Lack of Rab27a attenuates foam cell formation and macrophage inflammation in uremic apolipoprotein E knockout mice.

As the most common cardiovascular disease, atherosclerosis (AS), is a leading cause of high mortality in patients with chronic renal failure. Rab27a has been reported to regulate the progression of cardiovascular and renal diseases. Nevertheless, little studies investigated the role and mechanism of Rab27a in uremic-accelerated AS (UAAS). An animal model of UAAS was established in apolipoprotein E knockout (apoE-/-) mice using 5/6 nephrectomy (NX). We conducted in vitro and in vivo functional experiments to explore the role of Rab27a in UAAS, including the presence of oxidized low-density lipoprotein (ox-LDL). Rab27a expression was upregulated in the plaque tissues of NX apoE-/- mice. The knockout of Rab27a (Rab27a-/-) reduced AS-induced artery injury, as manifested by the reductions of plaque area, collagen deposition, inflammation and lipid droplet. Besides, cholesterol efflux was increased, while the expression of lipid metabolism-related proteins and the secretions of pro-inflammatory factors were decreased in ox-LDL-induced NX Rab27a-/- apoE-/- mice group. Further, Rab27a deletion inhibited the activation of nuclear factor κB (NF-κB) pathway. In conclusion, our study indicated that Rab27a deficiency attenuated foam cell formation and macrophage inflammation, depending on the NF-κB pathway activation, to inhibit AS progression in uremic apoE-/- mice. This finding may provide a new targeting strategy for UAAS therapy.

Efficacy of electroacupuncture in assisting postoperative healing of distal radius fractures: study protocol for a randomized controlled trial.

BACKGROUND: Manual reduction and surgical treatment are common methods for distal radius fractures (DRFs). The existing literature suggests that postoperative combined rehabilitation treatment and medication are effective for the healing of DRFs. However, the side effects of these treatments remain to be solved. Previous studies have shown that electroacupuncture (EA) can effectively relieve wrist swelling and improve the joint function in patients with DRFs, but more evidence is needed to prove the effectiveness of EA. This trial aims to explore the efficiency and feasibility of combined EA treatment in postoperative treatment of DRFs compared with routine treatment. METHODS: This is a parallel randomized controlled trial. A total of 222 patients diagnosed with moderate DRFs will be recruited and randomly assigned to an EA group or a routine treatment group at a ratio of 1:1. Routine treatment group will receive medication and rehabilitation. Yangxi (LI 5), Yangchi (TE 4), Yanggu (SI 5), Hegu (LI 4), and Taiyuan (LU 9) will be selected in the EA group for intervention three times a week on the basis of routine treatment. Both groups will receive 8 weeks of treatment and 4 weeks of follow-up. The primary outcome will be ulnar positive variance. The secondary outcomes will include radiographic healing rate, bone strength, hemorheological indices, serum biochemical indicators and inflammatory factors, grip strength, wrist swelling score, patient-rated wrist evaluation, disabilities of arm, shoulder and hand, and visual analogue scale. Outcomes will be evaluated at baseline, postoperative 3rd day, 2nd, 4th, 6th, 8th, and 12th weeks. DISCUSSION: The results of this study will help establish a more optimized scheme to treat patients with DRFs. Trial registration Chinese Clinical Trial Registry ChiCTR2200062857. Registered on 21 August 2022, www.chictr.org.cn/com/25/showproj.aspx?proj=175567 .

Electronic cigarettes versus nicotine-replacement therapy for smoking cessation: A systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION: Nicotine-replacement therapy (NRT) and electronic cigarettes (e-cigarettes) have been frequently used for smoking cessation. The aim of this review is to investigate the effectiveness and safety of e-cigarettes versus NRT for smoking cessation. METHODS: We searched PubMed, EMBASE, the Cochrane Library from inception to 10 October 2021. We included randomized controlled trials (RCTs) comparing e-cigarettes versus NRT for smoking cessation. Two authors independently screened titles, abstracts and full texts for eligibility. Paired authors extracted data, assessed risk of bias, and used GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) to rate the certainty of evidence. RESULTS: The study included five RCTs with 1748 participants. The meta-analysis suggested the e-cigarettes versus NRT increased the ≥6 months continuous abstinence rate (RR=1.67; 95% CI: 1.21-2.28; 55 more per 1000 participants, low certainty), and 7-day point abstinence rate at ≥6 months follow-up (RR=1.43; 95% CI: 1.19-1.72; 84 more per 1000, low certainty). However, we found no evidence that e-cigarettes versus NRT increased 3-6 months continuous abstinence rate (RR=1.07; 95% CI: 0.73-1.57; 10 more per 1000, very low certainty) and <3 months continuous abstinence rate (RR=1.20; 95% CI: 0.90-1.60; 54 more per 1000, low certainty); similar results were found at <3 months follow-up (RR=1.19; 95% CI: 0.92-1.54; 55 more per 1000, very low certainty) and 3-6 months follow-up in 7-day point abstinence rate (RR=1.01; 95% CI: 0.70-1.44; 2 more per 1000, very low certainty). The adverse events were not significant between e-cigarettes and NRT other than throat irritation (RR=1.27; 95% CI: 1.13-1.42; 118 more per 1000, low certainty). CONCLUSIONS: E-cigarettes appeared to be superior to NRT in ≥6 months continuous abstinence rate and 7-day point abstinence rate. At short-term duration, we found no evidence that e-cigarettes compared to NRT increased the <6 months continuous abstinence rate and 7-day point abstinence rate.