Diagnostic Accuracy of MRI in Knee Meniscus Tear and ACL Injury.

Objective: Knee injuries are very common and may lead to other secondary injuries if effective treatment is lacking. In addition to standardized physical examination, magnetic resonance imaging (MRI) is sometimes considered an aid in the diagnosis of knee trauma. In order to have a more accurate diagnosis of knee injuries, we compared MRI with arthroscopic findings in this study to evaluate the diagnostic accuracy of MRI for meniscal tears and anterior cruciate ligament injuries of the knee. Methods: One hundred and ten patients with suspected meniscal tears and anterior cruciate ligament injuries of the knee who were admitted to our hospital from June 2020 to June 2022 were selected as study subjects, and the clinical data of the patients were retrospectively analyzed. All patients underwent MRI for preoperative diagnosis, and the sensitivity, specificity, MRI findings, and confirmation of diagnosis were compared and analyzed, and the accuracy of MRI in diagnosing meniscal tears and ACL injuries of the knee was analyzed. Results: The mean ACL angle was (98.0 ± 5.4) in the MRI group and (118.0 ± 6.8) in the arthroscopic group, the difference between the two groups was statistically significant P < .05. The mean L/H value of the ACL was (2.12 ± 0.38) in the MRI group and (1.81 ± 0.19) in the arthroscopic group, which was statistically different between the two groups (P < .05). Among the patients, 68 meniscal injuries were found in the MRI examination, including 45 cases of knee meniscal tears and 23 cases of anterior cruciate ligament injuries. The sensitivity, specificity, positive and negative predictive values, agreement rate, kappa value, and Youden index of MRI in diagnosing meniscal tears and ACL injuries were all high. Conclusions: In terms of sensitivity and accuracy, MRI is an excellent imaging technique for the diagnosis of meniscal tears and anterior cruciate ligament injuries of the knee.

Differences in the Diagnosis and Treatment of Patients with Early-Stage Hepatocellular Liver Cancer by Multi-Row Spiral CTMDCT and Gd-EOB-DTPA-Enhanced MRI.

Objective: The assessment of liver cancer lesion characteristics mainly relies on multi-row spiral computed tomography (MDCT) and magnetic resonance imaging (MRI). MDCT suffers from a series of problems, such as low soft tissue contrast and large tumor boundary errors, which lead to its limited practical application value in liver cancer. In contrast, Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI has better soft-tissue contrast than MDCT and increases the clarity of liver cancer lesions. To investigate the differences between MDCT and Gd-EOB-DTPA-enhanced MRI in managing patients with hepatocellular liver cancer. Methods: A total of 80 patients diagnosed with hepatocellular carcinoma of the liver, who received treatment at our hospital between September 2020 and September 2022, were included in this study. These patients were evenly divided into two groups: the observation group and the control group, with 40 cases in each. The aim of this study was to compare the differences in signal indices of hepatobiliary stage between the two groups in patients with hepatocellular carcinoma. Results: A total of 89 cancer nodules were detected in patients by MDCT, and 109 cancer nodules were detected in patients by Gd-EOB-DTPA-enhanced MRI. When the number of nodules detected by both imaging modalities was statistically analyzed, the differences in the number of hepatocellular carcinoma (HCC) nodules detected by MDCT and Gd-EOB-DTPA-enhanced MRI were statistically significant (P < .05). Further analysis of the data by single cancer nodule, multiple cancer nodules, and cancer nodule size showed that the difference between the two imaging modalities was statistically significant (P < .05) in the diagnosis of patients with a single liver cancer nodule or multiple liver cancer nodules (94.8% vs.81.3%). The difference in the comparison was statistically significant (P < .05). Conclusion: Gd-EOB-DTPA-enhanced MRI demonstrates superior diagnostic efficacy in detecting small hepatocellular carcinoma, offers improved staging capabilities for hepatocellular carcinoma, and provides more precise guidance for treatment planning.Consequently, Gd-EOB-DTPA-enhanced MRI exhibits exceptional diagnostic value and serves as a valuable tool for guiding treatment decisions in patients with hepatocellular carcinoma.

Notoginsenoside R1 ameliorates the inflammation induced by amyloid­ß by suppressing SphK1­mediated NF­κB activation in PC12 cells.

Alzheimer's disease (AD) is the most common type of age­related dementia, and causes progressive memory degradation, neuronal loss and brain atrophy. The pathological hallmarks of AD consist of amyloid­ß (Aß) plaque accumulation and abnormal neurofibrillary tangles. Amyloid fibrils are constructed from Aß peptides, which are recognized to assemble into toxic oligomers and exert cytotoxicity. The fibrillar Aß­protein fragment 25­35 (Aß25­35) induces local inflammation, thereby exacerbating neuronal apoptosis. Notoginsenoside R1 (NGR1), one of the primary bioactive ingredients isolated from Panax notoginseng, exhibits effective anti­inflammatory and anti­oxidative activities. However, NGR1 pharmacotherapies targeting Aß­induced inflammation and cell injury cascade remain to be elucidated. The present study investigated the effect and mechanism of NGR1 in Aß25­35­treated PC12 cells. NGR1 doses between 250 and 1,000 µg/ml significantly increased cell viability suppressed by 20 µM Aß25­35 peptide treatment. Notably, the present study demonstrated that Aß25­35 peptide­induced sphingosine kinase 1 (SphK1) signaling activation was reduced after NGR1 treatment, further inhibiting the downstream NF­κB inflammatory signaling pathway. In addition, administration of SphK1 inhibitor II (SKI­II), a SphK1 inhibitor, also significantly reduced Aß25­35 peptide­induced apoptosis and the ratio of NF­κB p­p65/p65. Furthermore, SphK1 knockdown in PC12 cells using small interfering RNA alleviated Aß­induced cell apoptosis and inflammation, suggesting a pivotal role of SphK1 signaling in the anti­inflammatory effect of NGR1. In summary, NGR1 alleviated inflammation and apoptosis stimulated by Aß25­35 by inhibiting the SphK1/NF­κB signaling pathway and may be a promising agent for future AD treatment.

Archival single-cell genomics reveals persistent subclones during DCIS progression.

Ductal carcinoma in situ (DCIS) is a common precursor of invasive breast cancer. Our understanding of its genomic progression to recurrent disease remains poor, partly due to challenges associated with the genomic profiling of formalin-fixed paraffin-embedded (FFPE) materials. Here, we developed Arc-well, a high-throughput single-cell DNA-sequencing method that is compatible with FFPE materials. We validated our method by profiling 40,330 single cells from cell lines, a frozen tissue, and 27 FFPE samples from breast, lung, and prostate tumors stored for 3-31 years. Analysis of 10 patients with matched DCIS and cancers that recurred 2-16 years later show that many primary DCIS had already undergone whole-genome doubling and clonal diversification and that they shared genomic lineages with persistent subclones in the recurrences. Evolutionary analysis suggests that most DCIS cases in our cohort underwent an evolutionary bottleneck, and further identified chromosome aberrations in the persistent subclones that were associated with recurrence.

Simple oligonucleotide-based multiplexing of single-cell chromatin accessibility.

Microdroplet single-cell ATAC-seq is widely used to measure chromatin accessibility, however, highly scalable and simple sample multiplexing procedures are not available. Here, we present a transposome-assisted single nucleus barcoding approach for ATAC-seq (SNuBar-ATAC) that utilizes a single oligonucleotide adaptor for multiplexing samples during the existing tagmentation step and does not require a pre-labeling procedure. The accuracy and scalability of SNuBar-ATAC was evaluated using cell line mixture experiments. We applied SNuBar-ATAC to investigate treatment-induced chromatin accessibility dynamics by multiplexing 28 mice with lung tumors that received different combinations of chemo, radiation, and targeted immunotherapy. We also applied SNuBar-ATAC to study spatial epigenetic heterogeneity by multiplexing 32 regions from a human breast tissue. Additionally, we show that SNuBar can multiplex single cell ATAC and RNA multiomic assays in cell lines and human breast tissue samples. Our data show that SNuBar is a highly accurate, easy-to-use, and scalable system for multiplexing scATAC-seq and scATAC and RNA co-assay experiments.

Breast tumours maintain a reservoir of subclonal diversity during expansion.

Our knowledge of copy number evolution during the expansion of primary breast tumours is limited1,2. Here, to investigate this process, we developed a single-cell, single-molecule DNA-sequencing method and performed copy number analysis of 16,178 single cells from 8 human triple-negative breast cancers and 4 cell lines. The results show that breast tumours and cell lines comprise a large milieu of subclones (7-22) that are organized into a few (3-5) major superclones. Evolutionary analysis suggests that after clonal TP53 mutations, multiple loss-of-heterozygosity events and genome doubling, there was a period of transient genomic instability followed by ongoing copy number evolution during the primary tumour expansion. By subcloning single daughter cells in culture, we show that tumour cells rediversify their genomes and do not retain isogenic properties. These data show that triple-negative breast cancers continue to evolve chromosome aberrations and maintain a reservoir of subclonal diversity during primary tumour growth.

Disseminated mucormycosis with cerebellum involvement due to Rhizomucor pusillus in a patient with multiple myeloma and secondary myelodysplastic syndrome: A case report.

Mucormycosis is an angioinvasive fungal infection with a high mortality rate. Patients with hematological malignancies following voriconazole therapy are at high risk from mucormycosis. Here, the present study reports on a 68-year-old man diagnosed with multiple myeloma and secondary myelodysplastic syndrome, who was infected with disseminated mucormycosis with cerebellum involvement confirmed by mycological culture and histopathological examination. For patients with hematological malignancies who are receiving antifungal therapy, an opportunistic infection of mucormycosis should be considered if a 'breakthrough' infection occurs in the predilection sites (such as the sinuses, lungs, skin, brain and gastrointestinal tract). It is difficult to diagnose mucormycosis because of the limited reliable detection methods, and because mucormycosis often presents with an acute onset and progresses rapidly, particularly in immunocompromised patients. Antifungal therapy with amphotericin B or posaconazole should be started as soon as possible considering the empirical diagnosis.

Correction: Cold plasma gas loaded microbubbles as a novel ultrasound contrast agent.

Correction for 'Cold plasma gas loaded microbubbles as a novel ultrasound contrast agent' by Feihong Dong et al., Nanoscale, 2019, 11, 1123-1130.

Cold plasma gas loaded microbubbles as a novel ultrasound contrast agent.

Nowadays, cold atmospheric plasma (CAP) that contains lots of active free radicals has tremendous potential applications in biomedical engineering, and target delivery of a controllable dose of plasma gas is highly desired in clinical use. In this conceptual study, we developed a novel microbubble loaded by plasma gas and proposed an ultrasound-triggered strategy for the ultrasound-triggered release of free radicals from the microbubbles. The plasma microbubbles (PMBs) were fabricated by mixing plasma gas in the core of the surfactant microbubbles by a modified emulsification process. The resulting PMBs with an average size of 2.54 ± 2.28 µm were successfully fabricated using the proposed approach and the experimental result showed that PMBs exhibited a satisfactory ability to meet the requirement of ultrasound contrast-enhanced imaging. Furthermore, we depicted that ultrasound induced PMB destruction to release the plasma gas and PMBs with ultrasound stimulation could significantly improve the concentration of nitric oxide and hydrogen peroxide compared with the control group. In addition, Dil acting as a model drug was loaded into the PMBs and an in vitro cell experiment showed that Dil and plasma gas could be released from PMBs and internalized by PIEC cells with ultrasound mediation. Our experimental results showed that ultrasound induced PMB destruction could successfully release many active free radicals in plasma gas, including nitric oxide and hydrogen peroxide. The developed novel microbubbles demonstrated the technical potential of plasma gas loaded MBs for disease diagnostics and therapy with ultrasound imaging guidance.

[Prognostic Value of Morphology and Hans Classification in Diffuse Large B Cell Lymphoma].

OBJECTIVE: To investigate the prognostic value of morphology and Hans classification in diffuse large B cell lymphoma（DLBCL）. METHODS: Clinical data of 249 patients diagnosed with DLBCL in our hospital and Hangzhou Xixi hospital during Jan 2006 to Dec 2016 were analyzed retrospectively. These patients were classified into 3 groups: immunoblastic variant（IB） group, centroblastic variant（CB） group and others group according to the cell morphology. And DLBCL was also divided into GCB（germinal center B-cell-like）or non-GCB（non-germinal center B-cell-like） group by analyzing the expression of CD10, BCL6 and MUM1 (GCB: CD10 +,BCL6+-,MUM1+-/CD10-,BCL6+,MUM1-；non-GCB：CD10-,BCL6-,MUM1+-/CD10-,BCL6+,MUM1+). RESULTS: The univariate analysis displayed that the age，LDH level，IPI，IB，non-GCB，B-symptoms and rituximab all could influence the OS and EFS, the CR rate of CB subtype patients was significantly higher than that of the patients with IB subtype （68.3% vs 38.9%)(P=0.02）. IB subtype was the in dependent prognostic factor for both EFS and OS in the whole study. In multivariate analysis, IPI and IB were the independent prognostic factors for OS and EFS. IB subtype was also an independent prognostic factor in EFS and OS with or without rituximab. The expression of BCL2 and BCL6 was related with prognosis in R-CHOP, but not in CHOP treated patients. Other markers (CD5, CD10, IRF4/MUM1, HLA-DR and Ki-67 proliferation index) were not of the significant prognostic value for DLBCL. When accepted rituximab, the GCB and non-GCB were not different significantly for prognosis. However, the non-GCB group showed a poor prognosis without using rituximab （EFS P=0.020；OS P=0.020）. Multivariate Cox models showed that OS and EFS were not significantly different between GCB and non-GCB group, however, the IB subtype had a very significantly poor prognosis in OS and EFS (P=0.001, P=0.002). When the analysis was restricted to DLBCL with CB morphology only, no prognostic value was observed in Hans classification. CONCLUSION: The subtype of immunoblast is a major risk factor in patients treated with CHOP or R-CHOP. There is a significant association between the Hans classification and the morphologic subclassification. Results of this study have supplemented the data for the prognostic factor of DLBCL and demonstrated that the cytomorphologic diagnosis can be reproducible.

A novel drug-free strategy of nano-pulse stimulation sequence (NPSS) in oral cancer therapy: In vitro and in vivo study.

Nano-pulse stimulation (NPS) is a novel technology to induce cancer apoptosis. In this study, based on the energy-dose effect of NPS, we designed a special NPS sequence (NPSS) with low field intensity. The effectiveness and mechanisms of NPSS on oral cancer therapy were evaluated by cell proliferation assays, microscopic investigation, JC-1 mitochondrial membrane potential assay, tumor inhibition assays, immunohistochemistry (IHC) assay, Ca2+, NOS and ROS detection assays, respectively. The results demonstrated that NPSS treatment significantly inhibited oral cancer growth in vitro and in vivo. Furthermore, we found that NPSS treatment induced an obviously apoptosis and mitochondrial membrane potential (ΔΨm) reduction in Cal-27 cells. Notably, further experiments revealed that the mechanisms of crosstalk signaling between NO, ROS and Ca2+ involvement in NPSS treatment. In conclusion, this is a proof-of-concept study that provides a potential alternative strategy for developing and applying NPSS in oral cancer therapy.

Early mortality in acute promyelocytic leukemia: Potential predictors.

Acute promyelocytic leukemia (APL) is a rare leukemia characterized by the balanced reciprocal translocation between the promyelocytic leukemia gene on chromosome 15 and the retinoic acid receptor α (RARα) gene on chromosome 17, and accounts for 10-15% of newly diagnosed acute myeloid leukemia each year. The combined use of all-trans retinoic acid and arsenic trioxide (ATO) as primary therapy has markedly improved the survival rate of patients with APL. Mortality in the first 30 days following therapy remains a major contribution to treatment failure. In the present study, published data was reviewed with a focus on the factors associated with early mortality. When treated with ATO as a primary treatment, the fms-like tyrosine kinase-internal tandem deletion has no impact on early mortality. Low lymphoid enhancer binding factor-1 expression may be a reliable marker for early mortality and the target of therapy if it could be proven by further studies. Cluster of differentiation (CD)56+ and CD34+/CD2+ may be candidates to select high-risk patients. The risk of early mortality in APL still cannot be predicted via the cell surface makers, despite multiple studies on their prognostic significance. Typically, a complex translocation did not alter the survival rate in patients with APL; however, if an abnormal karyotype [e.g., Ide(17), ZBTB16/RARα and STAT5B/RARα] appeared singularly or as part of a complex mutation, there is a high possibility of early mortality if clinicians are unable to identify or monitor it.

Concurrent eosinophilia and IgG4-related disease in a child: A case report and review of the literature.

The current study presents the case of a 9-year-old Chinese boy who presented with eosinophilia and elevated serum levels of immunoglobulin G4 (IgG4). A bone marrow puncture identified an elevated eosinophil rate of 23% (normal range, <5%), which indicated eosinophilia. However, gene analysis, fluorescent in situ hybridization and other examinations, including bone marrow aspiration, blood routine, auto-antibody tests and parasitic and allergens screening, contradicted a diagnosis of secondary or clonal eosinophilia. Furthermore, the patient exhibited multiple lymph node swelling and a lymph biopsy strongly indicted a pathological diagnosis of IgG4-related disease (IgG4-RD). His peripheral blood flow cytometry confirmed an elevated count of plasmablasts, which is specific to IgG4-RD. The patient responded well to therapy with prednisone and remained healthy in all follow-ups. By taking all these factors into consideration, the boy was diagnosed with IgG4-RD. It is difficult to distinguish IgG4-RD from hypereosinophilic syndrome and the potential association between the two remains unclear. However, the present case study serves as a reminder that IgG4-RD may occur in children and medical professionals should not neglect this possibility.

Ultrasensitive and high-efficiency screen of de novo low-frequency mutations by o2n-seq.

Detection of de novo, low-frequency mutations is essential for characterizing cancer genomes and heterogeneous cell populations. However, the screening capacity of current ultrasensitive NGS methods is inadequate owing to either low-efficiency read utilization or severe amplification bias. Here, we present o2n-seq, an ultrasensitive and high-efficiency NGS library preparation method for discovering de novo, low-frequency mutations. O2n-seq reduces the error rate of NGS to 10-5-10-8. The efficiency of its data usage is about 10-30 times higher than that of barcode-based strategies. For detecting mutations with allele frequency (AF) 1% in 4.6 Mb-sized genome, the sensitivity and specificity of o2n-seq reach to 99% and 98.64%, respectively. For mutations with AF around 0.07% in phix174, o2n-seq detects all the mutations with 100% specificity. Moreover, we successfully apply o2n-seq to screen de novo, low-frequency mutations in human tumours. O2n-seq will aid to characterize the landscape of somatic mutations in research and clinical settings.

Ultra-precise detection of mutations by droplet-based amplification of circularized DNA.

BACKGROUND: NGS (next generation sequencing) has been widely used in studies of biological processes, ranging from microbial evolution to cancer genomics. However, the error rate of NGS (0.1 % ~ 1 %) is still remaining a great challenge for comprehensively investigating the low frequency variations, and the current solution methods have suffered severe amplification bias or low efficiency. RESULTS: We creatively developed Droplet-CirSeq for relatively efficient, low-bias and ultra-sensitive identification of variations by combining millions of picoliter uniform-sized droplets with Cir-seq. Droplet-CirSeq is entitled with an incredibly low error rate of 3 ~ 5 X 10(-6). To systematically evaluate the performances of amplification uniformity and capability of mutation identification for Droplet-CirSeq, we took the mixtures of two E. coli strains as specific instances to simulate the circumstances of mutations with different frequencies. Compared with Cir-seq, the coefficient of variance of read depth for Droplet-CirSeq was 10 times less (p = 2.6 X 10(-3)), and the identified allele frequency presented more concentrated to the authentic frequency of mixtures (p = 4.8 X 10(-3)), illustrating a significant improvement of amplification bias and accuracy in allele frequency determination. Additionally, Droplet-CirSeq detected 2.5 times genuine SNPs (p < 0.001), achieved a 2.8 times lower false positive rate (p < 0.05) and a 1.5 times lower false negative rate (p < 0.001), in the case of a 3 pg DNA input. Intriguingly, the false positive sites predominantly represented in two types of base substitutions (G- > A, C- > T). Our findings indicated that 30 pg DNA input accommodated in 5 ~ 10 million droplets resulted in maximal detection of authentic mutations compared to 3 pg (p = 1.2 X 10(-8)) and 300 pg input (p = 2.2 X 10(-3)). CONCLUSIONS: We developed a method namely Droplet-CirSeq to significantly improve the amplification bias, which presents obvious superiority over the currently prevalent methods in exploitation of ultra-low frequency mutations. Droplet-CirSeq would be promisingly used in the identification of low frequency mutations initiated from extremely low input DNA, such as DNA of uncultured microorganisms, captured DNA of target region, circulation DNA of plasma et al, and its creative conception of rolling circle amplification in droplets would also be used in other low input DNA amplification fields.