The impacts of exposure to risk factors during youth on the increasing global trend of early-onset pancreatic cancer

OBJECTIVES

An increasing trend of pancreatic cancer in young adults has emerged in some countries. This study aimed to investigate global trends of pancreatic cancer in young adults and explore the impact of exposure to risk factors on pancreatic cancer incidence during youth.

METHODS

Global and national data on pancreatic cancer incidence, disability-adjusted life-years, attributive mortality, and summary exposure values of risk factors were retrieved from the Global Burden of Disease 2019. The average annual percent change (AAPC) of incidence and mortality was calculated. Additionally, generalized additive models were applied to explore the non-linear associations between the levels and changes in the Human Development Index and AAPC.

RESULTS

Global pancreatic cancer incidence increased during various periods from 1990 to 2019, particularly in adults aged <45 years from 2010 to 2019, at an average annual increase rate of 0.7% (95% confidence interval: 0.4-1.0%). The AAPC of early-onset pancreatic cancer incidence from 2010 to 2019 was negatively correlated with Human Development Index levels in both 2010 and 2019 but positively correlated with Human Development Index acceleration. Significant increases in early-onset pancreatic cancer incidence were observed over this period in 32 of 88 countries, primarily in South America, North America, Oceania, and Africa. Early-onset pancreatic cancer mortality attributed to high body mass index and fasting plasma glucose increased, while that attributed to tobacco use declined.

CONCLUSIONS

An increasing trend has emerged in the global incidence and burden of early-onset pancreatic cancer over the last few decades. This rise may partly be attributed to global epidemics of high body mass index and fasting plasma glucose.

Effects of soyhulls with different particle size on the growth performance, blood indices and gut microbiota of yellow feather broilers

1. The objective of this study was to determine the effects of soyhulls with different particle sizes on the growth performance, blood indices and gut microbiota of yellow feather broilers.2. Total of 240 healthy, one-day-old, yellow feather broilers were randomly divided into four groups, with six pen replicates within each group and ten birds per pen. The control group birds were fed the basal diet (Control). For the treatment groups, 5% soyhulls with different particle sizes were included in the basal diet. The particle size geometric mean diameters (dgw) of the soyhulls in the three treatment groups were 299.69 μm (LowPS), 489.85 μm (MediumPS) and 734.83 μm (HighPS) with geometric standard deviation (Sgw) 1.75 μm, 1.62 μm and 1.67 μm, respectively.3. Results showed that the growth performance variables and organ indices were not different among the four groups. The MediumPS group had increased TG, T-CHO, ALT, HDL-C, and GSH-PX levels and decreased T-AOC levels, whereas LowPS and HighPS groups had increased HDL-C and GSH-PX levels (p < 0.05). Microbial diversity analysis showed that the intestinal microbiota of yellow feather broilers mainly included Firmicutes and Bacteroidetes. Inclusion of 5% soyhulls with different particle size had no effect on alpha diversity indices of caecal microbiota. The HighPS group had significantly higher relative abundance of Firmicutes spp. and lower Bacteroidetes spp. compared with the LowPS and MediumPS group but this was not different from the Control group. The relative abundance of Cyanobacteria spp. was significantly higher in the HighPS group than the other three groups. LEfSe analysis showed that there were more enriched biomarker taxa in the groups with soyhulls than the control group.4. Overall, the inclusion of soyhulls with different particle sizes had limited effects on growth performance, blood indices and caecal microbiota composition of yellow feather broilers.

Tetrahedral Framework Nuclear Acids Can Regulate Interleukin-17 Pathway to Alleviate Inflammation and Inhibit Heterotopic Ossification in Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that leads to serious spinal deformity and ankylosis. Persistent inflammation and progressive ankylosis lead to loss of spinal flexibility in patients with AS. Tetrahedral framework nucleic acids (tFNAs) have emerged as a one kind of nanomaterial composed of four specially designed complementary DNA single strands with outstanding biological properties. Results from in vivo experiments demonstrated that tFNAs treatment could inhibit inflammatory responses and heterotopic ossification to halt disease progression. In vitro, tFNAs were proved to influence the biological behavior of AS primary chondrocytes and inhibit the secretion of pro-inflammatory cytokines through interleukin-17 pathway. The osteogenic process of chondrocytes was as well inhibited at the transcriptional level to regulate the expression of related proteins. Therefore, we believe tFNAs had a strong therapeutic effect and could serve as a nonsurgical remedy in the future to help patients suffering from AS.

Biomechanical Study of Horizontal Screw-screw Crosslink in C1-2 Pedicle Screw-rod Fixation

STUDY DESIGN

This is a biomechanical study in vitro.

OBJECTIVE

To investigate the biomechanical differences between horizontal rod-rod crosslink (hR-R CL) and the horizontal screw-screw crosslink (hS-S CL) implementation in C1-2 pedicle screw-rod (C1-2 PSR) fixation.

SUMMARY OF BACKGROUND

To improve internal fixation stability, transverse connector (TC) is used in C1-2 PSR to increase torsional stiffness. The connection mode of horizontal connection includes hR-R CL and hS-S CL. hS-S CL adopted in C1-2 PSR was rarely reported and its biomechanics are still unclear.

MATERIALS AND METHODS

Six fresh cadaveric cervical spine specimens were each tested as an Intact model, then modified and tested as an Instability model (unstable odontoid fractures), and then as 3 internal fixation models, including C1-2 PSR, C1-2 pedicle screw-rod+horizontal rod-rod crosslink (C1-2 PSR+ hR-R CL), C1-2 pedicle screw-rod+horizontal screw-screw crosslink (C1-2 PSR+ hS-S CL). The ROM of the C1-2 segments was measured by applying 1.5 nm load in 6 loading conditions, including flexion-extension (FE), left and right lateral bending (LB), and left and right axial rotation (AR).

RESULTS

The C1-2 PSR+hR-R CL and C1-2 PSR+hS-S CL models, respectively, showed 60% and 75% lower ROM than the C1-2 PSR model in LB and AR conditions ( P <0.05). ROM was comparable between the C1-2 PSR+hR-R CL and the C1-2 PSR+hS-S CL models in all loading conditions ( P >0.05).

CONCLUSION

Both types of crosslinks showed superior C1-2 stability under LB and AR conditions than PSR without crosslinks. The C1-2 segment stability was comparable between the 2 types of crosslinks themselves.

Identification of blood metabolites linked to the risk of intervertebral disc diseases: a comprehensive Mendelian randomization study

BACKGROUND

Intervertebral disc degeneration (IVDD) has affected millions of people worldwide and dramatically affects human beings' quality of life. Observational studies hypothesize that metabolites play key roles as markers and effectors of IVDD, but their causality has not yet been illustrated.

METHODS

We conducted comprehensive Mendelian randomization (MR) to determine the causal relationship between 249 plasma metabolites and IVDD. Inverse-variance weighting was used as the primary estimate, whereas MR-Egger and weighed median were used to detect robustness. A series of sensitivity analyses including Cochran Q test, leave one out, and MR-Egger intercept analysis were also conducted.

RESULTS

In total, we found 13 blood metabolites significantly associated with IVDD, including phospholipids in very large high-density lipoprotein (HDL), free cholesterol to total lipids ratio in very large HDL, average diameter for HDL particles, cholesteryl esters to total lipids ratio in large HDL, free cholesterol to total lipids ratio in medium HDL, creatinine, free cholesterol to total lipids ratio in large HDL, phospholipids to total lipids ratio in very large HDL, cholesterol to total lipids ratio in very large HDL, cholesteryl esters to total lipids ratio in large HDL, phospholipids in large HDL, total lipids in very large HDL, and total lipids in large HDL. No pleiotropy was detected. Heterogeneity existed in several estimates and random-effect inverse-variance weighting was applied.

CONCLUSIONS

Our study highlighted the causal association of blood metabolites with the risk of IVDD. Our results provide new insights into possible treatment protocols controlling the concentration of specific blood metabolites in IVDD patients. Key messages What is already known on this topic Low back pain is the most common symptom for patients with intervertebral disc degeneration (IVDD) and influences the quality of life of large populations. Observational studies have indicated the association between metabolites and IVDD. However, causality has not been determined yet. What this study adds We conducted a comprehensive Mendelian randomization study to reveal the causal effect from 249 blood metabolites on low back pain. A total of 13 metabolites were found to causally affect the risk of IVDD, among which 11 were negatively associated and 2 were positively asscociated. How this study might affect research, practice, or policy These 13 significant metabolites could serve as biomarkers for IVDD and our results provide new insights into possible treatment protocols for IVDD patients.

CT-derived textural analysis parameters discriminate high-attenuation renal cysts from solid renal neoplasms

AIM

To assess the utility of textural features on computed tomography (CT) to differentiate high-attenuation cysts from solid renal neoplasms among indeterminate renal lesions detected incidentally on CT.

MATERIALS AND METHODS

Patients were included if they had an indeterminate renal lesion on CT that was subsequently characterised on ultrasound or magnetic resonance imaging (MRI). Up to three lesions per patient were included if they had a size ≥10 mm and density of 20-70 HU on unenhanced CT or any single phase of contrast-enhanced CT. Cases were categorised as benign or most likely benign cysts (Bosniak II and IIF) versus indeterminate (Bosniak III), mixed solid and cystic (Bosniak IV), or solid renal lesions. A random forest model was generated using 95 textural parameters and four clinical parameters for each lesion.

RESULTS

Two hundred and thirty-four patients were included who had a total of 278 lesions. Of these, 193 (69%) were benign or most likely benign cysts and 85 (31%) were indeterminate, mixed cystic and solid, or solid renal lesions. The random forest model had an area under the curve of 0.71 (95% confidence interval [CI]: 0.65, 0.78), with a sensitivity and specificity of 81.2% and 38.9%, respectively.

CONCLUSION

A multivariate model including textural and clinical parameters had moderate overall performance for discriminating benign or likely benign cysts from indeterminate, mixed solid and cystic, or solid renal lesions. This study serves as a proof of concept and may reduce the need for further follow-up by characterising a significant portion of indeterminate lesions on CT as benign.

Construction of a microcavity-based microfluidic chip with simultaneous SERS quantification of dual biomarkers for early diagnosis of Alzheimer's disease

Since there is no effective Alzheimer's disease (AD)-modifying therapy available currently, early analysis of AD core biomarkers has become one of great significance and common concern in clinical diagnosis. Herein, we designed an Au-plasmonic shell attached polystyrene (PS) microsphere in a microfluidic chip for simultaneous detection of Aβ1-42 and p-Tau181 protein. The corresponding Raman reporters were identified in femto gram level by ultrasensitive surface enhanced Raman spectroscopy (SERS). Both of Raman experimental data and finite-difference time-domain modeling demonstrates the synergetic coupling between PS microcavity with the optical confinement property and the localized surface plasmon resonance (LSPR) of AuNPs, so leading to highly amplified electromagnetic fields at the 'hot spot'. Moreover, the microfluidic system is designed with multiplex testing and control channels in which the AD-related dual proteins were detected quantitatively with a lower limit of 100 fg mL^-1. Thus, the proposed microcavity-based SERS strategy initiates a new way for accurately prediction of AD in human blood samples and provides the potential application for synchronous determination of multiple analytes in general disease assays.

[General anesthesia versus deep sedation for dental treatment in children: comparison of parental acceptance, oral health-related quality of life, and treatment efficacy]

OBJECTIVE

To compare the parental acceptance of dental treatment under general anesthesia and deep sedation in children and assess the changes in postoperative oral health-related quality of life and treatment efficacy.

METHODS

The parents of 131 children undergoing dental treatment in the Department of Stomatology of Sichuan Provincial People's Hospital from January, 2022 to June, 2022 were surveyed using a questionnaire of children's advanced oral behavior management, and 83 children receiving general anesthesia or deep sedation for dental treatment between January, 2018 and December, 2021 were also investigated for changes in quality of life after the treatment using a questionnaire. The treatment efficacy was assessed at the 1-year follow-up visit in 149 children who received dental treatment under general anesthesia or deep sedation during the same period.

RESULTS

The survey of perantal acceptance showed that 62.6% of the parents preferred deep sedation, 29.01% preferred general anesthesia, and 8.4% preferred compulsory treatment. Dental treatments under general anesthesia and deep sedation both significantly improved oral health-related quality of life of the children. While dental surgeries under general anesthesia resulted in the most significant improvement of pain symptoms, deep sedation was associated with both obvious relief of the children's pain symptoms and reduction of the parents' pressure level. No significant difference was found in the efficacy of treatments under general anesthesia and deep sedation at the 1-year follow-up.

CONCLUSION

Dental treatment in children under deep sedation has the highest parental acceptance, followed by treatment under general anesthesia, and the acceptance of compulsory treatment is the lowest. The treatments under general anesthesia and deep sedation significantly improve the quality of life of the children and their parents and both have good treatment efficacy.

Evidence of the Anomalous Fluctuating Magnetic State by Pressure-Driven 4f Valence Change in EuNiGe3

In rare-earth compounds with valence fluctuation, the proximity of the 4f level to the Fermi energy leads to instabilities of the charge configuration and the magnetic moment. Here, we provide direct experimental evidence for an induced magnetic polarization of the Eu³⁺ atomic shell with J = 0, due to intra-atomic exchange and spin-orbital coupling interactions with the Eu²⁺ atomic shell. By applying external pressure, a transition from antiferromagnetic to a fluctuating behavior in EuNiGe₃ single crystals is probed. Magnetic polarization is observed for both valence states of Eu²⁺ and Eu³⁺ across the entire pressure range. The anomalous magnetism is discussed in terms of a homogeneous intermediate valence state where frustrated Dzyaloshinskii-Moriya couplings are enhanced by the onset of spin-orbital interaction and engender a chiral spin-liquid-like precursor.

Cost-effectiveness analysis of five drugs for treating postmenopausal women in the United States with osteoporosis and a very high fracture risk

PURPOSE

Five strategies were recommended by the American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE) guidelines for the treatment of postmenopausal osteoporosis (PMO) patients with a very high fracture risk. We aimed to assess their cost-effectiveness in the United States (US).

METHODS

A microsimulation Markov model was created to compare the cost-effectiveness of five treatment strategies, including zoledronate, denosumab, abaloparatide, teriparatide, and romosozumab in PMO patients with a recent fracture from the healthcare perspective of the US. The data used in the model were obtained from published studies or online resources. Base-case analysis, one-way deterministic sensitivity analysis (DSA) and probability sensitivity analysis (PSA) were conducted for 65-, 70-, 75-, and 80-year-old patients.

RESULTS

In base case, at 65 years, zoledronate was the cheapest strategy. The incremental cost-effectiveness ratios (ICER, which represent incremental costs per QALY gained) of denosumab, teriparatide, abaloparatide, and romosozumab against zoledronate were $13,020/QALY (quality-adjusted years), $477,331 /QALY, $176,287/QALY, and $98,953/QALY, respectively. Under a willing-to-pay (WTP, which means the highest price a consumer will pay for one unit of a good of service) threshold of $150,000/QALY, denosumab and romosozumab were cost-effective against zoledronate. The PSA results showed that denosumab was the most cost-effective option with WTP thresholds of $50,000/QALY, $100,000/QALY and $150,000/QALY. The results were similar in other age groups. The DSA results indicated that the most common parameters that have important influence on the outcome were drug persistence, incidence of adverse events, the efficacy of drugs on hip fractures and the cost of the drug.

CONCLUSION AND RELEVANCE

Among PMO patients with a very high fracture risk in the US, zoledronate is the cheapest strategy and denosumab is the most cost-effective choice among these five strategies.

Chiral surface spin textures in Cu2OSeO3 unveiled by soft X-ray scattering in specular reflection geometry

Resonant elastic soft X-ray magnetic scattering (XRMS) is a powerful tool to explore long-periodic spin textures in single crystals. However, due to the limited momentum transfer range imposed by long wavelengths of photons in the soft x-ray region, Bragg diffraction is restricted to crystals with the large lattice parameters. Alternatively, small-angle X-ray scattering has been involved in the soft energy X-ray range which, however, brings in difficulties with the sample preparation that involves focused ion beam milling to thin down the crystal to below a few hundred nm thickness. We show how to circumvent these restrictions using XRMS in specular reflection from a sub-nanometer smooth crystal surface. The method allows observing diffraction peaks from the helical and conical spin modulations at the surface of a Cu   2 OSeO   3 single crystal and probing their corresponding chirality as contributions to the dichroic scattered intensity. The results suggest a promising way to carry out XRMS studies on a plethora of noncentrosymmetric systems hitherto unexplored with soft X-rays due to the absence of the commensurate Bragg peaks in the available momentum transfer range.

Effect of ontological insecurity on vaccination behavior against COVID-19: a hospital-based cross-sectional study

OBJECTIVE

Coronavirus disease 2019 (COVID-19) has brought great uncertainty to our society and it may have disrupted people's ontological security. Consequently, this hospital-based study concerns the impact of ontological insecurity on vaccination behavior against COVID-19.

STUDY DESIGN

This cross-sectional study was conducted among hospital inpatients.

METHODS

A questionnaire survey addressing inpatient ontological insecurity and vaccination behavior against COVID-19 was administered in Taizhou, China. A total of 1223 questionnaires were collected; specifically, 1185 of them were credible, for a validity rate of 96.9%.

RESULTS

The score of ontological insecurity was 13.27 ± 7.84, which was higher in participants who did not recommend vaccination for others than those who did (12.95 ± 8.25 vs 14.00 ± 6.78, P = 0.022). There was no difference between the vaccinated and unvaccinated groups (13.22 ± 7.96 vs 13.35 ± 7.67, P = 0.779). Lower ontological insecurity (odds ratio [OR] = 1.40, 95% confidence interval [CI]: 1.08-1.81) and being inoculated with COVID-19 vaccines (OR = 2.17, 95% CI: 1.67-2.82) were significantly associated with recommendation of COVID-19 vaccines to others after adjusting for sex, age, education, and occupation. Associations between low ontological insecurity and recommendations for COVID-19 vaccines were observed in men, adults aged 18-59 years, non-farmers, and vaccine recipients.

CONCLUSIONS

This study suggests that the ontological insecurity of participants affects their behavior of recommending the COVID-19 vaccination to others rather than getting vaccinated themselves. This promotion of vaccination can be considered from the perspective of improving ontological security in China.

miR-1297 inhibits osteosarcoma cell proliferation and growth by targeting CCND2

Cyclin D2 (CCND2) is abnormally overexpressed in many tumor types and has been associated with tumor cell proliferation. Although the important role of miR-1297 is well established, the molecular mechanism between CCND2 and miR-1297 in osteosarcoma (OS) has not been determined. In the present study, we found CCND2 was highly expressed in OS cells, and its downregulation suppressed cell proliferation, resulting in G1 phase cell cycle arrest. In contrast, miR-1297 was lowly expressed in OS compared to normal tissue. Several data platforms predicted that CCND2 was a target of miR-1297, which was validated by a dual-luciferase reporter assay that revealed miR-1297 could bind with CCND2-3'UTR. miR-1297 overexpression greatly inhibited CCND2 protein expression and exerted the same phenotypic effect as CCND2 downregulation in OS cells. Furthermore, miR-1297 inhibition could also be rescued by CCND2. Nude mice injected cells stable overexpressing miR-1297 OS cells showed lower size and tumor weight. Moreover, lower fluorescence activity recorded by in vivo imaging system and bone erosion revealed by microCT in the miR-1297 group demonstrated miR-1297 inhibited OS tumor growth via CCND2. Our findings demonstrated that miR-1297 can inhibit proliferation and tumor growth in OS by directly targeting CCND2, which indicates that miR-1297 may represent a novel therapeutic target for OS.

P-524 Bi-allelic CFAP61 variants cause male infertility in humans and mice with severe oligoasthenoteratozoospermia

Study question

Are mutations in cilia and flagella-associated protein 61 (CFAP61) associated with human male infertility?

Summary answer

Bi-allelic variants ([NM_015585.4: c.1654C&gt;T (p.R552C) and c.2911G&gt;A (p.D971N), c.144-2A&gt;G and c.1666G&gt;A (p.G556R)] in CFAP61 were identified as contributory genetics factor in severe oligoasthenoteratozoospermia (OAT).

What is known already

Cfap61 knockout mice were infertile due to multiple morphological abnormalities of the sperm flagella (MMAF). However, so far there is no direct evidence that mutations of CFAP61 cause OAT and male infertility.

Study design, size, duration

Variant screening was performed by whole-exome sequencing (WES) from 325 infertile patients with OAT and 392 fertile individuals. A knockout mouse model was generate to confirm the candidate disease-causing gene, intracytoplasmic sperm injection (ICSI) was used to evaluate the efficiency of clinical treatment.

Participants/materials, setting, methods

A total 325 OAT-affected patients and 392 men with normal fertility were recruited from China. WES was performed, followed by Sanger sequencing validation. In silico bioinformatics predictions and in vitro functional analyses were performed to evaluate the impacts of candidate disease-causing variants. Hematoxylin and eosin (H&E) staining, electron microscopy, and immunofluorescence assays were performed to evaluate the sperm morphology. Two OAT-affected men with CFAP61 variants were treated by ICSI, and pregnancy outcomes were followed.

Main results and the role of chance

We identified bi-allelic CFAP61 variants [NM_015585.4: c.1654C&gt;T (p.R552C) and c.2911G&gt;A (p.D971N), c.144-2A&gt;G and c.1666G&gt;A (p.G556R)] in two (0.62%) of the 325 OAT-affected men. In silico bioinformatics analysis predicted that all four variants were deleterious, and in vitro functional analysis confirmed the deleterious effects of the mutants. Notably, H&E staining and electron microscopy analyses of the spermatozoa revealed multiple morphological abnormalities of sperm flagella, the absence of central pair microtubules, and mitochondrial sheath malformation in sperm flagella from man with CFAP61 variants. Further immunofluorescence assays revealed markedly reduced CFAP61 staining in the sperm flagella. In addition, Cfap61-deficient mice showed the OAT phenotype, suggesting that loss of function of CFAP61 was the cause of OAT. Two individuals accepted ICSI therapy using their own ejaculated sperm, and one of them succeeded in fathering a healthy baby.

Limitations, reasons for caution

Limitations include the lack of in vivo data from the one of patients, and the exact molecular mechanism should be further investigated.

Wider implications of the findings

Our findings indicate that CFAP61 is essential for spermatogenesis and that bi-allelic CFAP61 variants lead to OAT and male infertility in humans and mice. In addition, our results show that ICSI treatment can be recommended for CFAP61-related OAT.

Trial registration number

not applicable

[Development and validation of a prognostic model based on SEER data for patients with esophageal carcinoma after esophagectomy]

OBJECTIVE

To develop a nomogram to predict the long-term survival of patients with esophageal cancer following esophagectomy.

METHODS

We collected the data of 7215 patients with esophageal carcinoma from the Surveillance, Epidemiology, and End Results (SEER) database during the period from 2004 and 2016. Of these patients, 5052 were allocated to the training cohort and the remaining 2163 patients to the internal validation cohort using bootstrap resampling, with another 435 patients treated in the Department of Cardiothoracic Surgery of Jinling Hospital between 2014 and 2016 serving as the external validation cohort.

RESULTS

In the overall cohort, the 1-, 3-, and 5-year cancer-specific mortality rates were 14.6%, 35.7% and 41.6%, respectively. Age (≥80 years vs < 50 years, P < 0.001), gender (male vs female, P < 0.001), tumor site (lower vs middle segment, P=0.013), histology (EAC vs ESCC, P=0.012), tumor grade (poorly vs well differentiated, P < 0.001), TNM stage (Ⅳ vs Ⅰ, P < 0.001), tumor size (> 50 mm vs 0-20 mm, P < 0.001), chemotherapy (yes vs no, P < 0.001), and LNR (> 0.25 vs 0, P < 0.001) were identified as independent risk factors affecting long-term survival of the patients. The nomograms established based on the model for predicting the survival probability of the patients at 1, 3 and 5 years after operation showed a C-index of 0.726 (95% CI: 0.714-0.738) for predicting the overall survival (OS) and of 0.735 (95% CI: 0.727-0.743) for cancer-specific survival (CSS) in the training cohort. In the internal validation cohort, the C-index of the nomograms was 0.752 (95% CI: 0.738-0.76) for OS and 0.804 (95% CI: 0.790-0.817) for CSS, as compared with 0.749 (95% CI: 0.736-0.767) and 0.788 (95%CI: 0.751-0.808), respectively, in the external validation cohort. The nomograms also showed a higher sensitivity than the TNM staging system for predicting long-term prognosis.

CONCLUSION

This prognostic model has a high prediction efficiency and can help to identify the high-risk patients with esophageal carcinoma after surgery and serve as a supplement for the current TNM staging system.

Bacillus Calmette Guerin injection improves hindlimb motor function and alleviates inflammation through upregulating Foxp3 expression in rats with spinal cord injury

Background:

Immune and inflammatory reactions are important factors leading to the secondary spinal cord injury.

Aim:

To investigate the effect of BCG on behavior after acute spinal cord injury in rats and its related mechanisms.

Methods:

Rats with spinal cord injury rats were generated according to modified Allen’s method. Rats were divided into BCG group (rats spinal cord injury intraperitoneally injecting with BCG), Model group (rats with spinal cord injury intraperitoneally injecting with normal saline) and Sham group (normal rats intraperitoneally injecting with normal saline). Basso, Beattie, and Bresnahan (BBB) scoring system was used for evaluating behavioral outcomes. Foxp3 expression in spinal cord tissues was evaluated using immunofluorescence analysis. HE staining was used for assessing the injury of spinal cord tissues.

Results:

BBB scores of Model group were remarkably lower compared to that of Sham group (P<0.05). Foxp3 expression was significantly downregulated in model group compared with that of Sham group (P<0.05). BBB scores of BCG group were significantly higher compared to that of model group at 3, 5, 7, and 14 days post treatment (P<0.05). In BCG group, there were fewer inflammatory cells, smaller cavities, and more complete structural arrangement than model group. BCG treatment significantly reduced the spinal cord injury score compared to that of model group (P<0.05). Post BCG treatment, Foxp3 expression was predominantly enhanced compared with that of model group (P<0.05).

Conclusion:

BCG could affect inflammation after spinal cord injury through upregulating the expression of Foxp3 and further promote the recovery of hindlimb motor function in rats with spinal cord injury.

Preoperative position and protection of radial nerve by B-ultrasound combined with MIPPO for treatment of middle-inferior humerus fractures

Background and purpose

Open reduction and internal fixation through the posterior approach are standard methods for treating middle-inferior humerus fractures. Given the limited operative field and difficulty in locating the radial nerve, the minimally invasive percutaneous plate osteosynthesis (MIPPO) technique via the posterior approach to treat middle-inferior humerus fractures has rarely been reported. This study aims to evaluate the clinical effect of the preoperative study of the radial nerve position by B-ultrasound and its intraoperative protection combined with MIPPO in managing middle-inferior humerus fractures.

Methods

The data were studied retrospectively involving 64 participants who had surgery for middle-inferior humerus fractures from the start of 2017 to the end of 2020. Participants were divided into two groups, those treated with the MIPPO technique, including newly developed dual procedures and preoperative position and protection of radial nerve by B-ultrasound (group A), and those treated with open reduction and internal plating fixation (group B).

Results

All the cases were followed up for 12–34 months (an average of 25.6 ± 8.76 months), and there was no significant difference in the mean operative duration, surgical incision infection, range of motion (ROM) and MEPS (Mayo elbow performance score) for groups A and B. However, the occurrence of complications (radial nerve palsy, bone nonunion and flexible internal fixation or ruptures) in group B was significantly higher than the group A. A statistically significant difference was observed in the intraoperative blood loss, hospital stay and fracture nonunion time between the two groups. All the cases gained bone union within the MIPPO group.

Conclusion

MIPPO via the posterior dual approach associated with preoperative position and protection of radial nerve by B-ultrasound does not increase radial nerve injury, however, it exhibits obvious advantages in the bone union, which is worthy of clinical application.

Finite Element Analysis of Horizontal Screw-Screw Crosslink Used in C1-C2 Pedicle Screw-Rod Fixation

BACKGROUND In the craniocervical junction, a C1-C2 pedicle screw-rod (PSR) fixation is applied to provide stability. The horizontal rod-rod crosslink (hR-R CL) is often used to enhance segmental posterior instrumentation. However, the biomechanics of the alternative horizontal screw-screw crosslink (hS-S CL) in the craniocervical junction are unclear. MATERIAL AND METHODS A nonlinear atlantoaxial instability 3-dimensional C1-C2 finite element model was constructed using computed tomography images. On this basis, 2 fixation models were established with C1-C2 PSR fixation using (1) a rod-rod crosslink (R-R CL), and (2) a screw-screw crosslink (S-S CL). Range of motion (ROM) of the atlantoaxial joint, stress distribution of the implants, and maximum stress value of the vertebral bodies were calculated and compared under 4 loading conditions, including flexion, extension, lateral bending, and axial rotation. RESULTS Atlantoaxial joint ROM was reduced by 90.19% to 98.5% with the hR-R CL, and by 90.1% to 98.7% with the hS-S CL, compared with the instability model. During axial rotation, the total stress peak of the PSR fixation was smaller with hS-S CL than with hR-R CL. The peak stress values of the vertebral bodies were comparable between the 2 fixation models. CONCLUSIONS The 2 tested crosslink models provided comparable stability. However, during axial rotation, the total stress peak of hS-S CL fixation was smaller than that of hR-R CL fixation. Since the atlantoaxial joint primarily functions as a rotational joint, our results suggested that the use of hS-S CL can provide a more stable environment for the implants.

Tracing TET1 expression in prostate cancer: discovery of malignant cells with a distinct oncogenic signature

Background

Ten–eleven translocation methylcytosine dioxygenase 1 (TET1) is involved in DNA demethylation and transcriptional regulation, plays a key role in the maintenance of stem cell pluripotency, and is dysregulated in malignant cells. The identification of cancer stem cells (CSCs) driving tumor growth and metastasis is the primary objective of biomarker discovery in aggressive prostate cancer (PCa). In this context, we analyzed TET1 expression in PCa.

Methods

A large-scale immunohistochemical analysis of TET1 was performed in normal prostate (NOR) and PCa using conventional slides (50 PCa specimens) and tissue microarrays (669 NOR and 1371 PCa tissue cores from 371 PCa specimens). Western blotting, RT-qPCR, and 450 K methylation array analyses were performed on PCa cell lines. Genome-wide correlation, gene regulatory network, and functional genomics studies were performed using publicly available data sources and bioinformatics tools.

Results

In NOR, TET1 was exclusively expressed in normal cytokeratin 903 (CK903)–positive basal cells. In PCa, TET1 was frequently detected in alpha-methylacyl-CoA racemase (AMACR)–positive tumor cell clusters and was detectable at all tumor stages and Gleason scores. Pearson’s correlation analyses of PCa revealed 626 TET1-coactivated genes (r > 0.5) primarily encoding chromatin remodeling and mitotic factors. Moreover, signaling pathways regulating antiviral processes (62 zinc finger, ZNF, antiviral proteins) and the pluripotency of stem cells were activated. A significant proportion of detected genes exhibited TET1-correlated promoter hypomethylation. There were 161 genes encoding transcription factors (TFs), of which 133 were ZNF-TFs with promoter binding sites in TET1 and in the vast majority of TET1-coactivated genes.

Conclusions

TET1-expressing cells are an integral part of PCa and may represent CSCs with oncogenic potential.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13148-021-01201-7.

[Comparison of single incision robot-assisted laparoscopic radical prostatectomy with and without extraperitoneal special channel device]

Objective: To compare the clinical effects of single-incision robot-assisted laparoscopic radical prostatectomy (RARP) with and without extraperitoneal special channel device. Methods: The clinical data of 70 patients who had undergone RARP in the Robotic Minimally Invasive Surgery Center of Sichuan Provincial People's Hospital from September 2020 to February 2021 were analyzed retrospectively, including 29 cases who were operated on without special channel device (group A) and 41 cases with special channel device (group B). All operations were performed by robot-assisted single-incision retrograde bladder neck exfoliation via extraperitoneal approach in patients by the same operator. The operation time, intraoperative blood loss, the bladder neck urethral anastomosis time, postoperative hospital stay, postoperative exhaust time, positive rate of incisal margin, indwelling time of urinary catheter, retention rate of postoperative erectile function, satisfaction rate of immediate postoperative urine control, positive rate of postoperative lymph node pathology, incision length, treatment cost and the rate of prostate specific antigen (PSA)lower than 0.2 μg/L at 6 weeks after operation were compared between the two groups. Results: All 70 cases were operated successfully. The difference of age[ (68.9±3.9) vs (69.4±5.4) years], preoperative PSA level[14.1(6.3, 19.8)vs13.7(5.8, 18.1)μg/L], prostate volume[44.8(30.7,172.6)vs 56.3(40.9,163.4)ml ] of the two groups was not statistically significant(all P>0.05). The difference of operation time [ (59.1±18.5) vs (59.6±18.0) min ], intraoperative blood loss [93(66,198)vs 95(68,203) ml ], bladder neck urethral anastomosis time [ (12.6±1.3) vs (13.7±2.8) min ], postoperative hospital stay [ (8.1±2.3) vs (9.1±1.3) d], postoperative exhaust time [ (1.4±0.6) vs (1.3±0.6) d], positive rate of incisal margin (20.7% vs 19.5%), indwelling time of the urinary catheter after operation [ (6.8±1.5) vs (7.1±2.0) d ], the retention rate of postoperative erectile function (31.0% vs 27.0%), the satisfaction rate of immediate postoperative urine control (79.3% vs 75.6%), the positive rate of postoperative lymph node pathology (17.2% vs 14.6%), the length of incision [ (5.1±0.5) vs (6.1±0.4) cm ], the rate of PSA lower than 0.2 μg/L at 6 weeks after operation (86.2% vs 83.0%) of the two groups was not statistically significant(all P>0.05). The operation cost of group A[(62 000±4 000) yuan]was lower than group B[(68 000±4 000) yuan] (P<0.05). Conclusion: Extraperitoneal non-special channel device single-incision RARP is safe and feasible.

Repair of spinal cord injury in rats via exosomes from bone mesenchymal stem cells requires sonic hedgehog

Objective

The loss of neural ability leading to subsequent diminishing of motor function and the impairment below the location of the injury is a result of the SCI (Spinal Cord Injury). Among the many therapeutic agents for SCI, the exosomes considered as extracellular vesicles seem to be the most promising. Sonic Hedgehog (Shh) is an exosome-carrying protein. This Study's purpose was to identify whether Shh is required for exosomes from BMSCs (mesenchymal stem cells of the bone) and plays a protective effect on SCI.

Methods

Spinal cord injection with shRNA Shh-adeno associated virus (sh-Shh-AAV) were used to silence Shh. Exosomes were extracted from BMSCs. Rats that had suffered SCI were given intravenous injections of exosomes through the veins of the tail. Immunohistochemistry was used to identify the expression of Shh glycoprotein molecule as well as the expression of Gli-1 (glioma-associated oncogene homolog 1) in the rat spinal cord tissues. Western blot was performed to measure the levels of growth associated protein-43 (GAP-43). The BBB (Basso Beattie Bresnahan) score was used to assess the motor functions of the hind legs. In the same manner, terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling or TUNEL and Nissl Staining was deployed to assess the level of regeneration of neurons and assess the level of histopathological damage in the tissues of the Spinal Cord.

Results

In the case of the rats with SCI, the levels of display of Gli-1 and Shh showed dramatic improvement after the BMSCs exosome injections. In comparison to rats with SCI, the subjects of BMSCs exosomes group showed an improvement in their SCI, including a higher BBB score and Nissl body count, increasing GAP-43 expression, along with a much-decreased number of cells that suffered apoptosis. While the exosome effect on Spinal Cord Injury was completely ineffective in rats that had Shh silencing.

Conclusions

Exosomes secreted from BMSCs showed great effectiveness in the SCI healing with a vital involvement of Shh in this repair.

Comprehensive evaluation of genetic variants using chromosomal microarray analysis and exome sequencing in fetuses with congenital heart defect

OBJECTIVE

To evaluate comprehensively, using chromosomal microarray analysis (CMA) and exome sequencing (ES), the prevalence of chromosomal abnormalities and sequence variants in unselected fetuses with congenital heart defect (CHD) and to evaluate the potential diagnostic yields of CMA and ES for different CHD subgroups.

METHODS

This was a study of 360 unselected singleton fetuses with CHD detected by echocardiography, referred to our department for genetic testing between February 2018 and December 2019. We performed CMA, as a routine test for aneuploidy and copy number variations (CNV), and then, in cases without aneuploidy or pathogenic CNV on CMA, we performed ES.

RESULTS

Overall, positive genetic diagnoses were made in 84 (23.3%) fetuses: chromosomal abnormalities were detected by CMA in 60 (16.7%) and sequence variants were detected by ES in a further 24 (6.7%) cases. The detection rate of pathogenic and likely pathogenic genetic variants in fetuses with non-isolated CHD (32/83, 38.6%) was significantly higher than that in fetuses with isolated CHD (52/277, 18.8%) (P < 0.001), this difference being due mainly to the difference in frequency of aneuploidy between the two groups. The prevalence of a genetic defect was highest in fetuses with an atrioventricular septal defect (36.8%), ventricular septal defect with or without atrial septal defect (28.4%), conotruncal defect (22.2%) or right ventricular outflow tract obstruction (20.0%). We also identified two novel missense mutations (c.2447G>C, p.Arg816Pro; c.1171C>T, p.Arg391Cys) and a new phenotype caused by variants in PLD1.

CONCLUSIONS

Chromosomal abnormalities were identified in 16.7% and sequence variants in a further 6.7% of fetuses with CHD. ES should be offered to all pregnant women with a CHD fetus without chromosomal abnormality or pathogenic CNV identified by CMA, regardless of whether the CHD is isolated. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.

Exosomes secreted from sonic hedgehog-modified bone mesenchymal stem cells facilitate the repair of rat spinal cord injuries

BACKGROUND

Spinal cord injuries (SCIs) can cause a loss of neurons and associated sensory and motor functionality below the injured site. No approaches to treating SCIs in humans have been developed to date. Exosomes are extracellular vesicles that hold promise as a potential therapeutic modality when treating such injuries. The present study was thus designed to determine whether sonic hedgehog (Shh)-overexpressing bone mesenchymal stem cell (BMSC)-derived exosomes were protective in the context of SCIs.

METHODS

Exosomes were extracted from control or Shh lentivirus-transduced BMSCs, yielding respective BMSC-Exo and BMSC-Shh-Exo preparations which were intravenously injected into SCI model rats. Shh expression in spinal cord tissues in these animals was then assessed via immunohistochemical staining, while Basso-Beattie-Bresnahan (BBB) scores were utilized to measure high limb motor function. Neuronal damage and regeneration within the spinal cord were additionally evaluated via terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), Nissl, hematoxylin and eosin, and immunofluorescent staining.

RESULTS

Both BMSC-Exo and BMSC-Shh-Exo preparations significantly increased Shh expression in the spinal cord of SCI model rats and improved BBB scores in these treated animals, while also increasing the frequencies of Nissl- and NeuN-positive neurons are reducing the numbers of apoptotic and GFAP-positive neurons. While both treatments yielded some degree of benefit to treated animals relative to untreated controls, BMSC-Shh-Exos were more beneficial than were control BMSC-Exos.

CONCLUSIONS

Shh-overexpressing BMSC-derived exosomes represent an effective treatment that can facilitate SCI repair in rats.

The effect of mild hypothermia plus rutin on the treatment of spinal cord injury and inflammatory factors by repressing TGF-β/smad pathway

Purpose

To probe the mechanism of mild hypothermia combined with rutin in the treatment of spinal cord injury (SCI).

Methods

Thirty rats were randomized into the following groups: control, sham, model, mild hypothermia (MH), and mild hypothermia plus rutin (MH+Rutin). We used modified Allen’s method to injure the spinal cord (T10) in rats, and then treated it with MH or/and rutin immediately. BBB scores were performed on all rats. We used HE staining for observing the injured spinal cord tissue; ELISA for assaying TNF-α, IL-1β, IL-8, Myeloperoxidase (MPO), and Malondialdehyde (MDA) contents; Dihydroethidium (DHE) for measuring the reactive oxygen species (ROS) content; flow cytometry for detecting apoptosis; and both RT-qPCR and Western blot for determining the expression levels of TGF-β/Smad pathway related proteins (TGF-β, Smad2, and Smad3).

Results

In comparison with model group, the BBB score of MH increased to a certain extent and MH+Rutin group increased more than MH group (p < 0.05). After treatment with MH and MH+Rutin, the inflammatory infiltration diminished. MH and MH+Rutin tellingly dwindled TNF-β, MDA and ROS contents (p < 0.01), and minified spinal cord cell apoptosis. MH and MH+Rutin could patently diminished TGF-β1, Smad2, and Smad3 expression (p < 0.01).

Conclusions

MH+Rutin can suppress the activation of TGF-β/Smad pathway, hence repressing the cellular inflammatory response after SCI.

Perpendicular and in-plane hole asymmetry in a strained NiFe2O4film

Strained materials can exhibit drastically modified physical properties in comparison to their fully relaxed analogues. We report on the x-ray absorption spectra (XAS) and magnetic circular dichroism (XMCD) of a strained NiFe₂O₄inverse spinel film grown on a symmetry matched single crystal MgGa₂O₄substrate. The Ni XAS spectra exhibit a sizable difference in the white line intensity for measurements with the x-ray electric field parallel to the film plane (normal incidence) vs when the electric field is at an angle (off-normal). A considerable difference is also observed in the FeL_2,3XMCD spectrum. Modeling of the XAS and XMCD spectra indicate that the modified energy ordering of the cation 3dstates in the strained film leads to a preferential filling of 3dstates with out-of-plane character. In addition, the results point to the utility of x-ray spectroscopy in identifying orbital populations even with elliptically polarized x-rays.

System-on-chip upgrade of millimeter-wave imaging diagnostics for fusion plasma

Monolithic, millimeter wave "system-on-chip" technology has been employed in chip heterodyne radiometers in a newly developed Electron Cyclotron Emission Imaging (ECEI) system on the DIII-D tokamak for 2D electron temperature and fluctuation diagnostics. The system employs 20 horn-waveguide receiver modules each with customized W-band (75-110 GHz) monolithic microwave integrated circuit chips comprising a W-band low noise amplifier, a balanced mixer, a ×2 local oscillator (LO) frequency doubler, and two intermediate frequency amplifier stages in each module. Compared to previous quasi-optical ECEI arrays with Schottky mixer diodes mounted on planar antennas, the upgraded W-band array exhibits >30 dB additional gain and 20× improvement in noise temperature; an internal eight times multiplier chain is used to provide LO coupling, thereby eliminating the need for quasi-optical coupling. The horn-waveguide shielding housing avoids out-of-band noise interference on each module. The upgraded ECEI system plays an important role for absolute electron temperature and fluctuation measurements for edge and core region transport physics studies. An F-band receiver chip (up to 140 GHz) is under development for additional fusion facilities with a higher toroidal magnetic field. Visualization diagnostics provide multi-scale and multi-dimensional data in plasma profile evolution. A significant aspect of imaging measurement is focusing on artificial intelligence for science applications.

Integrated package of electron cyclotron emission imaging data processing and forward modeling in OMFIT

An Electron Cyclotron Emission Imaging (ECEI) data analysis module has been developed for the OMFIT platform to accommodate the needs of users at the DIII-D tokamak for physics applications. The user can easily access the ECEI spatial observation windows in the plasma that are calculated based on the automatically retrieved hardware setup and available DIII-D equilibria, perform spectral analysis, and obtain 2D electron temperature fluctuation images. The module provides a powerful data post-processing package for extracting important physics parameters from the 2D measurements, including the radial structure and poloidal mode number of Alfven eigenmodes, as well as the frequency-vs-wavenumber dispersion relationship of broadband MHD. The module propagates characterized synthetic fluctuations for the user, so one can perform forward modeling tasks with simple analytical fluctuations.

Glassy dynamics of a binary Voronoi fluid: a mode-coupling analysis

The binary Voronoi mixture is a fluid model whose interactions are derived from the Voronoi-Laguerre tessellation of the configurations of the system. The resulting interactions are local and many-body. Here we perform molecular-dynamics (MD) simulations of an equimolar mixture that is weakly polydisperse and additive. For the first time we study the structural relaxation of this mixture in the supercooled-liquid regime. From the simulations we determine the time- and temperature-dependent coherent and incoherent scattering functions for a large range of wave vectors, as well as the mean-square displacements of both particle species. We perform a detailed analysis of the dynamics by comparing the MD results with the first-principles-based idealized mode-coupling theory (MCT). To this end, we employ two approaches: fits to the asymptotic predictions of the theory, and fit-parameter-free binary MCT calculations based on static-structure-factor input from the simulations. We find that many-body interactions of the Voronoi mixture do not lead to strong qualitative differences relative to similar analyses carried out for simple liquids with pair-wise interactions. For instance, the fits give an exponent parameter λ ≈ 0.746 comparable to typical values found for simple liquids, the wavevector dependence of the Kohlrausch relaxation time is in good qualitative agreement with literature results for polydisperse hard spheres, and the MCT calculations based on static input overestimate the critical temperature, albeit only by a factor of about 1.2. This overestimation appears to be weak relative to other well-studied supercooled-liquid models such as the binary Kob-Andersen Lennard-Jones mixture. Overall, the agreement between MCT and simulation suggests that it is possible to predict several microscopic dynamic properties with qualitative, and in some cases near-quantitative, accuracy based solely on static two-point structural correlations, even though the system itself is inherently governed by many-body interactions.

Mixed-reality hologram for diagnosis and surgical planning of double outlet of the right ventricle: a pilot study

AIM

To evaluate the mixed-reality (MR) hologram, a novel technology based on two-dimensional images, which simulates three-dimensional (3D) images and provides a dynamic and interactive alternative, for its usefulness in the diagnosis and surgical planning of double outlet of the right ventricle (DORV).

MATERIALS AND METHODS

Thirty-four patients who were suspected of DORV based on ultrasound findings underwent cardiac computed tomography angiography (CTA). The patients were assigned randomly to the MR holographic guidance (MRHG) group or the control group. For the patients in the MRHG group, the CTA images were converted into Standard Template Library (STL) files after segmentation, 3D reconstruction, colourisation, and transparentisation, and then exported for MR holographic visualisation. The CTA images of the patients in the control group were analysed using routine 3D reconstruction only. Diagnostic accuracy and surgical planning were compared between the two groups based on visualisation at surgery.

RESULTS

In the MRHG group, the 3D hologram observation was in concordance with the actual anatomical findings, and the DORV type was classified accurately in all patients. The diagnostic accuracy for the malformation was 95.5% in the MRHG group and 89.7% in the control group, but the difference was not significant (p=0.3). All the procedures were exactly the same as planned based on the 3D MR holographic model. The surgical planning time was shorter for the MRHG group (51.65 ± 11.11 min) than that for the control group (65.71 ± 18.07 min, p<0.05).

CONCLUSION

MR 3D holograms may provide a clear and deeper anatomical perception of DORV and improve surgical planning.

MicroRNA-130b-5p accelerates the migration and invasion of osteosarcoma via binding to TIMP2

OBJECTIVE

To elucidate the potential function of microRNA-130b-5p in the progression of osteosarcoma (OS) and the underlying mechanism.

MATERIALS AND METHODS

The relative level of microRNA-130b-5p in OS tissues and cell lines was determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The correlation between the microRNA-130b-5p level and the pathological characteristics of OS was analyzed by the Chi-square test. The Kaplan-Meier curves were introduced for assessing the survival of OS patients with high expression and low expression of microRNA-130b-5p. The regulatory effects of microRNA-130b-5p on the migratory and invasive abilities of MG63 and U2OS cells were evaluated by the transwell assay. The relative levels of matrix metalloproteinase 2 (MMP2) and MMP9 in OS cells with overexpression or knockdown of microRNA-130b-5p were determined. The binding relationship between microRNA-130b-5p and TIMP2 was verified through the dual-luciferase reporter gene assay. Finally, a series of rescue experiments were performed to uncover the role of microRNA-130b-5p/TIMP2 in the progression of OS.

RESULTS

MicroRNA-130b-5p was upregulated in OS tissues and cell lines. The high expression of microRNA-130b-5p indicated a poor prognosis of OS patients. The overexpression of microRNA-130b-5p accelerated OS cells to migrate and invade. Besides, the relative levels of MMP2 and MMP9 were upregulated in OS cells overexpressing microRNA-130b-5p. TIMP2 was the direct target of microRNA-130b-5p, which was negatively regulated by microRNA-130b-5p. The knockdown of TIMP2 reversed the regulatory effect of microRNA-130b-5p on the migratory and invasive abilities of the OS cells.

CONCLUSIONS

MicroRNA-130b-5p is upregulated in OS. It accelerates the progression of OS via inhibiting TIMP2 level.

Observation of compact ferrimagnetic skyrmions in DyCo3 film

Owing to the experimental discovery of magnetic skyrmions stabilized by the Dzyaloshinskii-Moriya and/or dipolar interactions in thin films, there is a recent upsurge of interest in magnetic skyrmions with antiferromagnetic spins in order to overcome the fundamental limitations inherent with skyrmions in ferromagnetic materials. Here, we report on the observation of compact ferrimagnetic skyrmions for the class of amorphous alloys consisting of 4f rare-earth and 3d transition-metal elements with perpendicular magnetic anisotropy, using a DyCo₃ film, that are identified by combining X-ray magnetic scattering, scanning transmission X-ray microscopy, and Hall transport technique. These skyrmions, with antiparallel aligned Dy and Co magnetic moments and a characteristic core radius of about 40 nm, are formed during the nucleation and annihilation of the magnetic maze-like domain pattern exhibiting a topological Hall effect contribution. Our findings provide a promising route for fundamental research in the field of ferrimagnetic/antiferromagnetic spintronics towards practical applications.

W-band system-on-chip electron cyclotron emission imaging system on DIII-D

Monolithic, millimeter-wave "system-on-chip" (SoC) technology has been employed in heterodyne receiver integrated circuit radiometers in a newly developed Electron Cyclotron Emission Imaging (ECEI) system on the DIII-D tokamak for 2D electron temperature profile and fluctuation evolution diagnostics. A prototype module operating in the E-band (72 GHz-80 GHz) was first employed in a 2 × 10 element array that demonstrated significant improvements over the previous quasi-optical Schottky diode mixer arrays during the 2018 operational campaign of the DIII-D tokamak. For compatibility with International Thermonuclear Experimental Reactor relevant scenarios on DIII-D, the SoC ECEI system was upgraded with 20 horn-waveguide receiver modules. Each individual module contains a University of California Davis designed W-band (75 GHz-110 GHz) receiver die that integrates a broadband low noise amplifier, a double balanced down-converting mixer, and a ×4 multiplier on the local oscillator (LO) chain. A ×2 multiplier and two IF amplifiers are packaged and selected to further boost the signal strength and downconvert the signal frequency. The upgraded W-band array exhibits >30 dB additional gain and 20× improvement in noise temperature compared with the previous Schottky diode radio frequency mixer input systems; an internal 8 times multiplier chain is used to bring down the LO frequency below 12 GHz, thereby obviating the need for a large aperture for quasi-optical LO coupling and replacing it with coaxial connectors. Horn-waveguide shielding housing avoids out-of-band noise interference on each individual module. The upgraded ECEI system plays an important role for absolute electron temperature evolution and fluctuation measurements for edge and core region transport physics studies.

Radiofrequency ablation versus laparoscopic hepatectomy for treatment of hepatocellular carcinoma: a systematic review and meta-analysis

Background

Several randomized controlled trials (RCTs) compared the effects of laparoscopic hepatectomy (LH) and radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC), but the results have remained inconsistent. Hence, a meta-analysis and a systematic review of these treatment modalities are necessary to evaluate their efficacy and safety for HCC treatment.

Methods

From the inception of this meta-analysis and review until August 31, 2019, we searched Medline, PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, and China Biomedical Literature Database for RCTs involving LH and RFA treatments of patients with HCC. The studies were screened and the data from these articles were extracted independently by two authors. Summary odd ratios (OR) or mean differences (MD) with 95% confidence intervals (CI) were calculated for each outcome with a fixed- or random-effect model. The outcomes for effectiveness evaluations included duration of surgery, estimated bleeding volume, incidence of blood transfusion during surgery, duration of hospital stay, and the outcome for safety included the incidence of cancer recurrence.

Results

Seven RCTs with a total of 615 patients were identified, 312 and 303 of which underwent RFA and LH treatments, respectively. The duration of surgery (MD = −99.04; 95% CI: −131.26–−66.82), estimated bleeding volume (MD = −241.97; 95% CI: −386.93–−97.02), incidence of blood transfusion during surgery (OR = 0.08; 95% CI: 0.02–0.37), and duration of hospital stay (MD = −3.4; 95% CI: −5.22–−1.57) in RFA treatment were significantly lower than those of LH treatment. However, the incidence of cancer recurrence was significantly higher for RFA treatment compared with LH treatment (OR = 2.68; 95% CI: 1.72–4.18).

Conclusions

LH treatment is preferred over RFA treatment with a better radical effect, but RFA treatment is more beneficial with smaller trauma, development of less complications, and shorter operating time when compared with HCC treatment.

[Comparison of radiological changes after Halo-pelvic traction with posterior spinal osteotomy versus simple posterior spinal osteotomy for severe rigid spinal deformity]

Objective

To compare the changes of scoliosis and kyphosis angles after Halo-pelvic traction with posterior spinal osteotomy versus simple posterior spinal osteotomy for severe rigid spinal deformity.

Methods

A clinical data of 28 patients with severe rigid spinal deformity between January 2015 and November 2017 was retrospectively analyzed. Sixteen patients were treated by Halo-pelvic traction with posterior spinal osteotomy (group A) and 12 patients were treated with posterior spinal osteotomy only (group B). There was no significant difference between the two groups ( P>0.05) in gender, age, body mass index, and preoperative pulmonary function, coronal and sagittal Cobb angles, and flexibility. The operation time, intraoperative blood loss, and complications were recorded. The coronal and sagittal Cobb angles were measured on X-ray films before operation (before traction in group A), at 10 days after operation, at last follow-up in the two groups and after traction in group A. The improvement rate of deformity after traction in group A, the correction rate of deformity after operation, and the loss rate of correction at last follow-up were calculated.

Results

All patients were followed up 24-30 months (mean, 26.5 months). The operation time and intraoperative blood loss were significantly less in group A than in group B ( t=7.629, P=0.000; t=8.773, P=0.000). In group A, 1 patient occurred transient numbness of both legs during continuous traction and 2 patients needed ventilator support for more than 12 hours. In group B, 7 patients needed ventilator support for more than 12 hours, including 1 patient with deep incision infection. The incidence of complications was 18.75% (3/16) in group A and 58.33% (7/12) in group B, and the difference between the two groups was significant ( χ ²=4.680, P=0.031). The coronal and sagittal improvement rates of deformity after traction in group A were 40.47%±3.60% and 40.70%±4.20%, respectively. There was no significant difference between the two groups ( P>0.05) in the coronal and sagittal Cobb angles at 10 days after operation and at last follow-up, in the correction rate of deformity after operation, and in the loss rate of correction at last follow-up.

Conclusion

For the severe rigid spinal deformity, Halo-pelvic traction with posterior spinal osteotomy and simple posterior spinal osteotomy can obtain the same orthopedic effect and postoperative deformity correction. However, the Halo-pelvic traction can shorten operation time, reduce blood loss and incidence of perioperative complications.

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

BACKGROUND

This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery.

METHODS

This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery.

RESULTS

A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498).

CONCLUSION

There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

Treatment of cervical spondylotic radiculopathy with posterior percutaneous endoscopic cervical discectomy: Short-term outcomes of 24 cases

To determine the short-term clinical outcomes of single-segment cervical spondylotic radiculopathy treated with posterior percutaneous endoscopic cervical discectomy (PPECD).Data of a total of 24 patients who underwent PPECD and local anesthesia for single-level segmental cervical spondylotic radiculopathy between March 2016 and December 2017 were reviewed. The Japanese Orthopaedic Association, visual analog scale (VAS), and neck disability index scores at preoperative 1 day, postoperative 1 day, 1 week, 1 month, 3 months, 6 months, and 1 year were recorded. The modified MacNab criteria at the last follow-up were re-recorded for the evaluation of clinical effectiveness.All operations were successfully completed under endoscopic guidance. No patient showed spinal cord, nerve root, vascular injuries, dural tears or other complications. The postoperative VAS scores of the arm and neck were significantly reduced compared with the preoperative VAS scores (P < .05), while postoperative the Japanese Orthopaedic Association scores were significantly increased (P < .05). The postoperative neck disability index scores were significantly reduced compared with preoperative scores (P < .05). The modified MacNab criteria at the last follow-up showed 16 excellent cases, 8 good cases, 0 fine cases, and 0 poor cases. Postoperative magnetic resonance imaging and cervical 3-dimensional computed tomography reconstruction showed that the intervertebral disc was adequately resected and the nerve root was not under compression.PPECD is safe and effective for the treatment of single-segment cervical spondylotic radiculopathy.

Analysis of Superimposed Influence of Double Layer Gas Flow on Gas-Assisted Extrusion of Plastic Micro-Tube

A plastic micro-tube is extremely small, and the melt is still in a molten state when the melt exits the die. The inner layer gas still flows in the micro-cavity after leaving the die, therefore, the diameter of the micro-tube increases gradually. When the outer layer gas leaves the die, it blows directly to the outer wall of the micro-tube. The flow of the double layer gas has a great influence on the extrusion of the micro-tube. To this end, a double layer gas-assisted extrusion model based on gas/melt two-phase flow is established. It focuses on the overlay effect of the double layer gas flow on the forming micro-tube. Through a finite element numerical simulation of the micro-tube extrusion process, forming the double gas layer inside and outside the tube wall, respectively, we obtain the shape, velocity, pressure drop and first normal stress difference of the micro-tube. The analysis shows that the double gas layer inside and outside the tube wall have asymmetrical effect on the melt, and they must be analyzed at the same time; the first normal stress difference is generated at the entrance of the die, exit of the die and downstream of the die exit; it reflects the extrusion deformation of the gas to the micro-tube, the degree of extrusion on the micro-tube wall, the distribution of the velocities X and Y, and the distribution of the pressure drop, to some extent. Compared with the micro-tube gas-assisted extrusion experiment, when the gas pressure is large, the result is consistent with the phenomenon of irregular corrugation on the wall surface of the micro-tube, the wall at the exit of the die is rapidly thinned and the wall downstream of the die exit gradually thins.

Clinical analysis of an anchor nail combined with a titanium cable in the treatment of lower patella fractures

OBJECTIVE

This study was performed to evaluate the clinical effect of an anchor nail and titanium cable for lower patella fractures and identify an effective treatment.

METHODS

Thirty-five patients with lower patella fractures were treated using anchor nail and titanium cable technology. The anchor was fixed to the main part of the patella; the lower patella was then fixed. A bone tunnel was created, and the titanium cable was fixed. The fracture was allowed to heal without tension. Postoperative radiographs were obtained at regular follow-up evaluations. The Böstman function scores were used to assess postoperative complications.

RESULTS

All patients were followed for an average of 15 months. The fracture healing time ranged from 12 to 24 weeks. The postoperative Böstman function scores were as follows: average, 28.6 points; excellent and good scores in 28 and 7 patients, respectively (100% rate of excellent and good scores). At 6 and 12 months postoperatively, the maximum degree of active extension of the affected knee joint was comparable with that of the healthy contralateral joint.

CONCLUSION

The combination of an anchor nail and titanium cable for lower patella fractures is simple and clinically satisfactory, restores knee function well, and is a worthy orthopedic method.

Systematic analysis of copy-number variations associated with early pregnancy loss

OBJECTIVES

Embryonic numerical and structural chromosomal abnormalities are the most common cause of early pregnancy loss. However, the role of submicroscopic copy-number variations (CNVs) in early pregnancy loss is unclear, and little is known about the critical regions and candidate genes for miscarriage, because of the large size of structural chromosomal abnormalities. The aim of this study was to identify potential miscarriage-associated submicroscopic CNVs and critical regions of large CNVs as well as candidate genes for miscarriage.

METHODS

Over a 5-year period, 5180 fresh miscarriage specimens were investigated using quantitative fluorescent polymerase chain reaction/CNV sequencing or chromosomal microarray analysis. Statistically significant submicroscopic CNVs were identified by comparing the frequency of recurrent submicroscopic CNVs between cases and a published control cohort. Furthermore, genes within critical regions of miscarriage-associated CNVs were prioritized by integrating the Residual Variation Intolerance Score and the human gene expression dataset for identification of potential miscarriage candidate genes.

RESULTS

Results without significant maternal-cell contamination were obtained in 5003 of the 5180 (96.6%) cases. Clinically significant chromosomal abnormalities were identified in 59.1% (2955/5003) of these cases. Three recurrent submicroscopic CNVs (microdeletions in 22q11.21, 2q37.3 and 9p24.3p24.2) were significantly more frequent in miscarriage cases, and were considered to be associated with miscarriage. Moreover, 44 critical regions of large CNVs were observed, including 14 deletions and 30 duplications. There were 309 genes identified as potential miscarriage candidate genes through gene-prioritization analysis.

CONCLUSIONS

We identified potential miscarriage candidate CNVs and genes. These data demonstrate the importance of CNVs in the etiology of miscarriage and highlight the importance of ongoing analysis of CNVs in the study of miscarriage. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.