Targeted delivery of antibody bound to antigen is a precise drug delivery mode. It is regarded as one of the ideal targeted drug delivery modes due to its high specificity and affinity, which opens up a new way to successfully solve the problem of poor selectivity of chemotherapy drugs in antitumor therapy. Currently, the research on antibody drug conjugates(ADCs) that bind monoclonal antibodies to target antigens has become a research hotspot of molecular targeted therapy. This paper reviews the mechanism of action, targeting strategies and progress in the targeted delivery of ADCs, in order to provide reference for the clinical development of new ADCs.

Objective:To investigate the effects of modified radical prostatectomy via an extraperitoneal approach on urinary control and sexual function in patients with prostate cancer.Methods:Fifty-six patients with stable prostate cancer who received treatment in Deqing People's Hospital between March 2015 and March 2018 were included in this study. They were randomly divided into observation and control groups ( n = 28/group). The observation group was subjected to modified radical prostatectomy via an extraperitoneal approach. The control group underwent standard laparoscopic surgery. Clinical efficacy and the effects of modified radical prostatectomy via an extraperitoneal approach on urinary control and sexual function were compared between the two groups. Results:Amount of blood loss and postoperative drainage were (125.39 ± 11.12) mL and (65.39 ± 10.12) mL in the observation group, and (224.79 ± 14.01) mL and (104.79 ± 15.01) mL in the control group. There were no significant differences in amount of blood loss and postoperative drainage between the two groups ( t = 18.83, 15.67, both P < 0.05). At 1, 3 and 6 months after surgery, the percentage of patients who had urinary control recovery in the observation group was 53.57% (15/28), 78.57% (22/28), 98.21% (27/28), respectively, which were significantly higher than those in the control group [21.43% (6/28), 35.71% (10/28), 67.86% (19/28), χ2 = 4.12, 7.21, 5.01, all P < 0.05]. At 1, 3 and 6 months after surgery, the score of erectile function recovery in the observation group was (15.98 ± 0.28) points, (15.99 ± 0.72) points, and (18.91 ± 0.48) points, which were significantly higher than those in the control group [(17.11 ± 0.34) points, (13.11 ± 0.48) points, (13.41 ± 0.39) points, t = 3.01, 12.89, 15.78, all P < 0.05]. Conclusion:Modified radical prostatectomy via an extraperitoneal approach can improve postoperative urinary control and sexual dysfunction.

Objective:To observe the effects of transurethral split of the prostate (TUSP) on the urodynamics, the sexual function and the quality of life of benign prostatic hyperplasia.Methods:Eighty patients with benign prostatic hyperplasia admitted to the Deqing People′s Hospital of Zhejiang Province from January 2017 to June 2019 were enrolled into the research objects prospectively. According to the random digits table method, they were divided into group A and group B, with 40 cases in each group. The group A was treated with TUSP, while the group B was treated with bipolar transurethral plasma kinetic prostatectomy (TUPKP). The operation time, intraoperative blood loss, bladder irrigation time, urinary catheter indwelling time, hospitalization time of the two groups were compared and surgical effects were evaluated. The changes of hemoglobin (Hb), serum sodium (Na), post-void residual volume (PVR), maximum urinary flow rate (Q max), international prostate symptom score (IPSS) and international index of erectile function score (IIEF-5), the quality of life index (QOL) of 2 groups before and after the operation were measured. Surgical complications were recorded. Results:The operation time, bladder irrigation time, urinary catheter indwelling time and hospital stay in group A were all shorter than that in group B: (15.63 ± 4.17) min vs. (58.79 ± 10.45) min, (6.26 ± 1.17) h vs. (45.51 ± 10.03) h, (3.07 ± 0.68) d vs. (5.67 ± 1.51) d, (3.63 ± 0.43) d vs. (6.08 ± 1.72) d, (18.32 ± 2.79) ml vs. (65.26 ± 20.64) ml, and there were statistical differences ( P<0.05); there were no statistical difference between 2 groups in surgical curative effect grade and Na 1 d after operation ( P>0.05); 1 day after operation, Hb in group A was higher than that in group B: (115.63 ± 9.78) g/L vs. (109.65 ± 8.36) g/L, and there was statistical difference ( P<0.05); PVR, Q max, IPSS, IIEF-5 and QOL 3 and 6 months after surgery were improved in 2 groups ( P<0.05), but the difference between 2 groups was not statistically significant ( P>0.05); the total complication rate in group A was lower than that in group B: 10.00% (4/40) vs. 27.50% (11/40), and there was statistical difference ( P<0.05). Conclusions:TUSP and TUPKP are equally effective in the treatment of benign prostatic hyperplasia, both of which can improve the symptoms of prostatic hyperplasia, improve the quality of life and improve sexual function. But TUSP has less intraoperative bleeding, shorter operation time, faster postoperative recovery, fewer complications, and higher safety.

Solid dispersions of the insoluble compound CHMFL-KIT-110 were prepared by solvent method with polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol graft copolymer (Soluplus),Poloxamer 407,PEG 6000,Copovidone (Kollidon VA64) as carriers and SLS,Tween 80,Cremophor RH40 as solubilizers. The optimal formulation was screened and obtained with dynamic solubilities and supersaturation performances as indexes. The final product was characterized by Fourier transform infrared (FT-IR),differential thermal analysis (DTA) and X-ray powder diffraction (XRPD). The stability and pharmacokinetic behavior in rats were also investigated. Results suggested that when the weight ratio of CHMFL-KIT-110/Soluplus/SLS was 1∶4∶0.5,dynamic solubility of the solid dispersions was significantly improved with no recrystallization. In the accelerated condition (40 °C,75% RH) for 30 days,CHMFL-KIT-110 in the solid dispersions was still amorphous with no crystal observed. The results of pharmacokinetics in rats showed that the cmax and AUC0→t of CHMFL-KIT-110 solid dispersions were 373.1 times and 358.7 times higher than those of free drugs,respectively. These results help to understand the formulation development and clinical practice of CHMFL-KIT-110.

According to the course teaching requirements of psychiatry,a serial teaching cases of case-based learning (CBL) is built based on cases from psychology department to assist in the theory teaching of Psychiatry.During the teaching process,the scenes where patients came to the psychology department were simulated and the information about the cases was provided step by step.For each step,students would be asked to discuss a series of questions regarding the cases in different groups.Along with CBL,students could thoroughly learn the main points of diagnosis and principles of treatment for common psychiatric disorders.The teaching effect showed that students' involvement in CBL courses,the interests in learning,self-study ability,independent thinking ability,capacity for self-expression,ability of creative thinking and comprehensive analysis and problem solving ability.were greatly improved.Most students were interested in CBL and it produced fruitful teaching results.

OBJECTIVETo investigate the diagnosis, treatment and surgical outcomes of ureteropelvic junction obstruction (UPJO) caused by renal crossing vessels.

METHODSThe case records of 24 patients discharged from Peking University Third Hospital between June 2001 and September 2011 with the diagnosis of UPJO caused by renal crossing vessels were reviewed .Of the 24 patients, 17 were male and 7 were female patients. The mean age was 28 years (range, 2-63 years). The mean disease duration was 22.3 months (range, 7 days to 180 months). Of which, 4 patients underwent open surgery, and the other 20 patients were treated with laparoscopic surgery. Surgical approach was decided by operative conditions: adhesion release technique, dismembered pyeloplasty or Y-V anastomosisor, with or without cut off the crossing vessels. The kind of crossing vessels was recorded, and the effect of surgery was evaluated by follow-up.

RESULTSFifteen cases were caused by oppressed renal crossing artery, 8 cases by renal crossing vein, and 1 case by 2 renal crossing arteries and 1 renal crossing vein. Among them, 11 cases were followed up successfully. Average follow-up time was 48.2 months (range, 13-120 months). Eight cases (8/11) were relieved, and 1 case (1/11) had no obvious improvement, another 2 cases (2/11) were aggravating. Among those 6 cases underwent adhesion release technique, 3 cases were relieved, 1 case had no obvious improvement, and 2 cases were aggravating. Five cases who underwent dismembered pyeloplasty was relieved significantly.

CONCLUSIONSRenal crossing artery is one of the main causes of UPJO, the crossing artery should be retained as far as possible. Crossing vessel oppression is not the only pathological cause of UPJO, so the treatment of UPJ constriction is also very important. Dismembered pyeloplasty seems to be the most efficacies treatment procedure for UPJO caused by repressed vessels, and the remission rate of adhesion release technique seems limited.

Adolescent ; Adult ; Arteries ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Hydronephrosis ; congenital ; etiology ; surgery ; Kidney ; blood supply ; Kidney Pelvis ; blood supply ; Laparoscopy ; methods ; Male ; Middle Aged ; Multicystic Dysplastic Kidney ; etiology ; surgery ; Renal Artery ; abnormalities ; Treatment Outcome ; Ureteral Obstruction ; etiology ; surgery ; Young Adult

[Abstract ] Objective Chronic renal disease,a common and frequent disease,is the most cause inducing chronic renal failure. There is an important guiding significance for renal biopsy in the diagnosis,treatment and prognosis of renal disease.The aim of this study was to analyze the characteristics of renal biopsy and the relation between pathological types and clinical presentation in Tibet. Methods Between June 2011 and December 2013 in General Hospital of Tibetan Military Command, Lhasa, percutaneous renal biopsy were per-formed in 107 renal patients.In this study, the gender, age, pathologic entities, and clinical manifestation were analyzed retrospectively. The final diagnosis was made by the clinical manifestation, laboratory examination,and pathologic results. Results The mean age at renal biopsy was 29.8 ±12.2(10~66)years in 47 male cases (43.9%) and 69 female cases (56.1%).This includes 75 Tibetan cases (70.1%), 31 Han cases (28.9%), and Bai cases (1.0%).The primary glomerular disease was 95.3%and the secondary glomerular disease was 4.7%in the total 107 cases.Fourty-four point three percent of the primary glomerular disease were male cases and 100%of secondary glomerular disease were female cases.The main pathological type of the primary glomerular disease was podocyte nephropathy (43.9%), followed by membranous nephropathy (18.7%), IgA nephropathy (11.2%), focal segmental glomerulosclerosis (9.3%) and mesangiocapillary glomerulonephritis (5.6%).The clinical manifestations of 107 cases were classified as syndrome of nephrotic syn-dromn(69.1%),urinary abnormalities(14.9%),isolated macrographic haematuria (3.7%),chronic renal failure(2.8%).Among the nephrotic syndrome,podocyte disease was 63.5%,membranous glomerulopathy was 18.9%,focal segmental glomeruolsclerosis was 8.1%,and membranoproliferative glomerulonephritis was 5.4%. Conclusion The primary glomerulonephritis was the most common glomerular diseases at high altitude area in Tibet.The most frequent type of pri-mary glomerular nephritis was podocyte disease, and the most frequent type of secondary glomerular nephritis was Henoch-Schonlein purpura glomerulonephritis.

OBJECTIVETo explore the expression of Notch signaling receptors Notchl, Notch3 and its ligand Jaggedl, Jagged2 in tongue squamous cell carcinoma (TSCC).

METHODSmRNA and protein expression levels of tissue samples from 74 cases of tongue cancer patients and human tongue cell line Cal-27 were detected by reverse transcriptase-polymerase chain reaction (RT-PCR), immunohistochemistry and Western blot. Its relationship with cell proliferation and clinical pathology was analyzed.

RESULTSmRNA and protein expression were detected in tongue cancer tissues, adjacent tissues and cell lines. Notchl and Notch3 protein expression in tongue cancer was higher than the adjacent tissues. Jaggedl and Jagged2 protein expression in tongue cancer and adjacent tissues had no difference. Notchl and Notch3 protein had correlation with tongue cancer clinical staging. Pathway protein expression had no correlation with pathological grade, age, gender. Notchl protein expression in lymph node metastasis-positive cases was higher than in lymph node metastasis-negative cases. The expression of Notch3 and Jagged2 had correlation. Jaggedl expression grade in metastasis-positive cases was higher than in negative cases.

CONCLUSIONNotch signaling molecules have active expression in TSCC and may play important roles in tongue cancer development.

Blotting, Western ; Carcinoma, Squamous Cell ; Cell Line ; Cell Proliferation ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Neoplasm Staging ; RNA, Messenger ; Receptors, Notch ; Tongue ; Tongue Neoplasms

Objective To report a retroperitoneal laparoscopic surgery for ureteropelvic junction obstruction (UPJO) by double renal veins.Methods A 28-year-old male patient with left low back pain for 6 months was diagnosed as left hydronephrosis and UPJO.A ureteral stent had been placed 3 months before and failed to improve hydronephrosis,so the ureteral stent was pulled out.CT scan showed that left UPJ went through the two renal veins,suggesting UPJO.Nephrogram showed that left GFR and right GFR were 35 ml/min and 34 ml/min,respectively.These results indicated mechanical obstruction of left upper urinary tract.The patient underwent retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty.Results The surgical procedure was successful.Two left renal veins were found,and the ventral one was in front of ureter,compressing the ureter.An aberrant renal artery went into left kidney with the ureter.0.5 cm stenosis of ureteropelvic junction was excised,and pyeloplasty was performed.A ureteral stent was placed into the ureter,then the pelvis and the ureter were sew up in front of the ventral renal vein.The surgical time was 240 min,and blood loss was 50 ml.Postoperative hospital stay time was 4 d.During 4 months' follow up,hydronephrosis was attenuated significantly.Conclusion Retroperitoneal laparoscopic surgery for UPJO with aberrant two renal vein might be a minimally-invasive and effective procedure.

Objective To review the clinical characteristics of paraganglioma of the urinary bladder with 5 cases reprt.Methods The clinical data of 5 patients (2 males and 3 females,age 23-68 years)with paraganglioma of the urinary bladder were reported.Two cases were diagnosed by ultrasonography during health examination,1 case was found by hematuria,1 had difficulty of voiding,and 1 presented with palpitation,chest discomfort while urination.Two cases were clinical diagnosed as bladder paraganglioma,1case urachal carcinoma,and 2 cases bladder tumor.Cystoscopy showed a protruding tumor within the bladder or bladder had compressed changes.One case of tumor located in the triangle,1 in the posterior wall,1in the top,2 in the anterior wall.Three cases of biopsy were negative.Three cases of preoperative endocrine examinations showed norepinephrine significantly higher.Results Laparoscopic partial cystectomy was performed in 3 cases,open partial cystectomy in 1 case,and transurethral resection of bladder tumor (TURBT) in 1 case.One case had the complication of stress cardiomyopathy during TURBT,3 cases found intraoperative hypertensive crisis.The bleeding volume was 20-800 ml (average 126 ml),and I case received blood transfusion.During the follow-up period for 3-48 months,the blood pressure was normal,and no recurrence was found.Conclusions Bladder paraganglioma is uncommon and easily misdiagnosed.For the patients with bladder tumor,accompanied by changes in blood pressure,palpitations during urination should be highly suspicious of bladder paraganglioma.Partial cystectomy is the main treatment method.