Prognostic Role of Pretreatment Geriatric Nutritional Risk Index in Colorectal Cancer Patients: A Meta-Analysis.

To identify the prognostic value of the pretreatment geriatric nutritional risk index (GNRI) in colorectal cancer. Several electronic databases were searched up to March 15, 2022, for relevant studies. The primary and secondary outcomes were overall survival (OS) and disease-free survival (DFS), respectively. The hazard ratios (HRs) with 95% confidence intervals (CIs) were combined. Bess's funnel plot and Egger's test were conducted to detect publication bias, and the trim-and-fill method was performed to identify potentially unpublished papers and their impacts on the overall results. Nine studies from Japan and China involving 3440 participants were enrolled in the current meta-analysis. The pooled results indicated that a low pretreatment GNRI was significantly associated with poorer OS (HR = 2.28, 95% CI: 1.69-3.07, P < 0.001; I2=63.5%, Pheterogeneity=0.005) and DFS (HR = 1.62, 95% CI: 1.35-1.96, P < 0.001; I2=46.4%, Pheterogeneity=0.114). Subgroup analysis stratified by country and treatment showed similar results. Significant publication bias was manifested by the asymmetric Begg's funnel plot and P = 0.012 of Egger's test, but three potentially unpublished studies did not have a significant impact on the overall results. A lower pretreatment GNRI was a novel prognostic risk factor for Japanese and Chinese colorectal cancer patients.

Dietary iron intake and its impact on osteopenia/osteoporosis.

BACKGROUND: Osteoporosis is a prevalent condition characterized by low bone density and increased risk of fractures, resulting in a significant healthcare burden. Previous research has suggested that serum ferritin levels may be related to the risk of developing osteoporosis. The aim of this study was to investigate the relationship between dietary iron intake and the development of osteoporosis. METHODS: Using data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2018, a total of 11,690 adults aged over 20 were evaluated. Bone mineral density (BMD) measurements of the femoral neck and lumbar spine were used to assess osteoporosis and osteopenia. Dietary iron intake was determined using food intake interviews and the Food and Nutrient Database for Dietary Studies. Logistic regression models were applied to investigate the association between dietary iron consumption and osteopenia and osteoporosis. RESULTS: After adjusting for sociodemographic factors, compared with those who had the first quartile (Q1) of dietary iron intake, the odds ratio (OR) for osteopenia across the quartiles of dietary iron intake levels was 0.88 (95%CI: 0.79-0.98), 0.80 (95%CI: 0.72-0.89), and 0.74 (95%CI: 0.67-0.83) for Q2, Q3, and Q4, respectively. And the OR for osteoporosis across the quartiles of dietary iron intake levels was 1.00, 0.77 (95%CI: 0.50-1.19), 0.54 (95%CI: 0.34-0.89), and 0.83 (95%CI: 0.54-1.29) for Q1, Q2, Q3, and Q4, respectively. Notably, the observed association was significant among females but not males. CONCLUSION: The risk of osteopenia/osteoporosis in females decreases with a moderate increase in dietary iron consumption. For females to preserve bone health, moderately increasing their dietary iron intake without overindulging should be seen as a key approach. Our study provides useful insights for developing dietary strategies to prevent and manage osteoporosis in vulnerable populations.

[Fatty acid composition analysis and nutrition evaluation of milk and dairy products sold in Yinchuan City].

OBJECTIVE: To analyze fatty acid composition of milk and dairy products sold in Yinchuan City, and to evaluate their nutritional value. METHODS: Twenty-two types of milk and dairy products were collected in 2022-2023, including 14 types produced in Ningxia and 8 types not produced in Ningxia. Fatty acids were determined and analyzed according to the first method of National Standard for Food Safety Determination of fatty acids in Food(GB 5009.168-2016). The fatty acid polyunsaturated index(PI), atherogenic index(AI) and thrombosis index(TI) were used to evaluate the nutritional value of milk and dairy products. RESULTS: There were 25 kinds of fatty acids in milk and dairy products produced in Ningxia, which were more than those not produced in Ningxia. The main saturated fatty acids(SFA)were palmitic acid(30.14%-42.57%), the main monounsaturated fatty acids(MUFA)were oleic acid(15.45%-25.21%), the main polyunsaturated fatty acids(PUFA)were linoleic acid(1.79%-9.37%), the content of α-linolenic acid was 0.04%-0.95%, n-3 PUFA was 0.14%-0.95%. Oleic acid of adult milk powder, sheep milk powder, pure milk and Ningxia wolfberry milk were higher than others, linoleic acid of adult milk powder and walnut milk were higher than others. The value of oleic acid and linoleic acid of Ningxia pure milk was higher than that in imported pure milk, and the value of n-6 PUFA/n-3 PUFA was much lower than that in imported pure milk. The content of oleic acid and linoleic acid in Ningxia wolfberry milk was close to that of pure milk, higher than that of children's milk, and the total fat content was lower than that of children's milk. The n-6 PUFA/n-3 PUFA ratio of concentrated milk, walnut milk, sweet milk, pure milk, Ningxia wolfberry milk, adult milk powder 1, sheep milk powder was close to the ideal intake value of dietary fatty acids recommended by the Chinese Nutrition Society. Except for low-fat pure milk, ice cream yogurt, imported pure milk, children's milk 1, adult milk powder 1 and sheep milk powder, the n-6 PUFA/n-3 PUFA ratio of other milk and dairy products in Ningxia were close to the recommended value of the Food and Agriculture Organization of the United Nations and World Health Organization. SFA∶MUFA∶PUFA was(1.99-4.23) ∶1∶(0.08-0.38), PI range: 1.87-11.27, AI range: 1.67-4.32, TI range: 2.34-5.76. CONCLUSION: The fatty acid composition of 22 types of milk and dairy products in Yinchuan City was different, and the nutrition was slightly different.

Surgesture: a novel instrument based on surgical actions for objective skill assessment.

BACKGROUND: Due to varied surgical skills and the lack of an efficient rating system, we developed Surgesture based on elementary functional surgical gestures performed by surgeons, which could serve as objective metrics to evaluate surgical performance in laparoscopic cholecystectomy (LC). METHODS: We defined 14 LC basic Surgestures. Four surgeons annotated Surgestures among LC videos performed by experts and novices. The counts, durations, average action time, and dissection/exposure ratio (D/E ratio) of LC Surgestures were compared. The phase of mobilizing hepatocystic triangle (MHT) was extracted for skill assessment by three professors using a modified Global Operative Assessment of Laparoscopic Skills (mGOALS). RESULTS: The novice operation time was significantly longer than the expert operation time (58.12 ± 19.23 min vs. 26.66 ± 8.00 min, P < 0.001), particularly during MHT phase. Novices had significantly more Surgestures than experts in both hands (P < 0.05). The left hand and inefficient Surgesture of novices were dramatically more than those of experts (P < 0.05). The experts demonstrated a significantly higher D/E ratio of duration than novices (0.79 ± 0.37 vs. 2.84 ± 1.98, P < 0.001). The counts and time pattern map of LC Surgestures during MHT demonstrated that novices tended to complete LC with more types of Surgestures and spent more time exposing the surgical scene. The performance metrics of LC Surgesture had significant but weak associations with each aspect of mGOALS. CONCLUSION: The newly constructed Surgestures could serve as accessible and quantifiable metrics for demonstrating the operative pattern and distinguishing surgeons with various skills. The association between Surgestures and Global Rating Scale laid the foundation for establishing a bridge to automated objective surgical skill evaluation.

Investigation of the Quality of Recovery of Surgical Patients Based on the Chinese Version of the Quality of Recovery-15 Survey, a Cross-Sectional Study.

PURPOSE: The quality of recovery (QoR) is an important indicator of a patient's health status in the early postoperative period. Despite its importance, the QoR from the patient's perspective is often neglected in clinical practice. This study was performed to survey and determine the QoR of surgical patients from their own subjective perspective and to provide a reference for the targeted postoperative care of surgical patients in the future. DESIGN: A descriptive and cross-sectional study. METHODS: The Chinese version of the Quality of Recovery-15 (QoR-15) scale was used to survey the QoR of 503 surgical patients in 20 surgical wards from 17 surgical departments of a large tertiary hospital in Sichuan Province, China. A questionnaire survey was administered to each patient before and after the operation, and the scores were compared. FINDINGS: There were no significant differences in "feeling worried or anxious" and "feeling sad or depressed" between the preoperative and postoperative periods (P > 0.05). The postoperative scores for the other items were significantly lower than the preoperative scores. The total postoperative QoR-15 score was significantly lower than the total preoperative score (P < 0.001). CONCLUSIONS: The QoR-15 scores of surgical patients were lower after the surgery than before, and patients still needed care after discharge. Therefore, due to the gradual shortening of the length of stay (LOS) of surgical patients, it is necessary for hospitals to construct a complete surgical patient transitional care process to meet the needs of patients after discharge and promote patient rehabilitation.

Life Cycle Exposure to Environmentally Relevant Concentrations of Diphenyl Phosphate (DPhP) Inhibits Growth and Energy Metabolism of Zebrafish in a Sex-Specific Manner.

Due to commercial uses and environmental degradation of aryl phosphate esters, diphenyl phosphate (DPhP) is frequently detected in environmental matrices and is thus of growing concern worldwide. However, information on potential adverse effects of chronic exposure to DPhP at environmentally realistic concentrations was lacking. Here, we investigated the effects of life cycle exposure to DPhP on zebrafish at environmentally relevant concentrations of 0.8, 3.9, or 35.6 µg/L and employed a dual-omics approach (metabolomics and transcriptomics) to characterize potential modes of action. Exposure to DPhP at 35.6 µg/L for 120 days resulted in significant reductions in body mass and length of male zebrafish, but did not cause those same effects to females. Predominant toxicological mechanisms, including inhibition of oxidative phosphorylation, down-regulation of fatty acid oxidation, and up-regulation of phosphatidylcholine degradation, were revealed by integrated dual-omics analysis and successfully linked to adverse outcomes. Activity of succinate dehydrogenase and protein content of carnitine O-palmitoyltransferase 1 were significantly decreased in livers of male fish exposed to DPhP, which further confirmed the proposed toxicological mechanisms. This study is the first to demonstrate that chronic, low-level exposure to DPhP can retard growth via inhibiting energy output in male zebrafish.

Is three-dimensional-printed custom-made ultra-short stem with a porous structure an acceptable reconstructive alternative in peri-knee metaphysis for the tumorous bone defect?

BACKGROUND: Long-lasting reconstruction after extensive resection involving peri-knee metaphysis is a challenging problem in orthopedic oncology. Various reconstruction methods have been proposed, but they are characterized by a high complication rate. The purposes of this study were to (1) assess osseointegration at the bone implant interface and correlated incidence of aseptic loosening; (2) identify complications including infection, endoprosthesis fracture, periprosthetic fracture, leg length discrepancy, and wound healing problem in this case series; and (3) evaluate the short-term function of the patient who received this personalized reconstruction system. METHODS: Between September 2016 and June 2018, our center treated 15 patients with malignancies arising in the femur or tibia shaft using endoprosthesis with a 3D-printed custom-made stem. Osseointegration and aseptic loosening were assessed with digital tomosynthesis. Complications were recorded by reviewing the patients' records. The function was evaluated with the 1993 version of the Musculoskeletal Tumor Society (MSTS-93) score at a median of 42 (range, 34 to 54) months after reconstruction. RESULTS: One patient who experienced early aseptic loosening was managed with immobilization and bisphosphonates infusion. All implants were well osseointegrated at the final follow-up examination. There are two periprosthetic fractures intraoperatively. The wire was applied to assist fixation, and the fracture healed at the latest follow-up. Two patients experienced significant leg length discrepancies. The median MSTS-93 score was 26 (range, 23 to 30). CONCLUSIONS: A 3D-printed custom-made ultra-short stem with a porous structure provides acceptable early outcomes in patients who received peri-knee metaphyseal reconstruction. With detailed preoperative design and precise intraoperative techniques, the reasonable initial stability benefits osseointegration to osteoconductive porous titanium, and therefore ensures short- and possibly long-term durability. Personalized adaptive endoprosthesis, careful intraoperative operation, and strict follow-up management enable effective prevention and treatment of complications. The functional results in our series were acceptable thanks to reliable fixation in the bone-endoprosthesis interface and an individualized rehabilitation program. These positive results indicate this device series can be a feasible alternative for critical bone defect reconstruction. Nevertheless, longer follow-up is required to determine whether this technique is superior to other forms of fixation.

Exendin-4 enhances proliferation of senescent osteoblasts through activation of the IGF-1/IGF-1R signaling pathway.

A growing body of evidence indicates that treatment with glucagon-like peptide-1 (GLP-1) receptor agonists can be beneficial for patients with osteoporosis. However, the underlying mechanism by which GLP-1 receptor agonists improve osteoporosis remains unclear. In this study, we assessed the anti-osteoporosis effects of Exendin-4, a highly potent GLP-1 receptor agonist, using a rat senescent osteoblast model. We found that Exendin-4 improved proliferation of senescent osteoblasts, as indicated by MTT assay and ALP activity detection. RT-qPCR revealed that Exendin-4 up-regulated the expression of bone metabolism genes (OPG, RANKL, BGP) and down-regulated the expression of aging-related genes (p16, p21, p53). Meanwhile, we observed a sustained increase in IGF-1 receptor (IGF-1R) expression, and not GLP-1 receptor (GLP-1R) expression, in senescent osteoblasts treated with Exendin-4. Furthermore, intervention with Exendin-4 in senescent osteoblasts increased IGF-1, p-PI3K, and p-Akt protein levels, as shown by western blot analysis. Finally, downregulation of IGF-1 by RNAi inhibited the anti-osteoporosis effects of Exendin-4, which is associated with the IGF-1/PI3K/Akt signaling pathway. In summary, these results indicate that the GLP-1 receptor agonist Exendin-4 promotes proliferation of senescent osteoblasts by up-regulating IGF-1R expression and activating the IGF-1/PI3K/Akt signaling pathway, thereby preventing senile osteoporosis.

Effect of Lactoferrin on the Expression Profiles of Long Non-coding RNA during Osteogenic Differentiation of Bone Marrow Mesenchymal Stem Cells.

Lactoferrin (LF) has demonstrated stimulation of osteogenic differentiation of mesenchymal stem cells (MSCs). Long non-coding RNAs (lncRNAs) participate in regulating the osteogenic differentiation processes. However, the impact of LF on lncRNA expression in MSC osteogenic differentiation is poorly understood. Our aim was to investigate the effects of LF on lncRNAs expression profiles, during osteogenic differentiation of rat bone marrow mesenchymal stem cells (rBMSCs), by RNA sequencing. A total number of 1331 putative lncRNAs were identified in rBMSCs during osteogenic differentiation in the study. LF influenced the expression of 120 lncRNAs (differentially expressed lncRNAs [DELs], Fold change > 1.5 or < -1.5; p < 0.05) in rBMSCs on day 14 of osteogenic differentiation, consisted of 60 upregulated and 60 down-regulated. Furthermore, the potential functions of DELs were of prediction by searching their target cis- and trans-regulated protein-coding genes. The bioinformatic analysis of DELs target gene revealed that LF led to the disfunction of transforming growth factor beta stimulus (TGF-ß) and positive regulation of I-κappa B kinase/NF-κappa B signaling pathway, which may relate to osteogenic differentiation of rBMSCs. Our work is the first profiling of lncRNA in osteogenic differentiation of rBMSCs induced by LF, and provides valuable insights into the potential mechanisms for LF promoting osteogenic activity.

The In Vitro Protective Role of Bovine Lactoferrin on Intestinal Epithelial Barrier.

The intestinal epithelial barrier plays a key protective role in the gut lumen. Bovine lactoferrin (bLF) has been reported to improve the intestinal epithelial barrier function, but its impact on tight junction (TJ) proteins has been rarely described. Human intestinal epithelial crypt cells (HIECs) were more similar to those in the human small intestine, compared with the well-established Caco-2 cells. Accordingly, both HIECs and Caco-2 cells were investigated in this study to determine the effects of bioactive protein bLF on their growth promotion and intestinal barrier function. The results showed that bLF promoted cell growth and arrested cell-cycle progression at the G2/M-phase. Moreover, bLF decreased paracellular permeability and increased alkaline phosphatase activity and transepithelial electrical resistance, strengthening barrier function. Immunofluorescence, western blot and quantitative real-time polymerase chain reaction revealed that bLF significantly increased the expression of three tight junction proteins-claudin-1, occludin, and ZO-1-at both the mRNA and protein levels, and consequently strengthened the barrier function of the two cell models. bLF in general showed higher activity in Caco-2 cells, however, HIECs also exhibited desired responses to barrier function. Therefore, bLF may be incorporated into functional foods for treatment of inflammatory bowel diseases which are caused by loss of barrier integrity.

Recurrent nonsevere hypoglycemia exacerbates imbalance of mitochondrial homeostasis leading to synapse injury and cognitive deficit in diabetes.

Recurrent nonsevere hypoglycemia (RH) can lead to cognitive dysfunction in patients with diabetes, although the involved mechanisms remain unclear. Here, we aimed to investigate the mechanism underlying RH-induced cognitive deficits with a focus on mitochondrial homeostasis. To establish a model that mimicked RH in patients with type 1 diabetes (T1DM) receiving insulin therapy, streptozotocin-induced mice with T1DM were subjected to recurrent, twice-weekly insulin injections over 4 wk. We found that RH disrupted the mitochondrial fine structure, reduced the number of mitochondria, and upregulated the expression of mitochondrial dynamics and mitophagy markers, including dynamin-related protein 1 (Drp1), Bcl-2/adenovirus E1B 19-kDa-interacting protein-3 (BNIP3), and microtubule-associated protein 1 light-chain 3 (LC3) in the hippocampus of T1DM mice. Moreover, RH and chronic hyperglycemia synergistically promoted the production of reactive oxygen species, impaired mitochondrial membrane potential, and suppressed mitochondrial energy metabolism. Under diabetic conditions, RH also altered the synaptic morphology and reduced the expression of synaptic marker proteins. Long-term recognition memory and spatial memory, assessed with the Morris water maze test, were also impaired. However, these effects were largely prevented by mitochondrial division inhibitor 1, a potent and selective Drp1 inhibitor. Thus, it appears that RH exacerbates the imbalance of mitochondrial homeostasis, leading to synapse injury and cognitive deficits in diabetes. The adjustment of mitochondrial homeostasis could serve as an effective neuroprotective approach when addressing low blood sugar conditions.

[Lycopene's protective effect on oxidative damage of L02 cells and its mechanism].

OBJECTIVE: To explore lycopene 's protective effect on H_2O_2 induced oxidative damage of L02 cells and its mechanism. METHODS: L02 cells were cultured by H_2O_2 to build the model of cellular oxidative damage. Different dose of lycopene was used to pretreat the cells, and cell survival rate was detected to verify the appropriate concentration. Then cellular ROS level, activity of cellular SOD and GSH-Px, cellular MDA content, and activity of ALT, AST and LDH in the culture medium were detected to observe lycopene 's effect on cellular oxidant damage. Finally, to observe lycopene 's activating effect on nuclear-translocation of Nrf2, L02 cells' nuclear protein was extracted to detect Nrf2 protein content, and also, mRNA expression level of Nrf2 target genes HO-1 and NQO1 was assayed to verify this mechanism. RESULTS: Pretreatment of 10 µmol/Llycopene raised cellular viability of L02 cells on H_2O_2 culturing condition, reduced cellular ROS, enhanced enzymatic activity of cellular SOD and GSH-Px, reduced cellular MDA content, and depressed the activity of ALT, AST and LDH in culture medium. Lycopene also increased nuclear Nrf2 protein content and enhanced the expression of its target genes HO-1 and NQO1. CONCLUSION: Lycopene could protect L02 cells from H_2O_2 induced oxidative damage, probably by promoting nuclear-translocation of Nrf2 and activating expression of its target antioxidant genes.

Development and Validation of a Machine Learning Model for Bone Metastasis in Prostate Cancer: Based on Inflammatory and Nutritional Indicators.

OBJECTIVE: To establish a predictive model for prostate cancer bone metastasis utilizing multiple machine learning algorithms. METHODS: Retrospective analysis of the clinical data of prostate cancer initially diagnosed in the Department of Urology of Gansu Provincial People's Hospital from June 2017 to June 2022. Logistic regression (LR) and least absolute shrinkage and selection operator (LASSO) are used to jointly screen the model features. The filtered features are incorporated into algorithms including LR, random forest (RF), extreme gradient boosting (XGBoost), naive Bayes (NB), k-nearest neighbor (KNN), and decision tree (DT), to develop prostate cancer bone metastasis models. RESULTS: A total of 404 patients were finally screened. Gleason score, T stage, N stage, PSA, and ALP were used as features for modeling. The average AUC of the 5-fold cross-validation for each machine learning model in the training set is as follows: LR (AUC=0.9054), RF (AUC=0.9032), NB (AUC=0.8961), KNN (AUC=0.8704), DT (AUC=0.8526), XGBoost (AUC=0.8066). The AUC of each machine learning model in the test set is KNN (AUC=0.9390, 95%CI: 0.8760-1), RF (AUC=0.9290, 95%CI: 0.8718-0.9861), NB (AUC=0.9268, 95%CI: 0.8615-0.9920), LR (AUC=0.9212, 95%CI: 0.8506-0.9917), XGBoost (AUC=0.8292, 95%CI: 0.7442-0.9141), DT (AUC=0.8057, 95%CI: 0.7100-0.9014). A comprehensive evaluation showed that LR performed well in interpretability and clinical applications. CONCLUSION: A bone metastasis model of prostate cancer was established, and it was observed that indicators such as inflammation and nutrition had a weak correlation with bone metastasis.

Occupant behavior, thermal environment, and appliance electricity use of a single-family apartment in China.

The household is the basic unit of a residential community or building. High-resolution, long-term open data are necessary to help study residential electricity consumption, smart home technologies, and electricity flexibility technologies at household level. This paper introduces an IoT-based data collection platform (IDCP) consisting of gateways, sensors, and cloud servers. This platform can collect data on the occupant presence, indoor environment, window-opening states, and appliance electricity consumption simultaneously. This study deployed the IDCP in a single-family apartment in Beijing, China, and compiled a dataset, namely, CN-OBEE, including data on the per-minute occupant behavior, thermal environment, and appliance electricity use of the apartment for an entire year (from May 31, 2021, to May 31, 2022), and hourly meteorological data collected by the nearest national weather station during the same period. This dataset is the first detailed and publicly available occupant behavior and electricity use dataset for Chinese homes. As a regional feature, the dataset compiled by this study includes window-opening behavior and the use of split air conditioners (ACs).

Translation, cultural adaptation, and validation of Numerical Pain Rating Scale and Global Rating of Change in Tibetan musculoskeletal trauma patients.

Tibetan-speaking patients seeking care in predominantly Mandarin-speaking healthcare settings frequently face communication barriers, leading to potential disparities and difficulties in accessing care. To address this issue, we translated, culturally adapted, and validated the Numerical Pain Rating Scale (NPRS) and the Global Rating of Change (GRoC) into Tibetan (NPRS-Tib and GRoC-Tib), aiming to facilitate cross-linguistic and cross-cultural interactions while examining potential challenges in the adaptation process. Using standard translation-backward translation methods, expert review, pilot testing, and validation through a cross-sectional study with a short-term longitudinal component, we engaged 100 Tibetan patients with musculoskeletal trauma for psychometric validation, including 37 women (aged 22-60 years, mean age 39.1 years). The NPRS-Tib and GRoC-Tib exhibited outstanding psychometric properties, with an Intraclass Correlation Coefficient (ICC) of 0.983 for NPRS-Tib indicating superb test-retest reliability, and expert review confirming good content validity for both instruments. A Spearman's correlation coefficient (Rho) of -0.261 (P = 0.0087) revealed a significant, albeit weak, correlation between changes in NPRS-Tib scores and GRoC-Tib scores. The adaptation process also presented notable challenges, including translation discrepancies from translators' diverse backgrounds and levels of expertise, ambiguity in scale options, and the lack of established tools for criterion validity assessment in Tibetan.

Development of a stable biosensor based on a SiO2 nanosheet-Nafion-modified glassy carbon electrode for sensitive detection of pesticides.

SiO(2) nanosheets (SNS) have been prepared by a chemical method using montmorillonite as raw material and were characterized by scanning electron microscopy and X-ray diffraction. SiO(2) nanosheet-Nafion nanocomposites with excellent conductivity, catalytic activity, and biocompatibility provided an extremely hydrophilic surface for biomolecule adhesion. Chitosan was used as a cross-linker to immobilize acetylcholinesterase (AChE), and Nafion was used as a protective membrane to efficiently improve the stability of the AChE biosensor. The AChE biosensor showed favorable affinity for acetylthiocholine chloride and catalyzed the hydrolysis of acetylthiocholine chloride with an apparent Michaelis-Menten constant of 134 µM to form thiocholine, which was then oxidized to produce a detectable and fast response. Based on the inhibition by pesticides of the enzymatic activity of AChE, detection of the amperometric response from thiocholine on the biosensor is a simple and effective way to biomonitor exposure to pesticides. Under optimum conditions, the biosensor detected methyl parathion, chlorpyrifos, and carbofuran at concentrations ranging from 1.0 × 10(-12) to 1 × 10(-10) M and from 1.0 × 10(-10) to 1 × 10(-8) M. The detection limits for methyl parathion, chlorpyrifos, and carbofuran were 5 × 10(-13) M. The biosensor developed exhibited good sensitivity, stability, reproducibility, and low cost, thus providing a new promising tool for analysis of enzyme inhibitors.

Predictive role of pretreatment skeletal muscle mass index for long-term survival of bladder cancer patients: A meta-analysis.

PURPOSE: To identify the predictive role of pretreatment skeletal muscle mass index (SMI) for long-term survival of bladder cancer patients. METHODS: Several databases were searched for studies investigating the relationship between pretreatment SMI and prognosis in bladder cancer. The overall survival (OS) and cancer-specific survival (CSS) were defined as primary and secondary outcomes, respectively. Hazard ratios (HRs) and 95% confidence intervals (CIs) were combined. RESULTS: Nine studies involving 1476 cases were included. The results demonstrated that a lower pretreatment SMI was significantly related to poorer OS (HR = 1.56, 95% CI: 1.33-1.82, P<0.001) and subgroup analysis based on thresholds of SMI revealed similar results. Besides, pretreatment SMI was also obviously related to CSS (HR = 1.75, 95% CI: 1.36-2.25, P<0.001). CONCLUSION: Lower pretreatment SMI was associated with worse long-term survival of bladder cancer patients.

Effect of glenohumeral ligaments on posterior shoulder stabilization: a biomechanical study.

OBJECTIVES: To theoretically confirm that the glenohumeral ligament (GHL), specifically the inferior glenohumeral ligament (IGHL), plays an important role in posterior shoulder stability in different postures, and to provide reference for clinical diagnosis and treatment of posterior shoulder instability (PSI). MATERIALS AND METHODS: In this retrospective study, bone-ligament-bone models were established in 15 fresh adult shoulder joint specimens and selective cutting was performed for analysis. The humeral head was loaded posteriorly at a central pressure of 22N using the INSTRON8874 biomechanical testing system and the load-displacement curve was plotted. The posterior displacement of the humeral head was measured after continuous cutting of the following structures: (1) complete; (2) superior glenohumeral ligament (SGHL); (3) SGHL + middle glenohumeral ligament (MGHL); (4) SGHL + MGHL + IGHL; (5) MGHL; (6) MGHL + IGHL; (7) anterior-bundle IGHL (IGHL-AB); (8) posterior-bundle IGHL (IGHL-PB); (9) IGHL. The results obtained were analyzed using the SPSS10.0 statistical software. RESULTS: Favorable posterior stability of the complete bone-ligament-bone model was observed, with an average displacement of 11.32±3.89 mm. The displacement of SGHL and SGHL + MGHL groups was not significantly increased compared with that in the complete group (P>0.05). After cutting of SGHL + MGHL + IGHL, the posterior displacement of all angles increased (P<0.05), resulting in PSI that was manifested in dislocation or subluxation. There was no obvious increase in posterior displacement after cutting the IGHL-AB (P>0.05). Significantly increased posterior displacement was observed at 45° abduction after cutting the IGHL-PB compared with the complete group, but not at the 90° abduction. The posterior displacement increased obviously at both 45° and 90° abduction when the IGHL was completely cut off (P<0.05). CONCLUSIONS: Repairing the IGHL plays a certain role in rebuilding the posterior stability of the shoulder joint. Detecting the function of the IGHL in the abduction and external rotation positions of the shoulder joint has certain significance for diagnosing PSI.

Literature review, report, and analysis of genotype and clinical phenotype of a rare case of ulnar-mammary syndrome.

Objective: The clinical characteristics of Ulnar-mammary syndrome (UMS) caused by mutations in TBX3 (T-Box transcription factor 3) were studied and the correlation between genotype and clinical phenotype were analyzed to improve awareness and early diagnosis of the disease. Methods: The clinical data of a boy aged 13 years and 5 months with left forearm deformity and growth retardation as the main features were analyzed. Genomic exon detection was performed, and the results were verified by Sanger sequencing. Simultaneously, we performed literature review to analyze the correlation between clinical phenotypes and genotypes. Results: The clinical manifestations in the child were short stature, ulnar hypoplasia of the forearm, hypohidrosis, retracted nipple, micropenis, and cryptorchidism. Laboratory examination revealed hyperthyroidism, growth hormone deficiency, and hypogonadotropic hypogonadism. Imaging results displayed delayed bone age, small pituitary gland, and persistence of Rathke's cleft cyst. The results of the exome sequencing revealed the deletion of AGA at positions 1121-1,124 of TBX3, which resulted in a frameshift mutation (c.1121-1124del AGAG; pGlu374fs). According to the American College of Medical Genetics (ACMG) assessment, the mutation is a pathogenic variant. A definitive diagnosis of UMS was made on the basis of the clinical phenotype of the patient. The Chinese and English literature were reviewed to analyze the correlation between TBX3 genotype and clinical phenotype. Conclusion: UMS is a rare hereditary disease caused by mutations in TBX3. There is significant clinical heterogeneity associated with the variants of this gene. To our knowledge, this mutation site in TBX3 has been reported for the first time, thereby expanding the mutation spectrum of this gene.

SurgSmart: an artificial intelligent system for quality control in laparoscopic cholecystectomy: an observational study.

BACKGROUND: The rate of bile duct injury in laparoscopic cholecystectomy (LC) continues to be high due to low critical view of safety (CVS) achievement and the absence of an effective quality control system. The development of an intelligent system enables the automatic quality control of LC surgery and, eventually, the mitigation of bile duct injury. This study aims to develop an intelligent surgical quality control system for LC and using the system to evaluate LC videos and investigate factors associated with CVS achievement. MATERIALS AND METHODS: SurgSmart, an intelligent system capable of recognizing surgical phases, disease severity, critical division action, and CVS automatically, was developed using training datasets. SurgSmart was also applied in another multicenter dataset to validate its application and investigate factors associated with CVS achievement. RESULTS: SurgSmart performed well in all models, with the critical division action model achieving the highest overall accuracy (98.49%), followed by the disease severity model (95.45%) and surgical phases model (88.61%). CVSI, CVSII, and CVSIII had an accuracy of 80.64, 97.62, and 78.87%, respectively. CVS was achieved in 4.33% in the system application dataset. In addition, the analysis indicated that surgeons at a higher hospital level had a higher CVS achievement rate. However, there was still considerable variation in CVS achievement among surgeons in the same hospital. CONCLUSIONS: SurgSmart, the surgical quality control system, performed admirably in our study. In addition, the system's initial application demonstrated its broad potential for use in surgical quality control.