Objective:To evaluate the expression and clinical significance of γ-glutamylcyclotransferase (GGCT) in patients with bladder urothelial cell carcinoma.Methods:Immunohistochemical staining for GGCT were performed on tissue sections of 86 patients with bladder urothelial cell carcinoma and 10 normal controls, and the correlations between GGCT and clinicopathological characteristics and the prognosis were analyzed.Results:The positive rate of the expression of GGCT in 86 cases of bladder urothelial cell carcinoma was 61.6% (53/86). GGCT protein was located mainly in cancer cell cytoplasm, and it can be seen in the nucleus of the tumor cells in some cases. The level of GGCT expression was positively related to pathological classification ( P<0.001), stage ( P=0.020), and tumor size ( P=0.025). Immunohistochemical semiquantitative analysis showed that the expression of GGCT in patients with T1 stage of non-muscle invasion bladder urothelial cell carcinoma was significantly higher than that with Ta stage ( P=0.034). Kaplan-Meier analysis showed that the expression of GGCT was correlated with the recurrence-free survival in patients with non-muscle invasive bladder cancer, the recurrence-free survival rate was lower in the GGCT positive group ( P=0.029). Multivariate COX regression analysis showed that the pathological stage ( OR=5.029, P=0.009) and the number of tumors ( OR=3.320, P=0.024)were the independent risk factors for recurrence-free survival in patients with early urothelial cell carcinoma of the bladder. Conclusions:The expression of GGCT is significantly increased in bladder urothelial cell carcinoma and is related to the malignant biological behavior and progression of tumor. Patients with GGCT positive early bladder tumor are inclined to recur.

Objective:To evaluate the expression and clinical significance of γ-glutamylcyclotransferase (GGCT) in patients with bladder urothelial cell carcinoma.Methods:Immunohistochemical staining for GGCT were performed on tissue sections of 86 patients with bladder urothelial cell carcinoma and 10 normal controls, and the correlations between GGCT and clinicopathological characteristics and the prognosis were analyzed.Results:The positive rate of the expression of GGCT in 86 cases of bladder urothelial cell carcinoma was 61.6% (53/86). GGCT protein was located mainly in cancer cell cytoplasm, and it can be seen in the nucleus of the tumor cells in some cases. The level of GGCT expression was positively related to pathological classification ( P<0.001), stage ( P=0.020), and tumor size ( P=0.025). Immunohistochemical semiquantitative analysis showed that the expression of GGCT in patients with T1 stage of non-muscle invasion bladder urothelial cell carcinoma was significantly higher than that with Ta stage ( P=0.034). Kaplan-Meier analysis showed that the expression of GGCT was correlated with the recurrence-free survival in patients with non-muscle invasive bladder cancer, the recurrence-free survival rate was lower in the GGCT positive group ( P=0.029). Multivariate COX regression analysis showed that the pathological stage ( OR=5.029, P=0.009) and the number of tumors ( OR=3.320, P=0.024)were the independent risk factors for recurrence-free survival in patients with early urothelial cell carcinoma of the bladder. Conclusions:The expression of GGCT is significantly increased in bladder urothelial cell carcinoma and is related to the malignant biological behavior and progression of tumor. Patients with GGCT positive early bladder tumor are inclined to recur.

OBJECTIVETo retrospectively evaluate the results of deep sternal wound infection (DSWI) after cardiac surgery.

METHODSBetween January 2010 and September 2013, 139 patients suffering from DSWI after median sternotomy. The incidence of DSWI was 0.47% (139/29 574). There were 111 (79.9%) male and 28 (20.1%) female patients. The mean age was (61 ± 11) years, the mean body weight was (74 ± 14) kg. The incidence of postoperative DSWI was 0.88% (91/10 341) after isolated coronary artery bypass grafting (CABG), 0.70% (15/2 143) after valve surgery or other cardiac surgery plus CABG, 0.21% (24/11 429) after valve surgery, 0.15% (3/2 002) after thoracic aortic surgery, and 0.19% (6/3 158) after congenital heart disease. The sternotomy was re-opened and extensive debridement of the wound was performed in all patients. When the wound was clean and there was a bed of fresh granulation tissue, the sternum was rewired. The surgical procedure performed included debridement, drainage, sternal wire reclosure and pectoralis major muscular transpositions depended on the clinical condition of the patient.

RESULTSThe in-hospital mortality was 9.3%. Failure of secondary sternal refixation appeared in 15 (10.8%) patients, the reoperation procedure of these 15 patients was pectoralis major muscular transpositions. Other complications included sepsis in 13 patients, perivalvular leakage in 3 patients, and cardiac rupture during the surgical procedure in 3 patients. The mean hospitalization was (39 ± 30) days.

CONCLUSIONDeep sternal wound infection is a life-threatening complication after cardiac surgery associated with high morbidity and mortality.

Adult ; Aged ; Aged, 80 and over ; Cardiac Surgical Procedures ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Sternum ; surgery ; Surgical Wound Infection ; surgery ; Young Adult

[Objective] To investigate and summarize the clinicopathological features, diagnosis, treatment and prognosis of adrenocortical carcinoma with rhabdoid features. [Methods] The clinical diagnosis and treatment of a case of adrenocortical carcinoma with rhabdoid features admitled to Department of Urology, Weifang People's Hospital were reported.The clinical manifestations, pathological features, diagnosis and prognosis of the disease were analyzed in combination with relevant literature. [Results] A 34-year-old male patient was admitted due to scrotal distension and pain that had persisted for 6 months.Imaging examination showed a huge soft tissue tumor in the left adrenal region of the retroperitoneum with compression displacement of the left kidney, leading to obstruction of venous return in the left spermatic vein, which in turn caused varicose veins.The levels of serum renin, angiotensin, aldosterone, cortisol, and catecholamine were within normal ranges.Surgical resection of the tumor was performed, and postoperative pathological examination revealed that the tumor tissue was predominantly composed of rhabdoid cells, exhibiting positive immunohistochemical staining for INI 1, Syn, Calretinin and Vimentin.Genetic testing did not identify any deletion of SMARCB1 and SMARCA4 mutations.Therefore, the diagnosis was adrenocortical carcinoma with rhabdoid features.At the current 20-month follow-up, no recurrence or metastasis was observed.A review of the literature found that only 7 cases of this disease had been reported. [Conclusion] Adrenocortical carcinoma with rhabdoid features is a rare disease, and a definitive diagnosis is dependent upon pathological examination.Surgical resection remains the primary treatment.Long-term follow-up is essential, and further research is needed to evaluate the impact of adjuvant therapy.

Due to the insufficient long-term protection and significant efficacy reduction to new variants of current COVID-19 vaccines, the epidemic prevention and control are still challenging. Here, we employ a capsid and antigen structure engineering (CASE) strategy to manufacture an adeno-associated viral serotype 6-based vaccine (S663V-RBD), which expresses trimeric receptor binding domain (RBD) of spike protein fused with a biological adjuvant RS09. Impressively, the engineered S663V-RBD could rapidly induce a satisfactory RBD-specific IgG titer within 2 weeks and maintain the titer for more than 4 months. Compared to the licensed BBIBP-CorV (Sinopharm, China), a single-dose S663V-RBD induced more endurable and robust immune responses in mice and elicited superior neutralizing antibodies against three typical SARS-CoV-2 pseudoviruses including wild type, C.37 (Lambda) and B.1.617.2 (Delta). More interestingly, the intramuscular injection of S663V-RBD could overcome pre-existing immunity against the capsid. Given its effectiveness, the CASE-based S663V-RBD may provide a new solution for the current and next pandemic.