The impact of long-term aspirin use on the patients undergoing shoulder arthroplasty.

BACKGROUND: Although aspirin is increasingly utilized to reduce the event of severe perioperative complications, the effect of long-term aspirin use (L-AU) on perioperative complications in patients undergoing shoulder arthroplasty (SA) has not been well studied. The goal of the present study is to identify the influence of L-AU on perioperative complications in individuals undergoing SA. METHODS: We selected data from the National Inpatient Sample database between 2010 and 2019, to identify adult patients with SA. Patients were subsequently categorized into L-AU and whole non-L-AU cohorts according to the presence of aspirin use. The demographic and comorbidity characteristics were matched using propensity score matching (PSM). The Pearson chi-square test, Wilcoxon rank test and logistic regression were utilized to assess the association of L-AU with perioperative complications. RESULTS: From 2010 to 2019, a total of 162,418 SA patients satisfied the inclusion criteria, with 22,659 (13.95%) using aspirin on a long-term basis. The vast majority of the patients with pre-existing L-AU were aged 65-74 years, female, White and had Medicare insurance. L-AU before surgery was linked to increased risks of perioperative complications, such as blood transfusion (adjusted odds ratio [aOR]: 1.339), genitourinary disease (aOR: 1.349), acute renal failure (aOR: 1.292), acute myocardial infarction (aOR: 1.494), higher total charge (L-AU vs. the whole non-L-AU vs. matched non-L-AU: $66,727.15 vs. $59,697.08 vs. $59,926.32), and prolonged hospitalization stay (LOS) (aOR: 0.837). However, L-AU was considered a protective factor of acute cerebrovascular disease (aOR: 0.722) and stroke (aOR: 0.725). CONCLUSIONS: Our study is based on the largest open-access all-payer inpatient database, revealing a noteworthy finding of aspirin's protective and adverse impact on different postoperative complications in the US population, such as acute cardiovascular disease, and stroke, etc. Further studies assessing the optimum preoperative aspirin duration and dosage to meet the best benefit quantity for patients with planned joint arthroplasties are suggested.

Efficacy of Montelukast combined with Sublingual Immunotherapy in the treatment of children with Obstructive Sleep Apnea Hypopnea Syndrome Complicated with allergic rhinitis.

Objective: To observe the efficacy of Montelukast combined with sublingual immunotherapy (SLIT) in the treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with allergic rhinitis (AR). Methods: This is a prospective study. A total of 102 children with OSAHS complicated with allergic rhinitis admitted to Hunan Children's Hospital from April 2020 to April 2021 were selected and randomly divided into two groups: sublingual group and two-drug combination group. Children in the sublingual group were treated with standardized dust mite drops Nos. 1-4 for SLIT, while those in the two-drug combination group were treated with Montelukast on top of the sublingual group. Statistical analysis and comparison were made between the two groups of children in terms of Sleep apnea hypopnea index (AHI), Hypoxic saturation (Lsao2), interleukin-4, Il-4), interleukin-17 (IL-17), OSA-18 Snoring Symptom Scale for Children (OSA-18), allergic rhinitis symptom scale (TNSS), efficacy, occurrence of adverse reactions, etc. Results: After treatment, the AHI index of the two-drug combination group was significantly decreased, and the Lsao2 index was significantly increased compared with the sublingual group (P<0.05). Compared with the sublingual group, the levels of IL-4 and IL-17 in the two-drug combination group were significantly decreased (P<0.05), the OSA-18 score and TNSS score were significantly lower (P<0.05). Moreover, compared with the sublingual group, the efficacy of the two-drug combination group was significantly increased (P<0.05), the incidence of adverse reactions was significantly lower (P<0.05). Conclusion: Montelukast combined with sublingual immunotherapy offers many advantages, such as effectively controlling nasal allergy symptoms in children with OSAHS complicated with allergic rhinitis and improving OSAHS symptoms.

Factors influencing utilization of communicable disease prevention and treatment education among the floating population: a cross-sectional study in China.

BACKGROUND: In China, communicable diseases (CD) have a negative impact on public health and economic stability. The influx of migrants, who make up a substantial portion of China's population and continue to rapidly expand, has seriously hampered CD prevention and control, needing special care. This study aimed to identify key factors influencing the utilization of CD prevention and treatment education (CDPTE) among the floating population. We are confident that the findings will highlight obstacles facing CDPTE among the migrants, and guide future development prevention, treatment of CD, and health education services. METHODS: A sample of migrants aged 15 years and above in 32 provincial units nationwide in 2018 was recruited by stratified multi-stage proportional to population size sampling (PPS). A structured questionnaire survey was conducted via face-to-face interviews. Subsequently, the Anderson health service utilization model was used as the theoretical framework and SPSS 26.0 statistical software was applied to analyze the data. The statistical description of the current situation of CDPTE acceptance and the chi-square test were used to compare the differences in CDPTE acceptance by different characteristics. Multivariate logistic regression was used to analyze key factors affecting the use of CDPTE among migrants. RESULTS: A total of 40.1% of the recruited participants reported receiving education on CD prevention and treatment, primarily delivered through traditional transmission media. Multilevel logistic regression results revealed that male migrants, aged 30-49 years, unmarried, with higher educational attainment, an average monthly household income of CNY 7,500-9,999 (or US$1,176-1,568), working more than 40 h per week, flowing into the Central and Western regions, migrated in the province, self-rated health, contracted family doctors and those with health records were more likely to receive CDPTE (p < 0.05). CONCLUSION: Our findings revealed unsatisfactory acceptance of education on CD prevention and treatment among migrants, implying that health education should be strengthened further. Publicity of relevant policies and works should be strengthened and specific interventions should be developed for key regions as well as vulnerable groups to enhance CDPTE. More financial support should also be provided to improve the quality of health education.

Music alleviates pain perception in depression mouse models by promoting the release of glutamate in the hippocampus of mice to act on GRIK5.

Objective: To explore the effect of music in pain perception and the molecular mechanism. Methods: Mice were separated to control, music, music + inhibitor, and saline group. Percentage pain reduction of mice in each group was determined. The contents of 5-HT, Glu, and NE in cerebrospinal fluid of mice in the four groups were determined by HPLC. FISH was used to analyze the distribution characteristics of GRIK5 in hippocampal tissues. The protein expressions of GRIK5, NMDA 1, and TRPC1 in the hippocampal tissues were determined via western blot. Results: Mice exposed to music showed a higher percentage of pain reduction compared to model animals, while injection of GRIK5 inhibitor weakened the effect of music. It increased the contents of 5-HT, Glu, and NE in mouse models of depression. The fluorescence signal in music group was significantly stronger than saline group. Music remarkably increased the expression of GRIK5, DLG4, NMDA 1, and TRPC1 proteins when compared with saline group. Conclusion: Music promoted the secretion of Glu. The glutaminergic pathway sensed Glu, subsequently activated GRIK5, DLG4, and NMDA 1 proteins to excite dopaminergic neurons, and finally promoted the production of 5-HT.

Inhibition of miR-205 promotes proliferation, migration and fibrosis of tenocytes through targeting MECP2: Implications for rotator cuff injury.

BACKGROUND: The production of inflammatory mediators is critical for tenocytes proliferation and migration, which play an important role in rotator cuff injury repair and regulation of collagen. MicroRNA (miRNA)-205 (miR-205) promotes the secretion of inflammatory factors. The mechanism of the tenocytes regulation by miR-205 remains unknown. In this paper, we showed that miR-205 can regulate the proliferation, migration and fibrosis of tenocytes. OBJECTIVES: To investigate the function and mechanism of miR-205/MeCP2 pathway on the proliferation, migration and fibrosis of rotator cuff tenocytes, in order to provide a new perspective on the repair of rotator cuff tear injury. MATERIAL AND METHODS: The tenocytes were collected under sterile conditions from the Achilles tendons of Sprague Dawley (SD) rats (weighing 150-200 g). The cells of passages 2-4 were used for the following experiments. All miRNA and vectors were transfected with Lipofectamine 2000. Reverse-transcription quantitative real-time polymerase chain reaction (RT-qPCR), Cell Counting Kit-8 (CCK-8) assay, luciferase reporter assay, and migration assay were performed. Then, immunoblotting analysis and statistical analysis were conducted. RESULTS: The CCK-8 and migration assay revealed that miR-205 inhibition resulted in increased tenocytes proliferation, migration and fibrosis. The miR-205 reduced the mRNA and protein expression levels of MECP2, which is involved in cell proliferation and migration of tenocytes. The miR-205 inhibited luciferase intensity under the control of the 3'UTRs of MECP2. CONCLUSIONS: The inhibition of MECP2 reversed the effect of miR-205 inhibitor on tenocytes, including the proliferation and migration of tenocytes, indicating that miR-205 may be valuable in miRNA-based therapies for rotator cuff injury.

The efficacy and safety of platelet-rich fibrin for rotator cuff tears: a meta-analysis.

BACKGROUND: The aim of this meta-analysis was to evaluate the efficacy and safety of platelet-rich fibrin (PRF) in improving clinical outcomes in rotator cuff tears. METHODS: We searched the following databases: Pubmed, Embase, and Cochrane library databases from inception to April 2018. Studies that compared platelet-rich fibrin versus placebo for rotator cuff tears were included in this meta-analysis. Risk ratio (RR) with 95% confidence interval (CI) was pooled for discontinuous outcome, and weighted mean difference (WMD) with 95% CI was pooled for continuous outcome. Stata 12.0 was used for meta-analysis. RESULTS: A total of eight studies with 219 patients were finally included in this meta-analysis. Compared with the control group, PRF has a negative role in reducing the re-tear rate (RR = 1.30, 95% CI = 0.97 to 1.75; P = 0.082). Subgroup analysis of re-tear rate was consistent in all subgroup analyses (single row or double row, volume, and risk of bias). There was no significant difference between the American Shoulder and Elbow Surgeons scale, University of California at Los Angeles scale, Constant score, and side effect (P > 0.05). CONCLUSION: In conclusion, our meta-analysis suggests that the PRF does not have better effect on improving the overall clinical outcomes and re-tear rate in the arthroscopic repair of rotator cuff tears.