Objective To explore the diagnosis and treatment features of tuberous sclerosis complex associated renal cell carcinoma.Methods A 22-year-old boy with a childhood history of epilepsy and mental retardation presented with a complaint of intermittent painless gross hematuria for the past 2 years.After superselective left renal artery embolization was done twice in the past year, painless gross hematuria was still repeated with 6- 10 months intervals.Physical examination showed retarded face, obesity, visible facial angiofibroma and a ditch fibroma.CT scan showed irregular lesions.The largest cross-section 14.2 cm × 9.0 cm in the left kidney was inhomogeneous enhanced from 45 - 54 HU in the plain phase to 60 - 78 HU in the contrast phase.Filling defect in the left renal vein and multiple fat-density lesions (CT value of -25 - -38 HU) with the largest cross-section 7.2 cm× 5.7 cm in the right kidney were also found in contrast CT scan.The PUBMED and CBM database were reviewed.Results Open retroperitoneal radical left nephrectomy was performed.Pathology showed renal clear cell carcinoma and renal vein thrombosis.There was no tumor recurrence or distant metastasis at 4-month follow-up.Conclusions Tuberous sclerosis complex associated renal cell carcinoma is rarely reported.Timely nephron-sparing surgery is necessary when the diagnosis is established, or radical nephrectomy is also necessary if nephron-sparing surgery is impossible.

Objective To determine the consistency between quantitative CT perfusion measurements of colorectal cancer obtained from single section with maximal tumor dimension and from average of whole tumor,and compare intra-and inter-observer consistency of the two analysis methods.Methods Twenty-two patients with histologically proven colorectal cancer were examined prospectively with 256-slice CT and the whole tumor perfusion images were obtained.Perfusion parameters were obtained from region of interest (ROI) inserted in single section showing maximal tumor dimension,then from ROI inserted in all tumor-containing sections by two radiologists.Consistency between values of blood flow (BF),blood volume (BV) and time to peak (TTP) calculated by two methods was assessed.Intra-observer consistency was evaluated by comparing repeated measurements done by the same radiologist using both methods after 3 months.Perfusion measurements were done by another radiologist independently to assess inter-observer consistency of both methods.The results from different methods were compared using paired t test and Bland-Altmnan plot.Results Twenty-two patients were examined successfully.The perfusion parameters BF,BV and TTP obtained by whole tumor perfusion and single-section analysis were (35.59 ± 14.59) ml · min-1 · 100 g-1,(17.55 ±4.21) ml · 100 g-1,(21.30 ±7.57) s and (34.64 ± 13.29)ml· min-1 · 100 g-1,(17.61 ±6.39)ml± · 100 g-1,(19.82 ±9.01)s,respectively.No significant differences were observed between the means of the perfusion parameters (BF,BV,TTP)calculated by the two methods (t =0.218,-0.033,-0.668,P ＞ 0.05,respectively).The intra-observer 95％ limits of consistency of perfusion parameters were BF-5.3％ to 10.0％,BV-13.8％ to 10.8％,TTP-15.0％ to 12.6％ with whole tumor analysis,respectively; BF-14.3％ to 16.5％,BV-24.2％ to 22.2％,TTP-19.0％ to 16.1％ with single section analysis,respectively.The inter-observer 95％ limits of consistency of perfusion parameters were BF-8.0％ to 8.3％,BV-10.9％ to 11.5％,TTP -14.5％ to 11.1％ with whole volume analysis,respectively; BF-10.2％ to 14.1％,BV-19.0％ to 17.6％,TTP-22.0％ to 24.0％ with single section analysis,respectively.Conclusion There was no statistically different between the single section and whole volume analysis of tumor perfusion CT.The whole volume perfusion analysis apparently improves intra-and inter-observer consistency and can reflect the whole tumor angiogenesis more accurately and repeatedly.

OBJECTIVE:To evaluate the research of antidepressive agents from the literatures perspectively in order to develop antidepressive agents in China.METHODS:The literatures about antidepressive agents recorded in PubMed database from Jan.1st,1998 to Oct.31th,2008 were analyzed with bibliometric methods.RESULTS:A total of 17784 literatures on antidepressive agents were recorded and the total number increased slowly.A total of 96 literatures were collected from Chinese literatures which increased rapidly in recent years.34 literatures among 74 literatures during 1998～2007 are in English and 40 in Chinese involved 56 institutes and 51 magazines.Literatures collected from Beijing took up the greatest proportion.CONCLUSION:It is needed to enlarge investment and scale of scientific research on antidepressive agents continuously.

Objective To determine the measurement consistency of diffusion coefficient D, perfusion fraction f and pseudodiffusion coefficient D*in rectal cancers based on different ROIs. Methods Forty-three patients with histologically proven rectal cancers were examined using echo-planar DW-MRI with eight b values (0 to 1 000 s/mm2). Intravoxel incoherent motion parameters were measured on intravoxel
incoherent motion map that contained the largest tumor cross-section, according to two distinct ROI protocols:freehand outline ROI and semi-automatic tumor center ROI. The two protocols were compared for differences in IVIM parameters and the interclass correlation coefficient (ICC) were also calculated. intra-and inter-observer variability using paired t test and Bland-Altman plot. Results The IVIM parameters(D, f and D*) obtained by ROIs for outlined and center analysis were (1.08 ± 0.24) × 10-3mm2/s, (0.16 ± 0.06), (26.59 ± 19.54) × 10-3mm2/s and (1.06 ± 0.27) × 10-3mm2/s, (0.17 ± 0.07), (30.79 ± 20.85) × 10-3mm2/s, respectively. No significant differences were observed between the means of the IVIM parameters (D, f, D*) calculated by the two methods (t=1.113,-0.259,-1.660;P=0.272, 0.797,0.104, respectively),and the relative ICC were 0.863, 0.469, 0.663, respectively. The intra-observer 95% limits of consistency of IVIM parameters were (-0.012—0.038) × 10-3mm2/s, (-0.003—0.007), (-0.923—1.166) × 10-3mm2/s with ROI outline tumor, respectively;(-0.024—0.044)×10-3mm2/s, (-0.005—0.015), (-1.670—4.195)×10-3mm2/s with center ROI, respectively. The inter-observer 95% limits of consistency of perfusion parameters were (-0.047—0.009) × 10-3mm2/s, (-0.015—0.009), (-7.206—3.190) × 10-3mm2/s with ROI outlined tumor, respectively;(-0.068—0.048) × 10-3mm2/s, (-0.005—0.041), (-17.657—0.779) × 10-3mm2/s with center ROI, respectively. Conclusions There was no statistically significant difference between the outlined ROI and tumor center ROI analysis of rectal cancers' IVIM parameters. The tumor analysis by outlined ROI protocol appropriately improves intra-and inter-observer consistency and can provide more reproducible and stable results.

Objective To reveal the main interests in studies of Kashin-Beck disease by analyzing the key words in Chinese papers on Kashin-Beck disease .Methods Chinese papers on Kashin-Beck disease were retrieved from CNKI, CBM, VIP, and Wanfang digital journal full-text database.A co-word matrix was generated by abstracting their key words which were analyzed by gCLUTO clustering .Results The studies on Kashin-Beck disease were centered on the role of fusarium metabolic toxins and fulvic acid in pathology of Kashin-Beck disease, etiology of Kashin-Beck disease, functional change in Kashin-Beck disease patients, relation between Kashin-Beck disease and geological envi-ronment, monitoring and X-ray diagnosis of Kashin-Beck disease, surgical treatment of Kashin-Beck disease, preven-tion and treatment efficiency analysis of Kashin-Beck disease.Social network figure showed that etiology of Kashin-Beck disease, relation between Kashin-Beck disease and geological environment, monitoring and X-ray diagnosis of Kashin-Beck disease, surgical treatment of Kashin-Beck disease, prevention and treatment efficiency analysis of Kashin-Beck disease were the hot spots in studies of Kashin-Beck disease at present.Conclusion The research subjects determined by co-word clustering analysis are consistent with the interests in studies of Kashin-Beck disease in China at present.

Objective To discuss the major complications of urologic laparoscopic surgery.Methods From January 2004 to May 2012,2 250 urologic laparoscopic surgical procedures were performed in our institute,including radical nephrectomies (690 cases),partial nephrectomies (285 cases),simple nephrectomies (126 cases),nephrouretectomies (270 cases),renal cyst operations (281 cases),adrenalectomies (310 cases),pyeloplasties (93 cases),ureterolithotomies (48 cases),radical prostatectomies (43 cases),radical cystectomies (49 cases),donor nephrectomies (50 cases) and retroperitoneal lymph node dissection (5 cases).Medical records of each procedure were retrospectively evaluated.Intraoperative and postoperative complications were graded according to the Satava and Clavien classifications,respectively.Major complications were defined as Satava grade Ⅱ or higher,and Clavien grade Ⅲ or higher.Results Among the 2 250 laparoscopic procedures,53 major complications occurred,resulting in a major complication rate of 2.36％.Major intraoperative and postoperative complication rates were 1.16％ (26 cases) and 1.20％ (27 cases),respectively.Vascular injuries were the most common intraoperative complications (58％) while the proportion of visceral injury was the second as 42％.The most common postoperative complication was bleeding (19 cases).Among them,3 cases died of multiple organ failure after second operations.Other major postoperative complications included wound infection (2 cases),urine leakage (1 case),adrenal crisis (1 case),ileus (2 cases) and incisional hernia (Ⅰ case) and 1 death caused by pulmonary embolism.Conclusion Major complications,including death,may occur at any stages during the urologic laparoscopic surgery.

Objective To understand the prevalence and cause of eye diseases in the middle and old aged population in community was of important significance for the prevention and treatment of relevant diseases.The present study attempts to survey the prevalence of common eye diseases and conditions of blindness and low vision in 50 years and older population in community of Beijing.MethodsThis was an ophthalmologic epidemiology survey.The 2 833 target population was included and registered in Western Chang'an street community in door-to-door and questionnaire manner between October,2006-October,2007.Multiple factors,such as demography,general conditions,lifestyles,education degree,economical status,medical status and the awareness of relevant ophthalmic knowledge of participants were recorded and evaluated.Relevant eye examinations including uncorrected visual acuity,pinhole visual acuity,non-contact intraocular pressure test,slit-lamp,funduscopy and optometry examinations were performed in Beijing No.2 Hospital by trained ophthalmologists.Blindness and low vision were evaluated based on WHO criteria.The causes of leading-blindness and low vision were analyzed.Oral informed consent was obtained from all of the subjects.Results2 410 individuals of 2 833≥50-year-old participants received complete surveys according to the designed process in this study with an examined rate of 85.07%.The incidence of blindness and low vision in examinees was 0.79% and 5.64% respectively.The positive factors related to blindness and low vision appeared to be age,education and an awareness of relevant ophthalmic knowledge (χ~2=26.62,18.28,21.32,P＜0.001).The primary causes of blindness in examined population,in order,were cataract,glaucoma and retinopathy,and those of low vision were cataracts,refractive error and diabetic retinopathy.ConclusionIt is emphasized that early prevention and treatment for cataract,glaucoma,diabetic retinopathy and refractive errors can reduce the prevalence of blindness and low vision in people over 50 years in the Western Chang'an street community of Beijing.

Objective To provide the evidence for cooperation in research on Kashin-Beck disease in China by ana-lyzing the research competence of authors in papers on Kashin-Beck disease and their cooperation .Methods Papers on Kashin-Beck disease were retrieved from 4 commonly used Chinese perodical databases .Key words Information was collected and organized using BICOMS to produce a co-words matrix,atlas of co-words was plotted using NetDraw, the data were analyzed using SPSS 17.0.Results Of the 3454 authors engaged in research of Kashin-Beck disease from 1957 to 2012,81 published 15 or more than 15 papers.Cluster analysis showed that these 81 authors were from Institute of Endemic Diseases,Xi'an Jiaotong University Medical School; Institute of Kashin-Beck Disease,Chinese Center for Endemic Disease Prevention and Control;Jilin No.2 Center for Endemic Disease Prevention and Control;Centers for Disease Prevention and Control of China Academy of Sciences , Henan Province and Gansu Province .Conclusion A large number of researchers are engaged in research of Kashin-Beck disease .Their research interest and charac-teristics are clear.However, the cooperation between different institutions is weak and should be strengthened.

BACKGROUND:Bone marrow mesenchymal stem cells have low immunogenicity and immunomodulatory effect,but there are seldom reports concerning the immunomodulatory effect of Wharton's jelly-derived mesenchymal stem cells of human umbilical cord and its mechanims.OBJECTIVE:To investigate the immunomodulatory effects and mechanisms of Wharton's jelly-derived mesenchymal stem cells of human umbilical cord on varient peripheral blood T lymphocytes.METHODS:Mesenchymal stem cells were isolateded from Wharton's jelly of human umbilical cord by tissue culture.T lymphocytes from human peripheral blood were stimulated by phytohemagglutinin and co-cultured with umbilical cord Wharton's jelly-derived mesenchymal stem cells and umbilical cord Wharton's jelly-derived mesenchymal stem cells supernatant respectively to measure A value following 72 hours of coculture using multifunctional microplate reader.Expression of cytokines including transforming growth factor-beta 1(TGF-β1)and interferon-y(IFN-γ)was evaluated by enzyme-labeled immunosorbent assay.RESULTS AND CONCLUSION:Wharton's jelly-derived mesenchymal stem cells could inhibite the proliferation of T lymphocytes induced by phytohemagglutinin.The proliferation inhibition rate was 56%(P＜0.01).Wharton's jelly-derived mesenchymal stem cells supernatant also had inhibitory effects on proliferation of T lymphocytes induced by phytohemagglutinin,in a dose-dependent fashion.The proliferation inhibition rates were 8.3% and 27% respectively in the 50% Wharton's jelly-derived mesenchymal stem cells supernatant and 100% Wharton's jelly-derived mesenchymal stem cells supematant groups(P＜0.05).Wharton's jelly-derived mesenchymal stem cells significantly decreased γ-interferon secrted from T-lymphocytes(P＜0.05).The secretion of TGF-β1 was lower in the coculture of Wharton's jelly-derived mesenchymal stem cells and T lymphocytes group than Wharton's jelly-derived mesenchymal stem cells alone group(P＜0.05).These indicated that Wharton's jelly-derived mesenchymal stem cells and Wharton's jelly-derived mesenchymal stem cells supernatant have inhibitory effects on proliferation of T lymphocytes induced by phytohemagglutinin.The mechanims may be associated with cell contant and inhibition of v-interferon secrted from T-lymphocytes.

Objective:To explore the effect of laparoscopic minimally invasive on anorectal dynamics and serum carcino-embryonic antigen (CEA) and carbohydrate antigen 724 (CA724) in patients with rectal cancer.Methods:38 cases of rectal cancer patients were selected as the research group from March 2014 to March 2016 and 40 cases of non neoplastic intestinal polyps as control group,Preoperative anorectal dynamics index (anal resting pressure (ARP),rectal resting pressure (RRP)and anal maximal contraction pressure (MSP),rectal maximum tolerated volume (MTV) of two groups were compared,Preoperative and 3 d,1,2 weeks after operation of serum CEA and CA724 levels were detected in the research group and the clinical curative effect was observed.Results:There was no significant difference of ARP,RRP,MSP,MTV before operation in research group compared with the control group(P＞0.05),and was significantly reduced 2,4 weeks after operation(P＜0.05),then gradually restored,and basically recovered to the preoperative level 12 weeks after operation.There was no significant difference of serum CEA and CA724 levels 3 d after operation compared with preoperative in research group (P＞0.05),and were significantly lower 1,2 weeks after operation compared with preoperative (P＜0.05).The clinical effective rate was 65.8％.Conclusion:Efficacy of laparoscopic minimally invasive in treatment of rectal cancer is effective,can effectively reduce the levels of tumor markers,although there are some influence on anorectal dynamics,but it can be returned to normal in the short term.