目的基于美国癌症肿瘤基因图谱(the cancer genome atlas,TCGA)数据库分析铜调节的细胞死亡相关基因与前列腺癌患者预后和免疫细胞浸润的关系。方法从TCGA数据库下载所有前列腺癌患者的基因数据,其中包括前列腺癌组织501例,正常组织52...目的基于美国癌症肿瘤基因图谱(the cancer genome atlas,TCGA)数据库分析铜调节的细胞死亡相关基因与前列腺癌患者预后和免疫细胞浸润的关系。方法从TCGA数据库下载所有前列腺癌患者的基因数据,其中包括前列腺癌组织501例,正常组织52例。运用R软件提取前列腺癌患者中铜调节的细胞死亡相关基因表达矩阵,进行差异分析、多因素回归分析筛选出预后基因,对预后基因进行生存分析,同时探讨预后相关基因与免疫细胞之间的相关性。结果甘氨酸裂解系统蛋白H(GCSH)与前列腺癌患者的预后显著相关,同时发现其与前列腺癌患者中的树突细胞、CD8^(+)T细胞、浆细胞也显著相关(P<0.05)。结论GCSH基因在前列腺癌的发生、发展中起重要作用,有望成为前列腺癌预后的标志物。展开更多
Objective:To evaluate the perioperative as well as early oncological outcomes of patients undergoing robotic retroperitoneal lymph node dissection for treatment of testicular cancer.Methods:We conducted a prospective ...Objective:To evaluate the perioperative as well as early oncological outcomes of patients undergoing robotic retroperitoneal lymph node dissection for treatment of testicular cancer.Methods:We conducted a prospective consecutive case series of patients undergoing robotic assisted retroperitoneal lymph node dissection for metastatic testicular cancer between May 2018 and July 2021 at our institution.Data were collected on patient and tumour characteristics,intraoperative and postoperative parameters,and functional and oncological outcomes.Descriptive statistics are presented.Results:Nineteen patients were identified;18(94.7%)completed the procedure robotically and one was converted to open surgery;78.9%of patients had stage≥IIB and 12(63.2%)patients had undergone prior chemotherapy.The median operative time was 300(interquartile range[IQR]240-315)min.Median blood loss was 100(IQR 50-175)mL.Median length of stay was 2(range 1-11)days.All robotically completed patients commenced diet and passed flatus on Day 1 and were discharged by Day 3.The median lymph node yield was 40.5(IQR 38-51)nodes.All patients undergoing nerve-sparing procedures recovered antegrade ejaculatory function.One patient had a Clavien-Dindo III complication(chylous ascites requiring drainage).At a median follow-up of 22.3(IQR 16.3-24.9)months,one patient developed retroperitoneal recurrence,which was successfully treated with second-line chemotherapy;no other patients have had recurrences.Conclusion:Robotic retroperitoneal lymph node dissection is a safe and feasible alternative to open surgery in appropriately selected patients,offering low morbidity.Early oncological outcomes are promising.Larger cohorts and longer follow-ups are required to validate our institution's findings.展开更多
恶性间皮瘤主要起源于间皮细胞,好发于胸、腹膜等部位,极少发生于睾丸鞘膜。据统计,睾丸鞘膜恶性间皮瘤(malignant mesothelioma of the tunica vaginalis testis,MMTVT)的发病率占比不到间皮瘤总发病率的1%[1]。该病罕见,缺乏特异性临...恶性间皮瘤主要起源于间皮细胞,好发于胸、腹膜等部位,极少发生于睾丸鞘膜。据统计,睾丸鞘膜恶性间皮瘤(malignant mesothelioma of the tunica vaginalis testis,MMTVT)的发病率占比不到间皮瘤总发病率的1%[1]。该病罕见,缺乏特异性临床表现及影像学特征,术前易误诊,故临床医生应对该病保持关注。近期遵义医科大学附属医院收治1例睾丸鞘膜恶性间皮瘤,现将其诊治过程报道如下。展开更多
Objective:To evaluate the impact of a standardized antibiotic stewardship protocol on three subsequent endpoints in patients undergoing urethroplasty.Methods:Men undergoing bulbar substitution urethroplasty between Ja...Objective:To evaluate the impact of a standardized antibiotic stewardship protocol on three subsequent endpoints in patients undergoing urethroplasty.Methods:Men undergoing bulbar substitution urethroplasty between January 2009 and December 2016 were stratified by urine culture (UCx) at the time of surgery (sterile vs. non-sterile) and were subjected to a standardized algorithm for urinalysis and antimicrobial therapy. We performed quantitative and qualitative exploration of UCx results and the microbial spectrum. The ability of the algorithm to improve antibiotic stewardship was tested by three endpoints: (a) immediate (UCx 2 days postoperatively), (b) short-term (21-day infectious complications), and (c) long-term (retreatment-free survival [RFS]). Statistical analyses included bivariate comparisons. The Kaplan–Meier estimators were used to compare RFS between the groups. The multivariable Cox regression was used to evaluate the independent effect of UCx status at the time of surgery on RFS.Results:Of 374 men, 235 (63%) had a sterile and 139 (37%) a non-sterile culture at the time of surgery. The proportion of sterile cultures at the time of surgery (63%) was significantly improved to 82% 2 days postoperatively (p<0.001). There were 16 (4.3%) patients with infectious complications with no difference between patients with sterile versus non-sterile culture (p=0.6). At median follow-up of 29 months, there was no difference in RFS (84%) between patients with sterile versus non-sterile culture (p=0.3). Positive UCx was not a predictor of recurrence after multivariable adjustment (p=0.5).Conclusion:A standardized protocol such as the one introduced improves antibiotic stewardship through frequent testing and culture-specific treatment. This is crucial in avoiding unnecessary antimicrobial treatment, and reducing infectious events and adverse effects of a positive UCx on long-term stricture recurrence.展开更多
Dear Editor,Prostatic small cell carcinoma(SCC)is a rare,deadly tumor with an overall median survival of fewer than 12 months[1-5].Here we describe a unique case of a patient with prostatic SCC who developed a concurr...Dear Editor,Prostatic small cell carcinoma(SCC)is a rare,deadly tumor with an overall median survival of fewer than 12 months[1-5].Here we describe a unique case of a patient with prostatic SCC who developed a concurrent tumor thrombus in the right iliac vein.展开更多
文摘目的基于美国癌症肿瘤基因图谱(the cancer genome atlas,TCGA)数据库分析铜调节的细胞死亡相关基因与前列腺癌患者预后和免疫细胞浸润的关系。方法从TCGA数据库下载所有前列腺癌患者的基因数据,其中包括前列腺癌组织501例,正常组织52例。运用R软件提取前列腺癌患者中铜调节的细胞死亡相关基因表达矩阵,进行差异分析、多因素回归分析筛选出预后基因,对预后基因进行生存分析,同时探讨预后相关基因与免疫细胞之间的相关性。结果甘氨酸裂解系统蛋白H(GCSH)与前列腺癌患者的预后显著相关,同时发现其与前列腺癌患者中的树突细胞、CD8^(+)T细胞、浆细胞也显著相关(P<0.05)。结论GCSH基因在前列腺癌的发生、发展中起重要作用,有望成为前列腺癌预后的标志物。
文摘Objective:To evaluate the perioperative as well as early oncological outcomes of patients undergoing robotic retroperitoneal lymph node dissection for treatment of testicular cancer.Methods:We conducted a prospective consecutive case series of patients undergoing robotic assisted retroperitoneal lymph node dissection for metastatic testicular cancer between May 2018 and July 2021 at our institution.Data were collected on patient and tumour characteristics,intraoperative and postoperative parameters,and functional and oncological outcomes.Descriptive statistics are presented.Results:Nineteen patients were identified;18(94.7%)completed the procedure robotically and one was converted to open surgery;78.9%of patients had stage≥IIB and 12(63.2%)patients had undergone prior chemotherapy.The median operative time was 300(interquartile range[IQR]240-315)min.Median blood loss was 100(IQR 50-175)mL.Median length of stay was 2(range 1-11)days.All robotically completed patients commenced diet and passed flatus on Day 1 and were discharged by Day 3.The median lymph node yield was 40.5(IQR 38-51)nodes.All patients undergoing nerve-sparing procedures recovered antegrade ejaculatory function.One patient had a Clavien-Dindo III complication(chylous ascites requiring drainage).At a median follow-up of 22.3(IQR 16.3-24.9)months,one patient developed retroperitoneal recurrence,which was successfully treated with second-line chemotherapy;no other patients have had recurrences.Conclusion:Robotic retroperitoneal lymph node dissection is a safe and feasible alternative to open surgery in appropriately selected patients,offering low morbidity.Early oncological outcomes are promising.Larger cohorts and longer follow-ups are required to validate our institution's findings.
文摘恶性间皮瘤主要起源于间皮细胞,好发于胸、腹膜等部位,极少发生于睾丸鞘膜。据统计,睾丸鞘膜恶性间皮瘤(malignant mesothelioma of the tunica vaginalis testis,MMTVT)的发病率占比不到间皮瘤总发病率的1%[1]。该病罕见,缺乏特异性临床表现及影像学特征,术前易误诊,故临床医生应对该病保持关注。近期遵义医科大学附属医院收治1例睾丸鞘膜恶性间皮瘤,现将其诊治过程报道如下。
文摘Objective:To evaluate the impact of a standardized antibiotic stewardship protocol on three subsequent endpoints in patients undergoing urethroplasty.Methods:Men undergoing bulbar substitution urethroplasty between January 2009 and December 2016 were stratified by urine culture (UCx) at the time of surgery (sterile vs. non-sterile) and were subjected to a standardized algorithm for urinalysis and antimicrobial therapy. We performed quantitative and qualitative exploration of UCx results and the microbial spectrum. The ability of the algorithm to improve antibiotic stewardship was tested by three endpoints: (a) immediate (UCx 2 days postoperatively), (b) short-term (21-day infectious complications), and (c) long-term (retreatment-free survival [RFS]). Statistical analyses included bivariate comparisons. The Kaplan–Meier estimators were used to compare RFS between the groups. The multivariable Cox regression was used to evaluate the independent effect of UCx status at the time of surgery on RFS.Results:Of 374 men, 235 (63%) had a sterile and 139 (37%) a non-sterile culture at the time of surgery. The proportion of sterile cultures at the time of surgery (63%) was significantly improved to 82% 2 days postoperatively (p<0.001). There were 16 (4.3%) patients with infectious complications with no difference between patients with sterile versus non-sterile culture (p=0.6). At median follow-up of 29 months, there was no difference in RFS (84%) between patients with sterile versus non-sterile culture (p=0.3). Positive UCx was not a predictor of recurrence after multivariable adjustment (p=0.5).Conclusion:A standardized protocol such as the one introduced improves antibiotic stewardship through frequent testing and culture-specific treatment. This is crucial in avoiding unnecessary antimicrobial treatment, and reducing infectious events and adverse effects of a positive UCx on long-term stricture recurrence.
文摘Dear Editor,Prostatic small cell carcinoma(SCC)is a rare,deadly tumor with an overall median survival of fewer than 12 months[1-5].Here we describe a unique case of a patient with prostatic SCC who developed a concurrent tumor thrombus in the right iliac vein.
