Recent Advances and Controversies in Minute Pulmonary Meningothelial-like Nodules / 中国肺癌杂志

Minute pulmonary meningothelial-like nodules (MPMNs) are benign small lesions in the lungs, with similar pathological characteristics to the meningeal epithelium. MPMNs have similar imaging manifestations to malignant tumors, which can lead to misdiagnosis in clinical practice. There is no consensus on the pathogenesis of MPMNs, with some suggest that MPMNs derive from reactive proliferation, while others suggest that MPMNs share a common origin and molecular mechanism with meningiomas in the central nervous system. Understanding the characteristics of MPMNs and studying their pathogenesis will help improve the understanding and diagnosis of MPMNs. In this article, we reviewed the clinical, pathological, imaging characteristics, differential diagnosis and pathogenesis of MPMNs. We also analyze the existing research advances regarding the pathogenesis and propose prospects for further research.
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125I low-dose-rate prostate brachytherapy and radical prostatectomy in patients with prostate cancer / 中华泌尿外科杂志

Objective:To compare the outcomes of low-dose-rate prostate brachytherapy (BT) and radical prostatectomy (RP) in patients with T 1c-T 3a prostate cancer. Methods:A group of 745 patients with T 1c-T 3a prostate cancer between January 2010 and August 2017 at Peking Union Medical College Hospital were identified. The records of these patients, who were followed up for a minimum of 2 years, were reviewed. 384 cases received BT. Their characters included age(72.1±6.6), tPSA (12.4±6.1) ng/ml, prostate volume (33.6±13.8) ml, Gleason grade group (2.0±1.2). In this group, T 1c-T 2a stage was diagnosed in 189 cases, T 2b-T 2c stage in 182 cases and T 3a stage in 13 cases.361 cases received RP. Their characters included age(65.7±6.2), tPSA(12.6±6.4) ng/ml, prostate volume (37.2±17.8) ml, Gleason grade group (1.9±1.2). In this group, T 1c-T 2a stage was diagnosed in 177 cases, T 2b-T 2c stage in 170 cases and T 3a stage in 14 cases.The log-rank test compared survival rates between the two modalities, and Cox regression identified factors associated with bRFS. Results:Median follow-up was 60 months. Kaplan-Meier analysis did not show any statistically significant differences in terms of cRFS( P=0.321), cancer specific survival (CSS, P=0.643) and overall survival (OS, P=0.565) rate between the two groups. BT was associated with improved bRFS compared to RP( P=0.018). Risk of biochemical recurrence was significantly lower with BT compared with RP in the patients with a biopsy Gleason grade group 2 and 3 ( P=0.008), or prostate volume ≤35 ml ( P=0.027), or tPSA ≤10 ng/ml ( P=0.013), or the clinical T stages of T 2b and T 2C( P=0.031), or in the intermediate-risk group according to NCCN risk classification ( P=0.003). On multivariate analysis of all 745 patients, age≤ 70 and T stage≥T 2b was associated with significantly shorter bRFS. Conclusions:BT produced equivalent cRFS, CSS and OS compared to RP, while it was associated with improved bRFS. BT On multivariate analysis of all 745 patients, age≤ 70 and T stage≥T 2b was associated with significantly lower bRFS.

Research progress in the use of surgical robotic systems in arthroplasty / 中华骨科杂志

With the application of robotic-assisted arthroplasty in the clinical setting during the last two decades,passive,semiautonomous,and autonomous surgical robotic systems have been developed and utilized in a wide range of surgical procedures.Such procedures include total hip arthroplasty,total knee arthroplasty,and unicompartmental knee arthroplasty.These robotic platforms can be divided into open platforms and closed systems.A navigation component is indispensable for all kinds of surgical robotic systems used in arthroplasty.Navigation components need two disparate approaches to realize three-dimensional reconstruction.Some robotic systems require preoperative imaging examination for navigation,while others only need intraoperative anatomic landmark identification.The following four types of FDA-approved surgical robotic systems are currently available for arthroplasty,the Robodoc autonomous system,the Rio haptic system,the iBlock cutting guide,and the Navio handheld system.Robotic-assisted arthroplasty reportedly facilitates more accurate milling,cutting,and drilling,allowing component aligument and bone morphing to be performed with higher precision and closer to preoperative planning.These advantages result in better postoperative function restoration and patient satisfaction.The learning curve is also acceptable for these systems.Nonetheless,robotic systems are still somewhat disappointing,because they are typically associated with prolonged surgical procedures and require adequate surgical field exposure.Moreover,the cost-effectiveness ratio of this technology in China is required for further investigation.Future designs of robotic arthroplasty systems should aim to overcome the current shortcomings in terms of security and reliability,facilitating further automation of more surgical procedures and reduction in the size of the systems.