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OBJECTIVE Alzheimer's disease(AD)is the most common neurodegenerative disease worldwide.Neuroinflammation is a potential target for the patients with AD.It is attributed to activated microglia and the release of various inflammatory mediators from infec-tion,ischemia and toxin accumulation.Accumulating evi-dence has indicated that the cGAS-STING pathway driven neuroinflammation in neurological disease.TSG is a main natural active ingredient that derived from polyg-onum multiflorum.Previous research from our group found that TSG has beneficial effects of anti-aging,anti-inflammatory action and improving memory function in APP/PS1 transgenic AD mice.Here,we investigated the effects of TSG on cognitive impairment and neuroinflam-mation in APP/PS1-AD mice and explore the underly-ing mechanism by which TSG ameliorates memory func-tion in the cGAS-STING-mediated inflammatory response.METHODS The Morris water mace test and the novel object recognition test were performed to test the effects of TSG on spatial learning and cognitive and memory abil-ity in APP/PS1 double transgenic AD mice model.In addi-tion,real-time quantitative PCR,Western blotting,ELISA analysis,and flow cytometry to examine gene and pro-tein expression of cGAS-STING related pro-inflammatory cytokines and chemokines.Statistical analyses were ana-lyzed using the SPSS 25.0 package by analysis of vari-ance(ANOVA).Neuman-Keuls or Tukey's multiple-com-parisons test were conducted as ANOVA justified post hoc comparisons between group means.RESULTS We demonstrated that AD transgenic mice exhibited cognitive deficits accompanied by the elevated serum and brain inflammation.The expressions of serum inflammatory cytokines and the activation of microglia in cerebral cor-tex and hippocampus were suppressed after TSG treat-ment,which was probably attributable to the decrease of cyclic GMP-AMP synthase(cGAS)and stimulator of interferon genes(STING)triggered immune response.Additionally,the data showed that TSG treatment reduced the expression level of inflammatory cytokines(IL-1β,TNF-α,IFN-β,IFN-α)in microglial cells BV2 primed with LPS and IFN-γ.CONCLUSION TSG implicated the health benefits in preventing cognitive disorders by inhib-iting neuroinflammation via cGAS-STING signalling path-way in AD.
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【Objective】 To investigate the penile appearance, sexual function, psychological status and related influencing factors of adult patients who underwent hypospadias repair surgery in their minors, so as to provide reference for the diagnosis, treatment and prognosis of hypospadias. 【Methods】 This study included 50 adult hypospadias patients who underwent urethroplasty in our hospital during May 2005 and Aug. 2018. The present appearance, sexual function and psychological status were evaluated. The correlation and consistency between hypospadias objective scoring evaluation (HOSE) and pediatric penile perception score (PPPS) were analyzed. Factors affecting the results were determined with univariate and multivariate regression analysis. 【Results】 The satisfaction rate of HOSE was significantly correlated with the urethral length and complications (P=0.024, P=0.033). The satisfaction rate of PPPS was significantly correlated with the number of urethral operations and postoperative complications (P=0.041, P=0.023). There was a weak correlation between HOSE and PPPS (r=0.291, P=0.040), but almost no consistency (Kappa=0.2, P=0.107). Sixty percent of the patients paid attention to the ventral appearance of penis, whose dissatisfaction rate of PPPS was higher than those who did not pay attention to the ventral appearance of the penis (19/30 vs. 6/20, P=0.021). Patients with multiple operations (>1), postoperative complications or unsatisfactory penile appearance were more likely to have inferiority complex (52.6% vs. 22.6%, P=0.029; 59.1% vs.14.3%, P=0.001;61.5% vs. 24.3%, P=0.015). Multivariate regression analysis showed that dissatisfaction with the appearance of the penis was an independent risk factor for patients’ perception of their own physical defects. Among the patients who believed that they had physical defects, the percentage of patients with grade IV penile erectile hardness was significantly lower than that of those who denied they had physical defects (9/17 vs. 27/33, P=0.047). 【Conclusion】 The undesirable postoperative penis appearance is likely to have a negative impact on patients’ long-term psychological state, which might further damage the sexual function in adulthood. Surgeons should pay attention to the penile appearance during the conduction of hypospadias repair.
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Objective:To analyze the clinical features and pregnancy outcomes in antepartum and postpartum hemolysis, elevated live enzymes, and low platelet count syndrome(HELLP syndrome).Methods:A retrospective study was conducted to collect maternal and neonatal information of pre-eclampsia complicated with HELLP syndrome in Peking University First Hospital during the ten years from April 2009 to March 2019. A total of 83 pregnant women were included according to the Tennessee Classification System. They were then allocated into two groups based on the onset time of HELLP syndrome: antepartum HELLP syndrome group ( n=70) and postpartum HELLP syndrome group ( n=13). The clinical features, symptoms, laboratory biomarkers, and pregnancy outcomes were compared between the two groups. Results:Among the 83 pregnant women with HELLP syndrome, 70 occurred prenatally (84%, 70/83) and 13 occurred postpartum (16%, 13/83). The twin or triplet pregnancy rate in the postpartum HELLP syndrome group was significantly higher than that in the antepartum HELLP syndrome group [6/13 vs 6% (4/70), P=0.001]. The gestational weeks for HELLP onset and delivery in the postpartum HELLP syndrome group were significantly later than those in the antepartum HELLP syndrome group [(35.8±3.0) vs (31.5±5.2) weeks, P=0.025; (36.7±2.3) vs (32.2±5.0) weeks, P=0.002]. The incidence of early-onset pre-eclampsia in the antepartum HELLP syndrome group was significant higher than that in the postpartum HELLP syndrome group [64% (45/70) vs 2/13, P=0.002]. The quantitative of 24-hour proteinuria was significant higher in the antepartum HELLP syndrome group than that in the postpartum HELLP syndrome group [(4.8±5.1) vs (1.8±1.6) g, P=0.002]. But there were no statistical significances in the comparison of other laboratory test indexes (all P>0.05). There were no significant differences between the two groups in clinical symptoms, severe maternal complications, transfusion or adverse maternal outcomes (all P>0.05). Conclusions:Antepartum and postpartum HELLP syndrome have similar clinical symptoms and laboratory characteristics. Both antepartum and postpartum HELLP syndrome could lead to severe maternal complications, which should be paid special attention in clinical practice, especially to the postpartum HELLP syndrome.
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Objective:To summarize our preliminary experience of the individual transurethral en bloc resection of bladder tumor (ERBT) based on vesical imaging-reporting and data system (VI-RADS).Methods:The clinical data of 32 bladder cancer patients admitted from January 2019 to October 2019 were retrospectively analyzed, including 26 males and 6 females. Among them, there were 27, 5, 26 and 6 patients who had primary, recurrent, single or mutiple blader tumors, respectively. And the median number of bladder tumor was 1(1-3) and the mean diameter was 2(0.6-4.5)cm.The patients were aged 37 to 82 years, with a median age of 63 years. All patients underwent multi-parameter magnetic resonance imaging (mpMRI) before surgery and acquired a VI-RADS score. Among the 32 patients, there were 8, 17, 2, 5, and 0 patients in the VI-RADS score category 1, 2, 3, 4, and 5, respectively. Based on the VI-RADS score and tumor size, morphology and number provided by the mpMRI, the urologists classified the tumor types into type 1, 2a, 2b, 2c, 3a, 3b, 3c, 4a, 4b or 5, and designed the surgical protocol for each type including the resection plan, boundary and depth. There were 8, 6, 7, 4, 0, 1, 1, 3, 2 and 0 patients in each type, respectively. The tumor types were further confirmed during the operation, and the operation was completed according to the surgical plans for different tumor types.Patients received intravesical therapy of gemcitabine within 24 hours after surgery.Results:All operations were successfully completed and none was converted to the traditional transurethral resection of the bladder tumor. The operation time was 5 to 35 minutes with a median time of 15 minutes. Tumor specimens from all patients contained the muscularis propria. Among the patients with scores 1, 2, 3 and 4, there were 8, 16, 1 and 0 patients diagnosed with non-muscle invasive bladder cancer (NMIBC), respectively. All the patients with NMIBC had negative basal resection margins and 6 out 7 muscle invasive bladder cancer (MIBC) patients had negative resection margins. There were no intraoperative complications such as bladder perforation and obturator reflex. Four patients experienced obvious postoperative bladder irritation and relieved after symptomatic treatment or removing catheter. Twelve patients received second resections, including 10 NMIBC patients and 2 MIBC patients. No residual tumor was found in the re-resected specimens. There were 9 and 12 NMIBC patients received regular intravesical therapy of gemcitabine or BCG, respectively. Among the 7 MIBC patients, 5 received radical cystectomy and two received bladder-preserving treatment including second resection, adjuvant chemotherapy and radiotherapy. The follow-up period was 3-12 months, with a median of 6 months. One NMIBC patient relapsed at 9th months after surgery and underwent ERBT.Conclusions:The personalized ERBT based on VI-RADS is safe and feasible, and can achieve negative margins in all NMIBC and some MIBC without severe complications.
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OBJECTIVE: To investigate the feasibility of using 8-hydroxy-2'deoxyguanosine(8-OHdG) in blood and urine samples as biomarkers for the evaluation of human DNA oxidative damage caused by diesel exhaust(DE). METHODS: A convenient sampling method was used to select 56 male workers exposed to DE in a car manufacturing factory as exposure group, and 52 male workers without exposure to DE were selected as the control group.Urine samples and blood samples were collected from workers in the 2 groups 8 hours after work, and the levels of 8-OHdG in urine and plasma were measured by ultra-high performance liquid chromatography tandem mass spectrometer. RESULTS: The median level of urinary 8-OHdG in the exposure group was higher than that of control group(2.54 vs 2.03 μg/g Cr, P<0.05). The median levels of plasma 8-OHdG in the exposure group and control group showed no statistical significance(32.20 vs 31.40 ng/L, P>0.05). CONCLUSION: The urinary 8-OHdG can be used as a biomarker for evaluating the oxidative damage induced by DE exposure.
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Labor management is crucial in providing safe delivery care and avoiding the first cesarean section.In 2014,the Obstetrics and Gynecology Branch of Chinese Medical Association updated the guideline on new labor management according to the study results published by Zhang and his colleagues in 2010 based on 62 415 cephalic,singleton pregnant women with spontaneous labor,vaginal delivery and healthy neonatal outcomes.In December 2018,the Labour Progression Study (LaPS),a cluster-randomised controlled trial at 14 obstetric units in Norway,was reported by Bernitz and his colleagues in The Lancet.The primary outcome was the rate of intrapartum caesarean sections (ICSs) in obstetric units using the WHO partograph (control group) or Zhang's partogram (intervention group),which did not show any differences.Here,we discussed the evidence that LaPS provided in reducing the ICSs rate.
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Objective To evaluate the accuracy and clinical significance of the vesical imagingreporting and data system (Ⅵ-RADS) in predicting muscle-invasive bladder cancer (MIBC).Methods The data of 59 bladder cancer patients who underwent multiparametric magnetic resonance imaging and surgery between 2014 March and 2019 May were retrospectively analyzed,which includes 51 males and 8 females,aged 36-82 years old,with a median age of 62 years old.According to the scoring methods specified by Ⅵ-RADS,radiologists read and scored all mpMRIs including T2-weighted imaging (T2WI),diffusion-weighted imaging(DWI),and dynamic contrast enhancement MRI(DCE-MRI) of all the included patients.And then the Ⅵ-RADS were compared with pathological diagnosis.Proportions of MIBC in each score category were calculated,and ROC curve was plotted and the area under the curve (AUC) was estimated to assess the sensitivity and specificity of Ⅵ-RADS in diagnosing MIBC.Results The number of patients in Ⅵ-RADS score category 1 to 5 were 12,28,2,15 and 2,respectively.And there were 0,2 (7.4％),1 (50.0％),13 (81.3 ％),2 (100.0％) MIBC patients in each score category,respectively.When Ⅵ-RADS ≥3 was used to define MIBC,it came to the largest Youden's Index(0.7913),with an AUC of 0.924.And the sensitivity and specificity were 88.9％ and 90.2％,respectively.Conclusions Ⅵ-RADS has high accuracy in predicting MIBC,and it is worthy of application and verification in further clinical practice.The urologists should be highly alert to the existence of MIBC when Ⅵ-RADS ≥3.
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Objective Toanalysisandcomparison MRImanifestationsofthepigmentedvillonodularsynovitis(PVNS)andgiant celltumoroftendonsheath(GCTTS),andfurthertoimprovethediagnosticaccuracyofthem.Methods 10patientswithPVNSand 20patientswithGCTTSconfirmedbyoperationandpathologywereanalyzedretrospectively.Allpatientswereexaminedwith MRI. Results Among10casesofPVNS,8caseswerelocatedinkneejoint,2infoot.5casesshoweddiffuseform,othersshowedfocal form.Comparedwiththesignalofskeletalmuscle,theproliferativesynovialappearedasisointensityonT1WI,mainlyisointensityor slighthyperintensityonT2WI.NodularhypointensityofT1andT2signalwereseenwithinthesynovialmembrane.Among20casesof GCTTS,18werelocalizedlesions,2werediffuselesions.Therewere3casesinkneejoint,8casesinhandsandfeetrespectively,1case inshoulderjoint.Among20casesofGCTTS,11caseswerenodularlesions,9caseswereirregularGshaped.Thelumpsappearedas isointensityorhypointensityonT1WI,andmostofthem wereslighthypointensityonT2WI.Conclusion The MRIsignalofPVNS andGCTTShaveoverlappinganddifference.Thelocation,morphologyoflesionscombinedwith MRIfindingscanimprovethediagnostic accuracyofthem.
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Objective To explore the effect of advanced glycation end products (AGEs) on proliferation of bone marrow mesenchymal stem cells (MSCs) and related mechanism.Methods The bone marrow MSCs were isolated from male Sprague Dawley rats and cultured in vitro.The flow cytometer was used to identify the bone marrow MSCs by detecting positive labels (CD29 and CD90) and negative labels (CD34 and CD45).The advanced glycation end products-bovine serum albumin (AGE-BSA),one of the AGEs,was used in this study.The methyl thiazolyl tetrazolium (MTT) method was used to detect the effect of AGE-BSA on proliferation of the bone marrow MSCs.In MTT test,there were 3 groups:AGE-BSA group,BSA group,and control group.In AGE-BSA group,different doses of AGE-BSA (0,25,50,100 and 200 μg/ml) was used to stimulate the bone marrow MSCs for 6 h,12 h or 24 h.In BSA group,the 200 μg/ml BSA was used to stimulate the bone marrow MSCs for 6 h,12 h or 24 h.Gene chips detection was used to detect change of genes expression in bone marrow MSCs.Results The proliferation of the bone marrow MSCs could be inhibited by AGE-BSA,in a dose- and time-related manner.Compared with the BSA group,after being treated with 100 μg/ml AGE-BSA for 24 h or 200 μg/ml AGE-BSA for 12 h and 24 h,the proliferation of the bone marrow MSCs decreased obviously.The gene chips detection found that there were changes in expression of 17 genes in the bone marrow MSCs after being treated with AGE-BSA (200 μ.g/ml) for 12 h or 24 h,and the genes were same at the two time points.Among 17 genes,the expression of 12 genes increased,including four inflammatory factors (CCL3,CCL2,CCL4 and IL-1β),and 5 genes decreased.Conclusion AGE-BSA can inhibit the proliferation of bone marrow MSCs,which may be related to the onset of the diabetic osteoporosis.