Therapeutic efficacy of tranexamic acid on traumatic brain injury: a systematic review and meta-analysis.

OBJECTIVE: Tranexamic acid (TXA) demonstrates therapeutic efficacy in the management of traumatic brain injury (TBI). The objective of this systematic review and meta-analysis was to evaluate the safety and effectiveness of TXA in patients with TBI. METHODS: The databases, namely PubMed, Embase, Web of Science, and Cochrane Library databases, were systematically searched to retrieve randomized controlled trials (RCTs) investigating the efficacy of TXA for TBI from January 2000 to November 2023. RESULTS: The present meta-analysis incorporates ten RCTs. Compared to the placebo group, administration of TXA in patients with TBI resulted in a significant reduction in mortality (P = 0.05), hemorrhage growth (P = 0.03), and volume of hemorrhage growth (P = 0.003). However, no significant impact was observed on neurosurgery outcomes (P = 0.25), seizure occurrence (P = 0.78), or pulmonary embolism incidence (P = 0.52). CONCLUSION: The administration of TXA is significantly associated with reduced mortality and hemorrhage growth in patients suffering from TBI, while the need of neurosurgery, seizures, and incidence of pulmonary embolism remains comparable to that observed with placebo.

The LRR receptor-like kinase ALR1 is a plant aluminum ion sensor.

Plant survival requires an ability to adapt to differing concentrations of nutrient and toxic soil ions, yet ion sensors and associated signaling pathways are mostly unknown. Aluminum (Al) ions are highly phytotoxic, and cause severe crop yield loss and forest decline on acidic soils which represent ∼30% of land areas worldwide. Here we found an Arabidopsis mutant hypersensitive to Al. The gene encoding a leucine-rich-repeat receptor-like kinase, was named Al Resistance1 (ALR1). Al ions binding to ALR1 cytoplasmic domain recruits BAK1 co-receptor kinase and promotes ALR1-dependent phosphorylation of the NADPH oxidase RbohD, thereby enhancing reactive oxygen species (ROS) generation. ROS in turn oxidatively modify the RAE1 F-box protein to inhibit RAE1-dependent proteolysis of the central regulator STOP1, thus activating organic acid anion secretion to detoxify Al. These findings establish ALR1 as an Al ion receptor that confers resistance through an integrated Al-triggered signaling pathway, providing novel insights into ion-sensing mechanisms in living organisms, and enabling future molecular breeding of acid-soil-tolerant crops and trees, with huge potential for enhancing both global food security and forest restoration.

Long-term prognosis of patients with distal gastric cancer underwent minimally invasive surgery combined with delta-shaped anastomosis / 中国内镜杂志

Objective To evaluate the long-term efficacy of total laparoscopic radical gastrectomy combined with delta-shaped anastomosis in treatment of distal gastric cancer. Methods The clinical data of 128 patients with distal gastric cancer who underwent laparoscopic radical gastrectomy from January 2014 to April 2016 were retrospectively reviewed. According to the different surgical methods, patients were divided into TLDG plus DA treatment group (DA group, 72 cases) and LADG plus TA treatment group (TA group, 56 cases). The operation time, intraoperative blood loss, disconnection time, postoperative exhaust time, lymph node dissection, hospitalization time and postoperative complications were recorded. Patients were followed up monthly by call, to April 2017. Results The blood loss [(55.6 ± 12.5) vs (85.6 ± 15.8) ml] and postoperative exhaust time [(2.5 ± 1.0) vs (4.5 ± 1.5) d] were significantly lower in the DA group than that in TA group (P < 0.05). There was no significant difference between the two groups in the operation time, the removal time, the number of lymph node dissection and the hospitalization time (P > 0.05). The incidence of anastomotic stenosis (0.00％ vs 7.14％), anastomotic fistula (0.00％ vs 8.93％) and anastomotic bleeding (0.00％ vs 7.14％) in DA group was significantly lower than that in TA group (P < 0.05). All the patients were followed up for 16 to 62 months in DA group. 16 patients died of tumor recurrence or metastasis, and the cumulative survival rate was 77.78％. TA group were all effective follow-up, the follow-up time of 15 to 61 months, 14 patients died of tumor recurrence or metastasis, the cumulative survival rate of 75.00％. There was no significant difference in cumulative survival rate between DA group and TA group (P > 0.05). Conclusion In the treatment of distal gastric cancer, there is a certain advantage in the effect of laparoscopic radical gastrectomy plus delta-shaped anastomosis in the treatment of distal gastric cancer over tubular anastomosis.