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Objective:To evaluate the effect of uncoupling protein 1 (UCP1) expression of perirenal fat on the prognosis of clear cell renal cell carcinoma (ccRCC) .Methods:From Feb. 2013 to Oct. 2013 and Mar. 2015 to Oct. 2015, 98 patients with ccRCC who underwent retroperitoneal laparoscopic radical nephrectomy were analyzed. UCP1 mRNA of perirenal fat around tumor was detected by RT-qPCR. Preoperative Computed tomography (CT) images were used to evaluate the thickness and adhesiveness of perirenal fat. According to the UCP1 mRNA value, the patients were divided into high UCP1 group (42 cases) and low UCP1 group (56 cases) . The general clinical data, perirenal fat thickness and adhesiveness were compared, and Kaplan Meier curve was used to evaluate the difference of progression free survival (PFS) between the two groups. Univariate and multivariate Cox analysis were used to determine the potential independent prognostic factors of PFS.Results:In the high UCP1 group, the renal fat thickness, the ratio of fat adhesion, the ratio of Ⅲ to Ⅳ in Fuhrman grade and the ratio of >T2 in T stage were higher than those in the low UCP1 group[ (13.84±2.41) vs (10.75±1.99) , 42.86% vs 16.07%, 28.57% vs 8.93%, 21.43% vs. 5.36%; P=0.000, P=0.003, P=0.011, P= 0.037]. During the follow-up period (median, 62.0 months) , 15 cases (12 cases of high UCP1 group, 3 case of low UCP1 group) developed tumor progression. Kaplan Meier curve showed that PFS of high UCP1 group was worse than that of low UCP1 group (71.43% vs 94.64%, P=0.001) . Cox regression analysis showed that high UCP1 expression and high T stage were significantly correlated with low PFS ( β=1.334, RR=3.796, 95% CI=1.009-14.280, P= 0.048; β=2.886, RR=17.930, 95% CI=5.538-58.047, P=0.000) . Conclusions:The increased UCP1 expression of perirenal fat may be an independent risk factor of tumor progression in ccRCC. Combined with the assessment of browning of perirenal adipose tissue may be helpful for risk stratification of ccRCC patients after surgery.
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One hundred and fifty patients with impacted upper-ureteral calculi were treated with ureteroscopic lithotripsy (URSL group,n =58),percutaneous nephrolithotomy (PCNL group,n =42) or retroperitoneal laparoscopic ureterolithotomy (RPLU group,n =50) from April 2011 to August 2015.The operative time,length of postoperative hospital stay,stone-free rate and the incidence of postoperative complications were observed and compared among three groups.The stone-free rate of URSL group one month after surgery was 77％,which was significantly lower than PCNL (95％) and RPLU groups (100％) (P ＜ 0.05).But the operative time and length of postoperative hospital stay of URSL group [(37.2 ± 5.6)min,(3.9-±0.8)d] were significantly shorter than PCNL group[(75.2 ±6.7) min,(7.9 ±0.9))d] and RPLU group [(65.3 ± 6.1) min,(8.7 ± 0.9) d] (all P ＜ 0.05).The postoperative complication rates of three groups were 8％,10％ and 10％,respectively.
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Objective To investigate the role of chitosan in combination with far infrared treatment on vascular access flow of arteriovenous fistula .Methods A total of 172 hemodialysis patients were recruited in this study .The patients were admitted to the blood purification center in Department of Nephrology in Daping Hospital from 2012 to 2013 .The 172 hemodialysis patients ,were randomized into 4 groups ,43 patients in each group ,including control group ,chitosan group ,far infrared group and combined treat‐ment group .The combined treatment group were treated with chitosan and far infrared in vessel puncture for 40 min at the begin‐ning of each dialysis ;chitosan group accepted the chitosan treatment only ;far infrared group just used far infrared therapy device ;control group were treated with conventional nurses .Arteriovenous fistula blood flow was detected by doppler ultrasound equip‐ment ,the maximum blood flow Qa0 (at the beginning of the study) ,Qa1 (1 month later in the study) ,Qa2(3 months later in the study) ,Qa3(6 months later in the study) ,were analyzed and compared .Results There were no significant difference at different times between the blood flow of arteriovenous fistula in the chitosan group (P>0 .05) .Qa2 and Qa3 of the far infrared group were significantly higher than Qa0 (P<0 .05) .Qa1 ,Qa2 ,Qa3 were significantly higher than Qa0 in the combined treatment group (P<0 .05) .Qa2/Qa0 and Qa3/Qa0 in the far infrared group were significantly higher than control group and chitosan group (P<0 .05) . Compared with the other three group ,Qa1/Qa0 ,Qa2/Qa0 and Qa3/Qa0 were significantly increased in the combined treatment group (P<0 .05) .Conclusion The chitosan and far infrared combined treatment can effectively protect the blood flow of arteriove‐nous fistula in the hemodialysis patients .The combined treatment is one effective method for nursing arteriovenous fistula .
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Adrenal teratoma is a rare germline tumor with a malignant potential. We present a case of left adrenal teratoma complicated by diabetes. The 64-year-old female patient showed multiple cystic space-occupying masses in the left kidney in B-mode ultrasound examination, and plain and enhanced CT reported a 9.0 cm heterogeneous mass in the left adrenal gland. After effective control of blood glucose, the mass was surgically removed and sent for pathological examination. The mass consisted of multiple cysts containing lipid-like substance with a cyst wall thickness of 0.2-0.4 cm; bony structures were found on the sections of the mass with fat tissues on the mass surface. A final diagnosis of left cystic mature adrenal teratoma was made based on the clinical and pathological findings and literature review. The patient was followed up for 6 months and no local recurrence or metastasis was found. Mature adrenal teratoma can be easily diagnosed by ultrasound and CT examinations and should be distinguished from other tumors of an adrenal source. Early diagnosis and early surgical resection is key to the treatment, and a definite diagnosis can be made pathologically. Chemotherapy is necessary in inoperable cases or for such tumors with a malignant potential. The patients should be followed up for life time after the treatment.
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Female , Humans , Middle Aged , Adrenal Gland Neoplasms , TeratomaABSTRACT
Major histocompatibility complex class Ⅰ chain related gene A(MICA) is located within the MHC class Ⅰ region of chromosome 6,including six exons.The MICA locus encodes membrane-bound polypeptides,similar with the classic class Ⅰ molecules,including three extracellular domains (α1,α2 and α3),a transmembrane domain,and a cytoplasmic tail,but is not associated with β2-microglobulin.MICA gene is expressed on endothelial cells,epithelial cells as well as most epithelial tumor cells surfaces,and are involved in the process of cell differentiation,proliferation and infiltration in a variety of tumor cells.Soluble MICA (sMICA) can be used as the prognosis predicting factor for some tumors.MICA gene plays an important role in the pathogenesis of a variety of malignant tumors,which might bring new ideas in prevention and treatment for malignant tumors.
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The clinical data of 42 patients with impacted upper-ureteral calculi undergoing retroperitoneal laparoscopicureterolithotomy(RPLU)from January 2008toDecember 2010 were retrospectively analyzed.RPLU was successfully performed in 40 cases,and simultaneous laparoscopic electrocoagulation ablation was also performed in 11 cases complicated with ureteral inflammatory polyps.No massive bleeding occurred during the operations.The stone-free rate 3 d after operation was 100％,and no stone left as reviewed by kidney ureter bladder X-ray (KUB) and B-ultrasonography.During the follow-up of 3 to 24 months (mean 11 months),40 cases showed no stone recurrence and no ureteral stricture in KUB and B-ultrasonography.The hydronephrosis of all RPLU patients relieved.Results indicate that RPLU is a safe and effective minimally invasive operation for treatment of impacted upper-ureteral calculi.
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BACKGROUND: Studies have demonstrated that incidence rate of acute rejection in renal transplant recipients with pre-production of major histocompatibility complex class I chain-related gene A (MICA), including parts of autoantibody, before transplantation in body, is obviously greater than that of recipients with negative antibody. OBJECTIVE: To investigate effects of exogenous antigen on MICA expression in endothelial cells. METHODS: The endothelial cells were cultured with exogenous recombinant MICA protein (group M5, M10 and M25) and heat shock protein-70 (group H5, H10 and H25) with dosages of 5, 10 and 25 μg/L, respectively, for 48 hours. Same volume of phosphate buffer saline was added into the control groups. RESULTS AND CONCLUSION: At 48 hours after induction, the expressions of MICA mRNA and protein were increased significantly in each experimental group (M5, M10 and M25) than that of the control group with significant (P 0.05). The expression of MICA membrane protein in the group M10 was obviously greater than that of the group M5 and M25 (P 0.05). However, the expression of MICA gene and sMICA level did not change after heat shock protein-70 stimulation. The exogenous MICA antigen up-regulates the expression of MICA mRNA and protein, especially increases the expression of membrane protein on the cell surface significantly, but sMICA in supernatant was dramatically decreased.
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Objective Effect of psychological intervention on functional rehabilitation of femoral supracondylar fractures.Methods 84 type C fracture patients according to AO criteria for the diagnosis were collected,and randomly divided into intervention group(n=42)and control group(n=42)according to patient sex,age,fracture condition,cultural degree balanced matching principle.The control group was given conventional treatment and fracture features of health guidance,the intervention group in addition to conventional treatment and rehabilitation guidance.Comprehensive mental intervention applied 4 times on postoperative 3 days,the 2nd,3rd,4th week.Self-anxiety scale and self-depression scale were used before operation and 6th month after operation.Results The anxiety and depression scores in two groups before intervention showed no significant difference P>0.05).6 months after the operation,the anxiety score(41.6±9.4 vs 48.7±8.5)and depression score(40.6±7.6 vs 47.4±9.2)in intervention group apparently decreased than that in control group(P<0.01).Function restoration of knee joint in different effect showed better than control group(u=-2.0591,P<0.05).Conclusion Psychological intervention can effectively promote the functional recovery of patients with femoral supracondylar fractures and promote anxiety and depression mood.
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Objective To compare the efficacy of tamsulosin and tolterodine for the adjunctive expulsive therapy in patients with lower ureteral stones.Methods A total of 160 patients with lower ureteral stones(4-10 mm)were included in the study.The patients were divided into 4 groups by block randomization.Group Ⅰ patients received tamsulosin 0.4 mg/d;group Ⅱpatients received tamsulosin 0.4 mg/d plus tolterodine 2 mg(twice a day);group Ⅲ patients received toherodine 2 mg(twice a day);and group Ⅳpatients served as controls.All patients were observed for 2 weeks.Remits The stone expulsion rate of group Ⅰ,Ⅱ,Ⅲ,Ⅳ was 76.9%(30/39),70.0%(28/40),46.2%(18/39)and 42.1%(16/38),respectively.The stone expulsion rate in group ⅠandⅡwas,higher than that in group Ⅲand Ⅳ(P＜0.05).The expulsion time of group Ⅰ,Ⅱ,Ⅲ,Ⅳ was(5.3±2.5),(6.4±2.2),(10.7±1.8),(12.8±3.4)d,respectively,with significant differences between group Ⅰ,Ⅱ andⅢ,Ⅳ,between groupⅢand Ⅳ(P＜0.05).Almost all of the patients tolerated the expulsive therapy and only 4 patients withdrew from treatment.No obvious side effect occurred.Conclusion The use of tamsulosin for the expulsion of lower ureteral stones is effective and safe;however,the use of tolteredine provides no additional advantages.
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Objective To investigate the prediction of anti-human leukocyte antigen antibodies (HLA) and anti-major histocompatibility complex class I-related chain A antibodies (MICA) to the development of acute rejection (AR) and kidney allograft function. Methods Forty-one kidney transplant patients were prospectively tested for anti-HLA and anti-MICA. Thirty-seven patients were screened using Luminex/single-antigen beads to determine the HLA and MICA-specific antibody levels at 0,30,90, 180,360,720 and 1080 days post-transplantation. The patients and donors of HLA and MICA allele typing were determined by PCR-SSOP, and donor specific antibody (DSA) and non-donor specific antibody (NDSA) were identified.Simultaneously,their serum creatinine (SCr) levels and clinical data were analyzed. Results Nine patients (21.95 % ,9/41 ) had pre-existing anti-HLA and(or) anti-MICA, including 6 cases of anti-MICA,2 cases of anti-HLA, and one case of anti-MICA and anti-HLA. Nine patients had pre-existing DSA and NDSA. In the 37 patients, 6 patients (16.2% ) developed de novo anti-HLA, and 3 (8.1%) developed de novo antiMICA. In patients positive for de novo anti-HLA, the titer of antibody was gradually increased during the follow-up of three years. Four patients out of 9 patients with pre-existing antibodies were suffered from AR (44.4%); In 6 patients positive for de novo anti-HLA,three cases (50.0%) were suffered from AR; In three patients positive for de novo anti-MICA,no AR occurred (P＜0.05). In two patients positive for DSA of HLAⅡ antibody detected at the third and seventh day after transplantation, the renal grafts were renovecd due to rejection. The Scr levels in patients positive for pre-existing MICA with AR were higher than in those positive for pre-existing MICA without AR at each scheduled time point during the follow-up period (P＜0.05). The Scr levels in patients negative for antibodies pre-transplantation and having AR were higher than in those having no AR at each scheduled time point during the follow-up period (P＜0. 01 ). The Scr levels in patients positive for de novo HLA and MICA and having AR one month following transplantation were higher than in those negative for antibodies and having no AR (P＜0.01 ). Conclusion Pre-existing and de novo anti-HLA were the irnportant factors for the development of AR, but the mismatch of HLA and MICA alleles in donors and patients was primary causes for generation of de novo antibodies.
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Objective To prepare monoclonal antibody against Prostate Stem Cell Antigen(PSCA) and explore the inhibitory effects of Anti-PSCA mAb in treatments of human prostate cancer xenografts in mice. Methods Balb/c mice were immunized by PC-3 cell line. After fusing and screening, the anti-PSCA McAb’s characterizations were determined. Solid tumors in mice were produced by subcutaneous injection with PC-3 cells in the flanks of the mice.We picked out 10 mice bearing human prostate cancer xenografts.They were divided into a treatment group (n_1=5) and a control group (n_2=5).200 ?g Anti-PSCA mAb was injected into abdominal cavity of each mouse of the treatment group and PBS for them of the control group.Anti-PSCA mAb and PBS were administered once every three days for consecutive three times.The mice survival conditions of two groups were recorded during 5 weeks.The serum PSA, the tumor weights and dimensions of survived mice were measured.The tumor volume inhibition rate was calculated. T-test was performed to compare differences of PSA in serum,tumor weights and volumes between the treatment and control groups.Routine pathological slides of tumor tissue were observed under light microscope to evaluate the range of tumor tissues damaged by Anti-PSCA mAb. Ultrastructure was observed with transmission electron microscope. Results A marine McAb was produced, which raised against PSCA,belonged to IgG1 subclass. The average PSA serum level of the two groups were(3.28?0.55)ng/ml and(7.26?0.43)ng/ml.The weights of tumors of the two groups were(0.95?0.17)g and(3.08?0.18)g.The volumes of them were(164.59?14.08)mm3 and(548.49?19.79)mm3.There are remarkable differences between the treatment group and the control group(P
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OBJECTIVE: To introduce the sorts of biomedical fibers, collagenous fibers, chitin fibers polyactic acid(PLA) fibers, etc. , and their preparation,properties and application respectively, and suggest China to pay attention to the research and development of biomedical fiber.DATA SOURCES: Literatures from January 1993 to December 2001 were computer-searched in http://www.sciencedirect.com, http://worldscinet.lib.tsinghua.edu.cn, with the key words of "biomedical and polymer,fibre" and the language was limited to English.: Literatures from January 1999 to December 2004 were computer-searched in http://www.wanfangdata.com.cn,with the key words of "Biological, medical, polymer and Chitin Fibers" and the language was limited to Chinese.STUDY SELECTION: Inclusion criteria: ①Chitin fibers②Collagenous fibers and PLA fibers③Alginic acid fibers④Polyglycolide fibers⑤β-hy droxybutanoic acid ester (PHB)⑥Polycaprolactone fiber. Exclusion criteria:① Obsolete literatures. ② Repeated study. DATA EXTRACTION: Totally 60 tests on biomedical fiber were collected, but only 15 literatures met the inclusion criteria. Altogether 45 literatures were excluded due to older and repeated study.DATA SYNTHESIS: ①The sorts of biomedical fibers: Classified according to the sources, biomedical fibers include metal ones (e.g. stainless steel wire), inorganic and nonmetal ones (e.g. alumina fibers) and macromolecular ones. Classified according to the interaction between living tissues and materials, they include bioinert fibers, bioactive fibers and bioabsobable fibers. Classified according to biomedical use, they include biomedical fibers compatible with hard tissues, biomedical fibers compatible with parenchyma, biomedical fibers compatible with blood and biomedical fibers used as medicine or for regulating the release of medicine ②The main biodegradable fibers include chitin fibers, collagenous fibers, PLA fibers and their copolymer fibers.CONCLUSION: As one of the important functional fibers, the biomedical fibers attract wide attention both at home and abroad. The research and development about them are still on the way and has shown hopeful prospective of application. Much attention should be paid on the research and development of biomechanical fibres.