Different peripheral nerve blocks for patients undergoing total knee arthroplasty: a network meta-analysis of randomized controlled trials.

INTRODUCTION: To comprehensively compare the effect of different peripheral nerve blocks for patients undergoing total knee arthroplasty (TKA). MATERIALS AND METHODS: PubMed, Embase, Cochrane Library, and Web of Science were comprehensively searched. The outcomes included postoperative pain, postoperative function, adverse events, oral morphine equivalent (OME), and perioperative indicators. Network plots, forest plots, league tables and rank probabilities were drawn for all outcomes. RESULTS: Totally 30 studies were included. For postoperative pain, continuous adductor canal block (cACB) + genicular nerve block (GNB) was most likely to be the most effective block regarding rest pain score at 24 h; cACB + GNB was most likely to result in the lowest rest pain score at 48 h; patients undergoing cACB + infiltration between the popliteal artery and the capsule of the knee (IPACK) + GNB was most likely to have the lowest motion pain score at 24 h; patients undergoing cACB + GNB was most likely to have the lowest motion pain score at 48 h. For postoperative function, patients undergoing cACB + IPACK + GNB had the highest likelihood to exhibit the shortest time in Timed Up and Go test (TUG); cACB + tibial nerve block (TNB) was most likely to be the most effective block in terms of range of motion (ROM); cACB + IPACK was most likely to be the optimal block concerning the ambulation distance. CONCLUSION: cACB combined with IPACK/GNB may be the most favorable block after TKA, continuous blocks may be better than single-shot blocks, and combined blocks may be better than separate blocks.

Microrna363-5p targets thrombospondin3 to regulate pathological cardiac remodeling.

Cardiac remodeling is an end-stage manifestation of multiple cardiovascular diseases, and microRNAs are involved in a variety of posttranscriptional regulatory processes. miR-363-5p targeting Thrombospondin3 (THBS3) has been shown to play an important regulatory role in vascular endothelial cells, but the roles of these two in cardiac remodeling are unknown. Firstly, we established an in vivo model of cardiac remodeling by transverse aortic narrow (TAC), and then we stimulated a human cardiomyocyte cell line (AC16) and a human cardiac fibroblast cell line (HCF) using 1 µmol/L angiotensin II (Ang II) to establish an in vitro model of cardiac hypertrophy and an in vitro model of myocardial fibrosis, respectively. In all three of the above models, we found a significant decreasing trend of miR-363-5p, suggesting that it plays a key regulatory role in the occurrence and development of cardiac remodeling. Subsequently, overexpression of miR-363-5p significantly attenuated myocardial hypertrophy and myocardial fibrosis in vitro as evidenced by reduced the area of AC16, the cell viability of HCFs, the relative expression of the protein of fetal genes (ANP, BNP, ß-MHC) and fibrosis marker (collagen I, collagen III, α-SMA), whereas inhibition of miR-363-5p expression showed the opposite trend. In addition, we also confirmed the targeted binding relationship between miR-363-5p and THBS3 by dual luciferase reporter gene assay, and the expression of THBS3 was directly inhibited by miR-363-5p. Moreover, overexpression of miR-363-5p with THBS3 simultaneously partially eliminated the delaying effect of miR-363-5p on myocardial hypertrophy and myocardial fibrosis in vitro. In conclusion, Overexpression of miR-363-5p attenuated the prohypertrophic and profibrotic effects of Ang II on AC16 and HCF by a mechanism related to the inhibition of THBS3 expression.

Preparation of Near-Spherical α-Al2O3 Particles by Enhanced Precipitation of Gibbsite from Sodium Aluminate Solution Using Highly Dispersed Al2O3 as Seeds.

The near-spherical α-Al2O3 particles (∼200 nm) were prepared for the first time through the precipitation of gibbsite from a supersaturated sodium aluminate solution, with the addition of an acidic solution containing highly dispersed nanosized Al2O3 seeds. The near-spherical α-Al2O3 were achieved by employing seeds at 1100 °C, with the initial nucleation temperature being only 900 °C, due to the highly homogeneous dispersion of the seeds into gibbsite formation by in situ growth that can effectively enhance the role of the seeds in the phase transition. Moreover, the precipitation rate of sodium aluminate solution was significantly accelerated by 17-fold. This acceleration was due to the slightly acidic solution breaking the stability of sodium aluminate solution through a neutralization reaction on the seed surface, leading to the rapid formation of gibbsite nuclei on the seed surface. Our findings provide a feasible approach for the fabrication of well-dispersed α-Al2O3 particles and make the industrial production of well-dispersed α-Al2O3 from sodium aluminate solution a commercial reality.

Protective effect of MP-40 mitigates BDL-induced hepatic fibrosis by inhibiting the NLRP3-mediated pyroptosis.

Background: Hepatic fibrosis and its associated consequences continue to pose a substantial global health challenge. Developing novel approaches to hepatic fibrosis management and prevention is critically necessary. Radix Paeoniae Alba (RPA) is widely used in Traditional Chinese Medicine (TCM) to treat various diseases. Our earlier research found that a bioactive component of RPA had a dose-dependent effect on anti-allergic asthma. RPA reduces allergic asthma by slowing the hepatic wind, according to "Treatise on Febrile Diseases". However, this bioactive fraction's pharmacological effects and mechanisms on the liver are unknown. Aim: This study examined the bioactive fraction MP-40, the methanol extract of RPA (MRPA), on bile duct ligation (BDL) for its anti-hepatic fibrosis activity and potential mechanisms. Methods: First, the effectiveness of MP-40 in treating BDL-induced hepatic fibrosis in mice and rats was evaluated through survival rates, ALT, AST HYP, and pathological changes. Molecular assays were performed using in vitro cultures of HSC-T6 activation. The expression of α-SMA and Collagen I evaluated fibro-tropic factors with HSC activation. Furthermore, the levels of pyroptosis were assessed by examining the expression of the pyroptosis-related proteins, including NLRP3, Cleaved Caspase-1, GSDMD-N, and 1L-1ß. Additionally, the effective constituents of MP-40 were identified by extraction, separation, and identification. Finally, PF and TGG, as the delegate compounds of MP-40, were tested to confirm their inhibition effects on HSC-T6 activation. Results: The findings demonstrated that MP-40 and MRPA could lower ALT, AST, and HYP levels, boost survival rates, and reduce liver damage in BDL mice and rats. Furthermore, MP-40 outperforms MRPA. MP-40 was proven to drastically diminish fibrotic α-SMA and Collagen I. The expression of pyroptosis-related proteins NLRP3, Cleaved Caspase-1, TGF-ß1, GSDMD-N, and 1L-1ß decreased. MP-40 inhibited the synthesis of pyroptosis-related proteins more effectively than MCC950 (an NLRP3-specific inhibitor). Monoterpene glycosides and tannins were shown to be the most potent MP-40 components. Finally, the delegate compounds MP-40, PF, and TGG were shown to have substantial inhibitory effects on HSC-T6 activation. Conclusion: The results proved that MP-40 alleviates BDL-induced cholestatic hepatic fibrosis by inhibiting NLRP3-mediated pyroptosis. PF and TGG play a role in treating BDL-induced cholestatic hepatic fibrosis in MP-40.

Gold nanorods as biocompatible nano-agents for the enhanced photothermal therapy in skin disorders.

Rod-shaped gold nanomaterials, known as gold nanorods (GNRs), may undergo specific surface alterations, because of their straightforward surface chemistry. This feature makes them appropriate for use as functional and biocompatible nano-formulations. By optimizing the absorption of longitudinally localized surface plasmon resonance (LSPR) in the near-infrared (NIR) region, which corresponds to the NIR bio-tissue window, GNRs with appropriate modifications may improve the results of photothermal treatment (PTT). In dermatology, potential noninvasive uses of GNRs to enhance wound healing, manage infections, combat cutaneous malignancies, and remodel skin tissues via PTT have attracted research attention in recent years. In this review, the basic properties of GNRs, such as shape, size, optical performance, photothermal efficiency, and metabolism, are discussed firstly. Then, the disadvantages of using these particles in photodynamic therapy (PDT) are proposed. Next, biological applications of GNRs-based PTT are summarized in detail. Finally, the limitations and future perspectives of this research are summarized, providing a comprehensive outlook for prospective GNRs with PTT.

Novel Ultrasensitive Fluorescent Probe for Bioimaging Carboxylesterase and Detecting Pesticide Residues in Foods.

Pesticide residues pose a significant threat to food safety and human health, necessitating the development of novel detection tools. Pesticides can inhibit the activity of certain biological enzymes, so enzyme inhibition is one of the methods of pesticide detection. In this study, we developed a novel near-infrared fluorescent probe named TCFCl-CES based on the tricyanofuran structure, for ultrasensitive detection of carboxylesterase (CES). TCFCl-CES exhibits strong and stable fluorescence, excellent specificity. Notably, the fluorescence intensity of TCFCl-CES shows a linear relationship with CES concentration, achieving an exceptionally low detection limit of 4.41 × 10-5 u/mL. This ultrasensitive probe can also effectively detect pesticide residues in vegetables and monitor CES activity in cells and liver tissues. TCFCl-CES stands out for its rapid and accurate detection capabilities, making it an essential tool for accurately monitoring pesticide residue. It also has great potential for tracking CES activity in biological systems. Additionally, it offers a robust solution for food safety and improving pesticide residue analysis.

Effects of functional composition on plant competitors, stress-tolerators, ruderals ecological strategies in forest communities across different climatic zones.

Ecological strategies identified by plant functional traits are valuable descriptors for understanding species, populations, communities, and ecosystems in response to environmental conditions. Ecological strategies, in conjunction with the functional structure of plant communities, serve as crucial tools for investigating complex relationships among the environment, vegetation, and ecosystem functions. However, it remains unclear whether the functional structure (specifically, community-weighted mean [CWM] traits) accurately reflects the optimal ecological strategies in forest communities. Here, we gathered seven functional traits for each species from four distinct forest vegetation types across four climatic zones, including leaf area (LA), specific leaf area (SLA), leaf dry matter content (LDMC), leaf phosphorus concentration (LPC), leaf nitrogen concentration (LNC), wood density (WD) and maximum plant height (H). We based on CSR (Competitors, Stress-tolerators, Ruderals) theory and "StrateFy" ordination method utilizing LA, LDMC and SLA to position them within CSR triangle and categorize them into four ecological strategy groups: Competitive, Stress-tolerant, Intermediate, and Ruderal ecological strategy groups (C-group, S-group, Int-group, and R-group). We then determined the proportion of species in each group. Subsequently, we calculated the CWM trait values for the remaining four functional traits: WD (CWM-WD), LPC (CWM-LPC), LNC (CWM-LNC) and H (CWM-H). Non-metric multidimensional scaling and hierarchical partitioning revealed that CWM-WD, CWM-LPC, CWM-LNC and CWM-H significantly influenced the ecological strategies of forest communities. The synergistic interaction of CWM-WD and CWM-LPC had the most significant impact on ecological strategies within forest communities. Notably, CWM-WD emerged as the most crucial single CWM trait for explaining variation in ecological strategies within forest communities. In conclusion, our study demonstrates that CWM traits effectively reflect optimal CSR ecological strategies in forest communities across different climatic zones, with CWM-WD serving as a preferred indicator. This can improve our critical insights into key ecological processes in forest communities using trait-based approach.

The association of psychological and trauma-related factors with biological and facial aging acceleration: evidence from the UK Biobank.

BACKGROUND: Psychological and trauma-related factors are associated with many diseases and mortality. However, a comprehensive assessment of the association between psycho-trauma exposures and aging acceleration is currently lacking. METHODS: Using data from 332,359 UK Biobank participants, we calculated biological aging acceleration, indexed by the presence of leukocyte telomere length (LTL) deviation (i.e., the difference between genetically determined and observed LTL > 0). The acceleration of facial aging (i.e., looking older than the chronological age) was assessed using a self-report question. Then, we estimated the associations of each psycho-trauma factor with biological and facial aging acceleration, using logistic regression models adjusted for multiple important covariates. Furthermore, restricted to 99,180 participants with complete psychological and trauma-related data, we identified clusters of individuals with distinct psycho-trauma patterns using the latent class analysis method and assessed their associations with aging acceleration using similar models. RESULTS: We observed most of the studied psycho-trauma factors were associated with biological and facial aging acceleration. Compared to the "Absence of trauma and psychopathology" cluster, the "adverse childhood experiences (ACEs) with psychopathology" cluster showed strong associations with those aging measurements (odds ratio [OR] = 1.13 [1.05 - 1.23] for biological and 1.52 [1.18 - 1.95] for facial aging acceleration), while no such association was observed for the "ACEs without psychopathology" cluster (1.04 [0.99 - 1.09] and 1.02 [0.84 - 1.24]. CONCLUSIONS: Our study demonstrated significant associations of psycho-trauma factors with both biological and facial aging acceleration. The differential aging consequences observed among ACEs exposed individuals with and without psychopathology prompt interventions aimed to improve individuals' psychological resilience to prevent aging acceleration.

Analysis of Tamarix chinensis Forest Characteristics, Salt Ion Distribution, and Non-Structural Carbohydrate Levels in the Yellow River Delta: A Spatial Study Based on Proximity to the Shoreline.

The distribution of vegetation in coastal wetlands is significantly influenced by soil properties. However, the mechanisms of how soil characteristics impact the physiological processes of Tamarix chinensis forests remain underexplored. This study examined changes in the soil physicochemical properties and structural attributes of natural T. chinensis forests in the Yellow River Delta with increasing distance from the shoreline. T. chinensis trees were classified into healthy, intermediate, and dying categories based on growth potential, and dynamic changes in salt ions and non-structural carbohydrates (NSCs) were investigated. Results indicated that increasing distance from the shoreline corresponded to decreased soil salinity and pH, and increased soil moisture. T. chinensis mortality rate decreased, while tree height and ground diameter increased with distance. Soil salt content was positively correlated with T. chinensis mortality, but negatively correlated with tree height and ground diameter. Trees with lower growth potential had higher Na+ but lower K+ and K+/Na+ ratio. Soil salt content was positively correlated with root and stem Na+, while soil moisture was positively correlated with leaf NSCs. These findings suggest that soil salt content and moisture significantly influence T. chinensis ion absorption and NSC accumulation, with sodium toxicity being a key factor in the spatial distribution of T. chinensis forests.

Berberine Inhibits Ferroptosis and Stabilizes Atherosclerotic Plaque through NRF2/SLC7A11/GPX4 Pathway.

OBJECTIVE: To investigate potential mechanisms of anti-atherosclerosis by berberine (BBR) using ApoE-/- mice. METHODS: Eight 8-week-old C57BL/6J mice were used as a blank control group (normal), and 56 8-week-old AopE-/- mice were fed a high-fat diet for 12 weeks, according to a completely random method, and were divided into the model group, BBR low-dose group (50 mg/kg, BBRL), BBR medium-dose group (100 mg/kg, BBRM), BBR high-dose group (150 mg/kg, BBRH), BBR+nuclear factor erythroid 2-related factor 2 (NRF2) inhibitor group (100 mg/kg BBR+30 mg/kg ML385, BBRM+ML385), NRF2 inhibitor group (30 mg/kg, ML385), and positive control group (2.5 mg/kg, atorvastatin), 8 in each group. After 4 weeks of intragastric administration, samples were collected and serum, aorta, heart and liver tissues were isolated. Biochemical kits were used to detect serum lipid content and the expression levels of malondialdehyde (MDA) and superoxide dismutase (SOD) in all experimental groups. The pathological changes of atherosclerosis (AS) were observed by aorta gross Oil Red O, aortic sinus hematoxylin-eosin (HE) and Masson staining. Liver lipopathy was observed in mice by HE staining. The morphology of mitochondria in aorta cells was observed under transmission electron microscope. Flow cytometry was used to detect reactive oxygen species (ROS) expression in aorta of mice in each group. The content of ferrous ion Fe2+ in serum of mice was detected by biochemical kit. The mRNA and protein relative expression levels of NRF2, glutathione peroxidase 4 (GPX4) and recombinant solute carrier family 7 member 11 (SLC7A11) were detected by quantitative real time polymerase chain reaction (RT-qPCR) and Western blot, respectively. RESULTS: BBRM and BBRH groups delayed the progression of AS and reduced the plaque area (P<0.01). The characteristic morphological changes of ferroptosis were rarely observed in BBR-treated AS mice, and the content of Fe2+ in BBR group was significantly lower than that in the model group (P<0.01). BBR decreased ROS and MDA levels in mouse aorta, increased SOD activity (P<0.01), significantly up-regulated NRF2/SLC7A11/GPX4 protein and mRNA expression levels (P<0.01), and inhibited lipid peroxidation. Compared with the model group, the body weight, blood lipid level and aortic plaque area of ML385 group increased (P<0.01); the morphology of mitochondria showed significant ferroptosis characteristics; the serum Fe2+, MDA and ROS levels increased (P<0.05 or P<0.01), and the activity of SOD decreased (P<0.01). Compared with BBRM group, the iron inhibition effect of BBRM+ML385 group was significantly weakened, and the plaque area significantly increased (P<0.01). CONCLUSION: Through NRF2/SLC7A11/GPX4 pathway, BBR can resist oxidative stress, inhibit ferroptosis, reduce plaque area, stabilize plaque, and exert anti-AS effects.

Discovery of small molecule inhibitors of neddylation catalyzing enzymes for anticancer therapy.

Protein neddylation, a type of post-translational modifications, involves the transfer of the ubiquitin-like protein NEDD8 to the lysine residues of a target substrate, which is catalyzed by the NEDD8 activating enzyme (E1), NEDD8 conjugating enzyme (E2), and NEDD8 ligase (E3). Cullin family proteins, core components of Cullin-RING E3 ubiquitin ligases (CRLs), are the most well-known physiological substrates of neddylation. CRLs, activated upon cullin neddylation, promote the ubiquitination of a variety of key signaling proteins for proteasome degradation, thereby regulating many critical biological functions. Abnormal activation of neddylation enzymes as well as CRLs has been frequently observed in various human cancers and is associated with poor prognosis for cancer patients. Consequently, targeting neddylation has emerged as a promising strategy for the development of novel anticancer therapeutics. This review first briefly introduces the properties of protein neddylation and its role in cancer, and then systematically summarizes all reported chemical inhibitors of the three neddylation enzymes, providing a focused, up to date, and comprehensive resource in the discovery and development of these small molecule inhibitors.

Research advances of coloring mechanism regulated by MicroRNAs in plants.

In plants, microRNAs (miRNAs) are a class of important small RNAs involved in their growth and development, and play a very significant role in regulating their tissue coloring. In this paper, the mechanisms on miRNA regulation of plant coloring are mainly reviewed from three aspects: macroscopic physiological and molecular foundations related to tissue coloring, miRNA biosynthesis and function, and specific analysis of miRNA regulation studies on leaf color, flower color, fruit color, and other tissue color formation in plants. Furthermore, we also systematically summarize the miRNA regulatory mechanisms identified on pigments biosynthesis and color formation in plants, and the regulatory mechanisms of these miRNAs mentioned on the existing researches can be divided into four main categories: directly targeting the related transcription factors, directly targeting the related structural genes, directly targeting the related long noncoding RNAs (LncRNAs) and miRNA-mediated production of trans-acting small interfering RNAs (ta-siRNAs). Together, these research results aim to provide a theoretical reference for the in-depth study of plant coloring mechanism and molecular breeding study of related plants in the future.

Engineered bacterial membrane vesicle as safe and efficient nano-heaters to reprogram tumor microenvironment for enhanced immunotherapy.

The immunosuppressive tumor microenvironment (TME) in solid tumors often impedes the efficacy of immunotherapy. Bacterial outer membrane vesicles (OMVs), as a promising cancer vaccine that can potently stimulate immune responses, have garnered interest as a potential platform for cancer therapy. However, the low yield of OMVs limits their utilization. To address this limitation, we developed a novel approach to synthesize OMV-like multifunctional synthetic bacterial vesicles (SBVs) by pretreating bacteria with ampicillin and lysing them through sonication. Compared to OMVs, the yield of SBVs increased by 40 times. Additionally, the unique synthesis process of SBVs allows for the encapsulation of bacterial intracellular contents, endowing SBVs with the capability of delivering catalase (CAT) for tumor hypoxia relief and activating the host cyclic GMP-AMP synthase (cGAS)/stimulator of interferon genes (STING) signaling pathway. To overcome the toxicity of lipopolysaccharide (LPS) on the SBVs surface, we decorated SBVs with a biocompatible polydopamine (PDA) shell, which allowed TME reprogramming using SBVs to be conducted without adverse side effects. Additionally, the photosensitizer indocyanine green (ICG) was loaded into the PDA shell to induce immunogenic cell death and further improve the efficacy of immunotherapy. In summary, the SBVs-based therapeutic platform SBV@PDA/ICG (SBV@P/I) can synergistically elicit safe and potent tumor-specific antitumor responses through combined immunotherapy and phototherapy.

Topological Rearrangement-Induced Mesoscale Phase Redistribution to Enhance the Fatigue Resistance of Polymer Blends.

Maintaining a high modulus to simultaneously withstand deformation and increase fatigue resistance to restrict crack propagation in a material presents a significant challenge. In this work, a straightforward strategy was developed to address this issue in polymers. A dynamic network was incorporated into a permanent one prior to the formation of the latter, and two incompatible polymer networks were created to prevent common phase separation. The mechanical and fatigue resistance properties were substantially enhanced by the exact modulation of the soft and hard phase distribution by precise control over the densities of dynamic and permanent networks as well as the number of reprocessing steps. The experimental results demonstrated a nearly 9-fold increase in the fatigue life of polyurethane compared with traditional design methods and a 2.5 times increase in modulus. This strategy shows potential for the design of fatigue-resistant thermosetting and thermoplastic materials. The results offer new insight into the development of durable, high-performance materials that are reprocessable and compatible.

[Changes in Soil Organic Carbon Density and Its Response to Climate Change and Human Activities Before and After the Grain for Green Project on the Loess Plateau].

Accurately assessing the changes in soil organic carbon storage （SOCS） before and after the Grain for Green Project （GFG） in the Loess Plateau （LP） and exploring the relationship between its spatial and temporal distribution and the influencing factors were important references for the development of regional recycling as well as the formulation of ecological protection policies. Based on the data of climate, human activities, and SOCD in the surface （0-20 cm） and deep （0-100 cm） soil before and after GFG in the LP from 2001 to 2020, we investigated the changes in SOCD at different spatial and temporal scales by using the methods of trend analysis, the kriging method, and variance partitioning analysis. The results showed that： ① Before and after the GFG, the surface SOCS of the whole region increased by 8 338.7×104 t； the deep SOCS increased by 1 160.02×104 t. ② In each bioclimatic subregion, the whole-region average SOCD of Ⅰ （Semi-Humid Forest Region）, Ⅱ （Semi-Humid Semi-Arid Forest and Grassland Region）, and Ⅲ （Semi-Arid Typical Grassland Region） showed a significant increasing trend, with a decreasing trend in Ⅳ （arid semi-arid desert grassland area） and Ⅴ （arid desert area）. ③ The average surface SOCS increase in different ecosystems was ranked as follows： cropland > grassland > woodland > shrubs > bare land and sparse vegetation. The deep soil increase was ranked as follows： grassland > cropland > woodland > shrubs > bare land and sparse vegetation. ④ Climate factors were the most important driving factors for changes in SOCD； the annual average temperature and precipitation were significantly positively correlated with changes in SOCD. The results of the study could provide data support for regional ecological management and land use policy formulation to promote high quality development of the ecological environment in the LP.

Observer-Based Asynchronous Boundary Stabilization for Stochastic Markovian Reaction-Diffusion Neural Networks.

This work investigates the observer-based asynchronous boundary stabilization for a kind of stochastic Markovian reaction-diffusion neural networks with exogenous disturbances. Specifically, parameter uncertainties are considered in the drift item. First, a hidden Markov model is introduced that guarantees the observer modes run asynchronously with the system modes. It should be noted that the asynchronous observer constructed in this work only uses the boundary measurement information. Then a nonfragile asynchronous observer-based boundary controller is designed. Taking advantage of inequality techniques and stochastic analysis method, sufficient criterion is provided to satisfy input-to-state exponentially mean-square stability, and the asynchronous boundary observer/controller gains are further derived. As a special case, the synchronous observer-based boundary stabilization is also obtained. Finally, a numerical example is exploited to manifest the validity of the established results.

Updated therapeutic options for human brucellosis: A systematic review and network meta-analysis of randomized controlled trials.

BACKGROUND: In clinical practice guidelines, there is no consensus about the medications that should be initially offered to patients with brucellosis. To provide informative evidence, we compared and ranked brucellosis medications based on their efficacy and safety. METHODS: For this systematic review and network meta-analysis, we searched 4 English databases and 3 Chinese databases, from the date of database inception to December 13, 2023. We included randomized controlled trials (RCTs) involving children and adolescents with brucellosis, comparing different antibiotic regimens. We excluded studies explicitly targeting patients with spondylitis brucellosis, endocarditis brucellosis, and neuro-brucellosis. The primary outcomes were overall failure (efficacy) and side effects (safety). Secondary outcomes were relapse and therapeutic failure. Pairwise meta-analysis was first examined. Data were analyzed using random effects network meta-analysis, with subgroup and sensitivity analyses performed. The Confidence in Network Meta-Analysis (CINeMA) framework was used to assess the certainty of evidence. The protocol was preregistered in PROSPERO (CRD42023491331). RESULTS: Of the 11,747 records identified through the database search, 43 RCTs were included in the network meta-analysis. Compared with standard therapy (Doxycycline + Rifampicin), Rifampicin + Tetracyclines (RR 4.96; 95% CI 1.47 to 16.70; very low certainty of evidence), Doxycycline + TMP/SMX (RR 0.18; 95% CI 0.06 to 0.52; low certainty of evidence), Doxycycline + Quinolones (RR 0.27; 95% CI 0.11 to 0.71; low certainty of evidence), Streptomycin + Tetracyclines (RR 0.04; 95% CI 0.01 to 0.16; low certainty of evidence), and Single (RR 0.05; 95% CI 0.02 to 0.16; moderate certainty of evidence) were less efficacious. Doxycycline + Gentamicin ranked the best in efficacy (SUCRA values: 0.94), the second is Triple (SUCRA values: 0.87), and the third is Doxycycline + Streptomycin (SUCRA values: 0.78). CONCLUSIONS: Brucellosis medications differ in efficacy and safety. Doxycycline + Gentamicin, Triple, and Doxycycline + Streptomycin have superior efficacy and safety. Treatment of brucellosis should strike a balance between efficacy, safety, and cost.

The Effect of Low-Dose Dexmedetomidine on Perioperative Neurocognitive Dysfunction in Elderly Patients Undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP): A Randomized, Controlled, Double-Blind Trial.

Objective: This study investigates the effect of low-dose dexmedetomidine infusion on perioperative neurocognitive function in elderly patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). Patients and Methods: This double-blind trial enrolled 80 elderly ERCP patients randomized to receive dexmedetomidine (Group D) or placebo (Group S). Group D received dexmedetomidine at 0.4 µg·kg-1·h-1 starting 15 minutes before surgery until completion, along with propofol at 1.5 mg/kg for anesthesia. Group S received saline and propofol in a similar manner. Anesthesia was maintained with dexmedetomidine at 0.4 µg·kg-1·h-1 and propofol at 1-2 mg/kg during surgery. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) preoperatively and on postoperative days 1, 3, and 5. Primary outcome was perioperative neurocognitive disorder (PND) incidence on day 5; secondary outcomes included changes in perioperative IL-6, cortisol, S100-ß, hemodynamics, anesthesia parameters, postoperative pain, agitation scores, and adverse events. Results: All 80 patients completed the trial. On postoperative day 5, the cumulative probability of PND incidence was significantly lower in Group D than in Group S (12.5% vs 35%, P=0.018). Group D also had lower levels of IL-6 (F=199.472, P<0.001), S100-ß (F=2681.964, P<0.001), and cortisol (F=137.637, P<0.001). Propofol doses were lower in Group D (706.1 ± 202.4 vs 1003.3 ± 203.7, P<0.001), and bradycardia rates were higher (45% vs 15%, P=0.003), though atropine use did not significantly differ between groups. Group D showed greater stability in mean arterial pressure. Postoperative complications and adverse reactions were similar across groups. Conclusion: Perioperative low-dose dexmedetomidine infusion with propofol in elderly ERCP patients ensures safe and effective monitored anesthesia care (MAC), reducing PND incidence by mitigating peripheral inflammation and stress responses. Long-term follow-up is needed to fully evaluate PND incidence.

Rational design of a NIR fluorescent probe and its application in food detection of viscosity and biosystem imaging.

Viscosity is one of the most important parameters of liquid foods and shows significant change during food spoilage. It is also an important component of the cell microenvironment and is closely associated with the development of liver injury. In this work, a viscosity-sensitive fluorescent probe named WZ-V based on the twisted intramolecular charge transfer (TICT) mechanism was successfully designed. WZ-V had a large Stokes shift, long wavelength emission, and the fluorescence intensity shows 290-fold enhancement in high viscosity. Probe WZ-V successfully detected viscosity changes caused by food thickeners, as well as in milk, orange juice, and lemonade spoilage processes. This provides a new tool for regulating the viscosity of liquid foods and monitoring viscosity changes during food spoilage. In addition, WZ-V has been successfully applied to image viscosity changes in liver injury, which provides an important reference for the study of liver diseases.