This article describes the surgical treatment of fecal incontinence. There are many surgical methods for fecal incontinence, and each treatment has its own advantages and disadvantages and indications. The appropriate surgical procedure should be selected according to the patient's history, anatomical structure and severity of incontinence. Injectable bulking agents is suitable for passive fecal incontinence. Sphincteroplasty is suitable for patients with sphincter injury caused by vaginal delivery or surgical trauma. Sacral nerve stimulation and posterior tibial nerve stimulation are relatively conservative methods. Gracilomyoplasty, artificial anal sphincter or magnetic anal sphincter can be used in the treatment of refractory fecal incontinence, but with many complications. Colostomy is the ideal choice for patients who have failed to respond to conservative treatment and cannot undergo these procedures.

This article describes the surgical treatment of fecal incontinence. There are many surgical methods for fecal incontinence, and each treatment has its own advantages and disadvantages and indications. The appropriate surgical procedure should be selected according to the patient's history, anatomical structure and severity of incontinence. Injectable bulking agents is suitable for passive fecal incontinence. Sphincteroplasty is suitable for patients with sphincter injury caused by vaginal delivery or surgical trauma. Sacral nerve stimulation and posterior tibial nerve stimulation are relatively conservative methods. Gracilomyoplasty, artificial anal sphincter or magnetic anal sphincter can be used in the treatment of refractory fecal incontinence, but with many complications. Colostomy is the ideal choice for patients who have failed to respond to conservative treatment and cannot undergo these procedures.

Human hair, a kind of natural fiber mainly composed of keratin and keratin-associated proteins, is a good biological sample that can be used to characterize the status of the body in a certain period of time. It is of highly importance in the detection of drugs, alcohol and stimulants because of the advantages of low cost, easy collection, easy transportation and storage. Proteomics is an emerging technology widely used in the field of life sciences to study protein expression and regulation at the holistic level. Investigating the composition and dynamic changes of hair proteins in different populations would have great potential in finding disease markers and distinguishing personal traits. In this paper, the structure and composition of hair, the changes of hair composition under psychological stress, and the research progress of hair proteomics were comprehensively reviewed. This will help using hair proteomics to identify body characteristics.
Humans ; Human Characteristics ; Proteomics ; Hair/chemistry* ; Keratins/chemistry* ; Metabolomics

The anterior cruciate ligament (ACL) injury is a common sports injury that has a significant impact on knee function and patients′ mobility. With the popularity of national fitness campaign in China, the incidence of ACL injury is increasing year by year. Currently, there still lacks clinical standards or guidelines on how to choose appropriate treatment methods, surgical plans and rehabilitation protocols for ACL injury. In order to timely reflect the new treatment concept of ACL injury, standardize its diagnosis and treatment and improve the curative effect, the Sports Medicine Society of Chinese Research Hospital Association and the Editorial Board of Chinese Journal of Trauma organized domestic orthopedic and sports medicine experts to formulate the "clinical evidence-based guideline for the diagnosis and treatment of anterior cruciate ligament injury (2022 version)" based on the level of evidence-based medicine and in compliance with the principle of scientificity, practicability and advancement. The present guideline includes 12 recommendations for the diagnosis, treatment and rehabilitation of ACL injury in order to provide guidance and assistance for the clinical diagnosis and treatment of ACL injury in China.

Objective:To evaluate the efficacy and safety of docetaxel plus hormone therapy in metastatic prostate cancer.Methods:From April 2016 to April 2019, 204 cases with bone metastatic prostate cancer in the Second Hospital of Tianjin Medical University were analyzed retrospectively. There were 97 patients responded to hormone therapy including 92 cases with high-burden metastasis (more than 4 bone metastases with one or more beyond the axial skeleton) and 5 cases with low-burden metastasis, with average age of 70 years (range 42-87 years) and median prostate specific antigen (PSA) of 74.1 ng/ml (range 11.0-145.0 ng/ml). Among them, there were 35 patients (36.1%) with a Gleason score of 7 or lower, and 62 patients (63.9%) with a Gleason score of 8 or higher. There were 26 patients suffering from bone pain, with average numerical rating scales(NRS) score of 3.7. In addition, there were 107 patients being resistant to hormone therapy, with average age of 73 years (range 56-83 years), and median PSA of 84.5 ng/ml (range 12.4-490.2 ng/ml), including 32 patients (29.9%) with a Gleason score of 7 or lower, and 75 patients (70.1%) with a Gleason score of 8 or higher. Among them, there were 75 patients suffering from bone pain, with average NRS score of 5.4. All patients received continuous hormone therapy combined with docetaxel (at a dose of 75 mg per square meter of body-surface area every 3w, plus prednisone 5 mg twice a day), and PSA progression-free survival (PSA-PFS), NRS score, pain relief, and adverse events were analyzed. Additional analysis of the correlation between PSA-PFS and subgroups with age, PSA level and Gleason score were performed.Results:For patients with metastatic hormone sensitive prostate cancer (mHSPC), 6 (6.2%) cases only received 1-2 cycles of chemotherapy due to different reasons, and the others received 3-6 cycles(average 4.7)with the median follow-up of 15 months. Of patients who received ≥3 cycles, there were 36 cases presenting PSA progression, with the median PSA-PFS of 22 months, average NRS score decline from 3.9 to 3.0, and pain relief rate of 72.0%(18/25). For patients with metastatic castration-resistant prostate cancer (mCRPC), 9 (8.4%)cases only received 1-2 cycles of chemotherapy, and the others received 3-14 cycles (average 5.6). Of patients who received≥3 cycles, there were 51 cases with PSA progression, with the median PSA-PFS of 11 months, average NRS score decline from 5.6 to 4.4, and pain relief rate of 48.6%(35/72). Subgroup analysis showed a significant correlation between PSA level and PSA-PFS for patients with mCRPC( P=0.026). Age or Gleason score was not significantly correlated to PSA-PFS in mHSPC or mCRPC( P>0.05). For patients with mHSPC, grade 3 or 4 neutropenia occurred in 17 cases(17.5%), nausea and vomiting in 27 cases(27.8%), and fatigue in 25 cases(25.8%). For patients with mCRPC, grade 3 or 4 neutropenia occurred in 24 cases (22.4%), nausea and vomiting in 34 cases(31.8%), and fatigue in 26 cases(24.3%). Allergic reaction and sensory neuropathy toxicity were occasional. Conclusion:Efficacy of docetaxel plus hormone therapy was confirmed in metastatic prostate cancer and adverse events were tolerable.

Objective:To explore the feasibility of radical prostatectomy without biopsy for patients with highly suspected localized prostate cancer diagnosed by multiparametric magnetic resonance imaging (mpMRI) and 68Ga-PSMA PET/CT. Methods:Patients were enrolled in this single-arm prospective study from March 2019 to January 2022 in the Second Hospital of Tianjin Medical University. Eligible patients were aged ≤80 years with an Eastern Cooperative Oncology Group (ECOG) performance-status score of 0 or 1. Based on mpMRI and 68Ga-PSMA PET/CT, patients were diagnosed with highly suspected localized prostate cancer with no evidence of distant lymphatic, bone or visceral metastases. Patients were excluded if they had obvious important organs dysfunction, suspected metastatic lesions or history of other malignant tumor. After fully informed of the surgical risks and possibilities of final pathology, patients received laparoscopic or robot-assisted laparoscopic radical prostatectomy. According to final pathological results, the diagnostic accuracy of mpMRI and 68Ga-PSMA PET/CT was evaluated. Pathological features were compared between low 68Ga-PSMA PET/CT maximum standardized uptake value (SUV max) group (SUV max<10) and high SUV max group (SUV max≥10). Baseline characteristics were compared between clinically significant prostate cancer (CsPCa) and clinically insignificant prostate cancer (cisPCa) + high grade prostatic intraepithelial neoplasia (HGPIN) patients. Additional analysis of the correlation between baseline parameters and different subgroups including pathological stage, ISUP grades and risk groups were performed in CsPCa patients. Results:31 patients were enrolled. Median age was 68 (ranging 48-79)years old. Median BMI was 25.6(ranging 21.9-31.4)kg/m 2. Median prostate specific antigen (PSA) was 23.5 (ranging 5.6-94.7)ng/ml. Median prostate volume was 37.6(ranging 16.2-127.9)ml. Median PSA density (PSAD) was 0.56(ranging 0.11-2.86)ng/ml 2. Fifteen cases were scored prostate imaging reporting and data system (PI-RADS) 4 and 16 cases were scored PI-RADS 5. Median 68Ga-PSMA PET/CT SUV max was 13.3 (ranging 4.6-36.7). All surgeries were successfully accomplished without open conversion. Median postoperative hospitalization time was 5 (ranging 4-7)d. No major complication occurred perioperatively. Recovery of urinary continence was within 6 months in all patients. According to the final pathological results, 1(3.2%) patient was confirmed with HGPIN. 30 (96.8%) patients were confirmed with adenocarcinoma, including 26 (86.7%) patients with CsPCa and 4(13.3%) patients with cisPCa. Among prostate cancer cases, the pathological stage of 11(36.7%) was T 2 and 19(63.3%) was T 3. Four(13.3%) cases were with ISUP grade 1, 7(23.3%) cases were with ISUP grade 2, 7(23.3%) cases were with ISUP grade 3 and 12 (40.0%) cases were with ISUP grade≥4.Two(6.7%) cases were in low risk group, 3(10.0%) cases were in intermediate risk group and 25 (83.3%) cases were in high risk group. Twelve(40.0%) patients had positive surgical margins. Standard pelvic lymph node dissection was carried out in 18 (17 prostate cancer and 1 HGPIN) cases. Sixty-two lymph nodes were dissected and none of them was positive. The diagnostic accuracy of mpMRI and 68Ga-PSMA PET/CT was 96.8%(30/31) in prostate cancer. Compared to low SUV max group, patients in high SUV max group had higher ISUP grade ( P=0.003) but there was no significant difference in positive surgical margin, seminal vesical invasion or pathological stage ( P>0.05). Among CsPCa patients, 10 (38.5%) cases were scored PI-RADS 4 and 16(61.5%) cases were scored PI-RADS 5. Median 68Ga-PSMA PET/CT SUV max was 14.3 (range 6.1-36.7). Compared to cisPCa and HGPIN patients, a smaller median prostate volume (34.3 vs. 73.0 ml, P=0.006), higher median PSAD (0.70 vs. 0.13 ng/ml 2, P=0.001), higher rates of PI-RADS 5 patients (61.5% vs. 0, P=0.018) and higher 68Ga-PSMA PET/CT SUV max (14.3 vs. 6.1, P=0.001) were found in CsPCa patients. Subgroup analysis showed no significant difference between SUV max and pathological stage (25.5 vs. 13.9), ISUP grades (15.4 vs. 14.4 vs. 14.0) and risk groups (9.7 vs. 14.9) in CsPCa patients ( P>0.05). Conclusions:The diagnostic accuracy of mpMRI and 68Ga-PSMA PET/CT is high in prostate cancer. With efficient communication, radical prostatectomy without biopsy for patients with highly suspected localized prostate cancer diagnosed by mpMRI and 68Ga-PSMA PET/CT is safe.

Objective:To investigate the correlation of preoperative peripheral lymphocyte-to-monocyte ratio(LMR)with the biochemical relapse and prognosis in prostate cancer(PCa)patients treated with endocrine therapy after radical prostatectomy(RP).Methods:Clinical data of 306 prostate cancer patients treated with endocrine therapy after radical prostatectomy were retrospectively analyzed in our hospital from June 2008 to June 2019.The end point of observation was biochemical relapse-free survival(RFS)in all patients receiving RP.The best cutoff value of preoperative LMR was calculated by receiver operating characteristic(ROC)curve.All patients were divided into the high LMR group(LMR≥2.8, n=93, 30.4%)and the low LMR group(LMR<2.8, n=213, 69.6%). The differences in clinical indicators of PCa were compared between high and low LMR groups.CoX regression model on the risk ratio of single and multiple factors were used to analyze the survival effect of preoperative LMR on the prognosis of PCa patients undergoing endocrine therapy after operation.Results:The median follow-up time was ranged from 4 to 132 months.The area under the ROC curve of LMR was 0.582(95% CI: 0.511-0.652, P<0.05), and the cutoff value of the preoperative LMR was 2.8, which was significantly associated with clinical T stage( P=0.023)and lymphatic metastasis( P=0.031). Kaplan-Meier analysis demonstrated that the low LMR group had a short RFS and a poor prognosis(31.0 months vs.38.5 months)than those in the high LMR group( P<0.05). Lymphatic metastasis and preoperative LMR were independent predictors for RFS in PCa patients treated with endocrine therapy after radical prostatectomy. Conclusions:Preoperative peripheral LMR can be used as an auxiliary indicator of the prognosis in PCa patients treated with endocrine therapy after radical prostatectomy.

With high accuracy and precision,next generation sequencing (NGS) has provided a powerful tool for clinical testing of genetic diseases.To follow a standardized experimental procedure is the prerequisite to obtain stable,reliable,and effective NGS data for the assistance of diagnosis and/or screening of genetic diseases.At a conference of genetic testing industry held in Shanghai,May 2019,physicians engaged in the diagnosis and treatment of genetic diseases,experts engaged in clinical laboratory testing of genetic diseases and experts from third-party genetic testing companies have fully discussed the standardization of NGS procedures for the testing of genetic diseases.Experts from different backgrounds have provided opinions for the operation and implementation of NGS testing procedures including sample collection,reception,preservation,library construction,sequencing and data quality control.Based on the discussion,a consensus on the standardization of the testing procedures in NGS laboratories is developed with the aim to standardize NGS testing and accelerate implementation of NGS in clinical settings across China.

Objective To study the effect of fufangxuanju capsule combined with tamoxifen citrate tablet on seminal plasma biochemistry in patients with asthenospermia.Methods One hundred and fifty patients with asthenospermia were divided into group A(treated with tamoxifen citrate tablet,45 cases),group B(treated with fufangxuanju capsule,45 cases)and group C(treated with tamoxifen citrate tablet and fufangxuanju capsule, 60 cases) according to random digits table method.All patients were treated for 2 months.The semen parameters and semen biochemical parameters were detected, and the pregnancy rate was followed up for 6 months.Results The semen volume,sperm density,sperm survival rate, grade a sperm percentage and grade a+b sperm percentage after treatment in group C were significantly higher than those in group A and group B: (4.41 ± 1.21) ml vs.(4.01 ± 0.87) and(3.97 ± 1.10)ml,(24.63 ± 4.44)×109/L vs.(20.45 ± 4.69)and(18.04 ± 3.05)×109/L,(64.05 ± 7.98)% vs.(45.15 ± 8.87)% and(51.47 ± 10.01)%,(26.05 ± 5.62)% vs.(15.01 ± 3.67)% and(18.31 ± 2.21)%, (55.30 ± 9.65)% vs.(38.07 ± 8.26)% and (44.35 ± 9.03)%, and there were statistical differences (P<0.05).There were no statistical differences between group A and group B (P>0.05).The fructose, a-glucosidase and acid phosphatase levels after treatment in group C were significantly higher than those in group A and group B:(30.36 ± 5.30)mmol/L vs.(24.01 ± 6.32)and(26.03 ± 5.53)mmol/L,(60.61 ± 8.86) U/L vs.(45.46 ± 8.87)and(50.56 ± 5.56)U/L,(140.12 ± 10.25)U/L vs.(98.36 ± 8.36)and(100.36 ± 8.36) U/L,and there were statistical differences(P<0.05);there were no statistical differences between group A and group B(P>0.05).The zinc after treatment in group C was significantly higher than that in group A and group B:(2 406.96 ± 187.60)μmol/L vs.(1 508.30 ± 135.87)and(2 001.30 ± 130.26)μmol/L,the zinc after treatment in group B was significantly higher than that in group A, and there were statistical differences(P<0.05).The pregnancy rate within 6 months in group C was significantly higher than that in group A and group B: 51.6% (31/60) vs.37.8% (17/45) and 33.3% (15/45), and there was statistical difference (P<0.05).There was no statistical difference between group A and group B (P>0.05).Conclusions Fufangxuanju capsule combined with tamoxifen citrate tablet can increase the concentration of fructose, a-glycosidase, zinc and acid phosphatase in seminal plasma, and improve the semen quality of patients with asthenospermia so as to increase the woman pregnancy rate.

Objective To investigate whether ROS/JNK/Egr-1 signaling pathway was activated in cardiomyocytes after hypoxia/reoxygenation ( H/R).Methods H9c2 cardiomyocytes were grouped randomly as follows: control group, H/R group, control +the ROS donor xanthine oxidase /hypoxanthine (XO/HX) group, H/R +the ROS scavenger edaravones (EDA) group, H/R +the ROS scavenger N-acetyl-L-cysteine (NAC) group, H/R +JNK inhibitor SP60012 group.To establish H9c2 H/R models and the myocardial cells were treated with different concentrations of EDA (2 × 10 -6,2 ×10 -5,2 ×10 -4 M), NAC (5 ×10 -4,2 ×10 -3,8 ×10 -3 M), XO/HX (1mU/mL/1.2 ×10 -4 M , 3mU/mL/3.6 ×10 -4 M, 5mU/mL/6.0 × 10 -4 M) and SP600125 (2 ×10 -5 M).ROS level was measured by flow cytometry, and Egr-1, p-JNK and total JNK protein levels were detected by Western blot.ResuIts ROS levels and Egr-1 protein levels in H/R group were significantly higher than control group (P<0.05).The moderate and high concentrations EDA and NAC of ROS scavenger significantly decreased the high levels of ROS and Egr-1 protein ( P<0.05 ) , but there were no significant differences of low concentration.There was a significant positive correlation between ROS levels and Egr-1 protein (r=0.91,P<0.01).JNK activation levels in each concentrations of XO/HX were significantly higher than control group, and JNK activation increased with the increasing of XO/HX concentrations (P<0.05).JNK activation level in H/R group was higher than control group, after treated by EDA and NAC of ROS scavenger and JNK inhibitor, JNA activation reduced (P<0.05).Egr-1 protein levels in H/R group was higher than that in control group, and JNK inhibitor reduced the expression of Egr-1 protein induced by H/R.ConcIusion H/R activates ROS/Egr-1 signaling pathway in H9c2 cardiomyocytes, and JNK activation plays an important role in this pathway.