Transforming growth factor-β is an important cytokine with various bioactivities, including embryonic development, wound healing, chemotaxis and cell cycle regulation. Epithelial-mesenchymal transition (EMT) is the main pathway of tumor cell to obtain the ability of invasion and metastasis. The TGF-β is the key factor known to induce EMT in cancer cells and plays an important role in the process. In recent years, some progress has been obtained. Some TGF-β inhibitors have approved in the market or in clinical trials. TGF-β inhibitors can play an important role on the treatment of tumors, glaucoma, liver and kidney fibrosis disease and scar repair. Novel TGF-β inhibitors reported in recent years were reviewed in this article.

OBJECTIVETo investigate whether telomerase activity, human telomerase RNA (HTR) and human telomerase reverse transcriptase (HTERT) expression were associated with tumor development in lung cancer and whether telomerase is regulated at gene level or transcriptional level.

METHODSExpression of HTR and HTERT was detected by reverse transcription-polymerase chain reaction (RT-PCR) in 68 human lung cancer and in 68 adjacent-neoplatic lung tissues. And telomerase activity was examined by a quantitative telomeric repeat amplification protocol (TRAP).

RESULTSIn 68 lung cancer tissues, telomerase activity, HTR and HTERT were expressed in 79%, 98.5% and 91.2% respectively, whereas all adjacent non-neoplastic lung tissues were telomerase negative. Most normal lung tissues expressed HTR (91.2%) and HTERT was detected in only 7 of 68 non-neoplastic tissues.

CONCLUSIONSThe relatively high frequency of telomerase activity in lung cancer whereas the detection of no telomerase activity in normal lung tissues suggested that telomerase may play an important role in tumorigenesis of lung cancer. Compared to HTR, HTERT expression was better associated with telomerase activity with a concordance of 88.9%. Telomerase activity may be regulated at transcription level or translation level.

DNA-Binding Proteins ; Gene Expression Regulation, Enzymologic ; Gene Expression Regulation, Neoplastic ; Humans ; Lung Neoplasms ; enzymology ; genetics ; RNA ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Telomerase ; genetics

OBJECTIVETo investigate the diagnosis, treatment and prognosis of adult prostatic sarcoma.

METHODSThe records of 7 patients with prostate sarcoma were reviewed in the light of clinical manifestation, laboratory examination, therapeutic methods and histological subtypes. Several clinicopathological variables were assessed for prognostic significance.

RESULTSOf the 7 cases, 3 were leiomyosarcoma, 3 rhabdomyosarcoma and the other malignant neurilemoma. Most patients presented urinary obstruction, and the diagnosis of prostate sarcoma was established with ultrasound guided biopsy. Histological subtypes were related to the rate of survival. Two patients received radical cystoprostatectomy and died 13 and 21 months respectively after operation. Two cases underwent total pelvic exenteration, followed by chemotherapy and/or radiotherapy and still alive 15 months after operation. The other 3 received only chemotherapy and/or radiotherapy and died 7 months on average after diagnosis.

CONCLUSIONThe long-term survival rate for adults with prostate sarcoma is low. Early diagnosis and complete surgical resection offer patients the best chance for survival. Long-term surveillance is necessary for the early detection of recurrence.

Adult ; Aged ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Prostatic Neoplasms ; diagnosis ; pathology ; therapy ; Retrospective Studies ; Sarcoma ; diagnosis ; pathology ; therapy

OBJECTIVE: To explore and evaluate the characteristics of spectra wave shapes and parameters of the superior vena cava (SVC) Doppler flow patterns in patients with pulmonary arterial hypertension(PAH) by echocardiography. METHODS: Forty-nine patients with PAH as the PAH group and the paired healthy subjects as the control group were included in this study. Transthoracic echocardiography was used, and the spectra of SVC flow Doppler velocities in the right supraclavicular fossa view were examined and recorded. Peak velocity and velocity time integral (VTI) were measured. RESULTS: The spectra wave shapes of SVC flow velocity in the PAH group were distinguished from those of the control. The peak velocity and VTI of S waves during inspiration and the rate of respiratory changes of peak velocity of SVC flow Doppler velocity in moderate and severe PAH groups were significantly lower than those of the control (P<0.05).The peak velocity and VTI of D waves of SVC flow Doppler velocity in the PAH groups were significantly lower than those of the control (P<0.05). The rate of respiratory changes of peak velocity of D waves in the PAH groups was significantly lower than those of the control (P<0.05). The peak velocity and VTI of AR, and VR waves of SVC flow Doppler velocity in the PAH groups were significantly higher than those of the control (P<0.05). Linear regression analysis revealed a significant correlation between pulmonary arterial systolic pressure(PASP) and the Vexp/Vins ratio (r=0.760, P<0.001). CONCLUSION The spectra wave shapes of SVC flow velocity in the PAH groups were distinguished from those of the control which may have some diagnostic value for PAH.The peak velocities and VTI of S waves during inspiration, D waves, AR waves and VR waves of SVC flow Doppler in the PAH groups are different from the control. The ratio of Vexp/Vins of S wave may be a non-invasive quantitative index to detect PAH.
Adolescent ; Adult ; Blood Flow Velocity ; Case-Control Studies ; Echocardiography, Doppler, Color ; methods ; Female ; Humans ; Hypertension, Pulmonary ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Vena Cava, Superior ; diagnostic imaging ; physiopathology ; Young Adult

Objective: To detect the mutation of epidermal growth factor receptor (EGFR) gene in peripheral blood of non-small cell lung cancer (NSCLC) patients in Yunnan area with Super-ARMS, and to explore its correlation with clinicopathological characteristics. Methods: A total of 222 blood samples from patients with NSCLC were collected between January 2017 to December 2018 in the Molecular Diagnostic Center of Yunnan Cancer Hospital. The EGFR gene mutation in peripheral blood samples was detected by SuperARMS, and the relationship between EGFR gene mutation and clinicopathological features was analyzed. Meanwhile, the independent risk factors influencing EFGR mutation were also analyzed. Results: In the peripheral blood of 222 NSCLC patients, there were 81 cases (36.5%) with EGFR gene mutation. Among them, exon 19 deletion and L858R gene point mutation were the most common (75.3% of total mutation); female patients had a higher mutation rate than male patients (45.9% vs 27.0%); patients <60 years old had a higher incidence of mutation than patients≥60 years old (43.2% vs 28.8%) (P<0.05 or P<0.01); moreover, patients with no history of smoking, no history of radical surgery, adenocarcinoma, advanced stage and no history of chemotherapy had higher incidence of EGFR mutation (43.9% vs 21.6%, 39.2% vs 21.2%, 43.9% vs 4.8%, 39.7% vs 23.3% and 44.0% vs 23.5%) (P<0.05 or P<0.01). Multivariate logistic analysis showed that young, no smoking history, adenocarcinoma and no surgical history were independent risk factors for EGFR gene mutation (all P<0.01). Conclusion: In the peripheral blood of patients with NSCLC in Yunnan, the mutation rate of EGFR gene is higher in patients with age<60 years old, adenocarcinoma and non-smoking. Super-ARMS method is more sensitive in the detection of EGFR mutation in peripheral blood of lung cancer patients.

Objective To analyze the reasons and outcomes of the unplanned re-operation in renal transplant recipients during perioperative period,and to summarize the corresponding strategies.Methods From January 2014 to September 2017,the clinical data of 20 cases of kidney transplantation which had a total of 22 unplanned re-operations were retrospectively analyzed.All patients were given quadruple immunosuppression with antibody induction and tacrolimus (TAC) and mycophenolate mofetil (MMF) plus prednisone (Pred).We analyzed the reasons,occurrence time,effect of re-operation and the renal function,as well as survival rate of all graft and recipient.The delayed graft function (DGF),acute rejection (AR) and incidence of pulmonary infection were monitored as well.Results Up to September 2017,during the follow-up of 1-36 months,the overall rate of unplanned re-operation was 4.6％,and 2 patients underwent 3 operations.For the reasons of re-operation,there were 18 cases of bleeding (13 cases of blood oozing from the wound surface,3 cases of renal parenchyma rupture because of rejection,and 2 cases of rupture of renal artery infection),2 cases of renal artery thrombosis and 2 cases of the repair of leakage of urine.Two operations were performed within 1 days for 9 cases,2-5 days for 5 cases,6-10 days for 3 cases,above 10 days for 45 cases.There was no deaths during the perioperative period.One patient died of rupture of exiliac aneurysm 3 months after the operation.One patient died of cerebral hemorrhage 6 months postoperation.The death censored graft survival rate was 72.2％ (13/18) and the incidence of DGF was 55 ％.Conclusion The major reason of unplanned re-operation for renal transplantation is associated with bleeding of various causes.And the incidence of DGF is high.If the secondary operation was performed with the correct decision,the kidney allograft recovers well.

Objective:To summarize the clinical experiences of managing patients with novel coronavirus(2019-nCoV) infection after kidney transplantation.Methods:Clinical data were retrospectively analyzed for two patients with 2019-nCoV infection after renal transplantation in January 2020. Case 1 was a 48-year-old male with CMV pneumonia secondary to 2019-nCoV infection at 4 months post-transplantation. CT imaging showed multiple patchy ground-glass opacities of both lungs. Case 2 was a 59-year-old male who screened positive for 2019-nCoV nucleic acid due to fever at 9 days post-transplantation and he showed no clinical manifestations of pneumonia. After a definite diagnosis, case 1 was transferred to a designated hospital for isolation. Treatment regimens: cefoperazone sulbactam sodium plus linezolid for anti-infection, gamma globulin for enhancing immunity, methylprednisolone for controlling inflammatory responses and antiviral regimens of arbidol tablets plus lopina-velitonavir tablets. Case 2 was isolated in a single room. The treatment plan included cefoperazone sulbactam sodium for anti-infection, gamma globulin for enhancing immunity, arbidol for antiviral therapy and other symptomatic measures.Results:During a follow-up period of 3 weeks, case 1 recovered with renal dysfunction, nucleic acid test of nasopharyngeal swab turned negative and pulmonary imaging improved. Case 2 showed no obvious clinical symptoms and nucleic acid test of nasopharyngeal swab turned negative thrice.Conclusions:Renal transplant recipients should take precautions to avoid exposure to high-risk environments. A definite diagnosis should be made on the basis of clinical manifestations and results of nucleic acid test and pulmonary imaging. Currently there is no effective antiviral agent and symptomatic treatment is a major option.

Objective To summarzie the experiences of kidney transplantation from rhabdomyolysis.Methods The surgical procedures and treatment protocols of the kidney transplantation in 3 cases from DD donors who suffered from anuria due to rhabdomyolysis were retrospectively analyzed.Results Three recipients were donated by two donors.When the blood of kidneys is washed out,the color of the kidneys was brown,and when the kidneys restored the blood perfusion,the transplanted kidneys were dark brown.All of these 3 cases had delayed renal function,and 2 recipients who received the kidneys from the same donor secreted the urine 3 weeks after surgery.The creatinine gradually decreased,and they discharged when the renal function was normal.The urine volume in the another recipient was 3000 ml or more per day in the first two days,gradually decreased from the third day,until anuria.We conducted an exploration of the transplanted kidney due to the area of transplantation uplift.We found that the kidney was bright red during the operation,the hematoma was removed and hemostasis was done,the urine volume gradually increased from one week after surgery,and the creatinine levels gradually decreased.After two months the creatinine levels were 103μmol/L.Conclusion For the patients with rhabdomyolysis,their kidneys can be transplanted after active preservation,evaluation of the donor kidney function and blood flow,and the short-term outcome is satisfactory.

Objective: To explore the diagnosis and treatment of BKV nephropathy after renal transplantation. Methods: A total of 62 patients with progressive creatinine elevation were routinely examined by blood and urine BKV-DNA. And 21 patients with positive results underwent graft biopsies for confirming a diagnosis. Results: Among 21 cases of BKV infection, 20 cases received leflunomide in replacing mycophenolate mofetil (MMF) and a lower dose of tacrolimus. One case with urine (-) & blood (+ ) received sirolimus in replacing tacrolimus and a lower dose of MMF. Among 11 cases with urine (+ ) and blood (-), urinary BKV-DNA turned negative & creatinine decreased markedly (n=4), urinary BKV-DNA load decreased & creatinine stablized (n=4), death from pulmonary infection with hepatic & renal failure (n=1), urine BKV-DNA load decreased & creatine increased (n=1), BKV–DNA load was not re-examined in 1 case of acute rejection and hydronephrosis with elevated creatine; Among 9 cases with urine (+ ) & blood (+ ), blood BKV-DNA turned negative with urinary BKV-DNA load & creatine decreased (n=6), blood BKV-DNA load decreased & creatine stablized (n=2) and no re-examination with a stable level of creatine (n=1); One case with urine (-) & blood (+ ) was not timely treated and ultimately leading to graft loss after an onset of acute rejection. Conclusions BKV nephropathy may be effectively treated by decreasing immunosuppressive intensity. However, clinicians should stay on a high alert for acute rejection due to an excessive reduction of immunosuppressive agents.

BACKGROUNDTo investigate the relationship between the telomerase activity and telomerase component expression in lung cancer, and to explore whether telomerase activity is regulated at the gene or transcriptional level.

METHODSExpression of the hTR and hTERT were detected in 68 human lung cancer tissues and responsive adjacent non-neoplastic lung tissues by semi-quantitative reverse transcription-polymerase chain reaction. Telomerase activity was detected by telomeric repeat amplification protocol.

RESULTSIn 68 lung cancer tissues, the positive rate of the telomerase activity, hTR and hTERT expression were 79.4% (54/68), 98.5% (67/68) and 91.2% (62/68) respectively. Whereas most adjacent non-neoplastic lung tissues expressed hTR (62/68, 91.2%) also, hTERT was detected in only 7 (10.3%) normal lung tissues and no telomerase activity were detected in the 68 non-neoplastic lung cancer tissues. As compared with hTR, hTERT expression was closely related to telomerase activity. The concordance was 89.0% (121/136), whereas the concordance between telomerase and hTR was 43.4% (59/136).

CONCLUSIONSThe results suggest that telomerase may play an important role in tumorigenesis of lung cancer. Telomerase activity may be regulated in transcription level or translation level.