Safety and efficacy of one-hole split endoscope technique for surgical treatment of thoracic ossification of the ligamentum flavum.

Surgical intervention is typically recommended for thoracic ossification of the ligamentum flavum (TOLF). This study aimed to evaluate the efficacy and safety of a novel non-coaxial one-hole split endoscope (OSE) technique for treating TOLF. We performed OSE procedure on 13 patients with TOLF from June 2022 to July 2023. The mean operative time was 117.5 ± 15.4 min. VAS scores for lower limbs decreased from 6.5 ± 0.8 preoperative to 1.6 ± 0.4 at the last follow-up (P < 0.001). ODI scores improved from 62.4 ± 5.7 preoperative to 18.6 ± 2.2 at the last follow-up (P < 0.001), and mJOA scores increased from 5.1 ± 1.6 preoperative to 8.4 ± 1.5 at the latest follow-up (P < 0.001). All patients achieved ASIA scale grade D or E at the final follow-up, except for two patients remained residual limb numbness. None of the thirteen patients suffered from severe perioperative complications. The OSE technique proves to be a safe and effective procedure for treating TOLF or even with dura mater ossification, characterized by minimal surgical trauma, relatively smooth learning curve and flexible operation.

Method for determining matching capacitances for floating cable traps in magnetic resonance imaging up to 14 T.

Floating cable traps (FCTs) enhance coil tuning, improve the signal-to-noise ratio of magnetic resonance imaging (MRI), and reduce the risks to patients. As MRI technology continues to advance, it becomes crucial to design efficient FCTs that are tailored to different magnetic fields and nuclei. Here, a method is proposed for determining and correcting the appropriate capacitances for FCTs in MRI systems. To validate the effectiveness of this approach, FCTs were designed and manufactured for hydrogen nuclei in magnetic fields of 1.5-14 T. The results of bench testing show that the attenuation of common-mode currents was more than -20 dB, and the maximum frequency deviation in all the FCTs was 0.345%. Furthermore, the results of magnetic resonance spin-echo imaging show that the signal-to-noise ratio was improved significantly by using the FCTs. Overall, this study shows the effectiveness of the designed FCTs in improving signal-to-noise ratio, and it provides valuable insights for designing efficient FCTs tailored to different magnetic fields and nuclei in MRI applications.

Paleoenvironments of Late Devonian tetrapods in China.

The major evolutionary transition from fish to amphibian included Late Devonian tetrapods that were neither fish nor amphibian. They had thick necks and small limbs with many digits on elongate flexuous bodies more suitable for water than land. Habitats of Devonian tetrapods are of interest in assessing selective pressures on their later evolution for land within three proposed habitats: 1, tidal flats, 2, desert ponds, and 3, woodland streams. Here we assess paleoenvironments of the Late Devonian tetrapod Sinostega from paleosols in Shixiagou Canyon near Zhongning, Ningxia, China. Fossil tetrapods, fish, molluscs, and plants of the Zhongning Formation are associated with different kinds of paleosols, representing early successional vegetation, seasonal wetlands, desert shrublands, and riparian woodlands, and paleoclimates ranging from semiarid moderately seasonal to monsoonal subhumid. The tetrapod Sinostega was found in a paleochannel of a meandering stream below a deep-calcic paleosol supporting well drained progymnosperm woodland in a monsoonal subhumid paleoclimate. This habitat is similar to that of the tetrapods Densignathus, Hynerpeton, and an indeterminate watcheeriid from Pennsylvania, USA. Chinese and Pennsylvanian Late Devonian tetrapods lived in productive woodland streams, choked with woody debris as a refuge from large predators. Habitats of other Devonian tetrapods have yet to be assessed from studies of associated paleosols as evidence for their ancient climate and vegetation.

Resveratrol and Sir2 Reverse Sleep and Memory Defects Induced by Amyloid Precursor Protein.

Resveratrol (RES), a natural polyphenolic phytochemical, has been suggested as a putative anti-aging molecule for the prevention and treatment of Alzheimer's disease (AD) by the activation of sirtuin 1 (Sirt1/Sir2). In this study, we tested the effects of RES and Sirt1/Sir2 on sleep and courtship memory in a Drosophila model by overexpression of amyloid precursor protein (APP), whose duplications and mutations cause familial AD. We found a mild but significant transcriptional increase of Drosophila Sir2 (dSir2) by RES supplementation for up to 17 days in APP flies, but not for 7 days. RES and dSir2 almost completely reversed the sleep and memory deficits in APP flies. We further demonstrated that dSir2 acts as a sleep promotor in Drosophila neurons. Interestingly, RES increased sleep in the absence of dSir2 in dSir2-null mutants, and RES further enhanced sleep when dSir2 was either overexpressed or knocked down in APP flies. Finally, we showed that Aß aggregates in APP flies were reduced by RES and dSir2, probably via inhibiting Drosophila ß-secretase (dBACE). Our data suggest that RES rescues the APP-induced behavioral deficits and Aß burden largely, but not exclusively, via dSir2.

Does the belt and road initiative reduce the carbon emission intensity of African participating countries?

The ambition of the Belt and Road Initiative (BRI) became an integral part of carbon emission abatement. The BRI impact on African participating countries' battle against carbon emissions intensity is a contentious subject. Urbanization and industrialization are the main sources of CO2 emissions in Africa and the driving force in the BRI. Using data on variables from 2010 to 2019 in 54 African countries, applying Difference-in-differences model (DID) and Propensity Score Matching-Difference-in-differences regression (PSM-DID), and robustness tests to investigate if the BRI's participation tends to reduce the carbon emissions intensity of African participating countries. This study finds that African countries' participation in the BRI minimizes the intensity of carbon emissions in those countries. Further analysis shows that low carbon development of BRI countries is more significant in countries that joined the BRI than those that did not join it. In addition, our results show that improving economic transformation such as the innovation in technology and industries' structures can boost the CO2 emission reduction technologies. These findings suggest that developing BRI collaboration with China will benefit the environment and African BRI participating countries' ability to achieve sustainable development. Our results further support the BRI's effect and recommend policy implications and methods for those countries' CO2 emission prevention and control actions.

Analysis of genetic diversity among Chinese Cyclocybe chaxingu strains using ISSR and SRAP markers.

Background: Cyclocybe chaxingu is an edible and medicinal fungal species commonly cultivated in China. The major problems currently facing by growers of C. chaxingu is the random labeling of strains and strains aging and degeneration. Therefore, an evaluation of genetic diversity is essential for the conservation and reproducing programs of this species. Methods: In the present study, 24 widely cultivated strains were collected from the main producing areas of China, and the genetic diversity analysis was performed. DNA polymorphism among these Chinese C. chaxingu strains was analyzed using inter-simple sequence repeat (ISSR) and sequence-related amplified polymorphism (SRAP) markers. Results: Eight ISSR primers amplified a total of 75 DNA fragments of which 61 (81.33%) were polymorphic. Fifteen SRAP primer combinations amplified 166 fragments of which 132 (79.52%) were polymorphic. Cluster analysis showed that the C. chaxnigu strains fall into five groups with a genetic distance values ranging from 0.06 to 0.60 by ISSR analysis, while the SRAP analysis divided the test strains into four groups within the range of genetic distance from 0.03 to 0.57. The results of the present study reveal a high level of genetic diversity among the widely cultivated C. chaxingu strains.

A study on the correlation between M2 macrophages and regulatory T cells in the progression of colorectal cancer.

BACKGROUND: M2 macrophages and regulatory T cells (Tregs) can promote tumors and development by inhibiting the anti-tumor immune response. This study investigated the effect of CD163-positive M2 macrophages and Foxp3-positive Tregs in the progression of colorectal cancer and lymph node metastasis. It also investigated the correlation between M2 macrophages and Tregs. METHODS: Postoperative tissue specimens and clinical data were collected from 197 patients with colorectal cancer who underwent initial surgical treatment in The Second Ward of Colorectal Surgery of the First Affiliated Hospital of Jinzhou Medical University from March 2020 to December 2020. Immunohistochemical methods were used to detect the expression levels of CD163 protein-labeled M2 macrophages and Foxp3 protein-labeled Tregs in colorectal cancer tissues, matched paracancer tissues, and lymph node tissues. The correlation between CD163 and Foxp3 in cancer tissues and lymph node tissues were analyzed, as well as the relationship between clinicopathological characteristics and preoperative tumor markers. RESULTS: M2 macrophages and Tregs were importantly positively correlated in cancer and lymph node tissues, which significantly increased in cancer and metastatic lymph node tissues. Interestingly, M2 macrophages in non-metastatic lymph nodes also increased significantly in patients with metastatic lymph nodes. In addition, both CD163 and Foxp3 were upregulated with increasing tumor node metastasis stage, depth of infiltration, and lymphatic metastasis; and both were positively correlated with carcinoembryonic antigen. CONCLUSION: CD163 may be a good predictor of pre-metastatic status of colorectal cancer lymph nodes. carcinoembryonic antigen affects the distribution of M2 macrophages and Tregs in colorectal cancer. There is a certain correlation between the two types of cells. It is possible that M2 macrophages, together with suppressor Tregs cells, promote an immunosuppressive environment.

Are ovarian responses and the number of transferable embryos different in females and partners of male balanced translocation carriers?

PURPOSE: To compare ovarian response and the number of transferable embryos between women with balanced autosomal translocations and women whose partners carry the translocation (control group). To investigate the predictive value of metaphase II (MII) oocyte number and biopsied embryo number for gaining at lowest one transferable embryo. DESIGN: We retrospectively analyzed 1942 preimplantation genetic testing for structural rearrangements (PGT-SR) cycles of 1505 balanced autosomal translocation couples over 8 years. All cycles were divided into two subgroups: Robertsonian and reciprocal translocations (ROBT and ReBT). Receiver operator characteristic (ROC) curves were plotted to ascertain a cutoff of MII oocytes and biopsied embryos as predictors of gaining at lowest one transferable embryo. RESULT: There were no statistical differences in baseline features or ovarian response indicators regarding the number of retrieved/MII oocytes, E2 level on the day of HCG, and ovarian sensitivity index (OSI) between women with balanced autosomal translocations and control group (P > 0.05). A decreased number of transferable embryos were found in women with balanced autosomal translocations regardless of the type of translocation. The cutoff values for gaining at lowest one transferable embryo are 12.5 MII oocytes and 4.5 biopsied embryos, respectively. CONCLUSION: Women with balanced autosomal translocations have a normal ovarian response, but fewer transferable embryos, meaning that higher gonadotropin (Gn) doses may be required to increase transferable embryos. When fewer than 12.5 MII oocytes or 4.5 blastocysts are obtained in a PGT-SR cycle, couples should be notified that the likelihood of gaining a transferable embryo is low.

Retiboletus atrofuscus (Boletaceae, Boletales), a new species from China.

Based on morphological and phylogenetic analyses, an ectomycorrhizal fungus collected from Jiangxi, China, is described as a new species. R. atrofuscus is morphological characterized by a dark gray to black pileus, white to pale yellowish white hymenophore, a grayish brown to pale yellow context, which turning orange-yellow to rusty yellow when injured, a prominently and coarsely white to pale yellow to black reticulation on upper 3/4 or entire stipe, grayish yellow to pale yellow to yellowish brown basidiospores in KOH with measuring (7-)7.5-13(-13.5) × (3-)3.5-5(-5.5) µm. Phylogenetic analysis results showed that R. atrofuscus formed an independent lineage within Retiboletus. Descriptions and hand drawings of the new species and comparisons with similar species are presented.

Divergences of soil carbon turnover and regulation in alpine steppes and meadows on the Tibetan Plateau.

The grasslands of the Tibetan Plateau store approximately 2.5% of global soil organic carbon (SOC) and considerable soil inorganic carbon (SIC) and have the potential to become a vast carbon source or sink as climate change progresses. However, the soil carbon (C) sequestration mechanisms that occur across large-scale natural gradients remain unclear. Here, humic substances (HS) were utilized to trace soil C turnover at 0-20 cm, and we compared divergences among three main grassland types (alpine meadow, alpine steppe, and artificial plantation) using structural equation modeling (SEM). The results showed that the alpine meadows sequestered the most soil C (63.99 ± 4.41 g kg-1 SOC and 4.11 ± 0.63 g kg-1 SIC), sequestering 2-3 times more than the alpine steppe ecosystems (19.78 ± 1.98 g kg-1 SOC and 9.21 ± 0.66 g kg-1 SIC). The alpine steppe and artificial plantation regions have strong C sink potential due to their low C/N ratios (P < 0.05). Importantly, SIC played an important role in the alpine steppes, accounting for nearly 26-37% of soil C. The ratios of recalcitrant HS to SOC were estimated as 46.50%, 65.09%, and 78.17% in the alpine meadow, alpine steppe, and artificial plantation ecosystems, respectively, indicating that SOC in the alpine meadow was the most sensitive to climate change. Fulvic acid (FA) accounted for 50.86% of SOC in the 0-20-cm interval, contributing most to the formation of SOC in all vegetation types. In addition, in contrast to climatic controls on soil C turnover in the alpine meadow, climate conditions rarely controlled C turnover in the alpine steppe. Moreover, sand and silt were the main soil minerals involved in C turnover in alpine meadow and alpine steppe ecosystems, respectively. Our study improves understanding of the mechanism by which soil C sinks form on the Tibetan Plateau under warming and wetting conditions.

Climate suitability assessment on the Qinghai-Tibet Plateau.

Climate is an important factor that affects livability, but the climate comfort model used for low altitudes is not applicable to high altitudes, and further study on climate suitability in high-altitude areas is needed. In response to the absence of high-altitude characteristics in the current climate comfort assessment methods, this study adds oxygen content and solar radiation as plateau characteristic indicators. We use the consulting graded method (CGM), least squares method (LSM) and questionnaire survey method (QSM) to obtain comprehensive weights for oxygen content, solar radiation and comfort index to build the Climate Suitability Index of Plateau (CSIP) and assess climate suitability on the Qinghai-Tibet Plateau. The CSIP decreases obviously as elevation increases from southeast to northwest on the Qinghai-Tibet Plateau, which means that the climate becomes increasingly unsuitable from southeast to northwest. The Qinghai-Tibet Plateau is divided into four regions-"very unsuitable" (83.8 × 104 km2, 32.4%), "unsuitable" (81.5 × 104 km2, 31.6%), "suitable" (67.9 × 104 km2, 26.3%), and "very suitable" (24.9 × 104 km2, 9.6%)-by the natural break method according to the CSIP. According to the different degrees of response of population density to CSIP, we plot the climate suitability line of the Qinghai-Tibet Plateau to provide basic theoretical support for regional planning in the Qinghai-Tibet region. The CSIP developed in this study provides a new climate suitability assessment method for high-altitude regions and a method for planning human activities on the Qinghai-Tibet Plateau from a climate-focused perspective.

M2-Type Macrophages Induce Tregs Generation by Activating the TGF-ß/Smad Signalling Pathway to Promote Colorectal Cancer Development.

PURPOSE: The increase of both M2-type macrophages and Tregs is closely associated with the development of colorectal cancer. However, the mechanism of their interaction is still unclear. In this study, we investigated the correlation of M2-type macrophages with Tregs and the possible mechanisms between them. METHODS: Using immunohistochemistry, we analysed Smad3 (a key protein in the TGF-ß/Smad signalling pathway) expression in colorectal cells, as well as infiltrating numbers of CD163 (a marker for M2-type macrophages), Foxp3 (a marker for Tregs) in 250 surgically resected colorectal cancer tissues, matched normal and paracancerous tissues. The relation of CD163 and Foxp3 was investigated in CRC with clinicopathological characteristics and preoperative tumour markers. RESULTS: CD163, Foxp3 and Smad3 were upregulated in CRC tissues compared to matched normal and paracancerous tissues. Interestingly, CD163 and Foxp3 were significantly positively correlated in CRC, and both were significantly positively correlated with Smad3. Both CD163 and Foxp3 were upregulated with increasing tumour TNM staging, increasing number of lymph node metastases and increasing vascular invasion. Additionally, CD163 was upregulated with increasing depth of infiltration. The number of M2-type macrophages and the expression levels of preoperative CEA, CA19-9 and CA72-4 were significantly positively correlated. The number of Tregs was significantly positively correlated with the expression levels of preoperative CEA and CA19-9. CONCLUSION: M2-type macrophages may induce Tregs generation through activation of the TGF-ß/Smad signalling pathway, which can promote the development of colorectal cancer.

The Combined Impact of Female and Male Body Mass Index on Cumulative Pregnancy Outcomes After the First Ovarian Stimulation.

Objectives: To evaluate the combined impact of male and female BMI on cumulative pregnancy outcomes after the first ovarian stimulation. Design: Retrospective cohort study. Setting: University-affiliated reproductive medicine center. Patients: A total of 15,972 couples undergoing their first ovarian stimulations from June 2009 to June 2016 were included. During the follow-up period between June 2009 and June 2018, 14,182 couples underwent a complete ART cycle involving fresh embryo transfer and subsequent frozen embryo transfers (FETs) after their first ovarian stimulations. Patients with a BMI <24 kg/m2 served as the reference group. Patients with a BMI ≥ 24 kg/m2 were considered to be overweight, and those with a BMI ≥28 kg/m2 were considered to be obese. Interventions: None. Primary Outcome Measure: The primary outcome was the cumulative live birth rate (CLBR), which defined as the delivery of at least one live birth in the fresh or in the subsequent FET cycles after the first ovarian stimulation. Results: In the analyses of females and males separately, compared with the reference group, overweight and obese females had a reduced CLBR (aOR 0.83, 95% CI 0.7.92 and aOR 0.76, 95% CI 0.64-0.90). Similarly, overweight males had a reduced CLBR (aOR 0.91, 95% CI 0.83-0.99) compared with that of the reference group. In the analyses of couples, those in which the male was in the reference or overweight group and the female was overweight or obese had a significantly lower CLBR than those in which both the male and female had a BMI <24 kg/m2. Conclusions: The CLBR is negatively impacted by increased BMI in the female and overweight status in the male, both individually and together.

Does the "10-Point Water Plan" reduce the intensity of industrial water pollution? Quasi-experimental evidence from China.

The Action Plan for Water Pollution Prevention and Control (i.e., the "10-Point Water Plan") is a regulation formulated by China to prevent and control water pollution and ensure China's water safety. To test the policy effect of the "10-Point Water Plan", we use data from 269 cities for the period from 2012 to 2017 to examine whether the implementation of the plan can help reduce the intensity of industrial water pollution. The results show that the industrial water pollution intensity in Central and Western China is significantly higher than that in other regions, and the implementation of the "10-Point Water Plan" significantly reduces industrial water pollution intensity in China. We further find that upgrading industrial structures and technological innovation are effective ways to ameliorate the intensity of industrial water pollution. In terms of spatial heterogeneity, the impact of the "10-Point Water Plan" on reducing industrial water pollution is smaller in areas with high environmental regulation intensity than in areas with low environmental regulation intensity. We also find a strong inhibitory effect of environmental regulations on industrial water pollution intensity in areas with low environmental regulation intensity. Our findings support the positive policy effect of the "10-Point Water Plan" and provide significant policy implications for water pollution prevention and control actions in China and other countries.

A Two-Pronged Pulmonary Gene Delivery Strategy: A Surface-Modified Fullerene Nanoparticle and a Hypotonic Vehicle.

Inhaled gene therapy poses a unique potential of curing chronic lung diseases, which are currently managed primarily by symptomatic treatments. However, it has been challenging to achieve therapeutically relevant gene transfer efficacy in the lung due to the presence of numerous biological delivery barriers. Here, we introduce a simple approach that overcomes both extracellular and cellular barriers to enhance gene transfer efficacy in the lung in vivo. We endowed tetra(piperazino)fullerene epoxide (TPFE)-based nanoparticles with non-adhesive surface polyethylene glycol (PEG) coatings, thereby enabling the nanoparticles to cross the airway mucus gel layer and avoid phagocytic uptake by alveolar macrophages. In parallel, we utilized a hypotonic vehicle to facilitate endocytic uptake of the PEGylated nanoparticles by lung parenchymal cells via the osmotically driven regulatory volume decrease (RVD) mechanism. We demonstrate that this two-pronged delivery strategy provides safe, wide-spread and high-level transgene expression in the lungs of both healthy mice and mice with chronic lung diseases characterized by reinforced delivery barriers.

A study of the correlation between M2 macrophages and lymph node metastasis of colorectal carcinoma.

BACKGROUND: Lymph node metastasis is a major prognostic sign of colorectal carcinoma and an important indicator for individualized treatment. M2 macrophages play a key role in carcinogenesis and tumor development by enhancing invasiveness and promoting lymph node metastasis. The purpose of this study was to investigate the effect of CD163-positive M2 macrophages on lymph node metastasis in colorectal carcinoma. METHODS: Postoperative lymph node tissues were obtained from 120 patients with colorectal carcinoma who underwent radical surgery in the First Affiliated Hospital of Jinzhou Medical University between December 2019 and May 2020. We detected the expression of the CD163 protein in lymph nodes using immunohistochemistry. Furthermore, the relationships between M2 macrophages identified by expression of CD163 and lymph node metastasis were analyzed using the independent sample t-test and Chi-square test. RESULTS: M2 macrophages were increased in metastatic lymph nodes and non-metastatic lymph nodes adjacent to the cancer. The M2 macrophage count was higher in patients with macro-metastases than in patients with micro-metastases. CONCLUSIONS: The presence of M2 macrophages represents an important indicator for lymph node metastasis in colorectal carcinoma and may be a potential marker for its prediction. Thus, M2 macrophage localization might offer a new target for the comprehensive treatment of colorectal carcinoma.

[The level of the stress biomarker salivary alpha amylase is correlated with semen quality in infertile young men].

Objective: To investigate the relationship between the level of the stress biomarker salivary alpha amylase (SAA) and semen quality in infertile young men. METHODS: Totally, 313 infertile and 96 normal healthy men, aged 20－40 years old, were enrolled in this study. The SAA levels and semen parameters of the subjects were measured and compared between the two groups. RESULTS: Compared with the normal healthy controls, the young infertility patients showed a significantly higher SAA level (ï¼»141.04 ± 44.13ï¼½ vs ï¼»151.48 ± 38.42ï¼½ µmol/L, P < 0.05) and percentage of immotile sperm (IMS) (ï¼»39.98 ± 14.53ï¼½% vs ï¼»64.48 ± 26.32ï¼½%, P < 0.05), but lower sperm concentration (ï¼»44.23 ± 21.63ï¼½ vs ï¼»32.42 ± 23.07ï¼½ ×106/ml, P < 0.05) and percentage of progressively motile sperm (PMS) (ï¼»52.13 ± 15.42ï¼½% vs ï¼»27.91 ± 21.22ï¼½%, P < 0.05). Sperm concentration (ï¼»26.33 ± 31.83ï¼½ vs ï¼»35.28 ± 27.70ï¼½ ×106/ml, P < 0.05) and the percentage of PMS were remarkably lower in the infertile men with a high than in those with a low SAA level (ï¼»19.85 ± 21.55ï¼½% vs ï¼»31.70 ± 20.02ï¼½%, P < 0.05), while the percentage of IMS was higher in the former than in the latter group (ï¼»74.19 ± 26.84ï¼½% vs ï¼»59.92 ± 24.85ï¼½%, P < 0.05). The SAA level in the young infertility patients was correlated positively with the percentage of IMS (r = 0.170, P < 0.01), but negatively with sperm concentration (r = －0.227, P < 0.01) and the percentage of PMS (r = －0.468, P < 0.01). CONCLUSIONS: The stress biomarker salivary alpha amylase level in infertile young men is negatively correlated with semen quality, and therefore semen parameters can be improved by reducing the stress level.

Enhancing nanoparticle penetration through airway mucus to improve drug delivery efficacy in the lung.

Introduction: Airway mucus gel layer serves as a key delivery barrier that limits the performance of inhaled drug delivery nanoparticles. Conventional nanoparticles are readily trapped by the airway mucus and rapidly cleared from the lung via mucus clearance mechanisms. These nanoparticles cannot distribute throughout the lung airways, long-reside in the lung and/or reach the airway epithelium. To address this challenge, strategies to enhance particle penetration through the airway mucus have been developed and proof-of-concept has been established using mucus model systems..Areas covered: In this review, we first overview the biochemical and biophysical characteristics that render the airway mucus a challenging delivery barrier. We then introduce strategies to improve particle penetration through the airway mucus. Specifically, we walk through two classes of approaches, including modification of physicochemical properties of nanoparticles and modulation of barrier properties of airway mucus.Expert opinion: State-of-the-art strategies to overcome the airway mucus barrier have been introduced and experimentally validated. However, data should be interpreted in the comprehensive context of therapeutic delivery from the site of administration to the final destination to determine clinically-relevant approaches. Further, safety should be carefully monitored, particularly when it comes to mucus-altering strategies that may perturb physiological functions of airway mucus.

Study of the Relationship Between Serum Amino Acid Metabolism and Lymph Node Metastasis in Patients with Colorectal Cancer.

PURPOSE: Lymph node metastasis is one of the important prognostic factors of colorectal cancer, and an important index of individualized treatment. The purpose of this study is to use metabonomics to identify potential molecular markers of lymph node metastasis in colorectal cancer (CRC). PATIENTS AND METHODS: Peripheral blood samples of 223 CRC patients were collected. The metabolic levels of amino acids and carnitine in peripheral blood of CRC patients, with and without lymph node metastasis, were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). RESULTS: The results show that there were significant differences in the levels of serum amino acids and carnitine between lymph node metastatic patients and lymph node non-metastatic patients. The diagnostic model that was constructed by 9 types of serum metabolites has a high diagnostic ability. CONCLUSION: LC-MS/MS is a detection method that has a broad application in predicting CRC prognosis, individualized treatment, and in studying the mechanism of lymph node metastasis.

Risk factors for lower extremity amputation in patients with diabetic foot ulcers: A meta-analysis.

PURPOSE: A considerable number of diabetic foot ulcer (DFU) patients require amputation every year, which worsens their quality of life, aggravates the social burden, and shortens their life expectancy. Considering these negative effects, it is important to explore the relative risk factors affecting amputation in DFU patients. METHODS: The PubMed, SCIE and Embase databases were comprehensively searched for prospective or retrospective studies published before October 31, 2019. All English language studies involving DFU patients were included, and RevMan 5.3 software was used to analyse the data. RESULTS: This meta-analysis includes 21 studies involving 6505 participants, including 2006 patients who required a lower limb amputation. The following variables were associated with an increased risk of amputation: male sex (odds ratios (OR) = 1.30, 95% confidence interval (CI) = 1.16~1.46, P<0.00001), smoking history (OR = 1.19, 95% CI = 1.04~1.35, P = 0.009), a history of foot ulcers (OR = 2.48, 95% CI = 2.00~3.07, P<0.00001), osteomyelitis (OR = 3.70, 95% CI = 3.02~4.53, P<0.00001), gangrene (OR = 10.90, 95% CI = 5.73~20.8, P<0.00001), a lower body mass index (mean difference IV (MD) = -0.88, 95% CI = -1.30~-0.47, P<0.0001), and a higher white blood cell count (MD = 2.42, 95% CI = 2.02~2.82, P<0.00001). However, age (MD = 1.24, 95% CI = -0.45~2.93, P = 0.15), type of diabetes (OR = 0.96, 95% CI = 0.61~1.52, P = 0.86), hypertension (OR = 1.19, 95% CI = 0.96~1.47, P = 0.12), and HbA1c level (MD = 0.02, 95% CI = -0.28~0.33, P = 0.87) were not associated with amputation in patients with DFU. CONCLUSIONS: Our meta-analysis identified several risk factors for amputation in DFU patients, including the male sex, a smoking history, a history of foot ulcers, osteomyelitis, gangrene, a lower body mass index, and a higher white blood cell count. Once gangrene occurs, the risk of amputation rapidly increases.