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Objective:To explore the clinical application of robot-assisted laparoscopic single-position nephroureterectomy and bladder sleeve resection for upper urinary tract urothelial carcinoma (UTUC).Methods:The clinicopathological data of 15 UTUC patients admitted to Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from October 2018 to May 2020 were retrospectively analyzed. There were 8 males and 7 females, with a median age of 58.6 (ranging 52.6-69.6) years, including 8 cases of renal pelvic cancer, 2 cases of upper ureteral cancer, 5 cases of middle and lower ureteral cancer.The tumor located on the left side in 5 cases and right side in 10 cases. All 15 patients underwent robot-assisted one-step transperitoneal nephroureterectomy and bladder sleeve resection by the same surgeon. The patients were placed in a 70° healthy side lying position with a 10° head lower and foot high position. After routinely dissecting the kidneys and controlling the renal hilum, we continued to dissect the ureter down to the orifice of the bladder. The lymph node dissection was performed when dissecting the kidney and ureter. Then the ureter was resected like a sleeve and the bladder was sutured. Observation indicators, such as operation time, blood loss, postoperative drainage tube and urinary catheter placement days, were recorded.Results:All 15 patients were successfully completed the operation in the same position and the same robot berth without conversion. The median operation time was 103 (ranging 82-185) min, and the intraoperative median blood loss was 60 (ranging 30-120) ml. The postoperative median drainage catheter placement time was 3 (ranging 2-5) d, the postoperative median hospital stay was 5 (ranging 4-7) d, and the postoperative urinary catheters were placed for 14 days. Postoperative pathological examinations of 15 patients showed UTUC without positive margins. The median follow-up time was 15 (ranging 10-30) months. All 15 patients survived. One patient was found a recurrence in the bladder after cystoscopy. There was no tumor progression after bladder tumor resection and bladder perfusion chemotherapy, and no tumor recurrence or metastasis was seen in the remaining 14 cases.Conclusions:Robot-assisted single-position transperitoneal nephroureterectomy for UTUC does not need to change patient position and robot berth, which effectively shortens the operation time, and achieves good tumor control effect. The short-term follow-up results were satisfactory.
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Objective To explore the spatial distribution clustering and influencing factors of chronic Keshan disease in China,and to provide evidence for prevention and control of Keshan disease.Methods Using non-probability sampling methods,combined with case search and key surveys,data on national detection rate of chronic Keshan disease,on disease influencing factors in 2013-2014 were collected;a spatial database was established,and ArcGIS 9.0 software was used to perform global Moran'sI,local Moran's I,local Getis-Ord Gi and inverse distance weighted interpolation analysis for the detection rate of national chronic Keshan disease.Spatial regression was used to analyze the influencing factors of chronic Keshan disease.Results Global autocorrelation analysis showed that Moran's I =0.03,Z =2.72,P ＜ 0.01,indicating that there was aggregation in the detection rate of Keshan disease.The results of local Moran's Ii showed that there were local high-detection rate clusters in the wards of Keshan disease,and the high-high aggregation areas were mainly concentrated in the wards of Gansu,Inner Mongolia,and Shanxi;the high-low aggregation areas were mainly located in the wards of Heilongjiang,Jilin,Shandong;the low-high aggregation area were mainly located in the wards of Heilongjiang.Getis-Ord Gi autocorrelation results showed that Keshan disease hotspots were mainly located in the wards of Inner Mongolia,Heilongjiang,Gansu,Shandong,Shanxi and Yunnan;the results of reverse distance weighted interpolation showed that the detection rates of the counties in Gansu and Inner Mongolia were higher than that in Heilongjiang,Jilin,Liaoning,Shanxi,Shandong,Shaanxi and Yunnan,the detection rate of wards in other provinces was at a lower level.Spatial regression analysis showed that the spatial distribution of chronic Keshan disease was negatively related to rural per capita net income and annual average temperature in the ward (Z =-2.808,-2.747,P ＜ 0.05).Conclusions Global chronic Keshan disease exists spatial aggregation,the local gathering area is mainly located in the wards of Gansu,Inner Mongolia.The spatial distribution of chronic Keshan disease may be affected by the level of rural per capita net income and annual average temperature in the ward.
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Objective To explore the spatial description of Keshan disease(KD)and to provide a basis for reasonable allocation of health resources and for making precision prevention and control strategies. Methods In 2013 and 2014, the KD's condition, prevention and control measures and their effects were investigated in the diseased affected counties in the provinces through combination of case search and key survey. Results A total of 16(100.0%,16/16)diseased provinces,315(96.0%,315/328)diseased counties were surveyed,and 1 562 people with KD were detected in 281 000 residents, the detection rate was 55.6/10 000. Chronic and latent KD detection rates were 8.9/10 000(250)and 46.7/10 000(1 312),respectively.There were 261(82.9%)diseased counties that had reached the control standards of KD,and 54(17.1%)did not meet the control standards,which mainly distributed in the provinces of Henan, Inner Mongolia, Gansu and Shanxi. Conclusions The detection rate of KD has been at a low level, but in Henan, Inner Mongolia, Gansu, and Shanxi, there are prevalent KD areas that have not yet reached the control level.This part of the areas should be treated as key prevention and control areas of KD.
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Classification,toxicity and determination method progress especially the pretreatment and limit of quantitation of beauvericin (BEA) and 4 main kinds of enniatins (ENNs) including enniatins A (ENA),enniatins A1 (ENA1),enniatins B (ENB) and enniatins B1 (ENB1) in food were introduced.The contamination levels of BEA,4 kinds of ENNs and their co-occurrence mycotoxins in food from Spain,Morocco,Italy,Japan and some other countries were analyzed.Establishment of high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) determination method for the complex food matrix was suggested.
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Objective To describe the status of prevalence,awareness,treatment,and control of hypertension among the residents in severe historical endemic areas of Keshan Disease in Heilongjiang Province,and to provide scientific evidence for prevention and control of hypertension.Methods In December 2015,Yongjin,Yongli groups of Yongjin Village,and Fengnian,Fengtian,Fengfu groups of Fengnian Village in Fanrong Township,Fuyu County,Qiqihaer City,Heilongjiang Province were selected via the cross-sectional method.The residents aged 18 years or older were surveyed as respondents by cluster sampling.Demography,risk factors,hypertension related information were collected through questionnaire survey.Blood pressure,height and weight were measured through physical examination.Blood pressure measurement was conducted with Omron HEM-1020 electronic sphygmomanometer,the diagnostic criteria was Chinese Guidelines for Prevention and Treatment of Hypertension (revised in 2010).Results Totally 683 residents were surveyed,the valid participants were 669,the prevalence of hypertension was 49.2％ (329/669),the standardized prevalence was 37.9％,the prevalence of men [58.0％ (164/283)] was higher than that of women [42.7％ (165/386),x2 =15.103,P ＜ 0.01],the prevalence increased with increasing age (total,men,women:x2tendency =9.044,4.560,7.789,all P ＜ 0.01).The awareness of hypertensive patients was 60.8％ (200/329),the standardized awareness was 41.2％,the awareness of men [54.3％ (89/164)] was lower than that of women [67.3％ (111/165),x2 =5.836,P ＜ 0.05],the awareness of hypertensive patients increased with increasing age (total,men,women:x2tendency =3.638,2.686,2.419,all P ＜ 0.05).The treatment of hypertensive patients was 51.1％ (168/329),the treatment of men [43.9％ (72/164)] was lower than that of women [58.2％ (96/165),x2=6.711,P ＜ 0.05],the treatment of hypertensive patients increased with increasing age (total,men,women:x2tendency =4.422,2.704,3.633,all P ＜ 0.01).The control rate of hypertensive patients was 5.5％ (18/329),the control rate among the treatment was 10.7％ (18/168).Conclusions The standardized prevalence of hypertension among the residents of the severe historical endemic areas of Keshan disease in Heilongjiang Province is higher than the national average (25.2％),the standardized awareness is lower than the national average (46.5％),the treatment and the control are low.We should pay more attention to the hypertension in the severe historical endemic areas of Keshan disease.
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A sesquiterpene synthase (AsSS4) full-length open reading frame (ORF) cDNA was cloned from wounded stems of Aquilaria sinensis by RT-PCR method. The result showed that the ORF of AsSS4 was 1,698 bp encoding 565 amino acids. Prokaryotic expression vector pET28a-AsSS4 was constructed and transformed into E. coli BL21 (DE3) pLysS. Recombinant AsSS4 protein was obtained after induction by IPTG and SDS-PAGE analysis with a MW of 64 kD. Enzymatic reactions using farnesyl pyrophosphate showed that recombinant AsSS4 protein purified by Ni-agarose gel yielded five sesquiterpene compounds, cyclohexane, 1-ethenyl-1-methyl-2, 4-bis(1-methylethenyl)-, β-elemene, α-guaiene, α-caryophyllene and δ-guaiene. This paper reported the first cloning and functional characterization of AsSS4 gene from A. sinensis, which will establish a foundation for future studies on the molecular mechanisms of wound-induce agarwood formation in A. sinensis
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Aquilaria sinensis callus induced by stem tips were used to establish the suspension cell system. The results showed that the most suitable medium for callus induction and subculture is MS + 2.0 mg x L(-1) NAA + 1.0 mg x L(-1) 6-BA. After 12 times of subculture, the energetic and loose callus, which were appropriate for cell suspension culture, were cultured and shook in liquid medium MS + 2.0 mg x L(-1) NAA + 1.0 mg x L(-1) 6-BA + 500.0 mg x L(-1) casein hydrolysate (CH) to establish the suspension cell system. The growth curve of suspension cells showed a "S" type. At the beginning of the culture, cell density increased slowly; during 4 to 6 days, suspension cells reached logarithmic growth period; during 7 to 12 days, suspension cells were in the platform period; but after 12 days, cell density and activity went down obviously. Agarwood sesquiterpenes were not detected in the suspension cells during the growth period, however, they could be detected in MeJA treated suspension cells. In this study, a stable and active growing suspension cell system was established, which was a proper system to study the mechanism of agarwood sesquiterpene formation, and additionally provided a potential way to generate agarwood sesquiterpenes through application of cell culture.
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This study is to explore new lead compounds by inhibition of Pin1 for anticancer therapy using temperature sensitive mutants. As Pin1 is conserved from yeast to human, we established a high-throughput screening method for Pin1 inhibitors, which employed yeast assay. This method led to the identification of one potent hits, 8-11. In vitro, 8-11 inhibited purified Pin1 enzyme activity with IC50 of (10.40 +/- 1.68) micromol x L(-1), induced G1 phase arrest and apoptosis, showed inhibitory effects on a series of cancer cell proliferation, reduced Cyclin D1 expression, was defined as reciprocally matched for protein-ligand complex in virtual docking analysis and reduced cell migration ability. In vivo, we could observe reduction of tumor volume after treatment with 8-11 in xenograft mice compared with vehicle DMSO treatment. Altogether, these results provide for the first time the involvement of 8-11 in the anticancer activity against Pin1.
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Objective To investigate the causes and treatment of familial neurohypophyseal diabetes insipidus with hydronephrosis.Methods A retrospective analysis was conducted in 6 cases (5 males and 1 female,aged 11 to 53 years) of familial neurohypophyseal diabetes insipidus with hydronephrosis treated in our institute from June 2009 to December 2010.All cases had polydipsia and polyuria since their childhood.The daily output of urine ranged from 5,290 to 15,040 ml.The urine specific gravity was less than 1.005.The water deprivation and vasopressin injection test showed positive results,and MRI showed that the shape and size of pituitary gland were in normal range.Ultrasound and IVU showed that all cases had hydronephrosis.Five adult cases were administered with Desmopressin 0.2 mg three times a day,and 1 juvenile patient given half dosage of Desmopressin as in adult.The case No.1 underwent percutaneous nephrostomy and bilateral ureteral reimplantation.Case No.2 received urethral catheterization for 5 days and Tamsulosin.Three cases with urinary tract infection were given antibiotics on the base of urine culture and antibiotic sensitivity test results.Follow-up was undertaken every 3 mon for the duration of 18-36 mon.Results In 6 cases,polydipsia and polyuria were significantly improved after the treatment.Daily urine output dropped to 6000 ml in 5 adult cases and decreased to 2000 ml in the juvenile case.The flank sore of case No.1 was relieved after percutaneous nephrostomy,and hydronephrosis improved 6 mon after bilateral ureteral reimplantation.The residual urine volume of case No.2 was reduced to 40 ml,and no recurrence was observed after anti-infection therapy.During the follow-up,6 cases showed relieved hydronephrosis and no recurrent infection.Conclusions It is of important to reduce the urine volume for the treatment of familial neurohypophyseal diabetes insipidus with hydronephrosis.Early diagnosis and treatment of the diseases is crucial for the improvement of renal function.
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Objective To investigate the efficacy and safety of Solifenacin for the treatment of overactive bladder in children. Methods A retrospective analysis was done in a children admitted to our hospital in January 2010,with lower urinary tract obstruction lead to overactive bladder.The boy was 4 years old,suffering from difficult urinating,urinary frequent,urgency and incontinence for 4 years.Imaging studies (B ultrasound,intravenous urography,CT,bladder voiding urethrography) found bilateral hydronephrosis and kidney collecting system separation with left 3.3 cm and right 2.3 cm in diameter; ureteral dilation with left 1.3 cm,right 1.6 cm in diameter.A transverse septum crossing the urethra at a right angle distal to the verumontanum was detected.According to history,physical examination and imaging examination,a diagnosis for posterior urethral valves was established.Under general anesthesia,urethroscopy found that the valve was attached below urethra wall,divided into two forks towards urethral lateral wall.The valve was excised.Three months later,although good voiding,the hydronephrosis and hydroureter still did not improve.After cystostomy and 6 months follow-up,hydronephrosis and hydroureter still not improved. B ultrasound showed the renal pelvis dilation with left 3.2 cm,right 2.0 cm in diameter,and bilateral ureteral dilation with left 1.3 cm,right 1.4 cm in diameter.Solifenacin (5 mg/tablet),1/3 tablet,about 1.7 mg per day was added. Results After oral Solifenacin one month,hydronephrosis and hydroureter began to improve.After 3 months,hydroureter disappeared; hydronephrosis improved significantly.. B-ultrasound showed the renal collecting system mild dilation with left 1.1 cm,right 1.0 cm in diameter.After 13 months follow-up,no side effects was detected. Conclusions Combined with the surgical treatment,Solifenacin can alleviate hydronephrosis secondary to OAB,and can also protect the renal function.
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Fournier's gangrene (FG) is an extremely aggressive and rapidly progressive polymicrobial soft tissue infection of the perineum, anal area or genitalial regions with a high mortality rate. The objectives of this study were to share our experience with the management of this serious infectious disease over the last 15 years. This retrospective study examined 24 patients diagnosed as having FG who were admitted to our hospital between March 1996 and December 2011. The gender, age, etiology, predisposing factors, laboratory findings, treatment modality, hospitalization time and spread of gangrene of the subjects were all recorded and analyzed. The results showed that the mean age of the patients was 48.33 years, the male-to-female ratio was 5:1 and the mortality rate was 20.8% (5/24). The most common predisposing factor was diabetes mellitus in 10 patients (41.6%), followed by alcohol abuse, obesity, neoplasms and immunosuppression. The most common etiology was peri-anal and peri-rectal abscesses (45.8%), followed by lesions of urogenital origin (33.3%) and cutaneous (8.3%) origin. No local pathologies could be identified in 3 (12.5%) patients. The most commonly isolated microorganisms were Escherichia coli (62.5%), followed by Enterococcus, Pseudomonas aeruginosa and Staphylococcus aureus. The median admission Fournier's gangrene severity index (FGSI) score for survivors was 5.63±1.89 against 13.6±3.64 for non-survivors which was designed for predicting the disease severity in the series. Early diagnosis and immediate extensive surgical debridement were significant prognostic factors in the management of Fournier gangrene. Individualized reconstructive modalities for wound coverage were useful in that they repaired the tissue defect and improved the quality of life. We are led to conclude that Fournier's gangrene is a severe condition with a high mortality. The Fournier's gangrene severity index (FGSI) score at admission serves as a good predictor for the disease severity. Early diagnosis, surgical debridement and aggressive fluid therapy are significant prognostic factors in the management of Fournier gangrene. Individualized reconstructive surgery modalities for wound coverage are useful to correct the tissue defect and improve the quality of life.
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Fournier's gangrene (FG) is an extremely aggressive and rapidly progressive polymicrobial soft tissue infection of the perineum, anal area or genitalial regions with a high mortality rate. The objectives of this study were to share our experience with the management of this serious infectious disease over the last 15 years. This retrospective study examined 24 patients diagnosed as having FG who were admitted to our hospital between March 1996 and December 2011. The gender, age, etiology, predisposing factors, laboratory findings, treatment modality, hospitalization time and spread of gangrene of the subjects were all recorded and analyzed. The results showed that the mean age of the patients was 48.33 years, the male-to-female ratio was 5:1 and the mortality rate was 20.8% (5/24). The most common predisposing factor was diabetes mellitus in 10 patients (41.6%), followed by alcohol abuse, obesity, neoplasms and immunosuppression. The most common etiology was peri-anal and peri-rectal abscesses (45.8%), followed by lesions of urogenital origin (33.3%) and cutaneous (8.3%) origin. No local pathologies could be identified in 3 (12.5%) patients. The most commonly isolated microorganisms were Escherichia coli (62.5%), followed by Enterococcus, Pseudomonas aeruginosa and Staphylococcus aureus. The median admission Fournier's gangrene severity index (FGSI) score for survivors was 5.63±1.89 against 13.6±3.64 for non-survivors which was designed for predicting the disease severity in the series. Early diagnosis and immediate extensive surgical debridement were significant prognostic factors in the management of Fournier gangrene. Individualized reconstructive modalities for wound coverage were useful in that they repaired the tissue defect and improved the quality of life. We are led to conclude that Fournier's gangrene is a severe condition with a high mortality. The Fournier's gangrene severity index (FGSI) score at admission serves as a good predictor for the disease severity. Early diagnosis, surgical debridement and aggressive fluid therapy are significant prognostic factors in the management of Fournier gangrene. Individualized reconstructive surgery modalities for wound coverage are useful to correct the tissue defect and improve the quality of life.
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Fournier Gangrene , Diagnosis , Pathology , Retrospective StudiesABSTRACT
This study examined the effect of nicotine on the expression of mutant p53 (mt-p53) in bladder cancer rats. The rat models of bladder cancer were established by infusing N-methyl-nitroso-urea (MNU, 10 mg/kg every 2 weeks for 8 weeks) into the bladder. Pathological examination on the bladder was conducted to confirm the establishment of the model. All the bladder cancer rats were randomly divided into an MNU group and 3 nicotine groups. In the nicotine groups, the rats were intragastrically administered nicotine at different concentrations (25, 15, 5 mg/kg respectively) 3 times per week for 8 weeks. The mt-p53 expression was detected by the immunohistochemical method. The results showed that rat bladder cancer models developed histopathological changes of bladder transitional cell carcinoma. The positive rate of mt-p53 expression in the 3 nicotine groups (25, 15, 5 mg/kg) was 75.00%, 58.33% and 41.67% by the 14th week, respectively, significantly higher than that in the MNU group (33.33%) (all P<0.05). The mt-p53 expression rate was positively correlated with the medication dose and time (P<0.05). It is concluded that nicotine may play an important role in the development of bladder cancer partially by increasing the expression of mt-p53.
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Objective To evaluate the efficacy and safety of α1-adrenergic blockers for treating young men with primary bladder neck obstruction (PBNO). Methods A retrospective review was done of the presenting symptoms and videourodynamic findings of 22 young men younger than 35 years with PBNO. Mean age was 28 years (range 18 to 35). The presenting symptoms were hesitancy in 21 (95%), weak stream in 17(77%), frequency in 16(73%), urgency in 8(36%) and pelvic pain in 6 (27%). Mean symptom duration was 28(3-62)months. A dose of 4 mg Doxazosion was adminis-tered for at least 6 months. International prostate symptom score(IPSS), Quality of life(QOL), uro-flowmetry, post-void residual urine and blood pressure were assessed before and 6 months after medi-cation. Improved urine flow was defined as at least 3 ml. per second increase in the maximum flow rate. Improved symptom was defined as more than a 40% decrease in IPSS. Successful treatment was defined as improved in urine flow and symptoms. Results Follow-up data were available for 21 of 22 patients. The medication period was 8.7±2.5 months and follow-up duration was 12.3±4.9 months. Mean Ⅰ-PSS decreased from 16.9±3.7 to 10.7±4.5. Mean QOL decreased from 4.3±1.2 to 2.5±1.0. Mean maximum flow rate increased from (9.8±3.5)ml to (14.9±3.6)ml. per second. Mean post-void residual urine decreased from (78.2±35.6)ml to (46.5±19.4)ml. There were significant differences(P<0.01). Treatment was successful in 14 patients (67%). Drug tolerability was good. Mean blood pressure was (110.0±7.9)/ (75.0±5.9)mm Hg and (107.0±8.7)/(72.0±7.1)mm Hg before medicine therapy and after 6 months medication(P>0.05). Conclusions Videourody-namics is the diagnostic gold standard of PBNO. In our experience α1-adrenergic blockers are clinically effective therapy and safety for PBNO and have been well tolerated in young male patients.
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A protocol for the isolation, purification and culture of motor neurons from newborn rat spinal cord was described and the effect of glial cell line-derived neurotrophic factor (GDNF) on the growth of neurite of motor neurons was investigated in vitro. Spinal motor neurons (SMNs) were dissociated from ventral spinal cord of postnatal day 1 rats. The culture system for SMNs was established by density gradient centrifugation, differential adhesion, and use of serum-free defined media and addition of exogenous GDNF. After 72-h culture, the cells displayed the characteristic morphology of motor neurons, exhibited extensive neuritic processes and were positive for choline acetyltransferase (ChAT) expression. The neurite length of SMNs in GDNF groups was significantly longer than that in control group (P<0.05). This protocol can be adapted for various postnatal motor neurons studies.