Progressive pre-disconnection of urethral mucosal flap during transurethral plasmakinetic enucleation of prostate improves postoperative urinary continence / 浙江大学学报·医学版

OBJECTIVES@#To investigate the effect of progressive pre-disconnection of urethral mucosal flap during transurethral plasmakinetic enucleation of prostate (TUPEP) on early recovery of urinary continence.@*METHODS@#Clinical data of patients with benign prostatic hyperplasia (BPH) admitted in Zhujiang Hospital of Southern Medical University during February and May 2022 were collected. All the patients underwent TUPEP, and the progressive pre-disconnection of urethral mucosal flap was performed in the procedure. The total operation time, enucleation time, postoperative bladder irrigation time and catheter indwelling time were recorded. Urinary continence was evaluated 24 h, 1 week, and 1, 3, 6 months after the removal of urinary catheter.@*RESULTS@#All surgeries were successfully completed at one time with less intraoperative bleeding, and there were no complications such as rectal injury, bladder injury or perforation of prostate capsule. The total operation time was (62.2±6.5) min, the enucleation time was (42.8±5.2) min, the postoperative hemoglobin decrease by (9.5±4.5) g/L, the postoperative bladder irrigation time was (7.9±1.4) h, and the postoperative catheter indwelling time was 10.0 (9.2, 11.4) h. Only 2 patients (3.6%) had transient urinary incontinence within 24 h after catheter removal. No urinary incontinence occurred at 1 week, and 1, 3, 6 months after operation, and no safety pad was needed. The Qmax at 1 month after operation was 22.3 (20.6, 24.4) mL/s, international prostate symptom scores were 8.0 (7.0, 9.0), 5.0 (4.0, 6.0) and 4.0 (3.0, 4.0) at 1, 3 and 6 months after surgery, and quality of life scores at 1, 3 and 6 months after surgery were 3.0 (2.0, 3.0), 2.0 (1.0, 2.0) and 1.0 (1.0, 2.0), all of these indicators were better than those before surgery (all P<0.01).@*CONCLUSIONS@#In the treatment of BPH, the application of progressive pre-disconnection of urethral mucosal flap in TUPEP can completely remove the hyperplastic glands and promote early recovery of postoperative urinary continence with less perioperative bleeding and decreased surgical complications.

Relationship between blood transfusion factors and early postoperative outcomes in patients undergoing orthotopic liver transplantation / 中华麻醉学杂志

Objective:To evaluate the relationship between blood transfusion factors (massive transfusion, transfusion of stored red blood cells and anhepatic transfusion) and early postoperative outcomes in the patients undergoing orthotopic liver transplantation.Methods:Patients with end-stage liver disease who underwent orthotopic liver transplantation and intraoperative blood transfusion from January 2021 to March 2022 in our hospital were retrospectively selected, and their clinical data were collected. The patients were divided into massive transfusion group (M group, total red blood cell transfusion ≥10 U) and non-massive transfusion group (NM group) according to the amount of intraoperative blood transfused. The patients were divided into fresh blood group (NS group) and stored blood group (S group, red blood cell storage time > 2 weeks) according to the storage time of red blood cells transfused. The patients were divided into transfusion in anhepatic stage group (group T) and nontransfusion in anhepatic stage group (group NT) according to whether blood was transfused in the anhepatic stage. Multivariate logistic regression, generalized linear model and generalized linear mixed model were used to analyze the relationship between blood transfusion factors and primary outcome measures (postoperative pulmonary complications, circulation overload, acute kidney injury, abdominal infection, thrombosis) and between blood transfusion factors and secondary outcome measures (duration of ICU stay, postoperative hospitalization, postoperative temperature ≥38.5 ℃ at any time point after surgery, postoperative liver and kidney function index, coagulation function index, platelet count and preoperative difference).Results:One hundred and six patients were enrolled in this study. The results of multivariate logistic regression analysis: Massive blood transfusion and infusion of stored blood were risk factors for postoperative pulmonary complications, massive blood transfusion was a risk factor for abdominal infection, Child-Turcotte-Pugh score for liver function and time of anhepatic phase were risk factors for postoperative acute kidney injury, Child-Turcotte-Pugh score was a risk factor for circulatory overload, and age and massive blood transfusion were risk factors for thrombosis ( P<0.05). The results of generalized linear model analysis: Intraoperative stored blood transfusion and blood transfusion during the anhepatic phase were risk factors for prolonged duration of ICU stay, massive blood transfusion, intraoperative stored blood transfusion and blood transfusion during the anhepatic phase were risk factors for prolonged hospitalization ( P<0.05), and there was no correlation between massive blood transfusion, intraoperative stored blood transfusion and blood transfusion during the anhepatic phase and temperature ≥38.5 ℃ at any time point after surgery ( P>0.05). The results of generalized linear mixed model analysis: There was statistically significant difference in the difference between preoperative and postoperative liver and kidney function indexes, coagulation function indexes and platelet counts in the patients with or without massive transfusion, stored blood transfusion or blood transfusion during the anhepatic phase ( P<0.05). Conclusions:Massive blood transfusion and infusion of stored blood are the main risk factors for early adverse outcomes after orthotopic liver transplantation in the patients.

Metabolic engineering of Escherichia coli for production of hydroxytyrosol / 生物工程学报

Hydroxytyrosol is an important fine chemical and is widely used in food and medicine as a natural antioxidant. Production of hydroxytyrosol through synthetic biology is of important significance. Here we cloned and functionally characterized a hydroxylase encoding gene HpaBC from Escherichia coli BL21, and both subunits of this enzyme can be successfully expressed to convert the tyrosol into hydroxytyrosol. A HpaBC gene integration expression cassette under the tac promoter was constructed, and integrated into the genome of a tyrosol hyper-producing E. coli YMG5A*R using CRISPR-Cas9 technology. Meanwhile, the pathway for production of acetic acid was deleted, resulting in a recombinant strain YMGRD1H1. Shake flask fermentation showed that strain YMGRD1H1 can directly use glucose to produce hydroxytyrosol, reaching a titer of 1.81 g/L, and nearly no by-products were detected. A titer of 2.95 g/L was achieved in a fed-batch fermentation conducted in a 5 L fermenter, which is the highest titer for the de novo synthesis of hydroxytyrosol from glucose reported to date. Production of hydroxytyrosol by engineered E. coli lays a foundation for further construction of hydroxytyrosol cell factories with industrial application potential, adding another example for microbial manufacturing of aromatic compounds.

Diagnostic value of 4-dimensional computed tomography in preoperative localization in patients with primary hyperparathyroidism / 中华内科杂志

Objective:To provide more options for preoperative localization diagnosis in patients with primary hyperparathyroidism (PHPT), the diagnostic efficacy of parathyroid 4-dimensional computed tomography (4D-CT) in patients with PHPT was evaluated.Methods:This was a single-center retrospective study including 57 patients with surgical proved PHPT. All of the patients underwent 4D-CT, 99Tc m -sestamibi parathyroid imaging (MIBI), and ultrasonography (US) preoperatively. The reference standard for correct localization was based on operation reports and pathology confirmation. The patients were grouped according to the preoperative serum calcium levels, tumor diameter, or ectopic lesions (yes/no), respectively. The sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) of 4D-CT, MIBI and US, alone or in combination, were analyzed in total and each subgroup patients. Results:Fifty-seven patients (39 women, 18 men; mean age of 56.5 years) were evaluated, including four cases with multi-gland disease and thirteen cases with ectopic parathyroid lesions. In all the patients, similar diagnostic efficacy was found in 4D-CT (AUC: 0.943) and MIBI (AUC: 0.927), both of which were higher than that of US (AUC: 0.847) ( P = 0.01 for 4D-CT vs. US; P = 0.04 for MIBI vs. US). In a subset analysis for ectopic quadrants, the diagnostic efficacy of 4D-CT was significantly higher than that of MIBI ( P = 0.04) or US ( P = 0.01), with the sensitivity of 100%, 69.2%, and 61.5%, and AUC of 0.989, 0.846, and 0.808 for 4D-CT, MIBI and US, respectively. Conclusions:4D-CT has similar diagnostic efficacy for preoperative localization to MIBI in patients with PHPT, and it is superior to MIBI and US in identifying the ectopic parathyroid gland. 4D-CT can be recommended as an alternative preoperative localization method, especially when parathyroid lesions could not be precisely located by US and MIBI.

A case report of transperineal ultrasound-guided transperineal prostate biopsy to diagnose an abdominoperineal resection patient / 中华泌尿外科杂志

Prostate biopsy is the gold standard for the diagnosis of prostate cancer. Currently, both conventional transrectal and transperineal prostatic puncture is guided by rectal ultrasound, but it cannot be performed in patients with abdominoperineal resection. We treated one suspected prostate cancer patient with abdominoperineal resection and successfully performed transperineal ultrasound-guided transperineal prostate biopsy.

Disposable versus reusable flexible ureteroscopes for treatment of upper urinary stones: a multicenter prospective randomized study / 中华泌尿外科杂志

Objective:To compare the performance and surgical outcomes of disposable digital flexible ureteroscope with a reusable fiberoptic flexible ureteroscope in treatment of upper urinary stones.Methods:A prospective, multicenter, single-blind and randomized controlled study was performed from April 2018 to December 2018. Eligible patients were randomized, in a ratio of 1∶1, to either experimental group or control group. The inclusion criteria for the study were: aged 18-60 years, solitary upper urinary stone or multiple stones with stone size less than 2 cm, absence of urinary tract infection (UTI) or UTI was controlled, normal liver and renal function. Exclusion criteria included: patients with congenital anomalies, calyceal diverticular stone, IP angle less than 30°, renal insufficiency. pregnancy or lactation, cardiopulmonary function abnormality and coagulation abnormalities. Patients in experimental group received ureteroscopy through a disposable digital flexible ureteroscope (PU3022A, PUSEN), while patients in control group received ureteroscopy through a reusable fiberoptic flexible ureteroscope (Flex-X2, STORZ). The primary endpoint was the high-quality rate of images during the operation. The secondary endpoints included success rate of fragmentation and postoperative complication rates.Results:93 patients were recruited, and 90 of them were finally complete the study (i.e., 45 patients in each group). The demographic and preoperative parameters were comparable between the two groups except the stone size in patients with solitary stone. The high-quality rate of images was significantly higher in experiment group than that in control group (100.0% vs. 15.6%, P<0.001). There were no significant differences in terms of success rate of fragmentation(68.9% vs. 71.1%, P=0.818), hemoglobin dropped (3.91 g/L vs. 3.62 g/L, P=0.880), serum creatinine changed, and postoperative complication rates(6.7% vs.6.7%, P=1.000). Conclusions:Disposable digital flexible ureteroscope achieves similar surgical outcomes to the reusable fiberoptic flexible ureteroscope with a better quality of endoscopic images.

Prevalence characters of peripheral artery disease and associated factors among Beijing residents aged equal and above 35 years old / 中华心血管病杂志

Objective@#To investigate the prevalence characters of peripheral artery disease (PAD) and associated factors among people aged 35 and above in Beijing.@*Methods@#This was a cross-sectional study. A total of 5 208 community-based individuals aged equal and above 35 in Beijing were chosen with stratified multistage random sampling method. Structure questionnaire was used to collected the information of demographic factors, habits and chronic disease history. Ankle brachial blood pressure was detected and ankle brachial index (ABI) was calculated. ABI was used to diagnose PAD (ABI≤0.90). Based on the 2010 Beijing Municipal Population Census, the age-and gender-specific weight-adjusted sample was acquired to estimate the prevalence of PAD and corresponding 95% confidence intervals (CI). Multivariate logistic regression analysis was performed to estimate the associated factors of PAD.@*Results@#The age-and sex-standardized prevalence of PAD was 3.84% (200/5 208, 95%CI 3.32%-4.36%). There was no significant difference between male and female (3.83%(102/2 664, 95%CI 3.10%-4.56%) vs. 3.85% (98/2 544, 95%CI 3.10%-4.60%), P=0.965). The prevalence of PAD in urban was higher than that in rural (4.34% (163/3 755, 95%CI 3.69%-4.99%) vs. 2.55% (37/1 453, 95%CI 1.74%-3.36%), P=0.001). Furthermore, the prevalence of PAD increased with age (Ptrend<0.01), and the difference between genders did not change with ageing (all P>0.05). In addition, age (OR=1.03, 95%CI 1.01-1.04), urban (OR=1.52, 95%CI 1.08-2.12), smoking (OR=1.83, 95%CI 1.29-2.59), hypertension (OR=1.61, 95%CI 1.17-2.22) and diabetes (OR=1.44, 95%CI 1.08-1.93) were related with increased risk of PAD in logistic regression analysis models.@*Conclusions@#The prevalence of PAD increases with age in Beijing and there are significant difference between urban and rural on prevalence of PAD. Age, urban, smoking, hypertension and diabetes are related with increased risk of PAD.

Correlation of clinical features and different clinical stages with body mass index in patients of prostate cancer / 中华泌尿外科杂志

Objective To retrospectively analyze the different clinical stages of patients with prostate cancer,and to investigate it's correlation with body mass index (BMI).Methods 363 patients with prostate cancer were enrolled from January 2008 to December 2016.There were 141 cases of stage Ⅱ,Ⅲ in 20 cases,202 cases of stage Ⅳ.According to the stratification of BMI (emaciation group,normal group,overweight group,obesity group),clinical data of different groups of prostate cancer patients were compared to analyze there correlation with BMI.Results Patient's age,pre-PSA concentration,Gleason scores and PSA density were significantly correlated with clinical stage (P ＜ 0.05).Prostate volume and weight had no significant correlation with staging.There was a significant correlation between different strata of BMI and clinical stage (P ＜ 0.05).Conclusion The different strata of BMI are closely related to the clinical stage.The higher BMI,the higher risk of the prostate cancer.

Thoughts and exploration on course construction of critical care medical / 中华医学教育探索杂志

At present,there are still many problems in critical care medicine education and teaching,such as imperfect theoretical system,inconsistent teaching materials,uneven teaching staff,lack of practice opportunities and places.The development of intensive care medical teaching should be combined with "organ-system-centered" teaching reform,strengthen the construction of the theoretical system,drive the development of teaching staff,build high-quality practice bases,promote the curriculum to be more specialized,optimized and standardized,so as to promote the development of the subject.

Is cryosurgery a feasible local therapy for bone metastatic prostate cancer?

<p><b>INTRODUCTION</b>This study aims to assess whether cryosurgery is a feasible local therapy for bone metastatic prostate cancer (bmPCa).</p><p><b>METHODS</b>A total of 23 patients with bmPCa who received cryosurgery and adjuvant androgen deprivation therapy (ADT) were included in the cryosurgery group (Group 1). Another 23 matched patients who received only ADT served as the control (Group 2). Prostate-specific antigen (PSA) nadir level, time to PSA nadir, time to castration-resistant prostate cancer (CRPC), progression-free survival and therapy response of bone metastases were compared between the groups.</p><p><b>RESULTS</b>The median follow-up time in Group 1 and Group 2 patients was 37 (range 19-53) months and 42 (range 24-56) months, respectively. Patients in Group 1 had fewer local complications, lower PSA nadir level (0.23 ng/mL vs. 4.01 ng/mL; p = 0.024), shorter median time to PSA nadir (3 months vs. 7 months; p < 0.001), longer median time to CRPC (36 months vs. 27 months; p = 0.002) and longer progression-free survival (35 months vs. 26 months; p = 0.003) compared to those in Group 2. Therapy responses of bone metastases were similar in the two treatment groups (p = 0.689).</p><p><b>CONCLUSION</b>Cryosurgery is a feasible local therapy for bmPCa patients with prostate volume less than 50 mL and without bulk tumours outside the prostate capsula. Cryosurgery may decrease PSA nadir level, local complications and time to PSA nadir, delay time to CRPC and improve progression-free survival.</p>

Effect of stroke duration on the cognitive function in the elderly population / 中国脑血管病杂志

Objective To analyze the effect of stroke duration on the cognitive function in the elderly population in Beijing.Methods Based on the Research Project of Beijing Chronic Disease Combined with Common Elderly Syndrome Community Management Practices,a cross-sectional study was used.From July 2013 to December 2014,the old population in 4 districts and a county (Xicheng District,Fangshan District,Tongzhou District and Yanqing County) in Beijing were sampled with the multi-stage,randomized and stratified sampling.A total of 3 024 subjects were enrolled in the study.The data were obtained from the questionnaires and clinical examinations.Mini-Mental State Examination (MMSE) was used as the evaluation index of cognitive function.The subjects were divided into either a normal cognitive function group (MMSE>26,n=1 878) or a cognitive impairment group (MMSE≤26,n=1 146) according to the MMSE scores.A multiple logistic regression model was used to analyze the effects of hemorrhagic stroke,ischemic stroke,and asymptomatic stroke,as well as disease duration on cognitive function.Results After adjusting for the confounding factors,such as sex,age,educational level,marriage,smoking,and alcohol consumption,the risks of occurring cognitive impairment in patients with hemorrhagic stroke in stroke duration for 1-3,4-10 and >10 years were OR 3.019 (95％CI 0.974-9.361,P=0.056),8.652 (95％CI 2.924-25.601,P10 years were 1.000 (95％CI 0.636-1.571,P=1.000),1.874 (95％CI 1.231-2.853,P=0.003),2.439 (95％CI 1.386-4.291,P=0.002) times of those without occurring stroke population.Stroke duration for 4-10 years in patients with hemorrhagic stroke and stroke duration for 4-10 and >10 years in patients with ischemic stroke were all the risk factors for occurring cognitive dysfunction.Conclusion For patients with stroke,stroke duration or long-term effects has a certain impact on cognitive function.

HSYA inhibits angiogenesis of H 22 transplanted tumor tissue and down-regulation of MMP-3 expression in mice / 基础医学与临床

Objective To investigate the inhibitory effect of hydroxy safflor yellow A ( HSYA ) on angiogenesis of H22 tumor-bearing mice and it's effects on the protein expression of MMP-3 .Methods After establishing the hep-atoma model for 24 h, the mice were randomly divided into control group , sorafenib group and HSYA group , the dose HSYA group received intraperitoneal injection at different dosages (1.125 and 2.25 mg/kg).The pathologi-cal changes were examined with HE staining , immunohistochemical staining and Western blot were applied to meas-ure the expression of angiogenesis related factor ( MMP-3 ) and we also detected the microvessel density with CD 34 . Results Compared with control group , the tumor cells proliferation and the new angiogenesis in HSYA group were suppressed .The expression of MMP-3 in HSYA group was significant reduced .Especially the dose of 2.25 mg/kg HSYA group ( P<0.01 ) , and tumor MVD-CD34 was also significantly reduced ( P<0.01 ) .But the effect is not better than sorafenib group .Conclusions HSYA may inhibit angiogenesis of tumor tissue in a certain concentration range and the anti-angiogenesis effect of HSYA may be related to inhibition of the protein expression of matrix met-alloproteinase-3 .

Protective effect of Pd-Ia on LPS-induced mouse acute lung injury and its mechanism / 中国药理学通报

Aim To explore the protective effects of dl-praeruptorin ( Pd-Ia) against acute lung injury induced by lipopolysaccharide ( LPS ) .Methods Acute lung injury model was induced by intranasal instillation LPS, and Pd-Ia was administered by intraperitoneal in-jection after 1 h of LPS exposure .Lung tissue samples were collected after 24 h of LPS administration to in-vestigate the role of Pd-Ia in acute lung injury .Results Pathomorpholoy showed a marked improvement of in-flammatory cell infiltration in Pd-Ia treated group , cel-lular staining also indicated a marked decrease of in-flammatory cells in BALF, and quantitative PCR and ELISA revealed a significant inhibition of cytokine IL-6,TNF-α, IL-1β, and chemokine MIP-1α, MIP-2 ex-pression .Pd-Ia attenuated LPS-induced histological se-verities and TNF-α, IL-6, IL-1β,MIP-1αand MIP-2 production .Conclusion Pd-Ia can alleviate the lung injury by ameliorating inflammation in lung .

Effect of stable DNA methyltransferase 3bknockdown on proliferation and apoptosis in bladder cancer cells in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of stable knockdown of DNA methyltransferase 3b (DNMT3b) on the proliferation and apoptosis of bladder cancer cells.</p><p><b>METHODS</b>Lentivirus expressing DNMT3b siRNA or the negative control siRNA was infected in human bladder cancer BIU-87 cells. MTT assay and flow cytometry were used to detect cell proliferation and apoptosis, respectively. The inhibitory effect of DNMT3b knockdown on xenograft tumors in nude mice was observed. Real-time PCR and Western blotting were carried out to investigate the expression level of cell apoptosis related genes. Methylation specific PCR was used to examine the methylation in the promoter region of the cell apoptosis related genes.</p><p><b>RESULTS</b>The results of real-time PCR and Western blotting showed that DNMT3b mRNA and protein level were stably knocked down in BIU-87 cells. Stable DNMT3b knockdown suppressed BIU-87 cell growth and the tumor formation ability of the cells in nude mice. DNMT3b knockdown promoted the apoptosis of BIU-87 cells, increased the mRNA and protein expression of the cell growth and apoptosis related genes including DAPK, Bax and RASSF1A, and significantly decreased the methylation of these genes.</p><p><b>CONCLUSION</b>Stable DNMT3b knockdown can affect the methylation of the cell growth and apoptosis related genes to regulate their expression, which might be a possible mechanism for suppressed cell growth and enhanced apoptosis of BIU-87 cells.</p>

In vivo biocompatibility of whole-kidney acellular matrix scaffolds prepared by perfusion method / 中国组织工程研究

BACKGROUND:The whole-kidney acelular matrix scaffold in rats prepared by perfusion method is proved to have goodin vitro biocompatibility, butin vivo biocompatibility is stil unclear. OBJECTIVE:To produce a whole-kidney acelular matrix scaffold in rats by perfusion method and to evaluate the in vivo biocompatibility of the scaffold. METHODS:The whole-kidney acelular matrix scaffold in Wistar rats was prepared by perfusion method and evaluated with the folowing tests. (1) Acute toxicity test: mice were subject to intraperitoneal injection of whole-kidney acelular matrix scaffold extract liquid, normal saline and phenol. (2) Hemolytic test: Anticoagulant blood samples from New Zealand rabbits were mixed with whole-kidney acelular matrix scaffold extract liquid, normal saline and distiled water, respectively. (3) Pyrogen test: Whole-kidney acelular matrix scaffold extract liquid was injected into the ear vein of New Zealand rabbits. (4) Intracutaneous stimulation test: Whole-kidney acelular matrix scaffold extract liquid was injected subcutaneously into New Zealand rabbits for observing whether there was a skin stimulus response. (5) Subcutaneous implantation test: The whole-kidney acelular matrix scaffold was implanted subcutaneously into the back of New Zealand rabbits. RESULTS AND CONCLUSION:There was no cel residual in the whole-kidney acelular matrix scaffold preparedby perfusion method, and no acute systemic toxicity, hemolytic reaction, pyrogen response, and skin stimulus respons, indicating the scaffold has a good histocompatibility in the rabbits. These findings suggest that the whole-kidney acelular matrix scaffolds in Wistar rats prepared by perfusion method have goodin vivo biocompatibility.

Application of rabbit in basic skill training of urologic laparoscopic surgery / 重庆医学

Objective To evaluate the application value of the rabbit for training the basic skills of urologic laparoscopic surgery . Methods The rabbit models of laparoscopic nephrectomy ,ureteral anastomosis and pyeloureteroplasty were established ;in the self-made simulation training box ,8 clinical doctors without the actual operating experience of laparoscopic surgery participated in 10 rounds of simulation training by taking the 3 operation models .The operation completion time for each time was recorded .The learning curves and the training effects were observed .Results 8 doctors were successfully completed training .The operative time of laparoscopic nephrectomy was declined from (45 .75 ± 6 .88)min at the first time to (30 .75 ± 4 .53)min at the sixth time and (25 .86 ± 3 .31)min at the final time ;the operative time of laparoscopic ureteral anastomosis from (56 .75 ± 7 .13)min at the first time to(43 .00 ± 4 .34)min at the eighth time and(35 .50 ± 4 .04)min at the final time ;the operative time of laparoscopic pyeloureteroplas-tyfrom(77.38±5.34)minatthefirsttimeto(59.13±7.26)minatthefinaltime;thedifferenceswerestatisticallysignificant(P<0 .05) .Furthermore ,the probability of repeated sewing and tearing tissue were significantly decreased on the whole .The controlled stitch length and edge length also were more accurate .The quality and appearance of the complete operation were significantly im-proved .Conclusion Rabbit can be conveniently used to set up the animal models for training laparoscopic nephrectomy ,ureteral an-astomosis and pyeloureteroplasty ,which is suitable for clinical urologic doctors to train the basic operating skills of laparoscopic sur-gery .

A training model for laparoscopic dismembered pyeloplasty / 南方医科大学学报

<p><b>OBJECTIVE</b>To introduce a training model for laparoscopic dismembered pyeloplasty.</p><p><b>METHODS</b>The model of ureteropelvic junction obstruction was simulated using pig kidney and chicken crop. With the model placed in a training box, 8 residents without laparoscopic experience but with basic technical training performed 10 rounds of anastomosis according to the standard operation procedures. For each resident, the operating time and quality of the operation were recorded and assessed.</p><p><b>RESULTS</b>All the 8 residents successfully completed the training. The operating time decreased from 72.70∓8.26 min in the first training session to 54.50∓7.69 min in the last training session, and the anastomosis error score decreased from 5.60∓1.35 to 2.50∓1.58 min, showing significant differences between the recordings (P<0.05).</p><p><b>CONCLUSION</b>This simple training model allows effective simulation of the surgical procedures of laparoscopic pyeloplasty and is suitable for training surgeons without laparoscopic experiences.</p>

Preparation and performance assessment of Gamma-peptide nucleic acid gene chip detection system based on surface plasmon resonance / 生物医学工程学杂志

The aim of this study was to build a gene chip system with surface plasmon resonance (SPR) technique, for which Gamma-peptide nucleic acid (Gamma-PNA) functioned as a probe, in order to improve sensitivity and its specificity. With the use of self-assembled monolayer (SAM) technology, surface chemistry of two-dimensional structure was used. Gamma-PNA was designed according to the bioinformatics, and was plated on the SPR chip modified by SAM. Subsequently, relevant parameters of the experiment were ensured and optimized. The results showed that the performances of Gamma-PNA probe was little affected by the ion concentration of buffer, and it had a strong light signal in a stable state. As the ion concentration was 0, there were still good hybrid reactions; pH value had less influence upon Gamma-PNA probe, and acid environment of buffer could be better. Gamma-PNA probe combined with sensor technologies achieved made the probe with dispensable labels and real-time detection. It also improved the efficiency of the hybridization and the stability, providing the foundation for clinical application.

Expression of myeloid-derived suppressor cells in the peripheral blood and its clinical significance in renal carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the expression of CD33⁺ HLA-DR⁻ myeloid-derived suppressor cells (MDSCs) in the peripheral blood of patients with renal carcinoma and its correlation with the clinicopathological features of renal cancer.</p><p><b>METHODS</b>Forty-four patients with renal carcinoma treated in our hospital between June, 2011 and October, 2012 and 18 healthy volunteers were enrolled in this study. Flow cytometry was performed to detect CD33⁺ HLA-DR⁻ MDSCs in the peripheral blood, and its correlation with the clinicopathological features of the patients were analyzed.</p><p><b>RESULTS</b>The positivity rate of CD33⁺ HLA-DR⁻ MDSCs in the peripheral blood was significantly higher in the cancer patients than in the healthy controls [(1.91 ± 0.66)% vs (0.62 ± 0.22)%, P<0.001]. The expression levels of CD33⁺ HLA-DR⁻ MDSCs in patients with renal carcinoma showed significant differences between stage I+II [(1.46 ± 0.44)%] and stage III [(2.04 ± 0.35)%] patients (P<0.01) and between stage III and stage IV patients [(2.50 ± 0.64)%] (P<0.05), but did not differ significantly in respect of age or gender.</p><p><b>CONCLUSION</b>CD33⁺ HLA-DR⁻ MDSCs expression in the peripheral blood is associated with tumor stage and differentiation in renal carcinoma and may play an important role in predicting the prognosis and tumor immunology of renal carcinoma.</p>

Construction of digital three-dimensional models of renal stones and virtual surgery simulation / 南方医科大学学报

<p><b>OBJECTIVE</b>To construct three-dimensional (3D) models of renal stones and perform percutaneous nephrolithotomy (PCNL) virtual surgery simulation. Methods CT images were obtained from 8 patients with renal stones. Images segmentation and reconstruction were performed using MIMICS 10.0 software to construct the 3D model of the renal stones, which provided the anatomical relationships between the kidney and the adjacent organs. The optimal PCNL virtual surgery simulation for each individual case was performed using FreeForm Modeling System on the basis of the 3D model.</p><p><b>RESULTS</b>Eight 3D models of renal stone were constructed. The 3D model of the renal stones represented the interrelationships of the stones, intrarenal vessel, and the collecting system with the adjacent anatomical structures. Individualized PCNL virtual surgery simulations including percutaneous puncture, dilatation and pneumatic lithotripsy were performed successfully in all the 8 3D models.</p><p><b>CONCLUSION</b>Digital 3D model of renal stone provides the reliable and comprehensive imaging information for surgical design, and PCNL virtual surgery simulation has important clinical significance to improve the stone clearance rate and reduce the surgical complications.</p>