1.Factors influencing recurrence within two years after the first TURBT and risk prediction model for NMIBC
Yunze WANG ; Rong FAN ; Shiming CHEN ; Jianwei SUN ; Aliyar AIXANJIANG ; Guofan DONG ; Kulaisi ENEVAR ; Wenguang WANG
Journal of Modern Urology 2025;30(4):322-326
Objective: To analyze the risk factors of recurrence after transurethral resection of bladder tumor (TURBT) in patients with non-muscle-invasive bladder cancer (NMIBC),and establish a risk prediction model,so as to optimize the clinical detection and management of NMIBC. Methods: A total of 174 patients with initial diagnosis of NMIBC who underwent TURBT in the First Affiliated Hospital of Xinjiang Medical University during Jan.2020 and Oct.2022 were followed up for 24 months,and were then divided into the recurrence group (n=74) and non-recurrence group (n=100).After univariate analysis and multivariate logistic regression,risk factors of recurrence were identified,a nomogram was established,and the calibration curve was plotted,which was verified with receiver operator characteristic (ROC) curve. Results: The 2-year recurrence rate was 42.53%.Logistic regression showed high body mass index (BMI),poor differentiation,multiple tumors,and tumor diameter greater than 3 cm were risk factors of recurrence (P<0.05,OR≥1),while immediate postoperative intravesical instillation was a protective factor (P<0.05).The C-index of the nomogram was 0.893 (95%CI:0.851-0.938),the area of ROC curve (AUC) was 0.894 (95%CI:0.847-0.941),the sensitivity was 82.4%,and the specificity was 83.0%. Conclusion: The prediction model based on BMI,tumor stage,grade,number,diameter,and immediate postoperative intravesical instillation fits well and can provide reference for predicting the risk of tumor recurrence.
2.Research progress on the role of lipoprotein-associated phospholipase A2 in acute coronary syndrome
Jianhong GUO ; Yaling WANG ; Wenguang CUI
Basic & Clinical Medicine 2024;44(1):103-107
Lipoprotein-associated phospholipase A2(Lp-PLA2)is a protein composed of 441 amino acids,which can promote the aggregation of inflammatory cells to the inflammatory response site and the release of inflammatory factors.It can promote the synthesis of matrix metalloproteinases,increase the number of foam cells and extra cel-lular matrix in atherosclerotic plaque,attenuate plaque fiber cap and prone to rupture,thus promote the onset of acute coronary syndrome(ACS).Therefore,the determination and regulation of Lp-PLA2 levels in patients with ACS are clinically significant.
3.Mevalonic acid reverses the antitumor effects of fluvastatin sodium on tongue squamous cell carcinoma cells
Yemei QIAN ; Weihong WANG ; Lin ZENG ; Jingyi LI ; Wenguang TANG ; Zhe ZHANG
Journal of Practical Stomatology 2024;40(2):227-232
Objective:To investigate mevalonic acid(MEV)on reversing the antitumor effects of fluvastatin sodium(FS)on tongue squamous cell carcinoma(TSCC)cells.Methods:TSCC HSC-4 cells were treated with different concentrations of FS and MEV re-spectively or in combination.Cell counting kit-8,flow cytometry,wound healing,immunofluorescence and western blotting assays were conducted to examine cell proliferation,apoptosis and migration capacities,as well as the expression levels of Ras homolog family member A(RHOA),tissue factor(TF)and B-cell lymphoma-2-associated X(BAX)proteins,respectively.Results:FS inhibited HSC-4 cell proliferation and migration,decreased the expression of RHOA and TF,and increased BAX expression.MEV reversed the above antitumor effects of FS and promoted intracellular RHOA and TF expression.Conclusion:MEV reverses the antitumor effects of FS on HSC-4 cells in vitro.
4.Clinical significance of HOXB4 gene expression levels in myelodysplastic syndromes
Yichen WANG ; Yanwen YAN ; Meihui SONG ; Xiangjun XUE ; Wenguang ZHOU ; Yuquan LI ; Ling QI ; Guanghua LI ; Xiangzong ZENG
The Journal of Practical Medicine 2024;40(3):321-325
Objective To investigate the expression of HOXB4 gene in patients with myelodysplastic syn-dromes(MDS)and its clinical significance in disease progression.Methods mRNA expression of HOXB4 gene in bone marrow mononuclear cells was detected by real-time fluorescence quantitative PCR(RT-qPCR),and the difference in HOXB4 expression was compared between 49 patients with MDS(MDS group)and 35 patients without MDS(group C).The relationship of mRNA expression of HOXB4 with disease characteristics and clinical prognosis was explored in MDS patients.Results mRNA expression level of HOXB4 gene was higher in MDS group than that in group C(P<0.05).The patients were divided into a high-and a low-expression group according to the median expression level of HOXB4.Leukocyte count was lower in the high-expression group in the low-expression group at the time of initial diagnosis.The proportion of patients with subtypes of primitive cellular hyperplasia,poor prognostic staging and leukemic transformation was higher in the high-expression group than in the low-expression group.Conclusions mRNA expression level of HOXB4 gene has certain relation with AML transformation in MDS patients.
5.Incidence of venous thromboembolism in esophageal cancer: a real-world study of 8 458 cases
Kunyi DU ; Xin NIE ; Kexun LI ; Changding LI ; Kun LIU ; Zhiyu LI ; Kunzhi LI ; Simiao LU ; Kunhan NI ; Wenwu HE ; Chenghao WANG ; Jialong LI ; Haojun LI ; Qiang ZHOU ; Kangning WANG ; Guangyuan LIU ; Wenguang XIAO ; Qiang FANG ; Qiuling SHI ; Yongtao HAN ; Lin PENG ; Xuefeng LENG
Chinese Journal of Digestive Surgery 2024;23(1):109-113
Objective:To investigate the incidence of venous thromboembolism (VTE) in patients with esophageal cancer (EC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 8 458 EC patients who were admitted to Sichuan Cancer Hospital from January 2017 to December 2021 were collected. There were 6 923 males and 1 535 females, aged (64±9)years. There were 3 187 patients undergoing surgical treatment, and 5 271 cases undergoing non-surgical treatment. Observation indicators: (1) incidence of VTE in EC patients; (2) treatment and outcomes of patients with VTE. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the nonparameter rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the nonparameter rank sum test. Results:(1) Incidence of VTE in EC patients. Of 8 458 EC patients, 175 cases developed VTE, with an incidence rate of 2.069%(175/8 458). Among 175 VTE patients, there were 164 cases of deep venous thrombosis (DVT), 4 cases of pulmonary embolism (PE), 7 cases of DVT and PE. There were 59 surgical patients and 116 non-surgical patients. There was no significant difference in thrombus type between surgical and non-surgical EC patients with VTE ( χ2=1.95, P>0.05). Of 3 187 surgical patients, the incidence of VTE was 1.851%(59/3 187), including an incidence of 0.157%(5/3 187) of PE. PE accounted for 8.475%(5/59) of surgical patients with VTE. Of 5 271 non-surgical patients, the incidence of VTE was 2.201%(116/5 271), including an incidence of 0.114%(6/5 271) of PE. PE accounted for 5.172%(6/116) of non-surgical patients with VTE. There was no significant difference in the incidence of VTE or PE between surgical patients and non-surgical patients ( χ2=1.20, 0.05, P>0.05). (2) Treatment and outcomes of patients with VTE. Among 175 EC patients with VTE, 163 cases underwent drug treatment, and 12 cases did not receive treatment. Among 163 cases with drug therapy, 158 cases underwent anticoagulant therapy, 5 cases were treated with thrombolysis. All the 163 patients were improved and discharged from hospital. Conclusions:The incidence of VTE in patients with EC is relatively low, as 2.069%. There is no significant difference in the incidence of VTE or thrombus type between surgical EC patients and non-surgical EC patients.
6.Efficacy and safety of branched stent and fenestrated stent for thoracic aortic diseases in short landing zone
Pengli ZHOU ; Yang WANG ; Qinghui ZHANG ; Ling WANG ; Zhengyang WU ; Wenguang ZHANG ; Xinwei HAN
Chinese Journal of Radiology 2024;58(4):422-429
Objective:To compare the efficacy and safety of Castor single-branch stent and in vitro fenestration stent in treating thoracic aortic diseases with insufficient landing zone.Methods:The clinical data of patients with thoracic aortic diseases treated with Castor single-branch stent or in vitro fenestrated stent between December 2017 and June 2021 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. A total of 184 patients were included, 99 patients were treated with Castor branch stent, and 85 patients with in vitro fenestration stent. All patients′ general clinical data, surgical data, perioperative and follow-up clinical and imaging data, and postoperative complications were collected. The χ2 test was used to compare the incidence of complications between the two groups, and the Kaplan-Meier method was used to plot the survival rate without adverse events between the two groups. Results:Stent placement was successful in all patients, and the success rate of the technique was 100%. Other branches were reconstructed in 2 patients in the Castor group and double fenestrated stent were reconstructed in 12 patients in the fenestrated group. The mean operation time of the Castor group was significantly shorter than that of the fenestrated group, the number of patients who received local anesthesia was significantly lower than that of the fenestrated group, and the endoleak rate during follow-up was significantly lower than that of the fenestrated group ( P<0.05). There was no significant difference in the postoperative hospital stay, the incidence rate of perioperative complications, mortality, the incidence rate of neurological complications, new dissection or aneurysm rate, branch stent stenosis rate, second surgical intervention rate, and false lumen thrombosis between the two groups ( P>0.05). The adverse event-free survival rate of the Castor group was slightly higher than that of the fenestrated group, but its difference was not statistically significant ( P>0.05). Conclusion:Castor branch stent and in vitro fenestration stent have good short-term and mid-term efficacy in the treatment of aortic diseases with insufficient landing zone, which are safe and effective options for reconstruction of LSA and other branch arteries.
7.Progress of Multi-Parameter Magnetic Resonance Imaging in Evaluating the Efficacy of Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer
Xiao WANG ; Wenguang LIU ; Yigang PEI ; Wenzheng LI
Chinese Journal of Medical Imaging 2024;32(3):299-304
Neoadjuvant chemoradiotherapy is a part of the current standard treatment mode for locally advanced rectal cancer,which enables a certain proportion of patients to achieve complete tumor response,improving the surgical resection rate and anal retention rate,and then prolonging the disease-free survival period of patients.MRI is the preferred imaging examination to evaluate the efficacy of neoadjuvant therapy.With the development of functional MRI,quantitative parameters derived from different imaging principles can provide more biological information about tumors,improving the clinical application value of MRI.Multi-parameter MRI combining conventional MRI sequences and functional sequences can more comprehensively evaluate the efficacy of neoadjuvant therapy,which is conducive to developing individualized treatment plans for patients in clinical practice and realize precision medicine.
8.A nomogram model for predicting spontaneous rupture and bleeding of renal angiomyolipoma
Yakun HOU ; Xingyu ZHOU ; Yu GAO ; Hongwen SONG ; Qiang LIU ; Yujie WANG ; Wenguang WANG
Journal of Modern Urology 2024;29(1):51-55
【Objective】 To establish a risk model for predicting spontaneous rupture bleeding of renal angiomyolipoma (RAML) in order to better assess and deal with the risk. 【Methods】 The information of 436 RAML patients diagnosed during Jan.2018 and Dec.2022 was retrospectively analyzed.According to the inclusion and exclusion criteria, 216 patients were included and divided into the rupture bleeding group (n=35) and non-rupture bleeding group (n=181).The factors influencing spontaneous rupture bleeding were identified using univariate and multivariate analysis, and a nomogram was constructed accordingly with R language.The nomogram was evaluated using Calibration curve and area under the receiver operator characteristic curve (AUC). 【Results】 It was found that clinical manifestations, tumor diameter, tumor convexity, tumor blood supply, and tuberous sclerosis complex (TSC) were significantly correlated with rupture bleeding.The Calibration curve fitted well with the nomogram.The AUC was 0.956 (95%CI: 0.856-0.943), indicating that the nomogram had good statistical performance. 【Conclusion】 The model can effectively predict the risk of spontaneous rupture bleeding of renal angiomyolipoma.
9.Prognosis of 233 advanced renal cell carcinoma patients in Urumqi: a two-center study
Dilixiati DILIYAER ; Shuai YUAN ; Jiande LU ; Bingzhang QIAO ; Wenguang WANG ; Peng CHEN ; Rexiati MULATI ; Azhati BAIHETIYA
Journal of Modern Urology 2024;29(4):306-311
【Objective】 To investigate the clinical features, treatment methods and prognosis of advanced renal cell carcinoma (RCC) patients in Xinjiang, especially the Han population. 【Methods】 Clinical data of 233 patients with advanced RCC treated in The First Affiliated Hospital and The Affiliated Cancer Hospital of Xinjiang Medical University were retrospectively analyzed, including 133 Han patients.The median age of patients was 52 years (range: 23 to 87), and the maximum tumor diameter was (7.73±4.04) cm.Survival curves were plotted using the Kaplan-Meier method.Multivariate and univariate Cox regression analysis were conducted for all patients, and further analysis was performed for the Han patients. 【Results】 Among the 233 patients, 131 died during the average follow-up of 27.6 months (range: 1 to 120), and the median survival time was 12 months.In this cohort, 110 patients had lymph node metastasis, and 200 had distant metastasis, among them, 21 (10.5%) patients had brain metastasis and 45 (22.5%) patients had adrenal metastasis.The 1-, 3-, and 5-year survival rate were 48.9%, 18.3% and 6.1%, respectively.Univariate analysis revealed that International mRCC Database Consortium (IMDC) score, pathological type, lymph node metastasis, distant metastasis, number of metastatic foci and treatment methods impacted the prognosis in Xinjian (P<0.05).Multivariate analysis indicated that IMDC score, pathological type and distant metastasis were significant factors influencing the prognosis, which were also the prognostic factors of the Han patients (P<0.05). 【Conclusion】 In Xinjiang, patients with advanced renal cell carcinoma have a 6.1% 5-year survival rate and a median survival time of 12 months.Brain and adrenal metastases are common.Prognostic factors include IMDC score, pathological type, and distant metastasis for all patients, including the Han patients.
10.Electroacupuncture alleviates hyperalgesia in spared nerve injury mice by regulating sympathetic-sensory coupling
Shiwei WU ; Fei WANG ; Zhicheng TIAN ; Wenguang CHU ; Ceng LUO
Chinese Journal of Neuroanatomy 2024;40(2):203-210
Objective:To observe the effects of electroacupuncture(EA)intervention on norepinephrine(NE)andα2A adrenergic receptors(α2A-R)in the dorsal root ganglion(DRG)of mice with spared nerve injury(SNI).Methods:Male C57BL/6 mice were randomly divided into sham surgery group(Sham),model group(SNI),negative control EA group(SNI+NC-EA),and EA group(SNI+EA).Mechanical and thermal stimuli were used to measure the paw withdrawal mechanical threshold(PWMT)and paw withdrawal thermal latency(PWTL).Immunofluorescence staining was used to detect the sprouting of sympathetic nerve fibers and the co-localization of α2A-R with large-diameter sensory neurons in mouse DRG.Enzyme-linked immunosorbent assay(ELISA)kits were used to measure NE levels in mouse serum and DRG,and Western Blot was used to detect tyrosine hydroxylase(TH)and α2A-R expression levels in DRG.Results:After SNI,the PWMT and PWTL were significantly decreased,and after electroacupuncture treatment,PWMT and PWTL were reversed and increased.Immune fluorescence staining showed that sympathetic ganglion sprouting increased in DRG after SNI,and significantly decreased after electroacupuncture;After SNI,NE,α2A-R,and TH in DRG all significantly increased,and their expression decreased after electroacupuncture intervention,but NE in the serum did not change significantly.Conclusion:In the SNI model,electroacupuncture may regulate the sympathetic-sensory coupling by inhibiting the release of NE and the expression of α2A-R in DRG,thereby producing analgesic effects.

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