Objective To investigate the effects of pretreatment with Xuebijing injection on renal tubular injury in rats with contrast-induced acute kidney injury(CI-AKI).Methods Twenty-four Sprague-Dawley(SD)rats were selected and divided into normal group,model group,control group,and treatment group according to the random number table method,with 6 rats in each group.The animal model of CI-AKI was prepared by adopting iohexol,and the normal group was not subjected to any treatment.The rats in the treatment group were injected with Xuebijing injection via the tail vein 15 hours before modeling until 24 hours after modeling.The injection volume was 10 mL/kg for every 6 hours.The control group was injected with normal saline at the same time point.After 24 hours of modeling,the urine of rats in each group was collected to determine the levels of blood urea nitrogen(BUN)and urine N-acetyl-β-D-gluco-aminidase(uNAG),and the blood was collected to determine the levels of serum creatinine(SCr).Then the rats were killed and the kidney tissues were extracted,and then stained with hematoxylin-eosin(HE),and the pathological changes of the kidney tissues were observed under the light microscope.Results BUN,SCr and uNAG were significantly higher in the model group than those in the normal group[BUN(μmol/L):37.29±6.18 vs.6.37±1.19,SCr(mmol/L):30.43±4.44 vs.14.90±1.61,uNAG(U/L):47.77±4.71 vs.11.32±3.62,all P<0.01];BUN,SCr and uNAG levels were obviously decreased in the treatment group compared to the model group[BUN(μmol/L):9.45±3.04 vs.37.29±6.18,SCr(mmol/L):19.83±2.16 vs.30.43±4.44,uNAG(U/L):21.70±6.21 vs.47.77±4.71,all P<0.05],however,BUN and uNAG in the treatment group were still significantly higher than those in the normal group[BUN(μmol/L):9.45±3.04 vs.6.37±1.19,uNAG(U/L):21.70±6.21 vs.11.32±3.62,P<0.05 or P<0.01];SCr in the treatment group was not statistically significant compared to the normal group(μmol/L:19.83±2.16 vs.14.90±1.61,P>0.05).Under the light microscope,the renal tubular epithelial cells at the junction of cortex and dermatomedulla in the kidneys of the model group were obviously vacuolated,accompanied by cell detachment and necrosis,and the tubules were dilated,with no obvious lesions in the glomeruli.The degree of damage in the control group and the treatment group was reduced compared with that in the model group.The degree of renal tubular damage in the model group was higher than that in the normal group;while the degree of renal tubular damage in the control group was significantly lower than that in the model group;and the degree of renal tubular damage in the treatment group was lower than that in the model group.There was no statistically significant difference in the degree of renal tubular damage between the treatment group and the control group.Conclusion Xuebijing injection may exert a protective effect on renal function in rats with CI-AKI by attenuating renal tubular injury.

Objective:To evaluate the safety and effectiveness for the treatment of totally robotic fundoplication.Methods:A retrospective analysis was conducted on the clinical data of 21 patients with gastroesophageal reflux disease (GERD) who underwent unassisted totally robotic fundoplication at the Second Department of General Surgery, Yan'an Hospital Affiliated to Kunming Medical University from Aug 2023 to Jan 2024. The postoperative outcomes were evaluated using SF-36, GERD-Q, and NRS scoring indicators.Results:All 21 patients successfully underwent the surgery. The robotic surgery time was (99±41) minutes, with precise intraoperative anatomy and insignificant blood loss of (1.7±1.4) ml. There were no intraoperative or postoperative complications, and no conversions to open surgery . Postoperative recovery of bowel function was rapid (11.71±3.33) hours, with minimal postoperative pain (NRS score of 1.67±0.48).The postoperative hospital stay was short (3.86±2.90) days, and patient satisfaction was high, SF-36 score of (80.90±1.14);The symptoms of reflux after surgery was significantly reduced.Postoperative GERD-Q score of (4.38±1.69) significantly lower than the preoperative score of (13.90±2.07).Conclusion:Totally robotic fundoplication provides clear view of intraoperative anatomical structures, rapid postoperative recovery, minimal pain, and effective anti-reflux outcomes.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

Objective To understand the types and distribution of Arboviruses in Hainan province.Methods Blood-sucking insects were collected in Hainan province from 2017 to 2018.After laboratory treatment,BHK-21 cells and C6/36 cells were inoculated with grinding supernatant of all blood-sucking insects to isolate all of involving virus.Arbovirus genes in blood-sucking insects were detected in parallel by RT-PCR method.Results A total of 15 062 mosquitoes were classified into four genera (Culex,Armigeres,Aedes,Anopheles) and 11 360 midges were collected.Culex tritaeniorhynchus was in the majority and accounted for 92.88％ (13 990/15 062) of all the mosquitoes collected.Four strains of virus isolates were notified by tissue culture method.Three strains of viruses belonged to Japanese encephalitis virus (JEV),with the other one as Getah virus (GETV).Five pools of JEV gene amplification were positive,from Culex tritaeniorhynchus.Results from the phylogenetic analysis showed that they belonged to genotype JEV-Ⅰ.The minimum infection rate of JEV was 0.57‰ (8/13 990).A total of 5 pools of Akabane virus (AKV) gene amplification were positive.The minimum infection rate of AKV was 0.44‰ (5/11 360).Based on the S gene and M gene sequences of the virus,data from the phylogenetic analysis showed that the five AKV strains carried by midges in Hainan province were in a separate evolutionary branch and with formed unique geographical distribution.Conclusions JEV and GETV had been isolated again from the mosquito specimens in this survey,since the 1980s.AKV was detected from the midge specimens in Hainan province.These results showed the needs of strengthening the programs on detection and monitor of JEV,GETV and AKV that were related to animal and human diseases in order to reduce the risks of related diseases in this area.

Objective To investigate the short-term efficacy,safety and factors affecting the efficacy of BCG intravesical therapy in high risk non-muscle-invasive bladder cancer (NMIBC) patients.Methods A total of 161 high-risk non-muscle invasive bladder cancer (NMIBC) patients were reviewed in our hospital from March 2014 to December 2017.They were all treated with BCG instillation after transurethral resection of bladder tumor (TURBT).There were 121 males (75.2％) and 40 females (24.8％).Median age was 65 years old,including 17 cases (10.6％) ＜50 years old,23 cases (14.3％) within 50-59 years old,72 cases (44.7％) within 60-69 years old,49 cases ≥70 years old (30.4％).There were 112 patients (69.6％) with primary bladder cancer and 49 (30.4％) patients with recurrent bladder cancer.56 cases (34.8％) had single tumor and 105 cases (65.2％) had multiple tumors.The tumors size in 106 cases (65.8％) was less than 3 cm,and tumor size in 55 cases (34.2％) was more than 3 cm.43 patients (26.7％) suffered carcinoma in situ.10 patients (6.2％) suffered urothelial carcinoma with variant types.According to the American Joint Commission for Cancer (AJCC) version 7 TNM staging system,25 cases (15.5％) were classified into Ta stage,129 cases (80.1％) were classified into T1 stage,and 7 cases (4.3％) were classified into Tis stage.There were 8 cases (5％) with low-grade cancer and 153 cases (95％) with high-grade cancer.69 patients (42.9％) received chemo-instillation before.43 cases were directly perfused without re-TURBT and 118 cases were perfused after re-TURBT.They were all treated with BCG instillation after transurethral resection of bladder tumor (TURBT).The 120 mg BCG were dissolved into 50 ml saline for instillation and were kept for 2 hours.Induction scheme of six-weekly and three fortnightly instillations started two weeks after the initial TUR or re-TUR.Maintenance instillations were then be offered in a scheme of ten monthly instillations.During treatment,patients were offered cystoscopy and cytology every three months,while CT and chest radiographs were reviewed every 6-12 months.Recurrence status and adverse effects were recorded.Univariate and multivariate regression analyses were performed to predict risk factors for failure of BCG instillation in bladder cancer.Results A total of 161 patients were followed up.The median follow-up time was 13 months,ranging 7-22 months.The overall recurrence rate was 26.1％ (42/161) and the 1-year recurrence-free survival rate was 79.0％.On univariate analysis,recurrence history,history of instillation chemotherapy application and history of re-staging transurethral resection influenced recurrence.Multivariate regression analysis showed recurrence status was an independent prognostic factor regarding recurrence-free survival.The incidence of adverse events in all 161 instillation patients was 40.4％ (26/65).Grade 1,grade 2 and grade 3 adverse events accounted for 53.8％ (35/65),40.0％ (26/65) and 6.2％ (4/65) respectively.6 cases (3.7％) reduced the dose of BGC and 1 case stop the instillation due to the intolerance of BCG.Conclusion Short-term efficiency and safety were confirmed in BCG-treated high-risk NMIBC patients.And recurrence status was an independent prognostic factor for recurrence-free survival.

Objective: To investigate the value of prostate health index (PHI) in the diagnosis of prostate cancer in patients with total prostate specific antigen (tPSA) <20 μg/L. Methods: Totally 1 135 patients with tPSA<20 μg/L and prostate biopsy indications at Department of Urology, Fudan University Shanghai Cancer Center from March 2013 to April 2016 were enrolled in this study. They were tested for serum tPSA, free prostate specific antigen and prostate specific antigen isoform 2, from which PHI was calculated. Diagnostic efficacy of PHI and tPSA were evaluated using receiver operating characteristic (ROC) curve analysis. The detection rates of prostate cancer were calculated in different ranges of PHI. Subgroup analysis of 716 patients, who were aged 50 or above with tPSA in the range of 4 to 10 μg/L and digital rectal examination negative, was performed. Results: In the biopsied objects with tPSA<20 μg/L, PHI was significantly higher in prostate cancer patients than that in non-cancer patients (48.4(37.4) vs. 26.5(16.9), U=52 674.00, P=0.000), PHI was also significantly higher in high-grade prostate cancer patients than that of low-grade prostate cancer patients (44.5(30.8) vs. 56.4(42.5), U=23 314.00, P=0.000). The area under the curve (AUC) of PHI for diagnosing prostate cancer was significantly higher than that of tPSA (0.771 vs. 0.627, P=0.000). When PHI was in the range of <27, 27 to <36, 36 to <55 and ≥55, the probability of prostate cancer was 9.4% (95%CI: 7.0% to 12.2%), 16.3% (95%CI: 12.2% to 20.8%), 31.0% (95%CI: 25.9% to 37.3%) and 66.4% (95%CI: 58.9% to 74.2%), respectively. Subgroup analysis showed that the AUC of PHI in diagnosing prostate cancer was significantly higher than that of tPSA (0.764 vs. 0.569, P=0.000). When PHI was in the range of <27, 27 to <36, 36 to <55 and ≥55, the probability of prostate cancer was 8.1% (95%CI: 5.4% to 11.3%), 14.0% (95%CI: 9.1% to 19.9%), 30.8% (95%CI: 23.6% to 38.7%) and 78.8% (95%CI: 66.7% to 88.9%), respectively. Conclusion PHI is superior to tPSA in the diagnosis of prostate cancer in Chinese men with tPSA<20 μg/L.

OBJECTIVETo study the pathological and clinical characteristics of a patient with spontaneous platelet aggregation of his giant and morphologically abnormal platelets.

METHODSPlatelet size and structure were observed under light microscope and electron microscope. Platelet aggregation was measured turbidometrically. Platelet glycoproteins (GP) were analyzed using flow cytometry. PCR and DNA sequencing were performed to identify the gene abnormality.

RESULTSThe patient had spontaneous platelet aggregation of giant platelets with thickened plasma membrane and increased number of granules in various shapes. Aspirin and ticlopidine did not affect the spontaneous aggregation. The expression of GP I b, GP II b, GP III a and P-selectin in the platelet membrane were in normal range. Results of gene analyses for GP I balpha, GP I bbeta and GPIX were also normal.

CONCLUSIONBoth morphological and functional abnormalities of the platelets from the patient were clearly distinguishable from that of other hereditary giant platelet disorders. It would probably represent a novel platelet disorder which had not been reported to date.

Aspirin ; pharmacology ; Bernard-Soulier Syndrome ; metabolism ; pathology ; Blood Platelet Disorders ; metabolism ; pathology ; Cell Size ; physiology ; Child ; Cytoplasmic Granules ; pathology ; ultrastructure ; Female ; Humans ; Platelet Aggregation ; drug effects ; physiology ; Platelet Aggregation Inhibitors ; pharmacology ; Platelet Membrane Glycoproteins ; genetics ; metabolism ; Ticlopidine ; pharmacology

OBJECTIVETo study the clinical, biological features and prognosis of acute biphenotypic leukemia (BAL) in the adults.

METHODSBone marrow specimens of 63 BAL patients were evaluated to prove the diagnosis and the classification by morphologic, cytochemical, immunologic and cytogenetic (MIC) examinations. These patients were treated with protocols suitable for acute myeloid leukemia (AML), or acute lymphoblastic leukemia (ALL), or both.

RESULTSNo significant difference in clinical features was observed between BAL, AML or ALL. Morphologically, the subtypes of M(5), M(1) and M(2) were predominant in AML, as L(2) and L(1) were in ALL. Immunologically, coexpression of myeloid and B lineage associated antigens was predominant and CD(34) was hyperexpressed in BAL, which suggested that BAL might originate from malignant transformation of earlier hematopoietic cells. Cytogenetically, Ph chromosome was observed in 25.5% (13/51) of BAL patients. Prognostically, both the treatment response and the overall survival of BAL patients were poor.

CONCLUSIONPatients with BAL have unique clinical, biological and prognostic features.

Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Cytogenetics ; Female ; Humans ; Leukemia, Myeloid ; drug therapy ; genetics ; immunology ; physiopathology ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; genetics ; immunology ; physiopathology

OBJECTIVETo evaluate the four techniques for clonal analysis in the early diagnosis of myelodysplastic syndromes (MDS).

METHODSFour techniques for clonal analysis were performed in bone marrow samples from fifty patients with suspected MDS: (1) Conventional cytogenetics (CC) for clonal chromosomal abnormalities; (2) BrdU-sister chromatid differentiation (BrdU-SCD) for cell cycle analysis; (3) Fluorescence in situ hybridization (FISH) for trisomy 8; (4) PCR-SSCP for N-ras mutation.

RESULTSThe diagnosis of forty-five patients was compatible with FAB criteria of MDS, the other five patients didn't fully meet the FAB criteria. They had either only one lineage dyspoiesis or no any obvious dysplastic features and two of them were diagnosed as suspicious refractory anemia (RA), one as anemia with hypercellular bone marrow and two as chronic aplastic anemia. The results of the four techniques performed in them showed that four patients had clonal karyotype abnormalities, two had prolonged cell cycle, three had trisomy 8 of different proportions, and one had N-ras mutation. Thus, they were all diagnosed as RA.

CONCLUSIONThe untypical MDS patients can be diagnosed early by examination with combining several clonal analysis techniques.

Adolescent ; Adult ; Aged ; Bromodeoxyuridine ; Child ; Child, Preschool ; Chromatids ; Chromosome Aberrations ; Cytogenetic Analysis ; methods ; Female ; Genes, ras ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Male ; Middle Aged ; Mutation ; Myelodysplastic Syndromes ; diagnosis ; genetics

OBJECTIVETo report two myelodysplatic syndromes (MDS) patients with t(3; 5) (q25; q34).

METHODSChromosome specimens were prepared by short-term culture of bone marrow cells. Karyotype analysis was performed by R banding technique, chromosome painting (fluorescence in situ hybridization, FISH) by using whole chromosome 3 and 5 probes in case 1.

RESULTSThe clinical and hematological findings were compatible with diagnosis of MDS. Karyotype analysis showed that both patients had identical t(3; 5) (q25; q34) translocation. A reciprocal translocation between chromosomes 3q and 5q was proved by FISH in one patient.

CONCLUSIONSt(3; 5) translocation is a rare chromosome abnormality specifically associated with MDS and frequently displays trilineage dysplasia. Chromosome painting technique is a reliable tool for detecting this translocation.

Adolescent ; Adult ; Antigens, CD ; analysis ; Chromosomes, Human, Pair 3 ; Chromosomes, Human, Pair 5 ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Leukocytes, Mononuclear ; classification ; immunology ; Male ; Myelodysplastic Syndromes ; genetics ; physiopathology ; Translocation, Genetic