BackgroundQuite a few randomized controlled trials (RCTs) investigating the efficacy of platelet-rich plasma (PRP) for treatment of knee osteoarthritis (OA) have been recently published. Therefore, an updated systematic review was performed to evaluate the temporal effect of PRP on knee pain and physical function.MethodsPubmed, Embase, Cochrane library, and Scopus were searched for human RCTs comparing the efficacy and/or safety of PRP infiltration with other intra-articular injections. A descriptive summary and quality assessment were performed for all the studies finally included for analysis. For studies reporting outcomes concerning Western Ontario and McMaster Universities Arthritis Index (WOMAC) or adverse events, a random-effects model was used for data synthesis.ResultsFourteen RCTs comprising 1423 participants were included. The control included saline placebo, HA, ozone, and corticosteroids. The follow-up ranged from 12 weeks to 12 months. Risk of bias assessment showed that 4 studies were considered as moderate risk of bias and 10 as high risk of bias. Compared with control, PRP injections significantly reduced WOMAC pain subscores at 3, 6, and 12 months follow-up (p = 0.02, 0.004, <0.001, respectively); PRP significantly improved WOMAC physical function subscores at 3, 6, and 12 months (p = 0.002, 0.01, <0.001, respectively); PRP also significantly improved total WOMAC scores at 3, 6 and 12 months (all p < 0.001); nonetheless, PRP did not significantly increased the risk of post-injection adverse events (RR, 1.40 [95% CI, 0.80 to 2.45], I 2 = 59%, p = 0.24).ConclusionsIntra-articular PRP injections probably are more efficacious in the treatment of knee OA in terms of pain relief and self-reported function improvement at 3, 6 and 12 months follow-up, compared with other injections, including saline placebo, HA, ozone, and corticosteroids.Review registrationPROSPERO CRD42016045410. Registered 8 August 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13018-017-0521-3) contains supplementary material, which is available to authorized users.
Background: Local ischemia is the main pathological performance in osteonecrosis of the femoral head (ONFH). There is currently no effective therapy to promote angiogenesis in the femoral head. Recent studies revealed that exosomes secreted by induced pluripotent stem cell-derived mesenchymal stem cells (iPS-MSC-Exos) have great therapeutic potential in ischemic tissues, but whether they could promote angiogenesis in ONFH has not been reported, and little is known regarding the underlying mechanism.Methods: iPS-MSC-Exos were intravenously injected to a steroid-induced rat osteonecrosis model. Samples of the femoral head were obtained 3 weeks after all the injections. The effects were assessed by measuring local angiogenesis and bone loss through histological and immunohistochemical (IHC) staining, micro-CT and three-dimensional microangiography. The effects of exosomes on endothelial cells were studied through evaluations of proliferation, migration and tube-forming analyses. The expression levels of angiogenic related PI3K/Akt signaling pathway of endothelial cells were evaluated following stimulation of iPS-MSC-Exos. The promoting effects of exosomes were re-evaluated following blockade of PI3K/Akt.Results: The in vivo study revealed that administration of iPS-MSC-Exos significantly prevented bone loss, and increased microvessel density in the femoral head compared with control group. We found that iPS-MSC-Exos significantly enhanced the proliferation, migration and tube-forming capacities of endothelial cells in vitro. iPS-MSC-Exos could activate PI3K/Akt signaling pathway in endothelial cells. Moreover, the promoting effects of iPS-MSC-Exos were abolished after blockade of PI3K/Akt on endothelial cells.Conclusions: Our findings suggest that transplantation of iPS-MSC-Exos exerts a preventative effect on ONFH by promoting local angiogenesis and preventing bone loss. The promoting effect might be attributed to activation of the PI3K/Akt signaling pathway on endothelial cells. The data provide the first evidence for the potential of iPS-MSC-Exos in treating ONFH.
Factors affectin g im mediate serial recall of individu al ite ms can be classi® ed according to whether they in¯uence the degradation of the representation , or in¯uence the ability to redintegrate a degraded representation . For recall of entire lists, factors can be cla ssi® ed according to whether or not they in¯uence the rate at which ite ms are recalled. We review experiments in order to classify the factors of serial positio n, word length, word frequency, and lex icality. We propose that the two classi® cation systems coincid e, at least for those factors whose classi® cation is know n for both schemes. We end by considering whether probability of recall of an entire list might be predicted from probability of recall of individu al ite ms.Les facteurs qui affecten t le rappel se riel imme diat d' ite ms peuvent eà tre classi® e s selon qu' ils in¯uencent la de gradation des repre sentations ou selon qu' ils in¯uencent la reconstruction d' une repre sentatio n de grade e. Pour le rappel de listes entie Á res, ces facteurs peuvent eà tre classi® e s selon qu' ils in¯uencent ou non le taux de rappel des ite ms. U n certain nom bre d' expe riences sont examine es dans le but de classi® er les facteurs de position se rielle, longueu r du mot, fre quence et lexicalite . Il est propose que les deux syste Á mes de classi® cation concorde nt, du moins pour les facteurs dont la classi® cation est connue pour les deux syste Á mes. Nous terminons en conside rant la possibilite que la probabilite de rappel pour une liste entie Á re puisse eà tre pre dite par la probabilite de rappeler chaque ite m se pare ment.IN TERNAT IO NAL JOU RNA L OF PSYCH OLOGY, 1999 , 34 (5/6), 447± 453Request s for reprints should be addresse d to Richard Schweickert,
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