ABSTRACT
Objective:To investigate the clinical features of diagnosis and treatment of renal parenchymal invasive urothelial carcinoma.Methods:The clinical data of 23 patients with renal parenchymal invasive urothelial carcinoma admitted to Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2014 to December 2020 were retrospectively analyzed. There were 12 males and 11 females. The mean age was (67.3±10.1) years old. Among them, 7 cases complained of painless hematuria and 9 cases were asymptomatic. Three cases underwent preoperative MRI examination, 19 patients underwent preoperative enhanced CT examination, and 1 patient underwent both MRI and enhanced CT examination. MRI examination showed renal lobulated and other T1 mixed with T2 signals, the boundary was not clear, and DWI showed obvious restricted diffusion. The tumor was located on the left side in 15 cases and on the right side in 8 cases. Preoperative diagnosis was made by fine needle aspiration biopsy in 1 patient, and specimens were obtained by flexible ureteroscope in 2 patients. No tumor was reported. The preoperative diagnosis of 22 patients was unclear and the nature of the tumor could not be determined. One patient was considered to have urothelial carcinoma by fine needle aspiration. All patients were treated by surgery, including 20 cases of laparoscopic radical nephrectomy and 3 cases of nephroureterectomy with bladder sleeve resection.Results:Postoperative pathological specimens showed yellow-white mass, high-grade invasive urothelial carcinoma invading renal parenchyma. Nine cases were T 3a stage, 14 cases were T 3b stage, and 5 cases were lymph node metastasis. The average postoperative follow-up time was (18.6±6.72)months, 2 patients were lost to follow-up, 8 patients died, and the overall mortality rate was 38.1%. Seven patients died of recurrence or metastasis. There were 3 cases of bladder recurrence and 5 cases of metastasis after operation. Conclusions:Renal parenchymal infiltrating urothelial carcinoma is difficult to diagnose in the early stage, with poor clinical biological behavior and poor overall prognosis. For patients diagnosed with renal parenchymal invasive urothelial carcinoma preoperatively, laparoscopic nephroureterectomy + bladder sleeve resection is recommended.
ABSTRACT
Objective:To explore the clinical application value of vector flow mapping (VFM) in assessment of early cardiac dysfunction in aortic stenosis (AS) patients with normal left ventricular ejection fraction (LVEF).Methods:The clinical study consisted of 37 patients with various degrees of AS (LVEF>50%) from October 2015 to February 2017 in Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, including 16 mild to moderate ones (AS1 group ) and 21 severe ones ( AS2 group ). A group of 35 age- and gender-matched healthy volunteers were selected as control group. Using Hitachi Aloka Prosound F75 color Doppler ultrasound diagnostic system, general two-dimensional parameters of left ventricular structure and function were measured. Furthermore, standard dynamic apical long axis view color Doppler flow images during 3 completed cardiac cycles were acquired for DAS-RS1 off-line workstation.Based on time-flow curve(T-F curve) of left ventricle, ECG, and the open-close of valves, the diastole period of left ventricle was divided into the isovolumic relaxation phase(P1), rapid filling phase(P2), slow filling phase(P3), atria contract phase (P4), and total diastolic phase(P0); the systole period was divided into isovolumetric contraction phase (P5), rapid ejecting phase(P6), slow ejecting phase(P7), and total systolic phase(P8). The left ventricular energy loss (EL) of three groups were acquired in all phases.Results:Left ventricular EL: ①Three peaks of EL appeared in P2, P4 and P6 respectively and total diastolic EL was almost equal to systolic. ②Compared with control group, the EL values of AS1 group increased in all phases, but only in P4, P7 and P0 with significant differences ( P<0.05). ③Compared with the other two groups, the EL values in AS2 group increased significantly in all phases of AS2 group ( P<0.01). Correlation analysis: ①For control group and AS group, there were both significant positive correlations between P0-EL, P8-EL and LVMI ( r=0.561, 0.585; 0.635, 0.652 respectively; P<0.01). ②There were both significant positive correlations between P2-EL and E, e′( r=0.623, 0.537; 0.576, 0.502 respectively; P<0.01), while P4-EL and A( r=0.482, 0.555, P<0.01). ③There were both significant positive correlations between P0-EL, P8-EL and E/e′( r=0.480, 0.459; 0.673, 0.590 respectively; P<0.01) and negative correlations between P0-EL, P8-EL and LVEF ( r=-0.537, -0.596; -0.569, -0.625 respectively; P<0.01). Conclusions:Quantitative evaluation of left ventricular EL by VFM technique is expected to provide a sensitive indicator for evaluating the cardiac structure and functional status in AS patients with normal LVEF.
ABSTRACT
Objective To investigate the feasibility of using optimized protocol of iodine contrast agent with fixed injection time in triple-rule-out CT examination of acute chest pain patients. Methods A prospective study was conducted. The patients who underwent triple-rule-out CT examination of acute chest pain at the Second Hospital of Shanxi Medical University from September 2017 to June 2018 were enrolled. According to the patient's body mass index (BMI), they were divided into BMI ≤ 23 kg/m2 group and BMI > 23 kg/m2 group. The patients in each group were subdivided into two subgroups according to the random number table, and they were given two iodine contrast injection protocols with fixed injection time (14 s). Protocol 1 was performed with 55 mL of total iodinated contrast media: iodinated contrast media was first injected at 5.0 mL/s for 8 s, followed by the same contrast media injection at 2.5 mL/s for 6 s, finally followed by injection of 40 mL of saline at a rate of 2.5 mL/s. Protocol 2 with 60 mL of total iodinated contrast media: iodinated contrast media was first injected at 5.0 mL/s for 10 s, followed by the same contrast media injection at 2.5 mL/s for 4 s, finally followed by injection of 40 mL of saline at a rate of 2.5 mL/s. The primary and objective evaluation was conducted on the image quality of the patients' blood vessels in different segments. The primary score, CT value and contrast-to-noise ratio (CNR) of the pulmonary artery, coronary artery, aorta and total effective radiation dose for the examination were recorded. Results A total of 92 patients were enrolled in the analysis. There were 44 patients in BMI≤ 23 kg/m2 group, in which 22 patients received in protocol 1 and protocol 2, 48 patients in BMI > 23 kg/m2 group, in which 24 patients in protocol 1 and protocol 2, respectively. There was no significant difference in the effective radiation dose between the two subgroups receiving different injection protocols in different BMI groups (mSv: 6.7±1.1 vs. 6.5±0.8 between protocol 1 and protocol 2 in BMI ≤ 23 kg/m2 group; 7.8±1.0 vs. 8.0±1.1 between protocol 1 and protocol 2 in BMI > 23 kg/m2 group, both P > 0.05). In BMI ≤ 23 kg/m2 group, the CT value, CNR and primary scores of pulmonary artery images in patients receiving protocol 2 were significantly higher than those receiving protocol 1 [CT value (HU): 584±110 vs. 472±86 for main pulmonary artery, 561±93 vs. 467±78 for left pulmonary artery, 555±91 vs. 472±83 for right pulmonary artery; CNR: 24.2±7.5 vs. 18.7±4.6 for main pulmonary artery, 23.2±6.8 vs. 18.6±4.8 for left pulmonary artery, 22.9±6.7 vs. 18.8±4.7 for right pulmonary artery; primary score:4.0 (4.0, 4.0) vs. 3.5 (3.0, 4.0), all P < 0.05]; and there was no statistically significant difference in the primary or objective evaluation of coronary artery or aortic image quality between the two protocols. In BMI > 23 kg/m2 group, the CT value, CNR and primary scores of coronary artery and aortic images in patients receiving protocol 2 were significantly higher than those receiving protocol 1 [CT value (HU): 369±63 vs. 315±61 for proximal right coronary artery (RCA), 388±63 vs. 323±63 for proximal left coronary artery (LCA), 328±83 vs. 272±51 for ascending aorta, 348±82 vs. 272±49 for aortic arch; CNR: 15.0±4.6 vs. 12.3±4.7 for proximal RCA, 15.7±3.8 vs. 12.8±5.2 for proximal LCA, 13.2±5.3 vs. 10.4±4.1 for ascending aorta, 14.1±5.3 vs. 10.4±3.9 for aortic arch; primary score: 4.0 (3.0, 4.0) vs. 3.0 (3.0, 4.0) for coronary, 4.0 (3.0, 4.0) vs. 3.0 (2.0, 4.0) for aorta; all P < 0.05]; and there was no statistically significant difference in the primary or objective evaluation of pulmonary artery image quality between the two protocols. Conclusions The effective radiation dose of triple-rule-out CT examination of acute chest pain is relatively low. The low-dose iodine contrast agent application program with fixed injection time can meet the needs of clinical diagnosis of triple-rule-out CT examination of acute chest pain patients. For patients with BMI ≤ 23 kg/m2, both protocols 1 and 2 can obtain excellent image quality; in order to avoid the influence of superior vena cava artifacts, protocol 1 is recommended. For patients with BMI > 23 kg/m2, application protocol 2 can obtain stable, excellent image quality that is more suitable for clinical applications.
ABSTRACT
Objective To investigate the duration of indwelling ureteral stent after the ureteroscopic lithotripsy.Methods 300 cases of patients were retrospectively analyzed from June 2015 to June 2017,including 168 with renal calculi and 132 with non-incarcerated upper ureteral calculi.The size of stone is ＜2 cm in diameter.According to the length of time for indwelling ureteral stent,all patients were divided into two groups-150 cases in 14-day group (Group A) and 150 in the 28-day group (Group B) for comparing the complication and outcome,and then received modular flexible ureteroscopic lithotripsy combined with holmium laser.Lastly,6F ureteral stent was indwelling postoperatively.Results Complications happened in both two groups after stenting.There were 140 cases (93.3％) complained of bladder irritation symptoms (LUTS) in Group A,while 107 (71.3％) in Group B;85 cases (56.7％) suffered from flank or abdominal pain in Group A and 36 (24％) in Group B;gross hematuria happened in 133 cases (88.7％) of Group A and 60 cases (40％) of Group B.As the duration of indwelling ureteral stent extended,the incidence of complications increased,significantly (P ＜ 0.05).CT scan showed there was no statistical difference in stone-free rate (diameter ＜ 3 mm) of two groups [A group:91.3 ％ (137/150) vs.B group:89.3 ％ (134/150),respectively].Conclusion With high stone-free rate and low complication incidence,2-week indwelling ureteral stent is safe for patients suffered from renal calculi or non-incarcerated upper ureteral calculi (diameter ＜ 2 cm).
ABSTRACT
Objective To evaluate the clinical value of a new optic puncture needle designed by our department for renal calculi treatment. Methods There were 8 patients undergoing micro-PCNL with the new device from June 2016 to February 2017. Values of basic demographic data ,operation time ,pain score ,drop in hemoglobin and complications were recorded. Results The mean stone size,operation time,pain score,drop in hemoglobin,and in-hospital time was(21.9 ± 7.3)mm,(43.6 ± 13.6)min,2.8 ± 1.3,7.0 g/L[(133.2 ± 10.3 g/L vs.(123.2 ± 13.9)g/L,P>0.05]and(3.1 ± 1.0)d,respectively. No patient required blood transfusion. Stone-free rate at 1 and 3 months post-operation were 87.5%(7/8)and 100%(8/8),respectively. One suffered urinary tract infections( ClavienⅠ)and was treated with antibiotics. There were no major complications. Conclusion The new device for treatment of renal calculi is feasible and effective.
ABSTRACT
Objective To evaluate the clinical value of a new optic puncture needle designed by our department for renal calculi treatment. Methods There were 8 patients undergoing micro-PCNL with the new device from June 2016 to February 2017. Values of basic demographic data ,operation time ,pain score ,drop in hemoglobin and complications were recorded. Results The mean stone size,operation time,pain score,drop in hemoglobin,and in-hospital time was(21.9 ± 7.3)mm,(43.6 ± 13.6)min,2.8 ± 1.3,7.0 g/L[(133.2 ± 10.3 g/L vs.(123.2 ± 13.9)g/L,P>0.05]and(3.1 ± 1.0)d,respectively. No patient required blood transfusion. Stone-free rate at 1 and 3 months post-operation were 87.5%(7/8)and 100%(8/8),respectively. One suffered urinary tract infections( ClavienⅠ)and was treated with antibiotics. There were no major complications. Conclusion The new device for treatment of renal calculi is feasible and effective.
ABSTRACT
Objective To evaluate the effect of micropercutaneous nephrolithotomy(microperc) for treatment of renal calculi with self-made F 4.8 optic puncture needle combined with ureteral access sheath.Methods There were 23 patients undergoing microperc with the self-made device from June 2016 to April 2017,Male,12 cases,female,11 cases.The mean ±SD (range) patient age was (49 ±14) years(28-67 years),stone volume was (1.7 ± 0.6) cm (1.0-3.0 cm) and stone density was (934.5 ± 282.7) HU (357-1 500 HU).The self-made all-seeing system consists of a puncture needle (F4.85) and two 3-way connector allowing the insertion of a flexible microoptic system,laser fiber and attaching to irrigation system.Single tract with one puncture with ultrasound guide was fit to treat the calices containing calculi or calices at one stage operation.The course of puncture could be " all-see" on the display which was connected with flexible microoptic system.After stone fragmentation,the procedure was terminated in tubeless fashion.Ureteral double J stent was inserted in order to prevent postoperative complications.The factors analysed were demographic variables including age,sex,stone volume,stone density [Hounsfield units (HU)] and stone location,and intra-and peri-operative variables such as operating time,drop in haemoglobin level,stone clearance and complications.Results Conversion to PCNL was required in one patient because intraoperative bleeding obscured vision.The mean ± SD (range) operation duration was (46.2 ± 19.9) min (20-120 min),pain score was 2.8 ± 1.2(1-6),hemoglobin decrease was 6.6 g/L,and in hospital time was (2.9 ± 0.8) d (2-5 d),respectively.No patient required blood transfusion.Stone-free rate at 1 and 3 months postoperation was 90.9％ (20/22) and 100 ％ (22/22),respectively.Two who suffered hematuria (Clavien Ⅰ)underwent conservative treatment and recorered well.One suffered urinary tract infections (Clavien Ⅱ) and was treated with antibiotics.There were no major complications.Conclusions Mircoperc with the self-made device and ureteral access sheath in management of renal calculi is feasible and effective.
ABSTRACT
Objective To evaluate the efficacy of ultrasound guided diverticular puncture combined with flexible ureteroscope to treat calyceal diverticulum calculi, which is difficult in finding the diverticular orifice during ureteroscopic surgery.Methods From November 2012 to July 2015, Twenty-four cases suffered caliceal diverticulum calculi were treated with PCNL or flexible ureterorenoscopic methods.Twelve cases were treated with PCNL in Group PCNL, and 12 cases in Group FURS were all not found orifice or wall under flexible ureteroscope. For Group FURS, ultrasound guided nephrostomy needle puncturing into diverticular calvity were performed, saline-diluted methylthioninium chloride was injected through needle sheaths.The diverticular opening could be recognized in six cases.Guidewires were inserted through needle sheaths for identifying the wall of diverticular cavity in another six cases that could not find the orifice.The stenotic infundibulum or diverticular wall was incised with 200 micron holmium laser fiber for fragment or extraction of diverticular calculi.Results The time of operation, stone free and fragment success cases in Group FURS and PCNL were ( 91.8 ±24.2 ) min vs.( 86.3 ±18.7 ) min, 9 cases vs.10 cases, and 10 cases vs.11 cases, respectively ( P all >0.05 ) .Residual calculi with clinical significance in Group FURS and PCNL disappeared after the second FURS surgery.The VAS score in Group FURS was marked lower than that in Group PCNL [ ( 3.1 ±1.2 ) vs.( 5.3 ±0.9 ) , P﹤0.05 ] .There was no significant difference complication rate between two groups ( 2 cases vs.3 cases, P>0.05 ) .Hospital stay in Group FURS was dramaticly shorter than Group PCNL(3.4 ±0.8) d vs.(5.4 ±1.0) d,P﹤0.05).Diverticula disappeared in 6 cases and became smaller in 6 cases in Group FURS, disappeared in 10 cases and became smaller in 2 cases in Group PCNL.Conclusion Flexible ureteroscope combining with the ultrasound guided puncture of diverticular calvity for management of caliceal diverticula maybe a safe and effective option.
ABSTRACT
Objective To evaluate the clinical feasibility of grading of ureteral stricture in renal allograft.Methods The clinical data of 9 case of ureteral stricture after renal transplantion from February 2015 to September 2015 were retrospectively analyzed and relative articles were reviewed to evaluate the significance of ureteral stricture grading.The diagnosis of ureteral stenosis was made by serum creatinine elevation,ultrasound of allograft kidneys and presence of stricture on a pyelogram.Grade 1 ureteral stenosis was defined as graft function deterioration with presence of hydronephrosis on ultrasound,but no obvious stricture identified on a pyelogranm.Grade 2 was defined as serum creatinine elevation,presence of hydronephrosis on ultrasound,and a focal (＜1 cm) distal ureteral stricture at the ureteral anastomotic site on a pyelogram.Grade 3 was defined as serum creatinine elevation,hydronephrosis on ultrasound,and a long segment (＞1 cm) distal ureteral stricture extending to proximal ureter or pelvis on pyelogram.Results One case,6 cases and 2 cases were classified to grade 1,2 (stricture length ＜1 cm) and 3 (＞1 cm),respectively.One case of grade 1,6 cases of grade 2 and 1 case of grade 3 were successfully dilated by balloon dilation catheter and endoureterotomy.One case of grade 3 was converted to open reconstructive surgery.Surgery success rate of grade 1 and 2 was 100％ (7/7) and 100％ (6/6) 6 and 9 months after surgery,respectively.Ureteral stenosis did not recur in one case of grade 1 and 6 cases of grade 2 during a follow-up period of 12 months after surgery.However,one case of grade 3 reoccurred 6 months after surgery,and reoperation was performed and there was no recurrence up to now (10 months).Conclusion Wuzhi tablet acted as an effective agent that makes rifampicin containing anti-tuberculosis chemotherapy possible and safe by stabilizing blood concentration of tacrolimus in post-renal transplant tuberculosis patients,which also reduced the dosage of tacrolimus as well as the risk of acute rejection greatly.
ABSTRACT
Objective To observe the effects of computer assisted training combined with the actual environment training on vascular cognitive impairment with no dementia (VCIND) after stoke.Methods Sixty elderly patients with VCIND after stroke were randomly divided into a research group and a control group,each of 30.All patients were given routine medication and rehabilitation training,while the research group was additionally provided with computer assisted training and the actual environment training lasting two months.All patients' cognitive function and activities of daily life (ADL) in both groups were assessed using the Montreal cognitive assessment scale(MoCA) and modified Barthel index(MBI) before and after treatment.Results After two months of treatment,the total score of MoCA (22.80 ± 4.63) and the scores of seven subprojects including visual space (4.00 ± 0.93),naming (2.67±0.62),attention(4.13 ±0.74),language(2.33 ±0.62),abstract thinking(1.60± 0.83),delayed memory(2.93 ±0.70) and orientation(5.13 ± 1.19) in the research group were significantly higher than those before treatment and those of the control group.However,in the control group,only the total score and the scores of naming,language and delayed memory in the control group significantly were higher than those before treatment.After treatment,the scores of MBI in both group were significantly promoted,reaching (61.53 ± 7.13) and (52.20 ± 4.93) for the research and control group respectively,with the former improving more significantly than the latter.Conclusion The computer assisted training combined with the actual environment training helps to improve cognitive function and ADL for patients with VCIND after stoke.Such combined therapy is worth of promoting in clinical practice.
ABSTRACT
<p><b>BACKGROUND</b>Organ preservation keeps the quality of the organs under prolonged ischemia. Continuous machine perfusions are gaining an important position in clinical research and practice. The aim of this study was to evaluate the protective effect of continuous hypothermic machine perfusion transport system (AirdriveTM) on cold ischemic injury of canine kidney.</p><p><b>METHODS</b>Ten kidneys of five healthy preserving canines were taken out after general anesthesia. Five kidneys were stored using common cold preservation (CCP group) by immersing it in the organ preservation solution, mixed with water and ice, and kept in a cold room at 4°C. The other five kidneys were stored using continuous machine perfusion preservation (CMP group) and were placed into the Airdrive(TM) continuous machine perfusion device at room temperature. The renal tissues were examined by histopathology, electron microscopy, and mitochondrial activity check at different time points.</p><p><b>RESULTS</b>Histologic sections showed that the structures of the ten renal tissues were similar during the first 24 hours. After 48 hours, the CCP group showed more pronounced changes, as the renal tubular epithelial cells were more obvious than those in the glomeruli. Oxygen consumption rate of state III and IV respiration in the CCP group decreased after 12-48 hours and increased at 48 hours, respectively, when compared to the CMP group (P < 0.05). Cortex respiratory control ratio and phosphorus oxygen ratio were significantly higher in the CMP group at 48 hours.</p><p><b>CONCLUSION</b>With prolonged storage time, the effect of continuous hypothermic machine perfusion transport system is better than that of common cold preservation on canine kidney.</p>
Subject(s)
Animals , Dogs , Male , Kidney , Kidney Transplantation , Organ Preservation , Methods , Organ Preservation SolutionsABSTRACT
Objective To explore the effect of MICA-Ab expression on the prognosis of sensitized renal transplantation recipients.Methods A total of 51 sensitized recipients (PRA more than 20%) in our hospital from August 2007 to April 2010 were enrolled in the study.In these patients,29 cases received protein A immunoadsorption and detection of MICA-Ab was performed before and after protein A immunoadsorption.Other 22 patients received MICA-Ab detection when they were hospitalized.Associations of PRA,HLA-matches,acute rejection,and serum creatinine of postoperative week 1 and week 4 with MICA-Ab were analyzed retrospectively.Results Sixteen recipients (31.4%) had positive MICA-Ab expression but their acute rejection rate was not higher as compared to the patients with negative MICA-Ab expression.Recipients with PRA＞40% showed higher expression level of MICA-Ab than recipients with PRA≤40% (P≤0.05).HLA-match did not show influence on MICA-Ab expression.MICA-Ab positive group had no higher serum creatinine level than negative group in postoperative week 4.MICA-Ab level decreased significantly after protein A immunoadsorption.Conclusions MICA-Ab expression increases in the sensitive recipients but does not influence the prognosis.Protein Aimmunoadsorption can eliminate MICA-Ab effectively in sensitized recipients.
ABSTRACT
Objective To explore the expression of anti-MICA antibodies and evaluate its influence on acute rejection and renal function in early period after renal transplantation. Methods A total of 29 sensitized subjects (PRA＞20 %) were enrolled in this study. All the patients underwent protein A immunoabsorption treatment and the expression of anti-MICA antibodies was detected before and after treatment. Triple immunosuppressive regimen consisting of tacrolimus, mycophenolate mofetil (MMF) and steroid was given to prevent graft rejection. The correlation between the expression of anti-MICA antibodies and acute rejection or serum creatinine (SCr) level was analyzed.Results The expression of anti-MICA antibodies was detected in 8 candidates (27. 6 % ,8/29) ,and 6 kinds of anti-MICA antibodies simultaneously expressed were found in one individual, 3 kinds in one case,and sole kind in 6 patients. There was no significant difference in acute rejection rate between positive anti-MICA antibodies group and negative group [37.5 % (3/8) vs 38. 1% (8/21), P＞0.05). The positive expression rate of anti-MICA antibodies in the recipients with PRA ≥40% was higher than that in those with PRA ＜40% [43. 8 % (7/16) vs 7. 7 % (1/13),P＜0.05]. The SCr level in patients positive for anti-MICA antibodies was markedly higher than that in those negative anti-MICA antibodies at the 1st week postoperatively ( 135.4 ± 21.4 vs 108. 6 -+ 31.6 μmol/L, P＜0.05). The SCr level in the patients with positive anti-MICA antibodies, however, was reduced to the normal range at the 2nd week after surgery (P＞0.05). The levels of anti-MICA antibodies were continuously decreased in the candidates undergoing protein A irnmunoadsorption treatment. Conclusion Higher expression of anti-MICA antibodies exists in sensitized recipients and possesses an influence on the recovery of renal function in early postoperative period. Protein A immunoadsorption can eliminate anti-MICA antibodies effectively in sensitized recipients.
ABSTRACT
Objective To assess the role of muhi-detector row CT (MDCT) in preoperative evaluation of living renal donors. Methods The data of 104 potential donors who underwent MDCT were retrospectively analyzed. All the candidates underwent 64-MDCT examination. First,unenhanced scans were performed on the kidneys. After administration of Ⅳ contrast medium,enhanced CT images of the arterial phase, venous phase, and excretory phase were obtained. The enhanced scan scope was from the top of diaphragmatic muscle to pubic symphysis. The scanning data obtained was post-processed for reconstructed images. The anatomy and variations displayed in MDCT images on kidneys, ureters, arteries and veins were recorded. The findings in surgery constituted the standard of reference for imaging findings, and the recorded results from images were compared with the findings in surgery to assess the role of MDCT in evaluation of potential donors. Results MDCT examination was successfully performed on 104 candidates. Anomalies of kidneys and ureters were found in 8 donors before surgery. The prevalence of accessory arteries and early branching in image was 27. 2 % (28/103) and 12. 6 % (13/103) respectively. There were 3 candidates with double veins and 3 with retroaortie left renal vein found in preoperative assessment. Ninety-three candidates underwent successful donor nephreetomy. The anomalies and variations of kidneys and ureters in images were all confirmed surgically. The detection rate of the accessory renal artery (ARA) was 80 %. The ARAs measuring > 1 mm in diameter and early branching were all detected by MDCT.The findings of veins found in performed sides coincided with those of MDCT images. Conclusion MDCT can accurately assess the anatomic information and variations of the donors' kidneys, and facilitate triaging donors and planning operation proposal
ABSTRACT
Objective To evaluate the clinical effect of potassium permanganate solution in treating the infected prepuce wound. Method From July 2000 to July 2007,97 patients with infected prepuce wound from Beijing Chaoyang hospital and other hospitals, aged 3 ～ 69 years, averaging 22.6 years, were all washed with 0. 1% potassium permanganate solution for 5～10 minutes 1～3 times a day. The 8 cases with abscess were sutured when exudate disappeared and fresh granulation tissue appeared. Results For the 89 infected patients, the wound surface became clear, dry and less exudate appeared after 3～5 days and then formed scabs. They all healed in 1 to 2 weeks. The 8 cases with abscess were all healed within 1 to 2 weeks after saturation. Conclusion Potassium permanganate solution is a convenient, economic and effective method in treating the infected prepuce wound.
ABSTRACT
In the recent few years,apart from the development of interventional technology,the development of new kinds material for packing intracranial aneurysms has hastened the promotion of endovascular interventional treatment greatly. Microvention company introduces lately Hydrocoil,a kind of hydro-agglutinated microspring coil which adopts a special hydrolink detachment technology,enriching the methods of endovascular treatment for cerebral aneurysms. Hydrocoil is a traditional platinum coil coated with expandable,unabsorble hydrogel material,which can improve the filling volume proportion of the aneurysm. At present it has been initially applied in clinic. This article summarizes the characteristics,the preclinical study,and the clinical application of Hydrocoil.(J Intervent Radiol,2007,16: 710-713)
ABSTRACT
Objective To explore the role of glycididazole(CMNa) in enhancing radiosensitivity to three-dimensional conformal radiotherapy(3D-CRT) and its safety in elderly patients with lung cancer.Methods Twenty-seven elderly patients with lung cancer,which had been confirmed by pathological examination,were treated with radiosensitizer glycididazole(CMNa) and 3D-CRT.Diluted with 100ml saline solution,800mg/m2 glycididazole(CMNa) was intravenously injected within 30 minutes,and 3D-CRT was performed within 3 hours.3D-CRT was composed of 6MeV liner accelerator at a dose of 5.0-6.0 Gy/fraction for 3 fractions/week with a total dosage of 40-42Gy/3-4weeks.Treatment plan was evaluated by dose volume histogram(DVH) to ensure peripheral normal tissue and sensitive tissue to receive the dose within a permitted extent.Results Seventeen cases(63%) showed complete responses(CR),and 10 cases(37%) showed partial responses(PR),theretore the total response rate was 100%(27/27).No patients suffered from obvious adverse effects.Conclusions With significant ability to enhance radiosensitivity,glycididazole combined with 3D-CRT afford an effective treatment for elderly patients with lung cancer.
ABSTRACT
6 cm AVMs(57.1%)were much higher than that with 0.05).Seizure was found in forty-three patients.After embolization the seizure in 20 patients disappeared,11 patients had been improved greatly.The total effective power was 72.1%.Conclusions The size and location of AVM is significantly associated with the onset of seizure.The number of feeding artery has no relation with the seizure.Endovascular embolization for the AVMs has got better cure effect.
ABSTRACT
AIM:In order to study the effect of the extracellular domain of cadherin 5 on the growth of a human breast cancer cell line MDA-MB435.METHODS:Cadherin extracellular domain repeats 1 to 4(CED1-4)was cloned by using RT-PCR technique,and inserted into the plasmid vector pMSCV.pMSCV-CED1-4 was propagated in XL-blue strain of Escherichia coli,extracted and purified.CED1-4 was cut by restriction endonuclease,examined by using agar gel electrophoresis,and finally sequenced.CED1-4 gene was transferred into MDA-MB435 cell line.The expression of CED1-4 gene in MDA-MB435 cell was analyzed by methods of RT-PCR and Western blotting.The effect of CED1-4 on the growth of MDA-MB435 cell was observed by the methods of proliferation experiments in vitro and the experiments in nude mice in vivo.RESULTS:The recombinant vector pMSCV-CED1-4 was successfully constructed.CED1-4 band appeared between the 1 636 bp and 1 018 bp in agar gel electrophoresis.The sequence result showed that CED1-4 had 1 452 bp and codes 484 amino acids.PCR and Western blotting identified that CED1-4 mRNA and protein were expressed in the transfected MDA-MB435 cells.Cell proliferation experiments showed that the proliferation rate of MDA-MB435 cells was lower in the experimental group than that in the experimental control group and the blank control group.The mean volume and weight of tumors in nude mice were lower in the experimental group than those in the experimental control group and the blank control group.CONCLUSION:The growth of a human breast cancer cell line MDA-MB435 is inhibited in vitro and in vivo by cadherin 5 extracellular domain CED1-4.
ABSTRACT
AIM: Gene transduction with a recombined murine stem cell retroviral vector has been investigated to find an effective way of gene transduction and to offer theory and experimental basis for the recombined murine stem cell retroviral vector used for gene transduction. METHODS: 1. Construction of retrovirus vector: EC1-4 gene (repeats 1-4 of cadherin-5 extracellular domain) and mutant (Ser 222A) MEK1 gene were cloned into retrovirus vector pMSCV after cut by Bgl Ⅱ and EcoR 1 restriction endonuclease. 2. Obtaining CD41 + cells and cell culture: Cells expressing CD34 + from cord blood were isolated. The inducement of cells expressing CD41 from CD34 + cells was performed by using TPO and cells CD41 + were selected by FACS. NIH 3T3 cells were cultured in high sugar DMEM medium and U937 in RPMI 1640 medium. UT7 cells which is cytokine-dependent cell line were grown in Iscove's modified Dulbeco's medium supplemented by GM-CSF. 3. Determination of viral titers: Retroviral vectors were transferred to packaging cell line 293. Retroviral containing supenatant was collected after transfection. The viral titers was tested on infection of NIH 3T3 cells by FACS analysis. 4. Western blot: Transduced CD41 +,UT7,U937 and MDA-MB-435 cells were analyzed by western blot to examine expression of transduced genes. RESULTS: A packaging cell line 293 produces high-titer MEK1 pMSCV retroviruses (3.1?10 7) and EC1-4 pMSCV retroviruses (1.0?10 8). With 8-folds dilution retroviruses,60.73% GFP positive cells have been obtained in MEK1 pMSCV transduced UT7 cells,72.56% in U937 cells and 30.57% in CD41 + cells,respectively. GFP positive cells have reached up 97.54 % in EC1-4 pMSCV transducted MDA-MB-435 cells. Phosphorylated MEK1 has been decreased in experiment group when TPO has stimulated CD41 + and UT7 cells or serum has stimulated U973 cells. This indicates that is a dominant negative effect of mutation MEK gene. EC1-4 gene transduced MDA-MB-435 cells have expressed EC1-4. CONCLUSION: The recombined murine stem cell retrovirus can effectively mediate gene transduction of CD41 +,UT7,U937 and MDA-MB-435 cells,and transduced genes can be stably expressed.