Associations between bone mineral density and coronary artery calcification: a systematic review and meta-analysis.

Background: The studies about the correlation between bone mineral density (BMD) and coronary arterial calcification (CAC) were still controversial. The aim of this study was to conduct a meta-analysis to evaluate the association between BMD and CAC. Methods: We systematically searched PubMed, Embase, Google scholar and Cochrane library for observational studies. We pooled odds ratio (OR) or correlation coefficient, and 95% confidence interval (CI) of the studies. Continuous data were pooled by mean difference (MD). Sub-group analysis was applied to investigate sources of heterogeneity. Funnel plots for publication bias was also performed. Results: Seventeen studies met the inclusion criteria. Pooled ORs for the prevalence of CAC in patients with low BMD versus patients with normal BMD was 2.11 (95% CI: 1.11 - 4.02, P = 0.02). The data pooled for comparing CAC score of low BMD and normal BMD patients is 33.77 (95% CI: 23.77 - 43.77, p = 0.000). The pooled ORs of multivariate logistic regression to predict the association were 1.00 (95% CI: 0.92 - 1.10, p = 0.95, age-adjusted), and 0.95 (95% CI: 0.86 - 1.05, p = 0.33, multivariable-adjusted). Cohort category and BMD assessment method were the main sources of heterogeneity. Conclusions: Low BMD is associated with higher prevalence and severity of CAC, especially in postmenopausal women. But the relation is not significant after adjusting age and other confounding variables. Low BMD and CAC may be two independent processes with aging. More large-scale studies with high-quality design are still needed to increase the understanding of them.

Neutrophil-to-lymphocyte ratio as a prognostic predictor for patients with cancer treated with stereotactic body radiation therapy: A meta-analysis.

Stereotactic body radiation therapy (SBRT) is effective for the treatment of cancer. Neutrophil-to-lymphocyte ratio (NLR) is a common prognostic factor in predicting survival of patients with cancer. Previous studies have reported that NLR may be able to predict survival of patients with cancer treated with SBRT; however, the results are inconsistent. Therefore, the present study performed a meta-analysis to pool the data of prognostic prediction using NLR for patients with cancer who underwent SBRT. PubMed, Google Scholar, Embase and The Cochrane Library were used to search for articles published before October 2020. Pooled hazard radios (HRs) with 95% confidence intervals (CIs) were used to evaluate the association of NLR levels with patient outcome following SBRT. The primary endpoint was overall survival (OS). Subgroup analyses were used to detect sources of heterogeneity. Publication bias was assessed by Egger's test and Begg's test. A total of nine studies involving 1,010 participants were included in the present meta-analysis. Univariate and multivariate analyses revealed that elevated NLR predicted a worse outcome for OS (HR, 1.35; 95% CI, 1.22-1.49; P<0.001 and HR, 1.29; 95% CI, 1.16-1.44; P<0.001, respectively), regardless of pre- and post-treatment groups. Subgroup analysis demonstrated that the prospective group showed more significant heterogeneity (I2=57.7%; P=0.124) than the retrospective group (I2=0%) and overall (I2=47.5%). In conclusion, both pre- and post-SBRT elevated NLRs were revealed to be independently associated with poor survival in patients with cancer who received SBRT.

High expression of Sam68 in sacral chordomas is associated with worse clinical outcomes.

Src-associated in mitosis of 68 kDa (Sam68), also known as KHDRBS1 (KH domain-containing, RNA-binding, signal transduction-associated 1), is a member of the signal transduction and activation of RNA family. Previous studies have demonstrated that the aberrant expression of Sam68 is associated with the progression and prognosis of a variety of cancers, but little is known about its expression and role in chordomas, which are rare and aggressive bone neoplasms. In this study, we analyzed 40 tumor tissues and 20 distant normal tissues obtained from 40 patients with sacral chordoma using immunohistochemistry, and observed the expression of Sam68 was significantly upregulated in sacral chordomas compared with normal tissues (P=0.001). A positive correlation between the expression of Sam68 and the cell proliferation index Ki-67 was determined using Spearman's rank correlation test (γ =0.599, P<0.001). In addition, high expression of Sam68 was significantly associated with surrounding muscle invasion (P<0.001). Moreover, Kaplan-Meier curves showed that patients with overexpressed Sam68 had shorter local recurrence-free survival time (P<0.001). Lastly, multivariate analysis indicated that Sam68 is an independent prognostic factor for the local recurrence-free survival of sacral chordomas (hazard ratio =5.929, 95% CI: 1.092-32.188, P=0.039). Our findings suggest the use of Sam68 as a predictor for the recurrence of sacral chordomas.

Expression of far upstream element-binding protein 1 correlates with c-Myc expression in sacral chordomas and is associated with tumor progression and poor prognosis.

The far upstream element (FUSE)-binding protein 1 (FUBP1), a well-known transcriptional regulator of the proto-oncogene c-Myc, has been demonstrated by previous work to be aberrantly expressed in a variety of tumors and plays a critical role in tumor progression; however, its expression and function in relatively rare and aggressive chordomas remains unclear. In this retrospective study, we reviewed clinicopathologic characteristics of 40 patients diagnosed with sacral chordoma, and analyzed 40 tumor and 20 distant normal tissues obtained from patients during the primary surgical tumor excision. Using immunohistochemistry, we observed an up-regulation in the expression of FUBP1 and c-Myc in sacral chordomas compared with the normal tissues (P = 0.001 for both). Additionally, positive correlations of FUBP1 expression with c-Myc (γ = 0.651, P < 0.001) and the cell proliferation index Ki-67 expression (γ = 0.447, P = 0.004) were indicated using Spearman's rank correlation coefficient. Increased expression of FUBP1 was significantly associated with tumor invasion into the surrounding muscles (P = 0.002). Kaplan-Meier curves demonstrated the association between FUBP1 levels and the patients' local recurrence-free survival (LRFS) (P < 0.001) but not with the overall survival (OS) (P = 0.070). The independent prognostic significance of FUBP1 levels for the LRFS was indicated by multivariate analysis (HR = 4.272; 95% CI, 1.133-16.112; P = 0.032). Our findings demonstrate an association between FUBP1 levels and chordoma progression and prognosis, suggesting that FUBP1 can be used as a biomarker and a potential therapeutic target.

A novel surgical approach for the treatment of tumors in the lesser trochanter.

The proximal femur is a common location for the development of primary benign bone tumors. However, there is currently no surgical technique designed specifically for treating tumors located in the lesser trochanter. In the present study, a novel procedure was developed for directly exposing the lesser trochanter for surgical intervention. This technique may be particularly suited to treating tumors that extend toward the lateral and anterior forward of the lesser trochanter. The new approach involved passing through the femoral triangle, separating the femoral nerve and femoral vessels (artery and vein) and resecting the tumor between the iliopsoas and pectineal muscles. The procedure was performed on six patients with various types of tumor, including one case with osteoid osteoma, one case with non-osteogenic fibroma, one case with osteoma, one case with liposarcoma and two cases of osteochondroma. The preliminary results indicated that the surgical durations were short (60-100 min), blood loss was minimal (30-200 ml) and that pain relief was achieved following surgery. Only one patient continued to experience mild pain, scoring 18 mm on a visual analog scale. The other patients were fully relieved of pain. Sensory dysfunction was experienced by one patient following surgery, with persistent numbness and paresthesias in the distribution of the femoral nerve. No cases of deep vein thrombosis, femur head necrosis, hip joint degeneration disease or local recurrence were identified in any patients during the follow-up period. In order to clarify the virtual tissue, such vessels, nerves and the available space in our approach area, we collected 20 cadaveric specimens and performed anatomical examinations in and around the formal triangle. The spaces between the femoral artery and femoral nerve were measured and analyzed, with the results demonstrating that a definite space existed. Therefore, the novel approach presented in the study may be useful in the resection of benign tumors and the preoperative palliative resection of malignant tumors. The technique may be particularly suited to tumors extending toward the lateral and anterior of the lesser trochanter.

The potential role of heat shock proteins in acute spinal cord injury.

PURPOSE: This study aims to investigate the differential expression proteins profile of spinal cord tissues after acute spinal cord injury (ASCI), provide preliminary results for further study and explore the secondary injury mechanisms underlying ASCI. METHODS: Using Allen's frame to establish ASCI model of Sprague-Dawley rats, then a stable isotope-labelled strategy using isobaric tags for relative and absolute quantitation (iTRAQ) coupled with two-dimensional (2D) liquid chromatography tandem mass spectrometry (2D LC-MS/MS) was performed to separate and identify differentially expressed proteins. RESULTS: A total of 220 differentially expressed proteins were identified in the spinal cord tissues of H-8 group (acute spinal cord injury after 8 h) compared with H-0 group (acute spinal cord injury after 0 h); Up to 116 proteins were up-regulated, whereas 104 proteins were down-regulated in the spinal cord tissues. Three of the differentially expressed Heat shock proteins (HSPs) namely, Hsp90ab1, Hspa4 and Hspe1 were down-regulated. CONCLUSION: The differentially expressed proteins of spinal cord tissues after ASCI will provide scientific foundation for further study to explore the secondary injury mechanism of ASCI.