Retzius-sparing robot-assisted laparoscopic radical prostatectomy for early-stage prostate cancer (with video) / 中华男科学杂志

Objective@#To investigate the application of Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) in the treatment of early-stage prostate cancer.@*METHODS@#We retrospectively analyzed the clinical data about 10 cases of early-stage prostate cancer treated by RS-RARP with the Da Vinci Robot Surgical System from September to October 2016.@*RESULTS@#All the operations were successfully completed without positive surgical margins. The operation time was 170－250 min (［196±25］ min), the intraoperative blood loss was 150－500 ml (［260±128］ ml), the postoperative hospital stay was 6－7 days, and the catheterization time was 14 days. Urinary continence occurred after catheter removal in 1 patient and was recovered 1 month later.@*CONCLUSIONS@#RS-RARP is a safe, effective and reliable method for the treatment of prostate cancer and conducive to the early recovery of urinary continence.

A retrospective study comparing the clinical efficacy of laparoscopic cryoablation and partial nephrectomy for renal cell carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the clinical outcomes of laparoscopic cryoablation (LCA) and laparoscopic partial nephrectomy (LPN) in the treatment of renal cell carcinoma (RCC).</p><p><b>METHODS</b>Between April 2005 and March 2009, 47 patients were treated with minimally invasive nephron sparing surgery (LPN or LCA) for RCC. The LCA group included 18 selected primary RCC cases (14 men and 4 women, mean age 63 years). There were 6 tumors located in the left, 11 located in the right and 1 located bilaterally. The maximum diameter of tumors was 1.5 - 5.0 cm (mean: 2.9 cm). The LPN group included 29 renal tumors patients (19 men and 10 women, mean age 61 years). The maximum diameter of tumors in this group was 2.0 - 4.5 cm (mean: 2.8 cm). Changes of hemoglobin (Hb), erythrocyte sedimentation rate (ESR), serum creatinine (SCr) and glomerular filtration rate (GFR) after operations were compared between LCA group and LPN group. The operative time, average intra-operative bleeding volume, postoperative hospital stay and incidence of postoperative complications of the 2 groups were analyzed and compared.</p><p><b>RESULTS</b>The 2 surgical procedures were both successful. There was no significant change of Hb, ESR, SCr and GFR after operations in LCA group and LPN group (P > 0.05). The operative time was (94 ± 29) min and (146 ± 45) min in LCA group and LPN group, respectively. The average estimated blood loss was (37 ± 20) ml and (274 ± 69) ml. The postoperative hospital stay was (4 ± 2) d and (10 ± 2) d. These differences between the 2 groups were significant (P < 0.01). No laparoscopic operative complications were noted in LCA group. Follow-up magnetic resonance imaging (MRI) at 1, 3, and 6 months identified the punched-out, nonenhancing, spontaneously resorbing, renal cryolesion. LCA group had completed a minimum follow-up of 6 months (mean 16, range 6 to 21 months). No evidence of local or port-site recurrence was found, and no patient developed metastatic disease. 3 - 36 months' (mean 20 months) follow-up showed no recurrence of tumors or metastatic disease in LPN group.</p><p><b>CONCLUSIONS</b>LCA for RCC is an accurate and effective intervention with a relatively low incidence of complications, and is superior to LPN in operative time, intraoperative bleeding volume and postoperative recovery.</p>

Inhibitory effect of TRPV6 silencing on prostate cancer cell line LNCaP in vitro / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the effects of the TRPV6 gene silencing by small interfering RNA (siRNA) on the proliferation, cell cycle and apoptosis of human prostate cancer LNCaP cells.</p><p><b>METHODS</b>We constructed two siRNA sequences (siTRPV6-1 and siTRPV6-2) targeting the TRPV6 gene and then transfected them into LNCaP cells mediated by liposome. The transcription of TRPV6 mRNA was detected by RT-PCR, and the effects of siRNA on the proliferation, cell cycle and apoptosis of the LNCaP cells were determined by MITT and flow cytometry.</p><p><b>RESULTS</b>Both siTRPV6-1 and siTRPV6-2 significantly suppressed the expression of TRPV6 mRNA in the LNCaP cells, and the expression was decreased with the extension of time, by 73 and 77% respectively at 72 h after transcription with siTRPV6-1 and siTRPV6-2 as compared with the blank control group (P < 0.01). The proliferation inhibition rates were the highest (34.53 and 29.32%) at 48 h in comparison with 24 and 72 h (P < 0.05). The number of cells was significantly increased in the GO and G1 phases and decreased in the S phase after siTRPV transfection (P < 0.01). The apoptosis rates of LNCaP cells were 14.45 and 12.73% respectively at 48 h after transfected with siTRPV6-1 and siTRPV6-2, significant higher than in the blank control and negative control groups (P < 0.05).</p><p><b>CONCLUSION</b>TRPV6-targeted siRNA can effectively inhibit the transcription of TRPV6 mRNA, inhibit the proliferation of LNCaP cells, arrest their cycles in the G0 and G1 phases, and induce their apoptosis.</p>

Preliminary study on diagnostic standard of functional constipation in children from five cities in North China / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the symptomatic criteria for diagnosis in children with functional constipation(FC) in North China.</p><p><b>METHODS</b>A screening program for FC in children was carried out in 5 northern cities (Beijing, Tianjin, Shenyang, Changchun, Harbin) of China according to symptoms using Rome III( criteria. Random clustered sampling of the inhabitants was carried out under stratification of city, region and school or kindergarten. Sample size of each area was in proportion to the population of the area. The range of age was 4-14. All the subjects were requested to fill in a questionnaire distributed by the teacher. The screening program was carried out immediately after a plot survey. A total of 20,000 questionnaires were distributed and 19,638 retrieved. According to the result of the screening, a small number of patients who fulfilled the criteria were further selected to undergo detail clinical examinations in the hospital including laboratory examination, colonic transit time, defecography or/and barium enema, electromyogram and anorectal manometry to exclude organic disease of the colon. A detailed questionnaire was filled in with the assistance from a trained doctor or a medical student. Potential risk factors and the relative symptoms were explored by comparing frequencies between FC group and non-FC group using χ2 and Logistic analysis.</p><p><b>RESULTS</b>Eighteen symptoms (defecation less than 3 times per week, dry hard sausage-shape stool, difficulty in defecation, abdominal pain, nausea and vomiting, etc) could exist in control group, but FC group had a higher frequency. The difference was statistically significant. Multivariable stepwise logistic regression analysis showed that defecation less than 3 times per week, hard sausage-shape feces, difficulty in defecation, and the need for laxative were associated with FC. The absence of other symptoms had no influence on diagnosis of FC. The sensitivity, specificity and diagnostic accuracy of symptomatic standard diagnostic test based on Rome III( criteria in FC children showed that ≥2 items had the best diagnostic accuracy but moderate sensitivity and specificity.</p><p><b>CONCLUSION</b>The symptomatic criteria for FC diagnosis in children are suggested as follows: (1) defecation frequency less than 3 times per week; (2) dry, hard, sausage-shape stool in most defecation; (3) difficulty in most defecation; (4) use of medication or digital evacuation. FC can be considered when 2 of the above 4 criteria are met and the symptoms last at least 2 months.</p>

Epidemiologic survey on the prevalence and distribution of childhood functional constipation in the northern areas of China: a population-based study / 中华流行病学杂志

Objective Functional constipation (FC) is a common complaint in childhood but the prevalence still remains unclear, the aim of this study was to explore the prevalence of FC in childhood in the northern parts of China. Methods A screening program on FC in childhood was carried out in 5 northern cities (Beijing, Tianjin, Shenyang, Changchun, Harbin) of China according to symptoms under the Rome Ⅲ criteria. Random clustered sampling of the inhabitants was carried out under stratification of cities, geographic zones, schools or nurseries.Sample size of each area was in proportion to the population of the area. The range of age was 4-14. All subjects under study were requested to fill in a questionnaire distributed by the teachers. The screening program was carried out immediately after a section survey was completed. All together, 20 000 questionnaires were distributed with 19 638 retrievals. According to the result of the screening, a small number of patients who met the criteria were further selected to undergo a detailed clinical examination in the hospital including laboratory examination, colonic transit time, defecography or/and barium enema, electromyologram and anorectal manometry to exclude organic disease of the colon. Simultaneously, a detailed questionnaire was requested to fill under the assistance of trained doctors or medical students.Prevalence of FC of the population was adjusted by the rate of correct diagnosis from the detailed study. Results The adjusted point prevalence of FC in 5 northern cities of China according to Rome Ⅲ criteria was 4.73% with higher prevalence rate of FC seen in the Beijing area (5.02%) than in other cities (4.82%, 4.76%, 4.27%, 4.40%, with P＜0.001 ). Male to female ratio was 1.26:1 with majority of the FC fell in the 4-6 year olds (5.76%). Conclusion FC appeared a common disorder in childhood in the northern parts of China which called for greater attention. Higher prevalence was noted in the age groups of 4-6.

Comparison of changes in body composition during puberty development of obese and normal-weight children in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To compare the changes in body composition, including fat mass index (FMI) and fat free mass index (FFMI) during puberty development of obese and normal-weight children in China, and to explore the effect of age and gender on body composition.</p><p><b>METHODS</b>A total of 356 children at the age of 7-15 years were enrolled in this study. Body composition of 10 normal-weight and obese children in each age group was measured by dual-energy x-ray absorptiometry (DEXA). FFMI and FMI were calculated according to the following formula: FFMI (kg x m(-2)) = FFM(kg) / height2 (m2) and FMI (kg x m(-2)) = FM (kg) / height2 (m2).</p><p><b>RESULTS</b>The fat mass and fat free mass of obese children were significantly higher than those of normal-weight children (P < 0.05). The FMI and FFMI of obese children increased significantly with age and were higher than those of the same sex, gender, and age normal-weight children (P < 0.05).</p><p><b>CONCLUSION</b>The levels of fat mass, fat free mass, FMI, and FFMI are different in obese and normal-weight children, and gender effects are significant in boys having higher levels of these indicators than in girls. FFMI and FMI can be used as monitoring indexes in weight control of obese children.</p>

Association of the common genetic variant upstream of INSIG2 gene with obesity related phenotypes in Chinese children and adolescents / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the association between the rs7566605 variant of INSIG2 and obesity-related phenotypes in Chinese children and adolescents.</p><p><b>METHODS</b>The study sample consisted of two independent cohorts of Chinese children and adolescents. Anthropometric indices, lipids, blood pressure, fasting glucose, insulin and percentage of fat mass were determined. PCR with restriction fragment length polymorphism analysis was performed for genotyping the rs7566605 variant.</p><p><b>RESULTS</b>In each of the two independent cohorts, no significant association was observed between rs7566605 and obesity under additive, dominant or recessive model. We also did not detect any difference in the genotype frequency between all the obese children and controls. Furthermore, we did not find evidence of an association between body composition indices and metabolic phenotypes in all children. However, the triglyceride level of CC homozygotes was significantly higher than that of GG+GC genotypes in obese children (P=0.022). Additionally, we observed a non-significant trend of severe obesity in a post-hoc test.</p><p><b>CONCLUSION</b>INSIG2 rs7566605 variant is not associated Chinese childhood obesity in two independent cohorts. Further study is needed to verify the effect of rs7566605 on triglyceride in obese children.</p>

Detection of DD3 mRNA in the urine of prostate cancer patients and its clinical significance / 中华男科学杂志

<p><b>OBJECTIVE</b>To detect the differential display code 3 mRNA (DD3 mRNA) in the urine sample of patients with prostate cancer and to evaluate its clinical significance.</p><p><b>METHODS</b>DD3 mRNA in the urine collected from 48 patients with prostate cancer, 23 patients with benign prostate hyperplasia (BPH) and 9 healthy male volunteers was measured by reverse transcriptase polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>DD3 products could not be detected in the urine samples of the BPH patients and healthy male volunteers, but could in 39/48 urine samples of the patients with prostate cancer. Significant difference was found between them (P < 0.01).</p><p><b>CONCLUSION</b>The detection of DD3 mRNA in the urine promises to be a non-invasive, simple and sensitive method for the early diagnosis and post-treatment monitoring of prostate cancer.</p>

Omission factors in detecting early stage prostate cancer by TRUS needle biopsy / 中华男科学杂志

<p><b>OBJECTIVE</b>To analyze and reduce the omission factors in detecting early stage prostate cancer by TRUS needle biopsy, and to improve the diagnosis of the disease.</p><p><b>METHODS</b>A total of 80 benign prostatic hyperplasia patients suspected of prostatic carcinoma underwent TRUS sextant biopsies. The pathological results being negative, the patients received transurethral resection of the prostate (TURP).</p><p><b>RESULTS</b>After TURP, 25 cases were pathologically diagnosed as prostate cancer, with an omission rate of 31.25% (25/80). Of the diagnosed cancer patients, 10 were treated by radical perineum prostatectomy, 8 by surgical castration, and 7 by medical castration.</p><p><b>CONCLUSION</b>Some tumors may fail to be detected by TRUS needle biopsy. Serial or multi-core needle biopsies can decrease the omission rate in the diagnosis of organ confined cancer.</p>

Gap junctions, connexins and sudden death caused by coronary heart disease / 法医学杂志

Gap junctions construct hydrophilic trans-membrane channels which adjust the intercellular communication of chemistry and electricity. In the heart, individual cardiac myocytes are linked by gap junctions. These junctions form low resistance pathways along which the electrical impulse flows rapidly and repeatedly between all the myocardium, ensuring their synchronous contraction. In recent years, some researchers have found that connexins, the protein molecules of gap junction channels, are reduced in number or redistributed from intercalated disks (ID) to lateral cell borders in a variety of cardiac disease, especially in ischemic heart disease. The gap junction remodeling is considered to be arrhythmogenic. These findings will lead us to a new realm in the diagnostic of sudden death caused by coronary heart disease.

Immunohistochemical study of Cx43 dephosphorylation in human left ventricular myocardium suffered by acute ischemia / 法医学杂志

OBJECTIVE@#This study was performed to detect the phosphorylation state of Cx43 in human left ventricular myocardium among sudden deaths caused by acute myocardial ischemia (AMI) especially sudden coronary death (SCD) and control groups. And then evaluate the significance of these findings in diagnosing the early pathological changes of acute myocardial ischemia.@*METHODS@#Immunohistochemistry (IHC) SP techniques were adopted to detect the phosphorylation state of Cx43 in the left ventricular myocardium samples of 45 deceased, which classified as group I--SCD, group II & III (other two groups of AMI) and Group IV & V (two control groups, sudden death caused by lethal acute cranio-cerebral injury or pathologic intracranial hemorrhage). In addition, we selected anti-Pan-Cadherin (construction protein of adherent junctions on the intercalated disc) and PHA-E+L/Bio, to detect the integration of myocardial mechanical coupling and membranes (applying affinityhistochemistry, AHC) respectively.@*RESULTS@#(1) Phosphorylated Cx43 positive staining was almost invisible in Group I, II and III or scattered in sarcoplasm in few samples; but it was assembling at the IDs clearly in group IV and V. (2) Strongly positive staining of Pan-Cadherin could be observed at the IDs and (3) integrated myocardial membranes were found in all samples.@*CONCLUSION@#These findings suggested that compared with the control groups, the integration of myocardial mechanical coupling and membranes did not alter in AMI. But Cx43, the key protein of electrical coupling on myocardial gap junctions, occurred dephosphorylation remarkably in AMI. Thus applying IHC techniques to detect the Cx43 dephosphorylation in human left ventricular myocardium maybe useful to recognize the onset of arrhythmia in AMI, especially in SCD whose myocardium without apparent morphological changes.