Objective To investigate the clinical and pathological characteristics of urocpithelial sarcomatoid carcinoma of the urinary system,and improve the diagnosis and treatment of these tumors.Methods We reviewed the pathology comfirmed urinary system caicinoma at the General Hospital of PLA from January 1999 to December 2010 and analyzed the clinical and pathological data of cases with sarcomatoid carcinoma in them retrospectively according to the literatures. Results A total of 4386 urinary system carcinoma were comfirmed,among them 18 (0.41％) cases of sarcomatoid carcinoma were identified,including 13 from bladder,4 from ureter and 1 multiple neoplasm of pelvis and ureter.The patients,11 males and 7 female,had a median age of 63.3 years (41-84 yrs).Gross hematuria (18 cases) were the main presenting symptoms,3 with flank pain,4 with pollakisuria,urgency and dysuria (urinary irritation symptoms] and 5 with urinary obstruction.The patient with multiple neoplasm of pelvis and ureter received allograft renal transplantation 7 years ago and took anti-rejection drugs all the way after operation.17 patients underwent surgical resection,9 radical cystectomy,5 radical nephroureterectomy,3 partial cystectomy and the remain was biopsy.Tumor size ranged from 2.5 to 12 cm (median,5.6 cm).Microscopically,coexisting high grade urothelial carcinoma was present in all the 18 cases,12 with sarcomatoid differentiation,3 with sarcomatoid and squamous carcinoma differentiation and 3 with sarcomatoid and glandular differentiation.Sarcomatoid component occupied 10 -90 percent.Immunohistochemical testing showed the sarcomatoid cells were positive for cytokeratin (CK) and vimentin.12 patients died of disease 20 days to 42 months (median,5.3 months) postoperatively.3 patients have been surviving with tumor free for 3,3 and 17 months respectinely,and the other 3 was failure to be followed. Conclusions Sarcomatoid carcinoma of the urinary bladder is a highly malignant disease,and the prognosis is very poor.The diagnosis depends on histopathologic and immunohistochemical studies.Early diagnosis and cystectomy or nephroureterectomy together with chemotherapy/radiotherapy may improve the curative effect.

Objective To study the anti-apoptotic effects of Levodopa on osteonecrosis of the femoral head induced by methylprednisolone (MPS).Methods Forty-four rabbits were randomly divided in to 3 groups.The model group (n=15) was injected with lipopolysaccharide (LPS,10 μg/kg) and then MPS (20 mg/kg) was given 3 times with 24 h interval.The treatment group (n=1 5) was firstly treated by the same methods as the model group,then was administered Levodopa (0.4 g·kg~(-1)·d~(-1)) orally after the last injection of MPS.The control group (n=14) was injected with sodium chloride alone.On the 6th and 8th week after modeling,radiography and MR images were taken in 7 rabbits of each group,specimens taken from the femoral heads were observed by HE stain and TUNEL analysis was made.Blood samples were taken for detection of insulin-like growth factor-1 (IGF-1) on the 8th week.Results On the 6th and 8th week,the average percentage of empty osteocyte lacunae in the treatment group (13.33‰±3.06‰,25.97‰±6.29‰) was significantly lower than that of the model group (21.44‰±4.77‰,33.86‰±8.38‰,P<0.01),and the average apoptosis index in the treatment group (74.93‰±14.32‰,120.67‰±13.13‰) was significantly lower than that of the model group (102.56‰±18.96‰,202.02‰±18.99‰.,P<0.01).On the 8th week,the level of IGF-1 in the treatment group was (14.78±2.37)ng/ml,which was higher than that of the model group obviously (10.12±2.49)ng/ml(P<0.01).Conclusion The Levodopa can decrease apoptosis of osteocytes and effectively prevent the progress of steroid-induced osteonecrosis of the femoral head.

OBJECTIVE To search for the reasons of unqualified level of bacteria in exit-entrance fluid of hemodialyzer and draft the measures of adjustment to meet the evaluation criteria for exit-entrance fluid of hemodialyzer.METHODS According to MOH′s Hospital Infection Management Standards to detect level and species of bacteria.RESULTS The average numbers of bacteria in exit-entrance fluid of hemodialyzer decreased from 2152.95?826.45 CFU/ml before adjustment to 579?541.04 CFU/ml after adjustment,checking with chi square test,the entrance fluid of hemodialyzer was ?2 =15.92,P

Objective To evaluate the change about the function of pituitary thyroid axis and the role of human chorionic gonadotropin (hCG) on regulation of pituitary thyroid axis in pregnancy Methods The study was designed to provide longitudinal information of parameters of thyroid function and hCG in 74 healthy women during pregnancy and after delivery Serum free triiodothyronine (FT 3), free thyroxin (FT 4), TT 3, TT 4, hCG and thyroid hormone binding globulin (TBG) concentrations were measured with radioimmunoassary and serum TSH concentration with immunoradiometric assay Results (1) The FT 3 and FT 4 values below the reference range were 5 88% and 9 80%, respectively, in third trimester and after delivery, both were 38 10% The serum TSH level below the reference range was 31 25% in first trimester and supranormal were 11 90% after delivery The serum hCG level at all stages of pregnancy was higher than postpartum (2) The serum FT 3 level was significantly higher in first (4 37?0 78) pmol/L and second (4 75?0 90) pmol/L trimesters than postpartum (2 96?0 84) pmol/L, decreased in third trimester (3 94?0 75) pmol/L and the lowest level after delivery The serum FT 4 level was significantly higher in first (14 07?1 44) poml/L and second (12 86?0 84) pmol/L trimesters than postpartum (10 45?1 45) poml/L, decreased in third trimester (11 29?1 00) pmol/L and the lowest level after delivery (3) The serum TSH level was the lowest values in early pregnancy (0 88?0 83) mU/L, showed significant increase in second (1 86?1 04) mU/L and third (1 48?0 90) mU/L trimesters and reached maximal level after delivery (2 82?1 42) mU/L (4) The serum hCG level was the highest in early pregnancy (309 05?320 02) ?g/L, then significant decreased in second (69 11?19 18) ?g/L and third (86 25?44 60) ?g/L trimesters and was the lowest levels after delivery (29 92?20 91) ?g/L (5) A significant negative correlation between TSH and hCG levels and a significant positive correlation between hCG and FT 4 and TT 4/TBG were demonstrated Conclusions (1) hCG may be as role on regulation of pituitary thyroid axis during pregnancy and during certain time of postpartum (2) After delivery, part of women were transient hypothyroxinemia

Objective To study the expression of Survivin in breast carcinoma combined with prognosis of ten-year follow-up.Methods The expression of Survivin was investigated by immunohistochemistry in 60 cases of breast cancer and 20 tumor surrounding tissue.All the cases were performed with prognosis of tenyear follow-up.Results The expression rate of Survivin in breast carcinoma(68.3%)was higher than that in fibroadenoma of bast tissue(25%)(χ2=20.03,P＜0.01).Survivin didn't experss in tumor surrounding tissue.There Was no relationship among the expression of Survivin and the histological differentiation,clinical staging,and lymph node metastasis of breast carcinoma.The expression of Survivin was correlated with the survival years of patients.Conclusion The expression of Survivin was up-regulated in breast carcinoma,which indicated that survivin may play an important role of the genesis and development of breast cancer,but it may play negative correlated with breast carcinoma.

Objective In order to explore the ways of reflecting the dose distribution in the implementation of the of IMRT (intensity modulated radiation therapy),a 2D diode array (2D-DA) was used in verifying the composite dose distribution of IMRT plans in the way of multi-gantry-angle composite (MGAC).Methods IMRT quality assure (QA) plans of 27 patients,based on the 2D-DA and solid water phantom,were designed and verified in two ways of single-gantry-angle composite (SGAC) and MGAC verifications.The comparison and analyzation of the dose distributions of the TPS calculation and the measurement of the 2D-DA were done.Results (1) When the beam central axes were not superposed with the detectors'plane of the 2D-DA,the verification passrate of SGAC and MGAC planar dose distribution of 27 patients'IMRT plan were 94.56%±4.28% and 94.81%±3.80% (the criteria:rvalue,3 ram/3%),respectively.There was no statistical difference between the results of two sets (t =-0.213,P＞0.05).(2) When one of the beam central axes was superposed with the detectors'plane of the 2D-DA,the verification passrate of MGAC planar dose distribution were 79.72%±12.77%.Conclusions Using the 2D-DA with a proper phantom,there was no statistical difference in the SGAC and MGAC verifications of IMRT plans when the beam central axes were not superposed with the detectors'plane.However,the MGAC dose distribution can provide more about the clinical dosimetry,and the errors in the implementation of the of IMRT were easier located.

Objective To explore the efficacy of circular wound edge protector(CWEP)in preventing surgical site infection (SSI)following open abdominal surgery,analyze the related risk factors for postoperative SSI,and provide scientific basis for preventing SSI following open abdominal surgery.Methods 162 patients who underwent open abdominal surgery in a hospital from March 2014 to December 2015 were randomly divided into intervention group (used CWEP during surgery)and control group (used sterile gauze pad to protect incision).Length of hospital stay,cost of dressing change,and SSI between two groups were compared,risk factors for postoperative SSI were analyzed.Results Incidence of SSI in intervention group was lower than control group (14.81%[12/81]vs 34.57%[28/81],P <0.05);grade-A incision healing rate of intervention group was higher than control group(86.42% vs 66.67%,P <0.05).The cost of dressing change in intervention group was lower than control group([305.5 ± 176.7]yuan vs [431.6 ± 381.4 ]yuan,P = 0.008 ). Multivariate logistic regression analysis indicated that hypoproteinemia(OR,2.88[95%CI ,1.21-6.87]),body mass index ≥24(OR,3.11[95%CI ,1.12-8.66]),and blood loss≥400 mL(OR,3.98[95%CI ,1.36- 11.64])were independent risk factors for postoperative SSI,while CWEP use was the protective factor(OR,0.24[95%CI ,0.09-0.59]).Conclusion CWEP can effectively reduce the incidence of SSI following open abdominal surgery.

Objective To evaluate the curative effect of urokinase combined with low molecular heparin sodium in managing arteriovenous fistula embolism. Methods Toally 48 patients with arteriovenous fistula embolism treated from January 2014 to October 2015 were selected for the study, where 22 were assigned into control group and 26 as trial group according to the registration time. The former group were treated with urokinase and the latter with urokinase combined with low molecular heparin sodium. The rate of recanalization, the rate of thrombosis recurrence, and the adverse reactions were compared between the two groups. Results The recanalization rate in the trial group was higher than that in the control group (P<0.05). The rate of thrombosis recurrence in the trial group was significantly lower than that the control group. There was no statistical difference in adverse reactions between the groups. Conclusion The thrombolytic effect of urokinase combined with low molecular heparin sodium is superior to that of urokinase alone, with a higher rate of recanalization.

Objective To investigate the level of soluble interleukin 7 receptor (sIL-7R) in serum of lupus nephritis(LN)patients and evaluate its clinical significance. Methods sIL-7R level in serum of LN patients and healthy controls were measured by ELISA , while total 24 hours urinary protein and complement C3 of LN patients were measured by BN ProSpec. The level of sIL-7R correlation with SLEDAI, total 24 hours urinary protein and complement C3 were analyzed respectively. Results The levelof sIL-7R was higher in serum of LN patients than healthy controls (P < 0.01). Moreover, its expression in serum was increased in LN patients in active stage than in LN patients in stable stage (P < 0.05). The level of sIL-7R was positively assosicated with SLEDAI, total 24 hours urinary protein(P < 0.01, P < 0.05) and negatively with complement C3 (P < 0.05). Conclusion The level of sIL-7R is upregulated in serum in LN patients and correlated with disease activity and progression, so it may be expected to become a potential marker of disease in prediction.

Purpose To investigate the clinicopathologic features, diagnosis and differential diagnosis of primary gastric inflammatory myofibroblastic tumor ( IMT) . Methods Four cases of gastric IMTs were studied by clinicopathologic analysis, immunohistochemistry and in situ hybridization, and the related literature was reviewed. Results In four cases there are two males and two females, age range from 21 to 51 years old, and tumor size ranged from 1. 5 to 6. 5 cm in the greatest dimension. Histologically, these tumors were composed of varied spindle cells and chronic inflammatory cells, in a myxoid or hyalinized stroma. Occasionally, there were calcifica-tion and ossification areas. Most of the spindle cells had bland appearance and a minority of the tumor cells showed mild atypia. One to two mitotic figures were recognized in 10 high power fields ( HPFs) in 1 to 2 patients. Smooth muscle actin staining was observed in all tumors and ALK staining observed in two tumors. One tumor focally expressed CD34. S-100, desmin, CD68, CD117 and DOG1 was negative in all IMTs. The patients were followed up from 24 to 66 months, and none of them had tumor relapsed or metastasis. Conclu-sions Primary gastric IMTs have an intermediate behavior, and a few cases have malignant potential. It should be distinguished from other spindle cell lesions similar to IMT.