AIM:To investigate whether melatonin can ameliorate acute myocardial infarction(AMI)by in-hibiting ferroptosis.METHODS:H9C2 cells were cultured in AnaeroPack system with low sugar and serum-free medium for 10 h to construct a cell model of AMI.Then cells were treated with melatonin and ferroptosis inducer erastin.The cell activity,reactive oxygen species(ROS),lipid peroxidation,mitochondrial membrane potential(MMP),and ferroptosis related protein expression were detected.A rat model of AMI induced by isoprenaline(ISO)injection was established to evaluate the effects of melatonin,in which the myocardial infarction size,cardiac injury,pathological changes,oxidative stress,iron ion and ferroptosis related protein expression were examined.RESULTS:Melatonin decreased the oxidative stress,lipid peroxidation and expression of ferroptosis protein in cardiomyocytes induced by hypoxia,but these effects could be impeded by the ferroptosis inducer erastin.Furthermore,in vivo experiments,we also found that melatonin im-proved the myocardial infarction size,cardiac injury,pathological changes,oxidative stress,and alleviated iron ion accu-mulation and ferroptosis.CONCLUSION:The cardioprotective effects of melatonin in AMI are associated with the inhi-bition of ferroptosis.

AIM:To investigate whether melatonin can ameliorate acute myocardial infarction(AMI)by in-hibiting ferroptosis.METHODS:H9C2 cells were cultured in AnaeroPack system with low sugar and serum-free medium for 10 h to construct a cell model of AMI.Then cells were treated with melatonin and ferroptosis inducer erastin.The cell activity,reactive oxygen species(ROS),lipid peroxidation,mitochondrial membrane potential(MMP),and ferroptosis related protein expression were detected.A rat model of AMI induced by isoprenaline(ISO)injection was established to evaluate the effects of melatonin,in which the myocardial infarction size,cardiac injury,pathological changes,oxidative stress,iron ion and ferroptosis related protein expression were examined.RESULTS:Melatonin decreased the oxidative stress,lipid peroxidation and expression of ferroptosis protein in cardiomyocytes induced by hypoxia,but these effects could be impeded by the ferroptosis inducer erastin.Furthermore,in vivo experiments,we also found that melatonin im-proved the myocardial infarction size,cardiac injury,pathological changes,oxidative stress,and alleviated iron ion accu-mulation and ferroptosis.CONCLUSION:The cardioprotective effects of melatonin in AMI are associated with the inhi-bition of ferroptosis.

Purpose: Reduced quality of life after cystectomy has made bladder preservation a popular research topic for muscle-invasive bladder cancer (MIBC). Previous research has indicated significant tumor downstaging after neoadjuvant chemotherapy (NAC). However, maximal transurethral resection of bladder tumor (TURBT) was performed before NAC to define the pathology, impacting the real evaluation of NAC. This research aimed to assess real NAC efficacy without interference from TURBT and apply combined modality therapies guided by NAC efficacy. Materials and Methods: Patients with cT2-4aN0M0 MIBC were confirmed by cystoscopic biopsy and imaging. NAC efficacy was assessed by imaging, urine cytology, and cystoscopy with multidisciplinary team discussion. Definite responders (≤ T1) underwent TURBT plus concurrent chemoradiotherapy. Incomplete responders underwent radical cystectomy or partial cystectomy if feasible. The primary endpoint was the bladder preservation rate. Results: Fifty-nine patients were enrolled, and the median age was 63 years. Patients with cT3-4 accounted for 75%. The median number of NAC cycles was three. Definite responders were 52.5%. The complete response (CR) was 10.2%, and 59.3% of patients received bladder-sparing treatments. With a median follow-up of 44.6 months, the 3-year overall survival (OS) was 72.8%. Three-year OS and relapse-free survival were 88.4% and 60.0% in the bladder-sparing group but only 74.3% and 37.5% in the cystectomy group. The evaluations of preserved bladder function were satisfactory. Conclusion After stratifying MIBC patients by NAC efficacy, definite responders achieved a satisfactory bladder-sparing rate, prognosis, and bladder function. The CR rate reflected the real NAC efficacy for MIBC. This therapy is worth verifying through multicenter research.

OBJECTIVETo demonstrate the clinical applicability of three-dimensional CT angiography by evaluating the anatomic features and variation of inferior mesenteric artery(IMA) and left colic artery(LCA) in order to provide reference to vessel ligation strategy in laparoscopic rectal cancer surgery.

METHODSClinical and image data of 123 patients receiving abdominal multislice CT at The Sixth Affiliated Hospital from 2014 to 2015 were retrospectively analyzed. The images were 3D-reconstructed with computer 3D CT angiography and arterial enhancement phase images were chosen for analysis. Linear distances from IMA root to abdominal aortic bifurcation and from LCA at IMA root level to IMA root were measured. Branch types of IMA, coursing pattern of LCA, and association between LCA and inferior mesenteric vein (IMV) site were summarized.

RESULTSOf 123 cases, 80 were males and 43 were females, mean age was (46.8±16.6) years, body weight was (57.7±10.4) kg, and BMI was (21.3±3.6) kg/m. The average distance from IMA root to abdominal aortic bifurcation was (42.5±7.9) mm, and this distance was closely associated with body weight (OR=4.771, 95%CI: 1.398 to 16.283, P=0.013). Longer distance tended to appear in the heavier patients. LCA and sigmoid artery (SA) originating from same single IMA was found in 61(49.6%) cases; LCA and SA forking at same point in 35(28.5%) cases; LCA and SA coursing together and forking afterwards in 24(19.5%) cases, and LCA disappearing in 3(2.4%) cases. In 71(57.7%) patients, LCA ascended medial to the lateral border of left kidney, while in 16(13.0%) patients, LCA arranged below the inferior border of left kidney. When the LCA site was higher and the distance from LCA to IMA root was closer [distance from LCA to IMA root level was (24.2±9.9) mm, (30.0±15.2) mm and (66.6±12.3) mm, F=83.2, P<0.001]. At the level of IMA root, LCA located medial to IMV in 21(17.1%) cases, located just lateral to IMV in 54(43.9%) cases, and located lateral and ascended far away from IMV in 48(39.0%) cases.

CONCLUSION3D-CT angiography is non-invasive, efficient and accurate in evaluating coursing features and variation of IMA and its branches, which can provide important reference to the surgeons, promising laparoscopic surgery smooth and safe.

Objective To study the prevalence,risk factors of overactive bladder (OAB) in middle-aged and senior residents in Zhengzhou China.Methods A randomized,community-based,crosssectional study was performed on 10 160 residents aged 40 or older in urban area of Zhengzhou by using a stratified system sampling approach.A questionnaire including the subjects' basic information,previous history,present history,the Chinese overactive bladder symptom score (OABSS) was filled on site.The diagnostic criteria for OAB was 'an urgency score for Question 3 of 2 or more,and an OABSS of 3 or more'.Chisquare test was used to determine the differences of prevalence between genders,age groups,BMI and people with and without diabetes mellitus (DM).A pairwise comparison was conducted between different age,BMI group by using Bonferroni method.Results A total of 10 160 residents were investigated and finally 9805 (96.5％) were qualified for final statistical analysis.The mean age was (57.9 ± 9.7) years.The overall prevalence of OAB was 2.1％ (209/9805),of which,with OABdry 1.0％,and OABwet 1.1％.Male subjects were more likely suffered from OAB than female,with 2.7％ (84/3129) versus 1.9％ (125/6676).The prevalence of OAB in both male and female increased with age.There was no significant difference in the prevalence of male and female before the age of 60 years (1.2％ versus 1.4％,P ＞ 0.05) and more common in men than in women after the age of 60 years (4.6％ versus 2.6％,P ＜ 0.05).The prevalence of the subjects with DM was significantly higher than those without DM (P ＜ 0.05).The subjects with BMIs of 30 or more were nore likely to have OAB (3.2％ versus 1.8％,P ＜ 0.05).Conclusions The prevalence of OAB increases with advancing age.The prevalence of male is higher than female after the age of 60 years.The diabetics and obese people are more likely to have OAB.

Objective To investigate the effects of solifenacin on the detrusor instability of patients with overactive bladder (OAB).Methods A total of 20 outpatients with OAB of.1 - 20 ( mean, 8 )years, 12 males and 8 females, aged 21 - 83 ( mean, 43) years were included in this study.Five mg solifenacin was given orally once daily for 12 weeks.Before and after treatment, overactive bladder symptom score (OABSS), patient perception of bladder condition symptoms rating scale (PPBC), and filling cystometry was performed.Results Before and after solifenacin administration, significant decrease were detected in term of unstable detrusor waves ( 2.3 ± 2.4) vs (0.6 ± 1.3 ) ( P ＜ 0.05 ), and detrusor overactivity ( DO ) disappeared in 6 patients.Bladder capacities at first desire to void and maximum bladder capacity were significantly increased (P ＜0.01 ).Bladder compliance and detrusor pressure at maximum urine flow had no significant difference (P ＞ 0.05 ).All patients had significant improvement in OAB symptoms evaluating by OABSS and PPBC ( P ＜ 0.05 ).Six patients had mild side effect of dry mouth and could be relieved by drinking more water.Conclusion Urodynamically, solifenacin decreases the detrusor overactivity, increases the bladder capacity and improves the quality of life of OAB patients.