1.Mechanism of Wogonin in Alleviating LPS-Induced Inflammation in BV-2 Cells and Protecting SH-SY5Y Cells
Mengfei SUN ; Jingfeng OUYANG ; Chunyang WU ; Jiaojiao CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(20):62-69
ObjectiveTo examine the protective mechanism of wogonin in SH-SY5Y cells cultured in the conditioned media with lipopolysaccharide (LPS)-induced BV-2 microglia. MethodBV-2 microglia were divided into the blank group, LPS group, low concentration group of wogonin (4 μmol∙L-1), medium concentration group of wogonin (8 μmol∙L-1), and high concentration group of wogonin (16 μmol∙L-1). The LPS group was given 1 mg·L-1 LPS, and the other three groups were treated with the corresponding concentration of wogonin for 4 h and then given 1 mg·L-1 LPS. The conditioned media from these groups were used to cultivate SH-SY5Y cells. Cell counting kit-8 (CCK-8) was used to assess the vitality of BV-2 cells in the above groups. The contents of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in the supernatant of BV-2 cells were determined by enzyme-linked immunosorbent assay (ELISA). The expression of tyrosine hydroxylase (TH) and α-Synuclein (α-Syn) in SH-SY5Y cells was detected by immunohistochemical staining (IHC). The nuclear transfer and fluorescence expression intensity of nuclear transcription factor-κB p65 (NF-κB p65) protein in SH-SY5Y cells were detected by immunofluorescence staining (IF). Western blot was used to detect the expression of Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/NF-κB pathway-related proteins in SH-SY5Y cells. ResultThe levels of IL-6 and TNF-α in the supernatant of BV-2 cells in the LPS group were significantly higher than those in the blank group (P<0.01). Compared with those in the LPS group, the IL-6 content of BV-2 cells in the low concentration group of wogonin was statistically significantly lower (P<0.05), whereas the IL-6 and TNF-α contents of the medium and high concentration groups of wogonin were statistically lower (P<0.05,P<0.01). The IL-6 and TNF-α contents in the high concentration group of wogonin decreased most significantly (P<0.01), and the intervention effect was the best. Compared with that in the blank group, the expression of α-Syn protein in SH-SY5Y cells cultured with conditioned media in the LPS group was significantly increased, and the expression of TH protein was significantly decreased (P<0.05). Compared with that in the LPS group, α-Syn protein expression in the medium and high concentration groups of wogonin showed a decreasing trend (P<0.05, P<0.01). TH protein expression was increased in the low, medium, and high concentration groups of wogonin (P<0.05, P<0.01). Compared with the blank group, NF-κB p65 protein gradually accumulated into the nucleus, and the fluorescence expression intensity was significantly enhanced (P<0.01). Compared with the LPS group, the NF-κB p65 protein was gradually dispersed outside the nucleus, and the fluorescence expression intensity was gradually weakened in all concentration groups of wogonin. The fluorescence intensity in the high concentration group of wogonin was significantly reduced (P<0.01). Compared with those in the blank group, the expression levels of TLR4 protein, phosphorylated(p)-NF-κB p65 protein, and MyD88 protein in the LPS group were significantly increased (P<0.05, P<0.01). Compared with those in the LPS group, the expressions of TLR4 protein, p-NF-κB p65 protein, and MyD88 protein in the medium concentration group of wogonin were all significantly decreased (P<0.05, P<0.01). The expressions of TLR4 protein, and MyD88 protein in the high concentration group of wogonin were significantly decreased (P<0.05, P<0.01). ConclusionWogonin may regulate the TLR4/MyD88/NF-κB signaling pathway to inhibit the release of LPS-induced inflammatory factors in BV-2 microglia and protect SH-SY5Y cells, thereby reducing inflammation and achieving neuroprotective effects.
2.Investigation on Preventive Effect of Total Saponins of Notoginseng Radix et Rhizoma on Aspirin-induced Small Intestine Injury Based on Serum Metabolomics
Wenhui LIU ; Guodong HUA ; Baochen ZHU ; Ruoyu GAO ; Xin HUANG ; Meng WANG ; Zheng LIU ; Jiaojiao CHENG ; Zhibin SONG ; Jingui WANG ; Chunmiao XUE
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):196-203
ObjectiveMetabolomics was utilized to investigate the preventive effect of notoginseng total saponins(NTS) on aspirin(acetyl salicylic acid, ASA)-induced small bowel injury in rats. MethodFifty male SD rats were randomly divided into normal and model groups, NTS high-dose and low-dose groups(62.5, 31.25 mg·kg-1), and positive drug group(omeprazole 2.08 mg·kg-1+rebamipide 31.25 mg·kg-1), with 10 rats in each group. Except for the normal group, rats in other groups were given ASA enteric-coated pellets 10.41 mg·kg-1 daily to establish a small intestine injury model. On this basis, each medication group was gavaged daily with the corresponding dose of drug, and the normal group and the model group were gavaged with an equal amount of drinking water. Changes in body mass and fecal characteristics of rats were recorded and scored during the period. After 14 weeks of administration, small intestinal tissues of each group were taken for hematoxylin-eosin(HE) staining, scanning electron microscopy to observe the damage, and the apparent damage of small intestine was scored. Serum from rats in the normal group, the model group, and the NTS high-dose group was taken and analyzed for metabolomics by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry(UPLC-Q-Exactive Orbitrap MS), and the data were processed by multivariate statistical analysis, the potential biomarkers were screened by variable importance in the projection(VIP) value≥1.0, fold change(FC)≥1.5 or ≤0.6 and t-test P<0.05, and pathway enrichment analysis of differential metabolites was performed in conjunction with Human Metabolome Database(HMDB) and Kyoto Encyclopedia of Genes and Genomes(KEGG). ResultAfter 14 weeks of administration, the average body mass gain of the model group was lower than that of the normal group, and the NTS high-dose group was close to that of the normal group. Compared with the normal group, the fecal character score of rats in the model group was significantly increased(P<0.05), and compared with the model group, the scores of the positive drug group and the NTS high-dose group were reduced, but the difference was not statistically significant. HE staining and scanning electron microscopy results showed that NTS could significantly improve ASA-induced small intestinal injury, compared with the normal group, the small bowel injury score of the model group was significantly increased(P<0.01), compared with the model group, the small bowel injury scores of the NTS low and high dose groups were significantly reduced(P<0.05, P<0.01). Serum metabolomics screened a total of 75 differential metabolites between the normal group and the model group, of which 55 were up-regulated and 20 were down-regulated, 76 differential metabolites between the model group and the NTS groups, of which 14 were up-regulated and 62 were down-regulated. NTS could modulate three differential metabolites(salicylic acid, 3-hydroxybenzoic acid and 4-hydroxybenzoic acid), which were involved in 3 metabolic pathways, namely, the bile secretion, the biosynthesis of folic acid, and the biosynthesis of phenylalanine, tyrosine and tryptophan. ConclusionNTS can prevent ASA-induced small bowel injury, and the underlying mechanism may be related to the regulation of bile secretion and amino acid metabolic pathways in rats.
3.Echocardiography evaluation of the short-term efficacy of interventional and surgical treatment for severe aortic valve stenosis
Wei CHENG ; Yingying ZHANG ; Qin XIA ; Jiaojiao HU ; Xiaojing YAO ; Jingqin FANG
Journal of Interventional Radiology 2024;33(5):479-482
Objective To discuss the clinical value of echocardiographic indicators in assessing the short-term efficacy of transcatheter aortic valve replacement(TAVR)and surgical aortic valve replacement(SAVR)in treating patients with severe aortic valve stenosis(AS).Methods The clinical data of 70 patients with severe AS,who received treatment at the Daping Hospital of Army Military Medical University of China between June 2019 and September 2022 were retrospectively analyzed.The patients were divided into SAVR group(n=40)and TAVR group(n=30).The preoperative one-week and postoperative one-month echocardiographic indicators were compared between the two groups.Results In both groups,the postoperative one-month peak aortic valve velocity(Vmax),aortic valve mean transvalvular pressure gradient(mPG),relative thickness of chamber wall(RWT),and left ventricular mass index(LVMI)were decreased when compared with preoperative values(all P<0.05);in TAVR group the left ventricular ejection fraction(LVEF),LVMI and incidence of perivalvular leakage were remarkably higher than those in SAVR group,while the Vmax and mPG were obviously lower than those in SAVR group(all P<0.05).In TAVR group,the mitral regurgitation decreased from preoperative 12 patients(40%)to postoperative 2 patients(6.7%)and the over-moderate tricuspid regurgitation decreased from preoperative 7 patients(23.3%)to postoperative one patient(3.3%)(all P<0.05).In SAVR group,the mitral regurgitation decreased from preoperative 15 patients(37.5%)to postoperative 2 patients(5.0%)and the over-moderate tricuspid regurgitation decreased from preoperative 9 patients(22.5%)to postoperative one patient(2.5%)(all P<0.05).The pulmonary artery hypertension in TAVR group decreased from preoperative 17 patients(56.7%)to postoperative 4 patients(13.3%),which in SAVR group decreased from preoperative 22 patients(55.0%)to postoperative 5 patients(12.5%)(P<0.05),but the differences in the above indexes between the two groups were not statistically significant(all P>0.05).Conclusion TAVR and SAVR have similar efficacy in improving secondary valve regurgitation and pulmonary artery hypertension caused by severe AS.TAVR is superior to SAVR in improving postoperative ventricular reverse remodeling and hemodynamics,although the incidence of paravalvular leakage in TAVR is higher than that in SAVR.(J Intervent Radiol,2024,33:479-482)
4.Establishment of Reference Interval for Serum n-HDL-C Level of Adult Population in Yan'an City of Shaanxi Province and Analysis of Influencing Factors
Yadong LIU ; Xin CHENG ; Xianxian LI ; Ye LEI ; Jiaojiao TANG ; Yanxing YANG
Journal of Modern Laboratory Medicine 2024;39(4):76-82
Objective To establish the reference interval of serum non-high-density lipoprotein cholesterol(n-HDL-C)in adults in Yan'an city of Shaanxi Province and analyze the influencing factors.Methods A total of 16 921 adults from 10 towns in Yan'an City of Shaanxi Province from January to September 2023 were selected by random sampling.Age,sex,smoking,drinking,exercise,hypertension,diabetes,dyslipidemia,chronic disease,residence,eating habits,marital status,education and monthly income were investigated.Height,weight,waist circumference and blood pressure were measured.Serum triglyceride(TG),total cholesterol(TCHO),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),Apolipoprotein A1(ApoA1),Apolipoprotein B(ApoB)and lipoprotein a[Lp(a)]levels were detected,and n-HDL-C levels were calculated:n-HDL-C(mmol/L)=TCHO(mmol/L)-HDL-C(mmol/L).The 95%reference interval(P25~P97 5)was calculated according to the percentile method recommended in WS/T402-2012 Health Industry Standard of the People's Republic of China.Multivariate logistic regression was used to analyze the influencing factors of serum n-HDL-C level.Results The serum n-HDL-C levels in both males and females were not normally distributed(S=2.119,2.091,all P<0.001).There were significant differences in serum levels of n-HDL-C among males aged>60 years old[2.98(2.50,3.37)mmol/L],18~30 years old[2.84(2.49,3.26)mmol/L],31~40 years old[2.98(2.62,3.42)mmol/L],41~50 years old[3.10(2.62,3.47)mmol/L]and 51~60 years old[3.05(2.64,3.46)mmol/L]contrast,and the differences were significant(H=3.618~5.680,all P<0.05).There were significant differences in serum levels of n-HDL-C among women aged 51~60 years[3.08(2.71,3.44)mmol/L],18~30 years[2.64(2.29,3.07)mmol/L],31~40 years[2.67(2.31,3.08)mmol/L]and 41~50 years old[2.94(2.58,3.29)mmol/L]contrast(H=8.161~13.445,all P<0.001).There were significant differences in serum n-HDL-C levels among patients aged>60 years old[2.98(2.57,3.34)mmol/L],18~30 years old,31~40 years old and 41~50 years old contrast,and the differences were significant(H=7.985~14.018,all P<0.001).The reference interval of serum n-HDL-C level in adult population was obtained by combining the age groups with no statistical significance:males aged 18~60 years old(1.97~3.97mmol/L),>60 years old(1.86~3.91mmol/L);females aged 18~50 years(1.82~3.74 mmol/L),>50 years old(1.94~3.88 mmol/L).A total of 16 921 adults were divided into normal n-HDL-C group and abnormal group,and the differences of serum TG(1.02±0.31 mmol/L vs 1.24±0.37mmol/L),TCHO(3.97±1.02 mmol/L vs 4.66±1.25 mmol/L),LDL-C(2.37±0.58mmol/L vs 2.59±0.67 mmol/L)levels and age(43.55±11.52 years vs 46.27±8.13 years)between the two groups were significant(t=2.041~3.151,all P<0.05),in which the abnormal rate of serum n-HDL-C level was 42.50%.Multivariate Logistic regression analysis showed that males,lack of exercise,overweight or obesity,dyslipidemia,urban residents,and high school education or above were the influential factors for serum n-HDL-C levels in adults in this region(all P<0.05).Conclusion The reference interval of serum n-HDL-C level in adults in this area was preliminarily established.Males,lack of exercise,overweight or obesity,dyslipidemia,urban residents,and high school education or above were the influential factors of abnormal serum n-HDL-C levels in adults in this area.
5.Multicenter evaluation of the diagnostic efficacy of jaundice color card for neonatal hyperbilirubinemia
Guochang XUE ; Huali ZHANG ; Xuexing DING ; Fu XIONG ; Yanhong LIU ; Hui PENG ; Changlin WANG ; Yi ZHAO ; Huili YAN ; Mingxing REN ; Chaoying MA ; Hanming LU ; Yanli LI ; Ruifeng MENG ; Lingjun XIE ; Na CHEN ; Xiufang CHENG ; Jiaojiao WANG ; Xiaohong XIN ; Ruifen WANG ; Qi JIANG ; Yong ZHANG ; Guijuan LIANG ; Yuanzheng LI ; Jianing KANG ; Huimin ZHANG ; Yinying ZHANG ; Yuan YUAN ; Yawen LI ; Yinglin SU ; Junping LIU ; Shengjie DUAN ; Qingsheng LIU ; Jing WEI
Chinese Journal of Pediatrics 2024;62(6):535-541
Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).
6.Multicenter study on the etiology characteristics of neonatal purulent meningitis
Yanli LIU ; Jiaojiao CAI ; Xiaoyi ZHANG ; Minli ZHU ; Zhenlang LIN ; Yicong PAN ; Junhu ZHENG ; Yiwei ZHAO ; Xiang WANG ; Hongping LU ; Meifang LIN ; Ji WANG ; Haihong GU ; Lizhen WANG ; Keping CHENG ; Yuxuan DAI ; Yuan GAO ; Junsheng LI ; Hongxia FANG ; Na SUN ; Lihua LI ; Xiaoquan LI ; Ying LIU ; Yingyu LI ; Wa GAO ; Minxia LI
Chinese Journal of Infectious Diseases 2023;41(6):393-400
Objective:To study the distribution and antibiotics resistance of the main pathogens of neonatal purulent meningitis in different regions of China.Methods:A retrospective descriptive clinical epidemiological study was conducted in children with neonatal purulent meningitis which admitted to 18 tertiary hospitals in different regions of China between January 2015 to December 2019. The test results of blood and cerebrospinal fluid, and drug sensitivity test results of the main pathogens were collected. The distributions of pathogenic bacteria in children with neonatal purulent meningitis in preterm and term infants, early and late onset infants, in Zhejiang Province and other regions outside Zhejiang Province, and in Wenzhou region and other regions of Zhejiang Province were analyzed. The chi-square test was used for statistical analysis.Results:A total of 210 neonatal purulent meningitis cases were collected. The common pathogens were Escherichia coli ( E. coli)(41.4%(87/210)) and Streptococcus agalactiae ( S. agalactiae)(27.1%(57/210)). The proportion of Gram-negative bacteria in preterm infants (77.6%(45/58)) with neonatal purulent meningitis was higher than that in term infants (47.4%(72/152)), and the difference was statistically significant ( χ2=15.54, P=0.001). There were no significant differences in the constituent ratios of E. coli (36.5%(31/85) vs 44.8%(56/125)) and S. agalactiae (24.7%(21/85) vs 28.8%(36/125)) between early onset and late onset cases (both P>0.05). The most common pathogen was E. coli in different regions, with 46.7%(64/137) in Zhejiang Province and 31.5%(23/73) in other regions outside Zhejiang Province. In Zhejiang Province, S. agalactiae was detected in 49 out of 137 cases (35.8%), which was significantly higher than other regions outside Zhejiang Province (11.0%(8/73)). The proportions of Klebsiella pneumoniae, and coagulase-negative Staphylococcus in other regions outside Zhejiang Province (17.8%(13/73) and 16.4%(12/73)) were both higher than those in Zhejiang Province (2.9%(4/137) and 5.1%(7/137)). The differences were all statistically significant ( χ2=14.82, 12.26 and 7.43, respectively, all P<0.05). The proportion of Gram-positive bacteria in Wenzhou City (60.8%(31/51)) was higher than that in other regions in Zhejiang Province (38.4%(33/86)), and the difference was statistically significant ( χ2=6.46, P=0.011). E. coli was sensitive to meropenem (0/45), and 74.4%(32/43) of them were resistant to ampicillin. E. coli had different degrees of resistance to other common cephalosporins, among which, cefotaxime had the highest resistance rate of 41.8%(23/55), followed by ceftriaxone (32.4%(23/71)). S. agalactiae was sensitive to penicillin, vancomycin and linezolid. Conclusions:The composition ratios of pathogenic bacteria of neonatal purulent meningitis are different in different regions of China. The most common pathogen is E. coli, which is sensitive to meropenem, while it has different degrees of resistance to other common cephalosporins, especially to cefotaxime.
7.Biplane transrectal ultrasound combining superb microvascular imaging in evaluating preoperative T staging of mid-low rectal cancer
Wei CHENG ; Qin XIA ; Anping REN ; Jiaojiao HU ; Xiaojing YAO ; Tao LI
Chinese Journal of General Surgery 2023;38(9):662-668
Objective:To explore the application value of biplane transrectal ultrasound (TRUS) combining superb microvascular imaging (SMI) in evaluating preoperative T stage of mid-low rectal cancer.Methods:From Jan 2021 to Apr 2022, 90 patients with middle and low rectal cancer undergoing surgical treatment in Da Ping Hospital, Army Medical Center of PLA were equally divided into trial group and control group . Patients in the control group received TRUS combining with color Doppler blood flow imaging (CDFI) mode, patients in the trial group received additional SMI . Preoperative ultrasound T staging was performed. Artery blood flow resistance index (RI), pulsation index (PI), peak systolic velocity (PSV), and end diastolic velocity (EDV) of tumors were measured and recorded. Receiver operating characteristics curves were drawn to evaluate the diagnostic efficacy.Results:The accuracy rate of the control group was 67% (30/45), and the consistence with the pathological stage (Kappa=0.510, P<0.05) was lower than that of 84% (38/45) and (Kappa=0.779, P<0.001) of the trial group ( χ2=3.850, P<0.05). Among different T stages, the difference of RI and PI were significant ( F=5.619, P=0.002; F=25.500, P<0.001), the difference of PSV was not significant ( F=1.464, P=0.231), and the difference of EDV was weakly correlated ( F=2.723, P=0.05). The ROC curves showed that the area under curve of RI, PI, EDV, and PSV was 0.573, 0.517, 0.527 and 0.501, respectively. With the diagnostic sensitivity rate for T1 to T4 as 70.4%, 58.8%, 93.3%, 68.8%, while the diagnostic specificity rate was 87.3%, 90.4%, 96.8%, 93.2%. Conclusion:Biplane TRUS combining SMI can improve the accuracy in preoperative ultrasound T staging of mid-low rectal cancer.
8.Molecular diagnosis and treatment of meningiomas: an expert consensus (2022).
Jiaojiao DENG ; Lingyang HUA ; Liuguan BIAN ; Hong CHEN ; Ligang CHEN ; Hongwei CHENG ; Changwu DOU ; Dangmurenjiapu GENG ; Tao HONG ; Hongming JI ; Yugang JIANG ; Qing LAN ; Gang LI ; Zhixiong LIU ; Songtao QI ; Yan QU ; Songsheng SHI ; Xiaochuan SUN ; Haijun WANG ; Yongping YOU ; Hualin YU ; Shuyuan YUE ; Jianming ZHANG ; Xiaohua ZHANG ; Shuo WANG ; Ying MAO ; Ping ZHONG ; Ye GONG
Chinese Medical Journal 2022;135(16):1894-1912
ABSTRACT:
Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients.
REGISTRATION
Practice guideline REgistration for transPAREncy (PREPARE), IPGRP-2022CN234.
Humans
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Meningioma/pathology*
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Consensus
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Neurosurgical Procedures
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Meningeal Neoplasms/pathology*
9.Comparison of clinical efficacy of transperitoneal robot assisted laparoscopic radical prostatectomy versus extraperitoneal single port robot assisted laparoscopic radical prostatectomy
Shangqing REN ; Qian LYU ; Hualin FENG ; Yong OU ; Yaoqian WANG ; Yi WEI ; Shida FAN ; Fang ZHOU ; Shan ZHONG ; Yu NIE ; Qiang WANG ; Cheng LUO ; Zhengjun CHEN ; Jingzhi TIAN ; Jiaojiao HUANG ; Xiaolin CHEN ; Dong WANG
Chinese Journal of Urology 2021;42(2):116-121
Objective:To compare the clinical efficacy of transperitoneal robot assisted laparoscopic radical prostatectomy (RARP) versus extraperitoneal single port RARP.Methods:A retrospective analysis was perfoumed on 142 cases of RARP from July 2019 to June 2020 in Robotic Minimally Invasive Center of Sichuan Provincial People's Hospital, including 82 cases(Group A) , aged 70.0(65.6-78.0), undergoing transperitoneal RARP and 60 cases(Group B), aged 68.2 years old(60.1-79.2), undergoing extraperitoneal single port RARP. For group A, PSA was 12.9(5.6-64.0) ng/ml, with 26 cases of less than 10 ng/ml(31.7%), 40 cases of 10-20 ng/ml(48.8%), and 16 cases of more than 20 ng/ml(19.5%), the Gleason score was 7.2(6.0-10.0), with 14 cases(17.1%) of ≤6, 56 cases(68.3%) of 7, and 12 cases(14.6%) of ≥8, and the prostate volume was 61.3(29.0-112.0) ml. There were 49 cases with BMI≤25 kg/m 2, accounting for 59.8%, and 33 cases with BMI>25 kg/m 2, accounting for 40.2%. There were 17 cases(20.7%) of T 1, 44 cases(53.7%) of T 2 and 21 cases(25.6%) of T 3. The proportion of lymph node dissection was 17.1%, and 4 cases(4.9%)had a history of operation. For group B, the PSA was 12.2(1.0-42.6)ng/ml, with 20 cases (33.3%) of <10 ng/ml, 31 cases(51.7%)of 10-20 ng/ml, and 9 cases (15%) of >20 ng/ml. Gleason score was 7.1(6.0-9.0), with 12 cases (20.0%) of ≤6, 42 cases (70.0%) of 7, and 6 cases (10.0%)of ≥8. Prostate volume was 42.4(31.2-72.8)ml on average. There were 37 cases (61.7%) with BMI≤25 kg/m 2, and 23 cases (38.3%)with BMI >25 kg/m 2 . There were 17 cases(28.3%)of T 1, 32 cases(53.3%)of T 2 and 11 cases(18.3%)of T 3.The proportion of lymph node dissection was 11.7% and 4 cases (6.7%) had a history of operation.There was no statistically significant difference in term of age, PSA level, Gleason score, BMI, clinical stage, proportion of lymph node dissection or history of operation between the two groups( P>0.05), but there was statistically significant difference for prostate volume( P<0.05). All operations were performed by the same operator. Four different ways of bladder neck and urethral dissociation was selected according to the intraoperative conditions in Group A, include VIP style, T-shape incision style, VIP plus T-shape incision style or the style along the lateral side of the bladder neck. Small and single anterograde incision stripping of bladder neck was routinely performed in the Group B. Postoperative follow-up was performed to compare the operation time, intraoperative blood loss, bladder neck and urethral anastomosis time, postoperative hospital stay, postoperative exhaust time, postoperative complications, positive rate of surgical margin, indwelling time of urinary catheter, urinary continence satisfaction rate of immediately after operation, 3 months and 6 months after operation, wound healing and aesthetics. Results:All of the operations were successfully completed under robot-assisted laparoscopy, and there was no conversion to open surgery. The operation time was 56.0(45.0-112.0) min in the Group A and 65.4(55.5-96.8) min in the Group B, and there was no statistically significant difference( P>0.05). The intraoperative blood loss was 76.2(30.0-120.5) ml and 55.6(45.5-114.6) ml, respectively, and the difference was not statistically significant( P>0.05). The time of bladder neck urethral anastomosis was 18.9(12.6-25.6) min and 16.2(10.7-19.3) min, respectively, and the difference was not statistically significant( P>0.05). The postoperative hospital stay days were 9.3(8.0-16.0) d and 8.4(7.0-13.0) d, respectively, and the difference was not statistically significant( P>0.05). The postoperative exhaust time was 1.3(0.7-3.0) d and 3.4(2.0-7.0) d, respectively, and the difference was statistically significant( P<0.05). There was 1 case of anastomotic fistula with ureteral injury in Group A, and no serious complication in Group B, and the difference was not statistically significant( P>0.05). The number of positive surgical margin in the two groups was 13(15.9%)and 9(15.0%)respectively, and the difference was not statistically significant( P>0.05). The indwelling time of urinary catheter after operation was 9(7-21) d and 6(4-8) d, respectively, and the difference was statistically significant( P<0.05). The number of patients with satisfactory urinary continence immediately after surgery, 3 months and 6 months after surgery in the two groups were 8(9.8%), 51(62.2%), 62(75.6%) and 17(28.3%), 43(71.7%) and 54(90.0%), respectively. The differences were statistically significant( P<0.05). The total incision lengths in the two groups were 12.1(10.4-13.4) cm and 5.6(5.0-6.0) cm, respectively, and the difference was statistically significant( P<0.05). Conclusions:The extraperitoneal single port RARP is safe and feasible, and the postoperative effect is similar to that of transperitoneal RARP. It has the advantages of shorter recovery time, higher urinary continence satisfaction rate, neater and more beautiful incision. The long-term therapeutic effect needs further confirming by prospective study.
10.Prevention and treatment of iatrogenic premature ovarian insufficiency:interpretation of the first Chinese guideline on ovarian tissue cryopreservation and transplantation
Ruan XIANGYAN ; Cheng JIAOJIAO ; Du JUAN ; Jin FENGYU ; Li YANGLU ; Gu MUQING ; O.Mueck ALFRED
Global Health Journal 2021;5(2):70-73
In recent years,with the rapid development of medical research,cancer diagnosis and treatment technology have significantly improved young cancer patient's survival rate.Anticancer therapy such as chemotherapy,radiother-apy,or hematopoietic stem cell transplantation can lead to premature ovarian insufficiency.The endocrine and reproductive function of the ovary is critical to women's physical and mental health.Ovarian tissue cryopreser-vation and transplantation can protect not only female fertility but also preserve ovarian endocrine function.This paper interprets the guidelines for ovarian tissue cryopreservation and transplantation issued by the Chinese Society of Gynecological Endocrinology affiliated to the International Society of Gynecological Endocrinology.The purpose of this guideline's interpretation is to promote more medical workers to understand the technology of ovarian tissue cryopreservation and transplantation,which can provide patients with more choices of fertility protection methods and improve their quality of life.

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