Table of Content

  

10 July 2018
Volume 56 Issue 7

Impact of CDK9 inhibition for T cells on TLR5-targeting monitoring during allorejection

LI Xiaomei, LIANG Ting, ZHANG Chao, CAO Hui, HOU Guihua

Journal of Shandong University (Health Sciences). 2018, 56(7):  1-6.  doi:10.6040/j.issn.1671-7554.0.2017.981

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Objective To explore the impact of T cells Cyclin-dependent kinase 9(CDK9)inhibition on Toll-like receptor 5(TLR5)targeting monitoring of acute allorejection. Methods ¹²⁵I-anti-TLR5 was prepared with Iodogen method. Label rate, stability and cell uptake and dissociation between spleen cells and ¹²⁵I-anti-TLR5 were analyzed. Allografted-SCID mouse models were established through T cells adoptive transferred and were divided into control group and CDK9 inhibition group. Another group of mice were injected with ¹²⁵I-anti-TLR5 before injection of unlabeled anti-TLR5 antibody(100 μL 10 mg/kg body weight)as a blocking group. Allograft survival and graft histopathology were observed. ¹²⁵I-anti-TLR5 was injected through tail vein at the peak of the control group rejection, and the biodistribution and whole-body phosphor-autoradiography were analyzed. Results T cells CDK9 inhibition apparently prolonged allograft survival from(20.00±1.58)d to(28.20±2.77)d, and weaken inflammation and increased expression of TLR5 on allografts. ¹²⁵I-anti-TLR5 was prepared successfully with high label rate(96.2%)and stability(>90% at 72 h). 山 东 大 学 学 报 (医 学 版)56卷7期 -李晓梅,等.抑制T细胞CDK9对TLR5靶向监测同种异体移植排斥的影响 \=-Recipient spleen cells-pretreated with CDK9 inhibitor increased the uptake ratio of ¹²⁵I-anti-TLR5 and reduced the dissociating ratio(P<0.05). Ex vivo biodistribution studies revealed that ¹²⁵I-anti-TLR5 could be accumulated in skin allograft. T/NT ratio(allograft/ oposite skin)of CDK9 inhibition group was higher than that of control group(3.70±0.16 vs 2.02±0.06)at 72 h post injection. Whole-body phosphor-autoradiography imaging showed that clear graft localization was developed at 48 h, lasting longer in CDK9 inhibition group than control group, and no obvious accumulating imaging was noted in blocked group. Conclusion The inhibition of CDK9 on T cells can prolong allograft survival through reducing inflammation and promoting the expression of TLR5 of allograft, which may favor in vivo monitoring of TLR5 targeting acute allorejection.

Effects of Fusobacterium nucleatum gavage on the intestinal microbiota of rats

SONG Lijin, GU Xiang, LI Lixiang, LI Ming, ZUO Xiuli, LI Yanqing

Journal of Shandong University (Health Sciences). 2018, 56(7):  7-14.  doi:10.6040/j.issn.1671-7554.0.2017.929

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Objective To investigate the effects of Fusobacterium nucleatum(F. nucleatum)gavage on the intestinal microbiota of rats. Methods A total of 16 male SD rats were randomly divided into 2 groups: intervention group(n=8)and control group(n=8). The intervention group was treated with F. nucleatum when the rats were 4, 5, 6, 7 and 8 weeks old. The control group was treated with the same dosage of normal saline at the same time. Feces was collected at the end of week 3, 8 and 12 to extract DNA, and then Illumina Miseq platform was used for 16S rRNA gene sequencing. Specific IgA against F. nucleatum in stool was detected with Western blotting. Results There were no significant differences between the two groups in terms of fecal microbial diversity and relative abundance of main phyla in week 3. The microbial diversity of the intervention group was significantly lower than that of the control group in week 8(P=0.009). The relative abundances of Firmicutes and Proteobacteriodes in the intervention group were significantly less than those in the control group(P<0.05), while the relative abundance of Bacteriodes in the intervention group was significantly higher than that in the control group in week 8(P<0.05). In week 12, the intervention group showed higher diversity(P=0.021), and there was no significant difference in the relative abundance of main phyla. Moreover, the treatment of F. nucleatum stimulated the production of specific IgA. Conclusion The F. nucleatum can interfere with intestinal microbiota independent on colonization, and this effect can last for some time. The production of specific IgA induced by F. nucleatum may explain why this bacterium does not colonize in the intestine.

Effects of adenouvirus-mediated HBx on lymphocyte in vitro

BI Tao, LU Qianqian, SUN Chuandong

Journal of Shandong University (Health Sciences). 2018, 56(7):  15-20.  doi:10.6040/j.issn.1671-7554.0.2017.583

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Objective To investigate the replication of adenovirus-mediated hepatitis B virus x gene(Ad-HBx)in lymphocytes and its effects on the secretion of interleukin-10(IL-10)and apoptosis of lymphocytes. Methods In vitro, lymphocytes collected from healthy human peripheral blood were transfected with Ad-HBx(Ad-HBx group)and Ad-EGFP(Ad-EGFP group). Non-treated lymphocytes served as the blank controls(Lymphocyte group). The expression of HBx in lymphocytes was detected with quantitative polymerase chain reaction(Q-PCR). The secretion of IL-10 was assessed with enzyme linked immunosorbent assay(ELISA). The apoptosis of lymphocytes was detected with flow cytometry. Results Q-PCR results showed that the expression of HBx was significantly higher in the Ad-HBx group than in the Ad-EGFP group and Lymphocyte group(P<0.05)48 h after transfection. ELISA results showed that the concentration of IL-10 was significantly lower in the Ad-HBx group than in the Ad-EGFP group and Lymphocyte group 12 h, 24 h, 36 h and 48 h after transfection(P<0.001). Flow cytometry results indicated that the apoptosis rate of Ad-HBx 山 东 大 学 学 报 (医 学 版)56卷7期 -毕涛,等. 腺病毒介导HBx对人淋巴细胞影响的体外实验 \=-group in the early stage was significantly higher than that of the Ad-HBx group and Lymphocyte group(P<0.05). Conclusion In vitro, HBx is highly expressed in healthy human peripheral blood lymphocytes. Ad-HBx inhibits the expression of IL-10 and promotes lymphocyte apoptosis in an early stage. HBx affects the regulation of human immune system possibly through gene expression, promotion of early apoptosis and inhibition of anti-inflammatory cytokines.

Protective effects of DRSAb on ischemia reperfusion induced renal injury in rats

SUN Jingjing, ZHANG Jiangwei, KUANG Peidan, ZHANG Ying, XUE Wujun, ZHENG Jin

Journal of Shandong University (Health Sciences). 2018, 56(7):  21-27.  doi:10.6040/j.issn.1671-7554.0.2017.493

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Objective To explore the protective effects of Na⁺/K⁺-ATPase DR region specific antibody(DRSAb)on ischemia/reperfusion induced renal injury and its mechanism. Methods Spragur-Dawley(SD)male rats were immunized with synthesised DR region peptides to prepare DRSAb. The biological activity of DRSAb was detected with Western blotting, and the mechanism of cell signal transduction was determined with flow cytometry. The activity of HK-2 cells was assessed with MTT. The protective effect of DRSAb on ischemia-reperfusion injury in rat kidney was evaluated with animal models of ischemia-reperfusion injury. Results The results showed that 90.02% of HK-2 cells could bind with DRSAb. The DRSAb immune sera could significantly enchance the tolerance of HK-2 cells to hypoxia, compared with control seara(OD: 0.50±0.03 vs 0.10±0.02, P<0.001). DRSAb could activate PI3K/AKT and PKCε kinase(P<0.001), which could be inhibited by LY294002 and PEAVSLKPT(P<0.001). Animal experiments indicated that DRSAb group demonstrated a significant improvement in renal function with a lower serum creatinine(sCr)and blood urea nitrogen(BUN)levels 3-6 days postoperative compared with the Control group(P<0.001). Histological evaluation showed that the Control group had visible vascular congestion, epithelial cell swelling and extensive tubular necrosis. 山 东 大 学 学 报 (医 学 版)56卷7期 -孙晶晶,等. DRSAb对缺血再灌注损伤大鼠肾脏的保护作用 \=-However, DRSAb group only had slight vascular congestion, mild epithelial cell edema, and no tubular necrosis. Conclusion DRSAb has protective effects against renal ischemia/reperfusion injury in rats, which is associated with the activiation of PI3K/AK and PKCε signalling pathways.

Effects of ginsenosides on the biofilm formation of Staphylococcus aureus

AN Jihong, L(¨overU)Weiling, ZHANG Yongzhou, HAN Shanshan, LIU Qiang

Journal of Shandong University (Health Sciences). 2018, 56(7):  28-32.  doi:10.6040/j.issn.1671-7554.0.2018.013

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Objective To investigate the effect of ginsenoside Rh2 on the biofim formation of Staphylococcus aureus(S.aureus). Methods The biofilm was constructed by using 96-well cell culture plate to study the effect of Rh2 on the biofilm formation of S.aureus, and the effect of Rh2 on the expression of adhesin-related genes of S.aureus was evaluated by RNA extraction and real-time quantitative PCR. The combination of 96-well cell culture plate with crystal violet staining was used to explore the synergistic antibiofilm effects of Rh2 in combination with ciprofloxacin(CIP), gentamicin(GEN)and vancomycin(VAN). Results Rh2 had no effect on the cell growth of S.aureus, while could significantly reduce the biofilm formation(P<0.05)at the concentration of 5 μg/mL. Rh2(10 μg/mL)could significantly inhibit the gene expressions of icaA, icaC and icaD(P<0.05), and promote the inhibitory effects of CIP, GEN and VAN on S.aureus biofilm formation(P<0.05). Conclusion Ginsenoside Rh2 can inhibit the biofilm formation of S. aureus by inhibiting the expressions of adhesion-related genes icaA, icaC and icaD. Rh2 can also promote the inhibitory effects of CIP, GEN and VAN on the biofilm formation of S.aureus.

Effect of nano titanium dioxide and copper ions on the developmental toxicity of zebrafish embryo

LIU Fasheng, HAN Jian, LI Sha, SHANG Hongyuan, MA Min, WANG Rongchun, ZHANG Aiping, HAN Liwen

Journal of Shandong University (Health Sciences). 2018, 56(7):  33-38.  doi:10.6040/j.issn.1671-7554.0.2017.1170

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Objective To investigate the effect of nano titanium dioxide(nano-TiO₂)combined with Cu²⁺ on the developmental toxicity of zebrafish embryos. Methods AB-line zebrafish was used for the animal model, the developmental toxicity of zebrafish embryos was evaluated by the hatching rate at 72 hours post fertilization(hpf), mortality rate at 96 hpf, and malformation rate at 120 hpf. Results Cu²⁺(0.12 - 4 mg/L)showed strong toxic effect on zebrafish embryos, while nano-TiO₂(0 - 200 mg/L)had no significant toxic effect on zebrafish embryos. The zebrafish embryos exposed to nano-TiO₂ and Cu²⁺ showed a degree of developmental toxicity, while the corresponding mortality rate and malformation rate were decreased and hatching rate was increased compared with those exposed to Cu²⁺. Conclusion Compared with Cu²⁺, the combination of nano-TiO₂ and Cu²⁺ shows lower development toxicity on zebrafish embryos.

Effects of implanted cardiac permanent pacemaker on anxiety or depression associated with bradyarrhythmia

ZHAO Ketong, ZHAO Jing, Aiyelabowo Faith, WANG Ying

Journal of Shandong University (Health Sciences). 2018, 56(7):  39-45.  doi:10.6040/j.issn.1671-7554.0.2018.327

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Objective To investigate the effects of implanted cardiac permanent pacemaker on anxiety or depression associated with bradyarrhythmia, and to explore the related risk factors. Methods A total of 212 outpatients with bradyarrhythmia were selected and according to the inclusion and exclusion criteria 198 patients were finally enrolled. According to the comprehensive assessment and patient willingness, patients were divided into control group(n=96)and pacemaker group(n=102). Each patients basic information, medical history, blood biochemical indexes, 24 h Holter monitoring results, and echocardiography results were acquired, and hamilton anxiety scale and hamilton depression scale were completed. The above examinations and questionnaires were completed again after 3 months. The data were collected and compared. Results The installation of cardiac permanent pacemaker significantly reduced anxiety or depression symptoms associated with bradyarrhythmia(P<0.001). Anxiety was significantly and positively correlated with women, age, wakefulness, syncope, the longest R-R interval, smoking, drinking, hypertension and diabetes(P<0.05). Depression was also remarkably and positively correlated with women, age, wakefulness, syncope and diabetes(P<0.05). Conclusion The implantation of cardiac permanent pacemaker can significantly alleviate symptoms of anxiety or depression associated with bradyarrhythmia.

Applicability of Global Lung Function Initiative 2012 reference equations for spirometry to elderly Chinese in Jinan City

LIU Chunhong, TIAN Xinyu, WANG Dexiang, SHI Hui, XIAO Wei

Journal of Shandong University (Health Sciences). 2018, 56(7):  46-50.  doi:10.6040/j.issn.1671-7554.0.2018.141

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Objective To validate the applicability of Global Lung Function Initiative(GLI)-2012 reference values for spirometry to elderly Chinese in Jinan City. Methods Healthy people aged 60-84 without smoking history were recruited and underwent spirometry. FVC(forced vital capacity), FEV₁(forced expiratory volume in one second),FEV₁/FVC, and MMEF(maximal midexpiratory flow)were recorded. Z-scores were computed according to the GLI-2012 reference values. Comparisons of GLI-2012 predicted values and observed values, and lower limit of normal(LLN)computed using GLI-2012 and Zhongshan-2011 equations were performed by paired t test. Results A total of 438 subjects(228 females, 210 males)were completely qualified. The Z-scores of FVC, FEV₁, FEV₁/FVC and MMEF for males were 0.23±1.34, 0.27±1.31, 0.03±0.71, -0.03±0.94, and for females were 0.22±0.95, 0.08±0.89, -0.28±0.65, -0.14±0.90. The predicted mean values of GLI-2012 were in good agreement with observed values. However, the LLN of FEV₁/FVC predicted by GLI-2012 equations was lower than that by Zhongshan-2011. The 95%CI of mean difference for males was(-5.79—-5.55)%(t=-91.310, P<0.001). The proportion of abnormal FEV₁/FVC in the sample was 0.9% in terms of the GLI-2012 LLN, which was similar to the proportion when using(-overx)-3s as the cut off 山 东 大 学 学 报 (医 学 版)56卷7期 -刘春红,等. 全球肺功能倡议预计值对济南市老年人的适用性检验 \=-value(0.7%). Conclusion The GLI-2012 predicted mean values for spirometry are appropriate for the elderly in Jinan City, but it underestimates the LLN and may lead to the missed diagnosis of obstructive ventilatory defects.

Relationship between PSMD6 gene rs831571 locus polymorphism and the susceptibility of T2DM: a case-control study

TIAN Zhongyan, LI Yuqian, LIU Xiaotian, SHI Yuanyuan, ZHANG Haiqing, ZHANG Xia, QIAN Xinling, YIN Lei, ZHAO Jingzhi, WANG Chongjian

Journal of Shandong University (Health Sciences). 2018, 56(7):  51-56.  doi:10.6040/j.issn.1671-7554.0.2017.1267

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Objective To explore the relationship between PSMD6 gene rs831571 locus polymorphism and the susceptibility of type 2 diabetes mellitus(T2DM)in Henan Han population, and to assess interaction between PSMD6 gene rs831571 locus polymorphism and environmental risk factors. Methods The participants were derived from the Rural 山 东 大 学 学 报 (医 学 版)56卷7期 -田忠艳,等.PSMD6基因rs831571位点多态性与2型糖尿病易感性的病例对照研究 \=-Diabetes, Obesity and Lifestyle(RuralDiab)study in China. A total of 1 052 patients with T2DM(T2DM group)and 1 052 participants without T2DM(control group)were included in the present study after a 1∶1 match based on the age and gender. A custom-by-design 2×48-Plcx SNPscan^TM Kit was applied to determine the genotypes of PSMD6 gene rs831571 locus. Logistic regression model was performed to estimate the association between T2DM and PSMD6 gene polymorphism and evaluate the interaction of PSMD6 gene-environmental risk factors. Results Significant difference was observed in the genotype frequencies of PSMD6 gene rs831571 locus in T2DM and control groups(P<0.05). After adjusting smoking, drinking, etc, the genotypes TT(OR=0.623, 95%CI: 0.456-0.853)and CT+TT(OR=0.825, 95%CI: 0.685-0.995)of PSMD6 gene rs831571 locus polymorphism decreased the susceptibility of T2DM. Combined effects analysis revealed that mutant type of MSPD6 with normal BMI or moderate or severe physical activity could attenuate the risk of T2DM, but PSMD6 gene-physical activity and PSMD6 gene-BMI interaction analysis was of no statistical significance(P>0.05). Conclusion PSMD6 gene rs831571 locus polymorphism is associated with the susceptibility of T2DM. In addition, mutant type of PSMD6 with normal BMI or moderate or severe physical activity can attenuate the risk of T2DM. The interactions of PSMD6 gene-physical activity and PSMD6 gene-BMI on T2DM present no statistical significance.

Correlation of Yes-associated protein and the pathological factors of colon cancer

GAO Zhenwen, YANG Shuping, XIE Xuexue, SONG Wei

Journal of Shandong University (Health Sciences). 2018, 56(7):  57-64.  doi:10.6040/j.issn.1671-7554.0.2017.1216

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Objective To investigate the expression of Yes-associated protein(YAP), a new transcriptional coactivator, and its correlation with the clincopathological factors and metastases of colon cancer. Methods A total of 104 paraffin embedded tissues were selected, including 80 colon cancer tissues and 24 metastatic tissues. The protein expressions of YAP and N-cadherin in the tissues were detected with immunohistochemical method. The expressions of YAP, E-cadherin and N-cadherin in six colon cancer cell lines were determined with qRT-PCR and Western blotting. Results There was no significant difference of YAP positive expression between the primary and metastatic colon cancer(P>0.05), while the positive expression of N-cadherin was significantly higher in primary colon cancer than in the metastatic cancer(P<0.05). There was positive correlation between YAP and N-cadherin in primary colon cancer(r=0.5003, P<0.001), but not in the metastatic cancer(r=0.0325, P>0.05). The positive expressions of YAP and N-cadherin were correlated with serosal invasion and distant metastases(P<0.05), not with anatomical and histological type, differentiation, tumor size, lymph node metastases, microvascular invasion, left-sided and right-sided colon cancer (P>0.05). In the six colorectal cancer cell lines(SW480, SW620, SW1116, DLD-1, HT29 and HCT116), there were no differences in the mRNA and protein expressions of YAP(P>0.05). E-cadherin was highly expressed in HT29 and 山 东 大 学 学 报 (医 学 版)56卷7期 -高振文,等.Yes相关蛋白与结肠癌病理因素的相关性 \=-SW1116, and N-cadherin was highly expressed in HCT116 and SW620. Conclusion YAP can promote the development and metastasis of colon cancer by regulating the epithelial-mesenchymal transition.

Application of CDFI in the establishment and evaluation of autogenous arteriovenousfistula

FENG Jingjing, ZHANG Luwei, ZHAO Peng, GUO Ning, TIAN Jun, CUI Xianquan

Journal of Shandong University (Health Sciences). 2018, 56(7):  65-69.  doi:10.6040/j.issn.1671-7554.0.2018.097

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Objective To explore the application value of color Doppler flow imaging(CDFI)in the establishment and evaluation of autogenous arteriovenousfistula(AVF). Methods Theclinical data of 312 patients undergoing AVF during Jan.1, 2016 and Dec.31, 2017 were retrospectively analyzed. According to whether these patients received preoperative CDFI examination,they were divided into the CDFI group and non-CDFI group. In the CDFI group, the diameter and blood flow of the radial artery and cephalic vein were evaluated before and after surgery. The success rate and operation time of the two groups were compared. Results The success rate of surgery was significantly higher in the CDFI group than in the non-CDFI group(99.27% vs 93.71%, P=0.01), while the operation time was markedly shorter ［(52.55±16.35)min vs(65.40±20.25)min, P<0.001］. In the CDFI group, after operation, the diameter of the radial artery ［(0.28±0.03)cm vs(0.20±0.03)cm］and blood flow ［(348.49±64.59)mL/min vs(90.04±61.05)mL/min］, and the diameter of the cephalic vein ［(0.33±0.05)cm vs(0.21±0.04)cm］ and blood flow ［(537.88±102.53)mL/min vs(25.38±18.51)mL/min］were significantly improved(all P<0.001). Conclusion Preoperative CDFI can promote the success rate, and shorten the operation time of AVF. Early postoperative CDFI can detect the diameter of blood vessels and blood flow toevaluate AVF function.

CT and MRI appearances of mixed epithelial and stromal tumor of kidney

ZHANG Lihong, WANG Linsheng, CHEN Dongfeng, CHEN Yueqin, LI Xian, LIU Yanjie, LI Lei

Journal of Shandong University (Health Sciences). 2018, 56(7):  70-75.  doi:10.6040/j.issn.1671-7554.0.2018.021

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Objective To summerize CT and MRI appearances of mixed epithelial and stromal tumor of kidney(MESTK), and to improve the diagnostic accuracy. Methods The clinical and imaging materials of 12 MESTK patients confirmed by pathology were analyzed retrospectively. The patients underwent unenhanced and enhanced CT scan, and four of them underwnt unenhanced and enhanced MRI scan at the same time. Results Twelve cases were all singular, with four located in the right side and eight in the left side; seven leisions were oval, three were round and two were irregular. The diameters of all lesions ranged from 2.5 to 6.4 cm, with a mean value of 4.4 cm. The tumors had well-defined margin and projected to the pelvis on unenhanced CT scan, with six presented solid cystic, 5 thick-wall cystic masses, and 1 thin-wall cystic masses. The solid portions in the masses depicted nodular and mass-like, accounting for 5%-65%, and calcification was found in one case. The tumors presented variably prolonged enhancement on enhanced triple-phased CT scan, with six cases being slightly enhanced, three being markedly enhanced and moderately enhanced. On unenhanced T₁WI and fat-suppressed T₂WI images, four cystic portions appeared hypointesity and hyperintensity, while the solid portions presented slightly hyperintensity and hypointesity, respectively. The tumors also demonstrated variably prolonged enhancement on enhanced T₁WI images. Adjacent renal pelvis and calices were compressed, but without 山 东 大 学 学 报 (医 学 版)56卷7期 -张丽红,等. 肾脏混合性上皮间质瘤的CT和MRI表现 \=-destruction. Conclusion MESTK usually depicts well-defined cystic or solid-cystic mass projecting to renal pelvis, and the amount and shape of its solid portions present diversity. The solid components is variably prolonged enhancement on multiple-phased enhanced CT and MRI. Comprehension the iconography features of MESTK is helpful to improve the diagnostic accuracy.

Dorsal root ganglion pulsed radiofrequency combined with lumbar lateral recess block in the treatment of lumbar spinal stenosis

XING Qianqian, FU Zhijian

Journal of Shandong University (Health Sciences). 2018, 56(7):  76-80.  doi:10.6040/j.issn.1671-7554.0.2017.993

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Objective To investigate the clinical efficacy and safety of dorsal root ganglion(DRG)pulsed radiofrequency(PRF)combined with lumbar lateral recess block in treatment of lumbar spinal stenosis(LSS). Methods A total of 40 patients with LSS treated with DRG-PRF combined with lateral recess block during June 2014 and June 2017 were enrolled as the observation group, and 40 patients with LSS treated with simple lateral recess block served as the control group. The visual analogue scale(VAS)was observed before treatment, 1 week, 1 month, 3 months and 6 months after treatment. The results were graded as excellent, good, fair or poor based on modified MacNab criteria. The possible risk factors affecting the curative effect were analyzed with Logistic regression. The complications and adverse reactions were recorded. Results There were no significant differences between the two groups in age(P=0.646), gender(P=0.823)and VAS scores before treatment(P=0.945). VAS scores decreased significantly after treatment in both groups(P<0.001), but the observation group had a more remarkable decrease 3 months(P=0.011)and 6 months(P=0.040)after trealment. The observation group had higher excellent and good rates 1 month(P=0.014)and 6 months(P=0.013)after treatment than the control group. Logistic regression analysis indicated that the curative effect was better in the observation group. No serious complications were observed in the observation group, while spondylodiscitis occurred in 2 cases in the control group. Conclusion The combination of DRG-PRF and lumbar lateral recess block shows better efficacy than simple lumbar lateral recess block in the treatment of LSS.

Efficacy of transurethral resection of bladder tumor in the treatment of muscle-invasive bladder cancer

LIU Jie, CUI Wei, CHE Zi, CUI Zhiqiang, WANG Cezheng, WANG Tong, LI Ming, LIU Ling, YANG Quancheng, SUN Bin, GAO Dianjun, Nie Qingsheng

Journal of Shandong University (Health Sciences). 2018, 56(7):  81-85.  doi:10.6040/j.issn.1671-7554.0.2018.288

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Objective To investigate the clinical efficacy and safety of transurethral resection of bladder tumor(TURBT)for T2 stage muscle invasive bladder cancer(MIBC). Methods The clinical data of 101 MIBC cases treated during Jan. 2008 and Feb. 2013 were retrospectively analyzed. All tumors were pathologically T2 stage. The patients were divided into the observation group(n=84)and control group(n=17). Patients in the observation received TURBT, during which the bladder wall around the tumor was removed thoroughly, including 1.5 cm bladder mucosa. Patients in the control group underwent radical cystectomy and pelvic lymph node dissection. The recurrence, complications, survival rate and quality of life of the two groups were recorded and compared. Results The average operation time was shorter in the observation group than in the control group［(53.1±10.3)min vs(202.4±31.5)min］. The average hospitalization time was shorter in the observation group than in the control group ［(11.7±1.7)d vs(28.0±4.7)d ］. 山 东 大 学 学 报 (医 学 版)56卷7期 -刘杰,等.经尿道膀胱肿瘤电切术治疗肌层浸润性膀胱癌的临床疗效 \=- The average intraoperative blood loss was less in the observation group than in the control group［(13.7±6.3)mL vs(470.6±143.1)mL］. The differences were statistically significant(P<0.001). The 1-year, 3-year and 5-year survival rate were 97.6%, 84.5%, and 78.5% in the observation group, and were 94.1%, 82.4% and 76.4% in the control group, with no statistical differences(P>0.05). In the observation group, urinary tract infection occurred in 4 cases, who were cured after anti-infection treatment. In the control group, hydronephrosis, ureteral obstruction and acute intestinal obstruction occurred in 1 case respectively. The complication rate and hospitalization costs were lower in the observation group than in the control group. In the observation group, the bladders were preserved, and the quality of life was significantly improved. Conclusion For patients with T2 stage, sporadic, small size(diameter ≤2 cm)MIBC, TURBT is safe and effective, and can improve patients’ quality of life. For patients with multiple, large size(diameter >2 cm)MIBC, radical cystectomy is the first choice.