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Testicular rupture, one of the most common complications in blunt scrotal trauma, is the rupture of tunica albuginea and extrusion of seminiferous tubules. Testicular rupture is more inclined to young men, and injury mechanisms are associated with sports and motor accidents. After history taking and essential physical examination, scrotal ultrasound is the first-line auxiliary examination. MRI is also one of the vital complementary examinations to evaluate testicular rupture after blunt scrotal trauma. Surgical exploration and repair may be necessary when the diagnosis of testicular rupture is definite or suspicious. Postoperative follow-up is to monitor the relief of local symptoms and changes of testicular functions. This review sums up the literatures about testicular rupture after blunt scrotal trauma in recent 16 years and also refers some new advantages and perspectives on diagnosis and management of testicular rupture.

Periodic sequences over finite fields, constructed by classical cyclotomic classes and generalized cyclotomic classes, have good pseudorandom properties. The linear complexity of a period sequence plays a fundamental role in the randomness of sequences. Let p, q, and r be distinct odd primes with gcd(p−1, q−1)=gcd(p−1, r−1)=gcd(q−1, r−1)=2. In this paper, a new class of generalized cyclotomic sequence with respect to pqr over GF(2) is constructed by finding a special characteristic set. In addition, we determine its linear complexity using cyclotomic theory. Our results show that these sequences have high linear complexity, which means they can resist linear attacks.

To evaluate the efficacy and safety of bipolar and monopolar transurethral resection of bladder tumor (TURBT) procedures for non-muscle invasive bladder cancer (NMIBC) patients.We searched for all studies investigating bipolar TURBT and monopolar TURBT for NMIBC patients in PubMed, Web of Knowledge, and the Cochrane Central Search Library. A systematic review and meta-analysis were performed. Efficacy was assessed by catheterization time, resection time, pathology, and recurrence rate. Safety was assessed by obturator nerve reflex, bladder perforation, hemoglobin decrease, and transfusion.Our searches identified eight studies. Bipolar TURBT is associated with decreased resection time, catheterization time, and hemoglobin changes. There were no statistically significant differences between bipolar TURBT and monopolar TURBT for rates of obturator nerve reflex, bladder perforation, and transfusion. The grade of cautery artifact had no different between the two procedures or even was lower in the bipolar arm. There was no significant difference in recurrence rate when comparing the two procedures.This systematic review indicates that the bipolar technique is more efficacious and safer for NMIBC patients. More large-scale, multicenter, randomized controlled studies are needed before final clinical recommendations can be made.

The refinement of the microstructure and uniform distribution of RE-rich intermetallic compounds are beneficial for strengthening and toughening the rare earth (RE) containing Mg alloy castings. A novel Mg–3RE–6Zn–1.4Y alloy was designed, and fabricated by rheo-squeeze casting (RSC) in this research. The semi-solid slurry used in the process was treated by direct ultrasonic vibration (DUV) and then casted with squeeze casting. The microstructure evolution and mechanical properties of the RSC alloy with different pressures were investigated. The RE-rich intermetallic compounds were analysed by X-ray diffraction (XRD), energy dispersive spectrometer (EDS) and transmission electron microscope (TEM). The results indicate that the increase of the pressure not only contributes to the refinement of α-Mg grains but also results in the increasing solid solubility in the matrix and uniform distribution of RE-rich intermetallic compounds along the grain boundary. The tensile properties increase continuously with the increase of applied pressure. The yield strength (YS), ultimate tensile strength (UTS) and elongation of RSC sample under 200 MPa pressure are 110 MPa, 180 MPa and 8.6%, which are improved by 17.0%, 19.2% and 81.7% respectively than the corresponding values of the samples without pressure. Keywords: Mg–RE alloy, Ultrasonic vibration, Rheo-squeeze casting, Pressure

The effects of Mn content on the oxidation behaviour of a Co-base superalloy with compositions of Co–29Cr–21Ni–23Fe–2.2Nb–1.6Si– x Mn ( x = 0, 0.5, 1, 2) (Co22 alloy for short, wt.%) have been studied. Isothermal oxidation behaviour was investigated, and it showed kinetics of the Mn-containing samples followed a two-stage parabolic law. In the absence of Mn, scales on Co22 alloys consisted mainly of Cr 2 O 3 and SiO 2 , and small amounts of Fe–Cr, Ni–Cr spinel nodules formed on the surface. When Mn was added, a triple oxide layer could be observed, consisting of Mn–Cr spinel as outer layer, Cr 2 O 3 as middle layer and SiO 2 in the innermost layer.

The work aims to study the effect of temperature on friction and wear properties of TiB2-50 mass%Ni coatings. TiB2-50Ni ceramics-metal composite coatings were fabricated on 304 stainless steel substrate by high velocity oxygen flame spraying (HVOF) with “shell and core type” Ni coated TiB2 powder. Microstructure, element map distribution and phase structure of HVOF coatings were characterized by SEM, EDS and XRD, respectively. High temperature friction and wear properties of TiB2-50Ni composite coatings and 304 stainless steel substrates were systematically investigated. Porosity, thickness, average surface roughness, micro-hardness and bond strength of HVOF TiB2-50Ni coating are 2.3%, 300.8 μm, 2.3 μm, 766.1 HV and 22.6 MPa, respectively. Values of nano-indentation hardness (H), Young's modulus (Er), ratio of hardness to elastic modulus (H/Er), yield strength (H3/Er2) and elastic recovery (η) of HVOF coatings are all higher than those of 304 stainless steel matrix. The friction coefficient of 304 stainless steel substrate fluctuates greatly with wear rate being increased sharply during high temperature wear test. However, the friction coefficient of HVOF TiB2-50Ni coating without significant fluctuation from room temperature to 600 °C. The wear rate of HVOF coating at 600 °C is (2.73 ± 0.01) × 10−5 mm3/N·m, which is about a quarter of the wear rate of 304 stainless steel substrate of (11.07 ± 0.01) × 10−5 mm3/N·m. As friction temperatures increasing from room temperature to 150 °C, 300 °C, 450 °C and 600 °C, oxygen contents of worn surfaces of TiB2-50Ni coatings increased from 5.10 mass% to 10.88 mass%, 20.40 mass%, 31.21 mass% and 38.78 mass%, respectively. Abrasive wear, adhesion wear and oxidation wear are the main wear mechanisms of HVOF TiB2-50Ni coatings during high temperature friction test. Comparing to 304 stainless steel matrix, TiB2-50Ni composite coating has more superior high temperature friction and wear properties.

The thermal degradation of lignin for value-added fuels and chemicals is important for environment improvement and sustainable development. The impact of pretreatment and catalysis of Ni(NO3)2 on the pyrolysis behavior of organsolv lignin were studied in the present work. Samples were pyrolyzed at 500 ∘C with an upward fixed bed, and the characteristics of bio-oil were determined. After pretreatment by Ni(NO3)2, the yield of monophenols increased from 23.3 wt.% to 30.2 wt.% in &ldquo, Ni-washed&rdquo, and decreased slightly from 23.3 wt.% to 20.3 wt.% in &ldquo, Ni-unwashed&rdquo, Meanwhile, the selective formation of vinyl-monophenols was promoted in &ldquo, which indicated that the existence of nickel species promoted the dehydration of C-OH and breakage of C-C in pyrolysis. In comparison with &ldquo, Water&rdquo, HHV of bio-oil derived from &ldquo, slightly increased from 27.94 mJ/kg to 28.46 mJ/kg, suggesting that the lowering of oxygen content in bio-oil is associated with improved quality. Furthermore, the content of H2 in gas products dramatically increased from 2.0% to 7.6% and 17.1%, respectively.

The internal friction of Cu50Zr50 metallic glass nano-pillars was investigated by using molecular dynamics simulations. An unusual non-monotonic variation of internal friction is revealed against the size of the specimen, which differs significantly from that of the bulk metallic glass. Meanwhile, by analyzing the rearranged atoms with high mobility, which play a vital role in affecting the internal friction, it is found that the rearrangement of surface atoms is more significant than that of the bulk ones, and their fraction depends on the sample size as well. With reducing the sample size, the fraction of rearranged atoms in the surface region increases, which could be described by an exponential equation. This finding suggests that the size dependence of internal friction originates directly from the different fractions of the rearranged atoms in the surface region of nano-pillars. Furthermore, a phenomenological model was established to describe the internal friction of the nano-pillars against their diameters. The presented results provide a quantitative insight into the size effect on internal friction in nanoscale metallic glasses, also shedding light on the atomistic mechanism of surface relaxation of amorphous solids.

Objectives To reveal the role of circular RNA (circRNA) DOCK1 (circDOCK1) as a potential biomarker and therapeutic target and its competing endogenous RNA mechanism in bladder carcinoma (BC). Methods The next‐generation sequencing (NGS) technology was introduced to screen the circRNA expression profiles of BC using microarray. qPCR and Western blots assay were employed to measure the gene expression in different groups. Cell counting kit‐8, EdU and transwell assays were applied to detect the cell viability, proliferation and migration potential, respectively. Luciferase reporter assay was used to test the binds between hsa‐miR‐132‐3p/Sox5. Xenografted tumour growth of nude mice was performed to test the role of circDOCK1 in vivo. Results CircDOCK1 was upregulated in BC tissues and cell lines. Repression of circDOCK1 reduced cell viability, inhibited cell proliferation and curbed the cell migration potential of BC cell. CircDOCK1 played its role via regulation of circDOCK1/hsa‐miR‐132‐3p/Sox5 pathway in BC cells. Suppression circDOCK1 inhibited the tumour growth in vivo. Conclusion In this study, we revealed that circDOCK1 affected the progression of BC via modulation of circDOCK1/hsa‐miR‐132‐3p/Sox5 pathway both in vitro and in vivo and providing a potential biomarker and therapeutic targets for BC.

Background/aims: Emerging evidence showed the long noncoding RNA X-inactive specific transcript (lncRNA XIST) may play a crucial role in various cancers. However, its prognostic value in cancer patients remains controversial. Therefore, we performed an in-depth meta-analysis to investigate the potential clinical value of lncRNA XIST as a prognostic marker for cancer patients. Methods: A comprehensive literature search was performed from PubMed, Embase and the Cochrane Central Search Library by January 2018. Pooled hazard ratios (HRs) or odds ratios (ORs) with 95% confidence interval (95% Cl) were calculated to evaluate the prognosis as well as clinicopathological parameters of XIST, respectively. Results: A total of 18 retrospective studies with 1351 cancer patients were included. Current meta-analysis revealed that elevated lncRNA XIST expression was associated with poor overall survival (OS) (HR = 2.14, 95% CI = 1.26–3.64; P = .005) and disease free survival (DFS) (HR = 4.52, 95% CI = 1.42–14.37; P = .011). The clinicopathological parameters analysis demonstrated that increased XIST expression was significantly associated with tumor size (OR = 2.93, 95% CI = 2.24–3.84; P

The basis of learning urology is to master the anatomy of the reproductive system. We can be outstanding surgeons only when clear maps of anatomy are carved in our minds. The aim of this chapter is to elaborate the applied anatomy of the scrotum, testis, epididymis and spermatic cord in the male reproductive system.

This chapter presents how the Chang’E-1 Topographic Atlas of the Moon (Li et al. in The Chang’E-1 topographic atlas of the Moon. Sinomaps Press, Beijing China, 2013; Li et al. in The Chang’E-1 topographic atlas of the Moon. Springer, Berlin, 2016) was designed and produced covering map designing, data processing, atlas editing, and publishing subtasks. Under this mapping framework, China’s Lunar Exploration Program has released several maps and atlases with high efficiency and will carry out mapping of Mars in the future. The tasks described here can be used for any planetary map, from map design to map publishing.

Introduction The study was carried out to examine the expression of ataxia telangiectasia mutant (ATM) of clear cell renal cell carcinoma (ccRCC), and to explore the relationship between the expression of ATM and the clinicopathologic parameters and prognosis of ccRCC. Materials and Methods Clinicopathologic data of the patients with ccRCC were collected from January 2011 to August 2015 in Xiangya Hospital, Central South University. The immunohistochemical method was used to detect the expression of ATM in ccRCC and adjacent tissues. The Kaplan-Meier survival method and log-rank test were used to analyze the relationship between ATM expression and the survival time of the patients with ccRCC. Univariate and multivariate Cox regression analysis was used to evaluate the risk factors for the prognosis of ccRCC. Results A total of 110 patients were selected in this study, including 73 men and 37 women. The expression of ATM in ccRCC is significantly lower than that in adjacent tissues. Further analysis found that the expression of ATM in the ccRCC tissues above grade II was lower than that of grade II or below. Kaplan-Meier survival analysis showed that the total survival time of the ATM low expression group was significantly shorter than that of the ATM high expression group. The multivariate Cox regression analysis showed that expression of ATM and clinical stage were independent factors affecting the prognosis of ccRCC. Conclusion ATM expression level could serve as an independent risk factor for the prognosis of ccRCC and could be considered as a potential therapeutic target of ccRCC.

Circular RNA_0001313 (circ_0001313), also known as circCCDC66, is a novel circRNA that recently found to be upregulated in colon cancer tissues and promote colon cancer progression. However, the role of circ_0001313 in regulating radio-sensitivity of colon cancer and its molecular mechanism remain undetermined. Here we found circ_0001313 was significantly upregulated and miR-338-3p was downregulated in radio-resistant colon cancer tissues compared to radio-sensitive tissues. Radiation treatment in colon cells triggered a remarkable upregulation of circ_0001313 and a downregulation of miR-338-3p. Knockdown of circ_0001313 reduced cell viability, colony formation rate and increased caspase-3 activity in colon cancer cells under irradiation. Moreover, circ_0001313 act as a sponge for miR-338-3p in colon cancer cells. Furthermore, miR-338-3p could reverse the effects of circ_0001313 knockdown on cell viability, colony formation, and caspase-3 activity. These findings revealed that knockdown of circ_0001313 could induce radio-sensitivity of colon cancer cells by negatively regulating miR-338-3p.

Bladder cancer (BCa) is one of the most prevalent cancers of the urinary system worldwide. Accumulating evidence suggests that long noncoding RNAs (lncRNAs) perform a vital function in the pathogenesis and progression of BCa. In the current study, we identified a novel lncRNA OXCT1-AS1 and investigated its role and potential mechanisms in BCa. The microarray results showed the expression of lncRNAs, microRNAs, and messenger RNAs between BCa primary tumor tissues and metastatic lymph nodes were significantly different. The quantitative polymerase chain reaction verification was performed to ensure the reliability of the screening results. The Cell Counting Kit 8 and transwell assay were used to assess the tumor cell proliferation and invasion abilities in vitro, respectively. The dual-luciferase activity assay was performed to investigate the potential mechanism of competing endogenous RNA network. lncRNA OXCT1-AS1, which elevated in metastasis lymph node, was significantly upregulated in BCa cell lines compared with SVHUC-1. We demonstrated OXCT1-AS1 inhibited miR-455-5p to decrease its binding to the JAK1 3'-untranslated region, which could upregulate the expression of JAK1 at the protein level, thus promoting BCa proliferation and invasion. Therefore, lncRNA OXCT1-AS1 could act as a potential biomarker and therapeutic target for patients with BCa.

OBJECTIVES: This study aims to define a radiomic signature for pre-operative differentiation between subclinical pheochromocytoma (sPHEO) and lipid-poor adrenal adenoma (LPA) in adrenal incidentaloma. The goal was to apply a predictive, preventive, and personalized medical approach to the management of adrenal tumors. PATIENTS AND METHODS: This retrospective study consisted of 265 consecutive patients (training cohort, 212 (LPA, 145; sPHEO, 67); validation cohort, 53 (LPA, 36; sPHEO, 17)). Computed tomography (CT) imaging features were evaluated, including long diameter (LD), short diameter (SD), pre-enhanced CT value (CT(pre)), enhanced CT value (CT(post)), shape, homogeneity, necrosis or cystic degeneration (N/C). Radiomic features were extracted and then were used to construct a radiomic signature (Rad-score) and radiomic nomogram. The area under the receiver operating characteristic curve (AUC) was used to evaluate their performance. RESULTS: Sixteen of three hundred forty candidate features were used to build a radiomic signature. The signature was significantly different between the sPHEO and LPA groups (AUC: training, 0.907; validation, 0.902). The radiomic nomogram based on enhanced CT features (M1) consisted of Rad-score, LD, SD, CT(pre), shape, homogeneity and N/C (AUC: training, 0.957; validation, 0.967). The pre-enhanced CT features based radiomic nomogram (M2) included Rad-score, LD, SD, CT(pre), shape, and homogeneity (AUC: training, 0.955; validation, 0.958). CONCLUSIONS: Our radiomic nomograms based on pre-enhanced and enhanced CT images distinguished sPHEO from LPA. In addition, the promising result using pre-enhanced CT images for predictive diagnostics is important because patients could avoid the additional radiation and risk associated with enhanced CT. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13167-018-0149-3) contains supplementary material, which is available to authorized users.

Objective: Previous studies indicated potential associations between polymorphisms in genes of VEGF/hypoxia/angiogenesis pathway and risk of urogenital carcinomas However, the results were controversial and inconclusive. Here, we conducted an in-depth meta-analysis to investigate the precise associations between polymorphisms in VEGF/hypoxia/angiogenesis related genes and risk of urogenital carcinomas. Methods: We searched PubMed, Web of Science, EMBASE, and Cochrane Library to identify all eligible publications. Pooled odds ratios (ORs) corresponding with the 95% confidence intervals (CIs) were calculated to evaluate their associations. Subgroup analysis was conducted to further ascertain such relationship and investigate sources of heterogeneity. Results: In the end, a total of 96 case-control studies fulfilled the inclusion criteria were enrolled for 12 polymorphisms in 4 VEGF/hypoxia/angiogenesis related genes. The pooled results showed eNOS-rs2070744 polymorphism conferred a significantly increased overall risk of urogenital carcinomas in allele, homozygote, and recessive models, respectively. In addition, eNOS-Intron 4a/b VNTR polymorphism was identified related to an increased risk of urogenital carcinomas in recessive model. And VEGF-rs699947 polymorphism was also identified an increased risk of renal cell carcinoma (RCC) in allelic, heterozygote, dominant, homozygote, and recessive models. Conclusion: To conclude, eNOS-rs2070744 and eNOS-Intron 4a/b VNTR polymorphisms are risk factors for urogenital carcinomas. VEGF-rs699947 polymorphism was also identified as an increased risk factor for renal carcinoma.

Sublytic C5b-9 formation on glomerular mesangial cells in rat Thy-1 nephritis (Thy-1N), a model of human mesangioproliferative glomerulonephritis, is accompanied by the production of proinflammatory cytokines, but the relationship between sublytic C5b-9 and cytokine synthesis and the underlying mechanism remains unclear. To explore the problems mentioned above, in this study, we first examined the levels of proinflammatory ILs (e.g., IL-23 and IL-36a) as well as transcription factor (KLF4) and coactivator (PCAF) in the renal tissues of Thy-1N rats and in the glomerular mesangial cell line (HBZY-1) stimulated by sublytic C5b-9. Then, we further determined the role of KLF4 and PCAF in sublytic C5b-9–induced IL-23 and IL-36a production as well as the related mechanism. Our results showed that the levels of KLF4, PCAF, IL-23, and IL-36a were obviously elevated. Mechanistic investigation revealed that sublytic C5b-9 stimulation could increase IL-23 and IL-36a synthesis through KLF4 and PCAF upregulation, and KLF4 and PCAF could form a complex, binding to the IL-23 or IL-36a promoter in a KLF4-dependent manner, causing gene transcription. Importantly, KLF4 acetylation by PCAF contributed to sublytic C5b-9–induced IL-23 and IL-36a transcription. Besides, the KLF4 binding regions on IL-23 or IL-36a promoters and the KLF4 lysine site acetylated by PCAF were identified. Furthermore, silencing renal KLF4 or PCAF gene could significantly inhibit IL-23 or IL-36a secretion and tissue damage of Thy-1N rats. Collectively, these findings implicate that the KLF4/PCAF interaction and KLF4 acetylation by PCAF play a pivotal role in the sublytic C5b-9–mediated IL-23 and IL-36a production of Thy-1N rats.

Objective: To evaluate the feasibility and accuracy of machine learning based texture analysis of unenhanced CT images in differentiating subclinical pheochromocytoma (sPHEO) from lipid-poor adenoma (LPA) in adrenal incidentaloma (AI). Methods: Seventy-nine patients with 80 LPA and 29 patients with 30 sPHEO were included in the study. Texture parameters were derived using imaging software (MaZda). Thirty texture features were selected and LPA was performed for the features selected. The number of positive features was used to predict results. Logistic multiple regression analysis was performed on the 30 texture features, and a predictive equation was created based on the coefficients obtained. Results: LPA yielded a misclassification rate of 19.39% in differentiating sPHEO from LPA. Our predictive model had an accuracy rate of 94.4% (102/108), with a sensitivity of 86.2% (25/29) and a specificity of 97.5% (77/79) for differentiation. When the number of positive features was greater than 8, the accuracy of prediction was 85.2% (92/108), with a sensitivity of 96.6% (28/29) and a specificity of 81% (64/79). Conclusions: Machine learning-based quantitative texture analysis of unenhanced CT may be a reliable quantitative method in differentiating sPHEO from LPA when AI is present.

Resveratrol possesses a wide spectrum of pharmacological properties and has been an ideal alternative drug for the treatment of different cancers, including prostate cancer. However, the mechanisms by which resveratrol inhibits the growth of prostate cancer are still not fully elucidated. To understand the effect of resveratrol on the apoptosis and the epithelial-to-mesenchymal transition (EMT) of prostate cancer as well as its related mechanism, we investigated the potential use of resveratrol in PC-3 prostate cancer cells in vitro using real-time PCR, fluorescence-activated cell sorting, Western blotting, etc. Resveratrol suppresses the PC-3 prostate cancer cell growth and induces apoptosis. Resveratrol also influences the expression of EMT-related proteins (increased E-cadherin and decreased Vimentin expression). Finally, resveratrol also suppressed Akt phosphorylation in PC-3 cells. This study indicates that resveratrol may be a potential anti-cancer treatment for prostate cancer; moreover, it...

We investigated the treatment outcomes of laparoscopic vesicovaginal fistula repair (LVVFR) in patients with supratrigonal vesicovaginal fistula (VVF) in contrast with open transperitoneal vesicovaginal fistula repair (OVVFR).We analyzed 58 VVF repairs from June 2005 to July 2014, with 22 patients in the LVVFR group and 36 in the OVVFR group. Demographic parameters, operative variables, and perioperative outcomes were retrospectively collected and analyzed. The chi-square test, Fisher's exact test, Student's t test and the Mann-Whitney U test were used for statistical analysis.Patients in both groups had comparable preoperative characteristics. Significantly shorter hospital stay (5.6 vs. 13.2 days, p 0.05) and less blood loss (52 vs. 103 ml, p 0.05) were observed in LVVFR group. Patients in the LVVFR group achieved a higher overall VVF success rate (95.5 % vs. 83.3 %, p 0.05) and recurrent VVF success rate (90.0 % vs. 75.0 %, p 0.05) than OVVFR group, but it was not statistically significant. Patients who underwent OVVFR experienced more postoperative symptomatic bladder spasms (8.3 % vs. 4.5 %, p 0.05), urinary tract infections (UTIs) (5.6 % vs. 0.0 %, p 0.05), and stress urinary incontinence (SUI) (5.6 % vs. 4.5 %, p 0.05), but fewer incidents of postoperative ileus (0.0 % vs. 4.5 %, p 0.05) than the LVVFR group; differences were not significant.Judging from this initial trial, LVVFR should be recommended as the primary intervention to treat supratrigonal VVF patients in view of its reduced blood loss and hospital stay.

To evaluate the effect of saphenous vein sparing during bilateral inguinal lymphadenectomy (BIL) for penile carcinoma patients.Between May 2011 and May 2013, 23 patients with penile carcinoma who underwent laparoscopic prophylactic BIL were included. All patients were randomized to receive the laparoscopic prophylactic inguinal lymphadenectomy with saphenous vein sparing on one limb and saphenous vein ligated on the other limb. Short-term and long-term complications were compared between the two groups.There was no significant difference between the two groups in operation time, harvested number of nodes and incidence of positive nodes. Saphenous vein preservation technique significantly reduced the morbidity of acute lymphedema and lower limb lymphedema after BIL. There was no difference between the two groups in acute cellulitis, seroma, wound breakdown, deep venous thrombosis and cellulitis. One patient developed a local recurrence at the 9 months after lymphadenectomy.Our preliminary findings suggest that laparoscopic prophylactic BIL with saphenous vein sparing is beneficial in patients with penile carcinoma by reducing the incidence of short-term and long-term postoperative complications.

The aim of the present study was to investigate whether the expression levels of CC-chemokine receptor 7 (CCR7) combined with computed tomography (CT) was associated with lymph node metastasis in bladder transitional cell carcinoma (BTCC). For this purpose, 115 cases of BTCC were analyzed at the Department of Urology of Xiangya Hospital, Central South University (Changsha, China). Preoperative CT scans of abdomen and pelvis, immunohistochemistry of CCR7 expression in the tumor specimens and pathological findings for lymph node metastasis were assessed. In addition, the sensitivity, specificity and accuracy of CCR7 and CT for the diagnosis of lymph node metastasis in BTCC were evaluated separately and jointly. The expression levels of CCR7 were observed to be significantly higher in BTCC than in normal controls (P

The agglomerated MoSi 2 powders, ideal for air plasma spraying, were prepared by spray drying and subsequent vacuum sintering of ultrafine MoSi 2 powders. The apparent density and flowability were measured by an apparent density instrument and a hall flowmeter. The structure of as-prepared powders and coatings was analyzed by X-ray diffraction and scanning electron microscopy. The results indicated that resultant powders were spherical and porous. It was found that heat treatment had decreased the sphericity as well as the porosity of the MoSi 2 particles. The agglomerated powders, sintered at 1300 °C for 1 h, showed 57.0% and 46% more flowability and apparent density, respectively, compared to that of the spray dried powders. The as-sintered MoSi 2 powders subjected to the plasma flame exhibited a further increase in the density. The as-sprayed coating by using the agglomerated powders with a size of 30–54 μm yielded a network structural MoSi 2 composite coating with MoSi 2 as the major phase.

While B cells in the tumor microenvironment may play important roles in cancer progression, their impacts on the bladder cancer (BCa) metastasis remain unclear. Here we found from human clinical BCa samples that BCa tissues could recruit more B cells than the surrounding normal bladder tissues and the in vitro co-culture assay also demonstrated that B cells could be recruited more easily towards BCa cells compared to normal bladder cells. Chamber invasion and 3D invasion assays showed the recruited B cells could then significantly increase the BCa cell invasion. Mechanism dissection found that recruited B cells could increase IL-8/androgen receptor (AR) signals in BCa cells that could then promote the expression of metastasis genes including MMP1 and MMP13. Blocking the IL-8/AR/MMPs signals either by anti-IL-8 neutralizing antibody, AR-siRNA, or MMPs inhibitors all partially reversed the infiltrating B cells capacity to increase the BCa cell invasion. The in vivo data from orthotopically xenografted BCa mouse model also confirmed that infiltrating B cells could increase BCa cell invasion via increasing AR signals. Together, these results demonstrate the key roles of B cells within the bladder tumor microenvironment that increase the BCa metastasis and may help us to develop the potential therapies via targeting these newly identified IL-8/AR/MMPs signals to better battle the BCa progression.

A protective MoSi2 coating on Nb substrate was prepared by air plasma spraying and annealing followed by siliconizing. The influence of annealing for plasma-sprayed Mo layer on the subsequent preparation of MoSi2 coating was investigated. Oxidation behavior of the MoSi2 coating was investigated at 1200 °C in air. Phase constituents and microstructure of the MoSi2 coating were characterized by x-ray diffraction and scanning electron microscopy. High-temperature annealing significantly decreases the porosity of the as-sprayed Mo coating (from 9.6 to 2.1%). After vacuum annealing, the splat boundaries and lamellar microstructure of the as-sprayed coating disappear and the recrystallized structure of the Mo coating appears. The MoSi2 coating falls off from the surface of the as-sprayed Mo coating during siliconizing process. The MoSi2 coating prepared on the annealed Mo layer surface has a dense microstructure, which shows a good interface bond between the coating and the Nb substrate. The coating has a multilayer structure, with MoSi2 outer layer, Mo middle layer, and Mo-Nb alloy inner layer. The MoSi2 coating exhibits an excellent oxidation resistance at 1200 °C in air.

Problem-based learning (PBL) is an approach to learning that is used to a greater degree in many medical schools worldwide. It surpasses traditional teaching not only in fostering understanding and the retention of knowledge,1 but also in developing social and cognitive abilities.2 However, it has limitations including more time consumption,3 concerns about overlooking things, the high self-motivation required and a predominating uncertainty about the breadth and depth of learning without a syllabus.4 How to avoid these shortcomings interests many medical workers. Not long ago, we have put forward WeChat-PBL teaching, which has proved efficient in overcoming its disadvantages.5 Now, we suggest some tips to exert its best benefits in WeChat-PBL teaching.

Problem-based learning (PBL) is an instructional student-centered approach which utilizes carefully constructed real-world, ill-defined problems as a context for students to extend their prior experiences and knowledge through discussion and self-directed and collaborative learning that fosters the development of problem-solving and reasoning skills.1 Compared with traditional lecture-dominant teaching and learning approaches, PBL prompts students to actively engage not only in knowledge construction and develop competencies across multiple contexts,2,3 but also in self-directed learning and general work-related skills.4 PBL has a large contribution to medical education, but it has limitations. It is considered less effective than traditional learning methods because it is time-consuming.5 Other obstacles to the popularity of PBL include a predominating uncertainty about the breadth and depth of learning without a syllabus, concerns about overlooking things, and the high self-motivation required.6 So implementations of PBL is highly desirable. It is well known that Facebook and Twitter are introduced into medical education in colleges and universities in the western countries,7 achieving great success. Recently, Chinese medical educators are actively exploring new teaching methods to adapt to the social development. New media, WeChat,8 have been widely utilized in medical schools and exert a positive influence. WeChat is the most popular platform visited daily by university students in China. It is currently recognized as the best social networking site used by people of all ages and professions in China. WeChat is connecting more than a half billion Chinese people now. Apart from free chat, WeChat’s large-scale network platform hosts a vast amount of user-generated data, including text, voice call, video, and images. Group chat is perfect for professional online discussion. Its characteristics of convenience, promptness, and good cross-platform support enrich and simplify the communication model to offer WeChat application users communication that is more prompt.9 WeChat, owing to its immediate communication and source sharing, break the spatial and temporal limitations and change the teaching mode of the traditional classroom, making communication more convenient. The teaching mode of WeChat combined with PBL Ethics Review is used for a ongoing prospective study comparing WeChat-PBL and PBL. It is not necessary to the present descriptive study. The teacher divides all students into several WeChat groups with 3-4 students per group. After obtaining written agreement from patients, the teacher collects their clinical data, including basic information, chief complaint, symptoms, signs, and laboratory examinations. These data are presented in words. Imaging data and surgery materials are presented in images and video, respectively. The teacher delivers the materials and questions to the WeChat groups before class. The students research this material individually and then discuss the questions with each other in their small WeChat group. They can communicate and exchange ideas with their WeChat group colleagues to solve the problems. One representative of each group shows their discussion and conclusions in a slide show to the classroom. The teacher makes comments about their work. Students can further discuss their experiences after class to enhance the teaching effects.

Background: Adrenalectomy is standard of care for phaeochromocytomas, but for bilateral phaeochromocytoma, the recommendations are inconsistent. However, large studies systematically investigating long-term outcomes for total adrenalectomies compared to those for patients with adrenal-sparing operations are lacking. Methods: A multi-center consortium-based registry was established to study clinical, genetic and surgical data in 623 patients with bilateral phaeochromocytomas. Findings: Of 623 patients, median age at diagnosis was 30 (range 3-79) years and 48% were female. Synchronous bilateral phaeochromocytomas were diagnosed in 396 patients and metachronousphaeochromocytomas in 227 (36%); interval to second operations were up to 40 (median 6) years. In 96% of tested patients germline mutations were detected in the genes RET (56%), VHL (34%), and others (10%). Of 849 operations, 385 (45%) surgeries in 326 patients were planned as adrenal-sparing which was successful in 251. 372 patients became steroid-dependent. Follow-up was up to 53 (median 11) years. Adrenal crises developed in 67 patients (18%) during follow-up, and 49 (13%) had manifestations of iatrogenic Cushing syndrome. Of the steroid-independent patients, 34 (14%) had developed another phaeochromocytoma within the remnant adrenal after up to 27, median 8 years, all treated with removal of the new phaeochromocytoma. Overall survival was mainly influenced by non-phaeochromocytoma comorbidities, whereas only 1% died of metastatic phaeochromocytoma. Cortical-sparing operations did not affect survival. Interpretation: Cortical-sparing operations avert lifelong steroid-dependency without affecting survival. Preoperative genetic testing is recommended even in unilateral phaeochromocytoma presentations to identify patients at heritable risk, to guide surgical approach, and inform for gene-specific extra-adrenal morbidities. Funding Statement: Supported in part by the grant AZV 16-32665A to Sarka Dvorakova and Petr Vlcek, and the Blank Foundation to Charis Eng. Declaration of Interests: None of the authors have relevant conflicts of interest. Ethics Approval Statement: The institutional review boards for human subjects’ protection or ethical committees of all participating centers approved this study. Patients provided written informed consent according to the protocols of respective institutional review boards. In The Netherlands data were collected anonymously, and no further Institutional Review Board approval is required.

Afatinib is a highly selective, irreversible inhibitor of the epidermal growth factor receptor (EGFR) and human EGFR 2 (HER-2). Although preclinical and clinical studies have indicated that afatinib has antitumor activity and clinical efficacy in non-small cell lung carcinoma, head and neck squamous cell carcinoma and breast cancer, there are few studies investigating its inhibitory effect on human bladder carcinoma cells. In this study, the antitumor effect of afatinib was investigated on the T24 bladder cancer cell line. The T24 bladder cancer cell line was treated with afatinib at various concentrations (0, 1, 5, 10 and 20 µmol/l). MTT assay was used to estimate the proliferation of the T24 cells; flow cytometric analysis was used to estimate the effect of afatinib on T24 cell apoptosis; cell invasion ability was assessed by a Transwell invasion assay; and western blot analysis was used to detect the expression of Bcl-2, Bax, Akt, extracellular-signal-regulated kinase (ERK)1/2, matrix metalloproteinase (MMP)-2 and MMP-9. The MTT assay demonstrated that afatinib inhibited the proliferation of T24 cells in a dose- and time-dependent manner. Flow cytometric analysis revealed that the cell apoptosis rate increased as the concentration of afatinib increased. The cell invasion assay indicated that afatinib treatment significantly inhibited the invasive behavior of T24 cells in a dose-dependent manner. Western blot analysis showed that with increasing afatinib concentrations, Bcl-2, phosphorylated (p)-ERK1/2, p-Akt, MMP-2 and MMP-9 expression levels were significantly decreased, whereas total (t)-ERK1/2 and t-Akt expression levels remained basically unchanged, and Bax expression levels were greatly increased. The results indicate that afatinib inhibits the proliferation and invasion of T24 cells in vitro and induces the apoptosis of these cells by inhibiting the EGFR signaling network.

To investigate the clinic value of microsurgical shunt for the treatment of varicocele combined with asthenspermia, the clinical data and therapeutic method for 3 patients, who conducted the microscope spermatic vein high ligation combined with superficial epigastric vein flow, were retrospectively analyzed. No postoperative complications were found, and the original symptoms and signs were disappeared. All patients were conducted scrotal ultrasound and semen routine after 3 months, and all indexes, including maximum internal diameter of the cord vein (erect position), sperm density, sperm survival rate, sperm deformity rate and sperm forward movement rate, were gradually improved. Consequently, high ligation of spermatic vein combined with vascular bypass surgery under the microscope can block the countercurrent venous blood and establish a new return channel to the testis. Meanwhile, it can also protect the testicular artery and lymph-vessel. It is worth to be spread for the treatment of varicocele combined with asthenospermia.为总结显微转流术治疗精索静脉曲张合并弱精症的临床经验，作者回顾性分析3例行显微镜下精索静脉高位结扎+腹壁浅静脉转流术患者的临床资料及治疗方法。患者术后均无明显并发症，原有症状及体征消失，3个月复查阴囊B超及精液常规检查，各项指标逐渐好转。显微镜下精索静脉高位结扎联合血管转流术既可阻断静脉血逆流，又能使睾丸建立新的回流通道，同时保护了睾丸动脉和淋巴管，是值得推广的治疗精索静脉曲张合并弱精症的方法。.

Objective: To evaluate the preoperative imaging manifestation and therapeutic effect of laparoscopic simple enucleation (SE) for localized chromophobe renal cell carcinoma (chRCC). Materials and Methods: Clinical data of 36 patients who underwent laparoscopic SE of localized chRCC at our institute were retrospectively analyzed. All patients underwent preoperative renal protocol CT (unenhanced, arterial, venous, and delayed images). CT scan characteristics were evaluated. After intraoperative occlusion of the renal artery, the tumor was free bluntly along the pseudocapsule and enucleated totally. The patients were followed up regularly after the operation. Results: Mean tumor diameter was 3.9±1.0 cm, 80% of tumors were homogeneous and all the tumors had complete pseudocapsule. The attenuation values were slightly lower than normal renal cortex and degree of enhancement of the tumors were significantly lower than normal renal cortex. Mean operation time was 104.3±18.2 min. Mean warm ischemia time (WIT) was 21.3±3.5 min. Mean blood loss was 78.6±25.4 mL. No positive surgical margin was identified. Mean postoperative hospital stay was 5.3±1.5 d. Hematuria occurred in 3 patients and all disappeared within 3 days. After a mean follow-up of 32.1±20.6 months, no patient had local recurrence or metastatic progression. Conclusion: Localized chRCCs have a great propensity for homogeneity and complete pseudocapsule. The attenuation values were slightly lower than normal renal cortex and small degree of enhancement. Laparoscopic SE is a safe and effective treatment for localized chRCC. The oncological results were satisfactory.

Due to considerable application of perfluorooctanoic acid (PFOA) and its refractory degradation, the widespread distribution of PFOA has already resulted in its’ risks to environment and organisms. However, the intrinsic characteristic of pristine multi-walled carbon nanotubes (MWCNTs) limited their application for removing PFOA from aqueous medium. Therefore, three nano-metals (nano-crystalline iron, copper and zinc) grafted MWCNTs were synthesized and characterized by BET-N2, TEM, FTIR, XPS and XRD as well as MWCNTs (as the control treatment) in this study. The results showed that nano metals were well grafted on the surface of MWCNTs. Adsorption were investigated by using radioactive labeled PFOA (14C-PFOA) to quantify the trace PFOA. Adsorption kinetics showed the adsorption of PFOA on the metal doped MWCNTs (MDCNTs) was controlled by intra-particle diffusion. Adsorption isotherms showed the sorption amounts on the MDCNTs were higher than the control. This attributed much to the hydrophobic interaction, electrostatic interaction and the formation of the inner sphere complexes. Ionic strength (0-100 mM) and ionic species (Ca2+) had little effects on the sorption of MDCNTs. PFOA adsorption on MDCNTs strongly depended on pH value in the medium. These results provide an innovative approach for removing trace PFOA from liquid medium.

Emerging evidence has demonstrated that androgen receptor (AR) is a promising therapeutic target for bladder cancer. However, the relationship between AR expression and its clinical significance remains controversial. The present in-depth meta-analysis aimed to investigate the correlation between AR expression and clinicopathological features, as well as prognostic value in bladder cancer. A systematic search was performed from PubMed, Web of Knowledge, Embase and the Cochrane Central Search Library by January 2017. The correlation between AR expression and tumor stage, tumor grade, recurrence free survival and progression free survival for patients with bladder cancer was evaluated. A total of 12 relevant studies with 1,652 patient samples were included. AR expression positively correlated with low tumor grade [odds ratio (OR), 1.95; 95% confidence interval (CI), 1.36-2.81], low tumor stage (OR, 2.06; 95% CI, 1.02-4.16) and low recurrence rate [hazard ratio (HR), 0.48; 95% CI, 0.31-0.75] in Caucasian patients. While, its expression had no significant impact on cancer susceptibility (OR, 1.62; 95% CI, 0.19-13.72; P=0.44) and progression-free survival (HR, 1.20; 95% CI, 0.86-1.66; P=0.77). The present meta-analysis indicated that AR expression correlates with tumor grade, clinical stage and recurrence rates in the specified population and classification system. Further studies are required to determine the precise role of AR in bladder cancer.

International audience; This paper gives an integrated probabilistic framework (IPF) that deals with the optimal layout of facilities in an industrial plant. The specific case of a crude oil tank farm is detailed in this present paper, which includes the tank fire as well as the corresponding optimal layout based on inherent safety and evacuation.The tank fire can be caused by the oxidative self-heating of pyrophoric iron sulfides which extensively exist on the inner wall of the crude oil tank, especially in the respiratory/safety valves. Oxidative self-heating, or spontaneous combustion of iron sulfides is a process of oxidation and generally influenced by five external factors including water content, mass per unit area of iron sulfides, operating temperature of tank, flow rate and concentration of oxygen facing the iron sulfides. According to the previous literature about self-heating process of iron sulfides, the maximum temperature (TmaxTmax) of solid phase is a vital indicator representing the pyrophoric feature of iron sulfides in specific circumstances. And the maximum temperature (TmaxTmax) can be predicted by the model developed from support vector machine (SVM) technique. While the predicted maximum temperature (TmaxTmax) is compared with a defined threshold value, it can be revealed whether the oxidative self-heating of iron sulfides will lead to explosion and then cause tank fire. On this grounds, the probability of tank fire due to the oxidative self-heating of iron sulfides can be obtained by Monte Carlo simulations.For tank fire, the major physical damage to the surrounding tanks and workers is thermal radiation rather than overpressure or missile projection. Considering the worst case scenario, that is the vapor-liquid interface in the tank covered with fire, then the thermal radiation flux passing through a receiver at a specified distance away from the tank can be derived. In reverse, the critical horizontal distance between tank and receiver can be obtained if the critical thermal radiation flux through a receiver is given. Assuming that the minimum and maximum risks of thermal radiation to a receiver are separately 0 and 1 corresponding to different thermal radiation fluxes, then the risk of a tank or worker receiving a given thermal radiation flux can be determined by the thermal radiation flux equation.In a crude oil tank farm containing more than one tank, the potential thermal radiation flux received by an object at an arbitrary location is the superposition of those from different tanks. For the optimization of space collocation and floor area of tank farm from inherently safe design, if the damage risk of an object from other overall tanks equals to the critical acceptable damage risk, and the corresponding floor area of tank farm is the minimum, it will certainly result in an optimal space collocation. The handling method for the mentioned problem inherently reduces property loss and casualty to some extent.

A series of Mo-Si-B alloys in the Moss+T2 (Mo5SiB2)+Mo2B three phase region were designed to examine the effect of the lower Si solubility limit in the Moss phase on the microstructure, hardness and oxidation behavior. X-ray diffraction (XRD), Scanning Electron Microscopy (SEM), Vickers hardness tests and Electron Probe Microanalysis (EPMA) were carried out for the evaluation. The XRD results show an unusual lattice constant expansion for the Moss that is consistent with B as an interstitial solute. SEM images establish the microstructure evolution during the annealing. The analysis of the indentations produced by the Vickers hardness tests demonstrate that the samples in the Moss + Mo2B + T2 three phase region have about a 50% higher fracture toughness than comparable samples in Moss + Mo3Si + T2 three phase region due to the lower Si solubility in the Moss phase. The thermogravimetric analysis (TGA) results show that the oxidation resistance is directly related to T2 phase fraction in the microstructure. Alloys with a Moss + Mo2B + T2 microstructure exhibit a similar oxidation behavior to those with a Moss + Mo3Si + T2 microstructure when the T2 phase fraction in the two alloys is similar. Mo-Si-B alloys in the Moss + Mo2B + T2 three phase region could achieve better mechanical properties than alloys in the Moss + Mo3Si + T2 three phase region and are attractive candidates for high temperature applications.

Objective To assess the safety, feasibility, and efficacy of percutaneous intrarenal cyst marsupialization and simultaneous nephrolithotomy in the management of a renal cyst with ipsilateral calculi in selected patients. Materials and Methods Between July 2010 and August 2013, 16 patients (11 men and 5 women; mean age, 51 years) with a solitary posterior or parapelvic renal cyst and ipsilateral calculi underwent percutaneous intrarenal cyst marsupialization and simultaneous nephrolithotomy in our center. Mean cyst size was 6.3 cm (range, 4.2-11.8 cm). Mean stone surface area was 5.8 cm2 (range, 1.8-12.1 cm2). By preoperative computed tomography planning and interoperative ultrasound guidance, the optimal puncture route was selected carefully to marsupialize the cyst and approach the target calyx. The cyst was marsupialized into the collecting system at the dilation process. Subsequently, percutaneous nephrolithotomy was performed in a standard fashion. Results The mean operative time was 68 minutes (range, 47-93 minutes), and the mean hospital stay was 4 days (range, 3-7 days). A nephrostomy tube and a double-J stent were placed for a prolonged period to ensure the channel remained opened. Nearly complete cyst regression and calculi clearance confirmed by postoperative imaging was achieved in all patients. No intraoperative or postoperative complications in Clavien grading score ≥2 were noted during a mean follow-up of 21 months (range, 8-25 months). Conclusion In selected patients with a posterior or parapelvic renal cyst and ipsilateral calculi, the percutaneous technique is a safe and effective option through intermediate follow-up.

To date, several studies have been conducted to assess the association between endothelial nitric oxide synthase (eNOS) gene 894G > T polymorphism and prostate cancer (PCa) risk, but the results are conflicting. To derive a more precise estimation of the relationship between 894G > T polymorphism and PCa risk, the present meta-analysis was performed. A total of eight case-control studies were included in this meta-analysis. The pooled odds ratio (OR) with 95 % confidence interval (CI) was calculated to evaluate the associations. Our results suggested that 894G > T polymorphism is associated with PCa risk under codominant (GT vs. GG) (OR = 1.11, 95 % CI = 1.01-1.22, P = 0.04) and overdominant (GT vs. GG + TT) (OR = 1.12, 95 % CI = 1.02-1.23, P = 0.02) models in the overall population, while there are no associations observed under dominant (GT + TT vs. GG), recessive (TT vs. GG + GT), and allelic (T vs. G) models. Moreover, when the eligible studies were stratified according to sources of control, significant association between 894G > T polymorphism and susceptibility of PCa was also identified under codominant (OR = 1.12, 95 % CI = 1.01-1.24, P = 0.03) and overdominant (OR = 1.13, 95 % CI = 1.02-1.25, P = 0.02) models when using healthy individuals as control. However, there are no significant associations found under any genetic models when using BPH patients as control group. In conclusion, the present meta-analysis suggested that the eNOS gene 894G > T polymorphism might be a risk factor in the onset of PCa.

Epithelial-mesenchymal transition (EMT) plays an important role in hepatocellular carcinoma (HCC) dissemination. Bromodomain PHD-finger transcription factor (BPTF) could regulate embrogenesis and stem cell differentiation, and it may be involved in tumor progression and EMT. In this study, we aimed to determine BPTF, E-cadherin and vimentin expression in tumor tissues and the clinical significance in relation to HCC. The BPTF, vimentin and E-cadherin expression of 106 HCC tissue samples was examined by immunohistochemical staining. BPTF and vimentin showed high expression and E-cadherin showed low expression in HCC. BPTF is associated with the tumor number, vascular invasion, Edmondson-Steiner grade, TNM stage and recurrence (P

In order to protect Niobium material from oxidation, MoSi2 coating was prepared on the Niobium substrate by spark plasma sintering. Oxidation behavior of MoSi2 coating was investigated in air over the temperature range of 1200–1500 °C. The interfacial diffusion between MoSi2 coating and Niobium substrate was also examined. Dense MoSi2 coating was successfully prepared using spark plasma sintering. The porosities of top and side coatings are about 5.5% and 6.4%, respectively. No cracks were present in the MoSi2 coating. Cracking and spallation of the SiO2 scale did not occur at test temperatures. Two intermediate phases—(Nb,Mo)5Si3 and Nb5Si3 phases, were detected in the boundary of MoSi2 coating and Nb substrate. The growth of the reaction layer was dominated by the diffusion of Si toward the Nb substrate and obeyed a parabolic rate law. A multi-layered structural coating formed on Nb substrate, which consisted of MoSi2, (Mo,Nb)5Si3 and Nb5Si3 in turn.

Objective To prospectively study the surgical strategies and clinical efficacy of laparoendoscopic single-site (LESS) inguinal lymphadenectomy compared with conventional endoscopic inguinal lymphadenectomy for the management of inguinal nodes. Patients and Methods A total of 12 patients with squamous cell carcinoma of the penis who underwent penectomy between February and July 2013 were enrolled in the study. All 12 patients underwent bilateral inguinal lymphadenectomy (LESS inguinal lymphadenectomy in one limb and conventional endoscopic inguinal lymphadenectomy in the other) with preservation of the saphenous vein. All lymphatic tissue in the boundaries of the adductor longus muscle (medially), the sartorius muscle (laterally), 2 cm above the inguinal ligament (superiorly), the Scarpa fascia (superficially) and femoral vessels (deeply) was removed in both surgical techniques. All 24 procedures were performed by one experienced surgeon. Results All 24 procedures (12 LESS and 12 conventional endoscopic inguinal lymphadenectomies) were completed successfully without conversion to open surgery. For LESS inguinal lymphadenectomy and conventional endoscopic inguinal lymphadenectomy groups, the mean ± sd operating time was 94.6 ± 14.8 min and 90.8 ± 10.6 min, respectively (P = 0.145). No significant differences in the incidence of postoperative complications (skin-related problems, hecatomb, lower extremity oedema, lymphatic complications and overall complications) were noted between the two groups (P > 0.05). No lower extremity oedema occurred in any limbs of the two groups. No significant differences were observed in either lymph node clearance rate or detection rate of histologically positive lymph nodes (P > 0.05). The patient satisfaction rate with scar appearance and cosmetic results was significantly better in the LESS inguinal lymphadenectomy group than in the conventional endoscopic inguinal lymphadenectomy group of (75 vs 25%; P = 0.039). Conclusions This preliminary study suggests that both LESS inguinal lymphadenectomy and conventional endoscopic inguinal lymphadenectomy are safe and feasible procedures for inguinal lymphadenectomy. Preservation of the saphenous vein during LESS inguinal lymphadenectomy/conventional endoscopic inguinal lymphadenectomy can effectively reduce the incidence of postoperative lower extremity oedema. LESS inguinal lymphadenectomy seems to provide better cosmetic results than conventional endoscopic inguinal lymphadenectomy.

Molybdenum disilicide (MoSi2) coatings were deposited on carbon steel by air plasma spraying technology with different feedstock powder sizes (i.e., powder A: −15 + 2.5 μm, powder B: −30 + 15 μm, powder C: −54 + 30 μm, powder D: −74 + 54 μm and powder E: −106 + 74 μm). Phase composition and microstructure of coatings were characterized by x-ray diffraction (XRD) and scanning electron microscope. The bonding strength and microhardness of coatings were also evaluated. The XRD results show that there exists mutual transformation between T-MoSi2 and H-MoSi2 phase and part of Mo-rich phases are formed because of oxidization during the spraying process. With the increase of spraying powders size, the content of Mo-rich phases (Mo or Mo5Si3) and molybdenum oxide (MoO3) in coatings decreases, and that of disilicide-rich phase (MoSi2) in coatings increases. The oxidation degree of MoSi2 particle gradually decreases during the spraying process with the increase of spraying powders size. The MoSi2 is the main phase of the as-sprayed coatings when the spraying powders size is beyond 30 μm. With the increase of spraying powders size, the porosity of the as-sprayed coating increases, and the bonding strength of the coating gradually decreases. The hardness of coatings first increases and then decreases with the increase of spraying powders size.

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.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.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/m(2), respectively; p = 0.008).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.

BACKGROUND To compare the clinical feasibility and oncological outcomes of video endoscopic inguinal lymph node dissection (VE-ILND) and open inguinal lymph node dissection (O-ILND) in the management of penile cancer. METHODS We searched published articles in the PubMed, Embase, Cochrane Library, Web of science, China National Knowledge Infrastructure, and Wanfang databases. Data were extracted by 2 independent authors, and meta-analysis was performed by using Review Manager software version 5.3. RESULTS Ten studies were included. Compared with the O-ILND group, the VE-ILND group exhibited less intraoperative blood loss (standardized mean difference [SMD] = 3.12; 95% confidence intervals [95% CIs] [1.27, 4.98]; P = .001), shorter hospital stay (SMD = 1.77; 95% CIs [0.94, 2.60]; P