A multi-stage ensemble network system to diagnose adolescent idiopathic scoliosis.

OBJECTIVES: To develop a deep learning algorithm to automatically evaluate and diagnose scoliosis on full spinal X-ray images. METHODS: This retrospective study collected full spinal X-ray images (anteroposterior) from four hospital databases from January 1, 2018, to March 31, 2021. The data were divided into training and validation sets. Full spinal X-ray images for external validation were independently collected at one hospital from April 1, 2021, to June 30, 2021. Model effectiveness was validated with a public dataset. Statistical software R was used to analyze the accuracy and sensitivity of the model curvature and anatomical balance parameters and assess interrater consistency. RESULTS: This study included 788 and 185 training and test datasets, respectively. The accuracy and recall of the algorithm model for the Cobb angle, apical vertebrae (AV), upper vertebrae, and lower vertebrae were 89.36%, 85.71%, 77.2%, and 80.24% and 97.35%, 93.38%, 84.11%, and 87.42%, respectively. The symmetric mean absolute percentage error at the Cobb angle was 5.99%, and the automatic measurement time was 1.7 s. The mean absolute error values of the Cobb angle and the distances between the center sacral vertical line and AV and C7 plumb line were 1.07° and 1.12 and 1.38 mm, respectively. Statistical analysis confirmed that the Cobb angle results were in good agreement with the gold standard (interclass coefficients of 0.996, 0.978, and 0.825; p < 0.001). CONCLUSION: Our deep learning algorithm model had high sensitivity and accuracy for scoliosis, which could help radiologists improve their diagnostic efficiency. KEY POINTS: • Our deep learning algorithm model had high sensitivity and accuracy for scoliosis, which could help radiologists improve their diagnostic efficiency. • Multi-center validation data were used in this study to guarantee the reliability of the research. • Algorithmic model measures 200 times faster than radiologists.

Circular RNA hsa_circ_0001658 Inhibits Intervertebral Disc Degeneration Development by Regulating hsa-miR-181c-5p/FAS.

METHODS: We obtained microarray data (GSE116726, GSE67566) from Gene Expression Omnibus database, and differential expression level of ncRNA in nucleus pulposus (NP) tissues of IDD patients was analyzed. The potential circRNA-miRNA-mRNA regulatory network was analyzed by starBase. The effect of the interaction between hsa_circ_0001658, hsa-miR-181c-5p, and FAS on the proliferation and apoptosis of human neural progenitor cells (hNPCs) was studied. RESULTS: hsa_circ_0001658 was significantly upregulated (logFC > 2.0 and adj.P.Val < 0.01) in the NP tissues of IDD patients, and hsa-miR-181c-5p expression was downregulated (logFC < -2.0 and adj.P.Val < 0.01). Silencing of hsa-miR-181c-5p or overexpression of hsa_circ_0001658 inhibited the proliferation of hNPCs and promoted their apoptosis. hsa_circ_0001658 acted as a sponge of hsa-miR-181c-5p. hsa-miR-181c-5p downregulated the expression of Fas cell surface death receptor (FAS), promoted the proliferation, and inhibited the apoptosis of hNPCs. hsa_circ_0001658 functioned in hNPCs through targeting hsa-miR-181c-5p/FAS. CONCLUSION: Circular RNA hsa_circ_0001658 inhibits IDD development by regulating hsa-miR-181c-5p/FAS. It is expected to be a potential target for the therapy of IDD.

Identification of aberrantly methylated-differentially expressed genes and potential agents for Ewing sarcoma.

BACKGROUND: Human DNA methylation is a common epigenetic regulatory mechanism, and it plays a critical role in various diseases. However, the potential role of DNA methylation in Ewing sarcoma (ES) is not clear. This study aimed to explore the regulatory roles of DNA methylation in ES. METHODS: The microarray data of gene expression and methylation were downloaded from the Gene Expression Omnibus (GEO) database, and analyzed via GEO2R. Venn analysis was then applied to identify aberrantly methylated-differentially expressed genes (DEGs). Subsequently, function and pathway enrichment analysis was conducted, a protein-protein interaction (PPI) network was constructed, and hub genes were determined. Besides, a connectivity map (CMap) analysis was performed to screen bioactive compounds for ES treatment. RESULTS: A total of 135 hypomethylated high expression genes and 523 hypermethylated low expression genes were identified. The hypomethylated high expression genes were enriched in signal transduction and the apoptosis process. Meanwhile, hypermethylated low expression genes were related to DNA replication and transcription regulation. The PPI network analysis indicated C3, TF, and TCEB1 might serve as diagnostic and therapeutic targets of ES. Furthermore, CMap analysis revealed 6 chemicals as potential options for ES treatment. CONCLUSIONS: The introduction of DNA methylation characteristics over DEGs is helpful to understand the pathogenesis of ES. The identified hub aberrantly methylated DEGs and chemicals might provide some novel insights on ES treatment.

[Analysis of intraoperative complications of microendoscopic disectomy and corresponding preventive measures].

OBJECTIVE: To analyze the reasons of intraoperative complications of microendoscopic disectomy (MED) and corresponding preventive measures. METHODS: From October 2001 to January 2012, the data of 851 patients with lumbar disc herniation underwent MED were retrospectively analyzed. There were 469 males and 382 females with an average age of 42.5 years ranging 16 to 75. Course of disease was from 1 to 18 months with an average of 3 months. The segments of herniated disc including L3,4 of 24 cases, L4,5 of 418 cases and L5S1 of 409 cases . Main symptoms included low back pain with lower extremity radial pain and numbness. Of them,unilateral lower extremity symptom was in 729 cases and bilateral symptom was in 122 cases. There were at least 2 abnormal signs in the four signs which including feeling anormaly, muscle strength anormaly,dysreflexia and muscle atrophy. Distraction test of nerve was positive. CT or MRI findings must coincide with the clinical symptoms and signs. No lumbar instability,spinal stenosis,the upper lumbar disc herniation or combined with cauda equina nerve syndrome were found in 851 patients. The intraoperative complications were recorded and analyzed for the reasons of the intraoperative complication and related prevention measures. RESULTS: According to the Macnab standard,424 cases obstained excellent results, 321 good,106 fair,with excellent and good rate of 87.5%. The result was similar to the traditional open operation. One cases transferred to open operation due to equipment breakdown, case died for myocardial infarction at 11 days after the operation, 2 cases occurred acute epidural hematoma in 1 hour after operation. Injury of dura mate of spinal cord occurred in 28 cases and incidence rate was 3.29%(28/851); traction injury of nerve root occurred in 38 cases and incidence rate was 4.46% (38/851). One case occurred in retroperitoneal hematoma, 2 cases in incomplete cauda equina injury and 2 cases in incomplete nerve root breakage. CONCLUSION: Skilled endoscopic hemostasis techniques,careful and meticulous operation is very important for the prevention of intraoperative complications. Moreover,timely finding and treating the complications was effective measures to prevent the coniplications.