Objective　To examine whether ischemia preconditioning (IPC) can decrease ischemia reperfusion(I/R) injury in retina and investigate the mechanism. Methods　Retinal ischemia was induced in SD rats by increasing the intraocular pressure to 14.63kPa for 60 minutes via cannulation into the anterior chamber. Retinal ischemia for 5 minutes constituted the preconditioning stimulus. Rats first underwent IPC and 60 minutes of ische- mia 30 minutes, 24 or 72 hours later or they underwent a 5-minute sham PC and 60 minutes of ischemia 24 hours later. Their electroretinography(ERG), Light microscopy(LM),transmission electron microscopy (EM) and the expression of heat shock protein 70(HSP70) were observed and the content of malandialdehyde(MDA) in rat retinas were measured 24 or 72 hours later after 60 minutes ischemia.Results　Ischemia induced histologic damage was completely prevented when IPC was performed 24 or 72 hours (but not 30 minutes) before ischemia. In contrast to the sham PC group, the amplitudes had complete recovery of b-waves with preischemia basline amplitudes (P<0.01),and the content of MDA was significantly decreased (P<0.01).Conclusion　IPC provides protection against retinal I/R injury just during limited period of time.

Objective To evaluate the safety and efficacy of nephron sparing surgery for small renal tumor. Methods A total of 43 patients with small renal tumor underwent nephron sparing surgery (NSS). Of the 43 patients, 27 were male and 16 were female, with an average age of 46.0(21-79)years. The mean diameter of the tumors was 3.1 (1.2- 4. 0)cm. Eighteen cases received open NSS, other 25 cases received retroperitoneal laparoscopic NSS. The perioperative data and renal function, postoperative complications and tumor recurrence were evaluated. Results The procedure was successful in all 43 patients, though 2 cases occurred serious bleeding during operation. The average operating time was 158. 0(69- 277) and 150. 0(60-226) min in open NSS and laparoscopic NSS groups. The average warm ischemia time was 23. 2(20-31) and 25.8(23-35) min. The average blood loss was 590.8(120-3000) and 468. 5(50-1600) ml. The average pre-operation creatinine was (65.9±22. 8)and(68.4±25.0)μmol/L. The average creatinine at the end of follow-up was(82. 2±24.1)and(85. 3±25.9)μmol/L. The average hospital stay was 19.2(11-47) and 12.5(10- 16) (P＜0.05). The histological results showed 25 cases of renal cell carcinoma (RCC, Tla) and 18 cases of benign lesions. Sixteen cases(37%)of minor complications were observed. Comparing the open NSS versus laparoscopic NSS group, perirenal hematoma rate was 6 % vs 12 % (P＜0.05), flank numbness rate was 11.1% vs 0(P＜0.05). During the mean 25-60(37. 4±7.2)months follow-up, 1 case with RCC relapsed in 20 months and received radical nephrectomy. 1 case with harmatoma was found a new lesion apart from the original site in 6 months and CT scan confirmed harmatoma, and then received active surveillance. The 3-year recurrence-free survival for all tumors in 2 groups was 94%, 96%, and that for RCC was 100% and 93%, separately. Conclusions Comparing with open NSS, laparoscopic NSS for small renal tumor has a shorter hospital stay and lower flank numbness rate, though has higher perirenal hematoma rate. There was no significant difference in other complications between the 2 groups. No irreversible renal function damage was observed in two groups. The tumor recurrencefree survival and RCC recurrence-free survival were no significant difference between two groups.

Objective To explore the correlation between the expression of hypoxia-inducihle factor-1α (HIF-1α) in the tissue of gastric cancer and the recurrence of gastric cancer after surgery.Methods A total of sixty patients with gastric cancer who received curative gastrectomy with complete follow-up data and recurrence after the surgery were taken as recurrence group.At same period,48 patients with gastric cancer treated and followed up for five years without recurrence were set as control group.The expressions of HIF-1α,CD34 and vascular endothelial growth factor (VEGF) in the gastric tissue section of recurrence group and control group were detected by immunohistochemistry streptavidin-peroxidase (S-P) staining.Chi-square test and Spearman correlation analysis were performed for the correlation analysis between the positive rates of HIF-1α and clinical pathological features.Kaplan-Meier method and Log-rank test were used for the analysis of survival condition in recurrence group.The independent prognostic factors of gastric cancer were analyzed by univariate analysis and Cox regression model.Results In recurrence group,the positive rate of HIF-1α expression was higher in cases with higher degree of gastric cancer differentiation,deeper invasion,lymph node metastasis,ascites,vascular invasion,lower TNM-stage and positive expression of VEGF.The differences were statistically significant (x2 =4.781,6.591,6.567,5.138,5.320,5.881 and 7.365,all P＜0.05).The positive rate of HIF-1α expression of recurrence group was correlated with the positive expression of VEGF and microvascular density (MVD) (r=0.350 and 0.317,both P＜0.05).The positive rate of HIF-1α expression of recurrence group (78.3％,47/60) was higher than that of control group (58.3 ％,28/48) and the difference was statistically significant (x2 =5.027,P＜0.05).The overall survival period of recurrence was nine months and one-year survival rate was 30.0％.Of which,the overall survival period and one-year survival rate of cases with negative HIF-1α expression were 18 months and 53.8％ and with positive expression were eight months and 21.3％.HIF-1α expression was independent prognostic factor of gastric cancer (OR =2.166,95％CI:1.183 to 3.965).Conclusions The expression of HIF-1α plays an important role in the angiogenesis of gastric cancer and is closely related with gastric cancer recurrence.Its expression can be considered as an indicator of gastric cancer recurrence and prognosis.

Objective To test and evaluate the JAK2 gene V617F mutation in patients with myeloproliferative tumors based on i-densy IS-5320 platform according to ISO15189 accreditation requirements.Methods Instrument performance verification.Selected from December 2014 to February 2017, 20 cases of JAK2 V617F mutation positive peripheral blood samples from Huashan Hospital of the Shanghai FuDan University Medical College and 20 cases of peripheral blood samples with negative JAK2V617F mutation.The Realtime PCR with TaqMan MGB probe was selected as the control method to verify and evaluate the accuracy of testing JAK 2 V617F mutation on i-densy IS-5320 platform.Whole blood samples were used to evaluate the reproducibility , cross-contamination and anti-interference ability of this platform.The ability of mutation load was verified by detecting mixtures of human erythnoleukemia cells and colorectal cancer cell HCT116 with 12 different proportions.Results I-densy IS-5320 platform and TaqMan MGB probe real-time fluorescence quantitative PCR show the same result .The within-run reproducibility and between-run reproducibility are both 100%.There is no observed contamination .High bilirubin and high triglyceride blood samples have no obvious interference on mutation detection .The mutation ratio with a load as low as 0.25%could be tested stably by i-densy IS-5320 platform.The detecting peak of melting curve can reflect the ratio of JAK2 V617F mutation to some extent.Conclusions I-densy IS-5320 can detect the mutation of JAK2 V617F gene in the whole blood directly.It has high sensitivity, accuracy and stability, and is easy to operate, and also can reflect the mutation load of JAK2 V617F, which could meet the clinical requirements for the detection of mutations.

Objective: To understand the prevalence and disease burden of major chronic diseases in the elderly in China and provide scientific basis for the prevention and control of chronic diseases and for the rational allocation of health resources. Methods: We analyzed the prevalence of chronic diseases in residents aged ≥60 years in China by using national and provincial surveillance data of chronic diseases and related risk factors in China. We conducted the analysis on the burden of chronic diseases in the elderly in China by using the data of global burden of disease. Results: The prevalence rates of hypertension, diabetes and hypercholesterolemia were 58.3%, 19.4% and 10.5% respectively in residents aged ≥60 years in China. Up to 75.8% of the residents aged ≥60 years had at least one chronic disease. The prevalence rate was higher in women than in men, higher in urban area than in rural area. With the increase of age, the prevalence rate of chronic diseases also increased. The top three chronic diseases with heavy disease burden in residents aged ≥70 years were stroke, myocardial infarction, cancer and chronic obstructive pulmonary disease. Conclusion The prevalence of major chronic diseases in the elderly is high with three quarters of the elderly suffering from at least one chronic disease, and the burden of chronic diseases is increasing.

OBJECTIVETo analyze the impact of platelet count on the prognosis of stage II-III colorectal cancer receiving adjuvant chemotherapy.

METHODSClinical and follow-up data of 286 patients with stage II-III colorectal cancer receiving adjuvant FOLFOX chemotherapy from March 2003 to October 2011 were analyzed retrospectively. Associations of baseline blood platelet count before chemotherapy and nadir blood platelet count during chemotherapy with relapse and death after adjuvant chemotherapy were analyzed by ROC curve and the optimal cutoff was selected. The association of the blood platelet count and the prognosis was analyzed by Kaplan-Meier and Cox regression model.

RESULTSROC curve showed the baseline blood platelet count was associated with recurrence (AUC=0.588, P=0.034). The optimal cutoff affecting recurrence was 276×10(9)/L. Kaplan-Meier showed those with baseline platelet count >276×10(9)/L receiving adjuvant chemotherapy had worse disease free survival (DFS) than those with baseline platelet count ≤276×10(9)/L, whose 5-year disease free survival(DFS) was 66% and 80% respectively (P=0.013). Cox regression analysis revealed baseline platelet count >276×10(9)/L was an independent unfavorable factor for DFS of adjuvant chemotherapy in colorectal cancer (HR=1.865, 95% CI: 1.108-3.141, P=0.019).

CONCLUSIONColorectal cancer patients receiving adjuvant chemotherapy with baseline platelet count >276×10(9)/L have worse prognosis.

Antineoplastic Combined Chemotherapy Protocols ; Chemotherapy, Adjuvant ; Colonic Neoplasms ; Colorectal Neoplasms ; Disease-Free Survival ; Fluorouracil ; Humans ; Leucovorin ; Neoplasm Staging ; Organoplatinum Compounds ; Platelet Count ; Prognosis ; Recurrence ; Retrospective Studies

Objective:To explore the feasibility, safety and short-term effect of the Hood technique in robotic-assisted radical prostatectomy (RARP).Methods:The data of 24 patients with localized prostate cancer underwent RARP with Hood technique From June 2020 to March 2021 were retrospectively reviewed. The mean age was 67.8 (57-76) years, and the mean body mass index was 25.17(18.31-32.54)kg/m 2. The mean tPSA value was 18.36(4.21-67.57)ng/ml and the mean biopsy Gleason score was 7.3 (6-8). In term of the clinical T stage, the 24 cases were composed of the T 1c stage in 1 case, T 2a stage in 5 cases, T 2b stage in 4 cases and T 2c stage in 14 cases. During Hood technique, the anterior bladder were limitedly isolated without exposing the outline of pelvis and prostate. Results:All the cases were completed robotically without conversion, transfusion or positive surgical margin. The average robot-assisted operation time was 84.5(63-110) mins. Estimated blood loss was 75.3(20-180) ml. The average time for maintaining the drain was 3.7(3-5) days. The mean postoperative hospital stay was 7.1(4-11) days. The mean catheterization time was 7.3(6-9) days after surgery. 23 patients achieved continence immediately after catheter removal, while 1 patient had continence full-recovery 2 weeks after surgery. The mean surgical Gleason score was 7.9 (6-9). In term of the surgical T stage, the 24 cases were composed of the pT 2a stage in 4 case, T 2b stage in 6 cases, T 2c stage in 14 cases.During 3-12 months’ follow-up, no biochemical recurrence was found. Conclusions:Hood technique were safe and valid in RARP with excellent immediate continence recovery. It facilitated Retzius sparing in a convenient approach with low positive surgical margin rate.

Background: Ferroptosis, which is caused by an iron-dependent accumulation of lipid hydroperoxides, is a type of cell death linked to diabetic kidney disease (DKD). Previous research has shown that fatty acid binding protein 4 (FABP4) is involved in the regulation of ferroptosis in diabetic retinopathy. The present study was constructed to explore the role of FABP4 in the regulation of ferroptosis in DKD. Methods: We first detected the expression of FABP4 and proteins related to ferroptosis in renal biopsies of patients with DKD. Then, we used a FABP4 inhibitor and small interfering RNA to investigate the role of FABP4 in ferroptosis induced by high glucose in human renal proximal tubular epithelial (HG-HK2) cells. Results: In kidney biopsies of DKD patients, the expression of FABP4 was elevated, whereas carnitine palmitoyltransferase-1A (CP-T1A), glutathione peroxidase 4, ferritin heavy chain, and ferritin light chain showed reduced expression. In HG-HK2 cells, the induction of ferroptosis was accompanied by an increase in FABP4. Inhibition of FABP4 in HG-HK2 cells changed the redox state, sup-pressing the production of reactive oxygen species, ferrous iron (Fe2+), and malondialdehyde, increasing superoxide dismutase, and reversing ferroptosis-associated mitochondrial damage. The inhibition of FABP4 also increased the expression of CPT1A, reversed lipid deposition, and restored impaired fatty acid β-oxidation. In addition, the inhibition of CPT1A could induce ferroptosis in HK2 cells. Conclusion Our results suggest that FABP4 mediates ferroptosis in HG-HK2 cells by inhibiting fatty acid β-oxidation.

Objective:Efficacy and safety of robot-assisted laparoscopic adrenalectomy as a treatment for large adrenal tumors.Three-dimensional(3D) reconstruction can effectively assist in preoperative planning of robotic adrenalectomy and reduce potential complications.Methods:We retrospectively reviewed the relevant information of patients who had a preoperative 3D reconstruction and underwent RA for adrenal masses larger than 10 cm. Thirteen male patients and sixteen female patients were included. The median(range) age was 43(25, 57) years old and the median tumor diameter was 12.1(10.3, 16.2) cm. The patients underwent preoperative CT enhancement scanning, and three-dimensional images were reconstructed based on the examination data. Robot-assisted laparoscopic adrenalectomy was performed under general anesthesia in 29 cases in this cohort.Results:All surgeries were completed successfully without major complications such as massive bleeding, secondary surgery, or even patient death. The median operative time was 131 (80, 245) min, and the median intraoperative bleeding was 330 (50, 2 200 ml) ml. 9 patients received blood transfusions. There were 11 cases of pheochromocytoma (37.9%), 10 cases of adenocarcinoma (34.5%) as well as 2 cases of teratoma (6.9%) and 6 cases of cortical carcinoma (20.7%). The patients were followed up for a median of 30 months after surgery. Except for 3 cases lost to follow-up and 2 patients with cortical cancer who developed recurrence or metastasis after surgery and died at 16 and 23 months after surgery, respectively, the remaining 24 cases have survived to date.Conclusions:RA is a safe and effective treatment for huge adrenal tumors. The 3D reconstruction could help the preoperative planning of RA and reduce potential complications.

Although the tumor suppressor P53 is known to regulate a broad network of signaling pathways, it is still unclear how certain drugs influence these P53 signaling networks. Here, we used a comprehensive single-cell multiomics view of the effects of ginsenosides on cancer cells. Transcriptome and proteome profiling revealed that the antitumor activity of ginsenosides is closely associated with P53 protein. A miRNA-proteome interaction network revealed that P53 controlled the transcription of at least 38 proteins, and proteome-metabolome profiling analysis revealed that P53 regulated proteins involved in nucleotide metabolism, amino acid metabolism and "Warburg effect". The results of integrative multiomics analysis revealed P53 protein as a potential key target that influences the anti-tumor activity of ginsenosides. Furthermore, by applying affinity mass spectrometry (MS) screening and surface plasmon resonance fragment library screening, we confirmed that 20()-protopanaxatriol directly targeted adjacent regions of the P53 DNA-binding pocket and promoted the stability of P53-DNA interactions, which further induced a series of omics changes.