Effect of miR-133 on apoptosis of trophoblasts in human placenta tissues via Rho/ROCK signaling pathway

OBJECTIVE

The aim of this study was to explore the role of micro ribonucleic acid (miR)-133 in the apoptosis of human placental trophoblasts through the Ras homolog gene family (Rho)/Rho-associated coiled-coil forming protein kinase (ROCK) signaling pathway.

PATIENTS AND METHODS

The plasma samples were collected from 30 patients with pre-eclampsia (PE) undergoing treatment and 30 healthy subjects (control group) who received physical examination in our hospital. The Reverse Transcription-Polymerase Chain Reaction (RT-PCR) was utilized to measure the expression of miR-133 in PE patients and healthy people. Meanwhile, blood pressure, urine protein content, liver function, and kidney function were detected in patients of both groups as well. Subsequently, the placental trophoblasts were extracted and transfected with inhibitors and miRNA mimics to suppress and overexpress miR-133, respectively. The transfection efficiency was determined by RT-PCR. The levels of interleukin-6 (IL-6), IL-1, and tumor necrosis factor-alpha (TNF-α) were measured in both groups. The terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) assay was performed to determine the apoptosis of trophoblasts. Next, the RT-PCR and Western blotting were carried out to detect the expressions of the Rho/ROCK pathway. Furthermore, the influence of miR-133 on the apoptosis of trophoblasts in human placenta tissues through Rho/ROCK was comprehensively observed.

RESULTS

In vivo experiments demonstrated that the urinary protein content, miR-133 level, systolic blood pressure, diastolic blood pressure, and liver function and renal function indexes were significantly elevated in pre-eclampsia (PE) patients in comparison with normal subjects (p<0.05). After transfection of mimics and inhibitors, the expression of miR-133 was remarkably up- and down-regulated, respectively. The content of the inflammatory factors in miR-133 mimics group was overtly higher than the other two groups. The TUNEL staining results showed that the number of apoptotic cells significantly increased and decreased in the miR-133 mimics group and miR-133 inhibitors group, respectively. Subsequent experiments indicated that the expressions of apoptosis gene Caspase3, pathway gene, and protein ROCKI were notably up-regulated in miR-133 mimics group. However, they were evidently down-regulated in miR-133 inhibitors group than in the control group. In addition, a consistent trend was observed in the protein expression level.

CONCLUSIONS

MiR-133 participates in the development and progression of PE through the Rho/ROCK signaling pathway, which may affect the apoptosis of trophoblasts in the placenta tissues.

[A long-term follow-up study on the occurrence of heterotopic ossification after artificial cervical disc replacement with Discover disc]

Objective: To analyze the incidence of heterotopic ossification after artificial cervical disc replacement with Discover disc, and to explore the effect of heterotopic ossification on postoperative radiological and clinical efficacy. Methods: From January 2010 to January 2015, 45 patients with cervical spondylosis underwent single-level artificial cervical disc replacement in Shanghai Changzheng Hospital, including 29 cases of cervical spondylotic myelopathy, 11 cases of cervical spondylotic radiculopathy and 5 cases of mixed cervical spondylosis. At the last follow-up, Mehren grading method was used for classification of heterotopic ossification, among which, grade 0-Ⅱ was defined as low grade ossification group, and 26 patients (16 male, 10 female) were enrolled in this group; grade Ⅲ-Ⅳ was defined as high grade ossification group, and 19 patients (12 males, 7 females) were included in this group. C(2-7) Cobb angle, cervical total range of motion and range of motion at index level were used to evaluate the radiological outcomes of the two groups. Japanese Orthopaedic Association (JOA) score, neck disability index (NDI) score and visual analogue scale (VAS) were used to evaluate the clinical outcomes of the two groups. The adjacent segment intervertebral disc height and range of motion were used to evaluate the effects of heterotopic ossification on adjacent segment. Results: All patients were followed up regularly for (98±18) months. There were no statistical differences between the two groups regarding to demographic data (all P>0.05). There was no significant differences in C(2-7) Cobb angle and total range of motion between the two groups at the last follow-up (all P>0.05), but range of motion at index level in the group with low grades was significantly higher than that in the group with high grades (7.8°±6.2° vs 2.6°±1.2°, t=3.60, P<0.05). There was no significant differences in JOA score, recovery rate and NDI score between the two groups (all P>0.05). There was no significant differences in the adjacent segment intervertebral disc height before operation and at the last follow-up (both P>0.05). There was no significant differences in range of motion at adjacent segment before operation (P>0.05), while range of motion at adjacent segment in the group with low grades was significantly lower than that in the group with high grades (9.5°±1.1° vs 10.6°±1.8° and 9.4°±1.4° vs 10.5°±1.7°, repectively, t=2.54, 2.31, both P<0.05). Conclusions: Heterotopic ossification does not affect the clinical outcomes, cervical curvature and cervical total range of motion after artificial cervical disc replacement with Discover disc. However, the higher grade of heterotopic ossification, the lower range of motion at index level and the higher range of motion at adjacent segment.

Circ-ZNF609 promotes carcinogenesis of gastric cancer cells by inhibiting miRNA-145-5p expression

OBJECTIVE

To elucidate the expression pattern and biological function of circular RNA ZNF609 (circ-ZNF609) in gastric cancer (GC).

PATIENTS AND METHODS

Circ-ZNF609 expression in GC tissues and adjacent normal tissues (ANT) was determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The regulatory effect of circ-ZNF609 on growth and metastasis of GC cells was evaluated through the Cell Counting Kit-8 (CCK-8), colony formation and transwell invasion assay, respectively. GC cell apoptosis influenced by circ-ZNF609 was examined by flow cytometry. The binding between circ-ZNF609 and miRNA-145-5p was verified by the Dual-Luciferase reporter gene assay. Finally, a series of rescue experiments were conducted to explore the mechanism of the circ-ZNF609/miRNA-145-5p axis in regulating GC progression.

RESULTS

QRT-PCR data revealed a higher level of circ-ZNF609 in GC tissues relative to ANT. Identically, circ-ZNF609 was highly expressed in GC cell lines relative to controls. The knockdown of circ-ZNF609 in BGC823 and MGC803 cells suppressed proliferative and invasive abilities. MiRNA-145-5p was predicted to be the target gene of circ-ZNF609 by bioinformatics, and further verified by the Dual-Luciferase reporter gene assay. Rescue experiments showed that miRNA-145-5p knockdown partially reversed the regulatory effect of circ-ZNF609 on growth and metastasis of GC cells.

CONCLUSIONS

Circ-ZNF609 promotes proliferative and invasive abilities of gastric cancer cells by inhibiting miRNA-145-5p expression as a ceRNA, thus accelerating gastric cancer progression.

MicroRNA-374b inhibits migration and invasion of glioma cells by targeting EGFR

OBJECTIVE

To investigate the expression level of microRNA-374b in glioma tissues and its influence on the invasive ability of glioma cells. Meanwhile, the regulatory mechanism of microRNA-374b in glioma was also explored.

PATIENTS AND METHODS

The expression level of microRNA-374b in 32 glioma tissues and para-cancerous tissues were detected by quantitative Real-time polymerase chain reaction (qRT-PCR). The relationship between microRNA-374b expression and clinical indicators of glioma was analyzed. Meanwhile, the expression of microRNA-374b in glioma cells was verified by qRT-PCR as well. Subsequently, microRNA-374b over-expression model was constructed in glioma cell lines, including U251 and U87. Next, the effect of microRNA-374b on cellular biological functions was analyzed using cell counting kit-8 (CCK-8) assay, Wound healing test and transwell invasion assay, respectively. Finally, the relationship between miRNA and epidermal growth factor receptor (EGFR) was explored.

RESULTS

QRT-PCR results showed that the expression level of microRNA-374b in glioma was significantly lower than that of adjacent tissues, and the difference was statistically significant. Compared with patients with higher expression of microRNA-374b, the occurrence rate of lymph node or distant metastasis was significantly higher in those with lower microRNA-374b expression. In addition, compared with NC group, the proliferation, invasion and migration abilities of cells in microRNA-374b mimics group was significantly decreased. Subsequently, results demonstrated that the expression of EGFR was significantly increased in glioma cells and tissues, which was negatively correlated with microRNA-374b expression. Subsequent cell recovery experiment indicated that microRNA-374b and EGFR had a mutual regulation and could affect the malignant progression of glioma all together.

CONCLUSIONS

MicroRNA-374b could inhibit the invasion and migration of glioma by regulating EGFR. Moreover, the expression of microRNA-374b was significantly associated with lymph node metastasis, distant metastasis and poor prognosis.

Qualitative and quantitative measures of prefemoral and quadriceps fat pads are associated with incident radiographic osteoarthritis: data from the Osteoarthritis Initiative

OBJECTIVE

To determine if qualitative and quantitative measures of prefemoral fat pad (PFP) and quadriceps fat pad (QFP) are associated with incident radiographic osteoarthritis (iROA) over 4 years in the Osteoarthritis Initiative (OAI) study.

DESIGN

Participants in this nested case-control study were selected from the OAI study with knees that had Kellgren Lawrence grades (KLG) of 0 or 1 at baseline. Case knees were defined by iROA (KLG≥ 2) over 4 years. Control knees without iROA were matched 1:1 with case knees. Magnetic resonance images (MRIs) were read at P0 (time of onset of iROA), P-1 (1 year prior to P0) and baseline, and used to assess PFP (i.e., prefemoral hyperintensity alteration, patellofemoral hyperintensity alteration, maximum axial area) and QFP (i.e., hyperintensity alteration, mass effect, maximum axial area). Conditional logistic regression analyses were performed to study the associations between PFP/QFP measures and iROA, after adjustment for covariates.

RESULTS

354 case knees with iROA were matched to 354 control knees. 66.9% of the participants were female, with an average age of 60.1 years. PFP prefemoral hyperintensity alteration measured at three time points (OR [95%CI]: 1.46 [1.18-1.82], 1.50 [1.20-1.88], 1.52 [1.22-1.89] respectively), PFP maximum axial area (OR [95%CI]: 1.07 [1.01-1.14], 1.08 [1.01-1.15], 1.08 [1.02-1.15] respectively) and QFP hyperintensity alteration (OR [95%CI]: 1.59 [1.27-2.00], 1.44 [1.13-1.82], 1.38 [1.09-1.73] respectively) were significantly associated with iROA in multivariable conditional logistic analyses. QFP mass effect measured at BL and P-1 (OR [95%CI]: 1.42 [1.11-1.82], 1.33 [1.01-1.73] respectively) were significantly associated with iROA.

CONCLUSIONS

Qualitative and quantitative measures of PFP and QFP are associated with increased iROA over 4 years.

[Expression of p-AKT and p-mTOR in pediatric Burkitt lymphoma and their correlation with prognosis]

Objective: To evaluate the expression of p-AKT and p-mTOR, the key proteins in PI3K/AKT/mTOR pathway in pediatric Burkitt lymphoma (BL), and to investigate the clinical and prognostic significance. Methods: Fifty-eight cases of pediatric BL and thirty cases of reactive hyperplastic lymphadenitis (RH) were collected at Children's Hospital of Fudan University from September 2011 to July 2018. Paraffin sections of tissues were immune stained for p-AKT and p-mTOR, and the expression was assessed and correlated with the clinical features and prognosis. Results: A total of 58 cases were diagnosed and 6 cases lost the follow-up. Of the remaining 52 BL patients including 43 males and 9 females, the median age was 5 years (range: 2 to 14 years). Regarding to the correlation between the two biomarkers, Spearman test showed that p-mTOR was positively associated with the expression of p-AKT (r=0.759, P<0.001). Of all BL patients, the positive rates of p-AKT and p-mTOR were 62.1% (36/58) and 60.3%(35/58) respectively, both significantly higher than control group (P=0.011, P=0.035 respectively). The presence of p-AKT was significantly associated with higher lactate dehydrogenase (LDH≥573 IU/L) level in patients of the disease (P=0.006), while p-mTOR was increased both in the higher LDH and lower ratio of albumin to globulin (A/G) group (P=0.006, P=0.034 respectively). Expression of p-AKT and p-mTOR did not show any statistical correlation with sex, age, St.jude stage, tumor size, B-symptom present or not, number of extra-nodal sites or international prognostic index (IPI) (P>0.05). Fifty-two patients had a median follow-up of 40 months (range: 5-87 months). Univariate analysis showed that p-AKT expression was significant in predicting both inferior OS (5-year estimate, 72.7% vs. 94.7%, χ(2)=4.123, P=0.042) and PFS (5-year estimate, 66.7% vs. 94.7%, χ(2)=5.822, P=0.016). The 5-year OS rate was 71.0% (22/31) for the p-mTOR positive cohort of patients compared to 95.2% (17/21) for p-mTOR negative group (χ(2)=4.881, P=0.027); however, there was no statistical significance in 5-year PFS rate (P>0.05). Especially, the 5-year OS and PFS rate of p-AKT/p-mTOR double-positive group were significantly lower than negative control group (including absence of single p-AKT or p-mTOR expression, and absence of both) (OS: 69.0% vs. 95.7%, χ(2)=6.285, P=0.012; PFS: 65.5% vs. 91.3%, χ(2)=5.405, P=0.020). The results of multivariate COX proportional risk regression analysis indicated that p-AKT/p-mTOR double-positive, higher LDH and IPI score 3-5 were independent prognostic factors for both OS and PFS, and the bulky tumor (>10 cm) for PFS of pediatric BL. Conclusion: The expression of p-AKT and p-mTOR may be a potential reference for diagnosis and the independent prognostic indicators of pediatric BL.

[Minimally invasive lateral lumbar interbody fusion significantly improves the sagittal balance for adult degenerative scoliosis]

Objectives: To evaluate the effect of minimally invasive lateral lumbar interbody fusion (LLIF/OLIF) on the sagittal balance of adult degenerative scoliosis. Methods: From January 2014 to June 2017, a total of 23 patients with degenerative scoliosis underwent staged minimally invasive surgery in Shanghai Ruijin Hospital. All patients were implanted with LLIF or OLIF cage from the lateral approach first, and was followed by the posterior percutaneous pedicle screw fixation or pedicle screw fixation via Wiltse approach. If the sagittal deformity correction was not satisfactory after the first surgery, a posterior osteotomy can be performed during the second stage operation. A biplanar X-ray of the whole spine was taken with the EOS imaging system before and after surgery. The EOS software was used to measure and evaluate the patient's sagittal balance parameters including pelvic incidence (PI), pelvic tilt (PT), lumbar lordosis (LL), the sagittal vertical axis (SVA) and the coronal Cobb angle. The visual analogue scale (VAS) score for low back pain, the Oswestry Disability Index (ODI) score were evaluated before and after surgery. Paired t test or repeated measures ANOVA was used to compare the data before and after surgery. Results: There were 6 males and 17 females with a mean age of (72±4) years (62-79 years). Nine patients were treated with LLIF and 14 patients with OLIF. Sixteen cases were implanted with three cages, five with two cages and two with four cages. The mean follow-up period was 24.2 months (15-42 months). After the first operation, the Cobb angle of the patient was significantly improved (18°±7° vs 33°±8°, t=13.2, P<0.01). All the parameters for sagittal balance, including PI-LL (20°±8° vs 31°±8(o)), SVA ((5.3±2.0) cm vs (8.2±3.5) cm), PT (16°±6° vs 23°±4°) were all significantly improved as well (t=6.8, 4.5, 9.0, ALL P<0.01). At the last follow-up, the VAS score of low back pain (3.4±1.1 vs 6.3±1.0) and ODI scores (27.3%±3.0% vs 47.1%±5.9%) were also significantly improved (t=11.3, 17.8, both P<0.01). No major complications occurred in this group. Conclusions: Minimally invasive LLIF/OLIF can significantly improve the coronal and sagittal balance of adult degenerative scoliosis. Staged minimally invasive surgery can significantly alleviate pain and improve function in these patients.

Machinability of Luxury Vinyl Tiles during Plain Milling Using a Helical Cutter

In order to better provide a theoretical basis for the machining of luxury vinyl tiles, a helical milling experiment was conducted by using diamond cutting tools, and special attention was given to the trends of cutting force and surface roughness in respect to tool geometry and cutting parameters. The results showed that the resultant force was negatively correlated to the helix angle and cutting speed, but positively correlated with the cutting depth. Then, that the surface roughness increased with a decrease of the helix angle and an increase of cutting depth, while as cutting speed raised, the surface roughness first declined and then increased. Thirdly, the cutting depth was shown to have the greatest influence on both cutting force and surface roughness, followed by helix angle and cutting speed. Fourth, the contribution of cutting depth only was significant to cutting force, while both the helix angle and cutting speed had insignificant influence on the cutting force and surface roughness. Finally, the optimal cutting conditions were proposed for industrial production, in which the helix angle, cutting speed and cutting depth were 70°, 2200 m/min and 0.5 mm, respectively.

[Analysis of aluminum content in unprocessed grains from different areas of China]

Objective: To investigate the aluminium content in unprocessed grains from different areas of China. Methods: From June 2013 to December 2014, nine provinces (Jilin, Shandong, Hubei, Hunan, Guangdong, Guangxi, Henan, Anhui and Jiangsu) were selected as sampling areas using stratified random sampling method. Three cities, counties or townships were randomly selected from each sampling area. Grain stations, grain depots, planting areas or farmers' markets located in non-aluminium mining areas or non-aluminium-involved industrial pollution areas were selected from each sampling area using a purposive sampling method. A total of 470 unprocessed grain samples (500 g per sample) including wheat, rice, corn, millet and soybean were collected from local grain stations, grain depots, planting areas and farmers' markets. The dried grains samples were analysed for aluminium content by inductively coupled plasma mass spectrometry. Bootstrap resampling method was applied to calculate the upper bound values of 95%CI of P(99) of aluminium contents for each kind of grain, which could be regarded as levels of concern for corresponding categories. Results: A total of 454 grain samples, including 109 wheat samples, 111 rice samples, 78 corn samples, 69 millet samples and 87 soybean samples, were used for analysis after excluding outlier values. There were 420 positive samples with detected aluminium and the overall detection rate was 92.5%. Among them, the aluminium contents were high in wheat and soybean with median values about 9.59 and 7.12 mg/kg, and maximum values about 31.55 and 28.80 mg/kg, respectively. The median and maximum values of aluminium contents in corn were about 4.65 and 26.79 mg/kg. Aluminium contents were low in rice and millet, with median values about 1.49 and 2.21 mg/kg, and maximum values about 7.56 and 8.07 mg/kg, respectively. Based on Bootstrap resampling method, the upper bound values of 95%CI of P(99) of aluminium contents in wheat, soybean, corn, rice and millet were 29.86, 28.80, 26.79, 7.56 and 8.07 mg/kg, respectively, which could be regarded as levels of concern for corresponding grains. Conclusion: Aluminium has been detected in most unprocessed grains. The accumulation of aluminium varies in different grains species.

[Exposure status and health risk assessment of deoxynivalenol from cereals in Chinese population in different regions]

Objective: To evaluate the dietary exposure to deoxynivalenol (DON) from cereals and health risk in Chinese residents in different regions. Methods: The data of DON concentration in cereals was derived from the national food safety risk surveillance from 2010 to 2017, with 15 422 samples of cereals included. China was roughly divided into north part and south part, along with the Qinling Mountains-Huaihe River line. Sample size of each type of cereals, i.e. wheat flour, maize meal, oats and rice was 4 948, 696, 626, 1 006 in the north, while 5 648, 1 068, 266, 1 164 in the south. The data of cereals consumption was derived from China National Nutrition and Health Survey in 2002 and 68 335 respondents aged 3 and above, with 34 234 from the north and 34 101 from the south, were included. Simple distribution model was applied for calculation and comparison of the dietary exposure to DON from cereals in northern and southern residents based on individual consumption of cereals, body weight and average DON concentration in each type of cereals. Results: Average DON concentration in wheat flour, maize meal, oats, and rice sampled in northern China were 235.4, 121.6, 7.0 and 4.6 μg/kg, respectively, while 239.1, 124.3, 29.0 and 15.5 μg/kg in cereals sampled in southern China. The average DON exposure from cereals in surveyed Chinese inhabitants was 0.78 μg/(kg·d). Among them, the DON exposure of northern residents was higher than that of southern residents (P<0.001), and the average exposures were 1.15 and 0.41 μg/(kg·d), respectively. A total of 49.2% of northern residents exceeded provisional maximum tolerable daily intake for DON exposure from cereals, which was much higher than that of southern residents (8.6%) (P<0.001). Wheat-based food products were the main source of DON exposure, with a contribution rate of 96.5% in the north and 68.3% in the south. Average DON exposure was the highest in the 3-6 years [2.12 μg/(kg·d) for children in north and 0.73 μg/(kg·d) in south]. Conclusion: Exposure to DON from cereals in northern residents of China was considerably high, with a certain health risk. Northern children aged 3 to 6 exposed even more DON and needed significant attention.

Evaluation of the readout electronics based on the center of gravity method for position sensitive radiation detection

In the application of position sensitive radiation detection, the center of gravity method is often used to obtain better spatial resolution. In order to obtain the resolution degradation caused by the readout electronics, an evaluation method is put forward in this paper. The principle of the method is to simulate the signal distribution on sense wires of the MWPC (Multiwire Proportional Chamber) detector. The evaluation software quantizes the simulated data and drives the digital to analog converter to generate test signals. The readout electronics is evaluated with these stimulus signals according to the readout scale. An evaluation board based on this method is implemented. Tests are carried out in the laboratory to evaluate a readout circuit for the MWPC detector. The position resolution contributed by the electronics is better than 15 μm when the swtiching frenquency of the switch array is 12.5 MHz. The test results proved that the evaluation method is correct and practical. It can greatly simplify the evaluation of the readout electronics.

Observation of an Unusual Upward-Going Cosmic-Ray-like Event in the Third Flight of ANITA

We report on an upward traveling, radio-detected cosmic-ray-like impulsive event with characteristics closely matching an extensive air shower. This event, observed in the third flight of the Antarctic Impulsive Transient Antenna (ANITA), a NASA-sponsored long-duration balloon payload, is consistent with a similar event reported in a previous flight. These events could be produced by the atmospheric decay of an upward-propagating τ lepton produced by a ν_{τ} interaction, although their relatively steep arrival angles create tension with the standard model neutrino cross section. Each of the two events have a posteriori background estimates of ≲10^{-2} events. If these are generated by τ-lepton decay, then either the charged-current ν_{τ} cross section is suppressed at EeV energies, or the events arise at moments when the peak flux of a transient neutrino source was much larger than the typical expected cosmogenic background neutrinos.

Machinability investigation in turning of high density fiberboard

A series of experiments were conducted to assess the machinability of high density fiberboard using cemented carbide cutting tools. The objective of this work was to investigate the influence of two cutting parameters, spindle speed and feed per turn, on cutting forces, chip formation and cutting quality. The results are as follows: cutting forces and chip-breaking length decrease with increasing spindle speed and decreasing feed per turn. In contrast, surface roughness increases with decrease of spindle speed and increase in feed per turn. Chips were divided into four categories based on their shape: dust, particle, splinter, and semicontinuous chips. Chip-breaking length had a similar tendency to the variance of cutting forces with respect to average roughness and mean peak-to-valley height: an increase in the variance of cutting forces resulted in increased average roughness and mean peak-to-valley height. Thus, high cutting speed and low feed rate are parameters suitable for high-quality HDF processing and will improve not only machining quality, but production efficiency.

[Two-year clinical and radiological outcomes of minimally invasive surgery for severe adult degenerative scoliosis]

Objectives: To evaluate the efficacy of restoring the balance in the coronal and sagittal planes and to evaluate clinical outcomes in the treatment of severe adult degenerative scoliosis patients using staged lateral lumbar interbody fusion (LLIF) and percutaneous transpedicle screw fixation (pTSF). Methods: A retrospective analysis was made on 13 patients with severe adult degenerative scoliosis treated with staged surgery in Ruijin Hospital between May, 2014 and July, 2015. The operation data were collected, including operation time, estimated blood loss, and complications. Preoperative and postoperative standing anteroposterior and lateral lumbar radiographs were obtained by EOS image system in all patients for measurement of sagittal and coronal plane alignment. All patients were available for at least 24 months of following-up (18-32 months). Paired sample t test was used to compare the parameters of each group pre- and post-operation. Results: All of the 13 patients received LLIF with staged transpedicle screw fixation. Mean operation time was (231±48) minutes and (155±33) minutes for two-stage surgery. Mean blood loss was (253±80) ml during one-stage LLIF surgery and (326±99) ml during two-stage pTSF surgery. The interval between two surgical procedures was from 7 to 42 days (mean 14 days). In the coronal plane, the mean Cobb angle of curves was 43.1°±7.3° preoperatively, and it was 11.4°±4.0°after one-stage LLIF (t=10.16, P<0.001) and 5.5°±1.9° after two-stage pTSF (t=6.14, P<0.001). In the sagittal plane, lumbar lordosis (LL) changed after each procedure was as follows: LLIF from 16.8°±8.4° to 30.1°±6.8° (t=5.21, P<0.001) and PSF to 37.1°±4.0° (t=5.04, P<0.001). Sagittal vertical axis (SVA) was reduced from (10.5±2.4) cm to (5.3±2.1) cm after one-stage LLIF (t=8.52, P<0.001) and to (3.1±1.5) cm after two-stage pTSF (t=5.51, P<0.001). In the spino-pelvic parameter, pelvic incidence(PI)-LL mismatch decreased from 33.6°±9.6° to 17.8°±4.5° (t=5.31, P<0.001) after LLIF and to 9.9°±3.7° after pTSF (t=4.68, P<0.001). The visual analogue scale (VAS) of low back pain and leg pain and the Oswestry dability Index (ODI) improved significantly at the last follow-up (t=10.42, 8.94, 19.20, all P<0.01). Conclusions: LLIF significantly improves segmental and coronal plane alignment in patients with degenerative lumbar scoliosis, and these patients can be effectively corrected by staged minimally invasive surgery.

A Modified Method of Activity-based Costing for Objectively Reducing Cost Drivers in Hospitals

Objectives: Activity-based costing (ABC) is widely used to precisely allocate indirect costs to medical services. In the ABC method, the indirect cost is divided among the medical services in proportion to the volume of “cost drivers”, for example, labor hours and the number of hours of surgery. However, the workload of data collection of cost drivers can be time-consuming and a considerable burden if there are many cost drivers. The authors aim to develop a method for objectively reducing the cost drivers used in the ABC method.

Methods: In the ABC method, the cost driver is assigned for each activity. We assume that these activities and cost drivers are the best combination. Our method, that is cost driver reduction (CDR), can objectively select surrogates of the cost drivers for each activity in ABC from candidate cost drivers. Concretely, the total indirect cost of an activity is temporarily allocated to the medical services using each candidate of cost drivers. The difference between the costs calculated by each candidate and the proper cost driver used in ABC is calculated to evaluate the similarity by the evaluation function.

Results: We estimated the cost of laboratory tests using our method and revealed that the number of cost drivers could be reduced from seven in the ABC to four. Similarly, the results of cost estimation obtained by our method were as accurate as those calculated using the ABC.

Conclusions: Our method provides two advantages compared to the ABC method: 1) it provides results that are as accurate as those of the ABC method, and 2) it is simpler to perform complicated estimation of hospital costs.

General-purpose readout electronics for white neutron source at China Spallation Neutron Source

The under-construction White Neutron Source (WNS) at China Spallation Neutron Source is a facility for accurate measurements of neutron-induced cross section. Seven spectrometers are planned at WNS. As the physical objectives of each spectrometer are different, the requirements for readout electronics are not the same. In order to simplify the development of the readout electronics, this paper presents a general method for detector signal readout. This method has advantages of expansibility and flexibility, which makes it adaptable to most detectors at WNS. In the WNS general-purpose readout electronics, signals from any kinds of detectors are conditioned by a dedicated signal conditioning module corresponding to this detector, and then digitized by a common waveform digitizer with high speed and high precision (1 GSPS at 12-bit) to obtain the full waveform data. The waveform digitizer uses a field programmable gate array chip to process the data stream and trigger information in real time. PXI Express platform is used to support the functionalities of data readout, clock distribution, and trigger information exchange between digitizers and trigger modules. Test results show that the performance of the WNS general-purpose readout electronics can meet the requirements of the WNS spectrometers.