Laparoscopic simultaneous anterograde inguinal and pelvic lymphadenectomy for penile cancer: two planses, three holes, and six steps.

Objective: To assess the feasibility, safety, and efficiency of simultaneous anterograde video laparoscopic inguinal and pelvic lymphadenectomy for penile cancer. Materials and methods: We reviewed retrospectively the records of 22 patients (44 lateral) who underwent inguinal lymph nodes dissection for penile cancer. The procedure was standardized as two planes, three holes, and six steps. Two Separate-planes: superior plane of eternal oblique aponeurosis/ / fascia lata; inferior plane of superficial camper fascia. Three holes: two artificial lateral boundary holes, the internal and external boundary holes, and the hole of oval fossa. Six steps: separate the first separate-plane; separate the second layer; separate two artificial lateral boundary holes; free great saphenous vein; separate the third hole and clean up the deep inguinal lymph nodes; pelvic lymphadenectomy. Results: A total of 22 cases were included and 9 patients underwent simultaneous pelvic lymphadenectomy. The average operation time on both sides was 7.52 ± 3.29 h, which was 0.5-1 h/side after skilled. The average amount of bleeding was 93.18 ± 50.84 ml. A total of 8 patients had postoperative complications, accounting for 36.36%, and no complications great than Clavien-Dindo class III occurred. Conclusion: This study demonstrated that the video laparoscopic simultaneous anterograde inguinal and pelvic lymphadenectomy is a feasible and safe technique. Indocyanine Green was helpful for lymph node identify.

The optimal intravesical maintenance chemotherapy scheme for the intermediate-risk group non-muscle-invasive bladder cancer.

OBJECTIVE: Although the current European Association of Urology(EAU) guideline recommends that patients with intermediate-risk non-muscle-invasive bladder cancer (NMIBC) should accept intravesical chemotherapy or Calmette-Guerin (BCG) for no more than one year after transurethral resection of bladder tumor(TURBT), there is no consensus on the optimal duration of chemotherapy. Hence, we explored the optimal duration of maintenance intravesical chemotherapy in patients with intermediate-risk NMIBC. SUBJECTS AND METHODS: This was a real-world single-center retrospective cohort study. In total 158 patients with pathologically confirmed intermediate-risk NMIBC were included, who were divided into 4 subgroups based on the number of instillations given. We used Cox regression analysis and survival analysis chart to explore the 3-yr recurrence outcomes of tumor.The optimal duration was determined by receive operating characteristic curve (ROC). RESULTS: The median follow-up was 5.2 years. Compared with instillation for 1-2 months, the Hazard Ratios(HR) values of instillation for less than 1 month, maintenance instillation for 3-6 months and > 6 months were 3.57、1.57 and 0.22(95% CI 1.27-12.41;0.26-9.28;0.07-0.80, P = 0.03;0.62;0.02, respectively). We found a significant improvement in 3-yr relapse-free survival in intermediate-risk NMIBC patients who maintained intravesical instillation chemotherapy for longer than 6 months, and the best benefit was achieved with 10.5 months of maintenance chemotherapy by ROC. CONCLUSIONS: In our scheme, the optimal duration of intravesical instillation with pirrubicin is 10.5 months. This new understanding provides valuable experience for the precise medical treatment model of intermediate-risk NMIBC.

Venous thrombosis, multiple carcinomatous foci and differences in metastatic pathways of penile carcinoma.

The aim of the present study was to explore the life-threatening complications and metastatic pathways of penile squamous cell carcinoma (SCC), as numerous patients with penile cancer are relatively young, are of good general health and have no visceral metastasis, yet have poor survival rates. A total of 94 patients with SCC of the penis who were surgically treated were included in the current study. The coagulation parameters, including prothrombin time (PT), fibrinogen and D-dimer, were analyzed. The patients' age ranged from 25 to 95 years (mean ± standard deviation, 53.3±1.4 years). A total of 77 patients (81.9%) underwent partial penectomy and 17 (18.1%) underwent radical penectomy. The PT was significantly different between patients whose tumour invaded the corpora cavenosum and those whose tumour had not invaded, and between patients with and without pelvic lymph node metastasis. A negative correlation was obtained between PT and pelvic lymph node metastasis. In addition, six typical SCC cases and one metastatic penile carcinoma case manifested with multiple carcinomatous foci, embolisms and evidence of a metastatic pathway occurring simultaneously with tumour progression were presented. The present study indicated that venous thrombosis is one of the life-threatening complications of advanced penile cancer. Furthermore, multiple carcinomatous foci were detected in histological images. Of note, direct clinical evidence for different metastatic pathways of primary and secondary penile carcinoma was provided.

The efficacy of 3D personalized insoles in moderate adolescent idiopathic scoliosis: a randomized controlled trial.

BACKGROUND: Bracing and exercise methods were used in scoliosis rehabilitation and proven effective. There was little evidence about the efficacy of insoles on scoliosis. OBJECTIVE: This study aimed to investigate the effects of 3D personalized insoles on curve magnitude, postural stability, and quality of life (QOL) in moderate adolescent idiopathic scoliosis (AIS) patients. METHODS: Thirty-six volunteers with adolescent idiopathic scoliosis, who had moderate curves (20°-45°), were randomly divided into the experimental and control groups. The control group received traditional rehabilitation with bracing and exercises, and the experimental group received the insole interventions in addition to traditional rehabilitation. The outcome measures were Cobb angle, angle of trunk rotation (ATR), postural stability, and quality of life (Scoliosis Research Society-22 questionnaire). Measurements were conducted at baseline examination, two months and six months. RESULTS: After two and six months of treatment, the Cobb angle and ATR in both groups were significantly decreased as compared with the baseline (p < 0.05), but no significant group difference in Cobb angle and ATR was found in the study (p > 0.05). There was a significant difference in the sagittal balance index at six months compared to the control group (p < 0.05), and a significant difference in the coronal balance index was observed at six months compared to baseline in the experimental group (p < 0.05). Quality of life did not change in either group (p > 0.05). CONCLUSION: Combining bracing with exercise in patients with moderate AIS is effective. 3D personalized insoles cannot reduce the Cobb angle and angle of trunk rotation of patients with moderate AIS but might have the potential to improve postural stability.

Inverse centrifugal effect induced by collective motion of vortices in rotating thermal convection.

When a fluid system is subject to strong rotation, centrifugal fluid motion is expected, i.e., denser (lighter) fluid moves outward (inward) from (toward) the axis of rotation. Here we demonstrate, both experimentally and numerically, the existence of an unexpected outward motion of warm and lighter vortices in rotating thermal convection. This anomalous vortex motion occurs under rapid rotations when the centrifugal buoyancy is sufficiently strong to induce a symmetry-breaking in the vorticity field, i.e., the vorticity of the cold anticyclones overrides that of the warm cyclones. We show that through hydrodynamic interactions the densely distributed vortices can self-aggregate into coherent clusters and exhibit collective motion in this flow regime. Interestingly, the correlation of the vortex velocity fluctuations within a cluster is scale-free, with the correlation length being proportional ( ≈ 30%) to the cluster length. Such long-range correlation leads to the counterintuitive collective outward motion of warm vortices. Our study brings insights into the vortex dynamics that are widely present in nature.

Urine-based regenerative RNA biomarkers for urinary bladder wound healing.

Background: This study aimed to investigate the expression of regeneration-related genes in canine urine during bladder repair. Materials & methods: Canine urine samples were collected after partial cystectomy. Regenerative mRNA of hypoxia-inducible factor (HIF), vascular endothelial growth factor (VEGF), key stem cell transcription factors and cholinergic signals were detected. Results: HIF-1α, VEGF, CD44, IL-6 and prominin-1 expression in canine urine after partial cystectomy exhibited two similar peaks at ∼2 weeks. HIF-1α and VEGF expression were higher in the afternoon than the morning. The expression of key stem cell transcription factors and cholinergic signals also exhibited a rhythm along with bladder healing. Conclusions: The expression of HIF-1α, VEGF, key stem cell transcription factors and cholinergic signals exhibited a time curve distribution during canine bladder healing. The expression trend of some regenerative genes was similar during bladder healing, and a cooperative effect may exist.

Deep-ultraviolet femtosecond laser source at 243†nm for hydrogen spectroscopy.

This paper reports on the generation of a 100 MHz repetition rate, 1.7 mW average power and femtosecond deep-ultraviolet (DUV) 243 nm laser source. The infra-red output of a broadband Titanium-Sapphire (TiSa) laser containing 729 nm light is mixed with its second harmonic in a ß-barium borate (BBO) crystal. By manipulating the group delay dispersion (GDD), we customize the spectral shape of TiSa resonator to improve conversion efficiency. This DUV laser is employed for direct frequency comb spectroscopy of hydrogen.

Applying MRI Intensity Normalization on Non-Bone Tissues to Facilitate Pseudo-CT Synthesis from MRI.

This study aimed to facilitate pseudo-CT synthesis from MRI by normalizing MRI intensity of the same tissue type to a similar intensity level. MRI intensity normalization was conducted through dividing MRI by a shading map, which is a smoothed ratio image between MRI and a three-intensity mask. Regarding pseudo-CT synthesis from MRI, a conversion model based on a three-layer convolutional neural network was trained and validated. Before MRI intensity normalization, the mean value ± standard deviation of fat tissue in 0.35 T chest MRI was 297 ± 73 (coefficient of variation (CV) = 24.58%), which was 533 ± 91 (CV = 17.07%) in 1.5 T abdominal MRI. The corresponding results were 149 ± 32 (CV = 21.48%) and 148 ± 28 (CV = 18.92%) after intensity normalization. With regards to pseudo-CT synthesis from MRI, the differences in mean values between pseudo-CT and real CT were 3, 15, and 12 HU for soft tissue, fat, and lung/air in 0.35 T chest imaging, respectively, while the corresponding results were 3, 14, and 15 HU in 1.5 T abdominal imaging. Overall, the proposed workflow is reliable in pseudo-CT synthesis from MRI and is more practicable in clinical routine practice compared with deep learning methods, which demand a high level of resources for building a conversion model.

Vortices as Brownian particles in turbulent flows.

Brownian motion of particles in fluid is the most common form of collective behavior in physical and biological systems. Here, we demonstrate through both experiment and numerical simulation that the movement of vortices in a rotating turbulent convective flow resembles that of inertial Brownian particles, i.e., they initially move ballistically and then diffusively after certain critical time. Moreover, the transition from ballistic to diffusive behaviors is direct, as predicted by Langevin, without first going through the hydrodynamic memory regime. The transitional timescale and the diffusivity of the vortices can be collapsed excellently onto a master curve for all explored parameters. In the spatial domain, however, the vortices exhibit organized structures, as if they are performing tethered random motion. Our results imply that the convective vortices have inertia-induced memory such that their short-term movement can be predicted and their motion can be well described in the framework of Brownian motions.

A Deep Ultraviolet Mode-locked Laser Based on a Neural Network.

Deep ultraviolet lasers based on the phenomenon of mode-locking have been used widely in many areas in recent years, for example, in semiconductors, the environment and biomedicine. In the development of a mode-locked deep ultraviolet laser, one of the most important aspects is to optimize the multiple parameters of the complex system. Traditional optimization methods require experimenters with more optimization experience, which limits the wide application of the lasers. In this study, we optimize the deep ultraviolet mode-locked laser system using an online neural network to solve this problem. The neural network helps us control the position of the crystal, the length of the cavity, the position of the focusing lens and the temperature of the frequency doubling crystal. We generate a deep ultraviolet mode-locked laser with a power of 18 mW and a spectral center at 205 nm. This result is greatly improved compared to previous results with the same pump power. This technology provides a universal solution to multiparameter problems in the optimization of lasers.

Comparison of Cd2+ adsorption onto amphoteric, amphoteric-cationic and amphoteric-anionic modified magnetic bentonites.

Organic-magnetic bentonites (OMBts), i.e., amphoteric modified MBt (BS-MBt), amphoteric-cationic modified MBt (BS-CT-MBt) and amphoteric-anionic modified MBt (BS-SDS-MBt), obtained by modifying magnetic bentonite (MBt) with amphoteric surfactant (BS), cationic surfactant (CT) and anionic surfactant (SDS) were investigated with the aim to remove cadmium (Cd2+). The modifier contents, surface charge and Cd2+ adsorption performances of OMBts were compared, and the influences of pH, temperature and ionic strength on Cd2+ removal were evaluated. Results showed that modifier contents of OMBts increased in the order: BS-CT-MBt > BS-MBt > BS-SDS-MBt. Although CEC of adsorbents increased in the order: MBt > BS-MBt > BS-SDS-MBt > BS-CT-MBt. The BS-MBt exhibited the highest Cd2+ adsorption capacity (233.19 mmol kg-1) than other adsorbents. The adsorption isotherms could be well described by Langmuir model. The Cd2+ adsorption capacities on MBt and OMBts increased with an increase in pH, temperature and with a decrease of ionic strength. According to characterizations (FT-IR and XPS) and experiments, Cd2+ adsorption on MBt and OMBts most possibly involved electrostatic interaction, ion exchange, and surface complexation. Furthermore, the adsorption of Cd2+ on BS-MBt was also attributed to the chelation. The amidocyanogen group of BS-CT-MBt inhibited adsorption of Cd2+ due to electrostatic repulsion, while Cd2+ was adsorbed on BS-SDS-MBt through electrostatic attraction induced by the sulfo group.

The enhanced expression of estrogen-related receptor α in human bladder cancer tissues and the effects of estrogen-related receptor α knockdown on bladder cancer cells.

Estrogen-related receptor α (ERRα) belongs to the superfamily of nuclear orphan receptors. However, the role of ERRα in bladder cancer remains unknown. This study examined the expression of ERRα in bladder cancer tissues and explored the molecular mechanisms of ERRα in bladder cancer progression. The expression of ERRα in bladder cancer tissues from 61 patients was determined by immunohistochemistry. We performed quantitative real-time polymerase chain reaction assay to detect the gene expression levels and carried out Western blot assay to measure protein levels. In vitro functional assays, including colony formation, Cell Counting Kit-8, Transwell invasion, and migration assays, were performed to detect bladder cancer cell growth, proliferation, invasion, and migration, respectively. Flow cytometry was used to determine the cell apoptotic rate of bladder cancer cells. Among the 61 detected bladder cancer tissues, 39 bladder cancer tissues showed positive ERRα immunoreactivity. Higher ERRα immunoreactivity score was significantly associated with TNM stage, tumor grade, distant metastasis, and poor survival in patients with bladder cancer. Univariate and multivariate analyses showed that ERRα immunoreactivity was an independent prognostic factor for overall survival in patients with bladder cancer. ERRα was found to be upregulated in bladder cancer cell lines, and knockdown of ERRα suppressed bladder cancer cell growth, proliferation, invasion, and migration; promoted bladder cancer cell apoptosis; and inhibited the epithelial-mesenchymal transition of bladder cancer cells. On the other hand, bladder cancer cell proliferation, invasion, and migration were significantly enhanced after cells were transfected with an ERRα-overexpressing vector. In vivo tumor growth and metastasis assays showed that ERRα knockdown resulted in remarkable inhibition of tumor growth and tumor metastasis in nude mice. Collectively, our results suggest that the enhanced expression of ERRα may play a key role in the development and progression of bladder cancer and ERRα may serve as an important prognostic factor for bladder cancer.

Muscarinic cholinergic signaling and overactive bladder-like symptoms associated with invasive bladder cancer.

The objective of the present study was to explore the association between muscarinic cholinergic signaling and urothelial bladder tumors. Possible associations among overactive bladder (OAB) symptoms and bladder tumors were retrospectively investigated using a multicenter Chinese database with prospectively collected data since 2010. Firstly, it was demonstrated that OAB symptoms, such as urgency, were more severe in patients with invasive bladder cancer and were associated with a reduced prognosis. Following this, muscarinic cholinergic receptor 3 (M3R) expression in urothelium was determined to be lower in invasive cancer tissue than in adjacent non-cancerous tissue, yet M3R upregulation was associated with a reduced progression free survival (PFS) time. Additionally, it was also demonstrated that muscarinic cholinergic receptor 2 (M2R) was upregulated in the sub-urothelium, and this was also associated with a reduced PFS time. Furthermore, it was determined that cholinesterase and acetylcholinesterase were lower in invasive cancer than in non-invasive cancer. In conclusion, the results indicated that M3R expression was downregulated in invasive bladder cancer, which may have a role as a protective anti-oncogene, in contrast to its oncogenic role in numerous other cancer types. Therefore, muscarinic cholinergic signaling may be a novel therapeutic target for treating bladder cancer.

A rare life-threatening disease: unilateral kidney compressed by huge chronic spontaneous retroperitoneal hemorrhage.

OBJECTIVES: To study an uncommon life-threatening disease, spontaneous retroperitoneal and perirenal hemorrhage. CASE DESCRIPTIONS: A 69-year-old male presented with pain in the left waist and back of 1 month duration. The renal abscess was suspected by magnetic resonance imaging before operation. The perirenal hematoma was cleaned by operation. In another case, the patient had a functional solitary left kidney compressed by a huge retroperitoneal mass and uropenia appeared. RESULTS: The first patient died of adult respiratory distress syndrome after surgery. The second patient died of cardiac insufficiency and pulmonary embolism on the second day after evacuation of retroperitoneal hematoma. CONCLUSION: Conservative surgery, such as selective arterial embolization, is a reasonable approach in patients with chronic spontaneous retroperitoneal and perirenal space hemorrhage and with poor general condition. We strongly recommend drainage or interventional therapy, but not a major surgery, in patients with poor condition.

The properties and dynamic changes of DOM subfractions during food waste and sugarcane leaves co-composting.

The purpose of this research was to evaluate the properties and dynamic changes of humic acids (HA), fulvic acids (FA), hydrophobic neutrals (HoN), and hydrophilic (Hi) fractions of dissolved organic matter (DOM) during food waste and sugarcane leaves co-composting process. The pools of HA, FA, HoN, and Hi were separated from DOM by fractionation method, and characterized using spectroscopic (UV-vis, FTIR) and pyrolysis-GC/MS analyses. The least peaks in the HA pool were found in FTIR spectra with the simple structure in HA. The highest value of SUV254 was observed in HA, indicating that the HA pool played a dominant role in aromaticity of DOM. Hydrophobic compounds (HA, FA, HoN) had higher percentages of alkanes and cyclo-alkanes at the end of composting, while lower contents in the Hi pool. Both DOM and its subfractions increased the Chinese flowering cabbage (Brassica campestris L.) seed germination rate (SGR), whereas HA had a significant effect on promoting the root growth.

Chip Scale Atomic Resonator Frequency Stabilization System With Ultra-Low Power Consumption for Optoelectronic Oscillators.

We present a long-term chip scale stabilization scheme for optoelectronic oscillators (OEOs) based on a rubidium coherent population trapping (CPT) atomic resonator. By locking a single mode of an OEO to the (85)Rb 3.035-GHz CPT resonance utilizing an improved phase-locked loop (PLL) with a PID regulator, we achieved a chip scale frequency stabilization system for the OEO. The fractional frequency stability of the stabilized OEO by overlapping Allan deviation reaches 6.2 ×10(-11) (1 s) and  âˆ¼ 1.45 ×10 (-11) (1000 s). This scheme avoids a decrease in the extra phase noise performance induced by the electronic connection between the OEO and the microwave reference in common injection locking schemes. The total physical package of the stabilization system is [Formula: see text] and the total power consumption is 400 mW, which provides a chip scale and portable frequency stabilization approach with ultra-low power consumption for OEOs.

Cystitis glandularis: A controversial premalignant lesion.

Cystitis glandularis (CG) has been hypothesized as a potential precursor of adenocarcinoma, although this remains controversial. The present study reports data accumulated from 166 cases of cystitis glandularis with follow-up periods ranging between 0.5 and 17 years. The association between intestinal and typical CG and bladder carcinoma was retrospectively evaluated. The patients included in the present study had presented with typical (n=155) or intestinal (n=11) CG between 1994 and 2010. Of those patients, concurrent carcinoma of the bladder was identified in 15 (9.0%) patients, including two cases of squamous cell carcinoma and 1 case of sarcoma. The cases of carcinoma were identified either prior to or concurrently with the diagnosis of CG. Follow-up was available for 9/11 (81.8%) patients with intestinal CG. Nine months following transurethral fulguration, 8/11 (72.7%) patients were in complete remission and 1/11 (9.1%) complained of urgency and dysuria; two patients were lost to follow-up. The follow-up of the patients ranged from 0.7 to 4.5 years (median, 2.67 years; mean, 2.82 years). No evidence of subsequent carcinoma was identified in any of the patients during the follow-up of the intestinal and typical CG groups. In addition, there was no evidence of carcinoma subsequent to CG in either of the typical or intestinal CG groups. The results did not support that CG increases the future risk of malignancy in the short term and repeated cystoscopies over a short period of time are not recommended.