Three dimensional nephrometry system for partial nephrectomy: Our initial exploration / 北京大学学报(医学版)

OBJECTIVE@#To construct a preoperative evaluation system for partial nephrectomy using CT three-dimensional visualization technology and to explore its practical value.@*METHODS@#The clinical data of the patients who underwent partial nephrectomy for renal tumors in Department of Urology, Peking University First Hospital were collected retrospectively. At the same time, the homogenized standard data of patients who underwent partial nephrectomy for renal tumors were collected in 16 clinical centers in China. The CT three-dimensional visualization system was applied (IPS system, Yorktal) to evaluate tumor anatomy, blood supply, perirenal fat and other information. The parameters were summarized to build a three-dimensional nephrometry system, on the basis of which virtual surgery design and intraoperative navigation were completed.@*RESULTS@#A three-dimensional visualization image was established based on the enhanced CT urography. The nephrometry system included the longest diameter and volume of the tumor, proportion volume of tumor invading the parenchyma, maximum depth of the tumor invading the parenchyma, contact surface area, flatness of the tumor surface, renal segment where the tumor was located, vascular variation, and perirenal fat. The average two-dimensional diameter of the tumor was (2.78±1.43) cm, the average three-dimensional maximum diameter was (3.09±1.35) cm, and the average postoperative pathological size was (3.01±1.38) cm. The maximum tumor diameter in the three-dimensional image was significantly related to the prolonged renal artery clamping time and intra-operative blood loss (r=0.502, P=0.020; r=0.403, P=0.046). The three-dimensional and pathological tumor volume were (25.7±48.4) cm3 and (33.0±36.4) cm3, respectively (P=0.229). The tumor volume was significantly related to the intraoperative blood loss (r=0.660, P < 0.001). The proportion volume of the tumor invading into renal parenchyma was significantly related to the prolongation of renal artery clamping and the occurrence of postoperative complications (r=0.410, P=0.041; r=0.587, P=0.005). The tumor contact surface area and the presence of vascular variation did not show correlation with the perioperative data and postoperative complications. While the preoperative evaluation was completed, the reconstructed three-dimensional image could be zoomed, rotated, combined display, color adjustment, transparency, and simulated cutting on the Touch Viewer system. The process generally consisted of showing or hiding the tissue, adjusting the transparency of the interested area, rotating and zooming the image to match the position of the surgical patient. Together, these functions met the requirements of preoperative virtual surgery plan and intraoperative auxiliary navigation.@*CONCLUSION@#Three-dimensional images can provide a more intuitive anatomical structure. The CT three-dimensional visua-lization system clearly displays tumor anatomical parameters, blood supply and perirenal fat. The three-dimensional nephrometry system for renal tumors can help predict the difficulty of partial nephrectomy and perioperative complications. Importing the reconstructed three-dimensional visualization image into the specified program or robot operating system can complete virtual surgery and intraoperative navigation, helping the surgeon to better grasp the surgical process. The indexes included in the nephrometry system and the score weights of each index need to be confirmed and perfected by multi-center study with large samples.

Heat shock-pretreated rat bone marrow-derived mesenchymal stem cells prevent apoptosis of ovarian granulosa cells induced by cisplatin / 第二军医大学学报

Objective: To study the preventive effects of heat shock-pretreated rat bone marrow-derived mesenchymal stem cells (MSCs) on the apoptosis of ovarian granulosa cells (GCs) induced by cisplatin. Methods: Rat bone marrow-derived MSCs were isolated, cultured and identified. After heat shock pretreatment for different durations, the apoptotic rates of MSCs were detected to determine the optimal condition of heat shock pretreatment. Cisplatin was added to simulate chemotherapy microenvironment in the ovary. MSCs were divided into normal group (without treatment), heat shock pretreatment group, cisplatin group (without heat shock pretreatment), and heat shock pretreatment+cisplatin group. The apoptotic rate of MSCs was determined. The ovarian GCs were isolated and divided into normal group (without treatment), cisplatin group, MSC prevention group (co-cultured with MSCs before adding cisplatin), and heat shock pretreatment MSC (HS-MSC) prevention group (co-cultured with HS-MSCs before adding cisplatin). The apoptotic rate of GCs was detected. Results: Heat shock pretreatment could reduce the apoptosis of MSCs. After receiving heat shock pretreatment at 42 °C for 1 h, MSCs presented the lowest apoptotic rate. After adding cisplatin, the apoptotic rate of MSCs in heat shock pretreatment+ cisplatin group was significantly lower than that of cisplatin group ([11.94 ± 0.63]% vs [14.30 ± 0.80]%, P<0.05). The apoptotic rate of GCs in HS-MSC prevention+cisplatin group was significantly lower than that of cisplatin group ([39.88±1.65]% vs ([53.81 ±1.89]%, P<0.05). Conclusion: Heat shock pretreatment can alleviate the apoptosis of MSCs during chemotherapy. Heat shock-pretreated MSCs have preventive effects on cisplatin-induced GC apoptosis.

Ｒeview on the association of CAG short tandem repeats of androgen receptor gene with tumorigenesis and prognosis / 中华疾病控制杂志

@#Abnormal expression of androgen receptor ( AＲ) and AＲ-mediated signaling pathways are closely related to the occurrence，outcome，and prognosis of various human disease，and to some ex- tent，AＲ lead to gender differences in these diseases． However，the specific mechanism is still unclear． CAG short tandem repeat ( STＲ) sequence in exon 1 of AＲ gene negatively correlates with the transcriptional regulation activity，affects the synthesis and biological function of the target proteins，and plays an important role in the development and prognosis of various tumors，such as prostate cancer，breast cancer，bladder cancer，liver cancer，and endometrial cancer． In this review，we summarized the current studies on the association between AＲ gene CAG STＲ and the common tumors，in order to provide clues for further exploring the mechanism of AＲ-related tumors with high incidence and gender differences，and screening populations with high risk for the corresponding tumors．

Inhibitory effect of heat shock pretreated rat bone marrow mesenchymal stem cells on chemotherapy-induced ovarian granulocyte apoptosis / 医学研究生学报

ObjectiveBone marrow-derived mesenchymal stem cells (MSCs) can promote ovarian angiogenesis, improve ovarian insufficiency caused by chemotherapy, and repair ovarian function, while heat shock pretreatment can reduce the apoptosis rate of stem cells and improve the therapeutic effect of stem cells. This study aims to investigate the effect of heat shock pretreatment on MSCs, and further study the effect of heat shock pretreated mesenchymal stem cells on chemotherapy-induced apoptosis of ovarian granulosa cells.Methods1. The bone marrow-derived MSCs of rats were isolated, cultured and identified, and pretreated within a 42 °C water bath for one hour. 2. Cisplatin (5 mg/L) was added to MSCs to simulate the local microenvironment of chemotherapy. MSCs were divided into four groups: blank control group, heat shock control group, model group, and heat shock model group. The effects of heat shock pretreatment on the proliferation, apoptosis and survival rate of MSCs were investigated by CCK-8 method, Hoechst33342/PI, and flow cytometry. 3. We isolate and culture rat ovarian granulosa cells (GCs) to establish an in vitro model of GCs injury under the induction of cisplatin (5 mg/L). The experiment was carried out in four groups: a control group, model group, MSCs model group, HS-MSCs model group. The apoptosis and survival rate were detected by Hoechst33342/PI and flow cytometry, respectively.Results1. The proliferation level and survival rate of MSCs in the heat shock control group were significantly higher than those in the other three groups, and the apoptosis rate was significantly lower than the other three groups (P<0.05). Compared to the model group, the proliferation level of the heat shock model group was significantly increased, and the apoptosis rate was significantly decreased (P<0.05), and the cell survival rate increased; 2. The apoptosis rate of GCs in the HS-MSCs model group was significantly lower than that in the other three groups. Compared to the MSCs model group, the apoptosis rate of GCs in the HS-MSCs model group was significantly decreased (P<0.05).ConclusionHeat shock pretreatment can increase the proliferation level and survival rate of MSCs, and reduce its apoptosis rate. Heat shock pretreated stem cells can effectively inhibit chemotherapy-induced apoptosis of ovarian granulosa cells.

Association of genetic polymorphisms of key molecules in JAK/STAT signaling pathway with susceptibility of hepatocellular carcinoma / 中华流行病学杂志

Objective To elucidate the association of genetic polymorphisms of key molecules in JAK/STAT signaling pathway with susceptibility of hepatocellular carcinoma (HCC).Methods A total of 367 HCC patients and 367 healthy controls were recruited in this sex- and age-matched case-control study.Genetic polymorphisms of IL-6 (rs1800796,-572C＞G),STAT3 (rs744166,+ 26312T＞C; rs3816769,+ 42240T＞C; rs6503695,+ 40980T＞C),EGFR (rs11543848,+ 142530A＞G),and mTOR (rs7211818,+ 170278A＞G; rs9674559,+ 196983A＞G; rs11653499,+65678G＞A) were genotyped using a mass spectrometry method.Odds ratio (OR) and 95％ confidence interval (CI) were calculated.Results Genotype frequency of the 8 polymorphisms of IL-6,STAT3,EGFR,and mTOR were not significantly different between the patients with HCC and the controls.When stratified by sex,the female subjects who carried STAT3 +26312CC,+ 42240CC,or + 40980CC had a decreased risk of HCC when compared to those who carried TT allele (OR=0.192,95％CI:0.047-0.784; OR=0.180,95％CI:0.045-0.725;OR=0.198,95％ CI:0.049-0.806,respectively).When compared with AA genotype on the site of EGFR + 142530,the (AG+ GG) genotype reduced the risk of HCC in women (OR=0.422,95％CI:0.179-0.994).Conclusion The polymorphisms of IL-6 (rs1800796) and mTOR (rs7211818,rs9674559,and rs11653499) were not associated with the HCC susceptibility.Those carrying CC allele in three loci (rs744166,rs3816769,and rs6503695) of STAT3 and (AG + GG) in rs11543848 of EGFR had a decreased risk of HCC in women.However,these results need to be validated using larger sample size.

Evolution analysis of hemagglutinin gene of novel influenza virus A/H1N1 in 2009 pandemic / 第二军医大学学报

Objective: To investigate the evolutionary relationship of the hemagglutinin (HA) gene of novel influenza virus A/H1N1 in 2009 pandemic with the HA genes of A/H1N1 viruses isolated in different parts of the world previously. Methods: The sequences of the HA gene of the novel A/H1N1 strain and the reference sequences of human, swine, and avian influenza A viruses were retrieved from NCBI. MEGA 4.0 software was employed to align, blunt nucleotide sequences, and construct phylogenetic tree. The deduced amino acid sequences of the HA genes of novel influenza virus A/H1N1 were compared with those of the A/H1N1 isolates in North America, Europe, and Asia. Results: Phylogenetic tree of the HA genes of A/H1N1 strains worldwide showed that the HA genes of novel influenza virus A/H1N1 in 2009 shared a high homology with those of the 7 human A/H1N1 influenza viruses isolated in North America during 1976 to 2007, and shared a low homology with those of the human influenza viruses A/H1N1 isolated in Europe and Asia. Phylogenetic tree of the HA gene between different species showed that the HA genes of novel influenza virus A/H1N1 in 2009 had a close evolutionary relationship with those of the two swine A/H1N1 strains isolated in 1998 and 2007 in North America, but a distant evolutionary relationship with those of swine and avian A/H1N1 isolated in Europe and Asia. Alignment of amino acid at important antigenic sites showed that the HA gene of the novel A/H1N1 strains shared important antigen sites with the swine A/H1N1 influenza viruses isolated in North America, and did not share with the swine A/H1N1 influenza viruses isolated in Europe and Asia or the human A/H1N1 influenza vaccine strains. Conclusion: The HA genes of the novel influenza virus A/H1N1 might originate from swine A/H1N1 influenza viruses in North America after a long time evolution and the reassortment with fragments of human A/H1N1 in the area, and the current A/human/H1N1 influenza vaccine may not be effective for the novel A/H1N1 virus.