Objective To explore the application value of vesicourethral anastomosis with maximal urethral length preservation(MULP)and bladder neck preservation(BNP)in laparoscopic radical prostatectomy(LRP)or robot-assisted laparoscopic radical prostatectomy(RALP)for high-risk prostate cancer(HRPC)in terms of early urinary continence and oncology.Methods Clinical data of 23 HRPC patients who underwent LRP(including RALP)with MULP and BNP in our hospital during May 2022 and Jan.2024 were retrospectively analyzed.Patients'basic information,surgical parameters,postoperative complications,oncological outcomes and urinary incontinence were collected and analyzed.Results All operations were completed successfully without conversion to open surgery.The operation time was(108±31)min,average blood loss(112±45)mL,hospital stay(5.5±1.5)days,urethral catheterization time(12.6±1.8)days,and no patient received blood transfusion during operation.The urinary continence rates at the time of catheter removal,and at 1,3,and 6 months after surgery were 39.1％,65.2％,73.9％,and 91.3％,respectively.Two patients had positive margins,both of which were at the neurovascular bundle.No patient developed surgery-related complications,urinary obstruction or fistula after surgery.Conclusion Vesicourethral anastomosis with MULP and BNP in LRP for HRPC can effectively improve patients'early urinary continence rate and postoperative quality of life without increasing the oncological risk.

BACKGROUND: Scholars have been trying to create a microenvironment similar to the human body, which can induce the directional differentiation of mesenchymal stem cells from human bone marrow, placenta and umbilical cord blood. OBJECTIVE: To compare the neuronal differentiation of human bone marrow mesenchymal stem cells, human placental mesenchymal stem cells and human umbilical cord blood mesenchymal stem cells induced by co-culture with nerve cells. METHODS: Human bone marrow mesenchymal stem cells, human placental mesenchymal stem cells and human umbilical cord blood mesenchymal stem cells cultured in vitro were co-cultured with nerve cells using the Transwell system. The morphological changes of three kinds of cells in the co-culture system were detected. After co-culture for4-5 days, immunofluorescence staining was used to measure the expression of neuron-specific enolase in cells. Mesenchymal stem cells only cultured in low glucose DMEM medium were used as controls. RESULTS AND CONCLUSION: These three kinds of mesenchymal stem cells were extended, and interconnected processes were detective. The positive expression of neuron-specific enolase was highest in the human umbilical cord blood mesenchymal stem cells followed by human placental mesenchymal stem cells and human bone marrow mesenchymal stem cells in order. In the control group, none of the three kinds of mesenchymal stem cells have neuronal morphology, and the expression of neuron specific enolase was negative for the immunofluorescence staining. To conclude, microenvironment provided by nerve cells can induce these three kinds of mesenchymal stem cells todifferentiate into neurons.

BACKGROUND:Uric acid, as an endogenous antioxidant, exhibits anti-oxidative and anti-DNA damage effects, promotes osteogenic differentiation, and therefore has been paid more attentions.
OBJECTIVE:To investigate the effects of different concentrations of uric acid on the expression of genes related to Wnt/β-catenin signaling pathways during osteogenic differentiation of human bone marrow mesenchymal stem cel s.
METHODS:Healthy adult human bone marrow mesenchymal stem cel s were in vitro isolated by adherent culture of whole bone marrow. Passage 3 bone marrow mesenchymal stem cel s were induced to differentiate into osteoblasts using different concentrations of uric acid (0, 140, 280, 560μmol/L). Alkaline phosphatase activity, cel proliferation capacity, and Wnt-3αandβ-catenin mRNA expression in the Wnt signaling pathways were detected.
RESULTS AND CONCLUSION:Alkaline phosphatase staining was positive. After treatment with uric acid, alkaline phosphatase activity and cel proliferation capacity were increased, the expression of Wnt signaling pathway-related genes Wnt-3a andβ-catenin was up-regulated in a dose-dependent manner. There were significant differences in the abovementioned indices between experimental groups and between each experimental group and control group (P<0.05). These findings suggest that uric acid up-regulates Wnt-3a/β-catenin signaling pathway and thereby promotes the osteogenic differentiation and proliferation of human bone marrow mesenchymal stem cel s in a dose-dependent manner.

BACKGROUND:Studies have shown that the number of osteoblasts is often decreased after osteoporosis, and osteoblast replacement therapy becomes a new target for the treatment of osteoporosis. OBJECTIVE:To observe the osteogenic differentiation of human bone marrow mesenchymal stem cels cultured in dexamethasone, vitamin C and beta-glycerophosphate. METHODS:Mesenchymal stem cels were isolated and purified from adult bone marrow using human lymphocyte separation medium. The expression of cel surface markers was detected by flow cytometry. Cel ultrastructure was observed by transmission electron microscope. Then, the bone marrow mesenchymal stem cels were cultured in osteogenic induction medium containing dexamethasone, vitamin C andβ-glycerophosphate, and RT-PCR was used to detect the bone morphogenetic protein-2 mRNA expression after osteogenic induction. RESULTS AND CONCLUSION:A large number of adherent cels were visible as fibrous growth at 2 weeks after culture and strongly expressed CD44, CD29, but did not express CD34, CD45. These cels could be induced to differentiate into osteoblasts, and express bone morphogenetic protein-2 mRNA. Alizarin red staining and alkaline phosphatase staining were positive for the cels. These findings suggest that human bone marrow mesenchymal stem cels cultured in dexamethasone, vitamin C and beta-glycerophosphate can differentiate into osteoblasts, and has a potential for the treatment of osteoporosis.

BACKGROUND:Uric acid as an endogenous antioxidant has garnered increasing attentions because of its anti-oxidation, anti-DNA damage and neuroprotective effects.
OBJECTIVE:To observe the effect of uric acid at different concentrations on the neural differentiation of bone marrow mesenchymal stem cells.
METHODS:Bone marrow mesenchymal stem cells were isolated, purified and cultured in vitro. The morphology change was observed. The third passages of bone marrow mesenchymal stem cells were induced to differentiate to neuron-like cells by induced liquid containing four different concentrations of uric acid (0 mmol/L as control group, 0.2 mmol/L, 0.4 mmol/L, 0.8 mmol/L) for 24 hours. Then, after second intervention for 1 hour, cells were detected by Nissl staining and specific markers were detected by immunohistochemistry method.
RESULTS AND CONCLUSION:After induction, the cellbody shrank, forming processes and connections. Nissl body was found in the cytoplasm. The positive rates of neuron-specific enolase were significantly higher in uric acid groups of different concentrations compared to the control group (P<0.05);moreover, the positive rates of neuron-specific enolase were increased as the increase in concentrations of uric acid (P<0.05). The positive rates of Nestin were decreased in uric acid groups of different concentrations compared to the control group (P<0.05). After 4 hours of induction, cells fel off significantly. In a certain period of time, uric acid can promote differentiation of bone marrow mesenchymal stem cells into neuron-like cells in a certain concentration-dependent manner in vitro.

Objective To observe the bone mineral density(BMD)in type 2 diabetic women and discuss the methods for evaluation of BMD.Methods BMD was measured by dual-energy X-ray absorptiometry(DEXA)at skeletal regions of supine and lateral spine,left femur neck and left hip in 484 type 2 diabetic women and 868 healthy women.The relation of BMD of healthy women in skeletal regions with age changes was found to fit a cubic regression model.Results The peak BMD of lateral spine and hip appeared at 25-34 and 35-44 years old respectively.BMD in diabetic women was not different from age-matched healthy women.The BMD values of the different age stages in diabetic women showed no difference(P>0.05)as compared with healthy women,and decreased with the age increase.The numbers of damaged bone sites were increased with the age increase.The BMD difference values between peak value and values of different age stages showed no difference between diabetic and healthy women groups(P>0.05).Conclusion The changes of BMD in type 2 diabetic women show no difference from age-matched healthy women.And in both diabetic and healthy women,BMD decreases with age increasing.

BACKGROUND:At present,mesenchymal stem cells(MSCs) is mainly obtained from stem cells.But the quantity of human bone marrow mesenchymal stem cells(BMSCs) is lower.Fetal MSCs possess weak immunogenicity and good differentiation potential.OBJECTIVE:To compare the biological difference in adult and fetal BMSCs.DESIGN,TIME AND SETTING:The cytology in vitro controlled study was performed at the Central Laboratory,Hospital Affiliated to Medical College,Qingdao University from February to October 2008.MATERIALS:Three samples of adult bone marrow blood were obtained from Hospital Affiliated to Medical College,Qingdao University.Three samples of fetal bone marrows were supplied by Qingdao Municipal Hospital.METHODS:Human and fetal BMSCs were harvested in vitro by the Percoll method,and incubated in LG-DMEM containing 10% volume fraction fetal bovine serum.Till cells were 90% confluent,cells were digested and passaged.The same passage of adult and fetal BMSCs were collected,and treated with KGla suspension and DMEM containing fetal bovine serum at 37 ℃ in 0.05 volume fraction CO2 for 2 hours.Non-adherent cells were removed.At the third passage,BMSCs at a density of 1?106 were incubated.When cells were 60%-80% confluent,cells were incubated in osteoblast medium for 16 days.MAIN OUTCOME MEASURES:Cell morphological changes were measured.Growth curve was detected by MTT assay.Cell adherent rate in vitro was calculated.Alkaline phosphatase staining was used to detect the differentiational results of osteoblasts.RESULTS:Adult and fetal BMSCs showed spindle-shape,but the fetal BMSCs were small.The doubling time of them was 50 hours and 30 hours,respectively.Compared with the adult BMSCs,cell adherent rate was significantly lower in the fetal BMSCs(t=4.22,P

Bone marrow mesenchymal stem cells is a new approach for diabetes treatment, it can transdifferentiate into insulin cells in vitro, that may overcome the shortage of human donor islets, avoid the immunological rejection and moral principle problems which are involved into the research of embryonic stem cells.Studies have shown that insulin gene and its other necessary gene can introduce into primary cells or other somatic stem cells directly in diabetes mellitus patients, such as hepatic cells, intestines epidermis K cells, fibroblast cells and liver tumor cells and so on.Thereby, it can be translated into insulin-secreting cells.At present, the main study direction internationally is how to import insulin gene into target cells effectively, and make it express in a physical model.

OBJECTIVE: Pancreatic stem cell transplantation is a new approach for diabetes treatment. It may overcome the shortage of human donor islets and avoid the long-term applying of immunity depressors. In this article, we review the recent progress of the sources, induced differentiation and the molecular markers of pancreatic stem cells. DATA SOURCES: A computer-based online search of PUBMED was undertaken to identify relative articles published in English from June 1997 to June 2006 with the keywords of "pancreatic, stem cell, differentiate, marker". Meanwhile, we searched Wanfang database for the related Chinese articles published between June 1997 and June 2006 with the same key words in Chinese. STUDY SELECTION: The articles were firstly selected and the quotations cited by every article were looked over. Inclusive criteria: The articles focusing on the source, induced differentiation and molecular markers of pancreatic stem cells. Exclusive criteria: Repeated experiments or Meta analysis articles. DATA EXTRACTION: According to the inclusive criteria, 31 articles were finally selected among the 82 ones collected from databases.Fifty-one old data or duplicated researches were excluded. Among the 31 selected articles, 6 presented the main conceptions, 15 were related to the sources of pancreatic stem cell and its induced differentiation, 9 were focused on the surface molecular markers and 2 discussed the major obstacles at present. DATA SYNTHESIS: Stem cells are pluripotential cells with the ability to self-renew; they are classified into two major classes: embryonic stem cell and adult stem cell. Pancreatic stem cells, belonging to the adult stem cells, could differentiate into tube cells, insulin-secreting cells, exocrine cells and other specific pancreatic tissue cells, which possess the fundamental properties of long-term proliferation and self-renewal. The studies on the sources, induced differentiation and molecular markers of pancreatic stem cells are extremely useful for the treatment of diabetes. Recent studies have shown that besides gene engineering, insulin-secreting cells are mainly generated from the differentiation of embryonic stem cells and adult stem cells such as pancreatic duct epithelial cells, nestin-expressing pancreatic stem/precursor cells, bone marrow mesenchymal stem cells and haematopoietic stem cells. The investigation on the molecular markers of pancreatic stem cell surface is essential to the basic and clinical research. PDX-1, nestin, CK-19, CK-20, Ngn3 and PGP9.5 are the major markers used in the identification, isolation and purification of pancreatic stem cells. CONCLUSION: The investigations on islet cells and pancreatic stem cells transplantations are promoting. Significant advancements in search for the sources and identification of pancreatic stem cells have been achieved. However, many obstacles should be overcome before any clinical breakthroughs can be expected. With the significant improvement in stem cell research and techniques, it is possible to obtain enough pancreatic stem cells from in vitro culture for transplantation.