Bioinformatics analysis and validation of mesenchymal stem cells related gene MT1G in osteosarcoma

BACKGROUND

Osteosarcoma (OS) is a primary malignant bone tumor arising from mesenchymal cells. The standard clinical treatment for OS involves extensive tumor resection combined with neoadjuvant chemotherapy or radiotherapy. OS's invasiveness, lung metastasis, and drug resistance contribute to a low cure rate and poor prognosis with this treatment. Metallothionein 1G (MT1G), observed in various cancers, may serve as a potential therapeutic target for OS.

METHODS

OS samples in GSE33382 and TARGET datasets were selected as the test cohorts. As the external validation cohort, 13 OS tissues and 13 adjacent cancerous tissues from The Second Affiliated Hospital of Nanchang University were collected. Patients with OS were divided into high and low MT1G mRNA-expression groups; differentially expressed genes (DEGs) were identified as MT1G-related genes. The biological function of MT1G was annotated using Kyoto Encyclopedia of Genes and Genomes (KEGG), Gene Ontology (GO) and gene set enrichment analysis (GSEA). Gene expression correlation analysis and competing endogenous RNA (ceRNA) regulatory network construction were used to determine potential biological regulatory relationships of DEGs. Survival analysis assessed the prognostic value of MT1G.

RESULTS

MT1G expression increased in OS samples and presented higher in metastatic OS compared with non-metastatic OS. Functional analyses indicated that MT1G was mainly associated with spliceosome. A ceRNA network with DEGs was constructed. MT1G is an effective biomarker predicting survival and correlated with increased recurrence rates and poorer survival.

CONCLUSIONS

This research identified MT1G as a potential biomarker for OS prognosis, highlighting its potential as a therapy target.

Modified Percutaneous Endoscopic Interlaminar Discectomy through the Near-spinous Process Approach for L4/5 Disc Herniation: A Retrospective Clinical Study

OBJECTIVE

Compared with traditional open surgery, percutaneous endoscopic lumbar discectomy (PELD) has the advantages of less trauma, faster recovery, and less postoperative pain, so it has been widely used in the field of spinal surgery. However, it still has the defect of intraoperative fluoroscopy occurrences, complications, and even the risk of damage to the spinal cord and nerve. This study aims to compare the clinical efficacy of modified percutaneous endoscopic interlaminar discectomy (MPEID) with percutaneous endoscopic transforaminal discectomy (PETD) in treating L4/5 lumbar disc herniation (LDH) and to evaluate the effectiveness and safety of MPEID.

METHODS

Thirty-four L4/5 LDH patients treated at the Second Affiliated Hospital of Nanchang University from June 2020 to June 2021 were studied retrospectively. Seventeen underwent MPEID and seventeen PETD. Variables analyzed included demographics, operative duration, intraoperative fluoroscopy occurrences, and surgical outcomes. Effectiveness was evaluated using the visual analogue scale (VAS), Oswestry disability index (ODI), and modified MacNab criteria. Lumbar Magnetic Resonance Imaging (MRI) was used to assess radiological outcomes. A paired t-test was performed to compare intragroup pre- and postoperative clinical data, VAS, and ODI scores.

RESULTS

The average operative time in PETD group was 91.65 ± 14.04 min, and the average operative time in MPEID group was 65.41 ± 12.61 min (p < 0.001). In PETD group, the fluoroscopy occurrences averaged 9.71 ± 1.05 times, with fluoroscopy occurrences averaging 6.47 ± 1.00 times (p < 0.001) in MPEID group. At 12 months follow-up, the clinical effect showed significant improvement in both two groups. The MPEID group showed a decrease in average VAS-back score from 5.41 ± 2.18 to 1.76 ± 1.09 (p < 0.001) and VAS-leg score from 6.53 ± 1.66 to 0.82 ± 0.64 (p < 0.001). The ODI scores decreased from 51.35 ± 10.65 to 11.71 ± 2.91 (p < 0.001). In the PETD group, the VAS-back score decreased from 4.94 ± 1.98 to 2.06 ± 1.25 (p < 0.001), VAS-leg score from 7.12 ± 1.73 to 1.12 ± 0.60 (p < 0.001), and ODI scores from 48.00 ± 11.62 to 12.24 ± 2.56 (p < 0.001). According to the modified MacNab criteria, MPEID had 15 excellent and two good results; PETD had 12 excellent and 5 good (p = 0.23). No nerve root injuries, dural tears, or significant complications were reported.

CONCLUSION

MPEID and PETD effectively treat L4/5 LDH, with MPEID showing shorter operative times and fewer fluoroscopies. Furthermore, the MPEID group can provide excellent clinical efficacy as the PETD group in the short term.

[Comparative study of percutaneous transfacet screw and pedicle screw in oblique lumbar interbody fusion for the treatment of single-level lumbar spinal stenosis]

Objective: To conduct a comparative study of radiological and clinical outcomes between percutaneous transfacet screw (TFS) and pedicle screw (BPS) in oblique lateral lumbar interbody fusion (OLIF) for single-level lumbar spinal stenosis. Methods: A retrospective cohort study. Patients who underwent OLIF with TFS or BPS for the treatment of single-level lumbar spinal stenosis at Beijing Jishuitan Hospital from January 2019 to June 2022 were retrospectively analyzed. Radiological parameters and clinical indicators were compared between the two groups. Radiological parameters included preoperative, immediate postoperative (within 5 days), and 1-year postoperative measurements of disc height and segmental lordosis angle, as well as interbody fusion status at 1 year postoperatively. Clinical indicators included operative time, blood loss, length of hospital stay, complications, and Oswestry Disability Index (ODI), visual analogue scale (VAS) scores for back pain, and leg pain before and 1 year after surgery. Results: Four male and 10 female patients with an average age of (61.0±11.2) years underwent OLIF with TFS, while 9 male and 12 female patients underwent OLIF with BPS, with a mean age of (60.9±6.7) years. There was no statistically significant difference in preoperative disc height between the TFS and BPS groups (P>0.05). The immediate postoperative disc height was (12.9±2.1) mm and it was (10.4±1.7) mm at 1-year follow-up in the TFS group; in the BPS group, it was (12.9±2.1) mm immediately postoperatively and (11.9±2.1) mm at 1-year follow-up; there was statistically significant difference between the two groups at 1-year follow-up (P=0.037). The segmental lordosis angle showed no significant differences within each group or between the two groups at preoperative, immediate postoperative, or 1-year postoperative follow-up (all P>0.05). At 1-year postoperative follow-up, the fusion rates was 92.9%(13/14) in the TFS group and 95.2%(20/21) in the BPS group, with no statistically significant difference between the two groups (P>0.05). The TFS group had a significantly shorter operative time and less blood loss compared to the BPS group [(164.3±33.9) minutes vs (191.7±31.8) minutes and (74.3±46.9) ml vs (124.8±54.0) ml, respectively] (both P<0.05). Both groups showed significant improvement in ODI and VAS scores at 1 year postoperatively compared to those preoperatively, but with no statistically significant difference was found between the groups (both P>0.05). Conclusions: OLIF with TFS fixation can effectively restore disc height and alleviate back and leg pain in patients with single-level lumbar spinal stenosis. Compared to the OLIF with BPS procedure, OLIF with TFS has shorter operative time and less blood loss.

Association between infarct location and haemorrhagic transformation of acute ischaemic stroke after intravenous thrombolysis

AIM

To evaluate the association between computed tomography (CT)-based imaging variables at the time of admission and haemorrhagic transformation (HT) after intravenous thrombolysis (IVT).

MATERIALS AND METHODS

One hundred and eight patients who were treated with IVT for acute ischaemic stroke (AIS) during January 2021 to July 2023 were analysed retrospectively. The infarct location was classified as cortical or subcortical in accordance with the Alberta Stroke Program Early CT Score (ASPECTS) system. Logistic regression and receiver operating characteristic curve analyses were performed to determine the relationship between ischaemic variables and HT.

RESULTS

Of the total, 18 (16.7%) patients had HT and seven (6.5%) had symptomatic intracerebral haemorrhage (sICH). Multivariate analysis revealed that cortical ASPECTS was independently associated with HT (odds ratio [OR], 0.197; 95% confidence interval [CI], 0.076-0.511; p=0.001) and cortical ASPECTS was independently associated with sICH (OR, 0.066; 95% CI, 0.009-0.510; p=0.009). To predict HT and sICH, cortical ASPECTS (HT area under the curve [AUC] = 0.881, sICH AUC = 0.971) provided a higher AUC compared with ASPECTS (HT AUC = 0.850, sICH AUC = 0.918).

CONCLUSION

Cortical ASPECTS seen on CT at the time of admission is associated with HT and sICH after IVT.

[Current status and prospects for the application of robot-assisted spine surgery]

Traditional spine surgery frequently encounters difficulties with inadequate surgical visualization and high risk.Robot-assisted spine surgery is quickly evolving,particularly in screw placement,providing three-dimensional imaging and precise positioning to optimize the surgical process. Robot-assisted systems can increase surgical precision,reduce operating time and radiation exposure,and improve patient prognosis. They also have strong image recognition and analysis capabilities,reducing intraoperative instability and fatigue and allowing remote manipulation.While robot-assisted spine surgery has demonstrated noteworthy advantages in regards to screw placement accuracy and reduced radiation exposure,its effects on operative time remain subject to debate,with cost being a significant hindrance to widespread implementation.Long-term clinical validation and studies of outcomes are necessary for the extensive use of robotic-assisted spine surgery.Future priorities include the enhancement of surgical navigation and imaging,integration of artificial intelligence,improvement of telesurgical capabilities,expansion of robotic functionality,and the development of policy guidance and clinical guidelines to accompany the growth of technology.Robot-assisted spine surgery enhances accuracy and safety,and is anticipated to assume an increasingly crucial role in spine surgery as technology advances and becomes more widely available.

Homocysteine modulates CXCL10/CXCR3 axis activity to induce endothelial dysfunction

Elevated homocysteine (Hcy) levels have been linked to the development of cardiovascular diseases, notably endothelial dysfunction, a critical precursor to atherosclerosis. In this extensive investigation, we explore the intricate pathways through which Hcy influences endothelial dysfunction, with particular attention to the CXCL10/CXCR3 axis. Employing a dual approach encompassing both in vitro and in vivo models, we scrutinize the repercussions of Hcy exposure on endothelial functionality. Our results reveal that Hcy significantly impairs crucial endothelial processes, including cell migration, proliferation, and tube formation. Concomitantly, Hcy upregulates the expression of adhesion molecules, exacerbating endothelial dysfunction. In a murine hyperhomocysteinemia (HHcy) model, we observed a parallel increase in plasma Hcy levels and adverse vascular effects. Moreover, our study unraveled a pivotal role of the CXCL10/CXCR3 axis in Hcy-induced endothelial dysfunction. Hcy exposure led to the upregulation of CXCL10 and CXCR3, both in vitro and in HHcy mice. Importantly, the blockade of this axis, achieved through specific antibodies or NBI-74330, mitigated the detrimental effects of Hcy on endothelial function. In conclusion, our findings illuminated the central role of the CXCL10/CXCR3 axis in mediating Hcy-induced endothelial dysfunction, providing valuable insights for potential therapeutic strategies in managing HHcy-related cardiovascular diseases.

PMAIP1, a novel diagnostic and potential therapeutic biomarker in osteoporosis

BACKGROUND

Osteoporosis is a common endocrine metabolic bone disease, which may lead to severe consequences. However, the unknown molecular mechanism of osteoporosis, the observable side effects of present treatments and the inability to fundamentally improve bone metabolism seriously restrict the impact of prevention and treatment. The study aims to identify potential biomarkers from osteoclast progenitors, specifically peripheral blood monocytes on predicting the osteoporotic phenotype.

METHODS

Datasets were obtained from Gene Expression Omnibus (GEO). Based on the differentially expressed genes (DEGs) and GSEA results, GO and KEGG analyses were performed using the DAVID database and Metascape database. PPI network, TF network, drug-gene interaction network, and ceRNA network were established to determine the hub genes. Its osteogenesis, migration, and proliferation abilities in bone marrow mesenchymal stem cells (BMSCs) were validated through RT-qPCR, WB, ALP staining, VK staining, wound healing assay, transwell assay, and CCK-8 assay.

RESULTS

A total of 63 significant DEGs were screened. Functional and pathway enrichment analysis discovered that the functions of the significant DEGs (SDEGs) are mainly related to immunity and metal ions. A comprehensive evaluation of all the network analyses, PMAIP1 was defined as osteoporosis's core gene. This conclusion was further confirmed in clinical cohort data. A series of experiments demonstrated that the PMAIP1 gene can promote the osteogenesis, migration and proliferation of BMSC cells.

CONCLUSIONS

All of these outcomes showed a new theoretical basis for further research in the treatment of osteoporosis, and PMAIP1 was identified as a potential biomarker for osteoporosis diagnosis and treatment.

Association of blood heavy metal concentrations with hearing loss: a systematic review and meta-analysis

OBJECTIVES

This study aimed to assess the associations between blood heavy metal concentrations and hearing loss.

STUDY DESIGN

This was a systematic review and meta-analysis.

METHODS

A comprehensive literature search was performed using Embase, PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature, Wanfang and Weipu databases. Ten studies were included, and a random or fixed-effects model was used for the meta-analysis. Review Manager 5.4 software was used for data synthesis, and Stata 15.1 software was used for the publication bias and sensitivity analyses.

RESULTS

Blood lead concentrations were significantly and substantially associated with hearing loss (mean difference (MD) = 1.14; 95% confidence interval [CI] = 0.03, 2.26; P = 0.04; I2 = 81%), and iron deficiency was significantly related to hearing loss (MD = -0.42; 95% CI = -0.66, -0.18; P = 0.12; I2 = 60%).

CONCLUSIONS

These results suggest an association between blood heavy metal concentrations and hearing loss. However, there were limitations: confounding factors, lack of description for the specific methods of blinding and independent verification of case definition, limited sample size, Chinese publications comprising half of the primary data and the lack of assessment of the relationship between different blood heavy metal concentrations and the severity of hearing loss. Therefore, larger and well-designed prospective cohort studies are required for further exploration.

[Serum glycocalyx markers in patients after cardiac arrest: association with outcomes]

Objective: To assess the levels of serum glycocalyx markers in the first 24 hours after cardiac arrest (CA) and investigate their relationship with 30-day outcomes. Methods: A retrospective cohort study was conducted on prospectively collected data from CA patients, who were admitted to the intensive care units of the Affiliated Hospital of Xuzhou Medical University and obtained return of spontaneous circulation for more than 24 hours between September 2021 and October 2022. Serum samples obtained at the 24-hour after CA were utilized to measure the levels of glycocalyx markers, including heparan sulfate (HS), hyaluronic acid (HA), and syndecan-1 (Sdc-1). Patients were allocated into good function (CPC1-2) and poor function (CPC3-5) groups on the basis of cerebral performance category (CPC) at 30 days post-CA. Logistic regression analysis was used to determine the association between serum glycocalyx markers and neurological outcomes. Patients were regrouped in light of 30-d mortality and Cox regression analysis was used to determine the association between serum glycocalyx markers and 30-d mortality. Results: A total of 71 patients were included in the study, including 31 (43.7%) females and 40 (56.3%) males, with an average age of (59.0±17.0) years. The poor function group (n=49) demonstrated significantly elevated levels of HS and HA when compared to the good function group (n=22) [HS: 2 461.0(1 623.0, 5 492.0) μg/L vs 1 492.0 (914.0, 2 550.0) μg/L, P=0.008; HA: 124.0(97.0, 365.0)μg/L vs 337.0(135.0, 1 421.0) μg/L, P=0.033]. Adjusted logistic regression analysis revealed that HS was independently associated with poor neurological outcome [odds ratio (OR)=0.389, 95% confidence interval (CI): 0.182-0.828, P=0.014]. In the 30-day mortality analysis, the death group (n=32) exhibited significantly higher levels of HS and HA when compared to the survival group (n=39) [HS: 1 880.0(1 011.0, 3 554.0) μg/L vs 2 500.0(1 726.0, 6 276.0) μg/L, P=0.027; HA: 162.0(99.0, 537.0) μg/L vs 813.0(148.0, 1 531.0) μg/L, P=0.025]. Adjusted Cox regression analysis indicated that elevated levels of HS and HA were independent risk factors (HS: HR=1.697, 95%CI: 1.126-2.557, P=0.011; HA: HR=1.336, 95%CI: 1.047-1.705, P=0.020) for 30-day mortality. Conclusions: High level of serum HS in 24 hours after CA may serve as a potential predictive marker for both neurological function and 30-day mortality. However, high level of serum HA appears to primarily predict 30-day mortality. Sdc-1 does not seem to contribute to outcome prediction.

Experimental study of modified Tavis-Cummings model with directly-coupled superconducting artificial atoms

The Tavis-Cummings model is intensively investigated in quantum optics and has important applications in generation of multi-atom entanglement. Here, we employ a superconducting circuit quantum electrodynamic system to study a modified Tavis-Cummings model with directly-coupled atoms. In our device, three superconducting artificial atoms are arranged in a chain with direct coupling through fixed capacitors and strongly coupled to a transmission line resonator. By performing transmission spectrum measurements, we observe different anticrossing structures when one or two qubits are resonantly coupled to the resonator. In the case of the two-qubit Tavis-Cummings model without qubit-qubit interaction, we observe two dips at the resonance point of the anticrossing. The splitting of these dips is determined by Δ λ=2g12+g32, where g1 and g3 are the coupling strengths between Qubit 1 and the resonator, and Qubit 3 and the resonator, respectively. The direct coupling J12 between the two qubits results in three dressed states in the two-qubit Tavis-Cummings model at the frequency resonance point, leading to three dips in the transmission spectrum. In this case, the distance between the two farthest and asymmetrical dips, arising from the energy level splitting, is larger than in the previous case. The frequency interval between these two dips is determined by the difference in eigenvalues (Δ λ=ε 1+-ε 1-), obtained through numerical calculations. What we believe as novel and intriguing experimental results may potentially advance quantum optics experiments, providing valuable insights for future research.

Evaluation of Safety and Efficacy of Preoperative Coronal MRI-Guided Minimally Invasive Surgery for Cervical Spondylotic Radiculopathy

BACKGROUND Key-hole surgery is a minimally invasive technique that has shown promise in various surgical procedures. This study aimed to assess the clinical effectiveness of preoperative coronal MRI-assisted key-hole surgery for the treatment of patients with cervical spondylotic radiculopathy (CSR). MATERIAL AND METHODS A total of 30 patients diagnosed with CSR and undergoing key-hole surgery with CMRI assistance were included in the study. Various parameters, including surgical segments, incision length, disease duration, operative time, intraoperative fluoroscopy times, intraoperative blood loss, complications, and length of hospitalization, were recorded. Precise measurements of Cobb angles and intervertebral space height were taken before and after the surgical procedure. Surgical outcomes were evaluated using modified Macnab criteria, visual analogue scale (VAS), Japanese Orthopaedic Association Scores (JOA), and neck disability index (NDI). RESULTS The average duration of disease was 6.47±3.29 months, with an average incision length of 1.94±0.15 cm and operative time of 57.83±4.34 minutes. The average intraoperative blood loss was 33.70±9.28 ml, with an average of 3.50±0.73 intraoperative fluoroscopies. The average duration of hospitalization was 4.10±1.27 days. Preoperative and postoperative measurements showed no statistically significant difference in C2-C7 Cobb angles and intervertebral space height. However, there were significant improvements in postoperative VAS, NDI, and JOA scores compared to preoperative scores. The surgical effectiveness rate was 100%, with a high rate of good and excellent outcomes. CONCLUSIONS The findings of this study suggest that preoperative CMRI-assisted key-hole surgery for single-segment CSR is a safe and effective treatment option with low complication rates. The clinical benefits include high security and good outcomes. Further research and larger studies are warranted to validate these findings.

A multiline fitting method for measuring ethylene concentration based on WMS-2f/1f

Coal spontaneous combustion risk assessment is a global technical challenge for the sustainable development of deep mining technology, and C2H4 is a key indicator for early warning of coal spontaneous combustion. Tunable diode laser absorption spectroscopy (TDLAS) has the advantages of high selectivity, high sensitivity, high accuracy and real-time on-line measurement, and it can detect multiple gases simultaneously, so it has significant advantages in the accurate detection of coal spontaneous combustion indicator gases. To address the problem of cross-interference between the near-infrared absorption lines of CH4 and C2H4, which are the indicator gases of spontaneous combustion in coal, a multi-line fitting method was proposed in this study to calibrate the concentration of C2H4. The high-precision Environics2000 automatic standard gas dispenser from the United States, which has a built-in CPU computer control and data control and processing system, was used. Its gas concentration accuracy: ± 1.0%, gas flow accuracy: ± 1.0%, gas repeatability accuracy: ± 1.0%, flow linearity accuracy: ± 0.5%, and inlet operating pressure: minimum 10 psig (0.67 bar) ~ 75 psig (5.04 bar). The measured and simulated WMS-2f/1f signals were multilinearly fitted using a multilinear fitting algorithm and wavelength modulation spectroscopy (WMS), and the measurement of C2H4 concentration was achieved based on the extracted spectral line information. The results show that the maximum relative error of C2H4 concentration measurement is 2.40%, which is 54% lower than that of the conventional 2f peak measurement method, thus demonstrating the effectiveness of the multilinear fitting algorithm in the inversion of C2H4 concentration under the interference of absorption lines. In addition, this study has far-reaching implications for the application of TDLAS technology in the accurate detection of coal spontaneous combustion indicator gases.

Risk Factors and Causes of Reoperation in Lumbar Disc Herniation Patients after Percutaneous Endoscopic Lumbar Discectomy: A Retrospective Case Series with a Minimum 2-Year Follow-Up

BACKGROUND Percutaneous endoscopic lumbar discectomy (PELD) has gained popularity as a minimally invasive surgery for treating lumbar disc herniation. However, there is limited research focusing on the reoperation rate and its associated factors. This study aims to investigate the rate of reoperation and identify the causes and risk factors for reoperation after PELD. MATERIAL AND METHODS We conducted a retrospective analysis of patients who underwent PELD (interlaminar and transforaminal approaches) at our hospital from November 2016 to May 2020. A matched case-control design was employed to identify relevant risk factors for reoperation, with a matching ratio of 1:3. Clinical characteristics and radiological parameters were compared, and univariate analysis was performed using independent samples t-test and chi-squared test. RESULTS Among the 435 patients included in the study, the reoperation rate for those with a minimum 2-year follow-up was 6.2% (27/435). The causes of reoperation and their respective rates were as follows: recurrence of lumbar disc herniation (3.2%, 14/435), incomplete decompression (1.8%, 8/435), persistent low back pain (0.7%, 3/435), and postoperative infection (0.5%, 2/435). Univariate analysis revealed that age (P=0.015), Pfirrmann grade IV-V (P=0.017), and lack of active straight leg raise exercises (P=0.026) were significantly associated with reoperation. Multiple logistic regression analysis indicated that age (P=0.001), Pfirrmann grade IV-V (P=0.033), and lack of active straight leg raise exercises postoperatively (P=0.003) were independent risk factors for reoperation after PELD. CONCLUSIONS The primary cause of reoperation in lumbar disc herniation patients after PELD was recurrence of the herniation. Additionally, severe disc degeneration, older age, and lack of active straight leg raise exercises were identified as significant risk factors associated with an increased reoperation rate.

Case report: Traumatic lumbosacral spondyloptosis with locked L5 inferior articular process

Background

Traumatic lumbosacral spondyloptosis is a very rare spinal disease caused by high-energy trauma. We report a case of traumatic lumbosacral spondyloptosis with locked L5 inferior articular process.

Case presentation

A 33-year-old man presented with multisite pain for 6 h following waist trauma and was admitted to the hospital. He suffered multiple injuries from severe impact on the waist after driving an out of control forklift truck. Preoperative imaging examinations revealed that the patient was diagnosed with traumatic lumbosacral spondyloptosis and the L5 inferior articular process was locked into the anterior margin of the S1 vertebra. A posterior instrumentation, decompression of the cauda equina, and interbody fusion procedure was performed. The patient received hyperbaric oxygen and rehabilitation treatment 10 days after the surgery. At the 6-month postoperative follow-up, the muscle strength of the lower limbs was improved, the patient had no numbness of both lower limbs, and the urinary retention symptom was significantly improved. The American Spinal Injury Association grade improved from grade C preoperatively to grade D postoperatively. As far as we know, there have been no relevant reports on traumatic lumbosacral spondyloptosis with locked L5 inferior articular process yet.

Conclusion

We believe that the hyperflexion and shear forces were the potential causes of this injury. In addition, the preoperative imaging examinations should be evaluated carefully. If the inferior articular process of L5 were locked, we suggest removing the bilateral inferior articular processes first and then perform reduction.

Analysis and verification of the circRNA regulatory network RNO_CIRCpedia_ 4214/RNO-miR-667-5p/Msr1 axis as a potential ceRNA promoting macrophage M2-like polarization in spinal cord injury

BACKGROUND

CircRNAs are involved in the pathogenesis of several central nervous system diseases. However, their functions and mechanisms in spinal cord injury (SCI) are still unclear. Therefore, the purpose of this study was to evaluate circRNA and mRNA expression profiles in the pathological setting of SCI and to predict the potential function of circRNA through bioinformatics.

METHODS

A microarray-based approach was used for the simultaneous measurement of circRNAs and mRNAs, together with qPCR, fluorescence in situ hybridization, western immunoblotting, and dual-luciferase reporter assays to investigate the associated regulatory mechanisms in a rat SCI model.

RESULTS

SCI was found to be associated with the differential expression of 414 and 5337 circRNAs and mRNAs, respectively. Pathway enrichment analyses were used to predict the primary function of these circRNAs and mRNAs. GSEA analysis showed that differentially expressed mRNAs were primarily associated with inflammatory immune response activity. Further screening of these inflammation-associated genes was used to construct and analyze a competing endogenous RNA network. RNO_CIRCpedia_4214 was knocked down in vitro, resulting in reduced expression of Msr1, while the expression of RNO-miR-667-5p and Arg1 was increased. Dual-luciferase assays demonstrated that RNO_CIRCpedia_4214 bound to RNO-miR-667-5p. The RNO_CIRCpedia_4214/RNO-miR-667-5p/Msr1 axis may be a potential ceRNA that promotes macrophage M2-like polarization in SCI.

CONCLUSION

Overall, these results highlighted the critical role that circRNAs may play in the pathophysiology of SCI and the discovery of a potential ceRNA mechanism based on novel circRNAs that regulates macrophage polarization, providing new targets for the treatment of SCI.

Exome-wide screening identifies novel rare risk variants for bone mineral density

Bone mineral density (BMD) is an independent risk factor of osteoporosis-related fractures. We performed gene-based burden tests to assess the association between rare variants and BMD, and identified several BMD candidate genes.

PURPOSE

BMD is highly heritable and a major predictor of osteoporotic fractures, but its genetic basis remains unclear. We aimed to identify rare risk variants contributing to BMD.

METHODS

Utilizing the newly released UK Biobank 200,643 exome dataset, we conducted a gene-based exome-wide association study in males and females, respectively. First, 100,639 males and 117,338 females with BMD values were included in the polygenic risk scores (PRS) analysis. Among individuals with lower 30% PRS, cases were individuals with top 10% BMD, and individuals with bottom 10% BMD were the controls. Considering the effects of vitamin D (VD), individuals with the highest 30% VD concentration were selected for VD-BMD analysis. After quality control, 741 males and 697 females were included in the BMD analysis, and 717 males and 708 females were included in the VD-BMD analysis. The variants were annotated by ANNOVAR software, then BMD and VD-BMD qualified variants were imported into the SKAT R-package to perform gene-based burden tests, respectively.

RESULTS

The gene-based burden test of the exonic variants identified genome-wide candidate associations in ANKRD18A (P = 1.60 × 10^-5, P_{Bonferroni adjust} = 2.11 × 10^-3), C22orf31 (P = 3.49 × 10^-4, P_{Bonferroni adjust} = 3.17 × 10^-2), and SPATC1L (P = 1.09 × 10^-5, P_{Bonferroni adjust} = 8.80 × 10^-3). For VD-BMD analysis, three genes were associated with BMD, such as NIPAL1 (P = 1.06 × 10^-3, P_{Bonferroni adjust} = 3.91 × 10^-2).

CONCLUSIONS

Our study suggested that rare variants contribute to BMD, providing new sights for broadening the genetic structure of BMD.

Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Lumbar Discectomy for Lumbar Disc Herniation: A Systematic Review and Meta-analysis

BACKGROUND

Unilateral biportal endoscopic discectomy (UBED) is a novel and minimally invasive surgery for lumbar disc herniation (LDH). However, efficacy and safety of UBED compared to the conventional percutaneous endoscopic lumbar discectomy (PELD) remains to be determined. A meta-analysis was performed in this study to compare between UBED and PELD for LDH.

METHODS

Relevant cohort studies were found by searching Medline, Web of Science, Embase, Wanfang, and CNKI from database inception to October 13, 2022. Results were pooled using a random-effects model incorporating heterogeneity.

RESULTS

In this meta-analysis, 12 studies involving 1175 patients with LDH were included. Pooled results showed that compared with PELD, UBED was associated with a longer surgery time (mean difference [MD] 17.62 min, P < 0.001) and hospital stay (MD 1.40 day, P = 0.04). However, UBED and PELD showed comparative efficacies in improving the Visual Analogue Scale of leg and back, and Oswestry Disability Index, scores. The incidence of perioperative complications was not significantly different between the 2 procedures (risk ratio [RR] 1.62, P = 0.25), while UBED was associated with a lower LDH recurrence during follow-up (RR 0.29, P = 0.03).

CONCLUSIONS

Although UBED is associated with longer surgery time and hospital stay, it shows similar efficacy to PELD in relieving pain and improving functional ability in patients with LDH. In addition, limited evidence suggests that UBED may be associated with a lower LDH recurrence as compared to PELD, while the incidence of perioperative complications is not different. These findings support UBED as a treatment for patients with LDH.

Accuracy of Coronal Magnetic Resonance Imaging Diagnosis of Multi-Segmental Lumbar Disc Herniation: A Single-Center Retrospective Analysis

BACKGROUND Multi-segment herniation of lumbar intervertebral discs is a complex lumbar spine disease, and it is difficult to identify the responsible segment using only magnetic resonance imaging (MRI). The present study screened 47 patients with multi-segment lumbar disc herniation (MSLDH) to evaluate coronal magnetic resonance imaging (CMRI) of three-dimensional fast-field echo with water-selective excitation to identify the responsible segment of multi-segment lumbar disc herniation (MSLDH) and to assess the accuracy and utility of CMRI. MATERIAL AND METHODS This retrospective study included 44 patients with low back pain or lower-extremity symptoms from January 2019 to December 2021. The imaging (including CMRI) and clinical data of the patients were analyzed by 3 independent, blinded experts. The Kappa statistical method was used to characterize the reader-to-reader reliability to qualitatively evaluate the data. RESULTS CMRI showed high diagnostic performance, with 90.2% sensitivity, 94.9% positive predictive value (PPV), 80% negative predictive value (NPV), and 83.4% accuracy, and there were significant differences in hospital length of stay (P=0.013) and surgical bleeding (P=0.006) (P<0.01) between single-segment and multi-segment patients. CONCLUSIONS CMRI is highly accurate in revealing the shape, signal, and position of the intraspinal and extraspinal lumbosacral plexus, and reducing surgical segments can help improve postoperative outcomes for patients.

Does Percutaneous Endoscopic Lumbar Discectomy for Adolescent Posterior Ring Apophysis Fracture Accompanied with Lumbar Disc Herniation Have Better Outcome Than Lumbar Disc Herniation Alone?

Objective

This study aims to compare the efficacy of percutaneous endoscopic lumbar discectomy (PELD) in treating adolescent posterior ring apophysis fracture (APRAF) accompanied by lumbar disc herniation (LDH) and lumbar disc herniation alone.

Methods

Herein we present a case series of adolescent patients who underwent PELD surgery from June 2017 to September 2021. All patients were divided into two distinct groups (ie Group A and B), based on their preoperative Computed tomography (CT) scans. Group A included patients with PRAF (type III) accompanied by LDH. Group B patients had LDH alone. The general clinical characteristics, clinical outcomes, and complications in patients from the two groups were assessed and compared.

Results

Compared to before surgery, the back and leg visual analog scores (VAS) and Oswestry Disability Index (ODI) were markedly improved in both groups' patients at all follow-ups. Notably, no significant differences were observed in the back and leg VAS scores, and ODI values between the two groups at different time points after surgery. The mean intraoperative blood loss was significantly lower in Group B, relative to Group A. The mean operation time was significantly shorter in Group B, compared to Group A. There was no statistically significant difference in complication and recurrence rates between the two groups.

Conclusion

APRAF (type III) accompanied by LDH and LDH alone can obtain roughly equal surgical effects through PELD surgery and turns out to be a safe and effective surgical approach.

The application of antidepressant drugs in cancer treatment

Antidepressants refer to psychotropic drugs which are used to treat mental illness with prominent emotional depression symptoms. It was reported that antidepressants had associated with anti-carcinogenic function which was associated with various signaling pathways and changing of microenvironment. Its mechanism includes cell apoptosis, antiproliferative effects, mitochondria-mediated oxidative stress, DNA damaging, changing of immune response and inflammatory conditions, and acting by inhibiting multidrug resistance of cancer cells. Accumulated studies showed that antidepressants influenced the metabolic pathway of tumor cells. This review summarized recent developments with the impacts and mechanisms of 10 kinds of antidepressants in carcinostasis. Antidepressants are also used in combination therapy with typical anti-tumor drugs which shows a synergic effect in anti-tumor. By contrast, the promotion roles of antidepressants in increasing cancer recurrence risk, mortality, and morbidity are also included. Further clinical experiments and mechanism analyses needed to be achieved. A full understanding of the underlying mechanisms of antidepressants-mediated anticarcinogenic effects may provide new clues for cancer prevention and clinical treatment.

Risk Factors Involved in the Early and Medium-Term Poor Outcomes of Percutaneous Endoscopic Transforaminal Discectomy: A Single-Center Experience

Objective

To investigate the risk factors involved in the early and medium-term poor outcomes of percutaneous endoscopic transforaminal discectomy (PETD) treatment of lumbar disc herniation (LDH) at the L4-5 level.

Methods

Between January 2015 and May 2020, we recruited 148 LDH patients at the L4-5 level who underwent PETD surgery. The patients were divided into Groups A and B, according to the surgical outcomes. Good and excellent outcomes were categorized into Group A, and generally good and poor outcomes were categorized into Group B. Clinical parameters (age, gender, symptom duration, hospital stay, operation time, blood loss, straight-leg raising (SLR), visual analog scale (VAS), Oswestry Disability Index (ODI) score and modified MacNab criteria) and radiologic parameters (foraminal height (FH), intervertebral height index (IHI), intervertebral angle (IVA), sagittal range of motion (sROM), and lumbar lordosis (LL)) were collected and analyzed using univariate and multiple logistic regression analyses.

Results

At the 6-month follow-up post operation, univariate analysis revealed that the symptom duration, SLR, IHI, and sROM were strongly associated with poor outcomes. However, multiple logistic regression analysis demonstrated that prolonged symptom duration, large SLR angel, and large sROM were independent risk factors for poor outcomes. At the 2-year follow-up post operation, univariate analysis suggested that advanced age, prolonged symptom duration, large preoperative VAS score, small FH, small IHI, and large sROM were potential risk factors for poor outcomes. However, multiple logistic regression analysis demonstrated that prolonged symptom duration, small IHI, and large sROM were independent risk factors for poor outcomes.

Conclusion

Our study demonstrated that prolonged symptom duration, large SLR angel, and large sROM were independent risk factors for poor outcomes immediately following PETD at the L4-5 level. However, prolonged symptom duration, small IHI, and large sROM were independent risk factors for poor outcomes at medium-term post PETD at the L4-5 level.

Development and validation of an individualized nomogram for predicting the high-volume (> 5) central lymph node metastasis in papillary thyroid microcarcinoma

PURPOSE

Papillary thyroid microcarcinoma (PTMC) frequently presents a favorable clinical outcome, while aggressive invasiveness can also be found in some of this population. Identifying the risk clinical factors of high-volume (> 5) central lymph node metastasis (CLNM) in PTMC patients could help oncologists make a better-individualized clinical decision.

METHODS

We retrospectively reviewed the clinical characteristics of adult patients with PTC in the Surveillance, Epidemiology, and End Results (SEER) database between Jan 2010 and Dec 2015 and in one medical center affiliated to Chongqing Medical University between Jan 2018 and Oct 2020. Univariate and multivariate logistic regression analyses were used to determine the risk factors for high volume of CLNM in PTMC patients.

RESULTS

The male gender (OR = 2.02, 95% CI 1.46-2.81), larger tumor size (> 5 mm, OR = 1.64, 95% CI 1.13-2.38), multifocality (OR = 1.87, 95% CI 1.40-2.51), and extrathyroidal invasion (OR = 3.67; 95% CI 2.64-5.10) were independent risk factors in promoting high-volume of CLNM in PTMC patients. By contrast, elderly age (≥ 55 years) at diagnosis (OR = 0.57, 95% CI 0.40-0.81) and PTMC-follicular variate (OR = 0.60, 95% CI 0.42-0.87) were determined as the protective factors. Based on these indicators, a nomogram was further constructed with a good concordance index (C-index) of 0.702, supported by an external validating cohort with a promising C-index of 0.811.

CONCLUSION

A nomogram was successfully established and validated with six clinical indicators. This model could help surgeons to make a better-individualized clinical decision on the management of PTMC patients, especially in terms of whether prophylactic central lymph node dissection and postoperative radiotherapy should be warranted.

[Study on parameters of robot-assisted ultrasonic drilling on bovine vertebral body]

Objective: To investigate the effect of ultrasonic parameter settings on maximum temperatures in the drilling site and penetration time and determine the most suitable parameters for efficient and safe robot-based ultrasonic bone drilling in spinal surgery. Methods: Five adult bovine thoracic and lumbar vertebrae specimens (T10-L6) were cut into 10 mm thick slices. A total of 50 slices were obtained. Among them, 30 and 20 slices were used for cancellous bone experiments and cortical bone experiments, respectively. In the cancellous bone experiment, the slices were randomly divided into three groups, corresponding to different feed rates of 0.8 mm/s, 1.6 mm/s, and 2.4 mm/s, respectively, with 10 slices in each group. The cancellous part of each slice was drilled 9 times with different output powers from 20% (48 W) to 100% (120 W). In the cortical bone experiment, the slices were randomly assigned into two groups, corresponding to a different feed rate (0.8 mm/s and 1.6 mm/s). Drilling was performed on the cortical part of each slice 4 times with different output power, which increased from 70% (84W) to 100% (120 W). All experiments were conducted at room temperature of 25 ℃. Maximum temperature and penetration time were recorded. The maximum grinding temperature and penetration time of cancellous bone and cortical bone under different output power and feed rate were compared. Results: At the same feed rate, the maximum temperature of the cancellous bone decreased as output power increased. There were statistically significant differences in the maximum temperature between the output powers of 120 W and 24 W under different feed rates(61.2 ℃±9.4 ℃ vs 70.9 ℃±5.7 ℃, 59.2 ℃±7.1 ℃ vs 69.5 ℃±10.7 ℃, 55.5 ℃±5.5 ℃ vs 69.2 ℃±9.3 ℃, all P<0.05). At the premise of the same output power, there was no significant difference in the maximum temperature among different feed rates (all P>0.05). At the feed rate of 0.8 mm/s, the maximum temperature of cortical bone decreased as the output power increased. The maximum temperature at the output power of 120 W was significantly lower than that of 84 W (P=0.048). However, at the feed rate of 1.6 mm/s, the maximum temperature could not be significantly lowered by the increase in output power (P>0.05). Under the same output power, the maximum temperature at the feed rate of 1.6 mm/s were all significantly lower than those of 0.8 mm/s (all P<0.05). The penetration time of cancellous bone did not decrease significantly with the increase in the output power (all P>0.05) while it decreased significantly as the feed rate increased (all P<0.05). Regarding cortical bone at the feed rate of 0.8 mm/s, the increase in output power could not shorten the penetration time (P>0.05); at the feed rate of 1.6 mm/s, the penetration time at the output power of 120 W was significantly shorter than that of 96 W (P=0.008). With the same output power, the penetration time at the feed rate of 1.6 mm/s were significantly shorter than those at 0.8 mm/s (all P<0.05). There was no statistical difference in the penetration failure rate among different feed rates with the same output power (all P>0.05). The penetration failure rate was 0 when the output power of cancellous bone was 48 W and above and the output power of cortical bone were 108 W and 120 W. Conclusions: The maximum temperature of vertebral cancellous bone and the cortical bone is primarily influenced by the output power and the feed rate, respectively; the penetration time of cancellous bone and the cortical bone is affected by the feed rate and both of feed rate and output power, respectively. The most suitable parameters are output power of 120 W and feed rate of 2.4 mm/s for cancellous bone and output power of 120 W and feed rate of 1.6 mm/s for cortical bone.

[Proximal incisal edge length and recent clinical observation of Siewert type Ⅱ advanced esophagogastric junction adenocarcinoma]

Objective: To investigate the clinical effect of the radical resection with a proximal incisal edge length of 20-25 mm and 30-35 mm in Siewert type Ⅱ advanced esophagogastric junction adenocarcinoma, to shorten the minimum safe distance of the proximal incisal edge to 20-25 mm. Methods: A retrospective cohort study method was used. The clinical data of 166 patients with Siewert type Ⅱ advanced esophagogastric junction adenocarcinoma who underwent total gastrectomy from January 2017 to August 2020 in the Department of Gastrointestinal Surgery, Heji Hospital Affiliated to Changzhi Medical College were retrospectively collected. According to the proximal incisal edge length, the patients were divided into two groups: the proximal incisal edge length of 20-25 mm group (69 cases) and 30-35 mm group (97 cases). The perioperative conditions and the 6-month follow-up after the operation were compared between the two groups. Results: There was no statistically significant difference in baseline information between the patients in the two groups (P>0.05). The operations of both groups were completed. The intraoperative operation time of the proximal incisal edge length of 20-25 mm group was shorter than that in the proximal incisal edge length of 30-35 mm group ((172±24)and(206±27)min, P<0.001). There were no significant differences in the amount of intraoperative blood loss, the treatment of the diaphragm during the operation and the positive rate of intraoperative freezing of the upper incisal edge between the patients in the two groups (all P>0.05). And there was no significant differences in the first exhaust time, gastric tube removal time, first feeding time and hospital stay after the operation of the two groups (all P>0.05). There was no significant differences in the incidence of anastomotic leakage, anastomotic stenosis, reflux esophagitis and intestinal obstruction after the operation between the patients in the two groups (all P>0.05). And there was no anastomotic leakage case among the 69 cases in the proximal incisal edge length of 20-25 mm group. Postoperative pathological treatment showed no significant differences in the vascular tumor thrombus and nerve infiltration between the two groups (both P>0.05). During the 6-month follow-up, there was no death or tumor recurrence in the two groups, and there was no significant difference in body weight loss at 6 months after the operation between the two groups (P=0.178). Conclusion: When radical resection of Siewert type Ⅱ advanced esophagogastric junction adenocarcinoma is performed, it is feasible to shorten the minimum safe distance of the proximal incisal edge to 20-25 mm under the premise of ensuring R0 resection. The operation time is shortened. Due to the shortening the incisal edge distance, the anastomotic tension is decreased, and the incidence of postoperative anastomotic leakage is also reduced.

Exogenous trehalose protects photosystem II by promoting cyclic electron flow under heat and drought stresses in winter wheat

Drought and rising global temperatures are important factors that reduce wheat production. Trehalose protects the reaction centres and improves photosystem II (PSII) activity under diverse stress conditions. However, the underlying mechanism remains unknown. Cyclic electron flow (CEF) plays an important role in protecting PSII under environmental stresses. Our study focused on the effects of exogenous trehalose on the activity of PSII, D1 protein content, plastoquinone (PQ) pool and ATP synthase activity in wheat seedlings under heat and drought stresses to explore the relationship between trehalose and CEF. The results indicated that heat and drought stresses decreased maximum photochemical efficiency of PSII (F_v /F_m ) and electron transport rate of PSII (EFR(II)), whereas the trehalose pretreatment improved photochemical efficiency and electron transport rate of PSII. The trehalose pretreatment stimulated CEF under heat and drought stresses. Furthermore, the proton gradient (ΔpH) across the thylakoid membrane and ATPase activity increased. The higher ΔpH and ATPase activity played a key role in protecting PSII under stresses. Trehalose pretreatment could reduce inhibition caused by heat and drought stresses on the PQ pool. Thus, our results indicated that photoinhibition in heat- and drought-stressed plants was alleviated by the trehalose pretreatment, which was mediated by CEF and the PQ pool.

Reactive-oxygen-species-scavenging nanomaterials for resolving inflammation

Reactive oxygen species (ROS) mediate multiple physiological functions; however, the over-accumulation of ROS causes premature aging and/or death and is associated with various inflammatory conditions. Nevertheless, there are limited clinical treatment options that are currently available. The good news is that owing to the considerable advances in nanoscience, multiple types of nanomaterials with unique ROS-scavenging abilities that influence the temporospatial dynamic behaviors of ROS in biological systems have been developed. This has led to the emergence of next-generation nanomaterial-controlled strategies aimed at ameliorating ROS-related inflammatory conditions. Accordingly, herein we reviewed recent progress in research on nanotherapy based on ROS scavenging. The underlying mechanisms of the employed nanomaterials are emphasized. Furthermore, important issues in developing cross-disciplinary nanomedicine-based strategies for ROS-based inflammatory conditions are discussed. Our review of this increasing interdisciplinary field will benefit ongoing studies and clinical applications of nanomedicine based on ROS scavenging.

POS0664 A MULTICENTER RANDOMIZED STUDY IN RHEUMATOID ARTHRITIS TO COMPARE IGURATIMOD, METHOTREXATE, OR COMBINATION: 52 WEEK EFFICACY AND SAFETY RESULTS OF THE SMILE TRIAL

Background:

Iguratimod (IGU) has demonstrated efficacy and safety for active rheumatoid arthritis (RA) patients in double-blind clinical trials in China and Japan as a new disease-modifying anti-rheumatic drug (DMARD). There are no studies evaluating the radiographic progression of structural joint damage of IGU for the treatment of RA using the mTSS as the primary endpoint.

Objectives:

Our study was to evaluate the efficacy and safety of IGU monotherapy and IGU combined methotrexate (MTX) compared with MTX monotherapy, including the inhibitory effects of joint destruction.

Methods:

This randomized, double-blind, parallel-controlled, multicenter study in patients with active RA who have not previously used MTX and biological DMARDs (bDMARDs) (ClinicalTrials.gov Identifier NCT01548001) was carried out in China. Patients were randomized 1:1:1 to receive IGU 25 mg twice a day (bid), MTX 10mg once a week(qw) for the first 4 weeks and 15 mg once a week(qw) for week 5 to 52, or IGU combined MTX (IGU+MTX) for 52 weeks. The primary endpoints were to assess and compare American College of Rheumatology 20% (ACR20) response and the change of modified total Sharp scoring (mTSS) score over 52 weeks (Intention-to-treat, ITT analysis). The non-inferiority test was used to analyze the difference of ACR20 response at 52 weeks between the IGU monotherapy and the MTX monotherapy arms, and the non-inferiority limit value was 10%. The difference test was used for the comparison between the IGU+MTX and MTX monotherapy arms. Two-way ANOVA was used to analyze the difference of the changes of mTSS score of each arm compared with baseline value (0 week).

Results:

A total of 895 patients were randomized to IGU 25mg bid (n =297), MTX 10-15mg qw(n=293), and IGU+MTX (n=305). Baseline characteristics were comparable between the arms (Table 1).

Table 1.

Demographic and Other Baseline Characteristics (SAS)

IGUMTXIGU+MTXNumber of Subjects297293305Age, mean (SD) years46.87(10.67)47.63(10.70)48.37(10.69)Female/male, %77.44/22.5679.18/20.8278.03/21.97Duration of RA, mean(SD) years11.67±7.1611.60±7.9811.67±7.27CRP, mean(SD) mg/L222.32±35.4720.67±26.6119.74±31.38Tender joint count, mean (SD)14.59±9.1614.83±9.3014.93±9.88Swollen joint count, mean (SD)9.81±6.639.73±7.209.51±6.22DAS28-CRP, mean (SD)5.084±0.9945.102±0.9795.103±0.956HAQ score, mean (SD)15.82±11.2515.24±10.9316.06±10.92

SAS: Safety Analysis Set; CRP: C-reactive protein;

DAS28: disease activity score; HAQ: Health Assessment Questionnaire

The study met its primary endpoints. More concretely, IGU monotherapy and IGU+MTX were found to be superior to MTX at week 52 with a higher ACR20 response of 77.44%(230/297, P=0.0019) and 77.05%(235/305, P=0.0028) versus 65.87%(193/293) (fig 1). As shown in fig 1, the structural remission (ΔmTSS≤0.5) was statistically significant for IGU monotherapy (57.4%, P=0.0308) but not for IGU+MTX arm (55%) versus MTX monotherapy (47.8%).

Overall incidence of the adverse events (AEs) leading to study discontinuation were reported in 13.8% (41/297) in IGU monotherapy arm, 11.26% (33/293) in MTX monotherapy arm and 11.51% (35/305) patients in IGU+MTX arm. The incidence of adverse drug reactions (ADR) leading to study discontinuation were 11.45% (34/297), 8.53% (25/293) and 9.21% (28/305), respectively. There was no one death and no significant difference in all the safety indicators among the three arms.

Conclusion:

Iguratimod alone or in combination with MTX demonstrated superior efficacy with acceptable safety compared to MTX for patients with active RA who have not previously used MTX bDMARDs.

Disclosure of Interests:

None declared

[Cognitive and gait dysfunction in the elderly caused by age-related cerebral small vessel disease and idiopathic normal pressure hydrocephalus: a case series of three patients]

Three cases with age-related cerebral small vessel disease and normal pressure hydrocephalus in the Department of Neurology of Sun Yat-sen University were retrospectively reviewed. All the patients exhibited gait disturbance, cognitive impairment and urinary incontinence. Meanwhile, the Craniocerebral imaging demonstrated cerebral small vessel disease and communicating hydrocephalus. The cerebralspinal fluid (CSF) Aβ42 levels decreased, and apolipoprotein E (APOE) genotypes were ε3/ε4,ε3/ε3,ε2/ε3, respectively. After treatment in an all-cause individualized manner, the symptoms of 3 patients were stable or improved.

MiR-129-5p protects against myocardial ischemia-reperfusion injury via targeting HMGB1

OBJECTIVE

To investigate the protective effect of miR-129-5p on ischemia-reperfusion (I/R) injury via targeting high mobility group box-1 (HMGB1).

MATERIALS AND METHODS

Rat models of myocardial I/R and hypoxia/reoxygenation (H/R) cardiomyocytes were established, and the miR-129-5p and HMGB1 expression levels in myocardium of I/R rats and in cardiomyocytes of H/R rats were quantified by RT-PCR. The over-expression of miR-129-5p was performed on I/R rats, and the over-expression of miR-129-5p and down-regulation of HMGB1 were performed on cardiomyocytes of H/R rats. Triphenyltetrazolium chloride (TTC) staining was used to measure myocardial infarct size (IS). TUNEL (TdT-mediated dUTP end nick labeling) staining was employed to observe cardiomyocyte apoptosis in the myocardium of rats, and flow cytometry to observe cardiomyocyte apoptosis of I/R and H/R rats respectively. Dual-Luciferase reporter assay was used to verify the target relation between miR-129-5p and HMGB1.

RESULTS

MiR-129-5p was lowly expressed and HMGB1 was highly expressed in myocardial I/R injury rats and cardiomyocytes of H/R rats. Over-expression of miR-129-5p effectively reduced myocardial IS and cardiomyocyte apoptosis in rats with myocardial I/R injury, and significantly down-regulated the pro-apoptotic protein Bax, as well as significantly up-regulated the anti-apoptotic protein Bcl-2. Either over-expression of miR-129-5p or low-expression of HMGB1 in cardiomyocytes of H/R rats also achieved the same effects as described above. Dual-Luciferase reporter assay determined that miR-129-5p was a target for HMGB1.

CONCLUSIONS

MiR-129-5p plays a protective role on myocardial I/R injury by regulating HMGB1 expression. Besides, it inhibits cardiomyocyte apoptosis and is expected to become a novel molecular marker or therapeutic target for myocardial I/R injury.

Construction of an MnO2 nanosheet array 3D integrated electrode for sensitive enzyme-free glucose sensing

MnO₂ based electrochemical enzyme-free glucose sensors remain significantly limited by their low electronic conductivity and associated complex preparation. In this paper, an MnO₂ nanosheet array supported on nickel foam (MnO₂ NS/NF) was prepared using a simple hydrothermal synthesis and employed as a 3D integrated electrode for enzyme-free glucose detection. It was found that MnO₂ NS/NF shows high performance with a wide linear range from 1 μM to 1.13 mM, a high sensitivity of 6.45 mA mM^-1 cm^-2, and a low detection limit of 0.5 μM (S/N = 3). Besides, MnO₂ NS/NF shows high selectivity against common interferences and good reliability for glucose detection in human serum. This work demonstrates the promising role of MnO₂ NS/NF as an efficient integrated electrode in enzyme-free glucose detection with high performance.

[Effect of piRNA NU13 in regulating biological behaviors of human Wilms tumor cells in vitro]

OBJECTIVE

To investigate the role of the differential piRNA NU13 derived from piwil2-induced cancer stem-like cells (piwil2-iCSCs) in regulating biological behaviors of Wilms tumor cells (G401).

OBJECTIVE

The expressions of piRNA NU13 and NOP56 were detected in Wilms tumor cell line G401 using RT-qPCR. G401 cells were transfected with piRNA NU13 mimics and inhibitor for its over-expression and inhibition, and the transfection efficiency was verified with RT-qPCR. The changes in proliferation of G401 cells after transfection were detected using CCK8 assay, and cell apoptosis was analyzed using flow cytometry. Wound healing assay and Transwell assay were performed to examine the changes in migration and invasion abilities of the transfected cells. The binding of NOP56 and piRNA NU13 was detected using dual luciferase experiment. The protein expressions of MMP2, MMP9, BAX, Bcl2, and NOP56 in the cells were detected with Western blotting.

OBJECTIVE

RTqPCR showed that the expression of piRNA NU13 decreased significantly in human Wilms tumor G401 cells as compared with that in renal tubular epithelial cell line HK2 (P < 0.05), and NOP56 was highly expressed in G401 cells and Wilms tumor tissues (P < 0.05). Over-expression of piRNA NU13 significantly suppressed the proliferation, migration and invasion of G401 cells, promoted cell apoptosis (P < 0.05), inhibited the expression of MMP2, MMP9 and Bcl2, and enhanced the expression of BAX (P < 0.05). The results of dual luciferase experiment showed that piRNA NU13 did not bind to NOP56 directly but regulated the expression of NOP56 in an indirect manner.

OBJECTIVE

piRNA NU13 is down-regulated and NOP56 is highly expressed in Wilms tumor. piNU13 may regulate the expression of NOP56 indirectly to inhibit the proliferation, migration and invasion and promote apoptosis of Wilms tumor cells in vitro.

[Analysis of the catastrophic health expenditure of HIV-positive maternal households in high AIDS endemic areas in Liangshan prefecture]

Objective: To analysis the income and expenditure of HIV-positive pregnant women and the catastrophic health expenditure of their households in high AIDS endemic areas in Liangshan prefecture. Methods: From December 2018 to January 2019, a total of 250 pregnant women were recruited from 2 of 17 counties in Liangshan Prefecture, including 133 HIV-positive pregnant women and 117 HIV-negative pregnant women. The data, including basic information of pregnant women, basic information of the family, annual family income in 2017, annual family health expenditure in 2017, and maternal and child-related expenditure in 2017, were collected for analyzing the incidence of catastrophic health expenditure in the family. Results: The average annual income and average annual health expenditure of HIV-positive pregnant women households were 7 000 CNY and 2 000 CNY, while those of HIV-negative pregnant women households were 10 000 CNY and 3 000 CNY, respectively. Based on the criteria of 15%, 25% and 40%, the incidence of catastrophic health expenditure of HIV-positive pregnant households was 39.10%, 33.83% and 27.82%, with average differences of 34.84%, 31.17% and 26.65%, respectively, while that of HIV-negative pregnant women households was 38.46%, 33.33% and 23.93%, with average differences of 31.68%, 28.35% and 24.22%, respectively. Conclusion: The incidence of catastrophic health expenditure of pregnant households in high AIDS endemic areas in Liangshan prefecture is high. The incidence of HIV-positive families is slightly higher than that of HIV-negative families. We suggest that medical insurance compensation in Liangshan prefecture should be improved to reduce the impact of catastrophic health expenditure.

[Perinatal outcomes on mortality and influencing factors among HIV-infected mothers in Sichuan province]

Objective: To explore the influencing factors on perinatal mortality of pregnant women with HIV infection to reduce the mother-to-child transmission in Sichuan province. Methods: In this study, 4 786 perinatal infants of the HIV-infected pregnant women were included. Related data on perinatal epidemiology was reported by all the 183 medical and health care institutions where the HIV prevention of mother-to-child transmission program was initiated in 2005-2016. Univariate χ(2) test and multivariate logistic regression methods were used to analyze the perinatal mortality outcomes and influencing factors. Results: The overall perinatal mortality rate was 25.7‰ (123/4 786) among HIV-infected pregnant women, with annual downwarding trend (trend χ(2)=32.220, P=0.000). Perinatal mortality rate appeared the highest (χ(2)=4.130, P=0.042), with more fetal deaths and stillbirths and less early neonatal death within 7 days in Liangshan county (χ(2)=29.626, P=0.000). Results from the multivariate logistic regression analysis showed that fewer pregnant numbers would contribute to the, lower perinatal mortality rate (1-2 pregnancies OR=0.417, 95%CI: 0.184-0.943; 3-4 pregnancies OR=0.447, 95%CI: 0.223-0.895). Perinatal deaths were more likely to be prevented if LPV/r protease inhibitor-based triple antiviral therapy was provided (OR=0.530, 95%CI: 0.285- 0.986) or delivery was taken place in the hospital (hospital of municipal-level and above OR=0.222, 95%CI:0.098-0.499; county-level hospital OR=0.282, 95%CI: 0.166-0.480; township-level hospital OR=0.134, 95%CI: 0.031-0.586) among HIV-infected pregnant women. However, premature delivery or neonatal asphyxia would increase the risk of perinatal mortality (premature delivery OR=8.285, 95%CI: 5.073-13.533; neonatal asphyxia OR=9.624, 95%CI: 4.625-20.028). Conclusions: The perinatal mortality rate of HIV-infected pregnant women appeared significantly higher than that in the province or the whole country. Strategies involving LPV/r-based triple antiviral therapy, promotion of hospital delivery, reducing the incidence rates of premature deliveries and neonatal asphyxia, should be strengthened.

Testicular hypertrophy as predictor of contralateral nonpalpable testis among Chinese boys: An 18-year retrospective study

OBJECTIVE

To assess the accuracy of contralateral testis hypertrophy for predicting the fate of nonpalpable testis in Chinese boys at different ages.

METHODS

The data of patients who presented with unilateral impalpable testis and who underwent laparoscopy at the Children's Hospital of Chongqing Medical University between January 1, 2000 and January 1, 2018 were reviewed. The boys were divided into four groups: age-matched volunteers with no testicular abnormalities represented the control group (group I), boys with palpable undescended testis (group II), boys with nonpalpable testis (NPT)/viable testis (VT) (group III), and boys with NPT/non-viable testis (NVT) group (group IV). Scrotal testes were prospectively measured by ultrasonography for volume and size, and diagnostic laparoscopy was performed to determine the state of the cryptorchid testis.

RESULTS

The mean contralateral testicular volume and length in the boys with an absent testis was 0.78mL and 17mm compared with 0.67mL and 15mm in the boys with a testis present and 0.63mL and 15mm in the controls, respectively (P<0.05). The predictive accuracy, sensitivity, and specificity for an absent testis were 64.9%, 75%, and 49%, respectively, for volume and 64.2%, 56.3%, and 76.4%, respectively for length at the optimal cutoff value of 0.65mL volume and 16.55mm length. Contralateral testis volume was the most accurate in predicting monorchism in 0-2-year-olds (sensitivity: 75%, specificity: 70%, accuracy: 73.1%) and the contralateral testicular length was most accurate for 4-6-years-old (sensitivity: 68.6%; specificity: 77.8%; accuracy: 72.2%). We also included 29 patients with bilateral undescended testis (UDT) and with unilateral nonpalpable. Cutoff values for testicular volume and length were 0.6mL (sensitivity: 81.8%, specificity: 88.9%, accuracy: 86.2%) and 13.5mm (sensitivity: 63.6%, specificity: 77.8%, accuracy: 77.8%).

CONCLUSION

The present results exclusively obtained from laparoscopic exploration suggest that a testis volume of>0.65mL or a testis length of>16.55mm could predict monarchism with an accuracy of about 65%. In younger patients aged 0-2 years and 4-6 years, the overall predictive accuracy increases to about 73% but laparoscopic exploration is still required.

The bone marrow-derived mesenchymal stem cells (BMSCs) alleviate diabetic peripheral neuropathy induced by STZ via activating GSK-3β/β-catenin signaling pathway

BACKGROUND

Diabetic peripheral neuropathy, a common complication of diabetic mellitus, has brought a threaten on patients' health. The bone marrow-derived mesenchymal stem cells (BMSCs) were reported to play an important role in diverse diseases. Nevertheless, the specific function of BMSCs in diabetic peripheral neuropathy remained uncharacterized.

METHODS

A wide range of experiments including RT-qPCR, western blot, H&E staining, oxidative stress assessment, measurement of thermal sensitivity, ELISA, urine protein and CCK-8 assays were implemented to explore the function and mechanism of BMSCs in vivo and vitro.

RESULTS

The experimental results displayed that BMSCs improve STZ-induced diabetes symptoms in rats by decreasing blood glucose and urinary protein. Functionally, BMSCs ameliorate oxidative stress, painful diabetic neuropathy, neurotrophic status and angiogenesis in STZ-induced rats. Moreover, BMSCs participate in the regulation of sciatic neuro morphology in diabetic neuropathy rat model. In mechanism, BMSCs alleviate diabetic peripheral neuropathy via activating GSK-3β/β-catenin signaling pathway in rats and improve Schwann's cells viability by activating GSK-3β/β-catenin signaling pathway under high glucose.

CONCLUSIONS

We verified that BMSCs alleviate diabetic peripheral neuropathy of rats induced by STZ via activating GSK-3β/β-catenin signaling pathway, which implied a novel biomarker for diabetic peripheral neuropathy treatment.

Validation of reference genes for the normalization of RT-qPCR expression studies on human laryngeal cancer and hypopharyngeal cancer

OBJECTIVE

Selecting stably expressed reference genes is crucial for evaluating real-time quantitative polymerase chain reaction (RT-qPCR) data via the relative quantification method. In the present-day study, our aim was to select optimal reference genes (RGs) for the investigation of target gene (TG) expression profiling in cancerous human laryngeal and hypopharyngeal tissues.

PATIENTS AND METHODS

12 cancerous laryngeal tissues and 10 cancerous hypopharyngeal tissues were investigated. The expression characteristics of 11 reference genes (18S rRNA, GAPDH, B2M, ACTB, TBP, ALAS1, RPL29, HMBS, HPRT1, GUSB, and PUM1), which were commonly used in RT-qPCR for the analysis of gene expression, were investigated using the geNorm, NormFinder, and BestKeeper algorithm programs.

RESULTS

HMBS, ALAS1, and B2M were suggested as optimal RGs for studying human laryngeal and hypopharyngeal cancerous tissues together, laryngeal cancerous tissue by itself, and hypopharyngeal cancerous tissue by itself, respectively. If 2 or more reference genes are needed to achieve better standardization, 3 reference genes can optimally be used in combination to improve the accuracy of relative quantitation normalization. The recommended combinations for studying human laryngeal and hypopharyngeal cancerous tissues together, laryngeal cancerous tissue by itself, and hypopharyngeal cancerous tissue by itself were HMBS + HPRT1 + GUSB, ALAS1 + GUSB + HMBS, and B2M + HPRT1 + TBP, respectively.

CONCLUSIONS

The recommended reference genes could be used to improve the accuracy of gene expression studies on the molecular mechanisms of cancerous human laryngeal and hypopharyngeal tissues. The selected combination of reference genes can effectively improve the accuracy of the relative quantitative diagnosis of gene expression levels, such as messenger RNA, circular RNA, and long-noncoding RNA.

[Characteristic and clinical significance of microRNA expression between 144 Uygur and Han women with endometrial carcinoma]

OBJECTIVE

To compare the expression patterns of microRNA (miRNA) between 144 Uygur and Han women with endometrial carcinoma and to investigate their clinical significance.

METHODS

Taqman miRNA low-density array was used to compare miRNA profiles between Uygur and Han women with non-endometrioid endometrial carcinoma (NEEC). Five miRNAs were further analyzed in the 144 endometrial cancers including 62 Uygur and 82 Han samples via real-time PCR to determine their expression patterns.

RESULTS

MiRNA expression profiles revealed that many miRNAs overexpressed or downregula-ted in one ethnic group, but did not express or changed slightly in the other ethnic group. Further detection in the 144 endometrial cancers showed that miR-141, miR-200a, and miR-205 overexpressed in both ethnic groups. In Uygur endometrioid endometrial carcinoma (EEC), tumors with miR-141/200a overexpression tended to be more aggressive in behavior, whereas in the Han group, EEC with miR-200a overexpression was relative mild. However, the NEEC with miR-200a overexpression also had aggressive clinicopathologic features in the Han women. MiR-145 and miR-143 expressed differentially between Uygur and Han groups, they overexpressed in the former and decreased in the latter (P<0.05). In the Uygur women miR-145/143 increased significantly in NEEC and there was a trend that NEEC exhibiting favorable clinicopathologic factors had higher miR-145 expression, and was statistically significant in tumors with myometrial invasion less than 1/2 thickness (P=0.042). By contrary, miR-145/143 decreased in Han group and EEC with worse clinicopathologic variables had lower expression although without statistical significance. NEEC in Han group had no such tendency.

CONCLUSION

Uygur and Han women might have different miRNA expression profiles. MiR-141/200a/205 overexpressed in endometrial carcinomas and miR-141/200a might behave differently between these two ethnic groups as well as in EEC and in NEEC. Although miR-145/143 showed inverse expression patterns between Uygur and Han women with endometrial cancer, they all exerted tumor suppression effect on endometrial cancer.

OP0035 EXAMINATION OF INTERSTITIAL LUNG DISEASE IN PATIENTS WITH RHEUMATOID ARTHRITIS – PREVALENCE, TIME TO ONSET, AND CLINICAL CHARACTERISTICS

Background:

Interstitial lung disease (ILD) is a known extraarticular manifestation of rheumatoid arthritis (RA). Previous studies have shown variability in the prevalence of RA-ILD, as well as clinical characteristics and risk factors of RA-ILD.

Objectives:

To evaluate the prevalence and time to onset of ILD and compare the clinical characteristics between RA patients (pts) with or without ILD using a large US electronic medical record (EMR)-based dataset.

Methods:

Pts with an initial RA diagnosis (ICD-9-CM code: 714.0; ICD-10-CM codes: M05 & M06) during the study period (01JAN2009-20SEP2019) were included from the Discus Analytics JointMan database. The initial RA diagnosis date was defined as the index date. Pts with ILD were identified by ICD diagnosis codes or by provider indication in the JointMan record. Pts who developed ILD before RA were excluded from this analysis. The prevalence and time to onset of ILD were reported. Pt demographics, comorbidities, RA characteristics and disease activity scores were compared for 6 months prior to or on the index date (baseline period) for selected adult RA pts with available information.

Results:

Among 8,963 identified RA pts, 337 (3.8%) were diagnosed with ILD on or after RA diagnosis. The median time to ILD onset post-RA was 2.3 years, and 47% had ILD within 2 years after RA diagnosis. RA-ILD pts were significantly older than those without ILD (65.8 years vs. 59.1 years; p<0.001; Table 1). At baseline, a higher percentage of RA-ILD pts had history of chronic obstructive pulmonary disease, positive rheumatoid factor, rheumatoid nodules, erosive joint disease, positive anti-cyclic citrullinated peptide antibody, and joint swelling compared to RA-only pts (Table 2). The mean ESR and RA disease activity scores were also significantly higher for RA-ILD pts.

Table 1.

Patient Demographics

Patient demographicsRA-ONLY COhort(N = 5,612)RA-ild coHORT(N = 205)P-valueAge, Mean ± SD, years59.1 ± 14.265.8 ± 11.8<.001Male, N (%)1,375 (24.5%)72 (35.1%)0.001Race, N (%) White4,014 (71.5%)165 (80.5%)0.005 African American365 (6.5%)9 (4.4%)0.226 Other/Missing1,233 (22.0%)31 (15.1%)0.020Table 2.

Baseline Clinical Characteristics

Clinical CharacteristicsRA-ONLY COhort(N = 3,846)RA-ild coHORT(N = 115)P-valueHistory of Chronic Obstructive Pulmonary Disease, N (%)102 (2.7%)8 (7.0%)0.006Hypertension, N (%)900 (23.4%)23 (20.0%)0.395Serious Infection, N (%)38 (1.0%)3 (2.6%)0.091Rheumatoid Factor Positive, N (%)1,388 (36.1%)69 (60.0%)<.001Joint Stiffness, N (%)1,092 (28.4%)39 (33.9%)0.197Rheumatoid Nodules, N (%)153 (4.0%)17 (14.8%)<.001Erosive Joint Disease, N (%)459 (11.9%)23 (20.0%)0.009Anti-CCP Antibody Positive, N (%)858 (22.3%)45 (39.1%)<.001Joint Swelling*, N (%)2,861 (58.0%)123 (68.0%)0.008Joint Tenderness*, N (%)3,728 (75.6%)138 (76.2%)0.851ESR**, Mean ± SD, mm/hr22.0 ± 22.630.1 ± 25.5<.001CRP**, Mean ± SD, mg/L22.5 ± 13.060.6 ± 25.00.086CDAI, Mean ± SD16.4 ± 12.318.9 ± 15.70.044DAS28-CRP, Mean ± SD2.6 ± 1.23.1 ± 1.4<.001DAS28-ESR, Mean ± SD3.3 ± 1.43.9 ± 1.5<.001SDAI, Mean ± SD20.2 ± 29.328.6 ± 40.20.048

* A total of 4,929 non-ILD and 181 ILD patients had joint swelling and tenderness data.

** Variables were calculated among patients who had available information.

Conclusion:

This large real-world RA population provides insight into the burden of ILD in RA pts. Pts with ILD had a higher proportion of comorbidities and RA-related conditions and higher RA activity. Further analysis is warranted to assess the risk factors of ILD and its prognosis.

Disclosure of Interests:

Joe Zhuo Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Qisu Zhang Consultant of: I am a paid employee of STATinMED Research which is a paid consultant to Bristol-Myers Squibb Company., Keith Knapp Consultant of: In the last year, I was a paid consultant to Bristol Myers-Squibb Company., Employee of: I am a paid employee of Discus Analytics., Yuexi Wang Consultant of: I am a paid employee of STATinMED Research which is a paid consultant to Bristol-Myers Squibb Company., Cynthia Gutierrez Consultant of: I am a paid employee of STATinMED Research which is a paid consultant to Bristol-Myers Squibb Company., Ding He Consultant of: I am a paid employee of STATinMED Research which is a paid consultant to Bristol-Myers Squibb Company., Lin Xie Consultant of: I am a paid employee of STATinMED Research which is a paid consultant to Bristol-Myers Squibb Company., Sonie Lama Shareholder of: I own shares of Bristol-Myers Squibb Company., Employee of: I am a paid employee of Bristol-Myers Squibb Company., Gary Craig Consultant of: I have served as a consultant to Bristol-Myers Squibb Company., Employee of: I am a paid employee of Arthritis Northwest and VP of Discus Analytics., Speakers bureau: I am a member of the speakers bureau for Bristol-Myers Squibb Company.

Molecular cloning and variant analysis of the TSHR gene in goose (Anser cygnoides)

1. The thyroid-stimulating hormone receptor (TSHR) is a glycoprotein hormone receptor which has a pivotal role in metabolic regulation and photoperiod control during reproduction in birds and mammals. However, the molecular characterisation of TSHR in goose is unknown. 2. The goose TSHR cDNA (TSHR-1) is 2334 bp in length and encodes a protein of 763 amino acids. This trial identified another three novel splice variants of goose TSHR, TSHR-2 (lacking the exon 3 in TSHR-1 transcript), TSHR-3 (lacking the exon 6 in the TSHR-1 transcript) and TSHR-4 (lacking 12 bp of exon 8 and the entire exon 9 in the TSHR-1 transcript). 3. Bioinformatics analysis indicated that all the deduced TSHR amino acid sequences contained seven putative transmembrane domains, and the TSHR-3 protein lacked one potential N-linked glycosylation site (N-E-S) compared to the other three deduced proteins. 4. A phylogenetic tree based on amino acid sequences showed that the goose TSHR protein was closely related to those of other avian species, especially duck and chickens. 5. One microsatellite and three single nucleotide polymorphisms (SNPs) were identified. For the c1109A/G locus, AA and GA genotypes were found in the Zhedong-White goose population, GG and GA genotypes were detected in the Landes goose population, but the AA genotype was only detected in the other four goose populations. 6. All the information derived from this study can facilitate further studies on the functions of the goose TSHR gene.

Reduced E-cadherin expression as a prognostic factor in non-muscle-invasive bladder cancer: A systematic review and meta-analysis

INTRODUCTION AND OBJECTIVES

The exact role of E-cadherin in non-muscle-invasive bladder cancer (NMIBC) is still unknown, and the aims of this study were to prove whether reduced E-cadherin expression can be a prognostic factor in patients with NMIBC.

MATERIALS AND METHODS

A meta-analysis was conducted to assess the prognostic value of reduced E-cadherin expression in NMIBC. The PubMed, Embase and Web of Science databases were included in the study search.

RESULTS

Fifteen studies with a total of 1538 NMIBC patients were included. The results showed that reduced E-cadherin expression was significantly associated with poor recurrence-free survival (RFS) (pooled HR 2.16, 95% CI 1.22-3.85) and progression-free survival (PFS) (pooled HR 1.91, 95% CI 1.52-2.40) in NMIBC patients.

CONCLUSION

E-cadherin can be a prognostic factor for patients with NMIBC.

Non-invasive cell-free fetal DNA testing for aneuploidy: multicenter study of 31 515 singleton pregnancies in southeastern China

OBJECTIVE

To analyze the non-invasive prenatal testing (NIPT) for aneuploidy results of 31 515 singleton pregnancies in Fujian province, southeastern China, and assess its performance in low-, moderate- and high-risk pregnancies.

METHODS

Women were categorized into groups according to whether their risk for fetal abnormality was low, moderate or high. Cell-free plasma DNA extracted from peripheral blood samples was subjected to low-coverage whole-genome sequencing. Standard Z-score analysis of the mapped sequencing reads was used to identify fetal aneuploidy, including the three main trisomies (T21, T18 and T13) and sex chromosome aneuploidy (SCA). NIPT-positive results were confirmed by amniocentesis and karyotyping. The performance of NIPT for detection of T21, T18, T13 and SCA was assessed by calculating the sensitivity and specificity.

RESULTS

The rate of chromosomal abnormality detected by NIPT in the study population was 1.38%. A higher rate of chromosomal abnormality was found in the high-risk group (1.57%) compared to the moderate-risk (1.05%) and low-risk (1.18%) groups (P < 0.05). Sensitivity and specificity, respectively, were 98.96% (95/96) and 99.94% (31 274/31 292) for detection of T21, 100% (25/25) and 99.96% (31 352/31 363) for T18, 100% (7/7) and 99.97% (31 373/31 381) for T13 and 100% (61/61) and 99.74% (31 245/31 327) for SCA. Positive predictive values were high for T21 (84.07%) and T18 (69.44%) and moderate for T13 (46.67%) and SCA (42.66%).

CONCLUSION

Our findings support the application of NIPT for reliable and accurate testing of the general population of reproductive-age women for clinically significant fetal aneuploidy. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.