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"Wu, Yu-Jie"
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Predictors of mid-term outcomes in 334 developmental dysplasia hips treated with total hip arthroplasty
Aims
Under the trend of gradual morphological evolution of different types of developmental dysplasia of the hip (DDH), this study aimed to investigate objective factors to predict complications in DDH patients after total hip arthroplasty (THA).
Methods
From July 2010 to December 2019, 241 DDH patients (334 hips) received THA. The minimum follow-up time was five years. Univariable and multivariable logistic regression analyses were used to determine predictors of complications.
Results
The incidence of periprosthetic fractures was 1.5% and BMI was independently associated with it (odds ratio [OR]: 0.698; 95% confidence interval [CI]: 0.505–0.966); acetabular prosthesis position was independently associated with limp (34.1%) (OR: 2.369; 95% CI: 1.267–4.432); height (OR: 0.003; 95% CI: 0.000-0.579), short left leg (OR: 0.203; 95% CI: 0.066–0.621) and femoral prosthesis distal size (OR: 0.778; 95% CI: 0.617–0.981) were associated with knee valgus (19.5%); limb length discrepancy (OR: 1.378; 95% CI: 1.034–1.835) and femoral head size (OR: 1.329; 95% CI: 1.053–1.678) were associated with knee pain (2.4%); femoral prosthesis (S-Rom) (OR: 0.045; 95% CI: 0.004–0.507) and acetabular prosthesis position (OR: 23.381; 95% CI: 1.297–421.580) were associated with thigh pain (distal femoral prosthesis) (2.1%); femoral prosthesis was associated with hip abnormal noise (5.4%) (S-Rom: OR: 0.034; 95% CI: 0.004–0.313; Corail: OR: 0.077; 95% CI: 0.008–0.726).
Conclusion
Tall, higher BMI, short left leg, lower limb length discrepancy, anatomical acetabulum, friendly femoral prosthesis, smaller femoral head size, or larger femoral prosthesis distal size were found to have lower complications, but the preoperative Crowe type was not confirmed as a risk factor.
Journal Article
Factors Associated With Complications in 176 Crowe IV Hips Treated With Total Hip Arthroplasty
Objective: Total hip arthroplasty (THA) in Crowe IV hip was a challenge for surgeons, along with some complications. Currently, most evaluations focused on the surgical techniques and radiographs, which were indirectly measured parameters and easily affected by the operators. Objective factors were not considered. This study aimed to investigate objective factors to predict the complications. Methods: We retrospectively reviewed a series of Crowe IV patients who received THA between July 2010 and December 2019 in our hospital. Demographics and surgical parameters were collected: gender, age, height, weight, sides of preoperative knee valgus, limb length discrepancy, hip surgical history, osteotomy length, acetabular prosthesis position, acetabular prosthesis sizes, femoral prosthesis, femoral head sizes, femoral prosthesis distal sizes, and acetabular liner. The complications periprosthetic fractures, periprosthetic infection, polyethylene lining wear, postoperative dislocation, limited flexion, limp, knee valgus, knee pain, thigh pain (distal femoral prosthesis), and hip abnormal noise were recorded. Univariable and multivariable logistic regression analyses were used to identify the predictors of complications. Results: A total of 136 Crowe IV patients (176 hips) were included in this study. The mean follow‐up time was 8.87 ± 2.60 (5–14) years. The mean limb length discrepancy was 2.73 ± 2.05 cm. Thirty‐two hips had a surgical history. One hundred and three hips underwent intraoperative osteotomy, and the mean osteotomy length was 3.42 ± 1.22 (1–7) cm. Complications occurred in 45% (79/176) Crowe IV hips. The height (odds ratio [OR]: 0.00; 95% confidence interval [CI]: 0.00–0.26), and preoperative left knee valgus (OR: 0.37; 95% CI: 0.16–0.88) were identified as independent significant factors for complications in Crowe IV hips. A residual limp was observed in 34.09%, knee valgus was 23.3%, hip abnormal noise was 7.39%, knee pain was 1.7%, thigh pain (distal femoral prosthesis) was 1.14%, and limited flexion was 0.57%. The incidence of polyethylene lining wear was 6.3%, periprosthetic fractures was 1.7%, postoperative dislocation was 1.14%, and periprosthetic infection was 0.57%. Conclusion: Our model provided a framework to guide decision‐making in Crowe IV hips for surgeons. A tall Crowe IV patient with preoperative left knee valgus was found to have a lower rate of complications.
Journal Article
Flash annealing boosts piezoelectricity of PVDF-TrFE
Annealing increases β-phase crystal contents of poly(vinylidene fluoride-trifluoroethylene) (PVDF-TrFE), thus improving its ferroelectricity and piezoelectricity. However, most studies focus on improving piezoelectricity of wet-processed PVDF-TrFE via long-time annealing. Here, we report a flash annealing strategy to boost piezoelectricity of PVDF-TrFE at a temperature above its Curie temperature, which has never been reported for polymer processing. Specifically, electrospun PVDF-TrFE fiber mats show a piezoelectric coefficient d
33
of −70.89 pm/V or −68 pC/N after flash annealing, which are superior to that of the mats annealed for 2 h. Besides, the mechanisms for an improvement of β-phase crystal content during flash annealing was interpreted by in-situ Raman spectroscopy, XRD, Fourier transform infrared spectroscopy, and molecular dynamics simulation. The as-fabricated piezoelectric films show promising applications in energy harvesting, high-frequency vibration. It unveils an intriguing way to significantly boost intrinsic piezoelectricity of PVDF-TrFE toward developing advanced flexible electronics and micro-electro-mechanical systems.
Poly(vinylidene fluoride-co-trifluoroethylene)’s (PVDF-TrFE) piezoelectricity can be enhanced by annealing, however current annealing methods are slow. Here, the authors perform ultra-fast flash annealing of PVDF-TrFE to achieve a high piezoelectricity.
Journal Article
A systematic review and Bayesian analysis of the adverse effects of dienogest
Background and objective
Endometriosis and adenomyosis are two common diseases that impair women’s health, and dienogest is one of the pharmacologic treatments which is the first-line therapeutic option for patients with pelvic pain and individuals who have no desire for immediate pregnancy. The goal of this study was to summarize the current evidence of adverse events associated with dienogest as well as the prevalence of these adverse events during treatment with dienogest.
Methods
Several databases (PubMed, Embase, Cochrane Central and Clinicaltrials.gov, etc.) and the US FDA Adverse Event Reporting System (FAERS) Public Dashboard were searched on May 31, 2023, using the topic words alongside free words of dienogest and “adverse reaction”. Studies were incorporated into this research if they reported or assessed safety issues or adverse reactions of dienogest during the period of endometriosis treatment or adenomyosis therapy. The extracted information comprised trial design, dienogest and control group demographics, as well as reported side effects.
Results
This systematic review comprehended 39 publications in total. The mean age of patients in the included studies was 34.43 years. The follow-up duration varied from 3 to 60 months. Most adverse reactions were common and not serious, and the most common adverse reactions during dienogest medication were abnormal uterine bleeding (55%, 95% CI 37–73%), amenorrhea (17%, 95% CI 2–42%) and swelling (13%, 95% CI 3–28%). Uncommon adverse reactions included dysmenorrhea (0.2%,
n
= 1), dyspepsia (0.4%,
n
= 1), and (lower) abdominal pain (1%, 95% CI 0–3%), urticaria (1%, 95% CI 0–3%) and peritonitis (1%,
n
= 1). Serious adverse reactions including decreased lumbar spine Bone Mineral Density (BMD), depression, peritonitis and so on have been reported. Heterogeneity assessment revealed that patient number and study design are influencing factors to adverse reaction prevalence. Moreover, abdominal pain, diarrhea, nausea and vomiting, back pain and anemia are side effects reported both in the FAERS database and in the systematic review.
Conclusions
Dienogest’s most frequent side effects were not severe. Dienogest is generally safe for treating endometriosis and adenomyosis. Nevertheless, people should be aware of serious adverse reactions, such as decreased lumbar spine BMD and hemorrhagic shock.
Journal Article
Elevated absolute NK cell counts in peripheral blood predict good prognosis in chronic lymphocytic leukemia
Purpose
The aim of this study was to investigate the prognostic significance of the absolute natural killer (NK) cell counts in peripheral blood in patients with chronic lymphocytic leukemia (CLL).
Methods
A total of 273 previously untreated patients with CLL from April 2004 and October 2015 were enrolled into this retrospective study. We analysed the T cell subsets of all patients and figured out the number of NK cells. Comparisons of NK cell count as continuous parameter in different groups were described using Mann–Whitney U test and the Kruskal–Wallis test. Kaplan–Meier method was used to survival analysis, and the Cox proportional hazards models were used for the estimation of prognostic factors.
Results
NK cell counts were calculated in 273 therapy-naive CLL patients, and higher number of NK cell was observed in those with Binet stage A/B, ZAP-70 < 20%, normal serum albumin and β
2
-microglobulin levels. Using a NK cell count cut-off of 0.40 × 10
9
/L, patients with lower NK cell count (< 0.40 × 10
9
/L) had a significantly shorter overall survival (OS) than those with higher NK cell count (≥ 0.40 × 10
9
/L) (
P
= 0.0014). Multivariate analysis showed that NK cell counts remained its prognostic value. However, the effect of NK cell count on time to treatment was not significant.
Conclusions
Our results suggest that NK cell count is an independent prognostic marker for OS in patients with CLL and NK cell counts ≥ 0.40 × 10
9
/L can routinely be used to identify patients with favorable survival.
Journal Article
Germline FOXJ2 overexpression causes male infertility via aberrant autophagy activation by LAMP2A upregulation
Spermatogenesis is a complex biological process that produces haploid spermatozoa and requires precise regulation by many tissue-specific factors. In this study, we explored the role and mechanism of Fork head box J2 (FOXJ2, which is highly expressed in spermatocytes) in the regulation of spermatogenesis using a germline-specific conditional
Foxj2
knock-in mouse model (
Stra8-Cre; Foxj2
tg/tg
mouse).
Foxj2
overexpression in mouse testes led to spermatogenesis failure, which started at the initiation of meiosis, and resulted in male infertility. Lysosomes and autophagy-related genes were upregulated in
Stra8-cre; Foxj2
tg/tg
mouse testes and the number of autolysosomes in the spermatocytes in
Stra8-cre; Foxj2
tg/tg
mice was increased. Chromatin immunoprecipitation-PCR and Dual-luciferase reporter assays showed that
Lamp2
(encoding lysosome‐associated membrane protein‐2) was a target of FOXJ2.
Foxj2
overexpression increased the expression levels of
Lamp2a
and
Hsc70
(70-kDa cytoplasmic heat shock protein) in the
Stra8-cre; Foxj2
tg/tg
mouse testes. Our results suggested that
Foxj2
overexpression in the germ cells of mouse testes affects chaperone-mediated autophagy by upregulating LAMP2A, leading to spermatogenesis failure at the initiation of meiosis, thus resulting in male infertility. Our findings provide a new insight into the function of FOXJ2 in spermatogenesis and the significance of autophagy regulation in spermatogenesis.
Journal Article
Mid-term outcomes after total hip arthroplasty in 106 Crowe II/III hips: different hip center positions
Background
Under the obvious acetabular superolateral bone defect of Crowe II/III hips, this study aimed to investigate the difference in surgical technique of different hip center positions from the surgical data and clinical outcomes.
Methods
From July 2007 to December 2016, 87 patients (106 Crowe II/III hips) consecutively received total hip arthroplasty (THA). The minimum follow-up time was 5 years. The mean limb length discrepancy was 1.97 ± 1.81 cm. Twenty-four hips had surgical histories. The patients were divided into three groups according to the acetabular prosthesis positions, depending on the Crowe classification, respectively, group 1 (Crowe I), group 2 (Crowe II) and group 3 (Crowe III). The surgical data and clinical results were used to evaluate the outcome of different surgical techniques of different hip center positions, including surgical time, blood loss, blood transfusion, number of osteotomy hips, osteotomy length, the distribution of prothesis, postoperative inpatient days, Harris hip scores, Visual Analogue Scale (VAS), Back Pain Function Scale (BPFS) and complications.
Results
The mean follow-up time was 8.93 ± 2.55 years. Nineteen hips performed intraoperative osteotomy. From group 1 to group 3, the mean osteotomy length were 0.53 ± 1.11 cm, 0.05 ± 0.22 cm, and 0.00 ± 0.00 cm, respectively (
p
= 0.083); the surgical time were 142.57 ± 57.94 min, 118.4 ± 41.22 min, and 120.00 ± 84.85 min, respectively (
p
= 0.324); the blood loss were 498.21 ± 368.53 mL, 333.33 ± 167.62 mL, and 350.00 ± 212.13 mL, respectively (
p
= 0.255); the blood transfusion were 288.48 ± 381.68 mL, 128.00 ± 235.17 mL, and 385.00 ± 219.20 mL, respectively (
p
= 0.199); the postoperative inpatient days were 7.95 ± 4.42 d, 7.47 ± 4.29 d, and 6.50 ± 0.71 d, respectively (
p
= 0.831). Among the groups, the distribution of acetabular prosthesis, acetabular liner, acetabular prosthesis sizes, femoral head sizes and femoral prothesis distal sizes were not significantly different (
p
> 0.05). Only the distribution of femoral prosthesis was significantly different (
p
= 0.046); the Harris, VAS, BPFS, and the distribution of complications were not significantly different (
p
> 0.05).
Conclusions
We provided a framework to guide decision-making in Crowe II/III hips for surgeons: the surgical technique of different hip center positions was stable and had good outcomes, but the acetabular prothesis position and femoral prothesis should be determined according to the intraoperative situation.
Level of evidence
Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Journal Article
Negative prognostic impact of low absolute CD4+ T cell counts in peripheral blood in mantle cell lymphoma
Tumor microenvironment and host immunity are closely related to outcome in patients with mantle cell lymphoma (MCL). However, few researchers have focused on the prognostic value of peripheral blood lymphocyte subsets counts. The purpose of this study was to investigate the prognostic value of lymphocyte subsets and absolute monocyte counts. Sixty‐eight patients were analyzed retrospectively. Absolute CD4+ T cell counts (ACD4C), CD8+ T cell counts, nature killer cell counts, and CD4/CD8 ratios were assessed by peripheral blood flow cytometry and correlated with clinical parameters and long‐term outcomes. The median follow‐up for all patients was 21 months and the median survival time was 44 months. The overall survival (OS) rate at 1, 3, and 5 years was 80%, 51%, and 41%, respectively. In our cohort, high absolute monocyte count, and low ACD4C and CD4/CD8 ratio were associated with unfavorable OS (P = 0.029, P = 0.027, and P = 0.045, respectively) by univariate analysis. Multivariate analysis indicated that low ACD4C was a significant predictor of unfavorable OS (P = 0.004) independent of the simplified MCL International Prognostic Index (P = 0.048) in patients treated with or without rituximab (P = 0.011). Low CD4+ T cell counts proved to be a significant predictor of unfavorable OS in patients with MCL. We studied 68 consecutive patients with mantle cell lymphoma (MCL) and found that low CD4+ T cell counts (<0.445 × 109/L) were associated with inferior overall survival (OS) by both univariate analysis and multivariate analysis. So we suppose that evaluation of peripheral blood CD4+ T cell counts could be a useful indicator of clinical outcome in MCL patients.
Journal Article