Comparison of efficacy and safety of conventional transarterial chemoembolization and drug-eluting bead transarterial chemoembolization in unresectable intrahepatic cholangiocarcinoma: A multicenter retrospective cohort study.

PURPOSE: The efficacy and safety of drug-eluting bead transarterial chemoembolization (DEB-TACE) and conventional TACE (c-TACE) in the treatment of patients with unresectable intrahepatic cholangiocarcinoma (ICC) remained controversial. Therefore, we aimed to compare the efficacy and safety between c-TACE and DEB-TACE among patients with ICC. METHOD: Between June 10, 2016 and November 19, 2022, consecutive patients with pathological diagnoses of ICC were divided into the DEB-TACE group and the c-TACE group based on the type of TACE treatment they received. The Kaplan-Meier method and log-rank test were used to compare overall survival (OS) between the two groups. Propensity score matching (PSM) was used to balance the characteristics between the c-TACE group and the DEB-TACE group. RESULTS: A total of 132 patients were included in this study, with 64 patients in the c-TACE group and 68 patients in the DEB-TACE group. The median OS for c-TACE and DEB-TACE was 5 and 12 months, respectively. The objective response rate (ORR) for c-TACE and DEB-TACE was 0 % and 66.2 %, respectively; the disease control rate (DCR) was 37.5 % and 91.2 %. There were no significant differences between c-TACE and DEB-TACE among adverse effects at 3 months after treatment (P > 0.05). The results remained consistent after PSM. The Cox regression demonstrated that the DEB-TACE was an independent protective factor for OS. CONCLUSIONS: Patients in the DEB-TACE group had longer OS and higher ORR and DCR than those in the c-TACE group, but no significant difference was observed between the two groups regarding adverse effects.

The Typical Nail lichen planus severity index (tNLPSI)：an outcome instrument for typical nail lichen planus.

INTRODUCTION: Despite numerous treatment options for Nail lichen planus (NLP), a validated method for measuring the severity of NLP and therapeutic response in clinical trials is absent. To develop and validate a measurement instrument (tNLPSI - typical nail lichen planus severity index) for typical nail lichen planus that could be used in clinical trials. METHODS: 48 patients with typical NLP diagnosed pathologically and 5 dermatologists participated. The physicians were trained to use the tNLPSI activity scale and Physician's Global Assessment (PGA). Using both tools, 5 physicians scored samples independently to estimate inter-rater reliability and intra-rater reliability in two sessions. In addition, tNLPSI activity scores were compared with physician global assessment (PGA) scores. RESULTS: The tNLPSI activity scale had excellent internal consistency and interrater reliability (Cronbach's alpha 0.990; ICC= 0.954; 95% CI= 0.930-0.971), and the correlations between the different graders' scores indicate good consistent (rp=0.934-0.968. In addition, the tNLPSI activity scale demonstrated high intra-rater reliability (ICC=0.996; 95% CI= 0.993-0.998), showing good reproducibility. And tNLPSI activity scores and PGA scores showed good construct validity (Spearman's rho= 0.941 and Spearman's rho= 0.903-0.935, respectively; P < 0.01). CONCLUSIONS: The tNLPSI activity scale was demonstrated to be consistent, reliable, reproducible, and feasible. It may prove to be a valuable tool in evaluating the treatment response in typical NLP clinical trials.

Systemic chemotherapy plus transarterial chemoembolization versus systemic chemotherapy alone for unresectable intrahepatic cholangiocarcinoma: a multicenter retrospective cohort study.

PURPOSE: Systemic chemotherapy (SYS) is the first-line treatment of unresectable intrahepatic cholangiocarcinoma (ICC). However, the survival benefit of SYS is still limited. This study compared the efficacy and safety of patients with unresectable ICC treated with transarterial chemoembolization (TACE) plus SYS to SYS alone. MATERIAL AND METHODS: The multicenter retrospective cohort study included patients aged ≥ 18 years old with pathologically diagnosed ICC. Patients with unmeasurable lesions, not receiving SYS treatment, Child-Pugh grade C, Eastern Cooperative Oncology Group performance status score of 3 or higher, prior liver resection, incomplete medical information, or discontinuation of the first SYS treatment were excluded. Data collection was mainly from the hospital system, and the survival outcome of patients was obtained through follow-up. Overall survival (OS) was estimated using the Kaplan-Meier method and compared using the log-rank test. Propensity score matching at a 1:1 ratio using the nearest neighbor matching algorithm was performed to reduce selection bias between the TACE plus SYS and SYS alone groups. The Cox proportional hazards model was used to identify prognostic factors associated with OS and to estimate their hazard ratios. Modified Response Evaluation Criteria in Solid Tumors criteria were utilized to evaluate the response of tumors to therapy. RESULTS: Between June 2016 and February 2023, 118 unresectable ICC patients from three hospitals were included in this study. Of them, 37 were in the TACE plus SYS group and 81 were in the SYS alone group. The median OS in the combination group was 11.3 months, longer than the 6.4 months in the SYS alone group (P = 0.011). A greater objective response rate (ORR) and disease control rate (DCR) were observed in the combination group than in the SYS alone group (ORR, 48.65 vs. 6.17%, P < 0.001; DCR, 89.19 vs. 62.96%, P = 0.004). There were 16 patients in each group after matching, and the matched results remained consistent regarding OS and tumor response. Adverse events (AEs) were similar in the two groups after matching. CONCLUSION: Compared to SYS alone, the combination treatment of TACE plus SYS was more effective than SYS alone in improving OS, ORR, and DCR without any significant increase in AEs. TACE plus SYS may be a viable treatment option for patients with unresectable ICC.

Application of a Radiomics Machine Learning Model for Differentiating Aldosterone-Producing Adenoma from Non-Functioning Adrenal Adenoma.

To evaluate the secretory function of adrenal incidentaloma, this study explored the usefulness of a contrast-enhanced computed tomography (CECT)-based radiomics model for distinguishing aldosterone-producing adenoma (APA) from non-functioning adrenal adenoma (NAA). Overall, 68 APA and 60 NAA patients were randomly assigned (8:2 ratio) to either a training or a test cohort. In the training cohort, univariate and least absolute shrinkage and selection operator regression analyses were conducted to select the significant features. A logistic regression machine learning (ML) model was then constructed based on the radiomics score and clinical features. Model effectiveness was evaluated according to the receiver operating characteristic, accuracy, sensitivity, specificity, F1 score, calibration plots, and decision curve analysis. In the test cohort, the area under the curve (AUC) of the Radscore model was 0.869 [95% confidence interval (CI), 0.734-1.000], and the accuracy, sensitivity, specificity, and F1 score were 0.731, 1.000, 0.583, and 0.900, respectively. The Clinic-Radscore model had an AUC of 0.994 [95% CI, 0.978-1.000], and the accuracy, sensitivity, specificity, and F1 score values were 0.962, 0.929, 1.000, and 0.931, respectively. In conclusion, the CECT-based radiomics and clinical radiomics ML model exhibited good diagnostic efficacy in differentiating APAs from NAAs; this non-invasive, cost-effective, and efficient method is important for the management of adrenal incidentaloma.

Clinical efficacy of flap transplantation combined with vacuum sealing drainage and methylprednisolone and cyclosporine in the treatment of pyoderma gangrenosum.

This study was aimed to evaluate the clinical efficacy of flap transplantation combined with vacuum sealing drainage and methylprednisolone and cyclosporine in the treatment of ulcer wound of patients with pyoderma gangrenosum (PG). From August 2014 to February 2022, 30 patients with pyoderma gangrenosum ulcer wounds were selected as the research objects and randomly divided into the observation group (n = 12) and the control group (n = 18) in this retrospective study. The patients in observation group were treated with VSD combined with flap transplantation and immunosuppressive agent treatment, while the control group was treated with normal dressing change combined with hormone and cyclosporine. The ulcer wound healing time and dressing change times were compared between the two groups. All the 30 cases of two groups healed after corresponding treatment. The wound healing time of ulcer in the observation group was 35-40 days, with an average healing time of (35.83 ± 1.95) days, and the wound healing time of the control group was 60-200 days, with an average healing time of (44.14 ± 9.67) days. The healing time of observation groups was significantly shorter than that in the control group (t = 4.652, P < .05). The frequency of dressing change in the observation group was seven-eight times, with an average of (7.17 ± 0.39) times, and the frequency of dressing change in the control group was 75-86 times, with an average of (79.22 ± 3.62) times. The difference between the two groups was significant (t = 6.214, P < .05). The treatment of VSD combined with flap transplantation and immunosuppressive agent treatment promote ulcer wound healing of pyoderma gangrenosum.

Mutation Detection and Functional Analysis of MSX1, PAX9, AXIN2, and BMP in Nonsyndromic Congenital Missing Teeth Based on Intelligent Image Detection.

Due to the complexity of clinical manifestations and the lack of standardized diagnostic criteria, it is still difficult to distinguish the etiological types of congenital edentulousness corresponding to genetic defects. This paper studies the application of deep learning image processing and digital image processing in medical images in detail and analyzes the functions of congenital edentulous hotspot genes. The cases in the control group and the study group were collected, and the gene mutations of direct sequence MSX1, PAX9, AXIN2, and BMP were analyzed, and new pathogens were found. The experimental results suggest that PAX9 and MSX1 genes may have a synergistic effect in nonsyndromic congenital edentulous patients. In severely missing teeth, the role of PAX9 may be greater than that of MSX1. The experimental results will help us lay the foundation for further understanding of the disease in the future.

Efficacy, safety, and prognostic factors of drug-eluting beads transarterial chemoembolization using CalliSpheres in treating huge hepatocellular carcinoma patients.

BACKGROUND: The treatment of huge hepatocellular carcinoma (HCC) is still challengeable due to its deteriorative heterogeneity, for which conventional transarterial chemoembolization (TACE) is proposed as an efficient therapy; however, drug-eluting beads TACE (DEB-TACE) is rarely reported in these patients. Thus, the current study aimed to explore the efficacy, prognostic factors, and safety of DEB-TACE using CalliSpheres in huge HCC patients. METHODS: Ninety-nine huge HCC patients treated by DEB-TACE using CalliSpheres were retrospectively reviewed. Treatment response, change of tumor markers, liver function indexes, progression-free survival (PFS), and adverse events were retrieved. RESULTS: Objective response rate (ORR) was 66.1%, 48.6%, and 23.8%, then disease control rate (DCR) was 85.5%, 67.6%, and 33.3% at month (M) 1, M3, and M6, respectively; furthermore, carcinoembryonic antigen (CEA) (p = 0.037), alpha fetoprotein (AFP) (p < 0.001), and protein induced by vitamin K absence or antagonist-II (PIVKA-II) (p < 0.001) were all declined at 1 month after DEB-TACE. The median PFS was 8.3 (95% confidence interval: 6.0-10.6) months with 1-year and 2-year PFS rates of 38.5% and 15.5%, accordingly. Moreover, elevated China liver cancer (CNLC) stage (p = 0.036, hazard ratio (HR): 1.937) and abnormal cancer antigen 199 (p = 0.019, HR: 2.465) were correlated with unfavorable PFS. Besides, liver function indexes were not deteriorated after DEB-TACE. Lastly, main adverse events included pain (20.2%), fever (17.2%), nausea (14.1%), and vomit (9.1%), which were mild and manageable. CONCLUSION: DEB-TACE using CalliSpheres presents satisfying efficacy and tolerable safety in huge HCC patients, suggesting that it might be a good treatment option for these patients.

A New Posterior Extensor Attachment-Point Reconstruction Technique for Cervical Spondylotic Myelopathy Involving C2 Segment: Clinical Outcome and Safety.

BACKGROUND AND STUDY AIM: Cervical spondylotic myelopathy (CSM) is a common degenerative disease that mainly occurs in elder patients, leading to different degrees of neurological dysfunction. Spinal cord involvement is mainly distributed at the C3-C7 segments, but it may also involve up to the C2 level. This study aimed to assess the clinical efficacy and safety of open-door laminoplasty using a new extensor attachment-point reconstruction technique for treating CSM involving the C2 segment. PATIENTS AND METHODS: Fifty-nine patients with CSM involving the C2 segment and undergoing open-door laminoplasty were included in this retrospective study. Based on the titanium plate used in the operation, patients were divided into two groups, a reconstructed titanium plate fixation (RPF) group (n = 28) and a conventional titanium plate fixation (CPF) group (n = 31). Improvements in neurological function, cervical range of motion (ROM), cervical curvature index (CCI), preservation of posterior cervical muscle mass, and axial symptoms were compared between the two groups. RESULTS: There were no significant differences in operative time and intraoperative blood loss between the groups (p > 0.05). The Japanese Orthopaedic Association (JOA) score significantly increased in both groups postsurgery (p < 0.05); the neurological recovery rate was similar between the two groups (64.1 ± 13.3% vs. 65.9 ± 14.7%, p > 0.05). There was no significant loss of cervical ROM in either group (p > 0.05). The anteroposterior dural sac diameter at the C2 level was significantly enlarged in both groups (p < 0.05). Alternatively, CCI was significantly reduced in the CRP group (p < 0.05) but unchanged in the RPF group (p > 0.05). The cross-sectional area of the posterior cervical muscles was also significantly reduced in the CPF group (p < 0.05) but maintained in the RPF group (p > 0.05). Finally, axial symptoms were more severe in the CPF group than in the RPF group (p < 0.05). CONCLUSION: Laminoplasty is an effective surgical procedure for CSM involving the C2 segment. The reconstructed titanium plate achieved superior maintenance of cervical curvature and reduced both muscle atrophy and severity of axial symptoms compared with titanium conventional plates.

The Association of Fecal Microbiota in Ankylosing Spondylitis Cases with C-Reactive Protein and Erythrocyte Sedimentation Rate.

The purpose of this work was to identify the features of the gut microbiome in cases of ankylosing spondylitis (AS) testing positive for human leukocyte antigen- (HLA-) B27 and healthy controls (HCs) as well as to determine how bacterial populations were correlated with C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Fecal DNA extracted from fecal samples from 10 AS cases and 12 HCs was subjected to 16S rRNA gene sequencing. The two research groups did not differ significantly regarding alpha diversity. By comparison to HCs, AS cases displayed a lower relative level of Bacteroidetes (P < 0.05), but a higher level of Firmicutes and Verrucomicrobia (P < 0.05). Furthermore, the correlation between the specific gut bacteria and ESR or CRP was investigated. At the phylum level, Firmicutes and Verrucomicrobia had a positive association with ESR and CRP, while Bacteroidetes exhibited an inverse correlation with ESR and CRP. Meanwhile, in terms of genus, Bacteroides had a positive association with ESR and CRP, whereas Ruminococcus and Parasutterella had an inverse correlation with ESR and CRP, and Helicobacter also displayed an inverse correlation with CRP. Such findings indicated dissimilarities between AS cases and HCs regarding the gut microbiome, as well as the existence of correlations between bacterial populations and both ESR and CRP.

MicroRNA-340 is involved in ultraviolet B-induced pigmentation by regulating the MITF/TYRP1 axis.

OBJECTIVE: There is growing evidence that ultraviolet B (UVB) irradiation can change the expression profile of microRNAs (miRNAs) in immortalized human epidermal melanocytes (Pig-1). We aimed to investigate the effect of miR-340 on regulating UVB-induced pigmentation. METHODS: Real-time quantitative PCR (qRT-PCR) was used to evaluate the expression of miR-340 in Pig-1 cells. Immunoblotting analysis, qRT-PCR, and luciferase reporter assays were used to detect the potential target of miR-340. The sodium hydroxide dissolution assay was used to assess the effect of miR-340 on changes in melanin content. RESULTS: Expression of miR-340 was reduced in human Pig-1 cells after UVB irradiation. We found a negative correlation between miR-340 and melanocyte inducing transcription factor (MITF) in Pig-1 cells after UVB irradiation. Knockdown and overexpression of MITF in Pig-1 cells down- and upregulated melanogenesis, respectively. Overexpression of miR-340 inhibited MITF expression, reduced the amount of melanin, and suppressed expression of multiple key molecules involved in the pigment synthesis pathway, whereas knockdown of miR-340 showed the opposite results. CONCLUSIONS: Our results showed that miR-340 inhibited melanogenesis by regulating the downstream molecules of MITF and its signaling pathways, suggested that miRNA-340 may be a new target for the clinical treatment of UVB-induced pigmentation.

Characterizing the heterogeneous correlations between the landscape patterns and seasonal variations of total nitrogen and total phosphorus in a peri-urban watershed.

Landscape patterns in a watershed potentially have significant influence on the occurrence, migration, and transformation of pollutants, such as nitrogen (N) and phosphorus (P) in rivers. Human activities can accelerate the pollution and complicate the problem especially in a peri-urban watershed with different types of land use. To characterize the heterogeneous correlations between landscape patterns and seasonal variations of N and P in a peri-urban watershed located upstream of Tianjin metropolis, China, observations of total nitrogen (TN) and total phosphorus (TP) at 33 locations were performed in the wet and dry seasons from 2013 to 2016. The data from individual locations were averaged for the wet and dry seasons and analyzed with geographical detector to identify influential landscape indices on seasonal water quality variations. The geographically weighted regression method, capable of analyzing heterogeneous correlations, was used to evaluate the integrated effects from different landscape indices. The results demonstrated that the location-weighted landscape contrast index (LWLI), the ratio of urban areas, and the ratio of forest areas were major influential indicators that affected TN and TP in river water. These indices also had integrated effects on variations of TN and TP together with other indices such as Shannon diversity index, landscape shape index, largest patch index, and contagion index. The integrated effects were different in the wet and dry seasons because of different effects of flushing and dilution by rainwater and the heterogeneity in landscape patterns. The LWLI had a positive relationship to water quality in the areas with high ratio of urban areas, indicating that domestic wastewater can be a major source of N and P pollution. The approaches and findings of this study may provide a reference for characterizing the major factors and integrated effects that control nonpoint source pollution in a watershed.

A multimodal therapeutic approach improves the clinical outcome of auricular keloid patients.

OBJECTIVE: We retrospectively studied the efficacy of personalized therapy with surgical resection plus prophylactic management of postsurgical auricular keloids by intralesional injection of betamethasone and local pressure therapy using magnets in patients with auricular keloids. METHODS: Surgical excision was performed in all patients, and surgical techniques including fusiform excision of the keloid scar, core excision of the keloid scar followed by flap repair, and scar graft were chosen. RESULTS: A total of 85 patients with 98 auricular keloids were eligible. Seventy-two (74%) patients had primary auricular keloids, and 13 patients had recurrent keloids after surgical excision. Keloids, were located in the helix in 28 (32.9%) cases, in the earlobe in 45 (52.9%) cases, and in the entire auricle in 12 (14.1%) cases. The size of auricular keloids ranged from 10 to 35 mm. Surgical resection was uneventful in all cases. Twenty-one (21.4%) patients received fusiform excision, 47 (47.9%) patients underwent core excision and flap repair, and 30 (30.6%) patients received skin grafts. The patients were followed up for median duration of 1 year (range: 12-24 months). The cure rate was 87.2%, and the recurrence rate was 12.8%. CONCLUSION: A personalized surgical approach based on the characteristics of auricular keloids in each patient and a multimodal therapeutic regimen including surgical excision, glucocorticoid blockade, and intralesional injection of glucocorticoids and pressure therapy improve the cure rate and reduce the recurrence rate of auricular keloids.

miR-221 alleviates the inflammatory response and cell apoptosis of neuronal cell through targeting TNFAIP2 in spinal cord ischemia-reperfusion.

This study aimed to examine the role of miR-221 in inflammatory response and apoptosis of neuronal cells after spinal cord ischemia/reperfusion (I/R) injury. Blood samples were obtained from 20 I/R patients and that of 20 healthy individuals were used as a control. AGE1.HN and SY-SH-5Y neuronal cell lines subjected to oxygen-glucose deprivation (OGD) stress were used in cell experiments. Real-time PCR and western blot were used to evaluate the expression of miR-221, tumor necrosis factor-α, and TNFAIP2. TUNEL assay analyzed cell apoptosis. I/R patients had lower serum levels of miR-221 than healthy controls. In OGD-AGE1.HN and SY-SH-5Y cells, miR-221 was significantly downregulated and TNFAIP2 mRNA and protein were upregulated; meanwhile, both proinflammatory cytokine tumor necrosis factor-α and anti-inflammation cytokine interleukin-6 were elevated and the percentage of apoptotic cells was increased. This inflammatory response and cell apoptosis induced by OGD stress were attenuated by miR-221 overexpression and enhanced by miR-221 knockdown. TNFAIP2 is a target gene for miR-221 and could be regulated negatively by the miR-221 mimic or the miR-221 inhibitor with or without OGD stress. Accordingly, TNFAIP2 overexpression reversed the inflammatory response and cell apoptosis induced by miR-221 under OGD stress. Downregulation of miR-221 occurs in spinal cord I/R injury and in cell lines subjected to oxygen-glucose deprivation. miR-221 regulates the inflammatory response and apoptosis of neuronal cells through its impact on TNFAIP2.

One-dimensional analytical solution for hydraulic head and numerical solution for solute transport through a horizontal fracture for submarine groundwater discharge.

Submarine groundwater discharge (SGD) has been recognized as a major pathway of groundwater flow to coastal oceanic environments. It could affect water quality and marine ecosystems due to pollutants and trace elements transported through groundwater. Relations between different characteristics of aquifers and SGD have been investigated extensively before, but the role of fractures in SGD still remains unknown. In order to better understand the mechanism of groundwater flow and solute transport through fractures in SGD, one-dimensional analytical solutions of groundwater hydraulic head and velocity through a synthetic horizontal fracture with periodic boundary conditions were derived using a Laplace transform technique. Then, numerical solutions of solute transport associated with the given groundwater velocity were developed using a finite-difference method. The results indicated that SGD associated with groundwater flow and solute transport was mainly controlled by sea level periodic fluctuations, which altered the hydraulic head and the hydraulic head gradient in the fracture. As a result, the velocity of groundwater flow associated with SGD also fluctuated periodically. We found that the pollutant concentration associated with SGD oscillated around a constant value, and could not reach a steady state. This was particularly true at locations close to the seashore. This finding of the role of fracture in SGD will assist pollution remediation and marine conservation in coastal regions.

mTOR-mediated Na+/Ca2+ exchange affects cell proliferation and metastasis of melanoma cells.

Melanoma is a common malignant tumor, which is associated with high mortality rate. The multiple-drug resistance of tumor cells often results in failure of chemotherapy. The aim of our study is to investigate the expression of Nav 1.6 in human melanoma cells and human epidermal melanocytes. Additionally, the effect of Na+channels on Ca+ current and mTOR activity in melanoma cells were also analyzed. The protein expression levels of Nav1.6 in human melanocyte PIG1, WM266 and WM115 cells were investigated by western blot. After treatment of Na+ channel inhibitor Tetroadotoxin (TTX) or mTOR inhibitor rapamycin (RAPA), the electrophysiological activity (Na+ current and Ca2+ current) in WM266 and WM115 cells was detected by patch clamp technique. The expression of mTORC1 phosphorylates S6 kinase (p-S6), cell invasion and migration, cell proliferation and cell apoptosis were also performed. Results shown that Nav 1.6 was overexpressed in WM266 and WM115 cells, and the inhibition of Na+ channel by TTX reduced Na+ current. Both TTX and RAPA suppressed Ca2+ current and the expression of p-S6, thus inducing Na+ channel which activates the mTOR-Ca2+ signaling pathway. Both TTX and RAPA suppressed cell invasion, migration and proliferation, and promoted cell apoptosis of WM266 cells. Thus, the Nav1.6 sodium channel promotes cell proliferation and invasion through mTOR-mediated Na+/Ca2+ exchange in melanoma. The observations will provide a new perspective for understanding the malignant biological behavior of melanoma cells, and potentially provide a new drug target.

Vancomycin microspheres reduce postoperative spine infection in an in vivo rabbit model.

BACKGROUND: Surgical site infections are common and devastating complications after implants related surgeries. Staphylococcus aureus contamination is a leading cause of surgical site infections. This study aims at assessing the effect of vancomycin microspheres on reducing Staphylococcus aureus infection in an in vivo rabbit model. METHODS: Sixty surgical sites of 20 New Zealand White rabbits underwent spinal implant were randomly divided to three groups: the control group, the vancomycin group and vancomycin microspheres group. The surgical sites were incubated with 100 µl 1 × 107 CFU S. aureus ATCC 25923. Prior to closure, vancomycin and vancomycin microspheres were placed into the wounds of the rabbits in the vancomycin group and the vancomycin microspheres group, respectively. The rabbits were killed on postoperative day 7. Standard quantification techniques were used to analyze biomaterial centered and soft tissue bacterial growth. The bacteria were further confirmed by PCR with primers from the thermostable nuclease gene of S. aureus. RESULTS: All the rabbits survived the surgery and no postoperative wound complications or systemic illness occurred. Results showed that the bacterial cultures were 76.9, 30.8, and 15.4% in the control group, vancomycin group, and vancomycin microspheres group. Vancomycin microspheres treatments significantly decreased the infection rate compared to the control group (p < 0.05). CONCLUSION: Vancomycin microspheres combined with preoperative ceftriaxone is effective to reduce postoperative S. aureus infection compared with the control group.

Differentiation between malignant and benign thyroid nodules and stratification of papillary thyroid cancer with aggressive histological features: Whole-lesion diffusion-weighted imaging histogram analysis.

PURPOSE: To explore the usefulness of whole-lesion histogram analysis of apparent diffusion coefficient (ADC) derived from reduced field-of-view (r-FOV) diffusion-weighted imaging (DWI) in differentiating malignant and benign thyroid nodules and stratifying papillary thyroid cancer (PTC) with aggressive histological features. MATERIALS AND METHODS: This Institutional Review Board-approved, retrospective study included 93 patients with 101 pathologically proven thyroid nodules. All patients underwent preoperative r-FOV DWI at 3T. The whole-lesion ADC assessments were performed for each patient. Histogram-derived ADC parameters between different subgroups (pathologic type, extrathyroidal extension, lymph node metastasis) were compared. Receiver operating characteristic curve analysis was used to determine optimal histogram parameters in differentiating benign and malignant nodules and predicting aggressiveness of PTC. RESULTS: Mean ADC, median ADC, 5th percentile ADC, 25th percentile ADC, 75th percentile ADC, 95th percentile ADC (all P < 0.001), and kurtosis (P = 0.001) were significantly lower in malignant thyroid nodules, and mean ADC achieved the highest AUC (0.919) with a cutoff value of 1842.78 × 10-6 mm2 /s in differentiating malignant and benign nodules. Compared to the PTCs without extrathyroidal extension, PTCs with extrathyroidal extension showed significantly lower median ADC, 5th percentile ADC, and 25th percentile ADC. The 5th percentile ADC achieved the highest AUC (0.757) with cutoff value of 911.5 × 10-6 mm2 /s for differentiating between PTCs with and without extrathyroidal extension. CONCLUSION: Whole-lesion ADC histogram analysis might help to differentiate malignant nodules from benign ones and show the PTCs with extrathyroidal extension. J. Magn. Reson. Imaging 2016;44:1546-1555.

Association of follistatin-like 3 concentrations in serum and synovial fluid with the radiographic severity of knee osteoarthritis.

OBJECTIVE: Follistatin-like 3 (FSTL3), a circulating glycoprotein, is correlated with obesity and inflammation, which are potential mechanisms of osteoarthritis (OA). This study aims to determine the correlation of FSTL3 concentrations in serum and synovial fluid (SF) with the radiographic severity of OA. METHODS: This study consisted of 200 patients with knee OA and 148 healthy controls. The radiological grading of OA in the knee was performed in accordance with Kellgren-Lawrence (KL) grading system. RESULTS: Knee OA patients had higher serum FSTL3 concentrations compared with healthy controls. Knee OA patients with KL grade 4 showed significantly elevated FSTL3 concentrations in serum and SF compared with those with KL grades 2 and 3. Moreover, knee OA patients with KL grade 3 had significantly higher FSTL3 concentrations in serum and SF compared with those with KL grade 2. FSTL3 concentrations in serum and SF of knee OA patients were significantly correlated with KL grading criteria. CONCLUSIONS: FSTL3 concentrations in serum and SF are correlated with the radiographic severity of OA.

[Transforaminal lumbar intervertebral fusion in the treatment of thoracolumbar disc herniation: technique feasibility and radiological outcomes].

OBJECTIVE: To explore the feasibility, safety and efficacy of treating thoracolumbar disc herniation with transforaminal lumbar intervertebral fusion (TLIF). METHODS: From December 2009 to May 2013, 15 consecutive patients with one-level thoracolumbar disc herniation underwent TLIF. There were 9 males and 6 females with an average age of 41.2 (25-72) years. According to the Japanese Orthopedic Association (JOA) criteria and Frankel grading system, it was evaluated for the clinical effects of all patients. RESULTS: The average operative duration was 140 (115-180) min and mean blood loss volume 329 (100-500) ml. The symptoms improved all greatly over an average follow-up period of 19 (3-44) months. According to the JOA criteria system, the outcomes were excellent (n = 9, 60%), good (n = 4, 26.6%) and fair (n = 2, 13.4%). Based on the Frankel grading system, 2 cases were classified as A (n = 2), 2 as B (n = 2), 4 as C (n = 4) and 7 as D (n = 7) preoperatively versus B (n = 1), C (n = 1), D (n = 4) and E (n = 9) postoperatively. CONCLUSION: The combined approach of TLIF plus posterior laminectomy is anatomically simple, visually distinct, relatively safe, reliable and efficacious in treatment of thoracolumbar disc herniation.