Objective To evaluate the diagnostic significance of B-ultrasound and CT in small renal tumor (≤3 cm). Methods The clinical data of 48 patients (29 men and 19 women) with small renal tumor were reviewed.Their mean age was 49 years.Of them,43 cases were asymptomatic,while 2 complained of hematuria,2 of lumbago and 1 of hematuria with lumbago.B-ultrasound, conventional CT,helical CT thin scan and intraoperative frozen section were evaluated. Results Of the 48 cases,36 of renal cell carcinoma (RCC),7 of renal angiomyolipoma (RAML),4 of oncocytic adenoma and 1 of metanephric adenoma were diagnosed by pathology after surgery.The diagnostic accuracy was 75%(36/48) for B-ultrasound,81%(39/48) for conventional CT,91%(20/22) for helical CT thin scan and 95%(19/20) for intraoperative frozen section,respectively. Conclusions Small renal tumor has high incidental rate as well as high benign rate.As the tumor is relatively smaller, it is difficult to differentiate between benign and malignant nature of the tumor by B-ultrasound and conventional CT.Helical CT thin scan and intraoperative frozen section are helpful for accurate diagnosis of the tumor.

Objective To explore the diagnosis and treatment features of tuberous sclerosis complex associated renal cell carcinoma.Methods A 22-year-old boy with a childhood history of epilepsy and mental retardation presented with a complaint of intermittent painless gross hematuria for the past 2 years.After superselective left renal artery embolization was done twice in the past year, painless gross hematuria was still repeated with 6- 10 months intervals.Physical examination showed retarded face, obesity, visible facial angiofibroma and a ditch fibroma.CT scan showed irregular lesions.The largest cross-section 14.2 cm × 9.0 cm in the left kidney was inhomogeneous enhanced from 45 - 54 HU in the plain phase to 60 - 78 HU in the contrast phase.Filling defect in the left renal vein and multiple fat-density lesions (CT value of -25 - -38 HU) with the largest cross-section 7.2 cm× 5.7 cm in the right kidney were also found in contrast CT scan.The PUBMED and CBM database were reviewed.Results Open retroperitoneal radical left nephrectomy was performed.Pathology showed renal clear cell carcinoma and renal vein thrombosis.There was no tumor recurrence or distant metastasis at 4-month follow-up.Conclusions Tuberous sclerosis complex associated renal cell carcinoma is rarely reported.Timely nephron-sparing surgery is necessary when the diagnosis is established, or radical nephrectomy is also necessary if nephron-sparing surgery is impossible.

Objective To study the clinical and pathologic features of chromophobe cell renal carcinoma and to improve the diagnosis and treatment of the disease. Methods The clinical and pathologic data of 19 patients (10 men and 9 women;mean age,53 years) with chromophobe cell renal carcinoma (9 on the left and 10 on the right) were analyzed.Of the 19 cases,12 were incidentally diagnosed of renal tumor during physical examination.Gross hematuria,low back pain and discomfort and abdominal mass occurred in 7 cases. Results B-ultrasound was mainly characterized by low echo of mass with intact capsule.CT scan revealed that most of the tumors were homogeneous hypodense solid masses,which were well circumscribed.The tumors averaged 8.2 cm in diameter.By TNM staging,8 cases had T_1N_0M_0 stage tumors and 11 cases had T_2N_0M_0 stage tumors.Radical nephrectomy was performed in 17 cases,and partial nephrectomy,in 2 cases.Follow-up was available for 16 patients (mean,4.8 years;range,3 months to 16 years)who were alive without recurrence and metastasis.Pathological features were as follows.①The cross-sections of the tumors were grossly homogeneous, dark brown and solid. One case had fibrous bands coalescence in the center of the tumor.②Microscopically the tumors were composed of 2 types of cells, typical and eosinophilic types,with very distinct borders.③Immunohistochemical assay was positive for CK8 and negative for Vimentin, and Hale colloidal iron staining was positive for the carcinoma cells.④Electron microscopy showed large numbers of vesicles within the cytoplasm. Conclusions Chromophobe cell renal carcinoma is a morphologically distinctive neoplasm with no specific findings on B-ultrasound and CT examinations.The tumors are larger in most cases but usually at early TNM stages with a favorable prognosis.

0.05),while the difference of dynamic HCO3-,BE in the umbilical blood gas analysis was significant statistically in the three groups(P

Objective To study the clinical features,diagnosis and treatment of bladder leiomyoma.Methods The clinical data of eight patients(3 men and 5 women)with bladder leiomyoma were analyzed retrospectively.Results The median age was 42 years ( range,27 -71 years).Three patients were treated with transurethral resection of bladder tumor( TURBT),two patients underwent partial cystectomy,two patients underwent enucleation of leiomyoma,and one patient underwent laparoscopic enucleation of leiomyoma of the bladder.The patients were well with no evidence of recurrent tumor after follow-up from 10 to 75 months.Conclusion Bladder leiomyoma is rare,surgery is the treatment of choice and technique depends on tumor size and localization.The laparoscopic approach seems to be an effective alternative in this group of tumors.

Objective To explore the relationship between the Interleukin 6 , matrix metalloproteinases 2 and early embryo arrest. Methods Real time-PCR was used to measure the mRNA expression of IL-6 and MMP-2 and immunohistochemistry (IHC, SP method)was used to measure the location and expression of the two different kinds of protein in villus. ELISA was used to measure the level of IL-6 in serum. Results Real-time PCR and IHC showed that the expression levels of IL-6 was significantly lower in experimental group than in control group, and MMP-2 was significantly higher than the control group (P < 0.05). Differenc of IL-6 level in serum between the two groups was not statistically significant (P > 0.05). Conclusion Proper expressions of IL-6 and MMP-2 in the villus tissue play a key role in the maintenance of early pregnancy.

OBJECTIVE: To investigate the relationship of group B (GBS) colonization in late pregnancy with perinatal outcome. METHODS: Pregnant women who underwent antenatal check-up at General Hospital of PLA Eastern Theater Command and the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2018 were enrolled in the study. The vaginal and rectal swab samples were collected for GBS culture at 35-37 weeks of pregnancy. The perinatal outcomes of positive and negative GBS groups were compared. The GBS-positive group samples were tested for antibiotic susceptibility. In GBS positive group the maternal and child perinatal outcomes were compared between pregnant women with antibiotics treatment and those without antibiotics. RESULTS: A total of 13 000 pregnant women were enrolled, and the overall colonization rate of GBS was 3.65%(475/13 000). The colonization rate of GBS in the vagina was 2.33%(303/13 000), and the colonization rate in the rectum was 1.75%(227/13 000). Through the collection and detection of rectal specimens, the positive rate of GBS increased by 56.77%(172/303). The monthly colonization rate of GBS showed significant fluctuations with the highest in March and October (all < 0.05). The sensitivity of 475 GBS-positive specimens to ceftriaxone, vancomycin and linezolid were 100%, and the sensitivity to ampicillin and penicillin were 97.26%and 93.47%, respectively. The resistance rates of the strains to levofloxacin, clindamycin, erythromycin and tetracycline were 30.11%, 48.00%, 52.21%and 88.63%. The incidence of premature rupture of membranes, postpartum hemorrhage, puerperal infection, neonatal pneumonia and sepsis in GBS positive group were significantly higher than those in GBS negative group (all < 0.01). In pregnant women with positive GBS, the incidence of puerperal infection, neonatal infection and admission to the NICU in the antibiotic group were significantly lower than those in the non-antibiotic group ( < 0.05 or < 0.01). CONCLUSIONS The total colonization rate of GBS is low. The detection of GBS can be significantly improved by supplementing rectal examination. Ceftriaxone, ampicillin and penicillin are currently the drugs of choice for the prevention and treatment of GBS-related diseases. GBS infection can increase the incidence of maternal and child complications. The use of antibiotics during labor can improve the outcome of mothers and infants.
Anti-Bacterial Agents ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Complications, Infectious ; Pregnancy Outcome ; Streptococcal Infections ; Streptococcus agalactiae ; Vagina