[Two cases of pyridaben poisoning were successfully treated by blood purification].

Pyridaben is a broad-spectrum acaricide widely used in agriculture, accidental or self-administration of large doses of pyridaben can cause multiple organ failure in patients. Due to its damage to multiple organs and no specific antidote, the mortality rate is high. This paper reports two patients who took a large amount of pyridaben, developed severe metabolic acidosis, hyperlactatemia, toxic encephalopathy, and liver, kidney, heart and digestive tract damage. After timely gastric lavage, catharsis, organ support andblood purification treatment, the condition improved and discharged. It is expected to provide clinical ideas for the treatment of pyridaben poisoning.

[Preliminary insights into the practice of hypoallergenic home visiting program].

Allergic diseases affect about 40% of the world's population. Environmental factors are important in the occurrence and development of allergic diseases. Dust mites are one of the most important allergens in the indoor environment. The World Health Organization proposes the "four-in-one, combination of prevention and treatment" treatment principle for allergic diseases, in which environmental control to avoid or reduce allergens is the first choice for treatment. Modern people spend much more time at home (including sleeping) than outdoors, and the control of the home environment is particularly critical. This practice introduces the hypoallergenic home visit program, which including home environment assessment, environmental and behavioral intervention guidance, and common household hypoallergenic supplies and service guidance for the patient's home environment. The real-time semi-quantitative testing of dust mite allergens, qualitative assessments of other indoor allergens, record of patients' household items and lifestyle, and precise, individualized patient prevention and control education will be conducted. The hypoallergenic home visit program improves the doctors' diagnosis and treatment data dimension, and becomes a patient management tool for doctors outside the hospital. It also helps patients continue to scientifically avoid allergens and irritants in the environment, effectively build a hypoallergenic home environment, reduce exposure to allergens in the home environment, and achieve the goal of combining the prevention and treatment of allergic diseases.

[Diagnosis and treatment procedures and health management for patients with hereditary angioedema].

As a recognized rare and highly fatal disease, hereditary angioedema (HAE) is difficult to diagnose and characterized by recurrent edema involving the head, limbs, genitals and larynx, etc. Diagnosis of HAE is not difficult. However, low incidence and lack of clinical characteristics lead to difficulty of doctors on timely diagnosis and correct intervention for HAE patients. Therefore, it is crucial to improve the awareness of this disease and prevent its recurrence. for HAE patients. In view of absent cognition of doctors and the general public on HAE, patients often suffer from sudden death or become disabled due to laryngeal edema which cannot be treated in time. Thus, based on the Internet mobile terminal platform, the team set up an all-day rapid emergency response system which is provided for HAE patients by setting up "one-click help". The aim is to offer optimization on overall management of HAE and designed the intelligent follow-up management to provide timely assistance and specialized suggestion for patients with acute attacks.

An Arabidopsis gene regulatory network for secondary cell wall synthesis.

The plant cell wall is an important factor for determining cell shape, function and response to the environment. Secondary cell walls, such as those found in xylem, are composed of cellulose, hemicelluloses and lignin and account for the bulk of plant biomass. The coordination between transcriptional regulation of synthesis for each polymer is complex and vital to cell function. A regulatory hierarchy of developmental switches has been proposed, although the full complement of regulators remains unknown. Here we present a protein-DNA network between Arabidopsis thaliana transcription factors and secondary cell wall metabolic genes with gene expression regulated by a series of feed-forward loops. This model allowed us to develop and validate new hypotheses about secondary wall gene regulation under abiotic stress. Distinct stresses are able to perturb targeted genes to potentially promote functional adaptation. These interactions will serve as a foundation for understanding the regulation of a complex, integral plant component.

A higher level of total bile acid in early mid-pregnancy is associated with an increased risk of gestational diabetes mellitus: a prospective cohort study in Wuhan, China.

PURPOSE: To assess the longitudinal associations between maternal total bile acid (TBA) levels during early mid-pregnancy and the subsequent risk of gestational diabetes mellitus (GDM). METHODS: In a prospective cohort study, pregnant women who were enrolled prior to gestational week 16 were followed until delivery. TBA levels were tested during weeks 14-18 of gestation. Using logistic regression, we analyzed the associations between quartiles of TBA and GDM based on a 75-g oral glucose tolerance test (OGTT) at 24-28 gestational weeks. RESULTS: The GDM rate was 7.9% (114/1441). The mean TBA level was higher in women with GDM than in those without GDM (2.1 ± 2.0 vs 1.5 ± 1.0 µmol/L, P = 0.000). The highest TBA level quartile (2.1-10.7 µmol/L) had a 1.78-fold (95% CI 1.01, 3.14) increased risk of GDM compared with that of the lowest quartile (0.0-0.8 µmol/L) after adjusting for pre-pregnancy body mass index (BMI), gestational, age at TBA test and other confounders. High TBA levels were involved in the fasting glucose level rather than that at 1 h and 2 h after OGTT in all participants. CONCLUSIONS: Pregnant women with higher serum TBA levels during early mid-pregnancy have a higher risk of developing GDM. TBA may be a new risk factor for GDM.

[Evaluating the impact of preoperative anemia on the prognosis of upper tract urothelial carcinoma following radical nephroureterectomy: A single-center retrospective study of 686 patients].

OBJECTIVE: To identify the effect of preoperative anemia on the prognosis of patients with upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy. METHODS: Clinicopathological and prognosis data on 686 patients with UTUC who underwent RNU at Peking University First Hospital between January 2000 and December 2013 were retrospectively analyzed. Preoperative anemia was defined as hemoglobin <130 g/L in men and <120 g/L in women based on the World Health Organization classification. The Kaplan-Meier method with log-rank test was applied to estimate the effect of anemia on survival. The associations of clinicopathologic features with overall survival and cancer-specific survival were evaluated using univariate and multivariate Cox regression models. RESULTS: There were 303(44.2%, 303/686) male and 383(55.8%, 383/686) female patients, and the median age was 68 years (interquartile range: 60-74 years). In all, 320 (46.6%, 320/686) patients were anemic before surgery. The median follow-up duration was 47 months. In all, 160 (23.3%) patients died, 141 (20.6%) died of cancer and 19 (2.7%) died of other disease or accidents. Preoperative anemia was associated with gender (P=0.002), age (P<0.001), lymph node positive (P=0.026), increased tumor grade (P=0.018), concomitant carcinoma in situ (P=0.038), tumor necrosis (P=0.007) and poor renal function (P<0.001). In univariate analysis, overall mortality was correlated with pre-operative anemia (P<0.001), gender (P=0.009), hydronephrosis (P=0.024), tumor stage (P<0.001), lymph node positive (P<0.001), tumor grade (P<0.001), tumor architecture(P<0.001), sarcomatoid differentiation (P=0.013), history of ureteroscope (P=0.033) and tumor hemorrhage (P<0.001); cancer-specific mortality was correlated with preoperative anemia (P=0.001), gender (P=0.001), hydronephrosis (P=0.043), tumor stage (P<0.001), lymph node positive (P<0.001), tumor grade (P<0.001), tumor architecture (P<0.001), sarcomatoid differentiation (P=0.016), history of ureteroscope (P=0.028) and tumor hemorrhage (P=0.003). A multivariate Cox proportional hazards model indicated that preoperative anemia was an independent prognositic predictor for overall mortality (P<0.001, HR=1.861) and cancer-specific mortality (P=0.003, HR=1.688). CONCLUSION: The preoperative anemia is an independent risk factor for cancer-specific survival and overall survival. Hemoglobin levels should be considered during patient counseling and in decision-making for further therapy.

[Comparison of efficacy and safety between two different methods of nephroureterectomy in two centers].

OBJECTIVE: To compare the efficacy and safety of complete transperitoneal laparoscopic nephroureterectomy (CTNU) and traditional retroperitoneoscopic nehroureterectomy (TRNU) for the management of upper urinary tract urothelial carcinoma(UTUC). METHODS: We retrospectively collected the clinical data of UTUC patients who underwent CTNU or TRNU surgery from January 2011 to December 2018 in Peking University First Hospital and Fujian Provincial Hospital, and compared the clinical characteristics, perioperative parameters, and follow-up results between the CTNU and TRNU surgeries. RESULTS: Finally, a total of 266 cases were included, with 94 cases in the CTNU group and 172 cases in the TRNU group. The proportion of left side lesions was bigger in TRNU group when compared with CTNU group (P<0.05). No significant differences were observed in clinical characteristics, such as age, gender, body mass index (BMI), American society of anesthesiologists score (ASA score) and tumor laterality. All surgery procedures were completed. The vascular resparing was performed by reason that left arteria renalis was injured accidently during surgical operation in one case of TRNU group. No serious complications were observed in both CTNU and TRNU groups. In CTNU group, operating time was (202.9±76.7) min, estimated blood loss was (68.4±73.3) mL, drainage duration was (3.9±1.5) d, drainage volume was (181.7±251.5) mL, and postoperative hospital stay was (7.8±4.1) d. In TRNU group, operating time was (203.5±68.7) min, estimated blood loss was (130.2±252.1) mL, drainage duration was (4.3 ±1.6) d, drainage volume was (179.1±167.5) mL, and postoperative hospital stay was (8.2±3.7) d. The estimated blood loss in CTNU group was significantly less than that in TRNU group (P=0.005).The median follow-up time was 39 months (range: 1-88 months). The 5-year overall survival rate (OS), cancer specific survival rate (CSS), intra-vesical recurrence free survival rate (IvRFS), disease free survival rate (DFS) of CTNU group was 75.6%, 86.9%, 73.8%, 57.5%, respectively. The OS, CSS, IvRFS and DFS of TRNU group was 66.3%, 83.5%, 75.9%, 58.6%, respectively.No significant differences were observed in the OS, CSS, IvRFS and DFS between the CTNU and TRNU groups. CONCLUSION: CTNU technique is a safe and effective surgical option, and further prospective randomized controlled trial is needed for further evaluation.

[Clinical characteristics and etiological analysis of sudden deafness patients with vertigo].

Objective: To explore the possible causes and mechanisms of sudden deafness with vertigo. Methods: Between August 2016 and December 2017, 74 patients with sudden deafness and vertigo were hospitalized in the Department of Otolaryngology, First Affiliated Hospital of Sun Yat-sen University. Among them, 36 were male and 38 were female, aged 18-75 (40.5±6.5) years. According to the results of magnetic resonance imaging (MRI), the patients were divided into two groups: internal ear hemorrhage (IEH) and non-IEH (NIEH). The characteristics of deafness, vertigo, laboratory examination and follow-up results were compared between the two groups. Results: In IEH group, deafness and vertigo occurred simultaneously in 22 cases (84.6%), abnormalities of semicircular canal function, cervical vestibular evoked myogenic potential (C-VEMP), ocular vestibular evoked myogenic potential (O-VEMP) in 26 cases (100%) and benign paroxysmal positional vertigo (BPPV) in 10 cases (38.5%). The total effective rate was 19.2% (5/26) after 14 days of treatment, and 11 cases (42.3%) appeared disturbance after 180 days of treatment. The abnormal rate of lateral vestibular function, C-VEMP and O-VEMP was 69.2% (18/26), 53.8% (14/26) and 57.7% (15/26) respectively. The improvement of hearing threshold was (28.6±9.7) dB. In NIEH group, deafness and vertigo occurred simultaneously in 25 cases (52.1%). The abnormalities of semicircular canal function, C-VEMP and O-VEMP happened in 37 cases (77.1%), 34 cases (70.8%), 26 cases (54.2%), respectively, and 6 cases (12.5%) were of BPPV. The total effective rate was 52.1% (25/48) after 14 days of treatment. After 180 days of treatment, 8 cases (16.7%) were out of balance, and the abnormal rate of lateral vestibular function, C-VEMP and O-VEMP were 31.2% (15/48), 25.0% (12/48) and 20.8% (10/48) respectively. The improvement of hearing threshold was (42.5±10.3) dB. The incidence of stimulantous deafness and vertigo, vestibular dysfunction rate, BPPV incidence rate and the total effective rate after 14 days of treatment were significantly different between the two groups (all P<0.05). The vestibular and cochlear dysfunction in IEH group was more serious than that in NIEH group. After 180 days of treatment, the vestibular dysfunction rate, imbalance rate and improvement of hearing threshold in NIEH group were significantly higher than that in IEH group (all P<0.05). The recovery of vestibular and cochlear function in NIEH group was better than that in IEH group. Conclusions: Sudden deafness with vertigo can cause vestibular and cochlear dysfunction. Different etiologies may lead to different clinical features and prognosis. The vestibular and cochlear function damage caused by inner ear hemorrhage was more serious and the recovery effect was poor.

[The long coding RNA GSTM3TV2 acts an oncogene to promote chemoresistance in pancreatic cancer].

Objectives: To examine the expression of the long coding RNA GSTM3TV2 in pancreatic cancer tissues and to examine its role and mechanism in chemoresistance of pancreatic cancer cells. Methods: The expression of lncRNA GSTM3TV2 in 15 pancreatic cancer specimens and corresponding adjacent to cancer tissue samples diagnosed by Department of Pathology, Peking Union Medical College Hospital was detected by real-time PCR.And the expressions of GSTM3TV2 in pancreatic cancer cell AsPC-1, BxPC-3, MIAPaCa-2, PanC-1, SU86.86, T3M4, and chemoresistant cells AsPC-1/GR and MIAPaCa-2/GR, and human pancreatic nestin-expressing cells hTERT-HPNE were detected. Pancreatic cancer cell lines were transfected with GSTM3TV2-pcDNA3.1(+)in order to get cells with GSTM3TV2 overexpression.GSTM3TV2-siRNA was transfected into pancreatic cancer cells to knock down GSTM3TV2. The cell chemoresistance was measured by CCK-8 and flow cytometry assay when incubated with nab-paclitaxel. At the same time, subcutaneous xenograft tumor models were established in nude mice to observe the effect of GSTM3TV2 on chemoresistance of tumor growth in nude mice.Western blot assay was also performed to detect the molecular mechanism of chemoresistance of GSTM3TV2. Results: Comparing toadjacent tissues(0.084±0.019), GSTM3TV2 expression was significantly upregulated in the pancreatic cancer tissues(0.493±0.084) (t=5.146, P<0.05). GSTM3TV2 expression were higher in the chemotherapy resistance pancreatic cancer cells AsPC-1/GR(210.799±19.788) and MIAPaCa-2/GR(122.408±23.419) than that in the AsPC-1(3.793±0.615) and the MIAPaCa-2(5.179±1.095)(t=21.800,P<0.05;t=-18.490,P<0.05). The results of in vivo experiments showed that the volume of subcutaneously transplanted tumors in the overexpressing GSTM3TV2 group ((1 059.609±102.498)mm(3)) was significantly larger than that in the control group((566.414±81.087) mm(3)) by treated with nab-paclitaxel(t=4.230,P<0.05).Meanwhile, GSTM3TV2 could promote the expression of Cyclin D1, CDK6, Cyclin E1, Vimentin, N-cadherin, ZEB1, Snail and Slug; but decrease cleaved caspase-3, cleaved PARP in pancreatic cancer cells. Conclusions: The expression level of GSTM3TV2 in pancreatic canceris higher than that in paired adjacent tissues. GSTM3TV2 may act as an oncogene to promote chemoresistance in pancreatic cancer through regulation of cell proliferation, apoptosis, and epithelial-mesenchymal transition.

Detection of live Salmonella enterica in fresh-cut vegetables by a TaqMan-based one-step reverse transcription real-time PCR.

Fresh-cut produce is at greater risk of Salmonella contamination. Detection and early warning systems play an important role in reducing the dissemination of contaminated products. One-step Reverse Transcription Polymerase Chain Reaction (RT-qPCR) targeting Salmonella tmRNA with or without a 6-h enrichment was evaluated for the detection of Salmonella in fresh-cut vegetables after 6-h storage. LOD of one-step RT-qPCR was 1·0 CFU per ml (about 100 copies tmRNA per ml) by assessed 10-fold serially diluted RNA from 106 CFU per ml bacteria culture. Then, one-step RT-qPCR assay was applied to detect viable Salmonella cells in 14 fresh-cut vegetables after 6-h storage. Without enrichment, this assay could detect 10 CFU per g for fresh-cut lettuce, cilantro, spinach, cabbage, Chinese cabbage and bell pepper, and 102 CFU per g for other vegetables. With a 6-h enrichment, this assay could detect 10 CFU per g for all fresh-cut vegetables used in this study. Moreover, this assay was able to discriminate viable cells from dead cells. This rapid detection assay may provide potential processing control and early warning method in fresh-cut vegetable processing to strengthen food safety assurance. SIGNIFICANCE AND IMPACT OF THE STUDY: Significance and Impact of the Study: Fresh-cut produce is at greater risk of Salmonella contamination. Rapid detection methods play an important role in reducing the dissemination of contaminated products. One-step RT-qPCR assay used in this study could detect 10 CFU per g Salmonella for 14 fresh-cut vegetables with a 6-h short enrichment. Moreover, this assay was able to discriminate viable cells from dead cells. This rapid detection assay may provide potential processing control and early warning method in fresh-cut vegetable processing to strengthen food safety assurance.

[The expression of KLK7 in pancreatic cancer and the effects on the biological behavior of pancreatic cancer cells].

Objective: To investigate the expression of KLK7 in pancreatic cancer and its clinical significance. Methods: Immunohistochemistry was used to detect the expression of KLK7 protein in pancreatic cancer tissue microarray with 92 samples. Statistical analysis of the relationship between KLK7 and clinicopathological characteristics was finished. Pancreatic cancer cell lines were infected with lentiviuses in order to get cells with KLK7 stable overexpression.KLK7-siRNA was transfected into pancreatic cancer cells to knock down KLK7.Cell proliferation and chemosensitivity were detected by CCK-8 assay; Cell invasion and migration abilities were detected by Transwell assay. At the same time, subcutaneous xenograft tumor models were established in nude mice to observe the effect of KLK7 on tumor growth in nude mice. Data were statistically analyzed by rank sum test, χ(2) test and Logistic regression analysis. Results: The expression level of KLK7 in pancreatic cancer tissues was higher than that in paired adjacent tissues (P<0.05). KLK7 expression was correlated with vascular invasion(χ(2)=7.535, P<0.05). Further univariate and multivariate analysis showed that KLK7 expression was an independent risk factor for vascular invasion of pancreatic cancer(χ(2)=7.535, P<0.05). The overexpression of KLK7 in pancreatic cancer cell lines BxPC-3 and CFPAC can increase their proliferation abilities, reduce the chemosensitivity and promote their migration and invasion behaviour; The results of in vivo experiments showed that the volume of subcutaneously transplanted tumors in the overexpressing KLK7 group was significantly larger than that in the control group (t=4.479, P<0.05). The group of overexpressing KLK7 showed greater tumor weight than the control group(t=2.831, P<0.05). Conclusions: The expression level of KLK7 in pancreatic ductal adenocarcinoma was higher than that in paired adjacent tissues and it is an independent risk factor for vascular invasion of pancreatic cancer.KLK7 can promote the proliferation of pancreatic cancer cells, reduce the chemosensitivity and increase the invasion and migration of pancreatic cancer cells.

[Clavien-Dindo classification and influencing factors analysis of complications after laparoscopic pancreaticoduodenectomy].

Objective: To semi-quantify the postoperative complications occurred after laparoscopic pancreaticoduodenectomy(LPD) using Clavien-Dindo score, thereafter exploring its impact factors. Methods: In this retrospective cohort study, the clinical data of 124 patients who had undergone LPD for periampullary tumor from June 2016 to June 2017 at Department of Biliary Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology were collected.Malignancy was confirmed based on postoperative pathological reports.Postoperative complications were semi-quantitated using Clavien-Dindo score.Multivariable logistic regression model was applied to explore the factors related to severe complications(Clavien-Dindo Ⅲb-Ⅴ). Results: Of the 124 patients, there were 64 males(51.6%) and 60 females(48.4%), with age of 57 years(range, 23-82 years). In total, postoperative complications occurred in 30 patients(24.2%). Among the 30 patients, 4 patients suffered Clavien-Dindo grade Ⅰ, 18 patients(14.5%) suffered Clavien-Dindo grade Ⅱ, 6 patients(4.8%) suffered Clavien-Dindo grade Ⅲa, 1 patient(0.1%) suffered Clavien-Dindo grade Ⅳb, and 1 patient(0.1%) suffered Clavien-Dindo grade Ⅴ.Intraabdominal hemorrhage occurred in 8 patients, pancreatic fistula was found in 10 patients(7 patients had biochemical leakage and 3 of them had grade B pancreatic fistula), both biliary fistula and gastrointestinal fistula were found in 1 patient.Abdominal infection occurred in 10 patients, both liver failure and renal failure occurred in one patient.Moreover, arrhythmia was found in two patients, and mortality occurred in one patient.Five patients suffered multiple complications.Univariable analysis showed that postoperative complications were associated with body mass index, American Society of Anesthesiologists(ASA) score, intraoperative blood transfusion, and pancreatic texture(P<0.05). In multivariable logistic regression, ASA grade Ⅲ, intraoperative blood transfusion, and pancreatic softness were independently related to postoperative complications after LPD(P<0.05). Conclusions: Clavien-Dindo score is feasible to be applied in management of patients with LPD.ASA score, texture of pancreas, and intraoperative blood transfusion were independently associated with postoperative complications.

MicroRNA-1285 inhibits malignant biological behaviors of human pancreatic cancer cells by negative regulation of YAP1.

Pancreatic ductal adenocarcinoma is a most deadly malignancy, with a 5-year survival rate of ~7%. Chemotherapy is the main treatment strategy of this disease. However, the high rate of resistance to chemotherapeutic agent contributes to poor prognosis. MicroRNAs are essential for the initiation, progression and chemoresistance of human malignancies. Previous studies have shown that miRNA-1285 participates in renal cell carcinoma and hepatocellular carcinoma. However, its roles in pancreatic ductal adenocarcinoma are poorly understood. In this study, we confirmed that miR-1285 was significantly down-regulated in gemcitabine-resistant pancreatic cancer cell lines by qRT-PCR. We found that miR-1285 suppressed cell proliferation as well as increased the sensitivity of PDAC cells to gemcitabine by CCK8 assays in vitro. Results from transwell assay indicated that miR-1285 inhibited pancreatic cancer cell migration and invasion. Experiments using different cell lines got identical results. All those results demonstrated that miR-1285 act as tumor suppressor of pancreatic cancer. To our knowledge, this study is the first to elucidate the function of miR-1285 in pancreatic cancer. Western blotting analysis verified that miR-1285 negatively regulated YAP1 protein level, together with EGFR and ß-catenin. YAP1 is a known oncoprotein of pancreatic cancer. As silencing of YAP1 activity might be beneficial in cancer prevention and treatment, our results suggest that miR-1285 might serve as a novel therapeutic target for miRNA-based therapy in pancreatic cancer. Further research elucidating the exact mechanisms of miRNA-1285 function and the correlation between miR-1285 levels in tissues or serum and clinical characteristics of pancreatic cancer is needed later.

[Prognostic factors of patients with T2N0M0 upper tract urothelial carcinoma: a single-center retrospective study of 235 patients].

OBJECTIVE: To evaluate the impacts of the prognostic factors of T2N0M0 upper tract urothelial carcinoma (UTUC) for Chinese patients. METHODS: A retrospective study was conducted including 235 patients who were diagnosed with T2N0M0 UTUC in our hospital and received radical nephroureterectomy (RNU) or partial ureterectomy during January 2000 and December 2013. The 3 and 5-year cancer-specific survival rates and bladder recurrence-free survival rates of all the patients were valued using Kaplan-Meier method, and the survival curves with statistical significance between the two were compared using the Log-rank test. Variables with significant differences in the univariate analysis were subjected to the multivariate analysis by Cox regression model. RESULTS: A total of 235 patients were included in this study, including 95 (40.4%) male patients and 140 (59.6%) female patients. The mean age was 66.73±10.49 years.The median follow-up time was 53 (rang: 3-142) months, and during the follow-up, 74 (31.5%) patients died of UTUC after a median of 35 months,and 96 (40.9%) patients developed intravesical recurrence after a median of 19.5 months. The 3 and 5-year cancer-specific survival rates of all the patients were 89.1% and 85.9%, respectively; the bladder recurrence-free survival rates were 85.5% and 80.2%, respectively. The independent prognostic factors of cancer-specific mortality were tumor age elder than 55 years (HR=3.138, 95%CI: 1.348-7.306, P=0.008) and diameter larger than 5 cm (HR=3.320, 95%CI: 1.882-5.857, P<0.001). The independent prognostic factors of bladder recurrence-free survival were ureter tumor (HR=1.757, 95%CI: 1.159-2.664, P=0.008) and lower tumor grade (HR=1.760, 95% CI: 1.151-2.692, P=0.009). CONCLUSION: T2N0M0 UTUC has a better cancer-specific survival. The intravesical recurrence was equivalent to non-muscle invasive UTUC but earlier. The tumor diameter larger than 5 cm and the patient age elder than 55 years were independently associated with cancer-specific mortality; the primary tumor located in ureter and lower tumor grade were more likely to develop intravesical recurrence.

[Clinical and pathological characteristics of prostate cancer patients younger than 55 years old].

Objective: Prostate cancer is commonly diagnosed among old men while younger men are rarely diagnosed with prostate cancer. In this study we identify clinical and pathological features of 154 patients with prostate cancer younger than 55 years old and to assist intreatment decisions. Methods: The medical records of 154 prostate cancer patients younger than 55 years old in Peking University First Hospital from Feb 1953 to Jun 2016 were reviewed, retrospectively. Data was collected including symptoms, digital rectal examination (DRE), prostate-specific antigen (PSA), Gleason score, tumor stage, treatment strategies. Results: The mean age was 50.9±4.5, and 25.3% patients were between 40-50 years. Fifty-six (36.4%) patients initially presented with lower urinary tract symptoms. A solid mass could be found by digital rectal examination in 48(31.2%) patients. All patients were diagnosed by pathology of biopsy or surgery. The median Gleason score was 8. Gleason 2-6, 3+ 4, 4+ 3, 8, 9-10 were 15 cases(9.7%), 28 cases(18.2%), 21 cases(13.6%), 15 cases(9.7%), 51 cases(33.1%), respectively. Based on 2009 AJCC TNM Classification criteria the distribution of tumor stage was T1, T2, T3, and T4 in 2(1.3%), 54 (35.1%), 60 (39.0%), and 37 (24.0%) patients. Forty patients (25.9%) were found with bone metastasis and four (2.5%) suffered from visceral metastasis. Fifty-three(34.4%)underwent hormonal therapy and 79(51.3%) underwent radical prostatectomy. Conclusion: Younger prostate caner patients usually presented with LUTS symptoms and were featured for higher tumor stage and aggressiveness. More optimal and personalized risk-based therapy options are required.

Morphological characterization and molecular mapping of an irradiation-induced Speckled mutant in the silkworm, Bombyx mori.

Speckled (Spc), an X-ray-induced lethal mutant of Bombyx mori, exhibits a mosaic dark-brown-spotted larval epidermis in both sexes and egg-laying problems only in females. Here, we report the morphological characterization and molecular mapping of the Spc mutant. Morphological investigations revealed that the epidermal ultrastructure of the small, dark-brown spots was more dense than that of the white regions in both Spc/+ mutants and wild type, and that the lethality of the Spc/Spc mutants occurred during early embryogenesis. Furthermore, the ovarioles and ovipositor were disconnected in approximately 85.5% of Spc/+ females, a further 2.5% had a connection between the ovarioles and ovipositor that was too narrow to lay eggs. The remaining females showed a normal connection similar to that of the wild type. We successfully narrowed down the location of the Spc mutation to a region on chromosome 4 that was ∼1041 kb long. Gene-prediction analysis identified 25 candidate genes in this region. Chromosome structure analysis indicated that a ∼305 kb deletion was included in the mapping region. Temporal and spatial reverse transcription PCR (RT-PCR) analysis showed that several genes in the mapped region are associated with the Spc mutant. Although the genes responsible for the Spc mutation were not definitively identified, our results further the current understanding of the complex mechanism underlying the multiple morphological defects in Spc mutants.

[Methylation status of RASSF1A gene promoter in upper tract urothelial carcinoma and its clinical significance].

OBJECTIVE: To investigate the methylation status of the RASSF1A gene promoter in upper tract urothelial carcinoma (UTUC) tissues and its correlation with clinicopathologic characteristics and postoperative recurrence of primary UTUC. METHODS: In a retrospective design, a total of 687 patients who underwent surgeries for primary UTUC in the urology department of Peking University First Hospital were enrolled. The methylation status of the RASSF1A gene promoter was analyzed using methylation-sensitive polymerase chain reaction on tumor specimens. RESULTS: Aberrant methylation for the RASSF1A gene promoter was detected in 183 (26.6%) DNA samples in total. Aberrant methylation of the RASSF1A gene was strongly associated with tobacco consumption (P=0.044), ipsilateral hydronephrosis (P<0.001 ), tumor location (P<0.001 ), tumor stage (P=0.001), tumor grade (P=0.007), lymph node metastasis (P=0.001) and growth pattern (P=0.013). The methylated RASSF1A gene promoter was an independent risk factor for bladder recurrence (P<0.001, HR=0.471) and contralateral recurrence (P=0.030, HR=0.269) of UTUC after surgery. Hypermethylated RASSF1A was predictive for improved bladder recurrence-free survival (BRFS) (P<0.001) and contralateral recurrence-free survival (CRFS) (P=0.021) in the UTUC patients. Compared with the patients with unmethylated RASSF1A, the patients containing tumors with hypermethylated RASSF1A had tendency toward longer recurrence-free survival time [(114.4±3.9) months vs. (84.0±3.2) months for BRFS, (138.1±1.8) months vs. (132.9±1.9) months for CRFS] and higher estimated cumulative recurrence-free survive rates ( five-year survival rate for example, 79.8%±3.4% vs. 57.4%±2.6% for BRFS, 98.9%±0.8% vs. 93.0%±1.4% for CRFS). Additionally, tumor multifocality (P=0.002, HR=1.538), and ureteroscopy before surgery (P=0.001, HR=1.725) were independent risk factors for bladder recurrence in postoperative UTUC patients. CONCLUSION: The methylation status of the RASSF1A gene promoter appears to be a promising epigenomic biomarker for assessing the aggressiveness of UTUC and a predictor predicting the urinary tract recurrence after surgery.

[Methylation status of RASSF1A gene promoter in upper tract urothelial carcinoma and its clinical significance].

OBJECTIVE: To investigate the methylation status of the RASSF1A gene promoter in upper tract urothelial carcinoma (UTUC) tissues and its correlation with clinicopathologic characteristics and postoperative recurrence of primary UTUC. METHODS: In a retrospective design, a total of 687 patients who underwent surgeries for primary UTUC in the urology department of Peking University First Hospital were enrolled. The methylation status of the RASSF1A gene promoter was analyzed using methylation-sensitive polymerase chain reaction on tumor specimens. RESULTS: Aberrant methylation for the RASSF1A gene promoter was detected in 183 (26.6%) DNA samples in total. Aberrant methylation of the RASSF1A gene was strongly associated with tobacco consumption (P=0.044), ipsilateral hydronephrosis (P<0.001 ), tumor location (P<0.001 ), tumor stage (P=0.001), tumor grade (P=0.007), lymph node metastasis (P=0.001) and growth pattern (P=0.013). The methylated RASSF1A gene promoter was an independent risk factor for bladder recurrence (P<0.001, HR=0.471) and contralateral recurrence (P=0.030, HR=0.269) of UTUC after surgery. Hypermethylated RASSF1A was predictive for improved bladder recurrence-free survival (BRFS) (P<0.001) and contralateral recurrence-free survival (CRFS) (P=0.021) in the UTUC patients. Compared with the patients with unmethylated RASSF1A, the patients containing tumors with hypermethylated RASSF1A had tendency toward longer recurrence-free survival time [(114.4±3.9) months vs. (84.0±3.2) months for BRFS, (138.1±1.8) months vs. (132.9±1.9) months for CRFS] and higher estimated cumulative recurrence-free survive rates ( five-year survival rate for example, 79.8%±3.4% vs. 57.4%±2.6% for BRFS, 98.9%±0.8% vs. 93.0%±1.4% for CRFS). Additionally, tumor multifocality (P=0.002, HR=1.538), and ureteroscopy before surgery (P=0.001, HR=1.725) were independent risk factors for bladder recurrence in postoperative UTUC patients. CONCLUSION: The methylation status of the RASSF1A gene promoter appears to be a promising epigenomic biomarker for assessing the aggressiveness of UTUC and a predictor predicting the urinary tract recurrence after surgery.

[Preoperative prognostic factors and preoperative risk stratification of upper tract urothelial carcinoma].

OBJECTIVE: To identify the preoperative prognostic factors of upper tract urothelial carcinoma (UTUC) and construct preoperative risk stratification system. METHODS: A retrospective study including 686 patients who were diagnosed with UTUC and received radical nephroureterectomy or partial ureterectomy in Peking University First Hospital during 2003 and 2013. RESULTS: Of the 686 UTUC patients, 303 (44.2%) were male and 383 (55.8%) female. The postoperative pathological examination showed that 203 (29.6%) had high tumor stages (T3, T4), 300 (43.7%) had high tumor grades (G3) and 54 (7.9%) had lymph nodes metastasis (N1). After multivariate analysis, renal pelvic tumor, large tumor, estimated glomerular filtration rate (eGFR)≥30 mL/min, and male were associated with high tumor stage. Ureteral tumor, large tumor, and non-smoking history were associated with high tumor grade. Renal pelvis tumor, large tumor, and preoperative anemia were associated with positive N status. During the follow-up, 208 (30.3%) died for cancer and 210 (30.6%) developed intravesical recurrence. Multivariate analysis showed: large tumor (P=0.001), concomitant ipsilateral hydronephrosis (P=0.041), and preoperative anemia (P=0.001) were independently associated cancer-specific mortality after surgery, while ureteral tumor (P=0.04), multiple tumor (P=0.005), and high preoperative creatinine (P=0.036) were independent risk factors for intravesical recurrence. CONCLUSION: Of the preoperative clinical parameters of UTUC patients, the large tumor, concomitant ipsilateral hydronephrosis, and preoperative anemia were independently associated with cancer-specific mortality after surgery. Ureteral tumor, multiple tumor, and high preoperative creatinine were independently associated with intravesical recurrence after surgery.

Gefitinib maintenance therapy in Chinese advanced-stage lung adenocarcinoma patients with EGFR mutations treated with prior chemotherapy.

UNLABELLED: The aim of this study was to determine the response of advanced-stage non-small cell lung cancer (NSCLC) patients with or without EGFR mutations to platinum-based chemotherapy with or without gefitinib maintenance. Patients were treated with four cycles of platinum-based chemotherapy. Patients with wild-type EGFR were observed (group 1; n=15). EGFR mutation-positive patients were randomly assigned to observation (group 2; n=7) or gefitinib maintenance (group 3; n=7). The median patient age was 59 years. The 1-year progression-free survival rates in groups 1, 2, and 3 were 6.7%, 28.6%, and 57.1%, respectively (p = 0.049); the 1-year overall survival rates were 53.3%, 57.1 %, and 100%, respectively (p = 0.111). The results indicate that patients with advanced-stage NSCLC with EGFR mutations have a better response to chemotherapy followed by gefitinib than chemotherapy alone and a better response to chemotherapy than wild-type patients. KEYWORDS: chemotherapy, gefitinib, NSCLC, tyrosine kinase inhibitors.