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Bladder cancer (BC) is one of the most common malignancies of the urinary tract. Surgery combined with chemoradiotherapy is the mainstay of treatment, but BC is markedly heterogeneous, leading to unsatisfactory outcomes. Antibody-drug conjugate (ADC), a new type of targeted drug, has achieved remarkable results in the treatment of tumors by coupling a chemical junction with a highly cytotoxic small molecule, which can exert anti-tumor effects while avoiding the impacts on normal cells. To date, several ADCs have been used in the treatment of BC at home and abroad, and play an increasingly important role in the field of BC therapy. This article briefly introduces the mechanism of ADC, the current application of ADC in BC treatment, and the problems and challenges faced, hoping to provide reference for clinical work.
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【Objective】 To investigate the preoperative epidemiological factors affecting the surgical outcomes of transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH) and to evaluate the clinical predictive value. 【Methods】 Patients undergoing TURP at our hospital during Dec.2018 and Sep.2021 whose pathological examination suggestive of BPH were involved. Before operation, the clinical data, International Prostate Symptom Score (IPSS), quality of life (QoL) score, overactive bladder (OAB) score, prostate-specific antigen (PSA), and urological ultrasound results were collected. After operation, all patients were followed up with telephone call or face-to-face interview, and the IPSS, QoL score and OAB score were examined. Patients were divided into effective and ineffective groups according to the efficacy rubrics. The epidemiological factors affecting the efficacy of TURP were identified with univariate analysis, the independent influencing factors were screened with binary logistic regression, and the diagnostic value of each independent influencing factor was evaluated using receiver operating characteristic (ROC) curve. 【Results】 OAB score (OR=0.749, 95%CI: 0.627-0.895, P=0.001), IPSS-V/S (OR=4.919, 95%CI: 1.617-14.963, P=0.005), history of urinary retention (OR=7.513, 95%CI: 2.289-24.656, P=0.001), and history of urinary incontinence (OR=2.656, 95%CI: 1.015-6.950, P=0.047) were independent influencing factors for poor postoperative outcomes. ROC curve revealed that the area under the ROC curve (AUC) showed that AUC of OAB score, IPSS-V/S, history of urinary retention, and history of urinary incontinence were 0.784 (95%CI: 0.718-0.841), 0.686 (95%CI: 0.614-0.751), 0.713 (95%CI: 0.643-0.777), and 0.723 (95%CI: 0.654-0.786), respectively. ROC curve of the regression model showed that the AUC was 0.888 (95%CI: 0.834-0.930), and the sensitivity and specificity were 93.53% and 67.35%, respectively. 【Conclusion】 Preoperative OAB score, IPSS-V/S, history of urinary retention, and history of urinary incontinence were independent epidemiological factors of poor outcomes after TURP in BPH patients. The diagnostic efficacy ranked from the highest to the lowest as regression model >OAB score>history of urinary incontinence >history of urinary retention>IPSS-V/S.
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Despite the increasing number of patients was diagnosed with prostate cancer due to widespread cancer screening, PSA testing does not differentiate between lethal and slow-growing inert prostate cancers. This leads to a proportion of patients being over-diagnosed and consequently over-treated.The current study has found that PSA exists as a precursor to post-translational modification, and that [-2]proPSA originates only from the peripheral zone of the prostate. Furthermore, the study has shown that prostate health index (PHI) calculated from [-2]proPSA, fPSA, and PSA has a higher positive predictive value for prostate cancer, making it useful in the diagnosis of clinically significant prostate cancer. This article reviews the progress of research related to PHI in prostate cancer diagnosis and treatment.
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Previous studies believe that oligometastasis has unique biological characteristics. Early active treatment for patients with oligometastatic prostate cancer can delay disease progression and improve survival. However, the current definition of oligometastasis is still unclear, and its optimal treatment is still a major concern of the medical community. This article reviewed recent research progresses in term of the definition and comprehensive treatment strategy of oligometastatic prostate cancer.
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Bladder cancer(BC) ranks the first of genitourinary tumor in China and is one of the most common urological malignancies, in which 25%-30% of patients were diagnosed with muscle-invasive bladder cancer. Radical cystectomy combined with pelvic lymph node dissection is the standard procedure for treatment, which can effectively avoid tumor recurrence or distant metastasis as well as improve the prognosis of patients. However, some patients may not tolerate or refuse to undergo radical bladder surgery due to worry about high complication rate, high morbidity and poor postoperative quality of life. With the increasing understanding of bladder cancer heterogeneity and biological behavior, the treatment of bladder cancer has changed from a surgery-based treatment model to an individualized and comprehensive treatment model by multidisciplinary collaboration. The bladder-preserving treatment can achieve the same oncological prognosis as that of radical bladder surgery with a better quality of life of the patients, which has become a hot topic and focus of research in muscle-invasive bladder cancer treatment. This article reviewed the progress of research related to the comprehensive treatment of muscle-invasive bladder cancer with preservation of the bladder.
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Exosomes are widely distributed in various body fluids. They are extracellular vesicles with a diameter of 30-100nm that contain a variety of biologically active substances. They play an important role in a variety of biological processes such as tumor invasion, migration and immune escape. With the progress of research, exosomes derived from bladder cancer have shown great potential in the early diagnosis and treatment of bladder cancer. This article reviews the main biological characteristics of exosomes and their new developments in the diagnosis and treatment of bladder cancer.
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Bladder cancer is a common malignant urothelial tumor, and the incidence of penile erectile dysfunction, reproductive dysfunction and urinary control disorder after radical cystectomy is very high, which seriously reduces the quality of life of young patients with bladder cancer. Preserving reproductive function and modified radical cystectomy is an innovation of traditional surgical methods, so it is of great clinical significance to actively explore the advantages and disadvantages of patient selection, surgical methods, tumor control, urine control, sexual and reproductive function. The paper reviews the relevant research progress at home and abroad.
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Kidney cancer is a common malignant tumor in urinary tumor system. Invasion of blood vessels is one of the important ways of metastasis. Tumors will involve the renal vein and inferior vena cava, leading to the formation of venous tumor thrombi. In recent years, the Da Vinci Robotic Surgical System has developed rapidly. Robotic surgery improves the accuracy of the operation. This article reviewed the related literature in recent years to summarizes indications, preoperative preparation, surgical skills, surgical efficacy and complications of renal cancer vena cava thrombectomy with Robotic.
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Urinary malignancy is a disease with high morbidity and mortality. Early detection, diagnosis, treatment response and prognosis can significantly improve patients' quality of life. The development of non-invasive liquid biopsy represents a major innovation in the field of precision medicine, opening up a new era for precision medicine and individualized treatment of cancer. Circulating biomarkers have shown a great potential utility in the diagnosis, treatment response, and prognosis of urinary tumors. This paper reviews the recent progress of liquid biopsy in urinary neoplasms.
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Objective To compare arthroscopic double-pulley knotless suture bridge with conven tional arthroscopic suture bridge in repair of rotator cuff tear.Methods From May 2013 to May 2015,70patients with rotator cuff tear were repaired at our department.They were 38 males and 32 females,with a mean age of 53.7 years.They were randomized into 2 equal groups to receive repair either using arthroscopic double-pulley knotless suture bridge (the experimental group) or using conventional arthroscopic suture bridge (the control group).The 2 groups were compared postoperatively in terms of VAS (visual analogue scale),Constant,ASES (American Shoulder and Elbow Surgeons) and UCLA (University of California at Los Angeles) scores,shoulder range of motion,and rotator cuff retear.Results The 2 groups were compatible with no significant differences in gender,age,laterality,tear type,or preoperative function or range of motion of the shoulder joint (P ＞ 0.05).At 12 months postoperatively,the VAS,Constant,ASES and UCLA scores and shoulder range of motion in the experimental group were respectively 1.1 ± 1.3,86.0 ±8.9,13.3 ± 0.8,32.0 ± 2.9,156.8° ± 15.0° and 55.9° ± 5.8°,significantly improved than the preoperative values (P ＜0.05).At 12 months postoperatively,the VAS,Constant,ASES and UCLA scores and shoulder range of motion in the control group were respectively 1.3 ± 1.3,86.6 ±4.2,13.1 ± 1.0,31.1 ±2.6,153.3°±10.0° and 55.7° ± 5.1 °,significantly improved than the preoperative values (P ＜ 0.05).At 12 months postoperatively,there were no significant differences between the 2 groups in VAS,Constant,ASES or UCLA scores or shoulder range of motion (P ＞ O.05).No case of rotator cuff retear occurred in the experimental group while 5 cases were observed in the control group,showing a significant difference (0 versus 14.3％) (P ＜ 0.05).Conclusions Compared with conventional arthroscopic suture bridge,arthroscopic double-pulley knotless suture bridge presents no significant differences in range of motion or function of the shoulder joint in repair of rotator cuff tear.However,the latter may lead to a lower incidence of rotator cuff retear and,additionally,is less skillfully demanding.
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Objective:To explore the correlation between single nucleotide polymorphisms (SNPs) in Homo sapiens longevity assur-ance homologue 2 (LASS2) gene 3′-untranslated regions (UTR) and susceptibility of bladder cancer among residents of Yunnan, China. Methods:A total of 105 bladder cancer patients (bladder cancer group) and 100 nonbladder cancer patients (control group) were se-lected. PCR method and sequence for LASS2-3′-UTR were performed to identify the SNPs correlated with bladder cancer. The relation-ships between the LASS2-3′-UTR polymorphisms and bladder cancer risk were analyzed. Results:An SNP (rs8444) was identified in LASS2-3′-UTR, and the T/C allele frequencies and genotype distributions of rs8444 largely differed between the bladder cancer and control groups (χ2=10.267, P=0.006;χ2=10.634, P=0.001). Individuals that carry the rs8444 C allele or CC genotype had a remarkably lower risk of bladder cancer compared with those that carry the T allele or TT genotype (OR=0.489, 95%CI:0.309-0.772, P=0.002;OR=0.258, 95%CI:0.081-0.827, P=0.023). No significant correlations were observed between the T/C allele frequencies and genotype distri-butions of rs8444 and TNM stage, as well as histological grade and distant metastasis in bladder cancer (P>0.05). Conclusion: The rs8444 C allele or CC genotype located within LASS2-3′-UTR can lower the susceptibility of bladder cancer among the residents of Yun-nan, China. However, it is not associated with the TNM stage, histological grade, and distant metastasis.
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Objective To systematically review the efficacy of arthroscopic distal clavicle resection (DCR) in repair of rotator cuff (RCR) with acromioclavicular arthritis.Methods The Cochrane Library,PubMed,Medline EMbase,CBM and WanFang Data were searched for studies up to May 2016 concerning the efficacy of arthroscopic distal clavicle resection in repair of rotator cuff with acromioclavicular arthritis.Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted the data and assessed the methodological quality of the studies included.Next,meta-analysis was performed using RevMan 5.3 software to compare the efficacy between the patients undergoing arthroscopic DCR plus RCR and those undergoing simple arthroscopic RCR.The randomized control trails (RCT) and clinical control trials (CCT) included were evaluated according to Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0) and Methodological Index for Non-randomized Studies (MINORS),respectively.Results A total of 5 studies (3 RCTs and 2 CCTs) involving 465 patients were included.No statistically significant difference was found between the RCR and the DCR plus RCR patients in Visual Analogue Scale (VAS) score,Constant score,American Shoulder and Elbow Surgeons (ASES) score,shoulder range of motion (ROM),postoperative acromioclavicular pain or rotator cuff retear (P ＞ 0.05).The 3 RCTs showed moderate bias risk and the 2 CCTs scored 21 MINORS points.Conclusion Since current evidence shows no advantages of arthroscopic DCR over RCR in repair of rotator cuff with acromioclavicular arthritis in VAS score,Constant score,ASES score,shoulder ROM,postoperative acromioclavicular pain or rotator cuff retear,arthroscopic DCR should not be recommended for routine use in clinic.
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Objective@#To evaluate the effects of three-dimensional printing patient-specific instrumentation(PSI) versus conventional instrumentation(CI) in the total knee arthroplasty.@*Methods@#According to "patient-specific" , "patient-matched" , "custom" , "Instrumentation" , "Guide Instrumentation" , "cutting blocks" , "total knee arthroplasty" , "total knee replacement" , "TKA" and "TKR" , the literature on PubMed, EMbase, Cochrane library, CBM and WanFang were searched. According to the inclusion and exclusion criteria, the high quality randomized control trial (RCT) studies about three-dimensional (3D) printing patient-specific instrumentation versus conventional instrumentation in the total knee arthroplasty were collected. The post-operative limb mechanical axis outlier, the position of the components outlier, post-operative knee function, operative time, post-operative blood transfusion and complications were analyzed by RevMan 5.3 software.@*Results@#A total of 13 high quality RCT studies were included. The results of Meta-analysis show that there were no statistical differences in the post-operative limb mechanical axis outlier(Z=0.55, P=0.58, 95% CI: 0.78 to 1.56), femoral coronal component outlier(Z=0.38, P=0.71, 95% CI: 0.69 to 1.72), tibia coronal component outlier(Z=1.95, P=0.05, 95% CI: 1.00 to 3.38), femoral rotation angle outlier(Z=0.36, P=0.72, 95% CI: 0.49 to 1.64), post-operative knee function(Z=1.18, P=0.24, 95% CI: -0.66 to 2.63), post-operative blood transfusions(Z=0.74, P=0.46, 95% CI: -0.10 to 0.05) and complications(Z=0.18, P=0.86, 95%CI: -0.07 to 0.05) between the PSI group and the CI group. But there are statistical differences in the operation time(Z=2.66, P=0.01, 95% CI: -15.97 to -2.41)and tibia sagittal component outlier (Z=3.69, P=0.00, 95% CI: 1.43 to 3.18)between the PSI group and the CI group.@*Conclusions@#In the primary total knee arthroplasty the PSI is not superior over the CI for the knee without severe knee varus or valgus deformity or contracture deformity, without the deformity around the knee and without the knee bone loss and obesity. The use of PSI in the primary total knee arthroplasty are not recommend.
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Objective: To optimize the formula of memantine hydrochloride sustained release pellets and investigate the drug release in vitro.Methods: Memantine hydrochloride sustained release pellets were prepared by a fluidized bed.The factors such as inlet air temperature, spray pressure and feeding rate were optimized by orthogonal tests.The Box-Behnken response surface methodology was used to screen the major influencing factors (ethyl cellulose aqueous dispersion, PEG 6000 and the coating weight) in the release of memantine hydrochloride.The coating formula and coating weight were optimized with the cumulative release rate of memantine hydrochloride in 2, 6,and 12 h as the response values.The drug release in vitro was also studied.Results: The optimum preparation parameters of the pellets were as follows: the inlet air temperature of 45℃, the spray pressure of 1.0 bar, and the feeding rate of 1.5 r·min-1.The best sustained release coating formula was as follows: the content of ethyl cellulose aqueous dispersion of 8.4%, the content of PEG 6000 of 2.3%, and the weight gain of sustained release layer of 16.7%.The memantine hydrochloride sustained release pellets had notable sustained release effect.Conclusion: Orthogonal tests and Box-Behnken response surface method can be used for the formula optimization of memantine hydrochloride sustained-release pellets.The established fitting model is simple with good predictability.
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Objective To compare the clinical effect of 2D and 3D laparoscopic radical prostectomy and summarize surgical experience of laparoscopic radical prostectomy of early prostate cancer.MethodsThe clinical data of 34 cases of prostate cancer treated in our institute from November 2015 to April 2016 were collected and analyzed retrospectively. The patients in observation group (11 cases) were treated by 3D laparoscopic radical prostectomy, while those in control group (23 cases) were given 2D laparoscopic radical prostectomy. The operation time, intraoperative bleeding volume, postoperative drainage time, quantity of drainage fluid within 24 hours postoperatively, indwelling catheter time, hospital time, positive surgical margin rate, potence rate, 30d-urinary continence rate and complications were compared between the two groups.Results All operations were successfully performed. There were no signiifcant differences in operation time, intraoperative bleeding volume, postoperative drainage time, quantity of drainage lfuid within 24 hours postoperatively, indwelling catheter time, hospital time, positive surgical margin rate, potence rate, 30d-urinary continence rate and complications between the two groups (P > 0.05). In observation group, the operation time was (153.52 ± 30.47) min and the potence rate was 50.0 %, 4 cases with uroclepsia (36.4 %), 1 case with urine leakage (9.1 %), no patient had urethral stricture or positive surgical margin, the 30d-urinary continence rate was 72.7 %. In control group, the operation time was (164.73 ± 28.65) min and the potence rate was 38.9 %, 13 cases with uroclepsia (56.5 %), 4 cases with urine leakage (17.4 %), 1 case with urethral stricture (4.3 %), 2 cases with positive surgical margin (8.7 %), 30d-urinary continence rate was 60.9 %.ConclusionLaparoscopic radical prostectomy is a safe, effective and less invasive method for treating early prostate cancer patients. Also 3D laparoscopic radical prostectomy play the similar functional results compared with 2D laparoscopic radical prostectomy, but 3D laparoscopic has the advantage in three dimensions space sense and accurate operation, it is worthy of promoting clinical application.
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Objective To investigate changes in bone mineral density (BMD) and analyze its related factors in community populations to provide the early diagnosis of osteoporosis (OP) and give right guidance to prevent osteoporosis. Methods The quantitative ultrasound BMD analyzer was used to measure BMD of heel in 8 711 adults in community. At the same time a questionnaire survey was conducted among these subjects. The data were analyzed by Logistic stepwise regression analysis. Results With the age changing, males and females tended to have different BMD variation. Male and female's BMD peak values were respectively in 35-age group, 30-age group and decreased as age increased. T value of BMD was different between male and female (-1.40(-2.0--0.7)vs-1.3(-2.0--0.5))(P<0.001). Both men and women had a higher incidence of low bone mass (53.34%vs 47.46%), and the difference was significant (P<0.001), whereas the incidence of osteoporosis after 55 years of age between men and women was statistically significance (P<0.05). BMD was the lowest for female than for male in 50-age group, and the prevalence rate of OP was remarkably increased. Analysis of related factors of BMD showed that body mass index (BMI), age, diabetes and menopause were risk facts. Conclusion The BMD among adults is related to many factors, in which the age, BMI and menopause are the most important factors. Much attention should be paid to low bone mass phenomenon, timely monitoring, timely intervention, develop healthy working and living habits, is important to the prevention of osteoporosis and its complications.
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Nucleic acid aptamer is the systematic evolution of ligands by exponential enrichment syn-thesized in vitro screening technology resulting single-stranded oligonucleotides (DNA or RNA),by folding into unique spatial structure specific recognition binding target molecules.Aptamers function is similar to the anti-bodies but more specifically,as novel molecular probes for the field of cancer therapeutics and diagnostics.
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Objective To assess the length of stay,early complication and cost of treatment in radical cystectomy (RC) patients with different Charlson Comorbidity Index Score (CCI).Methods A prospective study of a total of 102 patients who underwent RC between March 2012 and August 2014 in Center for Research of Urology in Yunnan Province,China.They were divided into three groups:69 cases in CCI=0 or 1group,19 cases in CCI=2 group,14 cases in CCI≥3 group.Comorbidities were graded according to CCI,and each patient was followed-up for 3 months after RC.Length of stay,early complications and treatment cost were analyzed by statistics.Results A total of 102 patients were analyzed.There were obvious differences with respect to length of stay,early complication and cost of treatment comparing patients in each CCI group,H=20.722,6.025,and 7.047,P＜0.05.The incidence of diversion-related early complications in patients with different CCI showed significant difference,H=7.100,P＜0.05,however,the non diversionrelated early complications did not show significant difference between patients with different CCI,H=2.590,P＞0.05.Conclusions Patients with different CCI showed difference in the length of stay,early complication and cost of treatment in RC patients with different CCI.CCI≥3 might help to identify patients at risk for early complications after RC,especially in the orthotopic urinary diversion operation.Patients' complication should be evaluated standardized before operation and these should be included in patients' consideration.
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Objective To investigate the change of sperm mitochondrial membrane potential in obese male infertility patients,and to explore the re?lationship of sperm mitochondrial membrane potential with the reactive oxygen species and free fatty acids in seminal plasma. Methods According to the research conditions,samples were randomly selected by cluster sampling from outpatient,and divided into normal body mass index fertile men as control group(n=51),normal body mass index infertile group(n=36),overweight infertile group(n=44),and obesity infertile group(n=45). Semen routine analysis was performed. Free fatty acid and reactive oxygen species in the seminal plasma was determined by ELSA method,sperm mitochondrial membrane potential was determined by flow cytometry. Results The rate of normal sperm mitochondrial membrane potential in nor?mal weight infertility(27.34%±13.38%),overweight infertility(28.26%±9.76%),obesity infertility group(25.27%±7.51%)were lower than the control group(35.12%±15.90%),the difference was statistically significant(P<0.05). Although obesity infertility group normal rate of mitochon?drial membrane potential were lower than normal weight infertility group and the overweight infertility group,but there was no statistically significant difference. The rate of sperm normal mitochondrial membrane potential was positively correlated with the rate of sperm progressive motility(r=0.29, P<0.01). Free fatty acid was positively correlated with reactive oxygen species in seminal plasma(r=0.30,P<0.01),reactive oxygen species in seminal plasma was negatively correlated with sperm normal mitochondrial membrane potential(r=-0.24,P<0.01). Conclusion Free fatty acid was elevated in the seminal plasma of overweight and obese patients with male infertility,which causes increased reactive oxygen species,reduced mitochondrial membrane potential,and eventually lead to the decline of sperm movement ability. Patients undergoing the treatment should be ad?vised to reduce the high fat diet and perform proper exercise.
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LASS gene family is a group of highly conserved and longevous gene LASS protein has a ceramide synthase activity,which can synthesize different types of ceramides.Ceramide is a key intermediate in tumor cells growth,signal transduction and other aspects.Thus it is inferred that the expression of LASS gene can suppress the occurrence and development of tumor within a certain range.