Objective To evaluate the diagnostic significance of B-ultrasound and CT in small renal tumor (≤3 cm). Methods The clinical data of 48 patients (29 men and 19 women) with small renal tumor were reviewed.Their mean age was 49 years.Of them,43 cases were asymptomatic,while 2 complained of hematuria,2 of lumbago and 1 of hematuria with lumbago.B-ultrasound, conventional CT,helical CT thin scan and intraoperative frozen section were evaluated. Results Of the 48 cases,36 of renal cell carcinoma (RCC),7 of renal angiomyolipoma (RAML),4 of oncocytic adenoma and 1 of metanephric adenoma were diagnosed by pathology after surgery.The diagnostic accuracy was 75%(36/48) for B-ultrasound,81%(39/48) for conventional CT,91%(20/22) for helical CT thin scan and 95%(19/20) for intraoperative frozen section,respectively. Conclusions Small renal tumor has high incidental rate as well as high benign rate.As the tumor is relatively smaller, it is difficult to differentiate between benign and malignant nature of the tumor by B-ultrasound and conventional CT.Helical CT thin scan and intraoperative frozen section are helpful for accurate diagnosis of the tumor.

The paper reported an investigation of the pharmacokinetics of SN-38 (7-ethyl-10-hydroxy-camptothecin) in rats and the tissue distribution in mice after injection of irinotecan hydrochloride nanoparticles (CPT-11) via tail veins. An LC-MS/MS method was established to determine the concentrations of SN-38 in whole blood of rats and in different tissues of mice. The pharmacokinetics and tissue distribution of SN-38 were compared after the intravenous injection of CPT-11 NPs and CPT-11 solution. Compared with irinotecan solution, the elimination half-life of SN-38 was prolonged from 2.17 h to 2.67 h after the intravenous injection of CPT-11 NPs, but its AUC had little change. After the injection of CPT-11 NPs in mice, over time, the concentrations of CPT-11-metabolized SN-38 in CPT-11 NPs were significantly higher in the whole blood, colon and lungs than those in CPT-11 solution, followed by in the spleen and liver, but those in the heart and brain had no change. However, the amount of SN-38 in the kidneys was reduced with time. CPT-11 NPs could prolong SN-38's (one of its metabolites) blood circulation time in rats and significantly increased the concentration of CPT-11-metabolized SN-38 in the whole blood, colon and lungs of mice. CPT-11 NPs made SN-38 efficiently target-bind to the colon and lungs of mice.

ObjectiveTo analyze intrathoracic or extrathoracic recurrence pattern after surgical resection of thoracic esophageal squamous cell carcinoma (TESCC) and its help for further modify and improvement on the target of postoperative radiation therapy. Methods One hundred and ninety-five patients who had undergone resection of TESCC at the Cancer Hospital,Chinese Academy of Medical Sciences enrolled from April 1999 to July 2007.Sites of failure on different primary location of esophageal cancer were documented.Results Patients with upper or middle thoracic esophageal cancer had higher proportion of intrathoracic recurrence.Patients with lower thoracic esophageal cancer had more intrathoracic reccurence and abdominal lymph node metastatic recurrence.Histological lymph node status has nothing to do with intrathoracic recurrence,supraclavicular lymph node ( SLN ) metastasis or distant metastasis ( χ2 =1.58,0.06,0.04,P =0.134,0.467,0.489,respectively),whereas the chance of abdominal lymph node metastases in N positive patients was significantly higher than that in N0 patients (28.7％: 10.6％,χ2 =9.94,P =0.001 ),and so did in middle thoracic esophageal cancer ( 20.0％: 5.6％,χ2 =5.67,P =0.015). Anatomic recurrence rate of patients with proximal resection margin no more than 3 cm was significantly higher compared to those more than 3 cm (25.0％: 11.3％,χ2=5.65,P=0.019).ConclusionsMediastinum is the most common recurrence site.According to recurrence site,the following radiation targets are recommended:when tumor was located at the upper or middle thoracic esophagus with negative N status,the mediastinum,the tumor bed and the supraclavicular region should be included as postoperative RT target;when tumor was located at the middle thoracic esophagus with positive N or located at the lower thoracic esophagus,the abdominal lymph node should be added.If the proximal resection margin was no more than 3 cm,the anastomotic-stoma should be included.

Radiotherapy and chemotherapy have little or no effect on advanced renal cell carcinoma, leading to a poor prognosis. Several factors couLd affect the survival rate of RCC. Some RCC patients could partly respond to immunotherapy.The newly emerging targeted therapy has a dramatic tuning point in improving outcomes for RCC. Further understanding of the anti-RCC mechanisms involves in chemokine-mediated angiogenesis and RCC cell proliferation. These new agents include Sorafenib, Sunitinib, Temsirolimus, Bevacizumab, etc. Combination treatment with immunotherapy may lead to improved outcomes in this disease.

Objective To study the clinical and pathologic features of chromophobe cell renal carcinoma and to improve the diagnosis and treatment of the disease. Methods The clinical and pathologic data of 19 patients (10 men and 9 women;mean age,53 years) with chromophobe cell renal carcinoma (9 on the left and 10 on the right) were analyzed.Of the 19 cases,12 were incidentally diagnosed of renal tumor during physical examination.Gross hematuria,low back pain and discomfort and abdominal mass occurred in 7 cases. Results B-ultrasound was mainly characterized by low echo of mass with intact capsule.CT scan revealed that most of the tumors were homogeneous hypodense solid masses,which were well circumscribed.The tumors averaged 8.2 cm in diameter.By TNM staging,8 cases had T_1N_0M_0 stage tumors and 11 cases had T_2N_0M_0 stage tumors.Radical nephrectomy was performed in 17 cases,and partial nephrectomy,in 2 cases.Follow-up was available for 16 patients (mean,4.8 years;range,3 months to 16 years)who were alive without recurrence and metastasis.Pathological features were as follows.①The cross-sections of the tumors were grossly homogeneous, dark brown and solid. One case had fibrous bands coalescence in the center of the tumor.②Microscopically the tumors were composed of 2 types of cells, typical and eosinophilic types,with very distinct borders.③Immunohistochemical assay was positive for CK8 and negative for Vimentin, and Hale colloidal iron staining was positive for the carcinoma cells.④Electron microscopy showed large numbers of vesicles within the cytoplasm. Conclusions Chromophobe cell renal carcinoma is a morphologically distinctive neoplasm with no specific findings on B-ultrasound and CT examinations.The tumors are larger in most cases but usually at early TNM stages with a favorable prognosis.

The effectiveness and safety of acupuncture combined with western medicine for angina of coronary artery disease are evaluated. Databases including Pubmed, Embase, Cochrane Library, CBMDisk,. CNKI, Wanfang, Chinese Clinical Trial Registry, etc. are searched with search time from beginning of the database establishment to January of 2014. As a result, totally 15 articles of acupuncture for angina of coronary artery disease that met the inclusive criteria were collected, involving 11 researches and 1 232 patients. The results of Meta-analysis indicate that based on regular western medicine, additional use of acupuncture could further improve symptoms of angina, increase efficacy of electrocardiogram (ECG) and reduce the dosage of nitroglycerin, in the meanwhile the hemorheology could be ameliorated, and the contents of C reactive protein (CRP), malondialdehyde (MDA), lipid peroxide (LPO), endothelin (ET) could be reduced, while the contents of superoxide dismutase (SOD) and nitric oxide (NO) could be increased; besides, the occurrence rate of cardiovascular event could be reduced without causing obvious adverse events. Except for certain outcomes (including dynamic ECG and blood viscosity) those have no statistical significance between treatment group and control group, the differences of remaining outcomes are: statistically significant. It is believed that acupuncture combined with regular treatment of western medicine are effective treatment plan for angina of coronary artery disease, which are superior to regular treatment of western medicine, but the results of this systematic review be taken with caution, and more clinical trials with high quality are looking forward to be included into Meta-analysis to increase the level of evidence.
Acupuncture Therapy ; Combined Modality Therapy ; Coronary Artery Disease ; drug therapy ; therapy ; Female ; Humans ; Treatment Outcome

The object of this study is to investigate the pharmacokinetic interaction of pioglitazone hydrochloride and atorvastatin calcium in healthy adult Beagle dogs following single and multiple oral dose administration. A randomized, cross-over study was conducted with nine healthy adult Beagle dogs assigned to three groups. Each group was arranged to take atorvastatin calcium (A), pioglitazone hydrochloride (B), atorvastatin calcium and pioglitazone hydrochloride (C) orally in the first period, to take B, C, A in the second period, and to take C, A, B in the third period for 6 days respectively. The blood samples were collected at the first and the sixth day after the administration, plasma drug concentrations were determined by LC-MS/MS, a one-week wash-out period was needed between each period. The pharmacokinetic parameters of drug combination group and the drug alone group were calculated by statistical moment method, calculation of C(max) and AUC(0-t) was done by using 90% confidence interval method of the bioequivalence and bioavailability degree module DAS 3.2.1 software statistics. Compared with the separate administration, the main pharmacokinetic parameters (C(max) and AUC(0-t)) of joint use of pioglitazone hydrochloride and atorvastatin calcium within 90% confidence intervals for bioequivalence statistics were unqualified, the mean t(max) with standard deviation used paired Wilcoxon test resulted P > 0.05. There was no significant difference within t1/2, CL(int), MRT, V/F. Pioglitazone hydrochloride and atorvastatin calcium had pharmacokinetic interaction in healthy adult Beagle dogs.

Objective:To investigate mechanisms underlying the signal crosstalk of VEGF-IL-6-STAT3 between cutaneous melanoma cells and vascular endothelial cells.Methods:EC-304 vascular endothelial cells were divided into 3 groups: control group cultured in conventional endothelial cell-conditioned medium, vascular endothelial growth factor (VEGF) group cultured in endothelial cell-conditioned medium containing 50 μg/L VEGF 165, A375 co-culture group co-cultured with a melanoma cell line A375. After 24-, 48- and 72-hour treatment, the culture medium was collected, and enzyme-linked immunosorbent assay was performed to detect the level of interleukin-6 (IL-6) . Cultured A375 cells were divided into 4 groups: control group receiving conventional culture in Dulbecco′s modified Eagle′s medium (DMEM) , A375+ EC-304 group co-cultured with EC-304 cells, A375+ EC-304+ IL-6 group co-cultured with EC-304 cells in DMEM containing 50 μg/L IL-6 (an agonist of the signal transducer and activator of transcription-3 [STAT3] pathway) , A375+ EC-304+ JSI-124 group co-cultured with EC-304 cells in DMEM containing 1 μmol/L JSI-124 (a STAT3 pathway inhibitor) . After 24-, 48- and 72-hour treatment, cells were collected, and Western blot analysis, cell counting kit-8 (CCK8) assay and Transwell invasion assay were performed to determine the protein expression of STAT3 and phosphorylated (p) -STAT3, cellular proliferative activity and invasive activity, respectively. Two-way analysis of variance and t test were used for statistical analysis. Results:The level of IL-6 significantly increased in the culture medium of EC-304 cells in the VEGF group and A375 co-culture group compared with the control group ( FVEGF = 29.63, P < 0.001; FA375 = 11.09, P = 0.020) . Compared with the control group, the A375+ EC-304 group showed significantly enhanced protein expression of p-STAT3 in A375 cells ( P < 0.001) , increased cell activity ( P < 0.001) , and increased number of invasive cells (152.66 ± 16.04 vs. 86.13 ± 7.24, t= 4.43, P < 0.001) ; compared with the A375+ EC-304 group, the A375+ EC-304+ IL-6 group showed significantly increased protein expression of p-STAT3 ( P < 0.001) , enhanced cell activity ( P < 0.001) , and increased number of invasive cells (187.34 ± 14.38, t= 2.17, P < 0.001) ; compared with the A375+ EC-304 group, the A375+ EC-304+ JSI-124 group showed significantly decreased protein expression of p-STAT3 ( P < 0.001) , decreased cell activity ( P < 0.001) , and decreased number of invasive cells (124.92 ± 8.72, t=-1.86, P < 0.001) . Conclusion:There is a signal crosstalk of VEGF-IL-6-STAT3 between cutaneous melanoma cells and vascular endothelial cells, which may play an important role in the proliferation and invasion of A375 cells.

Objective To evaluated the application value of two kinds of mass spectrometer(MS)and Vitek MS system in the i-dentification of routinely isolated bacteria in clinic.Methods 149 strains of common bacteria(including 14 genera and 30 species)i-solated from blood,urine,cerebral spinal fluid,secretion and sputum samples in our hospital from March 2012 to January 2013 were collected and simultaneously identified by 2 kinds of matrix-assisted laser desorption ionization-time of flight mass spectrometer (MALD-TOF-MS).The identification results were compared with those identified by the conventional biochemical identification (Vitek2 compact).The strains with the inconsistent results identified by 3 kinds of method were confirmed by 16S rDNA gene se-quencing.Results Among 149 common bacteria,the correct identification rates of genus and species by the Bruker Biotyper MS were 98% and 96% respectively and which by the Vitek MS system were 97% and 95% respectively.There were no misidentified bacterial strains by these two kinds of MS.Conclusion No statistical difference in the identification results was observed between these two kinds of MS system(P >0.05).Both exhibit excellent identification level and are suitable for the routine laboratory iden-tification of clinical microorganism.

ObjectiveTo study the clinical effect of the proximal femoral anatomical locking plate in the treatment of ipsilateral femoral shaft and neck fractures.Methods A retrospective study was done on 10 patients with ipsilateral femoral shaft and neck fractures treated with proximal femoral anatomical locking plate in our hospital from February 2009 to February 2011.After treatment,the outcome was assessed regularly by fracture union as was seen on serial radiographs and clinical function was estimated by Friedman and Vyman System.ResultsAll patients were followed up for 6-24 months ( average 16 months).All the fractures were healed within 2.5-4 months (average 3 months) in the femoral shaft and within 4-9 months (average 6 months) in the neck,respectively.According to Friedman and Vyman System,the overall clinical result was good in eight patients and fair in two,with excellent rate of 80％ (8/10).No osteonecrosis of the femoral head and fixation failure were observed during the followup. Conclusion Proximal femoral anatomical locking plate internal fixation is an effective treatment method for ipsilateral femoral shaft and neck fractures.