Objective To study the clinical significance of urinary hTERT in diagnosis and follow up of transitional cell carcinoma of urinary bladder.Methods Semi-quantitative RT-PCR was used to detected the expression of hTERT mRNA expression in 42 cases with bladder transitional carcinoma and 40 patients without carcinoma of bladder.Regular urine cytology results were compared with the expression of hTERT.Following-up observision of the changes of hTERT mRNA expression and its relation with recurrency in 36 cases of transitional cell carcinoma of urinary bladder was conducted.Results 30 0f 42 cases with bladder transcriptional carcinoma were found positive expression of hTERT.but only 3 in the control group of 40 cases presented the positive expression of hTERT.The overall sensitivity and specificity for hTERT were 71.43%and 92.50%.The sensitivities for hTERT were 50.00%,73.68%and 90.91%respectively in G1-G3 tumor.The urine hTERT expression level significantly increased with the tumor grade and clinical staging.The sensitivity and the specificity of urinary cytology were 19.05%and 100%.Compared with hTERT.the cytology had lower sensitivity and no difference in specificity.The recurrence of the tumor was found in 6 patients.8-16 weeks after positive expression of hTERT,cystoscope confirmed recurrence of bladder carcinoma.Conclusions hTERT is a tumor marker of transcriptional carcinoma of bladder.because of its relatively high sensitivity and specificity.Detection of hTERT in urine sediment is superior to traditional cytology.The urine hTERT rate significantly increases with the tumor grade and the clinical stage.hTERT can indicate recurrence of bladder carcinoma.so it is valuable to the monitoring of recurrence of transcriptional cell carcinoma of bladder.

Objective To investigate the expressions of Livin protein and VEGF protein in bladder urothelial carcinoma(BUC) ,and theirs relationships with the clinicopathologic parameters of bladder urothelial carcinoma. Methods The expression of Livin and VEGF protein in 69 samples of BUC tissue and 10 samples of normal bladder epithelium tissue were detected by immunohistochemical SP method. Their relationships with clinicopathologic data were statistically analyzed. Results The positive expression rate of Livin and VEGF in BUC tissues were 65.2% (45/69) and 46.4% ( 32/69), but negative in normal bladder epithelium tissues, which showed significant differences in the comparison (Ps ＜ 0. 05 ). We found significant difference in the comparison of Livin positive rate between groups with or without recurrence ( 78. 8 % vs 48. 1%, χ2 = 6. 13, P ＜ 0. 05 ); but no differences in pathological grade,TNM stage and tumor number( Gl 55.6% ,G2 64. 3% ,G3 73.9% ;Ta ～ T1 61.9% ,T2 ～ T4 70. 4%; Single-tumor 59. 6%, multi-tumor 77.3%; χ2 = 1.52,0. 52,2.07, Ps ＞ 0. 05 ). For BUC,the expression of VEGF was correlated with the pathological grade,TNM stage( Gl 16. 7% ,G2 53.6% ,G3 60. 9%, χ2 = 8. 91; Ta ～ T1 33.3%, T2 ～ T4 66. 7%; χ2 = 7. 34; Ps ＜ 0. 05 ), but not the tumor number and recurrence( Single-tumor 57.4% , multi-tumor 59. 1%, χ2 = 0. 01; with recurrence 51.5% , without recurrence 40. 7% ,χ2= 0. 69; Ps ＞ 0. 05 ). We found no relationship between the expression of Livin and VEGF (r =0. 056,P ＞ 0. 05 ). Conclusion The overexpressions of Livin and VEGF protein may play an important role in the occurrence and development of BUC. Combind detection of these two protein can be used in the diagnosis and prognosis of BUC.

Objective To investigate the clinical application of renal vessel angiography with 256-slice spiral CT in laparoscopic surgery for renals.Methods One hundred and fifty-five cases underwent computed tomograph angiography(CTA) who were all confirmed by operations.According to preoperative renal artery CTA case shown,the initial plan intraoperative renal artery was compared with the situation with the actual surgery.AIl axial images were reconstructed using technique.Results All patients underwent preoperative renal artery CTA operative findings correspond with the actual rate of 100％.CTA stereoscopic images were good at reflecting renal vascular anatomy and ectopic blood vessels line.Conclusion CTA can accurately evaluate out of shape and variation of the renal arteriesvariation.It has important significance of processing of renal arteries intraoperative rapid,dealing with the renal artery accurately and reducing blood loss or damage and other complications.

Objective To discuss the prognosis of the metastatic prostatic carcinoma and analyze the relative factors. Methods From 2001 to 2002, 32 cases of matastatic prostatic carcinoma were admitted to our hospital, the ages ranging from 54 to 87, with the mean age of 71 years. All the diagnosis was proved by the six cores transrectal biopsy of the prostate. The serum PSA ranged from 63 to 2000 ng/ml. Two cases had the Gleason score of 2 - 6, 19 cases had the Gleason score of 7 and 11 cases had the Gleason score of 8 - 10. Preoperative routine examinations included serum testosterone, pelvic CT or MRI scan, CXR and bone scan. Twenty-seven cases were found to have osseous metastasis, among them 8 cases combined with lymph nodes metastasis, and 5 cases with lymph nodes metastasis only. All of them were treated with gonadectomy and the blockade of the androgen receptor (with Bicalutamide 50 mg/d or Flutamide 250 mg/d). It lasted 7 - 48 months with first endocrine therapy,and mid last time 23 months. After first line endocrine therapy failure, Diethylstilbestrol and Estramustine were used in the androgen-independent stage. Thirteen cases were not effective, and second therapy had effect to 19 cases and it lasted for 3 - 15 months. Results The follow-up periods ranged from 13 to 98 months, with the mean period of 33 months. Twenty-eight cases died, 4 cases survived. The median survial period was 37 months, 1-year survival rate was 100% (32/32), 3-year survival rate was 53%(17/32) , 5-year survival rate was 19%(6/23). As to the survival period, there were negative correlaions between survival and the level of PSA (r= -0. 262, P=0. 045) and the Gl-eason score (r=- 0. 624, P=0. 001). There were positive correlations between survival and the level of testosterone (r=0. 514, P=0. 008) and the age (r=0. 311, P = 0. 032). And there was no correlation between survival and the number of the positive cores of the biopsy (r=0. 211, F = 0. 158) and the clinical stage (r=0. 211, P = 0. 352). Conclusions As to the metastatic prostatic carcinoma, there are correlations between the survival and the levels of testosterone before treatment, age, the Gl-eason score and the level of PSA. There is no relationship between the survival period of the metastatic prostatic carcinoma and the number of the positive cores of the biopsy and the clinical stage.

Objective To investigate the expression and clinical significance of α-actinin-1 protein (ACTN1) in prostate cancer (PCa) and prostatic hyperplasia (BPH). Methods The clinical data of patients with PCa or BPH treated in our school affiliated hospital were collected between January 2007—October 2014, according to certain criteria. Immunohistochemistry method was used to detect the expression of ACTN1 in 30 samples of PCa and 30 samples of BPH tissues. Western blot assay was used to detect the relative expression of ACTN1 in 18 samples of PCa and 20 samples of BPH tissues in two groups. Results The result of immunohistochemistry showed that the positive expression rates of ACTN1 were 76.7%and 20%in PCa and BPH groups respectively. The difference was statistically significant (P<0.01). Western blot assay showed that the relative expression of ACTN1was significantly higher in PCa group (0.591±0.182) than that in BPH group (0.037 ± 0.052, P < 0.05). There was no significant difference in expression level of ACTN1 between different age groups. There was no significant difference in serum prostate specific antigen (PSA) level between patients with or without bone metastasis, and patients with or without lymph node metastasis (P > 0.05). There were significant differences in ACTN1 levels between different Gleason score and T staging groups (P<0.05). Conclusion The expression ofα-actinin-1 is significantly higher in PCa tissues than that in BPH tissues. There is the relationship between expression of ACTN1, Gleason scores and T staging.

Objective To explore the efficacy and safety of the resection of prostate-tangerine techniquewith 980 nm diode laser benign prostatic chyperplasia(BPH).Methods Data of 60 patients with highvloum BPH treated with the resection of prostate-tangerine technique with 980 nm diode laser were reviewed.The age of the patients were 65-89 years old,and mean prostate volume was 74.5± 13 ml.The mean operative time,blood loss were oberseved and recored,the international prostate symptom score(IPSS),quality of life score (QOL),maximum urinary flow rate(Qmax) and residual urine volume (PVR) were collected and analyzed.Results The 60 cases were safe during the perioperative period.The average operation time was (70.2± 16.9) min,and there was no obvious bleeding during the operation and no blood transfusion cases.The time of remove the transurethral catheter was 2-5 d,and the mean time was (2.4±0.3) d.Follow up 1-3 months after operation,a significant reduction in IPPS was reported (P =0.000),significant durable improvements in Qmax,PVR before operation(P=0.000).Conclusion Transurethral vaporization of 980 nm diode laser could be a safe and effective treatment modality for BPH.

Objective To study the effect and mechanism of paeonol(PAE)on renal interstitial fibrosis in rats.Methods The rats were randomly divided into sham operation(Sham)group,unilateral ureteral obstruction(UUO)group,PAE low dose(PAE-L)group,PAE medium dose(PAE-M)group,PAE high dose(PAE-H)group and irbesartan(IRB)group.Except for the Sham group,the UUO model was established in other groups.Each group was given a corresponding intervention for two weeks.Serum creatinine(Scr),blood urea nitrogen(BUN),serum 8-hydroxydeoxyguanosine(8-OHdG)levels,renal tissue superoxide dismutase(SOD),glutathione peroxidase(GPX)activities,α-smooth muscle actin(α-SMA),type Ⅰ collagen(Col-Ⅰ),fibronectin(FN),silent information regulator 1(SIRT1),nuclear factor E2-related factor 2(Nrf2)protein expression were detected;observe pathological changes of kidney tissue and calculate collagen volume fraction(CVF).Results Compared with the UUO group,the serum levels of Scr,BUN,and 8-OHdG in each dose group of PAE were decreased,the activities of SOD and GPX in kidney tissue were increased,the positive expressions of α-SMA,Col-Ⅰ and FN in kidney tissue were decreased,and the protein expressions of SIRT1 and Nrf2 were increased.Masson staining showed a decrease of CVF in renal tissue(all P<0.05),and HE staining showed a different degree of improvement in pathological changes such as inflammatory cell infiltration and tubular dilatation in renal tissue;PAE improves renal interstitial fibrosis in rats in a dose-dependent manner(P<0.05),and the effect of large dose PAE on renal interstitial fibrosis in rats was similar to that of IRB.Conclusion PAE can alleviate UUO-induced rat renal interstitial fibrosis and oxidative stress,and improve rat renal function.And this mechanism may be related to the activation of the SIRT1/Nrf2 signaling pathway.

Objective:To explore the clinical application value of rapid next-generation sequencing (NGS) strategy based on targeted amplicon sequencing in the diagnosis of myeloid neoplasms.Methods:In this observational study, both rapid NGS and conventional NGS on the bone marrow or peripheral blood samples of 682 patients were prospectively performed from February 2021 to August 2022 in First Affiliated Hospital of Soochow University. The sequencing results were analyzed using the local Ion Reporter software and our lab′s self-built bioinformatics platform, respectively. The timeliness of the two sequencing platforms was compared, and the Kappa consistency test was used to evaluate the consistency between the two sequencing platforms. Patients aged between 18 and 59 years with newly diagnosed acute myeloid leukemia (AML) underwent screening by rapid NGS combining multiplex RT-PCR and in situ fluorescence hybridization technique within 72 hours, from whom high-risk patients according to European LeukemiaNet (ELN) 2017 were screened for individualized induction therapy.Results:In terms of timeliness, the median time from sample receipt to report issuance were 3 (2, 4) days and 13 (11, 15) days under rapid NGS and conventional NGS testing, respectively, with a statistically significant difference ( Z=?22.636, P<0.001). Among 682 specimens with a total of 1 507 variants, rapid NGS detected a total of 1 499 variants, with a detection rate of 99.5% and 674 cases were accurate, with an accuracy rate of 98.8%; the conventional NGS detected 1 506 variants, with a detection rate of 99.9% and 681 cases were accurate, with an accuracy rate of 99.9%. In 682 specimens, there were 181 negative and 501 positive, in which 8 cases were missed under rapid NGS, and 1 case was missed under conventional NGS. The kappa value was 0.967 by Kappa consistency test, and P<0.001, suggesting good consistency and consistency between the two NGS platforms. From February 2021 to July 2022, 286 patients who were rapidly diagnosed of AML contained 78 patients screened as the ELN 2017 adverse-risk category, including 42 patients enrolled, with age 39 (33, 52) years old. After one cycle of venetoclax combined with decitabine induction therapy, 78.6%(38/42) of the patients achieved composite complete remission. Among the rest 104 additional myeloid neoplasms, rapid NGS detected mutations in 80 patients, with a detection rate of 76.9%, among which 89.0%(215/242) of the variants could serve as the basis for the diagnostic classification, prognostic evaluation, and target therapy of myelodysplastic syndromes (MDS), myeloproliferative neoplasms (MPN), and myelodysplastic/myeloproliferative neoplasms (MDS/MPN). Conclusion:The rapid NGS based on targeted amplicon sequencing is in good consistency with conventional NGS, and shorters the diagnostic time, whose sensitivity and detection range meets the need for diagnostic classification, prognostic stratification, and target therapy of myeloid neoplasms.

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2018 to December 2019. Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 14 778 bacterial strains were collected from 50 hospitals, of which 4 117 (27.9%) were Gram-positive bacteria and 10 661(72.1%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.2%), Klebsiella pneumoniae (17.0%), Staphylococcus aureus (9.7%), coagulase-negative Staphylococci (8.7%), Pseudomonas aeruginosa (3.7%), Enterococcus faecium (3.4%), Acinetobacter baumannii(3.4%), Enterobacter cloacae (2.9%), Streptococci(2.8%) and Enterococcus faecalis (2.3%). The the prevalence of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus were 27.4% (394/1 438) and 70.4% (905/1 285), respectively. No glycopeptide-resistant Staphylococcus was detected. More than 95% of S. aureus were sensitive to amikacin, rifampicin and SMZco. The resistance rate of E. faecium to vancomycin was 0.4% (2/504), and no vancomycin-resistant E. faecalis was detected. The ESBLs-producing rates in no carbapenem-resistance E. coli, carbapenem sensitive K. pneumoniae and Proteus were 50.4% (2 731/5 415), 24.6% (493/2001) and 35.2% (31/88), respectively. The prevalence of carbapenem-resistance in E. coli and K. pneumoniae were 1.5% (85/5 500), 20.6% (518/2 519), respectively. 8.3% (27/325) of carbapenem-resistance K. pneumoniae was resistant to ceftazidime/avibactam combination. The resistance rates of A. baumannii to polymyxin and tigecycline were 2.8% (14/501) and 3.4% (17/501) respectively, and that of P. aeruginosa to carbapenem were 18.9% (103/546). Conclusions:The surveillance results from 2018 to 2019 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while E. coli was the most common pathogen, and ESBLs-producing strains were in majority; the MRSA incidence is getting lower in China; carbapenem-resistant E. coli keeps at a low level, while carbapenem-resistant K. pneumoniae is on the rise obviously.

Objective: To explore the temporal and spatial characteristics of search volume (SV) of allergic rhinitis (AR) and related search terms on Baidu Index, as well as the correlation between SV from Baidu Index and epidemiology of AR. Methods: SV of AR and related search terms in mainland area of China from January 2012 to December 2016 were extracted from Baidu Index. Firstly, we investigated the temporal and spatial characteristics of SV of AR and related search terms ("pollen allergy" and" dust mite allergy", etc.), and explored the correlation between SV of AR and SV of related search terms. Secondly, the SV of specific search terms in Beijing and Guangzhou were compared with the actual pollen count in Beijing from April to September in 2016 and the monthly outpatient volume of AR patients in the Otorhinolaryngology Hospital, The First Affiliated Hospital of Sun Yat-sen University from 2014 to 2016 respectively to analyze the consistency between SV from Baidu Index and the real-world data. Spearman correlation analysis was used to explore the correlation between different search terms according to the normality and homogeneity of variance of the data. P<0.05 was considered statistically significant. Results: SV of AR showed repetitively seasonal pattern, with the first peak in May and the second peak from August to September. SV of AR in northeast China, north China and northwest China were correlated with both SV of "pollen allergy" and "dust mite allergy" (r value was 0.533, 0.638, 0.609, 0.791, 0.517, 0.682, respectively, all P<0.05). In east China, central China, south China and southwest China, SV of AR showed significant correlation only with SV of "dust mite allergy" (r value was 0.897, 0.884, 0.799, 0.937, respectively, all P<0.05), but not with SV of "pollen allergy" (r value was 0.110, 0.171, 0.020, 0.265, respectively, all P>0.05). The correlation between pollen count and the SV of AR on the day and SV of "pollen allergy" on the next day was the highest (r value was 0.692 and 0.713, respectively, all P<0.05). The SV of AR was correlated with the monthly outpatient volume of AR patients one month and two months later (r value was 0.523 and 0.503, respectively, all P<0.05). Conclusion The SV of AR and related search terms show different trends in different times and regions which are consistent with the AR epidemiological survey, and significantly correlate with pollen count and AR outpatient volume.