Enhanced antibiofilm potential of low-intensity pulsed ultrasound combined with 0.35% povidone-iodine in a rat model of periprosthetic joint infection.

Aims: Although low-intensity pulsed ultrasound (LIPUS) combined with disinfectants has been shown to effectively eliminate portions of biofilm in vitro, its efficacy in vivo remains uncertain. Our objective was to assess the antibiofilm potential and safety of LIPUS combined with 0.35% povidone-iodine (PI) in a rat debridement, antibiotics, and implant retention (DAIR) model of periprosthetic joint infection (PJI). Methods: A total of 56 male Sprague-Dawley rats were established in acute PJI models by intra-articular injection of bacteria. The rats were divided into four groups: a Control group, a 0.35% PI group, a LIPUS and saline group, and a LIPUS and 0.35% PI group. All rats underwent DAIR, except for Control, which underwent a sham procedure. General status, serum biochemical markers, weightbearing analysis, radiographs, micro-CT analysis, scanning electron microscopy of the prostheses, microbiological analysis, macroscope, and histopathology evaluation were performed 14 days after DAIR. Results: The group with LIPUS and 0.35% PI exhibited decreased levels of serum biochemical markers, improved weightbearing scores, reduced reactive bone changes, absence of viable bacteria, and decreased inflammation compared to the Control group. Despite the greater antibiofilm activity observed in the PI group compared to the LIPUS and saline group, none of the monotherapies were successful in preventing reactive bone changes or eliminating the infection. Conclusion: In the rat model of PJI treated with DAIR, LIPUS combined with 0.35% PI demonstrated stronger antibiofilm potential than monotherapy, without impairing any local soft-tissue.

Interfacial self-assembly of a chiral pyrene exciplex into a superhelix with enhanced circularly polarized luminescence.

We found that the interfacially confined self-assembly of pyrene and phenanthrene glutamides can form strong exciplexes and amorphous superhelices, which show intensity-enhanced and sign-inverted CPL activity with improved quantum yield compared to a pyrene excimer. This work unveils the predominant role of supramolecular nanostructures over molecular configurations on CPL performance.

Cross-domain heterogeneous metasurface inverse design based on a transfer learning method.

In this Letter, a transfer learning method is proposed to complete design tasks on heterogeneous metasurface datasets with distinct functionalities. Through fine-tuning the inverse design network and freezing the parameters of hidden layers, we successfully transfer the metasurface inverse design knowledge from the electromagnetic-induced transparency (EIT) domain to the three target domains of EIT (different design), absorption, and phase-controlled metasurface. Remarkably, in comparison to the source domain dataset, a minimum of only 700 target domain samples is required to complete the training process. This work presents a significant solution to lower the data threshold for the inverse design process and provides the possibility of knowledge transfer between different domain metasurface datasets.

Construction and Validation Study of a Model for Predicting the Risk of Pulmonary Complications in Elderly Patients with Multiple Rib Fractures.

Objective: Given the high incidence of pulmonary complications and poor prognosis in patients with multiple rib fractures, we have developed a risk prediction model for pulmonary complications in patients with MRF. In order to identify the high-risk groups prone to pulmonary complications as early as possible, we will intervene in advance and provide targeted interventions to improve patients' quality of life and disease prognosis. Methods: The prospective cohort study design scheme was used to collect data information based on the hospital's electronic medical record system. The constructed cohort included 314 cases, and the validation cohort included 119 patients with MRF. The risk prediction model for pulmonary complications in patients with MRF was established using the backward screening method and multivariate logistic regression analysis. The predictive quality and clinical utility of the model were assessed using AUC, sensitivity, specificity, calibration curves, and clinical decision curves. Results: Seven predictors were finally included after multivariate logistic regression analysis: age, smoking history, diabetes mellitus, presence of other fracture combinations, serum albumin, treatment modality, and presence of underlying lung disease. The construction of the cohort yielded an AUC of 0.928 (95% CI 0899-0.956; P < .001) for the present model, with a sensitivity of 81.2% and a specificity of 76.8%, while the external validation cohort yielded an AUC of 0.942 (95% CI 0.900-0.983; P < .001), with a sensitivity of 76.7% and a specificity of 78.4%, and the H-L chi-squared tests all showed P > .05. Conclusions: The column-line diagram model of pulmonary complications in patients with MRF constructed in this study showed good discriminative and calibration performance in both internal and external validation, which is helpful for clinicians to identify individuals at high risk of pulmonary complications as early as possible, and thus can be recommended for clinical use.

Arsenic mobilization across the sediment-water interface of the Three Gorges Reservoir as a function of water depth using DGT and HR-Peepers, a preliminary study.

The artificial regulation of the Three Gorges Reservoir (TGR) creates large water level fluctuation zones (WLFZ) that may change the behavior of metals and metalloid in sediment, particularly redox sensitive elements. Mobilization of As, Fe and Mn across the sediment-water interface (SWI) in the TGR as a function of different water depth (periodically and permanently submerged sediments, respectively) was in situ determined by diffusive gradients in thin films (DGT) and high-resolution dialysis technique (HR-Peeper), respectively. The results showed that the mobilization of As was significantly affected by Fe/Mn especially Mn, across the SWI. Duo to the oxic-anoxic transitional state in near bottom water, the reduced Fe and Mn in sediment pore water could be oxidized and precipitated again, leading to the co-precipitation of As with Fe/Mn oxides (hydroxides). Consequently, concentrations of As, Fe and Mn in labile phases and pore water were generally low across the SWI, then they sharply increased at a few centimeters below the SWI. Considering different water depth, various trends were found in labile phase, whereas concentrations of As, Fe and Mn in pore water in permanently submerged sediments were significantly higher than those in periodically submerged sediments. The dry-re-wetting alternation processes in the WLFZ may play vital roles in the resupply capacity of sediments as it was found that periodically submerged sediments with longer re-wetting time had higher Fe/Mn resupply capacity than those with shorter re-wetting times and permanently submerged sediments.

UBTF tandem duplications in pediatric myelodysplastic syndrome and acute myeloid leukemia: implications for clinical screening and diagnosis.

Recent genomic studies in adult and pediatric acute myeloid leukemia (AML) demonstrated recurrent in-frame tandem duplications (TD) in exon 13 of upstream binding transcription factor (UBTF). These alterations, which account for ~4.3% of AMLs in childhood and about 3% in adult AMLs under 60, are subtype-defining and associated with poor outcomes. Here, we provide a comprehensive investigation into the clinicopathological features of UBTF-TD myeloid neoplasms in childhood, including 89 unique pediatric AML and 6 myelodysplastic syndrome (MDS) cases harboring a tandem duplication in exon 13 of UBTF. We demonstrate that UBTF-TD myeloid tumors are associated with dysplastic features, low bone marrow blast infiltration, and low white blood cell count. Furthermore, using bulk and single-cell analyses, we confirm that UBTF-TD is an early and clonal event associated with a distinct transcriptional profile, whereas the acquisition of FLT3 or WT1 mutations is associated with more stem celllike programs. Lastly, we report rare duplications within exon 9 of UBTF that phenocopy exon 13 duplications, expanding the spectrum of UBTF alterations in pediatric myeloid tumors. Collectively, we comprehensively characterize pediatric AML and MDS with UBTF-TD and highlight key clinical and pathologic features that distinguish this new entity from other molecular subtypes of AML.

Ninety-day postoperative mortality and complications in continuous and unselected single-stage revisions for chronic periprosthetic joint infection.

PURPOSE: Single-stage revision has gained significant attention as a major surgical approach for periprosthetic joint infection (PJI). However, the 90-day mortality and complication profile of single-stage revision is poorly characterized. The purposes of this study were to determine the incidence rates of and identify the risk factors for 90-day postoperative mortality and complications of single-stage revision for chronic PJI. METHODS: A retrospective review was conducted on patients who underwent single-stage revision for PJI between August 2000 and May 2022. Patient demographics, 90-day mortality, and postoperative complications were recorded. Complications were categorized into systemic and local complications. Patients in this study were further categorized into knee and hip revision groups. Univariate and multivariate logistic regression analyses were performed to identify significant independent predictors of the outcome measures. RESULTS: 348 patients (144 knees and 204 hips) were included in this study. The 90-day mortality rate was 0.9%. The incidence rates of postoperative complications in knee and hip surgeries were 31.3% and 19.6%, respectively. The most common complication was deep-vein thrombosis (DVT). Rheumatoid arthritis (RA) was the independent predictor of mortality. In the knee revision group, fungal infection was identified as the independent predictor of recurrent PJI; regular alcohol use was predictive of wound dehiscence. Among hip PJI patients, age ≥ 80 years was independently associated with DVT; RA was found to be a predictor of dislocation and wound dehiscence. CONCLUSION: For continuous and unselected patients with chronic PJI, single-stage revision demonstrated a satisfactory 90-day mortality. Nevertheless, the 90-day postoperative complication rates after single-stage revision in both knee and hip groups were relatively high.

["Load-Unload" Effect of Manganese Oxides on Phosphorus in Surface Water of the Pearl River Estuary].

Phosphorus (P) conveyed by surface runoff plays an essential role in regulating nutrient balance and primary production in estuarine waters. In this study, basic physiochemical properties, total phosphorus (TP, including speciation), particulate iron (PFe), particulate manganese (PMn), and particulate aluminum (PAl) of the surface water in the Pearl River Estuary (PRE) in different seasons were determined to investigate the spatiotemporal distribution characteristics of P and to identify the crucial factor controlling P migration and transformation in the freshwater-saltwater interaction zone. TP concentrations (28.88-233.68 µg·L-1) decreased with increasing salinity gradient owing to deposition and dilution. The proportions of P speciation followed a decreasing order as dissolved inorganic phosphorus (DIP, 37.3%) > particulate inorganic phosphorus (PIP, 22.7%) > dissolved organic phosphorus (DOP, 21.0%) > particulate organic phosphorus (POP, 19.0%). PIP was positively related to PFe, PMn, and PAl (P < 0.05), confirming their concurrent migration behaviors. In addition, the increase in salinity promoted the desorption of phosphate on the suspended particulate matters, which mainly took place near the freshwater-saltwater interface. A significant positive correlation (P < 0.001) between the solid-liquid phase partitioning coefficient (Kd) of phosphate and salinity indicated that PIP was present mainly in more stable forms in the brackish water. Most importantly, a better relationship between Kd and PMn (P < 0.01) supported our scientific hypothesis of the "load-unload" effect of Mn oxides on P:particulate-carrying phosphates transported from the freshwater zone tend to be desorbed and released into the brackish water.

Effects of the enhanced recovery after surgery intervention for preventing postpartum depression: a protocol for systematic review and meta-analysis.

INTRODUCTION: Postpartum depression (PPD), a prevalent public health problem, is a debilitating mental disorder for which preventive interventions could yield dramatic benefits. However, viable approach focusing the prevention of PPD for caesarean section (CS) patients remains limited currently. In recent decades, enhanced recovery after surgery (ERAS) has gradually been implemented in CS and appears to be a potential and favourable preventive intervention for PPD, but systematic evidence on this issue is lacking. Therefore, a meta-analysis is designed to systematically explore the potential effect of ERAS on the prevention of PPD in CS patients. METHODS AND ANALYSIS: Meta-analysis will be performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses statement. A systematic search across the PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, grey literature and Wanfang Database will be conducted from inception to July 2023. Relevant studies investigating the association between ERAS and PPD will be included. Two reviewers will independently carry out the literature selection, data extraction and risk of bias assessment. Disagreements will be resolved by group consensus. Statistical analyses will use the RevMan V.5.3 and STATA V.13 software. The Grading of Recommendations Assessment, Development, and Evaluation system will be used to evaluate the strength of evidence. ETHICS AND DISSEMINATION: This study raises no ethical issues. The pending meta-analysis may provide reliable evidence supporting ERAS as a viable preventive option for PPD in CS patients, further providing a useful reference for the health authorities and promoting the future clinical practice in this field. The formal results of this study will be submitted to a professional journal for publication. PROSPERO REGISTRATION NUMBER: CRD42023485929.

Impact of obese patients in ovarian cancer surgery on postoperative wound complications: A meta-analysis.

The effect of obesity on wound-related outcomes in post-ovarian cancer patients is not clear. A number of studies on the association of fat with post-operation injury in ovarian carcinoma have produced contradictory findings. This study aims to conduct a study of the available data to assess the association of obese individuals with significant surgery results in ovarian cancer. We looked up Cochrane Library, Embase, and PubMed for qualifying research on ovarian cancer operations to determine the primary evidence for evaluating the association of obesity with post-surgical wound injury in ovarian cancer. The odds ratio (OR) was analysed with a fixed effect model if the variability of the study was small; otherwise, the analysis of the data was done with a random effect model. Out of 1259 related trials which were reviewed for eligibility, 6 publications were chosen from 2009 to 2019, 3076 patients who had had an operation for ovarian cancer. Obesity has been linked to an increased rate of wound-related complications in ovarian cancer operations compared to those without obesity (OR, 0.50; 95% CI, 0.37, 0.69 p < 0.0001). Non-obesity was significantly less likely to occur with respect to operation time compared to those with obesity (MD, -48.00; 95% CI, -55.33, -40.68 p < 0.00001). There were no statistically significant differences in the rate of haemorrhage after the operation (OR, 0.26; 95% CI, 0.04, 1.57, p = 0.14). Because of the limited number of trials in this meta-analysis, caution should be exercised in their treatment. More high-quality research with a large sample is required in order to confirm the findings.

Estimation of water quality variables based on machine learning model and cluster analysis-based empirical model using multi-source remote sensing data in inland reservoirs, South China.

Reservoirs play important roles in the drinking water supply for urban residents, agricultural water provision, and the maintenance of ecosystem health. Satellite optical remote sensing of water quality variables in medium and micro-sized inland waters under oligotrophic and mesotrophic status is challenging in terms of the spatio-temporal resolution, weather conditions and frequent nutrient status changes in reservoirs, etc., especially when quantifying non-optically active components (non-OACs). This study was based on the surface reflectance products of unmanned aerial vehicle (UAV) multispectral images, Sentinel-2B Multispectral instrument (MSI) images and Landsat 7 Enhanced Thematic Mapper Plus (ETM+) by utilizing fuzzy C-means (FCM) clustering algorithm was combined with band combination (BC) model to construct the FCM-BC empirical model, and used mixed density network (MDN), extreme gradient boosting (XGBoost), deep neural network (DNN) and support vector regression (SVR) machine learning (ML) models to invert 12 kinds of optically active components (OACs) and non-OACs. Compared with the unclustered BC (UC) model, the mean coefficient of determination (MR) of the FCM-BC models was improved by at least 46.9%. MDN model showed best accuracy (R2 in the range of 0.60-0.98) and stability (R2 decreased by up to 13.2%). The accuracy of UAV was relatively higher in both empirical methods and machine learning methods. Additionally, the spatio-temporal distribution maps of four water quality variables were mapped based on the MDN model and UAV images, all platforms showed good consistency. An inversion strategy of water quality variables in various monitoring frequencies and weather conditions were proposed finally. The purpose of introducing the UAV platform was to cooperate with the satellite to improve the monitoring response ability of OACs and non-OACs in small and micro-sized oligotrophic and mesotrophic water bodies.

Molecular epidemiology of Coxiella burnetii infection in sheep and goats in Henan province, China.

Q fever is a significant zoonotic disease caused by Coxiella burnetii, an obligate intracellular gram-negative bacterium. Although C. burnetii infection has been identified in various animal species, domestic ruminants serve as the primary reservoirs and main sources of human infection. Understanding of the epidemiology of C. burnetii in domestic ruminants is crucial for preventing and controlling of C. burnetii infection in humans. In this study, spleen tissues from sheep and goats were collected in Hennan province, China. Through PCR screening, C. burnetii was detected in sheep and goats in Henan province with an overall infection rate of 6.8 %. Sequence comparison and phylogenetic analysis revealed that all newly identified C. burnetii strains shared a close genetic relationship with those found in humans worldwide. These findings highlight the high risk of C. burnetii infection among slaughterhouse workers and emphasize the importance of epidemiological studies that investigate samples from both humans and animals within the "One Health" framework. Such surveillance will contribute to a better understanding of the epidemic situation and aid in the development of effective prevention and control strategies for C. burnetii infections in humans.

UBTF Tandem Duplications in Pediatric MDS and AML: Implications for Clinical Screening and Diagnosis.

Recent genomic studies in adult and pediatric acute myeloid leukemia (AML) demonstrated recurrent in-frame tandem duplications (TD) in exon 13 of upstream binding transcription factor (UBTF). These alterations, which account for ~4.3% of AMLs in childhood and up to 3% in adult AMLs under 60, are subtype-defining and associated with poor outcomes. Here, we provide a comprehensive investigation into the clinicopathological features of UBTF-TD myeloid neoplasms in childhood, including 89 unique pediatric AML and 6 myelodysplastic syndrome (MDS) cases harboring a tandem duplication in exon 13 of UBTF. We demonstrate that UBTF-TD myeloid tumors are associated with dysplastic features, low bone marrow blast infiltration, and low white blood cell count. Furthermore, using bulk and single-cell analyses, we confirm that UBTF-TD is an early and clonal event associated with a distinct transcriptional profile, whereas the acquisition of FLT3 or WT1 mutations is associated with more stem cell-like programs. Lastly, we report rare duplications within exon 9 of UBTF that phenocopy exon 13 duplications, expanding the spectrum of UBTF alterations in pediatric myeloid tumors. Collectively, we comprehensively characterize pediatric AML and MDS with UBTF-TD and highlight key clinical and pathologic features that distinguish this new entity from other molecular subtypes of AML.

Quantitative Study of the Weakening Effect of Drilling on the Physical and Mechanical Properties of Coal-Rock Materials.

Coal seam drilling is a simple, economical, and effective measure commonly used to prevent and control rock burst. Following rock burst, coal exhibits significant dynamic characteristics under high strain-rate loading. Our purpose was to determine the physical processes associated with impact damage to drilled coal rock, and its mitigation mechanism. An impact test was carried out on prefabricated borehole coal specimens, and the impulse signals of the incident and transmission rods were monitored. The crack initiation, expansion, and penetration of coal specimens were video-recorded to determine the mechanical properties, crack expansion, damage modes, fragmentation, and energy dissipation characteristics of coal specimens containing different boreholes. The dynamic compressive strength of the coal specimens was significantly weakened by boreholes under high strain-rate loading; the dynamic compressive strength and the dynamic modulus of elasticity of coal rock showed a decreasing trend, with increasing numbers of boreholes and a rising and decreasing trend with increasing borehole spacing; the number and spacing of boreholes appeared to be design parameters that could weaken coal-rock material under high strain-rate loading; during the loading of coal and rock, initial cracks appeared and expanded in the tensile stress zone of the borehole side, while secondary cracks, which appeared perpendicular to the main crack, expanded and connected, destroying the specimen. As the number of boreholes increased, the fractal dimension (D) and transmission energy decreased, while the reflection energy increased. As the borehole spacing was increased, D decreased while the reflective energy ratio decreased and increased, and the transmissive energy ratio increased and decreased. Drilling under high strain modifies the mechanical properties of impact damaged coal rock.

Influence of lymphadenectomy on survival and recurrence in patients with early-stage epithelial ovarian cancer: a meta-analysis.

BACKGROUND: This meta-analysis aimed to evaluate the effectiveness of lymphadenectomy on survival and recurrence in patients with early-stage epithelial ovarian cancer (eEOC). METHODS: Relevant studies were searched from four online databases. Hazard ratios (HRs) with 95% confidence intervals (CIs) or risk ratios (RRs) with 95% CIs were used to evaluate the effects of lymphadenectomy on overall survival (OS), progression-free survival (PFS), and recurrence rates. A subgroup analysis was performed to explore the sources of heterogeneity, followed by sensitivity and publication bias assessments. RESULTS: Fourteen articles involving 22,178 subjects were included. Meta-analysis revealed that lymphadenectomy was significantly associated with improved OS (HR = 0.72; 95% CI:0.61, 0.84; P < 0.001), improved PFS (HR = 0.74; 95% CI: 0.67, 0.80; P < 0.001), and reduced recurrence rates (RR = 0.72; 95% CI: 0.60, 0.85; P < 0.001). Subgroup analysis showed that factors including area, histology, and source of the control group were significantly related to improved OS and PFS in patients with eEOC. Sensitivity analysis showed that the combined results were stable and reliable, and no significant publication bias was observed. CONCLUSIONS: Patients with eEOC can benefit from lymphadenectomy, with improved survival outcomes (OS and PFS) and a lower recurrence rate.

Effects of Varicocele Surgical Repair on Serum Hormone and Inhibin B Levels for Patients With Varicocele: A Systematic Review and Meta-Analysis.

Varicocele surgical repair can improve the function of the testis for patients with varicocele. We carried out a systematic review and meta-analysis to assess the effects of varicocele surgical repair on serum hormones and inhibin B levels in patients with varicocele. A literature search was performed in August 2022, and no language or geographic region restrictions were applied. The search included the following databases: PubMed, Embase, and Medline. A literature review was performed to identify all published clinical trials assessing serum hormone and inhibin B levels before and after varicocele surgical repair. The reference lists of retrieved studies were also investigated. A systematic review and meta-analysis were conducted. Eight articles were selected from 162 articles, including 452 patients. The combined analysis showed that after surgical treatment, mean serum testosterone, inhibin B, and sperm concentration levels increased compared with preoperative levels (p < .05). After surgical treatment, mean serum follicle-stimulating hormon (FSH), and Luteinizing hormone (LH) levels decreased compared with preoperative levels (p < .05). This meta-analysis demonstrates that varicocele surgical repair can improve testicular function, increase serum testosterone, and inhibin B levels and decrease serum FSH and LH levels in patients with varicocele. This might be related to the improvement of infertility. A large-scale multicenter randomized controlled study is needed for further confirmation.

Enhancing High-Temperature Energy Storage Performance of PEI-Based Dielectrics by Incorporating ZIF-67 with a Narrow Bandgap.

Polymer dielectrics are crucial for use in electrostatic capacitors, owing to their high voltage resistance, high energy storage density, and ultrahigh reliability. Furthermore, high-temperature-resistant polymer dielectrics are applied in various emerging fields. Herein, poly(ether imide) (PEI)-based polymer dielectrics prepared by adding a low loading of dimethylimidazolium cobalt (ZIF-67) with a narrow bandgaps are investigated. The results show that the composites exhibit considerably increased Young's modulus, suppressed conductivity loss, and improved breakdown strength compared with pure PEI. Consequently, a stable energy storage performance is realized for ZIF-67/PEI composites. Particularly, at 150 °C, 1 wt % ZIF-67/PEI composite affords an excellent energy storage density of 4.59 J/cm3 with a discharge energy efficiency of 80.6%, exhibiting a considerable increase compared with the values obtained for PEI (2.58 J/cm3 with a discharge energy efficiency of 68.8%). The results of this study reveal a feasible pathway to design polymer dielectrics with the potential for use in capacitive applications in harsh environments.

A new vaccination regimen using adenovirus-vectored vaccine confers effective protection against African swine fever virus in swine.

African swine fever (ASF) is an acute and highly contagious lethal infectious disease in swine that severely threatens the global pig industry. At present, a safe and efficacious vaccine is urgently required to prevent and control the disease. In this study, we evaluated the safety and immunogenicity of replication-incompetent type-2 adenoviruses carrying African swine fever virus (ASFV) antigens, namely CP204L (p30), E183L (p54), EP402R (CD2v), B646L (p72), and B602L (p72 chaperone). A vaccine cocktail delivered by simultaneous intramuscular (IM) and intranasal (IN) administration robustly elicited both systemic and mucosal immune responses against AFSV in mice and swine and provided highly effective protection against the circulating ASFV strain in farmed pigs. This multi-antigen cocktail vaccine was well tolerated in the vaccinated animals. No significant interference among antigens was observed. The combined IM and IN vaccination using this adenovirus-vectored antigen cocktail vaccine warrants further evaluation for providing safe and effective protection against ASFV infection and transmission.

Efficacy and safety of Gushen Antai Pills combined with dydrogesterone in the treatment of threatened miscarriage: a systematic review and meta-analysis.

Background: Despite some progress has been made in the pathogenesis and treatment of threatened miscarriage (TM), conventional treatment remains suboptimal. Thus, complementary medicine gradually become a new treatment option for treating threatened miscarriage. Gushen Antai Pills (GAP), a classic prescription of Traditional Chinese medicine (TCM), has became a popular complementary therapy to conventional western medicine (dydrogesterone) in treating threatened miscarriage in recent years. However, a systematic summary and analysis for its therapeutic effects is lacking. This meta-analysis aimed to systematically evaluate the effectiveness and safety of Gushen Antai Pills combined with dydrogesterone in the treatment of threatened miscarriage. Methods: A systematic search across seven electronic databases was conducted from inception to 17 September 2022. Studies were included if they were randomized controlled trials (RCTs) evaluating the effect of integrating Gushen Antai Pills and dydrogesterone in patients with threatened miscarriage, and reported the outcomes of interest. All statistical analyses were conducted using the Revman5.3 and Stata 13 software. The GRADE system was used to evaluate the quality of evidence. Results: Ten eligible randomized controlled trials involving 950 participants were contained in this meta-analysis. The pooled analysis showed that Gushen Antai Pills combined with dydrogesterone can significantly reduce the incidence of early pregnancy loss (RR: 0.29; 95% CI: 0.19-0.42; p < 0.00001) and alleviate clinical symptoms (RR: 1.39; 95% CI: 1.22-1.59; p < 0.00001), compared with treatment of dydrogesterone alone. Also, meta-analysis indicated that integrating Gushen Antai Pills and dydrogesterone is more effective than using dydrogesterone alone in improving hormone levels (serum levels of progesterone, ß-HCG and estradiol) for women with threatened miscarriage (all p < 0.00001). Meanwhile, the combined effects with significant heterogeneity also showed favorable consistency in the sensitivity analyses, indicating a good stability of present results. Moreover, no significant differences between Gushen Antai Pills combined with dydrogesterone and control group on adverse events was identified. The overall GRADE qualities were low to moderate. Conclusion: The overall available evidence suggested that Gushen Antai Pills combined with dydrogesterone had significant effects in improving pregnancy success rate, clinical symptoms and hormone levels for women with threatened miscarriage, with considerable safety and reliability. However, due to the partial heterogeneity, suboptimal quality and high risk of bias of some included studies, further rigorously designed randomized controlled trials are required. Systematic Review Registration: identifier https://INPLASY2022120035, https://inplasy.com/inplasy-2022-12-0035/.

Study on the mechanism of NLRP3 effect on the skeleton of de-ovalized mice.

Postmenopausal osteoporosis caused by estrogen deficiency affects millions of women worldwide. By influencing both osteoblast and osteoclast development, NOD-like receptor thermoprotein structural domain-associated protein 3 (NLRP3) is a key player in the etiology of osteoporosis (OP). The purpose of this research was to look into the mechanism of action of NLRP3 in osteoporosis caused by a lack of estrogen, highlighting that NLRP3 induces osteoblast pyroptosis and thus inflammatory responses in de-ovulated mice, thereby inhibiting osteogenic differentiation and participating in the development of osteoporosis. In de-ovulated mice, we found an enhanced inflammatory response and suppression of osteogenic activity. In vitro experiments, we found a significant increase in markers of cell pyroptosis and inflammatory responses and a significant decrease in markers of osteogenic differentiation in osteoblasts from de-ovulated mice. However, knockdown of the NLRP3 gene inhibited this cell pyroptosis and improved osteogenic differentiation of osteoblasts. Our findings indicate a potential therapeutic potential for the treatment of estrogen deficiency-induced osteoporosis by demonstrating the critical role that NLRP3 inflammatory vesicles and their downstream-mediated cellular pyroptosis play in bone differentiation.