Objective To explore prognostic factors of renal cell carcinoma and investigate the association of neutrophil-to-lymphocyte ratio (NLR) with the prognosis of renal cell carcinoma (RCC) in patients who received nephrectomy treatment.Methods We retrospectively reviewed the records of 1325 patients with renal cell carcinoma who underwent nephrectomy between January,2008 and December,2012.We retrospectively analyzed the clinicopathologic characteristics of patients.The optimal cutoff value for NLR was determined using receiver operating characteristic curve (ROC) analysis.We defined them as high NLR group when NLR ≥ 2.7 and low NLR group when NLR ＜ 2.7.Overall survival (OS) and recurrence free survival (RFS) were estimated using the Kaplan-Meier method and compared using the logrank test.Multivariate models were used to analyze the association of NLR with clinicopathologic outcomes.Results By the end of the study, 1220 cases were followed up.The follow-up rate was 92.1％.Mean follow-up was 40 months (range 2 months to 87 months).The three-year and five-year overall survival rate were 91.3％ and 86.9％, respectively.Meanwhile the three-year and five-year recurrence free survival rate were 88.2％ and 85.8％ ,respectively.2.7 was selected as the optimal cutoff value to differentiate between low NLR and high NLR.A NLR ≥2.7 was significantly associated with worse 5-year overall survival and worse 5-year recurrence free survival than a NLR ＜2.7,91.4％ vs 87.3％ ,89.6％ vs 71.9％ (P ＜0.05).Age ＞65, presentation mode with symptom, higher tumor stage, higher Fuhrman grade,histologic subtype,neutrophil count ≥ 4.5, lymphocyte count ＜ 1.7, NLR ≥ 2.7 significantly correlated with poor OS on univariate analysis.Multivariate analysis revealed that higher tumor stage, preoperative NLR ≥ 2.7 at diagnosis were poor independent prognostic factors for OS of renal cell carcinoma.Conclusion High NLR was independent poor predictor of renal cell carcinoma.

Objective To investigate the therapeutic effect of Liangxue-jiedu decoction on acute-on-chronic liver failure(ACLF)model mice and the Toll-like receptor 4(TLR4)/c-Jun amino terminal kinase(JNK)/nuclear factor κB(NF-κB)signaling pathway.Methods An ACLF mouse model was established using combined treatment of carbon tetrachloride,lipopolysaccharide,and D-galactosamine.Biochemical analysis was performed to evaluate liver function indicators,including alanine aminotransferase,aspartate aminotransferase,and total bilirubin.Histopathological examination was conducted to assess liver tissue morphological changes.Quantitative PCR was used to detect the mRNA expression of tumor necrosis factor alpha(TNF-α),interleukin(IL)-6,IL-1 β,and TLR4 in liver tissues.A CCK8 assay was used to evaluate the optimal interventional concentration of Liangxue-jiedu decoction on Raw 264.7 cells.Enzyme-linked immunosorbent assay was used to detect the contents of TNF-α,IL-6,and IL-1βin the cell supernatant.Protein immunoblotting was performed to measure the expression of TLR4/JNK/NF-κB signaling pathway-related proteins,including TLR4,NF-κB,p-ERKl/2,ERK1/2,p-JNK,and JNK.Results Compared with the ACLF model group,the Liangxue-jiedu decoction-treated group showed reduced cell necrosis,fibrosis,and inflammatory cell infiltration in liver tissues;decreased serum levels of alanine aminotransferase,aspartate aminotransferase and total bilirubin;and lower expression of TNF-α,IL-6,IL-1β,and TLR4 mRNA.Liangxue-jiedu decoction reduced TLR4/JNK/NF-κB signaling pathway-related protein expression in liver tissues.The in vitro result also showed that Liangxue-jiedu decoction reduced TNF-α,IL-6,and IL-1 β secretion by macrophage cells and down-regulated the expression of TLR4/JNK/NF-κB signaling pathway proteins.Conclusions Liangxue-jiedu decoction effectively improved liver function in ACLF mice in a manner closely related to the downregulation of TLR4/JNK/NF-κB pathway proteins.

Objective:To investigate the clinical characteristics and treatment analysis of unicentric retroperitoneal Castleman's dis-ease (CD) and to improve its levels of diagnosis and treatment. Methods:The clinical data of 18 patients with unicentric retroperitone-al CD were retrospectively reviewed from January 2002 to December 2016. We analyzed the demographic characteristics, clinical fea-tures, histological diagnosis, treatment, and prognostic characteristics of these patients. Results:The patients comprised 4 males and 14 females with a median age of 44.1 years old (ranging from 24 years old to 70 years old). The tumor was located in the kidney in one case, while it was located in the adrenal region in eight cases. In the other cases, the tumor was in the retroperitoneal region. Seven patients had a clinical atypical abdominal pain, and one patient had moderate anemia. All patients underwent surgical resection. The mean operation time was 153.3 min with a range of 60 min to 260 min. The mean blood loss was 447.2 mL (ranging from 10 mL to 3000 mL). Two cases had blood transfusion after operation, and one had urinary fistula complication. CD was confirmed by histopathol-ogy. Hyaline vascular type of CD was observed in 16 cases, and mixed type of CD was observed in 2 cases. The median follow-up was 25 months. One patient had tumor recurrence after 2 years of operation and died. Other patients remained alive without recurrence. Conclusion:Unicentric retroperitoneal CD is a rare disease that is often misdiagnosed because of the absence of specific clinical mani-festations. The final diagnosis depends on the results of a pathologic examination. Complete surgical resection offers a favorable result for unicentric retroperitoneal CD.

Objective To assess the effect of ascorbic acid/ferric chloride (AA/FeCl3) in attenuating cartilage damage in rats with osteoarthritis. Methods Thirty adult male Wistar rats with surgically induced osteoarthritis were randomized into 2 groups for treatment with intra-articular injection of saline (control group) or AA/FeCl3 mixture (AA group) once a week starting from the third week after the operation. At 6, 9, and 12 weeks after the operation, 5 rats from each group were sacrificed for observing subchondral bone changes on X-ray films and evaluation of cartilage degeneration in the right knee joints using safranin-O/Fast green staining and a modified OARSI scoring system. The degradation of the cartilage matrix was observed by immunohistochemical staining for type II collagen. Results X-ray examination in saline control group revealed the presence of osteophytes and narrowing of the joint space at 9 weeks, and the joint line disappeared at 12 weeks after the surgery; only slight irregularity of the articular surface was observed in the AA group at 9 and 12 weeks. OARSI scores were significantly lower in AA group than in the control group at 9 weeks (18.67 ± 0.67 vs 12.17 ± 2.75;P<0.05) and 12 weeks (20.11 ± 1.84 vs 13.77 ± 0.40;P<0.05) but not at 6 weeks after the surgery. The content of type 2 collagen in AA group was significantly higher than that in the control group at 6 weeks (0.36 ± 0.039 vs 0.49 ± 0.029;P<0.05) and 9 weeks after the surgery (0.25 ± 0.041 vs 0.38 ± 0.040;P<0.05). Conclusions Early intra-articular injection of AA/FeCl3 can effectively delay the progression of post-traumatic osteoarthritis in rats.

Objective To assess the effect of ascorbic acid/ferric chloride (AA/FeCl3) in attenuating cartilage damage in rats with osteoarthritis. Methods Thirty adult male Wistar rats with surgically induced osteoarthritis were randomized into 2 groups for treatment with intra-articular injection of saline (control group) or AA/FeCl3 mixture (AA group) once a week starting from the third week after the operation. At 6, 9, and 12 weeks after the operation, 5 rats from each group were sacrificed for observing subchondral bone changes on X-ray films and evaluation of cartilage degeneration in the right knee joints using safranin-O/Fast green staining and a modified OARSI scoring system. The degradation of the cartilage matrix was observed by immunohistochemical staining for type II collagen. Results X-ray examination in saline control group revealed the presence of osteophytes and narrowing of the joint space at 9 weeks, and the joint line disappeared at 12 weeks after the surgery; only slight irregularity of the articular surface was observed in the AA group at 9 and 12 weeks. OARSI scores were significantly lower in AA group than in the control group at 9 weeks (18.67 ± 0.67 vs 12.17 ± 2.75;P<0.05) and 12 weeks (20.11 ± 1.84 vs 13.77 ± 0.40;P<0.05) but not at 6 weeks after the surgery. The content of type 2 collagen in AA group was significantly higher than that in the control group at 6 weeks (0.36 ± 0.039 vs 0.49 ± 0.029;P<0.05) and 9 weeks after the surgery (0.25 ± 0.041 vs 0.38 ± 0.040;P<0.05). Conclusions Early intra-articular injection of AA/FeCl3 can effectively delay the progression of post-traumatic osteoarthritis in rats.