[Preoperative prognostic factors and preoperative risk stratification of upper tract urothelial carcinoma].

OBJECTIVE: To identify the preoperative prognostic factors of upper tract urothelial carcinoma (UTUC) and construct preoperative risk stratification system. METHODS: A retrospective study including 686 patients who were diagnosed with UTUC and received radical nephroureterectomy or partial ureterectomy in Peking University First Hospital during 2003 and 2013. RESULTS: Of the 686 UTUC patients, 303 (44.2%) were male and 383 (55.8%) female. The postoperative pathological examination showed that 203 (29.6%) had high tumor stages (T3, T4), 300 (43.7%) had high tumor grades (G3) and 54 (7.9%) had lymph nodes metastasis (N1). After multivariate analysis, renal pelvic tumor, large tumor, estimated glomerular filtration rate (eGFR)≥30 mL/min, and male were associated with high tumor stage. Ureteral tumor, large tumor, and non-smoking history were associated with high tumor grade. Renal pelvis tumor, large tumor, and preoperative anemia were associated with positive N status. During the follow-up, 208 (30.3%) died for cancer and 210 (30.6%) developed intravesical recurrence. Multivariate analysis showed: large tumor (P=0.001), concomitant ipsilateral hydronephrosis (P=0.041), and preoperative anemia (P=0.001) were independently associated cancer-specific mortality after surgery, while ureteral tumor (P=0.04), multiple tumor (P=0.005), and high preoperative creatinine (P=0.036) were independent risk factors for intravesical recurrence. CONCLUSION: Of the preoperative clinical parameters of UTUC patients, the large tumor, concomitant ipsilateral hydronephrosis, and preoperative anemia were independently associated with cancer-specific mortality after surgery. Ureteral tumor, multiple tumor, and high preoperative creatinine were independently associated with intravesical recurrence after surgery.

EFFECT OF NAC ON MOUSE GV OOCYTE SURVIVAL AND SUBSEQUENT EMBRYONIC DEVELOPMENT FOLLOWING VITRFICATION.

BACKGROUND: Oocytes that survive cryopreservation may accumulate ROS which are known to bring harmful effects on embryonic development. NAC is an antioxidant which can be a supplement to reduce oxidative stress. However, whether NAC can improve the developmental competence of vitrified GV-oocytes remains unclear. OBJECTIVE: The study was to investigate the effect of NAC on subsequent embryonic developmental competence of mice vitrified GV-oocytes. MATERIALS AND METHODS: This study compared the effects of different concentration of NAC on the cleavage and blastocyst rates of mice vitrified GV-oocytes. Then the effects of NAC on mitochondria distribution, ROS level and embryonic development of vitrified oocytes were tested. RESULTS: ROS activity of vitrified oocytes was significantly annihilated and mitochondrial distribution pattern was improved by 1.5 mM NAC (P<0.05). NAC supplementation throughout vitrification/warming and IVM media significantly improved the developmental competence of vitrified oocytes. CONCLUSION: Supplementation of NAC could partially overcome the damages by vitrification and improve the development ability of mice vitrified GV-oocytes.