Efficacy of modified anterior robot-assisted laparoscopic radical prostatectomy with preservation of Retzius space in 10 cases / 现代泌尿外科杂志

【Objective】 To investigate the safety, feasibility and clinical efficacy of modified anterior robot-assisted laparoscopic radical prostatectomy (RALRP) with preservation of Retzius space. 【Methods】 The clinical data of 10 patients who underwent RALRP using the modified anterior approach to preserve the Retzius space in our hospital during June 2021 and March 2022 were retrospectively analyzed, including the preoperative, intraoperative, postoperative and follow-up data. 【Results】 All operations were successful without conversion to open surgery. The average operation time (robotic arm operation time) was (98.6±47.7) min, blood loss (105.0±57.3) mL, postoperative drainage tube indwelling time (5.3±1.3) d, postoperative urinary catheter indwelling time (7.2±0.8) d, and postoperative hospital stay (9.2±2.2) d. Urinary continence was achieved immediately after removal of the urinary catheter in 6 patients, 2 patients recovered 2 weeks after extubation, and 2 patients recovered 3 months after extubation. Postoperative pathology showed pT2a stage in 1 case, pT2b stage in 2 cases, and pT2c stage in 7 cases; Gleason score was 6-7 points; all postoperative resection margins were negative. During the follow-up of 3-12 months, no tumor recurrence was observed, and no patient was readmitted due to surgical complications. 【Conclusion】 RALRP with modified anterior approach to preserve the Retzius space is safe and feasible, with no serious complications during and after surgery, and the early postoperative urinary continence effect is comparable to that of the posterior approach.

HA-ADT suppresses esophageal squamous cell carcinoma progression via apoptosis promotion and autophagy inhibition.

Esophageal squamous cell carcinoma (ESCC) is a major cause of cancer-related deaths. We have previously connected a non-sulfated glycosaminoglycan, hyaluronic acid (HA), with a common hydrogen sulfide (H2S) donor, 5-(4-hydroxyphenyl)-3H-1,2-dithiol-3-thione (ADT-OH), to reconstruct a novel conjugate, HA-ADT. In this study, we determined the effect of HA-ADT on the growth of ESCC. Our data suggested that HA-ADT exerted more potent effects than sodium hydrosulfide (NaHS, a fast H2S-releasing donor) and morpholin-4-ium (4-methoxyphenyl)-morpholin-4-ylsulfanylidenesulfido-λ5-phosphane (GYY4137, a slow H2S-releasing donor) on inhibiting the viability, proliferation, migration, and invasion of human ESCC cells. HA-ADT increased apoptosis by suppressing the protein expressions of phospho (p)-Ser473-protein kinase B (PKB/AKT), p-Tyr199/Tyr458-phosphatidylinositol 3-kinase (PI3K), and p-Ser2448-mammalian target of rapamycin (mTOR), but suppressed autophagy through the inhibition of the protein levels of p-Ser552-ß-catenin, p-Ser9-glycogen synthase kinase-3ß (GSK-3ß), and Wnt3a in human ESCC cells. In addition, HA-ADT was more effective in terms of the growth inhibition of human ESCC xenograft tumor than NaHS and GYY4137. In conclusion, HA-ADT can suppress ESCC progression via apoptosis promotion and autophagy inhibition. HA-ADT might be efficacious for the treatment of cancer.

The role and molecular mechanism of miR-494 in disease development and progression / 生理学报

MicroRNA-494 (miR-494) is a small non-coding RNA located in chromosome 14q32.31 and regulates post-transcriptional gene expression by promoting the degradation of its target mRNAs via binding to the 3' untranslated regions (3'UTR). It has been reported that miR-494 plays an important role in the occurrence, development and prognosis of various diseases. Several signaling pathways modulated by miR-494 including the PTEN/PI3K/AKT, nuclear factor κ-B (NF-κB), mitogen-activated protein kinase (MAPK), transforming growth factor-β (TGF-β)/SMAD, and Wnt/β-catenin are associated with physiological regulation and pathological process in many diseases. The stably expression of miR-494 in the blood stream suggests its potential as a biological marker for disease diagnosis, treatment, and prognosis. Based on recent research, we summarize the role and molecular mechanism of miR-494 in disease development and progression. We also discuss its potential as a marker for clinical diagnosis and prognosis of various diseases.

Analysis of choroidal thickness and blood perfusion in idiopathic macular hole eye / 中华眼底病杂志

Objective:To observe and analyze the macular choroidal thickness and choroidal blood perfusion (CBP) in eyes with idiopathic macular hole (IMH) and their correlation.Methods:A cross-sectional observational clinical study. From March 2019 to October 2021, 60 IMH patients with 60 eyes (IMH group) and 60 healthy volunteers with 60 eyes (control group) who consecutively visited Department of Ophthalmology of The First Affiliated Hospital of Zhengzhou University were included in the study. Among the 60 eyes in the IMH group, 8, 8, 15, and 29 eyes were at stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ, respectively. There was no significant difference in age, spherical equivalent power and axial length between the two groups ( t=1.327, 0.157, 0.542; P>0.05). The average macular choriodal thickness (AMCT) and CBP in different regions of the macular region of the examined eye were measured using a swept-frequency light source optical coherence tomography scanner. According to the zoning method for the treatment of diabetic retinopathy, the choroid within 6 mm of the fovea was divided into 3 concentric circles with the fovea as the center. They are the central area with a diameter of 1 mm, the inner ring area of 1-3 mm, and the outer ring area of 3-6 mm; the inner ring area and the outer ring area were divided into 4 areas by 2 radiations respectively, including the upper part of the inner superior (IS), the lower part of the inner inferior (Ⅱ ), and the nasal side of the inner nasal (IN), inner temporal (IT), outer superior (OS), outer inferior (OI), outer nasal (ON), outer temporal (OT), a total of 9 regions. The distribution characteristics of AMCT and CBP in different regions were observed. The correlation between AMCT and CBP was analyzed by Pearson correlation; the correlation between AMCT, CBP and IMH stage was analyzed by Spearman correlation. Results:Compared with the eyes of the control group, the AMCT of the affected eyes in the IMH group was significantly thinner in all areas of the macula, and the difference was statistically significant ( t=2.378, 4.641, 2.888, 3.390, 3.575, 4.870, 4.077, 4.946, 4.578; P<0.05). Compared with the control group, the CBP in the OS and OT regions of the affected eyes in the IMH group was significantly lower, the difference was statistically significant ( t=3.424, 4.516; P<0.05). The results of Pearson correlation analysis showed that there was a significant positive correlation between AMCT and CBP in the OT region ( r=0.314, P<0.001). Spearman correlation analysis showed that there was a significant positive correlation between AMCT and IMH staging in each region ( r=0.375, 0.374, 0.289, 0.379, 0.441, 0.392, 0.303, 0.341, 0.292; P<0.05). There was no significant correlation between CBP and IMH staging in IN, OI and OT regions ( r=-0.138, -0.016, -0.221; P>0.05); CBP and IMH staging in other regions were significantly negatively correlated ( r=-0.560, -0.390,-0.819, -0.692, -0.329, -0.587; P<0.05). Conclusions:The choroidal thickness in the macular region of the eyes with IMH is significantly thinner than that of the normal subjects; there is choroidal hypoperfusion in local areas. There is a significant positive correlation between local regional AMCT and CBP; IMH stage is higher, the trend of AMCT in each region is thickening, and the CBP in most regions decrease.

Analysis of choroidal thickness and blood perfusion in idiopathic macular hole eye / 中华眼底病杂志

Objective:To observe and analyze the macular choroidal thickness and choroidal blood perfusion (CBP) in eyes with idiopathic macular hole (IMH) and their correlation.Methods:A cross-sectional observational clinical study. From March 2019 to October 2021, 60 IMH patients with 60 eyes (IMH group) and 60 healthy volunteers with 60 eyes (control group) who consecutively visited Department of Ophthalmology of The First Affiliated Hospital of Zhengzhou University were included in the study. Among the 60 eyes in the IMH group, 8, 8, 15, and 29 eyes were at stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ, respectively. There was no significant difference in age, spherical equivalent power and axial length between the two groups ( t=1.327, 0.157, 0.542; P>0.05). The average macular choriodal thickness (AMCT) and CBP in different regions of the macular region of the examined eye were measured using a swept-frequency light source optical coherence tomography scanner. According to the zoning method for the treatment of diabetic retinopathy, the choroid within 6 mm of the fovea was divided into 3 concentric circles with the fovea as the center. They are the central area with a diameter of 1 mm, the inner ring area of 1-3 mm, and the outer ring area of 3-6 mm; the inner ring area and the outer ring area were divided into 4 areas by 2 radiations respectively, including the upper part of the inner superior (IS), the lower part of the inner inferior (Ⅱ ), and the nasal side of the inner nasal (IN), inner temporal (IT), outer superior (OS), outer inferior (OI), outer nasal (ON), outer temporal (OT), a total of 9 regions. The distribution characteristics of AMCT and CBP in different regions were observed. The correlation between AMCT and CBP was analyzed by Pearson correlation; the correlation between AMCT, CBP and IMH stage was analyzed by Spearman correlation. Results:Compared with the eyes of the control group, the AMCT of the affected eyes in the IMH group was significantly thinner in all areas of the macula, and the difference was statistically significant ( t=2.378, 4.641, 2.888, 3.390, 3.575, 4.870, 4.077, 4.946, 4.578; P<0.05). Compared with the control group, the CBP in the OS and OT regions of the affected eyes in the IMH group was significantly lower, the difference was statistically significant ( t=3.424, 4.516; P<0.05). The results of Pearson correlation analysis showed that there was a significant positive correlation between AMCT and CBP in the OT region ( r=0.314, P<0.001). Spearman correlation analysis showed that there was a significant positive correlation between AMCT and IMH staging in each region ( r=0.375, 0.374, 0.289, 0.379, 0.441, 0.392, 0.303, 0.341, 0.292; P<0.05). There was no significant correlation between CBP and IMH staging in IN, OI and OT regions ( r=-0.138, -0.016, -0.221; P>0.05); CBP and IMH staging in other regions were significantly negatively correlated ( r=-0.560, -0.390,-0.819, -0.692, -0.329, -0.587; P<0.05). Conclusions:The choroidal thickness in the macular region of the eyes with IMH is significantly thinner than that of the normal subjects; there is choroidal hypoperfusion in local areas. There is a significant positive correlation between local regional AMCT and CBP; IMH stage is higher, the trend of AMCT in each region is thickening, and the CBP in most regions decrease.

Effect and safety of aflibercept in the treatment of polypoidal choroidal vasculopathy with ranibizumab-resistant serous pigment epithelial detachment / 中华实验眼科杂志

Objective:To evaluate the effectiveness and safety of intravitreal injection of different doses of aflibercept for polypoidal choroidal vasculopathy (PCV) with serous pigment epithelial detachment (PED) resistant to ranibizumab.Methods:A non-randomized controlled clinical study was conducted.Seventy-three eyes of 73 patients with PCV and serous PED resistant to ranibizumab were enrolled at the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2020.All patients were treated by intravitreal injection of 2 mg or 4 mg aflibercept according to patients' willingness.2 mg aflibercept or 4 mg aflibercept was intravitreally injected monthly for three consecutive months following pro re nata (PRN) regimen in 2 mg aflibercept group (38 eyes) and 4 mg aflibercept group (35 eyes), respectively.PED height and central macular thickness (CMT) were measured by optical coherence tomography, and the best corrected visual acuity (BCVA) was examined with a visual acuity chart and converted to logarithm of the minimum angle of resolution (LogMAR) unit before injection and 1 month, 2, 3, 6 months from the first injection.Intraocular pressure and treatment-related adverse events were recorded.This study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2021-KY-1252).Written informed consent was obtained from each patient prior to entering study cohort.Results:Thirty-three patients (86.84%) in 2 mg aflibercept group and 30 patients (85.71%) in 4 mg aflibercept group finished the treatment and follow-up, respectively. The PED, BCVA and CMT before treatment and at the end of follow-up were (379.24±95.50) and (280.09±120.50)μm, 0.68±0.27 and 0.51±0.19, (393.96±100.81) and (291.70±44.09)μm in 2 mg aflibercept group, respectively, showing statistically significant differences (all at P<0.05).The PED, BCVA and CMT before treatment and at the end of follow-up were (393.07±93.76) and (278.63±145.07)μm, 0.66±0.31 and 0.48±0.22, (377.43±79.61) and (284.67±84.88)μm in 4 mg aflibercept group, respectively, with statistically significant differences (all at P<0.05).The CMT value in 4 mg aflibercept group was significantly lower than that in the 2 mg aflibercept group in one month after injection ( P<0.05).No severe ocular and systemic adverse events were found during the follow-up, such as retinal detachment, endophthalmitis, cataract, and persistent high intraocular pressure. Conclusions:Both 2 mg and 4 mg aflibercept can effectively treat ranibizumab-resistant PCV with serous PED, and improve the anatomical structure of retina and BCVA.4 mg aflibercept can accelerate the recovery of PED and CMT.

Target gene panel method versus whole-exome sequencing in detection of idiopathic hypogonadotropic hypogonadism in males / 中华男科学杂志

Objective@#To compare the efficiency of the target gene panel method and whole-exome sequencing (WES) in detecting idiopathic hypogonadotropic hypogonadism (IHH), and select a more suitable gene detection method.@*METHODS@#We selected 24 genes closely related to the molecular pathogenesis of IHH to make up the gene panel, detected the mutation sites in 73 patients with IHH using the panel method, and verified the results of sequencing with the Sanger method. Using the key words "idiopathic hypogonadotropic hypogonadism", we searched databases for relevant literature, calculated the positive rate of IHH detected by WES and compared it with that detected with the panel method.@*RESULTS@#Of the 73 cases of IHH detected with the panel method, 7 were found with pathogenic mutations, including 2 cases of FGFR1, 2 cases of CHD7, 2 cases of KISS1R, and 1 case of NR5A1 mutation. Sanger sequencing showed that the positive rate of the panel method was 9.7%. Of the 1 336 articles retrieved, 5 met the inclusion criteria and were included, in which WES revealed a positive rate of about 30%.@*CONCLUSIONS@#For detection of the diseases with clear mutated genes, the panel method is relatively inexpensive and has a high sequencing depth, while for detection of the diseases with complicated genetic patterns and unclear mutated genes, WES is more efficient. Further studies are needed for choice of the two methods for different purpose of detection./.

A novel hydrogen sulfide-releasing donor, HA-ADT, suppresses the growth of human breast cancer cells through inhibiting the PI3K/AKT/mTOR and Ras/Raf/MEK/ERK signaling pathways.

Breast cancer is one of the most frequent cancers among women worldwide. Hyaluronic acid (HA) is one of the best biopolymers in terms of safety issues and has been widely used in drug delivery and tissue engineering. 5-(4-hydroxyphenyl)-3H-1,2-dithiol-3-thione (ADT-OH) is a commonly used H2S donor. In this study, we designed and synthesized a conjugate, HA-ADT, by connecting HA with ADT-OH through chemical reactions. Our results indicated that HA-ADT could produce more H2S than NaHS and GYY4137. HA-ADT exerted more potent inhibitory effects than NaHS and GYY4137 in the proliferation, viability, migration, and invasion of human breast cancer cells. Similar trends were observed in the apoptosis and the protein levels of phospho (p)-PI3K, p-AKT, p-mTOR, H-RAS, p-RAF, p-MEK, and p-ERK in human breast cancer cells. Furthermore, HA-ADT exhibited more powerful inhibitory effects on the growth of human breast cancer xenograft tumors in nude mice. In conclusion, HA-ADT could suppress the growth of human breast cancer cells through the inhibition of the PI3K/AKT/mTOR and RAS/RAF/MEK/ERK signaling pathways. HA-ADT and its derivatives might be of great potential in the treatment of different types of cancer.

Surgical techniques and short-term outcomes of transvesical robot assisted radical prostatectomy / 中华泌尿外科杂志

Objective To introduce the technique and report our initial experience of transvesical robot assisted radical prostatectomy (TvRARP).Methods From April 2018 to August 2018,10 patients underwent TvRARP performed by a single surgical team were retrospectively reviewed.Preoperative data of patients [aged (58.6 ± 9.4) years,BMI (26.5 ± 3.1) kg/m2,tPSA (19.5 ± 4.1) ng/ml,biopsy Gleason score 6(6-7),prostate volume (33.4 ± 15.8) ml and IIEF-5 score 12 (10-16)] were collected.Preoperative study revealed 8 cases of cT1c,1 case of cT2a and 1 case of cT2b.All patients were continent preoperatively.During the surgical procedure,the bladder was opened,and a circumferential incision was then made around the internal urethral orifice.Initially,posterior dissection of bilateral vas deferens and seminal vesicles was performed,followed by posterior dissection towards apex.Lateral dissection of neurovascular bundles was performed before anterior dissection towards apex.The exposed urethra was transected and specimen was removed.Vesicourethral anastomosis and closure of bladder was performed in a standard way.Results All 10 cases were successfully performed robotically without conversion,transfusion or other major intraoperative or postoperative complications.Postoperative pathology confirmed 6 cases of pT2a,3 cases of pT2b and 1 case of pT2c [median Gleason score 6 (6-7)].One case was reported positive surgical margin.Operative time was (140.5 ± 35.5) mins.Estimated blood loss was (65.5 ± 35.5) ml.Urethral catheter was removed at 7 days postoperatively.Nine patients achieved urinary continence (0 pads) immediately after the removal of urinary catheter,while 1 patient returned to full continence at 2 weeks postoperatively.During a mean follow-up of 3 months (2-4 months),no biochemical recurrence was detected (tPSA ＜ 0.2 ng/ml).At 2 months postoperatively,IIEF-5 score was 11 (8-13) and no statistically difference was made compared with preoperative data (p ＞ 0.05).Conclusions Transvesical approach is a valid alternative of RARP in patients bearing localized low-risk prostate cancer.Tumor control and preservation of erectile function remains to be determined by long term follow-up.

Comparison of arterialized venous flap with different perfusion strategies for repairing hand soft tissue defects / 中国医师进修杂志

Objective To compare the clinical effects of of arterialized venous flap (AVF) with different perfusion strategies for repairing hand soft tissue defects. Methods Ninety-six patients with hand soft tissue defects from January 2015 to June 2018 in Gaozhou Traditional Chinese Medical Hospital were collected and randomly divided into two groups: the inverted group (48 patients) treated with anti-valve arterialized venous flap inverted anastomosis and the non-inverted group (48 patients) receiving pro-valve arterialized venous flap non-inverted anastomosis. The excellent and good rate of hand function recovery, flap survival rate,postoperative skin flap response degree and treatment satisfaction between two groups were compared. Results Compared with the inverted group, the flap survival rate in the non-inverted group increased significantly [97.9% (47/48) vs. 83.3% (40/48)], the proportion of mild flap response degree increased [45.8% (22/48) vs. 18.8% (9/48)], the proportion of severe flap response degree decreased significantly [12.5%(6/48) vs. 41.7%(20/48)], and the differences were statistically significant (χ2＝4.391, 7.032, 8.205, P < 0.05). The excellent and good rate of hand function recovery in inverted group and non-inverted group had no significant differences (χ2＝1.233, P＞0.05). There was no significant difference in satisfaction with the shape of skin flaps, finger function and donor site recovery between two groups(P＞0.05). Conclusions Compared with anti-valve arterialized venous flap inverted anastomosis, pro-valve arterialized venous flap non-inverted anastomosis on soft tissue defect repairment of hand can efficiently increase the survival rate of flap and improve the flap response degree after operation.

Purification and characterization of rat optic nerve head astrocytes / 眼科新进展

Objective To develop a set of methods for the culture and purification of astrocytes grown from explanted rat optic disc.Methods Rat optic disc and optic nerve were separated with anatomic microscopy and the blocks were cultivated primarily in culture flask with the medium containing DMEM/F-12.After digested by 2.5 g · L-1 trypsin,astrocytes were purified on the selective medium and passaged for two generations.Then cells were identified by immunofluorescent staining of glial fibrillary acidic protein (GFAP),neural cell adhesion molecule (NCAM) and Vimentin.Next,epidermal growth factor (EGF) was used to stimulate the purified cells for 24 h to observe their morphologic alteration.Finally,Western blot was used to detect the expression of GAFP,NCAM and Vimentin in the cells.Results When the tissue blocks were attached to the wall for 10 days,cells began to crawl out of the tissues and had different morphologies.After purified by the selective culture medium,satellite or anomalistic cells,possessing abundant cytoplasm,began to take a leading place.Immunofluorescent staining showed GFAP,NCAM and Vimentin were stained positively,and the purity of positive cells was above 90％.After stimulated by EGF,cells proliferated and the morphology changed;meanwhile,there was an increasing expression of GFAP,NCAM and Vimentin after stimulated by EGF when compared with the blank control group,and the difference was statistically significant (P ＜ 0.05).Conclusion Highly-purified astrocytes can be achieved by the culture of explanted lamina cribiosa and optic disc of rats in vitro.

Risk factors for periprosthetic joint infection after hip or knee arthroplasty in Mainland of China: a meta-analysis / 中国组织工程研究

BACKGROUND: Periprosthetic joint infection (PJI) is a serious and catastrophic complication after hip or knee arthroplasty. With aging population increasing, more patients will undergo hip or knee arthroplasty. Studies have shown that the risk for PJI following arthroplasty is different in different populations. OBJECTIVE: To evaluate the risk factors for PJI after hip or knee arthroplasty in Mainland of China through a meta-analysis, thereby providing reference for the prevention and control of postoperative PJI. METHODS: A computer-based search of WanFang, CNKI, VIP, CBM, PubMed, Cochrane, Embase and Medline databases was performed and the literatures concerning the risk factors for PJI after hip or knee arthroplasty in Mainland of China published before September 2016 were collected by manual retrieval and retrospective approach. All the literatures were screened based on the inclusion and exclusion criteria, followed by data extraction and analyzed on RESULTS AND CONLUSION: (1) Finally 14 literatures were included, including 417 patients with PJI. (2) The results of the meta-analysis showed that the risk factors for PJI after hip or knee arthroplasty including the complication of diabetic mellitus, long-term use of steroids, long operation time (> 90 minutes), age (> 65 years), and history of hip or knee Stata 12.0 software. surgery. (3) To conclude, PJI after hip or knee arthroplasty is related to multiple factors, so physicians should pay attention to these factors to reduce the incidence of PJI.

Diagnostic and prognostic value of preoperative serum carcinoembryonic antigen and carbohydrate antigen 19-9 in colorectal cancer / 中国现代普通外科进展

Objective:To evaluate the the diagnostic and prognostic value of preoperative serum carcinoembryonic antigen(pre-CEA) and carbohydrate antigen 19-9(pre-CA19-9) in colorectal cancer.Methods:382 colorectal carcinoma patients were analyzed retrospectively,who come from Beijing Hospital between June 2008 and June 2011.The clinical and histopathologic data such as age,sex,location of tumor,depth of tumor(T),lymph node metastasis(N),stage,and preoperative serum levels of CEA and CA 19-9 and prognosis were obtained.Results:The positive rate of pre-CEA,pre-CA19-9 and joint detection were 42.9％,18.6％ and 48.4％ respectively.The elevation of pre-CEA and pre-CA19-9 were significantly associated with depth of tumor,lymph node metastasis,perineural invasion,and stage (P＜0.05).Univariate analysis showed that the predictors of survival were the elevation of pre-CEA and pre-CA19-9 (P＜0.05).Multivariate analysis showed that the elevation of pre-CA19-9 and TNM were independent prognosis factors (P＜0.05).Conclusion:The pre-CEA and pre-CA19-9 have diagnostic and prognostic value in patients with colorectal cancer.Joint detection can increase the positive rate.Pre-CA19-9 was independent prognosis factors.

Diagnostic and prognostic value of preoperative serum carcinoembryonic antigen and carbohydrate antigen 19-9 in colorectal cancer / 中国现代普通外科进展

Objective:To evaluate the the diagnostic and prognostic value of preoperative serum carcinoembryonic antigen(pre-CEA) and carbohydrate antigen 19-9(pre-CA19-9) in colorectal cancer.Methods:382 colorectal carcinoma patients were analyzed retrospectively,who come from Beijing Hospital between June 2008 and June 2011.The clinical and histopathologic data such as age,sex,location of tumor,depth of tumor(T),lymph node metastasis(N),stage,and preoperative serum levels of CEA and CA 19-9 and prognosis were obtained.Results:The positive rate of pre-CEA,pre-CA19-9 and joint detection were 42.9％,18.6％ and 48.4％ respectively.The elevation of pre-CEA and pre-CA19-9 were significantly associated with depth of tumor,lymph node metastasis,perineural invasion,and stage (P＜0.05).Univariate analysis showed that the predictors of survival were the elevation of pre-CEA and pre-CA19-9 (P＜0.05).Multivariate analysis showed that the elevation of pre-CA19-9 and TNM were independent prognosis factors (P＜0.05).Conclusion:The pre-CEA and pre-CA19-9 have diagnostic and prognostic value in patients with colorectal cancer.Joint detection can increase the positive rate.Pre-CA19-9 was independent prognosis factors.

A comparative study of Retzius-sparing technique with veil of Aphrodite technique nerve sparing robotic-assisted laparoscopic radical prostatectomy / 中华泌尿外科杂志

Objective To introduce the technique and report our initial experience of Retziussparing robotic-assisted laparoscopic radical prostatectomy (RALP) and compare perioperative outcomes with the standard veil of Aphrodite technique (Veil technique).Methods nineteen Retzius-sparing RALP and 20 Veil nerve sparing RALP with posterior reconstruction for T1c to T2c prostate cancer performed by a single surgical team between 2015 January and 2016 December were retrospectively reviewed.Preoperative data of patients in Retzius-sparing group [patient age (66.3 ± 5.9) years,BMI (25.5 ± 3.1) kg/m2,tPSA (16.4 ± 5.0) ng/ml,biopsy Gleason score 6 (5-7),prostate volume (32.7 ± 7.4) ml and IIEF-5 score 14(5-18)] and Veil group[patient age (64.6 ±7.3) years,BMI (25.5 ±2.0) kg/m2,tPSA (18.5 ± 11.0) ng/ml,biopsy Gleason score 7(5-8),prostate volume (31.4± 10.8)ml and IIEF-5 score 15(6-19)].No significant difference was found between the two group in the above parameters (all P ＞ 0.05).All patients were continent preoperatively.Retzius-sparing RALP and Veil nerve sparing RALP were performed via transperitoneal RALP.Operative time,estimated blood loss,postoperative hospital stay,postoperative staging,postoperative Gleason score,return of urinary continence and postoperative IIEF-5 score of the two groups were statistically analyzed.Results All 39 cases were successfully performed robotically without conversion,transfusion or other major intraoperative and postoperative complications.Postoperative pathology confirmed pT2a 5 cases,pT2b 8 cases and pT2c 6 cases in Retzius-sparing group and pT2a 7 cases,pT2b 5 cases and pT2c 8 cases in Veil group (all P ＞ 0.05).For Retzius group,operative time was (106.5 ± 26.4) min and estimated blood loss was (48.9 ± 20.2) ml;for Veil group,operative time was (93.2± 20.8) min and estimated blood loss was (42.5 ± 16.8) ml.No significant difference was found in the above parameters (all P ＞ 0.05).Urethral catheter was removed at postoperative 7-day (Retzius-sparing group) and 21-day (Veil group),respectively.18 patients in Retzius-sparing group achieved urinary continence (0 pads) immediately after the removal of urinary catheter,while 1 patient returned to full continence in 2 weeks postoperatively.Patients in Veil group returned to continence (6.8 ± 3.6) weeks postoperatively (P ＜ 0.001).At 3-month follow up,IIEF-5 score was 14 (4-16) in Retziussparing group and 14 (4-18) in Veil group;no significant changes was noted in preoperative and postoperative IIEF-5 score in both groups,or in postoperative IIEF-5 scores in the two groups (P ＞ 0.05).No sign of tumor recurrence was appreciated for all cases (tPSA ＜ 0.2 ng/ml) during follow-up of 6 months (3 to 12 months).Conclusions Retzius-sparing RALP and the Veil nerve sparing RALP were both effective for the surgical treatment of localized prostate cancer.Our data revealed no statistical difference in perioperative outcomes between the two approaches,however,the Retzius-sparing technique seemed to yield a better outcome regarding early return to urinary continence postoperatively.

Discovery of Chromeno[4,3-c]pyrazol-4(2H)-one Containing Carbonyl or Oxime Derivatives as Potential, Selective Inhibitors PI3Kα.

A series of novel chromeno[4,3-c]pyrazol-4(2H)-one containing carbonyl or oxime derivatives (4a-n, 5a-n) have been synthesized and evaluated their biological activities as phosphatidyl inositol 3-kinase (PI3K) inhibitors. Out of them, compound 5l showed the most potent antiproliferative activities against HCT-116 with IC50 of 0.10 µM in vitro, and exhibited the most potent activity for PI3Kα with the value of 0.012 µM. Docking simulation of 5l into PI3Kα active site were performed to determine the probable binding model, and it indicated that compound 5l could be optimized as a potential inhibitor of PI3Kα in the further study.

Mechanism and process optimization of ultrafiltration of residual DNA in rabies vaccine / 军事医学

Objective To control residual DNA by optimizing methodology during the production of rabies vaccine using Vero cells as a vector .Methods The antigen recovery rate was assessed by linked immunosorbent assay-sandwich technique while the residual DNA was detected by DNA probe hybridization method .Antigen recovery and removal of DNA were the main indexes for evaluateing ultrafiltration , the vital part of rabies vaccine production .Three key factors in ultrafiltration were assessed: selection of membrane packages , ultrafiltration pressure and the concentration ratio .Then protamine was used to pretreat ultrafiltrates .Based on the two indicators mentioned above , the effect of protamine pretreat-ment on the ultrafiltrate was evaluated .Results and Conclusion The optimum condition of ultrafiltration was obtained on the basis of the general antigen recovery rate , DNA removal rate and actual production .The primary parameters of ultrafil-tration were as follows:7.5 ×105 ultrafiltration membrane packages, 20 times concentrated, 15 psi ultrafiltration pressure. After pretreatment with protamine , ultrafiltration has proved to be a molecular sieve in intercepting DNA ,while protamine can tangle the fragmented DNA and form a larger molecular segment , which is believed to be more conducive to ultrafiltra-tion interception .

Combined use of transmyocardial laser revascularization and endothelial progenitor cells enhances neovascularization and regional contractility in a canine model of ischemic hearts / 华中科技大学学报（医学）（英德文版）

The purpose of this study was to determine the combined effect of transmyocardial laser revascularization (TMLR) and the implantation of endothelial progenitor cells (EPCs) on cardiac function of ischemic hearts in canines. The left anterior descending artery (LAD) was occluded to establish the canine model of acute myocardial infarct (AMI). Four weeks later, the animals were randomly divided into four groups: TMLR group, in which transmyocardial laser-induced channels were established at the ischemic region; EPCs+TMLR group, in which EPCs were locally transplanted into laser-induced channels at the ischemic region; EPCs group, in which the EPCs were injected into the ischemic region; control group, in which the AMI animals received neither TMLR nor EPCs. The peripheral blood (50 mL) was sampled in all groups. Mononuclear cells from the peripheral blood were separated and cultured to obtain spindle-shaped attaching (AT) cells in vitro. AT cells were labeled with 1, 1'-dioctadecyl-1 to 3,3, 3',3'-tetramethyl-indocarbocyanine perchlorate (DiI) before injecting into the laser-induced channels or ischemic region. Four weeks after the first operation, TMLR was performed in the TMLR group and EPCs+TMLR group, and at the same time, the EPCs originating from the AT cells were mixed with calcium alginate (CA). Then the EPCs-CA composites were implanted into myocardial channels induced by laser in the EPCs+TMLR group, and into the myocardial infarct area in the EPCs group. All dogs underwent echocardiography at second month after LAD occlusion. Finally the samples of myocardium around the LAD were subjected to histochemical and immunohistologic examinations. The results showed there was no significant difference in the diameter of left atrium and ventricle before treatment among all groups (P>0.05). Eight weeks after modeling, the regional contractility in the LAD territory in the EPCs+TMLR group was increased as compared with control group and TMLR group, but there was no significant difference between control group and TMLR group. Neoangiogenesis was observed in the EPCs+TMLR group, and the fibrosis was seen in the TMLR group. There was no significant difference in neoangiogenesis around the channels induced by laser among EPCs+TMLR, EPCs and TMLR groups. It was concluded that TMLR combined with EPCs could improve the regional and global cardiac function in AMI, and augment neovascularizaiton in channels of ischemic myocardium induced by laser.

Combined use of transmyocardial laser revascularization and endothelial progenitor cells enhances neovascularization and regional contractility in a canine model of ischemic hearts / 华中科技大学学报（医学）（英德文版）

The purpose of this study was to determine the combined effect of transmyocardial laser revascularization (TMLR) and the implantation of endothelial progenitor cells (EPCs) on cardiac function of ischemic hearts in canines. The left anterior descending artery (LAD) was occluded to establish the canine model of acute myocardial infarct (AMI). Four weeks later, the animals were randomly divided into four groups: TMLR group, in which transmyocardial laser-induced channels were established at the ischemic region; EPCs+TMLR group, in which EPCs were locally transplanted into laser-induced channels at the ischemic region; EPCs group, in which the EPCs were injected into the ischemic region; control group, in which the AMI animals received neither TMLR nor EPCs. The peripheral blood (50 mL) was sampled in all groups. Mononuclear cells from the peripheral blood were separated and cultured to obtain spindle-shaped attaching (AT) cells in vitro. AT cells were labeled with 1, 1'-dioctadecyl-1 to 3,3, 3',3'-tetramethyl-indocarbocyanine perchlorate (DiI) before injecting into the laser-induced channels or ischemic region. Four weeks after the first operation, TMLR was performed in the TMLR group and EPCs+TMLR group, and at the same time, the EPCs originating from the AT cells were mixed with calcium alginate (CA). Then the EPCs-CA composites were implanted into myocardial channels induced by laser in the EPCs+TMLR group, and into the myocardial infarct area in the EPCs group. All dogs underwent echocardiography at second month after LAD occlusion. Finally the samples of myocardium around the LAD were subjected to histochemical and immunohistologic examinations. The results showed there was no significant difference in the diameter of left atrium and ventricle before treatment among all groups (P>0.05). Eight weeks after modeling, the regional contractility in the LAD territory in the EPCs+TMLR group was increased as compared with control group and TMLR group, but there was no significant difference between control group and TMLR group. Neoangiogenesis was observed in the EPCs+TMLR group, and the fibrosis was seen in the TMLR group. There was no significant difference in neoangiogenesis around the channels induced by laser among EPCs+TMLR, EPCs and TMLR groups. It was concluded that TMLR combined with EPCs could improve the regional and global cardiac function in AMI, and augment neovascularizaiton in channels of ischemic myocardium induced by laser.

Fabrication and magnetic property of BaSm(x)Fe(12-x)O19 (x < or = 0.4) nanofibers.

BaSm(x)Fe(12-x)O19 (x < or = 0.4) ferrite nanofibers were prepared by sol-gel method from starting reagents of metal salts and citric acid. These nanofibers were characterized by TG-DTA, FTIR, SEM, XRD and VSM. These results show that the BaSm(x)Fe(12-x)O19 (x < or = 0.4) ferrite nanofibers were obtained subsequently from calcination at 750 degrees C for 1 h. The BaSm(x)Fe(12-x)O19 (x < or = 0.4) microstructure and magnetic property are mainly influenced by chemical composition and heat-treatment temperature. The grain sizes of BaSm0.3Fe11.7O19 ferrite nanofibers are in a nanoscale from 40 nm to 62 nm corresponding to the calcination temperature from 750 degrees C to 1050 derees C. The saturation magnetization of BaSm(x)Fe(12-x)O19 ferrite nanofiber calcined at 950 degrees C for 1 h initially decreases with the Sm content from 0 to 0.3 and then increases with a further Sm content, while the coercivity exhibits a continuous increase from 348 kA x m(-1) (x = 0) to 427 kA x m(-1) (x = 0.4). The differences of magnetic properties are attributed to lattice distortion and enhancement for the anisotropy energy.