Objective To investigate the clinical features,diagnosis,treatment and prognosis of the renal secondary tumor.Methods From January 2000 to January 2014,the data from 31 patients,including 23 male patients and 8 female patients,with renal secondary tumors were analyzed retrospectively.Their mean age was 56 years old (ranging from 38 to 75 years old).The 31 renal secondary tumors rooted in lung cancer(n =14),lymphoma(n =5),colorectal cancer and gastric cancer(n =3),breast cancer(n =2),esophageal cancer(n =1),thyroid cancer (n =1),cervical cancer (n =1) and bladder cancer (n =1),respectively.There were 22 patients (71.0％) of renal metastasis accompany with other organs or lymph node metastasis.9 cases (29％) suffered with independent renal metastasis and 21 cases (67.7％) suffered with unilateral renal metastasis.5 cases(16.1％) were diagnosed as primary tumor with the renal metastasis at the same time,and the remaining 26 cases were found renal metastasis within 9 to 72 months after primary tumor (mean 30 months).There were only 5 patients (16.1％) with symptom.Ultrasound showed low echo range in 20 cases (65.6％) or uneven echo in 11 cases (34.4％).CT showed equal density (77.4％) in 24 cases or slightly low density shadow (22.6％) in 7 cases,most of which were endogenous,mild enhancement.10 cases (32.3％) were bilateral renal metastasis,unilateral renal multiple metastases was found in 6 cases (19.4％),and single metastasis was noticed in 15 cases (48.4％).The average diameter of the renal metastasis was 2.7 cm (ranging from 0.9 to 6.8 cm).Except 4 cases gave up the treatment,the remaining 27 cases were accepted comprehensive therapy about the primary tumor.the 9 patients with renal metastasis only were treated with chemotherapy or targeted therapy for the advanced primary tumor.Among the 9 patients,6 cases were undergone NSS or radical nephrectomy (RN) treatment.Results In 9 cases with only renal metastasis,6 cases,treated by surgery,recovered well.Postoperative pathological and immunohistochemical results confirmed the renal metastasis.Up to January 2015,the follow-up duration ranged from 2 months to 60 months [mean (22.6 ± 18.4) months].The survival time ranged from 1 month to 51 months [mean (13.2 ± 13.2) months].Among 22 cases with multiple metastasis,4 cases gave up treatment,whose average survival time was (2.0 ± 1.4) months.However,the average survival time in remaining 18 cases was (11.1 ± 4.7) months (P ＜ 0.05).In 9 cases with independent renal metastasis,the average survival time in 6 cases,accepted the procedure,was (26.2 ± 18.6) months.While,the average survival time in remaining 3 non-surgical cases,was (10.3 ± 4.0) months (P ＜ 0.05).Conclusions Renal secondary tumor was rare in clinic.Most cases have isolated lesion.Renal secondary tumor was advanced manifestation of the primary tumor,which could prolong the survival time according to the comprehensive treatment for the primary tumor.Surgical resection of the lesion before the comprehensive treatment could be chosen in the independent renal metastasis.

Objective To investigate the diagnosis value of mucin 7 in plasma and urine in the detection of bladder cancer.Methods Expression of mucin 7 was detected quantitatively in plasma and urine from 23 patients with bladder cancer and 23 patients as control group by enzyme-linked immunosorbent assay(ELISA) from November 2012 to September 2013.There were 15 were male and 8 were female in the 23 bladder cancer patients,aged from 41 to 95 years,with an average of 64 years.Of the 23 bladder cancer pathology,12 with high grade,11 with low grade,11 with invasive disease and 12 with noninvasive disease.There were 19 males and 4 females in the 23 patients in control group,aged from 28 to 85 years,with an average of 61 years.Results The amount of mucin 7 in plasma was significantly higher in bladder cancer group than that in control group [(7.43±4.54) ng/ml versus (4.55±.1.98) ng/ml,P=0.017].While there was no significant difference in urine between the two groups [(12.44±7.1 1) ng/ml versus (11.96±8.41)ng/ml,P=0.840].There was no significant differences in the amount of mucin 7 had in different grades and stages of bladder cancer (P＞0.05).Conclusions Expression of mucin 7 in plasma of patients with bladder cancer is significantly higher than that in control group.Mucin 7 expression has no significant correlation with the grading and staging of bladder cancer.Detecting mucin 7 expression quantitatively with ELISA for diagnosis of bladder cancer is a method with certain value.

Objective To analyze the X -ray, CT, and MR imaging findings in osteoid osteoma. Methods Forty-eight cases of osteoid osteoma proved by surgical pathology were collected, including 33 males and 15 females. Among the 48 cases, all patients had plane films, 32 were imaged with CT scanning, 10 with MR imaging, and 8 with all three techniques. The imaging findings of osteoid osteoma and the ability of X-ray, CT, and MRI in demonstrating the nidus and the surrounding reaction were analyzed. Results The imaging manifestations of osteoid osteoma revealed a circular or oval nidus with different bone sclerosis around the nidus. The diameters ranged from 0.4 cm to 1.7 cm, with the average of 9.7 cm. There were also soft tissue and bone morrow edema around the nidus or distinct effusion of joint on MR imaging in all 10 cases. Among 48 cases, only 37 cases showed nidus on plane film. All 32 cases with CT scanning showed nidus. The display ratios of nidus were 77% for X-ray and 100% for CT, respectively. 10 cases with MR imaging could be diagnosed correctly. But the nidus could be affirmed in only 8 cases, and the nidus was affirmed by comparing with plane film or CT in the other 2 cases. Conclusion Nidus is the key in diagnosing the osteoid osteoma correctly. Plane film is still an important checking method for osteoid osteoma. CT scan is the best method to demonstrate the nidus. MRI can demonstrate the soft tissue and bone morrow edema around the nidus sensitively, but probably lead to an incorrect diagnosis. Combining with X-ray or CT, MRI can make an accurate diagnosis.

Objective To determine the risk factors of Contrast-induced Nephropathy(CIN)and discuss means of minimizing the risk or preventing this complication.Methods A retrospective analysis of the data of 17 patients who were confirmed CIN in The Second Affiliated Hospital of Guzngzhou Medical College from 2004.6-2005.12 was admin- istrated.The contrast medium was lopamidol,doses varied from 70 mL to 150 mL.Serum creatinine(Scr)was meas- ured before and day 2,day 7 after angiography.Results Scr elevation of all the patients was 82.35?99.10?mol/Lat day 2.Scr of 11 patients returned to normal at day 7(103.82?20.49)?mol/L,the other 6 still remain high level (437.83?335.85)?mol/L and 3 of them needed hemodialysis therapy.Conclusion Risk factors of CIN include baseline Scr elevation,congestive heart failure,diabetes,high doses of contrast medium and concomitant use of nephro- toxic drugs.Contrast medium should be used at the minimal dose necessary in patients preexisting renal impairment.Di- uretics and other nephrotoxic drugs should be withheld for at least 24 hours before and after exposure to contrast medium. Additional fluids and hemofiltration should be given to prevent CIN.

Objective To assess the effectiveness and safety of vitamin D in preventing and treating bone loss in renal transplant patients.Methods Methods recommended by the Cochrane Collaboration were used.MEDLINE,EMBase,Cochrane Library and CNKI were searched from Jan.1990 to Nov.2009 to locate all the randomized controlled trials (RCT) concerning preventing and treating bone loss by vitamin D in renal transplant patients.The qualities of included trials were evaluated by two independent reviewers.Trails consistent with criteria wereanalyzed by Revman 4.2 software.Results Nine RCTs involving 658 post transplant patients were included.The qualities of included trials were graded as grade A in 4,grade B in 2 and grade C in 3.Meta-analysis showed that after being treated with vitamin D for one year,the difference of BMD,Z-score and T-score between the two groups was statistically significant (P＜ 0.05); the difference of PTH concentration was also statistically significant (P＜0.01),but there was no significant difference in concentrations of serum calcium and phosphorus,and the incidence of hypercalcemia (P＞0.05).Conclusion Current available evidence demonstrates that vitamin D is effective and safe in preventing and treating bone loss in renal transplant patients.

Objective: To summarize the impacts of the archived medical record value fund as established by the hospital, on the medical quality management, and propose improvement strategies. Methods: Retrospective analysis was made on 1 149 medical record scoring sheets, and the rate of connotations deducting scores in 197 of such sheets were compared. A statistical analysis was made on the archived medical records, regarding the rate of grade A medical records, defects composition of grade B medical records, the rate of connotation deducting scores, and the ability of the quality control experts (error correction ratio). Results: The archived medical record value fund has pushed up significantly the quality of medical records. For example, the rate of grade A medical records rose step by step from 89% to 95%; the rate of grade B medical records with single-item vetoes fell sharply, a difference of statistical significance (P<0.05); the connotation quality management of medical records was constantly improving, with the rate of connotation deducting scores gradually elevating (t=-4.409, P<0.05); the proportion of experts with strong error correction ability (error correction ratio≥80%) was elevated from 32.2% to 50.9%, a difference of statistical significance (P<0.05). Conclusions Archived medical record management can encourage medical quality management. The quality of medical records, especially the connotation quality of medical records has been improved. The ability of some quality control experts was also enhanced. The quality management system at hospital and department levels has made major progress.