Non-steroidal anti-inflammatory drugs (NSAIDs) are a key component of multimodal analgesia in paediatric surgical care but are often avoided in patients with chronic kidney disease (CKD) due to concerns for nephrotoxicity. This trial aims to evaluate the safety of short-term NSAID use in paediatric patients with mild-to-moderate CKD undergoing inpatient urological surgery.

Non-steroidal anti-inflammatory drugs （NSAIDs） are often used to treat horses' injuries and pain due to long-term training and competitions. In equestrian competitions， NSAIDs do not affect the upper limit of a horse's athletic ability， but they can enable the horse to perform close to its maximum capacity by reducing inflammation and pain. This not only affects the competition results， but also fails to ensure the health and welfare of the horses. Therefore， it has become crucial to effectively monitor and control NSAIDs residues during equestrian competition. In this study， a rapid screening and determination method for 33 NSAIDs in horse urine was established using QuEChERS pretreatment combined with ultra performance liquid chromatography-tandem mass spectrometry （QuEChERS-UPLC-MS/MS）. The pretreatment process， chromatographic conditions， and mass spectrometric conditions were also optimized. In brief， the target analytes in 1 mL of horse urine samples were extracted with 5 mL of acetonitrile. During extraction， 100 mg of NaCl was added as a salting-out agent， and the mixture was shaken for 3 min. Subsequently， the extract was purified using a QuEChERS method with 300 mg of anhydrous MgSO4， 40 mg of octadecylsilane-bonded silica （C18）， and 40 mg of primary secondary amine （PSA） as sorbents. After centrifugation， the supernatant was dried under nitrogen and reconstituted. The 33 NSAIDs were separated on an Agilent Poroshell 120 EC-C18 analytical chromatographic column （100 mm×3.0 mm，2.7 μm） with gradient elution using （A） 0.1% formic acid aqueous solution and （B） methanol solution as the mobile phases. The gradient elution program was as follows： 0-1 min， 30%B； 1-3 min， 30%B-60%B； 3-12 min， 60%B-85%B； 12-12.1 min， 85%B-95%B； 12.1-14 min， 95%B； 14-14.1 min， 95%B-30%B； 14.1-17 min， 30%B. Then， the target analytes were determined by UPLC-MS/MS in dynamic multiple reaction monitoring （dMRM） mode with positive/negative ion switching. Quantification was performed using the matrix-matched external standard method. The results showed that the method can rapidly and simultaneously determine the 33 NSAIDs in horse urine. The analytes had good linear relationships within their respective ranges， with correlation coefficients of >0.99. The limits of detection （LODs） and quantification （LOQs） were 0.1-1.0 μg/L and 0.9-5.4 μg/L， respectively. The recoveries of the 33 NSAIDs in horse urine were between 70.8% and 123.8% at three spiked levels of LOQ， 20 μg/L and 200 μg/L. The relative standard deviations of all targeted compounds ranged from 1.9% to 14.8%. The method was applied to 10 actual horse urine samples. The results revealed the presence of three NSAIDs， including ketorolac， lornoxicam and naproxen， with contents ranging from < LOQ to 6.87 μg/L. According to the Equine Prohibited Substances List published by the Federation Equestre Internationale （FEI）， ketorolac and naproxen are controlled medications. They are prohibited for use during competition period， as they may mask symptoms and aggravate clinical conditions. However， they are permitted for use during non-competition times. Lornoxicam is a banned substance and is strictly prohibited for use in horses at any time. The proposed method is simple， efficient and accurate， and is suitable for the simultaneous determination of the 33 NSAIDs residues in horse urine samples.

Non-biologic injection therapies are among the most commonly utilized interventions in sports medicine. Yet, the evidence supporting their use varies widely across injectates and clinical indications. This review provides an overview of the most broadly used non-biologic injectates in musculoskeletal care, including corticosteroids, local anesthetics, non-steroidal anti-inflammatory drugs (NSAID), normal saline, dextrose prolotherapy, hyaluronic acid, and botulinum toxin. For each agent, we discuss the mechanism of action, adverse effect profile, and current clinical evidence across a range of sports medicine conditions.

Cancer cachexia is a multifactorial systemic syndrome characterized by progressive muscle loss, with or without adipose tissue depletion, that cannot be reversed by conventional nutritional support. It affects cancer patients and is associated with reduced treatment tolerance, impaired physical function, poor quality of life, and increased mortality. The understanding of cachexia has evolved recently, from the perception of a simple nutritional disorder to a complex immune-metabolic syndrome, based on tumor-host interactions, systemic inflammation, metabolic dysregulation, and multi-organ dysfunction. This review summarizes the progression of cachexia research, highlighting key findings involving inflammatory cytokines, proteolytic pathways, mitochondrial dysfunction, and immune dysregulation. The development of therapeutic strategies is examined, from early nutritional and appetite-stimulating interventions to contemporary targeted therapies, including ghrelin receptor agonists, cytokine inhibitors, and anabolic agents. Despite advances in mechanistic understanding, numerous trials targeting single pathways have failed to produce meaningful functional or survival benefits, underscoring the limitations of reductionist approaches. Emerging evidence supports a paradigm shift toward multimodal, biomarker-guided, and patient-centered interventions that address the interconnected biological mechanisms underlying cachexia. Particular emphasis is given to novel immunomodulatory strategies, including agents such as R-ketorolac, which may restore immune homeostasis and target the root causes of cachexia. It is hypothesized that future therapeutic success will likely depend on integrated approaches combining immunological, metabolic, nutritional, and rehabilitative interventions.

A new enantioselective molecularly imprinted polymer (MIP) was developed for recognizing S-ketorolac (S-KR), a model chiral acidic drug. The synthetic process started with a resorcinol-formaldehyde resin (RSF), which was cyanoethylated under phase-transfer catalytic conditions to obtain RSF-CN. Then, the nitrile groups turned into cationic/basic hydrazidine sites after reacting with hydrazine hydrate, resulting in RSF-HD. Next, S-KR was interacted with RSF-HD in a DMF/water solution at pH 7, before adding glutaraldehyde for post-crosslinker. After that, the S-KR template was removed to get the final S-KR-imprinted polymer (S-KR-P). Tests, such as elemental analysis and solid-state [13]C NMR, verified each step. Adsorption tests showed a strong pH dependence, working best between pH 6 and 7. For isotherm studies, the maximum capacity for S-KR on S-KR-P was 525 mg/g, whereas R-KR had 252 mg/g. The non-imprinted polymers (NIPs) worked similarly for both, around 180 mg/g. The Langmuir model fits better than the Freundlich model, pointing to adsorption on defined binding sites. With a selectivity coefficient of about 12, it shows effective stereoselective recognition, making S-KR-P a great option for separating chiral ketorolac.

This review aimed to evaluate the efficacy and safety of subcutaneous nonsteroidal anti-inflammatory drugs (NSAIDs).

Secondary spontaneous pneumothorax (SSP), a complication of chronic obstructive pulmonary disease (COPD), recurs more frequently in underweight patients. This case report describes a 63-year-old malnourished man with COPD presenting with recurrent left-sided SSP shortly after hospital discharge for a previous episode. Following chest tube reinsertion and complete lung re-expansion, chemical pleurodesis was performed using 1000 mg doxycycline in saline. Transient pleuritic pain was controlled with intravenous ketorolac and intrapleural lidocaine. No other immediate or delayed adverse events occurred. In parallel, pulmonary rehabilitation, including breathing exercises, posture correction, moderate-intensity endurance and inspiratory muscle training, was initiated alongside nutritional repletion with a respiratory-specific oral nutritional supplement. Over a 22-month follow-up, the patient remained free of SSP recurrence, with improved functional capacity and weight gain. This report describes a long-term recurrence-free outcome after doxycycline pleurodesis combined with pulmonary rehabilitation and nutritional support in an underweight patient with COPD.