Correlation Between Coronal Position Sequence of Lumbar and WOMAC Score in Knee Osteoarthritis (KOA) in Standard Standing Position.

INTRODUCTION: Sagittal sequences of the spine have been shown to correlate with knee osteoarthritis (KOA), but coronal sequences and KOA have never been studied before. The study required patients to use a standard standing posture and aimed to explore the relationship between coronal position of lumbar spine and WOMAC score in KOA. METHODS: This is a cross-sectional observational study. Data on a total of 268 patients with KOA were collected. Patients were photographed in a standard standing position and lumbar-sacrum offset distance (L-SOD) and lumbar-knee offset distance (ΔL-KOD) were calculated. Patients were then divided into different groups according to different critical values and differences were compared. RESULTS: In the L-SOD of L1-3, WOMAC function (P = 0.021, P = 0.032, P = 0.001) and total score (P = 0.039, P = 0.034, P < 0.001) were different. In the L-SOD of L3-4, WOMAC pain score were different (P = 0.001, P = 0.032). At a cutoff of 13 mm, ΔL-KOD of L1-2 showed significant differences in pain part (P = 0.025, P = 0.039) and total score (P = 0.036, P = 0.050). There were significant differences in pain (P = 0.023, P = 0.027, P = 0.022), function (P = 0.048, P = 0.038, P = 0.047), and total score (P = 0.030, P = 0.027, P = 0.029) of L3-5. In the 18-mm cutoff group, only L1 and L2 have differences in the pain part (P = 0.050, P = 0.038). CONCLUSION: Coronal balance of the lumbar spine is associated with knee pain and function. The pelvis plays an important role in maintaining the coronal balance. Both the lumbar spine and the knee joint should be considered when developing the surgical strategy.

As a result of population aging, the number of patients suffering from both knee osteoarthritis (KOA) and degenerative diseases of the lumbar spine is increasing. It has been reported that patients with KOA have less symptomatic recovery after lumbar surgery, and that patients with lumbar degenerative disease have less symptomatic improvement after knee surgery than those without lumbar disease. So the knee and lumbar must be interacting in some way. Previous studies have confirmed the correlation between lumbar sagittal position sequence and KOA. However, no studies have been conducted on coronal sequences and KOA of the lumbar spine. We believe that it is because patients are required to stand naturally when taking coronal x-rays, and natural standing will lead to individual differences in the distance between the feet of patients, thereby preventing analysis. In our study, for the first time, we used a uniform stance to avoid this effect. The advantage of uniform stance is that individual differences can be excluded, and the same patient can be compared before and after treatment (because the natural stance of the patient's feet will be different before and after treatment), which is greatly conducive to the study. Our research found that the offset of the lumbar spine in the coronal position and the distance between the central vertical line of the lumbar spine and the bilateral knee joint are significantly correlated with knee pain and function. This may have some guiding significance for lumbar and knee surgery. For lumbar surgery (such as degenerative scoliosis), previous studies have suggested that short segment fixation is sufficient for patients with small Cobb angle. However, according to our conclusion, this may cause accelerated knee joint degeneration in the patient's later stages, which requires the surgeon to comprehensively evaluate the condition of the patient's knee and lumbar spine, and then formulate surgical strategies. The same is true for knee surgery: previous studies have shown no significant correlation between knee deformity and pain. Therefore, for patients with knee deformity and accompanying pain, knee surgery may not be the best choice, and it is more important to correct the deviation of the spine.

Paravertebral Muscle Morphology in L4-L5 Disc Herniation: Insights from the Michigan State University Classification.

BACKGROUND Lumbar disc herniation (LDH) at L4-L5 impacts paravertebral muscle morphology. Intervertebral disc degeneration is linked to paravertebral muscle changes, affecting LDH treatment outcomes. This study explored L4-L5 LDH paravertebral muscle alterations, specifically in the erector spinae, multifidus, and psoas major, using Michigan State University's classification to guide LDH treatment. MATERIAL AND METHODS The study enrolled 160 patients, including 39 normal patients and 121 L4-L5 LDH patients. Patients with LDH were grouped according to MSU classification and compared to the normal group according to demographics and imaging changes. RESULTS In patients with L4-L5 herniation in Zone B, the FI of the ES muscle at L3-L4 level, L4-L5 level, and L5-S1 level was higher than that of normal people (P=0.018, P=0.043, P=0.010, respectively), and there was no difference between FI of MF and normal people. The Zone B patients also had a smaller CSA of the ES muscle at L4-L5 level than that in the normal group (P=0.049). Patients in the Zone C group were older than those in the normal group (P=0.014). The CSA of the PM of patients with Grade 3 herniation differed from that of the normal group at the L4-L5 and L5-S1 level. They were higher than in normal people at L4-L5 level (P=0.011) and lower at L5-S1 level (P=0.028). CONCLUSIONS In patients with L4-L5 herniation in Zone B, the FI of ES at L3-S1 level was higher than in normal people, and the CSA at L4-L5 level was smaller than in normal people. In patients with Grade3 herniation, PM CSA was larger at L4-L5 level and smaller at L5-S1 level than in normal people.

EnT-Mediated Amino-Sulfonylation of Alkenes with Bifunctional Sulfonamides: Access to ß-Amino Sulfone Derivatives.

ß-Amino sulfones are commonly found structural motifs in biologically active compounds. Herein, we report a direct photocatalyzed amino-sulfonylation reaction of alkenes for the efficicient production of important compounds by simple hydrolysis without the need for additional oxidants and reductants. In this transformation, the sulfonamides worked as bifunctional reagents, simultaneously generating sulfonyl radicals and N-centered radicals which were added to alkene in a highly atom-economical fashion with high regioselectivity and diastereoselectivity. This approach showed high functional group tolerance and compatibility, facilitating the late-stage modification of some bioactive alkenes and sulfonamide molecules, thereby expanding the biologically relevant chemical space. Scaling up this reaction led to an efficient green synthesis of apremilast, one of the best-selling pharmceuticals, demonstrating the synthetic utility of the applied method. Moreover, mechanistic investigations suggest that an energy transfer (EnT) process was in operation.

METTL3 Reduces Oxidative Stress-induced Apoptosis in Presbycusis by Regulating the N6-methyladenosine Level of SIRT1 mRNA.

N6-methyl adenosine (m6A) modification is known to play a crucial role in various aging-related diseases. However, its involvement in presbycusis, a type of age-related hearing loss, is not yet clear. We examined the changes in oxidative stress levels in both plasma of presbycusis patients and mice. To determine the expression of m6A and its functional enzymes, we used liquid chromatography tandem-mass spectrometry (LC-MS/MS), enzyme-linked immunosorbent assay (ELISA), and RT-PCR to analyze the total RNA of presbycusis patients blood cells (n = 8). Additionally, we detected the expression of m6A functional enzymes in the cochlea of presbycusis mice using immunohistochemistry. We assessed the effects of m6A methyltransferase METTL3 on SIRT1 protein expression, reactive oxygen species (ROS) levels, and apoptosis in an oxidative stress model of organ of Corti 1 (OC1) cells. To observe the effect on SIRT1 protein expression, we interfered with the m6A recognition protein IGF2BP3 using siRNA. In both presbycusis patients and mice, there was an increased level of oxidative stress in plasma.There was a decrease in the expression of m6A, METTL3, and IGF2BP3 in presbycusis patients blood cells. The expression of METTL3 and IGF2BP3 was also reduced in the cochlea of presbycusis mice. In OC1 cells, METTL3 positively regulated SIRT1 protein levels, while reversely regulated the level of ROS and apoptosis. IGF2BP3 was found to be involved in the regulation of SIRT1 protein expression. In addition, METTL3 may play a protective role in oxidative stress-induced injury of OC1 cells, while both METTL3 and IGF2BP3 cooperatively regulate the level of m6A and the fate of SIRT1 mRNA in OC1 cells.

Advances in animal models of obstructive sleep apnea.

Animal experiments play an important role in the study of the pathogenesis of human diseases and new methods of diagnosis and treatment. Due to the great differences in the anatomical structure and physiology of the upper airway between animals and humans, there is currently no animal model that can fully simulate the pathological anatomy and pathophysiological characteristics of human obstructive sleep apnea (OSA) patients. Herein, we summarizes the construction methods of several OSA animal models that have been widely used in the studies published in the last 5 years, the advantages and limitations of each model as well as related evaluation techniques are described. This information has potential to provide further guide for the development of OSA related animal experiments.

SIRT3/GLUT4 signaling activation by metformin protect against cisplatin-induced ototoxicity in vitro.

Cisplatin is highly effective for killing tumor cells. However, as one of its side effects, ototoxicity limits the clinical application of cisplatin. The mechanisms of cisplatin-induced ototoxicity have not been fully clarified yet. SIRT3 is a deacetylated protein mainly located in mitochondria, which regulates a variety of physiological processes in cells. The role of SIRT3 in cisplatin-induced hair cell injury has not been founded. In this study, primary cultured cochlear explants exposed to 5 µM cisplatin, as well as OC-1 cells exposed to 10 µM cisplatin, were used to establish models of cisplatin-induced ototoxicity in vitro. We found that when combined with cisplatin, metformin (75 µM) significantly up-regulated the expression of SIRT3 and alleviated cisplatin-induced apoptosis of hair cells. We regulated the expression of SIRT3 to explore the role of SIRT3 in cisplatin-induced auditory hair cell injury. Overexpression of SIRT3 promoted the survival of auditory hair cells and alleviated the apoptosis of auditory hair cells. In contrast, knockdown of SIRT3 impaired the protective effect of metformin and exacerbated cisplatin injury. In addition, we found that the protective effect of SIRT3 may be achieved by regulating GLUT4 translocation and rescuing impaired glucose uptake caused by cisplatin. Our study confirmed that upregulation of SIRT3 may antagonize cisplatin-induced ototoxicity, and provided a new perspective for the study of cisplatin-induced ototoxicity.

The PERK/ATF4/CHOP signaling branch of the unfolded protein response mediates cisplatin-induced ototoxicity in hair cells.

Cisplatin is a widely used chemotherapeutic agent. However, its clinical application remains limited due to the high incidence of severe ototoxicity. It has been reported that the unfolded protein response (UPR) is involved in cisplatin-induced ototoxicity. However, the specific mechanism underlying its effect remains unclear. Therefore, the present study aimed to explore the sequential changes in the key UPR signaling branch and its potential pro-apoptotic role in cisplatin-induced ototoxicity. The hair cell-like OC-1 cells were treated with cisplatin for different periods and then the expression levels of the UPR- and apoptosis-related proteins were determined. The results showed that the apoptotic rate of cells was gradually increased with prolonged cisplatin treatment. Furthermore, the sequential changes in three UPR signaling branches were evaluated. The expression levels of activating transcription factor 4 (ATF4) and C/EBP homologous protein (CHOP) were gradually increased with up to 12 h of cisplatin treatment. The aforementioned expression profile was consistent with that observed for the apoptosis-related proteins. Subsequently, the proportion of apoptotic cells was notably decreased in CHOP-silenced hair cell-like OC-1 cells following treatment with cisplatin. Moreover, we found significant hair cells loss and a higher level of CHOP in cisplatin-treated cochlear explants in a time-dependent manner. Overall, the present study demonstrated that the protein kinase RNA­like endoplasmic reticulum kinase (PERK)/ATF4/CHOP signaling branch could play an important role in cisplatin-induced cell apoptosis. Furthermore, the current study suggested that CHOP may be considered as a promising therapeutic target for cisplatin-induced ototoxicity.

Amino-functionalization of lignocellulosic biopolymer to be used as a green and sustainable adsorbent for anionic contaminant removal.

In this work, natural biopolymer stemming from lignocellulosic peanut hull biomass was used as a green and low-cost adsorbent to eliminate anionic Congo red (CR) and Cr(VI) ions from aqueous sample. In order to enhance the removal performance, the lignocellulosic biopolymer was subjected to amino-modification by the graft copolymerization of (3-acrylamidopropyl) trimethylammonium chloride and N, N'-methylenebisacrylamide. The property of the prepared amino-functionalized biopolymer (AFB) was examined through FTIR, TG, SEM, particle size analysis, zeta potential determination and XPS. The adsorption efficacy of AFB for CR and Cr(VI) was tested at different pH, contact time and initial concentration. The kinetic, isotherm and thermodynamics investigations revealed that the uptakes of CR and Cr(VI) were the combination processes of chemical and physical interactions, and both endothermic in nature. The AFB exhibited good reusability without significant loss in adsorption capacity after five consecutive cycles. Mechanistic analysis indicated that the quaternary ammonium groups in AFB contributed a lot to the binding of anionic compounds through electrostatic attraction. In addition, n-π and hydrogen bonding while reduction and coordination were also responsible for the removal of CR and Cr(VI), respectively. The present study provides a favorable strategy for the removal of anionic contaminates in water by using green and sustainable lignocellulosic wastes.

Repair of cerebrospinal fluid leak during posterior thoracolumbar surgery using paraspinal muscle flap combined with fat graft.

Objective: This study aimed to propose a novel surgical method via combination of fat graft and paraspinal muscle flap, in order to treat cerebrospinal fluid (CSF) leak during posterior thoracolumbar surgery. The clinical outcomes were also evaluated. Methods: Data of a total of 71 patients who were diagnosed with intraoperative incidental durotomy and CSF leak after posterior thoracolumbar surgery in our hospital form January 2019 to January 2021 were retrospectively collected and analyzed. Among them, 34 and 37 patients were assigned into conventional suturing (CS) group and fat graft and paraspinal muscle flap (FPM) group, respectively. Patients' demographic and clinical data were compared between the two groups. Results: The average drainage tube time in the FPM group was 3.89 ± 1.17 days, which was shorter than that in the CS group (5.12 ± 1.56, P < 0.001). The drainage volume in the FPM group (281.08 ± 284.76 ml) was also smaller than that in the CS group (859.70 ± 553.11 ml, P < 0.001). Besides, 15 (44.11%) patients in the CS group complained of postural headache, which was more than that in the FPM group (7 patients, 18.91%). There was a statistically significant difference in postoperative visual analogue scale (VAS) score between the two groups (P = 0.013). Two patients underwent revision surgery resulting from incision nonunion and delayed meningeal cyst. Conclusion: Fat graft combined with paraspinal muscle flap showed to be an effective method to repair CSF leak during posterior thoracolumbar surgery. The proposed method significantly reduced postoperative drainage tube time and postoperative drainage volume. It also decreased the incidence and the degree of postural headache. The proposed method showed satisfactory clinical outcomes, and it is worthy of promotion.

Identification of a Prognostic Model Based on Fatty Acid Metabolism-Related Genes of Head and Neck Squamous Cell Carcinoma.

The fatty acid metabolism (FAM) is known to impact tumorigenesis, tumor progression and treatment resistance via enhancing lipid synthesis, storage and catabolism. However, the role of FAM in head and neck squamous cell carcinoma (HNSCC) has remained elusive. In the present study, we obtained a total of 69 differentially expressed FAM-related genes between 502 HNSCC samples and 44 normal samples from The Cancer Genome Atlas (TCGA) database. The HNSCC samples were divided into 2 clusters according to 69 differentially expressed genes (DEGs) via cluster analysis. Then DEGs in the two clusters were found, and 137 prognostic DEGs were identified by univariate analysis. Subsequently, combined with the clinical information of 546 HNSCC patients from TCGA database, a 12-gene prognostic risk model was established (FEPHX3, SPINK7, FCRLA, MASP1, ZNF541, CD5, BEST2 and ZAP70 were down-regulation, ADPRHL1, DYNC1I1, KCNG1 and LINC00460 were up-regulation) using multivariate Cox regression and LASSO regression analysis. The risk scores of 546 HNSCC samples were calculated. According to the median risk score, 546 HNSCC patients were divided into the high- and low-risk (high- and low score) groups. The Kaplan-Meier survival analysis showed that the survival time of HNSCC patients was significantly shorter in the high-risk group than that in the low-risk group (p < 0.001). The same conclusion was obtained in the Gene Expression Omnibus (GEO) dataset. After that, the multivariate Cox regression analysis indicated that the risk score was an independent factor for patients with HNSCC in the TCGA cohort. In addition, single-sample gene set enrichment analysis (ssGSEA) indicated that the level of infiltrating immune cells was relatively low in the high-risk group compared with the low-risk group. In summary, FAM-related gene expression-based risk signature could predict the prognosis of HNSCC independently.

Highly Diastereoselective Synthesis of Oxindoles Containing Vicinal Quaternary and Tertiary Stereocenters by a Domino Heck/Decarboxylative Alkynylation Sequence.

A palladium-catalyzed domino Heck/decarboxylative alkynylation reaction of trisubstituted alkenes or enamines is reported. For two different types of substrates, the current domino reaction employing different solvents and bases led to 3,3-disubstituted oxindoles and hydropyrimidinyl spirooxindoles containing vicinal quaternary and tertiary stereocenters in moderate to good yields, respectively. The general applicability of this method was shown by gram-scale syntheses and diverse transformations of the reaction products. The enantioselective version for this domino process was also studied.

The influence of ossification morphology on surgery outcomes in patients with thoracic ossification of ligamentum flavum (TOLF).

BACKGROUND: To determine whether there is a correlation between the type of ossification and radiological parameters, modified thoracic JOA scores, and complications in patients with thoracic ossification of ligamentum flavum treated by posterior thoracic surgery. METHODS: This retrospective cohort study included 48 patients with thoracic myelopathy caused by single-level thoracic ossification of ligamentum flavum who underwent thoracic posterior approach surgery in our Hospital o between December 2013 to December 2018. Patients were divided into unilateral, bilateral, and bridged groups in axial position, and beak and round groups in sagittal position. The differences were analyzed according to the ossification morphology. RESULTS: In axial myelopathy, there was no significant difference in preop and postop JOA scores and RR among the three groups in axial position (P = 0.884). In sagittal view, there was no significant difference in preoperative JOA score between the two groups (P = 0.710), while the postop JOA score and the recovery rate in the beak group were significantly lower than that of the round group (P = 0.010, P = 0.034). Two-way ANOVA showed that sagittal morphology had a significant effect on postop JOA score (P = 0.028), but axial morphology don't (P = 0.431); there was no interaction between them (P = 0.444). For the recovery rate, sagittal morphology also had a significant effect (P = 0.043), but axial ossification don't (P = 0.998); there was no interaction between them (P = 0.479). CONCLUSION: Sagittal morphology had a significant adverse effect on postop JOA score and surgical outcome, while axial morphology had no effect on surgical outcome, and there was no interaction between sagittal morphology and axial morphology.

Risk Factors for Poor Outcomes of Thoracic Ossification of Ligamentum Flavum After Laminectomy.

BACKGROUND Thoracic ossification of ligamentum flavum (TOLF) is a common pathological change of the thoracic ligamentum flavum. Identifying the risk factors for poor prognosis is critical for choosing suitable surgical methods. MATERIAL AND METHODS A total of 64 patients with TOLF after laminectomy were reviewed between January 2010 and April 2018 at the Department of Spine Surgery of the Third Hospital of Hebei Medical University. The Japanese Orthopaedic Association (JOA) scale was used to evaluate the neurological function of patients. According to the average JOA improvement rate, the patients were divided into the good prognosis group (Group GP) and the poor prognosis group (Group PP). Multivariate logistic regression analysis was used to identify the risk factors for poor outcomes. RESULTS The average JOA improvement rate was 53.04±24.29%. Group GP comprised 33 patients, while Group PP comprised 31 patients. Duration of preoperative symptoms (P=0.005), intramedullary high signal intensity (P=0.001), dural ossification rate (P=0.002), and sagittal configuration of ossification (P=0.012) were significantly higher in Group PP than in Group GP. Multivariate logistic analysis showed that duration of preoperative symptoms (P=0.022), intramedullary high signal intensity (P=0.010), dural ossification (P=0.007) and sagittal configuration of ossification (P=0.029) were risk factors for poor outcomes of TOLF after laminectomy. CONCLUSIONS After surgical treatment of TOLF, the symptoms of some patients either recovered slowly or did not recover. Longer than 17 months of preoperative symptoms, intramedullary high signal intensity, dural ossification, and sagittal configuration of ossification were the risk factors for poor outcomes of TOLF after laminectomy.

A highly efficient biomass-based adsorbent fabricated by graft copolymerization: Kinetics, isotherms, mechanism and coadsorption investigations for cationic dye and heavy metal.

Natural biomass materials are endowed with good potential for pollutant remediation due to low cost, environment friendliness and easy accessibility. In this work, an efficient biomass-based adsorbent named g-PS was fabricated by free radical graft copolymerization of peanut shell with methacrylic acid and N,N'-methylenebis(acrylamide). The structural and morphological properties of g-PS were characterized and analyzed. The effectiveness of g-PS as adsorbent to remove cationic dye and heavy metal pollutants (i.e. methylene blue (MB), basic red 46 (BR) and Cd(II)) from water was evaluated. The batch adsorption tests indicated that g-PS showed rapid removal rates for MB, BR and Cd(II), with the adsorption equilibriums achieved within 30 min. The adsorption processes of three compounds were more suitable to be described by Langmuir and pseudo-second-order models. The maximum adsorption capacities were 538.34 mg/g for MB, 687.52 mg/g for BR and 62.01 mg/g for Cd(II) at 298 K. The coadsorption experiments in the mixed system indicated that g-PS was still effective for simultaneous removal of both BR and Cd(II). Additionally, g-PS exhibited satisfactory removal performance even after seven repeated uses. The as-prepared g-PS can be used as a promising adsorbent candidate to dispose wastewater containing cationic dyes and heavy metals.

Repair of Delayed Meningeal Cyst after Spinal Surgery with Paraspinal Muscle Flap under Microscope.

BACKGROUND: Delayed meningeal cyst (DMC) is a rare complication after spinal surgery that is often ignored by clinicians, and its in-depth research is infrequent. In particular, no consensus has been reached about its surgical treatment. We found that patients with a DMC failed after conservative treatment, epidural blood patch, subarachnoid drainage, and initial attempts to eliminate the meningeal cyst. Therefore, we introduce the application of a paraspinal muscle flap repair under a microscope for the treatment of DMC. METHODS: In this study, 13 patients who were repaired by a paraspinal muscle flap under a microscope for DMC from January 2007 to January 2017 were retrospectively reviewed. Their ages were 18-68 years old (mean age 48.7 years). The course of the disease ranged from 3 weeks to 28 months after the operation for the primary disease, with an average of 10.6 months. Length >5 cm was called a large DMC and length >8 was called a giant DMC. By analyzing the effect of surgical treatment, we summarized the treatment experience of DMC and evaluated the risk factors for the formation of DMC. RESULTS: All patients were treated with paraspinal muscle flap repair under a microscope, and they healed well after the operation. There was no cerebrospinal fluid leakage or other operation-related complication. The mean follow-up was 16.5 months. Reexamination of the spine MRI showed no recurrence of the DMC. CONCLUSIONS: The application of paraspinal muscle flap under a microscope combined with glue, bedrest, and CSF drain, was an effective option for the patients with DMC.

Role of the Stria Vascularis in the Pathogenesis of Sensorineural Hearing Loss: A Narrative Review.

Sensorineural hearing loss is a common sensory impairment in humans caused by abnormalities in the inner ear. The stria vascularis is regarded as a major cochlear structure that can independently degenerate and influence the degree of hearing loss. This review summarizes the current literature on the role of the stria vascularis in the pathogenesis of sensorineural hearing loss resulting from different etiologies, focusing on both molecular events and signaling pathways, and further attempts to explore the underlying mechanisms at the cellular and molecular biological levels. In addition, the deficiencies and limitations of this field are discussed. With the rapid progress in scientific technology, new opportunities are arising to fully understand the role of the stria vascularis in the pathogenesis of sensorineural hearing loss, which, in the future, will hopefully lead to the prevention, early diagnosis, and improved treatment of sensorineural hearing loss.

The Prognostic Value and Immune Landscapes of a m6A/m5C/m1A-Related LncRNAs Signature in Head and Neck Squamous Cell Carcinoma.

Background: N6-methyladenosine (m6A), 5-methylcytosine (m5C) and N1-methyladenosine (m1A) are the main RNA methylation modifications involved in the progression of cancer. However, it is still unclear whether m6A/m5C/m1A-related long non-coding RNAs (lncRNAs) affect the prognosis of head and neck squamous cell carcinoma (HNSCC). Methods: We summarized 52 m6A/m5C/m1A-related genes, downloaded 44 normal samples and 501 HNSCC tumor samples with RNA-seq data and clinical information from The Cancer Genome Atlas (TCGA) database, and then searched for m6A/m5C/m1A-related genes co-expressed lncRNAs. We adopt the least absolute shrinkage and selection operator (LASSO) Cox regression to obtain m6A/m5C/m1A-related lncRNAs to construct a prognostic signature of HNSCC. Results: This prognostic signature is based on six m6A/m5C/m1A-related lncRNAs (AL035587.1, AC009121.3, AF131215.5, FMR1-IT1, AC106820.5, PTOV1-AS2). It was found that the high-risk subgroup has worse overall survival (OS) than the low-risk subgroup. Moreover, the results showed that most immune checkpoint genes were significantly different between the two risk groups (p < 0.05). Immunity microenvironment analysis showed that the contents of NK cell resting, macrophages M2, and neutrophils in samples of low-risk group were significantly lower than those of high-risk group (p < 0.05), while the contents of B cells navie, plasma cells, and T cells regulatory (Tregs) were on the contrary (p < 0.05). In addition, patients with high tumor mutational burden (TMB) had the worse overall survival than those with low tumor mutational burden. Conclusion: Our study elucidated how m6A/m5C/m1A-related lncRNAs are related to the prognosis, immune microenvironment, and TMB of HNSCC. In the future, these m6A/m5C/m1A-related lncRNAs may become a new choice for immunotherapy of HNSCC.

Tauroursodeoxycholic acid attenuates cisplatin-induced ototoxicity by inhibiting the accumulation and aggregation of unfolded or misfolded proteins in the endoplasmic reticulum.

Cisplatin-induced ototoxicity is one of the important reasons that limit the drug's clinical application, and its mechanism has not been fully elucidated so far. The aim of this study was to explore the attenuate effect of tauroursodeoxycholic acid (TUDCA), a proteostasis promoter, on cisplatin-induced ototoxicity in vivo and in vitro, and to explore its possible mechanism. Auditory brainstem response (ABR) was measured to identify the attenuate effects of TUDCA administered subcutaneously [500 mg/kg/d × 3d, cisplatin: 4.6 mg/kg/d × 3d, intraperitoneal injection (i.p.)] or trans-tympanically (0.5 mg/mL, cisplatin: 12 mg/kg, i.p. with a pump) in Sprague-Dawley (SD) rats subjected to cisplatin-induced hearing loss. The cochlear explants of neonatal rats and OC1 auditory hair cell-like cell lines cultured in vitro were used to observe the number of apoptotic cells and the endoplasmic reticulum (ER) stress in the control, cisplatin (5 µM for 48 h for cochlear explants, 10 µM for 24 h for OC1 cells), and cisplatin + TUDCA (1 mM for 24 h for cochlear explants, 1.6 mM for 24 h for OC1 cells) groups. Differences in the expression of key proteins in the ER protein quality control (ERQC) system were detected. The changes in the attenuate effect of TUDCA on cisplatin-induced ototoxicity after down-regulating calreticulin (CRT), UDP-glucose ceramide glucosyltransferase-like 1 (UGGT1), and OS9 ER lectin (OS9) were also measured. The effect of TUDCA (10 mM) on stabilizing unfolded or misfolded proteins (UFP/MFP) was analyzed in a cell-free 0.2 % bovine serum albumin (BSA) aggregation system in vitro. Both the subcutaneous and trans-tympanic TUDCA administration alleviated cisplatin-induced increase in ABR thresholds in rats. TUDCA was able to reduce cisplatin-induced apoptosis and alleviate ER stress in cochlear explants and OC1 cells. Under the cisplatin treatment, the expression levels of CRT, UGGT1, and OS9 in the auditory hair cell increased, and the expression of total ubiquitinated proteins decreased. TUDCA attenuated the effect of cisplatin on UGGT1 and OS9, and recovered the protein ubiquitination levels. After down-regulating CRT, UGGT1, or OS9, the protective effect of TUDCA decreased. In the cell-free experimental system, TUDCA inhibited the aggregation of denatured BSA molecules. In summary, TUDCA can attenuate cisplatin-induced ototoxicity, possibly by inhibiting the accumulation and aggregation of UFP/MFP and the associated ER stress.

Precise Surgical Treatment of Thoracic Ossification of Ligamentum Flavum Assisted by O-Arm Computer Navigation: A Retrospective Study.

OBJECTIVE: O-arm computer navigation-assisted technology (OACNAT) has been widely used in the treatment of thoracic ossification of ligamentum flavum (TOLF) in recent years, but there are few in-depth studies on the safety and effectiveness of this approach. The purpose of this study was to investigate the clinical effect of accurate surgical treatment for TOLF with OACNAT. METHODS: From January 2010 to January 2018, the clinical data of 64 patients with TOLF who underwent laminectomy and internal fixation in the Third Hospital of Hebei Medical University were retrospectively reviewed. The patients were divided into group A (with OACNAT, n = 33) and group B (without OACNAT, n = 31) according to the application of OACNAT during the operation. The possible operation-related variables, imaging results, and clinical effects were compared between the 2 groups. RESULTS: In terms of demographics, there were no significant differences between group A and group B in age, sex, body mass index, smoking, drinking, heart disease, hypertension and diabetes (P > 0.05). In terms of operation-related variables, imaging results, and clinical efficacy, there were significant differences in operation time, wound length, postoperative modified Japanese Orthopaedic Association (JOA) score, JOA score improvement rate, accuracy of screw placement, number of intraoperative fluoroscopy procedures, and cerebrospinal fluid leakage between group A and group B (P < 0.05). There were no significant differences in other variables between the 2 groups (P > 0.05). In contrast to group A, in group B, 2 patients had incorrect segmental localization, 3 patients had residual ossified ligamentum flavum after the operation, and 1 patient had postoperative neurologic impairment. On further analysis, compared with group B, group A had a shorter operation time, more accurate screw placement, fewer fluoroscopy procedures, higher JOA score improvement rate, and lower incidence of complications. CONCLUSIONS: The use of OACNAT accurately located the position, size, shape, and boundary of ossification of the ligamentum flavum during the operation, which could guide accurate decompression and improve the accuracy of pedicle screw placement. This approach not only reduced the incidence of incorrect segmental localization and incomplete or excessive decompression but also reduced the risk of related complications and improved the accuracy, safety, and effectiveness of the operation.

Association between Helicobacter pylori and otitis media with effusion in children: A systematic review.

BACKGROUND: Studies have shown that Helicobacter pylori (H. pylori) infection may be associated with the occurrence of otitis media with effusion (OME) in children. OBJECTIVE: This is a systematic review of the relevant published literature to explore the relationship between H. pylori infection and OME in children. METHOD: Articles published before October 30, 2019 in the PubMed, Web of Science, Ovid, the China National Knowledge Infrastructure (CNKI) database, and Wanfang databases were retrieved. Articles were screened based on prespecified inclusion and exclusion criteria. Quality assessment was applied to the included studies. Data in the included studies were extracted and classified for qualitative analysis. RESULTS: Ten studies, which enrolled a total of 397 cases and 334 controls, were included; all were case-control studies of varying quality. We summarized and compared H. pylori infections in different specimens from pediatric patients with OME. Due to the apparent heterogeneity between the included studies, meta-analysis was not appropriate, hence we carried out only a qualitative analysis. CONCLUSION: The detection rate of H. pylori in the middle ear, tonsil and gastric juice in children with OME was higher than that in children without OME. There is no clear and reliable conclusion as to whether there is a difference in the detection rate of H. pylori in adenoid specimens of children with or without OME. Eradication of H. pylori may improve symptoms of drug-resistant OME. Nevertheless, more studies of higher quality are needed to improve the conclusions.