Effects of the feeding protocol during blood transfusion on splanchnic tissue oxygenation and complications in very premature infants.

Background: The effects of blood transfusions on splanchnic oxygenation and complications related to blood transfusions, including red blood cell (RBC) transfusions, in premature infants undergoing enteral feeding, to provide clinical evidence for a management protocol for premature infants during the peri-transfusion period. Methods: This single-blind, randomized, controlled trial enrolled sixty eligible preterm infants who were randomly divided into the withholding feeding group (n = 30) or feeding group (n = 30). Enteral feeding was withheld for 8 h, beginning from the start of transfusion infants in the feeding group were fed according to the pre-transfusion feeding approach during and after RBC transfusion. Results: Baseline characteristics of those in the withholding and feeding groups were as follows: gestational age (weeks) 27.52 (24.86-30.14) and 27.13 (25.43-30.14); birth weight (g), 1,027 (620-1,450) and 1,027 (620-1,270); blood transfusion day, 48 (14-79) and 39 (10-78); and hemoglobin before blood transfusion (g/L), 81.67 (±10.56) and 85.93 (±14.77). No significant differences were observed between groups at baseline. No significant differences were observed in the average splanchnic tissue oxygenation changes or clinical results at any time. One patient in the withholding feeding group experienced transfusion-associated necrotizing enterocolitis. Conclusions: No differences in splanchnic oxygenation observed these feeding protocols. This study suggests the feasibility of a sizable trial to evaluate clinical outcomes. The risks of mesenteric ischemia and transfusion-related necrotizing enterocolitis for premature infants were not increased by enteral feeding during RBC transfusion. Clinical trial registration: ChiCTR2200055726 (https://www.chictr.org.cn/).

Spindle cell embryonal rhabdomyosarcoma of the prostate in an adult patient: a case report and review of the literature.

Rhabdomyosarcoma of the prostate is a rare mesenchymal tumor that originates from undifferentiated mesenchymal cells. Spindle cell rhabdomyosarcoma is a variant of embryonal rhabdomyosarcoma. The vast majority of these two pathological types occur in children, with only a few adult cases reported to date, and both are associated with poor clinical outcomes. We herein report a case involving a man in his early 40s with spindle cell embryonal rhabdomyosarcoma of the prostate. His chief complaint was difficult urination. The diagnosis was confirmed by puncture biopsy of the prostate, and pelvic lymph node metastasis was already present at the time of diagnosis. The patient underwent three courses of chemotherapy. However, his response to the treatment was very poor, and he died of the disease 4 months after diagnosis.

Optimizing lower limb rehabilitation: the intersection of machine learning and rehabilitative robotics.

Lower limb rehabilitation is essential for recovery post-injury, stroke, or surgery, improving functional mobility and quality of life. Traditional therapy, dependent on therapists' expertise, faces challenges that are addressed by rehabilitation robotics. In the domain of lower limb rehabilitation, machine learning is progressively manifesting its capabilities in high personalization and data-driven approaches, gradually transforming methods of optimizing treatment protocols and predicting rehabilitation outcomes. However, this evolution faces obstacles, including model interpretability, economic hurdles, and regulatory constraints. This review explores the synergy between machine learning and robotic-assisted lower limb rehabilitation, summarizing scientific literature and highlighting various models, data, and domains. Challenges are critically addressed, and future directions proposed for more effective clinical integration. Emphasis is placed on upcoming applications such as Virtual Reality and the potential of deep learning in refining rehabilitation training. This examination aims to provide insights into the evolving landscape, spotlighting the potential of machine learning in rehabilitation robotics and encouraging balanced exploration of current challenges and future opportunities.

The impact of the route of administration on the efficacy and safety of the drug therapy for patent ductus arteriosus in premature infants: a systematic review and meta-analysis.

Background: This systematic review and meta-analysis aims to explore the potential impact of the route of administration on the efficacy of therapies and occurrence of adverse events when administering medications to premature infants with patent ductus arteriosus (PDA). Method: The protocol for this review has been registered with PROSPERO (CRD 42022324598). We searched relevant studies in PubMed, Embase, Cochrane, and the Web of Science databases from March 26, 1996, to January 31, 2022. Results: A total of six randomized controlled trials (RCTs) and five observational studies were included for analysis, involving 630 premature neonates in total. Among these infants, 480 were in the ibuprofen group (oral vs. intravenous routes), 78 in the paracetamol group (oral vs. intravenous routes), and 72 in the ibuprofen group (rectal vs. oral routes). Our meta-analysis revealed a significant difference in the rate of PDA closure between the the initial course of oral ibuprofen and intravenous ibuprofen groups (relative risk (RR) = 1.27, 95% confidence interval (CI) [1.13-1.44]; P < 0.0001, I2 = 0%). In contrast, the meta-analysis of paracetamol administration via oral versus intravenous routes showed no significant difference in PDA closure rates (RR = 0.86, 95% CI [0.38-1.91]; P = 0.71, I2 = 76%). However, there was no statistically significant difference in the risk of adverse events or the need for surgical intervention among various drug administration methods after the complete course of drug therapy. Conclusion: This meta-analysis evaluated the safety and effectiveness of different medication routes for treating PDA in premature infants. Our analysis results revealed that compared with intravenous administration, oral ibuprofen may offer certain advantages in closing PDA without increasing the risk of adverse events. Conversely, the use of paracetamol demonstrated no significant difference in PDA closure and the risk of adverse events between oral and intravenous administration.

Bone morphogenetic protein-2 and pulsed electrical stimulation synergistically promoted osteogenic differentiation on MC-3T3-E1 cells.

Electrical stimulation (ES) plays an important role in regulating cell osteoblast differentiation. As a noninvasive rehabilitation therapy method, Es has a unique role in postoperative recovery. Bone morphogenetic protein-2 (BMP-2) is the most commonly used bioactive molecule in in situ tissue engineering scaffolds, and it plays an important regulatory role in the whole process of bone injury repair. In this study, the osteogenic regulation of MC-3T3-E1 cells was studied by combining pulsed electrical stimulation (PES) and different concentrations of BMP-2. The results showed that PES and BMP-2 could synergically promote the proliferation of MC-3T3-E1 cells. The qPCR results of osteoblast-related genes showed that PES was synergistic with BMP-2 to promote osteoblast differentiation mainly through the regulation of the Smad/BMP and insulin like growth factor 1 (IGF1) signaling pathways. The expression level of alkaline phosphatase (ALP) and alizarin red staining further demonstrated the synergistic effect of PES and BMP-2 on promoting osteogenic differentiation and mineralization of cells. PES and BMP-2 could also synergically promote cell proliferation, expression of collagen I (COL-I) and ALP, and cell mineralization on the 3D-printed polylactic acid scaffold. These results suggest that the use of PES can enhance the osteogenic effect of in situ bone repair scaffolds containing BMP-2, reduce the dose of BMP-2 alone, and reduce the possible side effects of high-dose BMP-2 in vivo.

100Gb/s coherent optical secure communication over 1000†km based on analog-digital hybrid chaos.

In recent years, the transmission capacity of chaotic secure communications has been greatly expanded by combining coherent detection and multi-dimensional multiplexing. However, demonstrations over 1000 km fiber are yet to be further explored. In this paper, we propose a coherent optical secure transmission system based on analog-digital hybrid chaos. By introducing an analog-digital converter (ADC) and a bit extraction into the feedback loop of entropy source, the broadband analog chaos is converted into a binary digital signal. This binary digital signal is then mapped to a 65536-level pulse amplitude modulation (PAM) signal and injected into the semiconductor laser (SL) to regenerate the analog chaos, forming a closed loop. The binary digital signal from the chaos source and the encrypted signal are transmitted via wavelength division multiplexing (WDM). By using conventional digital signal processing (DSP) algorithms and neural networks for post-compensation, long-haul high-quality chaotic synchronization and high-performance secure communication are achieved. In addition, the probability density distribution of the analog chaotic signal is effectively improved by adopting the additional higher-order mapping operation in the digital part of the chaos source. The proof-of-concept experimental results show that our proposed scheme can support the secure transmission of 100 Gb/s quadrature phase shift keying (QPSK) signals over 1000 km of standard single-mode fiber (SSMF). The decrypted bit error rate (BER) reaches 9.88 × 10-4, which is well below the 7% forward error correction (FEC) threshold (BER = 3.8 × 10-3). This research provides a potential solution for high-capacity long-haul chaotic optical communications and fills the gap in secure communications based on analog-digital hybrid chaos.

The Lnc-HOTAIR/miR122/PPARγ signaling mediated the occurrence and continuous development of alcohol-induced Osteonecrosis of the femoral head.

This study aimed to explore the mechanism of alcohol-induced Osteonecrosis of the femoral head (ONFH) through in vivo and in vitro experiments. In vitro, the Oil Red O staining showed that ethanol promoted extracellular adipogenesis in a dose-dependent manner. ALP staining and alizarin red staining showed that ethanol inhibited the formation of extracellular mineralization in a dose-dependent manner. The Oil Red O staining showed that miR122 mimics and Lnc-HOTAIR SiRNA rescued extracellular adipogenesis induced by ethanol in BMSCs. Besides, we found that the high expression of PPARγ in BMSCs recruited histone deacetylase 3 (HDAC3) and histone methyltransferase (SUV39H1), which reduced the histone acetylation level and increased the histone methylation level in the miR122 promoter region, respectively. In vivo, the levels of H3K9ac, H3K14ac, and H3K27ac of miR122 promoter region in the ethanol group were significantly decreased compared to the control group, respectively. The levels of H3K9me2 and H3K9me3 of miR122 promoter region in the ethanol group were significantly increased compared to the control group. Lnc-HOTAIR/miR-122/PPARγ signaling mediated the alcohol-induced ONFH in the rat model. Furthermore, the persistent decrease of miR122 expression mediated the continuous progress of alcohol-induced ONFH after stopping alcohol consumption.

Silicon and gadolinium co-doped hydroxyapatite/PLGA scaffolds with osteoinductive and MRI dual functions.

Introduction: An ideal bone repair scaffold should have dual functions of osteoinductive ability and in vivo imaging. In this study, the simultaneous substitution of silicon (Si) and gadolinium (Gd) in hydroxyapatite (HA) as potential multifunctional bone graft materials has been successfully developed. Methods: A series of HA nanoparticles (HA NPs) doped with different proportions of Si and Gd were prepared. The chemical structure and phase composition of the materials were analyzed using Fourier transform infrared (FTIR) spectroscopy and X-ray diffraction (XRD). The microstructure, magnetic properties, surface potential, and cytotoxicity of the materials were also analyzed. The magnetic resonance imaging (MRI) effect of Gd&Si-HA/poly(lactic-co-glycolic acid) (Gd&Si-HA/PLGA) composite materials was evaluated. Osteogenic-related gene expression, alkaline phosphatase (ALP) level, and mineralization capacity of MC3T3-E1 cultured on Gd&Si-HA/PLGA composite materials were also detected. Results and Discussion: The 1.5Gd&Si-HA@PLGA group showed good ability to promote osteogenic differentiation of cells. The MRI effect of the 1.5Gd&Si-HA@PLGA scaffold was observable. This HA material containing Si and Gd co-doping has a broad application prospect in the field of bone tissue engineering owing to its ability to enhance osteoinductive property and improve MRI effect.

Efficacy, residual effectiveness and safety of diacerein in the treatment of knee osteoarthritis: A meta-analysis of randomized placebo-controlled trials.

BACKGROUND: Osteoarthritis (OA) is the leading cause of disability in the elderly. Prevention and treatment of OA have become an urgent global demand. The pharmacologic role of diacerein in the treatment of osteoarthritis is controversial. We systematically reviewed the efficacy, safety, and residual effectiveness of diacerein. OBJECTIVES: To estimate the symptomatic efficacy, residual effect and safety of diacerein in the treatment of knee osteoarthritis, using a meta-analysis of published randomized controlled trials (RCTs). METHODS: On December 1, 2021, we searched PubMed Medline, Web of Science, Cochrane Library databases, Wan Fang Medical Database, and National Knowledge Infrastructure. This study followed the inclusion criteria of the principle P(Population), I(Intervention), C(Comparison), O(Outcome), S (Study design) principle. All studies were randomized controlled trials of knee osteoarthritis. Cochrane bias risk assessment tool was used to assess the risk of bias. Meta-analyses were performed using a random-effects model. To explore sources of heterogeneity, subgroup analysis, sensitivity analysis, regression analysis and publication bias analysis were performed. Drug side effects with complete data were extracted from the included articles and then a combined analysis of these data was performed. RESULTS: Eight studies were eligible and were included in our analysis (N = 1277 participants). All studies were randomized controlled trials of knee osteoarthritis. There was no significant difference in reduction of joint pain and improvement of function between diacerein and the control group. However, subgroup analysis suggested, compared with the placebo group, diacerein treatment yielded an improved mean reduction in visual analogue scale score of-0.44% (95% confidence interval [CI]-0.79 to 0.09), an improved the western Ontario and McMaster universities (physical function) score of -0.44% (95% CI-0.72 to -0.12). Follow-up analysis after discontinuation showed that diacerein treatment had a significant residual effect (95% CI-0.81 to- 0.24). Data on drug side effects described in the included articles were extracted for statistical analysis. There was an increased risk of diarrhea with diacerein (Risk Ratio [RR] = 1.95 [1.03 to 2.47]) and withdrawal event from therapy (RR = 0.93 [0.75 to 1.15]). CONCLUSION: Diacerein might be considered an effective drug for the treatment of patients with KOA, showing short-term residual effectiveness. Although it is associated with an increased risk of diarrhea, the adverse event is mostly tolerable.

Anp32e promotes renal interstitial fibrosis by upregulating the expression of fibrosis-related proteins.

Acidic nuclear phosphoprotein 32 family member e (Anp32e) has been reported to contribute to early mammalian development and cancer metastasis. However, the pathophysiological role of Anp32e in renal interstitial fibrosis (RIF) is poorly understood. Here, we demonstrated that Anp32e was highly expressed in the region of RIF in patients with IgA nephropathy, unilateral ureteral obstruction (UUO) mouse kidneys, and Boston University mouse proximal tubular (BUMPT) cells when treated with TGF-ß1; this upregulation was positively correlated with the total fibrotic area of the kidneys. The overexpression of Anp32e enhanced the TGF-ß1-induced production of fibrosis-related proteins (fibronectin (Fn) and collagen type I (Col-I)) in BUMPT cells whereas the knockdown of Anp32e suppressed the deposition of these fibrosis-related proteins in UUO mice and TGF-ß1-stimulated BUMPT cells. In particular, Anp32e overexpression alone induced the deposition of Fn and Col-I in both mouse kidneys and BUMPT cells without TGF-ß1 stimulation. Furthermore, we revealed that the overexpression of Anp32e induced the expression of TGF-ß1 and p-Smad3 while TGF-ß1 inhibitor SB431542 reversed the Anp32e-induced upregulation of Fn and Col-I in BUMPT cells without TGF-ß1 stimulation. Collectively, our data demonstrate that Anp32e promotes the deposition of fibrosis-related proteins by regulating the TGF-ß1/Smad3 pathway.

DAC/ADC-free 4 × 12.9 Gbit/s 65,536-level quantum noise stream cipher secure optical WDM transmission based on delta-sigma modulation.

We propose and experimentally study a novel, to the best of our knowledge, quantum noise stream cipher (QNSC) secure transmission scheme based on the delta-sigma modulation (DSM) technique. The cooperation of the QNSC and DSM mechanisms makes it possible to transmit an ultrahigh-order encrypted signal in the non-return-to-zero (NRZ) on-off keying (OOK) format. The delivery of the NRZ OOK waveform over the fiber link allows us to send and receive signals using digital ports, instead of high-speed and high-resolution digital-to-analog converters (DACs) and analog-to-digital converters (ADCs) in conventional QNSC systems. Meanwhile, clock synchronization can be achieved by using a simple clock data recovery algorithm. The extra clock signal transmission link in conventional QNSC systems is no longer needed. The proposed scheme is also compatible with wavelength division multiplexing (WDM) systems. In this work, 4 × 12.9 Gbit/s plaintext is encrypted to a 65,536-level QNSC signal and then transmitted over a 10-km standard single-mode fiber. The transmitter and receiver are established by commercial 100G QSFP28 optical modules with clock data recovery. This proposed scheme can be easily deployed in commercial systems due to its minimalist implementation architecture and relatively low hardware cost.

60 Gb/s coherent optical secure communication over 100†km with hybrid chaotic encryption using one dual-polarization IQ modulator.

We propose and experimentally study a coherent optical secure transmission system based on one dual-polarization in-phase and quadrature modulator (IQM). One beam of the polarized light is used to generate broadband chaos by configuring a nonlinear opto-electronic oscillator while the other beam carries the encrypted signal. The encrypted signal is obtained through sequential encryption of the analog and digital chaos. The mutual mask of the hybrid chaotic signals can effectively enhance the security performance. Moreover, by varying the encryption depth of analog and digital vectors, the transmission performance can be flexibly adjusted. A commercial dual-polarization IQM could simultaneously generate a chaotic signal and a load message, which provides a high-integration solution. A fast independent component analysis (ICA) algorithm is adopted to compensate for the rotation of state of polarization (RSOP). 60 Gb/s encrypted quadrature phase shift keying (QPSK) signal transmission over 100 km single-mode fiber is realized, and the decrypted bit error rate (BER) performance is below the 7% forward error correction (FEC) threshold (BER = 3.8 × 10-3).

Capacity expansion of chaotic secure transmission system based on coherent optical detection and space division multiplexing over multi-core fiber.

We propose and experimentally study a coherent optical chaotic secure transmission system through a multi-core fiber (MCF). The messages are encrypted by the chaotic carrier and transmitted through the outer cores of the MCF, whereas the chaotic carrier signal is concealed by transmitting through the center core. The MCF provides large transmission capacity expansion and security enhancement against eavesdroppers due to its physical structure. In addition, the designed optical chaos self-homodyne coherent detection strategy has high detection sensitivity and simple physical structure. Due to the prevalence of devices and digital signal processing (DSP) algorithms used in this system, it can be well compatible with a commercial coherent optical communication system. Error free 40 Gb/s/core encrypted 16 quadrature amplitude modulation (QAM) signal transmission over 10 km 7-core fiber is achieved, and 20 Gb/s quadrature phase shift keying (QPSK) signal transmission over a 100 km standard single-mode fiber (SSMF) is demonstrated to verify the long-distance transmission capability. The sensitivity to the secret key is also studied.

Experimental demonstration of a broadband optoelectronic chaos system based on highly nonlinear configuration of IQ modulator.

We experimentally investigated a novel broadband optoelectronic chaos generation scheme. The proposed system is achieved by adopting the highly nonlinear operation of an electro-optical exclusive-NOR (XNOR) logic gate and two delayed feedback loops that refer to the Boolean chaos model. The XNOR gate is established by a commercial use inphase and quadrature-phase (IQ) modulator that works at a specific bias point. The resulting power spectrum of the broadband chaos signal extends from DC to 29.1 GHz (10 dB bandwidth), and the probability density distribution is Gaussian distribution like. Owing to the strong nonlinearity of XNOR operation, the conditions to enter the chaos region are more relaxed compared to traditional optoelectronic oscillator (OEO) chaos systems, and the time delay signature (TDS) of the feedback loop is also suppressed. Moreover, to further enhance the performance of the generated chaos signal, we injected the optoelectronic chaotic signal into a semiconductor laser. Experimental results indicate that after the cascade optical injection, the bandwidth of the output chaos signal is extended to 38.4 GHz and the TDS is completely concealed; meanwhile, a perfect Gaussian distribution can be obtained.

Analog-digital hybrid chaos-based long-haul coherent optical secure communication.

We propose and numerically investigate a chaotic optical coherent secure communication scheme, which supports long-haul secure transmission for signals in advanced modulation formats. A hybrid optical chaos system is designed with coordination of digital and analog signals. The hybrid entropy source provides a broadband analog optical chaos signal, which could serve as the carrier to load quadrature amplitude modulation (QAM) data. Simultaneously, a digital binary signal generated from the entropy source is transmitted to establish long-haul chaotic synchronization. Coherent detection is utilized at the receiver, and a digital signal processing (DSP) algorithm is adopted to reduce transmission distortion. A 5 Gbaud 16QAM signal is encrypted by a phase chaos carrier with the effective bandwidth of 5.8 GHz. A bit error rate (BER) below forward error correction (FEC) can be achieved after transmitting over 1600 km based on digital-signal-induced chaos synchronization technology. Optimal launch power is investigated to minimize nonlinear effects of transmission links. System security is guaranteed by the high dynamical complexity of the chaotic source and the sensitive time delay as the secret key.

Prenatal caffeine exposure caused H-type blood vessel-related long bone dysplasia via miR375/CTGF signaling.

Caffeine has developmental toxicity. Prenatal caffeine exposure (PCE) caused intrauterine growth retardation (IUGR) and multiple organ dysplasia. This study intended to explore the effect and mechanism of PCE on long bone development in female fetal rats. In vivo, the PCE group pregnant rats were given different concentrations of caffeine during the gestational Day 9-20. The mRNA expression of osteogenesis-related genes were significantly reduced in PCE group. In the PCE group (120 mg/kg·d), the length and primary center of fetal femur were shorter, and accompanied by H-type blood vessel abundance reducing. Meanwhile, connective tissue growth factor (CTGF) expression decreased in the growth plate of the PCE group (120 mg/kg·d). In contrast, the miR375 expression increased. In vitro, caffeine decreased CTGF and increased miR375 expression in fetal growth plate chondrocytes. After co-culture with caffeine-treated chondrocytes, the tube formation ability for the H-type endothelial cells was decreased. Furthermore, CTGF overexpression or miR375 inhibitor reversed caffeine-induced reduction of tube formation ability, and miR375 inhibitor reversed caffeine-induced CTGF expression inhibition. In summary, PCE decreased the expression of CTGF by miR375, ultimately resulting in H-type blood vessel-related long bone dysplasia.

Vaspin regulated cartilage cholesterol metabolism through miR155/LXRα and participated in the occurrence of osteoarthritis in rats.

AIMS: This study intends to explore the role of Vaspin and cholesterol metabolism in the process of osteoarthritis (OA) and its mechanism in vitro and in vivo. MAIN METHODS: In vitro, chondrocytes were treated with interleukin-1ß (IL-1ß, 20 ng/mL) in combination with Vaspin at different concentrations for 48 h. The expressions of Aggrecan (ACAN), Collagen 2a1 (Col2a1), A Disintegrin And Metalloproteinase with Thrombo Spondin type 1 motifs 5 (ADAMTS 5), and Matrix metalloproteinase 13 (MMP13) were detected. In vivo, the expression of liver X receptor (LXRα) and other Cholesterol efflux related genes were detected in the rat OA knee cartilage-induced by papain. KEY FINDINGS: In vitro, in a concentration-dependent manner, Vaspin reversed the decreased expression of ACAN and Col2a1, and the increased expression of ADAMTS 5 and MMP13 caused by IL-1ß. Besides, Vaspin promoted the expression of LXRα and other Cholesterol efflux related genes in a concentration-dependent manner in chondrocytes. However, miR155 mimics reversed the Vaspin-induced expression changes of cholesterol efflux pathway in chondrocytes. In vivo, the expression of LXRα and other Cholesterol efflux related genes were decreased in the rat OA knee cartilage-induced by papain. Besides, the level of Vaspin was reduced and the miroRNA155 (miR155) expression was increased in OA knee cartilage of rats. SIGNIFICANCE: In conclusion, the decreased expression of Vaspin inhibited the expression of Cholesterol efflux pathway via miR155/LXRα. Finally, the inhibited Cholesterol efflux pathway led to the cholesterol accumulation and OA in cartilage.

Anti-renal interstitial fibrosis effect of norcantharidin is exerted through inhibition of PP2Ac-mediated C-terminal phosphorylation of Smad3.

Norcantharidin (NCTD), the demethylated analog of cantharidin isolated from Mylabris, is known to inhibit renal fibrosis. However, the underlying mechanism is largely unknown. The present study investigates whether NCTD exerts this effect through regulation of the protein phosphatase 2A catalytic subunit (PP2Ac)-Smad3 pathway. HK-2 human renal proximal tubule cells exposed to transforming growth factor (TGF)-ß1 were used as an in vitro model of renal fibrosis. The levels of total Smad3, C-terminal-phosphorylated Smad3 (p-Smad3), PP2Ac, and fibronectin (Fn) were evaluated by Western blotting. A PP2Ac overexpression plasmid and the PP2Ac inhibitor okadaic acid (OA) were used for functional analyses. The subcellular localization of Smad3 was visualized by immunofluorescence labeling. The results showed that PP2Ac overexpression increased Smad3 phosphorylation and nuclear translocation in HK-2 cells, while pharmacologic inhibition of PP2Ac with OA had the opposite effect. NCTD suppressed Fn and p-Smad3 expression and TGF-ß1-induced nuclear entry of Smad3, but these effects were abrogated by inhibition of PP2Ac. Thus, the anti-renal interstitial fibrosis effect of NCTD is exerted through inhibition of PP2Ac-mediated C-terminal phosphorylation of Smad3. These findings highlight the therapeutic potential of NCTD for the treatment of renal interstitial fibrosis.

Efficacy and safety of aspirin and rivaroxaban for venous thromboembolism prophylaxis after total hip or knee arthroplasty: A protocol for meta-analysis.

BACKGROUND: The purpose of this meta-analysis is to compare the efficacy and safety of aspirin and rivaroxaban in the prevention of venous thromboembolism (VTE) following either total knee arthroplasty or total hip arthroplasty. METHODS: A comprehensive literature search of several electronic databases (PubMed, Embase, and Web of Science) was conducted to identify relevant studies. Outcomes of interest included VTE rate, deep vein thrombosis (DVT) rate, pulmonary embolism rate, major bleeding events, mortality rate, blood transfusion, and wound complication. Risk ratio (RR) with 95% confidence intervals (95%CIs) were calculated using a fixed-effects model or random-effects model. RESULTS: A total of 8 studies with 97,677 patients met the inclusion criteria and were included in this meta-analysis. Compared with rivaroxaban, aspirin had a significantly higher incidence of DVT (RR = 1.48, 95%CI: 1.27, 1.72; P < .001), and decreased risk of blood transfusion (RR = 0.94, 95%CI: 0.93, 0.94; P < .001). However, there were no significant differences between the 2 drugs in terms of total VTE rate (RR = 1.39%, 95%CI: 0.94, 2.05; P = .101), pulmonary embolism rate (RR = 1.64, 95%CI: 0.92, 2.92; P = .094), mortality rate (RR = 1.13, 95%CI: 0.15, 8.27; P = .907), major bleeding (RR = 1.00, 95%CI: 0.44, 2.27; P = .995), and wound complication rate (RR = 0.37, 95%CI: 0.07, 1.87; P = .229). CONCLUSION: Our results suggested that aspirin and rivaroxaban offered similar effect in the prevention of VTE after total knee arthroplasty or total hip arthroplasty. However, rivaroxaban seemed to have better effect than aspirin in reducing the risk of DVT, and aspirin was safer than rivaroxaban in decreasing the blood transfusion rate.