[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.

Nitrogen acquisition strategy and its effects on invasiveness of a subtropical invasive plant.

Introduction: Preference and plasticity in nitrogen (N) form uptake are the main strategies with which plants absorb soil N. However, little effort has been made to explore effects of N form acquisition strategies, especially the plasticity, on invasiveness of exotic plants, although many studies have determined the effects of N levels (e.g. N deposition). Methods: To address this problem, we studied the differences in N form acquisition strategies between the invasive plant Solidago canadensis and its co-occurring native plant Artemisia lavandulaefolia, effects of soil N environments, and the relationship between N form acquisition strategy of S. canadensis and its invasiveness using a 15N-labeling technique in three habitats at four field sites. Results: Total biomass, root biomass, and the uptakes of soil dissolved inorganic N (DIN) per quadrat were higher for the invasive relative to the native species in all three habitats. The invader always preferred dominant soil N forms: NH4 + in habitats with NH4 + as the dominant DIN and NO3 - in habitats with NO3 - as the dominant DIN, while A. lavandulaefolia consistently preferred NO3 - in all habitats. Plasticity in N form uptake was higher in the invasive relative to the native species, especially in the farmland. Plant N form acquisition strategy was influenced by both DIN levels and the proportions of different N forms (NO3 -/NH4 +) as judged by their negative effects on the proportional contributions of NH4 + to plant N (f NH4 +) and the preference for NH4 + (ß NH4 +). In addition, total biomass was positively associated with f NH4 + or ß NH4 + for S. canadensis, while negatively for A. lavandulaefolia. Interestingly, the species may prefer to absorb NH4 + when soil DIN and/or NO3 -/NH4 + ratio were low, and root to shoot ratio may be affected by plant nutrient status per se, rather than by soil nutrient availability. Discussion: Our results indicate that the superior N form acquisition strategy of the invader contributes to its higher N uptake, and therefore to its invasiveness in different habitats, improving our understanding of invasiveness of exotic plants in diverse habitats in terms of utilization of different N forms.

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.

Ibrutinib facilitates the sensitivity of colorectal cancer cells to ferroptosis through BTK/NRF2 pathway.

Ibrutinib is a drug that inhibits the protein Burton's tyrosine kinase and thereby the nuclear translocation of Nrf2, which played a key role in mediating the activation of antioxidants during stress conditions and ferroptosis resistance. This study aimed to identify the effect of Ibrutinib and ferroptosis inducer on colorectal cancer (CRC) treatment and its underlying mechanism. In our study, we found the upregulation of Nrf2 was correlated with CRC progression and antioxidant proteins. Ibrutinib sensitized CRC to ferroptosis inducers, suggested by further reduced CRC cell viability, proliferation and decreased antioxidant protein levels in CRC cells after combination treatment of Ibrutinib and RSL3 or Ibrutinib and Erastin both in vivo and in vitro. Knockout of Nrf2 diminished the regulatory effect of Ibrutinib on CRC sensitivity to ferroptosis inducers. Altogether, this study demonstrated that Ibrutinib increases the sensitivity of CRC cell to ferroptosis inducers by inhibiting Nrf2.

Phenotypic plasticity and exotic plant invasions: Effects of soil nutrients, species nutrient requirements, and types of traits.

High-phenotypic plasticity has long been considered as a characteristic promoting exotic plant invasions. However, the results of the studies testing this hypothesis are still inconsistent. Overlooking the effects of species resource requirements and environmental resource availability may be the main reasons for the ambiguous conclusions. Here, we compared phenotypic plasticity between five noxious invasive species with different nutrient requirements (evaluated using the soil nutrient status of their natural distribution ranges) and their phylogenetically related natives under five nutrient levels. We found that species with high-nutrient requirements showed greater plasticity of total biomass than species with low-nutrient requirements, regardless of their status (invasive or native). Invasives with high-nutrient requirements had greater growth plasticity than their related natives, which may contribute to their invasiveness under high-nutrient environments. However, compared with the related natives, a higher growth plasticity may not help exotic species with low-nutrient requirements to invade nutrient-rich habitats, and exotic species with high-nutrient requirements to invade nutrient-limited habitats. In contrast, invasives with low-nutrient requirements exhibited lower growth plasticity than their related natives, contributing to their invasiveness under nutrient-limited habitats. Functional traits showed growth-related plasticity in only 10 cases (3.8%), and there was no functional trait whose plastic response to soil nutrients was beneficial to exotic plant invasions. Our study indicates that low-growth plasticity could also promote exotic plant invasions, high plasticity may not necessarily lead to invasiveness. We must test the adaptive significance of plasticity of functional traits when studying its biological roles.

Efficacy and Safety of Oblique Lumbar Interbody Fusion Versus Transforaminal Lumbar Interbody Fusion for Degenerative Lumbar Spondylolisthesis: A Systematic Review and Meta-Analysis.

OBJECTIVE: We critically evaluated the efficacy and safety of oblique lumbar interbody fusion (OLIF) versus transforaminal lumbar interbody fusion (TLIF) for degenerative lumbar spondylolisthesis (DLS). METHODS: PubMed, Embase, Cochrane Library, the Web of Science Core Collection, Chinese Biomedical Literature, China National Knowledge Infrastructure, Wanfang Digital Periodicals, and Chinese Science and Technology Periodicals were searched from their inception to February 2021. Randomized controlled trials and retrospective or prospective cohort studies (CSs) comparing OLIF and TLIF for DLS were included. A meta-analysis was conducted, if possible. RESULTS: Ten studies were included in the statistical analysis. The pooled results of the CSs showed no statistically significant differences (P > 0.05) in pain relief at 3 or 6 months of follow-up and functional improvement at 1 or 3 months of follow-up in DLS patients between those who had undergone OLIF versus TLIF. The pooled results of the CSs showed that OLIF could significantly improve the degree of lumbar lordosis, foraminal height, and disc height and decrease the intraoperative blood loss, postoperative drainage volume, operative duration, bed rest time, and hospital length of stay (P < 0.05) compared with TLIF. The incidence of adverse events was not significantly different statistically between OLIF and TLIF. CONCLUSIONS: The results from the present study suggest that pain relief and functional improvement were not significantly different between OLIF and TLIF. Nevertheless, the use of OLIF might improve radiological outcomes and reduce intraoperative blood loss, postoperative drainage volume, operative duration, bed rest duration, and hospital length of stay compared with TLIF. Additional high-quality randomized controlled trials are still required to confirm these findings.

Efficacy and Safety of Acupuncture Therapy for Patients with Acute Ankle Sprain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: The efficacy of acupuncture for acute ankle sprain (AAS) is controversial. This study aimed to critically assess the efficacy and safety of acupuncture for AAS. METHODS: Parallel-group randomized controlled trials (RCTs) were included regardless of language or publication date. Participants with AAS were included regardless of age, sex, race, nationality, or diagnostic criteria for AAS. Experimental interventions included acupuncture alone or in combination with traditional therapies. Control interventions included no treatment, placebo, or traditional therapies. The primary outcome was the Kofoed ankle score. The secondary outcomes included visual analogue scale, duration of pain, use of painkiller, ankle circumference, effective rate, cure rate, and adverse events. PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Digital Periodicals, and Chinese Science and Technology Periodicals database were searched to identify potentially eligible studies from inception to September 10, 2020. World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), ClinicalTrials.gov, Chinese Clinical Trial Registry (ChiCTR), and the reference list of eligible RCTs were checked to identify ongoing or unpublished studies. Risk of bias was assessed by the Cochrane Collaboration's tool. Statistical analyses were performed by RevMan 5.3 software. P < 0.05 indicated statistical significance. RESULTS: Seventeen eligible studies were included for the statistical analysis. There was no statistically significant difference of Kofoed ankle score between acupuncture and Rest, Ice, Compression, and Elevation (RICE) group (P=0.75). However, acupuncture could significantly relieve pain (P=0.02) and increase cure rate (P=0.004) compared with RICE. Moreover, acupuncture plus RICE could also significantly relieve pain (P < 0.00001) and increase cure rate (P=0.01) compared with RICE alone. Acupuncture combined with massage could significantly relieve pain (P=0.04) compared with massage alone. Acupuncture plus Chinese medicine might be more effective for relieving pain (P < 0.00001), reducing the duration of pain (P < 0.00001), and increasing cure rate (P=0.0002) compared with Chinese medicine alone. Two studies reported no adverse reactions. One study reported that a participant suffered from mild drug-related allergic reaction and was healed without treatment. CONCLUSIONS: The findings of the present study suggest that acupuncture may be beneficial for AAS. However, more large-scale and well-designed RCTs are warranted.

Altered Brain Regional Homogeneity Following Contralateral Acupuncture at Quchi (LI 11) and Zusanli (ST 36) in Ischemic Stroke Patients with Left Hemiplegia: An fMRI Study.

OBJECTIVE: To study the effect of contralateral acupuncture (CAT) at acupoints of Quchi (LI 11) and Zusanli (ST 36) on the unaffected limbs of ischemic stroke patients with left hemiplegia based on regional homogeneity (ReHo) indices. METHODS: Ten ischemic stroke patients with left hemiplegia received CAT on right side at LI 11 and ST 36. Functional magnetic resonance imaging (fMRI) was performed before and after acupuncture. A ReHo analytical method was used to compare brain responses of patients before and after CAT operated by REST software. RESULTS: The stimulation at both LI 11 and ST 36 on the unaffected limbs produced significantly different neural activities. CAT elicited increased ReHo values at the right precentral gyrus and superior frontal gyrus, decreased ReHo value at right superior parietal lobule, left fusiform gyrus and left supplementary motor area. CONCLUSIONS: Acupuncture at one side could stimulate bilateral regions. CAT could evoke the gyrus which was possibly related to motor recovery from stroke. A promising indicator of neurobiological deficiencies could be represented by ReHo values in post-stroke patients.

[Research progress on techniques for artificial propagation of corals].

The natural coral reef resources degrade rapidly because of climate change, environmental pollution and exploitation of aquarium species. Artificial propagation is an effective way to facilitate the reduction of wild harvesting, reef restoration, preservation of biodiversity. This paper reviewed the technique and research progresses focused on coral artificial propagation. We compared the advantages and disadvantages of sexual reproduction and asexual reproduction as well as in situ and ex situ propagation. Moreover, we summarized the important roles of irradiation, flow rate, nutrients, feed and other factors in coral propagation within recirculating aquaculture system (RAS). Irradiation is the key to successful ex situ coral culture and different species show different needs of radiation intensity and light spectrum. Therefore, artificial lighting in RAS, as well as. power and maintenance costs, are very important for ex situ coral aquaculture. In addition, corals are very sensitive to NH4+, NO3-, NO2- as well as phosphate in RAS, and many physical, chemical and biological methods are acquired to maintain low nutrients condition. Although RAS has progressed a lot in terms of irradiation, flow rate and nutrient control, future studies also should focus on sexual reproduction, genetic modification and disease control.