Innovation,thinking and prospect of benign prostatic hyperplasia surgery / 现代泌尿外科杂志

Benign prostatic hyperplasia (BPH) surgery has developed for more than 100 years. After several major revolutions, it is still constantly innovating, which in turn has profoundly affected people’s concept and strategy for treating BPH. This paper reviews the background and process of the evolution of BPH surgery, discusses the innovative methods and rules, and looks forward to the future developmental trend, in order to provide reference for the further development of BPH surgery.

Effect of expressing of anti-PD-1 antibody in mouse mammary gland on spleen T cells in transgenic mice / 生物工程学报

This study aims to investigate the effect of anti-PD-1 antibody expressed in mouse mammary gland on the surface antigen protein of spleen T cells, cytokine expression, spleen CD4+ T cell proliferation and proliferation related pathways of transgenic mice at the cellular level. Transgenic mice expressing anti-human PD-1 antibody at 8 weeks of age without pregnancy and 18 weeks of age with lactation were divided into two groups, with transgenic negative mice in each group as the control. Spleen lymphocytes were extracted and the changes of spleen lymphocytes were detected. Compared with transgenic negative mice, the proportion of effector T cells of spleen T cells in the immune system of transgenic mice with anti-PD-1 antibody expressed in breast increased, the proportion of Treg cells decreased, and the IFN-γ, IL-17 and IL-2 expressed in CD4+ T cells increased in varying degrees. Moreover, IL-4, IL-10 and TGF-β in CD4+ T cells did not change, nor did some cell surface protein molecules related to T cell stimulate. There was no significant difference in T cell proliferation between transgenic positive and transgenic negative mice. In transgenic positive mice, the expression of phosphorylated proteins in PI3K/Akt/mTOR and RAS/MEK/ERK pathways were partially up-regulated, but the whole pathway was not completely up-regulated. Therefore, it is feasible to use transgenic mice as host to express monoclonal antibodies related to immune system such as anti-PD-1 antibody.

Research hotspots of prostate cancer at the international conferences on urology in 2022 / 浙江大学学报·医学版

The American Urological Association (AUA), European Association of Urology (EUA) and International Urological Society (SIU) annual meetings were held in 2022. Studies on prostate cancer reported in the meetings mainly focus on the advances of diagnostic biomarkers (such as α-2, 3-1inked sialylation of terminal N-glycan on free PSA density, SelectMDx) and imaging techniques [such as multiparametric magnetic resonance imaging, prostate specific membrane antigen(PSMA)-PET/CT], the new method for prostate biopsy, the new treatments of prostate cancer including [177Lu] Ludotadipep and DROP-IN PSMA probe, and the prognosis assessment of prostate cancer (such as AR-V7). This article provides an overview on the research hotspots of three international academic meetings.

Expression and significance of programmed death-1 and T-cell immunoglobulin- and mucin domain-3-containing molecule 3 in hepatocellular carcinoma / 临床肝胆病杂志

ObjectiveTo investigate the expression and clinical significance of programmed death-1 (PD-1) and T-cell immunoglobulin- and mucin domain-3-containing molecule 3 (TIM-3) in hepatocellular carcinoma (HCC). MethodsThe paraffin blocks of HCC tissue and adjacent tissue (＞1 cm from the tumor margin) were collected from 46 patients with HCC who underwent surgical treatment in No. 900 Hospital of The Joint Service and Security Force of The Chinese People’s Liberation Army from January 2013 to December 2015. Immunohistochemistry was used to measure the expression of PD-1 and TIM-3, and their association with clinicopathological features and prognosis was analyzed. The Wilcoxon test was used for comparison of paired ranked data, and a Spearman correlation analysis was used to investigate the correlation between ranked data; the Kaplan-Meier method was used for survival analysis, and the log-rank test was used for comparison of survival rates between groups; the Cox regression model was used to perform a multivariate analysis. ResultsThe expression levels of PD-1 and TIM-3 in HCC tissue were higher than those in adjacent tissue (both P＜0.05). PD-1 was mainly localized in lymphocytes and TIM-3 was mainly localized in tumor-associated macrophages. The expression of PD-1 was positively correlated with that of TIM-3 in HCC tissue (rs=0.397, P=0.006). The expression level of PD-1 in HCC tissue was associated with tumor size (rs=0.480, P=0.001), portal vein tumor thrombus (rs=0.307, P=0.038), and TNM stage (rs=0.534, P＜0.001), and the expression level of TIM-3 was associated with portal vein tumor thrombus (rs=0.301, P=0.042), degree of pathological differentiation (rs=0356, P=0.015), and TNM stage (rs=0.416, P=0.004). For the patients with HCC, the 1-, 3-, and 5-year overall survival rates were 89.1%, 56.5%, and 34.4%, respectively, and the 1-, 3-, and 5-year disease-free survival rates were 52.2%, 21.7%, and 10.9%, respectively. The multivariate analysis showed that degree of pathological differentiation (hazard ratio ［HR］=4.723, 95% confidence interval ［CI］: 1.618-7.684, P=0.001), tumor size (HR=3.234, 95%CI: 1.327-7.883, P=0.010), TNM stage (HR=3.254, 95%CI: 1.076-9.835, P=0.037), and expression level of TIM-3 (HR=0.572, 95%CI: 0.329-0.995, P=0048) were independent prognostic factors for the overall survival of HCC patients, and degree of pathological differentiation (HR=2.945, 95%CI: 1.527-5.682, P=0.001) and TNM stage (HR=2.074, 95%CI: 1.259-9.793, P=0.016) were independent prognostic factors for the disease-free survival of HCC patients. ConclusionHigh expression levels of both PD-1 and TIM-3 are observed in HCC tissue, and PD-1 and TIM-3 may be involved in the progression and poor prognosis of HCC patients.

Consistency of prostate biopsy and radical prostatectomy Gleason grade groups and nomograms establishment for predicting upgrading and downgrading / 中华泌尿外科杂志

Objective@#To evaluate the consistency between prostate biopsy and postoperative pathological grade, analyze the influencing factors that may lead to upgrade or downgrade, and to establish a prediction model.@*Methods@#The clinical data of biopsy GS3+ 3=6(GR1, 330 cases) and GS3+ 4=7(GR2, 340 cases) patients from January 2013 to December 2018 in the first affiliated hospital, College of Medicine of Zhejiang university were retrospectively analyzed. The median age was 67 years old(ranging 35 to 100 years old). The median BMI was 23.74 kg/m2(ranging 16.22-38.74 kg/m2). The Median tPSA was 10.266 ng/ml(ranging 0.017-147.575 ng/ml). The median prostate volume was 29.43 ml(5.92-187.20 ml). The median PSAD was 0.34 (ranging 0.01-4.02). The median percentage of positive puncture cores was 0.25 (ranging 0.08-1.00). There were 161 patients in clinical stage ≤T1c, 344 patients in T2a-T2c and 165 patients in clinical stage ≥T3. 670 cases all accepted the radical prostatectomy. Consistency of prostate biopsy and radical prostatectomy Gleason grade was recorded. If the postoperative Gleason grade was higher than that in biopsy, it was defined as upgrade. Otherwise, it was defined as downgrade. Multivariate logistic regression model was used to evaluate the influencing factors leading to upgrades in GR1 patients or downgrades in GR2 patients. Nomograms were drawn based on the models with AUC and Horsmer-Lemeshaw test conducted to test the discrimination and calibration of the models.@*Results@#Among the 670 patients included, 165 cases (50.0% of GR1) upgrades and 27 cases (7.9% of GR2) downgrades. PSAD≥0.25(OR=3.015) and clinical stage≥T2b(OR=7.185)were independent influencing factors for the upgrade in GR1 patients, while PSAD<0.15(OR=4.208) and clinical stage≤T1c(OR=4.530) were independent influencing factors for downgrade. The nomograms were drawn with the above variables. The AUC of the model (0.781 for GR1 group, 0.741 for GR2 group) and the hosmer-remeshaw test results (P=0.993 for GR1 group, P=0.234 for GR2 group) show that the nomograms have good discrimination and calibration.@*Conclusions@#PSAD and clinical stage are independent influencing factors for the upgrade or downgrade. Nomograms may provide help for clinicians to judge the accuracy of prostate biopsy. However, the nomograms still needs to be verified in clinical practice

Consistency of prostate biopsy and radical prostatectomy Gleason grade groups and nomograms establishment for predicting upgrading and downgrading / 中华泌尿外科杂志

Objective To evaluate the consistency between prostate biopsy and postoperative pathological grade,analyze the influencing factors that may lead to upgrade or downgrade,and to establish a prediction model.Methods The clinical data of biopsy GS3 + 3 =6 (GR1,330 cases) and GS3 + 4 =7 (GR2,340 cases) patients from January 2013 to December 2018 in the first affiliated hospital,College of Medicine of Zhejiang university were retrospectively analyzed.The median age was 67 years old (ranging 35 to 100 years old).The median BMI was 23.74 kg/m2(ranging 16.22-38.74 kg/m2).The Median tPSA was 10.266 ng/ml(ranging 0.017-147.575 ng/ml).The median prostate volume was 29.43 ml (5.92-187.20 ml).The median PSAD was 0.34 (ranging 0.01-4.02).The median percentage of positive puncture cores was 0.25 (ranging 0.08-1.00).There were 161 patients in clinical stage ≤ T1c,344 patients in T2a-T2c and 165 patients in clinical stage ≥ T3.670 cases all accepted the radical prostatectomy.Consistency of prostate biopsy and radical prostatectomy Gleason grade was recorded.If the postoperative Gleason grade was higher than that in biopsy,it was defined as upgrade.Otherwise,it was defined as downgrade.Multivariate logistic regression model was used to evaluate the influencing factors leading to upgrades in GR1 patients or downgrades in GR2 patients.Nomograms were drawn based on the models with AUC and Horsmer-Lemeshaw test conducted to test the discrimination and calibration of the models.Results Among the 670 patients included,165 cases (50.0％ of GR1) upgrades and 27 cases (7.9％ of GR2) downgrades.PSAD ≥ 0.25 (OR =3.015) and clinical stage ≥ T2b (OR =7.185) were independent influencing factors for the upgrade in GR1 patients,while PSAD ＜ 0.15 (OR =4.208) and clinical stage ≤ T1c (OR =4.530) were independent influencing factors for downgrade.The nomograms were drawn with the above variables.The AUC of the model (0.781 for GR1 group,0.741 for GR2 group) and the hosmer-remeshaw test results (P=0.993 for GR1 group,P =0.234 for GR2 group) show that the nomograms have good discrimination and calibration.Conclusions PSAD and clinical stage are independent influencing factors for the upgrade or downgrade.Nomograms may provide help for clinicians to judge the accuracy of prostate biopsy.However,the nomograms still needs to be verified in clinical practice

Clinicopathologic analysis of prostatic cancer with single positive core biopsy after radical prostatectomy / 中华泌尿外科杂志

Objective To evaluate the clinical and pathological features of patients with prostate cancer who were diagnosed by single positive core biopsy and treated by radical prostatectomy (RP).Methods Between July 2012 and June 2016,164 patients with prostate cancer diagnosed by single positive core biopsy underwent RP.The mean age was 66.3 years old (ranged 41-82 years old),and the mean PSA level was 12.3 ng/ml (ranged 0.6-59.5 ng/ml).The biopsy Gleason score showed 6 scores in 113 cases,3 + 4 =7 scores in 21 cases,4 + 3 =7 scores in 18 cases,≥8 scores in 12 cases.Clinical stage was cT1 in 71 cases,cT2 in 92 cases,and cT3 in 1 case.The patients were divided into subgroups according to age,preoperative PSA level,biopsy Gleason score and clinical stage,and the pathological results were compared among these subgroups.Results Of the 164 patients,67 cases had Gleason score ≤ 6,52 cases Gleason score 3 + 4 =7,24 case Gleason score 4 + 3 =7,and 11 cases Gleason score ≥ 8.Ten patients had pT0 disease according to the RP specimen,3 had extraprostatic extensions,5 had seminal vesicle invasions,and 24 had positive surgical margins.Compared to the biopsy,the Gleason score of RP specimens was higher in 53 cases,concordant in 77 cases,and lower in 24 cases.There was no significant difference in the postoperative pathological features between the age group ＜ 70 years and the group ≥ 70 years.Compared with PSA ＜ 10 ng/ml,the likelihood of postoperative Gleason score ＞ 7 was significantly increased in PSA ≥10 ng/ml group [41.4％ (36/87) vs.66.2％ (51/77),P＜0.05].When the biopsy Gleason score was divided into four groups (6,3 + 4 =7,4 + 3 =7,≥ 8),there were significant differences in postoperative pathological stages among the four groups (P ＜ 0.05),and the patients with biopsy Gleason score 6 were more likely to have no residual cancer (stage T0) when compared with other Gleason scores [8.8％ (10/113) vs.0,P =0.09].The probability of no residual cancer in clinical T1 stage patients was significantly higher than that in T2 stage [11.3％ (8/71) vs.2.8％ (2/92),P =0.02],while the probability of Gleason score upgrading was significantly lower [23.9％ (17/71) vs.39.1％ (36/92),P ＜ 0.05].Conclusions Most single core prostate cancer have clinically significant disease.The treatment plan must be evaluated individually for patients with single core prostate cancer.

Regulatory Effects of Ionotropic and GroupⅠ Metabotropic Glutamate Receptors on Temperature Hypersensitivity in Rats / 中国医科大学学报

Objective To study the effects of ionic and group Ⅰ metabotropic glutamate receptors on rats' thermal hypersensitivity by intraplantar administration of drugs. Methods After intraplantar administration of glutamate receptor agonists,L-glutamic acid (Glu), N-methyl-D-aspartic-acid (NMDA),and (RS)-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid hydrobromide (AMPA);a Group Ⅰ mGluR agonist, (S) 3,5-dihydroxyphenylglycine [(S)-DHPG];a noncompetitive NMDA receptor antagonist, (+)-MK801 maleate (MK-801);a competitive AMPA/kainate receptor antagonist,6-cyano-7-nitroquinoxaline-2,3-dione (CNQX);and a selective GroupⅠ mGluR antagonist,7-hydroxyiminocyclo propan[b]chromen-1a- carboxylic acid ethyl ester (cpccoEt) into the left hind paws of rats whose L5-6 nerves were sham-operated or ligated,we examined the response of the rats to thermal stimuli provided by radiant heat. Results In sham-operated rats,glutamate,NMDA,AMPA,and (S)-DHPG reduced paw withdrawal latency (PWL) but did not have any effect on SNL rats. However,in SNL rats,MK-801,CNQX,and cpccoEt increased PWL but exerted no effect on sham-operated rats. Conclusion These results suggest that changes in sensitivity of peripheral ionic and group Ⅰ metabotropic glutamate receptors can lead to changes in peripheral nerve plasticity;the generation and maintenance of neuropathic pain caused by nerve injury is based on this plasticity.

Protection effect of endomucin on retinal neurons and its mechanism in streptozotocin-induced diabetic rat / 中华实验眼科杂志

Objective To investigate the change of endomucin(EMCN) expression in diabetic retinopathy (DR) and its protective role in neurons apoptosis.Methods Fifty-six clean SD rats were randomly divided into 4 groups,including normal control group with intravitreal injection of normal saline,diabetes mellitus (DM) group with intravitreal injection of normal saline,EMCN transfection group with intravitreal injection of adenovirus associated virus(AAV)-EMCN and mCherry transfection group with intravitreal injection of AAV-mCherry,14 rats for each group.Intravitreal injection was performed 2 weeks before diabetes modeling.Western blot analysis was used to measure the expression of EMCN and phosphorylated Akt (p-Akt)/Akt.Flat-mounted retinas were performed to test the transfection efficiency.Hematoxylin-eosin staining was performed to examine the morphology of retinal tissue.The expression of cleaved caspase-3 in retinas of rats was assayed by immunofluorescence.The retinal apoptotic cells were detected by TUNEL.The use and care of the rats followed the ARVO Statement.Results The levels of fasting plasma glucose were significantly higher in the DM group,EMCN transfection group and mCherry transfection group than those in the normal control group (all at P＜0.001).The expression of EMCN protein at 4 weeks and 8 weeks after modeling in the DM group were significantly lower than that in the normal control group (t=3.71,P＜0.05;t =10.09,P＜0.001).The mCherry transfection group was strongly expressed red fluorescence,the expression of EMCN was significantly lower in retinal tissue of DM group than that in the normal control group (t=13.67,P＜0.001).The expression of EMCN was notably upregulated in retinas of EMCN transfection group,comparing with that of DM group (t =3.18,P＜0.05).The expression of EMCN in mCherry transfection group was similar to that in the DM group (t =2.31,P=0.08).Initial morphologic degenerative changes were found in the DM group and mCherry transfection group,such as inter limiting membrane (ILM) was thicken,the number of RGCs was decreased,and the cells in outer nuclear layer (ONL) and inner nuclear layer (INL) arranged irregularly.The histologic change of retinas in the EMCN transfection group was milder than that in the DM group.The expression of cleaved caspase-3 was upregulated in INL of DM group and mCherry transfection group,compared with that in the normal control group.Compared with the normal control group,the number of TUNEL-positive cells noticeably increased in the ONL of DM group and mCherry transfection group,and the number of TUNEL-positive cells markedly reduced in the EMCN transfection group.The relative expression of p-Akt/Akt was significantly lower in the retinal tissue of DM group than that in the normal control group (t =5.52,P＜0.01).However,the relative expression of p-Akt/Akt was notably upregulated in retinas of EMCN transfection group,compared with that in the DM group (t=3.14,P＜0.05).The relative expression of p-Akt/Akt in mCherry transfection group was similar to that in the DM group (t =0.81,P =0.46).Conclusions The overexpression of EMCN can protect diabetic retinas neurons from apoptosis,and its mechanism maybe associated with activation of Akt signaling pathway.

Analysis the clinical characteristics of unilateral acute idiopathic maculopathy / 中华眼底病杂志

Objective To observe the clinical characteristics and fundus imaging features of unilateral acute idiopathic maculopathy (UAIM).Methods Retrospective cases series.Six eyes of 6 patients with UAIM were included in this study.There were 4 males and 2 females.All patients underwent best corrected visual acuity (BCVA),fundus color photography,spectral domain optical coherence tomography (SD-OCT) and fundus fluorescein angiography (FFA) examinations.3 patients underwent indocyanine green angiography (ICGA) examination.No intervention was given in all patients after diagnosis.The mean follow-up was 6.3 months.BCVA,fundus color photography,SD-OCT and FFA were performed in follow-up.Results The ocular symptoms included unilateral sudden decreased vision,metamorphopsia and central scotoma.All patients had a yellow-white lesion involving the macular and irregular small bleeding was seen in 3 eyes.Irregular hyperfluorescence in macular area was seen in all patients,some with the hemorrhages showed blocked fluorescence at the early stage of FFA and fluorescence storage at the late stage.ICGA showed that hypo-fluorescence in macular area continually.SD-OCT showed that subretinal fluid in the macular and lost the ellipsoid zone.During the follow-up period,the subretinal fluid was absorbed spontaneously in one month.The ellipsoid zone structure recovered gradually and the visual acuity were normal.At the time of the latest follow-up,the BCVA was 0.8 in 4 eyes,1.0 in 2 eyes.Conclusions UAIM is featured with a unilateral,acute,transient and exudative lesion in the macular,which can be spontaneously resolved;It mainly affects outer retina.

Observastion on effect of continuous femoral nerve block guided by ultrasound in postoperative analgesia in total knee arthroplasty / 重庆医学

Objective To observe the effect and adverse reactions of ultrasound guided continuous femoral nerve block in postoperative analgesia after total knee arthroplasty(TKA) and to conduct the comparative study with traditional patient-controlled intravenous analgesia. Methods Forty patients undergoing elective unilateral knee replacement in this hospital from August 2015 to March 2016 were selected and divided into the group A and B, 20 cases in each group. The group A adopted ultrasound guided continuous femoral nerve block analgesia, while the group B adopted patient-controlled intravenous analgesia(PCA). The VAS score on postoperative 4,8,12,24,48 h were compared between the two groups, the VAS score of continuous passive motion on postoperative 24,48,72 h were compared between the two groups, the muscle strength grade and knee joint maximum passive flexion and extension on postoperative 2-6 d were compared between the two groups. Postoperative adverse reactions were observed. The levels of C-reactive protein(CRP) and interleukin- 6 (IL-6) were tested. The ultrasound monitoring of lower extremity deep vein thrombosis occurrence was performed and the changes of serum D -dimer was observed. Results The rest state VAS score at each time point in the group A was significantly lower that in the group B (P<0.05). The VAS score of continuous passive function exercise at postoperative 24,48,72 h in the group A was significantly lower than that in the group B (P<0.05). The passive flexion and extension mobility on postoperative 2,3,4 d in the group A was significantly higher than that in the group B(P<0.05). There was no signifi cant difference in muscle strength at each time point between the two groups (P>0.05). The number of PCA pressing times in the group A was less than that in the group B (P<0.05). The CRP level at postoperative 6 h in the group the A was lower than that in the group B (P<0.05). The IL-6 level after operation in the two group was higher than that before operation, but the intergroup had no significant difference (P>0.05). The lower extremity deep venous thrombosis formation detected by ultrasound had no significant difference between the two groups. The D-dimer level during perioperative period in the group A was lower than that in the group B (P<0.05). Conclusion Ultrasound guided continuous femoral nerve block used in postoperative analgesia in the patients undergoing knee arthroplasty has definite analgesic effect, can alleviate postoperative stress damage and incidence of postoperative complications, and is conducive to consolidate the operative curative effect.

Chemokine (C-X-C motif) ligand 8 enhances the homing ability of human umbilical vein endothelial cells by promoting a paracrine response in mesenchymal stem cells under the high glucose environment / 中国组织工程研究

BACKGROUND:Chemokines can promote (MSCs) the secretion of vasoactive factors from mesenchymal stem cel s (MSCs) through paracrine mechanism, which have important role in accelerating angiogenesis. OBJECTIVE:Under the high glucose environment, to the effect of the supernatant of MSCs stimulated by chemokine (C-X-C motif) ligand 8 (CXCL-8) on human umbilical vein endothelial cel s (HUVECs), and to analyze the mechanism of Sonic Hedgehog signaling pathway in the stimulation of CXCL-8 on MSCs. METHODS:Under the high glucose environment, the MSCs supplemented with 100μg/L CXCL-8 were set as CXCL-8 group;the MSCs that were preprocessed with 5μmol/L octyl maleimide for 45 minutes and then stimulated with 100μg/L CXCL-8 were as Shh inhibitor group;the MSCs that were routinely cultured in a high-glucose medium were as control group. The cel supernatant of each group was extracted as conditioned medium (CM) to culture HUVECs, respectively, and these cel s were referred to as CXCL-8 CM group, Shh inhibitor CM group, and control CM group, respectively. Cel counting kit-8, cel scratch and Transwel chamber tests were used to observe the effect of each CM on HUVEC proliferation, apoptosis and chemotaxis. By establishment of a diabetic skin ulcer model in C57BL/6J mice, the CM of each group was used to treat the mouse model to confirm the effects of CXCL-8 stimulated MSCs CM on HUVEC homing and ulcer healing. RESULTS AND CONCLUSION:(1) The experimental results in vitro:compared with the control CM group, CXCL-8 CM group significantly promoted the proliferation of HUVECs, and decreased the apoptosis of HUVECs, the closure rate and migration rate of HUVECs were significantly increased (P<0.01 or P<0.01), and the levels of vascular endothelial growth factor and epidermal growth factor were significantly increased (P<0.01 or P<0.01). Compared with CXCL-8 CM group, however, the above results in the Shh inhibitor CM group showed reverse changes (P<0.01). (2) The experimental results in vivo:compared with the MSCs CM group and Shh inhibitor CM group, the healing effect of diabetic skin ulcer and the number of HUVECs labeled by green fluorescent protein in the CXCL-8 CM group were significantly increased (P<0.01). To conclude, these findings indicate that CXCL-8 stimulated MSCs secrete paracrine factors, vascular endothelial growth factor and epidermal growth factor, through the Sonic Hedgehog signaling pathway under the high glucose environment, which enhance the homing ability of HUVECs.

Multimodal fundus imaging in patients of syphilitic posterior uveitis at different stages / 中华眼底病杂志

Objective To observe the fundus imaging characteristics of different stages of syphilitic posterior uveitis. Methods Retrospective cases series. Forty-six eyes of 32 patients with syphilitic posterior uveitis were included. There were 14 patients (16 eyes) and 18 patients (30 eyes) were assigned to acute stage group (with the course<2 months) and chronic stage group (with the course≥2 months) respectively. All eyes received the examination of indirect ophthalmoscopy, color fundus photography, fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). All patients received regular anti-syphilitic treatment. Color fundus photography and OCT were followed after treatment. The fundus imaging characteristics of different stages of syphilitic posterior uveitis were observed. Results Indirect ophthalmoscopy and fundus color photography showed that in the acute stage group, there were 3/16 eyes with optic disc edema;4/16 eyes with a yellowish, placoid lesion involving the macular. There were only some pigment alterations on the fundus after treatment. In the chronic stage group, there were 4/30 eyes with optic disc hyperemia, 3/30 eyes with cystoid macular edema. After treatment, the optic hyperemia vanished gradually, but there were still some pigment alterations. The FFA images of two groups showed various vascular leakages. In the chronic stage group, patients also showed hyper-fluorescence with cystoid macular edema. The patients with course 2–3 years have more transmitted fluorescence on FFA. OCT showed that all eyes in the acute stage group had lost the ellipsoid zone, with irregular granular reflectivity of the retinal pigment epithelium (RPE) layer, 6 eyes with subretinal fluid in the macular. After treatment, the ellipsoid zone and RPE layer structure recovered gradually. In the chronic stage group, all eyes showed widespread loss of the ellipsoid zone, pigment migration and (or) cystoid macular edema. After treatment, the ellipsoid zone showed partial recovery. The outer ellipsoid zone was still discontinuous in patients with long duration. Conclusions Syphilitic posterior uveitis patients generally had normal fundus, but some cases had a yellowish, placoid lesion involving the macular. FFA showed various vascular leakages, and the chronic stage group showed more transmitted fluorescence. The major OCT change was loss of the ellipsoid zone or with subretinal fluid. After treatment, fundus showed no abnormal manifestations except some pigment alterations;the ellipsoid zone structure recovered gradually in acute stage eyes, partially recovered in chronic stage eyes.

Enhancing the ability of autophagy and proliferation of bone marrow mesenchymal stem cells by interleukin-8 through Akt-STAT3 pathway in hypoxic environment / 生物工程学报

To study the effects and mechanisms of interleukin-8 (IL-8) on the proliferation and autophagy of human bone marrow mesenchymal stem cells (hBMSC) under hypoxic condition. In the hypoxia model, we set the non-stimulated hBMSC as the hypoxia control group; the hBMSC stimulated by 100 μmol/L human IL-8 as the IL-8 group; the hBMSC stimulated by 50 μmol/L MK2206 (Akt protein inhibitor) and 100μmol/L IL-8 as the Akt inhibitor group; and the normal cultured hBMSC as the normal control group. The experiments of EdU cell proliferation and TUNEL apoptosis were respectively used to detect the number of positive cells that were labeled by EdU and apoptosis in each group, and Western blotting and ELISA were used respectively to detect the expression of autophagy protein (LC-3), Akt/STAT3 and other proteins in each group. The results indicated that the proliferation and autophagy of hBMSC in IL-8 group was higher than that in hypoxia control group and Akt inhibitor group, and the apoptosis rate in IL-8 group decreased. These results and the high expression of Akt, STAT3 and VEGF protein of IL-8 group show that under the hypoxic condition, IL-8 played a protective role on MSC through the Akt-STAT3 pathway. It had important significance in the protection of MSC against the injury due to ischemia and hypoxia, and promoted the application of MSC in regenerative medicine.

Determination of L-Tryptophan by Using Ordered Mesoporous Silica Modified Carbon Paste Electrode Based on Enhancement Effects of Surfactant / 分析化学

An ordered mesoporous silica ( OMS ) was synthesized through hydrothermal process. The synthesized material was characterized by different techniques such as X-ray diffraction, nitrogen adsorption-desorption and transmission electron microscope. The electrochemical characteristics of the OMS modified carbon paste electrode ( OMS/CPE ) were investigated by using cyclic voltammetry and electrochemical impedance spectroscopy. Compared with bare carbon paste electrode ( CPE ) , the OMS/CPE exhibited a larger electrode surface and a faster electron-transfer rate. Electrochemical behaviors and kinetic properties of L-tryptophan ( L-Trp) at the OMS/CPE in the presence of sodium dodecylsulphate ( SDS) were studied. The results showed that the voltammetric response of L-Trp at OMS/CPE was improved due to the synergistic effect of OMS and SDS. The electrochemical oxidation of L-Trp at OMS/CPE in the presence of SDS was an irreversible process involved two electrons and two protons, and the electrode process was controlled by the adsorption step. Some parameters such as SDS concentration, accumulation time, accumulation potential and pH were optimized. Under optimal conditions, the oxidation peak current was linearly proportional to L-Trp concentration in the range of 8. 0×10-8 to 4. 0×10-6 mol/L, with a detection limit of 7. 0×10-8 mol/L (S/N=3 ) . The proposed method was applied for the determination of L-Trp in oral liquid with the recoveries of 99 . 6%-102 . 6%.

Role of c-Jun N-terminal kinase signal pathway in sufentanil preconditioning against hepatic ischemia-reperfusion inj ury in rats / 临床麻醉学杂志

Objective To detect the protective effect of sufentanil preconditioning on hepatic ischemia-reperfusion injury in rats and the role of c-Jun N-terminal kinase signal pathway in the mech-enism.Methods One hundred and sixty-two SD rats(in either gender,weighing 250-300 g)were ran-domly divided into seven groups:Sham-operated group (group S,n = 30 ),ischemia-reperfusion group (group IR,n =30),sufentanil preconditioning group (group SF1:1 μg/kg,n =30;group SF5:5 μg/kg,n =30;group SF10:10 μg/kg,n =30),SP600125 group (group SP,n =30),and dimethyl sulphoxide control group (group DMSO,n =6),different doses of sufentanil was administered 30 min before hepatic ischemia in group SF1,SF5 and SF10.Blood and liver samples were collected from each group at 0(T1 ),1 (T2 ),2 (T3 ),4 (T4 ),and 6 (T5 )hours after reperfusion.Serum alanine amin-otransferase (ALT)and aspartate aminotransferase (AST)were measured by an automatic biochemi-cal analyzer.Malondialdehyde (MDA)and superoxide dismutase (SOD)in liver tissue was measured. Liver sample was stained with HE to observe the hepatic pathological changes.Immunohistochemical method was used to determine the expression of JNK and western blotting was used to detect the ex-pression of P-JNK.Results Compared with group S,levels of AST,ALT increased significantly in group IR,SF1,SF5,SF10 at T1-T5 and in group SP,DMSO at T3 (P <0.05 ).Compared with group IR,levels of AST,ALT decreased significantly in group SF1,SF5,SF10 at T1-T5 and in group SP at T3 (P <0.05).Compared with group S,levels of MDA,SOD increased significantly in group IR,SF1, SF5,SF10 at T1-T5 and in group SP,DMSO at T3 (P < 0.05 ).Compared with group IR,levels of MDA,SOD decreased significantly in group SF1,SF5,SF10 at T1-T5 and in group SP at T3 (P <0.05).Compared with group SF1 and SF5,levels of MDA,SOD decreased significantly in SF10 at T4 . Compared with T1 ,the expression of p-JNK in group IR increased significantly at T3 (P < 0.05 ). Compared with group S,the expression of p-JNK in groups IR,SF1,SF5,SF10,SP,DMSO increased significantly at T3 (P < 0.05 ).Compared with group IR,the expression of p-JNK in groups SF1, SF5,SF10,SP decreased significantly and that in groups SF5,SF10 were less than that in group SF1 (P <0.05 ).The expression of p-JNK in group SF10 was less than that in group SF5 (P < 0.05 ). Conclusion Sufentanil preconditioning can reduce the hepatic ischemia-reperfusion injury and the dos-age of 10 μg/kg was the most effective.The protective mechanisms may inhibit JNK pathway and re-duce the expression of JNK.

Artificial neural network analysis on computerized transrectal ultrasound in early detection of prostate cancer / 中华泌尿外科杂志

Objective To investigate the application of artificial neural network analysis on computerized transrectal ultrasound (ANNAcTRUS) in early detection of prostate cancer.Methods Sixty men with or without prior biopsies, either due to elevated PSA or abnormal digital rectal findings, were included in this study from January 2014 to July 2015.Patient's mean age was (65.6 ± 8.9) years (51-89 years).Their PSA level was (9.8 ± 4.9)μg/L.The patients received the ANNAcTRUS targeted 6-core biopsy.Each patient received six targeted biopsies of suspicious regions, which was identified by ANNAcTRUS online system.Histopathologic examination was further carried out to confirm the result of the targeted biopsies.Results According to the results of ANNAcTRUS,52 of 60 patients received biopsy in ANNAcTRUS group.ANNAcTRUS targeted 6-core biopsy was able to detect prostate cancer in 24 (46.2％) of 52 patients.The distribution of Gleason Score was as follows : 3 + 3 (n =9), 3 + 4 (n =8), 4 + 3 (n =4), 4 +4 (n =2) and 5 +4 (n =1).For patients without prior negative biopsy,ANNAcTRUS targeted 6-core biopsy was able to detect prostate cancer in 17 (51.5％) of 33 patients.Conclusions ANNAcTRUS targeted 6-core biopsy illustrates a higher detection rate of prostate cancer.Furthermore, ANNAcTRUS targeted 6-core biopsy tends to detect low-grade prostate cancer.

Comparison of retropubic radical prostatectomy and standard laparoscopic radical prostatectomy: a meta-analysis / 中华泌尿外科杂志

Objective To compare the outcomes of standard laparoscopic radical prostatectomy (SLRP) and retropubic radical prostatectomy (RRP) via meta-analysis.Methods A systematic literature search of articles from January 1992 to April 2015 was conducted via Pubmed,Web of Science,Cochrane Library,and EMBASE databases,and the references of the retrieved articles.Fixed-or random-effect models were used to summarize the estimates to evaluate operation time,blood loss,transfusion,catheterization time,hospital stay,surgical margin status,perioperative complications,postoperative erectile dysfunction,and postoperative urinary incontinence in these two approaches.Results A total of 17 articles were included in this study.Compared with RRP group,the operation time was longer in SLRP group (SMD =1.20,95％ CI 0.83,1.58).On the contrary,the SLRP group held advantages in blood loss (SMD =-2.02,95％ CI -2.67,-1.37),transfusion (RR =0.22,95％ CI 0.16,0.30),catheterization time (SMD =-1.44,95 ％ CI-2.34,-0.54),hospital stay (SMD =-0.97,95 ％ CI-1.29,-0.66) (P ＜ 0.05).Moreover,these two approaches showed no difference in surgical margin status (RR =0.94,95 ％ CI 0.84,1.05),perioperative complications (RR =0.78,95％ CI 0.60,1.02),postoperative erectile dysfunction (RR =1.13,95 ％ CI 0.97,1.31),and postoperative urinary incontinence (RR =0.85,95 ％ CI 0.57,1.28) (P ＞0.05).Conclusions Compared with RRP,SLRP could be a more suitable approach to treat localized prostate cancer.Random clinical trials are needed in the future to better evaluate these two approaches.

Clinical analysis of prostate cancer in young men under 50 years / 中华泌尿外科杂志

Objective To analyze the clinical features of patients with prostate adenocarcinoma under 50 years.Methods Between January 2008 and April 2014,we reviewed 21 cases with prostate cancer under 50 years old.The mean age in those patients was 48 years old (ranged 42-49 years old).Their tPSA level was elevated,including＞10 μg/L in 17 cases,4-10 μg/L in 4 cases.21 cases were all confirmed by pathology.The results Gleason score showed 6 scores in 3 cases,7 scores in 6 cases (3+4 scores in 5 cases and 4+3 scores in one case),8 scores in 7 cases and 9 scores in 5 cases.In the study,clinical stage was for T2N0M0 in 16 cases,T3N0M0 in 1 case,T4NxM0 in 1 case and T3-4N1M1 in 3 cases.The treatments were hormonal therapy was chosen in 5 cases and radical prostatectomy was performed in 16 cases,including 16 cases with T2N0M0 stage and one case with T3N0M0.Results In those patients who accepted the radical prostatectomy,the duration of follow-up ranged from 3 to 65 months (mean 23 months).During the follow-up,14 patients had a lower incidence of biochemical recurrence.1 patient (T2,PSA 82.8 μg/L,GS 9) had external beam radiotherapy one month after the radical prostatectomy because of tumor invasion into the prostatic capsule.Then his PSA level returned to the 0.2 μg/L.1 patient (T3,PSA 38.9 μg/L,GS 8) had external beam radiotherapy 18 months after the radical prostatectomy because of biochemical recurrence and the tPSA level returned to the 4.0 μg/L.All patients who underwent radical prostatectomy had favourable recovery of urinary continence.In 5 patients who had androgen deprivation therapy,2 patients died after 63 or 65 months and one patient was lost to follow-up.The PSA level in one patient decreased from 71.8 μg/L to 2 μg/L after four months treatment.One patient had castration resistant prostate cancer and the adjuvant external beam radiotherapy was considered,subsequently.Conclusions Men under the 50 years old,who are diagnosed with localised prostate cancer,usually demonstrated the early clinic stage and high Gleason scores.It should not be discouraged from RP.Young men with metastatic prostate cancer have a poor prognosis.

Protective effect and mechanism of sufentanil preconditioning on hepatic ischemia-reperfusion injury：by activating p38 mitogen-activated protein kinases signal pathway / 重庆医学

Objective To study the protective effect of sufentanil preconditioning on hepatic ischemia-reperfusion injury in rats and to investigate the mechanisms whether may be by activating p38 MAPK signal pathway to promote p38 MAPK phosphoryla-tion .Methods Thirty SD rats(in either gender ,weighing 220-270 g) were randomly divided into five groups :Sham-operated group (Ⅰ) ,ischemia-reperfusion group(Ⅱ);sufentanil preconditioning group(5 μg/kg ,Ⅲ) ,SB203580(an inhibitor of p38 MAPK) group (Ⅳ) ,and dimethyl sulphoxide (DMSO) control group(Ⅴ) .Sample specimens were collected from each group at 240 minutes after reperfusion .Serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were measured by an automatic biochem-ical analyzer .Malondialdehyde(MDA) and superoxide dismutase(SOD) in liver tissue was measured .HE staining was used to ob-serve the hepatic pathological changes ,and to examine the expression of phosphor-p38 mitogen-activated protein kinases (p-p38 MAPK)of hepatic tissues by western blotting .Results Compared with group Ⅰ ,levels of AST ,ALT and MDA showed signifi-cantly increased in group Ⅱ-Ⅴ ,but levels of SOD decreased ,and obvious pathological changes were observed in the liver .In GroupⅢ significantly decreased the elevated levels of ASL ,ALT and MDA but increased levels of SOD ,and lessened hepatic pathological changes ,caused promoted p38 MAPK phosphorylation at 240 minutes after reperfusion .The protective effects of sufentanil precon-ditioning were abolished by SB203580 pretreatment .There were no significant differences between group Ⅴ and group Ⅱ .Conclu-sion Sufentanil preconditioning can reduce the hepatic ischemia-reperfusion injury .The protective mechanisms may be by activating p38 MAPK signal pathway to promote p38 MAPK phosphorylation .