Comparing the efficacy of different intra-articular injections for knee osteoarthritis: A network analysis

Background:The findings on the effectiveness of platelet-rich plasma, ozone, and hyaluronic acid in the treatment of osteoarthritis of the knee are controversial, and the existing original studies and meta-analyses are mostly comparisons of a single joint cavity injection method, lacking direct and indirect comparisons of different drugs in the joint cavity. The lack of direct and indirect comparisons of different drugs in the joint cavity makes it difficult to have a clearer and more comprehensive understanding of joint cavity injection methods. In this study, the efficacy of platelet-rich, ozone, sodium hyaluronate, and combined knee cavity injections were compared directly or indirectly using a reticulated meta-analysis in this field, and the efficacy of treatment measures was ranked to provide more comprehensive and reliable evidence-based clinical evidence for the selection of knee cavity injections in osteoarthritis of the knee.Objective:To compare the effects of platelet-rich plasma, ozone, and sodium glassate injection interventions on the efficacy of osteoarthritis of the knee through reticulated Meta-analysis, and to comprehensively compare the clinical effectiveness of platelet-rich plasma, ozone, and sodium glassate injection joint cavity injection for the treatment of osteoarthritis of the knee.Methods:The PubMed, CBM, CNKI, VIP, and Wan-Fang databases were searched for information on the effectiveness of platelet-rich plasma, ozone, and sodium vitrate injection for the comparative treatment of osteoarthritis of the knee, with a search time frame of each database from the date of creation to July 20, 2021. Two investigators independently screened the literature, extracted data according to inclusion and exclusion criteria, and evaluated the quality of the literature in parallel. Statistical analysis was performed using Stata 16.0 software to compare the differences in the efficacy of each treatment measure using the ratio and 95% confidence interval as effect indicators and to rank the efficacy.Results:Thirty-three RCTs with 7003 patients with osteoarthritis of the knee were included, involving 5 therapeutic measures. Meta-analysis showed that the efficacy of platelet-rich plasma injection was superior to both ozone and hyaluronic acid therapies. Hyaluronic acid+ozone and platelet-rich plasma+hyaluronic acid were both superior to ozone and hyaluronic acid monotherapy. The differences in efficacy between hyaluronic acid and ozone compared with platelet-rich plasma were statistically significant, and the differences in efficacy between the 2 combination therapies (platelet-rich plasma+hyaluronic acid, hyaluronic acid+ozone) and the 3 monotherapies (platelet-rich plasma, ozone, hyaluronic acid) were statistically significant. Platelet-rich plasma+hyaluronic acid, hyaluronic acid+ozone compared with 3 monotherapies (platelet-rich plasma, ozone, hyaluronic acid) were statistically significant, except for the difference in efficacy with platelet-rich plasma, which was not statistically significant, indicating that this platelet-rich plasma+hyaluronic acid and Hyaluronic acid+ozone combination therapy was superior to monotherapy. Also, the efficacy of platelet-rich plasma was better than hyaluronic acid and ozone and the difference was statistically significant, indicating that platelet-rich plasma was more effective than ozone and sodium glass in the treatment of osteoarthritis of the knee in monotherapy.Conclusion:It is believed that in the course of clinical practice, hyaluronic acid+ozone or platelet-rich plasma+hyaluronic acid combination therapy or platelet-rich plasma therapy can be preferred for patients with osteoarthritis of the knee.     

基于人工智能的高血压性脑出血医疗文本信息自动识别系统

目的 构建基于人工智能的高血压性脑出血医疗文本信息自动识别系统,快速识别和分析患者临床信息,高效地输出正确的诊疗方案。方法 基于国内外最新高血压性脑出血诊疗指南,经多位高年资神经外科医生和专业人工智能团队共同讨论,构建基于语言表征模型和专家模块的高血压性脑出血医疗文本信息自动识别及决策系统（即H系统）。随后将收集到的高血压性脑出血病例分为训练集、测试集和验证集,以数据库中病例的真实治疗方案为金标准,先总体评价H系统的准确性,再将其与神经外科医生进行对比,分析H系统的判读效率。结果 在测试集中,H系统所输出的治疗方案的准确率为94.0%（91.5%~96.5%）,特异度为91.8%（86.3%~97.3%）,灵敏度为95.5%（89.3%~98.2%）,曲线下面积（area under the curve,AUC）值为0.936（0.922~0.950）（P=0.000）;在验证集中,H系统所输出的治疗方案的准确率为93.3%（89.5%~97.1%）,特异度为 89.9%（83.4%~96.4%）,灵敏度为95.8%（92.3%~99.3%）,AUC值为0.928（0.891~0.966）（P=0.000）。在处理同样的70例病例时,H系统用时（334.60±4.46）s,而神经外科医生用时（12 550.28±95.45）s;在50 min内,H系统处理的病例数为（383±3）例,而神经外科医生处理的病例数为（11±4）例。结论 本研究所构建的H系统能够对高血压性脑出血患者的急诊病例进行自动识别和分析,并快速输出准确的诊疗方案,可协助医生对高血压脑出血进行急诊诊疗。     

妊娠期亚临床甲状腺功能减退孕妇叶酸利用能力与血清同型半胱氨酸、维生素B12的相关性分析

目的 探究妊娠期亚临床甲状腺功能减退(妊娠期亚甲减)孕妇叶酸(FA)利用能力与血清同型半胱氨酸(Hcy)、维生素B₁₂的相关性。方法 选取100例妊娠期亚甲减孕妇为研究组;另选同期100例甲状腺功能正常孕妇为对照组。检测两组孕妇FA、Hcy、维生素B₁₂以及甲状腺功能,并分析其相关性。结果 两组FA利用能力比较,差异具有统计学意义(P<0.05)。研究组血清Hcy水平高于对照组,维生素B₁₂水平低于对照组,差异具有统计学意义(P<0.05)。两组游离三碘甲状腺原氨酸(FT₃)、游离四碘甲状腺原氨酸(FT₄)水平比较,差异无统计学意义(P>0.05),研究组促甲状腺激素(TSH)水平高于对照组,差异具有统计学意义(P<0.05)。FA利用能力与Hcy呈负相关(r=-0.454),与维生素B₁₂呈正相关(r=0.219);Hcy与维生素B₁₂、FT₃、FT₄呈负相关(r=...     

The Biomarkers for Predicting Viral Hepatitis-Associated Hepatocellular Carcinoma

BackgroundHepatocellular carcinoma (HCC) is the fifth most common cancer in the world, and more than half of the newly diagnosed cases are chronic hepatitis B patients. Due to the lack of specific clinical manifestations, many patients are already at an advanced stage at the time of diagnosis and therefore have missed the best time for treatment. Organs in a pathological state usually secrete specific substances into the blood, which can indirectly indicate the pathological state of the organ, so some biological markers in the blood can be used as a tool to predict the incidence of HCC.MethodsThe Research articles related to HCC were collected by searching PubMed databases with the keywords “hepatocellular carcinoma”, “serum biomarker”, “hepatitis B”, “prediction” and “prognosis”, and Additional articles were identified by manual search of references found in the primary articles, followed by a summary and review.ResultsViral hepatitis is the main cause of HCC worldwide, and this phenomenon is particularly prominent in Asian and African populations. A variety of serological markers including M2BPGi, IL-6 and COMP can be used to predict the incidence of long-term HCC in patients. The risk of HCC is dynamic rather than constant, and dynamic detection will help improve prediction accuracy. For hepatitis B patients, HBV DNA load and HBcr Ag are important predictive markers of HCC.ConclusionFor a high-risk population of HCC, early risk prediction is helpful to guide clinical work, and timely adjustments of the screening frequency and treatment plan are helpful to prolong the survival time of HCC patients.     

A Novel Herbal Extract Blend Product Prevents Particulate Matters-Induced Inflammation by Improving Gut Microbiota and Maintaining the Integrity of the Intestinal Barrier

Air pollutants of PM2.5 can alter the composition of gut microbiota and lead to inflammation in the lung and gastrointestinal tract. The aim of this study was to evaluate the protective effect of a novel herbal extract blend, FC, composed of Lonicera japonica extract, Momordica grosvenori extract, and broccoli seed extract, on PM2.5-induced inflammation in the respiratory and intestinal tract. A549 cells and THP-1 cells, as well as C57BL/6 mice, were stimulated with PM2.5 to establish in vitro and in vivo exposure models. The models were treated with or without FC. The expression of inflammatory cytokines and tight junction proteins were studied. Proteomic analysis was performed to elucidate mechanisms. Mouse feces were collected for gut microbiota analysis. FC was shown to modulate the upregulation of pro-inflammatory cytokines mRNA expression in A549 and THP-1 cells and downregulated tight junction proteins mRNA expression in A549 cells due to PM2.5 stimulation. In animal models, the decreased expression of the anti-inflammatory factor il-10, tight junction protein ZO-1, and the elevated expression of COX-2 induced by PM2.5 were improved by FC intervention, which may be associated with zo-1 and cox-2 signaling pathways. In addition, FC was shown to improve the gut microbiota by increasing the abundance of beneficial bacteria.     

Molecular Analysis of Caprine Enterovirus Circulating in China during 2016–2021: Evolutionary Significance

Here, we report the characterization of 13 novel caprine/ovine enterovirus strains isolated from different regions in China during 2016–2021. Immunoperoxidase monolayer assay showed that these viral strains shared strong cross-reaction with the previously reported caprine enterovirus CEV-JL14. Alignment analysis of the complete nucleotide sequences revealed 79.2%–87.8% and 75.0%–76.7% sequence identity of these novel caprine enterovirus strains to CEV-JL14 and TB4-OEV, respectively. Phylogenetic analyses clustered these novel strains to EV-G based on the amino acid sequences of P1 and 2C+3CD. Moreover, phylogenetic analysis of these caprine enterovirus strains identified three new EV-G types using VP1 sequences. These results demonstrate the genetic variations and the evolution of caprine enterovirus.     

Lipopolysaccharide mouse models for Parkinson’s disease research: a critical appraisal

Parkinson’s disease, the most common movement disorder, has a strong neuroinflammatory aspect. This is evident by increased pro-inflammatory cytokines in the serum, and the presence of activated microglial cells, and inflammatory cytokines in the substantia nigra of post-mortem brains as well as cerebrospinal fluid of Parkinson’s disease patients. The central and peripheral neuroinflammatory aspects of Parkinson’s disease can be investigated in vivo via administration of the inflammagen lipopolysaccharide, a component of the cell wall of gram-negative bacteria. In this mini-review, we will critically evaluate different routes of lipopolysaccharide administration (including intranasal systemic and stereotasic), their relevance to clinical Parkinson’s disease as well as the recent findings in lipopolysaccharide mouse models. We will also share our own experiences with systemic and intrastriatal lipopolysaccharide models in C57BL/6 mice and will discuss the usefulness of lipopolysaccharide mouse models for future research in the field.Key Words: C57BL/6 mice, intranasal models, lipopolysaccharide models, neuroinflammation, Parkinson’s disease, stereotaxic models, substantia nigra, systemic models     

黄芪沙参煎剂对博莱霉素诱导的大鼠肺纤维化模型的干预作用

目的：观察中药黄芪沙参煎剂对肺纤维化大鼠病理、肺泡灌洗液中细胞因子（TGF-β1）表达的影响,探讨黄芪沙参煎剂作用机制,为其临床治疗肺纤维化提供实验依据。方法：取体重190-210g的健康雌性SD大鼠90只,采用随机数字表随机分为6组,每组15只。博莱霉素（B组）、黄芪沙参煎剂高剂量组（H组）、中剂量组（M组）、低剂量组（L组）、强的松组（P组）、生理盐水组（N组）,各组大鼠于造模后第7、14和28天分别随机处死5只。行HE染色、Masson三色染色;右肺支气管肺泡灌洗,收集灌洗液（BALF）,用ELISA法测BALF上清液细胞因子TGF-β1的表达。结果：H组、M组、P组与B组早期肺泡炎和晚期肺纤维化程度比较,差异有统计学意义（P〈0.01）;第7、14、28天P组、H组、M组的BALF中TGF-β1水平与Β组相比差异有显著统计学意义（Ρ〈0.01）。结论：黄芪沙参煎剂具有与强的松相似的疗效,但副反应小、服用方便,可以明显减少肺泡炎症及肺纤维化形成。黄芪沙参煎剂治疗肺纤维化机制可能与早期抑制炎症细胞浸润,减少炎症细胞分泌释放细胞因子TGF-β1,从而抑制成纤维细胞产生胶原和ECM积聚,起到对肺纤维化的治疗作用。     

活血解毒方对缺氧/复氧所致心肌细胞凋亡的影响＊

目的 研究活血解毒方对缺氧/复氧（H/R）所致的心肌细胞凋亡的影响。方法 体外培养H9C2心肌细胞并分成正常对照组（Control组）、缺氧复氧组（H/R组）、H/R + 活血解毒中药组、LY294002组和活血解毒中药 + LY294002组，其中正常对照组给予DMEM培养基培养，缺氧复氧组给予缺氧4 h、复氧6 h处理，缺氧复氧 + 活血解毒中药组、LY294002组和活血解毒中药 + LY294002组分别给予活血解毒中药、LY294002、活血解毒中药配合LY294002预处理24 h，然后均给予缺氧4 h、复氧6 h处理。采用CCK8检测各组心肌细胞的存活率，流式细胞术检测各组细胞凋亡水平，电镜观察各组心肌细胞中线粒体、自噬体的变化，Western Blot检测各组细胞凋亡蛋白半胱氨酸天冬氨酸蛋白酶3（Caspase3）、半胱氨酸天冬氨酸蛋白水解酶3（Cleaved caspase3）、β-连环蛋白（β-Catenin）、p-p65、B淋巴细胞瘤-2（B-cell lymphoma-2，Bcl-2）蛋白的表达。结果 活血解毒方预处理显著增加H/R诱导的H9C2心肌细胞凋亡，降低凋亡相关蛋白Cleaved caspase3、β-Catenin、p-p65表达，增加Bcl-2表达。结论 活血解毒方可通过抑制细胞凋亡，降低缺氧/复氧所致的心肌细胞损伤，其作用机制可能与PI3K信号通路相关。