Background and purpose:The association between metabolic syndrome (MS) and renal cell carcinoma (RCC) is still unknown. The aim of this study was to elucidate how MS correlates with the prevalence and malignancy of RCC.Methods:This study enrolled 398 RCC patients (350 clear cell RCC patients, 5 XP11.2 transloca-tion RCC patients, 16 papillary RCC patients and 27 chromophobe RCC patients), 160 normal persons, and 32 benign renal tumor patients. The metabolic status of the patients was assessed, and the link between MS and the prevalence or malignancy of RCC was calculated.Results:Clear cell RCC patients had signiifcantly higher rates of hypertension, higher body mass index (BMI) and longer waist circumference. Forty-eight percent clear cell RCC patients had MS, while the number was 33% for papillary RCC, 26% for chromophobe RCC, 0% for XP11.2, 17% for AML, and 25%for normal people. MS patients had signiifcant higher rates of having clear cell RCC than no-MS patients, however this kind of difference was not seen in other types of RCC. Clear cell RCC patients with higher Furhman grade had lower rates of MS.Conclusion:Patients with MS are more likely to develop clear cell RCC. Patients with high Furhman grade tumors have low MS rates, indicating that high grade tumor may have other originating mechanisms other than metabolic disorders.

Objective To study the value of cervical length(CL) by transvaginal sonography in the mid-trimester and late-trimester for the prediction of preterm delivery.Methods The CL was measured by transvaginal sonography for 5277 pregnant women between 22-24 weeks and 28-32 weeks gestation,who were prenatal cared and delivered at the First Hospital of Peking University from June 2008 to November 2009.The pregnancy outcomes were followed,and the relationship between CL and preterm delivery and preterm premature rupture of membrane was studied.Results ( 1 ) The incidence of preterm delivery was 5.4％ (289/5370) total,among of them the incidence of therapeutic preterm delivery was 1.7％ (93/5370),spontaneously preterm delivery was 1.2％ (62/5370),and preterm premature rupture of membrane was 2.5 ％ (134/5370).There are 4 cases (4/5370) who occured late abortion.(2) Excluding the 93 women who had therapeutic preterm delivery,the mean CL of 22-24 weeks was ( 38.8±4.0) mm.The relative risk for preterm delivery when the CL＜30 mm was 5.2,when CL＜25 mm,the relative risk was 11.1,and when CL ＜15 mm the relative risk for preterm delivery was 13.8.The average CL during 28-32 weeks of gestation was ( 34.6±4.8) mm,was significantly shorter than that of 22-24 weeks ( P＜0.05 ).During this period the relative risk for preterm delivery when the CL＜30 mm was 6.9,when CL＜25 mm,the relative risk was 11.1,and when CL＜15 mm the relative risk for preterm delivery was 20.0.(3) A CL＜30 mm as the cutoff value for predicting preterm delivery during 22-24 weeks of gestation has only a 3％ sensitivity and 19％ positive predictive value,but had a 99％ specificity and 96％ negative predictive value.The sensitivity,positive predictive value,specificity and negative predictive value for a CL ＜ 30 mm as the cut-off value for predicting preterm delivery during 28-32 weeks of gestation was 33％,21％,95 ％ and 97 ％ respectively.(4) The total number of preterm premature rupture of membrane pregnant women was 134 (2.5％ ),who had a mean CL of (38.4 ±4.7) mm during 22-24 weeks of gestation,was similar with the women without preterm premature rupture of membrane ( PPROM),but during 28-32 weeks of gestation the women who occured PPROM had a mean cervical length of ( 30.6 ± 8.1 ) mm,and was significantly shorter than that of women without PPROM ( 34.7 + 4.6 ) mm.Conclusions ( 1 ) CL in 28-32 weeks of gestation issignificantly shorter than that of in the mid-gestation,but more than 90％ of women has a CL≥30 mm.(2)The shorter the CL is,the greater the relative risk of preterm delivery.According to different CL for clinical consulting objective relative risk could be provide.(3) The CL during 28-32 weeks of gestation can also predict preterm delivery,the sensitivity is obviously better than that of 22-24 weeks of gestation.(4) The CL during 28-32 weeks of gestation is valuable for predicting of PPROM.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

OBJECTIVETo evaluate clinical factors affecting Gleason score upgrade in patients receiving radical prostatectomy (RP).

METHODSA total of 322 patients with prostate cancer who received RP from January 2012 to December 2013 at Department of Urology at Fudan University Shanghai Cancer Center were included, and their data of age, body mass index (BMI), prostate-specific antigen (PSA), prostate volume, percentage core, clinical staging, pathological characteristics, biopsy Gleason score and RP Gleason score were analyzed. Differences in categorical variables and continuous variables were compared using χ² tests and Student's t-test, respectively. Unconditional multiple logistic regression was used to estimate OR and 95% CI of the association of Gleason score upgrade with clinical factors.

RESULTSGleason score upgrade occurred in 107 of 322 (33.3%) patients. There was no difference in age, BMI and clinical staging between the two groups. Compared with patients without Gleason score upgrade, higher levels of PSA (χ² =6.740, P=0.034), smaller prostate volume (t=3.481, P=0.002) and elevated percentage core (t=-2.097, P=0.037) were observed in patients with Gleason score upgrade. In addition, lymph node metastasis (χ² =4.193, P=0.041) and extracapsular extension (χ² =4.747, P=0.029) were more common in patients with Gleason score upgrade. After adjusting for potential confounders, PSA levels (OR=2.451, 95% CI: 1.290-4.660), prostate volume (OR=0.982, 95% CI: 0.969-0.995) and percentage core (OR=2.756, 95% CI: 1.033-7.357) were independent predictors for Gleason score upgrade.

CONCLUSIONGleason score upgrade happens at a relatively high rate. PSA levels, prostate volume and percentage core are important factors affecting Gleason score upgrade.

Biopsy ; Body Mass Index ; China ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Neoplasm Grading ; Prostate-Specific Antigen ; blood ; Prostatectomy ; Prostatic Neoplasms ; diagnosis ; surgery