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End-stage renal disease(ESRD) patients with malignant renal tumor has its unique clinicopathological characteristics, and there are currently few domestic related studies. A retrospective analysis was performed on the clinical data of 16 ESRD patients with malignant renal tumor in Jiangxi Provincial People's Hospital. Their ages ranged from 20 to 70 yrs (mean 47.6 yrs). Most of the patients were asymptomatic and all underwent radical nephrectomy or radical nephroureterectomy. Clear cell carcinoma occurred in 11 cases, and papillary renal cell carcinoma in 2 cases. The vast majority of 13 cases were low-stage, low-grade tumors. All 13 cases were followed up for an average of 43.7 months and no recurrence or metastasis was found. In addition, the patients of renal sarcomatoid carcinoma, renal pelvis carcinoma and renal sarcoma survived for 2 to 20 months with poor prognosis.
ABSTRACT
Optical coherence tomography (OCT) is a real-time, cross-sectional optical imaging technology. It is analogous to ultrasonography, except that OCT uses light waves instead of sound waves, and can provide three-dimensional morphological images of living tissues with a micrometer resolution. Through the use of endoscopes, needles, catheters and laparoscopes, OCT has demonstrated tremendous imaging potential in tumor surgery. The current studies suggest that OCT has potential for clinical applications in the following fields of gastrointestinal tumor surgery: (1) Early tumor detection and diagnosis: OCT can distinguish differences between polyp tissue, normal tissue and malignant tissue. It could possibly identify premalignant lesions or conditions potentially predisposing to malignancy, such as gastric and intestinal metaplasia, gastritis associated with Helicobacter pylori, and early gastric cancer involving the mucosa or submucosa. In addition, OCT can differentiate between adenomatous polyps and hyperplastic polyps. (2) Optical biopsy of lymph nodes: As a high-resolution, near-IR imaging modality, OCT is capable of visualizing microscopic features within tissue, distinguishing lymph node tissue from surrounding adipose tissue, revealing nodal structures such as germinal centers and intra-nodal vessels. Consequently, OCT has the ability to show changes in node microarchitecture during metastatic tumor infiltration. (3) Intraoperative guidance for real-time determination of surgical margins: In other tumors such as oral squamous cell carcinoma and breast cancer, it has been demonstrated that OCT can be used to rapidly scan large areas of tissue, to guide at the cellular level the surgical resection of neoplastic disease, and to scan tumor margins for the presence of residual disease, tumor foci, and potentially even metastasizing tumor cells. It implies that colorectal neoplasms surgeons can possibly use the laparoscopic OCT to detect the intestinal tumor margin and lymph nodes during operation in the future, so as to determine the appropriate range of bowel resection and lymph node dissection. At present, there are few reports about the intra-operative application of OCT in the field of gastrointestinal tumor surgery. Thus there is a tremendous opportunity for further research in this field.
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The rules of acupoint selection for diabetic peripheral neuropathy (DPN) based on data mining technology are analyzed. Literature regarding acupuncture for DPN published in core journals from January of 2005 to December of 2014 was retrieved in CNKI database and Wanfang database to establish a database of acupuncture prescriptions, which were included into the TCM Inheritance Platform software (Version 2.0). The data mining methods, including rule analysis, revised mutual information, etc. were applied to analyze the acupuncture prescriptions and the frequency of each acupoint was calculated. The results indicated Zusanli (ST 36), Sanyinjiao (SP 6), Quchi (LI 11), Yanglingquan (GB 34), Hegu (LI 4), Shenshu (BL 23), etc. were mostly selected in acupuncture for DPN; in addition, 19 acupoint combinations were acquired. It is concluded that acupuncture for DPN applied reinforcing methods as main rules, accompanied with promoting blood andcirculation; the acupoint selection focused onmeridians and back-points.
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Objective To discuss the diagnosis and treatment of the postoperative acquired primary hyperfibrinolysis secondary to bipolar plasmakinetic transurethral resection of the prostate ( BP-TURP ) . Methods A case with benign prostatic hyperplasia was retrospectively reviewed, who was an 88-year-old patient admitted on 14th October, 2013 because of repeated urinary retention for 10 years, and catheter indwelling for 20 days.Blood pressure was 101/59 mmHg on admission (1 mmHg=0.133 kPa).Digital rectal examination showedⅡ°prostate, smooth surface, rubbery and no nodules.Routine blood showed the leucocyte 4.6 ×109/L, neutrophils 0.62, hemoglobin 108 g/L, red blood cells 3.30 ×1012/L, platelet 90 ×109/L.Preoperative coagulation function showed prothrombin time (PT) 12.8 s (10-14), activated clotting time live enzymes (APTT) 34.8 s (21 -37), fibrinogen (FiB-C) 2.38 g/L (2 -4), D-dimer 0.50 mg/L (0-0.55), fibrin degradation products (FDP) 2.0 mg/L ( <5.0).Abdominal ultrasound showed hyperplasia of prostate ( 52 mm ×46 mm ×37 mm ) , protruding into the bladder about 20 mm. Abdominal CT scanning showed bladder diverticulum and stones, hyperplasia of prostate and calcification. The operation time of BP-TURP was 90 min with no significant intraoperative bleeding, and continuous bladder irrigation drainage was clear.Results Four hours after the operation, continuous bladder irrigation drainage became bright red.Seven hours after operation, blood pressure was 83/56 mmHg, and blood routine showed white blood cells 8.1 ×109/L, neutrophils 0.92, red blood cells 2.93 ×1012/L, hemoglobin 95 g/L, platelet 67 ×109/L.Transfusion of 4.5 U red blood cell suspension was administered.The prostatic fossa hemorrhage was suspected and bleeding was not alleviated after adjusting the catheter.Prostatic fossa electro-coagulation hemostasis was performed and bladder neck obvious oozing of blood was detected intraoperatively, and no venous sinus bleeding or obvious blood clots were detected.Four hours after the secondary surgery, continuous bladder irrigation drainage became pink again, and the conservative treatment had no effect.Blood coagulation function showed PT 16.9 s, APTT 43.5 s, FiB-C 0.34 g/L, D-dimer 1.70 mg/L, FDP 57.4 mg/L.The patient was diagnosed as postoperative acquired primary hyperfibrinolysis, and repeat plasma, red blood cell suspension, and tranexamic acid transfusion was administered.Continuous bladder irrigation drainage gradually became clear.Blood coagulation function index gradually returned to normal.Routine urine test showed red blood cells ( microscopy ) 4 -5/HPF. Conclusions After BP-TURP, acquired primary hyperfibrinolysis may occur.The outcome is good after timely diagnosis and effective treatment.
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Clinical data of 27 children with renal calculi (11 cases on the right side and 16 on left)who were treated with extracorporeal shockwave lithotripsy (ESWL) using HB-ESWL-VG lithotripter from April 2006 to October 2008 were retrospectively reviewed.The size of stones ranged from 5 mm to 17 mm in diameter (mean 11 mm).In 22 out of 27 cases (82%) stones were crushed completely after the first course.Eleven of 27 ESWL cases were stone-free in 7 days,8 patients in a month after treatment;the stonefree rate was 96% when patients were followed up for 1 year.The results suggest that ESWL is a safe and effective method for treatment of renal calculi in children.
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The contribution of angiogenesis inhibitor TNP-470 to the growth and metastasis of ACHN renal cell carcinoma (RCC) was studied. TNP-470 (40 mg/kg, every two days) was administrated to BABL/c nude mice bearing ACHN RCC. The mice were sacrificed after a treatment duration of 31 days and the weight and volume of subcutaneous tumors as well as foci of lung metastasis were measured. The microvascular density (MVD) of the tumor as well as the PCNA index and apoptotic index of the tumor cells were evaluated immunohistochemically. Result showed that the growth of ACHN RCC was suppressed significantly and none metastasis was observed in TNP-470-treated mice. Compared with the control group, the MVD was decreased markedly (P < 0.01) and the apoptotic index was increased significantly (P < 0.01) in the treated group. The tumor volume was positively correlated to the MVD (r = 0.7144, P < 0.01) and inversely correlated to the apoptotic index (r = -0.8607, P < 0.01), and MVD was conversely correlated to the apoptotic index. It was determined that TNP-470 could effectively inhibit angiogenesis of ACHN RCC, which resulting in ischemia and hypoxia, leading to increased apoptosis, thus obviously suppressing the growth and metastasis of ACHN RCC in nude mice.