Regulating Intermolecular Interactions and Film Formation Kinetics for Record Efficiency in Difluorobenzothiadizole-based Organic Solar Cells.

The difluorobenzothiadizole (ffBT) unit is one of the most classic electron-accepting building blocks used to construct D-A copolymers for applications in organic solar cells (OSCs). Historically, ffBT-based polymers have achieved record power conversion efficiencies (PCEs) in fullerene-based OSCs owing to their strong temperature-dependent aggregation (TDA) characteristics. However, their excessive miscibility and rapid aggregation kinetics during film formation have hindered their performance with state-of-the-art non-fullerene acceptors (NFAs). Herein, we synthesized two ffBT-based copolymers, PffBT-2T and PffBT-4T, incorporating different π-bridges to modulate intermolecular interactions and aggregation tendencies. Experimental and theoretical studies revealed that PffBT-4T exhibits reduced electrostatic potential differences and miscibility with L8-BO compared to PffBT-2T. This facilitates improved phase separation in the active layer, leading to enhanced molecular packing and optimized morphology. Moreover, PffBT-4T demonstrated a prolonged nucleation and crystal growth process, leading to enhanced molecular packing and optimized morphology. Consequently, PffBT-4T-based devices achieved a remarkable PCE of 17.5%, setting a new record for ffBT-based photovoltaic polymers. Our findings underscore the importance of conjugate backbone modulation in controlling aggregation behavior and film formation kinetics, providing valuable insights for the design of high-performance polymer donors in organic photovoltaics.

Vim-PSA Double-Target DBS for the Treatment of Holmes Tremor Secondary to Brainstem Hemorrhage: A Case Report.

We report the case of a 53-year-old man who was diagnosed with Holmes tremor and underwent deep brain stimulation of the ventro-intermediate thalamic nucleus and posterior subthalamic area. We assessed the patients' tremor with the Fahn-Tolosa-Marin Tremor Rating Scale at 1, 3, 6, 12 and 24 months after deep brain stimulation. Deep brain stimulation relieved the patient's tremor during the 24-month follow-up period.

H2O2 Photosynthesis from H2O and O2 under Weak Light by Carbon Nitrides with the Piezoelectric Effect.

Driven by the essential need of a green, safe, and low-cost approach to producing H2O2, a highly valuable multifunctional chemical, artificial photosynthesis emerges as a promising avenue. However, current catalyst systems remain challenging, due to the need of high-density sunlight, poor selectivity and activity, or/and unfavorable thermodynamics. Here, we reported that an indirect 2e- water oxidation reaction (WOR) in photocatalytic H2O2 production was unusually activated by C5N2 with piezoelectric effects. Interestingly, under ultrasonication, C5N2 exhibited an overall H2O2 photosynthesis rate of 918.4 µM/h and an exceptionally high solar-to-chemical conversion efficiency of 2.6% after calibration under weak light (0.1 sun). Mechanism studies showed that the piezoelectric effect of carbon nitride overcame the high uphill thermodynamics of *OH intermediate generation, which enabled a new pathway for 2e- WOR, the kinetic limiting step in the overall H2O2 production from H2O and O2. Benefiting from the outstanding sonication-assisted photocatalytic H2O2 generation under weak light, the concept was further successfully adapted to biomedical applications in efficient sono-photochemodynamic therapy for cancer treatment and water purification.

Association between mixed metal exposure and stroke risk in Shanxi Province: a case-control study.

BACKGROUND: Stroke is the second leading cause of death for all human beings and poses a serious threat to human health. Environmental exposure to a mixture of metals may be associated with the occurrence and development of stroke, but the evidence in the Chinese population is not yet conclusive. OBJECTIVES: This study evaluated the association between stroke risk and 13 metals METHODS: Metal concentrations in whole blood samples from 100 stroke cases and 100 controls were measured by ICP-MS. The cumulative impact of mixed metal on stroke risk was investigated by using three statistical models, BKMR, WQS and QGC. RESULTS: The case group had higher concentrations of Mg, Mn, Zn, Se, Sn, and Pb than the control group (p<0.05). BKMR model indicated a correlation between the risk of stroke and exposure to mixed metals. WQS model showed that Mg (27.2 %), Se (25.1 %) and Sn (14.8 %) were positively correlated with stroke risk (OR=1.53; 95 %Cl: 1.03-2.37, p=0.013). The QGC model showed that Mg (49.2 %) was positively correlated with stroke risk, while Ti (31.7 %) was negatively correlated with stroke risk. CONCLUSIONS: Mg may be the largest contributor to the cumulative effect of mixed metal exposure on stroke risk, and the interaction between metals requires more attention. These findings could provide scientific basis for effectively preventing stroke by managing metals in the environment.

Dynamics of simplicial SEIRS epidemic model: global asymptotic stability and neural Lyapunov functions.

The transmission of infectious diseases on a particular network is ubiquitous in the physical world. Here, we investigate the transmission mechanism of infectious diseases with an incubation period using a networked compartment model that contains simplicial interactions, a typical high-order structure. We establish a simplicial SEIRS model and find that the proportion of infected individuals in equilibrium increases due to the many-body connections, regardless of the type of connections used. We analyze the dynamics of the established model, including existence and local asymptotic stability, and highlight differences from existing models. Significantly, we demonstrate global asymptotic stability using the neural Lyapunov function, a machine learning technique, with both numerical simulations and rigorous analytical arguments. We believe that our model owns the potential to provide valuable insights into transmission mechanisms of infectious diseases on high-order network structures, and that our approach and theory of using neural Lyapunov functions to validate model asymptotic stability can significantly advance investigations on complex dynamics of infectious disease.

Efficient and Stable Air-Processed Organic Solar Cells Enabled by an Antioxidant Additive.

Current high-efficiency organic solar cells (OSCs) are generally fabricated in an inert atmosphere that limits their real-world scalable manufacturing, while the efficiencies of air-processed OSCs lag far behind. The impacts of ambient factors on solar cell fabrication remain unclear. In this work, the effects of ambient factors on cell fabrication are systematically investigated, and it is unveiled that the oxidation and doping of organic light absorbers are the dominant reasons causing cell degradation when fabricated in air. To address this issue, a new strategy for fabricating high-performance air-processed OSCs by introducing an antioxidant additive (4-bromophenylhydrazine, BPH) into the precursor solutions, is developed. BPH can effectively inhibit oxygen infiltration from the ambient to the photoactive layer and suppress trap formation caused by oxidation. Compared with conventional air-processed OSCs, this strategy remarkably increases the cell power conversion efficiency (PCE) from 16.7% to 19.3% (independently certified as 19.2%), representing the top value of air-processed OSCs. Furthermore, BPH significantly improves the operational stability of the cells in air by two times with a T80 lifetime of over 500 h. This study highlights the potential of using antioxidant additives to fabricate high-efficiency and stable OSCs in air, significantly promoting the industrialization of OSCs.

Synthesis and modification mechanism of vanadium oxide coated LiFePO4cathode materials with excellent electrochemical performance.

In an era of rapid industrial development, such that the demand for energy is increasing daily, lithium-ion batteries are playing a dominant role in energy storage devices due to their high safety and low cost. However, it is still a challenge for the preparation of advanced cathodes, which can determine the battery performance, with stable structures and fast diffusion of Li+. This is especially the case for lithium iron phosphate (LFP), a cathode material with severe limitations due to its low conductive efficiency. To improve its conductivity, LFP was compounded with defect-modified V2O5to prepare LFP/V/C materials with excellent electrochemical properties, which exhibited an initial capacity of 138.85 mAh g-1and 95% retention after 500 charge/discharge cycles at a current density of 5 C. Also, the effect of defects on ionic diffusion was discussed in detail by means of density function theor (DFT) calculations, confirming that the improvement of electrochemical performance is closely related to the introduction of hybrid conductive layers of surface cladding.

Molecular assembly of carbon nitride-based composite membranes for photocatalytic sterilization and wound healing.

Polymeric carbon nitride (pCN) has attracted increasing interest as a metal-free photocatalyst because of its high efficiency in reactive oxygen species (ROS) generation. However, due to poor solubility, compounding pCN at the molecular level into more advanced nanocomposites remains a challenge. Herein, we report the dissolution of pCN in polyphosphoric acid (PPA) for the first time and fluid-phase assembly with carbon nanotubes (CNTs) into a flexible free-standing membrane. Mechanism and generality studies disclosed that the coordination of the acidity, viscosity, and adsorption energy of the solvents led to the successful dissolution of pCN. Interestingly, the pCN/CNTs molecular composite membrane exhibited not only superior mechanical properties and cycling performance as a result of strengthened π-π interfacial interaction, but also outstanding inactivation of E. coli and S. aureus in sterilization and wound healing for laboratory mice via photogenerated oxygen radicals. It would open a new era of pCN for biomedical applications in molecular composite membranes, beyond the traditional solar fuel applications in powders.

Inflammatory bowel disease and risk of Parkinson's disease: evidence from a meta-analysis of 14 studies involving more than 13.4 million individuals.

Background: The relationship between inflammatory bowel disease (IBD) and the risk of Parkinson's Disease (PD) has been investigated in several epidemiological studies. However, the results of these studies were inconclusive and inconsistent. We evaluated the potential relationship between IBD and PD risk by a meta-analysis. Methods: Search the electronic databases PubMed, Embase and Cochrane databases from inception to November 30, 2022, to identify relevant studies that assess the risk of PD in patients with IBD. The cohort, cross-sectional, mendelian randomization and case-control studies that reported risk estimates of PD and IBD were included in our analysis. The random-effect model and fixed-effects model were used to calculate the summary relative risks (RRs) with 95% confidence intervals (CIs). Results: In total, 14 studies (nine cohort studies, two cross-sectional studies, two mendelian randomization studies and one case-control study) involving more than 13.4 million individuals were analyzed in our analysis. Our results suggested that the risk of PD in IBD patients is moderately increased, with the pooled RR was 1.17 (95% CI: 1.03-1.33, P = 0.019). Omit of any single study from this analysis had little effect on the combined risk estimate. No evidence of publication bias was found. In the subgroup analysis, the combined RR was 1.04 (95% CI: 0.96, 1.12, P = 0.311) for Crohn's disease (CD), and 1.18 (95% CI: 1.06, 1.31, P = 0.002) for ulcerative colitis (UC). In addition, a significant association was identified in patients with IBD aged ≥ 60 years (RR = 1.22; 95% CI: 1.06-1.41, P = 0.007), but not in age < 60 years (RR = 1.19; 95% CI: 0.58-2.41, P = 0.639). Meanwhile, the meta-analysis results suggested a protective role for IBD medication use against PD development, with the RR was 0.88 (95% CI: 0.74, 1.04, P = 0.126). Conclusion: Our results indicated that patients with IBD had a moderately higher risk of PD compared to non-IBD individuals. Patients with IBD should be aware of the potential risks for PD, especially who were ≥ 60 years old.

Spinal subdural hematoma in a patient with immune thrombocytopenic purpura following microvascular decompression: a rare case report.

This article reports a case of spontaneous spinal subdural hematoma (SSDH) after brain surgery in a patient with immune thrombocytopenic purpura (ITP), reviews the relevant literature, and discusses the etiology, pathogenesis, and clinical features of SSDH in patients with ITP. A male patient in his early 50 s with an 8-year history of ITP and suffering from coexistent hemifacial spasm and trigeminal neuralgia underwent microvascular decompression in our department. His preoperative corrected platelet count was within the normal range. On postoperative day 2, the patient complained of acute low back pain and sciatica. Lumbar magnetic resonance imaging demonstrated an SSDH extending from L3 to L4 with a significantly decreased platelet count (30.0 × 109/L). The pain was gradually relieved after 2 weeks of conservative treatment, and no neurological deficit occurred during the 1-year follow-up. Brain surgery may increase the risk of postoperative SSDH in patients with ITP. Clinicians planning brain surgery must conduct a rigorous assessment through detailed physical examination, laboratory tests, and medical history records and maintain perioperative platelet counts within the normal range to prevent various risks associated with spinal cord compression.

A homozygous PRKN-associated juvenile Parkinson's disease with pregnancy in China.

Background: Although Parkinson's disease (PD) is the second most common neurodegenerative disorder, pregnancy in patients with PD is a relatively rare occurrence because the most common age of onset of PD is beyond the childbearing age, except in patients with Young-Onset PD (YOPD) caused by parkin RBR E3 ubiquitin protein ligase (PRKN) mutations. Case: In this study, we report the case of a 30-year-old Chinese woman who was affected by PRKN-associated YOPD and was treated with levodopa/benserazide during pregnancy. She gave birth to a healthy baby boy with an Apgar score of 9 through an uncomplicated vaginal delivery. Conclusion: This case further suggests that levodopa/benserazide during pregnancy is safe in the treatment of PRKN-associated YOPD.

Fe-doped V2O5layered nanowire cathode material with high lithium storage performance.

As a lithium-ion battery cathode material with high theoretical capacity, the application of V2O5is limited by its unstable structure and low intrinsic conductivity. In this paper, we report a Fe doped V2O5nanowire with a layered structure of 200-300 nm diameter prepared by electrostatic spinning technique. The 3Fe-V2O5electrode exhibited a superb capacity of 436.9 mAh g-1in the first cycle when tested in the voltage range of 2.0-4.0 V at current density of 100 mA g-1, far exceeding its theoretical capacity (294 mAh g-1), and the high capacity of 312 mAh g-1was still maintained after 50 cycles. The superb performance is mainly attributed to its unique layered nanowire structure and the enhanced electrical conductivity as well as optimized structure brought by Fe-doping. This work made the homogeneous doping and nanosizing of the material easily achieved through electrostatic spinning technology, leading to an increase in the initial capacity of the V2O5cathode material and the cycling stability compared to the pure V2O5, which is an extremely meaningful exploration.

Use of oral glucose tolerance testing and HbA1c at 6-14 gestational weeks to predict gestational diabetes mellitus in high-risk women.

PURPOSE: To study the prediction of gestational diabetes mellitus (GDM) in high-risk pregnant women by testing fasting blood glucose, 1-h(1hPG) and 2-h plasma glucose (2hPG) after an oral glucose tolerance test, and glycated hemoglobin (HbA1c) in early pregnancy (6-14 weeks). METHODS: We recruited 1311 pregnant women at high risk for diabetes from the Obstetrics Clinic of Daxing District People's Hospital between June 2017 and December 2019. The tests performed during the first trimester included fasting blood glucose (FPG), HbA1c, and 75-g oral glucose tolerance test (OGTT) with 1hPG and 2hPG. Seventy-three pregnant women diagnosed with pregestational diabetes mellitus (PGDM) early in pregnancy and 36 who were missed in the second trimester were excluded. A total of 1202 women were followed up until 24-28 weeks for GDM. The receiver operating characteristic (ROC) and area under the ROC curve (AUC) were calculated to determine the predictive values of FPG, 1hPG, 2hPG, and HbA1c for GDM in early pregnancy in high-risk pregnant women. RESULTS: The AUC for 1hPG for the prediction of GDM in high-risk pregnant women was greater than those for FPG, 2hPG, and HbA1c. All differences were significant. The AUCs for the predictive values of FPG, 1hPG, 2hPG, and HbA1c in high-risk pregnant women were 0.63, 0.76, 0.71, and 0.67, respectively. The prevalence of PGDM among pregnant women at high risk of diabetes was 5.6%. CONCLUSION: First-trimester levels of FPG, 1hPG, 2hPG, and HbA1c in high-risk women are significant predictors of GDM, with 1hPG having the most significant predictive value.

Effects of Hemp Sanitary Pads on the Vaginal Microecology.

Objective: To evaluate the effect of hemp cotton sanitary pads on the vaginal microecology. Methods: A randomized controlled field trial was used to recruit 1002 community-based women of childbearing age. The women were randomly divided into experimental and control groups. The experimental group used hemp cotton sanitary pads, while the control group used two types of cotton sanitary randomly chosen from the top five sanitary pads in terms of market share in China. The vaginal microecology was compared between the two groups after three months. Results: According to the vaginal microecologic examination results at baseline, 1002 women were included in 3 groups: normal vaginal microecologic, vaginal microecological disorders, and suspected vaginal infections. The number of patients in three groups were 39 (3.9%), 652 (65.1%), and 311 (31%), respectively. Three months later, the vaginal microecologic status and vaginal pH value of the suspected vaginal infection group were not significantly different between the experimental group and control group. The experimental group outperformed the control group with respect to vaginal cleanliness and vaginal microecology status in the women without a vaginal infection (normal vaginal microecology or microecological disorders group). The rate of abnormal cleanliness in the experimental group was lower than the control group (31.95% [108/338] vs. 43.62% [154/353]). The incidence of suspected vaginitis in the experimental group was lower than the control group (15.29% [51/338] vs. 23.51% [83/353]). Conclusion: For women without vaginal inflammation, the use of hemp cotton sanitary pads during menstruation can help maintain the balance of the vaginal microecology to prevent reproductive tract infections.

Extended Conjugation Tuning Carbon Nitride for Non-sacrificial H2 O2 Photosynthesis and Hypoxic Tumor Therapy.

Artificial photocatalysis offers a clean approach for producing H2 O2 . However, the poor selectivity and activity of H2 O2 production hamper traditional industrial applications and emerging photodynamic therapy (PDT)/chemodynamic therapy (CDT). Herein, we report a C5 N2 photocatalyst with a conjugated C=N linkage for selective and efficient non-sacrificial H2 O2 production in both normoxic and hypoxic systems. The strengthened delocalization of π-electrons by linkers in C5 N2 downshifted the band position, thermodynamically eliminating side H2 evolution reaction and kinetically promoting water oxidation. As a result, C5 N2 had a competitive solar-to-chemical conversion efficiency of 0.55 % in overall H2 O2 production and exhibited by far the highest activity under hypoxic conditions (698 µM h-1 ). C5 N2 was further applied to hypoxic PDT/CDT with outstanding performance in apparent cancer cell death and synchronous bioimaging. The study sheds light on the photosynthesis of H2 O2 by carbon nitrides for health applications.

Complex Dynamics of Noise-Perturbed Excitatory-Inhibitory Neural Networks With Intra-Correlative and Inter-Independent Connections.

Real neural system usually contains two types of neurons, i.e., excitatory neurons and inhibitory ones. Analytical and numerical interpretation of dynamics induced by different types of interactions among the neurons of two types is beneficial to understanding those physiological functions of the brain. Here, we articulate a model of noise-perturbed random neural networks containing both excitatory and inhibitory (E&I) populations. Particularly, both intra-correlatively and inter-independently connected neurons in two populations are taken into account, which is different from the most existing E&I models only considering the independently-connected neurons. By employing the typical mean-field theory, we obtain an equivalent system of two dimensions with an input of stationary Gaussian process. Investigating the stationary autocorrelation functions along the obtained system, we analytically find the parameters' conditions under which the synchronized behaviors between the two populations are sufficiently emergent. Taking the maximal Lyapunov exponent as an index, we also find different critical values of the coupling strength coefficients for the chaotic excitatory neurons and for the chaotic inhibitory ones. Interestingly, we reveal that the noise is able to suppress chaotic dynamics of the random neural networks having neurons in two populations, while an appropriate amount of correlation coefficient in intra-coupling strengths can enhance chaos occurrence. Finally, we also detect a previously-reported phenomenon where the parameters region corresponds to neither linearly stable nor chaotic dynamics; however, the size of the region area crucially depends on the populations' parameters.

Empirical antibiotic treatment strategies for community-acquired pneumonia: a network meta-analysis.

OBJECTIVES: This network meta-analysis aimed to compare the efficacy and safety of fluoroquinolone (FQ) monotherapy, ß-lactam (BL) monotherapy and ß-lactam/macrolide (BL-M) combination therapy in hospitalized patients with community-acquired pneumonia (CAP). METHODS: Pubmed, Embase and the Cochrane Library were searched for randomized controlled trials (RCTs) comparing FQ monotherapy, BL monotherapy and BL-M combination therapy up to July 2021. The outcomes of interest included all-cause mortality, clinical success, microbiological success and drug-related adverse events. The summary relative risks (RRs) were estimated using pairwise and Bayesian network meta-analysis. RESULTS: A total of 12 RCTs involving 5009 patients were included. In pairwise meta-analysis, no significant differences were found among FQ monotherapy, BL monotherapy and BL-M dual therapy for all-cause mortality, clinical success or microbiological success. FQ monotherapy was associated with fewer adverse events compared with BL-M therapy (RR 0.80, 95% confidence interval [CI] 0.66-0.98). The network meta-analysis showed that there was no significant difference observed among FQ monotherapy, BL monotherapy and BL-M dual therapy regarding all the outcomes. CONCLUSION: FQ monotherapy, BL monotherapy and BL-M combination therapy demonstrated similar efficacy and safety for hospitalized patients with CAP in this network meta-analysis. Due to the limitations of quality and quantity of the included studies, it is difficult to make a definitive recommendation before more large-scale and high-quality RCTs are conducted.

Serum RANKL levels in Chinese patients with ankylosing spondylitis: a meta-analysis.

OBJECTIVE: We aimed to determine the association between serum receptor activator of nuclear factor-kappa B ligand (sRANKL) levels and ankylosing spondylitis (AS) in Chinese patients. METHODS: The PubMed, Cochrane Library, Embase, Chinese Biomedical Database, Web of Science, China National Knowledge Infrastructure, VIP, and Wan Fang databases were searched for studies conducted before October 1, 2020, without language restrictions. STATA version 12.0 and Revman version 5.3 were used to analyze the data. The standard mean differences (SMDs) and corresponding 95% confidence intervals (95% CIs) were calculated. RESULTS: Twelve clinical case-control studies, including 585 patients with AS and 423 healthy controls, were included. The combined SMD for sRANKL suggested that the sRANKL level was significantly higher in Chinese patients with AS than in healthy controls (SMD: 3.27, 95% CI 2.11-4.43, P < 0.00001). Serum RANKL-related factor osteoprotegerin (OPG) levels (SMD: 0.86, 95% CI 0.09-1.64, P < 0.03) were lower in the Chinese patients with AS than in healthy controls, and the RANKL/OPG ratio (SMD = 1.05, 95% CI 0.64-1.46, P < 0.00001) in Chinese patients with AS was approximately the same as that of healthy controls. Subgroup analysis indicated that patients from North and South China had higher sRANKL levels than controls; the sRANKL levels of patients from South China were higher in the subgroup with a Bath Ankylosing Spondylitis Functional Index (BASFI) of > 4 than those of patients in other subgroups. In terms of duration, patients with AS for > 8 years had higher sRANKL levels than health controls. Other subgroup analyses were conducted by region, language, source of control, age, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). In these subgroups, the sRANKL levels were significantly higher in the patients with AS than in healthy controls. The BASFI and BASDAI were sources of heterogeneity. CONCLUSIONS: The sRANKL levels are higher in Chinese patients with AS, especially among those from South China. sRANKL levels may be positively correlated with the pathogenesis of AS among Chinese patients.

Correlation of exosomal microRNA clusters with bone metastasis in non-small cell lung cancer.

20-40% of lung cancer patients develop bone metastasis (BM) with significantly decreased overall survival. Currently, BM is mainly diagnosed by computerized tomography (CT) scan or magnetic resonance imaging (MRI) when symptom develops. Novel biomarkers with higher prediction value of BM are needed. Plasma-derived exosomal microRNAs had been isolated and sequenced of total 30 non-small cell lung cancer (NSCLC) patients including 16 with bone metastasis and 14 without bone metastasis. Hierarchical clustering based on the total miRNA profile can clearly separate cancer patients and healthy individuals (H), but not patients with (BM +) or without (BM-) BM. Weight Co-expression network of miRNAs (WGCNA) analyses identified three consensus clusters (A, B, C) of highly correlated miRNAs, among which cluster B (144 miRNAs) showed significantly differential expression in lung cancer patients, especially in BM + group. Pathway analysis of cluster B miRNAs revealed enrichment in metabolic pathways that may involve in preconditioning of the metastatic niche. Three differentially expressed miRNAs between BM + and BM- patients within cluster B were identified as miR-574-5p, a suppressor of Wnt/ß-catenin pathway, was down-regulated, while miR-328-3p and miR-423-3p, two activators of the same pathway, were up-regulated in BM + patients. Cluster A miRNAs (n = 49) also showed trend of upregulation in BM + patients. Interestingly, pathway analysis indicated that 43 of them are associated with chromosome14, which has been suggested to promote epithelial-mesenchymal transition (EMT) and bone metastasis.

Correlation between osteoarthritis and monocyte chemotactic protein-1 expression: a meta-analysis.

OBJECTIVE: We evaluated the association between monocyte chemotactic protein-1 (MCP-1) and osteoarthritis. METHODS: We searched PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), VIP (Chinese database), and Wan Fang (Chinese database) (before May 10, 2020), with no language limitations. STATA version 12.0 and Revman version 5.3 were used for data analysis. The standard mean difference (SMD) and corresponding 95% confidence intervals (95% CIs) were calculated. Nine clinical studies, including 376 patients with osteoarthritis and 306 healthy controls, were evaluated. RESULTS: The combined SMDs of MCP-1 expression levels suggested that MCP-1 expression was significantly higher in patients with osteoarthritis than healthy controls (SMD = 1.97, 95% CI = 0.66-3.28, p = 0.003). Moreover, subgroup analysis implied that osteoarthritis patients from both Asians and mixed populations had higher MCP-1 expression levels than controls, whereas Caucasians did not (p > 0.05). Serum MCP-1 levels (SMD = 2.83, 95% CI = 1.07-4.6, p < 0.00001) were significantly higher in patients with osteoarthritis than in controls; however, this difference was not significant in synovial fluid and cartilage tissue. Subgroup analysis for ethnicity showed that MCP-1 levels were significantly higher in Chinese, Dutch, and Brazilian patients with osteoarthritis than in control groups, although significant differences were not observed for American and Italian subgroups. CONCLUSIONS: Our meta-analysis demonstrated that MCP-1 expression levels were higher in patients with osteoarthritis than in healthy controls and that MCP-1 may play important roles in the progression of osteoarthritis. Serum MCP-1 levels may serve as a potential biomarker for the diagnosis of osteoarthritis.