Graphitic carbon nitride alleviates cadmium toxicity to soybeans through nitrogen supply.

Graphitic carbon nitride (g-C3N4) is a promising candidate for heavy metal remediation, primarily composed of carbon (C) and nitrogen (N). It has been demonstrated that g-C3N4 adjusts rhizosphere physicochemical conditions, especially N conditions, alleviating the absorption and accumulation of Cadmium (Cd) by soybeans. However, the mechanisms by which g-C3N4 induces N alterations to mitigates plant uptake of Cd remain unclear. This study investigated the impact of g-C3N4-mediated changes in N conditions on the accumulation of Cd by soybeans using pot experiments. It also explored the microbiological mechanisms underlying alterations in soybean rhizospheric N cycling induced by g-C3N4. It was found that g-C3N4 significantly increased N content in the soybean rhizosphere (p < 0.05), particularly in terms of available nitrogen (AN) of nitrate and ammonium. Plants absorbed more ammonium nitrogen (NH4⁺-N), the content of which in the roots showed a significant negative correlation with Cd concentration in plant (p < 0.05). Additionally, g-C3N4 significantly affected rhizospheric functional genes associated with N cycling (p < 0.05) by increasing the ratio of the N-fixation functional gene nifH and decreasing the ratios of functional genes amoA and nxrA involved in nitrification. This enhances soybean's N-fixing potential and suppresses denitrification potential in the rhizosphere, preserving NH4⁺-N. Niastella, Flavisolibacter, Opitutus and Pirellula may play a crucial role in the N fixation and preservation process. In summary, the utilization of g-C3N4 offers a novel approach to ensure safe crop production in Cd-contaminated soils. The results of this study provide valuable data and a theoretical foundation for the remediation of Cd polluted soils.

Implications of GCLC in prognosis and immunity of lung adenocarcinoma and multi-omics regulation mechanisms.

BACKGROUND: Ferroptosis is an iron-dependent type of regulated cell death, and has been implicated in lung adenocarcinoma (LUAD). Evidence has proved the key role of glutamate-cysteine ligase catalytic subunit (GCLC) in ferroptosis, but its role in LUAD remains unclear. Herein, we explored the implications of GCLC and relevant genes in LUAD prognosis and immunity as well as underlying molecular mechanisms. METHODS: This work gathered mRNA, miRNA, DNA methylation, somatic mutation and copy-number variation data from TCGA-LUAD. WGCNA was utilized for selecting GCLC-relevant genes, and a GCLC-relevant prognostic signature was built by uni- and multivariate-cox regression analyses. Immune compositions were estimated via CIBERSORT, and two immunotherapy cohorts of solid tumors were analyzed. Multi-omics regulatory mechanisms were finally assessed. RESULTS: Our results showed that GCLC was overexpressed in LUAD, and potentially resulted in undesirable survival. A prognostic model was generated, which owned accurate and independent performance in prognostication. GCLC, and relevant genes were notably connected with immune compositions and immune checkpoints. High GCLC expression was linked with better responses to anti-PD-L1 and anti-CTLA-4 treatment. Their possible DNA methylation sites were inferred, e.g., hypomethylation in cg19740353 might contribute to GCLC up-regulation. Frequent genetic mutations also affected their expression. Upstream transcription factors (E2F1/3/4, etc.), post-transcriptional regulation of miRNAs (hsa-mir-30c-1, etc.), lncRNAs (C8orf34-AS1, etc.), and IGF2BP1-mediated m6A modification were identified. It was also found NOP58-mediated SUMOylation post-translational modification. CONCLUSIONS: Together, we show that GCLC and relevant genes exert crucial roles in LUAD prognosis and immunity, and their expression can be controlled by complex multi-omics mechanisms.

Synthesis, characterization, and sensitivity tests of La0.8Ba0.1Bi0.1FeO3 nanoparticles towards a few parts-per-billion of acetone gas.

In the present paper, the La0.8Ba0.1Bi0.1FeO3 powders were synthesized via the auto-combustion method. The optical, the positron annihilation spectroscopy and the gas sensing properties of our sample were investigated simultaneously. FTIR spectrum revealed the antisymmetric deformation vibrations of the Fe-O and Fe-O-Fe bonds inside the octahedron FeO6. The optical bandgap (Egap) of the La0.8Ba0.1Bi0.1FeO3 compound was found to be equal to 2.23 eV. We confirmed by the positron annihilation studies, the existence of open volume defects and vacancy sized defects, at the grain/interfaces between vacancy clusters and grains at the interfaces intersection (triple-lines). Notably, the La0.8Ba0.1Bi0.1FeO3 perovskite exhibits an excellent response toward acetone gas, with ultra-fast response and recovery times to some parts-per-billion (ppb) of this tested gas.

Retroperitoneoscopic enucleation adrenalectomy: a viable surgical option for small nonsecreting adrenal tumors with low potential of malignancy.

Laparoscopic total adrenalectomy has become the standard treatment for adrenal mass. Meanwhile, there has been a growing trend toward laparoscopic adrenal-sparing surgery worldwide to avoid the risk and potential complications of adrenal insufficiency. The objectives of this study were to describe a retroperitoneoscopic adrenal tumor enucleation technique, to assess the clinical outcomes of this technique in the treatment of 20-40 mm nonsecreting adrenal tumor (NAT) with low potential of malignancy, and to provide a feasible choice for patients who have preference on resection. This study was a retrospective analysis of 61 patients with low potential of malignancy in 20-40 mm NAT identified at the first imaging examination or during follow-up. All patients were scheduled for planned enucleation adrenalectomy by a single surgeon between July 2016 and December 2020 in Xuanwu Hospital, Beijing, China. In all patients, retroperitoneoscopic surgery was performed via a retroperitoneoscopic process for all the patients. The crucial techniques of enucleation are presented in the video. Safety and feasibility factors of enucleation technique were measured for this study. No blood transfusion or organ injury was registered during the operation. The median operation time was 75 min, and the median blood loss was 35 mL. All operations were successfully performed without open conversion. A total of 58 patients received successful enucleation surgery. Three cases were converted to retroperitoneoscopic total adrenalectomy. In this study, surgical outcomes of retroperitoneoscopic enucleation adrenalectomy as a method to remove adrenal tumors were assessed. This procedure is a feasible and safe technique with the added benefit of preserving the remaining functional adrenal tissue.

Global burden of prostate cancer attributable to smoking among males in 204 countries and territories, 1990-2019.

INTRODUCTION: Understanding the latest global spatio-temporal pattern of prostate cancer burden attributable to smoking can help guide effective global health policy. This study aims to elucidate the trends in smoking-related prostate cancer from 1990 to 2019 using Global Burden of Disease (GBD) 2019 study data. METHODS: Data on prostate cancer attributable to smoking were extracted from Global Burden of Disease Study (GBD) 2019. The numbers and age-standardized rates on smoking-related prostate cancer mortality (ASMR) and disability-adjusted life years (ASDR) were analyzed by year, age, region, country, and socio-demographic index (SDI) level. Estimated annual percentage change (EAPC) was calculated to evaluate the temporal trends of ASMR and ASDR from 1990 to 2019. RESULTS: Of all prostate cancer deaths and DALYs globally in 2019, 6% and 6.6% were attributable to smoking, which contributed to 29,298 (95% CI 12,789 to 46,609) deaths and 571,590 (95% CI 253,490 to 917,820) disability-adjusted life-years (DALYs) in 2019. The number of smoking-related deaths and DALYs showed an upward trend, increasing by half from 1990 to 2019, while ASMR and ASDR declined in five sociodemographic indexes (SDI) regions, with the fastest decline in high SDI regions. For geographical regions, Western Europe and East Asia were the high-risk areas of prostate cancer deaths and DALYs attributable to smoking, among which China and the United States were the countries with the heaviest burden. The ASMR has decreased in all age groups, with the fastest decrease occurring in 75-79 years old. The ASMR or ASDR tended to increase in countries with the lowest SDI, but declined in countries with the highest SDI. The EAPC in ASMR or ASDR was highly negatively correlated with Human Development Index (HDI) in 2019, with coefficients 0.46. CONCLUSION: The number of smoking-related prostate cancer deaths and DALYs continued to increase globally, whereas its ASMR and ASDR have been decreasing. This substantial progress is particularly significant in developed regions and vary across geographic regions. Medical strategies to prevent and reduce the burden should be adjusted and implemented based on country-specific disease prevalence.

Risk Factors of New-onset Diabetes After Renal Transplantation and Prognostic Analysis.

Context: New-onset diabetes after transplantation (NODAT) is one of the most common complications after renal transplantation and in kidney-transplant recipients is closely related to long-term adverse outcomes for recipients and transplants. The risk factors for NODAT still require exploration. Objectives: The study intended to explore the risk factors for new-onset diabetes after transplantation (NODAT) for patients receiving a renal transplantation, to provide a theoretical basis for reducing the incidence rate of NODAT and promoting a better outcome for patients. Design: The research team designed a retrospective study using clinical data of patients receiving renal transplantation at a hospital. Setting: The study took place in the Department of Urology at Xuanwu Hospital at Capital Medical University in Beijing, China. Participants: Participants were 396 patients who had undergone renal transplantation at the hospital, of whom 28 had NODAT syndrome, the NODAT group, and 368 didn't meet the diagnostic criteria for NODAT, the N-NODAT group. Outcome Measures: The research team calculated the incidence rate of NODAT and determined the causes of the disease, evaluated participants' preoperative risk factors-gender, preoperative systolic blood pressure (SBP), preoperative diastolic blood pressure (DBP), height, family history of diabetes, weight, smoking habits, age, drinking habits, pretransplant body mass index (BMI), preoperative fasting blood glucose, triglycerides (TG), total cholesterol (TC)-and their postoperative risk factors-acute rejection, use of immunosuppressive agents, blood CsA concentration, blood FK506 concentration, and renal function. Additionally, the team subjected the data in the two groups to univariate, logistic regression analysis and to multivariate, unconditional, logistic regression analysis to discover risk factors for NODAT. Results: Among the 396 participants, 28 had NODAT (7.1%), and 368 didn't suffer NODAT (92.9%). Statistically significant differences existed between the groups in participants' ages (0.013), weights (P = .032), smoking habits (P = .034), drinking habits (P = .034), BMIs (P = .023), preoperative fasting blood glucose (P < .05), preoperative TG (P < .05), and preoperative TC (P < .01). In the univariate logistic regression analysis, significant associations existed between age (P = .016), weight (P = .033), BMI (P = .025), smoking habits (P = .035), drinking habits (P = .043), preoperative fasting blood glucose (P = .048), preoperative TG (P = .049), preoperative TC (P = .009), acute rejection (P = .009), and immunosuppressive agents (P = .012) and the occurrence of NODAT (P < .05). In the multivariate unconditional logistic stepwise regression analysis, acute rejection (P = .011) and use of FK506 in immunotherapy (P = .013) were independent risk factors for NODAT. Conclusions: The risk factors of NODAT include age, weight, BMI, smoking habits, drinking habits, preoperative fasting blood glucose, preoperative TG, preoperative TC, acute rejection and exposure to immunosuppressive agents. Among them, only acute rejection and immunosuppressive agents are modifiable factors. The application of CsA as an immunosuppressive agent after surgery may decrease the incidence rate of NODAT and prolong the longevity of patients receiving renal transplantation.

A nanodiamond chemotherapeutic folate receptor-targeting prodrug with triggerable drug release.

Cancer chemotherapy is often accompanied by severe off-target effects that both damage quality of life and can decrease therapeutic compliance. This could be minimized through selective delivery of cytotoxic agents directly to the cancer cells. This would decrease the drug dose, consequently minimizing side effects and cost. With this goal in mind, a dual-gated folate-functionalized nanodiamond drug delivery system (NPFSSD) for doxorubicin with activatable fluorescence and cytotoxicity has been prepared. Both the cytotoxic activity and the fluorescence of doxorubicin (DOX) are quenched when it is covalently immobilized on the nanodiamond. The NPFSSD is preferentially uptaken by cancer cells overexpressing the folate receptor. Then, once inside a cell, the drug is preferentially released within tumor cells due to their high levels of endogenous of glutathione, required for releasing DOX through cleavage of a disulfide linker. Interestingly, once free DOX is loaded onto the nanodiamond, it can also evade resistance mechanisms that use protein pumps to remove drugs from the cytoplasm. This nanodrug, used in an in vivo model with local injection of drugs, effectively inhibits tumor growth with fewer side effects than direct injection of free DOX, providing a potentially powerful platform to improve therapeutic outcomes.

Construction of MicroRNA-mRNA Regulatory Network in the Molecular Mechanisms of Bleomycin-Induced Pulmonary Fibrosis.

Bleomycin is a common antitumor agent used to treat many different types of malignancies; however, its main side effect is pulmonary fibrosis. The mechanism of bleomycin-induced pulmonary fibrosis (BIPF) has not been fully elucidated. Therefore, to further explore the molecular mechanisms of BIPF, we screened for microRNA (miRNA) and mRNA expression obtained from BIPF samples from the Gene Expression Omnibus database. Subsequently, we identified the differentially expressed miRNAs and genes that overlapped with the differentially expressed miRNAs target genes, predicted by using the miRWalk database selected as a candidate. The candidate genes were visualized based on Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes analyses. A protein-protein interaction network was constructed. Hub differentially expressed genes were selected and corresponding miRNAs to construct a miRNA-mRNA regulation network. Then, we chose three key miRNAs to study their regulatory relationship in bleomycin-induced pulmonary fibrosis. Finally, mouse lung epithelial cells TC-1 and MLE-12 were treated with bleomycin with qPCR to validate the results of three important hub genes and all key miRNAs. And dual-luciferase report experiment was carried out to verify the interaction of mmu-miR-1946a and serpina3n. The results revealed that the imbalance of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) plays a pivotal role in the occurrence and development of BIPF. In addition, Serpina3n and mmu-miR-1946a were proved interaction and may be involved in the regulation of the balance between MMP-9 and TIMP-1. The experimental results also verify the analysis. Our findings provide new insights into the key mediators and pathways related to the molecular mechanisms of BIPF.

Circulating Tumor Cells: A Promising Biomarker in the Management of Nasopharyngeal Carcinoma.

Nasopharyngeal carcinoma (NPC) is a malignancy that arises from the mucosal epithelium of the nasopharynx, and its prognosis is relatively favorable. The 5-year overall survival rate in patients with locally advanced NPC currently exceeds 80%, but the development of individualized diagnosis and treatment at the molecular level is relatively lacking. Circulating tumor cells (CTCs) is the generic term for tumor cells that are present in the peripheral blood circulation. As a new biomarker with good clinical application prospects, the detection of CTCs has the advantages of being non-invasive, simple, and repeatable. By capturing and detecting CTCs in peripheral blood and monitoring the dynamic variation of its type and quantity, we can assess the biological characteristics of tumor in a timely manner and evaluate the therapeutic effect and prognosis of patients in advance, which will help to develop individualized treatments of tumors. The primary purposes of this review were the clinical application of CTCs in tumor stage determination, treatment efficacy evaluation, and prognosis prediction of NPC. In addition, we estimated the correlation between Epstein-Barr virus infection and CTCs and analyzed the difference in karyotypes and specific markers expressed on CTCs. We believe that our study will provide new insights and biomarkers for the individualized treatment of patients with NPC.

LncRNA RNF144A-AS1 Promotes Bladder Cancer Progression via RNF144A-AS1/miR-455-5p/SOX11 Axis.

BACKGROUND: Bladder cancer (BC) is the most commonly occurring malignant tumor of the urinary system worldwide. Long non-coding RNAs (lncRNAs), including lncRNA RNF144A-AS1 (RNF144A-AS1), perform an oncogenic role in BC progression. However, how RNF144A-AS1 is regulated in BC has not been fully investigated, and its role in BC is mostly obscure. In this study, we explore its role in BC progression. MATERIALS AND METHODS: The expression level of RNF144A-AS1 in BC tissues was explored via bioinformatics analysis and quantitative real-time PCR (qRT-PCR). We used RNF144A-AS1 siRNA (si-RNF144A-AS1) to inhibit the RNF144A-AS1 level in BC cell lines (J82 and 5637 cells). A series of experimental studies in vitro (CCK-8 assay, colony formation assay and Transwell assay) was performed to explore the role of si-RNF144A-AS1 on the proliferation, migration and invasion of J82 and 5637 cells. A BC xenograft model was established, and the effect of si-RNF144A-AS1 on xenograft growth was explored in vivo. The interactions among RNF144A-AS1, miR-455-5p and SOX11 were predicted by bioinformatics miRanda and Targetscan database, and verified by the luciferase reporter assay and RNA pull-down assay. Finally, miR-455-5p inhibitor and si-RNF144A-AS1 were cotransfected into J82 and 5637 cells. RESULTS: RNF144A-AS1 is overexpressed in BC tumors and cells, and its overexpression is correlated with poor prognosis. Knockdown of RNF144A-AS1 markedly suppressed the proliferation, migration and invasion of J82 and 5637 cells and significantly inhibited xenograft growth in nude mice, compared to si-NC. We found that RNF144A-AS1 serves as a sponge for miR-455-5p. Furthermore, a binding site of miR-455-5p was found in 3' UTR of SOX11 gene, and overexpression of miR-455-5p suppressed SOX11 levels. RNF144A-AS1 knockdown markedly decreased SOX11 expression levels, while miR-455-5p inhibitor restored this repressive effect. Restoration of SOX11 could reverse this repressive effect of RNF144A-AS1 on cell proliferation, migration and invasion abilities. CONCLUSION: Overall, our findings underline the critical role of RNF144A-AS1 in BC development, and our study reveals for the first time that RNF144A-AS1 promotes BC progression via the RNF144A-AS1/miR-455-5p/SOX11 axis.

Predictive Values of Preoperative Prognostic Nutritional Index and Systemic Immune-Inflammation Index for Long-Term Survival in High-Risk Non-Muscle-Invasive Bladder Cancer Patients: A Single-Centre Retrospective Study.

PURPOSE: This study aimed to investigate the associations between the preoperative prognostic nutritional index (PNI), systemic immune-inflammation index (SII) and overall survival (OS) and cancer-specific survival (CSS) in high-risk non-muscle-invasive bladder cancer (NMIBC) patients who received intravesical instillation of Bacillus Calmette-Guerin (BCG) after transurethral resection of bladder tumour (TURBT). PATIENTS AND METHODS: We retrospectively collected data from 387 high-risk NMIBC patients between January 2004 and December 2014. PNI was calculated as total lymphocyte count (109/L)×5+albumin concentration (g/L). SII was calculated as neutrophil count (109/L)×platelet count (109/L)/lymphocyte count (109/L). The cutoff values of PNI and SII were determined through receiver operating characteristic (ROC) analysis. OS and CSS were estimated by Kaplan-Meier analysis. The Log rank test was used to compare differences between the groups. Univariate and multivariate Cox regression analyses were performed to assess the predictive values of PNI and SII for OS and CSS. Additionally, highest-risk NMIBC patients were also divided into low or high groups according to PNI and SII. The OS and CSS of highest-risk NMIBC patients were estimated using Kaplan-Meier analysis with the Log rank test. RESULTS: The patients were divided into two groups according to the cutoff values of PNI (<50.17 vs ≥50.17) and SII (<467.76 vs ≥467.76). Kaplan-Meier analysis revealed that low PNI and high SII were associated with poorer OS and CSS in high-risk NMIBC patients. Univariate and multivariate Cox regression analyses revealed that PNI and SII were independent predictive factors for OS and CSS. Kaplan-Meier analysis also revealed that low PNI and high SII were related to poorer OS and CSS in highest-risk NMIBC patients. CONCLUSION: These results suggest that preoperative PNI and SII, based on standard laboratory measurements, may be useful noninvasive, inexpensive and simple tools for predicting the long-term survival of high-risk NMIBC patients who received intravesical instillation of BCG after TURBT.

The level of zinc finger of the cerebellum 2 is predictive of overall survival in clear cell renal cell carcinoma.

BACKGROUND: The zinc finger of the cerebellum 2 (ZIC2) has been reported to function as an oncogenic transcription factor. However, the level and prognostic value of ZIC2 in patients with clear cell renal cell carcinoma (ccRCC) remain unclear. METHODS: UALCAN was employed to analyze the level of ZIC2 mRNA in ccRCC samples compared to normal kidney tissues and to explore the impacts of ZIC2 expression according to tumor-node-metastasis (TNM) stages and histologic grades. The correlations between ZIC2 expression and clinicopathological parameters were investigated by bioinformatic analysis using UCSC Xena Browser in the light of data from The Cancer Genome Atlas. We used Kaplan-Meier analysis to assess the association between the level of ZIC2 and overall survival (OS), disease-free survival (DFS) in ccRCC patients. Moreover, Cox analyses were adopted to evaluate its prognostic value in ccRCC patients. RESULTS: ZIC2 expression was much higher in ccRCC samples than that in normal ones and increased with the escalation of TNM stages and histologic grades. In addition, the high ZIC2 expression group had significantly advanced age (age >65), T, N, M, TNM stage, histologic grade and lower 5-years OS (19.40% vs. 31.74%, P=0.006) than the low one. High ZIC2 expression was related to remarkably worse OS (P<0.001) in ccRCC patients, whereas no statistical relation was detected between the level of ZIC2 and DFS. Moreover, multivariate analysis indicated high level of ZIC2 is an independent factor of prognosis for worse OS (HR: 1.625, 95% CI, 1.146-2.302, P=0.006). CONCLUSIONS: The level of ZIC2 expression is an independent predictor for OS in ccRCC patients.

Efficacy and feasibility of day surgery using transurethral seminal vesiculoscopy under caudal block anesthesia for intractable hemospermia.

BACKGROUND: Transurethral seminal vesiculoscopy (TSV) is a safe and effective method for intractable hemospermia. It uses a natural cavity, is fast, involves little trauma, and boasts a low incidence of complications. Because uncontrollable penile erection during general anesthesia will severely influence the surgical operation or even damage the endoscope, spinal anesthesia was applied more on TSV. But spinal anesthesia extends the length of stay in the hospital and brings patients unnecessary discomfort. As the TSV is a quick recovery operation, we should think about a more suitable mode for these patients. METHODS: A total of 141 patients received TSV between January 2015 and July 2019: 81 patients received day surgery under caudal block (group A), and 60 received inpatient surgery under spinal anesthesia (group B). Operative time, postoperative hospital stay, hemospermia remission rate, magnetic resonance imaging (MRI) remission rate are compared. Visual analog scale (VAS) scores of groups were taken and compared at 2 time points: when there was pain during surgery (T1) and at the end of surgery (T2). Surgical methods of two groups are the same. RESULTS: The mean operative time of two groups are 34 min (group A) and 32 min (group B), and there was no statistical difference. Postoperative hemospermia remission rates are both 100% at 3 months, which at 6 months are 60% and 48%, and there was no statistical difference. MRI remission at 3 months are 72% and 57%, which has no statistical difference. Postoperative complications were mild in two groups like hematuria and dysuria which can relieve within one day, and there were no severe complications. Intraoperative pain was present in 18.5% (15/81) of group A. Their highest VAS score was 3 points, indicating mild pain, which did not influence the surgical process or postoperative recovery. The postoperative VAS scores were similar between the 2 groups. Group A did not require postoperative hospitalization, whereas the average postoperative hospitalization in group B was 2 days. CONCLUSIONS: Seminal vesiculoscopy can be performed as a day surgery under caudal block, which has obvious advantages in accelerating postoperative recovery and shortening the hospital stay.

Follicular dendritic cell sarcoma (FDCS) of urinary bladder with coexisting urothelial carcinoma-a case report.

BACKGROUND: Follicular dendritic cell sarcoma is a very rare bladder tumor with very few cases that have been reported in the English literature. CASE PRESENTATION: We report an unusual case of follicular dendritic cell sarcoma that is coexistent with urothelial carcinoma (UC) in the urinary bladder of a 73-year-old man, who first presented with lower abdominal pain. Microscopic examination of the first transurethral resection of bladder tumor (TURBT) sample showed a neoplasm containing spindle or ovoid-shaped cells that were arranged in storiform, nested or swirling patterns. Abundant mitotic Figs. (30 mitoses/10 high-power fields) and apoptotic bodies were present. The tumor cells were positive for CD21 and vimentin, partly positive for CD23, D2-40 and CD35. After 6 weeks, the tumor recurred lately, which surprisingly contained a component of urothelial carcinoma. The first TURBT sample was then reviewed and a coexisting UC mixed with FDCS was identified by examining the deeper levels of the tumor blocks. CONCLUSIONS: This case is, to our knowledge, the first time to report the coexistence of FDCS and UC in the urinary bladder of an elderly patient. And these two tumors may share a similar molecular mechanism.

A comparison of clinical outcomes between simultaneous integrated boost (SIB) versus sequential boost (SEQ) intensity modulated radiation therapy (IMRT) for head and neck cancer: A meta-analysis.

BACKGROUND: The optimal intensity modulated radiation therapy (IMRT) technique for head and neck cancer (HNC) has not been determined yet. The present study aimed to compare the clinical outcomes of the simultaneous integrated boost (SIB)-IMRT versus the sequential boost (SEQ)-IMRT in HNC. METHODS: A meta-analysis of 7 studies involving a total of 1049 patients was carried out to compare the treatment outcomes together with severe acute adverse effects of the SIB-IMRT versus the SEQ-IMRT in HNC patients. RESULTS: Comparison of the SIB-IMRT and SEQ-IMRT showed no significant difference in the measurement of overall survival (OS) (hazard ratio [HR] 0.94; 95% confidence inerval [CI], 0.70-1.27; P = .71), progression free survival (PFS) (HR 1.03; 95% CI, 0.82-1.30; P = .79), locoregional recurrence free survival (LRFS) (HR 0.98; 95% CI, 0.65-1.47; P = .91), and distance metastasis free survival (DMFS) (HR 0.87; 95% CI, 0.50-1.53; P = .63). Moreover, there were no significant differences in adverse effect occurrence between the SIB-IMRT and SEQ-IMRT groups. CONCLUSION: SIB-IMRT and SEQ-IMRT can provide comparable outcomes in the treatment of patients afflicted by HNC. Both IMRT techniques were found to carry a similar risk of severe acute adverse effect. SIB-IMRT may have advantages due to its convenience and short-course of treatment; however, the optimum fractionation and prescribed dose remained unclear. Furthermore, both IMRT techniques can be advocated as the technique of choice for HNC. Treatment plan should be individualized for patients.

Injecting RNA interference lentiviruses targeting the muscarinic 3 receptor gene into the bladder wall inhibits neurogenic detrusor overactivity in rats with spinal cord injury.

AIMS: To investigate the effects of injecting RNA interference (RNAi) lentiviruses targeting the muscarinic 3 (M3 ) receptor gene into the bladder wall on bladder activity in rats with spinal cord injury (SCI). METHODS: Four M3 RNAi lentiviruses were constructed and used to infect primary cultured bladder smooth muscle cells (BSMCs). Western blotting and quantitative reverse transcription polymerase chain reaction (qRT-PCR) were performed to determine the optimal RNAi lentivirus with the highest interference efficiency. Female Wistar rats were subjected spinal cord transection at T9-10 and randomly divided into three groups (n = 8), namely, blank control, negative control, and experimental groups, and injected into the bladder wall with saline, negative control shRNA, and M3 RNAi lentiviruses, respectively, 1 week after spinal cord transection. The normal rats were used as normal control group. Urodynamic parameters and bladder tissues were evaluated in the different groups. RESULTS: An M3 RNAi lentivirus with the highest interference efficiency (78.9%) was constructed and identified. Three weeks after injecting M3 RNAi lentiviruses into the bladder wall, Western blotting and qRT-PCR showed that the M3 receptor was significantly downregulated in the experimental group. Cystometric evaluation suggested that downregulating M3 receptor expression could substantially decrease basal pressure, residual volume, and non-voiding contraction number, increase intercontraction interval, and significantly improve bladder compliance in rats with SCI. CONCLUSION: Injecting RNAi lentiviruses targeting the M3 receptor gene into the bladder wall could effectively inhibit neurogenic detrusor overactivity (NDO) due to SCI. Thus, this approach may be a potential treatment for NDO in SCI.

Intake of Non-steroidal Anti-inflammatory Drugs and the Risk of Prostate Cancer: A Meta-Analysis.

Background: Epidemiological evidences regarding the association between the use of non-steroidal anti-inflammatory drugs (NSAIDs) and the risk of prostate cancer (PC) is still controversial. Therefore, we conducted a meta-analysis to explore the controversy that exists. Methods: Electronic databases including Medline, EMBASE, Web of Science, Cochrane Library, BIOSIS, Scopus, CBM, CNKI, WANFANG, and CQVIP were used to search for and identify eligible studies published until December 31, 2017. Pooled effect estimates for the relative risk (RR) were computed through fixed-effects or random-effects models as appropriate. Publication bias was evaluated by Egger's and Begg's tests and potential sources of heterogeneity were investigated in subgroup analyses. Results: A total of 43 observational studies were eligible for this meta-analysis. A protective effect was identified for the intake of any NSAIDs on the risk of PC (pooled RR = 0.89, 95% CI = 0.81-0.98). Moreover, the long-term intake of NSAIDs (≥5 years rather than ≥4 years) was associated with reduced PC incidence (pooled RR = 0.882, 95% CI = 0.785-0.991). Aspirin intake was also associated with a 7.0% risk reduction of PC (pooled RR = 0.93, 95% CI = 0.89-0.96). The inverse association became stronger for advanced PC and PC with a Gleason score ≥7 compared to the association with total PC. Interestingly, it was the daily dose (≥1 pill/day) rather than, long-term aspirin intake (≥4 or ≥5 years) that was associated with reduced PC incidence (pooled RR = 0.875, 95% CI = 0.792-0.967). The pooled effects for non-aspirin NSAIDs demonstrated no significantly adverse or beneficial effects on total PC, advanced PC, or PC with Gleason score ≥7, though all pooled RRs were >1. Conclusions: Our findings suggested a protective effect of the intake of any NSAIDs on the risk of PC, especially in those who took the NSAIDs for a long period. Moreover, aspirin intake was also associated with a decreased risk of PC, and there was a dose related association between aspirin intake and the risk of PC, while no significant effects of long-term aspirin intake were found on the PC incidence.

An In Vitro and Numerical Study of Moxibustion Therapy on Biological Tissue.

OBJECTIVE: Moxibustion therapy achieves satisfactory therapeutic effects largely depending on the heat stimulation of burning moxa. Understanding the thermal characteristics of heating process is an effective way to reveal the underlying mechanisms of moxibustion therapy. METHODS: This paper performs experimental study on temperature distributions of burning moxa sticks and fresh in vitro porcine abdominal tissue using an infrared camera and thermocouples. Meanwhile, a moxibustion model incorporating moxa stick burning model and tissue heat transfer model was established with consideration of radiation propagation and water evaporation. RESULTS: The burning features of moxa sticks were acquired and the radiation energy generated by the burning moxa stick was absorbed and scattered in biological tissue, resulting in a large temperature gradient in the skin layer. And the water evaporation led to a mass loss and reduced skin surface temperature. The numerical model was verified by experimental results and the effects of moxibustion treatment distance and duration can be quantified based on model calculation. CONCLUSION: The detailed heat transfer process of moxibustion was obtained experimentally and numerically. During moxibustion, the radiation attenuation and water evaporation have a significant influence on the energy transport in biological tissue which cannot be ignored. The treatment distance of 3 cm is the recommended value to achieve the treatment efficacy without thermal damage and pain. SIGNIFICANCE: This research would reveal the underlying mechanisms of moxibustion therapy. Besides, the developed models are expected to establish a guideline for moxibustion clinical treatment.

Comparison between extracorporeal shock wave lithotripsy and ureteroscopic lithotripsy for treating large proximal ureteral stones: a meta-analysis.

OBJECTIVE: To compare extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic lithotripsy (URSL) in terms of efficacy, complications, and overall efficiency in the management of proximal ureteral calculi. ESWL and URSL are the 2 most common modalities for treating ureteral stones. Previous studies and meta-analyses suggest that for stones <10 mm, ESWL is safer and of comparable efficacy compared with URSL. However, the choice between one modality over the other for the treatment of stones >10 mm is not as clear. METHODS: The literature was reviewed in the databases, and resulting reports were screened for relevance. This process yielded 10 articles, which were analyzed in terms of the initial stone-free rate (primary outcome measure) compared between the 2 treatment modalities. Pretreatment rate, operation time, auxiliary procedure rate, and complication rate constituted secondary measures in the analysis. RESULTS: A statistically higher initial stone-free rate was demonstrated for URSL compared with ESWL (odds ratio [OR] = 0.349; 95% confidence interval [CI] = 0.183-0.666; P = .001). ESWL showed a statistically higher retreatment rate compared with URSL (OR = 7.192; 95% CI = 4.934-10.482; P <.001). The 2 treatment modalities did not show statistically significant differences in mean operating time (OR = 10.35; 95% CI = -0.29 to 20.99; P = .056), auxiliary procedure rate (OR = 1.043; 95% CI = 0.415-2.616; P = .929), or in the complication rate (OR = 0.78; 95% CI = 0.304-1.984; P = .598). CONCLUSION: For treating large (>10 mm) proximate ureteral stones, URSL tends to be more effective than ESWL, yet without adding significant risk.

Preliminary experience of laparoscopic renal artery aneurysm clipping surgery.

Developments in endovascular therapy and laparoscopy have led to the expansion of minimally invasive surgical techniques in the treatment of renal artery aneurysm (RAA). In this study, we introduced a new surgical technique that combined the clipping technique widely used in neurosurgery with laparoscopic surgery to clip the aneurysm. RAA clipping was performed by retroperitoneal laparoscopy, and the procedures were completed with no conversions to open surgery. In addition, no perioperative complications were recorded. Our preliminary experience suggests that laparoscopic RAA clipping surgery is feasible and appears to be safe. Laparoscopic RAA clipping surgery has advantages of a simplified surgical process, short warm ischemia time, and excellent cosmetic results.