Objective: Our aims were to measure DNA content in primary lung cancer and to study the relationship between the DNA content and TNM stage, histological differentiation of tumor cell, cellular proliferation, and apoptosis. Methods: The DNA content and cellular proliferation were analyzed using flow cytometry. Tumor cell apoptosis was detected by using TUNEL method. Results: (1) The DNA index (DI) distribution ranged from 0.829 to 2.514. There were 41 cases (77.4%) of DNA aneuploid. The distribution of DI and DNA aneuploid was independent of histological subtypes（P>0.05）.(2) With the increase of TNM stage, the DI and the rate of DNA aneuploid increased（P<0.05）.(3) There was relationship between DI and histological differentiation of tumor cell. The DI was higher in tumors of poor differentiation than those in tumors of moderate and good differentiation（P<0.05 and P<0.01）. (4) The cellular proliferation index of aneuploid tumors was significantly higher than that of diploid tumors(P<0.01), while apoptosis index of aneuploid tumors was significantly lower than that of diploid tumors (P<0.01). Conclusion: Correlations exist between DNA content and TNM stage, hiological differentiation, cellular proliferation, and apoptosis.

OBJECTIVETo analyze the influence of intravesical Pirarubicin (THP) instillation on the prediction results of European Organization for Research and Treatment of Cancer (EORTC) risk tables and to discuss the efficacy of EORTC risk tables in clinical application.

METHODSWe retrospectively reviewed the clinical data of 389 patients with non-muscle invasive bladder cancer after TURBT treated with intravesical pirarubicin instillation. According to the EORTC Scoring System, all the cases were divided into low risk group, intermediate risk group and high risk group. The 1-year and 5-year recurrence and progression rates of each group were calculated and compared with the prediction results of the EORTC risk tables.

RESULTSThe 1-year recurrence and progression rates of the low risk group were 8.0% and 0, those of the intermediate risk group were 31.0% and 2.8%, and those of the high risk group were 52.5% and 18.6%, respectively. The 5-year recurrence and progression rates of low risk group were 16.0% and 5.3%, those of the intermediate risk group were 42.6% and 10.7%, and those of the high risk group were 63.9% and 41.9%, respectively. The prediction results of progression rate were similar to that of the EORTC risk tables while the overall recurrence rate was lower.

CONCLUSIONSThe EORTC risk tables can be effectively used to predict the recurrence rate and progression rate of non-muscle invasive bladder cancer. However, the EORTC risk tables have a tendency to overestimate the recurrence rate. Intravesical pirarubicin instillation is helpful to reduce the recurrence rate, yet has no obvious influence on the tumor progression.

Administration, Intravesical ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; administration & dosage ; therapeutic use ; Disease Progression ; Doxorubicin ; administration & dosage ; analogs & derivatives ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Retrospective Studies ; Risk Assessment ; Urinary Bladder Neoplasms ; drug therapy ; pathology

OBJECTIVETo investigate the diagnoses and treatment of interstitial cystitis (IC).

METHODSThe clinical data of 16 IC patients were analyzed respectively. The patients with urinary frequency, urgency, suprapubic pain and chronic pelvic pain. They were misdiagnosed as chronic cystitis, pelvic inflammation, endometriosis, cystophthisis and urethral syndrome, and were diagnosed finally by the means of pathology or cystoscopy. Among the 16 patients, 4 cases had the operation of ileal reservoir, Two cases had sigmoid-cysto-plasty, and 10 cases had drug treatment. The methods of IC diagnosis and treatment were discussed with the review of literature.

RESULTSThe pelvic ache disappeared completely in 4 cases after the operation of ileal reservoir; Two cases after cystoplasty felt lightly discomfortable in perineum occasionally, and their bladder capacity was above 350 ml, no recurrence after operation having been found after follow-up for 24 months and 33 months; Ten cases treated with non-operative treatment improved obviously, with the O'Leary-Sant IC symptom index and IC problem index decreased from 15.4 +/- 4.1, 9.4 +/- 2.7 to 4.1 +/- 2.1 and 5.1 +/- 3.9, respectively.

CONCLUSIONSSufficient attention should be paid to the diagnosis and differential diagnosis of IC; Early diagnosis and therapeutic alliance with manifold measures can relieve the patients' symptom and improve the quality of life.

Adult ; Cystitis, Interstitial ; diagnosis ; therapy ; Cystoscopy ; Diagnostic Errors ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Urinary Diversion ; methods

Objective To propose a new blood purification modality-hemodialysis with plasma- based dialysate (HD-PBD) plus high volume hemofiltration (HVHF) for patients with liver failure, and to evaluate the effect of this treatment on plasma cytokines.Methods Twelve patients with liver failure were included in this study.All patients received HD-PBD therapy in the first 6 hours,and then were treated with HVHF for 24 hours with the same filter (AV600).The levels of TNF-?,IL-1?, IL-6 and IL-8 in plasma before and after HD-PBD plus HVHF for 6 and 24 hours were examined respectively by ELISA,and changes of clinical parameters were observed at the same time point. Serum bilirubin,total bile acids (TBA),serum ammonia,blood urea nitrogen (BUN) and serum creatinine (Scr) were detected before and after treatment.Arterial blood gas analysis and the concentration of electrolytes were monitored before and after treatment.Results (1)HD-PBD for 6 hours was more effective than HVHF for 24 hours in removal of serum bilirubin and TBA(P＜0.05). (2)Serum ammonia,BUN,Ser,arterial blood HCO_3~-,PCO_2,PO_2 and electrolytes did not show significant difference before and after HD-PBD (P＞0.05),but these parameters significantly changed before and after HVHF (P＜0.05).(3)The average level of serum bilirubin was sharply decreased after HVHF for 24 h following HD-PBD(P＜0.05).(4)After HD-PBD plus HVHF,there was a marked reduction of the plasma levels of TNF-?,IL-6 and IL-8.Conclusions HD-PBD plus HVHF,a newly proposed modality for patients with liver failure,can effectively decrease serum bilirubin,TBA,BUN,Scr,ammonia and cytokines,and adjust water-electrolyte as well as acid- alkali balance.It is a low-cost,safe,simple and convenient therapy.

Objective: To observe the efficacy of electroacupuncture (EA) plus Yi Jin Jing (Sinew-transforming Qigong Exercises) for knee osteoarthritis (KOA). Methods: A total of 60 patients with KOA were divided into an observation group and a control group according to the random number table method, with 30 cases in each group. Patients in the observation group received the treatment of EA plus Yi Jin Jing (Sinew-transforming Qigong Exercises), while patients in the control group only received EA treatment. Both groups were treated for 5 weeks. The changes of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) scores in the two groups were observed after treatment. Results: After treatment, the total effective rate in the observation group (92.3％) was significantly higher than that in the control group (70.0％), (P<0.05); the WOMAC and VAS scores in both groups were significantly lower than those before treatment, showing statistical significance (all P<0.01); there were significant differences in the post-treatment changes in the WOMAC and VAS scores between the two groups (P<0.05, P<0.01). Conclusion: EA plus Yi Jin Jing (Sinew-transforming Qigong Exercises) is clinically effective for KOA. This combined treatment can alleviate clinical symptoms.

Animals ; Cell Cycle ; DNA-Binding Proteins ; Hypoxia ; enzymology ; genetics ; Myocytes, Cardiac ; cytology ; enzymology ; Promoter Regions, Genetic ; Rats ; Rats, Sprague-Dawley ; Telomerase ; genetics ; metabolism

BACKGROUNDBladder leiomyoma is an uncommon type of bladder neoplasms. Most publications are reports of isolated cases. The influence of tumor size on patients' early symptoms was seldom analyzed. We aim to investigate the clinical characteristics of bladder leiomyoma and the influence of tumor size on patients'symptoms in Chinese population.

METHODSWe reviewed the medical records of eight patients diagnosed with bladder leiomyoma at our department, collected 53 cases from Chinese National Knowledge Infrastructure (CNKI), Wangfang data base, and Chinese Biological Medicine Disk, and performed a pooled analysis. The clinical characteristics of the patients were analyzed and then classified into symptomatic and asymptomatic groups. The association between tumor size and the occurrence of symptoms was evaluated. Furthermore, Logistic regression model was constructed to discriminate variables.

RESULTSWomen comprised the majority of the patients (49/61, 80.3%). The mean age and tumor size were (42.3 ± 14.0) years and (45.0 ± 25.7) mm, respectively. Among all the symptoms, irritative symptoms occurred most frequently (37.7%, 23/61), followed by obstructive urinary symptoms (31.1%, 19/61), hematuria (24.6%, 15/61), and abdominal bulge or pain (14.8%, 9/61). In our study, patients who were 45 years old or younger tended to be asymptomatic compared with elder ones (14/36 vs. 3/25, P = 0.021). The histological, as well as anatomical, location of tumor, did not show significant differences between symptomatic and asymptomatic patients (P = 0.306 and 0.700). Tumors larger than 30 mm in the greatest diameter would cause clinical symptoms such as obstructive urinary symptoms (P = 0.048) and irritative symptoms (P = 0.037). Logistic regression confirmed the association between tumor size and the occurrence of symptoms, which was related with age.

CONCLUSIONSBladder leiomyoma occurs mainly in women and most frequently with irritative symptoms. The occurrence of symptoms is related to tumor size rather than the location. In this setting, patients with endovesical tumors smaller than 30 mm in the greatest diameter tended to be asymptomatic, which were usually treated with transurethral resection of bladder tumor.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Leiomyoma ; pathology ; Male ; Middle Aged ; Urinary Bladder Neoplasms ; pathology ; Young Adult

OBJECTIVETo summarize clinical and molecular features of two children with autosomal recessive chronic granulomatous disease caused by CYBA mutations.

METHODThe clinical records and CYBA mutations were reviewed for analysis of infections and inflammatory complications.

RESULTThe first case was a girl diagnosed with "liver and spleen abscess" in our hospital when she was 2.9 years old, with past history of neonatal impetigo and recurrent purulent lymphadenitis and positive family history. The results of DHR123 flow-cytometry showed that positive phagocytes after phorbol ester (PMA) stimulation was 84.63%. CYBA mutation analysis showed that she had heterozygous 35C > T, Q3X and IVS-2A > G. The second case was a boy diagnosed with "sepsis (salmonella D)" when he was 4 years old with a past history of impetigo, sepsis, perianal abscess, skin infection and positive family history. The results of flow cytometry showed that positive phagocytes after PMA stimulation was 96.13%. CYBA mutation analysis showed that he had homozygous 35C > T, Q3X and his parents were all carriers. All of them had BCG related axillary lymphnode calcification.

CONCLUSIONA22CGD cases had recurrent purulent infections (skin, lymphnode, liver and spleen, lung, blood), DHR123 flow cytometric analysis helped the diagnosis of CGD, CYBA mutation analysis ascertained the diagnosis of A22CGD.

Child, Preschool ; Chromosome Aberrations ; DNA Mutational Analysis ; Female ; Genes, Recessive ; Granulomatous Disease, Chronic ; diagnosis ; genetics ; Homozygote ; Humans ; Male ; Mutation ; NADPH Oxidases ; genetics

OBJECTIVETo investigate the expression of RKIP, p65 and pERK in hepatocellular carcinoma (HCC) and theIr correlation with invasion and metastasis of HCC.

METHODSReverse transcription polymerase chain reaction (RT-PCR) was used to detect the expression of RKIP mRNA. The expression levels of RKIP, p65 and pERK proteins in HCC tumor and peritumoral tissues were determined by immunohistochemistry and Western blot analysis. Statistical analysis was performed to determine the relationship between their expression and clinicopathological parameters.

RESULTSRKIP protein expression level (RKIP/actin) was 0.579 ± 0.380 in HCCs, 1.178 ± 0.659 in peritumoral tissues and 1.115 ± 0.442 in normal liver tissues. The pERK protein level was 1.023 ± 0.478, 0.605 ± 0.367 and 0.461 ± 0.293, p65 protein level was 0.83 ± 0.376, 0.63 ± 0.337 and 0.466 ± 0.345, respectively. Immunohistochemistry analysis showed that the RKIP positive rates in HCCs, peritumoral tissues and normal liver tissues, were 22.2%, 86.0%, and 93.8%, positive rates of p65 were 73.6%, 56.0% and 37.5%, positive rates of pERK were 65.3%, 38.0% and 31.3%, respectively. Statistical analysis revealed that there was a significant difference in RKIP protein expression levels (P < 0.05), but no significant difference in RKIP mRNA expression levels (P > 0.05) among HCC tumors, peritumoral tissues and normal liver tissues. The p65-positive and pERK-positive rates were higher in tumor tissues than that in peritumoral tissues and in normal liver tissues (P < 0.05), but RKIP-positive rates were lower in tumor tissues than that in paritumoral tissues and normal liver tissues (P < 0.05). RKIP protein expression levels were significantly lower in HCCs with intrahepatic or lymphatic metastasis than that in without. The RKIP positive rates in moderately and well differentiated HCCs were significantly higher than that in poorly differentiated HCCs. There was a relationship between RKIP and pERK expressions (P = 0.04), but RKIP expression was not correlated with p65 expression in HCCs (P = 0.143).

CONCLUSIONSOur findings indicate that the down-regulation of RKIP expression may serve as a predictive marker for HCC development, progression and metastasis, which may contribute to the elevated ERK activity. The inhibiting effect of RKIP on invasion and metastasis of liver cancer cells may be due to the down-regulation of pERK expression rather than p65 expression.

Adult ; Aged ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Down-Regulation ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Liver ; metabolism ; Liver Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Phosphatidylethanolamine Binding Protein ; genetics ; metabolism ; Phosphorylation ; RNA, Messenger ; metabolism ; Transcription Factor RelA ; metabolism

OBJECTIVEChronic pulmonary aspergillosis is different from acute pulmonary aspergillosis in clinical picture, radiogram, diagnostic procedures and prognosis. Four patients with chronic pulmonary aspergillosis had been misdiagnosed as having pneumonia or pulmonary tuberculosis for a long time before admission to the hospital. The purpose of this report was to summarize the clinical manifestations and laboratory findings for correct diagnosis of chronic pulmonary aspergillosis.

METHODSFour patients with chronic pulmonary aspergillosis seen between October 2002 and October 2004 were retrospectively studied. Their clinical manifestations, chest radiographic feature, immune status, diagnostic procedure, therapy and prognosis were reviewed.

RESULTSThe chief complaints of these patients were chronic cough and fever for 3 to 12 months. Chest wall abscess developed in the late course in case 1 and 4. Fine moist rales were heard and hepatosplenomegaly was found in case 1 and 2. No abnormal sign was found in case 3 and 4. Chest radiographic feature: lobar consolidation with adjacent pleural thickening was present in all cases. In early phase, solitary or multiple small nodules were found in 2 cases. Case 1-3 had normal IgG, IgM, IgA, IgE, T Cell subsets and NBT test. Case 4 had chronic granulomatous disease. Etiologic evidences: culture was positive for Aspergillus (A.) fulmigatus in sputum and in chest wall abscess in case 1 and 4; for A. niger in sputum and spore existing in lung tissue in case 2; for A. fulmigatus in sputum and hypha existing in lung tissue in case 3. All patients were treated with combination of amphotericin B and itraconazole. Their symptoms were controlled 10-30 d after treatment. In case 1 the disease relapsed 6 months later and the patient died at last due to giving up treatment by his parents. Case 2 was free of symptom for 12 months and his chest radiographic lesion disappeared completely 6 months later. Treatment of case 4 was given up. Case 3 continued to receive treatment and observation.

CONCLUSIONChronic pulmonary aspergillosis should be considered in children with long period fever and cough and lobar consolidation associated with adjacent pleural thickening or with nodular infiltration. The diagnosis of chronic pulmonary aspergillosis depended on identification of aspergillus from sputum or lung tissue. Combined amphotericin B and itraconazole might control the disease.

Amphotericin B ; administration & dosage ; Child ; Child, Preschool ; Chronic Disease ; Drug Therapy, Combination ; Female ; Humans ; Infant ; Itraconazole ; administration & dosage ; Male ; Pulmonary Aspergillosis ; diagnosis ; drug therapy