[A case of crizotinib-associated renal cysts].

Crizotinib-associated renal cysts (CARC) are the development of new renal cysts or pre-existing renal cysts after the treatment with crizotinib. Most CARC disappear after crizotinib is stopped. A few CARC showed aggressive behavior that could go beyond the invasion of the renal cortex into nearby structures, including perirenal space, psoas major muscle, intestine, and abdominal wall. A case of EML4-ALK fusion mutation in invasive lung adenocarcinoma has been reported. Multiple cystic changes occurred repeatedly in both kidneys, right rectus muscle, and psoas major muscle after treatment with crizotinib, and spontaneous absorption and resolution after discontinuation of the drug.

[Comparison of maternal-fetal outcomes between laparoscopic cervicoisthmic cerclage and McDonald cerclage in women with cervical insufficiency].

Objective: To compare the maternal and fetal outcomes of women with cervical insufficiency (CI) undergoing McDonald cerclage (MC) and laparoscopic cervicoisthmic cerclage (LCC), so as to provide evidence for the selection of cerclage methods. Methods: A retrospective trial was carried out in the First Affiliated Hospital of Sun Yat-sen University from January 2010 to December 2020. A total of 221 women who underwent the prophylactic cerclage were divided into MC group (n=54), LCC with MC history group (n=28) and LCC without MC history group (n=129) by the mode of operation and whether the pregnant women who underwent LCC had MC history. General clinical data, pregnancy complications and pregnancy outcomes were compared between the three groups. Results: (1) General clinical data: the proportion of women accepted cervical cerclage during pregnancy in MC group, LCC with MC history group and LCC without MC history group were 100.0% (54/54), 7.1% (2/28) and 27.1% (35/129), respectively (P<0.001). The indications of the three groups showed statistical significance (P=0.003), and the main indication was the history of abortion in the second and third trimester [75.9% (41/54) vs 89.3% (25/28) vs 84.5% (109/129)]. (2) Pregnancy complications: the incidence of abnormal fetal position [7.8% (4/51) vs 17.4% (4/23) vs 19.8% (24/121)], placenta accrete [5.9% (3/51) vs 13.0% (3/23) vs 11.6% (14/121)], uterine rupture [0 vs 4.3% (1/23) vs 5.8% (7/121)] in the MC group were all lower than those in LCC with MC history and LCC without MC history groups. However, there were no statistical significances (all P>0.05). Intrauterine inflammation or chorioamnionitis [15.7% (8/51) vs 0 vs 0.8% (1/121)] and premature rupture of membrane [23.5% (12/51) vs 4.3% (1/23) vs 0] were both significantly higher in MC group than those in LCC with MC history and LCC without MC history groups (all P<0.001). (3) Pregnancy outcomes: the cesarean section rate was significantly lower in MC group (41.2%, 21/51) than that in LCC with MC history group (100.0%, 23/23) and LCC without MC history group (100.0%, 121/121; P<0.001). MC group was associated with lower expenditure than LCC with MC history and LCC without MC history groups (12 169 vs 26 438 vs 27 783 yuan, P<0.001). The success rates of live birth cerclage did not differ significantly in MC (94.4%, 51/54), LCC with MC history (82.1%, 23/28) and LCC without MC history (93.8%, 121/129) groups (χ2=5.649, P=0.059). There was no significant difference in neonatal intensive care unit occupancy, neonatal birth weight and neonatal asphyxia between the three groups (all P>0.05). Conclusions: Both LCC and MC are the treatment choice for women with CI, which may get similar liver birth. However, MC has the advantages of low cesarean section rate, economical and easy operation. Therefore, MC is recommended as the first choice for CI patients, and LCC is for women with failed MC.

[The success rate of His-Purkinje system pacing in patients with various sites of atrioventricular block].

Objective: To evaluate the success rate of His-Purkinje system pacing (HPSP) in patients with various sites of atrioventricular block (AVB) and provide clinical evidence for the selection of HPSP in patients with AVB. Methods: This is a retrospective case analysis. 637 patients with AVB who underwent permanent cardiac pacemaker implantation and requiring high proportion of ventricular pacing from March 2016 to September 2021 in the Department of Cardiology, General Hospital of Northern Theater Command were enrolled. The site of AVB was determined by electrophysiological examination. His bundle pacing (HBP) was performed in the first 130 patients (20.4%) who were classified as the HBP group and HPSP included HBP and/or left bundle branch pacing (LBBP) was performed in later 507 patients (79.6%) and these patients were classified as the HPSP group. The basic clinical information such as age and sex of the two groups was compared, and the success rates of HBP or HPSP in patients with different sites of AVB and QRS intervals were analyzed. Results: The age of HBP group was (66.4±15.9) years with 75 males (57.7%). The age of HPSP group was (66.8±13.6) years with 288 (56.8%) males. Among 637 patients, 63.0% (401/637) had atrioventricular node block; 22.9% (146/637) had intra-His block; 14.1% (90/637) had distal or inferior His bundle block. Totally, the success rate of HPSP was higher than that of HBP [93.9% (476/507) vs. 86.9% (113/130), P<0.05]. In each group of patients with various AVB sites, the success rate of HPSP was higher than that of HBP respectively and both success rates of HBP and HPSP showed a declining trend with the distant AVB site. The success rate of HBP in patients with atrioventricular node block and intra-His block was higher than that in patients with distal or inferior His bundle block [95.2% (79/83) vs. 47.1% (8/17), P<0.001; 86.7% (26/30) vs. 47.1% (8/17), P=0.010]. The success rate of HPSP was higher than that of HBP in patients with distal or inferior His bundle block [87.7% (64/73) vs 47.1% (8/17), P=0.001]. In patients with QRS<120 ms, 94.9% (520/548) of AVB sites were in atrioventricular node or intra-His, and HBP had a similar high success rate with HPSP [95.6% (109/114) vs. 96.3% (418/434), P=0.943] in these patients. In patients with QRS ≥ 120 ms, 69.7% (62/89) of AVB sites were at distal or inferior His bundle, and the success rate of HBP was only 25.0% (4/16), while the success rate of HPSP was as high as 79.5% (58/73), P<0.001. Conclusions: In patients with QRS<120 ms and atrioventricular node block or intra-His block, success rates of HBP and HPSP are similarly high and HBP might be considered as the first choice. In patients with QRS ≥ 120 ms and AVB site at distal or inferior His bundle, the success rate of HPSP is higher than that of HBP, suggesting LBBP should be considered as the first-line treatment option.

[Application of indocyanine green fluorescence visualization in surgical resection of abdominal wall endometriosis].

Objective: To investigate the feasibility, effectiveness and safety of indocyanine green (ICG) navigation in the surgical resection of abdominal wall endometriosis (AWE). Methods: Seven women undergoing surgery for AWE in First Affiliated Hospital of Sun Yat-sen University (from July 1, 2021 to October 1, 2021) were collected. After exposure of the focus, ICG were used intravenously (0.25 mg/kg) as fluorescent dye for the intraoperative evaluation of AWE vascularization. Resection of the AWE was guided by direct visualization of the focus under standard laparoscopy with a near-infrared (NIR) camera head. Surgical margin around the AWE (3, 6, 9 and 12 point) and the margin under the focus were obtained for postoperative pathological examination of endometriosis. Time from injection to fluorescence visualization, the proportion of fluorescence visualization, time of fully resection of AWE, side effects related to the use of ICG, perioperative complications as well as the pathological result of the surgical margins were recorded. Results: ICG fluorescence of the AWE were seen in 5 patients (5/7). The mean time from injection to fluorescence visualization was (46.7±9.8) s. The mean time of fully resection of AWE was (16.4±7.0) minutes. There were no side effects related to the use of ICG. The rate of class-A wound healing was 7/7. All of the surgical margins were confirmed endometriosis-negative by postoperative pathological examination. Conclusion: ICG fluorescence visualization could conduct accurate resection of AWE, which is clinically safe and effective.

MicroRNA-124 inhibits proliferation and metastasis of esophageal cancer via negatively regulating NRP1.

This paper presents several inaccuracies and mistakes. Therefore, the article "MicroRNA-124 inhibits proliferation and metastasis of esophageal cancer via negatively regulating NRP1, by R.-K. Zang, J.-B. Ma, Y.-C. Liang, Y. Wang, S.-L. Hu, Y. Zhang, W. Dong, W. Zhang, L.-K. Hu, published in Eur Rev Med Pharmacol Sci 2018; 22 (14): 4532-4541-DOI: 10.26355/eurrev_201807_15508-PMID: 30058693" has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/15508.

[Application and efficacy of the adjustment on left ventricular electrical delay and the distance between right and left ventricular pacing polar in optimizing the left ventricular pacing polar].

Objective: To investigate the application and efficacy of left ventricular (LV) electrical delay (LVED) and the distance of right ventricular(RV) pacing polar to LV(DRLV) in optimizing LV pacing polar. Methods: Heart failure (HF) patients who implanted cardiac resynchronization therapy (CRT) device with a LV quadripolar lead from January 2014 to January 2018 at General Hospital of Northern Theater Command were enrolled in the study. Measurements of LVED and DRLV of each polar of the lead were performed in patients with HF who underwent CRT with LV quadripolar lead. The principle in turn for polar selecting used for clinical LV pacing was the pacing polar: (1)without phrenic nerve stimulation(PNS); (2)with appropriate capture threshold; (3)not located in apical; (4)with maximal LVED; (5)with maximal DRLV. The LV pacing polar was selected for CRT according to the procedure. The distribution of target veins implanted with LV quadripolar lead were calculated. The percentage of biventricular pacing at 6-month follow-up was recorded. The following indexes were compared before and 6-month after surgery, including QRS duration, LV end-systolic volume(LVESV), LV ejection fraction(LVEF), LV end-diastolic dimension(LVEDD), 6 minute walking distance(6MWD), New York Heart Association(NYHA) class. The efficacy and echocardiographic efficacy of CRT was evaluated. Results: There were twenty-nine HF patients enrolled. The mean age of enrolled patients was(61.7±7.6)years old, nineteen (66%)of them were male. There were seventeen(59%) patients diagnosed as dilated cardiomyopathy and twelve(41%) patients as ischemic cardiomyopathy. All patients were successfully implanted with LV quadripolar lead into target veins, and all four pacing sites were also in target veins. Target veins were located in lateral veins in 15 patients (52%), anterior veins in 2 patients (7%), posterior veins in 11 patients (38%), and lateral branches of great cardiac veins in 1 patient (3%). After 6-month of follow-up, the percentage of biventricular pacing was greater than 95%.There were nineteen(66%) patients optimized LV pacing polar by the largest LVED and four (14%) patients by the DRLV. Of the 29 patients, 5(17%) patients used D1 as the pacing polar, 5(17%) patients used M2 as the pacing polar, 7(24%) patients used M3 as the pacing polar, and 12(41%) patients used P4 as the pacing polar. The pacing polars (D1, M2) of traditional bipolar lead were used in 10(34%) patients, and the LV quadripolar lead specific pacing polars (M3, P4) were used in 19(66%) patients.Compared to a LV quadripolar lead, the LV pacing polar (M3, P4) selected in 19(66%) patients were not achievable with the traditional LV bipolar lead (D1, M2). Preoperative QRS duration, LVESV, LVEF, LVEDD, 6MWD and NYHA class were (171±24)ms, (231±79)ml, (28±5)%, (74±11)mm, (294±103)m, (3.2±1.0)class and the postoperative 6-month were (130±12)ms, (158±73)ml, (36±10)%, (66±12)mm, (371±86)m, (1.9±0.5)class. These indexes were significantly improved after 6 months operation(P<0.001). 97% and 83% patients were responders of CRT as assessed by 6-month efficacy and echocardiographic efficacy. Conclusion: The maximal LVED and DRLV can be used to select LV pacing polar with a high rate of CRT response rate.

MicroRNA-487a promotes proliferation of esophageal cancer cells by inhibiting p62 expression.

OBJECTIVE: MicroRNAs are endogenous, non-coding, small RNAs that can regulate biological processes. Previous studies have found that microRNA-487a serves as an oncogene. However, the role of microRNA-487a in esophageal cancer (EC) has not been reported. The aim of this investigation was to investigate the biological role of microRNA-487a in EC and its underlying mechanism. PATIENTS AND METHODS: The expression of microRNA-487a in 65 pairs of EC tissues and para-cancerous tissues was detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Chi-square test was used to analyze the relationship between microRNA-487a expression with age, sex, clinical stage and distant metastasis of OS patients. Kaplan-Meier survival analysis was conducted to evaluate the correlation between microRNA-487a expression and prognosis of EC patients. Subsequently, microRNA-487a expression in EC cell lines was detected as well. After microRNA-487a knockdown, cell counting kit-8 (CCK-8), EdU and transwell assay were conducted to evaluate the role of microRNA-487a in the biological performances of EC cells, respectively. Meanwhile, the apoptosis of EC cells was determined using flow cytometry. Finally, the interaction between microRNA-487a and p62 was explored by Western blot. Transwell assay was carried out in EC cells co-transfected with p62 overexpression plasmid and si-microRNA-487a. RESULTS: Compared with para-cancerous tissues, microRNA-487a expression was significantly higher in EC tissues, and the difference was statistically significant. MicroRNA-487a was highly expressed in EC cells as well. Low expression of microRNA-487a was positively correlated with clinical stage, whereas was not correlated with age, sex, lymph node metastasis and distant metastasis of EC patients. Kaplan-Meier survival curves showed that high expression of microRNA-487a was markedly associated with poor prognosis of EC. The knockdown of microRNA-487a significantly inhibited proliferative, migratory and invasive abilities of EC cells but induced cell apoptosis. Western blot results showed that the protein expression of p62 was remarkably upregulated after microRNA-478a knockdown in EC cells. Transwell assay demonstrated that co-transfection with overexpression plasmid of p62 and si-microRNA-487a in EC cells markedly decreased invasive and migratory abilities. CONCLUSIONS: MicroRNA-487a is highly expressed in EC and is closely correlated with clinical stage and poor prognosis of EC. Our findings confirm that microRNA-487a promotes malignant progression of EC by regulating p62 expression.

[Impact of diverse shapes of prostatic apex on positive apical margin rate and biochemical recurrence following laparoscopic radical prostatectomy].

Objective: To explore the effects of various forms of prostatic apex on positive apical margin rate (PAM) and biochemical recurrence (BCR) after laparoscopic radical prostatectomy. Methods: A retrospective analysis of 309 patients (aging (65±6) years) who were experienced laparoscopic radical prostatectomy from January 2010 to December 2016 at the Department of Urology, First Affiliated Hospital of Fujian Medical University. According to the relationship between prostate apex and membrane urethra at the mid-sagittal plane of preoperative MRI, all patients were classified into 4 categories. There were 31 patients for type 1, apex covering both anterior and posterior aspects of membranous urethra, 139 patients for type 2, apex covering anterior side of membranous urethra, 63 patients for type 3, apex covering posterior aspect of membranous urethra, 76 patients for type 4, apex not covering membranous urethra. PAM and BCR after operation were compared between this four groups respectively. The χ(2) test was used to compare PAM among the 4 types. Logistic regression analysis were undertaken to analyze the factors affecting PAM. Cox's proportional hazards regression model was undertaken to identify the variables influencing BCR. Results: There was no significant difference in the 4 groups concerning age, body mass index, prostate volume, preoperative prostate-specific antigen (PSA) value, postoperative Gleason score and pathological stage (P>0.05).The median follow-up time was 32 months (ranged from 12 to 60 months).The data showed that the apical type 3 patients has the highest PAM. There was statistical difference among the 4 groups in PAM (χ(2)=15.592, P=0.001). Preoperative level of PSA (OR=20.356, 95% CI: 2.440 to 169.810, P=0.005), postoperative Gleason score (OR=4.113, 95% CI: 1.911 to 8.849, P=0.001), pathological stage (OR=3.422, 95% CI: 1.600 to 7.319, P=0.002) and apical type 3 (OR=6.134, 95% CI: 2.196 to 17.132, P=0.001) were independent relactive factors of PAM. Preoperative level of PSA (HR=1.362, 95% CI: 1.006 to 1.843, P=0.045), postoperative Gleason score (HR=1.920, 95% CI: 1.384 to 2.665, P=0.001), pathological stage (HR=1.476, 95% CI: 1.098 to 1.983, P=0.010), PAM (HR=3.497, 95% CI: 2.407 to 5.081, P=0.001)and apical type 3 (HR=1.828, 95% CI: 1.266 to 2.639, P=0.001) were independent prognosis factors of BCR. Conclusion: Prostate apical type 3 could be a significant independent predictor of PAM, and an independent prognosis factor for BCR.

[Role of circulating T follicular helper subsets and T follicular helper effector memory cells in systemic lupus erythematosus].

Objective: To investigate the role of T follicular helper (Tfh) subsets and T follicular helper effector memory (Tfhem) cells in circulation of patients with systemic lupus erythematosus (SLE), and explore their roles in SLE disease activity index as biomarkers. Methods: This study enrolled 64 patients with SLE and 15 healthy controls. In peripheral blood from patients with SLE and health controls, the percentage of Tfhem (CD3(+)CD4(+)CD45RA(-)CXCR5(+)CCR7(low)PD-1(high)) cells, Tfh (CD3(+)CD4(+)CD127(high)CD25(l)ow CD45RA(-)CXCR5(+)) subset: Tfh1 (CXCR3(+)CCR6(-)Tfh), Tfh2 (CXCR3(-)CCR6(+) Tfh), Tfh17 (CXCR3(-)CCR6(+) Tfh), were detected by flow cytometry. The correlations of Tfhem/Tfh subsets with clinical indicators which we collected were analyzed. Results: The percentage of Tfhem was significantly increased in SLE patients compare to health controls (1.40±1.12 vs 0.51±0.24, P<0.000 1), and it was also correlated with systemic lupus erythematosus disease activity index (SLEDAI) (P=0.015 3) and anti-dsDNA antibody (P=0.003 1), but not with complement C3 (C3), complement C4 (C4), erythrocyte sedimentation rate (ESR), and C reaction protein (CRP). In addition, the percentage of Tfh2, but not Tfh1 or Tfh17, was significantly increased in SLE patients compare to health controls (3.83±2.74 vs 2.18±1.07, P=0.000 4). As compared to anti-dsDNA antibody<25 group, the percentage of Tfh2 in anti-dsDNA antibody>25 group was increased with no significant statistical difference (4.33±3.20 vs 3.70±1.070, P=0.069 6). Conclusion: Our investigation show that Tfhem is associated with SLEDAI and it is a valuable evaluation biomarker for disease process and treatment. Meanwhile Tfhem is also associated with anti-dsDNA antibody, and it plays an important role in autoantibody production in SLE pathogenesis. Tfhem may be a good therapeutic target in SLE. For the meantime, the percentage of Tfh2 is significantly increased in SLE patients, and it had certain correlation with anti-dsDNA antibody, it might be involved in the development of SLE.

MicroRNA-124 inhibits proliferation and metastasis of esophageal cancer via negatively regulating NRP1.

OBJECTIVE: MicroRNAs are a kind of endogenous, non-coding RNAs, which exert a significant role in pathological processes. Previous studies have reported that microRNA-124 is a tumor suppressor. The specific effect of microRNA-124 on esophageal cancer, however, has not been fully elucidated. This study aims to explore the role of microRNA-124 in esophageal cancer and its underlying mechanism. PATIENTS AND METHODS: MicroRNA-124 expressions in 75 esophageal cancer tissues, paracancerous tissues, and esophageal cancer cell lines were detected by qRT-PCR (quantitative Real-Time Polymerase Chain Reaction). The relationship between microRNA-124 expression, clinical progression, pathological indicators, and prognosis of patients with esophageal cancer was analyzed. For in vitro experiments, we performed CCK-8 (cell counting kit-8), colony formation and transwell assay to detect cell proliferation, migration, and invasion abilities after microRNA-124 overexpression in TE-1 and EC-109 cells, respectively. Western blot was utilized to explore the regulatory role of microRNA-124 in esophageal cancer cells. RESULTS: MicroRNA-124 was downregulated in esophageal cancer tissues than that of paracancerous tissues. Patients with esophageal cancer who had lower expression level of microRNA-124 presented higher tumor stage and metastasis incidence, as well as lower survival rate. In vitro studies demonstrated a decreased cell proliferation and migration abilities after microRNA-124 overexpression. Western blot results showed upregulated PI3K and AKT, and downregulated PTEN in esophageal cancer cells after overexpression of microRNA-124. Furthermore, microRNA-124 was confirmed to negatively regulate NRP1, so as to participate in the development of esophageal cancer. CONCLUSIONS: MicroRNA-124 is downregulated in esophageal cancer tissues, which is remarkably correlated to the development, pathological grade, and poor prognosis of esophageal cancer. Overexpressed microRNA-124 is capable of inhibiting the malignant progression of esophageal cancer via negatively regulating NRP1.

MiR-134 inhibits infiltration of trophoblast cells in placenta of patients with preeclampsia by decreasing ITGB1 expression.

OBJECTIVE: Preeclampsia (PE) is an idiopathic disorder of pregnancy. The specific regulatory mechanisms of microRNAs (miRs) in the placenta of PE patients have not yet been completely revealed. This study mainly explored the mechanism of miR-134 in preeclampsia. PATIENTS AND METHODS: Real-time PCR and Western blot were used to detect the expression of miR-134 and ITGB1 in the placenta of patients with preeclampsia and normal pregnant women. Dual luciferase reporter assay was performed to detect luciferase activity in miR-134 and NC groups, respectively. Cell proliferation ability after transfection was evaluated by MTS colorimetric assay, and the effect of miR-134 on the infiltration of trophoblast cells was explored by cell invasion experiment. In addition, co-transfection of miR-134 and ITGB1 expression plasmids was carried out, and then changes in the cell invasiveness were also detected by cell invasion experiment. RESULTS: Compared with placenta of normal pregnant women, miR-134 was significantly up-regulated in the placenta of patients with preeclampsia and negatively correlated with the expression of ITGB1. MiR-134 suppressed the infiltration of trophoblast cells by targeting ITGB1. When ITGB1 was overexpressed, the suppression of invasiveness of trophoblast cells by miR-134 was almost abolished. Meanwhile, we found that miR-134 inhibitor could promote the invasiveness of trophoblast cells. In addition, tumor necrosis factor-α (TNF-α) was found to enhance miR-134 expression as well as inhibit ITGB1 expression. CONCLUSIONS: MiR-134 inhibited the infiltration of trophoblast cells in preeclampsia by down-regulating ITGB1 expression.

[Diagnostic value of contrast-enhanced ultrasound in breast lesions of BI-RADS 4].

Objective: To investigate the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of BI-RADS 4 breast masses. Methods: A total of 72 patients were collected from the First Hospital of Shanxi Medical University from January 2016 to December 2017.79 breast masses were confirmed by biopsy or surgical pathology.All the masses were classified by BI-RADS according to conventional ultrasound and CEUS was performed in parallel.Based on the results of the CEUS predictive model, the benign and malignant features of the breast BI-RADS type 4 tumors were re-determined: (1) conventional ultrasound BI-RADS classification+ CEUS predictive model: both of them were malignant when malignant; (2) re-adjusting BI-RADS classification by CEUS predictive model: if the malignant CEUS predictive model, upgrade a class, if the benign CEUS predictive model, downgrade a class.The diagnostic efficiency of the two methods in breast masses of BI-RADS 4 was compared. Results: (1) There were 36 malignant masses and 43 benign masses in 79 breast masses.Diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the conventional ultrasound BI-RADS classification, CEUS predictive model, conventional ultrasound BI-RADS classification+ CEUS predictive model and the adjusted BI-RADS classification were 86.1%, 65.1%, 74.7%, 67.4%, 84.8%; 88.9%, 76.7%, 82.3%, 76.2%, 89.2%; 80.6%, 86.0%, 83.5%, 82.9%, 84.1%; 97.2%, 76.7%, 86.1%, 77.8%, 97.1%, respectively.(2) The area under the receiver operating characteristic (ROC) curve of conventional ultrasound BI-RADS classification, CEUS predictive model, conventional ultrasound BI-RADS classification+ CEUS predictive model and the adjusted BI-RADS classification was 0.756, 0.828, 0.833, 0.870, respectively.Before and after the adjustment of BI-RADS classification, the difference was statistically significant (Z=2.322, P<0.05). Conclusion: The diagnostic efficiency that CEUS predictive model adjusted classification of BI-RADS 4 breast masses is better, the method can reduce unnecessary biopsy.

[Effects of urethral fibrosis on urinary control after laparoscopic radical prostatectomy].

Objective: To determine the influence of urethral fibrosis on the recovery of urinary continence after laparoscopic radical prostatectomy. Method: A retrospective study of 203 patients from January 2010 to January 2014 who were underwent laparoscopic radical prostatectomy for prostate cancer in the First Affiliated Hospital of Fujian Medical University. The patients were divided into 2 groups according to preoperative T2-weighted magnetic resonance imaging of fibrosis status of the urethral wall and periurethral tissue. One hundred and forty-four(≤2 grade) and 59 (≥3 grade) were classified into the no/mild and severe urethral fibrosis groups respectively. Urinary continence at 1, 3, 6, 12 months after operation were compared between this two groups respectively. Result: There was no significant difference in the two groups with respect to age, body mass index (BMI), Charlson comorbidity index (CCI), international prostate symptom score (IPSS), prostate volume, preoperative prostate-specific antigen value, nerve-sparing procedure, postoperative Gleason score and pathological stage. The operation was completed successfully in all cases. With a median follow-up time of 15 months (ranged from 12 to 24 months), there was no statistical difference between the two groups in urinary continence at 1 month after operation (P>0.05). The incidences of continence in patients with no/mild fibrosis were significantly higher at 3, 6, 12 months after operation than those with severe fibrosis. (In the no/mild fibrosis group and severe fibrosis group, the continue rate at 3 mouths was 50.0% vs 28.8% P=0.005; at 6 mouths was 91.0% vs 59.3% P<0.001; at 12 mouths was 98.6% vs 88.1% P=0.003). Conclusion: Preoperative urethral fibrosis could be a significant predictor of recovery of the long-term urinary continence status after laparoscopic radical prostatectomy. Compared with no/mild fibrosis, severe fibrosis had worse long-term continence status.

[Heart rate control in chronic heart failure patients received cardiovascular implantable electronic device therapy: effects of optimized medication].

Objective: To investigate the heart rate control situation of chronic heart failure (CHF) patients who received cardiovascular implantable electronic device (CIED) therapy, and to assess the heart rate control efficacy by optimized medication adjustment. Methods: We performed a perspective study in heart failure with reduced left ventricular ejection fraction (HFrEF) patients who received CIED according to guideline recommendations, patients were enrolled from January 2012 to January 2017. Resting heart rate (RHR) recorded by electrocardiogram after 10 minutes' rest and medication usage within 1 month were recorded at baseline. RHR less than 70 beats per minute (bpm) was regarded as well controlled. ß-receptor blockers and (or) ivabradine would be added in patients whose RHR were over 70 bpm. RHR after optimized medication adjustment was recorded during follow-up period. Results: One hundred and fifty patients were included in this study with average RHR (80.6±11.9) bpm. RHR was<70 bpm in 27.3% (41/150) patients at baseline and ß-receptor blockers was underused in 80.7% patients (88/109) whose RHR was>70 bpm. The overall RHR decreased to (73.1±10.4) bpm and percent of patients with RHR<70 bpm increased to 70.0% (105/150) after up-titration of ß-receptor blockers compared to baseline (χ2=52.958, P<0.001). Ivabradine was added in the rest 45 patients and RHR was<70 bpm in 43 out of 45 patients after ivabradine use. The overall RHR decreased to (67.1±2.7) bpm and percent of RHR<70 bpm significantly increased to 98.7% (148/150) (χ2=44.504, P<0.001 vs. up-titration of ß-receptor blockers only). Conclusion: RHR in CHF patients who received CIED therapy is not ideally controlled in this patient cohort, individual up-titration ofß-receptor blockers and ivabradine use may help to optimize RHR in these patients.

Erythropoietin reduces hippocampus injury in neonatal rats with hypoxic ischemic brain damage via targeting matrix metalloprotein-2.

OBJECTIVE: Erythropoietin (EPO), as a type of the tissue-protective cytokines, is a 30.4 kDa hematopoietic glycoprotein. The purpose of this study was to explore the neuroprotective effects of EPO on the neonatal hypoxic-ischemic-induced hippocampus injury and the MMP-2 expression. MATERIALS AND METHODS: Neonatal Sprague-Dawley (SD) rats were randomly divided into an untreated group (control) and two hypoxia-ischemia (HI) groups treated with saline control or EPO. Hippocampi were harvested at various times after return to normoxia (6 h, 24 h, 3 days and 7 days post-HI) for analyses of infarct areas and expression using histology, Western blot and reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: EPO injections reduced the infarction and loss of brain tissue. HI group exhibited an enhanced MMP-2 positive staining compared to controls at 24 h, 3 and 7 days post-HI by immunohistochemistry. These results were confirmed by Western blot analysis of MMP-2 expression at 7 days post-HI. Levels of MMP-2 mRNA in the injured hippocampi increased significantly at 24 h and 7 days post-HI. In particular, the EPO treatment further significantly enhanced this increase. CONCLUSIONS: EPO protected hypoxic-ischemic-induced neonatal brain damage by up-regulating the MMP-2 expression. Hence, systemic EPO may have potential utility for the treatment of HI injury in human newborns.

[Clinical analysis of efficacy and quality of life of segmental bowel resection for bowel endometriosis].

OBJECTIVE: To evaluate the efficacy and quality of life of segmental bowel resection for bowel endometriosis. METHODS: Totally 62 symptomatic patients with bowel endometriosis undergoing segmental bowel resection were recruited. A visual analogue scale(VAS)and the 36-item short form health survey(SF-36)questionnaire were administered before and at least 1 year after surgery, respectively. Pregnancy rates were also recorded. RESULTS: Sixty-two patients in total underwent follow-up ranging from 12 to 74 months. All patients complained of obvious pain symptoms, including dysmenorrhea, dyspareunia, pain on defecation and chronic pelvic pain. The relief of dysmenorrhea(2.9 ± 2.2 versus 7.5 ± 2.9), dyspareunia(0.7 ± 0.5 versus 4.3 ± 2.2)and pain on defecation(1.6 ± 0.7 versus 7.3 ± 1.9)after surgery was statistically significant(all P<0.01). The scores for all 8 domains of the SF-36 questionnaire were significant improved after segmental bowel resection(all P<0.01). The complication rate was 45%(28/62), including 18 cases of urinary retention, 4 rectovaginal fistulas, 2 cases of vaginal dehiscence, and 1 case each of thrombogenesis, pelvic abscess and general peritonitis. All of the patients with complications recovered well throughout follow-up. The postoperative pregnancy rate of the previous infertile patients was 6/10. Among the 6 gestational cases, 2 had labour, 2 underwent caesarean sections, one had a spontaneous natural abortion, and one underwent uterine curettage. CONCLUSION: Segmental bowel resection could significantly relieve pain and improve quality of life for patients with bowel endometriosis.

An unusual ovarian neoplasm diagnosed in a patient with rupture of unicornuate uterus during pregnancy: a case report.

Unicornuate uterus is a rare disease characterized with reduced fertility, and ovarian tumor diagnosed during pregnancy is uncommon as well. These two diseases have been reported separately. However, patient suffering from both diseases has never been reported before. The authors herein report a case of a 32-year-old Chinese woman presenting with a unicornuate uterus with no horn, who suffered from acute abdominal pain and intra-abdominal hemorrhage at 26 weeks gestation. Incidentally, a borderline ovarian tumor (BOT) and rupture of uterus were found during an urgent exploratory laparotomy. During the follow-up, ovarian tumor recurred in the first year after the operation. The authors suggest that BOT with micropapillary patterns should be paid much more attention to, other than only assessing the histological type. Furthermore, they also suggest that a slightly increased in serum CA-125 value should not be ignored.

Identification of biomarkers for lymph node metastasis in early-stage cervical cancer by tissue-based proteomics.

BACKGROUND: Pelvic lymph node metastasis (PLNM) is the key to determining the treatment and prognosis of early-stage cervical cancer (CC, I-IIst). The aim of this study was to identify biomarkers for PLNM of CC, I-IIst. METHODS: Two-dimensional fluorescence difference gel electrophoresis and matrix-assisted laser desorption/ionisation-time-of-flight mass spectrometry (MALDI-TOF/TOF MS) were used to identify differentially expressed proteins in primary CC, I-IIst tissue with (n=8) and without (n=10) PLNM. The expression levels of three differential proteins (FABP5, HspB1, and MnSOD) were validated using western blotting and immunohistochemistry. An independent cohort of 105 CC, I-IIst patients was analysed to assess the correlation of FABP5, HspB1, and MnSOD with clinicopathologic factors and clinical outcomes. RESULTS: Forty-one differential proteins were identified. Upregulation of FABP5, HspB1, and MnSOD in CC, I-IIst with PLNM was confirmed and was significantly correlated with PLNM. FABP5, HspB1, and MnSOD were significant predictors of PLNM in univariate analysis. FABP5, HspB1, and lymphovascular space invasion (LVSI) were independent predictors of PLNM in multivariate analysis. Survival curves indicated that CC, I-IIst patients with FABP5, HspB1, and MnSOD upregulation had poor prognosis. CONCLUSIONS: FABP5, HspB1, and MnSOD may be potential biomarkers for PLNM of CC, I-IIst and may have important roles in the pathogenesis of PLNM.

Fabrication and measurement of nanostructures on the micro ball surface using a modified atomic force microscope.

In order to machine and measure nanostructures on the micro ball surface, a modified atomic force microscope (AFM) combining a commercial AFM system with a home built precision air bearing spindle is established. Based on this system, motions of both the AFM scanner and the air bearing spindle are controlled to machine nanostructures on the micro ball based on the AFM tip-based nano mechanical machining approach. The eccentric error between the axis of the micro ball and the axis of the spindle is reduced to 3-4 µm by the provided fine adjusting method. A 1000 nano lines array, 36 square pits structure, 10 square pits structure, and a zig-zag structure on the circumference of the micro ball with the diameter of 1.5 mm are machined successfully. The measurement results achieved by the same system reveal that the profiles and mode-power spectra curves of the micro ball are influenced by the artificially machined nanostructures significantly according to their distributions. This work is an useful attempt for modifying the micro ball profile and manufacture of the spherical modulation targets to study the experimental performance of the micro ball in implosion.