Objective To investigate the expression of p27 kip1 protein in prostatic intraepithelial neoplasia cells. Methods In 22 human prostatic samples, the expression of p27 kip1 protein in high grade prostatic intraepithelial neoplasia cells was evaluated by using immunohistochemical analysis. Results The expression of p27 kip1 in prostatic intraepithelial neoplasia cells was weaker than in adjacent prostatic epithelial cells in all the 22 prostate samples. Conclusions Decrease of the p27 kip1 expression may play a role in the development of PIN which may be an premalignant lesion.

Extranodal lymphomas (ENLs) comprise about a third of all non-Hodgkin lymphomas (NHL).Radiation therapy (RT) is frequently used as either primary therapy (particularly for indolent ENL),consolidation after systemic therapy,salvage treatment,or palliation.The wide range of presentations of ENL,involving any organ in the body and the spectrum of histological sub-types,poses a challenge both for routine clinical care and for the conduct of prospective and retrospective studies.This has led to uncertainty and lack of consistency in RT approaches between centers and clinicians.Thus far there is a lack of guidelines for the use of RT in the management of ENL.This report presents an effort by the International Lymphoma Radiation Oncology Group (ILROG) to harmonize and standardize the principles of treatment of ENL,and to address the technical challenges of simulation,volume definition and treatment planning for the most frequently involved organs.Specifically,detailed recommendations for RT volumes are provided.We have applied the same modern principles of involved site radiation therapy as previously developed and published as guidelines for Hodgkin lymphoma and nodal NHL.We have adopted RT volume definitions based on the International Commission on Radiation Units and Measurements (ICRU),as has been widely adopted by the field of radiation oncology for solid tumors.Organ-specific recommendations take into account histological subtype,anatomy,the treatment intent,and other treatment modalities that may be have been used before RT.

Male infertility microsurgery represents the fastest growing sub-specialty in urology and clinical andrology over the past two decades. The importance of microsurgery for male infertility has risen as a part of the urologist's armamentarium in the medical and surgical management of male infertility. Despite the advances in male infertility microsurgery in China, the lack of standardized and well-organized training programs for male infertility microsurgery remains a serious problem affecting its development. In this article, Zhao and Peng have shared their experience with the learning curve of male infertility microsurgery at the Center for Male Reproductive Medicine and Microsurgery, Weill Medical College of Cornell University, which centers on how to pay attention to the details and basic principles of microsurgery. Male infertility microsurgery is physically, technically and mentally challenging, and must be first learned in the laboratory. Clinical success depends heavily upon appropriate training in a microsurgical laboratory. Good training can significantly reduce operation time and surgical errors as well as improve the quality of outcomes.
Andrology ; education ; Humans ; Infertility, Male ; surgery ; Male ; Microsurgery ; education

OBJECTIVEWidely pacemaker/implantable cardioverter defibrillator (ICD) implantation is also related to an increasing need for transvenous lead extraction. Understanding the location and extent of pathological changes, including adhesions and fibrous tissue formation along the course of chronic pacemaker/ICD leads, are essential for operators performing lead extraction operations in order to reduce the potential life threatening complications.

METHODSThree parts are included in the research, pathological examination on 83 extracted pacemaker/ICD leads using excimer laser technique from March 2008 to March 2011, autopsy examination of one died patient during lead extraction for lead-related infective endocarditis, and anatomical analysis on pacemaker/ICD leads from 10 patients died of other non-cardiac causes.

RESULTSExtensive encapsulated fibrous tissue around the leads and extensive adhesion/fibrosis along the course of the leads from venous entry site to the lead/myocardial interface could be detected on transvenous pacemaker/ICD leads. Since the tissue at the junction between superior vena cava (SVC) and right atrium (RA) is very thin, free of pericardium, thus, this is a common place for extensive adhesion/fibrosis and myocardial perforation/tear during lead extraction, which accounted for one death during extraction in our cohort. Extensive adhesion and fibrosis were also observed at the tricuspid valve and subvalvular structures. Leads implanted to the right ventricular apex were close to the epicardial surface and prone to perforation through myocardium. It is common to observe thrombus on the leads or at the interface between leads and myocardial tissue, especially at right atrial appendage (RAA) at the site of lead insertion.

CONCLUSIONExtensive adhesions and fibrosis can be commonly seen along the course of pacemaker/ICD leads, and at SVC to RA junction, the tricuspid valve/subvalvular structures, and RA/RV lead interface. The tissue at SVC to RA junction is very thin, making it vulnerable for myocardial perforation/tear during lead extraction. Thrombus is commonly seen along the leads or at the lead-tissue interface.

Defibrillators, Implantable ; adverse effects ; Device Removal ; Fibrosis ; Heart Atria ; pathology ; Heart Ventricles ; pathology ; Humans ; Lasers, Excimer ; Myocardium ; pathology ; Pacemaker, Artificial ; adverse effects ; Thrombosis ; pathology ; Vena Cava, Superior ; pathology

OBJECTIVEGlucocorticoid can induce apoptosis by regulating some genes' expression, but its effect on the pro-apoptotic protein Puma in leukemia remains unclear. This study was designed to investigate the effect of glucocorticoid on the expression of Puma in glucocorticoid-induced apoptosis of acute lymphoblastic leukemia cells in vitro.

METHODSLeukemia cells from acute lymphoblastic leukemia patients were transplanted into the immunodeficient mice. The transplanted leukemia cells were collected and then were treated with dexamethasone at the final concentration of 1 microM. The expression of Puma protein and mRNA in leukemia cells after dexamethasone treatment was detected by Western Blot and real-time quantitative PCR. A drug sensitive test was performed by MTT assay.

RESULTSThe leukemia cells which came from the patients who had good clinical outcomes were sensitive to dexamethasone, while the ones from the patients who had poor clinical outcomes were resistant to dexamethasone in vitro. The sensitivity to dexamethasone in vitro between the resistant and sensitive leukemia cells was significantly different (P < 0.05). No upregulation of Puma protein and mRNA was detected in resistant and sensitive leukemia cells after dexamethasone treatment.

CONCLUSIONSGlucocorticoid can not upregulate the expression of Puma in glucocorticoid-induced apoptosis of acute lymphoblastic leukemia cells in vitro.

Animals ; Apoptosis ; drug effects ; Apoptosis Regulatory Proteins ; analysis ; genetics ; Dexamethasone ; pharmacology ; Gene Expression Regulation, Leukemic ; drug effects ; Humans ; Mice ; Neoplasm Transplantation ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; metabolism ; pathology ; Proto-Oncogene Proteins ; analysis ; genetics ; RNA, Messenger ; analysis ; Transplantation, Heterologous

HIV/STIs remain a major global public health problem. One of the global strategies for the prevention and control of HIV/STIs is to interrupt their transmission, which requires the public health methods based on scientific evidence and cost-effectiveness. The scale-up of male circumcision services in the priority countries of the HIV-prevention project in sub-Saharan Africa has been hampered by the scarcity of trained providers and relative technical difficulty of male circumcision techniques recommended by WHO and UNAIDS. Shang Ring is an innovative and disposable device for male circumcision, which has been safely used for over 600 000 males in China since 2006. Clinical studies of more than 3 000 cases of Shang Ring circumcision in China, Kenya, Zambia, and Uganda have demonstrated its safety, effectiveness, acceptability and ease of use. The most obvious advantages of Shang Ring include short procedure time (3-6 min), excellent postoperative cosmesis, low rate of complications, high acceptance by clients and providers, ease of use, and standardization for reliable performance. As an innovative technique, Shang Ring has a great potential for facilitating the safe and effective scale-up of circumcision services. This article comprehensively reviews the clinical studies of Shang Ring male circumcision in China and Africa.
Africa ; China ; Circumcision, Male ; instrumentation ; methods ; HIV Infections ; prevention & control ; Humans ; Male

Objective To study the separate and combined effects of environment,lifestyle,physical characteristics,blood biomarkers and genetic factors on aetiology of major chronic diseases in adult Chinese.Methods China Kadoorie Biobank (CKB) is a large blood-based prospective cohort study.The baseline survey took place in 5 urban and 5 rural areas across China during 2004-2008,with collection of data through questionnaire,physical examination and blood samples.Following the baseline survey,5％ of the randomly selected participants were surveyed in 2008,and repeated every 4-5 years.All participants would be followed for cause-specific mortality and morbidity through registries and for any hospital admission through linkages with health insurance databases.Results Overall,512 891 adults aged 30-79 years (mean 51.5) were recruited,including 41.0％ men and 55.9％ from rural areas.Blood collection was successfully done in 99.98％ of the participants.The prevalence of current regular smoking was 61.3％ in men and 2.4％ in women.The prevalence of regular alcohol consumption (i.e.,weekly) was 33.4％ in men and 2.1％ in women.At the baseline,41.8％ of men and 45.3％ of women were overweight or obese (i.e.,BMI≥24.0 kg/m2) and 32.2％ of men and 30.2％ of women were hypertensive (i.e.,SBP≥140 mm Hg or DBP≥90 mm Hg).For each of the main baseline variables,there were large variations on age,sex and areas of study.Conclusion CKB seemed to be a powerful and rich resource in studying the environmental and genetic determinants of major chronic diseases in the Chinese population.

The HLA B*58:01 allele has been worldwide reported as a pharmacogenetic susceptibility to allopurinol-induced severe cutaneous adverse reactions (SCARs). To prevent these life-threatening conditions, the American College of Rheumatology hingly recommended that the HLA-B*58:01 be screened prior to the initiation of allopurinol therapy. Therefore, we developed a rapid, robust, inexpensive screening method using SYBR® Green real time PCR to detect the HLA-B*58:01 allele. A total of 119 samples were tested. The assay has a sensitivity of 100% (95% CI: 69.15%-100%), a specificity of 100% (95% CI: 96.67%-100%), a positive predictive value of 100% (95% CI: 69.15%-100%) and a negative predictive value of 100% (95% CI: 96.67%-100%). HLA-B*58:01 genotyping results showed 100% agreement with those obtained from Luminex SSO/SBT/SSP. The lowest limit of detection of this method is 0.8 ng/µL of DNA. The unit cost of the test is only $3.8 USD. This novel screening test using SYBR® real time PCR would be appropriate to identify individuals with the HLA-B*58:01 allele for the prevention of allopurinol-induced SCARs.
Alleles* ; Allopurinol ; Cicatrix ; DNA ; HLA-B Antigens ; Limit of Detection ; Mass Screening* ; Methods* ; Real-Time Polymerase Chain Reaction ; Rheumatology ; Sensitivity and Specificity ; Stevens-Johnson Syndrome

Objective To study the effect of lateral wedge insoles with different stiffness on the knee adduction moment (KAM) under walking condition.Methods The gait of 15 healthy males wearing lateral wedge insoles with different stiffness was tested.The kinetics and kinematics data were collected by optical motion capture system and ground reaction force platform.The KAM and its peak values were calculated by Visual 3D software.The differences in peak KAM under 3 walking conditions (shoes only,shoes with softer or harder lateral wedge insoles) were analyzed.Results Compared with walking with the softer lateral wedge insoles,walking with the harder lateral wedge insoles could reduce the 1st and 2nd peak KAM by 9.3％ and 9.7％,respectively,with significant statistic differences.Conclusions Increasing some stiffness of lateral wedge insoles can further reduce the pressure and wear on medial compartment of the knee joint,which may relieve the symptom of knee osteoarthritis.

INTRODUCTION: The COVID-19 pandemic has affected the world for more than a year, with multiple waves of infections resulting in morbidity, mortality and disruption to the economy and society. Response measures employed to control it have generally been effective but are unlikely to be sustainable over the long term. METHODS: We examined the evidence for a vaccine-driven COVID-19 exit strategy including academic papers, governmental reports and epidemiological data, and discuss the shift from the current pandemic footing to an endemic approach similar to influenza and other respiratory infectious diseases. RESULTS: A desired endemic state is characterised by a baseline prevalence of infections with a generally mild disease profile that can be sustainably managed by the healthcare system, together with the resumption of near normalcy in human activities. Such an endemic state is attainable for COVID-19 given the promising data around vaccine efficacy, although uncertainty remains around vaccine immunity escape in emergent variants of concern. Maintenance of non-pharmaceutical interventions remains crucial until high vaccination coverage is attained to avoid runaway outbreaks. It may also be worthwhile to de-escalate measures in phases, before standing down most measures for an endemic state. If a variant that substantially evades immunity emerges, it will need to be managed akin to a new disease threat, with pandemic preparedness and response plans. CONCLUSION An endemic state for COVID-19, characterised by sustainable disease control measures, is likely attainable through vaccination.
COVID-19 ; Disease Outbreaks/prevention & control* ; Humans ; Influenza, Human/prevention & control* ; Pandemics/prevention & control* ; SARS-CoV-2