Identification of immune-related biomarkers co-occurring in acute ischemic stroke and acute myocardial infarction.

Background: Acute ischemic stroke (AIS) and acute myocardial infarction (AMI) share several features on multiple levels. These two events may occur in conjunction or in rapid succession, and the occurrence of one event may increase the risk of the other. Owing to their similar pathophysiologies, we aimed to identify immune-related biomarkers common to AIS and AMI as potential therapeutic targets. Methods: We identified differentially expressed genes (DEGs) between the AIS and control groups, as well as AMI and control groups using microarray data (GSE16561 and GSE123342). A weighted gene co-expression network analysis (WGCNA) approach was used to identify hub genes associated with AIS and/or AMI progression. The intersection of the four gene sets identified key genes, which were subjected to functional enrichment and protein-protein interaction (PPI) network analyses. We confirmed the expression levels of hub genes using two sets of gene expression profiles (GSE58294 and GSE66360), and the ability of the genes to distinguish patients with AIS and/or AMI from control patients was assessed by calculating the receiver operating characteristic values. Finally, the investigation of transcription factor (TF)-, miRNA-, and drug-gene interactions led to the discovery of therapeutic candidates. Results: We identified 477 and 440 DEGs between the AIS and control groups and between the AMI and control groups, respectively. Using WGCNA, 2,776 and 2,811 genes in the key modules were identified for AIS and AMI, respectively. Sixty key genes were obtained from the intersection of the four gene sets, which were used to identify the 10 hub genes with the highest connection scores through PPI network analysis. Functional enrichment analysis revealed that the key genes were primarily involved in immunity-related processes. Finally, the upregulation of five hub genes was confirmed using two other datasets, and immune infiltration analysis revealed their correlation with certain immune cells. Regulatory network analyses indicated that GATA2 and hsa-mir-27a-3p might be important regulators of these genes. Conclusion: Using comprehensive bioinformatics analyses, we identified five immune-related biomarkers that significantly contributed to the pathophysiological mechanisms of both AIS and AMI. These biomarkers can be used to monitor and prevent AIS after AMI, or vice versa.

Refining and psychometric evaluation of the falling risk assessment tool in ophthalmology inpatients.

AIMS: The aim of this study was to refine the Falling Risk Assessment Tool in Ophthalmology Inpatients (FRAT) and assess its psychometric properties. DESIGN: A cross-sectional design was used. METHODS: A convenience sample of 730 patients in the ophthalmology department was recruited in a level A tertiary hospital in Guangdong Province from July 2021 to January 2022. Data were analysed using item analysis, interrater reliability, content validation, internal consistency reliability and exploratory factor analysis. RESULTS: Five factors were extracted, accounting for 63.039% of the variance. The interrater reliability of the tool was 0.97. Cronbach's α was 0.658. The I-CVI was 0.75-1.00, the S-CVI/UA was 0.95 and the adjusted mean values of Kappa for indicators ranged from 0.72 to 1.00, as evaluated by the expert group. The FRAT showed satisfactory reliability and validity, and can be used to measure the fall risk assessment in ophthalmology inpatients. PATIENT OR PUBLIC CONTRIBUTION: After explaining the purpose, the patients received our fall risk assessment and answered the corresponding questionnaire questions.

An Intelligent Epileptic Prediction System Based on Synchrosqueezed Wavelet Transform and Multi-Level Feature CNN for Smart Healthcare IoT.

Epilepsy is a common neurological disease worldwide, characterized by recurrent seizures. There is currently no cure for epilepsy. However, seizures can be controlled by drugs and surgeries in about 70% of epileptic patients. A timely and accurate prediction of seizures can prevent injuries during seizures and improve the patients' quality of life. In this paper, we proposed an intelligent epileptic prediction system based on Synchrosqueezed Wavelet Transform (SWT) and Multi-Level Feature Convolutional Neural Network (MLF-CNN) for smart healthcare IoT network. In this system, we used SWT to map EEG signals to the frequency domain, which was able to measure the energy changes in EEG signals caused by seizures within a well-defined Time-Frequency (TF) plane. MLF-CNN was then applied to extract multi-level features from the processed EEG signals and classify the different seizure segments. The performance of our proposed system was evaluated with the publicly available CHB-MIT dataset and our private ZJU4H dataset. The system achieved an accuracy of 96.99% and 94.25%, a sensitivity of 96.48% and 97.76%, a specificity of 97.46% and 94.07% and a false prediction rate (FPR/h) of 0.031 and 0.049 FPR/h on the CHB-MIT dataset and the ZJU4H dataset, respectively.

Novel recombinant human thyroid-stimulating hormone in aiding postoperative assessment of patients with differentiated thyroid cancer-phase I/II study.

PURPOSE: Thyroid hormone withdrawal (THW) inevitably induced hypothyroidism in patients with differentiated thyroid cancer (DTC), and we aimed to evaluate the safety and efficacy of a novel recombinant human thyroid-stimulating hormone (rhTSH, ZGrhTSH) as an alternative of THW in China. METHODS: Totally, 64 DTC patients were enrolled with 24 in the dose-escalation cohort equally grouped into 0.9 mg × 1 day, 0.9 mg × 2 day, 1.8 mg × 1 day, and 1.8 mg × 2 day dosage, and 40 further enrolled into 0.9 mg × 2 day dose-expansion cohort. All patients underwent both ZGrhTSH phase and levothyroxine (L-T4) withdrawal phase for self-comparison in terms of TSH levels, the radioactive iodine (RAI) uptake, stimulated thyroglobulin level, and the quality of life (QoL). RESULTS: In ZGrhTSH phase, no major serious adverse events were observed, and mild symptoms of headache were observed in 6.3%, lethargy in 4.7%, and asthenia in 3.1% of the patients, and mostly resolved spontaneously within 2 days. Concordant RAI uptake was noticed in 89.1% (57/64) of the patients between ZGrhTSH and L-T4 withdrawal phases. The concordant thyroglobulin level with a cut-off of 1 µg/L was noticed in 84.7% (50/59) of the patients without the interference of anti-thyroglobulin antibody. The QoL was far better during ZGrhTSH phase than L-T4 withdrawal phase, with lower Billewicz (- 51.30 ± 4.70 vs. - 39.10 ± 16.61, P < 0.001) and POMS (91.70 ± 16.70 vs. 100.40 ± 22.11, P = 0.011) scores which indicate the lower the better. Serum TSH level rose from basal 0.11 ± 0.12 mU/L to a peak of 122.11 ± 42.44 mU/L 24 h after the last dose of ZGrhTSH. In L-T4 withdrawal phase, a median of 23 days after L-T4 withdrawal was needed, with the mean TSH level of 82.20 ± 31.37 mU/L. The half-life for ZGrhTSH clearance was about 20 h. CONCLUSION: The ZGrhTSH held the promise to be a safe and effective modality in facilitating RAI uptake and serum thyroglobulin stimulation, with better QoL of patients with DTC compared with L-T4 withdrawal.

Energy Efficient SWIPT Based Mobile Edge Computing Framework for WSN-Assisted IoT.

With the increasing deployment of IoT devices and applications, a large number of devices that can sense and monitor the environment in IoT network are needed. This trend also brings great challenges, such as data explosion and energy insufficiency. This paper proposes a system that integrates mobile edge computing (MEC) technology and simultaneous wireless information and power transfer (SWIPT) technology to improve the service supply capability of WSN-assisted IoT applications. A novel optimization problem is formulated to minimize the total system energy consumption under the constraints of data transmission rate and transmitting power requirements by jointly considering power allocation, CPU frequency, offloading weight factor and energy harvest weight factor. Since the problem is non-convex, we propose a novel alternate group iteration optimization (AGIO) algorithm, which decomposes the original problem into three subproblems, and alternately optimizes each subproblem using the group interior point iterative algorithm. Numerical simulations validate that the energy consumption of our proposed design is much lower than the two benchmark algorithms. The relationship between system variables and energy consumption of the system is also discussed.

Disrupted interhemispheric resting-state functional connectivity and structural connectivity in first-episode, treatment-naïve generalized anxiety disorder.

BACKGROUND: Aberrant functional and structural connectivity are considered to be involved in the underlying neural mechanism of generalized anxiety disorder (GAD). However, alterations in functional and structural interactions between the bilateral hemispheres are rarely examined. The current study aimed to characterized interhemispheric resting-state functional connectivity and white matter microstructural integrity of the corpus callosum in patients with GAD. METHODS: Resting-state Blood oxygen level-dependent and diffusion tensor image were acquired for patients with GAD and healthy subjects. The two groups were matched in age, gender, education years. The voxel-mirrored homotopic connectivity (VMHC) of whole brain and white matter integrity of the corpus callosum (CC) were compared between the two groups. Their correlations with clinical measures were further performed. RESULTS: Compare to controls, decreased resting-state VMHC were found in the precentral gyrus, middle cingulate gyrus and insula/putamen in patients with GAD. No regions of increased VMHC were detected in GAD. Compared to controls, GAD patients showed decreased fractional anisotropy (FA) values in CC2. In GAD group, further Pearson's correlation analyses showed that VMHC of the midcingulate gyrus positively correlated with FA of CC2, FA of CC2 negatively correlated with anxiety severity. Further mediation analyses demonstrated that attenuated VMHC in bilateral midcingulate gyrus partly mediated the association between white matter integrity of CC2 sub-region and anxiety severity. CONCLUSION: Our findings suggested impairment of interhemispheric coordination in GAD. Moreover, disrupted interhemispheric connectivity correlated with anxiety severity in GAD. Our findings provided a novel clue about the neural mechanism of GAD, and may contribute to further deep exploration and treatment of GAD. LIMITATIONS: The study was lack of comparison with non-GAD anxiety disorders.

Skip corpectomy and fusion (SCF) versus anterior controllable antedisplacement and fusion (ACAF): which is better for patients with multilevel cervical OPLL?

BACKGROUND: The aim of this study was to compare the clinical efficacy and radiological outcomes of skip corpectomy and fusion (SCF) with anterior controllable antedisplacement and fusion (ACAF) for treating multilevel ossification of the posterior longitudinal ligament (OPLL). METHODS: 62 patients with multilevel OPLL who had undergone SCF or ACAF were analyzed retrospectively. Types of OPLL, occupying ratio (OR), Japanese Orthopaedic Association (JOA) score, Recovery Rate (RR), Neck Disability Index (NDI) score, Cobb's angles of C2-C7, operation time, blood loss, hospital stay, ratings for fusion assessment and complications were recorded and assessed. RESULTS: Postoperative C2-C7 Cobb's angle (11.1 ± 3.2° vs. 13.7 ± 2.5°; P < 0.05), NDI scores at final follow-up (14.3 ± 1.6 vs. 13.3 ± 1.3; P < 0.05), and rate of cerebral fluid (CSF) leakage (5, 16.7% vs. 0,0%; P < 0.05) were significantly better in the ACAF group. At 6 months, bone graft fusion rate was significantly greater in the ACAF group (24.75% vs. 15.50%; P < 0.05). CONCLUSIONS: Surgical treatment of multilevel OPLL by SCF or ACAF showed no significant differences in clinical outcomes, with the exception of better NDI scores at final follow-up in ACAF. In addition, ACAF is better than SCF in terms of early bone graft fusion rate, lordotic curvature improvement, risk of CSF leakage.

A Secure Transmission Scheme Based on Artificial Fading for Wireless CrowdSensing Networks.

For secure transmission of low cost single antenna communication nodes in wireless crowdsensing networks under static channel, a physical layer communication scheme is proposed, where each digital modulated symbol is encrypted by a random key at the transmitter and decrypted with the same key at the receiver. The legal users exploit the synchronized chaotic sequence and the two-stage block interleaver to generate a complex random variable (random key), whereby its envelope obeys the Rayleigh distribution and its phase obeys the uniformly distribution. The modulated symbol is multiplied by the complex random variable (encryption) to imitate the Rayleigh fading of the channel at the transmitting end. The received symbol is divided by the identical complex random variable (decryption) to recover the transmitted message before the digital demodulation at the receiving end. Simulation results show that the bit error ratio (BER) performance of the legitimate users is consistent with the theoretical value of the Rayleigh fading channel, while the corresponding BER of the eavesdropper is too high (about 0.5) to intercept any information.

Bergapten promotes bone marrow stromal cell differentiation into osteoblasts in vitro and in vivo.

Many recent studies have suggested that bergapten (BP), a class of native compound with numerous biological activities such as anti-resorptive properties, may exert protective effects against postmenopausal bone loss. However, it remains unknown whether BP regulates or improves the osteogenic function of bone marrow stromal cells (BMSCs) in the treatment and prevention of osteoporosis. In our study, BMSCs were cultured in osteogenic induction medium with the addition of BP for 2 weeks and an ovariectomized mouse model of osteoporosis was used to investigate the anti-resorptive effect of BP by gavage administration for 3 months. The concentrations of BP used were 0.1, 1, and 10 µmol/L in vitro and the gavage dose was 20 mg/kg/d. The result of our study indicated that BP promotes the expression of alkaline phosphatase (ALP) by BMSCs in vitro in a dose-dependent manner, as revealed by ALP staining. Runt-related transcription factor 2 and osteocalcin were up-regulated both in vitro and vivo, while osterix and collagen Iα1, assessed by immunofluorescence and immunohistochemistry, were correspondingly raised in the presence of BP in BMSCs in vitro. In addition, a protective effect of BP against ovariectomy-induced bone loss was found by distal femur micro-CT scanning, with improvements of bone metabolism parameters such as bone mineral density, trabecular number, and trabecular separation. Furthermore, WNT/ß-catenin signaling was activated in the presence of BP in BMSCs in osteogenic culture. Finally, BP promoted differentiation of BMSCs into osteoblasts by up-regulation of the WNT/ß-catenin pathway.

99mTc-dextran lymphoscintigraphy can detect sentinel lymph node in breast cancer patients.

The aim of this study was to retrospectively determine the accuracy and feasibility of using 99mTc-dextran (DX) lymphoscintigraphy for the localization of sentinel lymph nodes (SLNs) in breast cancer patients. The relevant factors affecting lymphoscintigraphy were also investigated. In this study, 235 breast cancer patients underwent 99mTc-DX lymphoscintigraphic imaging and examination by a γ-probe method in combination with blue dye staining to detect SLNs. The detection results were considered in combination with rapid frozen pathology results to determine whether SLN metastasis was positive or negative. SLNs were identified in 191 patients by γ-probe detection among the 202 patients that tested positive by lymphoscintigraphic imaging, a coincidence rate of 94.6%. This suggested that lymph node metastasis had occurred and could be detected using lymphoscintigraphy. The axillary status of the breast cancer patients was also predicted using lymphoscintigraphy and the false-negative rate, sensitivity, specificity and positive predictive value were 13.3% (4/30), 90.7% (39/43), 23.4% (45/192) and 13.5% (21/155), respectively. The age of the patient, menstrual status, tumor location, tumor size, pathological type, preoperative biopsy and neoadjuvant chemotherapy were unrelated to the success of lymphoscintigraphy (P>0.05). 99mTc-DX lymphoscintigraphy is able to exactly determine the location of SLN in breast cancer patients, and can be used for guiding γ-probe methods and sentinel lymph node biopsy.

[Clinical applications of apparent diffusion coefficient value for evaluation of hip joint of ankylosing spondylitis active lesions].

OBJECTIVE: To evaluate the apparent diffusion coefficient (ADC) value in differential diagnosis of ankylosing spondylitis active lesions. METHOD: A total of 68 patients with AS involving hip joint who were diagnosed in Third Affiliated Hospital of Southern Medical University form March 2010 to December 2014 were evaluated by MRI. The ADC values of the hip joint lesions were measured and compared in 38 cases of ankylosing spondylitis active lesions (active group) and 30 cases of ankylosing spondylitis in stable period (stable group), all cases were confirmed by clinical diagnosis. RESULTS: There are 238 lesions were detected demonstrating hyperintens in DWI and ADC picture. The mean ADC values of active group and stable group were (1.00 ± 0.13) × 10⁻³ mm²/s and (0.65 ± 0.12) × 10⁻³ mm²/s (t=-11.85, P=0.00). The correlation coefficient between ADC and BASDAI score is 0.831 (P<0.01). ROC curve showed that the threshold ADC value differentiating active group and stable group was 0.81 × 10⁻³ mm²/s, with a sensitivity of 94.7%and specificity of 90%. CONCLUSION: The ADC value of hip joint lesion of AS patient can help to determine the nature of the ankylosing spondylitis.

[Magnetic resonance imaging for pelvic bone marrow fat deposition in patients with ankylosing spondylitis].

OBJECTIVE: To evaluate the diagnostic value of pelvis bone marrow fat depositions (BMFD) displayed by magnetic resonance imaging (MRI) in patients with ankylosing spondylitis (AS). METHODS: Eighty-eight subjects undergoing pelvic MRI examinations were enrolled in this study, including 44 with clinically confirmed AS (39 male and 5 female patients with a mean age of 26.41∓8.09 years) and 44 control subjects without AS (37 male and 7 female subjects with a mean age of 29.32∓7.31 years). The incidence of BMFD in the bilateral sacroiliac (SI) joints and acetabulum were compared between the two groups. The distribution features of BMFD of the periarticular cancellous bone marrow in the pelvis and in other regions of the pelvis were analyzed for the AS patients, and the incidence of BMFD was determined in different stages of sacroiliitis and hip arthritis. RESULTS: The incidence of BMFD in the SI joints and acetabulum was significantly higher in the AS patients than in the control subjects (P<0.01); The incidence of BMFD was significantly higher in the periarticular cancellous bone marrow than in the other positions of pelvis (P<0.01). The incidence of BMFD ranged from 40.0% to 45.9% in early stages of sacroiliitis, significantly lower than the incidence in later stages (58.3%-73.1%, P<0.01); the incidence showed no difference between different stages of hip arthritis (P>0.01). CONCLUSIONS: AS patients have a higher incidence of BMFD in the pelvis than control subjects. BMFD is distributed mainly under the articular surface, seen throughout the stages of AS, indicating that BMFD is an important pathological change of the bone marrow in AS to potentially allow early diagnosis of AS.

[Value of multi-detector row CT and magnetic resonance imaging in the diagnosis of retinal detachment].

OBJECTIVE: To summarize multi-detector row CT (MDCT) and magnetic resonance imaging (MRI) features of retinal detachment and evaluate the diagnostic value of these two imaging modalities. METHODS: The MDCT and MRI manifestations were reviewed in 45 cases (47 eyes) of retinal detachment, among which 16 cases (17 eyes) were examined by MDCT and 29 cases (30 eyes) by MRI. Thirty-two cases (33 eyes) were confirmed by operation, and the other 13 cases (14 eyes) were confirmed based on the clinical findings. RESULTS: MDCT and MRI displayed signs of fluid retention between the detached retina and the posterior wall of the eyeball in the cases. Among all these cases, 21 eyes showed simple retinal detachment and 26 had also other pathologies (hemorrhage in 20 eyes and calcification in 6 eyes). Choroidal osteoma was identified in 3 eyes and melanoma of choroid in 5 eyes. CONCLUSION: MDCT is sensitive in detecting calcification in the eyes and MRI with a minimal risk of radiation, and shows advantages in displaying hemorrhage and confined retinal detachment. Both MDCT and MR have high clinical value in the diagnosis of retinal detachment, and their choice depends on the individual condition of the patients.

[Multi-detector row computer tomography findings of fibrous dysplasia in orbital bone].

PURPOSE: To evaluate the efficacy of multi-detector row CT (MDCT) findings in the diagnosis of fibrous dysplasia (FD) in orbital bone. METHODS: The MDCT manifestations of 18 cases of FD in orbital bone (6 cases from the 458th hospital of PLA, 12 cases from the Zhongshan ophthalmic center of Sun Yat-Sen university) collected from April 2002 to August 2009 were reviewed. Six cases were confirmed by biopsy, 5 cases were confirmed by operation and postoperative pathology, the remaining 6 cases were confirmed based on typical CT findings. RESULTS: FD in orbital bone could be originated from monostotic single lesion (5 cases), monostotic multiple lesions (1 cases) or polyostotic multiple lesions (12 cases). Twelve lesions were originated in the frontal bone, 5 lesions in the sphenoid, 2 lesions in the ethmoid, 7 lesions in the temporal bone. CONCLUSIONS: MDCT is very important in the diagnosis and treatment strategy of FD in orbital bone correctly. It help identify the location and extension of the lesions based on the axial plane, coronal plane and sagittal plane view.