Cardio-Renal Syndrome ; physiopathology ; therapy ; Humans

Objective To investigate the expression of a novel imprinted gene,PEG10,in human gastric adenocarcinoma,and the effect of PEG10 on cell growth and proliferation of gastric cancer cells.Methods The PEG10 mRNA expressions in 40 human gastric adenocarcinoma,the corresponding adjacent normal tissues and 6 nomal gastric tissues were detected by RT-PCR.The expression vectors of PEG10 were constructed and transfected into gastric cancer cell line MKN45 which had no endogenetic PEG10 expression.Cell growth ability was measured by MTT assay.Results High PEG10 mRNA expression level was detected in 9 of 20(45.0%) human gastric adenocarcinoma which was significantly higher than those of the matched normal tissues(10.0%)(P

0.05). At day 30 after operation,half-pipe blockage occurred,and some yellow-green sediments were observed on the pipe wall in the straight tube group; a few of yellow-green sediments were found at top of wall,and some white floc sediments were observed in lumen but nothing was observed on valve in the venous valve tube group; a few of yellow-green sediments were found on pipe wall near the living valve,and some white floc sediments were observed in bile in the living valve tube group. At day 30 after operation,epithelium of mucous membrane was not intact,and gland proliferated lightly in the straight tube group; epithelium of mucous membrane was generally intact,and proliferation of gland was not found in the venous valve tube group; epithelium of mucous membrane was exactly intact,and glandular epithelial cells were not heteromorphism in the living valve tube group. CONCLUSION:The artificial bile ducts with a valve structure and living value structure has a good patency and plays an effective role of anti-reflux after a short-term observation,suggesting that a valve structure acts as a similar function to Oddis sphincter.

SUMMARY Intravesical bacillus Calmette-Guérin ( BCG) was a common treatment for non-muscle inva-sive urothelial carcinoma of the bladder. The complication of prostatic abscess was rare. We reported a case of tuberculous prostatic abscess after BCG therapy. A 65-year-old man was diagnosed as bladder cancer and accepted transurethral resection of bladder tumor ( TURBT) treatment. He received a 6-week induction course without any infection complication. Following the second BCG maintenance instillation, he complained of fever and dysuria. Transrectal ultrasound ( TRUS) demonstrated a well-defined complex mass in the right lobe of his prostate. The diagnosis of tuberculous prostatic abscess was considered after excluding other bacterial infection. The patient was treated with an anti-tuberculous regimen of isoniazid, rifampicin, and ethambutol. The symptoms were relieved after 4 weeks of anti-tuberculous therapy. Be-cause of the good response to the medicine, no further aspiration or drainage of prostatic abscess was car-ried out. The anti-tuberculous therapy had to be stopped for serious drug induced liver injury after 6 weeks of anti-tuberculous therapy. Eight weeks later of stopping anti-tuberculous therapy, the follow-up TRUS showed the disappearance of the prostatic abscess and the test of his liver function was normal. Considering the virulence of BCG is weaker than that of common tuberclebacillus, the shorter course of anti-tuberculous therapy maybe an alternative choice, and surgical drainage is not always necessary.

Objective To detect the expressions of enhancer of zeste homology 2 (EZH2) and signal transducer and activator of transcription 3 (STAT3) in gastric cancer tissues,and analyze the relationship between their expressions and clinicopathological factors and prognosis of patients.Methods The clinical data of 67 patients with gastric cancer who were admitted to the People's Hospital of Peking University from May 1999 to April 2000 were retrospectively analyzed.Gastric cancer tissues and adjacent normal tissues were harvested and fixed in 4％ formaldehyde,and then to make the tissue chips.The protein expressions of EZH2 and STAT3 were detected by immunohistochemical staining,and the relationship between the expressions of EZH2 and STAT3 and the prognosis of patients was analyzed.The correlation between the protein expressions of EZH2 and STAT3 in the gastric and colorectal tissues and the clinicopathological parameters was analyzed using the paired chi-square test.The survival curve was drawn by Kaplan-Meier method,and the survival rate was analyzed by using the Logrank test.The relationship between the clinicopathological factors and the prognosis of patients was analyzed using the COX proportional hazard model.Results The positive protein expression rates of EZH2 and STAT3 in the gastric cancer tissues were 73.1％ (49/67) and 67.2％ (45/67),which were significantly higher than 32.8％ (22/67) and 37.3％ (25/67) in the adjacent normal tissues (x2=21.839,11.964,P ＜0.05).The protein expression of STAT3 was correlated with the age,TNM staging,lymph node metastatic status (x2=5.475,9.998,5.475,P ＜ 0.05).The protein expression of EZH2 was correlated with TNM staging and lymph node metastatic status (x2=11.573,5.902,P ＜ 0.05).The co-expression rate of EZH2 and STAT3 proteins was 73.1％ (49/67),EZH2 and STAT3 had the common expression trend (r =0.397,P ＜ 0.05).The co-expression rate of EZH2 and STAT3 was increased as the increase of TNM stages,and the co-expression of EZH2 and STAT3 in the gastric cancer tissue was correlated with the TNM stages (x2 =6.997,P ＜ 0.05).The 5-year survival rate of patients with low protein expression of EZH2 was significantly higher than those with high protein expression of EZH2 (x2=7.386,P ＜ 0.05).The 5-year survival rate of patients with low proteins expression of STAT3 was significantly higher than those with high proteins expression of STAT3 (x2=12.253,P ＜ 0.05).The 5-year survival rate of patients with low co-expression of EZH2 and STAT3 protein was significantly higher than those with high co-expression of EZH2 and STAT3 proteins (x2 =8.765,P ＜ 0.05).The results of univariate analysis showed that age,TNM staging,EZH2 and STAT3 expression,lymph node metastasis and distal metastasis were the factors influencing the survival of patients with gastric cancer (RR =2.136,3.452,3.179,8.341,11.773,6.873,P ＜0.05).The results of multivariate analysis showed that TNM staging and STAT3 expression were independent factors influencing the prognosis of patients with gastric cancer (RR =2.453,7.535,P ＜ 0.05).Conclusions There is significant correlation between EZH2 and STAT3 protein expressions in gastric cancer tissues,and co-expression of EZH2 and STAT3 is associated with the TNM staging and the prognosis of the patients with gastric cancer.

Objective: Testicular mixed germ cell tumor is mixed with embryonal carcinoma, choriocarcinoma, yolk sac tumor, teratoma, seminoma and other two or more components of the testicular tumor, the clinical is relatively rare and high degree of malignancy, this article will summarize its clinical features and optimize its treatment.Methods: A retrospective analysis of the clinical data of 22 patients with testicular tumor mixed germ cell in Peking University Third Hospital from May 1994 to November 2016 was conducted using a combination of statistical analysis and discussion of the relevant literature.Results: The mean age of the 22 patients was (30.8±10.4) years and the rate of cryptorchidism was 13.6%.The maximum diameter of the tumor was (5.1±2.7) cm.The pathological results suggested that 12 cases (54.5%) contained two different germ cell tumor components, 7 cases (31.8%) contained 3 different tumor components, 2 cases (9.2%) contained 4 different tumor components, and 1 case (4.5%) contained 5 different tumor components.Tumor constituent analysis included yolk sac tumors(16 cases, 72.7%), mature teratoma (7 cases, 31.8%), immature teratoma (5 cases, 22.7%), embryonal carcinoma (17 cases, 77.3%) , choriocarcinoma (4 cases, 18.1%) and seminoma (6 cases, 27.3%).American Joint Committee of Cancer tumor staging indicated 19 cases of stage Ⅰ a tumor, 2 cases of stage Ⅱa tumor and 1 case of stage Ⅲa tumor.The mean values of human chorionic gonadotropin, alpha-fetoprotein and lactate dehydrogenase were 414.50 MIU/mL, 242.95 μg/L, 196.95 U/L (preoperative) and 17.20 MIU /mL, 90.20 μg/L, 183.70 U/L (postoperative within a year), and the comparison of the P values between the preoperative and the postoperative within a year were 0.079, 0.043 and 0.624.Fourteen patients underwent retroperitoneal lymph nodes dissection.Most patients lived with long-term survival (94.4%) after operation.Conclusion: Comprehensive treatment of radical orchiectomy with retroperitoneal lymphadenectomy combined with necessary radiotherapy or chemotherapy might help to control the tumor and achieve long-term survival for most patients with testicular mixed germ cell tumor.

Objective To report a multiple metastatic renal cell carcinoma (RCC) case successfully treated with cytoreductive nephrectomy after neoadjuvant Sunitinib,and discuss the efficacy and treatment regime of neoadjuvant targeting therapy.Methods A 51 years man presented with painless gross hematuria for one week and admitted into our hospital in August 2010.Abdominal CT demonstrated a 6.6 cm ×6.3 cm left lower pole renal tumor associated with renal vein tumor thrombus,bulky hilar lymph nodes and extensive local invasion.The patient was also found to have lung and right tibial metastasis.The clinical stage was T3bN1 M1.Percutaneous biopsy confirmed clear cell renal carcinoma.Neoadjuvant Sunitinib 50 mg daily was administered with 4 weeks on,2 weeks off schedule for two cycles.Cytoreductive nephrectomy was preformed 2 weeks after discontinuation of neoadjuvant Sunitinib.Imaging evaluation was performed to assess the primary tumor and metastatic sites.The patient was followed up till present.Results After two cycles of neoadjuvant treatment,CT scan revealed 23％ size reduction of left renal tumor to 5.1 cm ×4.4 cm,renal vein tumor thrombus regression,local perirenal invasion improvement,lung metastasis resolution and static right tibial metastasis.According to RECIST criteria,the objective response was stabilization of disease (SD).Cytoreductive nephrectomy was successfully performed to remove the primary tumor in December 2010.Pathology revealed Fuhrman Ⅱ renal cell carcinoma with major necrosis in primary tumor and thrombus localized in renal vein.During 6 months of post-operative follow-up,there was no local recurrence,lung metastasis had vanished completely and tibial metastasis had not progressed.Local recurrence and other distant metastasis were not demonstrated in 20mon follow-up till now.Disease control of this patient was partial response (PR) by RECIST.Conclusions Neoadjuvant Sunitinib treatment could result in downstaging of primary tumor and facilitate cytoreductive nephrectomy,thus eventually increase patient overall survival.

Objective To investigate the effects of Houpupaiqi mixture on the recovery of gastrointestinal function after open gastrointestinal surgery,and evaluate the efficacy and safety of Houpupaiqi mixture.Methods A total of 144 selected patients who underwent open gastrointestinal surgery were enrolled into the multi-center prospective randomized double-blind controlled clinical trial from October 2010 to September 2011.Of the 144 patients,66 were from People's Hospital of Peking University,72 were from Beijing Friendship Hospital of Capital University of Medical Sciences,and 6 were from People's Hospital of Guangdong Province.All the patients were randomly divided into 2 groups (test group:96 patients,control group:48 patients) at the ratio of 2∶1 according to the random number table.Five patients who did not meet the criteria were excluded from the study,and then there were 92 patients in the test group and 47 patients in the control group.The study was assessed by the ethics committees,and all the patients signed the informed consent form.Houpupaiqi mixture (50 ml) or placebo (50 ml) were administered in the test group and control group at postoperative 16 and 20 hours,respectively.Parenteral and enteral nutritional support were given after pulling out of gastric tube.A standard intravenous analgesia was applied in the 2 groups,and agents which stimulate or suppress gastrointestinal motility were prohibited.The time for the recovery of regular bowel sounds,the first exhaust and first defecation time,and the time of first solid food intake of the 2 groups were recorded.Vital signs were recored before operation and after drug administration.Blood and urinary routine test,hepatic and renal function test,electrocardiogram examination,record of adverse drug event were carried out at postoperative day 6.The time for the indexes above and relevant frequencies were calculated,and the survival curve were drawn by Kaplan-Meier method.All the time points were analyzed using the Log-rank test.The measurement data were analyzed using the t test or rank-sum test,and the enumeration data were analyzed using the chi-square test or Fisher exact probability.Results The median time for the recovery of regular bowel sounds,median time for first exhaust and defecation were 21.4 (20.0,23.7)hours,45.0 (40.0,54.0) hours and 65.5 (54.7,74.0) hours in the test group,and 47.5 (44.0,56.5) hours,91.0 (87.0,93.8)hours,98.0 (94.0,113.5)hours in the control group,there were significant differences between the 2 groups (Log-rank values =21.67,53.15,11.81,P＜0.05).The median time of first solid food intake were 72.5 (66.2,110.5) hours of the test group and 116.3 (114.8,117.3) hours of the control group,with no significant difference between the 2 groups (Log-rank value =13.70,P ＞ 0.05).There were no significant differences in the body temperature,respiration,heart rate,systolic blood pressure and diastolic blood pressure before and after medication between the 2 groups (Z =0.03,0.68,0.97,0.22,0.72,P ＞ 0.05).There were no significant differences in the number of patients with abnormal results of blood test,hepatic function,renal function and electrocardiogram between the 2 groups (P ＞ 0.05).No severe adverse event was observed in the clinical trial.Conclusion Houpupaiqi mixture significantly promotes the recovery of gastrointestinal function of the patients who underwent open gastrointestinal surgery with relatively low adverse events.

Objective To investigate the characteristics of decision-making impairment in male patients with heroin dependence in methadone maintenance treatment(MMT). Methods A total of 45 male patients in MMT were compared with matched 32 health controls on the Iowa Gambling Task. Results Participants with anxiety or depression had to be excluded, MMT subjects were required to have negative urine toxicology screening tests.The MMT group selected more net disadvantageous cards (number of cards selected from the disadvantageous decks minus number of cards selected from advantageous decks) than health controls( (9.11 ± 19.60, -4.25 ±10.27 respectively), t=3. 884, P＜0.01). A 2(group) ×5(block) ANOVA (analysis of variance) on the cards of net disadvantageous from the gambling task revealed a significant main effect of group( F= 12.414, P＜0.01 ).The ANOVA also revealed a significant main effect of block( F=6.871, P＜0.01 ). The study indicated the totalnumber of net disadvantageous cards for MMT subjects was negative correlation to the age of initial drug use ( r=- 0. 320, P ＜ 0. 05 ). Meanwhile, methadone dose and the time of enrollment MMT did not reveal a significant main effect on decision-making biases. Conclusion The deficit of decision making for male heroin dependent patients might be attributed to the dysfunction of the ventromedial prefrontal cortex, and this effect does not resolve with abstinence, even very long term abstinence. Methadone may not get worse this impairment in male patients who have a history of heroin use during maintenance treatment intervention.

Objective To evaluate the clinical efficacy of transpedicular intracorporeal bone graft with allogenic bone in treatment of thoracolumbar osteoporotic compression fracture. Methods A total of 45 patients with thoracolumbar osteoporotic compression fractures were treated with posterior short segment pedicle screw fixation and transpedicular intracorporeal bone graft with allogenic bone. Anteroposte-rior and lateral X-ray photographs were taken before and after operation and at follow up period to determine the ratio of anterior and middle compressed body height to the normal height, the vertebral angle and the superior-inferior endplate angle. The extent of local pain was measured by VAS score. The implant failure was also recorded during follow-up. Results The operative reduction and interbody bone grafting exerted a satisfactory effect on the ratio of anterior and middle body height to the normal height, the vertebral angle and the superior-inferior endplate angle. Local back pain disappeared immediately after surgery in 34 patients out of 38 patients followed up for more than two years. No implant failure was found during follow-up. Conclusions Early treatment with posterior short segment pedicle screw fixation and transpedicular intracorporeal bone graft with allogenic bone can effectively correct local deformity, prevent late vertebral collapse and implant failure and is an ideal treatment method for thoracolumbar osteoporotic compression fracture.