Objective:To discuss the surgical techniques and evaluate the clinical effects of laparoscopic varicocelectomy with testicular artery preservation.Methods:In this retrospective study, we collected clinical data of 97 patients with varicocele who underwent laparoscopic varicocelectomy from January 2015 to June 2020. All operations were performed by the same experienced urologist. Conventional laparoscopic varicocelectomy without testicular artery preservation was performed in earlier 35 patients (January 2015 to December 2016), which were taken as control group. The latter 62 patients (January 2017 to June 2020) underwent laparoscopic varicocelectomy with testicular artery preservation were taken as observational group. In observational group, average age was (21.9±6.7)years, there were 47 cases on the left side, 3 cases on the right side and 12 cases bilaterally, totaling 74 sides. There were 22 sides of varicose veinsⅠ, 28 sides of varicose veinsⅡand 24 sides of varicose veins Ⅲ. Clinical manifestations such as scrotal discomfort, pain and scrotal vein masses were observed on 35 sides (47.3%), infertility was observed in 24 cases (38.7%). Average sperm density was (23.7±5.9)×10 6/ml, average sperm motility (grade a+ b) was (33.9±4.1)%. In control group, average age was (23.7±4.6) years, there were 26 cases on the left side, 2 cases on the right side, 7 cases bilaterally, totaling 42 sides. There were 10 sides of varicose veinsⅠ, 17 sides of varicose veinsⅡ, 15 sides of varicose veinsⅢ. Clinical manifestations of scrotal discomfort, pain and scrotal vein masses were observed on 19 sides (45.2%), infertility was observed in 14 cases (40.0%). Average sperm density was (22.3±6.2)×10 6/ml, average sperm motility (grade a+ b) was (32.6±4.8)%.There was no significant statistical difference in preoperative clinical data between two groups ( P>0.05). The observational group followed the procedural steps of freeing the spermatic cord, isolating the testicular artery, and ligating the spermatic vein. The testicular artery was separated by the separating forceps and the electric hook, with the separating forceps holding the spermatic cord fascia in place and the electric hook (without electricity) bluntly separating the blood vessels and lymphatic vessels in the spermatic cord. The operative time, complications, recurrence rate, improvement rate of scrotal symptoms and semen quality, spontaneous pregnancy rate of spouses within 2 years in infertile patients were compared between the two groups. Results:The mean operative time in observational group was longer than control group [(35.8±7.7)min vs.(16.5±5.5)min, P<0.001]. Occurrence of postoperative acute epididymitis was lower in observational group compared to control group [1.4% (1 side) vs. 11.9% (5 sides), P<0.05] . No testicular atrophy (0 side) occurred in observational group, however, this complication could be found in 7.1% (3 sides) of control group ( P<0.05). Improvement rate of scrotal symptoms and semen quality was higher in observational group than that in control group after operations [77.1% (27 sides) vs. 47.4% (9 sides), P<0.05; and 72.6% (45 cases) vs.51.4% (18 cases), P<0.05]. The rates of spousal natural pregnancy within 2 years in infertile patients was higher in observational group than that in control group [70.8% (17 cases) vs. 50.0% (7 cases), P<0.05]. The rates of hydrocele and scrotal edema were similar in two groups [9.5% (7 sides) vs. 9.5 (4 sides)%, P>0.05], and the recurrence rate of varicocele was similar [8.1% (6 sides) vs. 7.1% (3 sides), P>0.05), without statistically significant difference. Conclusions:Using separating forcep and electronic hook can help to separate the testicular artery when performing laparoscopic varicocelectomy. In this operation, to preserve the testicular artery can get better effects an less complications.

Objective To investigate the expression of CD24 and Ki67 in the invasive breast ductal car-cinoma tissues, so as to assess the role of CD24 protein in the carcinogenesis and progression of breast canc-er. Methods The expression of CD24 and Ki67, Bcl-2 was examined by immunohistochemically in 86 breast cancer specimens and 30 non-cancer specimens ( ElivisionTM Plus). The relationship between CD24 expression and Ki67, Bcl-2, patient age, tumor size, histopathologic grade, axillary lymphnode metastasis, and clinical stage of breast cancer was analyzed. Results In 86 eases of invasive breast ductal carcinoma, the positive incidences of CD24 was 87.2% (75/86), which distinguished apparently from those of the con-trol group( P <0.01 ). In breast carcinoma tissues, the expression of CD24 was positively related to axillary lymphnode metastasis(P <0.01 ), but was not related to patients age,tumor size, histopathologic grade and clinical stage(P>0.05). CD24 expression was positively related to Ki67 (P<0.01 ) and negatively relat-ed to Bcl-2(P>0.05). Conclusion CD24 expression was related to the proliferation, invasion and me-tastasis of breast cancer cells and it can serve as an important marker for predicting biological behavior and prognosis of tumors.

Objective To investigate the expression of CD24 and FAK in the invasive breast ductal carcinoma tissues and their clin-ical significance. Methods Tissues were obtained from 86 patients with breast carcinoma and 30 non-cancer specimens. The expression of CD24 and FAK was detected by immunohistochemical technique (ElivisionTMPlus) and their correlation with tumor clinicopathological char-acters was analyzed. Results The positive rate of CD24 and FAK expression in 86 cases of breast carcinoma was 87.2% (75/86) and 72.1% (62/86) respectively, which was significantly different from that in control group(P<0.01). Expression of CD24 was significantly correlated with axillary lymph node metastasis(P<0.01). Expression of FAK was correlated with histopathologic grade, axillary lymph node metastasis and clinical stage (P<0.05). There was a positive correlation between the expressions of CD24 and FAK in breast carci-noma tissues (rs = 0.222, P < 0.05). Conclusion Expression of CD24 and FAK are closely correlated with the development of breast carcinoma and there is a markedly positive correlation between CD24 and FAK expression. These indexes can be helpful in understanding the biological behaviors and predicting the prognosis of breast carcinoma.

Objective To observe the protective effects of genistein sodium sulfonate(GSS)on mice chronic hepatic injury in-duced by carbon tetrachloride(CCl4 )and its influence on the protein expression of α7 nicotinic acetylcholine receptor(α7nAChR) and interleukin-1 beta (IL-1β)in liver tissue.Methods 60 SPF grade male Kunming mice were randomly divided into 5 groups,in-cluding the control group,model group,low and high doses GSS groups,and positive control group,12 cases in each group.Except for the control group,the other 4 groups were intra peritoneally injected by 10 % CCl4 with a volume of 0.1 mL/10 g for 6 weeks. The mice chronic liver injury was prepared.At the same time,the high and low doses DSS groups were given the different doses of GSS(0.30,0.10 mg/kg),the positive control group was given bifendate(DDB,2.5mg/kg),the control group and the model group were given the equal volume of normal saline for 6 consecutive weeks.The AST and ALT activity was detect and the ratio of ALT/AST was calculated;the Western blot method was used to detect the expression levels ofα7nAChR and IL-1βprotein in liver.Re-sults The serum levels of ALT and AST in the model group were increased obviously,and the expression level ofα7nAChR in the liver tissue was decreased,while the expression level of IL-1βwas increased;after the GSS treatment,the serum AST and ALT lev-els were significantly lower than those in the model group(P <0.05),while the expression level ofα7nAChR was increased (P <0.01)and the expression level of IL-1βwas decreased(P <0.05).Conclusion GSS might increase the expression ofα7nAChR in injured liver tissue,activates the cholinergic anti-inflammatory pathway,thus decreases the expression of inflammatory cytokines and antagonizes the mice chronic liver injury by inhibiting the inflammatory reaction.

Objective To evaluate the functional and oncological outcomes of patients with locally advanced prostate cancer (PCa) treated by hormone therapy combined with extra-fascia1 laparoscopic radical prostatectomy (LRP) plus extended lymph node dissection (ePLND).Methods From January 2004 to June 2016,a total of 255 PCa cases (pT3-4NxM0) who received LRP plus ePLND were enrolled into our study.The mean age of the patients was 67 (range 44-88) years,and median PSA level was 21.2 (range 0.6-454.0) ng/ml.The patients were divided into earlier group (from January 2004 to December 2011,160 cases) and later group (from January 2012 to June 2016,95 cases) according to different treatment periods.The baseline demographics between the two groups were similar.All patients routinely received adjuvant hormone therapy (AHT) postoperatively.The patients in the later group underwent collapsin response mediator protein 4 (CRMP4) methylation study on the prostatic biopsy preoperatively.Those with a CRMP4 methylation level ＞ 15％ or rectum/bladder neck invasion,were treated by neoadjuvant hormone therapy (NHT) for 3-6 months.Positive surgical margin (PSM),progression-free survival (PFS),cancer-specific survival (CSS),overall survival (OS) and postoperative continence rates between the two groups were analyzed and compared.Results The mean operative time of the earlier and later group were (239 ±65) min and (203±51) min,mean blood loss were (109-±65) ml and (96-±44) ml,mean dissected nodes were (19 ± 5) and (21 ± 7),respectively (all P ＞ 0.05).The total PSM rate was 19.2％,and PSM rates of the two groups were 23.1％ and 12.6％ (P =0.04).All the 255 cases received AHT and 25 cases in the later group underwent NHT.The median follow-up time was 73 months (range 10-152 months).The total 5-year PFS,CSS and OS rates were 77.7％,94.3％ and 87.1％,respectively,and the rates between groups were 73.8％ vs.86.1％ (P=0.03),93.1％ vs.98.6％ (P=0.07),and 85.0％ vs.92.8％ (P =0.11),respectively.The 1-year postoperative continence rates were 91.9％ vs.97.9％ (P =0.09).Conclusions Hormone therapy combined with LRP plus ePLND represents an oncological and functional effective option in patients with locally advanced PCa,and improved PFS might be acquired by preoperative tumor staging.

Objective To compare the efficacy of extended pelvic lymph node dissection (ePLND)and oncological outcome by fluorescence laparoscopic radical prostatectomy (FLRP) versus high-definition laparoscopic radical prostatectomy (HD-LRP) for men with locally advanced prostate cancer (LAPCa).Methods In a prospective trial,we recruited 51 patients with T3a-bNxM0 prostate cancer from July 2015 to April 2018.Patients were assigned to study group or control group according to random number method,and were underwent either FLRP + ePLND or HD-LRP + ePLND.21 in the study group were injected with 5 mg of indocyanine green (ICG) into the bilateral lobes of the prostate transperineally guiled by transrectal ultrasound 30 min before surgery for lymphography.During the surgical procedure a fluorescence laparoscope,optimized for detection in the near infrared range,was used to visualize the lymph nodes (green fluorescent) in the dissection region in the study group while a common laparoscopy introduced in control one.Lymph nodes were removed in the external iliac vessiles,internal iliac artery,obturator fossa regions,common iliac regions and presacral regions in both groups.Radical prostatectomy was completed in the both groups by similar steps.The operation time,blood loss,number of removed lymph nodes and positive lymph nodes,complication rate,biochemical recurrence (BCR) and metastasis free survival rates in 2 years were recorded and compared in the two groups.Results 51 eligible patients were selected,including 21 in the study group and 30 in the control group.The mean age of biopsy of study group and control one were (66.4 ± 7.7) and (66.8 ± 7.4),the mean age PSA (23.5 ± 16.8) ng/ml and (26.0 ± 20.1) ng/ml,the mean Gleason score of biopsy (8.1 ± 1.0) and (7.9 ± 0.9) respectively,and there was no statistical significant difference between two groups.The mean operation time of study group and control one were (45.9 ± 4.6) min and (56.4 ± 3.2) min,the mean removed lymph nodes were (27.7 ± 5.6) and (22.1 ±5.6) respectively,and there was statistical significant difference between two groups (all P ＜ 0.05).Lymph nodes invasion in pathology were reported in 8 cases(38.1％)in the study groups while 9 (30.0 ％) in the control one;the proportion of positive lymph node (metastasis) were 3.2％ (19/583) and 3.4％ (23/663) in the two groups respectively and no statistically significant difference was noted between the two groups.Lymphorrhagia occurred in 4 cases in the control group,and there was no serious complications in both groups.The median follow-up time was 20 (7-33) month and during this time,BCR observed of 1 (4.7％) in the study group and 8 (26.7％) in the control;meanwhile,the MFSR was recorded of 100.0％ (0)in the study group and 86.7％ (4)in the control one,showing a statistically significant difference between the two groups(P =0.04).Conclusions Comparing with LRP,FLRP achieved better results of LN dissection,which will improve oncological outcomes.

OBJECTIVETo investigate the antioxidant and cytotoxic properties of five diarylheptanoids (1-5) isolated from the rhizomes of Zingiber officinale.

METHODVarious models such as scavenging superoxide anions and 1,1-diphenyl-2- picrylhydrazyl (DPPH) radicals, inhibiting lipid peroxidation, as well as protecting of rat pheochromocytoma (PC12) cells induced by hydrogen peroxide (H2O2) were employed to assay the antioxidative effects of the diarylheptanoids. The cytotoxicities of compounds 1-5 were measured with MTT assays.

RESULTThe test compounds (1-5) showed promising DPPH inhibitory activities, and compound 5 exhibited the strongest DPPH scavenging activity with an IC50 value of (22.6+/-2.4) micromol x L(-1). Compounds 1, 3 and 4 showed potential anti-peroxidative effects with inhibitory rates of (66.3+/-15.4)%, (68.7+/-15.8)% and (72.2+/-10.6)%, respectively, at 100 microg x mL(-1). It could be observed that compounds 1, 3 and 4 demonstrated significant neuroprotective activities in a dose-dependent manner. Moreover, compound 3 exhibited certain cytotoxicities against human chronic myelogenous leukemia cells (K562) and its adriamycin-resistant cells (K562/ADR) with IC50 values of (34.9+/-0.6), (50.6+/-23.5) micromol x L(-1), respectively.

CONCLUSIONIn vitro results demonstrated that five diarylheptanoids (1-5) isolated from the roots of Z. officinale were capable of scavenging radicals, inhibiting lipid peroxidation and protecting PC12 cells against the insult by H2O2. Additionally, compound 3 could inhibit the growth of K562 and K562/ADR cells.

Animals ; Antioxidants ; toxicity ; Cell Proliferation ; drug effects ; Cytotoxins ; toxicity ; Diarylheptanoids ; isolation & purification ; metabolism ; toxicity ; Free Radicals ; metabolism ; Ginger ; chemistry ; Humans ; Hydrogen Peroxide ; metabolism ; K562 Cells ; Oils, Volatile ; pharmacology ; PC12 Cells ; Rats ; Rats, Sprague-Dawley