Efficacy and safety of Enhanced Recovery after surgery (ERAS) Protocols for Patients Undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion Surgery: a Systematic Review and Meta-analysis.

OBJECTIVE: To evaluate the efficacy and safety of enhanced recovery after surgery (ERAS) in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar degenerative disease. METHODS: Electronic databases including PubMed, Embase, the Cochrane Library, Web of Science, Clinical Trials.gov, etc. were searched from inception to October 2023. Randomized controlled trials (RCTs) and cohort studies (CSs) comparing ERAS program with traditional protocol of MIS-TLIF for LDD were included. RESULTS: A total of 11 studies were included for final analysis. The pooled results of RCTs showed that Compared with MIS-TLIF, the ERAS program used in MIS-TLIF could reduce the length of hospital stay, operation time, intraoperative blood loss and incidence of postoperative complications, decrease visual analog scale and oswestry disability index (ODI) score, and improve patient satisfaction (P<0.05). However, the pooled results of CSs revealed no statistical difference in the ODI score, fusion rate, operation time, and incidence of complications between the two groups (P>0.05). CONCLUSIONS: Compared with MIS-TLIF, the ERAS program used in MIS-TLIF could effectively shorten the length of hospital stay, operation time, decrease intraoperative blood loss and incidence of postoperative complications, promote postoperative pain relief, functional recovery, and patient satisfaction. This study confirmed the value of ERAS in MIS-TLIF surgery and provided evidence for the standardization of ERAS in the future. Considering that the pooled results of RCTs and CSs are not completely consistent, more high-quality studies are needed to confirm these conclusions.

[Status of outcome measures in randomized controlled trials of kidney-tonifying and blood-activating method in treatment of knee osteoarthritis].

This study assesses the status of outcome measures in the randomized controlled trial(RCT) involving the kidney-tonif-ying and blood-activating method for treating knee osteoarthritis(KOA), aiming to establish a theoretical foundation for the development of a core set of outcome measures in traditional Chinese medicine(TCM) treatment of KOA. The relevant articles were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane Library, and Web of Science, in addition to ClinicalTrials.gov and the China Clinical Trial Registration Center, with the time interval from inception to August 2023. The RCT of treating KOA with the kidney-tonifying and blood-activating method was included. Two assessors independently conducted literature screening, data collection, and qualitative analysis to compile the outcome measure results. A total of 350 RCTs were included, involving 165 outcome measures with the total frequency of 1 462. These outcome measures were categorized into six domains: symptom and sign measures(23) with the frequency of 718(49.1%), TCM symptom and syndrome measures(3) with the frequency of 53(3.6%), physical examination measures(130) with the frequency of 506(34.6%), quality of life measures(4) with the frequency of 20(1.3%), long-term efficacy measures(2) with the frequency of 6(0.4%), and safety measures(3) with the frequency of 159(10.9%). Additionally, 53 studies used TCM syndrome and symptom scores as indicators of efficacy, employing eight distinct measurement tools. The RCTs involving the kidney-tonifying and blood-activating method for treating KOA had a variety of problems, such as unclear prio-ritization of outcome measures, diversity in measurement tools, absence of standardized assessment criteria for specific measures, and non-standardized usage. These problems affected the research quality and reliability. Hence, it is advisable to draw upon international expertise, improve research design, and merge TCM efficacy characteristics with clinical research to establish a core set of KOA outcome measures aligned with TCM principles.

Quantitative trait loci detection for three tiller-related traits and the effects on wheat (Triticum aestivum L.) yields.

KEY MESSAGE: A total of 38 putative additive QTLs and 55 pairwise putative epistatic QTLs for tiller-related traits were reported, and the candidate genes underlying qMtn-KJ-5D, a novel major and stable QTL for maximum tiller number, were characterized. Tiller-related traits play an important role in determining the yield potential of wheat. Therefore, it is important to elucidate the genetic basis for tiller number when attempting to use genetic improvement as a tool for enhancing wheat yields. In this study, a quantitative trait locus (QTL) analysis of three tiller-related traits was performed on the recombinant inbred lines (RILs) of a mapping population, referred to as KJ-RILs, that was derived from a cross between the Kenong 9204 (KN9204) and Jing 411 (J411) lines. A total of 38 putative additive QTLs and 55 pairwise putative epistatic QTLs for spike number per plant (SNPP), maximum tiller number (MTN), and ear-bearing tiller rate (EBTR) were detected in eight different environments. Among these QTLs with additive effects, three major and stable QTLs were first documented herein. Almost all but two pairwise epistatic QTLs showed minor interaction effects accounting for no more than 3.0% of the phenotypic variance. The genetic effects of two colocated major and stable QTLs, i.e., qSnpp-KJ-5D.1 and qMtn-KJ-5D, for yield-related traits were characterized. The breeding selection effect of the beneficial allele for the two QTLs was characterized, and its genetic effects on yield-related traits were evaluated. The candidate genes underlying qMtn-KJ-5D were predicted based on multi-omics data, and TraesKN5D01HG00080 was identified as a likely candidate gene. Overall, our results will help elucidate the genetic architecture of tiller-related traits and can be used to develop novel wheat varieties with high yields.

Distribution characteristics and migration trends of hexabromocyclododecanes between seawater-sediment system in different seasons of fishing grounds along the Yellow sea and East China sea coasts.

Pollutants in the ecological environment of fishery seawater are harmful to the survival and reproduction of aquatic organisms. Hexabromocyclododecanes (HBCDs) were 42.9% detected within ND-48.89 ng/L in 177 seawater samples and 30.7% within ND-1.07 ng/g dw in 88 sediment samples of the fisheries in the Yellow Sea and East China Sea, respectively. γ-HBCD accounted for 65% of seawater and 89% of sediment samples. HBCDs in seawater in winter (ND-48.89 ng/L) were significantly higher than in summer (ND-4.99 ng/L), possibly because the re-suspension caused by winds and waves could re-migrate HBCDs from the sediment to the seawater in winter. However, seasonal differences of HBCDs in sediment were not significant. The fugacities indicated HBCDs' migrating trend from seawater to sediment due to their hydrophobic nature. There is almost no terrestrial input of HBCDs from the Yangtze and Yellow Rivers, and currently used fishery materials in marine may compose long-lasting sources of HBCDs.

Occurrence of polyhalogenated carbazoles and the combined effects with heavy metals on variation in bacterial communities in estuarine sediments.

Carbazole (CZ) and eight polyhalogenated carbazoles (PHCZs) were quantified by GC-MS in sediments of 12 estuaries, the interface linking large industrial and living areas to the Bohai Sea, China. These pollutants, heavy metals, and environmental factors caused integrated exposure to sediment bacteria. Four PHCZ congeners were detectable, with ΣPHCZs ranging from 0.56 to 15.94 ng/g dw. The dominant congeners were 3,6-dichlorocarbazole (36-CCZ) and 3-chlorocarbazole (3-CCZ), with a mean contribution of 72.6 % and 20.2 %. Significant positive correlations were found between 36-CCZ and both total organic carbon and heavy metals. Redundancy analysis of microbial variation implicated no impacts from PHCZs. Correlation analysis demonstrated an increase in abundance of Rhodocyclaceae but a decrease in Bacteroides-acidifaciens-JCM-10556 with presence of PHCZs, suggesting that these bacteria can be used as potential contamination indicators. The combined exposure of heavy metals, nutrients, and PHCZs may also increase toxicity and biological availability, adversely affecting the ecosystem and human health.

Efficacy and Safety of Bilateral Ultrasound-Guided Erector Spinae Plane Block for Postoperative Analgesia in Spine Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: A meta-analysis of randomized controlled trials was conducted to assess efficacy and safety of bilateral ultrasound-guided erector spinae plane block (ESPB) for postoperative analgesia in patients receiving spine surgery. METHODS: PubMed, Embase, and CENTRAL databases were searched by 2 reviewers independently to identify randomized controlled trials evaluating the efficacy of ultrasound-guided ESPB for pain management in patients undergoing spine surgery. For meta-analysis, mean difference (MD) and 95% confidence interval (CI) were selected for continuous data, and risk ratio (RR) and 95% CI were selected for dichotomous variables. RESULTS: A total of 25 randomized controlled trials including 1917 patients (873 in ESPB group and 874 in control group) were eligible for inclusion. At rest, ESPB was associated with significantly lower pain intensity at 0, 2, 4, 6, 8, 12, 24, and 48 hours compared with the control group. During movement, ESPB was associated with significantly lower pain intensity at 0, 4, 6, 8, 12, 24, and 48 hours compared with the control group. Significantly reduced opioid consumption (MD = -6.29, 95% CI [-8.16, 4.41], P < 0.001), prolonged time for first rescue analgesia (MD = 7.51, 95% CI [3.47, 11.54], P < 0.001), fewer patients needing rescue analgesia (RR = 0.34, 95% CI [0.28, 0.43], P < 0.0001), improved patient satisfaction (MD = 1.34, 95% CI [0.88, 1.80], P < 0.001), and shorter length of hospital stay (MD = -0.38, [95% CI -0.50, -0.26], P < 0.001) were demonstrated after use of ESPB. Additionally, ESPB was associated with decreased risks of any adverse event (RR = 0.51, 95% CI [0.43, 0.60], P < 0.001) and postoperative nausea and vomiting events (RR = 0.39, 95% CI [0.31, 0.49], P < 0.001). CONCLUSIONS: Ultrasound-guided ESPB is an effective adjunctive technique with good tolerability for multimodal analgesia in management of pain in patients undergoing spine surgery.

The Effectiveness of Tai Chi for Knee Osteoarthritis: An Overview of Systematic Reviews.

Background: Knee Osteoarthritis (KOA) has become a serious health issue for elderly patients. Several systematic reviews (SRs) have reported Tai Chi has widely been used in the treatment of KOA. However, the methodology and conclusions of these SRs are controversial. This overview aims to summarize and evaluate the available evidence for the efficacy and safety of Tai Chi for KOA. Methods: Two independent researchers searched eight databases from the inception to April 30, 2022. The included SRs were assessed respectively by A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, the Risk of Bias in Systematic Reviews (ROBIS) tool, and the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) statement. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to assess the quality of the included SRs in terms of outcome indicators. Results: Six SRs were finally included in this overview. The results of methodological quality, reporting quality, and risk of bias of the included SRs were generally unsatisfactory. The limitations were a lack of explaining the reasons for selection, a list of excluded literature, reporting bias assessment, and reporting the potential sources of conflict of interest. In addition, only 1 item was assessed as moderate quality by using the GRADE tool. Limitations were the most common downgraded factors. Conclusion: Tai Chi is effective as a non-pharmacological intervention in the integrative treatment of KOA. However, the quality of evidence and methodological quality of SRs is generally unsatisfactory, suggesting that these results must be interpreted with caution. Trial Registration/Protocol Registration: PROSPERO registration number: CRD42022315146.

A Bidirectional Mendelian Randomization Study of Sarcopenia-Related Traits and Knee Osteoarthritis.

Background: With the development of population aging worldwide, sarcopenia and knee osteoarthritis (KOA), two age-related diseases, will continue to impose increasing medical and economic burdens on the society. Previous studies have discovered an association between the two, but the causality remains controversial, and it is difficult to eliminate confounding factors. Therefore, a Mendelian randomization (MR) study was conducted to overcome these confounding factors and investigate the causal relationship between sarcopenia and KOA. Objective: The present work focused on assessing the causality between KOA and sarcopenia, so as to provide new strategies to prevent and treat these two conditions in clinic. Methods: We registered the title with PROSPERO (ID: CRD42023421096). The two-sample bidirectional MR analysis was conducted in two steps, with sarcopenia being the exposure whereas KOA being the outcome in the first step, and vice versa in the second step. Genome-wide association studies (GWAS) data on low hand-grip strength (n=256,523), walking pace (n=459,915), appendicular lean mass (ALM, n=450,243), and KOA (n=403,124) were obtained from the UK Biobank. Methods such as the inverse variance weighted (IVW) and weighted median were utilized for assessing the causality of KOA with sarcopenia, and sensitivity analyses were also conducted. Results: In the main MR analysis using the IVW method, evidence suggested that low hand-grip strength, walking pace, and ALM had adverse effects on KOA (p-value 0.0001, odds ratio (OR) 1.4569, 95% confidence interval (CI) 1.2007-1.7677 for low hand-grip strength; p-value 0.0003, OR 1.1500, 95% CI 1.050-1.183 for ALM; p-value 5.29E-19, OR 0.0932, 95% CI 0.0553-0.1572 for walking pace). However, there was no causality of KOA with sarcopenia in the opposite direction. Conclusion: Our study suggests an obvious unidirectional causality of KOA with sarcopenia, and supports the notion that patients with sarcopenia are more susceptible to the development of KOA.

Functional analysis of polyphenol oxidase 1 gene in common wheat.

Polyphenol oxidase (PPO) activity is a major cause of the undesirable brown color of wheat-based products. Ppo1, a major gene for PPO activity, was cloned based on sequence homology in previous studies; however, its function and regulation mechanism remain unclear. In this study, the function and genetic regulation of Ppo1 were analyzed using RNA interference (RNAi) and Targeting Induced Local Lesions IN Genomes (TILLING) technology, and superior mutants were identified. Compared with the control, the level of Ppo1 transcript in RNAi transgenic lines was drastically decreased by 15.5%-60.9% during grain development, and PPO activity was significantly reduced by 12.9%-20.4%, confirming the role of Ppo1 in PPO activity. Thirty-two Ppo1 mutants were identified in the ethyl methanesulfonate (EMS)-mutagenized population, including eight missense mutations, 16 synonymous mutations, and eight intron mutations. The expression of Ppo1 was reduced significantly by 6.7%-37.1% and 10.1%-54.4% in mutants M092141 (G311S) and M091098 (G299R), respectively, in which PPO activity was decreased by 29.7% and 28.8%, respectively, indicating that mutation sites of two mutants have important effects on PPO1 function. Sequence and structure analysis revealed that the two sites were highly conserved among 74 plant species, where the frequency of glycine was 94.6% and 100%, respectively, and adjacent to the entrance of the hydrophobic pocket of the active site. The M092141 and M091098 mutants can be used as important germplasms to develop wheat cultivars with low grain PPO activity. This study provided important insights into the molecular mechanism of Ppo1 and the genetic improvement of wheat PPO activity.

Efficacy and safety of early versus delayed reconstruction for anterior cruciate ligament injuries: A systematic review and meta-analysis.

OBJECTIVE: To critically evaluate the efficacy and safety of early versus delayed anterior cruciate ligament reconstruction (ACLR) for anterior cruciate ligament (ACL) injuries based on the different cut-off values of the timing of operation. METHODS: PubMed, Medline, Embase, Cochrane library, China National Knowledge Infrastructure, Chinese Biomedical Literature, and Wanfang Digital Periodical database were searched from inception to November 2022 without language restrictions. Randomized controlled trials (RCTs) and cohort studies (CSs) comparing early ACLR with delayed ACLR for ACL injuries were included. RESULTS: Twenty-four studies (10 RCTs and 14 CSs) were included. According to the information from included studies, 3 weeks, 4 weeks, 6 weeks, 6 months, and 12 months after ACL injuries were considered as the cut-off values of early and delayed ACLR. When 4 weeks were considered as the cut-off value, early ACLR could significantly improve Lysholm score, IKDC score and VAS score at 6 and 12 months postoperatively and decrease the incidence of adverse events compared with delayed ACLR (P < 0.05). However, no statistically significant difference in positive rate of Lachman test and incidence of meniscus injuries and chondral lesions between the two groups when 3 weeks, 6 weeks, 6 months or 12 months after ACL injuries were considered as the cut-off values of early and delayed ACLR (P > 0.05). CONCLUSION: The present study suggests that early ACLR, especially conducted within 3-4 weeks after ACL injuries, may be more effective for improving knee function and relieving pain compared with delayed ACLR. More high-quality RCTs are warranted.

Identification of lower brominated bisphenol A analogs as the photooxidation products of tetrabromobisphenol A bis(2,3-dibromopropyl) ether (TBBPA-BDBPE).

The transformation products and mechanism of tetrabromobisphenol A (TBBPA) derivatives are still largely unknown compared with TBBPA. In this paper, sediment, soil and water samples (15 sites, 45 samples) collected in a river flowing through brominated flame retardant manufacturing zone were analyzed to determine TBBPA derivatives, byproducts, and transformation products. TBBPA derivatives and byproducts were detected with concentrations ranging from none detection to 1.1 × 104 ng/g dw and with detection frequencies of 0-100 % in all samples. The concentrations of TBBPA derivatives such as TBBPA bis(2,3-dibromopropyl) ether (TBBPA-BDBPE) and TBBPA bis(allyl ether) in sediment and soil samples were higher than that of TBBPA. In addition, the occurrence of various unknown bromobisphenol A allyl ether analogs in the samples was further confirmed by using 11 synthesized analogs, which might be produced during the waste treatment process of the factories. The possible transformation pathways of TBBPA-BDBPE were revealed for the first time by using UV/base/persulfate (PS) as designed photooxidation waste treatment system in the laboratory. Ether bond cleavage, debromination, and ß-scission contributed to the transformation of TBBPA-BDBPE and the occurrence of transformation products in the environment. The concentrations of the transformation products of TBBPA-BDBPE ranged from none detection to 3.4 × 102 ng/g dw. These data provide new insights into the fate of TBBPA derivatives in environmental compartments.

Icariin-conditioned serum combined with chitosan attenuates cartilage injury in rabbit knees with osteochondral defect.

BACKGROUND: Knee osteoarthritis (KOA) is one of the most common degenerative diseases. Its development is closely related to cartilage injury and subchondral bone remodeling homeostasis. In the present study, we combined icariin-conditioned serum (ICS) with thiolated chitosan (CSSH), a material widely used in tissue engineering for cartilage repair, to demonstrate its effect on the repair of cartilage damage and abnormal subchondral remodeling. METHODS: New Zealand rabbits were undergoing surgery for cartilage defect, and joint cavity injection was performed in each group with 0.5 mL normal saline (NS), ICS, CSSH and ICS-CSSH in the right joint every week for five times. Positioning performance was observed using VICON motion capture system. Glycosaminoglycans (GAG) secretion of articular fluid was assessed. Osteoarthritis Research Society International (OARSI) score and immunohistochemical (IHC) analysis including H&E, Safranin O and collagen II staining were employed to evaluate the morphologic repair of cartilage and subchondral bone. mRNA expression of COL2A1, MMP13 and ADAMTS5 was detected in chondrocytes from injury area. RESULTS: ICS combined with CSSH attenuated cartilage injury and abnormal subchondral remodeling in rabbits with KOA. ICS and CSSH groups showed slight improvement in positioning performance, while ICS-CSSH group exhibited better positioning performance. ICS-CSSH group showed increased GAG secretion of articular fluid and expression of COL2A1 in articular chondrocytes. Furthermore, both macroscopic observation and IHC analysis showed femoral condyle in ICS-CSSH rabbits were repaired with more native cartilage and subchondral bone regeneration. CONCLUSIONS: ICS combined with CSSH could promote the repair of osteochondral defect and stabilize subchondral bone remodeling in rabbit knees.

Thin-layer chromatography coupled with HPLC-DAD/UHPLC-HRMS for target and non-target determination of emerging halogenated organic contaminants in animal-derived foods.

In this study, a simple, solvent-saving, and sensitive method was established using high-performance liquid chromatography coupled with high-resolution mass spectrometry to quantitively determine 16 emerging halogenated organic contaminants (HOCs), including polyhalogenated carbazoles, halogenated phenols, and tetrabromobisphenol-A analogs, and to qualitatively identify non-target HOCs in animal-derived food samples. The sample extracts were physically frozen to remove most lipids and further purified by thin-layer chromatography according to the targets polarity. The method detection limit and method quantification limit of 16 HOCs were in the range of 0.003-9.168 and 0.010-30.601 ng·g-1 dry weight, respectively. The recoveries were within 69.1-111.0 %, the intra/inter-day precisions were 0.1-6.1 % and 0.1-6.7 %, and the matrix effects were between -12.1 and 10.8 %, all within the acceptable range. Finally, 16 HOCs were detected in nine actual samples in range of not detected-307.22 ng·g-1 dry weight. Moreover, five bromides and two chlorides were identified by using non-target analysis in animal-derived foods.

Efficacy and safety of tension band wire versus plate for Mayo II olecranon fractures: a systematic review and meta-analysis.

PURPOSE: For olecranon fractures, the choice of tension band wire (TBW) or plate fixation has long been controversial. Therefore, this study aimed to evaluate the efficacy and safety of TBW and plate in the treatment of patients with Mayo II olecranon fractures by Meta-analysis. METHODS: PubMed, Embase, Cochrane, the Web of Science, China National Knowledge Infrastructure, Wanfang, and China Biomedical Database were searched for randomized controlled trials (RCTs) and cohort studies (CSs) where TBW was compared with plate for Mayo II olecranon fractures (OF). Subsequently, the data were extracted by two reviewers independently and were analysed via RevMan5.4.1. Besides, mean difference (MD), risk ratio (RR), and 95% confidence intervals (CIs) were calculated. Furthermore, Cochrane Risk of Bias Tool 2.0 and Newcastle-Ottawa Scale were adopted for assessing the risk of bias. RESULTS: A total of 1RCT and 10 CSs were included, when 449 cases were treated with TBW and 378 with plate. The plate has favourable postoperative long-term (≥ 1 year) functional score in MEPS (MD: - 3.06; 95% CI - 5.50 to 0.62; P = 0.01; I2 = 41%) and Dash score (MD: 2.32; 95% CI 1.91, 2.73; P < 0.00001; I2 = 0%), also carrying fewer complications (RR: 2.13; 95% CI 1.48, 3.08; P < 0.0001; I2 = 58%). Besides, there exists no significant difference in postoperative long-term (≥ 1 year) elbow flexion (MD: - 1.82°; 95% CI - 8.54, 4.90; P = 0.60; I2 = 71%) and extension deficits (MD: 1.52°; 95% CI - 0.38, 3.42; P = 0.12; I2 = 92%). Moreover, TBW is featured with a shorter operation time (MD = - 5.87 min; 95% CI - 7.93, - 3.82; P < 0.00001; I2 = 0) and less intraoperative bleeding (MD: - 5.33 ml; 95% CI - 8.15, - 2.52; P = 0.0002; I2 = 0). In terms of fracture healing time, it is still controversial. Furthermore, the subgroup analysis has revealed that for Mayo IIA OF, the plate has a better outcome in the long-term (≥ 1 year) postoperative MEPS, the Dash score, and the incidence of postoperative complications than TBW, while there is no significant difference in the long-term (≥ 1 year) postoperative elbow motion between two groups. CONCLUSIONS: Plate has better efficacy and safety for Mayo II OF. Considering that few studies are included in the meta-analysis, more high-quality RCTs are still required to confirm these findings. PROSPERO registration number: CRD42022313855.

The Effectiveness of Duloxetine for Knee Osteoarthritis: An Overview of Systematic Reviews.

Background: Knee osteoarthritis (KOA) has become a public health problem. Several systematic reviews (SRs) have reported that duloxetine may be an effective treatment for improving pain and depressive symptoms in patients with KOA. Aim: To evaluate the available results and provide scientific evidence for the efficacy and safety of duloxetine for KOA. Methods: A comprehensive search strategy was conducted across eight databases from inception to 31 December 2021. Two researchers independently selected eligible studies, collected data and evaluated those included SRs' quality. For assessing methodological quality, the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) was employed. Risk of Bias in Systematic Reviews (ROBIS) was used to assess the risk of bias. Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) was utilized for assessing reporting quality. In addition, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to determine primary outcome indicators' evidence quality. Results: Totally 6 SRs were contained in this overview. After assessment based on AMSTAR 2, ROBIS, and PRISMA, unsatisfactory results in terms of methodological quality, risk of bias as well as reporting quality, were obtained. Limitations included a search of grey literature, the reasons for selecting the study type, an excluded study list and the specific reasons, reporting bias assessment, and reporting of potential sources of conflict of interest. According to the GRADE results, the evidence quality was high in 0, moderate in 5, low in 19, and very low in 36. Limitations were the most commonly downgraded factor, followed by publication bias and inconsistency. Conclusion: Duloxetine may be an effective treatment for improving pain and depressive symptoms in KOA patients with acceptable adverse events. However, due to the low quality of the available evidence, the original study design and the quality of evidence from SRs should be further improved, so as to provide strong scientific evidence for definitive conclusions. Systematic Review Registration: PROSPERO; (http://www.crd.york.ac.uk/PROSPERO/), identifier (CRD42021289823).

Study of the scavenger and vector roles of microplastics for polyhalocarbazoles under simulated gastric fluid conditions.

Microplastics entering the digestive system of living organisms can serve as a carrier of hydrophobic organic pollutants (HOPs), increasing their exposure levels and the health risks they pose to both humans and animals. The desorption kinetics of six polyhalocarbazoles (PHCZs) from 5 mm and 0.15 mm polypropylene (PP) and polyvinyl chloride (PVC) microplastic particles were assessed using a combined microplastics and food system, representing the gastric system of vertebrates and invertebrates. Results showed that the chemical transfer of PHCZs is biphasic and reversible, with rapid exchange occurring within 2-48 h, followed by a period of slow transfer, which continues for weeks to months. The desorption capacity of PHCZs loaded on 0.15 mm microplastic particles was greater than that of 5 mm particles. The bioavailability percentage of PHCZ congeners for PP (24.2%-65.3%) and PVC (43.5%-57.2%) in the vertebrate fluid system were all lower than those in the invertebrate system (34.2%-70.7% for PP and 56.3%-72.7% for PVC, respectively). These findings indicate that physiological conditions, such as polarity, ingestion fluid, and microplastic affect the desorption of PHCZs from microplastics. In addition, desorption from PP was inhibited by the presence of foodstuff loaded with PHCZs due to competition, while desorption from PVC was not significantly affected by the presence of PHCZs contaminant food. Microplastics could provide a cleaning function in gastric fluid systems containing contaminated foodstuff, especially PP, which was capable of competitive adsorption of PHCZs from food. Few investigations have focused on the adverse effects of microplastic ingestion on human health, particularly in their role as vectors for HOPs, compared to other routes of exposure and transport. Therefore, these findings provide valuable insight into the health risks associated with dietary intake of microplastics and HOPs.

Determination and environmental risk assessment of organophosphorus flame retardants in sediments of the South China Sea.

As ubiquitous contaminants in the environment, organophosphorus flame retardants (OPFRs) would eventually settle in marine sediment. In this study, concentrations, spatial distributions, and ecological risks of seven OPFRs in sediment samples of the South China Sea (SCS) were investigated for the first time. Total concentration of all OPFRs ranged from 2.5 to 32.3 ng/g dry weight (dw), in which the abundance of tri-cresyl phosphates (TCPs) was the highest. OPFRs in the SCS were at a medium level compared with those from other parts of the world. The nearshore ocean current, ship transportation, and riverine inputs might influence the spatial distributions of OPFRs. The total inventory of six OPFRs in sediment was estimated to be 202.8 tons (16.7×104 km2). The hazard quotient (HQ) of OPFRs ranged from 0 to 3.2E-02, indicating the ignorable ecological risk of OPFRs in sediments of the SCS. This study provides insight into the occurrence of current-use OPFRs in the SCS which deserved long-term concern in the future due to their continuous terrigenous inputs.

Icariin: A Potential Molecule for Treatment of Knee Osteoarthritis.

Background: Knee osteoarthritis (KOA) is a degenerative disease that develops over time. Icariin (ICA) has a positive effect on KOA, although the mechanism is unknown. To investigate drug-disease connections and processes, network pharmacology is commonly used. The molecular mechanisms of ICA for the treatment of KOA were investigated using network pharmacology, molecular docking and literature research approaches in this study. Methods: We gathered KOA-related genes using the DisGeNET database, the OMIM database, and GEO microarray data. TCMSP database, Pubchem database, TTD database, SwissTargetPrediction database, and Pharmmapper database were used to gather ICA-related data. Following that, a protein-protein interaction (PPI) network was created. Using the Metascape database, we performed GO and KEGG enrichment analyses. After that, we built a targets-pathways network. Furthermore, molecular docking confirms the prediction. Finally, we looked back over the last 5 years of literature on icariin for knee osteoarthritis to see if the findings of this study were accurate. Results: core targets relevant to KOA treatment include TNF, IGF1, MMP9, PTGS2, ESR1, MMP2 and so on. The main biological process involved regulation of inflammatory response, collagen catabolic process, extracellular matrix disassembly and so on. The most likely pathways involved were the IL-17 signaling pathway, TNF signaling pathway, Estrogen signaling pathway. Conclusion: ICA may alleviate KOA by inhibiting inflammation, cartilage breakdown and extracellular matrix degradation. Our study reveals the molecular mechanism of ICA for the treatment of KOA, demonstrating its potential value for further research and as a new drug.