[Core techniques and values of full-endoscopic spine surgery via transforaminal approach].

Full-endoscopic spinal surgery via transforaminal approach (TF-FESS) originated from the minimally invasive techniques of percutaneous interventional treatment of intervertebral disc diseases through posterolateral approach.Thanks to the continuous development and improvement of full-endoscopic equipment alongside surgical instruments and techniques, a developed technical system has been established in discectomy, spinal canal decompression, interbody fusion, etc. The combination of these basic techniques can treat relatively complex degenerative spinal diseases. The core techniques of TF-FESS include percutaneous puncture, foraminoplasty, spinal canal decompression, discectomy, annulus fibrosus suture, interbody fusion. This paper elaborates on the key points of the core techniques, indications, advantages, disadvantages, and prospects of the TF-FESS.

[Cross-sectional study of low anterior resection syndrome in patients who have survived more than 5 years after sphincter-preserving surgery for rectal cancer].

Objective: In this study, we aimed to investigate the prevalence of low anterior resection syndrome (LARS) in patients who had survived for more than 5 years after sphincter-preserving surgery for rectal cancer and to analyze its relationship with postoperative time. Methods: This was a single-center, retrospective, cross-sectional study. The study cohort comprised patients who had survived for at least 5 years (60 months) after undergoing sphincter- preserving radical resection of pathologically diagnosed rectal adenocarcinoma within 15 cm of the anal verge in the Department of Gastrointestinal Surgery, Peking University People's Hospital from January 2005 to May 2016. Patients who had undergone local resection, had permanent stomas, recurrent intestinal infection, local recurrence, history of previous anorectal surgery, or long- term preoperative defecation disorders were excluded. A LARS questionnaire was administered by telephone interview, points being allocated for incontinence for flatus (0-7 points), incontinence for liquid stools (0-3 points), frequency of bowel movements (0-5 points), clustering of stools (0-11 points), and urgency (0-16 points). The patients were allocated to three groups based on these scores: no LARS (0-20 points), minor LARS (21-29 points), and major LARS (30-42 points). The prevalence of LARS and major LARS in patients who had survived more than 5 years after surgery, correlation between postoperative time and LARS score, and whether postoperative time was a risk factor for major LARS and LARS symptoms were analyzed. Results: The median follow-up time of the 160 patients who completed the telephone interview was 97 (60-193) months; 81 (50.6%) of them had LARS, comprising 34 (21.3%) with minor LARS and 47 (29.4%) with major LARS. Spearman correlation analysis showed no significant correlation between LARS score and postoperative time (correlation coefficient α=-0.016, P=0.832). Multivariate analysis identified anastomotic height (RR=0.850, P=0.022) and radiotherapy (RR=5.760, P<0.001) as independent risk factors for major LARS; whereas the postoperative time was not a significant risk factor (RR=1.003, P=0.598). The postoperative time was also not associated with LARS score rank and frequency of bowel movements, clustering, or urgency (P>0.05). However, the rates of incontinence for flatus (3/31, P=0.003) and incontinence for liquid stools (8/31, P=0.005) were lower in patients who had survived more than 10 years after surgery. Conclusions: Patients with rectal cancer who have survived more than 5 years after sphincter-preserving surgery still have a high prevalence of LARS. We found no evidence of major LARS symptoms resolving over time.

[Disease burden of chronic obstructive pulmonary diseases in China from 1990 to 2019].

Objective: To examine the trend of the burden on chronic obstructive pulmonary diseases (COPD) and epidemiologic transition on related risk factors among the Chinese population from 1990 to 2019. Methods: Based on the data from the Global Burden of Disease 2019 Study, we used the indicator numbers such as disability-adjusted life year (DALY), years of life lost (YLD), years lived with disability (YLL), and prevalence rate to describe the changes of COPD burden stratified by different sex and age groups from 1990 to 2019. We applied population attribution faction (PAF) to analyze the burden attributed to risk factors and epidemiological transition. Results: In 2019, the age-standard rate for DALY, YLD, and YLL and prevalence rate for COPD were 1 102.77/100 000 population,862.37/100 000 population, 240.40/100 000 population, and 2 404.41/100 000. Both age-standardized DALY and YLL rates for COPD in males were higher than in females, except for the YLD rate in females. COPD's top five risk factors were particulate matter pollution, smoking, occupational particulate matter, gases, and fumes, low temperature, and secondhand smoke. Smoking surpassed environmental particulate pollution in 1994 and became the first factor causing the disease burden of COPD. Since then, the order of risk factors has not changed. The PAF of environmental particulate pollutants increased by 1.78% annually, from 15.22% in 1990 to 25.37%, and the PAF of household air pollution from solid fuels decreased by 5.59% annually, from 40.30% in 1990 to 7.59%. Conclusions: From 1990 to 2019, the per person health loss caused by COPD in China showed an overall downward trend. The PAF of relevant risk factors has also changed, the importance of environmental factors is relatively declined, and the status of smoking and other related risk behaviors has become increasingly prominent. The prevention and control of COPD can focus on screening high-risk groups (≥40 years old, smoking, heavy air pollution, having occupational exposure), smoking cessation, and environmental treatment.

[Influence of different sphincter-preserving surgeries on postoperative defecation function].

Advances in surgical techniques and treatment concept have allowed more patients with low rectal cancer to preserve sphincter without sacrificing survival benefit. However, postoperative dysfunctions such as fecal incontinence, frequency, urgency, and clustering often occur in patients with low rectal cancer. The main surgical procedures for low rectal cancer include low anterior rectum resection (LAR), intersphincteric resection (ISR), coloanal anastomosis (Parks) and so on. The incidence of major LARS after LAR is up to 84.6%. The postoperative function of ISR is even worse than LAR. Moreover, the greater the extent of resection ISR surgery, the worse the postoperative function. There are few studies on the function of Parks procedure. Current evidence suggests that the short-term function of Parks procedure is inferior to LAR, but function can gradually recovered over time. Colorectal surgeons have attempted to improve postoperative defecation by modifying bowel reconstructions. Current evidence suggests that J pouch or end-to-side anastomosis during LAR does not reduce the incidence of defecation disorders. Pouch reconstruction during ISR cannot reduce the incidence of severe LARS either. In general, the protection of postoperative defecation function in patients with low rectal cancer still has a long way to go.

[Expression of melanoma-associated antigen-C2 in breast cancers and mechanism].

Objective: To analyze the expression pattern, mechanism and clinical significance of melanoma-associated antigen-C2 (MAGE-C2) in tumor-free breast specimens, breast benign disease specimens and breast cancer specimens. Methods: Reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry were used to investigate the expressions of MAGE-C2 in 60 tumor-free breast specimens, 60 breast benign disease specimens and 60 breast cancer specimens. The correlation of MAGE-C2 expression with clinicopathological parameters and prognosis of breast cancer patients were analyzed. The expression of MAGE-C2 was also detected by RT-PCR in breast cancer cell MCF-7 and MDA-MB-231 treated with DNA methylase inhibitor 5-aza-2'-deoxycytidine (5-aza-CdR) and histone deacetylase inhibitor trichostatin A (TSA). Results: The positive expression rates of MAGE-C2 mRNA and protein were 61.7% (37/60) and 58.3% (35/60) in breast cancer specimens, respectively, while negative expressed in breast and begin disease specimens. MAGE-C2 protein expression was associated with tumor grade, histological type and blood vessel invasion of breast cancer patients (P<0.05). The incidence of recurrence-free survival of patients with positive MAGE-C2 expression were lower than that of patients with negative MAGE-C2 expression (P<0.05). Multivariate Cox regression analysis showed that the clinical stage (P<0.01), lymph node metastasis (P<0.05) and MAGE-C2 expression (P<0.05) were the independent prognostic factors of breast cancer patients. The MAGE-C2 mRNA was not observed in the control and TSA treated breast cancer cells while upregulated in the 5-aza-CdR treated cells. Besides, 5-aza-CdR combined with TSA further enhanced MAGE-C2 mRNA level in breast cancer cells (P<0.05). Conclusions: MAGE-C2 is one of the tumor-specific antigen and its expression is related with the poor prognosis of breast cancer patients. DNA methylation and histone acetylation may be an important regulation mechanism of MAGE-C2 gene expression.

[Effect of autoflation on the prognosis of otitis media with effusion in children].

Objective: To investigate the effect of autoinflation on the prognosis of OME in children. Methods: Total of 325 pediatric patients, age ranged from 3 to 8 years, with OME(486 ears)diagnosed in our department from January 2019 to January 2020 were collected. Among them, 177 were males, 148 were females. Disease course ranged from 25 to 86 days. According to watchful waiting and autoinflation application during follow-up, these children were divided into two groups including 183 cases(271 ears) and 142 cases(215 ears), respectively. The average auditory threshold and tympanogram curve type in two groups were analyzed in the period of 3 months follow-up, and the recovery of OME was evaluated. Results: At the end of 1- and 2- month follow-up, the auditory threshold of patients in autoinflation group was significantly lower than that in watchful waiting group (t=2.139 5 and 2.680 6, P<0.05). However, at the end of 3- month follow-up, there was no significant difference between two groups (t=1.158 5, P>0.05). At the end of 1-, 2- and 3- month follow-up, 89 (33%, 89/271), 200 (74%, 200/271), 220 (81%, 220/271) and 176 (82%, 176/215), 178 (83%, 178/215), 183 (85%, 183/215) ears in watchful waiting group and autoinflation group had a hearing threshold <20 dB HL, respectively, in which ears with auditory threshold<20 dB HL in watchful waiting group were significantly less than those in autoinflation group at the end of 1 and 2 month follow-up (P<0.05), However, ears with auditory threshold<20 dB HL in watchful waiting group were not significantly different from that in the autoflation group at the end of 3- month follow-up (P>0.05). The proportion of ears with type A tympanogram curve was 74%(159/215), 79%(170/215), and 85%(183/215) at the end of 1-, 2- and 3- month follow-up in autoinflation group and 36%(98/271), 71%(192/271) and 76%(206/271) in watchful waiting group, respectively. Proportion of ears with type A tympanogram curve in autoflation group was significantly higher than that in watchful waiting group (P<0.05). Conclusion: Autoinflation can improve the hearing of children with OME in early stage, restore normal middle ear pressure, increase recovery rate, and reduce the choice of surgical treatment of OME.

[Investigation on the status quo of diagnosis and treatment related to the protection of defecation function in sphincter-preserving resections for rectal cancer: a cross-sectional study of Chinese colorectal surgeons].

Objective: To understand the current status of diagnosis and treatment regarding the protection of defecation function in Chinese surgeons performing sphincter-preserving resections (SPR) for rectal cancer in order to discover the problems existing in the function protection during SPR and provide support and reference for the standardized clinical management of rectal cancer. Methods: A cross-sectional survey was performed. Colorectal surgeons who obtained the medical qualifications and volunteered to participate in this study were included, and respondents with incomplete information were excluded. From October 18 to 22, 2020, randomized sampling was conducted among Chinese colorectal surgeons from Chinese Association of Colorectal Surgeons, Chinese Colorectal Cancer Committee, Chinese Sexology Association Anal functional Surgery Committee and National Health Commission Capacity Building and Continuing Education Committee. The questionnaire included basic information of the respondents, assessment of defecation function before SPR, intraoperative details, postoperative follow-up, evaluation and intervention of patients with low anterior resection syndrome (LARS). Observation indicator: results of the questionnaire survey. Result: A total of 231 questionnaires were collected, and 230 were effective, with an effective rate of 99.6%. Among these participants, 217 (94.3%) were males; 107 (46.5%) had medical doctor degrees; 129 (56.1%) were national commission members in colorectal surgery; 137 (59.6%) performed more than 50 SPR operations per year; 211 (91.7%) assessed defection function by auxiliary examinations before SPR. Rigid sigmoidoscopy (n=116, 55.0%) and anorectal manometer (n=81, 38.4%) were the most commonly used method. Among the 230 respondents, 64.8% (n=149) of surgeons used 2D laparoscopy for SPR surgery most commonly, and 51.3% (n=118) of surgeons performed direct colorectal anastomosis for reconstruction, and 98.3% (n=226) used staplers during anastomosis. All the surgeons indicated that they would follow up patients after SPR, and outpatient clinic was the most common method (84.4%, 184/230). When LARS occurred, 50.0% (115/230) of surgeons chose defecation function scale and 78.7% (181/230) actively provided guidance and intervention for patients. Conclusions: Chinese colorectal surgeons still have shortcomings in the protection of defecation function during SPR for rectal cancer. They do not make enough preoperative functional evaluation and postoperative functional recovery estimate for patients. The knowledge and use of defecation function scales and interventions on LARS are expected to be standardized.

[Research progress of different bowel reconstructions for postoperative functional protection during low anterior resections of rectal cancer].

Straight coloanal anastomosis (SCA), colonic J-pouch anastomosis (CJP), transverse coloplasty pouch anastomosis (TCP), and side-to-end anastomosis (SEA) are the most commonly used procedures of bowel reconstructions in the low anterior resections (LAR) of rectal cancer. Different bowel reconstruction procedures greatly affect postoperative bowel function, urinary function and sexual function. SCA is the most traditional procedure. CJP has been studied extensively and well-developed reconstruction method; however, recent studies have shown that CJP has the highest morbidity of complications, so the clinical application of CJP is limited. SEA is not inferior to CJP and SCA in the short-term and long-term defecation function, urination function, and sexual function, with reliable operational safety, so it is expected to become an alternative to SCA and CJP. The research on TCP is lacking, but there are some related clinical trials currently underway, and the results are worth expecting. The improvement and innovation of bowel reconstructions provide a bright prospect for better functional prognosis in patients with rectal cancer.

[Research progress of ferroptosis-related mechanism and diseases].

Ferroptosis is a new programmed cell death characterized by iron dependent and intracellular oxidative accumulation. Current studies have confirmed that ferroptosis is involved in the occurrence and development of neurotoxicity injury, tumors, cardiovascular diseases and other diseases. This paper reviews the mechanisms of ferroptosis and its role in related diseases based on recent studies.

[Effect of low dose ionizing radiation on peripheral blood cells of radiation workers in nuclear power industry].

Objective: To investigate the effects of long-term ionizing radiation on peripheral blood cells of nuclear power workers. Methods: In March 2019, a total of 530 radiation exposed workers in the nuclear power industry who underwent in-service radiation occupational health examination in Guangzhou occupational disease prevention and control hospital in 2018 and with service age ≥1 year were selected as the radiation group. At the same time, 545 workers in nuclear power industry were selected as control group. According to the methods and requirements of GBZ 235-2011 ＂technical specification for occupational health monitoring of radiation workers＂ and GBZ 98-2017 ＂health requirements for radiation workers＂, the occupational health monitoring data were collected, and the change rules of peripheral blood cells in the two groups were analyzed. Results: Compared with the control group, the total number of WBC, NEUT, LYMP, Hb, MCV and MCHC in radiation group were lower than those in control group (P<0.05) , and the difference was statistically significant (P<0.05) . The MPV increased significantly (P<0.05) . Compared with the control group, the abnormal rate of WBC and Hb in the radiation group was higher than that in the control group (P<0.01) , but there was no significant difference in the abnormal rate of RBC and PLT (P>0.05) . Conclusion: Low dose ionizing radiation has a certain cumulative damage effect on peripheral blood cells of radiation workers in nuclear power industry. The change rules of different cell subtypes are different, and the changes of WBC and PLT appear earlier.

Temporal and spatial expression of Sox9, Pax1, TGF-ß1 and type I and II collagen in human intervertebral disc development.

PURPOSE: An accurate understanding of cellular biochemical changes in human intervertebral disc (IVD)s and the corresponding mechanisms during the developmental process still remain unknown and important for investigating the function of critical factors in normal IVD development as well as ascertaining the therapeutic targets for the IVD degeneration. METHODS: Under ethical conditions, human fetal cervical IVDs at 4, 5, and 6 months of pregnancy were collected at abortion surgery. Normal adult human C3-C7 cervical IVDs were taken from cadaveric donors. Sox9, Pax1, TGF-ß1 and type I/II collagen protein and RNA were detected. The number of positive cells was counted to calculate the optical density value for each factor. RESULTS: Sox9, Pax1, and TGF-ß1 expression in the IVD was remarkably reduced with the developmental stage. The location of high expression of Sox9, Pax1, and TGF-ß1 changed with the developmental stage, and migrated from the nucleus pulposus to the annulus fibrosus and endplate. Higher Sox9, Pax1, and TGF-ß1 expression was finally observed around the sclerotome of the vertebral body. The anabolism of type I/II collagens is significantly increased in the IVD in the mid-trimester fetus. CONCLUSIONS: Sox9, Pax1 and TGF-ß1 participate in the developmental process of the human IVD and vertebral body. However, these factors show a separate expression of mRNA and protein, suggesting that they are expressed in the strict time and spatial order.

Research Note: Effects of riboflavin on reproductive performance and antioxidant status of duck breeders.

An experiment was conducted to investigate the effects of dietary riboflavin levels on reproductive performance, riboflavin status, and antioxidant status of laying duck breeders, to estimate the requirement of this vitamin for duck breeders. Different levels crystalline riboflavin (0, 2.5, 5, 10, and 15 mg/kg) were supplemented to a corn-soybean-corn gluten meal basal diet to produce 5 dietary treatments with different analyzed total riboflavin levels (1.48, 3.20, 6.30, 11.71, and 16.83 mg/kg). A total of 80 White Pekin duck breeders aged 40 wk were allotted to 5 dietary treatments of 16 birds each (8 replicates per treatment and 2 breeders per replicate), and all birds were raised individually for 9 wk. At the end of the experiment, reproductive performance, tissue riboflavin concentrations, and antioxidant status of White Pekin duck breeders were measured. The results showed that body weight, egg weight, egg production, and egg fertility were not affected by dietary riboflavin levels. However, among all of the laying duck breeders, the birds fed the basal diet without riboflavin supplementation had the lowest egg hatchability, plasma riboflavin, egg yolk riboflavin, and egg albumen riboflavin (P < 0.001). In addition, the duck breeders fed the basal diet without riboflavin supplementation showed the lowest antioxidant capacity indicated by greatest plasma malondialdehyde (MDA) content and lowest reduced glutathione content, total superoxide dismutase (T-SOD) activities, and total antioxidant capacity in both plasma (P < 0.001) and egg yolk (P < 0.001). These results revealed that dietary riboflavin supplementation improved the reproductive performance and antioxidant status of the duck breeders. According to the broken-line model, the riboflavin requirements (based on dietary total riboflavin) of laying duck breeders in terms of the egg hatchability, plasma riboflavin, egg yolk riboflavin, egg albumen riboflavin, plasma T-SOD activity, and plasma MDA content were 3.19, 7.42, 3.88, 7.44, 6.45, and 8.84 mg/kg, respectively.

L-butyl phthalein improves neural function of vascular dementia mice by regulating the PI3K/AKT signaling pathway.

OBJECTIVE: L-3-n-butylphthalide (L-NBP) is a type of anti-ischemic cranial nerve protective drug that may act on vascular dementia (VD). Phosphatidylinositol-3 kinase (PI3K)/protein kinase B (AKT/PKB) signaling pathway can up-regulate B-cell lymphoma 2 (Bcl-2) expression, reduce reactive oxygen species (ROS) production, and alleviate cell apoptosis. This study aimed at investigating the role of L-NBP on neurological function and cell apoptosis in VD mouse through regulating PI3K/AKT signaling pathway. MATERIALS AND METHODS: The mice were divided into four groups, including Sham, VD, VD + solvent, and VD + L-NBP. HT22 cells were cultured in vitro and treated by ischemia/reperfusion (I/R). HT22 cells were divided into four groups, including I/R, VD + solvent, VD + L-NBP, and VD + L-NBP + LY294002 groups. Phosphorylated AKT (p-AKT) and Bcl-2 expressions were tested. ROS content in hippocampus tissue was detected by flow cytometry. Cell apoptosis was evaluated by transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) assay. RESULTS: ROS content and cell apoptosis increased, while p-AKT and Bcl-2 expressions reduced in hippocampus tissue from VD group compared with sham group. L-NBP significantly up-regulated p-AKT and Bcl-2 expressions and decreased ROS content and cell apoptosis in hippocampus tissue. I/R treatment markedly induced HT22 cell apoptosis and ROS production, and reduced p-AKT and Bcl-2 expressions. L-NBP treatment markedly up-regulated p-AKT and Bcl-2 levels, restrained cell apoptosis, and reduced ROS content in TH22 cells intervened by I/R. LY294002 apparently attenuated the protective effect of L-NBP on HT22 cells. CONCLUSIONS: L-NBP protects VD by up-regulating PI3K/AKT signaling pathway, elevating Bcl-2 expression, reducing nerve cell apoptosis, and restraining ROS production.

Aberrant NEK2 expression might be an independent predictor for poor recurrence-free survival and overall survival of skin cutaneous melanoma.

OBJECTIVE: Never in Mitosis (NIMA) Related Kinase 2 (Nek2) is a serine/threonine-protein kinase encoded by the NEK2 gene and is an essential enzyme in cell cycle progression. In this study, we investigated NEK2 expression profile, its independent prognostic value in terms of recurrence-free survival (RFS)/overall survival (OS), and the potential mechanisms of its dysregulation in melanoma. PATIENTS AND METHODS: A retrospective study was conducted using data from Gene Expression Omnibus (GEO) datasets and the Cancer Genome Atlas (TCGA)-skin cutaneous melanoma (SKCM). RESULTS: NEK2 was significantly upregulated in melanoma tissues. NEK2 upregulation independently predicted poor OS (HR: 1.500, 95% CI: 1.092-2.059, p = 0.012) and RFS (HR: 2.213, 95% CI: 1.298-3.772, p = 0.004). NEK2 DNA amplification was common in melanoma (192/366, 52.5%), which was associated with significantly elevated NEK2 expression. NEK2 expression was weakly and negatively correlated with its DNA methylation (Pearson's r = -0.29). Loss of p53 was associated with increased NEK2 expression. CONCLUSIONS: Based on findings above, we infer that NEK2 expression independently predicts poor survival of melanoma. Its dysregulation might be related to DNA amplification/methylation and TP53 mutation.

Dose optimization of tacrolimus with therapeutic drug monitoring and CYP3A5 polymorphism in patients with myasthenia gravis.

BACKGROUND AND PURPOSE: Tacrolimus is beneficial for treatment of myasthenia gravis (MG) and has a narrow therapeutic range. Therefore, therapeutic drug monitoring is essential for tacrolimus to optimize dosage and prevent adverse reactions. However, no studies have explored the factors influencing tacrolimus blood concentration in patients with MG. Thus, we aimed to analyze these factors and discuss how to optimize tacrolimus dosage for MG treatment. METHODS: Data regarding clinical characteristics, therapeutic drugs and adverse reactions of patients with MG who received tacrolimus were collected from 2013 to 2015 at Beijing Hospital. Tacrolimus whole-blood concentrations were measured by chemiluminescent microparticle immunoassay and CYP3A5*3 gene polymorphism was detected by digital fluorescence molecule hybridization fluorescence. Regression analysis was applied to analyze the factors influencing blood concentrations and adverse reactions. RESULTS: It was shown that there was a correlation between concentration and dosage. Furthermore, co-administration of proton pump inhibitor and clarithromycin and CYP3A5*3 gene polymorphism could significantly increase the tacrolimus whole-blood levels. Adverse reactions were related to blood concentration, CYP3A5 genetic polymorphisms and combined medication though logistic regression analysis. CONCLUSIONS: The concentration of tacrolimus is affected by many factors. Therapeutic drug monitoring and detection of CYP3A5 gene polymorphism was essential for dosage optimization in patients with MG.

MiR-489 suppresses tumor growth and invasion by targeting HDAC7 in colorectal cancer.

PURPOSE: The expression of miR-489 is linked to tumor development and progression; nevertheless, its role in tumor growth and invasion of colorectal cancer (CRC) and the underlying mechanism has not been clarified. EXPERIMENTAL DESIGN: We used quantitative RT-PCR to measure the expression of mature miR-489 in human colorectal tissues and the corresponding CRCs. Targets of miR-489 were predicted with TargetScan and substantiated by dual-luciferase reporter assay. Furthermore, we did in vitro and in vivo analysis with expression vectors and small interfering RNAs, to elucidate the precise role of miR-489 and its target gene histone deacetylase 7 (HDAC7) on cell proliferation, survival, and invasion. RESULTS: Compared to the corresponding non-tumor tissues, miR-489 was frequently downregulated in CRC. By Kaplan-Meier analysis, we found that lower CRC recurrence free survival years in the group with elevated miR-489 expression than those with lower miR-489 expression. In addition, we examined that miR-489 obviously inhibited the migratory and invasive capability in CRC. In further study, we found that miR-489 targets the 3'-UTR of the HDAC7 transcript and downregulates its expression, and HDAC7 expression promoted tumor cell proliferation and invasion. We demonstrated that miR-489 suppresses tumor invasion and metastasis in CRC by targeting HDAC7. CONCLUSIONS: We identified that MiR-489 suppresses tumor growth and invasion in CRC by targeting HDAC7. The expression of miR-489 suggests CRC recurrence and metastasis, which shed crucial light on how miR-489 functions in CRC pathogenesis.

Characteristics and clinical outcomes of living renal donors in Hong Kong.

INTRODUCTION: In Asia, few reports are available on the outcomes for living renal donors. We report the short- and long-term clinical outcomes of individuals following living donor nephrectomy in Hong Kong. METHODS: We retrospectively reviewed the characteristics and clinical outcomes of all living renal donors who underwent surgery from January 1990 to December 2015 at a teaching hospital in Hong Kong. Information was obtained from hospital records and territory-wide electronic patient records. RESULTS: During the study period, 83 individuals underwent donor nephrectomy. The mean (± standard deviation) follow-up time was 12.0 ± 8.3 years, and the mean age at nephrectomy was 37.3 ± 10.0 years. A total of 44 (53.0%), four (4.8%), and 35 (42.2%) donors underwent living donor nephrectomy via an open, hand-port assisted laparoscopic, and laparoscopic approach, respectively. The overall incidence of complications was 36.6%, with most being grade 1 or 2. There were three (9.4%) grade 3a complications; all were related to open donor nephrectomy. The mean glomerular filtration rate was 96.0 ± 17.5 mL/min/1.73 m2 at baseline and significantly lower at 66.8 ± 13.5 mL/min/1.73 m2 at first annual follow-up (P<0.01). The latest mean glomerular filtration rate was 75.6% ± 15.1% of baseline. No donor died or developed renal failure. Of the donors, 14 (18.2%) developed hypertension, two (2.6%) had diabetes mellitus, and three (4.0%) had experienced proteinuria. CONCLUSION: The overall perioperative outcomes are good, with very few serious complications. The introduction of a laparoscopic approach has decreased perioperative blood loss and also shortened hospital stay. Long-term kidney function is satisfactory and no patients developed end-stage renal disease. The incidences of new-onset medical diseases and pregnancy-related complications were also low.