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1.
Epigenomics ; 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31920098

RESUMO

Aim: Circular RNAs (circRNAs) still have many potential functions in the process of tumor development that are not completely understood. The study aims to explore novel circRNAs and their mechanisms of action in breast cancer (BCa). Materials & methods: A combination strategy of RNA-sequencing (RNA-seq) technique, quantitative real-time PCR and bioinformatic analysis was employed to identify the potential mechanisms involving differentially expressed circRNAs in the serum exosomes and tissues of BCa patients. Results: The expression levels of hsa-circRNA-0005795 and hsa-circRNA-0088088 were significantly different both in serum exosomes and tissues and might function as competing endogenous RNAs and play vital roles in BCa development. Conclusion: We constructed two circRNA-miRNA networks and provided new insight into the prognosis and therapy of BCa using circRNAs from serum exosomes.

2.
Epigenomics ; 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31920104

RESUMO

Aim: We aimed to explore the roles of circular RNA, circVAPA in regulating cell migration and invasion of breast cancer. Materials & methods: CircVAPA expression was detected in breast cancer tissues and cells. The role of circVAPA was evaluated by MTT assay, wound-healing and transwell assay. The relationship between circVAPA and miR-130a-5p and the location of circVAPA were explored. Results: We discovered that circVAPA was dysregulated in breast cancer tissues and cells. Ectopic circVAPA regulated breast cancer migration, invasion and proliferation. CircVAPA was mainly expressed in the cytoplasm and could act as a miRNA sponge for miR-130a-5p, but did not regulate its parental gene. Conclusion: CircVAPA may promote migration and invasion capacity of breast cancer via harboring miR-130a-5p.

3.
BMC Musculoskelet Disord ; 21(1): 30, 2020 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-31937277

RESUMO

BACKGROUND: There is no available literature for comparison on muscle atrophy between the "stand-alone" oblique lateral interbody fusion (OLIF) and regular OLIF (i.e., combined with percutaneous pedicle screws fixation (PPSF) in patients with spondylolisthesis). This study aimed to identify changes in back muscle atrophy between the two surgeries. METHODS: This was a retrospective cohort study of patients who underwent OLIF or OLIF+PPSF at Beijing Jishuitan Hospital and Shanghai ChangZheng Hospital between 07/2014 and 10/2017. Computed tomography (CT) was used to measure functional cross-sectional area (FCSA) and fat infiltration percentage (FIP) of the multifidus and erector spinae before and 24 months after surgery. RESULT: There were no differences in FCSA and FIP between OLIF (n = 32) and OLIF+PPSF (n = 41) groups before surgery. In the OLIF group, the multifidus and erector spinae FCSA and FIP did not change at 24 months (FCSA: multifidus: from 8.59 ± 1.76 to 9.39 ± 1.74 cm2, P = 0.072; erector spinae: from 13.32 ± 1.59 to 13.55 ± 1.31 cm2, P = 0.533) (FIP: multifidus: from 15.91 ± 5.30% to 14.38 ± 3.21%, P = 0.721; erector spinae: from 11.63 ± 3.05% to 11.22 ± 3.12%, P = 0.578). In the OLIF+PPSF group, the multifidus and erector spinae FCSA decreased (multifidus: from 7.72 ± 2.69 to 5.67 ± 1.71 cm2, P < 0.001; erector spinae: from 12.60 ± 2.04 to 10.15 ± 1.82 cm2, P < 0.001), while the FIP increased (multifidus: from 16.13 ± 7.01% to 49.38 ± 20.54%, P < 0.001; erector spinae: from 11.93 ± 3.22% to 22.60 ± 4.99%, P < 0.001). The differences of FCSA and FIP between the two groups at 24 months were significant (all P < 0.001). The patients in the standalone OLIF group had better VAS back pain, and JOA scores than the patients in the OLIF combined group (all P < 0.05) at 1 week and 3 months after surgery. There were two cases (4.9%) of adjacent segment degeneration in the OLIF combined group, while there was no case in the OLIF alone group. CONCLUSIONS: Standalone OLIF had better clinical outcomes at 1 week and 3 months than OLIF+PPSF in patients with spondylolisthesis. OLIF may not result in paraspinal muscle atrophy at 24 months after surgery.

4.
Ecotoxicol Environ Saf ; 189: 110053, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31862514

RESUMO

Particulate matter with an aerodynamic diameter of less than 2.5 µm (PM2.5) derived from automobile exhaust can lead to serious male spermatogenesis dysfunction, but its specific molecular mechanism is unclear. In this experiment, we focused on the blood-testis barriers (BTB) and explored the intracellular mechanisms underlying the fertility toxicity of PM2.5 originating from automobile exhaust in the primary cultured Sertoli cells(SCs) of rats. After PM2.5 exposure, excessive reactive oxygen species (ROS) and increased apoptosis of SCs were detected. The expression of the BTB related proteins including ZO-1, Occludin, N-cadherin and ß-catenin were significantly decreased and the spatial arrangement of F-actin was completely disordered through Immunofluorescence and Western blots tests. The phosphorylation of Jun N-terminal kinase (JNK), extracellular signal regulatory kinase (ERK), p38 mitogen-activated protein kinase (MAPK) were upregulated and nuclear factor (erythroid-derived 2) -like 2-related factor (Nrf2) was downregulated respectively. However, combined utilization of vitamin C and E were observed to prevent the increase of ROS generation, reduce celluar apoptosis, increase the expression of BTB related proteins, reconstructed the spatial arrangement of F-actin as well as improved the Nrf2 expression and attenuated the phosphorylation of the MAPK kinases and cleaved caspase-3 levels. Furthermore, ERK inhibitor (SCH772984), JNK inhibitor (SP600125) and p38 MAPK inhibitor (SB203580) obviously up-regulated BTB-related proteins expression as well as activated Nrf2 expression at varying degrees, indicating that ROS-MAPKs-Nrf2 is involved in the signaling pathway that leads to PM2.5-induced spermatogenesis dysfunction. These findings indicate that PM2.5 derived from automobile exhaust causes oxidative stress, which in turn causes cellular apoptosis of SCs and damage of the blood-testis barrier, resulting male spermatogenesis dysfunction, in which ROS-MAPK-Nrf-2 pathways may play a key role.

5.
World J Pediatr ; 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31853884

RESUMO

BACKGROUND: To systematically evaluate the incidence characteristics of testicular microlithiasis (TM) in children and its association with primary testicular tumors (PTT). METHODS: A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. A priori protocol was registered in the PROSPERO database (CRD42018111119), and a literature search of all relevant studies published until February 2019 was performed. Prospective, retrospective cohort, or cross-sectional studies containing ultrasonography (US) data on the incidence of TM or the association between TM and PTT were eligible for inclusion. RESULTS: Of the 102 identified articles, 18 studies involving 58,195 children were included in the final analysis. The overall incidence of TM in children with additional risk factors for PTT was 2.7%. In children, the proportion of left TM in unilateral cases was 55.7%, the frequency of bilateral TM was 69.0%, and proportion of classic TM was 71.8% [95% confidence interval (CI) 62.4-81.1%, P = 0.0, I2 = 0.0%]. About 93.5% of TM remained unchanged, and newly detected PTT rate was very low (4/296) during follow-up. The overall risk ratio of TM in children with a concurrent diagnosis of PTT was 15.46 (95% CI 6.93-34.47, P < 0.00001). CONCLUSIONS: The incidence of TM in children is highly variable. Nonetheless, TM is usually bilateral, of the classic type, and remains stable or unchanged at follow-up. Pediatric patients with TM and contributing factors for PTT have an increased risk for PTT; however, there is no evidence to support mandatory US surveillance of children with TM.

6.
Ann Transl Med ; 7(18): 472, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31700908

RESUMO

Background: Laminectomy and laminoplasty are popularly used in posterior cervical spine surgery but still have involved complications. We aimed to compare the clinical outcomes of microscope-assisted extensor muscle-preserving laminectomy (MA-EMPL) and open-door laminoplasty (ODLP) in treating multilevel cervical spondylotic myelopathy (MCSM). Methods: A prospective study was designed to enroll twenty patients with MCSM underwent MA-EMPL, and recruit twenty-four patients with MCSM received ODLP (control). Radiographic measurements, outcome indicators including Japanese Orthopedic Association (JOA) score and visual analogue score (VAS) were used to evaluate technical effectiveness. Surgical complications were documented to assess technical safety. Results: Postoperative cervical curvature index and range of neck motion (ROM) were not significantly changed except ROM in ODLP group. Postoperative JOA score and VAS in both groups showed improvements at final follow-up. There was no statistical difference in postoperative neurological recovery rates between two groups (67.6%±17.8% vs. 70.15%±19.6%, P=0.632). However, VAS was significantly lower at postoperative 1 month in MA-EMPL group compared with ODLP group (P<0.001). The incidences of C5 palsy were 0 vs. 16.7% between MA-EMPL group and ODLP group. There was no axial symptom occurred in MA-EMPL group while six patients in ODLP group (0 vs. 25%, P=0.049). In addition, the mean blood loss and hospital stay were lesser in MA-EMPL group compared with ODLP group (P<0.001, P=0.002, respectively). Conclusions: MA-EMPL is an effective, safe and minimally invasive method in treatment of MCSM. Compared with ODLP, MA-EMPL has advantage to decrease intraoperative blood loss, hospital stay, postoperative VAS and axial symptom, as well as preserve postoperative ROM.

7.
Expert Rev Med Devices ; : 1-6, 2019 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-31778610

RESUMO

Introduction: Potential complications associated with screw malposition may result in neurological deficits or vascular injuries. Spine surgery has significantly developed under the assistance of technological progress. The advantages of applying robotic technology in spine surgery include the possibility of improving screw accuracy, reducing complications, decreasing fluoroscopy use.Areas covered: We critically evaluated the current literature on the radiographic and clinical outcomes of robotic-assisted spine surgery, including accuracy, radiation exposure, operative time, and complication rates.Expert opinion: Robotic-assisted spine surgery shows promising results and has the potentials for further investigations. The robot-assisted spine surgery is appeared to be more accurate in pedicle screw placement than the free-hand technique. In general, the robot-assisted technique is associated with shorter radiation exposure time but longer operative time than free-hand technique. For higher accuracy of robotic-assisted spine surgery, technical advancement and high-quality researches are needed. Artificial intelligent technology, decompression function, and higher accuracy are the directions for the development of robotic-assisted spine surgery.

8.
Orthop Surg ; 11(6): 1127-1134, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31762194

RESUMO

OBJECTIVE: To evaluate the long-term efficacy of Bryan cervical disc arthroplasty in the treatment of myelopathy patients compared with radiculopathy patients. METHODS: This study is a prospective study. Sixty-six patients (38 patients in myelopathy group and 28 patients in radiculopathy group) who were treated with Bryan cervical disc arthroplasty between 2004 and 2007 and followed for 10 years were included in this study. The Japanese Orthopaedic Association (JOA) score, neck disability index (NDI), and Odom's criteria were used to evaluate the clinical outcomes. X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) were used to evaluate the radiographic outcomes including the global range of motion (ROM), segmental ROM, and segment alignment before the surgery and at last follow-up. The incidence of segmental kyphosis, segmental mobility lost, and the grade of paravertebral ossification (PO) were also evaluated at last follow-up. RESULTS: The JOA score and NDI improved in both groups. Thirty-three of 38 patients in myelopathy group and all patients in radiculopathy group reported good or excellent outcomes according to Odom's criteria. The segmental ROM was (9.5° ± 4.4°) before surgery and maintained at (9.0° ± 5.5°) at last follow-up in myelopathy group. The segmental ROM was (9.5° ± 4.6°) and (9.0° ± 5.3°) before surgery and at last follow-up in radiculopathy group, respectively. The Bryan prosthesis remained mobile at last follow-up for 30 patients (78.9%) in the myelopathy group and 22 patients (78.6%) in the radiculopathy group. Of the patients in the myelopathy group, 21.1% developed segmental kyphosis, as did 21.4% of patients in the radiculopathy group. The incidence of PO and high-grade PO was 92.1 and 28.9% in the myelopathy group, and was 92.9 and 32.1% in the radiculopathy group. There was no significant difference between both groups. CONCLUSIONS: Bryan cervical disc arthroplasty was an effective and safe technique in treating patients with myelopathy. The clinical and radiographic outcomes in the myelopathy group were similar to those in the radiculopathy group at the 10-year follow-up.

9.
Artigo em Inglês | MEDLINE | ID: mdl-31770344

RESUMO

STUDY DESIGN: This is an in vitro biomechanical study. OBJECTIVE: This study aimed to investigate the biomechanical variations of lumbar spine motor units after bilateral facet joint severe violation in cadaver specimens and analyze the biomechanics under different moments. SUMMARY OF BACKGROUND DATA: The incidence of facet joint violation (FJV) is highly variable, and one of the most important factors is the lack of awareness of protection. Until now, the biomechanical effects of FJV remains unclear. METHODS: Biomechanical testing was performed on 12 human cadaveric spines under flexion-extension, lateral bending, and axial rotation loading. After intact analysis, pedicle screws were inserted at L5, and the biomechanical testing was repeated. Full range of motion (ROM) at the proximal adjacent levels under different moments was recorded and normalized to the intact (100%) noninstrumented spine. The relative ROM changes were compared between the control and severe violation groups. RESULTS: The adjacent-level ROM (flexion-extension, lateral bending, axial rotation) did not change significantly in the control group at each moment (7.5, 6.0, 4.5 N m) compared with the intact noninstrumented spine. In the severe violation group, the supradjacent-level ROM decreased significantly under all moments relative to the intact noninstrumented spine (P < 0.05) except for the ROM of lateral bending at moments of 7.5 and 6.0 N m. When comparing the ROM between the two groups, there were significant differences in all movements except lateral bending at 7.5 N m. CONCLUSIONS: When superior-segment bilateral facet joints are severely violated by screws, the flexion-extension and axial rotation ROM of adjacent vertebrae decreases at each moment (7.5, 6.0, 4.5 N m), and the lateral bending ROM decreases at 4.5 N m. LEVEL OF EVIDENCE: N/A.

10.
Artigo em Inglês | MEDLINE | ID: mdl-31568094

RESUMO

STUDY DESIGN: Prospective, randomized, controlled trial. OBJECTIVE: To compare robot-assisted and conventional implantation techniques by evaluating the accuracy and safety of implanting screws in cervical vertebrae. SUMMARY OF BACKGROUND DATA: Cervical spinal surgery is difficult and dangerous as screw misplacement might lead not only to decreased stability but also neurological, vascular, and visceral injuries. A new robot-assisted surgical procedure has been introduced to improve the accuracy of implant screw positioning. METHODS: We randomly assigned 135 patients with newly diagnosed cervical spinal disease and who required screw fixation using either robot-assisted or conventional fluoroscopy-assisted cervical spinal surgery. The primary outcomes were the discrepancies between the planned trajectories and the actual screw positions. RESULTS: Altogether, 127 patients underwent the assigned intervention (61 robot-assisted and 66 conventional fluoroscopy-assisted). The baseline characteristics including the screw types, were similar in the two groups. Altogether, 390 screws were planed and placed in the cervical vertebrae, and 94.9% were acceptable. The robot-assisted group had a better screw placement accuracy than the conventional fluoroscopy-assisted group with associated p values <0.001 [0.83 (0.44, 1.29) vs 1.79 (1.41, 2.50) mm]. The Gertzbein and Robbins scales also showed a significant difference between the two groups (p < 0.001). Furthermore, the robot-assisted group experienced significantly less blood loss during surgery than the conventional fluoroscopy-assisted group [200 (50, 375) vs 350 (100, 500) ml; p=0.002] and shorter length of stay after surgery (p = 0.021). These two groups did not differ significantly regarding the duration of the operation (p = 0.525). Neurological injury occurred in one case in the conventional fluoroscopy-assisted group. CONCLUSIONS: The accuracy and clinical outcomes of cervical spinal surgery using the robot-assisted technique tended to be superior to those with the conventional fluoroscopy-assisted technique in this prospective, randomized, controlled trial. LEVEL OF EVIDENCE: 2.

11.
Orthop Surg ; 11(5): 850-856, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31663290

RESUMO

OBJECTIVE: To compare the superior-level facet joint violations (FJV) between robot-assisted (RA) percutaneous pedicle screw placement and conventional open fluoroscopic-guided (FG) pedicle screw placement in a prospective cohort study. METHODS: This was a prospective cohort study without randomization. One-hundred patients scheduled to undergo RA (n = 50) or FG (n = 50) transforaminal lumbar interbody fusion were included from February 2016 to May 2018. The grade of FJV, the distance between pedicle screws and the corresponding proximal facet joint, and intra-pedicle accuracy of the top screw were evaluated based on postoperative CT scan. Patient demographics, perioperative outcomes, and radiation exposure were recorded and compared. Perioperative outcomes include surgical time, intraoperative blood loss, postoperative length of stay, conversion, and revision surgeries. RESULTS: Of the 100 screws in the RA group, 4 violated the proximal facet joint, while 26 of 100 in the FG group had FJV (P = 0.000). In the RA group, 3 and 1 screws were classified as grade 1 and 2, respectively. Of the 26 FJV screws in the FG group, 17 screws were scored as grade 1, 6 screws were grade 2, and 3 screws were grade 3. Significantly more severe FJV were noted in the FG group than in the RA group (P = 0.000). There was a statistically significant difference between RA and FG for overall violation grade (0.05 vs 0.38, P = 0.000). The average distance of pedicle screws from facet joints in the RA group (4.16 ± 2.60 mm) was larger than that in the FG group (1.92 ± 1.55 mm; P = 0.000). For intra-pedicle accuracy, the rate of perfect screw position was greater in the RA group than in the FG group (85% vs 71%; P = 0.017). No statistically significant difference was found between the clinically acceptable screws between groups (P = 0.279). The radiation dose was higher in the FG group (30.3 ± 11.3 vs 65.3 ± 28.3 µSv; P = 0.000). The operative time in the RA group was significantly longer (184.7 ± 54.3 vs 117.8 ± 36.9 min; P = 0.000). CONCLUSIONS: Compared to the open FG technique, minimally invasive RA spine surgery was associated with fewer proximal facet joint violations, larger facet to screw distance, and higher intra-pedicle accuracy.

12.
ACS Cent Sci ; 5(8): 1461-1467, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31482129

RESUMO

CO2 electrochemical reduction is of great interest not only for its technological implications but also for the scientific challenges it represents. How to suppress the kinetically favored hydrogen evolution in the presence of H2O, for instance, has attracted significant attention. Here we report a new way of achieving such a goal. Our strategy involves a unique water-in-salt electrolyte system, where the H2O concentration can be greatly suppressed due to the strong solvation of the high-concentration salt. More importantly, the water-in-salt electrolyte offers an opportunity to tune the H2O concentration for electrokinetic studies of CO2 reduction, a parameter of critical importance to the understanding of the detailed mechanisms but difficult to vary previously. Using Au as a model catalyst platform, we observed a zeroth-order dependence of the reaction rate on the H2O concentration, strongly suggesting that electron transfer, rather than concerted proton electron transfer, from the electrode to the adsorbed CO2 is the rate-determining step. The results shed new light on the mechanistic understanding of CO2 electrochemical reduction. Our approach is expected to be applicable to other catalyst systems, as well, which will offer a new dimension to mechanistic studies by tuning H2O concentrations.

13.
Phys Chem Chem Phys ; 21(32): 17517-17520, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31380550

RESUMO

Kinetic studies of photo- and photoelectro-catalysis fixation of CO2 are rare. Herein, a typical CO2 reduction addition to trans-stilbene is studied. Through Tafel analyses, the reaction rate-determining step (RDS) is identified as the first step of an anion free radical generation from the substrate, and the reaction order is 0.5.

14.
Neurospine ; 16(2): 267-276, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261466

RESUMO

OBJECTIVE: To investigate three-planar radiographic results and patient-reported outcomes (PROs) after correcting chronic atlantoaxial instability (AAI) by translaminar screw (TLS) and pedicle screw (PS) fixation, and to explore the potential association of atlantoaxial realignment with PRO improvements. METHODS: Twenty-three patients who underwent C1 lateral mass screw (LMS)-C2 TLS and 29 who underwent C1 LMS-C2 PS with ≥ 2 years of follow-up were retrospectively analyzed. Three-planar (sagittal, coronal, and axial) radiographic parameters were measured. PROs including the Neck Disability Index (NDI), Japanese Orthopaedic Association (JOA) score and the Short Form 36 Physical Component Summary (SF-36 PCS) were documented. Factors potentially associated with PROs were identified. RESULTS: The radiographic parameters significantly changed postoperatively except the C1-2 midlines' intersection angle in the TLS group (p = 0.073) and posterior atlanto-dens interval in both groups (p = 0.283, p = 0.271, respectively). The difference in bilateral odontoid lateral mass interspaces at last follow-up was better corrected in the TLS group than in the PS group (p = 0.010). Postoperative PROs had significantly improved in both groups (all p < 0.05). Thereinto, NDI at last follow-up was significantly lower in the TLS group compared with PS group (p = 0.013). In addition, blood loss and operative time were obviously lesser in TLS group compared with PS group (p = 0.010, p = 0.004, respectively). Multivariable regression analysis revealed that a change in C1-2 Cobb angle was independently correlated to PROs improvement (NDI: ß = -0.435, p = 0.003; JOA score: ß = 0.111, p = 0.033; SF-36 PCS: ß = 1.013, p = 0.024, respectively), also age ≤ 40 years was independently associated with NDI (ß = 5.40, p = 0.002). CONCLUSION: Three-planar AAI should be reconstructed by C1 LMS-C2 PS fixation, while sagittal or coronal AAI could be corrected by C1 LMS-C2 TLS fixation. PROs may improve after atlantoaxial reconstruction in patients with chronic AAI. The C1-2 Cobb angle is an independent predictor of PROs after correcting chronic AAI, as is age ≤ 40 years for postoperative NDI.

15.
Biol Trace Elem Res ; 2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31309448

RESUMO

Copper (Cu) has been used as a feed additive for many years. However, high Cu amounts can cause oxidative stress and adversely affect animal performance. Such negative effects may depend on the amounts and forms of Cu. In the present study, the effects of inorganic Cu (CuSO4) and organic Cu (chelate-Cu) present in mice feed on daily growth rate and Cu deposition in the liver, kidneys, spleen, brain, and serum were assessed in addition to the oxidative stress levels in the liver and brain. Organic Cu at a concentration of 15 mg/kg significantly enhanced daily growth rate in mice, whereas Cu deposition in the livers was significantly lower than that in the inorganic Cu group. Glutathione peroxidase activity in the liver of the mice fed with organic Cu significantly improved, whereas malondialdehyde levels in the brain and liver were significantly lower than that in the inorganic Cu group. The different effects of organic Cu and inorganic Cu provide key evidence supporting the use of organic Cu in animal feeds.

16.
Biosci Rep ; 39(6)2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31160488

RESUMO

Breast cancer (BCa) is one of the most frequently diagnosed cancers and leading cause of cancer deaths among females worldwide. Circular RNAs (circRNAs) are a new class of endogenous regulatory RNAs characterized by circular shape resulting from covalently closed continuous loops that are capable of regulating gene expression at transcription or post-transcription levels. With the unique structures, circRNAs are resistant to exonuclease RNase R and maintain stability more easily than linear RNAs. Recently, an increasing number of circRNAs are discovered and reported to show different expression in BCa and these dysregulated circRNAs were correlated with patients' clinical characteristics and grade in the progression of BCa. CircRNAs participate in the bioprocesses of carcinogenesis of BCa, including cell proliferation, apoptosis, cell cycle, tumorigenesis, vascularization, cell invasion, migration as well as metastasis. Here we concentrated on biogenesis and function of circRNAs, summarized their implications in BCa and discussed their potential as diagnostic and therapeutic targets for BCa.

17.
Chin Med J (Engl) ; 132(12): 1454-1460, 2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31205104

RESUMO

BACKGROUND: This study was designed to evaluate the clinical and radiographic outcomes of patients with nutcracker syndrome (NCS) who were treated with three-dimensional printing (3DP) extravascular titanium stents (EVTSs). The 3DP EVTS was expected to release the hypertension of the left renal vein (LRV) produced by its compression between the superior mesenteric artery (SMA) and the aorta without causing any complications. METHOD: The pre-operative kidney model of each patient was printed out to enable surgical planning. After that, the EVTS was designed based on the LRV's primitive physiologic structure using computer-aided design software, and each stent was printed out with a precision setting of 20 µm. Seventeen patients who had been suffering from NCS underwent laparoscopic 3DP EVTS placement. The surgical procedure was designed for the placement of EVTS, taking great care in positioning and fixing the stent. Surgical data, which included patient demographic characteristics as well as pre- and post-operative test results, were collected and analyzed. RESULTS: The mean duration of surgery was 75 ±â€Š9 min, and the mean blood loss was 20 ±â€Š5 mL. Computed tomography examinations revealed that the pre- and post-operative angle between the SMA and the aorta ranged from 18.7°â€Š±â€Š4.3° to 48.0°â€Š±â€Š8.8° (P < 0.05); in patients with left varicocele, the mean diameter of the left spermatic vein ranged from 3.7 ±â€Š0.5 to 1.3 ±â€Š0.2 mm (P < 0.05). Moreover, Doppler ultrasound examinations showed that the peak velocity of blood flow at the hilar area ranged from 12.4 ±â€Š3.3 to 18.5 ±â€Š3.4 cm/s (P < 0.05). No side effects were observed in the 24 to 42 months following surgery. CONCLUSION: The findings after 2 years of follow-up suggest that the 3DP EVTS is a safe and effective minimally invasive alternative for the treatment of NCS.


Assuntos
Síndrome do Quebra-Nozes/cirurgia , Stents , Titânio/química , Adolescente , Adulto , Feminino , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Impressão Tridimensional , Estudos Retrospectivos , Adulto Jovem
18.
J Pediatr Surg ; 54(10): 2130-2133, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31072676

RESUMO

PURPOSE: To describe the upper pole vascular anatomy of duplex kidney and provide our experience with laparoscopic upper pole partial nephrectomy (LUPPN). METHODS: A retrospective study was performed among patients with duplex kidney who underwent computed tomography angiography at one single institution, some of whom were subsequently treated with LUPPN. According to imaging results and intraoperative findings, the arterial supply to the upper moiety of a duplex system was classified based on number and branching pattern. RESULTS: A total of 84 children were included in the study. Twenty patients (23.8%) were managed conservatively and LUPPN in lateral position was performed in the others. All laparoscopic procedures were successfully completed as planned without conversion. No major intraoperative complications occurred. Of these patients, 68 cases (73.1%) were supplied with one branch of the renal artery. The vascular anatomy of duplex kidney was classified into three patterns according to the variation of arteries. In 71 cases (76.3%), the renal artery separated into two or more arteries near the renal parenchyma, called perihilar arterial branching. Other branching patterns featured accessory renal arteries and branches of the adrenal artery. Gender was not significantly associated with the vascular number (p = 0.19) and the pattern of variation (p = 0.83). CONCLUSIONS: LUPPN is an effective technique for children with duplex kidney. The upper renal moiety is mainly supplied by one branch of the renal artery and the most common pattern is perihilar arterial branching. Determining vascular variation before surgery might be beneficial to avoid intraoperative hemorrhage and accidental vessel injury. TYPE OF STUDY: Retrospective cohort study. LEVEL OF EVIDENCE: Level IV.

19.
World Neurosurg ; 128: e347-e354, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31029816

RESUMO

OBJECTIVE: To compare one-time accuracy rate between simulated freehand (SFH) and navigation simulated (NS) pedicle screw insertion, assuming no second chance to correct screws. METHODS: A simulated, comparative, cross-sectional study was conducted on 69 patients undergoing lumbar spine surgery. An intraoperative registration system captured the planned point of entry and trajectory of pedicle screws for both SFH under direct visualization and NS under navigation-aided visualization. Pedicle screw insertion was simulated for each captured image (370 screws) using Surgimap. Rajasekaran's method helped evaluate the point of entry accuracy and trajectory. RESULTS: Accuracy rate was better for the NS method (97.8%) than for the SFH method (63.8%). Of 370 screws in the SFH group, 134 penetrated the cortex, with 31 resulting in >4 mm penetration. Of 370 screws in the NS group, 8 penetrated the cortex, <4 mm penetration. Of 134 misplaced screws in the SFH group, 64 were due to error in the point of entry, 63 were due to error in the trajectory angle, and 7 were due to both errors. Of 8 errors in the NS group, 7 were due to the point of entry. CONCLUSIONS: Intraoperative navigation had significantly better one-time accuracy of pedicle screw insertion than freehand insertion and should be used to avoid injury to the pedicle and surrounding tissue from screw reinsertion.

20.
Orthop Surg ; 11(2): 153-159, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31025807

RESUMO

The pedicle screw placement procedure is the most commonly used technique for spinal fixation and can provide reliable three-column stabilization. Accurate screw placement is necessary in clinical practice. To avoid screw malposition, which may decrease the stiffness of the screw-rod construct or increase the likelihood of neural and vascular injuries, the surgeons must fully understand the regional anatomy. Deformities, such as scoliosis, kyphosis or congenital anomalies, may complicate the application of the pedicle screw placement technique and increase the chance of screw encroachments. Incidences of pedicle screw malposition vary in different districts and hospitals and with surgeons and techniques. Today, the minimally invasive spinal surgery is well developed. However, the narrow corridors and limited views for surgeons increase the difficulty of pedicle screw placement and the possibility of screw encroachment. Evidenced by previous studies, robotic surgery can provide accurate screw placement, especially in settings of spinal deformities, anatomical anomalies, and minimally invasive procedures. Based on the consensus of consultant specialists, the literature review and our local experiences, this guideline introduces the robotic system and describes the workflow of robot-assisted procedures and the precautions to take during procedures. This guideline aims to outline a standardized method for robotic surgery for thoracolumbar pedicle screw placement.

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