Melamine-induced infant urinary calculi: a report on 24 cases and a 1-year follow-up.

Melamine has been the main factor leading to infant urinary calculi occurring on a rather wide scale in China in 2008, which were the results of a rapid aggradation of metabolites such as cyanuric acid diamide, cyanuric acid, etc., causing uric acid stone to accumulate. Here, we present a report on 24 infants who were admitted to our department, their ages ranging from 3 to 10 months. All of these infants had a confirmed history of having been fed with the "Sanlu" brand milk powder, which contained excessive levels of melamine, with the highest being 2,563 mg/kg. The diagnosis, medical treatment and follow-up by ultrasonography at 1, 3, 6, 12 months were reported. 22 cases of these infants were rehabilitated after medical treatment and 1 infant underwent pyelolithotomy for relieving an obvious ureter obstruction. No recurrence was found in these babies thereafter. Another infant died from rapidly worsening renal failure. Therefore, this series of cases have demonstrated that melamine contained in the "Sanlu" milk powder was the main cause of these urinary stones. Urine alkalinization and stone liberalization were the most effective treatments. Fast diagnosis and treatment of acute obstructive urolithiasis may prevent the development of acute renal failure, which is associated with high morbidity and mortality rates.

[An experimental study of the inhibition of tamoxifen on rat model of benign prostatic hyperplasia].

OBJECTIVES: To study the inhibitory mechanism of tamoxifen on benign prostatic hyperplasia. METHODS: The Wistar male adult rats were injected into muscle with testosterone propionate 4-6 mg/kg, simultaneously were irrigated into stomach with tamoxifen citrate 0.21 mg/kg. The partly rats of each group were decapitated at 7, 15 and 30 days, then their index numbers of prostate were calculated, and the structural changes of the prostatic histocyte were observed in the light microscopy and scan electronic microscopy. RESULTS: At the 7th, 15th, and 30th day, the index numbers of prostate of those rats which had been injected only with testosterone propionate were higher than that of the control group and the irrigating group(P < 0.05). The hyperplasia of the prostatic epithelial cells and the ground substance of those rats, which had been irrigated with tamoxifen citrate, had not happened in light microscopy and the scan electronic microscopy. CONCLUSIONS: Tamoxifen could block the effect of the estrogen, which could suppress the prostatic hyperplasia. This study could provide the experimental evidences for using Tamoxifen to treat the human benign prostatic hyperplasia.

[Expression and significance of GST-Pi and HIF-1alpha in bladder carcinoma].

BACKGROUND & OBJECTIVE: Multidrug resistance plays an important role in chemotherapy failure of bladder cancer, but its mechanism is unclear. Hypoxia in tumors is generally associated with chemoresistance. However, the correlation of nuclear transcription factor hypoxia-inducible factor-1 (HIF-1) to multidrug resistance transporter glutathione-S-transferase-Pi (GST-Pi) has not been investigated. This study was to explore the expression and significance of GST-Pi and its correlation to HIF-1alpha in bladder carcinoma by tissue microarray. METHODS: A tissue microarray containing 119 cases of bladder carcinoma and 6 cases of normal bladder tissue was built up. The expression of GST-Pi and HIF-1alpha was detected by SABC immunohistochemistry. RESULTS: In the 119 cases of bladder carcinoma, the positive rate of HIF-1alpha was 57.9%, the positive rate of GST-Pi was 67.2%. The positive rate of HIF-1alpha in G3 grade bladder carcinoma was 64.6%. Their expression was closely related to pathologic grade, clinical stage, and postoperative relapse after adjuvant chemotherapy (P<0.01). HIF-1alpha expression was positively related to GST-Pi expression (P<0.01). CONCLUSIONS: Overexpression of HIF-1alpha may be related to hypoxia. Co-expression of HIF-1alpha and GST-Pi is a object index for judging differentiation and chemoresistance of bladder cancer.

[Intravesial instillation of recombination interferon-alpha and pirarubicin in the prophylaxis of local recurrence after resection of the superficial bladder cancer].

BACKGROUND & OBJECTIVE: Superficial transitional cell carcinoma (TCC) of urinary bladder tends to recur after transurethral surgery. This study was designed to evaluate the effect of interferon-alpha (IFN-alpha)and pirarubicin (THP) on decreasing postoperative recurrence of superficial bladder cancer. METHODS: Recombinant IFN-alpha and THP has been used in clinical study. One week After operation, 68 patients were prospectively enrolled and divided into two groups randomly: IFN-alpha plus THP group and THP group. The protocols of chemoimmunoprophylaxis include 8 weekly and 10 monthly instillation of 3 x 10(7) IU IFN-alpha plus 40 mg THP in 40 ml 5% glucose via catheter. RESULTS: The follow-up period ranged from 6 to 32 months (median 18.2 months). The cytoscopy and cytology with cold cup biopsies had been carried out every 3 months for 2 years. Recurrence after instillation of IFN-alpha combining THP was observed in only 4 cases (12.1%), bladder irritation was found in 4 cases, fatigue in 3 cases, and rash in 1 case as well. Among the 35 cases in THP group, recurrence was found in 8 cases (22.8%), bladder irritation in 5 cases, fatigue in 3 cases. IFN-alpha plus THP yielded better effect than THP alone (P< 0.05),especially in grade 3 and stage PT1 bladder cancer. CONCLUSIONS: IFN-alpha working in coordination with THP would be an effective remedy to prevent the recurrence of bladder cancer. The intravesical IFN-alpha plus THP appears to be more effective against recurrence than THP alone. Further study is needed for side-effect and popularization in such way.