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Purpose To investigate the therapeutic effect and possible mechanism of PI3K inhibitor 5d on prostate cancer. Methods The MTT cell proliferation assay was used to assess the PC-3 prostate cancer cell viability. The effect of compound 5d on cell cycle and apoptosis was detected by flow cytometry, and the expression of proteins was estimated by Western blotting. The xenograft models of DU145 and PC-3 cell lines were established to further explore the inhibitory activity of 5d on prostate cancer in vivo. Results The results of MTT experiment showed that 5d could significantly inhibit the proliferation of PC-3 cells in vitro. The flow cytometry results showed that 5d could arrest PC-3 cell cycle in G0 / G1 phase and promote apoptosis. Western blot analysis showed that 5d could effectively inhibit the activation of PI3K signaling pathway. The results of in vivo experiments showed that the tumor weights in the 5d treatment group was significantly reduced compared with the control group, and western blot results show that 5d can effectively inhibit the expression of PI3K signaling pathway in both tumor tissues. Conclusion PI3K inhibitor 5d can effectively inhibit the proliferation of prostate caner in vitro and in vivo.

Background. Noncancer death accounts for a high proportion of all patients with bladder cancer, while these patients are often excluded from the survival analysis, which increases the selection bias of the study subjects in the prediction model. Methods. Clinicopathological information of bladder cancer patients was retrieved from the Surveillance, Epidemiology, and End Results (SEER) database, and the patients were categorized at random into the training and validation cohorts. The random forest method was used to calculate the importance of clinical variables in the training cohort. Multivariate and univariate analyses were undertaken to assess the risk indicators, and the prediction nomogram based on the competitive risk model was constructed. The model’s performance was evaluated utilizing the calibration curve, consistency index (C index), and the area under the receiver operator characteristic curve (AUC). Results. In total, we enrolled 39285 bladder cancer patients in the study (27500 patients were allotted to the training cohort, whereas 11785 were allotted to the validation cohort). A competitive risk model was constructed to predict bladder cancer-specific mortality. The overall C index of patients in the training cohort was 0.876, and the AUC values were 0.891, 0.871, and 0.853, correspondingly, for 1-, 3-, and 5-year cancer-specific mortality. On the other hand, the overall C index of patients in the validation cohort was 0.877, and the AUC values were 0.894, 0.870, and 0.847 for 1-, 3-, and 5-year correspondingly, suggesting a remarkable predictive performance of the model. Conclusions. The competitive risk model proved to be of great accuracy and reliability and could help clinical decision-makers improve their management and approaches for managing bladder cancer patients.

The KangDuo surgical robot (KD-SR) was recently developed in China.To compare the safety and efficacy of the KD-SR versus the da Vinci Si Surgical System (DV-SS-Si) for robot-assisted partial nephrectomy (RAPN).A double-center prospective randomized controlled noninferiority trial of patients aged 18-75 yr with a suspicion of T1a N0M0 renal cancer (RENAL nephrometry score ≤9) was conducted.RAPN with the KD-SR versus the DV-SS-Si.The primary endpoint was the success rate of operation. The operation was successful if (1) there was no open or laparoscopic conversion, (2) the warm ischemia time was30 min for RENAL nephrometry scores of 4-6 or 40 min for RENAL nephrometry scores of 7-9, and (3) the pathological margin was negative. The secondary endpoint was the estimated glomerular filtration rate (eGFR). A threshold of 10% was set to demonstrate noninferiority.From September 2020 to March 2021, 100 participants were enrolled, of whom 99 (49 in the KD-SR group and 50 in the DV-SS-Si group) were finally included in the full analysis set and 98 (49 in the KD-SR group and -49 in the DV-SS-Si group) in the per-protocol set. Baseline demographic and clinical characteristics were similar between the two groups. All surgeries were completed successfully. The eGFR at postoperative weeks 4-12 and adverse events were similar between the two groups. The docking time and suture time per stitch were longer in the KD-SR group. The main limitation was that a negative margin was considered as the primary outcome rather than survival.The KD-SR achieved noninferior outcomes as compared with the DV-SS-Si regarding safety and efficacy for T1a tumors.The first trial comparing the KangDuo surgical robot (KD-SR) versus the da Vinci Si Surgical System for robot-assisted partial nephrectomy showed that the KD-SR is a viable option for minimally invasive treatment of T1a renal tumors.

Background Aberrant expression of long noncoding RNAs (lncRNAs) has been found to enroll in the initiation and progression of bladder cancer (BC). Earlier results show cancer-associated region long noncoding RNA-7 (CARLo-7) can be a prognostic marker for BC, but its biological function and the underlying mechanism is still to be discovered. Our study aims to explore the effects of CARLo-7 on the initiation and progression of BC and the potential mechanisms. Methods The expression of CARLo-7 in BC tissues and cell lines was determined by quantitative real-time polymerase chain reaction (qRT-PCR). T24 and HT1197 cells were transfected with CARLo-7 expression vector or sh-CARLo-7, then cell viability assay, BrdU assay, flow cytometry, Transwell cell migration, and invasion assay, and western blot were conducted to evaluate cell proliferation, apoptosis, invasion, migration, and epithelial-mesenchymal transition (EMT). Results CARLo-7 was dramatically upregulated in BC tissues and cell lines. Silencing CARLo-7 by sh-CARLo-7 significantly suppressed proliferation and induced apoptosis of BC cells, while enforced CARLo-7 expression promoted cell proliferation. Meanwhile, silencing CARLo-7 attenuated migration, invasion, and EMT of BC cells, while CARLo-7 overexpression had the contrary effects. The β-catenin, p-JAK2 and p-STAT3 levels were decreased by CARLo-7 knockdown, while activation of Wnt/β-catenin or JAK2/STAT3 pathways abolished the effects of CARLo-7 knockdown on cell proliferation and migration. Conclusions Collectively, CARLo-7 plays a critical role in regulating BC development by regulating cell proliferation, migration, invasion, and EMT through Wnt/β-catenin and JAK2/STAT3 signaling. Therefore, CARLo-7 might be a promising therapeutic target for BC.

Fast characterization methods are utilized to investigate DC and AC negative bias temperature instability (NBTI) characteristics in pMOSFETs with different TiN capping layer thicknesses ( ${t} _{\mathrm{ TiN}}$ ). The impacts of ${t} _{\mathrm{ TiN}}$ scaling on the threshold voltage shift ( ${\Delta }\text{V}_{\mathrm{ T}}$ ), pre-existing hole traps ( ${\Delta }\text{V}_{\mathrm{ HT}}$ ), generated traps (GTs), and their relative contributions are studied. The time exponents of ${\Delta }\text{V}_{\mathrm{ T}}$ and GTs, and the impacts of stress voltage, temperature, frequency, and duty cycle on the NBTI degradation are analyzed. DC and AC NBTI degradations increase with ${t} _{T}{}_{iN}$ . When ${t} _{\mathrm{ TiN}}$ is scaled down from 3 nm to 1 nm, the maximum operation field is improved by 60%, which originates from the reduction in both ${\Delta }\text{V}_{\mathrm{ HT}}$ and GTs. Moreover, we experimentally demonstrate that bulk trap generation is an ${f}$ -dependent process and that its relative contribution to ${\Delta }\text{V}_{\mathrm{ T}}$ increases with ${t} _{\mathrm{ TiN}}$ , which is an important factor for the improvement of NBTI through ${t} _{\mathrm{ TiN}}$ scaling.

Background Inferior vena cava (IVC) aneurysms are extremely rare with variable clinical manifestations. Patients are usually asymptomatic or present with complications of thrombosis and rupture. To date, there have been only a few reports of the condition in the literature, and diagnosis of IVC aneurysms may be difficult. Case presentation A 33-year-old male patient presented to hospital because of a retroperitoneal mass found by computerized tomography during a health examination. He was asymptomatic, and post medical history and physical examination were unremarkable. Laboratory tests including tests for paraganglioma were all negative. Contrast-enhanced computed tomography scan revealed a stenosis of IVC in the suprarenal segment and two retroperitoneal mass on the right side of IVC. The larger one is about 3 cm in diameter and the smaller one is about 1 cm in diameter, which was considered as a retroperitoneal tumor with an enlarged lymph node. However, two IVC diverticular aneurysms were confirmed during the retroperitoneal laparoscopic exploration. The larger aneurysm was resected from the IVC successfully. Since the smaller aneurysm was about 1 cm in diameter without thrombosis, we did not resect it during surgery. The patient recovered well from surgery and discharged from our department successfully. Conclusions This is the first report of multiple IVC aneurysms. Because of the extremely low prevalence of IVC diverticular aneurysm, it may be misdiagnosed as other disease. Due to the high rate of thrombosis, surgical treatment especially retroperitoneal laparoscopy is recommended for small diverticular aneurysms.

For Resistive RAM (RRAM)-based deep neural network, Random telegraph noise (RTN) causes accuracy loss during inference. In this work, we systematically investigated the impact of RTN on the complex deep neural networks (DNNs) with different datasets. By using 8 mainstream DNNs and 4 datasets, we explored the origin that caused the RTN-induced accuracy loss. Based on the understanding, for the first time, we proposed a new method to estimate the accuracy loss without going through time-consuming RTN simulation. The method was verified with other 10 DNN/dataset combinations that were not used for establishing the method. Finally, we discussed its potential adoption for the co-optimization of the DNN architecture and the RRAM technology, paving ways to RTN-induced accuracy loss mitigation for future neuromorphic hardware systems.

In this article, the steady and transient characteristics of the light-stimulated synaptic transistor based on amorphous indium–gallium–zinc oxide thin film are investigated. An optoelectronic trap charge model with steady and transient methods is employed to simulate the properties of such a neuromorphic device. The device simulation results agree well with the experimental data detected from the fabricated transistors. These numerical simulations can efficiently mimic the synaptic behaviors, such as excitatory postsynaptic current, paired-pulse facilitation, and even high-pass filtering characteristic as well. Furthermore, these results provide a prospective physical understanding of the photosensitive synaptic device for neuromorphic systems and brain-like chips.

In this letter, we present an experimental study on the frequency ( f ) dependence of trap generation under AC negative bias temperature instability (NBTI) stress in Si p-channel fin field-effect transistors (p-FinFETs), by adopting the direct-current current voltage (DCIV) method and an energy profiling technique. The interface trap generation ( $\Delta ~\text{N}_{IT}$ ) and bulk trap generation ( $\Delta ~\text{N}_{OT}$ ) are separated from the measured DCIV data and their ${f}$ dependences are independently investigated. The DCIV results indicate that the observed strong ${f}$ dependence of trap generation is primarily attributed to the ${f}$ -dependent $\Delta ~\text{N}_{OT}$ that exhibits a 36% reduction when ${f}$ increases from 10 Hz to 1 MHz. Furthermore, this ${f}$ -dependent $\Delta ~\text{N}_{OT}$ is mainly distributed between ${\text{E}_{v}}$ and ${\text{E}_{i}}$ , and exhibits a visible ${f}$ -dependent peak of energy density around ${\text{E}_{c}}$ .

The resistive switching behavior in resistive random access memories (RRAMs) using atomic-layer-deposited Ga2O3/ZnO composite film as the dielectric was investigated. By alternatively atomic-layer-depositing Ga2O3 and ZnO with different thickness, we can accurately control the oxygen vacancy concentration. When regulating ZnO to ∼31%, the RRAMs exhibit a forming-free property as well as outstanding performance, including the ratio of a high resistance state to the low resistance state of 1000, retention time of more than 1 × 104 s, and the endurance of 100. By preparing RRAMs of different Zn concentration, we carried out a comparative study and explored the physical origin for the forming-free property as well as good performance. Finally, a unified model is proposed to account for the resistive switching and the current conduction mechanism, providing meaningful insights in the development of high-quality and forming-free RRAMs for future memory and neuromorphic applications.

The impact of the field reduction effect on negative bias temperature instability (NBTI) parameter characterization and lifetime prediction was quantitatively studied in p-MOSFETs with a sub-1 nm equivalent oxide thickness (EOT). By comparing NBTI results under constant field stress and constant voltage stress, the field reduction effect was found to become severer at higher VG-STR and ${T}$ and cause a reduction in the voltage acceleration factor (VAF) at higher VG-STR and a reduction in activation energy EA at higher ${T}$ under constant voltage stress. To accurately evaluate NBTI lifetime, a modified NBTI model with field reduction correction (FRC) was proposed, and the 10-year NBTI degradation of a 32-stage ring oscillator was simulated. The results showed that the conventional model without including FRC had a worse prediction capability and overestimated frequency degradation for a ring oscillator. It is necessary to use an NBTI model with FRC for NBTI lifetime prediction of devices with a sub-1 nm EOT.

Background Maternally expressed gene 3 (MEG3) is a long non-coding RNA (lncRNA) and involved in progression of various human tumors. However, its underlying regulatory mechanism in tumorigenesis of bladder cancer (BC) remains unclear. To demonstrate effects of MEG3 on BC cell proliferation and elaborate its regulatory mechanism in BC. Methods Aberrant expressions of MEG3 and miR-93-5p were induced by cell transfection. The mRNA and protein expression were analyzed using qRT-PCR and western blot. Cell proliferation was examined by CCK-8 assay and EdU staining. The targeted regulation effect of MEG3 on miR-93-5p was confirmed by luciferase reporter assay. The number of LC3 punctated cells was detected by immunofluorescence. Xeno-graft mouse model was constructed for in vivo validation. Results MEG3 was down-regulated with increased expression of miR-93-5p in BC cells and tissues. Luciferase reporter assay showed that miR-93-5p was a direct target of MEG3 and was negatively regulated by MEG3. MEG3 overexpression inhibited cell proliferation and the expression of proliferation-, apoptosis- and autophagy-related proteins. The activation of PI3K/AKT/mTOR pathway was also suppressed with elevated cell apoptosis. miR-93-5p overexpression counteracted these results. In vivo experiments, we confirmed that miR-93-5p overexpression reversed the MEG3 overexpression-mediated suppression on tumor growth and protein expression. Conclusions lncRNA MEG3 could function as a competing endogenous RNA of miR-93 to regulate the tumorigenesis of BC via PI3K/AKT/mTOR pathway. The present research provided a new perspective to understanding the pathogenic mechanism of BC, and an effective therapeutic target for BC.

For the first time, we report the successful fabrication of well-behaved field-effect transistors based on Nb-doped β-Ga2O3 nanobelts mechanically exfoliated from bulk single crystals. The exfoliated β-Ga2O3 nanobelts were transferred onto a purified surface of the 110 nm SiO2/Si substrate. These Nb-doped devices showed excellent electrical performance such as an ultrasmall cutoff current of ∼10 fA, a high current on/off ratio of >108, and a quite steep subthreshold swing (SS, ∼120 mV/decade). Furthermore, we investigated the temperature dependence down to 200 K, providing insightful information for its operation in a harsh environment. This work lays a foundation for wider application of Nb-doped β-Ga2O3 in nano-electronics.

MIS-HEMT is one of the most promising structures to prohibit the unfavorable gate leakage in conventional AlGaN/GaN HEMTs. However, the extra insulator layer introduces massive border traps at insulator/AlGaN interface and results in the poor reliability. In this brief the energy distribution of border traps in AlGaN/GaN MIS-HEMT gate stack is extracted and investigated through a discharging-based trap energy profile technique. The technique adopts spot-Id sense measurement with 1 millisecond measurement time to capture the “whole (both fast and slow)” border traps. The results are beneficial to improve the reliability of AlGaN/GaN MIS-HEMT.

Random telegraph noise (RTN), as one dominant variation source in the ultra-scaled devices, has been attracting much more attention, and its analysis is of great importance to understand the fundamental physical mechanisms. In this work, with the advanced dual-point method, we successfully separate the impacts of each trap in multi-traps correlated RTN, especially for complex anomalous RTN signals. A four-level transfer curve and VG-dependent RTN magnitude are extracted in a two-trap transistor from the sub-threshold region to the linear region. Furthermore, current degradations contributed from each trap of three- and four-level RTN signals are identified and distinguished. The proposed method can be utilized to evaluate multiple traps RTN and explore the underlying physics.

To assess the outcome of ex vivo renal artery repair with orthotopic renal autotransplantation for patients with complex renal artery disease.The single-center study collected and analyzed the data from patients with complex renal artery disease undergoing ex vivo renal artery repair with orthotopic renal autotransplantation, retrospectively.A total of 21 complex renal artery lesions from 19 patients were included. The mean blood pressure showed a significant decrease from the preoperative to the postoperative period (P .05). Renal function kept stable for the perioperative period. No significant serum creatinine and estimated glomerular filtration rate alteration was observed compared with the immediate postoperative period (P = .439 and .904, respectively). The median renal cold ischemia time was 35.5 (76) minutes. Two patients developed perioperative complications, one with acute cholecystitis and one with acute renal failure after graft occlusion in a solitary kidney. During the median follow-up of 48 months, one single bypass graft of a solitary kidney was occluded, and four grafts developed restenosis. The primary and primary-assisted patency rates at the 5-year follow-up were 81.3% and 87.5%, respectively. No deaths were observed in the follow-up period.Ex vivo renal artery reconstruction with orthotopic renal autotransplantation in patients with complex renal artery disease offers stable control of blood pressure and renal function preservation, and should be considered as a potential alternative for other open surgical procedures.

Background To investigate the role of transmuscular quadratus lumborum block (TMQLB) for postoperative pain control, patient satisfaction and recovery in laparoscopic adrenalectomy. Methods Seventy-two patients aged between 18 and 70 years with an ASA I-II and scheduled for laparoscopic adrenalectomy were randomized to receive a single-shot TMQLB with 0.4 ml/kg 0.5 % ropivacaine or 0.4 ml/kg 0.9 % saline as placebo. The primary endpoint was pain on movement at 12 h after surgery evaluated by the numeric rating scale (NRS, 0–10). P-values Results NRS on movement at 12 h after surgery was lower in the TMQLB group compared with the control (median 2 vs. 3, p = 0.024). Intraoperative fentanyl consumption was lower in the TMQLB group (247.08 ± 63.54 vs. 285.44 ± 74.70, p = 0.022). The rate of using postoperative rescue tramadol was also lower in the TMQLB group (5.6 vs. 27.8 %, p = 0.027). Similar incidences of nausea and vomiting were observed (11.1 vs. 25 %, p = 0.220). Patient satisfaction of pain service was better in the TMQLB group (83.3 vs. 25 %, p p = 0.004) and flatus (18.5 vs. 23.5 h, p = 0.006). Conclusions TMQLB showed better control of postoperative pain on movement for laparoscopic adrenalectomy with improved patients’ satisfaction of anesthesia, shorter time to ambulation and flatus. Trial registration This study was registered at Clinicaltrials.gov (NCT03942237; registration date: 08/05/2019; enrollment date: 10/05/2019).

BACKGROUND With 1.6 billion users in 2021, TikTok has become the world's fastest-growing social media application ever since its first launch. Because of the explosion of information on it during the COVID-19 pandemic, more and more patients search for information on urinary tumors on TikTok. OBJECTIVE We aim to evaluate the quality and reliability of urinary tumor-related videos on TikTok by using robust assessing scales and share our thoughts based on the results for better public health promotion. METHODS We retrieved videos on bladder, prostate, and kidney cancer from TikTok. Each video's length and descriptions, hashtags, number of views/likes/comments, forms of expression, and the uploader's profile were included. Three validated assessment instruments: the Hexagonal Radar Schema, the Health on the Net Code scale, and the DISCERN instrument, were used for evaluating the quality and reliability of the information. All misinformation was counted and categorized. Univariate analysis of variance was performed for analyzing the results. The Post-Hoc least significant difference test was conducted to explore further explanation. RESULTS Out of 167 retrieved videos, only 61 (36.53%) met the inclusion criteria. Amongst them, 36.07% were misinformative, and the most common type was using outdated data. More than half of the videos could provide good (> 1 point) content on the diseases' symptoms and examinations. However, the definition and outcomes were poorly addressed (tied at 21.31 %). The HONcode scale and the DISCERN instrument revealed a consistent conclusion that most videos on TikTok were of poor to mediocre quality. Videos published by media agencies were statistically better than those posted by others in terms of reliability and overall score (P = .003 and .008, respectively). 86.89% of videos had at least two unexplained medical terms. Among them, healthcare professionals like to use professional terms most (mean = 5.28 words). CONCLUSIONS Most videos on urinary tumors on TikTok are of poor to medium quality and reliability. However, videos posted by media agencies enjoyed great public attention and interaction. Medical practitioners could improve the video quality by cooperating with media agencies and avoiding unexplained terminologies.

Enhanced recovery after surgery (ERAS) is a set of perioperative interventions to alleviate patients' stress response and complications, and to promote rehabilitation. Data on its implementation in renal cell carcinoma treated by laparoscopic partial nephrectomy are lacking.To evaluate the prospect of application of ERAS in laparoscopic partial nephrectomy based on real-world data.Sixty patients with T1a staging renal cell carcinoma (RCC) were randomly classified as the ERAS group (31 patients) or traditional treatment group (29 patients). Relevant endpoints including postoperative length of stay, ambulation, fart, oral intake, pain at different movement and time points, postoperative nausea and vomiting, complications as well as hospitalization expenses in the two groups were analyzed and compared.The ERAS optimization group presented a shorter time of first-time ambulation (p = 0.008), less pain at rest and ankle movement (p0.05), and less feeling of nausea 2 and 4 h after surgery (p = 0.006 and 0.027, respectively). (Although the differences in hospitalization expenses, postoperative length of stay, and complications were not reached in our study (p0.05), they were significantly lower than those reported in other literature.The idea of ERAS has had an imperceptible influence on clinical strategy making for over 20 years. This study shows that it could alleviate postoperative pain both at rest and movement, enable earlier walking, and reduce postoperative nausea in patients who have undergone laparoscopic partial nephrectomy. However, its efficacy is sometimes over-extended when compared to extreme conserative. Also, specific ERAS protocols and large-sample clinical trials are needed.

Backgroud: Bladder cancer (BLCA) is one of the most fatal types of cancer worldwide. However, there are limited methods for us to provide a prognostic prediction of BLCA patients. Therefore, we aimed at developing a lncRNA signature to improve the prognosis prediction of BLCA. Results An eight-lncRNA signature was significantly associated with recurrence free survival in BLCA patients from both discovery and validation groups. Furthermore, genes involved in the signature were enriched in extracellular matrix organization pathway. Finally, functional experiments demonstrated that six out of the eight lncRNAs significantly regulated the invasion of BLCA cells. Method A total of 343 BLCA patients from The Cancer Genome Atlas (TCGA) were employed and randomly divided into training (n=172) and validating (n=171) groups. The lncRNA expression profiles of BLCA patients were screened and a risk-score formula were created and validated according to the Cox regression analysis. Next, WGCNA method was employed to cluster genes that highly correlated with the risk scores based on the profiling data of TCGA dataset and transwell assay was also performed to further investigate the role of these lncRNAs. Conclusions Our results suggested that the eight-lncRNA signature was a candidate prognostic biomarker for predicting tumor recurrence of patients with BLCA.

The issue of contacts between the electrode and channel layer is crucial for wide-bandgap semiconductors, especially the β-Ga2O3 due to its ultra-large bandgap (4.6–4.9 eV). It affects the device p...

Purpose Radical prostatectomy (RP) is a common treatment for prostate cancer, but a fraction of patients may experience PSA recurrence after surgery, manifesting as an elevation in prostate specific antigen (PSA). Vast literature has reported different prognostic factors for PSA recurrence without reaching a consensus. This retrospective study investigated the efficacy of a new indicator in predicting PSA recurrence in patients after RP. Patients and methods From October 2000 to December 2015, 102 PCa patients who underwent laparoscopic prostatectomy in the Urology Department of Peking Union Medical College Hospital were analyzed. We calculated PSApostd3/PSApre, defined as the ratio of the PSA on day 3 postop as the numerator and the pre-operative PSA as the denominator, in these patients to represent PSA decrement after surgery, and investigated its relationship with PSA recurrence during follow-up. Results The receiver operating characteristic (ROC) curve of PSApostd3/PSApre derived a cut-off at 0.453 (sensitivity=0.704, specificity=0.853, P

A simple dual-point technique to measure the entire transfer characteristics (ID–VG) down to sub-threshold region in the nano-scaled MOSFET under random telegraph noise (RTN) condition with either capturing or emitting one elementary charge by a trap in the gate dielectric is proposed. Its compatibility with the commercial semiconductor analyzer makes it a readily-usable tool for future RTN study. In this letter, we use this technique to explore the VG dependence of RTN induced by a single trapped carrier in both n- and p-FETs.

Low-power circuits are important for many applications, such as Internet of Things. Device variations and fluctuations are challenging their design. Random telegraph noise (RTN) is an important source of fluctuation. To verify a design by simulation, one needs assessing the impact of fluctuation in both driving current $\Delta {I}_{d}$ and threshold voltage $\Delta {V}_{\textsf {th}}$ . Many early works, however, only measured RTN-induced $\Delta {I}_{d}$ . $\Delta {V}_{\textsf {th}}$ was not directly measured because of two difficulties: its average value is low and it is highly dynamic. Early works often estimated $\Delta {V}_{\textsf {th}}$ from $\Delta {I}_{d}/{g}_{m}$ ( ${V}_{g} = {V}_{\textit {dd}}$ ), where ${g}_{m}$ is the transconductance, without giving its accuracy. The objective of this paper is to develop a new Trigger-When-Charged (TWC) technique for directly measuring the RTN-induced $\Delta {V}_{\textsf {th}}$ . By triggering the measurement only when a trap is charged, measurement accuracy is substantially improved. It is found that there is a poor correlation between $\Delta {I}_{d}/{g}_{m}$ ( ${V}_{g} = {V}_{\textit {dd}}$ ) and the directly measured $\Delta {V}_{\textsf {th}}$ ( ${V}_{g} = {V}_{\textsf {th}}$ ). The former is twice of the latter on average. The origin for this difference is analyzed. For the first time, the TWC is applied to evaluate device-to-device variations of the directly measured RTN-induced $\Delta {V}_{\textsf {th}}$ without selecting devices.

This study aimed to provide rational guidelines for patients with subclinical Cushing syndrome (SCS), who are undergoing laparoscopic adrenalectomy, in order to avoid the risk of overtreatment.A total of 59 patients diagnosed with SCS caused by unilateral adrenal adenoma, who underwent laparoscopic adrenalectomy from 2010 to 2017, were included into the study. These patients did not receive prophylactic steroid treatment. After discharge, patients with adrenal insufficiency (AI) were treated with glucocorticoid. Then, cortisol levels were reevaluated at three months after surgery by morning serum cortisol.No severe perioperative complications occurred. After unilateral laparoscopic adrenalectomy, no patient developed AI and was readmitted. In the first week after surgery, 10 patients (16.9%) received steroid therapy at the clinic because of mild symptoms of AI. The probability of developing AI was greater in patients with 1-mg dexamethasone midnight suppression test (1 mg-DST)5 μg/dL than patients with mg-DST ranging within 1.8 to 5.0 μg/dL (P=0.042). The initial dose of hydrocortisone was 20.00±6.67 mg/d (range, 10 to 30), and the duration of treatment was 6.90±3.51 weeks (range, 3 to 12 wk). At three months after surgery, morning cortisol was5 μg/dL in all patients.After laparoscopic adrenalectomy, the probability of AI is small in patients with adrenal SCS, and the symptoms of AI were mild. Meanwhile, the HPA axis rapidly recovered. Therefore, prophylactic steroid treatment is not mandatory. Given that AI is more frequent in patients with higher cut-offs of 1 mg-DST, a more precise definition of SCS is necessary to better manage these patients.

The morbidity and mortality of prostate cancer (PCa) in China have increased obviously, which became the second leading cause of death in men with cancer. Hedgehog (Hh) signaling pathway is a key signaling pathway involved in the prostate cancer progression. The human oncogene SCL/TAL1 interrupting locus (STIL) can modulate the Hh signaling pathway, but its function in PCa has not been reported. Here, we showed that STIL was increased in high grade prostate cancer tissue. Knockdown of STIL in prostate cancer cells PC-3 and DU 145 significantly decreased the proliferation of cells and induced cellular apoptosis through casepase3/7 mediated pathway. Moreover, the colony formation ability was also inhibited when knockdown of STIL by lentivirus-mediated shRNA. Furthermore, the cellular signaling antibody array analysis revealed which signaling pathway was affected when silencing STIL. Altogether, we found that STIL could affect MAPK/ERK, PI3K/Akt and AMPK signaling pathways, thus promoting cellular proliferation, colony formation and suppressing cellular apoptosis in prostate cancer.

Objective: To report our management of bilateral adrenalectomy with autologous adrenal gland transplantation for persistent Cushing’s disease, and to discuss the feasibility of autologous adrenal transplantation for the treatment of refractory Cushing’s disease. Material and Methods: A retrospective analysis was performed in 4 patients (3 females, aged 14–36 years) who underwent autologous adrenal transplantation for persistent Cushing’s disease after endonasal transsphenoidal resection of a pituitary tumor. The procedure was performed by implanting a vascularized adrenal graft into the left iliac fossa with direct and indirect anastomoses. Postoperative follow-up was performed in 1, 1.5, 8, and 10 years, and an over 8-year long-term follow-up was reached in 2 out of the 4 cases. Hormone replacement dosage was guided by clinical symptoms and endocrine results including serum cortisol (F), 24 h urine-free cortisol, and adrenocorticotrophic hormone levels. Results: All 4 patients with symptomatic Cushing’s disease experienced resolution of symptoms after autotransplantation without Nelson Syndrome. Functional autografts were confirmed through clinical evaluation and endocrine results. One year after transplantation, adrenal function and hormone replacement dosage remained stable without adrenal hyperplasia. After long-term follow-up, dosages of hormone replacement were reduced in all patients. Conclusions: In this series of 4 patients, we demonstrate the long-term efficacy of bilateral adrenalectomy with autologous adrenal transplantation and propose this procedure as a viable treatment option for refractory Cushing’s disease.

4520 Background: RC48-ADC (Disitamab Vedotin) is a novel humanized anti-HER2 antibody-drug conjugate (ADC). RC48-ADC demonstrated a promising efficacy with a manageable safety profile in HER2-positive locally advanced or metastatic UC patients who failed to platinum based chemotherapy in RC48-C005 and RC48-C009 trials. Here are the pooled results of the two studies with the supplementary efficacy, safety and updated OS data. Methods: Both of the two trials are single-arm, multi-center, phase II trials. Eligible patients were 18̃80 years old, with central-laboratory confirmed, histologically HER2-postive (IHC2+,3+), unresectable mUC. Patients had at least one line of systemic chemotherapy. The primary endpoint was objective response rate (ORR). Progress-free survival (PFS), overall survival (OS), and safety were also assessed. Results: RC48-C005 and RC48-C009 enrolled HER2-positive locally advanced or metastatic UC patients from Nov 2017 to Sep 2020. 107 mUC patients (80 males; median age 63 y [40-79]) were enrolled. 64.5% patients had received ≥ 2 lines systemic chemotherapy. 90.7% patients had visceral metastases. As of 04 Sep 2021 (data cutoff), The overall confirmed ORR as assessed by the BIRC was 50.5% (95% CI: 40.6%, 60.3%). Similar responses were observed in prespecified subgroups. cORR was 52.1% (25/48) for patients with liver metastasis and was 55.6% (15/27) in patients with previous PD-1/L1 treatment. The cORR was 62.2% (28/45) for HER2 IHC2+&FISH+ or IHC3+ patients, 55.6% (5/9) for HER2 IHC2+&FISH unknown patients, and 39.6% (21/53) for HER2 IHC2+&FISH- patients respectively. DCR was 82.2% (95% CI:73.7%, 89.0%). The mPFS was 5.9 (95% CI:4.2, 7.2) months. The mOS was 14.2 (95% CI:9.7, 18.8) months. The median OS follow up time was 19.1 months. Most common treatment-related AEs were hypoaesthesia (50.5%), Leukopenia (49.5%), aspartate aminotransferase increased (43.0%), neutropenia (42.1%), alopecia (40.2%), asthenia (39.3%), alanine aminotransferase increase (35.5%), decreased appetite (31.8%). The grade ≥3 TRAEs (≥5%) only included hypoaesthesia (15.0%), neutropenia (12.1%) and r-GT increased (5.6%). Conclusions: RC48-ADC showed continuously a promising efficacy with a manageable safety profile in HER2-postive mUC patients who had failed at least one line systemic chemotherapy. Clinical trial information: NCT03507166, NCT03809013.

Background Prostate biopsy is the most common method for the diagnosis of prostate cancer and the basis for further treatment. Confirmation using radical prostatectomy specimens is the most reliable method for verifying the accuracy of template-guided transperineal prostate biopsy. The study aimed to reveal the spatial distribution of prostate cancer in template-guided transperineal saturation biopsy and radical prostatectomy specimens. Methods Between December 2012 to December 2016, 171 patients were diagnosed with prostate cancer via template-guided transperineal prostate biopsy and subsequently underwent laparoscopic radical prostatectomy. The spatial distributions of prostate cancer were analyzed and the consistency of the tumor distribution between biopsy and radical prostatectomy specimens were compared. Results The positive rate of biopsy in the apex region was significantly higher than that of the other biopsy regions (43% vs 28%, P

Rationale: Renal cell carcinoma (RCC) almost metastasizes to every organ, the possibility of adrenal metastasis is relatively low in patients that have undergone radical nephrectomy, only a few cases of bilateral adrenal metastasis are reported on literature. Although surgical treatment of metastases from RCC is preferred and contributes to the rate of survival, it is considered challenging to manage such cases due to the rarity of bilateral metastasis to the adrenal glands. Patient concerns: A 64-year-old Manchus female presented with an incidental ultrasonic finding of a left adrenal mass 4 years after radical nephrectomy for left renal cell carcinoma. Diagnosis: Abdominal contrast enhanced CT scan revealed bilateral adrenal masses, suggesting metastatic lesion. Examinations indicated neither local recurrence nor distant metastasis anywhere have been detected by whole body Positron Emission Tomography/Computed Tomography (PET/CT) scan except high radioactive uptake in bilateral adrenal glands. Interventions: Metachronous bilateral adrenalectomy was taken and laparoscopic right adrenalectomy was first performed. She was discharged home on third postoperative day. Pathological examination revealed metastatic renal cell carcinoma. Two months later she was performed laparoscopic left adrenalectomy. Outcomes: The patient healed without obvious complications and no tumor recurrence. Lessons: Bilateral metastatic adrenal recurrence from RCC is very rare. Early diagnosis of adrenal metastasis is challenging because they are usually silent both anatomically and functionally. Surgical intervention is a wise option for these patients that may improve survival, and metachronous bilateral adrenalectomy is proved to be safe and effective.

Background Renal tumors during pregnancy are rare and the treatment requires evaluation of both the patient and the fetus. No consensus or guidelines has been proposed or verified in this field. We successfully managed three renal tumor cases during pregnancy and reviewed the relative literature. Case presentation In the first renal cell carcinoma case diagnosed in the 21st week of pregnancy, laparoscopic retroperitoneoscopic partial nephrectomy was performed in the 26th week of pregnancy. In the second renal cell carcinoma case diagnosed in the 3rd week of pregnancy, laparoscopic retroperitoneoscopic radical nephrectomy was carried out after the abortion. In the third angiomyolipoma case who was diagnosed before pregnancy but received no treatment, we performed laparoscopic retroperitoneoscopic partial nephrectomy during the 17th week of pregnancy due to the rapid enlargement of the tumor. Conclusion Although no consensus or guidelines for the management of renal tumors in pregnant patients has been proposed or verified, the general rules of kidney tumor management in non-pregnant patients and the guidelines for surgery in pregnancy could be referred to. Renal tumors found in pregnant patients require an individualized treatment regimen involving surgical timing, routes, techniques, and excision ranges, which should be decided by both the patients and the surgical teams.

Pheochromocytoma (PHEO) is a rare neuroendocrine that tumor originated from the adrenal medulla that secrets catecholamines. Tumors from extra-adrenal chromaffin tissues are called extra-adrenal PHEO or paraganglioma (PGL). To our knowledge, adrenal PHEO and subclinical PGL with inferior vena cava (IVC) invasion had been sporadically reported, while functional PGL with IVC tumor thrombus has not been publicly reported yet. Perioperative management of those diseases is less well established because of their multidisciplinary nature and rarity. We herein present a case of primary malignant PGL with IVC invasion. A 16-year-old female patient with a history of severe paroxysmal hypertension was admitted to Peking Union Medical College Hospital on suspicion of retroperitoneal mass. In-house diagnostic work-up revealed a malignant PGL with IVC invasion, inferior mesenteric artery encasement and, aorta engagement. Multi-disciplinary discussions were held and careful preoperative preparation plans were made. After everything was ready, the functional PGL and tumor thrombus were completely resected, then a reconstruction of IVC was performed. The patient was discharged on postoperative day 14 and all her clinical symptoms disappeared afterward. No evidence of tumor residual or metastasis was found in the subsequent six months of follow-up. Gene tests were made for her and her family. Albeit its rarity, functional PGL with IVC invasion is not unresectable, a multi-disciplinary task force should be established to settle down every detail. We recommended 3-dimensional imaging reconstruction for gaining a better anatomic understanding. Literature reviews showed that complete resection is the premise of a good prognosis. In particular cases, complementary or alternative therapy like chemotherapy and (131)I-metaiodobenzylguanidine might help, family hereditary genetic tests are advised as well.

A straightforward and fast (~200 µs) DCIV technique, which is completely compatible with the commercial semiconductor analyzer., is demonstrated to measure the time kinetics of interface trap generation (ΔN I T ) during and after DC/AC NBTI stress in Si p-FinFETs. The measurement time of each VG step in a staircase IV waveform can be down to 2 µs, It is found that the repassivation of ΔN IT after DC stress is a very fast process and happens within 200 µs recovery time. The delayed recovery phenomenon of ΔN IT is observed only for Mode-B AC stress and high frequency (f) Mode-A AC stress., resulting in the f-dependent ΔN IT under Mode-A AC stress and f-Independent ΔN IT under Mode-B AC stress.

A comparative study is carried out to clarify the energy distribution of traps under hot carrier degradation (HCD) and negative bias temperature instability (NBTI) in short channel p-FinFETs. Two sources of traps, pre-existing traps and generated traps, are identified and their energy profiles are separated using Discharging-based Multi-pulse (DMP) method. The pre-existing traps are located below valance band of silicon (Ev), while the two generated traps are located in 0.4eV above E v and near conduction band (E c ) of silicon, respectively. The two generated traps are highly sensitive to stress voltage and stress time under NBTI and HCD, however, the generated trap 1 is more sensitive to stress temperature than generated trap 2 under HCD. When switching to long channel devices, the overall degradation is reduced due to less trap generation.