Study on the mechanism of miRNA-20a in regulating lipopolysaccharide-induced pyroptosis and inflammation of A549 cells / 中国新生儿科杂志

Methods:Cultured human alveolar epithelial A549 cells were assigned into LPS group and blank control group. LPS group was stimulated with LPS and adenosine triphosphate to induce pyroptosis and inflammation. A549 cells were divided into 4 groups: miR-20a mimics group, mimics-negative control (NC) group, inhibitor group and inhibitor-NC group. MiRNA-20a mimics, mimics-NC, inhibitor, and inhibitor-NC were transfected respectively into A549 cells, and after 24 h, the cells were collected to verify transfection efficiency by qPCR. MiRNA-20a mimics and the constructed TLR4-3'UTR double luciferase reporter plasmid were co-transfected into A549 cells, and luciferase activity was analyzed. MiRNA-20a mimics/inhibitors were transfected into A549 cells, and then the cells were stimulated by LPS for 8 h followed by adenosine triphosphate for 30 min. QPCR, Western Blot and ELISA were used to detect the expression of GSDMD, inflammatory factors (ASC, NLRP3, Caspase-1, IL-1β) and Signaling molecules (TLR4、NF-κB) in A549 cells at mRNA level and protein level. Immunofluorescence was used to detect the expression of TLR4 in the A549 cells and NF-κB in the nucleus of A549 cells after transfecting with miRNA-20a mimics/inhibitor.Results:The mRNA and protein expression of pyroptosis marker molecule (GSDMD) and inflammatory factors (ASC, NLRP3, Caspase-1, IL-1β) in A549 cells stimulated with LPS were significantly higher than those in the blank control group, and the differences were statistically significant ( P<0.05). The expression of miRNA-20 in the mimics group was significantly higher than that in the mimic-NC group ( P<0.05), while the expression of miRNA-20a in the inhibitor group was lower than that in the inhibitor-NC group ( P<0.01). The double luciferase reporter gene experiment showed that the relative fluorescence value of the co-transfection group for TLR4-3'UTR-WT and miRNA-20a mimics was significantly lower than the co-transfection group for TLR4-3'UTR-WT and miRNA-20a mimics-NC ( P<0.05). The mRNA and protein levels of pyroptosis marker molecule (GSDMD) , inflammatory factors (ASC, NLRP3, Caspase-1, IL-1β) and signaling molecules (TLR4, NF-κB) were decreased in the mimics group compared to the mimics-NC group, and increased in inhibitor group compared to inhibitor-NC group. Conclusions:miRNA-20a may inhibit LPS-induced pyroptosis and inflammation of A549 cells via TLR4/NF-κB signal pathway.Objetive:To explore the potential role of miRNA-20a in lipopolysaccharide (LPS) induced pyroptosis and inflamation of human alveolar epithelial A549 cells and its regulation mechanisim.

Polyethylene biodegradation: current status and perspectives / 生物工程学报

Polyethylene (PE) is the most abundantly used synthetic resin and one of the most resistant to degradation, and its massive accumulation in the environment has caused serious pollution. Traditional landfill, composting and incineration technologies can hardly meet the requirements of environmental protection. Biodegradation is an eco-friendly, low-cost and promising method to solve the plastic pollution problem. This review summarizes the chemical structure of PE, the species of PE degrading microorganisms, degrading enzymes and metabolic pathways. Future research is suggested to focus on the screening of high-efficiency PE degrading strains, the construction of synthetic microbial consortia, the screening and modification of degrading enzymes, so as to provide selectable pathways and theoretical references for PE biodegradation research.

Neoadjuvant radiohormonal therapy for oligo-metastatic prostate cancer: safety and efficacy outcomes from an open-label, dose-escalation, single-center, phase I/II clinical trial / 医学前沿

To evaluate the safety and efficacy of neoadjuvant radiohormonal therapy for oligometastatic prostate cancer (OMPC), we conducted a 3 + 3 dose escalation, prospective, phase I/II, single-arm clinical trial (CHiCTR1900025743), in which long-term neoadjuvant androgen deprivation was adopted 1 month before radiotherapy, comprising intensity modulated radiotherapy to the pelvis, and stereotactic body radiation therapy to all extra-pelvic bone metastases for 4-7 weeks, at 39.6, 45, 50.4, and 54 Gy. Robotic-assisted radical prostatectomy was performed after 5-14 weeks. The primary outcome was treatment-related toxicities and adverse events; secondary outcomes were radiological treatment response, positive surgical margin (pSM), postoperative prostate-specific antigen (PSA), pathological down-grading and tumor regression grade, and survival parameters. Twelve patients were recruited from March 2019 to February 2020, aging 66.2 years in average (range, 52-80). Median baseline PSA was 62.0 ng/mL. All underwent RARP successfully without open conversions. Ten patients recorded pathological tumor down-staging (83.3%), and 5 (41.7%) with cN1 recorded negative regional lymph nodes on final pathology. 66.7% (8/12) recorded tumor regression grading (TRG) -I and 25% (3/12) recorded TRG-II. Median follow-up was 16.5 months. Mean radiological progression-free survival (RPFS) was 21.3 months, with 2-year RPFS of 83.3%. In all, neoadjuvant radiohormonal therapy is well tolerated for oligometastatic prostate cancer.

Research progress of knee meniscal repair techniques / 中国修复重建外科杂志

OBJECTIVE@#To review the research progress of meniscus repair in recent years, in order to provide help for the clinical decision-making of meniscus injury treatment.@*METHODS@#The domestic and foreign literature related to meniscal repair in recent years was extensively reviewed to summarize the reasons for the prevalence of meniscal repair, surgical indications, various repair methods and long-term effectiveness, the need to deal with mechanical structural abnormalities, biological enhancement repair technology, rehabilitation treatment, and so on.@*RESULTS@#In order to delay the occurrence of osteoarthritis, the best treatment of meniscus has undergone an important change from partial meniscectomy to meniscal repair, and the indications for meniscal repair have been expanding. The mid- and long-term effectiveness of different meniscal repair methods are ideal. During meniscus repair, the abnormality of lower limb force line and meniscus protrusion should be corrected at the same time. There are controversies about the biological enhancement technology to promote meniscus healing and rehabilitation programs, which need further study.@*CONCLUSION@#Meniscal repair can restore the normal mechanical conduction of lower limbs and reduce the incidence of traumatic osteoarthritis, but the poor blood supply and healing ability of meniscal tissue bring difficulties to meniscal repair. Further development of new biological enhanced repair technology and individualized rehabilitation program and verification of its effectiveness will be an important research direction.

All-inside versus full-tibial tunnel techniques of anterior cruciate ligament reconstruction: a systematic review and meta-analysis / 中华骨科杂志

Objective:To compare the clinical efficacy of arthroscopic all-inside technique versus full-tibial tunnel technique for anterior cruciate ligament (ACL) reconstruction.Methods:Literature on all-inside versus full-tibial tunnel for ACL reconstruction was retrieved from databases including China National Knowledge Infrastructure (CNKI), Wanfang Data, Full-text Database of Chinese Medical Journals, PubMed, Web of Science, and Cochrane Library from their establishment to February 2023. Meta-analysis was performed on the included studies. Random effects model was used if heterogeneity was large, while fixed effects model was used if heterogeneity was small.Results:A total of 13 studies with 511 cases in the all-inside group and 465 cases in the full-tibial tunnel group were included in the meta-analysis, with a mean follow-up of 6-25.8 months. Meta-analysis showed that the graft diameter [ MD=0.42, 95% CI (0.11, 0.73), P=0.007] and International Knee Documentation Committee (IKDC) subjective score [ MD=1.11, 95% CI (0.36, 1.86), P=0.004] of the all-inside group was larger than full-tibial tunnel group, and the tibial tunnel widening of the all-inside group was less than full-tibial tunnel group [ MD=-1.70, 95% CI (-2.38, -1.01), P<0.001]. There were no significant differences in IKDC objective score [ OR=1.09, 95% CI (0.67, 1.78), P=0.730], Lysholm score [ MD=0.99, 95% CI (-0.08, 2.05), P=0.070], Tegner activity score [ MD=-0.01, 95% CI (-0.48, 0.45), P=0.950], bilateral knee anterior laxity difference [ MD=0.32, 95% CI (-0.22, 0.86), P=0.250], negative rate of pivot shift test [ OR=0.80, 95% CI (0.33, 1.91), P=0.610], graft re-rupture rate [ OR=0.76, 95% CI (0.34, 1.74), P=0.524] and return to sport rate [ OR=1.56, 95% CI (0.85, 2.86), P=0.150]. Conclusion:All-inside ACL reconstruction provides satisfactory efficacy. Compared with full-tibial tunnel technique, it has the advantages of larger graft diameter and less tibial tunnel widening, with no difference in joint function within 2 years postoperatively.

Methods of reducing the "killer turn" effect in the posterior cruciate ligament reconstruction / 中华骨科杂志

The reconstruction of the posterior cruciate ligament (PCL) through the tibial tunnel is the most commonly used reconstruction technique after ligament injury.However, when the graft passes through the tibial tunnel back to the medial condyle of the femur, a sharp angle is formed at the proximal end of the tibia, called the "killer turn". The existence of the "killer turn" can lead to graft wear and expansion of adjacent tibial tunnel after PCL reconstruction, affecting the stability of the posterior knee joint after operation and even leading to the failure of operation. There are several techniques, such as modifified tibial tunnel technique which the proximal exit of tibial tunnel is located in the inferior and lateral aspect of the PCL tibial anatomic insertion site, increasing the angle between the tibial tunnel and the tibial plateau, creating a tibial tunnel from the anterior lateral side of the tibia, remnant preserving as soft tissue cushion, and inlay and onlay techniques for reconstructing PCL without using tibial tunnel reconstruction, can reduce the "killer turn" effect. The above 6 techniques, theoretically, can effectively reduce or eliminate the "killer turn" effect and improve the posterior stability of the knee joint after PCL reconstruction, so as to improve the clinical efficacy of PCL reconstruction. But, the number of cases using these techniques is relatively small, and their effectiveness, reliability, and advantages and disadvantages for patients still need more clinical practice to further explore and verify.

Causes analysis and coping strategies of posterior laxity after posterior cruciate ligament reconstruction / 中华骨科杂志

It is difficult to maintain the initial posterior stability of the knee after posterior cruciate ligament reconstruction. Residual posterior knee laxity after operation is a problem of PCL reconstruction. It not only results in abnormal kinematics of the knee, but also leads to secondary meniscus injury and cartilage degeneration of the affected knee, and eventually leads to knee osteoarthritis, which may especially happen with persistent and severe posterior laxity. The main reasons of residual posterior knee laxity after PCL reconstruction are: improper treatment of the posterolateral corner injury, poor positioning of the femoral tunnel, small tibial slope, and unreasonable postoperative rehabilitation. There are some concepts and technologies, such as using artificial ligaments, tibial tunnel fixation with suspensory device or suspensory device combined with interference screws, enlargement of graft diameter, all-inside reconstruction combined suture augmentation, slow and gradual postoperative rehabilitation, which can eliminate or reduce the postoperative residual laxity, in order to improve clinical outcomes after PCL reconstruction. For the patients with flat tibial slopes, double-bundle PCL reconstruction and concurrent slope-increasing tibial osteotomy is suggested. It can reduce the risk of posterior laxity and improve the stability of the knee after operation.

All-inside anterior cruciate ligament reconstruction: a review of development, evolution and clinical significance / 中华骨科杂志

Rupture of anterior cruciate ligament (ACL) is one of the most common sports injuries of the knee, which may cause limitation of motor function and degeneration of the knee, seriously affecting patients' living quality. Currently, arthroscopic ACL reconstruction (ACLR) has been identified as the gold standard for ACL rupture. In an effort to further increase surgical accuracy and decrease surgical trauma so as to promotes quick recovery, all-inside ACLR has gained increasing attention in recent years. All-inside ACLR is as effective as traditional reconstruction, but it has benefits such as the preservation of tendons, preservation of bone mass, reduction of postoperative pain, prevention of synovial fluid leakage, expansion of the tendon-bone healing area, avoidance of complications related to extrusion screws, and suitability for children and adolescents. However, applying of numerous novel techniques for all-inside ACLR increases the learning curve, operating time, and cost. Besides, improper bone tunnel fabrication and graft fixation may lead to the widening of the bone tunnel, affecting the surgical effect. Therefore, in order to provide a theoretical foundation for further promoting the clinical application of this technique, this article reviews the development, evolution, and clinical outcomes of this technique as well as its advantages and disadvantages.

Advances in anterolateral ligament reconstruction: clinical practice and controversy / 中华骨科杂志

Rupture of the anterior cruciate ligament (ACL) is one of the most frequent forms of knee sports injuries. Nowadays, ACL reconstruction is commonly performed to help patients restore their rotational stability. However, in patients with high risk factors, the risk of ACL reconstruction failure remains high, primarily because of continuous postoperative anterolateral rotational instability. This rotational instability after ACL reconstruction has prompted researchers to focus on the anterolateral complex of the knee, such as iliotibial tract and anterolateral ligament (ALL). Among them, ALL has remained largely unappreciated for more than a century since its discovery in 1879. Even though it is still controversial, most studies in recent years have supported the anterolateral ligament as an independent ligament and a crucial anatomical component for preserving the rotational stability of the knee joint. Although augmentation of the anterolateral complex has experienced twists and turns, the anatomic ALL reconstruction, which can be performed minimally invasively and has a low risk of complications and minimal injury, is reappearing as a key strategy to address this problem. Currently, the majority of scholars believe that the need for combined ALL reconstruction during ACL reconstruction should be taken into account when there is severe rotational instability present, such as high-grade pivot shift test preoperatively, ACL revision surgery, and high requirements for rotational stability, such as age less than 25 years and the need to participate in pivoting sports. The corresponding suggested criteria are also put forth in the authoritative consensus of both domestic and foreign sources. However, the surgical indications chosen by different experts based on their individual experiences are not all consistent. Due to conflicting reports on the actual impact of ALL reconstruction on improving rotational stability and whether it will excessively restrict knee's internal rotation function, there is still much debate among researchers regarding whether ALL reconstruction and ACL reconstruction should be combined. Currently, there are two main reconstruction techniques: ALL single bundle reconstruction and Y-construct ALL double bundle reconstruction. Y-construct ALL double bundle reconstruction has a better ability to restore the original anatomy and is recommended in the consensus, but there is still a lack of randomized controlled trials between the two techniques. Therefore, the combination of ALL reconstruction at the time of ACL reconstruction has been clinically started in recent years for patients who are susceptible to failure after ACL reconstruction, which also raises many controversies.

The interpretation of the American Academy of Orthopaedic Surgeons "management of anterior cruciate ligament injuries evidence-based clinical practice guideline (2022)" / 中华骨科杂志

The anterior cruciate ligament (ACL) injury is a common sports injury, which can lead to the knee unstable, make it difficult for the patient to return to sports, and cause post-traumatic osteoarthritis. The difficulty of its clinical diagnosis and treatment has always been the focus of sports medicine research. In August 2022, the American Association of Orthopaedic Surgeons updated and published "evidence-based clinical practice guideline on management of ACL injuries (2022 version)" based on the "evidence-based clinical practice guideline on management of ACL injuries (2014 version)". In the prevention, diagnosis and treatment of ACL injuries, the new guideline offers 8 recommendations and 7 options according to different evidence strength. To assist clinicians in the diagnosis and treatment of ACL injuries, this article provides an interpretation of the new guideline. In comparison to the 2014 version, the new guideline does not recommend allografts any more, shortens the time for reconstruction after ACL injury from 5 months to 3 months, adds advice that ACL reconstruction can be combined with anterolateral ligament reconstruction or lateral extra-articular tenodesis, and does not recommend ACL repair. The new guideline also shares many similarities with the domestic "clinical evidence-based guideline for the diagnosis and treatment of anterior cruciate ligament injury (2022 version)", both of which advocate history and physical examination at diagnosis, early reconstruction, the use of autologous bone-patellar tendon-bone or hamstring tendon, and either single-bundle or double-bundle ACL reconstruction. The new ACL guidelines of the American Association of Orthopaedic Surgeons lack specific recommendations on artificial ligaments, techniques for bone tunnel creation, and rehabilitation programs, all of which are of concern to domestic physicians because they are based on evidence-based research from abroad. Therefore, in order to improve the diagnosis and treatment of ACL injuries in China, clinicians should not only follow the new ACL guidelines of the American Association of Orthopaedic Surgeons, but also combine the characteristics of Chinese patients, clinical practice, and pertinent domestic guidelines when diagnosing and treating ACL injuries.

Navigation-assisted valgus stress method can avoid over correction of high tibial osteotomy / 中华骨科杂志

Objective:To explore the role of navigation-assisted valgus stress method in avoiding excessive correction of lower limb mechanical axis after high tibial osteotomy (HTO).Methods:A retrospective study was carried out on osteoarthritis (OA) patients who were treated with HTO for medial compartment pain of knee from January 2020 to March 2022 in the Department of Joint Surgery, Shanghai Changhai Hospital, the First Affiliated Hospital of Naval Medical University. According to the different ways of confirming alignment during operation, they were divided into computer navigation assisted valgus stress HTO group (referred to as navigation group) and traditional rod fluoroscopy HTO group (referred to as traditional group). There were 28 patients in the navigation group, 10 males and 18 females, with age of 54.4±9.1 years (range, 41-73 years) and body mass index of 26.1±3.3 kg/m 2 (range, 19.8-35.2 kg/m 2); There were 30 patients in the traditional group, 13 males and 17 females, aged 56.9±8.5 years (range, 40-70 years), with a body mass index of 25.7±4.0 kg/m 2 (range, 19.2-32.9 kg/m 2). Measuring the mechanical femoral tibial angle (mFTA), joint line convergence angle (JLCA), medial proximal tibial angle (MPTA), Lysholm score and Hospital for Special Surgery (HSS) score before operation and at the last follow-up of the two groups, and conduct statistical analysis. Results:Both groups were followed up. The follow-up time of navigation group and traditional group was 21.3±8.7 months and 22.5±7.6 months, respectively, with no significant difference ( t=0.53, P=0.596). There were significant differences between the two groups in the amount of mechanical axis correction (ΔmFTA) and the amount of bone correction (ΔMPTA) ( t=2.09, P=0.041; t=2.58, P=0.012), while there was no significant difference in ΔJLCA ( t=0.32, P=0.753). In the navigation group, there were 9 cases (32%) of undercorrection, 17 cases (61%) with acceptable alignment, and 2 cases (7%) with over correction, while in the traditional group, there were 5 cases (17%) with under correction, 13 cases (43%) with acceptable alignment, and 12 cases (40%) with over correction. There was significant difference in the distribution rate of alignment between the two groups ( P=0.012), and the rate of overcorrection in the navigation group was significantly lower than that in the control group (7% vs. 40%, P=0.005). The intra group correlation coefficient between the navigation correction mechanical axis and ΔmFTA was 0.787. There was no significant difference in Lysholm score and HSS score between the two groups before and after surgery (all P>0.05), and they were significantly improved after operation (all P<0.05). Conclusion:Navigation-assisted valgus stress method HTO is reliable, which can accurately achieve the target alignment, reduce the incidence of over correction, and obtain good clinical results.

Clinical application of LARS artificial ligament in anterior cruciate ligament reconstruction: an update / 中华创伤杂志

The anterior cruciate ligament (ACL) is one of the most crucial components to maintain knee joint stability and also the most vulnerable structure during knee-related sports activities. ACL injuries often cause knee instability, difficulty in returning to sports, and secondary degenerative knee disease. Although using autograft to reconstruct the ACL is currently a popular choice in clinical settings, it has drawbacks such as limited autograft source, donor site morbidity and delayed return to sports. Ligament advanced reinforcement system (LARS) artificial ligament possesses unique advantages such as wide availability, no donor-site morbidity, and early recovery, avoiding the problems associated with autograft reconstruction of ACL, and it has drawn increasing attention in recent years. In this paper, the authors reviewed the characteristics of LARS artificial ligament and its application in ACL reconstruction, so as to provide reference for clinical treatment of ACL injuries.

Attitude towards electronic cigarette and associated factors among college students in Zhejiang Province / 中国学校卫生

Objective@#To understand the attitude of college students in Zhejiang towards e cigarette and its influencing factors, so as to provide basis for making prevention and control strategies.@*Methods@#In September 2020, 10 colleges and universities in Zhejiang Province were selected to conduct an online survey by a combination of typical sampling method and convenience sampling method. A multivariable Logistic regression model was used to analyze the influencing factors.@*Results@#Among 884 subjects, 93 (10.52%) were positive about e-cigarettes, 310 (35.07%) thought e-cigarettes were harmless, 252 (28.51%) thought e-cigarettes were not addictive and 67 (7.58%) of respondents were using e-cigarettes. Multivariate Logistic regression analysis showed that gender, grade, cost of living, whether or not smoking e-cigarettes were harmful to college students attitudes towards e-cigarettes( OR =0.59, 0.47, 1.87, 0.34, 0.54, P <0.05).@*Conclusion@#College students in Zhejiang Province have a positive attitude towards electronics and are not active in avoiding the dangers of smoking. To make full use of the work of concentrated trainees in tobacco control, efforts should be made to break the positive image of e-cigarettes. Junior college students should be the prioritized population for intervention, and female students should not be neglected.

Expression and bioinformatics analysis of circRNA_Dock6 in lung tissue of neonatal rats with acute respiratory distress syndrome / 中华实用儿科临床杂志

Objective:Differentially expressed circ_Dock6 was screened in vivo by applying circRNA high-throughput sequencing technology in lung tissue of newborn rats suffering from acute respiratory distress syndrome (ARDS). The corresponding target genes of microRNAs were predicted by bioinformatics, and their biological processes and signal pathways were analyzed as well. Methods:Real-time quantitative PCR was utilized to detect the expression of circ_Dock6 in the lung tissue of newborn rats in ARDS group (12 cases) and normal control group (12 cases). TargetScan, RNAhybrid and miRanda databases were adopted to predict the possible recruitment of miRNAs and their corresponding target genes by circ_Dock6.Functional enrichment analysis and signal pathway enrichment analysis were carried out on the target genes of each miRNA.Results:The expression of circ_Dock6 (0.44±0.29) in the lung tissue of ARDS group was significantly down-regulated ( t=2.060, P<0.05) compared with normal control group(1.63±1.33). The target gene intersections of miRNAs (miR-24-3p, miR-667-3p, miR-711, miR-203b-5p, miR-5132-5p, etc.) may be recruited by circ_Dock6 and were obtained from three databases.Its target gene aggregation function was enriched in various biological processes, including protein metabolism, protein amino acid phosphorylation, DNA-dependent transcriptional regulation, biological regulation, tissue and organ development, cell differentiation, signal regulation, gene expression, response to stimuli, almost all cellular components such as intracellular, organelle, cytoplasm, and nucleus, as well as molecular functions such as transferase activity, transcription factor activity, and phosphotransferase activity.The involved signaling pathways, including enrichment in mitogen-activated protein kinase(MAPK) signaling pathway, phosphatidylinositol-3-kinase-protein kinase B(PI3K-Akt)signaling pathway, and mammalian rapamycin target protein(mTOR)signaling pathway, were closely related to ARDS.Circ_Dock6 may play a significant role in the pathogenesis of ARDS. Conclusions:Circ_Dock6 may be closely correlated with the pathogenesis of neonatal ARDS.Through bioinformatics analysis, the prediction of its target genes and related signaling pathways laid the foundation for further explorations of its mechanism of action.

The Value of Tumor Treating Fields in Glioblastoma

Glioblastoma (GBM) is one of the most common tumors of the central nervous system, which is the most lethal brain cancer. GBM treatment is based primarily on surgical resection, combined with radiotherapy and chemotherapy. Despite the positive treatment, progression free survival and overall survival were not significantly prolonged because GBM almost always recurs. We are always looking forward to some new and effective treatments. In recent years, a novel treatment method called tumor treating fields (TTFields) for cancer treatment has been proposed. TTFields devices were approved by the Food and Drug Administration (FDA) for adjuvant treatment of recurrent and newly diagnosed GBMs in 2011 and 2015, respectively. This became the first breakthrough treatment for GBM in the past 10 years after the FDA approved bevacizumab for patients with relapsed GBM in 2009. This paper summarized the research results of TTFields in recent years and elaborated the mechanism of action of TTFields on GBM, including cell and animal experimental research, clinical application and social benefits.

Single-port robot-assisted laparoscopic radical prostatectomy through different approaches: initial experience and outcomes / 中华泌尿外科杂志

Objective:To evaluate the feasibility and effectiveness of sing-port robot-assisted laparoscopic radical prostatectomy(sp-RALP) through different approaches.Methods:The data of 115 patients who underwent sp-RALP through different approaches from May 2018 to June 2020 were retrospectively reviewed. In our study, 92 cases through extraperitoneal approach, 10 through transperineal approach and 13 though transvesical approach. Preoperative, intraoperative and early postoperative outcomes after various approaches were collected and analyzed. The mean age was 67(52-84) years, mean preoperative body mass index was 24.44(19.52-32.33) kg/m 2. Patients were graded as cT 1-3aN 0M 0 with no signs of regional lymph node invasion or distal metastasis. The median preoperative PSA was 9.77(6.54, 15.32) ng/ml. Results:All 115 sp-RALP were successfully completed with no conversion to open surgery or additional ports being placed. The mean operative time was 91.8(40-200)min, with 88.0(40-200)min for extraperitoneal approach, 132.5 (90-190)min for transperineal approach and 87.3(60-150)min for transvesical approach. The mean estimated blood loss was 85.5 (45-400)ml, with 77.6(50-200)ml for extraperitoneal approach, 178.0(80-400)ml for transperineal approach and 70.4 (45-150)ml for transvesical approach. Of the 115 patients, 60.9% (70/115)were <pT 3a, 39.1%(45/115) were ≥pT 3a. Positive margin(PSM) rate was 17.4%(20/115), with 31.1%(14/45) for ≥T 3a group, 8.6%(6/70) for <T 3a group. Postoperative pathology revealed a Gleason score of 3 + 3 in 6 patients, 3 + 4 in 45 patients, 4+ 3 in 52 patients, and ≥8 in 2 patients. Mean hospital stay was 3(1-7)d. Median postoperative PSA was 0.03(0.01, 0.05)ng/ml at 1 month postoperatively, and 88.7% patients reported less than 1 pad per day at 3 month postoperatively. Conclusions:With several advantages, such as better cosmesis, postoperative fewer pain, and better recovery as well as comparable oncological outcomes in the short-term follow-up, sp-RALP through various approaches is a feasible and effective procedure for organ-confined prostate cancer.

Intestinal microbiota and infant health in early life / 国际儿科学杂志

The establishment and development of the intestinal microbiota in early life is critical to the development of intestinal immune system, digestive function, metabolic function, and central nervous system function in infants.The first 1000 days of life is a critical period for the establishment of intestinal microbiota, which is susceptible to many factors.The disorder of intestinal microbiota in this period will increase the risk of some diseases in the long-term life.In this review, we will describe the main physiological functions of the early-life microbiota and its role in programming future health of infants.We also will describe the establishment and development of the intestinal microbiota in early life and its main drivers.

Effect of siRNA silencing apoptosis signal-regulating kinase 1 on inflammatory response of human alveolar epithelial A549 cells induced by lipopolysaccharide / 中国新生儿科杂志

Objective To study the effect of small interfering ribonucleic acid (siRNA) silencing apoptosis signal-regulating kinase 1 (ASK1) on inflammatory response of lipopolysaccharide-induced alveolar epithelial A549 cells and its mechanism.Method Cell inflammation model of A549 cells was induced by lipopolysaccharide.The expression of ASK 1 in A549 cells was silenced by liposome transfection of siRNA.The mRNA and expression levels of ASK1,interleukin 6 (IL-6),interleukin 8 (IL-8) and tumor necrosis factor alpha (TNF-α) in A549 cells were detected by immunoblotting,real-time fluorescence quantitative polymerase chain reaction and enzyme-linked immunosorbent assay.Result The expression of IL-6,IL-8 and TNF-α in the experimental group was significantly higher than that in the control group (P＜0.001),which indicated that the inflammatory model of A549 cells was successfully constructed.The mRNA level and expression of ASK1 in the interference group was significantly lower than that in the negative control group and the blank control group (P＜0.01),indicating that silencing ASK1 was also successful.The expressions of IL-6,IL-8 and TNF-α in the interference group (0.37±0.04,0.32±0.04,0.48 ±0.13) were significantly lower than those in the negative control group (1.04±0.11,1.22±0.19,0.93±0.14) and the blank control group (1.01±0.14,1.01 ±0.23,1.02±0.25).The expression of IL-6,IL-8 and TNF-α protein in the interference group (pg/ml) (122.6± 11.0,537.2±42.4,159.2± 19.6) were also significantly lower than those in the negative control group (267.4±20.4,1 289.8±55.3,327.0±26.3) and blank control group (246.6±18.7,1 300.3±35.6,325.2± 18.3),with significant difference (P＜0.05).There was no significant difference in each value between negative control group and blank control group (P＞0.05).Conclusion Silencing ASK1 by siRNA can down-regulate the expression of IL-6,IL-8 and TNF-α in A549 cells,suggesting that ASK 1 may be involved in the regulation of lipopolysaccharide-induced inflammation in A549 cells.

Dosimetry study of fourtypes of radiotherapy plan optimization methods in the hypofractionated radiotherapy for lung cancer / 中华放射肿瘤学杂志

Objective To discuss the dosimetric differences in the planning methods between physical and biological optimization during thehypofractionated radiotherapy for lung cancer.MethodsTen cases of non-small cell lung cancer (NSCLC) receiving radiotherapy were selected in this retrospective study.The VMAT plans for all patients were re-designed by physical functions (DV group),biological combined with physical functions (DV+EUD group and EUD+DV group) and biological functions (EUD group).The constrained functions were different,whereas the constrained conditions and optimized parameters were identical among four groups.The dosimetric differences among four optimization methods during thehypofractionated radiotherapy for lung cancer were evaluated through calculating and analyzing each dosimetry parameter.Results For the target area,the equivalent uniform dose was approximate between the EUD and EUD+DV groups.The EUD in these two groups was approximately 2.8％-3.6％ and 3.2％-3.7％ higher than those in the DV and DV+EUD groups.The average tumor control probability (TCP) in the EUD and EUD +DV groupswas considerably higher than those in the other two groups (both P＜0.05).The homogeneity index (HI) significantly differed (all P＜0.05),whereas the conformity index (CI) did not differ (all P＞0.05).For the organ at risk (OAR) area,the differences of EUD,V5,V1o,V20,V30 of normal lung tissues and the difference of dosimetry parameters in heart and spinal cord were not statistically significant (all P＞0.05).The mean dose of all lungs in the EUD and EUD+DV groupswas slightly lower than those in the other two groups.ConclusionsBiological optimization method has certain advantages in increasing EUD and TCP in the target area and decreasing the irradiation dose of normal lung tissues,which provides references for selecting the optimization method with biological functions in clinical practice.

Intestinal microbiota and infant health in early life / 国际儿科学杂志

The establishment and development of the intestinal microbiota in early life is critical to the development of intestinal immune system,digestive function,metabolic function,and central nervous system function in infants.The first 1000 days of life is a critical period for the establishment of intestinal microbiota,which is susceptible to many factors.The disorder of intestinal microbiota in this period will increase the risk of some diseases in the long-term life.In this review,we will describe the main physiological functions of the early-life microbiota and its role in programming future health of infants.We also will describe the establishment and development of the intestinal microbiota in early life and its main drivers.