Objective To investigate the safety and efficacy of the modified laparoscopic radical cystectomy and standard pelvic lymph node dissection for female bladder cancer patients.Methods Fortyone female patients with bladder cancer who underwent laparoscopic radical cystectomy(LRC) and standard pelvic lymph node dissection(sPLND) in our hospital from June 2003 to January 2016 were retrospectively analyzed.The patients were divided into two groups according to the surgical procedure.There were 15 patients with ≤ cT2 tumor and 1 patient with cT3 in the modified group.The average age was (62.2 ± 11.5) years.The median BMI was 20.7 kg/m2,ranging 18.4 to 22.2 kg/m2;The ASA level was less than Ⅱ in 9 (56.2％) cases and was level Ⅲ in 7 (43.8％) cases.There were 22 patients with ≤ cT2 tumor and 3 patients with cT3 in the traditional group.The average age was (60.4 ± 12.9)years.The median BMI was 21.7 kg/m2,ranging 18.4 to 23.1 kg/m2.ASA was less than level Ⅱ in 15(60.0％) cases and level Ⅲ in 10(40.0％) cases.All operations are performed under general anesthesia.In the traditional group,the plane between rectus and uterus is separated first.Then open the posterior cervical fornix and cut off the lateral bladder pedicle,cardinal ligament of uterus and urethra.The bladder and uterus are removed together.The sPLND is performed at last.In the modified group,the sPLND is performed first.Then separate the bladder and uterus until the anterior wall of the vagina can be exposed.The bladder and uterus are removed separately.Data of the operation and the complications were collected and analyzed.Results All patients were performed the operation successfully.No open conversion was recorded during the operation.No patient died during the peripheral operative phase.In modified group,10 patients received orthotopic ileal neobladder (OIN),5 patients received ileal conduit and 1 patient received ureterostomy.In traditional group,19 patients received OIN,3 patients received ileal conduit and 3 patients received ureterostomy.No significant difference of surgical method was noticed in those group.The median operative time in modified group and traditional group was 290 min (ranging 265-335 min) and 315 min (ranging 270-380 min),respectively(P ＞ 0.05).The median estimated blood loss in modified group and traditional group was 100ml (100,100) and 200ml (200,400),respectively (P ＜ 0.05).The rate of transfusion in modified group and traditional group was 6.3％ (1/16) and 18.5％ (5/27),respectively (P ＜0.05).The incidence of early complications between two groups showed no statistically difference.No major (Clavien grade 3 to 5) complications occurred in modified group.However major complications occurred in 3 patients in traditional group,followed by 2 neobladder vagina fistula,1 ileal anastomotic stoma fistula.All those complications were cured by operation.All patients were diagnosed urothelium carcinoma.In modified group,the tumor stage included carcinoma in suit in 2 cases,pTa-pT1 in 7 cases,pT2 in 6 cases,pT3 in one case.In traditional group,the tumor stage included pT1 in 12 cases,pT2 in 10 cases,pT3 in 3 cases.The numbers of resected lymph node in modified group and conventional group were 16 (ranging 7-19) and 10 (ranging 7-13),respectively (P ＞ 0.05).Conclusions The modified laparoscopic radical cystectomy and pelvic lymph node dissection for female bladder cancer patients could reduce the blood loss and incidence of neobladder vaginal fistula comparing with the traditional operation.

Fatigue, which is one of the most commonly reported symptoms in cancer, can negatively impact the functional status and the health-related quality of life of individuals. Although awareness and
study of CRF have grown in recent years,the biological mechanisms and risk factors that induce CRF remain unclear.This paper systematically reviews the available evidence on the biological mechanisms and the risk factors to guide the development of targeted, individualized interventions for cancer-related fatigue.

Objective To explore the clinical factors on the functional recovery of spinal cord cavernous hemangioma operation. Methods Fifty cases patients with complete spinal cord cavernous hemangioma were retrospectively analyzed their clinical data and its influence on prognosis of 2 years. Single factor and multiple factors analysis were performed. Results Compared with the preoperative stage,the grade of Aminoff-Logue score of 28 cases(50. 9%)had improved at least one grade,14 cases(25. 5%)patients with no significant changes and 13 cases(23. 6%)with decreased one grade at least. Logistic regression model showed that patients with clinical types(OR=3. 27,95%CI 2. 34-15. 83,P=0. 006),the time of the attacks to the surgery(OR=2. 93,95%CI 1. 41-10. 61,P=0. 012),and the attacks to the operation time( OR=4. 31,95%CI 2. 46 -12. 32,P = 0. 019 ) were related to neurological function recovery of spinal cord cavernous hemangiomas. Conclusion For patients with SCH dysfunction,regardless of what kind of clinical types of neurological dysfunction extent,should receive surgical treatment to improve neurological function recovery rate as soon as possible.

Methods: Preoperatively, all 160 patients with OVCFs underwent pressure-pain threshold (PPT), temporal summation (TS), conditioned pain modulation (CPM), and imaging assessments. Pain intensity and pain-related disability were evaluated before and after PVP. Results: Preoperatively, patients with OVCFs had lower PPTs in both local pain and pain-free areas and lower CPM and higher TS in pain-free areas than healthy participants (p<0.05). Unlike patients with acute fractures, patients with subacute/chronic OVCFs showed higher TS with or without lower CPM in the pain-free area compared with healthy participants (p<0.05). Postoperatively, RBP occurred in 17 of 160 patients (10.6%). All preoperative covariates with significant differences between the RBP and non-RBP groups were subjected to multivariate logistic regression, showing that intravertebral vacuum cleft, posterior fascia edema, numeric rating pain scale scores for low back pain at rest, and TS were independently associated with RBP (p<0.05). Conclusions Augmented central pain processing may occur in patients with OVCFs, even in the subacute stage, and this preexisting CS may be associated with RBP. Preoperative assessment of TS in pain-free areas may provide additional information for identifying patients who may be at risk of RBP development, which may be beneficial for preventing this complication.

Elucidation of molecular mechanisms underlying host-pathogen interactions is important for control and treatment of infectious diseases worldwide. Within the last decade, mass spectrometry (MS)-based proteomics has become a powerful and effective approach to better understand complex and dynamic host-pathogen interactions at the protein level. Herein we will review the recent progress in proteomic analyses towards bacterial infection of their mammalian host with a particular focus on enteric pathogens. Large-scale studies of dynamic proteomic alterations during infection will be discussed from the perspective of both pathogenic bacteria and host cells.
Animals ; Bacteria ; chemistry ; pathogenicity ; Bacterial Infections ; microbiology ; pathology ; Bacterial Proteins ; isolation & purification ; metabolism ; Host-Pathogen Interactions ; Humans ; Mass Spectrometry ; Protein Processing, Post-Translational ; Proteomics

Objective To study the clinical efficacy of platelet-rich plasma (PRP) in the treatment of acute Achilles tendon rupture.Methods A retrospective study was performed of the 21 patients who had been treated for acute Achilles tendon rupture at Department of Orthopaedics,The First Affiliated Hospital to Soochow University from January 2018 to January 2019.Of them,15 were treated by modified Kessler suture combined with PRP injection (PRP group) and 6 by simple modified Kessler suture (control group).The 2 groups were compared in terms of plantar flexion,dorsal expansion,visual analogue scale (VAS),Victorian Institute of Sport Assessment (VISA),and ankle-hindfoot score of American Orthopaedic Foot and Ankle Society (AOFAS) at 3,6,and 9 months postoperation.Results The 2 groups were comparable due to insignificant differences between them in the preoperative general data (P ＞ 0.05).All patients were followed up for 9 to 12 months (mean,11.3 months).At 3,6,and 9 months postoperation,the degrees of plantar flexion (33.5°±1.8°,38.1°±1.2°and41.6°±1.6°) and dorsal expansion (10.3°,16.5°and 21.5°) in the PRP group were all significantly larger than those in the control group (26.9°± 2.0°,31.5°±1.6°and35.6°±1.4°;5.3°,12.7°±0.6°and 18.2°),and the VISA scores (41.2±6.5,78.7±10.4 and 91.0 ± 4.1) and the AOFAS scores (75.5 ± 5.4,88.6 ± 5.2 and 95.2 ± 3.5) in the PRP group were all significantly higher than those in the control group (29.8 ±2.5,68.0 ±3.5 and 84.5 ±2.1;66.8 ±4.8,82.8 ±3.6 and 90.7 ± 1.1) (all P ＜ 0.05).At 3 and 6 months postoperation,the VAS scores in the PRP group (1.7 ± 0.9 and 1.3 ±0.4) were significantly lower than those in the control group (3.0±0.8 and 2.2 ± 0.7) (all P ＜ 0.05).Conclusion As PRP can release a high concentration of growth factors to promote recovery of Achilles tendon rupture and accelerate recovery of foot and ankle function,it can be considered a safe,practical and reliable treatment to use modified Kessler suture plus PRP injection.

Objective:For cancer patients who underwent extensive surgery, drastic release of myoglobin (Mb) after surgery can cause hypermyoglobinemia and related problems. This retrospective cohort study aims to summarize our experience and outcomes of 60 pa-tients with hypermyoglobinemia after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), to investi-gate the changes in postoperative Mb levels, and to explore the clinical value of Mb. Methods:This retrospective study covered 60 pa-tients with peritoneal carcinomatosis who were treated with CRS and HIPEC. All patients developed hypermyoglobinemia after opera-tion. Immediately after CRS and HIPEC, the patients were placed in a comprehensive treatment regimen consisting of hemodynamic stabilization therapies, nutritional support, anti-sepsis therapies, and psycho-physical therapies. For the treatment of hypermyoglo-binemia, intravenous injection of sodium bicarbonate solution according to the Mb level was given to the patients. Moreover, the pre-and post-operative concentrations of Mb, blood urea nitrogen (BUN), and creatinine (Cr) were evaluated. Results:Serum Mb levels af-ter CRS and HIPEC were significantly elevated and peaked on the surgery day. Prompt treatment with intravenous infusion of sodium bicarbonate solution could help decrease the serum Mb levels and alleviate potential damage. Serum Mb levels returned to normal in approximately 3-4 days. The serum BUN levels increased after operation and peaked on the fourth postoperative day. On the other hand, serum Cr levels increased 2 days after operation and began to decrease on the third postoperative day. One patient developed renal failure and sepsis and died on postoperative day 26. The other patients recovered from the surgery without major adverse events. Conclusion:Hypermyoglobinemia is a common lab abnormality after CRS and HIPEC, and serum Mb levels could be an early and sensitive indicator for dramatic disturbances in the internal milieu after surgery. Adequate treatment with sodium bicarbonate could accelerate the reduction in serum Mb levels and reduce the risk for major organ damages.

Objective Network Meta-analysis was conducted to evaluate the differences in the efficacy of different traditional Chinese medicine injections(TCMI)in patients with cancer-related fatigue.Methods The database was systematically searched and included in Cochrane Library,PubMed,Web of Science,CNKI,Wan Fang,China Biomedical Literature Database and Database of Chinese sci-tech periodicals until September,2022.These relevant randomized controlled trial literatures were evaluated the methodological quality by using of Cochrane risk of bias assessment tool.Results 18 articles involving 1404 patients and 6 traditional Chinese medicine injections(TCMI)were included.The results showed that Kangai injection[MD=-2.30,95％CI(-3.09,-1.52)]and Aidi injection[MD=-1.31,95％CI(-1.99,-0.62)]combined with chemotherapy were better than chemotherapy alone in improving CRF in cancer patients during chemotherapy,among which Kangai injection is more effective[MD=-1.05,95％CI(-1.89,-0.21)];Shenmai injection[MD=-1.24,95％CI(-1.91,-0.57)],Kangai injection[MD=-1.02,95％CI(-1.65,-0.39)],and Shenqifuzheng injection[MD=-0.54,95％CI(-0.90,-0.19)]were superior to palliative care alone in improving CRF in palliative care of cancer patients,among which Shenmai injection[MD=-1.26,95％CI(-2.15,-0.37)]is more effective.Conclusions The results demonstrated that TCMI can improve the degree of cancer-related fatigue in tumor patients at different stages.When combined with chemotherapy,Kangai injection was superior to other TCMI,while when combined with palliative treatment,Shenmai injection was superior to other TCMI.

Objective:To investigate the 2 years’ efficacy of intravesical instillation of domestic BCG versus epirubicin in the prevention of recurrence of intermediate-risk or high-risk non-muscular invasive bladder cancer and predictive factors of BCG instillation.Methods:From July 2015 to June 2020, 18-75 years old patients with moderate to high-risk non muscle invasive bladder cancer (NMIBC) confirmed by pathological examination were involved. The ECOG score was 0-2. Exclusion criteria included ①immune deficiency or impairment (such as AIDS), using immunosuppressive drugs or radiotherapy, suspected allergic to BCG or epirubicin or excipients of the two drugs, fever or acute infectious diseases including active tuberculosis or receiving anti tuberculosis treatment, with severe chronic cardiovascular and cerebrovascular diseases or chronic kidney disease; ②combined with other urogenital system tumors or other organ tumors; ③combined with muscle invasive bladder urothelial carcinoma (≥T 2); ④undergoing chemotherapy, radiotherapy or immunotherapy within 4 weeks (immediate instillation after surgery not included); ⑤ pregnant or lactating women; ⑥ comfirmed or suspected bladder perforation; ⑦gross hematuria; ⑧cystitis with severe bladder irritation that may affect the evaluation; ⑨participat in other clinical trials within 3 months; ⑩alcohol or drug addiction; ?any risk factors that may increasing the risk of patients. Epirubicin 50 mg was irrigated immediately after the operation(TURBT or laser resection). The patients were randomly divided into BCG15 group, BCG19 group and epirubicin group by the ratio of 2∶2∶1, and the patients were maintained intravescical instillation for 1 year. The recurrence and adverse events of the three groups were compared. Univariate and multivariate analysis was performed to predict the risk factors of BCG irrigated therapy failure. Result:By June 15, 2020, the median follow-up duration was 22.1 months(12.1, 32.3), and there was no statistical difference between the groups ( P=0.9024). There were 274 patients enrolled in BCG19 group, 277 patients enrolled in BCG15 group and 130 patients enrolled in the epirubicin group. The drop-off rate was 16.6%(113 cases)and made no difference between groups( P=0.6222). There were no significant difference in age, gender, BMI, or ECOG score( P>0.05). During the follow-up, 116 cases was detected recurrence or progression. The recurrence rate of the three groups was 14.2% and 14.8% in BCG19 group and BCG15 group, and 27.7% in the epirubicin group. There was no difference in recurrence rate between BCG19 and BCG15 group( P=0.9464). The recurrence rate of BCG19 group was lower than that of the epirubicin group ( P=0.0017). The recurrence rate of BCG15 group was lower than that of the epirubicin group ( P=0.0020). There was no difference in the cumulative recurrence free survival rate between BCG19 and BCG15 group (95% CI0.57-1.46, P=0.7173). The cumulative recurrence free survival rate of BCG 19 group was better than that of the epirubicin group( HR=0.439, 95% CI0.26-0.74, P=0.0006), and the cumulative recurrence free survival rate of BCG15 group was better than that of the epirubicin group ( HR=0.448, 95% CI0.29-0.80, P=0.0021). The total incidence of adverse events in 19 BCG19, BCG15 and epirubicin group were 74.5%, 72.6% and 69.8% respectively. There was no difference in the incidence of adverse events between BCG19 and BCG15 group( P=0.6153). The incidence of adverse events in epirubicin group was lower than that of BCG19( P=0.0051) and BCG15( P=0.0167) groups.There was no significant difference in the incidence of serious adverse events (SAE) among the three groups ( P=0.5064). Log rank test univariate analysis and Cox risk regression model multivariate analysis showed that the history of bladder cancer recurrence( HR=6.397, 95% CI1.95-20.94, P=0.0001)was independent risk factor for BCG irrigation failure. Conclusions:The 2 years’ efficacy of intravesical instillation of domestic BCG is better than than of epirubicin with good tolerance and safety. There is no difference between BCG19 and BCG15 group. BCG doesn’t increase SAE compared with epirubicin. Recurrence status was an independent prognostic factor regarding recurrence-free survival.

The jaw and femur are commonly used sites in basic research for modeling bone defects or inserting implants. An increasing number of studies have identified that the jaw and femur indeed show great differences in embryonic development and growth, histomorphology and bone metabolism. A literature review showed that, compared with the femur, the main osteogenic pathway of the jaw may have better osteogenic ability, and its stem cells have better proliferation and osteogenic differentiation ability. However, the jaw structure is less regular, the osteogenic differentiation ability of its osteoblasts is mineralization slightly weak, and the immune cells of the jaw are more sensitive to cytokines. These may be the reasons why the osseointegration of the jaw implant is different from that of the femur in animal experiments, but its specific mechanism has not been clarified.