Objective To compare the clinical efficacy of subinguinal microsurgical and single -port laparoscopic high ligation in the treatment of varicocele.Methods 218 patients with varicocele were enrolled in this study.According to the digital table,they were randomly divided into two group.148 cases were treated by subinguinal microscopic varicocelectomy(microscopic group),70 cases were treated by single -port laparoscopic high ligation varicocele(single -port laparoscopic group).Postoperative follow up was 3 -24months.The operative duration,length of hospital stay,hospitalization expense,postoperative complications and semen quality parameters were compared between the two groups.Results There were statistically significant differences in operative duration and hospitalization expense between the two groups(all P <0.05).There was no statistically significant difference in length of hospital stay (P >0.05).In the 218 followed -up patients,the sperm concentration and motility (grade a + b sperm)all significantly improved,which of the microscopic group and single -port laparoscopic group preoperation were (19.1 ± 8.2)×106 /mL,(18.2 ±7.9)×106 /mL and (22.7 ±7.8)%,(21.6 ±8.9)% respectively,which at 3 -6 months after operation were (56.2 ±10.8)×106 /mL,(45.8 ±12.9)×106 /mL and (58.8 ±9.7)%,(44.6 ±10.7)%, there were statistically significant differences compared with preoperation (t =6.227,9.579,all P <0.05 ). Conclusion The surgical methods in the treatment of varicocele can improve the quality of patients,but microscopic group is obviously better than single -port laparoscopic group in improvement of semen quality parameters,safety, patient -based compliance and economy.

Objective To evaluate the role of emergency and staged hepatectomy in peritoneal metastasis associated with ruptured hemorrhage of resectable hepatocellular carcinoma (HCC) patients,and investigate the impact of surgery timing-selecting on peritoneal metastasis of postoperative HCC patients.Methods A retrospective analysis was conduct on the pooled data from 38 HCC patients with spontaneously ruptured hemorrhage treated in our hospital from August 2011 to January 2016.These patients were divided into emergency group who underwent hepatectomy within 24 hours at admission,and staged group who underwent the procedure one week after admission.Perioperative events,overall survival (OS) and disease-freesurvival (DFS) rates,incidence of recurrent and metastatic disease were compared between the two groups.Results The perioperative blood loss and transfusion were much more in emergency group than staged group (both P ＜ 0.05).Nevertheless,the incidence of postoperative mortality was not significantly different (6.0％ vs 0％,P ＞ 0.05).The median survival was 22.5 months in emergency group versus 14.2 months in staged group.The 6-month,1-year,3-year OS rates in emergency group were 88.2％,82.4％ and 30.3％ respectively,and 6-month,1-year,3-year DFS rates were 81.3％,54.7％ and 27.3％.The 1-year OS and 6-month DFS rates were higher than those of staged group (both P ＜ 0.05).The incidence of peritoneal metastasis in staged group was higher than that in emergency group,but it was not significantly different (38.1％ vs 29.4％,P ＞ 0.05).Univariate and multivariate analysis indicated that tumor diameter ≥ 10 cm and AFP ＞ 10 000 μg/L were the risk factors for peritoneal metastasis after hepatectomy for HCC patients with spontaneously ruptured hemorrhage.Conclusions Emergency hepatectomy would warrant a better short-term prognosis compared with staged hepatectomy for the HCC patients with spontaneously ruptured hemorrhage.Staged hepatectomy would not raise the possibility of postoperative peritoneal metastasis.The predictors of tumor diameter ≥ 10 cm and AFP ＞ 10 000 μg/L were risk factors for peritoneal metastasis after hepatectomy for spontaneously ruptured HCC patients.

Objective To summarize the clinical experience and analyze the efficacy of transurethral plasma needle electrode en bloc resection for bladder cancer.Methods From February 2015 to August 2016,a total of 26 patients,including 21 males and 5 females,with bladder cancer received transurethral plasma needle electrode en bloc resection of bladder tumor.Their age ranged from 42 to 75 years,mean (56 ± 13) years.The size of tumor ranged from 1 to 4 cm,mean (2.3 ± 1.6) cm.The solitary tumor was found in 19 cases and multiple tumors were found in 7 cases,including 2 tumors in 5 cases,3 tumors in 2 cases.In 6 cases,the tumor located in the lateral bladder wall.All the pre-operative biopsy showed the urethelial carcinoma in all cases,No bladder extravasion or upper urinary tumor was noticed in the CTU before surgery.By using the electrode needle tip inserted into the bladder mucosa,blunt release or cut the tumor bases until the deep muscularis or the serosal layer,complete removal of the tumor.The specimen was removed from the bladder and sent to the pathological examination.The operation time,the volume of blood loss during operation,surgical complications,pathological diagnosis and the wounds recovery were recorded and analyzed.Results All surgeries were undergone successfully.Totally 35 tumors were resected with diameter of 1.0-4.0 cm,mean (2.3 ± 1.6)cm.The estimated blood loss was less than 10 ml.The operative duration ranged from 20 to 50 min,mean (30 ± 16)min.The duration for removing the single tumor ranged from 5 to 25 min.No obturator nerve reflex were observed during surgery.No blood loss and complications occurred after operation.All patients received 30 mg pirarubicin bladder instillation chemotherapy immediately and no adverse reaction was noticed.Postoperative pathological stages of enrolled cases were distributed as 33 cases of T1G1 staging,2 cases of T1G3 staging.No positive margin was observed.3 months after operation,cystoscopy showed that the wound healed well.A total of 26 cases followed up for 3-10 months (mean 6.0 ± 2.3 months).No one developed recurrence.Conclusions Transurethral plasma needle electrode en bloc resection of bladder tumor would reduce the incidence of complications and obturator nerve reflex.It can provide sufficient specimens for histological diagnosis.

Objective To compare the efficacy of three endoscopic surgery in impacted upper ureteral calculi treatment.Methods 218 patients with impacted upper ureteral calculi were treated with minimally invasive percutaneous nephrolithotomy (MPCNL),transurethral ureteroscope lithotripsy(URL)and retroperitoneal laparoscopic urerolithotomy (RLU)respectively.The operation safety,efficacy and complication were compared in the three groups.Results In the MPCNL group,URL group,RLU group one success rate of lithotripsy were 100.00%,85.19%,100.00% respec-tively.The mean operative time were (76.35 ±16.20)min,(46.26 ±15.30)min,(89.20 ±19.60)min respectively. Decreased hemoglobin values were (22.24 ±8.63)g/L,(4.15 ±1.89)g/L,(10.68 ±4.55)g/L respectively.The stone -free rates of one month postoperation were 96.32%,79.59%,100.00%.Length of hospital stay were (8.56 ± 2.13)d,(6.58 ±1.76)d,(9.79 ±2.14)d,respectively,the differences were statistically significant(t/χ2 =36.916, 27.629,all P <0.05).Conclusion MPCNL and URL for impacted upper ureteral calculi is safety and has good efficacy and less complications,but the MPCNL is recommended the first choice,some cases can try URL.

In this study,the effects of pirrolidine dithiocarbamate (PDTC) plus leflunomide (Lef) models were investigated.NIH mice and Wistar rats served as donors and recipients respectively.Mouse-to-rat cardiac xenotransplantation was performed.The recipients were divided into 5 groups:group A (the control group),group B (PDTC group),group C (PDTC plus CsA group),group D (PDTC plus Lef group) and group E (PDTC plus Lef and CsA group).The expressions of IKKα/β,by immunohistochemistry and Western blot as well as electrophoretic mobility shift assay (EMSA).The median survival time of cardiac xenografts in the control group,PDTC group,PDTC plus CsA group,PDTC plus Lef group and PDTC plus Lef and CsA group was (2.17±0.41),(2.33±0.52),(4.67±1.21),(7.00±1.79) and (9.00±1.41) days respectively.The survival time of xenografts in the PDTC plus Lef and CsA group was significantly longer than that in other four groups (P<0.05 for all),that in the PDTC plus Lef group longer than that in the control group,PDTC group and PDTC plus CsA group (P<0.05 for all),that in PDTC plus CsA group longer than the control group and PDTC binding activity were notably increased in mouse-to-rat cardiac xenografts.The expressions were decreased in the control group,PDTC group,PDTC plus CsA group,PDTC plus Lef and PDTC plus Lef and CsA group in turn.It was concluded that PDTC plus Lef and CsA can significantly suppress prolonging the survival of the cardiac xenografts.

Objective To investigate the clinical therapeutic effect of sigmoid neobladder after laparoscopic radical cystectomy in the treatment of invasive bladder cancer .Methods 21 patients with invasive bladder cancer accepted sigmoid neobladder after laparoscopic radical cystectomy and pelvic lymphadenectomy .The postoperative complications and clinical therapeutic effect were analyzed .Results All surgeries were completed successfully .The operation time was (245 ±125) min,blood lost was (98 ±45) mL.All the 21 patients were followed up for 3-24 months,mean of 12 months.Both side mild hydronephrosis in 6 cases (28.6%) and unilateral hydronephrosis in 1 case(0.5%).Average bladder reservoir was (548.8 ±221.6)mL,the maximum bladder pressure during the new bladder urine storage period was (2.26 ±0.24) kPa,the maximum bladder pressure during voiding period was (6.18 ±0.29) kPa,volume of residual urine was (87 ±52) mL.The mean maximum uroflow rate was (83.2 ± 5.6)mL/s.The continence of micturition was 90.4% in day-time and 76.1% in night-time.1 case had urethral stricture and got better after the urethral dilatation .Conclusion The sigmoid neobladder after laparoscopic radical cystectomy has more reliable results,without serious postoperative complications and patients with high quality of life after operation.This operation may be applied in clinical practice .

Objective To investigate the expression of proline rich tyrosine kinase 2 (Pyk2) in non-muscle invasive bladder cancer,and analyze its correlation to clinicopathologic features and prognosis of non-muscle invasive bladder cancer.Methods 114 surgical specimens and 50 normal bladder mucosa specimens were collected from 114 non-muscle invasive bladder cancer patients who underwent TURBT at our hospital,from June 2013 to March 2018.Of the 114 patients,63 were male and 51 were female,aged 42-87 years,average age of (63.6 ± 13.8) years,73 cases of tumor ＜3 cm,41 cases of tumor ≥3 cm,83 cases were single and 31 cases were multiple tumor,53 cases were high grade and 61 cases were low grade,59 cases were Ta and 55 cases were T1 stage.Pyk2 protein expression was detected by immunohistochemistry and western blot.The correlation of the expression of Pyk2 with clinicopathologic features,including gender,age,tumor size,the number of tumors,histological grade and clinical stage were analyzed.Survival analysis was calculated by using the Kaplan-Meier method,and the difference in survival curve was analyzed by using the log-rank test.Association of Pyk2 expression with prognosis of non-muscle invasive bladder cancer analyzed by using the Cox proportional hazards regression model.Results Compared with normal bladder tissues,expression of Pyk2 protein was increased in bladder cancer tissue significantly(0.571 ±0.230 vs.0.253 ± 0.152,P ＜0.01).The expression of Pyk2 protein was closely related to clinical stage(P =0.027) and grade(P =0.010),rather than gender (P =0.275),age (P =0.419),tumor size (P =0.317),and tumor number(P =0.208).The recurrence rate in the Pyk2 positive group and negative group were 46.1％ (35/76)and 28.9％ (11/38)respectively.The progression rate in the Pyk2 positive group and negative group were 35.5％ (27/76) and 10.5 ％ (4/38) respectively.Survival analysis suggested expression of Pyk2 in non-muscle invasive bladder cancer had a significant relation to recurrence-free survival rate(P ＜0.001) and progression-free survival rate(P =0.003).In the multivariable Cox analysis,we found that Pyk2 protein was an independent predictor of recurrence-free survival rate(HR 0.245,95％ CI 0.078-0.768,P =0.016) and progression-free survival rate (HR 0.095,95％ CI 0.012-0.764,P =0.027).Conclusions The expression of Pyk2 in non-muscle invasive bladder cancer was significantly increased.The expression of Pyk2 has a significant relation to recurrence and progression of non-muscle invasive bladder cancer.High Pyk2 expression is an independent prognostic factor in non-muscle invasive bladder cancer.

Objective To investigate the effect of blue light on the dioptric development of the eyes of lens-induced myopia(LIM)guinea pigs.Methods Three-week-old trichromatic guinea pigs were randomly divided into three groups:control group,white light LIM(WL)group,and blue light LIM(BL)group(420 nm LED light,with an illuminance of 700 lx);guinea pigs in the latter two groups wore-10.00 D lenses in their right eyes to induce myopia.All guinea pigs under-went a 12 h light/12 h dark treatment cycle.Before and 2,4 weeks after the intervention,the diopter,axial length,retinal thickness and choroidal thickness were measured in all groups.After 4 weeks of intervention,the corneal fluorescent stai-ning and retinal Hematoxylin and Eosin(HE)staining were conducted.Results Compared with the control group,from week 0 to week 2 of the intervention(changes in weeks 0-2),the eyes in the WL group drifted(-2.22±1.28)D towards myopia,the axial length lengthened by(0.40±0.05)mm,and the retinal and choroidal thicknesses reduced by(-7.42± 7.04)μm and(-6.29±4.66)μm,respectively;compared with the WL group,in the BL group,the eyes drifted toward hyperopia by(0.48±1.16)D,the axial length increased by(0.20±0.10)mm,and retinal and choroidal thicknesses in-creased by(1.36±7.46)μm and(8.05±8.08)μm,respectively(all P＜0.05).From week 2 to week 4(changes in weeks 2-4),compared with the control group,the diopter in the WL and BL groups progressed towards myopia,with changes of(-4.64±0.50)D and(-2.11±2.02)D,respectively(both P＜0.05);the axial length lengthened,and reti-nal and choroidal thicknesses reduced in the WL group,with changes of(0.44±0.06)mm,(-7.35±5.87)μm and(-4.84±2.61)μm,while the choroidal thickness and the retinal thickness decreased in the BL group,with changes of(-0.33±5.95)μm and(-4.78±4.96)μm,respectively.Observations of corneal fluorescence staining and retinal HE staining indicated that prolonged blue light exposure could lead to damage to corneal and retinal cells.Conclusion Blue light may influence the development of myopia through choroid-related mechanisms,but its inhibitory effect is not positive-ly correlated with time.Prolonged exposure to blue light can damage the cornea and retina,thereby reducing the inhibitory effect.

The complex function of the brain depends on the interaction of its intrinsic neurons and neural network systems,in which glutamatergic projection neurons and GABAergic inhibitory interneurons play an important role.There is a critical period in the postnatal development of the visual system when it is susceptible to the external environment,which may affect visual plasticity.Changes in the visual environment can lead to adaptive adjustment in neural connections and synaptic structures among visual cortexes,and the perineural network in the extracellular matrix has been proven to play an essential role in this process.The parvalbumin-positive inhibitory interneurons(PV+INs)contained in the perineural net-works are also involved in regulating plasticity during the critical period of visual development.PV+INs are a kind of inter-neurons that express the parvalbumin found in various parts of the brain.Recent studies have demonstrated that specific modulation of these neurons not only reveals some potential therapeutic mechanisms for disorders such as amblyopia,de-pression and autism but also provides a more precise treatment for these diseases.In this paper,various regulatory factors of PV+INs from their origin to the end of the critical period of visual development and their involvement in visual develop-mental plasticity were reviewed,with the aim of providing some guidance for basic research on visual cortical plasticity.

Ketone bodies have beneficial metabolic activities, and the induction of plasma ketone bodies is a health promotion strategy. Dietary supplementation of sodium butyrate (SB) is an effective approach in the induction of plasma ketone bodies. However, the cellular and molecular mechanisms are unknown. In this study, SB was found to enhance the catalytic activity of 3-hydroxy-3-methylglutaryl-CoA synthase 2 (HMGCS2), a rate-limiting enzyme in ketogenesis, to promote ketone body production in hepatocytes. SB administrated by gavage or intraperitoneal injection significantly induced blood ß-hydroxybutyrate (BHB) in mice. BHB production was induced in the primary hepatocytes by SB. Protein succinylation was altered by SB in the liver tissues with down-regulation in 58 proteins and up-regulation in 26 proteins in the proteomics analysis. However, the alteration was mostly observed in mitochondrial proteins with 41% down- and 65% up-regulation, respectively. Succinylation status of HMGCS2 protein was altered by a reduction at two sites (K221 and K358) without a change in the protein level. The SB effect was significantly reduced by a SIRT5 inhibitor and in Sirt5-KO mice. The data suggests that SB activated HMGCS2 through SIRT5-mediated desuccinylation for ketone body production by the liver. The effect was not associated with an elevation in NAD⁺/NADH ratio according to our metabolomics analysis. The data provide a novel molecular mechanism for SB activity in the induction of ketone body production.
Mice ; Animals ; Butyric Acid/metabolism* ; Ketone Bodies/metabolism* ; Liver/metabolism* ; Hydroxybutyrates/metabolism* ; Down-Regulation ; Sirtuins/metabolism* ; Hydroxymethylglutaryl-CoA Synthase/metabolism*