Reconstructive treatment using stent placement for type IIa+b lateral sinus dural arteriovenous fistulas complicated with sinus occlusion.

BACKGROUND: Cognard type IIa+b dural arteriovenous fistulas (DAVFs) in the lateral sinuses are often complicated with venous sinus obstruction and accompanied by clinical symptoms and a risk of hemorrhage. The purpose of this study was to assess venous sinus stenting as a viable alternative treatment in complex lateral sinus DAVFs and examine its efficacy and safety. METHODS: We retrospectively examined patients diagnosed with type IIa+b DAVF in the transverse or sigmoid sinus with associated venous sinus occlusion who were treated via stent placement between April 2017 and June 2019. RESULTS: Six patients were included in this study. Three patients had DAVFs in both the transverse and sigmoid sinuses, two in the transverse sinus and confluence of sinuses, and one in the transverse sinus. The most common symptoms were headache, dizziness, and limb weakness. At the last follow-up, three patients had significant improvement, and three were asymptomatic. Angiograms performed immediately after the surgery showed restoration of the anterograde venous drainage in all patients. According to the follow-up angiography results, two DAVFs were completely obliterated, and four remained as stable type I DAVFs. Most patients had satisfactory venous sinus drainage, except one who had in-stent stenosis. CONCLUSIONS: Stent placement can restore sinus patency, improve clinical symptoms, and decrease intracranial hemorrhage risk. This approach may be an effective option for treating type IIa+b lateral DAVFs complicated by sinus occlusion.

BioLadder: A bioinformatic platform primarily focused on proteomic data analysis.

BioLadder (https://www.bioladder.cn/) is an online data analysis platform designed for proteomics research, which includes three classes of experimental data analysis modules and four classes of common data analysis modules. It allows for a variety of proteomics analyses to be conducted easily and efficiently. Additionally, most modules can also be utilized for the analysis of other omics data. To facilitate user experience, we have carefully designed four different kinds of functions for customers to quickly and accurately utilize the relevant analysis modules.

Development and validation of a nomogram incorporating multi-parametric MRI and hematological indicators for discriminating benign from malignant central prostatic nodules: a retrospective analysis.

BACKGROUND: Prostate cancer poses a significant risk to men's health. In this study, a model for differentiating benign and malignant nodules in the central region of the prostate was constructed by combining multi-parametric MRI and hematological lab values. METHODS: This retrospective study analyzed the data acquired from Lianyungang First People's Hospital and The Second Affiliated Hospital of Hainan Medical College from January 2018 to December 2021. We included 310 MRI-confirmed prostatic nodule patients. The data were split into a training set (260 cases) and an external validation set (50 cases), with the latter exclusively from The Second Affiliated Hospital of Hainan Medical College to test the model's generalizability. Univariate and multivariate logistic regression identified critical measurements for differentiating prostate cancer (PCa) from benign prostatic hyperplasia (BPH), which were then integrated into a nomogram model. RESULTS: The key indicators determined by multivariate logistic regression analysis included apparent diffusion coefficient (ADC), standard deviation (StDev), neutrophil to lymphocyte ratio (NLR), and prostate specific antigen (PSA). The nomogram's performance, as indicated by the area under the curve (AUC), was 0.844 (95% CI: 0.811-0.938) in the training set and 0.818 (95% CI: 0.644-0.980) in the external validation set. Calibration and decision curves demonstrated that the nomogram was well-calibrated and could serve as an effective tool in clinical practice. CONCLUSION: The nomogram model based on ADC, StDev, NLR and PSA may be helpful to identify PCa and BPH.

Nattokinase's Neuroprotective Mechanisms in Ischemic Stroke: Targeting Inflammation, Oxidative Stress, and Coagulation.

AIMS: Nattokinase (NK), a potent serine endopeptidase, has exhibited a variety of pharmacology effects, including thrombolysis, anti-inflammation and anti-oxidative stress. Building on previous research highlighting NK's promise in nerve regeneration, our study investigated whether NK exerted protective effects in transient middle cerebral artery occlusion (tMCAO)-induced cerebral ischemia-reperfusion injury and the underlying mechanisms. Results：The rats were administered NK (5000, 10000, 20000 FU/kg, ig, 7 days before surgery, once daily). We showed that NK treatment dose-dependently reduced the infarction volume and improved neurological symptoms, decreased the pro-inflammatory and coagulation cytokines levels, and attenuated reactive oxygen species (ROS) in the infarcted area of tMCAO rats. And we also found that NK could exert neuroprotective effects in a variety of vitro models, including the microglia inflammation model and neuronal oxygen-glucose deprivation/reperfusion (OGD/R) model. Notably, NK effectively countered OGD/R-induced neuron death, modulating diverse pathways including autophagy, apoptosis, PARP-dependent death, and endoplasmic reticulum stress (ERS). Furthermore, the neuroprotection of NK was blocked by PMSF, a serine endopeptidase inhibitor. We revealed that heat-inactivated NK was unable to protect against tMCAO injury and other vitro models, suggesting NK attenuated ischemic injury by its enzymatic activity. We conducted a proteomic analysis and found inflammation and coagulation were involved in the occurrence of tMCAO model and in the therapeutic effect of NK. INNOVATION AND CONCLUSION: In conclusion, these data demonstrated that NK had multifaceted neuroprotective in ischemic brain injury, and the therapeutic effect of NK was related with serine endopeptidase activity.

Relationship between retinal volume changes and the prognosis of BRVO-ME treated with ranibizumab.

Background: This study aimed to evaluate the efficacy of ranibizumab for the treatment of macular edema secondary to branch retinal vein occlusion (BRVO-ME), changes in retinal volume and central retinal thickness (CRT) before and after therapy, and the connection between visual prognosis and changes in retinal volume. Methods: The 120 patients(121 eyes) of BRVO-ME were recruited from July 2020 to October 2022 at the Affiliated Hospital of Weifang Medical University. The clinical data of patients were retrospectively examined for changes in best-corrected visual acuity (BCVA), retinal volume, and CRT at 1 day, 1 week, 1 month, 3 months, 6 months and 1year after treatment. Findings: Visual acuity improved gradually and became steady approximately 1 months after treatment, whereas retinal volume decreased gradually in both the outer and full layers and stabilized around 6 month after treatment. The decline in retinal volume and CRT was more visible in the deeper layers than in the inner levels. A higher correlation was observed between retinal volume and BCVA than between CRT and BCVA. BCVA after one year of treatment had a high correlation with baseline outer retinal volume. Interpretation: Treatment of BRVO-ME with ranibizumab is highly effective, and the recovery of visual function was depends more on early treatment. The outer retina is the major site of edema. Changes in retinal volume may serve as a better predictor of visual prognosis than changes in CRT. Baseline ourter retinal volume is correlated with long-term visual prognosis.

Hepatic Oxidative Stress and Cell Death Influenced by Dietary Lipid Levels in a Fresh Teleost.

Ferroptosis is a form of regulated cell death characterized by iron-dependent lipid peroxidation, affecting physiological and pathological processes. Fatty liver disease associated with metabolic dysfunction is a common pathological condition in aquaculture. However, the exact role and mechanism of ferroptosis in its pathogenesis and progression remains unclear. In this study, an experiment was conducted using different dietary lipid levels in the feeding of largemouth bass (Micropterus salmoides) for 11 weeks. The results revealed that the growth performance and whole-body protein content significantly increased with the elevation of dietary lipid levels up to 12%. The activities of antioxidant enzymes as well as the content of GSH (glutathione) in the liver initially increased but later declined as the lipid levels increased; the contents of MDA (malondialdehyde) and GSSG (oxidized glutathione) demonstrated an opposite trend. Moreover, elevating lipid levels in the diet significantly increased liver Fe2+ content, as well as the expressions of TF (Transferrin), TFR (Transferrin receptor), ACSL4 (acyl-CoA synthetase long-chain family member 4), LPCAT3 (lysophosphatidylcholine acyltransferase 3), and LOX12 (Lipoxygenase-12), while decreasing the expressions of GPX4 (glutathione peroxidase 4) and SLC7A11 (Solute carrier family 7 member 11). In conclusion, the optimal lipid level is 12.2%, determined by WG-based linear regression. Excess lipid-level diets can up-regulate the ACSL4/LPCAT3/LOX12 axis, induce hepatic oxidative stress and cell death through a ferroptotic-like program, and decrease growth performance.

Oxytocin Alleviates Colitis and Colitis-Associated Colorectal Tumorigenesis via Noncanonical Fucosylation.

Colon cancer is increasing worldwide and is commonly regarded as hormone independent, yet recent reports have implicated sex hormones in its development. Nevertheless, the role of hormones from the hypothalamus-hypophysis axis in colitis-associated colorectal cancer (CAC) remains uncertain. In this study, we observed a significant reduction in the expression of the oxytocin receptor (OXTR) in colon samples from both patient with colitis and patient with CAC. To investigate further, we generated mice with an intestinal-epithelium-cell-specific knockout of OXTR. These mice exhibited markedly increased susceptibility to dextran-sulfate-sodium-induced colitis and dextran sulfate sodium/azoxymethane-induced CAC compared to wild-type mice. Our findings indicate that OXTR depletion impaired the inner mucus of the colon epithelium. Mechanistically, oxytocin was found to regulate Mucin 2 maturation through ß1-3-N-acetylglucosaminyltransferase 7 (B3GNT7)-mediated fucosylation. Interestingly, we observed a positive correlation between B3GNT7 expression and OXTR expression in human colitis and CAC colon samples. Moreover, the simultaneous activations of OXTR and fucosylation by l-fucose significantly alleviated tumor burden. Hence, our study unveils oxytocin's promising potential as an affordable and effective therapeutic intervention for individuals affected by colitis and CAC.

MCL restrained ROS/AKT/ASAH1 pathway to therapy tamoxifen resistance breast cancer by stabilizing NRF2.

Tamoxifen resistance is a common and difficult problem in the clinical treatment of breast cancer (BC). As a novel antitumor agent, Micheliolide (MCL) has shown a better therapeutic effect on tumours; however, little is known about MCL and its role in BC therapy. With tamoxifen stimulation, drug-resistant BC cells MCF7TAMR and T47DTAMR obtained a high oxidative status and Amidohydrolase 1 (ASAH1) was abnormally activated. The inhibition of ASAH1 rescued the sensitivity of resistant cells to tamoxifen. We found that MCL inhibited the expression of ASAH1 and cell proliferation, especially in MCF7TAMR and T47DTAMR cells. The high oxidative stress status of resistant cells stimulated the expression of ASAH1 by positively regulating AKT, which was restrained by MCL. MCL activated NRF2 by directly binding to KEAP1 and promoting the antioxidant level of tamoxifen-resistant (TAMR) cells. In addition, ACT001, the prodrug of MCL, significantly inhibited the tumour growth of TAMR cells in preclinical xenograft tumour models. In conclusion, ASAH1 mediates tamoxifen resistance in ER-positive BC cells. MCL could activate the cellular antioxidant system via NRF2/KEAP1 and inhibit ASAH1 expression through the ROS/AKT signalling pathway, thus suppressing cell proliferation. MCL could be used as a potential treatment for TAMR-BC.

Light consistency correction for the liquid crystal tunable filter hyperspectral imaging system.

In hyperspectral images, every pixel encompasses continuous spectral information. Compared with traditional colorimeters, using hyperspectral imaging systems (HIS) for fabric color measurement can result in obtaining richer color information. However, measuring fabric colors with liquid crystal tunable filter HIS can lead to challenges related to light consistency. In this paper, we adopted an innovative approach, integrating gradient boosted decision trees with a sliding window algorithm to develop a uniformity calibration model addressing the illumination uniformity issue. To address the consistency issues across various light sources, we further adopted a deep neural network (DNN) model to correct the reflectance measurements under different light sources. Subsequently, this model was merged with the uniformity calibration model to form a light-consistency correction model. Through calibration, we successfully reduced the color difference of the corrected samples from 3.636 to 0.854, an enhancement of 76.51%. This means that after calibration we can achieve consistency in fabric color measurements under nonuniform lighting and different light sources.

Boron induced multiple quorum-sensing circuits in parallel to assist in anaerobic digestion recovery from volatile fatty acids accumulation.

Exogenous quorum sensing (QS) molecular can regulate the activity and granulation process of anaerobic sludge in anaerobic digestion process, but would be impractical as a standalone operation. Here we demonstrated that application of 1 mg L-1 boric acid assisted in an upflow anaerobic sludge blanket (UASB) reactor recovery from volatile fatty acids (VFAs) accumulation. After VFAs accumulation, the chemical oxygen demand (COD) removal suddenly reduced from 78.98% to 55.86%. The relative abundance of acetoclastic methanogens decreased from 55.79% to 68.28%-23.14%∼25.41%, and lead to the acetate accumulate as high as 1317.03 mg L-1. Granular sludge disintegrated and the average size of sludge decreased to 586.38 ± 42.45 µm. Application of 1 mg L-1 boric acid activated the interspecies QS signal (AI-2) and then induced the secretion of intraspecies QS signal (N-acyl-homoserine lactones, AHLs). AHLs were then stimulated the growth of syntrophic acetate oxidizing bacteria and hydrogenotrophic methanogen. Moreover, the concentration of acetate decreased to 224.50 mg‧L-1, and the COD removal increased to 75.10% after application of 1 mg L-1 boric acid. The activated AI-2 may induce multiple quorum-sensing circuits enhance the level of AI-2 and AHLs in parallel, and in turn assisted in anaerobic digestion recovery from VFAs accumulation.

Physiological, biochemical and transcriptomic insights into the mechanisms by which molybdenum mitigates cadmium toxicity in Triticum aestivum L.

There are many heavy metal stresses in agricultural biological systems, especially cadmium (Cd) stress, which prevent the full growth of plants, lead to a serious decline in crop yield, and endanger human health. Molybdenum (Mo), an essential nutrient element for plants, regulates plant growth mainly by reducing the absorption of heavy metals and protecting plants from oxidative damage. The aim of this study was to determine the protective effect of Mo (1 µM) application on wheat plants under conditions of Cd (10 µM) toxicity. The biomass, Cd and Mo contents, photosynthesis, leaf and root ultrastructure, antioxidant system, and active oxygen content of the wheat plants were determined. Mo increased the total chlorophyll content of wheat leaves by 43.02% and the net photosynthetic rate by 38.67%, and ameliorated the inhibitory effect of cadmium on photosynthesis by up-regulating photosynthesis-related genes and light-trapping genes. In addition, Mo reduced the content of superoxide anion (O2•-) by 16.55% and 31.12%, malondialdehyde (MDA) by 20.75% and 7.17%, hydrogen peroxide (H2O2) by 24.69% and 8.17%, and electrolyte leakage (EL) by 27.59% and 16.82% in wheat leaves and roots, respectively, and enhanced the antioxidant system to reduce the burst of reactive oxygen species and alleviate the damage of Cd stress on wheat. According to the above results, Mo is considered a plant essential nutrient that enhances Cd tolerance in wheat by limiting the absorption, accumulation and transport of Cd and by regulating antioxidant defence mechanisms. ENVIRONMENTAL IMPLICATION: Cadmium (Cd)，is one of the most toxic heavy metals in the environment, and Cd pollution is a global environmental problem that threatens food security and human health. Molybdenum (Mo), as an essential plant nutrient, is often used to resist environmental stress. However, the mechanism of Mo treatment on wheat subjected to Cd stress has not been reported. In this study, we systematically analysed the effects of Mo on the phenotype, physiology, biochemistry, ultrastructure and Cd content of wheat subjected to Cd stress, and comprehensively analysed the transcriptomics. It not only reveals the mechanism of Mo tolerance to Cd stress in wheat, but also provides new insights into phytoremediation and plant growth in Cd-contaminated soil.

Advances in rapid point-of-care virus testing.

Outbreaks of viral diseases seriously jeopardize people's health and cause huge economic losses. At the same time, virology provides a new perspective for biology, molecular biology and cancer research, and it is important to study the discovered viruses with potential applications. Therefore, the development of immediate and rapid viral detection methods for the prevention and treatment of viral diseases as well as the study of viruses has attracted extensive attention from scientists. With the continuous progress of science and technology, especially in the field of bioanalysis, a series of new detection techniques have been applied to the on-site rapid detection of viruses, which has become a powerful approach for human beings to fight against viruses. In this paper, the latest research progress of rapid point-of-care detection of viral nucleic acids, antigens and antibodies is presented. In addition, the advantages and disadvantages of these technologies are discussed from the perspective of practical application requirements. Finally, the problems and challenges faced by rapid viral detection methods and their development prospects are discussed.

Immune checkpoint inhibitor for different age patients with NSCLC in efficacy: A systematic review and meta-analysis.

OBJECTIVE: This article is a Meta-analysis aiming to systematically evaluate the difference in efficacy of immune checkpoint inhibitor in patients with non-small cell lung cancer (NSCLC) by age. METHODS: We performed a Meta-analysis of published randomized controlled trials concerning for patients with NSCLC by age. We compared overall survival among three groups (age <65 years, age 65-75 years, age ≥75 years). Hazard ratios (HRs) and 95% confidence intervals (CIs) were collected and pooled. RESULTS: A total of 10,291 patients from 17 RCTs were included. In the group under age 65 years, immune checkpoint inhibitor can significantly prolong the overall survival of patients with NSCLC (HR = 0.73, 95% CI: 0.66∼0.81, P < 0.00001). In the age 65-75 years group, immune checkpoint inhibitors prolonged overall survival in patients with NSCLC (HR = 0.78, 95% CI:0.71∼0.84, P < 0.00001). However, it has no significant effect on the overall survival of NSCLC patients (HR = 0.88, 95% CI:0.72∼1.08, P > 0.05) in the group older than 75 years. CONCLUSIONS: Immune checkpoint inhibitors prolonged the overall survival of NSCLC patients in the age <65 years group and the age 65-75 years group, but in the age ≥75 years group, there was no significant effect on overall survival. This may be related to innate immune and adaptive immune dysregulation due to "immunosenescence" in older patients.

Effects of Selenium on the Lignin Deposition Pattern and Stem Mechanical Properties of Alfalfa (Medicago sativa L.).

Lignin provides structural support to plants; however, it reduces their utilization rate. According to our previous studies, selenium (Se) reduces lignin accumulation in alfalfa, but the specific mechanism involved remains unclear. Therefore, at the seedling stage, four root irrigation treatments using 2.5, 50, and 5 µmol/L sodium selenite (S-RI), selenomethionine (SS-RI), Se nanoparticles (SSS-RI), and deionized water (CK-RI) were performed. At the branching stage, four treatments of foliar spraying with the three Se fertilizers described above at a concentration of 0.5 mmol/L (S-FS, SS-FS, and SSS-FS) and deionized water (CK-FS) were administered. The results revealed that all Se treatments chiefly reduced the level of deposition of syringyl (S) lignin in the first internode of alfalfa stems. SS-FS and SSS-FS treatments mainly reduced the deposition of S and guaiacyl (G) lignins in the sixth internode of alfalfa stems, respectively, while S-FS treatment only slightly reduced the deposition of G lignin. S, SS, and SSS-RI treatments reduced the level of deposition of S and G lignins in the sixth internode of alfalfa stems. Se application increased plant height, stem diameter, epidermis (cortex) thickness, primary xylem vessel number (diameter), and pith diameter of alfalfa but decreased primary xylem area and pith parenchyma cell wall thickness of the first internode, and SS(SSS)-FS treatment reduced the mechanical strength of alfalfa stems. Therefore, Se application could decrease lignin accumulation by regulating the organizational structure parameters of alfalfa stems and the deposition pattern of the lignin monomers.

Schiff base functionalized dialdehyde starch for enhanced removal of Cu (II): Preparation, performances, DFT calculations.

Dialdehyde starch modified by 2-hydrazinopyridine (HYD-DAS) based on the reaction of dialdehyde starch (DAS) and 2-hydrazinopyridine was synthesized and characterized by FT-IR spectra, element analysis and SEM. HYD-DAS can efficiently adsorb Cu (II) ion to demonstrate visual color changes from yellow to dark brown in aqueous solutions. The influence on HYD-DAS to Cu (II) adsorption including pH value of solution, isotherm, kinetics, thermodynamics and possible mechanism had also been examined. Batch experiments indicate that HYD-DAS's to Cu (II) adsorption reaches equilibrium within 250 min, and its adsorption capacity and rate are 195.75 mg/g and 98.63 %, respectively. Moreover, HYD-DAS to Cu (II) adsorption remains robust and underscoring after five cycles to exhibit good selectivity and reusability. Kinetics studies suggest the absorption process follows a quasi-second-order with isotherms aligning to the Langmuir monolayer model, and thermodynamics reveals that it is a spontaneous endothermic nature of adsorption. Based on the analyses of XPS and DFT calculations, a possible mechanism for HYD-DAS to Cu (II) adsorption is that Cu (II) combined with nitrogen atoms from Schiff base and hydrazine pyridine ring in HYD-DAS.

An MRI radiomics approach to discriminate haemorrhage-prone intracranial tumours before stereotactic biopsy.

PURPOSE: To explore imaging biomarkers predictive of intratumoral haemorrhage for lesions intended for elective stereotactic biopsy. METHOD: This study included a retrospective cohort of 143 patients with 175 intracranial lesions intended for stereotactic biopsy. All the lesions were randomly split into a training dataset ( n =121) and a test dataset ( n =54) at a ratio of 7:3. Thirty-four lesions were defined as "hemorrhage-prone tumors" as haemorrhage occurred between initial diagnostic MRI acquisition and the scheduled biopsy procedure. Radiomics features were extracted from the contrast-enhanced T1 Weighted Imaging and T2 Weighted Imaging images. Features informative of haemorrhage were then selected by the LASSO algorithm, and an Support Vector Machine model was built with selected features. The Support Vector Machine model was further simplified by discarding features with low importance and calculating them using a "permutation importance" method. The model's performance was evaluated with confusion matrix-derived metrics and area under curve (AUC) values on the independent test dataset. RESULTS: Nine radiomics features were selected as haemorrhage-related features of intracranial tumours by the LASSO algorithm. The simplified model's sensitivity, specificity, accuracy, and AUC reached 0.909, 0.930, 0.926, and 0.949 (95% CI: 0.865-1.000) on the test dataset in the discrimination of "hemorrhage-prone tumors". The permutation method rated feature "T2_gradient_firstorder_10Percentile" as the most important, the absence of which decreased the model's accuracy by 10.9%. CONCLUSION: Radiomics features extracted on contrast-enhanced T1 Weighted Imaging and T2 Weighted Imaging sequences were predictive of future haemorrhage of intracranial tumours with favourable accuracy. This model may assist in the arrangement of biopsy procedures and the selection of target lesions in patients with multiple lesions.

Rupture-Related Features of Cerebral Arteriovenous Malformations and Their Utility in Predicting Hemorrhage.

BACKGROUND: Evaluating rupture risk in cerebral arteriovenous malformations currently lacks quantitative hemodynamic and angioarchitectural features necessary for predicting subsequent hemorrhage. We aimed to derive rupture-related hemodynamic and angioarchitectural features of arteriovenous malformations and construct an ensemble model for predicting subsequent hemorrhage. METHODS: This retrospective study included 3 data sets, as follows: training and test data sets comprising consecutive patients with untreated cerebral arteriovenous malformations who were admitted from January 2015 to June 2022 and a validation data set comprising patients with unruptured arteriovenous malformations who received conservative treatment between January 2009 and December 2014. We extracted rupture-related features and developed logistic regression (clinical features), decision tree (hemodynamic features), and support vector machine (angioarchitectural features) models. These 3 models were combined into an ensemble model using a weighted soft-voting strategy. The performance of the models in discriminating ruptured arteriovenous malformations and predicting subsequent hemorrhage was evaluated with confusion matrix-related metrics in the test and validation data sets. RESULTS: A total of 896 patients (mean±SD age, 28±14 years; 404 women) were evaluated, with 632, 158, and 106 patients in the training, test, and validation data sets, respectively. From the training set, 9 clinical, 10 hemodynamic, and 2912 pixel-based angioarchitectural features were extracted. A logistic regression model was built using 4 selected clinical features (age, nidus size, location, and venous aneurysm), whereas a decision-tree model was constructed from 4 hemodynamic features (outflow time, stasis index, cerebral blood flow, and outflow volume ratio). A support vector machine model was designed using 5 pixel-based angioarchitectural features. In the validation data set, the accuracy, sensitivity, specificity, and area under the curve of the ensemble model for predicting subsequent hemorrhages were 0.840, 0.889, 0.823, and 0.911, respectively. CONCLUSIONS: The ensemble model incorporating clinical, hemodynamic, and angioarchitectural features showed favorable performance in predicting subsequent hemorrhage of cerebral arteriovenous malformations.

Efficacy and safety of biologic agents for IgA nephropathy: A protocol for systematic review and meta-analysis.

BACKGROUND: IgA nephropathy (IgAN) is the most prevalent primary glomerulonephritis worldwide and a leading cause of chronic kidney failure. There are currently no definitive therapeutic regimens to treat or prevent the progression of IgAN. However, biologic agents offer novel therapeutic approaches that target immunological mechanisms to slow or halt disease progression. The objective of this study is to evaluate the efficacy and safety of biologic agents in patients with IgA nephropathy. METHODS: We will systematically search PubMed, EMbase, Web of Science, Cochrane Library, and www.clinicaltrials.gov for randomized controlled trials of biologic agents for the treatment of IgA nephropathy. The search period will span from the establishment of each database until October 2023. The quality assessment of included studies will be performed individually using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2), and meta-analysis will be conducted using Revman 5.4.1 software. CONCLUSIONS: The results of this study will provide evidence-based medical evidence for the clinical application of biologic agents in patients with IgA nephropathy. PROSPERO REGISTRATION NUMBER: CRD42023400450.

Progressive coronal caudal curve after corrective osteotomies for congenital cervicothoracic scoliosis: incidence and predictors.

OBJECTIVE: Postoperative progressive coronal caudal curve (PCC) was characterized by a postoperative de novo caudal S-curve ≥ 20° following congenital cervicothoracic scoliosis (CTS) corrective osteotomies, and at least 20° greater than the preoperative measurement, while the incidence was uncertain and the pathogenesis was equivocal. The objective of this study was to investigate the morbidity and potential factors contributing to PCC following CTS surgery. METHODS: This study reviewed 72 CTS patients between 2005 and 2021. Patients were categorized into two groups according to the absence or presence of PCC at last follow-up, namely the nonprogressive curve group (NPC-group) and the progressive curve group (PC-group). Demographics, radiographic data and the Scoliosis Research Society-22 (SRS-22) questionnaire results were reviewed. Multivariate linear regression analyses were utilized to determine possible predictors for PCC. RESULTS: PCC was observed in 11 (15%) of the total 72 patients. Compared with the NPC-group, the PC-group exhibited greater postoperative residual local curve (24.0 ± 9.7° vs. 9.1 ± 4.4°, P < 0.001), upper instrumented vertebra (UIV) tilt (16.9 ± 7.4° vs. 6.2 ± 3.7°, P < 0.001), T1 tilt (14.3 ± 9.4° vs. 6.6 ± 3.9°, P = 0.022) and neck tilt (10.1 ± 6.7° vs. 3.7 ± 2.5, P = 0.009). The multivariable linear regression demonstrated that the larger postoperative UIV tilt, residual local curve and neck tilt were associated with PCC. In addition, patients with PCC showed lower SRS-22 scores in terms of pain, mental health, self-image and satisfaction (P < 0.05). CONCLUSIONS: The morbidity of PCC was 15% in CTS patients who underwent corrective osteotomies. Greater residual local curve, postoperative UIV tilt and neck tilt were identified as predictors for PCC.