The Prognostic Value of Preoperative Naples Prognostic Score in Upper Tract Urothelial Carcinoma Patients after Radical Nephroureterectomy.

This study aims to determine the prognostic value of preoperative Naples prognostic score (NPS) on survival outcomes in upper tract urothelial carcinoma (UTUC) patients after radical nephroureterectomy (RNU). We conducted a retrospective study about UTUC patients at West China Hospital from January 2015 to June 2019. The X-Tile program was used to identify the optimal cutoff value of NPS. Overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS) were the endpoints of interest. Kaplan-Meier curves were used to estimate survival and Cox proportional hazard model was used for risk assessment. A total of 237 UTUC patients after RNU were identified and the threshold of NPS was determined to be 2. Preoperative high-NPS was associated with inferior OS (p = 0.004), CSS (p = 0.002) and PFS (p = 0.008), especially in locally advanced UTUC patients. Preoperative NPS was an independent predictor for OS (HR: 1.78; 95% CI: 1.08, 2.93), CSS (HR: 1.87; 95% CI: 1.11, 3.14) and PFS (HR: 1.60; 95% CI: 1.02, 2.50). The addition of NPS into the predictive model consisting of predictors from multivariate Cox regression resulted in better prediction performance. Preoperative NPS was a novel and reliable predictor for survival in UTUC patients after RNU, and should be further explored.

A meta-fusion RCNN network for endoscopic visual bladder lesions intelligent detection.

This study investigates a visual object detection technology in order to help doctors diagnose bladder lesions with endoscopy. A new object detection approach based on deep learning is presented, which derived from the cascade R-CNN and extended the ability of network for adapting insufficient endoscopic lesions samples when training a deep neural network. We propose a feature adaptive fusion model to increase the network's mobility and reduce the possibility of overfitting problems, and use task adaptation meta-learning approach to train the feature fusion process of the entire model and the target network update process in order to complete the task-adaptive classification and detection. The new model has been evaluated on the challenging object detection data set Pascal VOC and its converted format of Microsoft COCO, and the results show that the performance of our proposed method is superior to the original method. Therefore, we apply the proposed method to a custom bladder lesions data set to solve the auxiliary detection problem in the intelligent diagnosis of bladder lesions and demonstrated the effectiveness.

The occurrence and partition of total petroleum hydrocarbons in sediment, seawater, and biota of the eastern sea area of Shandong Peninsula, China.

To investigate the occurrence and partition of total petroleum hydrocarbons (TPHs), sediment, seawater, and biota of the eastern sea area of Shandong Peninsula (China) were sampled in 2016. Due to shipping activities and discharge of industrial wastes, the TPH levels in the sediment decreased from the coastal areas to the offshore area. Waterborne TPH concentrations showed a decreasing order of autumn > summer > spring > winter, probably caused by low input of pollutants from the river into the ocean in dry seasons and frequent aquaculture operations in wet seasons. The distribution coefficient (logKd) between sediment and seawater ranged from 2.00 to 5.05, suggesting that TPHs are preferentially retained by the sediment. Significant positive correlations between logKd and total organic carbon (TOC), mud (fine particles), and temperature, as well as negative correlations between logKd and dissolved oxygen (DO), hydrogen ion concentration (pH), and oxidation-reduction potential (Eh), suggest interactions between environmental behaviors of TPHs and physicochemical factors. Mean bioaccumulation factors (BAFs) of TPHs in fish, shrimps, and mollusks were determined to be 240 ± 200, 900 ± 1800, and 2630 ± 1280, respectively, suggesting that considerable bioaccumulation occurs in shrimps when TPHs are transported from the seawater to the shrimps. A negative linear correlation between logTPHs and trophic level indicated biodilution of TPHs along the marine food web. This is the first study that has focused on the accumulation of TPHs in the entire sediment-seawater-biota system.

Case report: Infantile generalized pustular psoriasis with IL36RN and CARD14 gene mutations.

Infantile pustular psoriasis (IPP) is an extremely rare skin disease associated with genetic factors. Gene mutations of IL36RN (interleukin-36 receptor antagonist), CARD14 (caspase recruitment family member 14), and AP1S1 (the σ1C subunit of the adaptor protein complex 1) had been identified to be involved in the pathogenesis of IPP. IPP usually develops with no preceding psoriasis vulgaris (PV) or familial history. Here, we report a case of a 6-month-old infant and make the diagnosis of IPP by a series of examinations; subsequently, by detecting coexistent mutations of IL36RN and CARD14, the diagnosis is intensified from a genetic point of view. We treated the child with traditional oral and topical drugs regardless of the commonly used acitretin considering its potential side effects, such as skeletal toxicity, and the lesions got conspicuous improvement with much reduction of inflammation. Owing to the genetic mutation of IL-36, there had been reported cases focusing on anti-IL36 biological agents in the treatment of IPP, and it could be a new weapon to treat and improve such IL-36RN-deficient skin diseases.

Body Composition Parameters May Be Prognostic Factors in Upper Urinary Tract Urothelial Carcinoma Treated by Radical Nephroureterectomy.

OBJECTIVE: This study assessed the association between body composition and prognosis of patients with upper urinary tract urothelial carcinoma (UTUC) patients treated by radical nephroureterectomy. METHODS: We retrospectively collected baseline data on age, sex, body mass index (BMI), hypertension, diabetes, and tumor-related factors. Computed tomography (CT) scans were performed to measure body composition parameters such as muscle attenuation (MA), total abdominal muscle area (TAMA), visceral fat area (VFA), intermuscular fat area (IMF), and lateral/posterior perirenal fat thickness (L/P PNF), visceral fat density (VD), and subcutaneous fat density (SD). Patient follow-up was conducted via telephone or in the clinic. The endpoints of follow-up were all-cause death, local progression or distant metastasis. Survival analysis was analyzed using the Kaplan-Meier method, and risk factors associated with prognosis were identified using univariate and multivariate Cox proportional hazard analyses. RESULTS: Among the 273 UTUC patients (median age, 68 years) enrolled in our study, 102 had a BMI > 24.0, 100 suffered from diabetes, and 120 had hypertension. A large proportion of patients (189) had high grade tumors. Across all patients, 1- and 3-year rates for overall survival were 86.45% and 75.55%; local progression-free survival, 92.11% and 89.67%; and distant metastasis-free survival, 85.23% and 80.17%. Based on the Cox regression analysis, MA, IMF, TAMA, TPA, TPT, APT, SMI and PMI significantly reduced the risk of local progression (p < 0.05), while PPNF = 1 point reduced the risk of distant metastasis (p < 0.05). Overall survival was significantly associated with MA, TAMA, and SMI (p < 0.05). CONCLUSION: Our findings illustrate that body composition parameters can act as independent predictors of prognosis in UTUC patients who underwent RNU. These results can help improve stratification of patients and optimize postoperative treatment.

Occurrence and partition of organochlorine pesticides (OCPs) in water, sediment, and organisms from the eastern sea area of Shandong Peninsula, Yellow Sea, China.

To evaluate the occurrence and partition of organochlorine pesticides (OCPs), hexachlorocyclohexanes (HCHs) and dichlorodiphenyltrichloroethanes (DDTs), water, sediment, and organisms were sampled from the eastern sea area of Shandong Peninsula (Yellow Sea, China) across all four seasons in 2016. There were three OCP hotspots in the sediment, mainly caused by the transportation of lindane and dicofol from adjacent Swan Lake and Guhe River. Waterborne OCP levels were highest in winter and lowest in spring, without vertical variability, suggesting that the Yellow Sea Cold Water Mass was governing the spatio-temporal distribution of OCPs in seawater. There was substantial accumulation of HCHs and DDTs in organisms via sediment, as indicated by the relatively low fraction of sedimental fugacity, high bio-sediment accumulation factor, and a positive linear correlation between logΣHCHs and trophic level. This is the first study that has focused on the accumulation of OCPs in entire sediment-seawater-organism system involving multi-phyla of species.

Occurrence, partition, and risk of seven heavy metals in sediments, seawater, and organisms from the eastern sea area of Shandong Peninsula, Yellow Sea, China.

To obtain a systematic knowledge on occurrence, partition, and risk of seven heavy metals (Cu, Pb, Zn, Cd, Cr, Hg, and As) in multi-media of marine ecosystem, sediments, seawater, and 20 species of organisms were collected from 62 sites in the eastern sea area of Shandong Peninsula, located in Yellow Sea (China), in four seasons of 2016. The concentrations were in the low-middle level compared with values from other sea areas all over the world. The highest concentrations of most of the seven elements were detected in sediments and seawater near the coastline. LogKd (distribution coefficient of sediment/water) ranged from 3.3 to 4.7. Concentrations of heavy metals in mollusc and/or crustacea were generally higher than that in fish (especially pelagic species), and while there was no significant relationships between pollutant concentrations and trophic levels. Cd and As were the most bio-accumulative elements, and As in mollusc may pose low non-carcinogenic risk We suggest that in the studied area heavy metals are mainly sourced from terrestrial input, preferentially retained by sediments, then accumulated in mollusc, and finally entered human body through mollusc consumption. Our study sounds an alarm for stricter control of metal emissions into this sea area.

Enhancement of bioenergy recovery from agricultural wastes through recycling of cellulosic alcoholic fermentation vinasse for anaerobic co-digestion.

Cellulosic alcoholic fermentation generates large amounts of vinasse, which was utilized in the present work to enhance the anaerobic digestion of rice straw and swine manure at different total solid (TS) contents. Straw fermentation resulted in bioethanol and vinasse yields of 95.2 g and 857.7 mL, respectively, per kg dry straw. Vinasse-straw co-digestion showed the highest cumulative biogas yield of 633.4 L kg-1 VS at 3% TS. Therefore, biogas productivity from co-digestion represented 92.1% higher than that of straw mono-digestion. Vinasse-manure co-digestion showed the highest cumulative biogas yield of 676.7 L kg-1 VS at 3% TS at a shorter technical digestion time, which resulted in 53.9% higher biomethane productivity than the corresponding vinasse-straw. Consequently, vinasse co-digestion at all studied TS ratios enhanced the total gross energy output rate (GEORtotal) over mono-digestion. Amongst, vinasse-manure co-digestion at 3% TS showed 7.9% higher GEORtotal than the highest recorded value from vinasse-straw co-digestion.

Ex vivo evaluation of femtosecond pulse laser incision of urinary tract tissue in a liquid environment: implications for endoscopic treatment of benign ureteral strictures.

BACKGROUND: The femtosecond (FS) pulse laser incises soft tissues with minimal peripheral damage and is a promising cutting tool for ureteroscopic endoureterotomy of benign ureteral strictures. OBJECTIVE: To evaluate the feasibility of applying the FS laser to ureteroscopic endoureterotomy. MATERIALS AND METHODS: A commercial Ti:Sapphire regenerative amplifier system (Coherent, RegA 9050, USA) was used in this study. Normal saline, 5% glucose solution, 4% mannitol solution, distilled water, and a 1% (v/v) suspension of whole blood with each of these solutions were tested for their attenuation rate (AR) of the FS laser's power. Bladder specimens from Sprague-Dawley (SD) rats were used as a surrogate model. The laser incised slots of 2 mm in length at bladder samples using three power grades (5×, 10×, and 20× the threshold power) combined with five effective pulse rates (40, 20, 10, 5, and 2.5 kHz), both in air and in normal saline. After samples were processed with standard hematoxylin-eosin staining procedures, the incision depth and collateral damage range were determined microscopically. RESULTS: The ARs of blood suspensions with each of the three isosmotic solutions were significantly higher than the other five solutions (P < 0.001). The FS laser's cutting depth and the collateral damage were increased with the laser power or power density but the collateral damages were less than 100 µm. Microbubble formation was detected in the liquid environments tested and influenced the effective laser power. CONCLUSIONS: Endoscopic application of the FS laser is feasible. Microbubble formation with the laser incision, however, may influence cutting effects. Proposed methods to address these issues include increasing the irrigation rate, using distilled water as irrigation or using gas insufflation instead of irrigation. It is necessary to evaluate these methods, as well as the long-term biologic response to laser incision, on living animal models in endoscopic settings before use on humans.