OBJECTIVE:The quality of systematic reviews/meta-analyses directly affects the reliability of clinical decision-making basis.Currently,there is no literature quality research on the systematic reviews/meta-analyses of platelet rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis both domestically and internationally.This article will comprehensively evaluate the methodological quality,reporting quality,and evidence quality of the systematic reviews/meta-analyses of platelet rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis.METHODS:Computer searches were conducted on CNKI,WanFang Data,VIP,CBM,PubMed,Embase,and The Cochrane Library.From the establishment of the database until January 24,2024,all systematic reviews/meta-analyses treated with platelet rich plasma versus hyaluronic acid for knee osteoarthritis were collected.Two evaluators independently conducted literature screening and data extraction,and used the AMSTAR 2,PRISMA 2020,and GRADE systems to evaluate and summarize the methodological,reporting,and evidence quality of the included systematic reviews/meta-analyses.RESULTS:A total of 18 qualified systematic reviews/meta-analyses were included,and the results showed that the efficacy and safety of platelet rich plasma might be better than that of hyaluronic acid.The methodological quality of all 18 studies was extremely low;4 reports had poor quality and relatively serious information defects,while 14 reports had moderate quality and some information defects.Among the 275 outcome measures of 16 systematic reviews/meta-analyses,there were 9 medium quality evidence,90 low-quality evidence,and 176 extremely low-quality evidence,with no high-quality evidence.CONCLUSION:At present,the quality of systematic reviews/meta-analyses literature on the treatment of knee osteoarthritis with platelet rich plasma versus hyaluronic acid is relatively low.In the future,the authors of the systematic reviews need to strictly follow the entries of quality evaluation tools such as AMSTAR 2 and PRISMA 2020 in terms of plan registration,research type explanation,retrieval strategy,exclusion list,research site and funding source,bias risk analysis,publication bias evaluation,and public information acquisition,and conduct evidence quality evaluation on the combined results of the systematic reviews/meta-analyses to provide more reliable and rigorous evidence-based basis for clinical practice.

Objective:To evaluate the efficacy of corticosteroids in male children with Duchenne muscular dystrophy (DMD), and provide evidence for the rational clinical use of medication.Methods:This was a multicenter medical record series study which conducted from January 15 th to March 14 th, 2025. A total of 53 male children with DMD admitted to the Department of Rehabilitation of Children′s Hospital, Zhejiang University School of Medicine, Children′s Hospital of Chongqing Medical University and Affiliated Children′s Hospital of Soochow University from 2020 to 2024 were enrolled. Clinical data, corticosteroid usage, and the follow-up data were collected. The North star ambulatory assessment (NSAA) was used as the primary efficacy indicator. Generalized estimating equations (GEE) exchangeable working matrices were used for longitudinal analysis, and the least squares mean were used to compare the change trend of the efficacy evaluation index across different medication durations. Results:The age at the initiation of corticosteroid treatment was (6.3±1.9) years. The follow-up duration was 1.2 (0.9, 2.2) years. After treatment, the raw scores and linear scores of NSAA were both significantly higher than those before treatment ((22±7) vs. (19±5) points, (60±16) vs. (53±8) points; t=3.98, 3.69; both P<0.001). The 10 meter running time and time rising from floor were both shorter than those before treatment (6 (4, 8) vs. 7 (6, 9) s, 5 (3, 6) vs. 6 (5, 9) s; Z=2.62, 3.47; both P<0.01). GEE model analysis revealed all nonlinear correlation between motor function (NSAA linear score, 10-meter running velocity, and rising from floor velocity) and the duration of corticosteroid treatment (all P<0.05). Least squares mean comparison all showed that the medication effect first increased and then decreased with duration, reaching the peak at 1.1-2.0 years after treatment (all P<0.05). Conclusions:Corticosteroids can improve the motor function in male children with DMD, with the maximum treatment effect occurring 1 to 2 years after the initiation of treatment. It is necessary to comprehensively leverage time-varying efficacy of corticosteroids to optimize individualized treatment regimens for maximal motor function benefits in children with DMD.

Objective To observe the effect of ultrasound-guided sacral canal injection of Neurotropin combined with comprehen-sive rehabilitation on severe sacral plexus injury after sacral fracture.Methods A case with severe sacral plexus injury ten months after sacral fracture was reviewed.He accepted ultrasound-guided sacral canal injection of Neurotropin along with comprehensive rehabilitation,and was assessed with American Spinal Injury Association Impairment Scale(AIS)impairment scale,manual muscle testing,Visual An-alog Scale(VAS),modified Barthel Index(MBI),Short-form of Health Survey(SF-36)and Functional Gait As-sessment(FGA),and measured the nerve conduction velocity and the structural organization of the sacrococcy-geal ligament using nerve conduction velocity tests,electromyography(EMG)and ultrasound examination be-fore and after treatment.Results After four weeks and ten weeks of treatment,the muscle strength,and scores of MBI,FGA and SF-36 increased,while the ASIA score improved from grade D to grade E,and VAS score decreased.During follow-up,the VAS score and physical pain and general health status scores of the SF-36 increased.After ten weeks of treatment,nerve conduction velocity increased,latency shortened,and the amplitude of evoked action potentials increased.The presence of spontaneous sharp waves decreased,and the peak of active potentials increased.The peak of ac-tive potentials in the right gluteus maximus,vastus lateralis and gastrocnemius muscles increased.The structural organization of the sacrococcygeal ligament appeared clearer and more orderly.No adverse reaction was ob-served.Conclusion Ultrasound-guided sacral canal injection of Neurotropin combined with comprehensive rehabilitation is ef-fective on pain,activities of daily living and quality of life for patients with severe sacral plexus injury during the sequelae period.

OBJECTIVE:The quality of systematic reviews/meta-analyses directly affects the reliability of clinical decision-making basis.Currently,there is no literature quality research on the systematic reviews/meta-analyses of platelet rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis both domestically and internationally.This article will comprehensively evaluate the methodological quality,reporting quality,and evidence quality of the systematic reviews/meta-analyses of platelet rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis.METHODS:Computer searches were conducted on CNKI,WanFang Data,VIP,CBM,PubMed,Embase,and The Cochrane Library.From the establishment of the database until January 24,2024,all systematic reviews/meta-analyses treated with platelet rich plasma versus hyaluronic acid for knee osteoarthritis were collected.Two evaluators independently conducted literature screening and data extraction,and used the AMSTAR 2,PRISMA 2020,and GRADE systems to evaluate and summarize the methodological,reporting,and evidence quality of the included systematic reviews/meta-analyses.RESULTS:A total of 18 qualified systematic reviews/meta-analyses were included,and the results showed that the efficacy and safety of platelet rich plasma might be better than that of hyaluronic acid.The methodological quality of all 18 studies was extremely low;4 reports had poor quality and relatively serious information defects,while 14 reports had moderate quality and some information defects.Among the 275 outcome measures of 16 systematic reviews/meta-analyses,there were 9 medium quality evidence,90 low-quality evidence,and 176 extremely low-quality evidence,with no high-quality evidence.CONCLUSION:At present,the quality of systematic reviews/meta-analyses literature on the treatment of knee osteoarthritis with platelet rich plasma versus hyaluronic acid is relatively low.In the future,the authors of the systematic reviews need to strictly follow the entries of quality evaluation tools such as AMSTAR 2 and PRISMA 2020 in terms of plan registration,research type explanation,retrieval strategy,exclusion list,research site and funding source,bias risk analysis,publication bias evaluation,and public information acquisition,and conduct evidence quality evaluation on the combined results of the systematic reviews/meta-analyses to provide more reliable and rigorous evidence-based basis for clinical practice.

Objective To observe the effect of ultrasound-guided sacral canal injection of Neurotropin combined with comprehen-sive rehabilitation on severe sacral plexus injury after sacral fracture.Methods A case with severe sacral plexus injury ten months after sacral fracture was reviewed.He accepted ultrasound-guided sacral canal injection of Neurotropin along with comprehensive rehabilitation,and was assessed with American Spinal Injury Association Impairment Scale(AIS)impairment scale,manual muscle testing,Visual An-alog Scale(VAS),modified Barthel Index(MBI),Short-form of Health Survey(SF-36)and Functional Gait As-sessment(FGA),and measured the nerve conduction velocity and the structural organization of the sacrococcy-geal ligament using nerve conduction velocity tests,electromyography(EMG)and ultrasound examination be-fore and after treatment.Results After four weeks and ten weeks of treatment,the muscle strength,and scores of MBI,FGA and SF-36 increased,while the ASIA score improved from grade D to grade E,and VAS score decreased.During follow-up,the VAS score and physical pain and general health status scores of the SF-36 increased.After ten weeks of treatment,nerve conduction velocity increased,latency shortened,and the amplitude of evoked action potentials increased.The presence of spontaneous sharp waves decreased,and the peak of active potentials increased.The peak of ac-tive potentials in the right gluteus maximus,vastus lateralis and gastrocnemius muscles increased.The structural organization of the sacrococcygeal ligament appeared clearer and more orderly.No adverse reaction was ob-served.Conclusion Ultrasound-guided sacral canal injection of Neurotropin combined with comprehensive rehabilitation is ef-fective on pain,activities of daily living and quality of life for patients with severe sacral plexus injury during the sequelae period.

Objective:To evaluate the efficacy of corticosteroids in male children with Duchenne muscular dystrophy (DMD), and provide evidence for the rational clinical use of medication.Methods:This was a multicenter medical record series study which conducted from January 15 th to March 14 th, 2025. A total of 53 male children with DMD admitted to the Department of Rehabilitation of Children′s Hospital, Zhejiang University School of Medicine, Children′s Hospital of Chongqing Medical University and Affiliated Children′s Hospital of Soochow University from 2020 to 2024 were enrolled. Clinical data, corticosteroid usage, and the follow-up data were collected. The North star ambulatory assessment (NSAA) was used as the primary efficacy indicator. Generalized estimating equations (GEE) exchangeable working matrices were used for longitudinal analysis, and the least squares mean were used to compare the change trend of the efficacy evaluation index across different medication durations. Results:The age at the initiation of corticosteroid treatment was (6.3±1.9) years. The follow-up duration was 1.2 (0.9, 2.2) years. After treatment, the raw scores and linear scores of NSAA were both significantly higher than those before treatment ((22±7) vs. (19±5) points, (60±16) vs. (53±8) points; t=3.98, 3.69; both P<0.001). The 10 meter running time and time rising from floor were both shorter than those before treatment (6 (4, 8) vs. 7 (6, 9) s, 5 (3, 6) vs. 6 (5, 9) s; Z=2.62, 3.47; both P<0.01). GEE model analysis revealed all nonlinear correlation between motor function (NSAA linear score, 10-meter running velocity, and rising from floor velocity) and the duration of corticosteroid treatment (all P<0.05). Least squares mean comparison all showed that the medication effect first increased and then decreased with duration, reaching the peak at 1.1-2.0 years after treatment (all P<0.05). Conclusions:Corticosteroids can improve the motor function in male children with DMD, with the maximum treatment effect occurring 1 to 2 years after the initiation of treatment. It is necessary to comprehensively leverage time-varying efficacy of corticosteroids to optimize individualized treatment regimens for maximal motor function benefits in children with DMD.

Objective To investigate the correlation of serum levels of Krüppel-like transcription factor 2(KLF2)and angiopoietin-1(Ang1)with the severity and prognosis of neonatal respiratory distress syndrome(NRDS).Methods A total of 416 children with NRDS who were treated in this hospital from January 2019 to December 2022 were selected as the NRDS group.According to the results of chest imaging examination,the NRDS group was divided into mild group(145 cases),moderate group(174 cases)and severe group(97 ca-ses).According to NRDS outcome the children were divided into the good prognosis group 322 cases and bad prognosis group 94 cases,another 150 healthy premature infants were selected as the control group in the hos-pital.Serum KLF2,Ang1 levels were measured by enzyme-linked immunosorbent assay(ELISA).Pearson correlation was used to analyze the correlation between serum KLF2,Ang1 levels and neonatal acute physiolo-gy score perinatal supplement Ⅱ(SNAPPE-Ⅱ),1 min Apgar score in neonates with NRDS.The receiver op-erating characteristic(ROC)curve was used to evaluate the value of serum KLF2,Ang1 levels in predicting the prognosis of children with NRDS.Results Compared with the control group,the NRDS group had signifi-cantly lower birth weight and serum KLF2,Ang1 levels(P<0.05).In the children with NRDS,the serum of KLF2,Ang1 levels and 1 min Apgar score gradually decreased with the increase in the severity of the disease(P<0.05).Compared with the good prognosis group,the children with NRDS in the poor prognosis group had significant decreased in the serum KLF2 and Ang1 levels and a significant increased in the SNAPPE-Ⅱscore(P<0.05).In children with NRDS,the serum levels of KLF2 and Ang1 were negatively correlated with SNAPPE-Ⅱ score and positively correlated with 1 min Apgar score(P<0.05).The area under the curve(AUC)of serum KLF2 and Ang1 levels in predicting the poor prognosis of NRDS children were 0.931 and 0.909,respectively.The AUC of the combination of KLF2 and Ang1 in predicting the poor prognosis of NRDS children was 0.949,which was higher than that of KLF2 or Ang1 alone,with a sensitivity of 96.81%.Conclu-sion Serum KLF2,Ang1 levels in children with NRDS are reduced,the two level with NRDS children with severe degree aggravating gradually decreas,and both have important value in predicting the prognosis of chil-dren with NRDS.

OBJECTIVE: To evaluate the clinical efficacy of ultrasound subgingival scaling combined with manual root planing for treatment of chronic periodontitis in elderly patients. METHODS: Forty elderly patients with chronic periodontitis were randomly divided into test group for treatment with ultrasound and Gracey subgingival curette for subgingival scaling combined with manual root planing and control group treated with ultrasound subgingival curette scaling (=20). We compared plaque index (PLI), bleeding index (BI), probing depth (PD), and attachment loss (AL) between the two groups before and at 6 weeks and 12 weeks after the treatment. RESULTS: After periodontal treatment, PLI, BI, PD and AL all decreased significantly in both groups compared with the levels before the treatment ( < 0.05). The patients in the test group showed significantly more obvious decrease of PD and AL than those in the control group ( < 0.05), but the reduction of PLI and BI was comparable between the two groups (>0.05). CONCLUSIONS Ultrasound subgingival scaling combined with manual root planing produces better therapeutic effect than ultrasonic subgingival scaling alone for treatment of chronic periodontitis in elderly patients.
Aged ; Chronic Periodontitis ; therapy ; Dental Scaling ; Humans ; Root Planing ; Treatment Outcome ; Ultrasonography

Objective:To systematically review the relationship between PTGER 4 genetic polymorphisms and the risk of inflam-matory bowel disease (IBD).Methods:All eligible case-control studies which published up to February 29,2016 were searched by PubMed,Embase,Web of Science.The studies in accordance with high quality were included in this study .We synthesized pooled odds ratio ( OR) and its 95%confidence interval ( CI) using STATA12.0.The sensitivity analysis was used to determine the stability of re-sults in meta-analysis.The Egger′s analysis was performed to evaluate the publication bias .Results:Twenty original publications invol-ving 44 case-control studies were included in this study ,in which 25179 patients with Crohn′s disease (CD),5261 patients with ulcer-ative colitis ( UC) and 44652 control subjects were detected .The allelic frequency ,additive model ,dominant model and recessive mod-el were used to analyze the association of rs 4613763 T/C polymorphism and CD ,and the pooled OR and 95%CI were as followings:1.24 (1.06-1.45),1.32 (1.06-1.64),1.25 (1.06-1.48),1.28 (1.03-1.59).For rs17234657T/G polymorphism and CD,the pooled OR (95%CI) of four genetic models were 1.35 (1.28-1.47),2.12 (1.70-2.63),1.46 (1.36-1.57) and 1.90 (1.54-2.35),re-spectively.For rs4495224A/C polymorphism and CD,the pooled OR(95%CI) were 1.05 (0.79-1.41),1.08 (0.62-1.88),1.12 (0.75-1.65) and 1.00 (0.67-1.49).And the pooled OR (95%CI) were 0.77 (0.67-0.88),0.59 (0.51-0.69),0.73 (0.61-0.87),0.68 (0.59-0.79) for rs9292777G/T polymorphism and CD.For rs1373692T/G polymorphism and CD,the pooled OR (95%CI) were 1.23 (0.96-1.57),1.39 (0.74-2.59),1.26 (0.74-2.13),1.31 (1.00-1.72).The pooled OR (95%CI) of allelic fre-quency , additive model , dominant model and recessive model for the association of rs 4613763 T/C polymorphism with UC were 1.30 (1.17-1.44 ), 1.73 ( 1.16-2.59 ), 1.32 ( 1.17-1.48 ), 1.64 ( 1.10-2.45 ), respectively.Conclusion: Polymorphisms of rs17234657T/G,rs4613763T/C and rs9292777G/T are associated with CD.Polymorphism of rs4613763T/C is associated with UC sus-ceptibility.

Objective Bladder cancer , which has a high rate of recurrence and invasion , is the most common genitourinary cancer.The article was to study the effect of specific chemokine receptor CXCR 4 on invasion capacity and intraluminal implantation of human bladder cancer cells . Methods A CXCR4 specific recombinant plasmid vector (short hairpin, shRNA) was constructed to select those cells which could inhibit the expression of CXCR 4, and these cells were divided into blank control group , negative control plasmid group and recombinant plasmid group (pshRNA-CXCR4-1, pshRNA-CXCR4-2).RT-PCR and immunofluorescence technique were used to detect the mRNA and protein expression of CXCR 4 respectively .Invasion capability in vitro of the cells was evaluated by Boyden chamber .20 nude mice were randomly divided into experimental group and control group ( n=10 ) .The experimental group was established by injection of 100μL shRNA-EJ-M3 into the bladder , while the control group was established by injection of 100μL EJ-M3, aiming to detect the effect of shRNA-CXCR4 on intraluminal implantation of human bladder cancer cells . Results The CXCR4 mRNA expression of the pshRNA-CXCR4-1 group (62.05 ± 1.35) was significantly lower than that of blank control group (174.38 ±1.96, P <0.05 ) and negative control plasmid group (166.27 ±1.82, P <0.05).There was no significant difference among the CXCR4 mRNA expression of the pshRNA-CXCR4-2 group, blank control group and negative control plasmid group ( 182.58 ± 4.2, 174.38 ±1.96, 166.27 ±1.82, P>0.05).In immunofluores-cence experiment, the red cell amount of the pshRNA-CXCR4-1 group(32.24 ±2.23) was lower than that of the blank control group (89.61 ±4.47,P<0.05) and negative control plasmid group (92.45 ±3.68, P<0.05).There was no significant difference among the red cell amount of the pshRNA-CXCR4-2 group, the blank control group and the negative control plasmid group (76.87 ±5.11, 89.61 ±4.47, 92.45 ±3.68, P>0.05).The Boyden chamber experiment showed that the number of penetrating cells of the pshRNA -CXCR4-1 group (39.67 ±8.45) was significantly lower than that of the blank control group (135.33 ±9.28, P<0.05) and that of the negative control plasmid group(123.63 ±6.36, P<0.05).As to the intraluminal implanting capability, the difference between the ex-perimental group and the control group of statistical significance (10%vs 70%,P<0.01). Conclusion CXCR4 shRNA can inhibit the expression of CXCR4 and significantly decrease the invasion capacity and intraluminal implantation of human bladder cancer cells .