Objective:To investigate the expression of MEK/ERK signaling pathways in renal cell car-cinoma with bone metastasis,and to analyze the differences of expressions of VEGFR-2,MEK,ERK on the primary and metastasis tissue and its mechanism.Methods:The tissue samples were obtained from 7 renal cell carcinoma patients kindly provided by Department of Urology,Peking University People’s Hos-pital from January 1,2009 to January 1,2010.The expression of MEK/ERK signaling pathways was de-tected in the 7 renal cell carcinoma patients`primary and matched metastatic tissues with ICH,The anti-body concentrations were 1 ∶200,1 ∶25,and 1 ∶250,respectively.The mutation of the twentieth exon of the PDGFRA gene,the second exon of the K-ras gene,the fifteenth exon of the Brafgene and the se-cond exon of the MEK1 gene were detected with PCR.Results:The expression intensities of VEGFR-2, MEK,and ERK were measured by H-score [intensity (1,2,3,or 4)multiplied by the distribution (%)].VEGFR-2,MEK,and ERK expressions were divided into 3 groups according to the positive dis-tribution of the tumor cells:1,0 -5%;2,6% -50%;and 3,>50%,To assess intratumor heteroge-neity,three distinct microscopic fields (×200)from each specimen were used to evaluate the expres-sions,Subsequently,the scores were averaged to obtain a single concatenated score for each tissue. VEGFR-2,MEK,and ERK expressions were assessed by 2 independent pathologists who were blinded to the clinicopathological data.The data were expressed as the mean value of the triplicate experiments.The expressions of MEK,and ERK were higher in the metastatic tissues than in the matched RCC tissues (6.10 ±4.10 vs.1.33 ±0.51,P =0.015;9.10 ±2.24 vs.4.43 ±2.84,P =0.021 )while the ex-pression of VEGFR-2 was not different between the primary and metastatic tissues (P =0.901).No mu-tation was detected on the twentieth exon of the PDGFRA gene,the second exon of the K-ras gene,the fifteenth exon of the Brafgene and the second exon of the MEK1 gene.Conclusion:MEK/ERK signa-ling pathways may play an important role in the metastasis and the resistance of sunitinib in RCC patients with bone metastasis.

Objective To investigate the expression of CKLF-like MARVEL transmembrane (CMTM)domain-containing family in clear cell renal cell carcinoma(ccRCC)and its significance.Methods Seventy-five samples of ccRCC were collected,including 50 males and 25 females,mean age (59 ± 10)years.There were 34 cases in clinical stage Ⅰ,23 cases in stage Ⅱ,14 cases in stage Ⅲ and 4 cases in stage Ⅳ.The pathological differentiation was 3 cases of grade Ⅰ,1 case of grade Ⅰ-Ⅱ,35 cases of grade Ⅱ,10 cases of grade Ⅱ-Ⅲ,18 cases of grade Ⅲ,3 cases of grade Ⅲ-Ⅳ and 5 cases of grade Ⅳ.The expression of CMTM3 and CMTM5 proteins in 75 cases of ccRCC and corresponding adjacent normal kidney tissues was detected by tissue microarray and immunohistochemistry.Results The positive expression rate of CMTM3 and CMTM5 was 98.7％,97.3％ in the adjacent normal kidney tissues,and 44.0％,68.0％ in ccRCC tissues(P ＜ 0.05).The expression of CMTM3 and CMTM5 had no correlation with the gender,age,clinical staging and pathological differentiation(P ＞ 0.05).Conclusion CMTM3 and CMTM5 could be ccRCC suppressor genes,and their mutation or methylation might be an early event in the carcinogenesis of ccRCC,thus promise them to be potential biomarkers in early diagnosis.

【Objective】 To investigate the efficacy of continuous saline bladder irrigation (CSBI) after a single immediate instillation of chemotherapy (SIIC) in patients with low- and immediate-risk non-muscle-invasive bladder cancer (NMIBC) undergoing transurethral resection of bladder tumor (TURBT). 【Methods】 Clinical data of 211 patients with with low- and immediate-risk NMIBC, who underwent TURBT in our hospital during Jan.2004 and Dec.2019 were collected.The patients were divided into two groups according to whether CSBI was conducted after SIIC.The recurrence rate, progression rate, recurrence-free survival and progression-free survival of the two groups were compared.Cox univariate and multivariate regression analyses were used to investigate whether CSBI was a risk factor for recurrence and progression. 【Results】 There were no significant differences in baseline data, recurrence rate and progression rate between the two groups (P>0.05).There was no significant difference in recurrence-free survival between the two groups, but the progression-free survival was shorter in CSBI group (χ²=8.270, P=0.004) .Multivariate Cox regression analysis indicated that diabetes (HR: 2.240, 95%CI:1.066-4.704, P=0.033) and multiple tumors (HR: 3.060, 95%CI: 1.639-5.711, P<0.001) were independent risk factors for recurrence and CSBI(HR: 7.914, 95%CI: 1.710-36.632, P=0.008) was an independent risk factor for progression. 【Conclusion】 CSBI after SIIC may increase the risk of progression in patients with low- and immediate-risk NMIBC, but a larger sample size is needed for validation.

Objective    To analyze the risk factors of anastomotic leakage after esophagectomy. Methods    The clinical data of 1 328 patients with esophageal cancer, who underwent esophagectomy in the First Affiliated Hospital of Henan University of Science and Technology from January 2010 to December 2016, were retrospectively analyzed. There were 726 males and 602 females, at an average age of 67.2±14.1 years. According to whether there was anastomotic leakage after operation, patients were divided into two groups: an anastomotic leakage group (167 patients) and a non-anastomotic leakage group (1 161 patients). Univariate and multivariate logistic regression analysis was used to identify related risk factors of anastomotic leakage after operation. Results     The incidence of postoperative anastomotic leakage was 12.6% (167/1 328). Univariate analysis showed that body mass index, arrhythmia, chronic obstructive pulmonary disease (COPD), diabetes, preoperative albumin level, preoperative chemotherapy and chemoradiotherapy, lesion location, anastomosis types and postoperative pulmonary infection were associated with statistically significant increase in risk of cervical anastomotic leakage (P<0.05). Logistic regression analysis showed that preoperative COPD, lesion location and postoperative pulmonary infection were independent risk factors of cervical anastomotic leakage after esophagectomy (P<0.05). Conclusion    The occurrence of cervical anastomotic leakage after esophageal cancer is related to many factors. The preoperative COPD, the lesion location and the postoperative pulmonary infection are independent high risk factors. Paying attention to these factors and doing perioperative management can effectively reduce the occurrence of anastomotic leakage.

Objective:To translate the University of Rhode Island Change Assessment of voice scale（URICA-Voice） into Chinese and test its reliability and validity. Methods:The URICA-Voice scale was converted into Chinese by literal translation, cultural adjustment, expert consultation, pre-investigation, and back translation. Convenience sampling was used to recruit patients at four speech therapy centers from February to May 2022. Then the Chinese version of the scale was distributed to them, and the reliability and validity of the scale were tested after data collection. Cronbach ɑ was used to evaluate the reliability. The critical ratio method and Pearson correlation coefficient were used for item analysis. Item-level content validity, scale-level content validity, and confirmatory factor analysis were used to test the validity of the scale. Results:A total of 247 valid questionnaires were collected. ①Item analysis: the critical ratios between a high-score and low-score groups of 32 items were all statistically significant（P<0.01） and all the critical ratios were above 3.00. The Pearson correlation between 32 items and the total score was significant（P<0.01）. ②Validity analysis: I-CVI=1.00, S-CVI/Ave=1.00, χ²/df=2.30, RMSEA=0.07. Except for item 9 and 23, the standardized factor loading coefficients of other items were all above 0.50. AVE of the four dimensions of the scale was all above 0.50, and the combined reliability of the four dimensions was all above 0.70. The correlation coefficients between dimensions were less than the square root of the AVE of the dimension itself. ③Reliability analysis: the Cronbach ɑ of the whole scale was 0.94, and the Cronbach ɑ of the four dimensions were 0.88, 0.92, 0.94, and 0.88 respectively. Conclusion:The Chinese version of URICA-Voice has good reliability and validity, and can be used as a specific measurement tool for evaluating the compliance of voice training in China.
Humans ; China ; Language ; Reproducibility of Results ; Surveys and Questionnaires ; Voice