Laparoscopic orchidopexy for the treatment of cryptorchidism in adults: a description of the technique and outcomes.

BACKGROUND: There are few studies on cryptorchidism in adults, and its treatment is still controversial. METHODS: To summarize the surgical strategy and clinical efficacy of laparoscopic orchidopexy for the treatment of cryptorchidism in adults, 37 adult cryptorchidism patients were retrospectively analyzed between September 2017 and February 2022. All 37 patients underwent laparoscopic orchidopexy, of whom 33 underwent inguinal hernia repair without tension. The intraoperative procedures and surgical techniques were recorded in detail. Preoperative examination and regular postoperative review of color Doppler ultrasound, and reproductive hormone, alpha-fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase levels were performed. RESULTS: All testes descended successfully into the scrotum, including 25 through the inguinal route and 12 through Hesselbach's triangle route. No intraoperative or postoperative complications were observed. The follow-up time was 38.6 (± 19.4) months, and no evidence of testicular malignancy was found during the follow-up period. After analyzing the reproductive hormone levels at 1 year postoperatively in 28 patients with more than 1 year of follow-up, it was found that the patients had a significant increase in testosterone levels and a decrease in follicle-stimulating hormone levels after surgery. None of the patients showed any significant improvement in semen quality after surgery. CONCLUSION: Our study suggests that laparoscopic orchidopexy is a safe and feasible surgical procedure for the treatment of cryptorchidism in adults, especially high cryptorchidism, which is difficult to treat. After comprehensive consideration, preserving the testis should be preferred for treating cryptorchidism in adults to maximize the protection of the patient's reproductive hormone secretion function.

Altered microbiota profile in seminal vesicles of men presenting with refractory hematospermia.

BACKGROUND: Currently, no recognized evidence is known about the bacterial communities found within seminal vesicles (SV) of men presenting with refractory hematospermia. METHODS AND RESULTS: Fifteen male patients with refractory hematospermia or anejaculation were enrolled, and 15 SV-Infection (SV-In) samples from SV with hemorrhage and/or stones, 11 SV-Control (SV-C) samples from SV with non-infection, and 14 Urine (Urine) samples from posterior urethra were obtained via transurethral seminal vesiculoscopy. Then the high-throughput 16 S rRNA gene sequencing method was performed to characterize the microbiota profile. Finally, a total of 1535 operational taxonomic units (OTUs) were found, 1295 OTUs were shared across three groups, 7 OTUs, 45 OTUs, and 48 OTUs were unique to SV-C group, SV-In group, and Urine group, respectively. The 5 top bacterial phyla (mean relative abundance) in all samples were Firmicutes (52.08%), Bacteroidetes (21.69%), Proteobacteria (12.72%), Actinobacteria (9.64%), and Fusobacteria (1.62%), the 5 top bacterial genera in all samples were Bacteroides (9.13%), Lactobacillus (5.38%), Bifidobacterium (5.35%), Faecalibacterium (5.10%), and Allobaculum (3.34%), of which Bifidobacterium had the highest level in SV-C samples and had a significant difference (P < 0.05) across all groups. Differential analysis showed genera Leuconostoc and LachnospiraceaeFCS020group were identified as biomarkers in the SV-In microbiota. CONCLUSION: Altered microbiota composition in seminal vesicles is related to refractory hematospermia in men, and the distribution of genus Leuconostoc or LachnospiraceaeFCS020group within seminal vesicles may interact with hematospermia. This study provides clues for the diagnosis and treatment of this urologic disorder.

miR-199b-3p contributes to acquired resistance to cetuximab in colorectal cancer by targeting CRIM1 via Wnt/ß-catenin signaling.

BACKGROUND: Despite advances in the development of efficient chemotherapy, the treatment of colorectal cancer (CRC) remains a challenge due to acquired chemoresistance. It has been reported that microRNAs (miRNAs) dysregulation is associated with the development of chemoresistance. Recently, the expression of miR-199b-3p has been found to be significantly different between cetuximab (CTx)-resistant and -sensitive CRC cells. However, its role and the underlying mechanisms in acquired chemoresistance to CTx in CRC are still obscure. METHODS: Here we report that miR-199b-3p is significantly up-regulated in both CTx-resistant (CTxR) CRC tissues and cell lines. RESULTS: Functional assays showed that suppressing miR-199b-3p could improve the sensitivity of CRC-CTxR cells to CTx, thereby reducing cell proliferation, migration and invasion, and enhancing cell apoptosis. Mechanistic studies revealed that CRIM1 is a direct target of miR-199b-3p in CRC-CTxR cells; and the effect of miR-199b-3p on CTx-resistance was exerted by regulating the Wnt/ß-catenin signaling pathway via CRIM1. Furthermore, mice xenograft models were established and confirmed that down-regulating miR-199b-3p restores the inhibition effect of CTx on tumor growth in CRC-CTxR. Collectively, our data suggest that silencing miR-199b-3p could enhance the anti-tumor effects of CTx on CTx-resistant CRC in vitro and in vivo by activating Wnt/ß-catenin signaling via the down-regulation of CRIM1. CONCLUSIONS: Our findings suggest miR-199b-3p might serve as a promising therapeutic target against CTx resistant CRC, and provide scientific information for exploring novel strategies of improving the efficacy of CTx for CRC patients.

NecroX-5 ameliorates bleomycin-induced pulmonary fibrosis via inhibiting NLRP3-mediated epithelial-mesenchymal transition.

BACKGROUND: Pulmonary fibrosis is a progressive and usually lethal pulmonary disease. Despite considerable research efforts, no effective therapeutic strategy for pulmonary fibrosis has been developed. NecroX-5 has been reported to possess anti-inflammatory, anti-oxidative and anti-tumor activities. In the present study, we aimed to determine whether NecroX-5 exhibits antifibrotic property in bleomycin (BLM)-induced pulmonary fibrosis. RESULTS: We found that pre-treatment with NecroX-5 alleviated inflammatory response, reduced oxidative stress, inhibited epithelial-mesenchymal transition (EMT), and ameliorated pulmonary fibrosis in vivo and in vitro. Our data further indicated that NecroX-5 substantially reduced activation of NLRP3 inflammasome and TGF-ß1/Smad2/3 signaling in vivo and in vitro. Additionally, NLRP3 overexpression significantly reversed the protective effects of NecroX-5 in lung epithelial cells exposed to BLM. CONCLUSIONS: Overall, our results demonstrate the potent antifibrotic properties of NecroX-5 and its therapeutic potential for pulmonary fibrosis.

Elastography and contrast-enhanced ultrasound to assess the effect of varicocelectomy: A case-controlled study.

To evaluate the changes in testicular stiffness and microcirculation caused by spermatic vein ligation in patients with varicocele, we conducted a case-controlled study. A total of 27 grade III left varicocele cases were enrolled. Testicular stiffness and perfusion were evaluated by shear wave elastography and contrast-enhanced ultrasound during subinguinal microscopic varicocelectomy. The external and the internal parenchyma of bilateral testes were selected to compare the shear wave velocity of bilateral testes during the spermatic vein ligation. We mapped and compared the intensity-time curves following bolus contrast injection three times in the same region of interest. Initially, the shear wave velocity of the left internal parenchyma was higher than the right side (1.10 ± 0.06 m/s vs. 1.00 ± 0.03 m/s). It decreased (1.09 ± 0.06 m/s) (p < 0.05) after ligation. Meanwhile, the left epididymis had the higher agent peak intensity (0.90 × 10E-5 AU), the largest area under the curve (80.20 × 10E-5 AU s), and the longest washout area (54.35 × 10E-5 AU s). In addition, the left internal parenchyma presented a sharper slope (0.18 × 10E-5 AU/s) (p < 0.05). In conclusion, the spermatic vein ligation improved the perfusion of the internal testicular parenchyma, but it could temporally deteriorate the stasis of the epididymis. These changes caused softer testicular parenchyma.

Magnetic resonance imaging compared to ultrasound as the preferred method for diagnosing intractable haematospermia.

We aimed to evaluate and compare the clinical diagnostic values of magnetic resonance imaging (MRI) and ultrasound in patients with intractable haematospermia. We performed a retrospective review of 23 patients with intractable haematospermia who were diagnosed with seminal vesicle haematocele and/or calculi by transurethral seminal vesiculoscopy (TSV). Patients' demographics, disease durations, operative times, and MRI and transrectal ultrasound (TRUS) results were recorded. McNemar's test was used to compare the positive diagnostic rates of MRI and TRUS. All patients had undergone preoperative seminal vesicle MRI and TRUS to identify the aetiology of the haematospermia. The average age and disease duration were 39.3 years and 24.1 months, respectively. The mean operative time was 81.1 min. The positive result rates for MRI and TRUS were 95.7% (22/23) and 39.1% (9/23), respectively. Compared with TRUS, MRI had a significantly higher preoperative positive diagnostic rate (p < 0.01). These results suggest that MRI should be considered as a method for diagnosing intractable haematospermia in patients when TRUS findings are negative or inconclusive.

Successful treatment of seminal vesicle calculi and prostatic utricle calculi by transurethral seminal vesiculoscopy.

To investigate the outcomes of transurethral seminal vesiculoscopy (TSV) for the treatment of seminal vesicle calculi (SVC), prostatic utricle calculi (PUC) and combination of them, a retrospective review on 27 patients with SVC and/or PUC who complained of intractable haematospermia was conducted. Patient demographics, disease duration, operation time, stone location and complications were recorded. The calculi in the seminal vesicle and/or prostatic utricle were removed by holmium laser lithotripsy and/or basket extraction. The stone composition was determined in 19 of 27 patients using Infrared spectroscopy. The average age and disease duration of patients were 39.4 years and 23.1 months respectively. The mean operative time was 78.5 min. We detected SVC, SVC and PUC, and PUC in 59.3% (16/27), 33.3% (9/27) and 7.4% (2/27) patients respectively. The stones were mainly composed of calcium oxalate dehydrate (COD), carbonate apatite (CA), COD and calcium oxalate monohydrate (COM), CA and magnesium ammonium phosphate, CA and COM, and COD and uric acid in 42.1% (8/19), 21.1% (4/19), 15.8% (3/19), 15.8% (3/19), 5.3% (1/19) and 5.3% (1/19) cases respectively. No intraoperative and post-operative complications were noted. These results suggested that SVC and PUC can be diagnosed and treated using TSVs.

Hypermethylated in cancer 1 (HIC1) suppresses bladder cancer progression by targeting yes-associated protein (YAP) pathway.

OBJECTIVES: Bladder cancer (BCa) is the most common malignant tumor in the urinary system. Growing evidence suggests that as a tumor suppressor gene, hypermethylated in cancer 1 (HIC1) is correlated with various malignancies in the modulation of tumor progression. This study aims to investigate the effect of HIC1 on regulating the proliferation, migration, and invasion of BCa. METHODS: Quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blot (WB) were used to evaluate the expression of HIC1 messenger RNA and protein in human BCa tissues and cells. Proliferation, migration and invasion assays, and flow cytometry assay were performed to assess the biological functional role of HIC1 in BCa. Co-immunoprecipitation (Co-IP) examined the protein-protein interaction. The signaling pathways involved in the mode of action of HIC1 in BCa were also investigated. RESULTS: HIC1 was found downregulated in tested samples. Cloning formation assay and cell-proliferation activity analysis showed that overexpression of HIC1 significantly inhibited the proliferation of BCa cells, while knockdown led to the opposite, namely the promotion of the proliferation. Flow cytometry assay confirmed the arrest of the cell cycle at the G1 phase with overexpression of HIC1 observed. Moreover, HIC1 inhibited migration and invasion of BCa. Co-IP showed the binding between YAP (yes-associated protein) and TEAD (TEA domain/transcription enhancer factor family members) as well as the cancerostatic activity of HIC1, partially manifested via its negative regulation of YAP signaling pathway. CONCLUSIONS: Our data unprecedently showed that HIC1 was responsible for the inhibition of proliferation, migration, and invasion of BCa via the YAP signaling pathway. These findings suggested that therapeutic strategies regulating HIC1 expression might provide effective treatments for BCa.

Clinical features of haematospermia associated with seminal vesicle calculi versus posterior urethral haemangioma.

To compare the clinical features of seminal vesicle calculi(SVC) versus posterior urethral haemangioma(PUH) to assist urologists in differentiating and diagnosing the causes of haematospermia. Patients with SVC or PUH were included. Patient age, disease duration, hospital stay, operation time, symptoms, surgical approach, pathological results and postoperative complications were recorded. A total of seven patients with SVC and 15 patients with PUH involved have an average age of 34.1 and 44.5 years separately. Patients with SVC complained of recurrent haematospermia; patients with PUH complained of recurrent haematospermia and urethral opening bleeding after sexual arousal. SVC manifested as a dark red blood-semen mixture with ejaculation pain and no blood clots; the condition could improve after anti-infective treatment. PUH manifested as no visible blood-semen mixture, bright red semen with blood clots and no ejaculation pain; the condition did not respond to anti-infective treatment. SVC was treated with holmium laser lithotripsy under a transurethral seminal vesiculoscopy. PUH was treated with transurethral resection and fulguration. Postoperative follow-up showed that the clinical symptoms gradually disappeared, with no postoperative complications. Both SVC and PUH can result in recurrent haematospermia. Therefore, urologists should treat haematospermia differently according to the cause.

Novel penile circumcision suturing devices versus the shang ring for adult male circumcision: a prospective study.

INTRODUCTION: To evaluate the safety and efficacy of a novel penile circumcision suturing devices PCSD and Shang ring (SR) for circumcision in an adult population. MATERIALS AND METHODS: A total of 124 outpatients were randomly assigned to receive PCSD (n=62) or SR (n=62). Patient characteristics, operative time, blood loss, return to normal activities time (RNAT), visual analogue scale (VAS), scar width, wound healing time, cosmetic result, and complications were recorded. RESULTS: There were no significant differences in blood loss, RNAT, or complications between the two groups. There were no significant differences in the VAS scores at theduring operation, and 6 or 24 hours after surgery (P>0.05). The wound scar width was wider in the SR group than in the PCSD group (P<0.01). Patients in the SR group had significantly longer wound healing time compared with those in the PCSD group (P<0.01). Patients who underwent PCSD wereere significantly more satisfied with the cosmetic results (P<0.01). CONCLUSIONS: SR and PCSD are safe and effective minimally invasive techniques for adult male circumcision. Compared with SRs, PCSDs have the advantages of faster postoperative incision healing and a good effect on wound cosmetics.

Meta-analysis of female stress urinary incontinence treatments with adjustable single-incision mini-slings and transobturator tension-free vaginal tape surgeries.

BACKGROUND: The study on SIMS and SMUS as a whole by Alyaa Mostafa et al showed that after excluding the TVT-S sling, there is no significant difference in patient-reported cure rate and objective cure rate between these two methods. In this paper, we systematically evaluate the relevant data on SIMS-Ajust and TVT-O/TOT and further confirm their safety and effectiveness, providing reliable clinical evidence. METHODS: By searching the Medline, Embase, Scopus, and Web of Science databases and the Cochrane Database of Systematic Reviews combined with manual searches, all reports on randomized controlled trials (RCTs) of single-incision mini-sling (SIMS-Ajust) and transobturator tension-free vaginal tape (TVT-O/TOT) surgeries were collected. Using RevMan 5.2 statistical software, the patient-reported cure rate, objective cure rate, operative time, postoperative pain, lower urinary tract injuries, groin pain, postoperative voiding difficulties, de novo urgency and/or worsening of preexisting surgery, vaginal tape erosion, repeated continence surgery, and other related data on both surgical methods were evaluated. RESULTS: A total of 154 relevant research reports were retrieved, and five randomized controlled trials were included in this study, involving a total of 678 patients. The meta-analysis results show no significant difference in the patient-reported cure rate and objective cure rate between SIMS-Ajust and TVT-O/TOT [RR = 0.95, 95% CI (0.87 to 1.04), P > 0.05; RR = 0.97, 95% CI (0.90-1.05), P > 0.05]. With respect to operation time and groin pain, SIMS-Ajust outperforms TVT-O/TOT [MD = -1.61, 95% CI (-2.48 to 0.74), P < 0.05; RR = 0.30, 95% CI (0.11 to 0.85), P < 0.05]. In terms of postoperative pain, lower urinary tract injuries, postoperative voiding difficulties, de novo urgency and/or worsening of preexisting surgery, vaginal tape erosion, and repetition of continence surgery, there is no significant difference between SIMS-Ajust and TVT-O/TOT [RR = 0.50, 95% CI(0.18-1.43), P > 0.05; RR = 2.82, 95% CI(0.14-57.76), P > 0.05; RR = 0.64, 95% CI(0.28-1.45), P > 0.05; RR = 1.06, 95% CI(0.66-1.71), P > 0.05; RR = 1.04, 95% CI(0.24-4.45), P > 0.05; RR = 1.64, 95% CI(0.41-6.61), P > 0.05]. CONCLUSIONS: SIMS-Ajust is safe and effective in the treatment of female stress urinary incontinence. Compared with TVT-O/TOT surgery, SIMS-Ajust surgery has the same high objective cure rate and patient-reported cure rate and low incidence of perioperative complications, in addition to its short operative time and low incidence of groin pain. Its long-term efficacy needs further observation.

[Efficacy of sildenafil citrate in men with erectile dysfunction following bilateral nerve-sparing radical prostatectomy: systematic review and meta-analysis].

OBJECTIVE: To systematically assess the efficacy and safety of oral sildenafil citrate for post bilateral nerve-sparig radical prostatectomy (post-BNSRP) erectile dysfunction (ED). METHODS: The following keywords: sildenafil, radical prostatectomy were used to search in Medline, Pubmed, Web of Science, Cochrane Library, CNKI, WanFang Database. The title, abstract and keywords of each article were independently screened by two reviewers. Randomized controlled trials (RCT) published between 1990 and 2014 were retrieved according to our inclusion and exclusion criteria. The efficacy and safety of oral sildenafil citrate for post-BNSRP ED were systematically assessed by meta-analysis. RESULTS: Four RCTs with 320 cases were included after literature retrieval and filtering. The potency rates were 32.1% (35/109) and 11.3% (7/62) between sildenafil and placebo groups after meta-analysis and showed statistically significant differences (OR = 4.66, 95% CI: 1.79-12.11). IIEF-5 score in sildenafil group was significant higher than that in the placebo group (WMD: 4.73, 95% CI: 3.26-6.19). In subgroup meta-analysis, the potency rates in high-dose, low-dose sildenafil groups and placebo groups were 30.4% (14/46), 25.0% (10/40) and 4.5% (2/44), respectively. There were statistically significant differences between the high-dose subgroup and placebo group (OR = 9.32, 95% CI: 1.96-44.23), and the low-dose subgroup and placebo group (OR = 6.99, 95% CI: 1.43-34.22). But there was no significant difference between high-dose and low-dose subgroups (OR = 1.31, 95% CI: 0.51-3.40). CONCLUSIONS: Compared with placebo, sildenafil has considerable efficacy for erectile function rehabilitationas as a primary treatment for post-BNSRP ED. There is no significant difference between high-dose and low-dose schedule for its efficacy. However, further studies are required to optimize treatment.

Down-regulation of the expression of CCAAT/enhancer binding protein α gene in cervical squamous cell carcinoma.

BACKGROUND: Cervical carcinoma is the second most common cancer and is an important cause of death in women worldwide. CCAAT/enhancer binding proteins (C/EBPs) are a family of transcription factors that regulate cellular differentiation and proliferation in a variety of tissues. However, the role of C/EBPα gene in cervical cancer is still not clear. METHODS: We investigated the expression of C/EBPα gene in cervical squamous cell carcinoma. C/EBPα mRNA level was measured by real-time quantitative RT-PCR in cervical cancer tissues and their adjacent normal tissues. C/EBPα protein level was measured by immunohistochemistry. Methylation in the promoter of C/EBPα gene was detected by MALDI TOF MassARRAY. We transfected HeLa cells with C/EBPα expression vector. C/EBPα expression in HeLa cells was examined and HeLa cell proliferation was measured by MTT assay and HeLa cells migration was analyzed by matrigel-coated transwell migration assays. RESULTS: There were significant difference in C/EBPα protein expression between chronic cervicitis and cervical carcinoma (P < 0.001). CEBPα mRNA level was significantly lower in cervical cancer tissues than in normal cervical tissues (P < 0.01). Methylation of the promoter of CEBPα gene in CpG 5, CpG-14.15, CpG-19.20 were significantly higher in cervical cancer than in normal cervical tissues (P < 0.05, P < 0.01, P < 0.05, respectively). CEBPα pcDNA3.1 construct transfected into HeLa cells inhibited cell proliferation and decreased cell migration. CONCLUSIONS: Our results indicate that reduced C/EBPα gene expression may play a role in the development of cervical squamous cell carcinoma.

SurgNet: Self-Supervised Pretraining With Semantic Consistency for Vessel and Instrument Segmentation in Surgical Images.

Blood vessel and surgical instrument segmentation is a fundamental technique for robot-assisted surgical navigation. Despite the significant progress in natural image segmentation, surgical image-based vessel and instrument segmentation are rarely studied. In this work, we propose a novel self-supervised pretraining method (SurgNet) that can effectively learn representative vessel and instrument features from unlabeled surgical images. As a result, it allows for precise and efficient segmentation of vessels and instruments with only a small amount of labeled data. Specifically, we first construct a region adjacency graph (RAG) based on local semantic consistency in unlabeled surgical images and use it as a self-supervision signal for pseudo-mask segmentation. We then use the pseudo-mask to perform guided masked image modeling (GMIM) to learn representations that integrate structural information of intraoperative objectives more effectively. Our pretrained model, paired with various segmentation methods, can be applied to perform vessel and instrument segmentation accurately using limited labeled data for fine-tuning. We build an Intraoperative Vessel and Instrument Segmentation (IVIS) dataset, comprised of ~3 million unlabeled images and over 4,000 labeled images with manual vessel and instrument annotations to evaluate the effectiveness of our self-supervised pretraining method. We also evaluated the generalizability of our method to similar tasks using two public datasets. The results demonstrate that our approach outperforms the current state-of-the-art (SOTA) self-supervised representation learning methods in various surgical image segmentation tasks.

Consensus-Agent Deep Reinforcement Learning for Face Aging.

Face aging tasks aim to simulate changes in the appearance of faces over time. However, due to the lack of data on different ages under the same identity, existing models are commonly trained using mapping between age groups. This makes it difficult for most existing aging methods to accurately capture the correspondence between individual identities and aging features, leading to generating faces that do not match the real aging appearance. In this paper, we re-annotate the CACD2000 dataset and propose a consensus-agent deep reinforcement learning method to solve the aforementioned problem. Specifically, we define two agents, the aging process agent and the aging personalization agent, and model the task of matching aging features as a Markov decision process. The aging process agent simulates the aging process of an individual, while the aging personalization agent calculates the difference between the aging appearance of an individual and the average aging appearance. The two agents iteratively adjust the matching degree between the target aging feature and the current identity through a form of synergistic cooperation. Extensive experimental results on four face aging datasets show that our model achieves convincing performance compared to the current state-of-the-art methods.

[Effect of MiR-424-5p on the Drug Resistance of Diffuse Large B-Cell Lymphoma Cells by Regulating PD-1/PD-L1 Signaling Pathway].

OBJECTIVE: To explore the effect of microRNA-424-5p (miR-424-5p) on the drug resistance of diffuse large B-cell lymphoma (DLBCL) cells by regulating the programmed death receptor-1 (PD-1)/programmed death ligand-1 (PD-L1) signaling pathway. METHODS: Human DLBCL cell line CRL2631 cells were induced to construct CRL2631-CHOP resistant cell line. RT-qPCR and Western blot were used to detect the expression levels of MiR-424-5p, PD-L1 mRNA and protein, and multidrug resistance gene-1 (MDR-1) protein in CRL2631 cells and CRL2631-CHOP cells, respectively. The target genes of MiR-424-5p was verified by dual luciferase reporter assay. The miRNA simulation/interference technology and thiazole blue (MTT) method were used to detect the resistance of CRL2631 cells and CRL2631-CHOP cells to CHOP. RESULTS: Compared with CRL2631 cells, the drug resistance of CRL2631-CHOP cells to CHOP and the levels of MDR-1 protein (P<0.05), PD-L1 mRNA and protein in the cells were significantly increased (both P<0.001), while the relative level of MiR-424-5p was significantly reduced (P<0.001). The result of the dual luciferase reporter assay showed that PD-L1 was the direct downstream target gene of MiR-424-5p (P<0.001). After transfection of MiR-424-5p inhibitor, the resistance of CRL2631 cells to CHOP drugs increased, and the expression level of MDR-1 protein (P<0.01), PD-L1 mRNA and protein also increased significantly (both P<0.01). After transfection of MiR-424-5p mimics, the resistance of CRL2631-CHOP cells to CHOP drugs decreased, and the expression level of MDR-1 protein (P<0.001), PD-L1 mRNA and protein also decreased significantly (both P<0.001). Overexpression of PD-L1 could reverse the inhibitory effect of upregulating MiR-424-5p on PD-L1 (P<0.001). CONCLUSION: Down-regulation of MiR-424-5p enhances the drug resistance of DLBCL cells by regulating the PD-1/PD-L1 signaling pathway.

The theoretical model and sinusoidal optimization strategy for oscillating shear valve type continuous waves generator.

Continuous-wave mud generator is widely adopted for real-time downhole data transmission of deep wells in the oil industry. There have been many studies on rotor structure optimization of continuous rotary valve tools but few studies on the different optimization mechanisms of oscillating shear valve tools. In this paper, a theoretical model of pressure wave generation for oscillating shear valve tools was presented, and the reason for the non-sinusoidal waveform was analyzed theoretically for the first time. A series of rotor rotation strategies were proposed to improve the sinusoidal properties of pressure waves without changing the mechanical structure of the rotor. Finally, CFD with different parameters was conducted to verify the feasibility of the optimization scheme. The numerical results give the recommended range of parameters under different control schemes. In addition, the relationship between throttle pressure drop and pressure wave waveform is found through comparison with previous research of the team, which provides a new research idea for the optimization of the pressure wave in the future.

Microvascular Doppler-assisted Microsurgical Left Spermatic-inferior Epigastric Vein Anastomosis for Treating Nutcracker Syndrome-associated Varicocele.

Background: Nutcracker syndrome (NCS) is a rare cause of varicocele and its treatment is still controversial. Objective: To summarize the surgical strategy and outcomes of microvascular Doppler (MVD)-assisted microsurgical left spermatic-inferior epigastric vein anastomosis (MLSIEVA) with microsurgical varicocelectomy (MV) at the same incision for treating NCS-associated varicocele. Design setting and participants: A retrospective analysis of 13 cases of NCS-associated varicocele between July 2018 and January 2022 was performed. Surgical procedure: A small incision in the body projection corresponding to the deep inguinal ring was chosen as the surgical incision. All patients underwent MLSIEVA and MV with the assistance of MVD. Measurements: Patients received real-time Doppler ultrasound (DUS) before and after surgery; urine red blood cells and protein were tested, with a follow-up time of 12-53 mo. Results and limitations: All patients had no intraoperative complications, and all postoperative symptoms of hematuria or proteinuria, scrotal swelling, and low back pain disappeared. Comparing pre- and postoperative DUS, two patients did not show any improvement in their postoperative measurements. However, in the remaining patients, the internal diameter of the renal vein at the hilum portion and at the aortomesenteric angle portion, as well as their ratio, improved significantly compared with preoperative measurements. No complications or recurrence of varicocele was observed during postoperative follow-up. Conclusions: Our study suggests that MVD-assisted MLSIEVA with MV is feasible with no major short-term complication and effective regarding the treatment of varicocele and NCS. Patient summary: We investigated microsurgery mediated by microultrasound for the treatment of varicocele associated with nutcracker syndrome. We found this procedure to be safe and effective with good long-term results.

Semi-Supervised CT Lesion Segmentation Using Uncertainty-Based Data Pairing and SwapMix.

Semi-supervised learning (SSL) methods show their powerful performance to deal with the issue of data shortage in the field of medical image segmentation. However, existing SSL methods still suffer from the problem of unreliable predictions on unannotated data due to the lack of manual annotations for them. In this paper, we propose an unreliability-diluted consistency training (UDiCT) mechanism to dilute the unreliability in SSL by assembling reliable annotated data into unreliable unannotated data. Specifically, we first propose an uncertainty-based data pairing module to pair annotated data with unannotated data based on a complementary uncertainty pairing rule, which avoids two hard samples being paired off. Secondly, we develop SwapMix, a mixed sample data augmentation method, to integrate annotated data into unannotated data for training our model in a low-unreliability manner. Finally, UDiCT is trained by minimizing a supervised loss and an unreliability-diluted consistency loss, which makes our model robust to diverse backgrounds. Extensive experiments on three chest CT datasets show the effectiveness of our method for semi-supervised CT lesion segmentation.

Research trends and hotspots in exercise rehabilitation for coronary heart disease: A bibliometric analysis.

Exercise rehabilitation can improve the prognosis of patients with coronary heart disease. However, a bibliometric analysis of the global exercise rehabilitation for coronary heart disease (CHD) research topic is lacking. This study investigated the development trends and research hotspots in the field of coronary heart disease and exercise rehabilitation. CiteSpace software was used to analyze the literature on exercise therapy for CHD in the Web of Science Core Collection database. We analyzed the data of countries/institutions, journals, authors, keywords, and cited references. A total of 3485 peer-reviewed papers were found, and the number of publications on the topic has steadily increased. The most productive country is the USA (1125), followed by China (477) and England (399). The top 3 active academic institutions are Research Libraries UK (RLUK) (236), Harvard University (152), and the University of California System (118). The most commonly cited journals are Circulation (2596), The most commonly cited references are "Exercise-based cardiac rehabilitation for coronary heart disease" (75), Lavie CJ had published the most papers (48). World Health Organization was the most influential author (334 citations). The research frontier trends in this field are body composition, participation, and function. Research on the effects of physical activity or exercise on patients with CHD is a focus of continuous exploration in this field. This study provides a new scientific perspective for exercise rehabilitation and CHD research and gives researchers valuable information for detecting the current research status, hotspots, and emerging trends for further research.