Distribution patterns of the right hepatic vein branches and their clinical significance in hepatic vein-guided anatomical hepatectomy / 中华肝胆外科杂志

Objective:To elucidate the spatial distribution patterns of the right hepatic vein by analyzing the image information obtained after CT three-dimension reconstruction of liver to provide guidance in surgical planning of anatomical hepatectomy.Methods:A retrospective analysis was performed on the clinical data of 77 subjects who underwent CT examination of the liver at the Second Affiliated Hospital of Harbin Medical University from September 2018 to October 2021. There were 42 males and 35 females, aged (50.2±12.8) years old. CT DICOM data of the patients were collected, and the two-dimensional image data were reconstructed into a three-dimensional model by using the 3D reconstruction software. The characteristics and typing were studied by analyzing the number of branches of the right hepatic vein and the spatial location of the main trunk.Results:Of 77 subjects, 645 branches of the right hepatic vein were observed in the liver CT 3D reconstruction model, including 268 (41.6%) right-sided branches, 240 (37.2%) dorsal branches, 70 (10.9%) left-sided branches, and 67 (10.3%) ventral branches. Each right hepatic vein possessed 3 (3, 4) right-sided branches, 3 (3, 4) dorsal branches, 1 (0, 1) left-sided branch, and 1 (0, 1) ventral branch. The numbers of branches in the four directions were significantly different ( H=175.89, P<0.001). Comparison showed that the number of right-sided branches was significantly more than that of the left-sided (χ 2=136.86) and ventral (χ 2=140.07), respectively. The number of dorsal branches was more than that of left-sided (χ 2=-123.36) and ventral (χ 2=126.57) branches, respectively. The differences were significant ( P<0.001). There were no significant differences between the number of ventral and left-sided branches, and between the dorsal and right-sided branches (all P>0.05). Conclusion:The right hepatic vein had fewer ventral and left-sided branches. It is relatively safe to dissect the right hepatic vein from the ventral or the left side during surgery. For resection of the central liver segments or segment VIII of the liver, it is reasonable to transect the liver along the left border of the right hepatic vein.

Preliminary results of domestic surgical robot-assisted remote nephrectomy based on 5G communication technology / 中华泌尿外科杂志

Objective:To explore the feasibility and safety of long-distance urological nephrotomy with the support of 5G communication technology by using the domestic robot.Methods:Clinical data of the patients with remote robot-assisted laparoscopic nephrectomy, which were completed from March to April 2021 by the Affiliated Hospital of Qingdao University (as the host hospital where the main operating system located) were retrospectively analyzed. There were 3 patients, including 2 males and 1 female.The average age was 61 (49-73) years, and the average body mass index was 23.73 (20.00-27.76) kg/m 2. One patient had a ASA classification of grade 2, and the other 2 patients had grade 3. All patients met the surgical criteria for non-functional nephrectomy. The chief surgeon who performing the telesurgery was located at the Affiliated Hospital of Qingdao University. The surgeon remotely controlled the bedside operating system (slave system) in 3 local hospitals located in other cities in Shandong Province (network communication distances of 82.5, 141 and 229 km, respectively) by manipulating the master system located in Qingdao. Images and operating instructions during surgery were transmitted using 5G wireless communication technology. Intraoperative network conditions, robot operation, and patient perioperative data were summarized. Results:All 3 tele-nephrectomies were successfully completed. The average network signal latency time was 27.3 (23-30) ms, with no packet loss, and the average total latency time was 177.3(173-180) ms. The mean resection time was 79.3 (52-111) min, and the average intraoperative blood loss was 31.1 (15.6-41.9) ml. There were no network related adverse events occurred during the operation, and the robot-related adverse events occured 3 times, all three of which were characterized by inconsistent master and slave movements of the manipulator arm and the bedside robotic arm. None of these adverse events affected the successful performance of the telesurgery. The mean postoperative exhaust time was 60.5 (38.5-78.0) h. The mean postoperative VAS score at 24 hours was 3.7 (3-4). The Clavien-Dindo classification were all grade I. No significant abnormality was found on the 30th day after surgery, and the patients recovered well at the follow-up until 6 months postoperatively.Conclusions:It is safe and feasible to perform remote robot-assisted laparoscopic nephrectomy based on 5G communication technology with no serious adverse events or surgical complications.However, the conclusion needs to be further verified by large sample and multi-center prospective study.

Two Compound Heterozygous Were Identified in SLC26A4 Gene in Two Chinese Families With Enlarged Vestibular Aqueduct

OBJECTIVES: To investigate the genetic causes of hearing loss with enlarged vestibular aqueduct (EVA) in two children from unrelated two Chinese families. METHODS: Sanger sequencing of all coding exons in SLC26A4 (encoding Pendrin protein) was performed on the two patients, their sibling and parents respectively. To predict and visualize the potential functional outcome of the novel variant, model building, structure analysis, and in silico analysis were further conducted. RESULTS: The results showed that the proband from family I harbored a compound heterozygote of SLC26A4 c.1174A>T (p.N392Y) mutation and c.1181delTCT (p.F394del) variant in exon 10, potentially altering Pendrin protein structure. In family II, the proband was identified in compound heterozygosity with a known mutation of c.919-2A>G in the splice site of intron 7 and a novel mutation of c.1023insC in exon 9, which results in a frameshift and translational termination, consequently leading to truncated Pendrin protein. Sequence homology analysis indicated that all the mutations localized at high conservation sites, which emphasized the significance of these mutations on Pendrin spatial organization and function. CONCLUSION: In summary, this study revealed two compound heterozygous mutations (c.1174A>T/c.1181delTCT; c.919- 2A>G/c.1023insC) in Pendrin protein, which might account for the deafness of the two probands clinically diagnosed with EVA. Thus this study contributes to improve understanding of the causes of hearing loss associated with EVA and develop a more scientific screening strategy for deafness.

Survival and prognostic analysis of adult nonclear cell renal cell carcinoma / 中华泌尿外科杂志

Objective@#To analyze the prognostic factors of adult nonclear cell renal cell carcinoma (nccRCC).@*Methods@#The clinical data of 286 patients with pathologically diagnosed one specific type of nccRCC after radical nephrectomy and nephron sparing surgery(NSS) in the affiliated hospital of Qingdao university followed up from January 2012 to January 2019 were retrospectively analyzed.There were 159 males and 127 females. Their age ranged from 17 to 81 years old, with an average age of 53. Based on the AJCC combination stage, 218 cases were in stage Ⅰ, 56 cases were in stage Ⅱ, 9 cases were in stage Ⅲ, 3 cases were in stage Ⅳ. Assay indicators were collected, including lymphocyte percentage(LY%)(31.5±10.5), neutrophil-lymphocyte ratio(NLR)(2.6±2.8), albumin(40.9±4.7)g/L, prealbumin(255.0±74.3)mg/L, lactate dehydrogenase (LDH)(201.0±174.0)U/L, creatine kinase isoenzyme (CK-MB)(20.0±62.1)U/L, total cholesterol(4.9±1.0)mmol/L, blood urea nitrogen/creatinine (BUN/Cr)(12.9±9.9), blood glucose(5.4±1.3)mmol/L, triglyceride(1.4±1.1)mmol/L, low-density lipoprotein cholesterol (LDL-C)(2.9±0.8)mmol/L. The optimal cut-off value of the above indexes were obtained by the receiver operating characteristic curve(ROC) in the SPSS software, and difference between high cut-off and low cut-off divided basing on the optimal cut-off value were evaluated respectively. The prognostic factors of adult nccRCC were evaluated by univariate and multivariate Cox proportional hazards regression analysis. Kaplan-Meier survival curve was used to study the survival relationship. The log-rank test were used to compare survival rate in two groups. The prognostic factors of nccRCC were analyzed after the results above were presented. Prognostic factors in renal chromophobe cell carcinoma and papillary cell carcinoma were analyzed by the same method.@*Results@#The 286patients were followed up from 1 to 87 months, with an average of 43.9 months. The 3-year and 5-year survival rates were 93.8% and 89.3%, respectively. Results of univariate and multivariate Cox regression model revealed that AJCC combined staging (HR=2.38, 95%CI1.48-3.83), LDH(HR=2.99, 95%CI1.16-7.69), blood glucose (HR=4.13, 95%CI 1.74-9.78), CK-MB (HR=3.85, 95%CI1.63-9.08) were independent prognostic factors of nccRCC. NLR(HR=8.28, 95%CI1.66-41.35) and LDH(HR=9.82, 95%CI2.94-32.82) were the independent prognostic factor in the renal chromophobe cell carcinoma subgroup and the papillary renal cell carcinoma subgroup, separately.@*Conclusions@#AJCC combination stage, LDH, blood glucose and CK-MB are independent prognostic factors of adult nccRCC. Patients with low LDH, hypoglycemia, CK-MB and early AJCC stage have better prognosis. NLR is an independent predictor of renal chromophobe cell carcinoma, and the low NLR group has a better prognosis and higher survival rate. LDH is an independent predictor of papillary renal cell carcinoma and low LDH is beneficial to patients' prognosis. NLR and LDH can be used as a prognostic indicator for clinical evaluation in renal chromophobe cell carcinoma and papillary renal cell carcinoma, respectively.

Survival and prognostic analysis of adult nonclear cell renal cell carcinoma / 中华泌尿外科杂志

Objective To analyze the prognostic factors of adult nonclear cell renal cell carcinoma (nccRCC).Methods The clinical data of 286 patients with pathologically diagnosed one specific type of nccRCC after radical nephrectomy and nephron sparing surgery (NSS) in the affiliated hospital of Qingdao university followed up from January 2012 to January 2019 were retrospectively analyzed.There were 159 males and 127 females.Their age ranged from 17 to 81 years old,with an average age of 53.Based on the AJCC combination stage,218 cases were in stage Ⅰ,56 cases were in stage Ⅱ,9 cases were in stage Ⅲ,3 cases were in stage Ⅳ.Assay indicators were collected,including lymphocyte percentage(LY％) (31.5 ± 10.5),neutrophil-lymphocyte ratio(NLR) (2.6 ± 2.8),albumin (40.9 ± 4.7) g/L,prealbumin (255.0 ± 74.3) mg/L,lactate dehydrogenase (LDH) (201.0 ± 174.0) U/L,creatine kinase isoenzyme (CK-MB) (20.0 ± 62.1) U/L,total cholesterol (4.9 ± 1.0) mmol/L,blood urea nitrogen/creatinine (BUN/Cr) (12.9 ±9.9),blood glucose(5.4 t± 1.3) mmol/L,triglyceride (1.4 ± 1.1) mmol/L,low-density lipoprotein cholesterol (LDL-C) (2.9 ± 0.8) mmol/L.The optimal cut-off value of the above indexes were obtained by the receiver operating characteristic curve(ROC) in the SPSS software,and difference between high cut-off and low cut-off divided basing on the optimal cut-off value were evaluated respectively.The prognostic factors of adult nccRCC were evaluated by univariate and multivariate Cox proportional hazards regression analysis.Kaplan-Meier survival curve was used to study the survival relationship.The log-rank test were used to compare survival rate in two groups.The prognostic factors of nccRCC were analyzed after the results above were presented.Prognostic factors in renal chromophobe cell carcinoma and papillary cell carcinoma were analyzed by the same method.Results The 286patients were followed up from 1 to 87 months,with an average of 43.9 months.The 3-year and 5-year survival rates were 93.8％ and 89.3％,respectively.Results of univariate and multivariate Cox regression model revealed that AJCC combined staging (HR =2.38,95％ CI1.48-3.83),LDH (HR =2.99,95％ CI1.16-7.69),blood glucose (HR =4.13,95％ CI 1.74-9.78),CK-MB (HR =3.85,95％ CI1.63-9.08) were independent prognostic factors of nccRCC.NLR(HR =8.28,95％ CI1.66-41.35) and LDH (HR =9.82,95％ CI2.94-32.82) were the independent prognostic factor in the renal chromophobe cell carcinoma subgroup and the papillary renal cell carcinoma subgroup,separately.Conclusions AJCC combination stage,LDH,blood glucose and CK-MB are independent prognostic factors of adult nccRCC.Patients with low LDH,hypoglycemia,CK-MB and early AJCC stage have better prognosis.NLR is an independent predictor of renal chromophobe cell carcinoma,and the low NLR group has a better prognosis and higher survival rate.LDH is an independent predictor of papillary renal cell carcinoma and low LDH is beneficial to patients'prognosis.NLR and LDH can be used as a prognostic indicator for clinical evaluation in renal chromophobe cell carcinoma and papillary renal cell carcinoma,respectively.

The difference expression and diagnostic value of RPL5 in papillary thyroid carcinoma of children and adults / 中华耳鼻咽喉头颈外科杂志

Objective@#To study the difference expression and diagnostic value of ribosomal protein L5 (RPL5) in papillary thyroid carcinoma (PTC) of children and adults.@*Methods@#Realtime-PCR was performed to detect the expression of RPL5 in 22 PTC tissues and 13 pericarcinous tissues. Receiver operating characteristic (ROC) curve and Youden's index were used to evaluate the diagnostic value of RPL5 in PTC of children and adults.@*Results@#The expression of RPL5 in PTC tissues was higher than in pericarcinous tissues. The area under curve (AUC) was 0.820 (P=0.001), and Youden′s index was 0.568. The expression of RPL5 in PTC of adults was higher than children (P<0.05). The AUC and Youden's index were respectively 0.721 (P=0.069) and 0.414 in children, whereas being respectively 0.896 (P=0.0005) and 0.709 in adults. RPL5 in diagnosis of PTC of adults was better than CK19, Galectin-3 and TPO, which are commonly used for the pathologic diagnosis of PTC.@*Conclusion@#The expression of RPL5 in PTC is higher than pericarcinous tissues, and its expression in PTC of adults is higher than children. Furthermore, PTC is a potential indicator for diagnosis of PTC.

Meta analysis of adenoid bacterial distribution in children with adenoid hypertrophy / 中国耳鼻咽喉头颈外科

OBJECTIVE To illuminate the adenoid bacteria distribution in children with adenoid hypertrophy. METHODS PubMed, Embash, Medline, CNKI, VIP Information and Wanfang data were searched for studies on the adenoid bacteria distribution and adenoid hypertrophy. Random effects meta-analysis was used to pool data. RESULTS Nine studies were included in this meta analysis. The pooled detection rates of haemophilus influenza, staphylococcus aureus and streptococcus pneumonia were 0.21 (95%CI, 0.09-0.32), 0.14 (95%CI, 0.09-0.20) and 0.15 (95%CI , 0.08-0.22) respectively. CONCLUSION Haemophilus influenzae, staphylococcus aureus, and streptococcus pneumoniae are three main kinds of pathogenic bacteria of adenoid hypertrophy in children.

Cytotoxicity and oxidative damage effect of silica nanoparticles on vascular endothelial cells / 吉林大学学报(医学版)

Objective To investigate the cytotoxicity of silica nanoparticles on vascular endothelial cells, and to clarify its action mechanism.Methods The 60 nm silica nanoparticle was selected and the invitro cultured human umbilical vein endothelial cells (HUVECs)were used as cell model.The HUVECs were divided into control and silica nanoparticle exposure groups with concentrations of 12.5,25.0,and 100.00 mg·L-1 .MTT assay was used for the determination of cell viability,lactate dehydrogenase (LDH)release assay for membrane integrity,flow cytometry (FCM)for intracellular reactive oxygen species (ROS)content,and real-time PCR assay for intracellular NF-E2-related factor 2 (Nrf2 ), heme oxygenase-1 (HO-1 ), superoxide dismutase 2 (SOD2 ) and glutamate-cysteine ligase catalytic subunit (GCLC)mRNA levels.Results The MTT results showed that the cell viabilities in each silica nnaoparticle exposure group were decreased compared with control group in a dose-dependent manner. Upon the silica nanoparticle exposure for 12 h,the cell viability was declined significantly only in 100 mg·L-1 exposure group compared with control group (P<0.05).When exposured for 24 h,the cell viabilities in 25.0, 50.0,and 100.0 mg·L-1 exposure groups were declined significantly compared with control group (P<0.05). Under the exposure to silica nanoparticle with the same dose, the cell viabilities were decreased along with the elongation of exposure time.LDH assay and FCM showed that except for that in 12.5 mg·L-1 exposure group, both the LDH activities in media and intracellular ROS levels in other exposure groups were increased compared with control group (P<0.05 ). The results of real-time fluorescence PCR showed that the mRNA levels of Nrf2, HO-1,SOD2 and GCLC in 100 mg·L-1 silica nanoparticle exposure group were increased significantly compared with control group (P<0.05).Conclusion Silica nanoparticles have toxicity to vascular endothelial cells,which includes reducing cell viability,membrane integrity destruction,induction of ROS generation,and tranSCriptional regulation of redox-related factors. Oxidative damage is one of the mechanisms of vascular endothelial toxicity mediated by silica nanoparticles.