Objective To compare the perioperative outcomes and short-term efficacy of three-port extraperitoneal laparoscopic radical prostatectomy (ELRP) and four-port ELRP.Methods Two hundred patients who had undergone ELRP for prostate cancer by a single surgeon from November 2010 to October 2014 were retrospectively analyzed.Among them,95 cases underwent three-port ELRP and 105 cases underwent four-port ELRP.On the basis of traditional four-port ELRP,three-port ELRP was characterized by the omission of the trocar on the inner side of right anterior superior iliac spine.The mean age was 66.8 ± 15.5 years,and mean total prostate specific antigen (tPSA) was 15.3 ± 12.4 μg/L.There were no significant differences including age,body mass index,tPSA,clinical stages,acceptance of neoadjuvant hormone therapy,history of transurethral resection of the prostate,history of diabetes mellitus between the 2 groups (P ＞ 0.05).Patients in three-port ELRP group had significantly smaller prostate volume than fourport group (35.6 ± 16.7 ml versus 42.2 ± 24.7 ml,P ＜ 0.05).The clinical factors as operative time,estimated blood loss,hospital stay,drainage tube keeping days,pathological Gleason scores,pathological stages,positive surgical margin rates,biochemical recurrence rates and urinary incontinence rates were compared between the 2 groups.Results The three-port group had significantly shorter operative time than the four-port group (81.0 ± 18.6 min versus 103.6 ±34.6 min),less estimated blood loss (102.6 ±75.8 ml versus 217.5 ± 182.9 ml),less positive surgical margin rates (13.7％ versus 27.6％).There were 9 patients having Gleason scores more than 7 in the three-port ELRP group and 29 patients in four-port ELRP group (P ＜ 0.05).There were no significant differences of hospital stay,drainage tube keeping days,pathological stages between the 2 groups (P ＞ 0.05).Eighty-three cases in the three-port ELRP group (87.4％) were followed up for 5-19 months with the median time of 11 months.Ninety-two cases in fourport ELRP group (87.6％) were followed up for 17-52 months and the median time was 27 months.There were no significant differences of biochemical recurrence rates and urinary incontinence rates between the 2 groups(P ＞ 0.05).Conclusions Compared to four-port ELRP,three-port ELRP can provide shorter operative time,less blood loss,better negative surgical margin rates,similar oncological control and recovery of postoperative continence.In experienced hands,three-port ELRP could be a feasible and effective option for localized prostate cancer.

Objective To evaluate the learning curve of three-port extraperitoneal laparoscopic radical prostatectomy(ELRP) and to minimize operative time and blood loss about this procedure.Methods From August 2013 to October 2014,the data from 95 consecutive patients,who had undergone three-port ELRP for prostate cancer,were retrospectively analyzed.The mean age was 65.9 ± 7.7 years,mean total PSA level was 15.4 ± 12.7 μg/L,and mean body mass index(BMI) was 24.8 ± 3.2 kg/m2.According to the number of procedures performed by the surgeon,all patients were classified into three chronologic groups,including group A (No.1-32),group B (No.33-64) and group C (No.65-95).There were no significant differences including age,BMI,tPSA,estimated prostate volume,clinical stages,history of neoadjuvant endocrine therapy,history of transurethral resection of the prostate (TURP) among group A,B and C (P ＞ 0.05).The operative outcomes analyzed were operative time,estimated blood loss,hospital stay,drainage tube indwelling days,pathological Gleason scores,pathological stages,positive surgical margin rates,biochemical recurrence rates and urinary incontinence rates.Among these 95 patients,the results of the first 32 cases were compared with those of the remaining 63 cases,the first 64 with the remaining 31.Results The average operative time in 95 patients was 81.0 ± 18.6 min.The sloping learning curve for this surgeon showed that the operative time for all 95 cases was strongly correlated with additional experience (| rs | =0.612,P＜0.01).Operative time,however,was not strongly correlated with the surgeon's experience in each group of A,B and C(P ＞0.05).Group A had longer operative time than that of Group B plus C(96.4 ± 11.3 min vs 73.2 ± 16.7 min,P ＜0.01).Group A plus B had longer operative time than that of group C (87.6 ± 17.2 min vs 67.5 ± 13.8 min,P ＜ 0.01).For all cases,the estimated blood loss was strongly correlated with additional experience (| rs | =0.677,P ＜ 0.01).Estimated blood loss was strongly correlated with the accumulation of experience for the initial 32 cases(| rs | =0.619,P ＜ 0.01).However,no strong correlation was observed over the next 63 cases.Group A had more blood loss than that of Group B plus C (158.7 ± 81.3 ml vs 74.1 ± 54.4 ml,P ＜ 0.01).Group A plus B had more blood loss than that of group C (125.5 ± 71.6 ml vs 55.3 ± 61.6 ml,P ＜ 0.01).But hospital stay,drainage tube keeping days were not strongly correlated with additional experience in each group(P ＞ 0.05).There were no significant correlation between the accumulation of experience and positive surgical margin rates,biochemical recurrence rates and urinary incontinence rates.Conclusion Our experience of three-port ELRP cases appears to be favorable with decreasing tendency in operative time,estimated blood loss with experience accumulation.Exposure to 32 surgeries,operative time and estimated blood loss reduced significantly,and after 64 cases operative time and estimated blood loss further reduced.

SUMMARY To explore the clinical pathological characteristics and improve the recognition in the diag-nosis and treatment of basal cell carcinoma (BCC)of prostate.Three cases of BCC of prostate were re-ported and the relevant literature was reviewed to investigate the diagnosis and treatment of this disease. We analyzed three cases of prostatic BCC.Their ages were within a range of 57 to 83 years.One of them complained of hematuria and two complained of dysuria.All of them presented with prostatic hyperplasia. Two of them presented with high prostate specific antigen (PSA)and one with normal PSA.Case 1 had prostate cancer invasion of bladder,rectal fascia,with lymph node metastasis,bone metastasis and lung metastases.The patient received bladder resection +bilateral ureteral cutaneous ureterostomy +lymph node dissection on November 2,2014 .Postoperative pathological diagnosis showed BCC.Reexamination of pelvic enhanced MRI in January 8,2015 suggested pelvic recurrence.Abdominal enhanced CT showed multiple liver metastases and pancreatic metastasis on July 11,2015.Prostate cancer specific death occurred in October 2015.Case 2 was diagnosed as BCC in prostate biopsy on March 27,2015. Positron emission tomography and computed tomography (PET-CT)showed pulmonary metastasis and bone metastasis.Then the patient received chemotherapy,endocrine therapy and local radiation therapy. Reexamination of PET-CT on January 11,2016 showed that the lung metastase tumors and bone metas-tase tumors were larger than before.Up to January 10,2016,the patient was still alive.Postoperative pathological changes of transurethral resection of prostate (TURP)in case 3 showed BCC might be con-sidered.The PET-CT suggested residual prostate cancer,which might be associated with bilateral pelvic lymph node metastasis.In April 20,2016,the review of PET-CT showed pelvic huge irregular hybrid density shadow,about 14.5 cm ×10.0 cm ×12.9 cm in size,and tumor recurrence was considered. Then the patient received local radiation therapy.The patient survived in the followed upon January 10, 2016.BCC of prostate is a rare subtype.Due to the local infiltrative and distant metastatic potentiality, active management is preferred and a life-long follow-up is necessary.

Objective Several studies have indicated that miR-15a,miR-15b and miR-16 may be the important regulators of apoptosis.Since attenuate apoptosis could protect myocardium and reduce infarction size,the present study was aimed to find out whether these miRNAs participate in regulating myocardial ischemia reperfusion (I/R) injury.Methods Apoptosis in mice hearts subjected to I/R was detected by TUNEL assay in vivo,while flow cytometry analysis followed by Annexin V/PI double stain in vitro was used to detect apoptosis in cultured cardiomyocytes which were subjected to hypoxia/reoxygenation (H/R).Taqman real-time quantitative PCR was used to confirm whether miR-15a/15b/16 were involved in the regulation of cardiac I/R and H/R.Results Compared to those of the controls,I/R or H/R induced apoptosis of cardiomyocytes was significantly iucreased both in vivo (24.4％ ± 9.4％ vs.2.2％ ± 1.9％,P ＜ 0.01,n =5) and in vitro (14.12％ ±0.92％ vs.2.22％ ± 0.08％).The expression of miR-15a and miR-15b,but not miR-16,was increased in the mice I/R model,and the results were consistent in the H/R model.Conclusions Our data indicate miR-15 and miR-15b are up-regulated in response to cardiac I/R injury,therefore,down-regulation of miR- 15a/b may be a promising strategy to reduce myocardial apoptosis induced by cardiac I/R injury.

Objective To compare the perioperative outcomes and postoperative complications of retroperitoneal laparoscopic partial nephrectomy ( RLPN) for the treatment of endophytic renal tumors and non-endophytic tumors.Methods Three hundred and ninety-two patients who underwent RLPN for kidney neoplasms from May 2005 to September 2012 were retrospectively analyzed . They were divided into endophytic renal tumor group ( 48 cases ) and non-endophytic tumor group ( 344 cases ) .There were no significant differences in the aspects of gender , age, body mass index, tumor side, diameter, preoperative estimated glomerular filtration rate (eGFR) between the two groups.Operative time, warm ischemia time, method of renal vascular occlusion , repair rate of renal collecting system , estimated blood loss , usage of laparoscopic ultrasonography , intraoperative complications , pathological types , postoperative hospitalization days, postoperative complications and postoperative eGFR were collected and analyzed .Results Patients with endophytic tumors had significantly more usage of laparoscopic ultrasonography (95.8%versus 1.2%, P<0.001) and higher repair rate of renal collecting system (35.4%versus 6.1%, P<0.001).Clamping segmental renal artery and without clamping renal vessels were not used in dealing with renal vessels of endophytic tumors (P<0.05).There were no significant differences of operative time , warm ischemia time, estimated blood loss , intraoperative complications , pathological types , postoperative hospitalization and postoperative eGFR (P>0.05) between the 2 groups.All the patients′surgical margins were negative.The rates of postoperative complication ( Clavien gradeⅠtoⅢb) were 4.2%and 2.9%in the endophytic group and non-endophytic group , respectively ( P >0.05 ) . Median follow-up was 42 ( 33 -108 ) months in endophytic group and 45 (33 -120) months in non-endophytic group.No local recurrence or metastasis occurred in the two groups .Conclusions In experienced hands , RLPN could represent a feasible , safe and effective treatment for selected patients diagnosed with endophytic renal tumors .Laparoscopic ultrasonography is valuable on locating the tumor and defining tumor margins in RLPN of endophytic renal tumors .

DNA microarrays have been acknowledged to represent a promising approach for the detection of viral pathogens. However, the probes designed for current arrays could cover only part of the given viral variants, that could result in false-negative or ambiguous data. If all the variants are to be covered, the requirement for more probes would render much higher spot density and thus higher cost of the arrays. Here we have developed a new strategy for oligonucleotide probe design. Using type I human immunodeficiency virus (HIV-1) tat gene as an example, we designed the array probes and validated the optimized parameters in silico. Results show that the oligo number is significantly reduced comparing with the existing methods, while specificity and hybridization efficiency remain intact. The adoption of this method in reducing the oligo numbers could increase the detection capacity for DNA microarrays, and would significantly lower the manufacturing cost for making array chips.

Abstract: Objective　To analyze the detection of SARS‑CoV‑2 in household environment and public place environment of Huangpu District, and describe the feature of SARS‑CoV‑2 contamination in the environment exposure to the infected cases, so as to support the control strategies such as disinfection and health communication. Methods　The results of RT-PCR test for the environmental samples exposure to the cases infected by SARS‑CoV‑2 during February 1 to March 31 2022 in Huangpu District of Shanghai were collected as the research data. Pearson χ2 was used to test the significance of the differences between positive rates of SARS‑CoV‑2 contamination. Results　From February 1 to March 31, household environment samples had a higher positive rate (6.47%, 234/3 618) of SARS‑CoV‑2 contamination while the public place samples had a lower one (1.22%, 47/3 582) in Huangpu District of Shanghai (χ2=141.908, P<0.01). Among the household buildings, the lane houses of old style representing poorer living condition had the highest positive rates (8.31%, 96/1 155) of SARS‑CoV‑2 contamination while the apartments representing better living condition had the lowest (3.59%, 22/612) (F=5.25，P<0.05). Among the samples from household environment, samples regarding sewerage had the highest positive rates (13.30%,58/436) of SARS‑CoV‑2 contamination, while samples regarding the tool of cooking and sweeping had the lowest (3.10%,17/548) (F=9.84，P<0.01). Among the samples from public place environment, samples regarding entertainment tools had the highest positive rates (13.33%, 2/15) of SARS‑CoV‑2 contamination, while samples regarding the tool of cooking and sweeping had the lowest (0.62%, 4/646) (F=4.22，P<0.01). Conclusion　In the environment exposure to the SARS‑CoV‑2 infected cases, the disinfection, ventilation and cleaning should be intensified strictly. SARS‑CoV‑2's surviving in sewage environment should be evaluation dynamically. More health communication should be pushed to people of poorer living condition.

Objective:To explore the clinical pathological characteristics and improve the recognition in the diagnosis and treatment of incidental (stage T1a -T1b)prostate cancer.Methods:Seven hundred and seventy-one patients who underwent TURP from May 2004 to September 2013 were analyzed retro-spectively.In our institution,TURP specimens should be totally submitted in an extensive sampling method.The tumor area was outlined by estimation of an experienced genitourinary pathologist and calcu-lated by the image analysis system software (Image J 1.47 h).The tumor area was then multiplied by the thickness of tissue.The total sum of all tumor volume was the estimated tumor volume.The clinical and pathological factors,follow-up results were obtained and we aimed to collect information about the period of watchful waiting (WW),PSA progression status,intervention status during the follow-up,the reason for intervention on WW and the type of intervention.Results:The average age of 771 patients was (71.3 ±5.9)years old,and the average BMI was (23.9 ±3.1)kg/m2 ,preoperative average tPSA was (4.4 ±2.8)μg/L.Eighty-six (11.2%)cases of incidental prostate cancer were detected.The patients in T1a group (77 cases,89.5%)had tumor volumes of (12.3 ±12.6)mm3 ,and the patients in T1b group had tumor volumes of (105.1 ±41.8)mm3 .The range of tumor volume was 0.4 -180.2 mm3 . The volume of all the 86 cases was less than 500 mm3 as the threshold of insignificant cancer.All the pa-tients were managed by WW.The mean follow-up time was 88.9 (27.9 -150.1)months.The Gleason score was <7 in 79 patients,and ≥7 in 7 patients.There was no significant difference in age,preopera-tive tPSA,preoperative PSAD,postoperative tPSA,prostate volume and TURP resection between T1a group and T1b group (P >0.05).Among 84 patients without follow-up losts,PSA progression occurred in 5 patients.One T1a patient underwent radical prostatectomy (RP)as an intervention,and 3 patients underwent hormone therapy.One patient in T1b group underwent radiotherapy for PSA progression and one was treated because of patient preference without evidence of disease progression.There were no pa-tients who died due to prostate cancer.Conclusion:Eighty-six (11.2%)cases of incidental prostate cancer were detected.The tumor volume of all the cases was insignificant cancer.The clinical outcomes of IPCa were satisfactory with the initial treatment of WW in the Chinese population.

The myelodysplastic syndromes (MDS) include a diverse groups of clonal and potentially malignant bone marrow disorders. Evidences exist that microenvironment cells from MDS marrow show functional abnormalities, which may be relevant to the incidence of such a disease. Mesenchymal stem cells (MSCs) are a very important component of hematopoietic microenvironment. This study was supposed to investigate the biological characteristics and functions of MSC derived from patients with MDS in low-risk. MSCs from bone marrow samples of 11 low-risk MDS patients were isolated, cultured and expanded. Morphology, immunophenotype and osteoblasts differentiation were analyzed. Their capacity of proliferation and hematopoietic supporting in vitro were measured. A real-time quantitative reverse transcriptase polymerase chain reaction method (RQ RT-PCR) was used for detecting the expression levels of relative cytokines and chemokines in MSC. MSCs from healthy donors were used as controls. The results showed that the culture-expanded cells from MDS patients displayed a typical fibroblast-like morphology. Cells were positive for SH2 (CD105), SH3 (CD73), Thy-1 (CD90), while negative for CD34 and CD45. After induction, these cells could differentiate into osteoblasts. The proliferative ability of MSCs in MDS patients were not different from those of MSC isolated from normal bone marrow (p > 0.05), however, their capacity of hematopoietic supporting in vitro were significantly weaker (p < 0.05). RQ RT-PCR detection indicated that the SDF-1 gene expression level in MSCs of low-risk MDS patients was significantly higher than that in MSC derived from healthy donors (p < 0.01). It is concluded that the abnormal function of MSC influences the regulation of hemotopoiesis in the bone marrow microenvironment of MDS patients. It is worthy to further investigate the new clue in etiological mechanism and therapeutic strategies for MDS.
Bone Marrow Cells ; pathology ; Chemokine CXCL12 ; genetics ; metabolism ; Hematopoiesis ; Humans ; Mesenchymal Stromal Cells ; pathology ; physiology ; Myelodysplastic Syndromes ; pathology ; physiopathology ; Risk Factors

UNLABELLEDTo study the method for dose calculation and beam weight optimization of intensity-modulated radiation therapy (IMRT).

METHODSThe IMRT dose calculation model based on two-dimensional convolution was constructed, the program of dose calculation and beam weight optimization with genetic algorithm was written with Visual c#.Net, and the optimization results were analyzed.

RESULTSGenetic algorithm optimization of beam weights can produce highly conformal dose distributions within a clinically acceptable computation time.

CONCLUSIONGenetic algorithm is valid and efficient in IMRT beam weight optimization, which may facilitate IMRT treatment planning.

Algorithms ; Humans ; Models, Statistical ; Models, Theoretical ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Conformal ; methods ; standards