[Clinical study of lumbar stability after unilateral biportal endoscopy in the treatment of degenerative lumbar diseases].

Objectives: To investigate the clinical efficacy of unilateral biportal endoscopy (UBE) in the treatment of degenerative lumbar disease (DLD) and its impact on postoperative lumbar stability. Methods: This is a retrospective case series study. A total of 109 cases of DLD treated with UBE in the Department of Orthopaedic, Beijing Chaoyang Hospital Affiliated to Capital Medical University from July 2020 to June 2022 were analyzed retrospectively. There were 47 males and 62 females, aged (53.3±8.2) years (range: 21 to 80 years). The surgical segments were single segment in 80 cases, two segments in 25 cases, and three segments in 4 cases. The low back pain and leg pain of visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) score and Oswestry disability index (ODI) were evaluated before and after operation. The modified MacNab criteria were used for evaluation of the clinical consequences. Postoperative three-dimensional lumbar CT was performed to observe the preservation of the facet joints and the angle of the medial surface of the facetectomy(ß angle). At 12 months after surgery, X ray of the flexion and extension lumbar spine were reviewed. The comparison and analysis of the data were conducted using paired sample t tests or generalized estimation equations. Results: All 109 patients underwent operative procedures successfully. The operation time was (94.5±37.1) minutes (range:56 to 245 minutes), the times of X ray was 6.8±4.0 (range:4 to 16 times), and the days of hospitalization was (5.3±3.7) days (range:4 to 14 days). Complications included dural tears in 4 cases, transient lower limb numbness in 4 cases, epidural hematoma in 2 case. The follow-up time was (19.6±7.2) months (range:12 to 36 months). The postoperative low back pain VAS, leg pain VAS, JOA score and ODI were significantly improved(all P<0.05). According to the modified MacNab criteria, the excellent and good rate was 88.99%(97/109) at 12 months after surgery. One case underwent revision surgery because of recurrent lumbar disc herniation. In term of radiographic evaluation, the area of the surgical side facet joints after UBE surgery was reserved more than 60%. The ß angle was less than 90° in all patients. After 12 months of surgery, there was no surgical segment instability or spondylolisthesis by the X-ray of the flexion and extension lumbar spine. Conclusion: UBE can achieve satisfactory clinical efficacy in the treatment of DLD, and maintain the stability of the lumbar spine.

Yes-associated protein nuclear translocation promotes anabolic activity in human articular chondrocytes.

OBJECTIVE: Yes-associated protein (YAP) has been widely studied as a mechanotransducer in many cell types, but its function in cartilage is controversial. The aim of this study was to identify the effect of YAP phosphorylation and nuclear translocation on the chondrocyte response to stimuli relevant to osteoarthritis (OA). DESIGN: Cultured normal human articular chondrocytes from 81 donors were treated with increased osmolarity media as an in vitro model of mechanical stimulation, fibronectin fragments (FN-f) or IL-1ß as catabolic stimuli, and IGF-1 as an anabolic stimulus. YAP function was assessed with gene knockdown and inhibition by verteporfin. Nuclear translocation of YAP and its transcriptional co-activator TAZ and site-specific YAP phosphorylation were determined by immunoblotting. Immunohistochemistry and immunofluorescence to detect YAP were performed on normal and OA human cartilage with different degrees of damage. RESULTS: Chondrocyte YAP/TAZ nuclear translocation increased under physiological osmolarity (400 mOsm) and IGF-1 stimulation, which was associated with YAP phosphorylation at Ser128. In contrast, catabolic stimulation decreased the levels of nuclear YAP/TAZ through YAP phosphorylation at Ser127. Following YAP inhibition, anabolic gene expression and transcriptional activity decreased. Additionally, YAP knockdown reduced proteoglycan staining and levels of type II collagen. Total YAP immunostaining was greater in OA cartilage, but YAP was sequestered in the cytosol in cartilage areas with more severe damage. CONCLUSIONS: YAP chondrocyte nuclear translocation is regulated by differential phosphorylation in response to anabolic and catabolic stimuli. Decreased nuclear YAP in OA chondrocytes may contribute to reduced anabolic activity and promotion of further cartilage loss.

[Based on CT radiomics model for predicting the response to first-line chemotherapy of diffuse large B-cell lymphoma].

Objective: To investigate the potential value of CT Radiomics model in predicting the response to first-line chemotherapy in diffuse large B-cell lymphoma (DLBCL). Methods: Pre-treatment CT images and clinical data of DLBCL patients treated at Shanxi Cancer Hospital from January 2013 to May 2018 were retrospectively analyzed and divided into refractory patients (73 cases) and non-refractory patients (57 cases) according to the Lugano 2014 efficacy evaluation criteria. The least absolute shrinkage and selection operator (LASSO) regression algorithm, univariate and multivariate logistic regression analyses were used to screen out clinical factors and CT radiomics features associated with efficacy response, followed by radiomics model and nomogram model. Receiver operating characteristic (ROC) curve, calibration curve and clinical decision curve were used to evaluate the models in terms of the diagnostic efficacy, calibration and clinical value in predicting chemotherapy response. Results: Based on pre-chemotherapy CT images, 850 CT texture features were extracted from each patient, and 6 features highly correlated with the first-line chemotherapy effect of DLBCL were selected, including 1 first order feature, 1 gray level co-occurence matrix, 3 grey level dependence matrix, 1 neighboring grey tone difference matrix. Then, the corresponding radiomics model was established, whose ROC curves showed AUC values of 0.82 (95% CI: 0.76-0.89) and 0.73 (95% CI: 0.60-0.86) in the training and validation groups, respectively. The nomogram model, built by combining validated clinical factors (Ann Arbor stage, serum LDH level) and CT radiomics features, showed an AUC of 0.95 (95% CI: 0.90-0.99) and 0.91 (95% CI: 0.82-1.00) in the training group and the validation group, respectively, with significantly better diagnostic efficacy than that of the radiomics model. In addition, the calibration curve and clinical decision curve showed that the nomogram model had good consistency and high clinical value in the assessment of DLBCL efficacy. Conclusion: The nomogram model based on clinical factors and radiomics features shows potential clinical value in predicting the response to first-line chemotherapy of DLBCL patients.

[Interaction of SENP6 with PINK1 Promotes Temozolomide Resistance in Neuroglioma Cells via Inducing the Mitophagy].

Temozolomide resistance is a major cause of recurrence and poor prognosis in neuroglioma. Recently, growing evidence has suggested that mitophagy is involved in drug resistance in various tumor types. However, the role and molecular mechanisms of mitophagy in temozolomide resistance in glioma remain unclear. In this study, mitophagy levels in temozolomide-resistant and -sensitive cell lines were evaluated. The mechanisms underlying the regulation of mitophagy were explored through RNA sequencing, and the roles of differentially expressed genes in mitophagy and temozolomide resistance were investigated. We found that mitophagy promotes temozolomide resistance in glioma. Specifically, small ubiquitin-like modifier specific protease 6 (SENP6) promoted temozolomide resistance in glioma by inducing mitophagy. Protein-protein interactions between SENP6 and the mitophagy executive protein PTEN-induced kinase 1 (PINK1) resulted in a reduction in small ubiquitin-like modifier 2 (SUMO2)ylation of PINK1, thereby enhancing mitophagy. Our study demonstrates that by inducing mitophagy, the interaction of SENP6 with PINK1 promotes temozolomide resistance in glioblastoma. Therefore, targeting SENP6 or directly regulating mitophagy could be a potential and novel therapeutic target for reversing temozolomide resistance in glioma.

[Clinicopathological characteristics and prognosis of non-Hodgkin lymphoma in oral and maxillofacial regions: An analysis of 369 cases].

OBJECTIVE: To investigate the clinicopathological characteristics and factors influencing the prognosis of non-Hodgkin lymphoma (NHL) in oral and maxillofacial regions. METHODS: Clinicopathological data of 369 patients with oral and maxillofacial NHL initially diagnosed in Peking University Hospital of Stomatology from 2008 to 2020 were collected and analyzed retrospectively. RESULTS: There were 180 males and 189 females. The median age of the patients was 56 years (3 months to 92 years), and the median duration was three months. Clinically, 283 cases manifested as mass, 38 cases as ulcerative necrotizing lesions, and 48 cases as diffuse soft tissue swelling. The lesions of 90 cases located in face and neck (75 cases neck, 20.3%), 99 cases were of major salivary glands (79 cases parotid glands, 20.9%), 103 cases of oral cavity, 50 cases of maxillofacial bones, 20 cases of Waldeyer's ring, and 7 cases of infratemporal fossa. In the study, 247 of the 369 patients had cervical lymphadenopathy, only 40 cases had B symptoms, and 23 cases had the bulky disease. Of the 369 NHLs, 299 (81%) were B-cell NHL, and 70(19%) were T-cell NHL. Diffuse large B-cell lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, follicular lymphoma, and extranodal natural killer (NK)/T-cell lymphoma nasal type were the most common pathological subtypes. According to Ann Arbor staging, 87, 138, 106, and 38 cases were classified as staged Ⅰ, Ⅱ, Ⅲ, Ⅳ, respectively. The me-dian follow-up time was 48 months, 164 patients died during the follow-up period. The overall survival rates for one year, two years, and five years were 90.1%, 82.4%, and 59.9%, respectively, and the median survival was (86.00±7.98) months. Multivariate analysis showed that age (P < 0.001), Ann Arbor staging (P < 0.001), elevated lactate dehydrogenase (P=0.014), and pathological subtype (P=0.049) were the independent factors influencing the overall survival rate of NHL patients. CONCLUSION: Oral and maxillofacial NHL has unique clinical characteristics and distribution patterns of pathological subtypes. Fewer patients had systemic symptoms. Neck and parotid glands were the most common sites invaded by NHL. Advanced age, Ann Arbor stage Ⅲ-Ⅳ, B symptoms, and T-cell NHL may predict a poor prognosis in oral and maxillofacial NHL patients.

Preoperative prediction of microvascular invasion in hepatocellular carcinoma: a radiomic nomogram based on MRI.

AIM: To develop a reliable model to predict microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC) by combining a large number of clinical and imaging examinations, especially the radiomic features of magnetic resonance imaging (MRI). MATERIALS AND METHODS: Three hundred and one consecutive patients from two centres were enrolled. Least absolute shrinkage and selection operator (LASSO) regression was used to shrink the feature size, and logistic regression was used to construct a predictive radiomic signature. The ability of the nomogram to discriminate MVI in patients with HCC was evaluated using area under the curve (AUC) of receiver operating characteristics (ROC), accuracy, and calibration curves. RESULTS: The radiomic signature showed a significant association with MVI (p<0.001 for all data sets). Other useful predictors of MVI included non-smooth tumour margin, internal arteries, and the alpha-fetoprotein (AFP) level. The nomogram demonstrated a strong prognostic capability in the training set and both validation sets, providing AUCs of 0.914 (95% confidence interval [CI] 0.853-0.956), 0.872 (95% CI: 0.757-0.946), and 0.881 (95% CI: 0.806-0.934), respectively. CONCLUSIONS: The preoperative radiomic nomogram, incorporating clinical risk factors and a radiomic signature, could predict MVI in patients with HCC. The MRI-based radiomic-clinical model predicted the MVI of HCC effectively and was more efficient compared with the radiomic model or clinical model alone.

Short-term outcomes of intracorporeal and extracorporeal anastomosis in robotic right colectomy: a systematic review and meta-analysis.

Ileocolic anastomosis is performed via extracorporeal or intracorporeal techniques in robotic right hemicolectomy. The aim of this meta-analysis was to compare the short-term outcomes of intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA) for robotic right colectomy. The EMBASE, PubMed, and Cochrane Library databases were searched systematically (from inception until March 1, 2020) for randomized and non-randomized control trials reporting the short-term outcomes of IA and EA for robotic right colectomy. Five observational cohort studies involving 585 participants were included in our meta-analysis. Compared to the EA group, the IA group showed significantly longer operation time [weighted mean difference (WMD): 28.88, 95% confidence interval (CI) 13.88-43.89, p = 0.0002], lower rate of anastomotic leak (odds ratio: 0.26, 95% CI 0.08-0.85, p = 0.03), and shorter time to first flatus (WMD: - 0.57, 95% CI - 0.95 to 0.19, p = 0.003). However, pooled results revealed no difference in blood loss, complications, wound infection, incisional hernia, length of incision, and hospital stay between the IA and EA groups (p < 0.05). This meta-analysis indicated that IA was superior to EA in terms of anastomotic leak and time to first flatus, but inferior in terms of operation time. Large-scale, multicenter, randomized studies are needed to confirm our findings.

[The urate-lowering efficacy of febuxostat and its relationship with residual renal function in peritoneal dialysis patients with hyperuricemia].

Objective: To investigate the urate-lowering efficacy of febuxostat in peritoneal dialysis (PD) patients with hyperuricemia (HUA) and its relationship with residual renal function. Methods: Patients with HUA who underwent PD in Ningbo First Hospital from January 2018 to October 2021 were enrolled and divided into experimental group and control group according to whether to use febuxostat. The clinical baseline data before treatment and clinical indicators during 1-12 months after treatment were collected in two groups, and the adverse reactions during the use of febuxostat were also recorded. The changes of serum uric acid, standard-reaching rate and residual renal function were compared between the two groups during the follow-up. Results: A total of 105 patients were included in the study. There were 55 patients in the experimental group [27 males and 28 females, with a mean age of (54.5±14.8) years] and 50 patients in the control group [32 males and 18 females, with a mean age of (53.8±15.2) years]. No statistically significant difference was detected in clinical baseline data between the two groups (all P>0.05). The serum uric acid of the experimental group [(479±77), (311±69), (286±61), (307±65), (312±57) µmol/L] and control group [(486±59), (454±71), (453±76), (463±70), (459±76) µmol/L] were lower than baseline values at 1, 3, 6 and 12 months after treatment and the differences of two groups were statistically significant (all P<0.05). The serum uric acid in experimental group was significantly lower than that of control group (P<0.05). At 1, 3, 6 and 12 months after treatment, the standard-reaching rate of serum uric acid in the experimental group was significantly higher than that of the control group (all P<0.05). The decrease of residual estimated glomerular filtration rate (eGFR) and residual renal urea clearance index (Kt/V) in the experimental group were significantly lower than those in the control group at 12 months after treatment (all P<0.05). During the follow-up, the incidence of adverse reactions in the experimental group was 9.09% (5/55). Conclusions: Febuxostat can effectively treat PD patients with hyperuricemia and has a high safety profile. Moreover, it may delay the loss of residual renal function.

[Combined resection of thoracic and abdominal organ clusters: a series of 50 cases].

Objective: To examine the technique and effect of combined thoracic and abdominal organ clusters resection. Methods: From February 2019 to August 2021, totally 50 cases of combined thoracoabdominal organ cluster resection were completed at Transplant Medical Center, the Second Affiliated Hospital of Guangxi Medical University from donation after brain death donors. There were 47 males and 3 females, aging (34.8±12.3) years (range: 5 to 55 years). The length of hospital stay(M(IQR)) was 4(4) days (range: 2 to 43 days), the length of tube time was 4(2) days (range: 1 to 43 days). Through the midsternal incision and the abdominal grand cross incision, the cold perfusion was performing simultaneously when the perfusion lines of each target organ was established respectively. The combined resection was performed with the diaphragm as the boundary and the organ cluster as the unit. The heart and lung were separated on site and sent to the transplant hospital, and the abdominal organ cluster was directly preserved and returned to our hospital for further separation and repair. Results: Totaly 21 hearts, 47 pairs of lungs, 49 livers, 47 pairs of kidneys and 11 pancreas were harvested by this surgical treatment. The resection time was (32.6±6.5) minutes (range: 19 to 50 minutes), with no hot ischemia time. There was no accidental injury that affected organ quality and function. Heart transplantation was performed in 17 cases, combined heart-kidney transplantation in 2 cases, double lung transplantation in 43 cases, single lung transplantation in 6 cases, liver transplantation in 41 cases, combined liver-pancreas-duodenal cluster transplantation in 1 case, combined liver-kidney transplantation in 3 cases, combined pancreas-kidney transplantation in 9 cases, and kidney transplantation in 74 cases. Conclusion: Simultaneous perfusion and combined resection of thoracic and abdominal organ clusters for donation after brain death donors are feasible and effective.

Urine marker analysis identifies evidence for persistent glomerular podocyte injury across allograft lifespan.

Long-term kidney transplant (KT) survival has remained relatively stagnant. Protocol biopsy studies suggest that glomerulosclerosis is a significant contributor to long-term graft failure. We previously demonstrated that podocyte loss in the first year post-transplantation predicted long-term allograft survival. However, whether increased podocyte loss continues over the lifespan of a KT remains unclear. We performed a cross-sectional analysis of 1182 urine samples from 260 KT recipients up to 19-years after transplantation. Urine pellet (UP) mRNAs were assayed for podocyte (NPHS2/podocin and nephrin/NPHS1), distal tubule (aquaporin2), and profibrotic cytokine (TGFbeta1). Multivariable generalized estimating equations were used to obtain "population-averaged" effects for these markers over time post-KT. Consistent with early stresses both podocyte and tubular markers increased immediately post-KT. However, only podocyte markers continued to increase long-term. A role for hypertrophic stresses in driving podocyte loss over time is implied by their association with donor BMI, recipient BMI, and donor-recipient BMI mismatch at transplantation. Furthermore, UP podocin mRNA was associated with urine TGFbeta1, proteinuria, and reduced estimated glomerular filtration rate, thereby linking podocyte injury to allograft fibrosis and survival. In conclusion we observed that podocyte loss continues long-term post-KT suggesting an important role in driving late graft loss.

Urinary complement proteins and risk of end-stage renal disease: quantitative urinary proteomics in patients with type 2 diabetes and biopsy-proven diabetic nephropathy.

PURPOSE: To investigate the association between urinary complement proteins and renal outcome in biopsy-proven diabetic nephropathy (DN). METHODS: Untargeted proteomic and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional analyses and targeted proteomic analysis using parallel reaction-monitoring (PRM)-mass spectrometry was performed to determine the abundance of urinary complement proteins in healthy controls, type 2 diabetes mellitus (T2DM) patients, and patients with T2DM and biopsy-proven DN. The abundance of each urinary complement protein was individually included in Cox proportional hazards models for predicting progression to end-stage renal disease (ESRD). RESULTS: Untargeted proteomic and functional analysis using the KEGG showed that differentially expressed urinary proteins were primarily associated with the complement and coagulation cascades. Subsequent urinary complement proteins quantification using PRM showed that urinary abundances of C3, C9, and complement factor H (CFAH) correlated negatively with annual estimated glomerular filtration rate (eGFR) decline, while urinary abundances of C5, decay-accelerating factor (DAF), and CD59 correlated positively with annual rate of eGFR decline. Furthermore, higher urinary abundance of CFAH and lower urinary abundance of DAF were independently associated with greater risk of progression to ESRD. Urinary abundance of CFAH and DAF had a larger area under the curve (AUC) than that of eGFR, proteinuria, or any pathological parameter. Moreover, the model that included CFAH or DAF had a larger AUC than that with only clinical or pathological parameters. CONCLUSION: Urinary abundance of complement proteins was significantly associated with ESRD in patients with T2DM and biopsy-proven DN, indicating that therapeutically targeting the complement pathway may alleviate progression of DN.

[Clinical characteristics and related factors of human respiratory syncytial viruses infection in premature infants within 2 years after birth in Shenzhen Children's Hospital].

Objective: To analyze the clinical characteristics and factors associated with human respiratory syncytial virus (HRSV) infection in preterm infants within the first 2 years of life. Methods: Children with respiratory tract infections admitted to Shenzhen Children's Hospital during the 3-year period from January 2016 to December 2018 who were <2 years old and whose gestational age at birth was <37 weeks were selected, and those who met the diagnostic criteria for RSV infection were categorized as the positive case group, and those who had no detectable influenza virus, parainfluenza virus and adenovirus antigens were categorized as the negative group. The clinical characteristics of the case group were retrospectively analyzed. A multivariable logistic regression model was used to analyze the associated factors. Results: A total of 1, 483 children were included, of whom 149 (10.1%) were HRSV positive (case group) and 447 (30.1%) were in the negative group (control group). In the case group, there were 88 (59.1%) male and 61 (40.1%) female children; 127 children (85.2%) in the mild-to-moderate disease group and 22 children (14.8%) in the severe disease group. The number of cases in the severe disease group was greater than that in the mild-to-moderate disease group [(17 cases, 77.3%) than (59 cases, 46.5%)], with statistical significance (P=0.010). A total of 117 cases (78.5%) had onset from February to July. Multivariable analysis showed that males [OR (95%CI) of 0.105 (0.013-0.112)], age at month [0.045 (0.036-0.112)], congenital heart disease [0.388 (0.206-0.940)] and bronchopulmonary dysplasia [0.622 (0.484-0.927)] were positively associated with HRSV infection in preterm infants. Conclusion: The high prevalence of HRSV infection in preterm infants in Shenzhen is from February to July each year, and male children are more common. Young age, congenital heart disease and bronchopulmonary dysplasia are all independent risk factors for HRSV infection in preterm infants.

[Merkel cell carcinoma: a clinicopathological study of 10 cases].

Objective: To investigate the clinicopathological features, differential diagnosis and prognosis of Merkel cell carcinoma (MCC). Methods: The clinical and pathological data of 10 patients with MCC were collected at the 940th Hospital of PLA. The histological characteristics were examined. Immunohistochemical EnVision method was used to detect thyroid transcription factor-1 (TTF1), broad-spectrum cytokeratin (CKpan), CK20, S-100, Ki-67, CD56, chromogranin A, synaptophysin and other markers in the 10 cases. Results: Intradermal MCC of the skin showed a nested, cord-like, cribriform distribution, polygonal cells, uniform size, and lack of cytoplasm. Tumor cell nuclei were large and round, with clear nuclear membranes, fine and scattered chromatin, absence of nucleoli, and mitotic figures of 10 per 50 high power fields. Among them, one patient had sarcoma and squamous cell carcinoma in situ, one patient had squamous cell carcinoma in situ, and one patient had unique cell morphology. Immunohistochemical staining showed that all cancer cells expressed CKpan, synaptophysin and CD56. There were seven cases with perinuclear dot-like positivity of CK20. Six MCCs expressed chromogranin A to varying degrees, while 2 MCCs were weakly positive for p63. The nuclear positive index in the Ki-67 hotspot area was 60%. Conclusion: The histology of MCC varies. Rendering a correct diagnosis of MCC requires adequate sampling, close correlation with clinical history and rational use of immunohistochemical staining. The treatment requires standardized surgery, postoperative radiotherapy and multimodal chemotherapy. Immunotherapy may replace the traditional treatment in the future.

[The clinical effect of percutaneous curved kyphoplasty for osteoporosis vertebral compression fractures].

Objective: To evaluate the clinical effect of percutaneous curved kyphoplasty (PCK) for osteoporosis vertebral compression fractures (OVCF). Methods: This is a prospective study.Patients with OVCF who underwent PCK at the Department of Orthopedics,Beijing Chaoyang Hospital, Capital Medical University from June 2018 to June 2019 were included.All the operations were performed by the same surgeon.X-ray examination was performed before and after the operation to measure the vertebral height and Cobb angle.The visual analogue scale (VAS) and Oswestry disability index (ODI) scores were evaluated before and after the operation,and the amount of bone cement injected was record.The leakage rate and distribution of bone cement was observed by CT examination after the operation,and the postoperative complications was collected during the follow-up.Paired-t test was used to compare the related indexes before and after operation. Results: There were 32 patients in our study,including 8 males and 24 females,aged (74.9±9.9) years (range:64 to 81 years).The intraoperative bone cement injection volume was (4.2±1.5) ml(range:2 to 6 ml).According to the classification of distribution of bone cement,28 cases were rated as type Ⅰ and 4 cases were rated as type Ⅱ. Bone cement leakage was observed in 12 cases (37.5%),and there was no intraspinal leakage or venous leakage.The vertebral height was improved from (21.9±6.2) mm preoperatively to (24.3±4.3) mm postoperatively(t=-2.836,P=0.008),Cobb angle improved from(M(QR))14°(15°)preoperatively to 12.5°(12.75°)postoperatively(Z=-1.950,P=0.051),VAS improved from 6.8±0.7 preoperatively to 1.7±0.8 postoperatively (t=28.946,P<0.01),ODI score improved from 73.4±7.3 preoperatively to 21.3±5.7 postoperatively (t=32.250,P<0.01).The patients were followed up for (19.7±3.7) months (range:15 to 29 months).One patient had refracture (3.1%,1/32),and no other complications such as neurological dysfunction and pulmonary embolism occurred. Conclusions: The clinical effect of PCK in the treatment of OVCF was satisfactory.This technique could reduce the difficulty of puncture to a certain extent,and be beneficial to the distribution of bone cement.

Podocyte stress and detachment measured in urine are related to mean arterial pressure in healthy humans.

Hypertension-associated progressive glomerulosclerosis is a significant driver of both de novo and all-cause chronic kidney disease leading to end-stage kidney failure. The progression of glomerular disease proceeds via continuing depletion of podocytes from the glomeruli into the ultrafiltrate. To non-invasively assess injury patterns associated with mean arterial pressure (MAP), we conducted an observational study of 87 healthy normotensive individuals who were cleared for living kidney donation. Urine pellet podocin and aquaporin2 mRNAs normalized to the urine creatinine concentration (UPod:Creat ratio and UAqp2:Creat ratio) were used as markers of podocyte detachment and tubular injury, respectively. The ratio of two podocyte mRNA markers, podocin to nephrin (UPod:Neph) as well as the ratio of podocin to the tubular marker aquaporin2 (UPod:Aqp2) estimated the relative rates of podocyte stress and glomerular vs. tubular injury. The MAP was positively correlated with the UPod:Neph and UPod:Aqp2, thereby confirming the relationship of MAP with podocyte stress and the preferential targeting of the glomerulus by higher MAP. In multivariable linear regression analysis, both UPod:Neph and UPod:Creat, but not UAqp2:Creat or proteinuria, were both significantly related to a range of normal MAP (70 to 110 mm Hg). Systolic, as opposed to diastolic or pulse pressure was associated with UPod:Creat. Thus, higher podocyte stress and detachment into the urine are associated with MAP even in a relatively "normal" range of MAP. Hence, urine pellet mRNA monitoring can potentially identify progression risk before the onset of overt hypertension, proteinuria or chronic kidney disease.

Spatial Patterns of Brain Activity Preferentially Reflecting Transient Pain and Stimulus Intensity.

How pain emerges in the human brain remains an unresolved question. Neuroimaging studies have suggested that several brain areas subserve pain perception because their activation correlates with perceived pain intensity. However, painful stimuli are often intense and highly salient; therefore, using both intensity- and saliency-matched control stimuli is crucial to isolate pain-selective brain responses. Here, we used these intensity/saliency-matched painful and non-painful stimuli to test whether pain-selective information can be isolated in the functional magnetic resonance imaging responses elicited by painful stimuli. Using two independent datasets, multivariate pattern analysis was able to isolate features distinguishing the responses triggered by (1) intensity/saliency-matched painful versus non-painful stimuli, and (2) high versus low-intensity/saliency stimuli regardless of whether they elicit pain. This indicates that neural activity in the so-called "pain matrix" is functionally heterogeneous, and part of it carries information related to both painfulness and intensity/saliency. The response features distinguishing these aspects are spatially distributed and cannot be ascribed to specific brain structures.

Role of imaging biomarkers for prognostic prediction in patients with pancreatic ductal adenocarcinoma.

Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive tumours. PDAC has a poor prognosis; therefore, it is necessary to perform further risk stratification. Identifying prognostic factors before treatment might help to implement suitable and personalised treatment for individuals and avoid side effects. Conventional staging systems and tumour biomarkers are fundamental to establish prognosis; however, they have obvious limitations. Novel imaging biomarkers extracted from advanced imaging techniques offer opportunities to evaluate underlying tumour physiological characteristics, such as mutational status, cellular composition, local microenvironment, tumour metabolism, and biological behaviour. Thus, imaging biomarkers might help the decision making of oncologists and surgeons. The present review discusses the functions of imaging biomarkers for prognostic prediction in patients with PDAC and their potential value for further translation in clinical practice.

Whole-genome sequencing reveals breed-differential CNVs between Tongcheng and Large White pigs.

Large phenotypic differences have been observed between Tongcheng and Large White pigs. However, little is known about their genetic basis. This study performed a genome-wide comparison of CNVs between Tongcheng and Large White pigs using genome sequencing data. By combining the advantages of three different strategies (read depth, paired-end mapping and split read), we detected in total 18 687 CNVs that covered approximately 3.5% of the pig genome length for Tongcheng and Large White pigs. We identified 1864 breed-stratified CNVs (top 10%) by performing VST statistics. Functional enrichment analyses for genes located in breed-stratified CNVs were found to be involved in pigmentation, behavior, immune system and reproductive processes, which coincide with phenotypic differences between the two breeds. Using a systematic analysis of the genome and transcriptome data, we further identified four novel breed-differential CNVs on the functional genes (disease-resistant, DCUN1D2 and SPARCL1; lipid metabolism, PLEKHA2 and SLCO1A2). Subsequent PCR validation confirmed their accurate breakpoint positions in 33 Tongcheng pigs and 33 Large White pigs. This study provides essential information on differential CNVs for further research on the genetic basis of phenotypic differences between Tongcheng and Large White pigs.

[Attaches the great importance of routine biopsy in vertebral augmentation].

Vertebral compression fractures(VCFs) are severe and common complications of osteoporosis. Most VCFs were caused by osteopenia or osteoporosis. Nevertheless, spinal metastases probably result in pathological fractures that easily confused with osteoporotic vertebral compression fractures(OVCFs). Using biopsy during vertebral augmentation(VA) is considered as the golden standard protocol to rule out pathological VCFs. Up to data, conventionally using biopsy during VA is suggested by more and more researchers to confirm the etiology of VCFs and to avoid missed diagnosis and misdiagnosis of spinal metastases with pathological vertebral fractures as the first manifestation. For patients with spinal metastases, histological evaluation of vertebral biopsy specimens is convenient for further treatment.

Brain regions preferentially responding to transient and iso-intense painful or tactile stimuli.

How pain emerges from cortical activities remains an unresolved question in pain neuroscience. A first step toward addressing this question consists in identifying brain activities that occur preferentially in response to painful stimuli in comparison to non-painful stimuli. A key confound that has affected this important comparison in many previous studies is the intensity of the stimuli generating painful and non-painful sensations. Here, we compared the brain activity during iso-intense painful and tactile sensations sampled by functional MRI in 51 healthy participants. Specifically, the perceived intensity was recorded for every stimulus and only the stimuli with rigorously matched perceived intensity were selected and compared between painful and tactile conditions. We found that all brain areas activated by painful stimuli were also activated by tactile stimuli, and vice versa. Neural responses in these areas were correlated with the perceived stimulus intensity, regardless of stimulus modality. More importantly, among these activated areas, we further identified a number of brain regions showing stronger responses to painful stimuli than to tactile stimuli when perceived intensity was carefully matched, including the bilateral opercular cortex, the left supplementary motor area and the right frontal middle and inferior areas. Among these areas, the right frontal middle area still responded more strongly to painful stimuli even when painful stimuli were perceived less intense than tactile stimuli, whereas in this condition other regions showed stronger responses to tactile stimuli. In contrast, the left postcentral gyrus, the visual cortex, the right parietal inferior gyrus, the left parietal superior gyrus and the right cerebellum had stronger responses to tactile stimuli than to painful stimuli when perceived intensity was matched. When tactile stimuli were perceived less intense than painful stimuli, the left postcentral gyrus and the right parietal inferior gyrus still responded more strongly to tactile stimuli while other regions now showed similar responses to painful and tactile stimuli. These results suggest that different brain areas may be engaged differentially when processing painful and tactile information, although their neural activities are not exclusively dedicated to encoding information of only one modality but are strongly determined by perceived stimulus intensity regardless of stimulus modality.