Objective To investigate the application value of urine excrement shunt surgery for the treatment of severe metabolic disorders after Sigma rectum pouch of bladder cancer.Methods From July 2011 to December 2013,4 male patients (mean age 72±10 years old,ranged from 58-82 years old),who received radical cystectomy and Sigma rectum pouch due to bladder cancer,were admitted in our hospital.Within four years after the operation,all patients complained about the recurrent fatigue,anorexia and even unconsciousness.The hyperchloremic metabolic acidosis,hypokalemia and renal dysfunction were diagnosed by blood gas analysis and biochemical tests.One week before urine excrement shunt operation,the arterial blood pH,HCO3-,serum potassium,chloride and creatinine were (7.15±0.08),(7.8±4.7)mmol/L,(3.1 ±0.2) mmol/L,(110.3±4.7) mmol/L,(314.8±66.4) μmol/L,respectively.They received urine excrement shunt surgery.The lower abdominal mid-line incision was made and the pouch was isolated from intestinal tract.The abdomen ostomy was made and the sigmoid colon and rectum were re-coincided in order to recover the intestinal continuity.The results of blood gas analysis,electrolytes and renal function after surgery were compared with those before surgery.Results The average operation time was (256.3±26.9) min and the mean volume of bleeding was (147.5±111.2) ml.There was no surgery related complication.Blood bicarbonate was (19.1±4.8) mmol/L one week after surgery,which was significantly improved than that before operation (P＜0.05).One month later,blood pH level descended to (7.38±0.05),potassium level was (3.9±0.3) mmol/L,creatinine was (208.8±50.8) umol/L.All of them were significantly improved,compared with those results before surgery (P＜0.05).Blood chloride was significantly reduced to (102.4±5.8) mmol/L (P＜0.05) after 6 months of operation.Nobody developed severe acidosis and electrolyte disturbances during 6 months to 3 years' follow-up.Conclusions Urine excrement shunt surgery can effectively corrected the acidosis and electrolyte disturbances due to the radical cystectomy and Sigma rectum pouch.It might be a alternative method to treat such kind of severe complications.

Objective To investigate the expression of hypoxia inducible factor-1α(HIF-1α) and vascular endothelial growth factor C(VEGF-C) in colon carcinoma,and their relation with clinical pathological parameters and prognosis. Methods Immunohistochemistry was used to detect the expression of HIF-1α and VEGF-C in 65 tissues of colon carcinoma. Results In all cases,the expression of HIF-1α had a positive correlation with the expression of VEGF-C(r= 0.638,P＜0.01).The expressions of HIF-1α and VEGF-C had significant correlation with clinical stage and nodal metastasis(P＜0.05) ,but had no relationship with sex,age and tumor size(P＞0.05). Conclusion The expression of HIF-1α and VEGF-C was correlated with nodal metastasis, tumorigenesis and prognosis of colon/carcinoma.

Objective To evaluate the application of measurement of T2*value,width of substantia nigra pars compacta (SNc) and the ratio of the width to the midbrain diameter in diagnosing Parkinson disease (PD) in early stage with susceptibility weighted imaging ( SWI) by 3T MR. Methods 59 patients with early stage idiopathic PD patients and 59 healthy controls,ranging in same ages and gender,had been scanned with routine sequences and SWI sequences by 3T MR. T2*value,width and the ratio of the width to the midbrain diameter of SNc were measured. The results of measurement were analyzed and compared. Results (1) The T2*values, width and the ratio of the width to the midbrain diameter was decreased in homolateral side SNc of symptoms of subjects with PD compared with the healthy controls ( <0.05) . (2) There was a significant reduction in the T2*values and the ratio of the width to the midbrain diameter in contralateral side SNc symptoms of subjects with PD compared with the healthy controls (P<0.05) . There was no differences in width of SNc ( >0.05) . Conclusion Measurement of T2*value, width and the ratio of the width to the midbrain diameter of SNc with SWI is reliable to diagnose PD.

can specifically combined with EGFR, which may be applied to noninvasive NIRF imaging of tumors highly expressed EGFR in vivo.

Exosomes are vesicles with a double globular membrane of lipids that can be secreted by a variety of cells, including stem cells. Exosomes have unique biological characteristics and irreplaceable powerful functions which play an important role in intercellular communication. The various cytokines, signal proteins, lipids and regulatory nucleic acids contained in stem cell exosomes can play a protective role against the injury of kidney, liver, heart, blood vessels and nerves. Stem cell exosomes delay the process of intervertebral disc degeneration by inhibiting the apoptosis of nucleus pulposus cells and increasing the synthesis of extracellular matrix, etc. The mechanism of its role is mainly through miRNA and related signaling pathways. Exosomes contain complex components. Although the mechanism of action of exosomes in intervertebral discs has been preliminarily explored, the components contained in exosomes are complex and the specific situation has not been fully understood, which still needs further study. In this review, the characteristics and functions of stem cell exosomes, extraction, identification and storage methods, the impacttovarious other tissues, as well as the effects on intervertebral discs and their mechanisms were elaborated in order to provide a basis for the study of intervertebral disc degenerative diseases.

Objective To compare the safety and efficacy of insulin degludec (IDeg) with those of insulin glargine (IGlar) in insulin-naive subjects with type 2 diabetes (T2DM).Methods This was a 26-week,randomized,open-label,parallel-group,treat-to-target trial in 560 Chinese subjects with T2DM (men/women:274/263,mean age 56 years,mean diabetes duration 7 years) inadequately controlled on oral antidiabetic drugs (OADs).Subjects were randomized 2:1 to once-daily IDeg (373 subjects) or IGlar(187 subjects),both in combination with metformin.The primary endpoint was changes from baseline in glycosylated hemoglobin(HbA1c) after 26 weeks.Results Mean HbA1c decreased from 8.2％ in both groups to 6.9％ in IDeg and 7.0％ in IGlar,respectively.Estimated treatment difference (ETD) of IDegIGlar in change from baseline was-0.10％ points (95％ CI-0.25-0.05).The proportion of subjects achieving HbA1c ＜ 7.0％ was 56.3％ and 49.7％ with IDeg and IGlar,respectively [estimated odds ratio of IDeg/IGlar:1.26 (95 ％ CI 0.88-1.82)].Numerically lower rateof overall confirmed hypoglycaemia and statistically significantly lower nocturnal confirmed hypoglycemia were associated with IDeg compared with IGlar,respectively [estimated rateratio of IDeg/IGlar 0.69 (95％ CI 0.46-1.03),and 0.43 (95％ CI 0.19-0.97)].No differences in other safety parameters were found between the two groups.Conclusions IDeg was non-inferior to IGlar in terms of glycaemic control,and was associated with a statistically significantly lower rate of nocturnal confirmed hypoglycaemia.IDeg is considered to be suitable for initiating insulin therapy in Chinese T2DM patients on OADs requiring intensified treatment.Clinical trail registration Clinicaltrials.gov,NCT01849289.

Objective To explore influences of the taper and connecting rib form on supporting performance of the stent, and provide an important scientific basis for structural design and clinical selection of the tapered stent. Methods A nonlinear finite element model for radial support performance of a novel balloon-expandable tapered stent was constructed, and the radial stiffness (RS) and stress distributions of the stent at different tapers (0°, 0.565°and 1.13°) and with different structural forms of stent linker (V-shape, I-shape, C-shape, S-shape, M-shape) were analyzed by plane compression. The relationship between structural design of the vascular stent and its radial support performance was studied. Results The RS of 0°stent, 0.565°stent, 1.13° stent was 2.51, 1.61, 0.85 N/mm, respectively. The RS of 0.565°stent and 1.13° stent was 35.86% and 66.14% lower than that of 0°stent (round straight stent), respectively. Except that the RS of C-shape linker stent was 1.48 N/mm, the RS of I, M, S and V-shape linker stents was not significantly different, which was 2.51, 2.61, 2.41, 2.52 N/mm, respectively, indicating that radial compression resistance of these four linker stents was almost the same. Conclusions Compared with traditional round straight stents, the RS of tapered stents will decrease, and the RS of stents will gradually decrease with the the taper increasing. Among all stent types in this study, except C-shape linker stents, the RS of other linker shapes has little effect on the RS of stents. The radial support performance of the stent can be improved by reducing the taper of the tapered stent, without changing the form of stent connecting ribs.

BACKGROUND: Triple-negative breast cancer (TNBC) is a type of highly invasive breast cancer with a poor prognosis. According to new research, long noncoding RNAs (lncRNAs) play a significant role in the progression of cancer. Although the role of lncRNAs in breast cancer has been well reported, few studies have focused on TNBC. This study aimed to explore the biological function and clinical significance of forkhead box C1 promoter upstream transcript (FOXCUT) in triple-negative breast cancer. METHODS: Based on a bioinformatic analysis of the cancer genome atlas (TCGA) database, we detected that the lncRNA FOXCUT was overexpressed in TNBC tissues, which was further validated in an external cohort of tissues from the General Surgery Department of the First Affiliated Hospital of Nanjing Medical University. The functions of FOXCUT in proliferation, migration, and invasion were detected in vitro or in vivo. Luciferase assays and RNA immunoprecipitation (RIP) were performed to reveal that FOXCUT acted as a competitive endogenous RNA (ceRNA) for the microRNA miR-24-3p and consequently inhibited the degradation of p38. RESULTS: lncRNA FOXCUT was markedly highly expressed in breast cancer, which was associated with poor prognosis in some cases. Knockdown of FOXCUT significantly inhibited cancer growth and metastasis in vitro or in vivo. Mechanistically, FOXCUT competitively bounded to miR-24-3p to prevent the degradation of p38, which might act as an oncogene in breast cancer. CONCLUSION Collectively, this research revealed a novel FOXCUT/miR-24-3p/p38 axis that affected breast cancer progression and suggested that the lncRNA FOXCUT could be a diagnostic marker and therapeutic target for breast cancer.
Humans ; Cell Line, Tumor ; Cell Movement/genetics* ; Cell Proliferation/genetics* ; Gene Expression Regulation, Neoplastic/genetics* ; MAP Kinase Signaling System ; MicroRNAs/metabolism* ; p38 Mitogen-Activated Protein Kinases/metabolism* ; RNA, Long Noncoding/metabolism* ; Triple Negative Breast Neoplasms/pathology*

Objective To study the expression and clinical significance of neural Wiskott-Alrdich syndrome protein(N-WASP)in pla-centas with preeclampsia.Methods This study included a total of 65 pregnant women:15 in the early-onset preeclampsia group,15 in the early-onset control group,15 in the late-onset preeclampsia group,and 20 in the late-onset control group.Real-time fluorescence quan-titative PCR(RT-qPCR)was used to detect the relative expression of N-WASP mRNA in placental tissues.Western blotting and immu-nohistochemistry were used to detect the expression and position of N-WASP protein in placental tissues from each group.Results RT-qPCR revealed significantly lower N-WASP mRNA expression levels in the placental tissue of the early-onset preeclampsia group compared to those in the early-onset control group(0.50±0.19 vs.0.93±0.73,P＜0.05).The N-WASP mRNA expression levels in late-onset preeclampsia placenta were significantly lower than those in the late-onset control group(0.83±0.34 vs.1.15±0.34,P＜0.05).Western blotting revealed significantly lower N-WASP protein expression in the placental tissue of early-onset preeclampsia compared to that in the early-onset control group(0.35±0.17 vs.0.72±0.21,P＜0.05).The N-WASP protein expression in late-onset preeclampsia placenta was significantly lower than that in the late-onset control group(0.39±0.16 vs.0.76±0.20,P＜0.05).The N-WASP mRNA expression in the placenta negatively correlated with the occurrence of early-onset(r =-0.37,P = 0.042)and late-onset preeclampsia(r =-0.39,P = 0.019).Immunohistochemistry revealed that N-WASP protein was localized in the cytoplasm of syncytiotrophoblasts,cytotrophoblasts,villous stromal cells,and vascular endothelial cells.Conclusion The low expression of N-WASP may be closely associated with preeclampsia.