Efficacy of Xianling Gubao capsule vs. its combination therapy in the treatment of primary osteoporosis: A network meta-analysis of randomized controlled trials.

Objective: This study aimed to evaluate the efficacy of the Xianling Gubao (XLGB) capsule alone and its combination therapy in primary osteoporosis (POP). Methods: Databases including PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP, and SinoMed were searched from their inception to January 16, 2024, for randomized controlled trials (RCTs) investigating the XLGB treatment for POP. A network meta-analysis (NMA) was performed to evaluate the efficacy and safety of multiple interventions in the treatment of POP. The Cochrane risk-of-bias tool was used to assess the quality of RCTs included in the meta-analysis. Software Stata (version 15.0) was used for statistical analysis. The surface under the cumulative ranking curve (SUCRA) method was used to present the findings from this NMA numerically and graphically by ranking multiple interventions. Results: A total of 107 RCTs were included in the meta-analysis, involving 10,032 participants and 21 interventions. Meta-analysis showed that XLGB + calcium (Ca) + calcitonin (99.9 %) was the most desirable treatment option for improving clinical efficacy. XLGB + Ca + bisphosphonate (BP) was most effective for improving bone mineral density (BMD) at the lumbar spine, femoral neck BMD, and serum bone Gla protein (BGP). SUCRA values for improving these three outcome measures by XLGB + Ca + BP were 87.4 %, 77.2 %, and 84.3 %, respectively. XLGB + calcitonin was the optimal option in terms of safety evaluation and improving visual analogue scale (VAS), with the SUCRA values being 89.6 % and 94.9 %, respectively. Conclusions: The XLGB combination therapy is a desirable option for treating POP as it can effectively improve the therapeutic effects, BMD, and serum BGP, as well as relieve pain in patients with POP.

A novel ultrasound image diagnostic method for thyroid nodules.

The incidence of thyroid nodules is increasing year by year. Accurate determination of benign and malignant nodules is an important basis for formulating treatment plans. Ultrasonography is the most widely used methodology in the diagnosis of benign and malignant nodules, but diagnosis by doctors is highly subjective, and the rates of missed diagnosis and misdiagnosis are high. To improve the accuracy of clinical diagnosis, this paper proposes a new diagnostic model based on deep learning. The diagnostic model adopts the diagnostic strategy of localization-classification. First, the distribution laws of the nodule size and nodule aspect ratio are obtained through data statistics, a multiscale localization network structure is a priori designed, and the nodule aspect ratio is obtained from the positioning results. Then, uncropped ultrasound images and nodule area image are correspondingly input into a two-way classification network, and an improved attention mechanism is used to enhance the feature extraction performance. Finally, the deep features, the shallow features, and the nodule aspect ratio are fused, and a fully connected layer is used to complete the classification of benign and malignant nodules. The experimental dataset consists of 4021 ultrasound images, where each image has been labeled under the guidance of doctors, and the ratio of the training set, validation set, and test set sizes is close to 3:1:1. The experimental results show that the accuracy of the multiscale localization network reaches 93.74%, and that the accuracy, specificity, and sensitivity of the classification network reach 86.34%, 81.29%, and 90.48%, respectively. Compared with the champion model of the TNSCUI 2020 classification competition, the accuracy rate is 1.52 points higher. Therefore, the network model proposed in this paper can effectively diagnose benign and malignant thyroid nodules.

The DARC Side of Inflamm-Aging: Duffy Antigen Receptor for Chemokines (DARC/ACKR1) as a Potential Biomarker of Aging, Immunosenescence, and Breast Oncogenesis among High-Risk Subpopulations.

The proclivity of certain pre-malignant and pre-invasive breast lesions to progress while others do not continues to perplex clinicians. Clinicians remain at a crossroads with effectively managing the high-risk patient subpopulation owing to the paucity of biomarkers that can adequately risk-stratify and inform clinical decisions that circumvent unnecessary administration of cytotoxic and invasive treatments. The immune system mounts the most important line of defense against tumorigenesis and progression. Unfortunately, this defense declines or "ages" over time-a phenomenon known as immunosenescence. This results in "inflamm-aging" or the excessive infiltration of pro-inflammatory chemokines, which alters the leukocyte composition of the tissue microenvironment, and concomitant immunoediting of these leukocytes to diminish their antitumor immune functions. Collectively, these effects can foster the sequelae of neoplastic transformation and progression. The erythrocyte cell antigen, Duffy antigen receptor for chemokines(DARC/ACKR1), binds and internalizes chemokines to maintain homeostatic levels and modulate leukocyte trafficking. A negative DARC status is highly prevalent among subpopulations of West African genetic ancestry, who are at higher risk of developing breast cancer and disease progression at a younger age. However, the role of DARC in accelerated inflamm-aging and malignant transformation remains underexplored. Herein, we review compelling evidence suggesting that DARC may be protective against inflamm-aging and, therefore, reduce the risk of a high-risk lesion progressing to malignancy. We also discuss evidence supporting that immunotherapeutic intervention-based on DARC status-among high-risk subpopulations may evade malignant transformation and progression. A closer look into this unique role of DARC could glean deeper insight into the immune response profile of individual high-risk patients and their predisposition to progress as well as guide the administration of more "cyto-friendly" immunotherapeutic intervention to potentially "turn back the clock" on inflamm-aging-mediated oncogenesis and progression.

Impact of Improved Design on Knudsen Force for Micro Gas Sensor.

Knudsen force generated by thermally driven gas flow in a microscale structure has been used for gas detection and has shown immeasurable potential in the field of microelectromechanical system (MEMS) gas sensors due to its novel sensing characteristics. In this article, the performances of three kinds of Knudsen force gas sensors with improved isosceles triangular shuttle arm structures were studied. In the first design, the top side and right side lengths were equal; in the second, the top side and bottom side lengths were equal; and for the third, the bottom side and right side lengths were equal. A detailed investigation including gas flow, thermal characteristics, Knudsen force, and coupling effects between the shuttle-heater pairs was conducted using the direct simulation Monte Carlo (DSMC) method and the main mechanisms for gas flow presented were almost the same in this work. However, the second design returned the highest Knudsen force performance. The value increased by 42.9% (P = 387 Pa) compared to the Knudsen force of the original square shuttle arm. The results also demonstrate that the coupling effects become weak toward the right with an increase in the number of shuttle-heater pairs.

Knudsen pumps: a review.

The Knudsen pump (KP) is a kind of micro-pump that can form thermally induced flows induced by temperature fields in rarefied gas environments. It has the advantages of having no moving parts, simple structure, easy construction and extension, a wide range of energy sources, and low energy consumption. With the development of Micro/Nano Electro Mechanical Systems (MEMS/NEMS), extensive studies have been conducted on KPs, and the applications of KPs have widened. In order to obtain efficient flow fields in KPs, it is necessary to adopt modern computational methods for simulation and analysis. In many circumstances, the simulation and experimental results have good agreement. However, there seems to be no comprehensive review on KPs at present. In this paper, KPs are first defined and classified according to the flow mechanisms of the thermally induced flows. Then, the three aspects of configurations, performance, and applications of KPs in the current state of research are reviewed and analyzed. Finally, the current problems of KP are discussed, and some suggestions are provided for future research and applications.

Alignment System and Application for a Micro/Nanofluidic Chip.

In this paper, a direct pre-bonding technology after alignment of the chip is presented to avoid the post-misalignment problem caused by the transferring process from an alignment platform to a heating oven. An alignment system with a high integration level including a microscope device, a vacuum device, and an alignment device is investigated. To align the chip, a method of 'fixing a chip with microchannels and moving a chip with nanochannels' is adopted based on the alignment system. With the alignment system and the assembly method, the micro/nanofluidic chip was manufactured with little time and low cost. Furthermore, to verify the performance of the chip and then confirm the practicability of the device, an ion enrichment experiment is carried out. The results demonstrate that the concentration of fluorescein isothiocyanate (FITC) reaches an enrichment value of around 5 µM and the highest enrichment factor is about 500-fold. Compared with other devices, an alignment system presented in this paper has the advantages of direct pre-bonding and high integration level.

A practical and efficient approach to imidazo[1,2-a]pyridine-fused isoquinolines through the post-GBB transformation strategy.

Diversity-oriented synthesis of the biologically intriguing imidazo[1,2-a]pyridine-fused isoquinoline systems from readily available starting materials was achieved through the Groebke-Blackburn-Bienaymé reaction followed by a gold-catalyzed cyclization strategy. The synthetic approach is characterized by mild reaction conditions and a broad substrate scope, allowing for the rapid construction of structurally complex and diverse heterocycles in moderate to good yields.

Synergistic effect of scavenger receptor A and low-density lipoprotein receptor on macrophage foam cell formation under inflammatory stress.

To provide experimental evidence for the effect of inflammation on cholesterol accumulation in macrophages, we investigated the expression of low-density lipoprotein receptor (LDL-R) and scavenger receptor A (SR-A) genes and proteins in the lipopolysaccharide (LPS)-stimulated macrophage-like RAW264.7 cell line. RAW264.7 cells were incubated in serum-free medium in the absence or presence of LDL alone, LDL+LPS and LPS alone. Intracellular cholesterol content, tumor necrosis factor α levels in the supernatants, mRNA and protein expression of LDL-R and SR-A in the treated cells were assessed by Oil Red O staining cholesterol enzymatic assay, enzyme-linked immunosorbent assay, semi-quantitative polymerase chain reaction and western blot analysis, respectively. Our results demonstrated that LPS was able to upregulate SR-A mRNA and protein expression, override LDL-R suppression induced by a high dose of LDL and increase LDL uptake by enhancing receptor expression, leading to foam cell formation in RAW264.7 cells. These findings suggest that the synergy of the upregulation of SR-A and dysregulation of LDL-R under inflammatory stress may contribute to macrophage-derived foam cell formation.

Hepatitis B virus infection increases the risk of cholangiocarcinoma: a meta-analysis and systematic review.

BACKGROUND AND AIM: A number of studies have shown that hepatitis virus infections may be associated with cholangiocarcinoma (CC). However, the relationship between hepatitis B virus (HBV) infection and CC, especially intrahepatic cholangiocarcinoma (ICC), is still controversial. METHODS: Relevant studies were identified by searching PUBMED, EMBASE and Web of Science Datebases up to September 2011. Pooled risk estimates were calculated using a random-effects model. Potential sources of heterogeneity were performed by subgroup analyses. A total of 18 papers were included in this meta-analysis. RESULTS: The pooled risk estimate of all studies showed a statistically significant increased risk of CC among individuals with HBV infection (rate ratio [RR]: 2.66; 95% confidence interval [CI]: 1.97, 3.60). Compared with those without HBV infection, persons with HBV infection had an increased risk of intra-CC (ICC) (RR: 3.42; 95% CI: 2.46, 43.74), extrahepatic CC (OR: 1.46; 95% CI: 0.98, 2.17), and CC (OR: 2.03; 95% CI: 1.15, 3.56). In a subgroup analysis of HBV infection and risk of ICC, the pooled risk estimate of studies in Asians (RR: 3.63; 95% CI: 2.56, 5.13) was higher than that in non-Asians (RR: 1.93; 95% CI: 0.78, 4.76). A Begg funnel plot and Egger test revealed no evidence for publication bias. CONCLUSIONS: This meta-analysis shows that HBV is associated with increased risk of CC, especially for ICC. Further investigation is needed to focus on the mechanism by which HBV may be involved in the pathogenesis of CC.

A hydrogen bonding motif for forming extended assemblies.

Oligoamide strands containing tertiary amide groups were found to share a basic structural motif that promotes the formation of H-bonded, chain- or tape-like supramolecular assemblies.