Objective:To assess the concordance of tumour grade in specimens obtained from diagnostic cystoscopic biopsy and transurethral resection of bladder tumour(TURBT)and explore the risk factors of upgrading.Methods:The me...Objective:To assess the concordance of tumour grade in specimens obtained from diagnostic cystoscopic biopsy and transurethral resection of bladder tumour(TURBT)and explore the risk factors of upgrading.Methods:The medical records of 205 outpatients who underwent diagnostic cystoscopic biopsy before initial TURBT were retrospectively reviewed.Comparative analysis of the tumour grade of biopsy and operation specimens was performed.Tumour grade changing from low-grade to high-grade with or without variant histology was defined as upgrading.Logistic regression an-alyses were performed to identify the risk factors of upgrading.Results:For the 205 patients,the concordance of tumour grade between specimens obtained from biopsy and operation was 0.639.The concordance for patients who were preoperatively diagnosed with low-grade and high-grade was 0.504 and 0.912,respectively.Univariate and multivariate logistic regression analyses showed that older age,tumour multifocality,high neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and low lymphocyte-to-monocyte ratio(LMR)were significantly associated with upgrading(odds ratio ranging from 0.412 to 4.364).The area under the curve of the different multivariate models was improved from 0.752 to 0.821,and decision curve analysis demonstrated a high net benefit when NLR,LMR,and PLR were added.Conclusion:Diagnostic cystoscopic biopsy may not accurately represent the true grade of primary bladder cancer,especially for outpatients with low-grade bladder cancer.Moreover,older age,tumour multifocality,high NLR,PLR,and low LMR are risk factors of upgrading,and systemic inflammatory markers improve the predictive ability.展开更多
Objective:To investigate oncological outcomes in patients with bladder cancer who underwent minimally invasive radical cystectomy(MIRC)or open radical cystectomy(ORC).Methods:We identified patients with bladder cancer...Objective:To investigate oncological outcomes in patients with bladder cancer who underwent minimally invasive radical cystectomy(MIRC)or open radical cystectomy(ORC).Methods:We identified patients with bladder cancer who underwent radical cystectomy(RC)in 13 centers of the Chinese Bladder Cancer Consortium(CBCC).Perioperative outcomes were compared between MIRC and ORC.The influence of surgical approaches on overall survival(OS)and cancer-specific survival(CSS)in the entire study group and subgroups classified according to pathologic stage or lymph node(LN)status was assessed with the log-rank test.Multivariable Cox proportional hazard models were used to evaluate the association among OS,CSS and risk factors of interest.Results:Of 2098 patients who underwent RC,1243 patients underwent MIRC(1087 laparoscopic RC and 156 robotic-assisted RC,respectively),while 855 patients underwent ORC.No significant differences were noted in positive surgical margin rate and 90-day postoperative mortality rate.MIRC was associated with less estimated blood loss,more LN yield,higher rate of neobladder diversion,longer operative time,and longer length of hospital stay.There was no significant difference in OS and CSS according to surgical approaches(pZ0.653,and 0.816,respectively).Subgroup analysis revealed that OS and CSS were not significantly different regardless of the status of extravesical involvement or LN involvement.Multivariable Cox regression analyses showed that the surgical approach was not a significant predictor of OS and CSS.Conclusions:Our study showed that MIRC was comparable to conventional ORC in terms of OS and CSS.展开更多
The myelination of axons was the last major evolution in the vertebrate nervous system.Myelin promotes the speed of action potential by two orders,and modulates the conduction of neurons,important for learning new ski...The myelination of axons was the last major evolution in the vertebrate nervous system.Myelin promotes the speed of action potential by two orders,and modulates the conduction of neurons,important for learning new skills.However,the intrinsic mechanism for high-speed information propagation in myelin in the nervous systems is still unclear.We propose that myelinated nerve fibres serve as dielectric waveguides for the high-frequency electromagnetic information in a certain mid-infrared to terahertz spectral range.Based on the structure characteristics of myelinated nerve composed of periodic nodes of Ranvier and myelin sheath,the energy for the signal propagation is supplied and amplified when crossing the nodes of Ranvier via a periodic relay.In this work,we exploit the quasi-quantum model of amplification for neural terahertz/infrared information at the nodes of Ranvier,and prove the existence of biomolecular ensemble for three-energy-level amplification,revealing the essential mechanism of high-speed electromagnetic information transmitting in myelinated nerves.展开更多
Hearing impairment is a common disease affecting a substantial proportion of the global population.Currently,the most effective clinical treatment for patients with sensorineural deafness is to implant an artificial e...Hearing impairment is a common disease affecting a substantial proportion of the global population.Currently,the most effective clinical treatment for patients with sensorineural deafness is to implant an artificial electronic cochlea.However,the improvements to hearing perception are variable and limited among healthy subjects.Moreover,cochlear implants have disadvantages,such as crosstalk derived from the currents that spread into non-target tissue between the electrodes.Here,in this work,we describe terahertz wave modulation,a new and minimally invasive technology that can enhance hearing perception in animals by reversible modulation of currents in cochlear hair cells.Using single-cell electrophysiology,guinea pig audiometry,and molecular dynamics simulations,we show that THM can reversibly increase mechano-electrical transducer currents(~50%higher)and voltage-gated K^(+)currents in cochlear hair cells through collective resonance of–C=O groups.In addition,measurement of auditory brainstem response(ABR)in guinea pigs treated with THM indicated a~10 dB increase in hearing sensitivity.This study thus reports a new method of highly spatially selective hearing enhancement without introducing any exogeneous gene,which has potential applications for treatment of hearing disorders as well as several other areas of neuroscience.展开更多
基金This study was supported by the Clinical Research Award of the First Affiliated Hospital of Xi'an Jiaotong University,China(No.XJTU1AF-CRF-2015-002 to DH).
文摘Objective:To assess the concordance of tumour grade in specimens obtained from diagnostic cystoscopic biopsy and transurethral resection of bladder tumour(TURBT)and explore the risk factors of upgrading.Methods:The medical records of 205 outpatients who underwent diagnostic cystoscopic biopsy before initial TURBT were retrospectively reviewed.Comparative analysis of the tumour grade of biopsy and operation specimens was performed.Tumour grade changing from low-grade to high-grade with or without variant histology was defined as upgrading.Logistic regression an-alyses were performed to identify the risk factors of upgrading.Results:For the 205 patients,the concordance of tumour grade between specimens obtained from biopsy and operation was 0.639.The concordance for patients who were preoperatively diagnosed with low-grade and high-grade was 0.504 and 0.912,respectively.Univariate and multivariate logistic regression analyses showed that older age,tumour multifocality,high neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and low lymphocyte-to-monocyte ratio(LMR)were significantly associated with upgrading(odds ratio ranging from 0.412 to 4.364).The area under the curve of the different multivariate models was improved from 0.752 to 0.821,and decision curve analysis demonstrated a high net benefit when NLR,LMR,and PLR were added.Conclusion:Diagnostic cystoscopic biopsy may not accurately represent the true grade of primary bladder cancer,especially for outpatients with low-grade bladder cancer.Moreover,older age,tumour multifocality,high NLR,PLR,and low LMR are risk factors of upgrading,and systemic inflammatory markers improve the predictive ability.
基金supported by the National Natural Science Foundation of China(Grant No.81825016,81772719,81772728,81572514)the Key Areas Research and Development Program of Guangdong(Grant No.2018B010109006)Medical Scientific Research Foundation of Guangdong Province(Grant No.A2018388).
文摘Objective:To investigate oncological outcomes in patients with bladder cancer who underwent minimally invasive radical cystectomy(MIRC)or open radical cystectomy(ORC).Methods:We identified patients with bladder cancer who underwent radical cystectomy(RC)in 13 centers of the Chinese Bladder Cancer Consortium(CBCC).Perioperative outcomes were compared between MIRC and ORC.The influence of surgical approaches on overall survival(OS)and cancer-specific survival(CSS)in the entire study group and subgroups classified according to pathologic stage or lymph node(LN)status was assessed with the log-rank test.Multivariable Cox proportional hazard models were used to evaluate the association among OS,CSS and risk factors of interest.Results:Of 2098 patients who underwent RC,1243 patients underwent MIRC(1087 laparoscopic RC and 156 robotic-assisted RC,respectively),while 855 patients underwent ORC.No significant differences were noted in positive surgical margin rate and 90-day postoperative mortality rate.MIRC was associated with less estimated blood loss,more LN yield,higher rate of neobladder diversion,longer operative time,and longer length of hospital stay.There was no significant difference in OS and CSS according to surgical approaches(pZ0.653,and 0.816,respectively).Subgroup analysis revealed that OS and CSS were not significantly different regardless of the status of extravesical involvement or LN involvement.Multivariable Cox regression analyses showed that the surgical approach was not a significant predictor of OS and CSS.Conclusions:Our study showed that MIRC was comparable to conventional ORC in terms of OS and CSS.
基金the National Natural Science Foundation of China(Grant Nos.51677145,and 11622542).
文摘The myelination of axons was the last major evolution in the vertebrate nervous system.Myelin promotes the speed of action potential by two orders,and modulates the conduction of neurons,important for learning new skills.However,the intrinsic mechanism for high-speed information propagation in myelin in the nervous systems is still unclear.We propose that myelinated nerve fibres serve as dielectric waveguides for the high-frequency electromagnetic information in a certain mid-infrared to terahertz spectral range.Based on the structure characteristics of myelinated nerve composed of periodic nodes of Ranvier and myelin sheath,the energy for the signal propagation is supplied and amplified when crossing the nodes of Ranvier via a periodic relay.In this work,we exploit the quasi-quantum model of amplification for neural terahertz/infrared information at the nodes of Ranvier,and prove the existence of biomolecular ensemble for three-energy-level amplification,revealing the essential mechanism of high-speed electromagnetic information transmitting in myelinated nerves.
基金supported by the National Defense Science and Technology Innovation Special Zone and the National Supercomputer Center in Tianjin.C.C.acknowledges the support from the XPLORER PrizeW.X.is a CIBR cooperative investigator(2020-NKX-XM-04)funded by the Open Collaborative Research Program of Chinese Institute for Brain Research.
文摘Hearing impairment is a common disease affecting a substantial proportion of the global population.Currently,the most effective clinical treatment for patients with sensorineural deafness is to implant an artificial electronic cochlea.However,the improvements to hearing perception are variable and limited among healthy subjects.Moreover,cochlear implants have disadvantages,such as crosstalk derived from the currents that spread into non-target tissue between the electrodes.Here,in this work,we describe terahertz wave modulation,a new and minimally invasive technology that can enhance hearing perception in animals by reversible modulation of currents in cochlear hair cells.Using single-cell electrophysiology,guinea pig audiometry,and molecular dynamics simulations,we show that THM can reversibly increase mechano-electrical transducer currents(~50%higher)and voltage-gated K^(+)currents in cochlear hair cells through collective resonance of–C=O groups.In addition,measurement of auditory brainstem response(ABR)in guinea pigs treated with THM indicated a~10 dB increase in hearing sensitivity.This study thus reports a new method of highly spatially selective hearing enhancement without introducing any exogeneous gene,which has potential applications for treatment of hearing disorders as well as several other areas of neuroscience.
