Objective To discuss the diagnosis and treatment of renal pelvic carcinoma associated with renal stone.Methods A total of 13 patients,aged from 49 to 73 years old and averaged 59years old.The history of renal stone was 16 years.13 patients accepted B ultrasound check and 1 was found soft tissue occupying.8 patients accepted IVU check and none was found soft tissue occupying.7 patients accepted CT scan and 4 were found soft tissue occupying.The fluorescence in situ hybridization (FISH) examination was done for 2 patients and both were positive.6 patients were found lesions at renal pelvis mucous membrane during the operation of percutaneous nephrolithotripsy,4 accepted radical operations of renal pelvic carcinoma and 2 patients accepted radical nephrectomy according to the biopsy pathology.4 were found soft tissue occupying before operation and accepted radical operation of renal pelvic carcinoma ultimately.1 patient suffered gross hematuria and renal insufficiency accepted the renal pelvic carcinoma vaporization under the ureteroscope.Results The pathology showed that 7 cases were transitional cell carcinoma,4 were transitional cell carcinoma combined squamous cell carcinoma (SCC) metaplasia and 2 were squamous cell carcinoma.6 of 8 patients' stone chemical composition were infection stone and 2 were calcic blended stone.3 patients were followed up 1 to 2 years and survival with no tumor recurrence.The tumor recurred 10 months of the patient accepted the operation of renal pelvic carcinoma vaporization and accepted vaporization again.1 patient bsuffered SCC and local lymph node metastasis.He died 13 months post-operation.Conclusions For the patient who had long history of stone,combining infection with symptoms of severe hematuria and postoperation hematuria,the possibility of renal pelvic carcinoma should be considered.CT scan and urine FISH may help for diagnosis.The biopsy should routinely perform for the doubtful mucosa lesion during the cavity stone operation.Early and timely diagnosis and operation is the key for the patients with pelvic carcinoma associated with renal stone.

Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis* ; Death, Sudden/etiology*

ObjectiveTo investigate the methylation status in the promoter region of secreting frizzled related protein 2 (SFRP2) gene in patients with myelodyplastic sydrome (MDS) and to initially explore the relationship between the methylation of this gene and prognosis/survival time.MethodsMSP method was applied to examine the promoter methylation of SFRP2 gene in 43 bone marrow or peripheral blood samples of MDS patients.As controls,70 normal peripheral blood samples from volunteers of general outpatients were examined.Then some of the patients were followed up.ResultsIn 43 patients of MDS,10 samples (23.3 ％)showed SFRP2 gene methylation,and all of them were semi-methylation status.In 70 controls,no sample showed SFRP2 gene methylation.The frequency of SFRP2 gene methylation in MDS patients was significantly higher than that in controls (x2 =17.86,P ＜0.0001).Of the 10 SFRP2 gene methylation samples,5 were bone marrow samples and 5 were peripheral blood samples.In this group of patients,3 patients were diagnosed as RA,1 patient was diagnosed as RAS,2 patients were diagnosed as RCMD,3 patients were diagnosed as RAEB and 1 patient was diagnosed as MDS-U.There was no significant difference between the different sample source (bone marrow or peripheral blood) for the results of the methylation status (x2 =0.912,P ＞0.05).Either no significant difference between the different sex,age,type,chromosome and WPSS score (all P ＞0.05).The progress of disease didn' t influence the methylation rate (P ＞0.05).16 patients accepted follow-up and 11patients died,3 patients went to AML.2 died patients showed SFRP2 gene methylation.The survival analyses showed no relationship between the methylation of this gene and survival time(x2 =0.022, P ＞0.05).ConclusionIn this MDS group,there is a high level of methyl-modification in SFRP2 gene.The methylation of SFRP2 may be one of the molecular mechanisms that contribute to the progress of patients with MDS.The peripheral blood sample maybe a better substitute in detection of SFRP2 with MDS.

Objective To investigate the effects of antihypertension and reversing left ventricular hypertro- phy by carvedilol or bisoprolol in patients with mild to moderate essential hypertension.Methods 40 cases of mild to moderate essential hypertension patients were selected for this random single-blind,paralleling controlled clinical study.Results Patients were randomized to take 12.5～25mg carvedilol tablet orlce daily or bisoprolol 2.5～5mg once daily if DBP was still in the range of 12.0～14.6kPa(90～110mmHg)after 2 weeks' placebo baseline. Carvedilol group included 20 cases,bisoprolol group included 20 cases,and the course was 24 weeks.Blood pressure and heart rate were measured and symptoms and signs were recorded.At the end of placebo and in 24 weeks heart ultrasound,blood routine,serum glucose,blood lipid,hepatic function and renal function were examined.SBP,DBP and heart rate of patients in two groups decreased obviously.There were significant differences between the two groups.Ventricular hypertrophy of carvedilol group improved than that in pretherapy.There were significant differ- ences between the two groups.Conclusion Carvedilol was well-tolerated with less side effects such as mild headache,tiredness,dizziness,slightly elevating of serum glucose.Carvedilol could well treat the mild moderate essen- tial hypertension effectively and safely by 12.5～25mg once daily.

BACKGROUND AND OBJECTIVECybeKnife is a newly developed technology in the field of stereotactic radiosurgery/radiotherapy (SRS/SRT). Compared with conventional SRS/SRT, there are many advantages for CyberKnife in terms of treating tumors that move with respiration, being real-time image-guidance, frameless, high accurateness, and so on. Recently, it has been used to treat different types of malignant carcinoma including intracranial and caudomedial tumors. This study was designed to evaluate the short-term efficacy and toxicity of the CyberKnife radiotherapy for locally advanced pancreatic cancer.

METHODSA total of 20 patients with locally advanced (stage II-III) pancreatic cancer treated with CyberKnife were recruited between April 2009 and December 2009. Of 20 patients, 13 were with cancer located at the pancreatic head and 7 were located at the pancreatic body and tail. The planning target volume (PTV) was defined as gross tumor volume (GTV) plus 2-3 mm, and more than 95% PTV should be covered by 75% isodose surface. The median of PTV was 47 cm³ (26-64 cm³). The median total prescription dose was 40 Gy (32-55 Gy) at 3-6 fractions. During treatment delivery, X-Sight Spine Tracking System was used in 5 patients to track movement of the tumor. Other 15 patients were implanted fiducials in the tumors to track movement of the tumor and patient breathing patterns.

RESULTSThe median follow-up time was 7 months (3-11 months). All patients had finished the treatment and 19 were alive by the last follow-up. Slight fatigue was the most common complain. Evaluated by CT scan, 6 were complete response, 9 were partial response, 3 were stable disease, and 1 was progression; 1 was dead. There were 6 patients with grade I granulocytopenia, 7 with grade I nausea, and 5 with grade II vomiting.

CONCLUSIONSThe CyberKnife radiosurgery for the locally advanced pancreatic cancer shows a high rate of local control and minimal toxicity. Long-term follow-up is necessary to evaluate the survival and late toxicity.

Adult ; Aged ; CA-19-9 Antigen ; blood ; Female ; Follow-Up Studies ; Humans ; Leukopenia ; etiology ; Male ; Middle Aged ; Nausea ; etiology ; Neoplasm Staging ; Pancreatic Neoplasms ; diagnostic imaging ; surgery ; Quality of Life ; Radionuclide Imaging ; Radiosurgery ; adverse effects ; Radiotherapy Dosage ; Remission Induction ; Thrombocytopenia ; etiology

Objective To observe the relationship between CYP3A4 * 1G genetic polymorphism with calcineurin inhibitor(CNI)-induced chronic nphrotoxicity in Chinese population.Methods Blood samples and clinical data were collected from 200 Chinese patients with CNI drug-induced chronic nephrotoxicity as treatment group and 200 Chinese kidney allograft recipients without chronic nephrotoxicity as the control.DNA was extracted from the blood samples of patients in two groups,and the frequencies of CYP3A4 * 1G genotypes were analyzed using polymerase chain reaction-restriction fragment length polymorphism.The relationship between the polymorphisms of CYP3A4 * 1G and the CNI drug-induced chronic nephrotoxicity was analyzed.Results The frequencies of the 3 gene types CYP3A4 * 1G RsaI 1/1,1/1G,and 1G/1G were 51％ (102/200),34.5％ (69/200) and 14.5％ (29/200) respectively in patients with CNI drug-induced chronic nephrotoxicity (treatment group),and49.5％ (99/200),45％ (90/200),and5.5％ (11/200) respectively in the control group.A statistical difference was found between the cases and the control (P ＜ 0.05,OR =2.914,95％ CI =1.41-6.01).Conclusion The polymorphism of CYP3A4 * 1 G/* 1G remained a significant independent risk factor for CNIs drug-induced chronic nephrotoxicity after kidney allograft.

Objective To explore the application value and forensic significance of ischemia modified albumin (IMA) in pericardial fluid to diagnose sudden cardiac death.Methods IMA level in pericardial fluid was detected in acute ischemic heart disease group (n=36),acute myocardial infarction group (n=6),cardiomyopathy group (n=4) and control group (n=15) by albumin cobalt binding method.The levels of IMA were compared among these groups.The best cut-off IMA value was estimated and the sensitivity and specificity of acute myocardial ischemia group was distinguished from control group by receiver operating characteristics (ROC) curve.Results The IMA level in acute ischemic heart disease group was significantly higher than that of control group (P＜0.05).Compared with acute myocardial infarction group and cardiomyopathy group,the IMA level in acute ischemic heart disease group had no significant difference (P＜0.05).The cut-off value for the identification of acute myocardial ischemia which obtained by ROC analysis was 40.65U/mL.And the sensitivity and specificity for distinguishing acute ischemia cardiac disease was 60.0％ and 80.5％,respectively.Conclusion The IMA value in pericardial fluid can be a reference marker for the diagnosis of acute myocardial ischemia,which also can provide objective basis for the forensic identification of sudden cardiac death.

Objective To investigate the effect of preconditioning with cannabinoid CB2 receptor agonist AM1241 on microglial activation and injury induced by lipopolysaccharide ( LPS) and interferon-γ (IFN-γ). Methods The microglial cells were chosen and assigned to control group,AM1241 treatment group, LPS/IFN-γ inducement group and AM1241+LPS/IFN-γ treatment group. Cells of control group were cultured in normal medium;cells of AM1241 treatment group were preconditioned with AM 1241 for 2 h, and then the medium was changed with normal medium;cells of LPS/IFN-γ inducement group were exposed to the medium containing 1 μg/mL LPS plus 50 U/mL IFN-γ for 24 h;cells of AM1241+LPS/IFN-γ treatment group were preconditioned with AM1241, then the medium were changed with normal medium for 2 h, and at last, cells of this group were exposed to 1 μg/mL LPS plus 50 U/mL IFN-γ for 24 h. Microglial metabolism was assessed by MTT assay;NO release was measured by Reagent Kit;microglial shapes were observed through microscope. Results CB2 receptor agonist preconditioning can up-regulate the microglial CB2 receptor expression markedly;cell metabolism of AM1241+LPS/IFN-γ treatment group (92.55 ±8.37%) was obviously higher than that of LPS/IFN-γ inducement group (75.04±3.01%, P<0.05);AM1241+LPS/IFN-γ treatment group (43.44±5.52 μmol/L) released significantly less NO than LPS/IFN-γ inducement group (90.87±4.28 (μmol/L, P<0.05). Cells of the LPS/IFN-γ inducement group were destroyed seriously with enlarged soma and thickened and shortened pseudopodium;cells of the AM1241+LPS/IFN-γ treatment group were destroyed slightly with slightly enlarged soma and thickened and shortened pseudopodium. Conclusion Preconditioning with cannabinoid CB2 receptor agonist AM1241 reduces microglial activation and injury induced by LPS plus IFN-γ.

Humans ; Kidney Transplantation ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Ureter ; surgery ; Urinary Tract ; surgery

This study was purposed to investigate the immune reconstitution of T-cells in patients who received haploidentical hematopoietic stem cell transplantation (hiHSCT). The peripheral blood was harvested from 22 patients before transplantation and at month 1, 3, 6 after hiHSCT. The proportions of T lymphocyte subtypes including CD3(+), CD4(+), CD8(+), CD45RO(+), and CD45RA(+)CD62L(+) were analyzed by flow cytometry, followed by the calculation of T cell numbers according to the amounts of peripheral blood leukocytes. Adenosine triphosphate (ATP) value in CD4(+) T cells was measured by ImmuKnow method to evaluate the function of lymphocytes. The results showed that the CD3(+) cell absolute value before transplantation was 833.75 ± 359.84/µl, but those values at month 1, 3, 6 after transplantation were 318.87 ± 266.71/µl, 1006.76 ± 512.32/µl and 1296.38 ± 958.77/µl respectively. The CD4(+) cell absolute value before transplantation was 336.99 ± 211.11/µl, but such values at month 1, 3, 6 after transplantation were 45.89 ± 44.21/µl, 142.97 ± 114.85/µl, and 181.78 ± 120.61/µl respectively. The CD8(+) cell absolute value before transplantation was 430.21 ± 159.48/µl, but those values at month 1, 3, 6 after transplantation were 230.44 ± 195.89/µl, 621.64 ± 318.83/µl, and 823.07 ± 633.55/µl respectively. The CD4(+)CD45RO(+) memory T cell absolute value before transplantation was 227.44 ± 73.34/µl, but such values at month 1, 3, 6 after transplantation were 43.47 ± 43.40/µl, 138.69 ± 110.17/µl, 147.73 ± 82.94/µl respectively. The CD8(+)CD45RO(+) memory T cell absolute value before transplantation was 212.70 ± 98.48/µl, but such values at month 1, 3, 6 after transplantation were 184.76 ± 168.65/µl, 445.90 ± 252.50/µl, 519.80 ± 475.53/µl respectively. CD4(+)CD45RA(+)CD62L(+) naive T cell number before transplantation was 68.94 ± 59.74/µl, but such cell numbers at month 1, 3, 6 after transplantation decreased to 2.44 ± 2.93/µl, 3.14 ± 3.48/µl, 23.22 ± 38.38/µl respectively. The CD8(+)CD45RA(+)CD62L(+) naive T cell absolute value before transplantation was 124.82 ± 60.95/µl, but those values at month 1, 3, 6 decreased to 19.37 ± 17.71/µl, 76.63 ± 50.85/µl, and 114.49 ± 174.29/µl respectively. The ATP value in CD4(+) T cells decreased to 210.19 ± 119.37 ng/ml at month 1 after transplantation and increased to 280.62 ± 110.03 ng/ml at month 3, and 357.28 ± 76.18 ng/ml at month 6 after transplantation. It is concluded that CD8(+) memory T cell reconstruction contributes critically to T cell recovery early after hiHSCT, while the thymic output function remains low. However, T cell function recovers to normal range at month 3 after transplantation.
Adolescent ; Adult ; CD8-Positive T-Lymphocytes ; cytology ; Child ; Child, Preschool ; Female ; Haplotypes ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunophenotyping ; Killer Cells, Natural ; immunology ; Lymphocyte Count ; Male ; T-Lymphocyte Subsets ; immunology ; Young Adult