Percutaneous kyphoplasty with or without temporary unipedicle screw reduction : A retrospective comparative study of osteoporotic vertebral fractures

Background

Temporary unipedicle screw reduction with percutaneous kyphoplasty (TUSR-PKP) is a relatively new method for managing osteoporotic vertebral compression fractures (OVCFs). A clinical retrospective comparative study was conducted to verify whether TUSR-PKP was noninferior to simple PKP regarding the management of OVCFs.

Methods

A total of 38 consecutive patients who sustained OVCFs without neurological deficits and had undergone surgeries in our hospital from June 2012 to January 2014 were included in the study: 24 patients underwent simple PKP (control group) and the other 14 patients underwent TUSR-PKP (treatment group). All 38 patients were asked to participate in a long-term (>1 year) follow-up. Visual analog scale (VAS) pain scores and Oswestry Disability Index (ODI) were recorded, and the Cobb angles and the vertebral body heights were measured on the lateral radiographs before surgery and on day 1, as well as 1, 3, 6, and 12 months after surgery.

Results

The patients in the treatment group had better vertebral height gain and greater improvement on ODI compared with the control group (p < 0.05). The VAS scores of the two groups were similar at all points until the end of the 1‑year follow-up period. Two patients from the treatment group and 5 patients from the control group had cement leakage. In the control group, 3 patients suffered adjacent or nonadjacent vertebra fractures.

Conclusion

TUSR-PKP is a safe and effective surgical option for OVCFs. Compared with simple PKP, TUSR-PKP provided at least equal results for OVCFs. Moreover, during the postsurgery observations, TUSR-PKP showed potential advantages including vertebral height gain, ODI improvement, and fewer subsequent refractures.

Altered long non-coding RNA transcriptomic profiles in brain microvascular endothelium after cerebral ischemia

The brain endothelium is an important therapeutic target for the inhibition of cerebrovascular dysfunction in ischemic stroke. Previously, we documented the important regulatory roles of microRNAs in the cerebral vasculature, in particular the cerebral vascular endothelium. However, the functional significance and molecular mechanisms of other classes of non-coding RNAs in the regulation of cerebrovascular endothelial pathophysiology after stroke are completely unknown. Using RNA sequencing (RNA-seq) technology, we profiled long non-coding RNA (lncRNA) expressional signatures in primary brain microvascular endothelial cells (BMECs) after oxygen-glucose deprivation (OGD), an in vitro mimic of ischemic stroke conditions. After 16h of OGD exposure, the expression levels for 362 of the 10,677 lncRNAs analyzed changed significantly, including a total of 147 lncRNAs increased and 70 lncRNAs decreased by more than 2-fold. Among them, the most highly upregulated lncRNAs include Snhg12, Malat1, and lnc-OGD 1006, whereas the most highly downregulated lncRNAs include 281008D09Rik, Peg13, and lnc-OGD 3916. Alteration of the most highly upregulated/downregulated ODG-responsive lncRNAs was further confirmed in cultured BMECs after OGD as well as isolated cerebral microvessels in mice following transient middle cerebral artery occlusion (MCAO) and 24h reperfusion by the quantitative real-time PCR approach. Moreover, promoter analysis of altered ODG-responsive endothelial lncRNA genes by bioinformatics showed substantial transcription factor binding sites on lncRNAs, implying potential transcriptional regulation of those lncRNAs. These findings are the first to identify OGD-responsive brain endothelial lncRNAs, which suggest potential pathological roles for these lncRNAs in mediating endothelial responses to ischemic stimuli. Endothelial-selective lncRNAs may function as a class of novel master regulators in cerebrovascular endothelial pathologies after ischemic stroke.

Neddylation controls basal MKK7 kinase activity in breast cancer cells

The c-Jun NH2-terminal protein kinase (JNK) pathway has been implicated in mammary tumor development. However, the molecular mechanisms regulating JNK activity in breast cancer cells remain unclear. Here, we report that the inhibition of ubiquitination-like post-translational modification neddylation through different strategies results in enhanced basal JNK phosphorylation in human breast cancer cells. The upregulation of basal JNK phosphorylation upon neddylation inhibition is independent of the deneddylation of Cullins, the well-characterized neddylation substrates. Since augmented basal JNK phosphorylation via ectopic MKK7 expression impedes proliferation and the epithelial-to-mesenchymal transition (EMT) phenotype, the neddylation system might contribute to mammary tumor development partially through limiting basal JNK phosphorylation. Further exploration reveals that MKK7, a JNK-specific MAP2K, undergoes neddylation in human breast cancer cells. MKK7 co-precipitates with a fragment of Ran-binding protein 2 (RanBP2), a large multimodular and pleiotropic protein that has been recognized as a SUMO E3 ligase. Knockdown of RanBP2 attenuates MKK7 neddylation and augments basal JNK phosphorylation without affecting the neddylation of Cullins, whereas ectopic expression of a RanBP2 fragment possessing SUMO E3 activity (RanBP2ΔFG) manifests the opposite effects. In vitro neddylation assays confirm that RanBP2ΔFG works as the neddylation E3 ligase for MKK7. The basal kinase activity of endogenous MKK7 increases upon RanBP2 knockdown but decreases upon the ectopic expression of RanBP2ΔFG. Furthermore, purified MKK7 shows reduced basal kinase activity after in vitro neddylation by RanBP2ΔFG. Consistently, RanBP2 knockdown leads to reduced proliferation and impaired EMT phenotype in human breast cancer cells and the effects of RanBP2 knockdown are reversed by simultaneous MKK7 knockdown. Taken together, our data suggest that MKK7 undergoes neddylation in human breast cancer cells, which limits its basal kinase activity.

Metabolic syndrome is an independent prognostic factor for endometrial adenocarcinoma

OBJECTIVE

To study the association between metabolic syndrome (MS) and the prognosis of patients with endometrial adenocarcinoma.

METHODS

A total of 385 patients with endometrial adenocarcinoma in the Department of Gynecologic Oncology, at the Zhejiang Cancer Hospital in China, between January 2001 and December 2008 were chosen. The deadline for the completion of follow-up was December 2013. The overall survival (OS) of the patients with MS was analyzed by the Kaplan-Meier method. Various clinical characteristics (e.g., clinical and surgical stage, vascular invasion, histological grade, tumor size, age at start of the first treatment, and lymphatic metastasis) related to the prognosis of endometrial adenocarcinoma were also evaluated.

RESULTS

A univariate analysis demonstrated that the OS rate of the patients with endometrial adenocarcinoma with MS was significantly worse than that of the patients without MS for all 385 patients (P = 0.001). Multivariate Cox proportional hazards regression analyses showed that stage (P = 0.001), lymphatic metastasis (P = 0.021), and MS (P = 0.049) were independent prognostic factors for endometrial adenocarcinoma. Furthermore, statistical analyses demonstrated that MS was closely related to stage (P = 0.021), grade (P = 0.022), vascular invasion (P = 0.044), tumor size (P = 0.035), and lymphatic metastasis (P = 0.014) but not with age at start of the first treatment (P = 0.188). Finally, according to the univariate analysis of the OS rate of 129 cases of endometrial adenocarcinoma with MS, stage (P = 0.001), vascular invasion (P = 0.049), tumor size >2 cm (P = 0.028), lymphatic metastasis (P = 0.002), and CA19-9 value >37 U/m (P = 0.002) all showed significantly low P values for OS.

CONCLUSION

Metabolic syndrome is an independent prognostic factor for endometrial adenocarcinoma.

Dual role of vitamin D-binding protein 1F allele in chronic obstructive pulmonary disease susceptibility: a meta-analysis

Vitamin D-binding protein (DBP), a highly polymorphic serum protein, encoded by GC gene, is important in the development of chronic obstructive pulmonary disease (COPD). This meta-analysis was performed to assess the association between GC polymorphisms (1F, 1S, and 2 alleles) and COPD susceptibility. Published case-control studies were retrieved from the Pubmed, Embase, and China National Knowledge Infrastructure databases. After data extraction, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Seven case-control studies were included. Pooled effect size showed that GC polymorphisms were not significantly associated with COPD susceptibility. According to ethnicity, the 1F allele was significantly correlated with COPD susceptibility in Asians (1F vs 1S, OR: 1.52, 95%CI: 1.16-2.00 and 1F vs 2, OR: 1.87, 95%CI: 1.42-2.44), indicating that individuals with the 1F allele have an increased risk of COPD compared to those with the 1S or 2 allele. However, the 1F allele was associated with a lower, insignificant risk of COPD than the 1S and 2 alleles in Caucasians (1F vs 1S, OR: 0.83, 95%CI: 0.64-1.08 and 1F vs 2, OR: 0.73, 95%CI: 0.54-0.98). Moreover, no significant association was found for the 1S and 2 alleles in Asians (OR: 1.23, 95%CI: 0.90- 1.69) and Caucasians (OR: 0.89, 95%CI: 0.70-1.13). After excluding each study, the pooled results were robust and no publication bias was observed. We found that the GC 1F allele confers a risk of COPD in Asians, whereas the 1F allele may protect against COPD in Caucasians.

Laparoscopic ovarian transposition in young women with cervical squamous cell carcinoma treated by primary pelvic irradiation

OBJECTIVE

To report the authors' experience with laparoscopic ovarian transposition and ovarian function preservation in young women with cervical squamous cell carcinoma treated by primary pelvic irradiation.

MATERIALS AND METHODS

Twenty-seven premenopausal patients were treated with radiotherapy for a cervical squamous cell carcinoma. Laparoscopic ovarian transposition to paracolic gutters with uterine conservation with pelvic common iliac lymph node and para-aortic lymph node sampling were performed in ten patients at the same time of laparoscopic ovarian transposition. Preservation of ovarian function was assessed by patients' symptoms and serum follicle-stimulating hormone level.

RESULTS

Bilateral or unilateral laparoscopic ovarian transposition was performed in 27 patients: 22 cases Stage IIB, one case Stage IIIA, and four cases Stage IIIB. No immediate intraoperative or postoperative complications were observed. Two of the ten patients were confirmed by lymph node metastases. One patient was lost to follow-up. Ovarian preservation was achieved in 18 (69.2%) of 26 patients. No patient was detected with ovarian metastasis at follow-up.

CONCLUSIONS

Laparoscopic ovarian transposition is a safe and effective procedure for preserving ovarian function. This procedure may be considered in premenopausal women who need to undergo pelvic irradiation for cervical squamous cell carcinoma, especially for those less than 40 years of age. Otherwise, para-aortic lymph node or common iliac lymph nods sampling at the same time of laparoscopic ovarian transposition may preferably guide radiation therapy.

Novel approach to documenting expert ECG interpretation using eye tracking technology: a historical and biographical representation of the late Dr Rory Childers in action

The 12-lead electrocardiogram (ECG) is a complex set of cardiac signals that require a high degree of skill and clinical knowledge to interpret. Therefore, it is imperative to record and understand how expert readers interpret the 12-lead ECG. This short paper showcases how eye tracking technology and audio data can be fused together and visualised to gain insight into the interpretation techniques employed by an eminent ECG champion, namely Dr Rory Childers.

Analysis of Th17-associated cytokines in tears of patients with dry eye syndrome

PURPOSE

To determine the levels of Th17-associated cytokines, particularly interleukin (IL)-17 and IL-22 in tears of patients with dry eye syndrome.

METHODS

Tear samples were collected from 20 healthy volunteers, 20 dry eye (DE) patients with non-Sjögren's syndrome (NSSDE) and 20 DE patients with Sjögren's syndrome (SSDE). Symptom questionnaire was self-administered and multiple dry eye disease (DED)-related clinical tests were performed. The levels of IL-17 and IL-22 in tears were measured by enzyme-linked immunosorbent assay.

RESULTS

The levels of IL-17 and IL-22 were significantly increased in tears of DE patients compared with those of controls and also higher in SSDE patients compared with those of NSSDE patients (P<0.05). Moreover, the levels of IL-17 and IL-22 were positively correlated with questionnaire score and keratopathy score but negatively correlated with tear film break-up time and Schirmer I test in both NSSDE and SSDE patients (P<0.05).

CONCLUSIONS

The levels of IL-17 and IL-22 in tears were significantly increased in DE patients, which were associated with the disease severity. Therefore, Th17 cell-associated cytokines, particularly IL-17 and IL-22, may have important roles in the immunopathogenesis of the DED.

First Report of Sweet potato chlorotic fleck virus Infecting Sweet Potato in Sichuan Province, China

Sweet potato chlorotic fleck virus (SPCFV) is one of several viruses naturally infecting sweet potato (Ipomoea batatas L.), and it has recently been classified as a new member of the genus Carlavirus (family Flexiviridae) (1). However, SPCFV is distantly related to typical carlaviruses, as most of its putative gene products share amino acid sequence identities of <40% with those of typical carlaviruses (1). China is the largest sweet potato producing country in the world. So far, SPCFV has been reported in eastern China, such as Jiangsu, Anhui, Henan (3), and Guangdong (2) provinces, but no reports exist in western China. Sichuan Province, located in southwestern China, is the largest sweet potato producing area in the country. There are big differences between the environment and climate conditions between Sichuan and eastern China. During 2012, a survey was constructed to determine the genetic diversity and distribution of sweet potato viruses in Sichuan. Forty-seven sweet potato samples exhibiting virus-like symptoms were collected from four different geographic areas of the province. Western blotting using the antisera obtained from the International Potato Center showed that two samples were positive for SPCFV, whereas with reverse transcription (RT)-PCR, only one isolate of SPCFV was obtained from a sample exhibiting symptoms of chlorosis, leaf distortion, and vein clearing. Serological detection indicated that the plant was co-infected with SPCFV, Sweet potato feathery mottle virus (SPFMV), and Sweet potato virus G (SPVG). Total RNA was extracted from symptomatic leaves using Trizol reagent (Invitrogen) according to the manufacturer's protocol, and RT-PCR was performed by using primer pairs SPCFV-CP F (5'-ATGGCGGCGAAGGAGGCTGATA-3') and SPCFV-CP R (5'-TCACTTGCACTTCCCATTAC-3') corresponding to the entire coat protein (CP) gene of SPCFV. Expected DNA fragments of 900 bp were obtained from the symptomatic plant but not from control plants. The obtained fragments were purified and cloned into the PMD19-T vector (TaKaRa). Recombinant plasmids were then transformed into competent cells of Escherichia coli strain DH5α. Nucleotide BLAST analysis revealed that the 900-bp fragment (GenBank Accession No. KC414676) shared 87 to 91% nucleotide identities with other SPCFV isolates available in the GenBank database. To our knowledge, this is the first report of the co-infection between SPCFV and other sweet potato viruses including SPFMV and SPVG in China, and this is the first molecular report of SPCFV in Sichuan, western China. It shows that SPCFV is spreading to a new ecological area of China, and the spread of the virus may affect sweet potato crop yields in western China. Some measures must be carried out quickly to control the virus. References: (1) V. Aritua et al. Arch. Virol. 152:813, 2007. (2) V. Aritua et al. Plant Dis. 93:87, 2009. (3) Q. Wang et al. Crop. Prot. 29:110, 2010.