Long-term versus Short-term Introvesical Chemotherapy in Patients with Non-muscle-invasive Bladder Cancer:A Systematic Review and Meta-analysis of the Published Results of Randomized Clinical Trials

In order to assess the effect of long-term versus short-term intravesical chemotherapy in preventing the recurrence of patients with non-muscle-invasive bladder cancer, we searched several da- tabases with words as mesh terms and free text words to find all eligible randomized clinical trials （RCTs） for the Comparison of the two strategies of instillation durations. ＂Observed-Expected events re- search （O-E）＂ and ＂Variance （V）＂ for calculating hazard ratio （HR） were used in Revman 5.2 software recommended by Cochrane Collabration for data analysis. Sensitivity and subgroup analysis were se- lected to minish heterogeneity. GRADEpro 3.6 profile recommended by Cochrane Collabration was employed for quality assessment of analyses. Finally, 13 eligible RCTs with 4216 patients were in- eluded in this review and 16 comparisons from 13 trials were involved for analysis. The pooled analysis revealed no significant difference between long-term and short-term duration [HR=0.99, 95% CI （0.89, 1.11）, P=-0.89]. Within the subgroup analysis, patients benefited from long-term instillations with a start regimen of one immediate instillation [HR=0.83, 95% CI （0.69, 1.00）, P=-0.05]. But patients were not suitable to receive long-term instillations with epirubicin （EPI） [HR=1.01, 95% CI （0.91, 1.13）, P=0.78] The progression rate was not reduced after long-term instillations [HR=0.96, 95% CI （0.66, 1.39）, P=0.82]. From our results, patients should not receive introvesical chemotherapy more than half a year. In contrast, patients with one immediate instillation are preferred to have a long-term duration at least one year. Long-term instillations can not reduce the progression rate.

A phase II study of neoadjuvant chemotherapy followed by organ preservation in patients with muscle-invasive bladder cancer

Objective:Conservative approaches in muscle-invasive bladder cancer(MIBC)have been evolved to avoid aggressive surgery,but are limited to elderly,frail,and patients medically unfit for surgery.Our study aimed to assess the response rate of neoadjuvant chemotherapy(NACT)before radiotherapy(RT)in MIBC patients.Methods:Forty patients with urothelial carcinoma of stage T2-T4a,N0,M0 were enrolled between November 2013 and November 2015,and treated with three cycles of NACT with gemcitabine-cisplatin.Post-NACT response was assessed using Response Evaluation Criteria in Solid Tumors(RECIST)criteria.Patients who achieved complete response(CR)and partial response(PR)>50%were treated with radical RT,and those who had PR<50%,stable disease(SD),and progressive disease(PD)underwent radical cystectomy(RC).Survival analysis was done with Kaplan-Meier method and point-to-time events were analyzed with Cox-proportional hazards regression model.Results:After NACT,35(87.5%)patients achieved either PR>50%or CR,and were treated with RT.Five(12.5%)patients who had PR<50%,SD,or PD underwent RC.All patients who received radiation showed CR after 6 weeks.Median follow-up was 43 months(range:10-66 months)and median overall survival(OS)was not reached.Three-year OS,local control,and disease-free survival were 70.1%,60.9%,50.6%,respectively,and 50%of patients preserved their functioning bladder.Three-year OS rate was 88.9%in patients who achieved CR to NACT,73.1%in patients with PR≥50%and 40%in patients with PR<50%.Conclusion:NACT followed by RT provides a high probability of local response with bladder preservation in CR patients.Appropriate use of this treatment regimen in carefully selected patients may omit the need for morbid surgery.

Novel coumarone-derived(S,E)-4-(4-fluorobenzylidene)-3-phenylchroman-3-ol inhibits muscle-invasive bladder cancer cells by repressing the S and G2 cell cycle phases

Background:This study aimed to select compounds with unique inhibitory effects on muscle-invasive bladder cancer(MIBC)from coumarone derivatives with similar parent nuclear structures and to reveal their tumor-suppressive effects using various approaches.Methods:Bladder cancer cell lines SW780 and T24,as well as human normal bladder epithelial cell line SV-HUC-1 were selected as the study model,and these urinary system cells were co-incubated with various concentrations of(S,E)-4-(4-methylbenzylidene)-3-phenylchroman-3-ol,(S,E)-4-(4-isocyanobenzylidene)-3-phenylchroman-3-ol,(S,E)-4-(4-fluorobenzylidene)-3-phenylchroman-3-ol(FPO),and(S,E)-3-phenyl-4-(4-(trifluoromethoxy)benzylidene)chroman-3-ol.Cell activity was detected using cell counting kit-8.FPO showed the strongest inhibitory effect on MIBC cells;therefore,it was selected for further experiments.We monitored the FPO-induced T24 cell morphological changes with an inverted microscope.The FPO-inhibited migration of T24 cells was examined using a cell scratch assay.We detected the clonogenic ability of T24 cells through a clone formation test and evaluated their proliferative ability using a 5-ethynyl-2’-deoxyuridine fluorescence staining kit.The inhibitory effect of FPO against the cell cycle was monitored using flow cytometry,and its suppressive effect on the DNA replication ability of T24 cells was detected using double fluorescence staining(Ki67 and phalloidin).Results:Among the four candidate coumarone derivatives,FPO showed the most significant inhibitory effect on MIBC cells and was less toxic to normal urothelial cells.FPO inhibited T24 cell growth in time and dose-dependent manners(the half-inhibitory concentration is 8μM).FPO significantly repressed the proliferation,migration,and clonogenic ability of bladder cancer T24 cells.Cell mobility was significantly inhibited by FPO:30μM FPO almost completely repressed migration occurred at after 24 h treatment.Moreover,FPO significantly suppressed the clonogenicity of bladder cancer cells in a dose-dependent manner.Mechanistically,FPO targeted the cell cycle,arresting the S and G2 phases on bladder cancer T24 cells.Conclusion:We discovered a novel anticancer chemical,FPO,and proposed a potential mechanism,through which it suppresses MIBC T24 cells by repressing the cell cycle in the S and G2 phases.This study contributes to the development of novel anticancer drugs for MIBC.

Characteristics of Emission Non-nulling Pulsars Through Simulation

We investigate the population and several properties of radio pulsars whose emission does not null(non-nulling)through simulation of a large pulsar sample.Emission from a pulsar is identified as non-nulling if(i)the emission does not cease across the whole pulse profile,and(ii)the emission is detectable.For(i),we adopt a model for switching in the plasma charge density,and emission persists if the charge density is non-zero.For(ii),we assume that detectable emission originates from source points where it is emitted tangentially to the magnetic field-line and parallel to the line-of-sight.We find that pulsars exhibiting non-nulling emission possess obliquity angles with an average of 42°.5,and almost half the samples maintain a duty cycle between 0.05 and 0.2.Furthermore,the pulsar population is not fixed but dependent on the obliquity angle,with the population peaking at 20°.In addition,three evolutionary phases are identified in the pulsar population as the obliquity angle evolves,with the majority of samples having an obliquity angle between 20°and 65°.Our results also suggest that emission from a pulsar may evolve between nulling and non-nulling during its lifetime.

Advances in treatment strategies for non–clear cell renal cell carcinoma

Renal cell carcinoma is the sixth most commonly diagnosed cancer in men and the tenth in women,with clear cell renal cell carcinoma accounting for nearly 75%of cases.The remaining 25%consists of non–clear cell renal cell carcinoma,a diverse and less prevalent group.Although current treatments for clear cell types are well-defined,progress in treating non–clear cell renal cell carcinoma has been limited owing to its heterogeneity and rarity,relying primarily on findings from small-scale phase Ⅱ clinical trials.This review examined recent advancements in the treatment of non–clear cell renal cell carcinoma,particularly in the areas of immunotherapy and targeted therapy.

Non-HDL-C水平和ApoB/ApoA1比值与初发心肌梗死的相关性研究

目的探究不同非高密度脂蛋白胆固醇(non-HDL-C)水平初次急性心肌梗死患者的临床特征及载脂蛋白B(Apo B)和载脂蛋白A1(Apo A1)比值以及non-HDL-C与冠状动脉(冠脉)病变程度的相关性。方法选取2021年12月至2023年4月于重庆医科大学附属第一医院心内科入院治疗的首次诊断为急性心肌梗死且行冠脉造影的患者410例。计算Apo B/Apo A1比值及non-HDL-C,根据non-HDL-C三分位数分为低non-HDL-C组(≤2.89 mmol/L)、中non-HDL-C组(2.9~4.16 mmol/L)、高non-HDL-C组(≥4.17 mmol/L),比较三组患者一般临床资料及冠脉病变特点的差异性。另采用Spearman秩相关和二元Logistics回归分析non-HDL-C水平、Apo B/Apo A1对冠脉病变严重程度的影响。结果与低non-HDL-C组相比,中non-HDL-C组和高non-HDL-C组患者年龄更小(P<0.05);高non-HDL-C组较另外两组具有更高水平的体质指数(BMI)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、ApoB、ApoA1、ApoB/ApoA1、白蛋白、γ-谷酰转移酶、尿酸(P<0.05)。三组间左前降支病变、回旋支病变、多支血管病变、Gensini评分相比,差异有统计学意义(P<0.05)。偏相关分析显示Apo B/Apo A1和non-HDL-C均与多支血管病变、Gensini评分呈正相关(P<0.05);多因素二元Logistics回归分析显示ApoB/ApoA1比值(OR=3.149,95%CI:1.209~8.201,P=0.019)、non-HDL-C≥4.17 mmol/L(OR=4.199,95%CI:1.524~11.565,P=0.006)是多支血管病变的独立危险因素。结论在初次急性心肌梗死青年患者有冠脉病变或(冠状动脉粥样硬化性心脏病)危险因素中,更应关注ApoB/ApoA1及non-HDL-C,同时严格控制non-HDL-C是心肌梗死患者潜在的降脂目标。

基于Non stationary-CNN-Transformer的海浪有效波高预测

针对海浪有效波高序列波动性、随机性较强,难以精确预测以及模型无法高效挖掘深层特征间关系的问题,提出一种基于Non stationary-CNN-Transformer模型的海浪有效波高预测方法。首先,使用平稳化模块减弱海浪时序数据的非平稳性;其次,利用一维卷积神经网络(CNN)提取相关数据间的深层特征并构建特征向量;最后,使用含有平稳性注意力的Transformer描述波高序列的时间依赖性捕捉到序列之间的全局关系,通过逆归一化处理后获得有效波高预测结果。该方法可消除海浪时序数据的非平稳性,提升数据的预测效果,并具有优异的特征提取能力且善于处理大规模时间序列数据。在实验中应用澳大利亚的浮标实测数据,通过7组对比实验分别预测0.5、3、6、12和24 h的有效波高,对所提模型进行全方位、多角度的验证。算例研究结果表明,该文所提模型在不同时间段精度有明显提升。

Progress in the Use of Glucocorticoids and Biological Agents in Non-Infectious Uveitis

One of the main immune-mediated diseases that lead to avoidable blindness is non-infectious uveitis. Glucocorticoids are the first-line therapy choice for noninfectious uveitis;however, biologics are also showing promise in the management of this condition. The description of glucocorticoid and biologic usage in non-infectious uveitis is the main topic of this paper.

Research Progress on Different Endoscopic Hemostatic Regimens for the Treatment of Acute Non-Varicose Upper Gastrointestinal Bleeding

Acute upper gastrointestinal hemorrhage is a highly prevalent clinical condition, with the majority of cases representing acute non-variceal upper gastrointestinal hemorrhage. With the advancement of modern medicine, endoscopy has become an indispensable tool in the diagnosis and treatment of various diseases. In order to achieve optimal results in the endoscopic treatment of non-variceal upper gastrointestinal bleeding, it is essential to make an accurate and timely diagnosis and select the most appropriate treatment method. This article introduces the definition of acute non-variceal upper gastrointestinal bleeding (ANVUGIB) and the importance of endoscopic treatment for this disease. It then presents an overview of various assessment systems for ANVUGIB and an overview of endoscopic advances in thermal coagulation, mechanical hemostasis, and topical pharmacological injection hemostasis for three aspects of ANVUGIB-related bleeding. In particular, this article discusses the therapeutic efficacy and safety of different treatment options for non-variceal upper gastrointestinal bleeding, as well as the advantages and limitations of these treatment options in managing this disease.

Investigating Non-Compliance with COVID-19 Vaccination through Hesitancy, Refusal, and Access Limitation: A Community-Based Survey from the Democratic Republic of the Congo

Introduction: Vaccination plays a pivotal role in mitigating the repercussions of the COVID-19 pandemic. However, vaccination campaigns encounter obstacles, especially in developing countries like the Democratic Republic of the Congo (DRC). This study aimed at investigating the roles of vaccine hesitancy, refusal, and access barriers, while identifying individual-level factors associated with non-vaccination in Mbujimayi, DRC. Methods: A community-based cross-sectional survey was conducted in three health districts and included 1496 residents. Attitudes and behaviors related to seeking COVID-19 vaccination were assessed using a standardized questionnaire. Hierarchical logistic regression modeling was used to assess factors potentially affecting non-compliance with vaccination. Results: Among participants (median age = 33, IQR = 23.3, M/F sex ratio = 0.7), 60% displayed misconceptions about COVID-19 or its vaccine, while only 35.2% perceived COVID-19 as a significant health threat. Vaccination coverage was estimated at 49.1% (95% CI: 47.5;52.6), with 71.8% of vaccinated individuals having received one dose. Among the unvaccinated individuals, 50.9% expressed no intention to be vaccinated in the future, citing hesitation (30.4%) or refusal (39.6%) mainly due to side effects or distrust of vaccines. Conversely, 32.7% of the unvaccinated persons expressed access barriers despite willingness to be vaccinated. Misconceptions about COVID-19 and its vaccines were the main drivers of vaccination non-compliance. Conclusion: These findings demonstrate significant vaccine non-compliance driven by hesitancy, refusal, and access barriers. Strategies to enhance vaccination coverage and pandemic preparedness should address misconceptions, sociodemographic barriers, and geographic disparities.

The Interventional Capacity of Community Health Volunteers for Screening and Linkages of Non-Communicable Diseases in Nyeri County, Kenya

Non-communicable diseases (NCDs) account for 63% of mortalities. Approximately 80% of these NCD-related deaths occur in LMICs. A quasi-experimental study utilizing a non-equivalent pre-and post-test was conducted from May 2022 to March 2023 with 370 study participants. Multistage cluster and random sampling were used to select ten community units, and therefore, 150 CHVs were chosen for the control unit, and 150 were used to form the interventional group. Data was collected from the KOBO app. Six (6) homogenous FGDs comprised ten members, and 10 KII were conducted across study sites. Quantitative data was analyzed using SPSS version 28.0, and qualitative data was audio-recorded, transcribed, and analyzed via N-Vivo 12. The study shows that 59.3% of respondents have minimal information, and 92.7% (n = 139) have no clear understanding of NCDs, with a pre-intervention capacity of 48.8%. Independent sample t-test showed a significant difference in capacity from a pre-intervention average of 48.75 (SD ± 5.7)%, which increased to 68.28 (SD ± 7.6)%, p < 0.001. A well-designed community interventional model plays a pivotal role in grassroots healthcare delivery but requires optimization for NCD management.

Roles of Community Pharmacists in Screening and Disseminating of Information about Non-Steroidal Anti-Inflammatory Drugs Risks: Implications for Drug Safety Assessment

Background: The increasing use of non-steroidal anti-inflammatory drugs (NSAIDs) both on prescription and over the counter raises a major global health concern because of the risks associated with their use if no proper guidance is given by the health care provider. This study assessed the roles of community pharmacists in screening and disseminating information about the risks associated with NSAID use in Zambia. Methodology: This was a national cross-sectional study in which a structured self-administered questionnaire was administered to 245 registered community pharmacists in Zambia. Stata/BE, version 15.1 (Stata Corporation, College Station, Texas, USA) and multivariate logistic regression model was used to determine factors associated with information dissemination about ADRs of NS-NSAIDs. Results: 231 of the 245 distributed questionnaires were returned giving a response rate of 94.3%. All (100%) participating community pharmacists claimed to have practiced dispensing NSAIDs. However, only 26 (11.0%) and 71 (30.8%) regularly screened for risk factor of selective COX-2 NSAIDS (SC2-NSAIDS) and non-selective NSAIDS (NS-NSAIDs) respectively. Information dissemination on adverse drug reactions (ADRs) of SC2-NSAIDS was regularly provided by only 22 (9.5%) of pharmacists while that of NS-NSAIDs was regularly provided by 49 (21.2%). In the multivariate logistic regression model, being the owner of a pharmacy (AOR: 5.4, CI: 1.84 - 16.4) was significantly associated with information dissemination about ADRs of NS-NSAIDs while an hour increase in the working hours per day (AOR: 0.9, CI: 0.64 - 0.95) was associated with less likelihood of information dissemination. Conclusion: Pharmacists working in community pharmacies in Zambia did not regularly screen and disseminate information about the risks associated with NSAID use. Therefore, pharmacists should be able to screen and monitor patients at risk and be aware of the majority of risk factors while dispensing NSAIDs to minimize the associated complications.

Primary Non-Hodgkin’s Malignant Lymphoma of the Uterus at the Reference Hospital of Maradi/Niger: A Case Report

Malignant non-Hodgkins lymphoma (MHNL) of the uterus is uncommon. We report a case diagnosed on the basis of histologic and immunohistochemical studies of a hysterectomy specimen induced by a very painful pelvic mass in a 50-year-old patient with no previous history of the disease. It was classified as Ann Arbor IV Bb after imaging, given the medullary infiltration and signs of clinical and biological evolutivity: the patient had received two courses of chemotherapy, CHOP protocol. She died 23 days after the second treatment due to a hypertensive crisis.

A Study on Near-Infrared Non-Invasive Blood Glucose Concentration Regression Prediction Based on PSO-MKL-SVR

To improve the accuracy of predicting non-invasive blood glucose concentration in the near-infrared spectrum, we utilized the Particle Swarm Optimization (PSO) algorithm to optimize hyperparameters for the Multi-Kernel Learning Support Vector Machine (MKL-SVR). With these optimized hyperparameters, we established a non-invasive blood glucose regression model, referred to as the PSO-MKL-SVR model. Subsequently, we conducted a comparative analysis between the PSO-MKL-SVR model and the PSO-SVR model. In a dataset comprising ten volunteers, the PSO-MKL-SVR model exhibited significant precision improvements, including a 16.03% reduction in Mean Square Error and a 0.29% increase in the Squared Correlation Coefficient. Moreover, there was a 0.14% higher probability of the Clark’s Error Grid Analysis falling within Zone A. Additionally, the PSO-MKL-SVR model demonstrated a faster operational speed compared to the PSO-SVR model.

Progress in the Study of Inflammatory Bowel Disease Patients with Primary Non-Responsiveness

Inflammatory bowel disease (IBD) is a group of chronic, nonspecific intestinal inflammatory disorders characterized by localized and systemic inflammation. The use of biologic agents in the treatment of IBD patients is widespread, and the occurrence of primary non-responsiveness during treatment is also significant. This review briefly summarizes the possible reasons for primary non-responsiveness in IBD patients, as well as predictive markers and current strategies to address it, providing a theoretical reference for early identification and management of IBD patients who do not respond to treatment.

Non-Spectrality of Certain Self-Affine Measures on the Generalized Spatial Sierpinski Gasket

Let μM,Dbe a self-affine measure associated with an expanding integer matrix M=[ p1,0,0;p4,p2,0;p5,0,p3]and the digit set D={ 0,e1,e2,e3}in the space R3, where p1,p2,p3∈Z\{ 0,±1 }, p4,p5∈Zand e1,e2,e3are the standard basis of unit column vectors in R3. In this paper, we mainly consider the case p1,p2,p3∈2Z+1, p2≠p3, p4=l(p1−p2), p5=l(p3−p1),where l∈2Z. We prove that μM,Dis a non-spectral measure, and there are at most 4-element μM,D-orthogonal exponentials, and the number 4 is the best. The results here generalize the known results.

Assessment of Barriers and Challenges to the Screening and Linkages of Non-Communicable Diseases by Community Health Volunteers in Nyeri County, Kenya

Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (LMICs), where 80% of NCD-related deaths occur. A quasi-experimental study addressed this challenge from May 2022 to March 2023. This study utilized a non-equivalent pre-and post-test design, with 300 participants in the quantitative and 70 in the qualitative. The study employed multistage cluster and random sampling to select ten community units, resulting in 150 community health volunteers (CHVs) in the control unit and 150 in the intervention group. Data collection was facilitated through the KOBO app. Qualitative data analysis involved six homogeneous focus group discussions (FGDs) and ten key informant interviews (KIIs), audio-recorded, transcribed, and analyzed using N-Vivo 12. Despite efforts to implement screening programs and improve linkages to care, significant barriers persist. This article reviews these barriers, drawing on current literature and empirical evidence. Key obstacles identified include limited awareness, inadequate healthcare infrastructure, cultural beliefs, financial constraints, fragmented healthcare systems, and challenges linking individuals to appropriate care services. The article explores strategies to overcome these barriers, emphasizing the importance of collaborative approaches involving stakeholders at various levels. Addressing these challenges aims to strengthen NCD screening and linkages to care, ultimately improving health outcomes for populations globally. Several recommendations emerge from the study’s findings and literature review. Raising awareness about NCDs and preventive measures is crucial and can be achieved through targeted health education campaigns and community outreach programs. Addressing healthcare infrastructure deficiencies, such as inadequate facilities and workforce shortages, is essential to ensure access to quality care. Cultural beliefs and practices also play a significant role in shaping health-seeking behavior. Engaging with local communities and incorporating cultural sensitivity into healthcare delivery can help bridge the gap between traditional beliefs and modern healthcare practices. Financial constraints pose a significant barrier to healthcare services, particularly in LMICs. Innovative financing mechanisms, such as health insurance schemes or subsidies, can help alleviate this burden and improve access to care. Furthermore, the fragmented nature of healthcare systems can hinder effective NCD management. Enhancing coordination and integration between primary care providers, specialists, and community health workers is essential to ensure seamless care delivery and patient follow-up. Finally, strengthening linkages between screening programs and care services is critical for the timely diagnosis and management of NCDs. This requires establishing robust referral systems and ensuring continuity of care for patients throughout their healthcare journey. In conclusion, addressing the multifaceted barriers to NCD screening and care linkage is essential for improving health outcomes globally. By implementing targeted interventions and fostering collaboration among stakeholders, progress can be made towards reducing the burden of NCDs and promoting population health.

Pang Fuwan Uses Yao Medicine to Observe the Therapeutic Effects on the Physical and Mental Symptoms of Patients with Advanced Non-Small Cell Lung Cancer

Objective: Investigate the efficacy and safety of Yao Medicine in the treatment of advanced non-small-cell lung carcinoma, and explore the best therapeutic measure for clinical benefit. Methods: From July 2020 to July 2022, 84 patients with advanced non-small-cell lung carcinoma were selected and randomly divided into the Observation Group and control group, and the control group was treated with routine Western medicine, with 42 cases in each group. The activity of daily living (ADL) was assessed before and after treatment, meanwhile, the self-rating depression scale (SDS) and self-rating anxiety SAS (SAS) were used to assess the improvement of a bad mood, and quality of life SF-36 was used to assess the quality of life, to judge the efficacy and safety. Results: The effective rate of observation group was 91.67%. The effective rate of the control group was 76.19%. The effective rate of the observation group was significantly higher than that of the control group (P 0.05). There were no significant differences in the scores of SDS, SAS and quality of life between the two groups before treatment (P > 0.05), and after treatment, the scores of SDS, SAS and quality of life in the two groups were compared with those in the control group (P > 0.05), the scores of VAS, SDS and SAS decreased significantly, while ESCV, angle of straight leg elevation, ADL, physiological score, emotional score, social score and health status score increased significantly, the difference was statistically significant (P 0.05). Conclusion: Yao Medicine can improve the psychosomatic symptoms of patients with advanced non-small-cell lung carcinoma better, with better efficacy and higher safety.

Influence of Non-Natural Ageing Temperature on the Microstructural Characteristics and Mechanical Properties of Cast Aluminum 6063 Alloy

This research considered the effect of non-natural aging on the microstructural characteristics and mechanical properties of as-cast aluminum 6063 alloys. The samples were developed through a sand casting process and machined into tensile and impact test samples before carrying out solution heat treatment at 550?C (0.83 Tm) on two parts of the samples while retaining one part as the control. The two parts were further divided into sets denoted A and B and were aged at 180?C (0.27 Tm) and 160?C (0.24 Tm), respectively, for 12 hours. The results showed that sample A has the optimal yield strength and ultimate tensile strength of 192 and 206 MPa, respectively. Likewise, the sample gave the highest impact strength value of about 9.63 J/mm2. The observed results were supported by the optical micrograph, which revealed that the sample has evenly dispersed precipitates in its microstructure. This is deemed responsible for the observed increase in strength of the sample.

外泌体来源非编码RNA对骨关节炎微环境的作用及临床应用进展

背景:骨关节炎是一种常见的关节退行性疾病,其发生发展的病因学机制尚不清楚。早期骨关节炎的及时诊治十分重要,目前尚无确切有效的方法。外泌体来源广泛,其中包含非编码RNA(Non-coding RNAs,ncRNAs),如微小RNAs、环状RNAs和长链非编码RNAs。外泌体ncRNAs可直接从原始细胞递送至邻近或远程细胞,通过细胞间通讯调节细胞活性,在重塑骨关节微环境中具有重要的调控作用。目的:总结外泌体来源ncRNAs对骨关节炎关节内微环境的干预作用,以及在临床应用中取得的进展,阐明其在骨关节炎诊治方面的潜力。方法:以“exosomes,non-coding RNA,osteoarthritis,application,signal pathway,synovial fluid,cartilage cells,cartilage matrix,subchondral bone,mechanism”为检索词在PubMed数据库中进行检索,最终纳入66篇相关文献进行综述分析。结果与结论:①外泌体来源ncRNAs在骨关节炎的发病过程中对关节内微环境具有重要调控作用,主要体现在外泌体ncRNAs调控关节内炎症反应、软骨细胞及软骨基质的退化,软骨下骨重塑和细胞间通讯。②外泌体中的ncRNAs可以作为骨关节炎的生物标志物,帮助骨关节炎的早期诊断和监测疾病进展与预后。③外泌体ncRNAs可作为骨关节炎的治疗靶点,外泌体携带miRNAs递送到关节的软骨细胞及软骨基质,发挥调控作用。④外泌体ncRNAs可以通过调控基因表达、促进细胞间通讯,提高软骨组织工程的效果,修复或再生受损软骨。⑤未来研究者应继续发掘外泌体来源ncRNAs对骨关节炎的干预机制,并可结合最新软骨组织工程的研究成果应用到临床之中,这将有效帮助解决骨关节炎患者的病痛。