Purpose To explore the consistency between T2 mapping and three-dimensional water-selective cartilage(3D-WATSc)sequence measurement of knee cartilage volume.Materials and Methods A total of 30 healthy volunteers were recruited and underwent 3D-WATSc and T2 mapping sequence scans of the left knee joint in the Affiliated Lihuili Hospital of Ningbo University from May to December 2022.A total of 20 subjects'T2 mapping sequences were randomly selected and eight groups of raw images with different TE(13,26,39,52,65,78,91,104 ms)were analyzed.The quality of the raw images was rated by two observers,and the consistency of two observers'scores were subjected by Kappa test.The TE value with the best image quality was determined via Welch analysis of variance and Games-Howell text post hoc test.Based on T2 mapping and 3D-WATSc sequences,semi-automatic segmentation measurements were performed on the cartilage volume of femoral condyle,tibial plateau and patellar posterior margin in 30 subjects.Intra group correlation coefficient(ICC)and Bland-Altman plot were used to test the consistency of cartilage volume between two observers under T2 mapping sequence,as well as between T2 mapping and 3D-WATSc sequences.Results The consistency of the scores of the two observers was moderate except for poor consistency at TE 104 ms(Kappa=0.318)and no statistical difference at TE 78 ms(P=0.052),with Kappa values greater than 0.40 and P<0.05,further analysis showed that the cartilage display quality score was optimal at TE 26 ms(M=2.90).Comparing TE 26 ms with the scores of the other seven groups in Games Howell text,except for TE 26 ms and TE 13 ms(M=2.55),TE 26 ms and TE 39 ms(M=2.62),which had no statistically significant difference in scores(P>0.05),there were significant differences in scores between TE 26 ms and the other TE groups(all P<0.05).On the T2 mapping(TR 2 000 ms,TE 26 ms)sequence,the ICC values of the cartilage volumes of each part segmented by two observers were all greater than 0.6,P<0.05,with the consistency of femoral condyle cartilage volume being the best(ICC=0.877,P<0.01).The consistency of the cartilage volumes of each part measured by 3D-WATSc and T2 mapping sequences was good(ICC>0.75,P<0.01),with the consistency of tibial plateau cartilage volume being the best(ICC=0.857,P<0.01).Conclusion The T2 mapping original grayscale image(TR 2 000 ms,TE 26 ms)can clearly display the morphology of knee joint cartilage,the consistency between T2 mapping and 3D-WATSc sequences in quantifying knee cartilage volume is good,and the T2 mapping single sequence provides a reliable scanning scheme for one-stop quantitative analysis of knee joint cartilage morphology and function.

Purpose To explore the consistency between T2 mapping and three-dimensional water-selective cartilage(3D-WATSc)sequence measurement of knee cartilage volume.Materials and Methods A total of 30 healthy volunteers were recruited and underwent 3D-WATSc and T2 mapping sequence scans of the left knee joint in the Affiliated Lihuili Hospital of Ningbo University from May to December 2022.A total of 20 subjects'T2 mapping sequences were randomly selected and eight groups of raw images with different TE(13,26,39,52,65,78,91,104 ms)were analyzed.The quality of the raw images was rated by two observers,and the consistency of two observers'scores were subjected by Kappa test.The TE value with the best image quality was determined via Welch analysis of variance and Games-Howell text post hoc test.Based on T2 mapping and 3D-WATSc sequences,semi-automatic segmentation measurements were performed on the cartilage volume of femoral condyle,tibial plateau and patellar posterior margin in 30 subjects.Intra group correlation coefficient(ICC)and Bland-Altman plot were used to test the consistency of cartilage volume between two observers under T2 mapping sequence,as well as between T2 mapping and 3D-WATSc sequences.Results The consistency of the scores of the two observers was moderate except for poor consistency at TE 104 ms(Kappa=0.318)and no statistical difference at TE 78 ms(P=0.052),with Kappa values greater than 0.40 and P<0.05,further analysis showed that the cartilage display quality score was optimal at TE 26 ms(M=2.90).Comparing TE 26 ms with the scores of the other seven groups in Games Howell text,except for TE 26 ms and TE 13 ms(M=2.55),TE 26 ms and TE 39 ms(M=2.62),which had no statistically significant difference in scores(P>0.05),there were significant differences in scores between TE 26 ms and the other TE groups(all P<0.05).On the T2 mapping(TR 2 000 ms,TE 26 ms)sequence,the ICC values of the cartilage volumes of each part segmented by two observers were all greater than 0.6,P<0.05,with the consistency of femoral condyle cartilage volume being the best(ICC=0.877,P<0.01).The consistency of the cartilage volumes of each part measured by 3D-WATSc and T2 mapping sequences was good(ICC>0.75,P<0.01),with the consistency of tibial plateau cartilage volume being the best(ICC=0.857,P<0.01).Conclusion The T2 mapping original grayscale image(TR 2 000 ms,TE 26 ms)can clearly display the morphology of knee joint cartilage,the consistency between T2 mapping and 3D-WATSc sequences in quantifying knee cartilage volume is good,and the T2 mapping single sequence provides a reliable scanning scheme for one-stop quantitative analysis of knee joint cartilage morphology and function.

Objective:To investigate the effects of marathon exercise on knee cartilage volume and T2 relaxation time (T2 value) based on MRI.Methods:From December 2018 to December 2021, 25 healthy volunteers without long-distance running habits and 32 non-professional marathon runners with long-term long-distance running were recruited to undergo knee MRI 3D water-selective excitation (three dimensional water-selective excitation, 3D-WATS) and T2 mapping imaging were performed, and the cartilage volumes in 5 knee areas and T2 values in 42 subareas were extracted for analysis. To compare the cartilage volume and its ratio to body surface area of knee joint of healthy volunteers and non-professional marathon runners, the T2 value of cartilage in each subregion, and the correlation between marathon exercise intensity and the volume and T2 value of cartilage in different regions.Results:Compared with healthy volunteers, there was no significant difference in cartilage volume or the ratio of body surface area to body volume of non-professional marathon runners ( P>0.05). There were significant differences between healthy volunteers and non-professional marathon runners in cartilage T2 values of the median layer of medial condyle of femur (47.61±5.65 ms and 44.29±6.10 ms) and the deep layer of medial condyle of femur (36.82±9.05 ms and 31.67±7.59 ms), deep precondylar area of medial femur (38.37±4.68 ms and 34.09±4.19 ms), shallow area of medial condylar area of femur (52.17±11.11 ms and 45.51±7.76 ms), middle layer of medial condylar area of femur (49.09±5.08 ms and 45.63±5.04 ms), medial layer of anterior condylar region of lateral femur (45.69±4.68 ms and 42.57±5.77 ms), superficial layer of posterior condylar region of lateral femur (55.42±18.41 ms and 47.99±8.39 ms), deep layer of anterior tibial medial plateau (33.40±7.76 ms and 29.03±5.69 ms), deep layer of posterior tibial medial plateau (31.28±5.02 ms and 27.92±5.99 ms), deep layer of patellofemoral surface (35.65±6.99 ms and 32.30±5.28 ms), respectively ( P<0.05). In non-professional marathon runners, the medial tibial plateau cartilage volume was negatively correlated with step frequency ( r=-0.371, P=0.035), the lateral femoral condylar cartilage volume was negatively correlated with step frequency ( r=-0.365, P=0.043), and the lateral tibial plateau cartilage volume was negatively correlated with step frequency ( r=-0.550, P=0.001). The T2 value of the medial layer cartilage in the anterior tibial medial plateau region was negatively correlated with body weight ( r=-0.277, P=0.039) and body mass index ( r=-0.290, P=0.030). The T2 value of the superficial layer of patellofemoral surface was negatively correlated with the amount of running in 3 months ( r=-0.457, P=0.010). The superficial T2 value in the posterior lateral plateau of the tibia was negatively correlated with stride length ( r=-0.437, P=0.014), and the medial layer cartilage T2 value in the anterior condylar area of the lateral femur was negatively correlated with stride frequency ( r=-0.380, P=0.035). Conclusion:Marathon exercise had little effect on the knee cartilage volume, but had a certain effect on the cartilage T2 value, resulting in changes in cartilage structure. The higher the step frequency, the smaller the cartilage volume. The greater the body weight or body mass index, the greater the amount of running in 3 months, and the greater the stride length, the lower the cartilage T2 value.

Objective:Using the established epilepsy patient database to validate the efficacy of the web-based epilepsy diagnosis and anti-seizure medications (ASM) selection tool, EpiPick, for domestic epilepsy patients.Methods:The retrospective collection of clinical data was conducted on patients aged 10 and above who were diagnosed with epilepsy at the Comprehensive Epilepsy Center of the First Affiliated Hospital of Kunming Medical University from January 2017 to December 2020, with regular follow-up and complete information. According to the first ASM recommended by the EpiPick tool and whether they are consistent with the actual ASM used by patients, patients were divided into EpiPick group and clinical group to verify the effectiveness of the EpiPick tool in selecting ASM. The drug retention rate, Engel score, and cumulative probability of no consecutive episodes within 30 months after using the first ASM were compared between the 2 groups, and Kaplan-Meier survival curves were drawn. Finally, the diagnostic results provided by the EpiPick tool were compared with the actual types of epileptic seizures diagnosed clinically, and consistency tests were performed.Results:A total of 364 epilepsy patients were included, including 237 in the EpiPick group and 127 in the clinical group. The ASM retention rates of patients in the EpiPick group and clinical group were 67.9%(161/237) and 56.7%(72/127), respectively, with statistically significant differences (χ2=4.534, P=0.039). Grades Ⅰ, Ⅱ, Ⅲ and Ⅳ according to the Engel scores in the EpiPick group patients who took the first ASM after diagnosis accounted for 47.3%(112/237), 14.8%(35/237), 12.7%(30/237), and 25.3%(60/237), respectively, compared to the clinical group of 32.3%(41/127), 11.8%(15/127), 11.0%(14/127), and 44.9%(57/127), respectively. There was a statistically significant difference in Engel scores between the 2 groups (χ2=14.968, P=0.002). The cumulative seizure-free rates in the EpiPick group at the 1st, 6th, 12th, 30th month and above after starting the first ASM were 73.8%, 61.2%, 53.2%, and 50.6%, respectively, which in the clinical group were 52.0%, 44.1%, 40.2%, and 33.5%, respectively. The logrank test showed a statistically significant difference in the cumulative probability of consecutive seizure freedom between the 2 groups ( HR=0.644 ,95% CI 0.476-0.871 ,P<0.001). After grouping by seizure type [focal seizures (196 cases) and generalized seizures (168 cases)], the cumulative seizure-free rates at the 1st, 6th, 12th, 30th month and above after starting ASM were significantly higher in the EpiPick group than in the clinical group (comparison between the 2 groups in patients with focal seizures: HR=0.654, 95%CI 0.443-0.964, P=0.004; comparison between the 2 groups in patients with generalised seizures: HR=0.586, 95%CI 0.361-0.954, P=0.014). Among 364 patients, 293 cases were clinically diagnosed with seizure classification consistent with the classification results of EpiPick tool. Agreement between the algorithm and the experts in classifying generalized seizures was 83.9%(104/124), which in classifying focal seizures was 78.8%(189/240; Kappa=0.591, P<0.001). Conclusion:Web-based EpiPick tool is suitable to be used to select the first ASM, and is portable for Chinese non-epilepsy specialists to choose ASM for epilepsy patients.

Objective To observe the value of MRI texture features combined with apparent diffusion coefficient(ADC)for differentiating uterine sarcoma(US)and cellular uterine leiomyoma(CUL).Methods Pelvic MRI data of 27 US patients(US group)and 34 CUL patients(CUL group)were retrospectively analyzed.The texture features of lesions were extracted from T2WI and diffusion weighted imaging(DWI),the ADC value were measured,and the average ADC value(ADCmean),the minimum ADC value(ADCmin)and standard ADC value(ADCst)were recorded.Then logistic regression(LR)models were constructed based on ADC value,optimal texture features alone and their combination,respectively,including LRADC,LRtexture and LRADC+texture models.Receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy of each model for differentiating US and CUL.Results The ADCmean,ADCmin and ADCst in US group were all lower than those in CUL group(all P＜0.05).A total of 3 750 texture features were extracted from pelvic T2WI and DWI,5 optimal features were finally obtained,and the constructed LRADC+texture model and LRtexture model had similar efficacy of differentiating US and CUL(AUC=0.921,0.887;P＞0.05),which were both higher than that of LRADC model(AUC=0.696;both P＜0.05).The calibration curve of LRADC+texture model was basically consistent with the ideal curve,which had better clinical benefits than LRADC and LRtexture models.Conclusion MRI texture features combined with ADC value could improve efficacy for differentiating US and CUL.

Auditory neuropathy spectrum disorder (ANSD) represents a variety of sensorineural deafness conditions characterized by abnormal inner hair cells and/or auditory nerve function, but with the preservation of outer hair cell function. ANSD represents up to 15％ of individuals with hearing impairments. Through mutation screening, bioinformatic analysis and expression studies, we have previously identified several apoptosis-inducing factor (AIF) mitochondria-associated 1 (AIFM1) variants in ANSD families and in some other sporadic cases. Here, to elucidate the pathogenic mechanisms underlying each AIFM1 variant, we generated AIF-null cells using the clustered regularly interspersed short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) system and constructed AIF-wild type (WT) and AIF-mutant (mut) (p.T260A, p.R422W, and p.R451Q) stable transfection cell lines. We then analyzed AIF structure, coenzyme-binding affinity, apoptosis, and other aspects. Results revealed that these variants resulted in impaired dimerization, compromising AIF function. The reduction reaction of AIF variants had proceeded slower than that of AIF-WT. The average levels of AIF dimerization in AIF variant cells were only 34.5％?49.7％ of that of AIF-WT cells, resulting in caspase-independent apoptosis. The average percentage of apoptotic cells in the variants was 12.3％?17.9％, which was significantly higher than that (6.9％?7.4％) in controls. However, nicotinamide adenine dinucleotide (NADH) treatment promoted the reduction of apoptosis by rescuing AIF dimerization in AIF variant cells. Our findings show that the impairment of AIF dimerization by AIFM1 variants causes apoptosis contributing to ANSD, and introduce NADH as a potential drug for ANSD treatment. Our results help elucidate the mechanisms of ANSD and may lead to the provision of novel therapies.

Auditory neuropathy spectrum disorder (ANSD) represents a variety of sensorineural deafness conditions characterized by abnormal inner hair cells and/or auditory nerve function, but with the preservation of outer hair cell function. ANSD represents up to 15% of individuals with hearing impairments. Through mutation screening, bioinformatic analysis and expression studies, we have previously identified several apoptosis-inducing factor (AIF) mitochondria-associated 1 (AIFM1) variants in ANSD families and in some other sporadic cases. Here, to elucidate the pathogenic mechanisms underlying each AIFM1 variant, we generated AIF-null cells using the clustered regularly interspersed short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) system and constructed AIF-wild type (WT) and AIF-mutant (mut) (p.‍T260A, p.‍R422W, and p.‍R451Q) stable transfection cell lines. We then analyzed AIF structure, coenzyme-binding affinity, apoptosis, and other aspects. Results revealed that these variants resulted in impaired dimerization, compromising AIF function. The reduction reaction of AIF variants had proceeded slower than that of AIF-WT. The average levels of AIF dimerization in AIF variant cells were only 34.5%‍‒‍49.7% of that of AIF-WT cells, resulting in caspase-independent apoptosis. The average percentage of apoptotic cells in the variants was 12.3%‍‒‍17.9%, which was significantly higher than that (6.9%‍‒‍7.4%) in controls. However, nicotinamide adenine dinucleotide (NADH) treatment promoted the reduction of apoptosis by rescuing AIF dimerization in AIF variant cells. Our findings show that the impairment of AIF dimerization by AIFM1 variants causes apoptosis contributing to ANSD, and introduce NADH as a potential drug for ANSD treatment. Our results help elucidate the mechanisms of ANSD and may lead to the provision of novel therapies.
Humans ; Apoptosis Inducing Factor/metabolism* ; NAD/metabolism* ; Dimerization ; Apoptosis

Objective To investigate the role of high mobility group protein2(HMGA2)and E-Cadherin in the development of prostate cancer(PCa). Methods A total of 60 paraffln-embedded specimens of PCa were collected from patients who underwent operation in Dalian Central Hospital from 2008 to 2016.The expression lev-els of HMGA2 and E-Cadherin in the specimens were examined by immunohistochemical staining.The correlations between the expression of HMGA2 and E-Cadherin and clinical features such as age,Gleason score,invasion,me-tastasis and TNM stage were studied. Results The expression levels of HMGA2 in PCas were significantly higher than that in controls(χ2=51.818,P<0.01),but the positive expression levels of E-Cadherin in PCas were lower than that in controls(χ2=53.494,P<0.01).The positive expression of HMGA2 and the loss of E-Cadherin were confirmed in PCa accompanied by metastasis,seminal invasion,Gleason score>7 and stageⅢ~Ⅳ(P<0.05). Overexpression of HMGA2 was associated with down-regulation of E-cadherin(Spearman′s r=-0.569,P<0.01). Conclusions Up-regulation of HMGA2 and down-regulation of E-Cadherin are cooperatively correlated with the invasion and metastasis in PCa.

Objective To evaluate the safety of Renaissance spine robot assisted system in spinal injury.Methods From March 2014 to May 2016,38 patients with spinal disease received spinal surgery assisted by spine robot system.They were 20 males and 18 females,with an average age of 42 years (range,from 12 to 69 years).There were 10 lumbar fractures,8 thoracic fractures and 20 spinal deformities.Pedicle screw implantation was conducted in 30 patients (PS group) and percutaneous vertebroplasty in 8 (PV group).One side was chosen randomly to use Mazor spine robot assisted system (assisted group) and the opposite side the conventional method (non-assisted group).The anteroposterior and lateral X-rays and CT scan of the lumbar and/or thoracic spine were performed in all patients after surgery.The precision of pedicle screws implantation in PS group was evaluated by the Abul-Kasimhierarchy grading system;location of the puncture trajectory,time used for puncture and radiation exposure time in PV group were evaluated.Results 208 pedicle screws were implanted in PS group,including 120 lumbar ones and 88 thoracic ones.For lumbar pedicle screw implantation,the excellent to good rate was 95.0％ (57/60) in the assisted group,significantly higher than that in the non-assisted group (80.0％,48/60) (P ＜ 0.05).For thoracic pedicle screw implantation,the excellent to good rate was 95.5％ (42/44) in the assisted group,significantly higher than that in the non-assisted group (77.3％,34/44) (P ＜ 0.05).There were 24 puncture trajectories in 8 patients in PV group,showing no pedicle penetration or cement leaking in any case.The mean time used for puncture was 5.5 ± 1.4 min in the assisted group,significantly shorter than that in the non-assisted group (17.8 ± 7.5 min) (P ＜ 0.05);the X-ray exposure time was 14.0 ± 4.0 s in the assisted group,significantly shorter than that in the non-assisted group (22.4 ± 6.0 s) (P ＜ 0.05).Conclusions Renaissance spine robot-assisted system deserves more clinical application,because in spinal surgery it can make pedicle screw implantation more precise and safer,and can reduce operation time and X-ray exposure time in percutaneous vertebroplasty.

Objective To compare the biomechanical properties of Gamma3 and InterTan nails in the fixation of femoral intertrochanteric fractures. Methods Twelve synthetic femora of 4th generation were randomized into 4 equal groups ( n=3 ) for assessment of the 2 constructs of fracture fixation ( Gamma3 versus InterTan nails ) . Groups A and B were made into models of stable femoral intertrochanteric fracture (AO/OTA type 31-A1. 1) and groups C and D into unstable ones(AO/OTA type 31-A2. 3) . The biomechanical properties of Gamma3 and InterTan nails in the 4 models were tested and compared. Results For stable fracture models, the fracture gap movement increased with the increasing axial load and the torque increased with the increasing torsion angle. There were significant differences between groups A and B in fracture gap movement and torque ( P <0. 05 ) . There was no significant difference between groups A and B in failure load ( 5, 855. 5 ± 627. 8 N versus 5, 547. 1 ± 365. 4 N ) ( P > 0. 05 ) . For unstable fracture models, there were no significant differences between groups C and D in fracture gap movement when the axial loads were 500 N, 600 N or 700 N ( P > 0. 05 ) , but there was a significant difference between the 2 groups when the axial load was larger than 800 N ( P <0. 05 ) . With the increasing torsion angle, the torque increased in groups C and D. There was a significant difference between the 2 groups in the torque at the same torsion angle ( P <0. 05 ) . There were a significant difference between groups C and D in failure load ( 2, 781. 5 ± 600. 6 N versus 3, 150. 5 ± 633. 8 N ) ( P=0. 007 ) . Conclusions For stable femoral intertrochanteric fractures, InterTan and Gamma3 nails may exhibit similar biomechanical properties. For unstable femoral intertrochanteric fractures, InterTan nails may provide obviously better biomechanical stability than Gamma3 nails.