Objective To evaluate the effect of mitotane as a preoperative adjuvant therapy in advanced adrenocortical carcinoma.Methods Mitotane was used in 2 patients as preoperative adjuvant therapy.Case 1,a 24-year-old woman had Cushing's symptom for 1 year and presented with edema in both legs for 1 month.Computed tomography (CT) showed a solid mass in the right adrenal.It was about 10.0 cm×7.8 cm with calcification,and the boundary of tumor was not clear.Enhanced CT scan showed heterogeneous enhancement and there was a suspicious filling defect in the inferior vena cava.Biopsy of adrenal neoplasm was made and pathological result was adrenocortical tissue.The patient was diagnosed as right adrenocortical carcinoma with tumor thrombus in vena cava.Mitotane was used for 6 months.Case 2,a 42-year-old woman who underwent left adrenal adenoma resection 9 years ago,presented with Cushing's syndrome for 2 years,and found masses in left retroperitoneal and abdominal wall for 6 months.CT showed multiple nodular soft tissues with pitting calcification and fusion in it,locating between retroperitoneal spleen and kidney.The biggest section was approximately 8 cm× 12 cm,with a largest diameter of 14 cm.Enhanced scan showed uneven density wiht CT value of about 32 HU.Nodule shadows which were obviously strengthened were found in front of the right side of the diaphragmatic muscle.And some heterogeneous enhanced nodule shadows could be seen in front of the right abdominal peritoneal and muscle layer.The patient was diagnosed as right adrenocortical carcinoma with multiple metastases.Mitotane was used for treatment for 5 months.Results Both of their Cushing's symptom were significantly improved by taking drugs.The main side effects were nausea,vomiting,dizziness,fatigue,diarrhea and so on,but all could be alleviated after drug dosage adjustment.CT reexamination showed the volume of the primary lesion and metastases were significantly reduced.The postoperative pathological report after remove of the tumor and metastases showed adrenocortical carcinoma.Followed up for 42 and 7 months,the patients had no recurrence.Conclusions Mitotane is effectiveas preoperative adjuvant therapy in adrenocortical carcinoma and metastases.It can reduce the lesions significantly,relieve the Cushing's symptom,and provide opportunity for surgical treatment.

Objective:To evaluate the performance of a novel master-slave transurethral surgical robot system and test its safety and effectiveness.Methods:In September 2021, two urologists (A and B) applied transurethral surgery robot prototype on simulate human tissue model experiments. The transurethral surgical robotic systems used in this study include: master-end control platform, slave-end surgical platform, and end-effector. The main end control platform adopted Omega7 force feedback main hand as the main controller, and the degrees of freedom include: up and down translation, left and right translation, front and back translation, end rotation, end pitch, end swing, end operation. The end-operated surgical platform adopts the Med 7 seven-degree-of-freedom medical collaborative robotic arm to apply precision through the end effector operated resectoscope. The end effectors were modular in design for maximum compatibility with existing surgical instruments. The two doctors routinely assembled the resectoscope and the transurethral surgical robot 20 times each to calculate the assembly time. The routine assembly time of the resectoscope included the time when the lens and light source were connected after the resectoscope had been installed, and the doctor entered the experimental module with the resectoscope in hand. The time to assemble the surgical robot included the time to install the resectoscope with the end effector and connect the lens and light source to enter the experimental module. Two doctors performed 25 simulated prostate resection and 5 simulated bladder resection procedures. The small intestine, heart and stomach of pigs were sutured to construct urethra, prostate and bladder structures that simulated human body: urethra (pig small intestine) was 16-18 cm long, prostate (pig heart) size was about 5 cm×5 cm×6 cm, and bladder (pig stomach) capacity was 250-300 ml. The model was placed in a 3D printed sleeve to simulate the fitting of the urethra to the silicone penis. Prostate resection surgery: the doctor operated the handle on the main end control platform, controld the slave actuator through human-computer interaction, and excisesed the "prostate" around the fixed point under direct vision, simulating standard transurethral prostatectomy, the resection ranges from the bladder neck to the tip of the prostate, and the two lobes and middle lobes were removed. Each operation lasted 40 minutes and the weight of the removed tissue was recorded. Transurethral esection of the bladder: each procedure involved removal of the triangle, bilateral walls, and apical area of the bladder to record the occurrence of perforation. The accuracy of master-slave operating distance, operation attitude accuracy, master-slave operation attitude repeatability, fixed point accuracy, master-slave control start delay time and master-slave control following delay time, robotic arm swing range, limit site and other indicators of the robot were verified by surgery.Results:The positioning accuracy of the end effector of transurethral surgical robot was less than 0.5 mm, the accuracy of master-slave operation distance was ≤0.5 mmthe repeatability distance was ≤0.2 mm, the accuracy of master-slave operation attitude was a≤0.30°, the angle b≤0.30°, the angle C≤0.15°, the accuracy of the fixed point ≤is 0.6 mm, the maximum activity space of the robotic arm was a hemispherical space with a radius of (1 493±5)mm. The delay time of master-slave control startup and master-slave control follow-up delay time did not exceed 100ms; When the end of the manipulator was collided by an external force during the movement, the system could automatically stop the movement of the manipulator, at this time the external force was(70±7) N, and the fixed point setting range was 30-170 mm. The assembly time of transurethral surgery robot by Doctor A and Doctor B was (111.35±57.88) s and (111.70±58.30), respectively.The time of routine assembly resectoscope was (44.90±4.89) s and (44.90±5.16) s, respectively, and the difference between the routine assembly time and robot assembly time of Doctor A and Doctor B were not statistically significant( P=0.679 and P=0.996), the assembly time of the two doctor robots was more than the conventional assembly time( P=0.001 and P=0.001). The average weight of prostate tissue resection in experiments was (43.60±12.42)g and (43.45±12.63)g, respectively. No significant difference was found between them( P=0.954). During the simulated bladder electrosurgery, the robot system could successfully complete the resection of the triangular region, bilateral walls, and top tissues of the bladder. In the surgical experiment, the system operated smoothly, without mechanical failure, module damage, perforation, and other complications. Conclusions:The transurethral surgery robot might be a choice for transurethral surgery.

P1B-ATPases are a group of proteins that can transport heavy metal ions across membranes by hydrolyzing ATP and they are a subclass of the P-type ATPase family. It was found that P1B-ATPases are mainly responsible for the active transport of heavy metal ions in plants and play an important role in the regulation of heavy metal homeostasis in plants. In this paper, we dissusses the mechanism of P1B-ATPases from the structure and classification of P1B-ATPases, and review the current research progress in the function of P1B-ATPases, in order to provide reference for future research and application of P1B-ATPases in improving crop quality and ecological environment management.
Adenosine Triphosphatases/metabolism* ; Biological Transport ; Metals, Heavy ; Plants/enzymology*

Heart failure with preserved ejection fraction (HFpEF) displays normal or near-normal left ventricular ejection fraction, diastolic dysfunction, cardiac hypertrophy, and poor exercise capacity. Berberine, an isoquinoline alkaloid, possesses cardiovascular benefits. Adult male mice were assigned to chow or high-fat diet with L-NAME ("two-hit" model) for 15 weeks. Diastolic function was assessed using echocardiography and noninvasive Doppler technique. Myocardial morphology, mitochondrial ultrastructure, and cardiomyocyte mechanical properties were evaluated. Proteomics analysis, autophagic flux, and intracellular Ca²⁺ were also assessed in chow and HFpEF mice. The results show exercise intolerance and cardiac diastolic dysfunction in "two-hit"-induced HFpEF model, in which unfavorable geometric changes such as increased cell size, interstitial fibrosis, and mitochondrial swelling occurred in the myocardium. Diastolic dysfunction was indicated by the elevated E value, mitral E/A ratio, and E/e' ratio, decreased e' value and maximal velocity of re-lengthening (-dL/dt), and prolonged re-lengthening in HFpEF mice. The effects of these processes were alleviated by berberine. Moreover, berberine ameliorated autophagic flux, alleviated Drp1 mitochondrial localization, mitochondrial Ca²⁺ overload and fragmentation, and promoted intracellular Ca²⁺ reuptake into sarcoplasmic reticulum by regulating phospholamban and SERCA2a. Finally, berberine alleviated diastolic dysfunction in "two-hit" diet-induced HFpEF model possibly because of the promotion of autophagic flux, inhibition of mitochondrial fragmentation, and cytosolic Ca²⁺ overload.
Male ; Mice ; Animals ; Heart Failure/drug therapy* ; Stroke Volume/physiology* ; Ventricular Function, Left/physiology* ; Berberine/therapeutic use* ; Disease Models, Animal ; Mitochondrial Dynamics ; Myocardium ; Homeostasis

Objective: To construct a scientific behavioral research of pasta matrix reaching task (PMRT) and comprehensively evaluate sensory-motor dysfunction caused by brain injury. Methods: Twenty-one SD rats were subjected to 14-days pasta matrix grasping training and then were randomly divided into model group (11 rats) and sham group (6 rats). Motor cortex ischemia was induced by injection of endothelin-1 in SD rats. The number of pasta grabed by the injured forelimb and the location in matrix were evaluated daily 7 days after surgery. The infarct volume was measured by Nissl staining at the 7 days, 14 days, and 28 days after stroke. Results: The number of pasta obtained by rats was reduced from (33.43±1.02) to (20.57±0.57) at 7 days post stroke in model group, and then increased to (26.85±0.98) at 28 days post stroke, although there was a significant difference between sham group(32.33±1.45) and ischemic group (t=3.198, P<0.05). The frequency of retrieval from each slot of the pasta matrix represented that sham group demonstrated a significant gain in performance in the antero quadrant of the matrix compared to ischemic rats by the fourth week after stroke.The stroke volume was decreased from (37.82±1.17)mm³ at 7 days post-stroke to (24.35±0.38)mm³ at 28 days post-stroke, indicating brain recovery from ischemic injury. Conclusion The pasta matrix reaching task can function as a versatile and sensitive behavioral assay that permits experimenters to collect accurate outcome data and manipulate limb use to mimic human clinical phenomena including compensatory strategies and focused rehabilitative training after stroke.