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Gliomas are common brain tumors. Despite extensive research, the 5-year survival rate of glioma remains low. Many studies have reported that circular RNAs (circRNAs) play a role in promoting the malignant progression of glioma; however, the role of circ_0059914 in this process remains unclear. In this study, we aimed to investigate the function and underlying mechanism of circ_0059914 in glioma. Western blotting and qRT-PCR were used to determine the levels of circ_0059914, miR-1249, VEGFA, N-cadherin, vimentin, Snail, and EIF4A3. EDU and colony formation assays were conducted to evaluate cell proliferation. Transwell assays were used to explore cell migration and invasion and tube formation assays were used to analyze angiogenesis. RNA immunoprecipitation (RIP) and dual-luciferase reporter assays were used to explore the relationship between EIF4A3, circ_0059914, miR-1249, and VEGFA. A xenograft tumor assay was performed to determine the role of circ_0059914 in vivo. Circ_0059914 expression was upregulated in gliomas. Knockdown of gliomal circ_0059914 expression reduced the proliferation, migration, invasion, epithelial-mesenchymal transition (EMT), angiogenesis, and growth of glioma cells in vivo. Circ_0059914 sponged miR-1249, and miR-1249 inhibition reversed the circ_0059914 knockdown-mediated effects in glioma cells. VEGFA was found to be a target gene of miR1249; overexpression of VEGFA reversed the effect of miR-1249 up-regulation in glioma. Finally, EIF4A3 increased the expression of circ_0059914. EIF4A3-induced circ_0059914 expression plays a role in promoting glioma via the miR-1249/VEGFA axis.
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BACKGROUND: The effects of Isopsoralen (ISO) in promoting osteoblast differentiation and inhibiting osteoclast formation are well-established, but the mechanism underlying ISO's improvement of Glucocorticoid- Induced Osteoporosis (GIOP) by regulating metabolism remains unclear. METHODS: This study aims to elucidate the mechanism of ISO treatment for GIOP through non-targeted metabolomics based on ISO's efficacy in GIOP. Initially, we established a GIOP female mouse model and assessed ISO's therapeutic effects using micro-CT detection, biomechanical testing, serum calcium (Ca), and phosphorus (P) level detection, along with histological analyses using hematoxylin and eosin (HE), Masson, and tartrate-resistant acidic phosphatase (TRAP) staining. Subsequently, non-targeted metabolomics was employed to investigate ISO's impact on serum metabolites in GIOP mice. RT-qPCR and Western blot analyses were conducted to measure the levels of enzymes associated with these metabolites. Building on the metabolomic results, we explored the effects of ISO on the cyclic Guanosine Monophosphate (cGMP)/Protein Kinase G (PKG) pathway and its role in mediating osteoblast differentiation. RESULTS: Our findings demonstrate that ISO intervention effectively enhances the bone microarchitecture and strength of GIOP mice. It mitigates pathological damage, such as structural damage in bone trabeculae, reduced collagen fibers, and increased osteoclasts, while improving serum Ca and P levels in GIOP mice. Non-- targeted metabolomics revealed purine metabolism as a common pathway between the Control and GIOP groups, as well as between the ISO high-dose (ISOH) group and the GIOP group. ISO intervention upregulated inosine and adenosine levels, downregulated guanosine monophosphate levels, increased Adenosine Deaminase (ADA) expression, and decreased cGMP-specific 3',5'-cyclic phosphodiesterase (PDE5) expression. Additionally, ISO intervention elevated serum cGMP levels, upregulated PKGI and PKGII expression in bone tissues, as well as the expression of Runt-related transcription factor 2 (Runx2) and Osterix, and increased serum Alkaline Phosphatase (ALP) activity. CONCLUSION: In summary, ISO was able to enhance the bone microstructure and bone strength of GIOP mice and improve their Ca, P, and ALP levels, which may be related to ISO's regulation of purine metabolism and promotion of osteoblast differentiation mediated by the cGMP/PKG pathway. This suggests that ISO is a potential drug for treating GIOP. However, further research is still needed to explore the specific targets and clinical applications of ISO.
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Neural progenitor cells (NPCs) are essential for in vitro drug screening and cell-based therapies for brain-related disorders, necessitating well-defined and reproducible culture systems. Current strategies employing protein growth factors pose challenges in terms of both reproducibility and cost. In this study, we developed a novel DNA-based modulator to regulate FGFR signaling in NPCs, thereby facilitating the long-term maintenance of stemness and promoting neurogenesis. This DNA-based FGFR-agonist effectively stimulated FGFR1 phosphorylation and activated the downstream ERK signaling pathway in human embryonic stem cell (HESC)-derived NPCs. We replaced the basic fibroblast growth factor (bFGF) in the culture medium with our DNA-based FGFR-agonist to artificially modulate FGFR signaling in NPCs. Utilizing a combination of cell experiments and bioinformatics analyses, we showed that our FGFR-agonist could enhance NPC proliferation, direct migration, and promote neurosphere formation, thus mimicking the functions of bFGF. Notably, transcriptomic analysis indicated that the FGFR-agonist could specifically influence the transcriptional program associated with stemness while maintaining the neuronal differentiation program, closely resembling the effects of bFGF. Furthermore, our culture conditions allowed for the successful propagation of NPCs through over 50 passages while retaining their ability to efficiently differentiate into neurons. Collectively, our approach offers a highly effective method for expanding NPCs, thereby providing new avenues for disease-in-dish research and drug screening aimed at combating neural degeneration.
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Células Madre Embrionarias Humanas , Células-Madre Neurales , Humanos , Reproducibilidad de los Resultados , Células-Madre Neurales/metabolismo , Neurogénesis/fisiología , ADN/metabolismo , ADN/farmacología , Diferenciación Celular , Células CultivadasRESUMEN
INTRODUCTION: Intraspinal tumours are common diseases in neurosurgery and spinal surgery. Due to the fact that most of them are benign tumours, surgical resection is usually effective, and it is also the main treatment for these tumours. To maintain the stability of the spine and to reduce the incidence of kyphosis, pedicle screw fixation is required after traditional laminectomy, but there are many complications. In recent years, tumour resection and laminectomy have become increasingly favoured by clinicians. However, the comparison of the clinical effects of lamina complex replantation and pedicle screw fixation after laminectomy in the treatment of intraspinal tumours is still unknown. This paper systematically compared the two methods from many aspects and discussed their advantages and disadvantages to obtain better clinical guidance. MATERIALS AND METHODS: In this study, a retrospective analysis was conducted to select 58 patients who underwent posterior approach tumour resection in the spinal surgery department of our hospital from January 2017 to January 2020. Among them, 32 patients underwent tumour resection and laminoplasty, and 26 patients underwent tumour resection and screw internal fixation. The age, sex, body mass index (BMI), smoking status, duration of symptoms, operation time, length of hospital stay, postoperative complications, amount of bleeding and other data were summarized, calculated and compared. RESULTS: 1. The age, sex, BMI, smoking status and symptom duration of the two groups were compared. The abovementioned results were not statistically significant. 2. The operation time, hospital stay, postoperative complications, intraoperative bleeding and adjacent segment degeneration (ASD) were counted and compared between the two groups. There was no significant difference in hospital stay or intraoperative bleeding between the two groups; in addition, the operation time, postoperative complications and incidence of ASD were statistically significant. 3. The visual analog scale (VAS) score, Oswestry Disability Index (ODI) score of thoracic and lumbar spines and Neck Disability Index (NDI) score of cervical spine patients in the two groups were counted, and the preoperative and postoperative data, as well as their changes, were counted and compared between groups and within groups. There was no statistical significance between the two groups; moreover, the postoperative scores were all significantly lower than preoperative in the group. 4. According to the spinal cord function ASIA grade, the preoperative, final follow-up and change values of the two groups were counted, and intragroup and intergroup comparisons were made. There was no significant difference between the two groups; in addition, the scores of the final follow-up were significantly higher than preoperative in the group. 5. The spinal mobility was measured and recorded before the operation and at the final follow-up. There was no significant difference between preoperative and postoperative cervical mobility, and there was no statistical significance observed; furthermore, the range of flexion, extension, rotation and lateral bending of the thoracic and lumbar spines in the screw fixation group was significantly lower than that in the lamina replantation group. CONCLUSIONS: Lamina replantation can be used as splendid methods for the treatment of Intraspinal tumour. Lamina replantation can reduce the operation time, as well as reduce the occurrence of postoperative cerebrospinal fluid leakage, iatrogenic spinal stenosis, posterior soft tissue adhesion and ASD. These complications are reduced in comparison to the other mode of management and better preserve the mobility of the spine.
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Tornillos Pediculares , Neoplasias de la Columna Vertebral , Humanos , Laminectomía/efectos adversos , Estudios Retrospectivos , Reimplantación , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Neoplasias de la Columna Vertebral/cirugía , Complicaciones Posoperatorias/etiología , Vértebras Lumbares/cirugíaRESUMEN
BACKGROUND: Spinal cord injury (SCI), which reportedly induces severe motor dysfunction, imposes a significant social and financial burden on affected individuals, families, communities, and nations. Acupuncture combined with moxibustion (AM) therapy has been widely used for motor dysfunction treatment, but the underlying mechanisms remain unknown. In this work, we aimed to determine whether AM therapy could alleviate motor impairment post-SCI and, if so, the potential mechanism. METHODS: A SCI model was established in mice through impact methods. AM treatment was performed in SCI model mice at Dazhui (GV14) and Jiaji points (T7-T12), Mingmen (GV4), Zusanli (ST36), and Ciliao (BL32) on both sides for 30 min once per day for 28 days. The Basso-Beattie-Bresnahan score was used to assess motor function in mice. A series of experiments including astrocytes activation detected by immunofluorescence, the roles of NOD-like receptor pyrin domain-containing-3 (NLRP3)-IL-18 signaling pathway with the application of astrocyte-specific NLRP3 knockout mice, and western blot were performed to explore the specific mechanism of AM treatment in SCI. RESULTS: Our data indicated that mice with SCI exposure exhibited motor dysfunction, a significant decrease of neuronal cells, a remarkable activation of astrocytes and microglia, an increase of IL-6, TNF-α, IL-18 expression, and an elevation of IL-18 colocalized with astrocytes, while astrocytes-specific NLRP3 knockout heavily reversed these changes. Besides, AM treatment simulated the neuroprotective effects of astrocyte-specific NLRP3 knockout, whereas an activator of NLRP3 nigericin partially reversed the AM neuroprotective effects. CONCLUSION: AM treatment mitigates SCI-induced motor dysfunction in mice; this protective mechanism may be related to the NLRP3-IL18 signaling pathway inhibition in astrocytes.
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Terapia por Acupuntura , Moxibustión , Fármacos Neuroprotectores , Traumatismos de la Médula Espinal , Ratas , Ratones , Animales , Proteína con Dominio Pirina 3 de la Familia NLR , Interleucina-18 , Ratas Sprague-Dawley , Fármacos Neuroprotectores/farmacología , Traumatismos de la Médula Espinal/complicaciones , Traumatismos de la Médula Espinal/terapia , Traumatismos de la Médula Espinal/metabolismo , Transducción de SeñalRESUMEN
There is an increasing demand for high-precision gas absorption spectroscopy in basic research and industrial applications, such as gas tracking and leak warning. In this Letter, a novel, to the best of our knowledge, high-precision and real-time gas detection method is proposed. A femtosecond optical frequency comb is used as the light source, and a broadening pulse containing a range of oscillation frequencies is formed after passing through a dispersive element and a Mach-Zehnder interferometer. Four absorption lines of H13C14N gas cells are measured at five different concentrations within a single pulse period. A single scan detection time of only 5â ns is obtained along with a coherence averaging accuracy of 0.0055â nm. High-precision and ultrafast detection of the gas absorption spectrum is accomplished while overcoming complexities related to the acquisition system and light source that are encountered in existing methods.
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Background: The aims of this study were to identify the relationship between the spinocranial angle (SCA) and clinical outcomes and to explore whether the SCA is a suitable indicator to predict clinical outcomes for patients with ossification of the posterior longitudinal ligament (OPLL). Methods: Sixty-five patients with cervical OPLL who underwent laminoplasty with at least 24 months of follow-up were selected for the current study and were divided into two groups according to whether the SCA was greater than or less than the mean preoperative SCA. Sagittal alignment changes were compared between the groups. The Pearson correlation coefficient was applied to assess the relationship among sagittal parameters. Univariate and multiple linear regression analyses were applied to identify the relationship between the recovery rate (RR) and radiological parameters. Results: Patients were classified into two groups based on the mean value of preoperative SCA (85.1°). SCA was negatively correlated with T1 slope (T1s) and cervical lordosis (CL) and positively correlated with the C2-7 sagittal vertical axis (cSVA) (p < 0.001). Patients with lower SCA had larger T1s and CL preoperatively and at the follow-up (T1s: p < 0.001; CL: p < 0.001) and showed greater loss of cervical lordosis after laminoplasty (p < 0.001). However, no significant differences in the incidence of kyphosis, Japanese Orthopaedic Association (JOA) or RR were noted between the two groups. Although Pre-SCA, Pre-CL, F/U-CL and Pre-T1sCL were significantly associated with RR, these indicators were not associated with RR in the multivariate regression analysis. Conclusion: Patients with lower SCA tended to have higher T1s and CL before surgery and greater loss of cervical lordosis at the follow-up visit but still maintained a greater lordosis angle. Although preoperative SCA is significantly related to RR, the relationship is not sufficient to indicate that preoperative SCA can be used to predict clinical outcomes. Therefore, further research is needed to confirm the impact of SCA on clinical outcomes for OPLL.
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We demonstrate an arbitrary distance measurement method by chirped pulse spectrally interferometry (CPSI) using femtosecond optical frequency comb (OFC). In this paper, the chirped fiber Bragg grating (CFBG) is used to investigate the mapping relationship between displacement and the center frequency of the chirped spectral interferogram. We overcome the direction ambiguity of dispersive interferometry (DPI) ranging and expand the range of distance measurement to 18 cm. Besides, we achieve a full range of dead-zone free ranging by introducing a variable optical delay line (VODL). And through principles simulation and experiment, it is demonstrated that the measurement accuracy is 12 µm in comparison with an incremental He-Ne laser interferometer and the minimum Allen deviation is 52 nm at an average time of 1.76 ms. Similarly, in the experiment with long-distance of â¼30m, the accuracy reaches 20 µm, and 2.51 µm repeatability is achieved under harsh environment.
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Since the dispersive interferometry (DPI) based on optical frequency combs (OFCs) was proposed, it has been widely used in absolute distance measurements with long-distance and high precision. However, it has a serious problem for the traditional DPI based on the mode-locked OFC. The error of measurements caused by using the fast Fourier transform (FFT) algorithm to process signals cannot be overcome, which is due to the non-uniform sampling intervals in the frequency domain of spectrometers. Therefore, in this paper, we propose a new mathematical model with a simple form of OFC to simulate and analyze various properties of the OFC and the principle of DPI. Moreover, we carry out an experimental verification, in which we adopt the Lomb-Scargle algorithm to improve the accuracy of measurements of DPI. The results show that the Lomb-Scargle algorithm can effectively reduce the error caused by the resolution, and the error of absolute distance measurement is less than 12 µm in the distance of 70 m based on the mode-locked OFC.
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In precision machining, the surface geometry of a device is one of the important parameters that directly affects the device performance. This paper proposes nonequal arm surface measurement of femtosecond optical frequency combs (OFCs) using the Savitzky-Golay filtering algorithm, which uses the high spatial coherence of OFCs to realize high-precision, nonequal surface measurements. The Savitzky-Golay filtering algorithm and a high-order polynomial envelope fitting algorithm are used to smooth and denoise the interference signals to improve signal quality and measurement accuracy. The experiments are carried out under the condition of nonequal arms, and the results show that the repeatability is 28.6 nm for 20 consecutive measurements on the step surface of a 0.5 mm gauge block. The frosted glass surface is measured 20 times, and the measurement repeatability at the center position is 89.6 nm, which verified the system capability of nonequal arm high-precision measurement under different reflective surfaces.
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A novel Fe2O3-Fe3C heterostructure encapsulated into a carbon matrix was designed as an anode material for lithium-ion batteries. The composite had the high specific capacity of metal oxides, and maintained the stability of metal carbides. The unique heterostructure and tubular structure were conducive to charge transfer and ion diffusion.
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BACKGROUND: The authors of this study aim to summarize their experience with lateral ventriculosinus shunt in the treatment of hydrocephalus patients and assess its clinical value. METHODS: Ventriculoperitoneal shunt was performed but failed due to obstruction and infection of the shunt. Lateral ventriculosinus shunt was inserted in 19 hydrocephalus patients by a Medtronic programmable shunt valve. All 19 patients suffered from either an obstruction or infection after ventriculoperitoneal shunting, while 11 cases had a peritoneal obstruction, 8 cases had an intracranial infection, and 1 case had an intra-abdominal infection. Among the 19 cases, there were 2 cases with obstructive hydrocephalus and 17 cases with communicating hydrocephalus. RESULTS: All clinical symptoms of 9 patients disappeared completely, while for 8 patients, noticeable improvement was accomplished, and only 2 patients showed no improvement. All 19 cases were followed up for 6 to 60 months. During the follow-up period, in 17 patients the shunt remained effective, while 2 cases underwent removal of the shunt due to low preoperative intracranial pressure and no significant changes in postoperative symptoms and ventricular size. During follow-up there was no thrombosis in the sagittal sinus, and no infection, over drainage, intracranial hemorrhage, or subdural effusion occurred. CONCLUSIONS: We demonstrate that lateral ventriculosinus shunt is a reliable option for failed ventriculoperitoneal shunt hydrocephalus patients. Nevertheless, the effectiveness and possible complications of this method need further confirmation by observation in a study with a larger cohort.
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Hidrocefalia , Derivación Ventriculoperitoneal , Humanos , Hidrocefalia/cirugía , Resultado del TratamientoRESUMEN
Glomus tumors are rare lesions that can arise anywhere along the spinal axis. Only 12 cases have been reported. We report a case of a patient with a rare glomangioma of the thoracic spine. Following a review of the 12 previous cases is a discussion of spinal glomus tumors, including clinical presentation, diagnosis, and treatment. A single, recent case arising from the extradural space of the thoracic spine is described, followed by a literature review of spinal glomus tumors. Including our case, 13 cases of glomus tumors have been reported. The mean age at the time of diagnosis was 44.6 years (range, 22-73 years) and the male-to-female (M:F) ratio was 1.17:1. The lesion was located in the cervical spine in 1 patient, the thoracic spine in 7 patients, the lumbar spine in 4 patients, and the sacrum in 1 patient. All the tumors were benign. However, there was 1 report of local recurrence because of incomplete removal. There were no malignant transformations, metastases, or deaths reported, with a mean follow-up of 20.09±28.43 months(range, 2-90 months). Spinal glomus tumors are rare, and the preoperative diagnosis is difficult. An overwhelming majority of glomus tumors are benign and are cured by simple local excision. Patients undergoing complete resection have an excellent long-term prognosis.
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Tumor Glómico , Neoplasias de la Columna Vertebral , Neoplasias Torácicas , Femenino , Tumor Glómico/cirugía , Humanos , Vértebras Lumbares , Masculino , Sacro , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Neoplasias de la Columna Vertebral/cirugíaRESUMEN
Tumor angiogenesis plays a crucial role in colorectal cancer development. Dysregulation of the receptor for the advanced glycation end-products (RAGE) transmembrane signaling mediates inflammation, resulting in various cancers. However, the mechanism of the RAGE signaling pathway in modulating development of colorectal cancer has not been explored. In this study, an aptamer-based RAGE antagonist (Apt-RAGE) was used to inhibit interaction between RAGE and S100B, thus blocking downstream NFκB-mediated signal transduction. In vitro results showed that Apt-RAGE effectively inhibited S100B-dependent and S100B-independent RAGE/NFκB activation in colorectal HCT116 cancer cells, thus decreasing proliferation and migration of cells. Notably, expression and secretion of VEGF-A were inhibited, implying that Apt-RAGE can be used as an antiangiogenesis agent in tumor therapy. Moreover, Apt-RAGE inhibited tumor growth and microvasculature formation in colorectal tumor-bearing mice. Inhibition of angiogenesis by Apt-RAGE was positively correlated with suppression of the RAGE/NFκB/VEGF-A signaling. The findings of this study show that Apt-RAGE antagonist is a potential therapeutic agent for treatment of colorectal cancer.
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Neoplasias Colorrectales , Productos Finales de Glicación Avanzada , Animales , Neoplasias Colorrectales/tratamiento farmacológico , Productos Finales de Glicación Avanzada/metabolismo , Humanos , Ratones , FN-kappa B/metabolismo , Receptor para Productos Finales de Glicación Avanzada/metabolismo , Transducción de SeñalRESUMEN
Ovarian hyperstimulation syndrome (OHSS) is a rare but serious complication of assisted reproductive technology application. The incidence of stroke symptoms associated with OHSS is lower than that of abdominal symptoms, which may occur in severe OHSS situation. If tissue plasminogen activator (tPA) is not applicable, mechanical thrombectomy (MT) is recommended for acute cerebral artery occlusion within 6 hours of symptom onset according to the current guidelines. However, the current experience and evidence is insufficient, whether acute cerebral artery occlusion associated with OHSS can be treated with MT. A 21-year-old woman underwent an ovulation induction with gonadotropin-releasing hormone agonist. Two days later, she presented with abdominal distension and diarrhea. Ascites and enlarged ovaries were confirmed by ultrasound. She was highly suspected of OHSS in by the Department of Obstetrics and Gynecology. Three days later, she presented with right-side hemiplegia, superficial coma, and aphasia, and right Babinsky sign was positive. The patient was diagnosed with left middle cerebral artery (LMCA) occlusion by computed tomography angiography (CTA). We performed emergent MT and achieved revascularization within 6 hours of cerebral ischemic symptom onset. After operation, the patient underwent various examinations, and ultrasound revealed deep vein thrombosis and right-to-left shunt due to cardiac atrial septal defect in this case. We thus reasoned that LMCA occlusion could be highly associated with OHSS. At 3-month follow-up, the patient recovered to a normal situation and was left with no neurological dysfunction. We here report MT treatment for a rare cerebral artery occlusion case associated with OHSS in right-to-left shunt patient. It is necessary to pay attention to ischemic symptoms in a severe OHSS situation in aggressive infertility treatment, especially in right-to-left shunt patients. More future studies are recommended for determining the effectiveness of the MT treatment in cerebral artery occlusion associated with OHSS.
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Síndrome de Hiperestimulación Ovárica , Accidente Cerebrovascular , Adulto , Femenino , Humanos , Infarto de la Arteria Cerebral Media/etiología , Embarazo , Accidente Cerebrovascular/etiología , Trombectomía , Activador de Tejido Plasminógeno/uso terapéutico , Adulto JovenRESUMEN
Traditional frequency modulated continuous wave (FMCW) LIDAR ranging is based on heterodyne detection, calculating unknown distance by extracting the frequency of the interference signal, while the main error source is frequency modulation (FM) nonlinearity. In this paper, a ranging system based on a microresonator soliton comb is demonstrated to correct the nonlinearity by sampling the ranging signals at equal frequency intervals, producing a ranging error lower than 20 µm, while at the range of 2 m. Advantages of fast data acquisition, light computation requirements, and a simple optical path, without long optical fiber, give this method a high practical value in precision manufacturing.
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OBJECTIVE: Aiming at the time consuming processing of existing thyroid nodule detection and difficulty in feature extraction, U-Net-based thyroid nodule detection is proposed to perform computed aided diagnosis. METHOD: This paper proposes a mark-guided ultrasound deep network segmentation model of thyroid nodules. By comparing with VGG19, Inception V3, DenseNet 161, segmentation accuracy, segmentation edge and network operation time, it is found that the algorithm in this paper has relative advantages. RESULTS: U-Net network-based ultrasound thyroid nodules segmented the nodule area overlapped with the manually depicted nodule area close to 100%, the segmentation accuracy rate was as high as 0.9785, and the U-Net segmentation result was closer to the manually depicted nodule. The accuracy of U-Net segmentation of the thyroid is about 3% higher than the other three networks. CONCLUSION: The segmentation of nodules based on U-Net proposed in this paper significantly improves the segmentation accuracy of thyroid nodules with a small training data set, and provides a comprehensive reference for clinical diagnosis and treatment.
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Nódulo Tiroideo , Algoritmos , Humanos , Nódulo Tiroideo/diagnóstico por imagen , Ultrasonido , UltrasonografíaRESUMEN
BACKGROUND: Simple bone cysts (SBCs) are common benign lytic bone lesions in children. This study focused on exploring a clinical treatment method, minimally invasive intramedullary decompression and drainage with elastic stable intramedullary nailing (ESIN) combined with intralesional injections of steroids, and evaluated its effectiveness, complications and morbidity through functional and radiographic outcomes. METHODS: The postoperative recovery of 18 children who suffered from SBCs of humerus was evaluated (mean follow-up, 40 months) from January 2009 to December 2016. These patients (11 males, 7 females; 8 in the left, 10 in the right; mean age, 10.9 years old) were treated with minimally invasive intramedullary decompression and drainage with ESIN combined with intralesional injections of steroids. The diagnosis was based on not only pre-operative typical medical images (X-rays/CT/MRI) but also surgical findings and pathological diagnosis. Radiological and functional outcomes were evaluated according to Capanna and Musculoskeletal Tumor Society (MSTS) score. The interclass differences were analyzed by t-test. RESULTS: According to Capanna and MSTS criteria, after treatment, 14 patients made full recoveries which was presented by all the cysts filled with bone tissue, and 4 patients made partially recoveries, which were presented by cystic spaces partially filled with low density bone. All the cysts responded to treatment method, and there was no cyst recurrence. All except 2 patients had good functional results. One of the two patients had irritation of the end of the nail and one patient had a valgus deformity. CONCLUSIONS: Treatment for SBCs of humerus by minimally invasive intramedullary decompression and drainage with ESIN combined with intralesional injections of steroids is safe, effective and convenient. The clinical effect is satisfactory and worth popularizing.
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Quistes Óseos/terapia , Descompresión Quirúrgica/instrumentación , Drenaje/instrumentación , Glucocorticoides/administración & dosificación , Húmero/patología , Procedimientos Quirúrgicos Mínimamente Invasivos/instrumentación , Adolescente , Quistes Óseos/diagnóstico , Quistes Óseos/patología , Clavos Ortopédicos/efectos adversos , Niño , Terapia Combinada/efectos adversos , Terapia Combinada/instrumentación , Terapia Combinada/métodos , Descompresión Quirúrgica/efectos adversos , Descompresión Quirúrgica/métodos , Drenaje/efectos adversos , Drenaje/métodos , Femenino , Estudios de Seguimiento , Humanos , Húmero/diagnóstico por imagen , Húmero/efectos de los fármacos , Húmero/cirugía , Inyecciones Intralesiones , Imagen por Resonancia Magnética , Masculino , Procedimientos Quirúrgicos Mínimamente Invasivos/efectos adversos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
PURPOSE: This study aimed to investigate the value of shear wave elastography (SWE) for characterization of breast masses in a Chinese population. PATIENTS AND METHODS: Two thousand two hundred seventy-three women consented to be prospectively enrolled for the characterization of breast masses with ultrasound and SWE. Breast masses were known from symptoms, palpability, and/or previous imaging screening with mammography and/or ultrasound. Correlation of SWE qualitative and quantitative features with malignancy risk and impact on diagnostic performance of combining SWE features were assessed, and the Breast Imaging Reporting and Data System (BI-RADS) scoring was calculated using histopathology as reference. RESULTS: Data of 2,262 masses (median size: 13 mm; range: 1.3-50) from 2,262 patients (median age: 43 years; range: 18-91) were investigated, of which 752 (33.3%) were malignant. Sensitivity and specificity of BI-RADS diagnosis were 97.5% (733/752) and 54.8% (827/1,510), respectively. By logistic regression, the combination of maximum elasticity (E max) measurements with BI-RADS assessments increased the area under the receiver operating characteristic curve from 0.908 (95% CI: 0.896-0.920) to 0.954 (95% CI: 0.944-0.962). Using E max of 30 kPa or lower to selectively downgrade BI-RADS 4a masses to follow-up, and E max of 160 kPa or higher to selectively upgrade BI-RADS 3 lesions to biopsy, specificity significantly increased from 54.8% (827/1,510) to 66.1% (998/1,510) (P<0.001) while sensitivity decreased nonsignificantly from 97.5% (733/752) to 96.9% (729/752) (P=0.2891). Positive predictive value for biopsy recommendation increased from 51.7% (733/1,417) to 58.7% (729/1,241) (P<0.001). CONCLUSION: Adding SWE maximum stiffness to BI-RADS 3 and BI-RADS 4a breast masses in a Chinese population increased significantly the specificity of breast ultrasonography, without significant change in sensitivity.
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OBJECTIVE: To observe the incidence, causes and deviation angle of axial offset in patients with fracture ununited treated by Ilizarov bone transport technology. METHODS: From January 2007 to December 2012, 10 patients with fracture ununited were treated by Ilizarov bone transport including 8 males and 2 females with an average age of (30.3 ± 10.6) years old ranging from 18 to 49 years old. The segment of bone defect involved upper tibial in 2 cases, medial tibia in 2 cases, lower tibial in 5 cases, upper femoral in 1 case. For Paley type of bone defect, 6 cases were type B1, 4 cases were B3. The incidence and deviation angle of axial offset after Ilizarov bone transport technology were observed and evaluated on bone result by Paley assessment. RESULTS: All patients were followed up from 19 to 32 months with an average of (22.0 ± 5.6) months. Three cases were natural healed at fracture ends, the other 7 cases were healed after bone graft. The time of external fixator was 16 to 28 months. At the last follow-up, there were 3 cases occurred coronal angulation of angle 5° to 11° with an average of (8.7 ± 3.2). Sagittal angulation was in 4 cases, angle 6° to 9° with an average of (8.5 ± 2.1)°. There were 4 cases occurred axial offset. In the last follow-up, according to Paley evaluation criteria, osseous results were excellent in 7 cases, good in 3 cases; functional results were excellent in 6 cases, good in 4 cases. CONCLUSION: Axial deviation after the Ilizarov bone transport treatment is relatively common, which will result in delayed healing of bone and poor limb alignment. In order to improve the bone healing, corresponding measurements should be taken to avoid or reduce the incidence of axial deviation during and after the operation.