[Changes of serum E2 and Otolin-1 levels in postmenopausal women with BPPV]

Objective:To investigate the changes of serum estradiol（E2） and otolith structural protein Otolin-1 levels in postmenopausal women with benign paroxysmal positional vertigo（BPPV）. Method:Forty postmenopausal women diagnosed as primary BPPV were selected as the experimental group. Meanwhile, 40 postmenopausal women without vertigo during the same time were selected as the control group. 4 ml of fasting peripheral venous blood was extracted in the morning, and E2 and Otolin-1 protein levels in serum of the two groups were detected by electrochemiluminescence（ECL） and ELISA, respectively. Result:①The serum level of E2 in the experimental group was（29.11±15.11） pg/ml, which was lower than that in the control group（37.18±12.24） pg/ml（P=0.010）. ②The serum level of Otolin-1 in the experimental group was（361.55±186.14） pg/ml, which was significantly higher than that in the control group（282.61±139.98） pg/ml（P=0.035）. ③Spearman correlation analysis was carried out on the serum levels of Otolin-1 and E2 in the experimental group and the control group, respectively, and no correlation was found between them（P=0.403 and 0.363, respectively）. ④In the control group, age was negatively correlated with serum E2 level（P=0.044, r=-0.320）, suggesting that age was only weakly correlated with E2 level. However, in the experimental group, there was no correlation between the two（P=0.148）. ⑤There was no correlation between age and serum Otolin-1 level in the two groups（P=0.705 and 0.076, respectively）. Conclusion:Compared with postmenopausal patients without vertigo, the level of E2 in postmenopausal BPPV patients decreased, but the level of Otolin-1 increased significantly. Therefore, the serum level of Otolin-1 may be used as a bio-marker to assist the diagnosis and efficacy evaluation of postmenopausal women with BPPV.

Interstitial brachytherapy of oral squamous cell carcinoma with ultrasound-guided iodine-125 radioactive seed implantation

OBJECTIVE

In this study, we investigated the clinical effect of interstitial brachytherapy on oral squamous cell carcinoma (OSCC) with ultrasound or CT-guided 125I radioactive seed implantation.

PATIENTS AND METHODS

116 patients with advanced oral squamous cell carcinoma, who received initial treatment or retreatment, were enrolled. Therein, 35 patients in the control group were treated with external radiation, systemic chemotherapy or conservative treatment, 41 patients in the ultrasound group were treated with ultrasound-guided125I radioactive seed interstitial implantation brachytherapy, and 40 patients in the CT group were treated with CT-guided 125I radioactive seed interstitial implantation. The median follow-up time was 15.0 months. The clinical outcomes were compared.

RESULTS

At the time of one month after treatment, the tumor diameters of the ultrasound group and the CT group were significantly decreased (p<0.05), which were less than the control group (p<0.05), and there was no difference in comparison between the ultrasound group and the CT group (p>0.05). At the time of one month after treatment, the effective rates were significantly higher in the ultrasound group and the CT group than the control group (p<0.001), and there was no difference in comparison between the ultrasound group and the CT group. And there was no difference in comparison of complication between these two groups (p>0.05). At the time of one month after treatment, the VAS scores of pain were significantly lower in the ultrasound group and the CT group than the control group (p<0.05). There were no differences in comparisons of T lymphocyte subset percentages before and after treatment (p>0.05), and T lymphocyte subset percentages in the control group were significantly decreased (p<0.05). The progression-free survivals, median survival times, and survival rates were significantly higher in the ultrasound group and the CT group than those in the control group (p<0.05), and there were no differences in comparisons between the ultrasound group and the CT group (p>0.05).

CONCLUSIONS

Both ultrasound and CT-guided iodine-125 radioactive seed interstitial implantation brachytherapy in the treatment of OSCC  can achieve better short-term and long-term clinical effects.

Plasma long non-coding RNAs (lncRNAs) serve as potential biomarkers for predicting breast cancer

OBJECTIVE

Recent studies have suggested that lncRNAs play important regulatory roles in occurrence and progression of many cancers including breast cancer. However, only a small number of lncRNAs have proved to be related to breast cancer. Moreover, the effect of lncRNAs on breast cancer is yet unclear. We aimed at examining whether the expression level of these lncRNAs in our breast cancer patients could be different to normal people, and whether these lncRNAs could serve as potential biomarkers for the diagnosis of breast cancer.

PATIENTS AND METHODS

We selected twelve lncRNAs as the research targets, which were previously found to be abnormally expressed in plasma of other cancers. The expression levels of these lncRNAs were measured by Quantitative Real-time Polymerase Chain Reaction (qRT-PCR) and compared between breast cancer patients and normal people.

RESULTS

The expression levels of plasma lncRNAs (H19, HOTAIR, and RP11-445H22.4) are found to increase significantly in breast cancer patients. The expression levels of other 9 lncRNAs were no significant changed compared with normal people.

CONCLUSIONS

lncRNAs may be related to the occurrence of breast cancer and serve as potential biomarkers for its diagnosis.

Imaging G-Ratio in Multiple Sclerosis Using High-Gradient Diffusion MRI and Macromolecular Tissue Volume

BACKGROUND AND PURPOSE

Remyelination represents an area of great therapeutic interest in multiple sclerosis but currently lacks a robust imaging marker. The purpose of this study was to use high-gradient diffusion MRI and macromolecular tissue volume imaging to obtain estimates of axonal volume fraction, myelin volume fraction, and the imaging g-ratio in patients with MS and healthy controls and to explore their relationship to neurologic disability in MS.

MATERIALS AND METHODS

Thirty individuals with MS (23 relapsing-remitting MS, 7 progressive MS) and 19 age-matched healthy controls were scanned on a 3T MRI scanner equipped with 300 mT/m maximum gradient strength using a comprehensive multishell diffusion MRI protocol. Macromolecular tissue volume imaging was performed to quantify the myelin volume fraction. Diffusion data were fitted to a 3-compartment model of white matter using a spheric mean approach to yield estimates of axonal volume fraction. The imaging g-ratio was calculated from the ratio of myelin volume fraction and axonal volume fraction. Imaging metrics were compared between groups using 2-sided t tests with a Bonferroni correction.

RESULTS

The mean g-ratio was significantly elevated in lesions compared with normal-appearing WM (0.74 vs 0.67, P < .001). Axonal volume fraction (0.17 vs 0.23, P < .001) and myelin volume fraction (0.17 vs 0.25, P < .001) were significantly lower in lesions than normal-appearing WM. Myelin volume fraction was lower in normal-appearing WM compared with that in healthy controls (0.25 vs 0.27, P = .009). Disability, as measured by the Expanded Disability Status Scale, was significantly associated with myelin volume fraction (β = -40.5, P = .001) and axonal volume fraction (β = -41.0, P = .016) in normal-appearing WM.

CONCLUSIONS

The imaging g-ratio may serve as a biomarker for the relative degree of axonal and myelin loss in MS.

Reduced SPOCK1 expression inhibits non-small cell lung cancer cell proliferation and migration through Wnt/β-catenin signaling

OBJECTIVE

Accumulating evidence suggests that SPARC/osteonectin, cwcv, and kazal-like domain proteoglycan 1 (SPOCK1) contributes to the initiation and progression of human cancers. However, little is known about the function mechanisms of SPOCK1 in non-small cell lung cancer (NSCLC). The aim of this study was to investigate the molecular mechanism of SPOCK1 in NSCLC.

PATIENTS AND METHODS

The expression levels of SPOCK1 in NSCLC tissues and cell lines were analyzed by qRT-PCR and Western blotting. The proliferative activity of NSCLC cells was determined by MTT and colony formation assays. The transwell assay was used to examine the cell migration and invasive ability. To study the impact of SPOCK1 on Wnt/β‑catenin signaling, we further performed Western blotting for related proteins in this pathway.

RESULTS

We observed that the expression of SPOCK1 at both protein and mRNA levels was also increased in human NSCLC tissues and cell lines. Functionally, down-regulation of SPOCK1 in NSCLC cells markedly suppressed cell proliferation, colony formation, migration and invasion in vitro. Mechanistically, we found that indicated the activation of Wnt/β-catenin pathway was suppressed by SPOCK1 silencing.

CONCLUSIONS

The expression of SPOCK1 served as a tumor promoter, possibly through the Wnt/β-catenin signaling pathway in NSCLC. Targeting SPOCK1 could be a potential therapeutic strategy in NSCLC.

Janus particles: design, preparation, and biomedical applications

Janus particles with an anisotropic structure have emerged as a focus of intensive research due to their diverse composition and surface chemistry, which show excellent performance in various fields, especially in biomedical applications. In this review, we briefly introduce the structures, composition, and properties of Janus particles, followed by a summary of their biomedical applications. Then we review several design strategies including morphology, particle size, composition, and surface modification, that will affect the performance of Janus particles. Subsequently, we explore the synthetic methodologies of Janus particles, with an emphasis on the most prevalent synthetic method (surface nucleation and seeded growth). Following this, we highlight Janus particles in biomedical applications, especially in drug delivery, bio-imaging, and bio-sensing. Finally, we will consider the current challenges the materials face with perspectives in the future directions.

A prospective study of focal brain atrophy, mobility and fitness

BACKGROUND

The parallel decline of mobility and cognition with ageing is explained in part by shared brain structural changes that are related to fitness. However, the temporal sequence between fitness, brain structural changes and mobility loss has not been fully evaluated.

METHODS

Participants were from the Baltimore Longitudinal Study of Aging, aged 60 or older, initially free of cognitive and mobility impairments, with repeated measures of fitness (400-m time), mobility (6-m gait speed) and neuroimaging markers over 4 years (n = 332). Neuroimaging markers included volumes of total brain, ventricles, frontal, parietal, temporal and subcortical motor areas, and corpus callosum. Autoregressive models were used to examine the temporal sequence of each brain volume with mobility and fitness, adjusted for age, sex, race, body mass index, height, education, intracranial volume and APOE ɛ4 status.

RESULTS

After adjustment, greater volumes of total brain and selected frontal, parietal and temporal areas, and corpus callosum were unidirectionally associated with future faster gait speed over and beyond cross-sectional and autoregressive associations. There were trends towards faster gait speed being associated with future greater hippocampus and precuneus. Higher fitness was unidirectionally associated with future greater parahippocampal gyrus and not with volumes in other areas. Smaller ventricle predicted future higher fitness.

CONCLUSION

Specific regional brain volumes predict future mobility impairment. Impaired mobility is a risk factor for future atrophy of hippocampus and precuneus. Maintaining fitness preserves parahippocampal gyrus volume. Findings provide new insight into the complex and bidirectional relationship between the parallel decline of mobility and cognition often observed in older persons.

[The etiological analysis of 260 hospitalized cases with bilateral adrenal lesions]

Objective: To summarize the etiologies of bilateral adrenal lesions and the changes of the disease profile in hospitalized patients. Methods: Bilateral adrenal lesion screening was conducted in all patients admitted to Peking University Third Hospital from 1994 to 2017. The etiologies and disease profiles of bilateral adrenal lesions were retrospectively analyzed. Results: A total of 260 patients with bilateral adrenal lesions were included in the study. There were 146 males and 114 females with a mean age of (55.4±16.2) years. The most common adrenal lesion was bilateral adrenal hyperplasia (75 cases, 28.8%), followed by bilateral adrenal adenomas (71 cases, 27.3%), metastatic carcinoma (51 cases, 19.6%), discordant bilateral adrenal lesions (27 cases, 10.4%), bilateral pheochromocytomas (13 cases, 5.0%), and others. The clear data of endocrine function evaluation could be found in 184 patients. Among them, 111 cases (60.3%) were nonfunctioning lessions, 34 cases (18.5%) with primary aldosteronism, 15 cases (8.1%) with pheochromocytoma, 13 cases (7.1%) with congenital adrenal hyperplasia, 6 cases (3.3%) with primary hypoadrenocorticism, and 5 cases (2.7%) with Cushing syndrome. Using every 8 years as a period of time, the number of hospitalized patients with bilateral adrenal lesions increased with years in three periods (8, 41 and 211 cases, respectively). Conclusions: The most common cause of bilateral adrenal lesions is adrenal hyperplasia in the hospitalized patients. More than half of bilateral adrenal lesions are nonfunctioning. In functional bilateral lesions, primary aldosteronism and pheochromocytoma account for a large proportion.

Postmenopausal spontaneous rupture of pyometra: A case report

RATIONALE

The incidence of spontaneous perforations in pyometra occurs rarely, only 0.01% to 0.5% in gynecological patients, with high mortality and morbidity. The clinical manifestation of perforated uterine pus is similar to that of gastrointestinal perforation, but the gynecological symptoms are not so obvious, which makes preoperative diagnosis difficult. Here, we report a rare case of peritonitis with laparotomy of pyometra.

PATIENT CONCERNS

An acute abdominal pain and purulent vaginal discharge developed in a 72-year-old woman who underwent an emergency laparotomy because of signs of diffuse peritonitis and in a state of shock.

DIAGNOSES

We made a diagnosis of spontaneous perforation of pyometra.

INTERVENTIONS

At laparotomy, about 1000 mL of pus with the source of uterine was found in the abdominal cavity, while gastrointestinal tract was intact and a crevasse with a diameter of 1.5 cm on posterior uterine wall was obvious. A total abdominal hysterectomy and a bilateral salphingo oophorectomy were performed.

OUTCOMES

The patient got discharged on 34th postoperative hospitalization day with only 1 complication of wound healing. Histopathological study revealed uterine purulent inflammation, with no evidence of malignancy.

LESSONS

Ultrasonography is the first and most sensitive examination for the evaluation of pyometra, but has limited role in the diagnosis of perforated pyometra. Additional diagnostic radiographic evaluation use for acute abdomen is total abdomen computed tomography scan and magnetic resonance imaging techniques of female pelvis.

A novel mechanism of memory loss in Alzheimer's disease mice via the degeneration of entorhinal-CA1 synapses

The entorhinal cortex (EC) is one of the most vulnerable brain regions that is attacked during the early stage of Alzheimer's disease (AD). Here, we report that the synaptic terminals of pyramidal neurons in the EC layer II (ECII_PN) directly innervate CA1 parvalbumin (PV) neurons (CA1_PV) and are selectively degenerated in AD mice, which exhibit amyloid-β plaques similar to those observed in AD patients. A loss of ECII_PN-CA1_PV synapses disables the excitatory and inhibitory balance in the CA1 circuit and impairs spatial learning and memory. Optogenetic activation of ECII_PN using a theta burst paradigm rescues ECII_PN-CA1_PV synaptic defects and intercepts the decline in spatial learning and memory. These data reveal a novel mechanism of memory loss in AD mice via the selective degeneration of the ECII_PN-CA1_PV pathway.

Network based subcellular proteomics in monocyte membrane revealed novel candidate genes involved in osteoporosis

In this study, label-free-based quantitative subcellular proteomics integrated with network analysis highlighted several candidate genes including P4HB, ITGB1, CD36, and ACTN1 that may be involved in osteoporosis. All of them are predicted as significant membrane proteins with high confidence and enriched in bone-related biological process. The results were further verified in transcriptomic and genomic levels.

INTRODUCTION

Osteoporosis is a metabolic bone disease mainly characterized by low bone mineral density (BMD). As the precursors of osteoclasts, peripheral blood monocytes (PBMs) are supported to be important candidates for identifying genes related to osteoporosis. We performed subcellular proteomics study to identify significant membrane proteins that involved in osteoporosis.

METHODS

To investigate the association between monocytes, membrane proteins, and osteoporosis, we performed label-free quantitative subcellular proteomics in 59 male subjects with discordant BMD levels, with 30 high vs. 29 low BMD subjects. Subsequently, we performed integrated gene enrichment analysis, functional annotation, and pathway and network analysis based on multiple bioinformatics tools.

RESULTS

A total of 1070 membrane proteins were identified and quantified. By comparing the proteins' expression level, we found 36 proteins that were differentially expressed between high and low BMD groups. Protein localization prediction supported the notion that the differentially expressed proteins, P4HB (p = 0.0021), CD36 (p = 0.0104), ACTN1 (p = 0.0381), and ITGB1 (p = 0.0385), are significant membrane proteins. Functional annotation and pathway and network analysis highlighted that P4HB, ITGB1, CD36, and ACTN1 are enriched in osteoporosis-related pathways and terms including "ECM-receptor interaction," "calcium ion binding," "leukocyte transendothelial migration," and "reduction of cytosolic calcium levels." Results from transcriptomic and genomic levels provided additional supporting evidences.

CONCLUSION

Our study strongly supports the significance of the genes P4HB, ITGB1, CD36, and ACTN1 to the etiology of osteoporosis risk.

Increasing expression of miR-5100 in non-small-cell lung cancer and correlation with prognosis

OBJECTIVE

A previous study indicated that miR-5100 served as a tumor oncogene in lung cancer. However, whether miR-5100 may serve as a novel prognostic marker in non-small cell lung cancer (NSCLC), has not been investigated. The aim of this study was to investigate miR-5100 expression and its clinical significance in NSCLC patients.

PATIENTS AND METHODS

Expression of miR-5100 was detected in NSCLC tissues and matched normal lung tissues by quantitative Real-time polymerase chain reaction. The correlation between miR-5100 expression and clinical features were statistically analyzed. Survival rate was analyzed by log-rank test, and survival curves were plotted according to Kaplan-Meier. The correlation between miR-5100 expression and prognosis of NSCLC patients was further evaluated by univariate and multivariate analysis.

RESULTS

As revealed by qRT-PCR analysis, the relative level of miR-5100 expression in NSCLC tissues was significantly upregulated, compared with that in corresponding noncancerous tissues (p < 0.01). Additionally, high miR-5100 expression was statistically associated with higher clinical stage (p < 0.001), N classification (p = 0.003) and M classification (p = 0.027), but lower differentiated degree (p < 0.001). Furthermore, the results of Kaplan-Meier suggested that NSCLC patients with higher miR-5100 expression had significantly poorer overall survival (p < 0.0001) and progression-free survival (p < 0.0001). Multivariate survival analysis verified that miR-5100 expression level was an independent predictor of both overall survival and progression-free survival for NSCLC patients.

CONCLUSIONS

Our data suggested that up-regulation of miR-5100 was correlated with NSCLC progression, which provided a potential prognostic biomarker and therapeutic target.

Association between MFN2 gene polymorphisms and the risk and prognosis of acute liver failure: a case-control study in a Chinese population

This study aimed to determine the role of mitofusin 2 (MFN2) gene polymorphisms in the risk and prognosis of acute liver failure (ALF). A total of 298 blood samples were collected from 138 ALF patients (case group) and 160 healthy participants (control group). Coagulation function, glutamic pyruvic transaminase (GPT), glutamic oxaloacetic transaminase (GOT), total bilirubin (TB), blood ammonia and lactic acid (LA) were measured. The predictive evaluation of MFN2 gene polymorphisms in the risk and prognosis of ALF patients was estimated using Kaplan-Meier survival analysis, haplotype analysis, binary logistic regression analysis and Cox regression analysis. Higher levels of GPT, GOT, TB, blood ammonia and LA were observed in ALF patients with the GG genotype of rs873457 or the TT genotype of rs4846085 than in those with the CC genotype of these two SNPs. The GTACAGC and GTGTGGC haplotypes were a protective factor and a risk factor for ALF, respectively. Blood ammonia and LA levels were independent risk factors and the CC genotype of rs873457 and the CC genotype of rs4846085 were protective factors for ALF. ALF patients with the GG genotype of rs873457 or the TT genotype of rs4846085 had a lower survival rate than those with other genotypes of these two SNPs. The rs4846085 and rs873457 polymorphisms were both independent factors affecting the prognosis of ALF patients. MFN2 gene polymorphisms (rs873457, rs2336384, rs1474868, rs4846085 and rs2236055) may be associated with ALF and the rs873457 and rs4846085 polymorphisms are correlated with the risk and prognosis of ALF.

Cytosolic proteome profiling of monocytes for male osteoporosis

In male Caucasians with discordant hip bone mineral density (BMD), we applied the subcellular separation and proteome profiling to investigate the monocytic cytosol. Three BMD-associated proteins (ALDOA, MYH14, and Rap1B) were identified based on multiple omics evidence, and they may influence the pathogenic mechanisms of osteoporosis by regulating the activities of monocytes.

INTRODUCTION

Osteoporosis is a serious public health problem, leading to significant mortality not only in aging females but also in males. Peripheral blood monocytes (PBMs) play important roles in bone metabolism by acting as precursors of osteoclasts and producing cytokines important for osteoclast development. The first cytosolic sub-proteome profiling analysis was performed in male PBMs to identify differentially expressed proteins (DEPs) that are associated with BMDs and risk of osteoporosis.

METHODS

Here, we conducted a comparative proteomics analysis in PBMs from Caucasian male subjects with discordant hip BMD (29 low BMD vs. 30 high BMD). To decrease the proteome complexity and expand the coverage range of the cellular proteome, we separated the PBM proteome into several subcellular compartments and focused on the cytosolic fractions, which are involved in a wide range of fundamental biochemical processes.

RESULTS

Of the total of 3796 detected cytosolic proteins, we identified 16 significant (P < 0.05) and an additional 22 suggestive (P < 0.1) DEPs between samples with low vs. high hip BMDs. Some of the genes for DEPs, including ALDOA, MYH14, and Rap1B, showed an association with BMD in multiple omics studies (proteomic, transcriptomic, and genomic). Further bioinformatics analysis revealed the enrichment of DEPs in functional terms for monocyte proliferation, differentiation, and migration.

CONCLUSIONS

The combination strategy of subcellular separation and proteome profiling allows an in-depth and refined investigation into the composition and functions of cytosolic proteome, which may shed light on the monocyte-mediated pathogenic mechanisms of osteoporosis.

Genetic association, mRNA and protein expression analysis identify ATG4C as a susceptibility gene for Kashin-Beck disease

OBJECTIVE

Recent study observed defective autophagy in chondrocytes with Kashin-Beck Disease (KBD). To clarify the potential role of autophagy-related ATG4C gene in the development of KBD, we conducted an integrative analysis of genetic association, messenger ribonucleic acid (mRNA) and protein expression of ATG4C in KBD patients.

METHODS

1026 subjects (559 KBD patients and 467 healthy cases) were enrolled in discovery association study. Four single nucleotide polymorphisms (SNPs) of ATG4C gene (rs11208030, rs4409690, rs12097658 and rs6587988) were genotyped by Sequenom MassARRAY platform. Association analysis was conducted by PLINK software. The significant SNPs of ATG4C were replicated using an independent sample of 899 subjects (including 90 KBD patients and 809 healthy controls). Ungenotyped SNPs in ATG4C gene were imputed by IMPUTE 2.0. Knee cartilage specimens were collected from five KBD patients and five healthy subjects. Quantitative real-time polymerase chain reaction (qRT-PCR) and western blot were performed to compare the mRNA and protein expression levels of ATG4C between KBD cartilage and control cartilage.

RESULTS

We observed significant association between KBD and rs11208030 (P value = 0.003), rs4409690 (P value = 0.004), rs12097658 (P value = 0.003) and rs6587988 (P value = 0.003) in both discovery and replication samples. The mRNA expression level of ATG4C (ratio = 0.168, P value = 0.007) in KBD chondrocytes was significantly lower than that in normal chondrocytes. Western blot (P value < 0.001) further confirmed the reduced expression of ATG4C protein in both KBD cartilage and chondrocytes.

CONCLUSION

Our results strongly suggest that ATG4C was a novel autophagy-related susceptibility gene of KBD.

Evaluation of the relationship and genetic overlap between Kashin-Beck disease and body mass index

OBJECTIVES

Body mass index (BMI) is one of the major factors affecting the development of osteoarthritis (OA) but there is currently no information available regarding the relationship between BMI and Kashin-Beck disease (KBD). Our aim in this study was to investigate the relationship and genetic overlap between BMI and KBD.

METHOD

A total of 2050 Han Chinese subjects participated in this study. Using a cohort of 333 grade I KBD patients, logistic regression analysis was conducted to evaluate the correlation between BMI and KBD. Another independent sample of 1717 subjects was genotyped for a genome-wide association study (GWAS) using Affymetrix Human SNP 6.0 Arrays. Single nucleotide polymorphism (SNP) effect concordance analysis (SECA) was applied to the GWAS summaries of KBD and BMI for pleiotropy analysis. Genome-wide bivariate association analysis (GWBAA) of KBD and BMI was carried out to identify the genes with pleiotropic effects on KBD and BMI. The relevance of identified genes with KBD was validated by gene expression profiling and immunohistochemistry.

RESULTS

BMI correlated positively with knee movement disorder in KBD (coefficient β = 0.068, p = 0.045). SECA identified a significant pleiotropic effect (empirical p = 0.021) between KBD and BMI. In the GWBAA, the rs1893577 of the ADAMTS1 gene achieved the most significant association signal (p = 7.38 × 10^-9). ADAMTS1 was also up-regulated in KBD vs. normal (ratio = 2.64 ± 2.80) and KBD vs. OA (ratio = 2.31 ± 2.01). The rate of ADAMTS1-positive chondrocytes in KBD was significantly higher than that in OA (p < 0.05) and healthy controls (p < 0.05).

CONCLUSIONS

Our results suggest that ADAMTS1 is a novel susceptibility gene for KBD.

Association of 3q13.32 variants with hip trochanter and intertrochanter bone mineral density identified by a genome-wide association study

We performed a GWAS of trochanter and intertrochanter bone mineral density (BMD) in the Framingham Heart Study and replicated in three independent studies. Our results identified one novel locus around the associated variations at chromosomal region 3q13.32 and replicated two loci at chromosomal regions 3p21 and 8q24. Our findings provide useful insights that enhance our understanding of bone development, osteoporosis, and fracture pathogenesis.

INTRODUCTION

Hip trochanter (TRO) and intertrochanter (INT) subregions have important clinical relevance to subtrochanteric and intertrochanteric fractures but have rarely been studied by genome-wide association studies (GWASs).

METHODS

Aiming to identify genomic loci associated with BMD variation at TRO and INT regions, we performed a GWAS utilizing the Framingham Heart Study (FHS, N = 6,912) as discovery sample and utilized the Women's Health Initiative (WHI) African-American subsample (N = 845), WHI Hispanic subsample (N = 446), and Omaha osteoporosis study (N = 971), for replication.

RESULTS

Combining the evidence from both the discovery and the replication samples, we identified one novel locus around the associated variations at chromosomal region 3q13.32 (rs1949542, discovery p = 6.16 × 10^-8, replication p = 2.86 × 10^-4 for INT-BMD; discovery p = 1.35 × 10^-7, replication p = 4.16 × 10^-4 for TRO-BMD, closest gene RP11-384F7.1). We also replicated two loci at chromosomal regions 3p21 (rs148725943, discovery p = 6.61 × 10^-7, replication p = 5.22 × 10^-4 for TRO-BMD, closest gene CTNNB1) and 8q24 (rs7839059, discovery p = 2.28 × 10^-7, replication p = 1.55 × 10^-3 for TRO-BMD, closest gene TNFRSF11B) that were reported previously. We demonstrated that the effects at both 3q13.32 and 3p21 were specific to the TRO, but not to the femoral neck and spine. In contrast, the effect at 8q24 was common to all the sites.

CONCLUSION

Our findings provide useful insights that enhance our understanding of bone development, osteoporosis, and fracture pathogenesis.

Levator resection with suspensory ligament of the superior fornix suspension for correction of pediatric congenital ptosis with poor levator function

PurposeTo evaluate the surgical outcome of levator resection with suspensory ligament of the superior fornix (SLSF) suspension in severe congenital ptosis with poor levator function (LF).Patients and methodsThe medical records of 25 patients who underwent levator resection with SLSF suspension between March 2011 and January 2013 were retrospectively reviewed. All of the patients had severe congenital ptosis (>4 mm) and poor LF (<4 mm). The follow-up time ranged from 12 to 18 months (median, 15 months). Data regarding eyelid position, cosmetic outcomes, and postoperative complications were evaluated.ResultsThe average preoperative margin reflex distance-1 (MRD1) measured -0.30±0.11 mm. The average postoperative MRD1 measured 3.1±1.25 mm at the last follow-up visit. There was a statistically significant difference between preoperative and postoperative MRD1 values (P<0.001). Excellent cosmetic results occurred in 14 patients, good cosmetic results occurred in eight patients and poor cosmetic results did not occur. Three patients (12%) underwent reoperation for residual ptosis. No serious postoperative complications occurred.ConclusionLevator resection with SLSF suspension is very effective in the treatment of severe congenital ptosis with poor LF. This surgery technique results in high functional and cosmetic successes in the long term.