1.Incidence, mortality, and disability-adjusted life years of female breast cancer in China, 2022
Kexin SUN ; Bailin ZHANG ; Shaoyuan LEI ; Rongshou ZHENG ; Xin LIANG ; Li LI ; Xiaolong FENG ; Siwei ZHANG ; Hongmei ZENG ; Yifei YAO ; Peiqing MA ; Shaoming WANG ; Ru CHEN ; Bingfeng HAN ; Wenqiang WEI ; Jie HE
Chinese Medical Journal 2024;137(20):2429-2436
Background::Breast cancer is ranked among the most prevalent malignancies in the Chinese female population. However, comprehensive reports detailing the latest epidemiological data and attributable disease burden have not been extensively documented.Methods::In 2018, high-quality cancer surveillance data were recorded in 700 population-based cancer registries in China. We extracted data on female breast cancers (International Classification of Diseases, Tenth Revision [ICD-10]: C50) and estimated the incidence and mortality in 2022 according to the baseline data and corresponding trends from 2010 to 2018. Pathological types were classified according to the ICD for Oncology, 3rd Edition codes. Disability-adjusted life years (DALYs) were calculated as the sum of the years of life lost (YLLs) and years lived with disability (YLDs).Results::In 2022, approximately 357,200 new female breast cancer cases and 75,000 deaths occurred in China, accounting for 15.59% and 7.94% of total new cancer cases and deaths, respectively. The age-standardized incidence rate (ASIR) was 33.04 per 100,000. When analyzed by pathological type, the ASIRs for papillary neoplasms, invasive breast carcinoma, rare and salivary gland-type tumors, and other types were 1.13, 29.79, 0.24, and 1.88 per 100,000, respectively. The age-standardized mortality rate (ASMR) was 6.10 per 100,000. A total of 2,628,000 DALYs were found to be attributable to female breast cancer in China, comprising 2,278,300 YLLs and 349,700 YLDs. The ASIR, ASMR, and age-standardized rate (ASR) for DALYs in urban areas were consistently higher than those in rural areas. We observed a four-fold increase in the ASIR and ASR for DALYs and an eight-fold increase in the ASMR among females over 55 years compared with those aged under 55 years.Conclusion::These data provide invaluable insights into the latest epidemiology of female breast cancer in China and highlight the urgency for disease prevention and control strategy formulation.
2.Imaging features of acute and subacute toxic encephalopathy induced by organic solvents
Journal of Practical Radiology 2024;40(1):19-21
Objective To analyze the imaging features of acute and subacute toxic encephalopathy induced by organic solvents.Methods A total of 8 cases with acute and subacute toxic encephalopathy induced by organic solvents were retrospectively enrolled,and all imaging data were further analyzed.Of 8 patients,all patients underwent the plain CT scan,there were 3 patients with plain and enhanced cranial MR scan,and 2 patients with plain cranial MR scan.Results White matter density on CT imaging was signifi-cantly and symmetrically decreased in all cases,but the involvement of gray matter nuclei was unclear.White matter involvement on MRI was diffuse and symmetrical on both hemispheres.There were differences in white matter among affected areas.The gray mat-ter nuclei in the cerebellar dentate nucleus,globus pallidus,and thalamus were most involved,but there was no evidence of involve-ment in the white matter of the lateral ventricle,corpus callosum,and temporal pole.All lesions were with high signal on the diffu-sion weighted imaging(DWI)and high and low signals on apparent diffusion coefficient(ADC)map and without enhancement.Con-clusion The lateral ventricle white matter,corpus callosum,and temporal pole white matter are not easily affected in cerebral white matter in patients with organic solvents toxic encephalopathy,contributing to differentiate from other toxic encephalopathies.
3.Novel programmed cell death in periprosthetic osteolysis
Xiaolong LIANG ; Kai ZHENG ; Dechun GENG ; Yaozeng XU
Chinese Journal of Tissue Engineering Research 2024;28(21):3393-3399
BACKGROUND:In addition to apoptosis,recent studies have discovered novel forms of programmed cell death in periprosthetic osteolysis,which is involved in regulating local chronic inflammation and the outcome of osteoblast and osteoclast under pathological conditions.This has an important value for the treatment and prognosis of periprosthetic osteolysis. OBJECTIVE:To provide new ideas and strategies for the prevention and treatment of periprosthetic osteolysis by summarizing studies on the novel forms of programmed cell death. METHODS:The first author used the computer to search the articles published from 2005 to 2022.Chinese search terms"wear particles,periprosthetic osteolysis,programmed cell death,apoptosis,autophagy,pyroptosis,necrotizing apoptosis,iron death"were used to search the databases of CNKI,WanFang and VIP.English search terms"osteolysis,wear debris,wear particles,peri*prosthetic osteolysis,PPOL,aseptic loosening,autophagy,regulated cell death,programmed cell death,apoptosis,pyroptosis,autophagic cell death,autophagy,necroptosis,ferroptosis"were used for search in PubMed and Web of Science databases.A total of 68 articles were finally included according to the inclusion criteria. RESULTS AND CONCLUSION:(1)Inadequate or excessive activation of autophagy can cause cell death,inhibit bone formation,and promote bone resorption,leading to bone metabolism disorders and osteolysis.(2)Recent studies have paid close attention to pyroptosis in periprosthetic osteolysis,where the Nod-like receptor,pyrin containing 3 inflammasome plays an important role in local inflammation.Inhibiting pyroptosis can effectively alleviate osteolysis.(3)In vitro studies have shown that necroptosis can inhibit the formation and function of osteoblasts and osteoclasts,affecting the process of osteolysis and destruction.(4)Ferroptosis is the newest form of programmed cell death,which is regulated by complex signaling pathways and mechanisms,but is not yet fully understood.(5)Autophagy,pyroptosis,necroptosis,and ferroptosis play important roles in the development of periprosthetic osteolysis,and their associated signaling pathways and genes require further investigation.
4.Preparation and characteristics comparison of three acute pancreatitis rat models
Xiaolong NIU ; Jialiang CHEN ; Huaqun ZHENG ; Guimei YANG ; Guangtao YAO
Chinese Journal of Tissue Engineering Research 2024;28(34):5480-5486
BACKGROUND:Establishing a stable and reliable animal model of acute pancreatitis is of great significance for understanding its pathogenesis,pathophysiological characteristics,and clinical medication.Domestic and foreign studies have shown that cerulein,L-arginine,and sodium taurocholate can induce acute pancreatitis,but their pathophysiological characteristics and model characteristics are still unclear. OBJECTIVE:To establish an acute pancreatitis rat model using cerulein,L-arginine,and sodium taurocholate and to observe the changing patterns of model features at different time points. METHODS:Ninety-six healthy male Sprague-Dawley rats were randomly divided into normal group,cerulein group,L-arginine group,and sodium taurocholate group,with 24 rats in each group.Within each group,there were three subgroups(n=8 per group):12-,24-,and 48-hour subgroups.Cerulein was administered via intraperitoneal injection six times with a 1-hour interval.L-arginine was administered through two intraperitoneal injections with a 1-hour interval.Sodium taurocholate was injected for inducing acute pancreatitis models through retrograde injection into the bile-pancreatic duct.By examining the rat survival rate,gross morphology of the pancreas,calculating the pancreatic organ index,and measuring levels of amylase,lipase,alanine transaminase,aspartate transaminase,blood urea nitrogen,and creatinine,as well as observing pancreatic tissue pathological features through hematoxylin-eosin staining and conducting a pancreatic injury scoring,we evaluated the changing patterns of model features at different time points. RESULTS AND CONCLUSION:Compared with the normal group,the overall survival rate of rats was 100%in the cerulein group,88%in the L-arginine group,and 96%in the sodium taurocholate group.The pancreatic organ index was increased in all groups.Gross observation indicated that,In the cerulein group,pancreatic edema,blurred lobes,and looseness were visible.In the L-arginine group,the pancreatic glands were enlarged and thickened with patchy bleeding.In the sodium taurocholate group,pancreatic tissue showed varying degrees of congestion and edema accompanied by scattered flakes of hemorrhage and necrosis.The levels of serum alanine transaminase,aspartate transaminase,blood urea nitrogen,creatinine,amylase,and lipase in rats exhibited consistent changes.In the cerulein group,these parameters possibly peaked at 12 hours(P<0.05)and then showed a declining trend.In the L-arginine group,they reached the highest levels at 24 hours(P<0.05)and significantly decreased at 48 hours.In the sodium taurocholate group,serum amylase and lipase remained at higher levels at 12 hours with a slow decline trend(P<0.05).Compared with the normal group,microscopic examination revealed mild acinar edema and widened interlobular spaces in the cerulein group,with a higher presence of inflammatory cells.In the L-arginine group,there was widening of interlobular spaces,extensive infiltration of inflammatory cells,and patchy necrotic areas.In the sodium taurocholate group,significant pancreatic edema,structural disarray,extensive necrotic foci,and inflammatory cell infiltration were observed.Compared with the normal group,the pathological scores of induced acute pancreatitis in all three models were significantly different at each time point(P<0.05).Moreover,the pathological scores in each group increased over time,indicating a gradual worsening of pancreatic tissue damage.When comparing different models at the same time,there were differences in pathological scores,with the sodium taurocholate group having the highest scores,followed by the L-arginine group,and the cerulein group having the lowest scores.Analyzing the three models at the same time point,the most severe condition was in the sodium taurocholate group,which was characterized by pancreatic hemorrhage and necrosis,followed by the L-arginine group,which was characterized by necrosis,and the least severe condition was in the cerulein group,mainly characterized by edema.The serum biochemical index levels of the cerulein and L-arginine groups decreased at 48 hours,indicating that these two models may have a tendency to self-heal and belong to a self-limiting disease course.The serum biochemical index levels of the sodium taurocholate group decreased slowly after 12 hours.Therefore,pancreatic injury in the sodium taurocholate group might not be relieved after 48 hours or longer.
5.Correlation of serum visfatin and resistin levels with cardiometabolic index and bone mineral density in elderly patients with essential hypertension complicated with osteoporosis
Jianwu ZHENG ; Lu LIANG ; Qin SHEN ; Xiaolong HE
Chinese Journal of Endocrine Surgery 2024;18(5):702-706
Objective:To investigate the correlation of serum visfatin and resistin levels with cardiometabolic index (CMI) and bone mineral density (BMD) in elderly patients with essential hypertension (EH) complicated with osteoporosis (OP) .Methods:From Feb. 2021 to Feb. 2023, 120 elderly patients with EH complicated with OP in Department of Cardiovascular Medicine, Hangzhou Hospital of Traditional Chinese Medicine were chosen (the EH complicated with OP group), and 50 healthy physical examination subjects (the NC group) and 50 EH complicated with low bone mass (the EH complicated with low bone mass group) were chosen as the control. Venous blood samples were collected from all patients, serum visfatin and resistin levels were measured, and CMI and BMD were tested. Statistical methods were used to analyze the data.Results:In EH patients with decreased bone mass or OP, the level of serum visfatin was often low, but resistin was elevated, which showed significant differences compared with that in the NC group ( F visfatin = 26.02, F resistin = 9.50, P < 0.001). The CMI in NC group was lower than that in the other two groups ( F = 52.54, P < 0.001). In terms of bone mass, BMD in NC group was higher than that in the other two groups, especially in the key parts of lumbar spine ( F=21.44, P < 0.001), femoral neck ( F=10.54, P < 0.001), Chinese triangle ( F=12.30, P < 0.001) and femoral trochanter ( F=4.87, P < 0.001), etc. BMD in EH complicated with low bone mass was also higher than that in EH complicated with OP group, including lumbar spine ( t=4.60, P < 0.001), femoral neck ( t=2.32, P=0.022), Chinese triangle ( t=4.58, P < 0.001) and femoral trochoid ( t=4.33, P < 0.001). In addition, visfatin was positively correlated with bone mass ( P < 0.05), lumbar spine ( r=0.36, P < 0.001), femoral neck ( r=0.38, P < 0.001), Chinese triangle ( r=0.28, P=0.020) and femoral trochoid ( r=0.37, P < 0.001), while resistin was negatively correlated with bone mass, lumbar spine ( r=-0.40, P < 0.001), femoral neck ( r=-0.50, P < 0.001), and femoral trochanter ( r=-0.40, P < 0.001). However, there was no significant correlation between CMI and visfatin ( r=0.06, P > 0.05) and resistin ( r=0.11, P > 0.05). Logistic analysis showed that visfatin level was a risk factor of OP in EH patients ( P < 0.001), and resistin was a protective factor ( P = 0.008) . Conclusion:Serum visfatin and resistin levels in elderly EH patients complicated with OP are correlated with BMD, suggesting that they may play an important role in disease development and treatment.
6.Baicalin Induces Ferroptosis in Gastric Cancer Cells via p53-mediated SLC7A11 Down-regulation
Xiaolong YUAN ; Zheng WEI ; Junping ZHANG ; Rui ZHENG ; Rui CHAO ; Xiaoping CAI
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(6):71-78
ObjectiveTo explore the inhibitory effect of different concentration of baicalin (0, 100, 200, 400 μmol·L-1) on the proliferation of human gastric cancer SGC-7901 cells and the underlying mechanism. MethodSGC-7901 cells were treated with baicalin. Then methyl thiazolyl tetrazolium (MTT) assay was employed to examine the inhibitory effect of baicalin on the cells. At the same time, ferrostatin-1 (Fer-1) was added to observe the viability of cells after baicalin treatment. The expression of ferroptosis-related genes was detected by Real-time polymerase chain reaction (Real-time PCR) and Western blot. The content of malondialdehyde (MDA) and the level of glutathione (GSH) were detected respectively by MTT assay and enzyme-linked immunosorbent assay. The role of tumor protein 53 (p53)/solute carrier family 7 member 11 (SLC7A11) pathway in the regulation of ferroptosis was investigated respectively via overexpression and small interfering RNA (siRNA) methods. ResultCompared with the blank group, baicalin decreased the viability of SGC-7901 (P<0.05, P<0.01) in a dose- and time-dependent manner. The intervention of Fer-1 significantly alleviated the decrease of SGC-7901 cell viability caused by baicalin (P<0.01). In addition, compared with the baicalin group, Fer-1+baicalin group showed decrease in MDA content and the mRNA and protein levels of prostaglandin-endoperoxide synthase 2 (PTGS2) in the cells (P<0.01), and increase in GSH activity and mRNA and protein levels of glutathione peroxidase 4 (GPX4) (P<0.01). The protein level of SLC7A11 in the baicalin group was decreased compared with that in the blank group (P<0.05, P<0.01) in a dose-dependent manner. Compared with the baicalin group, the reactive oxygen species (ROS) level and MDA content in SLC7A11-overexpressing cells were significantly decreased after baicalin treatment (P<0.01), and the GSH activity was significantly increased (P<0.01). The fluorescence intensity of p53 in the cells of the baicalin group was increased compared with that of the blank group (P<0.01). Compared with the baicalin group, the expression level of p53 protein in the cells transfected with p53 siRNA was significantly decreased after baicalin treatment (P<0.01), and the expression level of SLC7A11 was significantly increased (P<0.01). ConclusionBaicalin can effectively inhibit the proliferation of SGC-7901 cells by regulating p53/SLC7A11-mediated ferroptosis.
7.Erratum: Author correction to "TMEM16A inhibits angiotensin II-induced basilar artery smooth muscle cell migration in a WNK1-dependent manner" Acta Pharm Sin B 11(12) (2021) 3994-4007.
Huaqing ZHENG ; Xiaolong LI ; Xin ZENG ; Chengcui HUANG ; Mingming MA ; Xiaofei LV ; Yajuan ZHANG ; Lu SUN ; Guanlei WANG ; Yanhua DU ; Yongyuan GUAN
Acta Pharmaceutica Sinica B 2023;13(3):1340-1343
[This corrects the article DOI: 10.1016/j.apsb.2021.04.013.].
8.Single-cell transcriptomic atlas of mouse cochlear aging.
Guoqiang SUN ; Yandong ZHENG ; Xiaolong FU ; Weiqi ZHANG ; Jie REN ; Shuai MA ; Shuhui SUN ; Xiaojuan HE ; Qiaoran WANG ; Zhejun JI ; Fang CHENG ; Kaowen YAN ; Ziyi LIU ; Juan Carlos Izpisua BELMONTE ; Jing QU ; Si WANG ; Renjie CHAI ; Guang-Hui LIU
Protein & Cell 2023;14(3):180-201
Progressive functional deterioration in the cochlea is associated with age-related hearing loss (ARHL). However, the cellular and molecular basis underlying cochlear aging remains largely unknown. Here, we established a dynamic single-cell transcriptomic landscape of mouse cochlear aging, in which we characterized aging-associated transcriptomic changes in 27 different cochlear cell types across five different time points. Overall, our analysis pinpoints loss of proteostasis and elevated apoptosis as the hallmark features of cochlear aging, highlights unexpected age-related transcriptional fluctuations in intermediate cells localized in the stria vascularis (SV) and demonstrates that upregulation of endoplasmic reticulum (ER) chaperon protein HSP90AA1 mitigates ER stress-induced damages associated with aging. Our work suggests that targeting unfolded protein response pathways may help alleviate aging-related SV atrophy and hence delay the progression of ARHL.
Mice
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Animals
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Transcriptome
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Aging/metabolism*
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Cochlea
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Stria Vascularis
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Presbycusis
9.Temporal and spatial stability of the EM/PM molecular subtypes in adult diffuse glioma.
Jing FENG ; Zheng ZHAO ; Yanfei WEI ; Zhaoshi BAO ; Wei ZHANG ; Fan WU ; Guanzhang LI ; Zhiyan SUN ; Yanli TAN ; Jiuyi LI ; Yunqiu ZHANG ; Zejun DUAN ; Xueling QI ; Kai YU ; Zhengmin CONG ; Junjie YANG ; Yaxin WANG ; Yingyu SUN ; Fuchou TANG ; Xiaodong SU ; Chuan FANG ; Tao JIANG ; Xiaolong FAN
Frontiers of Medicine 2023;17(2):240-262
Detailed characterizations of genomic alterations have not identified subtype-specific vulnerabilities in adult gliomas. Mapping gliomas into developmental programs may uncover new vulnerabilities that are not strictly related to genomic alterations. After identifying conserved gene modules co-expressed with EGFR or PDGFRA (EM or PM), we recently proposed an EM/PM classification scheme for adult gliomas in a histological subtype- and grade-independent manner. By using cohorts of bulk samples, paired primary and recurrent samples, multi-region samples from the same glioma, single-cell RNA-seq samples, and clinical samples, we here demonstrate the temporal and spatial stability of the EM and PM subtypes. The EM and PM subtypes, which progress in a subtype-specific mode, are robustly maintained in paired longitudinal samples. Elevated activities of cell proliferation, genomic instability and microenvironment, rather than subtype switching, mark recurrent gliomas. Within individual gliomas, the EM/PM subtype was preserved across regions and single cells. Malignant cells in the EM and PM gliomas were correlated to neural stem cell and oligodendrocyte progenitor cell compartment, respectively. Thus, while genetic makeup may change during progression and/or within different tumor areas, adult gliomas evolve within a neurodevelopmental framework of the EM and PM molecular subtypes. The dysregulated developmental pathways embedded in these molecular subtypes may contain subtype-specific vulnerabilities.
Humans
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Brain Neoplasms/pathology*
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Neoplasm Recurrence, Local/metabolism*
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Glioma/pathology*
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Neural Stem Cells/pathology*
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Oligodendrocyte Precursor Cells/pathology*
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Tumor Microenvironment
10.Impact of body mass index on perioperative efficacy and complications of robot-assisted radical cystectomy with intracorporeal urinary diversion
Shuai WANG ; Wei ZHENG ; Qijun WO ; Xiaolong QI ; Feng LIU ; Dahong ZHANG
Chinese Journal of Urology 2023;44(2):102-108
Objective:To determine the impact of body mass index (BMI) on perioperative and oncological outcomes after robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion.Methods:Clinical data of bladder cancer patients undergoing robot-assisted radical cystectomy with intracorporeal urinary diversion in Zhejiang Provincial People's Hospital from January 2017 to January 2020 were retrospectively analyzed. Patients were divided into three groups according to BMI, including 61 cases in normal group (<25.0 kg/m2), 52 cases in overweight group (25.0-29.9 kg/m2) and 33 cases in obese group (≥30.0 kg/m2). In the normal group, the median age was 73.6(59, 79), including 45 male(73.8%), with 51 cases(83.6%) of ASA score 0-2, 10 cases (16.4%)of 3 or higher, and 10 cases (16.4%) undergoing neoadjuvant chemotherapy. Past medical history included smoking in 34 cases (55.7%), hypertension in 19 cases (31.1%), diabetes in 10 cases (16.4%), heart disease in 12 cases (19.7%), and abdominal surgery in 6 cases (9.8%). In the overweight group, the median age was 69.7(60, 78), including 38 male (73.1%), with 25 cases (48.1%)of ASA score 0-2, 27 cases (51.9%) of 3 or higher, and 9 cases (17.3%) undergoing received neoadjuvant chemotherapy. Past medical history included smoking in 30 cases (57.7%), hypertension in 20 cases (38.5%), diabetes in 10 cases (19.2%), heart disease in 9 cases (17.3%), and abdominal surgery in 5 cases (9.6%). In the obses group, the median age was 69.9(61, 78), including 21 male(63.7%), with 20 cases (60.6%)of ASA score 0-2, 13 cases(39.4%) of 3 or higher, 9 cases (27.3%) undergoing neoadjuvant chemotherapy. Past medical history included smoking in 18 cases (54.5%), hypertension in 17 cases (51.5%), diabetes in 19 cases (57.6%), heart disease in 7 cases (21.2%), and abdominal surgery in 4 cases (12.1%). After statistical comparison among the three groups, it was found that the proportion of patients with hypertension and diabetes in the obesity group and overweight group was higher than that in the normal group (all P<0.05), but there was no significant difference in other factors (all P>0.05). During the surgical process, robot-assisted radical cystectomy and bilateral pelvic lymph node dissection were performed firstly. The scope of lymph node dissection was divided into standard range and expanded range, and the diversion was divided into orthotopic neobladder and ileal bladder. During the orthotopic neobladder process, 40-50 cm ileum at the distance of 15 cm away from ileocecum was obtained by stapler, and then the U-shaped neobladder was made, and the new bladder was anastomosed with urethra and bilateral ureter. For ileal bladder, the ileum was cut off 15cm away from the ileocecum with stapler to obtain the 15 cm ileum to prepare the ileal conduit and restore the continuity of the ileum. The bilateral ureteral spacing 3cm was implanted on the ileal conduit. In the normal group, standard range lymphatic dissection was performed in 20 cases (32.8%), enlarged dissection in 41 cases (67.2%), orthotopic neobladder in 22 cases(36.1%), and ileal conduit in 39 cases (63.9%). In the overweight group, standard range lymphatic dissection was performed in 12 cases (23.1%), enlarged dissection in 40 cases (76.9%), orthotopic neobladder in 26 cases (49.1%), and ileal conduit in 26 cases (50.9%). In the obesity group, the standard range of lymphatic dissection was performed in 7 cases (21.2%), enlarged dissection in 26 cases (78.7%), orthotopic neobladder in 7 cases (21.2%), and ileal conduit in 26 cases (78.8%). There was no significant difference among the three groups (all P>0.05). Compared the operation time, intraoperative blood loss, postoperative exhaust time, postoperative time of taking solid food, postoperative hospital stay, postoperative complications (according to the Clavien-Dindo grading system, postoperative complications are reported inⅠ-Ⅱ grade as mild complications and above Ⅲ grade as serious complications) and pathology results in three groups. Results:All cases successfully underwent robotically without conversion or major intraoperative complications. The operation time in overweight and obsess group were longer than that of normal group with RARC or orthotopic neobladder [310(250, 350) min, 370(310, 420) min, 250(230, 310) min, ( P<0.05)], but there was no significant difference in RARC and ileal conduit[270(220, 300) min, 280(230, 300) min, 240(220, 290)min, P>0.05]. The estimated blood loss in overweight and obsess group was more than that in normal group [230(150, 450)ml, 310(250, 600)ml, 190(100, 350)ml, P<0.05], but there was no difference in blood transfusion rate [4(7.7%), 2(6.1%), 5(8.2%), P>0.05]. The exhaust time [2(1, 3) days, 2(1, 4)days, 2(1, 4)days], postoperative solid food intake time [4(3, 5)days, 4(3, 6)days, 4(3, 6)days] and the hospital stay[10(5, 16)days, 10(6, 17)days, 12(6, 20)days] were not different in three groups(all P>0.05). The mild complication rates in 90 days were significant higher in overweight and obsess groups[28 (53.8%), 16(48.5%), 20(32.8%), P<0.05], but the total and severe complication rates were not significantly different. The incidences of urinary system complications and incision complications in obese and overweight patients were significantly higher than those in normal group ( P<0.05). There was no significant difference in the incidence of gastrointestinal complications and ureteral anastomosis-related complications (stricture or urinary leakage)( P>0.05). There was no significant difference in the number of dissected lymph node, positive lymph node, positive rate of incisional margin and postoperative pathological stage among three different BMI groups(all P>0.05). Conclusion:Robot-assisted radical cystectomy combined with intracorporeal urinary diversion is a safe and effective method for the treatment of overweight, obese and even morbidly obese patients with bladder cancer. The recovery of intestinal function and the oncological results are not affected by body mass index. However, laparoscopic radical cystectomy for overweight and obese patients, especially for orthotopic neobladder, has the risk of long operation time, large amount of intraoperative bleeding and increased risk of minor postoperative complications.

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