Objective To evaluate the clinical efficacy of extraperitoneal laparoscopic radical prostatectomy(ELRP)for prostate cancer patients, and to summarize the experience of surgical treatment. Methods The clinical data of 50 prostate cancer patients who underwent ELRP by the same performer from January 2010 to June 2015 were retrospectively reviewed. Results All cases were all successfully completed ,no case was converted to open surgery. The average operation time was 238.8 min,average operative blood loss was 409.1 mL,and intraoperative or postopera?tive blood transfusion was 6(12%). The mean postoperative catheterization time was 23.7(17?38)d. The mean postoperative hospital stay was 15 (10?34)d. The postoperative recovery time of eating was 2?4 d,and the ambulation time was 1?3 d. Totally 3 cases(6%)had lymph node metasta?sis,and 7 cases(14%)had positive surgical margin. Totally 9 cases(18%)had surgery?related complication. Patients were followed up for 6 to 58 months,with an average of 12.5 months. One case(2%)had biochemical recurrence,and the tumor?free survival rate was 84%. At the end of fol?low?up,all of the patients were continent. Conclusion ELRP is safe and effective for the treatment of prostate cancer. With the development of minimally invasive techniques,the applications of RP are increasingly widespread. However,large?scale and long?term follow?up studies are still needed for high?risk prostate cancer patients.

The implementation of the "Healthy China" policy is inseparable from public health. The improvement of the national health level, the control of health risk factors and the improvement of health service ability and other aspects need to rely on the talent training and discipline construction of public health and preventive medicine in medical colleges, which highlights that the public health discipline construction and development of our country has a certain lag and limitations: unprofessional public health academic team and disciplines; separation of teaching research and practice in public health; lack of public health expertise and insufficient personnel scale; health emergency and legal system that do not match economic development, etc. Therefore, in order to promote the construction of healthy China, we should promote the integration of public health disciplines, strengthen the teaching and practice of health emergency response, improve the health emergency response and dynamic monitoring system focusing on prevention so that we can make public health disciplines both scientific and contemporary.

Objective To analyze the factors and prognosis of graft recovery after donation after citizens death (DCD) donor renal transplantation.Methods A retrospective analysis of 67 cases of DCD renal transplantation from August 2012 to September 2015 in our hospital was carried out.According to the stability of renal function after operation,the patients were divided into group A (51cases) with stable renal function,and 16 cases in group B (delayed graft function after operation).The clinical data of two groups including age,gender,cause of death,warm ischemia time,type of dialysis,and application of norepinephrine before operation were collected and analyzed.The related factors of graft function recovery were analyzed.Logistic regression analysis was used to analyze the risk factors of graft functional recovery after operation.The 3-month,6-month,1-year and 18-month survival rate after operation in the two groups was compared.Results The causes of death,the time of ischemia,the type of dialysis before operation,the application of norepinephrine before operation,infants and young donors were related factors of graft function recovery (P ＜ 0.05).Logistic regression analysis showed that cerebral hemorrhage death donor,the long thermal ischemia time,the preoperative hemodialysis and the application of norepinephrine before operation were the risk factors of delayed graft function recovery (P＜0.05).The 3-month,6-month,1-year and 18-month survival rate after operation in group A was higher than that in group B,with the difference being statistically significant (P＜0.05).Conclusion Cerebral hemorrhage death donor,the long thermal ischemia time,the preoperative hemodialysis and the application of norepinephrine before operation were the independent risk factors of delayed graft function recovery.And the prognosis of patients with delayed graft function was poor.Clinical risk should be eliminated or reduced in clinical practice,which can effectively prevent the delayed graft function and further improve the prognosis of the patients.

Objective:The morbidity of malignant melanoma keeps increasing annually.It has high risks of metastasis,drug resistance,and poor prognosis in clinics.Moreover,the available medicines used commonly,such as dacarbazine,temozolomide,the v-Raf murine sarcoma viral oncogene homolog B1(BRAF) inhibitor vemurafenib,and the programmed cell death protein 1 inhibitor pembrolizumab,have some limitations at some extent.Therefore,a more effective therapeutic strategy is still urgently necessary.Methods:In this study,Brucea javanica(L.)Merr.globulins were hydrolyzed with pepsin,then ultra-filtrated to collect small molecular peptides (≤3 kDa).The peptides were then analyzed by anti-proliferative assay,cell-cycle distribution,apoptosis assay,and in vitro wound-scratch assay.Finally,western blotting was conducted to elucidate the underlying anti-melanoma mechanism.Results:The small molecular peptide from B.javanica significantly inhibited malignant melanoma cell proliferation with the IC50 of 2.72 μg/mL for 72 h.Further analysis indicated that B.javanica peptides arrested cell cycle at the S and G2/M phases and induced apoptosis by upregulating p21,p53,Bax,caspase-3,and cleaved PARP while downregulating Bcl-2 expression.The inhibitory migration effects were also confirmed by wound-healing assay.Conclusion:The small molecular biopeptides from B.javanica may be a promising bioactive agent candidate for melanoma treatment.

Forensic examination materials are often plagued by trace amounts,mixes,and other factors.Single-cell isolation technology can solve these forensic problems to some extent by studying each cell individually to obtain comprehensive and reliable information.There are many single cell isolation techniques available in research reports,such as flow cytometry,laser capture microdissection,etc.This review will summarize the most common single cell isolation techniques used by researchers today,and summarize the application of various techniques in forensic science,summarize the selection strategies for single-cell isolation techniques in different scenarios based on cost,degree of automation,yield,cell damage rate,and the availability of relevant forensic platforms,and finally explore the forensic application prospects of single-cell isolation techniques.In general,single cell isolation can be applied to multiple fields such as mixed stain examination,post-mortem time inference,pre-and post-mortem injury determination,forensic toxicology analysis,forensic microbiology and forensic anthropology.The development of single cell isolation technology is of great value to the application of forensic medicine,and will provide a new way of deciphering difficult examination materials.

Objective: Remuzzi scoring system is utilized for assessing the degree of renal tissue damage in donors with hypertensive cerebral hemorrhage and donors with brain trauma after cardiac death. To explore the prognosis of hypertensive cerebral hemorrhage donor kidney in renal transplant recipients. Methods: The kidney donated by DCD between January 1, 2016 to June 1, 2018 were retrospectively reviewed. Pathological biopsy was performed before transplantation and hematoxylin-eosin (HE) staining after sectioning. The degree of renal tissue lesions was evaluated by Remuzzi scoring system. According to the source of donor kidney, they were divided into two groups of donors with heart failure due to hypertensive cerebral hemorrhage (HCH) and those with brain trauma (BT). Both groups of donor kidneys were preserved by low-temperature machine perfusion. The immunosuppressive regimen was identical in both groups. The prognosis of two groups was compared by serum creatinine (Scr) at Month 1/6/12 post-operation and cumulative graft survival rate over a follow-up period of 12-36 months. Results: The renal Remuzzi score of HCH donors was significantly higher than that of BT donors. The maximal creatinine clearance rate was significantly lower than that of BT donors [(86.8±27.8) vs (115.4±23.2) ml/min, P<0.05]. At 1/6/12 months post-transplantation, serum creatinine levels were (76.1±18.5), (72.4±16.2) and (71.4±16.8) μmol/L in BT group and (160.3±33.4), (154.3±32.6) and (146.4±29.1) μmol/L in HCH group. The SCr in BT group at 1/6/12 months was lower than that in HCH group (P<0.05). Kaplan-meier analysis showed no significant inter-group difference in graft survival between two groups over a follow-up period of 12 to 36 months (Log-Rank test, P=0.485). Conclusions No significant difference exists in short-term survival rate of kidneys from HCH and BT donors. The recipients of HCH donor's kidney have higher serum creatinine levels than those of BT donors. Selective use of kidney transplants in patients with cardiac death caused by HCH may greatly reduce the waste of donor kidney and improve the quality-of-life of patients with end-stage renal disease.

Objective:To explore the application and value of metagenomic next-generation sequencing (mNGS) in refractory infection after organ transplantation.Methods:A case report discussed about a patient with lumbar spine infection after kidney transplantation and the relevant literature was reviewed. The recipient was a 63-year-old man with low back pain after kidney transplantation. Lumbar spine magnetic resonance imaging showed lumbar spine infection. Multiple operations plus antibacterial and antituberculosis treatments were ineffective. Before and after treatment, numerous tests of traditional pathogenic microorganisms failed to detect any positive bacteria.Results:The detection of lumbar secretion by mNGS suggested aspergillus infection. The symptoms improved after dosing of voriconazole.Conclusions:The incidence of fungal infection of lumbar spine is low. The imaging manifestations are non-typical so that it is easy to misdiagnose. mNGS helps to timely diagnose and guide treatment. With a review of the literature, mNGS has some application value for some difficult and rare infectious diseases.

Objective:To explore the relationship between cardiac radiation dose and prognosis of patients with non-small cell lung cancer (NSCLC).Methods:From August 2015 to September 2018, the clinical data and cardiac dose parameters of 180 patients with locally advanced NSCLC who received radiotherapy in Tangshan people′s Hospital of Hebei Province were analyzed retrospectively.The relationship between cardiac dose parameters and overall survival rate was analyzed by K-M analysis, and the prognostic factors of NSCLC patients were identified by multivariate Cox regression.Results:The median survival time of NSCLC patients was 33.4 months.Univariate analysis indicated prescription dose≥56Gy ( HR 1.54, 95% CI1.28-2.86, P=0.011), hypertension ( HR 1.42, 95% CI1.34-1.89, P=0.012), mean cardiac dose≥13.9Gy ( HR 1.12, 95% CI1.05-2.61, P=0.031), V5≥70% ( HR 1.08, 95% CI1.01-2.16, P=0.044), and V30≥40% ( HR 1.16, 95% CI1.04-3.01, P=0.041), V50≥20% ( HR 1.23, 95% CI1.11-2.81, P<0.001), and V60≥5% ( HR 1.03, 95% CI1.00-1.89, P=0.037) were the prognostic factors of NSCLC patients.After multi-factor adjustments, receiving chemotherapy was a favorable factor for the prognosis of NSCLC patients ( HR 0.711, 95% CI0.35-0.89, P=0.005); hypertension was a factor of poor prognosis ( HR 1.641, 95% CI1.56-1.86, P=0.034); V50≥20% in cardiac dose ( HR 1.161, 95% CI1.13-3.82, P=0.002) was a poor prognostic factor in NSCLC patients. Conclusion:The cardiac dose V50 is an independent predictor of prognosis in patients with advanced NSCLC.The increase of cardiac radiation dose may increase the potential risk of death.In clinical practice, the prognosis of patients may be improved by reducing the cardiac radiation dose.

Objective:To explore the effects of the fat mass and obesity-associated gene(FTO)on apoptosis and the inflammatory response of chondrocytes in osteoarthritis(OA).Methods:Differences in FTO expression between normal human cartilage tissue samples and OA cartilage tissue samples were examined.Primary OA chondrocytes were isolated and cultured, and a rat OA model was constructed.The expression of FTO was detected in clinical, animal and cellular samples.Cells were treated with an FTO knockdown lentivirus vector(sh-FTO)and an m 6A methylation inhibitor(cycloleucine). The amount of m 6A and the expression levels of inflammatory cytokines, interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α), were detected.Flow cytometry was used to detect apoptosis in OA chondrocytes, and Western blot was used to detect the expression levels of B-cell lymphoma 2(Bcl-2)and Bcl-2-associated X protein(Bax). Results:Compared with the normal control group, FTO mRNA and protein expression in human OA cartilage tissue, rat OA cartilage tissue and OA chondrocytes was significantly increased(all P<0.05). After FTO knockdown, the level of m 6A increased, the levels of IL-6 and TNF-α decreased considerably, the apoptosis rate decreased, the expression of the proapoptotic protein Bax decreased considerably, and the expression of Bcl-2 increased considerably in primary OA chondrocytes.However, cycloleucine intervention clearly reduced the level of m6A, increased the levels of IL-6 and TNF-α, promoted cell apoptosis and the expression of apoptosis-related proteins, and reversed the effect induced by the FTO knockdown lentivirus in OA chondrocytes(all P<0.05). Conclusions:FTO may be involved in mechanisms related to the action of m 6A to promote OA chondrocyte apoptosis and the inflammatory response, thus accelerating the progression of OA.

Objective To investigate the value of a nomogram model based on contrast-enhanced CT radiomics in predicting the histological type of thymoma.Methods A total of 154 patients(101 in low-risk group and 53 in high-risk group)with thymoma confirmed by pathology were retrospectively selected.The cases were randomly divided into training set(n=107)and validation set(n=47)at a ratio of 7∶3.The three-dimensional volume of interest(VOI)of the whole lesion on the image from the arterial phase of contrast-enhanced CT was manually delineated,and the radiomics features were extracted.Based on the selected radiomics features,the radiomics model was constructed and the model Radiomics score(Radscore)was calculated.Clinical risk factors were screened to construct a clinical model,and a nomogram model was constructed by fusing Radscore and clinical risk factors.The receiver operating characteristic(ROC)curve,area under the curve(AUC),accuracy,sensitivity and specificity were compared to analyze the predictive efficacy and difference of different models for high-risk and low-risk thymoma.The decision curve and calibration curve were drawn to evaluate the clinical value and fitting performance of the nomogram model.Results Eleven radiomics features were selected to construct the radiomics model,and five clinical risk factors[myasthenia gravis(MG),morphology,border,surrounding tissue invasion and CT value in arterial phase]were used to construct the clinical model.In the training set,the AUC of the nomogram model(0.88)was higher than that of the radiomics model(0.80)and the clinical model(0.79),and the difference was statistically significant(Z=2.233,2.713,P=0.026,0.007,respectively).In the validation set,the AUC of the nomogram model was higher than that of the radiomics and clinical models,but the difference was not statistically significant.The calibration curve showed that the nomogram model had good fitting performance,and the decision curve showed that the nomogram model had high clinical benefit.Conclusion The nomogram model based on contrast-enhanced CT can effectively predict high-risk and low-risk thymoma,which is helpful to guide clinicians to make relevant decisions.