Prognostic impact of preoperative anemia on non-muscle-invasive bladder carcinoma treated with GreenLight laser vaporization.

In this study, we aimed to evaluate the impact of preoperative anemia (PA) on oncological outcomes among patients with non-muscle-invasive bladder cancer (NMIBC) treated with GreenLight laser vaporization of bladder tumor (PV-BT). Between January 2010 and December 2015, 407 patients with NMIBC who underwent PV-BT surgery were stratified into normal and anemia groups based on the World Health Organization classification (anemia cutoff value: hemoglobin level, <13.0 m g/dL in men and <12.0 mg/dL in women). The Student's t test and chi-square test were performed to assess the effects of PA on clinical and pathological characteristics of patients with NMIBC. The Kaplan-Meier method was used to investigate the influence of PA on oncological survival outcomes. Before PV-BT, 139 patients (34.2%) were anemic. No significant differences in age, sex, smoking habit, tumor size, focality, grade, and stage were found between the anemia and normal groups. At a median follow-up period of 32.5 months (range, 8-60 months), 74 patients (18.2%) had urothelial recurrence, 30 (7.4%) died from any cause, and 21 (5.2%) died from bladder cancer. In the Kaplan-Meier analysis, preoperative anemia was significantly associated with decreased cancer-specific survival (CSS) and overall survival (OS) of the patients with NMIBC. However, recurrence-free survival (RFS) showed no statistically significant difference between the PA and normal groups. The preoperative anemic patients with NMIBC who underwent PV-BT surgery had worse CSS and OS. PA can be a useful and cost-effective prognostic marker in the clinical practice for NMIBC treatment.

GreenLight laser photoselective vaporization of the prostate for treatment of benign prostate hyperplasia/lower urinary tract symptoms in patients with different post-void residual urine.

The purpose of this study is to assess the safety and efficacy of GreenLight laser photoselective vaporization of the prostate (PVP) for the treatment of benign prostate hyperplasia/lower urinary tract symptoms (BPH/LUTS) in patients with different post-void residual urine (PVR). BPH/LUTS patients treated with PVP from January 2014 to January 2016 were enrolled in the present study. All patients were divided into PVR > 50, 50 ≤ PVR < 400, and PVR ≥ 400 ml groups, and standard general and urological methods for BPH/LUTS were carried out. PVP surgery was performed, and the follow-up outcome was investigated 6 months after surgery. A total of 429 patients were included, and there were no significant differences in comorbid diseases or habits among the three groups. The maximum urinary flow rate (Qmax) differed significantly among the groups (P < 0.001), while patients in the PVR < 50 ml group had higher maximum detrusor pressure (Pdet.max) level than the other two groups (P < 0.001). Patients in 50 ≤ PVR < 400 (P < 0.001) and PVR ≥ 400 (P < 0.001) ml groups were more likely to develop detrusor underactivity than those in the PVR < 50 ml group. All patients were treated with PVP, and there were no severe complications requiring rehospitalization or reoperation except nine designed re-treatments. Follow-up data of 387 patients were available. Significant improvement in outcome parameters (International Prostate Symptom Score [IPSS], Qmax, and PVR) was observed in comparison with baseline measurements for the three groups. PVP significantly improved the IPSS, Qmax, and PVR in patients with different PVR; PVP is a safe and effective procedure for BPH/LUTS patients.

Heterometallic 3d-4f coordination polymers based on 1,4,7-triazacyclononane-1,4,7-triyl-tris(methylenephosphonate).

Five heterometallic 3d-4f coordination polymers based on 1,4,7-triazacyclononane-1,4,7-triyl-tris(methylenephosphonic acid) (notpH6) are reported. Compounds [FeLn(notpH)(H2O)4]ClO4·5H2O [Ln = Nd (FeNd), Gd (FeGd), Sm (FeSm), Eu (FeEu)] are isostructural. All show layer structures in which the Fe(notpH)(2-) unit serves as a metalloligand to link four equivalent Ln(III) ions into a layer. Compound [CuLa(notpH2)(H2O)2]ClO4·3H2O (CuLa) displays a chain structure, where the Cu(notpH2)(2-) unit connects the La(III) ions into a chain. The magnetic properties of FeLn are studied.

Tuning the field-induced magnetic transition in a layered cobalt phosphonate by reversible dehydration-hydration process.

A layered cobalt phosphonate, Co(2-pmp)(H(2)O)(2) (1) (2-pmpH(2) = 2-pyridylmethylphosphonic acid) is reported, which provides the first example of metamagnetic cobalt system that shows reversible changes in both structures and magnetic behaviors upon dehydration-hydration process.

Changes in magnetic order through two consecutive dehydration steps of metal-phosphonate diamond chains.

Hydrothermal reactions of the multitopic ligand 1-hydroxy-1-(piperidin-4-yl)methylidenebisphosphonic acid (hpdpH4) with cobalt or nickel sulfates afforded two new isostructural metal phosphonates, M3 II(hpdpH)2(H2O)6·4H2O [M = Co (Co-10H2O), Ni (Ni-10H2O)]. Their structures consist of parallel diamond chains of three MO6 octahedra bridged by the PO3C tetrahedra. Six of the seven oxygen atoms of the ligand are involved in coordination; for two ligands that amounts to 12 bonds for 3 MO6 and the remaining six are occupied by terminal water molecules. In addition, four water molecules sit in between the chains providing H-bonds to the formation of a 3D-net. Thermal analyses show identical two-step dehydration processes involving first the departure of six water molecules followed by the remaining four. A detailed study of the ac- and dc-magnetization as a function of temperature, field and frequency reveals associated drastic changes. The virgin form Co-10H2O is a paramagnet while its partial dehydrated form Co-4H2O is an antiferromagnet displaying canting below T N = 4.7 K and the fully dehydrated form Co is a ferrimagnet (T C = 12 K). Ni-10H2O and Ni-4H2O exhibit long-range ordered antiferromagnetism (T N = 2.7 and 4.0 K, respectively) and also become ferrimagnets (T C = 9.4 K) when fully dehydrated to Ni. The dehydrated samples can be fully rehydrated with the complete recovery of both the structures and magnetic properties.

Management of greenlight laser plus transurethral resection of prostate for elderly men.

The study is aiming to evaluate the treatment safety and efficacy of greenlight laser photovaporization of the prostate (PVP) combined with transurethral electrovaporization resection (TUVP) for elderly (≥ 70 years) men with lower urinary tract symptoms due to benign prostatic hyperplasia (BPH/LUTS) with a large prostate volume (≥ 80 mL). One hundred twelve BPH/LUTS patients treated with PVP were divided into 2 groups according to prostate volume (PV), the outcomes of the 2 groups were assessed at 12 months after the operation. Patients in the PV ≥ 80 group (n = 51) had a higher level of maximum detrusor pressure (Pdet.max) than those in the PV < 80 group (n = 61) (97.14  ±â€Š 36.68 vs 70.70 ±â€Š32.55, P < .001). Pdet.max level of the 2 groups was significantly decreased at the end of follow-up. International Prostate Symptom Score questionnaires (IPSS) score, maximum flow rate (Qmax), and residual urine volume (PVR) were significantly improved in comparison to the preoperative status (P < .001). PVP combined with TUVP can significantly improve outcomes (IPSS, Qmax, PVR) and is a safe and effective technique for elderly BPH/LUTS patients with a large prostate volume.

Assessment of noninvasive predictors of bladder detrusor underactivity in BPH/LUTs patients.

PURPOSE: To retrospectively assess the diagnostic predictive value of clinical characteristics to improve the diagnostic accuracy of bladder detrusor underactivity (DU) among benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS) patients who cannot undergo urodynamic examinations. METHODS: A total of 704 BPH/LUTS patients at Tianjin Medical Union Center from January 2013 through June 2016 were enrolled in the study. All cases were stratified by maximum detrusor pressure (Pdet.max) into two groups (DU and control). Patient and clinical variables were analyzed in both groups. RESULTS: One hundred twelve and 592 cases were classified into the DU and control group, respectively. PV (OR 0.976, 95% CI 0.961-0.991, P = 0.002) and PVR (OR 1.004, 95% CI 1.001-1.007, P = 0.004) were independent predictors of DU. In addition, Pdet.max was positively correlated with HTN (≥10 years) (r = 0.373, P = 0.001), smoking (r = 0.108, P = 0.039), IPSS (20-23) (r = 0.257, P = 0.013), PV (r = 0.305, P < 0.001), PSA (1-2.2 ng/mL) (r = 0.428, P = 0.002), PSAD (0-0.02) (r = 0.430, P = 0.02), and Q max (≤4 mL/s) (r = 0.372, P < 0.001), and inversely correlated with age (>76 years) (r = -0.265, P = 0.015), BMI (21-23) (r = -0.382, P = 0.001), DM (0-20 years) (r = 0.365, P = 0.009) and PVR (50-400 mL) (r = 0.423, P = 0.001). The AUCs for BMI, PV, tPSA, PSAD, Q max, and PVR were 0.762, 0.739, 0.727, 0.681, 0.749, and 0.716, respectively. Combined ROC analysis showed the AUC for PV + PVR was 0.774 with sensitivity of 77.78% and specificity of 73.68%. CONCLUSION: Clinical factors were effective for predicting DU and could help improve the diagnostic accuracy for BPH/LUTS patients who cannot undergo urodynamic examinations.

Prognostic implications of preoperative anemia in urothelial carcinoma: A meta-analysis.

The prognostic significance of preoperative anemia (PA) has been identified in various malignancies. However, its predictive role in urothelial carcinoma (UC) remains controversial. The aim of this study was to investigate the prognostic value of PA in UC patients. We performed a meta-analysis of the association between PA and survival outcome in UC patients. Electronic databases were searched up to June 30, 2016. Study characteristics and prognostic data were extracted from each included study. Cancer-specific survival (CSS), recurrence-free survival (RFS), and overall survival (OS) were pooled using hazard ratio (HR) with corresponding 95% confidence intervals (CI). Herein, 12 studies comprising 3815 patients were included in the meta-analysis. There were 1593 (41.76%) patients in the PA group and 2222 (58.24%) in the control group. The overall pooled HRs of PA for CSS, RFS, and OS were significant at 2.21, (95% CI: 1.83-2.65, Pheterogeneity = 0.49, I2 = 0%), 1.87 (95% CI: 1.59-2.20, Pheterogeneity = 0.22, I2 = 28%), and 2.04(95% CI: 1.76-2.37, Pheterogeneity = 0.36, I2 = 9%) respectively. Stratified analyses indicated that PA was a predictor of poor prognosis based on ethnicity, sample size, tumor T stage, G grade, lymphovascular invasion (LVI), concomitant carcinoma in situ (CIS), and follow-up values. Our findings show that PA has negative prognostic effects on the survival outcome (CSS, RFS, and OS) in UC patients and can serve as a useful and cost-effective marker to aid prognosis prediction.

The complete mitochondrial genome of Anser indicus (Aves, Anseriformes, Anatidae).

The bar-headed goose is known one of the world's highest-flying birds. In this study, the complete mitochondrial genome of Anser indicus (16,728 bp in length) was sequenced. Similar to the typical mtDNA of other vertebrates, goose mtDNA contained 37 genes (13 protein-coding genes, 2 rRNA genes and 22 tRNA genes) and a non-coding region (D-loop). The characteristics of the mitochondrial genome were analyzed in detail. We deduce that ND5 may be a major gene required for adaptation to high-altitude flight. The complete mitochondrial genome sequence of A. indicus obtained will be useful for phylogenetics, and biological characteristics.

Total triterpene acids, isolated from Corni Fructus, ameliorate progression of renal damage in streptozotocin-induced diabetic rats.

OBJECTIVE: To investigate whether total triterpene acids (TTAs), isolated from Cornus Fructus, attenuates renal function by reducing oxidative stress and down-regulating the expression of transforming growth factor ß1 (TGF-ß1). METHODS: Diabetes was induced by an injection of streptozotocin (40 mg/kg intravenously). Thirty rats were randomly divided into three groups: control group, diabetic model group and TTAs treatment group (50 mg/kg, intragastrically) administrated for 8 weeks from 5th to 12th week. All rats were anaesthetized and then were killed to remove kidneys. The renal function and redox enzyme system parameters were tested. Glomerular morphology was observed by a light microscopy. Immunohistochemistry and Western blot assays were employed to determine the protein levels of TGF-ß1. RESULTS: TTAs attenuated the levels of urinary protein, serum creatinine and blood urea nitrogen, although it did not significantly reduce the level of glucose. In addition, TTAs decreased the malondialdehyde while increased superoxide dismutase, catalase and glutathione peroxide activities in diabetic rats. The renal pathological changes in TTAs treatment group were ameliorated. Furthermore, TTAs also ameliorated the expression of TGF-ß1. CONCLUSION: TTAs improved renal function via reducing oxidative stress and down-regulation the expression of TGF-ß1 in diabetic rats.

Enantioseparation and chiral recognition of α-cyclohexylmandelic acid and methyl α-cyclohexylmandelate on hydroxypropyl-ß-cyclodextrin as chiral selector: HPLC and molecular modeling.

Enantioseparations of (R/S)-α-cyclohexylmandelic acid [(R/S)-CHMA] and methyl (R/S)-α-cyclohexylmandelate [(R/S)-MCHMA] were performed on an achiral column (ODS) with 2-hydroxypropyl-ß-cyclodextrin (HP-ß-CD) as a chiral mobile phase additive. The influences of chromatographic conditions on the retention behavior of (R/S)-CHMA and (R/S)-MCHMA were studied in detail. Meanwhile, the thermodynamics parameters of enantioseparations for (R/S)-CHMA and (R/S)-MCHMA were determined to discuss driven power in the enantioseparation process. The inclusion complexation of HP-ß-CD with each enantiomer for (R/S)-CHMA and (R/S)-MCHMA was simulated by molecular docking to understand the chiral recognition mechanism of (R/S)-CHMA and (R/S)-MCHMA on HP-ß-CD. The results showed that the chiral recognition ability of enantiometers of (R/S)-CHMA and (R/S)-MCHMA on HP-ß-CD is better than α-CD, ß-CD, γ-CD and DM-ß-CD. Under the selected chromatographic conditions, baseline separations of enantiomers of (R/S)-CHMA and (R/S)-MCHMA were achieved. It is proved that the stoichiometry for (R/S)-CHMA-HP-ß-CD and (R/S)-MCHMA-HP-ß-CD complexes is 1:1. However, the results of thermodynamics parameters analysis and molecular modeling show that the enantioseparations of CHMA and MCHMA on HP-ß-CD are enthalpy-driven processes and the primary driving forces responsible for chiral recognition are hydrophobic forces, dipole-dipole interaction, charge-transfer and hydrophobic interaction.

Protective effect of Icariin on the early stage of experimental diabetic nephropathy induced by streptozotocin via modulating transforming growth factor ß1 and type IV collagen expression in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Icariin is a major constituent of flavonoid isolated from the plant Herba epimedii, which is used as a traditional Chinese medicine to nourish the kidney and reinforce yang. Therefore, the pharmacological studied of its diabetic nephropathy effect was undertaken to validate its traditional use. MATERIALS AND METHODS: Diabetes was induced in male Sprague-Dawley rats by an injection of streptozotocin (40 mg/kg i.v.). Sustained blood glucose levels (>16.7 mmol/l) were considered as diabetic and selected for experimentation. Thirty rats were randomly divided into three groups: control, diabetic, diabetic+Icariin (80 mg/kg, i.g.) administered 8 weeks from 5th to 12th week. Experiment was carried out at the beginning of 13th week. All rats were anaesthetized and then were killed to remove kidneys. Blood glucose, serum creatinine (Cr), blood urea nitrogen (BUN), the activity of superoxide dismutase (SOD), malondialdehyde (MDA) and hydroxyproline (Hyp) in the kidney tissue were measured. Glomerular morphology was observed by light microscopy. Immunohistochemistry and Western blot were employed to determine the proteins levels of TGF-ß(1) and type IV collagen. RESULTS: The enhancement of Cr and BUN was found in model group, which was significantly attenuated by treatment with Icariin. Meanwhile, elevated MDA and Hyp levels in renal tissue as well as decreased SOD activities in renal tissue were significantly remitted by Icariin. The renal pathological changes in Icariin treatment group were ameliorated. Furthermore, the Icariin decreased the expression of TGF-ß(1) and collagen IV protein. CONCLUSIONS: Icariin can evidently relieve renal damage in rats with diabetic nephropathy induced by STZ, which might be related to modulating the expression of collagen IV and TGF-ß(1) protein.

A pH responsive electrochemical switch sensor based on Fe(notpH3) [notpH6 = 1,4,7-triazacyclononane-1,4,7-triyl-tris(methylene-phosphonic acid)].

The electrochemistry of a macrocyclic metal complex Fe(notpH(3)) [notpH(6)=1,4,7-triazacyclononane-1,4,7-triyl-tris(methylene-phosphonic acid)] reveals that the protonation/deprotonation of the non-coordinated P-OH groups in Fe(notpH(3)) affects its formal potential value (E(0)') considerably. Plotting E(0)' as function of solution pH gives a straight line with a slope of -585 mV pH(-1) in the pH range of 3.4-4.0, which is about ten times larger than the theoretical value of -58 mV pH(-1) for a reversible proton-coupled single-electron transfer at 20 °C. A sensitive pH responsive electrochemical switch sensor is thus developed based on Fe(notpH(3)) which shows an "on/off" switching at pH ∼ 4.0.