Clinical value of ankle flexion and extension exercises combined with a psychological intervention in knee osteoarthritis.

BACKGROUND: Considering the limited effectiveness of clinical interventions for knee osteoarthritis (KOA), it is necessary to continue to explore appropriate and effective treatment strategies to improve the condition of KOA patients. AIM: To clarify the influence of ankle flexion and extension exercises combined with a psychological intervention on the psychological status and activities of daily living (ADLs) of patients with KOA. METHODS: The research participants were 116 KOA patients admitted to The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine between May 2019 and May 2022, including 54 patients receiving routine treatment, care and psychological intervention (control group) and 62 patients additionally treated with ankle flexion and extension exercises (research group). The two groups were comparatively analyzed in terms of psychological status (Self-rating Anxiety/Depression Scale, SDS/SAS), ADLs, knee joint function (Lysholm Knee Scoring Scale), pain (Visual Analog Scale, VAS), fatigue (Multidimensional Fatigue Inventory, MFI), and quality of life (QoL; Short-Form 36 Item Health Survey, SF-36). RESULTS: After evaluation, it was found that the postinterventional SDS, SAS, VAS, and MFI scores in the research group were significantly reduced compared with the baseline (before the intervention) values and those of the control group, while the postinterventional Lysholm, ADL and SF-36 scores were markedly elevated. CONCLUSION: Therefore, ankle flexion and extension exercises are highly effective in easing negative psychological status, enhancing ADLs, daily living ability, knee joint function and QoL, and relieving pain and fatigue in KOA patients, thus warranting clinical promotion.

Influence of Lactose Supplementation on Regulation of Streptococcus thermophilus on Gut Microbiota.

It has been found that Streptococcus thermophilus (S. thermophilus) influenced the gut microbiota and host metabolism with strain specificity in C57BL/6J mice in the previous study, though it remains unclear whether lactose as a dietary factor associated with dairy consumption is involved as the mediator in the interaction. In the present study, integrated analysis of 16S rRNA gene sequencing and untargeted metabolomics by liquid chromatography-mass spectrometry of fecal samples in C57BL/6J mice was applied to evaluate the effect of lactose on the regulation of gut microbiota by two S. thermophilus strains (4M6 and DYNDL13-4). The results showed that the influence of lactose supplementation on gut microbiota induced by S. thermophilus ingestion was strain-specific. Although two S. thermophilus strains ingestion introduced similar perturbations in the fecal microbiota and gut microbial metabolism, the regulation of DYNDL13-4 on the gut microbiota and metabolism was more affected by lactose than 4M6. More specifically, lactose and 4M6 supplementation mainly enriched pathways of d-glutamine and d-glutamate metabolism, alanine, aspartate, and glutamate metabolism, and tryptophan and phenylalanine metabolism in the gut, whereas 4M6 only enriched tryptophan and phenylalanine metabolism. DYNDL13-4-L (DYNDL13-4 with lactose) had significant effects on sulfur, taurine, and hypotaurine metabolism in the gut and on phenylalanine, tyrosine, tryptophan biosynthesis, and linoleic acid metabolism in serum relative to the DYNDL13-4. Our study demonstrated the strain-specific effect of lactose and S. thermophilus supplementation on gut microbiota and host metabolism. However, considering the complexity of the gut microbiota, further research is necessary to provide insights to facilitate the design of personalized fermented milk products as a dietary therapeutic strategy for improving host health.

New enantiomeric lignans and new meroterpenoids with nitric oxide release inhibitory activity from Piper puberulum.

Six new lignans with various type of linkage between two C6-C3 fragments (1a, 1b, 2a, 2b, 3, 4), two new meroterpenoids (5, 6) and 24 known compounds (7-30) were isolated from an EtOH extract of the stems and leaves of Piper puberulum. The absolute configurations of enantiomers 1a and 1b were determined by single-crystal X-ray diffraction analysis, 2a and 2b were determined by comparing their calculated and experimental ECD spectra. Biogenetically, all the new lignans may come from the polymerization of two molecules of hydroxychavicol (30). In the anti-neuroinflammation activity assay, the IC50 values of fifteen compounds were lower than those of the positive control minocycline, and compound 1a showed good activity, but its enantiomer 1b showed no activity. Compound 1a have notable anti-neuroinflammatory activity, and can significantly decrease mRNA levels of proinflammatory cytokines (IL-1ß, IL-6, TNF-α) in a dose-dependent manner.

Analysis of Postoperative Complications and Related Factors Affecting Prognosis in 50 Patients with Distal Radius Fractures.

OBJECTIVE: To explore the postoperative complications of distal radius fractures and analyze the related factors that affect its prognosis. METHODS: The clinical data of 50 patients with distal radius fractures admitted to our hospital from October 2016 to September 2019 were retrospectively analyzed. All patients were followed up for 6-12 months, and their postoperative complications were recorded. Collect general patient information and related clinical data. During the follow-up process, Gartland and Werley wrist function scoring system was used to evaluate the prognosis of patients' joint function. Univariate analysis and multiple logistic regression models were used to analyze the related factors that affected the prognosis of patients. RESULTS: 15 patients with postoperative complications were found during the follow-up period, with an incidence rate of 30.00%. Univariate analysis showed that the patient's age, cause of injury, AO classification, shortened deformity, whether it was osteoporosis, surgical method, whether it was combined with other fractures on the same side, whether it was comminuted fracture, and the time to start postoperative exercise were all related to the distal radius. The prognosis of fractures is related (P < 0.05). Multivariate logistic analysis showed that age, AO classification, surgical method, whether it was combined with other fractures on the same side, whether it was comminuted fracture, and the time to start postoperative exercise were the independent factors affecting the prognosis of distal radius fractures (P < 0.05). CONCLUSION: The postoperative complications of distal radius fractures are higher. The prognosis is related to the patient's age, AO classification, surgical method, whether it is combined with other fractures on the same side, whether it is comminuted fracture, and the time to start postoperative exercise. Therefore, choosing an appropriate surgical method and starting exercise in time can effectively improve the recovery of the patient's wrist function and reduce the occurrence of complications.

Mindfulness Awareness Practice (MAP) to Prevent Dementia in Older Adults with Mild Cognitive Impairment: Protocol of a Randomized Controlled Trial and Implementation Outcomes.

BACKGROUND: With an aging population, developing non-pharmacological interventions (NPIs) to delay dementia has become critical. Apart from cognitive decline, dementia is associated with multiple pathophysiology, including increased oxidative stress, dysregulated gene expressions, cytokine, neurotrophin, and stress markers, telomere shortening, and deteriorations in brain connectivity. Although mindfulness practices have been proposed to ameliorate these biological changes, no empirical studies were conducted. We thus aimed to investigate the effects of mindfulness awareness practice (MAP) to prevent cognitive decline and improve peripheral biomarkers in community-dwelling older adults diagnosed with mild cognitive impairment (MCI). METHODS/DESIGN: This was a single-blinded and parallel-group randomized controlled trial with two arms (intervention and active control arms), conducted over nine months. A total of 60 consenting community-dwelling older adults diagnosed with MCI were planned to be randomized in a 1:1 ratio to either the MAP or the Health Education Program (HEP). Interventions were performed weekly for the initial 12 weeks, and monthly for the subsequent six months. Outcome measures were assessed at baseline, 3-month, and 9-month post-intervention by blinded assessors. Primary outcomes were neurocognitive tests, comprehensive peripheral biomarkers, and brain imaging scans. Secondary outcomes included basic health screening measures, affective symptoms, and measures of physical functions. Linear-mixed models were used to examine the effects of MAP on these outcome measures. SIGNIFICANCE: This is the first randomized controlled trial to systematically investigate the effects of a mindfulness intervention in improving cognitive functions and various biomarkers in community-dwelling older adults diagnosed with MCI. Our findings have the potential to inform mindfulness intervention as a novel approach to delay dementia.

Effect of Anti-Infective Reconstituted Bone Xenograft Combined with External Fixator on Serum CRP and PCT Levels and Prognosis of Patients with Bone Infection after Lower Extremity Long Bone Trauma.

Bone infection is one of the common complications of orthopedic surgery. After bone trauma occurs in the human body, the infection of Staphylococcus aureus and Gram-negative bacteria into the fracture area can lead to double infection of the soft tissue and bone tissue at the fracture site, leading to a variety of complications, mostly in the lower extremities. Bone infection easily causes bone destruction, bone nonunion, and bone defect, seriously affecting the quality of life of patients. The traditional treatment method of bone infection is to control the infection first and then repair the bone graft, but this method has a long course, poor efficacy, and high disability rate. In this study, anti-infective reconstituted bone xenograft (ARBX) combined with external fixation was used to treat patients with posttraumatic bone infections of the long bones of the lower extremities, to explore its efficacy, and to analyze its effects on serum CRP, PCT levels, and prognosis. Our results showed that ARBX combined with the external fixator had a good effect on the treatment of patients with bone infection after lower extremity long bone trauma, which could effectively enhance the repair and functional recovery of the limb bone, significantly alleviate the infection degree of patients, reduce the inflammatory response of the body, and have a good prognosis.

Gerobiotics: probiotics targeting fundamental aging processes.

Aging is recognized as a common risk factor for many chronic diseases and functional decline. The newly emerging field of geroscience is an interdisciplinary field that aims to understand the molecular and cellular mechanisms of aging. Several fundamental biological processes have been proposed as hallmarks of aging. The proposition of the geroscience hypothesis is that targeting holistically these highly integrated hallmarks could be an effective approach to preventing the pathogenesis of age-related diseases jointly, thereby improving the health span of most individuals. There is a growing awareness concerning the benefits of the prophylactic use of probiotics in maintaining health and improving quality of life in the elderly population. In view of the rapid progress in geroscience research, a new emphasis on geroscience-based probiotics is in high demand, and such probiotics require extensive preclinical and clinical research to support their functional efficacy. Here we propose a new term, "gerobiotics", to define those probiotic strains and their derived postbiotics and para-probiotics that are able to beneficially attenuate the fundamental mechanisms of aging, reduce physiological aging processes, and thereby expand the health span of the host. We provide a thorough discussion of why the coining of a new term is warranted instead of just referring to these probiotics as anti-aging probiotics or with other similar terms. In this review, we highlight the needs and importance of the new field of gerobiotics, past and currently on-going research and development in the field, biomarkers for potential targets, and recommended steps for the development of gerobiotic products. Use of gerobiotics could be a promising intervention strategy to improve health span and longevity of humans in the future.

Mindfulness intervention for mild cognitive impairment led to attention-related improvements and neuroplastic changes: Results from a 9-month randomized control trial.

Mindfulness-based interventions can enhance cognitive abilities among older adults, thereby effectively delaying cognitive decline. These cognitive enhancements are theorized to accompany neuroplastic changes in the brain. However, this mindfulness-associated neuroplasticity has yet to be documented adequately. A randomized controlled trial was carried out among participants with mild cognitive impairment (MCI) to examine the effects of a mindfulness-based intervention on various cognitive outcomes and cortical thickness (CT) in the context of age-related cognitive impairment. Participants were assigned to a mindfulness awareness program (MAP)(n = 27) and an active control condition - health education program (n = 27). In both, they attended weekly sessions for three months and subsequently, monthly sessions for six months. Cognitive assessments and structural scans were carried out across three time-points. Whole brain analyses on CT were carried out and were supplemented with region of interest-based analyses. ROI values and cognitive outcomes were analyzed with mixed MANOVAs and followed up with univariate ANOVAs. Nine-month MAP-associated gains in working memory span and divided attention, along with an increased CT in the right frontal pole and decreased CT in the left anterior cingulate were observed. Three-month MAP-associated CT increase was observed in the left inferior temporal gyrus but did not sustain thereafter. MAP led to significant cognitive gains and various CT changes. Most of these neurobehavioral changes, may require sustained effort across nine months, albeit at a reduced intensity. MAP can remediate certain cognitive impairments and engender neuroplastic effects even among those with MCI.

Mental awareness improved mild cognitive impairment and modulated gut microbiome.

There is ample scientific and clinical evidence of the effects of gut microbiota on the brain but no definitive evidence that the brain can affect changes in gut microbiota under the bi-directional gut-brain axis concept. As there is no pharmacotherapeutic intervention for the early stages of cognitive decline, research has focused on cognitive stimulation in reversing or slowing the impairment. Elderly patients diagnosed with mild cognitive impairment underwent a randomized-control trial of mindful awareness practice. Neuropsychological assessments, inflammatory markers, and gut microbiota profiles were tested. Here, we report that their cognitive impairment was improved and associated with changes in gut bacterial profile. A cognition-score-dependent-abundance was observed in Ruminococcus vs Recognition Trials (RT), Digit Span Backward (DSB), Semantic Fluency Span (SFS) and Memory Domain (MD); Coprococcus vs DSB, Color Trails Test 2 (CTT2) and Block Design (BD); Parabacteroides vs DSB and SFS; Fusobacterium vs DSB and CTT2; Enterobacteriaceae vs BD and SFS; Ruminococcaceae vs DSB; Phascolarctobacterium vs MD. The study showed for the first-time, alteration in the cognitive capacity leading to the corresponding changes in microbiota profiles. This strongly suggests that signals from the different segments of brain could dictate directly or indirectly the abundances of specific gut microbes.

A cost and efficacy analysis of performing arthroscopic excision of wrist ganglions under wide-awake anaesthesia versus general anaesthesia.

BACKGROUND: Arthroscopic excision has currently become popular for the treatment of wrist ganglions. The objective of this study was to evaluate the clinical outcomes and cost effectiveness of arthroscopic wrist ganglion excisions under Wide-Awake Local Anaesthesia No Tourniquet versus general anaesthesia. METHODS: We retrospectively reviewed patients who underwent arthroscopic ganglionectomy from April 2009 to October 2016 at our institute. They were separated into two groups according to anaesthesia techniques: general anaesthesia and Wide-Awake Local Anaesthesia No Tourniquet. We compared the clinical outcomes and cost-effectiveness of the two groups. RESULTS: Seventy-four patients were included. Both groups were matched with regard to the demographics and preoperative clinical assessments. We found no significant differences between groups in postoperative visual analog scale, modified Mayo wrist score, Disabilities of Arm, Shoulder and Hand score, recurrence, residual pain, or complications. Recurrence was found in five of 74 patients, one (4.3%) in the Wide-Awake Local Anaesthesia No Tourniquet group and four (7.8%) in the general anaesthesia group. One extensor tendon injury and four extensor tenosynovitis cases occurred in the general anaesthesia group. Regarding cost effectiveness, the mean operating time in the Wide-Awake Local Anaesthesia No Tourniquet and general anaesthesia groups were 88.7 ± 24.51 and 121.5 ± 25.75 min, respectively (p < 0.001). The average total costs of the Wide-Awake Local Anaesthesia No Tourniquet and general anaesthesia groups were €487.4 ± 89.15 and €878.7 ± 182.13, respectively (p < 0.001). CONCLUSIONS: For arthroscopic wrist ganglion resections, both anaesthesia techniques were effective and safe regarding recurrence rates, complications, and residual pain. The most important finding of this study was that arthroscopic ganglionectomy under Wide-Awake Local Anaesthesia No Tourniquet was superior to that under general anaesthesia for cost-effectiveness. LEVEL OF EVIDENCE: Level III, Retrospective comparative study.

Koumine Alleviates Lipopolysaccharide-Induced Intestinal Barrier Dysfunction in IPEC-J2 Cells by Regulating Nrf2/NF-κB Pathway.

Gelsemium elegans Benth. (G. elegans), a traditional Chinese medicine, has great potential as an effective growth promoter in animals, however, the mechanism of its actin remains unclear. Here, we evaluated the protective effects of koumine extract from G. elegans against lipopolysaccharide (LPS)-induced intestinal barrier dysfunction in IPEC-J2 cells through alleviation of inflammation and oxidative stress. MTT and LDH assays revealed that koumine significantly reduced LPS cytotoxicity. Transepithelial electrical resistance (TEER) and cell monolayer permeability assays showed that koumine treatment attenuated the LPS-induced intestinal barrier dysfunction with no particularly different effects in tight junction proteins such as ZO-1, claudin-1, and occludin. LPS-triggered inflammatory response was also suppressed by koumine, as evidenced by the downregulated inflammatory factors, including TNF-α, IL-6, IL-1ß, NO, iNOS, and COX-2, which was closely connected with the inhibition of NF-κB pathway for the decrease of phosphorylation of IκBα and NF-κB and nuclear translocation of p-p65. Amount of reactive oxygen species (ROS) and MDA induced by LPS was also reduced by koumine through activation of Nrf2 pathway, and increased in the levels of Nrf2 and HO-1 degradation of keap-1 to promote anti-oxidants, including superoxide dismutase (SOD) and catalase (CAT). To summarize, koumine-reduced the oxidative stress and inflammatory reaction triggered by LPS through regulation of the Nrf2/NF-κB signaling pathway and preventing intestinal barrier dysfunction.

The Influence of Cell Culture Density on the Cytotoxicity of Adipose-Derived Stem Cells Induced by L-Ascorbic Acid-2-Phosphate.

Ascorbic acid-2-phosphate (A2-P) is an oxidation-resistant derivative of ascorbic acid that has been widely employed in culturing adipose-derived stem cells (ASCs) for faster expansion and cell sheet formation. While high dose ascorbic acid is known to induce cellular apoptosis via metabolic stress and genotoxic effects, potential cytotoxic effects of A2-P at high concentrations has not been explored. In this study, the relationship between ASC seeding density and A2-P-induced cytotoxicity was investigated. Spheroid-derived ASCs with smaller cellular dimensions were generated to investigate the effect of cell-cell contact on the resistance to A2-P-induced cytotoxicity. Decreased viability of ASC, fibroblast, and spheroid-derived ASC was noted at higher A2-P concentration, and it could be reverted with high seeding density. Compared to control ASCs, spheroid-derived ASCs seeded at the same density exhibited decreased viability in the A2-P-supplemented medium. The expression of antioxidant enzymes (catalase, SOD1, and SOD2) was enhanced in ASCs at higher seeding densities. However, their enhanced expression in spheroid-derived ASCs was less evident. Furthermore, we found that co-administration of catalase or N-acetylcysteine nullified the observed cytotoxicity. Collectively, A2-P can induce ASC cytotoxicity at higher concentrations, which can be prevented by seeding ASCs at high density or co-administration of another antioxidant.

Effect of Acupuncture and Biofeedback on Fecal Incontinence after Anus Preservation Operation for Rectal Cancer / 中国康复理论与实践

Objective:To investigate the effect of acupuncture and biofeedback on the recovery of fecal incontinence after anus preservation operation for rectal cancer. Methods:From January 1st, 2016 to June 30th, a total of 226 patients with rectal cancer after anus preservation operation were selected. Finally, 120 patients with fecal incontinence were randomly divided into control group (n = 40), acupuncture group (n = 40) and observation group (n = 40). All the groups accepted levator ani movement. In addition, the acupuncture group received acupuncture, and the observation group received acupuncture and biofeedback, for three months. Cleveland Clinic Florida Faecal Incontinence Scores (CCF-FIS), anorectal pressure, pelvic floor surface electromyography and quality of life were measured before treatment, and one month, two months and three months after treatment. Results:There was no significant difference in CCF-FIS, anorectal pressure, pelvic floor surface electromyography and quality of life among three groups before treatment (F < 2.943, P > 0.05). After treatment, all the above indexes improved (F > 5.235, P < 0.01), and were better in the acupuncture group and observation group than in the control group (P < 0.05), especially in the observation group (P < 0.05) at each time point. The curative effect of the observation group was related to the location of the tumor (χ2 > 4.405, P < 0.05) one month after treatment, and it was related to whether pelvic autonomic nerve preservation was performed during the operation (χ2 > 4.706, P < 0.05) and whether radiotherapy was added after the operation (χ2 > 5.013, P < 0.05) at each time point after treatment. At three months follow-up, the recurrence rate was lower in the observation group (8.6%) than in the acupuncture group (35.7%) and in the control group (35.0%) (χ2 > 5.976, P < 0.05). No complication occurred in all groups. Conclusion:Acupuncture and biofeedback can improve the symptoms of defecation incontinence and promote the recovery of anal function after anus preservation operation for rectal cancer.

Revisit gut microbiota and its impact on human health and disease.

Trillions of microbes have evolved with and continue to live on human beings. With the rapid advances in tools and technology in recent years, new knowledge and insight in cross-talk between the microbes and their hosts have gained. It is the aim of this work to critically review and summarize recent literature reports on the role of microbiota and mechanisms involved in the progress and development of major human diseases, which include obesity, hypertension, cardiovascular disease, diabetes, cancer, Inflammatory Bowel Disease (IBD), gout, depression and arthritis, as well as infant health and longevity.

Effects of dietary pectin on the profile and transport of intestinal bile acids in young pigs.

Pectin has been known to lower circulating cholesterol by interacting with bile acid (BA) metabolism. The current study was aimed to investigate intestinal BA transport at the molecular level in a pig model. Twelve young pigs (11.05 ± 0.11 kg) were randomly divided into 2 groups and fed corn-soybean meal diets with either 5% pectin or cornstarch for 72 d. In pigs fed with pectin, total cholesterol and low-density lipoprotein cholesterol (LDL-C) were lowered but high-density lipoprotein (HDL-C) was increased (P < 0.05). Serum triglycerides tended to be lower in the pectin-fed animals (P = 0.093), whereas no change was noted in serum total bile acid. Along the length of the intestine, the size and composition of BA pools vary. The ratio of primary, secondary, taurine-conjugated, and glycine-conjugated BAs in the ileal pool was about 46:15:9:30, whereas it was 28:61:1:11 in the cecum and 22:65:3:9 in the colon (P < 0.05). In the feces, lithocholic acid and ursodeoxycholic acid (UDCA) made up of over 97% of the total BA pool. Overall, the ileum had the greatest expression of farnesoid X receptor (FXR) and apical sodium-coupled bile acid transporter (ASBT) than the duodenum, jejunum, cecum, and colon (P < 0.05), whereas organic solute transporters α/ß (OSTα/ß) gene expression was peaked in the ileum and jejunum (P < 0.05). Expression multidrug resistance protein 2 (MRP2) gradually decreased towards the end of the intestine (P < 0.05). Greater expression of G protein-coupled bile acid receptor and multidrug resistance protein 3 (MRP3) was found in the cecum and colon (P < 0.05). In pigs fed with 5% pectin, only cecal UDCA (P = 0.097) and hyocholic acid (P = 0.088) showed a decreasing tendency. But FXR, ASBT, and MRP2 were upregulated in the ileum and FXR, OSTα/ß, MRP2, and MRP3 in the cecum of PEC-fed pigs (P < 0.05). Liver enzymes involved in BA biosynthesis (CYP7A1, CYP27A1, bile acid-CoA synthase, and bile acid-CoA:amino acid N acyltransferase) were not affected by pectin consumption. In conclusion, the abundant distribution of BA transporters and the greater BA pool size suggests the ileum as the major site for intestinal BA reabsorption in pigs. In the ileum, pectin increased in-and-out BA transport on the apical membrane by increasing ASBT and MRP2, but it increased the overall BA transport in the cecum by increasing OSTα/ß and MRP3.

Dataset on gene expression in the elderly after Mindfulness Awareness Practice or Health Education Program.

It has been reported that relaxation techniques can improve physical health and cognitive function. A number of studies involving different types of relaxation practices showed changes in expression of genes. We investigated the gene expression pattern of a cohort of elderly subjects of Asian descent after weekly (for the first three months) and monthly (for the subsequent six months) intervention. Sixty consenting elderly subjects (aged 60-90 years) with mild cognitive impairment were assigned to either the Mindfulness Awareness Practice (MAP) or Health Education Program (HEP) group in a randomized controlled trial to assess the effectiveness of the programs in preventing further cognitive decline and evaluate the influence on neurological, cellular and biochemical factors. Blood samples were collected before the start of intervention and after nine months for gene expression profiling using Affymetrix Human Genome U133 Plus 2.0 arrays. The dataset is publicly available for further analyses.

Corticosteroid Is Associated with Both Hip Fracture and Fracture-Unrelated Arthropathy.

OBJECTIVE: We aimed to investigate whether and how corticosteroid use was associated with serious hip arthropathy. METHODS AND MATERIALS: This population-based cohort study analyzed the Taiwan National Health Insurance Research Database and screened the one-million random sample from the entire population for eligibility. The steroid cohort consisted of 21,995 individuals who had used systemic corticosteroid for a minimum of 6 months between January 1, 1997 and December 31, 2006. They were matched 1:1 in propensity score on the index calendar date with controls who never used steroid. All participants were followed up until occurrence of serious hip arthropathy that required arthroplasty, withdrawal from the national health insurance, or the end of 2011. Surgical indication was classified as fracture-related and -unrelated. The cumulative incidence of hip arthroplasty was estimated by the Kaplan Meier method. The association with steroid exposure was explored by the Cox proportional hazard model. RESULTS: Cumulative incidences of hip arthroplasty after 12 years of follow-up were 2.96% (95% confidence interval [CI], 2.73-3.2%) and 1.34% (95% CI, 1.2-1.51%) in the steroid users and non-users, respectively (P<0.0001). The difference was evident in fracture-related arthroplasty with 1.89% (95% CI, 1.71-2.09%) versus 1.10% (95% CI, 0.97-1.25%), but more pronounced in fracture-unrelated surgery, 1.09% (95% CI, 0.95-1.24%) versus 0.24% (95% CI, 0.19-0.32%). Multivariate-adjusted Cox regression analysis confirmed steroid use was independently associated with both fracture-related (adjusted hazard ratio [HR], 1.65; 95% CI, 1.43-1.91) and unrelated arthroplasty (adjusted HR, 4.21; 95% CI, 3.2-5.53). Moreover, the risk for fracture-unrelated arthropathy rose with steroid dosage, as the adjusted HR increased from 3.30 (95% CI, 2.44-4.46) in the low-dose subgroup, 4.54 (95% CI, 3.05-6.77) in intermediate-dose users, to 6.54 (95% CI, 4.74-9.02) in the high-dose counterpart (Ptrend<0.0001). CONCLUSIONS: Corticosteroid use is associated with long-term risk of hip arthroplasty, particularly for fracture-unrelated arthropathy.

Bioadhesive chitosan-loaded liposomes: A more efficient and higher permeable ocular delivery platform for timolol maleate.

The aim of this study was to develop and characterize a novel colloidal system, namely, timolol maleate chitosan coated liposomes (TM-CHL) to enhance the ocular permeation, precorneal residence time and bioavailability. The resulting TM-CHL was the most promising formulation with a mean particle size of 150.7nm and an EE% of 75.83±1.61%. In vitro release of the TM-CHL showed an extended drug release profile. The TM-CHL exhibited significant mucin adhesion and compared with commercial eye drops, TM-CHL produced a 3.18-fold increase in the apparent permeability coefficient (Papp), resulting in a significant enhancement of corneal permeation. In addition, the gamma scintigraphic study and the pharmacokinetic study showed that TM-CHL could be retained at the corneal surface for longer time compared with eye drops. The ocular irritation study indicated that the developed liposomes produced no significant irritant effects. Furthermore, pharmacodynamics results showed that the maximum intraocular pressure(IOP) produced by TM-CHL was (19.67±1.14) mmHg compared with the (23.80±1.49) mmHg for TM eye drops, revealing that TM-CHL was more effective in reducing the IOP. These results demonstrate that CHL is a potentially useful carrier for ocular drug delivery, which could improve the efficacy of TM.

Improvement of information service in hospitals of traditional Chinese medicine by making use of public WeChat platform / 中华医学图书情报杂志

The data of public WeChat public platform in 100 hospitals of traditional Chinese medicine were mined and analyzed by making use of the"Qingbo index" big data platform in terms of the WCI value, number of papers, number of readings, and number of praises. The factors influencing the information service of public WeChat platform in hospitals of traditional Chinese medicine were found by further analyzing and comparing the number of published papers, contents of information service, publication time of papers in such hospitals with Guangdong Provincial Hospital of Traditional Chinese Medicine and Jiangsu Provincial Hospital of Traditional Chinese Medicine as exam-ples. Suggestions were put forward for strengthening the operation and development of public WeChat platform and improving its information service.

Improvement of information service in hospitals of traditional Chinese medicine by making use of public WeChat platform / 中华医学图书情报杂志

The data of public WeChat public platform in 100 hospitals of traditional Chinese medicine were mined and analyzed by making use of the"Qingbo index" big data platform in terms of the WCI value, number of papers, number of readings, and number of praises. The factors influencing the information service of public WeChat platform in hospitals of traditional Chinese medicine were found by further analyzing and comparing the number of published papers, contents of information service, publication time of papers in such hospitals with Guangdong Provincial Hospital of Traditional Chinese Medicine and Jiangsu Provincial Hospital of Traditional Chinese Medicine as exam-ples. Suggestions were put forward for strengthening the operation and development of public WeChat platform and improving its information service.