Efficacy of European Organization for Research and Treatment of Cancer (EORTC) risk tables for the prediction of recurrence and progression of non-muscle invasive bladder cancer after intravesical pirarubicin instillation / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the influence of intravesical Pirarubicin (THP) instillation on the prediction results of European Organization for Research and Treatment of Cancer (EORTC) risk tables and to discuss the efficacy of EORTC risk tables in clinical application.</p><p><b>METHODS</b>We retrospectively reviewed the clinical data of 389 patients with non-muscle invasive bladder cancer after TURBT treated with intravesical pirarubicin instillation. According to the EORTC Scoring System, all the cases were divided into low risk group, intermediate risk group and high risk group. The 1-year and 5-year recurrence and progression rates of each group were calculated and compared with the prediction results of the EORTC risk tables.</p><p><b>RESULTS</b>The 1-year recurrence and progression rates of the low risk group were 8.0% and 0, those of the intermediate risk group were 31.0% and 2.8%, and those of the high risk group were 52.5% and 18.6%, respectively. The 5-year recurrence and progression rates of low risk group were 16.0% and 5.3%, those of the intermediate risk group were 42.6% and 10.7%, and those of the high risk group were 63.9% and 41.9%, respectively. The prediction results of progression rate were similar to that of the EORTC risk tables while the overall recurrence rate was lower.</p><p><b>CONCLUSIONS</b>The EORTC risk tables can be effectively used to predict the recurrence rate and progression rate of non-muscle invasive bladder cancer. However, the EORTC risk tables have a tendency to overestimate the recurrence rate. Intravesical pirarubicin instillation is helpful to reduce the recurrence rate, yet has no obvious influence on the tumor progression.</p>

Influence of clinical characteristics and tumor size on symptoms of bladder leiomyoma: a pooled analysis of 61 cases / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Bladder leiomyoma is an uncommon type of bladder neoplasms. Most publications are reports of isolated cases. The influence of tumor size on patients' early symptoms was seldom analyzed. We aim to investigate the clinical characteristics of bladder leiomyoma and the influence of tumor size on patients'symptoms in Chinese population.</p><p><b>METHODS</b>We reviewed the medical records of eight patients diagnosed with bladder leiomyoma at our department, collected 53 cases from Chinese National Knowledge Infrastructure (CNKI), Wangfang data base, and Chinese Biological Medicine Disk, and performed a pooled analysis. The clinical characteristics of the patients were analyzed and then classified into symptomatic and asymptomatic groups. The association between tumor size and the occurrence of symptoms was evaluated. Furthermore, Logistic regression model was constructed to discriminate variables.</p><p><b>RESULTS</b>Women comprised the majority of the patients (49/61, 80.3%). The mean age and tumor size were (42.3 ± 14.0) years and (45.0 ± 25.7) mm, respectively. Among all the symptoms, irritative symptoms occurred most frequently (37.7%, 23/61), followed by obstructive urinary symptoms (31.1%, 19/61), hematuria (24.6%, 15/61), and abdominal bulge or pain (14.8%, 9/61). In our study, patients who were 45 years old or younger tended to be asymptomatic compared with elder ones (14/36 vs. 3/25, P = 0.021). The histological, as well as anatomical, location of tumor, did not show significant differences between symptomatic and asymptomatic patients (P = 0.306 and 0.700). Tumors larger than 30 mm in the greatest diameter would cause clinical symptoms such as obstructive urinary symptoms (P = 0.048) and irritative symptoms (P = 0.037). Logistic regression confirmed the association between tumor size and the occurrence of symptoms, which was related with age.</p><p><b>CONCLUSIONS</b>Bladder leiomyoma occurs mainly in women and most frequently with irritative symptoms. The occurrence of symptoms is related to tumor size rather than the location. In this setting, patients with endovesical tumors smaller than 30 mm in the greatest diameter tended to be asymptomatic, which were usually treated with transurethral resection of bladder tumor.</p>

Distribution and differentiation of mesenchymal stem cells in tumor tissue / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Tumor has an ability to become enriched in mesenchymal stem cells (MSCs) and of guiding MSCs to migrate to tumor tissue. But there are lack of relevant reports on the distribution and differentiation of MSCs in tumor tissue and the effect on tumor growth after MSCs engrafted in tumor tissue. In this study, we observed the distribution of bone marrow MSCs in tumor tissue and the possibility of MSCs differentiating into myofibroblast under the induction of local tumor microenvironment.</p><p><b>METHODS</b>Twenty-four New Zealand rabbits were randomly classified into the control group and the test group. MSCs were isolated and cultured for each animal. vx-2 tumor tissue was transplanted under the bladder mucosa of each animal. One week after the transplantation, the self F2 passage MSCs marked by 4', 6-diamidino-2-phenylindole were transplanted into tumor tissue in the test group while only Dulbecco's modified Eagle's medium-low glucose was infused into the control group. Ultrasonography was performed for each animal 1, 2, 3 and 4 week (s) after the vx-2 tumor mass was transplanted. The maximum bladder tumor diameter of each animal was recorded and the mean value of each group was calculated. One animal from each group was sacrificed in the third week and the remaining animals in the fourth week to observe the tumor development. Another animal treated the same as the test group was sacrificed to observe the distribution of MSCs in tumor tissue one week after self MSCs transplantation. Immunofluorescence was used to trace MSCs in tumor tissue. The double labeling immunofluorescence for alpha-smooth muscle actin (alpha-SMA) and vimentin was performed to identify whether the MSCs can differentiate into myofibroblast.</p><p><b>RESULTS</b>The ultrasonography showed no tumor mass one week after the vx-2 tumor mass transplantation. The mean maximum tumor diameter of the control group and test group was (0.70 +/- 0.14) cm and (0.78 +/- 0.14) cm, respectively, and there was no significant difference (t = 1.308, P = 0.204). The tumor growth rate of the test group increased gradually in the third and fourth weeks, and the difference of the mean maximum tumor diameter between the two groups also increased gradually and was statistically significant (P < 0.05). MSCs distributed uniformly in tumor tissue one week after transplantation while most were distributed in the tumor stroma three weeks after transplantation. The double labeling immunofluorescence showed that the expression of alpha-SMA as well as Vimentin increased significantly three weeks after mesenchymal stem cells engrafted into tumor, indicating that MSCs had differentiated into myofibroblasts under the induction of the tumor microenvironment.</p><p><b>CONCLUSION</b>MSCs can accelerate the tumor development and can differentiate into myofibroblast under the induction of tumor microenvironment.</p>

Primary cutaneous T-cell lymphoma of the penis complicated by Fournier gangrene: a case report / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the clinical presentation, pathologic characteristics, diagnosis and treatment of cutaneous T-cell lymphoma of the penis.</p><p><b>METHODS</b>A 49-year-old man presented with painful swelling and inflammation of the foreskin, failed to respond to antibiotic treatment and dorsal incision, and was instead complicated by Fournier gangrene. Then he underwent debridement and pathological examination.</p><p><b>RESULTS</b>Pathological results indicated cutaneous T-cell lymphoma of the penis. Immunohistochemistry showed CD3 and CD45 RO to be positive, but CD30, CD79a, CD20 and HMB negative. The patient was treated by interferon alpha and ultraviolet B for 2 weeks, followed by total removal of the external genitalia because of necrosis of the corpus spongiosum, which involved the scrotum and right testis on pathological examination.</p><p><b>CONCLUSION</b>Cutaneous T-cell lymphoma of the penis is a rare condition and easily mis diagnosed in the early phase. Definitive diagnosis depends on pathological study.</p>

Diagnosis and treatment of interstitial cystitis: report of 16 misdiagnosed cases / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the diagnoses and treatment of interstitial cystitis (IC).</p><p><b>METHODS</b>The clinical data of 16 IC patients were analyzed respectively. The patients with urinary frequency, urgency, suprapubic pain and chronic pelvic pain. They were misdiagnosed as chronic cystitis, pelvic inflammation, endometriosis, cystophthisis and urethral syndrome, and were diagnosed finally by the means of pathology or cystoscopy. Among the 16 patients, 4 cases had the operation of ileal reservoir, Two cases had sigmoid-cysto-plasty, and 10 cases had drug treatment. The methods of IC diagnosis and treatment were discussed with the review of literature.</p><p><b>RESULTS</b>The pelvic ache disappeared completely in 4 cases after the operation of ileal reservoir; Two cases after cystoplasty felt lightly discomfortable in perineum occasionally, and their bladder capacity was above 350 ml, no recurrence after operation having been found after follow-up for 24 months and 33 months; Ten cases treated with non-operative treatment improved obviously, with the O'Leary-Sant IC symptom index and IC problem index decreased from 15.4 +/- 4.1, 9.4 +/- 2.7 to 4.1 +/- 2.1 and 5.1 +/- 3.9, respectively.</p><p><b>CONCLUSIONS</b>Sufficient attention should be paid to the diagnosis and differential diagnosis of IC; Early diagnosis and therapeutic alliance with manifold measures can relieve the patients' symptom and improve the quality of life.</p>

Treatment of the paraplegic patient with erectile dysfunction by implantation of China-made three-piece inflatable penile prosthesis / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of the treatment on paraplegic patients with erectile dysfunction (ED) by implantation of China-made three-piece inflatable penile prosthesis.</p><p><b>METHODS</b>Eighteen paraplegic patients with ED refractory to non-operative treatment were implanted with three-piece inflatable penile prosthesis through an incision at the border of penis and scrotum. The rate of maintained coitus and the satisfactory coitus of spouse were obtained by inquiring and letter visiting.</p><p><b>RESULTS</b>Operations were successfully performed upon all 18 patients. Follow-ups after operations ranged from 3 months to 36 months, mean follow-up being 18 months. Fluid exudation from penile prosthesis and localized infection occurred in one patient and mechanic complication occurred in two. Maintained coitus rate was 17/18. Ejaculation reflection occurred in three patients.</p><p><b>CONCLUSIONS</b>Treatment of paraplegic patient with ED refractory to non-operative treatment by implantation of China-made three-piece inflatable penile prosthesis has good concealment and rehabilitative effect, with similar mechanical troubles to imported products. With excellent covertness, implantation of three-piece inflatable penile prosthesis is well accepted by ED patients.</p>