OBJECTIVE: To investigate the safety and prognostic factors influencing the treatment of upper urinary tract urothelial carcinoma (UTUC) combined with bladder cancer (BCa) by laparoscopic simultaneous radical cystectomy and nephroureterectomy (RCNU). METHODS: The clinical data of patients admitted to Peking University Third Hospital for laparoscopic RCNU surgery from January 2009 to September 2023 were analyzed retrospectively. Based on the same gender, age (±5 years), history of uroepithelial tumors, underlying diseases, T-stage, N-stage, M-stage, American Society of Anesthesiologists (ASA) score, Charlson comorbidity index, and body mass index (BMI) (±5), 34 patients with RCNU were matched 1 ∶1 with patients with bladder cancer who underwent laparoscopic radical cystectomy (RC) alone. Kaplan-Meier survival analysis was used to calculate patient survival, and Cox proportional regression risk model was used to analyze clinical factors affecting prognosis. RESULTS: Of the 68 patients enrolled, the follow-up rate was 100% with a median follow-up time of 27.0 (11.7, 60.2) months. Comparison of intraoperative conditions (including operation time, estimated intraoperative bleeding, intra-operative blood transfusion, etc.) between the two groups of patients showed no significant difference (P>0.05). Comparison of preoperative creatinine and postoperative creatinine between the two groups of patients showed significant differences (P < 0.05). The perioperative Clavien grade Ⅲ-Ⅳ complication rates were 2.9% (1/34) in the RC group and 5.9% (2/34) in the RCNU group. There was no significant difference in terms of perioperative complications between the two groups. Overall survival was significantly lower in the patients receiving RCNU compared with the matched group receiving RC alone (P < 0.05). Cox regression analysis suggested that two factors, high N stage and high postoperative creatinine, were independent risk factors affecting the prognosis of patients in the 2 groups (P < 0.05). CONCLUSION The overall survival prognosis of patients undergoing RCNU surgery was worse compared with laparoscopic RC surgery alone during the same period. There was no clinically significant difference between the two groups in terms of operation time, intraoperative bleeding, and perioperative complications, and there were clinically significant differences in preoperative renal function and post-operative renal function.
Humans ; Laparoscopy/methods* ; Nephroureterectomy/methods* ; Cystectomy/methods* ; Prognosis ; Male ; Retrospective Studies ; Female ; Urinary Bladder Neoplasms/mortality* ; Middle Aged ; Aged

Iron overload is strongly associated with heart disease. Ferroptosis is a new form of regulated cell death indicated in cardiac ischemia-reperfusion (I/R) injury. However, the specific molecular mechanism of myocardial injury caused by iron overload in the heart is still unclear, and the involvement of ferroptosis in iron overload-induced myocardial injury is not fully understood. In this study, we observed that ferroptosis participated in developing of iron overload and I/R-induced cardiomyopathy. Mechanistically, we discovered that Parkin inhibited iron overload-induced ferroptosis in cardiomyocytes by promoting the ubiquitination of long-chain acyl-CoA synthetase 4 (ACSL4), a crucial protein involved in ferroptosis-related lipid metabolism pathways. Additionally, we identified p53 as a transcription factor that transcriptionally suppressed Parkin expression in iron-overloaded cardiomyocytes, thereby regulating iron overload-induced ferroptosis. In animal studies, cardiac-specific Parkin knockout mice (Myh6-CreER ^T2 /Parkin ^fl/fl ) fed a high-iron diet presented more severe myocardial damage, and the high iron levels exacerbated myocardial I/R injury. However, the ferroptosis inhibitor Fer-1 significantly suppressed iron overload-induced ferroptosis and myocardial I/R injury. Moreover, Parkin effectively protected against impaired mitochondrial function and prevented iron overload-induced mitochondrial lipid peroxidation. These findings unveil a novel regulatory pathway involving p53-Parkin-ACSL4 in heart disease by inhibiting of ferroptosis.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Ischemic heart disease (IHD) is associated with high morbidity and mortality rates. Reperfusion therapy is the best treatment option for this condition. However, reperfusion can aggravate myocardial damage through a phenomenon known as myocardial ischemia/reperfusion (I/R) injury, which has recently gained the attention of researchers. Several studies have shown that Chinese herbal medicines and their natural monomeric components exert therapeutic effects against I/R injury. This review outlines the current knowledge on the pathological mechanisms through which mitochondria participate in I/R injury, focusing on the issues related to energy metabolism, mitochondrial quality control disorders, oxidative stress, and calcium. The mechanisms by which mitochondria mediate cell death have also been discussed. To develop a resource for the prevention and management of clinical myocardial I/R damage, we compiled the most recent research on the effects of Chinese herbal remedies and their monomer components.

Traditional Chinese medicine (TCM) has become an important treasure trove of natural resources for the development of new medicines due to their diverse compositions, significant therapeutic effects, and few side effects. The screening of active ingredients in TCM represents a crucial step in elucidating the material basis and mechanism of action of TCM. At present, efficient and precise molecular recognition techniques based on intermolecular interactions have been extensively employed for the identification of active ingredients in TCM. This paper presents a review of the fundamental principles underlying solution-phase/affinity ligand fishing, solid-phase/affinity ligand fishing, molecular imprinting and molecular docking techniques, with a particular focus on their applications in the screening of active ingredients in TCM. Furthermore, the paper compares the advantages and disadvantages of the various techniques and identifies the limitations of existing techniques. In conclusion, the paper identifies the prospective trajectory of molecular recognition techniques in the domain of TCM research. This paper not only provides theoretical references for the development of new methods of active ingredient screening but also helps to promote the modernization and internationalization of TCM.

AIM: To study the protective effect of fenofibrate on diabetic retinal neurodegeneration and observe its effect on miR-26a-5p and its target gene PTEN in the retinal of diabetic mice.METHODS: Diabetic mice models were established and they were gavaged by fenofibrate. H& E staining and transmission electron microscopy were used to observe the impairments of retinal neurons. Real-time PCR was used to examine the expression of miR-26a-5p, and Western blotting was employed to measure the expression of phosphatase and tensin homologue(PTEN)in the retina of diabetic mice. The expression level of nuclear factor-κB(NF-κB), interleukin-1β(IL-1β)and the morphology of neural tissues were observed.RESULTS: When compared with the diabetic mice, fenofibrate significantly attenuated the damage to retinal ganglion cells and the atrophy of retinal nerve fiber layer. While the level of miR-26a-5p was increased and the levels of PTEN and inflammatory mediators were significantly decreased in the retina of fenofibrate treated diabetic mice, with significant statistical significance(P<0.05).CONCLUSIONS: Fenofibrate protects against diabetic retinal neurodegeneration by upregulating miR-26a-5p and inhibiting PTEN, attenuating the inflammatory response and alleviating retinal cell injury.

To introduce a case of local skin necrosis by hematoma after alar reduction. A 20-year-old female patient underwent comprehensive rhinoplasty with ear cartilage paddind nose tipand and alar reduction. After 7 days, the right nasal alar wound was covered with blood scabs, and poorly healed. Debridement and suturing were performed. On the 7th day after debridement, there was sudden blackening of the incision edge which enlarged the area. The patient was treated with dressing change for 18 days but did not improve. She came to the First Affiliated Hospital of Guangxi University of Chinese Medicine for treatment. The hematoma was cleared and the bleeding points were explored. After multiple routine dressing changes, the skin on the wound edge became necrotic, turning black and dry before removal. After 25 days of dressing changes, no skin flap repair was performed, and the wound healed without obvious scars. The nose was basically on the opposite side. Therefore, attention should also be paid to preventing hematoma during alar reduction. For small amounts of hematoma in special areas, timely treatment should be taken to avoid skin necrosis and ulceration.

To introduce a case of local skin necrosis by hematoma after alar reduction. A 20-year-old female patient underwent comprehensive rhinoplasty with ear cartilage paddind nose tipand and alar reduction. After 7 days, the right nasal alar wound was covered with blood scabs, and poorly healed. Debridement and suturing were performed. On the 7th day after debridement, there was sudden blackening of the incision edge which enlarged the area. The patient was treated with dressing change for 18 days but did not improve. She came to the First Affiliated Hospital of Guangxi University of Chinese Medicine for treatment. The hematoma was cleared and the bleeding points were explored. After multiple routine dressing changes, the skin on the wound edge became necrotic, turning black and dry before removal. After 25 days of dressing changes, no skin flap repair was performed, and the wound healed without obvious scars. The nose was basically on the opposite side. Therefore, attention should also be paid to preventing hematoma during alar reduction. For small amounts of hematoma in special areas, timely treatment should be taken to avoid skin necrosis and ulceration.

Objective:To evaluate the analgesic effects of lidocaine cream and ice application during botulinum toxin type A treatment on bilateral gastrocnemius hypertrophy.Methods:A retrospective study was conducted, including 60 patients who underwent botulinum toxin type A treatment for bilateral gastrocnemius hypertrophy at Peking University Shenzhen Hospital from January 2020 to January 2022. Patients were divided into two groups based on the analgesic methods: lidocaine surface anesthesia group (lidocaine group, 30 cases) and ice application analgesia group (ice group, 30 cases). The lidocaine group consisted of 2 males and 28 females, with a mean age of (27.0±5.0) years, while the ice group consisted of 30 females, with a mean age of (26.2±4.4) years. Depending on individual needs, 100-200 U of botulinum toxin type A was injected into the calf muscle of each patient. In the lidocaine group, nurses applied lidocaine cream to the injection area and covered it with a film before injection. In the ice group, nurses used custom-made ice packs to surround the injection site for 10 minutes. Pain levels were assessed using the visual analog scale (VAS) during injection, including pain scores for needle puncture and drug injection. The incidence of postoperative adverse reactions and patient satisfaction rates were also recorded.Results:The VAS score for needle puncture pain was (2.60±1.25) in the lidocaine group and (2.30±1.12) in the ice group, with no statistically significant difference ( P=0.331). However, the VAS score for drug injection pain was significantly higher in the lidocaine group (3.47±1.25) than that in the ice group (2.77±1.28, P=0.036). The overall analgesic VAS score was (3.37±1.16) in the lidocaine group, also significantly higher than that (2.60±1.25) in the ice group ( P=0.017). Two patients in the lidocaine group experienced localized swelling, and one reported localized itching with a rash, while no adverse reactions were observed in the ice group. Patient satisfaction rates were 86.7% (26/30) in the lidocaine group and 93.3% (28/30) in the ice group. Conclusions:Ice application provides superior analgesic effects compared to lidocaine cream surface anesthesia during botulinum toxin type A treatment for bilateral gastrocnemius hypertrophy.

Purpose To establish a non-invasive model for predicting axillary lymph node metastasis(ALNM)based on breast cancer related metabolic parameters.Materials and Methods A total of 158 patients diagnosed as breast cancer in Meizhou People's Hospital from January 1,2016 to March 30,2023 were selected,and all of them underwent whole-body PET/CT examination in our department before operation.Metabolic parameters of primary breast cancer[maximum standard uptake value(SUVmax),metabolic volume,total glycolysis(TLG)],highest axillary lymph node uptake SUVmax(SUVmaxALN),axillary lymph node short diameter and clinical related indexes[age,maximum tumor diameter,pathological type and tumor location]were obtained.According to the surgical and pathological results,the patients were divided into ALNM positive[ALNM(+)]group and ALNM negative[ALNM(-)]group.The relationship between the parameters of the two groups was analyzed,the best influencing factors were screened out,and binary Logistic regression was used to establish a prediction model to obtain the primary metabolic parameters of breast cancer.Results There were significant differences in TLG,metabolic volume,axillary lymph node short diameter and SUVmaxALN between ALNM(+)group and ALNM(-)group(Z=-3.924--1.812,all P<0.05),but there were no significant differences in age,tumor maximum diameter,pathological type,tumor location,primary focus SUVmax and SUVavg(all P>0.05).Multivariate Logistic regression analysis showed that TLG of breast cancer primary focus and SUVmaxALN could be used as independent risk factors of ALNM of breast cancer,and the regression model established by using these two factors was Logit(P)=0.142+0.443×SUVmaxALN-0.013×TLG.The area under the curve of ALNM prediction model based on TLG and SUVmaxALN was 0.769(95%CI 0.691-0.841,P<0.001).Conclusion TLG of breast cancer primary focus and SUVmaxALN can be used as independent predictors of ALNM of breast cancer,and the prediction model based on these two factors can predict ALNM well.This non-invasive method may have a certain application prospect in clinic.