The causal relationship between gut microbiota and bone mineral density: a Mendelian randomization study.

Background: The gut microbiota has emerged as an intriguing and potentially influential factor in regulating bone health. However, the causal effect of the gut microbiota on bone mineral density (BMD) appears to differ throughout various life stages. Methods: We conducted a Mendelian randomization (MR) analysis to investigate the potential causal relationship between gut microbiota and BMD in five distinct age groups: 0-15, 15-30, 30-45, 45-60, and 60 years and older. The analysis employed three different methods, namely MR-Egger, weighted median, and Inverse-variance weighting, to ensure the robustness of our findings, a series of sensitivity analyses were also conducted, such as horizontal pleiotropy tests, heterogeneity tests, and leave-one-out sensitivity tests. Results: In the age group of 0-15 years, Eubacterium_fissicatena_group and Eubacterium_hallii_group were identified as risk factors for BMD. During the 15-30 age group, Phascolarctobacterium, Roseburia, and Ruminococcaceae_UCG_003 were found to be protective factors for BMD. In the 30-45 age group, Lachnospira genus demonstrated a protective effect on BMD, while Barnesiella and Lactococcus were identified as risk factors for BMD. Moving on to the 45-60 age group, Eubacterium_ventriosum_group, Lachnospiraceae_UCG_004, and Subdoligranulum were observed to be protective factors for BMD, while Eubacterium_coprostanoligenes_group, Fusicatenibacter, and Lactococcus were associated with an increased risk of BMD. In individuals aged 60 years and older, Fusicatenibacter and Ruminococcaceae_UCG_002 were also noted as risk factors for BMD. Conversely, Eubacterium_ruminantium_group, Ruminococcus_gauvreauii_group, Alistipes, and Coprococcus_3 were found to be protective factors for BMD, whereas Barnesiella and Sellimonas were identified as risk factors for BMD. Conclusion: A robust causal relationship between gut microbiota and bone mineral density (BMD) exists throughout all stages of life, with Firmicutes phylum being the primary group associated with BMD across age groups. Gut microbiota linked with BMD primarily belong to the Firmicutes phylum across age groups. The diversity of gut microbiota phyla associated with BMD depicts relatively stable patterns during the ages of 0-45 years. However, for individuals aged 45 years and above, there is an observed increase in the number of gut microbiota species linked with BMD, and by the age of 60 years, a trend toward an increase in the Bacteroidetes phylum categories is proposed.

Pleomorphic Adenoma of Nasal Septum a Case Report.

Introduction: Pleomorphic adenoma is a common benign tumor of large and small salivary glands. It mainly occurs in the parotid gland, followed by the submandibular gland, sublingual gland and small salivary gland in the oral cavity. It is very rare in the nasal septum. Patient Concerns: A 27-year-old female patient attended our clinic with Nasal congestion and a diminished sense of smell. Diagnoses: Endoscopic examination revealed a mass within the right nasal passage. A pathological biopsy revealed pleomorphic adenoma. Interventions: The nasal septum pleomorphic adenoma was resected by endoscopic approach. Outcomes: No recurrence was observed for over 41 months of follow-up. Conclusion: To prevent recurrence, extensive local resection with clear histological margins and long-term endoscopic follow-up with an endoscope are necessary.

Observation on the efficacy of sublingual immunotherapy with dust mite allergen for perennial allergic rhinitis and the mechanism of action on ILCs with ILC1s and ILC2s and ILC3s.

BACKGROUND: Allergic rhinitis (AR) is considered to be 1 of the most difficult diseases to treat globally. It has a serious impact on the quality of life and social economy of patients and has become an important global health problem. Several drugs have been recommended to treat AR, but their effectiveness and mechanism of action in these patients remain unclear. The purpose of this study will be to compare the efficacy and mechanism of action of 2 drugs for the treatment of AR (moderate to severe): a Dermatophagoides Farinae Drops Sublingual Immunotherapy and a Momethasone Furoate nasal spray as an adjunct to the treatment of subjects with AR. METHODS: A randomized, prospective, double-blind (patient and evaluator) clinical trial. The participants (n = 60) will be randomly distributed into 2 groups. The experimental group will receive a sublingual Immunotherapy for 3 months. The control group will receive the mometasone furoate nasal spray for 3 months. Before treatment, 1 month and 3 months after treatment, total nasal symptom score scale, Visual analogue Scale and Quality of Life questionnaire of rhinoconjunctivitis will be measured and Changes of the serums of IgE, interferon-γ, IL-4, IL-17, tumor necrosis factor-α, IL-5, IL-9, IL-13, IL-25, IL-33, vascular endothelial growth factor, TSLP and IL-22 in both groups. The measurements will be performed by the same researcher who was unaware of the participants' subgroup. DISCUSSION: We believe that the treatment of perennial AR with sublingual Immunotherapy and nasal hormones will be more effective in these patients. Furthermore, the sublingual Immunotherapy mainly acts mostly on the cellular immunity, while nasal hormones mainly act on local inflammatory responses. We expect to clarify which treatments are more effective and how they work in improving perennial AR.

Effectiveness of Low-temperature plasma tonsillectomy for chronic tonsillitis. A protocol of systematic review and meta-analysis.

AIM: Recurrent episodes of chronic tonsillitis (CT) can affect a patient's quality of life, physical and mental health. Clinicians often perform surgeries to remove them. Traditional surgical methods are varied, despite their advantages. However, this remains controversial. This study aimed to examine both the safety and efficacy of low-temperature plasma tonsillectomy (LTPT) in treatment of chronic tonsillitis, which may provide a substitute for clinicians and compensate for the short supply of therapeutic procedures. METHODS AND ANALYSIS: This protocol is guided by the Preferred Reporting Items for Systematic. REVIEW AND META-ANALYSIS: Protocols (PRISMA-P) and by the Cochrane Collaboration Handbook. We will formulate strict inclusion and exclusion criteria in English databases (PubMed, EMBASE, and Web of Science) and search literature in different clinical registration platforms (Cochrane Library). The including articles were evaluated by the Cochrane RCT evaluation criteria. The primary main endpoints will include the duration of operation, blood loss during surgery, time of formation and exfoliation of the pseudomembrane, average pain and duration post-operation, and time for normal diet. The Secondary endpoints will include complications of postoperative bleeding and infection. Stata 15.0 will be used for data analysis. Subgroup analysis, sensitivity analysis, and meta-regression were used to detect the sources of heterogeneity. Begg's Test will quantitatively detect publication bias quantitatively. ETHICS AND DISSEMINATION: The results of this meta-analysis and meta-regression will be disseminated through publication in a peer-reviewed journal. The data used in this meta-analysis will not contain individual patient data; therefore, ethical approval is not required. KEY WORDS: Chronic tonsillitis, Low-temperature plasma tonsillectomy, Meta-analysis, Protocol, Systematic review.

[Clinical application of lumbar hyperextension MRI in the diagnosis of lumbar spinal stenosis].

OBJECTIVE: To evaluate the diagnostic value of lumbar hyperextension MRI, through studying the changes of spinal stenosis degree in lumbar hyperextension position. METHODS: From September 2018 to February 2020, 26 patients with lumbar spinal stenosis did lumbar spine neutral and hyperextension MRI scans. There were 11 males and 15 females, aged from 43 to 85 (64.00±10.37) years. As 6 patients induced and aggravated the symptoms of low back and leg pain in the hyperextension position, qualified MRI data could not be collected. Because of that, a total of 20 patients' qualified data were collected. Mimics Medical 21.0 medical image processing software was used to measure the relevant diagnostic parameters of lumbar spinal stenosis, analyze the change rules statistically, and evaluate the degree of lumbar spinal stenosis and changes in nerve compression in the hyperextension position. RESULTS: The sagittal diameter and cross sectional area of the lumbar spinal bony canal do not change significantly with the body position;the sagittal diameter of the dural sac, the sagittal diameter of the dural sac, and the disc yellow space all have different degrees of decline in the hyperextension position. CONCLUSION: For the imaging diagnosis of lumbar spinal stenosis, lumbar spine hyperextension position MRI can be a good complement for the routine neutral MRI examination, and it is more sensitive to the clinical diagnosis of lumbar spinal stenosis.

Effects of houttuynia cordata thunb. on rhinosinusitis by nasal irrigation: A protocol for systematic review and meta-analysis.

BACKGROUND: The herba Houttuynia cordata Thunb. (HC) has anti-inflammatory, antibacterial and antiviral effects. Through nasal irrigation, the related preparation of HC is beneficial for treating rhinosinusitis or promoting recovery after an endoscopic sinus surgery. However, it remains controversial whether nasal irrigation with HC preparation can provide evidence-based clinical benefits for rhinosinusitis patients. METHODS: With reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 8 databases are perused to perform a methodical investigation of nasal irrigation with HC preparation and health-related results amongst rhinosinusitis patients. The main research purpose is to determine the influence of PRISMA standards on medical results pertaining to rhinosinusitis patients, including quantitative symptom recording and effective rate. With reference to the Cochrane Handbook, quality assessment of qualified papers is conducted using the Cochrane Risk Assessment Tool. RESULTS: The results will be publicised through a peer-reviewed journal publication. CONCLUSION: The results of the systematic review will summarise evidences for the efficacy of nasal irrigation with HC preparation in rhinosinusitis treatment. ETHICS AND DISSEMINATION: Since this study involves a methodical investigation of issued medical papers, ethical authorisation and informed patient consent are not necessary.

Efficacy and safety of modified Yupingfeng formula in treating allergic rhinitis: A protocol for systematic review and meta analysis.

BACKGROUND: Allergic rhinitis (AR) is a non-infectious chronic nasal mucosal disease mediated mainly by IgE, which affects 40% of the global population and has a recurrence rate of more than 50%. The modified Yupingfeng formula (MYPFF) is widely used in the treatment of allergic rhinitis in China. However, there is no evidence-based medical evidence for the efficacy and safety of MYPFF in the treatment of allergic rhinitis. METHODS: Database as China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database (VIP database), Wan-Fang Database, the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, and Web of Science will be searched for relevant literature from inception to September 2020. Data extraction will be performed on the obtained literature. Then RevMan V.5.3 will be used for the assessment of the risk of bias and data synthesis. RESULTS: The results will be published in a peer-reviewed journal. CONCLUSION: The conclusion of the study will provide an evidence to efficacy and safety of MYPFF in treating allergic rhinitis, which will be of significant meaning for further research and clinical practice. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/RV9P4.

Is nasal septal suturing an alternative technique to nasal packing?: A protocol for systematic review and meta-analysis.

BACKGROUND: Nasal septal suturing is a commonly used alternative treatment to nasal packing after septoplasty. Besides alleviating postoperative discomfort, extensive studies have shown that nasal septal suturing is more effective than nasal packing. However, its clinical benefits remain controversial. METHODS: We will perform a systematic review of nasal packings effect-related outcome in comparison to nasal septum suture among septoplasty patients by searching 8 databases, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). All eligible studies will be screened against the inclusion and exclusion criteria. Two independent reviewers will extract the data. Moreover, Review Manage 5.3 will be used for quality assessment and data analysis. Then, the random effects model or fixed effects model will be applied according to the heterogeneity. In conformity with the GRADE criteria, the merits of the evidence and recommended strength will be assessed. RESULTS: This protocol will guide subsequent systematic reviews and meta-analyses. The differences in efficacy between nasal septal suturing and nasal packing after septoplasty will be evaluated in terms of efficiency, adverse reaction, comfort degree, and other factors. CONCLUSION: This proposed study will explore the possibility of adopting nasal septal suturing as an alternative to nasal packing after septoplasty. OSF REGISTRATION NUMBER:: doi: 10.17605/OSF.IO/WF3GX.

[Progress of epithelial-derived thymic stromal lymphopoietin (TSLP) in allergic diseases: An update].

Thymic stromal lymphopoietin (TSLP) is an important factor that affects the development of allergic diseases. Single nucleotide polymorphism of TSLP is closely related to the susceptibility, course and severity of allergic diseases. Following exposure to allergens, multiple signalling pathways in epithelial cells mediate TSLP expression and induce an immune cascade. TSLP affects epithelial physical barrier damage by inhibiting the expression of tight junctions, adhesion junctions and desmosomes and destroying the lipid layer. Two isomers of TSLP have antibacterial properties and can enhance the defence ability of the skin and mucosa. Moreover, TSLP plays a protective role by up-regulating the expression of tight junction proteins during early inflammation. In allergic diseases, TSLP participates in the proliferation and differentiation of various immune cells through the TSLP receptor pathway and releases pro-inflammatory and chemokine factors, thus mediating immune inflammation. Furthermore, TSLP is involved in airway remodelling in respiratory allergies by inducing fibrocyte migration and recruitment and promoting epithelial-mesenchymal transformation. Therefore, inhibition of TSLP may be a potential target for the treatment of allergic diseases. Research on biological agents targeted by TSLP is warranted for the treatment of allergic diseases in the future.

The Tai Chi training for middle-aged and elderly patients with knee osteoarthritis: A protocol for systematic review and meta analysis.

BACKGROUND: Knee osteoarthritis (KOA) is a disabling joint disease with an increasingly prevalence among the older individuals. Tai Chi, one of the ancient meditative movements, has been recognized to have clinical benefits for KOA. We aim to evaluate the efficacy and safety of Tai Chi for patients with KOA through this systematic review. METHODS: Five English databases (Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED, and CINAHL), 4 Chinese databases (CBM, CNKI, CQVIP, and Wanfang), and 5 clinical trial registration databases (ClinicalTrials.gov, ANZCTR, EU-CTR, ChiCTR, and ICTRP) will be searched from establishment of the database until November 31, 2019. Grey literature will be searched in SIGLE, Grey Net, Microsoft Academic, Google Scholar, Open Aire, World Wide Science.org, and WorldCat. There will be no restrictions on language. The randomized controlled trials of Tai Chi training for patients with KOA will be included. The primary outcome will be assessed according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Meta-analysis will be conducted with the use of RevMan 5.3. The specific process will refer to the Cochrane Handbook 5.1 for Systematic Review. RESULTS: High-quality synthesis of current evidence on the efficacy and safety of Tai Chi training for KOA will be provided in this study. CONCLUSION: This systematic review aims to present evidence for whether Tai Chi training is an effective intervention which can improve both physical condition and life quality in patients suffering KOA.