Objective To make a systematical review of the safety and efifcacy of Etomidate plus Fentanyl-class drugs and Propofol plus Fentanyl-class drugs in older patients undergoing gastroscopy. Methods We searched the Cochrane library, PubMed, Embase, China Biology Medicine (CBM), CNKI, VIP, Wanfang Database for all randomized controlled trials (RCTs) about the efifcacy of Etomidate plus Fentanyl-class drugs(Fentanyl, Sufentanil, remifentanil) in older patients undergoing gastroscopy. The quality of the studies was evaluated by the method recommended by the Jadad scale. Meta-analysis was conducted using the Cochrane Collaboration’s RevMan 5.3 software. Results 11 RCTs involving 1 535 patients were analyzed. Meta-analysis showed that patients in the Etomidate group had a lower heart rate [Weighted Mean Difference (WMD)=2.25, 95%CI(0.93, 3.56), P=0.001] and mean arterial pressure [WMD=9.09, 95%CI (7.60, 10.57), P=0.000] lfuctuation than whose of the Propofol group.The hypoxemia occurrence [O^R=0.46, 95%CI (0.32, 0.65), P=0.000] in Etomidate group is also lower than which of the Propofol group. For side effects aspects, the risk of apnea[O^R=0.26, 95%CI(0.15, 0.48), P=0.000] and injection pain [O^R=0.02, 95%CI (0.01, 0.05), P=0.000] in the Etomidate group is much lower than the Propofol group ,while the myoclonus [O^R=8.14, 95%CI (4.18, 15.87), P=0.000], nausea and vomiting [O^R=3.44, 95%CI (2.03, 5.84), P=0.000] were more incidental than the Propofol group. Conclusion Etomidate plus Fentanyl-class drugs can effectively maintain circulatory system for the old undergoing painless gastroscopy, demonstrated to be a safe and valid anesthesia method.

Objective:To investigate the clinical effect of amiodarone on patients with atrial fibrillation after heart valve replacement, and to provide reference basis for improving the efficacy of patients with atrial fibrillation after heart valve replacement.Methods:The PubMed, Web of Science, WILEY medical and nursing discipline database, Cochrane Library, CNKI, Wanfang database, VIP database and China Biology Medicine disc were searched by computer. Randomized controlled trials (RCTs) about amiodarone treating patients with atrial fibrillation after heart valve replacement were searched from the establishment of the database to 24th September , 2019. After two people's independent literature screening and literature quality evaluation, relevant data were extracted and quantitative comprehensive analysis was conducted with Revman 5.3 software.Results:A total of 7 articles were included, including 6 Chinese articles and 1 English article. There were 710 patients in total, including 363 cases in the experimental group and 347 cases in the control group. Quantitative synthesis was performed with Revman 5.3 software, and the results showed that amiodarone treatment for atrial fibrillation after valve replacement could improve the recovery rate of atrial fibrillation ( RR=1.36, 95% CI: 1.20-1.54, P<0.05) . The rate of sinus rhythm maintenance was increased ( RR=1.41, 95% CI: 1.16-1.72, P=0.002) , the ICU monitoring time was shortened ( MD=-1.09, 95% CI: -1.32--0.86, P<0.05) , and the total days in hospital was reduced ( MD=-3.92, 95% CI: -4.25--3.59, P<0.05) . Conclusions:Amiodarone treatment for atrial fibrillation after valve replacement can improve the recovery rate of atrial fibrillation and the rate of sinus rhythm maintenance, reduce the ICU monitoring time and the total days in hospital, which is worthy of clinical application.

Bone diseases, such as osteoporosis and osteoarthritis, have emerged as pressing public health concerns requiring immediate attention and resolution. Cellular therapy and tissue engineering techniques are among the most promising therapeutic approaches for such conditions. Human induced pluripotent stem cells (hiPSCs) possess remarkable capacity for indefinite self-renewal in vitro and the ability to differentiate into all somatic cell types originating from the three germ layers, thereby making them a promising source of osteoblasts. Consequently, it is crucial to establish a well-delineated system for osteogenic differentiation of hiPSCs in vitro, with the aim to generate osteoblast-like cells that conform to clinical application standards. Numerous research teams have achieved substantial advancements in both the direct osteogenic differentiation of hiPSCs and the indirect pathway via mesenchymal stem cells. In this article, we provide a comprehensive review of these two osteogenic differentiation pathways and their current applications, with the aim of serving as a valuable reference for bone regeneration technologies. Current research efforts have relied on embryoid body formation and monolayer induction methods utilizing biomaterials to develop a system that facilitates in vitro culture and osteogenic differentiation of hiPSCs. However, the existing research is primarily constrained by unclear system components and low efficiency. Therefore, the development of a stepwise and three-dimensional induction system based on stringent regulation by specific compounds is a primary research direction for the future.