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Abstract Background Targeted protein degradation of neosubstrates plays a crucial role in hematological cancer treatment involving immunomodulatory imide drugs (IMiDs) therapy. Nevertheless, the persistence of inevitable drug resistance and hematological toxicities represents a significant obstacle to their clinical effectiveness. Methods Phenotypic profiling of a small molecule compounds library in multiple hematological cancer cell lines was conducted to screen for hit degraders. Molecular dynamic-based rational design and cell-based functional assays were conducted to develop more potent degraders. Multiple myeloma (MM) tumor xenograft models were employed to investigate the antitumor efficacy of the degraders as single or combined agents with standard of care agents. Unbiased proteomics was employed to identify multiple therapeutically relevant neosubstrates targeted by the degraders. MM patient-derived cell lines (PDCs) and a panel of solid cancer cell lines were utilized to investigate the effects of candidate degrader on different stage of MM cells and solid malignancies. Unbiased proteomics of IMiDs-resistant MM cells, cell-based functional assays and RT-PCR analysis of clinical MM specimens were utilized to explore the role of BRD9 associated with IMiDs resistance and MM progression. Results We identified a novel cereblon (CRBN)-dependent lead degrader with phthalazinone scaffold, MGD-4, which induced the degradation of Ikaros proteins. We further developed a novel potent candidate, MGD-28, significantly inhibited the growth of hematological cancer cells and induced the degradation of IKZF1/2/3 and CK1α with nanomolar potency via a Cullin-CRBN dependent pathway. Oral administration of MGD-4 and MGD-28 effectively inhibited MM tumor growth and exhibited significant synergistic effects with standard of care agents. MGD-28 exhibited preferentially profound cytotoxicity towards MM PDCs at different disease stages and broad antiproliferative activity in multiple solid malignancies. BRD9 modulated IMiDs resistance, and the expression of BRD9 was significant positively correlated with IKZF1/2/3 and CK1α in MM specimens at different stages. We also observed pronounced synergetic efficacy between the BRD9 inhibitor and MGD-28 for MM treatment. Conclusions Our findings present a strategy for the multi-targeted degradation of Ikaros proteins and CK1α against hematological cancers, which may be expanded to additional targets and indications. This strategy may enhance efficacy treatment against multiple hematological cancers and solid tumors.

Abstract The interaction of the polyphenol–protein–polysaccharide ternary system plays a critical regulatory role in many biological processes including cellular signal transduction, molecular recognition, and assembly. Moreover, the interactions of the three elements can form complex molecular structures and affect their respective functions and activities. It is necessary to clarify the correlation between the binding force and functional characteristics of polyphenols, proteins, and polysaccharides in the ternary system to effectively improve the sensory, functional, and nutritional properties of food. Hence, this paper systematically reviews the interactions of the ternary system composed of polyphenols, proteins, and polysaccharides. Moreover, this article also analyzes the interaction between the two components in the ternary system based on the functional characteristics of these components. Furthermore, this review comprehensively introduces the application of ternary systems. The findings are expected to provide important guidance for the polyphenol–protein–polysaccharide ternary system in biology, medicine, and food industry. Graphical Abstract

Abstract Objective To evaluate the biomechanical characteristics of grafts from three different anterior cruciate ligament (ACL) reconstructive surgeries and to determine which method is better at restoring knee joint stability. Methods A 31-year-old female volunteer was enrolled in the study. According to the magnetic resonance imaging of her left knee, a three-dimensional model consisting of the distal femur, proximal tibia and fibula, ACL, posterior cruciate ligament, medial collateral ligament and lateral collateral ligament was established. Then, the ACL was removed from the original model to simulate the knee joint after ACL rupture. Based on the knee joint model without the ACL, single-bundle ACL reconstruction, double-bundle ACL reconstruction, and flat-tunnel ACL reconstruction were performed. The cross-sectional diameters of the grafts were equally set as 6 mm in the three groups. The bone tissues had a Young’s modulus of 17 GPa and a Poisson’s ratio of 0.36. The ligaments and grafts had a Young’s modulus of 390 MPa and a Poisson’s ratio of 0.4. Six probes were placed in an ACL or a graft to obtain the values of the equivalent stress, maximum principal stress, and maximum shear stress. After pulling the proximal tibia with a forward force of 134 N, the distance that the tibia moved and the stress distribution in the ACL or the graft, reflected by 30 mechanical values, were measured. Results The anterior tibial translation values were similar among the three groups, with the double-bundle ACL reconstruction group performing the best, followed closely by the patellar tendon ACL reconstruction group. In terms of stress distribution, 13 out of 30 mechanical values indicated that the grafts reconstructed by flat bone tunnels had better performance than the grafts in the other groups, while 12 out of 30 showed comparable outcomes, and 5 out of 30 had worse outcomes. Conclusion Compared with traditional single-bundle and double-bundle ACL reconstructions, flat-tunnel ACL reconstruction has advantages in terms of stress dispersion. Additionally, flat-tunnel ACL reconstruction falls between traditional double-bundle and single-bundle ACL reconstructions in terms of restoring knee joint stability and is superior to single-bundle ACL reconstruction.

Abstract Aims MNDA (myeloid nuclear differentiation antigen) has been considered as a potential diagnostic marker for marginal zone lymphoma (MZL), but its utility in distinguishing MZL from other B-cell non-Hodgkin lymphomas (B-NHLs) and its clinicopathologic relevance in diffuse large B-cell lymphoma (DLBCL) are ambiguous. We comprehensively investigated MNDA expression in a large series of B-NHLs and evaluated its diagnostic value. Methods MNDA expression in a cohort of 1293 cases of B-NHLs and 338 cases of reactive lymphoid hyperplasia (RLH) was determined using immunohistochemistry and compared among different types of B-NHL. The clinicopathologic relevance of MNDA in DLBCL was investigated. Results MNDA was highly expressed in MZLs (437/663, 65.9%), compared with the confined staining in marginal zone B-cells in RLH; whereas neoplastic cells with plasmacytic differentiation lost MNDA expression. MNDA expression was significantly higher in mantle cell lymphoma (MCL, 79.6%, p = 0.006), whereas lower in chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL, 44.8%, p = 0.001) and lymphoplasmacytic lymphoma (LPL, 25%, p = 0.016), and dramatically lower in follicular lymphoma (FL, 5.2%, p

Abstract Objective The study aims to evaluate the accuracy of an MRI-based artificial intelligence (AI) segmentation cartilage model by comparing it to the natural tibial plateau cartilage. Methods This study included 33 patients (41 knees) with severe knee osteoarthritis scheduled to undergo total knee arthroplasty (TKA). All patients had a thin-section MRI before TKA. Our study is mainly divided into two parts: (i) In order to evaluate the MRI-based AI segmentation cartilage model’s 2D accuracy, the natural tibial plateau was used as gold standard. The MRI-based AI segmentation cartilage model and the natural tibial plateau were represented in binary visualization (black and white) simulated photographed images by the application of Simulation Photography Technology. Both simulated photographed images were compared to evaluate the 2D Dice similarity coefficients (DSC). (ii) In order to evaluate the MRI-based AI segmentation cartilage model’s 3D accuracy. Hand-crafted cartilage model based on knee CT was established. We used these hand-crafted CT-based knee cartilage model as gold standard to evaluate 2D and 3D consistency of between the MRI-based AI segmentation cartilage model and hand-crafted CT-based cartilage model. 3D registration technology was used for both models. Correlations between the MRI-based AI knee cartilage model and CT-based knee cartilage model were also assessed with the Pearson correlation coefficient. Results The AI segmentation cartilage model produced reasonably high two-dimensional DSC. The average 2D DSC between MRI-based AI cartilage model and the tibial plateau cartilage is 0.83. The average 2D DSC between the AI segmentation cartilage model and the CT-based cartilage model is 0.82. As for 3D consistency, the average 3D DSC between MRI-based AI cartilage model and CT-based cartilage model is 0.52. However, the quantification of cartilage segmentation with the AI and CT-based models showed excellent correlation (r = 0.725; P values

Abstract The new power system is characterized by high penetration of renewable energy sources and a high proportion of power electronics (namely, double‐high). The grid‐forming control is an effective method to improve the grid‐connected stability of wind turbine generators (WTGs) in the “double‐high” grid. The control method based on the DC‐link voltage can effectively realize the grid‐forming control for WTGs. However, there is a disadvantage that the DC‐link voltage cannot be maintained at the given value. To address this, the grid synchronization mechanism of DC‐link voltage is explored and the specific implementation of a novel DC‐link voltage synchronous control applicable to full‐scale power conversion WTGs is proposed. Then, the boundary of the inertial coefficient is probed through the state‐space method. And a compensation control is proposed to enlarge the inertial response capability based on the mechanism of damping characteristics. Finally, the PSCAD/EMTDC simulation and RTLAB hardware‐in‐loop experiment show that the synchronization frequency can accurately map the grid frequency changes in real‐time under the premise that the DC‐link voltage remains constant. In addition, the inertial coefficient can be increased by more than five times with the compensation strategy, which can enhance the support capability of the WTGs to the power grid.

The continuously refined genome assembly of the Chinese cabbage accession Chiifu is widely recognized as the reference for Brassica rapa. However, the high self-incompatibility of Chiifu limits its broader utilization. In this study, we report the development of self-compatible Chiifu lines through a meticulous marker-assisted selection (MAS) strategy, involving the substitution of the Chiifu allele of MLPK (M-locus protein kinase) with that from the self-compatible Yellow Sarson (YS). A YS-based marker (SC-MLPK) was employed to screen 841 B. rapa accessions, confirming that all eight accessions with the mlpk/mlpk (mm) genotype exhibited self-compatibility. Additionally, we designed 131 High-Resolution Melting (HRM) markers evenly distributed across the B. rapa genome as genomic background selection (GBS) markers to facilitate the introgression of self-compatibility from YS into Chiifu along with SC-MLPK. Genome background screening revealed that the BC3S1 population had a proportion of the recurrent parent genome (PR) ranging from 93.9% to 98.5%. From this population, we identified self-compatible individuals exhibiting a high number of pollen tubes penetrating stigmas (NPT) (>25) and a maximum compatibility index (CI) value of 7.5. Furthermore, we selected two individuals demonstrating significant similarity to Chiifu in both genetic background and morphological appearance, alongside self-compatibility. These selected individuals were self-pollinated to generate two novel lines designated as SC-Chiifu Lines. The development of these self-compatible Chiifu lines, together with the SC-MLPK marker and the set of HRM markers, represents valuable tools for B. rapa genetics and breeding.

Abstract Background Previous studies on cancer of unknown primary (CUP) mainly focus on treatment and prognosis in western populations and lacked clinical evaluation of different IHC markers, so this study aimed to evaluate characteristics of CUP and recommend a diagnostic strategy from a single center in China. Methods and results Data of 625 patients with CUP were retrospectively collected and reviewed. The patients ranged in age from 20 to 91 years, with a female-to-male ratio of 1.3:1. The predominant histological type was poor or undifferentiated adenocarcinomas (308; 49.3%). The results of Canhelp-Origin molecular testing for the identification of the tissue of origin in 262 of 369 patients (71.0%) were considered predictable (similarity score > 45), with the most common predicted primary tumor site being the breast (57, 21.8%). Unpredictable molecular results correlated with more aggressive clinical parameters and poor survival. Thee positivity rates of several targeted antibodies (GATA3, GCDFP15, TTF1, Napsin A, and PAX8), based on the clinically predicted site, were lower than those reported for the corresponding primary tumors. Nonetheless, TRPS1 and INSM1 were reliable markers of predicted breast carcinoma (75.0%) and neuroendocrine tumors (83.3%), respectively. P16 expression, as well as HPV and EBER testing contributed significantly to the diagnosis of squamous cell carcinomas. Survival analysis revealed that older ages (> 57), ≥ 3 metastatic sites, non-squamous cell carcinomas, bone/liver/lung metastases, unpredictable molecular results, and palliative treatment correlated with poor overall survival. Conclusions We recommend a CUP diagnostic strategy involving the use of targeted antibody panels as per histological findings that is potentially applicable in clinical practice. The markers TRPS1, INSM1, and P16 expression, as well as HPV and EBER testing are particularly valuable in this aspect. Molecular testing is also predictive of survival rates.

As a novel guanylate cyclase stimulator, SGC003F is being developed for the treatment of heart failure with a reduced ejection fraction (HFrEF). This study aimed to assess the effect of P-glycoprotein (P-gp) inhibition on SGC003F exposure in vivo, comparing plasma and tissue levels, and evaluating the role of P-gp in the small intestine, blood–brain barrier (BBB), and kidney in impacting the tissue exposure. Tariquidar, a P-gp inhibitor, was added to monolayer transport assays to observe the changes in the transmembrane characteristics of SGC003F. Rats were given SGC003F with tariquidar via various routes to measure plasma, tissue, urine, and fecal concentrations. The inclusion of tariquidar significantly altered the pharmacokinetics of SGC003F. In LLC-PK1-MDR1 cells, tariquidar reduced the efflux ratio of SGC003F from 6.56 to 1.28. In rats, it enhanced the plasma AUC by 3.05 or 1.61 times, increased the Cmax by 2.13 or 1.07 times, and notably improved bioavailability from 46.4% to 95%. Additionally, co-administration with tariquidar led to a decrease in fecal excretion and an increase in tissue exposure, with only a moderate effect on the partition ratios in the small intestine and brain. P-gp inhibition impacts SGC003F exposure, with plasma levels not fully reflecting tissue levels. P-gp in the small intestine and BBB affects SGC003F’s pharmacokinetics, warranting further clinical drug–drug interaction (DDI) studies.

Background: Bilateral deep thalamic nucleus brain stimulation (STN-DBS) surgery is often used to treat the motor symptoms of patients with Parkinson's disease. The change of neurocognitive symptoms in patients is, however, still unclear. Objective: We aimed at analyzing the deterioration of neurocognitive symptoms in patients with Parkinson's disease after deep brain stimulation surgery under different follow-up times. Methods: A comprehensive literature review was conducted using Pubmed, Cochrane Library, and Web of Science to screen eligible study records, the meta-analysis was performed using an inverse variance method and a random-effects model. Additionally, the areas of analysis include five: cognition, executive function, memory capacity, and verbal fluency (phonetic fluency and semantic fluency). They were analyzed for changes at six and twelve months postoperatively compared to baseline. The Meta-analysis has been registered with PROSPERO under the registration number: CRD42022308786. Results: In terms of overall cognitive performance, executive function, and memory capacity, the original studies show a trend of improvement in these areas at 12 months postoperatively compared with 6 months, at variance, patients did not improve or deteriorated in phonetic fluency(d = −0.42 at both 6-month and 12-month follow-up) and semantic fluency from 6 to 12 months postoperatively. Conclusion: In terms of most neurocognitive symptoms, including cognitive ability, executive function, and learning memory capacity, bilateral STN-DBS surgery appears to be safe at relatively long follow-up times. However, postoperative phonetic and semantic fluency changes should still not be underestimated, and clinicians should pay more attention to patients' changes in both.

Abstract DC short‐circuit fault has become one of the major concerns in bipolar DC system operation under complicated conditions. Compared with conventional two‐port DC‐DC converter, fault‐tolerant DC‐DC converter with multiple external ports is evaluated as a preferential choice for high reliability, availability and flexibility required bipolar DC system due to its capability of fault reconfiguration. This article focuses on a type of fault‐tolerant DC‐DC converter interconnected with DC bus and integrated energy storage devices applied in bipolar DC system and theoretical analyses on transmitted power characteristics under bipolar mode and monopolar mode are also carried out in this article. For bipolar mode, the minimized‐peak‐current control strategy is proposed to reduce current stress on switching devices. As for monopolar mode and source‐port fault mode, the fault reconfiguration method and constant‐transmitted‐power control strategy are designed to eliminate fault impaction and achieve the constant transmitted power of output port connected with critical load, by means of power sharing between input port and normal output port or between the normal output ports. Furthermore, intersection of zero‐voltage‐switching (ZVS) operation area under different working modes is depicted with consideration of two optimizing control. Finally, the performance of the proposed fault reconfiguration method and optimizing control have been tested in PLECS environment and experimental prototype to verify the reliability and flexibility.

Abstract Background The positioning of implant components for total hip arthroplasty (THA) is essential for joint stability, polyethylene liner wear, and range of motion. One potential benefit of the direct anterior approach (DAA) for THA is the ability to use intraoperative fluoroscopy for acetabular cup positioning and limb-length evaluation. Previous studies comparing intraoperative fluoroscopy with no fluoroscopy during DAA have reported conflicting results. This meta-analysis aimed to evaluate whether intraoperative fluoroscopy improves component positioning compared to no fluoroscopy during direct anterior total hip arthroplasty. Methods A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. We searched Web of Science, EMBASE, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, CNKI, VIP, and Wanfang database in May 2023 to identify studies involving intraoperative fluoroscopy versus no fluoroscopy during direct anterior total hip arthroplasty. Finally, we identified 1262 hips assessed in seven studies. Results There were no significant differences in terms of acetabular cup inclination angle (ACIA, P = 0.21), ACIA within safe zone rate (P = 0.97), acetabular cup anteversion angle (ACAA, P = 0.26); ACAA within safe zone rate (P = 0.07), combined safe zone rate (P = 0.33), and limb-length discrepancy (LLD, P = 0.21) between two groups. Conclusion Even though intraoperative fluoroscopy was not related to an improvement in cup location or LDD. With fewer experienced surgeons, the benefit of intraoperative fluoroscopy might become more evident. More adequately powered and well-designed long-term follow-up studies were required to determine whether the application of the intraoperative fluoroscopy for direct anterior total hip arthroplasty will have clinical benefits and improve the survival of prostheses.

Abstract The diode‐rectifier (DR)‐based high‐voltage direct current (HVDC) transmission is regarded as a low‐cost alternative to the HVDC transmission for offshore wind farms (OWFs) integration. However, the DR would generate harmonic voltages in the offshore grid, which greatly affects the power quality. To solve this problem, this paper utilizes a parallel‐connected small‐capacity auxiliary converter to suppress the harmonic voltages and provide black‐start energy for the OWFs. In addition, the submodule branches (SMBs) of the auxiliary converter can be used as part of the HVDC chopper. On this basis, a coordinated grid fault ride‐through (FRT) strategy is proposed in this paper. After a grid fault occurs, the HVDC chopper constructed by the auxiliary converter is able to constrain the DC‐link voltage. At the same time, the OWFs are controlled to reduce the output active power. As a result, the cost of the FRT can be significantly reduced. The proposed harmonic voltage suppression and the FRT method are verified through the simulation model in Simulink.

Abstract Natural articular cartilage is a typical self‐healing and superlubrication system capable of maintaining extremely low friction under physiological loadings. Cartilage wear and accidental trauma can cause irreversible defects to cartilage and subchondral bone with a significant decrease in intra‐articular lubrication, leading to the development of severe osteoarthritis and osteochondral defect. To address the important clinical problem of osteochondral defect, a bioinspired hard–soft (PEEK‐lubrication hydrogel) composite scaffold is designed and developed. The polymerization of polyethylene glycol diacrylamide (PEGDAA) and 2‐methacryloyloxyethyl phosphorylcholine (MPC) on polyetheretherketone (PEEK) substrate is achieved by UV initiation to form a strong interfacial bonding, and nano‐hydroxyapatite is deposited on porous PEEK substrate via polydopamine coating to improve osteogenic capability. Accordingly, the composite scaffold is successfully developed with lubrication and osteogenic activity. The tribological tests show that the lubrication performance of the composite scaffold is based on the hydration lubrication mechanism of the upper hydrogel layer, and the in vitro and in vivo experiments demonstrate that the composite scaffold is endowed with excellent biocompatibility and bioactivity. In conclusion, the bioinspired strategy for preparing a hard–soft composite scaffold shows a promising way in the treatment of osteochondral defect and provided a guideline for designing functional PEEK‐based biomaterials in tissue engineering scaffolds.

Fluid mastic asphalt (FMA) is a skeleton dense hot-mixed asphalt mixture with the internal porosity of less than 1 %, which is formed by mixture fluidity or vibration-assisted slurry extraction. In order to improve the fluidity of SBS modified asphalt binder used in FMA, it should be heated at ultra-high temperature which refers to 200 ℃ and above. The performance degradation of asphalt binder which is heated at ultra-high temperature in the asphalt storage tank cannot be avoided. At present, there are few studies on the performance degradation of SBS modified asphalt binder in the process of construction at ultra-high temperature. This study proposes an aging test method which is aging of large volume (ALV) and then short-term aging in laboratory which aims to replace extraction and recovery from old asphalt mixture. The macro performance of SBS modified asphalt binder are analyzed by penetration, ductility, softening point, dynamic shear rheometer (DSR) and bending beam rheometer (BBR). The microscopic changes of SBS modified asphalt binder are analyzed by Fourier transform infrared spectroscopy (FTIR) and gel permeation chromatography (GPC). The results shows that, taking aging of large volume at 165 ℃ as the standard, the change rate of that before and after short-term aging and mix change between that and other kind of aging of large volume reaches a third and above. The carbonyl group occurs in the infrared spectrum of aging in the form of volume at 225 ℃ but else asphalt binder which undergo aging in the form of volume at other temperature do not. The molecular weight decreases significantly and the distribution range becomes wider.

Carbon nitrides form a series of polymer semiconductors popular in photocatalysis. In the course of photoresponse, the separation of light-induced electron–hole pairs is one of the critical factors that affect the conversion rate from photoenergy to chemical substance. Exciton binding energy (Eb) is treated as a classical parameter to evaluate the barrier of exciton dissociation. In this work, we study the electronic and optical nature of two specific members of the carbon nitride family, polymeric carbon nitride (melon) and crystallized poly(triazine imide) (PTI/Li+Cl−) by employing the photoluminescence spectra and density functional theory (DFT) calculations based on the Wannier-Mott exciton module. The results of self-consistent GW computation were applied. The measurement of photoluminescence spectra, by which exciton binding energies are estimated, is likewise discussed. Generally, compared with the results calculated by GW-BSE, the DFT results based on the Wannier-Mott model are closer to the experimental values. From a materials perspective, on the other hand, the exciton binding energy of the melon is lower than that of PTI/Li+Cl−.

The bipolar low-voltage DC (LVDC) distribution system has become a prospective solution to better integration of renewables and improvement of system efficiency and reliability. However, it also faces the challenge of power and voltage imbalance between two poles. To solve this problem, an interface converter with bipolar asymmetrical operating capabilities is applied in this paper. The steady-state models of the bipolar LVDC distribution system equipped with this interface converter in the grid connected mode and off-grid mode are analyzed. A control scheme based on DC offset injection at the secondary side of the interface converter is proposed, enabling the bipolar LVDC distribution system to realize the unbalanced power transfer between two poles in the grid-connected mode and maintain the inherent pole voltage balance in the off-grid mode. Furthermore, this paper also proposes a primary-side DC offset injection control scheme according to the analysis of the magnetic circuit model, which can eliminate the DC bias flux caused by the secondary-side DC offset. Thereby, the potential core magnetic saturation and overcurrent issues can be prevented, ensuring the safety of the interface converter and distribution system. Detailed simulations based on the proposed control scheme are conducted to validate the function of power and voltage balance under the operation conditions of different DC loads.

Wind-farm-side modular multilevel converters (WFMMCs) used in modular multilevel converter based high-voltage direct current (MMC-HVDC) transmission systems must be able to control the AC grid voltage in offshore wind farms. Different AC voltage control strategies can significantly affect the dynamic characteristics of WFMMCs. However, existing studies have not provided a general methodology of controller parameter design, and few comparative studies have been conducted on control performance under varying operating conditions as well as the effects of different AC voltage control modes (AVCMs) on the stability of MMC-HVDCs with offshore wind farms. This paper provides a controller parameter design method for AVCMs, which is tested in various operating scenarios. Sequence impedance models of offshore wind farms and WFMMCs under different AVCMs are then developed. The effects of AVCMs on the small-signal stability of the interconnected system are then analyzed and compared using the impedance-based method. Finally, case studies are conducted on a practical MMC-HVDC system with offshore wind farms to verify the theoretical analysis.

Abstract Background Morphological markers presenting the lateral extension of acromion and the greater tuberosity of humerus were proposed to diagnose and predict rotator cuff tears (RCTs) in recent years, but few studies have addressed the combined performance when using two predictors together. As a presence of a RCT may be associated with the impingement caused by both acromion and the greater tuberosity, we believe a combined utilization of predictors could result in a better diagnostic and predictive performance than using a single predictor. The aim of this study is to (i) explore whether the combination is more efficient to predict and diagnose RCTs; (ii) find out which combination is the most superior screening approach for RCTs. Methods This was a retrospective study and patients who visited our hospital and were diagnosed with or without partial-thickness or full-thickness RCTs via magnetic resonance imaging from January 2018 to April 2022 were enrolled and classified into two groups respectively. Four predictors, the critical shoulder angle (CSA), the acromion index (AI), the greater tuberosity angle (GTA) and the double-circle radius ratio (DRR) were picked to participate in the present study. Quantitative variables were compared by independent samples t tests and qualitative variables were compared by chi-square tests. Binary logistic regression analysis was used to construct discriminating combined models to further diagnose and predict RCTs. Receiver operating characteristic (ROC) curves were pictured to determine the overall diagnostic performance of the involved predictors and the combined models. Results One hundred and thirty-nine shoulders with RCTs and 57 shoulders without RCTs were included. The mean values of CSA (35.36 ± 4.57 versus 31.41 ± 4.09°, P

To investigate the extraction effect of total flavonoids from Crataegus pinnatifida by using ultrasonic-assisted deep eutectic solvents, and optimize the extraction parameters. Firstly, ten kinds of deep eutectic solvents (DESs) composed with different components were prepared for extracting total flavonoids of C. pinnatifida, and the DESs with the highest yield were selected. Then, water content and the proportion of each component contained in DESs were screened on the basis of the single factor experiments. Meanwhile, the response surface methodology (RSM) was employed to optimize extraction temperature, liquid-solid ratio and ultrasonic time, and obtain the extraction parameters. As results, glycerol/choline chloride (molar ratio 3:1) DESs containing 50% water was chosen as the optimal extraction solvent, and the optimum extraction parameters were as follow: Ultrasonic time (21 min), liquid-solid ratio (42 mL/g) and extraction temperature (72 ℃). Under the above extraction condition, the yield of total flavonoids, rutin, vitexin, hyperoside, quercetin in DESs extract were 7.72%, 0.24%, 0.33%, 0.18% and 0.27%, respectively, which were superior to the traditional alcohol extraction method. The DPPH radical scavenging rate of DESs extract at 0.1 mg/mL was 86%. Compared with methanol extract, the antioxidant activity of DESs extract was enhanced. Therefore, ultrasonic-assisted deep eutectic solvents extraction method could effectively improve the yield of total flavonoids from C. pinnatifida, and would provide the scientific evidence for the resource development and utilization of C. pinnatifida.

The segmentation of knee joint is of great significance for diagnosis, guidance and treatment of knee osteoarthritis. However, manual delineation is time-consuming and labor-intensive since various anatomical structures are involved in the 3D MRI volume. Automatic segmentation of the whole knee joint requires no human effort, additionally can improve the quality of arthritis diagnosis and treatment by describing the details more accurately. Existing knee joint segmentation methods in the literature focus on only one or few structures out of many. In this paper, we study the feasibility of knee joint segmentation on MR images based on neural networks and deal with the following challenges: (1) end-to-end segmentation of 15 anatomical structures, including bone and soft tissue, of the whole knee on MR images; (2) robust segmentation of small structures such as the anterior cruciate ligament, accounting for about 0.036% of the volume data. Experiments on the knee joint MR images demonstrate that the average segmentation accuracy of our method achieves 92.92%. The Dice similarity coefficients of 9 structures were above 94%, five structures were between 87% and 90%, and the remaining one was about 76%.

Abstract Superhydrophobic surfaces have huge applications in wetting fields. However, the surface is prone to mechanical abrasion and environmental damage in the application. This paper provides an alternative approach to preparing durable superhydrophobic surfaces, reveals the wear mechanism of the copper alloy surface and compares the tribological properties of different surfaces. Then, take the superhydrophobic surface of the circular truncated cone microstructure as an example to verify the durability under friction and wear, atmospheric environment, and acid and alkali media. The results show that compared with the polished surface, the copper alloy surface with microstructures can effectively reduce the friction coefficient of the surface and improve the tribological performance. The prepared superhydrophobic surface can endure abrasion under certain pressure and distance, and keep great stability in the atmospheric environment and acid–base conditions.

Brassica crops encompass a diverse array, including vegetables, oil crops, ornamentals, and condiments [...]

Objective In this study we concerned on the morphological characteristics of the greater tuberosity of humerus and proposed the double‐circle radius ratio as a new predictor for the diagnosis of rotator cuff tears. Methods This was a retrospective study and patients who visited our hospital and were diagnosed with or without rotator cuff tears via magnetic resonance imaging from January 2018 to July 2021 were enrolled and classified into two groups respectively. In a standard anteroposterior view, the radius of the best‐fit circle of humeral head and the radius of the concentric circle passing through the most lateral edge of the greater tuberosity were measured in each shoulder. The ratio of these two radiuses was named as the double‐circle radius ratio. Angular parameters including the greater tuberosity angle and the critical shoulder angle were also measured in the anteroposterior view. Independent samples t tests and chi‐square tests were used to find significant differences between groups. Significant associations between those measured variables and demographic characteristics were analyzed with simple linear regression analysis. Receiver operating characteristic curves were pictured to determine applied cutoff values by using Youden index. Multivariable‐adjusted analysis for the occurrence of rotator cuff tears was carried out by using multiple logistic regression analysis. For all tests a p value of 1.38 resulted in 11.252‐fold odds of developing rotator cuff tears (95% CI, 3.388–37.368; P = 0.000). Conclusion The double‐circle radius ratio is significantly larger in patients with rotator cuff tears and could be regarded as an eligible predictor for rotator cuff tears.

The diode rectifier (DR) based hybrid dc converter can significantly increase the economy of the offshore wind power transmission system comparing with the traditional modular multilevel converter (MMC). However, the start-up and shut-down methods of this hybrid dc converter are not studied. In this paper, the start-up and shut-down strategies of the hybrid dc converter are proposed. The start-up process can be divided into two stages: uncontrollable precharging stage and controllable precharging stage. In the uncontrollable precharging stage, the calculation method of the precharging current is given and the design method of the current limiting resistor is presented. In the controllable precharging stage, a circulating current control strategy is proposed to balance the inner energy of the converter and charge the submodule capacitors to the rated value. Besides, the corresponding shut-down strategy is also introduced. Simulation results based on MATLAB/Simulink and hardware-in-the-loop experiment results based on the RT-LAB are provided to support the proposed strategies. The proposed start-up and shut-down strategies can charge and discharge the submodules of the hybrid DC converter safely and cheaply.

To enhance the oxidation aging resistance of asphalt binder, slow-release porous calcium carbonate (CaCO3) microspheres loaded with asphalt rejuvenator were proposed. The porous calcium carbonate microspheres fabricated by a double decomposition method regulated by polyacrylic acid (PAA) and sodium dodecyl sulfonate (SDS) were used as carriers for the asphalt rejuvenator. The test results showed that the porous CaCO3 microspheres possessed higher specific surface areas and porosities, and the weight ratio of the rejuvenator loaded on the CaCO3 microspheres was up to15%. Frequency sweep test results showed that the complex modulus of the asphalt binder added with rejuvenator-loaded CaCO3 microspheres decreased after aging. When the content of the CaCO3 microspheres added in asphalt binder reached 70%, the complex modulus is even less than that of neat asphalt. Additionally, the slow-release mechanism of the CaCO3 microspheres loaded with rejuvenator was studied based on molecular dynamics simulations. The simulation results also showed that the composition and structure of the molecule played an important role in the diffusion ability. This study provides a reference for developing a new method to delay the oxidation aging of asphalt, and it provides theoretical and experimental data support for the design of oxidation-aging resistance asphalt mixtures.

Abstract Background The aim of the present study was to assess the prevalence of deficient mismatch repair (MMR) in Chinese ovarian clear cell carcinoma (CCC) patients and its association with clinicopathologic features. Methods Immunohistochemistry with four antibodies against MLH1, PMS2, MSH2 and MSH6 was performed on whole section slides, and the results were correlated with clinicopathologic variables. Results A total of 108 cases were included in the present study with a median age of 52 years at first diagnosis. Early-stage disease and platinum-sensitive recurrence accounted for 62.3 and 69.6%, respectively, of the total cases. Overall, the estimated 5-year overall survival was 70.3 and 20.7% in patients with early- and late-stage tumors, respectively. Deficient MMR was identified in 5.6% (6/108) of the cohort and included MSH2/MSH6 (n = 4) and MLH1/PMS2 (n = 2). The average age of the six patients with deficient MMR was 45.6 years, and the rate of MMR-deficient tumors in women ≤50 years was relatively higher than that in women over 50 years (10.0% vs. 2.9%; P = 0.266). Half of the patients with deficient MMR were diagnosed with synchronous (endometrial or colorectal) and metachronous (endometrial) cancer, which was significantly more than their intact counterparts (P = 0.002). All six patients with deficient MMR had early-stage tumors, and the majority (83.3%) were platinum sensitive. The median progression-free survival was slightly higher in patients with defective MMR expression than in their intact counterparts (30 months vs. 27 months), but significance was not achieved (P = 0.471). Conclusions Young ovarian CCC patients with concurrent diagnosis of endometrial and colorectal cancer are more likely to have MMR-deficient tumors, thereby warranting additional studies to determine whether patients harboring MMR abnormalities have a favorable prognosis.

Abstract Background Despite Vast improvements in technology and surgical technique in total knee arthroplasty (TKA), approximately 15–25% TKAs, have suboptimal subjective clinical outcomes. Our study sought to evaluate if sensor-guided balancing improves postoperative clinical outcomes compared to a conventional gap balancing technique. Methods We searched Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, CNKI, VIP, and Wanfang database in March 2022 to identify studies involving sensor-guided balancing versus conventional gap balancing technique in TKA. Finally, we identified 2147 knees assessed in nine studies. Results Compared with manual gap balancing, Sensor-guided gap balancing resulted in less rate of Manipulation under anesthesia (MUA) (P = 0.02), however more rate of intraoperative additional procedures (P = 0.0003). There were no significant differences in terms of KSS (P = 0.21), KSS Function score (P = 0.36), OKS (P = 0.61), KOOS (P = 0.78), operative time (P = 0.17), Mechanical axis (P = 0.69) and rate of reoperation between two groups. Conclusion Compared with conventional manual gap balancing techniques, sensors have more balancing procedures being performed. However, it did result in a reduction in the rate of MUA. More extensive, high-quality RCTs are required to verify our findings further.

Abstract Background The combined positive score (CPS) of the programmed death ligand‐1 (PD‐L1) 22C3 assay is a predictive marker of pembrolizumab monotherapy for advanced esophageal cancer (EC) patients. However, little is known about the association of the PD‐L1 22C3 CPS with the clinicopathological features and heterogeneity of PD‐L1 expression in EC in the Chinese population in a real‐world setting. Methods We examined the association of the PD‐L1 22C3 CPS with clinicopathological characteristics in 533 EC specimens. Further, we compared 37 cases' different blocks of the same specimen and 50 paired primary/metastatic lymph node lesions to investigate the heterogeneity of PD‐L1 expression. Results PD‐L1 positive expression was observed in 45.0% of 533 EC patients, including 46.8% with squamous cell carcinoma, 15.4% with adenocarcinoma, 28.6% with basaloid squamous carcinoma, 42.9% with spindle cell carcinoma, and 33.3% with neuroendocrine tumors. PD‐L1 positive expression was positively associated with lymph node metastasis (59.2% chance, p = 0.021) and venous/lymphatic invasion (66.3% chance, p = 0.029). PD‐L1 expression was highly consistent in different paraffin blocks of the same surgically resected specimen (concordance rate: 86.5%, p = 0.000016) and a moderate consistency (concordance rate: 78.0%, p = 0.000373) for the primary and metastatic lymph node lesion comparison. Conclusions This is a novel study which demonstrated a positive correlation between a high PD‐L1 22C3 CPS and invasion/metastasis risk in EC surgical specimens. Both paired blocks and paired primary/metastatic lymph node lesions showed significant concordance. PD‐L1 heterogeneity was inferred to be mainly related to positive mononuclear inflammatory cells (MICs), which might have substantial implications for clinical practice.

This article utilizes the research method of the Life Cycle Assessment (LCA) to scrutinize Lithium Iron Phosphate (LFP) batteries and Ternary Lithium (NCM) batteries. It develops life cycle models representing the material, energy, and emission flows for power batteries, exploring the environmental impact and energy efficiency throughout the life cycles of these batteries. The life cycle assessment results of different power battery recycling process scenarios are compared and analyzed. This study focuses on retired LFP batteries to assess the environmental and energy efficiency during the cascade utilization stage, based on a 50% Single-Cell Conversion Rate (CCR). The findings of the research reveal that, in terms of resource depletion and environmental emission potential, LFP batteries exhibit lower impacts compared to NCM batteries. The use of hydrometallurgy in recovering LFP power batteries leads to minimal life cycle resource consumption and environmental emission potential. During the cascade utilization stage of LFP batteries, significant benefits are noted, including a 76% reduction in mineral resource depletion (ADP e) and an 83% reduction in fossil energy depletion (ADP f), alongside notable reductions in various environmental impact factors. Simultaneously, considering the sensitivity of life cycle assessment indicators and their benefit percentages to different CCRs, it is observed that ODP exhibits the highest sensitivity to CCR changes, while evaluation indicators such as HTP, AP, and GWP show relatively lower sensitivity. This study can provide an effective reference for the establishment of an energy saving and emission reduction evaluation system of power batteries.

Abstract Purpose Neuroendocrine cervical carcinoma (NECC) is an uncommon malignancy of the female reproductive system. This study aimed to evaluate cancer-specific mortality and to construct prognostic nomograms for predicting the survival of patients with NECC. Methods we assembled the patients with NECC diagnosed between 2004 to 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. Meanwhile, we identified other patients with NECC from the Wenling Maternal and Child Health Care Hospital between 2002 to 2017. Fine and Gray’s test and Kaplan–Meier methods were used to evaluate cancer-specific mortality and overall survival (OS) rates, respectively. Nomograms were constructed for predicting cancer-specific survival (CSS) and OS for patients with NECC. The developed nomograms were validated both internally and externally. Results a total of 894 patients with NECC were extracted from the SEER database, then classified into the training cohort (n = 628) and the internal validation cohort (n = 266). Besides, 106 patients from the Wenling Maternal and Child Health Care Hospital served as an external validation cohort. Nomograms for predicting CSS and OS were constructed on clinical predictors. The validation of nomograms was calculated by calibration curves and concordance indexes (C-indexes). Furthermore, the developed nomograms presented higher areas under the receiver operating characteristic (ROC) curves when compared to the FIGO staging system. Conclusions we established the first competing risk nomograms to predict the survival of patients with NECC. Such a model with high predictive accuracy could be a practical tool for clinicians.

Abstract Introduction The efficacy of tourniquet use during primary total knee arthroplasty (TKA) is thought to reduce intraoperative blood loss, improve surgical exposure, and optimize cement fixation. Tranexamic acid (TXA) use can decrease postsurgical blood loss and transfusion requirements. This review aimed to appraise the effects of tourniquet use in TKA for patients with tranexamic acid use. Methods A meta-analysis was conducted to identify relevant randomized controlled trials involving TXA plus a tourniquet (TXA-T group) and use of TXA plus no tourniquet (TXA-NT group) in TKA. Web of Science, PubMed, Embase, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CNKI, and Wanfang database were searched from 2010 through October 2021. Results We identified 1720 TKAs (1690 patients) assessed in 14 randomized controlled trials. Compared with the TXA-NT group, the TXA-T group resulted in less intra-operative blood loss (P

Modular multilevel converter-based high-voltage direct current (MMC-HVDC) transmission is becoming a trend in offshore wind-farm integration. However, the large DC-side energy dissipation equipment, which is utilized to dissipate surplus wind power under grid fault conditions, will largely increase the cost of MMC-HVDC systems. To reduce the cost, a novel low voltage ride-through (LVRT) strategy is proposed in this paper. When a grid fault occurs and the DC voltage exceeds the limit, the sending end converter is controlled to reduce the AC voltage of the wind farm. The LVRT of the wind generators will be activated, and the output active power of the wind farm is reduced. With this coordination, the DC-side energy dissipation equipment only needs to dissipate surplus power in the early stage of the grid fault before the output active power of the wind farm drops. Therefore, the heat generated by braking resistors can be significantly reduced. On this basis, the braking resistors can be distributed into the submodules of the receiving end converter (REC) station. The LVRT problem can be solved without building an individual energy dissipation station. Using the proposed coordination strategy, the construction cost of the MMC-HVDC system with offshore wind farm integration can be significantly reduced.

Cretaceous sandstones have weak cementation and high porosity while exhibit a high apparent brittleness. Compression and torsion (C-T) fractures are widely distributed in Cretaceous sandstones due to asymmetric tectonic convergence action. However, studies on C-T fracture formation and the mechanisms causing variability in Cretaceous sandstones containing no oil or gas are rare due to the challenges in sampling intact sandstone cores, despite their significance to mine shaft sinking. Therefore, this study used binder jetting-based 3D printing to prepare artificial Cretaceous sandstone and developed a real-time X-ray computed tomography- (CT-) aided torsion shear apparatus to test them. The test results showed that the 3D printed (3DP) sandstone had characteristic indexes that approached and even exceeded the lower limits of Cretaceous sandstone cores, thereby accurately representing the unavailable cores. Furthermore, the 3DP sandstones had anisotropic properties comparable to the sandstone cores. Under C-T action, the 3DP sandstone exhibited a pronounced strain gradient of 2.0 %/mm perpendicular to fracture inclination. The inclination angles of fractures formed under C-T action tended to increase as the cell pressure increased, and that approached the orientation angles of maximal principal stress. The maximal and minimal principal stresses exerted inclination-slip and width-stretching effects, respectively, on C-T fractures. But the effect of inclination-slip on the C-T fractures was stronger than that of width-stretching. This insight into C-T fracture formation will guide future studies on the fracture evolution and its disaster-dominating mechanisms arisen from disturbances by shaft sinking.

As a nonlinear control method, the Euler–Lagrange- (EL-) based passivity-based control (PBC) has been studied for grid-tied converters based on energy function to achieve better performance. However, the EL-based PBC method is dependent on an accurate mathematical model. In the traditional EL-based PBC research for LCL-filtered grid-tied inverter, the effect of the digital control delay is rarely considered and the stability under the grid impedance uncertainties is not discussed, especially in the capacitive grid or complex weak grid. To address these concerns, this study proposes a modified EL-based PBC method based on the output admittance reshaping for LCL-filtered grid-tied inverters. The system’ passive region is expanded by adding capacitor current feedback loop up to the Nyquist frequency. The potential resonance is thus eliminated irrespective of the grid impedance. Additionally, the stable region and control parameters design methods of the modified EL-based PBC method with inverter-side control are also carried out. To verify the correctness of the theoretical analysis, both simulation and experimental results are investigated from a 3 kW grid-tied inverter prototype.

Abstract Enlarging the speed range of wind turbines is an effective way to increase power production in low‐frequency band wind which contains more energy and is very challenging for DFIG‐based wind energy conversion system (WECS). The analysis shows that current controllability of the converter is the main factor limiting bidirectional speed range extension (BSRE). This problem can be solved by increasing dc‐bus voltage, but a constant and high dc‐bus voltage will increase the electrical stress and switching losses of the converter. This paper proposed a dynamic minimum dc‐bus voltage (DMDCV) technique in which the dc‐bus voltage can automatically adjust to enable the back‐to‐back voltage source converter to work in linear modulation mode at its minimum value, thus supporting BSRE while also achieving multiple goals including low electrical stress and low switching losses. Two implementation methods of DMDCV with and without modulation depth loop are proposed and discussed. The co‐simulation results verified the feasibility of DMDCV and the advantages of BSRE in improving power generation.

Abstract Here, a modular DC‐DC auto‐transformer is proposed with a developed scheme of two‐port submodules. The proposed two‐port submodule is composed of six switches and single capacitor, and it is featured with three general working states. In the proposed DC‐DC auto‐transformer, all two‐port submodules are connected in the input‐series‐output‐series structure. Then the general primary and secondary ports of the submodules of the proposed DC‐DC auto‐transformer are connected in series to achieve the auto‐transformer operation capability. All submodule capacitors are actively connected in the transformer to form the primary and secondary side voltages. The capacitor utilization is increased therefore. Different voltage ratios can be achieved by arranging different submodule numbers in each working state simultaneously. The volume is reduced due to the developed two‐port submodule which eliminates of AC transformers. Detailed topology, working principles, modulation method, and control strategy are provided in the paper. Voltage and current fluctuations are analysed, and the system parameter design method is proposed in detail. Both a simulation system with 40 submodules and a down‐scaled experimental system with three submodules were set up and verified the proposed approach.

Fungi, as the unique natural resource, are rich in polysaccharides, proteins, fats, vitamins, and other components. Therefore, they have good medical and nutritional values. Polysaccharides are considered one of the most important bioactive components in fungi. Increasing researches have confirmed that fungal polysaccharides have various biological activities, such as antioxidant, immunomodulatory, anti-tumor, hepatoprotective, anti-aging, anti-inflammatory, and radioprotective activities. Consequently, the research progresses and future prospects of fungal polysaccharides must be systematically reviewed to promote their better understanding. This paper reviewed the extraction, purification, structure, biological activity, and underlying molecular mechanisms of fungal polysaccharides. Moreover, the structure–activity relationships of fungal polysaccharides were emphasized and discussed. This review can provide scientific basis for the research and industrial utilization of fungal polysaccharides.

Abstract Increasing evidence suggests the pivotal role of hematopoietic pre-B-cell leukemia transcription factor (PBX)-interacting protein (HPIP/PBXIP1) in cancer development and progression, indicating that HPIP inhibition may be a promising target for cancer therapy. Here, we screened compounds inhibiting breast cancer cell proliferation with HPIP fused with green fluorescent protein as a reporter. A novel agent named TXX-1-10 derived from rimonabant, an antagonist of cannabinoid receptor 1 with anticancer effects, has been discovered to reduce HPIP expression and has greater inhibitory effects on breast cancer cell growth and metastasis in vitro and in vivo than rimonabant. TXX-1-10 regulates HPIP downstream targets, including several important kinases involved in cancer development and progression (e.g., AKT, ERK1/2, and FAK) as well as cell cycle-, apoptosis-, migration-, and epithelial-to-mesenchymal transition (EMT)-related genes. Consistent with the results of anticancer effects, genome-wide RNA sequencing indicated that TXX-1-10 has more significant effects on regulation of the expression of genes related to DNA replication, cell cycle, apoptosis, cell adhesion, cell migration, and invasion than rimonabant. In addition, TXX-1-10 significantly regulated genes associated with the cell growth and extracellular matrix organization, many of which were shown to be regulated by HPIP. Moreover, compared with rimonabant, TXX-1-10 greatly reduces blood-brain barrier penetrability to avoid adverse central depressive effects. These findings suggest that HPIP inhibition may be a useful strategy for cancer treatment and TXX-1-10 is a promising candidate drug for cancer therapy.

Abstract A considerable amount of rotating synchronous machines are being replaced by the increasing capacity of converter‐based resources, which has stimulated a demand for grid‐forming converters (GFCs) for grid supporting. The inertia and frequency responses of GFC are remarkably similar to those of synchronous generator (SG), but the inadequate capability of sourcing short‐circuit current of GFCs during grid fault can lead to several serious consequences. The low short‐circuit current level fails to trigger protection relays and cannot provide sustained voltage support during the fault or more effectively support the recovery of voltage after fault clearance. The short‐term overcurrent capability of GFC can be promoted either from the point of view of the power devices or from the topology of it. The overcurrent capability of converter is hard‐earned, so full use of it should be made. This paper proposes an optimal control strategy of short‐circuit current of GFC, which can enable the GFC to source the short‐circuit current with an optimal angle within the allowable magnitude. A detailed simulation model of the proposed method here is set up in PSCAD/EMTDC. The simulation results show that the proposed method can achieve better voltage supporting results compared with the traditional reactive support control.

Objective To find out which structure is crucial for the formation of shoulder impingement syndrome with the purpose of directing surgical procedures of subacromial decompression and discussing whether it is necessary to manage acromioclavicular joint during operation and how to do it properly. Methods This was a retrospective study. Clinical data and preoperative computed tomography (CT) images were collected from patients who were diagnosed with rotator cuff tears between January 2017 and August 2019 (sample size: 46) and those who were diagnosed without rotator cuff tears between March 2018 and August 2019 (sample size: 44) in our institution, respectively. Three‐dimensional models of shoulders were established by multiplanar reconstruction of CT scans and measurements were performed on these models. The parameters such as the acromial length and width, the axial tilt, and the distance from acromial margin to glenoid plane were measured in an adjusted axial plane, and the critical shoulder angle and the spatial volume under acromioclavicular joint were measured in an adjusted coronal plane. The demographic characteristics, the acromial morphology and the spatial volume under acromioclavicular joint were compared to find significant differences between the two groups. The association between the axial tilt and the distance from acromial margin to glenoid plane was evaluated by an ordinary least squares linear regression. Results The patients with rotator cuff tears consisted of 16 males and 30 females, among which 30 right shoulders and 16 left shoulders were included. The patients without rotator cuff tears consisted of 28 males and 16 females, among which 15 right shoulders and 29 left shoulders were involved. Significant differences between the groups were found in the acromial width (3.332 cm vs 3.111 cm), the axial tilt (33.765° vs 23.829°), the critical shoulder angle (32.630° vs 30.363°), the distance from anterior 3 cm of lateral acromial margin (range, 2.476 cm–3.302 cm vs 1.993 cm–3.089 cm), and anterior 0.9 cm of medial acromial margin (range, 0.967 cm–2.369 cm vs 0.668 cm–1.993 cm) to glenoid plane, and the spatial volume under acromioclavicular joint (1.089 cm vs 1.446 cm) in the two groups. No significant differences were found in the age (60.0 years vs 58.3 years) or the acromial length (4.187 cm vs 4.184 cm). Significant association was revealed by linear regression analysis between the axial tilt and the distance from anterior two‐thirds of lateral acromial margin to glenoid plane, and similar association was also found in the anterior half of medial margin. Conclusion Anterior two‐thirds of lateral acromial margin, anterior half of medial acromial margin, and inferior aspect of acromioclavicular joint are crucial structures and need to be fully decompressed when treating patients with rotator cuff tears.

Abstract Background The interscalene brachial plexus block (ISB) is a commonly used nerve block technique for postoperative analgesia in patients undergoing shoulder arthroscopy surgery; however, it is associated with potentially serious complications. The use of suprascapular nerve block (SSNB) has been described as an alternative strategy with fewer reported side effects for shoulder arthroscopy. This review aimed to compare the impact of SSNB and ISB during shoulder arthroscopy surgery. Methods A meta-analysis was conducted to identify relevant randomized controlled trials involving SSNB and ISB during shoulder arthroscopy surgery. Web of Science, PubMed, Embase, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CNKI, and Wanfang database were searched from 2010 through March 2021. Results We identified 1255 patients assessed in 17 randomized controlled trials. Compared with the ISB group, the SSNB group had higher VAS at rest in PACU (P = 0.003), 1 h after operation (P = 0.005), similar pain score 2 h (P = 0.39), 3-4 h (P = 0.32), 6-8 h after operation (P = 0.05), then lower VAS 12 h after operation (P = 0.00006), and again similar VAS 1 day (P = 0.62) and 2 days after operation (P = 0.70). As for the VAS with movement, the SSNB group had higher pain score in PACU (P = 0.03), similar VAS 4-6 h after operation (P = 0.25), then lower pain score 8-12 h after operation (P = 0.01) and again similar VAS 1 day after operation (P = 0.3) compared with the ISB group. No significant difference was found for oral morphine equivalents use at 24 h (P = 0.35), duration of PACU stay (P = 0.65), the rate of patient satisfaction (P = 0.14) as well as the rate of vomiting (P = 0.56), and local tenderness (P = 0.87). However, the SSNB group had lower rate of block-related complications such as Horner syndrome (P < 0.0001), numb (P = 0.002), dyspnea (P = 0.04), and hoarseness (P = 0.04). Conclusion Our high-level evidence established SSNB as an effective and safe analgesic technique and a clinically attractive alternative to interscalene block with the SSNB’S advantage of similar pain control, morphine use, and less nerve block-related complications during arthroscopic shoulder surgery, especially for severe chronic obstructive pulmonary disease, obstructive sleep apnea, and morbid obesity. Given our meta-analysis’s relevant possible biases, we required more adequately powered and better-designed RCT studies with long-term follow-up to reach a firmer conclusion.

Objective To compare the blood loss after procedures of primary unilateral or one‐stage bilateral total knee arthroplasty (TKA) caused by open‐box prosthesis and closed‐box prosthesis. Methods This was a retrospective study. Patients undergoing procedures of primary TKA between January 2017 and July 2020 in our institution were assessed for eligibility for this study. Those who were diagnosed with knee osteoarthritis and underwent primary unilateral or one‐stage bilateral TKA by using PFC Sigma PS150 (closed‐box prosthesis) or Vanguard (open‐box prosthesis) knee systems and had complete data of laboratory indexes on postoperative day (POD) 1, POD 3, and POD 5 were the interested population. At last 243 patients were enrolled, among which 88 patients were classified into the unilateral closed‐box group, 66 patients into the unilateral open‐box group, 47 patients into the one‐stage bilateral closed‐box group, and 42 patients into the one‐stage bilateral open‐box group. The perioperative management and operative techniques were almost the same for each patient, except the selection of prosthesis, which was decided according to surgeon's preference. The baseline information, postoperative laboratory indexes tested on POD 1, POD 3, and POD 5 including hemoglobin, hematocrit, platelet, thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), and international normalized ratio (INR), the primary outcome measurements including the maximum decreased value of hemoglobin and the volume of total blood loss, and the secondary outcome measurements including the transfusion rate and the average transfused red blood cell (RBC) units were well compared between the open‐box group and the closed‐box group. Results The baseline was comparable between groups, except higher preoperative levels of hemoglobin (134.43 g/L vs 126.51 g/L, P = 0.003) and hematocrit (39.92% vs 37.37%, P = 0.000) observed in the one‐stage bilateral open‐box group. The differences of postoperative coagulation function monitored by TT, PT, APTT, and INR were clinically irrelevant between groups. For patients receiving unilateral TKA, significantly higher value of decreased hemoglobin (26.06 g/L vs 21.05 g/L, P = 0.025) and significantly larger amount of total blood loss (920.34 mL vs 723.19 mL, P = 0.013) were observed in the open‐box group. For patients receiving one‐stage bilateral TKA, the open‐box prosthesis was observed to cause more hemoglobin drop (37.81 g/L vs 32.02 g/L, P = 0.071) and total blood loss (1327.26 mL vs 1177.42 mL, P = 0.247) compared to the closed‐box prosthesis, though the differences were not significant. The transfusion rate and the average transfused RBC units were not significantly different between the open‐box group and the closed‐box group no matte whether the patients were from the unilateral TKA group or from one‐stage bilateral TKA group. Conclusion The use of open‐box prosthesis caused more hemoglobin drop and total blood loss than closed‐box prosthesis after primary unilateral or one‐stage bilateral TKA, resulting in comparable transfusion rate and average transfused RBC units between groups.

Abstract Background Despite the prevalence and recurrence of polyploidization in the speciation of flowering plants, its impacts on crop intraspecific genome diversification are largely unknown. Brassica rapa is a mesopolyploid species that is domesticated into many subspecies with distinctive morphotypes. Results Herein, we report the consequences of the whole-genome triplication (WGT) on intraspecific diversification using a pan-genome analysis of 16 de novo assembled and two reported genomes. Among the genes that derive from WGT, 13.42% of polyploidy-derived genes accumulate more transposable elements and non-synonymous mutations than other genes during individual genome evolution. We denote such genes as being “flexible.” We construct the Brassica rapa ancestral genome and observe the continuing influence of the dominant subgenome on intraspecific diversification in B. rapa. The gene flexibility is biased to the more fractionated subgenomes (MFs), in contrast to the more intact gene content of the dominant LF (least fractionated) subgenome. Furthermore, polyploidy-derived flexible syntenic genes are implicated in the response to stimulus and the phytohormone auxin; this may reflect adaptation to the environment. Using an integrated graph-based genome, we investigate the structural variation (SV) landscapes in 524 B. rapa genomes. We observe that SVs track morphotype domestication. Four out of 266 candidate genes for Chinese cabbage domestication are speculated to be involved in the leafy head formation. Conclusions This pan-genome uncovers the possible contributions of allopolyploidization on intraspecific diversification and the possible and underexplored role of SVs in favorable trait domestication. Collectively, our work serves as a rich resource for genome-based B. rapa improvement.

Abstract: Anthocyanins are natural flavonoid organic compounds widely existing in natural fruits and vegetables. Increasing researches have confirmed that anthocyanins have various biological activities, such as antioxidant, immunomodulatory, anti-tumor, hepatoprotective, anti-aging, and anti-inflammatory activities. Therefore, anthocyanins have been widely used in food, health products, cosmetics, medicine, chemical industry, and other fields. The extraction and purification of anthocyanins from natural plants is the premise of anthocyanins application. The research progresses and future prospects of anthocyanins must be systematically reviewed to promote their better understanding. This paper reviewed the latest research progress in extraction and purification of anthocyanins, analyzed and compared the effects of different extraction and purification methods on the extraction rate and purity of anthocyanins. This review can provide scientific basis for the research and industrial utilization of anthocyanins.

Abstract Background Cement mantle penetration and the cement–bone interface strength were critical to a successful primary total knee arthroplasty (TKA). It remained unclear whether decreased blood and fat in the cancellous bone achieved with the use of a tourniquet increases tibial cement mantle penetration in different zones on AP and lateral view in TKA according to criteria defined by the Knee Society Scoring System (KSS). The purpose of this study was to determine whether tourniquet use influences tibial cement mantle penetration in different zones on AP and lateral view in TKA according to KSS. Methods We conducted a meta-analysis to identify studies involving the impact of tourniquet use and no tourniquet use on tibial bone cement penetration in primary TKA in electronic databases, including Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, VIP, Wanfang database, up to January 2021. Finally, we identified 1231 patients (1231 knees) assessed in twelve studies. Results Tourniquet use increases the cumulative cement mantle penetration (P < 0.00001), mean cement mantle penetration (P = 0.004), and cement mantle in zone 3(P < 0.0001) on AP view. However, there were no significant differences in cement mantle in zone 1(P = 0.5), zone 2(P =0 .54), zone 4(P = 0.07) on AP view, and zone 1(P = 0.32), zone 2(P = 0.38) on lateral view between two groups. There were also no significant differences in length of surgery(P = 0.7), change in hemoglobin(P = 0.4), transfusion rates(P = 0.47), and complications such as muscular calf vein thrombosis(P = 0.21), superficial infection (P = 0.72), and deep vein thrombosis (P = 0.66) between two groups. Conclusion The application of a tourniquet increases the thickness of the tibial bone cement penetration—the increase in the thickness of bone cement penetration mainly located in zone 3 on the anteroposterior (AP) view.

Abstract Background Ovarian clear cell carcinoma (OCCC) is the second subtype of ovarian epithelial carcinoma reported to be closely related to Lynch syndrome (LS). ARID1A mutation is an important pathogenetic mechanism in OCCC that leads to loss of ARID1A expression in approximately half of OCCCs. However, the correlation of MMR status and ARID1A deficiency is unclear. The current study aimed to identify the clinical and histopathological characteristics of OCCC associated with dMMR and to further explore the association between dMMR and ARID1A deficiency. Methods A cohort of 176 primary OCCC patients was enrolled and review included histological characteristics (nuclear atypia, necrosis, mitosis, stromal hyalinization, and background precursors) and host inflammatory response (tumor-infiltrating lymphocytes, peritumoral lymphocytes, intratumoral stromal inflammation and plasma cell infiltration). Immunohistochemical staining of MLH1, PMS2, MSH2, MSH6 and ARID1A was performed using tissue microarrays. Results dMMR was detected in 10/176 tumors (6 %), followed by MSH2/MSH6 (6/176), MLH1/PMS2 (3/176), and MSH6 (1/176). The average age of patients with dMMR was younger than that of patients with intact MMR (46 y vs. 53 y). Tumors with diffuse intratumoral stromal inflammation remained significantly associated after multivariate analysis. ARID1A expression was absent in 8 patients with dMMR (8/10), which is a significantly higher frequency than that observed in patients with intact MMR (80 % vs. 43.2 %). Conclusions Our study indicates that diffuse intratumoral stromal inflammation of OCCCs is associated with dMMR, with loss of MSH2/MSH6 expression being most frequent. dMMR is strongly associated with the loss of ARID1A expression in OCCC.

The species Brassica rapa includes enormous leafy vegetables with extreme leaf morphological diversity. Leaf traits such as size, shape, weight, and ratio of the leaf blade to the petiole contribute to yield, appearance, and desirability to consumers. These leaf-related traits are controlled by quantitative trait loci (QTLs). The construction of high-density bin maps using low-coverage sequencing is a powerful method for QTL fine-mapping and gene identification. In this study, we performed whole-genome re-sequencing of Wutacai ‘Zhongbaye’ and Chinese cabbage ‘HN53’ and 150 F2 individuals to construct a high-density bin map for QTL mapping of 11 leaf-related traits. The parental lines and F2 population were re-sequenced at 10x and 1x coverage, respectively. A map containing 565 bin markers was constructed based on parental single-nucleotide polymorphisms and a modified sliding window approach. The total map length was 944.6 cM and the average distance of the bins was 1.65 cM. In total, 60 significant QTLs controlling 11 leaf-related traits were detected. We further identified candidate genes responsible for these complex leaf-related traits. These findings suggest that this cost-effective bin-mapping approach is capable of rapid identification of QTLs and candidate genes, and will thus facilitate the dissection of the underlying molecular basis of leaf morphological variations and accelerate the improvement of B. rapa vegetable breeding.

Brassica rapa is one of the most important leafy vegetable crops with large cultivated area in China. To increase the availability of DNA markers in B. rapa, we developed insertion-deletion (InDel) markers utilizing high-resolution melting (HRM) curve analysis. We designed primers for 252 InDels (≥ 3 bp) evenly distributed in the genome and tested gene polymorphisms with eight accessions. In total, 208 markers were specifically amplified, and 148 InDels with polymorphism were genotyped successfully using HRM. We further analyzed the correlation with InDel size, GC number, and predicted the difference in Tm values (∆Tm) using 208 markers with specific amplification. We found that the success rate of InDel markers was correlated with the GC number of InDel and the predicted-∆Tm, but not clearly correlated with the length of InDel. When the GC number within InDel was ≥ 8, the successful rate exceeded 90.0%. When the predicted-∆Tm reached 0.5 °C, the success rate was greater than 90.0%, and when it was ≥ 0.6 °C, the rate climbed to 100.0%, indicating their role as the optimal parameter for successful development of an applicable InDel marker. The polymorphic InDel markers can be easily genotyped using HRM. They are of great value in genetic analysis, construction of linkage map, and molecular marker-assisted selection in B. rapa.