Intradural extramedullary capillary hemangioma with intramedullary component: A case series

Rationale:Capillary hemangioma in the spinal cord is an exceedingly rare entity that is liable to be misdiagnosed. To summarize the clinical presentation, radiological characteristics, and pathological features of capillary hemangioma in the spinal cord and to share our experience for the diagnosis and treatment of intradural extramedullary capillary hemangioma.Patient concerns:Three patients underwent surgical treatment at our hospital between January 2020 and August 2020. All patients were male[median age at presentation: 57 years (range: 56–60)]. Two patients were experiencing pain and numbness in the lower back, and 1 patient was experiencing numbness and weakness in the left lower limb. The duration of symptoms ranged from 1 to 5 months.Diagnosis:All patients were diagnosed with spinal cord capillary hemangioma after treatment. All lesions were in an intradural extramedullary location and involved spinal cord components. Two patients had lesions in thoracic segments (T8, Th9-10), and 1 patient had a lesion in lumbar segment (L1).Interventions:All patients underwent microscopic laminectomy and complete resection of the extramedullary and intramedullary components of the spinal cord capillary hemangiomas.Outcomes:Postoperatively, all patients experienced transient numbness and pain in the lower limbs, which gradually decreased over time. None of the patients experienced bleeding, severe numbness or pain, or recurrence of symptoms at 3-month follow-up.Conclusion:Intradural extramedullary capillary hemangioma has unique morphological characteristics. Gross-total resection of the extramedullary and intramedullary components of spinal cord capillary hemangioma is recommended for patients with symptoms of spinal cord compression. Careful preoperative imaging and intraoperative decision-making may help avoid residual lesions or reoperation.     

The effects of hydroxyapatite implantation with the autogenous sclera cap: A cohort study

We performed a novel hydroxyapatite (HA) prosthesis implantation method in which an HA implant was implanted into the scleral shell with an autogenous scleral cap.Twenty-six patients who had undergone the novel HA prosthesis implantation method and 32 patients who had undergone traditional HA prosthesis implantation were retrospectively reviewed. The postoperative activity of the artificial eye was measured by the Hirschberg test combined with arc perimetry. The visual analog score (VAS) was used to evaluate 2-month postoperative pain and 2-month postoperative discomfort. HA implant vascularization was measured with enhanced magnetic resonance imaging (MRI) 2 and 6 months after the operation. The enhancement volume (V_E) and the volume of the HA implant (V_HA) were measured. All cases were followed up for 2 years. Measurement data were processed using SAS 6.12.There was a statistically significant difference (P = .016) between the percentages of excellent grade in the two groups. Two months after implantation, the median pain scores of the study and control groups were 2 and 2.5, respectively, and there was a statistically significant difference (W = 585.0, P = .004); there was a statistically significant difference (W = 535.5, P = .000) between the median discomfort scores of the study group (score = 1) and control group (score = 2); the mean VE/VHA values of the study and control groups were 0.3075 and 0.1535, respectively, and there was a statistically significant difference (t = −8.196, P = .000). Six months after implantation, the V_E/V_HA values of the study and control groups were 0.9686 and 0.5934, respectively, and there was a statistically significant difference (W = 549.0, P = .000). Within 2 years of postoperative follow-up, there were no serious complications in the study group.In the study group, in which the hydroxyapatite implant was implanted into a preserved scleral shell with unaltered muscles and covered with an autogenous scleral cap, postoperative activity and the fibrovascularization of the HA implant were significantly increased, and postoperative pain and discomfort were significantly reduced.     

Successful limb salvage in progressive proximal tibia osteosarcoma following denosumab chemotherapy: A case report

Rationale:Osteosarcoma (OS) is a primary malignant bone tumor that originates in the mesenchymal tissue. It is the most common type of pleomorphic tumor occurring in children and adolescents. Currently, there is no established systematic treatment for OS that progresses during standard preoperative chemotherapy.Patient concerns and diagnoses:We describe a 14-year-old male patient with a 4-month history of pain in the upper right leg. Based on the results of percutaneous biopsy, a diagnosis of OS was made. After admission, the patient was treated with first-line chemotherapy agents. After a single course of treatment, the tumor progressed locally and no limb salvage was feasible.Interventions and outcomes:Intervention with denosumab combined with chemotherapy led to a significant reduction in tumor volume and ossification of soft tissue, which successfully resulted in limb salvage rather than amputation. The patient showed no evidence of recurrent or distant metastasis at 6-month follow-up.Lessons:Treatment with receptor activator of nuclear factor-ĸB ligand inhibitor denosumab combined with standard chemotherapy is effective for advanced OS progressing after chemotherapy. We recommend denosumab therapy for successful limb salvage in patients with high-grade OS associated with osteolytic bone destruction and refractory to preoperative neoadjuvant chemotherapy.     

Dynamic Interactions of Post Cleaved NS2B Cofactor and NS3 Protease Identified by Integrative Structural Approaches

Diseases caused by flaviviruses such as dengue virus (DENV) and West Nile Virus (WNV), are a serious threat to public health. The flavivirus single-stranded RNA genome is translated into a polyprotein which is cleaved into three structural proteins and seven non-structural proteins by the viral and cellular proteases. Non-structural (NS) protein 3 is a multifunctional protein that has N-terminal protease and C-terminal helicase domains. The NS3 protease requires co-factor NS2B for enzymatic activity and folding. Due to its essential role in viral replication, NS2B-NS3 protease is an attractive target for antiviral drugs. Despite the availability of crystal structures, dynamic interactions of the N- and C-termini of NS2B co-factor have been elusive due to their flexible fold. In this study, we employ integrative structural approaches combined with biochemical assays to elucidate the dynamic interactions of the flexible DENV4 NS2B and NS3 N- and C-termini. We captured the crystal structure of self-cleaved DENV4 NS2B₄₇NS3 protease in post cleavage state. The intermediate conformation adopted in the reported structure can be targeted by allosteric inhibitors. Comparison of our new findings from DENV4 against previously studied ZIKV NS2B-NS3 proteins reveals differences in NS2B-NS3 function between the two viruses. No inhibition of protease activity was observed for unlinked DENV NS2B-NS3 in presence of the cleavage site while ZIKV NS2B-NS3 cleavage inhibits protease activity. Another difference is that binding of the NS2B C-terminus to DENV4 eNS2B₄₇NS3Pro active site is mediated via interactions with P4-P6 residues while for ZIKV, the binding of NS2B C-terminus to active site is mediated by P1-P3 residues. The mapping of NS2B N- and C-termini with NS3 indicates that these intermolecular interactions occur mainly on the beta-barrel 2 of the NS3 protease domain. Our integrative approach enables a comprehensive understanding of the folding and dynamic interactions of DENV NS3 protease and its cofactor NS2B.     

Mycotoxins in Tea ((Camellia sinensis (L.) Kuntze)): Contamination and Dietary Exposure Profiling in the Chinese Population

Tea is popular worldwide with multiple health benefits. It may be contaminated by the accidental introduction of toxigenic fungi during production and storage. The present study focuses on potential mycotoxin contamination in tea and the probable dietary exposure assessments associated with consumption. The contamination levels for 16 mycotoxins in 352 Chinese tea samples were determined by ultra-performance liquid chromatography–tandem mass spectrometry. Average concentrations of almost all mycotoxins in tea samples were below the established regulations, except for ochratoxin A in the dark tea samples. A risk assessment was performed for the worst-case scenarios by point evaluation and Monte Carlo assessment model using the obtained mycotoxin levels and the available green, oolong, black, and dark tea consumption data from cities in China. Additionally, we discuss dietary risk through tea consumption as beverages and dietary supplements. In conclusion, there is no dietary risk of exposure to mycotoxins through tea consumption in the Chinese population.     

Development and Primary Application of an Indirect ELISA Based on Rep Protein to Analyze Antibodies against Porcine Cocirvirus-like Virus (PCLV)

Porcine circovirus-like virus (PCLV) is a member of circovirus that contains a single-strand DNA genome, which may be one of the pathogens that causes diarrheal symptoms in pigs. The Rep protein encoded by the genome of PCLV may be responsible for viral genome replication. The development of serological detection methods for PCLV is of great necessity for clinical diagnosis, as well as epidemiological investigations. Therefore, this study attempted to build an indirect enzyme-linked immunosorbent assay (ELISA) to examine antibodies against PCLV based on the His-tagged recombinant Rep protein. Full-length PCLV Rep protein was induced and expressed in E. coli and was purified as an antigen to establish an ELISA detection kit. The purified Rep protein was used to inject into mice to produce specific antibodies. There was no cross-reaction of Rep-based ELISA with antisera against other porcine viruses. The intra-assay and inter-assay coefficient variations (CVs) were 0.644–8.211% and 0.859–7.246%, respectively, indicating good repeatability. The non-cross-reaction with TGEV, PRRSV and PCV2 testing showed high sensitivity and high specificity for this ELISA assay. A total of 1593 serum samples collected from different pig farms in Jiangxi Province were tested for anti-PCLV Rep antibodies, and 284 (17.83%) of the 1593 samples were Rep antibody positive. Altogether, the indirect ELISA detection tool developed in this study could be applied to examine serum of PCLV antibodies with good repeatability, high sensitivity and high specificity. In addition, field sample detection results suggested that the PCLV antibody has a low prevalence in pig populations in Jiangxi Province of China.     

High-Throughput Screening of FDA-Approved Drug Library Reveals Ixazomib Is a Broad-Spectrum Antiviral Agent against Arboviruses

The emergence of significant arboviruses and their spillover transmission to humans represent a major threat to global public health. No approved drugs are available for the treatment of significant arboviruses in circulation today. The repurposing of clinically approved drugs is one of the most rapid and promising strategies in the identification of effective treatments for diseases caused by arboviruses. Here, we screened small-molecule compounds with anti-tick-borne encephalitis virus, West Nile virus, yellow fever virus and chikungunya virus activity from 2580 FDA-approved drugs. In total, 60 compounds showed antiviral efficacy against all four of the arboviruses in Huh7 cells. Among these compounds, ixazomib and ixazomib citrate (inhibitors of 20S proteasome β5) exerted antiviral effects at a low-micromolar concentration. The time-of-drug-addition assay suggested that ixazomib and ixazomib citrate disturbed multiple processes in viruses’ life cycles. Furthermore, ixazomib and ixazomib citrate potently inhibited chikungunya virus replication and relieved virus-induced footpad swelling in a mouse model. These results offer critical information which supports the role of ixazomib as a broad-spectrum agent against arboviruses.     

Impact of Obesogenic Environments on Sugar-Sweetened Beverage Consumption among Preschoolers: Findings from a Cross-Sectional Survey in Beijing

The excessive consumption of sugar-sweetened beverages (SSBs) has been proven to be critical for obesity among preschoolers. This study aimed to describe the SSB consumption rates among preschoolers in the Dongcheng District of Beijing, China, and to explore the association between obesogenic environmental determinants and consumption. We applied a stratified cluster sampling method and recruited 3057 primary caregivers of preschoolers in June 2019 to participate in the survey. The caregivers reported their children’s consumption rates of six categories of SSBs and their exposure rates to SSB-related obesogenic environments. The associations between them were tested using multivariate logistic regression models. The mean (SD) age of the children was 5.6 (0.6) years and nearly half (48.3%) were girls. About 84.5% of the children had consumed SSBs over the past three months, and sugar-sweetened milk beverages had the highest consumption rate. Higher exposure to advertisements for the corresponding SSB categories in children, higher frequency rates of consuming SSBs and of taking children to fast-food restaurants in caregivers, and lower frequency rates of reading the Nutrition Facts Panels by caregivers were associated with higher SSB consumption rates among children (p < 0.05 in all of the SSB categories investigated, except for the Nutrition Facts Panel reading behaviors for the sports and energy beverages). SSB consumption among preschoolers is of concern, and comprehensive policy actions and education are urgently needed.     

Polyphenol Mechanisms against Gastric Cancer and Their Interactions with Gut Microbiota: A Review

The lack of new drugs and resistance to existing drugs are serious problems in gastric cancer(GC) treatment. The research found polyphenols possess anti-Helicobacter pylori(Hp) and antitumor activities and may be used in the research and development of drugs for cancer prevention and treatment. However, polyphenols are affected by their chemical structures and physical properties, which leads to relatively low bioavailability and bioactivity in vivo. The intestinal flora can improve the absorption, utilization, and biological activity of polyphenols, whereas polyphenol compounds can increase the richness of the intestinal flora, reduce the activity of carcinogenic bacteria, stabilize the proportion of core flora, and maintain homeostasis of the intestinal microenvironment. Our review summarizes the gastrointestinal flora-mediated mechanisms of polyphenol against GC.     

3 D MEDIC和3 D SPACE磁共振神经成像在腰骶丛神经根的一致性对比研究

目的 验证三维多回波数据联合成像 (three dimensional multi-echo data imagine combination with selective water excitation, 3D MEDIC WE)和三维快速自旋回波成像 (three dimensional sampling perfection with application optimized contrasts by using different flip angle evolution, 3D SPACE STIR) 序列在腰骶丛神经根成像中的可行性和重复性。方法 将55例受试者分为腰椎无异常表现的正常对照组(20例)、单纯性腰椎间盘突出症(lumbar disc herniation, LDH)组(20例)和慢性炎性脱髓鞘性多发性神经根神经病症(chronic inflammatory demyelinating polyradiculoneuropathy, CIDP)组(15例),分别应用两种腰骶丛神经根成像,评价图像质量参数信噪比(signal to noise ratio,SNR)、对比噪声比(contrast to noise ratio,CNR)和对比度(contrast ratio,CR),并验证正常对照组、CIDP组和LDH组测量神经根直径的一致性。结果 两序列测得神经根直径的一致性较高(正常组r=0.95,CIDP组r=0.99,LDH组r=0.97,P<0.001),图像质量评价指标显示,3D SPACE STIR序列在SNR、CNR和CR三项指标中占优,3D MEDIC WE定性评估图像质量评分较高。两序列均能清晰显示正常腰骶丛神经根、病变所致的弥漫性形态增粗神经根以及间盘突出受挤压变形的神经根。结论 3D MEDIC WE和3D SPACE STIR序列可应用于腰骶丛神经根成像,两序列对正常和异常形态、走行的神经根评估具备很高的可行性和重复性。综合考量临床图像的定性、定量评价,可择优选择恰当的序列为腰骶丛神经根成像提供影像支持。