Objective To evaluate the prognosis of surgery in multilocular cystic renal cell carcinoma (MCRCC). Methods The characteristics of prognosis of surgery in 22 MCRCC cases out of 482 cases of renal cell carcinoma were reviewed.The MCRCC cases accounted for 4.56% of the renal cell carcinoma cases with a male-to-female ratio of 2.67∶1 in the same period.The mean age of the 22 patients was 47 years (age range,32-74 years). Results Of the 22 cases,18 underwent radical nephrectomy and 4 partial nephrectomy.The diameter of the tumors ranged 1.8-11.0 cm (mean 4.8 cm).Histological examination showed that 21 cases were of clear cell carcinoma and 1 of clear cell carcinoma mixed with granular cell carcinoma.Pathological staging showed pT 1N 0M 0 in 19 cases (86.4%),pT 2N 0M 0 in 2(9.1%) and pT 3bN 0M 0 in 1(4.5%).The classification by tumor nuclear grading system showed 5 cases (23%) of G 1 and 17 (77%) of G 2.Twenty patients were followed up for 9-56 months (mean,27.6 months) and 2 were lost of follow-up.Of the 20 patients,19 survived with no evidence of cancer and 1 died of intercurrent disease (upper gastrointestinal massive hemorrhage due to hepatocirrhosis). Conclusions MCRCC represents a distinct subtype of renal cell carcinoma.It is usually with low grade,low stage and is found incidentally.Our results indicate that MCRCC can be cured by surgery.Regardless of tumor size,the prognosis of MCRCC is favorable.

Surfactants are employed widely in household and industryial products wordwide.Everyday millions pounds surfactants and their products are dispersed into soil, water, food and human body that posing a threat to human health. The paper expatiated on the topic that the threats of surfactants on food safety with arguments as: acute toxicity, genetic toxicity, estrogenic effects, bioconcentrate and so on. At last, the article emphasized it is essential to have comprehensive study on the surfactants toxicity and influence on food safety.

Objective To investigate the efficacy of low-dose retention enema for treating ulcerative colitis.Methods Eighty patients diagnosed with chronic recurrent ulcerative colitis were randomly divided into control group and observation group with equal number.The retention enema was used in the control group and the improved retention enema was used in the observation group. Enema was done once every night,10 days as a course of treatment in both groups.The two groups were compared in terms of liquid retention time,curative effect after two courses and patients’satisfaction degree with enema.Results The liquid retention time in the intestinal lumen in the observation group was significantly longer than that of the control group.The efficacy was significantly better than the control group.Patients satisfaction with enema in the observation group was significantly higher than that of the control group (P<0.05).Conclusions The improved low-dose liquid enema is effective in the treatment of ulcerative colitis for its liquid retention time in the intestines.It is effective,comfortable,convenient,and likely to be accepted by patients.

Objective To evaluate the feasibility and effectiveness of percutaneous intraductal radiofrequency ablation (RFA) in treating biliary stent stenosis. Methods A total of 43 cases with biliary obstruction caused by biliary stent stenosis were enrolled in this study. Through percutaneous transhepatic pucturing of biliary duct, an EndoHPB catheter was placed in the stenotic site of the biliary stent, which was followed by RFA treatment. After RFA, biliary drainage catheter was reserved. The drainage catheter was removed when angiography confirmed that the stent was patent. Results Cholangiography showed that the biliary stent became patency after RFA in all patients. No procedure-related complications occurred. After RFA, the median patency time of the stenotic biliary stent in survival patients was 107 days (12-180 days). Conclusion The results of this preliminary clinical study indicate that percutaneous intraductal radiofrequency ablation has excellent effect and safety for the treatment of biliary stent stenosis, although more reliable and randomized controlled trials are needed before its effect and safety can be further proved.

Acclimatization ; Dizziness ; rehabilitation ; therapy ; Humans ; Vestibulocochlear Nerve ; physiology

Objective: Intra-abdominal hypertension(IAH),commonly seen in various critical surgical cases,may lead to body ischemia and reperfusion damage and result in serious inflammatory response.Previous studies were concentrated mostly on the risk of IAH,but less on IAH-induced reperfusion damage.The purpose of this study was to investigate the impact of IAH on the intestine.Methods: A total of 120 Sprague-Daley rats were divided into an abdominal compartment syndrome(ACS) group,with intra-abdominal pressure(IAP) increased to 20 mmHg,an ACS/decompression(ACS/DE) group,with increased IAP followed by decompression,and two control groups,with IAP unchanged.Malondialdehyde(MDA),myeloperoxidase(MPO),glutathione(GSH) and glutathione peroxidase(GSH-Px) enzyme of the intestine were measured.Additionally,ileal tissues were taken for histopathological examinations and apoptosis detection;the liver,spleen,and mesenteric lymph nodes were obtained for microbiological analysis.Results: In the presence of IAH,MDA and MPO were increased,while GSH and GSH-Px were decreased.Microbiological analysis suggested bacterial translocation across the gut.Morphological examinations indicated that Chiu's score and apoptotic index in the ACS/DE group were the highest in the four groups.Conclusion: Oxidative stress plays an important role in the intestinal damage and bacterial translocation in abdominal compartment syndrome.Additionally,the influence of oxygen free radicals occurs mainly during the reperfusion rather than the IAH period.

Objective To evaluate the relationship between von Hippel-Lindau (VHL) gene mutations and the prognosis of Chinese sporadic clear cell renal cell carcinoma (CCRCC). Methods VHL gene mutations were detected by polymerase chain reaction (PCR), direct DNA sequencing in 74 paired specimens of sporadic CCRCC and normal kidney. The mutation findings, pathologic fea-tures and prognostic characteristics were analyzed. Results Fifty-one patients (68.9%) were in clinical stage T1, 9 patients (12.2%) were in T2 and 14 patients (18.9%) were in T3. In the aspect of pathological grade, 15 patients (20.3%) were in G1, 50 patients (67.6%) were in G2 and 9 pa-tients (12.2%) were in G3. VHL gene mutations were detected in 40 of 74 cases (54.1%). There were no significant differences of VHL gene mutations in different pathological grade and clinical stage of CCRCC, P=0.915, P=0.237, respectively. All patients were followed up for 34 to 107 months (mean 71 months). Seven patients died of CCRCC. Another 11 patients developed CCRCC related me-tastasis. Five-year tumor-free survival was 78%. The incidence of death or metastasis of CCRCC in VHL gene mutation group (15.0%, 6/40) was significant lower than non-mutation group (35.3%,12/34), P=0.043. Logistic regression results showed that lower tumor pathological grade and stage, better patients' prognosis would be (P=0.016, P=0.024, respectively). However, VHL gene muta-tion was related with better prognosis (P=0.033). This association was stronger among patients with high grade tumors (G3, P=0.048). Conclusions There are frequent VHL gene mutations in spo-radic Chinese CCRCC. Tumors' pathological grade and clinical stage are the important parameters for prognosis. However, VHL mutations are strongly associated with better cancer specific survival for CCRCC patients. These associations are relatively stronger in patients with high grade tumors.

Objective To investigate the trends in and characteristics of syphilis epidemiology in China,and to provide a scientific basis for the development of control strategies.Methods An epidemiological study was performed on syphilis cases reported from 31 provinces,autonomous regions and municipalities between 2000 and 2013.Results The reported syphilis incidence increased yearly from 6.43 per 100 000 person-years in 2000 to 32.86 per 100 000 person-years in 2013,with an average annual growth rate of 13.37％.Syphilis was reported in most (99％) counties/districts in China mainland except for a few remote mountain areas,with a significant difference in the incidence of syphilis between different regions.The regions with a high incidence of syphilis included minority areas in Northwest China (Xinjiang,Qinghai and Ningxia),Minjiang River area,Yangtze River Delta (Zhejiang,Shanghai),Zhujiang River Delta (Guangxi,Guangdong),etc.There had been a rapid increase in the incidence of syphilis in some regions previously reported to have a low incidence (such as Guizhou,Shaanxi,Henan,etc).Among the reported cases,female patients predominated with an average male/female ratio of 0.92 ∶ 1.The incidence of syphilis was highest in the age group of 20-39 years,but increased yearly by more than 30％ in the population aged ＞ 60 years.Of 20 occupations,peasant workers accounted for the highest proportion (31.56％) of syphilis cases,and retired population showed the most rapid increase by about 27.35％ per year.The constituent ratio of primary and secondary syphilis in all the syphilis cases had declined yearly,while that of latent syphilis increased by more than 50％ after 2010.Conclusions Syphilis remains a major public health issue in China,and measures based on the epidemiological features are urgently needed to effectively control epidemic syphilis.

OBJECTIVETo explore the effect of Peitu Shengjin Recipe (PSR) on nutritional states and immune functions of stable phase chronic obstructive pulmonary disease (COPD) patients.

METHODSTotally 62 stable phase COPD patients were randomly assigned to the treatment group (30 cases) and the control group (32 cases). All patients inhaled Seretide (50/500 µg), twice per day. Besides, patients in the treatment group additionally received PSR, one dose per day. After three months of treatment, the COPD assessment test (CAT) score, the index of nutritional states [including body mass index (BMI) , thickness of skin fold (TSF), mid-arm muscle circumference (MAMC), serum albumin, serum prealbumin], and immune functions (including IgA, IgM, and IgG) were compared between the two groups.

RESULTSBy the end of the treatment, the CAT score decreased more obviously in the treatment group than in the control group (P < 0.05). The improvement of BMI, TSF, MAMC, serum albumin, and serum prealbumin was better in the treatment group than in the control group (P < 0.05). IgM and IgG also increased more in the treatment group (P < 0.05). There was no statistical difference in IgA between the two groups (P > 0.05).

CONCLUSIONSAdditionally use of PSR could improve nutritional states and immune functions of stable phase COPD patients to some extent. Meanwhile, it also could improve their health related quality of life.

Body Mass Index ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Nutritional Status ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; immunology ; Quality of Life ; Serum Albumin

Objective To estimate the application of ultrasound measurement of detrusor wall thickness (DWT) in the assessment of curative effect after operation. Methods Detrusor thickness was measured by linear ultrasound (7. 5 MHz) either at a filling volume of 50% of cystometric capacity or at 250 ml filling in 86 patients, who were diagnosed equivocal BOO, during a pressure-flow study. All patients accepted transurethral resection of the prostate. At 3 months post-surgery, the patients were divided into two groups according to curative effect after operation. The volume of the prostate, age and DWT were compared between the two groups. Results There was no difference in either age or volume of the prostate between the two groups. DWT was significantly higher (P＜0.01) in the more curative effect group (37 cases, DWT 2. 5±0.3 mm) compared to the less curative effect group (49 cases, 2.2±0. 3 mm). As a predictor of curative effect, DWT of 2. 8 mm or greater had a positive predictive value of 100%, a negative predictive value of 62%, specificity of 100% and sensitivity of 19%. Receiver operating characteristic analysis (ROC) revealed that DWT had a high predictive value for curative effect post-surgery with an AUC of 0. 84±0. 04. Conclusions In patients with equivocal BOO, ultrasonographically assessed detrusor thickness may have a predictive value for curative effect post-surgery. However, this cutoff value needs to be validated in a larger study population.