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BACKGROUND: The aim of this study was to investigate the clinical features and treatment options for pediatric adrenal incidentalomas(AIs) to guide the diagnosis and treatment of these tumors. METHODS: The clinical data of AI patients admitted to our hospital between December 2016 and December 2022 were collected and retrospectively analyzed. All patients were divided into neonatal and nonneonatal groups according to their age at the time of the initial consultation. RESULTS: In the neonatal group, 13 patients were observed and followed up, and the masses completely disappeared in 8 patients and were significantly reduced in size in 5 patients compared with the previous findings. Four patients ultimately underwent surgery, and the postoperative pathological diagnosis was neuroblastoma in three patients and teratoma in one patient. In the nonneonatal group, there were 18 cases of benign tumors, including 9 cases of ganglioneuroma, 2 cases of adrenocortical adenoma, 2 cases of adrenal cyst, 2 cases of teratoma, 1 case of pheochromocytoma, 1 case of nerve sheath tumor, and 1 case of adrenal hemorrhage; and 20 cases of malignant tumors, including 10 cases of neuroblastoma, 9 cases of ganglioneuroblastoma, and 1 case of adrenocortical carcinoma. CONCLUSIONS: Neuroblastoma is the most common type of nonneonatal AI, and detailed laboratory investigations and imaging studies are recommended for aggressive evaluation and treatment in this population. The rate of spontaneous regression of AI is high in neonates, and close observation is feasible if the tumor is small, confined to the adrenal gland and has no distant metastasis.
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Neoplasias das Glândulas Suprarrenais , Neuroblastoma , Teratoma , Humanos , Recém-Nascido , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/terapia , Neoplasias das Glândulas Suprarrenais/patologia , Neuroblastoma/diagnóstico , Neuroblastoma/terapia , Estudos Retrospectivos , Teratoma/diagnóstico , Teratoma/cirurgiaRESUMO
Antisense transcription of protein-coding genes has been increasingly recognized as an important regulatory mechanism of gene expression. However, less is known about the extent and importance of antisense transcription of noncoding genes. Here, we investigate the breadth and dynamics of antisense transcription of miRNAs, a class of important noncoding RNAs. Because the antisense transcript of a miRNA is likely to form a hairpin suitable as the substrate of ADARs, which convert adenosine to inosine in double-stranded RNAs, we used A-to-I RNA editing as ultrasensitive readout for antisense transcription of the miRNAs. Through examining the unstranded targeted RNA-seq libraries covering all miRNA loci in 25 types of human tissues, we identified 7275 editing events located in 81% of the antisense strand of the miRNA loci, thus uncovering the previously unknown prevalent antisense transcription of the miRNAs. We found that antisense transcripts are tightly regulated, and a substantial fraction of miRNAs and their antisense transcripts are coexpressed. Sense miRNAs have been shown to down-regulate the coexpressed antisense transcripts, whereas the act of antisense transcription, rather than the transcripts themselves, regulates the expression of sense miRNAs. RNA editing tends to decrease the miRNA accessibility of the antisense transcripts, therefore protecting them from being degraded by the sense-mature miRNAs. Altogether, our study reveals the landscape of antisense transcription and editing of miRNAs, as well as a previously unknown reciprocal regulatory circuit of sense-antisense miRNA pairs.
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Regulação da Expressão Gênica , MicroRNAs/biossíntese , RNA Antissenso/biossíntese , Adenosina/metabolismo , Humanos , Inosina/metabolismo , MicroRNAs/química , MicroRNAs/genética , MicroRNAs/metabolismo , Edição de RNA , RNA Antissenso/química , RNA Antissenso/genética , RNA Antissenso/metabolismo , RNA-SeqRESUMO
BACKGROUND: Although it has been suggested that loneliness is a risk factor for adverse health outcomes, living arrangement may confound the association. This study aimed to investigate whether the associations of loneliness with adverse health outcomes differ in community-dwelling older adults according to different living arrangements. METHODS: In the 2008/2009 wave of Chinese Longitudinal Healthy Longevity Survey, 13,738 community-dwelling older adults (≥65 years) were included for analyses. Living arrangements and loneliness were assessed. Health outcomes including cognitive and physical functions were assessed using MMSE, ADL/IADL scales and Frailty Index in the 2008/2009 and 2011/2012 waves; mortality was assessed in the 3-year follow-up from 2008/2009 to 2011/2012. The effect modificaitons of loneliness on adverse health outcomes by living arrangements were estimated using logistic regression or Cox proportional hazards regression models. RESULTS: Living alone older adults were significantly more likely to be lonely at baseline (52% vs 29.5%, OR = 1.90, 95% CI = 1.67-2.16, P < 0.001), compared with those living with others. Loneliness in older adults was a significant risk factor for prevalent cognitive impairment and frailty, and 3-year mortality, especially among those who lived with others (OR = 1.32, 95% CI = 1.15-1.52, P < 0.001; OR = 1.39, 95% CI = 1.24-1.57, P < 0.001; HR = 1.14, 95% CI = 1.05-1.24, P = 0.002, respectively). In contrast, among the living alone older adults, loneliness was only significantly associated with higher prevalence of frailty (OR = 1.42, 95% CI = 1.07-1.90, P = 0.017). Living arrangement significantly modified the associations of loneliness with prevalent cognitive impairment and 3-year mortality (P values for interaction = 0.005 and 0.026, respectively). CONCLUSIONS: Living arrangement modifies the associations of loneliness with adverse health outcomes in community-dwelling older adults, and those who lived with others but felt lonely had worse cognitive and physical functions as well as higher mortality. Special attention should be paid to this population and more social services should be developed to reduce adverse health outcomes, in order to improve their quality of life and promote successful aging.
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Fragilidade , Solidão , Idoso , Ambiente Domiciliar , Humanos , Vida Independente , Avaliação de Resultados em Cuidados de Saúde , Qualidade de VidaRESUMO
m6A is a prevalent internal modification in mRNAs and has been linked to the diverse effects on mRNA fate. To explore the landscape and evolution of human m6A, we generated 27 m6A methylomes across major adult tissues. These data reveal dynamic m6A methylation across tissue types, uncover both broadly or tissue-specifically methylated sites, and identify an unexpected enrichment of m6A methylation at non-canonical cleavage sites. A comparison of fetal and adult m6A methylomes reveals that m6A preferentially occupies CDS regions in fetal tissues. Moreover, the m6A sub-motifs vary between fetal and adult tissues or across tissue types. From the evolutionary perspective, we uncover that the selection pressure on m6A sites varies and depends on their genic locations. Unexpectedly, we found that â¼40% of the 3'UTR m6A sites are under negative selection, which is higher than the evolutionary constraint on miRNA binding sites, and much higher than that on A-to-I RNA modification. Moreover, the recently gained m6A sites in human populations are clearly under positive selection and associated with traits or diseases. Our work provides a resource of human m6A profile for future studies of m6A functions, and suggests a role of m6A modification in human evolutionary adaptation and disease susceptibility.
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Adenosina/análogos & derivados , Metilação de DNA , Evolução Molecular , Regiões 3' não Traduzidas , Adenosina/metabolismo , Adulto , Suscetibilidade a Doenças , Epigenoma , Feto/metabolismo , Genética Populacional , Células HEK293 , Humanos , Metiltransferases/deficiência , Metiltransferases/genética , Especificidade de ÓrgãosRESUMO
Adenosine-to-inosine (A-to-I) RNA editing regulates miRNA biogenesis and function. To date, fewer than 160 miRNA editing sites have been identified. Here, we present a quantitative atlas of miRNA A-to-I editing through the profiling of 201 pri-miRNA samples and 4694 mature miRNA samples in human, mouse, and Drosophila. We identified 4162 sites present in â¼80% of the pri-miRNAs and 574 sites in mature miRNAs. miRNA editing is prevalent in many tissue types in human. However, high-level editing is mostly found in neuronal tissues in mouse and Drosophila Interestingly, the edited miRNAs in neuronal and non-neuronal tissues in human gain two distinct sets of new targets, which are significantly associated with cognitive and organ developmental functions, respectively. Furthermore, we reveal that miRNA editing profoundly affects asymmetric strand selection. Altogether, these data provide insight into the impact of RNA editing on miRNA biology and suggest that miRNA editing has recently gained non-neuronal functions in human.
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MicroRNAs/biossíntese , MicroRNAs/genética , Edição de RNA/fisiologia , Animais , Drosophila melanogaster , Feminino , Humanos , Masculino , CamundongosRESUMO
BACKGROUND: Physical performance tests are simple means of predicting an individual's risk of cognitive decline. AIMS: This study aimed to assess the predictive value of physical performance tests and develop predictive models for cognitive function. METHODS: Cognitive function was tested biennially and calculated for mental intactness, episodic memory, and global cognition. Using a generalized estimating equation (GEE), we examined each baseline physical performance test as a predictor of cognitive decline. Using a multivariate linear regression model (MLRM), we developed predictive models for cognitive function. Bland-Altman analysis was performed to analyze the agreement between estimated and measured cognition. We validated the predictive model internally with 1000 bootstrap resamples. RESULTS: Better physical performance test results, except for standing balance, were associated with a slower cognitive decline over time and better cognitive function at follow-up. Regarding the predictive models, all physical performance tests were included in men; only five chair stands test was included in women. Bland-Altman analysis showed that measured cognition was equivalent to estimated cognition in men (mean bias, 0; 95% limits of agreement, - 8.56 to 8.56) and women (mean bias, 0; 95% limits of agreement - 8.79 to 8.7). Bootstrap analysis showed that predictors were selected in 78.4-100% for men and 64.5-100% for women. DISCUSSION: Bland-Altman and bootstrap analysis demonstrated good agreement and stability of the predictive models. CONCLUSIONS: Physical performance tests are simple, easily obtainable, and clinically relevant markers for cognitive function with aging; predictive models based on physical performance can be used to predict cognitive function.
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Disfunção Cognitiva , Aposentadoria , Envelhecimento , Cognição , Disfunção Cognitiva/diagnóstico , Feminino , Humanos , Estudos Longitudinais , MasculinoRESUMO
BACKGROUND: Urinary tract infection (UTI) is common in children. The purpose of this retrospective study was to determine the various risk factors that usually affect the prognosis of UTI in children diagnosed with the disease. METHODS: In the present retrospective study, we enrolled all pediatric patients diagnosed with UTI and hospitalized between 1 January 2013 and 31 July 2016 at Nanjing Children's Hospital. We then collected all the relevant patient clinical demographics and characteristics. RESULTS: The study involved 2,092 pediatric patients diagnosed with UTI. On logistic regression analysis, factors that could affect the prognosis of pediatric UTI were complications, hospitalization, intensive care unit (ICU) admission, type of UTI, urine culture results, blood lymphocytes, urine nitrites (NIT) and antibiotics (unstandardized coefficients, 0.06, <0.001, -0.28, 0.32, <0.001, 0.01, -0.11, 0.01, respectively, all P < 0.001). CONCLUSION: Complications, hospitalization, type of UTI, urine culture results, blood lymphocytes, and antibiotics had a significant, positive association with UTI prognosis. Meanwhile, ICU admission and urine NIT had a negative association with prognosis.
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Infecções Urinárias/diagnóstico , Antibacterianos/uso terapêutico , Pré-Escolar , China/epidemiologia , Feminino , Hospitalização , Hospitais Pediátricos , Humanos , Unidades de Terapia Intensiva , Masculino , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Urinálise , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologiaRESUMO
Aberrant aggregation and activation of lung fibroblasts is a key process in pulmonary fibrosis, but the underlying mechanism remains enigmatic. Forkhead Box O3a (FoxO3a) is considered to be an important transcription factor that could regulate both cell cycle and cell viability. To investigate the role of FoxO3a on LPS-induced lung fibroblast proliferation, we transfected FoxO3a-SiRNA or FoxO3a-OE lentivirus into cultured mouse lung fibroblasts to knockdown or overexpress FoxO3a and pretreated mouse lung fibroblasts with gefitinib to enhance FoxO3a activity. The proliferation of lung fibroblasts was evaluated by CCK8 assay, the expression of FoxO3a, phosphorylated FoxO3a (p-FoxO3a) and p27 were measured by Western blot. We found that the proliferation of mouse lung fibroblasts mediated by LPS is accompanied by the inactivation of FoxO3a. The knockdown of FoxO3a could further decreased the expression of p27 mediated by LPS, while the overexpression of FoxO3a significantly increased the expression of p27 and suppressed LPS-induced lung fibroblast proliferation. Upon treating fibroblasts with gefitinib, the phosphorylation of FoxO3a was reduced and FoxO3a translocated into the nucleus, the expression of p27 was significantly increased and the proliferation of lung fibroblasts mediated by LPS could also be inhibited effectively. The results indicate that overexpression and reduced phosphatase activity of FoxO3a inhibit LPS-induced lung fibroblast proliferation through the activation of FoxO3a/p27 signaling pathways. Thus, to enhance FoxO3a activity could be a potential therapeutic target for LPS-induced pulmonary fibrosis.
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Inibidor de Quinase Dependente de Ciclina p27/metabolismo , Proteína Forkhead Box O3/metabolismo , Animais , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Fibroblastos/citologia , Proteína Forkhead Box O3/genética , Fatores de Transcrição Forkhead/metabolismo , Regulação da Expressão Gênica/efeitos dos fármacos , Técnicas de Silenciamento de Genes , Lipopolissacarídeos/farmacologia , Pulmão/citologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Fosforilação/efeitos dos fármacos , RNA Interferente Pequeno/metabolismo , Transdução de Sinais/efeitos dos fármacosRESUMO
Commercially available guided bone regeneration (GBR) membranes often exhibit limited mechanical properties or bioactivity, leading to poor performance in repairing bone defects. To surmount this limitation, we developed a Janus structural composite membrane (Mg-MgO/PCL) reinforced by dual Mg (Mg sheets and MgO NPs) by using a combined processing technique involving casting and electrospinning. Results showed that the addition of Mg sheets and MgO NPs enhanced the mechanical properties of the composite membrane for osteogenic space maintenance, specifically tensile strength (from 10.2 ± 1.2 to 50.3 ± 4.5 MPa) and compression force (from 0 to 0.94 ± 0.09 N mm-1), through Mg sheet reinforcement and improved crystallization. The dense cast side of the Janus structure membrane displayed better fibroblast barrier capacity than a single fiber structure; meanwhile, the PCL matrix protected the Mg sheet from severe corrosion due to predeformation. The porous microfibers side supported preosteoblast cell adhesion, enhanced osteogenesis, and angiogenesis in vitro, through the biomimetic extracellular matrix and sustainable Mg2+ release. Furthermore, the Mg-MgO/PCL membrane incorporating 2 wt % MgO NPs exhibited remarkable antimicrobial properties, inducing over 88.75% apoptosis in Staphylococcus aureus. An in vivo experiment using the rat skull defect model (Φ = 5 mm) confirmed that the Mg-MgO/PCL membrane significantly improved new bone formation postsurgery. Collectively, our investigation provides valuable insights into the design of multifunctional membranes for clinical oral GBR application.
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Óxido de Magnésio , Poliésteres , Ratos , Animais , Óxido de Magnésio/farmacologia , Poliésteres/farmacologia , Poliésteres/química , Regeneração Óssea , Osteogênese , Adesão CelularRESUMO
Biodegradable Mg/polymer composite fibers offer a promising therapeutic option for tissue injury because of bioactive Mg2+ and biomimetic microstructure. However, current studies are limited to the contribution of Mg2+ and the single microstructure. In this study, we designed Mg/poly (lactic-co-glycolic acid) (Mg/PLGA) composite microfibers that significantly enhanced angiogenesis and tissue regeneration synergistically by Mg2+ and self-sculptured microstructure, due to spontaneous in situ microphase separation in response to the weakly alkaline microenvironment. Our composite microfiber patch exhibited superior performance in the adhesion, spreading, and angiogenesis functions of human umbilical vein endothelial cells (HUVECs) due to the joint contribution of the hierarchically porous microstructure and Mg2+. Genomics and proteomics analyses revealed that the Mg/PLGA composite microfibers activated the cell focal adhesion and angiogenesis-related signaling pathways. Furthermore, the repair of typical soft tissue defects, including refractory urethral wounds and easily healed skin wounds, validated that our Mg/PLGA composite microfiber patch could provide favorable surface topography and ions microenvironment for tissue infiltration and accelerated revascularization. It could cause rapid urethral tissue regeneration and recovery of rabbit urethral function within 6 weeks and accelerate rat skin wound closure within 16 days. This work provides new insight into soft tissue regeneration through the bioactive alkaline substance/block copolymer composites interactions.
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Pele , Cicatrização , Ratos , Humanos , Animais , Coelhos , Células Endoteliais da Veia Umbilical Humana , Porosidade , Concentração de Íons de HidrogênioRESUMO
The practical application of anaerobic ammonium oxidation (anammox) technology was seriously limited by lack of anammox seeding sludge. In this work, a pilot-scale expanded granular sludge bed (EGSB) reactor was used for rapid proliferation of anaerobic ammonium oxidizing bacteria (AnAOB) using anammox-hydroxyapatite (anammox-HAP) technology. The excellent settleability of anammox-HAP granular sludge (with an excellent settling velocity of 395 m/h) supported the up-flow velocity of 9.6 m/h with recirculation ratio of 19. A high nitrogen loading rate (NLR) of 26.4 g N/L/d was achieved in the pilot-scale reactor, with a cell yield of 0.23 g VSS/g NH4+-N. The high recirculation ratio and up-flow velocity brought about the efficient mass transfer for anammox, eliminating free ammonia inhibition, resulting in the high NLR and cell yield. Results of microbial community revealed that the relative abundance of unclassified Brocadiaceae increased from 18.55% to 82.80%, illustrating the rapid proliferation of AnAOB.
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Compostos de Amônio , Esgotos , Oxidação Anaeróbia da Amônia , Anaerobiose , Bactérias Anaeróbias , Reatores Biológicos/microbiologia , Proliferação de Células , Durapatita , Nitrogênio , Oxirredução , Esgotos/microbiologiaRESUMO
Feature selection (FS), which aims to identify the most informative subset of input features, is an important approach to dimensionality reduction. In this article, a novel FS framework is proposed for both unsupervised and semisupervised scenarios. To make efficient use of data distribution to evaluate features, the framework combines data structure learning (as referred to as data distribution modeling) and FS in a unified formulation such that the data structure learning improves the results of FS and vice versa. Moreover, two types of data structures, namely the soft and hard data structures, are learned and used in the proposed FS framework. The soft data structure refers to the pairwise weights among data samples, and the hard data structure refers to the estimated labels obtained from clustering or semisupervised classification. Both of these data structures are naturally formulated as regularization terms in the proposed framework. In the optimization process, the soft and hard data structures are learned from data represented by the selected features, and then, the most informative features are reselected by referring to the data structures. In this way, the framework uses the interactions between data structure learning and FS to select the most discriminative and informative features. Following the proposed framework, a new semisupervised FS (SSFS) method is derived and studied in depth. Experiments on real-world data sets demonstrate the effectiveness of the proposed method.
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OBJECTIVE: To develop and validate a prediction nomogram based on motoric cognitive risk syndrome for cognitive impairment in healthy older adults. METHODS: Using two longitudinal cohorts of participants (aged ≥ 60 years) with 4-year follow-up, we developed (n = 1,177) and validated (n = 2,076) a prediction nomogram. LASSO (least absolute shrinkage and selection operator) regression model and multivariable Cox regression analysis were used for variable selection and for developing the prediction model, respectively. The performance of the nomogram was assessed with respect to its calibration, discrimination, and clinical usefulness. RESULTS: The individualized prediction nomogram was assessed based on the following: motoric cognitive risk syndrome, education, gender, baseline cognition, and age. The model showed good discrimination [Harrell's concordance index (C-index) of 0.814; 95% confidence interval, 0.782-0.835] and good calibration. Comparable results were also seen in the validation cohort, which includes good discrimination (C-index, 0.772; 95% confidence interval, 0.776-0.818) and good calibration. Decision curve analysis demonstrated that the prediction nomogram was clinically useful. CONCLUSION: This prediction nomogram provides a practical tool with all necessary predictors, which are accessible to practitioners. It can be used to estimate the risk of cognitive impairment in healthy older adults.
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To investigate the immediate and lasting effects of transcranial electrical stimulation (tES) on working memory (WM) in schizophrenia. We performed a literature search to identify randomized controlled trials (RCTs) evaluating the ability of tES to ameliorate WM. Twelve studies were included: 215 patients in the active stimulation group and 214 in the sham stimulation group. Meta-analysis demonstrated a significant efficacy of tES on WM in follow up, a summary of one or more assessments weeks after the last tES session (standardized mean difference (SMD) 0.33, 95% confidence interval (CI) 0.04 to 0.62; p = 0.02; n = 190, 4 studies; I2 = 33%) compared to sham tES, while non-significant results were observed for WM assessed immediately after the last tES session (SMD 0.14, 95% CI -0.12 to 0.41; p = 0.30; n = 417, 11 studies; I2 = 41%) in schizophrenia. There was no significant difference between the two groups in tolerability and dropouts. Evidence of low quality indicates that effects of tES on WM in schizophrenia may appear a few weeks after the last tES session, but not always be present when tested immediately after the last tES session. Further large-scale RCTs with a parallel-group design, sample size estimation and a longer follow-up period are needed.
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Memória de Curto Prazo/fisiologia , Esquizofrenia/terapia , Estimulação Transcraniana por Corrente Contínua/métodos , Humanos , Estimulação Transcraniana por Corrente Contínua/efeitos adversosRESUMO
The entorhinal cortex (EC) plays an essential role in age-related cognitive decline. However, the effect of functional connectivity (FC) changes between EC and other cerebral cortices on cognitive function remains unclear. The aim of this study was to explore the modulation of two interventions (cognitive training and aerobic exercise) on EC-FC in community-dwelling older adults. In total, 94 healthy older adults aged between 65 and 75 years were assigned to either the cognitive training or aerobic exercise group to receive 24 sessions over 12 weeks, or to a control group. Resting-state functional magnetic resonance imaging was performed at both baseline and 12-month follow-up. Compared to the cognitive training group, the aerobic exercise group showed greater EC-FC in the bilateral middle temporal gyrus, right supramarginal gyrus, left angular gyrus, and right postcentral gyrus. Compared to the control group, the cognitive training group had a decreased EC-FC in the right hippocampus, right middle temporal gyrus, left angular gyrus, and right postcentral gyrus and an increased EC-FC in the bilateral pallidum, while the aerobic exercise group showed increased EC-FC between the right medial prefrontal cortex(mPFC), bilateral pallidum, and right precuneus. Baseline EC-FC in the mPFC was positively correlated with the visuospatial/constructional index score of the Repeatable Battery for the Assessment of Neuropsychological Status. In the cognitive training group, EC-FC value changes in the right hippocampus were negatively correlated with changes in the RBANS delayed memory index score, while in the aerobic exercise group, EC-FC value changes in the left angular gyrus were positively correlated with changes in the RBANS attention index score. These findings support the hypothesis that both cognitive training and aerobic exercise can modulate EC-FC in aging populations but through different neural pathways.
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BACKGROUND: Testicular torsion (TT) remains an emerging issue for pediatric patients. This study's objective was to determine risk factors of TT outcomes in the Chinese pediatric cohort from a single center. METHODS: We performed a retrospective cohort study of patients who met the inclusion criteria in our center from 2013 to 2018. Clinical demographics, and TT-related data, including laterality, torsion degree, torsion direction, position to the cavity of tunica vaginalis, enorchia, and outcomes, were reviewed and extracted from medical charts and databases. Statistical analysis was conducted to compare and figure out the risk factors of TT outcomes. RESULTS: A total of 84 pediatric patients were enrolled in this study. Among these variables, age, duration of symptoms, and the patient transfer were significantly associated with the outcomes of TT (P<0.005). Patients transferred from other medical facilities underwent more orchiectomy than those without transfer (univariate analysis, P<0.0001; multivariate analysis, P=0.001). No difference was found in other variables between patients with or without transfer (P>0.05). Moreover, transferred patients tended to show worse testicular function. CONCLUSIONS: We have reported that age, duration of symptoms, and patient transfer were three significant risk factors in this cohort. Patients with transfer tended to suffer from more orchiectomy and worse prognosis of TT.
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Background: Mild cognitive impairment (MCI) is an early stage of Alzheimer's disease. Repetitive transcranial magnetic stimulation (rTMS) has been widely employed in MCI research. However, there is no reliable systematic evidence regarding the effects of rTMS on MCI. The aim of this review was to evaluate the efficacy and safety of rTMS in the treatment of MCI. Methods: A comprehensive literature search of nine electronic databases was performed to identify articles published in English or Chinese before June 20, 2019. The identified articles were screened, data were extracted, and the methodological quality of the included trials was assessed. The meta-analysis was performed using the RevMan 5.3 software. We used the GRADE approach to rate the quality of the evidence. Results: Nine studies comprising 369 patients were included. The meta-analysis showed that rTMS may significantly improve global cognitive function (standardized mean difference [SMD] 2.09, 95% confidence interval [CI] 0.94 to 3.24, p = 0.0004, seven studies, n = 296; low-quality evidence) and memory (SMD 0.44, 95% CI 0.16 to 0.72, p = 0.002, six studies, n = 204; moderate-quality evidence). However, there was no significant improvement in executive function and attention (p > 0.05). Subgroup analyses revealed the following: (1) rTMS targeting the left hemisphere significantly enhanced global cognitive function, while rTMS targeting the bilateral hemispheres significantly enhanced global cognitive function and memory; (2) high-frequency rTMS significantly enhanced global cognitive function and memory; and (3) a high number of treatments ≥20 times could improve global cognitive function and memory. There was no significant difference in dropout rate (p > 0.05) between the rTMS and control groups. However, patients who received rTMS had a higher rate of mild adverse effects (risk ratio 2.03, 95% CI 1.16 to 3.52, p = 0.01, seven studies, n = 317; moderate-quality evidence). Conclusions: rTMS appears to improve global cognitive function and memory in patients with MCI and may have good acceptability and mild adverse effects. Nevertheless, these results should be interpreted cautiously due to the relatively small number of trials, particularly for low-frequency rTMS.
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OBJECTIVES: We aimed to investigate the safety concerns associated with placing double-J ureteric stents post-laparoscopic pyeloplasty surgery for congenital ureteropelvic junction obstruction (UPJO) and hydronephrosis. METHODS: A total of 1349 patients with postoperative double-J stent placement at our center were included. Clinical variables for enrolled patients were collected by two independent authors. We compared clinical variables and the efficacy of stenting post-laparoscopic pyeloplasty. RESULTS: The mean age of the patients was 4.23 ± 2.39 years. A total of 58.49% of patients were diagnosed with left UPJO with hydronephrosis and 33.95% were diagnosed with right UPJO. Furthermore, 7.56% of patients had bilateral UPJO. In all cases, 96.96% of indwelling double-J stents were successfully removed 4 weeks post-surgery. A total of 3.04% of the patients still required further management, including stent migration to the renal pelvis (0.37%), stent migration to the bladder (0.30%), prolapse of the stent through the ureter (0.15%), blockage of stents (1.85%), and fouling of stents (0.37%). CONCLUSIONS: Double-J ureteric stents used after laparoscopic pyeloplasty for treating UPJO in hydronephrosis for pediatric patients is a safe, feasible, and beneficial method, which can be recommended for routine procedures. However, caution should be practiced for follow-up and removal using this method.
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Hidronefrose/terapia , Stents , Obstrução Ureteral/terapia , Criança , Pré-Escolar , Terapia Combinada , Feminino , Humanos , Hidronefrose/etiologia , Pelve Renal/patologia , Pelve Renal/cirurgia , Laparoscopia , Masculino , Procedimentos de Cirurgia Plástica , Resultado do Tratamento , Ureter/patologia , Ureter/cirurgia , Obstrução Ureteral/complicações , Obstrução Ureteral/diagnósticoRESUMO
Accurate and systematic transcriptome-wide detection of 5-methylcytosine (m5C) has proved challenging, and there are conflicting views about the prevalence of this modification in mRNAs. Here we report an experimental and computational framework that robustly identified mRNA m5C sites and determined sequence motifs and structural features associated with the modification using a set of high-confidence sites. We developed a quantitative atlas of RNA m5C sites in human and mouse tissues based on our framework. In a given tissue, we typically identified several hundred exonic m5C sites. About 62-70% of the sites had low methylation levels (<20% methylation), while 8-10% of the sites were moderately or highly methylated (>40% methylation). Cross-species analysis revealed that species, rather than tissue type, was the primary determinant of methylation levels, indicating strong cis-directed regulation of RNA methylation. Combined, these data provide a valuable resource for identifying the regulation and functions of RNA methylation.
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5-Metilcitosina/metabolismo , Genoma , RNA Mensageiro/genética , Animais , Sítios de Ligação , Biologia Computacional , Éxons , Células HeLa , Humanos , Mamíferos/metabolismo , Metilação , Biossíntese de Proteínas , RNA Mensageiro/metabolismo , Especificidade da EspécieRESUMO
OBJECTIVE: To study the efficacy of grip strength (GS) as a predictor of cognitive function in a large, nationwide sample of Chinese participants aged 45 years and above. METHODS: We used data from three waves (W1, W2, and W3) fielded by the China Health and Retirement Longitudinal Study (CHARLS). Cognitive function was tested biennially and calculated using two categories: episodic memory and mental intactness. Demographics, health behaviors, and medical conditions were considered potential confounders. Using multivariate linear regression models (MLRMs), we examined the association between baseline GS (measure in W1) and cognitive function in W3. Using a generalized estimating equation (GEE), we examined baseline GS as a predictor of cognitive function change. RESULTS: Total 9,333 individuals (53.2% women), with a mean baseline episodic memory score of 6.5, mean baseline mental intactness score of 7.2, and aged over 45 years (mean age = 58.6), were selected. The mean follow-up time was 4.0 years (range: 3.3-5.0 years). Using MLRMs and comparing the lowest GS score with the highest baseline GS score, we observed a significant correlation with a higher global cognitive function in both women (ß = 1.061, p < 0.001) and men (ß = 1.233, p < 0.001). After adjusting baseline global cognition, the highest GS level was still statistically significant in both women (ß = 0.543, p < 0.05) and men (ß = 0.742, p < 0.001). GEE suggested that the participants in the highest GS quartile had better cognitive performance over time in both women (ß = 0.116, p = 0.030) and men (ß = 0.143, p = 0.008) than those in the lowest quartile. CONCLUSION: Higher baseline level of GS was significantly related to better cognitive function and slowed the rate of its decline. Thus, it is an independent predictor of better cognitive status in middle-aged and elderly Chinese.