The clinical efficacy and safety of platelet-rich plasma on frozen shoulder: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: To systematically review the clinical efficacy (pain, function, quality of life) and safety of platelet-rich plasma (PRP) in the treatment of frozen shoulder through meta-analysis, and provide evidence-based medical evidence for the effectiveness of PRP in the treatment of frozen shoulder. METHODS: A search was conducted on international databases (Pubmed, Web of science, Embase) and Chinese databases (CNKI, Wanfang, VIP) to search the clinical studies on the efficacy of platelet-rich plasma in treating frozen shoulder (adhesive capsulitis/periarthritis/50 shoulder) and their corresponding references published from inception until January 2024. Thoroughly excluded literature not meeting the predetermined inclusion criteria, extracted relevant data from the literature, and input it into RevMan5.4 for meta-analysis. RESULTS: This study ultimately included 14 RCTs, with a total of 1024 patients. The results showed that PRP has significant advantages compared with control groups in VAS (mean difference (MD) =-0.38, 95% confidence interval(CI)(-0.73, -0.03), P = 0.03), UCLA (MD = 3.31, 95% CI (1.02,5.60),P = 0.005), DASH (MD = -4.94,95% CI (-9.34, -0.53),P = 0.03), SPADI (SPADI Total: MD =-16.87, 95% CI (-22.84, -10.91), P < 0.00001; SPADI Pain: MD =-5.38, 95% CI (-7.80, -2.97), P < 0.0001; SPADI Disability: MD =-11.00, 95% CI (-13.61,-8.39), P < 0.00001), and the active and passive Range of Motion (active flexion: MD = 12.70, 95% CI (7.44, 17.95), P < 0.00001; passive flexion: MD = 9.47, 95% CI(3.80, 15.14), P = 0.001; active extension: MD = 3.45, 95% CI(2.39, 4.50), P < 0.00001; active abduction: MD = 13.54, 95% CI(8.42, 18.67), P < 0.00001; passive abduction: MD = 14.26, 95% CI (5.97, 22.56), P = 0.0008; active internal rotation: MD = 5.16, 95% CI (1.84, 8.48), P = 0.002; passive internal rotation: MD = 3.65, 95% CI(1.15, 6.15), P = 0.004; active external rotation: MD = 10.50, 95% CI(5.47, 15.53), P < 0.0001; passive external rotation: MD = 6.00, 95% CI (1.82, 10.19), P = 0.005) except passive extension (MD = 2.25, 95% CI (-0.77, 5.28), P = 0.14). In terms of safety, most studies reported no adverse effects, and only one study reported common complications of joint puncture such as swelling and pain after treatment in both PRP and control groups. Previous studies have shown a risk of osteonecrosis caused by corticosteroids. Therefore, the safety of PRP treatment is more reliable. CONCLUSION: The results showed that PRP was more durable and safer than corticosteroids and other control groups in the treatment of frozen shoulder. STUDY DESIGN: Systematic review. TRIAL REGISTRATION: PROSPERO CRD42022359444, date of registration: 22-09-2022.

Response of changes in lake area to drought and land use change.

The lake area is a crucial parameter that characterizes the state of a lake. Under the dual pressures of climate change and human activity, the magnitude and frequency of changes in lake areas become more pronounced. This process poses a serious threat to the local ecological environment. In this study, we constructed a lake water extraction model (LakeNet) based on a fully convolutional neural network. We extracted and analyzed the spatiotemporal characteristics of the area of nine major lakes from 1987 to 2022, as well as the driving factors behind these changes. Our results indicate that: 1) LakeNet exhibits high extraction accuracy and can remove some clouds. 2) The area of the nine major lakes shows a fluctuating downward trend (-8.11km2/10a), with drought and land use changes identified as significant driving forces behind the changes in lake boundaries, drought events caused the lake area to decrease, and the expansion of cropland further reduced the lake area. 3) Due to variations in lake area, the impact of drought on the area of the nine major lakes exhibits a lag effect, smaller lakes are likely to respond more quickly to drought.

Effect of quick acupuncture combined with rehabilitation therapy on improving motor and swallowing function in patients with stroke.

OBJECTIVE: To investigate the effect of quick acupuncture combined with rehabilitation therapy on motor and swallowing function of patients with stroke. DESIGN: A retrospective study. SETTING: Single center study. PARTICIPANTS: One hundred and twenty patients with stroke were divided into control and observation group based on the therapeutic regimen. INTERVENTION: Control group (n = 60) only received rehabilitation therapy, and observation group (n = 60) received rehabilitation therapy combined with quick acupuncture. Acupuncture was performed once a day, and 6 times/week for 4 consecutive weeks. MAIN MEASURES: The simplified Fugl-Meyer assessment scale and Barthel index were used to assess limb motor function and daily living ability. The Dysphagia Outcome Severity Scale and Swallowing Quality of Life questionnaire were conducted to estimate the dysphagia severity and life quality of patients with swallowing disorders. The therapeutic efficacy and complications after treatment were analyzed and counted. RESULTS: After treatment, the scores of the observation group were significantly improved compared with the control group (P < 0.05). In the observation group, the therapeutic efficacy was 93% (n = 56); the complication rate was 5% (n = 3); the therapeutic efficacy of the control group was 75% (n = 45); and the complication rate was 25% (n = 15), indicating that the therapeutic efficacy of the observation group is better and the incidence of complications is lower than that of the control group. CONCLUSION: This study suggests that rehabilitation therapy combined with rapid acupuncture therapy has a potential therapeutic effect on the relief of swallowing and motor dysfunction after stroke.

Puromycin Prodrug Activation by Thioredoxin Reductase Overcomes Its Promiscuous Cytotoxicity.

Overexpression of the selenoprotein thioredoxin reductase (TrxR) has been documented in malignant tissues and is of pathological significance for many types of tumors. The antibiotic puromycin (Puro) is a protein synthesis inhibitor causing premature polypeptide chain termination during translation. The well-defined action mechanism of Puro makes it a useful tool in biomedical studies. However, the nonselective cytotoxicity of Puro limits its therapeutic applications. We report herein the construction and evaluation of two Puro prodrugs, that is, S1-Puro with a five-membered cyclic disulfide trigger and S2-Puro with a linear disulfide trigger. S1-Puro is selectively activated by TrxR and shows the TrxR-dependent cytotoxicity to cancer cells, while S2-Puro is readily activated by thiols. Furthermore, S1-Puro displays higher stability in plasma than S2-Puro. We expect that this prodrug strategy may promote the further development of Puro as a therapeutic agent.

In-series double cladding fibers for simultaneous refractive index and temperature measurement.

A fiber-optic sensor for simultaneous measurement of refractive index (RI) and temperature was proposed and demonstrated. It was fabricated by cascading two sections of specialty double cladding (DC) fibers which presented a pair of well-separated resonant spectra dips. The sensing properties of temperature and ambient RI were investigated theoretically based on the coupled mode theory. Experimental results indicated that these two resonant spectra shifts were linearly dependent on the variation of the RI in the range of 1.3333 approximately 1.4118 and on the temperature in the range of -10 degrees C approximately + 80 degrees C. Such a fiber-optic sensor is simple and easy for mass production and has potential applications for biosensors or chemical sensors.