Ultrasound-guided fascia iliaca compartment block versus intravenous analgesia in geriatric hip fractures: a systematic review and meta-analysis of randomized trials demonstrating superior pain control

BackgroundSevere pain in elderly hip fracture patients exacerbates perioperative risks. This meta-analysis compares ultrasound-guided fascia iliaca compartment block (UG-FICB) with intravenous analgesia for pain management.MethodsA comprehensive search of randomized controlled trials (RCTs) published through February 2025 was conducted across major databases, including English-language databases and Chinese databases. Outcomes analyzed via RevMan 5.3 using random/fixed-effect models. Primary outcomes encompassed Visual Analog Scale (VAS) scores, analgesic consumption, patient satisfaction, main adverse reactions, and gastrointestinal adverse events. Secondary outcomes included intraoperative blood loss, operative time, length of stay, and respiratory adverse events.ResultsA total 26 RCTs (n = 2,347), UG-FICB significantly not only reduced Visual Analog Scale (VAS) scores at all timepoints: 0.5 h (p = 0.02), 2 h (p = 0.001), 4 h (p = 0.002), 6 h (p < 0.00001), 12 h (p = 0.0002), 24 h (p < 0.00001), and 48 h postoperatively (p = 0.003), but also reduced postoperative analgesic consumption (OR = 5.27, p < 0.00001). Patients receiving UG-FICB exhibited fewer drug-related adverse events, including dizziness (OR = 2.34), hypersomnia (OR = 3.58), and gastrointestinal complications (nausea OR = 2.57; constipation OR = 4.82; p < 0.05). UG-FICB also shortened length of stay (MD = 1.88 days, p < 0.00001) and enhanced satisfaction (OR = 0.26, p = 0.0002).ConclusionCompared to intravenous analgesia, UG-FICB provides superior, sustained pain relief with fewer opioid-related complications and higher patient satisfaction. UG-FICB’s safety and efficacy advantages strongly support its adoption as first-line therapy in geriatric hip fractures protocols

Efficacy, acceptability and side-effects of oral versus long-acting- injectables antipsychotics:Systematic review and network meta-analysis

Long-acting injectable antipsychotics (LAIs) are primarily used for relapse prevention, but in some settings and situations, they may also be useful for acute treatment of schizophrenia. We conducted a systematic review and frequentist network meta-analysis of randomized-controlled trials (RCTs), focusing on adult patients in the acute phase of schizophrenia. Interventions were risperidone, paliperidone, aripiprazole, olanzapine, and placebo, administered either orally or as LAI. We synthesized data on overall symptoms, complemented by 17 other efficacy and tolerability outcomes. Confidence in the evidence was assessed with the Confidence-in-Network-Meta-Analysis-framework (CINeMA). We included 115 RCTs with 25,550 participants. All drugs were significantly more efficacious than placebo with the following standardized mean differences and their 95 % confidence intervals: olanzapine LAI -0.66 [-1.00; -0.33], risperidone LAI -0.59[-0.73;-0.46], olanzapine oral -0.55[-0.62;-0.48], aripiprazole LAI -0.54[-0.71; -0.37], risperidone oral -0.48[-0.55;-0.41], paliperidone oral -0.47[-0.58;-0.37], paliperidone LAI -0.45[-0.57;-0.33], aripiprazole oral -0.40[-0.50; -0.31]. There were no significant efficacy differences between LAIs and oral formulations. Sensitivity analyses of the primary outcome overall symptoms largely confirmed these findings. Moreover, some side effects were less frequent under LAIs than under their oral counterparts. Confidence in the evidence was moderate for most comparisons. LAIs are efficacious for acute schizophrenia and may have some benefits compared to oral formulations in terms of side effects. These findings assist clinicians with insights to weigh the risks and benefits between oral and injectable agents when treating patients in the acute phase.</p

Human BCR/ABL1 induces chronic myeloid leukemia-like disease in zebrafish

Chronic myeloid leukemia (CML) is induced by the BCR/ABL1 oncogene, which encodes a protein tyrosine kinase. We examined the effect of direct overexpression of the human p210BCR/ABL1 oncoprotein in zebrafish. Humanized p210BCR/ABL1 protein was detectable in Tg(hsp70: p210BCR/ABL1) transgenic zebrafish embryos and adult kidney marrow. Transgenic zebrafish developed CML, which could be induced via cells transplanted into recipients. The expression of human BCR/ABL1 promoted myeloid lineages in Tg(hsp70:p210BCR/ABL1) transgenic embryos. A total of 77 of 101 (76.24%) Tg(hsp70:p210BCR/ABL1) adult transgenic zebrafish (age 6 months-1 year) developed CML. CML in zebrafish showed a triphasic phenotype, similar to that in humans, involving a chronic phase predominantly characterized by neutrophils in various degrees of maturation, an accelerated phase with an increase in blasts and immature myeloid elements, and a blast phase with >90% blasts in both the peripheral blood and kidney marrow. Tyrosine kinase inhibitors, as the standard drug treatment for human CML, effectively reduced the expanded myeloid population in Tg(hsp70:p210BCR/ABL1) transgenic embryos. Moreover, we screened a library of 171 compounds and identified ten new drugs against BCR/ABL1 kinase-dependent or -independent pathways that could also reduce lcp1+ myeloid cell numbers in Tg(hsp70:p210BCR/ABL1) transgenic embryos. In summary, we generated the first humanized zebrafish CML model that recapitulates many characteristics of human CML. This novel in vivo model will help to elucidate the mechanisms of CML disease progression and allow high-throughput drug screening of possible treatments for this disease

Antimony pollution threatens soils and riverine habitats across China: An analysis of antimony concentrations, changes, and risks

The adverse effects of antimony (Sb) pollution on ecosystems and human health caused by its use, enrichment, and bioaccumulation have become global environmental problems, particularly in China. Based on a scientometric analysis of the research topics and evolution of Sb pollution, 210 peer-reviewed articles across 264 locations in China were selected to analyze Sb concentrations, changes, and risks in different environments (i.e., soil, sediment, and water). Substantially elevated concentrations were reported in the chosen environments throughout the studied literature, with approximately 36.6%, 41.3% and 20.8% of the soil, water and sediment sampling sites, respectively, exceeding the national and international guidelines. Although Sb concentrations were stable in water and sediment, those in soil slightly increased slightly over the past two decades. The majority of studies and the highest Sb concentrations were typically concentrated in Hunan, Guangxi, and Guizhou, where most Sb deposits and intensive mining and smelting activities are concentrated. A temporal analysis over three crucial periods of the Sb industry further indicated that Sb concentrations and pollution had increased in several provinces in recent years. The estimated risk quotient, using Monte Carlo simulations, indicated that species were markedly affected by Sb contamination, with 21.6% of events occurring in the high-risk category. The ingestion of contaminated soils posed the highest potential health risk to the population, with 47.9% of the events indicated to represent at least a low risk. Risks of water ingestion were estimated to exist in 4.9% of the simulated exposure events. More environmental campaigns for Sb pollution control are urgently needed, especially in Sb hotspots, to reduce environmental pressure and avoid direct and indirect hazards to organisms and populations

Integrative genetic and multi-omics analysis reveals the interleukin-6 receptor’s role in recurrent spontaneous abortion

BackgroundRecurrent spontaneous abortion (RSA) significantly impacts women’s health, yet the underlying biological mechanisms remain poorly defined. Understanding the molecular contributors to RSA is crucial for developing targeted interventions.ObjectiveThis study aims to investigate the causal relationships between plasma proteins and RSA, focusing on the identification of potential therapeutic targets through multi-omic approaches.MethodsWe utilized two-sample Mendelian randomization (MR) analyses integrating genome-wide association study (GWAS) data for both plasma proteins and RSA. Proteomic data were sourced from the UK Biobank-Plasma Proteome Project and deCODE Health Study. We further validated our findings through both bulk and single-cell RNA sequencing of clinical specimens, alongside quantitative real-time polymerase chain reaction and immunohistochemistry. A phenome-wide association study was also conducted to assess the safety and broader implications of identified targets.ResultsOur analyses identified the interleukin 6 receptor (IL6R) as a key candidate, with elevated plasma levels correlating with increased RSA risk. Furthermore, IL6R was found to be upregulated in RSA-related endometrial and decidual tissues. The phenome-wide association study provided insights into potential side effects and additional therapeutic indications for IL6R.ConclusionIL6R upregulation is mechanistically implicated in the pathogenesis of RSA, establishing it as a validated causal biomarker and a potentially actionable therapeutic target. This study not only highlights the role of IL6R in RSA but also supports its development into a therapeutic strategy with a comprehensive safety profile

Efficacy and safety of ciprofol for sedation in outpatient gynecological procedures: a phase III multicenter randomized trial

ObjectiveCiprofol (also known as cipepofol and HSK3486), is a compound similar to propofol in chemical structure and hypnotic effect. Herein we evaluated the efficacy and safety of ciprofol for sedation in outpatient gynecological procedures.MethodsThis phase III multicenter randomized trial with a non-inferiority design was conducted in nine tertiary hospitals. We enrolled 135 women aged 18–65 years who were scheduled for ambulatory gynecological procedures. Patients were randomly assigned to receive either ciprofol (0.4 mg/kg for induction and 0.2 mg/kg for maintenance) or propofol (2.0 mg/kg for induction and 1.0 mg/kg for maintenance) sedation in a 2:1 ratio. Patients and investigators for data collection and outcome assessment were blinded to study group assignments. The primary outcome was the success rate of sedation, defined as completion of procedure without remedial anesthetics. The non-inferiority margin was set at −8%. Secondary outcomes included time to successful induction, time to full awake, time to meet discharge criteria, and satisfaction with sedation assessed by patients and doctors. We also monitored occurrence of adverse events and injection pain.ResultsA total of 135 patients were enrolled; 134 patients (90 patients received ciprofol sedation and 44 patients propofol sedation) were included in final intention-to-treat analysis. The success rates were both 100% in the two groups (rate difference, 0.0%; 95% CI, −4.1 to 8.0%), i.e., ciprofol was non-inferior to propofol. When compared with propofol sedation, patients given ciprofol required more time to reach successful induction (median difference [MD], 2 s; 95% CI, 1 to 7; p &lt; 0.001), and required more time to reach full awake (MD, 2.3 min; 95% CI, 1.4 to 3.1; p &lt; 0.001) and discharge criteria (MD, 2.3 min; 95% CI, 1.5 to 3.2; p &lt; 0.001). Fewer patients in the ciprofol group were dissatisfied with sedation (relative risk, 0.21; 95% CI, 0.06 to 0.77; p = 0.024). Patients given ciprofol sedation had lower incidences of treat-emergent adverse events (34.4% [31/90] vs. 79.5% [35/44]; p &lt; 0.001) and injection pain (6.7% [6/90] vs. 61.4% [27/44]; p &lt; 0.001).ConclusionCiprofol for sedation in ambulatory gynecological procedures was non-inferior to propofol, with less adverse events and injection pain.Clinical trial registrationClinicalTrials.gov, identifier NCT04958746

Organic ligand-induced dissolution kinetics of antimony trioxide

The influence of low-molecular-weight dissolved organic matter (LMWDOM) on the dissolution rate of Sb2O3 was investigated. Some representative LMWDOMs with carboxyl, hydroxyl, hydrosulfuryl and amidogen groups occurring naturally in the solution were chosen, namely oxalic acid, citric acid, tartaric acid, EDTA, salicylic acid, phthalandione, glycine, thiolactic acid, xylitol, glucose and catechol. These LMWDOMs were dissolved in inert buffers at pH = 3.7, 6.6 and 8.6 and added to powdered Sb2O3 in a stirred, thermostatted reactor (25 degrees C). The addition of EDTA, tartaric acid, thiolactic acid, citric acid and oxalic acid solutions at pH 3.7 and catechol at pH 8.6 increased the rate of release of antimony. In the 10 mmol/L thiolactic acid solution, up to 97% by mass of the antimony was released after 120 min reaction. There was no effect on the dissolution of Sb2O3 for the other ligands. A weak correlation between dissolution rate with the dissociation constant of ligands and the stability of the dissolved complex was also found. All the results showed that the extent of the promoting effect of ligands on the dissolution of Sb2O3 was not determined by the stability of the dissolved complex, but by the dissociation constant of ligands and detachment rate of surface chelates from the mineral surface. This study can not only help in further understanding the effect of individual low-molecular-weight organic ligands, but also provides a reference to deduce the effect of natural organic matters with oxygen-bearing functional groups on the dissolution of antimony oxide minerals. (C) 2016 The Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences. Published by Elsevier B.V

Removal of Sb(III) and Sb(V) from aqueous media by goethite

This study investigated the removal of Sb(III) and Sb(V) from aqueous media through their adsorption onto oxide minerals (goethite) under a set of conditions (initial Sb concentration, pH, reaction time, and interaction temperature). The kinetic studies suggested that the adsorption equilibriums for both Sb(III) and Sb(V) were achieved within 24 h. The adsorption data collected at three different temperatures were successfully modeled using both the Langmuir and Freundlich isotherms. The adsorption of Sb(III) onto goethite was greater than that of Sb(V) at the three investigated temperatures. The thermodynamic parameters (ΔG°, ΔH°, and ΔS°) were calculated from the dependence of the adsorption process on the reaction temperature, and the calculated parameters suggest that the adsorption of both Sb(III) and Sb(V) onto goethite is spontaneously endothermic. The adsorption of Sb(III) and Sb(V) on goethite was dependent on pH within the investigated pH range.</jats:p