Silibinin has been widely used to treat liver diseases due to its antioxidant activity. However, the effects of silibinin on the central nervous system have not been thoroughly investigated. The pathological hallmarks of Alzheimer's disease are the accumulation of amyloid β protein, development of neurofibrillary tangles and increased oxidative stress, which ultimately lead to irreversible neuronal loss and cognitive impairment. Our findings show that silibinin ameliorated memory impairments in APP/PS1 mice in the Morris water maze via suppression of oxidative stress and inhibition of apoptosis. Treatment with silibinin reduced malondialdehyde content level and increased glutathione and superoxide dismutase activity in APP/PS1 mice. A terminal deoxynucleotidyl transferase dUTP nick end labeling assay revealed an anti-apoptotic effect of silibinin. Silibinin suppressed the activation of caspase-3 by inhibiting Jun N-terminal kinase phosphorylation and the downstream hippocampal Bax/Bcl-2 ratio. Silibinin treatment significantly increased levels of synaptophysin and PSD95 in APP/PS1 transgenic mice. These results suggest that silibinin could be a potential therapeutic agent for the treatment of Alzheimer's disease.

ObjectiveWe conducted this systematic review and meta-analysis of studies on patients who underwent unicompartmental knee arthroplasty (UKA) to compare the complication rates, revision rates and non-implant-specific complications between robotic-assisted and conventional UKA.DesignSystematic review and meta-analysis.Data sourcesThe PubMed, Embase, Web of Science and Cochrane databases were searched up to 30 June 2020.Eligibility criteriaCase–control studies comparing robotic-assisted and conventional UKA.Data extraction and synthesisData from all eligible articles were independently extracted by two authors. We analysed the differences in outcomes between robotic-assisted and conventional UKA by calculating the corresponding 95% CIs and pooled relative risks (RRs). Heterogeneity was assessed using the χ2 and I2 tests. All analyses were performed using the ‘metafor’ package of R V.3.6.2 software.ResultsA total of 16 studies involving 50 024 patients were included in the final meta-analysis. We found that robotic-assisted UKA had fewer complications (RR: 0.52, 95% CI: 0.28 to 0.96, p=0.036) and lower revision rates (RR: 0.42, 95% CI: 0.20 to 0.86, p=0.017) than conventional UKA. We observed no significant differences in non-implant-specific complications between the two surgical techniques (RR: 0.80, 95% CI: 0.61 to 1.04, p=0.96). No publication bias was found in this meta-analysis.ConclusionsThis study provides evidence that robotic-assisted UKA has fewer complications and lower revision rates than conventional UKA; however, owing to important limitations, the results lack reliability, and more studies are required.PROSPERO registration numberCRD42021246927.

Background:The thoracic surgery team of the Shanghai Chest Hospital has been publishing its annual report since 2018, summarizing the services and major progress over the last year.Methods: All patients receiving thoracic surgery services at the Department of Thoracic Surgery and the Department of Oncological Surgery at the Shanghai Chest Hospital in 2020 were enrolled. The number of surgical resections, types of surgical procedures, disease histological types, and perioperative outcomes were collected and compared with the results from previous years.Results: In the year 2020, the thoracic team of the Shanghai Chest Hospital faced the unprecedented challenge of the coronavirus disease 2019 (COVID-19) epidemic. A total of 15,664 patients received thoracic surgeries at the Shanghai Chest Hospital, only an 8.0% decrease compared with the previous year of 2019.These included 13,493 pulmonary procedures, 1,075 esophageal procedures, 969 mediastinal procedures, 66 tracheal procedures, 2 lung transplantations, and 59 other procedures. The rate of minimally invasive surgeries among all procedures was 91.1%, including 721 robotic-assisted thoracic surgeries, both of which increased from the year before. In addition, the average length of hospital stay continuously decreased, being only 3.82 days after pulmonary surgery and 10.96 days after esophageal surgery. Meanwhile, the quality of thoracic surgery has improved, with continuously lower rates of perioperative complications and an inhospital mortality rate of only 0.14%. Conclusions:The services provided and progress made in 2020 by the thoracic surgery team of the Shanghai Chest Hospital were reviewed in this annual report, reflecting a consistent effort to help our patients with high-standard services and state-of-the-art surgical techniques.

were retrospectively collected. Detailed data on surgical volume, procedures, and peri-operative outcomes, stratified by each specialty, were carefully studied and compared with the results from previous years. Progress in education and research were also reported.Results: In 2018, 58 thoracic surgeons, including 23 attending surgeons and 35 clinical fellows and residents, performed 14,054 major thoracic surgeries, including 11,958 pulmonary procedures, 866 esophageal procedures, 957 mediastinal procedures, 45 trachea procedures, and 7 lung transplantations. The total volume increased by 13.9% compared with the previous year. Among them, 88.4% were accomplished via minimally invasive approaches, including both video-assisted thoracoscopic/laparoscopic surgery and robotic surgery. There was a clear trend towards increased use of minimally invasive techniques for more complicated thoracic diseases in each specialty. More importantly, the unplanned reoperation rate, readmission to ICU rate, and 30-day mortality rate were all maintained in an extremely low level, being 0.37%, 0.82% and 0.21%, respectively. Conclusions: Tremendous effort has been engaged in improving Thoracic Surgery service at the Shanghai Chest Hospital. The year 2018 witnessed not only continuous increase in volume but also persistent high quality and safety in patient care. With these accomplishments and focus on more innovations, we will strive to deliver higher level of medical services in the future.

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