Objective To investigate the features of malignancy in end-stage aristolochic acid nephropathy (AAN) patients undergoing renal replacement therapy in the First Affiliated Hospital of Wenhou Medical University.Methods One hundred and two patients diagnosed as end-stage AAN during 2004 to 2013 were enrolled in the study,and separately udergoing hemodialysis,peritoneal dialysis and renal transplantation,to study the features of the malignancy and its risk factors.Results (1) There were totally 42 AAN patients suffering from malignancy,and 39 of them had urinary cancer.Eight cases of urinary cancer had metastasis,and 11 cases of bladder cancer had repeated recurrences.Patients suffering from malignancy had an increased mortality compared to patients without malignancy (13/42 vs 7/60,P =0.022).(2) Thirteen malignacy cases were diagnosed before the end-stage of AAN,the rest cases appeared in 1-13 years[(4.62±3.31) years] after renal replacement.(3) A further logistic regression analysis of the 29 maligancy patients after renal replacement showed that,the dose of aristolochic acid (counted by Mutong) was the only risk factor of malignancy (P =0.091),compared with the dose of Mutong less than 60 g,the patients with an accumulated dose of Mutong more than 200 g had a 4.26 folds (95％CI 1.02,17.83)higher risk of malignancy.There was no statistic difference of the malignancy risk among different renal replacement therapies,which however might influence the pathogenic sites of the urinary cancer.The simple bladder cancer was the most common malignancy among the hemodialysis patients (72.72％),and the upper urinary tract cancer among the peritoneal dialysis patients (66.67％),while the complex of both were dominant among the renal transplantation patients(40.00％).Conclusions Among the end-stage of AAN patients undergoing renal replacement therapy in Wenzhou area,the incidence of urinary cancer is high,with a character of complex,multiple and repeated recurrences.The occurence of malignancy seems to be separated from the renal function,but turns out obviously dose-dependent.There was no statistical difference of cancer risk among hemodialysis,peritoneal dialysis,and renal transplantation,which may induce different pathogenic sites of the urinary cancer.

Objective: To explore automatic breast full volume imaging (ABVS) and color doppler ultrasound (CDFI) for breast cancer neoadjuvant chemotherapy (NCT) in the evaluation of curative effect. Methods:The application of a CDFI and ABVS 42 cases of breast cancer patients receiving NCT lesions imaging characteristics before and after observation and analysis. Results:ABVS from coronal distribution and audio-visual change according to the primary tumor, and CDFI images showing the primary tumors and blood flow changes within all have significant difference in patients with complete remission after NCT (P<0.01);ABVS from coronal distri-bution and audio-visual change according to the primary tumor, and CDFI showed lesions in blood flow changes, etc. in patients with the absence of change and easing some lesions have no significant difference (P>0.05). Conclusion:We use ABVS and CDFI for breast cancer before and after the NCT curative effect evaluation of great clinical significance and value.

Objective To study the association between Mycoplasma penetrans (Mpe) infection and clinicopathology of IgA nephropathy (IgAN). Methods Blood samples of 118 IgAN patients, 90 patients with chronic kidney disease (CKD) and 89 healthy people were collected. Mpe DNA in serum was detected by PCR and positive samples were confirmed by Southern blotting. According to Mpe infection, IgAN patients were divided into positive and negative groups. Association between clinicopatholgical features of IgAN and Mpe infection was examined.Results Significantly higher Mpe positive rate was found in IgAN group as compared to CKD and healthy groups (16.0% vs 2.2% and 1.1%, P＜0.01). In Mpe positive group, 42.1% patients presented macroscopic hematuria, which was significantly higher than that in Mpe negative group (P＜0.01). While Mpe negative group had greater proteinuria, higher serum creatinine level, higher Lee grading of pathology compared to Mpe positive group. There were no differences of tubulointerstitial lesions and arteriole hypertrophy between two groups. Conclusions IgAN patients have higher Mpe infection rate than CKD patients and healthy people. Mpe positive IgAN patients have more macroscopic hematuria. Mpe infection may be associated with the pathogenesis of IgAN.

Objective: To examine the relationship of clinicopathological features and treatment strategies with the prognosis of patients with initially diagnosed stageⅣbreast cancer bone metastasis (IDBCBM). Methods: Clinical data from 74 patients with IDBCBM who were treated at Tianjin Medical University Cancer Institute and Hospital between March 2007 and November 2016 were analyzed retrospectively. A univariate analysis of prognosis was conducted using a Log-rank test, and the subsequent multivariate analysis was conducted using a Cox regression model. Results: The median age of the patients was 53.3 years. The median total survival duration (overall survival, OS) was 34.3 months, and the 3-and 5-year survival rates were 37.8% and 12.2%, respectively. Patients for whom the first distant metastasis was bone metastasis only had a better prognosis, with a median survival duration of 41.7 months and overall 3-and 5-year survival rates of 54.5% and 20.4%, respectively. In the univariate analysis, molecular subtype, hormonal receptor status, HER-2 expression levels, nodal status, Ki-67 index, number of bone metastases (NBM), initial mode of metastasis, mode of therapy, and locoregional treatment showed an association with prognosis. Further, multivariate analysis demonstrated that Ki-67 index, NBM, mode of therapy, and initial mode of metastasis were independent factors affecting OS (P<0.05). Conclusions: A high Ki-67 index, single mode therapy, the presence of multiple bone metastases, and accompanying visceral metastasis were associated with a poor prognosis. However, it remains unclear whether locoregional treatment, including surgery and radiotherapy treatment of the primary tumor, is beneficial.

Objective:To investigate the factors influencing the prognosis of patients with estrogen receptor (ER)-positive de novo stage Ⅳ breast cancer.Methods:The clinical data of 339 patients with ER-positive de novo stage Ⅳ breast cancer treated in Tianjin Medical University Cancer Hospital and Cangzhou Hospital of Integrated TCM-WM from February 2010 to December 2017 were retrospectively analyzed. Related factors such as age, time of chief complaint, the clinical T/N stage, site of metastasis, expressions of molecular markers and treatment mode were included. Univariate log-rank test and multivariate Cox regression model were used to analyze the effects of prognostic factors on patients' overall survival (OS).Results:Univariate analysis showed that there were statistically significant differences in the OS of patients stratified by clinical N stage at first diagnosis, metastasis sites at first diagnosis, ER expression, progesterone receptor (PR) expression, Ki-67 positive index and p53 expression, endocrine therapy, chemotherapy at first diagnosis, surgery and radiotherapy of the primary lesions (all P < 0.01). Multivariate Cox regression analysis results showed that metastasis sites at first diagnosis, Ki-67 positive index, surgery and radiotherapy of the primary lesions were all independent influencing factors of OS for breast cancer patients (all P < 0.01). Conclusions:Patients with ER-positive de novo stage Ⅳ breast cancer have a good prognosis when they have oligometastasis, Ki-67 positive index ≤ 20%, and they receive surgery and radiotherapy of the primary lesions.

Adaptation, Psychological ; Adolescent ; COVID-19 ; Child ; China ; Cross-Sectional Studies ; Female ; Humans ; Male ; SARS-CoV-2