Comparison of clinical efficacy of robot-assisted and freehand core decompression in the treatment of osteonecrosis of the femoral head: a systematic review and meta-analysis.

OBJECTIVE: At present, the core decompression (CD) has become the main surgical procedure for the treatment of osteonecrosis of the femoral head (ONFH); however, the CD surgery requires high operator experience and repeated fluoroscopy increases the radiation damage to patients, and medical staff. This article compares the clinical efficacy of robot-assisted and freehand CD for ONFH by meta-analysis. METHODS: Computer searches of PubMed, Web of Science, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, WanFang, and Chinese BioMedical Literature Database were conducted from the time of database inception to November 15, 2023. The literature on the clinical efficacy of robot-assisted and freehand CD in the treatment of ONFH was collected. Two researchers independently screened the literature according to the inclusion and exclusion criteria, extracted data, and strictly evaluated the quality of the included literature. Outcome measures encompassed operative duration, intraoperative blood loss volume, frequency of intraoperative fluoroscopies, visual analog scale (VAS) score, Harris hip score (HHS), complications, and radiographic progression. Data synthesis was carried out using Review Manager 5.4.1 software. The quality of evidence was evaluated according to Grades of Recommendation Assessment Development and Evaluation (GRADE) standards. RESULTS: Seven retrospective cohort studies involving 355 patients were included in the study. The results of meta-analysis showed that in the robot-assisted group, the operative duration (MD = -17.60, 95% CI: -23.41 to -11.78, P < 0.001), intraoperative blood loss volume (MD = -19.98, 95% CI: -28.84 to -11.11, P < 0.001), frequency of intraoperative fluoroscopies (MD = -6.60, 95% CI: -9.01 to -4.20, P < 0.001), and ΔVAS score (MD = -0.45, 95% CI: -0.67 to -0.22, P < 0.001) were significantly better than those in the freehand group. The GRADE evidence evaluation showed ΔVAS score as low quality and other indicators as very low quality. There was no significant difference in the terms of ΔHHS (MD = 0.51, 95% CI: -1.34 to 2.35, P = 0.59), complications (RR = 0.30, 95% CI: 0.03 to 2.74, P = 0.29), and radiographic progression (RR = 0.50, 95% CI: 0.25 to 1.02, P = 0.06) between the two groups. CONCLUSION: There is limited evidence showing the benefit of robot-assisted therapy for treatment of ONFH patients, and much of it is of low quality. Therefore, caution should be exercised in interpreting these results. It is recommended that more high-quality studies be conducted to validate these findings in future studies. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/ #recordDetails, CRD42023420593.

Simultaneous cluster structure learning and estimation of heterogeneous graphs for matrix-variate fMRI data.

Graphical models play an important role in neuroscience studies, particularly in brain connectivity analysis. Typically, observations/samples are from several heterogenous groups and the group membership of each observation/sample is unavailable, which poses a great challenge for graph structure learning. In this paper, we propose a method which can achieve Simultaneous Clustering and Estimation of Heterogeneous Graphs (briefly denoted as SCEHG) for matrix-variate functional magnetic resonance imaging (fMRI) data. Unlike the conventional clustering methods which rely on the mean differences of various groups, the proposed SCEHG method fully exploits the group differences of conditional dependence relationships among brain regions for learning cluster structure. In essence, by constructing individual-level between-region network measures, we formulate clustering as penalized regression with grouping and sparsity pursuit, which transforms the unsupervised learning into supervised learning. A modified difference of convex programming with the alternating direction method of multipliers (DC-ADMM) algorithm is proposed to solve the corresponding optimization problem. We also propose a generalized criterion to specify the number of clusters. Extensive simulation studies illustrate the superiority of the SCEHG method over some state-of-the-art methods in terms of both clustering and graph recovery accuracy. We also apply the SCEHG procedure to analyze fMRI data associated with attention-deficit hyperactivity disorder (ADHD), which illustrates its empirical usefulness.

Effects of blood pressure and antihypertensive drugs on osteoarthritis: a mendelian randomized study.

BACKGROUND: Previous studies have suggested that antihypertensive drugs may play a role in the treatment of osteoarthritis, but these studies may be limited by confounding factors and lead to biased results. Therefore, we conducted a Mendelian randomization study to investigate the effects of blood pressure and antihypertensive drugs on osteoarthritis. METHODS: We used published large-scale genome-wide association data and applied univariate and multivariate Mendelian randomization methods. The main analysis model was inverse variance weighting, and the reliability of the results was tested using MR-Egger intercept analysis, Cochran's Q test, and leave-one-out analysis. We comprehensively evaluated the relationship between systolic blood pressure, diastolic blood pressure, 12 antihypertensive drugs, and osteoarthritis. We also conducted verification in the independent queue of UK Biobank and built a simple linear regression model to obtain an independent comparison. RESULTS: We found no evidence that systolic and diastolic blood pressure significantly affected osteoarthritis. However, among antihypertensive drugs, we observed a significant positive correlation between potassium-preserving diuretics and aldosterone antagonists and all osteoarthritis (OR: 0.560, 95% CI 0.406-0.772, P = 0.0004). Sensitivity analysis showed no horizontal pleiotropy or heterogeneity, and the leave-one-out analysis demonstrated the reliability of the results. This result was replicated with nominally statistical significance in the validation cohort and exhibited significant correlation in the linear regression analysis. CONCLUSIONS: Our study suggested that controlling the protein targets of potassium-sparing diuretics and aldosterone antagonists may have beneficial results for osteoarthritis. These findings provide valuable medication strategies for the control of hypertension in patients with osteoarthritis.

Evaluating the Effects of Cu2+ on the Development and Reproduction of Spodoptera litura (Lepidoptera: Noctuidae) Based on the Age-Stage, Two-Sex Life Table.

Copper (Cu2+) is a micronutrient that promotes the development and reproduction of organisms. However, with the rapid expansion of modern industry and agriculture, Cu2+ concentrations are increasing, which might have negative impacts on biological and ecological safety. Spodoptera litura is not only an intermittent outbreak pest but also can be used as a model organism to assess environmental and ecological risks. Therefore, the effects of the life history and population parameters of S. litura fed on artificial diets with different Cu2+ concentrations were analyzed using the age-stage, two-sex life table. Our results showed that not only the preadult survival rate but also the intrinsic rate of increase (r) and the finite rate of increase (λ) were significantly increased under exposure to low Cu2+ concentrations (2, 4, and 8 mg/kg). In addition, the population growth of S. litura was significantly faster, indicating that S. litura can adapt well to low concentrations and is likely to undergo outbreaks of damage. Whereas, in addition to a significant reduction in preadult survival rate, population growth rate, pupal weight, pupal length, adult body weight, and oviposition were also significantly reduced under exposure to high Cu2+ concentration (32 mg/kg). And when the concentration reached 64 mg/kg, the survival rate of adults was extremely low, suggesting a decrease in the adaptation of S. litura. These results can help to understand the population dynamics of S. litura and predict potential ecological risks.

Preparation of hollow-fiber nanofiltration membranes of high performance for effective removal of PFOA and high resistance to BSA fouling.

Nanofiltration (NF) process has become one of the most promising technologies to remove micro-organic combined water pollution. Developing a NF membrane material with efficient separation for perfluorooctanoic acid (PFOA) combined pollution is highly desired, this manuscript targets this unmet need specifically. In this work, hydrophilic SiO2 nanoparticles with various contents blended with carboxylic multiwalled carbon nanotube were used to modify poly (m-phenylene isophthal amide) (SiO2/CMWCNT/PMIA) hollow fiber NF membrane. The modified membrane with 0.1 wt% SiO2 doping exhibits way better fouling resistance with irreversible fouling ratio decreased dramatically from 18.7% to 2.3%, and the recovery rate of water flux increases significantly from 81.2% to 97.7%. The separation experiment results had confirmed that the modified membrane could improve the rejection from 97.2% to 98.6% for perfluorooctanoic acid (PFOA) and its combined pollution with bovine serum albumin (BSA). It is clear that this reported SiO2/CMWCNT/PMIA hollow fiber NF membrane potentially could be applied in water treatment. This research also provides a theoretical basis for efficiently removal of PFOA and its combined pollution by NF membrane.

The Influence of Gut Microbiota on the Fecundity of Henosepilachna vigintioctopunctata (Coleoptera: Coccinellidae).

The gut microbiota of insects usually plays an important role in the development and reproduction of their hosts. The fecundity of Henosepilachna vigintioctopunctata (Fabricius) varies greatly when they develop on different host plants. Whether and how the gut microbiota regulates the fecundity of H. vigintioctopunctata was unknown. To address this question, we used 16S rRNA sequencing to analyze the gut microbiomes of H. vigintioctopunctata adults fed on two host plant species (Solanum nigrum and Solanum melongena) and one artificial diet. The development of the ovaries and testes was also examined. Our results revealed that the diversity and abundance of gut microorganisms varied significantly in insects reared on different diets. The gut microbiota of H. vigintioctopunctata raised on the two host plants was similar, with Proteobacteria being the dominant phylum in both groups, whereas Firmicutes was the dominant phylum in the group reared on the artificial diet. The predominant microbiota in the S. nigrum group were Acinetobacter soli and Acinetobacter ursingii (Acinetobacter, Moraxellaceae); Moraxella osloensis (Enhydrobacter, Moraxellaceae); and Empedobacter brevis (Empedobacter, Weeksellaceae). The microbiota in this group are associated with high lipid metabolism. In addition, the beetles' ovaries and testes were more highly developed in the S. nigrum group than in the other two groups. These findings provide valuable information for elucidating the complex roles the gut microbiota play in the fecundity of H. vigintioctopunctata, and may also contribute to developing future novel control strategies involving this economically important pest.

Insight into the influence of humic acid and sodium alginate fractions on membrane fouling in coagulation-ultrafiltration combined system.

Membrane fouling has become the one of main obstacles for the widespread application of membrane technology in water treatment processes. Coagulation as pretreatment is proven to be effective for the alleviation of membrane fouling. In this study, the influence of humic acid (HA)/sodium alginate (SA) fractions in the structure and resistance of cake layer on the membrane surface was investigated. The presence of SA at an appropriate fraction could facilitate the formation of large and loosely branched flocs and thereby form a more permeable cake layer on the membrane surface due to good bridging and charge neutralization abilities of SA molecules. The particle image velocimetry (PIV) technique was employed for monitoring the dynamic formation process of cake layer under different HA/SA fractions. The cake layer with a higher thickness was observed to be rapidly formed on the membrane surface at the presence of SA in water. According to the theoretical analysis, the membrane fouling in coagulation-ultrafiltration (UF) combined system demonstrated to be highly dependent on the size and intra-porosity of flocs. The fractal dimension of flocs might have an impact on the resistance of cake layer through affecting the porosity of aggregated flocs. The SA molecules could be used as the coagulant aid for effective alleviation of membrane fouling and the improvement of filtration performance in a coagulation-UF combined system.

Influence of incorporating beta zeolite nanoparticles on water permeability and ion selectivity of polyamide nanofiltration membranes.

A novel polyamide (PA) thin film nanocomposite (TFN) membrane modified with Beta (ß) zeolite was prepared by interfacial polymerization on a poly (ether sulfone) (PES) ultrafiltration membrane. Compared with the PA thin film composite (TFC) membrane, the introduction of ß zeolite with porous structure notably increased the water flux of TFN membrane. Because the ß zeolite with tiny-sized and well-defined inner-porous acted as prior flow channels for water molecules and a barrier for the sulfate ions. The successful introduction of ß zeolite into the (PA) selective layer and their dispersion in the corresponding layer were verified by scanning electron microscope (SEM) and atomic force microscopy (AFM). Water contact angle, zeta potential measurements were used to characterize the changes of membrane surface properties before and after incorporating the ß zeolite. With the ß zeolite introducing, the water contact angle of modified TFN membrane was decreased to 47.8°, which was benefited to improve the water flux. Meanwhile, the negative charges of the modified TFN membrane was increased, resulting in an enhancement of separation effect on SO42- and Cl-. In term of nanofiltration (NF) experiments, the highest pure water flux of the TFN membranes reached up to 81.22 L m-2 hr-1 under operating pressure of 0.2 MPa, which was 2.5 times as much as the pristine TFC membrane.

Preparation of SGO-modified nanofiltration membrane and its application in SO42- and Cl- separation in salt treatment.

The lack of fresh water in the world makes the search for an effective method to decontaminate water an urgent priority. An important step is to remove different multivalent ions in salt treatment. Nanofiltration (NF) has been used for treating water containing different kinds of salts. In this work, sulfonate group-modified graphene oxide (SGO) was prepared, and added during the interfacial polymerization (IP) reaction to prepare SGO-modifiedNF membranes (PA-SGO). The chemical composition, structure and surface properties of PA and PA-SGO membranes were characterized by FT-IR, XPS, SEM, AFM, contact angle and zeta potential measurements. Their water flux, salt rejection and anti-fouling abilities were investigated systematically. The testing results showed that the water flux of PA-SGO (0.03% SGO) was 45.85 LMH under a pressure of 0.2 MPa, and the salt rejection varied in the order of Na2SO4 (98.99%) > MgSO4 (91.25%) > MgCl2 (42.27%) > NaCl (21.96%). An anti-fouling experiment indicated that the PA-SGO membrane had good anti-fouling properties because of its decreased roughness and increased hydrophilicity and electronegativity. The PA-SGO membrane has good potential for use in removing salt ions from water.

Preparation, characterization and performance of poly(m-phenylene isophthalamide)/organically modified montmorillonite nanocomposite membranes in removal of perfluorooctane sulfonate.

Nanocomposite membranes containing poly(m-phenylene isophthalamide) (PMIA) and organically modified montmorillonite (OMMT) were prepared by a combination of solution dispersion and wet-phase inversion methods, and the effects of OMMT addition on the properties and performance of fabricated nanofiltration membranes were investigated. The membranes were characterized by contact angle measurements, scanning electron microscopy (SEM), atomic force microscopy (AFM), thermogravimetric analysis, and zeta potential. The performance of the membranes was elucidated by the removal of perfluorooctane sulfonate (PFOS) at neutral pH. Increasing OMMT concentration improved the thermal stability and hydrophilicity of the membranes. The permeation and rejection of PFOS were significantly improved. The performance of fabricated nanofiltration membranes in removal of PFOS varied depending on the solute and membrane properties as well as solution conditions. Finally, a comparison between fabricated membranes and a commercial NF membrane (ESNA1-K1, Hydecanme) proved that the OMMT addition is a convenient procedure for producing nanocomposite membranes with superior properties and performance.

Exploring the association between grip strength and adverse pregnancy and perinatal outcomes: A Mendelian randomization study.

Background: Previous observational studies have demonstrated an association between grip strength and detrimental pregnancy and perinatal outcomes. However, the causality of this relationship remains uncertain. Objective: This study aims to investigate if there is a causal relationship between grip strength and adverse pregnancy and perinatal outcomes, providing evidence to support active intervention for adverse pregnancy outcomes. Study design: A two-sample Mendelian randomization method was used to select GWAS data from the UK Biobank and the FinnGen Biobank as data sources. The inverse variance weighting method was used as the main analysis method. The reliability of the results was verified through sensitivity analysis, including Cochran's Q test, MR-egger intercept regression analysis, leave-one-out analysis, and funnel plot. Independent queues are also used to verify the reliability of the results. Results: The study demonstrated a significant positive correlation between genetically predicted hand grip strength and offspring birth weight, specifically left-hand grip strength (ß = 0.193, 95 % CI: 0.099-0.286, p = 0.0001) and right-hand grip strength (ß = 0.310, 95 % CI: 0.235-0.384, p = 3.27E-16). Sensitivity analysis indicated no horizontal multi-effect, and leave-one-out analysis along with the funnel plot showed no abnormalities. The verification queue also yielded similar results. Conclusion: This study revealed a significant association between grip strength-related traits and offspring birth weight, suggesting a potential protective effect. Moreover, a negative predictive trend was observed for other adverse pregnancy outcomes. Modifying grip strength through an active lifestyle and continuous monitoring of pregnant women's grip strength may have implications for improving pregnancy outcomes. However, further research is warranted to investigate these findings more comprehensively.

Clinical evaluation of platelet-rich plasma therapy for osteonecrosis of the femoral head: A systematic review and meta-analysis.

OBJECTIVE: This meta-analysis aims to assess the efficacy and safety of platelet-rich plasma (PRP) for osteonecrosis of the femoral head (ONFH). METHODS: We comprehensively searched randomized controlled trials in PubMed, Web of Science, EMBASE, the Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, WanFang, and Chinese BioMedical Literature Database from inception until October 25, 2024. The literature on the clinical efficacy of autologous PRP for ONFH was collated. According to the inclusion and exclusion criteria, the literature was screened, quality evaluated and the data was extracted. Meta-analysis was carried out with the software Review Manager 5.4.1 software and Stata 17.0 software. In addition, potential publication bias was detected by the funnel plot test and Egger's test. The GRADE system was used to evaluate the quality of evidence for outcome indicators. RESULTS: Fourteen studies involving 909 patients were included in this study. Compared with non-PRP, PRP exhibited significant improvements in the Harris hip score (HHS) at 3 months (MD = 3.58, 95% Cl: 1.59 to 5.58, P = 0.0004), 6 months (MD = 6.19, 95% Cl: 3.96 to 8.41, P < 0.00001), 12 months (MD = 4.73, 95% Cl: 3.24 to 6.22, P < 0.00001), ≥ 24 months (MD = 6.83, 95% Cl: 2.09 to 11.59, P = 0.0003), and the last follow-up (MD = 6.57, 95% Cl: 4.81 to 8.33, P < 0.00001). The PRP also showed improvement in HHS compared to baseline than the non-PRP at 3 months (MD = 3.60, 95% Cl: 1.26 to 5.94, P = 0.003), 6 months (MD = 6.17, 95% Cl: 3.74 to 8.61, P < 0.00001), 12 months (MD = 5.35, 95% Cl: 3.44 to 7.25, P < 0.00001), ≥ 24 months (MD = 8.19, 95% Cl: 3.76 to 12.62, P = 0.0003), and the last follow-up (MD = 6.94, 95% Cl: 5.09 to 8.78, P < 0.00001). The change in visual analog scale (VAS) score 3 months post intervention (MD = -0.33, 95% Cl: -0.52 to -0.13, P = 0.001), 6 months (MD = -0.69, 95% Cl: -0.90 to -0.48, P < 0.00001), 12 months (MD = -0.75, 95% Cl: -1.05 to -0.46, P < 0.00001), ≥ 24 months (MD = -1.05, 95% Cl: -1.20 to -0.89, P < 0.00001), and the last follow-up (MD = -0.75, 95% Cl: -0.97 to -0.54, P < 0.00001). The PRP also showed a decrease in VAS score compared to baseline than the non-PRP at 3 months (MD = -0.29, 95% Cl: -0.41 to -0.17, P = 0.003), 6 months (MD = -0.63, 95% Cl: -0.96 to -0.30, P = 0.0002), 12 months (MD = -0.78, 95% Cl: -1.22 to -0.33, P = 0.0006), ≥ 24 months (MD = -1.11, 95% Cl: -1.27 to -0.96, P < 0.00001), and the last follow-up (MD = -0.74, 95% Cl: -1.05 to -0.43, P < 0.00001). Additionally, it was found that the PRP group had the advantages in the following aspects: collapse rate of the femoral head (RR = 0.33, 95% Cl: 0.17 to 0.62, P = 0.0006), rate of conversion to total hip arthroplasty (RR = 0.37, 95% Cl: 0.18 to 0.74, P = 0.005), and overall complications (RR = 0.33, 95% Cl: 0.13 to 0.83, P = 0.02). The GRADE evidence evaluation showed overall complication as very low quality and other indicators as low quality. CONCLUSION: There is limited evidence showing benefit of PRP therapy for treatment of ONFH patients, and most of this evidence is of low quality. Caution should therefore be exercised in interpreting these results. It is recommended that future research involve a greater number of high-quality studies to validate the aforementioned conclusions. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/ #recordDetails, CRD42023463031.

Causal impact of human blood metabolites and metabolic pathways on serum uric acid and gout: a mendelian randomization study.

Objective: Hyperuricaemia and gout are common metabolic disorders. However, the causal relationships between blood metabolites and serum urate levels, as well as gout, remain unclear. A systematic evaluation of the causal connections between blood metabolites, hyperuricemia, and gout could enhance early screening and prevention of hyperuricemia and gout in clinical settings, providing novel insights and approaches for clinical treatment. Methods: In this study, we employed a bidirectional two-sample Mendelian randomization analysis utilizing data from a genome-wide association study involving 7,286 participants, encompassing 486 blood metabolites. Serum urate and gout data were sourced from the Chronic Kidney Disease Genetics consortium, including 288,649 participants for serum urate and 9,819 African American and 753,994 European individuals for gout. Initially, LDSC methodology was applied to identify blood metabolites with a genetic relationship to serum urate and gout. Subsequently, inverse-variance weighting was employed as the primary analysis method, with a series of sensitivity and pleiotropy analyses conducted to assess the robustness of the results. Results: Following LDSC, 133 blood metabolites exhibited a potential genetic relationship with serum urate and gout. In the primary Mendelian randomization analysis using inverse-variance weighting, 19 blood metabolites were recognized as potentially influencing serum urate levels and gout. Subsequently, the IVW p-values of potential metabolites were corrected using the false discovery rate method. We find leucine (IVW P FDR = 0.00004), N-acetylornithine (IVW P FDR = 0.0295), N1-methyl-3-pyridone-4-carboxamide (IVW P FDR = 0.0295), and succinyl carnitine (IVW P FDR = 0.00004) were identified as significant risk factors for elevated serum urate levels. Additionally, 1-oleoylglycerol (IVW P FDR = 0.0007) may lead to a substantial increase in the risk of gout. Succinyl carnitine exhibited acceptable weak heterogeneity, and the results for other blood metabolites remained robust after sensitivity, heterogeneity, and pleiotropy testing. We conducted an enrichment analysis on potential blood metabolites, followed by a metabolic pathway analysis revealing four pathways associated with serum urate levels. Conclusion: The identified causal relationships between these metabolites and serum urate and gout offer a novel perspective, providing new mechanistic insights into serum urate levels and gout.

Genetic link between depression and musculoskeletal disorders: insights from Mendelian randomization analysis.

Background: The association between depression and musculoskeletal diseases has long been a subject of contentious debate. However, the causal relationship between the two remains uncertain. This study employs a two-sample Mendelian randomization (MR) analysis to investigate the causality between depression and six musculoskeletal diseases. Methods: In this study, we performed MR analysis to systematically explore the causal relationship between depression and six musculoskeletal disorders. Single nucleotide polymorphisms (SNPs) that are linked to depression were employed as instrumental variables. To ensure robust and reliable conclusions, multiple analytical approaches were utilized, including inverse variance weighting(IVW), weighted median, and MR-Egger regression. Additionally, sensitivity analysis methods such as the MR-Egger intercept test, Cochran's Q test, leave-one-out analysis, and funnel plot were employed. Results: Our MR analysis revealed a significant association between depression and cervical spondylosis (depression: OR 1.003, 95% CI 1.002-1.005, P = 8.32E-05; major depressive disorder: OR 1.003, 95% CI 1.001-1.005, P = 0.0052). Furthermore, a strong correlation was noted between major depressive disorder (MDD) and knee osteoarthritis (KOA) (OR 1.299, 95% CI 1.154-1.463, P = 1.50E-5). Sensitivity analysis confirmed the robustness of these findings. Our independent validation study also corroborated these results. Conclusion: The MR analysis conducted in this study provides evidence supporting a genetic link between depression and cervical spondylosis, as well as KOA. Targeted interventions to manage depression in susceptible populations may contribute to lowering the risk of cervical spondylosis and KOA in these cohorts.

Is Ancient Medical Treatment an Option for Curating Osteosarcoma Combined with Chemotherapy? A Basic Analysis of Clinic Pharmacy.

BACKGROUND: As a malignant tumor, osteosarcoma (OS) ranks first place among adolescent cancers and is susceptible to developing resistance to chemotherapeutic agents. Differently, Traditional Chinese medicine (TCM) has multiple pharmacodynamic targets and complex biological components, which can inhibit tumor survival and drug resistance and gradually play an important role in the treatment of sarcoma. METHODS: This study is to systematically evaluate the safety and efficacy of TCM combined with chemotherapy performed in the clinical treatment of OS. Based on multiple mainstream databases, eleven articles on the relationship between natural products and chemotherapy involving 656 patients were selected from all the literature published as of June 2022. Revman 5.4 software was used for a comprehensive search analysis, supplemented by established exclusion criteria, the Jadad scale, and the evaluation methods provided by Cochrane. RESULTS: The efficiency of TCM combined with chemotherapy was significantly increased compared with chemical drugs alone [OR=2.56, 95% CI (1.36,4.79), Z=2.92, P=0.003]. Meanwhile, the adverse reactions such as nausea and vomiting, hepatotoxicity, and hematological changes caused by chemical drugs were alleviated correspondingly. CONCLUSION: This study indicates that the mode of TCM combined with chemotherapy sheds light on the clinical treatment of OS, which is much better than the one-way mode.

Integrated Network Pharmacology and Experimental Validation Approach to Investigate the Mechanisms of Radix Rehmanniae Praeparata - Angelica Sinensis - Radix Achyranthis Bidentatae in Treating Knee Osteoarthritis.

Background: Knee osteoarthritis (KOA) is a persistent degenerative condition characterized by the deterioration of cartilage. The Chinese herbal formula Radix Rehmanniae Praeparata- Angelica Sinensis-Radix Achyranthis Bidentatae (RAR) has often been used in effective prescriptions for KOA as the main functional drug, but its underlying mechanism remains unclear. Therefore, network pharmacology and verification experiments were employed to investigate the impact and mode of action of RAR in the treatment of KOA. Methods: The destabilization of the medial meniscus model (DMM) was utilized to assess the anti-KOA effect of RAR by using gait analysis, micro-computed tomography (Micro-CT), and histology. Primary chondrocytes were extracted from the rib cartilage of a newborn mouse. The protective effects of RAR on OA cells were evaluated using a CCK-8 assay. The antioxidative effect of RAR was determined by measuring reactive oxygen species (ROS), superoxide dismutase (SOD), and glutathione (GSH) production. Furthermore, network pharmacology and molecular docking were utilized to propose possible RAR targets for KOA, which were further verified through experiments. Results: In vivo, RAR significantly ameliorated DMM-induced KOA characteristics, such as subchondral bone sclerosis, cartilage deterioration, gait abnormalities, and the degree of knee swelling. In vitro, RAR stimulated chondrocyte proliferation and the expression of Col2a1, Comp, and Acan. Moreover, RAR treatment significantly reduced ROS accumulation in an OA cell model induced by IL-1ß and increased the activity of antioxidant enzymes (SOD and GSH). Network pharmacology analysis combined with molecular docking showed that Mapk1 might be a key therapeutic target. Subsequent research showed that RAR could downregulate Mapk1 mRNA levels in IL-1ß-induced chondrocytes and DMM-induced rats. Conclusion: RAR inhibited extracellular matrix (ECM) degradation and oxidative stress response via the MAPK signaling pathway in KOA, and Mapk1 may be a core target.

The effects of operating parameters on spiramycin removal by nanofiltration membrane.

Spiramycin removal from wastewater using four nanofiltration (NF) membranes (NF270, NF90, ESNA1-K1 and ESNA1-LF2-LD) was studied. The effects of operating pressure, feed temperature, feed concentration, cation and anion ions on the permeate flux rate and spiramycin rejection were investigated. The results show that increasing operating pressure resulted in the increase of both permeate flux and spiramycin rejection. The flux rate increased almost linearly with temperature, while the spiramycin rejection decreased. The permeate flux rate declined relatively with increasing feed concentration of spiramycin for NF270 and ESNA1-LF2-LD membranes compared with NF90 and ESNA1-K membranes. The presence of cations reduced spiramycin rejection, with the strength of influence for the NF270 NF membrane following the order Mg(2+)>Ca(2+)>K(+). The presence of anions also resulted in decreased spiramycin rejection, the strength of the effect following the order NO(3)(-)>Cl(-)>SO(4)(2-) for the NF270 membrane.

Effects of ion concentration and natural organic matter on arsenic(V) removal by nanofiltration under different transmembrane pressures.

The removal of As(V) from synthetic water was studied using four different nanofiltration (NF) membranes (ESNA-1-K1, NF270, ESNA-1-LF, and HODRA-CORE). The influences of ion concentration, transmembrane pressure (TMP), and the presence of natural organic matter (humic acid, HA) on the arsenic removal efficiency and permeate flux were investigated. The arsenic rejection of ESNA-1-LF was higher than those of the other membranes in all experiments (> 94%), and the HODRA-CORE membrane gave the lowest removal of arsenic (< 47%). An increase in the ion concentration in the feed solution and addition of HA decreased the arsenic rejection of the HODRA-CORE membrane. However, both increasing of the ion concentration and addition of HA made the rejection increased for the other membranes (ESNA-1-K1, NF270, and ESNA-1-LF). With increasing TMP, for all four NF membranes, increases in both arsenic rejection and permeate flux were observed. The permeate fluxes of the four NF membranes decreased to some extent after addition of HA to the solutions for operating time of 6 hr.

Efficacy and safety of traditional Chinese medicine in the treatment of osteonecrosis of the femoral head.

BACKGROUND: Hip joint-preserving treatment options for osteonecrosis of the femoral head (ONFH) have been a research hotspot in recent years. The combination of Chinese and Western medicine has been used in clinical practice to treat early- and mid-stage ONFH. However, there is still a lack of high-quality evidence to verify the effectiveness and safety of this approach. OBJECTIVE: To systematically evaluate the clinical efficacy and safety of the combination of traditional Chinese medicine (TCM) with Western medicine in the treatment of early- and mid-stage ONFH. METHODS: Multiple electronic databases were searched to identify the randomized controlled trials (RCTs) examining the use of TCM in the treatment of ONFH. Based on the inclusion and exclusion criteria, eligible studies were selected, and the quality of the studies was evaluated using the risk of bias assessment tool recommended by the Cochrane system Evaluator manual 5.1.0. The meta-analysis of the included data was performed using Review Manager 5.4.1 software and Stata 17.0 software. RESULTS: A total of 47 RCTs involving 3266 subjects were included in the meta-analysis. The results are observed: (1) Harris score: TCM + Western medicine versus Western medicine (SMD = 1.25, 95% Cl: 1.02 to 1.48, P < 0.00001), TCM + physiotherapy versus physiotherapy (SMD = 2.26, 95% Cl: 1.42 to 3.10, P < 0.00001), and TCM + hip preservation surgery versus hip preservation surgery (SMD = 1.28, 95% Cl: 1.03 to 1.53, P < 0.00001); (2) Visual analogue scale score: TCM + Western medicine versus Western medicine (SMD = -3.99, 95% Cl: -7.41 to -0.57, P = 0.02), TCM + physiotherapy versus physiotherapy (SMD = -0.99, 95% Cl: -1.44 to -0.54, P < 0.0001), and TCM + hip preservation surgery versus hip preservation surgery (SMD = -1.08, 95% Cl: -1.75 to -0.40, P = 0.002); (3) Imaging improvement: TCM + physiotherapy versus physiotherapy (RR = 1.42, 95% Cl: 1.15 to 1.76, P = 0.001) and TCM + hip preservation surgery versus hip preservation surgery (RR = 1.21, 95% Cl: 1.11 to 1.31, P < 0.0001); and (4) Occurrence of adverse reaction: TCM + Western medicine versus Western medicine (RR = 0.73, 95% Cl: 0.28 to 1.92, P = 0.53), TCM + physiotherapy versus physiotherapy (RR = 0.46, 95% Cl: 0.03 to 7.33, P = 0.58), and TCM + hip preservation surgery versus hip preservation surgery (RR = 1.11, 95% Cl: 0.36 to 3.45, P = 0.86). CONCLUSION: TCM combined with Western medicine is an effective and safe approach for the treatment of ONFH. However, due to the low quality and quantity of the included studies, additional large-scale, high-quality studies are required to verify the above conclusions. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/#recordDetails , CRD42023392030.

Physical Activity, Sedentary Behavior, and Osteoarthritis: A Two-Sample Mendelian Randomization Analysis.

Background: Sedentary behavior and physical activity are still ambiguous in their effects on osteoarthritis. We aimed to evaluate the effects of physical activity and sedentary behavior on osteoarthritis to provide a reference for the prevention of osteoarthritis. Methods: This study was conducted in Changchun, China in 2022. We used two-sample Mendelian randomization with the SNP as an instrumental variable to investigate the effect of physical activity and sedentary behavior on osteoarthritis. In addition, a two-step Mendelian randomization method was used to test whether mediating factors (BMI, smoking, Apolipoprotein B) were involved in mediating the effects of exposure factors on osteoarthritis. Results: TV watching was causally related to knee osteoarthritis and spine osteoarthritis, and they were positively correlated (knee osteoarthritis: OR=1.162,95 %CI: 1.027-1.315, P=0.017; spine osteoarthritis: OR=1.208,95 %CI: 1.033-1.413, P=0.018). BMI played a mediating role in the process of TV watching with knee osteoarthritis and spine osteoarthritis. ((The proportion of BMI mediating effect: knee osteoarthritis: 47.1% (95% CI: 36.7%~63.2%); spine osteoarthritis: 29.5% (95% CI: 19.3%~40.8%)). The proportion of Smoking mediating effect in the process of TV watching with spine osteoarthritis was 16.1% (95% CI: 3.7% ~ 31.6%). Conclusion: TV watching is a potential risk factor for osteoarthritis and plays a role through modifiable factors such as BMI and smoking, therefore, interventions on these factors have the potential to reduce the burden of osteoarthritis caused by longer TV watching times.