by Zhikai Su, Zhenjie Ling, Haoqiang Chen, Lei Hu, Songtao Xiang, Qian Li, Jianfu Zhou
ObjectiveEvidence suggests that nephrolithiasis and hyperlipidemia are linked. The study is designed to identify diagnostic biomarkers for nephrolithiasis in conjunction with hyperlipidemia using bioinformatics analysis, while exploring the potential common denominator pathogenesis.
MethodsThe NCBI Gene Expression Omnibus (GEO) database provided separate datasets for nephrolithiasis and hyperlipidemia. We employed the R limma package to detect differentially expressed genes (DEGs), which were subsequently analyzed for enrichment using Gene Set Enrichment Analysis (GSEA), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Immune cell infiltration was analyzed by the CIBERSORT method. The WGCNA-R package clustered genes with similar expression profiles, followed by an analysis of the associations between the modules and specific traits or phenotypes. The STRING database was utilized to establish a protein-protein interaction (PPI) network and key functional modules, which were then analyzed using Cytoscape software. Diagnostic genes for both diseases were screened from core hub genes using least absolute shrinkage and selection operator (Lasso) regression. Subsequently, we generated receiver operating characteristic (ROC) curves to validate the predictive ability of these diagnostic genes for diagnosing nephrolithiasis in combination with hyperlipidemia. Lastly, the Network Analyst platform facilitated the construction of transcription factor-gene (TF-gene) and TF-miRNA regulatory networks.
ResultsBased on datasets of nephrolithiasis and hyperlipidemia, we identified 167 DEGs and 74 hub genes through WGCNA. Using PPI networks and machine learning techniques, we recognized three frequently diagnostic genes (HSP90AB1, HSPA5, and STUB1), which demonstrated high diagnostic validity. The functional enrichment of these three diagnostic genes primarily involved pathways related to cellular metabolism.
ConclusionsOur study identified three candidate diagnostic genes that can predict nephrolithiasis in conjunction with hyperlipidemia, providing a solid foundation for further exploration into the pathogenesis of nephrolithiasis and hyperlipidemia.
The Latarjet procedure is the accepted method of operation for patients with anterior shoulder instability. However, as arthroscopy becomes more and more popular, more and more patients are being treated with minimally invasive techniques for the treatment of anteriorly unstable shoulder. This research aims to compare the curative effects of arthroscopic Latarjet (AL) and open Latarjet (OL) on postoperative anterior shoulder instability. Our hypothesis is that arthroscopy will produce better results than open surgery. During the study, a review was conducted on four main databases, including EMBASE and Cochrane Library. Six cohort studies comparing AL with OL in the treatment of anterior shoulder instability were included. Patients who were operated by open technique up to 2023 were referred to as OL and those who underwent arthroscopic surgery were referred to as AL. Comparison was made between the two methods of operation. The statistical analysis was done with RevMan 5.3. The analysis included Visual Analogue Scale (VAS) scores and postoperative wound infections. A total of six studies were included for analysis under inclusion and exclusion criteria. There were 798 patients, 476 was AL group and 322 was OL group. No statistical significance was found on the incidence of postoperative wound infection in the patients who underwent the Latarjet procedure (odds ratio [OR], 1.43; 95% confidence interval [CI], 0.28–7.31; p = 0.67) and the VAS score after surgery (mean difference [MD], 0.70; 95% CI, −0.67 to 2.06; p = 0.32) for patients. However, it has now been demonstrated that arthroscopy is a safe and viable alternative. The only drawback of arthroscopic Latarjet surgery is probably that it has a long learning curve and requires a lot of practice from the surgeon.