A 35-year-old woman patient,complained of intermittent pain in the left flank for a week.Abdominal ultrasound and computed tomography scan revealed a left renal mass.Nephrectomy was performed,and a final diagnosis of adult Wilms' tumor was made based on histopathology and immunohistology.Chemotherapy was conducted for 4 times with dactinomycin D,vincristine and doxorubicin after surgery.At the time of the last recheck,the patient was alive with no evidence of disease.Adult Wilms' tumor is the exceptional malignant renal tumor.Only 1%-2% of Wilms' tumor is diagnosed in adult patients.Because of unspecific tumor symptoms in adults,the diagnosis is frequently made by histology.The diagnosis of adult Wilms' tumor is difficult to make preoperatively because diagnostic imaging only confirms the presence of a renal mass.Stage and histology are the clinical factors guiding the selection of postsurgical treatment and prognosis.Having retrospected 6 cases of adult Wilms' tumor between 1950 and 2007 and reviewed related reports,we conclude that the proper strategies of adjuvant treatment as applied to childhood Wilms' tumor patients after surgery can conspicuously improve the outcome in adult patients.

Gas Chromatography-Mass Spectrometry ; methods ; Humans ; Malathion ; metabolism ; urine

BackgroundMonocyte chemotactic protein-1 (MCP-1)plays an important role in the tumor,inflammation,diabetic retinopathy and other neovascular disease,but the expression and the role of MCP-1 in the oxygen induced retinopathy(OIR) model have rarely been reported. Objective This study was to investigate the expression of MCP-1 in the retina development of newborn mouse and in mouse models with OIR.Methods C57BL/6J newborn mice were divided into two groups and 60 mice in each group.Mice in OIR group were exposed to 75％ oxygen for 5 days and then to room air.All mice in normal control group exposed to room air only.Ten mice in each group were randomly chosen and sacrificed at postnatal 5,7,12,14,17,21 days.The expression of MCP-1 in mouse retina was detected with the method of immunohistoehemistry and reverse transcription polymerase chain reaction(RT-PCR).Results MCP-1 positive cells were seen in normal mouse retina.Up-regulation of MCP-1 positive cells was detected both in 12 days in normal control group and in 14 days in OIR group.MCP-1 mRNA was detected in mouse retina at 5 days,and a transient up-regulation of MCP-1 mRNA was observed in 12 days in normal control group.MCP-1 mRNA in OIR group significantly increased in 14 days in comparison with the normal control group( P =0.028,P =0.001 ). Conclusions Expression of MCP-1 is detectable in whole retinal development procession of mice.A transient up-regulation of MCP-1 expression is detected in the critical period of retinal vascular development in mice models with OIR,which is closely related to the retinal vascular development and progression of retinal new vessels.

OBJECTIVETo evaluate the prognostic factors of ureter transitional cell carcinoma (TCC).

METHODSBetween January 2001 and December 2005 133 TCC patients were treated. And the data was retrospectively analyzed.

RESULTSA mean age of the 133 patients was 68 years (range 43 - 87 years) at diagnosis. Altogether the non-invasive ureter TCC was found in 42 patients (31.6%) and the invasive ureter TCC in 91 patients (68.4%). Invasive ureter TCC growth was more common in distally located tumors (82.5%) compared to mid (62.5%) and proximal ureter (47.1%). Tumor stage, grade and location of the tumor were all correlated with disease specific survival in a univariate analysis. In a multivariate Cox analysis, tumor stage and grade were significantly associated with disease specific survival.

CONCLUSIONSMore invasive tumors are found in ureter than in bladder. Ureter cancer is more frequently found in the distal part. Distally located ureteral tumors are more likely invading into the muscular cell layers compared to proximally located tumors. Tumor stage and grade are still the more important prognostic factors for ureter TCC.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Analysis ; Ureteral Neoplasms ; pathology ; surgery

Aged ; Antigens, CD34 ; metabolism ; Breast Neoplasms ; metabolism ; pathology ; therapy ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Epithelioid Cells ; pathology ; Female ; Follow-Up Studies ; Hemangiosarcoma ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Mastectomy, Radical ; Neoplasms, Second Primary ; metabolism ; pathology ; Radiotherapy, Adjuvant ; Vimentin ; metabolism

[Summary] Propylthiouracil-induced anti-neutrophil cytoplasmic antibodies ( ANCA ) positive vasculitis ( APV) is an autoimmune diseases with multi-system damage. Its basic pathological lesions are characterized by necrotizing vasculitis. We present a case of propylthiouracil-induced APV, with regard to its pathogenesis, clinical manifestation, diagnosis, treatment, and outcomes for futher understanding this disease.

OBJECTIVETo compare the difference in the clinical efficacy on premature ovarian failure (POF) between the acupoint catgut implantation combined with artifical periodic therapy and the simple artificial periodic therapy and explore its effect mechanism.

METHODSSixty-five patients of POF were randomized into the two groups. In a western medication group, 32 cases were treated with the artificial periodic therapy with the oral administration of medroxyprogesterone acetate tablets. In a catgut implantation + western medication group, 33 cases were treated with the acupoint catgut implantation combined with artificial periodic therapy. The acupoints of Neiguan (PC 6), Zusanli (ST 36), Guanyuan (CV 4) and Sanyinjiao (SP 6) were selected. The treatment was lasted for half a year and the follow-up visit was for another half a year in the two groups. Kupperman index was used to assess the improvements in the clinical symptoms. The levels of serum sexual hormones such as follicle stimulating hormone (FSH) and estradiol (E2) were evaluated of the patients in the two groups before and after treatment. The efficacy was compared between the two groups.

RESULTSThe scores of the clinical symptoms were all significantly improved after treatment and in the follow-up in the two groups (P < 0.01, P < 0.05). In the 6-month follow-up visit after treatment, the result in the catgut implantation + western medication group was better than that in the western medication group (8.17 +/- 1.19 vs 13.68 +/- 1.08, P < 0.01). FSH was reduced after treatment in the two groups (all P < 0.01) and E2 was increased (all P < 0.05). The curative and remarkably effective rates were 75.8% (25/33) and 81.8% (27/22) after treatment and in the follow-up visit in the catgut implantation + western medication group, which were better than 67.9% (19/28) and 53.6% (15/28) in the western medication group separately (P < 0.05, P < 0.01).

CONCLUSIONThe acupoint catgut implantation combined with artificial periodic therapy achieve the remarkable improvements in the clinical symptoms of POF in the patients and the better results as compared with the simple western medication therapy. The combined therapys efficacy is stable and the long-term efficacy is apparently superior. The effect mechanism is related to the improvements in the serum sexual hormone levels.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Catgut ; utilization ; Female ; Follicle Stimulating Hormone ; metabolism ; Humans ; Primary Ovarian Insufficiency ; metabolism ; therapy ; Prostheses and Implants ; Treatment Outcome ; Young Adult

Objective: To investigate the relationship between chemosensitivity to L-OHP and expressions of multidrug resistance (MDR) associated factors in lymph node metastases (LNMs) of gastric carcinoma. Methods: The chemosensitivity to L-OHP was measured by MIT assay, and the expressions of P-gp, GST-π, P53, Survivin and Bcl-2 were determined by immunohistochemistry in 54 paired primary tumor (PT) and LNMs of gastric carcinoma. Results: The inhibition rates of LNMs cells for L-OHP were lower than those of PT (P<0.05). The expressions of P-gp, GST-π and Bcl-2 were higher in LNMs than in PT (P<0.05), and no signifi-cant difference was found in the expression of P53 and Survivin between LNMs and PT (P>0.05). Positive cor-relations among P-gp, P53 and Bcl-2 were found in PT and LNMs (r=0.3424, 0.7123, 0.4548, P<0.05). There was no significant difference in the expression of GST-π and Survivin between PT and LNMs (P>0.05). There was statistically negative correlation between inhibition rates and expression of P-gp, GST-π, and Survivin in PT (P<0.05). In LNMs, only Survivin was negatively correlated with inhibition rates of L-OHP (P<0.05). Conclu-sion: The LNMs of gastric carcinoma are heterogeneous with PT in respect to chemosensitivity to L-OHP and expression of multidrug resistance associated factors. The main factors that affect chemosensitivity to L-OHP are also significantly different between PT and LNMs. Effective adjuvant chemotherapy after surgery and re-version to multidrug resistance (MDR) of gastric carcinoma depend on targeting the metastatic lesions of gas-tric carcinoma.

Air ; analysis ; Chromatography, Gas ; methods ; Styrenes ; analysis ; Workplace

OBJECTIVE: To investigate the immunoregulation and short-term therapeutic effects of super-selective intra-arterial chemotherapy combined with Fuzheng Kang'ai Granules, a compound Chinese herbal medicine, on patients with late gastric cancer. METHODS: Forty patients with late gastric antrum cancer were randomly divided into study group and control group. Patients in the study group were orally administered Fuzheng Kang'ai Granules 48 hours after the first super-selective left gastric artery chemotherapy with high-dose drugs (EAP regime: VP(16) 100 mg/m(2) + epirubicin 60 mg/m(2) + carboplatin 200 mg/m(2)), while patients in the control group were only administered the same local artery chemotherapy as in the study group. RESULTS: The short-term therapeutic efficacy in the study group and control group were 82.5% and 57.5% respectively (P<0.01). The occurrence rates of side effects in the study group were significantly lower than those in the control group (P<0.01). The Karnofsky score of life quality of the study group was obviously higher than that of the control group after treatment (P<0.05). The half survival time and one year survival rate in the study group and control group were (24.9 +/- 1.36) month, 70% (28/40) and (13.7 +/- 0.72) month, 35% (14/40) respectively. They were significantly improved in the study group compared with the control group (P<0.01). The levels of cytokines interleukin 2 (IL-2), tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma) after treatment in the study group were significantly higher than those before treatment (P<0.05 or P<0.01), as well as than those after treatment in the control group (P<0.01). On the other hand, the level of immune inhibitory factor soluble interleukin-2 receptor (sIL-2R) after treatment in the study group was lower than that before treatment, as well as than that after treatment in the control group (P<0.01). CONCLUSIONS: The super-selective intra-arterial chemotherapy combined with Fuzheng Kang'ai Granules has good short-term therapeutic efficiency and few side effects for patients with late gastric antrum cancer. It can significantly improve the life quality, extend the survival period, and improve the survival rate in patients with late gastric antrum cancer, which may be due to the up-regulation of the immune regulating factors such as IL-2, TNF-alpha, IFN-gamma and down-regulation of the immune inhibitory factor sIL-2R.