Incidence and Survival of Patients With Malignant Primary Spinal Cord Tumors: A Population-Based Analysis.

OBJECTIVE: Epidemiological studies on spinal cord tumors are rare, and studies on primary intramedullary tumors are even rarer. The incidence and survival of patients with primary intramedullary spinal cord tumors have not been well documented. We aimed to study the incidence and survival of patients with primary spinal cord malignant and borderline malignant tumors based on data from the Surveillance, Epidemiology, and End Results (SEER) database and provide information for revealing the epidemiology and exploring the prognosis of patients with primary intramedullary tumors. METHODS: Patients in the SEER database with microscopically diagnosed malignant and borderline malignant primary spinal cord tumors from 2000 and 2019 were included in this study. We analyzed the distribution of patients according to the demographic and clinical characteristics. Then, we extracted the incidence rate and 5-year relative survival for the whole cohort and different subgroups of the cohort. Finally, multivariate Cox proportional hazards models were used to analyze the independent prognostic factors associated with overall survival. RESULTS: A total of 5,211 patients with malignant and borderline malignant primary spinal cord tumors were included in this cohort study. Ependymoma, astrocytoma (including oligodendrogliomas and glioblastoma), lymphoma and hemangioblastoma were the most common pathological types. The age-adjusted incidence rates of primary spinal cord ependymoma was 0.18 per 100,000. The incidence rate for females was significantly lower than that for males. The incidence rate was highest in Caucasian. The incidence rate of ependymoma was significantly higher than that of other pathological types. The incidence of astrocytoma was highest among people aged 0-19 years, the incidence of ependymoma was highest among people aged 40-59 years, and the incidence of lymphoma was highest among people aged 60 years or older. The 5-year observed survival and relative survival rates for the whole cohort were 82.80% and 86.00%, respectively. Patients diagnosed with ependymoma had significantly better survival than their counterparts. We also found the impact of surgery and chemotherapy on the prognosis of patients with different tumors varies a lot. CONCLUSION: We conducted a population-based analysis of malignant and borderline malignant primary spinal cord tumors with the aim of revealing the epidemiology and survival of patients with primary intramedullary spinal cord tumors. Despite some shortcomings, this study provides valuable information to help us better understand the epidemiological characteristics of primary intramedullary spinal cord tumors.

Effects of physical activity and depressive symptoms on cognitive function in older adults: National Health and Nutrition Examination Survey.

BACKGROUND & AIMS: Population aging is a growing phenomenon, with cognitive impairment becoming a prevalent issue among the elderly. This study aimed to investigate the impact of physical activity and depressive symptoms on cognitive function in older adults using a nationally representative data set of U.S. older adults aged ≥ 60 years. METHODS: The study comprised 2713 participants aged ≥ 60 from the National Health and Nutrition Examination Survey 2011-2014. Participants were classified into two groups: Cognitive impairment and No-Cognitive impairment, determined by the results of the Digit Symbol Substitution Test (DSST). Physical activity (PA) was assessed using the Global Physical Activity questionnaire (GPAQ), while depressive symptoms were evaluated using the Patient Health Questionnaire (PHQ-9). Logistic regression analysis examined the relationship between physical activity, depressive symptoms and cognitive function. RESULTS: Multifactorial logistic regression analysis showed that high levels of physical activity were found to be significantly associated with a lower risk of cognitive impairment compared to low levels of physical activity [OR = 0.789, 95% CI:0.632 ~ 0.986, P = 0.037]. On the other hand, the presence of major depressive symptoms was significantly associated with a higher risk of cognitive impairment compared to the absence of depressive symptoms [OR = 3.482, 95% CI: 2.278 ~ 5.324, P < 0.001]. Participants in the recreational physical activity group exhibited higher Cognitive scores (P < 0.001), indicating better cognitive functioning. CONCLUSION: High levels of Physical activity were independently associated with a lower incident cognitive impairment. Additionally, the severity of depression was positively correlated with an increased risk of cognitive impairment.

Cause of Death Among Patients With Thyroid Cancer: A Population-Based Study.

Background: Over the last decades, the number of patients diagnosed with thyroid carcinoma has been increasing, highlighting the importance of comprehensively evaluating causes of death among these patients. This study aimed to comprehensively characterize the risk of death and causes of death in patients with thyroid carcinoma. Methods: A total of 183,641 patients diagnosed with an index thyroid tumor were identified from the Surveillance, Epidemiology, and End Result database (1975-2016). Standardized mortality rates (SMRs) for non-cancer deaths were calculated to evaluate mortality risk and to compare mortality risks with the cancer-free US population. Cumulative mortality rates were calculated to explore the factors associated with higher risk of deaths. Results: There were 22,386 deaths recorded during follow-up, of which only 31.0% were due to thyroid cancer and 46.4% due to non-cancer causes. Non-cancer mortality risk among patients with thyroid cancer was nearly 1.6-fold (SMR=1.59) that of the general population. Cardiovascular diseases were the leading cause of non-cancer deaths, accounting for 21.3% of all deaths in thyroid cancer patients. Non-cancer causes were the dominant cause of death in thyroid cancer survivors as of the third year post-diagnosis. We found that males with thyroid cancer had a higher risk of all-cause mortality compared with females. The risk of suicide was highest in the first post-diagnostic year (<1 year: SMR=1.51). The long-term risk of Alzheimer's disease was notably increased in thyroid cancer patients (>5 years: SMR=8.27). Conclusion: Non-cancer comorbidities have become the major risks of death in patients with thyroid tumor in the US, as opposed to death from the tumor itself. Clinicians and researchers should be aware of these risk trends in order to conduct timely intervention strategies.

Epidemiology and Survival of Patients With Optic Pathway Gliomas: A Population-Based Analysis.

BACKGROUND: We aimed to analyze the epidemiology and outcomes of pediatric patients and adult patients with optic pathway gliomas in the United States using a population-based method. METHODS: Data for patients with optic pathway gliomas diagnosed between 2000 and 2018 were extracted from the SEER database. We divided the patients into a pediatric group and an adult group. Descriptive analyses were conducted to analyze demographic and clinical characteristics and treatment. We used the chi-square test to evaluate differences between pediatric and adult patients with optic pathway gliomas. The possible prognostic indicators were analyzed by Kaplan-Meier curves and Cox proportional hazards models. RESULTS: Optic pathway gliomas represented 86.6% of all lesions originating from the optic pathway. In total, 1257 cases of optic pathway gliomas were included in our study. Pediatric patients accounted for 83.7% in this cohort, and most of the patients were diagnosed at 1-4 years old. Chemotherapy was chosen most often for pediatric patients, but radiation therapy was chosen most often for adult patients. Pilocytic astrocytoma accounted for 59.1% of pediatric patients and 37.5% of adult patients. The overall survival (OS) rates were 94.8% 5 years after diagnosis and 93.0% 10 years after diagnosis. Survival analysis showed that surgery, radiation and chemotherapy did not help patients obtain a better prognosis. Overall, pediatric patients had a better prognosis. CONCLUSION: Optic pathway gliomas are relatively rare lesions with good prognosis. They mostly affect children, and pilocytic astrocytoma is the most common histological diagnosis. Highly individualized treatment is essential for such patients.

Epidemiology and Survival of Patients With Brainstem Gliomas: A Population-Based Study Using the SEER Database.

BACKGROUND: Brainstem glioma is a primary glial tumor that arises from the midbrain, pons, and medulla. The objective of this study was to determine the population-based epidemiology, incidence, and outcomes of brainstem gliomas. METHODS: The data pertaining to patients with brainstem gliomas diagnosed between 2004 and 2016 were extracted from the SEER database. Descriptive analyses were conducted to evaluate the distribution and tumor-related characteristics of patients with brainstem gliomas. The possible prognostic indicators were analyzed by Kaplan-Meier curves and a Cox proportional hazards model. RESULTS: The age-adjusted incidence rate was 0.311 cases per 100,000 person-years between 2004 and 2016. A total of 3387 cases of brainstem gliomas were included in our study. Most of the patients were white and diagnosed at 5-9 years of age. The most common diagnosis confirmed by histological review was ependymoma/anaplastic ependymoma. The median survival time was 24 months. Patients with tumors less than 3 cm in size had a better prognosis. Surgery was effective at improving overall survival. There was no evidence that radiotherapy and chemotherapy improved overall survival. CONCLUSION: Brainstem gliomas can be diagnosed at any age. Ependymoma/anaplastic ependymoma is the most common pathological diagnosis. The prognosis is poor, and timely diagnosis and surgery are effective at improving the prognosis. We suggest that more attention should be given to the treatment of patients with brainstem gliomas.

A stable gene set for prediction of prognosis and efficacy of chemotherapy in gastric cancer.

BACKGROUND: Gastric cancer (GC) is a primary reason for cancer death in the world. At present, GC has become a public health issue urgently to be solved to. Prediction of prognosis is critical to the development of clinical treatment regimens. This work aimed to construct the stable gene set for guiding GC diagnosis and treatment in clinic. METHODS: A public microarray dataset of TCGA providing clinical information was obtained. Dimensionality reduction was carried out by selection operator regression on the stable prognostic genes discovered through the bootstrap approach as well as survival analysis. FINDINGS: A total of 2 prognostic models were built, respectively designated as stable gene risk scores of OS (SGRS-OS) and stable gene risk scores of PFI (SGRS-PFI) consisting of 18 and 21 genes. The SGRS set potently predicted the overall survival (OS) along with progression-free interval (PFI) by means of univariate as well as multivariate analysis, using the specific risk scores formula. Relative to the TNM classification system, the SGRS set exhibited apparently higher predicting ability. Moreover, it was suggested that, patients who had increased SGRS were associated with poor chemotherapeutic outcomes. INTERPRETATION: The SGRS set constructed in this study potentially serves as the efficient approach for predicting GC patient survival and guiding their treatment.

Cajanonic acid A regulates the ratio of Th17/Treg via inhibition of expression of IL-6 and TGF-ß in insulin-resistant HepG2 cells.

BACKGROUND: The objectives of the present study are to investigate whether cajanonic acid A (CAA) can reduce insulin resistance (IR) in HepG2 cells and to gain a preliminary understanding of the mechanisms underlying this effect. METHODS: Following induction of IR in HepG2 cells, we tested the regulatory effect of CAA on glucose consumption and evaluated hepatocyte production of IL-6, TGF-ß, and key molecules in the insulin transduction pathway. A transwell co-culturing system was used to assess the effect of CAA on IR in HepG2 cells during the differentiation of CD4+ T cells by calculating the ratio of (Th17)/regulatory T cell (Treg). We evaluated the effect of CAA on the expression of IL-17RC cells and HepG2 cell apoptosis by immunofluorescence and flow cytometry assay. RESULTS: CAA improved dexamethasone-induced reduction in glucose consumption in HepG2 cells, inhibited hepatocyte production of IL-6 and TGF-ß, increased the expression of IL-17RC cell, and increased cellular apoptosis in insulin-resistant HepG2 cells. When co-cultured with CD4+ T cells, insulin-resistant HepG2 cells induced a decrease in the ratio of Th17/Treg, but CAA dampened the effect. Application of IL-6 and TGF-ß, together with CAA, reversed the effect of CAA on insulin-resistant HepG2 cells. Overexpression of IL17R, however, counteracted the effect of IL-6 neutralizing antibody within the culture system. CONCLUSION: CAA can regulate the ratio of Th17/Treg by mediating the expression of IL-6 and TGF-ß in insulin-resistant HepG2 cells.

Role and mechanism of the Th17/Treg cell balance in the development and progression of insulin resistance.

The pathogenic mechanism of insulin resistance and associated diseases such as metabolic syndrome and diabetes remains unclear. Since inflammatory cytokines secreted by T cells play an important role in immune system homeostasis, we evaluated the role of interleukin-6 (IL-6) and the Th17/Treg balance in insulin sensitivity and the underlying mechanism in a rat model. After establishing an insulin-resistant rat model, the rats were injected with anti-mouse IL-6R receptor antibody (MR16-1) to block IL-6. Adipose tissue and blood samples were obtained for the analysis of cytokines, Th17 and Treg markers, and insulin sensitivity blood parameters, for comparisons with those of the normal control group, IL-6-blocked control group, and insulin resistance control group. In the insulin resistance control group, the expression levels of IL-6, RORγt, and IL-17 increased, whereas those of IL-10, FoxP3, and CD4+CD25+Treg decreased. Insulin sensitivity decreased, whereas glucose, total serum cholesterol, triglycerides, and free fatty acid levels significantly increased. However, the completely opposite effects for all parameters were detected in the insulin resistance IL-6-blocked group. Insulin resistance can cause inflammation and an imbalance in Th17 cells/Treg cells. IL-6 can restore this imbalance and play an important role in the development and progression of insulin resistance.