Atypical and delayed spinal cord MRI features of COVID-19-associated myelopathies: a report of four cases and literature review.

We reported four patients with coronavirus disease 2019 (COVID-19)-associated myelopathies, highlighting the delayed and atypical spinal cord magnetic resonance imaging (MRI) features and the literature review. All four patients were males, aged 37 to 72 years old. The latencies from COVID-19 to the onset of myelitis were 5, 15, 30, and 80 days. The initial symptoms were numbness and weakness of lower limbs in three cases, and back pain with weakness of lower limbs in one case. The peak symptoms included paraplegia, sphincter dysfunction, sensory disturbance level, and spastic gait. The EDSS scores were 7.5, 9.0, 9.0, and 7.5, respectively. Magnetic resonance imaging (MRI) showed delayed atypical spinal cord lesions at onset, i.e., two cases without lesions, one with linear spinal meningeal enhancement, and one with punctate lesions on T2-weighted imaging (T2WI). During the follow-up period, punctate, linear, and cloudy lesions in the lateral and posterior funiculus were seen on T2WI in the peak stage. The prominent features of spinal cord lesions were linear spinal meningeal enhancement, the mismatch of deteriorated clinical symptoms, and inapparent MRI findings. All four patients were left with an obvious disability, with two patients completely bedridden and two who could stand with support. This report highlights the recognition of COVID-19-associated myelopathy even months after initial infection, especially in patients with delayed and atypical spinal cord findings on MRI.

Selenium-oxidizing Agrobacterium sp. T3F4 decreases arsenic uptake by Brassica rapa L. under a native polluted soil.

Toxic arsenic (As) and trace element selenium (Se) are transformed by microorganisms but their complex interactions in soil-plant systems have not been fully understood. An As- and Se- oxidizing bacterium, Agrobacterium sp. T3F4, was applied to a native seleniferous As-polluted soil to investigate As/Se uptake by the vegetable Brassica rapa L. and As-Se interaction as mediated by strain T3F4. The Se content in the aboveground plants was significantly enhanced by 34.1%, but the As content was significantly decreased by 20.5% in the T3F4-inoculated pot culture compared to the control (P < 0.05). Similar result was shown in treatment with additional 5 mg/kg of Se(IV) in soil. In addition, the As contents in roots were significantly decreased by more than 35% under T3F4 or Se(IV) treatments (P<0.05). Analysis of As-Se-bacterium interaction in a soil simulation experiment showed that the bioavailability of Se significantly increased and As was immobilized with the addition of the T3F4 strain (P < 0.05). Furthermore, an As/Se co-exposure hydroponic experiment demonstrated that As uptake and accumulation in plants was reduced by increasing Se(IV) concentrations. The 50% growth inhibition concentration (IC50) values for As in plants were increased about one-fold and two-fold under co-exposure with 5 and 10 µmol/L Se(IV), respectively. In conclusion, strain T3F4 improves Se uptake but decreases As uptake by plants via oxidation of As and Se, resulting in decrease of soil As bioavailability and As/Se competitive absorption by plants. This provides a potential bioremediation strategy for Se biofortification and As immobilization in As-polluted soil.

Comprehensive analysis of m6A related gene mutation characteristics and prognosis in colorectal cancer.

BACKGROUND: Colorectal cancer is considered as the second most common cancer worldwide. Studies have shown that m6A RNA methylation abnormalities play an important role in the pathogenesis of many human diseases, including cancer. The current study was designed to characterize the mutation of m6A related genes and explore their prognostic role in colorectal cancer. METHODS: RNA-seq data and somatic mutation data of TCGA-COAD and TCGA-READ were downloaded from UCSC xena for comprehensive analysis. M6A related genes were selected from previous literatures, including "Writer" protein (METTL3, METTL5, METTL14, METTL16, ZC3H13, RBM15, WTAP, KIAA1429), "Reader" protein YTHDF1, YTHDF2, YTHDF3, YTHDC1, YTHDC2, HNRNPC, IGF2BP1, IGF2BP2, IGF2BP3), and "Eraser" protein (FTO, ALKBH5). Kaplan-Meier diagrams were used to explore the correlation between m6A-related genes and colorectal cancer prognosis. The correlations between m6A-related genes and clinical parameters and immune-related indicators were explored by Spearman correlation analysis. And finally, the expression patterns of five key genes (RBMX, FMR1, IGF2BP1, LRPPRC and YTHDC2) were detected by qPCR in CRC specimens. RESULTS: In CRC, the expressions of m6A-related genes were significantly different between CRC and normal control except METTL14, YTHDF2, YTHDF3. Some of CRC patients (178 in 536) have a m6A-related genes mutation. ZC3H13 has highest mutation frequency of all m6A-related genes. M6A-related genes mainly enrich in regulation of mRNA metabolic process pathway. Patients with high expressions of FMR1, LRPPRC, METTL14, RBMX, YTHDC2, YTHDF2, YTHDF3 have poor prognosis in CRC. There was a significant correlation between the FMR1, LRPPRC, RBMX, YTHDC2, IGF2BP1 expression and the clinical characteristics of CRC. In addition, these genes are significantly associated with immune-related indicators. According to the expression patterns of FMR1, LRPPRC, RBMX, YTHDC2, and IGF2BP1, patients with CRC were clustered into two groups, and their survival was significantly different. By evaluating the tumor microenvironment in two clusters using ssGSEA, expressions of immune checkpoints and GSVA enrichment analysis, we observed that the immune and stem cell index of two cluster were much different. The qPCR results showed that RBMX expression was markedly elevated in cancerous tissues than in the normal colonic tissues. CONCLUSION: Our study identified novel prognostic markers associated with immune of CRC cancer patients. Moreover, the potential mechanisms of prognostic markers in regulating the etiology of CRC cancer were investigated. These findings enrich our understanding of the relationships between m6a related genes and CRC, and may provide novel ideas in the therapy of CRC patients.

Comparison of Intercostal Block and Epidural Analgesia for Post-thoracotomy: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

BACKGROUND: Thoracotomy is associated with severe postoperative pain. Effective management of acute pain after thoracotomy may reduce complications and chronic pain. Epidural analgesia (EPI) is considered the gold standard for postthoracotomy analgesia; however, it is associated with complications and limitations. Emerging evidence suggests that an intercostal nerve block (ICB) has a low risk of severe complications. Anesthetists will benefit from a review that assesses the advantages and disadvantages associated with ICB and EPI in thoracotomy. OBJECTIVES: This meta-analysis aimed to evaluate the analgesic efficacy and adverse effects of ICB and EPI for pain treatment after thoracotomy. STUDY DESIGN: Systematic review. METHODS: This study was registered in the International Prospective Register of Systematic Reviews (CRD42021255127). Relevant studies were searched for in PubMed, Embase, Cochrane, and Ovid databases. Primary (postoperative pain at rest and during cough) and secondary (nausea and vomiting, morphine consumption, and length of hospital stay) outcomes were analyzed. The standard mean difference for continuous variables and the risk ratio for dichotomous variables were calculated. RESULTS: Nine randomized controlled studies with a total of 498 patients who underwent thoracotomy were included. The results of the meta-analysis demonstrated no statistically significant differences between the 2 methods in terms of the Visual Analog Scale scores for pain at 6-8, 12-15, 24-25, and 48-50 hours at rest and at 24 hours during coughing after surgery. There were no significant differences in nausea and vomiting, morphine consumption, or length of hospital stay between the ICB and EPI groups. LIMITATIONS: The number of included studies was small, and the quality of evidence was low. CONCLUSIONS: ICB may be as effective as EPI for pain relief after thoracotomy.

Coal Structure Characteristics in the Northern Qinshui Basin and Their Discrimination Method Based on the Particle Size of Drilling Cuttings.

Coal structure, including primary coal, cataclastic coal, granulated coal, and mylonitized coal, is one of the key factors controlling coal and gas outburst, and it also determines the efficiency of coalbed methane (CBM) extraction. Therefore, it is significant to identify the characteristics of coal structures and to predict them in advance. In this work, the spatial distribution, mechanical properties, and microscopic morphology of the four coal structures from the No. 3 coal seam of the Xinyuan Mine in the northern part of the Qinshui Basin were investigated through the in situ observation in the roadway, the hardness coefficient (f) test, and the scanning electron microscope analysis. Moreover, the drilling cuttings from the gas pressure releasing holes were sampled and sieved, and then, the correspondence between different coal structures and the particle size of the cuttings was analyzed quantitatively based on the Rosin-Rammler model. The result shows that the spatial distribution of the coal structure has strong heterogeneity in the vertical and lateral directions. The f value decreases successively with the increase in coal structure deformation, which indicate that f can directly characterize the coal structure. Furthermore, the relations between f and drilling cutting average particle size (d 0), crushability indicator (n), crushing degree index (λ), and the median diameter (d 50) were established. Specifically, the coal deformation degree is positively correlated with the mass fraction of large particles in the cuttings under the same drilling parameters. Overall, as f increases, d 0 and d 50 decrease, and n and λ increase. However, parameters d 0, d 50, and λ of granulated coal are inconsistent with other coal structures, and mylonitized coal is inconsistent with other coal structures in n, as a result of the coal structure broken characteristics itself and the difference in the stress state between the coal and the drill bit during the rock breaking process. Ultimately, the coal structures determined by the surface CBM well logging curve and the cuttings particle size method were compared, and they have a high degree of coincidence in the distinction between primary coal and tectonic coal.

Analysis of influencing factors of rehabilitation treatment effect in patients with first-episode stroke.

OBJECTIVE: To explore the influencing factors of rehabilitation treatment effect in patients with first-episode stroke and provide a theoretical basis for clinical practice. METHODS: The clinical data of patients with first-episode stroke who received rehabilitation treatment in our hospital from January 2015 to January 2019 were collected and analyzed retrospectively. The Modified Barthel Index (MBI) and Frenchay Activity Scale (FAS) were used to evaluate the rehabilitation treatment effect. Spearman rank correlation analysis was carried out to investigate the relationship between the data characteristics and rehabilitation treatment effect, and univariate and multivariate logistic regression analyses were conducted to explore the independent factors influencing the rehabilitation treatment effect in the first-episode stroke group. RESULTS: In this study, 786 cases of 873 patients with first-episode stroke were included, with an effective inclusion rate of 90.0%. Univariate analysis showed that MBI and FAS scores were statistically different among patients with different ages, history of hypertension, the number of residual symptoms, depression status, attitude towards rehabilitation, starting time of rehabilitation, rehabilitation treatment duration, and family environment scores (all P<0.05). According to the Spearman rank correlation analysis, age, residual symptoms, depressive status, and starting time of rehabilitation were all negatively correlated with MBI score (r = -0.584, -0.683, -0.573, -0.783) and FAS score (r = -0.438, -0.771, -0.552, -0.599), while the scores of MBI (r = 0.683, 0.572, 0.662) and FAS (r = 0.735, 0.603, 0.724) were positively correlated with the scores of rehabilitation treatment attitude, rehabilitation treatment duration and family environment (all P<0.05). Moreover, according to multivariate logistic regression analysis, age, the number of remaining symptoms, depression status, attitude towards rehabilitation treatment, starting time of rehabilitation treatment, rehabilitation treatment duration, and family environment score could independently affect MBI and FAS scores of patients with stroke (all P<0.05). CONCLUSION: Age, the number of residual symptoms, depression status, attitude towards rehabilitation treatment, starting time of rehabilitation treatment, rehabilitation treatment duration, and family environment score are independent factors for rehabilitation treatment effect in patients with first-episode stroke.