Technique Selection of Bricker or Wallace Ureteroileal Anastomosis in Ileal Conduit Urinary Diversion: A Strategy Based on Patient Characteristics

Objectives

This study was designed to establish an individualized selection strategy for the two most common types of ureteroenteric anastomotic techniques (Bricker and Wallace anastomosis) used in ileal conduit (IC) diversion.

Methods

Patients who underwent IC diversion after radical cystectomy for transitional cell carcinoma between January 2009 and December 2011 were prospectively collected. The choice of anastomosis type (Bricker vs. Wallace) was successively based on tumor characteristics, ureteral anomalies, and ureteral length after retrosigmoidal tunneling.

Results

Ninety-nine patients were enrolled in the final study. Fifty-three patients underwent Bricker anastomosis, and 46 underwent Wallace anastomosis. Ureteral stricture developed in 6 (6.1 %) patients and the overall stricture rate for all ureters was 3.1 % (6/196). Strictures occurred at an average of 13.3 months after surgery and were predominately located in the left ureter (66.7 %, 4/6). The difference in the ureter stricture rates between the two groups was not statistically significant: 3.8 % (4/104) and 2.2 % (2/92) for Bricker and Wallace, respectively (p = 0.686). There were no significant differences in age, sex, body mass index (BMI), prevalence of pelvic radiation therapy, length of stay, follow-up time, or time to stricture between the two techniques. Patients in whom stricture developed had a significantly higher mean BMI compared with those without stricture (25.2 vs. 23.3 kg/m², respectively; p = 0.008).

Conclusions

Our preliminary outcomes demonstrate that this selection strategy of Bricker vs. Wallace anastomosis seems to be clinically reliable, providing an acceptable low ureteral stricture rate of 3.1 %. However, the potential advantage for oncologic control of this strategy is needed to further confirm.     

Alpha5 nicotinic acetylcholine receptor mediates nicotine-induced HIF-1α and VEGF expression in non-small cell lung cancer

By binding to nicotinic acetylcholine receptors (nAChRs), nicotine induces the proliferation and apoptosis of non-small cell lung cancer (NSCLC). Previous studies have indicated that α5-nAChR is highly associated with lung cancer risk and nicotine dependence. However, the mechanisms through which α5-nAChRs may influence lung carcinogenesis are far from clear. In the present study, we investigated the roles of α5-nAChR in the nicotine-induced expression of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF). Immunohistochemistry was used to detect the expression of α5-nAChR and HIF-1α in 60 specimens of lung cancer and para-carcinoma tissue. The correlations between the expression levels of α5-nAChR and HIF-1α and other clinicopathological data were analyzed. In a cell line that highly expressed α5-nAChR, the loss of α5-nAChR function by siRNA was used to study whether α5-nAChR is involved in the nicotine-induced expression of HIF-1α and VEGF through the activation of the ERK1/2 and PI3K/Akt signaling pathways. Cell growth was detected using the cell counting kit-8 (CCK-8). α5-nAChR (78.3%) and HIF-1α (88.3%) were both overexpressed in NSCLC, and their expression levels were found to be correlated with each other (P < 0.05). In the A549 cell line, α5-nAChR and HIF-1α were found to be expressed under normal conditions, and their expression levels were significantly increased in response to nicotine treatment. The silencing of α5-nAChR significantly inhibited the nicotine-induced cell proliferation compared with the control group and attenuated the nicotine-induced upregulation of HIF-1α and VEGF, and these effects required the cooperation of the ERK1/2 and PI3K/Akt signaling pathways. These results show that the α5-nAChR/HIF-1α/VEGF axis is involved in nicotine-induced tumor cell proliferation, which suggests that α5-nAChR may serve as a potential anticancer target in nicotine-associated lung cancer.     

肝细胞癌发病危险因素Logistic回归分析*

目的 探讨肝细胞癌发病的危险因素。方法 2019年1月～2021年1月青海省第四人民医院消化科和青海大学附属医院介入科确诊为肝细胞癌(HCC)患者150例,收集患者临床资料,采用Logistic回归分析法行单因素和多因素分析。结果 单因素Logistic回归分析显示,年龄、肝癌家族史、饮酒史、血小板计数、HBsAg阳性、血清HBV DNA和肝硬化等7个因素具有显著性意义,多因素Logistic回归分析显示,年龄(P=0.001,OR=1.077)、肝癌家族史(P=0.008,OR=4.351)、血小板计数异常(P=0.004,OR=9.071)、HBsAg阳性(P＜0.001,OR=16.418)、HBV DNA(P=0.004,OR=6.345)和肝硬化(P＜0.001,OR=9.315)为HCC发生的独立危险因素。结论 了解HCC发生的危险因素有助于预防,及时抗病毒和预防肝硬化的发生可能非常有意义。     

Emulating Solar Spectral Reflectance of Natural Leaf with Bionic Leaf Prepared from 4A Zeolite-Derived Ultramarine Green Pigment

The emulation of the reflectance of green leaf in the solar spectral band (300–2500 nm) has garnered increasing attention from researchers. Currently, various materials have been proposed and investigated as potential bionic leaves. However, the problems such as poor weather durability, heavy metal pollution, and complex preparation technology still persist. Herein, a bionic leaf is prepared from an ultramarine green pigment as the functional material, polyvinylidene fluoride (PVDF) as the film-forming material, and LiCl as the humidizer. To prepare the ultramarine green pigment, the sulfur anion is added into the β cage of the 4A zeolite. The mechanisms and properties were discussed based on X-ray diffraction (XRD), scanning electron microscopy (SEM), Raman spectroscopy, and spectroscopic methods. The results show that the as-fabricated bionic leaf based on the 4A zeolite-derived ultramarine green pigment was able to demonstrate a high spectral similarity coefficient of 0.91 with the green leaf. Furthermore, the spectral similarity coefficient was increased to 0.94 after being subjected to a simulated rainforest environment for 48 h, which indicated its high weather durability.     

A Comparative Study of Electron Radiation Responses of Pu2Zr2O7 and La2Zr2O7: An ab initio Molecular Dynamics Study

In this study, the response of Pu₂Zr₂O₇ and La₂Zr₂O₇ to electronic radiation is simulated, employing an ab initio molecular dynamics method. It is shown that Pu₂Zr₂O₇ undergoes a crystalline-to-amorphous structural transition with 0.3% electronic excitation, while for La₂Zr₂O₇, the structural amorphization occurs with 1.2% electronic excitation. During the microstructural evolution, the anion disorder further drives cation disorder and eventually results in the structural amorphization of Pu₂Zr₂O₇ and La₂Zr₂O₇. The difference in responses to electron radiation between Pu₂Zr₂O₇ and La₂Zr₂O₇ mainly results from the strong correlation effects between Pu 5f electrons and the smaller band gap of Pu₂Zr₂O₇. These results suggest that Pu₂Zr₂O₇ is less resistant to amorphization under local ionization rates that produce a low level of electronic excitation, since the level of the concentration of excited electrons is relatively low in Pu₂Zr₂O₇. The presented results will advance the understanding of the radiation damage effects of zirconate pyrochlores.     

Genotoxicity assessment using micronuclei assay in rheumatoid arthritis patients

OBJECTIVES: This study investigated whether: (i) rheumatoid arthritis (RA) patients have more micronuclei (MN) than healthy controls; (ii) methotrexate (MTX) treated RA patients have more MN than those not using MTX, and (iii) folic acid supplementation decreases the number of MN in MTX treated patients. METHODS: MN assays were performed in oral mucosa sweeps of 50 consecutive MTX treated RA patients, 30 consecutive RA patients not receiving MTX and 39 healthy controls. MTX treated RA patients were then randomly placed in a cross-over design to receive folic acid supplementation, and MN assays were repeated after 6 weeks. RESULTS: The MTX-RA patients had a mean age of 46 +/- 10 yrs and a mean disease duration of 12 +/- 9 yrs; 80% were women. The MTX dose range was 8.7 +/- 1.5 mg/week and the mean duration of use was 16 +/- 18 months. In the non-MTX RA group, the mean age was 48 +/- 14 yrs, the mean disease duration was 13 +/- 9 yrs, and 87% were women. At baseline, the number of MN were significantly higher in RA patients as compared with controls (3.31 +/- 2.3 vs 0.8 +/- 0.8, p <0.001). No difference in MN numbers was observed between users and non-users of MTX. Folic acid supplementation did not decrease the MN number in the MTX treated RA patients. CONCLUSIONS: Genotoxicity, as assessed by the MN assay, is increased in RA patients. These results suggest that genotoxicity is associated with RA itself and not with MTX use. Folic acid supplementation had no effect on the number of MN.     

Oral iron chelators--development and application

Iron chelation therapy is the only therapeutic approach that leads to enhanced iron excretion in beta-thalassaemia major and other transfusion-dependent patients. Although desferrioxamine has been used in such treatment over the last three decades, it is not an ideal drug due to its poor oral availability. Consequently extensive research effort has been directed towards the identification of non-toxic, orally active iron chelators. An ideal candidate must possess a range of critical physicochemical and biological properties, such as high selectivity and affinity for iron(III), tightly controlled distribution and metabolic profiles and low toxicity. Unfortunately, hexadentate ligands are generally associated with poor oral bioavailability, whereas many tridentate and bidentate molecules are orally active. The tridentate triazoles have been investigated for clinical potential; they are readily absorbed from the gastrointestinal tract and promote iron excretion with high efficacy. In similar fashion, several bidentate hydroxypyridinones have been demonstrated to possess potential as oral chelating agents.     

Studies on the T4+2H4+ cell of peripheral blood lymphocyte in systemic lupus erythematosus]

The cell surface phenotype of peripheral blood lymphocytes in patients with systemic lupus erythematosus (SLE) was studied with the anti-T4+, T8+ and T4+2H4+ monoclonal antibodies by flow cytometry. 13 patients with active SLE had a markedly low percentage of T4+2H4+ cells but had normal percentage of T8+ cells. Our results reveal that the influence of T cell to B cell is not only because of the quantity of T cells, also because of the function of T cells. The abnormality of T4+2H4+ cells may be important in the pathogenesis of SLE.     

Genetic marking shows that Ph+ cells present in autologous transplants of chronic myelogenous leukemia (CML) contribute to relapse after autologous bone marrow in CML

Relapse after autologous bone marrow transplantation for chronic myelogenous leukemia (CML) can be due either to the persistence of leukemia cells in systemic tissues following preparative therapy, or due to the persistence of leukemia cells in the autologous marrow used to restore marrow function after intensive therapy. To help distinguish between these two possible causes of relapse, we used safety-modified retroviruses, which contain the bacterial resistance gene NEO, to mark autologous marrow cells that had been collected from patients early in the phase of hematopoietic recovery after in vivo chemotherapy. The cells were then subjected to ex vivo CD34 selection following collection and 30% of the bone marrow were exposed to a safety-modified virus. This marrow was infused after delivery of systemic therapy, which consisted of total body irradiation (1,020 cGy), cyclophosphamide (120 mg/kg), and VP-16 (750 mg/m2). RT PCR assays specific for the bacterial NEO mRNA, which was coded for by the virus, and the bcr-abl mRNA showed that in two evaluable CML patients transplanted with marked cells, sufficient numbers of leukemia cells remained in the infused marrow to contribute to systemic relapse. In addition, both normal and leukemic cells positive for the retroviral transgenome persisted in the systemic circulation of the patients for at least 280 days posttransplant showing that the infused marrow was responsible for the return of hematopoiesis following the preparative therapy. This observation shows that it is possible to use a replication-incompetent safety-modified retrovirus in order to introduce DNA sequences into the hematopoietic cells of patients undergoing autologous bone marrow transplantation. Moreover, this data suggested that additional fractionation procedures will be necessary to reduce the probability of relapse after bone marrow transplantation in at least the advanced stages of the disease in CML patients undergoing autologous bone marrow transplantation procedures.