Analysis of risk factors for pathological diagnosis upgrading after resection of colorectal adenoma / 中华消化杂志

Objective:To investigate the risk factors that affected pathological diagnosis upgrading after resection of colorectal adenoma.Methods:From January 2017 to December 2022, a total of 1 059 patients who underwent adenoma resection after pathologically diagnosed as adenoma by endoscopic forceps biopsy(EFB)were included in General Hospital of Ningxia Medical University. The patients were divided into the pathologically no difference group (1 003 cases) and the pathologically upgraded group (56 cases) based on the comparison of pathological diagnosis of EFB specimens and the specimens after adenoma resection. Clinical information and endoscopic characteristics of the adenoma were compared between the 2 groups. The clinical information included smoking history, family history of colorectal cancer, and the endoscopic characteristics included maximum diameter, morphological characteristics, surface depression, erosion or ulceration, and surface color of adenoma. Chi-square test and Fisher′s exact test were used for statistical analysis. Multivariate logistic regression model was used to analyze the risk factors for pathological diagnosis upgrading after adenoma resection.Results:The proportions of patients with smoking history, family history of colorectal cancer, concomitant hypertension, and coronary heart disease in the pathologically upgraded group were higher than those in the pathologically no difference group (46.43%, 26/56 vs.26.12%, 262/1 003; 8.93%, 5/56 vs.0.70%, 7/1 003; 46.43%, 26/56 vs.30.11%, 302/1 003; 21.43%, 12/56 vs.9.27%, 93/1 003), and the differences were statistically significant( χ2=11.05, Fisher′s exact test, χ2=6.61 and 8.78; all P<0.05). There were statistically significant differences between the pathologically no difference group and pathologically upgraded group in the maximum diameter (929 cases (92.62%) and 23 cases (41.07%) of < 20 mm, and 74 cases (7.38%) and 33 cases (58.93%) of ≥20 mm, respectively), morphological characteristics (220 cases (21.93%) and 28 cases (50.00%) with pedicle, and 783 cases (78.07%) and 28 cases (50.00%) without pedicle, respectively), surface color (347 cases (34.60%) and 3 cases (5.36%) of near normal mucosa, 613 cases (61.12%) and 50 cases (89.29%) of red surface color, and 43 cases (4.29%) and 3 cases (5.36%) of white surface color, respectively), erosion or ulceration (78 cases (7.78%) and 36 cases (64.29%) had erosion or ulceration, and 925 cases (92.22%) and 20 cases (35.71%) had no erosion or ulceration, respectively), and surface depression (6 cases (0.60%) and 8 cases (14.29%) of depression, and 997 cases (99.40%) and 48 cases (85.71%) of non depression, respectively) ( χ2=155.18, 23.30, 20.58 and 176.31, Fisher′s exact test; all P<0.001). The result of multivariate logistic regression analysis showed that surface depression ( OR=25.198, 95% confidence interval (95% CI) 5.812 to 109.246, P<0.001), erosion or ulceration( OR=9.913, 95% CI 4.652 to 21.124, P<0.001), red surface color ( OR=4.276, 95% CI 1.053 to 17.363, P=0.042), white surface color ( OR=8.803, 95% CI 1.398 to 55.435, P=0.021), maximum diameter≥20 mm ( OR=4.689, 95% CI 2.265 to 9.706, P<0.001), family history of colorectal cancer ( OR=8.764, 95% CI 1.418 to 54.162, P=0.019) and smoking history ( OR=2.713, 95% CI 1.376 to 5.349, P=0.004) were independent risk factors for pathological diagnosis upgrading after adenoma resection. Conclusion:Surface depression, maximum diameter ≥20 mm, erosion or ulceration, white or red surface color, family history of colorectal cancer and smoking history may enhance the heterogeneity of adenomas, interfere with the accuracy of EFB pathology, and lead to an upgrade of pathological diagnosis after adenoma resection.

Automatic synthesis and in vivo imaging of Al 18F-NOTA-FAPI-04 / 中华核医学与分子影像杂志

Objective:To automatically synthesize Al 18F-1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid (NOTA)-fibroblast activation protein inhibitor (FAPI)-04, perform PET/CT imaging in vivo, and evaluate its diagnostic efficacy on tumors. Methods:Al 18F-NOTA-FAPI-04 was produced in All-in-one automatic synthesis module and its quality control was conducted by high performance liquid chromatography (HPLC) equipped with a radioactive detector. Al 18F-NOTA-FAPI-04 PET/CT imaging was performed in normal BALB/c mice ( n=3) and 4T1 breast cancer models ( n=3) to determine its biodistribution. Then Al 18F-NOTA-FAPI-04 and 18F-FDG PET/CT imaging were performed in a hepatocellular carcinoma patient (male, 51 years old). Results:The synthesis time of Al 18F-NOTA-FAPI-04 was about 35 min, and the radiochemical yield was (25.2±1.9)% (attenuation correction, n=3). The product was colorless transparent solution with pH value of 7.0-7.5, and the specific activity was (46.11±3.07) GBq/μmol (attenuation correction, n=3). The radiochemical purity was above 99.0% and was still above 98.0% at room temperature after 6 h. PET/CT imaging in mice showed that physiological uptake of Al 18F-NOTA-FAPI-04 was mainly in biliary system and bladder, and Al 18F-NOTA-FAPI-04 highly concentrated in tumor xenografts. PET/CT imaging in the patient showed that Al 18F-NOTA-FAPI-04 obtained high tumor background ratio (TBR) values of 4.1, 8.9, 5.4, 4.8, 2.2 in parasternal lymph nodes, anterior diaphragmatic lymph nodes, hilar lymph nodes, pancreaticoduodenal ligament lymph nodes, abdominal aortic lymph nodes, respectively, while TBR values were 1.0, 2.8, 5.0, 2.1, 1.1 by 18F-FDG. Conclusions:Al 18F-NOTA-FAPI-04 can be synthesized with short time, high radiochemical yield and good stability using All-in-one module. Al 18F-NOTA-FAPI-04 PET/CT imaging has high contrast and excellent diagnostic efficacy on tumors.

LZTS2 tumor suppressor gene and advancements in tumor re-search / 中国肿瘤临床

Leucine zipper tumor suppressor 2 (LZTS2) is a novel tumor suppressor gene that has been increasingly recognized in recent years. Currently, many studies illustrate that LZTS2 gene, the important candidate tumor suppressor gene, is already involved in the inhibition of tumorigenesis and aberrant proliferation of tumor cells, and other functions of tumor cells. Information from these stud-ies can contribute to the formulation of new strategies for the treatment of tumors.

Construction of a capsular tissue-engineered ureteral stent seeded with autologous urothelial cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the feasibility of constructing a capsular poly L-lactic acid (PLLA) ureteral stent seeded with autologous urothelial cells using tissue engineering methods.</p><p><b>METHODS</b>The capsular ureteral stent was constructed by subcutaneously embedding PLLA ureteral stent in the back of beagles for 3 weeks to induce the formation of connective tissue on the surfaces. After decellularization of the stent, the expanded autologous urothelial cells were seeded on the stent. The surface structure and cell adhesion of the stent were observed using HE staining, scanning electron microscope (SEM) and immunocytochemical staining. MTT assay was used to evaluate urothelial cell proliferation on the capsular PLLA ureteral stent and on circumferential small intestinal submucosa graft.</p><p><b>RESULTS</b>HE staining and VIII factor immunohistochemistry revealed numerous capillaries in the connective tissue encapsulating the stent without obvious local inflammatory response. The results of SEM and immunocytochemical staining showed that the capsule contained rich collagenic fibers forming three-dimensional structures, and the seeded autologous urothelial cells could adhere and well aligned on the surface. MTT assay showed normal growth of the cells on the stent as compared with the cells grown on circumferential small intestinal submucosa graft.</p><p><b>CONCLUSION</b>The capsular PLLA ureteral stent allows adhesion and proliferation of autologous urothelial cells and shows a potential in applications of constructing tissue-engineered ureter.</p>

Construction of an anti-tumor immunogene vaccine pVAX-IL-12-GB and its expression in vivo and in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To construct a novel immunogene therapeutic plasmid that expresses human interleukin-12 (IL-12), granulocyte-macrophage colony stimulating factor (GM-CSF) and B7.1 and observe its expression in vivo and in vitro.</p><p><b>METHODS</b>Human IL-12 gene fragment was cloned into the upper stream of IRES gene in the previously constructed plasmid pVAX-IRES-GM-CSF-B7.1, and the positive recombinant plasmid pVAX-IL-12-GB was transfected into 293T cells via Lipofectamine 2000. The expressions of IL-12 and GM-CSF-B7.1 mRNA and proteins in the transfected cells were assayed by RT-PCR and ELISA, and B7.1 expression was tested by fluorescence-activated cell sorting and immunofluorescence assay. The plasmid pVAX-IL-12-GB was delivered into mouse muscle by electroporation, and the expression of IL-12 in the muscle tissue was identified by immunohistochemistry.</p><p><b>RESULTS</b>Enzyme digestion, PCR and sequence analysis all confirmed successful construction of the recombinant plasmid pVAX-IL-12-GB. IL-12, GM-CSF and B7.1 expressions were all detected in transfected 293T cells, and the expression of IL-12 was also detected in the transfected mouse muscular tissues.</p><p><b>CONCLUSION</b>A novel anti-tumor immunogene vaccine constructed can be expressed both in vivo and in vitro, which facilitates further studies of tumor immunogene therapy.</p>

Effect of carteolol hydrochloride eye drops on 24-hour variation of intraocular pressure / 中华老年医学杂志

Objective To investigate the effect of carteolol hydrochloride eye drops on 24-hour variation of intraocular pressure (IOP). Methods The 30 patients who had never used any anti-glaucoma eye drops were chosen, and their 24-hour variation of IOP (at 2:00 AM, 6:00 AM, 10:00 AM, 2:00 PM, 6:00 PM, 10:00 PM) were measured. Then carteolol hydrochloride eye drops were used twice a day (7:00 AM and 7:00 PM), 1-2 drops each time. Fifteen days later, their 24-h IOP was measured again and the data were analyzed. Results The average IOP at six monitoring points before treatment were (19.77±2.51) mm Hg, (19.52±2.34) mm Hg, (20.38±2.71) mm Hg, (20.07±3.65) mm Hg, (19.97±4.10) mm Hg and (19.97±4.31) mm Hg, the corresponding data after 15 days of treatment were (17.12±2.38) mm Hg, (17.42±2.60) mm Hg, (18.18±2.36) mm Hg, (18.02±3.77) mm Hg, (17.72±3.17) mm Hg and (17.35±3.40) mm Hg (t=11.68, P=0.000). The difference before and after treatment was (2.46±2.05) mm Hg during day and (2.17±1.88) mm Hg during night, and no significant difference was found between them. Conclusions Carteolol hydrochloride eye drops could significantly reduce the IOP, the decreased extent of 24-h IOP is stable.

Use of phosphorylated-signal transduction and activators of transcription 3 in the early diagnosis of prostate cancer / 中华泌尿外科杂志

Objective To investigate the expression of Phosphorylated-signal transduction and activators of transcription 3 (P-STAT3) proteins in human prostate tissue from patients received re-peated biopsies. And consider the usefulness of detecting expression of P-STAT3 in early diagnosis of prostate cancer (PCA). Methods Fifty-eight patients (29 cases of PCA, and 29 cases of benign prostatic hyperplasia (BPH)) who had received repeated biopsies were involved in this study. Immu-nolabelling has been carried out on PCa patients' samples of cores from initially negative biopsies, typ-ical cores from cancer field, and other cores of the same batch biopsies showing no sign of prostate cancer. BPH patients' samples of cores from initial biopsies were set as control. All specimens were done immunohistochemistry stain with anti-P-STAT3 monoclonai antibody. The association of P-STAT3 expression in prostate tissues with the pathology result was evaluated. Results Compared with 10.3% in specimens of patients free of prostate cancer, the positive rate of anti-P-STAT3 stained in typical cores from cancer field, other cores of the same batch biopsies showing no sign of prostate cancer, and cores from initially negative biopsies, was 93.1 % (27/29), 82.8 % (24/29) and 86.2 % (25/29), respectively. There were significant differences of these values between former and laters' (X2=60.123,P=0.000). If P-STAT3 positive in tissue of initially biopsies was considered as the di-agnostic standard of prostate cancer, then it would show a relatively high sensitivity (86.2%) and specificity (89.7%). Conclusion IHC stain for P-STAT3 in prostate biopsy samples could be served as an adjunct to the current diagnostic approach to prostate biopsy for early diagnosis of pros-tate cancer.

Experimental studies and evaluation on safety of compound aluminum sulfate injection / 中国临床药理学与治疗学

AIM: To study the in situ stimulation effect of compound aluminum sulfate injection after i.m. in rabbit quadriceps and dog bladder. The absorption of aluminum and the healing of the bladder wall were also studied to give an evaluation on the safety of the compound injection. METHODS: Compound aluminum sulfate injection was i.m. injected into quadriceps of the rabbits. The in situ stimulation effect was observed macrographically. Blood samples were collected at different time after i.m. injection. Aluminum concentrations were determined by ICP-MS assay and simulated with DAS software. Tissue necrosis as well as the healing of the bladder wall were observed macrographically or pathologically after the injection was given into dog bladder. RESULTS:Severe stimulation was observed after intra quadriceps injection, however, there was no obvious elevation of blood aluminum concentration. The average AUC0-24 was 2.93±1.82 mg·h·L-1 (n=5), corresponding to a relative bioavailability of about 2.77%. Injecting in bladder muscle necrotized the bladder wall in situ, but fibroblast generated and took place of the necrotized membrane and muscle four weeks after injection. There was no bleeding or perforation on the bladder wall. CONCLUSION:Caused compound aluminum sulfate injection in situ necrosis which healed up in 4 weeks. Aluminum absorption is very low after injection, giving a further explanation to the safety of the compound injection.

Clinical analysis of 7 cases of adult prostate sarcoma / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the diagnosis, treatment and prognosis of adult prostatic sarcoma.</p><p><b>METHODS</b>The records of 7 patients with prostate sarcoma were reviewed in the light of clinical manifestation, laboratory examination, therapeutic methods and histological subtypes. Several clinicopathological variables were assessed for prognostic significance.</p><p><b>RESULTS</b>Of the 7 cases, 3 were leiomyosarcoma, 3 rhabdomyosarcoma and the other malignant neurilemoma. Most patients presented urinary obstruction, and the diagnosis of prostate sarcoma was established with ultrasound guided biopsy. Histological subtypes were related to the rate of survival. Two patients received radical cystoprostatectomy and died 13 and 21 months respectively after operation. Two cases underwent total pelvic exenteration, followed by chemotherapy and/or radiotherapy and still alive 15 months after operation. The other 3 received only chemotherapy and/or radiotherapy and died 7 months on average after diagnosis.</p><p><b>CONCLUSION</b>The long-term survival rate for adults with prostate sarcoma is low. Early diagnosis and complete surgical resection offer patients the best chance for survival. Long-term surveillance is necessary for the early detection of recurrence.</p>

Vardenafil for the treatment of erectile dysfunction in men with diabetes / 中华男科学杂志

The prevalence of erectile dysfunction (ED) is higher in diabete patients than in non-diabete men. Moreover, the treatment of ED is more challenging in men with diabetes. Vardenafil, a novel and highly selective phosphodiesterase 5 inhibitor, is the first line therapy for the broad ED population. Recent large-scale clinical trials indicated that vardenafil improved erectile function in ED men with diabetes regardless of the baseline ED severity and plasma HbA1c levels, and it was generally well tolerated.

Three managements of bladder tumors under cystoscopy / 医疗卫生装备

Objective To discuss three managements of bladder tumors under cystoscopy.Methods Of all the patients,1174 were injected compound aluminum sulphate in tumor pedicle,and 700 cases were treated with transurethral resection of bladder tumor (TURBT) and 34 cases were treated with holmium laser.Results The first management,without obturator nerve reflex and tumor recurrence in situ,was easy and economical but not fit for big tumors without pedicles.With the requirements for related techniques and equipments,TURBT might be accompanied by bleeding,obturator nerve reflex and tumor recurrence in situ.Of the 34 cases treated with holmium laser,there were 3 ones with ectopic recurrence and no one with recurrence in situ.With the requirement for holmium laser equipment,the third management was the most expensive one.Conclusion All of the three managements have their advantages and disadvantages.The doctor should select the right management or perform cross application according to the condition of the patient.

The discussion of clinical analysis and prevention methods of VDT visual fatigue / 中华老年医学杂志

Objective To investigate the manifestation and the prevention means of video display terminal (VDT) visual fatigue in old people. Methods Conventional eye inspection were performed for 45 patients, including optical muscle movement, position of eye, confluence function and presbyopia. Results We found that the average difference between middle distance correcting lens and 33 cm reading distance from presbyopia correcting lens was about 0.52 DS( P

Diagnosis of prostate carcinoma in 317 Cases / 中华泌尿外科杂志

Objective To review the diagnosis of prostatic cancer in 317 cases encountered between 1969 and 1999. Methods The clinical data of the 317 cases were retrospectively analysed. Results Prostatic cancer constituted 2.2% of the inpatients of the urology department,9.8% of genito urological tumors.In recent 10 years,the new cases of prostatic cancers hospitalized was 4.2 folds more than 20 years before.Since the use of PSA assessment,the diagnosis rate of prostatic cancer especially the T 1 and T 2 cases was significantly elevated (60.2% vs 50.0%). The diagnoses rate of DRE and TRUS was 86.1% and 89.1% whereas if combined with PSA assessment the diagnosis rate of either DRE or TRUS was increased to 99.0%. Serum PSA level was intimately correlated with the grade and stage of prostatic cancer. Conclusions The prostatic cancer inpatients tends to increase.Serum PSA assessment is of important value in detecting early cases of prostatic cancer.PSA,DRE and TRUS are the cardinal means for the screening of prostatic cancer and when used combinedly the diagnosis rate and accuracy are elevated.

Analysis of factors influencing the disease-free survival after radical prostatectomy for prostate adenocarcinoma / 中华泌尿外科杂志

Objective To analyze the factors that influence the disease-free survival time after radical prostatectomy for prostate adenocarcinoma and to study the expression and significance of Bcl-2,C-erbB-2,Ki-67 in prostate adenocarcinoma. Methods A total of 51 cases of prostate adenocarcinoma undergoing radical prostatectomy were reviewed.Cox proportional hazard model was used to investigate the impact and co-impacts of the factors,which included age, preoperative PSA level,Gleason scores of biopsies and operative specimens,EPE,MR,SVI,LN,PAT,PRT and having testes or not during follow-up.Immunohistochemical staining was used in biopsies and resected specimens to evaluate the positivity of Bcl-2,C-erbB-2,Ki-67 in 15 of the 51 cases. Results In stepwise Cox proportional hazards model, the prognostic factors for recurrence were age(P=0.011),maximal androgen blockade(P=0.017), positive margin of resection(P=0.000),postoperative Gleason score(P=0.002),having testes or not after operation(P=0.040).The expressions of 3 types of proteins showed negative correlation with the prognosis of prostate carcinoma. Conclusions Among clinicopathologic factors,positive resected margin is the most powerful prognostic factor.Patients will benefit from maximal androgen blockage before radical prostatectomy.Disease-free survival after radical prostatectomy is not influenced by not having pelvic lymphadenectomy after finding no enlarged lymph nodes intraoperatively.Not preserving testes after prostatectomy is a favorable factor.The prognosis of prostate carcinoma can be predicted with the expressions of Bcl-2,C-erbB-2 and Ki-67 in biopsies or resected specimens.

Analysis of benign renal tumors and tumor-like lesions (report of 49 cases) / 中华泌尿外科杂志

Objective To evaluate the differentiation and diagnosis of benign renal tumors and tumor-like lesions. Methods The data of 49 cases of benign renal tumors and tumor-like lesions were retrospectively analyzed.All the 49 cases underwent B-ultrasonography and CT;14 cases underwent MRI.The clinical manifestation,imaging features and the pathological results were evaluated.21 cases of benign renal tumors and tumor-like lesions were misdiagnosed as renal carcinoma and underwent nephrectomy.28 cases underwent nephron-sparing tumor excision. Results There was no specificity of the clinical presentation in all the cases.CT and MRI showed that angiomyolipoma had imaging features of intra-tumoral fat.Color Doppler ultrasonography showed the specific features of renal arterio-venous fistula and renal artery aneurysms.The other imaging features of benign renal tumors and tumor-like lesions had no specificity.28 cases who underwent nephron-sparing surgery were followed up for 1 to 9 years and had no relapse.Their renal functions were normal. Conclusions Bulltrosonography,CT and MRI are contributive to the diagnosis and treatment of benign renal tumors and tumor-like lesions.Using nephron-sparing surgery for indeterminate renal masses may reduce misdiagnosis and unnecessary nephrectomy.

The use of appendix anastomosed to the umbilicus as the outlet of continent urinary reservoir / 中华泌尿外科杂志

Objective To evaluate and recommend the use of appendix anastomosed to umbilicus as the outlet of urinary reservoir. Methods The procedure has been conducted in 17 cases underwent total cystectomy from Jan 1995 to May 2000 and the outcome has been studied. Results Continence has been achieved in all.Neither difficulty in catheterization nor acute pyelonephritis was noted.There has been slight bilateral hydronephrosis in 2 patients. Conclusions The use of appendix anastomosed to umbilicus as the outlet of continent urinary reservoir is a good alternative for urinary diversion.

Holmium laser resection of bladder tumors: 34 cases report / 解放军医学杂志

Objective To evaluate the clinical experience in the treatment of the bladder cancer with holmium laser. Methods From June 2001 to June 2002, a total of 34 cases of transitional cell bladder carcinoma, including 30 male and 4 female, with clinical stage T 1 to T 2a and grade I to Ⅱ, were treated with holmium laser. A 550um end firing fiber was delivered through 21 Fr cystoscopy and power(1 to 1.5 J) was delivered at 15 to 40 pulses per second. Results Bladder tumors were resected easily in 26 cases with holmium laser. In 7 cases it was supplemented with TURBT. Only in one case, holmium laser treatment was given up because of continuous bleeding. The patient was then treated with partial cystectomy. Laser operating time ranged form 5min to 60min, mean 20min. Side effects such as uncontrollable bleeding, perforation of bladder, and obturator nerve reflection were not found. 30 cases were followed up for 3 to 12 months, and tumor recurrence were found in 3 cases. Conclusion Holmium laser resection of bladder tumors is a safe, effective, simple method with less side effects. But the field of vision will be obscure unless continuous irrigation is given during operation.

CLINICAL EVALUATION OF URINARY LEVEL OF NUCLEAR MATRIX PROTEIN 22(NMP22)IN DIAGNOSIS OF UROTHELIAL CANCER / 解放军医学杂志

To evaluate the clinical value of NMP22 for the diagnosis of urothelial cancer. Urinary NMP22 was determined with enzyme linked immunoaorbent assay (ELISA) in 50 patients in whom 24 patients were suffering from cancer of urothelium, and 20 cases of cancer of other origins, and 6 cases of artificial bladder after total cystectomy for cancer. The median NMP22 value of urothelial cancer was 37 49U/ml, which was significantly higher than those of other patients (4 33U/ml, P