Potential Gradient-Driven Dual-Functional Electrochromic and Electrochemical Device Based on a Shared Electrode Design.

The integration of electrochromic devices and energy storage systems in wearable electronics is highly desirable yet challenging, because self-powered electrochromic devices often require an open system design for continuous replenishment of the strong oxidants to enable the coloring/bleaching processes. A self-powered electrochromic device has been developed with a close configuration by integrating a Zn/MnO2 ionic battery into the Prussian blue (PB)-based electrochromic system. Zn and MnO2 electrodes, as dual shared electrodes, the former one can reduce the PB electrode to the Prussian white (PW) electrode and serves as the anode in the battery; the latter electrode can oxidize the PW electrode to its initial state and acts as the cathode in the battery. The bleaching/coloring processes are driven by the gradient potential between Zn/PB and PW/MnO2 electrodes. The as-prepared Zn||PB||MnO2 system demonstrates superior electrochromic performance, including excellent optical contrast (80.6%), fast self-bleaching/coloring speed (2.0/3.2 s for bleaching/coloring), and long-term self-powered electrochromic cycles. An air-working Zn||PB||MnO2 device is also developed with a 70.3% optical contrast, fast switching speed (2.2/4.8 s for bleaching/coloring), and over 80 self-bleaching/coloring cycles. Furthermore, the closed nature enables the fabrication of various flexible electrochromic devices, exhibiting great potentials for the next-generation wearable electrochromic devices.

A toughening mechanism of the strain rate-optimal chain length on polymer-modified calcium silicate hydrates (CSH).

Polymers are known to effectively improve the toughness of inorganic matrices; however, the mechanism at the molecular level is still unclear. In this study, we used molecular dynamics simulations to unravel the effects and mechanisms of different molecular chain lengths of polyacrylic acid (PAA) on toughening calcium silicate hydrate (CSH), which is the basic building block of cement-based materials. Our simulation results indicate that an optimal molecular chain length of polymers contributes to the largest toughening effect on the matrix, leading to up to 60.98% increase in fracture energy. During the uniaxial tensile tests along the x-axis and z-axis direction, the configuration evolution of the PAA molecule determines the toughening effect. As the polymer unfolds and its size matches the defects of CSH, the stress distribution of the system becomes more homogeneous, which favors an increase in toughness. Furthermore, based on our simulation results and a mathematical model, we propose a theory of "strain rate/optimal chain length". This theory suggests that the optimal toughening effect can be achieved when the molecular chain length of the organic component is 1.3-1.5 times the largest defect size of the inorganic matrix. This work provides molecular-scale insights into the toughening mechanisms of an organic/inorganic system and may have practical implications for improving the toughness of cement-based materials.

Super-amphiphobic arabic gum-based coatings on textile for on-demand oily and dye wastewater treatment.

Different membrane materials have broadly been constructed for oil-containing water separation, but most of preparation routes involve corrosive or toxic chemicals and especially many materials have only single superwetting property. Herein, a novel and eco-friendly cellulose-based textile membrane is developed by incorporating the composite coating consisting of arabic gum (AG), attapulgite (APT), and iron (Fe) onto cellulose textiles. The functionalized textile is superoleophobic underwater and superhydrophobic underoil. As a result, the textile prewetted with water or oil can be employed to separate light oil layer/water and heavy oil layer/water mixtures, respectively, and the separation efficiency to the two types of mixtures is larger than 98.3 %. Results also reveal that the decorated textile possesses superior stability and recyclability in purifying oily wastewater. More importantly, such coated textile is capable of filtrating water-soluble contaminants (dyes) from polluted water. Due to the versatility and environmental compatibility of product as well as the accessibility as agricultural and forestry product as raw materials, the advanced textiles may offer effective solutions to oily wastewater purification and water-soluble contaminant removal.

Multi-layered cement-hydrogel composite with high toughness, low thermal conductivity, and self-healing capability.

The inherent quasi-brittleness of cement-based materials, due to the disorder of their hydration products and pore structures, present significant challenges for directional matrix toughening. In this work, a rigid layered skeleton of cement slurry was prepared using a simplified ice-template method, and subsequently flexible polyvinyl alcohol hydrogel was introduced into the unidirectional pores between neighboring cement platelets, resulting in the formation of a multi-layered cement-based composite. A toughness improvement of over 175 times is achieved by the implantation of such hard-soft alternatively layered microstructure. The toughening mechanism is the stretching of hydrogels at the nano-scale and deflections of micro-cracks at the interfaces, which avoid stress concentration and dissipate huge energy. Furthermore, this cement-hydrogel composite also exhibits a low thermal conductivity (around 1/10 of normal cement) and density, high specific strength and self-healing properties, which can be used in thermal insulation, seismic high-rise buildings and long-span bridges.

Bioinspired Super Thermal Insulating, Strong and Low Carbon Cement Aerogel for Building Envelope.

The energy crisis has arisen as the most pressing concern and top priority for policymakers, with buildings accounting for over 40% of global energy consumption. Currently, single-function envelopes cannot satisfy energy efficiency for next-generation buildings. Designing buildings with high mechanical robustness, thermal insulation properties, and more functionalities has attracted worldwide attention. Further optimization based on bioinspired design and material efficiency improvement has been adopted as effective approaches to achieve satisfactory performance. Herein, inspired by the strong and porous cuttlefish bone, a cement aerogel through self-assembly of calcium aluminum silicate hydrate nanoparticles (C-A-S-H, a major component in cement) in a polymeric solution as a building envelop is developed. The as-synthesized cement aerogel demonstrates ultrahigh mechanical performance in terms of stiffness (315.65 MPa) and toughness (14.68 MJ m-3 ). Specifically, the highly porous microstructure with multiscale pores inside the cement aerogel greatly inhibits heat transfer, therefore achieving ultralow thermal conductivity (0.025 W m-1 K-1 ). Additionally, the inorganic C-A-S-H nanoparticles in cement aerogel form a barrier against fire for good fire retardancy (limit oxygen index, LOI ≈ 46.26%, UL94-V0). The versatile cement aerogel featuring high mechanical robustness, remarkable thermal insulation, light weight, and fire retardancy is a promising candidate for practical building applications.

Detection of all isoforms of human leukocyte antigen G in maternal serum could be clinically applied for prediction of preeclampsa.

OBJECTIVE: Previously, a number of previous studies on human leukocyte antigen G (HLA-G) and preeclampsia (PE) have demonstrated that expression of HLA-G is significantly reduced in women with PE. However, no study has confirmed whether maternal serum HLA-G could be used as a clinical test when HLA-G1/-G5 isoforms were measured. Therefore, the present study is to develop a novel HLA-G ELISA which is able to detect all isoforms of HLA-G and then to perform a retrospective case-control study to investigate clinical significance of maternal serum HLA-G for predicting PE. METHODS: A recombinant HLA-G fragment which containing partial sequences of HLA-G α1 and α2 domains was constructed to develop two novel monoclonal antibodies against HLA-G. A novel HLA-G sandwich ELISA which could detect all isoforms of HLA-G was developed. By using the ELISA, predictive effectiveness of maternal serum HLA-G in a retrospective case control study was evaluated. RESULTS: At the first trimester and early second trimester, detection of maternal serum HLA-G had the sensitivity of 54.3% and 48.5% and the specificity of 97.8% and 96.3% in the prediction of PE. These were significantly higher than those at the third trimester (P < 0.05). CONCLUSION: HLA-G isoforms other than HLA-G1/-G5 are expressed in some pregnant women who have low level or lack HLA-G1/-G5. Measurement of all HLA-G isoforms in maternal serum could be used as a clinical test for early prediction of PE.

The effect of anthocyanins supplementation on liver enzymes among patients with metabolic disorders: A systematic review and meta-analysis of randomized clinical trials.

The present study aims to summarize and quantitatively examine the available evidence on the effectiveness of anthocyanin supplementation on liver enzymes among patients with metabolic disorders, by employing a systematic review and meta-analytic approach. Online databases including PubMed/Medline, Scopus, ISI Web of Science, and Cochrane Library were searched up to June 2020 for randomized controlled trials (RCTs) that examined the effect of anthocyanin supplementation on serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) among patients with metabolic disorders. To estimate the overall effect of anthocyanin supplementation, we employed the random-effects model. In total, 12 RCTs were included in the systematic review. Pooled analysis did not show any significant changes in ALT (WMD: -0.92 U/L, 95% CI: -4.19 to 2.35, p = .58; I2  = 91.3%) and AST (WMD: -1.22 U/L, 95% CI: -3.43 to 0.99, p = .28; I2  = 87.0) concentrations after supplementation with anthocyanin. The dose and duration of supplementation were the potential sources of heterogeneity among most of the trials. However, subgroup analysis showed that the effect is not statistically significant in all subgroups. Overall, in our study, anthocyanin does not have any effect on liver enzyme levels significantly. However, future high-quality studies are still needed to confirm the results.

Therapeutic effects of Yiqi Huoxue prescription on diabetic nephropathy: a meta-analysis and systematic review.

BACKGROUND: Traditional Chinese medicine (TCM) has demonstrated excellent effects in treating diabetic nephropathy, and Yiqi Huoxue prescription has been widely used clinically. In the study, its effects on the kidney function and blood glucose of patients were explored. METHODS: Chinese and English databases including PubMed, Medline, Embase, and Web of Sciences were used to retrieve articles comparing the treatment of diabetic nephropathy using Yiqi Huoxue prescription on the basis of conventional Western medicine treatment (experimental group) and conventional Western medicine treatment alone (control group) published from January 2000 to December 2020. The risk of bias assessment tool of the Cochrane System Review Manual 5.2.2 and the Jadad scale were used to evaluate the quality of the included literature. The outcome indexes were extracted, and the Review Manager 5.3 software was used for meta-analysis. RESULTS: A total of 13 articles that satisfied the inclusion/exclusion criteria were included in this study. After treatment, compared to the control group, the experimental group exhibited lower urine microalbumin excretion rate (UAER) [mean difference (MD) =-33.94, 95% confidence interval (CI), -42.60 to -25.28, P<0.00001], serum creatinine (SCr) (MD =-7.43, 95% CI, -11.50 to -3.36, P=0.0004), blood urea nitrogen (BUN) (SMD =-1.23, 95% CI, -2.49 to 0.03, P=0.04), blood glucose-related indexes [fasting blood glucose (FBG)] (MD =-0.43, 95% CI, -0.87 to 0.01, P=0.03), glycosylated hemoglobin (HbA1c) (MD =-0.38, 95% CI, -0.68 to -0.08, P=0.01), blood lipid-related indexes [triglycerides (TG)] (MD =-0.44, 95% CI, -0.76 to -0.13, P=0.006), and serum total cholesterol (TC) (MD =-0.37, 95% CI, -0.57 to -0.18, P=0.0002). Furthermore, the experimental group also showed higher effectiveness rate (odds ratio =3.81, 95% CI, 2.71 to 5.35, P<0.00001) after treatment. DISCUSSION: The included literature had low bias risk. Yiqi Huoxue prescription on the basis of conventional Western medicine can significantly improve the renal function and reduce the levels of blood glucose and blood lipids of patients with diabetic nephropathy.

Ramie Yield Estimation Based on UAV RGB Images.

Timely and accurate crop growth monitoring and yield estimation are important for field management. The traditional sampling method used for estimation of ramie yield is destructive. Thus, this study proposed a new method for estimating ramie yield based on field phenotypic data obtained from unmanned aerial vehicle (UAV) images. A UAV platform carrying RGB cameras was employed to collect ramie canopy images during the whole growth period. The vegetation indices (VIs), plant number, and plant height were extracted from UAV-based images, and then, these data were incorporated to establish yield estimation model. Among all of the UAV-based image data, we found that the structure features (plant number and plant height) could better reflect the ramie yield than the spectral features, and in structure features, the plant number was found to be the most useful index to monitor the yield, with a correlation coefficient of 0.6. By fusing multiple characteristic parameters, the yield estimation model based on the multiple linear regression was obviously more accurate than the stepwise linear regression model, with a determination coefficient of 0.66 and a relative root mean square error of 1.592 kg. Our study reveals that it is feasible to monitor crop growth based on UAV images and that the fusion of phenotypic data can improve the accuracy of yield estimations.

Entecavir-induced interferon-λ1 suppresses type 2 innate lymphoid cells in patients with hepatitis B virus-related liver cirrhosis.

The immunomodulatory effects of entecavir (ETV) in anti-hepatitis B virus (HBV) therapy have long been recognized. This study aimed to determine the effects of ETV on non-natural killer innate lymphoid cells (non-NK ILCs) in HBV-related liver disease progression. We enrolled treatment-naïve chronic hepatitis B (CHB) and HBV-related liver cirrhosis (LC) patients treated with ETV for 24 months. Before and after therapy, the frequency and cytokine profiles of ILC2s and non-NK ILCs subset homeostasis and their clinical significance were determined, and serial serum interferon (IFN)-λ levels were analysed. Peripheral blood mononuclear cells (PBMCs) of untreated LC patients were cultured with serum from untreated and ETV-treated LC patients in addition to being subject to IFN-λ1 neutralization and stimulation, and the frequency and cytokine production of ILC2s as well as non-NK ILCs subset ratios were calculated. Furthermore, IFN-λ receptor expression on non-NK ILCs and dendritic cells (DCs) was measured. After 24 months of ETV treatment, the frequency and cytokine production of ILC2s (IL-4, IL-13, IFN-γ, TNF-α) decreased with increased ILC1/ILC2 and decreased ILC2/ILC3 ratios, revealing a close association with disease status in LC patients. Long-term ETV administration-induced serum IFN-λ1 levels were negatively correlated with ILC2s. ETV-treated LC serum culture and IFN-λ1 stimulation yielded similar effects on suppression of ILC2s, and IFN-λ1 neutralization in serum culture partly inhibited this effect. The IFN-λ receptor was detected on DCs but not on non-NK ILCs. In conclusion, ETV suppresses the frequency and cytokine profiles of ILC2s by increasing IFN-λ1 in LC patients.

Use of routine computed tomography scans for detecting osteoporosis in thoracolumbar vertebral bodies.

OBJECTIVE: This study observed the distribution of CT attenuation values for T10-L3 vertebral bodies and derived the Hounsfield unit (HU) thresholds using the quantitative computed tomography (QCT) as a reference to predict osteoporosis and normal bone density. METHODS: We included 482 subjects who were scheduled to undergo CT lung cancer screening and pulmonary nodule follow-up from May 2015 to February 2019. The subjects were scanned with the calibration phantom beneath the back while performing a chest CT scan. The volumetric bone mineral density (vBMD) and CT attenuation values of T10-L3 vertebral bodies were measured, and the correlation between the two measurements was analyzed. Receiver operator characteristic (ROC) curves were generated to determine diagnostic optimal thresholds. RESULTS: A total of 2716 vertebral bodies of 457 participants were measured after exclusion screening. CT attenuation value of each plane's vertebral body showed a strong correlation with vBMD. The optimal threshold of > 141 HU was 93.5% sensitive and 86.1% specific for the recognition of normal BMD. The optimal threshold of < 102.4 HU was 96.9% specific and 82.1% sensitive for distinguishing osteoporosis from osteopenia and normal BMD. The average CT attenuation values of vertebral bodies with compressed and normal morphology were 108.9 ± 20.6 and 136.8 ± 32.2 HU, respectively. CONCLUSION: Sagittal reconstruction of the thoracic vertebrae using routine thoracic CT image combined with CT attenuation value measurements of the spine is valuable for predicting bone mineral density in high-risk populations. The mean CT attenuation values of the vertebral bodies with vertebral compression appearance were lower than that of normal vertebral shape.

Hierarchical Toughening of a Biomimetic Bulk Cement Composite.

Because of the inherent quasibrittleness and heterogeneity, matrix-directed toughening of concrete and cement composites remains to be a huge challenge. Herein, inspired by nacre materials, a novel biomimetic bulk cement composite is fabricated via a facile and efficient process based on compacting prefabricated multisized cement-polymer hybrid prills. This method combines with the three-dimensional "brick-bridge-mortar" structure design and synchronously the intrinsic and extrinsic toughening strategies. Such an approach shows the remarkable maximum toughness enhancement of 27-fold with 71% increase in flexural strength via cooperation with only 4 wt % organic matter. More attractively, it alters the traditional brittle fracture of cement composites to a distinct ductile fracture. In addition, such a biomimetic composite demonstrates the long-term ever-increasing strength and toughness, performing the excellent ductile-fracture retention ability. The hierarchical toughening mechanisms are further revealed with the synergy of microscopic characterizations and simulation methods. This strategy provides a new route for the development of high toughness biomimetic cement-based materials for potential applications in civil engineering domain.

Experimental Study on Mechanical and Functional Properties of Reduced Graphene Oxide/Cement Composites.

This study develops a novel self-sensing cement composite by simply mixing reduced graphene oxide (rGO) in cementitious material. The experimental results indicate that, owing to the excellent dispersion method, the nucleation and two-dimensional morphological effect of rGO optimizes the microstructure inside cement-based material. This would increase the electric conductivity, thermal property and self-induction system of cement material, making it much easier for cementitious material to better warn about impending damage. The use of rGO can improve the electric conductivity and electric shielding property of rGO-paste by 23% and 45%. The remarkable enhancement was that the voltage change rate of 1.00 wt.%-rGO paste under six-cycle loads increased from 4% to 12.6%, with strain sensitivity up to 363.10, without compromising the mechanical properties. The maximum compressive strength of the rGO-mortar can be increased from 55 MPa to 71 MPa. In conclusion, the research findings provide an effective strategy to functionalize cement materials by mixing rGO and to achieve the stronger electric shielding property and higher-pressure sensitivity of rGO-cement composites, leading to the development of a novel high strength self-sensing cement material with a flexural strength up to 49%.

Serum amyloid A levels in patients with liver diseases.

BACKGROUND: Serum amyloid A (SAA) is an acute phase protein mainly synthesized by the liver. SAA induces inflammatory phenotype and promotes cell proliferation in activated hepatic stellate cells, the major scar forming cells in the liver. However, few studies have reported on the serum levels of SAA in human liver disease and its clinical significance in various liver diseases. AIM: To investigate the serum levels of SAA in patients with different liver diseases and analyze the factors associated with the alteration of SAA levels in chronic hepatitis B (CHB) patients. METHODS: Two hundred and seventy-eight patients with different liver diseases and 117 healthy controls were included in this study. The patients included 205 with CHB, 22 with active autoimmune liver disease (AILD), 21 with nonalcoholic steatohepatitis (NASH), 14 with drug-induced liver injury (DILI), and 16 with pyogenic liver abscess. Serum levels of SAA and other clinical parameters were collected for the analysis of the factors associated with SAA level. Mann-Whitney U test was used to compare the serum SAA levels of patients with various liver diseases with those of healthy controls. Bonferroni test was applied for post hoc comparisons to control the probability of type 1 error (alpha = 0.05/6 = 0.008). For statistical tests of other variables, P < 0.05 was considered statistically significant. Statistically significant factors determined by single factor analysis were further analyzed by binary multivariate logistic regression analysis. RESULTS: All patients with active liver diseases had higher serum SAA levels than healthy controls and the inactive CHB patients, with the highest SAA level found in patients with pyogenic liver abscess (398.4 ± 246.8 mg/L). Patients with active AILD (19.73 ± 24.81 mg/L) or DILI (8.036 ± 5.685 mg/L) showed higher SAA levels than those with active CHB (6.621 ± 6.776 mg/L) and NASH (6.624 ± 4.891 mg/L). Single (P < 0.001) and multivariate logistic regression analyses (P = 0.039) for the CHB patients suggested that patients with active CHB were associated with an SAA serum level higher than 6.4 mg/L. Serum levels of SAA and CRP (C-reactive protein) were positively correlated in patients with CHB (P < 0.001), pyogenic liver abscess (P = 0.045), and active AILD (P = 0.02). Serum levels of SAA (0.80-871.0 mg/L) had a broader fluctuation range than CRP (0.30-271.3 mg/L). CONCLUSION: Serum level of SAA is a sensitive biomarker for inflammatory activity of pyogenic liver abscess. It may also be a weak marker reflecting milder inflammatory status in the liver of patients with CHB and other active liver diseases.

Determination of Aggregate Surface Morphology at the Interfacial Transition Zone (ITZ).

Here, we present a comprehensive method to illustrate the uneven distribution of the interfacial transition zone (ITZ) around the aggregate and the effect of aggregate surface morphology on the formation of ITZ. First, a model concrete sample is prepared with a spherical ceramic particle in roughly the central part of the cement matrix, acting as a coarse aggregate used in common concrete/mortar. After curing until the designed age, the sample is scanned by X-ray computed tomography to determine the relative location of the ceramic particle inside the cement matrix. Three locations of the ITZ are chosen: above the aggregate, on the side of the aggregate, and below the aggregate. After a series of treatments, the samples are scanned with a SEM-BSE detector. The resultant images were further processed using a digital image processing method (DIP) to obtain quantitative characteristics of the ITZ. The surface morphology is characterized at the pixel level based on the digital image. Thereafter, K-means clustering method is used to illustrate the effect of surface roughness on ITZ formation.

5S Multifunctional Intelligent Coating with Superdurable, Superhydrophobic, Self-Monitoring, Self-Heating, and Self-Healing Properties for Existing Construction Application.

There is a constant drive to develop ultra-high-performance multifunctional coatings for existing construction used in modern engineering technologies. For these materials to be used in unsound infrastructure protections, they are required to present enhanced robustness while bearing functionalities to meet multiple uses. Single-function coating is not smart enough to provide satisfactory protection, and the preparation process of multifunctional materials is complex, costly, and provides poor durability. Thus, existing coatings are not suitable to generate an intelligent closed-loop protection system. Herein, we report an innovative 5S multifunctional intelligent coating (5SC) for existing construction materials with superdurable, superhydrophobic, self-monitoring, self-heating, and self-healing properties. The 5SC material showed highly durable superhydrophobic properties as revealed by the main failure tests of building materials including physical friction (abrasion, scratching), 100% tensile strain, photoaging (3000 h of ultraviolet (UV) aging), acid corrosion (concentrated hydrochloric acid and sulfuric acid), and freeze-thaw aging (salty solution). The coated surface was highly sensitive to pressure, with monitoring thresholds from 1 to 30 000 N per 0.01 m2. It showed an early heating rate as high as 6 °C/min while maintaining very good self-monitoring and ice-melting drainage performance to protect the existing structures. This novel composite material is suitable for constructions in extreme areas where corrosion and freeze-thaw damage can occur. This multifunctional material presents a very broad range of applications and development potential in the construction field.

The efficacy of fascia iliaca compartment block for pain control after hip arthroplasty: A meta-analysis.

PURPOSE: To assess the effect of fascia iliaca compartment block (FICB) on pain control and morphine consumption in patients with total hip arthroplasty (THA). METHODS: We searched databases (PubMed, Embase, Cochrane Library) for eligible randomized controlled trials (RCTs) published prior to September 12, 2018. We only included THA patients who received FICB versus placebo for pain control. Risk ratios (RRs), standard mean differences (SMD) and 95% confidence intervals (CI) were determined. Stata 12.0 was used for the meta-analysis. RESULTS: A total of 326 THA patients from 7 RCTs were subjected to meta-analysis. Overall, FICB was associated with lower VAS scores at 1-8 h and 12 h compared with placebo (P < 0.05). However, there was no significant difference between VAS at 24 h (SMD = -0.56, 95% CI [-1.42, 0.31], P = 0.206) and 48 h after THA (SMD = -0.82, 95% CI [-2.07, 0.44], P = 0.204). Compared with the control group, FICB significantly decreased the occurrence of nausea (RR = 0.41, 95% CI 0.25 to 0.69, P = 0.010; I2 = 0.0%). There was no significant difference in the risk of falls between the FICB and control groups (P > 0.05). CONCLUSIONS: FICB has a beneficial role in reducing pain intensity and morphine consumption after THA. Moreover, FICB has morphine-sparing effects when compared with a control group. More high-quality RCTs are needed to identify the optimal technique and volume of injectate for FICB.

Optimal strategies for the prevention of heterotopic ossification after total hip arthroplasty: A network meta-analysis.

BACKGROUND: Nonselective nonsteroidal anti-inflammatory drugs (NSAIDs), selective NSAIDs, and radiation are widely used for the prevention of heterotopic ossification (HO) after total hip arthroplasty (THA). Previous studies have suggested that nonselective NSAIDs, selective NSAIDs and radiation can prevent HO after THA, though the results are conflicting. In this network meta-analysis, we aimed to comprehensively analyze the efficacy and safety of three strategies for preventing HO after THA compared to a placebo. PATIENTS AND METHODS: Relevant studies about nonselective NSAIDs, selective NSAIDs, radiation and controls that were used to prevent HO after THA were collected. Data were extracted independently by two reviewers. Network meta-analysis was applied to assess treatment efficacy and safety. The surface under the cumulative ranking curve (SUCRA) method was used to assess which treatment was ranked the highest. The node-splitting method was used to calculate inconsistency. RESULTS: Radiation was found to be the most efficient option for preventing overall incidence of HO and Brooker IV, I, II and III HO after THA. Selective NSAIDs were the safest option, and radiation was ranked second for preventing HO after THA, as the treatments were ranked taking discontinuation caused by nongastrointestinal side effects (DNGSE) and the incidence of complications into consideration. CONCLUSIONS: A network meta-analysis concluded that radiation is the most efficacious method for preventing HO after THA.

Is opening-wedge high tibial osteotomy superior to closing-wedge high tibial osteotomy in treatment of unicompartmental osteoarthritis? A meta-analysis of randomized controlled trials.

BACKGROUND: High tibial osteotomy (HTO) is an effective surgical technique that can stop or inhibit progression of knee osteoarthritis (OA) and avoid or postpone the need for knee arthroplasty. This meta-analysis determined whether opening-wedge high tibial osteotomy (OWHTO) was superior to closing-wedge high tibial osteotomy (CWHTO) in treatment of unicompartmental OA. METHODS: Databases (PubMed, Embase, Web of Science, Cochrane Library and Google) were searched from the time of their establishment to 1st August 2018 for randomized controlled trials (RCTs) comparing OWHTO and CWHTO in patients with unicompartmental OA. The Cochrane risk of bias tool was used to assess methodological quality. Statistical analysis was performed with Stata 12.0. RESULTS: Nine RCTs (599 participants) were included in this meta-analysis. The pooled results showed that there were no significant differences between OWHTO and CWHTO VAS knee pain scores, HSS knee scores, walking distances or hip-knee-ankle (HKA) angles (P > 0.05). Furthermore, there were no significant differences between the two groups in complication and survival rates (p > 0.05). Nevertheless, there was a significantly greater tibial slope angle in OWHTO patients (P < 0.00001). CONCLUSION: CWHTO reduced the inclination of the tibial plateau, whereas OWHTO increased the posterior tilt, and these factors should be considered in the specific need of an individual patient when choosing the type of osteotomy. Therefore, we are unable to conclude which method is superior.