Establishment of a PCR-SSP method for the simultaneous amplification and identification of the presence of KIR genes / 中华医学遗传学杂志

OBJECTIVE@#To develop a polymerase chain reaction-sequence specific primer (PCR-SSP) method for simultaneous amplification and identification of the KIR genes among Chinese population.@*METHODS@#Peripheral blood samples from 132 healthy donors who had given blood at Shenzhen Blood Center from January 2015 to November 2015 were selected as the study subjects. Based on the polymorphism and single nucleotide polymorphism (SNP) information of high-resolution KIR alleles in the Chinese population and the IPD-KIR database, specific primers were designed to amplify all the 16 KIR genes and the 2DS4-Normal and 2DS4-Deleted subtypes. The specificity of each pair of PCR primers was verified by using samples with known KIR genotypes. During PCR amplification of the KIR gene, co-amplification the fragment of human growth hormone (HGH) gene by multiplex PCR was used as the internal control to prevent false negative results. A total of 132 samples with known KIR genotypes were randomly selected for blind inspection to verify the reliability of the developed method.@*RESULTS@#The designed primers can specifically amplify the corresponding KIR genes, with clear and bright bands for the internal control and KIR genes. The results of detection are fully consistent with the known results.@*CONCLUSION@#The KIR PCR-SSP method established in this study can yield accurate results for the identification of the presence of KIR genes.

Development status of international transplantation pregnancy registration and its enlightenment for China / 中华器官移植杂志

With the continuous improvements of survival rate and quality-of-life for organ transplant recipients, the issue of pregnancy in organ transplant recipients is receiving greater attention from transplant specialists and obstetricians.Currently there are three major global registries related to transplant pregnancy, namely The United Kingdom Obstetric Surveillance System (UKOSS), The Australian and New Zealand Dialysis and Transplant Registry (ANZDATA) and The International Transplant Pregnancy Registry International (TPRI). Among them, TPRI is the most comprehensive and longest running system with a focus on the impact of pregnancy on transplant recipients and the impact of immunosuppressants on fertility and pregnancy outcomes.As the second largest organ transplant country in the world, China also has high expectations for pregnancy and fertility among transplant recipients.Therefore it is imperative to establish a pregnancy and childbirth registration office for organ transplantation in China, standardize the recording of relevant population data and conduct researches for formulating scientific guidance, providing reliable medical consultations and services for patients with pregnancy needs after organ transplantation in China.

Correlation between professional quality of life and social support of Chinese nurses: a meta-analysis / 中华劳动卫生职业病杂志

Objective: To systematically evaluate the correlation between professional quality of life and social support of Chinese nurses based on Pearson and Spearman correlation coefficients. Methods: In databases including PubMed, Cochrane Library, CINAHL, Medline, CBM, CNKI、Wanfang, and other databases were searched by computer for the literatures on correlation between Chinese nurses' professional quality of life and social support from January 2005 to July 2020. The Chinese and English search terms are "nurse" "professional quality of life" "empathy satisfaction" "empathy fatigue" "professional quality of life" "ProQOL" "comparison satisfaction" "comparison fatigue" "social support" "competent social support" "SSRS" "PSSS", etc. Literatures were screened according to the inclusion and exclusion criteria. After evaluating quality and extracting data, meta-analysis was conducted using RevMan 5.3 software. Results: A total of 12 studies were included. The meta analysis showed that nurses' compassion satisfaction, burnout, secondary traumatic stress were related to social support, summary r were 0.35, -0.26 and -0.23 respectively. The correlation between compassion satisfaction and social support were increased with sample, the south was higher than the north, and comprehensive departments were higher than other departments (P<0.05) . The correlation between burnout and social support were increased with time and sample, and the south was higher than the north, oncology was higher than others, non-random sampling was higher than random sampling, using ProQOL and Perceived Social Support Scale (PSSS) was higher than Professional Quality of Life Scale (ProQOL) and Social Support Racting Scale (SSRS) (P<0.05) . The correlation coefficient between secondary traumatic stress and social support in oncology was higher than others, random sampling was higher than non-random sampling, using ProQOL and PSSS was higher than ProQOL and SSRS (P<0.05) . Conclusion: There is a positive and weak correlation between compassion satisfaction and social support, and a negative and weak correlation between burnout and secondary traumatic stress and social support. There are differences in different time, research design, region and department.

AHP based model for assessing the scrap priority of key equipment in blood screening laboratories / 中国输血杂志

【Objective】 To establish scrap indicators for key equipment in blood screening laboratory of blood centers and quantitatively assess the running status of key equipment, so as to provide a scientific method for equipment scrap. 【Methods】 Through the literature review and Delphi method, the scrap indicators of key equipment in blood screening laboratories were established in terms of applicability, economy and advancement of the equipment. The weights of relevant indicators were calculated by analysis hierarchy process (AHP), and the quantitative assessment model of equipment scrap priority was established according to the indicators and its weight. The equipment running data from January 2020 to December 2020 of Laboratory Department were collected and analyzed using the model, and its accuracy was verified based on experience. 【Results】 Thirteen second-level scrap indicators were established, and the weights of the three first-level indexes of applicability, economy and advancement were 0.582, 0.114 and 0.306, respectively. Among the total 30 key equipment, the model score of 4 equipment was less than 0.5, and the running status after manually checking met the scrap standard. 【Conclusion】 The model can accurately assess the scrap priority of key equipment and facilitate the procurement budget and scrapping identification in advance, which can avoid the waste of resources and ensure safe, efficient and orderly laboratory work.

Characteristics and Forensic Identification of Blunt Vertebral Artery Injury / 法医学杂志

Blunt vertebral artery injury occurs frequently in forensic practice. However, injuries of the vertebral artery are easily ignored or overlooked because of its relatively deep location. Through literatures review, this paper finds that the manners of blunt vertebral artery injury are varied and one or more injury mechanisms may be involved simultaneously. Patients often undergo immediate or delayed cerebral apoplexy as well as compression and injury of surrounding structures, due to direct injury or secondary aneurysm or dissection, resulting in disability or death. Diseases such as, vertebral atherosclerosis and dysplasia can increase the disability and death risk and the difficulty of forensic identification. In forensic identification, the details of the case should be considered. For cases of suspected vertebral artery injury, in addition to routine examination of intracranial segment, attention should be paid to the examination of extracranial segment. If conditions permit, angiography can be used prior to or during the autopsy to improve the identification efficiency and accuracy of opinions.

Preliminary report of preclinical trial of multi-genome engineering pig-to-macaque heart, liver and kidney transplantation / 器官移植

Objective To investigate the application prospect of the most extensive genome engineering pig internationally in preclinical xenotransplantation. Methods Porcine endogenous retrovirus (PERV) knockout combined with 3 major heterologous antigen gene knockouts and 9 humanized genes for inhibition of complement activation, regulation of coagulation disorders, anti-inflammatory and anti-phagocytosis were transferred into a pig (PERV-KO/3-KO/9-TG) as a donor, and the heart, liver and kidney were obtained and transplanted to 3 Rhesus macaque recipients respectively to establish a preclinical research model of pig-to-Rhesus macaque xenotransplantation. The functional status of xenografts after blood flow reconstruction was observed and the survival of recipients was summarized. The hemodynamics of xenografts were monitored. The change of hematological indexes of each recipient was compared. The histopathological manifestation of xenografts was observed. Results After the blood flow was reconstructed, all xenografts showed ruddy color, soft texture and good perfusion. The transplant heart, liver and kidney showed full arterial and venous blood flow and good perfusion at 1 d after operation. The postoperative survival time of heart, liver, and kidney transplant recipients was 7, 26, and 1 d, respectively. The levels of creatine kinase, creatine kinase isoenzyme, and lactate dehydrogenase increased in heart transplant recipient at 1 d after operation, and gradually recovered to near normal levels at 6 d after operation. All indexes increased sharply at 7 d after operation. The level of aspartate aminotransferase increased in liver transplant recipients at 2 d after operation, and the alanine aminotransferase basically returned to normal at 10 d after operation, but the total bilirubin continued to increase. Both aspartate aminotransferase and alanine aminotransferase increased at 12 d after operation, and reached a peak at 15 d after operation. The kidney transplant recipient developed mild proteinuria at 1 d after operation, and died of sudden severe arrhythmia. Histopathology showed that the tissue structure of cardiac and renal xenografts was close to normal, and liver xenografts presented with patchy necrosis, the liver tissue structure was disordered, accompanied by inflammatory damage, interstitial hemorrhage and thrombotic microangiopathy. Conclusions PERV-KO/3-KO/9-TG pig shows advantages in overcoming hyperacute rejection, mitigating humoral rejection and coagulation dysregulation. However, whether it can be used as potential donor for clinical xenotransplantation needs further evaluation.

Clinical efficacy of adult kidney transplantation from unilateral pediatric donor kidney / 器官移植

Objective To evaluate the clinical efficacy of adult kidney transplantation from unilateral pediatric donor kidney. Methods Clinical data of pediatric donors (n=10) and adult recipients (n=19) undergoing kidney transplantation were retrospectively analyzed. The changes of renal function, liver function and the maximal diameters of the kidney allografts were compared at 1, 7, 14, 28, 60 d after operation. The short-term survival and incidence of postoperative complications of the recipients were analyzed. Results Ten donors included 6 males and 4 females, aged (7±3) years old, with a body mass index (BMI) of (16.3±3.8) kg/m2. All donors were donation after brain death followed by cardiac death. Among 19 recipients, 12 were males and 7 were females, aged (34±12) years old, with a BMI of (20.3±1.3) kg/m2.An oblique incision was created in the lower right abdomen of the recipients. The arteries and veins of donor kidney were anastomosed with the external iliac arteries and veins of the recipients. The ureter of donor kidney was anastomosed with the bladder of the recipients. After anastomosis, the kidney was placed and fixed in the right iliac fossa. The serum creatinine and blood urea nitrogen levels of the recipients were decreased at 1 week after kidney transplantation, and restored to normal range at postoperative 2 weeks. All parameters related to liver function were normal after operation. At postoperative 1 month, the maximal diameters of the kidney allografts were (9.5±0.3) cm on average, which basically reached those of normal adults. The 1-year survival rate of 19 recipients was 95%. One recipient died from pulmonary infection after ineffective treatment. Two recipients developed rejection, and 1 recipient experienced urinary system infection, who were healed after corresponding treatment. Conclusions Adult kidney transplantation from unilateral pediatric donor kidney is safe, feasible and effective, which can be utilized to enlarge the source of donor kidneys.

Establishment and internal validation of preoperative nomograms for predicting the possibility of testicular salvage in patients with testicular torsion / 亚洲男科学杂志(英文版)

This study aimed to establish nomograms to preoperatively predict the possibility of testicular salvage (TS) in patients with testicular torsion. The clinical data of 204 patients with testicular torsion diagnosed at Xijing Hospital and Tangdu Hospital (Xi'an, China) between August 2008 and November 2019 were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to determine the independent predictors of TS. Based on multivariate regression coefficients, nomograms to predict possibility of TS were established. The predictive ability of the nomograms was internally validated by receiver operating characteristic (ROC) curves and calibration plots. The duration of symptoms ranged from 2 h to 1 month, with a median of 3.5 days. Thirty (14.7%) patients underwent surgical reduction and contralateral orchiopexy, while the remaining 174 (85.3%) underwent orchiectomy and contralateral orchiopexy. Finally, long symptom duration was an independent risk predictor for TS, while visible intratesticular blood flow and homogeneous testicular echotexture under color Doppler ultrasound were independent protective predictors. Internal validation showed that the nomograms, which were established by integrating these three predictive factors, had good discrimination ability in predicting the possibility of TS (areas under the ROC curves were 0.851 and 0.828, respectively). The calibration plots showed good agreement between the nomogram-predicted possibility of TS and the actual situation. In conclusion, this brief preoperative prediction tool will help clinicians to quickly determine the urgency of surgical exploration.

Recurrence and progression factors of papillary urothelial neoplasm of low malignant potential / 中华泌尿外科杂志

Objective@#To investigate the pathological characteristics of bladder low malignant potential papillary urothelial tumors (PUNLMP) and the predic factors of recurrence and pathological progress.@*Methods@#We retrospectively analyzed 150 patients of bladder PUNLMP in the Department of Urology of Xijing Hospital from February 2009 to February 2019. Among the 150 patients, 118 patients were males and 32 patients were females. The average age was 57 years, ranging 20-93 years. There were 112 cases of single tumor and 38 cases of multiple tumor. All patients received transurethral resection of bladder tumor (TURBT) and 136 patients received bladder infusion chemotherapy, including 61 patients for pirarubicin, 58 patients for gemcitabine, 11 patients for epirubicin, and 11 patients for mitomycin. 14 patients did not receive bladder infusion chemotherapy. In this study, univariate and multivariate logistic regression analysis were used to investigate independent predictors of recurrence and pathological progression in patients of bladder PUNLMP who received TURBT.@*Results@#The average follow-up time was 25.6 months, ranging 5.5-122.7 months. Among the patients, 21 patients occurred recurrence. The recurrent duration ranged from 2.2 to 108.3 months (mean 23.1 months). 12 patients had pathological progression, including 9 patients for low-grade non-invasive papillary urothelial carcinoma, 1 patient for high-grade non-invasive papillary urothelial carcinoma, 1 patient for high-grade invasive urothelial carcinoma, 1 patient for squamous cell carcinoma. The progressive duration ranged from 2.2 to 56.3 months (mean 21.5 months). Among the 150 patients, 18 patients with inverted growth pattern did not recur. There were significant differences in the number of tumors and the tumor length between the recurrence and non-recurrence groups, same as the progression and non-progression groups. The univariate and multivariate logistic regression analysis results showed that the number of tumors was an independent predictor of tumor recurrence (OR=7.884, 95%CI 2.815-22.082, P<0.05)and progression(OR=6.107, 95%CI 1.659-22.473, P=0.006) in patients of bladder PUNLMP. Bladder infusion chemotherapy failed to reduce the risk of recurrence and progression.@*Conclusions@#About 14% (21/150) patients of bladder PUNLMP reoccurred after TURBT. About half of them had pathological progression, and most of them progressed to low-grade non-invasive papillary urothelial carcinoma. Multiple tumors was an independent risk factor for postoperative recurrence and progression. Bladder infusion chemotherapy did not reduce the risk of recurrence and progression in patients of bladder PUNLMP.

Recurrence and progression factors of papillary urothelial neoplasm of low malignant potential / 中华泌尿外科杂志

Objective To investigate the pathological characteristics of bladder low malignant potential papillary urothelial tumors (PUNLMP) and the predic factors of recurrence and pathological progress.Methods We retrospectively analyzed 150 patients of bladder PUNLMP in the Department of Urology of Xijing Hospital from February 2009 to February 2019.Among the 150 patients,118 patients were males and 32 patients were females.The average age was 57 years,ranging 20-93 years.There were 112 cases of single tumor and 38 cases of multiple tumor.All patients received transurethral resection of bladder tumor (TURBT) and 136 patients received bladder infusion chemotherapy,including 61 patients for pirarubicin,58 patients for gemcitabine,11 patients for epirubicin,and 11 patients for mitomycin.14 patients did not receive bladder infusion chemotherapy.In this study,univariate and multivariate logistic regression analysis were used to investigate independent predictors of recurrence and pathological progression in patients of bladder PUNLMP who received TURBT.Results The average follow-up time was 25.6 months,ranging 5.5-122.7 months.Among the patients,21 patients occurred recurrence.The recurrent duration ranged from 2.2 to 108.3 months (mean 23.1 months).12 patients had pathological progression,including 9 patients for low-grade non-invasive papillary urothelial carcinoma,1 patient for high-grade noninvasive papillary urothelial carcinoma,1 patient for high-grade invasive urothelial carcinoma,1 patient for squamous cell carcinoma.The progressive duration ranged from 2.2 to 56.3 months (mean 21.5 months).Among the 150 patients,18 patients with inverted growth pattern did not recur.There were significant differences in the number of tumors and the tumor length between the recurrence and non-recurrence groups,same as the progression and non-progression groups.The univariate and multivariate logistic regression analysis results showed that the number of tumors was an independent predictor of tumor recurrence (OR =7.884,95％ CI 2.815-22.082,P ＜ 0.05) and progression (OR =6.107,95％ CI 1.659-22.473,P =0.006) in patients of bladder PUNLMP.Bladder infusion chemotherapy failed to reduce the risk of recurrence and progression.Conclusions About 14％ (21/150) patients of bladder PUNLMP reoccurred after TURBT.About half of them had pathological progression,and most of them progressed to low-grade noninvasive papillary urothelial carcinoma.Multiple tumors was an independent risk factor for postoperative recurrence and progression.Bladder infusion chemotherapy did not reduce the risk of recurrence and progression in patients of bladder PUNLMP.

Detecting the aminopyridine compounds in workplace air by solvent eluting-gas chromatography / 中国职业医学

OBJECTIVE: To establish a method for simultaneous detection of 2-aminopyridine, 3-aminopyridine and 4-aminopyridine in workplace air by solvent eluting-gas chromatography. METHODS: 2-aminopyridine, 3-Aminopyridine and 4-aminopyridine in workplace air were collected by glass fiber filter paper dipped with sulfuric acid solution, and eluted using sodium hydroxide solution. After that, the eluent was separated by capillary column, and finally detected using the nitrogen and phosphorus detector. RESULTS: The quantitative determination ranges of 2-aminopyridine, 3-aminopyridine and 4-aminopyridine were 0.30-800.00, 0.80-800.00 and 2.00-800.00 mg/L respectively, with the correlative coefficients greater than 0.999 9. The minimum detectable concentrations were 4.67, 8.00 and 40.00 μg/m~3 respectively, and the minimum quantification concentrations were 14.00, 28.00 and 133.33 μg/m~3(45.00 L sample, 3.00 mL eluent) respectively. The average elution efficiencies were 79.63%-98.61%, 83.80%-101.42% and 81.60%-100.29% respectively. The within-run relative standard deviations(RSD) were 1.13%-3.65%, 1.47%-4.00% and 1.94%-5.15% respectively, and the between-run RSD were 1.77%-5.30%, 2.06%-4.65% and 2.59%-6.46% respectively. Samples were stable at room temperature for at least 14 days. CONCLUSION: This method is appropriate to be applied for simultaneous detection of 2-aminopyridine, 3-aminopyridine and 4-aminopyridine in workplace air.

Survival study of patients with stage N1-3 testicular seminoma / 国际肿瘤学杂志

Objective@#To explore the independent predictors for disease-specific survival (DSS) rate in patients with stage N1-3 testicular seminoma (TS), and establish a nomogram to predict individual 5-year DSS.@*Methods@#The data of N1-3 TS patients registered in the SEER database of National Cancer Institute (USA) from January 2004 to December 2015 were retrospectively analyzed. The 5-year overall survival (OS) rate and DSS rate were calculated using Kaplan-Meier method and the differences among different subgroups were assessed using log-rank test. Besides, the independent predictors of DSS were defined using multivariate Cox regression analysis, and nomogram was drawn using R software. Furthermore, the predictive performance of the nomogram was internally validated using the C-index and calibration plot.@*Results@#TNM stage ⅢA (HR=5.604, 95%CI: 1.252-25.083, P=0.024), ⅢB (HR=6.710, 95%CI: 1.923-23.410, P=0.003) and ⅢC (HR=13.189, 95%CI: 3.916-44.420, P<0.001), age at diagnosis ≥45 years old (HR=3.575, 95%CI: 2.014-6.344, P<0.001), and patients without spouse (HR=2.346, 95%CI: 1.406-3.914, P=0.001) were identified as independent risk factors for DSS. On internal validation, the predictive accuracy of our nomogram was 0.751 (C-index: 0.751, 95%CI: 0.694-0.808). Besides, the calibration plot showed that the predicted survival outcomes were highly consistent with the actual survival outcomes.@*Conclusion@#The study confirms that age at diagnosis ≥45 years old, TNM stage ≥ⅢA and patients without spouse are the independent risk factors for DSS in TS patients with stage N1-3, and the nomogram for predicting individual 5-year DSS is established.

Determination of cyclohexanol in urine by headspace solid-phase microextraction coupled with gas chromatography / 中华劳动卫生职业病杂志

Objective@#To establish a method for determining cyclohexanol in urine by headspace solid-phase microextraction (HS/SPME) coupled with gas chromatography (GC) .@*Methods@#After the urine sample was hydrolyzed by β-glucuronidase, 2.0 g of NaCl was added, then the analyte in urine was adsorbed by a CAR/PDMS solid phase micro-extraction head in a water bath at 50 ℃ for 20 min. And the extraction head was inserted into the gas chromatograph gasification chamber to desorb, the analyte was detected after separated by the capillary through the flame ionization detector.@*Results@#The linear range of the method was 0.1-5.0 mg/L with the correlation coefficients (r) 0.999. The average recovery was 84.5%-96.3%, the inter-day precision was 3.81%-6.00%, and the detection limit was 0.03 mg/L.@*Conclusion@#The method is founded to be low detection limit, simple operation and no need of organic solvent. So it is suitable for the detection of cyclohexanol in urine of occupational exposure to cyclohexanone.

Individualized prediction of the risk of inguinal lymph node metastasis in patients with squamous cell carcinoma of penile / 中华泌尿外科杂志

Objective@#To investigate the independent predictors of inguinal lymph node metastasis (LLM) in patients with penile squamous cell carcinoma (SCCP), and to establish a nomogram for predicting individual LLM risk.@*Methods@#The data of patients with SCCP diagnosed at the department of urology, Xijing Hospital from July 2009 to June 2019 were analyzed retrospectively. A total of 101 patients were included in this study, with age of 55 (26-84) years. There were 25 (24.8%) and 76 (75.2%) patients with and without palpable inguinal lymph node enlargement, respectively. There were 47 cases (46.5%), 40 cases (39.6%) and 14 cases (13.9%) in T1, T2 and T3 stages, respectively; there were 67 cases (66.3%), 21 cases (20.8%) and 13 cases (12.9%) in Broder 1, 2 and 3, respectively. The average value (or median) of fibrinogen was 2.84 (1.72-5.00)g/L; alkaline phosphatase was 80(32±214)U, hemoglobin was 147(81-180)g, platelet count was (193.74±65.68×109/L, absolute value of neutrophils, monocytes and lymphocytes were 3.98(1.19-11.85)×109/L, 0.44(0.17-1.90)×109/L and 1.68(0.58-4.13)×109/L, respectively. The average (or median) value of PLR, NLR and LMR were 113.38(18.80-418.42), 2.42(0.59-10.22) and 3.84 (1.08-9.89), respectively. There were 26 cases (25.7%) with LLM and 75 cases (74.3%) without LLM. The independent predictors of LLM were identified by univariate and multivariate logistic regression analyses. The R software was used to establish the nomogram by integrating all independent predictors, and the bootstrap method was used to internally validated our nomogram, where the value of AUC (area under the ROC curve) was calculated and the calibration plot was drawn.@*Results@#Clinical inguinal lymph node status (P<0.006), T stage (P<0.021), Broder grade (P<0.017) and absolute neutrophil value (P<0.043) were independent predictors of LLM. The accuracy of our nomogram was 0.875 (AUC=0.875, 95%CI 0.859-0.891); Moreover, the risk of LLM predicted by nomogram was in good consistency with the actual LLM rate, and the errors of the nomogram-predicted LLM risks were all within 10%.@*Conclusions@#Clinical inguinal lymph node status, T stage, broder grade and absolute value of neutrophils were identified as independent predictors of LLM in patients with SCCP on the basis of single center data. A generic nomogram predicting LLM risk for Chinese patients was developed, which would be helpful to screen SCCP patients who need prophylactic inguinal lymph node dissection.

Live birth after uterus transplantation in China: a case report and literature review / 中华器官移植杂志

Objective@#To explore the therapeutic feasibility of uterus transplantation for uterine infertility.@*Methods@#Retrospective analysis was performed for the diagnosis, treatment and pregnancy course of the first domestic case of uterus transplantation and the relevant literature reviewed. The recipient was a 22-year-old woman with a congenital absence of uterus and vagina. Previously she underwent vaginal reconstruction and the donor was her mother. The specific procedures included donor/recipient screening, ethical argumentation, assisted reproductive technology of obtaining frozen embryos, Vinci robot-assisted uterine procurement, orthotopic replacement & fixation of retrieved uterus, revascularization; immunoregulation & monitoring of transplanted uterine recipient, assisted reproductive technology after transplantation and gestational management.@*Results@#The durations of donor and recipient surgeries were 360 and 530 min respectively. No complications of recipient or donor occurred during the perioperative period. First menstruation occurred at 40 days post-transplantation and regularly thereafter. Pregnancy occurred after embryo transfer at 31 months post-transplantation. No rejection episodes occurred after transplantation or during gestation. Caesarean delivery occurred near gestational week 34. The boy weighed 2000 grams at birth and the mother remained well.@*Conclusions@#In conjunctions with literature review, uterine infertility may be treated by modified uterus transplantation. And a new path is paved for healthy pregnancy of women with uterine infertility.

Live birth after uterus transplantation in China :a case report and literature review / 中华器官移植杂志

Objective To explore the therapeutic feasibility of uterus transplantation for uterine infertility .Methods Retrospective analysis was performed for the diagnosis ,treatment and pregnancy course of the first domestic case of uterus transplantation and the relevant literature reviewed .The recipient was a 22-year-old woman with a congenital absence of uterus and vagina .Previously she underwent vaginal reconstruction and the donor was her mother . The specific procedures included donor/recipient screening , ethical argumentation ,assisted reproductive technology of obtaining frozen embryos , Vinci robot-assisted uterine procurement ,orthotopic replacement & fixation of retrieved uterus , revascularization;immunoregulation &monitoring of transplanted uterine recipient , assisted reproductive technology after transplantation and gestational management .Results The durations of donor and recipient surgeries were 360 and 530 min respectively .No complications of recipient or donor occurred during the perioperative period .First menstruation occurred at 40 days post-transplantation and regularly thereafter .Pregnancy occurred after embryo transfer at 31 months post-transplantation .No rejection episodes occurred after transplantation or during gestation .Caesarean delivery occurred near gestational week 34 .The boy weighed 2000 grams at birth and the mother remained well . Conclusions In conjunctions with literature review , uterine infertility may be treated by modified uterus transplantation .And a new path is paved for healthy pregnancy of women with uterine infertility .

Individualized prediction of the risk of inguinal lymph node metastasis in patients with squamous cell carcinoma of penile / 中华泌尿外科杂志

Objective To investigate the independent predictors of inguinal lymph node metastasis (LLM) in patients with penile squamous cell carcinoma (SCCP),and to establish a nomogram for predicting individual LLM risk.Methods The data of patients with SCCP diagnosed at the department of urology,Xijing Hospital from July 2009 to June 2019 were analyzed retrospectively.A total of 101 patients were included in this study,with age of 55 (26-84) years.There were 25 (24.8％) and 76 (75.2％) patients with and without palpable inguinal lymph node enlargement,respectively.There were 47 cases (46.5 ％),40 cases (39.6％) and 14 cases (13.9％) in T1,T2 and T3 stages,respectively;there were 67 cases (66.3％),21 cases (20.8％) and 13 cases (12.9％) in Broder 1,2 and 3,respectively.The average value (or median) of fibrinogen was 2.84 (1.72-5.00) g/L;alkaline phosphatase was 80 (32 ± 214) U,hemoglobin was 147 (81-180) g,platelet count was (193.74 ± 65.68 × 109/L,absolute value of neutrophils,monocytes and lymphocytes were 3.98(1.19-11.85) × 109/L,0.44(0.17-1.90) × 109/L and 1.68(0.58-4.13) × 109/L,respectively.The average (or median) value of PLR,NLR and LMR were 1 13.38 (18.80-418.42),2.42 (0.59-10.22) and 3.84 (1.08-9.89),respectively.There were 26 cases (25.7％) with LLM and 75 cases (74.3％) without LLM.The independent predictors of LLM were identified by univariate and multivariate logistic regression analyses.The R software was used to establish the nomogram by integrating all independent predictors,and the bootstrap method was used to internally validated our nomogram,where the value of AUC (area under the ROC curve) was calculated and the calibration plot was drawn.Results Clinical inguinal lymph node status (P ＜0.006),T stage (P ＜0.021),Broder grade (P ＜ 0.017) and absolute neutrophil value (P ＜ 0.043) were independent predictors of LLM.The accuracy of our nomogram was 0.875 (AUC =0.875,95％ CI 0.859-0.891);Moreover,the risk of LLM predicted by nomogram was in good consistency with the actual LLM rate,and the errors of the nomogram-predicted LLM risks were all within 10％.Conclusions Clinical inguinal lymph node status,T stage,broder grade and absolute value of neutrophils were identified as independent predictors of LLM in patients with SCCP on the basis of single center data.A generic nomogram predicting LLM risk for Chinese patients was developed,which would be helpful to screen SCCP patients who need prophylactic inguinal lymph node dissection.

Efficacy and safety of adjuvant targeted therapy for patients with non-distant metastasis renal cell carcinoma / 中华泌尿外科杂志

Objective To evaluate the efficacy and adverse events of adjuvant targeted therapy for non-distant metastatic renal cell carcinoma (ndmRCC).Methods A comprehensive literature search was conducted in PubMed,SpringerLink,Web of Science,and the Cochrane Library.All clinical randomized controlled trials on adjuvant targeting therapy for ndmRCC were retrieved.Literature screening,data extraction and literature quality evaluation were conducted by three researchers independently,and metaanalysis was performed using Review Manager Version 5.3.Outcomes we were interested in included progression-free survival (PFS),overall survival (OS),and adverse events.Results A total of 4 RCTs with 5 studies and 4 944 ndmRCC patients were selected for meta-analysis.Targeted adjuvant therapy improved the PFS of ndmRCC patients.The hazard ratio (HR) was 0.92(95％ CI0.85-1.00,P =0.05) between the targeted therapy group and the placebo group.With the extension of follow-up,this effect was more significant,and the HR was 0.89 (95％ CI0.81-0.97,P =0.01).However,targeted adjuvant therapy did not extend the OS of ndmRCC patients,and the HR was 0.92(95％ CI0.81-1.05,P =0.22).Compared with the placebo,targeted adjuvant therapy increased the incidence of adverse events and the number of patients who had to discontinue because of adverse events was also increased.The odds ratios were 6.03 (95％ CI5.30-6.86,P ＜ 0.001) and 7.65 (95 ％ CI6.31-9.26,P ＜ 0.001),respectively.Conclusions Targeted adjuvant therapy can improve the PFS of ndmRCC patients after surgery,but it cannot improve the OS.At the same time,it increases the incidence of adverse events.

Significance of Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Patients with Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To investigate the significance of neutrophil/lymphocyte ratio(NLR) and platelet/lymphocyte ratio(PLR) in patients with multiple myeloma (MM).@*METHODS@#Eighty patients with multiple myeloma admitted in our hospital from August 2007 to August 2010 were selected. The clinical data of the patients, including hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red blood cell distribution width (RDW), white blood cell(WBC) count, absolute neutrophil count (ANC), platelet count (PC), glomerular filtration rate (GFR), calcium, albumin, β2 microglobulin and so on were collected and analyzed.@*RESULTS@#The optimal threshold of NLR was 2.78 (sensitivity: 83.3%, specificity: 43.1%). The optimal threshold of PLR was 155.58 (sensitivity: 67.7%, specificity: 36.9%). All patients were grouped according to NLR and PLR values, patients with high NLR and PLR had lower albumin levels and higher clinical stages. High NLR patients were mainly men, hemoglobin, GFR values, albumin levels were lower, and the white blood cells count and β2 microglobulin level were higher. High PLR patients showed low albumin level and higher clinical stage. Multivariate analysis showed that β2 microglobulin and NLR were prognostic factors in patients with multiple myeloma (P2.78) associates with poor prognosis in patients with MM, and it may be considered as an independent prognostic factor for MM patients.

Survival study of patients with stage N1-3 testicular seminoma / 国际肿瘤学杂志

Objective To explore the independent predictors for disease-specific survival (DSS) rate in patients with stage N1-3 testicular seminoma (TS),and establish a nomogram to predict individual 5-year DSS.Methods The data of N1-3 TS patients registered in the SEER database of National Cancer Institute (USA) from January 2004 to December 2015 were retrospectively analyzed.The 5-year overall survival (OS) rate and DSS rate were calculated using Kaplan-Meier method and the differences among different subgroups were assessed using log-rank test.Besides,the independent predictors of DSS were defined using multivariate Cox regression analysis,and nomogram was drawn using R software.Furthermore,the predictive performance of the nomogram was internally validated using the C-index and calibration plot.Results TNM stage ⅢA (HR =5.604,95％ CI:1.252-25.083,P =0.024),ⅢB (HR =6.710,95％ CI:1.923-23.410,P =0.003) and ⅢC (HR =13.189,95％ CI:3.916-44.420,P ＜ 0.001),age at diagnosis ≥45 years old (HR =3.575,95％ CI:2.014-6.344,P ＜ 0.001),and patients without spouse (HR =2.346,95％ CI:1.406-3.914,P =0.001) were identified as independent risk factors for DSS.On internal validation,the predictive accuracy of our nomogram was 0.751 (C-index:0.751,95％ CI:0.694-0.808).Besides,the calibration plot showed that the predicted survival outcomes were highly consistent with the actual survival outcomes.Conclusion The study confirms that age at diagnosis ≥45 years old,TNM stage ≥ ⅢA and patients without spouse are the independent risk factors for DSS in TS patients with stage N1-3,and the nomogram for predicting individual 5-year DSS is established.