analysis. Results The incidence of preoperative asymptomatic PE was 18.9% (17/90 patients). In the univariate analysis, the risk factors for preoperative asymptomatic PE were male sex, hypertension, cerebrovascular accident, smoking, plasma D‐dimer level, potassium level, urea level, creatinine level, and cysteine level. Multivariate logistic regression analysis showed that the risk of preoperative asymptomatic PE was higher in patients with hypertension (odds ratio [OR] = 10.048; 95% confidence interval [CI], 1.118–90.333), cerebrovascular accident (OR = 20.135; 95% CI, 1.875–216.164), smoking (OR = 48.741; 95% CI, 4.155–571.788), high plasma D‐dimer levels (OR = 1.200; 95% CI, 1.062–157.300), and high plasma potassium levels (OR = 12.928; 95% CI, 1.062–157.300). All patients were followed up for 21.0 months (range, 2 to 36 months). Mortality within the first year postoperatively was higher in patients with PE (29.41% vs 9.59%, P = 0.046). Conclusions In view of the high incidence of preoperative asymptomatic PE and the inferior prognosis in individuals with PE, routine CTPA examination for preoperative asymptomatic PE could be useful for patients aged ≥60 years with hip fracture for whom surgery is delayed.

Rheumatoid arthritis (RA), a common autoimmune disorder, is associated with a chronic inflammatory response and unbalanced bone metabolism within the articular microenvironment. Adiponectin, an adipokine secreted by adipocytes, is involved in multiple functions, including lipid metabolism and pro-inflammatory activity. However, the mechanism of adiponectin performance within arthritic inflammation remains unclear. In this study, we observed the effect of adiponectin on the expression of oncostatin M (OSM), a pro-inflammatory cytokine, in human osteoblastic cells. Pretreatment of cells with inhibitors of phosphatidylinositol 3-kinase (PI3K), Akt, and nuclear factor (NF)-κB reduced the adiponectin-induced OSM expression in osteoblasts. Stimulation of the cells with adiponectin increased phosphorylation of PI3K, Akt, and p65. Adiponectin treatment of osteoblasts increased OSM-luciferase activity and p65 binding to NF-κB on the OSM promoter. Our results indicate that adiponectin increased OSM expression via the PI3K, Akt, and NF-κB signaling pathways in osteoblastic cells, suggesting that adiponectin is a novel target for arthritis treatment.

Transition metal oxides (TMOs) are important anode materials in sodium-ion batteries (SIBs) due to their high theoretical capacities, abundant resources, and cost-effectiveness. However, issues such as the low conductivity and large volume variation of TMO bulk materials during the cycling process result in poor electrochemical performance. Nanosizing and compositing with carbon materials are two effective strategies to overcome these issues. In this study, spherical MnFe2O4@xC nanocomposites composed of MnFe2O4 inner cores and tunable carbon shell thicknesses were successfully prepared and utilized as anode materials for SIBs. It was found that the property of the carbon shell plays a crucial role in tuning the electrochemical performance of MnFe2O4@xC nanocomposites and an appropriate carbon shell thickness (content) leads to the optimal battery performance. Thus, compared to MnFe2O4@1C and MnFe2O4@8C, MnFe2O4@4C nanocomposite exhibits optimal electrochemical performance by releasing a reversible specific capacity of around 308 mAh·g−1 at 0.1 A·g−1 with 93% capacity retention after 100 cycles, 250 mAh·g−1 at 1.0 A g−1 with 73% capacity retention after 300 cycles in a half cell, and around 111 mAh·g−1 at 1.0 C when coupled with a Na3V2(PO4)3 (NVP) cathode in a full SIB cell. [ABSTRACT FROM AUTHOR]

Background: The purpose was retrospectively to investigate functional and clinical outcomes after anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) reconstruction using a single allograft.Methods: Patients with severe chronic lateral instability of the ankle underwent surgery after conservative treatment failed. Ultrasounds of the ankle were performed, and if the AFTL and CFL were completely torn without enough soft tissue for repair, the ligaments were reconstructed using allograft tendon. Outcomes were assessed by clinical examination, stress radiography, ultrasound, the American Orthopaedic Foot and Ankle Society score (AOFAS), and Karlsson Ankle Functional score (KAFS) before surgery and at final follow-up.Results: Nineteen patients, ten men and nine women with mean age of 27.9 years (range, 19-41 years), underwent reconstruction. Mean follow-up was 30 months (range, 24-40 months). At final follow-up, all patients had returned to activity without instability, pain, or limited range of motion. On stress radiography, mean talar tilt angle decreased from 17.32° ± 3.58° before surgery to 4.16° ± 1.12° at follow-up (p < 0.001). Mean anterior drawer test (ADT) distance decreased from 9.79 ± 1.01 mm before surgery to 3.97 ± 0.99 mm at follow-up (p < 0.05). Mean AOFAS improved from 64.00 ± 18.43 to 90.32 ± 5.17 points (p < 0.001), and mean KAFS improved from 50.84 ± 16.73 to 90.89 ± 5.08 points (p < 0.001). Ultrasound showed the reconstructed ligaments maintained good continuity and excellent tension. No case of infection and immunological rejection was reported.Conclusion: This novel reconstruction technique takes into account the anatomical specialty of AFTL and CFL. This case series showed increased stability of the ankle in clinical and functional outcomes.Trial Registration: The trial registration number (TRN) and date of registration: ChiCTR-ORC-17010796 , Mar 6th 2017. Retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: At present, the exact mechanism of postoperative delirium has not been elucidated. The purpose of this study was to analyze the incidence of delirium in patients undergoing orthopedic surgeries and to explore possible related factors. Methods: This is a retrospective study. We used 582 patients who had undergone orthopedic surgery between January 2011 and December 2014. The surgeries consisted of 155 cases of internal fixation for intertrochanteric fracture (IFIF), 128 cases of femoral head replacement (FHR), 169 cases of total hip arthroplasty (THA) and 130 cases of total knee arthroplasty (TKA). Among the 582 patients, 75 developed postoperative delirium (an incidence of 12.9%). The demographics of the patients, which included age, gender, operation duration and blood loss, were statistically analyzed with univariate logistic regression analysis and then multivariate logistic regression. To investigate the influences of different electrolytes disorders for postoperative delirium, the Chi-square test was used. Results: Multivariate logistic regression analysis indicated that postoperative delirium incidence in patients aged 70-79 years and in patients aged =80 years was higher than that in patients aged <70 years, odds ratio (OR) values were 6.33 and 26.37, respectively. In addition, the incidence of postoperative delirium in the group of patients with electrolyte disorders was higher than that in the normal group (OR, 2.38). There were statistically significant differences between the delirium group and the non-delirium group in the incidences of the sodium and calcium disorders. Conclusions: Aging and postoperative electrolyte disorders (hyponatremia and hypocalcemia) are risk factors for postoperative delirium in patients undergoing orthopedic surgeries. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA), a common autoimmune disorder, is associated with a chronic inflammatory response and unbalanced bone metabolism within the articular microenvironment. Adiponectin, an adipokine secreted by adipocytes, is involved in multiple functions, including lipid metabolism and pro-inflammatory activity. However, the mechanism of adiponectin performance within arthritic inflammation remains unclear. In this study, we observed the effect of adiponectin on the expression of oncostatin M (OSM), a pro-inflammatory cytokine, in human osteoblastic cells. Pretreatment of cells with inhibitors of phosphatidylinositol 3-kinase (PI3K), Akt, and nuclear factor (NF)-κB reduced the adiponectin-induced OSM expression in osteoblasts. Stimulation of the cells with adiponectin increased phosphorylation of PI3K, Akt, and p65. Adiponectin treatment of osteoblasts increased OSM-luciferase activity and p65 binding to NF-κB on the OSM promoter. Our results indicate that adiponectin increased OSM expression via the PI3K, Akt, and NF-κB signaling pathways in osteoblastic cells, suggesting that adiponectin is a novel target for arthritis treatment. [ABSTRACT FROM AUTHOR]

Abstract: Novel polyelectrolytes complex (PEC)/11-phosphotungstic acid hydrate (PW11) hybrid membranes (PEC/PW11) were prepared by blending sodium alginate (SA) and gelatin (GE), followed by incorporating with PW11, and then crosslinking by γ-Glycidoxypropyltrimethoxysilane (GPTEOS). Structures of the membranes were characterized by X-ray diffraction (XRD), FT-IR, thermogravimetry (TG), scanning electron microscopy (SEM), atomic force microscopy (AFM) and contact angle goniometer methods. The characterization results demonstrated that the amorphous regions in the membrane and hydrophilicity of the membrane enhance with increasing PW11 content; thermal stability of the membrane strengthened with the introducing of PW11; PW11 was homogeneously dispersed in the PEC matrix when PW11 content was no higher than 9wt%. Swelling experiments showed that the degree of swelling (DS) of the PEC/PW11 hybrid membranes increased with increasing PW11 content or water content in feed. Sorption experiments demonstrated that when PW11 was no more than 9wt%, both the sorption selectivity and diffusion selectivity increase with increasing PW11 content, then decrease with further increasing PW11 content. PEC/PW11 hybrid membrane containing 9wt% PW11 exhibited the best pervaporation performance, whose averaged permeation flux was 0.440kg/m2/h and separation factor was 144 for 90wt% aqueous solution of acetic acid at 50°C. [Copyright &y& Elsevier]

The title binuclear complex, [Co(2)(C(8)H(3)NO(6))(2)(C(10)H(8)N(2))(3)(H(2)O)(6)], has been synthesized hydro-thermally from 3-nitro-phthalic acid (H(2)NPA), Co(NO(3))(2)·6H(2)O and 4,4'-bipyridine (4,4'-bipy). The mol-ecule of the complex occupies a special position on an inversion centre. The Co(II) atom has a slightly distorted octa-hedral environment formed by two N atoms from two 4,4'-bipy ligands, one carboxyl-ate O atom from NPA, and three O atoms of water mol-ecules. An extensive O-H⋯O and N-H⋯O hydrogen-bonding system links mol-ecules of the complex into a three-dimensional network.

The asymmetric unit of the title compound, [Cu(C(6)H(15)NO(3))(H(2)O)(2)]SO(4)·H(2)O, contains a complex cation, a sulfate anion and one uncoordinated water mol-ecule. In the complex cation, the Cu(II) ion is coordinated by five O atoms (three of which are from the triethano-lamine ligand and two from coordinated water mol-ecules) and one N atom of the triethano-lamine ligand in a typical Jahn-Teller-distorted octa-hedral geometry. Classical inter-molecular O-H⋯O hydrogen bonds link the cation, the sulfate anion and the water mol-ecule into a two-dimensional network.

The title compound, [Ni(C(6)H(15)NO(3))(2)]SO(4), contains two triethano-lamine (TEA) ligands bound to an Ni(2+) metal centre, which lies on a crystallographic inversion centre, and one sulfate anion located on a twofold rotation axis such that the asymmetric unit contains one-half molecule of the cation and of the anion. The triethano-lamine ligands coordinate via each axial N atom and two of the three O atoms, while the third arm of the ligand has the hydroxyl group pointing away from the metal centre. The sulfate anions are hydrogen bonded to the coordinated hydroxyl groups and also to the free arm, forming a two-dimensional supra-molecular hydrogen-bonded network expanding parallel to (010).

In the title compound, (C(14)H(24)N(2)O(8))[CdCl(4)]·4H(2)O, the Cd atom in the tetra-hedral [CdCl(4)](2-) anion lies on a twofold rotation axis, and the diprotonated organic mol-ecule, trans-N,N,N',N'-tetra-kis(carb-oxy-meth-yl)cyclo-hexane-1,2-diammon-ium, has 2 symmetry with the twofold rotation axis running through the mid-point of two C-C bonds in the cyclo-hexane unit. In the crystal structure, classical intra-molecular O-H⋯O and N-H⋯O and inter-molecular O-H⋯O, N-H⋯O, O-H⋯Cl and C-H⋯Cl hydrogen bonds are observed.

In the title metal-organic framework complex, {[Cu(C(4)H(4)N(2))(2)](C(8)H(5)O(7)S).H(2)O}(n) or {[Cu(I)(pyz)(2)](H(2)SIP).H(2)O}(n) (pyz is pyrazine and H(3)SIP is 5-sulfoisophthalic acid or 3,5-dicarboxybenzenesulfonic acid), the asymmetric unit is composed of one copper(I) center, one whole pyrazine ligand, two half pyrazine ligands lying about inversion centres, one H(2)SIP(-) anion and one lattice water molecule, wherein each Cu(I) atom is in a slightly distorted tetrahedral coordination environment completed by four pyrazine N atoms, with the Cu-N bond lengths in the range 2.017 (3)-2.061 (3) A. The structure features a three-dimensional diamondoid network with one-dimensional channels occupied by H(2)SIP(-) anions and lattice water molecules. Interestingly, the guest-water hydrogen-bonded network is also a diamondoid network, which interpenetrates the metal-pyrazine network.

The title compound, [Cu(2)(C(14)H(8)O(4))(2)(C(10)H(8)N(2))(2)], is a centrosymmetric binuclear copper(II) complex, with a Cu⋯Cu separation of 6.136 (16) Å. The Cu atom displays a cis-CuN(2)O(2) square-planar geometry, although two long (> 2.43 Å) Cu⋯O contacts complete a distorted cis-CuN(2)O(4) octa-hedron. Extensive C-H⋯O hydrogen bonds link the mol-ecules into a three-dimensional network.

The novel title polyvanadate(V), poly[[octa-mu-aqua-dodecaaqua-mu(4)-octacosaoxidodecavanadato-hexasodium] tetrahydrate], [Na(6)(H(2)O)(20)(V(10)O(28)).4H(2)O](n), contains [V(10)O(28)](6-) anions which lie about inversion centres and have approximate 2/m symmetry and which are linked to [Na(3)(H(2)O)(10)](3+) cations through two terminal and two mu(2)-bridging O atoms. The structure contains three inequivalent Na(+) cations, two of which form [Na(2)(H(2)O)(8)](n) chains, which are linked via NaO(6) octahedra involving the third Na(+) ion, thus forming a three-dimensional framework.