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Objective To study the ultrastructure of the renal papillary Randall's plaque in calclum oxalate stone formers. Methods The 14 biopsy samples of the Randall's plaque in 12 patients with calcium oxalate stone undergoing PCNL for stone removal were obtained using endoscopic biopsy technique,followed by staining with hematoxylin-eosin or fixing with osmium tetroxide,and then the ultrastructure of the Randall's plaque was observed under light microscope and transmission electron microscope. Results In all 12 patients,72 renal papillae were examined.All kidReys were found to have papillary plaque and 7 of the patients had attached stones.Sixty-three papillae(87.5%)contained plaque.Calcium deposition was seen in the 12 renal papilla tissue by light microscopy.Transmission electron microscopy images of the 2 Randall's plaque samples showed several cluster of sharp and large crystals lied closer to the surface of Randall's plaque.The typical crystals were acicular with light profile. Conclusions Randall's plaque is an interstitial medullary and papillary deposit of calcium oxalate.The appearance of the deposition of calcium oxalate crystals lies upon Randall's plaque,which might be an explanation for the mechanism of calcium oxalate stone formation.
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Objective To improve the diagnosis and treatment of primary adrenocortical carcinoma. Methods Retrospective analysis was performed in clinical data of 16 patients with primary adrenocortical carcinoma. The diagnosis was based on clinical presentations,hormonal studies and imaging. Surgical treatment was underwent on 13 cases. All patients were followed up for 3 to 62 months. Results Of 16 cases,functional tumors were in 8,including Cushing′s syndrome in 5,combination of Cushing′s syndrome and virilization in 2,and hyperaldosteronism in 1. Imaging studies revealed the tumors were 4.8 to 19.5 cm in diameter,average in 7.8 cm. Distant metastasis occurred in 3 cases. Radical surgery was done in 13 cases without distant metastasis,including radical adrenalectomy in 8,adrenalectomy plus nephrectomy in 2,adrenalectomy plus surgical extirpation of intracaval tumor thrombus in 2,and partial resection of the wall of inferior vena cava in 1. Pathologic stages were stage Ⅰ in 2 cases,stage Ⅱ in 8,stage Ⅲ in 3,stage Ⅳ in 3. Among the 11 cases who were treated over 2 years after operation,6 cases were still survival,while 1 case had pulmonary and 1 case had bone metastasis. The other 5 cases survive in average of 26 months. Conclusions Prognosis of primary adrenocortical carcinoma is poor. The keys to early diagnosis are clinical manifestations plus imaging. Surgical treatment is the only effective therapy for the disease.
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Objective:To construct DNA vaccines expressing prostate-specific membrane antigen(PSMA) and/or granulocyte-macrophage colony-stimulating factor(GM-CSF) and to determine their immunoactivity.Methods: Recombinant plasmids pIRES-PSMA-mGM-CSF,pIRES-PSMA,and pIRES-mGM-CSF were constructed with DNA vaccine vector pIRES.After identified by endonuclease digestion,the above 3 plasmids and blank pIRES vector were used to immunize C56BL/6 mice(n=15).LDH release assay was used to exam the cytotoxicity of cytolytic T lymphocytes in each group.Results: We successfully constructed the above mentioned recombinant plasmids.Mice in pIRES-PSMA-mGM-CSF immunized group had the highest specific cytotoxicity,followed by pIRES-PSMA and pIRES-mGM-CSF immunized groups.The blank pIRES group had the lowest cytotoxicity(P
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Objective To assess the diagnostic value of NMP22 and BTA stat in the detection of bladder cancer. Methods 82 symptomatic patients suspicious of bladder cancer were asked to have urine NMP22,BTA stat,and cytological examination before cystoscopy. Results 32 patients were pathologicaly diagnosed as transitional cell carcinoma,and 50 cases were other benign urological conditions.The sensitivity of NMP22 (87.5%) was significantly better than BTA stat (65.6%) and urinary cytology ( 21.9 %), P