Bone Mineral Density Is Inversely Associated With Mortality in Chronic Kidney Disease Patients: A Meta-Analysis.

Low bone mineral density (BMD) is suggested to be associated with increased mortality in the general health population, but the relationship in chronic kidney disease (CKD) patients is still unclear. We performed a meta-analysis to investigate the association of BMD in different sites with risk of all-cause mortality in CKD patients. We searched PubMed, EMBASE, and Web of Science to identify eligible cohort studies that evaluated the association between BMD at different sites and risk of all-cause mortality in CKD patients. Twelve cohort studies were identified, which included 2828 CKD patients and 1052 deaths. Compared with normal/high level of total body BMD, lower total body BMD was associated with 25% higher risk of all-cause mortality. The pooled relative risk (RR) was 1.25 (95% confidence interval [CI] 1.09, 1.42) with little heterogeneity across studies. Regarding BMD measured at different sites, the risk of all-cause mortality was highest for lower BMD at hip/femoral neck (pooled RR = 1.69; 95% CI 1.20, 2.40). The pooled RRs were 1.26 (95% CI 1.04, 1.53) and 1.17 (95% CI 1.00, 1.37) for lower BMD at arm and spine, respectively. Similarly, the risk of death for per SD decrease in BMD was also higher at hip/femoral neck (pooled RR = 1.43, 95% CI 1.15, 1.77) compared with arm (pooled RR = 1.03, 95% CI 1.00, 1.06) and spine (pooled RR = 1.17, 95% CI 0.98, 1.39). In conclusion, lower BMD values at hip, arm, spine, as well as the whole body are associated with increased risk of all-cause mortality in CKD patients. The excess risk is highest for patients with lower BMD at hip/femoral neck, suggesting BMD measured at hip region may be the best indicator of mortality risk in CKD patients. © 2022 American Society for Bone and Mineral Research (ASBMR).

Automatic lumbar spinal MRI image segmentation with a multi-scale attention network.

Lumbar spinal stenosis (LSS) is a lumbar disease with a high incidence in recent years. Accurate segmentation of the vertebral body, lamina and dural sac is a key step in the diagnosis of LSS. This study presents an lumbar spine magnetic resonance imaging image segmentation method based on deep learning. In addition, we define the quantitative evaluation methods of two clinical indicators (that is the anteroposterior diameter of the spinal canal and the cross-sectional area of the dural sac) to assist LSS diagnosis. To improve the segmentation performance, a dual-branch multi-scale attention module is embedded into the network. It contains multi-scale feature extraction based on three 3 × 3 convolution operators and vital information selection based on attention mechanism. In the experiment, we used lumbar datasets from the spine surgery department of Shengjing Hospital of China Medical University to evaluate the effect of the method embedded the dual-branch multi-scale attention module. Compared with other state-of-the-art methods, the average dice similarity coefficient was improved from 0.9008 to 0.9252 and the average surface distance was decreased from 6.40 to 2.71 mm.

miR-548d-3p inhibits osteosarcoma by downregulating KRAS.

MicroRNAs (miRNAs) are known to be associated with certain cancers, including osteosarcoma. We examined osteosarcoma tissues and cell lines, and found that most expressed lower levels of miR-548d-3p than adjacent tissues and normal cell lines. KRAS was identified as a potential target gene of miR-548d-3p. In osteosarcoma cells, miR-548d-3p exerted tumor-suppressive effects by downregulating KRAS. Functional assays revealed that miR-548d-3p mimics dramatically reduced cell growth and migration in vitro. These results suggest that miR-548d-3p mimics could be applied for osteosarcoma treatment.

SPAG9 is overexpressed in osteosarcoma, and regulates cell proliferation and invasion through regulation of JunD.

Sperm-associated antigen 9 (SPAG9) is a recently characterized oncoprotein that is considered to be involved in several forms of malignant tumor. However, its biological function and expression pattern in human osteosarcoma have not yet been elucidated. In the present study, SPAG9 expression was analyzed in 58 cases of human osteosarcoma by immunohistochemistry. The results demonstrated that SPAG9 was overexpressed in 63.8% (37/58) of osteosarcoma tissues, while normal bone tissues exhibited negative SPAG9 expression. SPAG9 small interfering RNA was employed in the U2OS cell line, which has high endogenous expression, and SPAG9 transfection was performed in the MG63 cell line, which has low endogenous expression. MTT and Matrigel invasion assays demonstrated that SPAG-9-knockdown significantly reduced U2OS cell invasion and proliferation, while SPAG9 transfection enhanced MG63 cell proliferation and invasion. Furthermore, it was observed that SPAG9 positively regulated cyclin D1, phosphorylated-c-Jun NH2-terminal kinase (JNK) and JunD expression. Treatment with the JNK inhibitor, SP600125, abolished the upregulatory effect of SPAG9 on JunD. Taken together, the present study identified SPAG9 as a critical oncoprotein involved in osteosarcoma proliferation and invasion, possibly functioning through JNK-JunD signaling.

Prevalence of C5 nerve root palsy after cervical decompressive surgery: a meta-analysis.

PURPOSE: To investigate the epidemiological prevalence of C5 palsy in patients following cervical decompressive surgery. METHODS: We searched the PUBMED database for relevant studies that mentioned the incidence of C5 palsy after cervical surgery. We also manually screened reference lists for additional qualified articles. Relevant prevalence estimates were calculated by an appropriate meta-analysis. Subgroup analysis, sensitivity analysis, and publication bias assessment were also performed, respectively. RESULTS: Finally, a total of 79 studies, with 704 C5 palsy cases in 13,621 patients, were included in our meta-analysis. The overall pooled prevalence of C5 palsy was 5.3% (95% CI 4.6-6.0%). Individuals after posterior cervical surgery (5.8%) had a slightly higher prevalence than those after anterior surgery (5.2%), and a similar trend was observed between ossification of posterior longitudinal ligament (OPLL) (5.8%) and cervical spondylotic myelopathy (CSM) (4.5%). The highest prevalence (11.0%) was found in patients who underwent laminectomy and fusion (LIF), while those who received anterior cervical discectomy and fusion (ACDF) had the lowest prevalence (3.3%). Other intermediate prevalence estimates increased gradually, from cervical laminoplasty-only (CLP-only) (5.1%), to CLP plus other posterior procedures (6.5%) and anterior cervical corpectomy and fusion (ACCF) (7.5%). The prevalence was significantly higher in male (5.2%) than in female (2.2%) patients. In most cases, C5 palsy was unilateral and transient, and diagnosed within 3 days (3.4%). CONCLUSION: Cervical surgery is associated with high risk of C5 palsy, particularly in patients who received LIF and in male patients. These figures may be useful in the estimation of the probability of C5 palsy following cervical surgery.