Objective To evaluate the feasibility and outcomes of robotic-assisted laparoscopic pyeloplasty in children .Methods A retrospective study was performed in patients who underwent robotic-assisted laparoscopic pyeloplasty ( Anderson-Hynes ) at our institution between January 2014 to August 2014.Totally 6 boys were diagnosed as left ureteropelvic junction obstruction depending on the symptoms and radiographic studies .The mean age was 9 years ( range 4 -12 years ) .Results The procedure was performed successfully without conversion to open surgery in all of the cases .Mean operative time was 216 min (range 175-269 min), with a mean robotic anastomosis time of 45 min (range 30-60 min).Mean estimated blood loss was less than 15 ml.The mean hospitalization was 4.5 days.Mean follow-up period was 10 months ( range 7 -14 months ) .There were no perioperative complications , and recovery was uncomplicated (without recurrence, pyelonephritis, nephrarctia) in all of the patients.Conclusion Robotic-assisted laparoscopic pyeloplasty can be safely performed in children older than 4-year-old with ureteropelvic junction obstruction .

Objective:To develop and verify a predictive model based on CT characteristics for predicting infected walled-off necrosis (IWON) in MSAP and SAP patients.Methods:The clinical and CT data of 1 322 patients diagnosed as MSAP and SAP according to the 2012 Atlanta revised diagnostic criteria in the First Affiliated Hospital of Naval Medical University from January 2015 to December 2020 were continuously collected. Finally, 126 patients who underwent enhanced CT scans within 3 days after admission and percutaneous catheter drainage of WON during hospitalization were enrolled. Among them, there were 63 MSAP and 63 SAP patients. According to the results of the culture from drainage fluid, the patients were divided into sterile walled-off necrosis group (SWON group, n=31) and infected walled-off necrosis group (IWON group, n=95). Patients were divided into training set (18 patients with SWON and 74 patients with IWON from January 2015 to December 2018) and validation set (13 patients with SWON and 21 patients with IWON from January 2019 to December 2020). Univariate and multivariate logistic regression analysis were performed to establish a model for predicting IWON. The model was visualized as a nomogram. The receiver operating characteristic curve (ROC) was drawn. The predictive efficacy of the model was evaluated by the area under the curve (AUC), sensitivity, specificity and accuracy, and the clinical application value was judged by decision curve analysis (DCA). Results:Univariate regression analysis showed that age, etiology, WON with bubble sign and the lowest CT value of WON were significantly associated with IWON. Multivariate logistic regression analysis showed that older age, biliary acute pancreatitis, WON with bubble sign, and the greater minimum CT value of WON were independent predictors for IWON. The formula for the prediction model was 0.12+ 0.01 age-0.75 hyperlipidemia-1.62 alcoholic-2.62 other causes+ 19.18 WON bubble sign+ 0.10 minimum CT value of WON. The AUC, sensitivity, specificity, and accuracy of the model were 0.85 (95% CI 0.76-0.94), 67.57%, 88.89%, and 71.74% in the training set and 0.78(95% CI0.62-0.94), 66.67%, 84.62%, and 73.53% in the validation set, respectively. The decision analysis curve showed that when the nomogram differentiated IWON from SWON at a rate greater than 0.38, using the nomogram could benefit the patients. Conclusions:The prediction model established based on CT characteristics might non-invasively and accurately predict the presence or absence of IWON in MSAP and SAP patients, and provide a basis for guiding treatment and evaluating prognosis.

Objective To analyze the genetic characteristics of chromosomes and related fusion genes in acute myeloid leukemia (AML) (non-M3), and to evaluate the prognosis of patients with chemotherapy of DA regimen with different doses of daunorubicin. Methods Fifty-six patients with newly diagnosed non-M3 AML from January 2013 to January 2015 were collected. Adopted short-term culture method was used to treat bone marrow, R-binding chromosome karyotyping was used to detect cytogenetic. Thirty-one types of fusion gene were identified by PCR and 10 % agarose gel electrophoresis. All patients treated by DA regimen were divided into group A, group B and group C according to different dosage of daunorubicin. Then, complete remission (CR) rate and survival time in the 3 groups were observed. The effect of cytogenetic and molecular biology abnormality on the chemotherapy, CR rate and overall survival (OS) of the 3 groups were analyzed by the chi-square test. Results Among the 56 patients, 18 cases (32.1%) had abnormal chromosome karyotype, 6 cases (10.7 %) had abnormal number of chromosome, 16 cases (28.6 %) had abnormal structure of chromosome, and 4 cases (7.1 %) had both abnormal number and structure of chromosome. Meanwhile, the most common abnormal structure was t(8;21), and the most common abnormal quantity were+8, -Y. Detective rate of genetic abnormality was raised to 62.00 % through fusion gene and chromosome karyotype analysis. The total CR rate of DA-induced chemotherapeutic regimen was 73.2 %, and the two-year OS rate was 42.9%. The remission rate of chemotherapy in the middle-risk group was significantly lower than that in the low-risk group (χ 2 = 8.976, P = 0.002), but there was no significant difference between the low-dose chemotherapy group and the standard dose chemotherapy group (P>0.05). The standard dose group showed a significant advantage in the OS rate (χ2= 8.045, P= 0.005). Conclusions Adult acute leukemia has its unique cytogenetic characteristics, which can assist in guiding clinical diagnosis, classification and prognosis. The prognosis of middle-risk patients is significantly lower than the low-risk group. Low-risk patients could benefit from a reduced dose of DA regimen, but the standard dose DA regimen has a significant advantage in long-term survival.

Objective:To analyze the MRI findings of solid pseudopapilloma of the pancreas (SPTs) and nonfunctional pancreatic neuroendocrine tumors (PNETs), and to establish and verify the prediction model of SPTs and PNETs.Methods:The clinical and MRI data of 142 patients with SPTs and 137 patients with PNETs who underwent surgical resection and were confirmed by pathology in the First Affiliated Hospital of Naval Medical University from January 2013 to December 2020 were collected continuously. Age, gender, body mass index (BMI), lesion size, location, shape, boundary, cystic change, T 1WI signal, T 2WI signal, enhancement peak phase, whether the enhancement degree was higher than that of pancreatic parenchyma in the enhancement peak phase, enhancement pattern, whether pancreatic duct and common bile duct were dilated, whether the pancreas shrank, and whether it invaded adjacent organs and vessels were recorded. According to the international consensus on prediction model modeling, patients were divided into training set (106 SPTs and 100 PNETs between January 2013 and December 2018), and validation set (36 SPTs and 37 PNETs between January 2019 and December 2020). The above characteristics of patients in training and validation set were analyzed by univariate and multivariate logistic regression, and a prediction model was established to distinguish SPTs and PNETs, and then visualized as a nomogram. The receiver operating characteristic curve (ROC) of the nomogram of training set and verification set was drawn, and the area under the curve (AUC), sensitivity, specificity and accuracy were calculated to evaluate the prediction efficiency of the model, and the clinical application value of the prediction model was evaluated by decision curve analysis (DCA). Results:Univariate regression analysis showed that there were significant differences on age, gender, lesion size, shape, cystic change, T 1WI signal, peak phase of enhancement, degree of enhancement in peak phase, pattern of enhancement and invasion of adjacent organs between SPTs group and PNETs group (all P value <0.05). Multivariate regression analysis showed that the older age, male patients, the smaller lesion, no high signal on T 1WI, the enhancement peak phase located in arterial phase or venous phase, and the enhancement degree in peak phase higher than that of pancreatic parenchyma were the six independent predictors of PNETs. The prediction model was established by using these six factors and visualized as a nomogram. The formula for predicting PNETs probability was 4.31+ 1.13×age+ 1.31×tumor size-1.29×female-4.18×high T 1WI signal+ 1.28×the enhancement degree higher than that of pancreatic parenchyma -4.69 ×enhancement peak in delay phase. The prediction model was visualized as a nomogram. The AUC values in the training set and validation set were 0.99(95% CI0.977-1.000) and 0.97 (95% CI 0.926-1.000), respectively. The sensitivity, specificity and accuracy in the training set are 98.00%, 94.34% and 96.12% and in the validation set were 86.49%, 97.22% and 91.78% respectively. The results of decision curve analysis show that the prediction model can accurately diagnose SPTs and PNETs. Conclusions:The prediction model established in this study can accurately differentiate SPTs from PNETs, and can provide important information for clinical decision and prognosis.

Objective:To investigate the MRI features of intraductal papillary mucinous tumor (IPMN) of the pancreas and establish a prediction model for predicting the malignancy risk.Methods:The clinical data of 260 IPMN patients who underwent MRI and pathological confirmed in the First Affiliated Hospital of Naval Medical University from October 2012 to April 2020 were retrospectively analyzed. According to the pathological results, all patients were divided into benign group (including IPMN with low-grade dysplasia) and malignant group (including IPMN with high grade dysplasia and invasive carcinoma). According to international consensus of prediction model modeling, patients were divided into training set and validation set in chronological order. A prediction model was developed based on a training set consisting of 193 patients (including 117 patients with benign IPMN and 76 patients with malignant IPMN) between October 2012 and April 2019, and the model was validated in 67 patients (including 40 patients with benign IPMN and 27 patients with malignant IPMN) between May 2019 and April 2020. The multivariable logistic regression model was adopted to identify the independent predictive factors for IPMN malignancy and establish and visualized a nomogram. The ROC was drawn and AUC was calculated. The decision curve analysis was used to evaluate its clinical usefulness.Results:The IPMN type, cyst size, thickened cyst wall, mural nodule size, diameter of main pancreatic duct (MPD) and the abrupt change in the caliber of the MPD with distal pancreatic atrophy in the training set and validation set, and jaundice and lymphadenopathy in the training set were significantly different between benign group and malignant group ( P<0.05). The multivariable logistic regression model of characteristics included the jaundice, cyst size, mural nodule size ≥5 mm, the abrupt change in caliber of the MPD with distal pancreatic atrophy were independent risk factors for IPMN maligancy. The model for predicting IPMN malignancy was -0.35+ 2.28×(jaundice)+ 1.57×(mural nodule size ≥5 mm)+ 2.92×(the abrupt change in caliber of the MPD with distal pancreatic atrophy)-1.95×(cyst <3 cm)-1.05×(cyst≥3 cm). The individualized prediction nomogram using these predictors of the malignant IPMN achieved an AUC of 0.85 (95% CI 0.79-0.91) in the training set and 0.84 (95% CI 0.74-0.94) in the validation set. The sensitivity, specificity and accuracy of the training set were 72.37%, 85.47% and 80.31%, respectively. The sensitivity, specificity and accuracy of the validation set were 81.48%, 75.00% and 77.61%, respectively. The decision curve analysis demonstrated that when the IPMN malignancy rate was >0.16, the nomogram diagnosing IPMN could benefit patients more than the strategy of considering all the patients as malignancy or non-malignancy. Conclusions:The nomogram based on MRI features can accurately predict the risk of malignant IPMN, and can be used as an effective predictive tool to provide more accurate information for personalized diagnosis and treatment of patients.

Timely removal of oxidatively damaged proteins is critical for cells exposed to oxidative stresses; however, cellular mechanism for clearing oxidized proteins is not clear. Our study reveals a novel type of protein modification that may play a role in targeting oxidized proteins and remove them. In this process, DSS1 (deleted in split hand/split foot 1), an evolutionally conserved small protein, is conjugated to proteins induced by oxidative stresses in vitro and in vivo, implying oxidized proteins are DSS1 clients. A subsequent ubiquitination targeting DSS1-protein adducts has been observed, suggesting the client proteins are degraded through the ubiquitin-proteasome pathway. The DSS1 attachment to its clients is evidenced to be an enzymatic process modulated by an unidentified ATPase. We name this novel protein modification as DSSylation, in which DSS1 plays as a modifier, whose attachment may render target proteins a signature leading to their subsequent ubiquitination, thereby recruits proteasome to degrade them.
Free Radicals ; metabolism ; HeLa Cells ; Humans ; Oxidation-Reduction ; Oxidative Stress ; genetics ; Proteasome Endopeptidase Complex ; genetics ; metabolism ; Protein Binding ; Protein Modification, Translational ; genetics ; Ubiquitin ; metabolism ; Ubiquitination ; genetics

OBJECTIVETo investigate the expression of long noncoding RNA linc00261 in hepatocellular carcinoma (HCC) and its correlation with the clinicopathological features and postoperative outcomes of the patients.

METHODSReal-time fluorescence quantitative PCR (qRT-PCR) was used to detect the expression of linc00261 in surgical specimens of HCC and adjacent tissues from 74 patients. The correlation of the expression level of linc00261 in HCC with the clinicopathological parameters of the patients was analyzed using Chi-square test. The Cox's proportional hazards regression model was used to assess the value of linc00261 in predicting the prognosis of HCC patients after operation. The expression of linc00261 was also examined in 5 HCC cell lines using qRT-PCR. The HCC cell lines MHCC-LM3 and SNU-449 were transfected with small interfering RNAs targeting linc00261 for linc00261 knockdown, and the changes in the cell proliferation, migration and invasion abilities were observed using CCK-8 assay and Transwell assay.

RESULTSThe expression level of linc00261 in HCC was significantly correlated with AFP (=0.032), tumor size (=0.007), microscopic vascular invasion (MVI; =0.01), and TNM stage (=002). The patients with lowered expressions of linc00261 in HCC tissues had a significantly shortened tumor-free survival time ( < 0.05), and a lowered expression of linc00261 was identified as an independent risk factor affecting postoperative recurrence-free survival time of the patients ( < 0.05). In HCC cell lines MHCC-LM3 and SNU-449 cells, linc00261 knockdown obviously promoted the cell migration and invasion ( < 0.01) but did not significantly affect cell proliferation ( > 0.05).

CONCLUSIONSLinc00261 may serve as a new prognostic biomarker for predicting the postoperative outcomes of the patients with HCC.

BACKGROUNDThere are limited eligible clinical markers at present to monitor the progress of chronic myeloid leukemia (CML). Heme oxygenase-1 (HO-1), as one of the most important oxidation-regulating enzymes in vivo, suggests the onset and progression of cancer when highly expressed. Furthermore, HO-1 level is related with the occurrence and development of hematological diseases. But the relationship between HO-1 expression and progression/relapse of CML has seldom been studied hitherto. This study aimed to investigate the relationship between them to find out a new molecular marker for prediction.

METHODSA total of 60 peripheral blood and bone marrow (BM) samples from 25 CML patients in different phases were collected respectively to detect the expressions of HO-1 and bcr/abl using real-time PCR. Routine blood test was performed to detect the changes of leukocyte and platelet counts. The proportion of primitive cells in BM was detected by flow cytometry. The relationship between high HO-1 expression and CML progression and relapse was explored by the analysis of variance by Wilcoxon test and linear regression analysis. The diagnostic accuracy and cutoff values were determined by receiver operating characteristic curve.

RESULTSRelative expression of HO-1 mRNA in CML patients peripheral blood was significantly higher than that of donors (P < 0.0001), which were 0.57±3.78 and (1.417±1.125)×10(-6), respectively. HO-1 expression level in CML patients was 0.061 5±0.062 4, which decreased to 0.009 4±0.006 7 upon CMoR, and remained remarkably higher 0.016 3±0.017 5 than that of normal donors (1.417±1.125)×10(-6), P < 0.001. When relapse occurred, HO-1 expression significantly increased from 0.020 6±0.021 0 to 3.852±10.285 in CMoR stage and undergoing relapse. According to progression of CML, HO-1 expression level in CML patients increased from CP (0.009 5±0.017 6) to AP (0.028 0±0.055 7) and then to BP (0.276 7 ± 0.447 0). And there was a linear correlation between HO-1 expression and proportion of primitive CML cells. The diagnostic accuracies and cutoff values of HO-1 expression for CML-CP, CML-AP, and CML-BP were 1.0, 0.748, and 0.965, respectively, as well as 0.000 070, 0.001 917, and 0.020 696, respectively.

CONCLUSIONHO-1 may be a potential molecular indicator for the progression and relapse of CML.

Bone Marrow ; metabolism ; Female ; Flow Cytometry ; Gene Expression ; Heme Oxygenase-1 ; blood ; genetics ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; diagnosis ; enzymology ; pathology ; Male ; Predictive Value of Tests ; Real-Time Polymerase Chain Reaction

BACKGROUNDOveractive bladder (OAB) is a series of symptoms with high prevalence in elderly people. This study was conducted using the overactive bladder symptom score (OABSS) to evaluate the efficacy of solifenacin succinate for the treatment of OAB.

METHODSThis was a prospective, multicenter, single-arm, 12-week study that enrolled 241 OAB patients. The patients received 5-10 mg/day solifenacin. Changes in OABSS, symptoms from voiding diary, perception of bladder condition (PPBC) score, international prostate symptom score (IPSS) and quality of life (QOL) were evaluated at weeks 0, 4, and 12. The relationship between OABSS and PPBC score or parameters of voiding diary was also evaluated.

RESULTSAt baseline, the mean OABSS for all patients was 9.41 ± 2.40, and was reduced significantly at week 12 (-3.76 points; 61.21%, P < 0.0001). The OABSS subscore, PPBC score, IPSS, and QOL were also significantly reduced during the study (P < 0.0001). The overall incidence of adverse events was 19.91% (44 cases). The gastrointestinal system was the most commonly affected (11.31%). Around 5.88% of the cases had adverse events related to the genitourinary system. There was a strong correlation between OABSS and urinary symptoms that was recorded in the 3-day voiding dairy.

CONCLUSIONSWe showed that solifenacin was clinically effective for relieving OAB symptoms, considering the balance between efficacy, patients' well-being, and tolerability. OABSS integrates four OAB symptoms into a single score and can be a useful tool for research and clinical practice.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Muscarinic Antagonists ; therapeutic use ; Prospective Studies ; Quality of Life ; Quinuclidines ; therapeutic use ; Solifenacin Succinate ; Tetrahydroisoquinolines ; therapeutic use ; Treatment Outcome ; Urinary Bladder, Overactive ; drug therapy