Temporal and spatial stability of the EM/PM molecular subtypes in adult diffuse glioma / 医学前沿

Detailed characterizations of genomic alterations have not identified subtype-specific vulnerabilities in adult gliomas. Mapping gliomas into developmental programs may uncover new vulnerabilities that are not strictly related to genomic alterations. After identifying conserved gene modules co-expressed with EGFR or PDGFRA (EM or PM), we recently proposed an EM/PM classification scheme for adult gliomas in a histological subtype- and grade-independent manner. By using cohorts of bulk samples, paired primary and recurrent samples, multi-region samples from the same glioma, single-cell RNA-seq samples, and clinical samples, we here demonstrate the temporal and spatial stability of the EM and PM subtypes. The EM and PM subtypes, which progress in a subtype-specific mode, are robustly maintained in paired longitudinal samples. Elevated activities of cell proliferation, genomic instability and microenvironment, rather than subtype switching, mark recurrent gliomas. Within individual gliomas, the EM/PM subtype was preserved across regions and single cells. Malignant cells in the EM and PM gliomas were correlated to neural stem cell and oligodendrocyte progenitor cell compartment, respectively. Thus, while genetic makeup may change during progression and/or within different tumor areas, adult gliomas evolve within a neurodevelopmental framework of the EM and PM molecular subtypes. The dysregulated developmental pathways embedded in these molecular subtypes may contain subtype-specific vulnerabilities.

Methodological framework for identifying sustainability intervention priority areas on coastal landscapes and its application in China.

In regional sustainability evaluation and policy analysis, the paradigm of safe operating spaces (SOS) has been widely applied. Yet, SOS is not readily useful for informing policy interventions toward sustainability transition. This study reports on a methodological framework that operationalizes SOS at the regional scale for designing spatially targeted sustainability interventions. In particular, this framework accounts for teleology by integrating policy orientations of the place-variant "major function" of development, and provides early-warnings by integrating long-term social-environmental trends. The framework we proposed has been applied by the Chinese government in a coastal province (Liaoning) for a landscape sustainability project, which is introduced here step-by-step. The four main steps include: (1) Quantifying SOS status across multiple "what to sustain" dimensions, e.g., land scarcity, water scarcity, pollutant discharge, and ecosystem health for the inland, and coastal exploitation intensity, marine environmental quality, and marine ecosystem biodiversity for the sea. (2) Quantifying SOS status in terms of the place-variant "what to develop" dimensions, e.g., urbanization-oriented, agriculture-stock-oriented, versus conservation-oriented development. (3) Integrating the two as a composite indicator of three ordinal levels to classify the current SOS status. (4) Developing a multi-level sustainability early-warning system by cross-analysis of the SOS status and social-environmental interaction trends (e.g., changes in, e.g., resource utilization efficiency, pollutant discharge, and eco-environmental quality). The potential use of the framework is demonstrated through the case of Liaoning Province, China, which helps policy-makers to identify priority areas for sustainability interventions. Methodological robustness and future directions of applying this multi-level sustainability early-warning system are further discussed.

Effect of ultrasound-guided median nerve block on carpal tunnel syndrome / 临床麻醉学杂志

Objective To observe the clinical effects of ultrasound-guided median nerve block on carpal tunnel syndrome.Methods A total of 40 patients (69 hands,aged 33-61 years,ASA Ⅰ or Ⅱ,were randomly assigned into ultrasound group (group U) and control group (group C),20 cases in each.The ultrasound group underwent ultrasound-guided median nerve blocking,while the control group did through by anatomic landmark palpation.3 ml of 4.5 mg bupivacaine,5 mg triamcinolone acetonide and 100 μg vitamin B12 was injected in a single shot in the two groups.Symptoms and functions were evaluated by Boston carpal tunnel questiormaire (BCTQ) at the onset and after the treatment.Electrophysiological parameters were recorded at the time of pretreatment and post-treatment.Cases receiving two or more and side effects were also recorded.Results Both the symptom severity scale (SSS) and funcational status scores(FSS) of the BCTQ showed significant decrease 1 month after treatment in the two group (P＜0.05).Compared with group C,SSS of group U showed a significant decrease (P＜0.05),while there was no significance difference in FSS.Compared with pretreatment,MDL,SDL3 showed a significant decrease and SNCV showed significant increase 1 month after treatment in the two group (P＜0.05),while there was no significant change in the MNCV.SNCV was quicker in group U than in group C at 1 month after treatment (P＜0.05),while other electrophysiological parameters were not significantly different between the two groups.Less cases with treatment times≥2 and less side effects were found in group U than in group C (P ＜ 0.05).Conclusion Median nerve blocking under ultrasound guidance effectively improves the symptom in patients with carpal tunnel syndrome and reduces complications.