Application of multiplanar reconstruction and 3D printing in anterior cruciate ligament revision. / 多平面重建及3D打印在前交叉韧带翻修术中的应用.

OBJECTIVES: Anterior cruciate ligament injury is the most common type of knee joint ligament injury. Anterior cruciate ligament reconstruction has a high failure rate, with bone tunnel abnormalities as the most significant factor in these failures. Digital orthopedic technology can effectively develop implementation plans for the revision, thus increasing the success rate. This study aims to develop a surgical plan for anterior cruciate ligament revision by employing multiplanar reconstruction (MPR) for measuring bone tunnel position and diameter, and simulating bone tunnel creation via 3D printing preoperatively. METHODS: A total of 12 patients who underwent anterior cruciate ligament revision at the Third Xiangya Hospital of Central South University between 2014 and 2021 were retrospectively studied. The data included patient demographics, preoperative formulated knee joint 3D printing models, and preoperative knee CT scans. The study measured the bone tunnel's diameter and position to guide the establishment of revision bone tunnels during surgery, reassessed the postoperative bone tunnels, and evaluated knee joint functional scores [including International Knee Documentation Committee Knee Evaluation Form (IKDC) score, Lysholm score, and Tegner exercise level score]. RESULTS: Preoperative measurements revealed suboptimal femoral tunnels positions in 4 patients and tibial tunnels positions in 2 patients. MPR and 3D printing technology were used to guide the establishment of a new bone canal during surgery, and postoperative measurements were satisfactory for all patients. Preoperative measurements demonstrated the interclass correlation coefficient for femoral tunnels and tibial tunnels diameters were 0.843 (P<0.05) and 0.889 (P<0.001), respectively. Meanwhile, the intraclass correlation coefficient were 0.811 (P<0.05) and 0.784 (P<0.05), respectively. The intraoperative diameter of femoral and tibial tunnels showed excellent correlation with postoperative CT measurements, with intraclass correlation coefficient values of 0.995 (P<0.001) and 0.987 (P<0.001), respectively. All bone tunnel positions were within the normal range. At the final follow-up, knee joint function scores in all 12 patients improved significantly compared to pre-surgery (P<0.001), and the reoperation rate was zero. CONCLUSIONS: MPR and 3D printing technology can accurately measure the parameters of reconstructed anterior cruciate ligament bone tunnels. Personalized revision plans for patients with reconstruction failure enhances the success rate of revision surgery and improves patient prognosis.

Lightweight Attentive Graph Neural Network with Conditional Random Field for Diagnosis of Anterior Cruciate Ligament Tear.

Anterior cruciate ligament (ACL) tears are prevalent orthopedic sports injuries and are difficult to precisely classify. Previous works have demonstrated the ability of deep learning (DL) to provide support for clinicians in ACL tear classification scenarios, but it requires a large quantity of labeled samples and incurs a high computational expense. This study aims to overcome the challenges brought by small and imbalanced data and achieve fast and accurate ACL tear classification based on magnetic resonance imaging (MRI) of the knee. We propose a lightweight attentive graph neural network (GNN) with a conditional random field (CRF), named the ACGNN, to classify ACL ruptures in knee MR images. A metric-based meta-learning strategy is introduced to conduct independent testing through multiple node classification tasks. We design a lightweight feature embedding network using a feature-based knowledge distillation method to extract features from the given images. Then, GNN layers are used to find the dependencies between samples and complete the classification process. The CRF is incorporated into each GNN layer to refine the affinities. To mitigate oversmoothing and overfitting issues, we apply self-boosting attention, node attention, and memory attention for graph initialization, node updating, and correlation across graph layers, respectively. Experiments demonstrated that our model provided excellent performance on both oblique coronal data and sagittal data with accuracies of 92.94% and 91.92%, respectively. Notably, our proposed method exhibited comparable performance to that of orthopedic surgeons during an internal clinical validation. This work shows the potential of our method to advance ACL diagnosis and facilitates the development of computer-aided diagnosis methods for use in clinical practice.

Preoperative ultrasound can accurately predict the diameter of double-stranded peroneus longus tendon autografts.

PURPOSE: This study aimed to determine the correlation between the intraoperative diameter of double-stranded peroneus longus tendon (2PLT) and length of the PLT autograft and preoperative ultrasound (US) measurements, as well as radiographic and anthropometric measurements. The hypothesis was that US can accurately predict the diameter of 2PLT autografts during operation. METHODS: Twenty-six patients underwent ligament reconstruction with 2PLT autografts were included. Preoperative US was used to calculate the in situ PLT cross-sectional area (CSA) at seven levels (0, 1, 2, 3, 4, 5, 10 cm proximal to the harvest start point). Femoral width, notch width, notch height, maximum patellar length, and patellar tendon length were determined on preoperative radiographs. Intraoperative measurements of PLT were made, including all fiber lengths of PLT and diameters of 2PLT using sizing tubes calibrated to 0.5 mm. RESULTS: CSA at 1 cm proximal to the harvest site had the highest correlation with the diameter of 2PLT (r = 0.84, P < 0.001). Calf length had the highest correlation with PLT length (r = 0.65, P < 0.001). The diameter of the 2PLT autografts could be predicted by the following formula: 4.6 + 0.2 × [sonographic CSA of PLT at 1 cm level]; the length of PLT could be predicted by the following formula: 5.6 + 0.5 × Calf length. CONCLUSION: The diameter of 2PLT and length of PLT autografts can be accurately predicted by preoperative US and calf length measurements, respectively. Accurate preoperative prediction of the diameter and length of autologous grafts can provide the most suitable and individualized graft for patients. LEVEL OF EVIDENCE: IV.

Medial meniscus tears are most prevalent in type I ACL tears, while type I ACL tears only account for 8% of all ACL tears.

PURPOSE: This study aimed to assess the distribution of different anterior cruciate ligament (ACL) tear locations in different magnetic resonance imaging (MRI) planes, and to explore the relationships of ACL tear types with both meniscus injuries and bone bruising. METHODS: A retrospective study was performed in patients under 60 years old who underwent MRI scans in the sagittal and coronal oblique planes of the knee for ACL tears between 2014 and 2020. Patients with reports of chronic tears, partial tears, or prior surgeries were excluded. Tear locations were classified into five types, and the meniscus tear measurement variables included the presence of ramp, root, bucket-handle, and other types of tears. All injuries were confirmed by arthroscopy. Meanwhile, the presence and location of bone bruising were analysed and scored with the Whole-Organ Magnetic Resonance Imaging Score (WORMS) bone bruising subscale. RESULTS: A total of 291 patients were included. The prevalence rates of type I and type III injuries were 23/291 (7.9%) and 145/291 (49.8%) in the sagittal plane and 22/291 (7.6%) and 179/291 (61.5%) in the oblique coronal plane, respectively. The prevalence of medial meniscus tears with ACL tears was 126/291 (43.3%), while that of lateral meniscus tears with ACL tears was 77/291 (26.5%). The highest prevalence of medial meniscus injury with ACL tears was 15/22 (68.2%) for type I injuries. Bone bruises were located on the lateral femoral center in 125 patients (46%) and on the lateral tibia posterior in 132 patients (48%); the common areas of bone bruising were slightly correlated with type III ACL tears but not correlated with type I ACL tears. CONCLUSION: The plane in which an MRI scan is performed affects the classification of ACL tears. The tear type is associated with the prevalence of medial meniscus injuries, and medial meniscus tears are most prevalent in type I ACL tears. LEVEL OF EVIDENCE: IV.

Effects of Diet on Larval Survival, Growth, and Development of the Sea Cucumber Holothuria leucospilota.

Because most tropical sea cucumbers have been overexploited around the world, the sea cucumber Holothuria leucospilota has become increasingly commercially important in recent years. Restocking and aquaculture of H. leucospilota using hatchery-produced seeds could both enhance declining wild populations and provide sufficient beche-de-mer product to satisfy increasing market demand. Identifying an appropriate diet is important for successful hatchery culture of the H. leucospilota. In this study, we trialed different ratios of microalgae Chaetoceros muelleri (2.00-2.50 × 106 cells/mL) and yeast (Saccharomyces cerevisiae, ~2.00 × 106 cells/mL) in diets for H. leucospilota larvae (6 d after fertilization, referred to as "day 0") at proportions 4 : 0, 3 : 1, 2 : 2, 1 : 3, and 0 : 4 by volume, in 5 treatments (A, B, C, D, and E, respectively). Larval survival rates in these treatments decreased over time, with the survival highest in treatment B (59.24 ± 2.49%) on day 15 (double that of the lowest rate in treatment E (28.47 ± 4.23%)). For any sampling event, larval body length in treatment A was always the lowest after day 3, and that for treatment B was always the highest, except on day 15. The maximum percentage of doliolaria larvae occurred in treatment B (23.33%) on day 15, followed by treatments C, D, and E (20.00%, 10.00%, and 6.67%, respectively). No doliolaria larvae occurred in treatment A, and pentactula larvae occurred only in treatment B (3.33%). On day 15 in all treatments, late auricularia larvae had hyaline spheres, but these were not prominent in treatment A. Densities of juveniles attaching to settlement plates varied with treatments, and the values were very low for the larvae only fed microalgae (A, 2.39 ± 1.95 ind per plate) or yeast (E, 2.13 ± 1.05 ind per plate)-only ~5% of the maximum number settling in treatment B (45.56 ± 7.24 ind per plate). Increased larval growth, survival and development, and juvenile attachment indicates that diets combining microalgae and yeast are more nutritionally balanced than single diets for hatchery of H. leucospilota. A combined diet of C. muelleri and S. cerevisiae at a 3 : 1 ratio is optimum for the larvae. Based on our results, we propose a larval rearing protocol to facilitate mass production of H. leucospilota.

Urgently reveal longly hidden toxicant in a familiar fabrication process of biomass-derived environment carbon material.

Biomass-derived N-doped carbon (BNC) is an important environmental material and widely used in the fields of water purification and soil remediation. However, the toxicant in the commonly used synthesis process of BNC materials have been largely ignored. Herein, we firstly report the presence of a highly toxic by-product (KCN) in the activation process of BNC materials consequential of the carbothermal reduction reaction. Because this carbothermal reduction reaction also regulates the N-doping and pore development of BNC materials, the KCN content directly relates with the properties of BNC material properties. Accordingly, a high KCN content (∽ 611 mg) can occur in the production process of per g BNC material with high specific surface area (∽ 3600 m2/g). Because the application performance of BNC material is determined by the surface area and available N doping, therefore, production of a BNC material with high performance entails high risk. Undoubtedly, this study proves a completely new risk recognition on a familiar synthesis process of biomass-based material. And, strict protective device should be taken in fabrication process of biomass-derived carbon material.

Organoarsenic conversion to As(III) in subcritical hydrothermal reaction of livestock manure.

Liquid phase produced by the subcritical hydrothermal liquefaction (HTL) of livestock manure is extensively used in agronomic and environmental applications, but the potential risks caused by inherent pollutants (e.g., roxarsone, ROX) of the livestock manure have not been considered. This study shows that less toxic ROX is completely converted into highly toxic As(III) and As(V) in the HTL reaction with temperature more than 240 °C. Moreover, more than 81.5% of As is distributed in the liquid phase generated by the livestock manure HTL reaction. Notably, the hydrothermal products of livestock manure facilitate the conversion of As(V) to As(III). The resulting hydrochar and aldehydes act as electron donors for As(V) reduction, thus resulting in the formation of As(III). Furthermore, the dissociated As promotes the depolymerization and deoxygenation of the macromolecular compounds to produce more small oxygen-containing compounds such as aldehydes, further boosting the As(V) reduction to As(III). These results indicate that the liquid phase of the livestock manure has potential risks in applications as a fertilizer. Such findings have substantial implications in biomass utilization and redox reactions of envirotechnical and biogeochemical relevance.

Reveal a hidden highly toxic substance in biochar to support its effective elimination strategy.

With the aim to develop optimized biochar with minimal contaminants, it is important significance to broaden the understanding of biochar. Here, we disclose for the first time, a highly toxic substance (metal cyanide, MCN, such as KCN or NaCN) in biochar. The cyanide ion (CN-) content in biochar can be up to 85,870 mg/kg, which is determined by the inherent metal content and type in the biomass with K and Na increasing and Ca, Mg and Fe decreasing its formation. Density functional theory (DFT) analysis shows that unstable alkali oxygen-containing metal salts such as K2CO3 can induce an N rearrangement reaction to produce for example, KOCN. The strong reducing character of the carbon matrix further converts KOCN to KCN, thus resulting biochar with high risk. However, the stable Mg, Ca and Fe salts in biomass cannot induce an N rearrangement reaction due to their high binding energies. We therefore propose that high valent metal chloride salts such as FeCl3 and MgCl2 could be used to inhibit the production of cyanide via metal interactive reaction. These findings open a new point of view on the potential risk of biochar and provide a mitigation solution for biochar's sustainable application.

N-rich hydrochar derived from organic solvent as reaction medium generates toxic N-containing mineral in its pyrochar.

Low-grade hydrochar is often thermally activated to produce pyrochar. However, the interaction between inherent metals and N element during hydrochar activation process has never been considered. Present study revealed that a highly toxic N-containing mineral (MCN, M: metal) can be formed in N-rich hydrochar-based pyrochar via N rearrangement and subsequent carbothermal reactions. This atypical hydrochar is mainly produced from organic wastes with K2CO3 or Na2CO3 (such as food waste) in an organic solvent medium. The CN- concentration of studied pyrochar can reach to 9807 mg/kg, which is mainly determined by content and type of metal in hydrochar. The low N conversion rate (<4.2%) indicates that formation of MCN is independent of N content in hydrochar. Essentially, formation of MCN can be significantly inhibited by FeCl3 via the anionic interactions between Fe and K salt. This discovery can likely offer a new guide for the application of N-rich hydrochar-based pyrochar.

Phosphorus and nitrogen transformation in antibiotic mycelial residue derived hydrochar and activated pyrolyzed samples: Effect on Pb (II) immobilization.

In this study, lincomycin residue (LR, a type of antibiotic mycelial residue) derived hydrochar samples (LR-HCs) were obtained from hydrothermal carbonization (HTC), and pyrolysis applied to these LR-HCs to produce activated pyrolyzed samples (LR-APs). Transformation of phosphorus (P) and nitrogen (N) species during HTC and pyrolysis was of primary interest and characterized by several techniques. Nitrogen content of dry LR was calculated by elemental analysis, being 7.91 wt. %, decreasing to 2.51 after HTC and 1.12 wt. % after concesutive HTC and pyrolysis. FT-IR analysis provided evidence for amine groups in LR samples. XPS analysis described N species (Pyridinic-N, Amine-N, Protein-N, Pyrrolic-N, and Quaternary-N) and P species (ortho-P/pyro-P and Ar-P) in LR samples, effectively. Sequential extraction showed that the HTC and pyrolysis changed the proportion of the P species from labile (P-NaHCO3 and P-NaOH) to stable ones (P-residue). Utilization and suitability of as-prepared LR-HCs and LR-APs for heavy metal Pb (II) immobilization show promising results. To help understand immobilization process, kinetic (pseudo-1st-order and pseudo-2nd-order) and isotherm (Freundlich) models were tested and verified. Results confirmed that P and N species were transformed during HTC and pyrolysis and that these processes lead to an advantageous effect on Pb (II) removal from solution.

Conversion of phosphorus and nitrogen in lincomycin residue during microwave-assisted hydrothermal liquefaction and its application for Pb2+ removal.

Treatment of antibiotic fermentative residue (AFR) produced from pharmaceutical industries and their application in the environment has been gaining researchers' interest. In this study, lincomycin residue (LMR, the type of AFR) was treated with microwave-assisted hydrothermal liquefaction (MW-HTL) in a temperature range 120-210 °C, transforming effect of phosphorus (P) and nitrogen (N) functional groups in LMR samples was characterized with elemental analysis, XRD, XPS, FT-IR, and P-extraction, and utilized LMR samples for Pb2+ removal from aqueous solutions. The temperature had a significant impact on P and N functional groups conversion justified by characterization techniques and also responsible for Pb2+ adsorption. LMR hydrochar produced at 210 °C was accounted highest Pb2+ adsorption capacity (57.4 mg g-1), higher four folds than raw LMR (13.8 mg g-1). To understand the mechanism and rate defining phase of adsorption equilibrium isotherm and kinetic models were applied systematically. Adsorption results of LMR and its derived hydrochar samples found connectivity with Langmuir and pseudo-first-order isotherm models. Adsorption mainly occurred as ion-exchange dependent on the substitution of metal ions (Pb2+) to Ca2+ ions present in P-materials, and surface adsorption dependent on surface functional groups of LMR samples. Better operation feasibility of MW-HTL treated LMR, elaboration of P and N conversion behavior and high sorption of Pb2+ ions could make LMR a frontrunner for heavy metals immobilization.

Improvement of the phytoremediation efficiency of Neyraudia reynaudiana for lead-zinc mine-contaminated soil under the interactive effect of earthworms and EDTA.

Slow plant growth, low biomass, and low bioavailability of heavy metals in soil are important factors that limit remediation efficiencies. This study adopted a pot cultivation method to evaluate the phytoremediation efficiency of Neyraudia reynaudiana, planted in contaminated soil from a lead-zinc mining area. The soil was inoculated with earthworms (Eisenia fetida), and mixed with the chelating agent ethylenediaminetetraacetic acid (EDTA) one month after planting. The addition of earthworms significantly increased the aboveground biomass of N. reynaudiana and activated heavy metals in the soil, thus facilitating heavy metal uptake by N. reynaudiana. The addition of EDTA significantly increased the incorporation and transport of heavy metals, reduced the uptake of heavy metals by the plant cell wall, and increased the proportions of cellular soluble constituents. Especially with regard to lead, inoculation with earthworms and EDTA application significantly promoted the accumulation efficiency of N. reynaudiana, increasing it 7.1-16.9-fold compared to the control treatment without earthworms and EDTA, and 1.5-2.3-fold compared to a treatment that only used EDTA.

Complex role of connexin 43 in astrocytic tumors and possible promotion of glioma­associated epileptic discharge (Review).

Connexin (Cx)43 is a multifunction protein which forms gap junction channels and hemi­channels. It also contains abundant binding domains which possess the ability to interact with certain Cx43­associated proteins and therefore serve a fundamental role in various physiological and pathological functions. However, the understanding of the association between cancer and Cx43 along with Cx43­gap junctions (GJ) remains unclear. All available data illustrate that Cx43 and its associated GJ serve important functions in cancers. The expression levels of Cx43 demonstrate a downward trend and an increase in the levels of malignancy, particularly in astrocytomas. The GJ intercellular communication activity in glioma cells can be adjusted via Cx43 phosphorylation and through the combination of Cx43 and its associated protein. Available evidence reveals Cx43 as a tumor­inhibiting factor that suppresses glioma growth and proliferation. However, its mechanism is also regarded as complicated and ambiguous. Furthermore, it is apparent that Cx43­GJ and the carboxyl tail may contribute to glioma growth and proliferation too. However, this valuable role could be weakened by its effects on migration and invasiveness. The detailed mechanism remains unclear and full of controversies. Cx43 can enhance the motor ability and invasiveness of astrocytic glioma cells. It is also able to influence glioma cells to detach from the tumor core to the peritumoral neocortex. This peritumoral region has recently been regarded as the basic focus of glioma­associated seizure. Thus, Cx43 may take part in the onset and development of glioma­associated epileptic discharge. In addition, change and increase of Cx43 expression in GJs has been observed in seizure perilesional tissue, which is associated with brain tumors. Cx43 or GJ/hemi­channels exert enduring effects in the promotion of glioma­associated epileptic release through direct mass effects and change of the tumor microenvironment. However, there are still a number of issues concerning this aspect that require further exploration. Cx43, as a potential treatment target against this incurable disease and its common symptom of epilepsy, requires further investigation.

Biomarkers related with seizure risk in glioma patients: A systematic review.

Increasing evidence indicates that genetic biomarkers play important roles in the development of glioma-associated seizures. Thus, we performed a systematic review to summarise biomarkers that are associated with seizures in glioma patients. An electronic literature search of public databases (PubMed, Embase and Medline) was performed using the keywords glioma, seizure and epilepsy. A totall of 26 eligible studies with 2224 cases were included in this systematic review of publications to 20 June, 2016. Genetic biomarkers such as isocitrate dehydrogenase 1 (IDH1) mutations, low expression of excitatory amino acid transporter 2 (EAAT2), high xCT expression, overexpression of adenosine kinase (ADK) and low expression of very large G-protein-coupled receptor-1 (VLGR1) are primarily involved in synaptic transmission, whereas BRAF mutations, epidermal growth factor receptor (EGFR) amplification, miR-196b expression and low ki-67 expression are associated with regulation of cell proliferation. However, there is limited evidence regarding the roles of RAD50 interactor 1 (RINT1) and olig2 in epileptogenesis among glioma patients. Glioma-related seizure was related to the dysfunction of tumor microenvironment. Our findings may provide new mechanistic insights into targeted therapy for glioma-related seizures and may result in the development of multi-target therapies.

Significance of the prognostic nutritional index in patients with glioblastoma: A retrospective study.

OBJECTIVE: Accumulating evidence demonstrates that prognostic nutritional index(PNI) is linked to the clinical outcome of patients with malignant tumors, but few studies had investigated the clinical significance of PNI in glioblastoma multiforme(GBM). This study aimed to clarify the association between PNI and the clinical outcome of patients with GBM. METHODS: The clinical data of 84 patients with GBM were retrospectively analyzed. PNI was calculated from the following formula: 10×serum albumin (g/dL)+0.005×total lymphocyte count (per mm3). X-tile software was used to determine the cut-off of PNI and other hematological parameters. GBM patients were dichotomized as two groups based on the PNI cut-off. RESULTS: The optimal PNI cut-off level was 44.4. There were 14 patients with a PNI<44.4 and 70 patients with a PNI≥44.4. The results showed that PNI score was associated with gender, serum albumin, and hemoglobin level. Univariate analysis suggested that age, extent of resection, adjuvant treatment, platelet count and PNI score were predictors of overall survival in patients with GBM. The 1- and 2-survival rates of patients with a PNI<44.4 were 28.60 and 0%, respectively, while the corresponding values for patients with a PNI≥44.4 were 52.90 and 5.70%, respectively. Based on multivariate analysis, a PNI≥44.4 (HR:0.479, 95% CI:0.235-0.975,p=0.042) remained an independent prognostic indicator for a favorable outcome of patients with GBM. Furthermore, patients with a PNI≥44.4 may have a better efficacy of adjuvant treatment than patients with a PNI<44.4 (HR:0.259, 95% CI:0.096-0.700, p=0.008). CONCLUSION: A PNI>44.4 was an independent prognostic parameter of overall survival in patients with GBM and the efficacy of adjuvant treatment. Interventions aimed at correcting the nutritional and immune status of patients with GBM may, therefore, promote the effectiveness of adjuvant treatment and improve the survival outcomes.

Changes in subcellular distribution and antioxidant compounds involved in Pb accumulation and detoxification in Neyraudia reynaudiana.

The effects of increasing concentrations of lead (Pb) on Pb accumulation, subcellular distribution, ultrastructure, photosynthetic characteristics, antioxidative enzyme activity, malondialdehyde content, and phytochelatin contents were investigated in Neyraudia reynaudiana seedlings after a 21-day exposure. A Pb analysis at the subcellular level showed that the majority of Pb in the roots was associated with the cell wall fraction, followed by the soluble fraction. In contrast, the majority of the Pb in the leaves was located in the soluble fraction based on transmission electron microscopy and energy dispersive X-ray analyses. Furthermore, high Pb concentrations adversely affected N. reynaudiana cellular structure. The changes in enzyme activity suggested that the antioxidant system plays an important role in eliminating or alleviating Pb toxicity, both in the roots and leaves of N. reynaudiana. Additionally, the phytochelatin contents in the roots and leaves differed significantly between Pb-spiked treatments and control plants. Our results provide strong evidence that cell walls restrict Pb uptake into the protoplasm and establish an important protective barrier. Subsequent vacuolar compartmentalization in leaves could isolate Pb from other substances in the cell and minimize Pb toxicity in other organelles over time. These results also demonstrated that the levels of antioxidant enzymes and phytochelatin in leaves and roots are correlated with Pb toxicity. These detoxification mechanisms promote Pb tolerance in N. reynaudiana.

An analysis of 170 glioma patients and systematic review to investigate the association between IDH-1 mutations and preoperative glioma-related epilepsy.

Seizure is a common presenting symptom of glioma, and many biomarkers have been suggested to be associated with preoperative seizure; however, the relationships between IDH (isocitrate dehydrogenase) mutations and glioma-related epilepsy only recently been studied. The authors aimed to examine the correlations between IDH mutations in glioma patients with preoperative seizures and tumor location. A series of 170 glioma samples were analyzed for IDH1 R132H mutations (amino acid change from arginine to histidine at codon 132) with immunohistochemistry (IHC) staining and for IDH mutations with direct DNA sequencing when the IHC results were negative. If either the IHC or direct DNA sequencing result was positive, the IDH status was defined as mutated. The results of the IDH mutation examinations were used to analyze the relationship between mutations and glioma-related epilepsy. The study population consisted of 64 (37.6%) World Health Organization (WHO) grade II gliomas, 58 (34.1%) grade III, and 48 (28.3%) grade IV gliomas. A total of 84 samples with IDH1 mutations were observed in our study, and 54 of these presented with seizures as the initial symptoms, whereas 28 of the patients with wild-type IDH status presented with seizures (p=0.043 for the WHO grade II gliomas, p=0.002 for the grade III gliomas and p=0.942 for the grade IV gliomas, chi-squared tests). Among the WHO grade II and III gliomas, IDH1 mutations were significantly associated with preoperative seizures, but no significant relationship between IDH mutations and preoperative seizures was found with glioblastoma multiforme.

Lead tolerance mechanism in Conyza canadensis: subcellular distribution, ultrastructure, antioxidative defense system, and phytochelatins.

We used hydroponic experiments to examine the effects of different concentrations of lead (Pb) on the performance of the Pb-tolerable plant Conyza canadensis. In these experiments, most of the Pb was accumulated in the roots; there was very little Pb accumulated in stems and leaves. C. canadensis is able to take up significant amounts of Pb whilst greatly restricting its transportation to specific parts of the aboveground biomass. High Pb concentrations inhibited plant growth, increased membrane permeability, elevated antioxidant enzyme activity in roots, and caused a significant increase in root H2O2 and malondialdehyde content. Analysis of Pb content at the subcellular level showed that most Pb was associated with the cell wall fraction, followed by the nucleus-rich fraction, and with a minority present in the mitochondrial and soluble fractions. Furthermore, transmission electron microscopy and energy dispersive X-ray analysis of root cells revealed that the cell wall and intercellular space in C. canadensis roots are the main locations of Pb accumulation. Additionally, high Pb concentrations adversely affected the cellular structure of C. canadensis roots. The increased enzyme activity suggests that the antioxidant system may play an important role in eliminating or alleviating Pb toxicity in C. canadensis roots. However, the levels of non-protein sulfhydryl compounds, glutathione, and phytochelatin did not significantly change in either the roots or leaves under Pb-contaminated treatments. Our results provide strong evidence that cell walls restrict Pb uptake into the root and act as an important barrier protecting root cells, while demonstrating that antioxidant enzyme levels are correlated with Pb exposure. These findings demonstrate the roles played by these detoxification mechanisms in supporting Pb tolerance in C. canadensis.

Potential role of fractional anisotropy derived from diffusion tensor imaging in differentiating high-grade gliomas from low-grade gliomas: a meta-analysis.

BACKGROUND AND PURPOSE: It is crucial to accurately differentiate high-grade gliomas (HGGs) from low-grade gliomas (LGGs) preoperatively, as treatment strategies vary. So we performed a meta-analysis to assess the sensitivity and specificity of fractional anisotropy (FA) value derived from diffusion tensor imaging (DTI) in differentiating HGGs from LGGs. MATERIALS AND METHODS: Between January 2005 and June 2014, relevant articles were searched from the Embase and Medline databases for analysis. Statistical analyses were performed using Meta-Disc 1.4. RESULTS: A total of 221 patients included in the FA analysis: 127 with HGGs and 94 LGGs. The pooled sensitivity, specificity and diagnostic odds ratio (DOR) for differentiating HGGs from LGGs were 93% (95% CI 0.87-0.97), 85% (95% CI 0.76-0.92), and 55.41 (95% CI 16.77-183.07), respectively. And computation of heterogeneity metrics revealed an acceptable level of the between-study heterogeneity of DOR (I(2)=30.9%). CONCLUSIONS: The results of our meta-analysis present that the FA derived from DTI act as a useful diagnostic marker could be used in distinguishing the HGGs from LGGs in the preoperative and the clinical application values are to be confirmed by further larger case-control studies.

Meta-analysis of peritumoural rCBV values derived from dynamic susceptibility contrast imaging in differentiating high-grade gliomas from intracranial metastases.

BACKGROUND AND PURPOSE: In the preoperative period, it is very important to accurately differentiate high-grade gliomas from intracranial metastases, as treatment strategies vary. Hence we performed a meta-analysis to evaluate the sensitivity and specificity of peritumoural relative cerebral blood volume (rCBV) values derived from dynamic susceptibility contrast imaging (DSCI) in differentiating high-grade gliomas from intracranial metastases. MATERIALS AND METHODS: Between 2004 and June 2014, relevant studies were searched from the databases of Medline and Embase for analysis. A total of 3 eligible studies were included in this analysis. Statistical analysis was performed with Meta-Disc 1.4. RESULTS: A total of 136 patients included in the rCBV analysis: 79 with high-grade glioma and 57 with metastasis. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR) and diagnostic odds ratio (DOR) for differentiating high-grade glioma from metastasis were 82% (95% CI 0.72-0.90), 96% (95% CI 0.88-1.00), 18.04 (95% CI 5.41-60.15), 0.19 (95% CI 0.12-0.31), and 90.20 (95% CI 23.10-352.27), respectively. The value of Cochran's Q of DOR was 0.78 (P = 0.6774), and I2 was 0.0%, revealing that no statistically significant between-study heterogeneity was found. CONCLUSIONS: The results of this present study clearly present that the peritumoural rCBV values derived from DSCI could be used in distinguishing high-grade gliomas from intracranial metastases in the preoperative.