Objective To analyze the clinical features of urothelial carcinoma in renal allograft re- cipients and to investigate its diagnosis and treatment.Methods A retrospective study was undertaken on 1293 renal allograft recipients in our center between 1998 and 2003.Of them ,21 cases(72.4% )had urothe- lial carcinoma(4 males and 17 females).All the cases had not had tumor before transplantation.In 17 cases the protopathy was chronic interstitial nephritis(CIN).The mean interval between tumorigenesis and trans- plantation was 26 months(range,6-62 months).Of the 21 cases,6 had bladder transitional cell carcinoma (TCC);6 had unilateral pelvic or ureter TCC;8 had unilateral pelvic or ureter and bladder TCC;1 had bilat- eral pelvic and ureter TCC.In 10 cases,the ipsilateral upper urinary tract of the graft was involved;and in 4 cases,the contralateral upper urinary tract was involved.Painless gross hematuria and iterative urinary tract infection were the cardinal symptoms.Surgical treatment was performed in 19 cases.Postoperatively,all the cases received immunosuppressants at one third reduction dose in combination with intravesical instillation chemotherapy.Results Two cases receiving palliative treatment died 5 and 8 months after diagnosis.The other 19 cases were followed for 2-5 years.Of them,13 cases had tumor recurrence.The recurrence sites were bladder and the contralateral upper urinary tract.All the cases had no acute rejection at reduced dose of immunosuppressants,and all had normal renal function except for 2 cases,who underwent removal of the graft and had dialysis again.Conclusions Renal allograft recipients whose protopathy is CIN and female recipients have the risk of urothelial carcinoma after renal transplantation.Urothelial carcinoma occurs more often in ipsilateral upper urinary tract of the graft than in contralateral upper urinary tract.Considering the high possibility of bilateral upper urinary tract involvement by TCC,prophylactic bilateral nephroureterectomy with bladder cuff excision should be considered in renal allograft recipients who have involvement of contra- lateral upper urinary tract of the graft.

Objective To study the epidemiological characteristics of measles in Fuyong Street in order to predict its occurrence and reduce its incidence by establishing preventive and control measures.Methods Epidemiological data in Fuyong Street between 2003 and 2007 were analyzed.Results The result showed that 393 measles cases were reported in the whole street during 2003 and 2007,329 were confirmed by laboratory,and 60 were local cases.The measles annual average incidence was 18.29/100 000.The high incidence period was from March to August and the most measles cases were young adults and infants.30.79% cases had no immunization history and 24.68% cases had immunization history.Conclusions The incidence of measles is kept at a high level.It will go on possibly for half a year or a year.A comprehensive control measures should be thaken to strengthen vaccination program especially for foreign people and to reinforce the surveillance and analysis of epidemic situation in order to avoid the outbreak of the disease.

Acupuncture Points ; Acupuncture, Ear ; Adult ; Dizziness ; therapy ; Headache ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion ; Rhinitis, Allergic, Seasonal ; therapy

Autoimmune Lymphoproliferative Syndrome ; diagnosis ; genetics ; immunology ; therapy ; Biomarkers ; blood ; Child, Preschool ; Humans ; Male ; Mutation ; Prednisolone ; administration & dosage ; therapeutic use ; Ultrasonography, Doppler, Color ; fas Receptor ; genetics

Objective To observe the effects of low frequency transcranial magnetic stimulation (LF-TMS) on the electroencephalogram (EEG),expression of NPY in hippocampus in pilocarpine (PLO)-induced epileptic rats. Methods Forty male Sprague-Dawley rats (240-260 g) were used to establish a model of epilepsy by in- tradominal injection of pilocarpine,and then randomized into 2 groups:a control group and an intervention group. The control group was treated by sham LF-TMS,while the intervention group was treated by LF-TMS once daily for 7 days.Ⅰgroup simply celiac inject pilocarpine.Ⅱgroup celiac inject PLO after LF-TMS.The EEG was recorded in both groups and the checked pathology.Pathological item include HE staining,NPY immunohisto chemical staining. Results The latency for seizure attack was significantly lengthened,while the frequency of seizure attack and times of major seizure attack were significantly decreased in the intervention group.The HE staining revealed significant de- generation and necrosis of neurons in the hippocampus,especially in the CA3 region,in rats in the control group. The pathologic changes were significantly less severe in the intervention,Immunohistochemical staining showed a sig- nificantly higher expression of NPY in the hippocampus as compared with the intervention group. Conclusion U- sing the PLO-induced epilepsy model,LF-TMS could not only postpone the generation of kindling but also inhibit the progress of epilepsy.The increased NPY expression in the hippocampusin the intervention group implied a close rela- tionship between NPY and epilepsy attack.

Objective To explore the risk factors for asthma in children.Methods A 1:1 matched and hospital-based case-control study was conducted to analyses risk factors for asthma in 300 pairs of children by logistic regression analysis. Results The result of univariate Logistic regression analysis showed that there were 17 related factors for children asthma, including disease history of parents in respiratory system,family income,atopie character,history of acute respiratory infections, eating habit,the amount of sea foods intakes,foam plastics,family decoration,the way of exhaust fume in kitchen,the exhaust effectiveness,raising pet in house,family history of asthma,family history of allergic rhinitis,family history of food allergy,dust allergy of parents,systemic therapy after the first attack.With multivariate Logistic regression analysis,7 factors were entered the model,6 risk factors including father's history of respiratory diseases(OR 3.771,95%CI 1.533～9.278),low family income(OR 1.503, 95%CI 1.258～1.795),atopy(OR 3.788,95%CI 2.368～6.058),meat-eating habit(OR 2.042,95%CI 1.481～2.815),asthma history of family members(OR 1.710,95%CI 0.988～2.958),the family history of allergic rhinitis(OR 1.991,95%CI 1.234～3.211), and 1 protective factor of raising pet in house(OR 0.443,95%CI 0.265～0.739).The coefficients of these factors in multivariate logistic regression model were 1.327、0.407、1.322、0.714、0.536、0.689、and-0.814 respectively.Conclusion Children asthma was a multi-factorial complex disease,and the interaction of environmental and genetic risk factors played an important role in the onset of this disease.

Objective To observe the curative effectiveness of kidney transplantation on uremic patients complicated with Thalassemia.Methods Forty-six cases of uremic patients complicated with Thalassemia(26 cases of alpha-thalassemia,20 cases of beta-thalassemia)subject to kidney transplan- tation were retrospectively studied as the anemia group.Incidence of delayed graft function restoration, rejection(hyperacute rejection,accelerated rejection and acute rejection)and anemia correction were observed.Time needed for renal function restoration was recorded and creatinine value(Cr)was mea- sured in those patients whose kidney function restored after kidney transplantation.Control group in- cluded 131 cases of kidney transplantation performed concurrently that accompanied with different con- tent of anemia other than thalassemia.Results Incidence of DGF was 26.1% and 23.7% in thalasse- mia group and control group,respectively.Six months after transplantation,39 cases in thalassemia group and 109 cases in control group with follow-up were host and kidney alive.In 6 months,rejection ratio was 30.8% in thalassemia group and 32.1% in control group respectively.Cr value was(121?20)?mol/L and(128?33)?mol/L in thalassemia group and control group,respectively.Ratio of anemia correction in thalassmia and control groups was 79.5% and 76.1%,respectively.No indexes above were found to be statically significantly different between these two groups.Conclusion Uremic patients complicated with thalassemia is suitable for kidney transplantation,with clinical effectiveness similar to those without thalassemia.

Objective To evaluae possible association between interleukin-1 beta (IL-1?) gene exon 5 polymorphism and childhood asthma.Methods The study was conducted in two different groups: asthmatic children(n=55) and healthy children(n=35). The IL-1? gene exon 5 polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP). Results Frequencies of CC,CT and TT genotypes were 92.7%,7.3%,0, and frequencies of C,T allele were 96.4%,3.6% in asthmatic group. However, frequencies of CC,CA and AA genotypes were 85.7%,14.3%,0, and frequencies of C,T allele were 92.9% ,7.1% in healthy group. There were no significant difference in distribution of genotypes and allele frequencies between two groups.Conclusion IL-1? gene exon 5 polymorphism may not be associated with childhood asthma.

ObjectiveTo observe the curative effect of the Chinese traditional medicine combined with traction and physical therapeutic on lumbar intervertebral discprolapse (LIDP).Methods95 LIDP patients were randomly divided into the treatment group (50 cases) and control group (45 cases). Patients of the treatment group were treated by Chinese traditional medicine, traction and physical therapy. Patients of the control group were treated by traction and physical therapy only.ResultsThe total clinical effective rate of the treatment group was 100%, but that of the control group was 75.6%, there was a significant difference between two groups (P<0.05).ConclusionChinese traditional medicine therapeutics is an effective non-surgical therapeutics for LIDP.

BACKGROUNDMalignant tumor is the most common complication occurred in transplant recipients. It is widely recognized that immunosuppressive treatments increase the risk of cancer in transplant recipients. The efficacy and safety of rapamycin (RPM) in combination with low-dose calcineurin inhibitor (CNI) in treating 15 renal allograft recipients which developed urothelial carcinoma were observed.

METHODSImmunosuppressive regimen in all recipients was altered with rapamycin to replace mycophenolate mofetil (MMF) or azathioprine (Aza). The initial loading dosage was 2 mg/d, and the next dosage was 1 mg/d. The dosage of rapamycin was carefully adjusted according to the blood drug level and concentration of the drug was maintained at 4 - 6 microg/L. In all the 15 patients, the calcineurin inhibitor was reduced down to one third of the original dosage after the rapamycin blood concentration became stable. Surgical treatment and intravesical instillation chemotherapy were carried out in all patients. Recurrence of the tumor was monitored throughout the study. Post-transplant renal function and side effects were also closely monitored.

RESULTSAmong the 15 patients, 9 had no tumor recurrence in 2 years, 2 had tumor recurrences twice, and 4 had once. There was no acute rejection observed during RPM treatment. Post-transplant renal function in 11 patients was improved, with a decreased creatinine level. Hyperlipoidemia and thrombocytopenia were the most frequent adverse events which responded well to corresponding treatments.

CONCLUSIONAmong the renal allograft recipients with urothelial carcinoma, combination of rapamycin and low dose calcineurin inhibitor treatment is effective and safe.

Adult ; Azathioprine ; therapeutic use ; Female ; Humans ; Immunosuppressive Agents ; therapeutic use ; Kidney Transplantation ; adverse effects ; Male ; Middle Aged ; Mycophenolic Acid ; analogs & derivatives ; therapeutic use ; Sirolimus ; therapeutic use ; Urinary Bladder Neoplasms ; drug therapy ; pathology ; Urothelium ; pathology