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.

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.

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

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 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.

OBJECTIVETo study the baseline distribution of polymorphisms in the promoter of peroxisome proliferators activated receptor co-activator 1 (PPARGC1A) gene in ethnic Hans from Beijing, and to assess their association with type 2 diabetes (T2DM).

METHODSA 2-stage study was designed. Firstly, the promoter region of PPAGC1A gene was screened with PCRRFLP in a small population (n=216, T2DM/control: 104/112), which was followed by a replication study of a larger group (n=1546, T2DM/control: 732/814). Fasting plasma glucose, insulin, blood lipid, height, weight, waist circumference, and blood pressure were measured in all subjects. Potential association was assessed by logistic regression. Linkage disequilibrium and haplotype analysis were conducted with Haploview software.

RESULTSFive polymorphisms were identified with Sanger sequencing, among which T-2120C (rs3755857), -1999C/G (rs2946386) and -1437T/C (rs2970870) were included for genotypic analysis based on their moderate levels of heterozygosity. No significant difference was found between the two groups. When adjusted for age and gender confounding, we have combined the OR values from population 1 and population 2 based on Mantel-Haenszel fixed model, and recognized a mild contribution of C allele of -1999C/G (rs2946386) to the 1.18-fold risk of T2DM (P=0.03, OR=118). No haplotype was associated with T2DM after permutation correction.

CONCLUSIONThe C allele of -1999C/G ( rs2946386) in the promoter region of the PPARGC1A gene is mildly associated with T2DM. Variations in the promoter region of the PPARGC1A gene seem not to confer the risk of T2DM in our population.

Adult ; Aged ; Asian Continental Ancestry Group ; ethnology ; genetics ; Blood Glucose ; metabolism ; Case-Control Studies ; China ; ethnology ; Diabetes Mellitus, Type 2 ; blood ; ethnology ; genetics ; Ethnic Groups ; genetics ; Female ; Genetic Variation ; Humans ; Lipids ; blood ; Male ; Middle Aged ; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; Transcription Factors ; genetics

OBJECTIVETo investigate the relationship between a blood pressure variability (BPV)-based scoring system (BPVSS) and the target organ damage in patients with hypertension.

METHODSWe selected 95 consecutive inpatients with essential hypertension admitted between January and June, 2015 in the Department of Cardiology of Guangzhou General Hospital of Guangzhou Military Command. The BPV indices were analyzed for their correlation with the parameters of target organ damage (IVSd, LVPWd, baPWV_L/R, and IMT_L/R). The patients with a BPVSS of 3.9 or higher (control, 43 cases) and those with a lower BPVSS (observation group, 52 cases) were compared for differences in IVSd, LVPWd, baPWV_L/R, IMT_L/R and the proportion of carotid plaques.

RESULTSSimilar with the traditional BPV indices, BPVSS was negatively correlated with IMT_L/R (r=-0.278/-0.324, P<0.05). BPVSS was also negatively correlated with IVSd (r=-0.241), LVPWd (r=-0.223), and baPWV_L/R (r=-0.468/-0.373) (P<0.05). IVSd, LVPWd, baPWV_L/R and IMT_L/R were all significantly higher in the observation group than in the control group (t=2.307, 2.516, 3.250/2.790, and 2.372/3.425, respectively; P<0.05). The proportion of carotid plaques in the observation group was significantly higher than that in the control group (Χ(2)=27.833, P<0.001).

CONCLUSIONBPVSS indicates the severity of target organ damage in patients with hypertension. A greater BPV is correlated with a lower BPVSS score and more severe damages of the heart and blood vessels.

Blood Pressure ; Carotid Stenosis ; diagnosis ; pathology ; Essential Hypertension ; Humans ; Hypertension ; pathology

OBJECTIVETo identify potential markers for predicting invasion, metastasis, and prognosis of gastric adenocarcinoma (GAC).

METHODSThe expressions of Slug, ZEB1 and KISS-1 were detected immunohistochemically in 261 GAC tissues and 80 normal gastric tissues.

RESULTSThe positivity rates of Slug, ZEB1, and KISS-1 in gastric tissues were 2.5%, 1.3%, and 87.5%, respectively, significantly different from the rates of 62.1%, 28.4%, and 41.1% in GAC tissues (P<0.05). The expression level of Slug was significantly correlated with the depth of invasion, lymph node metastasis, and pTNM stages; the positivity rates of both ZEB1 and KISS-1 were significantly correlated with the tumor grade, depth of invasion, lymph node metastasis and pTNM stages. Slug expression was positively correlated with ZEB1 expression, and KISS-1 expression was inversely correlated with Slug and ZEB1 expressions. Kaplan-Meier analysis showed that the overall survival time of patients with positive expressions of Slug and ZEB1 was significantly shorter than that of the negative patients, and the survival time of patients positive for KISS-1 was significantly longer than the negative patients. COX multivariate analysis showed that positive Slug, ZEB1 and KISS-1 protein expressions and pTNM stages were independent prognostic factors of GAC (P<0.05).

CONCLUSIONThe abnormal expressions of Slug, ZEB1 and KISS-1 may contribute to the tumorigenesis of GAC and are related with lymph node metastasis, pTNM stages, and prognosis of GAC. The combined detection of Slug, ZEB1, and KISS-1 expression has an important value in predicting the progression and prognosis of GAC.

Adenocarcinoma ; metabolism ; pathology ; Disease Progression ; Homeodomain Proteins ; metabolism ; Humans ; Immunohistochemistry ; Kaplan-Meier Estimate ; Kisspeptins ; metabolism ; Lymphatic Metastasis ; Neoplasm Grading ; Prognosis ; Proportional Hazards Models ; Snail Family Transcription Factors ; Stomach Neoplasms ; metabolism ; pathology ; Transcription Factors ; metabolism ; Zinc Finger E-box-Binding Homeobox 1