Objective To evaluate the feasibility and effectiveness of enhanced recovery after surgery(ERAS)in minimally invasive surgery for adrenal tumors.Methods A total of 139 patients underwent retroperitoneal laparoscopic adrenalectomy were selected in this study.The maximum tumor diameter was≤6.0 cm.According to the perioperative plan,patients were divided into the ERAS group(n=65)and the conventional group(n=74).The general information(age,gender,tumor location and tumor diameter),surgical indicators(surgical time and surgical blood loss),postoperative rehabilitation indicators(first off-bed ambulation time,first exhaust time,postoperative catheterization time,postoperative drainage tube retention time and postoperative hospitalization time)and incidence of complications were compared between two groups of patients.Results There were no significant differences in gender,age,tumor location,tumor diameter,surgical time and surgical blood loss between the two groups of patients(P＞0.05).In the ERAS group,first off-bed ambulation time,first exhaust time,the indwelling duration of catheters and drainage tubes were shorter than those in the conventional group,and the overall incidence of postoperative complications was lower in the ERAS group than that in the conventional group(P＜0.05).Conclusion The ERAS protocol is safe and feasible for minimally invasive surgery in patients with adrenal tumors with a maximum tumor diameter of≤6.0 cm.

OBJECTIVETo explore the clinical diagnostic features and treatment of desmoplastic small round cell tumor (DSRCT), and to improve the understanding and management of this tumor.

METHODSThe clinicopathological data of nine patients treated in our hospital from October 2004 to June 2014 were retrospectively analyzed and a review of the literature was made. The clinical manifestations, pathological characteristics, diagnosis and differential diagnosis, treatment and prognosis of this tumor were summarized and analyzed.

RESULTSNine patients with DSRCT, 5 males and 4 females, with an average age of 21 years (range 8-56 years) were included in this study. Ultrasound examination revealed irregular low-density mass shadow in the abdominal cavity. CT examination found that 6 cases had abdominal and retroperitoneal multiple solid tumor nodules, uneven density, and visible low density fluid area. Postoperative pathological examination revealed that the tumor cells were small, mostly elliptic, gathered to form clear structure of nests with clear irregular boundaries. The central portion of large tumor nests often showed necrosis. Scattered fibroblasts and large amount of hyalinization of collagen fibers were seen in the interstitial tissue around the nests. Six patients received laparotomy surgery, however, all failed to resect the tumor completely. Three patients received postoperative chemotherapy, i. e. two cases had carboplatin and paclitaxel chemotherapy, and one case of chemotherapy regimen not specified. Two patients had radiation and chemotherapy (no concrete plan was available). Another case was lost to follow-up. Two of the three patients without surgery received chemotherapy with CAP (cyclophosphamide+adriamycin+carboplatin) and total rectal lesions, pelvic and inguinal lymph nodes, ilium metastases radiation therapy. Another one patient received EP regimen (DDP+VP16) which was then changed into a TP chemotherapy alone. Eight of the nine cases died shortly after surgery, and only one patient treated with chemotherapy alone was still alive after 11 months of follow-up.

CONCLUSIONSDesmoplastic small round cell tumor is a very rare, special type of soft tissue tumor, with very poor prognosis. This tumor may be preliminarily diagnosed according to the imaging characteristics and detection of tumor markers, however, final diagnosis is made by pathology. Surgery is the priority of treatment, combined with complementary radiation and chemotherapy.

Abdominal Neoplasms ; complications ; diagnosis ; mortality ; therapy ; Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Biomarkers, Tumor ; analysis ; Carboplatin ; administration & dosage ; Child ; Combined Modality Therapy ; methods ; Cyclophosphamide ; administration & dosage ; Desmoplastic Small Round Cell Tumor ; complications ; diagnosis ; mortality ; therapy ; Doxorubicin ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Paclitaxel ; administration & dosage ; analysis ; Prognosis ; Retrospective Studies

ObjectiveToinvestigatethecorrelationofaspirinresistance(AR),genepolymorphismof platelet membrane glycoprotein (GP)Ⅱb HPA-3 and recurrent ischemic stroke. Methods The consecutive patients w ith acute ischemic stroke and gender, age-matched healthy subjects w ere enrol ed. Adenosine diphosphate (ADP) and arachidonic acid (AA) w ere used as inducing agents. The platelet aggregation rate (PAgT) was detected by flow cytometry. AR was defined as PAgTADP≥39.27% and PAgTAA≥34.27%. Polymerase chain reaction-restriction fragment length polymorphism w as used to detect the GPⅡbHPA-3 genotype. Results A total of 224 patients w ith acute ischemic stroke (case group) and 98 healthy subjects (control group) were enroled. In the case group, 162 patients had the first-ever stroke (first-ever stroke group) and 62 had recurrent stroke (recurrent stroke group). The incidence of AR in the case group w as 15.18%, in w hich the incidence of AR in the recurrent group w as significantly higher than that in the first-ever stroke group (27.42%vs.10.49%; χ2 =9.977, P=0.002). The frequencies of bb genotype ( P=0.004) and b alele (P=0.001) in the recurrent group were significantly higher than those in the first-ever stroke group. In the case group, the frequencies of bb genotype ( P=0.028) and b alele (P=0.004) in the AR group w ere significantly higher than those in the non-AR group. Multivariable logistic regression analysis show ed that AR (odds ratio [OR] 2.933, 95%confidence interval [CI] 1.326-6.486;P=0.008) and bb genotype (OR 2.198, 95%CI1.164-4.149, P=0.015) w ere the independent risk factors for recurrent ischemic stroke. Conclusions AR and GP Ⅱb HPA-3 bb genotype are associated w ith recurrent ischemic stroke.

Objective To explore the clinical diagnostic features and treatment of desmoplastic small round cell tumor ( DSRCT ) , and to improve the understanding and management of this tumor. Methods The clinicopathological data of nine patients treated in our hospital from October 2004 to June 2014 were retrospectively analyzed and a review of the literature was made. The clinical manifestations, pathological characteristics, diagnosis and differential diagnosis, treatment and prognosis of this tumor were summarized and analyzed. Results Nine patients with DSRCT, 5 males and 4 females, with an average age of 21 years ( range 8?56 years) were included in this study. Ultrasound examination revealed irregular low?density mass shadow in the abdominal cavity. CT examination found that 6 cases had abdominal and retroperitoneal multiple solid tumor nodules, uneven density, and visible low density fluid area. Postoperative pathological examination revealed that the tumor cells were small, mostly elliptic, gathered to form clear structure of nests with clear irregular boundaries. The central portion of large tumor nests often showed necrosis. Scattered fibroblasts and large amount of hyalinization of collagen fibers were seen in the interstitial tissue around the nests. Six patients received laparotomy surgery, however, all failed to resect the tumor completely. Three patients received postoperative chemotherapy, i.e. two cases had carboplatin and paclitaxel chemotherapy, and one case of chemotherapy regimen not specified. Two patients had radiation and chemotherapy ( no concrete plan was available) . Another case was lost to follow?up. Two of the three patients without surgery received chemotherapy with CAP ( cyclophosphamide + adriamycin + carboplatin) and total rectal lesions, pelvic and inguinal lymph nodes, ilium metastases radiation therapy. Another one patient received EP regimen ( DDP+VP16) which was then changed into a TP chemotherapy alone. Eight of the nine cases died shortly after surgery, and only one patient treated with chemotherapy alone was still alive after 11 months of follow?up. Conclusions Desmoplastic small round cell tumor is a very rare, special type of soft tissue tumor, with very poor prognosis. This tumor may be preliminarily diagnosed according to the imaging characteristics and detection of tumor markers, however, final diagnosis is made by pathology. Surgery is the priority of treatment, combined with complementary radiation and chemotherapy.

Objective To explore the clinical diagnostic features and treatment of desmoplastic small round cell tumor ( DSRCT ) , and to improve the understanding and management of this tumor. Methods The clinicopathological data of nine patients treated in our hospital from October 2004 to June 2014 were retrospectively analyzed and a review of the literature was made. The clinical manifestations, pathological characteristics, diagnosis and differential diagnosis, treatment and prognosis of this tumor were summarized and analyzed. Results Nine patients with DSRCT, 5 males and 4 females, with an average age of 21 years ( range 8?56 years) were included in this study. Ultrasound examination revealed irregular low?density mass shadow in the abdominal cavity. CT examination found that 6 cases had abdominal and retroperitoneal multiple solid tumor nodules, uneven density, and visible low density fluid area. Postoperative pathological examination revealed that the tumor cells were small, mostly elliptic, gathered to form clear structure of nests with clear irregular boundaries. The central portion of large tumor nests often showed necrosis. Scattered fibroblasts and large amount of hyalinization of collagen fibers were seen in the interstitial tissue around the nests. Six patients received laparotomy surgery, however, all failed to resect the tumor completely. Three patients received postoperative chemotherapy, i.e. two cases had carboplatin and paclitaxel chemotherapy, and one case of chemotherapy regimen not specified. Two patients had radiation and chemotherapy ( no concrete plan was available) . Another case was lost to follow?up. Two of the three patients without surgery received chemotherapy with CAP ( cyclophosphamide + adriamycin + carboplatin) and total rectal lesions, pelvic and inguinal lymph nodes, ilium metastases radiation therapy. Another one patient received EP regimen ( DDP+VP16) which was then changed into a TP chemotherapy alone. Eight of the nine cases died shortly after surgery, and only one patient treated with chemotherapy alone was still alive after 11 months of follow?up. Conclusions Desmoplastic small round cell tumor is a very rare, special type of soft tissue tumor, with very poor prognosis. This tumor may be preliminarily diagnosed according to the imaging characteristics and detection of tumor markers, however, final diagnosis is made by pathology. Surgery is the priority of treatment, combined with complementary radiation and chemotherapy.

The androgen receptor (AR), a nuclear hormone and transcription factor, is the most therapeutic relevant target in pros-tate cancer (PCa) and in the castration-resistant prostate cancer (CRPC). Significant efforts have been focused on understanding the mechanisms involved in the development and progression of CRPC. Recent work has revealed the importance of epigenetic events in-cluding the regulation of AR signaling by methylation, acetylation, and non-coding RNA in the tumorigenesis and development of PCa. We summarize recent findings on the mechanisms of epigenetic regulation of AR signaling in PCa.

Objective To investigate the distribution of glycoprotein (GP) Ⅱ b HPA-3 polymorphism in Chinese Han population in Tianjin and its correlation with ischemic stroke.Methods The patients in this study were divided into either a ischemic stroke group (n =150) or a control group (n =135).Genotyping was conducted by using polymerase chain reaction-restriction fragment length polymorphism and was verified by sampling sequencing Each genotype and allele frequency distribution and its correlation with ischemic stroke were compared.Results The ab genotype,bb genotype and b allele frequency in the patient group were significantly higher than those in the control group (P =0.000),while aa genotype and a allele frequency were significantly lower than those in the control group (P =0.000).There were no significant differences in the frequencies of GPⅡ b genotype and b allele between the different gender and the age groups in the patient group.Although there were no significant differences in genotype frequencies between all etiologic subtypes,b allele frequency in the large artery atherosclerotic stroke subgroup was significantly higher than that in the small vascular occlusive stroke subgroup and that in the cardioembolism subgroup (61.8％ vs.46.7％ vs.47.5％ ;x2 =6.573,P =0.037).Multivariate logistic regression analysis showed that hypertension (odds ratio [OR] 7.475,95％ confidence interval [CI]3.700-15.003; P =0.000) and b allele (OR 3.678,95％ CI 1.245-10.863; P =0.018) were the independent risk factors for ischemic stroke.Conclusions GP Ⅱ b HPA-3 polymorphism may be associated with the risk of ischemic stroke onset.Carrying b allele may be an independent risk factor for ischemic stroke,especially large artery atherosclerotic stroke.

Vasohibin-1 (VASH1),which is induced in response to angiogenic stimuli such as vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF)-2,has recently been isolated as a novel negative feedback inhibitor of angiogenesis.Several studies have demonstrated that VASH1 plays important roles in the development of various tumors and it would potentially be a biomarker and a candidate for molecular targeted therapy for patients with cancer in the future.

Objective To explore the correlation and role of E2F3 gene,miR-17-5p and miR-20a in the cell lines of transitional cell carcinoma of bladder. Methods The plasmids of pcDNA3.1-HA-E2F3 and pAAV-siRNA-E2F3 were used to overexpress and knockdown E2F3.The mimics of miR-17-5p,miR-20a and their anti-miRNA oligonucleotides were used to overexpress and screen miR-17-5p and miR-20a.The expression levels of E2F3 gene,miR-17-5p and miR-20a were detected by quantitative real-time PCR,and E2F3 protein were detected by Western blot. Results When E2F3 was overexpressed,the 2- △△Ct of miR-17-5p and miR-20a were 2.26 ± 0.30 and 4.04 ± 0.51,it was statistically significant to compared with control (P ＜ 0.05) ; when E2F3 was knockdown,the 2 △△Ct of miR-17-5p and miR-20a were 0.49 ± 0.02and 0.65 ± 0.04 (P ＜ 0.05) ; when miR-17-5p and miR-20a were overexpressed simultaneously,the level of E2F3 mRNA was significantly decreased,the average E2F3 protein gray scale was 55.31 ± 7.89,the control was 103.67 ± 13.61 (P ＜ 0.05 ) ; when miR-17-5p and miR-20a were knockdown simultaneously,the E2F3 mRNA was significantly increased,the E2F3 protein gray scale was 295.68 ± 19.25,the control was 103.67 ± 13.61 ( P ＜ 0.05 ). Conclusions miR-17-5p and miR-20a could be up-regulated by E2F3 gene,and the E2F3 gene could be down-regulated by miR-17-5p and miR-20a.The regulatory feedback loop of E2F3 gene,miR-17-5p and miR-20a exists in transitional cell carcinoma of bladder. The loop maybe plays a key role in the development of bladder cancer.

Objective To explore the function and mechanism of estrogen receptor α (ERα) in bladder cancer cell proliferation and aggressivity.Methods The ERα expression bladder cancer cell line T24ERα model was established.The cell growth was detected by MTT assay,apoptosis by flow cytometry,cell invasion by matrigel transwell.Western blot was used to check signals by ERα regulation in bladder cancer cells related to the proliferation and metastatic ability.Results Compared to the control group,the cell inhibition rates of experimental group in 96 h and 144 h were 18.85％ and 37.21％,respectively.The difference was significant compared with the control group (P ＜ 0.05).The apoptosis rates of the experimental group and control group were (18.93 ±1.41)％ and (9.91 ±1.08)％ (P＜0.05).The experimental group through matrix adhesive cell proportion was (10.00 ± 2.00)％,significantly lower than that of the control group (26.00 ± 3.61) ％ (P ＜ 0.05).Western blot showed integrin-β1,p-FAK,p-Src and Scr expression were reduced compared to control group (P ＜ 0.05).Conclusion ERα could inhibit bladder cancer cell growth and metastasis through down-regulating integrin-β1-FAK/Src signal pathway,while promote the apoptosis of bladder cancer cells.