E-cadherin and FGFR3 are risk factors determining prognosis of patients with bladder urothelial carcinoma.

OBJECTIVE: To explore the diagnostic value of the combined detection of E-cadherin and FGFR3 in patients with bladder urothelial carcinoma and their correlation with patient prognosis. METHODS: The study retrospectively analyzed the case data of 96 patients with bladder urothelial carcinoma treated at the Yixing Guanlin Hospital from June 2018 to June 2020. Tumor tissue of each patient and matched healthy tissue were collected for immunohistochemical staining. Differences in FGFR3 and E-cadherin expression were identified between tumor and healthy tissues. The influence of clinical characteristics on the recurrence was analyzed using a univariate analysis. Then, a multivariate logistic regression analysis was performed to analyze the risk factors for recurrence in patients with bladder urothelial carcinoma. The diagnostic value of FGFR3, E-cadherin and their combination for disease recurrence and prognosis was analyzed. The correlation of FGFR3 and E-cadherin expression with disease recurrence was discussed. RESULTS: The positive expression of FGFR3 in the cancer tissues was significantly higher than that in the adjacent tissue, while the positive expression of E-cadherin showed the opposite (P<0.05). Logistic regression analysis showed that tumor size, TNM stage, pathological grade, FGFR3 and E-cadherin were risk factors for the recurrence of bladder urothelial carcinoma (P<0.05). The area under the curve of FGFR3 combined with E-cadherin in evaluating prognosis and recurrence was 0.957. Correlation analysis revealed that FGFR3 was significantly and positively correlated with the patients' prognostic recurrence while E-cadherin was negatively correlated with it. CONCLUSION: FGFR3 and E-cadherin are risk factors affecting the prognosis of patients with bladder urothelial carcinoma, and they are associated with the outcome of bladder cancer.

Comparison of environmental controls on daily actual evapotranspiration dynamics among different terrestrial ecosystems in China.

Terrestrial actual evapotranspiration (ETa) is a key state variable modulating land surface processes; however, it remains challenging to recognize how daily ETa responses to environmental variables vary with ecosystems, which is relevant for understanding various ecosystem processes. To this end, comprehensive datasets were synthesized for 22 field sites equipped with eddy covariance towers from the ChinaFLUX network and the National Tibetan Plateau Data Center, which included four different ecosystems across China (e.g., barren or sparsely vegetated-BAR, grassland, forest, and cropland ecosystems). The impacts of environmental variables on daily ETa variations at each field site were assessed by the boosted regression tree (BRT) method. Overall, the BRT results showed that invariant of ecosystem types, net radiation (Rn) was the primary control on daily ETa dynamics with an average contribution of 62.9 % for all the sites, followed by leaf area index-LAI (18.4 %), vapor pressure deficit (8.2 %), soil water content-SWC (7.4 %), and wind speed (3.1 %). More importantly, it was revealed that the interactions of daily ETa with energy (Rn) and water (SWC) supplies could be significantly modified by vegetation through various regulation mechanisms. Specifically, for the BAR and grassland ecosystems, the influences of vegetation on daily ETa highly depended on local land cover and hydrological conditions (e.g., groundwater). For the forest ecosystem, the contrasting impacts of LAI between evergreen and temperate forests were largely attributed to the differences in LAI dynamics over growing seasons, while physiological differences in crops affected the daily ETa responses to LAI variations at cropland sites. This study underscored the varying interactions of daily ETa with Rn and SWC, which could be further shaped by vegetation through a variety of regulation mechanisms across different ecosystems.

Diagnostic role of plasma ORM2 in differentiating prostate cancer from benign prostatic hyperplasia.

PURPOSE: Markers are needed to increase the diagnostic accuracy of prostate-specific antigen (PSA) in prostate cancer (PCa) screening. Mounting evidence has shown that plasma proteins can be hopeful biomarkers for cancer diagnosis. METHODS: Tandem mass tag (TMT)-based proteomics and parallel reaction monitoring (PRM) analysis were used to screen the differential proteins and further validated in other independent studies (n = 539). Receiver-operating characteristic (ROC), decision curves and nomograms were applied to assess the diagnostic accuracy of biomarkers. RESULTS: Three candidate proteins (DBP, LCAT and ORM2) were preliminarily screened. Subsequent validation studies revealed significant upregulation of ORM2 in PCa patients across other independent cohorts. ORM2 yielded excellent discriminative power for PCa from benign prostatic hyperplasia (BPH) patients (AUC = 0.861 and 0.814 in validation phases 2a and 2b, respectively). Importantly, the combination of ORM2 and PSA gave better predictive accuracy than PSA alone. We incorporated age, PSA and ORM2 into a nomogram, which yielded C-index of 0.883 in validation phase 2a. A similar C-index of 0.879 was obtained in external validation phase 2b. CONCLUSIONS: In summary, our study suggests that ORM2 could be treated as a complementary biomarker for PSA in distinguishing PCa from BPH.

Congestion patterns of electric vehicles with limited battery capacity.

The path choice behavior of battery electric vehicle (BEV) drivers is influenced by the lack of public charging stations, limited battery capacity, range anxiety and long battery charging time. This paper investigates the congestion/flow pattern captured by stochastic user equilibrium (SUE) traffic assignment problem in transportation networks with BEVs, where the BEV paths are restricted by their battery capacities. The BEV energy consumption is assumed to be a linear function of path length and path travel time, which addresses both path distance limit problem and road congestion effect. A mathematical programming model is proposed for the path-based SUE traffic assignment where the path cost is the sum of the corresponding link costs and a path specific out-of-energy penalty. We then apply the convergent Lagrangian dual method to transform the original problem into a concave maximization problem and develop a customized gradient projection algorithm to solve it. A column generation procedure is incorporated to generate the path set. Finally, two numerical examples are presented to demonstrate the applicability of the proposed model and the solution algorithm.

Therapeutic effect of endonasal endoscopy dacryocystorhinostomy in the treatment of acute dacryocystitis / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To investigate the therapeutic effect of endoscopic dacryocystorhinostomy in the treatment of acute dacryocystitis.·METHODS: Totally 55 patients with acute dacryocystitis was divided into two groups according to the clinical manifestations:the group of redness and swelling and the group of abscess rupture. The bleeding and pain after operation were observed. Operation effect and skin scar of lacrimal sac area was observed and compared between two groups.·RESULTS: The patients were followed up from 3mo to 2a, and effective rates of the two groups of patients were compared, which showed no statistically significant difference ( x2 = 0. 307, P> 0. 05 ). Surgery before the abscess ruptured had the minimal impact on the appearance. The appearance impact of the group of abscess rupture was higher than that of the group of redness, and there are statistically significant difference (x2=12. 44, P<0. 05).·CONCLUSION:Endonasal endoscopic dacryocystorhinostomy is an effective method on the treatment of acute dacryocystitis. Early surgery has the advantages of quick recovery, scarlessness and high efficiency. Therefore, it worthy of clinical promotion.

Endoscopic transethmoidal approach with or without medial rectus detachment for orbital apical cavernous hemangiomas.

PURPOSE: To determine the indications for the addition of a transcaruncular approach along with detachment of the medial rectus muscle during the removal of small apical cavernous hemangiomas using an endoscopic transethmoidal approach. DESIGN: Retrospective, noncomparative case series. METHODS: Multicenter study of 12 patients with apical orbital tumors removed using an endoscopic transethmoidal approach. The decision to detach the medial rectus muscle with the addition of a transcaruncular approach was made during surgery for tumors largely lateral to the medial rectus muscle. Tumors adjacent to the medial orbital wall were removed via an endoscopic transethmoidal approach alone. RESULTS: Seven tumors were removed via an endoscopic transethmoidal approach combined with medial rectus muscle detachment, whereas 5 patients underwent removal without detachment of the medial rectus. All patients had visual impairment. Complete excision of the hemangiomas was achieved in all patients and tumor size ranged from 6 × 5 mm to 20 × 12 mm. The mean postoperative follow-up time was 11.8 ± 4.3 months. At final follow-up, the best-corrected visual acuity improved in 11 patients. Three patients had transient horizontal diplopia resulting from partial paralysis of the medial rectus muscle after detachment during surgery. CONCLUSIONS: The endoscopic transethmoidal approach with or without medial rectus detachment is a promising approach for selected small cavernous hemangiomas located at the deep medial orbital apex. Detachment of the medial rectus muscle can be a useful technique for tumors located largely lateral to the medial rectus muscle. Further studies will be required to demonstrate the safety and efficacy of this technique.

Endoscopic transcaruncular repair of large medial orbital wall fractures near the orbital apex.

PURPOSE: To study the suitability of an endoscopic transcaruncular approach (ETA) for repair of large medial orbital wall fractures (MOWFs) near the orbital apex. DESIGN: A retrospective, noncomparative case series with description of the surgical technique. PARTICIPANTS: Ninety-three consecutive patients (93 orbits) with large isolated MOWFs near the orbital apex. METHODS: The isolated MOWFs were determined by computed tomography (CT) scans of the orbit in all patients. All patients underwent fracture repair by an ETA, and the vertical and horizontal dimensions of the defects were measured during surgery. Porous polyethylene sheets (1.0 mm thick) were used to repair the bony defects. Patients were followed for 6 to 15 months. MAIN OUTCOME MEASURES: Size of vertical and horizontal fracture defects, rate of complete repair of the fracture defects, correction of enophthalmos, resolution of diplopia, and complications 6 months after surgery. RESULTS: All surgeries were completed uneventfully. The mean postoperative follow-up time was 9.7 ± 3.0 months. Under direct endoscopic visualization, all entrapped and herniated orbital contents were released and reposited, the entire boundary of the fractures were exposed adequately, and the implants were placed to overlie all edges of the fracture stably in all cases. The vertical and horizontal fracture defects measured during surgeries ranged from 16 to 30 mm and from 25 to 34 mm, respectively. Six months after surgery, complete reconstruction of the bony defects was demonstrated by orbital CT scans, and symmetry of the both eyes was acquired in 92 of 93 patients (98.9%). Of 30 patients with significant preoperative enophthalmos of more than 2 mm, 29 (96.7%) were corrected, with a mean improvement of 3.37 ± 0.77 mm. Diplopia within the 30° visual field of the gaze was resolved in 40 of 43 patients (93.0%). Three patients (7.0%) had residual diplopia on medial gaze because of presumed paralysis of the medial rectus muscle. Intraorbital hemorrhage occurred in 1 patient the day after surgery and resolved with conservative treatment. CONCLUSIONS: The ETA seems to be a useful method for recovery of the normal anatomic features of the orbits for patients with large MOWFs near the orbital apex.

[Surgical management of vascular injury of extremities].

OBJECTIVE: To summarize the importance of surgical management to repair vascular injury in limbs salvage, and to analyze the influence factors in the management. METHODS: From 1993 to 2000, 42 cases of 58 vascular injuries were reviewed; there were 37 males and 5 females, aging from 12 to 70 years old. Emergency operations were performed in 38 cases and selective operations in 4 cases from 1 hour to 45 days after injury. There were 22 cases of complete rupture in 32 blood vessels, 5 cases of partial rupture in 6 blood vessels, and 15 cases of vascular defect in 20 blood vessels, with 5 cm to 10 cm defect. The operation management included end-to-end anastomosis in 22 cases, side-to-end anastomosis in 1 case, vascular repair in 5 cases and vascular grafting in 14 cases. All of the cases were followed up for 6 months to 7 years. RESULTS: In those received emergency operations, it was successful in 35 cases, with amputation in the other 3 cases; after operation, there were 5 cases of post-operative angio-crisis, 1 case of hematoma and 1 case of pseudoaneurysm. In those received selective operation, all succeeded but 1 case of post-operative angio-crisis. After the follow-up, except for 3 cases of amputation, the other limbs survived; and function of the survived limbs recovered satisfactorily after operation except poor recovery in 7 cases of replantation of the limbs. CONCLUSION: To repair vascular injury immediately, to manage angio-crisis and to remove influence factors is the key to save the injured limbs and to maintain the function of them.