Stress urinary incontinence (SUI) and underactive bladder (UAB) are common types of lower urinary tract dysfunction in women.As the treatment mechanisms of the two conditions are contradictory, the treatment of SUI patients complicated with UAB remains a difficult clinical problem.In order to improve the treatment rate of such patients and promote research, this paper reviews the latest domestic and overseas diagnostic criteria of UAB, summarizes the treatment experience of conventional midurethral sling (tension-free vaginal tape or outside-in transobturator tape) and adjustable sling procedures (transobturator adjustable tape or Remeex system) combined with medication or intermittent catheterization, and the application prospects of cutting-edge technologies such as stem cell injection, cytokine therapy and gene therapy, so as to provide reference for clinicians and researchers.

Objective:To explore the relationship between glycosylated hemoglobin A 1c/high-density lipoprotein cholesterol ratio (HbA 1c/HDL-C) and urinary albumin-creatinine ratio (UACR) in Chinese adults. Methods:In this cross-sectional study, the clinical data of 43 820 community residents (age>40 years) from the Risk Evaluation of Cancers in Chinese Diabetic Individuals (REACTION study; March-December 2012) across eight centers (Liaoning, Guangdong, Shanghai, Gansu, Guangxi, Henan, Hubei, and Sichuan) in China were collected and analyzed. Participants were divided into three groups based on UACR levels:<10 mg/g, 10-30 mg/g, and >30 mg/g. The HbA 1c/HDL-C ratio was divided into four groups according to quartile division of the subjects: 1st quartile (Q1<3.79), 2nd quartile (3.79≤Q2<4.59), 3rd quartile (4.59≤Q3≤5.66), and 4th quartile (Q4>5.66). Multivariate ordinal logistic regression model was used to analyze the relationship between HbA 1c/HDL-C and UACR. Receiver operating characteristic (ROC) analysis was used to explore the predictive value of HbA 1c/HDL-C to UACR. Results:The 43 820 subjects included 13 452 (30.70%) male and 30 378 (69.30%) female patients, with an average age of (58.00±0.05) years. According to results of one-way analysis of variance analysis, the HbA 1c/HDL-C ratio was significantly associated with the risk of increased UACR ( F=495.73, P<0.001). After adjusting for clinically relevant confounding variables in logistic regression model, compared with participants with the lowest HbA 1c/HDL-C ratio (Q1), women with the highest HbA 1c/HDL-C ratio (Q4) had a 1.483-fold (95% CI 1.376-1.598, P<0.001) and men had a 1.161-fold (95% CI 1.019-1.323, P<0.001) increased risk of UACR. The ROC curve analysis showed that the area under the curve of HbA 1c/HDL-C for predicting increased UACR was 0.623 (95% CI 0.597-0.606), with a sensitivity of 60.18% and a specificity of 54.91%. The HbA 1c/HDL-C ratio showed the highest predictive value of all glycemic and lipidemic parameters. In individuals with well-controlled blood glucose (HbA 1c<6.5%) or lipid levels (HDL-C≥1.0 mmol/L), the HbA 1c/HDL-C ratio was still independently associated with the risk of increased UACR after adjusting for confounding variables [ OR(95% CI) of quartile 4: 1.563 (1.210-2.019, P=0.001) in participants with HbA 1c<6.5% and 1.822 (1.687-1.968, P<0.001) in participants with HDL-C≥1.0 mmol/L]. Conclusion:As a novel compound indicator for evaluating glucose homeostasis and dyslipidemia, the HbA 1c/HDL-C ratio was independently associated with increased UACR in the general population aged>40 years in China, which was superior to both glycemic and lipid parameters alone.

Skeletal muscle is one of the most important organs in animal, and the regulatory mechanism of skeletal muscle development is of great importance for the diagnosis of muscle-related diseases and the improvement of meat quality of livestock. The regulation of skeletal muscle development is a complex process, which is regulated by a large number of muscle secretory factors and signaling pathways. In addition, in order to maintain steady-state and maximum use of energy metabolism in the body, the body coordinates multiple tissues and organs to form the complex and sophisticated metabolic regulation network, which plays an important role for the regulation of skeletal muscle development. With the development of omics technologies, the underlying mechanism of tissue and organ communication has been deeply studied. This paper reviews the effects of crosstalk among adipose tissue, nerve tissue and intestinal tissue on skeletal muscle development, with the aim to provide a theoretical basis for targeted regulation of skeletal muscle development.
Animals ; Muscle, Skeletal/metabolism* ; Adipose Tissue/metabolism* ; Signal Transduction

In the process of animal fat deposition, the proliferation and differentiation of pre-adipocytes and the change of lipid droplet content in adipocytes are regulated by a series of transcription factors and signal pathways. Although researchers have conducted in-depth studies on the transcriptional regulation mechanisms of adipogenesis, there are relatively few reports on post-transcriptional modification on mRNA levels. The modification of mRNA m⁶A regulated by methyltransferase, demethylase and methylation reading protein is a dynamic and reversible process, which is closely related to fat deposition in animals. Fat mass and obesity associated proteins (FTO) act as RNA demethylases that affect the expression of modified genes and play a key role in fat deposition. This article summarized the mechanism of FTO-mediated demethylation of mRNA m⁶A in the process of animal fat deposition, suggesting that FTO may become a target for effective treatment of obesity. Moreover, this review summarized the development of FTO inhibitors in recent years.
Adipocytes ; Adipogenesis/genetics* ; Alpha-Ketoglutarate-Dependent Dioxygenase FTO/genetics* ; Animals ; Obesity/genetics* ; RNA, Messenger/genetics*

MicroRNA (miRNA) is a type of highly conserved nucleotide sequence composed of 18 to 25 nucleotides, which can specifically bind to the 3'-noncoding regions of mRNA, and then play a negative regulatory role in degrading mRNA or inhibiting translation. Long non-coding RNA (lncRNA) is a type of nucleotide sequence that exceeds 200 nucleotides in length and cannot encode proteins or can only encode protein peptides. It regulates gene expression at the levels of epigenetic, transcriptional and post-transcriptional. As an important energy storage organ, fat plays an important role in regulating the energy balance of animals, and is closely related to meat production traits such as meat production and meat quality. And the disorder of fat function can lead to hyperlipidemia, type 2 diabetes and a series of cardiovascular diseases, so the molecular regulation mechanism of animal fat deposition has attracted more attention. In recent years, more and more studies have found that miRNA and lncRNA play a crucial role in animal fat deposition. We review here the current research progresses in the role of miRNA and lncRNA in animal fat deposition, to provide theoretical guidance and new ideas for further revealing the molecular regulation mechanism of animal fat deposition.

This article reported a case of malignant pheochromocytoma and paraganglioma with cranial metastasis. The patient was a 25-year-old man. At the age of 10, he was diagnosed with retroperitoneal paraganglioma. He received radiotherapy after partial resection of the tumor. At the age of 15, when he consulted for headache and hypertension, a space occupying lesion was found on the right adrenal without further diagnosis and treatment. His headache and hypertension were aggravated at the age of 25. Then he visited our medical center and diagnosed with right adrenal pheochromocytoma. He undertook an operation to remove the right adrenal lesion, and his blood pressured could be controlled in the normal range with oral antihypertensive medication. One year after the surgery, a cranial lesion with positive 131I-metaiodobenzylguanidine imaging was found following the increase of norepinephrine and dopamine in both blood and urine. The diagnosis of malignant pheochromocytoma with cranial metastasis was confirmed. The cranial lesion was treated with cyberknife therapy for 4 times, and the lesion was slightly reduced. Four year after the removal of right adrenal tumor, he developed multiple bone metastasis in the right ribs and left ilium, and then he received 131I-metaiodobenzylguanidine radiotherapy. Additionally, the results of gene test indicated a pathogenic mutation of SDHB. During the follow-up period of one year after the treatment, his blood pressure fluctuated to about 140/90mmHg with 10mg of phenoxybenzamine once a day. The case is a malignant pheochromocytoma with multiple bone metastasis characterized by a long course with an ideal prognosis in a way. Consequently, we suggested the diagnostic pathway with genetic testing based on clinical phenotype to approach more timely diagnosis and reasonable evaluation of the prognosis in pheochromocytoma and paraganglioma. Furthermore, clinicians should pay more attention to the long-term surveillance.

Objective To investigate the correlation between body mass index (BMI) and the occurence of papillary thyroid carcinoma (PTC) among the patients with thyroid nodules. Methods This cross-sectional study collected the data of 4 350 patients with thyroid nodules who underwent thyroidectomy in our hospital from January 1994 to December 2013. The patients were divided into normal weight (BMI 18.50~23.9 kg/m 2), overweight (BMI 24.0~27.9 kg/m 2), and obese (BMI≥28.0 kg/m 2) groups according to BMI, as well as benign nodules and papillary thyroid carcinoma groups based on their pathological finding. The differences of age-sex composition, nodule diameter, TSH level, overweight and obese constituent ratio between two groups were also analyzed. Logistic regression method was used to evaluate the risk factors of PTC. Results (1) Compared with the benign nodule group, there was a higher proportion of patients under the age of 40 years (34.1% vs 19.5%, P<0.01) in PTC group, with smaller tumour diameters [ 1.0 (0.7-2.0) cm vs 3.0 (2.0-4.0) cm, P<0.01]and higher TSH levels [ 1.9 (1.2-3.0) mU/L vs 1.6 (0.9-2.5) mU/L, P<0.01]. (2) The proportion of obese patients was higher in PTC group than that in the benign nodule group (28.7% vs 20.7%, P<0.01) among male patients. While the difference was not found among female patients. (3) Stratification analysis according to gender and age showed that the proportion of overweight (49.4% vs 44.1%, P<0.05) or obese (26.5% vs 15.3%, P<0.01) in PTC group was higher than that of benign nodule group among male patients aged≤40 years and the proportion of obese patients in PTC group was higher than that of benign nodule group (30.8% vs 22.2%, P<0.01) among male patient aged 41 to 65 years. (4) A multivariate analysis indicated that overweight (OR=4.947) and obesity (OR=7.648) were all independent risk factors for PTC (P<0.01) among male patients aged≤40 years. Conclusion Overweight and obesity are associated with higher PTC risk for male patients aged 40 years or less.

Objective To investigate the trends in the clinicopathological characteristics of thyroid cancer patients undergoing surgery from 1994 to 2013. Methods A retrospective analysis was conducted on the clinical data of inpatients with thyroid nodular diasease undergoing thyroidectomy with pathology results from January 1994 to December 2013. The trends in the pathogenic constituent of thyroid nodule and the clinicopathological characteristics of 3 399 patients with thyroid cancer were analyzed. Results (1) Over the past 20 years, the proportion of patients diagnosed as thyroid cancer was gradually increased, especially those with papillary thyroid cancer (PTC). Whereas the proportions of benign nodule and other rare thyroid cancer were gradually decreased(P<0.01). (2) The average age of patients with thyroid cancer was (44.30±11.72) years, with the peak incidence at 30~59 years. The incidence of thyroid cancer was increasing in both males and females, especially more evident in the absolute increase in women(P<0.05). (3) Among 3 399 patients with thyroid cancer, 56.20%(1 910/3 399)underwent subtotal lobectomy. 20.74%(705/3 399)underwent total/near total thyroidectomy, showing an increase trend (P<0.01). Ultrasound-guided aspiration biopsy for thyroid nodule were performed in 48.87% (1 661/3 399)patients before operation. The proportion of aspiration biopsy was gradually increased since 2004. (4) An increase in thyroid cancer of tumor sizes less than 2.0 cm was observed, especially those size≤1.0 cm(P<0.01). 83.96%(2 854/3 399)patients revealed TNM Ⅰ~Ⅱ stage, and the proportion of patients with TNM Ⅲ~Ⅳ stage was gradually decreased since 2006(P<0.01). Conclusion Over the past 20 years, the proportion of thyroid cancer, especially papillary thyroid microcarcinoma reveals an ascending tendency. The percentages of patients undertaking total/near total thyroidectomy and ultrasound-guided aspiration biopsy before operation are on the rising.

Objective To explore the potential influence of gender on screening value of aldosterone-renin ratio (ARR) for primary aldosteronism (PA).Methods The biochemical parameters were collected of 451 PA patients and 300 essential hypertension (EH) patients who were diagnosed in the General Hospital of PLA from 1992 to 2014. Each group was then divided into two groups by gender. The clinical characteristics were compared and then the receiver operating characteristic curve (ROC) was conducted to evaluate the best cut-off value.Results The plasma aldosterone concentration (PAC), serum sodium and ARR were much higher, but the plasma rennin activity (PRA), serum potassium and BMI were much lower in PA patients than in EH patients (P<0.01), and no significant difference existed between the two groups in age, duration of hypertension and blood pressure. The PRA was obviously lower in males than in females either in PA or in EH patients, but no signicantcant difference existed between males and females in PAC (P>0.05). The best cut-off value of ARR in male PA patients was 19.11, the relevant area under the curve (AUC) was 0.968, the sensitivity and specicantcity was 92.44% and 93.08%, and the Youden index (YI) was 0.86. The best cut-off value of ARR in female PA patients was 27.26, with AUC 0.956, sensitivity 92.07%, specicantcity 90.00% and YI 0.82, respectively. If the cut-off value was set at 27.26 in males, the specicantcity would rise a little, but the sensitivity and YI would sharply decrease. Similarly, the sensitivity would increase a little but the specicantcity and YI would fall substantially if the cut-off value in females was set at 19.11. The best cut-off value of ARR in men was smaller than the ocantcial value recommended by guidelines.Conclusion Gender is an important factor should be considered while ARR is used in PA screening, and the cut-off value of ARR in screening female PA patients should be setting higher.

OBJECTIVETo investigate the effects of lead exposure on the copper concentration in the brain and serum and the expression of copper transporters in the choroid plexus among rats.

METHODSSixty specific pathogen-free Sprague-Dawley rats were randomly divided into a control group and three lead-exposed groups, with 8 mice in each group. The lead-exposed groups were orally administrated with 500 (low-dose group)), 1 000 (middle-dose group), and 2 000 mg/L (high-dose group) lead acetate in drinking water for eight weeks. And the rats in control group were given 2 000 mg/L sodium acetate in drinking water. The content of lead and copper in the serum, hippocampus, cortex, choroid plexus, bones, and cerebrospinal fluid (CSF) was determined by inductively coupled plasma-mass spectrometry (ICP-MS). Confocal and real-time PCR methods were applied to measure the expression of copper transporters including copper transporter 1 (Ctr1), antioxidant protein 1 (ATX1), and Cu ATPase (ATP7A).

RESULTSCompared with the control group, the lead-exposed groups showed significantly higher lead concentrations in the serum, cortex, hippocampus, choroid plexus, CSF, and bones (P < 0.05) and significantly higher copper concentrations in the CSF, choroid plexus, serum, and hippocampus (P < 0.05). Confocal images showed that Ctr1 protein was expressed in the cytoplasm and cell membrane of choroid plexus in control group. However, Ctr1 migrated to CSF surface microvilli after lead exposure. Ctr1 fluorescence intensity gradually increased with increasing dose of lead, except that the middle-dose group had a higher Ctr1 fluorescence intensity than the high-dose group. In addition, the middle- and high-dose groups showed a lower ATX1 fluorescence intensity compared with the control group. Real-time PCR data indicated that the three lead-exposed groups showed significantly higher mRNA levels of Ctr1 and ATP7A compared with the control group (P < 0.05).

CONCLUSIONCopper homeostasis in the choroid plexus is affected by lead exposure to induce copper homeostasis disorders in brain tissue, which may be one of the mechanisms of lead neurotoxicity.

Adenosine Triphosphatases ; Animals ; Brain ; Cation Transport Proteins ; drug effects ; Choroid Plexus ; drug effects ; metabolism ; Copper ; metabolism ; Homeostasis ; Organometallic Compounds ; toxicity ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley