The application of "S.I.S" technique improves long-term continence after robotic radical prostatectomy.

AIMS: To propose a novel S.I.S technique during the robotic-assisted radical prostatectomy (RARP), encompassing pubourethral suspension, posterior wall intensification, and bladder neck stripping, and to present functional and oncological outcomes with a special focus on long-term continence. METHODS: From January 1, 2018, to December 31, 2019, consecutive patients who underwent RARP were retrospectively investigated and separated into the S.I.S group and the conventional group. Preoperative patient characteristics, tumor status, and perioperative parameters were collected, followed by the assessment of self-reported status on continence, using an International Consultation on Incontinence Modular Questionnaire-urinary incontinence short form (ICIQ-UI-SF). Statistical comparisons were performed on variables between the two surgery groups, and multivariate logistic regression analysis was used to determine predictive factors for postoperative incontinence severity. RESULTS: A total of 602 subjects were analyzed with a median follow-up of 24 months. There was no significant difference regarding baseline characteristics and perioperative parameters, except for a more advanced tumor stage in the S.I.S group. The application of the S.I.S technique did not jeopardize the positive surgical margin rate at the bladder neck or long-term tumor control. Notably, the patient-reported degree of incontinence was significantly reduced with the assistance of S.I.S technique, as evidenced by the diminished severe-to-very severe cases. On multivariate analysis, both preoperative body mass index and use of S.I.S modification were independent predictive factors for the long-term incontinence severity. CONCLUSIONS: The application of S.I.S technique during RARP is feasible and superior compare with the conventional approach, with a significantly alleviated long-term incontinence severity, without compromising cancer control.

Compound eyes of the small white butterfly Pieris rapae have three distinct classes of red photoreceptors.

The two subspecies of the small white butterfly, the European Pieris rapae rapae and the Asian P. r. crucivora, differ in wing colouration. Under ultraviolet light, the wings of both male and female P. r. rapae appear dark, whereas the wings of male P. r. crucivora are dark and those of females are bright. It has been hypothesized that these sexually dimorphic wing reflections in P. r. crucivora may have induced the evolution of a fluorescing-screening pigment in the violet-opsin-expressing photoreceptors of males, thus facilitating greater wavelength discrimination near 400 nm. Comparing the compound eyes of the two subspecies using genetic, microscopical, spectrographic, and histological methods revealed no differences that would meaningfully affect photoreceptor sensitivity, suggesting that the fluorescing-screening pigment did not evolve in response to sexually dimorphic wing reflections. Our investigation further revealed that (i) the peri-rhabdomal reddish-screening pigments differ among the three ommatidial types; (ii) each of the ommatidial types exhibits a unique class of red photoreceptor with a distinct spectral peak; and (iii) the blue, green, and red photoreceptors of P. rapae exhibit a polarization sensitivity > 2, with red photoreceptors allowing for a two-channel opponency form of polarization sensitivity.

Clinicopathological characteristics and risk factors for recurrence of well-differentiated pancreatic neuroendocrine tumors after radical surgery: a case-control study.

BACKGROUND: Well-differentiated pancreatic neuroendocrine tumors (PanNETs) usually have a good prognosis; however, there are patients that experience recurrence after curative resection. AIM: To explore recurrence-related risk factors by analyzing clinicopathological data of PanNETs after radical surgery. METHODS: Clinical and pathological data from 47 patients with well-differentiated PanNETs at China-Japan Friendship Hospital from January 2012 to March 2016 were analyzed retrospectively. Univariate and multivariate analyses of the risk factors of PanNETs for postoperative recurrence were conducted. RESULTS: Among the 47 patients with well-differentiated PanNETs, there were 38 cases with non-functioning tumors, 9 cases with functional tumors (6 insulinomas, 1 gastrinoma, 1 glucagonoma, and 1 VIPomas). There are 17 cases (36.2%) in the pancreatic head, 17 (36.2%) in the body and tail, 9 (19.1%) in the tail, and 4 (8.5%) in the body. The median tumor size was 3.65 (IQR 2-5.5) cm. Fourteen cases (29.8%) were NET G1, and 33 cases (70.2%) were NET G2. In regard to the clinical stage, 9 (19.1%) cases were IA, 14 (29.8%) cases were IB, 7 (14.9%) cases were IIA, 14 (29.8%) cases were IIB, and 3 cases unknown. There were 17 patients who presented with postoperative recurrence. Univariate analysis showed that AJCC TNM staging, Ki67 index, vascular invasion, margin status, and the regional stage of the tumors are related to the recurrence of patients with PanNETs (p < 0.05). The results of multivariate analysis showed that Ki67 index ≥ 10% is an independent risk factor for the postoperative recurrence of PanNETs (p < 0.05). CONCLUSION: The Ki67 index ≥ 10% is an independent risk factor for recurrence in well-differentiated PanNETs after radical surgery, and close surveillance for these patients may be needed.

An annular pulse forming line based on coaxial transmission lines.

The miniaturization, lightweight, and solidification of pulse forming lines (PFLs) are of prime significance during the evolution of pulsed power technology. In this paper, an all-solid-state annular pulse forming line (APFL) based on film-insulated coaxial transmission lines is developed to generate fast-rise time quasi-square pulses. First, a coiled coaxial transmission line (CCTL) comprised of multilayer polypropylene films with outstanding insulating properties is constructed. It can withstand direct current voltages up to 200 kV, with a cross section diameter of 7.4 mm. In addition, in order to turn the pulse transmission direction from circumferential to axial, a compact insulated terminal with a 90° bend structure is designed for CCTL. Although single terminal inductance can slow down the rising edge of the output pulse, their parallel connection in an APFL can weaken such an effect. The APFL, with a characteristic impedance of 2.95 Ω and a transmission time of 13 ns, is composed of three CCTLs with six terminals, which can run over 100 thousand times under the pulse voltage of 75 kV. Finally, 15 series APFL modules are employed to assemble a multi-stage PFL for the Tesla-type pulse generator. When charged to a voltage of 1 MV, the mixed PFL consisting of a coaxial line and the multi-stage PFL outputs quasi-square pulses with a voltage amplitude, rise time, and width of 510 kV, 4 ns, and 41.5 ns, respectively, and the fluctuation of the flat top is about 6%.

Development of Microcystoid Macular Degeneration in the Retina of Nonhuman Primates: Time-Course and Associated Pathologies.

PURPOSE: Microcystoid macular degeneration (MMD) is a condition where cystoid vacuoles develop within the inner nuclear layer of the retina in humans in a variety of disorders. Here we report the occurrence of MMD in non-human primates (NHPs) with various retinal ganglion cell (RGC) pathologies and evaluate the hypothesis that MMD does not precede RGC loss but follows it. METHODS: Morphological studies were performed of the retinas of NHPs, specifically both rhesus (Macaca mulatta) and cynomolgus macaques (Macaca fascicularis), in which MMD was identified after induction of experimental glaucoma (EG), hemiretinal endodiathermy axotomy (HEA), and spontaneous idiopathic bilateral optic atrophy. In vivo imaging analyses included fundus photography, fluorescein angiography (FA), optical coherence tomography (OCT), adaptive optics scanning laser ophthalmoscopy (AOSLO), light microscopy, and electron microscopy. RESULTS: MMD, like that seen on OCT scans of humans, was found in both rhesus and cynomolgus macaques with EG. Of 13 cynomolgus macaques with chronic EG imaged once with OCT six of 13 animals were noted to have MMD. MMD was also evident in a cynomolgus macaque with bilateral optic atrophy. Following HEA, MMD did not develop until at least 2 weeks following the RNFL loss. CONCLUSION: These data suggest that MMD may be caused by a retrograde trans-synaptic process related to RGC loss. MMD is not associated with inflammation, nor would it be an independent indicator of drug toxicity per se in pre-clinical regulatory studies. Because of its inconsistent appearance and late development, MMD has limited use as a clinical biomarker.

Synchronous primary colorectal mucinous adenocarcinoma and pancreatic ductal adenocarcinoma: A case report.

The present study reports a rare case of synchronous colorectal mucinous adenocarcinoma (CMAC) and pancreatic ductal adenocarcinoma (PDAC). A 61-year-old man complained of hematochezia for half a month. Colonoscopy and biopsy in a local hospital revealed mucinous adenocarcinoma in the sigmoid colon, and a subsequent abdominal computed tomography examination in Ren Ji Hospital (Shanghai, China) identified an unexpectedly hypovascular lesion in the body and tail of the pancreas, in addition to a mass in the colon. The patient then underwent combined surgery consisting of a distal pancreaticosplenectomy and a sigmoidectomy, and the postoperative pathological tests confirmed the co-occurrence of CMAC and PDAC. Next-generation sequencing demonstrated no deleterious germline mutations, but did find some critical somatic mutations concerning both tumors. The patient received 12 cycles of a combination of 5-fluorouracil, leucovorin, irinotecan and oxaliplatin (modified FOLFIRINOX regimen) as adjuvant chemotherapy thereafter. Complete remission was achieved at 1 year after the surgery. To the best of our knowledge, this is the first documented case of such synchronous malignances (CMAC and PDAC) in the literature, and its publication therefore improves our overall understanding in this field.

Inhibitory effects of Schisandrin C on collagen behavior in pulmonary fibrosis.

Pulmonary fibrosis (PF) is a serious progressive fibrotic disease that is characterized by excessive accumulation of extracellular matrix (ECM), thus resulting in stiff lung tissues. Lysyl oxidase (LOX) is an enzyme involved in fibrosis by catalyzing collagen cross-linking. Studies found that the ingredients in schisandra ameliorated bleomycin (BLM)-induced PF, but it is unknown whether the anti-PF of schisandra is related to LOX. In this study, we established models of PF including a mouse model stimulated by BLM and a HFL1 cell model induced by transforming growth factor (TGF)-ß1 to evaluate the inhibition effects of Schisandrin C (Sch C) on PF. We observed that Sch C treatment decreased pulmonary indexes compared to control group. Treatment of Sch C showed a significant reduction in the accumulation of ECM as evidenced by decreased expressions of α-SMA, FN, MMP2, MMP9, TIMP1 and collagen proteins such as Col 1A1, and Col 3A1. In addition, the expression of LOX in the lung tissue of mice after Sch C treatment was effectively decreased compared with the MOD group. The inhibition effects in vitro were consistent with those in vivo. Mechanistic studies revealed that Sch C significantly inhibited TGF-ß1/Smad2/3 and TNF-α/JNK signaling pathways. In conclusion, our data demonstrated that Sch C significantly ameliorated PF in vivo and vitro, which may play an important role by reducing ECM deposition and inhibiting the production of LOX.

Impact of humid climate on rheumatoid arthritis faecal microbiome and metabolites.

Studies have shown that high humidity is a condition that aggravates the pain of rheumatoid arthritis (RA), but the relevant mechanism is controversial. Currently, there is a lack of experimental animal studies on high humidity as an adverse factor related to the pathogenesis of RA. We used healthy SD rats and collagen-induced arthritis (CIA) rats to investigate the effects of high humidity on arthritis. Integrated metabolomics analyses of faeces and 16S rRNA sequencing of the faecal microbiota were performed to comprehensively assess the diversity of the faecal microbiota and metabolites in healthy and CIA rats. In this study, high humidity aggravated arthritis in CIA rats, which manifested as articular cartilage lesions, increased arthritis scores, and an increase in proinflammatory cytokines. High humidity had a certain effect on the articular cartilage extent, arthritis score and proinflammatory cytokines of healthy rats as well. Furthermore, high humidity caused significant changes in faecal microbes and metabolites in both healthy and CIA rats. 16S rRNA sequencing of faecal samples showed that high humidity increased the amount of inflammation-related bacteria in healthy and CIA rats. Faecal metabolomics results showed that high humidity significantly altered the level of faecal metabolites in healthy rats and CIA rats, and the changes in biological functions were mainly related to the inflammatory response and oxidative stress. Combined analysis showed that there was a strong correlation between the faecal microbiota and faecal metabolites. High humidity is an adverse factor for the onset and development of RA, and its mechanism is related to the inflammatory response and oxidative stress. However, the question of how high humidity impacts RA pathogenesis needs to be further investigated.

Surgical Treatment of Hand and Foot Gout Stone and Influence Factors on Prognosis.

Purpose: To explore the technique of surgical treatment of hand and foot gout stone by using 3D CT reconstruction images and influence factors on prognosis. Method: 48 cases of hand and foot gout were treated surgically and retrospective analyzed. Before operation, we used 3D CT reconstruction images to check the accurate site and amount of uric acid (white chalk foam) deposition. Different surgical methods were applied depending on the different deposition site of urine acid stone. The frequency of gout attack and blood uric acid was compared before and after surgery. Patients were followed up to observe the recovery and recurrence and then analyzed the reason of unsuccessful healing. Result: Sutures were removed 2 weeks after operation in all cases. The frequency of gout attack and blood uric acid of patients 3 months after operation was lower than those before operation, and the differences were statistically significant. Follow-up ranged from 1 to 3 years, with an average of 1.8 years. Three cases were not followed up. The remaining 45 cases were healed in the first stage. 40 cases had improved joint function, increased range of motion, and relieved discomfort after movement. 5 cases had no improvement in joint function after operation, and 3 of them had gout stone recurrence (nonoperative area) and were treated by second hospital operation. Conclusion: Surgical treatment of gout stone in hand and foot under the guidance of three-dimensional CT reconstruction image can effectively alleviate the local symptoms of gout stone and improve the function of hand and foot. Deep tissue can be thoroughly washed by the pressure of pulse gun after resection of the lesion, which can reduce the incidence of gout stone. Malnutrition, hypoproteinemia, and residual urine acid in the wound are the main reasons for unsuccessful healing.

Effects of Lactobacillus supplementation on glycemic and lipid indices in overweight or obese adults: A systematic review and meta-analysis.

BACKGROUND & AIMS: Recent evidence suggests that gut microbiota may represent an important factor to affect the development of obesity and obesity-related diseases. Although several randomized controlled trials (RCTs) have explored the ability of Lactobacillus to improve metabolic parameters in adults who are overweight or obese, their findings have been inconsistent and require further analysis. Therefore, this systematic review and meta-analysis aimed to determine the ability of Lactobacillus supplementation to improve glycemic control, the lipid profile, and blood pressure in adults who are overweight or obese. METHODS: Seven electronic databases and two trial registers were searched up to April 2022 to identify eligible RCTs evaluating the effects of Lactobacillus supplementation in overweight or obese adults. Mean differences (MDs) or standardized mean differences were pooled using a random-effects model. RESULTS: Nine eligible RCTs with 598 participants were included. We found that Lactobacillus supplementation significantly reduced low-density lipoprotein cholesterol (MD -5.27 mg/dL; 95% confidence interval [CI] -8.28, -2.25; P = 0.0006) and total cholesterol (MD -4.84 mg/dL; 95% CI -8.29, -1.39; P = 0.006), particularly when taken in capsule, powder, or tablet form, for 12 weeks, as ≥1 × 1010 colony forming units/day, or as part of a normal diet. Benefits of Lactobacillus on fasting plasma glucose were seen after 12 weeks of supplementation (MD -1.81 mg/dL; 95% CI -3.08, -0.54; P = 0.005) and on triglycerides when taking a normal diet (MD -14.14 mg/dL; 95% CI -24.38, -3.91; P = 0.007). Lactobacillus had only a short-term beneficial effect on fasting plasma insulin and blood pressure and no significant beneficial effect on high-density lipoprotein cholesterol. CONCLUSIONS: Lactobacillus supplementation has a beneficial effect on low-density lipoprotein cholesterol and total cholesterol in adults who are overweight or obese, and also on fasting plasma glucose and triglycerides under certain conditions. Therefore, Lactobacillus supplementation represents a promising approach in the management of obesity-related diseases.

Apoptosis Detection in Retinal Ganglion Cells Using Quantitative Changes in Multichannel Fluorescence Colocalization.

KcapTR488 is a dual-fluorophore peptide sensor for the real-time reporting of programmed cell death by fluorescence imaging. KcapTR488 contains a nuclear localization sequence (NLS) conjugated with Texas Red, a caspase-cleavable sequence (DEVD), and a C-terminus conjugated to Alexa Fluor 488 (AF488). The synthesis and preliminary evaluation in cellulo of KcapTR488 for monitoring cell death by fluorescence imaging has been previously reported, but its utility in vivo has yet to be tested or validated. Herein, in vitro solution experiments verified the intramolecular fluorescence resonance energy transfer (FRET) between the two fluorophores and enabled a quantitative analysis of enzyme rates and selectivity. The sensor delivery kinetics in live rat models were quantified by ex vivo fluorescence microscopy. Studies in healthy control retinas demonstrated that KcapTR488 concentrated in the nucleus of retinal ganglion cells (RGC), with a strong colocalization of red and green fluorescence signals producing robust FRET signals, indicating an intact reporter. By contrast, using an acute but mild NMDA-induced retinal injury model, dual-color confocal ex vivo microscopy of cleaved KcapTR488 identified sensor activation as early as 2 h after injection. Quantitative changes in fluorescence colocalization were superior to changes in FRET for monitoring injury progression. Longitudinal monitoring revealed that the NLS-Texas Red fragment of the cleaved sensor moved out of the cell body, down the axon, and exited the retina, consistent with anterograde axonal transport. Thus, KcapTR488 may be a powerful tool to study RGC death pathways in live preclinical models of glaucoma.

Induction of photosensitivity by heterologous expression of melanopsin.

Melanopsin has been proposed to be the photopigment of the intrinsically photosensitive retinal ganglion cells (ipRGCs); these photoreceptors of the mammalian eye drive circadian and pupillary adjustments through direct projections to the brain. Their action spectrum (lambda(max) approximately 480 nm) implicates an opsin and melanopsin is the only opsin known to exist in these cells. Melanopsin is required for ipRGC photosensitivity and for behavioural photoresponses that survive disrupted rod and cone function. Heterologously expressed melanopsin apparently binds retinaldehyde and mediates photic activation of G proteins. However, its amino-acid sequence differs from vertebrate photosensory opsins and some have suggested that melanopsin may be a photoisomerase, providing retinoid chromophore to an unidentified opsin. To determine whether melanopsin is a functional sensory photopigment, here we transiently expressed it in HEK293 cells that stably expressed TRPC3 channels. Light triggered a membrane depolarization in these cells and increased intracellular calcium. The light response resembled that of ipRGCs, with almost identical spectral sensitivity (lambda(max) approximately 479 nm). The phototransduction pathway included Gq or a related G protein, phospholipase C and TRPC3 channels. We conclude that mammalian melanopsin is a functional sensory photopigment, that it is the photopigment of ganglion-cell photoreceptors, and that these photoreceptors may use an invertebrate-like phototransduction cascade.

A 100 kV, 50 Hz repetitive high-voltage pulse lifetime test platform.

The pulse lifetime characteristics of solid materials have been widely concerned in the field of pulse power technology. In this paper, a repetitive high-voltage pulse lifetime test platform for the pulse lifetime test of insulation materials is set up. The platform contains a closed magnetic-core transformer and a sample cavity. The transformer insulated by transformer oil was stably operated at the 100 kV/50 Hz mode with maximum rise time of 45 µs. The sample cavity insulated by SF6 gas includes a gas switch with an amplitude jitter less than 3% at the 50 Hz mode. The platform has advantages of high efficiency and reliability. First, it can generate three kinds of different pulses simultaneously, which satisfied the insulation test requirements under different pulse conditions. The first kind of the generated pulse is a sinusoidal pulse with an amplitude of 100 kV when the gas switch keeps open. The second one is a unipolar microsecond pulse when the gas switch closes. The last one is a nanosecond pulse generated by secondary capacitor discharge. Second, long-time operation of the platform including the pulse transformer is realized. The platform was stably operated for more than 20 × 106 pulses at the 50 Hz/100 kV mode for pulse lifetime tests of solid pulse forming lines and other solid materials.

Aidi Injection, Compound Kushen Injection, or Kanglaite Injection: Which Is the Best Partner with Systemic Chemotherapy for Patients with HCC? A Network Meta-Analysis.

OBJECTIVE: The aim of this network meta-analysis (NMA) was to explore the effectiveness of different traditional Chinese medicine injections (TCMIs) combined with systemic chemotherapy for the treatment of hepatocellular carcinoma (HCC). METHODS: A comprehensive search for randomized controlled trials (RCTs) was performed with regard to different TCMIs for treating HCC in seven electronic databases up to November 2019. The quality assessment of the included RCTs was conducted according to the Cochrane risk of bias tool. The objective response rate (ORR), clinical benefit rate (CBR), and Karnofsky performance score (KPS) data were extracted. The network meta-analysis used the network package in Stata software to analyse the data and draw a map of the evidence summarizing the direct and indirect comparisons. RESULTS: A total of 1697 articles were retrieved through the comprehensive search. Twenty RCTs focusing on Aidi injection, compound Kushen injection, and Kanglaite injection as adjuvant therapies to chemotherapy were included, involving a total of 1418 patients. The NMA statistics showed that all three indicators (ORR, CBR, and KPS) were better in the combined treatment group of TCMIs with chemotherapy than that in the single treatment group of chemotherapy alone. Kanglaite injection tended to be better than the other two in terms of primary outcome, but there was not a significant difference. The combined treatment group had fewer adverse reactions than the single treatment group. Moreover, several articles reported that TCMIs combined with chemotherapy could increase the number of CD3+ and CD4+ T lymphocytes and the ratio of CD4+/CD8+ T lymphocytes. CONCLUSIONS: TCMIs combined with systemic chemotherapy could be an effective and safe treatment option for patients with HCC. Kanglaite injection showed a tendency to be better than the other two kinds of injections in terms of ORR. Nevertheless, additional results from multicentre trials and high-quality studies will be pivotal for supporting our findings.

5-GW Tesla-type pulse generator based on a mixed pulse-forming line.

To shorten the length of the pulse-forming line (PFL) and generate pulses with good flat-top quality, a 5-GW Tesla-type pulse generator based on a mixed PFL is developed in this paper to produce intense electron beams and generate high-power microwaves (HPMs). The mixed PFL is composed of a coaxial PFL and a multistage series annular PFL, which, in turn, consists of 18 coaxial-output capacitor-loaded annular PFL modules in series. The generator can produce quasi-square electrical pulses with a width of 43 ns and a peak power of 5 GW on a matched load. In experiments where it is used to drive a relative backward-wave oscillator to generate HPMs, the results show that the HPM frequency is 16.15 GHz and the power is 1.06 GW with an efficiency of 25% when the voltage of the diode is 620 kV and the beam current is 6.9 kA.

Axonal Transport as an In Vivo Biomarker for Retinal Neuropathy.

We illuminate a possible explanatory pathophysiologic mechanism for retinal cellular neuropathy by means of a novel diagnostic method using ophthalmoscopic imaging and a molecular imaging agent targeted to fast axonal transport. The retinal neuropathies are a group of diseases with damage to retinal neural elements. Retinopathies lead to blindness but are typically diagnosed late, when substantial neuronal loss and vision loss have already occurred. We devised a fluorescent imaging agent based on the non-toxic C fragment of tetanus toxin (TTc), which is taken up and transported in neurons using the highly conserved fast axonal transport mechanism. TTc serves as an imaging biomarker for normal axonal transport and demonstrates impairment of axonal transport early in the course of an N-methyl-D-aspartic acid (NMDA)-induced excitotoxic retinopathy model in rats. Transport-related imaging findings were dramatically different between normal and retinopathic eyes prior to presumed neuronal cell death. This proof-of-concept study provides justification for future clinical translation.

Clinicopathological characteristics and prognosis of 77 cases with type 3 gastric neuroendocrine tumours.

BACKGROUND: For the rarity of type 3 gastric neuroendocrine tumours (g-NETs), their clinicopathological characteristics and prognosis are not well illustrated. AIM: To describe the clinicopathological features and outcome of type 3 g-NETs in the Chinese population. METHODS: Based on the 2019 WHO pathological classification, the clinicopathological characteristics and prognosis of patients with type 3 g-NETs in China were retrospectively analysed. RESULTS: A total of 77 patients (55.8% of females) with type 3 g-NETs were analysed, with a median age of 48 years (range: 28-79 years). The tumours were mainly located in the gastric fundus/body (83.1%) and were mostly solitary (83.1%), with a median size of 1.5 cm (0.8-3.5 cm). Of these, there were 37 G1 tumours (48.1%), 31 G2 (40.3%), and 9 G3 (11.7%). Ten (13.0%) and 24 (31.2%) patients had lymph node and distant metastasis, respectively. In addition, type 3 g-NETs were heterogeneous. Compared with G1 NETs, G2 NETs had a higher lymph node metastasis rate, and G3 NETs had a higher distant metastasis rate. G1 and G2 NETs with stage I/II disease (33/68) received endoscopic treatment, and no tumour recurrence or tumour-related death was observed within a median follow-up time of 36 mo. Grade and distant metastasis were identified to be independent risk factors for prognosis in multivariable analysis. CONCLUSION: Type 3 g-NETs are obviously heterogeneous, and the updated WHO 2019 pathological classification may be used to effectively evaluate their biological behaviors and prognosis. Also, endoscopic treatment should be considered for small (< 2 cm), low grade, superficial tumours.

Clinicopathological features and prognostic validity of the European Neuroendocrine Tumor Society (ENETS) and American Joint Committee on Cancer (AJCC) 8th staging systems in colonic neuroendocrine neoplasms.

PURPOSE: This study aimed to investigate the characteristics of colonic neuroendocrine neoplasms (NENs) and to validate the prognostic value of the European Neuroendocrine Tumor Society (ENETS) and American Joint Committee on Cancer (AJCC) 8th staging systems. METHODS: A total of 167 and 1248 patients with colonic NENs from 12 medical centers across China and from the Surveillance, Epidemiology, and End Results (SEER) cancer registry in the United States, respectively, were reviewed. Patients were staged according to the ENETS and AJCC 8th staging systems. RESULTS: Clinicopathological features of colonic NENs in the Chinese cohort and SEER cohort were significantly distinct. In both the Chinese cohort and the SEER cohort, colonic neuroendocrine carcinoma (NEC) and mixed adeno-neuroendocrine carcinoma (MANEC) were more frequent in the midgut than in the hindgut. Tumors originating from the midgut tended to be larger and at a more advanced stage than those from the hindgut. The AJCC 8th staging system and the ENETS system appeared to have similar prognostic ability for colonic NEC/MANEC. CONCLUSIONS: Our study revealed that tumors originating from the midgut and the hindgut shared different clinicopathological features. The AJCC 8th staging system and the ENETS system appeared to have similar prognostic ability for colonic NEC/MANEC.

A meta-analysis of surgical decompression in the treatment of diabetic peripheral neuropathy.

BACKGROUND: Over the last decade, surgical decompression procedures have been commonly used in the treatment of diabetic peripheral neuropathy (DPN). However, the effectiveness of them remains to be proved. METHODS: A comprehensive literature search of databases including PubMed-Medline, Ovid-Embase, and Cochrane Library was performed to collect the related literatures. The Medical Subject Headings used were "diabetic neuropathy," "surgical decompression," and "outcomes." The methodological index for nonrandomized studies was adopted for assessing the studies included in this review. Analyses were performed with Review Manager (Version 5.3, The Nordic Cochrane Centre, the Cochrane Collaboration, Copenhagen, 2014). RESULTS: A total of 12 literatures (including 8 prospective and 4 retrospective) encompassing 1825 patients with DPN were included in the final analysis. Only 1 literature was identified as a randomized-controlled trial. The remaining 11 literatures were observational studies; 7 of them were classified as upper-extremity nerve decompression group and 4 of them were classified as lower-extremity nerve decompression group. Meta-analysis shows that Boston questionnaire symptom severity and functional status of upper extremities, and distal motor latency and sensory conduction velocity of median nerve of DPN patients are significantly improved after carpal tunnel release. Besides, visual analog scale and 2-point discrimination are considered clinically and statistically significant in lower extremities after operation. CONCLUSIONS: The findings from our review have shown the efficacy of surgical decompression procedures in relieving the neurologic symptoms and restoring the sensory deficits in DPN patients. As there are few high-quality randomized-controlled trials or well-designed prospective studies, more data are needed to elucidate the role of surgical procedures for DPN treatment in the future.

Hsa-miR-202-3p, up-regulated in type 1 gastric neuroendocrine neoplasms, may target DUSP1.

AIM: To detect abnormal microRNA (miRNA) expression in type 1 gastric neuroendocrine neoplasms (g-NENs) and find potential target genes. METHODS: Tumour tissues from patients with type 1 g-NENs were used as experimental samples, and gastric mucosal tissues from the same patients obtained during gastroscopy review after several months were used as control samples. miRNA expression was examined with Agilent human miRNA chips and validated via RT-PCR. Three types of target gene prediction software (TargetScan, PITA, and microRNAorg) were used to predict potential target genes of the differentially expressed miRNAs, and a dual-luciferase reporter assay system was used for verification. RESULTS: Six miRNAs were significantly upregulated or downregulated in the tumours compared to the control samples. Among them, miR-202-3p was extraordinarily upregulated. RT-PCR of seven sample sets confirmed that miR-202-3p was upregulated in tumour tissues. In total, 215 target genes were predicted to be associated with miR-202-3p. Among them, dual-specificity phosphatase 1 (DUSP1) was reported to be closely related to tumour occurrence and development. The dual-luciferase reporter assay showed that miR-202-3p directly regulated DUSP1 in 293T cells. CONCLUSION: miR-202-3p is upregulated in type 1 g-NEN lesions and might play important roles in the pathogenesis of type 1 g-NENs by targeting DUSP1.