Screening of characteristic biomolecules related to bladder cancer based on construction of ceRNA regulation network.

OBJECTIVES: The purpose of this study is to screen bladder cancer-associated biomarkers by combining lncRNA, miRNA, and mRNA expression profile of bladder cancer, and to explore bladder cancer-associated tumor markers by constructing a ceRNA regulation network. METHODS: Bladder cancer mRNA and miRNA samples were downloaded from the TCGA database; the lncRNA and mRNA detected in the RNA-seq expression profile were identified using the HUGO Gene Nomenclature Committee database. RESULTS: Screening for significant differentially expressed RNA resulted in 1693 mRNAs, 66 lncRNAs, and 130 miRNAs. Then, the significant differently expressed RNAs from the screening were subjected to annotation analysis of GO functional nodes and KEGG signaling pathways. A ceRNA regulation network consisting of lncRNA-miRNA-mRNA was constructed by synthesizing lncRNA-miRNA and miRNA-mRNA. Finally, a ceRNA regulation network consisting of two lncRNAs, one miRNA, and three mRNAs was obtained. KM remodeling curve analysis was performed for each factor. CONCLUSIONS: In bladder cancer tumor samples, samples down-regulated by LINC01198, PPTRD-AS1, has-miR-216a, SEMA3D, EPHA5, and DCLK1 had a good overall survival prognosis, indicating that these several characteristic target molecules were found to be high-risk factors for bladder cancer tumors.

Catastrophic thoracolumbar spinal massive hematoma triggered by intraspinal anesthesia puncture: A CARE-compliant case report.

RATIONALE: Intraspinal anesthesia, the most common anesthesia type of orthopedic operation, is regarded as safe and simple. Despite of the rare incidence, puncture related complication of intraspinal anesthesia is catastrophic for spinal cord. Here we present an intradural hematoma case triggered by improper anesthesia puncture. The principal reason of this tragedy was rooted in the neglect of spine deformities diagnosis before anesthesia. To the best of our knowledge, there is no specific case report focusing on the intradural hematoma triggered by improper anesthesia puncture. PATIENT CONCERNS: Hereby a case of thoracolumbar spinal massive hematoma triggered by intraspinal anesthesia puncture was reported. The presenting complaint of the patient was little neurologic function improvement after surgery at 6-month follow-up. DIAGNOSES: Emergency MRI demonstrated that massive spindle-like intradural T2-weighted image hypointense signal masses from T12 to S2 badly compressed the dural sac ventrally, and his conus medullaris was at L3/4 intervertebral level with absence of L5 vertebral lamina. Hereby, the diagnoses were congenital spinal bifida, tethered cord syndrome, spine intradural hematoma, and paraplegia. INTERVENTIONS: Urgent surgical interventions including laminectomy, spinal canal exploration hematoma removal, and pedicle fixation were performed. The patient received both medication (mannitol, mecobalamin, and steroids) and rehabilitation (neuromuscular electric stimulation, hyperbaric oxygen). OUTCOMES: Postoperation, he had regained only hip and knee flexion at II grade strength. His neurologic function was unchanged until 3 weeks postoperation. Six-month follow-up showed just little neurologic function improvement, and the American Spinal Injury Association grade was C. LESSONS: By presenting an intradural hematoma case triggered by improper anesthesia puncture, we shared the treatment experience and discussed the potential mechanism of neurologic compromise. The principal reason for this tragedy is preanesthesia examination deficiency. Necessary radiology examinations must be performed to prevent misdiagnosis for spinal malformation.

A 6­gene risk score system constructed for predicting the clinical prognosis of pancreatic adenocarcinoma patients.

Pancreatic adenocarcinoma (PAC) is the most common type of pancreatic cancer, which commonly has an unfavorable prognosis. The present study aimed to develop a novel prognostic prediction strategy for PAC patients. mRNA sequencing data of PAC (the training dataset) were extracted from The Cancer Genome Atlas database, and the validation datasets (GSE62452 and GSE79668) were acquired from the Gene Expression Omnibus database. The differentially expressed genes (DEGs) between good and poor prognosis groups were analyzed by limma package, and then prognosis­associated genes were screened using Cox regression analysis. Subsequently, the risk score system was constructed and confirmed using Kaplan­Meier (KM) survival analysis. After the survival associated­clinical factors were screened using Cox regression analysis, they were performed with stratified analysis. Using DAVID tool, the DEGs correlated with risk scores were conducted with enrichment analysis. The results revealed that there were a total of 242 DEGs between the poor and good prognosis groups. Afterwards, a risk score system was constructed based on 6 prognosis­associated genes (CXCL11, FSTL4, SEZ6L, SPRR1B, SSTR2 and TINAG), which was confirmed in both the training and validation datasets. Cox regression analysis showed that risk score, targeted molecular therapy, and new tumor (the new tumor event days after the initial treatment according to the TCGA database) were significantly related to clinical prognosis. Under the same clinical condition, 6 clinical factors (age, history of chronic pancreatitis, alcohol consumption, radiation therapy, targeted molecular therapy and new tumor (event days) had significant associations with clinical prognosis. Under the same risk condition, only targeted molecular therapy was significantly correlated with clinical prognosis. In conclusion, the 6­gene risk score system may be a promising strategy for predicting the outcome of PAC patients.