Polymorphisms in TYMS for Prediction of Capecitabine-Induced Hand-Foot Syndrome in Chinese Patients with Colorectal Cancer / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Capecitabine is an extensively used oral prodrug of 5-fluorouracil in treatment of colon cancer and is known to cause hand-foot syndrome (HFS). As the target enzyme for capecitabine, thymidylate synthase (TYMS) plays a key role for 5-fluorouracil metabolism and has been associated with some side effects caused by capecitabine. The aim of our study is to identify the possible genetic predictors of capecitabine-induced HFS (CAP-HFS) in Chinese colorectal cancer patients. @*Materials and Methods@#Whole exons of TYMS were sequenced for 288 extreme phenotype HFS patients, including 144 severe or early-onset (first 2 cycles) moderate HFS extreme cases and 144 extreme controls with no reported HFS. The associations between polymorphisms and CAP-HFS were analyzed using logistic regression under an additive model. @*Results@#We identified a novel risk mutation (c.1A>G, chr18:657743), was associated with severe HFS in an extreme case who was affected during the first cycle of treatment. Moreover, we identified three new variants, rs3786362, rs699517, rs2790, and two previously reported variants, 5’VNTR 2R/3R and 3′-untranslated region 6-bp ins-del, which were significantly associated with CAP-HFS (p < 0.05). In silico analysis revealed that the effect of these polymorphisms in the TYMS region on the development of HFS might not be restricted solely to the regulation of TYMS expression, but also the TYMS catalytic activity through the indirect effect on ENOSF1 expression. @*Conclusion@#This study identified new polymorphisms in TYMS gene significantly associated with CAP-HFS, which may serve as useful genetic predictors for CAP-HFS and help to elucidate the underlying mechanism of HFS.

Polymorphisms in TYMS for Prediction of Capecitabine-Induced Hand-Foot Syndrome in Chinese Patients with Colorectal Cancer / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Capecitabine is an extensively used oral prodrug of 5-fluorouracil in treatment of colon cancer and is known to cause hand-foot syndrome (HFS). As the target enzyme for capecitabine, thymidylate synthase (TYMS) plays a key role for 5-fluorouracil metabolism and has been associated with some side effects caused by capecitabine. The aim of our study is to identify the possible genetic predictors of capecitabine-induced HFS (CAP-HFS) in Chinese colorectal cancer patients. @*Materials and Methods@#Whole exons of TYMS were sequenced for 288 extreme phenotype HFS patients, including 144 severe or early-onset (first 2 cycles) moderate HFS extreme cases and 144 extreme controls with no reported HFS. The associations between polymorphisms and CAP-HFS were analyzed using logistic regression under an additive model. @*Results@#We identified a novel risk mutation (c.1A>G, chr18:657743), was associated with severe HFS in an extreme case who was affected during the first cycle of treatment. Moreover, we identified three new variants, rs3786362, rs699517, rs2790, and two previously reported variants, 5’VNTR 2R/3R and 3′-untranslated region 6-bp ins-del, which were significantly associated with CAP-HFS (p < 0.05). In silico analysis revealed that the effect of these polymorphisms in the TYMS region on the development of HFS might not be restricted solely to the regulation of TYMS expression, but also the TYMS catalytic activity through the indirect effect on ENOSF1 expression. @*Conclusion@#This study identified new polymorphisms in TYMS gene significantly associated with CAP-HFS, which may serve as useful genetic predictors for CAP-HFS and help to elucidate the underlying mechanism of HFS.

Impact of Coronary Atherosclerosis on Diastolic Function in Patients With Coronary Heart Disease / 中国循环杂志

Objectives: To explore the impact of coronary atherosclerosis on diastolic function in patients with coronary heart disease. Methods: Present study included 600 patients with suspected coronary heart disease (CHD) admitted to our hospital between September 2014 to August 2017, coronary arteriography(CAG)was performed in all patients. Patients were divided into control group (n=150, CAG negative patients) , atherosclerosis group (n=150 ), and coronary heart disease group (n=300). Echocardiography, CAG, left ventriculography were measured in all patients, left ventricular diastolic function, coronary volume and pressure were compared among groups. Results: Left ventricular end-diastolic volume(LVEDV), left atrial volume index(LAVI) and left ventricular diastolic time constant (T) were significantly higher, while the ratio of early-to-late diastolic velocity (E/A) , the maximal rise velocity of left ventricular pressure (+dp/dtmax) , the maximum decrease velocity of left ventricular pressure (-dp/dtmax), the first third diastolic filling fraction (1/3 FF)and the last third of the diastolic filling fraction (p1/3 FF) were significantly reduced in the coronary atherosclerosis group and the coronary heart disease group as compared to control group (all P<0.05); left ventricular ejection fraction (LVEF) in CHD group was lower than that in control group (P<0.05); incidence of E/A<1.2 was significantly different among the 3 groups (P<0.01). Multivariate logistic regression analysis indicated that Gensini score was an independent risk factor for diastolic dysfunction(OR=1.93, 95%CI:1.31~2.68, P=0.01). The coronary artery end-diastolic volume (CEDV) , the coronary artery end-systolic volume ( CESV) , the maximum decrease velocity of coronary artery pressure (C-dp/dtmax), the maximum rise velocity of coronary artery pressure (C+dp/dtmax) were significantly decreased in the coronary sclerosis group (P<0.05) ; CEDV, CESV, C-dp/dtmax, C+dp/dtmaxwere significantly decreased in the coronary heart disease group (P<0.01) as compared with the control group. Compared with the coronary atherosclerosis group, the CEDV, CESV, C-dp/dtmax, C+dp/dtmaxwere significantly decreased in CHD group (P<0.05). CESV, C-dp/dtmax, C+dp/dtmax in the coronary sclerosis group were significantly decreased (P<0.05), CEDV, CESV, C-dp/dtmax, C+dp/dtmaxin the coronary heart disease group were significantly decreased (P<0.01).Compared with the coronary atherosclerosis group, the CEDV, CESV, C-dp/dtmax, C+dp/dtmaxwere significantly decreased in CHD group (P<0.05). Spearman correlation analysis showed that Gensini score was negatively correlated with C-dp /dtmax(r=-0.43, P<0.01). Conclusions:Diastolic dysfunction is a sensitive index of myocardial ischemia in patients with coronary heart disease. In patients with coronary atherosclerosis, cardiac diastolic dysfunction could be shown in the absence of cardiac systolic dysfunction. The severity of coronary atherosclerosis is positively related to coronary diastolic dysfunction, which may lead to decrease of coronary vascular compliance, thus induce cardiac diastolic dysfunction.

Impact of plasma homocysteinemia on contrast-induced nephropathy after percutaneous coronary intervention in patients with coronary syndrome / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the impact of plasma homocysteinemia(Hcy) on contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) patients.</p><p><b>METHODS</b>Consecutive 684 ACS patients undergoing first PCI in our department between January 2013 and December 2014 were prospectively enrolled.Patients were divided into 2 groups according to the pre-procedural plasma Hcy level: high-Hcy group (Hcy≥10 μmol/L, n=404) and control group (Hcy<10 μmol/L, n=280). The CIN was defined as serum creatinine ≥ 44.2 μmol/L or 25% increase compared to baseline within 48-72 h after PCI.The baseline clinical data and the ratio of CIN were compared between the 2 groups.Multivariate logistic regression analysis was used to define the independent risk factors for CIN.</p><p><b>RESULTS</b>CIN occurred in 133(19.4%) out of 684 enrolled patients, and the incidence of CIN was significantly higher in high Hcy group than in the control group (22.0%(89/404)vs. 15.7%(44/280), P=0.040). After adjusting the confounding factors, including age, acute myocardial infarction, co-morbidities(hypertension, diabetes mellitus, and old myocardial infarction), laboratory examination (level of cystatin C and uric acid), glomerular filtration rate, left ventricular ejection fraction, angiographic and procedural characteristics (3 diseased vessels, multiple stent implantation), treatment at admission (spironolactone, digoxin), multivariate logistic regression analysis showed that high Hcy was independently associated with the development of CIN (OR=1.70, 95%CI 1.60-2.64, P=0.021).</p><p><b>CONCLUSION</b>Elevated Hcy prior PCI is an independent risk factor of CIN in ACS patients undergoing first PCI.</p>

Effectiveness and safety of the side-branch balloon pre-imbedding technique on coronary bifurcation lesions in elderly patients / 中华老年医学杂志

Objective To study the effectiveness and safety of the side-branch (SB) balloon preimbedding technique on coronary bifurcation lesions (CBLs) in elderly patients.Methods A retrospective analysis was conducted on 111 elderly patients with CBLs in our hospital from January 2011 to January 2013,of whom 59 patients received SB balloon pre-imbedding and 52 patients received SB wire protection.The immediate blood flow of the side-branch after treatment,the performance of the stent,and major adverse cardiovascular events (MACE) during hospitalization,6 and 12 months after treatment,and coronary angiography 6 months after treatment were compared between the two groups.Results There were no statistical differences between the two groups in clinical characteristics,lesion distribution,length and diameter of MB or SB,bifurcation angle,length and number of main branch(MB) stenting,or MACE during hospitalization and 6 months after treatment (each P＞0.05).There was no statistical difference in immediate postoperative angiography between patients with thrombolysis in myocardial infarction (TIMI) grade 3,coronary stenosis more than 25％ in the MB (P＞0.05).The percentages of patients with coronary stenosis more than 50 ％ in SB and patients who needed SB stenting were lower in the balloon pre-imbedding group than in the wire protectiongroup[8.5％ (5/59) vs.23.1％ (12/52),42.4％ (25/59) vs.61.5％ (32/52),each P＜0.05].After 6 months of treatment,there was no statistical difference in coronary angiography in TIMI grade 3 of MB and coronary stenosis more than 25％ in MB between the two groups (P＞0.05)Also,the percentage of patients with TIMI grade 3 in SB was higher in the balloon pre-imbedding group than in the wire protection group (37/41 vs.24/34,P＜0.05);the percentage of patients with coronary stenosis more than 50％ in SB was lower in the balloon pre-imbedding group than in the wire protection group (3/41 vs.8/34,P＜0.05);and the degree of stenosis,the late lumen loss and the incidence of stem restenosis in SB were lower in the balloon pre-imbedding group than in the wire protection group (P＜0.01).The incidence of MACE 12 months after PCI was lower in the balloon pre-imbedding group than in the wire protection group (7/59 vs.14/52,P＜0.05).The pre-balloon imbedding group had a lower cost than the wire protection group,but with no statistical significance [(55 113±968) RMB vs.(61 023±1 311) RMB,P＞0.05].Conclusions SB balloon preimbedding is safe for the treatment of CBLs in elderly patients,and its effectiveness in both short-and long-term is better than that of wire protection.

Glucagon-like peptide-1 protects against cardiac microvascular endothelial cells injured by high glucose

Objective: To investigate the protective effect of glucagon-like peptid-1 (GLP-1) against cardiac microvascular endothelial cell (CMECs) injured by high glucose. Methods: CMECs were isolated and cultured. Superoxide assay kit and dihydroethidine (DHE) staining were used to assess oxidative stress. TUNEL staining and caspase 3 expression were used to assess the apoptosis of CMECs. H89 was used to inhibit cAMP/PKA pathway; fasudil was used to inhibit Rho/ROCK pathway. The protein expressions of Rho, ROCK were examined by Western blot analysis. Results: High glucose increased the production of ROS, the activity of NADPH, the apoptosis rate and the expression level of Rho/ROCK in CMECs, while GLP-1 decreased high glucose-induced ROS production, the NADPH activity and the apoptosis rate and the expression level of Rho/ROCK in CMECs, the difference were statistically significant (. P<0.05). Conclusions: GLP-1 could protect the cardiac microvessels against oxidative stress and apoptosis. The protective effects of GLP-1 are dependent on downstream inhibition of Rho through a cAMP/PKA-dependent manner, resulting in a subsequent decrease in the expression of NADPH oxidase.

Glucagon-like peptide-1 protects against cardiac microvascular endothelial cells injured by high glucose

OBJECTIVE@#To investigate the protective effect of glucagon-like peptid-1 (GLP-1) against cardiac microvascular endothelial cell (CMECs) injured by high glucose.@*METHODS@#CMECs were isolated and cultured. Superoxide assay kit and dihydroethidine (DHE) staining were used to assess oxidative stress. TUNEL staining and caspase 3 expression were used to assess the apoptosis of CMECs. H89 was used to inhibit cAMP/PKA pathway; fasudil was used to inhibit Rho/ROCK pathway. The protein expressions of Rho, ROCK were examined by Western blot analysis.@*RESULTS@#High glucose increased the production of ROS, the activity of NADPH, the apoptosis rate and the expression level of Rho/ROCK in CMECs, while GLP-1 decreased high glucose-induced ROS production, the NADPH activity and the apoptosis rate and the expression level of Rho/ROCK in CMECs, the difference were statistically significant (P<0.05).@*CONCLUSIONS@#GLP-1 could protect the cardiac microvessels against oxidative stress and apoptosis. The protective effects of GLP-1 are dependent on downstream inhibition of Rho through a cAMP/PKA-dependent manner, resulting in a subsequent decrease in the expression of NADPH oxidase.

Relationship between hyperhomocysteine and long-term outcome of coronary artery disease patients after drug-eluting stent implantation / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the relationship between hyperhomocysteinemia (H-Hcy) and long-term outcome of coronary artery disease (CAD) patients after drug-eluting stent (DES) implantation in a single centre.</p><p><b>METHODS</b>A total of 1 408 consecutive patients implanted with DES in our department between March 2011 and January 2013 were enrolled in this prospective study. Patients were stratified into H-Hcy (Hcy≥10 µmol/L, n=798, 56.7%) and non-H-Hcy group (Hcy<10 µmol/L, n=610, 43.3%). The clinical characteristics, coronary artery lesions, SYNTAX score and 1-year major adverse cardiac and cerebrovascular events (MACCE) were compared between the two groups.</p><p><b>RESULTS</b>Compared with non-H-Hcy group, coronary artery stenosis was severer as shown by higher diseased arteries (2.11±0.87 vs. 1.91±0.82, P<0.001), higher incidence of three diseased arteries (39.7% vs. 29.5%, P<0.001) and higher SYNTAX score (36.99±29.66 vs. 27.39±22.70, P=0.001) in H-Hcy group. The 1-year incidence of MACCE was also higher in H-Hcy group compared with non-H-Hcy group(18.4% vs. 8.9%, P<0.001). Multivariate Cox analysis showed that diabetes mellitus (OR=1.530, 95%CI 1.142-2.050, P=0.004), age (OR=1.065, 95%CI 1.038-1.093; P<0.001), and Hcy (OR=1.019, 95%CI 1.005-1.033, P=0.009) are the independent predictors for 1-year MACCE.</p><p><b>CONCLUSION</b>High Hcy level is correlated with the severity of coronary artery stenosis, and serves as an independent predictor of MACCE after stenting in CAD patients.</p>

Role of C6ORF120, an N-glycosylated protein, is implicated in apoptosis of CD4⁺ T lymphocytes / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although CD4(+) T cell apoptosis and CD8(+) T cell responses have been extensively studied during HIV infection, how apoptosis signals being initiated in CD4(+) T cells still need to be elucidated. The present study was designed to characterize the function-unknown gene, C6orf120, and elucidates its primary role in tunicamycin-induced CD4(+) T apoptosis.</p><p><b>METHODS</b>The C6orf120 coding sequence was amplified from peripheral blood mononuclear cells (PBMCs) total RNA of AIDS patients. The DNA fragment was inserted into the pET-32a expression system, transformed into Escherichia coli, and preparation of C6ORF120 recombinant protein. The magnetic cell separation technology was used to prepare primary CD4(+) T cells and CD8(+) T cells. The primary T cells were cultured at 1 × 10(6) cells/ml, treated with 0, 0.1, 1, 10, 100, and 200 ng/ml of C6orf120 recombinant protein for 48 hours, then harvested for cell cycle and apoptosis analysis. Tunicamycin (0.5 µmol/L) was used to induce endoplasmic reticulum stress in Jurkat cells. The biomarker 78 KDa glucose-regulated protein (GRp78) and growth arrest and DNA damage (GADD) were used to evaluate endoplasmic reticulum stress of Jurkat cells.</p><p><b>RESULTS</b>We prepared C6ORF120 recombinant protein and its polyclonal antibody. Immunohistochemical analysis showed that C6orf120 mainly expressed in hepatocytes and cells in germinal center of lymph node. At concentration of 0.1, 1, 10, 100, and 200 ng/ml, C6orf120 recombinant protein could induce apoptosis of Jurkat cells and primary CD4(+) T cells, and promoting G2 phase of its cell cycle. Western blotting analysis showed that C6ORF120 recombinant protein increased the expression of GRp78 and GADD in Jurkat cells in vitro.</p><p><b>CONCLUSION</b>Our results suggested that C6ORF120 could induce apoptosis of CD4(+) T cells, at least in part, mediated with endoplasmic reticulum stress.</p>

Long-term outcome of urethral reconstruction using colonic mucosa graft for the treatment of longsegment, complex urethral strictures / 中华泌尿外科杂志

ObjectiveTo investigate the long-term outcome of urethral reconstruction using colonic mucosa grafts for the treatment of long-segment,complex urethral strictures and to identify clinical factors that impact long-term outcomes. MethodsForty-six patients underwent colonic mucosal graft urethroplasty from October 2000 to September 2009 were retrospectively reviewed.The mean age was 39 years ( range,17 -70).The patients underwent an average of 2.7 prior unsuccessful repairs and the mean length of urethral strictures was 15.2 cm (range,10.0 to 20.0).The voiding status of all patients was evaluated postoperatively.Some of the paitents underwent uroflowmetry.urethrography and urethroscopy.Successful repair was defined as voiding well with urinary peak flow greater than 15 ml/s without the need for any post-operative procedures,such as dilatation. ResultsUrethral reconstruction was done with colonic mucosa grafts 11.0 -21.0 cm long (mean 15.4).One patient was lost to follow-up.Mean follow-up in the remaining cases was 62 months ( range 20 - 120 ).Complications related to urethroplasty developed in four patients (8.9％).Of these patients,meatal stenosis developed in three patients at 3,8 and 24 months respectively.Anastomotic site stricture occurred at the neourethra and proximal urethra in one patient at 29 months.In another two patients,recurrent strictures unrelated to urethroplasty were found. ConclusionsColonic mucosa graft urethroplasty could be an effective technique for the treatment of complex urethral strictures or panurethral strictures.The factors that impact long-term outcomes are meatal stenosis and stenosis at the anastomosis.

Serous-lined tunnel technique in urinary reconstruction / 中华泌尿外科杂志

Objective To examine the feasibility of using the serous-lined tunnel technique for orthotopic neobladder, continent cutaneous diversion and ureteral replacement by the intestinal segment. Methods In 31 patients of orthotopic ileal neobladder, the serous-lined tunnel techniques were used for antirefluxing ureteral implantation: In 13 patients of continent ileal pouch, the techniques were adopted for continent-valve construction and for uretersl implantation: In 3 patients (with lower ureteric cancer), the same techniques were applied for constructing the ileal ureters with a proximal antirefluxing mechanism. Results With a mean follow-up of 27 mon( 12-132 mon), 88 ureters implanted into ileal neobladders or continent pouches functioned well with neither obstruction nor reflux: 12 in 13 continent valves functioned well with no incontinence. 3 patients with ileal ureters showed no ileo-ureteric reflux and had reduced hydronephrosis comparing to that of before surgery.Conclusions Ureteral reimplantation and continent valve formation achieved by adopting the serouslined tunnel technique provide satisfactory results. The versatility of the technique is obvious in the present experience and the creative application of the serous-lined tunnel technique should be possible in urinary reconstruction.

Immunogenicity of DNA vaccines encoding structural proteins and regulatory/accessory proteins derived from an HIV-1 CRF01_AE isolate circulating in China / 中华微生物学和免疫学杂志

Objective To construct two DNA vaccines encoding Gag-Env fusion protein and Tat-Rev-Integrase(C-half)-Vif-Nef fusion protein derived from the first HIV-1 CRF01_AE isolate(AE2f) in Chi-na and to evaluate the immunogenicity in mice. Methods Two DNA vaccines were constructed by inserting the codon optimized and synthesized gag-env fusion gene and tat-rev-integrase(c-half)-vif-nef fusion gene de-rived from AE2f into mammalian expression vector pDRVISV1. 0, the generated DNA vaccines were desig-nated as pSVAE/GE and pSVAE/TRIVN, respectively, and their in vitro expression were determined by Western blot with transfected 293T cells. Mice were i. m. immunized with either pDRVI1.0 as mock control, pSVAE/GE or pSYAE/TRIVN for 4 times at two-week interval. Two weeks following the final im-munization, cellular responses to pool of HIV-1 Env, Gag, Tat, Rev, Intergrase, Vif and Nef peptides were evaluated by ELISPOT assay. Results The construction of DNA vaccine pSVAE/GE and pSVAE/TRIVN was validated by restriction enzyme digestion and bidirectional sequencing. Western blot showed a specific band at molecular mass 220×10~3 in lane of pSVAE/GE transfeeted 293T cell and a specific band at 95×10~3 in the lane of pSVAE/TRIVN. Both DNA vaccines mounted significant specific T cell responses with (3010 ± 566) SFC/10~6 splenocytes for DNA vaccine pSV AE/GE and (948 ± 737) SFC/10~6 spleno-cytes for DNA vaccine pSVAE/TRIVN, whereas the mock control of pDRVISV1.0 only raised marginal T cell responses. Conclusion Both pSVAE/GE and pSVAE/TRIVN were capable of expressing the inserted fusion immunogen genes and able to elicit vigorous cellular immune responses, therefore, these DNA vac-cines are highly immunogenic.

Diagnosis and management of prostatic ductal adenocarcinoma / 中华泌尿外科杂志

Objective To discuss the pathological and clinical features, diagnosis and treatment of prostatic duct adenocareinoma. Methods The clinical data of nine cases of prostatic duct adeno-carcinoma were retrospectively analyzed, with the average age of 76 (59-106) years. Six cases were presented with dysuresia and/or nocturia, and two of them had the painless gross hematuria. Two pa-tients presented painless gross hematuria as the first symptom. One case was detected the elevated ser-um PSA in a routine healthy examination. Radical prostatectomy (RP) was performed in 1 case;RP and bilateral orchidectomy and external beam radiotherapy (EBRT) were performed in 1 case;5 cases underwent transurethral resection of the prostate (TURP) combined with photoselective vaporization of the prostate (PVP) by green laser and bilateral orchidectomy;1 case underwent TURP combined with PVP;1 case underwent bilateral orchidectomy combined with EBRT. Eight cases took flutamide for 3-45 months. All patients were followed-up according to the scheduled time. Results The op-erations were successfully performed in all 9 patients. The papillary or cauliflower-like tumors infiltra-ted colli culus seminalis and prostate duct nearby. The glands were coated with tall pseudostratified columnar cells. The nuclei were large, dark stained with more frequent mitoses. The positive rates of immunolabelling antibody PSA, AR, PAP were found to be 89%(8/9), 100%(5/5), 100%(5/5) re-spectively. The distribution of Gleason score was 6-7(3 cases), and≥8(6 cases), and a coexisting acinar carcinoma component was identified in 5 cases of the group. Nine cases had a mean follow up for 20(3-48) months. Five cases have developed biochemical recurrence, of whom 3 died of bone metas-tasis and multiple organ failure, and 1 developed lung and bone metastasis. Three cases remained alive without recurrence. The remaining 1 case survives during the follow-up survey for 6 months until now, without examinations due to the old age. Conclusions Duct adenocarcinoma of the prostate presents the low incidence and lacks of typical symptoms in the early stage. Diagnosis was confirmed mainly on the basis of pathology. The tumors tend to have a more advanced stage and a very short term survival rate. The treatment options and management are similar to that of high-grade adenocar-cinoma of the prostate;meanwhile, close follow-up survey should be performed.

Diagnosis and treatment of posterior urethral stricture: twenty-year clinical experience / 中华泌尿外科杂志

tionale and effective surgical approach, and technique.

Expression of Omi/HtrA2 UP-regulated in the spermatozoa of chronic bacterial prostatitis patients / 中华男科学杂志

<p><b>OBJECTIVE</b>To determine the expression of Omi/HtrA2 in the spermatozoa of chronic bacterial prostatitis patients and explore the potential mechanism of chronic prostatitis inducing male infertility.</p><p><b>METHODS</b>Forty-one patients diagnosed as suffering from chronic prostatitis were included, and so were 12 healthy normal men as controls. Spermatozoa in the semen were purified by Percoll gradient technique to separate the seminal plasma and other round cells. Sperm concentration, motility, morphology, pro-inflammatory cytokines, Omi/HtrA2 mRNA and protein levels in the spermatozoa of the patients were measured.</p><p><b>RESULTS</b>Significantly increased levels of pro-inflammatory cytokines were observed in the seminal plasma of the prostatitis patients, and so were Omi/HtrA2 mRNA and protein levels as compared with the normal men.</p><p><b>CONCLUSION</b>Chronic prostatitis patients presented important alterations in semen quality parameters and up-regulated expression of Omi/HtrA2 mRNA and proteins in the spermatozoa.</p>

Analysis of expressed sequence tags (EST) from Panax quinquefolium root / 药学学报

To investigate the profile of gene expression in American ginseng (Panax quinquefolium L.) and discover its functional genes, for the first time, expressed sequence tags (EST) library of four-year-old American ginseng roots has been established. According to BLAST and Gene Ontology analysis, eleven genes, encoding cytochrome P450, glucosyltransferase, farnesyltransferase and cyclase family protein, are found to be associated with ginsenosides biosynthesis. Six other genes are obtained encoding auxin-regulated protein, auxin response factor 4 and auxin-repressed protein in the roots of American ginseng. In addition, thirteen expressed transcripts are stress-connected proteins and twelve expressed other transcripts are closely related to plant defense in four-year-old American ginseng roots. Furthermore, 62 genes no hit in BLAST and in Interproscan may be new genes. These results indicate EST is an useful tool for research on functional genomics of P. quinquefolium and it can be applied to the molecular modification of the ginsenosides biosynthetic pathway ultimately for improving the quality of American ginseng germplasm.

Clinical analysis of operative treatment of 191 patients with posterior urethral strictures / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the various operative details of strictures of the posterior urethra that are essential for a successful result.</p><p><b>METHODS</b>The clinical data of 191 patients with posterior urethral strictures or distraction defects from January 1990 to January 2006 were analyzed retrospectively. All patients underwent a retrograde and voiding urethrogram, 62 patients had urethral ultrasonography, 48 patients had urethroscopy, 3 patients had MRI. Repair was performed with a simple anastomosis after urethral mobilization in 66 patients, separation of the corporeal bodies in 48 patients, separation of the corporeal bodies and inferior pubectomy in 30 patients, transpubic anastomosis in 18 patients, pull-through operation in 3 patients, and optical urethrotomy in 26 patients. Followup ranged from 6 to 48 months.</p><p><b>RESULTS</b>The mean stricture length was 3.6 cm (range from 1.5 to 8.0 cm). Posterior urethral strictures is in 31 (16%), posterior distraction defects is in 160 (84%), of which the length of the distraction defects < 3 cm is in 102 (53.4%), and the the length of the distraction defects > 3 cm is in 58 (30.6%). The overall successful results (Qmax > 15 ml/s) after operation was 84.3%. Optical urethrotomy was 69%, the successful results with anastomotic urethroplasty were 97% with a simple anastomosis; 79% with separation of the corporeal bodies; 80% with separation of the corporeal bodies and inferior pubectomy; 83% with transpubic anastomosis; and 67% with pull-through operation.</p><p><b>CONCLUSIONS</b>The anastomotic urethroplasty is better than the optical urethrotomy, the length of the strictures or distraction defect which is lower than 3 cm is much more successfully corrected.</p>

The treatment of complex urethral stricture greater than 8 cm long / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the selection of different procedures and the feasibility for the treatment of long segment urethral stricture.</p><p><b>METHODS</b>Seventy-six patients with complex urethral stricture greater than 8 cm long underwent different procedures of urethroplasty. Of them various mucosa grafts urethral reconstruction were adopted in 42 cases (colonic mucosal graft, n = 26; buccal mucosal graft, n = 10; bladder mucosal graft, n = 6); One-stage pedicle flaps urethroplasty in 20; two-stage urethroplasty of Johanson procedure in 12; and penile urethra-prostatic urethra anastomosis, three-stage urethroplasty in 2.</p><p><b>RESULTS</b>In early followed up (within 6 months postoperatively), 67 patients (88%) voided well and complications developed in 10. Among the 70 patients who lasted more than 1 year after operation, 51 cases were followed up. Forty-four patients voided well, and complications developed in 8. Of the 8 cases urethral restructure developed in 2 (18%) for pedicle flaps urethroplasty, 2 for colonic mucosal urethroplasty (9%), 1 for buccal mucosal graft (1/7), 1 for bladder mucosal graft (1/3); penile chordee in 2 (2/5), and one of them was accompanied by hair bearing neourethra for two-stage urethroplasty of Johanson procedure.</p><p><b>CONCLUSIONS</b>Colonic mucosal and buccal mucosal grafts urethroplasty are feasible procedures for the treatment of long segment urethral stricture, and Colonic mucosal graft urethroplasty may be considered when more conventional procedures fail or complicated urethral strictures greater than 10 cm long.</p>

Adrenal myelolipoma:clinical diagnosis and management of 26 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the diagnosis and management of adrenal myelolipoma.</p><p><b>METHODS</b>The clinical data of 26 cases were analyzed retrospectively and the selected articles were reviewed. There were no specific clinical symptom and endocrine abnormality, except increasing catecholamine in 2 cases. All cases but two were diagnosed by B-model ultrasound scanning (B-US), CT or magnetic resonance imaging (MRI).</p><p><b>RESULTS</b>Twenty-six cases were surgically treated, the diameter of the tumor was 5 - 10 cm, simple tumor resection was performed in 16 cases, and complete adrenal resection was performed in 10 cases. All the operated cases were proved by pathologists. The duration of follow-up was from 6 - 28 months after surgery. No recurrence was observed.</p><p><b>CONCLUSIONS</b>The diagnosis of adrenal myelolipoma could be established based on B-US, CT or MRI. The tumors whose diameter is larger than 5 cm in size should be removed.</p>

Clinical application of mastoscopic axillary sentinel lymph node biopsy / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the technique and significance of mastoscopic axillary sentinel lymph node biopsy.</p><p><b>METHODS</b>Sixty-two patients with breast cancer use methylene blue to test axillary sentinel lymph node. Sentinel lymph node was moved with endoscopy, and endoscopic axillary lymph nod dissection was performed. Pathological examination of sentinel lymph node and axillary lymph node was made with HE. To evaluate detection rate and false negative rate in sentinel lymph node.</p><p><b>RESULTS</b>Among the 62 patients, 61 were confirmed by endoscopic axillary sentinel lymph nod biopsy. Detection rate was 98.4%. Thirty-five cases were no metastasis, 27 cases were metastasis, false negative rate was 0.</p><p><b>CONCLUSIONS</b>Mastoscopic axillary sentinel lymph node biopsy has a high detection rate, good efficiency of cosmetic and lower complications. It has higher sensitivity than traditional axillary lymph nod dissection and provide accurate lymph node stages.</p>