Objective To evaluate the feasibility of laparoscopically assisted dismembered pyeloplasty without the V-flap reconstruction.Methods A total of 13 cases of ureteropelvic junction obstruction(UPJO) underwent laparoscopically assisted dismembered pyelopasty via a small incision through the retroperitoneal approach without the V-flap pyeloplasty technique.After exposing the proximal ureter and renal pelvis to identify the UPJ obstruction,the UPJ area is then excised and the apex of the ureter is then anastomosed to the most inferior aspect of the renal pelvis. Results All the operations had been successfully completed.The operating time was 100~180 min(mean,121 min),and the intraoperative blood loss,30~100 ml(mean,70 ml).Follow-up for 3~20 months(mean,12.3 months) in 12 cases revealed a full recovery of renal functions and disappearance of hydronephrosis.Conclusions Laparoscopically assisted dismembered pyeloplasty without the V-flap reconstruction is feasible in the treatment of UPJO.

Objective To evaluate the diagnosis and micro-invasive treatment of ureteral obstruction after complete cystectomy. Methods All the 12 patients (primary diseases:10 cases of bladder tumor,1 of small bladder of tuberculosis,1 of radiocystitis;post-operative ureteral obstruction:9 cases of anastomotic stenosis,3 of supra-anastomotic obstruction) underwent MRI and experienced nephroscopic monitoring for diagnosis.Eleven patients underwent surgical treatment.Of them,6 cases received ureter nickel-titanium alloy trestle;4 cases (6 sides),ureter trestle,and 1,ureterocystostomy. Results All the 12 cases were correctly diagnosed.Of them 11 were followed up for 3 months to 5 years.IVU showed normal renal function and complete resolution of hydronephrosis of the diseased kidneys in 9 cases and relief of hydronephrosis in 2.Cr and BUN were normal in all the cases.Only one case of bladder cancer died of lung metastasis. Conclusions Pelviureteroradiography under MRI or nephroscopic monitoring is the most valuable method of examination for ureteral obstruction after complete cystectomy.Surgical ureter trestle and nickel-titanium alloy ureter trestle are simple,micro-invasive and effective for paitens with such post-operative obstruction.

Aim To study the influence of PD on the activity of PKC(protein kinase C) of VSMC during ischemia and hypoxia.Methods The hypoxia model was made by drawing off the oxygen of an enclosed acryl glass box and ischemia model was made by low sugar culture medium. Then the activity of PKC was measured by ?-scintillation counting instrument.Results It was found that the activity of PKC of cytoplasm in VSMC in ischemia and hypoxia situation increased (vs normal group P0.05 ).Conclusion PD can reverse the PKC activities induced by ischemia and hypoxia. It may be one of the mechanisms of PD to have antishock effect.

Objective To determine whether intravenously transplanted bone marrow stromal cells (BMSCs) could promote recovery of lower urinary tract function in rats with spinal cord transaction.Method The BMSCs were harvested from rats and labeled with 5-bromo-2'-deoxyuridine (BrdU) (30 g/mL) in vitro for 3 days for intravenous transplantation.The BMSCs of 5th passage were characterized by flow cytometry of CD45 and CD90.Twenty-four male Sprague-Dawley rats were divided randomly into three goups.Sixteen rats received a spinal cord transection and a transplantation of cell culture medium (OP-controls,n =8) or BMSCs (n =8).Eight rats were justly given T8-T9 laminectomy (CNS-intact group,n =8).Urodynamic tests,HE staining and immunohistochemistry of the spinal cord with anti-BrdU at 28th day after transplantation were performed.Result The cultured BMSCs of 5th passage expressed 5.94％ of CD45 and 99.4％ of CD90 on flow cytometry.BMSC rats showed significant decrease in residual urine volume (0.85 ± 0.16 mL vs.1.54 ± 0.66 mL,P＜ 0.05),leak point pressure (33.85 ± 3.73 mmHg vs.40.83 ± 3.85 mmHg,P＜0.01),episodes of non-inhibitory contraction (NVC) (2.17 ± 1.12 vs.9.71 ± 3.84,P＜0.01) and increase in voiding efficiency (26.37 ± 6.97％ vs.2.68 ± 1.47,P＜0.01) compared to OP-control rats.In OP-control rats,only tonic EUS activity was remained and busting EUS activity was abolished during bladder filling.While,the tonic EUS activity and busting EUS activity were remained in BMSCs rats.Otherwise,the silent period between EUS bursts was shorter in BMSCs rats (68.86 ± 13.78 ms,P＜ 0.05) and OP-control rats (33.4 ms) than CNS-intact rats (132.79 ± 17.11 ms).Cells derived from BMSCs,identified by 5-BrdU immunoreactivity,survived and were distributed at the damaged tissue (T10),lumbar and sacral spinal cord.Conclusion Intravenously transplanted BMSCs survived in the injured spinal cord,lumbar and sacral cord for rebuilding new voiding reflex and inhibiting afferent sprouting leading to baldder dysfunction.So they had beneficial effects on the recovery of lower urinary tract function in rats with spinal cord transection.

Objective To compare two operative approaches for treatment of distal hypospadias. Methods One hundred and seven patients were recruited into the study. Group1(n=51) underwent OUPF and group2(n= 56) underwent TIPU repair. The results were analyzed with Chi-square and two Sided test. Results Operative times for OUPF and TIPU repair were (103±29) min and (92±21)min respectively (P>0.05). Fistula occurred rates were 7.8% (4/51)and 14.2% (8/56) (P>0.05). Satisfied rates for the appearance of the penis post-operation were 84.8% (39/46)and 87.8%(36/41) respectively (P>0.05). 87 patients were followed up. With mean follow-ups of 15 months (range 6 to 47) , the overall complication rates were 15.7% (8/51) and 32.1 % (18/56)(P<0. 05) for OUPF and TIPU repair. Only 4 of 51 patients (7.8%) undergoing OUPF underwent re-operations, compared to 15 of 56 patients (26.8%) undergoing TIPU repair (P<0.001). A plateau uroflow curve (vs normal bell curve)was observed in 33.3% (13/39)and 67.6(25/37) ,respectively(P<0. 001). The average flow rate was 9. 4 ml per second (range 3. 2 to 17. 1) in patients undergoing OUPF repair, compared to 6. 8 ml per second (3. 3 to 15, P<0. 05) for those undergoing TIPU repair. Mean peak flow rates were12.2 ml per second (range 3.9 to 22.9) and 8. 3 mi per second (range 3.7 to 18. 1, P<0.01) for OUPF and TIPU procedures. Conclusion OUPF is superior to TIPU in the surgical treatment of distal hypospadias.

OBJECTIVETo investigate the clinical effect of Halo-vest head ring in the treatment of replantation of total scalp avulsion.

METHODSWe treated 11 cases of total scalp avulsion with the anastomosis of arteriovenous vessels and Halo-vest head ring from December 2006 to February 2015.

RESULTSOne patient's replanted scalp got necrosis because of serious contusion which was healed without hair growth after free skin graft and dressing. All the scalp flaps in the other 10 patients survived. After 3-96 months follow-up, the wound completely healed, the scalp and hair grew well with satisfactory appearance.

CONCLUSIONSThe use of Halo-vest head ring for replantation of total scalp avulsion can effectively improve the survival rate and survival area.

Anastomosis, Surgical ; methods ; Bandages ; Graft Survival ; Humans ; Lacerations ; surgery ; Necrosis ; etiology ; Prostheses and Implants ; Replantation ; methods ; Scalp ; injuries ; pathology ; surgery ; Skin Transplantation ; methods ; Surgical Flaps

Objective:To investigate the expressions of TRIM25 and RIG-Ⅰ in liver cancer tissues and their relationship with the prognosis of patients.Methods:The data of 82 patients with liver cancer who were admitted to the Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University from January 2017 to January 2018 were retrospectively analyzed, and their cancer tissue and paracancerous tissue (>5 cm from the edge of the tumor) specimens were collected. The protein expressions of TRIM25 and RIG-Ⅰ in cancer tissues and paracancerous tissues were detected by immunohistochemistry. The relationship between TRIM25 and RIG-Ⅰ expressions in cancer tissues of patients and clinicopathological features was analyzed. Kaplan-Meier method was used to analyze the overall survival (OS) of patients with different TRIM25 and RIG-Ⅰ expression status.Results:The positive rate of TRIM25 in cancer tissues was higher than that in paracancerous tissues [68.29% (56/82) vs. 21.95% (18/82), P < 0.001], and the positive rate of RIG-Ⅰ in cancer tissues was lower than that in paracancerous tissues [31.71% (26/82) vs. 74.39% (61/82), P < 0.001]. The positive rate of TRIM25 in cancer tissues of poorly differentiated patients was higher than that of highly and moderately differentiated patients ( P < 0.05), and the positive rate of RIG-Ⅰ was lower than that of highly and moderately differentiated patients ( P < 0.05). The positive rate of TRIM25 in cancer tissues of patients with extrahepatic metastasis was higher than that of patients without extrahepatic metastasis ( P < 0.05), but the positive rate of RIG-Ⅰ was lower than that of patients without extrahepatic metastasis ( P < 0.05). The positive rate of TRIM25 in patients with clinical Ⅲ-Ⅳ was higher than that in patients with stage Ⅰ-Ⅱ ( P < 0.05), but the positive rate of RIG-Ⅰ was lower than that in patients with stage Ⅰ-Ⅱ ( P < 0.05). The median follow-up time was 27 months (4-48 months), 2 patients were lost to follow-up. At the end of follow-up in January 2022, the overall survival rate was 43.75% (35/80). The survival rates of patients with TRIM25-positive and TRIM25-negative cancer tissues were 33.33% (18/54) and 65.38% (17/26), respectively. The survival rates of patients with RIG-Ⅰ-positive and RIG-Ⅰ-negative cancer tissues were 64.00% (16/25) and 34.55% (19/55), respectively. Kaplan-Meier analysis showed that the OS of patients with TRIM25-negative cancer tissues was better than that of patients with TRIM25-positive cancer tissues, and the OS of patients with RIG-Ⅰ-positive cancer tissues was better than that of patients with TRIM25-negative cancer tissues, and the differences were statistically significant (both P < 0.05). Conclusions:The expression of TRIM25 is increased and the expression of RIG-Ⅰ is decreased in liver cancer tissues. The expressions of TRIM25 and RIG-Ⅰ in liver cancer tissues are associated with prognosis.

Objective:To evaluate the various wire tension belt ventral compression wiring technologiesfor treating several types of femoral greater trochanter fractures in total hip replacement, according to the different types of greater trochanter of femur fractures.Methods:From March 2013 to June 2019, a total of 1 280 cases of primary total hip arthroplasty were completed in our hospital, 21 patients with greater trochanter fractures were identified in total hip replacement. There were 11 males and 10 females with an average age of 65.81±6.45 years (range 42-76 years). All of them were unilateral. There were 11 cases on the left and 10 cases on the right. There were 11 cases of osteoarthritis secondary to hip dysplasia, 4 cases of hip osteoarthritis, 4 cases of aseptic necrosis of femoral head and 2 cases of femoral neck fracture. Different wire tension belt ventral compression wiring technologies were used for each fracture type. Harris hip function score, Parker activity score, and visual analogue scale (VAS) score of hip pain were evaluated during follow-up. X-ray films were taken to evaluate the fracture healing, prosthesis position, loosening and dislocation.Results:Three new fracture types were proposed: A transverse fracture from the greater trochanter tip to the base (4 cases); B oblique fracture from the greater trochanter tip to the base (according to the fracture line direction, type B was further divided into types B1 (4 cases) and B2 (6 cases); and C fracture line from the greater trochanter to subtrochanteric plane (7 cases). Among the 21 patients, one died at an early stage, two were lost during follow-up, and 18 were followed up for an average of 30.7±7.6 months. In 18 patients, the mean operation time was 110.0±20.0 min, and the mean intraoperative blood loss was 356.9±115.7 ml. The patients' Harris score was 35.26±5.52 at the preoperative, 65.7±6.42 at the 3 months after operation, and 87.75±6.21 at the final follow-up. The difference was statistically significant ( F=377.23, P<0.001). The patients' Parker score was 2.17±0.98 at the preoperative, 5.94±1.11 at the 3 months after operation,and 8.01±0.77 at the final follow-up. The difference was statistically significant ( F=170.96, P<0.001). The patients' VAS score was 6.22±1.11 at the preoperative, 2.61±0.92 at the 3 months after operation, and 1.28±0.67 at the final follow-up. The difference was statistically significant ( F=139.71, P<0.001). Deep vein embolism, heterotopic ossification was noted in one and another patient, respectively. The patient with non-union refused reoperation and had a broken steel wire, lower-limb limp, and no notable pain at the 12-month follow-up examination. Radiographs of 17 patients showed good location of the femoral prosthesis and no chronic pain. Conclusion:Different types of greater trochanter fractures in total hip arthroplasty were proposed, using different wire tension belt ventral compression wiring technologies for the various types of femoral greater trochanter fractures during total hip replacement can improve clinical outcomes.

OBJECTIVETo investigate the polymorphism in the promoter region of PCA3 gene and its relationship with risk of prostate cancer (PCa).

METHODSThe promoter region of PCA3 gene of the DNA of peripheral blood mononuclear cells was detected by sequence analysis in the 186 PCa and 141 BPH patients and 135 healthy control individuals. If the samples were detected with polymorphism of insection/deletion, clone sequence analysis was used with pBS-T carrier to verify it.

RESULTSThere were 5 polymorphisms. TAAA repeat times: 4, 5, 6, 7, 8, and 8 genotypes (TAAA 4/5, TAAA 4/6, TAAA 5/5, TAAA 5/6, TAAA 5/7, TAAA 5/8, TAAA 6/6, and TAAA 6/7) were detected in the promoter region of PCA3 gene. The eight genotypes were divided into three groups: ≤10TAAA, 11TAAA, ≥12TAAA. Unconditional logistic regression analysis models were used to analyze the relationship between different genotypes and cancer risks adjusted by sex and age. The type 11TAAA and ≥12TAAA was associated with higher relative risk for prostate cancer than the group ≤10TAAA [OR=1.74, 95% CI=1.06-2.87 (for type 11TAAA); OR=5.63, 95% CI=1.85-17.19 (for type ≥12TAAA)]. In the 186 PCa patients, there was 62.4% allele of PCA3 gene with AG/CA mutation found in the promoter 18-19 bp region of PCA3 gene and it had a close relation with the development of prostate cancer.

CONCLUSIONSShort tandem repeats are found in the promoter region of the PCA3 gene in PCa patients, and the increase of TAAA repeat sequences highly enhance the relative risk of prostate cancer development. The occurrence of such STR might be related to the mutations in their upstream loci.

Antigens, Neoplasm ; genetics ; metabolism ; Base Sequence ; Genes, Neoplasm ; physiology ; Genotype ; Humans ; Leukocytes, Mononuclear ; Male ; Microsatellite Repeats ; Mutation ; Polymorphism, Genetic ; Promoter Regions, Genetic ; Prostatic Neoplasms ; epidemiology ; genetics ; Risk

Traumatic brain injury (TBI)-induced coagulopathy has increasingly been recognized as a significant risk factor for poor outcomes, but the pathogenesis remains poorly understood. In this study, we aimed to investigate the causal role of acrolein, a typical lipid peroxidation product, in TBI-induced coagulopathy, and further explore the underlying molecular mechanisms. We found that the level of plasma acrolein in TBI patients suffering from coagulopathy was higher than that in those without coagulopathy. Using a controlled cortical impact mouse model, we demonstrated that the acrolein scavenger phenelzine prevented TBI-induced coagulopathy and recombinant ADAMTS-13 prevented acrolein-induced coagulopathy by cleaving von Willebrand factor (VWF). Our results showed that acrolein may contribute to an early hypercoagulable state after TBI by regulating VWF secretion. mRNA sequencing (mRNA-seq) and transcriptome analysis indicated that acrolein over-activated autophagy, and subsequent experiments revealed that acrolein activated autophagy partly by regulating the Akt/mTOR pathway. In addition, we demonstrated that acrolein was produced in the perilesional cortex, affected endothelial cell integrity, and disrupted the blood-brain barrier. In conclusion, in this study we uncovered a novel pro-coagulant effect of acrolein that may contribute to TBI-induced coagulopathy and vascular leakage, providing an alternative therapeutic target.