The effects of LY117018 HCL (LY) treatment on bone metabolism, spine bone mineral density (BMD), bone mineral content (BMC), and serum cholesterol were studied in ovariectomized (OVX) rats. Experiment 1 was designed to observe the preventive effects of LY on bone loss due to ovariectomy (OVX; prevention study). The rats were divided into three groups: sham group, OVX + vehicle, and OVX + LY. LY was administrated at the same time of OVX. Experiment 2 was designed to investigate the interventional effects of LY on OVX rats with osteopenia (intervention study). The rats were divided into the sham and OVX groups, first. The OVX rats were allowed to lose bone for 6 weeks. At 6 weeks post-OVX, the OVX rats were divided into two groups: OVX + vehicle and OVX + LY. The longitudinal effects of LY on bone were studied by dual-energy X-ray absorptiometry and biochemical markers including urinary pyridinoline (Pyr), deoxypyridinoline (Dpyr), and serum osteocalcin. Urinary Pyr and Dpyr increased maximally at 6 weeks post-OVX, decreased at 12 and 18 weeks post-OVX, although the OVX rats had significantly higher levels of Pyr and Dpyr than the sham group during the experiment. LY was a very potent inhibitor of Pyr and Dpyr excretion while at the same time only partially reducing the bone loss in the high turnover phase at 6 weeks postovariectomy. However, at the later time points at 12 and 18 weeks, no further bone loss occurred in rats treated with LY, while the vehicle-treated group lost another 10% in spine BMD and BMC. LY also completely blocked further bone loss when used in an intervention protocol. LY significantly reduced serum cholesterol levels in OVX rats. The results suggest that LY is not fully protective during the early rapid bone loss phase, but the compound is fully protective during the later slow phase of bone loss in both the protocols.

This meta-analysis compared the efficacy of oblique lumbar interbody fusion (OLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lumbar degenerative diseases. A computer search for the published literature on OLIF and MIS-TLIF for the treatment of lumbar degenerative diseases in the PubMed, Web of Science, Embase, CINAHL, MEDLINE, Cochrane Library, and other databases was performed, from which 522 related articles were retrieved and 13 were finally included. Two reviewers independently extracted data from the included studies and analyzed them using RevMan 5.4. The quality of the studies was assessed using the Cochrane systematic analysis and the Newcastle–Ottawa scale. Meta-analysis showed that the blood loss [95% confidence intervals (CI) (− 121.01, − 54.56), $$P<0.001$$P < 0.001 ], hospital stay [95% CI (− 1.98, − 0.85), $$P<0.001$$P < 0.001 ], postoperative fusion rate [95%CI (1.04, 3.60), $$P=0.04$$P = 0.04 ], postoperative disc height [95% CI (0.50, 3.63), $$P=0.01$$P = 0.01 ], and postoperative foraminal height [95% CI (0.96, 4.13), $$P=0.002$$P = 0.002 ] were all better in the OLIF group; however, the complication rates were significantly lower in the MIS-TLIF group [95% CI (1.01, 2.06), $$P=0.04$$P = 0.04 ]. However, there were no significant differences between the two in terms of surgery time, patient satisfaction, or postoperative functional scores. The OLIF group had the advantages of lower blood loss, a shorter hospital stay, a higher postoperative fusion rate, and better recovery of the disc and foraminal heights, whereas MIS-TLIF had a relatively lower complication rate.

Background: The primary management modalities for the patella in TKA include patellar resurfacing, patellar non-resurfacing, patellar resurfacing with denervation, and patellar non-resurfacing with denervation. Traditionally, meta-analyses have predominantly focused on examining comparisons between two management modalities. However, this study performed a network meta-analysis to compare all four patellar management interventions to identify the most optimal approach for patellar management in TKA. Methods: A computer-based search of PubMed, China National Knowledge Infrastructure (CNKI), The Cochrane Library, Web of science, Embase, and MEDLINE databases was performed to identify randomized controlled trials focusing on the four management interventions for the patella in TKA. Comparisons included two-by-two comparisons as well as those involving more than two concurrent comparisons. The search timeframe spanned from inception to June 30, 2023. Two independent authors extracted the data and evaluated the quality of the literature. The Cochrane Collaboration Risk of Bias (ROB) tool was used to evaluate the overall quality of the literature. Subsequently, a network meta-analysis was conducted using the “gemtc” package of the R-4.2.3 software. Outcome measures such as anterior knee pain (AKP), reoperation rate, and patient satisfaction rate were evaluated using odd ratio (OR) and 95% confidence intervals (CI). Additionally, the knee society score (KSS), function score (FS), and range of motion (ROM) were evaluated using mean differences (MD) with associated 95% CI. The different treatment measures were ranked using the surfaces under the cumulative ranking curves (SUCRA). Results: A total of 50 randomized controlled trials involving 9,283 patients were included in the analysis. The findings from this network meta-analysis revealed that patellar resurfacing exhibited significantly lower postoperative reoperation rate (OR 0.44, 95% CI 0.24–0.63) and AKP (OR 0.58, 95% CI 0.32–1) compared to non-resurfacing. Additionally, patellar resurfacing exhibited higher postoperative KSS clinical scores in comparison with non-resurfacing (MD: 1.13, 95% CI 0.18–2.11). However, for postoperative FS, ROM, and patient satisfaction, no significant differences were observed among the four management interventions. Conclusion: Patellar resurfacing emerges as the optimal management modality in primary TKA. However, future studies should aim to reduce sources of heterogeneity and minimize the influence of confounding factors on outcomes. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023434418 identifier: CRD42023434418

Background: The goal of our study is to investigate whether the methylation levels of AHCY and CBS promoters are related to the risk of cerebral infarction by detecting the methylation level of AHCY and CBS genes. Methods: We extracted peripheral venous blood from 152 patients with cerebral infarction and 152 gender- and age-matched healthy controls, and determined methylation levels of AHCY and CBS promoters using quantitative methylation-specific polymerase chain reaction. We used the percentage of methylation reference (PMR) to indicate gene methylation level. Results: We compared the promoter methylation levels of two genes (AHCY and CBS) in peripheral blood DNA between the cerebral infarction case group and the control group. Our study showed no significant difference in AHCY promoter methylation between case and control. Subgroup analysis by gender showed that the methylation level of AHCY in males in the case group was lower than that in the control group, but the difference was not statistically significant in females. In a subgroup analysis by age, there was no significant difference in the AHCY methylation level between the case and control in the young group (≤44 years old). However, the level of AHCY gene methylation in the middle-aged group (45–59 years old) was significantly higher and the aged group (≥60 years old) was significantly lower than that in the control groups. However, CBS promoter methylation levels were significantly lower in the case group than in the control group (median PMR: 70.20% vs 104.10%, P = 3.71E-10). In addition, the CBS methylation levels of males and females in the case group were significantly lower than those in the control group (male: 64.33% vs 105%, P = 2.667E-08; female: 78.05% vs 102.8%, P = 0.003). We also found that the CBS levels in the young (23–44), middle-aged (45–59), and older (60–90) groups were significantly lower than those in the control group (young group: 69.97% vs 114.71%; P = 0.015; middle-aged group: 56.04% vs 91.71%; P = 6.744E-06; older group: 81.6% vs 119.35%; P = 2.644E-04). Our ROC curve analysis of CBS hypomethylation showed an area under the curve of 0.713, a sensitivity of 67.4%, and a specificity of 74.0%. Conclusion: Our study suggests that hypomethylation of the CBS promoter may be closely related to the risk of cerebral infarction and may be used as a non-invasive diagnostic biomarker for cerebral infarction.