Villous adenoma coexistent with focal well-differentiated adenocarcinoma of female urethral orifice: A case report and review of literature

BACKGROUND Villous adenomas of the urinary tract are uncommon. They are morphologically similar to and difficult to differentiate from their counterpart in the colon. The histogenesis and malignant potential are uncertain.CASE SUMMARY A 63-year-old woman was admitted to our hospital with a mass in the urethral orifice. Gross and microscopic pathological examination was suggestive of urethral villous adenoma with focal well-differentiated adenocarcinoma. The whole urethra and part of the bladder were excised. No further treatment was offered. Carcinoembryonic antigen, cytokeratin 7, cytokeratin 20, epithelial membrane antigen, and p53 protein were positive, and the ratio of Ki-67 was 60%. After follow-up at 11 mo, the patient was cured and had no recurrence.CONCLUSION Immunohistochemistry is important for differential diagnosis of villous adenoma of the urinary system. Complete surgical resection of the urinary tract is curative.

Vaginal enterocele after cystectomy:A case report

BACKGROUND After undergoing radical cystectomy combined with hysterectomy,female patients may suffer from pelvic organ prolapse due to the destruction of pelvic structures,which mainly manifests as the prolapse of tissues of the vulva to varying degrees and can be accompanied by symptoms,such as bleeding and inflammation.Once this complication is present,surgical intervention is needed to resolve it.Therefore,preventing and managing this complication is especially important.CASE SUMMARY The postoperative occurrence of acute enterocele is rare,and a case of acute small bowel vaginosis 2 mo after radical cystectomy with hysterectomy is reported.When the patient was admitted,physical examination revealed that the small bowel was displaced approximately 20 cm because of vaginocele.A team of gynecological,general surgery,and urological surgeons was employed to return the small bowel and repair the lacerated vaginal wall during the emergency operation.Eventually,the patient recovered,and no recurrence was seen in the half year of follow-up.CONCLUSION We review the surgical approach for such patients,analyze high-risk factors for the disease and suggest corresponding preventive measures.

Intestinal Microbiota Metabolism and Atherosclerosis

Objective： This review aimed to summarize the relationship between intestinal microbiota metabolism and cardiovascular disease （CVD） and to propose a novel CVD therapeutic target. Data Sources： This study was based on data obtained from PubMed and EMBASE up to Jtme 30, 2015. Articles were selected using the following search terms： ＂＇Intestinal microbiota＂, ＂trimethylamine N-oxide （TMAO）＂, ＂trimethylamine （TMA）＂, ＂cardiovascular＂, and ＂atherosclerosis＂. Study Selection： Studies were eligible if they present information on intestinal microbiota metabolism and atherosclerosis. Studies on TMA-containing nutrients were also included. Results： A new CVD risk factor, TMAO, was recently identified. It has been observed that several TMA-containing compounds may be catabolized by specific intestinal microbiota, resulting in TMA release. TMA is subsequently converted to TMAO in the liver. Several preliminary studies have linked TMAO to CVD, particularly atherosclerosis; however, the details of this relationship remain unclear. Conclusions： Intestinal microbiota metabolism is associated with atherosclerosis and may represent a promising therapeutic target with respect to CVD management.

The relationship between human papillomavirus and penile cancer over the past decade:a systematic review and meta-analysis

Human papillomavirus (HPV) infection appears to play an important role in the development of penile cancer (PeCa), but their relationship remains unclear. Therefore, we performed a systematic review and meta-analysis to elucidate their relationship. We systematically searched Embase, PubMed, Cochrane Library, and Web of Science for case-control studies and cross-sectional studies using polymerase chain reaction (PCR) tech no logy on formali n?fixed paraffi n-embedded (FFPE) or pa raff i n-embedded (PE) PeCa tissues to detect HPV (published between January 1, 2007, and December 29, 2017;no language restrictions). Twenty-two studies were identified, and 1664 cases were available for analysis. The combined HPV infectious risk of PeCa is 51.0%(95% confidence interval [Cl]: 43.0%-60.0%). The three most common subtypes of HPV were HPV16 (28.5%), HPV18 (2.3%), and HPV6 (2.3%). The virus was relevantly associated with basaloid (85.5%, 95% Cl: 77.2%-93.8%) and warty (50.0%, 95% Cl: 35.2%-64.8%) carcinomas. The invasiveness of PeCa was not associated with HPV (X^2 = 0.181, df = 1, P< 0.671). HPV infection in PeCa tended to be moderately differentiated (54.4%, 95% Cl: 47.7%-61.1%). This study found that almost half of PeCa patients are associated with HPV. The most comm only associated geno type is HPV16, but several other geno types were also detected. In addition to types 6 and 11, other single low-risk HPV infections have been found to contribute to PeCa to a lesser degree. HPVpositive tumors tend to exhibit warty and/or basaloid features, corresponding to a moderate histological grade. The role of HPV in PeCa should be revisited to provide evidenee for the development of PeCa in the presenee of HPV infection.