Objective To study the clinic features and risk factors of bladder cancer occurrence after radical nephroureterectomy of urothelial carcinoma of the upper tract.Methods 61 cases of urothelial carcinoma of the upper tract from March 2013 to December 2013 in Beijing Friendship Hospital are retrospectively studied.31 patients are male,while the other 30 patients are female.Age of them ranges from 43 to 90 years old,and the average age is 69 years old.17 patients are accompanied with diabetes.32 patients are accompanied with hypertension.12 patients have the history of chronic nephrosis.7 patients have the history of renal transplation operation.47 patients have the symptom of hematuresis.16 patients have the symptom of lumbago.Body mass index ＜ 18.5 kg/m2 2 cases,18.5 ～ 22.9 kg/m2 25 cases,23.0 ～ 24.9 kg/m2 10 cases,25.0 ～ 29.9 kg/m2 20 cases,≥ 30.0 kg/m2 4 cases.25 patients' serum creatinine is abnormal,while the other 36 patients'is normal.36 patients have left tumors,while the other 25 patients have right tumors.39 patients have hydronephrosis before operation.25 patients go through ureteroscopy.11 patients have the concurrence of bladder cancer preoperatively.25 patients have renal pelvic carcinoma,while the other 36 patients have carcinoma of ureter.14 patients have multiple tumors,while the other 47 patients just have single tumors.The size of tumor ranges from 0.5cm to 8.0cm,and the average size is 2.9cm.27 patients have the cauliflower-like tumors,while the other 34 patients have other shaped tumors.28 cases have the positive results of cytology,while the other 33 cases donl have.6 patients go through cystoscopic operation of ureterovesical junction,while the other 55 patients go through open operation of ureterovesical junction.Kaplan Meier analysis is used to find univariate risk factors of the bladder cancer occurrence postoperatively,and Log-rank test is used after that.Cox regression analysis is used to identify the independent risk factor from all the univariate risk factors.Results Time of surgery ranges from 2.0 hours to 7.5 hours,and the average time is (4.9 ± 1.2) hours.39 patients' tumors are equal or greater than T2 stage,while the other 22 patients'tumors are less than T2 stage.2 patients have Ⅰ grade tumors,40 patients have Ⅱ grade tumors,and the other 19 patients have Ⅲ grade tumors.12 patients go through systematic chemotherapy,while the other 49 patients don l.23 patients go through intravesical instillation postoperatively,while the other 38 donl.Follow-up time of 61 cases ranges from 22 months to 31 months,and the average time is (27.3 ± 2.7) months.3 to 30 months after radical nephroureterectomy,21 cases(34.4％) have bladder cancer occurrence.4 of patients who have concurrence of bladder cancer preoperatively go through the occurrence of bladder cancer(57.1％,4/7),and 17 of patients who dont have concurrence of bladder cancer preoperatively go through the occurrence of bladder cancer(3 1.5％,17/54).8 of patients with multiple tumors go through the occurrence of bladder cancer(57.1％,4/7),while 13 of patients with a single tumor go through the occurrence of bladder cancer(27.7％,13/47).18 of patients who have tumors equal or greater than T2 stage have the occurrence of bladder cancer(46.2％,18/39),while 3 of patients who have tumors less than T2 stage have the occurrence of bladder cancer(13.6％,3/ 22).3 of patients with postoperative intravesical instillation have the occurrence of bladder cancer(13.0％,3/23),while 18 of patients without postoperative intravesical instillation have the occurrence of bladder cancer(47.4％,18/38).Single factor analysis shows that preoperative concurrence of bladder cancer(P =0.003),multiple tumors (P =0.044),T stage (P =0.023) and postoperative intravesical instillation (P =0.002) have significant influence on the occurrence of bladder cancer.And Cox proportional hazards regression model analysis shows that the preoperative concurrence of bladder cancer (RR =2.860,P =0.024,regression coefficient =1.051) and postoperative intravesical instillation (RR =0.201,P =0.011,regression coefficient =-1.065) are significantly related to the occurrence of bladder cancer after radical nephroureterectomy.Conclusions The preoperative concurrence of bladder cancer and postoperative intravesical instillation are the independent risk factors of the bladder cancer occurrence after radical nephroureterectomy.And the preoperative concurrence of bladder cancer is a risk factor,while the postoperative intravesical instillation is a protective factor.

Objective To evaluate the expression of Sp3 gene of peripheral blood mononuclear cells (PBMC) in multiple sclerosis (MS) patients in Guizhou and the relationship between Sp3 gene expression and immunological function. Methods Two pairs of primers were used to amplify cDNAs generated from 31 MS patients and 30 healthy controls. The serum levels of sIL-2R were measured in 27 patients with MS and 30 healthy controls by sandwiched ELISA. Results The deficient expression of Sp3 gene in MS patients was significantly higher than that in control (41.9% ( 12/31 ) vs 6. 7% (2/30) ,x2 =7. 133 ,P =0. 008). The sIL-2R levels in MS patients were significantly higher than those in control (( 2788.5 ± 1079. 8 ), ( 1270. 7 ± 489. 4) μg/L, t = 6. 170, P = 0. 001 ). The concentration of sIL-2R in MS with negative ((3364.0 ± 1252.3) μg/L) and positive((2450.0 ± 827.0) μg/L) expression of Sp3 gene were significantly increased compared with control (F = 32. 059, P < 0. 05 ). The sIL-2R levels were significantly rising in MS patients with negative expression of Sp3 gene compared with MS patients with positive expression of Sp3 gene ( q = 4. 213, P < 0. 05 ). Conclusions A remarkable deficient expression of Sp3 gene in PBMC has been found in MS patients in Guizhou. sIL-2R may take part in the process of MS. The expression of Sp3 gene is not affected by immune state, however, MS patients with Sp3 deficient expression tend to have a more serious impairment in immunological functions.

Objective To summarize the author' s clinical experiences in the diagnosis and treatment of urachal carcinoma.Methods Thirteen cases with urachal carcinoma from 1990-2011 at Beijing Friendship Hospital affiliated to Capital Medical University were retrospectively reviewed and analyzed.Results The most common complaint was hematuria;B ultrasonic or CT scan demonstrated a parenchyma or vesica between the bladder dome and abdominal wall.Nine patients underwent extensive pattical excision of the bladder,3 paitents underwent radical resection,and 4 patients received comprihensive chemotherapy.The five-year survival rate was 30.7％.Conclusion Extensive partial excision of the bladder is recommended for urachal carcinoma.

Objective To investigate the inhibitory effects of trichostatin A(TSA)on bladder cancer cell lines and its synergetic effect with anticancer drugs in treating bladder cancer in vitro and in vivo.Methods The inhibitory effects of TSA on human bladder cancer cell lines in vitro were detected by MTT assay.Hoechst staining was used to observe morphology for apoptotic cells after TSA treatment.Western blot was used to detect expression of acetyl-histone H3 and survivin.In vivo synergetic effects of TSA with anticancer drugs were detected in bladder cancer model rats.Results TSA significantly inhibited growth of bladder cancer cell lines in concentration and time dependent manner.Better results of tumor inhibition have been achieved when it was combined with DDP,MMC and ADM than used alone.After TSA treatment,the survivin expression in bladder cancer cells decreased and acetyl-histone H3 expression increased.Intravesical application of TSA combined with MMC can significantly inhibited tumor growth and progression.Conclusion TSA has direct anti-cancer effect and can enhance the action of several chemotherapy agents markedly.TSA may be an excellent candidate agent for intravesical application to treat bladder cancer.

Objective To study the growth suppressive effect of demethylation drug 5-aza-2'-deoxycytidine on bladder tumor cells. Methods The growth suppressive effect of DAC on 4 transitional cell carcinoma (TCC) cell lines was measured using the Cell Proliferation Reagent WST-1 assay.The effects of DAC on apoptosis induction and cell cycle arrest were analyzed by flow cytometric analysis. Caspase 3, 9 activities were analyzed by APOPCYTO Caspase Colorimetric Assay Kit and PCNA expression was also investigated by Western blot to clarify the mechanism of DAC against TCC. Results DAC inhibited the growth of all TCC cell lines tested in a dose-dependant manner, however,growth suppressive effect of DAC was independent of p53 status in TCC. DAC inhibited proliferation via inducing G2/M cell cycle arrest but not via inducing apoptosis. After treated with 0, 1 and 8 μmol/L DAC, cells of RTl 12 in G2/M phase was (36.3 ± 3.4) %, (46.2 ± 4.6) % and (56.5 ±6.2) %, TCCsup was (37.5 ± 3.8) %, (48.4 ±4.9) % and (60.1 ± 6.7) %, respectively. The expression of PCNA was decreased by DAC, but caspase3, 9 activities were not activated. Conclusion DAC could suppress the growth of TCC cells and might be a new strategy to treat bladder malignancy in the future.

Objective To determine the efficacy of liver cancer resection combined with splenectomy for patients with hepatocellular carcinoma with hypersplenism.Methods Among 35 patients with hepatocellular cancer and hypersplenism treated from March 2004 to January 2006 at our hospital,12 patients accepted simultaneous liver cancer resection and splenectomy (the splenectomy group)and 23 only accepted liver cancer resection (the non-splenectomy group).The liver function,platelets and white blood cells were analyzed retrospectively.Results All the operations were successfully carried out.Within 1 week after operation,the white blood cell count increased from (3.2 ± 1.7) × 109/L to (8.5±-5.3) × 109/L,the platelet count increased from (52.6±23.7) × 109/L to (245.3±94.6) ×109/L(P＜0.01) in the group of patients with combined splenectomy,while little change occurred in the non-splenectomy group.The liver function in the splenectomy group recovered to the preoperational value within 1 week.Two years after operation,7 (58.3％) patients were still surviving in the splenectomy group and the mean tumor-free survival was (16.4 ± 4.3) months compared with (14.3 ±5.2) months in 10 (43.5％) patients in the non-splenectomy group,(P＜0.005).Conclusion Liver cancer resection combined with splenectomy was efficacious to hepatocellular cancer with hypersplenism.

Head ; surgery ; Humans ; Neck ; surgery ; United States

Objective To find out the distribution of TCM constitution on the patients with stroke in Beijing. Method The TCM Constitution Questionnaire was used to evaluate 489 patients with stroke in three hospitals in Beijing. Results The qi-deficiency constitution (140 patients, 28.63%), yin-deficiency constitution (95 patients, 19.43%), blood-stasis constitution(89 patients, 18.20%) and phlegm-heat constitution (73 patients, 14.93%) were the most common constitution, while qi-depression constitution (22 patients, 4.50%) and yang-deficiency constitution (20 patients, 4.09%) were the less common. The top three constitution in middle aged wereqi-deficiency (33 patients, 27.27%), phlegm-heat (23 patients, 19.01%) and blood stasis (22 patients, 18.18%). The top three constitution in the aged groupwere qi-deficiency (107 patients, 29.08%), yin-deficiency (76 patients, 20.65%) and blood-stasis (67 patients, 18.21%). Conclusions Stroke is closely related with imbalance of TCM constitution. The prevention and treatment of stroke patients with different ages should vary according to the constitutions.

Animals ; DNA-Binding Proteins ; analysis ; Liver Cirrhosis, Experimental ; etiology ; metabolism ; Male ; Mitogen-Activated Protein Kinase 3 ; Mitogen-Activated Protein Kinases ; analysis ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Smad3 Protein ; Trans-Activators ; analysis

BACKGROUNDSuperficial urothelial carcinoma (SUC) of the bladder is a common urinary tract tumor in China. There is a high recurrence rate of this tumor even after surgery and intravesical instillation. Previous reports have described a suppression of the immune system in cancer patients. Dendritic cells (DCs) play a pivotal role in the induction of an effective antitumor immune response. The aim of this study was to investigate the effects of surgery and epirubicin intravesical chemotherapy (IC) on peripheral blood DCs in subsets of patients with bladder SUC.

METHODSA total of 66 SUC patients and 38 healthy controls were enrolled in this study. All the patients had undergone transurethral resection (TUR) of their cancer and adjunctive IC after tumor removal. The patients were divided into a non-recurrence group (n = 40) and a recurrence group (n = 26) based on the presence or absence of tumor recurrence. Blood samples were taken preoperatively (PreOP), on postoperative days (POD) 1 and 7, and at postoperative month (POM) 3. Flow cytometric analysis was used for the determination and quantitation of the surface markers CD80 and CD86 in circulating DC subsets.

RESULTSThe preoperative percentages of myeloid dendritic cells (mDCs) and expression of CD80 and CD86 were impaired in SUC patients compared to healthy controls (P < 0.05). The percentages of mDCs and these surface markers decreased significantly on POD 1 and increased on POD 7, remaining higher than the preoperative values in POM 3 (P < 0.05). The percentages of mDCs, and CD80 and CD86 in the non-recurrence group on PreOP, POD 7, and POM 3 were higher than those in recurrence group.

CONCLUSIONSSurgical removal of SUC and adjunctive IC were associated with improved circulating mDC counts and function. Persistent depression of mDC counts and function after treatment in recurrence patients indicated lower antitumor immunity that may lead to tumor recurrence.

Adult ; Aged ; China ; Dendritic Cells ; immunology ; metabolism ; Epirubicin ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Urinary Bladder Neoplasms ; drug therapy ; immunology ; surgery