Multidimensional characteristics of musculoskeletal pain and risk of hip fractures among elderly adults: the first longitudinal evidence from CHARLS.

BACKGROUND: Hip fractures are a major public health concern among middle-aged and older adults. It is important to understand the associated risk factors to inform health policies and develop better prevention strategies. Musculoskeletal pain is a possible implicating factor, being associated with physical inactivity and risk of falls. However, the association between musculoskeletal pain and hip fractures has not been clearly investigated. METHODS: A nationally representative sample of the Chinese population was obtained from the China Health and Retirement Longitudinal Study (CHARLS). The study collected patient information on their demographic characteristics, socioeconomic status, other health-related behavior, and history of musculoskeletal pain and hip fractures. Univariate and multivariate analyses were conducted to investigate the factors influencing the risk of hip fracture, including factors related to the individual and to musculoskeletal pain. P for trend test was performed to assess the trend of each continuous variable. The robustness and bias were assessed using the bootstrap method. Restricted cubic spline regression was utilized to identify linear or non-linear relationships. RESULTS: Among the 18,813 respondents, a total of 215 individuals reported that they have experienced a hip fracture. An increased risk of hip fracture was associated with the presence of waist pain and leg pain (P < 0.05), as well as with an increased number of musculoskeletal pain sites (P < 0.05). For individuals aged 65 and above, a significant association was found between age and the risk of hip fracture (P < 0.05). Furthermore, respondents with lower education level had a higher risk of hip fracture compared to those with higher education levels (P < 0.05). CONCLUSION: In the Chinese population, the risk of hip fracture was found to be associated with both the location and extent of musculoskeletal pain, as well as with other factors such as age and demographic characteristics. The findings of this study may be useful for informing policy development and treatment strategies, and provide evidence for comparison with data from other demographic populations.

Preference of musculoskeletal pain treatment in middle-aged and elderly chinese people: a machine learning analysis of the China health and retirement longitudinal study.

BACKGROUND: Musculoskeletal pain is a major cause of physical disability, associated with huge socioeconomic burden. Patient preference for treatment is an important factor contributing to the choice of treatment strategies. However, effective measurements for evaluating the ongoing management of musculoskeletal pain are lacking. To help improve clinical decision making, it's important to estimate the current state of musculoskeletal pain management and analyze the contribution of patient treatment preference. METHODS: A nationally representative sample for the Chinese population was derived from the China Health and Retirement Longitudinal Study (CHARLS). Information on the patients' demographic characteristics, socioeconomic status, other health-related behavior, as well as history on musculoskeletal pain and treatment data were obtained. The data was used to estimate the status of musculoskeletal pain treatment in China in the year 2018. Univariate analysis and multivariate analysis were used to find the effect factors of treatment preference. XGBoost model and Shapley Additive exPlanations (SHAP) method were performed to analyze the contribution of each variable to different treatment preferences. RESULTS: Among 18,814 respondents, 10,346 respondents suffered from musculoskeletal pain. Approximately 50% of musculoskeletal pain patients preferred modern medicine, while about 20% chose traditional Chinese medicine and another 15% chose acupuncture or massage therapy. Differing preferences for musculoskeletal pain treatment was related to the respondents' gender, age, place of residence, education level, insurance status, and health-related behavior such as smoking and drinking. Compared with upper or lower limb pain, neck pain and lower back pain were more likely to make respondents choose massage therapy (P < 0.05). A greater number of pain sites was associated with an increasing preference for respondents to seek medical care for musculoskeletal pain (P < 0.05), while different pain sites did not affect treatment preference. CONCLUSION: Factors including gender, age, socioeconomic status, and health-related behavior may have potential effects on people' s choice of treatment for musculoskeletal pain. The information derived from this study may be useful for helping to inform clinical decisions for orthopedic surgeons when devising treatment strategies for musculoskeletal pain.

Comparative proteomic analysis reveals novel insights into the continuous cropping induced response in Scrophularia ningpoensis.

BACKGROUND: Scrophularia ningpoensis is a well-known medicinal crop. Continuous cropping seriously affects the yield and quality, but little is known about the influence of continuous cropping on metabolic pathways. In this study, the difference in protein abundance between continuous cropping and non-continuous cropping of S. ningpoensis roots was studied by proteomics, and the molecular mechanism that protects S. ningpoensis against continuous cropping was explored. RESULTS: The results suggested that continuous cropping in S, ningpoensis altered the expression of proteins related to starch and sucrose metabolism, glycolysis/gluconeogenesis, pentose phosphate pathway, citric acid cycle, phenylalanine, tyrosine and tryptophan biosynthesis, phenylpropanoid biosynthesis, terpenoid backbone biosynthesis, monoterpenoid biosynthesis, sesquiterpenoid and triterpenoid biosynthesis, and steroid biosynthesis. Among these processes, the most affected were phenylpropanoid biosynthesis and starch and sucrose metabolism, which may be important for continuous cropping resistance. CONCLUSION: The effect of continuous cropping on S. ningpoensis was demonstrated at the proteome level in this work, and identified candidate proteins that may cause continuous cropping reactions. The paper provides the theoretical foundation and scientific reference for enhancing the continuous cropping resistance of S. ningpoensis. © 2022 Society of Chemical Industry.

Breakage risk of different sacroiliac screws in unilateral sacral fractures a finite element analysis.

OBJECTIVE: To compare the breakage risk of lengthened sacroiliac screws and ordinary sacroiliac screws to treat unilateral vertical sacral fractures and provide a reference for clinical application. METHODS: A finite element model of Tile C pelvic ring injury (unilateral type Denis II fracture of the sacrum) was produced. The sacral fractures were fixed with a lengthened sacroiliac screw and ordinary sacroiliac screw in 6 types of models. The maximal von Mises stresses and stress distributions of the two kinds of screws when standing on both feet were measured and compared. RESULTS: The maximal von Mises stress of the lengthened screw was less than that of the ordinary screw. Compared with ordinary screw, the stress distribution in the lengthened screw was more homogeneous. CONCLUSIONS: The breakage risk of screws fixed in double segments is lower than that of screws fixed in single segments, the breakage risk of lengthened screws is lower than that of ordinary screws, and the breakage risk of screws fixed in S2 segments is lower than that of screws fixed in S1 segments.

Treatment of Early to Intermediate Stage Ankle Osteoarthritis With Nonosteotomy Approaches: Intermediate-Term Efficacy.

This study aimed to investigate the intermediate-term efficacy of nonosteotomy approaches in the treatment of early to intermediate stage ankle osteoarthritis (OA). Forty-two patients received treatment for early to intermediate stage ankle osteoarthritis with nonosteotomy approaches were reviewed. The surgical satisfaction was evaluated at 1 year after surgery and the last follow-up period; the American Orthopaedic Foot and Ankle Society (AOFAS) scale and Visual Analog Scale (VAS) were employed for the evaluation of function and pain, respectively, and the stage of ankle osteoarthritis was determined. At 1 year surgery and the last follow-up period, the surgical satisfaction was 37 (88.1%) and 35 (83.3%), respectively, and the favorable function was noted in 34 (80.9%) and 32 (76.2%), respectively. The AOFAS score significantly increased from 50.62 ± 10.81 (range 30-60) before surgery to 81.43 ± 12.00 (range 75-95) at 1 year after surgery (p < .0001) and 79.67 ± 10.34 (range 70-96) at the last follow-up period (p < .0001 vs before surgery; p = .107 vs 1 year). The VAS score reduced from 5.07 ± 1.57 (range 4-7) before surgery to 1.97 ± 1.41 (range 0-3) at 1 year (p < .0001) and 1.80 ± 1.15 (range 0-3) at the last follow-up period (p < .0001 vs before surgery; p = .265 vs 1 year). Moreover, the AOFAS score and VAS score in patients with ankle osteoarthritis at different stages were improved significantly after surgery (p < .0001). Intermediate-term follow-up period shows that nonosteotomy approaches are able to relieve pain and improve postoperative function in the treatment of early to intermediate stage ankle osteoarthritis; the improvement determined according to imaging examination is not completely consistent with that determined based on clinical function.

Ankle Arthrodesis Combined With Mosaic Bone Autograft Transplantation for End-Stage Ankle Osteoarthritis With Large Cysts of Talar Dome.

End-stage ankle osteoarthritis with large cysts of talar dome can be challenging to treat. Twenty patients diagnosed as end-stage ankle arthritis with large talar cysts between 04/2010 and 02/2016 were randomly divided into experimental group (10 cases) and conventional group (10 cases) by random number method. Patients in the experimental group were treated with ankle arthrodesis combined with a concomitant procedure of mosaic bone autograft transplantation, the conventional group under the ankle arthrodesis. The operation time, intraoperative blood loss, postoperative hospital stay, the time of bone union, and postoperative height of the talus between the 2 groups were compared. The preoperative and postoperative American Orthopaedic Foot and Ankle Society ankle-hindfoot scale score were also recorded and compared. There was no significant difference in the operation time, intraoperative blood loss, and postoperative hospital stay between the 2 groups. The postoperative height of the talus body and the time of bone union were better in the experimental group than that in the conventional group (p < .05). The results of follow-up showed that the American Orthopaedic Foot and Ankle Society scores of the conventional group were lower than those in the experimental group (p < .001). And the incidence of complication (10%) in the experimental group was significantly lower than that in the conventional group (40%). The use of tibiotalar arthrodesis combined with mosaic bone autograft transfer may be potentially an effective option for the treatment of end-stage ankle arthritis with large talar cysts.

Correction: Rating Hospital Performance in China: Review of Publicly Available Measures and Development of a Ranking System.

[This corrects the article DOI: 10.2196/17095.].

Rating Hospital Performance in China: Review of Publicly Available Measures and Development of a Ranking System.

BACKGROUND: In China, significant emphasis and investment in health care reform since 2009 has brought with it increasing scrutiny of its public hospitals. Calls for greater accountability in the quality of hospital care have led to increasing attention toward performance measurement and the development of hospital ratings. Despite such interest, there has yet to be a comprehensive analysis of what performance information is publicly available to understand the performance of hospitals in China. OBJECTIVE: This study aims to review the publicly available performance information about hospitals in China to assess options for ranking hospital performance. METHODS: A review was undertaken to identify performance measures based on publicly available data. Following several rounds of expert consultation regarding the utility of these measures, we clustered the available options into three key areas: research and development, academic reputation, and quality and safety. Following the identification and clustering of the available performance measures, we set out to translate these into a practical performance ranking system to assess variation in hospital performance. RESULTS: A new hospital ranking system termed the China Hospital Development Index (CHDI) is thus presented. Furthermore, we used CHDI for ranking well-known tertiary hospitals in China. CONCLUSIONS: Despite notable limitations, our assessment of available measures and the development of a new ranking system break new ground in understanding hospital performance in China. In doing so, CHDI has the potential to contribute to wider discussions and debates about assessing hospital performance across global health care systems.

A guideline for homology modeling of the proteins from newly discovered betacoronavirus, 2019 novel coronavirus (2019-nCoV).

During an outbreak of respiratory diseases including atypical pneumonia in Wuhan, a previously unknown ß-coronavirus was detected in patients. The newly discovered coronavirus is similar to some ß-coronaviruses found in bats but different from previously known SARS-CoV and MERS-CoV. High sequence identities and similarities between 2019-nCoV and SARS-CoV were found. In this study, we searched the homologous templates of all nonstructural and structural proteins of 2019-nCoV. Among the nonstructural proteins, the leader protein (nsp1), the papain-like protease (nsp3), the nsp4, the 3C-like protease (nsp5), the nsp7, the nsp8, the nsp9, the nsp10, the RNA-directed RNA polymerase (nsp12), the helicase (nsp13), the guanine-N7 methyltransferase (nsp14), the uridylate-specific endoribonuclease (nsp15), the 2'-O-methyltransferase (nsp16), and the ORF7a protein could be built on the basis of homology templates. Among the structural proteins, the spike protein (S-protein), the envelope protein (E-protein), and the nucleocapsid protein (N-protein) can be constructed based on the crystal structures of the proteins from SARS-CoV. It is known that PL-Pro, 3CL-Pro, and RdRp are important targets for design antiviral drugs against 2019-nCoV. And S protein is a critical target candidate for inhibitor screening or vaccine design against 2019-nCoV because coronavirus replication is initiated by the binding of S protein to cell surface receptors. It is believed that these proteins should be useful for further structure-based virtual screening and related computer-aided drug development and vaccine design.

Fibrous red phosphorene: a promising two-dimensional optoelectronic and photocatalytic material with a desirable band gap and high carrier mobility.

By using density-functional theory, we have systematically investigated the structural stabilities, electronic structures, and optical properties of monolayer fibrous red phosphorene. We find the monolayer fibrous red phosphorene lattice to be dynamically and thermodynamically stable based on phonon spectra calculation and ab initio molecular dynamics simulation. A small cleavage energy of approximately 0.88 J m-2 is required for creating it from its bulk, suggesting the possibility of exfoliation in experiments. Furthermore, we find that monolayer fibrous red phosphorene is a semiconductor with an indirect bandgap of approximately 2.46 eV, and the bandgap is less susceptible to the number of stacked atomic layers. Moreover, the monolayer is expected to have highly directional anisotropy effective masses and high carrier mobilities (∼104 cm2 V-1 s-1), comparable with those of monolayer black phosphorene. In addition, fibrous red phosphorene nanosheets can absorb visible light as well as their band edge alignments are well positioned for the feasibility of both photo-oxidation and photo-reduction of water within the range of -5 to 5% biaxial strains. These combined properties make the fibrous red phosphorene nanosheets an alternative to diverse nanodevices, and pave the way for a potential photocatalyst.

Biomechanical comparison of three minimally invasive fixations for unilateral pubic rami fractures.

BACKGROUND: To compare the mechanical characteristics of a percutaneous superior pubic intramedullary screw, percutaneous bridging plate and percutaneous screw-rod system of the anterior ring for the treatment of unilateral vertical pubic fractures to provide a reference for clinical application. METHODS: A finite element model of pelvic anterior ring injury (unilateral vertical pubic fracture) was produced. The fractures were fixed with a percutaneous superior pubic intramedullary screw, percutaneous bridging plate and percutaneous screw-rod system of the anterior ring and their combinations in 5 types of models. The fracture stabilities under vertical, bilateral and anterior-posterior load were quantified and compared based on the displacement of the hip joints' midpoint as quantificational index of fracture stability. RESULTS: In the condition of bilateral and anterior-posterior load, the vertical, bilateral and anterior-posterior displacements of the hip joints' midpoint of different models were significantly different respectively. In general, the displacements of the 5 pelvic anterior ring fixations were ranked from maximum to minimum as follows: bridging plate, pelvic anterior screw-rod system, combination of bridging plate and pelvic anterior screw-rod system, superior pubic intramedullary screw and combination of superior pubic intramedullary screw and pelvic anterior screw-rod system. CONCLUSION: For the fixation in unilateral pubic fractures of pelvic ring injury, the percutaneous superior pubic intramedullary screw is optimal, the percutaneous pelvic anterior screw-rod system is the second choice, and percutaneous bridging plate ranks the third. The percutaneous pelvic anterior screw-rod system can significantly increase fixation stability of the percutaneous superior pubic intramedullary screw and the percutaneous bridging plate.

Efficacy and acceptability of neoadjuvant endocrine therapy in patients with hormone receptor-positive breast cancer: A network meta-analysis.

BACKGROUND: The optimal sequence of endocrine therapy in a neoadjuvant setting for hormone receptor-positive (HR+) breast cancer is unclear. Our study evaluated the efficacy and acceptability of neoadjuvant endocrine therapy for HR+ breast cancer. METHODS: We identified studies based on titles and abstracts that were published before 22 June 2018 in the following databases: PubMed, EMBASE, and the Cochrane Library. Eligible studies were randomised controlled trials with at least one arm that evaluated the effectiveness of one or a combination of anastrozole, letrozole, palbociclib, tamoxifen, fulvestrant, abemaciclib, everolimus, gefitinib, ribociclib, taselisib, and exemestane. We pooled effect sizes using the odds ratio (OR) and corresponding 95% credibility interval (95% CrI). The primary outcomes were response rate and treatment completion. RESULTS: Our network meta-analysis included 3,306 participants and 16 eligible studies, which assessed 15 treatments. In terms of response rates, compared with letrozole combined therapy, tamoxifen was associated with a significant reduction in response rate (OR, 0.34; 95% CrI, 0.13-0.85; OR, 0.32; 95% CrI, 0.13-0.80; OR, 0.26; 95% CrI, 0.09-0.83; and OR, 0.30; 95% CrI, 0.09-0.96; for letrozole plus everolimus, letrozole plus taselisib, letrozole plus zoledronic acid, and letrozole plus lapatinib, respectively). Based on the surface under the cumulative ranking curves ranking, letrozole plus zoledronic acid was associated with the highest rate of response (87.6%), followed by letrozole plus lapatinib (85.2%), and letrozole plus taselisib (79.3%). CONCLUSIONS: Ultimately, our study established that letrozole plus zoledronic acid may be an optimal treatment based on its current rank in a neoadjuvant setting for HR+ breast cancer.

The global state of research in nonsurgical treatment of knee osteoarthritis: a bibliometric and visualized study.

BACKGROUND: Osteoarthritis (OA) is the most common joint disorder among elderly individuals. Nonsurgical treatment plays an important role in treating knee OA. The aim of the present study was to investigate the trends and research status about nonsurgical treatment of knee OA. METHODS: Publications about the nonsurgical treatment of knee OA from 1994 to 2018 were searched from the Web of Science (WoS) database. The data were analyzed by using bibliometric methodology. The software VOSviewer was used for bibliographic coupling, coauthorship, cocitation, co-occurrence analysis and to investigate the publication trends in nonsurgical treatment of knee OA. RESULTS: In total, 8512 articles were included. The number of publications increased annually worldwide. The United States has made the largest contribution to this field, with the most publications, citations and the highest H-index. The most contributive institutions were Harvard University, the University of California system and Assistance Publique Hopitaux Paris (APHP). The journal Osteoarthritis and Cartilage published the most relative articles. Studies could be classified into five clusters: articular cartilage study, biomechanics study, physiotherapy study, oral pharmacologic study and intra-articular injection study. Articular cartilage and physiotherapy were predicted as the next hot topics in this field. CONCLUSIONS: There will be an increasing number of publications on the nonsurgical treatment of knee OA based on current global trends. The United States made the largest contribution to this field. More focus will be placed on cartilage-related and physiotherapy research, which may be the next popular topics in the nonsurgical treatment of knee OA.

Hittorf's violet phosphorene as a promising candidate for optoelectronic and photocatalytic applications: first-principles characterization.

Utilizing density functional theory, we investigate the structural stabilities, electronic structures, and optical properties of monolayer violet phosphorene, i.e., Hittorfene, under an external vertical electric field and upon in-layer biaxial strain control. We find that compared with monolayer black phosphorene, monolayer violet phosphorene has a significantly larger direct band gap of 2.50 eV, and it is sensitive to an external vertical electric field, under which it undergoes an intriguing direct-indirect and insulator-metal transition. By applying an in-layer biaxial strain, the semiconductor characteristic of monolayer violet phosphorene is found to be robust and stable over a wide range of strains (-10 to 10%), with a minimum bulk gap still being up to 0.90 eV at a tensile strain of 10%. This demonstrates that the band edges of monolayer violet phosphorene not only can straddle water redox potentials in the equilibrium state but can also be available within the strain range of -7 to 7% for facilitating photocatalytic water splitting. In particular, the suitable band edges and intensive absorption of visible light suggest that a strain ratio of -7% would be the more favorable condition for water splitting under visible light.

Evaluation of a consulting training course for international development assistance for health.

BACKGROUND: Development assistance for health (DAH) is an important component of foreign assistance. International health consultants usually play a key role in the international DAH field. However, there is still a shortage of consulting training in China. To address this issue and develop new backup force of DAH for China, the Global Health Institute of Wuhan University (GHIWHU) launched a training program called the "Consulting Training Course for International Development Assistance for Health". The purpose of this article is to evaluate the impact of the training on participants. METHODS: We conducted the analysis using Kirkpatrick's model. An evaluation survey examining participants' reaction (level 1) and learning (level 2) was carried out among trainees following the training, and a follow-up telephone interview of application (level 3) was made in three months after the training. RESULTS: A total of 25 participants from Chinese Consortium of Universities for Global Health (CCUGH) attended the training program. Results of satisfaction evaluation indicated that the training program was well received, with more than 85% of participants felt satisfied or relatively satisfied with the training. Trainees' self-ratings of the consulting knowledge and skills showed a significant increase (p < 0.001) from pre- to post-training. The follow-up interview revealed that the majority of participants applied the acquired knowledge and skills under various circumstances such as consulting program, teaching processes, writing reports, and et al. Meanwhile, participants considered that the lack of opportunities was one of the major application barriers. In addition, they expressed the willingness to participate in more relevant training and the need for more practice opportunities. CONCLUSIONS: This is the first study evaluating a consulting training program in China. The results show that the training course has been successfully implemented and participants have been given consulting knowledge and skills. Future research should use better-designed training methods based on demand surveys and consider providing participants with practice or practicum opportunities. Also, it is necessary to conduct both primary and advanced training courses and evaluate participants' long-term behavior changes resulting from the training.

Influence of the drying method on the bioactive compounds and pharmacological activities of rhubarb.

BACKGROUND: Raw rhubarb samples that have been subjected to different drying procedures will have different therapeutic effects, possibly due to processing-induced variations in the chemical composition. In the present work, the fresh materials were processed by smoking, sun-drying, shade-drying and oven-drying at low, moderate and high temperatures. To facilitate the selection of a suitable drying method for rhubarb, the quality of rhubarb processed under various drying conditions was evaluated based on the simultaneous determination of multiple bioactive constituents in combination with bioactivity assays. RESULTS: The total concentrations of 12 compounds in smoked rhubarb were higher than the concentrations of the same components in raw rhubarb and rhubarb products processed using other drying techniques. Smoked rhubarb was found to substantially inhibit Na+ /K+ -ATPase and thrombin. In addition, higher content of anthraquinones led to higher Na+ /K+ -ATPase inhibitory activities, and higher gallic acid content increased the antithrombin capacity. CONCLUSION: The results confirmed that post-harvest fresh plant materials, especially roots, were still physiologically active organs that could undergo series of anti-dehydration mechanisms, including the production of related secondary metabolites during the early stages of dehydration. Therefore, the proper design of drying processes could enhance the quality of rhubarb as well as other similar medicinal plants. © 2018 Society of Chemical Industry.

An sd2 hybridized transition-metal monolayer with a hexagonal lattice: reconstruction between the Dirac and kagome bands.

Graphene-like two-dimensional materials have garnered tremendous interest as emerging device materials due to their remarkable properties. However, their applications in spintronics have been limited by the lack of intrinsic magnetism. Here, we perform an ab initio simulation on the structural and electronic properties of several transition-metal (TM) monolayers (TM = Cr, Mo and W) with a honeycomb lattice on a 1/3 monolayer Cl-covered Si(111) surface. Due to the template effect from the halogenated Si substrate, the TM-layers will be maintained in an expanded lattice which is nearly 60% larger than that of the freestanding case. All these isolated TM-layers exhibit ferromagnetic coupling with kagome band structures related to sd2 hybridization and a strong interfacial interaction may destroy the topological bands. Interestingly, the W-monolayer on the Cl-covered Si substrate shows a half-metallic behavior. A Dirac point formed at the K point in the spin-down channel is located exactly at the Fermi level which is crucial for the realization of a quantum spin Hall state. Moreover, the reconstruction process between the Dirac and kagome bands is discussed in detail, providing an interesting platform to study the interplay between massless Dirac fermions and heavy fermions.

Design, synthesis, immunocytochemistry evaluation, and molecular docking investigation of several 4-aminopyridine derivatives as potential neuroprotective agents for treating Parkinson's disease.

Neuroprotection refers to the relative preservation of neuronal structure and function. Neuroprotective agents refer to substances that are capable of preserving brain function and structure. Currently, there are no neuroprotective agents available that can effectively relieve the progression of Parkinson's disease. In this work, five novel 4-aminopyridine derivatives, including three amides and two ureas, were designed, synthesized, and evaluated using the rat PC12 mice pheochromocytoma cell line as an in vitro model. As well as human Rho kinase inhibitory experiment was performed. Among them, compound 3, which exhibited high cell viability, low cytotoxicity and good efficacy of inhibition on α-synuclein, oxidation, inflammation and Rho kinase, was profound as potential agents for Parkinson's disease (PD).

Quantitative studies of rhubarb using quantitative analysis of multicomponents by single marker and response surface methodology.

In this work, we developed a novel approach to evaluate the contents of bioactive components in rhubarb. The present method was based on the quantitative analysis of multicomponents by a single-marker and response surface methodology approaches. The quantitative analysis of multicomponents by a single-marker method based on high-performance liquid chromatography coupled with photodiode array detection was developed and applied to determine the contents of 12 bioactive components in rhubarb. No significant differences were found in the results from the quantitative analysis of multicomponents by a single-marker and the external standard method. In order to maximize the extraction of 12 bioactive compounds in rhubarb, the ultrasonic-assisted extraction conditions were obtained by the response surface methodology coupled with Box-Behnken design. According to the obtained results, we showed that the optimal conditions would be as follows: proportion of ethanol/water 74.39%, solvent-to-solid ratio 24.07:1 v/w, extraction time 51.13 min, and extraction temperature 63.61°C. The analytical scheme established in this research should be a reliable, convenient, and appropriate method for quantitative determination of bioactive compounds in rhubarb.

Comparison of intravascular ultrasound guided versus angiography guided drug eluting stent implantation: a systematic review and meta-analysis.

BACKGROUND: Intravascular ultrasound (IVUS) can be a useful tool during drug-eluting stents (DES) implantation as it allows accurate assessment of lesion severity and optimal treatment planning. However, numerous reports have shown that IVUS guided percutaneous coronary intervention is not associated with improved clinical outcomes, especially in non-complex patients and lesions. METHODS: We searched the literature in Medline, the Cochrane Library, and other internet sources to identify studies that compare clinical outcomes between IVUS-guided and angiography-guided DES implantation. Random-effects model was used to assess treatment effect. RESULTS: Twenty eligible studies with a total of 29,068 patients were included in this meta-analysis. The use of IVUS was associated with significant reductions in major adverse cardiovascular events (MACE, odds ratios [OR] 0.77, 95 % confidence intervals [CI] 0.71-0.83, P < 0.001), death (OR 0.62, 95 % CI 0.54-0.71, p < 0.001), and stent thrombosis (OR 0.59, 95 % CI: 0.47-0.73, P < 0.001). The benefit was also seen in the repeated analysis of matched and randomized studies. In stratified analysis, IVUS guidance appeared to be beneficial not only in patients with complex lesions or acute coronary syndromes (ACS) but also patients with mixed lesions or presentations (MACE: OR 0.69, 95 % CI: 0.60-0.79, p < 0.001, OR 0.81, 95 % CI 0.74-0.90, p < 0.001, respectively). By employing meta-regression analysis, the benefit of IVUS is significantly pronounced in patients with complex lesions or ACS with respect to death (p = 0.048). CONCLUSIONS: IVUS guidance was associated with improved clinical outcomes, especially in patients with complex lesions admitted with ACS. Large, randomized clinical trials are warranted to identify populations and lesion characteristics where IVUS guidance would be associated with better outcomes.