ABSTRACT
The treatment of gastric cancer is limited and the prognosis is poor. Tumor immunotherapy has been an effective new treatment for cancer in addition to surgery,chemotherapy,radiotherapy and targeted therapy because of its remarkable survival benefit. As one of the methods of tumor immunotherapy,immunological checkpoint inhibitors have been approved for the treatment of various tumors,suggesting that the era of gastric cancer immunotherapy has arrived. This article describes the mechanism of action and related research progress of immunological checkpoint inhibitors in immunotherapy.
ABSTRACT
Objective The aim of this study was to explore the expression of constitutive photomorphogenesis factor 9 signa-ling complex subunit 6(CSN6) in hepatocellular carcinoma( HCC),and its clinicopathological factors and prognosis. Methods The expression of CSN6 at levels of protein and mRNA in hepatocellular carcinoma and normal hepatic tissues was analyzed using public human protein Atlas database and StarBase database. The TCGA database was used to analyze the differential expression of CSN6 in patients with different tumor stages and graded of hepatocellular carcinoma. Immunohistochemistry was used to detect the expression of CSN6 protein in 106 patients with HCC and analyzed its relationship with multiple clinicopathological factors and overall survival. Results The expression of CSN6 was elevated in hepatocellular carcinoma tissues when compared to normal hepatic tissues. CSN6 was more highly expressed in patients with high pathological grades(G3 and G4)and high stages (Ⅱ and Ⅲ);patients with hepato-cellular carcinoma with high expression of CSN6 had a shorter overall survival. The expression of CSN6 in hepatocellular carcinoma was associated with tumor differentiation and hepatitis B virus infection, and was an independent predictor of overall survival. Conclusion The expression of CSN6 is significantly increased in hepatocellular carcinoma. The increased expression of CSN6 in HCC tissues suggests a poor prognosis. The increased expression is associated with the malignant progression of hepatocellular carcino-ma and has a potential new prognostic marker and therapeutic target.
ABSTRACT
Objective The SNPs of caspase family have been studied in breast cancer,head and neck cancer,esophageal cancer,lung cancer and other cancer. There are few studies between the SNP of CASP3,7 and the risk of gastric cancer in Chinese population. The aim of this study was to investigate the relationship between the SNP of CASP3,7 genes and the genetic susceptibility of gastric cancer using large samples. Methods Blood samples from 1000 cases of gastric cancer and 1036 cases of normal non-cancer control in Northeast China were collected for genomic DNA extraction. Based on the dbSNP NCBI database and HapMap data-base,potential SNP sites were selected for CASP3,7,which locate CASP3,CAS′s 3′UTR. The Tasman probe method was used for gen-otyping of the SNP sites of CASP3,7. The difference between the different variables in the case-control group was analyzed by the bi-lateral χ2 test. After the Hardy-Weinberg genetic balance test for each locus,the χ2 test was used to compare the genotype frequency differences between the case and control groups. Univariate and multivariate logistic regression models were used to analyze the associ-ation between genotype and disease. The stratification analysis of each locus compared the genotypes between the different sexes,ages, smoking,and drinking status. Results The χ2 test compared the differences between the case and control groups. The results showed that there was a significant difference in the smoking,drinking status and smoking in packet number( Pack-years) between the case and control groups(P<0. 05). The genotype frequencies of selected loci were in accordance with Hardy-Weinberg′s law of genetic balance(P>0. 05). Combining and analyzing genotypes with risk alleles,there showed that individuals with two risk genotypes in- creased by 69. 6% in comparison with individuals with 0~1 risk genotype. After adjusted for covariate effects,individuals with three risk genotypes were increased by 27. 6% when compared to individuals with 0~1 risk genotypes. Individuals with more than one risk genotype were increased by 35% when compared to individuals with 0-1 risk genotypes. In the stratified analysis,after combination of two genes,the risk genotype in the sub-layer of age ≤60 years old,male,never smoking,annual smoking package ≤25,gastric non-cardiac adenocarcinoma was statistically associated with disease,i. e. more risk of gastric cancer. Conclusion Univariate analy-sis showed that the SNPs at the four sites selected in this study were not associated with the risk of gastric cancer. However,multivari-ate analysis of CASP3 and CASP7 at the four sites showed that individuals with two risk genotypes increased the risk of gastric cancer in comparison with individuals with 0~1 risk genotypes. In addition,after stratified analysis of the two sites of CASP7,the risk of gas-tric cancer is more obvious in people aged≤60 years,never smoking or smoking≤25 packs per year,and non-gastric cardia adeno-carcinoma.
ABSTRACT
Colorectal cancer is one of the common malignant tumors,and its morbidity and mortality are in the third and fourth places,respectively. About 60% of patients are in an advanced stage at the diagnosis,and their 5-year survival rate is around 13% . In the past 20 years,since the standardized application of advanced first-line chemotherapy and targeted drugs for metastatic colorectal cancer(mCRC),mCRC treatment has made a major breakthrough. The use of oxaliplatin,capecitabine,bevacizumab,cetux-imab and other drugs have doubled the median survival and increased the 5-year survival rate by 20% . The usual mode of first-line treatment of mCRC in the late stage is continuous medication until the disease progress or the intolerable toxicity occurs. However,be-cause of the accumulation of toxicity of chemotherapy drugs,only one-third of patients can continue to receive treatment until the dis-ease progresses. After completing established initial treatment cycle and achieving CR/PR/SD,the patients continue to use low -dose,low-toxic drugs for maintenance treatment,which can delay the progression and metastasis of the tumor,and reduce the side effects of drug. At present,maintenance therapy has become the main treatment mode after advanced first -line chemotherapy for mCRC. However,the optimal maintenance regimen for mCRC remains inconclusive,and existing maintenance regimens still do not find a balance between optimal outcome and maximum quality of life. This article will review the clinical studies of mCRC′s existing main-tenance treatment regimens,summarize the current status of mCRC maintenance therapy,and discuss individualized treatment strate-gies.
ABSTRACT
Objective The aim of this study was to investigate the expression of miR-320a and cephalospermoma syndrome protein(CYLD)in patients with gastric cancer and its relationship with clinicopathological characteristics and prognosis. Methods A total of 460 patients with gastric cancer underwent tumor resection in our hospital from March 2013 to November 2014 were enrolled. Tumor tissues,non-tumor gastric mucosa tissues and normal tissues were collected. The expression of miR-320a and CYLD at levels of mRNA and protein were detected by Real-Time PCR,immunohistochemistry and Western blotting. The relationship between the expression of miR-320a and CYLD,and the clinicopathological features&prognosis of gastric cancer patients was analyzed. Results The relative expression of miR-320a and CYLD at the mRNA level in tumor tissues was(0. 37 ± 0. 09),(0. 91 ± 0. 23),and the relative expression in non-tumor tissues was(0. 86 ± 0. 15),(1. 56 ± 0. 42),respectively. The relative expression of miR-320a and CYLD mRNA in tumor tissues was significantly different from non-tumor tissues(t=60. 078,29. 113,P=0. 000),the positive ex-pression rate of CYLD protein in tumor tissues was 43. 48% when compared to 73. 91% in non-tumor tissues. The difference was statistically significant(χ2=86. 624,P=0. 003). The expression level of miR-320a was significantly associated with the diameter of the tumor and lymph node metastasis(χ2=25. 859 and 13. 742,P<0. 05). The expression of CYLD was also significantly associated with the TNM stage and degree of tumor differentiation(χ2=37. 725 and 59. 323,P<0. 05). The median survival of patients with low miR-320a expression(20. 36 months,95% CI:19. 252 ~21. 462 months) and those with high miR -320a expression(28. 29 months,95% CI:27.158~29.412 months)were statistically significant(χ2=87.967,P<0.001).The median survival of patients with CYLD negative expression(17. 70 months,95% CI:16. 599~18. 796 months)and those with CYLD positive expression(26. 74 months,95% CI:25. 474~27. 997 months)were statistically significant(χ2=109. 887,P<0. 001);The median survival of patients with the co-expressed miR-320a and CYLD was(29. 01 months,95% CI:26. 831~28. 946 months)and those with the non-co-expressed miR-320a and CYLD(17. 13 months,95% CI:17. 214~19. 568 months)were statistically significant(χ2=117. 680,P<0. 001). There showed a positive correlation between the expression of miR-320a and CYLD at mRNA level(r=0. 607,P<0. 001);miR-320a at the low expression,CYLD at the negative expression,TNM staging,lymph node metastasis and degree of tumor differen-tiation were independent risk factors for the prognosis of gastric cancer(HR=1. 939,2. 180,1. 561,1. 719,1. 608,95% CI:1. 141~3.295,1.252~3.796,1.014~2.403,1.115~2.650,1.097~2.357,respectively)(P<0.05).Conclusion The expressions of miR-320a and CYLD in tumor tissues of patients with gastric cancer is significantly decreased,which is related to the occurrence and development of diseases,and poor prognosis. It is a potential target for diagnosis and treatment of gastric cancer.
ABSTRACT
Antiangiogenic targeted therapy plays an important role in the treatment of malignant tumors,especially in the process of antitumor treatment including transformation stage,late stage,and maintenance stage.Apatinib(YN968D1)is a self-developed antian-giogenic targeted agent that was approved and launched for third-line and subsequent-line treatment for advanced gastric adenocarci-noma or gastro-esophageal junction adenocarcinoma.Moreover,the use of apatinib for other multiple solid tumors has been investi-gated.With an increase in the number of clinical studies on apatinib,concerns have been raised about its safety.Hence,we highlight the common adverse reactions of apatinib in clinical application and the incidences of various adverse events in different tumor treat-ments.We provide a comprehensive analysis of available clinical data and compare the advantages and disadvantages of apatinib with other common antiangiogenic drugs regarding their adverse reactions.Overall,these results will help to provide a better understand-ing of the safety of this medicine in the hope of helping physicians to provide patients with a safe and effective treatment.
ABSTRACT
Objective To investigate the clinical efficacy and safety of visual standard channel combined with visual ultrafine channel PCNL precision puncture in treatment of complex renal calculi. Methods From June 2015 to October 2016, 48 cases of complicated renal calculi were treated with multi-channel lithotripsy with visual standard channel ultrasonic pneumatic lithotripsy combined with visual superfine channel PCNL precision puncture holmium laser lithotripsy. Including 10 cases of staghorn stone, 38 cases of multiple renal stones. Results 110 channels were established in 48 patients. 4 cases of preoperative renal insufficiency with infection in the puncture found in the pus and stones load larger, intraoperative diarrhea and PCNL simple treatment of obstruction site stones; 44 cases to complete one of the surgery: There were single channel established in every one of 5 cases, and double channels established in every one of 24 cases, three channels in established in every one of 15 cases; There were two cases of surgery in 8 cases and there were 12 new channels established. The average time of unilateral first operation was 75 (35 ~ 125) min. The first clearance rate was 79.2% (38/48), and the total clearance rate of postoperative stone was 87.5% (42/48). 6 cases of residual stone combined with ESWL and drug row of stone, followed up for 3 months, 6 cases of stone row net, the total stone clearance rate of 100.0% (48/48). Two consecutive postoperative no sepsis, bleeding, ureteral injury and other serious complications. Conclusions Visual standard channel combined with visual superfine channel PCNL precise puncture for the treatment of complex renal calculi is safe and effective, with high fruiting rate and low complication, which can be popularized in clinical practice.
ABSTRACT
Objective To observe ransurethral flexible ureteroscopey for two-step precise method treatment of parapelvic cyst. Methods From May 2014 to November 2015, 23 patients of parapelvic cyst underwent a ransurethral flexible ureteroscopey for two-step precise method treatment, then analyze the clinical data of patients, observe the therapeutic effect. Results All patients underwent primary surgery successfully while 4 cases among them were confirmed as urine level puncture calyceal diverticulum treated with flexible ureteroscopy diverticulum expand drainage, the other 19 cases were confirmed as renal cyst and treated with cyst incision drainage successfully. The hemoglobin before and after surgery showed no changes. With no blood transfusion, the average postoperative hospitalization time was 2 d. 1 day after surgery, KUB was to locate the DJ tube position; 1 month later, ultrasound or CT check show that the cyst volume was significantly reduced, postoperative follow-up range from 6 months to 1 year. All the patients had no long-term complications. Conclusion Ransurethral flexible ureteroscopey for two-step precise method treatment of parapelvic cyst and renal pelvis lamp beside diverticulum provide a clear direction for the next operation. It's simple operation with no significant complications and recovered quickly, which is an ideal method for the treatment of renal pelvic.
ABSTRACT
Objective To observe the clinical effect of oblique supine lithotomy position rigid single-access percutaneous nephrolithotomy combined with FURS in treatment of complex urinary tract stones. Methods From May 2013 to January 2016, 40 cases of multiple kidney stones and staghorn calculi patients underwent oblique supine lithotomy position balloon establish standard single renal access, using percutaneous percutaneous combind with FURS, clinical data of patients, including operative time, blood loss, stone stone clearance rate, hospitalstay, incidence of complications and other indicators. Results The patients were successfully implemented Phase I single-access surgery, the median time 52.5 min, stone stone clearance rate of 100%, before and after surgery no difference in the amount of bleeding, no blood transfusion patients, followed up for 3 months to six months, no significant concurrent operation disease. Conclusion Oblique supine lithotomy bit single-access percutaneous percutaneous combined with FURS treatment of complex renal calculi can improve stone clearance rate, increased patient comfort during surgery to avoid damage to the kidneys multi-channel, shorter operative time, treatment obvious.
ABSTRACT
Objective To observe the clinical effect of modified laparoscopic adrenalectomy for adrenal pheochromocytoma. Methods 23 patients with adrenal pheochromocytoma were treated with modified posterior laparoscopic adrenalectomy. The changes of blood pressure, heart rate, operation time and blood loss during and after operation were observed. Results 23 patients were successfully operated, the operation time was (62.3 ± 11.7) min, the intraoperative blood loss was (34.4 ± 17.7) ml, there has no hemorrhage occurred while 3 cases were transferred to ICU for intraoperative blood pressure and heart rate fluctuation significantly, and back to general ward after 2 days, while there was no significant difference in blood pressure and heart rate preoperatively. Conclusion Modified laparoscopic adrenalectomy is safe and effective for pheochromocytoma and holds the advantages of clear anatomy, short operative time, less bleeding and less change in blood pressure and heart rate.
ABSTRACT
Objective To explore the feasibility and safety of visualization puncture combined with flexible ureteroscopy in the treatment of lower calyx stones.Method Visualization puncture combined with flexible ureteroscopy to treat the lower calyx stones was done in our center from January to August 2016 in our hospital.32 cases of patients were enrolled to have a retrospective analysis.There were 18 males and 14 females,aged from 25 to 65 years,with an average age of 43 years.The diameter of stone was 1.0-2.0 cm,with an average of (1.4 ± 0.6) cm.We used general anesthesia and then adjusted the surgery bed to operation side lateral elevation was 30 °-35.Flexible ureteroscopy with 200μm holmium laser was used firstly to break calculi as much as possible.Ultrasound-guided F4.8 visualization puncture system was used to establish F4.8 channel.The power option was 2001μm hohnium laser to crush calculus of the renal calculi to treat the calculus of the distal end of soft lens which still can not be touched by ureteroscopy.Routine nephrostomy tube was not placed.The soft ureter sheath F5 double-J tube,and indwelling balloon catheter were routinely placed.We removed the catheter after 1-2 days and the double J tube after 4 to 6 weeks.Results The flexible ureteroscopy lithotripsy operation time was 8-25 mins in all of the 32 patients.Visualization puncture channels were successfully established in 3-7 mins,and the visualized puncture stone search rate of 100％ (32/32).The success rate of first stage lithotripsy was 93.8％ (30/32).Two cases of lower calyx stones diverticulum diverted to PNCL due to poor visibility by bleeding.The operation time was 30-60 mins and the average of 45 mins.KUB review at day one after the surgery showed that there were residual stones in 5 cases.The stone free rate at one month after the surgery is 100.0％.The average postoperative hospital stay was (2.0 ± 1.5) days.There were uo bleeding,ureteral avulsion and perforation,septic shock,pleural effusion and intestinal injury and other serious complications.Conclusions Navigation ultrasound-guided visualization puncture combined with flexible ureteroscopy is safe and effective to treat lower calyx stones.
ABSTRACT
Objective The objectives of this study were to compare the clinicopathological features of different Lauren type gastric cancer,to carry out survival analysis,and to screen the prognostic factors.Methods The clinical pathologic data of gastric cancer patients who underwent surgical treatment at the Affiliated Tumor Hospital of Harbin Medical University from January 1,2007 to June 30,2007 were retrospectively analyzed.The 633 cases of gastric cancer patients were divided into intestinal type gastric cancer and diffuse type of gastric cancer groups,which were analyzed clinical and pathological characteristics and survival.Results Compared with diffuse type of gastric cancer,the proportion of intestinal type gastric cancer was slightly high(51.66% vs. 48.34%),the proportion of male was also high(2.94:1 vs.2.03:1,P=0.035).These could be more often in elderly patients age(≥60 years)(54.43% vs.35.94%,P<0.001).The prognosis of intestinal type gastric cancer was significantly better than diffuse gastric cancer(median survival time:90.9 months vs.37.33 months, P=0.014).Multivariate analysis showed that age ≥60 years old,CA199 abnormalities,larger tumors,poor differ-entiation,serosal invasion,initial lymph node metastasis,palliative surgery and non-pyloric resection were poor prognostic factors in gastric cancer.Conclusion Lauren type can be better respond to the clinicopathological fea-tures of different gastric cancer and guide to the prognosis.
ABSTRACT
Objective The objectives of this study were to compare the clinicopathological features of different Lauren type gastric cancer,to carry out survival analysis,and to screen the prognostic factors.Methods The clinical pathologic data of gastric cancer patients who underwent surgical treatment at the Affiliated Tumor Hospital of Harbin Medical University from January 1,2007 to June 30,2007 were retrospectively analyzed.The 633 cases of gastric cancer patients were divided into intestinal type gastric cancer and diffuse type of gastric cancer groups,which were analyzed clinical and pathological characteristics and survival.Results Compared with diffuse type of gastric cancer,the proportion of intestinal type gastric cancer was slightly high(51.66% vs. 48.34%),the proportion of male was also high(2.94:1 vs.2.03:1,P=0.035).These could be more often in elderly patients age(≥60 years)(54.43% vs.35.94%,P<0.001).The prognosis of intestinal type gastric cancer was significantly better than diffuse gastric cancer(median survival time:90.9 months vs.37.33 months, P=0.014).Multivariate analysis showed that age ≥60 years old,CA199 abnormalities,larger tumors,poor differ-entiation,serosal invasion,initial lymph node metastasis,palliative surgery and non-pyloric resection were poor prognostic factors in gastric cancer.Conclusion Lauren type can be better respond to the clinicopathological fea-tures of different gastric cancer and guide to the prognosis.
ABSTRACT
Objective Comparing and analyzing the advantages and disadvantages of rigid and flexible ureteroscopy in treatment of renal multiple stones or staghorn calculi. Methods 80 patients of renal multiple stones and staghorn calculi from May 2012 to March 2015 were randomly divided into two groups, group A: flexible ureteroscopy as adjuvant technique of balloon dilatation to establish standards channel of rigid nephrolithotripsy, group B: rigid ureteroscopy as auxiliary to flexible ureteroscopy nephrolithotomy. Clinical data of the two groups including operative time, blood loss, stones clearance rate, hospital stay and other indicators of surgical complications were comparatively analyzed. Results TAll the patients received successful surgical procedures. The operation time in group A was 50.4 min, gravel time was 25.6 min, while operation time in group B was 90.3 min, gravel time was 70.3 min. The differences between the two groups was statistically significant. Other indicators such as blood loss, stones clearance rate, complication rate showed no statistical significance. Conclusion Combined techniques of rigid and flexible ureteroscopy was proceeded widely to improve stone clearance rate when dealing with multiple stones and staghorn calculi, while rigid-ureterscopy-based combination has advantages of shorter operation time and this combination should be promoted in top units.
ABSTRACT
Objective To evaluate the efficacy and safety of tubeless of modular flexible ureteroscope combined with ultramini nephrostomy tract for the treatment of upper ureteral calculi in paediatric patients. Methods 20 cases of children with upper ureteral calculi (age≤7 years old), in our hospital underline of modular flexible ureteroscope combined with ultramini nephrostomy tract lithotripsy, the stones located on the left side in 12 cases, 8 cases on the right. The average age of children in the 4 years (2 to 7 years), the average diameter of stones 1.0 cm (0.7 ~1.5 cm), multiple 9 (including 3 cases of multiple bilateral, 6 cases of unilateral multiple) single stones 11 cases. Ultrasound-guided percutaneous nephrolithotomy establish supermicro channel (F11), application modular and flexible uretero﹣scope holmium laser lithotripsy systems. Results Tubeless of modular flexible ureteroscope combined with ultramini nephrostomy tract calculi Clear Phase 91%(21/23), 2 cases of bilateral stones with phased surgical treatment, surgi﹣cal staging stone clearance rate was 100 % (23/23). Postoperative hemoglobin decline was no significant change. Children do not need a blood transfusion, creatinine, blood urea nitrogen and CRP were no significant differences in change, not placed before and after surgery and renal fistula DJ tube (no tube-based). The mean postoperative hospi﹣tal stay was two days, followed up for 6 months to 1 year, all patients had no long-term complications. Conclusion Tubeless of modular flexible ureteroscope combined with ultramini nephrostomy tract for the treatment of Upper ureteral calculi in paediatric patients is an effective and safety method, can shorten hospital stay.
ABSTRACT
Objective To analyze the relationship between Arg -1 expression and the clinical pathologi-cal factors ,proliferation and prognosis value in patients with colorectal cancer .Methods The expression of Arg-1 was observed in normal tissues ,chronic inflammatory tissues ,and adenomas inflammatory carcinoma tissues of mice.At the same time,Arg-1 expression was observed in human colorectal cancer adjacent tissues ,inflamed tis-sues and colorectal cancer tissues .Arg-1 expressed in 20 cases colorectal inflammation -cancer model in mice . Arg-1 expressed in 20 normal colorectal tissues .Fiftheen colitis tissues and 110 colorectal cancer tissues were examined by Immunohistochemistry .Statistical analysis was used to analyze the changes of Arg -1 expression in different groups of mice and human colon tissue cases .Results Arg-1 protein expression in normal tissues of mice was gradually increased in colon ,chronic inflammatory tissues,adenomas,inflammatory carcinoma,with sta-tistical significances(P<0.05).Arg-1 expression in para -carcinoma tissue,colitis tissues,colorectal cancer tissues was gradually increased with statistical significance (P<0.05).Conclusion Arg-1 protein is associat-ed with colorectal cancer TNM stage .Arg-1 protein may be involved in occurrence and development process of inflammation-associated colon tumor and may be a candidate of proliferated and prognostic biomarker in patients with colorectal cancer .
ABSTRACT
In recent years ,the treatment of malignant tumor has entered the era of individualization and molecular target .Therefore,research and development of new therapeutic targets for cancer patients has become a top priority.A large number of clinical and experimental research found that HGF is produced by mesenchymal cells,which is combined with epithelial cells of specific receptors c -Met to activate the receptor tyrosine activity , promoting the growth ,migration and morphological change of a variety of cell ,and then to promote the tumor inva-sion,metastasis and angiogenesis .HGF and its receptor c-Met play an important role in the progression of thy-roid cancer,breast cancer,lung cancer,head and neck squamous cell carcinomas ,central nervous system tumors and digestive system tumors .HGF/c-Met signaling pathway ,as a new targets for a variety of solid tumors ,is con-sidered to be the most promising therapeutic targets in recent years ,it has also become one of the hot spots of cur-rent research.This article will mainly discuss HGF and c -Met receptor′s structure,function,activation mecha-nism and research progress in a variety of malignant tumor .A large number of clinical and experimental research found that HGF is produced by mesenchymal cells and epithelial cells with a specific receptor combination c -Met and activates the receptor tyrosine activity .
ABSTRACT
Objective To study the expression of acid secreted proteins that are rich in cysteine protein (SPARC protein)in gastric adenocarcinoma tissue and its relationship with the prognosis of patients with gastric cancer.Methods In order to detect SPARC protein expression levels in gastric adenocarcinoma ,104 primary gastric adenocarcinoma samples as well as 30 normal gastric tissues adjacent to carcinoma were studied by immu-nohistochemistry .Results The positive rate of SPARC protein in 30 cases of gastric mucosa adjacent to carcino-ma is 20%,and with weak expression or no expression;The positive rate in 104 cases of gastric cancer tissues was 76.1%,the difference was significant(P<0.01).The high expression rate of SPARC and lymph node metastasis in gastric adenocarcinoma were positively correlated (P<0.01).The SPARC expression rate of well and moderate differentiation of gastric adenocarcinoma were significantly lower than that of the low differentiation ( P<0 .05 ) . The average survival time of gastric cancer patients with high SPARC expression was 27.4 months.However,the average survival time of the patients with low SPARC expression was 40.9 months.The difference was significant (P<0.05).Conclusion SPARC protein is mainly high expressed in gastric cancer stromal tissue cells and fi-broblasts .The expression level of SPARC protein is significantly associated with lymph node metastasis and tumor differentiation degree .The high expression of SPARC patients survival time is short and the prognosis is poor . However ,SPARC protein is not an independent prognostic factor .
ABSTRACT
PURPOSE: To assess the safety and efficacy of an ultramini nephrostomy tract, which we were using for the first time, combined with flexible ureterorenoscopy (URS) in the treatment of pediatric patients with multiple renal calculi. MATERIALS AND METHODS: Twenty pediatric patients (age, < or =6 years) underwent ultramini percutaneous nephrolithotomy (PCNL) combined with flexible URS. The group had multiple renal calculi, which were bilateral in 3 cases and were located in a total of 23 sites. The calculi were located in 2 calyces in 10 cases, scattered in more than 2 calyces in 7 cases, and limited to 1 calyx in 3 cases. The average patient age was 37.35 months (range, 14-68 months). The average stone diameter was 2.0 cm (range, 1-3.0 cm). In all patients, an ultramini nephrostomy tract was established under ultrasound guidance (dilated to F10) with simultaneous sheath placement. The flexible URS was placed into the collecting system during holmium laser lithotripsy. RESULTS: When ultramini PCNL was combined with flexible ureterorenoscopic holmium laser lithotripsy, the complete stone-free rate was 87% (20/23). The average level of hemoglobin decreased to 1.0 g/dL after the operation. No blood transfusions were needed. Levels of blood urea nitrogen, creatinine, and C-reactive protein were not significantly different before and after the operation. The average duration of hospitalization was approximately 4.85 days, and all cases were followed up for 6 to 12 months. No complications were found. CONCLUSIONS: Ultramini PCNL combined with flexible ureterorenoscopic holmium laser lithotripsy is a safe and effective treatment for children with multiple renal calculi.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Kidney Calculi/pathology , Length of Stay/statistics & numerical data , Lithotripsy, Laser/methods , Nephrostomy, Percutaneous/methods , Retrospective Studies , Treatment Outcome , Ultrasonography, Interventional/methods , Ureteroscopy/methodsABSTRACT
Objective To investigate new type cytokine induced killer cells expansion using advanced breast cancer′s peripheral blood .Methods peripheral blood mononuclear cells were isolated from 8 advanced breast cancer volunteers and co -cultured with Cytokine induced killer cells .These cells were placed in plastic flasks containing CIK-MediumTM supplemented with 10% auto-plasma in the presence of IL -2 ( 1 000 IU/mL) .The cultures were fed with CIK-MediumTM supplemented with IL -2 following the proliferation capacity . Cell proliferation was measured by cell counting during the cultivation .Fourteen days after cultivation ,cell mark-ers CD3/CD16/CD56 were examined by flow cytometry .51Cr and MTT assays were employed in cytotoxicity as-says.Cytokines were assayed by ELISA method .Results CD16+,CD16+CD56+,CD56+CIK cells were 5.8~11.6%in 2 ×107 fresh PBMCs and 95.2~97.6%in co-cultured cells after 18 days cultivation .The in vitro ex-pansion rate of new type cytokine induced killer cells was up to more than 8.2 ×108 in total,the cytotoxicity are ef-fective killing cells against MCF 7 and BT20 breast cancer cell lines .New type cytokine induced killer cells expand-ed from all PBMCs and secreted cytokines IFN -and TNF-.Conclusion The present culture could be useful to clarify the mechanisms of CIK cells expansion in vitro and feasible for breast cancer immmuno cell therapy .