Objective The purpose of this study was to investigate the clinical significance of serum vascular endothelial growth factor(S-VEGF)in patients of esophageal squamous cell carcinoma with the end-point of progress-free survival rate.Methods Sera from 89 patients with esophageal squamous carcinoma,who presented and treated with concurrent chemoradiotherapy or surgical resection in Cancer Center d Sun Yat-Sen University from December 2002 to May 2004,were sampled at the time of pre-treatment.30 cases of health individuals without any evidence of disease were selected as control group.For patients with surgical resection were performed with esophagectomy and extended lymphadenectomy.For patients with concurrent chemoradiotherapy comprised of cisplatin and 5-fluorouracil.The radiotherapy dose of 2 Gy per day was initiated on Day 1 of chemotherapy and continued daily for 5 days per week for 6 weeks,for a total close of 60 Gy.Two courses of chemotherapy were given during radiotherapy at 6-week intervals.The serum vascular endothelial growth factor(S- VEGF)levels were measured with a solid phase enzyme Human VEGF Immunoassay ELISA kit.The end point of this study was progress-free survival,and time was calculated from the date of diagnosis to date of relapse or last follow evaluation.Results S-VEGF level of patients with esophageal squamous cell carcinoma was significantly higher than that of heahhy controls(475.93?44.76 pg/ml vs.294.20?23.40 pg/ml;P=0.020).S-VEGF levels in patients with StageⅢand StageⅣdisease were significantly higher than those in patients with Stage I and StageⅡdisease.The 1-year progress-free survival rate d high S-VEGF group(≥475 pg/ml)was significantly lower than that of the low S-VEGF group(＜475 pg/ml)(24% vs.66%;P=0.0004).The 1-year progress-free survival rate of the patients with StageⅠand StageⅡdisease was significantly higher than that of patients with StageⅢand StageⅣdisease(71% vs.29%;P=0.0015).The variables were assessed by multivariate analysis using the Cox proportional hazards model,and the results revealed that the clinical stage and the S-VEGF were first and second independent prognosis factor,respectively.Conclusions In the current study,a high S-VEGF was found to be associated with tumor progression,poor treatment response,and poor survival in patients with squamous cell carcinoma of the esophagus.

Objective To analyze the CT features of renal cell carcinoma,so as to improve the diagnostic accuracy of renal cell carcinoma.Methods Three hundred cases of renal cell carcinoma proved by pathology were examined by means of CT.There were 214 male and 86 female in this group.Their age ranged from 9 to 81 years,with a mean of 53.7 years.Their CT features were retrospectively reviewed. Results The masses were 1.5—16.0 cm(mean,4.8 cm)in greatest dimension,125 masses on left kidney and 175 masses on right kidney.According to WHO histological classification of tumours of the kidney in 2004,there were 238 cases of clear cell renal cell carcinoma,6 cases of multilocular clear cell renal cell carcinomas,23 cases of papillary renal cell carcinoma,14 cases of chromophobe renal cell carcinoma and 19 cases of renal cell carcinoma,unclassified.The above subtype of renal cell carcinoma demonstrated characteristic features.Clear cell renal cell carcinoma exhibited inhomogenous(due to hemorrhage,necrosis or cystic degeneration)and hypervaseular.Multilocular clear cell renal cell carcinoma presented as a multilocular cystic mass lacking an,expansile nodule,and with regular thin cyst wall and septa.Papillary renal cell carcinoma exhibited inhomogenous and hypovascular.Chromophobe renal cell carcinoma was relatively homogenous and hypovascular.Renal cell carcinoma,unclassified showed inhomogenous and hypervascular,and was more invading growth compared to clear cell renal cell carcinoma. Conclusion Common subtype of renal cell carcinoma demonstrated characteristic features in CT and it is helpful for differentiation.

Objective To investigate the clinical efficacy of intraluminal enucleation in transurethrat vapor- ization and electro-reesection of the prostate.Methods A retrospective analysis was reviewed in 62 case of prostatic hypertrophy,which were treated with intraluminal enucleation in vaporization of prostate.All pacients had a sucessful operation.There were 12 case in unipolar vaporization and 50 in plasmakenitic bipolar vaporization.Results Opera- tion time ranged from 50 to 162 minutes,with an average of 76min.Bleeding ranged from 40 to 200 ml,with an av- erage of 110ml.There was no blood transfusion.The weight of prostate was 62～138g,the catheter was maintained for 3～5 days postoperatively.The hospital stay was 7～10 days,average 8 days.All patients were cured.There was a fllow-up for 1～20 months,with an average of 8 months.The IPSS decreased by 22 points on average,and peak urine flow(Qmax)increasd to(16.8?3.3)ml/s.There wre no urethralstricture,permanent urinary incontinence, TURS,postoperative hemorrhage,retrograde ejaculation and recurrence.Conclusions Intraluminal enucleation in treatment of prostalic hypertroply is a new,safe,and effective method,which should be popularized in clinical prac- tice.

BACKGROUNDPolyunsaturated omega-3 fatty acids may beneficially influence healing processes and patient outcomes. The aim of this research was to study the clinical efficacy of fish oil enriched total parenteral nutrition in elderly patients after colorectal cancer surgery.

METHODSFifty-seven elderly patients with colorectal cancer were enrolled in this prospective, randomized, double-blind, controlled clinical trial. All patients received isocaloric and isonitrogenous total parenteral nutrition by continuous infusion (20 - 24 hours per day) for seven days after surgery. The control group (n = 28) received 1.2 g/kg soybean oil per day, whereas the treatment group (n = 29) received 0.2 g/kg fish oil and 1.0 g/kg soybean oil per day. Blood samples were taken pre-operatively, and at days one and eight after the operation. The plasma levels of CD4, CD8, CD4/CD8, interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were measured. Clinical outcomes were then analysed.

RESULTSPatient characteristics were comparable between the two groups. At day eight post-surgery, IL-6, TNF-α and CD8 titres were lower in the treatment group when compared to the control group; these results reached statistical significance. In the treatment group, there were fewer infectious complications and incidences of systemic inflammatory response syndrome (SIRS), and shorter lengths of hospital stay were observed. The total cost of medical care was comparable for the two groups. No serious adverse events occurred in either group.

CONCLUSIONSFish oil 0.2 g/kg per day administrated to elderly patients after colorectal surgery was safe and may shorten the length of hospital stay and improve clinical outcomes.

Aged ; CD4 Antigens ; blood ; CD4-CD8 Ratio ; CD8 Antigens ; blood ; Colorectal Neoplasms ; blood ; surgery ; Colorectal Surgery ; Female ; Fish Oils ; therapeutic use ; Humans ; Interleukin-6 ; blood ; Male ; Middle Aged ; Parenteral Nutrition, Total ; methods ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo determine the validity of the pulmonary function equipment.

METHODS12 young students (including six males and six females) were enrolled as our research subjects. And the values of oxygen consumption (VO(2)), carbon dioxide production (VCO(2)) and energy expenditures (EE) of the subjects under three typical activity intensities: resting, moderate intensity (on a treadmill with grade 10% and speed 2.7 km/h) and hard intensity (on a treadmill with grade 10% and speed 5.8 km/h) were measured using the pulmonary function equipment (K4b(2)) and Douglas-bag respectively. And the Douglas-bag method was used as reference and the results were compared with the other method.

RESULTSThe measured VO(2) values by using the Douglas-bag and the pulmonary function equipment under three typical activity intensities were: at rest (0.22 ± 0.03), (0.22 ± 0.05) L/min (t = 0.120, P > 0.05); moderate intensity condition (0.95 ± 0.12), (0.96 ± 0.14) L/min (t = 0.240, P > 0.05); hard intensity condition (1.63 ± 0.28), (1.54 ± 0.35) L/min (t = 1.487, P > 0.05). For VCO(2) values: at rest (0.18 ± 0.02), (0.18 ± 0.04) L/min (t = 0.425, P > 0.05); moderate intensity (0.82 ± 0.11), (0.83 ± 0.13) L/min (t = 0.579, P > 0.05); hard intensity (1.64 ± 0.27), (1.52 ± 0.39) L/min (t = 2.330, P < 0.05). And for EE values, at rest (269.40 ± 35.70), (267.02 ± 55.39) kJ/h (t = 0.200, P > 0.05); moderate intensity (1165.76 ± 148.06), (1185.91 ± 161.89) kJ/h (t = 0.326, P > 0.05); hard intensity (2062.91 ± 341.97), (1912.27 ± 483.88) kJ/h (t = 1.718, P > 0.05) respectively. The results showed that there were no significant differences between the two methods except the VCO(2) values under high intensity condition was underestimated by the pulmonary function equipment. Bland-Altman test showed that the difference of the two methods was evenly distributed by the mean and standard error of the system was 24.7 kJ/h. Our data showed the results from the Douglas-bag and the pulmonary function equipment were consistent.

CONCLUSIONPulmonary function equipment had good validity in assessing the energy expenditure in Chinese adults.

Adolescent ; Adult ; Energy Metabolism ; physiology ; Exercise Test ; instrumentation ; Female ; Humans ; Male ; Oxygen Consumption ; physiology ; Respiratory Function Tests ; instrumentation ; Students ; Young Adult

OBJECTIVEConsidering the difficulty in classifying some cases with eye trauma by Birmingham Eye Trauma Terminology (BETT) in our epidemiological study, we introduce a new classification for epidemiological study of mechanical eye injuries based on BETT.

METHODSA retrospective investigation was carried out in 31 hospitals from January 2005 to December 2010. All medical records of inpatients with eye injuries were reviewed. A total of 10 718 patients (11 227 eyes) were diagnosed as mechanical eye injuries. All mechanical eye injuries were tried to be classified using BETT. While some eye injuries were difficult to categorize. We recorded the injury type and case number. A new classification based on BETT was also used for the same project.

RESULTSOf 10 718 patients (11 227 eyes) with mechanical eye injuries, the following cases cannot be classified by BETT: 1 488 patients (1 559 eyes) with merely orbital or ocular adnexa injury, 1 961 (2 054) globe injuries associated with orbital or ocular adnexa injury, 271 (284) ocular surface foreign body (OSFB) or ocular wall foreign body (OWFB), 77 (89) contusion, 9 (11) lamellar laceration associated with OSFB or OWFB, 29 (30) rupture associated with OSFB, OWFB or intraocular foreign body and 60 (62) lace- ration associated with OSFB or OWFB. While according to our new classification, all eye injuries can be categorized without any difficulty.

CONCLUSIONDifficulty in classifying some eye injuries in epidemiological study by BETT brings some trouble to our study, which can be solved by our new eye injury classification to some extent. It is hoped that other ophthalmologists present better ones to make the classification more perfect.

Adolescent ; Eye Injuries ; classification ; epidemiology ; Humans ; Retrospective Studies ; Young Adult

OBJECTIVEThe purpose of this study was to assess the imaging characteristics of abdominal pheochromocytoma in multiphasic spiral CT scanning, and to determine whether these image characteristics can aid in differentiating pheochromocytoma from other types of tumors or not.

METHODSThe image data of dynamic enhanced CT of 79 pathologically confirmed pheochromocytomas in 70 patients were retrospectively reviewed.

RESULTSAmong the 70 patients, there were 41 patients with endocrine symptoms related to pheochromocytoma, 15 had a latent pheochromocytoma and the remaining 14 cases presented with a non-functioning pheochromocytoma. There were totally 79 tumors in 70 patients, with a single lesion in 63 cases, while multiple lesions in the other 7. Sixty cases had a tumor located in the adrenal gland, while 8 in retroperitoneal space, and 2 cases had both intraadrenal and ectopic lesions simultaneously. Sixty patients had a benign pheochromocytoma, the other 10 had a malignant one or relapse after operation. The average size of the tumor was 5.8 cm (range, 2 approximately 15 cm in the longest diameter). Seventy-seven pheochromocytomas had a well defined boundary except two big ones with a unclear margin, which were finally proven to be malignant. Homogeneous enhancement was found in 6 lesions with a diameter

CONCLUSIONApproximately half of the abdominal pheochromocytomas are lack of endocrine symptoms related with their tumors. However, they may display some typical CT characteristics, such as that a small lesion is often homogeneous but hypervascular, a larger tumor may present hemorrhage, necrosis, and cystic change with rich or moderate blood supply. However, when a small tumor has moderate blood supply, it should be differentiated with an adrenal adenoma; when a big one has moderate blood supply, it should be differentiated with other malignant tumors. Furthermore, a part of malignant pheochromocytomas is really difficult to be differentiated from some benign lesions by spiral CT images alone.

Adenoma ; blood supply ; diagnostic imaging ; surgery ; Adolescent ; Adrenal Gland Neoplasms ; blood supply ; diagnostic imaging ; surgery ; Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Pheochromocytoma ; blood supply ; diagnostic imaging ; surgery ; Radiographic Image Enhancement ; Retroperitoneal Neoplasms ; blood supply ; diagnostic imaging ; surgery ; Retrospective Studies ; Tomography, Spiral Computed ; methods ; Young Adult

OBJECTIVETo investigate the role of multiphasic spiral computed tomography (SCT) in the differential diagnosis of small renal cell carcinoma.

METHODSThe data of 100 patients with small renal cell carcinoma (< or = 3.0 cm) proved by pathology were retrospectively reviewed in order to analyze the features of SCT during plain, corticomedullary and excretory phases. There were 83 males and 17 females, with a mean age of 54. 3 years ranging from 9 to 81 years.

RESULTSThere were 38 tumor masses in the left kidney and 62 in the right one. They were 1.0-3.0 cm (mean, 2.5 cm) in the greatest dimension. According to the 2004 WHO histological classification criteria for the tumors of the kidney. Seventy-six patients had clear cell renal cell carcinoma, 4 multilocular clear cell renal cell carcinomas, 9 papillary renal cell carcinoma, 4 chromophobe renal cell carcinomas and 7 unclassified renal cell carcinomas. Clear cell renal cell carcinoma exhibited rich blood supply and inhomogeneous density due to hemorrhage, necrosis or cystic degeneration. Multilocular clear cell renal cell carcinoma presented as a multilocular cystic mass with thin wall and septa, instead of an expansile nodule. Papillary renal cell carcinoma showed inhomogeneous density and hypovascular distribution. Chromophobe renal cell carcinoma was relatively homogeneous and hypovascular. Compared with clear cell renal cell carcinoma, unclassified renal cell carcinoma showed inhomogeneous density and hypervascular distribution with more invading growth features than the other subtypes.

CONCLUSIONCommonly encountered subtypes of the small renal cell carcinoma exhibit their own specific features in multiphasic spiral CT, which may be helpful in differential diagnosis, but each subtype should be differentiated from the renal oncocytoma, cystic nephroma, complex renal cyst, renal angiomyolipoma with minimal fat and renal infiltrating urothelial carcinoma.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Papillary ; diagnostic imaging ; Carcinoma, Renal Cell ; diagnostic imaging ; Child ; Diagnosis, Differential ; Female ; Humans ; Kidney Neoplasms ; diagnostic imaging ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Tomography, Spiral Computed ; methods

OBJECTIVETo explore the relationship between hypoxia and the apoptosis of corpus cavernosum smooth muscle cells (CCSMC) in SD rats.

METHODSCCSMCs were cultured in vitro and identified by immunohistochemistry, and then underwent hypoxia interference at the concentration of 1% O2 for 12, 24, 48 and 72 hours, with normal oxygen concentration as the control. Flow cytometry was used to determine the cycles and apoptosis of the cells.

RESULTSThe cultured CCSMCs grew well, positive for anti-smooth muscle alpha-actin monoclonal antibody immunohistochemical staining. Flow cytometry showed that the number of CCSMCs in G0/G1 was gradually increased within 48 hours and then decreased, just opposite to the proportion of the S phase cells. But no regular change was found in the proportion of the cells in the G2/M phase.

CONCLUSIONHypoxia promotes the apoptosis of CCSMCs in a time-dependent manner, to the maximum at 48 hours, and then cell lysis may occur, but with no further apoptosis.

Animals ; Apoptosis ; Cell Hypoxia ; Cells, Cultured ; Male ; Muscle, Smooth, Vascular ; cytology ; Penis ; pathology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo explore the effect of hypoxia on the fibrosis of corpus cavernosum smooth muscle cells (CCSMC) in SD rats.

METHODSCCSMCs were cultured in vitro, identified by immunohistochemistry, and then exposed to hypoxia at the concentration of 1% O2 for 12, 24, 48 and 72 hours. Those exposed to normal oxygen concentration for the corresponding lengths of time were used as the control. The relative expressions of TGF-131, type I collagen and type DI collagen were determined by RT-PCR.

RESULTSThe in vitro cultured CCSMCs grew well, and the anti-a-smooth muscle actin monoclonal antibodies were positive on immunohistochemical staining. The relative expression levels of TGF-beta1, type I collagen and type mI collagen were positively correlated with the time of hypoxia interference within 48 hours, and did not increase further with prolonged exposure.

CONCLUSIONWhen exposed to hypoxia, the relative expressions of TGF-beta1, type I collagen and type mI collagen in the CCSMCs of SD rats increased with the length of time, and reached the peak at 48 hours. Hypoxia can cause fibrosis of CCSMCs in SD rats.

Animals ; Cell Hypoxia ; Cells, Cultured ; Collagen Type I ; metabolism ; Extracellular Matrix ; Fibrosis ; Male ; Muscle, Smooth ; cytology ; pathology ; Oxygen ; metabolism ; Penis ; metabolism ; pathology ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; metabolism