Purpose: To intelligently diagnose whether there is bladder outlet obstruction (BOO) in female with decent detrusor contraction ability by focusing on urodynamic study (UDS) data. Materials and Methods: We retrospectively reviewed the UDS data of female patients during urination. Eleven easily accessible urinary flow indicators were calculated according to the UDS data of each patient during voiding period. Eight diagnosis models based on back propagation neural network with different input feature combination were constructed by analyzing the correlations between indicators and lower urinary tract dysfunction labels. Subsequently, the stability of diagnostic models was evaluated by five-fold cross-validation based on training data, while the performance was compared on test dataset. Results: UDS data from 134 female patients with a median age of 51 years (range, 27–78 years) were selected for our study.Among them, 66 patients suffered BOO and the remaining were normal. Applying the 5-fold cross-validation method, the model with the best performance achieved an area under the receiver operating characteristic curve (AUC) value of 0.949±0.060 using 9 UDS input features. The accuracy, sensitivity, and specificity for BOO diagnosis model in the testing process are 94.4%, 100%, and 89.3%, respectively. Conclusions The 9 significant indicators in UDS were employed to construct a diagnostic model of female BOO based on machine learning algorithm, which performs preferable classification accuracy and stability.

Objective: To investigate the health-seeking intention for urinary incontinence among adult women in Gansu Province, so as to provide insights into the management of female urinary incontinence. Methods : Women at ages of 20 years and older who lived in 8 communities and 8 villages of Gansu Province for at least one year were recruited using the multi-stage stratified cluster random sampling method. A face-to-face questionnaire survey was conducted from October 2019 to February 2020, and the demographic features, urinary incontinence status and health-seeking intention were collected and descriptively analyzed. Results: A total of 3 580 questionnaires were allocated and 3 485 were recovered, with a recovery rate of 97.35%. The respondents had a mean age of ( 51.18±17.13 ) years, with 1 759 respondents ( 50.47% ) that lived in urban areas, and 1 726 ( 49.53% ) that lived in rural areas. There were 1 150 respondents with self-reported urinary incontinence ( 33.00% prevalence ), including 340 cases with stress urinary incontinence ( 29.57% ), 78 cases with urge urinary incontinence ( 6.78% ) and 732 cases with mixed urinary incontinence ( 63.65% ). The overall proportion of health-seeking intention for urinary incontinence was 41.57%, and the proportions of health-seeking intention were 51.76%, 39.74% and 37.02% for stress, urge and mixed urinary incontinence, respectively. The proportion of health-seeking intention for urinary incontinence appeared a tendency towards a decline with the increase in household monthly income per capita and frequency of urinary leakage, and appeared a tendency towards a rise with the increase in educational levels ( P<0.05 ). In addition, a higher proportion of health-seeking intention for urinary incontinence was seen in women living in urban areas than in rural areas (5 3.63% vs. 31.98%, P<0.05 ), and a higher proportion was found in women with mental labors than in those with physical labors ( 60.81% vs. 40.24%, P<0.05 ), while a higher proportion was found in married women than in divorced or widowed women ( 44.33% vs. 23.53%, P<0.05 ). Conclusions There is a low proportion of health-seeking intention for urinary incontinence among adult women in Gansu Province. Age, occupation, place of residence, educational level, income, marital status, and frequency of urine leakage may affect the intention to seek medical care for urinary incontinence among adult women.

Recent insights collectively suggest the important roles of lysyl oxidase (LysOX) in the pathological processes of several acute and chronic neurological diseases, but the molecular regulatory mechanisms remain elusive. Herein, we explore the regulatory role of LysOX in the seizure-induced ferroptotic cell death of neurons. Mechanistically, LysOX promotes ferroptosis-associated lipid peroxidation in neurons via activating extracellular regulated protein kinase (ERK)-dependent 5-lipoxygenase (Alox5) signaling. In addition, overexpression of LysOX via adeno-associated viral vector (AAV)-based gene transfer enhances ferroptosis sensitivity and aggravates seizure-induced hippocampal damage. Our studies show that pharmacological inhibition of LysOX with β-aminopropionitrile (BAPN) significantly blocks seizure-induced ferroptosis and thereby alleviates neuronal damage, while the BAPN-associated cardiotoxicity and neurotoxicity could further be reduced through encapsulation with bioresponsive amorphous calcium carbonate-based nanocarriers. These findings unveil a previously unrecognized LysOX-ERK-Alox5 pathway for ferroptosis regulation during seizure-induced neuronal damage. Suppressing this pathway may yield therapeutic implications for restoring seizure-induced neuronal injury.

Neuroendocrine neoplasms, commonly deriving from neuroendocrine cells of gastrointestinal tract and pancreas, are remarkably heterogeneous. As for gastroentero-pancreatic neuroendocrine neoplasms, surgery is the first choice for treatment, whereas molecular targeted therapy provides a new treatment option for patients with local advancement or metastases. Drugs for molecular targeted therapy used clinically include somatostatin analogs, mammalian target of rapamyoin pathway inhibitors, tyrosinekinase inhibitors, immunotherapy and so on. Research findings from experiments and clinic trials will possibly provide new therapeutic methods for molecular targeted therapy in the future.

Objective To investigate the impacts of garcinia acid on the proliferation and invasion abilities of human bladder cancer cell line(BIU-87), and to study the possible molecular mechanisms. Methods The BIU-87 cells were cultured in vitro, and then the cells were divided into control group, low-dose, middle-dose, and high-dose garcinia acid groups. The cells in the drug groups were treated with 20, 40, 80μmol/L of garcinia acid for 24, 48, and 72 h, and control group were incubated by normal medium. The inhibition of proliferation of BIU-87 cells was performed using CCK8 assay. The abilities of BIU-87 cell invasion were assessed using Transwell chambers, and the expression levels of vascular endothelial growth factor(VEGF) were analyzed using Western Blot technology.Results Compared with control group, the proliferation inhibitory rates of cells after treatment with low-, middle-, and high-dose garcinia acid for 24, 48, and 72 h were significantly decreased(P<0.05). Moreover, the proliferation inhibitory rates in different drug groups were greatly increased with the time extension. Compared with control group, the number of cells passing through the membrane(26 ± 4, 41 ± 4, 53 ± 5vs.119 ± 7) in low-, middle-, and high-dose garcinia acid group significantly decreased(P<0.05), the expression levels of VEGF (41.2 ± 6.2, 23.8 ± 5.2, 17.9 ± 4.7 vs. 14.8 ± 4.2) in low-, middle-, and high-dose garcinia acid group significantly decreased(P<0.05).Conclusions The Garcinia acid can inhibit the proliferation and invasion of BIU-87 cells via the down-regulation of VEGF expression.

OBJECTIVETo investigate clinicopathological features and prognostic factors of appendiceal neuroendocrine neoplasms(a-NEN).

METHODSClinical data of 20 patients diagnosed with a-NEN at Zhongshan Hospital of Fudan University between January 2000 and December 2016 were retrospectively analyzed. Pathological diagnosis was based on the WHO classification criteria of digestive system tumors (2010 edition). Based on the mitotic count and Ki-67 index, a-NENs were divided into grade 1 neuroendocrine tumor (NET G1), grade 2(G2) NET G2) and grade 3 (neuroendocrine carcinoma, NEC). Some special types of a-NEN (e.g. goblet cell carcinoid) and mixed adenoneuroendocrine neoplasms were classified as mixed adenoneuroendocrine carcinoma (MANEC). Follow-up was conducted by telephone or return visits. Univariate analysis was carried out using the Kaplan-Meier method, and the log-rank test was used to draw survival curves.

RESULTSOf 20 patients, 14 were male and 6 were female with median age of 54 years. Seventeen cases presented acute right lower quadrant abdominal pain, 1 chronic right lower quadrant abdominal pain, 1 persistent abdominal discomfort with outburst whole abdominal pain and 1 was found during body check without symptoms. Twenty cases comprised 8 G1 patients, 4 G2 patients, 3 G3 patients, and 5 MANEC patients. When diagnosed, there was 1 patient with liver metastasis, 1 patient with abdominal and pelvic metastases, and 2 patients with postoperative pathological findings of lymph node metastasis. Six patients underwent appendectomy, 12 underwent right hemicolectomy, 1 underwent right hemicolectomy plus small intestine resection, and 1 underwent partial hepatectomy plus right hemicolectomy. The follow-up time was 7-187 months(average, 36 months). The total 1- and 3-year survival rates were 94.7% and 60.2%, respectively. Univariate analysis showed that age >50 years (χ=7.036, P=0.008), pathology grade as MANEC (χ=5.297, P=0.021), and metastasis (χ=6.558, P=0.010) indicated lower 5-year survival rate.

CONCLUSIONSMost a-NEN patients have no typical symptoms, and the main complaint at consultation is acute right lower quadrant abdominal pain. Prognosis is poor for patients with age >50 years, MANEC pathology grade and metastasis.

Appendiceal Neoplasms ; complications ; diagnosis ; surgery ; Carcinoma, Neuroendocrine ; complications ; diagnosis ; therapy ; Female ; Gastrointestinal Neoplasms ; Humans ; Male ; Middle Aged ; Neuroendocrine Tumors ; complications ; diagnosis ; surgery ; Prognosis ; Retrospective Studies

Gastroenteropancreatic neuroendocrine neoplasms are a group of heterogeneous tumors originated from the gastrointestinal peptidergic neurons and neuroendocrine cells.Rectum is one of the major sites of gastroenteropancreatic neuroendocrine neoplasms.Although the progression of rectal neuroendocine neoplasms (rNENs) is relatively slow,metastasis could occurs and liver is the major target organ invaded by distant metastatic rNENs.Surgical operation can be used as the preferred method for the treatment of rNENs and its metastasis at present.If the clinical situations of tumors are not eligible for the operation,interventional treatment can be considered as an alternative treatment.The chemotherapies and molecule-targeted drugs for rNENs are primarily in the light of therapeutic methods for pancreatic neuroendocrine neoplasms,it may help patients achieve partial response or stable disease,and prolong patients survival time.However,there has been few clinical researches directed toward rNENs and no an extensive consensus for treatment of rNENs up to now,and more evidences of evidence-based medicine should be necessitated.This paper has discussed and summarized treatment progression of rNENs and its metastasis.

Objective: To investigate the effects of sulforaphane (SFN) on oxidative stress and Nrf2(Nuclear factor E2-related factor 2)/HO-1(heme oxygenase-1) signaling pathway in renal tubular epithelial cells (HK-2).Methods: HK-2 cells were cultured in vitro and divided into five groups, including the control group, H2O2 group, H2O2+10 μmol·L-1 SFN group, H2O2+20μmol·L-1 SFN group and H2O2+40 μmol·L-1 SFN group.The levels of MDA, NO, GSH and the activity of SOD were measured.The expression levels of Nrf2, HO-1 mRNAR and proteins were analyzed using RT-PCR and Western Blot methods.Results: The levels of MDA and NO in H2O2 group significantly increased when compared with those in the control group, while the levels of GSH and the activity of SOD significantly decreased(P<0.05).The levels of MDA and NO in the cells after the treatment of sulforaphane at different concentrations significantly reduced when compared with those in H2O2 group, while the levels of GSH and the activity of SOD significantly increased(P<0.05).The results of RT-PCR and Western Blot analysis showed that the expression levels of Nrf2, HO-1 mRNAR and proteins in the cells after the treatment of sulforaphane at different concentrations were significantly up-regulated when compared with those in H2O2 group (P<0.05).Conclusion: Sulforaphane can strengthen the antagonism effects on oxidative stress injury in HK-2 cells and the underlying mechanism might be associated with activating Nrf2/HO-1 signal transduction pathway.

Objective To investigate the relationship between learning and memory deficit and demyelination of the corpus callosum in twelve-month old APP/PS1 transgenic mice. Methods Twelve twelve-month old APP/PS1 transgenic mice were as AD group, and age-matched wild type (WT) littermates were as WT group. Learning and memory ability was tested with Morris water maze, and the mor-phology of nerve fiber of corpus callosum was detected with Luxol Fast Blue staining. Immunohistochemistry was used to detect myelin ba-sic protein (MBP) in the corpus callosum. Thioflavine S staining was used to detect amyloid plaque in the corpus callosum. Results Com-pared with WT group, the latency increased (Z>2.873, P<0.01) and the times crossing the location of the platform decreased (t=-7.339, P<0.001) in AD group. The nerve fibers were sparse and disorganized, with a lot of vacuoles in the corpus callosum of AD group. The positive expression of MBP in the corpus callosum was significantly decreased (t=-4.481, P<0.001) in AD group compared with WT group. There were amyloid plaques in the corpus callosum of AD group. Conclusion Twelve-month old APP/PS1 transgenic mice exhibit learning and memory deficit, which may be attributed to the deposition of the amyloid plaque mediated demyelinated injury of the corpus callosum.

Objective To compare the serological non-invasive liver fibrosis tests and pathological examination in the clinical diagnosis of chronic hepatitis B. Methods Selected 97 patients with chronic hepatitis B in our hospital as the research object and tested non-invasive liver fibrosis tests and liver biopsy pathological examination.Compare the test results of two kinds. Results The serum noninvasive hepatic fibrosis index(PⅢP,Ⅳ-C,HA,LN)showed good positive correlation with pathological stage. The correlation coefficient suggested that with the aggravation of hepatic fibrosis,liv-er fibrosis indexes tended to rise gradually,and the indicators differences were statistically significant (P<0.05). Con-clusion Liver biopsy in patients with chronic hepatitis B diagnosis detection is the "gold standard" with greater injury. Serological non-invasive liver fibrosis tests has high diagnostic value,can reduce the number of puncture biopsy.