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Objective:To explore the feasibility and safety of long-distance urological nephrotomy with the support of 5G communication technology by using the domestic robot.Methods:Clinical data of the patients with remote robot-assisted laparoscopic nephrectomy, which were completed from March to April 2021 by the Affiliated Hospital of Qingdao University (as the host hospital where the main operating system located) were retrospectively analyzed. There were 3 patients, including 2 males and 1 female.The average age was 61 (49-73) years, and the average body mass index was 23.73 (20.00-27.76) kg/m 2. One patient had a ASA classification of grade 2, and the other 2 patients had grade 3. All patients met the surgical criteria for non-functional nephrectomy. The chief surgeon who performing the telesurgery was located at the Affiliated Hospital of Qingdao University. The surgeon remotely controlled the bedside operating system (slave system) in 3 local hospitals located in other cities in Shandong Province (network communication distances of 82.5, 141 and 229 km, respectively) by manipulating the master system located in Qingdao. Images and operating instructions during surgery were transmitted using 5G wireless communication technology. Intraoperative network conditions, robot operation, and patient perioperative data were summarized. Results:All 3 tele-nephrectomies were successfully completed. The average network signal latency time was 27.3 (23-30) ms, with no packet loss, and the average total latency time was 177.3(173-180) ms. The mean resection time was 79.3 (52-111) min, and the average intraoperative blood loss was 31.1 (15.6-41.9) ml. There were no network related adverse events occurred during the operation, and the robot-related adverse events occured 3 times, all three of which were characterized by inconsistent master and slave movements of the manipulator arm and the bedside robotic arm. None of these adverse events affected the successful performance of the telesurgery. The mean postoperative exhaust time was 60.5 (38.5-78.0) h. The mean postoperative VAS score at 24 hours was 3.7 (3-4). The Clavien-Dindo classification were all grade I. No significant abnormality was found on the 30th day after surgery, and the patients recovered well at the follow-up until 6 months postoperatively.Conclusions:It is safe and feasible to perform remote robot-assisted laparoscopic nephrectomy based on 5G communication technology with no serious adverse events or surgical complications.However, the conclusion needs to be further verified by large sample and multi-center prospective study.
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OBJECTIVE@#To analyze the clinical features and genetic variants in four neonates with very long chain acyl-coenzyme A dehydrogenase (VLCAD) deficiency.@*METHODS@#Neonates with a tetradecenoylcarnitine (C14:1) concentration at above 0.4 μmol/L in newborn screening were recalled for re-testing. Four neonates were diagnosed with VLCAD deficiency by MS-MS and genetic testing, and their clinical features and genotypes were analyzed.@*RESULTS@#All cases had elevated blood C14:1, and the values of first recalls were all lower than the initial test. In 2 cases, the C14:1 had dropped to the normal range. 1 case has remained at above 1 μmol/L after the reduction, and the remainder one case was slightly decreased. In total eight variants of the ADACVL genes were detected among the four neonates, which included 5 missense variants and 3 novel variants (p.Met344Val, p.Ala416Val, c.1077+6T>A). No neonate showed salient clinical manifestations.@*CONCLUSION@#Above findings have enriched the spectrum of ADACVL gene mutations and provided a valuable reference for the screening and diagnosis of VLCAD deficiency.
Subject(s)
Humans , Infant, Newborn , Acyl-CoA Dehydrogenase/genetics , Acyl-CoA Dehydrogenase, Long-Chain , Congenital Bone Marrow Failure Syndromes , Genetic Testing , Lipid Metabolism, Inborn Errors , Mitochondrial Diseases , Muscular Diseases , Tandem Mass SpectrometryABSTRACT
Objective:This study aimed to compare the detection efficacy of transrectal ultrasound-guided transrectal cognitive fusion targeted+ systematic prostate biopsy and transperineal cognitive fusion targeted + systematic biopsy in patients with suspected prostate cancer (PCa). In addition, the relative clinical characteristics of PCa were evaluated.Methods:A total of 385 patients with suspected prostate cancer in the affiliated hospital of Qingdao University from May 2019 to November 2019 were retrospectively analyzed. All patients met the prostate biopsy criterion, who underwent transrectal(n=275)and transperineal(n=110)prostate biopsy respectively. There were no significant differences of mean age [(70.7±7.3)years vs.(69.2±8.4) years], PSA [(55.12±116.96)ng/ml vs. (63.41±315.34)ng/ml], prostate volume [(55.96±35.26)ml vs. (64.35±55.99)ml] between two groups. According to preoperative prostate magnetic resonance imaging combined with intraoperative ultrasound, 2-4 needles targeted puncture of suspected lesion were performed, followed by 12 needle systematic prostate biopsy. The detection rate of prostate cancer between two biopsy ways were compared. The related factors of PCa including age, prostate volume and PSA level were collected for univariable and multivariable logistic analysis. The cancer detection rate was compared and logistic regression was used to assess the impact of patient characteristics on PCa detection.Results:For all patients, the detection rate with cancer between transrectal group and transperineal group were 121/275(40.0%) and 67/110(60.9%), respectively. The transperineal group detected a higher rate of PCa ( P=0.003)and more clinically significant prostate cancers (csPCa) (54.6% vs.36.7%, P=0.001) than that of the transrectal group, there were significant differences between two groups ( P<0.05). Univariate and multivariate logistic regression analysis revealed that PSA( OR=1.025, P=0.001) and prostate volume( OR=0.984, P=0.001)were two independent factors for the detection rate of prostate cancer between two biopsy ways( P<0.05). The effect of age on the detection rate of PCa in the transperieal group was significantly lower than that of the transrectal group( OR=0.037, P=0.238 vs. OR=0.053, P=0.002). Conclusion:The transperieal biopsy could find more PCa than the transrectal biopsy. PSA level and prostate volume could affect the detection rate of cancer between two prostate biopsy ways.
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Ampullary carcinoma is a rare malignant tumor of the digestive tract. Compared with other malignant tumors around the ampulla, its prognosis is significantly better, but the prognosis of some patients with ampulla cancer is unsatisfactory. Studies have confirmed that the systemic inflammatory response is closely related to the prognosis and efficacy of tumors, and the tumor microenvironment plays a vital role in tumor progression and prognosis. In recent years, inflammatory parameters and related prediction models have become a hot spot in predicting the prognosis and survival of ampullary cancer, and they have been confirmed to have certain predictive value. This article reviews the correlation between inflammatory parameters and prognosis of ampullary carcinoma and presents the possible progress for future research.
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Objective:To investigate the clinical characteristics and pathogenic mutations of propionic acidemia.Methods:Clinical data of two patients with propionic acidemia admitted to the Obstetrics and Gynecology Hospital of Nanjing Medical University from May 2017 to June 2018 were collected. Genomic DNA was extracted from the peripheral blood of the patients and their parents. Inherited disease panel based on Ion Torrent semiconductor sequencing technology was performed to detect gene mutations, and those with suspected pathogenic mutations were verified by Sanger sequencing. Descriptive statistical analysis was used for data analysis.Results:Case 1 was suspected of sepsis and admitted to the Obstetrics and Gynecology Hospital of Nanjing Medical University due to "drowsiness and milk rejection" on the second day after birth. Tandem mass spectrometry suggested the level of propionyl carnitine and its ratios to acetylcarnitine and free carnitine were increased. Urine gas chromatography-mass spectrometry showed elevated 3-hydroxypropionic acid and methylcitric acid. Genetic analysis revealed that the infant carried c.331C>T (p.R111X)/c.1228C>T (p.R410W) compound heterozygous mutations in the PCCB gene. The infant was diagnosed with propionic acidemia and treated with a special diet with an L-Carnitine supplement but died of sudden coma and vomiting without precipitating factors at three months of age. Case 2 presented with sudden vomiting, drowsiness, and anergia on the admission at five-months old. Tandem mass spectrometry showed increased propionyl carnitine level and its ratios. Compound heterozygous mutations of c.146delG (p.G49EfsX16)/c.1253C>T (p.A418V) in the PCCB gene were identified in the patient, of which c.146delG (p.G49EfsX16) was a de novo mutation and was evaluated as a pathogenic mutation. The patient was on a special diet with an L-Carnitine supplement, but with disobedience. Followed up to the age of three years and eight months, the child was severely underdeveloped. Conclusions:Neonates with clinically suspected sepsis may have propionic acidemia, and tandem mass spectrometry and genetic testing should be performed as soon as possible to confirm or rule out the diagnosis. Further investigations on the pathogenesis and function of the new mutation are still needed.
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Objective:To investigate the function of circ-EIF3I on the growth and metastasis of hepatocellular carcinoma (HCC) and its possible mechanism.Methods:A total of 39 HCC patients admitted to the Fourth Hospital of Hebei Medical University from May 2014 to October 2015 were selected as the study subjects, including 29 males and 10 females, aged (62.2±5.6) years old. Part of HCC tissues and adjacent tissues were obtained during the surgical operation. Fluorescence quantitative PCR was used to detect the expression of circ-EIF3I, and Western blotting was used to detect phosphoglycerate kinase 1 (PGK1) in HCC and adjacent tissues, respectively. Small molecule RNA interference and gene overexpression experiments were used to adjust its expression in Hep3B and Huh-7 HCC cell lines, and then MTT cell viability test was used to detect cell proliferation ability. Transwell assaya was used to detect cell migration and invasion ability. Finally, the dual luciferase report experiment was used to detect the targeting relationship between circ-EIF3I and miR-149-5p/miR-1271-5p, and the targeting relationship between miR-149-5p/miR-1271-5p and PGK1.Results:Compared with adjacent tissues, the relative expression of circ-EIF3I [(4.32±0.62) vs. (1.24±0.59)] and PGK1 [(2.69±0.19) vs. (1.00±0.07)] in HCC tissues from 39 cases were increased, and the differences were statistically significant (all P<0.05). Compared with the negative control group, the cell viability of the circ-EIF3I small molecule interfering RNA group was reduced [Hep3B: (55.3±7.5)% vs. (100.0±9.2)%; Huh-7: (42.7±6.0)% vs. (100.0±5.6)%] , the number of migrating cells was decreased [Hep3B: (71.0±10.0) vs. (130.0±15.0); Huh-7: (50.0±8.5) vs. (125.0±10.0)], the number of invasive cells also was decreased [Hep3B: (52.0±7.0) vs. (105.0±13.0); Huh-7: (60.0±8.0) vs. (144.0±11.0)], the difference was statistically significant (all P<0.05). The dual luciferase report experiment confirmed that circ-EIF3I could target miR-149-5p/miR-1271-5p, and miR-149-5p/miR-1271-5p can target PGK1. Over expression of PGK1 could significantly reverse the effects of knockdown of circ-EIF3I on the proliferation, migration and invasion of HCC cells. Conclusion:Knockdown of circ-EIF3I could inhibit the proliferation, migration, invasion of HCC cells by regulating the miR-149-5p/miR-1271-5p/PGK1 molecular axis.
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Objective:To screen new drugs for treatment of phenylalanine hydroxylase deficiency.Methods:From October 2019 to October 2020, virtual drug screening was performed in Center of Genetic Medicine, Nanjing Maternity and Child Health Care Hospital, Women's Hospital of Nanjing Medical University computer according to the characteristics of the binding ability of phenylalanine hydroxylase to drug spatial structure. Ten candidate drugs were screened from the FDA drug library (including 2 697 kinds of active pharmaceutical ingredients). A eukaryotic expression system was used to determine the effects of drugs on the activity of phenylalanine hydroxylase at the molecular level. Drug-sensitive mutants were screened.Results:Among the 10 candidate drugs, neoplasm hydrochloride, fluocinonide acetate and risperidone increased 23% [ t = 18.21, P < 0.001, vs. non-drug-treated phenylalanine hydroxylase group (i.e., only solvent and no drug added to the reaction system)], 21% ( t = 3.44, P < 0.05, vs. non-drug-treated phenylalanine hydroxylase group), 31% ( t = 19.57, P < 0.001, vs. non-drug-treated phenylalanine hydroxylase group) of the activity of phenylalanine hydroxylase. The remaining drugs exhibited weak even inhibitory effects on the activity of phenylalanine hydroxylase. 25% of p.D101N mutant could be activated by risperidone ( t = 15.86, P < 0.001, vs. non-drug-treated p.D101N mutant group). Conclusion:Neoplasm hydrochloride, fluocinonide acetate and risperidone can be used as potential therapeutic drugs for phenylalanine hydroxylase deficiency, and p.D101N mutant can be used as the drug-sensitive mutation site.
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Objective:To analyze the detection of neonatal inherited metabolic diseases in Nanjing.Methods:We researched the results of 175 767 newborns by tandem mass spectrometry from December 2013 to July 2018. Amino acids, acylcarnitines, and succinylacetone were detected by non-derivatized tandem mass spectrometry to screen the abnormity of newborn amino acid, organic acid, or fatty acid oxidation metabolism disease. Gene panels based on high throughput sequencing technology were carried out to detect gene mutation of positive neonates. Descriptive statistics were used to analyze all the data.Results:The positive rate of primary screening was 2.1% (3 691/175 767), 3 598 of 3 691 positive cases were recalled. At last, 62 cases of the inherited metabolic disease were diagnosed. Among them, there were 35 cases of amino acid metabolism disease, 12 cases of organic acid metabolism disorder, and 15 cases of fatty acid metabolism defect. The total incidence of neonatal inherited metabolic disease was 0.035 3%, among which amino acid metabolic diseases were 0.019 9%, organic acid metabolic diseases were 0.006 8%, and fatty acid metabolic diseases were 0.008 5%. The diseases with the highest incidence were phenylalanine hydroxylase deficiency (0.015 9%), methylmalonic acidemia (0.005 1%), and primary carnitine deficiency (0.005 1%). Among 62 children, 51 (82.2%) were diagnosed by gene diagnosis (including 17 cases of phenylalanine hydroxylase deficiency and 34 cases of other inherited metabolic diseases). Another 11 children with phenylalanine hydroxylase deficiency refused gene diagnosis. Two pathogenic mutations were found in 17 children with phenylalanine hydroxylase deficiency. Two pathogenic mutations were found in 29 of the other 34 children with inherited metabolic disease, which were from their parents, while only one pathogenic mutation was found in the other five children, of which two cases with hypermethioninemia were autosomal dominant inheritance.Conclusions:Neonatal inherited metabolic diseases with high incidence in Nanjing are phenylalanine hydroxylase deficiency, methylmalonic acidemia, and primary carnitine deficiency. Some cases screened by tandem mass spectrometry only showed abnormal screening indicators. No specific clinical symptoms were found during follow-up, and further follow-up was needed.
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OBJECTIVE: To investigate the effects of Gypsum Fibrosum and Gypsum Fibrosum Preparatum in promoting granulation. METHODS: The wounds of muscle layer were produced in rats by using surgical operation. Two round wounds, with diameter about 1.5 cm, were cut at the depilatory area of two sides of the back of each rat, with an interval of 2 cm, deep to muscle layer, and the thickness of the knife wound of muscle layer was about 0.15 cm. Forty SD rats with the wounds were randomly divided into 4 groups: untreated group, beifuji-treated group, Gypsum Fibrosum-treated group and Gypsum Fibrosum Preparatum-treated group, with 10 rats in each group. Then the wounds were sprinkled with powders of Gypsum Fibrosum and Gypsum Fibrosum Preparatum, or sprayed with beifuji solution, respectively. The healing state of granulation tissues of the wounds was observed at the eighth and fourteenth day respectively. RESULTS: The number of fibroblasts, the number of capillary tubes and the area of capillary tubes in granulation tissue of wounds in the Gypsum Fibrosum Preparatum-treated group were significantly higher than those in the untreated group and Gypsum Fibrosum-treated group (P0.05). CONCLUSIONS: Gypsum Fibrosum Preparatum can accelerate the formation of collagenoblast and micrangium in wounds, and the proliferation of granulation tissues, thus promoting the skin wounds to healing. The effect of Gypsum Fibrosum is changed after being calcined, and Gypsum Fibrosum Preparatum has obvious effect in promoting granulation.
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It is the aim of studies in cognitive process to understand how the impressive cognitive capacity of the human mind is uninterruptedly developed and how the process is controlled. We have been focusing attention on the central question with stereoscopic research. A multi-channel EEG data acquisition system is constructed for cognition studies which not only works perfectly in the EEG collection and signal processing of stereoscopic visual evoked potentials(VEP) but also is suitable for investigative and clinical use. We have identified the fact that the processing of stereoscopic depth information is done in the cortical advance functional areas with labeled characteristic signaling of the depth related VEP and the results were shown to be of no difference when compared with the ones of other investigations. We believe, the stereoscopic depth cognition is both a dynamic multi-factor processing process and a consequence of depth perception in advanced cortical areas through biological feedback to the whole process of visual signal processing. It is our novel and significant supposition in the psychophysical study, and the experimental results of the VEP are presented in this article.