Objective To explore whether polymorphisms in non-coding RNA has potential as biomarkers for predicting the risk of kidney transplantation rejection.Methods A total of 79 patients who had received kidney transplants were recruited from the First Affiliated Hospital of China Medical University and divided into the rejection group (n =26) and non-rejection group (n =53).Four polymorphisms in miRNA and 8 polymorphisms in lncRNA were detected by MALDI-TOF-MS.Results When compared with the wild genotype,the mutation genotype in miR-27a rs895819 and lnc-LRFN2-2 rs61516247 had 11.72 and 4.87 folds increased risk of kidney transplantation rejection (P =0.046,OR=1.04-131.74 and P =0.047,95％ CI =1.02-23.21,respectively).The other three polymorphisms in miRNA and 7 polymorphisms in lncRNA showed no significant associations with transplantation rejection risk (P ＞ 0.05).Conclusion The miR-27a rs895819 and lnc-LRFN2-2 rs61516247 polymorphisms were associated with the risk of kidney transplantation rejection.

Objective To evaluate the feasibility and effectiveness of the application of IQQA (Intelligent/interactive Qualitative and Quantitative Analysis) three-dimensional reconstruction technique in precise laparoscopic or robot-assisted laparoscopic partial nephrectomy (LPN or RAPN) for renal hilar tumors.Methods The study retrospectively reviewed 11patients with hilar tunors from February 2016 to February 2017.Of the 11 patients,4 were women and 7 were men,with an average age of 51 years (range 38 to 70 years).The average tumor size was 3.1 cm (range 1.7 to 4.3 cm).For tumor stage,9 patients were in T1a stage and 2 patients were in T1b stage.Tbe average R.E.N.A.L score was 8.7 (range 7 to 10).The mean preoperative GFR was 40.6 ml/min (range 32 to 45 ml/min).IQQA three-dimensional reconstruction technique was applied for the purpose of precise navigation and resection of the tumors.Multivariate analysis was used to identify predictors of warm ischemia time,estimated blood loss,major perioperative complications,and postoperative renal function.Results All 11 laparoscopic or robot-assisted laparoscopic hilar partial nephrectomies were successfully completed without conversion to a hand-assisted or an open approach.Under the navigation of IQQA,all tumors were found precisely at the first time during surgeries.The final pathologic examination revealed that all the 11 patients were clear cell renal cell carcinomas.The mean operative time was 142 minutes (range 90 to 230 minutes),with a mean warm ischemia time of 24 minutes (range 17 to 33 minutes).The estinated blood loss was 146 ml (range 50 to 400 ml).No intraoperative complications occurred.Two patients suffered from postoperative complications.One patient with gross hematuria was recovered by consistent bladder irrigation.The other patient with postoperative hemorrhage needed transfusion.All patients had negative margins on the final pathologic examination.At a mean follow-up period of 3 months,the mean GRR is 22.5 ml/min (range 13 to 34 ml/min) without any disease recurrence.Conclusions With peculiar features,such as accurate location,complete resection and fewer perioperative complications,the application of IQQA three-dimensional reconstruction technique in precise partial nephrectomy represents a safe and effective procedure for hilar tumors.

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:The purpose of this study was to evaluate the effect of computer-assisted surgical navigation in the reduction and fixation of unilateral zygomatic complex fractures.Methods:A retrospective analysis was performed on the patients suffering from unilateral zygomatic complex fractures treated by computer-aided surgical navigation technology in the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Wuhan University from January 2013 to December 2017. Spiral CT was used before surgery, the data was imported into BrainLAB navigation workstation or AccuNavi—a navigation workstation to design the surgery plan, and then the surgery plan was imported into the surgical navigation workstation to assist the reduction and fixation of the zygomatic complex fracture. Three-dimensional CT was used within 1 week after surgery to measure the reference values of the postoperative healthy and affected zygomatic prominence, which were analyzed by the paired t-test. At the same time, the reduction of the fracture was evaluated by the difference of the bilateral reference values of the zygomatic prominence, and the absolute value of the difference less than 2 mm was judged as exact reduction. All patients underwent postoperative follow-up, and wound healing and facial appearance and functional recovery were evaluated. Results:A total of 45 patients were involved in this study, including 39 males and 6 females, aged 21-68 years old. The postoperative zygomatic prominence values of the healthy side and affected side were (80.78±6.14) mm and (80.85±6.10) mm, respectively. There was no statistical significance ( t=0.362, P=0.719) between the reference values of the bilateral zygomatic prominence after operation. The absolute value of the difference between the zygomatic prominence of the healthy and the affected sides after operation was (0.92±0.68) mm. Fourty-three cases achieved exact reduction of the fracture. In the other 2 cases, the absolute value of the zygomatic prominence difference was 2.3 mm and 2.2 mm, respectively. The surgical incisions of all patients healed well without complications such as infection, accompanying with satisfactory facial appearance and function recovery. Conclusions:The application of computer-aided surgical navigation in unilateral zygomatic complex fracture surgery can effectively ensure the accuracy of fracture reduction, and it is a valued application.

Objective:To evaluate the role of silencing information regulator 1 (SIRT1)/nuclear factors E2-related factor2 (Nrf2) signaling pathway in berberine-induced reduction of renal ischemia-reperfusion (I/R) injury in mice.Methods:Thirty SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 18-22 g, were divided into 5 groups ( n=6 each) using a random number table method: sham operation group (S group), renal I/R group (RIR group), berberine+ I/R group (B group), berberine+ I/R+ SIRT1 inhibitor EX527 group (BE group) and berberine+ I/R+ Nrf2 inhibitor ATRA group (BA group). After the right kidney was removed, the left renal artery was clamped for 45 min followed by reperfusion to establish the model of renal I/R injury.In B, BE, and BA groups, berberine 100 mg·kg -1·d -1 was given for intragastric administration at 14 days before surgery.In group BE and group BA, EX527 5 mg·kg -1·d -1 and ATRA 10 mg·kg -1·d -1 were injected intraperitoneally at 3 days before surgery, respectively.The equal volume of normal saline was given for 14 consecutive days in group S and group RIR.Blood samples were collected from orbital vein at 24 h of reperfusion for measurement of serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations, for determination of the interleukin-1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) contents (by enzyme-linked immunosorbent assay) and expression of SIRT1, Nrf2, apoptosis-associated speck-like protein containing CARD (ASC), caspase-1, nucleotide-binding oligomerization domain-like receptor containing pyrin domain (NLRP3) (by Western blot) and for examination of the pathological changes of renal tubules (with a light microscope). The damage to the renal tubules was scored. Results:Compared with group S, the concentrations of serum Cr and BUN, the contents of renal IL-1β and TNF-α and renal tubular injury score were significantly increased in RIR, B, BE and BA groups, the expression of SIRT1, Nrf2, ASC, caspase-1 and NLRP3 was up-regulated in RIR, BE and BA groups, and the expression of SIRT1, Nrf2, caspase-1 and NLRP3 was up-regulated in group B ( P<0.05). Compared with group RIR, the concentrations of serum Cr and BUN, the contents of renal IL-1β and TNF-α and renal tubular injury score were significantly decreased in B, BE and BA groups, the expression of SIRT1 and Nrf2 in group B, Nrf2 and ASC in BE group and SIRT1, ASC and caspase-1 in BA group was up-regulated, and the expression of ASC, caspase-1 and NLRP3 in group B, SIRT1 and NLRP3 in BE group and Nrf2 in BA group was down-regulated ( P<0.05). Compared with group B, the serum concentrations of Cr and BUN, the contents of IL-1β and TNF-α and renal tubular injury score were significantly increased in BE and BA groups, the expression of ASC, caspase-1 and NLRP3 in BE and BA groups was up-regulated, and the expression of SIRT1 in BE and Nrf2 in BA groups was down-regulated ( P<0.05). Conclusion:SIRT1/Nrf2 signaling pathway is involved in the process of berberine-induced reduction of renal I/R, which is related to inhibiting pyroptosis in mice.

Objective:The purpose of this study was to evaluate the effect of computer-assisted surgical navigation in the reduction and fixation of unilateral zygomatic complex fractures.Methods:A retrospective analysis was performed on the patients suffering from unilateral zygomatic complex fractures treated by computer-aided surgical navigation technology in the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Wuhan University from January 2013 to December 2017. Spiral CT was used before surgery, the data was imported into BrainLAB navigation workstation or AccuNavi—a navigation workstation to design the surgery plan, and then the surgery plan was imported into the surgical navigation workstation to assist the reduction and fixation of the zygomatic complex fracture. Three-dimensional CT was used within 1 week after surgery to measure the reference values of the postoperative healthy and affected zygomatic prominence, which were analyzed by the paired t-test. At the same time, the reduction of the fracture was evaluated by the difference of the bilateral reference values of the zygomatic prominence, and the absolute value of the difference less than 2 mm was judged as exact reduction. All patients underwent postoperative follow-up, and wound healing and facial appearance and functional recovery were evaluated. Results:A total of 45 patients were involved in this study, including 39 males and 6 females, aged 21-68 years old. The postoperative zygomatic prominence values of the healthy side and affected side were (80.78±6.14) mm and (80.85±6.10) mm, respectively. There was no statistical significance ( t=0.362, P=0.719) between the reference values of the bilateral zygomatic prominence after operation. The absolute value of the difference between the zygomatic prominence of the healthy and the affected sides after operation was (0.92±0.68) mm. Fourty-three cases achieved exact reduction of the fracture. In the other 2 cases, the absolute value of the zygomatic prominence difference was 2.3 mm and 2.2 mm, respectively. The surgical incisions of all patients healed well without complications such as infection, accompanying with satisfactory facial appearance and function recovery. Conclusions:The application of computer-aided surgical navigation in unilateral zygomatic complex fracture surgery can effectively ensure the accuracy of fracture reduction, and it is a valued application.

OBJECTIVE Choosing the optimizing assistance materials and the best proportional to make the solid dispersion of Ginkgolides,which so that can tremendously improve the dissolution rate of Ginkgolides.METHODS We determine the dissolution rate of the solid dispersion respectively,which are made by Eudragit EPO and PVP K30 in different drug-material ratio.In addition,quantitative phase determination of them are measured by DSC,X-RD and SEM.RESULTS The dissolu-tion rate of the solid dispersion with the Ginkgolides-EPO ratio in 1∶2,1∶4,1∶6,1∶8 were 65%,68%,70% and 71%respectively in five minutes.In the corresponding proportion,The dissolution rate of the solid dispersion made by PVP K30 were 40%,50%,66%,70% respectively.In the same time,the dissolution rate of the drug substance were 10%.Phase i-dentification results showed that Ginkgolides can evenly dispers in amorphous state in the solid dispersion.CONCLUSION The solid dispersion with the Ginkgolides-EPO ratio of 1∶2 is the best choice to preparation,which has the tremendous drug-loading and dissolution efficiency,thereby having a excellent prospect of application.

OBJECTIVE To study the prediction effect of TCM physical personality and constitution on the risks of MD complicated with CHD.METHODS TCM physical personality and constitution of 110 T2MD patients were tested by five pat-tern personality inventor and five-five constitution.CHAID model of decision tree in EXCEL and SPSS was used to establish disease risk model of MD complicated with CHD predicted by TCM personality and constitution types.And the prediction ac-curacy of the model was evaluated.RESULTS Tested by cross validation,the prediction accuracy of MD disease model estab-lished with the Shao-yin personality,Yin-cold constitution and blood-stasis constitution as the predictor variables was relatively higher(93.6%),and three rules for predicting CHD risk were obtained.CONCLUSIONS The prediction rules of the MD complicated with CHD by TCM personality and constitution are consistent with the traditional understanding of Chinese medi-cine,which provides a reference for high-risk population's early screening,CHD prevention and treatment,clinical differentia-tion and treatment.

Background:The purpose of this study was to analyze cases of AO31-A2 intertrochanteric fractures (ITFs) and to identify the relationship between the loss of the posteromedial support and implant failure.Methods:Three hundred ninety-four patients who underwent operative treatment for ITF from January 2003 to December 2017 were enrolled.Focusing on posteromedial support,the A2 ITFs were divided into two groups,namely,those with (Group A,n =153) or without (Group B,n =241) posteromedial support post-operatively,and the failure rates were compared.Based on the final outcomes (failed or not),we allocated all of the patients into two groups:failed (Group C,n =66) and normal (Group D,n =328).We separately analyzed each dataset to identify the factors that exhibited statistically significant differences between the groups,In addition,a logistic regression was conducted to identify whether the loss of posteromedial support of A2 ITFs was an independent risk factor for fixation failure.The basic factors were age,sex,American Society of Anesthesiologists (ASA) score,side of affected limb,fixation method (intramedullary or extramedullary),time from injury to operation,blood loss,operative time and length of stay.Results:The failure rate of group B (58,24.07％) was significantly higher than that of group A (8,5.23％) (x2 =23.814,P ＜ 0.001).Regarding Groups C and D,the comparisons of the fixation method (P =0.005),operative time (P =0.001),blood loss (P =0.002)and length of stay (P =0.033) showed that the differences were significant.The logistic regression revealed that the loss of posteromedial support was an independent risk factor for implant failure (OR =5.986,95％ CI:2.667-13.432) (P ＜ 0.001).Conclusions:For AO31-A2 ITFs,the loss of posteromedial support was an independent risk factor for fixation failure.Therefore,posteromedial wall reconstruction might be necessary for the effective treatment of A2 fractures that lose posteromedial support.

The myelodysplastic syndrome (MDS) is a heterogeneous group of clonal disorders originating from hematopoietic stem cells (HSC), characterized by unilineage or multilineage dysplasia of myeloid cells, ineffective hematopoiesis, peripheral blood cytopenias and high risk of transform into acute myeloid leukemia (AML). The pathogenesis, hematopoietic function change and prognosis of MDS are closely related to the bone marrow microenvironment. Bone marrow microenvironment is a complex network system, among them, stromal cells including abnormal morphology and function of mesenchymal stem cells, impaired osteoblast differentiation, increased number of vascular endothelial cells, and decreased number of monocytes/macrophages can promote the pathogenesis of MDS. The abnormal expression of cytokines such as tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF) and stromal cell-derived factor-1 (SDF-1) are also closely related to the pathogenesis of MDS. Low expression of genes such as Dicer1, high expression of AURKA, and low expression of SPINT2 all contribute to the pathogenesis of MDS. Aberrant activation of Wnt/β-catenin signaling pathways, abnormal PI3K/AKT and Hh signaling pathways are also involved in the pathogenesis and progression of MDS. The study of the interaction between MDS and bone marrow microenvironment will further elucidate the pathogenesis, progress and prognosis of the disease, and will contribute to the development of targeted therapy. This review provides the research progress of bone marrow microenvironment stromal cells, cytokines, genes, and signaling pathway abnormalities in MDS.