Nourishing Yin traditional Chinese medicine: potential role in the prevention and treatment of type 2 diabetes.

Type 2 diabetes mellitus (T2DM), a common and frequently occurring disease in contemporary society, has become a global health threat. However, current mainstream methods of prevention and treatment, mainly including oral hypoglycemic drugs and insulin injections, do not fundamentally block the progression of T2DM. Therefore, it is imperative to find new ways to prevent and treat diabetes. Traditional Chinese medicine is characterized by multiple components, pathways, and targets with mild and long-lasting effects. Pharmacological studies have shown that nourishing yin traditional Chinese medicine (NYTCM) can play a positive role in the treatment of T2DM by regulating pathways such as the phosphatidylinositol 3-kinase/serine-threonine kinase, mitogen-activated protein kinase, nuclear factor-kappa B, and other pathways to stimulate insulin secretion, protect and repair pancreatic ß cells, alleviate insulin resistance, ameliorate disordered glucose and lipid metabolism, mitigate oxidative stress, inhibit inflammatory responses, and regulate the intestinal flora. The pharmacologic activity, mechanisms, safety, and toxicity of NYTCM in the treatment of T2DM are also reviewed in this manuscript.

UPLC-Q-TOF-MS, network analysis, and molecular docking to investigate the effect and active ingredients of tea-seed oil against bacterial pathogens.

Object: This research intended to probe the antibacterial effect and pharmacodynamic substances of Tea-Seed Oil (TSO) through the use of ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS) analysis, network analysis, and molecular docking. Methods: The major chemical components in the methanol-extracted fractions of TSO were subjected to UPLC-Q-TOF-MS. Network pharmacology and molecular docking techniques were integrated to investigate the core components, targets, and potential mechanisms of action through which the TSO exert their antibacterial properties. To evaluate the inhibitory effects, the minimum inhibitory concentration and diameter of the bacteriostatic circle were calculated for the potential active ingredients and their equal ratios of combinatorial components (ERCC) against Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. Moreover, the quantification of the active constituents within TSO was achieved through the utilization of high-performance liquid chromatography (HPLC). Results: The methanol-extracted fractions contained a total of 47 chemical components, predominantly consisting of unsaturated fatty acids and phenolic compounds. The network pharmacology analysis and molecular docking analysis revealed that various components, including gallocatechin, gallic acid, epigallocatechin, theophylline, chlorogenic acid, puerarin, and phlorizin, have the ability to interact with critical core targets such as serine/threonine protein kinase 1 (AKT1), epidermal growth factor receptor (EGFR), a monoclonal antibody to mitogen-activated protein kinase 14 (MAPK14), HSP90AA1, and estrogen receptor 1 (ESR1). Furthermore, these components can modulate the phosphatidylinositol-3-kinase protein kinase B (PI3K-AKT), estrogen, MAPK and interleukin 17 (IL-17) signaling pathways, hereby exerting antibacterial effects. In vitro validation trials have found that seven components, namely gallocatechin, gallic acid, epigallocatechin, theophylline, chlorogenic acid, puerarin, and phloretin, displayed substantial inhibitory effects on E. coli, S. aureus, P. aeruginosa, and C. albicans, and are typically present in tea oil, with a total content ranging from 15.87∼24.91 µg·g-1. Conclusion: The outcomes of this investigation possess the possibility to expand our knowledge base concerning the utilization of TSO, furnish a theoretical framework for the exploration of antibacterial drugs and cosmetics derived from inherently occurring TSO, and establish a robust groundwork for the advancement and implementations of TOS products within clinical settings.

Effects of programmed death-ligand 1 expression on OK-432 immunotherapy following transurethral resection in non-muscle invasive bladder cancer.

The present study aimed to investigate the effect of the negative costimulatory molecule programmed death-ligand 1 (PD-L1) on immunotherapy with OK-432, following transurethral resection of bladder tumors in non-muscle invasive bladder cancer (NMIBC), and to elucidate the underlying mechanism. PD-L1 was detected by immunohistochemical staining in tumor specimens from 55 cases of NMIBC following postoperative immunotherapy with OK-432. The PD-L1 mRNA and protein expression levels were measured in the bladder cancer T24 cell line and the human uroepithelial SV-HUC-1 cell line, following treatment with interleukin (IL)-2, interferon (IFN)-α and IFN-γ, by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blot analysis, respectively. PD-L1 was widely expressed in the NMIBC tumors, with 56.4% (31/55) of specimens exhibiting positive staining. When compared with PD-L1-negative patients, PD-L1-positive patients exhibited significantly increased recurrence [48.4% (15/31) vs. 16.7% (4/24)] and progression [16.1% (5/31) vs. 4.2% (1/24)] rates (P<0.05). RT-qPCR and western blotting demonstrated that cytokines IL-2, IFN-α and IFN-γ markedly upregulated PD-L1 mRNA expression rates and protein levels in bladder cancer T24 cells (P<0.05), but had no significant effect in non-tumor SV-HUC-1 cells. In conclusion, PD-L1 expression was negatively-associated with the efficacy of OK-432 intravesical immunotherapy in patients with NMIBC. The results indicated that the involved mechanism occurred via upregulation of PD-L1 by immune cytokines, which in turn suppressed the antitumor effectiveness of the immune system, thereby promoting tumor recurrence and progression.

Management of adrenal incidentaloma: the role of adrenalectomy may be underestimated.

BACKGROUND: To demonstrate clinical characteristics of adrenal incidentaloma in South China and explore its comprehensive management. METHODS: The clinical data of patients with adrenal neoplasm from Jan 1998 to Dec 2012 were retrospectively analysed. Patients with suspicion of adrenal abnormalities or those in whom adrenal abnormalities were detected in the staging procedures of other cancers were excluded. Most patients with adrenal incidentaloma chose to have adrenalectomy, and some chose surveillance. The relationships between clinical features were analysed with a chi-square test and rank sum test. RESULTS: In total, 634 patients with adrenal incidentaloma were studied. Their age ranged from 17 to 85 years old with a median age of 50 years. Of 478 cases with pathological results, adenoma was the most common tumour (233/478), with 84 cases of pheochromocytoma and 36 cases of adrenocortical carcinoma were 84 and 36. When the tumour size was ≤4 cm, >95 % were benign; when the tumour size was >6 cm, 33 % were malignant. For patients with a tumour size ≤4 cm, 249/376 cases had an adrenalectomy performed. Due to anxiety over a potential malignant transformation and enlargement, most patients (>80 %) under surveillance preferred to undergo adrenalectomy. CONCLUSIONS: Pheochromocytoma and adrenocortical carcinoma were not rare tumours of adrenal incidentaloma, and 4 cm is a good size cutoff to use in the diagnosis of an adrenal incidentaloma. Other than surveillance, laparoscopic adrenalectomy may become the method of choice for management of small adrenal incidentaloma.

[Preliminary investigation of intestinal microflora in patients with hepatic cirrhosis].

OBJECTIVE: To examine the differential levels of fecal Bifidobacterium, Bacteroides, Eubacterium rectale-Clostridium, Escherichia coli, Enterococcus, and Clostridium difficile between patients with hepatic cirrhosis and healthy controls. Fecal samples were collected from 29 patients with hepatic cirrhosis treated in the Department of Digestive Diseases at Zunyi Hospital between March and December of 2010. METHODS: Fecal samples were collected from 13 healthy college students for use as controls. All samples were assessed by pH measurement, bacterial culture for turbidity, fluorescence in situ hybridization, and laser scanning confocal microscopy. The t-test and rank correlation test were used to determine statistical significance of intergroup differences in each tested parameter. RESULTS: The feces of patients with hepatic cirrhosis had higher pH than that of healthy controls (6.79+/-0.64 vs. 6.18+/-0.74, P less than 0.05). The bacterial turbidity was not significantly different between the feces of hepatic cirrhosis patients and healthy controls (1.15+/-0.59 vs. 1.39+/-1.01, P more than 0.05). The numbers of Bifidobacterium, Bacteroides, Eubacterium rectale-Clostridium, Escherichia coli, Enterococcus, and Clostridium difficile in feces of patients with hepatic cirrhosis were significantly lower than those of the controls (all P less than 0.01). No significant correlation was found between the number or ratio of bacteria species and the severity of hepatic cirrhosis (Child-Pugh scores; P more than 0.05). CONCLUSION: The total quantity of intestinal bacteria in patients with hepatic cirrhosis is not significantly different from that in healthy patients. However, the profile of intestinal bacteria is different, which may explain the increased pH of fecal samples from patients with hepatic cirrhosis, but the differential profile is not correlated to cirrhosis pathogenesis.

[Synergetic killing effects of external magnetic fields combined with porphyrin-dextran magnetic nanoparticles on the human bladder cancer cells].

OBJECTIVE: To study the synergetic killing effects of external magnetic fields combined with the photodynamic action of porphyrin-dextran iron oxide magnetic nanoparticles (PDMN) on human bladder cancer cells in vitro. METHODS: The PDMN were produced by using the chemical co-precipitation and redox process and the physicochemical properties were characterized. Methyl thiazolyl tetrazolium (MTT) and flow cytometry were used to determine the effects of photodynamic therapy of PDMN combined with external pulsed electromagnetic fields (5 mT) on killing human bladder cancer BIU-87 cells respectively. RESULTS: The diameters of PDMN were 10-15 nm and the saturation magnetization was 0.20 emu/g. Effective diameter of PDMN was 94.8 nm. PDMN could remarkably inhibit the proliferation and induce the obvious apoptosis of BIU-87 cells, and the rates of growth inhibition and apoptosis were (17.61±2.73)% and (24.53±5.74)% respectively. Moreover, external pulsed electromagnetic fields (5 mT) could also suppress the proliferation and induce apoptosis of BIU-87 cells. Furthermore, the photodynamic action of PDMN combined with external magnetic fields significantly inhibited the proliferation and promote apoptosis of BIU-87 cells, and the rates of growth inhibition and apoptosis was (28.11±4.25)% and (24.53±5.74)%, respectively, which were significantly higher than those of other groups (P<0.01). CONCLUSION: The chemical modified photodynamic action of PDMN could effectively inhibit proliferation and induce apoptosis of BIU-87 cells. Moreover, these effects on BIU-87 cells could be strengthened by the combination with external magnetic fields.

Clinical analysis of management of pediatric testicular germ cell tumors.

OBJECTIVE: To analyze our experiences of pediatric testicular tumors and investigate the management of pediatric testicular germ cell tumors. Pediatric testicular tumors are rare and the treatment of them has not been well defined. METHODS: Children treated for primary testicular tumors between January 1998 and July 2010 were retrospectively analyzed. For yolk sac tumor, the difference of survival rates between patients with and without retroperitoneal lymph node dissection (RPLND) was calculated. RESULTS: Eighty-seven cases met our criteria and 78 were germ cell tumors, including 40 cases with yolk sac tumor. Patients were 3-128 months old (median 19), and 53 patients were diagnosed at younger than 2 years of age. For germ cell tumors, serum α-fetoprotein and ß-human chorionic gonadotropin were elevated in 48 and 7 patients, respectively, including 38 and 2 in those with yolk sac tumor. RPLND and chemotherapy were performed in 13 and 19 patients, respectively, and surveillance was performed in 50 patients. With median follow-up of 50 months, 6 patients had recurrence, 4 patients died, and the others achieved complete remission. For stage I yolk sac tumor, the difference of survival rates between patients with and without RPLND was not significant (P = .808). CONCLUSION: Yolk sac tumor is the most common type of pediatric testicular tumor. For stage I yolk sac tumor, radical inguinal orchiectomy is effective, salvage chemotherapy is promising, and RPLND may not be necessary.

Primary mucinous adenocarcinoma of the renal pelvis with elevated CEA and CA19-9.

Primary adenocarcinoma of the renal pelvis is rarely reported in the literature. Here we present a case of primary mucinous adenocarcinoma of the renal pelvis with elevated serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels. A 56-year-old woman was referred to our center with intermittent fever and left-sided back pain for 1 month. Computed tomography showed bilateral nephrolithiasis, mild right hydronephrosis and left pyonephrosis accompanied with ambiguous soft tissues. A radionucleorenogram showed that the glomerular filtration rate of the left and right kidney was 0 and 79 ml/min, respectively. Left nephrectomy was performed without lymph node dissection. Histopathology revealed mucinous adenocarcinoma and elevated serum CEA and CA19-9 levels were found. She died of multiorgan metastasis after 5 months. A review of the literature is also reported.

[Expression and significance of macrophage migration inhibitory factor in bladder urothelial cell carcinoma].

OBJECTIVE: To evaluate the expression and clinical significance of macrophage migration inhibitory factor (MIF) in patients with bladder urothelial cell carcinoma. METHODS: Immunohistochemical staining for MIF was performed on tissue sections of 110 patients with bladder urothelial cell carcinoma and 10 normal controls, and the correlations between MIF and clinicopathological characteristics and prognosis were also analyzed. RESULTS: Normal bladder urothelium from control subjects showed negative or weak staining of MIF. Of the cancer specimens, 72/110 (65.5%) showed a moderate to strong staining of MIF. The expression of MIF protein was found predominantly in the tumor cell cytoplasm and inversely correlated with tumor stage. 27 cases also showed a positive intranuclear staining of MIF, which was inversely correlated with tumor grade, stage and tumor size. Kaplan-Meier analysis showed that the expression of MIF in the cell nuclei was associated with disease-free survival for the cancer patients, but multivariate analysis showed that MIF was not an independent prognostic factors. CONCLUSIONS: The expression of MIF in non-muscle invasive bladder cancer tissues was more frequently than that in muscle-invasive disease, the positive staining of MIF in cell nuclei might be a favorable biomarker for patients with bladder urothelial cell carcinoma.

[Establishment of a rat model of erectile dysfunction after radical prostatectomy by crush injury or resection of the cavernous nerve].

OBJECTIVE: To establish a rat model mimicking erectile dysfunction following radical prostatectomy by crush injury or reaction of the cavernous nerve (CN). METHODS: Thirty rats were randomized into CN crush group, CN resection group and sham-operated group. Four weeks after surgery, the rat models were evaluated by apomorphine test and ICP/MAP measurement. Fluorogold (FG) retrograde tracer was used to assess the CN injury. The penile tissues were then harvested for immunohistochemical detection of the nNOS-positive fibers to evaluate the CN injury. RESULTS: The rats in CN crush group and CN resection group exhibited erectile dysfunction in apomorphine test or in response to electrical stimulation of the ganglion stellatum (MPG). In the sham-operated group, the rats showed normal erectile function with increased ICP/MAP following electrical stimulation (P<0.05). Immunohistochemistry revealed reduced nNOS-positive fibers in both CN crush group and CN resection group as compared with those in the sham-operated group (P<0.05), showing no significant difference between the former two groups (P>0.05). The FG-positive MPG cells in CN crush group and CN resection group were significantly less than that in the sham-operated group (P<0.05), and the positive cells were even less in CN resection group (P<0.05). CONCLUSION: The rat CN is structurally similar to human CN, and crush injury and resection of the CN are both reliable methods for establishing rat models of erectile dysfunction following radical prostatectomy.

[Multivariate analysis of recurrence factors for non muscle-invasive bladder urothelial carcinomas].

OBJECTIVE: To discuss the risk factors of recurrent non-muscle-invasive bladder cancer and elucidate its clinical significance. METHODS: The retrospective survival analysis of 161 patients with non-muscle-invasive bladder cancer was performed by Kaplan-Meier method, Log-rank test and COX proportional hazard model. RESULTS: On univariate analysis, the parameters of tumor stage, tumor grade, number of tumors and previous recurrence were significant for tumor recurrence (all P < 0.05). On multivariate analysis of COX proportional hazard model, all the above risk factors remained significant for tumor recurrence. The hazard ratios were as follows: tumor stage (RR = 3.810, P = 0.001), tumor grade (RR = 2.416, P = 0.009), number of tumors (RR = 1.736, P = 0.036) and previous recurrence (RR = 1.810, P = 0.010). CONCLUSION: Tumor stage and tumor grade plays the most important role in tumor recurrence.

Analysis of long-term survival in patients with localized renal cell carcinoma: laparoscopic versus open radical nephrectomy.

OBJECTIVES: To assess the impact of surgical approaches and clinico-pathological parameters on the prognosis of localized renal cell carcinoma (RCC) after laparoscopic radical nephrectomy (LRN) or open radical nephrectomy (ORN). METHODS: Between 2002 and 2008, 336 patients with localized RCC were treated at our two institutions. Of these, 261 were classified as clinical stage pT1 and 75 as pT2, the mean age was 52.3 years. One hundred forty-two patients underwent LRN, and 194 underwent ORN. The medical records of all patients were retrospectively reviewed. RESULTS: The mean follow-up was 44 months (12-84 months). The 3-, 5-, and 7-year cancer-specific survival (CSS) rates of LRN group (96.3, 94.6, and 92.5%, respectively) were equivalent to ORN (97.4, 94.2, and 91.4%, respectively). The mean CSS rates were not significantly different between LRN and ORN groups for either pT1 (82.3 vs. 81.6 months, P = 0.713) or pT2 (69.0 vs. 72.1 months, P = 0.729). Univariate analysis demonstrated significant impact of tumor stage (pT1 vs. pT2, P = 0.002) and tumor grade (G1/2 vs. G3/4, P = 0.045) on CSS. Surgical approach (laparoscopic or open) was not a statistically significant factor on CSS. Multivariate analysis identified that tumor stage was an independent prognostic factor for CSS of localized RCC (P = 0.007). CONCLUSIONS: Based on the long-term follow-up, our evaluation suggests that LRN is oncologically equivalent to ORN for patients with pT1 or pT2 tumors. Among the clinical variables, tumor stage appears to be an independent prognostic factor of CSS of localized RCC patients.

[Value of 3D 1H-MRS with body coil at 3T in the differential diagnosis of the prostate cancer].

OBJECTIVE: To assess the value of three dimensional proton magnetic resonance spectroscopy (3D 1H-MRS) with body coil at 3T in the differential diagnosis of prostate cancer. METHODS: Forty patients suspected of prostate cancer underwent MRI and MRS examinations, and then transrectal ultrasound guided prostate biopsy for pathological diagnosis. The MRI and MRS features of benign prostate hyperplasia, prostate cancer and prostatic intraepithelial neoplasia (PIN) were analyzed in comparison with the pathological reports, and the receiver operating characteristic curve was drawn for the diagnosis of cancer from peripheral zones. RESULTS: The examinations were accomplished for all the patients. The mean ratios of (Cho + Cre)/Cit in the interstitial and glandular hyperplasia tissues, the cancer tissue of the central and peripheral glands, the healthy peripheral gland and PIN were 0.75 +/- 0.23, 0.59 +/- 0.14, 1.79 +/- 0.90, 1.18 +/- 0.95, 0.46 +/- 0.18, and 0.97 +/- 0.10, respectively, with statistically significant differences between the cancer and normal prostate tissues (P < 0.01). The optimum threshold for the diagnosis of prostate cancer in the peripheral zone was 0.68 with a sensitivity of 88.6% and a specificity of 88.7%. CONCLUSION: The 3D 1H-MRS with body coil at 3T has a high sensitivity and specificity in the differential diagnosis of prostate cancer, and can provide valuable information for the diagnosis of PIN.

Utility of fluorescence in situ hybridization in the diagnosis of upper urinary tract urothelial carcinoma.

The purpose of this study was to evaluate the clinical utility of fluorescence in situ hybridization (FISH) assay as a non-invasive method for diagnosing and monitoring urothelial carcinoma (UC) in the upper urinary tract (UUT). Urine specimens from 21 consecutive patients with UUT-UC and 10 healthy controls were analyzed by means of cytology and FISH. For FISH analysis, labeled probes specific for chromosomes 3, 7, and 17 and for the p16 (9p21) gene were used to assess chromosomal abnormalities indicative of malignancy. Sensitivity and specificity of both techniques were determined and compared. The frequency of chromosomal aberrations of malignant cells from UUT was also determined. Overall sensitivity of FISH was significantly higher than that of urine cytology (85.7% vs. 23.8%, p = 0.0009). Specificities for both FISH and cytology were 100% (p = ns). Of 21 patients with UUT-UC, polysomies of chromosome 3, 7 and 17 were observed in 57.1%, 52.4% and 28.6%, respectively, and loss of the p16 gene in 47.6%. FISH has a higher sensitivity than cytology and a similar specificity in dectecting UUT-UC. It may be a promising non-invasive tool for the diagnosis and surveillance of UUT-UC.

Metastasis to the penis in a patient with adenocarcinoma of lung, case report and literature review.

Metastasis of lung cancer to the penis is very rare; it causes various clinical symptoms seriously affecting the quality of life. Early recognition and appropriate management will likely enhance survival in these patients. Here, we report a case of penile metastasis secondary to pulmonary carcinoma along with a review of the literature. One case of penile metastasis secondary to pulmonary carcinoma was detected in a 51-year-old patient who was admitted to the First Affiliated Hospital of Sun Yat-Sen University with persistent cough along with swelling of the perineum and penis. The clinical features, diagnosis, and treatment of this disease along with a relevant literature are reviewed and discussed. A MEDLINE search was performed to identify similar reports in the literature. CT scan revealed lung mass, and a glans penis ulcer and enlargement of inguinal lymph nodes was discovered upon physical examination. CT-guided percutaneous puncture of the lung mass revealed adenocarcinoma of lung, and biopsies of the glans penis ulcer and inguinal lymph nodes confirmed metastatic adenocarcinoma. The patients received chemotherapy and died of acute pulmonary embolism in less than 2 months. Metastasis of lung cancer to the penis is extremely rare. It presents an advanced form of lung cancer, and thus survival is extremely short. Although treatment of penile metastasis is almost always palliative, early recognition may enhance survival for these patients.

[The diagnosis and treatment of the Mullerian duct cyst: 48 cases report].

OBJECTIVE: To study the diagnosis and treatment methods of Mullerian duct cyst. METHODS: The records of 48 patients with Mullerian duct cyst were reviewed and the diagnosis and treatment methods were compared. From January 1993 to December 1997, eight patients visited the clinic, most of whom complained of the chronic prostatitis symptom. They all underwent the transrectal ultrasonography (TRUS). Seven patients were treated by transperineal TRUS-guided aspiration therapy. One patient with the large Mullerian duct cyst was extirpated by open operation. From January 2002 to December 2007, we treated forty patients. Most of them visited us complained of the obstructive azoospermia. All patients were diagnosed by the TRUS and twelve patients underwent MRI examine. Thirty-nine patients with smaller Mullerian duct cyst were treated by transurethral cyst incision therapy. One patient with large Mullerian duct cyst was extirpated by laparoscopic operation. RESULTS: One of the eight patients, recurrence was detected at the half-year's follow-up and cured by transurethral cyst incision. All the 40 patients underwent TRUS at three months postoperative follow-up, no cysts recurrence. At the six months postoperative follow-up, ten of thirty-nine patients obstructive azoospermia patients had made their wives pregnant successfully. Nine patients of the other twenty-nine patients had sperms in semen. One 19 years old patient's symptom disappeared. CONCLUSIONS: The patient with Mullerian duct cyst often complained of chronic prostatitis symptom and the obstructive azoospermia. TURS was the preferred examine method in the diagnosis of the Mullerian duct cyst. And MRI could offer more exact informations. Transurethral cyst incision was effective methods for Mullerian duct cyst. Laparoscopic Mullerian duct cyst resection was a good choice for the large cysts.

[Clinical analysis of renal cell carcinoma: report of 271 cases].

OBJECTIVE: To study the diagnosis and treatment of renal cell carcinoma. METHOD: From January 1993 to December 2000 the data of 271 cases of renal cell carcinoma were reviewed. RESULTS: Ultrasonography and CT scanning were still the main diagnostic methods. Surgical operation was performed on 234 patients. Radical nephrectomy was performed on 197 patients (72.6%); Nephron sparing surgery was performed on 19 patients; Metastatic tumor resection was performed on 6 patients and other procedures for 12. The pathological results showed that 137 cases (61.4%) were clear cell carcinoma, 18 cases (8. 1%) of granular cell carcinoma, 32 cases (14. 3%) being combination of the above two varieties, 23 cases (10.3%) of renal papillary adenocarcinoma, 13 cases being renal cell of other types. And 210 cases (77.5%) had been successfully followed up. The 1, 3, 5 and 10 year survival rates were 95.3% (182/191), 88.7% (107/122), 74.7% (56/75) and 32.1% (10/31) respectively. CONCLUSIONS: Ultrasonography is the first select examination method of detecting of renal cell carcinoma, and CT scanning is the most valuable diagnostic mean. Early diagnosis and prompt radical nephrectomy or nephron sparing nephrectomy are the critical points for achieving long-term survivals of patients with renal cell carcinoma.

[Diagnosis and therapy for penile cancer: a report of 46 cases with literature review].

BACKGROUND & OBJECTIVE: Penile cancer is an uncommon malignancy, which is mainly treated by surgery, radiation and chemotherapy. This study was to investigate reasonable curative methods for penile cancer. METHODS: Medical records of 46 patients with penile cancer in the Department of Urology, The First Affiliated Hospital of Sun Yat-sen University between Jan. 1996 to Jan. 2005 were analyzed retrospectively. Forty-four patients had squamous cell carcinoma, one had Paget disease, and one had verrucous carcinoma. RESULTS: Thirty-nine patients received partial penectomy, four received total penectomy and perineal urethrostomy, one Paget disease patient received lesion resection and skin grafting, two patients did not receive surgery. Nine out of 10 patients with positive lymph node received ilioinguinal lymphadenectomy, and five received pelvic lymphadenectomy. Forty-one cases were regularly followed up for one to 10 years. The 1-, 2-, 5- and 10- year survival rates were 95.1%, 95.1%, 82.9% and 31.7%, respectively. Prognosis of patients with pelvic lymph node metastasis was poor. Two patients who had pelvic lymph node metastasis died of lung metastasis within two years after surgery. CONCLUSIONS: Partial penectomy is an appropriate and effective management for penile cancer. Lymph node metastasis is an important prognostic factor for penile cancer. Patients with ilioinguinal lymph node metastasis should receive lymphadenectomy as early as possible to improve the therapeutic effect. The prognosis is poor for patients with pelvic lymph node metastases.

[Clinical analysis of 14 cases of urachal carcinoma].

BACKGROUND & OBJECTIVE: Urachal carcinoma is a rare malignancy. This study was to summarize our clinical experience in the diagnosis and treatment of urachal carcinoma. METHODS: Fourteen cases of urachal carcinoma treated from May 1994 to April 2007 at Cancer Center and The First Affiliated Hospital of Sun Yat-sen University were retrospectively reviewed and analyzed. RESULTS: The most common complaints of the 14 patients were hematuria and irrigative bladder symptoms. Cystoscopy mainly revealed broad-based tumors located at the dome of the bladder. Soft-tissue masses between the bladder dome and the abdominal wall were detected by imaging examinations; the wall of the bladder was often invaded. Thirteen patients were found adenocarcinoma, the other one was malignant stromal cell tumor. Seven patients underwent extensive partial excision of the bladder, among which one case developed local recurrence 24 months after operation, while the other six cases were followed up for 14-120 months, with a median follow-up of 42 months without recurrence. Three patients underwent radical bladder resection and urinary diversion, two of which were followed up for 16 months and 84 months respectively without recurrence, while the other one died from surgical complications 3 months after operation. One case underwent partial cystectomy at another hospital developed recurrence 10 months after operation. Three advanced cancer patients received chemotherapy, two of which achieved progression free survival for seven and eight months respectively, while the other one died three months after chemotherapy. The one- and five-year survival rates were 85.7% and 61.2%, respectively. CONCLUSIONS: Extensive partial excision of the bladder is recommended for urachal carcinoma. Radical removal of the tumor during the first treatment and comprehensive therapies for advanced cancer patients and patients with recurrence or metastasis after operation are critical to improve the treatment efficacy of urachal carcinoma.

[Diagnosis and treatment of primitive neuroectodermal tumor of the penis: a case report and review of the literature].

OBJECTIVE: To investigate the clinical and pathological characteristics, treatment and prognosis of peripheral primitive neuroectodermal tumor (PNET) of the urinary tract and reproductive system. METHODS: The clinical data and pathological characteristics of a PNET patient was analyzed and relevant literature reviewed. RESULTS: The diagnosis was established by pathological and immunohistochemical method. The patient underwent radical surgery, followed by chemotherapy. CONCLUSION: Pathology and immunohistochemistry help the diagnosis of PNET. For the treatment of the tumors in the early stage, surgery is the best choice, and for that in the late stage, it can be followed by chemotherapy. The PNET of the penis is a rare disease and evidence still lacks for the evaluation of its prognosis.