Background::Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods::A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of covariance.Results::All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. Conclusions::The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.

Immunosuppressants are the most commonly used therapeutic means to reduce organ transplantation rejection and improve short-term clinical outcomes of patients after transplantation. However, systemic use of immunosuppressants increases the risk of opportunistic infections and the incidence of malignancies. Therefore, the efficient targeted delivery of immunosuppressants to target organs is particularly important. Lymph nodes are the main sites of transplant rejection activation. In recent years, drug delivery systems targeting lymph nodes have played an increasingly important role in the treatment of organ transplant rejection. This review briefly introduces the mechanism of action of lymph nodes in transplant rejection, and focuses on the construction of lymph node targeted drug delivery system and its application in transplant rejection, aiming to apply it in the treatment of transplant rejection toimprove patient outcomes.

Objective To explore the effect of miR-23b-3p regulation on osteogenic differentiation of renal intersti-tial fibroblasts(hRIFs)on the formation of Randall plaque and its possible mechanism.Methods qRT-PCR was used to detect the expression levels of miR-23b-3p and osteogenic marker:myocyte enhancer factor 2C(MEF2C),osteocalcin(OCN),osteopontin(OPN),runt-related transcription factor 2(Runx2)mRNA in Randall plaque tis-sue of CaOx stone patients(RP)and normal papillary tissue of kidney tumor patients undergoing nephrectomy(nRP).Isolation and culture of human normal hRIFs were isolated and cultured in vitro.The miR-23b-3p overex-pression plasmid pSi-miR-23b-3p and its negative no-load plasmid pSi-NC,the MEF2C lentivirus overexpression plasmid Lv-MEF2C and the no-load plasmid Lv-NC were transfected into hRIFs cells,and the cells were induced to osteogenic differentiation for 14 days.The activity of alkaline phosphatase(ALP)was determined by ELISA.Aliz-arin red staining was used to observe the formation of mineralized nodules.The expression levels of miR-23b-3p and MEF2C,OCN,OPN,Runx2 mRNA were detected by qRT-PCR.The expression level of MEF2C protein was de-tected by Western blot.Dual luciferase reporter gene assay verified the targeting relationship between miR-23b-3p and MEF2C.Results ① Compared with the nRP group,miR-23b-3p was low expressed and MEF2C,OCN,OPN,and Runx2 were highly expressed in the RP group.② 14 days after osteogenic induction of hRIFs cells,the activity of ALP in cells significantly increased,the ability of cells to form mineralized nodules was enhanced,the expression level of miR-23b-3p significantly decreased,the mRNA expression levels of MEF2C,OCN,OPN,and Runx2 significantly increased,and the expression level of MEF2C protein significantly increased.③ Overexpres-sion of miR-23b-3p decreased the activity of ALP in hRIFs cells after osteogenic induction,inhibited the formation of mineralized nodules in cells,and down-regulated the mRNA expression levels of OCN,OPN,and Runx2 in cells.④ Overexpression of MEF2C reversed the inhibitory effect of miR-23b-3p overexpression on osteoblast differ-entiation of hRIFs cells.⑤ MEF2C was the downstream target gene of miR-23b-3p.Conclusion miR-23b-3p is underexpressed in RP tissues and during osteoblastic differentiation of hRIFs cells.Up-regulation of miR-23b-3p in-hibits osteogenic differentiation of hRIFs cells,and its mechanism may be related to targeted silencing MEF2C.

In March 2019, a patient with advanced prostate cancer was diagnosed in Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, and the disease progressed to the stage of mCRPC after traditional endocrinotherapy. Serious adverse event occurred after 1 month of treatment with abiraterone, which result in drug withdrawal, and replaced therapy by enzalutamide, the effect was good.

Objective:To discuss the clinical efficacy of laparoscopic radical cystectomy in the treatment of bladder cancer after partial cystectomy.Methods:The clinical data of 30 patients who underwent laparoscopic radical cystectomy after PC in Sichuan Provincial People's Hospital from March 2016 to August 2020 were retrospectively analyzed. Including 24 males and 6 females with an average age was 62.5 (45.5-82.5)years.6 out of 30 cases underwent pelvic lymph node dissection during PC. All patients had definite pathological diagnosis for the high-grade urothelial carcinoma after PC, and the tumor staging was pT 2-3bN 0M 0.5 patients received postoperative adjuvant chemotherapy with gemcitabine and cisplatin, 6 received postoperative adjuvant radiotherapy, 13 received postoperative adjuvant radiotherapy and chemotherapy, and all patients were received maintenance intravesical instillation. Median time for local tumor recurrence after PC was 9(5-29) months, all patients had pathological diagnosis for the high-grade papillary urothelial carcinoma, cT 2-4N 0M 0 stage.The average tumor diameter was 3.5(2.5-4.5)cm, an average number of tumors was 2(1-3). Laparoscopic salvage cystectomy was performed after recurrence.General anesthesia, supine position, 5 ports were inserted through the abdominal approach. Standard pelvic lymph node dissection (PLND) was used to clean the pelvic lymph nodes. Those who had underwent PLND no longer clean the obturator and peripheral iliac vessels, but including the common iliac vessel and the bifurcation of the abdominal aorta and lymphatic tissues around the inferior vena cava, as well as the presacral lymph nodes. Results:All 30surgeries were successfully performed. The average operative time was 270(240-310)min, average estimated intraoperative blood loss was 180(50-300)ml, and there was no blood transfusion during the perioperative period.The average number of lymph nodes dissected was 18 (10-27). There were 4 cases with positive lymph nodes, of which 3 cases were positive for 2 obturator lymph nodes, and 1 case was positive for 3 obturator and external iliac lymph nodes. No serious intraoperative complications occurred.No lymphatic leakage occurred. The average drainage duration was 4(3-7) d, and postoperative hospital stays was 9(7-20)d. The postoperative pathology was invasive high-grade papillary urothelial carcinoma, and pathological TNM stage was pT 2-4aN 0-2M 0.13 patients received postoperative adjuvant chemotherapy. The average postoperative follow-up time was 23(3-31) months. There were 2 cases of pelvic recurrence and 1 case of retroperitoneal lymph node metastasis. These 3 cases received adjuvant chemotherapy and radiotherapy. Conclusions:Radical cystectomy should be the primary treatment for recurrence of bladder cancer after partial cystectomy.

Objective: To delineate the clinical and genetic features of two pedigrees affected with aromatic L-amino acid decarboxylase (AADC) deficiency. Methods: The clinical features, family history and results of genetic testing of 2 patients with AADC deficiency were retrospectively analyzed. Results: Both patients featured hypotension, developmental delay and oculogyric crisis during infancy.Genetic testing confirmed that they have respectively carried c. 714+ 4 (IVS6) A>T/c.175(exon2)G>A compound heterozygous variants and c. 714+ 4(IVS6)A>T homozygous variant. Conclusion The clinical manifestation of children with AADC deficiency may include hypotonia, developmental delay and paroxysmal oculogyric crisis. The combination of 3-O-methyldopa testing and variant analysis is not only very useful for early diagnosis, but also important for the evaluation of treatment effect and prognosis of the disease. Discovery of the novel variants has enriched the variant spectrum of AADC deficiency.

Objective: To investigate the relationship between miR-141-3p and transforming growth factorβ2 (TGF-β2), and its effects on the malignant biological behaviors of human prostate cancer cell line C4-2B. Methods:After the transfection of miR-141-3p mimic, the mRNAexpression of miR-141-3p and TGF-β2 in C4-2B cells was detected by qRT-PCR. Bioinformatics method validated the relationship between miR-141-3p and TGF-β2. miR-141-3p mimic alone or with TGF-β2 over-expression vector was transfected into C42B cells, and then Western blotting was used to detect the expression of TGF-β2 protein in C4-2B cells, Hochest33258 staining was used to detect cell apoptosis, and Transwell assay was used to detect the invasion ability of cells in each group. Results:After the transfection of C4-2B cells with miR-141-3p mimic, the level of miR-141-3p increased significantly, and the level of TGF-β2 mRNA decreased significantly (all P<0.01). The activity of luciferase was significantly reduced after the co-transfection with miR-141-3p mimic and wild type report plasmid (P<0.01); However, the activity of luciferase was not obviously changed after co-transfection with miR141-3p mimic and mutant type report plasmid (P>0.05).After co-transfection with miR-141-3p mimic and pc-TGF-β2, the proliferation of C4-2B cells decreased significantly, the number of apoptotic cells increased significantly, and the cell invasion ability decreased significantly (all P<0.01). Conclusion: miR-141-3p inhibits the proliferation and invasion of human prostate cancer C4-2B cells and induces cell apoptosis by targeting TGF-β2.

Objective To observe the effects of individualized testosterone replacement therapy on serum total testosterone(TT)and sex hormone in males with late-onset hypogonadism(LOH). Methods A total of 78 cases with LOH males were divided into group A(TT<8 nmol/L)and group B(8≤TT<11.5 nmol/L)according to the serum TT level,and the B group was randomly divided into the B1 group and the B2 group.They were given the individualized testosterone replacement therapy,and the treatment effect was compared among the 3 groups. Results After treatment,the SHBG level in the 3 groups was significantly reduced(P<0.05)whereas the serum TT level was significantly higher(P<0.05). The TT level in the B1 group was significantly higher than that in the B2 group(P ＜0.05). The levels of E2and FSH in the 3 groups were significantly lower(P ＜0.05)whereas the level of P was significantly higher(P ＜0.05). The ADAM scores in the 3 groups were significantly better than those before treatment(P<0.05),and there was no significant difference between the B1 group and the B2 group (P ＞0.05). There was no significant difference in the total incidence rate of adverse reactions between the group A and the other two groups(P ＞0.05),and the rate in the B2 group was lower than that in the B1 group(P <0.05). Conclusions In supplementary treatment of LOH,TT ＜8 nmol/L recommended to choose conventional dose,and 8≤TT<11.5 nmol/L can choose a small dose of testosterone.

BACKGROUND:Catheter associated urinary tract infection is a difficult problem for clinical practice management, and its key pathogenesis is the bacterial biofilm formation on the surface of the catheter material. Therefore, developing a new anti-infective urinary catheter has become an area of interest in the current studies of anti-infective biological materials. OBJECTIVE:To review the research literatures on anti-infective urinary catheter, and provide a direction for further study and clinical application. METHODS:Al related Chinese patent papers of anti-infective urinary catheters were retrieved by Google’s proprietary search platform (http://www.google.com/advanced_patent_search) until the deadline of March 26, 2014, with the search strategy of‘Return the patents with the fol owing proprietary name:urinary catheter’. RESULTS AND CONCLUSION:According to the predefined search strategy, 949 potential y relevant patent papers were screened out for further identification, and 23 papers referred to anti-infective catheters that were obviously eligible were included. The analyses showed that:(1) The antibacterial coating agents of the majority of papers were antibacterial agents of nano-inorganic metal cations, only four papers used antibiotic coated. (2) The drug-eluting catheters were mainly composite-coated. (3) The drug release modes from coating were mainly extended-release but release mechanism was not clarified. (4) The preparation process was chemical bond or ionic bond in one paper, blending methods in one paper, repeated electroplating in one paper, electrospinning technology in one paper, and physical impregnation methods in 12 papers (52.17%). (5) The antimicrobial mode was ultrasonic-antibacterial method in two patent papers, sterile sleeve in one paper, hydrophilic coating in one paper, catheter made by blending polymer material and anti-infective agents in one paper, drug coated films made by coating with antimicrobial drug liquid and drying process in 20 papers (82.61%). In conclusion, there have been no translational and applied clinical researches about the anti-infective urinary catheter, and the relevant researches were only at the laboratory level. The research methods of Chinese patent for anti-infective urinary catheter were limited, and need to be further improved.

Objective To summarize clinical characteristics of infradiaphragmatic craniopharyngioma and explore its prognosis factors. Methods The clinical date, imaging and follow-up findings were analyzed retrospectively in 58 pa?tients with infradiaphragmatic craniopharyngioma who underwent surgical operation in our hospital. Factors related to the postoperative quality of life of patients were analyzed using multi-factors Logistic regression analysis. Results There were 45 minor cases with infradiaphragmatic craniopharyngioma, of which forty cases (88.9%) had preoperative visual im?pairment. Preoperative endocrine examination revealed that 21 cases (46.7%) had pan-hypopituitarism and 24 cases (53.3%) had pari-hypopituitarism. In addition, preoperative MRI showed that 38 cases (84.4%) had tumor involvement in/on the saddle and the average tumor size was(4.53 ± 1.71)cm. There were 13 adult cases, of which 8 cases (61.5%) had preoperative visual impairment. Only 1 case (15.4%) had pan-hypopituitarism, 7 cases had pari-hypopituitarism and 5 cases had normal pituitary function. Ten cases (76.9%) had tumor involvement in/on the saddle and average tumor size was(2.92 ±1.18)cm. Multi-factors Logistic regression analysis revealed the patient's age (OR=0.090, P=0.090) and tu?mor size (OR=8.350, P=8.350), preoperative vision loss (OR=0.086, P=0.086), preoperative hypopituitarism (OR=0.198, P=0.198) were the relative factors affecting the quality of life. Conclusion Infradiaphragmatic craniopharyngioma is
more common in minor patients. The clinical features and prognosis are significantly different between minor patients and adult patients. Age, size of tumors, preoperative vision loss and hypopituitarism of patients are associated with poor prog?nosis.