Objective To study the clinical features,pathological characteristics and prognosis of renal cell carcinoma(RCC)in young adults,and to improve the recognition of RCC in young population. Methods The data of 35 young patients with RCC under the age of 35 years from August 1983 to June 2005 were analyzed retrospectively.There were 22 males and 13 females with a mean age of 31 years(age range, 19-35 years).The clinical presentations were as follows:painless hematuria in 12 cases(34%),low back pain in 12(34%),abdominal mass in 2(6%),fever in 3 and Stauffer syndrome in 1.The tumor size was 1.2-13.8 cm in diameter(mean,6.0cm).AJCC staging showed stage I tumor in 8 cases,stageⅡin 4, stageⅢin 18 and stageⅣin 5.Of the 35 cases,28 underwent radical nephrectomy(including simultaneous extraction of the vena cava emboli in 3 cases and extraction with pulmonary lobectomy in 1);5 cases under- went partial nephrectomy;and 2 cases lost the chance of operation(1 of them had biopsy).Results The operations were successful.The postoperative pathologic diagnoses consisted of clear cell carcinoma in 23 ca- ses,mixed cell carcinoma in 5,papillary cell carcinoma in 2,and chromophobe cell carcinoma in 2,low-dif- ferentiated and undifferentiated cell carcinoma each in 1.Of them,26 cases were followed for 12-148 months(mean,56 months).Postoperative 3-and 5-year survival rates were 65% and 50%,respectively. Conclnsions In young population,RCC is difficult to diagnose because of occult symptoms at early stage and lack of tumor specificity,which leads to relatively late clinical staging at diagnosis.RCC is characterized by higher malignancy,easy invasion to surrounding tissues and metastasis,and thus poor prognosis.

Objective To discuss the cause,treatment and prevention of splenic injury during the urological surgery.Methods The clinical data of 16 cases with splenic injury in operation for renal and adrenal tumors in 496 cases were retrospectively analyzed.Nine cases were left radical nephrectomy,3 cases were left renal hamartoma enucleation,4 cases were left adrenal tumor resection.Damage located at outer edge of the spleen in 8 cases,the splenorenal ligament in 6 cases,and the splenic hilum in 2 cases.In these 16 cases,14 patients spared the spleen (Ⅰ Grade injury 8 cases,Ⅱ grade 6 cases).The injuryed spleen was directly pressed with hemostatic gauze in 3 cases; 5 patients used coagulation,bonding,hemostatic gauze to stop bleeding; 2 cases of grade Ⅱ injury used U-shaped suture and coated with fibrin glue,then compressed with hemostatic gauze to stop bleeding; 2 cases of grade Ⅱ injuries with the greater omentum stitched into the seam,sprayed biological glue,were compressed with gelatin sponge; 2 cases of grade Ⅱ injury underwent splenic artery branch ligation.The other 2 cases (1 Ⅱ grade and 1 Ⅲ grade) underwent splenectomy.Results All of the 16 patients were cured and followed up for 6 months to 5 years.There was no delayed bleeding of spleen and splenic dysfunction.One patient died of tumor recurrence 6 months after operation.Conclusions Splenic injury is a common complication during urological surgery,especially the tumor is large or adhered to spleen in the upper pole of left kidney.Once spenic injury occurs,doctors should choose the right treatment plan according to surgical injury,and try to save the spleen.

Objective To assess the clinical significance of three-dimensional speckle tracking imaging (3D-STI) in the evaluation of left ventricular myocardial function in breast cancer survivors with postoperative anthracycline-based chemotherapy.Methods A total of 51 breast cancer survivors with postoperative anthracycline-based chemotherapy were recruited and 31 female healthy volunteers as the controls.Conventional echocardiography and 3D-STI derived parameters [including global longitudinal strain (GLS) and global area strain (GAS)] were measured before and at 3 and 6 anthracycline-based chemotherapeutic cycles.The receiver operating characteristics (ROC) curve was constructed to determine optimal sensitivity and specificity of 3ID-STI derived parameters for the prediction of future cardiotoxicity.Results In comparison with the controls and baseline cases,GLS and GAS deteriorated significantly (P ＜ 0.05 for both).No statistical difference in GCS and conventional parameters showed before and after the initiation of chemotherapy (P ＜0.05,respectively).The ROC curves showed that GAS as the best 3D-STI predictor of patients who develop cardiotoxicity during the follow-up.The area under ROC(AUC) of GAS was 0.894,and its optimal cut-off value was-28.4％,with a specificity of 88.0％ and a sensitivity of 82.9％.AUC of GLS was 0.802,and its optimal cut-off value was-14.3％,with a specificity of 62.0％ and a sensitivity of 85.4％.Conclusions Early decreases in GAS and GLS based on 3D-STI may allow the prediction of subsequent cardiotoxic development accurately in breast cancer survivors with postoperative anthracycline-based chemotherapy.

OBJECTIVE To search a method for identifying Clostridium perfringens and genotyping their toxin for gene diagnosis by multiplex PCR.METHODS The mutiplex PCR was developed with three sets of primers(designed) based on the sequences of three C.perfringens toxin genes(CP?,CP? and CPE) published in GenBank to identify C.perfringens and genotype their three toxin genes.RESULTS Three expected(sequences) were (obtained) successfully by multiplex PCR and identified by electrophoresis.CONCLUSIONS The(specific) sequences of C.perfringens could be amplified and their three genes of toxins could be identified by this multiplex PCR(system).Such method should be helpful for developing gene diagnosis well.

OBJECTIVE To discuss a highly effective method to immobilize probe on the surfaces of piezoelectric DNA sensors.METHODS Pseudomonas aeruginosa probe was immobilized on the gold surface of gene sensor(array) with routine self-assembly method(SAM)(non-reduction method) and SAM with deoxidized probe((reduction) method),respectively.The changes in frequency and time-cost were compared in reactions with(different) concentrations of probe.RESULTS Reduction method had the advantage of more probe immobilization;less time consumed in testing and higher changes in frequency during the reaction than non-reduction method.CONCLUSIONS Reduction method has a better ability to immobilize probe on the surfaces of piezoelectric DNA sensors.

OBJECTIVE To establish a SNP detection method by DNA piezoelectric biosensor and detect a SNP relative to HBV infection. METHODS To establish a model experiment with synthesis DNA sequences as target and find the lowest sensitivity. After extraction of genome DNA from inpatient blood sample, the SNP sites located in ESR1 gene region in samples were detected by SNP detecting method established. RESULTS The frequency shift of target-A was 416.0?21.5Hz, the frequency shift of target-G was 9.4?5.0Hz. And it could be detected that the lowest sensitivity of target-A was 2?10-11 mol/L. The three genotypes of blood samples, TT, TC and CC, had different frequency shifts, 109.4?13.4Hz, 52.0?11.4Hz and 7.2?4.5Hz, respectively. CONCLUSIONS SNP in blood sample could be detected specifically and sensitively by DNA piezoelectric biosensor.

Objective To observe the influence of silymarin on expressions of transforming growth factor-?1(TGF-?1) and collagen type Ⅲ(Col Ⅲ) in rats with experimental tubulointerstitial fibrosis(TIF) induced by unilateral ureteral obstruction(UUO).Methods Se-venty-two Sprague-Dawley rats were randomly divided into 3 groups:sham operation group(n=24),model group(n=24) and silymarin treatment group(n=24).The rats in model group and treatment group were operated by ligation of left-ureter.The rats in sham opera-tion group operated by dissociating left-ureter were taken as controls.Rats in treatment group were fed with silymarin [30 mg/(kg?d)]24 h before operation,and rats in model group and sham operation group were treated by intragastric administration with the same volume nomal saline at the same time.Eight rats were killed at day 7,14,and 21,respectively.The score of TIF changes,histologically,was evaluated under light microscope.Expressions of TGF-?1 and Col Ⅲ in tubulointerstitial tissue in 3 groups were investigated by immunohistochemistry.Results 1.The TIF pathological index in treatment group was less than that in model group,but more than sham operation group at day 14 and 21(Pa

Arthropods of medical importance such as mosquitoes, ticks and sandflies are one of the key drivers of arthropod-borne diseases outbreak, posing a great threat to global public health security. For further understanding the transmission mechanisms of arthropod-borne diseases and establishing the prevention and control measures, a series of experiments of arthropods infection need to be carried out under laboratory conditions. Besides the regular biosafety requirements, some specific considerations need to be taken into account when performing arthropod infection and the infected arthropod rearing. Except for the physical containment composed of biosafety facilities, a comprehensive assessment of the biosafety risks during operations and corresponding preventive measures are also critical to eliminate or mitigate the biosafety risks. In this paper, we introduce our practice in handling mosquito infection with Risk Group 2 pathogens in Arthropod Containment Level-2 (ACL-2) laboratory, with an aim to provide a reference for researchers in related fields.

Objective To evaluate the quality of intraoperative wake?up test in the patients undergoing scoliosis correction surgery under etomidate?based anesthesia. Methods Thirty patients of both sexes, aged 13-32 yr, weighing 40-65 kg, of ASA physical statusⅠorⅡ, undergoing elective scoliosis correction surgery, were randomly assigned into etomidate group ( group E, n=15 ) or propofol group (group P, n=15) using a random number table. Anesthesia was induced with etomid 0.3 mg∕kg (group E) or propofol 2mg∕kg ( group P ) injected intravenously, midazolam, fentanyl and rocuronium. The patients were mechanically ventilated after naso?tracheal intubation. Etomidate 0.6-1. 2 mg · kg-1 · h-1 and propofol 8- 10 mg·kg-1 ·h-1 were infused intravenously during surgery in E and P groups, respectively. Both remifentanil and cisatracurium were used for maintenance of anesthesia in the two groups. Cisatracurium infusion was stopped before wake?up test. The infusion rate of propofol was adjusted to 4 mg·kg-1 ·h-1 at 15 min before wake?up test. After the scoliotic angle was corrected, infusion of etomidate and propofol was stopped, and the infusion rate of remifentanil was adjusted to 0.025μg·kg-1 ·min-1 in both groups. The wake?up time was recorded, and the quality of wake?up was assessed. Mean arterial pressure (MAP) and heart rate were recorded before anesthesia ( T0 ) , immediately before the patients were awakened ( T1 ) , when the patients responded to commands from doctors ( T2 ) , and after anesthesia was deepened ( T3 ) . At T0 , the end of surgery ( T4 ) , and 24 h after surgery ( T5 ) , blood samples were collected from the internal jugular vein for determination of plasma cortisol concentrations. Results The patients were awakened successfully in the two groups, and there were no significant differences in the wake?up time, quality of wake?up, and MAP, HR and plasma cortisol concentrations at each time point between the two groups. MAP and HR were significantly higher at T2 than at T0 in the two groups. MAP and HR were within the normal range during wake?up test, and no patients developed severer cardiovascular events in the two groups. Conclusion Etomidate?based anesthesia provides better quality of intraoperative wake?up test in the patients undergoing scoliosis correction surgery, which is similar to that of propofol?based anesthesia.

Objective To report the clinical outcome and prognostic factors for locally recurrent nasopharyngeal carcinoma(NPC)treated with intensity modulated radiotherapy(IMRT).Methods From January 2001 to August 2004,the data of 132 such NPC patients were analyzed retrospectively;104 male and 28 female with a median of 44.5 years(range 21-73 years).Ninety-eight patients(74.2%)were confirmed by biopsy as having NPC:9 with WHO TypeⅡand 89 WHO TypeⅢ.The other 34 patients were only diagnosed by MRI scan because of the extension/invasion was in the base of skull and/or cavernous sinus.Median interval time were 24 months(range 6-184 months).According to the 1992 Chinese Fuzhou Staging System:stageⅠ3.8 %,Ⅱ10.6 %,Ⅲ22.0% andⅣa 63.6%;T1 5.3%,T2 10.6%,T3 22.7% and T4 55.3%.Twenty-two patients had recurrence in the neck lymph nodes.IMRT was given with the sequential tomotherapy system(NOMOS Peacock systems)of 6 MV X-rays.Prescription dose was 60-70 Gy in GTV,with the fractional dose of 1.94-2.8 Gy.Sixty patients were also supplemented with two to six courses of cisplatin-based chemotherapy.Results The median volume of GTV was 39.5 cm~3(range 0.8-158.9 cm~3).The D95,V95,mean dose and fractionation dose of GTV was 66.9 Gy,98.3%,69.8 Gy and 2.32 Gy,respectively.The median follow-up time was 12 months(range,2-47 months).The 1-,2-and 3-year local progression-free rate was 96.4%,88.4% and 85.3%,respectively.The overall 1-,2-and 3-year survival rate was 6.5.9%,49.6% and 41.6%,respectively.Eleven patients developed distant metastases.Forty-seven patients were observed to devdop mucosa necrosis and/or massive hemorrhage in the nasopharynx.On univariate and multivariate analysis,fractional dose and vohane of GTV were significant prognostic factors for overall survival(P=0.016,0.009).Conclusions The local control and survival rate can be improved for patients with locally recurrent nasopharygeal carcinoma after treatment of intensity modulated radiotherapy.The fractional dose and volume of GTV are independent prognostic factors for the overall survival. The main death reasons are mucosa necrosis and/or massive hemorrhage in the nasopharynx.