The TNM staging is the most common tumor staging system of lung cancer.The new revisioned 7th lung cancer TNM staging is published by the international association for the study of lung cancer (IASLC) in the 13th world conference on lung cancer.Accurate clinical staging depends on the multi-analysis from medical histroy,clinical examination,imaging examination and invasive test,which has important significance for guiding the treatment of lung cancer.The 7th lung cancer TNM classification has been revised respectively from the primary focus,lymph node metastasis and remote viscera metastasis,so as to make it more accurately corresponding to the prognosis of patients.

Objective To evaluate the effects of peer education program on HIV/AIDS prevention among senior high school students. Methods Three senior high schools were randomly selected from Hongkou District of Shanghai as sample schools. One hundred and forty-three students from one class of each school were randomly selected as intervention group,and 152 students from another class of each school were served as control group. Six class hours of peer education program on HIV/AIDS prevention were conducted among intervention group. The same questionnaires which contained knowledge of reproductive health,HIV/AIDS and sexually transmitted diseases were administered before the program,one week and one year after the program. Results The knowledge scores before the program,one week and one year after the program in intervention group were 21.66?8.71,31.72?7.78 and 30.97?8.46,respectively,and those in control group were 22.32?9.24,22.61?8.66 and 22.51?9.16,respectively. There was no significant difference in the knowledge scores before the program between intervention group and control group,while there were significant differences in the knowledge scores one week and one year after the program between intervention group and control group (P

Objective To summarize the clinical and pathological characteristics of gastrointestinal stromal tumors with hepatic metastasis, and to analyze its survival and explore its principles of diagnosis and treatment. Methods Among 99 patients diagnosed as gastrointestinal stromal tumors who had a completely case history in our hospital, we retrospectively analyzed the clinical data of 26 patients with hepatic metastatic and the factors influencing survival. Results The average age at diagnosis of primary and hepatic metastatic gastrointestinal stromal tumors was 50.8 and 51.8 years old respectively. Five cases were confirmed by pathological examination, 12 cases were diagnosed by the exploration during the operation and 14 patients had an imaging diagnosis only. Synchronous and metachronous hepatic metastasis happened in 8 and 18 patients respectively. The median interval between the primary tumor and the metachronous hepatic metastasis was 12 months. The primary sites of 12 cases were in stomach, 5 in colorectum, 6 in small intestine and 3 in extra-gastrointestinal tract.Four cases of the hepatic metastatic tumors were treated with surgical resections, 2 with injections of anhydrous alcohol, 3 with interven-tional therapies, 7 with systemic chemotherapies, 8 with imatinib and 2 without treatment. The median survival was 21 months after hepatic metastasis. The administration of imatinib was an important factor prolonging the survival after hepatic metastasis. Conclusions The most frequent primary site of hepatic metastatic stromal tumor is the stomach while small intestinal stromal tumors are most inclined to metastasize to the liver. Treatment with imatinib for more than 3 months can prolong the survival.

History, 20th Century ; History, 21st Century ; Periodontics ; history

Actins ; metabolism ; Angiomyolipoma ; pathology ; Carcinoma, Renal Cell ; pathology ; Diagnosis, Differential ; Epithelioid Cells ; metabolism ; pathology ; Female ; Gastrointestinal Neoplasms ; pathology ; Gastrointestinal Stromal Tumors ; pathology ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; Lung Neoplasms ; pathology ; Lymphangioleiomyomatosis ; pathology ; Male ; Melanoma ; pathology ; Melanoma-Specific Antigens ; metabolism ; Pancreatic Neoplasms ; pathology ; Perivascular Epithelioid Cell Neoplasms ; metabolism ; pathology ; Sarcoma, Clear Cell ; pathology ; Skin Neoplasms ; pathology ; Uterine Neoplasms ; pathology

BACKGROUND: Lower urinary tract abnormality (LUTA) can lead to end-stage renal disease (ESRD). However, insufficient attention has been paid to these patients in China, and they are usually thought unsuitable for kidney transplantation because of high incidences of graft dysfunction and septic complication.OBJECTIVE: To explore the characteristics and postoperative follow-up after kidney transplantation in four patients with LUTA.DESIGN, TIME AND SETTING: A retrospective analysis of LUTA cases was performed from July 2002 to June 2006 at the Organ Transplantation Center of Chinese PLA, Second Affiliated Hospital of General Hospital of Chinese PLA.PARTICIPANTS: Four ESRD cases of LUTA, who received allograft kidney transplantation.METHODS: Four cases of LUTA experienced detail evaluation before kidney transplantation. Ureter was reimplanted into the original bladder during transplantation and suprapubic cystostomy was performed as urinary drainage.MAIN OUTCOME MEASURES: Patient and graft survival, graft function, urinary tract infection (UTI) and graft rejection were supervised after surgery and quality of life was evaluated.RESULTS: Two patients recovered well with normal renal function and no rejection. Despite the moderate but easily controlled UTI, they handled the urinary diversion well and were satisfied with the quality of life. One patient experienced an acute rejection 17 days after transplantation and survived with functional graft until now after the rejection was reversed. One patient lost the graft for repeated hemorrhage at the site of vascular anastomosis, and then returned to hematodialysis.CONCLUSION: Kidney transplantation is suitable but special for patients with LUTA. Careful evaluation before transplantation, suitable urinary drainage and rigorous follow-up after surgery are keys to the success of kidney transplantation for this subgroup of patients.

Objective To study the chimerism formation in kidney transplantation recipient receiving peripheral blood stem cells (PBSCs) of the donor after the patient received preoperative total lymphoid irradiation (TLI). Methods 5 patients of living donor kidney transplantation were involved in present study. The mean age of donors was 40 and that of recipients was 27. There was one patients with 4 HLA antigen mismatches out of 6 HLA-A, B, DR antigens, two patients with 3 HLA-mismatches, and two patients with 1 HLA-mismatch. The patients received TLI in doses 90cGy/d from day -5 to day -1. The immunosuppression protocol for these patients during operation and afteroperation was similar to that for other cases, but the dosage was slightly reduced. Donor PBSCs were harvested twice via leukapheresis after the administration of human recombinant granulocyte colony stimulating factor (G-CSF). PBSCs were infused intravenously to the recipients on postoperative day 4 and 7. Chimerism of peripheral blood cell in recipients was detected by PCR-SSP assays. The grafted kidney function, acute rejection frequency and GVHD episodes were also observed. Results After 5 days of G-CSF based mobilizing regimen, the average number of PBSCs harvested from donors was 34?10~6. At 1 month post-transplantation, donor type HLA-DR gene was detected in all the recipients. At 2 and 3 months post-transplantation, chimerism was not detectable in the recipient with 4 HLA antigens (including 2 HLA-DR) mismatched donor kidney and in the recipient with 3 HLA (including 2 HLA-DR and 1 HLA-B) mismatched donor, respectively. In the other 3 recipients, chimerism was still positive 3 months post-transplantation. There were no symptoms of GVHD or infections after infusion of PBSCs. Transplanted kidneys functioned normally and no rejection episodes were observed till the end of the study. The immunosuppressant dosage was lower for these 5 cases than those after conventional cadavar renal transplantation. Conclusions Non-myeloablative TLI conditioning regimen is a safe and effective method which can promote the engraftment of donor PBSCs and induce hemopoietic chimerism. Chimerism can alleviate rejection of the transplanted kidney and reduce the immunosuppressant dosage. Collection and infusion of PBSCs are simple, convenient, effective, and inexpensive, and it is an optimal source of hemopoietic stem cells.

Objective To determine the changes in expressions of thrombin receptor and fibrin deposit in glomeruli during the process of senility. Method Rats were divided into 3 groups (8 rats in each group): 3-month-old group (3m), 12-month-old group (12m) and 24-month-old group (24m). Fibrin deposition was detected by Martius-Scarlet-Blue staining and direct immunofluorecence method. Immunohistochemical studies were performed to detect the expression of thrombin receptor (PAR-1) and transforming growth factor-? (TGF-?). Semi-quantitative PCR was performed to detect the changes in PAR-1 mRNA expression. A quantitative analysis of the expressions was performed by image analysis system. Result Significant pathological changes were found in glomeruli during the process of senility. Fibrin deposition was not observed in glomeruli in different groups. Significant expression of PAR-1 was found in glomerular endothelial cells, mesangial cells and epithelial cells in 3m rats. On the contrary, in 24m rats, PAR-1 expression in glomeruli was significantly decreased. Expression of TGF-? was increased with senility in glomeruli. PAR-1 gene expression, barely detectable in control tissue, was strikingly increased in 24m rats. Conclusion Thrombin receptor activation could be found in glomeruli of senile rat, and it is independent of fibrin deposition. Activation of PAR-1 may play an important role in the process of renal senility.

Objectives To investigate the surgical technique and some other related problems of simultaneous heptorenal transplantation. Methods Combined liver-kidney transplantation was performed in one patient with huge polycystic liver, bilateral kidney, and another with liver cirrhosis after hepatitis B complicated with hepatic carcinoma and uremia due to chronic nephritis. Donors' organs were infused in situ with UW solution and rapidly harvested. Orthctopic or piggyback liver tranlsplantation was carried out and the kidney was transplanted with conventional method respectively. The patients received an immunosuppression therapy including simulect (CD25 antibody), FK506 or CsA, Mycophenolate mofitil (MMF), and Predinision. Results Both transplanted organs rapidly functioned well after the operation. One patient recovered well but suffered from ALI (acute lung injury) on the 2nd postoperative day and ARDS on the 11th postoporative day. There were no acute rejection or recurrence of the primary diseases in both cases. Conclusions Simultaneous hepatorenal transplantation is one of the treatment methods for end stage liver and kidney diseases. Skillful operative technique, comprehensive perioperative monitoring and appropriate management are all important factors for obtaining a successful result. It requires more shillful techniques than single organ transplantation.

Objective To investigate the safety and effectiveness of the application of an immunosuppressing primed total lymphoid irradiation (TLI) of the recipient in kidney transplantation of living donor kidney graft. Methods 5 recipients, 3 males and 2 females with the average age of 27, underwent the primed regimen of TLI. As to 6 HLA-A, B, DR antigens of donors and recipients, 4 HLA antigen mismatches were found in one case, 3 mismatches in two cases, and 1 mismatch in two cases. The donor grafts were procured by the technique of hand-assisted transperitoneal laparoscopic living donor nephrectomy (HLDN). The primed regimen of TLI was carried out 5 days before the operation in a dosage 90 cGy/d. The intra- and postoperative immunosuppressant protocols for these cases were similar to that for the other cases, but the doses were reduced slightly. WBC, total T cell, CD4~+ and CD8~+ T cell subsets and Th1/Th2 immune deviation were examined in recipients periodically. The function of the grafted kidney, acute rejection frequency, and side effects of TLI were also observed. Results In the recipients undergone TLI, the total WBC and T cell, CD4~+ and CD8~+ subsets were reduced to a base value at 1-2 weeks post-transplantation and did not restore to the pre-transplantation levels until the investigation was ended. A particular phenomenon showing that in TLI based regimen T cells were shifted from Th1 to Th2 cells was observed. No side effects of TLI, such as infection, were found during the observation. Transplanted kidneys functioned normally and no rejection episodes were observed up to the end of the study. The immunosuppressant doses for those 5 cases were lower than that of conventional protocol. Conclusions TLI based non-myeloablative primed regimen is a safe and effective method for immunosuppression without serious side effects, and it can markedly alleviate kidney transplant rejection and reduce the dosage of immunosuppressive drugs.