bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrative Taxonomy and Molecular Phylogeny of Three Poorly Known Tintinnine Ciliates, with the Establishment of a New Genus (Protozoa; Ciliophora; Oligotrichea)
Authors: Wang Rui , Bai Yang , Hu Tao , Xu Dapeng , Suzuki Toshikazu , Hu Xiaozhong
Published: December 2020

Background: The taxonomic classification of the suborder Tintinnina Kofoid & Campbell, 1929, a species-rich group of planktonic ciliated protozoans with characteristic lorica, is very ambiguous for a long time largely due to the lack of cytological and molecular data for most species. Among the group, Tintinnopsis is the largest, most widespread, and most taxonomically complex genus with about 170 species occurring in nearshore waters. The highly polyphyletic status of this speciose genus has also been revealed by previous researches.Results: We here first documented the live morphology, infraciliature, and molecular data, as well habitat characteristics of three poorly known tintinnine species, viz. Tintinnopsis karajacensis Brandt, 1896, Tintinnopsis gracilis Kofoid & Campbell, 1929, and Tintinnopsis tocantinensis Kofoid & Campbell, 1929, isolated from the coastal waters of China. Based on revelation of the unique cytological feature (the elongated ciliary tuft with densely arranged kinetids in it) in the former two species, which is apparently different from all other Tintinnopsis forms, Antetintinnopsis gen. nov. is thus erected with T. karajacensis designated as the type species. Moreover, these two species are placed in a highly supported clade, which branches away from other Tintinnopsis (including type species, T. beroidea) clades, in the phylogenetic analyses based on SSU rDNA and LSU rDNA sequences, which thus justifies the establishment of the new genus. Meanwhile, two other new combinations were made for Tintinnopsis hemispiralis and T. subacuta.Conclusions: The molecular data adopted here resulted in a well-resolved phylogenetic inference that provided strong evidence that the cytological characters are of valuable taxonomic delimitation for Tintinnina. This study also contributes to the broadening of our understanding of the tintinnine biodiversity and evolution.
Analysis of Growth and Physiological Variations Among Cyclocarya Species of Different Genotypes in a Clonal Seed Orchard
Authors: Feng Ying , Li Xiaofeng , Huang Junpo , Lin Guangxin , Yang Xinyu , Zheng Chenqi
Published: December 2020

Background: Cyclocarya paliurus (C. paliurus) is a woody species that has many medical benefits to human health. Geographical species has been formed among different natural forests of C. paliurus, but gradually decrease or extinct by human’s excessively exploitation in recent years. So, it is worthy to conserve this native and valuable species in China. Environmental factors affected plant growth, and seed is the only way for breeding offspring among Cyclocarya species, herein, we assess plant growth of six genotypes (FJ, JX, TG, WF, JH, AJ) from 2017 to 2019 year and physiological variations from April to October in 2018 during the construction of a clonal seed orchard.Results: The survival rate of plant reached 100% in a C. paliurus seed orchard. Plant height and basal diameter varied in different genotypes. Plant of six genotypes had different changes in water content and total soluble sugar content from April to October, Ca content reached maximum among the four detected mineral content, four kinds of antioxidant enzyme activity was in order of SOD＞PPO＞POD＞CAT, and the highest content of phytochemical was total flavonoid. Plant growth and physiological changes during growth period was significantly correlated with environment factors by correlation analysis. Conclusions: Plants of ex situ conservation adapted changeable environmental factors by physiological changes and showed the differentiation of plant growth in a clonal seed orchard. This would provide a foundation for ex situ conservation management in Cyclocarya species and selection of suitable cultivation provenance.
Bioinformatic Analysis Identifing FGF1 Gene as a New Prognostic Indicator in Clear Cell Renal Cell Carcinoma 
Authors: Zhang Xiaoqin , Wang Ziyue , Zeng Zixin , Shen Ningning , Wang Bin , Zhang Yaping , Shen Honghong , Lu Wei , Wei Rong , Ma Wenxia , Wang Chen
Published: December 2020

Background clear cell renal cell carcinoma (ccRCC) has been the commonest renal cell carcinoma (RCC). Although the disease classification, diagnosis and targeted therapy of RCC has been increasingly evolving attributing to the rapid development of current molecular pathology, the current situation is still challenge considering the comprehensive and progressively developing nature of malignant cancer. The study is to identify more potential responsible genes during the development of ccRCC using bioinformatic analysis, thus aiding more precise interpretation of the disease. Methods Firstly, different cDNA expression profiles from Gene Expression Omnibus (GEO) online database were used to screen the abnormal differently expressed genes (DEGs) between ccRCC and normal renal tissues. Then, based on the protein-protein interaction network (PPI) of all DEGs, the module analysis was performed to scale down the potential genes, and further survival analysis assisted our proceeding to the next step for selecting a credible key gene. Thirdly, immunohistochemistry (IHC) and quantitative real-time PCR (QPCR) were conducted to validate the expression change of the key gene in ccRCC comparing to normal tissues, meanwhile the prognostic value was verified using TCGA clinical data. Lastly, the potential biological function and signaling mechanism of gene regulation during ccRCC development was preliminary explored. Results Four cDNA expression profiles were picked from GEO database based on the number of containing sample cases, and a total of 192 DEGs, including 39 up-regulated and 153 down-regulated genes were shared in four profiles. Based on the DEGs PPI network, four function modules were identified highlighting a FGF1 gene involving PI3K-AKT signaling pathway which was shared in 3/4 modules. Further, both the IHC performed on 104 local ccRCC samples containing tissue microarray and QPCR conducted using 30 different samples confirmed that FGF1 was aberrant lost in ccRCC. And Kaplan-Meier overall survival analysis revealed that FGF1 gene loss was related to worse ccRCC patients survival. Lastly, the pathological clinical features of FGF1 gene and the probable biological functions and signaling pathways it involved were analyzed using TCGA clinical data. Conclusions Using bioinformatic analysis, we revealed that FGF1 expression was aberrant lost in ccRCC which correlated statistical significantly with patients survival, and the gene’s clinical features and potential biological functions were also explored. However, more detailed experiments and clinical trials are needed to support its potential drug-target role in clinical medical use.
Assessment of Corn Starch as Substitute for Agarose in DNA Gel Electrophoresis
Authors: Djankpa Francis Tanam , Wiafe Gideon Akuamoah , Boateng Bernard Ntim , Tsegah Korantema Mawuena , Essien-Baidoo Samuel , Ulanja Mark Bilinyi , Affram Kwame Ofori , Ussif Abdala Mumuni , Agyeman Desmond Owusu , Asante Gabriel
Published: December 2020

ObjectiveThe use of agarose in nucleic acid electrophoresis is the gold standard. However, agarose is very expensive and not readily available in resource limited developing countries like Ghana. Hence, finding a more affordable and readily available alternative to agarose will be a major boost to molecular research in developing countries. This study was aimed at investigating the use of corn starch as a potential substitute for agarose in DNA gel electrophoresis.ResultsGenomic DNA extracted from Plasmodium falciparum and primers were obtained from the West African Centre for Cell Biology of Infectious Pathogens and amplified using polymerase chain reaction. The amplicon was run on agarose gel to ascertain the molecular weight (as a positive control). When visualized under both blue light and ultraviolet light, the DNA and ladder showed clear and clean bands with the expected molecular weight. Corn starch was then modified with sodium borate buffer, casted into a gel and used to run the same DNA sample. Our findings indicated that similar to agarose, the DNA sample and ladder migrated successfully through the modified starch gel but no bands were visible when visualized under blue and ultra-violet light.
Availability of Standard Operating Guidelines for Primary Healthcare Facilities in Sub-saharan Africa: A Scoping Review Protocol
Authors: Sharpley Nelly , Kuupiel Desmond , Wyk Jacqueline Marina van
Published: December 2020

Background: Primary healthcare (PHC) clinics play an essential role in the delivery of community-based health services, particularly in resource-limited settings. However, there is little systematic documentation on the availability of standard operating guidelines governing their operation or evaluating the services provided by PHC facilities. This study, therefore, will aim to systematically map literature and describe the evidence on the availability of standard operating guidelines or procedures for PHC facilities in sub-Saharan Africa (SSA).Methods: This scoping review study will be conducted inline with the Arksey and O'Malley's framework. PubMed, EBSCOhost (Academic search complete, CINAHL with full text, and Health Sources), Scopus, and Google Scholar will be searched from 2010 to 2020 for relevant evidence sources using a search strategy comprising of keywords, Boolean terms, and medical subject headings. This study will include evidence sources/studies written/published in English that focused standard on standard operating guidelines for staffing and operational management, patient care and service provision, and quality monitoring procedures to assess the functioning of PHC facilities in SSA. The screening of the evidence sources/studies at all the stages and the data extraction will be conducted independently by two reviewers. Thematic analysis will be carried out to identify the themes and sub-themes and the findings relating to this study's research question summarised and reported for each theme narratively. Discussion: This scoping review anticipates to highlight standard operating guidelines available for staffing and operational management, patient care and service provision, and quality monitoring procedures to assess the functioning of PHC facilities to inform the development of relevant standard operating guidelines to improve healthcare services at the primary level. This study also anticipates revealing literature gaps for future research to ensure the attainment of universal health coverage by 2030.
Prokaryotic Argonaute From Archaeoglobus Fulgidus Interacts With DNA as a Homodimer
Authors: Golovinas Edvardas , Rutkauskas Danielis , Manakova Elena , Jankunec Marija , Silanskas Arunas , Sasnauskas Giedrius , Zaremba Mindaugas
Published: December 2020

Argonaute (Ago) proteins are found in all three domains of life. The best characterized group is eukaryotic Argonautes (eAgos), which are the core of RNA interference. The best understood prokaryotic Ago (pAgo) proteins are full-length pAgos. They are composed of four major structural/functional domains (N, PAZ, MID and PIWI) and thereby closely resemble eAgos. It was demonstrated that full-length pAgos function as prokaryotic antiviral systems, with the PIWI domain performing cleavage of invading nucleic acids. However, the majority of identified pAgos are shorter and catalytically inactive (encode just MID and inactive PIWI domains), thus their action mechanism and function remain unknown. In this work we focus on AfAgo, a short pAgo protein encoded by an archaeon Archaeoglobus fulgidus. We find that in all previously solved AfAgo structures, its two monomers form substantial dimerization interfaces involving the C-terminal β-sheets. Led by this finding, we have employed various biochemical and biophysical assays, including SEC-MALS, SAXS, single-molecule FRET and AFM, to show that AfAgo is indeed a homodimer in solution, which is capable of simultaneous interaction with two DNA molecules. This finding underscores the diversity of prokaryotic Agos and broadens the range of currently known Argonaute-nucleic acid interaction mechanisms.
Spontaneous Common Bile Duct Perforation in Full Term Pregnancy: A Rare Case Report and Review of Literature
Authors: Masroor Matiullah , Sarwari Mohammad Arif
Published: December 2020

Background: Spontaneous biliary system perforation is a rare presentation in clinical practice. It is even rare in adult population than infants. The condition is rarely suspected and diagnosed preoperatively because of small number of cases, vague sign and symptoms and ambiguous presentation.Case presentation: we are presenting an interesting case of spontaneous perforation of common bile duct in a 16 years old lady presented a week after her first delivery to the emergency department with complain of diffuse abdominal pain, abdominal distention, fever, vomiting and constipation. She was having generalize peritonitis but the cause of peritonitis was unknown despite of all available investigations performed. She underwent exploratory laparotomy and a perforation in the supra duodenal region of common bile duct was found intraoperatively. Common bile duct repair over T-tube and cholecystectomy performed and patient recovered.Conclusion: Spontaneous biliary perforation is a rare cause of acute abdomen in adults and extremely rare in pregnancy and its belated diagnoses and management is leading to high morbidity and mortality. All physicians especially surgeons should be aware of its possibility and consider it a cause of peritonitis on differential diagnosis especially when there is no apparent etiology available for the presentation.
Evaluation of Mandibular Arch Form in A Sudanese Adult Sample With Normal Occlusion 
Authors: Mustafa Raja , Abuaffan Amal
Published: December 2020

Background: In fixed orthodontic therapy, maintenance of the original mandibular arch form is considered an essential factor for stability, moreover with the popular use of elastic archwires, and because its shape cannot be easily altered, the pre-determination of mandibular arch form becomes very important for each patient. The purpose of this study is to analyze the mandibular dental arch forms of Sudanese adults with normal occlusion and provides an easy method for orthodontists to determine different types of arch form. Methods: This Descriptive analytical, cross-sectional study determined the mandibular arch in a sample of 104 Sudanese university students. Measurements were done in the mandibular dental cast. Three arch widths and three arch lengths measurements were established and five ratios were determined. Analysis of arch form was done according to Raberin’s polynomial method. Results: The mid arch form was the most prevalent (75%), followed by narrow arch form (11.54%), wide arch form (6.73%), and pointed arch form (6.73%). There were no cases in flat arch form. Conclusions: In Sudanese subjects, four types of arch form were recognized. Norms of transverse and sagittal dimensions of the mandibular arch to determine types of the mandibular arch form in Sudanese orthodontic patients become available.
Development of a Structure-based Computational Simulation to Optimize the Blocking Efficacy of Pro-antibodies
Authors: Huang Bo-Cheng , Lu Yun-Chi , Liao Jun-Min , Liu Hui-Ju , Hong Shih-Ting , Hsieh Yuan-Chin , Chuang Chih-Hung , Chen Huei-Jen , Liao Tzu-Yi , Ho Kai-Wen , Wang Yeng-Tseng , Cheng Tian-Lu
Published: December 2020

Background: The on-target toxicity of monoclonal antibodies (Abs) is mainly due to the fact that Abs cannot distinguish target antigens (Ags) expressed in disease regions from those in normal tissues during systemic administration. In order to overcome this issue, we “copied” an autologous Ab hinge as an “Ab lock” and “pasted” it on the binding site of the Ab by connecting a protease substrate and linker in between to generate a pro-Ab, which can be specifically activated in the disease region to enhance Ab selectivity and reduce side effects. Previously, we reported that 70% of pro-Abs can achieve more than 100-fold blocking ability compared to the parental Abs. However, 30% of pro-Abs do not have such efficient blocking ability. This is because the same Ab lock linker cannot be applied to every Ab due to the differences in the complementarity-determining region (CDR) loops. Here we designed a method which uses structure-based computational simulation (MSCS) to optimize the blocking ability of the Ab lock for all Ab drugs. MSCS can precisely adjust the amino acid composition of the linker between the Ab lock and Ab drug with the assistance of molecular simulation.Results: We selected αPD-1, αIL-1β, αCTLA-4 and αTNFα Ab as models and attached the Ab lock with various linkers (L1 to L7) to form pro-Abs by MSCS, respectively. The resulting cover rates of the Ab lock with various linkers compared to the Ab drug were in the range 28.33%-42.33%. The recombinant pro-Abs were generated by MSCS prediction in order to verify the application of molecular simulation for pro-Ab development. The binding kinetics effective concentration (EC-50) for αPD-1 (200-250-fold), αIL-1β (152-186-fold), αCTLA-4 (68-150-fold) and αTNFα Ab (20-123-fold) were presented as the blocking ability of pro-Ab compared to the Ab drug. Further, there was a positive correlation between cover rate and blocking ability of all pro-Ab candidates. Conclusions: The results suggested that MSCS was able to predict the Ab lock linker most suitable for application to αPD-1, αIL-1β, αCTLA-4 and αTNFα Ab to form pro-Abs efficiently. The success of MSCS in optimizing the pro-Ab can aid the development of next-generation pro-Ab drugs to significantly improve Ab-based therapies and thus patients’ quality of life.
Establishment of a Chronic Trypanosoma Equiperdum Infection Model in Mice
Authors: Tanaka Yusuke , Suganuma Keisuke , Watanabe Kenichi , Kobayashi Yoshiyasu
Published: December 2020

Dourine, caused by chronic infection with Trypanosoma equiperdum, is one of the African trypanosomiasis in equids. Since the pathogenesis of dourine has not yet been elucidated, experimental studies using mouse infection models are needed. However, mice cannot be infected with most T. equiperdum strains or rapidly develop parasitemia if infection is established and die within a few days. A sequential method of isolating parasites from dourine-affected horses and adapting them to in vitro cultures using soft agarose media was recently developed. Various T. equiperdum strains adapted to in vitro conditions have since been established using this technique. We used one of these strains, the T. equiperdum IVM-t2 strain. In the present study, we inoculated mice with the IVM-t2 strain and successfully produced a chronic infection model in mice. In the clinical examination, periodic parasitemia and skin plaques, which are characteristic clinical signs of dourine-affected horses, were observed. A histopathological examination revealed that some of the lesions observed in infected horses, such as vaginitis, trypanosomal sand, and peripheral neuritis, were reproduced in mice. This mouse model will be a valuable tool for pathological, immunological, and parasitological in vivo research, and will contribute to investigations on the mechanisms underlying the disease process and the host-protozoa relationship.
Conventional vs. High-definition tDCS: A Comparison of Neurophysiological and Behavioural Effects
Authors: Masina Fabio , Arcara Giorgio , Galletti Eleonora , Cinque Isabella , Gamberini Luciano , Mapelli Daniela
Published: December 2020

High-definition transcranial direct current stimulation (HD-tDCS) seems to overcome a drawback of Conventional tDCS: the wide-spread diffusion of the electric field. Nevertheless, most of the differences that characterise the two techniques are based on mathematical simulations and not on real, behavioural and neurophysiological, data. The study aims to compare Conventional and HD-tDCS, investigating differences both at a behavioural level, in terms of dexterity performance, and a neurophysiological level, as modifications of alpha and beta power as measured with EEG. Thirty participants took part in three sessions, one for each montage: Conventional tDCS, HD-tDCS, and sham. In all the conditions, the anode was placed over C4, while the cathode/s placed according to the montage. At baseline, during, and after each stimulation condition, dexterity was assessed with a Finger Tapping Task. In addition, resting-state EEG was recorded at baseline and after the stimulation. Power spectrum density was calculated, selecting two frequency bands: alpha (8–12 Hz) and beta (18–22 Hz). Linear mixed effect models (LMMs) were used to analyse the modulation induced by tDCS. To evaluate differences among the montages and consider state-dependency phenomenon, the post-stimulation measurements were covariate-adjusted for baseline levels. We observed that HD-tDCS induced an alpha power reduction in participants with lower alpha. Conversely, Conventional tDCS induced a beta power reduction in participants with higher beta at baseline. Furthermore, data suggested a positive behavioural effect of HD-tDCS on dexterity in participants with lower beta at baseline. Conventional and HD-tDCS distinctively modulated cortical activity. The study highlights the importance of considering state-dependency to determine the effects of tDCS on individuals.
Short-Term Outcomes in Infants With Mild Neonatal Encephalopathy: A Retrospective, Observational Study
Authors: Aoki Yoshinori , Kono Tatsuo , Enokizono Mikako , Okazaki Kaoru
Published: December 2020

Background: Neonatal encephalopathy due to acute perinatal asphyxia is a major cause of perinatal brain damage. Moderate to severe neonatal encephalopathy is associated with high mortality and morbidity rates. However, the neurodevelopmental outcomes in neonates with mild neonatal encephalopathy are unclear. The primary aim of this single-center observational study was to assess the short-term outcomes in term neonates with mild neonatal encephalopathy due to perinatal asphyxia. A secondary aim was to identify predictors of a poor prognosis by identifying the characteristics of these infants according to their short-term outcomes.Methods: We retrospectively investigated all infants with perinatal asphyxia at Tokyo Metropolitan Children’s Medical Center from January 2014 to December 2019. An abnormal short-term outcome was defined as any one of the following: seizures or abnormal electroencephalography, abnormal brain magnetic resonance imaging obtained within the first 4 weeks of life, abnormal neurological examination findings at discharge, and gastrostomy or tube feeding. Results: In total, 110 term infants with perinatal asphyxia during the study period were screened and 61 were diagnosed with mild neonatal encephalopathy. Eleven (18%) of these infants had an abnormal short-term outcome. The median Thompson score at admission was significantly higher in infants with abnormal short-term outcomes than in those with normal short-term outcomes (5 [interquartile range, 4-5.5] vs 2 [interquartile range, 1-3], p < 0.01). Receiver operating characteristic curve analysis showed that a cutoff value of 4 had high sensitivity and specificity (90.9% and 83.0%, respectively) for prediction of an abnormal short-term outcome.Conclusions: Eighteen percent of infants with mild encephalopathy had an abnormal short-term outcome, such as abnormal brain magnetic resonance imaging findings. The Thompson score at admission may be a useful predictor of an abnormal short-term outcome in infants with mild neonatal encephalopathy.
Acupoint Application Therapeutic Mechanism for Novel Coronavirus Pneumonia: A Network Pharmacology Analysis
Authors: Liu Shan , zhang chi , Zhang Zexin , Guo Wei , Xia Jiangnan , Li Jing , Wang Zhijie
Published: December 2020

Background and objective: Acupoint application (AA) therapy, a traditional Chinese medicine external treatment method, is recommended as a complementary Chinese medicine therapy for treating new coronavirus pneumonia (COVID-19), and can help improve curative effects, promote patient recovery, and improve immunity to prevent disease, but the mechanism is not clear. We sought to explore the key targets and mechanisms of Ephedra and Asarum, the main components used in AA, in the treatment of COVID-19 in this study. Methods: The active compounds and related targets of Ephedra and Asarum used in AA were screened by searching four databases. COVID-19-related target genes were identified from three disease databases, and the key targets of treating COVID-19 were obtained by Venn diagram using Cytoscape 3.2.1 software, gene ontology (GO) enrichment analysis, and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were used to explore possible mechanisms and pathways. The verification of the binding force between the compounds and target genes was completed by performing molecular docking with Autodock and pymol software.Results: Twenty-four active components of AA corresponded to 252 targets, with 713 target genes related to COVID-19, and 56 key genes were selected. GO analysis results showed that biological processes mainly included the inflammatory and immune responses, and cell components were mainly the plasma membrane and nucleus, with molecular functions including protein binding and identical protein binding. The top pathways included Immune System, Cytokine Signaling in Immune System, Adaptive Immune System, Signaling by Interleukins, Innate Immune System, and Signaling by GPCR.Conclusion: The results of this study preliminarily verified that Ephedra and Asarum used in AA therapy could treat COVID-19 via multiple compounds and multi-pathways, which provided a basis for clinical application and further research.
Resilience of The Hellenic Navy Seals Assessed by Heart Rate Variability During Cognitive Tasks
Authors: Mourtakos Stamatis , Vassiliou Georgia , Papageorgiou Christos , Philippou Anastasios , Bersimis Fragkiskos , Geladas Nikolaos , Koutsilieris Michael , Sidossis Labros , Papageorgiou Charalabos
Published: December 2020

Background

The interaction between high physical performance under extreme conditions and the simultaneous control of the cognitive executive functioning has been a subject of research in literature for the past few decades. Stroop test and Heart-rate variability (HRV), have been verified as a valuable clinical tool for the assessment of cerebral and autonomic/ cardiovascular stress responses respectively.
Objective

The investigation of HRV adaptive response to stress and cognitive stress resilience under strenuous conditions.
Methods

34 subjects were enrolled (n = 34). Of them, 18 were candidates under intense preparation for their enlistment in the Hellenic Navy SEALs (H.N.S.) and 16 were healthy controls, matched for sex and similar in age and demographics. All subjects underwent standard Color Word Stroop Testing, arithmetic stroop testing and emotional stroop testing, along with mental state and personality examination with the use of Symptom Checklist 90 Revised (SCL-90R) scl-90 and Eysenck Personality Questionnaire (EPQ), respectively. HRV variables in time and frequency domains recordings were acquired, during each aforementioned cognitive testing procedure.
Results

Our results showed that H.N.S.’s performance on both cognitive and emotion stroop tasks (p ≥ 0.054 for all cognitive and emotion stroop tasks’ features) was equivalent to controls even though they exhibited statistically significant lower levels of HRV in different time (ranged from p < 0.01 to p < 0.05) and frequency domain variables (ranged from p < 0.01 to p < 0.05). Finally, in a between group comparison of the psychometric tools, O.Y.K.s had significantly higher somatization, anxiety and neuroticism than controls.
Conclusion

In conclusion, these findings indicate flexible autonomic regulation (HRV) supports recovery following challenge during cognitive and emotional tasks (stroop tests), which in turn supports problem solving or adaptability skills. HRV measurement begins to be a sophisticated and relevant tool for both scientific and clinical insights, promising to be an index regarding the psychophysiological resilience especially in the neurovisceral integration (NVI) model. However further longitudinal research on the field is required.
Clinical features of COVID-19 patients with comorbid coronary heart disease
Authors: Yang Hang , GUO RUI , Yang Lincheng , Zhang Ruitao , Ling Yunpeng , Ge Qinggang
Published: December 2020

Background: In addition to the lungs, the coronavirus disease 2019 (COVID-19) also affects multiple organs throughout the body. The relationship between COVID-19 infection and cardiovascular disease, and the mechanisms by which this disease causes damage to the cardiovascular system are unclear. Coronary heart disease (CHD) is one of the common comorbidities of COVID-19, but there is insufficient evidence for its clinical features and impact on clinical outcomes. The aim of this study was to analyze the clinical characteristics of COVID-19 patients with comorbid CHD and the possible risk factors for the occurrence of critical illness. Methods: A single-center, retrospective study was conducted to analyze COVID-19 patients admitted to the Sino-French New City Campus of Tongji Hospital in Wuhan, Hubei Province and treated by the Peking University National Medical Assistance Team between January 29 and March 10, 2020. Patients testing positive for SARS-CoV-2 viral nucleic acid in nasopharyngeal swab specimens and who had comorbid CHD, were included in the study. Clinical data and laboratory test results of eligible patients were collected, and the factors associated with the occurrence of critical illness among these patients were evaluated. Results: A total of 205 patients were enrolled in this study, including 20 CHD patients and 185 non-CHD patients. The mean age was 66.7 years. Compared to non-CHD patients, more CHD patients had comorbid hypertension and diabetes (P < 0.05). In terms of laboratory tests, the CHD group did not differ significantly from the non-CHD group in blood routine, blood chemistry, and various inflammatory cytokines. More CHD patients experienced myocardial injury (25% vs 8.1% P < 0.031) and CHD patients were more likely to progress to critical illness (40% vs 16.8%P = 0.012). Univariate logistic regression analysis indicated that a history of CHD, occurrence of myocardial injury, high white blood cell (WBC) count, low lymphocyte count, and elevated levels of Cr, ferritin, IL-2R, IL-8 at admission were factors associated with the occurrence of critical illness. Multivariate regression analysis found that a history of CHD（OR=3.529, 95% CI =1.032-12.075, P =0.044），high WBC count（OR=1.289, 95% CI =1.136-1.463, P＜0.001） and low lymphocyte count（OR=0.215, 95% CI =0.075-0.616, P =0.004）were independent factors for the occurrence of critical illness among COVID-19 patients. Conclusion: COVID-19 patients with comorbid CHD commonly exhibited myocardial injury and were prone to developing critical illness. Among COVID-19 patients, a history of CHD，high WBC count and low lymphocyte count were independent risk factors for the occurrence of critical illness. Greater attention and vigilance are needed in this regard during clinical practice.
Comparison of Early Clinical Results of Femoral Neck System and Cannulated Screws in the Treatment of Unstable Femoral Neck Fractures
Authors: Zhou Xiaoqiang , Li Zhiqiang , Xu Renjie , She Yuanshi , Zhang Xiangxin , Chen Guangxiang , Yu Xiao
Published: December 2020

Objective: To compare the early clinical effects of femoral neck system and three cannulated screws in the treatment of patients with unstable femoral neck fractures.Methods: A retrospective analysis was conducted on 81 patients who received FNS or cannulated screws internal fixation for Pauwels Type-3 femoral neck fracture in our hospital from January 2019 to December 2019. A pair-matched clinical research was performed. People who received FNS were test group and people received cannulated screws were control group. Matching requirements were as follows： the same gender, the similar age and the similar BMI. A total of 30 pairs were successfully matched, with an average age of 53.84 years old. The operation time, intraoperative blood loss, hospital stay, hospitalization cost, postoperative VAS score, time walking without crutches, Harris score, femoral head necrosis rate and complication rate were compared between the two groups.Results: Postoperative re-examination of radiographs showed satisfactory reduction in all patients, and all the patients were followed up for 10-22 months. Patients in the FNS group had lower postoperative VAS scores, earlier time to walk without crutches, higher Harris scores at the last follow-up and lower complication rate (P<0.05). However, intraoperative blood loss and hospitalization costs in the FNS group were more（P<0.05）. There was no statistically significant difference in operation time, hospital stay and femoral head necrosis rate between two group (P>0.05).Conclusion: For patients who were unstable femoral neck fracture, FNS has better clinical efficacy than cannulated screws, though FNS is more expensive. The excellent biomechanical performance and clinical efficacy of FNS make it a new choice for the treatment of unstable femoral neck fracture.Fund program: Key medical research project of Jiangsu Health Committee（K2019010）
Association of Acute Inflammatory Cytokines, Fracture Malreduction, and Functional Outcome 12 Months After Intra-articular Ankle Fracture – A Prospective Cohort Study of 46 Patients with Ankle Fractures
Authors: Pham That Minh
Published: December 2020

Background Several malreduction criteria have been proposed for ankle surgery, but the criteria of most importance for functional outcome remain undetermined. Furthermore, the acute inflammatory response in the ankle joint after fracture is hypothesized to result in osteoarthritis development, but no study has investigated the correlation between the levels of these inflammatory cytokines and post-surgical functional outcomes. We aimed to identify malreduction criteria and inflammatory cytokines associated with functional outcome after ankle surgery.MethodsDuring surgery, synovial fluid from the fractured and healthy contralateral ankles of 46 patients was collected for chemiluminescence analysis of 22 inflammatory cytokines and metabolic proteins. The quality of fracture reduction was based on 9 criteria on plain X-rays and 5 criteria on weight-bearing computed tomography (WBCT) scans. After 3 and 12 months, we recorded scores on American Orthopedic Foot and Ankle Society (AOFAS) scale, the Danish version of Foot Function Index (FFI-DK), EQ-5D-5L index score, the Kellgren Lawrence score, and joint space narrowing. ResultsTibiofibular (TF) overlap (p=0.02) and dime sign (p=0.008) correlated with FFI-DK. Tibiotalar tilt correlated positively with joint space narrowing at 3 months (p=0.01) and 12 months (p=0.03). TF widening correlated with FFI-DK (p=0.04), AOFAS (p=0.02), and EQ-5D-5L (p=0.02). No consistent correlations between synovial cytokine levels and functional outcomes were found at 12 months.ConclusionsMalreduction of TF overlap, TF widening, and tibiotalar tilt were the most important criteria for functional outcome after ankle surgery. Increased inflammatory cytokine levels after fracture did not affect functional outcome at 12 months.Trial registration: This cohort study is registered the 10th of December 2018 at ClinicalTrials.gov (NCT03769909, https://clinicaltrials.gov/ct2/show/NCT03769909), was approved by the local committee on health ethics (The Regional Committees on Health Research Ethics for Southern Denmark: J.No. S-20170139), and was reported to the National Danish Data Protection Agency (17/28505).
Minimally Invasive Pedicle Subtraction Osteotomy via Tubular Retractor for Adult Rigid Spinal Kyphoscoliosis:A Case Report and Review of the Literature
Authors: Xing ZeJun , Ma Zhuo , Ma Xun
Published: December 2020

ObjcetiveTo describe a new technique, minimally invasive pedicle subtraction osteotomy (MIS PSO) via tubular retractor, for severe rigid adult spinal deformity.MethodsWe present a case with severe rigid thoracolumbar kyphoscoliosis and describe the surgical procedure , to which this patient responded favorably.ResultsNo surgical complications were seen and estimated blood loss was 600ml. The operation process time was about 5 hours. She received 2 unit of packed red blood cells intraoperatively. VAS was 8.5 points at pre-operation and 2 .0 points at 2 years follow-up. The ODI score improved from 33 to 9. Fusion was confirmed by wedging of L2 vertebral body on CT reconstructive films. Routine x-rays showed that spinal imbalance was corrected and maintained at the final follow up. Maximal ambulation distance increased to 5000 feet at 2 years follow-up.ConclusionA MIS PSO is a feasible option for the treatment of certain subtypes of adult spinal deformity. It is technically feasible that although limited by learning curve of minimally invasive tubular technique and open PSO technique. Both operation skill of the surgeons and proper patient selection is the key to successfully treating adult patients with deformity using MIS PSO.
A New Dressing System Which Is Waterproof, Breathable, Bacteriostatic, Low-Cost and Reduces the Number of Dressing Changes in the Primary Total Hip Arthroplasty: A Feasibility Study
Authors: Su Shilong , Zhong Da , Wang Chenggong , Gao Fawei , Lei Pengfei , Hu Yihe
Published: December 2020

Background Total hip arthroplasty is one of the most successful operations for the treatment of advanced hip osteoarthritis and osteonecrosis of the femoral head. Periprosthetic joint infection (PJI) is the most serious complication of joint replacement, and postoperative wound complication is the risk factor of PJI, so it is very important to manage the surgical wound. We innovatively invented a new dressing system to reduce the occurrence of postoperative wound complications and improve the quality of life and functional recovery of patients after operation. We designed this clinical study to confirm the clinical safety and feasibility of this new dressing system. Methods A total of 120 patients who underwent the primary unilateral total hip arthroplasty were enrolled in the study. The data collected included the number of dressing changes and postoperative hospital stay, The Visual Analogue Scale (VAS) score, The Harris Hip Score (HHS), The Hip disability and Osteoarthritis Outcome Score (HOOS) and The Short Form-36 (SF-36), ASEPSIS score, The Stony Brook Scar Evaluation Scale (SBSES), wound complications, and satisfaction. We made a statistical analysis of the data. Trial registration: Chinese Clinical Trial Registry, ChiCTR2000033822. Registered 13 June 2020 - Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=54735 Results The average number of dressing changes was 0.74 ±0.46, and the average postoperative hospital stay was 3.67 ±0.97 days. The new dressing system calculates that the cost of a change of dressing is 33 dollars. The results of VAS, HHS, HOOS, and SF-36 showed that with the implementation of joint replacement and the extension of recovery time, the pain, functional activity, and quality of life of patients were continuously improved. The results of the four indexes of the ASEPSIS score were all 0. The SBSES score was 3.55±0.61 at seven days after operation and 4.38±0.71 at one month after operation. No wound complications were recorded until one month after the operation. One month after the operation, the satisfaction rate was 92.53 ±3.62%. Conclusion We have invented such a new dressing system for surgical wounds after total hip arthroplasty and confirmed the clinical safety and feasibility of the new dressing system.
Integrated Analysis of a circRNA-miRNA-mRNA Axis in Intervertebral Disc Degeneration
Authors: Wei Laifu , Tu Bizhi , Gao Fei , Qian Jun
Published: December 2020

Background: Low back pain (LBP) is a common symptom in daily life and one of the primary causes is intervertebral disc degeneration (IDD). Growing studies have indicated that circular RNAs (circRNAs) are intimately associated with IDD; however, the underlying mechanism has not yet been elucidated. We aimed to explore how circRNAs regulate IDD in an effort to provide novel insight for clinical diagnosis and treatment. Methods: The sequencing data of circRNAs, microRNAs (miRNAs), and mRNA were acquired from Gene Expression Omnibus (GEO) datasets. By analyzing the dataset consisting of a control group and degenerated group, differentially expressed circRNAs, miRNAs, and mRNAs were collected, and then the intersection of circRNAs, miRNAs, and mRNAs was screened. According to these intersectional RNAs, we constructed an integrally circRNA-miRNA-mRNA network. Finally, using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses, we further clarified functions of the intersectional mRNA in IDD. Results: we obtained 620 differentially expressed circRNAs(DEcircRNAs), 13 miRNA (DEmiRNA), 273 mRNAs(DEmRNAs), 12 intersectional miRNAs, and 47 intersectional mRNAs. Finally, based on interactional 8 circRNA, 5 miRNAs and 15 mRNAs, an integrally circRNA-miRNA-mRNA network was constructed. Eight circRNAs, contained hsa_circ_0032254, hsa_circ_0003183, hsa_circ_0032253, hsa_circ_0001293, hsa_circ_0004565, hsa_circ_0091570, hsa_circ_0077526, and hsa_circ_0057552, may regulate IDD onset and progression by acting as competing endogenous RNAs. The results of GO and KEGG analyses implied that the targeted genes might significantly correlate to IDD.Conclusion: our findings improved a better understanding of the circRNA-related ceRNA regulatory mechanism in IDD and offered possible targets for IDD treatment.
The Clinical Outcomes of Ultrasound-Guided Hip Joint Injection in The Treatment of Persistent Pain After Hip Arthroscopy
Authors: Gao Guanying , Fu Qiang , Wu Ruiqi , Liu Rongge , Cui Ligang , Xu Yan
Published: December 2020

Background: To evaluate the short-term and long-term clinical outcomes of ultrasound-guided hip joint injection in the treatment of persistent pain after hip arthroscopy.Methods: Patients who had persistent pain after hip arthroscopy and underwent ultrasound-guided hip injection for treatment between January 2016 and February 2019 were involved. Pre-injection patient-reported outcomes (PROs) and post-injection PROs 1 month after injection and at final follow-up were obtained, including visual analog scale (VAS), modified Harris Hip Score (mHHS), Hip Outcome Score – Sport Specific Subscale (HOS - SSS) and Hip Outcome Score - Activity of Daily Living (HOS – ADL). VAS 10 minutes after injection was also recorded. Patient satisfaction with outcome of injection (graded as excellent, good, fair or poor) was documented at the end of follow-up. Results: A total of 33 patients were involved in this study. The mean follow-up time after injection was 24.1 months. The mean time between surgery and injection was 10.7 months. The VAS, mHHS, HOS-SSS and HOS-ADL improved from 5.6 ± 1.4, 56.4 ± 10.7, 59.1 ± 8.5 and 44.2 ± 17.1 to 3.3 ± 2.1, 67.3 ± 12.7, 69.1 ± 14.7 and 57.2 ± 23.0, respectively at 1 month after injection and improved to 2.4 ± 2.2, 76.4 ± 11.7, 80.3 ± 14.3 and 69.6 ± 23.0 at final follow-up. All results demonstrated statistically significant difference between different time point (P < 0.05). Three (9.1%) patients thought the outcome of ultrasound-guided hip injection was excellent, 8 (24.2%) thought the outcome was good, 9 (27.3%) thought the outcome was fair, and 13 (39.4%) thought the effect of injection was poor.Conclusion: Ultrasound-guided hip joint injection would be a feasible treatment method of persistent pain after hip arthroscopy, especially in older patients, patients with higher BMI and patents who are sensitive to intra-articular injection.Level of Evidence IV.
Comparison of Clinical Outcomes Between Stand-Alone Oblique Lumber Interbody Fusion and Posterior Lumbar Interbody Fusion for Treatment of Degenerative Lumbar Diseases
Authors: Guo Run Peng , Gao Xian Da , Du Pei Yu , Ding Wen Yuan , Ma Lei
Published: December 2020

Background: This study evaluated the clinical and imaging results of oblique lumber interbody fusion (OLIF) and posterior lumbar interbody fusion (PLIF) in the treatment of degenerative lumbar diseases.Methods: The clinical data of 99 patients with degenerative lumbar diseases in the Third Hospital of Hebei Medical University from January 2016 to January 2018 were analyzed retrospectively. 49 cases were dealt with by OLIF (stand-alone) (OLIF group) and 50 cases with PLIF (PLIF group). Clinical and imaging data were collected before surgery and at each follow-up visit. Clinical data included operation time, blood loss, incision length, length of hospital stay, visual analogue score (VAS), Oswestry dysfunction index (ODI), Japanese orthopaedic association (JOA) scores and complications. imaging measurment included the height of segmental intervertebral space, lumbar lordotic angle, operative segmental lordotic angle and fusion rate. The relationship between clinical results and radiology was assessed by comparing the radiological results before and after operation.Results: 99 cases of interbody fusion were performed successfully, and all patients had clinical improvement. The follow-up time was 24-38 months. The operation time, intraoperative blood loss, incision length and hospital stay in OLIF group were significantly less than those in the PLIF group (p<0.05). The intervertebral disc height, lumbar lordotic angle and operative segmental lordotic angle in the two groups were significantly enhanced compared with those before operation, and the difference was statistically significant (p<0.05). All of them achieved satisfactory fusion effect. Complications were found in 5 cases in OLIF group and 13 cases in PLIF group.Conclusion: Both OLIF and PLIF are effective in the treatment of degenerative lumbar diseases. Compared with PLIF, OLIF has a lot advantages in early stage after operation, However, similar clinical outcomes were achieved in the two approaches at mid-term follow-up visit.