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Objective To explore the diagnostic value of MRI in adnexal torsion.Methods A retrospective study was conducted on 32 patients with adnexal torsion confirmed by surgery and pathology.The MRI features were analyzed in combination with clinical data.Results Among the 32 cases of adnexal torsion,there were 12 cases of ovarian cyst,5 cases of cystic ovarian teratoma,4 cases of theca cell tumor,6 cases of ovarian cystadenoma,1 case of high-grade serous carcinoma,1 case of corpus luteum hematoma,1 case of simple ovarian torsion,1 case of ovarian goiter,1 case of fibrotheca cell tumor with serous cystadenoma;There were 13 cases on the left side and 19 cases on the right side;The torsion angle of adnexal was about 90 °-1 440 °.MRI showed that 13 of 32 patients were cystic masses and 19 were cystic solid masses;torsion pedicle can be seen near the mass,of which 13 cases showed"whirlpool sign",27 cases showed"T2WI dot low signal sign",10 cases showed"nodule sign",5 cases showed"triangle sign",and 9 cases had structural disorder around the mass.Enhancement showed no obvious enhancement in 12 cases,and mild enhancement in 20 cases.Thirty cases complicated with pelvic effusion;The uterus moved to the affected side in 9 cases,to the healthy side in 20 cases,and no obvious deviation in 3 cases.Conclusion The MRI imaging features of adnexal torsion are characteristic,which are cystic or cystic solid lesions.The torsion pedicle is characterized by"whirlpool sign"and"T2WI dot low signal sign",etc.The enhancement is mild or no enhancement.Combined with the clinical history,it is of great value for the preoperative diagnosis and treatment of adnexal torsion.
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【Objective】 To investigate the clinical value of transrectal contrast-enhanced ultrasound (CEUS) in the diagnosis of prostate cancer in different total prostate specific antigen (tPSA) intervals. 【Methods】 According to serum tPSA levels, 96 patients meeting the inclusion criteria were divided into 3 groups:4-10 ng/mL, >10-20 ng/mL and >20 ng/mL groups. All patients underwent transrectal CEUS. With pathological results as reference, the diagnostic value of transrectal CEUS in different tPSA intervals was evaluated. 【Results】 Of the 96 cases, 62 were confirmed by pathology as prostate cancer and 34 as benign prostatic hyperplasia (BPH). The main perfusion characteristics of prostate cancer under CEUS were rapid enhancement (64.52%), rapid clearance (70.97%), uneven enhancement (83.87%) and high enhancement (61.29%);the main characteristics of BPH were non-rapid enhancement (70.59%), non-rapid clearance (73.53%), uniform enhancement (76.47%) and non-high enhancement (52.94%). There were significant differences in terms of enhancement speed, clearance speed and enhancement uniformity between prostate cancer and BPH (P<0.05), but no significant difference in the enhancement intensity. The sensitivity of transrectal CEUS in the diagnosis of prostate cancer in low, medium and high tPSA groups were 58.33%, 70.37% and 95.65%, the specificity were 83.33%, 76.92% and 66.67%, and the accuracy were 73.33%, 72.50% and 92.31%, respectively. Transrectal CEUS showed consistency at different serum tPSA levels for the diagnosis of prostate cancer, with statistical significance. Moreover, in the 4.0 ng/mL ≤tPSA<10.0 ng/mL group, the diagnostic specificity was the highest. 【Conclusion】 Transrectal CEUS is helpful in the differential diagnosis of benign and malignant prostatic lesions, especially for patients with different serum tPSA levels.
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Intraoperative ultrasound assisted localization is routinely used in the surgical treatment of completely endogenous renal cell tumor, however the localization and guidance ability of conventional ultrasound will decline to a certain extent for isoechoic renal tumor. A 62 years old female patient with right renal tumor was reported. The tumor diameter was about 2.3 cm× 1.7 cm, equivalent to the isoechoic of kidney. Laparoscopic partial nephrectomy was performed under the real-time guidance of contrast-enhanced ultrasound. The tumor was found to be lack of blood supply during the operation, and the tumor contour was clearly developed by contrast agent.The operation was successfully completed, and the pathological diagnosis was polycystic renal tumor with low malignant potential.The incisional margin was negative.The patient recovered well after operation without complications.No recurrence or metastasis was found after 6 months of follow-up.The renal function was good.
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IgG4-related diseases have a low incidence and are easily misdiagnosed as tumors in clinical treatments. A 26-year-old male patient was admitted to the hospital because of a left adrenal tumor found in health examination for more than 5 months. The tumor in the left adrenal region could be seen from abdominal CT, and the retroperitoneal laparoscopic resection of the left adrenal tumor was performed. Postoperative pathology was consistent with IgG4-related diseases, and serum IgG4 was abnormally high. After 2 months’ follow-up, serum IgG4 returned to normal, and no special discomfort.
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The incidence of solitary fibroma of seminal vesicle is low, and the source of seminal vesicle is rare. A 38-year-old patient was admitted to hospital because of intermittent gross hematuria for more than one month. Seminal vesicle space occupying lesions can be seen in pelvic MRI. Laparoscopic resection of right seminal vesicle tumor was performed, and the pathological diagnosis tended to solitary fibroma. During the 5-month follow-up, the symptoms of hematuria disappeared and no recurrence.
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Objective To investigate the effect of siRNA silencing α1 antitrypsin (α1-AT) gene on the biological behavior of rheumatoid arthritis fibroblast-like synoviocytes (RA-SFs).Methods Primary culture of knee synovial tissue from 5 patients with rheumatoid arthritis (RA) was performed.The artificially synthesized silencing α1-AT siRNA specifically inhibits the expression of α1-AT in RA-SFs.After 24 and 36 hours of transient transfection,the inhibition efficiency was detected by Quantitative reverse transcription polymerase chain reaction (RT-qPCR),and the expression of related genes after α1-AT gene silencing was detected.Furthermore,ethyl thiazolyl tetrazolium (MTT) assay,Trans-well chamber,cell scratch and enzyme-linked immunosorbent assay (ELISA) were used to detect the effects of interfering α1-AT expression on cell proliferation,invasion and migration,and secretion of interleukin (IL)-17,Tumor necrosis factor (TNF)-α,IL-1α,IL-1β and other related inflammatory factors.At the same time,when the pathway inhibitor (ERK inhibitor,signal transducer and activator of transcription 3 (STAT3) inhibitor,NF-κB inhibitor) stimulated cells,the effect on α1-AT was changed.One-way analysis of variance was used for comparison between the two groups;further pairwise comparison using LSD-t test;The count data was checked by x2 test.Results Compared with the negative control group,the siRNA α1-AT group was transfected for 24 hours,the α1-AT mRNA level was significantly inhibited (P<0.05),and the proliferation rate of RA-SFs was not affected (P>0.05),and the invasion and migration ability of cells decreased significantly (P<0.05).The secretion of IL-17 and IL-1β was slightly decreased (P>0.05),while TNF-α and IL-1α were not affected (P>0.05).In addition,the expression of α1-AT downstream genes Matrix metallop roteinases (MMP)-2 169,Hu-Bax1,MMP-9,Hu Bax and Hu Bcl-xl were significantly decreased (P<0.05).Moreover,the signaling pathway inhibitors ERK inhibitor (PD98059) and NF-κB inhibitor (PDTC) had significant effects on α1-AT (P<0.05).Conclusion The α1-AT gene silencing has potential effect on the biological behavior of RA SFs.Further study of this mechanism is helpful to provide evidence for the treatment of RA.
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Objective@#To investigate the effect of siRNA silencing α1 antitrypsin (α1-AT) gene on the biological behavior of rheumatoid arthritis fibroblast-like synoviocytes (RA-SFs).@*Methods@#Primary culture of knee synovial tissue from 5 patients with rheumatoid arthritis (RA) was performed. The artificially synthesized silencing α1-AT siRNA specifically inhibits the expression of α1-AT in RA-SFs. After 24 and 36 hours of transient transfection, the inhibition efficiency was detected by Quantitative reverse transcription polymerase chain reaction (RT-qPCR), and the expression of related genes after α1-AT gene silencing was detected.Furthermore, ethyl thiazolyl tetrazolium (MTT) assay, Trans-well chamber, cell scratch and enzyme-linked immunosorbent assay (ELISA) were used to detect the effects of interfering α1-AT expression on cell proliferation, invasion and migration, and secretion of interleukin (IL)-17, Tumor necrosis factor (TNF)-α, IL-1α, IL-1β and other related inflammatory factors. At the same time, when the pathway inhibitor (ERK inhibitor, signal transducer and activator of transcription 3 (STAT3) inhibitor, NF-κB inhibitor) stimulated cells, the effect on α1-AT was changed. One-way analysis of variance was used for comparison between the two groups; further pairwise comparison using LSD-t test; The count data was checked by χ2 test.@*Results@#Compared with the negative control group, the siRNA α1-AT group was transfected for 24 hours, the α1-AT mRNA level was significantly inhibited (P<0.05), and the proliferation rate of RA-SFs was not affected (P>0.05), and the invasion and migration ability of cells decreased significantly (P<0.05). The secretion of IL-17 and IL-1β was slightly decreased (P>0.05), while TNF-α and IL-1α were not affected (P>0.05). In addition, the expression of α1-AT downstream genes Matrix metallop roteinases (MMP)-2 169, Hu-Bax1, MMP-9, Hu Bax and Hu Bcl-xl were significantly decreased (P<0.05). Moreover, the signaling pathway inhibitors ERK inhibitor (PD98059) and NF-κB inhibitor (PDTC) had significant effects on α1-AT (P<0.05).@*Conclusion@#The α1-AT gene silencing has potential effect on the biological behavior of RA SFs. Further study of this mechanism is helpful to provide evidence for the treatment of RA.
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Objective To analyze the feasibility and safety in application of resectoscope combined with laparoscopy in the operation treatment of paraganglioma of urinary bladder.Methods 7 cases patients with paraganglioma of urinary bladder treated in our hospital from November 2014 to August 2018 were analyzed retrospectively.There were 5 males and 2 females,average age of 31.1 years (22-37 years),average body mass index was 22.3 kg/m2 (18.3-22.5 kg/m2).All the 7 cases patients complained of dizziness and palpitation after urination,average basal systolic blood pressure was 111.8 mmHg (97-124 mmHg),the average fluctuation of systolic blood pressure before and after urination was 64.9 mmHg(28-91 mmHg),the CT and cystoscopy prompt bladder tumor,the average diameter was 2.7 cm(2.1-3.5 cm).The average of plasma norepinephrine was 706.3 pg/ml(330-997 pg/ml);the average of plasma dopamine was 101.1 pg/ml(44-145 pg/ml);the average of 24h urinary vanilmandelic acid was 13.4 mg/24h (10.3-16.1 mg/24h).All the patients has controlled the blood pressure and dilate the blood vessels with phenoxybenzamine hydrochloride,accepted the operation of resectoscope combined with laparoscopy partial cystectomy and bladder sutura per abdomen after ample dilatancy.The patients had lithotomy position with trendelenburg,preparation of gas peritoneal cavity by transabdominal,inside the resectoscope by transurethral at the same time,mutilated bladder mucosa beside 1cm at the edge of the tumor,and cut full thickness bladder wall,take the extraperitional fat as the standard procedure;we could see the cutting edge clear at this time by laparoscopy,cut off the pelvic peritoneum,extraperitional fat and the tumor.The sample placed in bladder,close the bladder with absorbable or barbed wires,take out the sample by resectoscope.Results All the 7 cases patients operation was successfully completed,no cases has been transfered to open.The average time of operation is 85.3 min(65-100 min),the average amount of bleeding is 27.9 ml(10-50 ml).The average fluctuation of systolic blood pressure is 8.7 mmHg(6-15 mmHg).Bladder washout was stopped 24h after operation,catheter was removed 1 weeks after operation.There is no obvious complications occurred.The average hospital stay is 3.7 days (3-5 days).The average pain score of 4 cases 4h after operation is 3.8 (2-5),reevaluation 24h after operation is 2.3 (1-4).The average follow-up time is 7.9 months(2-15 months).All the 7 cases patients clinical symptoms disappeared,there is no fluctuation of systolic blood pressure before and after urination,there is no recurrence of the tumor.Conclusions To the paraganglioma of urinary bladder in fundus of bladder or anterior wall of bladder,we can accurate resection tumor by resectoscope combined with laparoscopy,reduce blood pressure fluctuations,reduce the surgical trauma and the distress of patients.It is a safety and effective minimally invasive surgery.
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Objective To investigate the influence of Smac to the chemosensitivity of cyclophosphamide (CTX) and doxorubicin (DOX) in MCF-7 cells.Methods MCF-7 cells were exposed to CTX,DOX and the combination of both.3-(4,5-dimethyl-2-thiazoly)-2,5-diphenyl-2 H-tetrazolium bromide (MTT) assay was used to estimate the cell viability.Apoptosis was measured by acridine orange staining and Ho.33342/PI dou-ble staining.The mRNA and protein expressions of Smac were determined by RT-PCR and Western blotting.The study also analyzed the changes of pro-apoptotic proteins active caspase-3 and active caspase-9.Results CTX,DOX and the combination of both drugs reduced the cell survival rates in a concentration-dependent manner.The cell viability after being treated with 4.0 μg/ml CTX or 0.2 μg/ml DOX or 2.0 μg/ml CTX and 0.1 μg/ml DOX for 48 hours was (52.90 ± 8.78) %,(53.35 ± 6.29) % and (34.19 ± 5.43) %,respectively.The drug combination developed a stronger inhibitory effect compared to the single drugs (t =9.051,P=0.014;t =9.074,P =0.014).The Smac mRNA and protein levels in 2.0 μg/ml CTX and 0.1 μg/ml DOX group were 7.47 ± 0.82 and 4.13 ± 0.36,which were higher than those in 4.0 μg/ml CTX group (3.27 ± 0.40 and 2.28 ± 0.27;t =-50.120,P =0.000;t =-42.588,P =0.000) and 0.2 μg/ml DOXgroup (3.34±0.62and2.45±0.40;t=-46.233,P=0.000;t=-39.541,P=0.000).Furthermore,pro-apoptotic proteins active caspase-3 and active caspase-9 increased activity was confirmed by Western blotting.Conclusion Smac plays a vital role in enhancing the sensitivity of chemotherapeutic drugs CTX and DOX in MCF-7 cell line.
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Objective The present study investigated the expression of heat shock cognate protein 70 (Hsc70) in the synovial tissues and blood samples of patients with rheumatoid arthritis (RA) to determine the pathological role of this protein in the pathogenesis of the disease.Methods The expression of Hsc70 in synovial membranes was quantitatively analyzed by immunohistochemistry,real-time quantitative PCR and western blotting.The samples from osteoarthritis (OA) and ankylosing spondylitis (AS) were used as controls.The levels of Hsc70 in blood of patients with RA were determined using enzyme linked immunosorbent assay (ELISA) with the samples of the healthy subjects as controls.Statistical analysis was conducted with one-way ANOVA,LSD test and Spearmen's correlation.Results Immunohistochemistry showed that Hsc70 had significantly increased expression in synovial tissues of RA than in the samples of OA and AS.Real-time PCR and western blotting confirmed the above findings.ELISA detected significantly elevated level of Hsc70 in blood of patients with RA as compared with samples from the controls (P<0.01).Conclusion The study suggests that the up-regulation of Hsc70 may be involved in the pathogenic process of RA.