Background:This meta-analysis aimed to perform a meta-analysis to compare the efficiency and safety between femoral nerve block (FNB) and fascia iliaca block (FIB) for postoperative pain control in patients undergoing total knee and hip arthroplasties.Methods:A systematic search was performed in Medline (1966-2017.05), PubMed (1966-2017.05), Embase (1980-2017.05), ScienceDirect (1985-2017.05) and the Cochrane Library. Inclusion criteria (1) Participants: Only published articles enrolling adult participants that with a diagnosis of end-stage of osteoarthritis and prepared for unilateral TKA or THA; (2) Interventions: The intervention group received FIB for postoperative pain management; (3) Comparisons: The control group was received FNB for postoperative pain control; (4) Outcomes: Visual analogue scale (VAS) scores in different periods, opioids consumption, length of stay and postoperative complications; (5) Study design: clinical randomized control trials (RCTs) were regarded as eligible in our study. Cochrane Hand book for Systematic Reviews of Interventions was used for assessment of the included studies and risk of bias was shown. Fixed/random effect model was used according to the heterogeneity tested by I2 statistic. Sensitivity analysis was conducted and publication bias was assessed. Meta-analysis was performed using Stata 11.0 software.Results:Five RCTs including 308 patients met the inclusion criteria. The present meta-analysis indicated that there were no significant differences between groups in terms of visual analog scale (VAS) score at 12 hours (SMD = −0.080, 95% CI: −0.306 to 0.145, P = .485), 24 hours (SMD = 0.098, 95% CI: −0.127 to 0.323, P = .393), and 48 hours (SMD = −0.001, 95% CI: −0.227 to 0.225, P = .993). No significant differences were found regarding opioid consumption at 12 hours (SMD = 0.026, 95% CI: −0.224 to 0.275, P = .840), 24 hours (SMD = 0.037, 95% CI: −0.212 to 0.286, P = .771), and 48 hours (SMD = −0.016, 95% CI: −0.265 to 0.233, P = .900). In addition, no significant increase of complications was identified between groups.Conclusion:There is no significant differences of VAS scores at 12-48 hour and opioids consumption at 12-48 hour between two groups following total joint arthroplasty. No increased risk of nausea, vomiting and pruritus was observed in both groups. More high-quality large RCTs with long follow-up period are necessary for proper comparisons of the efficacy and safety of FNB with FIB. The present meta-analysis exists some limitations that should be noted: (1) Only five articles were included in present meta-analysis, although all of them are recently published RCTs, the sample size are relatively small; (2) Functional outcome is an important parameter, due to the insufficiency of relevant data, we cannot perform a meta-analysis. (3) Dose and types of local anesthetics are varied, which may influence the results; (4) The duration of follow up is relatively short which leads to underestimating complications. (5) Publication bias in present meta-analysis ...

Polysaccharides are important pharmacologically active substances found in the perennial orchid Dendrobium huoshanense. In the present study, we sought to determine whether antioxidant and anti-inflammatory mechanisms were involved in Dendrobium huoshanense polysaccharides (DHPs)-mediated protection from D-galactose-induced intestine injury in an aging rat model. The effects of DHPs on ileal antioxidant capacity, mucosal barrier integrity and the inflammatory response were investigated in D-galactose-treated rats. The results showed that DHP administration largely attenuated the D-galactose-induced malondialdehyde (MDA), interleukin (IL)-6, tumor necrosis factor (TNF)-a, IL-4, IL-10, Toll-like receptor four and NF-jBp65 content increases and also markedly renewed the total antioxidant capacity and the claudin and occludin contents of ileal tissues from the D-galactose-treated rats. We also found that DHP more markedly affected the IL-6 and TNF-a levels than it did the IL-4 and IL-10 levels in the ileal tissues from the D-galactose-treated rats. These results suggest that DHPs can protect the rat ileum from D-galactose-induced injury by attenuating lipid peroxidation, improving antioxidant capacity and mucosal barrier integrity, correcting imbalanced inflammatory cytokine networks and suppressing the inflammatory response. The novel insights into the mechanism involved in DHPs protection of ileal health in our D-galactose-induced aging model rat advances current understanding of the aging process.