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BACKGROUND@#Bladder cancer, characterized by a high potential of tumor recurrence, has high lifelong monitoring and treatment costs. To date, tumor cells with intrinsic softness have been identified to function as cancer stem cells in several cancer types. Nonetheless, the existence of soft tumor cells in bladder tumors remains elusive. Thus, our study aimed to develop a micro-barrier microfluidic chip to efficiently isolate deformable tumor cells from distinct types of bladder cancer cells.@*METHODS@#The stiffness of bladder cancer cells was determined by atomic force microscopy (AFM). The modified microfluidic chip was utilized to separate soft cells, and the 3D Matrigel culture system was to maintain the softness of tumor cells. Expression patterns of integrin β8 (ITGB8), protein kinase B (AKT), and mammalian target of rapamycin (mTOR) were determined by Western blotting. Double immunostaining was conducted to examine the interaction between F-actin and tripartite motif containing 59 (TRIM59). The stem-cell-like characteristics of soft cells were explored by colony formation assay and in vivo studies upon xenografted tumor models.@*RESULTS@#Using our newly designed microfluidic approach, we identified a small fraction of soft tumor cells in bladder cancer cells. More importantly, the existence of soft tumor cells was confirmed in clinical human bladder cancer specimens, in which the number of soft tumor cells was associated with tumor relapse. Furthermore, we demonstrated that the biomechanical stimuli arising from 3D Matrigel activated the F-actin/ITGB8/TRIM59/AKT/mTOR/glycolysis pathways to enhance the softness and tumorigenic capacity of tumor cells. Simultaneously, we detected a remarkable up-regulation in ITGB8, TRIM59, and phospho-AKT in clinical bladder recurrent tumors compared with their non-recurrent counterparts.@*CONCLUSIONS@#The ITGB8/TRIM59/AKT/mTOR/glycolysis axis plays a crucial role in modulating tumor softness and stemness. Meanwhile, the soft tumor cells become more sensitive to chemotherapy after stiffening, that offers new insights for hampering tumor progression and recurrence.
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Animals , Mice , Humans , Proto-Oncogene Proteins c-akt/metabolism , Actins/metabolism , Neoplasm Recurrence, Local , TOR Serine-Threonine Kinases/metabolism , Urinary Bladder Neoplasms , Glycolysis , Cell Line, Tumor , Cell Proliferation , Mammals/metabolism , Tripartite Motif Proteins/metabolism , Intracellular Signaling Peptides and Proteins/metabolism , Integrin beta ChainsABSTRACT
Diabetic nephropathy （DN）， a major cause of chronic kidney disease （CKD）， aggravates the prevalence of end-stage renal disease （ESRD） and threatens human health. The pathogenesis of DN is complex， in which inflammation is a key pathological link in the cascade injury. Therefore， the treatment targeting inflammation helps to delay the progression of DN. NOD-like receptor protein 3 （NLRP3）， a classical proteasome， acts as an inducer of innate immune responses. The activated NLRP3 inflammasomes produce and release inflammatory mediators to trigger pyroptosis and uncontrolled autophagy and mediate the stress signals promoting renal fibrosis， thus participating in the development and progression of DN. The NLRP3 inflammasome as a core site inducing inflammation is widely involved in DN progression and may be a novel target. The active components and compound prescriptions of Chinese medicines are increasingly applied in the prevention and treatment of DN. The latest studies have discovered that Chinese medicines can treat DN by regulating the activation of NLRP3 inflammasomes. Although studies have been conducted to explore the mechanism of Chinese medicines in the treatment of DN via NLRP3 inflammasome， the systematic review remains to be carried out. This paper reviews the relevant publications in recent years and introduces the research progress from the assembly and activation of NLRP3 inflammasomes， the mechanism of NLRP3 inflammasomes in the treatment of DN， and the regulation of NLRP3 inflammasomes by Chinese medicines for the prevention and treatment of DN， aiming to lay a foundation for the relevant studies and provide new targets and strategies for the prevention and treatment of DN.
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The ASCO-GU 23 conference was held offline as scheduled after the pandemic. A total of 167 abstracts in the field of renal cell carcinoma has been posted during the conference, covering the first PET/CT diagnostic technology targeting tumors in renal cell carcinoma, risk stratified interpretation of the previous clinical trial results, and exploring the value of tumor and serum biomarkers for precise classification therapy, as well as providing evidence for the therapeutic scheme sequencing.
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【Objective】 To explore the impacts of groove negative pressure drainage on the short-term prognosis of patients with transperineal anastomotic urethroplasty. 【Methods】 A retrospective case-control study was conducted to analyze the clinical data of 78 patients who underwent transperineal anastomotic urethroplasty during May 2021 and Apr.2022, including 42 patients in the groove negative pressure drainage group (experimental group) and 38 in the rubber strip drainage group (control group). The postoperative drainage volume, rate of scrotal edema, rate of infection, visual analog scale (VAS) score, and maximum urine flow rate were compared between the two groups. 【Results】 Compared with the control group, the experimental group had a longer length of incision [ (12.9±1.6)cm vs. (12.1±1.5)cm, P=0.041] and larger drainage volume 3 days after surgery [(66.1±51.9)mL vs. (36.0±16.9)mL, P=0.001] , but lower rate of scrotal edema (21.4% vs.47.2%, P=0.016) and lower VAS score (3.2±1.0 vs.3.9±1.1, P=0.008). There were no significant differences in the infection rate 7 days after surgery and the maximum urine flow rate 1 month after surgery (P>0.05). 【Conclusion】 Groove negative pressure drainage can be used to drain the effusion of perineum tissue adequately and decrease wound-specific complications, which is beneficial to the rapid recovery after transperineal anastomotic urethroplasty.
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ASCO-GU is one of the landmark meetings of urogenital cancer. Within 2022 meeting, the extended follow up result of adjuvant pembrolizumab after nephrectomy in renal cell carcinoma as well as the efficacy and safety of neoadjuvant Axitinib and avelumab for local advanced renal cell carcinoma have been released. There were also explorations in local therapy for oligometastasis, novel combination system therapy and regiments alterations. The further research protocol of immunostimulatory IL-2 cytokine prodrug and PARP inhibitor for metastatic RCC were also disclosed.
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Objective:To investigate the efficacy of the biopsy strategy combining 6-core systematic and 3-core MRI-targeted biopsy on prostate cancer (PCa) detection in biopsy-na?ve patients.Methods:The clinical data of 121 biopsy-na?ve patients who underwent transperineal prostate biopsy in West China Hospital of Sichuan University from July 2018 to January 2020 were retrospectively analyzed. The average age was (64.7±9.1) years old. Pre-biopsy prostate-specific antigen (PSA) was (12.4±7.5)ng/ml, f/t PSA was 0.13±0.05. Prostate volume was (43.1±26.1) ml and PASD was (0.35±0.27) ng/ml 2. The prostate-imaging and data system (PI-RADS) score of MRI before biopsy was reported to be 3 for 29 patients (24.0%), 4 for 54 patients (44.6%) and 5 for 38 patients (31.8%). All 121 patients underwent 12-core systematic biopsy combined with a 3-core or 5-core MRI-targeted biopsy, of which 61 patients underwent 3-core targeted biopsy and 60 underwent 5-core targeted biopsy. There was no significant difference in the pre-biopsy clinical data between the two groups ( P>0.05). A 6-core systematic biopsy was redefined as the results of 6 cores among the 12-core systematic biopsy. We compared the detection rates among the single 12-core systematic biopsy, 6-core systematic biopsy, MRI-targeted biopsy (3-core or 5-core), and different systematic biopsy combing with targeted biopsy for any PCa and clinically significant PCa, and we also analyzed the cumulative cancer detection rates for MRI-targeted biopsy of different cores. Results:Of the 121 patients in this study, the biopsy results were negative for 43 patients (35.5%) and positive for 78 (64.5%). The detection rate of clinically significant PCa was 55.4% (67/121). The detection rate of the 6-core systematic biopsy combined with MRI-targeted biopsy was 62.0% (75/121) for PCa and 55.4% (67/121) for clinically significant PCa, which was of no difference compared with that for the 12-core systematic biopsy combined with MRI-targeted biopsy ( P>0.05), but the 6-core systematic biopsy combined with MRI-targeted biopsy avoided the overdiagnosis of 3 patients with Gleason score 3+ 3. The detection rate of PCa for MRI-targeted biopsy was 57.9% (70/121), including 42.1% (51/121) for the first core, 55.4% (67/121) for the first two cores, and 57.9% (70/121) for the first three cores. Compared with the single-core targeted biopsy for suspicious lesions, the first 2-core targeted biopsy ( OR=1.7, 95% CI 1.0-2.8) and 3-core targeted biopsy ( OR=1.9, 95% CI 1.1-3.1) can significantly increase the detection rate of PCa, while the fourth or fifth core of targeted biopsy can not increase the detection rate additionally (60%, 36/60). Conclusion:For patients with suspected PCa, the prostate biopsy strategy combing 6-core systematic and 3-core MRI-targeted biopsy performs no inferior than the current 12-core systematic biopsy combined with MRI-targeted biopsy.
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Objective:To explore the value of single nucleotide polymorphism for molecular warning of hypertensive intracerebral hemorrhage in Li Nationality in Hainan.Methods:Totally 56 patients with hypertensive intracerebral hemorrhage of Li Nationality in Hainan Province, 100 healthy controls of Li nationality and 203 healthy controls of Han nationality in Hainan Province from January 2019 to October 2020 were selected as the research subjects.After genomic DNA was extracted, rs2494739, rs2494744 and rs2498794 of AKT1 gene were genotyped and analyzed by SPSS 25.0 to explore the differences between Han and Li Nationality, and between Li healthy population and intracerebral hemorrhage population.Results:There was no difference in the frequencies of rs2498794, rs2494739 and rs2494744 polymorphisms of AKT1 gene among Han and Li healthy controls ( P>0.05). The rates of AA, AG and GG at rs2498794 locus in Li Nationality patients with intracerebral hemorrhage (14.28%, 39.29% and 46.43%) were significantly different from those of Li control group (44.00%, 47.00% and 9.00%)( P<0.05). The distribution rates of AA, AG and GG of rs2494744 in Li Nationlity patients with intracerebral hemorrhage were 57.14%, 37.50% and 5.36%, respectively, which were statistically significant compared with the control group (20.00%, 44.00% and 36.00%) ( P<0.05). The incidence of CC, CT and TT at rs2494739 locus in Hainan Li Nationality patients were 14.28%, 46.43% and 39.29% respectively, which were also significantly different from those in Li control group(34.00%, 41.00% and 25.00%) ( P<0.05). The incidence of rs2494744-A in intracerebral hemorrhage group (75.89%) was much higher than that in Li control group (42.00%), and the OR value of rs2494744-A was 4.35.The incidence of rs2498794-G in intracerebral hemorrhage group and control group were 66.07% and 32.50%, respectively, and the OR was 4.04.Alleles rs2494744-A and rs2498794-G were moderately associated with the incidence of intracerebral hemorrhage ( P<0.05). Conclusion:rs2494744-AA, rs2498794-GG and alleles rs2494744-A and rs2498794-G are the risk factors of HICH in Li nationality, which is of great value to the construction of its molecular early warning system.
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Purpose@#Drug resistance is one of the main causes of chemotherapy failure in patients with small cell lung cancer (SCLC), and extensive biological studies into chemotherapy drug resistance are required. @*Materials and Methods@#In this study, we performed lncRNA microarray, in vitro functional assays, in vivo models and cDNA microarray to evaluate the impact of lncRNA in SCLC chemoresistance. @*Results@#The results showed that KCNQ1OT1 expression was upregulated in SCLC tissues and was a poor prognostic factor for patients with SCLC. Knockdown of KCNQ1OT1 inhibited cell proliferation, migration, chemoresistance and promoted apoptosis of SCLC cells. Mechanistic investigation showed that KCNQ1OT1 can activate transforming growth factor-β1 mediated epithelial-to-mesenchymal transition in SCLC cells. @*Conclusion@#Taken together, our study revealed the role of KCNQ1OT1 in the progression and chemoresistance of SCLC, and suggested KCNQ1OT1 as a potential diagnostic and prognostic biomarker in SCLC clinical management.
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Objective:To investigate the association between rs2494739 polymorphism of the AKT1 gene and cerebral infarction in the Han and Li ethnic groups in Hainan.Methods:A total of 143 cases of cerebral infarction and 197 healthy controls from the Han ethnic group, and 93 cases of cerebral infarction and 75 healthy controls from the Li ethnic group were enrolled.Genomic DNA was collected from peripheral blood.Rs2494739 polymorphisms were detected with the Snapshot technology, and SPSS 25.0 was used for statistical analysis.Results:The CC, CT and TT genotypes of rs2494739 were found in both the Han and Li ethnic groups, and their frequencies of distribution were 19.6%, 51.7% and 28.7% in the Han cases and 20.3%, 51.8% and 27.9% in the Han controls, whereas the frequencies were 19.3%, 45.2% and 35.5% in the Li cases and 33.3%, 42.7% and 24.0% in the Li controls, conforming to the Hardy-Weinberg equilibrium( P>0.05). The detection rate of genotype CC in the Li healthy controls was significantly higher than that in the Han controls( P<0.05), while no statistical difference was found between the Han and Li cases( P>0.05). The codominance hereditary model showed rs2494739 polymorphisms were not associated with cerebral infarction in the Han and Li ethnic groups( P=0.981 and 0.081, respectively)in Hainan.Further analysis revealed that the distribution frequency of genotype CC in the Li control group was significantly higher than that in the Li patient group( P=0.039, OR=0.48, 95% CI: 0.237~0.970). The distribution frequency of the T allele in the cases was significantly higher than that in the controls( P=0.020, OR=1.67, 95% CI: 1.082-2.576). Conclusions:Healthy Han and healthy Li ethnic groups in Hainan show differences in polymorphisms of rs2494739, which are not associated with the occurrence and development of cerebral infarction in the Hainan Han population.The CC genotype is a protective factor for the Li ethnicity from cerebral infarction and the T allele may be a susceptibility factor for cerebral infarction for the Li ethnicity in Hainan.
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Objective:To investigate the early warning effect of two polymorphisms of AKT1 gene (rs1130214, rs2494744) on the risk of atherosclerotic cerebral infarction in Hainan province.Methods:In this study, totally 243 patients with atherosclerotic cerebral infarction who were hospitalized of Hainan Province from January 2019 to October 2020 were selected as the cerebral infarction group, including 148 Han nationality people and 95 Li nationality people. And 272 healthy people who received physical examination in the same hospital during the same period were selected as the control group, including 197 Han nationality people and 75 Li nationality people.All participants signed informed consent. The peripheral anticoagulant DNA was collected, and the genomic DNA was extracted and amplified by PCR.The genotypes of rs1130214 and rs2494744 were analyzed by mass spectrometry, and the distribution frequency of genotypes in cerebral infarction group and control group was analyzed by Chi-square test with SPSS 25.0 software.Results:Regardless of nationality, there was no significant difference in the distribution frequency of rs1130214 and rs2494744 of AKT1 gene between cerebral infarction group and control group (both P>0.05). The frequencies of AA, AG and GG genotypes of rs2494744 locus were 44.59%, 51.36% and 4.05% in the cerebral infarction group of Han nationality, while they were 47.21%, 42.13% and 10.66% in the control group of Han nationality, with significant difference between the two groups(χ 2=6.396, P<0.05). The independent effects of the three genotypes were analyzed by regression analysis. The results showed that GG genotype might be a resistance factor of cerebral infarction in Han population ( P=0.024, OR=0.354, 95% CI: 0.139-0.901). The frequency of AA, AG and GG genotypes of rs2494744 was 58 (61.05%), 25 (26.32%), 12 (12.63%) in the control group of Li nationality, and 28 (37.33%), 39 (52.00%), 8 (10.67%) in the control group of Li nationality. The results showed that the distribution of AA was significantly higher than that of the control group ( P<0.05, OR= 2.631, 95% CI=1.410-4.09), while AG was on the contrary ( P<0.05, OR=0.330, 95% CI=0.173-0.627). Conclusion:AA genotype of rs2494744 in AKT1 gene polymorphism is a risk factor for cerebral infarction in Li nationality group, which has potential early warning value for cerebral infarction in Hainan Li nationality group, while AG has protective effect on cerebrovascular health in Hainan Li nationality group.
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Objective:To investigate the value of serum microRNA-92a (miR-92a) and microRNA-146a (miR-146a) expression levels combined with lung ultrasound score (LUS) in predicting the severity and prognosis of acute respiratory distress syndrome (ARDS).Methods:116 patients with ARDS admitted to Danzhou People's Hospital from January 2017 to March 2020 were enrolled. On the day of admission, the expression levels of serum miR-92a and miR-146a were detected by real-time fluorescent quantitative reverse transcript-polymerase chain reaction (RT-PCR), and pulmonary ultrasound examination was performed in 12 lung regions, with the total score as LUS score. The difference of each index was analyzed among the ARDS patients with different 28-day prognosis (survival group and death group) and different severity [mild group: 200 mmHg < oxygenation index (OI) ≤ 300 mmHg (1 mmHg = 0.133 kPa), moderate group: 100 mmHg < OI≤200 mmHg, severe group: OI≤100 mmHg]. Multivariate Logistic regression was used to analyze the risk factors of death in patients with ARDS. Receiver operating characteristic (ROC) curve was drawn to analyze the value of miR-92a and miR-146a combined with LUS score in predicting the death of patients with ARDS.Results:116 ARDS patients were included, 39 cases in the death group, 77 cases in the survival group; 20 cases in the mild group, 38 cases in the moderate group and 58 cases in the severe group. The expression levels of serum miR-92a, miR-146a and LUS score in the death group were significantly higher than those in the survival group [miR-92a (2 -ΔΔCt): 3.75±1.64 vs. 2.10±0.78, miR-146a (2 -ΔΔCt): 1.93±0.72 vs. 0.76±0.20, LUS score: 25.80±4.75 vs. 13.40±3.60, all P < 0.01]. With the aggravation of ARDS patients, the expression levels of serum miR-92a and miR-146a and LUS score gradually increased ( F values were 8.115, 6.740 and 6.216 respectively, all P < 0.01). The expression levels of serum miR-92a, miR-146a and LUS score in severe group were significantly higher than those in the moderate group and mild group [miR-92a (2 -ΔΔCt): 3.65±1.62 vs. 2.87±1.16, 1.94±0.68; miR-146a (2 -ΔΔCt): 1.85±0.58 vs. 1.30±0.51, 0.68±0.17; LUS score: 24.15±4.65 vs. 18.60±4.20, 12.20±3.15, all P < 0.01]. Multivariate Logistic regression analysis showed that low OI [odds ratio ( OR) = 2.748, 95% confidence interval (95% CI) was 1.913-6.225, P = 0.024], high LUS score ( OR = 1.685, 95% CI was 1.183-2.758, P = 0.016), high expression levels of serum miR-92a ( OR = 2.560, 95% CI was 1.806-5.627, P < 0.001) and miR-146a ( OR = 1.984, 95% CI was 1.375-3.816, P = 0.008) were independent risk factors for the death of ARDS patients. ROC curve analysis showed that the area under ROC curve (AUC) of patients with ARDS predicted by miR-92a and miR-146a combined with LUS score was significantly higher than that predicted by the three alone (0.918 vs. 0.842, 0.825, 0.807, all P < 0.01), and the sensitivity (94.0%) and specificity (85.2%) were higher. Conclusion:The expression levels of serum miR-92a, miR-146a and LUS score are related to the severity and prognosis of the patients with ARDS, and the combination of the three indicators has better value in predicting the prognosis of the patients with ARDS.
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Objective:To investigate the ultrasonographic features of thyroid lymphoma and its different pathological types.Methods:The clinical manifestations and sonographic findings were analyzed retrospectively in 30 patients with pathological confirmed thyroid lymphoma from January 2014 to November 2019 in Ruijin Hospital Affiliated to the Shanghai Jiao Tong University of Medicine. Ultrasonographic features of different pathological types of thyroid lymphoma were compared.Results:There were 30 patients included in the study. All the lesions were pathologically diagnosed as diffuse large B-cell lymphoma(17/30, 56.7%), mucosa-associated lymphoma(8/30, 26.7%), follicular lymphoma(3/30, 10.0%), gray zone lymphoma(1/30, 3.3%), and lymphoblastic lymphoma(1/30, 3.3%). Clinical features included short-term neck enlargement (60.0%), with compression symptoms (46.7%), Ⅲ/Ⅳ cervical region lymphadenopathy (63.3%), thyroid dysfunction (10.0%), combined with Hashimoto′s thyroiditis (63.3%). Statistical differences were found in the longitudinal diameter of the lesion ( P=0.036), ultrasonographic features ( P=0.036), and the margin of the lesion ( P=0.005) between diffuse large B-cell lymphoma and mucosa-associated lymphoid tissue lymphoma.Ultrasonographic features ( P=0.005) and lesion edges ( P=0.020) differed significantly between different aggressiveness. Conclusions:Patients with Hashimoto′s who have noticed a short-term enlargement of extremely low echogenic mass in the thyroid gland and lymphadenopathy in the neck Ⅲ/Ⅳ region should be suspected of having thyroid lymphoma. Very low echo lesions with irregular edges and flaky hyperechoes are characteristic features of diffuse large B cell lymphoma, and very low echo lesions with rims and grid echoes are characteristics of mucosa-associated lymphoma.
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Objective To analyze the clinical outcome of definitive perineal urethrostomy for the treatment of complex adult anterior urethral strictures.Methods From June 2012 to February 2018,28 patients who underwent the definitive perineal urethrostomy for a complex anterior urethral stricture were retrospectively reviewed.The mean age of the patients was 62.3 (range 34 to 77) years and stricture etiology was lichen sclerosus in 46.4％ (13/28) of the cases,iatrogenic stricture after transurethral resection of the prostate in 35.7％ (10/28),failed hypospadias repair in 10.7％ (3/28),infection 3.6％ (1/28)and idiopathic etiology 3.6％ (1/28).The mean stricture length was 9.6 (range 4.5 to 16.0) cm and the stricture length ＜5 cm in 7.1％ (2/28) of the cases,5-10 cm in 35.7％ (10/28) and ＞ 10 cm in 57.1％ (16/28).0f28 patients 21 (75％) underwent prior urethral dilation,4 (14.3％) underwent direct vision internal urethrotomy (DVIU) and 17 (60.7％) underwent urethroplasty.Among the medical history of interest,hypertension was observed in 17 patients (60.7％),chronic ischemic heart disease in 11 patients (39.3％),diabetes mellitus in 9 patients (32.1％) and chronic obstructive pulmonary disease (COPD) in 9 patients (32.1％).All patients completed the perineal urethrostomy with inverted U-shaped perineal skin flap.The patient was placed in a normal lithotomy position and an inverted U-shaped perineal incision was made.We can get an inverted U-shaped perineal skin flap after dissecting along the bulbospongiosus muscle.The bulbar urethra was opened along the ventral surface and the margins of the spongiosum tissue were closed with perineal skin flap.We analyzed the clinical characteristics of the patients,the outcome of the technique and investigated the satisfaction rates of the patients by outpatient follow-up or telephone interview.Surgical success was defined as functional voiding without the need for further procedures.Results The perioperative complications included 3 cases of urinary tract infection,1 case of bleeding and 1 case of wound dehiscence.Mean follow-up length was 27.2 (range 6.0 to 64.0)months.Of 28 cases 26 (92.9％) were successful and the mean maximum urinary flow rate was 26.5 (range 17.0 to 40.0) ml/s.Postoperatively,2 cases of urethrostomy strictures were found in 2 months and 4 months,respectively.They required periodic outpatient dilation and the younger one was in the waiting list for revision of the perineostomy and the older one refused the revision.Of 28 patients 24 (85.7％) were satisfied with the results obtained with surgery,15 were very satisfied,9 cases satisfied and 4 cases dissatisfied.Conclusions The successful rate of the definitive perineal urethrostomy for the complex adult anterior urethral strictures was high and patients were satisfied with the outcome of the surgery.The definitive perineal urthrostomy is a well-tolerated treatment option for patients with complex anterior urethral strictures,especially for those aged and with extensive comorbidities.
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Autoimmune diseases (ADs) increase the risk of non-Hodgkin's lymphoma and contribute to poor prognosis of patients. However, the association between immunologic markers and clinical outcome has rarely been investigated. This study aims to analyze the prognostic value of pretreatment immunologic markers in newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL). We retrospectively reviewed the data on 502 patients with DLBCL treated in our institution from January 2013 to March 2018. Survival functions were estimated using Kaplan-Meier method and Cox regression model. The 3-year progression free survival (PFS) and overall survival (OS) rates were 70.2% and 80.9%, respectively, and the complete remission (CR) rate was 78.1%. Among the patients, those with multiple ( ⩾ 3) abnormal immunologic markers had significantly shorter 3-year PFS (52.7% vs. 77.3%, P 60 years for OS (P = 0.014). In conclusion, the immunologic status was closely related to lymphoma progression, and this study provides new insights into the risk stratification of patients with DLBCL.
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Biomarkers , China , Disease Progression , Immunotherapy , Methods , Lymphoma, Large B-Cell, Diffuse , Mortality , Therapeutics , Multivariate Analysis , Prognosis , Retrospective Studies , Survival Analysis , Survival RateABSTRACT
Objective To analyze the characteristics of nerve damage in diabetic peripheral neuropathy by ultrasound and neuroelectrophysiological techniques and provide a basis for early diagnosis and treatment of diabetic peripheral neuropathy. Methods From January 2016 to May 2018, 225 patients with type 2 diabetes admitted to the hospital were divided into DPN group (110 cases) and non-diabetic peripheral neuropathy (NDPN) group (115 cases),and 120 healthy volunteers were as controls. Ultrasound and nerve conduction velocity(NCV) were used to analyze the characteristics of nerve damage in diabetic peripheral neuropathy(DPN). Results Among the three study groups, the sensory nerves conduction velocity and motor nerves conduction velocity of the ulnar nerve, median nerve, and common peroneal nerve were significantly reduced in the DPN group. But in the same group,the ulnar nerve, median nerve, and common peroneal nerve cross-sectional area (CSA) was significantly increased [(8.68 ± 1.89) mm2 vs. (6.79 ± 1.69) and (5.82 ± 1.57) mm2, (10.59 ± 1.82) mm2 vs. (7.98 ± 1.97) and (7.25 ± 1.71) mm2, (21.24 ± 2.53 )mm2 vs. (16.54 ± 2.49) and (15.40 ± 2.20) mm2]. In the measurement of sensory nerve conduction velocity, the abnormalities of ulnar nerve, median nerve and common peroneal nerve were significantly higher than thoseof motor nerve [34.54%(38/110) vs. 18.18%(20/110), 36.36% (40/110)vs. 20.90% (23/110), 52.72% (58/110) vs. 20.00% (22/110)]. In ultrasound and SCV, the proportion of ulnar nerve and median nerve injury was higher in patients aged 45 years or older or patients over 10 years of course (P<0.05). The proportion of median nerve injury was higher in patients with larger MAGE (P < 0.05). In the abnormal performance of ultrasound: the proportion of abnormal ulnar nerve, median nerve and common peroneal nerve in patients with large MAGE was significantly higher than that in patients with small MAGE (P<0.05); the results of ultrasound measurement of CSA showed that the ulnar nerve, median nerve and common peroneal nerve thickening were more obvious in patients with MAGE>4 mmol/L. Conclusions DPN affects sensory nerves first, and the proportion of injury is significantly higher than that of motor nerves; lower limb nerves are more susceptible to damage, compared with upper limb nerves; patients aged 45 years or older or patients with course over 10 years have a higher proportion of ulnar nerve and median nerve damage; patients with larger MAGE (>4 mmol/L) have a higher proportion of median nerve damage. The characteristics above can provide an effective basis for the prevention, diagnosis and treatment of DPN.
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Objective To investigate the expression of Sirtuin1 (SIRT1) in brain tissue of rats with different doses of fluorosis-induced brain injury.Methods Forty-eight clean SD rats were divided into 4 groups based on body weight (90-100 g) via the random number table method:the control group (normal feed containing fluoride 4.5 mg/kg),low fluoride groups (feed containing fluoride 25.0 mg/kg),middle fluoride groups (feed containing fluoride 50.0 mg/kg),high fluoride groups (feed containing fluoride 100.0 mg&g),twelve rats in each group,half male and half female.Rats in each group drank tap water freely.Low,middle and high fluorine groups were free to eat the designated different formulations of raw coal and mixed peat baked corn feed,other feed ingredients were the same as those in control group,the rats were sacrificed at 90 d of fluorine exposure.At 7 d before the rats were sacrificed,Morris water maze and platform experiment were employed to test the ability of learning and memory in rats.Take the brain tissue and thigh long bones after the rats were sacrificed,immediately.The fluorine ion selective electrode method was used to detect urinary fluoride and fluorine content in bone in rats.The brain SIRT1 mRNA and protein expression levels were detected by Real-Time PCR and Western blotting,respectively.Results In the space exploration experiments,the mean time to first passage of platform of the rats in control group and low,middle and high fluorine groups were (9.8 ± 3.5),(15.8 ± 5.1),(22.2 ± 7.9) and (30.5 ± 8.5) s,respectively.The differences between groups were statistically significant (F =10.853,P ＜ 0.05).The number of passed through the platform of the rats in control and low,middle and high fluorine groups were (5.2 ± 2.1),(3.3 ± 1.6),(1.3 ± 1.1) and (1.2 ± 0.8) time/60 s,respectively.The differences between groups were statistically significant (F =10.105,P＜ 0.05).In the control group and low,middle and high fluoride groups,the resting time of the original platform quadrant were (30.5 ± 9.8),(22.7 ± 4.6),(13.8 ± 4.8) and (7.0 ± 2.4) s,respectively.The differences between groups were statistically significant (F =17.433,P ＜ 0.05).And the middle,high fluoride groups compared with the control group was significantly different (P ＜ 0.05).With increase of fluoride dosage,the first time to cross the platform gradually extended,the number of crossing the platform and the original platform quadrant dwell time decreased gradually,the differences between the middle,high fluoride groups and the low fluoride group were statistically significant (P ＜ 0.05).The mRNA expression of SIRT1 in control group and low,middle and high fluoride groups were 0.979 ± 0.088,0.907 ± 0.050,0.426 ± 0.073,0.219 ± 0.092,respectively.The differences between groups were statistically significant (F =136.837,P ＜ 0.05).The levels of SIRT1 protein in control group,low,middle and high fluoride groups were 1.224 ± 0.139,0.988 ± 0.096,0.581 ± 0.084 and 0.269 ± 0.066,respectively.The differences between groups were statistically significant (F =107.961,P ＜ 0.05).The levels of SIRT1 mRNA and protein were gradually decreased with increase of fluoride dose in the low,middle and high fluoride groups (P ＜ 0.05).Conclusions Fluorosis can affect the learning and memory ability of rats.SIRT1 mRNA and protein expressed in rat brain is decreased,which is more obvious with the increase of fluoride dose.
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Objective To investigate the effect of pelvic floor stabilized structure preservation (PPSS) during robot-assisted laparoscopic radical prostatectomy (RARP)on postoperative continence recovery.Methods From October 2017 to April 2018,86 patients with prostatic cancer who underwent traditional RARP and RARP plus PPSS were included.There were 31 patients in non-PPSS group and 55 patients in PPSS group.In non-PPSS group,patients age was (68.48 ± 7.79) years old,BMI was (24.79 ± 3.05) kg/m2,median prostate volume was 63.54 (53.00-99.36) cm3,clinic T-stage T1-T2,T3,T4 accounted for 49.39％,22.58％,6.45％ and ISUP grade 1,2,3,4,5 accounted for 22.58％,22.81％,12.90％,12.90％,19.35％ respectively.In PPSS group,patients age was (69.53 ± 6.81)years old,BMI was (23.95 ± 3.03) kg/m2,median prostate volume was 73.39 (54.88-94.23) cm3,clinic T-stage T1-T2,T3,T4 accounted for 72.73％,7.27％,3.64％ and ISUP grade 1,2,3,4,5 accounted for 21.82％,18.18％,23.64％,18.18％,10.91％ respectively.The preoperative PSA,BMI,clinical T-stage,ISUP grade,and postoperative hospital days had no significant differences (P ＞ 0.05)between the two groups.Both groups were operated via transperitoneal approach.In the non PPSS group,endo-pelvic fascia and pubic prostate ligament was cut,and dorsal vessel complex was ligated.In PPSS group,the partial endo-pelvic fascia was bluntly pushed to the pelvic wall to preserve tendon arch,and pubic prostate ligament also was preserved without suturing and ligating dorsal vascular complex.The catheter was removed 7 d after RARP.The continence recovery were compared between the two groups,including pad number on the day of I,7,14,30,90 and ICI-Q-SF scores on the day of 30 and 90 after catheter removal.Results There was no significant difference in pad numbers used between the two groups on the day of 1,7,14,30 after catheter removal.On the 90th day,the proportions of using pad ≥4 in PPSS group were significantly lower than those in non-PPSS group (1.89％ vs.20.69％,P =0.004).No significant difference was found in ICI-Q-SF scores on the 30th and 90th day between the two groups.Univariate analysis showed that PPSS group used less pads than non-PPSS group on the 90th day [OR =0.07(95％ CI 0.01-0.65),P =0.019];T3 patients used more pads than T1-T2 patients [OR =9.19 (95％ CI 1.32-63.87),P =0.025].After adjusting for age,ISUP grading,T staging,and PSA,multivariate regression analysis showed that the risk of using pad ≥ 4 in PPSS group compared with non-PPSS group was 0.46,0.34,0.27,0.25,and 0.03 on the day of 1,7,14,30 and 90 after catheter removal,respectively.The PPSS approach didn't increase the risk of positive surgical margin.Conclusions Preservation of pelvic stabilized structure in RARP is very efficient in term of continence rate after RARP,and it does not increase the risk of positive surgical margin.
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Objective To explore the expressions of trefoil factors (TFFs) in bladder cancers and their clinical significance.Methods Using real-time fluorescence quantitative PCR and immunohistochemical staining from January 2013 to December 2013 in our hospital underwent surgical resection in 50 cases of superficial bladder cancer (including 20 cases of primary and 30 cases of recurrent bladder cancer) expression of TFF1,TFF2 and TFF3 and 10 cases of adjacent normal tissues.There were 32 males and 18 females,aged 45-73 years,with an average of 57 years.Pathological T staging:25 cases (50％) in pTa,25 cases in pT1 phase (50％),pathological grade:low grade 24 cases (48％),26 high grade (52％).Results TFF1,TFF2,TFF3 and mRNA in primary bladder cancer tissue expression levels were 2.04 (1.86-2.22) 、0.88 (0.11-1.6) 、0.92 (0.11-1.73) the recurrence of bladder cancer tissue expression levels were 2.22 (1.94-2.22) 、2.32 (0.22-4.42) 、2.45 (0.35-4.55) while in the adjacent normal tissues were 0.60(0.52-0.68) 、0.58(0.18-0.98) 、0.56(0.16-0.96).The adjacent normal tissues of TFF1,TFF2,TFF3 mRNA was lower than that of bladder cancer (P ＜ 0.05) and the recurrent bladder cancer,the relative expression of TFF2,TFF3 of mRNA was higher than that of primary bladder cancer (P ＜ 0.05),while the recurrent bladder cancer and primary bladder carcinoma TFF1 mRNA expression showed no significant difference (P ＞ 0.05).There was no significant difference in the positive expression rate of TFF1 between high-grade and low-grade bladder cancer [71％ (17/24) vs.77％ (20/26),P =0.88].And the positive rates of TFF2 and TFF3 in high-grade bladder cancer were 83％ (20/24) and 83 ％ (20/24) respectively,which were higher than those in low-grade bladder cancer [65 ％ (17/26),77％ (20/26),all P ＜0.05].The results of follow-up showed that the median recurrence-free survival (RFS) for 50 patients was 31 (18-38) months.The median RFS of patients with strong positive TFF1 and with weak positive (25 months and 27 months) were shorter than TFF1 negative (31 months,all P ＜0.05).The median RFS of patients with strong positive TFF2 (24 months) and TFF2 negative (30 months) were shorter than those of the weakly positive patients (median 33 months,all P ＜ 0.05).The median RFS of patients with TFF3 strongly positive (24 months) and weakly positive (28 months) were shorter than that of TFF3 negative patients (31 months,all P ＜ 0.05),and TFF3 strong positive RFS was shorter than TFF3 weak positive (P ＜ 0.05).Conclusions The expression rates of TFF1,TFF2 and TFF3 in bladder cancer tissues are higher than that of normal tissue,and they are higher than that of the primary bladder cancer tissue in the recurrent bladder cancer.TFF1 and TFF2 may be involved in the recurrence and progression of bladder cancer,and the role of TFF3 needs to be further verified.
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Objective To investigate the expression changes of p53 and p21 in premature ovarian failure in female rats exposed to coal burning fluorosis.Methods Ablactation 24 SD female rats were chosen to establish animal model (the model group),in fluorine 90 days were put to death.Observed the changes of the teeth of the female rats during fluorine exposure and ovarian granulosa cell premature aging change,detected fluorine contents of urine and bone,and expression of the ovarian granular cell gene p53 and p21.Results In the model group,fluorine spot tooth,the fluorine contents of urine and bone increased significantly.In the model group,there was no premature aging of ovarian granulosa cells in the low fluorine group,but with the increase of dye fluorine metering,ovarian granulosa cells became mild,moderate to severe progressive edema trends,cells morphological damaged fuzzy,and atresia follicles increased significantly,corpus luteum degraded,mature follicle significantly reduced,and the ovarian function gradually signs of premature aging presented.With the increase of dye fluoride measurement,the expression of aging gene p53 and p21 in each group gradually increased,compared with the control group,there was statistically significant difference (P＜0.05).Conclusion Premature ovarian failure caused by coal-burning fluorosis was significantly related to the expression of genes p53 and p21.
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Objective@#To evaluate the feasibility and efficacy of naked-eye assessment (NA) of ultrasound-guided fine needle aspiration cytology(US-FNAC) smears, which was performed by a trained non-cytological physician.@*Methods@#A total of 290 smears of FNAC in 143 thyroid nodules were used to evaluate the value of NA by an assistant with more than two years experience of intervention with ultrasound guidance. NA results such as the background of smear (bloody/non-bloody), thickness (thick/thin), as well as the contents (granulated/non-granulated) were recorded. The correlation between NA and cytological results was analyzed. Number of cells under microscopy, the non-diagnostic rate, and the significance between benignity and malignancy with different features of specimens were compared.@*Results@#There was no significant difference between the NA background and cytological findings(P=0.707, 0.200, 0.705, respectively). There was significance in number of cells, non-dianostic rate between thick and thinner specimens (P=0.000, 0.001, respectively). However, there was no significance in benignity and malignancy between thick and thinner specimens (P=0.385). There was significance in cytology results between the granulated and non-granulated smears(all P=0.000). The difference was found in 51.1% of the smears with granulates were malignancy in cytology. While 77.8% of the non-granulated smears were ultimately diagnosed as benignity.@*Conclusions@#The NA could be performed by a trained non-cytological physician and contribute to preliminary predictions of cytology effect.