BackgroundCurrently, many studies have been published on the relationship between the gut microbiome and knee osteoarthritis. However, the evidence for the association of gut microbiota with knee osteoarthritis has not been comprehensively evaluated.ObjectiveThis review aimed to assess existing results and provide scientific evidence for the association of low-grade inflammation caused by gut microbiota disturbances with knee osteoarthritis.MethodsThis study conducted an extensive review of the current literature using four databases, PubMed, EMBASE, Cochrane Library and Web of Science before 31 December 2021. Risk of bias was determined using ROBINS and SYRCLE, and quality of evidence was assessed using GRADE and CAMADARES criteria. Twelve articles were included.ResultsStudies have shown that a high-fat diet leads to a disturbance of the gut microbiota, mainly manifested by an increase in the abundance of Firmicutes and Proteobacteria, a decrease in Bacteroidetes, and an increase in the Firmicutes/ Bacteroidetes ratio. Exercise can reverse the pattern of gain or loss caused by high fat. These changes are associated with elevated levels of serum lipopolysaccharide (LPS) and its binding proteins, as well as various inflammatory factors, leading to osteoarthritis (OA).ConclusionThis systematic review shows that a correlation between low-grade inflammation caused by gut microbiota disturbances and severity of knee osteoarthritis radiology and dysfunction. However, there was a very small number of studies that could be included in the review. Thus, further studies with large sample sizes are warranted to elucidate the association of low-grade inflammation caused by gut microbiota disturbances with osteoarthritis, and to explore the possible mechanisms for ameliorating osteoarthritis by modulating gut microbiota.

Studies have found that magnetic stimulation (MS) can induce the plasticity of the spinal cord and promote axon regeneration, resulting in improving motor dysfunction after SCI. However, In the clinical application of repetitive trans-spinal magnetic stimulation (rTSMS), there is no uniform standard for the formulation of treatment parameters, the most important of which is the treatment frequency. This progress has been compared in six groups of animals. After rTSMS, the BBB score and the inclined plate test score of SCI rats increased significantly. Besides, the frequency of 1 Hz significantly increased spinal cord function in the acute and subacute phases after SCI, and the frequency of 15 Hz increased spinal function in the intermediate and chronic phases after SCI. Western blot analysis showed that the expression of GAP-43 in the 15 Hz magnetic stimulation (MS) group increased significantly. Also, rTSMS induced the expression of GAP-43 which may promote axon growth and guided the formation of new nerve connections.This study showed that rTSMS improves spinal cord function in SCI rats. Furthermore, 1 Hz stimulus is more conducive to the recovery of motor function in the acute and subacute phases after SCI, and the frequency of 15 Hz is more conducive to the recovery of motor function in the intermediate and chronic phases after SCI. Besides, rTSMS increases the expression of GAP-43 in the injured spinal cord.

Spinal cord injury (SCI) leads to the permanent loss or reduction of the function of movement and sensation, and no effective clinical treatment has been reported. Animal studies have shown that intermittent fasting (IF) has a neuroprotective effect on SCI, but it has not been used in clinical treatment of SCI. Intermittent fasting from dawn to sunset is a form of fasting during human activity, which may improve the dysfunction of patients with SCI. Therefore, this study is the first to explore the safety of intermittent fasting from dawn to sunset in the treatment of SCI. Twenty-six SCI participants were randomly divided into a control group or an IF group. The IF group was fasted for more than 14 hours a day, and the control group had normal diet and water. Changes in blood routine, liver function, renal function, electrolytes, plasma glucose, weight, body mass index (BMI), American Spinal Injury Association (ASIA) score and occurrence of adverse events were monitored before enrollment and at the end of IF intervention. The IF group developed hypoglycemia, hunger, weight loss, and intestinal dysfunction (nausea, abdominal discomfort, diarrhea). There were no significant differences in blood routine, liver function, renal function, electrolytes and ASIA scores before and after IF intervention, or compared with the control group. Compared with the control group, there was no difference in body weight and BMI before IF intervention, and weight loss after IF intervention, but there was no significant change in BMI. Moreover, there were significant differences in body weight and BMI before and after IF intervention. The plasma glucose of the IF group began to decrease from the 14th day, and there were significant differences in plasma glucose before and after IF intervention. These findings suggested that IF was safe and feasible for SCI participants.