Objective To evaluate the clinical application value of dual color fluorescence in-situ hybridization (FISH) in detecting urothelial carcinoma of the urinary bladder.MethodsThe probes of chromosome 3,7,17centromeres and chromosome 9p21 region (p16) were labeled by random primer method.FISH was performed on interphase nuclei of 80 urine specimens of cancer of the urinary bladder and 20 cases of healthy persons served as normal controls.Threshold value was established.The pathological diagnosis was the golden standard.Chromosome aberration was counted.The correlations between chromosome aberration and pathologic grading and staging and their sensibility of diagnosis for urothelial carcinoma of the urinary bladder were analyzed. Results The rate of numerical aberration of chromosome 3,7,17,9p21 was 47.5％(38/80),60.7％ (49/80),51.3％ (41/80) and 58.8％ (47/80) respectively.The positive rate of the combined use of 3,7,17 and 9p21 chromosome probes for detecting urothelial carcinoma of urinary bladder was 76.3％ (61/80).The aberrations had no correlation to tumor stage.The aberration of chromosome 3,7 and 17 were correlated to pathologic grade significantly (P ＜ 0.05).ConclusionThe progression of urothelial carcinoma of the urinary bladder is related to the aberrations of chromosome.FISH is believed to be a very important method in diagnosis of urothelial carcinoma of the urinary bladder,which may have important clinical significance for the postoperative recurrence detection and prognosis.

Objective To assess the safety and efficacy of abdominal radical nephrectomy and systematic lymph node dissection for treatment of renal carcinoma. Methods A total of 136 patients underwent radical nephrectomy and regional clearance of lymph nodes from July 2004 to June 2008.There were 92 males and 44 females in the study group.Ages ranged from 23 to 81 years,with a mean age of 54 years.The mean tumor diameter was 55 mm (range,15-170 mm).The tumor size detected by CT and MRI was consistent with that detected by B-ultrasound,98 were stage Ⅰ,13stage Ⅱ,12 stage Ⅲ,and 2 stage Ⅳ. Results All 136 cases underwent radical nephrectomy with retroperitoneal lymphadenectomy.All operations were successful without any major complication.The operative time was 90 to 180 min,with an average of 120 min,and blood loss was 20-400 ml,with an average of 50 ml.The pathological diagnoses were as follows: renal cell carcinoma 123 cases (90%), papillary renal cell carcinoma six cases(4%),chromophobic two cases(1.4%),oncocytoma two cases(1.4%),collecting duct two(1.4%),and others three cases(2.2%).Eight cases reported positive lymph nodes.Of the 136 cases,92 cases were T1 N0 M0,11 were T2 N0 M0,10 were T3 N0 M0,eight were T3 N1 M0 and two were T1 N0 M1.Ninety-five cases (70%) were followed-up at six to 40 months (mean,20 months).The one year and three year survival rates were 96% (91/95) and 86% (82/95),respectively.Conclusions Radical nephrectomy with systematic lymph dissection has advantages of accurate staging,effective resecting of renal tumors and preventing recurrence.Radical nephrectomy is an effective method for the treatment of renal carcinoma.

Objective To investigate the efficacy and toxicity of sorafenib in the treatment of advanced renal cell carcinoma. Methods From May 2007 to JUN 2009, 33 patients with advanced renal cell carcinoma were given oral sorafenib 400-600 mg twice daily. There were 23 males and 10 females in the study group. The pathological diagnosis of the primary tumors was clear cell carcinoma in 29 patients, papillary renal cell carcinoma in 2 patients, chromophobe renal cell carcinoma in 1 patient and chromophobe renal cell carcinoma mixed with clear renal cell carcinoma in 1 patient. Fifteen patients had multiple organ metastases and 18 patients had single organ metastasis. The median follow-up time was 29 weeks. Results Four (12%) patients achieved partial remission, 2 (6%) patients achieved progression disease, the remaining 27 (82%) patients achieved stable disease. Complete remission was not observed in the group. Two of the partial remission patients benefited on bone metastases. Common toxicities were skin reaction (85%), diarrhea (46%), erythra (42%), alopecia (36%), oral ulcer (18%) and hypertension (9%). Conclusions Sorafenib could be effective in controlling tumor growth. The overall effectiveness was 12%, the disease control proportion was 94% in this group and its toxicity was relatively minor and well tolerated.

Objective:To evaluate the value of the crescent sign for predicting the invasiveness of lung adenocarcinoma presenting as pure ground-glass nodule (pGGN).Methods:The clinical, pathological and imaging data of 316 patients (320 pGGNs) confirmed lung adenocarcinoma by surgery and pathology from July 2013 to June 2018 in the First Affiliated Hospital of Wenzhou Medical University were retrospectively analyzed. All pGGNs were divided into preinvasive group (148 pGGNs) and invasive group (172 pGGNs) according to histopathology. Logistic regression analysis was used to determine the risk factors for invasiveness of pGGN, and the ROC curve analysis was performed on each risk factor.Results:Crescent sign was found in 24 cases (16.2%) in the preinvasive group and 49 (28.5%) in the invasive group, and the difference between the two groups was statistically significant (χ2=6.804 ,P=0.009).There were statistically significant differences in patient′s age, lesion size, shape, lobulation sign, and vascular stretch sign between the two groups ( P<0.05). The ROC curve showed that with the lesion size 10.5 mm as the optimal cut off value, the sensitivity for differential diagnosis of preinvasive and invasive lesions was 65.7%, the specificity was 61.5%, and the area under the curve was 0.666. Logistic regression analysis showed that maximum diameter of the lesion ≥10.5 mm, irregular shape, crescent sign and vascular stretch were independent risk factors of invasiveness of pGGN, and the OR value (95%CI) were 3.192 (1.981-5.144), 3.672 (1.545-8.725), 1.972 (1.104-3.521), and 2.026 (1.087-3.777), respectively. A logistic model was established based on the above four independent risk factors, and the area under curve was 0.711 (95%CI 0.655-0.768). Conclusion:Crescent sign can effectively reflect the invasiveness of pGGN. Maximum diameter of the lesion ≥10.5 mm, irregular shape, crescent sign and vascular stretch sign are independent risk factors of invasiveness of pGGN.

Objective:To analyze measurement results of serum allergen-specific immunoglobulin E (IgE) in patients with eczema/dermatitis.Methods:A retrospective analysis was conducted on serum allergen-specific immunoglobulin E (IgE) levels in 3 051 patients with eczema/dermatitis, who visited the allergy clinic of Huashan Hospital from April 1, 2021 to March 31, 2022. The serum allergen-specific IgE level was detected by using the Phadia allergen detection system, and positive rates of allergens were calculated to determine common inhaled allergens and food allergens in patients with eczema/dermatitis. Comparisons of enumeration data between groups were performed by chi-square test.Results:Among the 3 051 patients with eczema/dermatitis, there were 1 412 with atopic dermatitis and 1 639 were other eczema/dermatitis. Detection of serum allergen-specific IgE showed that 1 629 (53%) patients were positive for allergens, and the number of positive allergen-specific IgEs in each patient was 3.0 ± 1.6. The top 3 common inhaled allergens in patients with eczema/dermatitis were Dermatophagoides farinae (904/1 522, 59%) , Dermatophagoides pteronyssinus (891/1 513, 59%) and Alternaria alternata (206/1 068, 19%) , and the top 3 common food allergens were shrimps (251/1 432, 18%) , egg white (165/992, 17%) and cow milk (149/994, 15%) . Among the 3 051 patients, 25 (1%) were aged < 2 years, 571 (19%) aged 2 - 12 years, 285 (9%) aged 12 - 18 years, and 2 170 (71%) were aged > 18 years. The most common food allergens were both egg white in the age groups of < 2 years and 2 -12 years (77%, 37%, respectively) , and were both shrimps in the age groups of 12 - 18 years and > 18 years (31%, 17%, respectively) . Dermatophagoides pteronyssinus and Dermatophagoides farina were the top 2 common inhaled allergens in all age groups, with the positive rate ranging from 36% to 84%; in addition, the positive rate of molds was relatively high in the age group of 2 - 12 years (mold mixture: 37%; Alternaria alternata: 27%) . From April 2021 to March 2022, the positive rate of outdoor allergens ranged from 10% to 15% among outpatients in every month; the positive rates of tree pollen and grass pollen increased from April 2021, and peaked in October 2021. The patients with atopic dermatitis showed a significantly increased positive rate of allergens (73%) compared with those with other eczema/dermatitis (37%, χ2 = 389.36, P<0.001) , and the rank of common allergens in the patients with atopic dermatitis was basically the same as that in those with eczema/dermatitis. Conclusions:The common allergens were Dermatophagoides farina, Dermatophagoides pteronyssinus and Alternaria alternata in the patients with eczema/dermatitis. Food allergy was more common in infant patients, and inhalation allergy was more common in child, adolescent and adult patients. The positive rate of allergen-specific IgEs was markedly higher in the patients with atopic dermatitis than in those with other eczema/dermatitis.

Diabetic gastroparesis (DGP) is characterized by delayed gastric emptying caused by reduction of gastrointestinal motility. Its clinical manifestations include vomiting, nausea, belching, early satiety, postprandial fullness, and abdominal distention, etc. The mechanism of DGP is still not clear. Depletion of interstitial cells of Cajal, myopathy and neuropathy are considered to be the main pathogenic factors. Gastric prokinetics, gastric electric stimulation and endoscopic therapy are the main treatment options, but the long-term efficacy of these symptomatic treatment is not very satisfactory, which seriously affects patients' quality of life. This article reviewed the advances in study on pathogenesis and treatment of DGP.