Analysis of the Current Status and Influencing Factors of the Readiness for Discharge of Patients after Prostate Cancer Surgery Based on the Concept of Enhanced Recovery after Surgery (ERAS)

Objective To investigate the level of readiness for discharge of patients after prostate cancer surgery based on the concept of Enhanced Recovery After Surgery (ERAS), and to explore its influencing factors, so as to provide references for improving the readiness for discharge of patients after prostate cancer surgery. Methods The general information questionnaire, the discharge preparation scale, and the discharge guidance quality scale were used to investigate 119 patients discharged from the urological surgery department of a tertiary A-level hospital in Guangzhou after radical prostatectomy. Results The total score of discharge readiness of patients after radical prostatectomy was 147.74 ± 35.71 points, which was at a lower middle level and the total score of discharge guidance quality was 180.68 ± 38.91 points, which was at a medium level. Multiple linear regression analysis showed that education level, family monthly income, Gleason score, whether to perform lymphatic dissection, whether to discharge with a urinary catheter, and the quality of discharge guidance were the main factors influencing the readiness for discharge of patients after prostate cancer surgery. Conclusion In clinical nursing work, it is necessary to implement individualized health education according to the characteristics and needs of different patients to improve the level of preparation for discharge of patients after prostate cancer surgery.

Significant association between IL-18 and OCT4 gene polymorphisms in susceptibility and clinical characteristics of prostate cancer

Objective Recent studies have shown abnormal expression of octamer-binding transcription factor 4(OCT4) and interleukin-18(IL-18) to be related to cancer. However, the molecular mechanisms by which the IL-18 and OCT4 gene polymorphisms are associated with prostate cancer remain unclear. In this study, we aimed to determine whether the presence of IL-18 and OCT4 polymorphisms were associated with size, grade, tumor, nodes and metastasis(TNM) stage, or survival in patients with prostate cancer.Methods Polymorphisms in OCT4 and IL-18 genes were evaluated to determine susceptibility to prostate cancer in 120 patients. A control group consisted of 125 Chinese participants. Genotyping was performed using TaqMan allelic discrimination assays, and statistical analysis was performed using SPSS. Results No association was found between OCT4 and IL-18 gene polymorphisms and prostate cancer susceptibility. For OCT4 AA and IL-18-607 CC genotypes, there was a significant association with higher tumor grade(P = 0.03 and P = 0.025) and stage(P = 0.04 and P = 0.001). The OCT4 and IL-18-137 GG genotype was correlated with higher tumor grade(P = 0.028) and stage(P = 0.008). Furthermore, OCT4 AA was significantly more frequent in patients with lymph node metastasis(P = 0.02) and distant metastasis(P = 0.01). The Cox proportional hazard model showed that tumor grade and stage grouping were independent prognostic factors but IL-18 and OCT4 polymorphisms were not. Conclusion The OCT4 gene may have a profound effect on prostate cancer risk. Polymorphism variants in the IL-18(IL-18-607 and IL-18-137) and OCT4 genes may be associated with poor prognoses for individuals with prostate cancer.

Clinical study of IL-18 and NANOG gene polymorphisms in prostate cancer patients

Objective Recent studies have shown abnormal expression of NANOG and IL-18 to be related to cancer. However, the molecular mechanism by which IL-18 and NANOG gene polymorphisms are associated with prostate cancer is unclear. In this study, we examined whether IL-18 and NANOG gene polymorphisms and their interaction with prostate cancer-related risk factor are associated with the susceptibility to and clinicopathological development of prostate cancer among Chinese men.Methods Polymorphisms in the NANOG and IL-18 genes were evaluated for susceptibility in 120 patients with prostate cancer. The control group consisted of 125 samples from Chinese men. Genotyping was conducted using Taq Man allelic discrimination assays. Statistical analysis was performed using SPSS software. Results No association of NANOG and IL-18 gene polymorphisms and overall prostate cancer susceptibility was detected. The IL-18-607 CC genotype was significantly associated with a higher tumor grade(P = 0.025) and stage(P =0.001). The IL-18-137 GG genotype correlated with a higher tumor grade(P = 0.028) and stage(P = 0.008). The IL-18-137 G allele was significantly more frequent in patients with lymph node metastasis(P = 0.035). The IL-18-607 CC genotype was associated with distant metastasis(P = 0.025). However, no significant association was observed between NANOG polymorphisms and any clinicopathological feature. The Cox proportional hazard model showed that tumor grade and stage grouping were independent prognostic factors in IL-18, while IL-18 polymorphism was not. Polymorphism variants in the IL-18(IL-18-607 and IL-18-137) and NANOG(genotypes AC) genes might be associated with a worse prognosis of patients with prostate cancer.Conclusion NANOG may be associated with the early stages of prostate cancer carcinogenesis. IL-18 and NANOG gene polymorphisms may play a major role in the growth, invasion, and metastasis of prostate cancer.

Multimodality-imaging manifestations of primary renal-allograft synovial sarcoma:First case report and literature review

BACKGROUND Primary renal synovial sarcoma (PRSS) is an extremely rare tumor with a poor prognosis. Its imaging and immunohistochemical characteristics may overlap with other renal tumors, which renders its early diagnosis in a dilemma. The diagnosis of primary renal synovial sarcoma requires histopathology and the confirmation of SYT-SSX gene fusion using molecular techniques. Cases of primary renal synovial sarcoma have been previously reported in the literature. However, to our knowledge, primary renal allograft synovial sarcoma was never described. CASE SUMMARY A 43-year-old male patient who underwent kidney transplantation 9 months ago came to our hospital for regular follow-up. Traditional ultrasonography revealed multiple hypo-echo neoplasms in the renal allograft. Contrast-enhanced computed tomography (CECT) showed slightly hyper-density masses with slow homogeneous enhancement. Ultrasound-guided biopsy was conducted for accurate pathological diagnosis. The neoplasms were diagnosed as synovial sarcoma by pathological, immunohistochemical, and genetic analyses. Positron emission tomography/CT showed no evidence of metastasis. At approximately one week post biopsy, contrast-enhanced ultrasound was conducted to eliminate active hemorrhage. One month later, CECT showed that the biggest neoplasm grew from 3.3 cm to 5.7 cm in diameter. Parametric imaging was conducted with SonoLiver CAP to conduct further quantitative analysis, which showed that the enhancement pattern was heterogeneous hyper-vascular enhancement. Radical surgical resection of the whole renal allograft and ureter was conducted without additional adjuvant chemotherapy or external radiotherapy. Anlotinib was chosen for targeted therapy with a good response. CONCLUSION We propose multimodality imaging for accurate diagnosis of renal allograft synovial sarcoma especially when it is formed by spindle-shaped cells.

Preoperative diagnosis of renal oncocytoma: case report and literature review

To differentiate renal oncocytoma from renal carcinoma, the clinical data of four patients with incidentally found renal oncocytomas were studied in this report. And additional Immunohistochemistry examinations were done to confirm diagnosis. Renal oncocytomas were found incidentally in four patients during medical examination. No characteristic changes were found in laboratory tests. Radiology examination provided the location and possibility of renal oncocytoma. History, laboratory test and radiology exanimation indicated the diagnosis of renal oncocytoma, but the final identify of renal oncocytoma need pathology examination.

Impact of IL-18 gene promoter polymorphisms on renal cell carcinoma occurrence and prognosis in Chinese Han population

Objective Genetic polymorphisms in various inflammatory cytokines have been associated with the risk and growth or invasiveness of renal cell carcinoma(RCC).However,the molecular basis of RCC pathogenesis is unclear.The aim of this study was to explore a possible association between two IL-18 gene promoter polymorphisms,-137G/C and -607 C/A,and RCC occurrence and prognosis in a Chinese Han population.Methods Chinese Han patients with RCC(n=175) and age-matched healthy controls(n=200) were analyzed by single nucleotide polymorphism genotyping during follow-up.Results IL-18-137G allele frequency was significantly higher in patients with lymph node metastasis(Odds ratio [OR],3.52;95% confidence interval [CI],0.97-16.17;P=0.045).The IL-18-607 CC genotype was associated with distant metastasis(OR,2.81;95% CI,1.35-6.24;P=0.025).The IL-18-137G allele was correlated with more advanced tumor stage(OR,1.83;95% CI,1.05-3.72;P=0.026) and higher tumor grade(OR,2.23;95% CI,0.78-4.12;P=0.041).The IL-18-607 CC genotype frequency was significantly higher in patients with more advanced cancer stage(OR,2.92;95% CI,1.80-6.87;P=0.001) and higher tumor grade(OR,2.21;95% CI,1.25-12.25;P=0.035).The IL-18-607 allele was associated with more advanced cancer stage(OR,2.47;95% CI,1.38-3.83;P=0.002).Carriers of the GG genotype with the -137G/C polymorphism had a 2.165-times higher risk of RCC progression than carriers of the GC genotype(Hazard ratio=2.15,95% CI,1.270-3.687).Conclusion The IL-18-137G allele was correlated with more advanced stage,higher tumor grade,and lymph node metastasis.IL-18 gene promoter polymorphism -137G/C may thus influence the prognosis of RCC patients.

Comparison of the postoperative trauma of the retroperitoneal laparoscopic intrasinusal pyelolithotomy and percutaneous nephrolithotomy

Objective: To study the postoperative trauma of the retroperitoneal laparoscopic intrasinusal pyelolithotomy (RLIP) and percutaneous nephrolithotomy (PCNL). Methods: A total of 118 patients who were diagnosed with single pelvis calculus in Shanghai Punan Hospital of Pudong New District between September 2013 and February 2017 were selected and randomly divided into RLIP group and PCNL group who received retroperitoneal laparoscopic intrasinusal pyelolithotomy and percutaneous nephrolithotomy respectively. The removal of the stones was observed 1 week and 4 weeks after surgery, and 3mL of cubital venous blood was collected 3 d and 7 d after operation to detect the renal function indicators, inflammatory markers and stress indicators. Results: The stone removal success rate of RLIP group 1 week and 4 weeks after operation were significantly higher than those of PCNL group, serum BUN, Scr and Cys-C contents as well as eGFR levels were not significantly different between RLIP group and PCNL group 3 d and 7 d after operation, and serum Cor, NE, HSP70, NO, IL-6, hs-CRP, TNF-α and PGE2 contents of RLIP group 3 d and 7 d after operation were significantly lower than those of PCNL group. Conclusion: RLIP is significantly better than PCNL in stone removal and causes significantly less postoperative trauma than PCNL.

恶性肿瘤骨转移及骨相关疾病临床诊疗中国专家共识(英文)

Since 1980s, palliative medicine has been an independent educational project. The development of palliative care in China started in the early 1990s. During the last 18 years, we have seen an increasing allocation of resources to palliative care, the establishment of an academic chair in palliative medicine, and more focused interest and awareness of the need for palliative care in the society at large. So the doctors in China have established principles of treatment on clinical diagnosis and treatment of malignant tumor bone metastases and bone related complications. In order to share our experience with the world, after two years’ preparation, the top-level experts in palliative medicine have written the consensus statement on clinical diagnosis and treatment of malignant tumor bone metastases and bone related complications. The overview includes not only the achievements in the world, but the hands-on experience in clinic, especially the experience in combination of TCM and Western medicine. We hope that the publication of this consensus statement will contribute to the palliative medicine development in this field, thus bring benefits to the majority of patients.

白细胞介素-18基因607和137多态性在前列腺癌临床特性的影响(英文)

Objective: The aim of this study was to determine whether the presence of IL-18 polymorphisms -137 G/C and -607 A/C was associated with grade, clinical stage, and survival in patients with prostate cancer. Methods: The study cohort included 126 patients with prostate cancer. Control group consisted of 125 samples from Chinese population. Genomic DNA was extracted from EDTA-anticoagulated peripheral blood leukocytes by the salting-out method. The genotyping of the two IL-18 polymorphisms was performed using predesigned TaqMan SNP Genotyping Assays. Results: The studied IL-18 gene polymorphisms did not influence susceptibility to prostate cancer in the analyzed group of patients (IL-18-607, P = 0.342; IL-18-137 P = 0.715) but may contribute to disease onset and aggressiveness. IL-18-607 CC genotype was significantly associated with higher tumor grade (P = 0.025) and stage (P = 0.001). IL-18-137 GG genotype was correlated with higher tumor grade (P = 0.018) and stage (P = 0.007). The Cox proportional hazard model showed that tuumor grade and stage grouping were independent prognostic factors but IL-18 polymorphism was not. Polymorphism variants in the IL-18 gene (IL-18-607 and IL-18-137) may be associated with a worse prognosis for prostate cancer. Conclusion: High levels of IL-18 production may play a major role in the growth, invasion and metastasis of prostate cancer.

Cold-preserved human spermatozoa in electrolyte-free solution retain their pene-tration capacity

Objective: To evaluate penetration capacity of human sperm preserved in electrolyte-free (EF) solution at 4 ℃.Methods: The motility, acrosomal status penetration rate and fertility index of human sperm were assessed before and after cold-preservation in EF solution, respectively.Results: The motility of human sperm cold-preserved in EF solution for 1 week was significantly higher than that of human sperm cold-preserved in modified human tubal fluid (mHTF) (43.4%±7.9% vs 9.5%±2.5%, P<0.01 ).Although acrosomal status of human sperm cold-preserved in the EF solution before reinitiation was not different from those of the fresh sperm (capacitated sperm: 7.6%±1.8% vs 6.4±1.8%; acrosome-reacted sperm: 3.0%±1.7% vs 2.4±1.1%, P>0.05), the percentage of capacitated and acrosome-reacted sperm in the EF solution significantly increased after reinitiation (capacitated sperm: 16.0%±2.3% vs 7.6±1.8%, acrosome-reacted sperm: 9.4%±2.1% vs 3.0%±1.7%, P<0.01).The penetration rate and fertility index of cool-preserved human sperm in the EF solution were comparable with those of fresh sperm (48.1% vs 50.9%; 1.38±0.16 vs 1.29±0.13, respectively, P>0.05).Conclusion: Cold-preservation did not induce capacitation and acrosome reaction of human sperm in the EF solution, but human sperm cold-preserved in the EF solution for 1 week possesses as much penetration capacity as fresh sperm.

血清白细胞介素-18和NO活性在前列腺癌患者的临床价值(英文)

Objective:The aim of the study was to estimate the clinical value of serum interleukin-18(IL-18)and nitric oxide(NO)activities in patients with prostate cancer.Methods:The 50 patients with prostate cancer and 25 control subjects were measured in serum IL-18 by enzyme-linked immunosorbent assay(ELISA)and nitrate+nitrite level by an index of NO generation.Results:Serum IL-18 and nitrate+nitrite levels were significantly higher in patients with prostate cancer when compared to the control subjects(P<0.05).Serum IL-18 level was significantly higher in patients with stages B,C and D when compared to patients with stage A(P<0.05).Serum IL-18 level was significantly higher in the metastatic patients compared with the nonmetastatic patients(P<0.01).There was no difference in serum nitrate and nitrite level between metastatic and nonmetastatic patients(P>0.05).The serum IL-18 and nitrate and nitrite levels decreased after patients underwent surgical resection.Conclusion:Serum IL-18 level may be a useful marker to predict prognosis of patients with prostate cancer after surgery.Long-term follow-up is required to clarify this hypothesis.

前列腺癌患者血清白细胞介素-18和VEGF相关性(英文)

Objective: The aim of our study was to analyze interleukin-18 (IL-18) and vascular endothelial growth factor (VEGF) serum levels in patients with prostate cancer before and after operation and the possible correlation between IL-18 and VEGF serum levels. Methods: Serum IL-18 and VEGF levels were measured by enzyme-linked immunosorbent assay (ELISA) in 36 patients with prostate cancer before and after radical prostatectomy and in 25 healthy controls. Results: Serum IL-18 and VEGF levels were significantly higher in patients with prostate cancer before operation with respect to healthy controls (P < 0.05), with a highly significant correlation between IL-18 and VEGF (R = 0.800, P = 0.017). It was significantly reduced in IL-18 and VEGF after operation. IL-18 and VEGF serum concentrations were correlated with the clinicalopathological status of patients with prostate cancer. Conclusion: It is correlative with serum IL-18 and VEGF. Serum IL-18 and VEGF levels may be useful prognostic marker in patients with prostate cancer.

Role and significance of SIRT1 in regulating the LPS-activated pyroptosis pathway in children with congenital hydronephrosis

Objective To explore the characteristics and mechanism of sirtuin 1(SIRT1)in lipopolysaccharide(LPS)-activated pyroptosis in the renal tissue of children with congenital hydronephrosis(CHn).Methods We detected the expression characteristics and clinical significance of SIRT1 and pyroptosis pathway proteins in CHn renal tissues by immunohistochemistry.The degree of renal fibrosis was detected by Masson staining.The human renal tubular epithelial cell line(HK-2)was cultured in vitro and treated with LPS(1µg/mL),the SIRT1-specific agonist SRT1720(2.5µmol/L)and small interfering RNA(siRNA)-SIRT1 for 48 hours.After 48 hours,Cell Counting Kit-8 was used to detect the changes in cell proliferation ability,and ELISA was used to detect the changes in the expression of interleukin(IL)-1β and IL-18 in the cell supernatant.Real-time PCR(quantitative RT-PCR)and western blot analysis were used to detect the expression of SIRT1,caspase-1,caspase-4,NOD-like receptor thermal protein domain associated protein 3(NLRP3),and cleaved gasdermin D(GSDMD)in each group.Results Serum inflammatory cytokines were significantly elevated in 13 children with CHn with urinary tract infection,mainly caused by Gram-negative bacteria.Severe renal fibrosis occurred in children with CHn.Compared with the control group,the expression of SIRT1 in CHn kidney tissues was decreased,and the expression of caspase-4 and GSDMD was increased.LPS inhibited the expression of SIRT1 in HK-2 cells,promoted the expression of caspase-1,caspase-4,NLRP3,cleaved GSDMD,promoted the expression of IL-1β and IL-18 in the supernatant,and promoted pyroptosis in HK-2 cells.SRT1720 can inhibit LPS-activated pyroptosis by promoting SIRT1 expression,while siRNA-SIRT1 can further aggravate LPS-activated pyroptosis after inhibiting SIRT1 expression.Conclusions LPS can promote the inflammatory response in children with CHn by activating non-canonical pyroptosis and inhibiting SIRT1 expression.Promoting SIRT1 expression can inhibit pyroptosis of renal tubular epithelial cells,reduce the release of IL-18 and IL-1β,and alleviate the progression of renal fibrosis in children with CHn.

Evodiamine induces extrinsic and intrinsic apoptosis of ovarian cancer cells via the mitogen-activated protein kinase/phosphatidylinositol-3-kinase/protein kinase B signaling pathways

OBJECTIVE: To explore the effects of evodiamine on ovarian cancer cells and the mechanisms underlying such effects.METHODS: Human ovarian cancer cells HO-8910 PM were treated with evodiamine at 0, 1.25,2.5, and 5 μM for 1-4 d. 3-(4,5-Dimethiylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT) assay was used to detect the growth inhibition rate of evodiamine-treated HO-8910 PM cells. The cell cycle was observed via propidium iodide(PI) staining. Apoptosis induction was assessed via Annexin V-fluorescein isothiocyanate/propidium iodide(Annexin V-FITC/PI) double staining assay. To verify the mechanism of apoptosis, caspase-dependent apoptotic pathway-related protein was detected by Western blot analysis. The expression levels of mitogen-activated protein kinase(MAPK)and/or phosphatidylinositol-3-kinase(PI3K)/pro-tein kinase B(Akt) pathway-related proteins were also investigated.RESULTS: Evodiamine significantly inhibited the proliferation of HO-8910 PM cells in a dose- and time-dependent manner. Evodiamine induced G2/M arrest with an increase of cyclin B1 level, and promoted cell apoptosis with a decrease of B cell lymphoma/lewkmia-2(Bcl-2) and an increase of Bcl-2-associated X protein(Bax) level. In addition,evodiamine treatment led to the activation of caspase-8, caspase-9, and caspase-3 and the cleavage of poly(ADP-ribose)-polymerase(PARP). Evodiamine targeted the MAPK and/or PI3K/Akt pathways by reducing the expression and activity of PI3 K, Akt, and extracellular signal-regulated kinase mitogen-activated protein kinase(ERK1/2 MAPK)and the activity of p38 MAPK.CONCLUSION: Evodiamine can inhibit the growth of ovarian cancer cells by G2/M arrest and intrinsic and extrinsic apoptosis. In addition, evodiamine-induced PI3K/Akt, ERK1/2 MAPK, and p38 MAPK signaling may be involved in cell death.

Current status and future perspectives of immunotherapy in bladder cancer treatment

The treatment strategy of bladder cancer has evolved not only through the traditional modalities of surgery and chemotherapy but also by immunotherapy over the past several decades.Immunotherapies such as intravesical Bacillus Calmette-Guérin(BCG)vaccines and immune checkpoint blockades(ICBs)are sometimes used for treating patients with bladder cancer,especially those who develop resistance to conventional first-line treatments such as surgery and chemotherapy.Unfortunately,it is a limited number of individuals that see clinical benefits from this approach,and complicating matters more is that many of these patients suffer severe immune-related adverse events(ir AEs).If current momentum continues to result in improved response rates and managed ir AEs,immunotherapy could be poised to revolutionize the landscape of urothelial carcinoma therapeutics.

Morphometric study of the testis and reproductive tract （including sperm granuloma） after vasectomy in mature rats

By utilizing the rabbit model, previous studies have found good evidence indicating that vasectomy-induced spermatogenic damage is pressure-mediated： the damage occurs when the occluded reproductive tract is unable to accommodate additional spermatozoa produced by the testis. More studies with the more commonly used rat model have shown, however, controversial results on whether and why the damage occurs. In this study, 12 mature male Sprague-Dawley rats were subjected to unilateral vasectomy： double ligation （without severing） of the vas deferens exposed via a small inguinal incision; 37 days after the operation, the testes, epididymides, vasa deferentia （juxta-epididymal segments）, and sperm granulomas （at the vasectomy site） were removed to obtain methacrylate resin-embedded sections and morphometric studies carried out with light microscopy. Marked spermatogenic damage with spermatids and spermatocytes depleted in the seminiferous epithelium in 43% of the seminiferous tubule profiles was demonstrated in 5 of the 12 testes on the vasectomized side, and the damage was associated with smaller or absent sperm granulomas; in the other 7 testes with essentially normal spermatogenesis, there was an increase （by 111% on average） in the volume of the tubule lumen, associated with larger granulomas or granulomas containing more spermatozoa. There was an overall increase （by 66%） in the thickness of the rete testis in the 12 testes; the epididymis or vas deferens showed no distension. It seems therefore that the spermatogenic damage induced by vasectomy in rats is pressure-mediated as well, and that variation in the damage depends mainly on the postoperative development of the sperm granuloma.

Case study of a patient with cryptozoospermia associated with a recessive TEX15 nonsense mutation

Dear Editor, Male infertility, which affects approximately 20 million people worldwide, is commonly caused by spermatogenic dysfunctions, including severe oligozoospermia, cryptozoospermia, and nonobstructive azoospermia, which are largely genetic in origin.

Sperm cryopreservation in the human sperm bank:11-year results of the Chinese mainland sperm banking network

To the Editor:Montegazza in 1866 was the first to suggest banks for frozen human semen.[1]In 1981,China's first human sperm bank was successfully established at the CITIC Xiangya Hospital.During the previous four decades,from 1981 to 2020,there were 27 human sperm banks in Chinese mainland.Human sperm banks provide cryopreservation of spermatozoa services for males needing to preserve fertility for an extended period in the Chinese mainland.

Zero ischemia partial nephrectomy

Clinical stage Tl renal masses are now a common type of urological tumor. Among them, twenty percent are benign and only about 20%-25% appear to be potentially aggressive^1＇2 Historically, radical nephrectomy was considered to be the gold standard treatment for this kind of tumor. However,