In-stent Restenosis After Stenting for Superior Mesenteric Artery Dissection Is Associated With Stent Landing Zone: From Clinical Prediction to Hemodynamic Mechanisms.

OBJECTIVE: To identify risk factors for in-stent restenosis (ISR) in patients undergoing stent placement for superior mesenteric artery dissection (SMAD) and to determine the hemodynamic mechanism underlying ISR. METHODS: For this retrospective study, patients with SMAD who had ISR after stent placement were included in the ISR group, and age- and sex-matched patients with SMAD who did not experience ISR after stent placement were included in the control group. Clinical, imaging, and hemodynamic data were assessed. Multivariable regression was used to identify independent ISR risk factors. Structural and fluid dynamics simulations were applied to determine the hemodynamic mechanism underlying the occurrence of ISR. RESULTS: The study population included 26 patients with ISR and 26 control patients. Multivariate analysis demonstrated that stent-to-vascular (S/V) ratio (odds ratio [OR], 1.14; 95% confidence interval [CI]: 1.00-1.29; p=0.045), stent proximal position >10 mm away from the SMA root (OR, 108.67; 95% CI: 3.09-3816.42; p=0.010), and high oscillatory shear index (OSI) area (OR, 1.25; 95% CI: 1.02-1.52; p=0.029) were predictors of ISR. In structural and fluid dynamics simulations, a stent proximal position near the abdominal aorta (AA) or entering into the AA reduced the contact area between the proximal struts of the stent and the vascular wall, and alleviated the distal lumen overdilation. CONCLUSION: The S/V ratio, stent proximal position away from the SMA root (>10 mm), and high OSI area are independent risk factors for ISR in patients with SMAD undergoing stent placement. Deploying the proximal end of the stent near the AA or entering into the AA appears to improve the hemodynamic environment in the SMA lumen and ultimately reduce the risk of ISR. CLINICAL IMPACT: In-stent restenosis is an uncommon but potentially catastrophic complication after stent placement for the management of superior mesenteric artery dissection. This study identified risk factors for in-stent restenosis and demonstrated that, as long as the stent can fully cover the dissection range, deploying the proximal end of the stent near the abdominal aorta or less entering into the abdominal aorta may reduce the risk of in-stent restenosis in this patient population.

Factors associated with false lumen changes in patients with superior mesenteric artery dissection.

BACKGROUND: False lumen changes (FLCs) are the main reference for the prognosis judgment and treatment plan selection for type IIa superior mesenteric artery dissection (SMAD). METHODS: For this retrospective study, 55 patients with symptomatic type IIa SMAD were included. Computational fluid dynamics (CFD) analysis was used to explore the hemodynamic basis of FLCs. Correlation and multiple linear regression analyses were performed to identify clinical, morphological and hemodynamic factors associated with FLCs. RESULTS: The FLCs of patients with successful conservative treatment (n = 29) are significantly higher than those with failed conservative treatment (n = 26) (58.5 ± 21.1% vs 10.9 ± 17.4%, p < 0.0001). Positive correlations were seen between FLCs and the morphological parameters false lumen length (FLL)/dissection entrance length (DEL) and FLL. In terms of hemodynamic parameters, negative correlations were seen between FLCs and time-averaged wall shear stress (TAWSS), vorticity, and high areas of TAWSS and vorticity, whereas positive correlations were seen between FLCs and oscillatory shear index (OSI), relative residence time (RRT), and high areas of OSI and RRT. Multiple linear regression analysis identified symptom duration (odds ratio [OR], 0.93; 95% CI, 0.91-0.96; p < 0.0001), FLL/DEL (OR, 1.30; 95% CI, 1.01-1.67; p = 0.044), and high RRT area (OR, 2.03; 95% CI, 1.48-2.78; p < 0.0001) as predictors of FLCs. CONCLUSION: The clinical predictor symptom duration, morphological factor FLL/DEL, and the hemodynamic factor high RRT area can serve as predictors of FLCs in patients with symptomatic type IIa SMAD.

A change in strategy for filter choice leads to improved filter retrieval rates.

OBJECTIVE: To assess whether a new strategy for the choice of inferior vena cava filter placed would improve filter retrieval rates at our institution. METHODS: Consecutive patients who underwent retrievable filter placement for temporary embolic protection between January 2021 and January 2023 were considered for study inclusion. Risk factors for nonretrieval of short-term filters were identified in patients receiving filters between January 2021 and January 2022 (prestrategy group). For patients treated between February 2022 and January 2023 (poststrategy group), a long-term filter was recommended for those with these risk factors, and a short-term filter was recommended for those without these risk factors. RESULTS: The study population included 303 patients (prestrategy group, n = 154; poststrategy group, n = 149). Long-term immobilization (odds ratio [OR] = 38.000; 95% confidence interval [CI]: 6.858-210.564), active cancer (OR = 17.643; 95% CI: 5.462-56.993), and venous thromboembolism detected in the intensive care unit (OR = 28.500; 95% CI: 7.419-109.477) were identified as independent risk factors for nonretrieval of short-term filters. The total retrieval rate was significantly higher in the poststrategy group (87.2%) than in the prestrategy group (72.7%; P = 0.002); the short-term filter retrieval rate was also significantly higher in the poststrategy group (84.5%) than in the prestrategy group (68.5%; P < 0.001). CONCLUSION: The proposed strategy for filter choice based on risk factors for short-term filter nonretrieval can accurately identify patients who need long-term filter placement while also increasing the retrieval rates for both short-term filters retrieval rates and overall retrieval rates.

Characteristics of Option and Denali Inferior Vena Cava Filters.

BACKGROUND: To assess the characteristics of Option and Denali filters and to identify associations between these characteristics in each filter type. METHODS: Consecutive patients who underwent Option or Denali filter placement between August 2019 and August 2022 were included in this retrospective study. RESULTS: A total of 119 patients (Option, n = 60; Denali, n = 59) were included. The retrieval rates were 45.0% for Option filters and 40.7% for Denali filters. The incidence of tilt at placement was higher for Option filters (76.7%) than for Denali filters (11.9%; P < 0.001). The tilt angle of Option filters at placement was correlated with the common iliac vein-inferior vena cava (CIV-IVC) angle. The incidence of tilt angle change after placement was higher for Option filters (74.1%) than for Denali filters (8.3%; P = 0.001). The IVC contraction rate after retrieval of Option is less than Denali (22.2% vs. 87.5%, P < 0.001). The median fluoroscopy time during Option filter retrieval was longer than during Denali filter retrieval. The fluoroscopic time was related to tilt angle during retrieval of Option filters. CONCLUSIONS: Option filters are more likely than Denali filters to tilt at placement, and the tilt angle of Option filters is more prone to change after placement. The tilt angle at placement in Option filters is related to the CIV-IVC angle. Option filters require a longer fluoroscopic time during retrieval than Denali filters, and this increased fluoroscopic time is related to the tilt angle. Denali is more likely to cause IVC constriction after placement.

Multimodal Study of the Superior Mesenteric Artery Wall.

BACKGROUND: To quantitatively analyze histological and fiber structure of the superior mesenteric artery (SMA) wall and to further explore the possible relationship between the architecture and histology changes of vessel wall and the occurrence of related diseases. METHODS: Histological and fiber structure analysis were performed on SMA specimens obtained from 22 cadavers. The SMA specimens were divided into initial, curved, and distal segments, and each segment was separated into the anterior and posterior walls. RESULTS: From the initial to the curved to the distal segment, the ratio of elastin decreased (31.4% ± 6.0%, 21.1% ± 5.8%, 18.6% ± 4.7%, respectively; P < 0.001), whereas the ratio of smooth muscle actin (24.5% ± 8.7%, 30.5% ± 6.8%, 36.1% ± 7.3%, respectively; P < 0.001) increased. Elastic fiber longitudinal amplitude of angular undulation was highest in the initial segment [7° (3.25°, 15°)] and lowest in the curved segment [2° (1°, 5°)]. In SMA curved segment, the anterior wall, when compared with the posterior wall, demonstrated a lower ratio of elastin (19.0% ± 5.8% vs. 23.3% ± 5.0%; P = 0.010) and collagen (41.4% ± 12.3% vs. 49.0% ± 10.2%; P = 0.032), a lower elastic fiber longitudinal amplitude of angular undulation [1° (1°, 5°) vs. 3° (2°, 5.25°); P = 0.013], a lower average fiber diameter (8.06 ± 0.36 pixels vs. 8.45 ± 0.50 pixels; P = 0.005), and a lower average segment length (17.96 ± 1.59 pixels vs. 20.05 ± 2.33 pixels; P = 0.001). CONCLUSIONS: SMA wall structure varies along the circumferential and axial directions, the presence of dense undulated elastic fiber protects the SMA initial segment of from dissection and aneurysm, but highly cross-linked collagen fiber here increases the likelihood of plaque formation. In the anterior wall of the curved segment, lower elastin and collagen content, lower elastic fiber undulation, and higher degree of collagen fiber cross-linking leads to the occurrence of SMA dissection and aneurysm. In the distal segment, high levels of vascular smooth muscle cells and bundles of long collagen fiber offer protection against the development of SMA-related diseases.

Distinguishing between aldosterone-producing adenomas and non-functional adrenocortical adenomas using the YOLOv5 network.

BACKGROUND: You Only Look Once version 5 (YOLOv5), a one-stage deep-learning (DL) algorithm for object detection and classification, offers high speed and accuracy for identifying targets. PURPOSE: To investigate the feasibility of using the YOLOv5 algorithm to non-invasively distinguish between aldosterone-producing adenomas (APAs) and non-functional adrenocortical adenomas (NF-ACAs) on computed tomography (CT) images. MATERIAL AND METHODS: A total of 235 patients who were diagnosed with ACAs between January 2011 and July 2022 were included in this study. Of the 215 patients, 81 (37.7%) had APAs and 134 (62.3%) had NF-ACAs' they were randomly divided into either the training set or the validation set at a ratio of 9:1. Another 20 patients, including 8 (40.0%) with APA and 12 (60.0%) with NF-ACA, were collected for the testing set. Five submodels (YOLOv5n, YOLOv5s, YOLOv5m, YOLOv5l, and YOLOv5x) of YOLOv5 were trained and evaluated on the datasets. RESULTS: In the testing set, the mAP_0.5 value for YOLOv5x (0.988) was higher than the values for YOLOv5n (0.969), YOLOv5s (0.965), YOLOv5m (0.974), and YOLOv5l (0.983). The mAP_0.5:0.95 value for YOLOv5x (0.711) was also higher than the values for YOLOv5n (0.587), YOLOv5s (0.674), YOLOv5m (0.671), and YOLOv5l (0.698) in the testing set. The inference speed of YOLOv5n was 2.4 ms in the testing set, which was the fastest among the five submodels. CONCLUSION: The YOLOv5 algorithm can accurately and efficiently distinguish between APAs and NF-ACAs on CT images, especially YOLOv5x has the best identification performance.

LncRNA XIST upregulates TRIM25 via negatively regulating miR-192 in hepatitis B virus-related hepatocellular carcinoma.

BACKGROUND: Long non-coding RNA (lncRNA) XIST has been implicated in the progression of a variety of tumor diseases. The purpose of this study was to explore the molecular role of lncRNA XIST in human hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). METHODS: The expression levels of lncRNA XIST, miR-192 and TRIM25 in HBV-related HCC tissues and HepG2.2.15 cells were detected by qRT-PCR. Biological information and luciferin gene reporter assay were performed to detect the interaction among lncRNA XIST, miR-192 and TRIM25. CCk-8 assay, wound healing assay and colony formation assay were conducted to detect the proliferation and migration ability of HepG2.2.15 cells. RESULTS: qRT-PCR results showed that the expression levels of lncRNA XIST were remarkably increased in HBV-related HCC tissues and HepG2.2.15 cells. In addition, miR-192 was a direct target gene of lncRNA XIST, and the expression of miR-192 and lncRNA XIST were negatively correlated. Moreover, overexpression of miR-192 observably inhibited the proliferation and migration of HCC cells, while overexpression of lncRNA XIST showed an opposite effect. Furthermore, TRIM25 was a direct target of miR-192, and lncRNA XIST could up-regulate the expression of TRIM25 by targeting miR-192. CONCLUSION: LncRNA XIST could up-regulate the expression of TRIM25 by targeting and binding to miR-192, thus accelerating the occurrence and development of HCC.

Long noncoding RNA MIR99AHG promotes gastric cancer progression by inducing EMT and inhibiting apoptosis via miR577/FOXP1 axis.

BACKGROUND: Long non-coding RNAs (lncRNAs) play a vital role in the genesis and development of human cancer. LncRNA MIR99AHG has been reported to be upregulated in acute myeloid leukemia (AML); however, its function in gastric cancer (GC) is still not clear. Here we were aiming to screen the prognostic lncRNA candidates and to explore the function of MIR99AHG in GC. METHODS: We have preliminarily screened some candidate lncRNA biomarkers in GC tissues through analyzing microarray datasets. The expression level of MIR99AHG in GC cell lines and tissues was monitored via qPCR. Survival analysis was performed with the patients of our hospital and TCGA database cases. CCK-8 assay, trans-well assay and flow cytometry were performed to determine cell proliferation, invasion, migration and apoptosis. Meanwhile, a target of MIR99AHG was predicted and identified by luciferase reporter gene detection experiments. RESULTS: MIR99AHG was strongly up-regulated in human GC and contributed to cancer progression. Kaplan-Meier analysis revealed that up-regulating MIR99AHG expression was positively correlated with unfavorable overall survival (P < 0.01) of patients from our hospital and TCGA database. Knockdown of MIR99AHG expression inhibited cell proliferation, invasion, migration and promoted cell apoptosis. Moreover, MIR99AHG worked as an oncogenic gene though competing for endogenous RNA (ceRNA) of miR-577. CONCLUSIONS: Our findings suggested that MIR99AHG contributes to malignant phenotypes of GC and may become a promising therapeutic target.

EGFL7 promotes hepatocellular carcinoma cell proliferation and inhibits cell apoptosis through increasing CKS2 expression by activating Wnt/ß-catenin signaling.

Epidermal growth factor-like domain multiple 7 (EGFL7) is an important sport stimulating factor and motility related factors significantly enhanced the tumor cell metastasis and overexpressed in many cancers, including hepatocellular carcinoma (HCC), associated with tumorigenesis. However, the molecular mechanism by which EGFL7 regulates HCC cell proliferation and apoptosis and the correlation between EGFL7 and cyclin-dependent kinases regulatory subunit 2 (CKS2), which is essential for biological function, have not fully explained. In this study, EGFL7 and CKS2 expression in patients with HCC was measured by real-time polymerase chain reaction and immunohistochemistry. After HCC cells respectively transfected with pLKO.1-EGFL7-shRNA, pLVX-Puro-EGFL7 recombined vector or CKS2 small interfering RNA, cell counting kit-8 and flow cytometry was performed to examine the cell proliferation and apoptosis, respectively, and the expression of ß-catenin, CKS2, CDK2, and cleaved caspase-3 was measured by Western blot analysis. We found that EGFL7 and CKS2 were overexpressed in HCC tissues and a positive correlation was found between them. EGFL7 knockdown markedly inhibited proliferation and promoted apoptosis of HCC cells, along with decreased expression of CKS2 and CDK2, but increased cleaved caspase-3 expression, while EGFL7 overexpression showed an opposite effect. EGFL7 silencing in nude mice also showed decreased tumor growth and altered protein expression similar to its effect in HCC cells in vitro. Importantly, CKS2 silencing significantly inhibited EGFL7-induced HCC cell proliferation and protein expression, and Wnt/ß-catenin signaling pathway inhibitor IWR-1-endo significantly inhibited CKS2 expression in HCC cells. Taken together, EGFL7 promotes HCC cell proliferation and inhibits cell apoptosis through increasing CKS2 expression by activating Wnt/ß-catenin signaling.

Nuclear shape descriptors by automated morphometry may distinguish aggressive variants of squamous cell carcinoma from relatively benign skin proliferative lesions: a pilot study.

We evaluated whether degrees of dysplasia may be consistently accessed in an automatic fashion, using different kinds of non-melanoma skin cancer (NMSC) as a validatory model. Namely, we compared Bowen disease, actinic keratosis, basal cell carcinoma, low-grade squamous cell carcinoma, and invasive squamous cell carcinoma. We hypothesized that characterizing the shape of nuclei may be important to consistently diagnose the aggressiveness of a skin tumor. While basal cell carcinoma is comparatively relatively benign, management of squamous cell carcinoma is controversial because of its potential to recur and intraoperative dilemma regarding choice of the margin or the depth for the excision. We provide evidence here that progressive nuclear dysplasia may be automatically estimated through the thresholded images of skin cancer and quantitative parameters estimated to provide a quasi-quantitative data, which can thenceforth guide the management of the particular cancer. For circularity, averaging more than 2500 nuclei in each group estimated the means ± SD as 0.8 ± 0.007 vs. 0.78 ± 0.0063 vs. 0.42 ± 0.014 vs. 0.63 ± 0.02 vs. 0.51 ± 0.02 (F = 318063.56, p < 0.0001, one-way analyses of variance). The mean aspect ratios were (means ± SD) 0.97 ± 0.0014 vs. 0.95 ± 0.002 vs. 0.38 ± 0.018 vs. 0.84 ± 0.0035 vs. 0.74 ± 0.019 (F = 1022631.931, p < 0.0001, one-way analyses of variance). The Feret diameters averaged over 2500 nuclei in each group were the following: 1 ± 0.0001 vs. 0.9 ± 0.002 vs. 5 ± 0.031 vs. 1.5 ± 0.01 vs. 1.9 ± 0.004 (F = 33105614.194, p < 0.0001, one-way analyses of variance). Multivariate analyses of composite parameters potentially detect aggressive variants of squamous cell carcinoma as the most dysplastic form, in comparison to locally occurring squamous cell carcinoma and basal cell carcinoma, or benign skin lesions.

Multimodal integration of radiology and pathology signatures for distinguishing between aldosterone-producing adenomas and nonfunctional adrenal adenomas.

OBJECTIVE: To develop and validate a nomogram combining radiomics and pathology features to distinguish between aldosterone-producing adenomas (APAs) and nonfunctional adrenal adenomas (NF-AAs). METHODS: Consecutive patients diagnosed with adrenal adenomas via computed tomography (CT) or pathologic analysis between January 2011 and November 2022 were eligible for inclusion in this retrospective study. CT images and hematoxylin & eosin-stained slides were used for annotation and feature extraction. The selected radiomics and pathology features were used to develop a risk model using various machine learning models, and the area under the receiver operating characteristic curve (AUC) was determined to evaluate diagnostic performance. The predicted results from radiomics and pathology features were combined and visualized using a nomogram. RESULTS: A total of 211 patients (APAs, n = 59; NF-AAs, n = 152) were included in this study, with patients randomly divided into either the training set or the testing set at a ratio of 8:2. The ExtraTrees model yielded a sensitivity of 0.818, a specificity of 0.733, and an accuracy of 0.756 (AUC = 0.817; 95% confidence interval [CI]: 0.675-0.958) in the radiomics testing set and a sensitivity of 0.999, a specificity of 0.842, and an accuracy of 0.867 (AUC = 0.905, 95% CI: 0.792-1.000) in the pathology testing set. A nomogram combining radiomics and pathology features demonstrated a strong performance (AUC = 0.912; 95% CI: 0.807-1.000). CONCLUSION: A nomogram combining radiomics and pathology features demonstrated strong predictive accuracy and discrimination capability. This model may help clinicians to distinguish between APAs and NF-AAs.

Efficacy and safety of radiofrequency in the treatment of trigeminal neuralgia: a systematic review and meta-analysis.

To assess the effectiveness of radiofrequency (RF) versus other percutaneous strategies (balloon compression, glycerol rhizotomy [GR], and microvascular decompression [MVD]) in patients with trigeminal neuralgia. We systematically searched the electronic databases of PubMed, Embase, and the Cochrane Library to identify eligible studies throughout October 2020. The odds ratio (OR) with 95% confidence interval (CI) was applied to assess effect estimates using the random-effects model. Eighteen retrospective cohort studies that enrolled 6391 patients with trigeminal neuralgia were included. We noted that RF was associated with an increased incidence of immediate pain relief compared with GR (OR 2.65; 95% CI 1.29-5.44; P = 0.008). Moreover, RF was associated with an increased risk of pain recurrence compared with MVD (OR 3.80; 95% CI 2.00-7.20; P < 0.001). Furthermore, RF was associated with an increased incidence of postoperative anesthesia compared with GR (OR 3.01; 95% CI 1.11-8.13; P = 0.030) or MVD (OR 4.62; 95% CI 2.15-9.93; P < 0.001). This study found that RF was superior to GR for the improvement in immediate pain relief; whereas, RF yielded an excess risk of pain recurrence compared with MVD. Moreover, the incidence of postoperative anesthesia in patients treated with RF significantly increased compared with the incidence after treatment with GR and MVD.

Immunotherapy for lung cancer: Focusing on chimeric antigen receptor (CAR)-T cell therapy.

Besides traditional treatment strategies, including surgery, radiotherapy, and chemotherapy for lung cancer as the leading cause of cancer incidence and death, immunotherapy has also emerged as a new treatment strategy. The goal of immunotherapy is to stimulate the immune system responses against cancer, using various approaches such as therapeutic vaccines, monoclonal antibodies, immune checkpoint inhibitors, and T-cell therapy. Chimeric antigen receptor (CAR)-T cells, one of the most popular cancer immunotherapy approaches in the last decade, are genetically engineered T-cells to redirect patients' immune responses to recognize and eliminate tumor-associated antigens (TAA)-expressing tumor cells. CAR-T cell therapy provides promising benefits in lung tumors. In this review, we summarize different immunotherapy approaches for lung cancer, the structure of CAR-T cells, currently undergoing CARs in clinical trials, and various TAAs are being investigated as potential targets in designing CAR-T cells for lung cancer.

MiR-129-5p Promotes Radio-sensitivity of NSCLC Cells by Targeting SOX4 and RUNX1.

BACKGROUND: Dysregulation of microRNAs (miRNAs) figures prominently in the radio- sensitivity of non-small cell lung cancer (NSCLC). MiR-129-5p can block the development of a variety of tumors. However, whether miR-129-5p modulates radio-sensitivity of NSCLC cells remains unknown. OBJECTIVE: This study was aimed to explore the role and the underlying mechanism of miR-129-5p in the radiosensitivity of NSCLC. METHODS: Radio-resistant NSCLC cell lines (A549-R and H1299-R) were constructed using A549 and H1299 cells. Quantitative real-time polymerase chain reaction (qRT-PCR) was employed to quantify miR-129-5p, SRY-box transcription factor 4 (SOX4) mRNA, and RUNX family transcription factor 1 (RUNX1) mRNA expression levels. Cell apoptosis and cell cycle were detected by flow cytometry. Cell counting kit-8 (CCK-8) assay and colony formation experiments were used to measure cell proliferation. γ-H2AX was examined by Western blot to confirm DNA injury. Dual- luciferase reporter experiments were applied to analyze the interactions among miR-129-5p, RUNX1, and SOX4. RESULTS: In A549-R and H1299-R cells, compared with the wild-type cell lines, miR-129-5p expression was remarkably reduced while SOX4 and RUNX1 expressions were increased. The transfection of miR-129-5p into NSCLC cell lines markedly induced cell apoptosis, DNA injury, cell cycle arrest, and inhibited cell proliferation and colony formation. RUNX1 and SOX4 were validated as target genes of miR-129-5p, and the restoration of RUNX1 or SOX4 could counteract the influence of miR-129-5p on A549-R cells. CONCLUSIONS: MiR-129-5p sensitizes A549-R and H1299-R cells to radiation by targeting RUNX1 and SOX4.

LncRNA GATA6-AS1 Inhibits the Progression of Non-Small Cell Lung Cancer via Repressing microRNA-543 to Up-Regulating RKIP.

BACKGROUND: Much evidence unveils the significance of long non-coding RNAs (lncRNAs) in diverse cancers. This study was designed to clarify the function and mechanism of lncRNA GATA6 antisense RNA 1 (GATA6-AS1) in the progression of non-small cell lung cancer (NSCLC). METHODS: GATA6-AS1, miR-543 and Raf kinase inhibitor protein (RKIP) mRNA expressions were detected by qRT-PCR. Chi-square test was adopted to analyze the relationship between GATA6-AS1 expression and the clinicopathological parameters of NSCLC patients. NSCLC cells H1299 and H460 cells were used as overexpression or knockdown models, respectively, and cell proliferation and metastasis were determined by CCK-8 and Transwell assays. RKIP, E-cadherin, N-cadherin, STAT3, p-STAT3 expressions in NSCLC cells were detected by Western blot. The targeting relationship between GATA6-AS1 and miR-543 was confirmed by dual-luciferase reporter assay. RESULTS: GATA6-AS1 was significantly lowly expressed in NSCLC tissues and cell lines, and its low expression level was significantly correlated with larger tumor size and positive lymph node metastasis. GATA6-AS1 overexpression inhibited the proliferation, migration, invasion and epithelial-mesenchymal transition of NSCLC cells, while GATA6-AS1 knockdown caused the opposite effects. Mechanistically, it was confirmed that GATA6-AS1 impeded NSCLC cell proliferation and metastasis by adsorbing miR-543 and up-regulating the expression of RKIP. CONCLUSIONS: As a tumor suppressor, GATA6-AS1 participates in suppressing the progression of NSCLC by modulating the miR-543/RKIP axis.

Radiofrequency Thermocoagulation Through Foramen Rotundum Versus Foramen Ovale for the Treatment of V2 Trigeminal Neuralgia.

BACKGROUND: Percutaneous radiofrequency thermocoagulation through the foramen rotundum (FR) is a new approach for the treatment of V2 trigeminal neuralgia (TN). OBJECTIVES: This study aimed to compare the efficacy and safety of the FR approach with that of the foramen ovale (FO) approach. STUDY DESIGN: Nonrandomized controlled clinical trial. SETTING: The study was conducted at Huaian Hospital of Huaian City, Huaian, China. METHODS: From July 2014 to December 2016, 80 consecutive patients with V2 TN were prospectively assigned into the FO group (n = 40) or the FR group (n = 40). All radiofrequency thermocoagulation procedures were performed under the guidance of digital subtraction angiography (DSA). Patients in the FO group were treated with Gasserian ganglion ablation through the Hartel approach. Patients in the FR group received ablation of the maxillary nerve at the internal opening of the FR. Facial pain was evaluated using the Visual Analog Scale preoperatively and postoperatively at 1 week, 6 months, and 1 year. RESULTS: All surgical procedures were successfully completed using DSA guidance. The FR group had no facial pain at postoperative 1 week, 6 months, and 1 year. The facial fain was not relieved in 4 patients of the FO group. They were treated with radiofrequency thermocoagulation of the maxillary nerve through the FR and maintained painless at postoperative 1 week, 6 months, and 1 year. At postoperative 1 year, another 3 patients relapsed in the FO group. The incidences of facial numbness and swelling did not differ significantly between the 2 groups (all P > 0.05). There was no postoperative corneal involvement or masticatory weakness in the FR group. However, corneal involvement and masticatory weakness occurred postoperatively in 22 (55%) patients and 31 (77.5%) patients in the FO group. The FR group had significantly shorter operation time than the FO group (19.3 ± 5.9 vs. 32.7 ± 8.7 minutes; P < 0.05). LIMITATIONS: We were unable to avoid the V1 and V3 branches, despite multiple adjustments of the needed position in 35 of the 40 patients in this group. CONCLUSIONS: For the treatment of V2 TN, thermocoagulation of the maxillary nerve through the FR had better efficacy and fewer complications in comparison with the Gasserian ganglion ablation through the FO. KEY WORDS: Neuralgia, pain, radiology, facial pain.

Predictive values of serum VEGF and CRP levels combined with contrast enhanced MRI in hepatocellular carcinoma patients after TACE.

This study explored the predictive value of serum vascular endothelial growth factor (VEGF) and C-reactive protein (CRP) levels combined with enhanced magnetic resonance imaging (MRI) in hepatocellular carcinoma (HCC) patients after transcatheter arterial chemoembolization (TACE). One hundred and seventeen patients who received TACE from June 2010 to December 2012 in our hospital were included in this study. Serum VEGF and CRP levels before and after TACE were determined by ELISA and single immunodiffusion method for analyzing the association of serum levels with pathological features. Enhanced MRI was utilized before and after TACE to measure tumor size and ADC value in enhanced region and non-enhanced region. MRI data were combined with serum VEGF and CRP levels to analyze the predictive value in efficacy and prognosis for HCC patients after TACE. The serum VEGF and CRP levels after TACE were increased, but can return to normal levels in a certain time. VEGF and CRP levels were not statistically associated with tumor location, tumor staining or presence of membrane (all P > 0.05), but closely correlated with combined portal vein tumor thrombus, combined arteriovenous fistula and distant metastasis (all P < 0.05). Low levels of serum VEGF and CRP, small tumor size and low ADC value before treatment indicated a better prognosis. The sensitivity and specificity of serum VEGF and CRP levels, tumor size and ADC value were respectively 92.31% and 88.46%, 93.85% and 90.38%, 81.54% and 78.85% as well as 47.69% and 84.62%. Serum VEGF and CRP levels, tumor size and ADC value could predict the efficacy of TACE for HCC patients. Serum VEGF and CRP levels combined with enhanced MRI may serve as markers for efficacy and prognosis evaluation in HCC patients after TACE.

3D Image-Guided Percutaneous Radiofrequency Thermocoagulation of the Maxillary Branch of the Trigeminal Nerve Through Foramen Rotundum for the Treatment of Trigeminal Neuralgia.

Percutaneous radiofrequency thermocoagulation of the trigeminal ganglion through the foramen ovale is a well-established procedure for the treatment of trigeminal neuralgia (TN). However, this approach can be tricky when individual trigeminal sub-branch nerve block is required. We report our initial experience of image-guided radiofrequency thermocoagulation of the maxillary branch through the use of foramen rotundum.From February 2012 to February 2015, we treated 25 patients with isolated TN of the maxillary branch. Radiofrequency thermocoagulation of the maxillary branch through the foramen rotundum was performed under fluoroscopy. TN pain was evaluated using the visual analogue scale both before and after the procedure.The mean preoperative visual analogue scale score was 8.6 ±â€Š0.8. The pain completely disappeared after the initial procedure in 22 patients and after a second procedure in 2 patients. An additional patient had a postoperative visual analogue scale score of 2 and did not undergo further treatment. Facial numbness occurred in 23 patients but was tolerable. Patients were followed up for a mean of 14.74 months (range, 1-29 months). Recurrence was observed in 9 patients (36%) during the follow-up period. All recurrences were well managed with repeat procedures.Percutaneous radiofrequency thermocoagulation of the maxillary branch through the foramen rotundum under fluoroscopy is a safe and effective procedure for the treatment of isolated TN of the maxillary branch.