Objective To evaluate the efficacy and safety of itraconazole injection in treatmeat of invasive fungal infections.Methods The clinical trial was conducted in 16 patients(17 times)with invasive fungal infection from August 2003 to August 2005,including 1 case confirmed,11 cases(12 times)suspected and 4 cases for empiric treatment.They were treated with iv itraconazole injection in a dose of 200 mg twice daily in the first and the second day,from the third day to 14th day they were given iv itraconazole injection in a dose of 200 mg once daily,and then treated with capsule in a dose of 200 mg twice daily for another 28 days.Two cases were treated with iv itraconazole injection in a dose of 200 mg twice daily for 9 days and 14 days;1 case in a dose of 200 mg once daily for 21 days.Results 62 strains were isolated from 16 patients with invasive fungal infection,including 40 strains in urine cultivate,and 21 strains of tropic candida were primacy.In confirmed and suspected patients,the cure rate was 6/13,the effective rate was 11/13 and the eradication rate was 6/13.The incidence of adverse reaction was 3/24.Conclusion Itraconazole injection is effective and safe in treatment of severe invasive fungal infections,especially in severe ill,old patients for long time use.

Objective To investigate the role of hexosamine biosynthesis pathway (HBP) in the functionalalterationofmesangialcellstransinfectedwith glucose transporter 1 (GLUT1) gene. Methods Rat mesangial cells were transinfected with the human GLUT1 gene (MCGT1) by retrovirus vector. Mesangial cells transinfected with bacterial ?-galactosidase (MCLacZ) were used as control. Glucose uptake was detected with 2-deoxy-〔 3H〕-D-glucose (2-DG). Cell size, RNA/DNA ratio, protein/DNA ratio and the synthesis of fibronectin were evaluated by flow cytometry. The activity of glutamine: fructose-6-P aminotransferase (GFAT), which is the key enzyme of HBP, was assayed by spectrophotometry. The expression of GFAT gene was analyzed by RT-PCR. Results MCGT1 demonstrated higher 2-DG uptake than MCLacZ 〔(741.0?60.5)dpm/?g protein vs (92.2?9.0)dpm/?g protein,P

Background and purpose:Carcinoembryonic antigen(CEA) is mainly used in post-surveillance of colorectal cancer(CRC). Recently, bile CEA assay was reported to be of value in the diagnosis of OHM(occult hepatic metastasis) in CRC. We measured CEA levels in both peripheral vein and bile from patients with CRC to evaluate the change of bile CEA levels in patients with CRC and its relation to liver metastasis (LM). Methods:Three groups were enrolled in our study. Primary CRC Group: 27 patients with CRC but without LM; LM Group: 14 patients with LM from CRC; Control Group: 20 patients with benign biliary diseases (cholelithiasis or cholecystitis). Both serum and bile were collected to measure CEA levels in all groups but only bile CEA was measured in control group. Results:Bile CEA level in control group, primary CRC group and LM group were 1.73 ng/ml,13.7 ng/ml and314.27 ng/ml respectively, (P

Urethral reconstruction is required in congenital abnormalities such as hypospadia and urethral stricture caused by trauma or infection. The development of tissue engineering has brought new hope to the field of urethral reconstruction. Much progress has been made in the experimental and clinical research of using tissue engineering for urethral reconstruction as well as the research of the scaffold materials. This review focuses on the recent progress in this field.

The development of tissue engineering has provided new methods for organ replacement and disease treatment.The research of seed cells includes cell selection,culture,transplantation,tracing and so on.The tracing technique of seed cells involves molecular biology,molecular immunology,molecular imaging and many other subjects,making it difficult to select a label for seed cells.This review summarizes the recent research progress in the tracing technique of seed cells.

Objective To improve the diagnosis and treatment of primary adrenocortical carcinoma. Methods Retrospective analysis was performed in clinical data of 16 patients with primary adrenocortical carcinoma. The diagnosis was based on clinical presentations,hormonal studies and imaging. Surgical treatment was underwent on 13 cases. All patients were followed up for 3 to 62 months. Results Of 16 cases,functional tumors were in 8,including Cushing′s syndrome in 5,combination of Cushing′s syndrome and virilization in 2,and hyperaldosteronism in 1. Imaging studies revealed the tumors were 4.8 to 19.5 cm in diameter,average in 7.8 cm. Distant metastasis occurred in 3 cases. Radical surgery was done in 13 cases without distant metastasis,including radical adrenalectomy in 8,adrenalectomy plus nephrectomy in 2,adrenalectomy plus surgical extirpation of intracaval tumor thrombus in 2,and partial resection of the wall of inferior vena cava in 1. Pathologic stages were stage Ⅰ in 2 cases,stage Ⅱ in 8,stage Ⅲ in 3,stage Ⅳ in 3. Among the 11 cases who were treated over 2 years after operation,6 cases were still survival,while 1 case had pulmonary and 1 case had bone metastasis. The other 5 cases survive in average of 26 months. Conclusions Prognosis of primary adrenocortical carcinoma is poor. The keys to early diagnosis are clinical manifestations plus imaging. Surgical treatment is the only effective therapy for the disease.

Objective To evaluate the clinical value of cystectomy with prostate capsule sparing in orthotopic bladder replacement for bladder cancer. Methods A total of 56 male patients (mean age,62 years) with bladder cancer were included.Of them 40 cases were of primary tumors and 16 were of recurrent ones.Pathology by cystoscopy and biopsy showed transitional cell carcinoma in 53 cases and squamous cell carcinoma in 3.According to the analysis of B ultrasound,CT,MRI and cystoscopy, they were clinically diagnosed as recurrent multiple superficial tumors (n=27) and invasive tumors (n=29).Radical cystectomy with prostate capsule sparing was performed on them.Detubularized ascending colon (20 cases) or ileal segment (36 cases) was used to form a neobladder,which was anastomosed with distal portion of prostate capsule. Results Mean operative time of ascending colonic neobladder and ileal neobladder was 5 h 50 min and 6 h 20 min,with blood loss of 580 ml and 540 ml,respectively.Pathology showed pT 1N 0 in 28 cases,pT 2N 0 in 25 and pT 3N + in 3.During the follow up of 4 to 102 months (mean,42 months) 3 patients of pT 3N + died of bladder cancer and 5 died of other diseases.The cancer specific 5 year survival was 94% in cases of T 1N 0,83% in T 2N 0.At 1 year follow up,17 out of 18 patients (94%) with ascending colonic neobladder and 30 out of 30 patients (100%) with ileal neobladder were fully continent during the day,and 46 (96%) voided 1 to 2 times at night and could stay dry.Of 31 patients with preoperative adequate sexual function, 23 (74%) maintained potency postoperatively. Conclusions Radical cystectomy with distal prostate capsule sparing and reconstruction with an orthotopic neobladder is a relatively safe and reliable surgical procedure.It can improve the continence and potency without compromising the principle of tumor control.

Background and purpose: As the most common tracer used for PET/CT to detect malignant tumors. ~(18)F-fluorodeoxyglucose (~(18)F-FDG) can reflect the metabolism of glucose. However, there exists physiologic uptake in the intestinal tract of healthy people. Because ileocecal foci is predilection site of malignant tumors and inflammatory disease, the purpose of this study was to investigate the discrimination of PET/CT detection of incidental ileocecal high FDG uptake. Methods: We retrospectively analyzed 28 unexpected ileocecal focal uptake of ~(18)F-FDG localized by PET/CT, and then semi-quantitatively analyzed the extent of radioactive uptake in ileocecal foci. After PET/CT, the etiology of the findings was confirmed histologically by surgery, endoscopic or by long-term follow-up. All the data were assessed for statistical significance using one-way ANOVA. Results: In all the ileocecal foci, there were 14(50%) physiologic FDG uptake, 8 (28.6%) benign diseases and 6 (21.4%) malignant tumor. Maximal standardized uptake value was 5.2±1.6 in physiologic uptake, 6.8±4.1 in benign lesions and 12.8±5.5 in malignant lesions. There was statistically significant difference between malignant tumors and the other 2 groups. According to ROC analysis, when SUN_(max) was 6.75, the sensitivity and specificity of ileocecal malignant tumor were 100% and 86.4%, respectively. Conclusion: The significant value of discrimination between benign and malignant lesions of ileocecal focal FDG uptake by PET/CT was affirmative. It is very important to recognize physiologic uptake of ileocecal conjunction in the interpretation of image. Semi-quantitative analyze was not helpful to identify benign lesions from physiologic uptake.

Background and purpose: 18F-FDG has been considered to be of limited value for the detection of bladder lesions because of interference by the 18F-FDG excreted in urine. Delayed pelvic images with“diluted and iflled bladder”use a method of 18F-FDG PET/CT with delayed images after oral hydration so as to increase the detection rate of 18F-lfuorodeoxyglucose(FDG) PET/CT imaging for the lesions of bladder. Methods:48 patients with bladder lesions(35 patients with bladder primary tumor and 13 patients with metastatic tumor) underwent 18F-FDG PET/CT detection and were required oral hydration of 1200-1800 mL water, urination frequently, holding urine when the more scan began. Lesions conifrmed by histopathology, MRI, CT or clinical follow-up at least 1 year. Results:89%(43/48) of patients were obtained good clearance and the urine SUVmax declined from 33.14(9-66.80)to 3.23(1.35-5.65) signiifcantly and the statistical difference was signiifcant (t=8.703, P<0.01). The interval time between two scan was 2 h approximately. At the same time, the SUVmax of bladder lesion was 2.8-25.0. Detection sensitivity, speciifcity and accuracy were 90.47%(19/21), 81.48%(22/27)and 85.41%(41/48), respectively. Conclusion: 18F-FDG activity in the bladder signiifcantly decreased in most patients with“diluted and iflled bladder”. The PET/CT scan can highly detect lesions of bladder tissues. Our method with high accuracy and better endurance could be applied to detect the lesions in bladder.

Objective To investigate the relationship between bladder outlet obstruction(BOO) and serum prostatic specific antigen(PSA) in patients with benign prostatic hyperplasia(BPH).Methods The study of pressure-flow urodynamic examination,IPSS score and serum PSA were performed in 253 cases with BPH.Results Based on the bladder outlet obstruction index(BOOI),all patients were divided into three groups: Definite BOO group had 156 patients,mild BOO group had 61 patients,no BOO group had 36 patients.The data of tPSA were(4.54?1.71) ?g/L,(2.45?1.74) ?g/L and(1.85?1.71) ?g/L respectively,there were significant differences between definite BOO group and other two groups(P0.05).Conclusion As a easy detection index,serum PSA may partially reflect the severity of BOO,combined with IPSS score,uroflow, type of B supersonic wave,it would give some guide for patients with BPH to select therapies and judge the prognosis.