Efficacy and safety of LY01005 versus goserelin implant in Chinese patients with prostate cancer: A multicenter, randomized, open-label, phase III, non-inferiority trial / 中华医学杂志(英文版)

BACKGROUND@#LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer.@*METHODS@#We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels.@*RESULTS@#On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]).@*CONCLUSION@#LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT04563936.

Association between early life exposure to famine and risk for subtype and classification of hypertension in middle and old age / 公共卫生与预防医学

Objective To investigate the relationship between exposure to famine in early life stage and hypertension phenotype and grade in middle and old age. Methods People born between 1951 and 1965 in the 2015 China Health and Elderly Care Follow-up Survey were included in the study, and were divided into unexposed group, fetal exposed group, childhood exposed group and adolescent exposed group according to the time of famine occurrence and birth year of the participants. Logistic regression model was used to explore the effects of different famine exposure periods in early life stage on hypertension classification （including normal high value, grade I, grade II and grade III） and phenotype （including isolated systolic hypertension[ISH], isolated diastolic hypertension [IDH] and combined systolic and diastolic hypertension [SDH]）. Results Compared with unexposed group, fetal famine exposure （OR=1.59, 95% CI :1.10-2.30）, childhood famine exposure （OR=1.67, 95% CI :1.04-2.70） and adolescent famine exposure （OR=3.42, 95% CI : 2.51-4.66） were the risk factors for ISH. Only famine exposure during adolescence （OR=1.54, 95% CI: 1.07-2.21） was a risk factor for SDH. In addition, fetal famine exposure （OR=1.41, 95% CI: 1.05-1.89） and adolescent famine exposure （OR=2.22 , 95% CI: 1.71-2.88） were risk factors for developing grade I hypertension. Famine exposure in childhood （OR=2.45, 95% CI: 1.21-4.94） and famine exposure in adolescence （OR=2.45, 95% CI: 1.44-4.19） were risk factors for grade 2 hypertension. Conclusion Famine exposure in early life stage was associated with the phenotype and grade of hypertension. Therefore, balanced nutrition in early life is important to prevent hypertension in adulthood.

Surgical technique and efficacy of P. R.E.S.S. bladder cuff excision / 中华泌尿外科杂志

Objective:To explore the surgical technique and efficacy of pure retroperitoneoscopic extravesical standardized seeable (P.R.E.S.S.) technique for bladder cuff excision (BCE).Methods:Ninety five patients with UTUC from five domestic centers (30 cases from Changzheng Hospital, 21 cases from Peking University First Hospital, 20 cases from Yuhuangding Hospital, 21 cases from Dalian Medical University affiliated No.2 Hospital and 3 cases from General Hospital of Eastern Theater Command)between August 2017 and December 2020 were retrospectively analyzed. There were 57 males and 38 females with a mean age of (67.7±10.0) years and median tumor size of 3.0 cm. All patients underwent pure retroperitoneoscopic radical nephroureterectomy with a single surgical position and four (36 cases) or five (59 cases) trocar layout according to the surgeon’s prefer habit and experience. The demographics of the two groups were the age of [(66.3±11.2)years vs. (68.6±9.1)years], male/female ratio of (25/11 cases vs. 32/27 cases), body mass index of [(25.0± 3.0)kg/m 2 vs. (24.8±3.4)kg/m 2], tumor maximum diameter of [2.8(1.6, 3.5)cm vs. 3.0(2.0, 4.0)cm], left/right side tumor of(19/17 cases vs. 34/25 cases), T 1-2/T 3-4/Tis stage of(25/10/4 cases vs. 49/10/0 cases), and multifocal tumors of(3 cases vs. 2 cases), and the difference was not statistically significant( P>0.05). On the other hand, the differences of hydronephrosis of the operated kidney(13 cases vs. 39 cases, P=0.004), and tumor location (in renal pelvis or calyx or upper/middle/lower ureter being 23/9/4 cases vs. 35/4/20 cases, P=0.005), were statistically significant. The umbilical artery cord was used as anatomical landmark in the process of P. R.E.S.S. bladder cuff excision. The pelvic floor and extraperitoneal space around the ureter were expanded, the bladder wall was opened to form pneumovesicum, and a sufficient bladder cuff resection and exact bladder cuff closure was performed. Perioperative outcomes and follow-up data were analyzed, and the clinical outcomes between the four and five trocars were compared to evaluate the impact of trocar layout on the surgical outcomes. Results:There were 91(95.8%) cases successfully undergoing P. R.E.S.S. BCE technique, with one case converted to open BCE due to bleeding and three cases converted to distal ureter Hem-o-lok clipping because of poor exposure. Median operative time was 180(125, 230)min, and estimated blood loss was 100(50, 100)ml. The overall complication rate was 10.5%(10/95), including 2 cases(2.1%) of intraoperative bleeding, with 1 case treated by transfusion (400 ml), the other case converted to open surgery without transfusion. There were 8 cases of postoperative complications(8.4%), including 7 cases of Clavien-Dindo grade Ⅱ(3 cases of secondary hemorrhage, one case for each of drug allergy, acute renal insufficiency, blood creatinine increased to 490 μmol/L, or lung infection with lymphatic leakage), 1 case of grade Ⅲa(intestinal obstruction treated with insertion of the intestinal obstruction catheter under local anesthesia), and all these patients were discharged smoothly. The difference between the four and five trocars was not statistically significant in the following variables, including the rate of surgical conversion(8.3% vs. 1.7%), estimated intraoperative blood loss(100 ml vs. 60 ml), ratio of intraoperative lymph node dissection (25.0% vs.20.3%), P. R.E.S.S. bladder cuff excision success rate(91.7% vs.98.3%), the incidence of intraoperative and postoperative complications (13.8% vs.8.5%), pT 1-2/pT 3-4/pTis stage(22/11/3 cases vs.37/19/3 cases) and the proportion of recurrence or metastasis(8.3% vs.3.4%)(all P>0.05). However, the differences in the operation time(190 min vs.170 min, P=0.011)and postoperative hospital stay(5 d vs.6 d, P=0.005) were statistically significant. Conclusions:P. R.E.S.S. bladder cuff resection technique is safe and feasible during the procedure of pure retroperitoneoscopic radical nephroureterectomy by a single surgical position and facilitates seeable adequate bladder cuff excision by establishing an enlarged pelvic lateral extraperitoneal space and pneumovesicum. Five-trocar technique is more suitable for patients with lower ureteral tumors but may be associated with a longer postoperative hospital stay compared with the four-trocar technique.

Efficacy and complications of intravesical instillation of BCG for prevention of recurrence of moderate and high-risk non muscle invasive bladder cancer / 中华泌尿外科杂志

Objective To assess the efficacy and side effects of intravesical instillation of BCG after transurethral resection of the bladder tumor (TURBT) in non-muscle invasive bladder cancer (NMIBC) patients.Methods The clinical data of patients treated with BCG 120 mg per course induced perfusion or more after TURBT from December 2013 to October 2016 in 18 hospitals of northeast China region,were analyzed retrospectively.The first part,data of 106 patients with moderate,high-risk NMIBC were collected.A total of 83 patients were male,while the other 23 patients were female.The average age was 66.7 years old.The clinical staging were T1 in 86(81.1％) cases,Ta in 20(18.9％) cases and carcinoma in situ in 6 (5.7％) patients.Intravesical instillation of BCG was executed after transurethral resection of the bladder tumor.The incidence rate of recurrence and progression during more than 6 months' follow-up time were observed.Multivariate analyses were done by using logistic analysis and Cox proportional hazards regression model with Kaplan-Meier method.The second part,treatment compliance of 276 patients with bladder cancer,including moderate/high-risk NMIBC in 263 cases,moderate/high-risk NMIBC followed with renal pelvis/ureteral carcinoma in 8 cases were and moderate/high-risk NMIBC with renal pelvis/ureteral carcinoma in 5 cases who treated with BCG after the surgeries,were observed.Patients consisted of 211 males and 65 females with average age of 68.3 years.Results With a median follow-up of 12 months,9 (8.5％) patients experienced tumor recurrence and 2 (1.9％) patients were found progression in the first part.The one-year cancer free recurrence rate of the patients was 91.5％.Statistically significant prognostic factors for recurrence identified by multivariable analyses were prior recurrence of the tumors (OR =3.214,95％CI0.804-12.845,P =0.099).In the second port,an incidence rate of adverse effects was 64.1％ (177/276).The Ⅲ/Ⅳ degree complications were occurred in 11 patients and satisfactory outcomes achieved with active treatment.A total of 36 patients withdrawal with the major causes were recurrence and progression of bladder tumor in 12 cases (4.4 ％),9 cases (3.3 ％) with economic reasons and 11 cases (4.0％) with serious complications.Conclusions NMIBC patients treated with intravesical BCG therapy have approving cancer free recurrence rates and acceptable adverse effects.Prior recurrence may be prognostic factor of recurrence after intravesical BCG therapy.

Research on standard compilation for prevention and treatment of venous thromboembolism of inpatients / 中华医院管理杂志

In view of the risks in prevention, diagnosis and treatment of venous thromboembolism of inpatients, as well as the key points and difficulties of the quality management for such inpatients, standardized clauses of the standard were developed. This standard, in line with the service process of clinical diagnosis and treatment of the disease, comprises such four core normative parts as disease assessment, disease prevention, disease diagnosis and treatment, and continuous improvement, as well as 16 key points deserving more management efforts. Standardized requirements on quality management, may constrain the medical behavior, and explore a standardized path in accordance with the medical quality management for VTE control of these patients.

Introduction and interpretation of guidelines on thromboprophylaxis in the perioperative period of urological surgery / 中华外科杂志

Venous thromboembolism had drawn great attention of global experts, as it is the third leading cause of cardiovascular-associated death, ranking after coronary heart disease and stroke. Numerous health care organizations had introduced guidelines for thromboprophylaxis during the perioperative period in their own fields. The paper reviewed the available guidelines pertaining to urological surgery from America Urological Association, American College of Chest Physicians and European Association of Urology. Compared with the first two guidelines, the European Association of Urology guideline is a milestone which recommended the most detailed prophylactic measures for the procedure-specific and patient-specific according to the evidence-based medicine. Meanwhile, there was still no reliable evidence in fields of the effect of new oral anticoagulants in urology, needing further study. Although they were similar in patient management and prophylaxis principles, there are still some differences in risk factors, assessments, and recommendations of prophylactic measures. In this context, we planed to summarize the highlights and compare the differences of three guidelines addressing the use of thromboprophylaxis in urology, in order to provide reference for Chinese urologists to select the best prevention strategies for patients in the perioperative period.

Clinical analysis in 116 patients with adrenal incidentaloma / 中国医师进修杂志

Objective To reveal pathogenesis and etiology in adrenal incidentaloma. Methods The clinical data of 116 patients with adrenal incidentaloma from January 1, 2015 to January 1, 2017 were retrospectively analyzed. Results In 116 patients with adrenal incidentaloma, 49 cases (42.2％) were male and 67 cases (57.7％) were female; there were 14 cases (12.1％) aged from 20 to 40, 63 cases (54.3％) aged from 40 to 60, and 39 cases (33.6％) > 60 years. Forty-three patients (37.1％) were found by health examination, 26 patients (22.4％) were found because of hypertension, 27 patients (23.3％) were found by CT detection because of other diseases, and 20 cases (17.2％ ) were found because of other reasons. The result of endocrine function examination showed that nonfunctioning adrenal tumor was in 56 cases (48.3％); functional adrenal tumor was in 44 cases (37.9％), among whom primary aldosteronism was in 27 cases, Cushing syndrome was in 10 cases, and pheochromocytoma was in 7 cases;nonfunctioning non- adenoma was in 16 cases (13.8％ ). Conclusions It is frequent that the adrenal incidentaloma is found by health examination. The patients with adrenal incidentaloma should examine the endocrine function and identify the benign or malignant. And if necessary, surgical treatment should be performed.

Clinical Outcome of Extraperitoneal Laparoscopic Radical Prostatectomy for Prostate Cancer / 中国医科大学学报

Objective To evaluate the clinical efficacy of extraperitoneal laparoscopic radical prostatectomy(ELRP)for prostate cancer patients, and to summarize the experience of surgical treatment. Methods The clinical data of 50 prostate cancer patients who underwent ELRP by the same performer from January 2010 to June 2015 were retrospectively reviewed. Results All cases were all successfully completed ,no case was converted to open surgery. The average operation time was 238.8 min,average operative blood loss was 409.1 mL,and intraoperative or postopera?tive blood transfusion was 6(12%). The mean postoperative catheterization time was 23.7(17?38)d. The mean postoperative hospital stay was 15 (10?34)d. The postoperative recovery time of eating was 2?4 d,and the ambulation time was 1?3 d. Totally 3 cases(6%)had lymph node metasta?sis,and 7 cases(14%)had positive surgical margin. Totally 9 cases(18%)had surgery?related complication. Patients were followed up for 6 to 58 months,with an average of 12.5 months. One case(2%)had biochemical recurrence,and the tumor?free survival rate was 84%. At the end of fol?low?up,all of the patients were continent. Conclusion ELRP is safe and effective for the treatment of prostate cancer. With the development of minimally invasive techniques,the applications of RP are increasingly widespread. However,large?scale and long?term follow?up studies are still needed for high?risk prostate cancer patients.

Age-specific Reference Ranges for Prostate-specific Antigen in Dalian / 中国医科大学学报

Objective To determine the age-specific normal ranges of serum prostate-specific antigen (PSA) levels in Dalian,China.Methods Serum samples were collected from 8 453 asymptomatic men who underwent health examinations at the Second Affiliated Hospital of Dalian Medical University.Results The median PSA level was 0.93 μg/L,and the interquartile level was 0.81 μg/L.The 95th percentile level was 3.49 μg/L.The 95th percentile levels according to age group were:20 to ＜30 years,0 to 1.67 μg/L;30 to ＜40 years,0 to 2.01 μg/L;40 to ＜50 years,0 to 2.41 μg/L;50 to ＜60 years,0 to 3.25 μg/L;60 to ＜70 years,0 to 3.92 μg/L;70 to ＜80 years,0 to 5.48 μg/L;and older than 80 years,0 to 9.35 μg/L.The differences between the different age groups were statistically significant (P ＜ 0.01).The serum PSA value was positively correlated with age (r =0.251,P ＜ 0.001).Conclusion There were clear differences in age-specific PSA levels in Dalian,and these were lower than the standard OESTERLING.Screening for prostate cancer according to age-specific PSA reference values may be useful in the early detection of prostate cancer and may also reduce the risk of over-diagnosis.

Analysis of HIV infection and its epidemic characteristics among pregnant women in Hunan from 2011 to 2015 / 中国医师杂志

Objective To investigate the prevalence of human immunodeficiency virus (HIV) infection and its characteristics among pregnant women in Hunan.Methods Data from information system of prevention of mother-to-child transmission of HIV management in Hunan 2011-2015 was analyzed in the study (3 + 1 mode by year statistics).Results The total HIV-positive infection rate was 0.19‰ among pregnant women from 2011 to 2015 in Hunan.The rate of HIV infection showed upward trend by years (P ＜ 0.05).The proportion of diagnosis of HIV positive cases intrapartum was 44.66％,showed declining trend by years (P ＜ 0.05).The 786 cases of HIV positive pregnant women were mainly the Han's,the age distribution of 20 to 35 years old,90.21％ of them were farmers or unemployed.A percentage (76.84％) of them had junior high school education level or lower 37.91％ of them were found in delivery or postpartum.A percentage (36.51％) of them accepted service in delivery or postpartum.A percentage (45.67％) of them was infected through sexual contact,46.82％ of them were infected by unknown ways.Conclusions The rate of HIV infection among pregnant women was increased by years in Hunan.It is suggested to strengthen health education among high-risk groups and high incidence areas,improve detection rate of early pregnant women,implement the Prevention of Mother to Child Transmission (PMTCT) measures to reduce the rate of mother to child transmission of Acquired Immune Deficiency Syndrome (AIDS).

Application of Dorsal Vein Complex Ligation Free in Laparoscopic Radical Prostatectomy / 中国医科大学学报

Objective To assess the efficacy of dorsal vein complex(DVC)ligation free in laparoscopic radical prostatectomy. Methods The data of 25 patients underwent laparoscopic radical prostatectomy that performed by the same surgeon in our hospital from January 2012 to January 2014 were retrospectively analyzed. Among them,14 cases underwent sutured DVC,11 cases received sutured DVC. Results All the operations were completed with laparoscope and without convert to open surgery. The mean operation time was 246±24.7 min and 236±26.1 min in DVC liga?tion and DVC ligation free,the blood loss was 337.5±120.2 mL and 322.2±104.9 mL in DVC ligation and DVC ligation free,the blood transfusion rate was 14.3%and 18.2%in DVC ligation and DVC ligation free ,the urinary incontinence rate of 6 months after operation was 21.4%and 9.1%in DVC ligation and DVC ligation free,no significant difference was found in the operation time,blood loss,blood transfusion rate and urinary in?continence rate among the two groups(P>0.05). Conclusion DVC ligation free is a safe and effective technique during laparoscopic radical prostatectomy and may simplify the operative procedure and without increase of the risk of bleeding ,which can be more conducive to the early re?covery of postoperative urinary control.

Hinokitiol induces bladder cancer J82 cells apoptosis via autophagy induction / 中国癌症杂志

Background and purpose: Bladder cancer is the most common urological malignancy in our country which seriously threatens human health, and its incidence increased year by year. This study aimed to investigate the effects of hinokitiol on the proliferation, apoptosis and autophagy in human bladder cancer cell lines. Methods:CCK-8 assays were performed to analyze the effects of hinokitiol on the proliferation of J82 cells. Apoptosis rate was determined by lfow cytometry. Cleaved caspase 3, LC3 and P62 protein expression was determined using Western blot. EGFP-LC3 microscopy assay was performed to assess autophagy. Results: Hinokitiol significantly inhibited the proliferation of J82 cells and induced cell apoptosis via caspase pathway. The apoptosis effect of hinokitiol could be partially antagonized by Z-VAD-FMK. Hinokitiol induced autophagy of J82 cells, increased LC3 expression and down-regulated P62 expression. 3-MA is able to rescue Tet-induced cell death. Conclusion:Hinokitiol can inhibit the proliferation of J82 cells and induce cell apoptosis via autophagy activation.

Expressions of activation antigens CD69 and HLA-DR in peripheral blood mononuclear cells and skin lesions of patients with psoriasis vulgaris / 中华皮肤科杂志

Objective To investigate changes in expressions of activation antigens CD69 and HLA-DR in CD3+T lymphocytes in peripheral blood and skin lesions in patients with psoriasis vulgaris. Methods Peripheral blood samples were obtained from 20 patients with psoriasis vulgaris and 20 healthy controls, and skin specimens from the lesions of 15 out of the 20 patients and 10 healthy controls. Flow cytometry was performed to quantify the expressions of CD69 and HLA-DR in peripheral blood CD3+T cells, and an immunohistochemical study to measure the expression of HLA-DR in skin specimens. Statistical analysis was carried out by a two-sample t-test and Pearson correlation analysis with the SPSS 19.0 software. Results Compared with the healthy controls, the patients with psoriasis vulgaris showed increased expression rates of CD69 (4.70%± 1.90%vs. 1.56%± 0.95%, t=6.629, P<0.01)and HLA-DR (8.97%± 1.79% vs. 3.02% ± 1.15%, t= 6.204, P< 0.01)in peripheral blood. Pearson correlation analysis revealed that the percentage of CD3+HLA-DR+cells in peripheral blood was positively correlated with the psoriasis area and severity index (PASI)score (r=0.5626, P<0.05). The expression rate of HLA-DR was significantly higher in the dermis (64.87%± 17.31%vs. 19.80%± 5.69%, t=7.916, P<0.01), but lower in the epidermis(11.80%± 5.55%vs. 27.40%± 8.61%, t=5.479, P<0.01)in the psoriatic specimens compared with the control specimens. Immunohistochemically, HLA-DR was widely expressed in the dermis of psoriatic lesions, but mainly distributed around blood vessels in the control skin. Conclusions There is an aberrant activation of CD3+T cells in peripheral blood and inflammatory cells in skin lesions in patients with psoriasis vulgaris, and the percentage of CD3 +HLA-DR+ cells in peripheral blood is correlated with the severity of psoriasis vulagaris.

Cytosolic Ca(2+) as a multifunctional modulator is required for spermiogenesis in Ascaris suum

The dynamic polar polymers actin filaments and microtubules are usually employed to provide the structural basis for establishing cell polarity in most eukaryotic cells. Radially round and immotile spermatids from nematodes contain almost no actin or tubulin, but still have the ability to break symmetry to extend a pseudopod and initiate the acquisition of motility powered by the dynamics of cytoskeleton composed of major sperm protein (MSP) during spermiogenesis (sperm activation). However, the signal transduction mechanism of nematode sperm activation and motility acquisition remains poorly understood. Here we show that Ca(2+) oscillations induced by the Ca(2+) release from intracellular Ca(2+) store through inositol (1,4,5)-trisphosphate receptor are required for Ascaris suum sperm activation. The chelation of cytosolic Ca(2+) suppresses the generation of a functional pseudopod, and this suppression can be relieved by introducing exogenous Ca(2+) into sperm cells. Ca(2+) promotes MSP-based sperm motility by increasing mitochondrial membrane potential and thus the energy supply required for MSP cytoskeleton assembly. On the other hand, Ca(2+) promotes MSP disassembly by activating Ca(2+)/calmodulin-dependent serine/threonine protein phosphatase calcineurin. In addition, Ca(2+)/camodulin activity is required for the fusion of sperm-specifi c membranous organelle with the plasma membrane, a regulated exocytosis required for sperm motility. Thus, Ca(2+) plays multifunctional roles during sperm activation in Ascaris suum.

Feasibility study of TNF-α increasing bone marrow mesenchymal stem cell migration to ischemic tissues / 中华创伤杂志

Objective To study the feasibility of TNF-α promoting migration of rat mesenchymal stem cells (MSCs) to local damaged tissues. Methods The MSCs was exposed to TNF-α at different concentrations and the expression rate of surface adheslon molecules and specific markers as well as their adhesion to endothelial cells were detected.Based on the above steps,the MSCs stimulated with the optimal concentration of TNF-α were obtained and were injected intravenously to the rats whose hindlimbs experienced ischemia damage.The rats were executed for achieving the muscle samples in the ischemic area,which were made into frozen section to count the number of MSCs. Results ( 1 ) Twenty-four hours after the TNF-o stimulation,the expression of adhesion molecule (VCAM-1) of MSCs increased in a concentration-dependent manner,while the expression of adhesion molecules (ICAM-1,L-Selectin and VLA4) of MSCs showed no significant changes.Besides,the expression rate of specific markers of MSCs was also obscure.(2) Exposed to 10 ng/ml TNF-o,MSCs presented an obviously increased ability in adhesion to the endothelial cells.(3) MSCs stimulated with 10 ng/ml TNF-α showed a larger number in the ischemia-damaged tissue of rat hindlimbs than that in the control group. Conclusion TNF-α at concentration of 10 ng/ml is effective within a short term in increasing VCAM-1 expression in rat MSCs and promoting the adhesion of MSCs to endothelial cells without affecting their character.

Case-control study on environmental factors in congenital heart disease / 中南大学学报(医学版)

OBJECTIVE@#To explore the relation between environmental factors and the occurrence of congenital heart disease (CHD).@*METHODS@#A hospital-based case-control study was conducted. Mothers of 123 patients with congenital heart disease and 246 normal newborns were interviewed with standardized questionnaires. Chi-square test and logistic regression models were performed to analyze the influencing factors.@*RESULTS@#As shown in multivariable logistic model, gravida with occupational exposure (OR=4.10), or gravida with chronic diseases during progestational pregnancy (OR=5.95), gravida with abnormal childbearing history (OR=6.27), and gravida catching a cold in the early stage of pregnancy (OR=2.07) would increase the risk of CHD. On the contrary, eating meat, egg (OR=0.18) and milk (OR=0.23), and taking multivitamin and microelement (OR=0.35) during the pregnancy reduced the risk of CHD.@*CONCLUSION@#The risk of the offspring developing CHD is associated with gravida's exposure to many environmental factors during pregnancy. It is time to strengthen the intervention measures to reduce the occurrence of CHD.

Efficacy of solifenacin with or without tamsulosin in patients with overactive bladder / 中华泌尿外科杂志

Objective To evaluate the efficacy of solifenacin with or without tamsulosin in patients with overactive bladder (OAB).Methods Fifty-three patients with OAB were randomly divided into two groups (group A 27 patients, group B 26 patients).The patients received either solifenacin 5 mg/day in group A or combined with Tamsulosin 0.2 mg/day in group B for two weeks.During the treatent period all the patients recorded voiding and adverse events in a diary.The symptoms of urgency, frequency, incontinence were evaluated by OABSS scores at the begining and end of the therapy period.The results of the efficacy and safety were analyzed by using SPSS 13.0.Results The OABSS scores at the begining and end for the two groups were significantly different ( P ＜ 0.01 ).In both groups the efficacy was obvious.The OABSS scores at the end of the therapy between group A and B were significantly different (P ＜0.05 ).The efficacy of group B was better than that of group A.Conclusion The efficacy of solifenacin combined with tamsulosin was better than solifenacin alone in OAB.

Relationship between photoallergens and melasma / 中华皮肤科杂志

Objective To study the relationship between common photoallergens and melasma.Methods Twenty allergens were selected according to the National Diagnostic Criteria for Photosensitive Dermatitis induced by cosmetics,National Diagnostic Criteria for Contact Dermatitis induced by cosmetics and National Diagnostic Criteria for Occupational Skin Diseases.Based on the standard procedures for photopatch test recommended by the British Photodermatology Group (BPG),photopatch test was performed on 50 patients with melasma and 30 normal controls.Results The positivity rate of photopatch test was 48.0%(24/50)in patients suffering from melasma,significantly higher than in the controls[23.33%(7/30),P<0.05].Conclusion Patients with melasma appear more likely to have positive photopatch test than normal controls.

Inhibition effects of nuclear factor-κB on cytokines releasing from human corneal fibroblasts / 解剖学报

Objective To investigate the inhibition effects of nuclear factor-κB(NF-κB) on cytokine expression of cultured human corneal fibroblasts in vitro. Methods The cultured human corneal fibroblasts were used in the present experiment. Cell viability insensitive to emodin on cultured human corneal fibroblasts in vitro was assessed using the MTT assay.Cells were randomly divided into three groups:control group(group 0 hour,n=6),lipopolysaccharidel (LPS)group (n=24)and emodin pretreatment group(n=24). Cells of the emodin pretreatment group were incubated with emodin for 30 minutes before LPS challenged. The cultured human corneal fibroblasts were then challenged with LPS, the expression of interleukin-8(IL-8) mRNAs was detected by reverse transcription polymerase chain reaction analysis (RT-PCR) and the proteins of IL-8 secreted from these cells were assessed by enzyme-linked immunosorbent assays (ELISA). Western blotting analysis was used for detecting the protein expression of inhibitor of nuclear factor-κB-α(IκB-α)induced by LPS.At the same time,the effects of emodin on these expressions were also assessed in fibroblasts. Results The concentration of emodin used in this study was safe to these cultured human corneal fibroblasts in vitro. Both the protein release and mRNA expression of IL-8 in corneal fibroblasts increased significantly after challenged with LPS, however, the protein level of IκB-α significantly decreased after treated with LPS. These results indicated that LPS could mediate the activation of NF-κB and upregulate the expression of cytokines in corneal fibroblasts. Pretreated with emodin 30 min before challenged with LPS, the activation of NF-κB induced by LPS was markedly inhibited, and the mRNA expression as well as protein release of IL-8 were also inhibited(P<0.01).Conclusion These results suggest that LPS takes part in the degeneration of IκB-α and the expression of IL-8 in cultured human corneal fibroblasts in vitro. Emodin, an active component from the rhizome of Rheum palmatum, can inhibit the activation of NF-κB via decreasing this degeneration, which results in suppressing LPS-induced cytokine release from cultured human corneal fibroblasts.

Compare the clinical efficacy of retroperitoneal laparoscopic versus open radical nephrectomy / 中国医师进修杂志

Objective To evaluate the clinical efficacy and complication rate by open or retroperitoneal laparoscopic radical nephrectomy for renal tumor with stages T1N0M0 or T2N0M0.Methods Between October 2003 and October 2006,90 patients with renal cell carcinoma,which were clinically localized stages T1N0M0 or T2NOM0 Based on the patients' options to undergo retroperitoneal laparoscopic radical nephrectomy (group A,49 patients)and open radical nephrectomy(group B,41 patients).The clinical efficacy were compared between group A and group B,retrospectively.Results In group A,the operations of 46 patients were successful,4 cases occurred major complications(8.7%)during the follow-up visit which lasted for (21.9±6.1)months.The operations in group B were all successful.9 cases occurred major complications (22.5%)during the follow-up visit which lasted for(24.9±7.8)months.All cases were renal malignant tumors with pathologically confirmed stages T1N0M0 or T2N0M0 and there were no renal pedical lymph node metastasis.The age,weight,body mass index(BMI),tumor size,operating time and the time of follow-up were no statistically significant differences between the two groups(P＞0.05),while the blood loss,amount of postoperative drainage,time to ambulation,recovery of intestinal function after operation,hospital stay,use of analgesic and transfusion blood or plasma in group A were significantly reduced than those in group B(P＜0.01). Conclusions As compared with open radical nephrectomy,retroperitoneal laparoscopic radical nephrectomy afords patients with renal cell carcinoma an impreved postoperative course with minimal invasion,less pain,quicker recovery and less complications,while providing equally effective cancer control for patients with T1N0M0 or T2N0M0 tumor.