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Objective To investigate the etiology,clinical manifestations,imaging finding,pathology and treatment of primary bladder schwannoma.Methods A case of bladder schwannoma was reported and discussed in the literature.A 64-year-old male patient with painless gross hematuria for 4 months was admitted on October 5,2016.Enhanced computed tomography (CT) showed left anterior bladder wall lesions with mildly enhancement.Preoperative diagnosis was bladder cancer.The patient underwent transurethral resection of bladder tumor (TURBT).During surgery,a 3 cm × 3 cm polypoid soft tissue was found in the left side of bladder,which convex to the bladder with smooth surface and wide base.Results The bladder neoplasm was resected successfully.The intraoperative bleeding was about 100 ml.Postoperative pathology showed a large number of myloid spindle cells with immunohistochemical S-100 (+),considering source of mesenchymal tissue.No recurrence was noticed during the 3 months' follow-up.Retrieving domestic and foreign literature,we found 17 cases with bladder schwannoma from 1993 to 2016.Bladder schwannoma occurs in the age of 40-69 years old.There is no relationship with the agenda.It is often seen in the top or the side wall of the bladder with single growth and rare malignant.The clinical manifestations was mainly painless gross hematuria,CT and magnetic resonance imaging(MR) showed less specificity than other solid tumors of the bladder,which is difficult to identify.Partial cystectomy or TURBT is the main strategy.Postoperative pathology is the gold standard for diagnosis.The immunohistochemical stainings often showed S-100(+).Conclusions Bladder schwannoma is extremely rare in benign bladder tumor,and it could easily be misdiagnosed.The diagnosis should be performed by histopathological examination.Because it will become malignant,it is suggested that the positive treatment should be done.Treatment methods have not been clearly defined,and the effect of surgical resection is good.
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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.
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ObjectiveTo evaluate the laparoscopic procedure and therapeutic efficacy of retroperitoneal laparoscopic surgery for the treatment of adrenal ganglioneuroma.Methods6 patients [4 male and 2 female,32 to 59 (mean 41.3) years old],underwent retroperitoneal laparoscopic resection of adrenal ganglioneuroma. In this group, 2 patients with left adrenal ganglioneuroma, 4 patients with right adrenal ganglioneuroma. ResultsAll of the 6 cases was successfully performed uneventfully with retroperitoneal laparoscopic adrenalectomy. Pathologic studies confirmed there were 6 cases of adrenal ganglioneuroma. No case was transferred to open operation.The blood pressure remained stable during operation.Mean tumor size was (5.9±2.1) cm (tumor diameter 3.6-11.2 cm) Mean operative time was 120(90-210) min.Mean estimated blood loss was 160 (50-700) ml.Postoperative hospital stay ranged from 7 to 9 days.All the patients were cured without relapse during 4-32 month, follow-up. ConclusionsRetroperitoneal laparoscopic procedures for adrenal ganglioneuroma causes less traumatic;less operative blood loss;distinct image during operation;less postoperative discomfort;faster postoperative recovery and earlier return to daily activities and diet.Retroperitoneal laparoscopic procedure should be considered as the first choice for adrenal ganglioneuroma.
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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.
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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.
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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.