Comparative study of functional optical zone:small incision lenticule extraction versus femtosecond laser assisted excimer laser keratomileusis

AIM:To investigate the size of functional optical zone(FOZ)after small incision lenticule extraction(SMILE)versus femtosecond laser assisted excimer laser keratomileusis(FS-LASIK)for myopia correction and potential associated factors for FOZ.METHODS:A total of 133 patients who received corneal refractive surgery in our hospital between November 2018 and July 2021 were retrospectively enrolled.There were 63 patients(123 eyes)in SMILE group and 70patients(139 eyes)in FS-LASIK group.The size of FOZ was measured using Pentacam 3-dementional anterior segment analyzer before and 3mo after surgery,so as to analyze postoperative achieved functional optical zone(AFOZ)and its contributing parameters.RESULTS:When planned functional optical zone(PFOZ)was 6.5 mm for both groups,AFOZ was 1.45±0.27 and 1.67±0.25 mm smaller than preoperative FOZ in SMILE group and FS-LASIK group 3mo after surgery.AFOZ in SMILE group was significantly larger than that in FS-LASIK group(P<0.001).Variation of FOZ was negatively correlated with preoperative spherical equivalent(SE)and positively correlated with variation of mean keratometry value(△Km),variation of spherical aberration(△SA),and variation of Q-value(△Q,all P<0.001)in both groups.Multiple variable linear regression equations were△FOZ=1.354-0.1×pre-SE+0.336×△Q+1.462×△SA in SMILE group and△FOZ=1.512+0.137×△Q+0.468×△SA in FS-LASIK group.CONCLUSION:AFOZ is significantly smaller than preoperative FOZ in both SMILE and FS-LASIK groups.With the same PFOZ,larger AFOZ is achieved in SMILE group than in FS-LASIK group.

甲泼尼龙对机械通气相关性肺损伤大鼠肺组织水通道蛋白5表达的影响

目的探讨甲泼尼龙(Mp)对机械通气相关性肺损伤大鼠肺组织水通道蛋白5(AQP5)表达影响及其作用机制。方法将100只SD大鼠随机分为5组:正常对照组(C组)、机械通气组(V组)和不同剂量甲泼尼龙组(Mp1,Mp_2,Mp_3组)。C组不行机械通气,自然呼吸空气; V组:大潮气量机械通气4 h,吸入氧浓度为21%; Mp1,Mp_2,Mp_3组:机械通气前10 min分别静脉注射Mp 2,10,30 mg·kg^(-1)。于插管即刻,机械通气1,2和4 h(t1-4)时采集股动脉血样,进行动脉血气分析,计算氧合指数(OI)。机械通气4 h后放血处死大鼠,检测肺通透指数(LPI)与肺湿干重(W/D)比;Western blotting法检测p38丝裂原活化蛋白激酶(p38MAPK)、磷酸化p38丝裂原活化蛋白激酶(p-p38MAPK)和水通道蛋白5(AQP5)的表达水平,计算p-p38MAPK/p38MAPK比值;采用RT-PCR法测定AQP5 mRNA表达;光镜下观察各组肺组织病理变化,计算肺泡损伤率(IAR)。结果与C组比较,V组和Mp1组OI降低,肺组织W/D比、LPI和IAR升高(P<0.05),p-p38MAPK表达水平和p-p38MAPK/p38MAPK比值升高(P<0.05),AQP5和AQP5 mRNA表达水平下降(均P<0.05),Mp_2和Mp_3组上述指标差异无统计学意义(P>0.05);与V组比较,Mp_2和Mp_3组OI升高,肺组织W/D比、LPI和IAR降低(P<0.05),肺组织p-p38MAPK表达水平和p-p38MAPK/p38MAPK比值下降(P<0.05),AQP5和AQP5 mRNA表达水平升高(P<0.05),Mp_2和Mp_3组上述指标差异无统计学意义(P>0.05)。Mp_2和Mp_3组肺组织病理学损伤较V组减轻。结论 Mp可减轻大鼠机械通气相关性肺损伤,其机制与抑制p38MAPK磷酸化、上调AQP5表达有关,中等剂量甲泼尼龙为较合适的肺保护剂量。

Trillium tschonoskii maxim extract attenuates abnormal Tau phosphorylation

Large-scale epidemiological studies have found that hyperhomocysteinemia is a powerful, independent risk factor for Alzheimer's disease. Trillium tschonoskii maxim is a traditional Chinese medicine that is used to promote memory. However, scientific understanding of its mechanism of action is limited. This report studied the potential neuroprotective effects of Trillium tschonoskii maxim extract against homocysteine-induced cognitive deficits. Rats were intravenously injected with homocysteine(400 μg/kg) for 14 days to induce a model of Alzheimer's disease. These rats were then intragastrically treated with Trillium tschonoskii maxim extract(0.125 or 0.25 g/kg) for 7 consecutive days. Open field test and Morris water maze test were conducted to measure spontaneous activity and learning and memory abilities. Western blot assay was used to detect the levels of Tau protein and other factors involved in Tau phosphorylation in the hippocampus. Immunohistochemical staining was used to examine Tau protein in the hippocampus. Golgi staining was applied to measure hippocampal dendritic spines. Our results demonstrated that homocysteine produced learning and memory deficits and increased levels of Tau phosphorylation, and diminished the activity of catalytic protein phosphatase 2A. The total number of hippocampal dendritic spines was also decreased. Trillium tschonoskii maxim extract treatment reversed the homocysteine-induced changes. The above results suggest that Trillium tschonoskii maxim extract can lessen homocysteine-induced abnormal Tau phosphorylation and improve cognitive deterioration such as that present in Alzheimer's disease.

Sustainable functional urethral reconstruction:Maximizing early continence recovery in robotic-assisted radical prostatectomy

Objective:To evaluate the safety profile and short-term functional outcome of sustainable functional urethral reconstruction(SFUR)in robotic-assisted radical prostatectomy(RARP).Methods:One hundred and sixty-two consecutive prostate cancer patients who underwent RARP were retrospectively analyzed,in which 53 had undergone SFUR while the other 109 had undergone conventional RARP procedures.Immediate,2-week,1-month and 3-month continence recovery and other perioperative data were compared to evaluate short-term surgical and functional outcome.Results:The median age was 68 and 67 years in the experimental group and control group,respectively(pZ0.206),with a median prostate-specific antigen(PSA)of 13.6 ng/mL(interquartile range[IQR],8.46e27.32 ng/mL)in the experimental group and 13.84 ng/mL(IQR,9.12e26.80 ng/mL)in control group(pZ0.846).Immediate,2-week,1-month and 3-month continence recovery rates between the groups were 34.0%vs.3.7%,50.9%vs.14.7%,62.3%vs.27.5%,and 79.2%vs.63.3%(all p<0.05).The morphological changes made by the new reconstruction technique were maintained on magnetic resonance imaging(MRI)3 months postoperatively.Nerve-sparing procedures and adoption of the new reconstruction technique were significantly relevant to continence recovery on logistics regression model(p<0.001).Conclusions:SFUR is a safe and easy-to-handle modification that may contribute to early continence return for RARP.Long-term follow-up and prospective studies are required to further evaluate its value in postoperative quality-of-life improvement.

Experience of one single surgeon with the first 500 robot-assisted laparoscopic prostatectomy cases in China's Mainland

Objectives: To summarize the experience of the first 500 robot-assisted laparoscopicradical prostatectomy (RALP) cases by one surgeon and analyze the influencing factorsof functional and oncological outcomes.Methods: Between April 2012 and October 2017, 500 patients who underwent RALP wereincluded and divided sequentially into five equal groups. Patients’ preoperative, perioperativeand postoperative outcomes were analyzed and evaluated, and the Kruskal-Wallis test wasused to analyze and compare the effect of surgeon experience by case.Results: There is a statistically significant reduction in operative time, intraoperative estimatedblood loss and postoperative hospital stay time (all p<0.001) with the increased experience.The results show that experience was the most important influencing factor in bothoperative time and blood loss. Pelvic lymph node dissection (PLND) might increase the operativetime. The total positive surgical margin (PSM) rate was 21.8%. The PSM rate in pT3 tumorswas significantly higher than that in pT2 tumors (12.0% vs. 37.1%, p<0.001). The 5-yearbiochemical recurrence (BCR)-free rate was 70.8%. The results of Cox regression showed thatpreoperative prostate-specific antigen (PSA), postoperative Gleason score (GS), and pathologicT stage were independent risk factors for BCR.Conclusion: After approximately 200 cases, the surgeon reached a plateau for RALP, but theoutcomes could still improve after more cases. The surgeon’s experience was the most importantinfluencing factor for both operative time and blood loss. PSM rate was mainly determinedby tumor stage rather than by operation experience.

Re: Experience of one single surgeon with the first 500 robot-assisted laparoscopic prostatectomy cases in China's Mainland

Robotic-assisted laparoscopic prostatectomy(RALP)has maintained an essential role in the treatment of localized prostate cancer.The so-called“trifecta”including cancer control,urinary continence,and sexual potency are three goals that surgeons need to pay close attention to.The study demonstrated that RALP for patients in Asia is safe and feasible,and the effects of RALP are at least comparable,and superior to those of open surgery or laparoscopic surgery in functional and oncologic outcomes.

Priapism secondary to chronic myeloid leukemia treated by a surgical cavernosa-corpus spongiosum shunt: Case report

Priapism secondary to chronic myeloid leukemia(CML)is rarely observed in the clinic.Here,we present an 18-year-old patient with priapism for over 72 h due to hyperleukocytosis.Emergent interventions such as therapeutic aspiration and intracorporal injection of phenylephrine failed before a surgical corpora cavernosa-corpus spongiosum shunt was inserted to relieve symptoms.During hospitalization,bone marrow aspiration confirmed the diagnosis of CML.

Finite element methods for fractional diffusion equations

Due to the successful applications in engineering,physics,biology,finance,etc.,there has been substantial interest in fractional diffusion equations over the past few decades,and literatures on developing and analyzing efficient and accurate numerical methods for reliably simulating such equations are vast and fast growing.This paper gives a concise overview on finite element methods for these equations,which are divided into time fractional,space fractional and time-space fractional diffusion equations.Besides,we also involve some relevant topics on the regularity theory,the well-posedness,and the fast algorithm.

Gastrodin Attenuates Pentylenetetrazole-Induced Seizures by Modulating the Mitogen-Activated Protein Kinase-Associated Inflammatory Responses in Mice

Gastrodin, the major component isolated from the rhizome of the Chinese traditional medicinal herb Gastrodia elata(‘‘Tianma''), has a long history in the treatment of epilepsy and other neurological disorders.However, the molecular mechanisms are not clear. Here,we found that gastrodin ameliorated pentylenetetrazole(PTZ)-induced epileptic seizures with improvement of the electroencephalographic pattern in mice. Further studies demonstrated that gastrodin decreased the levels of the pro-inflammatory cytokines interleukin-1b and tumor necrosis factor-a while increasing interleukin-10, an antiinflammatory cytokine in the brain. Furthermore, gastrodin attenuated the PTZ-induced microglial activation along with inhibition of mitogen-activated protein kinases,c AMP response element binding protein, and NF-j B. Our data suggest that gastrodin attenuates seizures by modulating the mitogen-activated protein kinase-associated inflammatory responses.

Short-term therapeutic outcomes of robotic-assisted laparoscopic radical prostatectomy for oligometastatic prostate cancer:a propensity score matching study

Background:The role of local treatment in oligometastatic prostate cancer(PCa)is gaining interest with the oligometastases hypothesis proposed and the improvement of various surgical methods and techniques.This study aimed to compare the short-term therapeutic outcomes of robotic-assisted laparoscopic radical prostatectomy(RALP)for oligometastatic prostate cancer(OPC)vs.localized PCa using propensity score matching.Methods:Totally 508 consecutive patients underwent RALP as a first-line treatment.The patients were divided into two groups according to oligometastatic state:the OPC group(n=41)or the localized PCa group(n=467).Oligometastatic disease was defined as the presence of two or fewer suspicious lesions.The association between the oligometastatic state and therapeutic outcomes of RALP was evaluated,including biochemical recurrence(BCR)and overall survival(OS).A Cox proportional hazards model was used to assess the possible risk factors for BCR.Results:Totally 41 pairs of patients were matched.The median operative time,the median blood loss,the overall positive surgical margin rate,the median post-operative hospital stays,and the post-operative urinary continence recovery rate between the two groups showed no statistical significance.The 4-year BCR survival rates of the OPC group and localized PCa group were 56.7%and 60.8%,respectively,without a significant difference(P=0.804).The 5-year OS rates were 96.3%and 100%,respectively(P=0.326).Additionally,the results of Cox regression showed that oligometastatic state was not an independent risk factor for BCR(P=0.682).Conclusions:Our findings supported the safety and effectiveness of RALP in OPC.Additionally,oligometastatic state and sites did not have an adverse effect on BCR independently.

Initial experience with a novel method for cognitive transperineal magnetic resonance imaging-targeted prostate biopsy

A cognitive magnetic resonance imaging(MRI)-targeted prostate biopsy conducted by an experienced clinician enhances the detection rate of(high-grade)prostate cancer;however,this method is less successful in the hands of inexperienced surgeons.Therefore,an alternative method of conducting a cognitive MRI-targeted biopsy that can be successfully performed by the inexperienced clinicians should be developed.Ninety-six males suspected of prostate cancer were analyzed using systematic biopsy and cognitive MRI-targeted biopsy based on our novel three-dimensional matrix positioning method.Typically,the core principle of the latter procedure was to put the MRI and ultrasound images into the same virtual coordinate system.Afterward,the targeted biopsy was transformed to target a coordinate for the suspected lesion in the MRI.Subsequently,patients were assessed for the presence/absence of prostate cancer or high-grade prostate cancer.According to our results,the overall detection rate of prostate cancer was 70.8%(68/96),and the detection rate of high-grade prostate cancer was 56.3%(54/96).Specifically,the detection rate of prostate cancer by systematic biopsy was 54.2%(52/96)and that by targeted biopsy was 59.4%(57/96;P=0.560).Clearly,the combined application of targeted biopsy could remarkably increase the detection rates of prostate cancer(P=0.025)and high-grade prostate cancer(P=0.009).Taken together,the findings of this study suggest that the combination of systematic biopsy with our three-dimensional matrix positioning-driven cognitive-targeted biopsy is superior to systematic biopsy in detecting prostate cancer and high-grade prostate cancer.

Identification and characterization of soybean dreg soluble dietary fibre by combination of extrusion pre-treatment and enzymatic modification

OBJECTIVES:Soybean dreg is a by-product of soy milk processing,which contains high levels of soluble dietary fibre(SDF).In this study,we aimed to provide comprehensive processes of pre-treated extrusion for the improving structure and properties of soybean dreg soluble dietary fibre(SDSDF),which would be a valuable approach to enhance physiological activity.METHODS:Here,we characteristic the functional role of SDSDF employing to extrusion pretreatment.Soybean dregs were pre-treated using the twin screw extrusion method followed by enzymatic modification using neutral protease,α-amylase,glucoamylase,and cellulose to produce SDSDF.The physical properties and antioxidant activity of SDSDF were investigated.RESULTS:The morphology and crystal structure of SDSDF were observed that,through extrusion processing and enzymatic modification,the SDSDF yield increased by 106.28%.Moreover,the surface structure showed block-shaped or reticular formations in the extruded SDSDF,and the size of block-shaped cells was about 10μm.Infrared spectroscopic analysis showed that a characteristic absorption peak of polysaccharide appeared at 1631 cm−1 during extrusion processing.However,after extrusion processing,decreased absorption peaks were observed for the extruded SDSDF.Furthermore,XRD analysis showed that the 2θdiffraction peak changed at 24.16°for the extruded SDSDF.CONCLUSIONS:The overall findings suggest that the water holding capacity(WHC),oil holding capacity(OHC),expansibility,and the water solubility were significantly decreased in extruded SDSDF.In addition,the scavenging ability of 1,1-diphenyl-2-picrylhydrazyl(DPPH),-OH,O_(2)^(-),and the total reducing power were significantly improved,indicating that beneficial changes had taken place in the crystal structure of cellulose or hemicellulose to improve the physiological activity in extruded SDSDF.