Three cancers in the renal pelvis, bladder, and colon: A case report.

BACKGROUND: Multiple primary cancers are rare occurrences that can involve either metachronous or synchronous development. It is particularly rare for an individual to have more than two primary cancers. In this report, we present a case study of an elderly man who was diagnosed with three heterochronous cancers in the renal pelvis, bladder, and colon. CASE SUMMARY: On December 30, 2014, a 51-year-old Chinese man was admitted to our hospital with complaints of intermittent painless gross hematuria for the preceding week. A computed tomography (CT) scan revealed wall thickening in the left ureter's upper segment, while a CT urography revealed a left renal pelvis tumor. A successful laparoscopic radical resection of the left renal pelvis tumor was subsequently performed at Shanghai Zhongshan Hospital in January 2015. The pathological findings after the surgery revealed a low-grade papillary urothelial carcinoma of the renal pelvis. The final pathological tumor stage was pT1N0M0. After surgery, this patient received 6 cycles of intravenous chemotherapy with gemcitabine and carboplatin, as well as bladder infusion therapy with gemcitabine. On December 18, 2017, the patient was admitted once again to our hospital with a one-day history of painless gross hematuria. A CT scan showed the presence of a space-occupying lesion on the posterior wall of bladder. Cystoscopic examination revealed multiple tumors in the bladder and right cutaneous ureterostomy was performed under general anesthesia on December 29, 2017. The postoperative pathological findings disclosed multifocal papillary urothelial carcinoma of the bladder (maximum size 3.7 cm × 2.6 cm). The bladder cancer was considered a metastasis of the renal pelvis cancer after surgery. The pathological tumor stage was pT1N0M1. The patient refused chemotherapy after surgery. After another six years, the patient returned on February 28, 2023, complaining of periumbilical pain that had lasted six days. This time, a CT scan of the abdomen showed a tumor in the ascending colon, but a subsequent colonoscopy examination indicated a tumor in the descending colon. On March 12, 2023, a subtotal colectomy and an ileosigmoidal anastomosis were carried out under general anesthesia. Postoperative pathological findings revealed that all three tumors were adenocarcinomas. The final pathological tumor stage was pT3N0M0. The patient had an uneventful postoperative recovery and was discharged without complications. CONCLUSION: The case of this elderly man presents a rare occurrence of metachronous primary cancers in the renal pelvis and colon. Bladder cancer is considered a metastasis of renal pelvis cancer after surgery. Optimal treatment can be implemented by evaluating the patient's histological features, clinical history, and tumor distribution correctly.

The Effects of Temperature on Dynamics of Psychiatric Outpatients.

Background: Climate changes affect mental states and alter the risk for psychiatric diseases. Seasonal changes in temperature lead to dynamics in the occurrence of psychiatric conditions and pose challenges in the administration of clinical psychiatry services. Methods: The present study aims to retrospectively analyze outpatient data with weather reports from January 2014 to March 2019 at Shanghai Mental Health Center, one of the largest psychiatric hospitals in the world, in order to provide policy insights into the administration of psychiatric clinics. Results: The results show steady increases in the number of overall patients over the past 5 years with several peaks within each year. Temperature changes and weather information reliably predict the increased number of psychiatric patients. Conclusions: We conclude that mental health hospitals should prepare for patient dynamics based on the weather forecast.

A new report of a mosaic dwarf viroid-like disease on mulberry trees in China.

A viroid-like disease causing mosaic leaves and dwarfism was found on mulberry plants in Zhejiang, China. Grafting of stems from infected plants onto healthy plants resulted in the same symptoms on the healthy plants. A circular small RNA (Mmd-v RNA1) was isolated from the infected plant leaves and caused identical symptoms after more than two years. Nucleotide sequencing indicated that the Mmd-v RNA1 contains 356 nt (GenBank accession no. NC_011362) without viroid characteristic regions, only sharing 30 nt sequence identity with that of the Cherry small circular viroid-like RNA 1 (isolate cscRNA1.150, GenBank accession no. DQ357628). This description is the first of viroid-like RNA infection of mulberry trees.