By means of cell hybridization in situ with digoxigenin labeled probe, we detected the expression of C-myc protooncogene in peripheral blood mononuclear cells from 31 SLE patients and 10 healthy persons. The results showed that the level of C-myc mRNA in SLE patients was significantly higher than that in normal controls, and the increased level correlated with disease activity. There was also a positive correlation between C-myc mRNA and serum levels of ANA, anti-dsDNA, IgG, C3. Our study indicates that C-myc gene is important for the pathogenesis of SLE.

Objective To investigate the clinical features and prognosis of the patients with renal cell carcinoma and venous tumor thrombus.Methods Fifty-six patients with renal cell carcinoma and venous tumor thrombus were selected as our subjects,who underwent radical nephrectomy and thrombectomy in the Second Hospital of Tianjin Medical University from June 2002 to May 2014.There were 28 patients with stage Ⅰ tumor thrombus,l5with stage Ⅱtumor thrombus,9 with stage Ⅲ tumor thrombus and 4 with stage Ⅳtumor thrombus.All patients underwent renal tumor resection and embolectomy,and were follow-up.Results Of all the patients,46 were male and 10 were female with a mean age of 61.7(age ranging from 42 to 83).Twenty-four were presented on the left kidney and 32 were right.The clinical features were as follows:The tumor size was 2.5 to 14 cm in diameter(mean:6.2 cm),there were 21 cases with low back pain,18 cases with hematuria,lcases with abdominal.Pathological results showed that 39 with clear cell carcinoma,9 with papillary cell carcinoma,3 with chromophobe cell carcinoma,1 with low-differentiated cell carcinoma and 1 with undifferentiated cell carcinoma,3 with sarcomatoid differentiation.Forty-three patients were followed up,and the median follow up period was 20.4 months (2-90 months).The median survival time for the patients was 47 months and the 5 year overall survival was 45.2％.The survival time of the patients with early tumor thrombus(below hepaticvein) was (55.3 ± 4.9) month,significantly longer than that of the patients with advanced tumor thrombus (above hepaticvein) ((24.8 ± 5.3) months,P =0.047).Conclusion Patients with renal cell carcinoma and venous tumor thrombus are characterized with high malignancy and poor prognosis.Surgical operations are effective therapies for the patients.Long term outcome of the early tumor thrombus patients is significantly better than that of the advanced tumor.

Objective To observe the effect of MAP4K4 targeted shRNA on biological characteristics such as proliferation,invasiveness,and apoptosis in human bladder cancer cell.Methods Differentially expressed genes was screened out through cDNA microarray analysis in 5 pairs of fresh-frozen muscle-invasive bladder cancer(MIBC) and adjacent normal tissue obtained from radical cystectomy.Combining the results of genechip and literature review,MAP4K4 was picked up for further analysis.To verify the result of microarray analysis,16 pairs of fresh muscle-invasive bladder cancer (MIBC) and adjacent tissues were assessed for the expression of MAP4K4 mRNA and protein through RT-PCR,qRT-PCR and Western-blot.T24 cell line was stably trasfected with MAP4K4 targeted shRNA and control shRNA,respectively.The effects of MAP4K4 silencing on proliferation,invasiveness and apoptosis of T24 cells transfected with MAP4K4 targeted shRNA and control shRNA were assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT),transwell and flowcytometry (FCM) assay.Results MAP4K4 was overexpressed in muscle invasive bladder cancer than in normal tissue.Down regulation of MAP4K4 expression decreased bladder cancer cell proliferation(MAP4K4-targeted versus control,P＜0.001),invasiveness(MAP4K4-targeted versus control,P=0.004)and promoted cell apoptosis(MAP4K4-targeted versus control,P=0.023).Conclusions MAP4K4 is overexpressed in muscle invasive bladder cancer than in normal tissue.Down-regulation of MAP4K4 expression inhibits the invasive ability of bladder cancer.Therefore,MAP4K4 might be a potential therapeutic target for bladder cancer.

Objective To summarize the pathological and imaging features and treatment of retroperitoneal bronchogenic cyst.Methods The clinical data of 2 cases treated from October 2001 to November 2009 were summarized.The first patient was a 55-year-old woman with the chief complaint of lumbago in the left flank for 10 d.B-ultrasound showed mixed solid and cystic mass in spleen space with a diameter of 3.9 cm with thin wall and without rich blood supply.CT showed the lesion in the left adrenal gland region measured about 4 cm ×4 cm with low density with CT value of 10 HU,and enhanced scan was not obvious with CT value of 20 HU.It was diagnosed as left adrenal tumor and tumor resection was performed.The second case was a 17-year-old young man with the chief complaint of gross hematuria for 3 weeks after strenuous exercise.Ultrasonography found a 8.4 cm × 7.7 cm × 9.0 cm anechoic area surrounding the bladder.CT showed about 9.0 cm × 7.2 cm × 9.0 cm cystic lesion with thin wall,and the center density was uniformity in presacral space with CT value of8 HU.IVU showed visible semi-circular lower edge on the right edge of the bladder.The patient was diagnosed of presacral cyst and cystectomy was performed successfully.Results The pathology report of the first case:organizing wall with fibrous connective tissue,with most of the lining overlying pseudostratified ciliated columnar epithelium,goblet cells and subepithelial basement membrane.Pathological diagnosis was bronchogenic cyst,and the patient was followed up for 9 months without recurrence.The pathology report of the second case:pathological tissue fibers false wall tissue lining ciliated columnar epithelium,goblet cells seen in epithelium,fibrous tissue in the visible structure of mixed glands,a small amount of cartilage and muscle tissue.The diagnosis was bronchogenic cyst,and the patient was followed up for 2 years without recurrence.Conclusions Retroperitoneal bronchogenic cyst is rare and easily misdiagnosed.Radiology imaging can identify cystic features,while a few may be with high density without specificity.Surgical removal of retroperitoneal bronchogenic cyst with symptoms has good prognosis and may prevent malignant transformation and secondary infection.

Objective To explore the function and mechanism of estrogen receptor α (ERα) in bladder cancer cell proliferation and aggressivity.Methods The ERα expression bladder cancer cell line T24ERα model was established.The cell growth was detected by MTT assay,apoptosis by flow cytometry,cell invasion by matrigel transwell.Western blot was used to check signals by ERα regulation in bladder cancer cells related to the proliferation and metastatic ability.Results Compared to the control group,the cell inhibition rates of experimental group in 96 h and 144 h were 18.85％ and 37.21％,respectively.The difference was significant compared with the control group (P ＜ 0.05).The apoptosis rates of the experimental group and control group were (18.93 ±1.41)％ and (9.91 ±1.08)％ (P＜0.05).The experimental group through matrix adhesive cell proportion was (10.00 ± 2.00)％,significantly lower than that of the control group (26.00 ± 3.61) ％ (P ＜ 0.05).Western blot showed integrin-β1,p-FAK,p-Src and Scr expression were reduced compared to control group (P ＜ 0.05).Conclusion ERα could inhibit bladder cancer cell growth and metastasis through down-regulating integrin-β1-FAK/Src signal pathway,while promote the apoptosis of bladder cancer cells.

The pediatric reference intervals in clinical laboratory play an important role in diagnosis of illness,therapeutic monitoring,prediction of prognosis and health evaluation.Compared with establishing reference interval for adults,there are more challenges to establish pediatric reference intervals.Therefore,the procedure and key technologies of direct method and indirect method are stated based on the characteristics of children population and pediatric,by which to define,transfer and validate pediatric reference intervals.This study will provide systematically methodological ideas for clinical laboratories to establish pediatric reference intervals.

Objective To investigate the clinical effect of angioplasty for symptomatic intracranial atherosclerotic stenosis. Methods Eighty-two patients with symptomatic intracranial atherosclerotic stenosis whom underwent angioplasty after the failure of standard medical therapy were enrolled from Nan-jing Stroke Registry Program from September 2010 to June 2013.Nine of them underwent routine balloon angioplasty alone and 73 underwent intracranial stenting.The median time from onset to surgery was 24.5 days.The occurrence of endpoint events (any stroke ≤30 d after procedure,death and ischemic stroke >30 d in guilty vessels or original stenosis had restenosis and needed to be treated again)was assessed. The incidence of restenosis was followed up with imaging (CTA or DSA). Results (1)In the 82 patients, the success rate of operation was 92.7%(n=72 ),and 78 (95.1%)received follow-up,4 were lost to follow-up.The median follow-up time was 22.5 months (range 9 to 29 months ).Ten patients had an endpoint event,7 of them were ischemic stroke,1 was cerebral hemorrhage,and two were severe asymptomatic restenosis who underwent stenting again.The endpoint events of 3 patients occurred at day 30 after procedure (at ≤24 h after procedure).Kaplan-Meier curves showed that the incidences of cumulative endpoint events at 1,6,12,and 24 months were 3.7%,8.6%,11%,and 13%,respectively.(2)60 patients (73.2%)received imaging examination (11 CTA and 49 DSA ).Restenosis occurred in 17 patients (28.3%),among them the incidence of symptomatic restenosis was 5%(n =3 ),and asymptomatic restenosis was 23.3%(n=14). Conclusion After a comprehensive assessment and a rigorous screening, the safety is high and the mid- and long-term efficacy are satisfactory in patients with symptomatic intracranial arterial stenosis who are treated with angioplasty when their medical treatment is invalid.

Objective:To understand the clinical and laboratory characteristics of primary Epstein-Barr virus (EBV) infection in children.Methods:Totally 210 cases with primary EBV infection from September 2016 to March 2017 in Department of Infectious Diseases, Children′s Hospital of Fudan University in Shanghai were retrospectively collected. The clinical information (fever, rash, etc), and laboratory data such as liver function, EBV test (serological test, polymerase chain reaction (PCR)-DNA) were analyzed.Results:The age of children with primary EBV infection was (4.2±2.4) years. Numbers of patients with fever, tonsil and/or pharynx exudation, cervical lymphadenopathy, eyelid edema and rash were 187 (89.0%), 130 (61.9%), 204 (97.1%), 95 (45.2%) and 21 (10.0%), respectively. A total of 120 cases (57.1%) presented with typical triplets of infectious mononucleosis. Absolute lymphocyte count ≥5.0×10 9/L was found in 177 cases (84.3%), and abnormal lymphocyte ratio≥0.10 was found in 184 cases (87.6%). Elevated transaminase level was found in 96 cases (45.6%), and 72 cases were followed until transaminase level back to normal, in whom 97.2% (70/72) patient returned to normal within six weeks. Epstein-Barr viral capsid antigen (EBV-VCA)-IgM was positive in 192 cases (91.4%). EBV-VCA-IgG and Epstein-Barr viral early antigen (EBV-EA)-IgG positive were presented in 182 cases (86.7%) and 62 cases (29.5%), respectively. Epstein-Barr viral nuclear antigen (EBV-NA)-IgG was negative in all cases. EBV DNA test was carried in 199 cases, of which 122 cases (61.3%) were positive. Conclusions:Pediatric primary EBV infection mainly occurs in preschoolers. Most patients are presented with enlarged cervical lymph nodes, fever, and positive EBV serological markers. Transient transaminase elevation is observed in some cases.

Objective To investigate the effect of genistein on the proliferation,migration and invasion of prostate cancer cells and its molecular mechanism.Methods Prostate cancer LNCaP and CWR22RV1 cells were divided into the control group(conventional culture)and the experimental group(50μmol/L genistein treatment).The effect of genistein on the proliferation of prostate cancer cells were analyzed by MTT assay.The effect of genistein on the migration and invasion of prostate cancer cells were analyzed by cell scratch assay and Transwell assay.The protein levels of epithelial interstital transformation(EMT)intermediate markers E-Cadherin,N-Cadherin,Vimentin,and tumor stem cell markers CD44 and Oct-4 were detected by Western blot assay.Results MTT assay showed that genistein could inhibit the proliferation of prostate cancer cells.The scratch closure rates of LNCaP and CWR22RV1 cells were significantly reduced in the experimental group compared with those in the control group,and the number of cells passing through the Transwell membrane was significantly reduced(P＜0.05).Western blot assay showed that genistein could down-regulate the expression levels of N-Cadherin,Vimentin,CD44 and Oct4 in prostate cancer cells,and up-regulate the expression of E-Cadherin in epithelial cells(P＜0.01).Conclusion Genistein reduces the dryness of prostate cancer cells by inhibiting the EMT process,thus reducing the proliferation,migration and invasion of prostate cancer cells.

Objective To evaluate the feasibility and effectiveness of enhanced recovery after surgery(ERAS)in minimally invasive surgery for adrenal tumors.Methods A total of 139 patients underwent retroperitoneal laparoscopic adrenalectomy were selected in this study.The maximum tumor diameter was≤6.0 cm.According to the perioperative plan,patients were divided into the ERAS group(n=65)and the conventional group(n=74).The general information(age,gender,tumor location and tumor diameter),surgical indicators(surgical time and surgical blood loss),postoperative rehabilitation indicators(first off-bed ambulation time,first exhaust time,postoperative catheterization time,postoperative drainage tube retention time and postoperative hospitalization time)and incidence of complications were compared between two groups of patients.Results There were no significant differences in gender,age,tumor location,tumor diameter,surgical time and surgical blood loss between the two groups of patients(P＞0.05).In the ERAS group,first off-bed ambulation time,first exhaust time,the indwelling duration of catheters and drainage tubes were shorter than those in the conventional group,and the overall incidence of postoperative complications was lower in the ERAS group than that in the conventional group(P＜0.05).Conclusion The ERAS protocol is safe and feasible for minimally invasive surgery in patients with adrenal tumors with a maximum tumor diameter of≤6.0 cm.