Cardiovascular safety of zoledronic acid in the treatment of primary osteoporosis: A meta-analysis and systematic review.

PURPOSE: Osteoporosis is intimately linked to cardiovascular disease and it has been uncertain that zoledronic acid is not correlated with cardiovascular disease. We intended to assess the cardiovascular safety of zoledronic acid in the treatment of primary osteoporosis. METHODS: We included only randomized controlled trials (RCTs) of patients with osteoporosis receiving zoledronic acid or a placebo. We systematically searched PubMed, Embase, Web of Science, Cochrane CENTRAL, Scopus, the Chinese National Knowledge Infrastructure, ClinicalTrials.gov, and ICTRP from the time of database creation to April 5, 2023. Two investigators extracted data independently on study characteristics, outcomes of interest, and risk of bias based on PRISMA guidelines. RESULTS: As of April 5, 2023, our search identified 32,361 records, and after excluding these records, 9 RCTs were included in the meta-analysis. The overall risk ratio for cardiovascular events with zoledronic acid for primary osteoporosis compared with placebo was 1.15 (95 % CI 1.05-1.26, I2=12 %, P = 0.002), while the risk of major adverse cardiovascular events with zoledronic acid (RR 1.03, 95 % CI 0. 89-1.18, I2=21 %, P = 0.71) was not significant, possibly due to atrial fibrillation (RR 1.21, 95 % CI 0.99-1.47, I2=0 %, P = 0.06) versus the increased relative risk of arrhythmia (RR 1.30, 95 % CI 1.11-1.52, I2=34 %, P = 0.001). Overall, the cardiovascular risk of zoledronic acid for the treatment of primary osteoporosis was not significant; however, the relative risk of elevated atrial fibrillation and arrhythmias remains to be further studied. CONCLUSIONS: In women with primary osteoporosis, zoledronic acid may increase the risk of atrial fibrillation (P = 0.06) and arrhythmias (P = 0.001) compared with placebo, independent of the risk of major adverse cardiovascular events, angina, and heart failure. However, the sample size of men with primary osteoporosis is small, and the cardiovascular risk of zoledronic acid in men with osteoporosis is uncertain.

Damage characteristics and surface description of near-wall materials subjected to ultrasonic cavitation.

For the analysis of ultrasonic cavitation erosion on the surface of materials, the ultrasonic cavitation erosion experiments for AlCu4Mg1 and Ti6Al4V were carried out, and the changes of surface topography, surface roughness, and Vickers hardness were explored. Cavitation pits gradually expand and deepen with the increase of experiment time, and Ti6Al4V is more difficult to erode by cavitation than AlCu4Mg1. After experiments, the cavitation damage characteristics such as the single pit, the rainbow ring area, the fisheye pit, and some small pits were observed, which can be considered to be induced by a single micro-jet impact, ablation effect caused by the high temperature, micro-jet impingement with a sharp angle, and multibeam micro-jets coupling impact or negative pressure in the local area produced by micro-jet impact, respectively. The surface roughness and Vickers hardness of the material increase slowly after rapid growth at different points in time as the experiment time increases. With the increase of the ultrasonic amplitude, both of them first increase and then decrease after the ultrasonic amplitude is greater than 10.8 µm. The increases in surface roughness and Vickers hardness tend to decrease as the viscosity coefficient increases. Ultrasonic cavitation can cause submicron surface roughness and increase surface hardness by 20.36%, so it can be used as a surface treatment method.

A Kinetic Study of the Pozzolanic Reaction of Fly Ash, CaO, and Na2O in the Preparation of Fly Ash Belite Cement.

Fly ash belite cement is a kind of low-carbon cement prepared by a two-step process involving hydrothermal synthesis and low-temperature calcination. Pozzolanic reaction pastes, as the precursors of fly ash belite cement prepared by hydrothermal synthesis, are affected mainly by reaction temperature, time, ratios of the mass of fly ash/lime (FA/CA), and the dosage of Na2O. The absorbance rate of CaO with reaction time was tested for all samples, and the reaction kinetic model and parameters of the granule-hydrothermal synthesis method were discussed. A kinetic model for the hydrothermal synthesis in the presence of Na2O was proposed based on the Kondo's modified Jander equation and Arrhenius equation. The activation energy (Ea) of the process was determined to be 67.76 kJ/mol. In addition, with an increasing dosage of Na2O, the pre-exponential factor A of the Arrhenius equation increased. However, the hydrothermal reaction degree was accurately predicted using the kinetic model characterized by the absorption rate of CaO. The results indicated that Na2O, as an alkali activator, facilitated the diffusion of Ca2+ firstly, then partly dissolved the amorphous phase in the mixtures and, finally, accelerated the formation of poorly crystallized hydrates.

Dose-normalization for exposure to mycophenolic acid and the early clinical outcome in patients taking tacrolimus after heart transplantation.

BACKGROUND: The early phase of MPA exposure has rarely been investigated after solid organ transplantation, especially in heart transplantation patients. We evaluated the association between exposure to mycophenolic acid (MPA), a main metabolite of mycophenolate mofetil (MMF), and clinical events within 3 months after heart transplantation. MATERIAL AND METHODS: Trough (C0) and area under the curve (AUC)0-12h levels of MPA and its metabolite, mycophenolic acid glucuronide (MPAG), were determined using high-performance liquid chromatography. Corresponding clinical endpoints included acute rejection or MMF-related adverse events (gastrointestinal symptoms, leucopenia, and anemia). AUC measurements (n=77) were collected from 21 patients. Dose-normalized C0 and AUC0-12h levels were used to evaluate the association between MPA or MPAG exposure and MMF-related adverse events. RESULTS: No acute rejection or mortality occurred during the follow-up period. Twelve patients (57%) developed 13 MMF-related adverse events. The MMF dose was tapered from 2.50 g/day on D1 to 1.55±0.54 g/day on D90. Significantly higher levels of dose-normalized MPA C0 and AUC0-12h were associated with the events than with the absence of the events (C0: 1.04±0.42 vs. 0.84±0.85 µg/mL/g [p=0.047]; AUC0-12h: 20.37±3.21 vs. 14.97±1.13 µg × h/mL/g; [p=0.038]). Conclusions Dose-normalized MPA exposure may protect against MMF toxicity in the early stage after heart transplantation. The MMF dose can be decreased to near 1.5 g/day 3 months post-transplantation without jeopardizing patient safety; a well-planned, tapered MMF regimen should also be considered.

[Crop productivity model and its application].

Within agricultural ecosystems the interaction between crop and surroundings is quite complicated. In order to know the feedbacks of crop to surroundings in agricultural ecosystem, a research on crop productivity model is becoming important. This paper discussed the backgrounds of the emergency of crop productivity model, thinking that the crop productivity model was a means which could be used to simulate growth process by mathematical ways and computer technology, and analyzed the physiology of crop growth and the correlation between crop and surroundings. At the same time, it discussed four phases of crop productivity model developing, including infancy, youth, adolescent and maturity. Secondly, the paper summarized the crop productivity model's function of agricultural eco-environment protection from three aspects, including scientific research, management of crop, and analysis of agricultural decision, and discussed the disadvantages of crop productivity model. The disadvantages embodied in three facets: 1) though the simple crop productivity model could be used easily in practice, its regional adaptiability was too weak; 2) complicated crop productivity model had too much parameters to obtain, which made it difficult to use in practice; 3) the inconsistency of basic data format in different research areas also made the model's regional adaptability too weak. It's indicated in this paper that the establishment of universal and uniform basic data format is favorable to the extension and application of crop productivity model in other regions. Geographic information system (GIS) was emerged in 1960, which has powerful functions of obtaining, depositing, managing and analyzing spatial data, and is useful to solve the problem of weakly regional adaptability. Meanwhile, friendly interface is favorable to the extension in common users. Finally, the paper discussed the combination of crop productivity model and geographic information system, summarized some researches on friendly interface of crop productivity model, and pointed out that the establishment of universal crop productivity model interface is the focus of the future.