Objective · To observe the change of serum complement C1q tumor necrosis factor-related protein1 (CTRP1) level and explore its relationship with serum adiponectin (APN) level in elderly male metabolic syndrome (MS) patients. Methods · Clinical data of 279 male objects (60-90 years old) were analyzed retrospectively, serum CTRP1 and APN levels of all objects were tested by enzyme-linked immuno sorbent assay (ELISA). The patients were divided into three groups, i.e. 105 MS patients (MS group), 90 MS patients combined with hypertension (HMS group), and 84 non-MS patients (control group). All general information, including height, body weight, systolic blood pressure (SBP), diastolic blood pressure, fasting blood glucose, fasting insulin and serum three acyl glycerin (TAG) were recorded, in order to calculate body mass index (BMI) and homeostasis model assessment of insulin resistance (HOMA-IR). Results · Compared with the control group, serum CTRP1 levels of patients in MS group and HMS group both increased, and the latter was more obviously. Serum APN levels of patients decreased obviously in HMS group and MS group. The level of serum CTRP1 was negatively related with the level of serum APN. Conversely, serum CTRP1 level was positively related with blood glucose, BMI, SBP, TAG and HOMA-IR. Conclusion · The level of serum CTRP1 is elevated, while the level of serum APN declines in elderly male MS patients. The serum level of CTRP1 is even higher in HMS patients. Serum CTRP1 level is related to many risk factors of atherosclerosis.

Objective To compare the clinical outcomes of retroperitoneal laparoscopic and open radical nephrectomy in patients with T1 renal cell carcinoma (RCC). Methods 352 patients under-went radical nephrectomy for T1 RCC, 185 by retroperitoneal laparoscopic radical nephrectomy(group A) and 167 by open radical nephrectomy through an extraperitoneal flank incision(group B). The op-eration time, blood loss during operation, hospital stay and complication after surgery were analyzed and compared. All the cases were followed up for 6-42 months(median, 25 months) and the survival rates were recorded. Results The operation time of group A, B was 55-130(75.6±11.2)min vs. 50-140(68.0±10.6)min(P0.05). Blood loss was 50-1200(110.6±32.3)ml vs. 50-1500 (160.8±38.1)ml(P<0.05). Eight cases of group A and 132 cases of group B took analgesic after surgery(P<0.05). The fasting period was 1-2(1.3±0.5)day vs. 2-5(2.9±1.2)d of group B (P<0.05)ilengthof hospital stay was 3-7(4.6±1.2)d vs. 7-14(8.9±1.6)d(P<0.05). The survival rate was 85.4 % vs. 86.2% (P0.05). Conclusions Compared with open radical nephrec-tomy, retroperitoneal laparoscopic radical nephrectomy is associated with lower blood loss, narcotic requirement and complications, a shorter hospital stay and earlier resumption of routine activities. Retroperitoneal laparoscopic radical nrphrectomy has become a gold standard therapy in T1 renal cell carcinoma.

Objective To summarize the clincical experience of transumbilical Laparoendoscopic Single-site (LESS) nephrectomy and to evaluate its safety and efficacy. Methods From December 2008 to August 2010, we have performed 20 cases of transumbilical LESS nephrectomy by Tri-Port system, of which 9 patients underwent LESS radical nephrectomy (left 8, right 1, stage T1 ), 1 patient underwent LESS radical resection of right ureteral carcinoma, 10 patients underwent LESS simple nephrectomy (left 5, right 5). The Tri-Port system was inserted transperitoneally through a 2 cm umbilical incision. A 5-mm 30° telescope was introduced through the port to visualize the operative field. Flexible equipment and standard laparoscopic equipment were used to perform the procedures.The incisions were extended to about 6cm in order to remove the specimens. Results Conversion to open surgery was necessary in one LESS radical resection of right ureteral carcinoma and one LESS simple nephrectomy, while the remaining 18 cases were successful (the addition of a single 5-mm port was necessary in 2 cases of LESS radical nephrectomy). The mean operative time was 197 min (85-510 min), mean estimated blood loss was 126 ml (50-400 ml), without blood transfusion in the perioperative period, mean postoperative hospital stay was 6.3 d (3-14 d), and mean duration of catheter drainage was 3.6 d (0- 14 d). Conclusions Transumbilical LESS nephrectomy is feasible, safe,minimally invasive and cosmetic. Long-term follow-up and a clinical control study are needed for evaluating clinical outcomes.

Objective To explore the function of specialized training course in training singleport laparoscopic skills.Methods The specialized training course for single-port laparoscopy included cutting rubber bands into‘Z’shape,cutting‘petaloid’folded slips and peeling oranges.Twelve residents were enrolled into traditional laparoscopy training for one week and then randomized into two groups:6 trainees performed the specialized training course for 2 h daily and the others as the control group continued to practice the traditional course for 2 h daily.One week later,the trainees were tested on performing porcine single-port laparoscopic nephrectomy.Operation time and performance was compared.T test were performed using SAS 9.1.3 statistics software,and a P＜0.05 was considered to be statistical significance.Results Operation time of the specialized group was decreased significantly(59.2±17.3)min vs.(87.0±25.5)min,P=0.049,and the total global rating scale score increased significantly(26.3±2.2 vs 18.2±2.8,P=0.000 17).Conclusion The specialized course is beneficial to the training of single-port laparoscopic skills.

Objective To investigate the role of AKT/GSK3β/mTOR signaling molecule in myocardial protection of sevoflurane postconditioning.Methods Thirty-nine male Sprague-Dawley rats,weighing 200-250 g,installed in vivo myocardial ischemia-reperfusion model by left anterior de-scending coronary occlusion for 30 min.Rat hearts were randomly divided into 3 groups (n = 13 ):sham control group (group Sham),purely ischemia-reperfusion group (group IR),sevoflurane post-conditioning group (group SPC).With the exception of group Sham,each group was subjected to oc-clusion for 30 min followed by 2 h reperfusion.Group SPC was subjected to sevoflurane postcondi-tioning:2.4% sevoflurane was inhaled for 1 5 min starting from the end of ischemia until 1 5 min after beginning of reperfusion,while 33% oxygen was inhaled in the other groups.At the end of 2 h reper-fusion,cardiac function was evaluated by two-dimensional echocardiography,myocardial infarction size was measured by using 1% 2,3,5-triphenyltetrazolium chloride triazole (TTC),myocardial ultra-structural alterations was detected by transmission electron microscopy (TEM),cardiomyocytes ap-optosis was examined by terminal deoxynucleotidyl nickend labeling (TUNEL),the expressions of p-AKT/t-AKT, p-GSK3β/t-GSK3β, p-mTOR/t-mTOR,Bcl-2 and Bax proteins was measured by Western blot.Results Compared with group Sham,cardiac function was deteriorated,myocardial in-farct size was increased,cardiomyocyte mitochondrial damage was increased,positive apoptotic car-diomyocyte was increased,the expression of Bcl-2 was down-regluated,and the expressions of p-AKT/t-AKT,p-GSK3β/t-GSK3β,p-mTOR/t-mTOR and Bax were up-regluated in group IR (P <0.05).Compared with group IR,cardiac function was improved,myocardial infarct size was de-creased,cardiomyocyte mitochondrial damage was decreased,positive apoptotic cardiomyocyte was decreased,the expression of Bax was down-regluated,and the expressions of p-AKT/t-AKT,p-GSK3β/t-GSK3β,p-mTOR/t-mTOR and Bcl-2 were up-regluated in group SPC (P < 0.05 ). Conclusion Sevoflurane postconditioning can mitigate ischemia-reperfusion injury to in vivo rat hearts,decreased cardiomyocyte mitochondrial damage,inhibited cardiomyocyte apoptosis,and its mechanism was related to the activation of AKT/GSK3β/mTOR signaling molecule.

Objective To summarize the surgical experience in robotic-assisted laparoscopic partial nephrectomy,and to investigate the efficacy and safety of this surgery.Methods The clinical data of 12 patients who underwent robot-assisted laparoscopic partial nephrectomy in Changhai Hospital from March to July in 2012 were analyzed.All the patients were male and the age range was 43-66 years.In 4 cases the tumors were in the left kidney,and 8 in the right.In 7 cases the tumors were in the dorsal part of the kidney,and 2 in the ventral part.There were 3,5 and 4 cases in the upper,middle and lower pole of the kidney respectively.Preoperative GFR test was normal in all cases.Kidney CT scan showed the maximum diameters of the tumors were 2.0-5.8 cm,with an average of 3.3 cm.The pre-operative stages in all cases were T1N0M0.Results The surgery was successfully completed in all cases.The mean duration of the surgery was 160-310 min,with an average of 242 min.The blood loss was 30-300 ml,with an average of 135 ml,and the intraoperative blood transfusion was unnecessary.The warm ischemia time was 20-49 min,with an average of 31 min.There was no intraoperative morbidity,and no conversion to open surgery.The postoperative length of hospitalization was 9-31 d,with an average of 14 d.Gross hematuria arose in 1 patient at 1 week after the surgery.The post-operative pathology showed renal clear cell carcinoma with Furhman Grade Ⅱ in 11 cases,and renal angiomyolipoma in 1 case.The maximum diameters of the tumors were 2.0-5.0 cm,with an average of 3.5 cm.The tumor resection margin was negative in all cases.Conclusions Robot-assisted laparoscopic partial nephrectomy is safe and effective for local renal tumors.This surgery has significant advantage over traditional laparoscopic partial nephrectomy,in terms of the resection of the renal tumors and the reconstruction of the kidney.

Objective:To initially investigate whether simultaneous radiochemotherapy with hyperthermia can prolong the survival of glioblastoma (GBM) patients.Methods:Clinical data of 61 GBM patients undergoing surgery in our hospital from September 2016 to June 2019 were retrospectively analyzed. According to different treatment methods, all patients were divided into the control group ( n=34) and observation group ( n=27). In the control group, three-dimensional radiotherapy with a dose of 60 Gy combined with temoazolamine chemotherapy was delivered. In the observation group, simultaneous radiochemotherapy with 15-20 cycles of hyperthermia at 40-41℃ was supplemented. The survival time was calculated by Kaplan-Meier method, and the survival time was compared with log-rank test between two groups. Results:The median progression-free survival in the observation group was significantly longer than that in the control group (14.33 months vs.9.94 months, P<0.05). The median overall survival in the observation group was also remarkably higher than that in the control group (18 months vs. 14 months, P<0.05). Conclusions:Simultaneous radiochemotherapy with hyperthermia is innovatively applied to treat GBM after surgical resection. Preliminary findings demonstrate that compared with chemoradiotherapy, simultaneous radiochemotherapy with hyperthermia can prolong the survival time of GBM patients.

OBJECTIVETo investigate the effect of risperidone, an antipsychotic drug, on the Akt-GSK3β pathway and the role of PI3K in dopamine D2 receptor (DRD2) expression and Akt-GSK3β signal pathway.

METHODSHuman glioma cells (U251) were cultured in vitro. Cells without any treatment as control, Western blotting was used for measuring the expression of Akt (Thr308 and Ser473) and GSK3β (Ser9) protein phosphorylation by risperidone and LY294002 in U251 cell, and real-time PCR was used for detecting the expression of DRD2 mRNA.

RESULTSRisperidone has significantly enhanced the expression of phosphorylated Akt and phosphorylated GSK3β (P< 0.05), but did not alter the mRNA expression of DRD2. LY294002 could reduce the phosphorylation of Akt and GSK3β (P< 0.01, P< 0.05), and also decrease the DRD2 mRNA (P<0 .05).

CONCLUSIONRisperidone can activate the Akt-GSK3β signaling pathway in the U251 cells, and PI3K is a common regulatory site in Akt-GSK3β signaling and D2 receptor gene expression.

Antipsychotic Agents ; pharmacology ; Cell Line, Tumor ; Glioma ; drug therapy ; genetics ; metabolism ; Glycogen Synthase Kinase 3 ; genetics ; metabolism ; Glycogen Synthase Kinase 3 beta ; Humans ; Phosphatidylinositol 3-Kinases ; genetics ; metabolism ; Phosphorylation ; Proto-Oncogene Proteins c-akt ; genetics ; metabolism ; Risperidone ; pharmacology ; Signal Transduction ; drug effects

OBJECTIVETo explore the association of a functional polymorphism Val158Met of COMT gene and attention and executive function in first-episode treatment-naive patients with schizophrenia and healthy controls.

METHODSTrail making test (TMT) and clinical performances were evaluated in 103 first-episode treatment-naive patients with schizophrenia and 99 healthy controls. Polymorphism of COMT Val158Met was analyzed using polymerase chain reaction-restriction fragment length polymorphism method. A general linear model was used to investigate the effect of genotype subgroups on the attention and executive function.

RESULTSThere was a significant difference between control subjects and patients with schizophrenia on the TMT-A and B. However, no significant difference among Val/Val, Val/Met and Met/Met on the TMT-A and B in control subjects and patients with schizophrenia was detected.

CONCLUSIONThe association among COMT Met variant and trail making testing (attention and executive function) has been replicated. However, no association of COMT Met variant with disruption of dopaminergic influence on neurocognitive function was detected. This may be due to the heterogeneity of population.

Adolescent ; Adult ; Amino Acid Substitution ; Attention ; physiology ; Catechol O-Methyltransferase ; genetics ; Executive Function ; physiology ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Schizophrenia ; genetics ; physiopathology ; Schizophrenic Psychology ; Trail Making Test ; Young Adult

Objective To compare the operative-postoperative outcomes of laparoscopic and robotassisted partial nephrectomy (LPN and RAPN) for patients with T1 b renal masses.Methods A total of 169 T1 b renal mass patients receiving LPN (n =69) or RAPN (n =100) in our center between October 2009 and October 2017 were retrospectively collected.There were 46 males and 23 females in LPN group,with a mean age of (55.0 ± 11.9) years.The mean tumor size was (5.09 ± 0.76) cm,and mean R.E.N.A.L score was 6.36 ± 1.53.49 procedures (71％) were performed via a retroperitoneal approach in LPN group.There were 59 males and 41 females in RAPN group with a mean age of (52.9 ± 11.7) years.The mean tumor size was(4.95 ±0.66) cm,and mean R.E.N.A.L score was 8.17 ± 1.50.31 procedures (31％)were performed via a retroperitoneal approach in RAPN group.There was statistical significance between two groups in R.E.N.A.L score and surgery approach (P ＜ 0.001).The group covariates were balanced through propensity score matching (PSM) using 1∶ 1 nearest neighbor matching method.After PSM,operating time,estimated blood loss,warm ischemia time,incidence of complications,hospital stay and postoperative follow-up status were compared between LPN(n =36)and RAPN(n =36)group.Results After PSM,patient distributions were closely balanced.In the LPN vs the RAPN group,there were significant different in warm ischemia time [(23.9 ± 7.3) min vs.(20.4 ± 6.7) min,P ＜ 0.05],estimated blood loss [(136.9 ± 80.2) ml vs.(136.9 ± 80.2) ml,P ＜ 0.05],incidence of complications (8.7％ vs.1.0％,P ＜0.05),and hospital stay [(11.5 ±3.8)d vs.(9.8 ± 1.80)d].There was no significant differences resulted regarding operating time [(164.5 ± 64.4) min vs.(169.0 ± 42.5) min,P ＞ 0.05],variation of estimated glomerular filtration rate from baseline [(9.97 ± 8.98)％ vs.(9.27 ± 9.19)％,P ＞ 0.05],positive surgical margin rate (1.4％ vs.0,P ＞ 0.05) and rate of recurrence or metastasis (1.4％ vs.1.4％,P ＞ 0.05) between groups.Conclusion Considering operative,functional and oncologic outcomes,both RAPN and LPN performed by an experienced surgeon were acceptable for patients with T1b renal masses.If available,robotic approach may reduce operative trauma and complications.