Prediction of outcomes for symptomatic spinal cavernous malformation surgery: a multicenter prospective clinical study.

PURPOSE: Clinical outcome of spinal cavernous malformation (SCM) varies because of its unclear natural history, and reliable prognostic prediction model for SCM patients is limited. The aim of the present study was to investigate potential factors that predict one-year neurological status in postoperative patients with SCM. METHODS: This was a multicenter prospective observational study in consecutive patients with SCMs. SCMs treated microsurgically between January 2015 and January 2021 were included. Outcome was defined as the American Spinal Injury Association Impairment Scale (AIS) grade at one year after operation. Multivariable analyses were used to construct the best predictive model for patient outcomes. RESULTS: We identified 268 eligible SCM patients. Neurological outcome had worsened from preoperative baseline in 51 patients (19.0%) at one year. In the multivariable logistic regression, the best predictive model for unfavorable outcome included symptom duration ≥ 26 months (95% CI 2.80-16.96, P < 0.001), size ≤ 5 mm (95% CI 1.43-13.50, P = 0.010), complete intramedullary (95% CI 1.69-8.14, P = 0.001), subarachnoid hemorrhage (95% CI 2.92-12.57, P < 0.001), AIS B (95% CI 1.91-40.93, P = 0.005) and AIS C (95% CI 1.12-14.54, P = 0.033). CONCLUSIONS: Admission size of the lesion, morphology, symptom duration, AIS grade and the presence of subarachnoid hemorrhage were strong outcome predictors regarding prognostication of neurological outcome in postoperative patients with SCMs. A decision to surgically remove a symptomatic SCM should be justified by systematic analysis of all factors potentially affecting outcome.

Bioinformatics analysis of potential glioblastoma circular RNA sponge network.

Background: Circular RNA is emerging functional molecule for glioblastoma. However, the function and regulatory of circular RNA (circRNA) remains unclear. In this study, the circRNA sequencing and array data of glioblastoma were analyzed by multiple bioinformatics methods to establish a potential molecular sponge mechanism regulation network. Methods: Gene Expression Omnibus datasets were used to extract circRNAs. CircInteractome was used to predict microRNAs binding to circRNAs. Chinese Glioma Gene Atlas database was used to screen the microRNAs with expression and survival trends. MiRabel database was used to predict potential gene targets of microRNAs. The Cancer Genome Atlas database was used to screen the gene targets of sponge network. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis were to explain the gene targets functions. R software, Cytoscape software and Bioinformatics website were used to establish the network and visualize the results. Results: Hsa_circ_0000219, hsa_circ_0001073 and hsa_circ_0070700 were selected from more than 2000 differentially expressed circRNAs of Gene Expression Omnibus Series (GSE) GSE146463, GSE92322 and GSE86202 datasets. Hsa-miR-1248 and hsa-miR-1290 were up regulated and related to glioblastoma poor prognosis. Targets of these microRNAs including ARHGEF7, CELA2b, RNF11, YPEL1 and ZNF37a were also screened via expression and survival data. Gene targets function were mainly enriched in signal transduction, cell plasma membrane, ATP binding and calcium signaling pathway. Conclusions: A circRNA molecular sponge regulatory network including hsa-miR-1248 and hsa-miR-1290 has been established. In this network, hsa_circ_0001073, hsa_circ_0070700, hsa_circ_0000219, hsa-miR-1248, hsa-miR-1290, and RNF11 may have the potential being emerging glioblastoma therapeutic targets. However, their function and significance for glioblastoma need further experiments to verify.

Development of Nontoxic Biodegradable Polyurethanes Based on Polyhydroxyalkanoate and L-lysine Diisocyanate with Improved Mechanical Properties as New Elastomers Scaffolds.

A nontoxic and biodegradable polyurethane was prepared, characterized, and evaluated for biomedical applications. Stretchable, biodegradable, and biocompatible polyurethanes (LPH) based on L-lysine diisocyanate (LDI) with poly(ethylene glycol) (PEG) and polyhydroxyalkanoates(PHA) of different molar ratios were synthesized. The chemical and physical characteristics of the LPH films are tunable, enabling the design of mechanically performance, hydrophilic, and biodegradable behavior. The LPH films have a Young's modulus, tensile strength, and elongation at break in the range of 3.07-25.61 MPa, 1.01-9.49 MPa, and 102-998%, respectively. The LPH films demonstrate different responses to a change of temperature from 4 to 37 °C, with the swelling ratio for the same sample at equilibrium varying from 184% to 151%. In vitro degradation tests show the same LPH film has completely different degradation morphologies in pH of 3, 7.4, and 11 phosphate buffered solution (PBS). In vitro cell tests show feasibility that some of the LPH films are suitable for culturing rat bone marrow stem cells (rBMSCs), for future soft-tissue regeneration. The results demonstrate the feasibility of the LPH scaffolds for many biomedical applications.