Objective To Validate the prognostic significance of the European Organization for Research and Treatment of Cancer (EORTC) risk tables in Chinese patients with non-muscle invasive bladder cancer (NMIBC). Methods According to the scoring standard of the EORTC system, 225 NMIBC patients were reviewed and divided into 3 groups: low, intermediate and high risk groups for recurrence and progression respectively. The probabilities of recurrence and progression at 1 year and 5 year for each group were calculated using life-table analysis and then compared with the EORTC risk tables. Log-Rank test and multivariable analysis were used to analyze the possible differences between risk groups and to find independent prognostic factors. Results For low (n= 32, 25), intermediate (n=109, 128) and high (n=84, 72) risk groups, the probabilities of recurrence and progression at 1 year were 15. 1%, 31.2%, 55.5% and 0. 3%, 2. 0%, 15.5% respectively. The probabilities at 5 year were 28. 2%, 55.2%, 75.0% and 1.4%, 12.9%, 54. 7%. All the results were similar to that of EORTC tables except the probability of progression at 5 year for the high progression risk group.The differences between different risk groups were significant (P＜0.01). In a multivariable analysis for recurrence and progression, the EORTC scores had independent significance (P＜0.01). Conclusions EORTC risk tables could stratify NMIBC patients effectively according to the risk of recurrence and progression. It could be a useful tool for Chinese urologists.

Objective To determine the main CT features and the key points of differential diagnosis of multilocular cystic renal cell carcinoma (MCRCC) classified according to 2004 WHO pathological diagnostic criteria. Methods According to the criteria, 40 patients were divided into two groups: MCRCC group and other subtypes of cystic renal cell carcinoma (CRCC). The CT findings were evaluated and compared between two groups for cystic content, wall, septum, nodularity, calcification and enhancement. ROC curve was used to determine the cut-off value of the possible CT feature which could distinguish MCRCC from other subtypes of CRCC. Results Seventeen cases of MCRCC group and 23 cases of CRCC group were included in this study according to the diagnostic criteria. MCRCC appeared as a well defined multilocular cystic mass with thin wall and sepia and no expansile solid nodules. Thickness of cystic wall and/or septum is was main CT findings to distinguish MCRCC from other subtypes of CRCC (P ＜ 0.01 ). The cut-off value of the thickness was 6 mm and its sensibility, specificity was 89% ,75% respectively. Conclusion Cystic wall and/or septum with a thickness of less than 6 mm are the main CT findings to dis tinguish MCRCC from other subtypes of CRCC.

Objective To investigate the relationship between tumor location and the risk of developing bladder cancer in pafients treated by nephroureterectomy(NU)for upper urinary tract transitional cell carcinoma(UUT-TCC).Methods The clinical data of 168 UUT-TCC patients who underwent NU were reviewed.Univariate and multivariate analysis were carried out to determine the risk factors for intravesical recurrence after NU.Results The recurrence-free survival rate at 1,3 and 5 years after NU were 88%, 76%and 63%.All patients were followed up for a median period of 45(12-107)months During this period, a total of 49 patients developed bladder tamors after surgery,of which 28 cases were renal pelvic carcinoma, 2 cases were rniddle ureter carcinoma and 19 cases were distal ureter carcinoma.The recurrence-free survival of renal pelvic carcinoma and ureter carcinoma had no significant difference by Log-Rank test(P>0.05).On multivariate analysis,only locating in distal ureter carcinoma was the independent risk predictor for intravesical recurrence after NU (P<0.01).Conclusion Pafients with UUT-TCC at distal ureter carry a higher risk for intraeesieal recunerrce after NU than those with TCC at other location of upper urinary tract.

Objective To explore the mechanism of effects of cardiac sympathetic anesthesia on left ventricular ejection fraction(LVEF) and left cardiac cavity size of patients with dilated cardiomyopathy.Method 121 consecutive patients with dilated cardiomyopathy were divided into cardiac sympathetic nerve blockade group(TEA group) and control group(c group).In TEA group,5％ lidocaine was injected into thoracic epidural cavity for about 4 to 8 weeks in addition with routine therapy.In c group,only routine therapy was used.We observe the changes of LVEF and left cardiac cavity size before and after treatment in both groups. Result In TEA group,after anesthesia,LVEF was increased from(31.3± 12.8) to(47.3± 21.3),P<0.001;left ventricular end－ diastolic diameter was reduced from(69.1± 7.1)to (65.1± 8.0),P<0.001;left atrial diameter was decreased from(44.0± 6.2)to(39.4± 7.2),P< 0.001. Conclusion Cardiac sympathetic anesthesia can effectively improve the ejection performance of dilated cardiomyopathy and make the dilated cardiac cavity turn to normal level.

Objective To explore the role of microRNA (miR)-22 and miR-1825 in the diagnosis and differential diagnosis of juvenile systemic lupus erythematous (JSLE).Methods The cases of JSLE hospitalized in Capital Institute of Pediatrics Teaching Hospital Affiliated to Peking University from June 2013 to May 2014 were selected as study group.The cases with systemic juvenile idiopathic arthritis (sJIA),nephrotic syndrome (NS),Kawasaki disease (KD),Henoch-Schonlein purpura(HSP) were selected as patients control group.The healthy children were selected as healthy control group.The expression levels of miR-22 and miR-1825 in the plasma of JSLE,sJIA,NS,KD,HSP and healthy children were detected by using real-time PCR respectively.Receiver operating characteristic curve (ROC) analysis was performed to evaluate the value of miR-22 and miR-1825 miRNA as a biomarker with the sensitivity and specificity.Three data bases,included Targetscan,PicTar and miRanda,were applied to predict the target gene.The target gene was analyzed by adopting Gene Ontology (GO) in terms of molecular function,biological process and cellular component,and by adopting Kyoto Encyclopedia of Genes and Genomes (KEGG) in terms of pathway.Results Compared with healthy children,the amount of miR-22 and miR-1825 in JSLE patients were lower,and there were significant differences(t =-3.076,-9.054,P ＜0.01,0.000 1).The levels of the miR-22 and miR-1825 miRNAs in controls of sJIA,NS,KD,HSP were significantly higher than those of JSLE (t =-4.410,-4.477,-4.494,-2.971,all P ＜ 0.000 1;t =-9.043,-6.045,-10.416,-8.712,all P ＜ 0.000 1),but there was no difference compared with healthy children(all P ＞ 0.05).The area under ROC curve(AUC) of miR-22 between JSLE and healthy children was 0.777.The AUC of miR-1825 between JSLE and healthy children was 1.000.The AUCs between JSLE and controls of sJIA,NS,KD,HSP of miR-22 were 0.731-1.000.The AUCs between JSLE and controls of sJIA,NS,KD,HSP of miR-1825 were 0.939-1.000.There was positive relation between the amount of miR-22 and complement C3 in plasma(r =0.493,P =0.027).Conclusions The amount of miR-22 and miR-1825 in the plasma of JSLE embrace the potential of distinguishing JSLE from healthy children,sJIA,NS,KD,HSP.MiR-22 has the ability to predict the activity of JSLE.

Objective To investigate the prevalence of psychological distress and analyze the relevant factors among patients with bladder tumor so as to provide evidence for future clinical practice. Methods Totally 128 patients were recruited from a urological surgery ward of a comprehensive hospital in Beijing in the study by using self-design questionnaire and the psychological distress thermometer (DT) recommended by the U.S. national comprehensive cancer network (NCCN). The acquired data were analyzed by SPSS17.0. Results The average score of the patients was 4.00(1.00~5.00). The identification rate of psychological stress was 55.47%( 71/128 ) , higher than the Chinese normal ( U = 8 . 28 , P < 0 . 05 ) . The relevant factors of psychological stress based on the rank from high to low scores included emotion problems ( 1 . 63 ± 0 . 67 ) , practical problems ( 1 . 42 ± 0 . 64 ) , communication problems (1.29 ± 0.65), physical problems (1.28 ± 0.33) and religion problems (1.00 ± 0.08). Conclusions The prevalence of psychological distress is higher among patients with bladder tumor and the influence factors mainly include emotional problems , practical problems and communication problems. Nurses should pay attention to the psychological distress of patients with bladder tumors and develop targeted interventions so as to relieve their distress.

Objective To investigate the value of 18F-FDG PET/CT for differentiating multiple myeloma from bone metastases with undetermined origin.Methods A retrospective study was performed on patients with multiple bone destructions and without extraosseous primary malignant tumor in 18F-FDG PET/CT imaging.A total of 26 patients (12 males,average age 55.4 years) with multiple myeloma and 20 patients (9 males,average age 50.2 years) with multiple bone metastases confirmed by biopsy or histopathology from January 2011 to December 2013 were included into this study.The characteristics of 18F-FDG PET/CT and urine Bence-Jones protein were used to establish the diagnostic criteria.Myeloma was diagnosed if two or more of the following conditions could be satisfied:more than 10 bone lesions,osteolytic or mixed bone destruction,SUVmax＜4.0,and positive urine Bence-Jones protein.Two-sample t test and x2 test were used.Results The average number of bone lesions in multiple myeloma patients was 15.8,which was more than that (7.8) in patients with bone metastases.About 71.8％ (296/412) of bone lesions in multiple myeloma and 28.8％ (45/156) of bone metastases were osteolytic.The percentage of osteolytic lesions was significantly higher in multiple myeloma (x2=87.2,P＜0.05).The SUVmax of bone lesions of multiple myeloma and bone metastases were 3.81 ±2.17 and 5.82± 3.44 (t =8.29,P＜0.05) respectively.According to the diagnostic criteria,the sensitivity,specificity and accuracy of 18F-FDG PET/CT for the differentiation of myeloma from bone metastases were 88.5％ (23/26),85.0％ (17/20) and 87.0％ (40/46).Its diagnostic efficiency was higher than urine Bence-Jones protein (sensitivity:65.4％ (17/26);x2=3.90) and original 18 F-FDG PET/CT evaluation (specificity:10/18,accuracy:64.1％ (25/39);x2 =3.99,6.12) respectively (all P＜0.05).Conclusion Combining the evaluation of structural properties and metabolism on 18F-FDG PET/CT with urine Bence-Jones protein level may provide additional value for the differentiation of multiple myeloma from bone metastases with undetermined origin.

Objective To discuss the relationship between TCM constitutional types and the levels of transforming growth factor beta 1 (TGF-β1) of patients with knee osteoarthritis (KOA). Methods A total of 161 patients with KOA as a case group filled out questionnaires about 9 TCM constitution types, and 50 cases of unrelated healthy volunteers were selected randomly as control group. The serum samples of two groups were collected. The levels of TGF-β1 were detected and compared by double antibody sandwich ELISA. Results Compared with the control group, the level of TGF-β1 in the case group decreased, with statistical significance (P<0.05). Compared with the control group, the levels of TGF-β1 significantly decreased in the case group of qi deficiency type, with statistical significance (P<0.05). There were no types of special intrinsic and blood stasis. Compared with the control group, the levels of TGF-β1 in the other six types of patients with KOA had no statistical significance (P>0.05). Conclusion The incidence of KOA with qi deficiency type may be related to the decrease of TGF-β1 level. The decreasing level of TGF-β1 may be one of the mechanisms of molecular biology that qi deficiency was linked to KOA.

Objective To observe the clinical efficacy ofErxian Decoction combined with elcatonin for the treatment of postmenopausal osteoporosis.Methods Eighty cases of female patients with postmenopausal osteoporosis were randomly divided into treatment group and control group, 40 cases in each group. The control group received intramuscular injections elcatonin treatment, and the treatment group received oralErxian Decoction on the basis of the treatment of the control group, for 12 weeks. The main clinical symptom score, VAS score and bone mineral density (BMD) of L2-L4 and in the tibia of the two groups were observed before and after treatment to assess the therapeutic effect.Results After treatment, VAS scores of the two groups were significantly lower (P<0.05). The total effective rate of the treatment group was 92.5% (37/40); the control group was 75.0 (30/40), with statistical significance (P<0.05). The treatment group was significantly better than the control group in main symptom scores, especially in improving body symptoms (P<0.05). BMD of the treatment group was significantly higher than the control group.ConclusionErxian Decoction combined with elcatonin therapy for postmenopausal women with osteoporosis can significantly improve clinical symptoms and increase BMD.

Objective To summarize the imaging features of computed tomography (CT)and magnetic resonance imaging (MRI) combined with multi-technology imaging and compare its effects in the preoperative evaluation of malignant perihilar biliary obstruction.Methods The clinical data of 20 patients receiving CT and MRI who were diagnosed with malignant perihilar biliary obstruction by pathological examination at the Wuxi Second People's Hospital between January 2008 and April 2014 were retrospectively analyzed.Patients receiving CT combined with negative-contrast CT cholangiopancreatography (nCTCP) and computed tomography angiography (CTA) were allocated into the CT group,and patients receiving MRI combined with magnetic resonance cholangiopancreatography (MRCP) and magnetic resonance angiography (MRA) were allocated into the MRI group.The images of the 2 groups were analyzed by 2 independent reviewers.The classification of malignant perihilar biliary obstruction,hepatic artery and portal vein invasions and lymph node and organ metastases were evaluated respectively,and then the results of evaluation were compared with the results of surgery and pathological examinations.The comparison between the accuracy of imaging examination in the 2 groups and accuracy of perihilar biliary obstruction classification were analyzed by the chi-square test.The comparison of evaluating accuracy (sensitivity and specificity) among vascular invasion and lymph node and organ metastases were done by the receiver operating characteristic (ROC) curve analysis,and the comparison of its accuracy were done by the z-score test.Results The imagings of bile duct involvement of the 2 groups showed that there were irregular thickening bile duct wall combined with retrograde intrahepatic bile duct dilatation.The symptoms of vascular invasion included the stricture and occlusion of blood vessels or more than half of vascular contact surface with tumor.The symptoms of lymph node metastasis included the enlarging short-axis or round-like circular enhanced lesions.The symptoms of organ involvement included the unclear boundary of lesions or low-density necrotic foci within organ.All the 20 patients underwent the surgical treatment,including 13 patients with hilar cholangiocarcinoma and 7 patients with gallbladder carcinoma.Hepatic artery invasions were detected in 5 patients,portal vein invasions in 10 patients,lymph node metastases in 10 patients and organ metastases in 4 patients.The cases of classification of perihilar biliary obstruction,hepatic artery invasion,portal vein invasion,lymph node metastasis and organ metastasis which were evaluated respectively by reviewer 1 and 2 were 18/18,19/18,18/18,17/16 and 18/19 in the CT group and 17/16,14/13,17/16,15/14 and 19/18 in the MRI group.The imaging of the 2 groups were compared with the evaluating accuracies of classification of malignant hilar biliary obstruction,hepatic artery and portal vein invasions,lymph node and organ metastases in the 2 groups,showing no significant differences (x2=12.593,8.889,z=1.823,1.956,0.462,0.817,0.977,0.751,0.233,1.403,P＞0.05).Conclusion CT and MRI for malignant hilar biliary obstruction had the same imaging features,meanwhile,they can provide an equivalent performance in the classification of malignant hilar biliary obstruction,hepatic artery and portal vein invasions and lymph node and organ metastases.