[Dosimetric analysis of different optimization algorithms for three-dimensional brachytherapy for gynecologic tumors]

OBJECTIVE

To investigate the dosimetric difference between manual and inverse optimization in 3-dimensional (3D) brachytherapy for gynecologic tumors.

METHODS

This retrospective study was conducted among a total of 110 patients with gynecologic tumors undergoing intracavitary combined with interstitial brachytherapy or interstitial brachytherapy. Based on the original images, the brachytherapy plans were optimized for each patient using Gro, IPSA1, IPSA2 (with increased volumetric dose limits on the basis of IPSA1) and HIPO algorithms. The dose-volume histogram (DVH) parameters of the clinical target volume (CTV) including V200, V150, V100, D90, D98 and CI, and the dosimetric parameters D2cc, D1cc, and D0.1cc for the bladder, rectum, and sigmoid colon were compared among the 4 plans.

RESULTS

Among the 4 plans, Gro optimization took the longest time, followed by HIPO, IPSA2 and IPSA1 optimization. The mean D90, D98, and V100 of HIPO plans were significantly higher than those of Gro and IPSA plans, and D90 and V100 of IPSA1, IPSA2 and HIPO plans were higher than those of Gro plans (P < 0.05), but the CI of the 4 plans were similar (P > 0.05). For the organs at risk (OARs), the HIPO plan had the lowest D2cc of the bladder and rectum; the bladder absorbed dose of Gro plans were significantly greater than those of IPSA1 and HIPO (P < 0.05). The D2cc and D1cc of the rectum in IPSA1, IPSA2 and HIPO plans were better than Gro (P < 0.05). The D2cc and D1cc of the sigmoid colon did not differ significantly among the 4 plans.

CONCLUSION

Among the 4 algorithms, the HIPO algorithm can better improve dose coverage of the target and lower the radiation dose of the OARs, and is thus recommended for the initial plan optimization. Clinically, the combination of manual optimization can achieve more individualized dose distribution of the plan.

Is the interspinous process device safe and effective in elderly patients with lumbar degeneration? A systematic review and meta-analysis of randomized controlled trials

BACKGROUND CONTEXT

Lumbar spinal stenosis is one of the most common diseases affecting the elderly that is characterized by the narrowing of the spinal canal and peripheral neural pathways which may cause back pain and neurogenic intermittent claudication in affected patients. Recently, as an alternative treatment between conservative therapy and decompression surgery, interspinous process device (IPD) such as X-stop, Coflex, DIAM, Aperius, Wallis, etc., has gained enough popularity.

PURPOSE

The purpose of this study was to evaluate the efficacy and safety of IPD in the treatment of degenerative lumbar spinal stenosis compared with decompression surgery.

STUDY DESIGN

This study was a systematic review and meta-analysis of randomized controlled trials.

PATIENT SAMPLE

555 patients' samples were collected for this study.

OUTCOME MEASURES

The Visual Analogue Scale and the Oswestry Disability Index were analyzed, as well as the Zurich Claudication Questionnaire For efficacy evaluation. Complication and reoperation rate was utilized for the assessment of safety.

METHODS

A comprehensive literature search was performed through Pubmed, EMBASE, Web of Science, and Cochrane Library until October 2023. Among the studies meeting the eligible criteria, any study in which IPD was utilized in the treatment of degenerative lumbar spinal stenosis was included in the current review. For efficacy evaluation, the Visual Analogue Scale and the Oswestry Disability Index were analyzed, as well as the Zurich Claudication Questionnaire. Complication and reoperation rates were utilized for the assessment of safety.

RESULTS

Five randomized controlled trials with 555 patients were included. There were no significant differences in VAS leg pain (SMD - 0.08, 95% CI - 0.32 to 0.15) and back pain (SMD 0.09, 95%CI-0.27 to 0.45), ODI scores (MD 1.08, 95% CI - 11.23 to 13.39) and ZCQ physical function (MD-0.09, 95% CI-0.22 to 0.05) for IPD compared with decompression surgery. In terms of ZCQ symptom severity (MD - 0.22, 95% CI - 0.27 to - 016), decompression surgery showed superior to the IPD. As for complications (RR 1.08, 95% CI 0.36 to 3.27), the IPD had no advantages compared to decompression surgery, whereas inferior to it in reoperation rate (RR 2.58, 95% CI 1.67 to 3.96).

CONCLUSIONS

This systematic review and meta-analysis indicated no superiority in the clinical outcome for IPD compared with decompression surgery. However, more clinical studies are warranted to determine the efficacy and safety of IPD.

Multi-objective pedestrian tracking method based on YOLOv8 and improved DeepSORT

A multi-objective pedestrian tracking method based on you only look once-v8 (YOLOv8) and the improved simple online and real time tracking with a deep association metric (DeepSORT) was proposed with the purpose of coping with the issues of local occlusion and ID dynamic transformation that frequently arise when tracking target pedestrians in real complex traffic scenarios. To begin with, in order to enhance the feature extraction network's capacity to learn target feature information in busy traffic situations, the detector implemented the YOLOv8 method with a high level of small-scale feature expression. In addition, the omni-scale network (OSNet) feature extraction network was then put on top of DeepSORT in order to accomplish real-time synchronized target tracking. This increases the effectiveness of picture edge recognition by dynamically fusing the collected feature information at various scales. Furthermore, a new adaptive forgetting smoothing Kalman filtering algorithm (FSA) was created to adapt to the nonlinear condition of the pedestrian trajectory in the traffic scene in order to address the issue of poor prediction attributed to the linear state equation of Kalman filtering once more. Afterward, the original intersection over union (IOU) association matching algorithm of DeepSORT was replaced by the complete-intersection over union (CIOU) association matching algorithm to fundamentally reduce the target pedestrians' omission and misdetection situation and to improve the accuracy of data matching. Eventually, the generalized trajectory feature extractor model (GFModel) was developed to tightly merge the local and global information through the average pooling operation in order to get precise tracking results and further decrease the impact of numerous disturbances on target tracking. The fusion algorithm of YOLOv8 and improved DeepSORT method based on OSNet, FSA and GFModel was named YOFGD. According to the experimental findings, YOFGD's ultimate accuracy can reach 77.9% and its speed can reach 55.8 frames per second (FPS), which is more than enough to fulfill the demands of real-world scenarios.

Comparative Study on the Efficacy of Two Perioperative Chemotherapy Regimens for Lumbar Brucellosis

Objective

The clinical efficacy of perioperative chemotherapy regimen (rifampicin, doxycycline, levofloxacin, ceftriaxone) was evaluated for lumbar brucellosis spondylitis patients with neurological injury.

Methods

In Beijing Ditan Hospital affiliated with Capital Medical University, 32 patients with lumbar brucellosis spondylitis underwent surgery and triple perioperative chemotherapy (rifampicin, doxycycline, levofloxacin) between 2011 and 2021 due to neurological injury, and 34 patients matched up with the triple group underwent rifampicin, doxycycline, levofloxacin, and ceftriaxone. Both groups were compared in terms of changes in inflammation index, low back/leg pain, lumbar function, neurological function, and adverse drug reactions.

Results

There was no significant difference in erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), low back pain visual analogue scale (VAS), leg pain VAS, lumbar Oswestry disability index (ODI) and nerve function injury rate between the two groups before chemotherapy (P>0.05). The ESR, CRP at 1 week and 2 weeks after chemotherapy and 1 week, 2 weeks, 1 month postoperatively in the quadruple group were significantly lower than those in the triple group, which is the same to ESR 3 months postoperatively (P<0.05). The low back pain VAS, leg pain VAS and lumbar ODI in the quadruple group were significantly lower than those in the triple group at 1 month and 3 months postoperatively (P<0.05). The recovery rate of neurological function in the quadruple group was significantly higher than that in the triple group at 3 and 6 months postoperatively (P<0.05). Both groups did not experience significantly different perioperative and postoperative adverse reactions (P>0.05).

Conclusion

For lumbar brucellosis spondylitis with neurological injury, quadruple perioperative chemotherapy of rifampicin, doxycycline, levofloxacin and ceftriaxone can significantly reduce perioperative inflammation, and improve low back/leg pain, as well as promoting neurological function recovery in the short term.

Low profile posterior lumbar-sacral interbody fusion for lumbosacral degenerative diseases: a technical note

BACKGROUND

The purpose of this study was to report our surgical experience in patients with lumbosacral degenerative diseases who underwent posterior decompression and interbody fusion fixed with cortical bone trajectory screw and sacral alar screw, which is known as low-profile posterior lumbosacral interbody fusion (LP-PLSIF).

METHODS

Patients with lumbosacral degenerative disease who underwent LP-PLSIF and traditional PLSIF (control group) internally fixed with pedicle screws were included retrospectively. Patients' demographic data, operative parameters, and perioperative complications were recorded and analyzed.

RESULTS

A total of 18 patients were enrolled in this study, which included 9 patients (5 male and 4 female) who underwent LP-PLSIF, and 9 patients (4 male and 5 female) who underwent traditional PLSIF. There wasn't a significant difference in the average age between the two groups, 56.78 ± 10.92 years in the LP-PLSIF group and 60.22 ± 8.21 years in the PLSIF group (p = 0.460). The bone mineral density (BMD) of the two groups of patients were -2.00 ± 0.26 T and -2.13 ± 0.19 T, respectively (P = 0.239). The mean postoperative follow-up time was 12.7 months (range, 12-14 months). The mean operation time was 142.78 ± 11.21 min and 156.11 ± 13.41 min in the LP-PLSIF group and PLSIF group respectively (P < 0.05). The average blood loss was 137.78 ± 37.09 ml in the LP-PLSIF group, and 150.00 ± 27.84 ml in the PLSIF group (P = 0.441). The average postoperative drainage was 85.56 ± 37.45 ml and 122.22 ± 22.24 ml in the LP-PLSIF group and control group respectively (P < 0.05). Patients in the LP-PLSIF group had shorter incision length compared with the control group, 61.44 ± 10.56 mm vs. 74.56 ± 10.22 mm (P < 0.05). The average length of hospitalization of 11.33 ± 2.92 days in the LP-PLSIF group, and 11.11 ± 1.62 days in the PLSIF group (p = 0.844). All patients had significant improvement in VAS pain score, ODI, and JOA evaluation. However, patients in the LP-PLSIF group had better improvement in terms of VAS back pain and ODI in the short term after the operation. There were no neurological complications or wound infection. The fusion rate at the last follow-up was 100% (9 of 9) in the LP-PLSIF group, and 88.89% (8 of 9) in the control group based on CT scans. 1 patient in the control group had asymptomatic sacral pedicle screw loosening.

CONCLUSIONS

LP-PLSIF is a safe and effective surgical technique for patients with lumbosacral degenerative disease, which has the potential strength of less invasive and better clinical improvement.

Association between triglyceride glucose index and H-type hypertension in postmenopausal women

Background

Recent studies have reported better predictive performance of triglyceride glucose (TyG) index for cardiovascular events in women, however, whether this association persists in postmenopausal women is inconclusive. We investigated the association between TyG index and H-type hypertension (HHT) in postmenopausal women.

Methods

1,301 eligible women with hypertension were included in this cross-sectional study. Concomitant homocysteine levels >10 μmol/L were defined as H-type hypertension. The TyG index was calculated as ln [triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. Multivariable logistic regression models and restricted cubic spline models were used to assess the association between TyG index and H-type hypertension in postmenopausal women, and subgroup analyses were performed for potential confounders.

Results

Of the 1,301 hypertensive patients, 634 (48.7%) participants had H-type hypertension. In each adjusted model, TyG index was significantly associated with the risk of H-type hypertension. each 1-unit increase in TyG index was associated with an increased risk of H-type hypertension in all participants (OR = 1.6; 95% CI, 1.3-2.0; P < 0.001), and there was a linear relationship between TyG index and H-type hypertension (P for linear trend < 0.001).

Conclusion

TyG index is positively associated with H-type hypertension in postmenopausal women, suggesting that TyG index may be a promising marker for H-type hypertension. By controlling lipid levels and blood glucose levels, it may help prevent H-type hypertension in postmenopausal women.

Advances in epigenetic research of adolescent idiopathic scoliosis and congenital scoliosis

Scoliosis is a three-dimensional structural deformity of the spine; more than 80% of scoliosis has no specific pathogenesis but is understood to be closely related to genetic, hormonal, and environmental factors. In recent years, the epigenetic alterations observed in scoliosis have been analyzed in numerous studies to determine the pathogenesis and progression of this condition, however, there is currently no comprehensive review of the epigenetic factors to date. We searched PubMed, Embase, and Web of Science databases for relative studies without language and date restrictions in March 2023. Twenty-five studies were included in this review and analyzed from the four main aspects of epigenetic alteration: DNA methylation, non-coding RNAs, histone modifications, and chromatin remodeling. The relationship between DNA methylation, non-coding RNAs, and scoliosis was considerably reported in the literature, and the corresponding related signaling pathways and novel biomarkers observed in scoliosis provide insights into innovative prevention and treatment strategies. However, the role of histone modifications is rarely reported in scoliosis, and few studies have investigated the relationship between scoliosis and chromatin remodeling. Therefore, these related fields need to be further explored to elucidate the overall effects of epigenetics in scoliosis.

Effect of K‑line on posterior cervical surgery versus anterior cervical surgery in patients with multi-level ossification of posterior longitudinal ligament

PURPOSE

To evaluate the influence of K-line on the outcome of open-door laminoplasty versus anterior cervical corpectomy decompression and fusion (ACCF) for patients with more than two levels of ossification of the posterior longitudinal ligament (OPLL).

METHODS

60 patients undergoing open-door laminoplasty and 62 patients undergoing ACCF from January 2013 to January 2020 with more than 2 years of follow-up were included. Eighty-four cases with the ossification mass not beyond the K-line were grouped as K-line (+), while thirty-eight cases were grouped as K-line (-). The operation time, intraoperative blood loss, hospital stay, preoperative, postoperative, and last follow-up JOA scores, and postoperative complications were investigated.

RESULTS

The improvement rate of JOA scores after posterior approaches in cases of group K-line (+) and K-line (-) was 72.4% and 53.1%, respectively, which showed a significant difference (P < 0.01). In group K-line (+), the improvement of JOA scores for open-door laminoplasty was 73.4% and 71.8% for ACCF, which showed no significant difference (P > 0.05). In group K-line (-), the improvement of JOA scores for ACCF was 52.1% and 42.9% for open-door laminoplasty, which showed a significant difference (P < 0.05). The incidence of C5 palsy was significantly lower in cases with ACCF than in cases with open-door laminoplasty (P < 0.05).

CONCLUSION

For patients with more than two levels of OPLL, preoperative K-line (+) predicates a better outcome than K-line (-). For cases with K-line (-), ACCF provides better neurologic function recovery. For patients with K-line (+), open-door laminoplasty provides the same neurologic function recovery of ACCF.

Adaptive visual-tactile fusion recognition for robotic operation of multi-material system

The use of robots in various industries is evolving from mechanization to intelligence and precision. These systems often comprise parts made of different materials and thus require accurate and comprehensive target identification. While humans perceive the world through a highly diverse perceptual system and can rapidly identify deformable objects through vision and touch to prevent slipping or excessive deformation during grasping, robot recognition technology mainly relies on visual sensors, which lack critical information such as object material, leading to incomplete cognition. Therefore, multimodal information fusion is believed to be key to the development of robot recognition. Firstly, a method of converting tactile sequences to images is proposed to deal with the obstacles of information exchange between different modalities for vision and touch, which overcomes the problems of the noise and instability of tactile data. Subsequently, a visual-tactile fusion network framework based on an adaptive dropout algorithm is constructed, together with an optimal joint mechanism between visual information and tactile information established, to solve the problem of mutual exclusion or unbalanced fusion in traditional fusion methods. Finally, experiments show that the proposed method effectively improves robot recognition ability, and the classification accuracy is as high as 99.3%.

[Electroencephalographic microstates in vestibular schwannoma patients with tinnitus]

OBJECTIVE

To explore the biomarkers of tinnitus in vestibular schwannoma patients using electroencephalographic (EEG) microstate technology.

METHODS

The EEG and clinical data of 41 patients with vestibular schwannoma were collected. All the patients were evaluated by SAS, SDS, THI and VAS scales. The EEG acquisition time was 10-15 min, and the EEG data were preprocessed and analyzed using MATLAB and EEGLAB software package.

RESULTS

Of the 41 patients with vestibular schwannoma, 29 patients had tinnitus and 12 did not have tinnitus, and their clinical parameters were comparable. The average global explanation variances of the non-tinnitus and tinnitus groups were 78.8% and 80.1%, respectively. The results of EEG microstate analysis showed that compared with those without tinnitus, the patients with tinnitus had an increased frequency (P=0.033) and contribution (P=0.028) of microstate C. Correlation analysis showed that THI scale scores of the patients were negatively correlated with the duration of microstate A (R=-0.435, P=0.018) and positively with the frequencies of microstate B (R=0.456, P=0.013) and microstate C (R=0.412, P=0.026). Syntax analysis showed that the probability of transition from microstate C to microstate B increased significantly in vestibular schwannoma patients with tinnitus (P=0.031).

CONCLUSION

EEG microstate features differ significantly between vestibular schwannoma patients with and without tinnitus. This abnormality in patients with tinnitus may reflect the potential abnormality in the allocation of neural resources and the transition of brain functional activity.

[Treatment of orbital vascular malformations with intralesional bleomycin injection and N-butyl-2-cyanoacrylate glue embolization]

Objective: To evaluate the clinical efficacy of bleomycin lavage combined with N-butyl-2-cyanoacrylate glue embolization and resection in the treatment of orbital vascular malformations. Methods: It was a retrospective case series study. Patients with orbital vascular malformations diagnosed at the Ophthalmology Division of Chinese PLA General Hospital from January 2018 to October 2021 were included and divided into exophthalmos group and non-exophthalmos group based on whether the patients had postural exophthalmos. Intralesional bleomycin injection and N-butyl-2-cyanoacrylate glue embolization were performed. The preoperative and postoperative visual acuity, the dosages of bleomycin and isobutyl cyanoacrylate glue, pathological results, imaging findings and remission rate were recorded and analyzed. The Chi-square test, Wilcoxon signed rank analysis and Mann-Whitney U test were used for statistical analysis. Results: A total of 58 patients (58 eyes)were included, and there were 22 males (37.9%)　and 36 females (62.1%). Nineteen (32.8%) patients had postural exophthalmos, and 39 (67.2%) patients did not suffer postural exophthalmos. The patient's age of the two groups was 39.0 (28.0, 54.5) years vs. 14.0 (5.7, 26.5) years, with a statistically significant difference (Z=-3.96, P<0.001). There was no significant difference in gender, eye laterality, follow-up time and the disease course between the two groups (all P>0.05). During the operation, the dosage of bleomycin was 15 000 (13 500, 15 000) U in the exophthalmos group, and 15 000 (9 000, 16 500) U in the non-exophthalmos group (Z=-0.70, P=0.944). The dosages of N-butyl-2-cyanoacrylate glue were 2.8 (1.0, 3.0) ml and 1.7 (1.0, 2.2) ml, respectively, in the two groups, with no significant difference (Z=-1.11, P=0.268). There was no visual impairment in both groups, while the visual acuity in 5 patients without postural exophthalmos was improved postoperatively. The imaging examination results showed no difference in the malformed vascular area before and after the treatment in the exophthalmos group [384.0 (329.0, 458.0) mm² vs. 330.5 (271.6, 356.7) mm²; Z=-1.26, P=0.208], but a significantly decreased area after the treatment in the non-exophthalmos group [960.8 (822.1, 1058.3) mm² vs. 311.6 (164.6, 361.6) mm²; Z=-2.67, P=0.008]. All patients had no obvious local or systemic adverse reactions during the follow-up. The pathology reports showed vascular malformations in all 15 specimens obtained from the exophthalmos group, as well as vascular malformations in 41.0% (16/39) of specimens and venous lymphatic malformations in 59.0% (23/39) of specimens from the non-exophthalmos group. Thirty-nine patients had complete remission (67.2%), 19 patients had partial remission (32.8%), and the effective treatment rate was 100%. Conclusion: Bleomycin lavage combined with N-butyl-2-cyanoacrylate glue embolization can achieve good therapeutic effects on orbital vascular malformations.

Zinc oxide nanoparticles inhibit osteosarcoma metastasis by downregulating β-catenin via HIF-1α/BNIP3/LC3B-mediated mitophagy pathway

Osteosarcoma (OS) therapy faces many challenges, especially the poor survival rate once metastasis occurs. Therefore, it is crucial to explore new OS treatment strategies that can efficiently inhibit OS metastasis. Bioactive nanoparticles such as zinc oxide nanoparticles (ZnO NPs) can efficiently inhibit OS growth, however, the effect and mechanisms of them on tumor metastasis are still not clear. In this study, we firstly prepared well-dispersed ZnO NPs and proved that ZnO NPs can inhibit OS metastasis-related malignant behaviors including migration, invasion, and epithelial-mesenchymal transition (EMT). RNA-Seqs found that differentially expressed genes (DEGs) in ZnO NP-treated OS cells were enriched in wingless/integrated (Wnt) and hypoxia-inducible factor-1 (HIF-1) signaling pathway. We further proved that Zn²⁺ released from ZnO NPs induced downregulation of β-catenin expression via HIF-1α/BNIP3/LC3B-mediated mitophagy pathway. ZnO NPs combined with ICG-001, a β-catenin inhibitor, showed a synergistic inhibitory effect on OS lung metastasis and a longer survival time. In addition, tissue microarray (TMA) of OS patients also detected much higher β-catenin expression which indicated the role of β-catenin in OS development. In summary, our current study not only proved that ZnO NPs can inhibit OS metastasis by degrading β-catenin in HIF-1α/BNIP3/LC3B-mediated mitophagy pathway, but also provided a far-reaching potential of ZnO NPs in clinical OS treatment with metastasis.

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Zn²⁺ released from bioactive ZnO NPs trigger OS metastasis inhibition.

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ZnO NPs inhibit OS metastasis through degrading β-catenin expression via HIF-1α/BNIP3/LC3B-mediated mitophagy pathway.

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Tissue microarray of OS patients detected higher β-catenin expression which confirmed the potential of ZnO NPs in clinical.

Adding sacral anchors through an S1 alar screw and multirod construct as a strategy for lumbosacral junction augmentation: an in vitro comparison to S1 pedicle screws alone with sacroiliac fixation

OBJECTIVE

Achieving solid fusion of the lumbosacral junction continues to be a challenge in long-segment instrumentation to the sacrum. The purpose of this study was to test the condition of adding sacral anchors through an S1 alar screw (S1AS) and multirod construct relative to using S1 pedicle screws (S1PSs) alone with sacroiliac fixation in lumbosacral junction augmentation.

METHODS

Seven fresh-frozen human lumbar-pelvic spine cadaveric specimens were tested under nondestructive moments (7.5 Nm). The ranges of motion (ROMs) in extension, flexion, left and right lateral bending (LB), and axial rotation (AR) of instrumented segments (L3-S1); the lumbosacral region (L5-S1); and the adjacent segment (L2-3) were measured, and the axial construct stiffness (ACS) was recorded. The testing conditions were 1) intact; 2) bilateral pedicle screw (BPS) fixation at L3-S1 (S1PS alone); 3) BPS and unilateral S2 alar iliac screw (U-S2AIS) fixation; 4) BPS and unilateral S1AS (U-S1AS) fixation; 5) BPS and bilateral S2AIS (B-S2AIS) fixation; and 6) BPS and bilateral S1AS (B-S1AS) fixation. Accessory rods were used in testing conditions 3-6.

RESULTS

In all directions, the ROMs of L5-S1 and L3-S1 were significantly reduced in B-S1AS and B-S2AIS conditions, compared with intact and S1PS alone. There was no significant difference in reduction of the ROMs of L5-S1 between B-S1ASs and B-S2AISs. Greater decreased ROMs of L3-S1 in extension and AR were detected with B-S2AISs than with B-S1ASs. Both B-S1ASs and B-S2AISs significantly increased the ACS compared with S1PSs alone. The ACS of B-S2AISs was significantly greater than that of B-S1ASs, but with greater increased ROMs of L2-3 in extension.

CONCLUSIONS

Adding sacral anchors through S1ASs and a multirod construct was as effective as sacropelvic fixation in lumbosacral junction augmentation. The ACS was less than the sacropelvic fixation but with lower ROMs of the adjacent segment. The biomechanical effects of using S1ASs in the control of long-instrumented segments were moderate (better than S1PSs alone but worse than sacropelvic fixation). This strategy is appropriate for patients requiring advanced lumbosacral fixation, and the risk of sacroiliac joint violation can be avoided.

[Comparison of time series and case-crossover analyses in environmental epidemiology]

Time-series and case-crossover are two main study designs in environmental epidemiology. However, due to the differences in design principles and model construction between the two analyses, the results of the two analyses may not be consistent. Herein, we examined the short-term effect of cold spells on cardiovascular mortality in Nanjing using both time series and case-crossover analyses, aiming to provide a basis for the selection of appropriate research design in environmental epidemiology.

Disentangling Diet- and Medium-Associated Microbes in Shaping Daphnia Gut Microbiome

Host genotype and environment are considered crucial factors in shaping Daphnia gut microbiome composition. Among the environmental factors, diet is an important factor that regulates Daphnia microbiome. Most of the studies only focused on the use of axenic diet and non-sterile medium to investigate their effects on Daphnia microbiome. However, in natural environment, Daphnia diets such as phytoplankton are associated with microbes and could affect Daphnia microbiome composition and fitness, but remain relatively poorly understood compared to that of axenic diet. To test this, we cultured two Daphnia magna genotypes (genotype-1 and genotype-2) in sterile medium and fed with axenic diet. To check the effects of algal diet-associated microbes versus free water-related microbes, Daphnia were respectively inoculated with three different inoculums: medium microbial inoculum, diet-associated microbial inoculum, and medium and diet-mixed microbial inoculum. Daphnia were cultured for 3 weeks and their gut microbiome and life history traits were recorded. Results showed that Daphnia inoculated with medium microbial inoculum were dominated by Comamonadaceae in both genotypes. In Daphnia inoculated with mixed inoculum, genotype-1 microbiome was highly changed, whereas genotype-2 microbiome was slightly altered. Daphnia inoculated with diet microbial inoculum has almost the same microbiome in both genotypes. The total number of neonates and body size were significantly reduced in Daphnia inoculated with diet microbial inoculum regardless of genotype compared to all other treatments. Overall, this study shows that the microbiome of Daphnia is flexible and varies with genotype and diet- and medium-associated microbes, but not every bacteria is beneficial to Daphnia, and only symbionts can increase Daphnia performance.

Association between body fat percentage and H-type hypertension in postmenopausal women

Background

Previous studies have explored the relationship between body fat percentage (BFP) and hypertension or homocysteine. However, evidence on the constancy of the association remains inconclusive in postmenopausal women. The aim of this study was to investigate the association between BFP and H-type hypertension in postmenopausal women.

Methods

This cross-sectional study included 1,597 eligible female patients with hypertension. Homocysteine levels ≥10 mmol/L were defined as H-type hypertension. BFP was calculated by measuring patients' physical parameters. Subjects were divided into 4 groups according to quartiles of BFP (Q1: 33.4% or lower, Q2: 33.4–36.1%, Q3: 36.1–39.1%, Q4: >39.1%). We used restricted cubic spline regression models and logistic regression analysis to assess the relationship between BFP and H-type hypertension. Additional subgroup analysis was performed for this study.

Results

Among 1,597 hypertensive patients, 955 (59.8%) participants had H-type hypertension. There were significant differences between the two groups in age, BMI, educational background, marital status, exercise status, drinking history, WC, TG, LDL, Scr, BUN, and eGFR (P < 0.05). The prevalence of H-type hypertension in the Q1 to Q4 groups was 24.9, 25.1, 24.9, and 25.1%, respectively. After adjusting for relevant factors, we found that the risk of H-type hypertension in the Q4 group had a significantly higher than the Q1 group (OR = 3.2, 95% CI: 1.3–7.5).

Conclusion

BFP was positively associated with the risk of H-type hypertension in postmenopausal women. Postmenopausal women should control body fat to prevent hypertension.

Model Selection for the Preclinical Development of New Drug-Radiotherapy Combinations

Radiotherapy plays an essential role in the treatment of more than half of all patients with cancer. In recent decades, advances in devices that deliver radiation and the development of treatment planning software have helped radiotherapy attain precise tumour targeting with minimal toxicity to surrounding tissues. Simultaneously, as more targeted drug therapies are being brought into the market, there has been significant interest in improving cure rates for cancer by adding drugs to radiotherapy to widen the therapeutic window, the difference between normal tissue toxicity and treatment efficacy. The development of new combination therapies will require judicious adaptation of preclinical models that are routinely used for traditional drug discovery. Here we highlight the strengths and weaknesses of each of these preclinical models and discuss how they can be used optimally to identify new and clinically beneficial drug-radiotherapy combinations.

Analysis of risk factors and prognosis of post-stroke pulmonary infection in integrated ICU

OBJECTIVE

The incidence of SAP (stroke-associated pneumonia) is high in integrated ICU (Intensive Care Unit), and it might result in sepsis, which exacerbates the clinical outcome and increases mortality. It is necessary to investigate the epidemiological features of post-stroke infection and sepsis, identify the risk factors and analyze the prognosis.

PATIENTS AND METHODS

We retrospectively analyzed the data of 329 patients with cerebral infarction or cerebral hemorrhage, from seven tertiary university hospitals in Suzhou, Jiangsu Province, between January 1, 2016, and December 31, 2016. Basic demographic and clinical data including common health evaluation, stroke severity, microbiological parameters, surgical interventions and treatments were recorded for the analysis. SAP was diagnosed according to the criteria and recommendation from American Heart Association (AHA).

RESULTS

188 (66.4%) patients suffered pneumonia, 124 patients were diagnosed as SAP. Compared with SAP, patients with non-SAP pulmonary infection had prolonged mechanical ventilation time, prolonged central venous catheter indwelling time, and higher incidence of sepsis (17.7% vs. 48.4%). 53 patients (18.7%) developed sepsis during hospitalization, whose mortality rate during hospitalization and the occurrence of neurologic dysfunction at 3 months were significantly increased (p<0.05). 130 positive results of sputum cultures were found. The detected pathogens were mainly gram-negative bacteria. The pathogenic detection rate of non-SAP patients with pulmonary infection was higher (78.1%). The in-hospital mortality was 16.3% and the related risk factors were higher NIHSS score at admission, lower GCS score at admission, pulmonary infection (especially non-SAP pulmonary infection) and sepsis during hospitalization.

CONCLUSIONS

The incidence of pulmonary infection after stroke in the integrated ICU is high, and it is easy to be complicated with sepsis, prolonging the mechanical ventilation time, central venous catheter indwelling time and hospitalization time, and the prognosis of long-term neurological function is relatively poor. The definition of stroke-associated pneumonia has implications for the classification of clinical infections, the prediction of possible pathogenic pathogens, and the guidance of anti-infective treatment.

MiR-16 inhibits proliferation of cervical cancer cells by regulating KRAS

OBJECTIVE

The aim of this study was to explore the effects of micro ribonucleic acid (miR)-16 on the proliferation and apoptosis of cervical cancer (CC) cells and its related regulatory mechanism.

MATERIALS AND METHODS

The downstream regulatory targets of miR-16 were analyzed based on the miRNA online database. HCC94 cells were selected as experimental objects. Subsequently, the cells were transfected with miR-16 mimic (miR-16 mimic group), miR-16 small interfering RNA (siRNA) (miR-16 siRNA group) and only Lipofectamine 2000 transfection reagent [blank control group and miR-16 normal control (NC) group]. The expression level of miR-16 in HCC94 cells was measured via quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Cell counting kit-8 (CCK-8) assay, 5-Ethynyl-2'-deoxyuridine (EdU) staining assay and flow cytometry were then conducted to detect the effects of miR-16 on the viability, proliferation and apoptosis of HCC94 cells, respectively. Additionally, the effect of miR-16 on the protein expression level of Kirsten rat sarcoma viral oncogene homolog (KRAS) in HCC94 cells was determined via Western blotting.

RESULTS

MiRNA online database analysis showed that KRAS was the downstream target of miR-16. Compared with miR-16 NC group, the viability and proliferation ability of HCC94 cells increased significantly in miR-16 siRNA group but decreased significantly in miR-16 mimic group (p<0.05). However, the apoptosis rate evidently declined in miR-16 siRNA group while increased remarkably in miR-16 mimic group (p<0.05). In addition, the protein expression level of KRAS in HCC94 cells was significantly higher in miR-16 siRNA group but significantly lower in miR-16 mimic group when compared with miR-16 NC group (p<0.05).

CONCLUSIONS

MiR-16 is lowly expressed in HCC94 cells. Moreover, highly expressed miR-16 represses the viability and proliferation of HCC94 cells and promotes their apoptosis by targeted regulation on KRAS.

A184 INCIDENCE OF VENOUS THROMBOTIC EVENTS AND RISK FACTORS IN CHILDREN HOSPITALIZED WITH INFLAMMATORY BOWEL DISEASE: A RETROSPECTIVE, CASE-CONTROL STUDY

Background

Limited research has been published to describe the incidence of venous thromboembolism (VTE) and relevant risk factors in Canadian children with inflammatory bowel disease (IBD).

Aims

The present study aimed to investigate the incidence of VTE amongst hospitalized pediatric IBD patients over a 10-year period and identify risk factors for the development of VTE.

Methods

A retrospective, matched case-control study was performed at McMaster Children’s Hospital. Hospitalized pediatric patients with IBD (&lt;18 years old) from September 2009 to August 2020 were selected. Inpatient data was extracted from the medical record database, including baseline demographic data, thromboembolic events and potential risk factors for VTE.

Results

There were 890 hospitalizations of IBD patients during the study period. 15 (1.69%) were diagnosed with a VTE, including 4 males and 11 females (mean age 13.4±2.9 years old). 12 ulcerative colitis (UC) (80%) and 3 Crohn’s disease (CD) (20%) hospitalizations were comprised in the VTE group. There was a significant difference in VTE rate between females (2.7%) and males (0.8%) (P = 0.03). The VTE rate in the UC group (4.2%) was significantly higher than in the CD group (0.6%) (P = 0.001). The incidence of VTE amongst hospitalized IBD patients did not vary over the 10-year period (P = 0.496). Length of stay in hospital, albumin level and central venous catheter were shown to be significantly different, although they were not identified as independent risk factors (P &gt;0 .05). Of the 15 hospitalizations with VTE, 6/15 (40%) were superficial VTEs in the extremities and 9/15 (60%) had a deep vein thrombosis (DVT) including 6 in the extremities and 3 in the abdomen. VTEs were associated with a peripheral line in 7 patients and with a PICC line in 4 hospitalizations. 2 of 9 (22%) with extremity DVT developed symptomatic pulmonary embolism. An inherited thrombotic condition was identified in 2 of 15 with VTEs. 12/15 (80%) with VTEs were symptomatic and all VTE related symptoms happened in patients with extremity thrombosis and pulmonary embolism. 7 of 15 (47%) VTEs were treated with anticoagulation therapy for 1–6 months. VTE related symptoms and repeat imaging tests significantly improved, and no patient developed a bleeding complication as a result of treatment.

Conclusions

The VTE rate in pediatric IBD patients was relatively low at McMaster Children’s hospital. Children with VTE were disproportionately females with ulcerative colitis compared with children with no VTE. Central venous line insertion may be correlated with the risk for VTE in children with IBD. Most VTEs and related symptoms happened in patients with extremity thrombosis and secondary pulmonary embolus. Anticoagulation therapy in children with IBD with active disease appears to be safe.

Funding Agencies

Kids Dig Health Funding from McMaster Children’s Hospital, McMaster University

Supplemental iodine-containing prenatal multivitamins use and the potential effects on pregnancy outcomes in a mildly iodine-deficient region

PURPOSE

The use and contribution of prenatal multivitamins (PMV) as iodine source for pregnant women in China, especially in mildly iodine-deficient region, have not been well studied. This study aimed to explore the association between PMV intake during pregnancy and thyroid function in mothers and newborns.

METHODS

We performed a study involving women with a history of taking PMV during pregnancy between January 2013 and October 2015, in Shanghai, a mildly iodine-deficient region. Maternal thyroid function in early and late pregnancy, and neonatal TSH on postnatal d 3 were obtained from medical records. We compared the outcomes in pregnant women who took exclusively iodine-containing PMV (I + PMV) with those who took exclusively non-contained PMV (I- PMV). Propensity score matching (PSM) was used to identify women with similar baseline characteristics.

RESULTS

After PSM, 1280 women in I + PMV and 2560 in I- PMV had similar propensity scores and were included in the analyses. Introduction of I + PMV to women was associated with slightly higher maternal thyroid hormone production (higher maternal FT4, p = 0.01, non-significantly lower TSH, p = 0.79) and lower neonatal TSH levels (p < 0.0001). The frequency of adverse pregnancy outcomes or thyroid dysfunctions did not differ between groups in late pregnancy. Mothers received I + PMV (0.2 SD) had a stronger association of maternal TSH with neonatal TSH than those who received I- PMV (0.1 SD). These effects were only shown in TPOAb-negative mothers, not in TPOAb-positive mothers.

CONCLUSION

TPOAb-positive women display an impaired iodine transport in thyroid and placenta, and this may explain the lack of changes in maternal and neonatal thyroid parameters with I + PMV supplementation in these women. This phenomenon might suggest that these women require different iodine doses or treatment approach in comparison with TPOAb-negative women.

[Consistency of effective orifice area of prosthetic mitral valve estimated using 2-dimensional and 3-dimensional transesophageal echocardiography]

OBJECTIVE

To analyze the consistency of effective orifice area (EOA) of prosthetic mitral valve estimated using 2- dimensional (2D) and 3-dimensional (3D) transesophageal echocardiography (TEE).

OBJECTIVE

This study was conducted among 34 patients undergoing mitral valve replacement surgery in Nanjing First Hospital between March and June in 2019. The diameter of the left ventricular outflow tract (LVOT) measured by 2D-TEE was used to calculate the cross sectional area of LVOT (CSALVOT). In 3D-TEE method, LVOT area was measured directly by planimetry on an enface view. The EOAs of the prosthetic mitral valve were calculated for both methods using the continuity equation. Bland-Altman plot consistency test was used to analyze the consistency between the two sets of EOA results, and linear regression analysis was used to analyze their correlation.

OBJECTIVE

The EOA of the prosthetic mitral valve differed significantly between 2D method and 3D method (2.22±0.71 cm² vs 2.35±0.70 cm², P < 0.001) with a mean difference of -0.14±0.20 cm² and 95% coherence boundaries of (-0.53, 0.25 cm²). The regression equation for EOA-3D and EOA-2D is y=0.27 + 0.94x, showing a good correlation between the two methods.

OBJECTIVE

EOA estimation of the prosthetic mitral valve using 2D and 3D TEE has a good consistency, and the results estimated by the 2D method are slightly lower by about 6% than those by the 3D method.

Hsa_circ_0005075 predicts a poor prognosis and acts as an oncogene in colorectal cancer via activating Wnt/β-catenin pathway

OBJECTIVE

Emerging evidence has demonstrated vital regulation of circular RNAs (circRNAs) on tumorigenesis and progression of tumors. Abnormally expressed circRNAs hsa_circ_0005075 (circ_0005075) has been reported in several tumors. In this study, we aimed to explore the expression profiles, prognostic value, and potential function of circ_0005075 in colorectal cancer (CRC) PATIENTS AND METHODS: RT-PCR was used to detect the expression of circ_0005075 in both CRC tissues and cell lines. The associations between circ_0005075 expression and clinicopathological features and clinical prognosis were statistically analyzed. The effects of circ_0005075 on CRC cells were evaluated by Cell Counting Kit-8 (CCK-8), colony formation assays, Flow cytometer, and transwell assays. Western blot was performed to explore whether circ_0005075 modulated the Wnt/β-catenin pathway.

RESULTS

We observed that circ_0005075 expression was significantly up-regulated in both CRC tissues and cell lines. Then, clinical assays indicated that high circ_0005075 expression was significantly associated with histology/differentiation, depth of invasion, advanced TNM stage, and shorter overall survival and disease-free survival of CRC patients. Cellular studies indicated that circ_0005075 can enhance the proliferation, migration, and invasion capacities of CRC cells, thereby promoting tumor progression. Further mechanistic investigation showed that circ_0005075 displayed its tumor-promotive roles through activating Wnt/β-catenin pathway.

CONCLUSIONS

Our present data revealed circ_0005075 as a potential molecular marker and target for the prognosis and treatment of CRC patients.

Comparison of contrast-enhanced ultrasound and contrast-enhanced computed tomography for the diagnosis of cervical lymph node metastasis in squamous cell carcinoma of the oral cavity

Early detection of cervical lymph node metastasis (CLNM) from squamous cell carcinoma (SCC) of the oral cavity remains challenging. This prospective study was performed to evaluate the ability of contrast-enhanced ultrasound (CEUS) to detect CLNM from oral cavity SCC. Additionally, its diagnostic value was compared with that of contrast-enhanced computed tomography (CECT). Forty-eight consecutive patients with SCC of the oral cavity were enrolled. All subjects were examined preoperatively with both CEUS and CECT. Subsequently, neck dissections were performed for these patients, and cervical lymph nodes separated from the surgical specimens were assessed histologically. The diagnostic performance of these two examinations was compared based on the results of histopathology. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and Youden index for CEUS and CECT were 69.39% vs. 44.90%, 94.71% vs. 97.12%, 89.88%% vs. 87.16%, 75.56% vs. 78.57%, 92.92% vs. 88.21%, and 64.10% vs. 42.02%, respectively. A significant difference was observed in terms of sensitivity (P=0.024) and Youden index (rate difference 22.08%, 95% confidence interval 2.72-41.44%). Therefore, CEUS appears to be a promising diagnostic tool that is superior to CECT for detecting CLNM from SCC of the oral cavity, with a higher sensitivity.

Sex modulates the apolipoprotein E ε4 effect on white matter and cortical functional connectivity in individuals with amnestic mild cognitive impairment

BACKGROUND AND PURPOSE

Recent studies from the Alzheimer's Disease Neuroimaging Initiative show that, in the USA, 75% of patients with Alzheimer's disease are female. To date, there have rarely been any attempts to analyze data by sex or gender, which limits the potential for discovering the effects of sex or gender on disease. Little evidence is available regarding the effect of gender and apolipoprotein E (APOE) ε4 on white matter (WM) connection from the functional perspective due to the lack of appropriate techniques for detecting blood-oxygen-level-dependent signals in WM.

METHODS

We took advantage of a new framework known as functional tensor imaging to investigate the effect of sex and APOEε4 on WM cortical functional connectivity throughout the brain.

RESULTS

In a group of female patients with amnestic mild cognitive impairment, we found a significantly reduced functional connectivity in the left posterior limb of the internal capsule, left superior fronto-occipital fasciculus, bilateral temporopolar area and right somatosensory association cortex in APOEε4 carriers in contrast to non-carriers. We also found a significant APOEε4 by sex interaction effect on the right somatosensory association cortex, left temporopolar area and left superior temporal gyrus. The clinical Montreal Cognitive Assessment score was significantly negatively associated with the right somatosensory association cortex with APOEε4 by sex interaction in males.

CONCLUSIONS

These results indicate that increased APOE-related risk in women may be associated with decreased activity in both gray matter and WM in patients with amnestic mild cognitive impairment compared with men. The finding suggests accounting for sex differences in neuroimaging biomarkers, diagnostics and treatment strategy.

MiR-203 over-expression promotes prostate cancer cell apoptosis and reduces ADM resistance

The article "MiR-203 over-expression promotes prostate cancer cell apoptosis and reduces ADM resistance, by Chen LZ, Ding Z, Zhang Y, He ST, Wang XH, published in Eur Rev Med Pharmacol Sci. 2018 Jun;22(12):3734-3741. DOI: 10.26355/eurrev_201806_15253. PMID: 29949147" has been withdrawn from the authors. The Publisher apologizes for any inconvenience this may cause.

Three-dimensional reconstruction method based on bionic active sensing in precision assembly

With the prevailing application of new materials and the higher requirements for the quality and efficiency of production in the equipment manufacturing industry, traditional assembly methods can hardly meet the needs of large-scale production, especially in the field of high-precision assembly. Robot assembly guided by visual perception has become the key of the research in the field of engineering technology. It requires higher accuracy of robot visual perception and the control over force, position and so on. However, in 3C assembly, most products are made of transparent materials such as glass. Because of the transparency and specular reflection of the surface, 3D reconstruction of transparent objects is a very difficult problem in computer vision, in that the traditional visual perception methods could not be accurate enough. The present research proposes a bionic active sensing algorithm for 3D perception and reconstruction and realizes high-precision 3D by applying the registration algorithm. The purpose is to solve the problems existing in the traditional visual perception method, such as difficulties in achieving active sensing, low accuracy of point clouds registration, and complex computation. The results of the experiments show that the present method is efficient and accurate in 3D reconstruction. It reduces the planar reconstruction error to 0.064 mm and the surface reconstruction error to 0.177 mm.

MiR-203 over-expression promotes prostate cancer cell apoptosis and reduces ADM resistance

OBJECTIVE

Extra-cellular signal regulated kinase (ERK)/mitogen activated protein kinase (MAPK) signaling pathway is widely involved in cell proliferation, apoptosis, and drug resistance. MAPK kinase 1 (MEK1) is the upstream protein kinase of ERK that can activate ERK/MAPK signaling pathway. microRNA 203 (MiR-203) down-regulation is found to be associated with prostate cancer pathogenesis. Bioinformatics analysis showed the complementary targeted relationship between miR-203 and the 3'-UTR of MEK1 mRNA. This study explored the role of miR-203 in regulating prostate cancer cell proliferation, apoptosis, and ADM resistance through affecting MEK1 expression.

MATERIALS AND METHODS

Dual luciferase assay confirmed the targeted relationship between miR-203 and MEK1. MiR-203, MEK1, p-ERK1/2, and B cell lymphoma 2 (Bcl-2) expressions were compared in normal prostate epithelial cells PrEC, prostate cancer cells PC-3M, and drug resistance cells PC-3M/ADM. PC-3M, PC-3M/ADM cell apoptosis and proliferation were detected by using flow cytometry under ADM treatment at IC50 concentration of PC-3M cells. PC-3M cells were cultured in vitro and divided into four groups, including microRNA-normal control (miR-NC), miR-203 mimic, small interfere NC (si-NC), and si-MEK1.

RESULTS

MiR-203 targeted and inhibited MEK1 expression. MiR-203 levels and cell apoptosis were significantly lower, while MEK1, p-ERK1/2, Bcl-2, and cell proliferation were significantly higher in PC-3M/ADM cells compared to the PC-3M cells. MiR-203 mimic and/or si-MEK1 transfection significantly reduced MEK1, p-ERK1/2, and Bcl-2 levels, attenuated cell proliferation, induced cell apoptosis, and decreased drug resistance.

CONCLUSIONS

MiR-203 elevation suppressed prostate cancer PC-3M cell proliferation, promoted apoptosis, and weakened ADM resistance through targeted inhibiting MEK1 expression to alleviate ERK/MAPK signaling pathway and Bcl-2 expression.

Observation of second sound in graphite at temperatures above 100 K

Wavelike thermal transport in solids, referred to as second sound, is an exotic phenomenon previously limited to a handful of materials at low temperatures. The rare occurrence of this effect restricted its scientific and practical importance. We directly observed second sound in graphite at temperatures above 100 kelvins by using time-resolved optical measurements of thermal transport on the micrometer-length scale. Our experimental results are in qualitative agreement with ab initio calculations that predict wavelike phonon hydrodynamics. We believe that these results potentially indicate an important role of second sound in microscale transient heat transport in two-dimensional and layered materials in a wide temperature range.

Imaging features of metanephric adenoma and their pathological correlation

AIM

To analyse the imaging features of metanephric adenoma (MA) and their pathological correlation.

MATERIALS AND METHODS

The imaging findings in 11 patients with MA were studied retrospectively. Ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) findings were studied in seven, 11, and six patients, respectively. The enhancement pattern, attenuation, lesion location, size, cystic or solid appearance, capsule sign, and presence of calcifications were evaluated.

RESULTS

On ultrasonography, MA presented as hypoechoic (4/7), slightly hyperechoic (1/7), isoechoic (2/7), and with a clear boundary. Unenhanced CT showed unclear boundaries (11/11), homogeneous isodensity (8/11), with calcification (1/11), necrosis (1/11), and heterogeneous hyperattenuation (1/11). Mean CT attenuation values on unenhanced and enhanced CT (cortical phase, corticomedullary phase, and excretory phase) were 38.87±6.66, 55.71±17.74, 67.77±16.86, and 65.62±15.99 HU, respectively. The degree of enhancement of the lesions in each phase was statistically significantly lower than that of the surrounding normal renal parenchyma (p=0.00). The pattern of enhancement of the solid component was slight and gradual enhancement (9/11). The tumour was located entirely within the renal medulla in nine cases, and two cases demonstrated an exophytic pattern. All tumours showed a clear boundary on enhanced CT, but capsules were not found. The mean greatest tumour diameter was 3.5 cm. MA showed markedly hyperintense on the diffusion-weighted MRI sequence (DWI) and delayed enhancement of the tumour capsule on enhanced MRI.

CONCLUSIONS

Imaging features of MA are usually solid and hypovascular, and show prolonged, and homogeneous mild enhancement that is less than that of the surrounding normal renal parenchyma in all phases. MA is markedly hyperintense on DWI.

Physcion 8-O-β-glucopyranoside prevents hypoxia-induced epithelial-mesenchymal transition in colorectal cancer HCT116 cells by modulating EMMPRIN

Epithelial-mesenchymal transition (EMT) is considered as the most important mechanism that underlies the initiation of cancer metastasis. Here we report that Physicon 8-O-β-glucopyranoside (PG), a major active ingredient from a traditional Chinese herbal medicine Rumex japonicus Houtt, is capable of preventing human colorectal cancer cells from hypoxia-induced EMT. The treatment of the cells with PG reversed the EMT-related phenotype that has the morphological changes, down-regulation of E-cadherin, and hypoxia-induced cell migration and invasion. The effect was mediated at least in part by inhibiting the mRNA and protein expressions of EMMPRIN via modulation of PTEN/Akt/HIF-1α pathway. In addition, we found that PG-mediated prevention of EMT involved blockade of the hypoxia-induced up-regulation of Snail, Slug and Twist. In summary, this study showed that PG can prevent EMT induced by hypoxia, the environment that commonly exists in the center of a solid tumor. Given the low toxicity of PG to the healthy tissues, our study suggests that PG can serve as a safe therapeutic agent for suppressing cancer metastasis.

Long-term immunogenicity and immune persistence of live attenuated and inactivated hepatitis a vaccines: a report on additional observations from a phase IV study

Both live attenuated (HA-L) and inactivated (HA-I) hepatitis A vaccine were licensed for routine use in China. Although phase 1, 2 and 3 clinical studies of both vaccines have been completed, further systematic evaluation of their immunogenicity and immunological persistence under phase 4 clinical studies in a wide range of conditions and involving large populations is necessary. A phase IV clinical trial (NCT02601040) was performed in 9000 participants over 18 months of age. Geometric mean concentrations (GMCs) and seroconversion rates (SRs) were compared at five time points during 3 years for 1800 individuals among them. The SRs of HA-L and HA-I were 98.08% (95% CI 95.59%-99.38%) and 99.64% (95% CI 98.93%-100.00%) respectively 28 days after administration of the first dose, and remained at 97.07% (95% CI 94.31%-98.73%) or above and 96.73% (95% CI 94.07%-98.42%) or above respectively during the following 3 years. The GMCs for both the HA-L and HA-I groups showed that both vaccines elicited high anti-HAV titres, considerably more than the threshold of protection needed against HAV infection in humans, and these titres were sustained. Hence, both HA-I and HA-L vaccines could provide an excellent long-term protective effect, and supported the routine use of both vaccines.

Clinical and molecular insights into Glanzmann's thrombasthenia in China

Glanzmann's thrombasthenia (GT) is a rare bleeding disorder characterized by spontaneous mucocutaneous bleeding. The disorder is caused by quantitative or qualitative defects in integrin αIIbβ3 (encoded by ITGA2B and ITGB3) on the platelet and is more common in consanguineous populations. However, the prevalence rate and clinical characteristics of GT in non-consanguineous populations have been unclear. We analyzed 97 patients from 93 families with GT in the Han population in China. This analysis showed lower consanguinity (18.3%) in Han patients than other ethnic populations in GT-prone countries. Compared with other ethnic populations, there was no significant difference in the distribution of GT types. Han females suffered more severe bleeding and had a poorer prognosis. We identified a total of 43 different ITGA2B and ITGB3 variants, including 25 previously unidentified, in 45 patients. These variants included 14 missense, 4 nonsense, 4 frameshift, and 3 splicing site variants. Patients with the same genotype generally manifested the same GT type but presented with different bleeding severities. This suggests that GT clinical phenotype does not solely depend on genotype. Our study provides an initial, yet important, clinical and molecular characterization of GT heterogeneity in China.

Microstructures, mechanical, and biological properties of a novel Ti-6V-4V/zinc surface nanocomposite prepared by friction stir processing

Background

The interaction between the material and the organism affects the survival rate of the orthopedic or dental implant in vivo. Friction stir processing (FSP) is considered a new solid-state processing technology for surface modification.

Purpose

This study aims to strengthen the surface mechanical properties and promote the osteogenic capacity of the biomaterial by constructing a Ti-6Al-4V (TC4)/zinc (Zn) surface nanocomposites through FSP.

Methods

FSP was used to modify the surface of TC4. The microstructures and mechanical properties were analyzed by scanning electron microscopy, transmission electron microscopy, nanoindentation and Vickers hardness. The biological properties of the modified surface were evaluated by the in vitro and in vivo study.

Results

The results showed that nanocrystalline and numerous β regions, grain boundary α phase, coarser acicular α phase and finer acicular martensite α′ appeared because of the severe plastic deformation caused by FSP, resulting in a decreased elastic modulus and an increased surface hardness. With the addition of Zn particles and the enhancement of hydrophilicity, the biocompatibility was greatly improved in terms of cell adhesion and proliferation. The in vitro osteogenic differentiation of rat bone marrow stromal cells and rapid in vivo osseointegration were enhanced on the novel TC4/Zn metal matrix nanocomposite surface.

Conclusion

These findings suggest that this novel TC4/Zn surface nanocomposite achieved by FSP has significantly improved mechanical properties and biocompatibility, in addition to promoting osseointegration and thus has potential for dental and orthopedic applications.

Estrogen-dependent association of HDAC4 with fear in female mice and women with PTSD

Women are at increased risk of developing post-traumatic stress disorder (PTSD) following a traumatic event. Recent studies suggest that this may be mediated, in part, by circulating estrogen levels. This study evaluated the hypothesis that individual variation in response to estrogen levels contributes to fear regulation and PTSD risk in women. We evaluated DNA methylation from blood of female participants in the Grady Trauma Project and found that serum estradiol levels associates with DNA methylation across the genome. For genes expressed in blood, we examined the association between each CpG site and PTSD diagnosis using linear models that adjusted for cell proportions and age. After multiple test correction, PTSD associated with methylation of CpG sites in the HDAC4 gene, which encodes histone deacetylase 4, and is involved in long-term memory formation and behavior. DNA methylation of HDAC4 CpG sites were tagged by a nearby single-nucleotide polymorphism (rs7570903), which also associated with HDAC4 expression, fear-potentiated startle and resting-state functional connectivity of the amygdala in traumatized humans. Using auditory Pavlovian fear conditioning in a rodent model, we examined the regulation of Hdac4 in the amygdala of ovariectomized (OVX) female mice. Hdac4 messenger RNA levels were higher in the amygdala 2 h after tone-shock presentations, compared with OVX-homecage control females. In naturally cycling females, tone-shock presentations increased Hdac4 expression relative to homecage controls for metestrous (low estrogen) but not the proestrous (high estrogen) group. Together, these results support an estrogenic influence of HDAC4 regulation and expression that may contribute to PTSD in women.

Co-occurrence of DSM-IV mental disorders and alcohol use disorder among adult Chinese males

BACKGROUND

Studies from high-income countries report moderate-to-strong positive associations between alcohol use disorder (AUD) and other mental disorders, but there is little evidence about the comorbidity of AUD from low-and-middle-income countries.

METHODS

A sample of 74 752 adults from five provinces that account for >12% of China's adult population was screened using the General Health Questionnaire, and the Structured Clinical Interview for DSM-IV was administered by psychiatrists to a subsample of 9619 males. The associations between AUD and other mental disorders at each site and the characteristics of men with AUD with and without comorbid mental disorders were estimated using logistic regression and summarized across sites using meta-analysis. Generalized estimation equations estimated the associations between the clinical features of alcohol dependence and comorbidity.

RESULTS

Robust inverse associations were found between current AUD and any mood disorder (adjusted OR = 0.6, 95% CI = 0.4-0.8) and any anxiety disorder (OR = 0.5, 95% CI = 0.3-1.0). Compared with men without AUD, men with AUD without comorbid disorders were more likely to be middle-aged, to be currently married, and to have higher family incomes. Men with comorbid AUD and other disorders were more likely to have the clinical features of alcohol dependence than men with AUD without comorbid disorders.

CONCLUSIONS

Inverse associations between AUD and other mental disorders and the higher social status of men with AUD than men without AUD found in this large, representative sample of community-dwelling Chinese males highlight the importance of considering the local substance-use culture when designing clinical or preventive interventions for addictive conditions.