[The efficacy of chemotherapy re-challenge in third-line setting for metastatic colorectal cancer patients: a real-world study].

Objective: To explore the efficacy of chemotherapy re-challenge in the third-line setting for patients with metastatic colorectal cancer (mCRC) in the real world. Methods: The clinicopathological data, treatment information, recent treatment efficacy, adverse events and survival data of mCRC patients who had disease progression after treatment with oxaliplatin-based and/or irinotecan-based chemotherapy and received third-line chemotherapy re-challenge from January 2013 to December 2020 at Tianjin Medical University Cancer Institute and Hospital were retrospectively collected. Survival curves were plotted with the Kaplan-Meier method, and the Cox proportional hazard model was used to analyze the prognostic factors. Results: A total of 95 mCRC patients were included. Among them, 32 patients (33.7%) received chemotherapy alone and 63 patients (66.3%) received chemotherapy combined with targeted drugs. Eighty-three patients were treated with dual-drug chemotherapy (87.4%), including oxaliplatin re-challenge in 35 patients and irinotecan re-challenge in 48 patients. The remaining 12 patients were treated with triplet chemotherapy regimens (12.6%). Among them, as 5 patients had sequential application of oxaliplatin and irinotecan in front-line treatments, their third-line therapy re-challenged both oxaliplatin and irinotecan; 7 patients only had oxaliplatin prescription before, and these patients re-challenged oxaliplatin in the third-line treatment. The overall response rate (ORR) and disease control rate (DCR) reached 8.6% (8/93) and 61.3% (57/93), respectively. The median progression free survival (mPFS) and median overall survival (mOS) were 4.9 months and 13.0 months, respectively. The most common adverse events were leukopenia (34.7%) and neutropenia (34.7%), followed by gastrointestinal adverse reactions such as nausea (32.6%) and vomiting (31.6%). Grade 3-4 adverse events were mostly hematological toxicity. Cox multivariate analysis showed that gender (HR=1.609, 95% CI: 1.016-2.548) and the PFS of front-line treatments (HR=0.598, 95% CI: 0.378-0.947) were independent prognostic factors. Conclusion: The results suggested that it is safe and effective for mCRC patients to choose third-line chemotherapy re-challenge, especially for patients with a PFS of more than one year in front-line treatments.

Source apportionment and ozone formation mechanism of VOCs considering photochemical loss in Guangzhou, China.

Understanding the sources and impact of volatile organic compounds (VOCs) on ozone formation is challenging when the traditional method does not account for their photochemical loss. In this study, online monitoring of 56 VOCs was carried out in summer and autumn during high ozone pollution episodes. The photochemical age method was used to evaluate the atmospheric chemical loss of VOCs and to analyze the effects on characteristics, sources, and ozone formation of VOC components. The initial concentrations during daytime were 5.12 ppbv and 4.49 ppbv higher than the observed concentrations in the summer and autumn, respectively. The positive matrix factorization (PMF) model identified 5 major emission sources. However, the omission of the chemical loss of VOCs led to underestimating the contributions of sources associated with highly reactive VOC components, such as those produced by biogenic emissions and solvent usage. Conversely it resulted in overestimating the contributions from VOC components with lower chemical activity such as liquefied petroleum gas (LPG) usage, vehicle emissions, and gasoline evaporation. Furthermore, the estimation of ozone formation may be underestimated when the atmospheric photochemical loss is not taken into account. The ozone formation potential (OFP) method and propylene-equivalent concentration method both underestimated ozone formation by 53.24 ppbv and 47.25 ppbc, respectively, in the summer, and by 40.34 ppbv and 26.37 ppbc, respectively, in the autumn. The determination of the ozone formation regime based on VOC chemical loss was more acceptable. In the summer, the ozone formation regime changed from the VOC-limited regime to the VOC-NOx transition regime, while in the autumn, the ozone formation regime changed from the strong VOC-limited regime to the weak VOC-limited regime. To obtain more thorough and precise conclusions, further monitoring and analysis studies will be conducted in the near future on a wider variety of VOC species such as oxygenated VOCs (OVOCs).

[Colorectal cancer cells induce the formation of cancer-associated fibroblasts by activating the ERK signaling pathway in fibroblasts].

OBJECTIVE: To investigate the mechanism by which conditioned medium of colorectal cancer cells promotes the formation of cancer-associated fibroblasts (CAFs). METHODS: Normal human colorectal fibroblasts (CCD-18Co cells) in logarithmic growth phase were treated with the conditioned media of colorectal cancer HCT116 cells (HCT116-CM) or Caco-2 cells (Caco-2-CM) alone or in combination with 300 nmol/L ERK inhibitor SCH772984. The expression levels of CAFs-related molecular markers were detected in the treated cells with real-time quantitative PCR (RT- qPCR) and immunofluorescence assay, and the changes in cell proliferation, colony formation and migration were assessed with RTCA, colony formation and wound healing assays; Western blotting was performed to detect the activated signaling pathways in the fibroblasts and the changes in CAFs formation after blocking of the signaling pathway. RESULTS: HCT116-CM and Caco-2-CM significantly upregulated mRNA expression levels of CAFs markers (including α-SMA, FAP, FN and TGF-ß) in CCD-18Co cells, and strongly promoted fibroblast transformation into CAFs (P < 0.05). The two conditioned media also promoted the proliferation, colony formation and migration of CCD-18Co cells (P < 0.05) and significantly increased the levels of α-SMA protein and ERK phosphorylation in the cells (P < 0.05). The ERK inhibitor SCH772984 obviously inhibited the expression of α-SMA and the transformation of CCD-18Co cells into CAFs induced by the conditioned medium of colorectal cancer cells (P < 0.05). CONCLUSION: Colorectal cancer cells may induce the formation of colorectal CAFs by activating the ERK pathway in the fibroblasts.

[The role of fluorescent cholangiography in preventing biliary tract injury and finding bile leakage].

The study investigated the clinical value of fluorescence cholangiography using indocyanine green (ICG) in laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) in preventing bile duct injury (BDI) and detecting bile leakage. A total of 300 patients who underwent fluorescent navigation LC and LCBDE in the Second Department of General Surgery, Shengjing Hospital Affiliated to China Medical University from June 2020 to September 2022 were selected as the research objects for observation and analysis. There were 114 males and 186 females, and aged (50.7±14.0) years with the body mass index (BMI) of (23.6±1.6) kg/m². All 300 cases of fluorescence navigation surgery were successfully completed, of which 5 patients received fluorescence-guided LCBDE and primary suture. The results showed that the application of fluorescence cholangiography with ICG can effectively avoid and detect the occurrence of BDI and bile leakage. Meanwhile, it is reasonable to hypothesize that ICG can be used for rapid localization and the final check to prevent the recurrence of bile leakage when bile leakage is suspected in the second operation.

Signatures of selection reveal candidate genes involved in production traits in Chinese crossbred buffaloes.

Identification of selection signature is important for a better understanding of genetic mechanisms that affect phenotypic differentiation in livestock. However, the genome-wide selection responses have not been investigated for the production traits of Chinese crossbred buffaloes. In this study, an SNP data set of 133 buffaloes (Chinese crossbred buffalo, n = 45; Chinese local swamp buffalo, n = 88) was collected from the Dryad Digital Repository database (https://datadryad.org/stash/). Population genetics analysis showed that these buffaloes were divided into the following 2 groups: crossbred buffalo and swamp buffalo. The crossbred group had higher genetic diversity than the swamp group. Using 3 complementary statistical methods (integrated haplotype score, cross population extended haplotype homozygosity, and composite likelihood ratio), a total of 31 candidate selection regions were identified in the Chinese crossbred population. Here, within these candidate regions, 25 genes were under the putative selection. Among them, several candidate genes were reported to be associated with production traits. In addition, we identified 13 selection regions that overlapped with bovine QTLs that were mainly involved in milk production and composition traits. These results can provide useful insights regarding the selection response for production traits of Chinese crossbred buffalo, as identified candidate genes influence production performance.

[Research and development technology platform and research progress of universal influenza vaccine].

Vaccination is the most effective measure to prevent influenza. However, due to the existence of antigen drift and/or antigen shift of influenza virus, the vaccine strains often do not match the epidemic strains, so that the protection provided by influenza vaccine is still limited. With the rapid development of new vaccine technology, a kind of influenza vaccine with extensive protection or universal has attracted great attention. It can effectively induce humoral and cellular immunity against the conserved epitopes of influenza virus, provide good protection against various types/subtypes of influenza virus, and has a rapid production platform, which is the ideal goal for the development of a new generation of universal influenza vaccine. This article reviews the latest research progress of influenza universal vaccine.

[Surface modification of titanium implant with hBMP-2/hIGF-1 for promoting biocompatibility and osteogenesis].

OBJECTIVE: To prepare the human bone morphogenetic protein-2(hBMP-2)/human insulin-like growth factor-1(hIGF-1)coating titanium(Ti)and assess its performance as a dental implant material. METHODS: hBMP-2 and hIGF-1 were coated to the smooth surface of a Ti plate, and its efficacy for promoting bone formation and bone integration was compared with a pristine Ti plate.The surface characteristics of the metal samples were evaluated using scanning electron microscope (SEM) and by contact angle measurement.MG63 cells were seeded on the surface of the Ti plates, and MTT assay and alizarin red staining was used to examine the cell proliferation and formation of calcified nodules, respectively.Alkaline phosphatase (ALP)secretion of the cells was examined with ELISA, and cellular expressions of osteocalcin and osteopontin were detected with Western blotting for assessing osteogenesis. RESULTS: SEM examination showed that the surface of Ti with hBMP-2 and hIGF-1 coating presented with a radial pattern resembling snowflakes.The contact angles of non-coated Ti, hBMP-2-coated Ti, hIGF-1-coated, and hBMP-2/-hIGF-1-coated Ti samples were 83.2°, 54°, 56° and 54°, respectively.Compared with the non-coated Ti plate, the surface-modified Ti samples showed a significantly smaller contact angle (P=0.032, 0.029, and 0.028), indicating a good hydrophilicity of the samples.MTT assay showed that MG63 cells grew well on the surface of the coated Ti plates.The hBMP-2/IGF-1 coating significantly induced cellular secretion of ALP(P=0.021, 0.014)and obviously promoted osteogenesis of MG63 cells (P < 0.05).Western blotting results showed that hBMP-2/IGF-1 coating significantly enhanced the expressions of osteocalcin and osteopontin in the seeded cells (P < 0.05). CONCLUSION: hBMP-2 and hIGF-1 coating of Ti material can promote osteogenesis of the cells seeded on its surface to improve the performance of such Ti material as dental implants.

[Incidence of deeply infiltrating endometriosis among 240 cases of pelvic endometriosis and analysis of its clinical and pathological characteristics].

Objective: To evaluate the incidence of deeply infiltrating endometriosis (DIE) among patients of pelvic endometriosis confirmed by pathology and to make analysis of its clinical and pathological characteristics. Methods: From January 1, 2018 to December 31, 2018, clinical data of 240 cases of pelvic endometriosis diagnosed by laparoscopy and pathology hospitalized in Peking University First Hospital were analyzed retrospectively for the characteristics of symptoms, pelvic examination and anatomic distribution of endometriosis foci. Results: (1) Among 240 cases of pelvic endometriosis, 94 were diagnosed with DIE with an incidence of 39.2% (94/240); of them the diagnosis were made preoperatively in 44 cases (46.8%, 44/94). (2) Compared with those without DIE, patients with DIE had higher rates of secondary dysmenorrhea [53.2% (50/94) versus 38.4% (56/146), P=0.033], anal pain [43.6% (41/94) versus 28.1% (41/146), P=0.013], dyspareunea [39.4% (37/94) versus 18.5% (27/146), P=0.001] and frequent bowel movement [33.0% (31/94) versus 15.8%(23/146), P=0.002]. (3) Patients with DIE had higher rates of bad movement of uterus [21.3% (20/94) versus 6.8% (10/146), P=0.001], painful nodularity on uterosacral ligaments [26.6% (25/94) versus 6.2% (9/146), P<0.01], painful nodularity of posterior fornix [19.1% (18/94) versus 4.8% (7/146), P<0.01], blue nodule in vaginal wall [6.4% (6/94) versus 0 (0/146), P=0.003] by pelvic examination compared with those without DIE. (4) Ninety-four patients with DIE had a total of 162 nodules, of those 88 (54.3%, 88/162) located in uterosacral ligaments, 14 (8.6%, 14/162) in the rectum, 7 (4.3%, 7/162) in vaginal wall, 6 (3.7%, 6/162) in ureter, 4 in bladder (2.5%, 4/162), 2 (1.2%, 2/162) in Douglas pouch. Forty-three DIE patients (45.7%, 43/94) had more than one nodules. Patients with DIE had concomitant ovarian endometriosis in 69 cases (73.4%, 69/94), with a total of 103 endometrial cysts. (5) Patients with DIE had a higher rate of obliterated Douglas pouch [76.6% (72/94) versus 19.2% (28/146), P<0.01]. Conclusions: More than one third of patients with pelvic endometriosis have concomitant DIE with a lower rate of preoperative diagnosis. Pelvic pains, bad movement of uterus and painful nodulirity around cervix suggest the presence of DIE.

The use of a single ammonium acidic salt towards simple green co-precipitation synthesis for Mn4+-activated fluorides.

Herein, a simple green co-precipitation route for Mn4+-activated fluorides has been realized via individually using the aqueous acidic salt NH4HF2 as a solvent. The systematic explorations of ionization, erosion, solvent concentration, solvency on reactants, and reaction with an extra weak acid disclosed that the near-saturated aqueous NH4HF2, ionizing into abundant HF2-, H+, and F- ions, exhibited large dissolving capacity and good stabilization on Mn4+ without obvious toxicity. The green synthesized example of Cs2GeF6:Mn4+ emitted a typical narrow band red light at 633 nm with normal optimal doping at ∼8 at%. Compared with its contrast prepared from the HF system, it experienced only ∼10% reduction in quantum efficiency and slight emission attenuation below 150 °C as the more humidity-sensitive weaker acid surface aroused lattice thermal vibration. The further action as red component fabricated a high-quality warm white light-emitting diode (W-LED) with a high color rendering index (Ra ∼ 91), high luminous efficacy (∼149 lm W-1), low correlated color temperature (∼3211 K), and good color stability against the operating environment. Combined with the universal synthesis of A2XF6:Mn4+ (A = K, Rb, Cs; X = Si, Ge), our findings can probably open up a simple and feasible green synthetic strategy for efficient Mn4+-doped fluorides using acidic salts.

[Anatomical study of rat trigeminal motor nucleus-lateral pterygoid muscle projection pathway].

Objective: To determine the opening and closing action of the external muscle, the projection pathway of the axon terminal of trigeminal motor nucleus (Vmo) neuron to the lateral pterygoid muscle was revealed. Methods: In this study, 10 SD rats of 8 weeks old were included. The left lateral pterygoid muscle of SD rats was surgically exposed, and the wound was closed after intramuscular injection of hydroxystilbamidine/fluorogold (FG) 3-5 µl. Seven days after the operation, the experimental animals were perfused, samples collected and sectioned for immunofluorescence staining. After FG injection into the lateral pterygoid muscle, the FG reversed in the Vmo neurons. Results: In the Vmo neurons on the FG injection side (left side), a large number of FG reversed neurons were found in the corpus luteum and dendrites. These neurons were not only distributed in the dorsolateral part of the trigeminal motor nucleus that innervated the closed muscle, but also in the ventral medial portion of the trigeminal nucleus of the open muscle. Conclusions: The neuronal conduction pathway between the Vmo and the lateral pterygoid muscle innervates the lateral pterygoid muscle. The neurons are distributed both in the dorsolateral and in the nucleus of the ventral ventricle. It is concluded that the lateral pterygoid muscle involve in the jaw closing and opening movement.

Genome-wide analysis reveals genetic diversity, linkage disequilibrium, and selection for milk production traits in Chinese buffalo breeds.

The water buffalo is an important dual-purpose livestock that is widespread throughout central and southern China. However, there has been no characterization of the population genetics of Chinese buffalo. Using an Axiom buffalo genotyping array (Thermo Fisher Scientific, Wilmington, DE), we analyzed the genetic diversity, linkage disequilibrium pattern, and signature of selection in 176 Chinese buffaloes from 13 breeds. A total of 35,547 SNP passed quality control and were used for further analyses. Population genetic analysis revealed a clear separation between swamp and river types. Ten Chinese indigenous breeds were clustered into the swamp group, the Murrah and Nili-Ravi breeds were clustered into the river group, and the crossbred breed was closer to the river group. Genetic diversity analysis showed that the swamp group had a lower average expected heterozygosity. Linkage disequilibrium decay distance was much shorter in the swamp group compared with the river group, with an average square of correlation coefficient value of 0.2 of approximately 50 kb. Analysis of runs of homozygosity indicated extensive remote and recent inbreeding within swamp and river groups, respectively. Moreover, one genomic region under selection was detected between the river and swamp groups. Our findings contribute to our understanding of the characterization of population genetics in Chinese buffaloes, which in turn may be used in buffalo breeding programs.

Association between maximum mouth opening and area of bony fusion in simulated temporomandibular joint bony ankylosis.

The aim of this study was to investigate the quantitative association between active/passive maximum mouth opening (AMMO/PMMO) and the severity of simulated temporomandibular joint (TMJ) bony ankylosis. Twenty-eight male sheep were divided randomly and equally into surgical and control groups. Surgical group animals underwent bilateral TMJ osteotomy during which left lateral pterygoid muscle function was blocked. Control animals did not undergo surgery. Body weight, AMMO/PMMO, and TMJ morphological features were evaluated preoperatively and at 12 and 24 weeks post-surgery. In the surgical group, only the right TMJ complexes with maintained lateral pterygoid muscle function developed TMJ bony ankylosis. The AMMO/PMMO and end-feel distance in the surgical group were significantly lower than those in the control group (P < 0.001, both) at 12 and 24 weeks post-surgery. Moreover, AMMO (r = -0.940 and -0.952, P < 0.001, both) and PMMO (r = -0.944 and -0.953, P < 0.001, both) were negatively correlated with the area (mm2) of bony fusion post-surgery. These findings may be useful for the clinical treatment of early mandibular condyle fracture, with the use of occlusal pads/open-mouth plates to relax the lateral pterygoid muscle and block its function. When bony ankylosis developed in the TMJ, the greater the area of bony fusion, the more limited were AMMO/PMMO.

Bioinformatics analysis of candidate genes for milk production traits in water buffalo (Bubalus bubalis).

Water buffalo (Bubalus bubalis) is an important livestock species in developing countries due to its contribution to meat, milk production, and a certain form of labor. However, the genetic potential of buffalo milk production traits has not been fully exploited. To date, 516 candidate genes associated with milk production traits of buffalo have been identified. The present study aimed to explore the possible molecular mechanisms underlying milk production traits of this species through functional genomics analysis of these candidate genes by using different bioinformatics tools. Gene ontology (GO) analysis indicated that these candidate genes were associated with complex biological processes, such as cell proliferation and mitotic nuclear division. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis demonstrated that these candidate genes were enriched in multiple signaling pathways, such as AMPK, ErbB, Toll-like receptor, and Jak-STAT. In addition, one function module consisting of 57 nodes and 139 edges were identified from the protein-protein interaction (PPI) network. GO analysis showed that the 57 candidate genes in this function module were enriched in three main biological processes, including homeostasis, metabolism, and cell response. These three distinct biological processes are well known for regulating mammary gland activities, which explained clearly the mechanism underlying milk production traits. This study provides a novel perspective for better understanding of the biological processes linked with milk production traits. This knowledge is conducive to the improvement of milk yield and composition of this species.

Geographical distribution of ozone seasonality over China.

Up to now, a nation-wide scale study of surface ozone (O3) concentrations in China was limited due to scarce observation. Thanks to the establishment of national air quality monitoring network in 2013, surface O3 data from 1402 stations during 2014-2017 were collected to investigate O3 seasonality. Our analysis reveals that the variations of monthly O3 averaged from daily mean concentration during a year show different temporal profiles depending on latitude. A unimodal structure (UMS) is generally found for latitudes over 35°N, whereas a bimodal structure (BMS) is in most of the cases identified south of 35°N. The peak of UMS is found in the period of May to July, whereas the first and second peaks of BMS are found from April to June, and from July to October, respectively. In addition, the seasonality of O3 presents a strong dependence on pseudo-equivalent potential temperature and monsoonal clouds. The onset and retreat of warm and wet air are correlated to the summer minimum in BMS cases and to the sharp decrease of UMS in July. As far as the relationships between O3 and carbon monoxide are concerned, the effects of clean maritime air masses on the summer trough of O3 are not significant for inland sites. Overall, summer monsoon bringing warm and moist air and subsequent clouds leads to the suppression of photochemical production, thereby contributing directly to the geographical distribution of O3 seasonality.

[Analysis of risk factors for postoperative haemorrhage following coblation assisted tonsillectomy].

Objective: To investigate the risk factors for postoperative haemorrhage following coblation assisted tonsillectomy, thus provide the guidence for the clinical treatment. Method: The clinical data of 1 128 patients who underwent tonsillectomy were analyzed retrospectively. Result: The rate of postoperative haemorrhage was 6.02%. Univariate analysis and logistic regression analysis showed a significant relationship between age and postoperative haemorrhage(P<0.05). Conclusion: Age was an independent risk factor for postoperative haemorrhage following coblation-assisted tonsillectomy. .

Systematic analyses for candidate genes of milk production traits in water buffalo (Bubalus Bubalis).

Water buffalo (Bubalus bubalis) is of great economic importance as a provider of milk and meat in many countries. However, the milk yield of buffalo is much lower than that of Holstein cows. Selection of candidate genes related to milk production traits can be applied to improve buffalo milk performance. A systematic review of studies of these candidate genes will be greatly beneficial for researchers to timely and efficiently understand the research development of molecular markers for buffalo milk production traits. Here, we identified and classified the candidate genes associated with buffalo milk production traits. A total of 517 candidate genes have been identified as being associated with milk performance in different buffalo breeds. Nineteen candidate genes containing 47 mutation sites have been identified using the candidate gene approach. In addition, 499 candidate genes have been identified in six genome-wide association studies (GWASes) including two studies performed with the bovine SNP chip and four studies with the buffalo SNP chip. Genes CTNND2 (catenin delta 2), APOB (apolipoprotein B), FHIT (fragile histidine triad) and ESRRG (estrogen related receptor gamma) were identified in at least two GWASes. These four genes, especially APOB, deserve further study to explore regulatory roles in buffalo milk production. With growth in the number of buffalo genomic studies, more candidate genes associated with buffalo milk production traits will be identified. Therefore, future studies, such as those investigating gene location and functional analyses, are necessary to facilitate the exploitation of genetic potential and the improvement of buffalo milk performance.

No high Tibetan Plateau until the Neogene.

The Late Paleogene surface height and paleoenvironment for the core area of the Qinghai-Tibetan Plateau (QTP) remain critically unresolved. Here, we report the discovery of the youngest well-preserved fossil palm leaves from Tibet. They were recovered from the Late Paleogene (Chattian), ca. 25.5 ± 0.5 million years, paleolake sediments within the Lunpola Basin (32.033°N, 89.767°E), central QTP at a present elevation of 4655 m. The anatomy of palms renders them intrinsically susceptible to freezing, imposing upper bounds on their latitudinal and altitudinal distribution. Combined with model-determined paleoterrestrial lapse rates, this shows that a high plateau cannot have existed in the core of Tibet in the Paleogene. Instead, a deep paleovalley, whose floor was <2.3 km above mean sea level bounded by (>4 km) high mountain systems, formed a topographically highly varied landscape. This finding challenges prevailing views on tectonic processes, monsoon dynamics, and the evolution of Asian biodiversity.

Does simultaneous bilateral total joint arthroplasty increase deep infection risk compared to staged surgeries? A meta-analysis.

BACKGROUND: Several studies have compared the incidence of periprosthetic joint infection (PJI) between simultaneous bilateral total joint arthroplasty (SBTJA) and staged bilateral total joint arthroplasty (StBTJA) patients following primary total joint arthroplasty. However, these studies lacked statistical power. AIM: To determine by meta-analysis whether SBTJA increases deep infection risk compared to StBTJA. METHODS: All studies were retrieved from PubMed, Embase, Cochrane Library databases, Web of Science, PEDro, CINAHL, SPORTDiscus, and Scopus. A meta-analysis was conducted to compare PJI rate between SBTJA and StBTJA patients. FINDINGS: Overall, there were 16 studies with 36,765 patients who underwent SBTJA and 71,558 patients who underwent StBTJA. The pooled data showed that the PJI rate of SBTJA was lower than that of StBTJA (0.84% vs 1.57%; odds ratio (OR): 0.57; 95% confidence interval (CI): 0.49-0.66; heterogeneity, I2 = 0%; P = 0.74). In subgroup analysis, the pooled data revealed that there was no significant difference between SBTJA and StBTJA groups for PJI if the two groups had similar baseline demographics (four studies; OR: 0.55; 95% CI: 0.21-1.40; heterogeneity, I2 = 0%; P = 0.77). The pooled data showed that the PJI rate of SBTJA patients was comparable with that of StBTJA patients within a three-month staging interval (three studies; OR: 1.22; 95% CI: 0.38-3.88; heterogeneity, I2 = 0%; P = 0.42). CONCLUSION: SBTJA does not increase the risk of subsequent PJI compared to StBTJA. Further studies are needed to provide higher quality evidence to evaluate the two modes of procedure.

Association between phosphodiesterase type 5 inhibitors use and risk of melanoma: a meta-analysis.

This meta-analysis aimed to clarify the actual association between the phosphodiesterase type 5 inhibitors (PDE5-Is) use and the risk of melanoma in erectile dysfunction (ED) patients. A systematic literature search was conducted in online databases in October, 2016 to identify studies focusing on the association between PDE5-Is use and the risk of melanoma. Summarized multivariate adjusted risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to assess the strength of associations. A total of six clinical trials containing more than one million participants were included. ED patients  using PDE5-Is shared a significant high risk of melanoma (RR=1.12, 95% CI=1.03-1.21, p=0.006). Positive associations were observed in all kinds of prescriptions: single prescription (RR=1.20, 95% CI=1.06-1.35, p=0.003), medium number of prescription (RR=1.15, 95% CI=1.01-1.30, p=0.03), and high number of prescription (RR=1.18, 95% CI=1.05-1.34, P=0.006). Additionally, PDE5-Is were also found to be significantly associated with increased risk of basal cell carcinoma (RR=1.14, 95% CI=1.09-1.19, p<0.00001). Our study indicates that PDE5-Is use could significantly increase the risk of melanoma and basal cell carcinoma. However, the risk of melanoma did not rise significantly with the increased number of prescriptions. Consequently, owing to the lack of information about other potential synergistic factors, it is difficult for us to make a solid conclusion that application of PDE5-Is is the direct cause of increased risk of melanoma. Their relationship needs to be validated by further evidences.