Zirconium-based nanoclusters as molecular robots for water decontamination.

Water contamination owing to anionic pollutants is a persisting and ubiquitous global threat. The current remediation technologies are mostly low in efficiency, expensive in materials and often associated with complicated processes. Herein, we report a characteristic zirconium-based nanocluster that can work as molecular robots for the efficient remediation of anions-contaminated water with great effectiveness and molecular-level accuracy. It exhibits a stimuli-responsive behavior to facilitate the water treatment process: dissolve in acidic aqueous solutions for molecular-level decontamination and quickly aggregate for post-remediation collection. It can precisely capture the representative anionic pollutants, whilst featuring satisfactory capacities (ca. 175 mg-arsenic/g, 60 mg-chromium/g, 45 mg-fluoride/g, 70 mg-phosphorus/g, respectively), super-fast kinetics (finishing uptake within seconds, which is two to four orders of magnitude faster than typical sorbents), as well as multi-cycle applications without appreciable loss of activity. The coexisting common ions show no effect on the target uptake. The responsible active site investigation shows that four active sites are responsible for the monovalent pollutant removal, and the active sites work in pairs to capture divalent chromate species. Cost analysis shows its economical applicability in practical applications. This work would lead to the development of effective water decontamination with higher effectiveness, more convenience, lower cost and more practical application value.

Rethinking development and major research plans of Industrial Internet in China.

This paper gives a definition of the Industrial Internet and expounds on the academic connotation of the future Industrial Internet. From this foundation, we outline the development and current status of the Industrial Internet in China and globally. Moreover, we detail the avant-garde paradigms encompassed within the National Natural Science Foundation of China (NSFC)'s "Future Industrial Internet Fundamental Theory and Key Technologies" research plan and its corresponding management strategies. This research initiative endeavors to enhance interdisciplinary collaborations, aiming for a synergistic alignment of industry, academia, research, and practical implementations. The primary focus of the research plan is on the pivotal scientific challenges inherent to the future industrial internet. It is poised to traverse the "first mile", encompassing foundational research and pioneering innovations specific to the industrial internet, and seamlessly bridges to the "last mile", ensuring the effective commercialization of scientific and technological breakthroughs into tangible industrial market applications. The anticipated contributions from this initiative are projected to solidify both the theoretical and practical scaffolding essential for the cultivation of a globally competitive industrial internet infrastructure in China.

PRDX2 regulates stemness contributing to cisplatin resistance and metastasis in bladder cancer.

BACKGROUND: Cisplatin (CDDP)-based chemotherapy has emerged as the primary treatment for muscle-invasive bladder cancer and metastatic bladder cancer. Nevertheless, a significant proportion of patients experience rapidly developed chemoresistance, leading to treatment ineffectiveness. Existing evidence suggests that chemoresistance is governed by various factors, including tumor stem cells, epithelial mesenchymal transition, and reactive oxygen species (ROS). However, limited research has been conducted on the role of PRDX2, a crucial ROS scavenger, in the modulation of chemoresistance in bladder cancer. METHODS: Cisplatin-resistant cell lines were established using the concentration gradient overlay method, and differentially expressed genes in resistant cells were screened through RNA sequencing. The expression of PRDX2 in cells and tissues was assessed using RT-qPCR, Western Blot, and immunohistochemistry. The expression of PRDX2 in bladder cancer and adjacent tissues was evaluated using a bladder cancer tissue microarray. Furthermore, the impact of PRDX2 knockdown on tumor formation and metastasis was investigated in vivo by applying subcutaneous tumor xenografts tail vein metastasis assays. RESULTS: We demonstrated that PRDX2 is significantly upregulated in bladder tumors and cisplatin-resistant bladder tumor cell lines. Overexpression of PRDX2 can promote tumor proliferation, migration, and invasion both in vitro and in vivo. We have found that knockdown of PRDX2 expression can effectively reverse cell resistance to cisplatin. Mechanistically, our findings suggest that PRDX2 is involved in regulating tumor stemness and epithelial-mesenchymal transition (EMT). Knockdown of PRDX2 affects the PI3K-AKT and mTOR signaling pathways, thereby influencing tumor stemness and EMT, ultimately impacting the chemotherapy resistance of the tumor. CONCLUSIONS: This study provides a new insight into the regulation of chemotherapy resistance in bladder cancer by PRDX2. Targeting PRDX2 can serve as a potent therapeutic target for chemotherapy resistance.

​Meta-analysis of the applied value of the growth differentiation factor 15 detection in HFpEF diagnosis.

OBJECTIVE: To systematically evaluate the diagnostic value of growth differentiation factor-15 (GDF-15) for heart failure with preserved ejection fraction (HFpEF). METHODS: Chinese and English literature on the diagnosis of HFpEF using GDF-15 were searched in PubMed, Embase, Web of Science (WOS), Cochrane Library, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database, WanFang Database, and others. The literature on the diagnostic value of the GDF-15 test for HFpEF was screened from the establishment of the database to April 2023 according to the inclusion and exclusion criteria. The quality of the included studies was then assessed based on the QUADAS-2 list, and the threshold effect was evaluated using the Meta-Disc1.4 software. STATA 17.0 software was used to combine the sensitivity, specificity, and area under the curve (AUC) of the included studies. Moreover, heterogeneity was evaluated by the inconsistency index (I2) and Cochrane Q index, and the source of heterogeneity was explored by subgroup analysis, meta-regression, and sensitivity analysis. Finally, Deek's quantitative funnel plot was used to assess whether there was publication bias among the included studies. RESULTS: A total of ten studies involving 1550 patients were included. The pooled sensitivity was 0.77 (95%CI: 0.70-0.83), the specificity was 0.79 (95%CI: 0.68-0.87), the positive likelihood ratio was 3.9 (95%CI: 2.6-5.9), and the negative likelihood ratio was 0.21 (95%CI:0.12-0.36). The diagnostic odds ratio was 19 (95%CI: 9-37), and the AUC of SROC was 0.88 (95%CI: 0.85-0.9). The results of the heterogeneity test showed significant heterogeneity among the studies (I2 = 96%, p = 0.000 < 0.01). Meta-regression analysis showed that there was a significant difference in diagnostic efficacy between the gold standard group (p = 0.0064 < 0.05), while there was no significant difference in diagnostic efficacy among the three subgroups of age, gender, and comprehensive group (p > 0.05). After excluding the articles that did not include biomarkers for the diagnosis of HFpEF, the average age ≥73 years old, and the proportion of women >55%, the remaining four articles had the pooled sensitivity of 0.80 (I2 = 60.1%, p = 0.06 >​ 0.05) and the pooled specificity of 0.84 (I2 = 0%, p = 0.61 >​0.05), which insisted that there is no significant heterogeneity among them. CONCLUSION: With its high sensitivity and specificity for HFpEF diagnosis, GDF-15 is a novel biomarker for HFpEF diagnosis.

Risk factors for intraoperative blood loss in resection of intracranial meningioma: Analysis of 530 cases.

PURPOSE: Excision of intracranial meningioma has been associated with major intraoperative blood loss (IBL). The objective of the study was to identify factors affecting IBL during removal of meningioma. METHODS: We retrospectively studied medical records of 530 adult patients who underwent surgery for intracranial meningioma at Sichuan Provincial People's Hospital between September 2018 and May 2022. We obtained the following data from each patient's medical chart: age, sex, height, weight, comorbidities, blood pressure, history of smoking and alcohol, imaging examination findings, pathologic diagnosis, albumin, creatinine, calcium, magnesium, hemoglobin (Hb), hematocrit, platelet count, activated partial thromboplastin time, international normalized ratio, fibrinogen concentration and blood transfusion. Univariate and multivariate analyses were performed to identify risk factors for greater IBL during removal of intracranial meningioma. RESULTS: A total of 530 patients were included in our study. Univariate analysis revealed that sex (p = 0.004), two-dimensional (2D) tumor area (p < 0.001), sinus involvement (p = 0.014), World Health Organization grade (p = 0.015), preoperative albumin level (p = 0.032), preoperative Hb level (p = 0.001) and preoperative platelet count (p = 0.004) were significantly associated with greater IBL. Multivariate analysis revealed that greater 2D tumor area (p < 0.001), higher preoperative albumin concentration (p = 0.029) and higher preoperative platelet count (p = 0.03) were independent risk factors for greater IBL in resection of intracranial meningioma. CONCLUSION: Larger tumor size, higher preoperative albumin concentration and higher preoperative platelet count were identified as independent risk factors for greater IBL in resection of intracranial meningioma.

Effects of Sacubitril/Valsartan on cardiac function, blood biochemistry and clinical efficacy in early ventricular remodeling after acute myocardial infarction.

Ventricular remodeling (VR) after acute ST-elevation myocardial infarction (STEMI) is an important predictor for medium- and long-term prognosis. This study focuses on the relevant indexes of VR in patients with AMI, in which, the intervention effects of sacubitril/valsartan and enalapril were compared, guiding the clinical treatment. 58 patients with acute STEMI treated with PCI were divided into research group and control group. UCG was performed at 1 week, 1 month and 3 months after MI, and the patients' indexes were collected to compare VR and adverse reactions in the two groups. The test results showed that there was no statistical difference in the baseline data of patients in the two groups, which were comparable. In the blood biochemical index examination, no statistical difference was found in cTnI and NT-proBNP between the two groups. At 1 week after operation, the levels of cTnI and NT-proBNP in research group were lower than those in the control group. In ECG examination, there was no statistical significance in the levels of LVEF, LVEDD and LVESD at admission between the two groups. After 1 week, the results of LVEF, LVEDD, LVESD in the research group were higher than those in the control group. The results of this study show that sacubitril/valsartan can be used in patients with AMI instead of enalapril. Sacubitril/valsartan improves cardiac function in patients with emergency percutaneous coronary intervention (PCI) for AMI, inhibits ventricular remodeling, and has a low incidence of adverse cardiac events and adverse drug reactions.

The effects of Malassezia in the activation of Interleukin (IL)-23/IL-17 axis in Psoriasis.

We explore the association of Malassezia and IL-23/IL-17 axis in the skin lesions of patients with Psoriasis. From October 2018 to October 2020, 202 psoriasis patients were hospitalized in the dermatology department of Yantaishan hospital. The patients' skin lesions were collected, and Malassezia-specific mRNA in the skin lesions was determined. The patients were subdivided into Malassezia high and low distribution groups as per the Malassezia-specific mRNA results. Psoriasis Area and Severity Index (PASI) scores between the two groups were performed. LL-37, IL-23, IL-17A, and tumor necrosis factor α (TNF-α) expression in the skin lesions of the two groups were determined. Malassezia mRNA and the correlation of LL-37 with inflammatory factors TNF-α, IL-23, and IL-17A were determined. The relevance of inflammatory factors, Malassezia infection, and LL-37 content with PASI score were studied. The Malassezia high distribution group was treated with etoconazole, and the effects of treatment on the PASI score, IL-23, TNF-α, and IL-17A were determined. The PASI score, neutrophil, eosinophil, and peripheral blood white blood cell counts, and lgG in the Malassezia high distribution group were significantly higher than in the low distribution group (P<0.05). IL-23, LL-37, TNF-α, and IL-17A levels in the Malassezia high distribution group were significantly higher than in the low distribution group (P<0.05). Malassezia and LL-37 levels had a moderate positive correlation (R=0.5009, P<0.0001). Malassezia and LL-37, IL-17A, TNF-a, and IL- 23 correlated positively. Malassezia, IL-17A, LL37, TNF-a, and IL-23 correlated positively with the PASI score of Psoriasis. Ketoconazole therapy inhibited the PASI score, IL-23, TNF-a, and IL-17A expressions in patients. Malassezia enhances the progression of Psoriasis through the aberrant activation of the IL-23/IL-17 axis.

Construction of a Family of Maximally Entangled Bases in ℂd⊗ℂd'.

In this paper, we present a new method for the construction of maximally entangled states in Cd⊗Cd' when d'≥2d. A systematic way of constructing a set of maximally entangled bases (MEBs) in Cd⊗Cd' was established. Both cases when d' is divisible by d and not divisible by d are discussed. We give two examples of maximally entangled bases in C2⊗C4, which are mutually unbiased bases. Finally, we found a new example of an unextendible maximally entangled basis (UMEB) in C2⊗C5.

MicroRNA miR-124-3p suppresses proliferation and epithelial-mesenchymal transition of hepatocellular carcinoma via ARRDC1 (arrestin domain containing 1).

Hepatocellular carcinoma (HCC) is responsible for high morbidity and mortality worldwide. Increasing evidence suggests that microRNAs intensively participate in HCC development and progression. In the current study, we aimed to explore the impact of miR-124-3p in the proliferation and epithelial-mesenchymal transition (EMT) of HCC. The RT-qPCR assay was employed to determine miR-124-3p expression in human HCC specimens and cell lines. Luciferase assay was used to validate the miR-124-3p target gene. Western Blot and RT-qPCR were performed to study the effects of miR-124-3p modulation on ARRDC1 (Arrestin Domain Containing 1) mRNA and protein expressions. MTT assay, wound healing assay, EdU assay, and Transwell assay were utilized to verify the impact of miR-144-3p modulation on HCC proliferation and EMT via ARRDC1. We found that MiR-124-3p expression downregulates in HCC. Overexpression of miR-124-3p reduced the HCC cell proliferation and EMT. Meanwhile, we determined that the expression of ARRDC1 is increased in HCC, and miR-124-3p directly binds the 3'UTR of ARRDC1 and inhibits its expression at mRNA and protein level, suggesting that miR-124-3p was capable of negatively modulating ARRDC1. Besides, cotransfection of ARRDC1-overexpression plasmid and miR-124-3p mimics increased the cell proliferation and EMT as compared to miR-124-3p mimics. Our study concluded that miR-124-3p directly binds the 3'UTR of ARRDC1 and exerts anti-tumorous effects by inhibiting the HCC proliferation and EMT. Therefore, miR-124-3p/ARRDC1 axis may serve as a novel therapeutic target to inhibit HCC growth and metastasis.

High clinical diagnostic accuracy of combined salivary gland and myocardial metaiodobenzylguanidine scintigraphy in the diagnosis of Parkinson's disease.

Background: Decreased myocardial uptake of 131I-metaiodobenzylguanidine (MIBG) is known to be an important feature to diagnose Parkinson's disease (PD). However, the diagnosis accuracy of myocardial MIBG scintigraphy alone is often unsatisfying. Recent studies have found that the MIBG uptake of the major salivary glands was reduced in PD patients as well. Purpose: To evaluate the diagnostic value of major salivary gland MIBG scintigraphy in PD, and explore the potential role of myocardial MIBG scintigraphy combined with salivary gland MIBG scintigraphy in distinguishing PD from non-PD (NPD). Methods: Thirty-seven subjects were performed with 131I-MIBG scintigraphy. They were classified into the PD group (N = 18) and the NPD group (N = 19), based on clinical diagnostic criteria, DAT PET and 18F-FDG PET imaging findings. Images of salivary glands and myocardium were outlined to calculated the MIBG uptake ratios. Results: The combination of left parotid and left submandibular gland early images had a good performance in distinguishing PD from NPD, with sensitivity, specificity, and accuracy of 50.00, 94.74, and 72.37%, respectively. Combining the major salivary gland and myocardial scintigraphy results in the early period showed a good diagnostic value with AUC, sensitivity and specificity of 0.877, 77.78, and 94.74%, respectively. Meanwhile, in the delayed period yield an excellent diagnostic value with AUC, sensitivity and specificity of 0.904, 88.89, and 84.21%, respectively. Conclusion: 131I-MIBG salivary gland scintigraphy assisted in the diagnosis and differential diagnosis of PD. The combination of major salivary gland and myocardial 131I-MIBG scintigraphy further increased the accuracy of PD diagnosis.

miR-455 Inhibits the Viability and Invasion by Targeting RAB18 in Hepatocellular Carcinoma.

BACKGROUND: Hepatocellular carcinoma (HCC) has been regarded as the fifth most common cancer worldwide with a low prognosis. miR-455 usually played the role of a tumor suppressor in multiple cancers. The aim of this study was to investigate the roles of miR-455 in HCC. MATERIALS AND METHODS: Cell viability and invasion were measured by CCK8 and Transwell assays. Luciferase reporter assay was performed to verify that miR-455 directly binds to the 3'-noncoding region (UTR) of RAB18 mRNA in Huh7 cells. RESULTS: The expression of miR-455 was lower in HCC tissues and cell lines than in nontumor tissues and normal cell line, and downregulation of miR-455 was connected with worse outcome of HCC patients. miR-455 suppressed cell proliferation in vitro and in vivo, and it inhibited the abilities of cell invasion and EMT in HCC. RAB18 was upregulated in HCC tissues and cell lines, and the expression of RAB18 was regulated by miR-455. RAB18 reversed partial roles of miR-455 on cell viability and invasion in HCC. CONCLUSION: miR-455 inhibited cell viability and invasion by directly targeting the 3'-UTR of RAB18 mRNA of hepatocellular carcinoma.

Pineal Region Glioblastomas: Clinical Characteristics, Treatment, and Survival Outcome.

OBJECTIVE: Given the rarity of patients with pineal glioblastoma (GBM), clinical characteristics, treatment, and prognostic factors are not well characterized. This study aimed to investigate these characteristics and identify the prognostic factors of overall survival (OS). METHODS: A retrospective analysis of newly diagnosed patients with pineal GBM, including our 3 cases and an additional 44 cases from published articles, was conducted. Survival analysis was performed by Kaplan-Meier analysis and Cox regression analysis was used to determine the prognostic factors. RESULTS: A total of 47 patients (28 males and 19 females) were enrolled, with a median age of 46 years (range, 5-74 years). Forty-four patients (90.9%) had preoperative obstructive hydrocephalus. Among 38 patients, 21 (55.3%) had distal leptomeningeal dissemination. Forty-five patients (95.7%) had resection/biopsy, 6 of whom had gross total resection, 22 had subtotal resection, 7 had partial resection, and 10 had biopsy. Adjuvant therapy included radiotherapy in 36 patients and chemotherapy in 27 patients. The median OS was 10.0 months. The 6-month, 1-year, and 2-year survival was 68.0%, 42.6%, and 17.0%, respectively. Cox regression analysis showed that patients receiving biopsy (P = 0.042) or chemotherapy (P = 0.029) had the better OS and these were regarded as independent prognostic factors. Further survival analysis showed that chemoradiotherapy had better survival benefit than other regimens. CONCLUSIONS: In this study, we summarized the characteristics of patients with pineal GBM and showed the correlation between clinical characteristics and prognosis. This study may give readers a deep understanding of these rare GBMs and provide some references for future management.

Risk factors for hydrocephalus following fourth ventricle tumor surgery: A retrospective analysis of 121 patients.

BACKGROUND AND AIM: Most patients who present with a fourth ventricle tumor have concurrent hydrocephalus, and some demonstrate persistent hydrocephalus after tumor resection. There is still no consensus on the management of hydrocephalus in patients with fourth ventricle tumor after surgery. The purpose of this study was to identify the factors that predispose to postoperative hydrocephalus and the need for a postoperative cerebrospinal fluid (CSF) diversion procedure. MATERIALS AND METHODS: We performed a retrospective analysis of patients who underwent surgery of the fourth ventricle tumor between January 2013 and December 2018 at the Department of Neurosurgery in West China Hospital of Sichuan University. The characteristics of patients and the tumor location, tumor size, tumor histology, and preventive external ventricular drainage (EVD) that were potentially correlated with CSF circulation were evaluated in univariate and multivariate analysis. RESULTS: A total of 121 patients were enrolled in our study; 16 (12.9%) patients underwent postoperative CSF drainage. Univariate analysis revealed that superior extension (p = 0.004), preoperative hydrocephalus (p<0.001), and subtotal resection (p<0.001) were significantly associated with postoperative hydrocephalus. Multivariate analysis revealed that superior extension (p = 0.013; OR = 44.761; 95% CI 2.235-896.310) and subtotal resection (p = 0.005; OR = 0.087; 95% CI 0.016-0.473) were independent risk factors for postoperative hydrocephalus after resection of fourth ventricle tumor. CONCLUSION: Superior tumor extension (into the aqueduct) and failed total resection of tumor were identified as independent risk factors for postoperative hydrocephalus in patients with fourth ventricle tumor.

Long-Chain Non-Coding SOX21-AS1 Promotes Proliferation and Migration of Breast Cancer Cells Through the PI3K/AKT Signaling Pathway.

AIM: This study aimed to investigate the effect of long-chain non-coding SOX21-AS1 on the proliferation and migration of breast cancer (BC) cells through the PI3K/AKT signaling pathway. METHODS: Eighty-eight BC and adjacent tissues were collected, and BC cells and normal breast epithelial cells were purchased. LncRNA SOX21-AS1 expression in tissues and cells was detected by RT-PCR. miR-NC, si-SOX21-AS1, and Sh-SOX21-AS1 were transfected into BC cells. The PI3K/AKT signaling pathway was interfered with L740Y-P (activator of the PI3K/AKT pathway) and LY294002 (inhibitor of the PI3K/AKT pathway) in BC cells. The SOX21-AS1 expression in BC tissues and cells was tested by qRT-PCR, and the expression levels of p-PI3K, p-AKT, N-cadherin, E-cadherin, and vimentin were detected by WB. RESULTS: SOX21-AS1 was highly expressed in BC, and the p-PI3K and p-AKT levels were also high. Cell experiments showed that inhibiting SOX21-AS1 expression could inhibit the proliferation, invasion, migration, and EMT of BC cells, and up-regulating its expression could promote the proliferation, invasion, migration, and EMT of ovarian cancer cells. The tumor-forming experiment in nude mice was consistent with the results in vitro. 740Y-P intervention could reverse the inhibition effect of Si-SOX21-AS1 on BC cell proliferation, invasion, migration, and EMT, while LY294002 intervention could reverse the promotion effect of Sh-SOX21-AS1 on BC cell proliferation, invasion, migration, and EMT. CONCLUSION: SOX21-AS1 is highly expressed in BC tissues. Silencing BC expression can inhibit the proliferation, invasion, migration, and EMT of cells by inhibiting the PI3K/AKT signaling pathway, which may be a new target for diagnosis and treatment.

A comparison between superhydrophobic surfaces (SHS) and slippery liquid-infused porous surfaces (SLIPS) in application.

Slippery liquid-infused porous surfaces inspired by the Nepenthes pitcher plant exhibit excellent performances and are known for their extremely low contact angle hysteresis (<5°) and smooth surface. In contrast, superhydrophobic surfaces (SHS) exhibit poor pressure stability, difficulty in self-healing, and difficulty in removing low surface tension liquids or organic solvents, which can affect the stable air layer. Thus, these issues can be avoided through the replacement of SHS with slippery liquid infused porous surfaces (SLIPS). In this review, the theoretical models of SHS and SLIPS are classified initially, and several design standards for the preparation of SLIPS are briefly described. Then, we focus on comparing the differences in the application of SHS and SLIPS, such as pressure stability, transparency, and droplet manipulation. However, there are still some problems that need to be improved during the preparation of SLIPS, such as the evaporation of the lubricant layer, the use of a lubricant layer of toxic perfluoropolyether and other substances, and easily lost nanostructured lubricant layer. Accordingly, several new improved methods are proposed in this review, and finally, the potential applications and development prospects of SLIPS are presented.

Clinical value of color Doppler ultrasound combined with serum CA153, CEA and TSGF detection in the diagnosis of breast cancer.

In the present retrospective study, the clinical value of color Doppler ultrasound combined with the detection of the serum tumor markers carbohydrate antigen 153 (CA153), carcinoembryonic antigen (CEA) and tumor specific growth factor (TSGF) as diagnostic tools for breast cancer was investigated. A total of 103 patients with breast cancer and 50 patients with benign breast lesions were enrolled in the study. All patients were examined by color Doppler ultrasonography. Electrochemiluminescence was used to measure the expression levels of CA153 and CEA, and chemical colorimetric assay for the measurement of TSGF expression. The differences in mass boundary, morphology, internal echo, calcification, peak blood flow velocity (Vmax), resistance index (RI), pulsatility index (PI) and blood flow signal classification between the two groups were statistically significant (P<0.05). The expression levels of CA153, CEA and TSGF in the serum of patients in the breast cancer group were significantly higher than those in the benign lesion group (P<0.01). In the breast cancer group, CA153, CEA and TSGF expression levels were significantly higher in patients with high-stage cancer and recurrence, compared with the patients with low-stage cancer and no recurrence. The sensitivity, accuracy and negative predictive value of the combined detection were significantly improved compared with those of the single tests (P<0.01). Color Doppler ultrasound combined with the detection of CA153, CEA and TSGF levels in the serum of patients can be used as an effective tool that can improve the accuracy of breast cancer diagnosis leading to early diagnosis and clinical intervention.

Risk factors for the recurrence of world health organization grade â ¡ ependymomas of spinal cord in adults after microsurgical resections: A retrospective study of 118 patients in a single center.

OBJECTIVE: To identify the risk factors for recurrence of World Health Organization (WHO) grade Ⅱ ependymomas of spinal cord in adults after microsurgical resections. PATIENTS AND METHODS: A total of 118 adult patients diagnosed with WHO grade Ⅱ ependymomas of spinal cord at west china hospital from January 2010 to December 2016 were reviewed retrospectively. To identify the risk factors for recurrence, we performed univariate analyses and multivariate logistic regression analyses successively. RESULTS: Twelve patients had a recurrence with a median recurrence time of 30 months [inter-quartile range (IQR) 23.5-75.5 months]. Univariate analysis showed that age (p = 0.030), STR (p < 0.001), index of Ki-67 (p = 0.004), and Vimentin (+, p = 0.004) were associated with postoperative recurrence of ependymomas of spinal cord in adults, while univariate analysis showed that only STR [odds ratio (OR) = 18.838, 95 % confidence interval (CI): 3.068-115.673; p = 0.002], index of Ki-67 (OR = 1.381, 95 % CI: 1.021-1.868; p = 0.036), Vimentin (+; OR = 6.706, 95 % CI: 1.218-36.928; p = 0.029) were independent risk factors for recurrence. CONCLUSIONS: The recurrence rate of WHO grade Ⅱ ependymomas of spinal cord in adults was about 13.6 %. Subtotal resection is a critical risk factor for recurrence. A high index of Ki-67 is another independent risk factor for recurrence. Positive Vimentin may also play a role in this process. GTR is very important to prevent recurrence after operation if it is safe to conduct. In cases with higher index Ki-67 and Vimentin (+), close follow-ups are necessary.