Objective To investigate the clinical and pathological features of urothelial carcinoma with clear cell variant.Methods The pathological and clinical data of 7 cases pathological diagnosed urothelial carcinoma with clear cell variant between March 2005 and May 2014 were retrospectively reviewed.There were 6 males and 1 female,aged 46-75 years (mean,61 years).Clinical manifestations included gross hematuria in 5 cases,hematuria and backache in another 2 cases.The mean tumor size was 3.5 cm (ranged 2.0-6.0 cm).One case was multiple tumor and 6 cases were single tumor.Five cases were positive in urine cytology.All the 7 cases accepted surgical treatment,including radical nephroureterectomy in 2 cases,transurethral resection of bladder tumor plus pharmorubicin regular intravesicalinstillationin 1 case,and radical cystectomy in 4 patients.Results Pathological findings revealed that all the tumors were high-grade urothelial carcinoma with clear cell variant in different proportion.Among them,clear cell tumor was predominant in 1 case and focal in other 6 cases.Meanwhile,tumorsaccompanied by glandular differentiation were found in 2 cases,squamous differentiation was found in 1 case,and micropapillary variant was found in 1 case.Vascular tumor embolus was found in 4 cases.Pathological stage was pT2a (n =1),pT2b (n =3),and pT3a (n =3).Immunohistochemicalstaining revealed cytokeratin 7 (+),cytokeratin 20 (+),epithelial membrane antigen (+)and prostate specific antigen (-).Six cases were followed up.The bladder preservation case was followed up for 8 months without recurrence.In 3 radical cystectomy cases,1 died of cancer 25 months after surgery and another 2 case were followed up for 10 and 12 months after surgery without recurrence and metastasis.In 2 nephroureterectomy cases,1 died of tumor metastasis 18 months after surgery and the other case was followed up for 6 months without recurrence or metastasis.Conclusions Urothelialcarcinoma with clear cell variant is a malignancy often with advanced stage and poor prognosis.Radical surgery is recommended for the treatment.

In order to study the chemical constituents in the water extract of the stem of Nauclea officinalis, column chromatography over D101 macroporous resin and silica gel and an automatic purification system were used to isolate and purify the chemical constituents from the extract. Nine compounds were obtained. By analysis of the physicochemical properties and spectral data, their structures were identified as naucleamide G (1), 3, 4-dimethoxyphenol-beta-D-apiofuranosyl (1-->6)-beta-D-glucopyranoside (2), kelampayoside A (3), 3alpha, 5alpha-tetrahydrodeoxycordifoline lactam (4), naucleamide A-10-O-beta-D-glucopyranoside (5), pumiloside (6), 3-epi-pumiloside (7), strictosamide (8) and vincosamide (9), separately. Among them, compound 1 is a new compound, compound 2 was found in plants of the genus Nauclea for the first time, and compounds 3 and 4 were isolated from this plant for the first time.

Objective To investigate the clinical characteristics of Turner syndrome in patients with spondyloarthropathy.MethodsSix patients from our hospital were included and the clinical manifestations,laboratory parameters and imaging presentations were analyzed retrospectively and the relevant literature were reviewed.ResultsThe mean age of these 6 cases was (27±5) years.Two cases were spondyloarthropathy,3 cases were ankylosing spondylitis,1 was psoriatic arthritis.Five cases were complicated with peripheral arthriris,2 cases were complicated with inflammatory back pain,4 cases had vertebral activity limitation,3 cases had joint deformity.The karyotype of 6 cases was 45,XO.Six cases were complicated with osteoporosis.Conclusion Turner syndrome can be presented with spondyloarthropathy,arthritis,osteoporosis.Dysplasia of bone is common.

Objective To reconstruct three-dimensional (3D) image of heart and coronary artery on internet and explore the reliability. Methods After the contrast medium was injected into coronary artery of 2 heart specimens, hearts were scanned by UFCT with enhancement volume. One patient's UFCT images of coronary artery angiography were also chosen.Then the primitive images were transposed format, removed noise, specified interesting areas. 3D software on server was applied to reconstruct heart and coronary artery. Results The reconstructed 3D images of the heart and coronary artery were realistically displayed, freely rotated and transected.Main parts and branches of coronary artery were similar to those in the images of the UFCT. Conclusion Heart and coronary artery can be reconstructed on internet,which offers a new approach for reconstructing organs and tissues of human being.;

Objective To study the clinical and histopathologic features of small renal carcinoma (diameter≤4 cm)and provide theoretical basis for evaluating the safety,efficacy and prognosis of nephron sparing surgery.Methods This retrospective study collected the pathological data of 490 patients with small renal cell carcinoma,who were treated in our hospital,from May 2000 to October 2014.We recorded and analyzed the tumor size,histological subtype,Fuhrman grading,pathological stage,the existence of mulifocality,vascular invasion,tumor psuedocapsule,hemorrhage or necrosis and distant metastasis.Results The median diameter of tumor was (3.2 ± 0.6) cm,ranged 0.6 to 4.0 cm.Of all the subjects,422 (86.1％) were clear cell carcinoma,32 (6.5％) were chromophobe cell carcinoma,23 (4.7％) were papillary carcinoma and 13 (2.7％) were other rare types.Among the 422 clear cell carcinoma cases,27 were Fuhrman grade Ⅰ,157 were Ⅰ-Ⅱ grade,210 were grade Ⅱ,21 were Ⅱ-Ⅲ grade,7 were grade Ⅲ and no one was grade Ⅳ.Multifocal tumors were found in 18 cases (3.7％) and tumor embolus of renal vein was found in 6 cases (1.2％).Intact psuedocapsule were found in 326 (66.5％) tumors with the thickness ranged from 0.2 to 1.0 mm.Tumor infiltration without the psuedocapsule penetration were found in 82 cases (16.7％),penetrated into the psuedocapsule were found in 11 cases (2.2％),infringement of perirenal fat were found in 9 cases (1.8％).Hemorrhage and necrosis were found in 240 cases (48.9％),synchronous lung metastases occurred in 3 patients (0.6％).Logistic regression analysis revealed that tumor invasion and pseudocapsule penetration were related to Fuhrman Ⅱ-Ⅲ,Ⅲ and tumor diameter (P =0.04).Moreover,tumor size was related with histological grade and renal capsule invasion (P =0.02).Nevertheless,there was no relationship among tumor size,renal vein embolus or mulifocality (P =0.35).Conclusions Although most small renal tumors are high differentiation and low grade,but rare cases are aggressive with infringement of perirenal fat or early distant metastasis,suggesting heterogeneity in its biological behavior.Most small renal tumors have obvious psuedocapsule.When the tumor size is greater than 3.0 cm and its Fuhrman classification was high,the psuedocapsule and perirenal fat are more likely to be infiltrated.Nephron sparing surgery should remove the tumor and its surface adipose tissue entirely.

Objective To investigate the histopathologic characteristics of bladder tumor and provide theoretical basis for the reasonable selection of treatment modality.Methods This retrospective study collected the pathological data of 4 200 bladder tumor from May 2001 to October 2014.There were 3 443 male and 757 female, and the average diameter of these tumors was (1.8 ± 0.6) cm (ranged 0.2 to 6.5 cm).Among all cases, 3 214 (76.5％) cases were solitary tumor while 986 (23.5％) were multiple tumors.The histologic subtype, pathological grade and stage, the existence of vascular and lymphovascular invasion, tumor in situ, abnormal variants and rare subtypes were recorded and analyzed.Results 162 cases (3.9％)were benign tumors and 4 038 cases (96.1％)were malignant tumors including 4 008 cases of urothelial cancer (UC), 18 cases of primary adenocarcinoma and 12 cases of primary bladder squamous carcinoma.Furthermore, 2 460 (61.4％)cases were high grade UC while 1 548(38.6％)cases were low grade.320 cases were found intravascular tumor embolus or lymphovascular tumor thrombus and 391 (9.3％)cases were found metaplasia of squamous epithelium.Moreover, there were 230 cases of squamous differentiation, 120 cases of glandular differentiation, 110 cases of both squamous and glandular differentiation, and 39 cases (0.9％)of other rare subtypes or variations.On pathological stage, 112 (2.8 ％) cases were carcinoma in situ, 548 (13.7％)cases were Ta, 2 599(65.1％)cases were T1, 480(12％)cases were T2, 92 cases(2.3％)were T3 and 23 cases(0.6％)were T4 stage, with the rest cases being unable to be accurate staging.Multiple Logistic regression analysis revealed that lymphovascular invasion was related to tumor grade , pathological stage and abnormal differentiation (P ＜ 0.02).Moreover, UC with squamous and glandular differentiation were related with tumor recurrence and progression (P =0.02).Conclusions Most bladder tumors were high grade and low stage urothelial cancer with various forms of differentiation.Squamous and glandular differentiation were most common variation which should be avoided to diagnosed as hybrid carcinoma.Lymphovascular tumor thrombus and abnormal differentiation were correlated with tumor stage and grade.

Objective To investigate the effect of propofol on the cerebral injury induced by ketamine in neonatal rats. Methods Eighty 7-day-old SD rats of both sexes, weighing 12-20 g, were randomly divided into 4 groups (n = 20 each): normal saline (NS) group, ketamine-induced cerebral injury group (group K), propofol group (group P) and propofol combined with ketamine group (group PK). Group NS received intraperitoneal NS 1 ml. In groups K, P and PK, ketamine 70 mg/kg, propofol 70 mg/kg and propofol 70 mg/kg + ketamine 70 mg/kg were injected intraperitoneally once every 2 h for 3 times respectively. Ten rats in each group were selected and sacrificed at 24 h after emergence from anesthesia and the hippocampi obtained to determine the neuronal apoptosis (by TUNEL) and Bcl-2 and Bax protein expression(by immunohitochemistry). The apoptosis rate was calculated.The other 10 rats in each group were selected at 21 days after the intraperitoneal injection and the learning and memory functions (escape latency and frequency of crossing the original platform) were evaluated using Morris water maze. Results Compared with group NS, the apoptosis rate was significantly increased in group K, Bcl-2 protein expression was up-regulated in groups P and PK, and Bax protein expression was up-regulated, the escape latency was significantly prolonged and the frequency of crossing the original platform was significantly decreased in the other groups (P ＜ 0.05 .or 0.01 ). Compared with group K, the apoptosis rate was significantly decreased in group PK, Bax protein expression was down-regulated in group P, and Bcl-2 protein expression was up-regulated,the escape latency was significantly shortened and the frequency of crossing the original platform was significantlyincreased in groups P and PK ( P ＜ 0.05). Conclusion Propofol can reduce the cerebral injury induced by ketamine in neonatal rats, and the regulation of the Bcl-2 and Bax protein expression and inhibition of the neuronal apoptosis in hippocampus may be involved in the mechanism.

Objective To investigate the protective role of bone marrow-derived stem cells (BMDSCs) in progressive glomerulosclerosis rats,and to observe whether BMDSCs promote glomenlar repair and regeneration.Methods Progressive glomerulosclerosis was induced in enhanced green fluorescent protein (EGFP) bone marrow chimeric rats by injecting with anti-Thy1.1 antibody,followed by unilateral nephrectomy.Subsequently,these rats were treated with either BMDSCs infusion (treatment group,10 rats) or phosphate-buffered saline (untreated group,1O rats).Renal function and histological alterations were examined at week 12 after Thy1.1 antibody injection.Repair and regeneration of glomerular endothelial cells was detected by immunofluorescence.Results Only 3 rats survived in untreated group,other 7 rats died at week 2,7,9,11 after antibody injection.In treatment group,9 rats survived at week 12,only 1rat died at week 10.The BUN and Scr were significantly lower in treatment group as compared to untreated group [BUN(43.55±29.06) vs (76.58±66.19) mmol/L,Scr (138.79±75.14) vs (233.38±164.43) μmol/L].Proteinuria was not significantly different between two groups at day 3,7,14 and 28,while it was significantly decreased at day 42,56 and 84 in treatment group compared with untreated group.Light microscopy showed that there was severe diffuse mesangial cell proliferation,mesangial matrix expansion and glomerulosclerosis in untreated group,and such changes were ameliorated in treatment group.The mesangial expansion index and glomerular sclerosis index in untreated group was significantly higher than those in treatment group.More BMDCs were recruited into the glomeruli and differentiated into glomerular endothelial cells in treatment group as compared with untreated group.Double immunofluorescence stain also demonstrated that BMDSCs infusion promoted glomerular capillary repair and regeneration.Conclusion BMDSCs infusion can improve renal function and histological changes,and promote the repair and regeneration of glomerular capillary.

Objective To investigate whether toll like receptor ( TLR) signaling pathways can in-crease the expression of IL-17 R in neuralglial cells , and if they can whether the increased IL-17 R is func-tional.Methods Experimental autoimmune encephalomyelitis (EAE) was induced in B6 mice by immuni-zation with an emulsion of myelin oligodendrocyte glycoprotein 35-55 ( MOG35-55 ) in complete Freund's adju-vant (CFA).The expression of Il17ra and Il17rc in the brains and spinal cords of mice with EAE were de-tected by real-time PCR.Luxol fast blue ( LFB) staining was performed to the spinal cord sections to detect tissue demyelination.Immunohistological staining against IL-17RA and CD3 were undertook to visualize IL-17RA+and CD3 + cells.Same approaches were also applied to immunized Rag1 -/- mice to figure out whether T cells infiltration is necessary for increasing IL-17RA expression in the central nervous system ( CNS) .Then B6 mice were immunized with incomplete Freund′s adjuvant ( IFA) plus different TLRs ago-nists to measure the expression of Il17ra in the brains and spinal cords by qPCR .The purified astrocytes , microglia and oligodendrocytes isolated from neonatal mice brains were cultured in vitro for two weeks , and then treated with different TLRs agonists .The expression of Il17ra at mRNA and protein levels in the cells were determined by qPCR and Western blot respectively .The astrocytes were treated with IL-17A and LPS individually or in the combination to detect the level of CCL 2, CXCL8 and IP-10 in the supernatant by ELISA.Results B6 mice with induced EAE showed significantly increased Il17ra expressions in the brain and spinal cord , which was also detected in immunized Rag1 -/-mice.Although no spinal cord demyeliza-tion and CD3 cells infiltration were detected in Rag1 -/-mice, significantly increased number of IL-17RA positive cells could still be visualized .In vivo TLRs agonist participated immunization and in vitro treatment of purified neuroglial cells demonstrated that TLRs agonists could directly evoke IL -17RA expression in the CNS or cultured astrocytes , microglia and oligodendrocytes with high efficiency .Both IL-17 A and LPS could stimulate astrocytes to secrete CCL2, CXCL8 and IP-10, however, a combined use of IL-17A and LPS fur-ther augmented the production of these chemokines to a large extend .Conclusion Taken together , we con-cluded that TLRs agonists could directly stimulate neuroglial cells to express IL -17RA which functionally re-spond to IL-17A by secreting chemokines .

Objective To verify the clinical applicability of the published standard intervals (WS/T402-2012) for WBC , RBC ,PLT and Hb based on the health examination results of Han and Uygur populations in Urumqi .Methods This was a retro-spective study .The results of WBC ,RBC ,PLT and Hb from health examination individuals of Han and Uygur populations from August 2013 to January 2015 were collected ,9 307 health subjects age range from 20 to 79 years of the two nationalities were cho-sen using health examination information system .The percents of health subjects failed falling in the published standard interval were calculated to verify the judgment criterion ,fail falling rate < 10 .00% was regard as qualified .Results The test of normality revealed that the Han and Uygur′s results of all verified items were skewed distributions .The 2 .5% and 97 .5% percentiles of the results of two nationalities :WBC Han(3 .6 ~ 9 .6) × 109 /L ,Uygur(3 .8 ~ 9 .9) × 109 /L ;RBC Han Male (4 .3 ~ 5 .9) × 1012 /L and Female (3 .9 ~ 5 .2) × 1012 /L ,Uygur Male (4 .4 ~ 5 .8) × 1012 /L and Female (3 .9 ~ 5 .2) × 1012 /L ;PLT Han(130 ~ 351) × 109 /L , Uygur(145 ~ 370) × 109 /L) ,and Hb Han :Male (133 ~ 178)g/L and Female (111 ~ 153)g/L ,Uygur :Male (133 ~ 174) g/L and Fe-male (110 ~ 152)g/L .The significant differences of each testing item were found in the different sex from the same nationality(P<0 .01) .The percents of health subjects failed falling in the published standard interval were < 10 .00% in both Han and Uygur na-tionality .Conclusion The published standard reference intervals for WBC ,RBC ,PLT and Hb are applicable to our laboratory for the detection of Han and Uygur populations .