Proteomic analysis of serum extracellular vesicles from biliary tract infection patients to identify novel biomarkers.

Biliary tract infection (BTI), a commonly occurring abdominal disease, despite being extensively studied for its initiation and underlying mechanisms, continues to pose a challenge in the quest for identifying specific diagnostic biomarkers. Extracellular vesicles (EVs), which emanate from diverse cell types, serve as minute biological entities that mirror unique physiological or pathological conditions. Despite their potential, there has been a relatively restricted exploration of EV-oriented methodologies for diagnosing BTI. To uncover potent protein biomarkers for BTI patients, we applied a label-free quantitative proteomic method known for its unbiased and high-throughput nature. Furthermore, 192 differentially expressed proteins surfaced within EVs isolated from individuals afflicted with BTI. Subsequent GO and KEGG analyses pinpointed Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) and Crumbs homolog 3 (CRB3) as noteworthy biomarkers. Validation via data analysis of plasma-derived EV samples confirmed their specificity to BTI. Our study leveraged an unbiased proteomic tool to unveil CEACAM1 and CRB3 as promising protein biomarkers in serum EVs, presenting potential avenues for the advancement of diagnostic systems for BTI detection.

Identification of an m6A RNA Methylation Regulator Risk Score Model for Prediction of Clinical Prognosis in Astrocytoma.

Astrocytoma (AS) is the most ubiquitous primary malignancy of the central nervous system (CNS). The vital involvement of the N6-methyladenosine (m6A) RNA modification in the growth of multiple human tumors is known. This study entailed probing m6A regulators with AS prognosis to construct a risk prediction model (RS) for potential clinical use. A total of 579 AS patients' (of the Chinese Glioma Genome Atlas,CGGA) data and the expression of 12 published m6A-related genes were included in this study. Cox and selection operator (LASSO) regression analyses for independent prognostic factors and multifactor Cox analysis established an R.S. model to predict the AS patient prognosis. This was subject to verification employing 331 samples from the TCGA data set followed by gene ontology and pathway enrichment study with gene set enrichment analysis (GSEA). The R.S. constructed with three m6A genes inclusive of WTAP, RBM15, and YTHDF2 emerged as independent prognostic factors in AS patients with vital involvement in the advancement and development of the malignancy. In a nutshell, this work reported an m6A-related gene risk model to predict the prognosis of AS patients to pave the way for discerning diagnostic and prognostic biomarkers. Further corroboration employing relevant wet-lab assays of this model is warranted.

[Post-stroke constipation treated with acupoint embedding therapy: a multi-center randomized controlled trial].

OBJECTIVE: To verify the clinical effect of acupoint embedding therapy on post-stroke constipation. METHODS: The multi-central randomized controlled trial was adopted. 210 patients of post-stroke constipation were divided into an acupoint embedding group (105 cases, 4 cases dropped off) and a sham-embedding group (105 cases, 6 cases dropped off). In the acupoint embedding group, the acupoint embedding therapy was used at Tianshu (ST 25), Daheng (SP 15), Xiawan (CV 10), Zhongwan (CV 12), Qihai (CV 6), Guanyuan (CV 4) and Daju (ST 27). In the sham-embedding group, the sham-embedding therapy was given, in which, the acupoint selection, needle devices and manipulation were the same as the acupoint embedding group. But, no absorbable surgical suture was used in the needle tube. The treatment was given once every two weeks and 4 treatments were required in either group. It was to compare the weekly average complete spontaneous bowel movements (CSBMs) during treatment (from the 3rd to the 8th week) between the two groups, the weekly average spontaneous bowel movements (SBMs), Bristol stool form score (BSFS), the score of the patient assessment of constipation quality of life questionnaire (PAC-QOL) and the score of defecation difficulty before and after treatment. RESULTS: The percentage of the cases with weekly average CSBMs ≥ 3 times in the patients of the acupoint embedding group was higher markedly than the sham-embedding group [91.1% (92/101) vs 43.4% (43/99), P<0.01]. Compared with the values before treatment, the weekly average SBMs and BSFS scores after treatment were all increased obviously in the two groups (P<0.01), and PAC-QOL score and the score of defecation difficulty were reduced remarkably (P<0.01). After treatment, the increase range of SBMs and BSFS scores, as well as the decrease range of PAC-QOL score and the defecation difficulty score in the acupoint embedding group were all higher than the sham-embedding group respectively (P<0.05). CONCLUSION: The acupoint embedding therapy remarkably increases the spontaneous bowel movements, improves in feces form and defecation difficulty and strengthens the quality of life in the patients of post-stroke constipation.

Intracranial Anatomic Landmarks for Endoscopic Endonasal Transcribriform Approach to Anterior Skull Base.

OBJECTIVES: To help surgeons locating anatomic landmarks when performing endoscopic endonasal transcribriform approach to anterior skull base. METHODS: High-resolution axial computed tomography (CT) images at thickness of 0.6 mm, and reconstructed 0.41-mm thick gapless sagittal and coronal CT images were taken from 123 subjects. Using mimics software, first located elementary points and line: nasal spine, midpoint of posterior hard palate and the line between them; then located measured points right/left posterior and anterior points; measured distances between measured points and from measured points to nasal spine and angles between lines connecting measured points to nasal spine and the basic line. RESULTS: The distances from nasal spine to right/left posterior and anterior points of anterior skull base are 68.67 ± 6.04 and 61.71 ± 5.09 mm, corresponding angles are 45.89 ± 4.20° and 72.07 ± 4.06°, respectively. The width and length of defect of anterior skull base are 24.45 ± 2.62 and 31.03 ± 4.96 mm; its area ranges from 373.75 ± 94.08 to 800.91 ± 195.07 mm. CONCLUSIONS: The study provides information about anterior skull base anatomic landmarks, which can help surgeons to locate them and avoid relative complications during endoscopic endonasal transcribriform approach to anterior skull base. The measurements can be used as surgical indicators to investigate the landmarks.

The posterior pedicled inferior turbinate-nasoseptal flap: a potential combined flap for skull base reconstruction.

OBJECTIVES: To develop a combined pedicled flap comprising the mucoperiosteum and mucoperichondrium of the inferior turbinate, lateral nasal wall, nasal floor, and nasal septum based on the posterior lateral nasal artery, a branch of the sphenopalatine artery, for the reconstruction of skull base defects resulting from endoscopic expanded endonasal approaches. METHODS: Eleven fresh adult cadaver heads were dissected. Arterial distribution patterns of the inferior turbinate, lateral nasal wall, nasal floor, and nasal septum were investigated. The posterior pedicled inferior turbinate-nasoseptal flap was designed, measured, and harvested, and its ability to cover ventral skull base defects was examined. RESULTS: The inferior turbinate artery and/or posterior lateral nasal artery had 3.19 ± 1.47 (range 2-7) branches [mean outer diameter of largest branch, 0.40 ± 0.10 (range 0.24-0.60) mm] that anastomosed with the nasoseptal artery. These anastomosing arteries allowed the posterior lateral nasal artery to supply arterial blood to the nasoseptal mucoperichondrium and mucoperiosteum. Mean flap length was 100.65 ± 5.61 (range 91.43-109.44) mm, and minimum and maximum widths were 25.21 ± 2.29 (range 22.36-30.23) and 44.53 ± 5.02 (range 36.45-54.10) mm, respectively. Mean flap area was 3090.69 ± 288.08 (range 2612.97-3880.09) mm(2). The flap covered defects extending from the frontal sinus to the foramen magnum in all specimens. CONCLUSIONS: Harvesting of a posterior pedicled inferior turbinate-nasoseptal flap is feasible. It should be considered a useful option for the reconstruction of large defects involving the anterior skull base, planum sphenoidale, sella turcica, and/or clivus.

A Novel Method to Locate Intracranial Anatomic Landmarks of Sella Using Three-Dimensional Computed Tomography Reconstruction Images for Endoscopic Endonasal Transsphenoidal Surgery.

OBJECTIVE: To help surgeons to locate the intracranial anatomic landmarks when performing endoscopic endonasal tanssphenoidal surgery using measurements based on three-dimensional computed tomography (CT) reconstruction images. METHOD: High-resolution axial CT images at the thickness of 0.6 mm, and reconstructed 0.41-mm-thick gapless sagittal and coronal CT images were taken from 111 subjects. Using mimics software, first located the points of nasal spine, midpoint of the posterior hard palate and the basic line between them. Then located the medial edge of foramen lacerums, optic canals, midpoints of tuberculum sellae and posterior-inferior sellar floor, measured their distances to nasal spine and angles between the line connecting these structures to nasal spine and the basic line. RESULTS: The mean distance from nasal spine to optic canal is 73.12 ± 4.10 mm, and the corresponding angle is 39.79° ± 3.13°. The distance from the medial edge of foramen lacerum to nasal spine is 79.91 ± 4.01 mm, and the corresponding angle is 23.27° ± 2.89°. The distances from midpoints of the tuberculum sellae and posterior-inferior sellar floor to nasal spine are 76.16 ± 4.56 mm and 82.05 ± 4.81 mm, and the corresponding angles are 34.97° ± 3.24° and 26.39° ± 3.51°, respectively. The distances between both foramen lacerums and optic canals are 22.54 ± 3.25 and 23.44 ± 3.49 mm, respectively. The distance from the midpoint of tuberculum sellae to posterior-inferior sellar floor is 13.33 ± 1.87 mm. CONCLUSION: The current study provides information about intracranial anatomic landmarks, which can help neurosurgeons to locate them and avoid relative complications during endoscopic endonasal transsphenoid surgery. The measurements can be used as surgical indicators to investigate these anatomic landmarks.