Objective To investigate the expression and clinical significance of circular RNA(circRNA)051778 in lung adenocarcinoma-malignant pleural effusion(LA-MPE)and tuberculous pleural effusion(TPE).Methods This is a cross-sectional study.A total of 212 patients were recruited from the Jiangxi Chest Hospital between October 2018 and September 2019,and their pleural effusion samples and/or plasma samples were collected.The exosomal circRNA profile was sketched by circRNA microarray.Differentially expressed circRNAs(DECs)were verified by droplet digital PCR.In addition,a putative circRNA-miRNA-mRNA network was constructed,and Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analyses were performed to predict the functions of the DECs.The diagnostic value of circRNA_051778 was evaluated by binary logistic regression and receiver operating characteristic curve.Results The expression level of circRNA_051778 in the LA-MPE samples was(3.92±0.48)copies/100 ng cDNA,while that in the TPE samples was(21.53±2.22)copies/100 ng cDNA.Compared to that in the TPE samples,circRNA_051778 was significantly downregulated in the LA-MPE samples(P＜0.001).The potential targets of circRNA_051778 were enriched in positive regulation of GTPase activity,cytoplasm,protein binding,and cancer-related pathways.The area under the curve(AUC)for the combined assessment of circRNA_051778 with liquid-based thin-layer cytology(TCT),erythrocyte sedimentation rate(ESR),and tuberculosis antibody(TBA)was 0.98(95％confidence interval:0.97-1.00),with the sensitivity being 88.0％and the specificity being 100.0％.Conclusion Exosomal circRNA_051778 is downregulated in LA-MPE.According to the findings from the GO and KEGG analyses,exosomal circRNA_051778 may play a role in cancer development and has the potential to serve as a marker for differential diagnostic of LA-MPE and TPE when it is used in combination with TCT,ESR,and TBA.

Objective To analyze the factors that influence screw penetration after plating for proximal humerus fractures of Neer two-or three-part.Methods We reviewed the patients with proximal humerus fracture of Neer types Ⅱ & Ⅲ who had been treated from January 2006 to June 2017.The data were documented regarding gender,age,Neer classification,osteoporosis,surgical procedure,cephalic screw number,type of medial support and screw penetration.They were divided into 2 groups according to the presence or absence of screw penetration.x2 test and independent samples t test were used with software IBM SPSS 22.0.The multivariate logistic regression was used to identify the independent risk factors when there were two or more statistically significant factors.The two-side test was used and significance was set to P ＜ 0.05.Results Altogether 78 patients were included in our analysis,including 27 males (34.62％) and 51 females (65.38％) with an average age of 57.41 years (from 18 to 85 years).Their average follow-up time was 7.7 months (from 3 to 24 months).There were 54 Neer two-part fractures (69.23％) and 24 Neer three-part ones (30.77％).Screw penetration was observed in 18 patients (23.08％) but not in the other 60 ones (76.92％).The x2 test and independent samples t test revealed that screw penetration was significantly associated with gender (P =0.003),osteoporosis (P =0.003) and cephalic screw number (P =0.003) but not with age (P =0.256),Neer classification(P =0.754),surgical procedure((P =0.308) or type of medial support (P =0.186).The multivariate logistic regression revealed that osteoporosis (P =0.027) and cephalic screw number (P =0.026) were independent risk factors for screw penetration.Conclusions After plating for proximal humerus fractures of Neer two-or three-part,the patients with osteoporosis and those receiving more than 5 cephalic screws may face a higher risk of screw penetration than those without osteoporosis and those receiving 4 cephalic screws.