Dental Implantation, Endosseous ; Dental Implants ; Humans ; Maxilla ; Tissue Engineering

Objective To discuss the efficacy of urinary continence in patients undergoing radical prostatectomy with bladder neck extension and mucosal eversion reconstruction anastomosis.Methods From August 2016 to November 2018,31 patients with prostate cancer underwent laparoscopic radical prostatectomy.The patients were 62-85 years old(mean 74.8 years),and the mean PSA score was 16.5 ng/ml(6.8-34.2 ng/ml).The pathological examination confirmed that the Gleason score was 6-9 and the prostate size was 44-83 ml.All patients underwent laparoscopic radical prostatectomy with bladder neck extension and mucosal eversion reconstruction anastomosis.Surgical procedure:After resection of the prostate in laparoscopic radical prostatectomy,the bladder neck was sutured at 6 o'lock position to narrow the bladder neck (" tennis racquet" reconstruction).The interval was 1 cm,and 2-3 needles were sutured,the distance between the neck of the bladder and the ureter was extended.The bladder neck mucosa and urethral mucosa eversion were performed.The posterior wall of the bladder neck was sutured at interval of 1 cm on both sides of the midline.After the knot was tightened,the posterior wall of the bladder was folded and bladder neck was elevated.The posterior wall of the bladder and the posterior wall of the urethra were sutured to reduce the distance between the bladder and the urethra.Finally,the bladder and urethra were anastomosed.The postoperative urinary continence recovery and the clinical effect were recorded.Results The operation time of 31 patients ranged from 80 to 210,with an average of 139.7 minutes.Intraoperative bleeding was 50-330 ml,with an average of 144.2 ml.None of the patients switched to open surgery during the operation,and there was no injury to large vessels and rectum,and no anastomotic leakage.Postoperative pathology showed 21 cases of pT2 stage,10 cases of pT3 stage,2 cases of positive margin,including 1 case of basal part and 1 case of apex part,both of which received medical castration therapy postoperatively.The surgical margin was positive in 2 cases (6.45％).31 patients removed the urinary catheter in ten days after surgery.17 cases (54.8％) recovered instantly urinary continence;7 cases (22.6％) urinary continence in 1 month after operation;4 cases (12.9％) urinary continence in 3 months after operation;and 3 cases (9.7％) urinary control in 6 months after operation.One case had urinary retention after removing the urinary catheter,and cathetered for 2 more weeks.After pulling out again,the urinary continence was good.Conclusions Laparoscopic radical prostatectomy with bladder neck extension and mucosal eversion reconstruction anastomosis may be helpful for early recovery of urinary continence.

Objective To establish the paclitaxel-resistant gastric cancer cell(HGC-27/PTX) and to investigate the changes of characteristics before and after resistance,as well as the possible resistant mechanisms.Methods The paclitaxel-resistant gastric cancer cell HGC-27/PTX was established by increasing paclitaxel dose gradually and intermittently.The IC50 (50% inhibitory concentration) and cell cycle were determined by CCK-8 assay and flow cytometry,respectively.The differentially expressed genes (DEGs) and signaling pathways were analyzed using RNAseq.Results The establishment of HGC-27/PTX cells lasted 9 months,and the sensitivity of paclitaxel of HGC-27/PTX cells was significantly lower than parental cells (P<0.05).Compared to parental cells,the morphology of HGC-27/PTX cells was slightly different,and the proportion of S and G2/M phase was obviously increased (P<0.01).A total of 274 DEGs were identified between the resistant and parental cells with 130 genes up-regulated and 144 genes down-regulated.DEGs were significantly enriched in extracellular matrix (ECM)-receptor interaction(P<0.001) and PI3K-Akt signaling pathways (P<0.05),which could provide evidences for reversing paclitaxel resistance.Conclusions The paclitaxel-resistant gastric cancer cells HGC-27/PTX was established with stable culturein vitro,which provides an ideal model for future study on the mechanism of drug resistance.

Objective To assess the clinical efficacy of a modified complete retroperitoneal laparoscopic nephroureterectomy via 3 port approach.Methods From August 2013 to February 2016,23 patients with complete retroperitoneal laparoscopic renal and ureteral sleeve resection were treated with modified three port approach,including 15 males and 8 females.The average age was 67 years old (ranging 44-83 years old).All patients had complained about the hematuria before operation and urine exfoliated cells showed moderate to severe nuclear atypia.All patients accepted the abdominal CT and urography CTU examination,pre-operatively.All of them was diagnosed localized upper urinary tract malignant tumors based on those images,including 13 cases in the pelvis,and 10 cases in the upper segment of the ureter.No chemotherapy,radiotherapy or immunotherapy was performed before surgery.No patients have the history of severe basic disease or upper urinary procedure.The operations were performed under general anesthesia,patients take the contralateral back 30 degrees slope,low elevation head foot,waist bridge,side waist stretch.In the anterior superior iliac spine perpendicular to the line 2 cm parallel to the lower intersection of the rib border were disposed into the 12 mm trocar.Above the anterior superior iliac spine two cross finger level with the intersection of the anterior axillary node,we placed into the 10 mm trocar placement lens.Laparoscopic placement of third casing form an isosceles triangle with the first two casing.The renal fascia was incised with an ultrasonic knife from the renal dorsal side,and the renal hilum was isolated from the kidney by suction aspirator.The renal artery and vein were separated and closed by hem-o-lok.Along the psoas muscle surface to ureter,ureteral clipping by hem-o-lok but not to cut off the free distal ureteral,the lens is composed of first casing into,using ultrasonic knife to free ureter to the bladder wall segment,with 30 mm endoscopic stapler ureter and bladder wall cut off part.Operation time,blood loss and postoperative recovery were recorded in 23 cases.Results All 23 cases were successfully operated without related the operative complication.The operative duration ranged from 3.5 to 6.1 h (mean 4.8 h),the blood loss was 30-880 ml (mean 304 ml),and the postoperative stay was 8-30 d (mean 17.8 d).There are 3 cases of positive lymph node by postoperative pathological reports.Within 2 to 30 months following up,2 patients died of tumor progression in 6 months after surgery.4 patients were diagnosed with bladder cancer in 15 months,15 months,21 months,24 months after surgery,respectively.And the transurethral resection of bladder tumor was performed.Conclusion The modified complete retroperitoneal laparoscopic nephroureterectomy via three ports is safe and reliable.

Objective To investigate the expression of JAM-1 after microwave irradiation and its correlation with blood-brain barrier integrity. Methods A total of 160 male Wistar rats were divided into a sham radiation group and a radiation group. The radiation group was subdivided into three sub-groups treated with micrewaves at average power densities of 10, 30 and 100 mW/cm2. Rats in each group were sacrificed and their brain tissue sampled at 6 hours and 1, 3, 7 and 14 days after the irradiation. Evans blue ( EB ) dye, laser confocal microscopy,Western blotting, RT-PCR and image analysis were used to test the permeability of the blood-brain barrier and the expression of JAM-1 in protein and at the gene level in the rats' hippocampus and cortex. Results There was an increase of EB in the hippocampus 3 to 14 days after 10 and 100 mW/cm2 microwave irradiation. The EB level increased progressively in the 10 and 30 mW/cm2 groups within 7 d after irradiation but recovered by the 14th day. It also increased progressively in the 100 mW/cm2 group within 14 d after irradiation. In the hippocampus, EB was observed only in the lumens of the blood vessels in the sham group, but EB had diffused out of the blood vessels in the irradiated groups by the 3rd day after irradiation. After 10 or 30 mW/cm2 microwave irradiation, JAM-1 protein in the hippocampus and cortex decreased significantly within 7 d after irradiation but recovered by the 14th day. It decreased progressively in the 100 mW/cm2 group within 14 d after irradiation. The expression of JAM-1 mRNA in the hippocampus decreased significantly at 6 h after irradiation at all power levels, but it recovered within 7 days in the 10 and 30 mW/cm2 groups. Conclusions Microwave radiation can decrease the expression of JAM-1 in the hippocampus and cortex. The degree of decrease is positively correlated with the microwave radiation power. The change might involve increasing the permeability of the blood-brain barrier.

Objective To study the prevention effects of AduoLa Fuzhenglin(ADL)Oll the brain injury induced by microwave radiation in rats.Methods A total of 140 male Wismr rats were divided randomly into 5 groups,including control group,microwave exposed group,low dosage(0.75 g·kg-1·d-1)group.middle dosage(1.5 g·kg-1·d-1)group and high dosage(3 g·kg-1·d-1)group.Rats in three ADL groups were lavaged with ADL per day for 2 weeks before radiation.After administration,rats were exposed to microwave at 30 mW/cm2 for 15 min.The abilities of learning and memory were detected by Morris water maze,and the contents of amino acids neurotransmitter of hippocampus were detected by HPLC, then the histology and uhrastrncture of hippocampus were observed with light and electron microscope at 6 h,7 and 14 d after exposure.Results The abilities of learning and memory were declined(F=0.000-0.043,P<0.05)from 6 h to 7 d after exposure,and the contents of four kinds of amino acid neurotransmitter in hippocampus were decreased,of which GLU,GLY and GABA were decreased significantly(F=0.000-0.007,P<0.01)at 6h after exposure,then tissue edema,neuronal degeneration,neuron mitoehondria swelling and cavitation,endocytoplasmie rotieulum broaden,synaptic cleft blurred,and perivascular space widen were found in the hippocampus at 6 h and 7 d after exposure.The changes in low dosage group were similar to those of the radiation group.However,in middle and high dosage groups,the abilities of learning and memory were normal to some extent with the significant differences compared to the radiation group from 6 h to 7 d after exposure(F=0.015-0.028.P<0.05).The contents of four kinds of amino acid neurotransmitter were not decreased,especially GLU contents close tO normal level.There were significant differences between middle and high dosage groups and radiation group at 6 h after exposure(F=0.000-0.042,P<0.05).Moreover,no obvious injury in the hippocampus was observed in middle and high dosage groups at 6 h and 7 d after exposure.Conclusions Exposure to 30 mW/cm2 microwave radiation could decrease the abilities of learning and memory,induce amino acid neurotransmitter turbulence,and injure the histology and uhrastructure of hippocampus.ADL at the dosages of 1.5 and 3 g·kg-1·d-1 would have preventive effects on the injury induced by microwave exposure.The concentration of 1.5 g·kg-1 ·d-1 of ADL might be the effective dosage to prevent the brain damage after microwave exposure.

Programmed cell death protein 1 (PD?1 / CD279) and cytotoxic T Lymphocyte Antigen?4 (CTLA?4) are important immune checkpoints, through the role of the corresponding ligands and inhibit T cell activation and production of cytokines, in maintaining the body′s vital role in peripheral tolerance. The use of anti?CTLA?4/PD?1/PD?L1 monoclonal antibodies to block the tumor signaling pathway has shown excellent anti?tumor efficacy in a variety of solid tumors, and it is expected that immunotherapy will be available for the treatment of 60% advanced tumors in the next decade. Esophageal cancer is one of the major causes of cancer?related deaths worldwide, and its 5?year survival rate is generally low. Currently, radiotherapy, chemotherapy, and surgery are the standard treatments for esophageal cancer, and there is no effective treatment scheme for patients with esophageal cancer who fail to respond to standard treatment. Due to the diversity of somatic cell gene mutations and the generation of neo?antigens in esophageal cancer, immunotherapy has become a feasible treatment scheme to improve the prognosis of esophageal cancer. In this situation, the application of immunotherapy for esophageal cancer or more specific immune checkpoint inhibitors has gradually become the focus of the treatment of esophageal cancer. Nowadays, the research of immune checkpoint inhibitors, such as ipilimumab, tremelimumab, pembrolizumab, nivolumab and avelumab on esophageal cancer is proceeding at an amazing speed. The phase Ⅰb clinical study of immunotherapy for esophageal cancer, which previously attracted great interest, has been replaced by the phaseⅢclinical study, and the results of the relevant studies also show a good prospect for the application of immune checkpoint inhibitors for esophageal cancer. However, the prediction of therapeutic effect and the selection of the best candidates still need to be further studied.

Programmed cell death protein 1 (PD?1 / CD279) and cytotoxic T Lymphocyte Antigen?4 (CTLA?4) are important immune checkpoints, through the role of the corresponding ligands and inhibit T cell activation and production of cytokines, in maintaining the body′s vital role in peripheral tolerance. The use of anti?CTLA?4/PD?1/PD?L1 monoclonal antibodies to block the tumor signaling pathway has shown excellent anti?tumor efficacy in a variety of solid tumors, and it is expected that immunotherapy will be available for the treatment of 60% advanced tumors in the next decade. Esophageal cancer is one of the major causes of cancer?related deaths worldwide, and its 5?year survival rate is generally low. Currently, radiotherapy, chemotherapy, and surgery are the standard treatments for esophageal cancer, and there is no effective treatment scheme for patients with esophageal cancer who fail to respond to standard treatment. Due to the diversity of somatic cell gene mutations and the generation of neo?antigens in esophageal cancer, immunotherapy has become a feasible treatment scheme to improve the prognosis of esophageal cancer. In this situation, the application of immunotherapy for esophageal cancer or more specific immune checkpoint inhibitors has gradually become the focus of the treatment of esophageal cancer. Nowadays, the research of immune checkpoint inhibitors, such as ipilimumab, tremelimumab, pembrolizumab, nivolumab and avelumab on esophageal cancer is proceeding at an amazing speed. The phase Ⅰb clinical study of immunotherapy for esophageal cancer, which previously attracted great interest, has been replaced by the phaseⅢclinical study, and the results of the relevant studies also show a good prospect for the application of immune checkpoint inhibitors for esophageal cancer. However, the prediction of therapeutic effect and the selection of the best candidates still need to be further studied.

Objective To explore the changes of SOX9 and WT1 expressions in rat Sertoli cells irradiated by EMP ( electromagnetic pulse),S-HPM ( S-band high power microwave) and X-HPM ( Xband high power microwave).Methods Primary Sertoli cells were isolated from 3-week-old Wistar rats and its purity was immunocytochemistrically indentified with WT1.After exposure to 6 × 104 V/m EMP,100 mW/cm2 S-HPM and X-HPM for 4 min respectively,SOX9 and WT1 expressions in Sertoli cells were determined with real-time PCR and Western blot,respectively.Results SOX9 mRNA expression was decreased at 6 and 12 h post-irradiation of three different bands of electromagnetic microwave ( F =15.20and 4.84,P ＜ 0.05 ).SOX9 protein expression was also decreased at 6 and 24 h after irradiation ( F =8.46 and 7.47,P＜0.05).WT1 mRNA expression was decreased at6 and 12 h (F=13.46 and 5.08,P ＜ 0.05 ),but its protein expression was decreased only at 24 h post-irradiation ( F =10.26,P ＜ 0.05 ).Conclusions Three bands of electromagnetic radiation reduce the expressions of SOX9 and WT1 in rat Sertoli cells,which may provide molecular foundation for genital system hazards induced by microwave radiation.

This article retrospectively analyzed the clinical data of 8 patients with vesicovaginal fistula after radiotherapy for cervical cancer admitted in our hospital from January 2015 to October 2021. All of them underwent cystostomy under local anesthesia. A single J tube of bilateral ureters was retained under cystoscope, and the single J tube was introduced into the fistula bag through the cystostomy opening. All patients wore diapers for a long time before operation, and used urine pads 0-2 pieces/day after operation. QOL score was 5.3±0.5 points before operation, and 2.5±0.5 points after operation. The patient's body odor basically disappeared. The vesicovaginal fistula can be repaired by surgery, but for patients who cannot be operated or failed repeatedly due to various reasons, a single J tube of bilateral ureters can be drawn out through the cystostomy opening, which can improve the quality of life of patients through minor trauma.