Objective:To investigate the safety and efficacy of four-hook needle combined with holographic image in robot-assisted partial nephrectomy for completely intrarenal tumors.Methods:The clinical data of 8 patients with completely intrarenal tumors treated by robot-assisted partial nephrectomy with four-hook needle combined with holographic image admitted to General Hospital of Central Theater Command from October 2023 to December 2023 were retrospectively analyzed. There were 6 males and 2 females, with average age of (44.5±12.0) years old. Tumors of 6 cases were in the left side and 2 cases in the right side. The maximum diameter of the tumor was (23.2±8.1) mm. The R. E.N.A.L. score was (9.0±1.4). The preoperative serum creatinine (Scr) was (73.1±14.7) μmol/L. CT-guided four-hook needle was used to locate the edge of completely intrarenal tumor before surgery. During the operation, the tumor was precisely resected under the guidance of hologram and four-hook needle. Perioperative data of patients were collected and analyzed.Results:All the tumor were successfully resected under the guidance of four-hook needle and hologram without conversion to radical nephrectomy or open surgery. The mean operative time was (117.0±14.5) min, the mean hot ischemia time was (20.2±5.1) min, the mean intraoperative blood loss was (75.0±17.3) ml, and the average hospitalization time was (9.5±1.3) days.The one week postoperative Scr was (73.2±14.8) μmol/L, which had no significant difference with that of before operation ( P=0.952). None of them received blood transfusion. The pathology results of 8 patients were clear cell renal cell carcinoma, and the surgical margins were negative. Conclusions:For completely intrarenal tumors, the four-hook needle combined with the hologram can guide the surgeon to quickly locate the tumor, accurately resect the tumor, reduce perioperative complications, and is safe and effective.

Objective:To investigate the clinical application value of injection of indocyanine green(ICG)via vasopuncture in fluorescence laparoscopic radical prostatectomy(FLRP).Methods:We retrospectively analyzed the clinical data on 50 cases of PCa treated by injection of ICG via vasopuncture in FLRP.The patients were aged(70.60±5.67)years old,with an average PSA value of(18.42±2.69)μg/L.During the operation,we injected ICG at 0.5 ml by vasopuncture through the vas deferens at each side of the scrotum,observed the visualized images of the vas deferens and seminal vesicles using normal high-definition,black-and-white fluorescence,green fluorescence,and color fluorescence respectively,and then isolated the adherent seminal vesicles under the laparoscope.Results:A total of 93 injections of ICG were completed,86 bilaterally,4 on the right and 3 on the left.The vas defer-ens and seminal vesicles were visualized in 41 cases(60 sides,64.52%),19 bilaterally,7 on the right and 15 on the left.Spillage of the fluorescent agent occurred in 9 cases during the incision of the bladder neck and adhesion of the seminal vesicles was found intra-operatively in 10 cases,in which the seminal vesicles were all quickly located by fluorescence visualization.No rectal injury occurred during the surgery.Mild scrotal subcutaneous bruises were observed in 2 cases,with a postoperative pathological Gleason's score of 7.44±0.88.Conclusion:Injection of ICG by vasopuncture is minimally invasive and safe.ICG-mediated near-infrared imaging and real-time fluorescence imaging of the vas deferens and seminal vesicles can achieve precise positioning and removal of the seminal vesicles and prostate gland without causing rectal injury.

Objective:To explore a better measurement mode of shear wave elastography (SWE) in the skin of lymphedema limbs, and to test its diagnostic efficacy in lymphedema.Methods:Between 1st and 10th August, 2023, 22 healthy volunteers were recruited in the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ulrasound, the First Afiliaed Hospital of Sun Yat-Sen University to measure the Young's modulus (E-value) of limb skin by SWE using a gel pad (GP group) and the thick-layer coupling gel (CG group) respectively. Then between 15th August and 28th September, 2023, 11 patients with 13 lower limb lymphedema, who were treated in the Department of Microsurgery, Orhopaedic Trauma and Hand Surgery, the First Affiliaed Hospital of Sun Yat-Sen University, were consecutively enrolled to find out the E-value of skin in oedematous limbs. The receiver operating characteristic curve (ROC) was constructed and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated to evaluate the diagnostic efficiency. SPSS 26.0, R studio and GraphPad Prism 8 software were used for statistical analysis. Paired sample non-parametric test (Wilcoxon signed rank test) was used to compare the difference in E-value between the 2 groups. P<0.01 was considered statistically significant. Spearman correlation test was used to analyse the correlation of E-value values between the GP group and CG group. Results:Overall, it was found from the healthy volunteers that E-value of skin in distal limbs were higher than that in proximal limbs, especially in lower extremities. E-value of all scanned location in GP group were found higher than those of CG group with statistically significant difference ( P<0.01), and the values of interclass correlation coefficient (ICC) showed a good repeatability. The 11 patients with lymphedema in 13 lower extremities were examined with the thick-layer coupling gel. The skin E-value in calf of patients with lymphedema were significantly higher than that of the healthy volunteers ( P<0.01), except the skin of thighs ( P>0.01). A lymphedema was diagnosed while either a skin E-value was 27.6 kPa calculated by Youden index or with the thickness of skin was 2.3 mm. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy in the diagnosis of a lymphedema were found at 92.3%, 100%, 100%, 95.7% and 97.1%, respectively. The area under curve (AUC) of ROC was 0.962. The correlation coefficients (R) of E-value in arm, forearm, thigh and lower leg in the GP group and CP group were 0.665, 0.882, 0.850 and 0.815, respectively, which were all significantly correlated. Conclusion:Application of thick layer coupler in ultrasound skin SWE is highly feasible, and the combination of ultrasound skin SWE and skin thickness has higher diagnostic efficiency in the diagnosis of lower extremities lymphedema. It allows more accurate ultrasonic image technical support for early monitoring and diagnosis of lymphedema, microsurgical treatment and a quantitatively perioperative evaluation.

Objective:To compare and analyze the distribution characteristics of fluoride and arsenic in drinking water in coal-burning borne endemic fluorosis and arsenic poisoning areas and non-endemic areas of Guizhou Province, and to assess the health risk.Methods:From January 2018 to December 2019, drinking water samples were collected from all endemic and non-endemic townships in 37 coal-burning borne endemic fluorosis counties (cities and districts) and 4 coal-burning borne endemic arsenic poisoning counties (cities and districts) in Guizhou Province. Fluoride and arsenic levels in drinking water were determined in all the affected and non-affected townships. Among them, 3 800 water samples were collected from fluorosis areas, 1 445 water samples from non-endemic areas, and 117 water samples from arsenic poisoning areas and non-endemic areas, respectively. Based on Monte Carlo simulation, a health risk assessment model recommended by the US Environmental Protection Agency (EPA) was applied to quantitatively evaluate the health risks caused by fluoride and arsenic in drinking water in different regions through different pathways (drinking water intake or skin contact) to different populations (adult males, adult females and children).Results:According to the "Hygienic Standards for Drinking Water" (GB 5749-2022), the qualified rates of fluoride and arsenic levels in drinking water in the study area were 100%. The results of the health risk evaluation showed that in the same evaluation area (endemic area or non-endemic area), there were statistically significant differences in the average annual health risks caused by fluoride and arsenic exposure through drinking water among different populations through two different routes ( P < 0.001), with children's health risks > adult males > adult females ( P < 0.05). The average annual health risks of fluoride and arsenic in water samples from different water periods and source types were compared via the two exposure routes, and the differences were statistically significant ( P < 0.05). At high ( P95) and moderate ( P50) exposure levels, the average annual total health risks of fluoride in drinking water via the two exposure routes (drinking water intake and skin contact) for adult males, adult females, children and the general population in fluorosis areas were a -1: 2.50 × 10 -9 and 8.64 × 10 -10, 2.20 × 10 -9 and 7.61 × 10 -10, 3.00 × 10 -9 and 1.04 × 10 -9, 2.36 × 10 -9 and 8.15 × 10 -10, respectively, and a -1: 2.44 × 10 -9 and 6.92 × 10 -10, 2.15 × 10 -9 and 6.09 × 10 -10, 2.93 × 10 -9 and 8.32 × 10 -10, 2.30 × 10 -9 and 6.53 × 10 -10 in non-endemic areas, respectively; the average annual total health risks of adult males, adult females, children, and the general population caused by arsenic ingestion through drinking water and skin contact in arsenic poisoning areas were a -1: 9.10 × 10 -7 and 3.67 × 10 -7, 8.11 × 10 -7 and 3.22 × 10 -7, 1.13 × 10 -6 and 4.45 × 10 -7, 8.95 × 10 -7 and 3.47 × 10 -7, respectively, and a -1: 2.42 × 10 -6 and 5.61 × 10 -7, 2.11 × 10 -6 and 4.80 × 10 -7, 2.88 × 10 -6 and 6.55 × 10 -7, 2.21 × 10 -6 and 5.25 × 10 -7 in non-endemic areas, respectively; average annual total health risks of adult males, adult females, children and the general population were all in the safe range [fluoride in drinking water: negligible levels recommended by the Royal Society and the Dutch Ministry of Construction and Environment were 1.0 × 10 -7 a -1 and 1.0 × 10 -8 a -1, respectively; arsenic in drinking water: the maximum acceptable level recommended by the International Commission on Radiological Protection (ICRP) was 5.0 × 10 -5 a -1]. Conclusions:The fluoride and arsenic levels in the drinking water of coal-burning borne endemic fluorosis and arsenic poisoning areas and non-endemic areas in Guizhou Province meet the requirements of hygienic standards for drinking water; the overall health risks of fluoride and arsenic to people of different ages and genders ingested through drinking water and through skin contact are within an acceptable range.

Objective To determine the role of AAMP in osteosarcoma cells and explore the mechanism of invasion and metastasis of osteosarcoma cells regulated by AAMP through the YAP signaling pathway.Methods Public sequencing data analysis was used to explore the correlation between AAMP and osteosarcoma.q-PCR,Western blot,and immunohistochemistry were used to detect the expression levels of osteosarcoma cell-related molecules.CCK-8 was used to detect cell proliferation ability.Transwell and wound healing assays were used to detect the invasive and metastatic abilities of osteosarcoma cells.Immunofluorescence was used to detect the cell localization and expression levels of related molecules.Results High expression of AAMP was negatively correlated with the prognosis of patients with osteosarcoma(P<0.05),and the expression of AAMP in patients with metastatic osteosarcoma increased(P<0.05).Compared with the control group,the AAMP interference group showed significantly decreased migratory,invasive,and EMT activities(P<0.05).The expression of p-CFL1 reduced after the knockdown of AAMP,and the cell plate pseudopods decreased significantly(P<0.05).A positive correlation was found between the expression levels of AAMP and YAP in osteosarcoma cells(P<0.05).Interfering with YAP expression can affect the migration and invasion of osteosarcoma cells.Conclusion AAMP promotes osteosarcoma cell metastasis by regulating the YAP signaling pathway,suggesting that AAMP may be a key molecule in promoting invasion and metastasis of osteosarcoma.

Objective This study aimed to investigate the lipid-lowering activity of LFBEP-C1 in high glucose-fed Caenorhabditis elegans(C.elegans). Methods In this study,the fermented barley protein LFBEP-C1 was prepared and tested for its potential anti-obesity effects on C.elegans.The worms were fed Escherichia coli OP50(E.coli OP50),glucose,and different concentrations of LFBEP-C1.Body size,lifespan,movement,triglyceride content,and gene expression were analyzed.The results were analyzed using ANOVA and Tukey's multiple comparison test. Results Compared with the model group,the head-swing frequency of C.elegans in the group of LFBEP-C1 at 20 μg/mL increased by 33.88%,and the body-bending frequency increased by 27.09%.This indicated that LFBEP-C1 improved the locomotive ability of C.elegans.The average lifespan of C.elegans reached 13.55 days,and the body length and width of the C.elegans decreased after LFBEP-C1 intake.Additionally,LFBEP-C1 reduced the content of lipid accumulation and triglyceride levels.The expression levels of sbp-1,daf-2,and mdt-15 significantly decreased,while those of daf-16,tph-1,mod-1,and ser-4 significantly increased after LFBEP-C1 intake.Changes in these genes explain the signaling pathways that regulate lipid metabolism. Conclusion LFBEP-C1 significantly reduced lipid deposition in C.elegans fed a high-glucose diet and alleviated the adverse effects of a high-glucose diet on the development,lifespan,and exercise behavior of C.elegans.In addition,LFBEP-C1 regulated lipid metabolism mainly by mediating the expression of genes in the sterol regulatory element-binding protein,insulin,and 5-hydroxytryptamine signaling pathways.

This paper summarizes Professor ZHANG Wei's experience in treating post-stroke dysphagia by using"unblocking pharyngeal orifice"grouping acupoints based on the concept of"harmonization and balance".Professor ZHANG Wei based on the theoretical of"the treatments should focus on where the meridians and collaterals pass through""the treatments should focus on where the acupoints are",target treatment,yin and yang balance,etc.,aiming at the basic pathogenesis of post-stroke dysphagia,that is,the obstruction of meridians and pharyngeal orifices,the obstruction of qi movement,as well as the fundamental pathogenesis of yin and yang imbalance and qi and blood disorder in stroke.She puts forward the concept of"harmonization and balance",followed the treatment principle of"unblocking the collaterals by opening and closing,relieving sore throat and opening the orifices,balancing yin and yang".The treatment characteristics of"selecting local acupoint and make direct action""taking its own advantages by selecting multi-channel acupoint""taking tongue,neck and body as a trinity acupuncture"and"combining supplementation and drainage to make a proper acupuncature therapy"have formed a unique"unblocking pharyngeal orifice"grouping acupoints.Professor ZHANG initially constructed a treatment plan combining tongue group acupoints,neck group acupoints and body group acupoints,and achieved unique effects in the clinical treatment of post-stroke dysphagia.

Objective: To investigate the effect of the AML1-ETO (AE) fusion gene on the biological function of U937 leukemia cells by establishing a leukemia cell model that induces AE fusion gene expression. Methods: The doxycycline (Dox) -dependent expression of the AE fusion gene in the U937 cell line (U937-AE) were established using a lentivirus vector system. The Cell Counting Kit 8 methods, including the PI and sidanilide induction, were used to detect cell proliferation, cell cycle-induced differentiation assays, respectively. The effect of the AE fusion gene on the biological function of U937-AE cells was preliminarily explored using transcriptome sequencing and metabonomic sequencing. Results: ①The Dox-dependent Tet-on regulatory system was successfully constructed to regulate the stable AE fusion gene expression in U937-AE cells. ②Cell proliferation slowed down and the cell proliferation rate with AE expression (3.47±0.07) was lower than AE non-expression (3.86 ± 0.05) after inducing the AE fusion gene expression for 24 h (P<0.05). The proportion of cells in the G(0)/G(1) phase in the cell cycle increased, with AE expression [ (63.45±3.10) %) ] was higher than AE non-expression [ (41.36± 9.56) %] (P<0.05). The proportion of cells expressing CD13 and CD14 decreased with the expression of AE. The AE negative group is significantly higher than the AE positive group (P<0.05). ③The enrichment analysis of the transcriptome sequencing gene set revealed significantly enriched quiescence, nuclear factor kappa-light-chain-enhancer of activated B cells, interferon-α/γ, and other inflammatory response and immune regulation signals after AE expression. ④Disorder of fatty acid metabolism of U937-AE cells occurred under the influence of AE. The concentration of the medium and short-chain fatty acid acylcarnitine metabolites decreased in cells with AE expressing, propionyl L-carnitine, wherein those with AE expression (0.46±0.13) were lower than those with AE non-expression (1.00±0.27) (P<0.05). The metabolite concentration of some long-chain fatty acid acylcarnitine increased in cells with AE expressing tetradecanoyl carnitine, wherein those with AE expression (1.26±0.01) were higher than those with AE non-expression (1.00±0.05) (P<0.05) . Conclusion: This study successfully established a leukemia cell model that can induce AE expression. The AE expression blocked the cell cycle and inhibited cell differentiation. The gene sets related to the inflammatory reactions was significantly enriched in U937-AE cells that express AE, and fatty acid metabolism was disordered.
Humans ; U937 Cells ; RUNX1 Translocation Partner 1 Protein ; Leukemia/genetics* ; Core Binding Factor Alpha 2 Subunit/genetics* ; Oncogene Proteins, Fusion/genetics* ; Leukemia, Myeloid, Acute/genetics*

Objective: To evaluate the prognostic value of left ventricular ejection fraction (LVEF) reserve assessed by gated SPECT myocardial perfusion imaging (SPECT G-MPI) for major adverse cardiovascular event (MACE) in patients with coronary artery disease. Methods: This is a retrospective cohort study. From January 2017 to December 2019, patients with coronary artery disease and confirmed myocardial ischemia by stress and rest SPECT G-MPI, and underwent coronary angiography within 3 months were enrolled. The sum stress score (SSS) and sum resting score (SRS) were analyzed by the standard 17-segment model, and the sum difference score (SDS, SDS=SSS-SRS) was calculated. The LVEF at stress and rest were analyzed by 4DM software. The LVEF reserve (ΔLVEF) was calculated (ΔLVEF=stress LVEF-rest LVEF). The primary endpoint was MACE, which was obtained by reviewing the medical record system or by telephone follow-up once every twelve months. Patients were divided into MACE-free and MACE groups. Spearman correlation analysis was used to analyze the correlation between ΔLVEF and all MPI parameters. Cox regression analysis was used to analyze the independent factors of MACE, and the optimal SDS cutoff value for predicting MACE was determined by receiver operating characteristic curve (ROC). Kaplan-Meier survival curves were plotted to compare the difference in the incidence of MACE between different SDS groups and different ΔLVEF groups. Results: A total of 164 patients with coronary artery disease [120 male; age (58.6±10.7) years] were included. The average follow-up time was (26.5±10.4) months, and a total of 30 MACE were recorded during follow-up. Multivariate Cox regression analysis showed that SDS (HR=1.069, 95%CI: 1.005-1.137, P=0.035) and ΔLVEF (HR=0.935, 95%CI: 0.878-0.995, P=0.034) were independent predictors of MACE. According to ROC curve analysis, the optimal cut-off to predict MACE was a SDS of 5.5 with an area under the curve of 0.63 (P=0.022). Survival analysis showed that the incidence of MACE was significantly higher in the SDS≥5.5 group than in the SDS<5.5 group (27.6% vs. 13.2%, P=0.019), but the incidence of MACE was significantly lower in the ΔLVEF≥0 group than in theΔLVEF<0 group (11.0% vs. 25.6%, P=0.022). Conclusions: LVEF reserve (ΔLVEF) assessed by SPECT G-MPI serves as an independent protective factor for MACE, while SDS is an independent risk predictor in patients with coronary artery disease. SPECT G-MPI is valuable for risk stratification by assessing myocardial ischemia and LVEF.
Humans ; Male ; Middle Aged ; Aged ; Coronary Artery Disease/diagnostic imaging* ; Stroke Volume ; Myocardial Perfusion Imaging ; Retrospective Studies ; Ventricular Function, Left ; Myocardial Ischemia

Humans ; Consensus ; Hypersensitivity ; Desensitization, Immunologic/adverse effects* ; Immunotherapy/adverse effects* ; Injections, Subcutaneous ; Allergens