[Objective] To investigate the clinical application of microscope-assisted subinguinal hierarchical dissection in the treatment of varicocele (VC), so as to provide reference for clinicians. [Methods] The clinical data of 113 VC patients admitted to our hospital during Jul.2021 and Jun.2022 were retrospectively analyzed.All patients were treated with microscope-assisted hierarchical anatomical spermatic vein ligation under the external ring, with layered isolation.The number of intraoperative ligations of the internal spermatic veins and external spermatic vein, preserved arteries as well as the number of lymphatic vessels were recorded. [Results] Among the 13 patients with a mean age of (28.7±6.0) years, 98 had left-side lesion and 15 had bilateral lesion.The degree of varicocele: degree Ⅱ in 44 cases and degree Ⅲ in 69 cases.Intraoperative ligation of the internal spermatic veins: (9.18±3.21) on the left side and (9.02±3.39) on the right side.Intraoperative ligation of the external spermatic veins: (1.47±0.93) on the left side and (1.41±1.10) on the right side.Preservation of the internal spermatic arteries: (2.03±1.07) on the left side, (1.97±0.99) on the right side.Preservation of the external spermatic arteries: (1.42±0.50) on the left side and (1.40±0.50) on the right side.Preservation of lymphatics: (3.87±2.07) on the left and (3.89±1.99) on the right. [Conclusion] Hierarchical dissection ensures the integrity of the vas deferens and its vascular system, and tubular isolation aids in intraoperative reference identification, avoid omission of tiny veins and injury to lymphatic vessels, which helps to improve the surgical skills of beginners or less experienced surgeons.

Liver biopsy is a key method for clarifying the diagnosis of liver diseases and has an important value in determining disease severity, deciding treatment timing, and predicting treatment response and prognosis. By recognizing the pattern of liver pathological injury, pathologists evaluate the nature of lesions as the basis of diagnosis and differential diagnosis, and among these patterns, liver tissue with "normal appearance" requires careful observation of easily overlooked pathological changes, so as to reduce misdiagnosis or missed diagnosis. This article mainly introduces the thoughts in the pathological diagnosis of liver tissue with normal appearance and the key points in differential diagnosis.

Objective:To explore effects of psychological resilience and social support on quality of life in patients undergoing ileal conduit surgery.Methods:Using the convenient sampling method, a total of 232 patients who underwent total cystectomy and ileal conduit surgery in Department of Urology in a Class ⅢGrade A general hospital from January 2014 to December 2018 were investigated by using the general data questionnaire, City of Hope Quality of Life-Ostomy Questionnaire (COH-QOL-OQ) , Perceived Social Support Scale (PSSS) and 10-item Connor Davidson Resilience Scale (CD-RISC-10) from March to August 2020.Results:The age of patients was (65.79±8.67) years old, the postoperative time was (42.14±15.76) months, the total score of quality of life was (263.28±28.71) , the score of social support was (71.81±8.02) and the score of psychological resilience was (31.27±5.27) . Multiple linear regression analysis showed that psychological resilience (β=0.18, P<0.01) , self-care (β=0.30, P<0.01) , age (β=0.18, P<0.01) , recurrent carcinoma (β=0.13, P<0.05) and self-paying (β=-0.21, P<0.05) were influence factors of quality of life of patients, which could explain the variability of 21.2%. Conclusions:A variety of factors affect quality of life of patients after ileal conduit surgery for a long time. Therefore, attention should be paid to continuing treatment and nursing, improving self-care ability and psychological quality, promoting quality of life and improving disease outcomes.

Purpose: Combining targeted agents with adjuvant chemotherapy prolongs survival in human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients, but also increases the risk of adverse effects. The updated results of 3 randomized controlled trials (RCTs) were reported in 2019. Given the lack of adequate head-to-head pairwise assessment for anti-HER2 agents, network meta-analysis facilitates obtaining more precise inference for evidence-based therapy. Methods: RCTs comparing at least 2 anti-HER2 regimens in an adjuvant setting for HER2-positive early-stage breast cancer (EBC) were included. Hazard ratios for overall survival (OS) and disease free survival (DFS), with respective 95% confidence intervals were pooled for assessment of efficacy. A Bayesian statistical model was used, and odds ratios (ORs) for adverse events (AEs) were used to pool effect sizes. Results: We demonstrated that 1-year trastuzumab plus chemotherapy had increased efficacy compared to shorter or longer treatment duration. The OR of cardiac events gradually increased from 6 months to 1 and 2-year trastuzumab arms, relative to chemotherapy only.Compared to trastuzumab plus chemotherapy, dual HER2-targeting therapies increased DFS, especially for hormone receptor negative patients. Dual anti-HER2 blockade regimens revealed an increased probability of gastrointestinal reactions. As a second agent, pertuzumab showed significantly higher DFS and OS. Conclusion We conclude that 1-year adjuvant trastuzumab should remain as the standard treatment for HER2-positive EBC patients, as it has greater efficacy and a manageable proportion of AEs. Clinical efficacy can be increased for hormone receptor-negative tumors by including a second HER2-targeted agent to the treatment regimen. For hormone receptorpositive cases with basal disease, it is acceptable to reduce the risk of cardiotoxicity by shortening the duration of trastuzumab.

Biomarkers ; Breast Neoplasms ; Breast ; Drug Therapy ; Humans ; Neoadjuvant Therapy ; Neoplasm, Residual ; Pathology ; Prognosis ; United States Food and Drug Administration

Objective: To compare the methylation profiles in tissues of oral leukoplakia (OLK) and oral squamous cell carcinoma (OSCC) with healthy tissues of oral mucosa, in order to identify the role of DNA methylation played in tumorigenesis. Methods: DNA samples extracted from tissues of 4 healthy oral mucosa, 4 OSCC and 4 OLK collected from patients of the Department of Oral Medicine, Capital Medical University School of Stomatology were examined and compared using Methylation 450 Bead Chip. The genes associated with differentially methylated CpG sites were selected for gene ontology (GO) analysis and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment. Results: Multiple differentially methylated CpG sites were identified by using the above mentioned assay. Hypermethylation constitutes 86.18% (23 290/27 025) of methylation changes in OLK and hypomethylation accounts for 13.82% (3 734/27 025) of methylation changes. Both hypermethylated and hypomethylated CpG sites were markedly increased in OSCC tissue compared with OLK tissue. The majority of differentially methylated CpG sites were located outside CpG islands, with approximately one-fourth in CpG shores flanking the islands, which were considered highly important for gene regulation and tumorigenesis. Pathway analysis revealed that differentially methylated CpG sites in both OLK and OSCC patients shared the same pathway enrichments, most of which were correlated with carcinogenesis and cancer progression (e.g., DNA repair, cell cycle, and apoptosis). Conclusions In the present study, methylation-associated alterations affect almost all pathways in the cellular network in both OLK and OSCC. OLK and OSCC shared similar methylation changes whether in pathways or genes, indicating that epigenetically they might have the same molecular basis for disease progression.

Objective To investigate the correlation between the-308 site,-238 site gene polymorphism of TNF-αa promoter region in hypemricemh and its metabolic phenotype.Methods HUA patients 188,normal people(NHU)51,the-308G/A site single nu-cleofide polymorphism of TNF-a gene promoter region was decided by Polymerase chain reaction-restriction fragment length polymor-phism(PCR-RFLP)method.The level of serum uric acid is detected by uricase.blood glucose by glucose oxidase.Selective inhibition assay for total cholesterol,triglyceride and high-density lipoprotein cholesterol.All these tests were complted within three hours afterextraction.Keep blood samples at-20℃ to detect the concentration of insulin using immunoradiometrie assay.HUA patients 35.NHU 39,the -238G/A site single nucleofide polymorphism of TNF-a gene promoter region was decided by the same method.Results By smdying two single nucleotide polymorphism,the GA+AA frequency of-308 site(23.94%)in HUA was significantly higher than NHU(11.76%)(P=0.0001);the genotype frequencies of GA and GG in-238 site had no significant difference between the two groups(P=0.08).Meanwhile,comparing GA+AA genotype and CG group of-308 site,waist-hip ratio,systolic and diastolic blood pressure,uric acid,triglycerides differences were statistically significant(P=0.05-0.01);the difference in-238 site between the two genotypes waft no significance.Conclusion The results of this study show-308A carriers of TNF-α promoter region in HUA individual is correlated with hyperuficemia and its metabolic phenotype.

Objective To observe the clinical effect of Shiwei Wendan Decoction on coronary heart disease stable angina pectoris of qi deficiency and stasis-phlegm type. Methods Sixty patients of stable angina pectoris which belonged to the type of qi deficiency and stasis-phlegm were divided randomly into the treatment group and the control group,and each group has 30 cases. The treatment group was given Shiwei Wendan Decoction and the control group was given Tongxinluo Capsule for 4 week,one course. The changes of symptoms integral,ECG,clinical efficacy,blood-fat and CRP of the two groups were observed after the treatment. Results The total effective power of the treatment group was higher than that of the control group (P

Objective: To investigate the role of the recombinant S protein of SARS-CoV in the induction of chemokine IP-10 and other cytokines in airway epithelial cells and immunocytes. Methods: Using insect-baculovirus expression system and Nickel affinity Magnet Beads, S protein of SARS-CoV was produced and then used to stimulate cultured human bronchial epithelial cells (16HBE), human peripheral blood mononuclear cells(PBMC), human peripheral blood monocytes and alveolar macrophages. The levels of IP-10 and the cytokines involved in immunoreaction in response to virus infection were detected in the supernatants of those cells cultured with the S protein by liquid chip system. Results: Under normal condition, no detectable IP-10 was found in 16HBE. A high level of IP-10(79.97? 13.81) pg/ml was detected in the 16HBE 12 hrs after being treated with the S protein, and the induction of IP-10 by S protein displayed at a significant quantity-effect reaction, but not in PBMC, monocytes and alveolar macrophages. In contrast, IFN-? was able to induce the production of IP-10 in either 16HBE or the immunocytes. Conclusion: 1.S protein of SARS-CoV can induce a high level of IP-10 in lung epithelial cells at early stage after the virus infection, which may initiate the process of the immune damage in the lung. 2. S protein of SARS-CoV induces the production of IP-10 by a way of IFN-? independent.

AIM: To investigate the molecular mechanism by which the SARS-CoV S protein induces chemokine IP-10 in airway epithelial cells.METHODS: cDNA microarrays were used to screen the gene expression profiles of human bronchial epithelial cells(16HBEs) stimulated by SARS-CoV S protein.In addition,RT-PCR,EMSA,and Western blotting were performed to analyze the phosphorylation of JAK/STAT signal pathway.The changes of IRF-1 and IP10 gene expression and the influence by the corresponding inhibitors were analyzed.RESULTS: IRF-1,a key transcription factor of the JAK/STAT signal pathway,was activated in human bronchial epithelial cells after stimulation by the S protein of SARS-CoV.The IP-10 gene expression was detected 2 h following the phosphorylation of STAT1 after 15 min,which was blocked by STAT1or JAK2 inhibitors.Electrophoretic mobility shift assay(EMSA) demonstrated that the nuclear proteins bound to ISRE and GAS but not NF-?B DNA motif.CONCLUSION: The SARS-CoV S protein induces IP-10 gene expression in human bronchial epithelial cells through activation of the JAK/STAT signal pathway,suggesting that the JAK/STAT signal pathway activated by virus plays key roles in virus infection related acute lung injury.