Background: Can laparoscopic orchiopexy achieve a better testicular position and a higher success rate than open orchiopexy for palpable undescended testis in children? We conducted a prospective comparison study with a large volume of cases to answer this question. Methods: A total of 256 patients with palpable undescended testis who were admitted between January 1, 2017 and December 31, 2017 were included in this study. Among them, 124 patients underwent laparoscopic orchiopexy and 132 patients underwent open inguinal orchiopexy. The outcome evaluated index included final testicular position, success rate, and complications. Results: Of 256 patients, the mean age was 2.4 years; 218 patients had unilateral palpable testis, and the other 38 patients had bilateral palpable testis. There were no significant differences between laparoscopic orchiopexy group and open orchiopexy group with respect to age, side, preoperative testicular position, and testicular volume. The final testicular position in laparoscopic group was better than that in open group (lower position rate: 89.3% versus 77.9%, P = .01). There was no significant difference in success rate (laparoscopic group: 100%; and open group: 98.5%). There were 3 complications in the laparoscopic group and 6 complications in open group (P > .05). No testicular atrophy was found in either group. No testicular ascent occurred in laparoscopic group while there were 2 cases in open group, which required additional surgery for correction. Of patients who underwent surgery at the age of 3 years or older (n = 75), laparoscopic surgery was associated with markedly better testicular position than open surgery (lower position rate: 88.1% versus 69.6%, P = .03). Conclusions: Laparoscopic orchiopexy is associated with better testicular position and comparable success rate comparing to open orchiopexy for palpable undescended testis in children. This procedure could be recommended for palpable undescended testis, especially in older children.
Numerous studies have demonstrated that preferentially expressed antigen in melanoma (PRAME) is abnormally expressed in various solid tumours. However, the clinicopathological features and prognostic value of the PRAME expression in patients with cancer remain unclear. Accordingly, we performed a meta-analysis to accurately assess the association of the expression level of PRAME with clinicopathological features and cancer prognosis. Relevant study collection was performed in PubMed, Web of Science, and Embase until 28 February 2020. A total of 14 original studies involving 2,421 patients were included. Our data indicated that the PRAME expression was significantly associated with tumour stage ( OR = 1.99 , 95% CI: 1.48–2.67, P < 0.001 ) and positive lymph node metastasis ( OR = 3.14 , 95% CI: 1.99–4.97, P < 0.001 ). Pooled results showed that overexpression of PRAME is positively correlated with poor disease-free survival ( HR = 1.60 , 95% CI: 1.36–1.88, P < 0.001 ), progression-free survival ( HR = 1.88 , 95% CI: 1.02–3.46, P = 0.042 ), metastasis-free survival ( HR = 1.86 , 95% CI: 1.05–3.31, P = 0.034 ), and overall survival ( HR = 1.75 , 95% CI: 1.53–1.99, P < 0.001 ). In summary, these data are suggesting that PRAME is tumorigenic and may serve as a prognostic biomarker for cancer.
Background The aim of this study was to review the growth data, gonadal function and tumour risk of children and adolescents with 45,X/46,XY mosaicism who presented to a single centre in China. Methods We conducted a retrospective review of the records of 32 patients with 45,X/46,XY mosaicism or variants who were hospitalized from August 2005 to September 2018. The main outcomes measured were growth data, genital phenotype, gonadal function, gonadal position, and histological results. Results A total of 32 patients were included. The age at diagnosis ranged from 0.6 to 16.3 years. Nineteen patients exhibited ambiguous genitalia, 12 had short stature, and 1 showed a lack of breast development. Seventeen patients were raised as males, and 15 were raised as females. The external masculinisation score (EMS) of patients raised as male was 4.5 (1~12) [median (range)]. The EMS of the females was 0 (0~1.5) [median (range)]. Patients showed normal heights under 2 years old, with a height SDS of 0 (− 1.5~1.4) [median (range)]. Growth appeared to decelerate after age 2 years, with SDS decreased to − 2.8 (− 3.0~ − 0.9) [median (range)]. The percentage of short stature was higher in females than in males (76.9% vs 50.0%). Twenty-five patients had gonadal pathological results. Complete gonadal dysgenesis (CGD) and mixed gonadal dysgenesis (MGD) were the most common pathogenic subtypes, accounting for 48.0 and 36.0%, respectively. Ovotesticular tissue was observed in only 4.0% of patients. Gonadoblastoma and positive OCT3/4 results were found in 18.8% of gonads in children over 2 years of age. Palpable gonads accounted for 50% of these. All patients who had gonadoblastoma were raised as females. Conclusions Patients with 45,X/46,XY might have normal heights until 2 years old. Growth decelerations after 2 years of age were common. Patients who are being raised as females seemed to be shorter than males. CGD and MGD were the most common gonadal pathogenic subtypes. The tumour risk is high in these patients, even in palpable gonads and female patients.
Objective. Family with sequence similarity 19 member A5 (FAM19A5), a novel chemokine-like peptide, is a secreted protein mainly expressed in the brain. FAM19A5 was recently found to be involved in a variety of neurological diseases; however, its correlation with vascular dementia (VaD) remains unclear. The aim of the study is to explore the association between serum FAM19A5 and cognitive impairment in subjects with VaD. Method. 136 VaD subjects and 81 normal controls were recruited in the study. Their demographic and clinical baseline data were collected on admission. All subjects received Mini-Mental State Examination (MMSE) evaluation, which was used to test their cognitive functions. A sandwich enzyme-linked immunosorbent assay (ELISA) was applied to detect the serum levels of FAM19A5. Results. No significant differences were found between the two groups regarding the demographic and clinical baseline data (p>0.05). The serum FAM19A5 levels were significantly higher compared to normal controls (p<0.001). The Spearman correlation analysis indicated that serum FAM19A5 levels and MMSE scores have a significant negative correlation in VaD patients (r=−0.414, <0.001). Further multiple regression analysis indicated that serum FAM19A5 levels were independent risk predictors for cognitive functions in VaD (β=0.419, p=0.031). Conclusion. The serum FAM19A5 level of VaD patients is significantly increased, which may serve as a biomarker to predict cognitive function of VaD.
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