With the rapid advancement of technology,artificial intelligence(AI)has emerged as a transformative force in gastroenterology,particularly in diagnosing upper gastrointestinal diseases such as Barrett's esophagus(...With the rapid advancement of technology,artificial intelligence(AI)has emerged as a transformative force in gastroenterology,particularly in diagnosing upper gastrointestinal diseases such as Barrett's esophagus(BE),esophageal cancer,gastroesophageal reflux disease(GERD),and esophagogastric varices.AI's capabilities in image analysis,classification,detection,and segmentation have significantly improved diagnostic accuracy and efficiency.For BE,AI models achieve high sensitivity and specificity in detecting early neoplastic changes and guiding targeted biopsies.In esophageal cancer,AI enhances early lesion detection,improving intervention success rates.For GERD,AI classifies disease severity based on the Los Angeles grading system and accurately segments lesions.Additionally,AI detects esophagogastric varices and predicts bleeding risks more effectively than traditional methods.Despite these advancements,challenges remain,including the need for high-quality data,multi-center validation,and ensuring AI model interpretability.Future research should address these issues and further integrate AI into clinical practice to optimize patient outcomes.This review highlights AI's transformative impact on upper gastrointestinal disease diagnosis,emphasizing its potential to revolutionize endoscopic practice and improve patient care.展开更多
In this study,a pair of dicarboxylic acids as cis-trans isomerism—citraconic acid(CA)and mesaconic acid(MA),was incorporated into polymeric networks of poly(N-isopropylacrylamide)(PNIPAM)-based core-shell microgels v...In this study,a pair of dicarboxylic acids as cis-trans isomerism—citraconic acid(CA)and mesaconic acid(MA),was incorporated into polymeric networks of poly(N-isopropylacrylamide)(PNIPAM)-based core-shell microgels via semi-batch precipitation polymerization.We demonstrated that the pH-temperature dual responsiveness of the core-shell microgels is highly correlated with the structure and position of the acid isomers.Both the cis-trans molecular structure and the crosslinking position of the dicarboxylic acids significantly influenced the hydration capacity and surface charge density of the core-shell microgels.These diverse properties first influenced the swelling behavior,further affecting the interfacial behavior of the microgels,including the oil-water dynamic interfacial tension and air-water compression isotherms.Furthermore,the rheological behavior of the microgel suspensions also displayed distinct dependences on the frequency and temperature,illustrating that the cis-trans molecular structure and crosslinked position of the dicarboxylic acids also significantly influenced the interparticle clustering in the bulk solution.Our results suggest that the pH sensitivity of the cis-trans dicarboxylic acid isomer affects the ionization and surface charge distribution of the core or shell layers of individual microgels,which further determines the interparticle interaction and cooperative rearrangement at interfaces and in the bulk.展开更多
Schwann cell proliferation,migration and remyelination of regenerating axons contribute to regeneration after peripheral nervous system injury.Lithium promotes remyelination by Schwann cells and improves peripheral ne...Schwann cell proliferation,migration and remyelination of regenerating axons contribute to regeneration after peripheral nervous system injury.Lithium promotes remyelination by Schwann cells and improves peripheral nerve regeneration.However,whether lithium modulates other phenotypes of Schwann cells,especially their proliferation and migration remains elusive.In the current study,primary Schwann cells from rat sciatic nerve stumps were cultured and exposed to 0,5,10,15,or 30 mM lithium chloride(LiCl)for 24 hours.The effects of LiCl on Schwann cell proliferation and migration were examined using the Cell Counting Kit-8,5-ethynyl-2′-deoxyuridine,Transwell and wound healing assays.Cell Counting Kit-8 and 5-ethynyl-2′-deoxyuridine assays showed that 5,10,15,and 30 mM LiCl significantly increased the viability and proliferation rate of Schwann cells.Transwell-based migration assays and wound healing assays showed that 10,15,and 30 mM LiCl suppressed the migratory ability of Schwann cells.Furthermore,the effects of LiCl on the proliferation and migration phenotypes of Schwann cells were mostly dose-dependent.These data indicate that lithium treatment significantly promotes the proliferation and inhibits the migratory ability of Schwann cells.This conclusion will inform strategies to promote the repair and regeneration of peripheral nerves.All of the animal experiments in this study were ethically approved by the Administration Committee of Experimental Animal Center of Nantong University,China(approval No.20170320-017)on March 2,2017.展开更多
In this editorial,we review the work of Razali et al published in World J Gas-troenterology,with a particular focus on the effect of rs10889677 variation in the phosphatidylinositol 3-kinase(PI3K)pathway and buparlisi...In this editorial,we review the work of Razali et al published in World J Gas-troenterology,with a particular focus on the effect of rs10889677 variation in the phosphatidylinositol 3-kinase(PI3K)pathway and buparlisib on colitis-associated cancer.The role of PI3K in promoting cancer progression has been widely recognized,as it is involved in regulating the survival,differentiation,and prolif-eration of cancer cells.The complement Clq/TNF-related protein 6(CTRP6)is a newer tumor-associated factor.Recent studies have revealed the pro-tumor effect of CTRP6 in gastric cancer,hepatocellular carcinoma,colorectal cancer,and other gastrointestinal tumors through the PI3K pathway.This article attempts to reveal the mechanism through which the CTRP6 affects the development of digestive system tumors through the PI3K pathway by summarizing recent research.展开更多
BACKGROUND Bioresorbable scaffolds(BRS)are a promising alternative to traditional drugeluting stents(DES)for the treatment of acute coronary syndrome(ACS).They offer the potential for complete resorption,which may red...BACKGROUND Bioresorbable scaffolds(BRS)are a promising alternative to traditional drugeluting stents(DES)for the treatment of acute coronary syndrome(ACS).They offer the potential for complete resorption,which may reduce long-term complications such as stent thrombosis and late restenosis.However,the safety,compatibility,and long-term outcomes of BRS in patients with intermediate to low-risk ACS have yet to be thoroughly investigated.AIM To investigate the safety,compatibility,and long-term outcomes of BRS in patients with intermediate to low-risk ACS.METHODS Patients with intermediate to low-risk ACS who underwent percutaneous coronary intervention with either DES or BRS,and were continuously recruited from January 2019 to June 2022 at a single center,were analyzed.Baseline data and clinical follow-up were collected for patients who underwent DES implantation(control group)and BRS implantation(observation group),and the survival outcomes and complications during a maximum follow-up period of 3 years were compared.The primary clinical endpoint was device-oriented composite endpoint(DoCE),representing the occurrence of one of the following events:Cardiac death,stent thrombosis,target vessel myocardial infarction,and clinically driven target lesion revascularization.Secondary endpoints included coronary artery bypass grafting,target vessel revascularization,and non-cardiac death.RESULTS A total of 128 patients were included in this study,with an average age of 63 years.Among them,95 were male(74%).The study involved treatment of 201 blood vessels:87(43%)received BRS,and 114(57%)received DES.A total of 97 patients completed the full 3-year follow-up.During this period,5 patients(17%)in the observation group and 7 patients(16%)in the control group experienced a major cardiovascular event(DoCE).At the 1-year follow-up,7 patients(15%)in the observation group and 6 patients(10%)in the control group experienced DoCE,and this difference was statistically significant(P<0.05).At the 2-year follow-up,there was also a significant difference between the two groups in the number of patients who needed repeat treatment of the target blood vessel(P<0.05).In the observation group,18 patients(33%)underwent follow-up coronary angiography.During the follow-up period,one patient in the observation group was found to have re-narrowing in the proximal and middle segments of the left anterior descending artery,possibly due to BRS collapse.Another patient in the observation group developed chronic total occlusion in multiple vessels at the 3-year follow-up and underwent coronary artery bypass grafting.CONCLUSION In low-to intermediate-risk ACS patients,those who got BRS had their first major heart event sooner than those who got DES.BRS is more tissue-friendly,yet over three years both groups had about the same amount of problems-only a few BRS patients still saw the scaffold collapse or the vessel slowly block.展开更多
Background: Delayed gastric emptying(DGE) is one of the most common complications after pancreaticoduodenectomy(PD). DGE represents impaired gastric motility without significant mechanical obstruction and is associate...Background: Delayed gastric emptying(DGE) is one of the most common complications after pancreaticoduodenectomy(PD). DGE represents impaired gastric motility without significant mechanical obstruction and is associated with an increased length of hospital stay, increased healthcare costs, and a high readmission rate. We reviewed published studies on various technical modifications to reduce the incidence of DGE. Data sources: Studies were identified by searching Pub Med for relevant articles published up to December 2022. The following search terms were used: “pancreaticoduodenectomy”, “pancreaticojejunostomy”, “pancreaticogastrostomy”, “gastric emptying”, “gastroparesis” and “postoperative complications”. The search was limited to English publications. Additional articles were identified by a manual search of references from key articles. Results: In recent years, various surgical procedures and techniques have been explored to reduce the incidence of DGE. Pyloric resection, Billroth II reconstruction, Braun's enteroenterostomy, and antecolic reconstruction may be associated with a decreased incidence of DGE, but more high-powered studies are needed in the future. Neither laparoscopic nor robotic surgery has demonstrated superiority in preventing DGE, and the use of staplers is controversial regarding whether they can reduce the incidence of DGE. Conclusions: Despite many innovations in surgical techniques, there is no surgical procedure that is superior to others to reduce DGE. Further larger prospective randomized studies are needed.展开更多
This editorial reviews the molecular mechanisms underlying the roles of the long non-coding RNA(lncRNA)small nucleolar RNA host gene 16(SNHG16)in digestive system cancers based on two recent studies on lncRNAs in dige...This editorial reviews the molecular mechanisms underlying the roles of the long non-coding RNA(lncRNA)small nucleolar RNA host gene 16(SNHG16)in digestive system cancers based on two recent studies on lncRNAs in digestive system tumors.The first study,by Zhao et al,explored how hBD-1 affects colon cancer,via the lncRNA TCONS_00014506,by inhibiting mTOR and promoting autophagy.The second one,by Li et al,identified the lncRNA prion protein testis specific(PRNT)as a factor in oxaliplatin resistance by sponging ZNF184 to regulate HIPK2 and influence colorectal cancer progression and chemoresistance,suggesting PRNT as a potential therapeutic target for colorectal cancer.Both of these two articles discuss the mechanisms by which lncRNAs contribute to the development and progression of digestive system cancers.As a recent research hotspot,SNHG16 is a typical lncRNA that has been extensively studied for its association with digestive system cancers.The prevailing hypothesis is that SNHG16 participates in the development and progression of digestive system tumors by acting as a competing endogenous RNA,interacting with other proteins,regulating various genes,and affecting downstream target molecules.This review systematically examines the recently reported biological functions,related molecular mechanisms,and potential clinical significance of SNHG16 in various digestive system cancers,and explores the relationship between SNHG16 and digestive system cancers.The findings suggest that SNHG16 may serve as a potential biomarker and therapeutic target for human digestive system cancers.展开更多
Nonmonotone gradient methods generally perform better than their monotone counterparts especially on unconstrained quadratic optimization.However,the known convergence rate of the monotone method is often much better ...Nonmonotone gradient methods generally perform better than their monotone counterparts especially on unconstrained quadratic optimization.However,the known convergence rate of the monotone method is often much better than its nonmonotone variant.With the aim of shrinking the gap between theory and practice of nonmonotone gradient methods,we introduce a property for convergence analysis of a large collection of gradient methods.We prove that any gradient method using stepsizes satisfying the property will converge R-linearly at a rate of 1-λ_(1)/M_(1),whereλ_(1)is the smallest eigenvalue of Hessian matrix and M_(1)is the upper bound of the inverse stepsize.Our results indicate that the existing convergence rates of many nonmonotone methods can be improved to 1-1/κwithκbeing the associated condition number.展开更多
Background： Mineral and bone disorder is one of the severe complications in kidney transplant recipients （KTRs）. Previous studies showed that bisphosphonates had favorable effects on bone mineral density （BMD）. W...Background： Mineral and bone disorder is one of the severe complications in kidney transplant recipients （KTRs）. Previous studies showed that bisphosphonates had favorable effects on bone mineral density （BMD）. We sought to compare different bisphosphonate regimens and rank their strategies. Methods： We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials （CENTRAL） up to April 01, 2017,for randomized controlled trials （RCTs） comparing bisphosphonate treatments in adult KTRs. The primary outcome was BMD change. We executed the tool recommended by the Cochrane Collaboration to evaluate the risk of bias. We performed pairwise meta-analyses using random effects models and network meta-analysis （NMA） using Bayesian models and assessed the quality of evidence. Results： A total of 21 RCTs （1332 participants） comparing 6 bisphosphonate regimens were included. All bisphosphonates showed a significantly increased percentage change in BMD at the lumbar spine compared to calcium except clodronate. Pamidronate with calcium and Vitamin D analogs showed improved BMD in comparison to clodronate with calcium （mean difference [MD], 9.84; 95% credibility interval [CrI], 1.06-19.70）. The combination of calcium and Vitamin D analogs had a significantly lower influence than adding either pamidronate or alendronate （MD, 6.34; 95% CrI, 2.59-11.01 and MD, 6.16; 95% CrI, 0.54-13.24, respectively）. In temas of percentage BMD change at the femoral neck, both pamidronate and ibandronate combined with calcium demonstrated a remarkable gain compared with calcium （MD, 7.02; 95% CrI, 0.30-13.29 and MD, 7.30; 95% CrI, 0.32-14.22, respectively）. The combination of ibandronate with calcium displayed a significant increase in absolute BMD compared to any other treatments and was ranked best. Conclusions： Our NMA suggested that new-generation bisphosphonates such as ibandronate were more favorable in KTRs to improve BMD. However, the conclusion should be treated with caution due to indirect comparisons.展开更多
文摘With the rapid advancement of technology,artificial intelligence(AI)has emerged as a transformative force in gastroenterology,particularly in diagnosing upper gastrointestinal diseases such as Barrett's esophagus(BE),esophageal cancer,gastroesophageal reflux disease(GERD),and esophagogastric varices.AI's capabilities in image analysis,classification,detection,and segmentation have significantly improved diagnostic accuracy and efficiency.For BE,AI models achieve high sensitivity and specificity in detecting early neoplastic changes and guiding targeted biopsies.In esophageal cancer,AI enhances early lesion detection,improving intervention success rates.For GERD,AI classifies disease severity based on the Los Angeles grading system and accurately segments lesions.Additionally,AI detects esophagogastric varices and predicts bleeding risks more effectively than traditional methods.Despite these advancements,challenges remain,including the need for high-quality data,multi-center validation,and ensuring AI model interpretability.Future research should address these issues and further integrate AI into clinical practice to optimize patient outcomes.This review highlights AI's transformative impact on upper gastrointestinal disease diagnosis,emphasizing its potential to revolutionize endoscopic practice and improve patient care.
基金financially supported by the National Natural Science Foundation of China(No.22303033)the Fundamental Research Funds for the Central Universities,China(No.JUSRP123017)+1 种基金Wuxi“Taihu Light”Science and Technology Project-Basic Research(No.K20231063)the Research Matching Grant Scheme at CUHK(No.8601309)。
文摘In this study,a pair of dicarboxylic acids as cis-trans isomerism—citraconic acid(CA)and mesaconic acid(MA),was incorporated into polymeric networks of poly(N-isopropylacrylamide)(PNIPAM)-based core-shell microgels via semi-batch precipitation polymerization.We demonstrated that the pH-temperature dual responsiveness of the core-shell microgels is highly correlated with the structure and position of the acid isomers.Both the cis-trans molecular structure and the crosslinking position of the dicarboxylic acids significantly influenced the hydration capacity and surface charge density of the core-shell microgels.These diverse properties first influenced the swelling behavior,further affecting the interfacial behavior of the microgels,including the oil-water dynamic interfacial tension and air-water compression isotherms.Furthermore,the rheological behavior of the microgel suspensions also displayed distinct dependences on the frequency and temperature,illustrating that the cis-trans molecular structure and crosslinked position of the dicarboxylic acids also significantly influenced the interparticle clustering in the bulk solution.Our results suggest that the pH sensitivity of the cis-trans dicarboxylic acid isomer affects the ionization and surface charge distribution of the core or shell layers of individual microgels,which further determines the interparticle interaction and cooperative rearrangement at interfaces and in the bulk.
基金supported by the National Natural Science Foundation of China,No.81970820(to HX)
文摘Schwann cell proliferation,migration and remyelination of regenerating axons contribute to regeneration after peripheral nervous system injury.Lithium promotes remyelination by Schwann cells and improves peripheral nerve regeneration.However,whether lithium modulates other phenotypes of Schwann cells,especially their proliferation and migration remains elusive.In the current study,primary Schwann cells from rat sciatic nerve stumps were cultured and exposed to 0,5,10,15,or 30 mM lithium chloride(LiCl)for 24 hours.The effects of LiCl on Schwann cell proliferation and migration were examined using the Cell Counting Kit-8,5-ethynyl-2′-deoxyuridine,Transwell and wound healing assays.Cell Counting Kit-8 and 5-ethynyl-2′-deoxyuridine assays showed that 5,10,15,and 30 mM LiCl significantly increased the viability and proliferation rate of Schwann cells.Transwell-based migration assays and wound healing assays showed that 10,15,and 30 mM LiCl suppressed the migratory ability of Schwann cells.Furthermore,the effects of LiCl on the proliferation and migration phenotypes of Schwann cells were mostly dose-dependent.These data indicate that lithium treatment significantly promotes the proliferation and inhibits the migratory ability of Schwann cells.This conclusion will inform strategies to promote the repair and regeneration of peripheral nerves.All of the animal experiments in this study were ethically approved by the Administration Committee of Experimental Animal Center of Nantong University,China(approval No.20170320-017)on March 2,2017.
文摘In this editorial,we review the work of Razali et al published in World J Gas-troenterology,with a particular focus on the effect of rs10889677 variation in the phosphatidylinositol 3-kinase(PI3K)pathway and buparlisib on colitis-associated cancer.The role of PI3K in promoting cancer progression has been widely recognized,as it is involved in regulating the survival,differentiation,and prolif-eration of cancer cells.The complement Clq/TNF-related protein 6(CTRP6)is a newer tumor-associated factor.Recent studies have revealed the pro-tumor effect of CTRP6 in gastric cancer,hepatocellular carcinoma,colorectal cancer,and other gastrointestinal tumors through the PI3K pathway.This article attempts to reveal the mechanism through which the CTRP6 affects the development of digestive system tumors through the PI3K pathway by summarizing recent research.
文摘BACKGROUND Bioresorbable scaffolds(BRS)are a promising alternative to traditional drugeluting stents(DES)for the treatment of acute coronary syndrome(ACS).They offer the potential for complete resorption,which may reduce long-term complications such as stent thrombosis and late restenosis.However,the safety,compatibility,and long-term outcomes of BRS in patients with intermediate to low-risk ACS have yet to be thoroughly investigated.AIM To investigate the safety,compatibility,and long-term outcomes of BRS in patients with intermediate to low-risk ACS.METHODS Patients with intermediate to low-risk ACS who underwent percutaneous coronary intervention with either DES or BRS,and were continuously recruited from January 2019 to June 2022 at a single center,were analyzed.Baseline data and clinical follow-up were collected for patients who underwent DES implantation(control group)and BRS implantation(observation group),and the survival outcomes and complications during a maximum follow-up period of 3 years were compared.The primary clinical endpoint was device-oriented composite endpoint(DoCE),representing the occurrence of one of the following events:Cardiac death,stent thrombosis,target vessel myocardial infarction,and clinically driven target lesion revascularization.Secondary endpoints included coronary artery bypass grafting,target vessel revascularization,and non-cardiac death.RESULTS A total of 128 patients were included in this study,with an average age of 63 years.Among them,95 were male(74%).The study involved treatment of 201 blood vessels:87(43%)received BRS,and 114(57%)received DES.A total of 97 patients completed the full 3-year follow-up.During this period,5 patients(17%)in the observation group and 7 patients(16%)in the control group experienced a major cardiovascular event(DoCE).At the 1-year follow-up,7 patients(15%)in the observation group and 6 patients(10%)in the control group experienced DoCE,and this difference was statistically significant(P<0.05).At the 2-year follow-up,there was also a significant difference between the two groups in the number of patients who needed repeat treatment of the target blood vessel(P<0.05).In the observation group,18 patients(33%)underwent follow-up coronary angiography.During the follow-up period,one patient in the observation group was found to have re-narrowing in the proximal and middle segments of the left anterior descending artery,possibly due to BRS collapse.Another patient in the observation group developed chronic total occlusion in multiple vessels at the 3-year follow-up and underwent coronary artery bypass grafting.CONCLUSION In low-to intermediate-risk ACS patients,those who got BRS had their first major heart event sooner than those who got DES.BRS is more tissue-friendly,yet over three years both groups had about the same amount of problems-only a few BRS patients still saw the scaffold collapse or the vessel slowly block.
文摘Background: Delayed gastric emptying(DGE) is one of the most common complications after pancreaticoduodenectomy(PD). DGE represents impaired gastric motility without significant mechanical obstruction and is associated with an increased length of hospital stay, increased healthcare costs, and a high readmission rate. We reviewed published studies on various technical modifications to reduce the incidence of DGE. Data sources: Studies were identified by searching Pub Med for relevant articles published up to December 2022. The following search terms were used: “pancreaticoduodenectomy”, “pancreaticojejunostomy”, “pancreaticogastrostomy”, “gastric emptying”, “gastroparesis” and “postoperative complications”. The search was limited to English publications. Additional articles were identified by a manual search of references from key articles. Results: In recent years, various surgical procedures and techniques have been explored to reduce the incidence of DGE. Pyloric resection, Billroth II reconstruction, Braun's enteroenterostomy, and antecolic reconstruction may be associated with a decreased incidence of DGE, but more high-powered studies are needed in the future. Neither laparoscopic nor robotic surgery has demonstrated superiority in preventing DGE, and the use of staplers is controversial regarding whether they can reduce the incidence of DGE. Conclusions: Despite many innovations in surgical techniques, there is no surgical procedure that is superior to others to reduce DGE. Further larger prospective randomized studies are needed.
文摘This editorial reviews the molecular mechanisms underlying the roles of the long non-coding RNA(lncRNA)small nucleolar RNA host gene 16(SNHG16)in digestive system cancers based on two recent studies on lncRNAs in digestive system tumors.The first study,by Zhao et al,explored how hBD-1 affects colon cancer,via the lncRNA TCONS_00014506,by inhibiting mTOR and promoting autophagy.The second one,by Li et al,identified the lncRNA prion protein testis specific(PRNT)as a factor in oxaliplatin resistance by sponging ZNF184 to regulate HIPK2 and influence colorectal cancer progression and chemoresistance,suggesting PRNT as a potential therapeutic target for colorectal cancer.Both of these two articles discuss the mechanisms by which lncRNAs contribute to the development and progression of digestive system cancers.As a recent research hotspot,SNHG16 is a typical lncRNA that has been extensively studied for its association with digestive system cancers.The prevailing hypothesis is that SNHG16 participates in the development and progression of digestive system tumors by acting as a competing endogenous RNA,interacting with other proteins,regulating various genes,and affecting downstream target molecules.This review systematically examines the recently reported biological functions,related molecular mechanisms,and potential clinical significance of SNHG16 in various digestive system cancers,and explores the relationship between SNHG16 and digestive system cancers.The findings suggest that SNHG16 may serve as a potential biomarker and therapeutic target for human digestive system cancers.
基金supported by the National Natural Science Foundation of China(No.11701137)the Natural Science Foundation of Hebei Province(No.A2021202010).
文摘Nonmonotone gradient methods generally perform better than their monotone counterparts especially on unconstrained quadratic optimization.However,the known convergence rate of the monotone method is often much better than its nonmonotone variant.With the aim of shrinking the gap between theory and practice of nonmonotone gradient methods,we introduce a property for convergence analysis of a large collection of gradient methods.We prove that any gradient method using stepsizes satisfying the property will converge R-linearly at a rate of 1-λ_(1)/M_(1),whereλ_(1)is the smallest eigenvalue of Hessian matrix and M_(1)is the upper bound of the inverse stepsize.Our results indicate that the existing convergence rates of many nonmonotone methods can be improved to 1-1/κwithκbeing the associated condition number.
基金This study was supported by a grant from the National Natural Science Foundation of China （No. 81570668）.
文摘Background： Mineral and bone disorder is one of the severe complications in kidney transplant recipients （KTRs）. Previous studies showed that bisphosphonates had favorable effects on bone mineral density （BMD）. We sought to compare different bisphosphonate regimens and rank their strategies. Methods： We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials （CENTRAL） up to April 01, 2017,for randomized controlled trials （RCTs） comparing bisphosphonate treatments in adult KTRs. The primary outcome was BMD change. We executed the tool recommended by the Cochrane Collaboration to evaluate the risk of bias. We performed pairwise meta-analyses using random effects models and network meta-analysis （NMA） using Bayesian models and assessed the quality of evidence. Results： A total of 21 RCTs （1332 participants） comparing 6 bisphosphonate regimens were included. All bisphosphonates showed a significantly increased percentage change in BMD at the lumbar spine compared to calcium except clodronate. Pamidronate with calcium and Vitamin D analogs showed improved BMD in comparison to clodronate with calcium （mean difference [MD], 9.84; 95% credibility interval [CrI], 1.06-19.70）. The combination of calcium and Vitamin D analogs had a significantly lower influence than adding either pamidronate or alendronate （MD, 6.34; 95% CrI, 2.59-11.01 and MD, 6.16; 95% CrI, 0.54-13.24, respectively）. In temas of percentage BMD change at the femoral neck, both pamidronate and ibandronate combined with calcium demonstrated a remarkable gain compared with calcium （MD, 7.02; 95% CrI, 0.30-13.29 and MD, 7.30; 95% CrI, 0.32-14.22, respectively）. The combination of ibandronate with calcium displayed a significant increase in absolute BMD compared to any other treatments and was ranked best. Conclusions： Our NMA suggested that new-generation bisphosphonates such as ibandronate were more favorable in KTRs to improve BMD. However, the conclusion should be treated with caution due to indirect comparisons.
