ObjectiveTo explore the protective methods to the patients with insensitive feet caused by leprosy.Methods295 patients affected by leprosy (PAL) with insensitive feet did self-care and wore protective shoes which were bought in general market and met the requireing of with soft and elastic insole,hard sole higher instep, et al.All the patients had been followed up for 3 years.ResultsAll cases persisted on wearing those shoes, only 1 case occured fresh ulcer and no ulcers relapsed.Cracks and ulcers on foot declined by 96.15% and 32.81% respectively, and bone loss had no change.ConclusionsThe protective foot-wears can prevent the fresh ulcers happening and the healed ulcers reappearing for PALs with numb feet. It is important to educate the PALs how to choose the kind of foot-wears and how to do self-care.

A droplet digital polymerase chain reaction ( ddPCR) method for quantifying E. coli O157:H7 by targeting rfbE gene was developed. The probe concentration in ddPCR was optimized and the linearity range, precision, limit of detection ( LOD) and limit of quantification ( LOQ) were also evaluated. The optimized probe concentration was 300 nmol/L. The ddPCR response was linear over the E. coli O157:H7 genome DNA concentration range from 4 to 1. 25×105 copies in 20 μL ddPCR system and the linear correlation coefficient (R2) was 0. 999. The ddPCR precision (RSD) was less than 5% over the DNA concentration range from 760 to 88400 copies/20 μL. The LOD and LOQ was 3 copies in 20 μL and 4 copies in 20 μL, respectively. Specificity test showed that the ddPCR was specific for detecting E. coli O157:H7. Both ddPCR and standard real time quantitative PCR showed the same results for 16 real samples of chicken meat, pork and beef, which indicated that ddPCR method was suitable for detection of E. coli O157:H7 in food.

Objective To discuss the application value of CT angiography (CTA) in evaluating renal artery anatomy of laparoscopic nephron-sparing surgery (LNSS) before operation. Methods Retroperitoneal LNSS was performed in 87 patients with renal tumors. Forty cases underwent CTA before LNSS, volume rendering and maximum intensity projection of renal artery were used as three-dimensional reconstruction. The other 47 without CTA were compared as control. Treatment out-comes of the 2 groups were compared, including operation time, warm ischemia time, blood loss, con-version to open surgery, hospitalization stay after operation, and complications after operation. Re-sults All the procedures were completed laparoscopically with no conversion to open surgery in CTA group. One patient underwent conversion to open surgery in the control group. In CTA and control group, the operation time was 94 min(range, 76-118)and 115 min(90-190, P<0.05). The warm ischemia time was 23 min(12-39)and 29 min(18-40, P<0.05). Blood loss was 90 ml(9.0-160) and 130 m1(90-600, P<0.01). Hospitalization stay after operation was 4.1 d(3-5) and 5.5 d(3-9), respectively(P<0.05). The pathologic examination showed negative surgical margin in all cases of renal cell carcinoma. The patients were followed up for 4 months to 32 months. Neither distant nor local recurrences were observed, and the renal function was normal in all cases. Urinary leakage oc-curred in 1 patient of each group. Conclusions CTA could be an effective method in evaluating the supply blood vessels of kidney before LNSS. And it can shorten the operation time and warm ischemia time, reduce the blood loss, as the result of helping the operaters deal with renal artery more quickly and accurately.

Objective To investigate the clinical presentations, pathologic features, and the di-agnosis and treatment of prostate sarcomatoid carcinoma. Methods Two cases of prostate sarcoma-told carcinoma were analyzed with review of the relevant literature. Case 1, a 51-year-old man com-plained of dysuria and perineal discomfort for 2 months, was admitted because of acute urinary reten-tion. His serum PSA was 2.31 ng/ml. Heterogeneous density of the prostate left lobe and bladder neck involvement was shown on CT scan. Prostate sarcomatoid carcinoma was confirmed by transrec-tal prostate biopsy, and patient accepted radical cystoprostatectomy and ideal conduit followed with lo-cal radiotherapy and hormonal therapy. Case 2 was a 54-year-old male. This ease was admitted with a history of dysuria and intermittent gross hematuria for 1 month. Hypoechoic lesion was found by ul-trasonography,and heterogeneous density of the prostate was shown on CT scan. His serum PSA was 2.61 ng/ml. The prostate biopsy result showed prostate sarcoma. Radical cystoprostatectomy and ide-al conduit was performed on this case. Results The diagnosis of prostate sarcomatoid carcinoma in the 2 cases was confirmed by postoperative pathology. Under microscope, the neoplasm was mainly composed of epithelial and sarcomatoid mesenchymal cells,with a transitional region of these cells. Im-munohistochemical staining showed that the cells were positive for cytokeratin and epithelial membrane antigen. Vimentin was negative in the epithelial cells, but was positive in the majority of sarcomatoid cell. Both patients died of multi-metastasis at 43 and 19 months after surgery respectively. Conclu-sions Sarcomatoid carcinoma of the prostate is extremely rare with a high grade of malignancy,and its prognosis is poor. The diagnosis depends on pathological features and immunohistochemical studies. Radical resection combined with endocrine therapy and radiotherapy is considered to be the most relia-ble treatment so far.

Objective:To investigate the role of TRPV5 and TRPV6 in intracellular calcium regulation and biological behaviors of SW480 colon cancer cells. Methods:qRT-PCR, Western blot, and immunocytochemistry were applied to determine the mRNA and protein ex-pression levels of TRPV5 and TRPV6 in SW480 colon cancer cell line upon treatment with TRPV5 and TRPV6 agonist, 1-25(OH)2D3, and inhibitor, CuCl2. The change of intracellular Ca2+level was examined with a confocal laser scanning microscope. Scratch test, MTT, and TUNEL assays were used to analyze the cell migration, proliferation, and apoptosis, respectively. Results:As an agonist of TRPV5 and TRPV6, 1-25(OH)2D3 significantly up-regulated the mRNA and protein expression levels of TRPV5 and TRPV6 in SW480 cell lines. On the other hand, CuCl2, being an inhibitor of TRPV5 and TRPV6, effectively down-regulated the TRPV5 and TRPV6 mRNA and protein expres-sion levels (P<0.05). The intracellular calcium concentration in SW480 cell line significantly increased upon treatment with 1-25 (OH)2D3, and significantly decreased with CuCl2 treatment (P<0.05). 1-25(OH)2D3 promoted cell proliferation and migration, and inhibit-ed apoptosis of SW480 cell in a time-and dose-dependent manner (P<0.05). However, CuCl2 significantly repressed cell proliferation and migration and induced apoptosis (P<0.05). Conclusion: TRPV5 and TRPV6 can affect the biological behaviors of colon cancer SW480 cells by regulating intracellular Ca2+level.

ObjectiveTo observe the clinical characteristic and treatment response of the Gleason 5 + 5 prostate cancer and to summarize the prognostic factor of such patients. MethodsFrom January 2005 to May 2010,21 cases of Gleason 5 + 5 prostate cancer were enrolled in this study.The average age was 73 years and the pre-treatment PSA was 60.8 ng/ml.Six of the 21 cases had a PSA level ≤20 ng/ml.The maximal androgen deprivation therapy (ADT) in the form of castration and Casodex or fluctamide was carried out once the diagnosis was made.Bone metastasis was revealed in 16 cases.PSA levels were tested at the 4th month and then every 3 months after the castration.The observation endpoint was 6 months.Extracorporeal beam irradiation or the systemic chemotherapy was carried out if the PSA did not drop to a normal range after 6 months. ResultsIn the study group with initial PSA ＞ 20 ng/ml,the PSA did not drop to normal range in 5 cases; of which 4 had bone metastasis.With systemic chemotherapy,3 cases died within 1 year.Another case,with localized disease,received an extracorporeal beam irradiation and died within 1 year due to progression of the tumor.Among the remaining 10 cases sensitive to total androgen blockage,7 survived through the end of the study period.One case had PSA recurrence in month seven after the initial therapy and died at month 19.One case had PSA recurrence at month 22 and died at month 36.The patient had his PSA augmented at month 24 after total androgen blockage and the patient passed away 4 months later.Of the 6 cases who had an initial PSA ≤20 ng/ml 4 died within one year. ConclusionsGleason 5 +5 prostate cancer is relatively resistant to ADT with a worse prognosis,especially for the cases with a nadir PSA ＞4 ng/ml after 6 months’ ADT.The patients who had an initial PSA ≤20 ng/ml might have an unsatisfactory clinical outcome.

Objective To observe the relationship of viral load,serum cytokines and tissue damage after severe fever with thrombocytopenia syndrome virus (SFTSV)infection,and to explore the impact of SFTSV levels on tissue injury and prognosis.Methods Twenty-four ambulatory and hospitalized patients who were infected with SFTSV were enrolled between May 2011 and July 2012 at Department of Infectious Disease, First Affiliated Hospital with Nanjiang Medical University. According to their prognosis,they were divided into cure and death group,while 32 healthy blood donators were also enrolled from center blood station in Nanjing as control.The serum SFTSV load was detected using fluorescence quantitative polymerase chain reaction (PCR).The serum T helper (Th)1/Th2/Th17 cytokines in patients with severe fever with thrombocytopenia syndrome (SFTS)were determined dynamically and quantitatively by flow cytometry.The relationships between viral load,cytokines and serum enzymes, white blood cell (WBC),platelet (PLT)counts were analyzed.Comparisons among groups were achieved by rank sum test and correlation analysis among serum cytokines,blood cell counts and tissue damage was done by Spearman correlation test.Results All of the 24 patients showed a positive reaction to SFTSV RNA.The SFTSV loads of 21 cured cases,those of 2 were > 7.0 lg copy/mL,and those of 3 death patients were 6.7 lg copy/mL,8.8 lg copy/mL and 9.8 lg copy/mL,respectively.Serum level of interleukin (IL)-6 (21 .76 pg/mL in day 5 and 7.12 pg/mL in day 7)and IL-10 (14.33 pg/mL in day 5 , 14.13 pg/mL in day 7 and 3.01 pg/mL in day 9)of cured patients were significantly higher than those of healthy controls (IL-6:2.82 pg/mL and IL-10:1 .56 pg/mL)(P <0.05 ).At day 7 and day 9,serum levels of IL-6 of death cases were 137.61 pg/mL and 1 450.83 pg/mL,respectively and serum levels of IL-10 were 50.26 pg/mL and 49.43 pg/mL,respectively.Both of the indicators in the death group were significantly higher than those of cure group (P <0.05 ).However,serum levels of IL-2 and IL-4 were significantly lower than those in healthy control group (P <0.05 ).In the cure group,WBC and PLT counts were lowest during the early course of the disease,and serum alamine aminotransferase (ALT), aspartate aminotransferase (AST ), lactic dehydrogenase (LDH ) and creatine kinase (CK ) were significantly higher than their upper limits of normal.The correlation analysis showed that serum IL-6, IL-10 levels were negatively correlated with PLT count (r=-0.390 and -0.608,respectively;both P <0.01),and positively correlated with SFTSV load (r=0.560 and 0.758,respectively),ALT (r=0.412 and 0.390,respectively),AST (r = 0.686 and 0.764,respectively),LDH (r = 0.633 and 0.677, respectively)and CK (r =0.527 and 0.636,respectively)(all P <0.01 ).Conclusions SFTSV load, IL-6,IL-10 and serum enzyme levels are closely related to the severity of the disease.The inflammatory and anti-inflammatory cytokine storm after SFTSV infection may be involved in the immune pathological injury in patients with SFTS.

Objective To assess the prognosis of patients with bladder neck (BN) involvement in radical prostatectomy specimens and compare it with patients with seminal vesicle invasion (SVI).Methods From January 2002 to December 2008,42 patients with prostate carcinoma who underwent radical prostatectomy were analyzed retrospectively.The mean age was 70.3 years (range 59-78 years).The patients were divided into two groups according to 2002 TNM system:pT4a group (bladder neck invasion) with 17 cases and pT3b group (unilateral or bilateral seminal vesicle invasion)with 25 cases.Postoperative outpatients were followed-up on a regular basis,two consecutive postoperative serums PSA greater than 0.2 μg/L defined as a biochemical recurrence.The postoperative follow-up to the time of biochemical recurrence or follow up to the deadline without biochemical recurrence were defined as biochemical recurrence free survival time.Results All patients were followed up for 50-122 months.The patients with BN involvement 17.6％ (3/17) had biochemical recurrence,whereas seminal vesicle invasion 24.0％ (6/25),there was no statistical significance between the two groups (P＞0.05).Conclusions Postoperative adjuvant therapies can improve the biochemical recurrence free survival.In this study,the prognosis of pT4a and pT3b group is similar.A conceivable down-staging of BN involvement in the TNM staging system should be considered.

Objective To analyze human leucocyte antigen (HLA)-A0201 restricted antigen-specific cytotoxic lymphocytes (CTL), and to investigate the difference of T cell response to specific antigen epitopes between patients with acute phase of acute hepatitis B and active phase of chronic hepatitis B. Methods Peripheral blood mononuclear cells (PBMC) from 5 patients with acute phase of acute hepatitis B and 6 patients with active phase of chronic hepatitis B were isolated. The numbers and functions of CD8+ T-lymphocyte epitope peptide specific CTL were detected using enzyme-linked immunosorbent spot (ELISPOT) assay, and the 3 peptides were from HBV polymerase region (Pol575-583), envelope region (Env348-357) and core region (Core18-27), respectively. The data were analyzed using t test. Results The spot formation cell counts (SFC) of Pol575-583, Env348-357 and Core18-27 stimulations in patients with acute phase of acute hepatitis B were 110±13, 165±17 and 185±20, respectively; and those in patients with active phase of chronic hepatitis B were 22±4, 23±5 and 30±5, respectively; the differences were all significant (t=10.9, 15.2 and 8.0, respectively, all P<0.05). The CTL responses to the three peptides in patients with acute phase of acute hepatitis B were Pol575-5830.05). The SFC were increased upon non-antigen specific HLA-A2404 restricted epitope (Core117-125), but the difference was not significant compared with negative control group (P>0.05). Conclusions Hepatitis B virus-specific CTL responses in patients with acute hepatitis B are significantly higher than those in patients with chronic hepatitis B. The number and function of polyclonal CTL are both impaired in patients with chronic hepatitis B.

Objective To explore the safety and efficacy of laparoscopic nephron sparing nephrectomy for renal tumor. Methods The data of 72 patients diagnosed as renal rumor and treated with laparoscopic nephron sparing nephrectomy were retrospectively analyzed.Procedure detailed as following:firstly,the renal tumor was exposed completely after routine institution of 4 passages;secondly,the tissue 3 cm around the tumor was labeled and then incised using cool scissors after Bulldog occlusion of the renal artery;thirdly,the lesion was covered with anti-bleeding gauze and then intermittently sutured using 1-0 absorbable Dixon suture and crossing Hem-o-lok. Results Operation time was 90-190 min,with warm ischemia time 12-40 min.Bleeding volume was 20-600 m1.with one intra-operative infusion and 4 post-operative infusions.Pathological diagnosis was clear cell RCC in 52 cases,angiomyolipoma in 14,chromophobe RCC in 5,and collective duct cancer in 1 case.Hospitalization time was 5-12 days.With 1-52 months follow-up,no tumor recurrence and metastasis was observed. Conclusions Treatment by laparoscopic nephron sparing nephrectomy for renal tumor could be safe and efficient,but operative experiences and skills are needed.The method of intermittent suture and crossing Hem-o-lok could be useful to shorten the operation time and reduce the complications.