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BACKGROUND: Dysregulation of osteogenic differentiation is a crucial event during osteoporosis. The bioactive phytochemical icariin has become an anti-osteoporosis candidate. Here, we elucidated the mechanisms underlying the promoting function of icariin in osteogenic differentiation. METHODS: Murine pre-osteoblast MC3T3-E1 cells were stimulated with dexamethasone (DEX) to induce osteogenic differentiation, which was evaluated by an Alizarin Red staining assay and ALP activity measurement. The mRNA amounts of SPI1 and SMAD5 were detected by real-time quantitative PCR. Expression analysis of proteins, including osteogenic markers (OPN, OCN and RUNX2) and autophagy-associated proteins (LC3, Beclin-1, and ATG5), was performed by immunoblotting. The binding of SPI1 and the SMAD5 promoter was predicted by the Jaspar2024 algorithm and confirmed by chromatin immunoprecipitation (ChIP) experiments. The regulation of SPI1 in SMAD5 was examined by luciferase assays. RESULTS: During osteogenic differentiation of MC3T3-E1 cells, SPI1 and SMAD5 were upregulated. Functionally, SPI1 overexpression enhanced autophagy and osteogenic differentiation of MC3T3-E1 cells, while SMAD5 downregulation exhibited opposite effects. Mechanistically, SPI1 could enhance SMAD5 transcription and expression. Downregulation of SMAD5 also reversed SPI1 overexpression-induced autophagy and osteogenic differentiation in MC3T3-E1 cells. In MC3T3-E1 cells under DEX stimulation, icariin increased SMAD5 expression by upregulating SPI1. Furthermore, icariin could attenuate SPI1 depletion-imposed inhibition of autophagy and osteogenic differentiation of MC3T3-E1 cells. CONCLUSION: Our findings demonstrate that the SPI1/SMAD5 cascade, with the ability to enhance osteogenic differentiation, underlies the promoting effect of icariin on osteogenic differentiation of MC3T3-E1 cells.
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Diferenciación Celular , Flavonoides , Osteoblastos , Osteogénesis , Proteína Smad5 , Flavonoides/farmacología , Animales , Ratones , Osteogénesis/efectos de los fármacos , Diferenciación Celular/efectos de los fármacos , Proteína Smad5/metabolismo , Proteína Smad5/genética , Osteoblastos/efectos de los fármacos , Osteoblastos/metabolismo , Autofagia/efectos de los fármacos , Transducción de Señal/efectos de los fármacos , Células 3T3RESUMEN
OBJECTIVE: This study aimed to evaluate if placement of transverse cesarean skin incision above or below the overhanging pannus is associated with wound morbidity in morbidly obese patients. STUDY DESIGN: We identified a cohort of patients with body mass index (BMI) ≥40 kg/m2 undergoing cesarean delivery at a single center from 2017-2020 with complete postpartum records. Data was abstracted after institutional review board exemption, and patients were grouped by low transverse or high transverse skin incision. The primary outcome was a composite of wound infection, fascial dehiscence, incisional hernia, therapeutic wound vacuum, and reoperation. Secondary outcomes included the individual components of the composite, blood transfusion, operative time, and immediate neonatal outcome. T test and χ2 were used for continuous and categorical comparisons. Logistic regression was used to compute adjusted odds ratios for categorical outcomes and linear regression to compare operative times adjusting for factors associated with wound complications and surgical duration respectively. RESULTS: 328 patients met inclusion criteria: 65 with high transverse (infraumbilical and supraumbilical) and 263 with low transverse (Pfannenstiel) incision. 11% of patients had wound morbidity; high transverse incision was associated with 3.64-fold increased odds of composite wound morbidity (23.1% vs 8%, aOR 3.64, 95% CI 1.52-8.70) and 5.73-fold increased odds of wound infection (13.8% vs. 4.9%, aOR 5.73, 95% CI 1.83-17.96). Time from skin incision to delivery was 1.87 min longer (11.09 vs 14.98 min, ß = 1.87, 95% CI 0.17-4.61). There was no significant difference in neonatal outcomes, non-low transverse hysterotomy, or total operative time. CONCLUSION: High transverse skin incision for cesarean delivery was strongly associated with increased wound morbidity in morbidly obese patients.
Outcomes after cesarean delivery were assessed for 328 patients with morbid obesity.High transverse skin incision for cesarean delivery was associated with increased wound morbidity and wound infection.Prospective studies will be needed to determine if skin incision placement causes wound morbidity.
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Cesárea , Obesidad Mórbida , Humanos , Femenino , Cesárea/efectos adversos , Cesárea/métodos , Cesárea/estadística & datos numéricos , Embarazo , Obesidad Mórbida/cirugía , Obesidad Mórbida/complicaciones , Adulto , Estudios Retrospectivos , Tempo Operativo , Infección de la Herida Quirúrgica/epidemiología , Infección de la Herida Quirúrgica/etiología , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiologíaRESUMEN
Purpose: This study aimed to investigate the alteration trends and overlaps of positive features in benign and malignant thyroid nodules of different sizes based on the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS). Patients and Methods: 1337 patients with 1558 thyroid nodules were retrospectively recruited from November 2021 to December 2023. These nodules were divided into three groups according to maximum diameter: A (≤10 mm), B (10-20 mm), and C (≥20 mm). C-TIRADS positive features were compared between benign and malignant thyroid nodules of different sizes. In addition, the trends of positive features with changes in nodule size among malignant thyroid nodules were analyzed. Results: The incidence of positive features in malignant thyroid nodules was higher than that in benign. As benign nodules grow, the incidence of all positive features showed a linear decreasing trend (Z values were 72.103, 101.081, 17.344, 33.909, and 129.304, P values < 0.001). With the size of malignant thyroid nodules increased, vertical orientation, solid, marked hypoechogenicity, and ill-defined/irregular margins/extrathyroidal extension showed a linear decreasing trend (Z = 148.854, 135.378, 8.590, and 69.239, respectively; P values < 0.05), while suspicious microcalcifications showed a linear increasing trend (Z = 34.699, P<0.001). In terms of overlapping characteristics, group A had a significantly higher overlapping rate than the other two groups, and the overlapping rate of solid indicators remained the highest among all three groups (P < 0.05). Conclusion: Differences in positive features were observed between thyroid nodules of different sizes. Except for suspicious microcalcifications, the incidence of other four positive features decreased with increasing nodule size. In addition, a negative correlation was observed between the overlap rate and nodule size. These results may provide a basis for sonographers to upgrade or downgrade thyroid nodules based on their own experience.
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BACKGROUND: Unilateral percutaneous endoscopic debridement and drainage (UPEDD) and bilateral PEDD (BPEDD) are commonly implemented, and have consistently yielded favorable clinical outcomes. Nevertheless, there is a scarcity of literature contrasting the advantages and disadvantages between these 2 procedures. OBJECTIVE: The goal of this research was to conduct a meta-analysis to compare the clinical effects of UPEDD and BPEDD. STUDY DESIGN: A systematic review and meta-analysis. METHODS: A systematic review of studies reporting outcomes following UPEDD and/or BPEDD procedures was performed. The extracted data were used for meta-analysis. Pooled event rates for positive bacteria culture, pain control satisfaction, reoperation, and complications were estimated. The pooled operation time and blood loss were also calculated. RESULTS: Among 764 retrieved articles, 28 studies with 661 patients met the inclusion criteria and were used for our meta-analysis. A total of 21 studies (462 patients) investigated UPEDD outcomes and 7 studies (199 patients) investigated BPEDD outcomes. For the UPEDD group, the pooled event rates for positive bacteria culture, pain control satisfaction, reoperation, and complications were 72%, 91%, 9% and 4%, respectively; the pooled operation time and blood loss were 89.90 minutes and 59.77 mL. For the BPEDD group, these were 79%, 92%, 4%, 8%, 93.23 minutes and 64.93 mL, respectively. LIMITATIONS: First, all included studies were retrospective series, limiting our study design to a single-arm meta-analysis. Second, there was a limited amount of studies that were determined to be fitting, particularly on BPEDD; the sample size was also small. Third, the clinical effects of UPEDD and BPEDD needed to be compared in greater detail, such as the time it took for inflammatory markers to return to normal, the incidence of local kyphosis, and whether the duration of antibiotic use could be shortened after adequate debridement with BPEDD. Lastly, further studies are necessary to compare the clinical outcome of PEDD and percutaneous endoscopic interbody debridement and fusion. CONCLUSIONS: Both UPEDD and BPEDD can provide a relatively reliable causative-pathogen identification and satisfactory clinical outcome. The 2 techniques are not significantly different in terms of positive bacteria culture rate, pain control satisfaction rate, complication rate, and reoperation rate.
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Drenaje , Endoscopía , Humanos , Desbridamiento , Estudios Retrospectivos , DolorRESUMEN
Background/Aims: : Necrotizing pancreatitis (NP) presents a more severe clinical trajectory and increased mortality compared to edematous pancreatitis. Prompt identification of NP is vital for patient prognosis. A risk prediction model for NP among Chinese patients has been developed and validated to aid in early detection. Methods: : A retrospective analysis was performed on 218 patients with acute pancreatitis (AP) to examine the association of various clinical variables with NP. The least absolute shrinkage and selection operator (LASSO) regression was utilized to refine variables and select predictors. Subsequently, a multivariate logistic regression was employed to construct a predictive nomogram. The model's accuracy was validated using bootstrap resampling (n=500) and its calibration assessed via a calibration curve. The model's clinical utility was evaluated through decision curve analysis. Results: : Of the 28 potential predictors analyzed in 218 AP patients, the incidence of NP was 25.2%. LASSO regression identified 14 variables, with procalcitonin, triglyceride, white blood cell count at 48 hours post-admission, calcium at 48 hours post-admission, and hematocrit at 48 hours post-admission emerging as independent risk factors for NP. The resulting nomogram accurately predicted NP risk with an area under the curve of 0.822, sensitivity of 82.8%, and specificity of 76.4%. The bootstrap-validated area under the curve remained at 0.822 (95% confidence interval, 0.737 to 0.892). This model exhibited excellent calibration and demonstrated greater predictive efficacy and clinical utility for NP than APACHE II, Ranson, and BISAP. Conclusions: : We have developed a prediction nomogram of NP that is of great value in guiding clinical decision.
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Facing with serious carbon emission issues, the production of green H2 from electrocatalytic hydrogen evolution reaction (HER) has received extensive research interest. Almost all kinds of noble metal phosphides (NMPs) consisting of Pt-group elements (i.e., Ru, Rh, Pd, Os, Ir and Pt) are all highly active and pH-universal electrocatalysts toward HER. In this review, the recent progress of NMP-based HER electrocatalysts is summarized. It is further take typical examples for discussing important impact factors on the HER performance of NMPs, including crystalline phase, morphology, noble metal element and doping. Moreover, the synthesis and HER application of hybrid catalysts consisting of NMPs and other materials such as transition metal phosphides, oxides, sulfides and phosphates, carbon materials and noble metals is also reviewed. Reducing the use of noble metal is the key idea for NMP-based hybrid electrocatalysts, while the expanded functionality and structure-performance relationship are also noticed in this part. At last, the potential opportunities and challenges for this kind of highly active catalyst is discussed.
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BACKGROUND: Osteoporotic supracondylar femoral fractures (OSFF) have historically been managed by the lateral anatomical locking plate with reasonable success. However, for some kinds of unstable and osteoporotic supracondylar femoral fractures (UOSFF), especially with bone defects, unilateral locking plate (ULLP) fixation failed or resulted in implant breakage. This paper is going to explore what is the stable internal fixation for UOSFF by adding the bilateral locking plate (BLLP) fixation. METHODS: OSFF models were divided into two groups according to the fracture line type, which would be further subdivided according to their angle of fracture line, presence of bone defect, location, and degree of bone defect. Thereafter, kinds of locking plate fixation were constructed. A 2010-N load was applied to the femoral head, and a 1086-N load was applied to the greater trochanter. In this condition, the maximum von Mises stress distribution of models were investigated. RESULTS: Firstly, it was obviously found that the stress concentration in the BLLP group was more dispersed than that in the ULLP group. Secondly, according to the fracture line analysis, the stress value of fracture line type in "\" model group was higher than that of "/" model group. Moreover, with the increase in fracture line angle, the stress value of the model increased. Thirdly, from the bone defect analysis, the stress value of the medial bone defect (MBD) model group was higher than that of the lateral bone defect (LBD) model group. And as the degree of bone defect increased, the stress value increased gradually in the model group. CONCLUSION: In the following four cases, lateral unilateral locking plate fixation cannot effectively stabilize the fracture end, and double locking plate internal fixation is a necessary choice. First, when the angle of the fracture line is large (30, 45). Second, when the fracture line type is "/." Third, when the bone defect is large. Fourth, when the bone defect is medial.
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Fracturas del Fémur , Fracturas del Cuello Femoral , Humanos , Fracturas del Fémur/cirugía , Análisis de Elementos Finitos , Tornillos Óseos , Fenómenos Biomecánicos , Fijación Interna de Fracturas/métodos , Placas ÓseasRESUMEN
BACKGROUND: The pathogenesis of benign prostatic hyperplasia (BPH) has not been fully elucidated. Ras homology family member A (RhoA) plays an important role in regulating cell cytoskeleton, growth and fibrosis. The role of RhoA in BPH remains unclear. METHODS: This study aimed to clarify the expression, functional activity and mechanism of RhoA in BPH. Human prostate tissues, human prostate cell lines, BPH rat model were used. Cell models of RhoA knockdown and overexpression were generated. Immunofluorescence staining, quantitative real time PCR (qRT-PCR), Western blotting, cell counting kit-8 (CCK-8), flow cytometry, phalloidine staining, organ bath study, gel contraction assay, protein stability analysis, isolation and extraction of nuclear protein and cytoplasmic protein were performed. RESULTS: In this study we found that RhoA was localized in prostate stroma and epithelial compartments and was up-regulated in both BPH patients and BPH rats. Functionally, RhoA knockdown induced cell apoptosis and inhibited cell proliferation, fibrosis, epithelial-mesenchymal transformation (EMT) and contraction. Consistently, overexpression of RhoA reversed all aforementioned processes. More importantly, we found that ß-catenin and the downstream of Wnt/ß-catenin signaling, including C-MYC, Survivin and Snail were up-regulated in BPH rats. Downregulation of RhoA significantly reduced the expression of these proteins. Rho kinase inhibitor Y-27632 also down-regulated ß-catenin protein in a concentration-dependent manner. However, overexpression of ß-catenin did not affect RhoA-ROCK levels, suggesting that ß-catenin was the downstream of RhoA-ROCK regulation. Further data suggested that RhoA increased nuclear translocation of ß-catenin and up-regulated ß-catenin expression by inhibiting its proteasomal degradation, thereby activating Wnt/ß-catenin signaling. Overexpression of ß-catenin partially reversed the changes in cell growth, fibrosis and EMT except cell contraction caused by RhoA downregulation. Finally, Y-27632 partially reversed prostatic hyperplasia in vivo, further suggesting the potential of RhoA-ROCK signaling in BPH treatment. CONCLUSION: Our novel data demonstrated that RhoA regulated both static and dynamic factors of BPH, RhoA-ROCK-ß-catenin signaling axis played an important role in the development of BPH and might provide more possibilities for the formulation of subsequent clinical treatment strategies.
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Hiperplasia Prostática , Animales , Humanos , Masculino , Ratas , beta Catenina/metabolismo , Proliferación Celular , Fibrosis , Hiperplasia Prostática/genética , Hiperplasia Prostática/metabolismo , Hiperplasia Prostática/patología , Vía de Señalización WntRESUMEN
The recent progress in CuMnAs and Mn3X (X = Sn, Ge, Pt) shows that antiferromagnets (AFMs) provide a promising platform for advanced spintronics device innovations. Most recently, a switchable Fermi-arc is discovered by the ARPES technique in antiferromagnet NdBi, but the knowledge about electron-transport property and the manipulability of the magnetic structure in NdBi is still vacant to date. In this study, SdH oscillations are successfully verified from the Dirac surface states (SSs) with 2-dimensionality and nonzero Berry phase. Particularly, it is observed that the spin-flop transition only appears when the external magnetical field is applied along [001] direction, and features obvious hysteresis for the first time in NdBi, which provides a powerful handle for adjusting the spin texture in NdBi. Crucially, the DFT shows the Dirac cone and the Fermi arc strongly depend on the high-order magnetic structure of NdBi and further reveals the orbital magnetic moment of Nd plays a crucial role in fostering the peculiar SSs, leading to unveil the mystery of the band-splitting effect and to manipulate the electronic transport, high-effectively, in the thin film works in NdBi. It is believed that this study provides important guidance for the development of new antiferromagnet-based spintronics devices based on cutting-edge rare-earth monopnictides.
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Deoxynivalenol (DON) has a strong toxic effect on the gastrointestinal mucosa of poultry. In this study, we evaluated chicken embryo development and glandular stomach damage to clarify the immunotoxic effects of DON injected through the allantoic cavity of chicken embryos. The glandular stomach index, routine blood indices, plasma inflammatory factors, pathological changes in the glandular stomach, and transcriptome results were analyzed in the hatching chicks. The results showed that DON was supertoxic to chicken embryos, causing edema, shedding, and bleeding of the mucosa of the glandular stomach, which triggered inflammatory reactions. As the toxin concentration increased, the immune system was successively activated and inhibited, and regulation was carried out by the differential regulation of the mitogen-activated protein kinase (MAPK) signal pathway. These results suggested that the immunotoxic effect of DON on the glandular stomach of chicken embryos was closely related to the regulation of the MAPK signaling pathway.
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BACKGROUND: Benign prostatic hyperplasia (BPH) is a common disease in elderly men, mainly resulted from an imbalance between cell proliferation and death. Glutathione peroxidase 3 (GPX3) was one of the differentially expressed genes in BPH identified by transcriptome sequencing of 5 hyperplastic and 3 normal prostate specimens, which had not been elucidated in the prostate. This study aimed to ascertain the mechanism of GPX3 involved in cell proliferation, apoptosis, autophagy and ferroptosis in BPH. METHODS: Human prostate tissues, GPX3 silencing and overexpression prostate cell (BPH-1 and WPMY-1) models and testosterone-induced rat BPH (T-BPH) model were utilized. The qRT-PCR, CCK8 assay, flow cytometry, Western blotting, immunofluorescence, hematoxylin and eosin, masson's trichrome, immunohistochemical staining and transmission electron microscopy analysis were performed during in vivo and in vitro experiments. RESULTS: Our study indicated that GPX3 was localized both in the stroma and epithelium of prostate, and down-regulated in BPH samples. Overexpression of GPX3 inhibited AMPK and activated ERK1/2 pathway, thereby inducing mitochondria-dependent apoptosis and G0/G1 phase arrest, which could be significantly reversed by MEK1/2 inhibitor U0126 preconditioning. Moreover, overexpression of GPX3 further exerted anti-autophagy by inhibiting AMPK/m-TOR and up-regulated nuclear factor erythroid 2-related factor 2 (Nrf2)/glutathione peroxidase 4 (GPX4, mitochondrial GPX4 and cytoplasmic GPX4) to antagonize autophagy-related ferroptosis. Consistently, GPX3 deficiency generated opposite changes in both cell lines. Finally, T-BPH rat model was treated with GPX3 indirect agonist troglitazone (TRO) or GPX4 inhibitor RAS-selective lethal 3 (RSL3) or TRO plus RSL3. These treatments produced significant atrophy of the prostate and related molecular changes were similar to our in vitro observations. CONCLUSIONS: Our novel data manifested that GPX3, which was capable of inducing apoptosis via AMPK/ERK1/2 pathway and antagonizing autophagy-related ferroptosis through AMPK/m-TOR signalling, was a promising therapeutic target for BPH in the future.
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Ferroptosis , Hiperplasia Prostática , Anciano , Animales , Humanos , Masculino , Ratas , Proteínas Quinasas Activadas por AMP , Apoptosis , Glutatión Peroxidasa , Hiperplasia , Sistema de Señalización de MAP Quinasas , Mitocondrias , Próstata , Serina-Treonina Quinasas TORRESUMEN
Objective.This study aims to propose a generalized AI method for pathology cancer diagnosis and prognosis prediction based on transfer learning and hierarchical split.Approach.We present a neural network framework for cancer diagnosis and prognosis prediction in pathological images. To enhance the network's depth and width, we employ a hierarchical split block (HS-Block) to create an AI-aided diagnosis system suitable for semi-supervised clinical settings with limited labeled samples and cross-domain tasks. By incorporating a lightweight convolution unit based on the HS-Block, we improve the feature information extraction capabilities of a regular network (RegNet). Additionally, we integrate a Convolutional Block Attention Module into the first and last convolutions to optimize the extraction of global features and local details. To address limited sample labels, we employ a dual-transfer learning (DTL) mechanism named DTL-HS-Regnet, enabling semi-supervised learning in clinical settings.Main results.Our proposed DTL-HS-Regnet model outperforms other advanced deep-learning models in three different types of cancer diagnosis tasks. It demonstrates superior feature extraction ability, achieving an average sensitivity, specificity, accuracy, and F1 score of 0.9987, 1.0000, 1.0000 and 0.9992, respectively. Furthermore, we evaluate the model's capability to directly extract prognosis prediction information from pathological images by constructing patient cohorts. The results show that the correlation between DTL-HS-Regnet predictions and the presence of cancer-associated fibroblasts is comparable to that of pathologists.Significance.Our proposed AI method offers a generalized approach for cancer diagnosis and prognosis prediction in pathology. The outstanding performance of the DTL-HS-Regnet model demonstrates its potential for improving current practices in image digital pathology, expanding the boundaries of cancer treatment in two critical areas.
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Neoplasias , Humanos , Neoplasias/diagnóstico por imagen , Redes Neurales de la Computación , Aprendizaje Automático SupervisadoRESUMEN
The performance of rolling parameters and annealing processes on the microstructure and properties of Cu strip were studied by High Precision Rolling Mill, FIB, SEM, Strength Tester, and Resistivity Tester. The results show that with the increase of the reduction rate, coarse grains in the bonding Cu strip are gradually broken and refined, and the grains are flattened when the reduction rate is 80%. The tensile strength increased from 248.0 MPa to 425.5 MPa, while the elongation decreased from 8.50% to 0.91%. The growth of lattice defects and grain boundary density results in an approximately linear increase in resistivity. With the increase of annealing temperature to 400 °C, the Cu strip recovers, and the strength decreased from 456.66 MPa to 220.36 MPa while the elongation rose from 1.09% to 24.73%. The tensile strength and elongation decreased to 192.2 MPa and 20.68%, respectively, when the annealing temperature was 550 °C. The trend of yield strength of the Cu strip was basically the same as that of tensile strength. The resistivity of the Cu strip decreased rapidly during a 200~300 °C annealing temperature, then the trend slowed, and the minimum resistivity was 3.60 × 10-8 Ω·m. The optimum tension range annealing was 6-8 g; less or more than that will affect the quality of the Cu strip.
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Background: GRAS transcription factors play a variety of functions in plant growth and development and are named after the first three transcription factors GAI (GIBBERRELLICACIDINSENSITIVE), RGA (REPRESSOROFGAI), and SCR (SCARECROW) found in this family. Oat (Avena sativa) is one of the most important forage grasses in the world. However, there are few reports on the GRAS gene family in oat. Methods: In order to understand the information and expression pattern of oat GRAS family members, we identified the GRAS members and analyzed their phylogenetic relationship, gene structure, and expression pattern in oat by bioinformatics technology. Results: The results showed that the oat GRAS family consists of 30 members, and most of the AsGRAS proteins were neutral or acidic proteins. The phylogenetic tree divided the oat GRAS members into four subfamilies, and each subfamily has different conservative domains and functions. Chromosome location analysis suggested that 30 GRAS genes were unevenly distributed on five chromosomes of oat. The results of real-time quantitative reverse transcription-PCR (qRT-PCR) showed that some AsGRAS genes (AsGRAS12, AsGRAS14, AsGRAS21, and AsGRAS24) were all up-regulated with increasing stress treatment time.The results of this study provide a theoretical basis for further research into the corresponding stress of oat. Therefore, further studies concentrating on these AsGRAS genes might reveal the many roles played by GRAS genes in oat.
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Avena , Genoma de Planta , Avena/genética , Filogenia , Genoma de Planta/genética , Perfilación de la Expresión Génica/métodos , Familia de Multigenes/genética , Factores de Transcripción/genética , Estrés Fisiológico/genéticaRESUMEN
OBJECTIVES: The purpose of this study was to develop a prediction model to assess the risk of adjacent vertebral compression fractures (AVCFs) after percutaneous kyphoplasty (PKP) surgery. DESIGN: A retrospective chart review. SETTING AND PARTICIPANTS: Patients were collected from the Quzhou People's Hospital, from March 2017 to May 2019. Patients were included if they suffered from osteoporotic vertebral compression fractures (OVCFs), underwent PKP surgery and were followed up for 2 years. INTERVENTIONS: None. METHODS: This was a retrospective cohort study of all PKP surgery procedures of the thoracic, lumbar and thoracolumbar (TL) spine that have been performed for OVCF from 1 March 2017 up to 1 May 2019. The least absolute shrinkage and selection operator (LASSO) regression model was used to optimise feature selection for the AVCF risk model. Multivariable logistic regression analysis was applied to build a predicting model incorporating the feature selected in the LASSO regression model. The C-index, calibration plot and decision curve analysis were applied to assess this model. RESULTS: Gender, age, the number of surgical vertebrae, cement volume, bone mineral density, diabetes, hypertension, bone cement leakage, duration of anti-osteoporosis treatment after surgery and TL junction were identified as predictors. The model displayed good discrimination with a C-index of 0.886 (95% CI 0.828-0.944) and good calibration. High C-index value of 0.833 could still be reached in the interval validation. Decision curve analysis showed that the AVCF nomogram was clinically useful when intervention was decided at the AVCF possibility threshold of 1%. CONCLUSIONS: This study developed a clinical prediction model to identify the risk factors for AVCF after PKP surgery, and this tool is of great value in sharing surgical decision-making among patients consulted before surgery. TRIAL REGISTRATION NUMBER: researchregistry7716.
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Fracturas por Compresión , Cifoplastia , Fracturas Osteoporóticas , Fracturas de la Columna Vertebral , Humanos , Cifoplastia/efectos adversos , Cifoplastia/métodos , Estudios Retrospectivos , Fracturas por Compresión/etiología , Fracturas por Compresión/cirugía , Modelos Estadísticos , Resultado del Tratamiento , Fracturas de la Columna Vertebral/cirugía , Fracturas de la Columna Vertebral/complicaciones , Pronóstico , Vértebras Lumbares/cirugía , Vértebras Lumbares/lesiones , Cementos para Huesos/efectos adversos , Fracturas Osteoporóticas/cirugía , Fracturas Osteoporóticas/etiologíaRESUMEN
BACKGROUND: Muscle-invasive bladder cancer (MIBC) is characterized as bladder tumors that infiltrate into the muscle layer, along with multiple metastasis and poor prognosis. Numerous research studies have been performed to identify the underlying clinical and pathological alterations that occur. However, few studies have revealed the molecular mechanism of its progression based upon the immunotherapy response. Our present study was designed to identify biomarkers which may predict the immunotherapy response by investigating the tumor microenvironment (TME) in MIBC. METHODS: The transcriptome and clinical data of MIBC patients were obtained and analyzed with R version 4.0.3 (POSIT Software, Boston, MA, USA) ESTIMATE package. Differentially expressed immune-related genes (DEIRGs) were identified and further analyzed via the protein-protein interaction network (PPI). Meanwhile, univariate Cox analysis was utilized to screen out the prognostic DEIRGs (PDEIRGs). Then, the PPI core gene was matched with PDEIRGs to obtain the target gene-fibronectin-1 (FN1). Human MIBC and control tissues were collected and FN1 was measured with Quantitative Reverse Transcription PCR (qRT-PCR) and Western-Blot. Finally, the relationship between FN1 expression level and MIBC was validated through survival, univariate Cox, multivariate Cox, Gene Set Enrichment Analysis (GSEA) and correlation analysis of tumor infiltrating immune cells. RESULTS: TME DEIRGs were identified and the target gene FN1 was obtained. The higher expression of FN1 was confirmed in MIBC tissues via bioinformatics analysis, qRT-PCR and Western-Blot. Moreover, higher FN1 expression correlated with reduced survival time and FN1 expression was further favorably correlated with clinic-pathological features (grade, TNM stage, invasion, lymphatic and distant metastasis). Additionally, the genes in the high FN1 expression group were mainly enriched in immune-related activities and macrophage M2, T cell CD4, T cell CD8 and T cell follicular helper cells were correlated with FN1. Finally, it was observed that FN1 was closely related to key immune checkpoints. CONCLUSIONS: FN1 was identified as a novel and independent prognostic factor for MIBC. Our data also suggests FN1 can predict MIBC patients' response to immune checkpoints inhibitors.
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Fibronectinas , Neoplasias de la Vejiga Urinaria , Humanos , Biomarcadores , Neoplasias de la Vejiga Urinaria/genética , Neoplasias de la Vejiga Urinaria/terapia , Pronóstico , Músculos/metabolismo , Músculos/patología , Inmunoterapia , Microambiente TumoralRESUMEN
Prostate volume (PV) differs dramatically among benign prostatic hyperplasia (BPH) patients. Estimation of PV is important to guide the most appropriate pharmacologic or interventional treatment approach. However, the underlying pathophysiological mechanisms for the differences in PV remain unknown. We recently found that the myosin II system might participate in the etiology and development of BPH via static and dynamic factors. Our present study aims to explore the expression and functional activities of myosin II isoforms including smooth muscle (SM) myosin II (SMM II) and non-muscle myosin II (NMM II) in hyperplastic prostates with varied PV. Human hyperplastic prostates and the testosterone-induced rat BPH model were employed for this study. Hematoxylin and Eosin (H&E), Masson's trichrome, immunohistochemical staining, in vitro organ bath, RT-polymerase chain reaction (PCR) and Western-blotting were performed. Also, a BPH tissue microarray (TMA) was constructed to determine the correlations between myosin II isoforms with clinical parameters of BPH patients. With the increase of PV, the expression of NMMHC-A, NMMHC-C, SM-A and LC17b isoforms were increased, and the contractility of prostate smooth muscle was enhanced but force developed more slowly. Consistently, NMMHC-A, NMMHC-C, SM-A and LC17b were correlated positively with PV. Similar outcomes were also observed in the BPH rat model with different PVs. Alterations in the expression and function of myosin the II system may be involved in the pathophysiological mechanism of PV differences between BPH patients.
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Próstata , Hiperplasia Prostática , Masculino , Humanos , Ratas , Animales , Próstata/metabolismo , Hiperplasia Prostática/metabolismo , Contracción Muscular , Miosina Tipo II/metabolismo , Isoformas de Proteínas/metabolismoRESUMEN
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD), a common liver disease worldwide, can be reversed early in life with lifestyle and medical interventions. This study aimed to develop a noninvasive tool to screen NAFLD accurately. METHODS: Risk factors for NAFLD were identified using multivariate logistic regression analysis, and an online NAFLD screening nomogram was developed. The nomogram was compared with reported models (fatty liver index (FLI), atherogenic index of plasma (AIP), and hepatic steatosis index (HSI)). Nomogram performance was evaluated through internal and external validation (National Health and Nutrition Examination Survey (NHANES) database). RESULTS: The nomogram was developed based on six variables. The diagnostic performance of the present nomogram for NAFLD (area under the receiver operator characteristic curve (AUROC): 0.863, 0.864, and 0.833, respectively) was superior to that of the HSI (AUROC: 0.835, 0.833, and 0.810, respectively) and AIP (AUROC: 0.782, 0.773, and 0.728, respectively) in the training, validation, and NHANES sets. Decision curve analysis and clinical impact curve analysis presented good clinical utility. CONCLUSION: This study establishes a new online dynamic nomogram with excellent diagnostic and clinical performance. It has the potential to be a noninvasive and convenient method for screening individuals at high risk for NAFLD.
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Enfermedad del Hígado Graso no Alcohólico , Humanos , Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Encuestas Nutricionales , Nomogramas , Factores de Riesgo , Pruebas de Función HepáticaRESUMEN
Background: Angiomyofibroblastoma (AMFB) is an uncommon disease with few literature reports, leading to the poor understanding of its diagnosis, treatment, and postoperative follow-up plans among gynecologists. Objective: To study the clinical and pathological features of vulvar AMFB and discuss its treatment and prognosis. Case Summary: The 3 cases were characterized by a gradually increasing painless mass in the vulva. Preoperative diagnosis was difficult and mainly depended on ultrasonic examination. Immunohistochemistry confirmed clear boundaries of AMFB. This condition could be completely cured by surgery, and the prognosis was good. Conclusion: The vulvar AMFB is a rare tumor that is frequently misdiagnosed before surgery. Ultrasound is preferred in auxiliary diagnosis, and surgery remains the best treatment, and long-term follow-up is necessary to avoid recurrence or other complications.
RESUMEN
Benign prostatic hyperplasia (BPH) is a common disease in elderly men. It is characterized by prostatic enlargement and urethral compression and often causes lower urinary tract symptoms (LUTs) such as urinary frequency, urgency, and nocturia. Existing studies have shown that the pathological process of prostate hyperplasia is mainly related to the imbalance of cell proliferation and apoptosis, inflammation, epithelial-mesenchymal transition (EMT), and growth factors. However, the exact molecular mechanisms remain incompletely elucidated. Cell adhesion molecules (CAMs) are a group of cell surface proteins that mediate cell-cell adhesion and cell migration. Modulating adhesion molecule expression can regulate cell proliferation, apoptosis, EMT, and fibrotic processes, engaged in the development of prostatic hyperplasia. In this review, we went over the important roles and molecular mechanisms of cell adhesion molecules (mainly integrins and cadherins) in both physiological and pathological processes. We also analyzed the mechanisms of CAMs in prostate hyperplasia and explored the potential value of targeting CAMs as a therapeutic strategy for BPH.