Objective To investigate if the endothelin-1 (ET-1),nitric oxide(NO) can affect renal artery blood flow and explore the clinical value of ultrasonography in hypertensive disorder complication pregnancy.Methods 18 patients of gestational hypertension,18 patients of gently preeclampsia,20 patients of severe preeclampsia and 20 normal pregnancy women were chosen in random.Color Doppler ultrasonography was used to detect the peak systolic velocity (PSV),end diastolic velocity (EDV),resistive index (RI),pulsatility index (PI) of renal interlobar artery.The levels of serum ET-1 and NO were measured by enzyme-linked immunosorbent assay (ELISA) and nitric acid recovery respectively.Results The level of EDV in preeclampsia patients were significant lower than the control group (P ＜0.05).The levels of RI,PI,S/D in preeclampsia patients were significant higher than the control group (P ＜0.05).The level of ET-1 in study group was higher than control group (P ＜0.01).The level of NO in study group was lower than control group (P ＜0.01).There was positive correlation between the RI,PI,S/D of renal interlobar artery and the level of serum ET-1.There was inverse correlation between the RI,PI,S/D of renal interlobar artery and the level of serum NO.Conclusions Endothelial dysfunction can cause unbalance of renal vessel systolic-diastolic function.The level of renal artery blood flow parameters can reflect the state of vessel function and have clinical value in hypertensive disorder complication pregnancy.

Objective To evaluate the clinical features,pathological grades,treatment and prognosis in bladder cancer patients under 40 years.Methods A retrospective review of transitional cell carcinoma of the bladder in patients under 40 years who had been treated from January 1994 to April 2005 were conduc- ted.The patients were divided into 2 groups(group A,20-30 years;group B,31-40 years)based on their age.The differences in pathologic grading,recurrence rate and positive rate of urine cytology were compared between the 2 groups.The statistical analyses were performed using x~2 test.Results The incidence of bladder cancer in patients under 40 years was 4.2%(92/2200).The male/female ratio was 2.7:1.0.At initial visit,86%(68.7% in group A and 91.1% in group B)of the patients presented with gross hematuri- a;and 25.0% in group A and 33.9% in group B concomitantly had frequency and dysuria.The mean disease course in the 2 groups was 3.8 months for male and 6.9 months for female.Solitary tumor occurred in 19 ca- ses(100.0%)in group A and 63(86.3%)in group B;and multiple carcinomas,in 10 cases(13.7%)in group B.All were superficial bladder cancers in group A,while 6(8.2%)were invasive carcinomas in group B.According to WHO pathological grading of bladder cancer,in group A,10 cases(52.6%)had G_1,8 (42.1%)had G_2 and 1(5.3%)had G_3 tumors;in group B,8 cases(11.0%)had G_1,49(67.1%)had G_2 and 16(21.9%)had G_3 tumors(P＜0.01).The positive rate of urine cytology was 53.3% in all 92 ca- ses(25.0% in group A and 60.7% in group B,P＜0.05).The diagnostic rates by B-ultrasound and cysto- scopy were 98.6% and 100.0%,respectively.Of the 92 patients,11(12.0%)were treated by partial cys- tectomy,73(79.3%)by TUR-Bt and 8(8.7%)by cystectomy.The follow-up was 3-115 months(mean, 39 months).The overall recurrence rate was 12.0%,with 5.3%(1/19)in group A and 13.7%(10/73)in group B.Of 10 patients with multiple carcinomas,6(60.0%)developed recurrence;and of 82 with solitary tumors,5(6.1%)developed recurrence,with significant difference between them(P＜0.01).Two of the multiple carcinoma patients developed invasive carcinoma.Conclusions In bladder cancer patients under 40 years,the positive rate of urine cytology,pathological grading and recurrence rate increase with age.Multi- ple tumors,invasive carcinoma and long-term smoking are high risk factors for tumor recurrence.TURBt is the main surgical method for treating bladder cancer patients under 40 years.

Objective To investigate the regularity of intrapulnonary lobar and segmental lymph nodes metastasis in patients with cT1N0M0 stage lung adenocarcinoma.To provide a basis for more accurate determination of N stage and indication for pulmonary segmental resection.Methods A prospective study was performed from March 2014 to December 2015.103 cases of cT1 N0M0 stage lung adenocarcinoma received lobectomy and mediastinal lymph node dissection in the thoracic surgery department of China-Japan Friendship Hospital.Intrapulmonary lobar and segmental lymph nodes were dissected and sorted carefully then sent to the pathological department with the corresponding lung specimen and other lymph nodes.Statistical analysis was carried out considering size of the lesion,imaging features,serum CEA levels,pathological subtypes and so on.Results In total 103 cases,pN0 was confirmed in 82 cases,pN1 in 15 cases,pN1 + N2 in 5 cases,and skipping-pN2 in 1 case.14 cases(93.3％) in pN1 group were detected with station 12-14 lymph node metastasis,while only 5 cases (33.3％) were detected with station 12-14 LSNs metastasis.4 cases(66.7％) in pN2 group were detected with station 12-14 lymph node metastasis,while only 1 case(16.7％) with station 13 and station 7 lymph node metastasis.If LSNs were not detected,the false negative rate of N staging could be as high as 6.1％ (5/82),The rate of missed diagnosis of lymph node metastasis might be 30％ (6/20) to N1 stations alone.41.2％ (7/17)cases with metastasis to the adjacent LSNs had been proved with metastasis to the isolated LSNs.The metastasis rate of the isolated LSNs was significantly lower(P =0.049) in pure GGNs compared with those part-solid/solid nodules.Invasive adenocarcinoma had higher metastasis rate of isolated LSNs,compared with preinvasive lesions or minimally invasive adenocarcinomas,with no statistical difference between groups (P =0.055).No significant difference in isolated LSNs metastasis rate was found between groups with different serum CEA levels(P =0.251) or tumor size(P =0.197).Conclusion Dissection of intrapulmonary lobar and segmental lymph nodes might facilitate a more accurate N stage,reduce the false negative rate of lymph node metastasis,and provide basis for more accurate assessment of prognosis and postoperative adjuvant treatment.The sampling area of lymph nodes during segmental resection should include the adjacent LSNs of the target segment.The isolated LSNs metastasis rate of cT1N0M0 stage lung adenocarcinoma with pureGGN as imaging feature is relative low,which might be suitable for segmentectomy when meeting other criteria.

Metformin is currently the first-line drug for the treatment of type 2 diabetes, and it is the most widely used oral hypoglycemic drug in the world. In addition to its significant hypoglycemic effect, metformin also has potential therapeutic effects on diseases such as tumors, obesity, thyroid diseases, polycystic ovarian diseases and cardiovascular diseases. However, the specific mechanism of action of metformin is still unclear. A large number of studies have shown that the regulation of energy metabolism by metformin is not only the core of its mechanism of action in the treatment of type 2 diabetes, but also an important mechanism for its therapeutic effects in diseases such as tumors and cardiovascular diseases. In this paper, the clinical application and related drug mechanisms of metformin in the treatment of non-diabetic diseases were summarized, so as to provide reference for the majority of medical workers, and look forward to a more in-depth exploration of its drug mechanism and clinical application in the future.

BACKGROUND: Lung cancer and chronic obstructive pulmonary disease (COPD) are both common diseases in respiratory system and the leading causes of deaths worldwide. The purpose of this study was to determine whether the severity of COPD affects long-term survival in non-small cell lung cancer (NSCLC) patients after surgical resection. METHODS: A retrospective research was performed on 421 consecutive patients who had undergone lobectomy for NSCLC. Classification of COPD severity was based on guidelines of the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Characteristics among the three subgroups were compared and recurrence-free survivals were analyzed. RESULTS: A total of 172 patients were diagnosed with COPD, 124 as mild (GOLD-1), 46 as moderate(GOLD-2), and 2 as severe (GOLD-3). The frequencies of recurrence were significantly higher in higher COPD grades group (P<0.001). Recurrence-free survival at five years were 78.1%, 70.4%, and 46.4% in Non-COPD, GOLD-1 COPD, and GOLD-2/3 COPD groups, respectively (P<0.001). In univariate analysis, age, gender, smoking history, COPD severity, tumor size, histology and pathological stage were associated with recurrence-free survival. Multivariate analyses showed that older age, male, GOLD-2/3 COPD, and advanced stage were independent risk factors associated with recurrence-free survival. CONCLUSIONS NSCLC patients with COPD are at higher risk for postoperative recurrence, and moderate/severe COPD is an independent unfavorable prognostic factor. The severity of COPD based on pulmonary function test can be a useful indicator to identify patients at high risk for recurrence. Therefore, it can contribute to adequate selection of the appropriate individualized treatment.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; complications ; mortality ; physiopathology ; surgery ; Female ; Humans ; Lung Neoplasms ; complications ; mortality ; physiopathology ; surgery ; Male ; Middle Aged ; Multivariate Analysis ; Pulmonary Disease, Chronic Obstructive ; complications ; mortality ; physiopathology ; Respiratory Function Tests ; Retrospective Studies