Efficacy and Safety of the Safe Triangular Working Zone Approach in Percutaneous Vertebroplasty for Spinal Metastasis.

OBJECTIVE: This study aimed to assess the technical feasibility, efficacy, and safety of the safe triangular working zone (STWZ) approach applied in percutaneous vertebroplasty (PV) for spinal metastases involving the posterior part of the vertebral body. MATERIALS AND METHODS: We prospectively enrolled 87 patients who underwent PV for spinal metastasis involving the posterior part of the vertebral body, with or without the STWZ approach, from January 2019 to April 2022. Forty-nine patients (27 females and 22 males; mean age ± standard deviation [SD], 57.2 ± 11.6 years; age range, 31-76 years) were included in group A (with STWZ approach), accounting for 54 vertebrae. Thirty-eight patients (18 females and 20 males; 59.1 ± 10.9 years; 29-81 years) were included in group B (without STWZ approach), accounting for 57 vertebrae. Patient demographics, procedure-related variables, and pain relief as assessed using the visual analog scale (VAS) were collected at different time points. Tumor recurrence in the vertebrae after PV was analyzed using Kaplan-Meier curves. RESULTS: The STWZ approach was successful from T1 to L5 without severe complications. Cement filling was satisfactory in 47/54 (87.0%) and 25/57 (43.9%) vertebrae in groups A and B, respectively (p < 0.001). Cement leakage was not significantly different between groups A and B (p = 1.000). Mean VAS score ± SD before and 1 week and 1, 3, 6, 9, and 12 months after PV were 7.6 ± 1.8, 4.2 ± 2.0, 2.7 ± 1.9, 1.9 ± 1.5, 1.7 ± 1.4, 1.7 ± 1.1, and 1.6 ± 1.3, respectively, in group A and 7.2 ± 1.7, 4.0 ± 1.3, 3.4 ± 1.6, 2.4 ± 1.2, 1.8 ± 1.0, 1.4 ± 0.5, and 1.7 ± 0.9, respectively, in group B. Kaplan-Meier analysis showed a lower tumor recurrence rate in group A than in group B (p = 0.001). CONCLUSION: The STWZ approach may represent a new, safe, alternative/auxiliary approach to target the posterior part of the vertebral body in the PV for spinal metastases.

An MRI radiomics nomogram improves the accuracy in identifying eligible candidates for fertility-preserving treatment in endometrioid adenocarcinoma.

It is difficult to identify eligible candidates for fertility-preserving treatment (FPT) among endometrioid adenocarcinoma (EAC) and atypical hyperplasia (AH) patients. Therefore, new approaches for improving the accuracy of candidate selection are warranted. From December 2014 to January 2020, 236 EAC/AH patients (age <50 and premenopausal) were retrospectively reviewed and randomly divided into the primary group (n=158) and validation group 1 (n=78). From February 2020 to December 2021, 51 EAC/AH patients were prospectively enrolled and formed the validation group 2. From the primary group, 385 features were extracted using pyradiomics from multiparameter magnetic resonance imaging (MRI) (including T2-weighted imaging, diffusion-weighted imaging, apparent diffusion coefficient, and contrast enhancement sequences) and 13 radiomics features were selected using a least absolute shrinkage and selection operator. A clinical model based on clinical information (myometrial invasion on MRI and tumor grade in curettage) and a radiomics nomogram by integrating clinical information with the radiomics features was developed to identify eligible candidates of FPT. For identifying eligible candidates of FPT, the areas under the receiver operating characteristic curve (AUCs) were 0.63 (95% confidence interval [CI]: 0.53-0.73) in the primary group, and 0.62 (95% CI: 0.45-0.78) and 0.69 (95% CI: 0.53-0.86) in validation groups 1 and 2, respectively, for the clinical model; were 0.86 (95% CI: 0.80-0.93) in the primary group, and 0.82 (95% CI: 0.71-0.93) and 0.94 (95% CI: 0.87-1.0) in validation groups 1 and 2, respectively, for the radiomics nomogram. With the help of radiomics nomogram, the treatment decision determined from the clinical model was revised in 45 EAC/AH patients. The net reclassification index (NRI) was 0.80 and integrated discrimination improvement (IDI) was 0.17, indicating that the nomogram could improve the accuracy in identifying eligible EAC/AH candidates for FPT.

[Trend of change in sperm concentration in Chinese fertile males from 1984 to 2019].

OBJECTIVE: To investigate the trend of change in the sperm concentration of Chinese fertile males from 1984 to 2019. METHODS: We searched CNKI, CQVIP and Wanfang Database for literature relevant to human sperm concentration published from 1984 to 2019, and analyzed the trend of change in the sperm concentration of fertile men in China in the past 35 years. RESULTS: A total of 9 495 publications were identified, of which 73 with 11 606 subjects were included. Based on the results of fitting calculation, the perm concentration of the males declined significantly from 98.8486 ×106/ml in 1984 to 72.5531 ×106/ml in 2019, with a mean decrease of 0.7513 ×106/ml annually (P < 0.01), and the reduction was more significant in North than in South China (－1.2754 vs －0.4587 ×106/ml, P = 0.01). CONCLUSIONS: The sperm concentration of fertile Chinese men was decreasing in the past 35 years, which might be related to unhealthy living habits and environmental pollution.

[The study of anti-tumor activities of DC vaccine loaded with multi-epotipes of survivin].

AIM: To observe the anti-tumor activity of dendritic cell (DC)vaccine loaded with multi-epitopes of survivin. METHODS: The recombinant plasmid pPIRESneo3.0-survivin (4)/Th which include four survivin HLA-A2-restricted CD8(+); CTL epitopes and a CD4(+);Th epitope, pPIRESneo3.0-survivin (4) which include four survivin CD8(+); CTL epitopes, were transfected into human dendritic cells respectively. There were five groups, which included survivin(4)/Th group, survivin(4)group, empty plasmid group, untransfected group and T lymphocytes group The expression of CD83 and CD86 on the surface of DCs, the expression of CD4 and CD8a on the surface of T lymphocytes, the apoptotic rates of MCF-7 cells after treated by DC vaccine were measured by flow cytometry; IFN-γ levels of all groups were detected by ELISA and the growth inhibition of MCF-7 cells after being treated with DC vaccine was tested by MTT colorimetry. RESULTS: The results of flow cytometry revealed that high levels CD83 and CD86 were expressed on the surface of DCs; high levels CD4 and CD8a were expressed on the surface of T lymphocytes; the IFN-γ levels in survivin(4)/Th group [(66.50±3.34)ng/L]were significantly higher than that in survivin(4)group[(46.10±1.35)ng/L], empty plasmid group[(25.17±0.32)ng/L], untransfected group [(25.47±0.95)ng/L] or T lymphocytes group[(23.73±0.50)ng/L](P<0.05). The inhibition rate of MCF-7 cells in survivin(4)/Th group was significantly higher than that in survivin(4)group, empty plasmid group, untransfected group or T lymphocytes group(P<0.05). The apoptotic rate of MCF-7 cells in survivin(4)/Th group was (10.63±0.29)% after treated by DC vaccine, which was significantly higher than that in in survivin(4)group, empty plasmid group, untransfected group or T lymphocytes group(P<0.05). CONCLUSION: The DCs vaccine loaded with multi- CD8(+); CTL epitopes of survivin has strong anti-tumor effects. CD4(+); Th cells can promote the anti-tumor activity of CD8(+);CTL.