5'-tiRNA-Gln inhibits hepatocellular carcinoma progression by repressing translation through the interaction with eukaryotic initiation factor 4A-I / 医学前沿

tRNA-derived small RNAs (tsRNAs) are novel non-coding RNAs that are involved in the occurrence and progression of diverse diseases. However, their exact presence and function in hepatocellular carcinoma (HCC) remain unclear. Here, differentially expressed tsRNAs in HCC were profiled. A novel tsRNA, tRNAGln-TTG derived 5'-tiRNA-Gln, is significantly downregulated, and its expression level is correlated with progression in patients. In HCC cells, 5'-tiRNA-Gln overexpression impaired the proliferation, migration, and invasion in vitro and in vivo, while 5'-tiRNA-Gln knockdown yielded opposite results. 5'-tiRNA-Gln exerted its function by binding eukaryotic initiation factor 4A-I (EIF4A1), which unwinds complex RNA secondary structures during translation initiation, causing the partial inhibition of translation. The suppressed downregulated proteins include ARAF, MEK1/2 and STAT3, causing the impaired signaling pathway related to HCC progression. Furthermore, based on the construction of a mutant 5'-tiRNA-Gln, the sequence of forming intramolecular G-quadruplex structure is crucial for 5'-tiRNA-Gln to strongly bind EIF4A1 and repress translation. Clinically, 5'-tiRNA-Gln expression level is negatively correlated with ARAF, MEK1/2, and STAT3 in HCC tissues. Collectively, these findings reveal that 5'-tiRJNA-Gln interacts with EIF4A1 to reduce related mRNA binding through the intramolecular G-quadruplex structure, and this process partially inhibits translation and HCC progression.

Application of enhanced recovery program in laparoscopic distal pancreatectomy / 浙江大学学报·医学版

Objective: To evaluate the feasibility and safety of applying enhanced recovery after surgery (ERAS) protocol in patients undergoing laparoscopic distal pancreatectomy. Methods: Data of 36 patients undergoing laparoscopic distal pancreatectomy from May 2016 to May 2017 in the First Affiliated Hospital, Zhejiang University School of Medicine were reviewed. The patients were divided into ERAS group (n=12) and control group (n=24). The patients in ERAS group received a series of enhanced recovery procedures, including multimodal analgesia, early off-bed activity and early oral food-taking, etc. Operation time, intraoperative blood loss, time to first flatus, postoperative complications, and length of postoperative hospital stay were evaluated. Results: There were no statistically significant differences in operation time and intraoperative blood loss between ERAS group and control group (all P0.05). The time to first flatus and length of postoperative hospital stay were significantly shortened in ERAS group (all PP0.05). Conclusion: The ERAS protocol for laparoscopic distal pancreatectomy can significantly promote gastrointestinal function recovery and shorten postoperative hospital stay, and may reduce the incidence of postoperative complications.

Comparative study on the efficacy and safety of robot assisted laparoscopic and retropubic radical prostatectomy / 中华泌尿外科杂志

Objective To compare the efficacy and safety of robot assisted laparoscopic radical prostatectomy (RALRP) and retropubic radical prostatectomy (RRP).Methods From May 2004 to September 2013,data from 124 prostate cancer patients were collected.Of them,41 cases underwent RALRP,and 83 cases underwent RRP.The following clinical data was reviewed and analyzed,including operation time,blood loss,transfusion rate,duration of catheterization,time of postoperative hospital stay,postoperative pathology,continence and biochemical recurrence.Results All the operations were successfully performed,without RALRP converted to open surgery.The mean operation time of the RALRP group and the RRP group was 224 min and 165 min,mean blood loss was 266 ml and 659 ml,the transfusion rates were 20％ and 86％,the mean postoperative hospital stay was 16.4 d and 17.9 d,the positive margin rates were 24％ and 10％,the differences were significant (P ＜ 0.05).The mean catheterization time was 27.2 d and 23.5 d (P ＞ 0.05).The 6-month,1-year and 2-year biochemical recurrence rates were 8％,21％ and 24％ in RALRP group,and 13％,16％,31％ in RRP group.The 3-month,6-month,1-year and 2-year continence rates were 56％,70％,80％ and 94％ in RALRP group,and 55％,70％,78％ and 79％ in RRP group.For biochemical recurrence and continence rates,there was no significant difference between the 2 groups.Conclusions RALRP possesses advantages of less bleeding and faster recovery.In addition,the effect of postoperative oncology and continence is similar to open surgery.

Prevalence of ETS gene fusion in prostate cancer and its correlation with patients' clinicopathologic index / 中华泌尿外科杂志

Objective To explore the prevalence of ETS gene fusion in prostate cancer and its correlation with patient's clinicopathologic index.Methods Ninety-one samples from prostate needle biopsy cases with median age 75 (55-90) years and 18 samples from radical prostatectomy cases with median age 72 (63-81) years were collected from Oct.2010 to Feb.2012.TMPRSS2-ERG,TMPRSS2-ETV1 and TMPRSS2-ETV4 fusions were tested by multi-probe fluorescence in situ hybridization (FISH) assay.Fusion positive and negative cases were compared with age,TNM stage,Gleason score (median Gleason score 7 (6-9)),and PSA value (median PSA 33.4 μg/L,mcan PSA 118.8 μg/L).In needle biopsy cases,there were early stage 32 (34％),locally advanced prostate cancer 36 (40％),metastasis 23 (26％) ; in radical prostatectomy cases,there were 9 cases in T2 stage,8 cases in T3 stage,1 cases in T4a stage,respectively.Results TMPRSS2-ERG fusions were present in 14.3％ (13/91,95％ confidence interval,0.071-0.215)biopsy specimens and in 11.1％ (2/18,95％ confidence interval,0-0.256) radical prostatectomy specimens.No TMPRSS2-ETV1 or TMPRSS2-ETV4 fusions were found in any cases.Altogether,13 (86.7％)cases possessed deletion pattern.And 7 (46.6％) hold insertion pattern.5 cases had both deletion and insertion pattern.38.5％ (5/13) deletion pattern had distant metastasis.Except one metastatic case harbored both deletion and insertion pattern,there was no insertion pattern accompanied with metastasis.There were no differences between fusion positive and negative cases in the distribution of age (P =1.000),PSA (P =1.138),primary Gleason score (P=2.186),Gleason score (P=2.107),TNM stage (P=2.052) and Risk Degree (P=2.597).Conclusions The TMPRSS2-ERG fusion positive cases harbor more deletion pattern than insertion pattern.There are no differences between fusion positive and negative cases in the distribution of age,PSA,Gleason score,TNM stage and Risk Degree.

Application of solifenacin for female overactive bladder failed in tolterodine treatment / 中华泌尿外科杂志

ObjectiveTo investigate the clinical efficacy and safety of solifenacin for female overactive bladder (OAB) who failed in toherodine treatment. MethodsFrom Jan 2010 to Oct 2010,48 cases of female OAB were treated with 5 mg/d solifenacin for 4 weeks after the failure of tolterodine treatment.The improvement of the perception of bladder condition as well as the mean numbers of day-time micturition,urgency episodes,urge incontinence episode per day,nocturia and pads usage were used as objective indexes for the evaluation of therapeutic effect. ResultsAfter 4-week solifenacin treatment,the mean numbers of day-time micturition,urgency episodes,urge incontinence episode per day,nocturia and pads usage were respectively decreased from the baselines ( 8.7 ± 1.5),(3.4 ± 2.1 ),( 2.4 ± 1.8 ),(2.1 ± 1.8 ) and (2.2 ±1.6) to be (7.2 ±2.5),(2.0 ±1.8),(1.5 ±1.2),(1.2 ±0.8) and (1.4 ±0.8).The perception of bladder condition was improved in 42 cases.The withdrawal from the treatment was seen in 3 cases due to headache and dry mouth.No severe adverse event was found in the rest 45 patients. Conclusion Solifenacin might be an effective and safe alternative agent in the treatment of female OAB who failed in tolterodine treatment.

Value of MR diffusion weighted imaging in the diagnosis of prostate cancer / 中华泌尿外科杂志

Objective To investigate the value of magnetic resonance (MR) diffusion weighted imaging(DWI) in the diagnosis of prostate cancer(PCa). Methods Fifty-seven patients with suspected prostate cancer underwent DWI and T_2-weighted imaging (T_2W). These images and apparent diffusion coefficient (ADC) maps results were compared with histopathologic findings. Receiver operating characteristic(ROC) analysis was used to compare the cancer detection performance of them. The results were rated on a scale of scores Ⅰ (benign) to Ⅴ (malignant) on the basis of ADC maps. Abnormal voxels were overlaid on the corresponding transverse TRUS images and used to perform voxel-guided biopsy. Results DWI had a sensitivity of 85%, specificity of 82%, positive predictive value of 80%, negative predictive value of 86% , and accuracy of 83%. T2WI had a sensitivity of 77%, specificity of 71%, positive predictive value of 69%, negative predictive value of 79%, and accuracy of 74%. The areas under the ROC curves for DWI and T_2WI were 0. 830 and 0. 742, respectively. The performance of DWI in PCa detection was significantly better than of T_2WI (P<0. 05). 6 of 30 patients with negative DWI results also had negative biopsy findings. PCa was detected in 17(85%) of 24 men findings with voxel score Ⅳ , with a sensitivity of 100%, specificity of 46%, positive predictive value of 71 %, negative predictive value of 100% , and accuracy of 77%. Conclusions The performance of DWI in PCa detection was better than of T_2 WI. ADC maps can be transferred to TRUS images and used to sample regions of cancer in men with rising PSA levels and negative findings at prior biopsy with good accuracy. DWI appears to be a robust and reliable method to examine the whole prostate within an acceptable scan time in clinical settings.

AMACR (P504s)—a new immunohistochemical method for diagnosis of prostate carcinoma / 中华泌尿外科杂志

Objective To evaluate the expression of alpha-methylacyl-coenzyme-A racemase (AMACR,P504s) with immunohistochemical staining in diagnosis of prostate carcinoma. Methods A total of 133 specimens were taken from the patients (mean age,71 years),including 46 cases of prostate carcinoma (PCa) (1 case of stage A,19 cases of stage B,14 cases of stage C,12 cases of stage D;4 cases of gradeⅠ,14 cases of gradeⅡ,28 cases of grade Ⅲ),53 cases of benign prostate hyperplasia (BPH),13 cases of prostate intraepithelial tumor (PIN),9 cases of normal prostate,6 cases of prostatitis,3 cases of metastatic prostate cancer.Two sections of each specimen were made,with 1 stained by hematoxylin and eosin,and the other stained immunohistochemically by a rabbit monoclonal antibody to AMACR (P504s).AMACR staining expression was characterized as negative (score,1), weak (positive) (2), moderate (3) or strong (4). Results In 46 cases of PCa,AMACR staining expression was negative in 2 cases,weak in 1,moderate in 25 and strong in 18,with a mean staining intensity of 3.28 [95% confidence interval (CI), 3.07-3.50]. In 53 cases of BPH, the staining expression was negative in 47 cases, weak in 6, with a mean intensity of 1.11 (95% CI, 1.02-1.20).In 13 cases of PIN, the staining expression was negative in 12, weak in 1, with a mean intensity of 1.08 (95% CI, 0.91-1.24).The score of PCa group was significantly different from those of the latter 2 groups (P

Oral etopside and cyclophosphamide combination in patients with hormone-refractory prostate carcinoma / 中华泌尿外科杂志

Objective To evaluate the efficacy of oral etopside (VP16) and oral cyclophosphamide (CPM) combination in the treatment of hormone-refractory prostate cancer (HRPC). Methods Between June 2000 and July 2003,9 patients with HRPC were treated with oral etopside (50 mg/d) and oral cyclophosphamide (100 mg/d) for 21 days with every 28 days as a cycle.Inclusion criteria were previous complete androgen blockade,anti-androgen (flutamide) withdrawal evaluation,and clinical or biochemical disease progression.The therapy was continued until there was evidence of disease progression or the patients could not tolerate the adverse effects of the medications. Results All the 9 patients had a mean follow-up of 7.5 months.PSA levels decreased by at least 50%,from pre-treatment of (90.5?43.6)ng/ml to post-treatment of (24.8?22.2)ng/ml,in 4 patients. The mean duration of response was 6.8 months (range,2-15 months).An objective response was obtained in 2 patients (1 of CR and 1 of PR).Toxic and adverse effects were minimal. Conclusions The combination of oral VP16 and CPM may be an efficacious and well-tolerated regimen in patients with HRPC.

Application of intravesical ureterectomy in the treatment of renal pelvic and ureteral malignancy / 中国癌症杂志

Purpose:To improve the surgical technique in the treatment of renal pelvic and ureteral malignancy.Methods:From May. 1998 to December. 2000 intravesical ureterectomy has been carried out for 9 cases of renal pelvic malignancy . the distal ureter was intussuscepted into the bladder by traction of a ureteral catheter that had been attached to the cephalad end of the ureter after the kidney was removed. Patients have been followed up for 6 to 30 months with a mean of 18.6 months.Results:No surgical complication has been observed. On cystoscopy, no tumor occurrence has been found at the site of the removed ureteral orifice and other part of the bladder.Conclusions:The surgical technique is characterized by good results,few complication and simplicity.

Experience with intravesical instillation of recombinant interferon- alpha and mitomycin C therapy for superficial bladder tumors / 中华泌尿外科杂志

Objective For preventing the recurrence of superficial transitional cell carcinoma of bladder. Methods Recombinant interferon-alpha and mitomycin C have been used combindly in cl inical study.42 patients were divided into two groups: recombinant interferon-a lpha plus mitomycin group and mitomycin C group.The protocol of chemoimmunoprop hylaxis include 6 weekly and 6 two weekly instillation of 3?10 7 IU recombinan t interferon-alpha plus 40mg mitomycin C in 40ml normal saline via catheter.Che moimmunotherapy was given once monthly for at least two years. Resul ts Follow-up(from 6 to 30 months with a median of 18 months)consist ed of cystoscopy and cytology with cold cup biopsies carried out every 3 months for 2 years. Recurrence after instillation of recombinant interferon-alpha plus mitomycin C was observed in only 2 (10%). Recombinant interferon-alpha plus mi tomycin C yielded better effect ive rate(P

Total Cavopulmonary Connection for Complex Cardiac Anomalies with the Functional Single Ventricle / 华中科技大学学报（医学）（英德文版）

From Aug. 1999 to Feb. 2001, 8 patients with complex congenital heart diseases, including 5 cases accompanied by hypoplastic left ventricle and 3 by hypoplastic right ventricle, were subjected to total cavopulmonary connection (TCPC). Eight cases underwent the operation under cardiopulmonary bypass and 7 of whom under no cardiac clamp. Seven cases received cavopulmoanry anastomosis by flaring method and one case by end-side anastomosis. All the patients underwent the intracardiac tunnels to drain inferior vena cava and plus 4 mm fenestration except one. The results showed that 6 patients had postoperative oxygen saturation more than 90 %, sinus rhythm, no anastomostic stoma obstruction, no flow reguigitation and CVP<16 cmH2O. Two (25 %) patients died postoperatively from high venous pressure of 18—20 cmH2O, finally from cardiac failure and anoxima. It was concluded that TCPC was an effective treatment for complex congenital cardiac diseases, especially with ventricular maldevelopment. Intracardiac tunnel plus 4 mm fenestration and flaring cavopulmonary anastomosis could prevent the postoperative complications. Larger anastomotic stoma, venous pressure less than 16 cmH2O and artery saturation more than 90 % might indicate excellent TCPC procedures in our experience.

Total Cavopulmonary Connection for Complex Cardiac Anomalies with the Functional Single Ventricle / 华中科技大学学报（医学）（英德文版）

From Aug. 1999 to Feb. 2001, 8 patients with complex congenital heart diseases, including 5 cases accompanied by hypoplastic left ventricle and 3 by hypoplastic right ventricle, were subjected to total cavopulmonary connection (TCPC). Eight cases underwent the operation under cardiopulmonary bypass and 7 of whom under no cardiac clamp. Seven cases received cavopulmoanry anastomosis by flaring method and one case by end-side anastomosis. All the patients underwent the intracardiac tunnels to drain inferior vena cava and plus 4 mm fenestration except one. The results showed that 6 patients had postoperative oxygen saturation more than 90 %, sinus rhythm, no anastomostic stoma obstruction, no flow reguigitation and CVP<16 cmH2O. Two (25 %) patients died postoperatively from high venous pressure of 18—20 cmH2O, finally from cardiac failure and anoxima. It was concluded that TCPC was an effective treatment for complex congenital cardiac diseases, especially with ventricular maldevelopment. Intracardiac tunnel plus 4 mm fenestration and flaring cavopulmonary anastomosis could prevent the postoperative complications. Larger anastomotic stoma, venous pressure less than 16 cmH2O and artery saturation more than 90 % might indicate excellent TCPC procedures in our experience.

Combined use of oral estramustine phosphate and oral etoposide in patients with hormone refractory prostate carcinoma / 中华泌尿外科杂志

50% for more than 1 month as effective,and the efficacy for soft tissue metastases were classified as complete,partial remission,stabilization and progression.Results All patients were followed up for 6-24 months(mean,12 months) with the evaluation of efficacy and toxicity.PSA levels decreased by at least 50% in 6 of 12 cases(50%);it decreased from(63.9?47.3)ng/ml before treatment to(14.4?8.8)ng/ml after treatment,with a mean duration of response being 7.5 months(range,5-12 months).Partial remission of soft tissue metastases was obtained in 2 cases;the metastatic lesions were reduced from 4.0 cm?5.0 cm,(3.0cm?)(3.5) cm to 2.0 cm?2.0 cm,1.0 cm?1.5 cm,respectively,by the treatment,with response duration being 3 and 8 months,respectively.Toxicities were minimal with leukopenia at grade Ⅰ in 1 case,anemia at grade Ⅰ in 1,baldness at grade Ⅰ in 1,nausea at grade Ⅰ in 2 and impaired liver function at grade Ⅱ in 1.Conclusions The combination of oral estramustine phosphate and oral etoposide may be an effective and well-tolerated regimen in patients with HRPC.