Primary Ewing’s sarcoma of kidney/primitive neuroectodermal tumor: two cases report / 中华泌尿外科杂志

This article reported 2 cases primary renal Ewing sarcoma (PRES)/primitive neuroectodermal tumor (PNET). By reviewing literature, renal PRES/PNET has a high degree of malignancy, and early symptoms are not typical. It needs to be combined with clinical manifestations, imaging examinations and pathological examination results. At present, surgical treatment is the main treatment, combined with radiotherapy and chemotherapy or targeted treatment might help.

The evaluation of super-selective prostatic arterial embolization in the treatment of benign prostatic hyperplasia / 中华泌尿外科杂志

Objective To evaluate the clinical efficacy of super-selective prostatic arterial embolization(PAE) for the treatment of benign prostatic hyperplasia(BPH).Methods From February 2012to March 2015,a total of 17 patients with BPH who failed in medical treatment,or unwilling to accept surgery were selected for PAE as the study group.The mean age was 73 years (range 61-84 years) and the mean prostatic volume was 64.6 ml (ranging 50-85 ml).The study group underwent super selective arterial embolization.The internal iliac artery angiography was performed and the main blood vessel of prostate was showed.The femoral artery was punctured under local anesthesia and X-ray monitoring,a F4-5 Cobra catheter was inserted,and then the Embosphere microspheres were implanted.A total of 40 patients who underwent transurethral resection of the prostate(TURP) were selected as the control group.The mean age was 70 years (ranging 59-87 years).The mean prostatic volume was 68.7 ml(ranging 55-90 ml).All cases were followed up for 1 year.The changes of prostatic volume (PV),international prostate symptom score(IPSS),quality of life (QOL),pre-and post-treatment peak urinary flow (Qmax) were evaluated.Results For the 17 patients who underwent PAE,the PV decreased from (64.6 ± 10.2) ml to(42.0 ± 7.5) ml,the IPSS decreased from 23.9 ±4.9 to 13.1 ±3.5,QOL decreased from 4.1 ±0.7 to 2.1 ±0.7,and Q increased from (9.5 ± 3.7) ml/s to(21.8 ± 4.2) ml/s,which were statistically significant (P ＜ 0.05) compared with the pre-treatment parameters.The post-operative parameters of the control group were also significantly improved compared with the preoperative parameters (P ＜ 0.05).Conclusions PAE is safe and effective in treating BPH,especially for those failing in medical treatment,or unwilling to accept surgery.

Expression of galanin in the prostate carcinoma and its significance / 肿瘤研究与临床

Objective To study the expression and significance of galanin (GLA) in the prostate carcinoma (PCa).Methods The samples from 50 patients with benign prostatic hyperplasia (BPH) and 50 patients with PCa and 30 PCa patients with bone metastasis were examined by immunohistochemical staining.Results The positive rates of GLA expression in BPH,PCa,and PCa with bone metastasis were 18 ％ (9/50),68 ％ (34/50),and 80 ％ (24/30),respectively,and there were statistically significant differences between PCa patients,PCa patients with bone metastasis and BPH patients (x2 =25.5,29.74,both P ＜ 0.01),but there was no significant difference between PCa patients and PCa patients with bone metastasis (x2 =1.35,P ＞ 0.05).Conclusion GLA has higher expression in prostatic cancer cells,it might be an important indicators for differentiating prostate cancer from benign prostatic hyperplasia and predicting the prognosis of prostate carcinoma.

Effect of L-carnitine on renal ischemia-reperfusion injury / 中华器官移植杂志

Objective To investigate the effect of L-camitine on renal ischemia-reperfusion (IR) injury (IRI) and Nrf2-ARE signaling pathway in rats.Methods Rats were randomly separated into the following experimental groups:control group (group C),IRI group (group I) and L-carnitine group (group L).Rats accepted no treatment of ischemic reperfusion in group C.In groups I and group L,the renal IRI model was established.L-carnitine was injected through the tail vein in group L,while the equal volume of saline was injected in group C and group I.Rats were killed at 3,6,and 24 h after IR.The levels of serum creatinine (Cr) and blood urea nitrogen (BUN),the activity of superoxide dismutase (SOD) and the content of malonaldehyde (MDA) in serum were measured.The histopathological lesions were observed in renal tissues after 24-h IR.RT-PCR was used to detect the levels of Nrf2,HO-1 and γ-GCS mRNA.Western blotting and immunohistochemistry were used to detect the levels and localization of Nrf2 protein in renal tissues after 6-h IR.Results The levels of Cr and BUN in group I and group L were higher than those in group C at 3 h after IR.At 6 h after IR,the levels of Cr and BUN in group L were lower than those in group I (P＜0.01 ).At 24 h after IR,the levels of Cr and BUN in group L were still lower than those in group I though both of them were reduced (P＜0.05).At all time points,the activity of SOD in group L was higher and the content of MDA was lower than those in group I (P＜ 0.05). As compared with group I,the renal histopathological lesions were alleviated in group L at 24 h after IR.At 6 h after IR,levels of Nrf2,HO-1,γ-GCS mRNA and Nrf2 protein in group I were increased as compared with group C,but decreased as compared with group L.Beyond that,the expression of nuclear Nrf2 protein in group L was higher than that in group I.Conclusion L-carnitine can protects the kidney against IRI significantly,which may be due to the up-regulated expression of antioxidant genes by activating the Nrf2-ARE signaling pathway.

Expression of MCP1 gene in serum and tumor tissues in bladder urothelial carcinoma patients and its clinical significance / 肿瘤研究与临床

Objective To investigate the monocyte chemoattractant protein (MCP1) gene expression of the bladder urothelial carcinoma and its correlation with the pathogenesis of the bladder urothelial carcinoma.Methods Thirty cases of patients with the bladder urothelial carcinoma, including 20 cases of male and 10cases of female, were taken the blood and bladder tissue.In control group, 30 cases of non-cancer patients,including 20 cases of male and 10 cases of female, were taken the blood samples.ELISA method was used to detected the concentration of plasma MCP1, immunohistochemical method to investigate the expression of MCP1 in the bladder urothelial carcinoma and adjacent tissues.Real-time quantitative RT-PCR was applied to detected the expression of MCP1. Data of the two groups were comparied and the relationship between the expression of MCP1 and the clinical characteristics of the bladder urothelial carcinoma was analyzed.Results MCP1 in group of patients with the bladder urothelial carcinoma was (193.4±105.7) pg/ml, and higher than that in non-tumor group (91.8±34.6) pg/ml (t = 8.37, P ＜0.001).MCP1 in invasive bladder cancer was (204.3±167.5) pg/ml and superficial bladder cancer was (130.6±69.2) pg/ml (t = 2.667, P = 0.013). By immunohistochemistry, the MCP-1 positive rate in the bladder urothelial carcinoma was 70.0 % (21/30), that in adjacent cancer tissue was 43.3 % (13/30) (χ2 = 4.9, P ＜0.05). The positive rate of MCP1 in invasive bladder cancer in tumor group was 80.0 % (8/10) and that in superficial bladder cancer was 65.0 %(13/20).At the same time, MCP- 1 positive intensity in the bladder urothelial carcinoma was significantly higher than that in adjacent tissues. The intensity in invasive bladder cancer was higher than that in superficial ones. Total RNA and mRNA levels of MCP-1 in the bladder urothelial carcinoma were statistically differences compared with that in adjacent tissues (χ2 = 10.08, P ＜0.05).Conclusion The upregulation of MCP1 gene expression is likely to play an important role in the incidence and metastasis of the bladder urothelial carcinoma.

Diagnosis and treatment of acute focal renal infarction / 中华泌尿外科杂志

Objective To review the clinical diagnosis and treatment of acute focal renal infarction. Methods Three cases of focal renal infarction were reported and the literature was reviewed.The patients aged from 45 to 63 years with mean age of 54. Two cases had low back pain, 1 case with abdominal pain. Based on clinical history, B-ultrasonography and CT scan, focal renal infarction was diagnosed in 3 patients. There were 2 cases on left kidney and 1 case right. All cases were applied digital subtraction angiography (DSA) and thrombolytic anticoagulant therapy. Results Two cases received DSA and thrombolytic therapy. The other one case received pethidine 50 mg, progesterone 20 mg treatment, the salvia infusion and low molecular heparin 6000 U anticoagulant therapy. All patients had symtoms relieved after 1 d. A week later CT scan, 3 cases of renal infarction were apparently disappeared. Serum creatinine and urea nitrogen were normal. Three patients were followed, mean follow-up time was 1. 5 (0. 5-2) years. Conclusions The diagnosis of acute focal renal infarction mainly depends on B-ultrasound and CT. Early diagnosis and treatment is important for achieving recovery of the compromised renal function. Renal infarction should be suspected in the presence of abdominal pain of sudden onset.

Clinical analysis of 118 cases of aldosterone producing adrenal cortical neoplasms / 中华泌尿外科杂志

Objective To evaluate the diagnosis and treatment of aldosterone producing adreral cortical neoplasms,and analyse the reason of misdiagnosis. Methods From 1998 to 2005,118 patients with aldosterone producing adrenal cortical neoplasms were diagnosed and treated.of these patients,age of onset was(37.3±8.4)years,age of diagnosis was(44.54-10.1)years.The age of 46 EH patients in the control group was(45.6±14.2)years.The information of the history,plasma/urine potassium,the ratio of night/day urine volume,PRA,PAC,ratio of erect position ALD/renin were recorded and analyzed.The diagnosis was all confirmed by surgery and pathological studies. Results It was found that plasma potassium(2.6±0.7)mmol/L;urine potassium(56.0±31.2)mmol/24 h,PRA(2.1±1.2)μg·L-1·h-1,PAC(840.5±527.1)pmol/L,ratio of erect position ALD/renin (254.24±153.4)in APA group.And plasma potassium concentration was(3.9±0.5)mmol/L,urine potassium(13.0±5.3)mmol/24 h,PRA(9.34±3.4)μg·L-1·h-1,PAC(393.94±216.4)pmol/L,ratio of erect position ALD/renin(23.94±15.5)in EH terms.There were significant differences between APA and EH groups(P<0.05).Average time of misdiagnosis in APA was(7.2±6.2)years,7 cases (6%)had complication before diagnosis.In all the patients,serum potassium level elevated to normalange within 1 month postoperatively.In 100 cases out of 118,the blood pressure dropped to normal range within three months after surgery.There were significant differences of the age of onset[(34.5 ±9.1)versus(48.5±12.1)years],persistence time of hypertension[(6.2±5.2)versus(8.85±6.6)years] and the ratio of night/day urine volume(0.9±0.7)versus(1.3±0.6),between normal and high postoperative blood pressure patients(P<O.05). Conclusions Appropriate treatment depends on diagnosis and localization of the causative lesion.No specificity of symptom,small gross tumor volume,deficient recognition of secondary hypertension play an important role in misdiagnosis.Factors affecting the prognosis outcome of postoperative blood pressure are age,persistence time of hypertension and the ratio of night/day urine volume.

Identification of novel mutations in the phenylalanine hydroxylase gene of classical phenylketonuria / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the mutations of phenylalanine hydroxylase (PAH) gene in the cases of classical phenylketonuria (PKU).</p><p><b>METHODS</b>The exons 3-12 of the PAH gene in 32 PKU patients from Inner Mongolia were studied by using PCR-single strand conformation polymorphism technique and DNA direct sequencing.</p><p><b>RESULTS</b>Fourteen point mutations were identified. The frequencies of mutations were R243Q (12/64), Y356X (6/64), Y204C (5/64), R261Q (2/64), Y161S (2/64), R252Q (1/64), R111X (2/64), D282G (1/64), S303P (1/64), G239D (1/64), R413P (1/64), IVS7nt+2 (2/64), IVS4nt+3 (1/64) and IVS9nt+34 (2/64). Two novel mutations IVS4nt+3 (G>C) and IVS9nt+34 (G>A) were first found. The S303P (T>C) and D282G (A>G) were first documented in Chinese PAH gene.</p><p><b>CONCLUSION</b>This study demonstrated the variety of the mutation type PAH gene of PKU in Inner Mongolia population, and confirmed that R243Q, Y356X, Y204C were the hot spots of PAH gene mutation.</p>

Aggressive angiomyxoma of the genitourinary system (report of 2 cases and review of literature) / 中华泌尿外科杂志

Objective To investigate the clinical features and treatment of aggressive angiomyxoma of the genitourinary system. Methods Two cases of aggressive angiomyxoma of the genitourinary system were reviewed. One case was a 55 year old man.He presented with a painless inguinal mass which was indicated in low echo by ultrasound;and he underwent surgical complete excision.The other case was a 14 year old female presenting with frequent urination,hematuria,dysuria and urethral mass.After the IVU,CT and 3 dimensional CT examination revealed the extent and blood supply,partial cystectomy and ureteroneocystostomy were performed on her. Results The 2 patients were followed up for 2 to 6 months after surgery,with no recurrence and metastasis.Case 1 was diagnosed with aggressive angiomyxoma involving the spermatic cord and the immunohistochemical testing was positive for Vimentin and SMA,negative for Desmin and S 100.Case 2 was diagnosed with aggressive angiomyxoma of the urinary bladder and the immunohistochemical testing showed that the cancer cell was positive for CD 34 ,SMA,Vimentin,and negative for Desmin,Caldesmon,ER,PR and S 100. Conclusions Aggressive angiomyxoma is a rare,benign and locally aggressive neoplasm.The histopathologic and immunohistochemical studies reveal the definite diagnosis.The therapy is surgical excision as complete as possible.Radiotherapy combined with endocrinotherapy may be used for recurrence and difficult excision of the tumor.Long term follow up and close monitoring with imaging techniques are essential for timely identification of recurrence and for prompt resection.