[The ineffective or short-term recurrence of trigeminal neuralgia after microballoon compression:different causes and management strategies].

Objectives: To explore the causes of ineffective or short-term recurrence (within 3 months)of trigeminal neuralgia treated by percutaneous microballoon compression(PBC), and to examine the reoperative strategies and clincal outcomes of modified PBC. Methods: The clinical data of 21 patients with ineffective or short-term recurrence after PBC treatment (5.7% of 369 patient received PBC) admitted to the Department of Neurosurgery,Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University from June 2018 to June 2020 were retrospectively analyzed.There were 8 males and 13 females, mean aged 66.6 years (range:51 to 79 years).Among them,2 patients was ineffective after PBC and 19 patients relapsed within 3 months.The distribution of pain was along V2 branches in 2 cases,V3 branches in 3 cases,V1+V2 branches in 1 case,and V2+V3 branches in 15 cases.The mean time of recurrence was 46.8 days (range:23 to 76 days) among the 19 patients with short-term recurrence.The patients were divided into 4 types based on the causes of postoperative ineffectiveness or short-term recurrence.TypeⅠ:extracapsular false pear (1 case);Type Ⅱ:invalid true pear(2 cases);Type Ⅲ:capsular rupture (6 cases);Type Ⅳ:compression blind area (12 cases).The individualized modified PBC operation plans were used according to the types of the patients and the clinical effect and complications of the patients were observed. Results: The pain symptoms of the patients disappeared after the second operation with immediate effective rate of 100%. All patients had mild facial numbness after surgery.Five patients(23.8%,5/21) had masseter muscle weakness, 3 (14.3%,3/21) had peristomatous herpes, 1(4.8%, 1/21) had diplopia.No bleeding or other complications occurred.All patients were followed up for at least 12 months (range:13 to 28 months). One patient (4.8%,1/21) (compression blind area type) had pain recurrence 9 months after surgery, and cured by receiving the original modified PBC surgery again with no recurrence after another 13 months' follow-up. None of the other patients relapsed during the follow-up period.Up to the last follow-up,19 cases(90.5%,19/21) were cured,and 2 cases (9.5%,2/21) were relieved. Conclusions: The main reason for ineffective or short-term recurrence of PBC in trigeminal neuralgia patients is the ineffectively compressed of trigeminal ganglion.According to the different types of patients,the use of individualized modified surgical scheme can improve the efficacy of PBC surgery.

The value of MiR-146a and MiR-4484 expressions in the diagnosis of anti-SSA antibody positive Sjogren syndrome and the correlations with prognosis.

OBJECTIVE: The aim of this study was to investigate the value of micro ribonucleic acid-146a (miR-146a) and miR-4484 expressions in the diagnosis of anti-SSA antibody positive Sjogren syndrome (SS) and their correlations with prognosis. PATIENTS AND METHODS: 70 patients with anti-SSA antibody positive SS were selected as the observation group, and the non-positive Sjogren syndrome (PSS) subjects were collected as the control group at the same time. Fluorescent quantitative polymerase chain reaction (PCR) method was used to detect serum expressions of miR-146a and miR-4484 in two groups. Expression changes of miR-146a and miR-4484 in patients before and after treatment were compared. After 3 years of follow-up, 70 patients were divided into high expression and low expression subgroups based on the average expressions of miR-146a and miR-4484. Prognosis in each subgroup was compared. RESULTS: The expressions of miR-146a and miR-4484 in the observation group were significantly up-regulated compared with those in the control group (p<0.05). After treatment, the expressions of miR-146a and miR-4484 were significantly down-regulated compared with those before treatment (p<0.05). Combined detection of miR-146a and miR-4484 was superior to single index detection in the diagnosis and prognosis of PSS (p<0.05). The 3-year follow-up showed that the incidences of renal injury and pulmonary interstitial lesion in patients with low miR-146a and miR-4484 expressions were significantly lower than those with high expressions (p<0.05). However, there were no significant differences in the survival rate between the two groups (p>0.05). CONCLUSIONS: Serum expressions of miR-146a and miR-4484 in anti-SSA antibody positive PSS patients are significantly up-regulated. Their detection can improve the diagnostic rate of SS. Expressions of miR-146a and miR-4484 are closely correlated to the prognosis of the patients, which can be used as prognostic predictors.

Circulating UCA1 is highly expressed in patients with systemic lupus erythematosus and promotes the progression through the AKT pathway.

OBJECTIVE: To investigate the role of Urothelial Carcinoma Associated 1 (UCA1) during the progression of systemic lupus erythematosus (SLE) and the underlying mechanism. PATIENTS AND METHODS: UCA1 expression in peripheral blood of SLE patients, as well as the expression of protein kinase B (AKT) in the peripheral blood mononuclear cell (PBMC), was detected by qRT-PCR. Expression differences in UCA1 and AKT between different groups were compared by t-test or univariate analysis. Through correlation analysis, the correlation between UCA1, AKT and clinical indicators of patients was analyzed. After overexpression and knockout of UCA1, the effect on phenotypes of BaF3 cell was examined. Finally, we analyzed the correlation between AKT and UCA1, and the effect on AKT pathway after overexpression and knockout of UCA1. RESULTS: We found that plasma level of UCA1 and AKT was significantly enhanced in SLE patients. By analyzing the clinical data, a higher UCA1 level was observed in female patients than in males. In addition, UCA1 level in SLE patients with active stage and pathological lesions was higher than those in a stable stage without organ involvement. Correlation analysis showed that there was a positive correlation between UCA1 and C3, anti-ds-DNA, ESR and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Similarly, there was a positive correlation between AKT and C3, anti-ds-DNA, erythrocyte sedimentation rate (ESR) and SLEDAI, respectively. After overexpression and knockdown of UCA1, it was found that overexpression of UCA1 significantly enhanced cell proliferation, while the interference with UCA1 significantly inhibited cell proliferation. Western blot revealed increased expressions of PI3K and AKT after overexpressing UCA1, whereas knockdown of UCA1 led significantly decreased expressions of PI3K and AKT. CONCLUSIONS: UCA1 expression was significantly increased in SLE, which promoted the progression of SLE by activating AKT pathway.

The conductive properties of single DNA molecules studied by torsion tunneling atomic force microscopy.

The conductive properties of single natural λ-DNA molecules are studied by torsion tunneling atomic force microscopy (TR-TUNA). The currents both parallel to and perpendicular to the DNA chains are investigated, but only weak or even no current signals are detected by TR-TUNA. To improve the conductance of DNA molecules, silver and copper metallized DNAs are fabricated and their conductivities are checked by TR-TUNA. It is found that for both Cu- and Ag-DNAs, the conductivity perpendicular to the DNA chain is enhanced significantly as the metal clusters are attached to the DNA chains. But parallel to the chain the electrical transport is still weak, most probably due to the 'beads-on-a-string' constructions of metallized DNAs.