Application of a novel computer-assisted surgery system in percutaneous nephrolithotomy: A controlled study.

BACKGROUND: Most complex renal stones are managed primarily with percutaneous nephrolithotomy (PCNL). However, PCNL is still a great challenge for surgeons because of poor comprehension on complex adjacent structures. Novel techniques are required to assist in planning and navigation. AIM: To apply and evaluate the Hisense computer-assisted surgery (CAS) system in PCNL. METHODS: A total of 60 patients with complex renal stones were included. Thirty patients in the CAS group had three-dimensional (3D) virtual models constructed with the CAS system. The model assisted in planning and navigating in the CAS system. Thirty patients in the control group planned and navigated as standard PCNL, without the application of the CAS system. Success rate of one attempt, operation time, initial stone-free rate, decrease in hemoglobin, and complications were collected and analyzed. RESULTS: There were no statistically significant differences in the baseline characteristics or planning characteristics. The success rate of one puncturing attempt (90% vs 67%, P = 0.028) and the initial stone-free rate (87% vs 63%, P = 0.037) were significantly higher in the CAS group. However, there were no statistically significant differences in the operation time (89.20 ± 29.60 min vs 92.33 ± 33.08 min, P = 0.859) or in the decrease in hemoglobin (11.07 ± 8.32 g/L vs 9.03 ± 11.72 g/L, P = 0.300) between the CAS group and the control group. No statistically significant differences in the incidence of complications (Clavien-Dindo grade ≥ 2) were found. CONCLUSION: Compared with standard PCNL, CAS-assisted PCNL had advantages in terms of the puncturing success rate and stone-free rate. The Hisense CAS System was recommended to assist in preoperative planning and intraoperative navigation for an intuitive, precise and convenient PCNL.

Renal phenotypes correlate with genotypes in unrelated individuals with tuberous sclerosis complex in China.

PURPOSE: To explore the relationship between the genotype and renal phenotype in a Chinese cohort and guide clinical decision-making for treating tuberous sclerosis complex (TSC). MATERIALS AND METHODS: We reviewed 173 patients with definite TSC at three centers in China from September 2014 to September 2020. All the patients underwent TSC1 and TSC2 genetic testing as well as renal phenotypic evaluation. All analyses were performed using the SPSS software, version 19.0, with a cut-off P value of 0.05 considered statistically significant. RESULTS: We identified variants in 93% (161/173) cases, including 16% TSC1 and 77% TSC2 variants. Analysis of the relationship between the genotype and renal phenotype, revealed that those with TSC2 variants were more likely to develop severe renal AML (> 4) (P = 0.044). In terms of treatment, TSC2 variants were more likely to undergo nephrectomy/partial nephrectomy (P = 0.036) and receive mTOR medication such as everolimus (P < 0.001). However, there was no significant difference between the two groups in terms of their response to the everolimus treatment. CONCLUSION: Patients with TSC2 variants exhibit more severe renal phenotypes, especially those associated with renal angiomyolipomas (AML), and they often require nephrectomy/partial nephrectomy or mTOR medication. Detection of the genotype is helpful in TSC management.

Everolimus versus sirolimus for angiomyolipoma associated with tuberous sclerosis complex: a multi-institutional retrospective study in China.

PURPOSE: To evaluate the efficacy and safety of everolimus and sirolimus in patients with tuberous sclerosis complex-associated angiomyolipomas (TSC-AML). MATERIALS AND METHODS: We performed a multi-institutional retrospective study of TSC-AML patients treated with oral everolimus 10 mg or sirolimus 2 mg per day for at least 3 months. Angiomyolipoma volume was estimated using orthogonal measurements by MRI or CT. Adverse events (AEs) were assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events. All analyses were performed using SPSS 19.0 software. RESULTS: Response rates were high in both groups. With the prolonged medication durations, the therapeutic efficacy of both agents became more significant. The TSC-AML volume reduction after 6 and 12 months was more pronounced in patients with everolimus than those with sirolimus. More than half of the patients treated with everolimus had ≥ 50% reduction, and approximately 80% of them had ≥ 30% reduction, which was higher than that in patients treated with sirolimus. Regarding safety, there was no significant difference in the incidence of AEs between the two groups. CONCLUSIONS: Both everolimus and sirolimus are excellent therapeutic options for TSC-AML. However, everolimus has a better therapeutic efficacy than sirolimus, particularly in reducing TSC-AML volume. Everolimus is therefore recommended as the first choice of therapy for TSC-AML.

Effect of electroacupuncture stimulation at Zusanli acupoint (ST36) on gastric motility: possible through PKC and MAPK signal transduction pathways.

BACKGROUND: Electroacupuncture (EA) stimulation has been shown to have a great therapeutic potential for treating gastrointestinal motility disorders. However, no evidence has clarified the mechanisms contributing to the effects of EA stimulation at the Zusanli acupoint (ST.36). This study was designed to investigate the regulative effect of EA stimulation at the ST.36 on gastric motility and to explore its possible mechanisms. METHODS: Thirty Sprague-Dawley rats were randomly divided into three groups: the ST.36 group, the non-acupoint group, and the control group. EA stimulation was set at 2 Hz, continuous mode, and 1 V for 30 min. The frequency and average peak amplitude of gastric motility were measured by electrogastrography. The protein kinase C (PKC) and mitogen-activated protein kinase (MAPK) signaling pathways were assessed using real-time polymerase chain reactions. Caldesmon (CaD) and calponin (CaP) protein expression in the gastric antrum were detected on Western blots. A Computed Video Processing System was used to evaluate morphological changes in smooth muscle cells (SMCs) from the gastric antrum. RESULTS: EA stimulation at ST.36 had a dual effect on the frequency and average peak amplitude. Additionally, EA stimulation at ST.36 regulated the expression of some genes in the PKC and MAPK signaling pathways, and it regulated the expression of the CaD and CaP proteins. EA serum induced SMC contractility. Promotion of gastric motility may correlate with up-regulation of MAPK6 (ERK3), MAPK13, and Prostaglandin-endoperoxide synthase 2 (PTGS2) gene expression, and the down-regulation of the collagen, type I, alpha 1 (COL1A1) gene and CaD and CaP protein expression. Inhibition of gastric motility may correlate with down-regulation of the Interleukin-1 receptor type 2 (IL1R2) and Matrix metalloproteinase-9 (MMP9) genes, and up-regulation of CaD and CaP protein expression. CONCLUSIONS: EA stimulation at ST.36 regulated gastric motility, and the effects were both promoting and inhibiting in rats. The possible mechanisms may correlate with the PKC and MAPK signal transduction pathways.

Body weight changes in breast cancer patients following adjuvant chemotherapy and contributing factors.

Weight gain commonly occurs in breast cancer patients who receive adjuvant chemotherapy. Weight gain may cause psychosocial stress and is associated with patient prognosis and survival. Several factors contributing to weight gain have been identified in Western populations. However, there was lack of information associated with body weight changes following adjuvant chemotherapy in Chinese breast cancer patients. To the best of our knowledge, this is the first such study to be conducted in the Chinese population. A total of 98 patients who received adjuvant chemotherapy following a modified radical mastectomy were included in this study. Their weight was measured prior to the first and following the last cycle of chemotherapy. A weight gain, or loss, of >1 kg following adjuvant chemotherapy was considered to be significant. Cancer stage, treatment modalities, menopausal status and other clinical information were obtained through medical record review. The results revealed that the weight changes ranged from -11 to +9 kg, with a mean value of -0.4±4.4 kg. A total of 66.7% of the patients exhibited weight changes (34.6% gained >1 kg and 32.1% lost weight), whereas 33.3% of the patients maintained a stable weight (P<0.001). Patients aged ≤40 years [odds ratio (OR)=1.429, P=0.028], with a weight of ≥60 kg at diagnosis (OR=2.211, P=0.023), who received ≥4 cycles of chemotherapy (OR=1.591, P=0.039) and a total hormone dose of ≥200 mg (OR=2.75, P=0.013) exhibited a higher risk of weight gain. In conclusion, the body weight changes observed in Chinese breast cancer patient post-adjuvant chemotherapy were different from those observed among Western populations, represented predominantly by weight gain and were reflected by approximately equal percentages of weight gain, stable weight and weight loss.

Synthesis of dienyl ketones via palladium(II)-catalyzed direct cross-coupling reactions between simple alkenes and vinyl ketones: application to the synthesis of vitamin A1 and bornelone.

An efficient and general method for the synthesis of conjugated dienyl ketones via palladium(II) acetate catalyzed direct cross-coupling between simple alkenes and vinyl ketones is reported. This method has been successfully applied for the synthesis of Vitamin A1 and bornelone.

[Expression and clinical significance of Nrf2 in esophageal squamous cell carcinoma].

AIM: To study the expression and clinical significance of Nrf2 (Nuclear factor E2 p45-related factor 2) in esophageal squamous cell carcinoma (ESCC). METHODS: The expression of Nrf2 in 32 cases of EC tissues, 30 cases of adjacent tissues, 21 positive Lymph node tissues and 24 negative Lymph node tissues was assessed by SP immunohistochemical method. RESULTS: The main location of Nrf2 was nuclear, and the positive rates of Nrf2 in the cancer tissues was 78.13%, while that in the adjacent tissues group was 13.33%, and showed 66.67% and 20.83% in the positive Lymph node tissues and negative Lymph node tissues respectively, there was a significant difference between the two groups (P<0.05). The Nrf2 positive rate was closely correlated with the lymph node metastasis (P<0.05), but showed no statistical associated with age, sex, TNM stage, degree of tumor differentiation and the location of tumor. CONCLUSION: The Nrf2 has high expression in ESCC tissues, and the positive rate is closely correlated with the lymph node metastasis, The Nrf2 may play an important role in ESCC oncogenesis and drug resistence.

[Expression and distribution of Nrf2 in several hepatocellular carcinoma cell lines].

AIM: The aim of this study was to investigate the expression and the distribution of Nuclear factor-erythroid 2 p45-related factor 2 (Nrf2) in several human hepatocellular cancer cell lines (HepG2, Hep3B, SMMC-7721). METHODS: Flow cytometry was used to figure out the percentages of Nrf2-positive cells in these three cell lines. The localization of Nrf2 was estimated by the laser confocal microsopy and the expression levels of Nrf2 in hepatocellular cancer cell lines were detected by Western blot analysis. RESULTS: The percentages of Nrf2 positive cells in HepG2, Hep3B, and SMMC-7721 were 99.39%, 99.94%, and 99.98% through the flow cytometry. The laser confocal microsopy showed that Nrf2 mainly localized in the cytoplasm of HepG2 cells, distributed evenly in the cytoplasm and nucleus of Hep3B cells, and mainly localized in the nucleus of SMMC-7721 cells. Western blot analysis confirmed the result by the laser confocal microsopy. CONCLUSION: The data on the expression and localization of Nrf2 will be helpful for the following research on the role of Nrf2 in the drug resistance of hepatocellular carcinoma to chemotherapy.

[Effect of low dose propofol on biological behavior of esophageal squamous cell carcinoma cell line Eca109].

AIM: To detect the effect of low dose propofol on the proliferation, apoptosis, migration, and invasion of esophageal squamous cell carcinoma cell line Eca109. METHODS: The proliferation, apoptosis, migration, and invasion of esophageal squamous cell carcinoma cell line Eca109 were detected by MTT assay, flow cytometry, transwell assay respectively. The effect of low dose propofol on expression of heme oxygenase-1 (HO-1) was confirmed by Real-time quantitative PCR. RESULTS: Low dose propofol could inhibit the proliferation, migration, invasion and promate the apoptosis of esophageal squamous cell carcinoma cell line Eca109. And low dose propofol increased the expression of HO-1 mRNA in a dose-dependment manner. CONCLUSION: Low dose propofol affects the biological behavior of esophageal squamous cell carcinoma cell line Eca109, which has a relationship with increasing the expression of HO-1.

[Effects of antidiabetic drug metformin on human breast carcinoma cells with different estrogen receptor expressing in vitro].

AIM: To research different effects of human breast carcinoma cells with different estrogen receptor expressing by antidiabetic drug metformin, and preliminary explore the possible underlying molecular mechanisms. METHODS: Cells were treated with metformin. Growth inhibition rates of the cells were measured by MTT assay. Cell cycle and apoptosis were detected by flow cytometery (FCM). Expressions of HIF-1α mRNA in the cells were measured by RT-PCR. RESULTS: After drug intervention, the cell proliferation were inhibited by metformin, and reinforced with the concentration and reaction time increase (P<0.05). The growth inhibition rates of MCF-7(ER(+);) breast carcinoma cell were higher than MDA-MB-231(ER(-);) breast carcinoma cell at each concentration group (P<0.05). The results of FCM prompted: MCF-7(ER(+);) breast carcinoma cell was arrested in G1 phase by metformin significantly in a dose-dependent increase(P<0.05). While for MDA-MB-231(ER(-);) breast carcinoma cell, only the 20 and 40 mmol/L groups had significant difference compared with the control group(P<0.05); and the percentage of G1 phase arresting were lower than MCF-7(ER(+);) breast carcinoma cell at the same concentration group(P<0.05). The effect of apoptosis for these two kinds of cells via metformin were not obvious(P<0.05). The expressions of HIF-1α mRNA detected by RT-PCR prompted: the expressions of HIF-1α mRNA for these two breast carcinoma cells were in a dose-dependent decrease(P<0.05). CONCLUSION: The effect of metformin for human breast carcinoma cell with estrogen receptor was better than the one without estrogen receptor. Maybe the molecular mechanism had a relationship with HIF-1α up-regulating.

[Differential expression of hsa-miR-126 and hsa-miR-518b in esophageal squamous carcinoma].

OBJECTIVE: To identify the differentially expressed microRNAs (miRNAs) between esophageal squamous carcinoma (ESC) and adjacent non-tumorous tissue (NT). METHODS: The expression levels of the miRNAs were detected in 3 fresh ESC and NT samples by hybridization with miRNAs microarray chip. Real-time quantitative RT-PCR was performed to confirm the results of the microarray analysis. The expressions of hsa-miR-126 and hsa-miR-518b in ESC were validated by real-time quantitative RT-PCR in another independent 15 matched samples. RESULTS: A total of 11 miRNAs exhibited differential expressions in ESC samples as compared to their expressions in the NT samples, including a 1 up-regulated miRNA and 10 down-regulated miRNAs. Compared with normal esophageal samples, the ESC tissues showed up-regulated hsa-miR-126 and down-regulated hsa-miR-518b expression. CONCLUSION: hsa-miR-126 and hsa-miR-518b are differentially expressed in ESC, and they might play important roles in the carcinogenesis and progression of ESC.

[Expression profiles of microRNA in colon adenocarcinoma].

AIM: to investigate the difference of microRNA (miRNA) expression profiles in colon adenocarcinoma and adjacent non-tumorous tissue (NT), for further studies on molecular mechanism of miRNA on colon adenocarcinoma. METHODS: the fresh samples of 3 colon adenocarcinoma and NT were obtained and total RNA was isolated with TRIzol reagent. Hybridization was carried out on miRNA microarray chip. Quantitative Real Time polymerasechain reaction (qRT-PCR) was performed to confirm results obtained by microarray analysis. RESULTS: 80 miRNAs with more than 2-fold change could be differentially expressed between NT and colon adenocarcinoma. 27 human miRNAs were found significantly down-regulated, while 2 miRNAs was found significantly up-regulated (P<0.05). The expression of miRNAs measured by qRT-PCR were consistent with that by miRNA microarray analysis in the same samples. CONCLUSION: there were differentially expressed miRNAs in colon adenocarcinoma and NT. These different miRNAs might be correlated to the process of carcinogenesis and progression of colon adenocarcinoma. The miRNAs expression profiles might be an important molecular biomarker in the diagnosis of colon adenocarcinoma and target gene for tumor therapy.

[Study on estimation of radiation dose using FTIR in mice thymus].

Fourier transform infrared spectroscopy (FTIR) was applied to study the biochemical changes in the radiation damaged mouse thymus which increased with radiation dose and provided a new method for the estimation of the radiation dose of radiation damaged patients. The results demonstrated that with the dose increasing, the peak positions like 1 550, 1 400, 1 400 and 1 640 cm(-1) at the dose of 2, 3 and 5 Gy showed some difference, and there was obvious variance in the intensity: (1) The intensity ratio of 1 085 to 1 236 cm(-1) related to nucleic acid tended to decrease. (2) The intensity ratio of 1 640/1 550 decreased. (3) The intensity at 2 958, 2 925, 1 460 and 1 400 cm(-1) showed no significant difference. The results suggest that it may be possible for FTIR to become an effective method to estimate the radiation dose in clinic.

[Effect of fractioned irradiation on HIF-1alpha and MDR1 expression in esophageal cancer cells].

OBJECTIVE: To examine the effect of fractioned ionizing radiation on the expression of hypoxia inducible factor-1alpha (HIF-1alpha) and multidrug resistance (MDR1) in human esophageal cancer cells. METHODS: The mRNA and protein levels of HIF-1alpha and MDR1 in esophageal caner EC9706 cells incubated in the presence of 150 micromol/L CoCl(2) were measured before and after the irradiation by quantitative RT-PCR and Western blotting, respectively. The chemosensitivity and radiosensitivity of the cells were analyzed by MTT assay and clone formation assay. RESULTS: MDR1 and HIF1alpha expressions were significantly up-regulated in the cells following hypoxia or irradiation (P<0.05). The surviving cell fraction in the exclusive irradiation group was significantly lower than that irradiation+hypoxia group (P<0.05). Compared with exclusive hypoxia group, MDR1 and HIF1alpha expressions were decreased significantly in irradiation+hypoxia group (P<0.05). HIF1alpha expression showed a positive correlation to MDR1 expression (P<0.01). CONCLUSION: Hypoxia is an important factor to induce resistance to chemo- and radiotherapy. Low-dose fractioned irradiation can lower MDR1 and HIF1alpha expressions in esophageal cancer cells, which should be considered when combining radiotherapy chemotherapy for esophageal cancer patients.

[Dose effect of radiotherapy on drug resistance in esophageal cancer cell].

AIM: To investigate the dose effect of fractioned ionizing radiation on the expression of MDR1 in human esophageal cancer cells. METHODS: The mRNA and protein levels of MDR1 in esophageal cancer cell line EC9706 incubated in culture containing 150 micromol/L CoCl(2); pre- and post-irradiation were measured by quantitative reverse transcription-polymerase chain reaction (QRT-PCR) and Western blot analysis, respectively. The chemo-sensitivity was analyzed by MTT. RESULTS: Comparing with the control group, hypoxia culture significantly induced MDR1 expression (P<0.05). After 20 fractions of irradiation, the MDR1 expression was significantly up-regulated in 2 Gy/d.f group (P<0.05), while obviously decreased in 1 Gy/d.f group (P<0.05). Consequently, the cell inhibitory rate was significantly reduced in 2 Gy/d.f group, but increased in 1 Gy/d.f group (P<0.05). CONCLUSION: These results indicate that MDR1 is differentially modulated by different doses of fractionated radiation, which should be taken into account when combining radiotherapy chemotherapy for esophageal cancer patients.

Generation of fusion protein EGFRvIII-HBcAg and its anti-tumor effect in vivo.

The epidermal growth factor receptor variant III (EGFRvIII) is the most common variation of EGFR. Because it shows a high frequency in several different types of tumor and has not been detected in normal tissues, it is an ideal target for tumor specific therapy. In this study, we prepared EGFRvIII-HBcAg fusion protein. After immunization with fusion protein, HBcAg or PBS, the titers of antibody in BALB/c mice immunized with fusion protein reached 2.75 x 10(5). Western blot analysis demonstrated that the fusion protein had specific antigenicity against anti-EGFRvIII antibody. Further observation showed fusion protein induced a high frequency of IFN-gamma-secreting lymphocytes. CD4+T cells rather than CD8+T cells were associated with the production of IFN-gamma. Using Renca-vIII(+) cell as specific stimulator, we observed remarkable cytotoxic activity in splenocytes from mice immunized with fusion protein. Mice were challenged with Renca-vIII(+) cells after five times immunization. In fusion protein group, three of ten mice failed to develop tumor and all survived at the end of the research. The weight of tumors in fusion protein were obviously lighter than that in other two groups (t = 4.73, P = 0.044; t = 6.89, P = 0.040). These findings demonstrated that EGFRvIII-HBcAg fusion protein triggered protective responses against tumor expressing EGFRvIII.

[Construction of a prokaryotic expression vector for apoptin and preparation of polyclonal antibody of apoptin].

OBJECTIVE: To construct a prokaryotic expression vector for apoptin and prepare polyclonal antibody of apoptin. METHODS: Apoptin gene amplified from pGEM-T/Apoptin plasmid by PCR was cloned into pET-28a (+). E.coli BL21 (DE3) was transformed by the recombinant plasmid, and apoptin protein expression induced by IPTG was analyzed by SDS-PAGE. BALB/c mice were immunized with the protein and the titer of the antibody was determined using indirect enzyme-linked immunosorbent assay (ELISA). RESULTS: Apoptin gene was successfully cloned into pET-28a (+), and the expression of a protein with relative molecular mass of about 17 000 was identified by SDA-PAGE. After 5 immunizations of the mice with the protein, the blood antibody titer reached 1:5x10(5). CONCLUSION: The prokaryotic expression vector for apoptin is successfully constructed and the polyclonal antibody of apoptin is obtained, which allows further functional study of apoptin.

[Construction and identification of recombinant adeno-associated virus vector harboring fusion gene NT4-Apoptin-HA2-TAT].

AIM: To construct a recombinant adeno-associated virus vector harboring fusion gene NT4-Apoptin-HA2-TAT, laying a foundation for gene therapy research of malignant tumors. METHODS: The Apoptin and HA2-TAT gene were inserted in pUC19/NT4 vector after digested with restriction enzyme. The fusion gene of NT4-Apoptin-HA2-TAT was sub-cloned into the shuttle plasmid of adeno-associated virus; the products were co-transferred into HEK-293 cell line with helper plasmid pAAV/Ad and adeno-plasmid pFG140.The recombinant adeno-associated virus was produced by homologous recombination of above 3 plasmids in HEK-293 cells and its titer was measured by quantitative dot blot hybridization. The effect of AAV-NT4-Apoptin -HA2-TAT on HepG2 cell line was measured by a colorimetric 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H-tetrazolium bromide (MTT) assay. RESULTS: The NT4-Apoptin-HA2-TAT was confirmed by restriction enzyme digestion and DNA sequencing. High titer of recombinant adeno-associated virus was obtained by homologous recombination in HEK-293 cells (3.14 x 10(15) pfu/L). AAV-NT4-Apoptin-HA2-TAT had strong deduce apoptosis effect on HepG2 cells. Compared with Adeno-associated mock virus and in normal cell line NIH3T3, Aden-associated virus NT4-Apoptin-HA2-TAT significantly decreased the survival rate of HepG2 cells. CONCLUSION: The recombinant adeno-associated virus vector encoding gene NT4-Apoptin-HA2-TAT has been successfully constructed in this experiment by molecular cloning and in vitro recombination techniques, laying a foundation for further research of gene therapy of cancer.

[DNA typing of HLA-I and II antigens with medium resolution method by DNA chip technique].

OBJECTIVE: To establish a DNA typing method for the HLA-I and II antigens in the Chinese of Han Nationality in Northern China with medium resolution method by DNA chip technique. METHODS: Corresponding primers for the sense exon fragments of HLA-A, HLA-B, HLA-DR, HLA-DQB, and HLA-DQA were designed. A DNA typing chip was made with specific medium resolution typing probes designed according to the gene frequency of HLA-I and II alleles among the Chinese of Han nationality in Northern China. Unsymmetrical PCR was used to amplify the HLA-I and II exon2 and exon3 in 30 samples from the Chinese of Han nationality in Northern China, and then the PCR products were labeled and hybridized with the probes on the chip. The typing of HLA-I and II was certified by scanning the hybridized products and analyzing them with a set of computer software. RESULTS: HLA-I and II alleles were successfully typed in 30 clinical samples. The h probes with medium resolution were able to discern 42 HLA-I and II alleles accurately. By using this chip 30 HLA-I and II alleles were distinguished and 6 new specific alleles were found. CONCLUSION: DNA typing of HLA-I and II by chip has been proven to be a high-resolution and high-specificity method. It is able to check out new alleles that can not be distinguished by other methods with the same resolution, and it is more intuitive and more suitable for clinical application.