[Single-center study of laparoscopic radical nephrectomy with Mayo 0-2 level inferior vena cava thrombectomy].

OBJECTIVE: To investigate the safety and feasibility of laparoscopic treatment for renal carcinoma with Mayo 0-2 level venous thrombosis. METHODS: From January 2015 to February 2018, 58 renal carcinoma cases with venous thrombus underwent laparoscopic radical nephrectomy with inferior vena cava thrombectomy in Department of Urology, Peking University Third Hospital, of which, 51 cases were male, and 7 female, aged 29-82 years. According to the Mayo grade classification, 20 cases were level 0, 20 cases were level 1, and 18 cases were level 2, with left side being 22 cases, and right side 36 cases. The patients except for those complicated with hemorrhagic diseases, cardiac and pulmonary insufficiency, or those who could not tolerate anesthesia and surgical contraindications, underwent the operation after comprehensive examinations. RESULTS: The 58 cases of renal tumor with venous tumor emboli were successfully completed with the surgeries, including 50 cases of totally laparoscopic surgery, 8 cases of laparoscopy surgery from convert to open (among the patients who were converted to open surgery, 7 were complicated with grade 2 tumor thrombus and 1 with grade 1 tumor thrombus). The main reasons for converting to open surgery were huge tumors (the largest of which was about 16 cm in diameter), severe adhesion and difficulty of separation. For different patients, different surgical methods and procedures were adopted according to the tumor direction and the different grade of tumor thrombus. Radical nephrectomy combined with vena cava tumor thrombus removal was performed in 55 cases and segmental resection of vena cava in 3 cases. The operation time was 132-557 min, and blood loss was 20-3 000 mL. Post-operative pathological types: 51 cases were clear cell carcinoma, 5 cases were type 2 of papillary carcinoma, 1 case was squamous cell carcinoma, and 1 case was chromophobe cell tumor. In the study, 47 cases were followed up for 1-36 months, and 4 cases died (the survival time was 5-15 months, with an average of 10.2 months). CONCLUSION: Laparoscopic radical nephrectomy with inferior vena cava thrombectomy is a reasonable choice for renal tumor with Mayo 0-2 level venous thrombosis. For different tumor directions and different grades of tumor thrombus, an appropriate operation plan can give the maxim benefit to the patients with skillful surgeons.

Effects of a Chinese medical herbs complex on cellular immunity and toxicity-related conditions of breast cancer patients.

Rose geranium (Pelargonium graveolens, Geraniaceae) has anti-cancer and anti-inflammatory properties, and promotes wound healing. Similarly, Ganoderma tsugae (Ganodermataceae), Codonopsis pilosula (Campanulaceae) and Angelica sinensis (Apiaceae) are traditional Chinese herbs associated with immunomodulatory functions. In the present study, a randomised, double-blind, placebo-controlled study was conducted to examine whether the Chinese medicinal herb complex, RG-CMH, which represents a mixture of rose geranium and extracts of G. tsugae, C. pilosula and A. sinensis, can improve the immune cell count of cancer patients receiving chemotherapy and/or radiotherapy to prevent leucopenia and immune impairment that usually occurs during cancer therapy. A total of fifty-eight breast cancer patients who received chemotherapy or radiotherapy were enrolled. Immune cell levels in patient serum were determined before, and following, 6 weeks of cancer treatment for patients receiving either an RG-CMH or a placebo. Administration of RG-CMH was associated with a significant reduction in levels of leucocytes from 31·5 % for the placebo group to 13·4 % for the RG-CMH group. Similarly, levels of neutrophils significantly decreased from 35·6 % for the placebo group to 11·0 % for the RG-CMH group. RG-CMH intervention was also associated with a decrease in levels of T cells, helper T cells, cytotoxic T cells and natural killer cells compared with the placebo group. However, these differences between the two groups were not statistically significant. In conclusion, administration of RG-CMH to patients receiving chemotherapy/radiotherapy may have the capacity to delay, or ease, the reduction in levels of leucocytes and neutrophils that are experienced by patients during cancer treatment.

Contribution of tomato phenolics to suppression of COX-2 expression in KB cells.

Tomatoes, which are consumed worldwide, contain abundant phenolics. The objective of this study was to understand the suppression effect of phenolics in fresh and heated tomatoes on the expression of cyclooxygenase 2 (COX-2). Both small and big tomatoes of fresh or heated (in boiling water for 30 min) treatments were used. Sephadex LH-20 gel was used to separate the noncondensed tannin containing and the condensed tannin containing fractions from the crude phenolic extracts of tomatoes. The condensed tannin containing fraction was rich in condensed tannins and simple phenolics. The noncondensed tannin containing fraction contained abundant nontannin flavans. This study explored the effect of tomato phenolic extracts on the regulation of 12-o-teradecanoylphorbol-13-acetate (TPA)-induced inflammatory responses in KB cells. HPLC showed that tomato phenolic profiles were similar between small and big tomatoes either by fresh or heated treatment. Fresh tomato extracts had 70.8 +/- 4.8% (mean +/- SD) noncondensed tannin containing polyphenols (6.68 +/- 0.09 mg/g dry weight), 27.4 +/- 6.9% condensed tannin containing polyphenols (3.52 +/- 0.24 mg/g dry weight), and 1.7 +/- 0.6% other residues. Instead, heated tomato had 53.3 +/- 4.3% noncondensed tannin containing polyphenols (2.70 +/- 0.20 mg/g dry weight), 24.2 +/- 1.7% condensed tannin containing polyphenols (7.37 +/- 0.03 mg/g dry weight), and 22.5 +/- 4.8% other residues. Cell studies showed that phenolic extracts of heated tomatoes resulted in increased suppression of COX-2 expression compared with that of fresh tomato. Noncondensed tannin containing fraction of fresh tomato greatly suppressed COX-2 expression (P < 0.05) that compared to the negative control, but both noncondensed tannin containing and condensed tannin containing fractions of heated tomatoes showed suppression on COX-2 expression. These results suggest that tomato phenolics may play an important role in the chemoprevention of cancer.