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author:("WANG, dongen")
1.  Protein Profiling of Bladder Urothelial Cell Carcinoma 
PLoS ONE  2016;11(9):e0161922.
This study aimed to detect protein changes that can assist to understand the underlying biology of bladder cancer. The data showed forty five proteins were found to be differentially expressed comparing tumors vs non-tumor tissues, of which EGFR and cdc2p34 were correlated with muscle invasion and histological grade. Ten proteins (ß-catenin, HSP70, autotaxin, Notch4, PSTPIP1, DPYD, ODC, cyclinB1, calretinin and EPO) were able to classify muscle invasive BCa (MIBC) into 2 distinct groups, with group 2 associated with poorer survival. Finally, 3 proteins (P2X7, cdc25B and TFIIH p89) were independent factors for favorable overall survival.
PMCID: PMC5023150  PMID: 27626805
2.  AB108. The changes of detrusor relaxation capacity and βreceptor expressions in type 2 diabetic rats 
Translational Andrology and Urology  2016;5(Suppl 1):AB108.
To investigate the changes in relaxation capacity and expression of β receptors with the progression of type 2 diabetes mellitus in SD rat model.
Detrusor strips, when stimulated in vitro by isoprenaline, a β receptor, at increasing concentrations (1×10-9–3×10-5), were employed to conduct the contraction/relaxation test. This may allow the determination of the changes in contractility at various time points in rats with diabetes mellitus (DM) and normal controls. Flow cytometry was adopted to examine the alteration in β3 receptors on the cellular membrane following digestion of detrusor cells. The cells of bladder were homogenized for subsequent assessment of the changes in G protein subtypes at various time points by Western blotting.
In our present study, detrusor strips were subjected to isoprenaline stimulation at various concentrations, rats with DM were associated with a lower half maximal inhibitory concentration (IC50) yet higher maximal distention (Emax) when compared with normal controls at week 8 (P<0.05 and 0.01, respectively). An opposite trend was noted at week 16 (P<0.01 and 0.05, respectively). A lower IC50 and profoundly reduced Emax were found in rats with DM at week 24 (both P<0.01). At week 8, rats with DM yielded increased expression of β3 receptors on the cellular membrane (P<0.05). However, suppression of β3 receptor expression was noted at week 16 when compared with that of normal controls (P<0.05), as suggested by the intensity of fluorescence. The reduction in β3 receptor expression in rats with DM was further aggravated at week 24 (P<0.01).
Increased relaxation capacity is associated with a higher sensitivity to isoprenaline at the early stage of disease in rats with DM, the results that coincided with raised, but not suppressed, β3 receptor expression in the detrusor that could have stemmed from compensation.
PMCID: PMC4842527
β receptors; relaxation; diabetes mellitus; detrusor
3.  Clinicopathologica Epidemiological Characteristics and Change Tendencies of Renal Cell Carcinoma in Shanxi Province of China from 2005 to 2014 
PLoS ONE  2015;10(12):e0144246.
RCC is the most common solid renal malignancy in adults worldwide. To provide the insight of clinicopathologica epidemiological characteristics and change tendencies of renal cell carcinoma (RCC), 2154 cases were collected from Shanxi Province of China, including diagnose time, age, gender, tumor size, Fuhrman grade, tumor stage, tumor location, local advance or distant metastasis and first symptom from 2005 to 2014. This retrospectively investigation, as its general objective, was to analyze the clinicopathologica epidemiological characteristics and the change tendencies of RCC.
Between 2005 and 2014, 2154 patients who were diagnosed with RCC in three large tertiary hospitals at Shanxi Province were included. The patients’ demographic features, pathological diagnoses and metastatic statuses were analyzed. Statistics methods include the chi-squared test, analysis of variance, Spearman’s correlation analysis, Logistic regression and ARIMA modeling.
Of the 2154 included patients, the constituent ratio of female /male was 63.1% and 36.9%, with the median age of 57 years old. Fuhrman grade distributions differed significantly between males and females (p = 0.024). Also, a significant difference in tumor size was found by different clinical stages (p < 0.001), with a linear correlation (p < 0.001). Moreover, Spearman’s analysis indicated tumor grade has a negative correlation with female (p = 0.009) and a positive correlation with tumor size (p = 0.000). It was found that the tumor diameter is bigger in the left side (p = 0.022). Furthermore, the metastasis rate was higher in the bigger tumor (p < 0.001) and the left-sided tumors (p = 0.027). Logistic regression also showed that tumor size is a risk factor for metastasis (OR = 1.724). The risk of local advance or distant metastasis in the left kidney was 1.6-fold greater than that of the right kidney. From 2005 to 2014 the number of RCC cases gradually increased (mainly for pathological grade II and III, but grade I and IV), while the average tumor size decreased, showing the severity increase mildly. Base on the results of a time series analysis-prediction the average RCC size would continue to decrease from the first quarter of 2015 to the fourth quarter of 2016.
The cases of RCC increased from 2005 to 2014 with clear cell type as the main pathological type in this population. The characteristics in the constituent ratios of the RCC vary depending on gender, pathological grade, tumor size, and location, which may be the important factors impacting treatment and prognosis.
PMCID: PMC4669184  PMID: 26633179
4.  Highly differentiated squamous cell carcinoma arising from a suprapubic cystostomy tract in a patient with transplanted kidney 
Squamous cell carcinoma arising from a suprapubic cystostomy tract (SCC-SCT) is a relatively rare bladder malignancy. We present a case of highly differentiated SCC-SCT involving the bladder in a 61-year-old patient with transplanted kidney. Abdominal magnetic resonance imaging revealed an anomalous mass (8 cm × 6 cm × 5 cm) surrounding the suprapubic cystostomy and a space-occupying lesion in the bladder. The pathology report revealed highly differentiated SCC. The patient received radiation therapy after he refused aggressive surgical management in 2012. There was no evidence of metastasis at his latest follow-up in early 2015.
PMCID: PMC4723986  PMID: 26885141
Squamous cell carcinoma; suprapubic cystostomy; bladder malignancy
5.  AB069. The observation on affection of TURED on obstructive azoospermia 
Translational Andrology and Urology  2015;4(Suppl 1):AB069.
Explore the curative effect of obstructive azoospermia by using operation.
Eighteen18 patients treated by TURED operation in CSEA, 17 of them need cut-through verumontanum to find the openings of ejaculatory duct by 22# resectoscope, then take a bit of seminal fluid by using seminal vesicle mirror, and find semens in microscope. Three of them need use holmium laser to enlarge enlarge. All of them were required indwelling 14# catheter 2 days after operation, and encourage them to have sex soon.
The 18 patients within about 1 week after operation. Fourteen of them can find semens in seminal fluid, one of them make a successful conception. Nine patients need to take medicine to improve the quality of semens.
Combined tiny operational trauma and rapid recovery, TURED is a valid approach to cure obstructive azoospermia and worth using widely.
PMCID: PMC4708828
Obstructive azoospermia; seminal vesicle mirror; operation
6.  A comparison of NBI and WLI cystoscopy in detecting non-muscle-invasive bladder cancer: A prospective, randomized and multi-center study 
Scientific Reports  2015;5:10905.
Several single-center studies have investigated whether narrow-band imaging (NBI) cystoscopy is more effective in detecting primary and recurrent non-muscle invasive bladder cancer (NMIBC) compared with white-light imaging (WLI) cystoscopy. In this study, we further evaluated the diagnostic value of NBI cystoscopy compared with WLI cystoscopy for primary NMIBC in a multi-center study. Suspected bladder cancer patients from 8 research centers received both NBI and WLI. Two experienced doctors in each center were responsible for the NBI and WLI assessments, respectively. The number of tumors and position of each tumor were recorded, and suspicious tissues were clamped and histologically examined. The sensitivity, specificity, and false-positive rate of NBI and WLI were evaluated. Of the 384 patients, 78 had a confirmed urothelial carcinoma (UC). The sensitivities of NBI and WLI were 97.70%, and 66.67%, respectively (P < 0.0001); the specificities were 50% and 25%, respectively; and the false positive rates were 50% and 75%, respectively. Based on 300 valid biopsy specimens, the NBI and WLI sensitivities were 98.80% and 75.45%, respectively (P < 0.0001). These results suggest that NBI has a high sensitivity and has superior early bladder tumor and carcinoma in situ (CIS) detection rates compared with WLI cystoscopy.
PMCID: PMC4456941  PMID: 26046790
7.  Epigenetic Regulation of Elf5 Is Associated with Epithelial-Mesenchymal Transition in Urothelial Cancer 
PLoS ONE  2015;10(1):e0117510.
E74-like factor 5 (Elf5) has been associated with tumor suppression in breast cancer. However, its role in urothelial cancer (UC) is completely unknown. Immunohistochemistry (IHC) and methylation specific PCR (MSP) were done to detect Elf5 expression level and its promoter methylation. Results revealed that low expression of Elf5 on protein and mRNA levels were associated with tumor progression, early relapse and poor survival. In vitro, down-regulation of Elf5 can increase epithelial-mesenchymal transition (EMT). Aberrant Elf5 methylation was identified as major mechanism for Elf5 gene silence. Accordingly, restoration of Elf5 by infection or demethylating treatment effectively reversed EMT processes. In conclusion, we identified Elf5 as a novel biomarker of UC on several biological levels and established a causative link between Elf5 and EMT in UC.
PMCID: PMC4309403  PMID: 25629735
8.  Willingness of Parkinson's Disease Patients to Participate in Research Using Internet-Based Technology 
Telemedicine Journal and e-Health  2012;18(9):684-687.
Motor impairment and travel time have been shown to be important barriers to recruitment for Parkinson's disease (PD) clinical trials. This study determined whether use of Internet-based video communication for study visits would improve likelihood of participating in PD clinical trials. Subjects and Methods: University of Utah PD clinic patients were invited to complete a survey asking if they would be willing to participate in a hypothetical research study under four different scenarios. McNemar's test was used to test the hypothesis that remote assessments would improve willingness to participate. Results: Willingness to participate was 101/113 (87%) in the standard scenario. Willingness to participate was highest (93%; p=0.046) with most visits occurring via telemedicine at a local clinic, followed by some visits occurring via telemedicine at a local clinic (91%; p=0.157). Willingness to participate was lower with some (80%; p=0.008) or most (82%; p=0.071) visits occurring by home telemonitoring. Conclusions: Use of telemedicine may be an acceptable means to improve participation in clinical trials. This would need to be confirmed with the use of a larger-scale inquiry involving rural populations. Future research should assess subject or caregiver comfort and trainability with respect to computer-based technology in the home and systems barriers for wider implementation of telemedicine in neurology.
PMCID: PMC3491628  PMID: 22954069
Parkinson's disease; clinical trials; telemedicine; telemonitoring; neurodegenerative disease
9.  CTSA-IP: A solution to identifying and aggregating intellectual property across the NIH Clinical-Translational Science Award (CTSA) consortium of biomedical research institutes 
CTSA-IP ( is a web-based, open access intellectual property (IP) search tool that aggregates and promotes technologies from member institutions of the National Institutes of Health’s (NIH) Clinical Translational Science Awards (CTSA) consortium. Its ultimate aim is to stimulate collaborative research activity by encouraging the formation of public-private partnerships with CTSA institutions and the NIH. First launched in 2009, CTSA-IP has grown rapidly and met its first objectives of developing wide member institution participation and site usage. This article will discuss the strategy employed in the initiative of aggregating IP across institutional boundaries, the promise that lies therein, as well as the challenges encountered and lessons learned in promoting CTSA-wide engagement.
PMCID: PMC3670705  PMID: 22029803
10.  Immunogenicity of Trivalent Influenza Vaccine in Extremely-Low-Birth-Weight, Premature versus Term Infants 
Influenza vaccine immunogenicity in premature infants is incompletely characterized.
To assess the immunogenicity of trivalent, inactivated influenza vaccine (TIV) in extremely low-birth-weight (ELBW, ≤1000 grams birth weight), premature (<30 weeks gestation) infants. We hypothesized that geometric mean titers (GMT) of influenza antibody would be lower in premature than in full-term (≥37 week) infants.
In this prospective, multicenter study, former premature and full-term infants ages, 6–17 months, received 2 doses of TIV during the 2006–7 or 2007–8 influenza seasons. Sera were drawn before dose 1 and 4–6 weeks after dose 2. Antibody was measured by hemagglutination inhibition.
Over two years, 41 premature and 42 full-term infants were enrolled; 36 and 33 of these infants, respectively, had post-vaccination titers available. Premature infants weighed less (mean 1.3 – 1.8 kg difference) at the time of immunization than full-term infants. Pre-vaccination titers did not differ between groups. Premature infants had higher post-vaccination antibody GMT than full-term infants to H1 (2006–7, 1:513 v. 1:91, P=0.03; 2007–8, 1:363 v. 1:189, P=0.02) and B/Victoria (2006–7, 1:51 v. 1:10, P=0.02). More premature than full-term infants had antibody titers ≥ 1:32 to B/Victoria (85% v. 60%, p=0.04) in 2007–8. Two (5%) premature and 8 (19%) full-term infants had adverse events, primarily fever, within 72 hours after vaccination. No child had medically-diagnosed influenza.
Former premature infants had antibody responses to two TIV doses greater than or equal to those of full-term children. Two TIV doses are immunogenic and well tolerated in ELBW, premature infants 6–17 months old.
PMCID: PMC3090695  PMID: 21273938
Premature infant; very low birth weight infant; influenza vaccines; immunization; vaccines
12.  Assessing Patient Preferences for Delivery of Reminders on Scheduled Visits in a Psychiatry Ambulatory Service 
Reminder systems can improve compliance with care standards, yet the reminder delivery parameters and associations with other success factors have not been fully understood. In this study, we assessed patient preferences for reminder delivery in a psychiatry ambulatory service, using both quantitative and qualitative analyses. Results from a survey showed that most patients had a positive attitude to reminders for both scheduled (76%) and missed (89%) visits. Phone call (61%) delivered two days before an appointment (47%) was the most preferred type and time of reminder delivery. Logistic regressions on survey data showed that preferences of reminder delivery parameters were associated with service types and patient populations, which was cross-validated by the follow-up interviews with the staff at two ambulatory sites. A single-mode reminder delivering method cannot satisfy different types of patients. Intervention designs that involve building a system with a variety of methods customized to patient needs and balanced with administrative simplicity need to be further studied.
PMCID: PMC2655869  PMID: 18693942
13.  The InterMed Approach to Sharable Computer-interpretable Guidelines: A Review 
InterMed is a collaboration among research groups from Stanford, Harvard, and Columbia Universities. The primary goal of InterMed has been to develop a sharable language that could serve as a standard for modeling computer-interpretable guidelines (CIGs). This language, called GuideLine Interchange Format (GLIF), has been developed in a collaborative manner and in an open process that has welcomed input from the larger community. The goals and experiences of the InterMed project and lessons that the authors have learned may contribute to the work of other researchers who are developing medical knowledge-based tools. The lessons described include (1) a work process for multi-institutional research and development that considers different viewpoints, (2) an evolutionary lifecycle process for developing medical knowledge representation formats, (3) the role of cognitive methodology to evaluate and assist in the evolutionary development process, (4) development of an architecture and (5) design principles for sharable medical knowledge representation formats, and (6) a process for standardization of a CIG modeling language.
PMCID: PMC305452  PMID: 14527977
14.  GESDOR – A Generic Execution Model for Sharing of Computer-Interpretable Clinical Practice Guidelines 
We developed the Guideline Execution by Semantic Decomposition of Representation (GESDOR) model to share guidelines encoded in different formats at the execution level. For this purpose, we extracted a set of generalized guideline execution tasks from the existing guideline representation models. We then created the mappings between specific guideline representation models and the set of the common guideline execution tasks. Finally, we developed a generic task-scheduling model to harmonize the existing approaches to guideline task scheduling. The evaluation has shown that the GESDOR model can be used for the effective execution of guidelines encoded in different formats, and thus realizes guideline sharing at the execution level.
PMCID: PMC1480330  PMID: 14728262
15.  Extended attributes of event monitor systems for criteria-based notification modalities. 
The efficacy of event monitors (EMs) at reducing morbidity and mortality of certain clinical conditions (CCs) is well established. In addition, studies have shown that user inverted exclamation mark s preferences on the modality of notification are correlated to the type of reminder or alert. Nonetheless, few institutions have implemented large scale automated monitoring of a considerable number of distinct CCs, and to our knowledge, none of these sizable projects also offer user-customizable communication modalities (CMs) over all monitored conditions. As both the numbers of CMs and CCs increase, the complexity of customizing user preferences amplifies following a geometric progression. This paper demonstrates an automated approach, based on generic notification attributes (NAs) and notification criteria (NC), which significantly simplifies the management and personalization of the CMs for institutions where the manual assignment of a CM for every alert is forbidding. The methods by which these NAs were developed, their significance for existing CCs and their implementation using the Arden Syntax and Guideline interchange format (GLIF) are described. The proposed Criteria-Based Notification is shown to improve two facets of the management of event monitors: 1) the assignment of CMs becomes independent from clinical conditions, de-facto removing institution-specific CMs from the knowledge bases of the event monitors and inserting CC-specific and institution-independent NAs, thus increasing their reusability and sharability; 2) knowledge-based independent NAs facilitate both institution-level management and user-level preference configuration.
PMCID: PMC2244499  PMID: 12463927
16.  GLEE--a model-driven execution system for computer-based implementation of clinical practice guidelines. 
We have developed the GLEE system for execution of guidelines encoded in the GLIF3 format. This system can be integrated with a local clinical information system through standard interfaces to EMRs and clinical applications. The execution model of GLEE takes the "system suggests, user controls" approach. A tracing system is used to record the state of guideline steps and their transitions. GLEE provides an internal event-driven execution model that can be hooked up with the clinical event monitor in a local environment. We discuss the execution flexibility provided by GLEE and issues related to its integration in a local environment. Potential use of GLEE includes clinical decision support, quality assurance, guideline development and medical education.
PMCID: PMC2244320  PMID: 12463946

Results 1-17 (17)