Effects of modified radical prostatectomy via an extraperitoneal approach on urinary control and sexual function in patients with prostate cancer / 中国基层医药

Objective:To investigate the effects of modified radical prostatectomy via an extraperitoneal approach on urinary control and sexual function in patients with prostate cancer.Methods:Fifty-six patients with stable prostate cancer who received treatment in Deqing People's Hospital between March 2015 and March 2018 were included in this study. They were randomly divided into observation and control groups ( n = 28/group). The observation group was subjected to modified radical prostatectomy via an extraperitoneal approach. The control group underwent standard laparoscopic surgery. Clinical efficacy and the effects of modified radical prostatectomy via an extraperitoneal approach on urinary control and sexual function were compared between the two groups. Results:Amount of blood loss and postoperative drainage were (125.39 ± 11.12) mL and (65.39 ± 10.12) mL in the observation group, and (224.79 ± 14.01) mL and (104.79 ± 15.01) mL in the control group. There were no significant differences in amount of blood loss and postoperative drainage between the two groups ( t = 18.83, 15.67, both P < 0.05). At 1, 3 and 6 months after surgery, the percentage of patients who had urinary control recovery in the observation group was 53.57% (15/28), 78.57% (22/28), 98.21% (27/28), respectively, which were significantly higher than those in the control group [21.43% (6/28), 35.71% (10/28), 67.86% (19/28), χ2 = 4.12, 7.21, 5.01, all P < 0.05]. At 1, 3 and 6 months after surgery, the score of erectile function recovery in the observation group was (15.98 ± 0.28) points, (15.99 ± 0.72) points, and (18.91 ± 0.48) points, which were significantly higher than those in the control group [(17.11 ± 0.34) points, (13.11 ± 0.48) points, (13.41 ± 0.39) points, t = 3.01, 12.89, 15.78, all P < 0.05]. Conclusion:Modified radical prostatectomy via an extraperitoneal approach can improve postoperative urinary control and sexual dysfunction.

Application of radionuclide renal dynamic imaging combined with double plasma method in evaluation of split renal glomerular filtration rates pre- and post-interventional treatment in patients with unilateral hydronephrosis / 中华核医学与分子影像杂志

Objective:To explore the value of 99Tc m-diethylene triamine pentaacetic acid (DTPA) renal dynamic imaging combined with double plasma glomerular filtration rate (GFR) in the evaluation of split renal function in adult patients undergoing interventional therapy for unilateral hydronephrosis. Methods:Retrospective analysis of 79 patients (39 males, 40 females, age (41.4±16.3) years) with unilateral hydronephrosis in First Hospital of Shanxi Medical University from January 2015 to December 2019 were performed. All patients underwent surgery to relive obstruction. 99Tc m-DTPA renal dynamic imaging was performed before and after surgery to obtain bilateral renogram and GFR was measured by Gates method (marked as gGFR). Meanwhile, the corrected double plasma method was used to measure the GFR of both kidneys (marked as dGFR all). Double plasma GFR of the affected kidney (marked as dGFR) was obtained according to the ratio of renogram and dGFR all. Patients were divided into mild to moderate group (dGFR≥20 and <40 ml·min -1·1.73 m -2 ), severe group (dGFR≥10 and <20 ml·min -1·1.73 m -2) and extremely severe group (dGFR<10 ml·min -1·1.73 m -2) according to dGFR before surgery. Postoperative renal dynamic imaging and dGFR were reexamined to analyze the GFR recovery values (ΔgGFR, ΔdGFR). Data were analyzed by χ2 test, paired t test, one-way analysis of variance, Pearson correlation analysis and Bland-Altman consistency test. Results:There were 34 patients in mild to moderate group, 24 patients in severe group, 21 patients in extremely severe group. Significant differences were found in both gGFR and dGFR before and after surgery in mild to moderate group, as well as those in the extremely severe group ( t values: 2.42-3.34, all P<0.05 ), but there was no significant difference in severe group ( t values: 1.24, 1.27, both P>0.05). The ΔgGFR and ΔdGFR were not significantly different among three groups ( F values: 0.45, 0.34, both P>0.05). GFR mesured by the 2 methods (gGFR, dGFR) before and after operation correlated well in each group (before surgery, r values: 0.68-0.82; after surgery, r values: 0.80-0.91, all P<0.001). GFR measured by the two methods showed poor consistency in the mild to moderate and severe groups (>5%(5.88%, 2/34; 8.33%, 2/24) values before and after surgery exceeding 95% consistency limit), while good consistency was demonstrated in the extremely severe group (<5%(4.76%, 1/21) values before and after surgery exceeding 95% consistency limit). Conclusions:Preoperative GFR in patients with unilateral hydronephrosis cannot predict the recovery of renal function after interventional treatment. For the evaluation of split renal GFR in patients with unilateral upper urinary tract obstructive hydronephrosis, corrected dual plasma method combined with kidney ratio of renogram is more appropriate for the determination of GFR. Gates method has some limitations, however, it can be recommended for the evaluation of GFR in patients with extremely severe renal impairment before and after interventional surgery.

The value of transurethral cylindrical dilatation of the prostate in the treatment of patients with benign prostatic hyperplasia / 中国医师进修杂志

Objective:To observe the effects of transurethral split of the prostate (TUSP) on the urodynamics, the sexual function and the quality of life of benign prostatic hyperplasia.Methods:Eighty patients with benign prostatic hyperplasia admitted to the Deqing People′s Hospital of Zhejiang Province from January 2017 to June 2019 were enrolled into the research objects prospectively. According to the random digits table method, they were divided into group A and group B, with 40 cases in each group. The group A was treated with TUSP, while the group B was treated with bipolar transurethral plasma kinetic prostatectomy (TUPKP). The operation time, intraoperative blood loss, bladder irrigation time, urinary catheter indwelling time, hospitalization time of the two groups were compared and surgical effects were evaluated. The changes of hemoglobin (Hb), serum sodium (Na), post-void residual volume (PVR), maximum urinary flow rate (Q max), international prostate symptom score (IPSS) and international index of erectile function score (IIEF-5), the quality of life index (QOL) of 2 groups before and after the operation were measured. Surgical complications were recorded. Results:The operation time, bladder irrigation time, urinary catheter indwelling time and hospital stay in group A were all shorter than that in group B: (15.63 ± 4.17) min vs. (58.79 ± 10.45) min, (6.26 ± 1.17) h vs. (45.51 ± 10.03) h, (3.07 ± 0.68) d vs. (5.67 ± 1.51) d, (3.63 ± 0.43) d vs. (6.08 ± 1.72) d, (18.32 ± 2.79) ml vs. (65.26 ± 20.64) ml, and there were statistical differences ( P<0.05); there were no statistical difference between 2 groups in surgical curative effect grade and Na 1 d after operation ( P>0.05); 1 day after operation, Hb in group A was higher than that in group B: (115.63 ± 9.78) g/L vs. (109.65 ± 8.36) g/L, and there was statistical difference ( P<0.05); PVR, Q max, IPSS, IIEF-5 and QOL 3 and 6 months after surgery were improved in 2 groups ( P<0.05), but the difference between 2 groups was not statistically significant ( P>0.05); the total complication rate in group A was lower than that in group B: 10.00% (4/40) vs. 27.50% (11/40), and there was statistical difference ( P<0.05). Conclusions:TUSP and TUPKP are equally effective in the treatment of benign prostatic hyperplasia, both of which can improve the symptoms of prostatic hyperplasia, improve the quality of life and improve sexual function. But TUSP has less intraoperative bleeding, shorter operation time, faster postoperative recovery, fewer complications, and higher safety.

Mechanism of PD-L1 in thyroid carcinoma and its application in diagnosis and treatment / 国际肿瘤学杂志

Programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) participate in the regulation of immune checkpoint and are closely related to the occurrence and development of thyroid carcinoma. PD-L1 is expressed differently in different types of thyroid cancer and can be used as a biomarker for the diagnosis of some tumors. The expression of PD-L1 in thyroid cancersis associated with higher tumor invasiveness and higher risk of recurrence. PD-1/PD-L1 immune checkpoint is a promising target for the treatment of some thyroid cancers. Further discussion of the mechanism of PD-1/PD-L1 pathway and its role in the diagnosis and treatment of thyroid cancer and the biomarkers related to the therapeutic effect can provide new ideas for the diagnosis and treatment of thyroid cancer.

Searching for the use of virtual reality and real-time recording technique in the functional ex-periment teaching / 中华医学教育探索杂志

Functional experiment plays an important role in understanding the mechanisms of diseases and principles of diagnosis and treatment. It requires students to master basic skills of func-tional operation, and complicated disciplines of functional alteration as well. Thus functional experi-ment needs to be an open course. The use of the virtual reality (VR) and real-time recording tech-niques provides potential for this exploration. By the way of real-time recording system, HD video of experiment operation is played, which helps guiding students to learn basic experiment skills; while based on the development status of VR technology, it is more applicable for learning by oneself, such as preview before the class and review for the test, and furthermore, the advantage of VR technique will be more apparent, if the key development focuses on experiment extensions to disclose more compli-cated functional alterations. This new technique helps to improve teaching effects of functional experi-ment.

Study of synergistic effect of free fatty acid and iron on the establishment of nonalcoholic fatty liver disease model / 中华预防医学杂志

<p><b>OBJECTIVE</b>To establish nonalcoholic fatty liver disease (NAFLD) model induced by free fatty acid (FFA) and iron, and to explore the synergistic effect of FFA and Fe(2+) on the pathogenesis of NAFLD and mechanisms.</p><p><b>METHODS</b>Human liver carcinoma cell HepG2 was respectively treated with 0.250, 0.500, 1.000 mmol/L oleic acid, 0.500 mmol/L oleic acid+0.125 mmol/L Fe(2+), 0.500 mmol/L oleic acid+0.250 mmol/L Fe(2+), and 0.500 mmol/L oleic acid+0.500 mmol/L Fe(2+). Human liver carcinoma cell HepG2 was normally cultured in the control group. Lipid accumulation of cells were observed by oil red O staining and the determination of the triglyceride (TG) contents by GPO-PAP, then the expression of key genes involved in fatty acid β-oxidation (fatty acyl CoA synthetase-1 (ACSL-1), carnitine acyl transferase 1 (CPT-1a), fatty acid synthetase (FAS)) was determined using RT-PCR. The differences of TG content and ACSL-1, CPT-1a, FAS, mRNA relative value were analyzed among different groups.</p><p><b>RESULTS</b>The results of oil red O staining indicated that the contents of lipid droplets were obviously elevated with the increase of Fe(2+) concentration in human liver carcinoma cell HepG2 treated with 0.500 mmol/L oleic acid and different concentrations of Fe(2+). The TG contents of HepG2 cell in control group, 0.250, 0.500, 1.000 mmol/L oleic acid groups, 0.500 mmol/L oleic acid+0.125 mmol/L Fe(2+) group, 0.500 mmol/L oleic acid+0.250 mmol/L Fe(2+) group, 0.500 mmol/L oleic acid+0.500 mmol/L Fe(2+) group respectively were (90.0 ± 1.6), (131.7 ± 5.4), (153.7 ± 3.0), (254.1 ± 4.0), (164.5 ± 6.0), (180.1 ± 7.7), (235.6 ± 4.5) nmol/mg (F = 396.00, P < 0.05). The expression levels of ACSL-1 mRNA in 0.500 mmol/L oleic acid group, 0.500 mmol/L oleic acid+0.125 mmol/L Fe(2+) group, 0.500 mmol/L oleic acid +0.250 mmol/L Fe(2+) group, 0.500 mmol/L oleic acid +0.500 mmol/L Fe(2+) group respectively were (0.94 ± 0.02), (0.89 ± 0.04), (0.85 ± 0.02), (0.74 ± 0.04) (F = 50.00, P < 0.05); the mRNA levels of CPT-1a were (0.89 ± 0.03), (0.79 ± 0.05), (0.67 ± 0.04), (0.51 ± 0.05) (F = 79.00, P < 0.05); the mRNA levels of FAS were (1.31 ± 0.05) , (1.44 ± 0.03), (1.51 ± 0.05), (1.56 ± 0.06 ) (F = 79.70, P < 0.05).</p><p><b>CONCLUSION</b>The NAFLD liver cell model could be established by oleic acid and Fe(2+) in HepG2 cells. FFA and iron might be involved in the pathogenesis of NAFLD through the intervention of fatty acid β-oxidation.</p>

Association of regulatory region of HLA-DPB1 with nasopharyngeal carcinoma in southern Chinese Hans / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To clarify the association between regulatory region of HLA-DPB1 (3'UTR) with Naso pharyngeal carcinoma in Guangdong Province Hans.@*METHOD@#The allelic types of HLA-DPB1-3'UTR were detected by sequence specific primer (SSP) in 104 patients with NPC and 105 control individuals from Guangdong Province Hans.@*RESULT@#The frequencies of allelic types B/B, haplotype B were higher in patients with NPC than those of the control individuals.@*CONCLUSION@#Positive association may exist between certain HLA-DPB1 alleles and NPC in Guangdong Province Hans.

The neuroendoscope-assisted surgical treatment of communicating tumors on anterior skull base:report of 19 cases / 中国医师进修杂志

Objective To investigate the clinical effects of communicating tumors on anterior skull base with neuroendoscope-assisted surgery. Methods Nineteen eases of crani-nosel and crani-orbital nosel communicating tumors underwent the combined craniofacial approach. The defect of anterior skull base was repaired with the compound flap with pedicel frontal galea muscle and temporalis myofascial flap.Results All 19 patients were successfully treated without CSF leak and cranial infection. The tumor total re-section rate was 78.9%, subtotal resection rate was 15.8% ,partial resection rate was 5.3%. Four patients of benign tumor were survival,15 patients of malignant tumor 2- year survival was 11, 3-year survival was 8,above 5- year survival was 6. Conclusion The neuroendoscope-assisted combined craniofacial approach can provide a relatively safe and effective resection for communicating tumors on anterior skull base,and has better clinicall value.

Blood Pressure-Regulation in Patients with Intracerebral Hemorrhage and Clinical Significance of Transcranial Doppler Monitoring / 国际脑血管病杂志

Objective: To study the adjustment amplitude of blood pressure in patients with hypertensive intracerebral hemorrhage and the guiding significance in clinical practice in monitoring the changes of cerebral hemodynamics by transcranial Doppler (TCD). Methods: The blood pressures of sixty-four hospitalized patients with intracerebral hemorrhage were monitored dynamically within 10 hours after the onset. Among them, 38 patients had intracranial hematoma puncture and tube drainage within 24 hours of hospitalization (operation group), and 18 patients had conservative treatment (conservative group). Patients were monitored with TCD at the time of hospitalization on day 1, 4, 7, and 14. Another 8 unoperated patients (antihypertensive group) were monitored with TCD before and after antihypertensive treatment, and they were compared with the TCD parameters of 26 simple hypertensive patients (control group) before and after antihypertensive treatment. Results: There was no significant difference in TCD parameters in the control group before and after antihypertensive treatment, however, the blood flow velocity of bilateral middle cerebral arteries (MCA) decreased, and the pulsatility index (PI) increased after antihypertensive treatment in the antihypertensive group. The blood pressure in patients with intracerebral hemorrhage decreased gradually during the treatment, while the blood flow velocity of bilateral MCA decreased first, and then increased. The PI values of bilateral MCA increased first, and then decreased. The blood flow velocity in the conservative group decreased within the first week of the onset. It began to increase at week two and the changes of PI values were contrary to it. The blood flow velocity of MCA increased on day 7 and PI values decreased in the operation group, and there was significant difference between the 2 groups on day 14. The blood pressure decreased more significant in the operation group than that in the conservative group, and there were significant differences in systolic pressure between the 2 groups on day 14 (P