Objective To investigate the clinical features and prognosis of the patients with renal cell carcinoma and venous tumor thrombus.Methods Fifty-six patients with renal cell carcinoma and venous tumor thrombus were selected as our subjects,who underwent radical nephrectomy and thrombectomy in the Second Hospital of Tianjin Medical University from June 2002 to May 2014.There were 28 patients with stage Ⅰ tumor thrombus,l5with stage Ⅱtumor thrombus,9 with stage Ⅲ tumor thrombus and 4 with stage Ⅳtumor thrombus.All patients underwent renal tumor resection and embolectomy,and were follow-up.Results Of all the patients,46 were male and 10 were female with a mean age of 61.7(age ranging from 42 to 83).Twenty-four were presented on the left kidney and 32 were right.The clinical features were as follows:The tumor size was 2.5 to 14 cm in diameter(mean:6.2 cm),there were 21 cases with low back pain,18 cases with hematuria,lcases with abdominal.Pathological results showed that 39 with clear cell carcinoma,9 with papillary cell carcinoma,3 with chromophobe cell carcinoma,1 with low-differentiated cell carcinoma and 1 with undifferentiated cell carcinoma,3 with sarcomatoid differentiation.Forty-three patients were followed up,and the median follow up period was 20.4 months (2-90 months).The median survival time for the patients was 47 months and the 5 year overall survival was 45.2％.The survival time of the patients with early tumor thrombus(below hepaticvein) was (55.3 ± 4.9) month,significantly longer than that of the patients with advanced tumor thrombus (above hepaticvein) ((24.8 ± 5.3) months,P =0.047).Conclusion Patients with renal cell carcinoma and venous tumor thrombus are characterized with high malignancy and poor prognosis.Surgical operations are effective therapies for the patients.Long term outcome of the early tumor thrombus patients is significantly better than that of the advanced tumor.

Objective To evaluate the effects of endogenous NO on the chemosensitivity of human breast cancer cell. Methods MCF-7 cells were cultured as monolayer, incubated with cytokine IL-1β. The pro-duction of NO was detected by NO assay. The expression of iNOS protein was measured by Western blotting. Establishing control group and experimental group, the chemosensitivity of MCF-7 cells incubated by L-NMMA and L-Arg to ADM and 5-Fu was studied by MTT assay. Results There was a positive correlation of dose-dependence between NO production and IL-1β concentration. MCF-7 cells expressed plenty of iNOS by induetion of IL-1β. There was no significant difference on iNOS whether L-NMMA and L-Arg existed or not. Incubating MCF-7 cells with 0. 5 μmol/L or 1 μmol/L ADM, the survival rate of experiment group was remarkablely decreased(P < 0.05) ; L-NMMA significantly increased survival rate of experiment group(P < O. 05) ; L-Arg decreased survival rate of experiment group(P < 0.05). Conclusion The induction of IL-113 in MCF-7 cells can increase the production of endogenous NO, which increases MCF-7 cells' sensitivity to chemotherapy.

Objective To explore the value of preoperative diagnosis for breast cancer patients in different locating ways. Methods The tissues were gotten by core needle biopsy from 146 breast cancer patients through different locating ways,and were taken for histopathological examinations and were compared with postoperative pathologic results. Results Seventy-four cases were biopsied with ultrasound-guide (ultrasound-guide group), and 72 cases with free-hand (free-hand group), without serious complications.Compared with postoperative pathologic results,the false negative rate in ultrasound-guide group was 5.41%(4/74);the false negative rate in free-hand group was 18.06% (13/72). The accuracy of the ultrasound-guided biopsy was higher than that in free-hand (U = 13.63,P ＜ 0.01 ). Conclusions Preoperative ultrasoundguided biopsy and postoperative pathologic examination has no significant difference, with high consistency.The study provides a good basis for selection for clinical work,so as to the more effective guide for the comprehensive treatment of breast cancer patients.

OBJECTIVE: To explore the value of computer-aided design/computeraided manufacturing (CAD/CAM) technology for individual reconstruction of the thyroid cartilage defects. METHOD: Select the 20 New Zealand white rabbits (male or female). Randomly divided into two groups. Group A in the pre-operative CT scan of the throat, three-dimensional reconstruction of the thyroid cartilage imaging, surgical removal of either side of the thyroid cartilage, defect implanted in the use of CAD/CAM technology and mirror technology to produce personalized restorative materials; Group B surgical resection either side of the thyroid cartilage, defect implanted production of non-personalized probably according to the experimental animals unilateral thyroid cartilage repair materials. After surgery by gross observation, electronic laryngoscopy observed experimental animals throat. RESULT: General check and electronic laryngoscopy show: the use of CAD/CAM technology to prepare the individual repair materials throat plays better supporting role than the non personalized materials. CONCLUSION CAD/CAM technology before surgery designed to provide a personalized solid model to improve the accuracy of the surgery, time saving surgery to reduce surgical complications.
Animals ; Computer-Aided Design ; Female ; Image Processing, Computer-Assisted ; Male ; Prostheses and Implants ; Rabbits ; Reconstructive Surgical Procedures ; Thyroid Cartilage ; surgery ; Tomography, X-Ray Computed

Objective To analyze corpus uteri epidemiology in selected cancer registering areas of China during 2003-2007,and to provide scientific information for its prevention and control in China.Methods The incident and mortality data of corpus uteri cancer in 32 cancer registering areas of China with better quality during 2003-2007,which were selected according to the criteria of and provided by National Center for Cancer Registration,were analyzed.Results There were 8850 new cases and 1559 death cases of corpus uteri cancer,which accounted for 2.96％ ( 8 850/299 306 ) of all female new cancer cases and 0.94％ ( 1 559/166 305) of all female cancer death cases,respectively.Corpus uteri cancer was the 9th most common cancer for all new female cancer cases which world age adjusted incidence rates was 5.04/105,and 19th most common cancer for all female cancer death cases which world age adjusted mortality rate was 0.83/105 in 32 selected cancer registering areas of China during 2003-2007.Zhongshan city,Guangzhou city in Guangdong province and Beijing were the areas with the highest incidence rates in which were 14.51/105,8.51/105 and 6.69/105,respectively.Zhongshan city in Guangdong province,Dafeng city in Jiangsu province and Feicheng city in Shandong province were the areas with the highest mortality rates,in which were 4.03/105,3.19/10s and 1.65/105 respectively during 2003-2007.There were increasing trends for its incidence rates in above 32 areas during 2003-2007,its world age adjusted incidence rates increased from 3.94/105 in 2003 to 5.56/105 in 2007 ( P =0.026 ),while its urban world age adjusted incidence rates increased from 4.57/105 in 2003 to 6.18/105 in 2007 (P =0.038),and rural rates increased from 1.74/105 in 2003 to 3.01/105 in 2007 ( P =0.013 ),and the results showed that urban areas obviously higher than rural areas ( P ＜ 0.01 ).Although there was a slow increasing trend for its world age adjusted mortality rates in above 32 areas during 2003-2007 which increased from 0.64/105 in 2003 to 0.87/105 in 2007 ( P =0.214 ),and from 0.66/105 in 2003 to 0.88/105 in 2007 in urban areas ( P =0.340 ),and from 0.57/105 in 2003 to 0.83/105 in 2007 in rural areas( P =0.070),while increasing trends without statistical significance.But mortality rates in urban areas were obviously higher than those of rural areas (P ＜0.01 ).Conclusions Although the world standardized incidence and mortality rates of corpus uteri cancer were at low level worldwide,there were increasing trends for its incidence rates during 2003-2007 in the 32 selected cancer registering areas of China.Moreover,its incidence and mortality rates were at high level worldwide in some areas such as Zhongshan city of Guangdong province and Dafeng city of Jiangsu province during the period,in which suggested that its prevention and control should be enhanced.

Objective To investigate the effects of heat-inactivated Cryptococcus neoformans(H-CN)on an experimental murine model of meningoencephalitis and on IL-1?,IFN-?and TNF-?gene ex-pression on the brain and spleen.Methods An experimental murine model of intracerebral infection with C.neoformans was established.Mice were divided into H-CN-treated group and control group.The brain and spleen of two groups were collected to obtain total RNA,and IL-1?,IFN-?and TNF-?were detected by RT-PCR method.After intracerebral challenging with lethal doses of C.neoformans,the survival time and colony forming units(cfu)of C.neoformans in the brain of two group were observed.Results The survival time was prolonged,and cfu of C.neoformans were decreased in the brain of H-CN-treated group in com-parison with those of control group.Expression of IL-1?was positive,and IFN-?and TNF-?negative in the brain tissue of H-CN-treated mice;while expression of IL-1?,IFN-?and TNF-?was all negative in the control mice,as indicated by RT-PCR.Expression of3cytokines,IL-1?,IFN-?and TNF-?was all positive in the spleen tissue of both groups,suggesting that there was no significant difference in the levels of cytokine gene transcripts in both groups.Conclusion These findings suggest that murine resistance to central nervous system infection of C.neoformans be enhanced by intracerebral administration of H-CN,and anti-cryptococcal mechanism probably involves a local cytokine IL-1?elicitated by H-CN in central nerve system.

0.05).PZs of clinical and environmental isolates were0.501?0.049and0.565?0.131,respectively(P

Objective To investigate the clinical features and CT appearances of primary adenosquamous carcinoma (ASC)of the liver and to improve the understanding of this disease for the sake of misdiagnosis.Methods The clinical features and CT appearances in 7 patients proved by operation and pathology were reviewed,retrospectively.Results All of the patients had dull pain in upper abdo-men,fever,chills and a long history of cholangitis and biliary calculi.In addition,all patients had not the history of hepatitis B and liver cirrhosis.And the serum AFP level was normal.The single lesion was found in every patient including 4 lesions in the left lobe of liver and the other 3 in the right lobe.Plain CT showed all masses with hypodensity,heterogeneity and unclear edge in liver,and multiple irregular and more hypodense areas in lesions were found.Slight heterogeneous honeycomb-like enhancement in the arterial phase was showed.In the venous phase,persistent honeycomb-like enhancement with uneven separations,nodular bulge and hypo-dense necrotic area was found.In the delayed phase,further honeycomb-like enhancement with hypodense necrotic area and obvious-ly enhanced nodular bulge was showed.The bile ducts in the liver and around the mass were dilated and had pneumatosis in company with lithiasis in choledochus and intrahepatic bile duct in 5 patients.Conclusion Primary hepatic ASC has certain clinical character-istics in older patients.The CT characteristic features included:honeycomb-like lesions with persistent,heterogeneous,delayed en-hancement and heterogeneous separation,uneven inner edge and enhanced nodular bulge.

PURPOSETo review the characteristics and evolution of the fungal spectrum, and the risk factors causing fungal infection, and to make progress in diagnosing fungal infection after organ transplantation.

DATA SOURCESAn English-language literature search (MEDLINE 1990 - 2000) and bibliographic review of textbooks and review articles.

STUDY SELECTIONTwenty-three articles were selected from the literature that specifically addressed the stated purpose.

RESULTSFungal infections in organ transplant patients were generally divided into two types: (1) disseminated primary or reactivation infection with one of the geographically restricted systemic mycoses; (2) opportunistic infection by fungal species that rarely cause invasive infection in normal hosts. The risk factors of fungal infection after a transplant can be evaluated and predicted according to the organ recipient's conditions before, during and after the transplant. Progress in early diagnostic methods during the past 10 years has mainly revolved around two aspects, culture and non-culture.

CONCLUSIONSIt is important to undertake a systemic evaluation on the condition of the organ recipient before, during and after a transplant; should any risk factor for fungal infection be suspected, diagnosis should be made as early as possible by employing mycological techniques including culture and non-culture methods.

Objective To report a case of disseminated cryptococcosis with cutaneous manifestations and osteomyelitis. Methods and Results A 33 year old female was admitted due to multiple nodules and ulcers on the upper arms, shoulders, buttocks and thighs for one year. The patient was pregnant when admitted, and gave birth to a premature baby during her illness. The nodules increased half a month after delivery, which was suspected to be hematogenously disseminated pulmonary tuberculosis and was given anti tuberculous therapy for three months but failed. Physical examination showed there were 39 nodules or ulcers on the face, gum, trunk, buttocks and extre mities. The bone structure of the left tibia and fibula destroyed and a sinus developed on the left fibula. Microbiologic examination showed that lots of spores were seen in the smear of pus and necrotic tissues, which produced yeast like colonies in culture with positive urease and caffeic acid test. Cryptococcus neoformans, serotype A was identified by API yeast reaction band and serology. Inoculation with mice and rats showed that their brains, lungs and livers were involved easily. Further identification as C.neoformans var.neoformans was obtained based on sequence analysis of ribosomal internal transcribed spacer region 2. The anti tuberculous therapy was stopped and anti fungal therapy was initiated at once. Intravenous and topical amphotericin B in combination with fluconazole were chosen in the initial therapy and itraconazole for maintenance. The nodules disappeared after 30 days and the last ulcer in the left tibia healed completely after 200 days. The anti fungal therapy was discontinued after 277 days and the patient was completely cured.