The golden standard for the treatment of invasive bladder cancer is radical cystectomy. However its application is limited in certain circumstances because of surgical trauma,complications,and impacts on quality of life. As organ preservation protocols have become the standard in the treatment of some malignancies such as breast cancer、anal cancer、esophageal cancer,the multimodality treatment with bladder preservation was introduced to cure invasive bladder cancer, which can retain normal bladder function without a marked compromise of overall survival and is a viable, reasonable alternative for the treatment of invasive bladder cancer. This review highlights the advances in multimodality treatment with bladder preservation for invasive bladder cancer.

Objective To observe the efficacy and safety of albumin-bound paclitaxel on the patients with advanced malignance in more than the third-lines (including the third-lines).Methods 34 patients with advanced malignance diagnosed by pathological evidence accepted more than the third-lines (including the third-lines) chemotherapy containing albumin-bound paclitaxel after failure of chemotherapy.The efficacy and safety were observed.Results Totally 110 cycles chemotherapy were completed,with a mean of 3.24 cycles in each of the 34 patients.No CR patients,12 cases of PR,9 cases of SD and 13 cases of PD were found.The response rate (RR) was 35.29 ％ (12/34) and the disease control rate (DCR) was 61.76 ％ (21/34).The main toxicity was hematologic toxicity,including neutropenia in 26 cases (76.47 ％),anemia in 14 cases (41.18 ％) and thrombocytopenia in 3 cases (8.82 ％).Other common adverse reactions included alopecia in 27 patients (79.41％) and muscle and joint pain in 15 cases (44.18 ％).Conclusions The albumin-bound paclitaxel is effective and tolerable in patients with advanced malignance in more than the third-lines (include the thirdlines) chemotherapy.

Idiopathic macular hole after the internal limiting membrane (ILM) is removed during surgery, the intraoperative optical coherence tomography can be used to observe the presence of debris tissue (RF) protruding into the vitreous cavity at the edge of the hole. Current studies suggest that RF may be caused by epiretinal proliferation and vitreomacular traction, but it is still controversial, and the influence of postoperative anatomical and functional recovery is not clear. Common points can still be found, some of the studies suggest that RF is not conducive to postoperative anatomical and functional recovery during the operation, ILM fragments remain on RF tissues after ILM peeling and re-staining. However, in some studies suggest that RF is beneficial to postoperative anatomical and functional recovery, and ILM fragments on RF are removed. This suggests that whether ILM is removed on RF lead to a certain influence on the postoperative efficacy. There are few researches on RF at present, so it is necessary to understand RF from its essence and assist judgment through histological analysis.

Objective To explore the relationship between serum tumor markers and cervical cancer by using Logistic regression, and to further establish the diagnosis model of squamous cell carcinoma antigen (SCC) in cervical cancer by using chi-squared automatic interaction detector (CHAID) analysis of decision tree.Methods Total of 581 cases of cervical cancer,342 cases of cervical benign diseases and 341 cases of healthy controls who detected tumor markers in Taizhou Hospital of Zhejiang during 2010-2013, were retrospectively studied.The test results of carbohydrate antigen 199 (CA199), carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), SCC, and alpha fetoprotein (AFP) were reviewed.The Logistic regression were firstly used in screening the related tumor markers of cervical cancer, and then the CHAID method of decision tree was used in determining the values of the related tumor markers on the diagnosis of cervical cancer.The SCC elevated cases of uterine disease from January 2014 to December 2014 were collected to verify the diagnostic value of SCC in cervical cancer patients.Results Logistic regression analysis showed that among the 5 tumor markers which might be associated with cervical cancer, SCC was the only one which had statistical significance between cervical cancer and cervical benign diseases (Wald x2 =22.120,P =0.000), the OR and its 95％ CI was 1.900 (1.454-2.483).With the SCC numerical increases, the proportion of patients with cervical cancer also gradually increased, when SCC ＞ 2.20 μg/L, the positive predictive value was 94.7％.In 284 cases of SCC higher than 2.20 μg/L who considered as uterus related diseases, there were 270 cases (95.1％) who were eventually confirmed as cervical cancer.Conclusion There was a good diagnostic value of SCC for cervical cancer patients.

Objective To investigate the clinical efficacy of neoadjuvant chemotherapy combined with radical gastrectomy for advanced gastric cancer.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 73 patients who underwent neoadjuvant chemotherapy combined with radical gastrectomy for advanced gastric cancer at the First Affiliated Hospital of Zhejiang University between June 2004 and December 2009 were collected.Neoadjuvant chemotherapy regimens included XELOX and FOLFOX.Patients received radical gastrectomy within 2 weeks after the completion of the last cycle of neoadjuvant chemotherapy and then continued to undergo postoperative neoadjuvant chemotherapy.Observation indicators:(1) adverse event of neoadjuvant chemotherapy;(2) surgical and postoperative situations;(3) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect survival of patients up to December 2014.Measurement data with skewed distribution were described as M (range).Overall survival time was from the beginning of treatment to death or end of follow-up (patients with loss to follow-up).Progression-free survival time was from the beginning of treatment to tumor progression,recurrence and metastasis or death.The survival curve was drawn by the Kaplan-Meier method.Results (1) Adverse event of neoadjuvant chemotherapy:of 73 patients,38 received XELOX regimens and 35 received FOLFOX regimens,with a median cycle of 3 (range,1-7 cycles).There were 55 adverse events during neoadjuvant chemotherapy,including 47 with grade 1-2 and 8 with grade 3-4.(2) Surgical and postoperative situations:all the 73 patients underwent successful D2 radical gastrectomy for gastric cancer,including 40 receiving total gastrectomy,31 receiving distal gastrectomy,1 receiving total gastrectomy with transverse colon resection and 1 receiving distal gastrectomy with cholecystectomy.Of 73 patients,10 with postoperative complications were improved by conservative treatment,including 3 with pleural effusion,2 with peritoneal effusion,2 with anastomotic bleeding,2 with cholecystitis and 1 with lympha fistula.No patient received reoperations or died within 30 days postoperatively.Pathological TNM staging:22 patients were detected in stage Ⅰ-Ⅱ,45 in stage Ⅲ,4 in stage Ⅳ and 2 in stage T0N1M0.Three patients (in stage T0N0M0) had complete remission.Forty-three patients underwent postoperative chemotherapy.(3) Followup:all the 73 patients were followed up for 8-125 months,with a median time of 51 months.The median survival time,5-year overall survival rate and 5-year disease-free survival rate of 73 patients were 52 months,41.1％ and 34.2％,respectively.Conclusion XELOX and FOLFOX regimens of neoadjuvant chemotherapy combined with radical gastrectomy for advanced gastric cancer are safe and effective.

Objective To evaluate the prognostic value of bilateral inguinal lymph node metastases in node-positive penile cancer. Methods Sixty patients with surgically resected node-positive penile cancer were analyzed. All the patients underwent regional lymph node dissection. Recurrence free survival curves were plotted by Kaplan-Meier method and compared by the Log-rank test. Multivariate survival analysis was performed using Cox regression model. Results Of all the patients, 18 cases had bilateral inguinal lymph node metastases. The 3-year recurrence free survival rate in patients with bilateral invovlement was significantly lower than those with unilateral disease (26.7 % vs 65.3 %, χ2 =10.6, P=0.001). In order to evaluate wether the prognostic significance of bilateral lymph node metastases was dependent of increased number of positive nodes, the two predictors were included in multivariate survival analysis.Both the number of metastatic nodes and bilateral nodal disease were independent prognostic factors (P ＜0.05).Comparisons of survival curves showed those patients with bilateral nodal disease and more than 2 metastatic nodes had worst outcome. Conclusion Bilateral inguinal lymph node metastases is an important prognostic factor in penile cancer irrespective of the number of positive lymph node.

ObjectiveTo explore the efficacy of several skin flaps in treating of the soft tissue defect with or without osteomyelitis at foot in cold environment. MethodsThe damaged foot should be re-warmed immediately. Several kinds of skin flaps were transplanted for 35 cases of soft tissue defect at foot in particularly, among them, 11 cases were with osteomyelitis and bone exposuring. ResultsThere were 31 cases survived by the first intention, 4 case presented partial necroses and healing by dress changing at the second intention. The appearance and function of damaged feet recovered well.ConclusionImmediate re-warming and skin flaps transplant can repair the acute or old soft tissue defect with osteomyelitis in cold environment.

Objective To construct and evaluate a nomogram for predicting the risk of regional lymph node metastases according to pathological features of the primary penile squamous cell carcinoma. Methods The clinical and pathological data of 73 patients who had undergone partial/radical penectomy and ilio/inguinal lymphadenectomy for squamous cell carcinoma of the penis from 1990 to 2005 were retrospectively collected. The expressions of molecular markers (p53, Ki-67, E-cadherin and MMP-9) were determined by immunohistochemistry. A logistic regression model was used to construct the nomogram. Results Tumor grade, the expression level of p53 and lymphovascular invasion were independent prognostic factors of regional lymph node involvement (P<0. 05). The nomogram predicting the risk of metastatic lymph node involvement showed a good concordance index (0. 92) and good calibration. Conclusions Based on the pathological findings of primary tumor, a nomogram to predict the probability of regional lymph node involvement in penile squamous cell carcinoma patients is constructed. This statistical tool is not only helpful in judging individualizing tumor risk, but also in facilitating patients communication in treatment options.

Objective To investigate the expression levels of DNA methyltransferases 1, 3A and 3B in CD4+ T cells of MRL/lpr mice, and explore their relationship with the expression levels of methylation-sensitive genes (ITGAL, CD70). Methods CD4+ T ceils were isolated from spleens of 16-week-old MRL/lpr and BALB/c control mice by anti-CIM antibody labeled magnetic beads. Transcription levels of DNA methyhransferases 1, 3A and 3B and methylation-sensitive genes(ITGAL, CD70) were measured by real-time mice when compared with BALB/c control mice and the difference was significant (P<0.05), while the expression of DNMTI and DNMT3A showed a tendency of decrease (P>0.05). The mRNA expression of CD70 was significantly higher (P<0.01), but the expression of ITGAL had no significant difference between the two P<0.01 ). Conclusion Decreased expression of DNMT3B may attribute to the elevated expression of methylation-seusitive gene CD70, thus lead to the dysfunction of CD4+ T cell and play an important role in the pathogenesis of SLE.

Objective To isolation and identify the pathogen of stem blight of Malvaceae.Methods The stems were collected from stem blight-diseased plants (J) and healthy ones (W) of Abelmoschus manihot (L.) Medic.in Yixing City of Jiangsu Province then cultured to isolate newborn mycelium.The pathogen isolated but unidentified were inoculated in stems of healthy plants of Abelmoschus manihot ( L.) Medic.and pathogenicity was verified.Finally, the pathogenic specie( s) was or were identified by morphological characteristic, rDNA-ITS analysis and polymerase chain reaction (PCR) method.Results The same fungus were excluded which were the same species in J and W, the three fungus of J2, J5 and J6 were acquired.J5 was preliminarily identified to have pathogenicity and it was Fusarium equiseti under the microscope.The genome DNA of J5 was amplified to a length of 524bp, and homology highly with Fusarium equiseti (100%).Conclusion The pathogen was identified as Fusarium equiseti.