Publications by authors named "Xiaoran Zhang"

100 Publications

mRNA-engineered mesenchymal stromal cells expressing CXCR2 enhances cell migration and improves recovery in IBD.

Mol Ther Nucleic Acids 2021 Dec 21;26:222-236. Epub 2021 Jul 21.

Department of Medical Ultrasonic, The Third Affiliated Hospital, Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou 510630, China.

Mesenchymal stromal cells (MSCs) have shown significant heterogeneity in terms of therapeutic efficacy for inflammatory bowel disease (IBD) treatment, which may be due to an insufficient number of MSCs homing to the damaged tissue of the colon. Engineering MSCs with specific chemokine receptors can enhance the homing ability by lentiviral transduction. However, the unclear specific chemokine profile related to IBD and the safety concerns of viral-based gene delivery limit its application. Thus, a new strategy to modify MSCs to express specific chemokine receptors using mRNA engineering is developed to evaluate the homing ability of MSCs and its therapeutic effects for IBD. We found that CXCL2 and CXCL5 were highly expressed in the inflammatory colon, while MSCs minimally expressed the corresponding receptor CXCR2. Transient expression of CXCR2 in MSC was constructed and exhibited significantly enhanced migration to the inflamed colons, leading to a robust anti-inflammatory effect and high efficacy. Furthermore, the high expression of semaphorins7A on MSCs were found to induce the macrophages to produce IL-10, which may play a critical therapeutic role. This study demonstrated that the specific chemokine receptor mRNA-engineered MSCs not only improves the therapeutic efficacy of IBD but also provides an efficient and safe MSC modification strategy.
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http://dx.doi.org/10.1016/j.omtn.2021.07.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413681PMC
December 2021

N-carbamoylglutamate improves lipid metabolism, inflammation, and apoptosis responses in visceral adipocytes of Japanese seabass (), in vivo and in vitro.

Anim Nutr 2021 Sep 10;7(3):707-715. Epub 2021 Jul 10.

National Aquafeed Safety Assessment Center, Feed Research Institute, Chinese Academy of Agricultural Sciences, Beijing, 100081, China.

This study applied in vivo and in vitro methods to investigate the effect of dietary N-carbamoylglutamate (NCG) on lipid metabolism, inflammation and apoptosis related-gene expression in visceral adipose tissue and isolated adipocytes of Japanese seabass (). A basal diet and a test diet supplemented with 720 mg/kg NCG were fed to the fish for 10 weeks. During the growth trial, no mortality and no significant differences in growth performance were observed in fish between the 2 groups ( > 0.05). Plasma Arg content and mRNA level of argininosuccinate synthetase () in adipose tissue were significantly increased, which indicated that NCG inclusion promoted endogenous Arg synthesis. Thereafter, the potential effects of NCG treatment on lipid metabolism-related genes expression were studied through in vivo and in vitro methods. In the present study, we successfully established a primary adipocytes culture system and isolated pre-adipocytes in vitro of Japanese seabass for the first time. Both the results in vivo and in vitro showed that NCG treatment decreased the mRNA levels of genes related to adipogenesis (fatty acid synthase, ), cholesterol synthesis (3-hydroxy-3-methylglutaryl-CoA reductase, ) and fat deposition (lipoprotein lipase [] and leptin), which revealed the underlying mechanism of NCG on reducing fat deposition. The results of this study demonstrated that NCG inclusion reduced the expression of inflammatory and apoptosis cytokines markedly in vivo and in vitro. In conclusion, NCG did exert beneficial effects on ameliorating adipogenesis, inflammation and apoptosis via promoting Arg endogenous synthesis in Japanese seabass.
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http://dx.doi.org/10.1016/j.aninu.2021.02.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8379344PMC
September 2021

Spontaneous epidural pneumorrhachis in 14 years old.

Surg Neurol Int 2021 6;12:329. Epub 2021 Jul 6.

Department of Neurosurgery, UPMC, Pittsburgh, Pennsylvania, United States.

Background: Pneumorrhachis is an exceedingly rare complication of pneumomediastinum as air tracks through tissue planes into the epidural (or subdural space). The majority of these patients present with a clear history of trauma, iatrogenic injury, pneumothorax, vomiting, or retching.

Case Description: A 14-year-old male presented with the asymptomatic spontaneous onset of pneumorrhachis associated with significant pneumomediastinum of unclear etiology.

Conclusion: Most patients with pneumorrhachis present with nonfocal neurological examinations. For these patients, it is critical to rule out infection as the cause of epidural gas. If other systemic signs are present, then urgent contrast-enhanced magnetic resonance imaging should be obtained. The majority of patients will demonstrate spontaneous radiographic resolution of pneumorrhachis within several days.
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http://dx.doi.org/10.25259/SNI_414_2021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8326144PMC
July 2021

Chronic encapsulated expanding hematomas after stereotactic radiosurgery for intracranial arteriovenous malformations.

J Neurosurg 2021 Jul 30:1-11. Epub 2021 Jul 30.

Departments of1Neurological Surgery and.

Objective: Cerebral arteriovenous malformations (AVMs) are rare cerebral vascular lesions that are associated with high morbidity and mortality from hemorrhage; however, stereotactic radiosurgery (SRS) is a well-validated treatment modality. Few reports have delineated a subgroup of patients who develop delayed chronic encapsulated expanding hematomas (CEEHs) despite angiographic evidence of AVM obliteration following radiosurgery. In this report, the authors performed a retrospective review of more than 1000 radiosurgically treated intracranial AVM cases to delineate the incidence and management of this rare entity.

Methods: Between 1988 and 2019, 1010 patients with intracranial AVM underwent Gamma Knife SRS at the University of Pittsburgh Medical Center. In addition to a review of a prospective institutional database, the authors performed a retrospective chart review of the departmental AVM database to specifically identify patients with CEEH. Pertinent clinical and radiological characteristics as well as patient outcomes were recorded and analyzed.

Results: Nine hundred fifty patients with intracranial AVM (94%) had sufficient clinical follow-up for analysis. Of these, 6 patients with CEEH underwent delayed resection (incidence rate of 0.0045 event per person-year). These patients included 4 males and 2 females with a mean age of 45.3 ± 13.8 years at the time of initial SRS. Four patients had smaller AVM volumes (4.9-10 cm3), and 3 of them were treated with a single SRS procedure. Two patients had larger-volume AVMs (55 and 56 cm3), and both underwent multimodal management that included staged SRS and embolization. Time to initial recognition of the CEEH after initial SRS ranged between 66 and 243 months. The time between CEEH recognition and resection ranged from 2 to 9 months. Resection was required because of progressive neurological symptoms that correlated with imaging evidence of gradual hematoma expansion. All 6 patients had angiographically confirmed obliteration of their AVM. Pathology revealed a mixed chronicity hematoma with areas of fibrosed blood vessels and rare areas of neovascularization with immature blood vessels but no evidence of a persistent AVM. All 6 patients reported persistent clinical improvement after hematoma resection.

Conclusions: CEEH after SRS for AVM is a rare complication with an incidence rate of 0.0045 event per person-year over the authors' 30-year experience. When clinical symptoms progress and imaging reveals progressive enlargement over time, complete resection of a CEEH results in significant clinical recovery. Knowledge of this rare entity facilitates timely detection and eventual surgical intervention to achieve optimal outcomes.
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http://dx.doi.org/10.3171/2021.1.JNS203476DOI Listing
July 2021

Characterization of systemic immunosuppression by IDH mutant glioma small extracellular vesicles.

Neuro Oncol 2021 Jul 13. Epub 2021 Jul 13.

UPMC Hillman Cancer Center, Pittsburgh, PA, USA.

Background: Gliomas are the most common primary brain tumors and are universally fatal. Mutations in the isocitrate dehydrogenase genes (IDH1 and IDH2) define a distinct glioma subtype associated with an immunosuppressive tumor microenvironment. Mechanisms underlying systemic immunosuppression in IDH mutant (mutIDH) gliomas are largely unknown. Here, we define genotype-specific local and systemic tumor immunomodulatory functions of tumor-derived glioma exosomes (TEX).

Methods: TEX produced by human and murine wildtype and mutant IDH glioma cells (wtIDH and mutIDH, respectively) were isolated by size exclusion chromatography (SEC). TEX morphology, size, quantity, molecular profiles and biodistribution were characterized. TEX were injected into naive and tumor-bearing mice, and the local and systemic immune microenvironment composition was characterized.

Results: Using in vitro and in vivo glioma models, we show that mutIDH TEX are more numerous, possess distinct morphological features and are more immunosuppressive than wtIDH TEX. mutIDH TEX cargo mimics their parental cells, and induces systemic immune suppression in naive and tumor-bearing mice. TEX derived from mutIDH gliomas and injected into wtIDH tumor-bearing mice reduce tumor-infiltrating effector lymphocytes, dendritic cells and macrophages, and increase circulating monocytes. Astonishingly, mutIDH TEX injected into brain tumor-bearing syngeneic mice accelerate tumor growth and increase mortality compared with wtIDH TEX.

Conclusions: Targeting of mutIDH TEX represents a novel therapeutic approach in gliomas.
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http://dx.doi.org/10.1093/neuonc/noab153DOI Listing
July 2021

Efficacy and Safety of Bone Marrow-Derived Mesenchymal Stem Cells for Chronic Antibody-Mediated Rejection After Kidney Transplantation- A Single-Arm, Two-Dosing-Regimen, Phase I/II Study.

Front Immunol 2021 25;12:662441. Epub 2021 Jun 25.

Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Objective: To investigate the efficacy and safety of bone marrow-derived mesenchymal stem cells (BM-MSCs) on chronic active antibody-mediated rejection (cABMR) in the kidney allograft.

Methods: Kidney recipients with biopsy-proven cABMR were treated with allogeneic third-party BM-MSCs in this open-label, single-arm, single-center, two-dosing-regimen phase I/II clinical trial. In Regimen 1 (n=8), BM-MSCs were administered intravenously at a dose of 1.0×10 cells/kg monthly for four consecutive months, while in Regimen 2 (n=15), the BM-MSCs dose was 1.0×10 cells/kg weekly during four consecutive weeks. The primary endpoints were the absolute change of estimated glomerular filtration rate (eGFR) from baseline (delta eGFR) and the incidence of adverse events associated with BM-MSCs administration 24 months after the treatment. Contemporaneous cABMR patients who did not receive BM-MSCs were retrospectively analyzed as the control group (n =30).

Results: Twenty-three recipients with cABMR received BM-MSCs. The median delta eGFR of the total BM-MSCs treated patients was -4.3 ml/min per 1.73m (interquartile range, IQR -11.2 to 1.2) 2 years after BM-MSCs treatment (P=0.0233). The median delta maximum donor-specific antibody (maxDSA) was -4310 (IQR -9187 to 1129) at 2 years (P=0.0040). The median delta eGFR of the control group was -12.7 ml/min per 1.73 m (IQR -22.2 to -3.5) 2 years after the diagnosis, which was greater than that of the BM-MSCs treated group (P=0.0342). The incidence of hepatic enzyme elevation, BK polyomaviruses (BKV) infection, cytomegalovirus (CMV) infection was 17.4%, 17.4%, 8.7%, respectively. There was no fever, anaphylaxis, phlebitis or venous thrombosis, cardiovascular complications, or malignancy after BM-MSCs administration. Flow cytometry analysis showed a significant decreasing trend of CD27IgD double negative B cells subsets and trend towards the increase of CD3CD4PD-1/lymphocyte population after MSCs therapy. Multiplex analysis found TNF-α, CXCL10, CCL4, CCL11 and RANTES decreased after MSCs treatment.

Conclusion: Kidney allograft recipients with cABMR are tolerable to BM-MSCs. Immunosuppressive drugs combined with intravenous BM-MSCs can delay the deterioration of allograft function, probably by decreasing DSA level and reducing DSA-induced injury. The underlying mechanism may involve immunomodulatory effect of MSCs on peripheral B and T cells subsets.
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http://dx.doi.org/10.3389/fimmu.2021.662441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8267917PMC
June 2021

Effect of Electroacupuncture on Bladder Dysfunction via Regulation of MLC and MLCK Phosphorylation in a Rat Model of Type 2 Diabetes Mellitus.

Evid Based Complement Alternat Med 2021 10;2021:5558890. Epub 2021 Jun 10.

Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, China.

Previous studies observed have reported that electroacupuncture (EA) is effective in relieving diabetic bladder dysfunction (DBD); however, little is known about the mechanism. Therefore, we explored the effects and mechanisms of EA on DBD in streptozotocin-high-fat diet- (STZ-HFD-) induced diabetic rats. The Sprague-Dawley male rats were divided randomly into four groups: normal group, diabetes mellitus group (DM group), DM with EA treatment group (EA group), and DM with sham EA treatment group (sham EA group). After 8 weeks of EA treatment, the body weight, serum glucose, bladder weight, and cystometrogram were evaluated. The bladder wall thickness was examined by abdominal ultrasound imaging. After the transabdominal ultrasound measurements, hematoxylin-eosin (HE) staining was used to observe the bladder mucosa layer. The bladder detrusor smooth muscle cells (SMCs) and fibroblasts were observed under transmission electron microscopy (TEM). The phospho-myosin light chain (p-MLC), phospho-myosin light chain kinase (p-MLCK), and phospho-myosin phosphatase target subunit 1 (p-MYPT1) levels in the bladder were examined using Western blot. The bladder weight, serum glucose, bladder wall thickness, volume threshold for micturition, and postvoid residual (PVR) volume in the diabetic rats were significantly higher than those in the control animals. EA treatment significantly reduced the bladder weight, bladder wall thickness, volume threshold for micturition, and PVR volume in diabetic rats. EA caused a significant increase in the MLC dephosphorylation and MLCK phosphorylation levels in the group compared to the sham EA and model groups. EA reduced the infiltration of inflammatory cells in the bladder mucosa layer of diabetic rats. In addition, EA repaired the damaged bladder detrusor muscle of diabetic rats by reducing mitochondrial damage of the SMCs and fibroblasts. Therefore, EA could reduce the bladder hypertrophy to ameliorate DBD by reversing the impairment in the mucosa layer and detrusor SMCs, which might be mainly mediated by the regulation of p-MLC and p-MLCK levels.
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http://dx.doi.org/10.1155/2021/5558890DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8213478PMC
June 2021

GLIS1, a potential candidate gene affect fat deposition in sheep tail.

Mol Biol Rep 2021 May 16;48(5):4925-4931. Epub 2021 Jun 16.

State Key Laboratory of Reproductive Regulation & Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot, 010070, China.

Fat deposition in sheep tails is as a result of a complicated mechanism. Mongolian sheep (MG) and Small Tail Han sheep (STH) are two fat-tailed Chinese indigenous sheep breeds while DairyMeade and East Friesian (DS) are two thin-tailed dairy sheep breeds recently introduced to China. In this study, population genomics analysis was applied to identify candidate genes associated with sheep tails based on an in-depth whole-genome sequencing of MG, STH and DS. The selective signature analysis demonstrated that GLIS1, LOC101117953, PDGFD and T were in the significant divergent regions between DS and STH-MG. A nonsynonymous point mutation (g.27807636G>T) was found within GLIS1 in STH-MG and resulted in a Pro to Thr substitution. As a pro-adipogenic factor, GLIS1 may play critical roles in the mesodermal cell differentiation during fetal development affecting fat deposition in sheep tails. This study gives a new insight into the genetic basis of species-specific traits of sheep tails.
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http://dx.doi.org/10.1007/s11033-021-06468-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8260413PMC
May 2021

A small-cohort study on tumor recurrence and surgery-related complications associated with proximal fibular tumors and the potential utility of biopsy.

J Clin Transl Res 2021 Feb 25;7(1):108-115. Epub 2021 Feb 25.

Department of Radiology, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province 050051, PR China.

Aim: The aim of the study was to assess the incidence of tumor recurrence, iatrogenic peroneal nerve injury, and wound healing problems in a small cohort of patients with proximal fibular tumors who had undergone surgery, and to determine the relative risk of pre-operative biopsies on these outcome variables.

Methods: The study entailed a retrospective single-center analysis of patients with a histologically confirmed tumor in the proximal fibula who had undergone surgery at our institute between 2004 and 2019 ( = 66). The accuracy of diagnosis based on pre-operative biopsy ( = 10) was compared to the histological diagnosis based on resection specimens. The association between pre-operative biopsy and patient demographics and medical history as well as tumor recurrence, iatrogenic peroneal nerve injury, and impaired wound healing was analyzed statistically. The data were presented against a backdrop of bone cancer incidence and 5-year survival rates in China.

Results: Recurrence, iatrogenic peroneal nerve, and wound healing issues were identified in 5 (7.6%), 8 (12.1%), and 6 patients (11.0%), respectively. A biopsy was acquired from ten of 66 patients. The pre-operative biopsy diagnostic accuracy rate was 100%. Males had an 11.2-fold higher risk of undergoing pre-operative biopsy than females (95% CI, 1.3-94.1; = 0.013). Pre-operative biopsies were 11.2 times more likely to be obtained from patients with malignant and benign aggressive tumors in the proximal fibula compared to benign tumors (95% CI, 1.1-63.1; = 0.013). Patients who had undergone biopsy were 12.4 times more likely to receive Type I or Type II resection (95% CI, 1.5-104.3; = 0.006) and had a 7.6-fold greater chance to have impaired wound healing (95% CI, 1.3-45.1; = 0.040), which was observed mainly in osteosarcoma patients. There were no significant associations of biopsy with tumor recurrence ( = 0.162) and iatrogenic peroneal nerve injury ( = 0.095).

Conclusions: Biopsy of proximal fibular lesions does not increase the risk for tumor recurrence and iatrogenic peroneal nerve injury but may be associated with post-surgical wound healing problems. This is particularly relevant for male patients and malignant and aggressive benign lesions, where biopsies are considerably more likely to be acquired to guide diagnosis and clinical management. Due to the relatively low incidence of this cancer type and the scarcity of pre-operative biopsies, larger cohort studies are warranted to validate the results.

Relevance For Patients: Patients who present with proximal fibular tumors are often young. Depending on the diagnosis of the bone cancer subtype, the surgical intervention may entail highly invasive and risky procedures. Taken together, it is imperative to ensure accurate diagnosis of the bone cancer subtype to prevent unnecessary procedures. Diagnostic accuracy can be increased by acquiring a histological specimen of the malignant bone tissue. However, it is currently not completely established whether bone biopsies in the proximal fibula can be safely performed and whether such biopsies lead to seeding metastases. Because of the rarity of these tumors and procedures, studies are needed even when these entail a small sample size.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8177019PMC
February 2021

Hyperbranched concave octahedron of PtIrCu nanocrystals with high-index facets for efficiently electrochemical ammonia oxidation reaction.

J Colloid Interface Sci 2021 Nov 17;601:1-11. Epub 2021 Apr 17.

Collaborative Innovation Center of Sustainable Energy Materials, School of Physical Science and Technology; Guangxi Key Laboratory of Electrochemical Energy Materials; Key Laboratory of New Processing Technology for Non-ferrous Metal and Materials, Ministry of Education, Guangxi University, Nanning, 530004, China.

Ammonia oxidation reaction (AOR) via electrocatalysis is one of the most efficient ways of utilizing ammonia (a zero-carbon fuel with high hydrogen content) for renewable energy systems. However, AOR seriously suffers from the slow kinetics, and low durability due to its multi-electron transfer process and the poison of the reaction intermediates (N and NO) to precious metal catalysts. Herein, hyperbranched concave octahedral nanodendrites of PtIrCu (HCOND) with high-index facets of {553}, {331} and {221} were developed for the first time using a solvothermal method. The HCOND possesses PtIr-rich edges and exhibit highly efficient AOR activity and stability in alkaline media, wherein their onset potential is 0.35 V vs.RHE, which is 60 mV and 160 mV lower than that of the PtIrCu nanoparticles (NPs) (0.41 V) and commercial Pt/C (0.51 V), respectively, and its high mass activity of 40.6 A g at the 0.5 V vs.RHE is 10.3 times, 2.34 times higher than that of commercial Pt/C (3.9 A g) and PtIrCu NPs (17.3 A g), respectively. In addition, its peak current density (122.9 A g) is only reduced by 17.7% after 2000-cycles accelerated durability test. Meanwhile, the performance of PtIrCu HCOND is also better than that of other previously reported morphologies of Pt based catalysts (eg. nanoparticles, nanocubes, nanofilm, nanoflowers). The improvement is critically ascribed to unique advantages of the specific HCOND structure including PtIr rich surface, high-index faceted nanodendrites, strong lattice strain and electronic effects. These characteristics endow the HCOND with great promise to reduce Pt and Ir loading dramatically in the practical application of direct ammonia fuel cells.
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http://dx.doi.org/10.1016/j.jcis.2021.04.068DOI Listing
November 2021

Proteomic profiling of ovine milk after grading up.

J Dairy Res 2021 May 14;88(2):201-204. Epub 2021 May 14.

The State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, Inner Mongolia University, Hohhot, Inner Mongolia Autonomous Region, 010018, PR China.

We have previously bred Chinese local dairy sheep through grading up with local Small-Tailed Han (STH) sheep as female parent and DairyMeade (DM) sheep as male parent. In this research communication we characterize the whey protein profile of STH sheep and their offspring (F1, F2) to reveal physiological differences and variation in milk traits. A total of 1032 whey proteins were identified through tandem mass tag labeling (TMT) proteome profiling. Three proteins were significantly differentially abundant between F1 and STH milk, six between F2 and STH milk and five between F1 and F2 milk. In terms of differential changes between generations, WASHC4 and CUTA of F1 and Ig-like domain-containing protein of F2 milk were dominant whey proteins. Overall, the results showed that the whey protein profiles of different generations varied little. The crossbreeds of STH and DM sheep would be suitable for the development of the Chinese local sheep milk industry, and the F2 may be a better population for sheep milk production.
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http://dx.doi.org/10.1017/S0022029921000455DOI Listing
May 2021

Automatic spinal cord segmentation from axial-view MRI slices using CNN with grayscale regularized active contour propagation.

Comput Biol Med 2021 05 18;132:104345. Epub 2021 Mar 18.

School of Automation, Beijing Institute of Technology, Beijing, 100081, China. Electronic address:

Accurate positioning of the responsible segment for patients with cervical spondylotic myelopathy (CSM) is clinically important not only to the surgery but also to reduce the incidence of surgical trauma and complications. Spinal cord segmentation is a crucial step in the positioning procedure. This study proposed a fully automated approach for spinal cord segmentation from 2D axial-view MRI slices of patients with CSM. The proposed method was trained and tested using clinical data from 20 CSM patients (359 images) acquired by the Peking University Third Hospital, with ground truth labeled by professional radiologists. The accuracy of the proposed method was evaluated using quantitative measures, the reliability metric as well as visual assessment. The proposed method yielded a Dice coefficient of 87.0%, Hausdorff distance of 9.7 mm, root-mean-square error of 5.9 mm. Higher conformance with ground truth was observed for the proposed method in comparison to the state-of-the-art algorithms. The results are also statistically significant with p-values calculated between state-of-the-art methods and the proposed methods.
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http://dx.doi.org/10.1016/j.compbiomed.2021.104345DOI Listing
May 2021

Amyloid-β (25-35) regulates neuronal damage and memory loss via SIRT1/Nrf2 in the cortex of mice.

J Chem Neuroanat 2021 Jul 11;114:101945. Epub 2021 Mar 11.

Department of Biochemistry and Molecular Biology, Shenyang Medical College, 146 Huanghe North Street, Yuhong District, Shenyang, Liaoning, 110034, People's Republic of China; Center for Precision Medicine, Shenyang Medical Colleges, 146 Huanghe North Street, Yuhong District, Shenyang, Liaoning, 110034, People's Republic of China; Key Laboratory of Environment Pollution and Microecology, Shenyang Medical Colleges, 146 Huanghe North Street, Yuhong District, Shenyang, Liaoning, 110034, People's Republic of China. Electronic address:

Alzheimer's disease (AD) is the most common type of dementia. AD is pathologically characterized by synaptic dysfunction and cognitive decline due to the aggregation of a large amount of amyloid-β (Aβ) protein in the brain. However, recent studies have discovered that the Aβ is produced as an antimicrobial peptide that acts against bacteria and viruses. This has renewed interest in the effect of Aβ on AD. Thus, in this study, we investigated the different concentrations of Aβ on neuroprotection and further explore the related mechanisms. Firstly, we detected the cognitive function using the Y-maze test, novel object recognition memory task and Morris water maze test. Then, we analyzed the ultrastructure of synapses and mitochondria, in addition to evaluating SOD levels. We also examined the effect of Aβ on the viability and structure of the primary neurons. The western blot analysis was used to measure the protein levels. The results showed that mice treated with high concentration of Aβ impaired the learning-memory ability and disordered the structure of neurons and mitochondria. Meanwhile, high concentration of Aβ decreased the SIRT1/Nrf2 related antioxidant capacity and induced apoptosis. In contrast, mice treated with low concentration of Aβ increased SOD levels and SIRT1/Nrf2 expressions, and induced autophagy. Our data suggest that low concentration of Aβ may increase SOD levels through SIRT1/Nrf2 and induce autophagy.
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http://dx.doi.org/10.1016/j.jchemneu.2021.101945DOI Listing
July 2021

Mesenchymal Stromal Cells Rapidly Suppress TCR Signaling-Mediated Cytokine Transcription in Activated T Cells Through the ICAM-1/CD43 Interaction.

Front Immunol 2021 22;12:609544. Epub 2021 Feb 22.

Key Laboratory for Stem Cells and Tissue Engineering, Ministry of Education, Center for Stem Cell Biology and Tissue Engineering, Sun Yat-sen University, Guangzhou, China.

Cell-cell contact participates in the process of mesenchymal stromal cell (MSC)-mediated T cell modulation and thus contributes to MSC-based therapies for various inflammatory diseases, especially T cell-mediated diseases. However, the mechanisms underlying the adhesion interactions between MSCs and T cells are still poorly understood. In this study, we explored the interaction between MSCs and T cells and found that activated T cells could rapidly adhere to MSCs, leading to significant reduction of TNF-α and IFN-γ mRNA expression. Furthermore, TCR-proximal signaling in activated T cells was also dramatically suppressed in the MSC co-culture, resulting in weakened Ca signaling. MSCs rapidly suppressed TCR signaling and its downstream signaling in a cell-cell contact-dependent manner, partially through the ICAM-1/CD43 adhesion interaction. Blockade of either ICAM-1 on MSCs or CD43 on T cells significantly reversed this rapid suppression of proinflammatory cytokine expression in T cells. Mechanistically, MSC-derived ICAM-1 likely disrupts CD43-mediated TCR microcluster formation to limit T cell activation. Taken together, our results reveal a fast mechanism of activated T cell inhibition by MSCs, which provides new clues to unravel the MSC-mediated immunoregulatory mechanism for aGVHD and other severe acute T cell-related diseases.
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http://dx.doi.org/10.3389/fimmu.2021.609544DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937648PMC
July 2021

The Initial Impact of COVID-19 on Total Hip and Knee Arthroplasty.

J Arthroplasty 2021 07 13;36(7S):S56-S61. Epub 2021 Jan 13.

Avant-garde Health, Boston, MA.

Background: The SARS-CoV-2 (COVID-19) pandemic caused a massive disruption in elective arthroplasty practice in the United States that to date has not been quantified. We sought to determine the impact of COVID-19 on arthroplasty volumes in the United States, how this varied across the country, and the resultant financial implications.

Methods: We conducted a retrospective analysis of Medicare fee-for-service beneficiaries undergoing primary and revision total knee arthroplasty (TKA) and total hip arthroplasty (THA) from January 1 through March 31, 2020 with 74,080 TKAs and 54,975 THAs identified. We calculated the percent drop in average daily cases from before and after March 18, 2020. We then examined variation across states in arthroplasty case volumes as it related to reported COVID-19 cases, the impact of COVID-19 on length of stay and percentage of patients discharged home. Finally, we calculated the revenue impact on hospitals and surgeons.

Results: There was a steep decline in TKA and THA volumes in mid-March of 94% and 92%, respectively. There was a significant variation for arthroplasty case volumes across states. We found minimal change in length of stay except for primary THAs with fracture going from 5 + days to 4 days. We saw an increasing trend in discharge to home with the greatest effect in primary THAs with fracture. The total daily hospital Medicare revenue for arthroplasty declined by 87% and surgeon revenue decreased by 85%.

Conclusion: The beginning of the COVID-19 pandemic caused a significant decrease in arthroplasty volumes in the Medicare population with a resultant substantial revenue loss for hospitals and surgeons.
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http://dx.doi.org/10.1016/j.arth.2021.01.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837224PMC
July 2021

Evaluation of modified permeable pavement systems with coal gangue to remove typical runoff pollutants under simulated rainfall.

Water Sci Technol 2021 Jan;83(2):381-395

Key Laboratory of Urban Stormwater System and Water Environment, Ministry of Education, Beijing University of Civil Engineering and Architecture, Beijing 102616, China E-mail: Beijing Engineering Research Center of Sustainable Urban Sewage System Construction and Risk Control, Beijing University of Civil Engineering and Architecture, Beijing 100044, China.

Coal gangue (CG) as mineral waste was properly treated and applied as the filter media in permeable pavement systems due to its good sorption ability and mechanical strength. Batch experiments show the maximum adsorption capacity of calcined CG to phosphorus could reach 2.63 mg/g. To evaluate the removal effect of typical runoff pollutants including chemical oxygen demand (COD), total nitrogen (TN), total phosphorus (TP) and ammonia (NH-N), the gravel and sand in a traditional pavement system were replaced by CG respectively. The leaching behavior of the four pollutants in CG modified systems is limited and comparable with traditional system, indicating pretreated CG as filler would not cause environmental risk. CG-based pavement systems improved the removal efficiency of the four pollutants especially for TP. The removal mechanisms including interception, adsorption and microorganism degradation. The removal rates of COD, NH-N and TN by CG modified and traditional systems decreased with rainfall duration, while it is not obviously changed with rainfall recurrence period and drying period. Overall, the permeable pavement with CG layers that replaced both sand and gravel layers show best removal efficiency of all pollutants investigated especially for TP (>95%). This study provides a new way for CG utilization and gives the reference for the process design of permeable pavement.
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http://dx.doi.org/10.2166/wst.2020.574DOI Listing
January 2021

Dose- and Time-Dependent Effects of Human Mesenchymal Stromal Cell Infusion on Cardiac Allograft Rejection in Mice.

Stem Cells Dev 2021 02 4;30(4):203-213. Epub 2021 Feb 4.

Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Heart transplantation is the final life-saving therapeutic strategy for many end-stage heart diseases. Long-term immunosuppressive regimens are needed to prevent allograft rejection. Mesenchymal stromal cells (MSCs) have been shown as immunomodulatory therapy for organ transplantation. However, the effect of dose and timing of MSC treatment on heart transplantation has not yet been examined. In this study, we infused three doses (1 × 10, 2 × 10, or 5 × 10 cells) of human MSCs (hMSCs) to the recipient BALB/c mice before (7 days or 24 h) or after (24 h) receiving C57BL/6 cardiac transplants. We found that infusion of high dose hMSCs (5 × 10) at 24 h post-transplantation significantly prolonged the survival time of cardiac grafts. To delineate the underlying mechanism, grafts, spleens, and draining lymph nodes were harvested for analysis. Dose-dependent effect of hMSC treatment was shown in: (1) alleviation of International Society of Heart and Lung Transplantation (ISHLT) score in grafts; (2) reduction of the population of CD4 and CD8 T cells; (3) increase of regulatory T (Treg) cells; (4) and decrease of serum levels of inflammatory cytokines and donor-specific antibodies. Taken together, we showed timing critical and dose-dependent immunomodulatory effects of hMSC treatment against acute allograft rejection in a mouse model of heart transplantation.
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http://dx.doi.org/10.1089/scd.2019.0300DOI Listing
February 2021

Fully automated left atrium segmentation from anatomical cine long-axis MRI sequences using deep convolutional neural network with unscented Kalman filter.

Med Image Anal 2021 02 26;68:101916. Epub 2020 Nov 26.

Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada; Servier Virtual Cardiac Centre, Mazankowski Alberta Heart Institute, Edmonton, Canada; Department of Computing Science, University of Alberta, Edmonton, Canada. Electronic address:

This study proposes a fully automated approach for the left atrial segmentation from routine cine long-axis cardiac magnetic resonance image sequences using deep convolutional neural networks and Bayesian filtering. The proposed approach consists of a classification network that automatically detects the type of long-axis sequence and three different convolutional neural network models followed by unscented Kalman filtering (UKF) that delineates the left atrium. Instead of training and predicting all long-axis sequence types together, the proposed approach first identifies the image sequence type as to 2, 3 and 4 chamber views, and then performs prediction based on neural nets trained for that particular sequence type. The datasets were acquired retrospectively and ground truth manual segmentation was provided by an expert radiologist. In addition to neural net based classification and segmentation, another neural net is trained and utilized to select image sequences for further processing using UKF to impose temporal consistency over cardiac cycle. A cyclic dynamic model with time-varying angular frequency is introduced in UKF to characterize the variations in cardiac motion during image scanning. The proposed approach was trained and evaluated separately with varying amount of training data with images acquired from 20, 40, 60 and 80 patients. Evaluations over 1515 images with equal number of images from each chamber group acquired from an additional 20 patients demonstrated that the proposed model outperformed state-of-the-art and yielded a mean Dice coefficient value of 94.1%, 93.7% and 90.1% for 2, 3 and 4-chamber sequences, respectively, when trained with datasets from 80 patients.
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http://dx.doi.org/10.1016/j.media.2020.101916DOI Listing
February 2021

Ultrathin-shell IrCo hollow nanospheres as highly efficient electrocatalysts towards the oxygen evolution reaction in acidic media.

Nanoscale 2020 Dec 26;12(47):24070-24078. Epub 2020 Nov 26.

Guangxi Key Laboratory of Electrochemical Energy Materials; Key Laboratory of New Processing Technology for Non-ferrous Metal and Materials, Ministry of Education; Collaborative Innovation Center of Sustainable Energy Materials, School of Physical Science and Technology, Guangxi University, Nanning, 530004, China.

Improving the utilization of Ir electrocatalysts for the oxygen evolution reaction (OER) to significantly reduce their loading is essential for low-cost hydrogen production in proton exchange membrane water electrolysis. Herein, IrCo hollow nanospheres featuring a novel structure with ultrathin continuous shells which have only eleven atomic layers (2.26 nm) were synthesized by a facile sequential reduction route using NaBH as a reducing agent at room temperature. It is revealed that the key intermediate in the formation of hollow nanospheres is amorphous cobalt boride formed between Co and NaHB in the first reducing step. The average diameter of the IrCo nanospheres was found to be 73.71 nm with the atomic ratio of 47.1% and 52.9% for Co and Ir, respectively. The IrCo hollow nanospheres exhibit highly efficient OER activity and long-term durability with a low overpotential of 284 mV at 10 mA cm (32.5 μg cm) and a high mass activity of 8.49 A mg (5.7 times higher than that of commercial IrO (1.49 A mg) at 1.7 V. The performance is also proved using an overall water splitting device with the overpotential of 318 mV to achieve 10 mA cm as well as a 17 mV shift at 5 mA cm after 14 h. This improvement is critically attributed to the advantages of the hollow structure, ultrathin continuous shells which are oxidized into IrOin situ and strong lattice strain effects induced by the specific hollow structure and alloying Co into Ir crystal lattices (1.6% against metallic iridium). These characteristics endow the hollow nanospheres with great potential to minimize the Ir loading dramatically for practical applications, compared to other previously reported structures like nanoparticles, nanoneedles and nanowires.
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http://dx.doi.org/10.1039/d0nr06601jDOI Listing
December 2020

Determinants of anxiety and depression in patients with cubital tunnel syndrome.

BMC Psychiatry 2020 11 17;20(1):540. Epub 2020 Nov 17.

Department of Hand Surgery, The Third hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China.

Background: The aim of this cross-sectional study to assess the proportions of anxiety and depression in patients with CuTS, and to explore the associated demographic and clinical features.

Methods: From May 2011 to January 2017, 246 patients diagnosed with CuTS were recruited. The Hospital Anxiety and Depression Scale was used to assess the proportions of depression and anxiety. Patient demographic and clinical data were collected. Univariate analysis and multivariate regression were carried out to identify the variables that were independently associated with anxiety and depression.

Results: The proportions of depression and anxiety were 17.9% (n = 44) and 14.2% (n = 35), respectively. Five patients had both possible/probable anxiety and depression. Logistic regression analysis revealed that diabetes mellitus was independently associated with depression; and the modified McGowan grade was independently associated with anxiety.

Conclusions: In patients with CuTS, the proportions of depression and anxiety were 17.9% and 14.2%, respectively. Early screening for anxiety and depression is beneficial for patients with CuTS.
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http://dx.doi.org/10.1186/s12888-020-02934-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7673081PMC
November 2020

A comparison of the growth status, rainfall retention and purification effects of four green roof plant species.

J Environ Manage 2021 Jan 26;278(Pt 1):111451. Epub 2020 Oct 26.

Key Laboratory of Urban Stormwater System and Water Environment, Ministry of Education, Beijing University of Civil Engineering and Architecture, Beijing, 100044, China.

Vegetation is a key component of green roofs and one of the most important factors affecting the rainfall quantity and quality of green roofs. Four plant species (Sedum lineare Thunb., Sedum spurium 'Coccineum', Sedum aizoon L. and Sedum spectabile) and two planting methods (single-plant and mixed-plant) were tested on extensive green roofs (EGRs) in 2019. Plant growth status (plant height and vegetation coverage), rainfall volume control, nutrient concentration and load reduction were used to analyse the impact of the situation and the different plant growth conditions. The results showed that the growth status of Sedum lineare Thunb., Sedum aizoon L. and Sedum spectabile was great, and the vegetation coverage was more than 95% in summer. Each EGR with different sedum species had strong rainfall retention effects. The average retention rates of Sedum spectabile, Sedum lineare Thunb, mixed plants, Sedum aizoon L. and Sedum spurium 'Coccineum' were 90.98% and 91.38%, 88.51%, 83.42% and 84.17%, respectively. The average total nitrogen (TN) and nitrate nitrogen (NO-N) concentrations of Sedum lineare Thunb. were 13.77 mg/L and 7.64 mg/L, which were higher than those of other sedum species, and the average concentrations of ammonia nitrogen (NH-N) and total phosphorus (TP) of mixed plants were 4.01 mg/L and 0.48 mg/L, which were higher than those of single plants. Different plant species had different effects on nutrient loads. The EGRs of single plants and mixed plants indicated sinks of TN and NH-N and sources of TP, but the performance of NO-N was inconsistent. Comprehensively, Sedum lineare Thunb., Sedum aizoon L. and Sedum spectabile were suitable for the green roofs. This study provides scientific support for the green roofs' application of actual projects and has a strong reference value for the development of green infrastructure.
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http://dx.doi.org/10.1016/j.jenvman.2020.111451DOI Listing
January 2021

Effects of Guizhi decoction for diabetic cardiac autonomic neuropathy: A protocol for a systematic review and meta-analysis.

Medicine (Baltimore) 2020 Sep;99(39):e22317

Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu.

Background: Diabetic cardiac autonomic neuropathy (DCAN) is one of the serious complications of diabetes. The pathogenesis of DCAN has not been fully elucidated. There is currently no effective treatment for such chronic disease. Traditional Chinese medicine has a long clinical history for the prevention and treatment of diabetes and chronic complications, and it also shows certain advantages in the treatment of DCAN. Many clinical studies have confirmed that Chinese medicine Guizhi decoction can reduce the clinical symptoms and improve neuronal function of patients with DCAN. So we intend to conduct a systematic review further clarified the effectiveness and safety of Guizhi decoction for DCAN.

Methods: We will search each database from the built-in until July 2020. The English literature mainly searches Cochrane Library, PubMed, EMBASE, and Web of Science, while the Chinese literature comes from CNKI, CBM, VIP, and Wangfang database. Simultaneously we will retrieval clinical registration tests and grey literatures. In this study, only the clinical randomized controlled trials (RCTs) were selected to evaluate the efficacy and safety of Guizhi decoction in the treatment of DCAN. The 2 researchers independently conducted literature selection, data extraction, and quality assessment. Statistical heterogeneity among studies will be evaluated using the Cochran Q test (x) and the I statistical value. We will utilize the Review Manage software V5.3.0 (The Nordic Cochrane Center, The Cochrane Collaboration, 2014, Copenhagen, Denmark) to statistically analyze all data.

Ethics And Dissemination: This study is a protocol for a systematic review of Guizhi decoction as a treatment of DCAN patients.

Results: This study will provide high-quality synthesis of effectiveness and safety of Guizhi decoction for DCAN.

Conclusion: This systematic review aims to provide new options for Guizhi decoction treatment of DCAN in terms of its efficacy and safety.

Registration Number: INPLASY202080018.
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http://dx.doi.org/10.1097/MD.0000000000022317DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7523786PMC
September 2020

Vitamin D supplementation in the treatment of type 2 diabetic microangiopathy: A protocol for a systematic review and meta-analysis.

Medicine (Baltimore) 2020 Aug;99(33):e20978

Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, P.R. China.

Background: The number of people with diabetes is growing exponentially.Human studies have shown that vitamin D supplementation is beneficial for type 2 diabetic microangiopathy. However, owing to the low quality, small sample size, and methodological heterogeneity of these studies, this conclusion is not convincing. Consequently, in order to determine whether vitamin D supplementation is effective and safe in type 2 diabetic microangiopathy, it is necessary to conduct a meta-analysis of high-quality clinical trials.

Methods: We will search each database from the built-in until March 2020. The English literature mainly searches Cochrane Library, PubMed, EMBASE, and Web of Science, while the Chinese literature comes from CNKI, CBM, VIP, and Wangfang database. Simultaneously we will retrieval clinical registration tests and grey literatures. In this study, only the clinical randomized controlled trials were selected to evaluate the efficacy and safety of vitamin D in the treatment of type 2 diabetic microangiopathy. The two researchers independently conducted literature selection, data extraction and quality assessment. Statistical heterogeneity among studies will be evaluated using the Cochran Q test (x) and the I statistical value. We will utilize the Review Manage software V5.3.0 (The Nordic Cochrane Center, The Cochrane Collaboration, 2014, Copenhagen, Denmark) to statistically analyze all data.

Ethics And Dissemination: Ethics and dissemination: This study is a systematic review of vitamin D supplementation as a treatment of type 2 diabetic microangiopathy.

Results: This study will provide high-quality synthesis of effectiveness and safety of vitamin D supplementation for type 2 diabetic microangiopathy.

Conclusion: This systematic review aims to provide new options for vitamin D treatment of type 2 diabetic microangiopathy in terms of its efficacy and safety.

Registration Number: LNPLASY202050055.
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http://dx.doi.org/10.1097/MD.0000000000020978DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7437839PMC
August 2020

A red-emission fluorescent probe for visual monitoring of lysosomal pH changes during mitophagy and cell apoptosis.

Analyst 2020 Nov 1;145(21):7018-7024. Epub 2020 Sep 1.

Institute of Environmental Science, Shanxi University, Taiyuan, 030006, P. R. China.

We presented a novel red-emission fluorescent probe (MSO) for selectively monitoring lysosomal pH fluctuation in living cells. The probe was designed by employing rhodamine B as the off-on pH sensitive moiety owing to the unique spirocycle group and morpholine as the lysosome targetable unit. Based on the H-induced spirocyclic ring opening process, MSO displayed significant pH sensing properties around 590 nm, with a pK value of 5.42 and a good linear pH response ranging from 5.00 to 6.00. Besides, the probe possessed other prominent photophysical properties such as good selectivity and excellent photostability as well as low cytotoxicity, together making the red-emission probe more favorable for long-time and real-time imaging in live cells. Furthermore, MSO selectively accumulated into lysosomes and successfully visualized the mitophagy, cell apoptosis and heat shock processes by monitoring the rise of lysosomal pH.
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http://dx.doi.org/10.1039/d0an01141jDOI Listing
November 2020

Autophagy inhibition is the next step in the treatment of glioblastoma patients following the Stupp era.

Cancer Gene Ther 2021 Sep 5;28(9):971-983. Epub 2020 Aug 5.

Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

It has now been nearly 15 years since the last major advance in the treatment of patients with glioma. "The addition of temozolomide to radiotherapy for newly diagnosed glioblastoma resulted in a clinically meaningful and statistically significant survival benefit with minimal additional toxicity". Autophagy is primarily a survival pathway, literally self-eating, that is utilized in response to stress (such as radiation and chemotherapy), enabling clearance of effete protein aggregates and multimolecular assemblies. Promising results have been observed in patients with glioma for over a decade now when autophagy inhibition with chloroquine derivatives coupled with conventional therapy. The application of autophagy inhibitors, the role of immune cell-induced autophagy, and the potential role of novel cellular and gene therapies, should now be considered for development as part of this well-established regimen.
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http://dx.doi.org/10.1038/s41417-020-0205-8DOI Listing
September 2021

PretiMeth: precise prediction models for DNA methylation based on single methylation mark.

BMC Genomics 2020 May 15;21(1):364. Epub 2020 May 15.

School of Automation Engineering, University of Electronic Science and Technology of China, Chengdu, 611731, China.

Background: The computational prediction of methylation levels at single CpG resolution is promising to explore the methylation levels of CpGs uncovered by existing array techniques, especially for the 450 K beadchip array data with huge reserves. General prediction models concentrate on improving the overall prediction accuracy for the bulk of CpG loci while neglecting whether each locus is precisely predicted. This leads to the limited application of the prediction results, especially when performing downstream analysis with high precision requirements.

Results: Here we reported PretiMeth, a method for constructing precise prediction models for each single CpG locus. PretiMeth used a logistic regression algorithm to build a prediction model for each interested locus. Only one DNA methylation feature that shared the most similar methylation pattern with the CpG locus to be predicted was applied in the model. We found that PretiMeth outperformed other algorithms in the prediction accuracy, and kept robust across platforms and cell types. Furthermore, PretiMeth was applied to The Cancer Genome Atlas data (TCGA), the intensive analysis based on precise prediction results showed that several CpG loci and genes (differentially methylated between the tumor and normal samples) were worthy for further biological validation.

Conclusion: The precise prediction of single CpG locus is important for both methylation array data expansion and downstream analysis of prediction results. PretiMeth achieved precise modeling for each CpG locus by using only one significant feature, which also suggested that our precise prediction models could be probably used for reference in the probe set design when the DNA methylation beadchip update. PretiMeth is provided as an open source tool via https://github.com/JxTang-bioinformatics/PretiMeth.
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http://dx.doi.org/10.1186/s12864-020-6768-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7227319PMC
May 2020

Vitamin D supplementation for nonalcoholic fatty liver disease in type 2 diabetes mellitus: A protocol for a systematic review and meta-analysis.

Medicine (Baltimore) 2020 May;99(19):e20148

Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072.

Background: Nonalcoholic fatty liver disease (NAFLD) is strongly associated with type 2 diabetes mellitus (T2DM), and low vitamin D levels are positively associated with NAFLD and T2DM. But there is absence of convincing evidence-based medicine to confirm the efficacy of vitamin D supplementation for T2DM with NAFLD. Thus, we aimed to conduct this meta-analysis to summarize the efficacy of vitamin D supplementation for T2DM combined with NAFLD, and help to further clarify its beneficial action on diabetic patients with NAFLD.

Methods: The study only selects clinical randomized controlled trials of vitamin D supplementation for T2DM combined with NAFLD. We will search each database from the built-in until July 2020. The English literature mainly searches Cochrane Library, Pubmed, EMBASE, and Web of Science. While the Chinese literature comes from CNKI, CBM, VIP, and Wangfang database. Meanwhile, we will retrieve clinical trial registries and grey literature. Two researchers worked independently on literature selection, data extraction, and quality assessment. The dichotomous data is represented by relative risk (RR), and the continuous is expressed by mean difference (MD) or standard mean difference (SMD), eventually the data is synthesized using a fixed effect model (FEM) or a random effect model (REM) depending on the heterogeneity. The imaging markers of liver, biomarkers of hepatic steatosis, serological indexes of hepatic fibrosis, serum NAFLD liver fat score were evaluated as the main outcomes. While several secondary outcomes were also evaluated in this study. The statistical analysis of this meta-analysis was conducted by RevMan software version 5.3.

Results: This meta-analysis will further determine the beneficial efficacy of vitamin D supplementation for T2DM combined with NAFLD.

Conclusion: This study determines the positive efficacy of vitamin D supplementation for diabetic patients with NAFLD.
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http://dx.doi.org/10.1097/MD.0000000000020148DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220265PMC
May 2020

Impact of endplate-implant area mismatch on rates and grades of subsidence following stand-alone lateral lumbar interbody fusion: an analysis of 623 levels.

J Neurosurg Spine 2020 Mar 6:1-5. Epub 2020 Mar 6.

Objective: Stand-alone lateral lumbar interbody fusion (LLIF) is a useful minimally invasive approach for select spinal disorders, but implant subsidence may occur in up to 30% of patients. Previous studies have suggested that wider implants reduce the subsidence rate. This study aimed to evaluate whether a mismatch of the endplate and implant area can predict the rate and grade of implant subsidence.

Methods: The authors conducted a retrospective review of prospectively collected data on consecutive patients who underwent stand-alone LLIF between July 2008 and June 2015; 297 patients (623 surgical levels) met inclusion criteria. Imaging studies were examined to grade graft subsidence according to Marchi criteria. Thirty patients had radiographic evidence of implant subsidence. The endplates above and below the implant were measured.

Results: A total of 30 patients with implant subsidence were identified. Of these patients, 6 had Marchi grade 0, 4 had grade I, 12 had grade II, and 8 had grade III implant subsidence. There was no statistically significant correlation between the endplate-implant area mismatch and subsidence grade or incidence. There was also no correlation between endplate-implant width and length mismatch and subsidence grade or incidence. However, there was a strong correlation between the usage of the 18-mm-wide implants and the development of higher-grade subsidence (p = 0.002) necessitating surgery. There was no significant association between the degree of mismatch or Marchi subsidence grade and the presence of postoperative radiculopathy. Of the 8 patients with 18-mm implants demonstrating radiographic subsidence, 5 (62.5%) required reoperation. Of the 22 patients with 22-mm implants demonstrating radiographic subsidence, 13 (59.1%) required reoperation.

Conclusions: There was no correlation between endplate-implant area, width, or length mismatch and Marchi subsidence grade for stand-alone LLIF. There was also no correlation between either endplate-implant mismatch or Marchi subsidence grade and postoperative radiculopathy. The data do suggest that the use of 18-mm-wide implants in stand-alone LLIF may increase the risk of developing high-grade subsidence necessitating reoperation compared to the use of 22-mm-wide implants.
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http://dx.doi.org/10.3171/2020.1.SPINE19776DOI Listing
March 2020

The Financial Implications of the Removal of Total Knee Arthroplasty From the Medicare Inpatient-Only List.

J Arthroplasty 2020 06 4;35(6S):S33-S36. Epub 2020 Feb 4.

Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR.

Background: Centers for Medicare and Medicaid Services removed total knee arthroplasties (TKAs) from the Inpatient-Only list on January 1, 2018, which meant TKAs could be performed on a hospital outpatient basis. We sought to understand (1) what the financial implications have been for hospitals, (2) to what extent financial incentives have influenced the adoption of outpatient TKAs across hospitals, (3) whether adoption of outpatient TKAs has impacted the success of hospitals with managing post-acute care (PAC) spend, and (4) the financial implications to Medicare of the adoption of outpatient TKAs.

Methods: We used national patient-level Medicare fee-for-service Part A claims data (100% sample) from January 2018 through June 2019 to calculate the inpatient and outpatient TKA payment rate for each hospital, and the distribution in these payments across the country. We then ran case-level regressions to understand the factors associated with adoption of outpatient TKAs, and the drivers of PAC spend. Finally, we quantified the savings to Medicare.

Results: Hospitals on average received $3682 (30%) lower payment from Medicare for outpatient TKA cases, but this varied widely across hospitals. The difference in payment rates across hospitals was not statistically significantly related to their adoption rate of outpatient TKAs. PAC spend was higher for same-day discharges, but lower for cases that stayed at least 1 night. Based on the adoption rate of outpatient TKAs in Q2 2019, Medicare saved $355M on a run rate basis.

Conclusion: Hospitals have adopted outpatient TKAs independent of the financial impact. Medicare has benefited from lower PAC spend and lower payments to hospitals.
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http://dx.doi.org/10.1016/j.arth.2020.01.074DOI Listing
June 2020

An Examination of the Adoption of Outpatient Total Knee Arthroplasty Since 2018.

J Arthroplasty 2020 06 4;35(6S):S24-S27. Epub 2020 Feb 4.

Avant-garde Health, Boston, MA.

Background: The Centers for Medicare and Medicaid Services removed total knee arthroplasties (TKAs) from the inpatient-only (IPO) list on January 1, 2018, which meant that TKAs could be performed on a hospital outpatient basis. We examined the following: (1) the national rate of adoption of outpatient TKAs over time, (2) how adoption varied across hospitals, and (3) whether adoption of outpatient TKAs has positively or negatively impacted 90-day TKA readmission rates.

Methods: We used national patient-level Medicare Fee-for-Service Part A claims data (100% sample) from January 2017 through June 2019 to look at the quarterly trend in percent of TKAs performed as outpatient, and the distribution in this percentage across hospitals in the country. We ran a case-level regression to understand whether inpatient vs outpatient coding status relates to 90-day readmission rates.

Results: In 2017 prior to the removal of TKAs from the IPO list, 0.2% were performed as outpatient. In the first quarter (Q1 2018) after the rule change, 24.9% were performed as outpatient, and by the second quarter of 2019, 36.4% were performed as outpatient. These rates varied widely across hospitals from 0% (10th and 25th percentiles) to 78% (90th percentile) from January 2018 through March 2019. There was no difference in readmission rates for same-day discharges, but outpatient cases discharged after one or more nights in the hospital had statistically lower readmissions than inpatient cases.

Conclusion: There was a rapid increase in the adoption of hospital outpatient TKAs following their removal from the Medicare IPO, which has resulted in lower readmission rates, and so adoption is likely to continue.
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http://dx.doi.org/10.1016/j.arth.2020.01.073DOI Listing
June 2020
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