The application of topical antibiotics for the prevention of infections in primary joint arthroplasty. An umbrella review of systematic reviews and meta-analysis.

This umbrella review aim to explore the effect of topical antibiotics in infection prevention after primary joint arthroplasty, and provide a specific theoretical basis for clinical treatment. The review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched PubMed, EMBASE, Medline, and the Cochrane Library on infection prevention by topical antibiotics from inception to 10 April 2023. The two researchers individually and strictly screened the literature according to the inclusion and exclusion criteria, performed the literature quality evaluation and data extraction, and used Stata 17 for data analysis. This study included six studies with one systematic review and five meta-analyses. The pooled analysis showed that topical antibiotic administration effectively reduced the incidence of overall infection and periprosthetic joint infection. However, it does not reduce the risk of superficial infection. Besides, the topic of antibiotics significantly increases the incidence of other sterile complications of the incision. According to the current evidence, topical application of antibiotics can reduce the incidence of overall infection and periprosthetic joint infection after primary joint arthroplasty. Although it increases the incidence of complications such as delayed healing of incisions, the pros and cons should be weighed in clinical decision making. However, they should not be discarded due to side effects.

Study on the Phase Equilibria of the Fe-Al-Ni-O System at 750°C.

Phase equilibria of the Fe-Al-Ni-O system at 750°C were determined by scanning electron microscopy coupled with energy-dispersive X-ray spectrometer and X-ray power diffraction. 54 alloys were prepared with weighted metal and Ni2O3 powder and were annealed at 750°C for 45 days. Two four-phase equilibrium regions and three three-phase equilibrium regions were confirmed, and the boundary between spinel and corundum was obtained. Comparing with the Fe-Al-Ni-O oxidation diagram at 750°C calculated with FSstel and FToxid databases, the phase boundary of the spinel and corundum oxides from experiments was inclined to the Ni-Al side. The determined relationship between primary oxides and alloy composition in this work can be used as a reference for the preparation of the oxide film by selective oxidation.

Retinal microvasculature features in patients with Behcet's disease: a systematic review and meta-analysis.

This meta-analysis aimed to analyze retinal microvasculature features in eyes with Behçet's disease (BD) using optical coherence tomography angiography (OCTA). Electronic databases, including PubMed, Web of Science, Embase, and Cochrane Library, were comprehensively searched for published studies comparing retinal microvasculature characteristics between eyes with BD and controls. Continuous variables were calculated using the mean difference (MD) with 95% confidence interval (CI). Review Manager software (version 5.30) was used to conduct statistical analysis. A total of 13 eligible studies involving 599 eyes with BD and 622 control eyes were included in the meta-analysis. The pooled results showed that the macular whole enface superficial and deep vessel density (VD) values measured by OCTA were significantly lower in eyes with BD than in control eyes (superficial VD: MD = - 3.05, P < 0.00001; deep VD: MD = - 4.05, P = 0.0004). The foveal superficial and deep VD values were also significantly lower in the BD group than in the control group (superficial VD: MD = - 1.50, P = 0.009; deep VD: MD = - 4.25, - = 0.03). Similarly, the analysis revealed a significant reduction in the parafoveal superficial and deep VD in eyes with BD than in control eyes (superficial VD: MD = - 3.68, P < 0.00001; deep VD: MD = - 4.95, P = 0.0007). In addition, the superficial and deep foveal avascular zones (FAZs) were significantly larger in patients with BD than in controls (superficial FAZ: MD = 0.06, P = 0.02; deep FAZ: MD = 0.12, P = 0.03). The present meta-analysis found that macular whole enface VD, foveal VD, and parafoveal VD were lower in eyes with BD, and the FAZ was larger in patients with BD. The findings suggest that OCTA can assist clinicians in diagnosing and monitoring the status of patients with BD.

Albumin-to-Fibrinogen Ratio Independently Predicts 28-Day Mortality in Patients with Peritonitis-Induced Sepsis.

BACKGROUND: This study is aimed at investigating whether albumin-to-fibrinogen ratio (AFR) could independently predict the prognosis in patients with peritonitis-induced sepsis. METHODS: A total of 246 eligible patients who were scheduled to undergo surgical treatment for peritonitis-induced sepsis were enrolled in this study. The primary observational endpoint was 28-day hospital mortality. Cox proportional hazards regression analysis with the Wald test was performed to identify prognostic factors for 28-day mortality in septic patients. Receiver operating characteristic (ROC) and Kaplan-Meier curve analyses were carried out to evaluate the association of baseline AFR and prognosis in septic patients. RESULTS: Of all the cohort study participants, there were 59 nonsurvivors with a 28-day mortality of 24.0% (59/246). Baseline AFR (hazard ratio (HR): 0.67, 95% confidence interval (CI): 0.42-0.93, P = 0.018) and the presence of septic shock (HR: 2.43, 95% CI: 1.42-3.91, P = 0.021) were two independent prognostic factors for 28-day mortality in patients with peritonitis-induced sepsis by multivariate Cox analysis. Baseline AFR was a significant predictor for 28-day mortality with an area under the curve (AUC) of 0.751, a cut-off value of 8.85, a sensitivity of 66.10%, and a specificity of 70.05%, respectively (95% CI: 0.688-0.813, P < 0.001). A low baseline AFR level (≤8.85) was significantly associated with a lower overall survival rate in septic patients by Kaplan-Meier curve analysis with log-rank test (P = 0.004). CONCLUSIONS: This study indicates that AFR independently predicts 28-day mortality in patients with peritonitis-induced sepsis.

Monocyte Programmed Death Ligand-1, A Predicator for 28-Day Mortality in Septic Patients.

BACKGROUND: Sepsis is a great health burden for millions of people worldwide and plays a critical role in the cause of death in intensive care units. Previous studies have revealed that programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) play critical roles in the immunosuppression phase induced by sepsis. The objective of this present study was to establish whether PD-1/PD-L1 expressions were associated with 28-day mortality of septic patients. METHODS: Consecutive patients admitted to the intensive care units of Taizhou People's Hospital for the treatment of sepsis from June 2014 through June 2016 were included. The demographic and clinical characteristics, laboratory tests, PD-1 and PD-L1 expressions on monocytes/CD4+T/CD8+T cells were compared between survivors and nonsurvivors. Univariate and multivariate logistic regression analyses were plotted for prognostic factors associated with mortality at day-28 in septic patients. RESULTS: A total of 177 septic patients were finally admitted to this study protocol, including 131 survivors and 46 nonsurvivors with a mortality of 26.0%. High PD-L1/monocytes expressions showed an independently significant association with 28-day mortality in septic patients (odds ratio: 4.73, 95% CI: 1.78-15.32, P = 0.033). The receiver operating characteristic curve analysis also indicated PD-L1/monocytes as a predicator for 28-day mortality with a cutoff value of 45.68%. CONCLUSIONS: Our results suggested monocyte PD-L1 expression on admission was an independent risk factor for day-28 mortality in septic patients.

Identification of key pathogenic genes of sepsis based on the Gene Expression Omnibus database.

Sepsis is a life-threatening condition in which an uncontrolled inflammatory host response is triggered. The exact pathogenesis of sepsis remains unclear. The aim of the present study was to identify key genes that may aid in the diagnosis and treatment of sepsis. mRNA expression data from blood samples taken from patients with sepsis and healthy individuals was downloaded from the Gene Expression Omnibus database and differentially expressed genes (DEGs) between the two groups were identified. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and protein­protein interaction (PPI) network construction, was performed to investigate the function of the identified DEGs. Furthermore, for validation of these results, the expression levels of several DEGs were analyzed by reverse transcription quantitative­polymerase chain reaction (RT­qPCR) in three patients with sepsis and three healthy blood samples to support the results obtained from the bioinformatics analysis. Receiver operating characteristic analyses were also used to analyze the diagnostic ability of the identified DEGs for sepsis. The results demonstrated that a total of 4,402 DEGs, including 1,960 upregulated and 2,442 downregulated genes, were identified between patients with sepsis and healthy individuals. KEGG pathway analysis revealed that 39 DEGs were significantly enriched in toll­like receptor signaling pathways. The top 20 upregulated and downregulated DEGs were used to construct the PPI network. Hub genes with high degrees, including interleukin 1 receptor­associated kinase 3 (IRAK3), S100 calcium­binding protein (S100)A8, angiotensin II receptor­associated protein (AGTRAP) and S100A9, were demonstrated to be associated sepsis. Furthermore, RT­qPCR results demonstrated that IRAK3, adrenomedullin (ADM), arachidonate 5­lipoxygenase (ALOX5), matrix metallopeptidase 9 (MMP9) and S100A8 were significantly upregulated, while ectonucleoside triphosphate diphosphohydrolase 1 (ENTPD1) was upregulated but not significantly, in blood samples from patients with sepsis compared with healthy individuals, which was consistent with bioinformatics analysis results. Therefore, AGTRAP, IRAK3, ADM, ALOX5, MMP9, S100A8 and ENTPD1 were identified to have potential diagnostic value in sepsis. In conclusion, dysregulated levels of the AGTRAP, IRAK3, ADM, ALOX5, MMP9, S100A8 and ENTPD1 genes may be involved in sepsis pathophysiology and may be utilized as potential diagnostic biomarkers or therapeutic targets.

Delayed growth of glioma by a polysaccharide from Aster tataricus involve upregulation of Bax/Bcl-2 ratio, activation of caspase-3/8/9, and downregulation of the Akt.

In this study, a homogeneous polysaccharide (ATP-II), with a molecular weight of 3.4 × 10(4) Da, was successfully purified from Aster tataricus by DEAE-Sepharose CL-6B ion exchange and Sepharose CL-6B gel filtration chromatography. Monosaccharide component analysis indicated that ATP-II was composed of glucose, galactose, mannose, rhamnose, and arabinose in molar ratios of 2.1:5.2:2.1:1.0:1.2. We evaluated the anticancer efficacy and associated mechanisms of ATP-II on glioma C6 cells in vitro and in vivo. The results showed that treatment of C6 cells with ATP-II inhibited cell proliferation and this biological response came from induction of DAN damage and consequent inducing apoptosis. Likewise, oral ATP-II administration resulted in consistent regression of glioma tumors and induced apoptosis of transplanted tumor tissues by increasing the ratio of Bax/Bcl-2 and activation of caspase-3, caspase-8, and caspase-9 cascade. Importantly, the efficient downregulation of Akt, which is successfully detected in tumor tissues, is a unique contribution to retard the tumor growth by ATP-II. These data suggest that ATP-II may be a potential candidate for glioma treatment.

Correlation between matrix metalloproteinase expression and activation of the focal adhesion kinase signaling pathway in herpes stromal keratitis.

The present study aimed to investigate the correlation between matrix metalloproteinase-2 (MMP-2) expression and activation of the focal adhesion kinase (FAK) signaling pathway in herpes stromal keratitis (HSK). The cornea of 24 BALB/c mice was infected with herpes simplex virus type 1 (HSV-1) to construct a model of HSK. Six additional mice served as negative controls. Immunohistochemical staining was used to detect FAK expression levels. Human corneal epithelial (HCE) cells cultured in vitro were infected with HSV-1 and the expression levels of MMP-2, FAK and phosphorylated-FAK (p-FAK) in HCE cells were detected using reverse transcription-polymerase chain reaction (RT-PCR), western blot analysis and immunohistochemistry at 2, 20 and 40 h following infection. In the HSK rat model, the corneal epithelial cells appeared deranged and the number of neutrophils and FAK-positive cells was significantly increased compared with that of the negative control group (P<0.05). Repeated measures analysis of variance of RT-PCR showed no significant differences in MMP-2 and FAK mRNA expression levels in the infected cells at various time points, and no significant differences between infected cells and the negative control group were observed. There was no interaction between groups and time points. Pairwise comparisons showed that MMP-2 and FAK mRNA expression levels were significantly increased in virus-infected cells compared with those of the control group. Over time, MMP-2 and FAK mRNA expression levels did not differ significantly in virus-infected cells or in control cells. Western blot analysis indicated no significant differences in p-FAK, FAK and MMP-2 expression levels between the infected and control cells at 2 h (P>0.05). Infected cells showed a significant increase in MMP-2 and p-FAK expression levels than that of the control cells at 20 and 40 h (P<0.05). p-FAK, FAK and MMP-2 expression levels in virus-infected cells at 2 h differed significantly from those at 20 and 40 h (P<0.05). Immunohistochemical staining results showed that a longer infection time was associated with an increased number of cells staining positive for MMP-2, FAK and p-FAK. Following HSV-1 infection of the corneal epithelium, the FAK signaling pathway was activated, resulting in increased secretion of MMP-2 in the corneal tissue and accelerated formation of corneal ulcers and necrotic lesions.

Influence of antisense oligonucleotides targeting tumor necrosis factor-alpha on experimental herpetic-induced chorioretinitis of mouse eye.

OBJECTIVE: To investigate the effect on the pathological process of topical treatment with antisense oligonucleotides (ASON) targeting tumor necrosis factor-alpha (TNF-alpha) in experimental herpes simplex virus type-1 (HSV-1)-induced chorioretinitis of mouse eye. METHODS: 50 BALB/c mice were randomly divided into two different groups (25 mice in each group). The Von Szily model was induced in mice by inoculating 1x10(5) plaque-forming units of HSV-1 (KOS strain) into the anterior chamber of the right eye. In one group, FITC-labeled ASON targeting TNF-alpha was injected subconjunctively into the left eye on days -1, 1, and 4, whereas phosphate buffer was used in the same way on the same days in another group. The clinical appearances were observed after infection each day and the eyes were examined histologically. The TNF-alpha content of retina and choroid were measured by ELISA. RESULTS: After infection, acute inflammation appeared in the right eye of both groups. As for the non-inoculated eye, the inflammation in the ASON group was significantly decreased compared to the PBS group. The number of inflammatory cells in the ASON group was significantly lower than in the PBS group, especially in the choroid, retina and ciliary body. The TNF-alpha content in the choroid and retina of the ASON group was diminished. CONCLUSION: The results suggested that TNF-alpha ASON reduced the content of TNF-alpha in mouse eyes, and this topical treatment decreased the inflammatory reaction. It may be an effective method for treating HSV-1-induced chorioretinitis in the clinic.

Suprachoroidal hemorrhage during pars plana vitrectomy in traumatized eyes.

BACKGROUND: Suprachoroidal hemorrhage (SCH) is a rare but dangerous complication of intraocular surgery. There are some risk factors for this devastating complication during pars plana vitrectomy. In this case, we will report the intraoperative occurrence of SCH during pars plana vitrectomy in traumatized eyes. METHODS: Retrospective analysis of SCH during pars plana vitrectomy in five eyes with the history of blunt (n = 1) or penetrating (n = 4) trauma was made. Baseline systemic and ocular characteristics, surgical procedures, time point of SCH, management of SCH, and final visual outcomes were measured. RESULTS: One eye with associated myopia developed SCH during the time of producing vitreous posterior detachment under ocular hypotony. In other two eyes, SCH developed under ocular hypotony during fluid-gas exchange. The remaining two eyes got SCH when the depression of the area of pars plana occurred. Sclerotomy closure was performed immediately once SCH occurred. Vitrectomy and posterior sclerotomy were then performed between 8 and 12 days later. After a median follow-up of 12 months (range: 3-20 months), final visual acuity was above 20/400 in four eyes, no light perception in one eye, the best visual acuity was 20/60. CONCLUSIONS: Ocular trauma is one of the vital risk factors for the development of intraoperative SCH during pars plana vitrectomy. It is important to control effectively the intraocular inflammation preoperatively and avoid abrupt ocular hypotony and pressure on the area of pars plana intraoperatively to the limit.

Astrocytoma of the ciliary body.

PURPOSE: To report the occurrence of an astrocytoma of the ciliary body. METHODS: The patient was evaluated by ophthalmoscopic examination (including color ultrasonography and ultrasound biomicroscopy) as well as operating therapy. Histopathology and immunocytochemical analysis were performed. RESULTS: A 29-year-old woman was found to have a left ciliary body tumor. Color ultrasonography revealed a 12 x 10 mm size, a low-level echo boundary, and a bright echogenic band. Ultrasound biomicroscopy showed that the lesion was located in the superior temporal quadrant of the ciliary body and extended backward for 6 mm from the limbus. The tumor was carefully dissected free and completely removed via episcleral incision. Histopathology revealed a fibrillary astrocytoma. Staining for glial fibrillary acidic protein yielded positive results and neuron-specific enolase yielded negative results. CONCLUSIONS: We describe an astrocytoma of the ciliary body in a patient, which is an extremely rare ocular tumor. Histopathology and immunocytochemical analysis were required to establish the diagnosis.