With the development of population aging, the incidence of lower limb artery ischemic diseases is gradually increasing. Although various treatments such as medication and endovascular surgery are currently available, patients with compromised microcirculation in the distal limbs and poor outflow pathways often do not achieve satisfactory results. Additionally, these treatments can be costly, and long-term patency rates are not ideal. The amendment in situ autologous great saphenous vein arterialization surgery utilizes the patient′s great saphenous vein to provide arterial blood in a retrograde manner and re-establishes blood supply to the tissues through the venous microcirculation system in the distal foot. This approach can achieve good limb salvage results and long-term patency. Therefore, this article aims to elaborate on the methods and value of amendment in situ autologous great saphenous vein arterialization surgery.

Objective:To investigate the changes in interaction proteome of NUS1 mutant R290C and their relations with pathogenicity of Lennox Gastaut syndrome (LGS). Methods:The wild-type and mutant NUS1(R290C) plasmids were constructed and transfected into human embryonic kidney HEK293T cells; 48 h after that, NUS1 protein expression in HEK293T cells was detected by Western blotting. Co-immunoprecipitation, silver nitrate staining, and proteomic analysis were used to analyze the proteins interacted with wild-type or mutant NUS1 and identify the differential interacting proteins. Enrichment analyses of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were performed to annotate the molecular function and signaling pathways involved in the differential proteins. DisGeNet database was used to analyze the association between differential proteins and human diseases. Protein-protein interaction (PPI) was used to analyze the interaction network of NUS1 with protein folding regulatory proteins (RTN4 and DHDDS) and developmental epileptic encephalopathy related proteins.Results:(1) There was no significant difference in NUS1 protein expression between the wild-type and mutant NUS1 transfected HEK293T cells ( t=0.536, P=0.620). (2) Compared with that with wild-type NUS1 plasmid, number of proteins interacting with mutant NUS1 plasmid was significantly reduced in the transfected cells; 310 differential interacting proteins were screened in the mutant NUS1. (3) GO and KEGG enrichment analyses showed that the differential proteins were mainly involved in protein folding reaction and translation regulation. (4) DisGeNet association analysis showed that the two most relevant proteins in the differential interacting proteins were associated with frontotemporal dementia and developmental epileptic encephalopathy. (5) PPI analysis showed that NUS1 may be involved in occurrence of neurological diseases such as LGS by affecting protein folding signaling pathways. Conclusion:NUS1 mutant R290C alters its interacting protein lineage and mediates the development of LGS and other neurological diseases probably by regulating protein folding-related signaling.

Humans ; Data Warehousing ; East Asian People ; Intracranial Hemorrhages/diagnostic imaging* ; Asian People ; Cerebral Hemorrhage/diagnostic imaging*

BACKGROUND: Sarcopenia is an age-related progressive skeletal muscle disorder involving the loss of muscle mass or strength and physiological function. Efficient and precise AI algorithms may play a significant role in the diagnosis of sarcopenia. In this study, we aimed to develop a machine learning model for sarcopenia diagnosis using clinical characteristics and laboratory indicators of aging cohorts. METHODS: We developed models of sarcopenia using the baseline data from the West China Health and Aging Trend (WCHAT) study. For external validation, we used the Xiamen Aging Trend (XMAT) cohort. We compared the support vector machine (SVM), random forest (RF), eXtreme Gradient Boosting (XGB), and Wide and Deep (W&D) models. The area under the receiver operating curve (AUC) and accuracy (ACC) were used to evaluate the diagnostic efficiency of the models. RESULTS: The WCHAT cohort, which included a total of 4057 participants for the training and testing datasets, and the XMAT cohort, which consisted of 553 participants for the external validation dataset, were enrolled in this study. Among the four models, W&D had the best performance (AUC = 0.916 ± 0.006, ACC = 0.882 ± 0.006), followed by SVM (AUC =0.907 ± 0.004, ACC = 0.877 ± 0.006), XGB (AUC = 0.877 ± 0.005, ACC = 0.868 ± 0.005), and RF (AUC = 0.843 ± 0.031, ACC = 0.836 ± 0.024) in the training dataset. Meanwhile, in the testing dataset, the diagnostic efficiency of the models from large to small was W&D (AUC = 0.881, ACC = 0.862), XGB (AUC = 0.858, ACC = 0.861), RF (AUC = 0.843, ACC = 0.836), and SVM (AUC = 0.829, ACC = 0.857). In the external validation dataset, the performance of W&D (AUC = 0.970, ACC = 0.911) was the best among the four models, followed by RF (AUC = 0.830, ACC = 0.769), SVM (AUC = 0.766, ACC = 0.738), and XGB (AUC = 0.722, ACC = 0.749). CONCLUSIONS: The W&D model not only had excellent diagnostic performance for sarcopenia but also showed good economic efficiency and timeliness. It could be widely used in primary health care institutions or developing areas with an aging population. TRIAL REGISTRATION Chictr.org, ChiCTR 1800018895.
Humans ; Aged ; Sarcopenia/diagnosis* ; Deep Learning ; Aging ; Algorithms ; Biomarkers

Objective:To investigate the relationship between pancreatic fibrotic marker transforming growth factor-β(TGF-β) and platelet derived growth factor-BB(PDGF-BB) and serum glycated hemoglobin (HbA1c) levels in patients with type 3c diabetes mellitus secondary to chronic pancreatitis(CP-T3cDM).Methods:The clinical data of 39 patients with CP-T3cDM admitted to the Department of Gastroenterology of the First Affiliated Hospital of Naval Medical University between February 2018 and August 2020 were collected, and the patients' age, gender, body mass index, duration of chronic pancreatitis and diabetes mellitus, smoking history, alcohol consumption history, serum HbA1c level at admission, degree of pancreatic atrophy, morphology of the main pancreatic duct, and treatment of diabetes mellitus were recorded. Serum TGF-β and PDGF-BB were detected by ELISA. Patients were divided into high and low level group according to the median TGF-β and PDGF-BB levels, respectively. Clinical characteristics of patients were compared between the TGF-β and PDGF-BB high and low level group. The correlation between TGF-β, PDGF-BB and HbA1c was analyzed by Spearman's correlation analysis.Results:A total of 39 CP-T3cDM patients were included; 35 were male and 4 were female. The age of first onset of chronic pancreatitis was (42±14) years old, and the duration of diabetes mellitus was 24(4, 36) months. The serum HbA1c level was (7.8±1.6)%, and the serum TGF-β and PDGF-BB levels were 20.5(10.5, 43.1) and 647.5(276.9, 1349.2)pg/ml, respectively. The serum HbA1c levels of patients in the high-level group of serum TGF-β and PDGF-BB were significantly higher than those in the corresponding low-level group [8.6%(7.4%, 9.9%) vs 6.7%(6.2%, 7.8%) and 8.6%(7.4%, 9.6%) vs 6.7%(6.1%, 7.8%), respectively] , and the difference was statistically different (both P value <0.01), while none of other indicators showed statistically significant differences between both groups. The correlation analysis showed that the levels of TGF-β and PDGF-BB were significantly positively correlated with HbA1c level ( r=0.45, 0.53, both P value <0.01). Conclusions:Increased pancreatic fibrosis in patients with CP-T3cDM was an important factor contributing to elevated blood glucose level. Patients with higher serum pancreatic fibrotic factors exhibited a significant increase in HbA1c level.

Objective:To verify the clinical value of the good outcome following attempted resuscitation (GO-FAR) score in predicting the neurological status of patients with in-hospital cardiac arrest (IHCA) in the Chinese population.Methods:The clinical data of patients with IHCA who were admitted to the Zigong Fourth People's Hospital from January 1 to December 31, 2020 were retrospectively analyzed. Used Glasgow-Pittsburgh cerebral performance category (CPC) score 1 point as the end point, the subjects were divided into 4 groups according to the score: ≤ 0 group, 1-8 group, 9-20 group and ≥ 21 group. Taken the group which GO-FAR score ≤ 0 as the reference group, the odds ratio ( OR) of the other three groups compared with this group was calculated. The receiver operator characteristic curve (ROC curve) was performed to evaluate the predictive value of the GO-FAR score in favorable neurological outcome. A calibration curve was drawn for the Hosmer-Lemeshow test to analyze the degree of calibration of the GO-FAR score for predicting good neurological outcome. Results:A total of 230 IHCA patients were enrolled in the study, including 130 males, aged 74 (65, 81) years old, and 23 case (10.0%) had good neurological prognosis. There were statistically significant differences in GO-FAR-related variables, including age, a normal neurological function on admitted, acute stroke, metastatic cancer, septicemia, medical noncardiac admission, hepatic insufficiency, hypotension, renal insufficiency or dialysis, respiratory insufficiency, pneumonia, etc (all P < 0.05). Taken the GO-FAR score ≤ 0 group as the reference group, the OR values of good neurological prognosis in the GO-FAR score 1-8 group were 0.54 [95% confidence interval (95% CI) was 0.17-1.53, P = 0.250], 9-20 group were 0.17 (95% CI was 0.02-0.67, P = 0.009) and ≥ 21 group were 0.25 (95% CI was 0.05-0.85, P = 0.025). The area under the ROC curve (AUC) of the GO-FAR score for predicting favorable neurological outcome in IHCA patients was 0.653 (95% CI was 0.529-0.777, P = 0.015) and there was no significant difference in Hosmer-Lemeshow test ( P = 0.311). All these suggested that there was no significant difference between the predicted value and the actual value. Conclusions:GO-FAR score can be applied to predict neurological prognosis of IHCA patients in Chinese population. It can help clinicians to predict the prognosis of cardio-pulmonary resuscitation (CPR) and propose critical recommendations in treatment for these patients or their families.

In the past ten years, the research and application of microbiome has continued to increase. The microbiome has gradually become the research focus in the fields of life science, environmental science, and medicine. Meanwhile, many countries and organizations around the world are launching their own microbiome projects and conducting a multi-faceted layout, striving to gain a strategic position in this promising field. In addition, whether it is scientific research or industrial applications, there has been a climax of research and a wave of investment and financing, accordingly, products and services related to the microbiome are constantly emerging. However, due to the rapid development of microbiome sequencing and analysis related technologies and methods, the research and application from various countries have not yet unified on the standards of technology, programs, and data. Domestic industry participants also have insufficient understanding of the microbiome. New methods, technologies, and theories have not yet been fully accepted and used. In addition, some of the existing standards and guidelines are too general with poor practicality. This not only causes obstacles in the integration of scientific research data and waste of resources, but also gives related companies unfair competition opportunity. More importantly, China still lacks national standards related to the microbiome, and the national microbiome project is still in the process of preparation. In this context, the experts and practitioners of the microbiome worked together and developed the consensus of experts. It can not only guide domestic scientific research and industrial institutions to regulate the production, learning and research of the microbiome, the application can also provide reference technical basis for the relevant national functional departments, protect the scale and standardized corporate company's interests, strengthen industry self-discipline, avoid unregulated enterprises from disrupting the market, and ultimately promote the benign development of microbiome-related industries.
China ; Consensus ; Humans ; Industry ; Microbiota

Objective:To compare the efficacy of oblique lumbar interbody fusion (OLIF) and minimally invasive interbody fusion (MI-TLIF) for degenerative lumbar spondylolisthesis.Methods:Data of 40 patients with I-II degree single level degenerative lumbar spondylolisthesis from January 2018 to December 2018 were retrospectively analyzed. According to the operation procedure, they were divided into two groups: OLIF group and MI-TLIF group, and each group had 20 patients. There were 15 males and 5 females in the OLIF group, aged 50.3±8.8 years; and there were 13 males and 7 females in the MI-TLIF group, aged 51.7±8.7 years. According to the Meyerding's grade system, there were 16 patients of type I in the OLIF group and 15 cases in the MI-TLIF group; and there were 4 patients of type II in the OLIF group and 5 cases in the MI-TLIF group. The operation time, intra-operative hemorrhage, postoperative drainage, recessive blood loss and albumin loss were recorded. The CRP and ESR on the third day after operation, the VAS score and ODI score before and after operation were recorded. The lumbar lordosis (LL), fused segmental lordosis (FSL) and disc height (DH) before and after operation were recorded. The time of getting out of bed and walking and the hospital stay were recorded. Paired t-test was used to analyze the data.Results:Forty patients successfully underwent the operation. The operation time of OLIF group was 96±20 min, with intraoperative blood loss of 61±32 ml and postoperative drainage volume of 18±8 ml. The operation time of MI-TLIF group was 132±26 min, with intraoperative blood loss of 262±102 ml and postoperative drainage volume of 95±42 ml; and there was statistical difference between the two groups ( t=4.901, 8.404, 8.064; P< 0.001). On the third day after operation, the occult blood loss was 139±47 ml in the OLIF group and 486±192 ml in the MI-TLIF group; the albumin loss was 4.2±1.9 g/L in the OLIF group and 10.2±3.9 g/L in the MI-TLIF group; CRP was 34±11 mg/L in the OLIF group and 106±39 mg/L in the MI-TLIF group; ESR was 41±15 mm/1 h in the OLIF group and 71±24 mm/1 h in the MI-TLIF group, and there all were statistical differences between the two groups ( t=7.838, 6.184, 7.983, 4.675; P< 0.001). The VAS scores were 2.2±1.5, 1.8±1.3 and ODI scores were 14%±11%, 59%±17%, respectively. There was no significant difference between the two groups. The LL were 33.41°±9.25°, 32.07°±9.54°, FSL were 11.59°±5.09°, 10.61°±4.56° and DH were 10.35±2.30 mm, 10.85±1.85 mm, respectively. There was no significant difference between the two groups. The follow-up time was 13.5±2.3 months in the OLIF group and 14.1±2.8 months in the MI-TLIF group. Three patients in the MI-TLIF group had radiation pain in the lower extremity on the third day after operation, which relieved after NSAID drugs and mannitol treatment. In the group of OLIF, the skin temperature of the left lower extremity increased in 1 case on the first day after operation, in which sympathetic chain injury was considered, and the patient recovered after 2.5 months; in the group of OLIF, the numbness in the front of the left thigh and the weakness of flexion of the hip was found in 3 cases, in which the edema or injury of the psoas major muscle was considered. Conclusion:Compared with MI-TLIF in the treatment of I, II degree single segment degenerative lumbar spondylolisthesis, OLIF has the advantages of shorter operation time, less intraoperative and postoperative blood loss, lower inflammation index, earlier time to get out of bed and shorter hospital stay. However, the outcomes of the two surgeries were similar.

In mammalian cells, long noncoding RNAs (lncRNAs) form complexes with proteins to execute various biological functions such as gene transcription, RNA processing and other signaling activities. However, methods to track endogenous lncRNA dynamics in live cells and screen for lncRNA interacting proteins are limited. Here, we report the development of CERTIS (CRISPR-mediated Endogenous lncRNA Tracking and Immunoprecipitation System) to visualize and isolate endogenous lncRNA, by precisely inserting a 24-repeat MS2 tag into the distal end of lncRNA locus through the CRISPR/Cas9 technology. In this study, we show that CERTIS effectively labeled the paraspeckle lncRNA NEAT1 without disturbing its physiological properties and could monitor the endogenous expression variation of NEAT1. In addition, CERTIS displayed superior performance on both short- and long-term tracking of NEAT1 dynamics in live cells. We found that NEAT1 and paraspeckles were sensitive to topoisomerase I specific inhibitors. Moreover, RNA Immunoprecipitation (RIP) of the MS2-tagged NEAT1 lncRNA successfully revealed several new protein components of paraspeckle. Our results support CERTIS as a tool suitable to track both spatial and temporal lncRNA regulation in live cells as well as study the lncRNA-protein interactomes.

Objective To observe the clinical efficacy and safety of the lenalidomide-based therapy regimen in the treatment of high-intermediate-risk B-cell non-Hodgkin lymphoma (B-NHL). Methods A retrospective analysis of 23 high-intermediate-risk B-NHL patients who were admitted to Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from June 2015 to February 2018 was conducted, of which 7 relapsed or refractory (R/R) patients received lenalidomide combined with rituximab (R2) and plus different salvage chemotherapy regimens (DHAP, GDP, ICE) of each 28-day cycle; 5 elderly patients were initially treated with R2 of each 28-day cycle; 11 patients were administered by maintenance monotherapy of lenalidomide of each 28-day cycle, or R2 therapy of 3-month cycle. The primary endpoint was overall response, and the secondary endpoints were progression-free survival (PFS) and safety. Results The median follow-up time was 4.5 months (1-20 months) in the R/R and elderly initial-treated patients. The median time to response in the R/R group was 3 months (2-7 months), of which 3 patients were complete remission (CR), overall response was 3 patients, and the median PFS was 7 months. The median time to response in the elderly initial treatment group was 4 months (2-5 months), 1 of 4 eligible patients was CR and 2 were partial remission (PR), overall response was 3 patients, and the median PFS time had not reached. The median follow-up time in the maintenance treatment group was 15 months (2-32 months), the median PFS time had not reached, and the 1-year PFS rate was 64％ (95％ CI 36％-92％). The most common grade 3-4 adverse events were leukopenia and thrombocytopenia, each accounting for 35％, and most patients were tolerable. Conclusion Lenalidomide as an immunomodulator is effective and safety for elderly initial treatment, R/R and maintenance treatment patients with high-intermediate-risk B-NHL, and it can prolong their survival.