Application of three-dimensional reconstruction of renal tumor vessels to guide laparoscopic partial nephrectomy of hilar tumors and non-hilar tumors under zero ischemia.

OBJECTIVE: To investigate the safety and efficacy of three-dimensional reconstruction of renal tumor vessels to guide laparoscopic partial nephrectomy of hilar tumors and non-hilar tumors under zero ischemia. METHODS: The clinical data of 82 patients with renal cancer who underwent zero ischemia retroperitoneal laparoscopic partial nephrectomy in the department of urology of our hospital from January 2018 to January 2021 were retrospectively reviewed. The patients were divided into hilar group and non-hilar group. The clinical data of all patients were statistically analyzed by t-test or χ2. RESULTS: There was no significantly difference in gender, age, tumor diameter and pathological stage between hilar and non-hilar tumor group. Most of the target vessels in the hilar tumor group were single targets, while most of the target vessels in the non-hilar tumor group were multiple targets (P<0.05). There was no significantly difference between the groups for mean operative time and length of stay. But hilar tumor group had significantly longer operation time (109.3 ± 9.2 vs. 90.3 ± 9.5 min, p<0.001). There was no significant difference in renal GFR and serum creatinine between the two groups. Hilar tumor group had no significantly difference of change of creatinine and GFR at post-operative 6 and 12 months as compared with non-hilar tumor group. There were no bleeding, urinary leakage, infection and other related complications in the two groups after 1 month follow-up. After 12 months of follow-up, there was no tumor recurrence and metastasis in the two groups. CONCLUSION: The application of three-dimensional renal tumor vascular reconstruction technology can better realize laparoscopic zero ischemia nephron sparing surgery. The target vessels of patients with hilar, single and early renal cancer are easier to find, which is more suitable for three-dimensional renal tumor vascular reconstruction technology to implement laparoscopic zero ischemia nephron sparing surgery.

Undergraduate medical education in the United Kingdom and its implications to China / 中华医学教育探索杂志

Curriculum for undergraduate medical education in the United Kingdom consists of two parts, namely pre-clinical and clinical courses. Medical undergraduate students are encouraged to study for a second degree and individualized education is emphasized. Various methods are employed in teaching highly integrated courses, mainly according to human organs and systems or physiological functions. Drawing lessons from relevant experiences of the United Kingdom, China should further strengthen the formulation and supervision of standards and guidelines for undergraduate medical education, and actively promote the reform of teaching models in order to facilitate the connection and integration between basic medical education and clinical practice. It's also suggested that priorities be given to the cultivation of compound medical talents and individualized education for medical students. Finally, educational system should be further improved in order to enhance the effects of clinical practice.

Cryptococcal Encephalitis Complicating Anti-N-methyl-D-aspartate Receptor Encephalitis in an Immunosuppressed Patient / 中国医学科学院学报

Cryptococcal encephalitis is a fatal central nervous system infectious disease,whereas anti-N-methyl-D-aspartate(NMDA)receptor encephalitis(NMDARE)is an autoimmune syndrome associated with psychological symptoms,behavioural abnormalities,seizures,and dyskinesias.Despite their distinct pathologies and pathogenic mechanisms,both of them can lead to cognitive dysfunction and abnormal behaviors,although anti-NMDARE can also have mood and mental disorders as its core manifestations.A patient with nephrotic syndrome accompanied by both cryptococcal encephalitis and anti-NMDARE was treated in our center,which for the first confirmed that these two conditions could coexist in one patient.The underlying mechanism may be similar to that of anti-NMDARE after other infections.

Analysis of C-reactive protein, fibrinogen and erythrocyte sedimentation rate in patients with obstructive sleep apnea hypopnea syndrome / 中国基层医药

Objective@#To investigate the changes of C-reactive protein(CRP), fibrinogen(FIB) and erythrocyte sedimentation rate(ESR) in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS), and their relationship with sleep respiratory parameters.@*Methods@#From June 2015 to August 2018, 70 OSAHS patients[observation group, apnea hypopnea index(AHI)≥5/h]and 20 persons in the snoring control group(control group, AHI<5/h) who received the monitor of polysomnography in the Pingxiang People′s Hospital were enrolled.The levels of CRP, FIB and ESR were measured and compared between the two groups.The correlations were analyzed between the levels of inflammatory markers and sleep breathing parameters.@*Results@#The two groups had no statistically significant differences in age, gender and BMI(all P>0.05). The CRP, FIB and ESR of the observation group were (4.5±3.0)mg/L, (3.3±0.9)g/L, (11.4±5.4)mm/h, respectively, which were significantly higher than those of the control group[(2.0±1.5)mg/L, (2.9±0.5)g/L, (7.6±2.6)mm/h](t=5.12, 2.68, 4.36, all P<0.05). The level of CRP was positively correlated with AHI, oxygen desaturation index(ODI)(r=0.285, P<0.05 and r=0.282, P<0.05), and negatively correlated with the lowest SaO2 and the average SaO2(r=-0.257, P<0.05 and r=-0.259, P<0.05). The level of FIB was positively correlated with AHI, ODI(r=0.430, P<0.01 and r=0.311, P<0.01), and negatively correlated with the lowest SaO2(r=-0.287, P<0.01). There were no correlations between ESR and sleep breathing parameters.@*Conclusion@#The levels of CRP, FIB and ESR are increased in OSAHS patients, and the levels of CRP and FIB are proportional to the severity of OSAHS, suggesting that OSAHS patients has systemic inflammatory response.

Current status of synthetic lethality effects in cancer research / 中国肿瘤临床

Most carcinogenic mutations, including those causing a loss of function, are not directly "druggable" with traditional small-molecule inhibitors, such as targeted drugs. Thus, despite our growing cognition of carcinogenic mutations that drive tumor progres-sion, there are still problems regarding targeted therapy for tumors. The application of synthetic lethality effects is expected to be-come a new breakthrough in tumor-targeted therapy. Therefore, identifying a combination of genetic mutations that generate synthet-ic lethality effects plays important roles in targeted therapy for tumors. This article reviews the origin and development of synthetic le-thality effects, the forms of interaction, related screening techniques, clinical treatment strategies, and significance and challenges.

Analysis of C-reactive protein, fibrinogen and erythrocyte sedimentation rate in patients with obstructive sleep apnea hypopnea syndrome / 中国基层医药

Objective To investigate the changes of C-reactive protein (CRP),fibrinogen (FIB) and erythrocyte sedimentation rate (ESR) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS),and their relationship with sleep respiratory parameters.Methods From June 2015 to August 2018,70 OSAHS patients [observation group,apnea hypopnea index (AHI) ≥ 5/h] and 20 persons in the snoring control group (control group,AHI ＜ 5/h) who received the monitor of polysomnography in the Pingxiang People's Hospital were enrolled.The levels of CRP,FIB and ESR were measured and compared between the two groups.The correlations were analyzed between the levels of inflammatory markers and sleep breathing parameters.Results The two groups had no statistically significant differences in age,gender and BMI(all P ＞ 0.05).The CRP,FIB and ESR of the observation group were (4.5 ± 3.0) mg/L,(3.3 ± 0.9) g/L,(11.4 ± 5.4) mm/h,respectively,which were significantly higher than those of the control group [(2.0 ± 1.5) mg/L,(2.9 ± 0.5) g/L,(7.6 ± 2.6) mm/h] (t =5.12,2.68,4.36,all P ＜ 0.05).The level of CRP was positively correlated with AHI,oxygen desaturation index (ODI) (r =0.285,P ＜ 0.05 and r =0.282,P ＜ 0.05),and negatively correlated with the lowest SaO2 and the average SaO2 (r =-0.257,P ＜ 0.05 and r =-0.259,P ＜ 0.05).The level of FIB was positively correlated with AHI,ODI (r =0.430,P ＜ 0.01 and r =0.311,P ＜0.01),and negatively correlated with the lowest SaO2 (r =-0.287,P ＜0.01).There were no correlations between ESR and sleep breathing parameters.Conclusion The levels of CRP,FIB and ESR are increased in OSAHS patients,and the levels of CRP and FIB are proportional to the severity of OSAHS,suggesting that OSAHS patients has systemic inflammatory response.

Geriatric medical education for medical undergraduate students in UK and its implications to China / 中华医学教育探索杂志

In the United Kingdom,undergraduate education of geriatric medicine focuses on helping students understand or describe relevant contents,with only a few ability requirements.At most medical schools,the teaching of geriatric medicine is integrated with other clinical curriculums,such as mental health and internal medicine.The pedagogy of geriatric medicine that consists of formal and informal ones,tends to become varied and has some innovations in terms of simulation education,interdisciplinary education,and student-centered education.Based on the relevant experience in the UK,it is suggested that China should study and formulate the teaching requirements of geriatrics for undergraduate clinical medicine specialty in order to standardize and promote related work.Medical colleges and universities can better integrate geriatric knowledge into the existing curriculum system,constantly innovate geriatric teaching methods,actively use simulation teaching,student-centered education and other ways to improve the teaching effect.

The impact of the hospital-level initial funding for overseas returnee on the ability of scientific research projects of young people in the third class hospital / 中华医学科研管理杂志

Objective Through the investigation of the research funding status of returnees before and after their long-term (more than 3 months) study at abroad in a three class hospital,this paper analyzed the influence of the hospital level initial funding to help young talent to obtain scientific research funding,discussed appropriate measurement to enhance the scientific research capacity of hospital young talents to provide reference for management.Methods Long-term sponsored study abroad returnees from 2005 to 2015 of this hospital were recruited as subjects,divided into two groups according to whether they got the hospital-level initial funding after returning,comparative analysis was conducted to understand the influence of such funding to help obtaining subsequent research projects of these young talents.Results The number of subjects per capita returned to the obtained group was higher than that of the non obtained group,and the proportion of high-level subjects at provincial and ministerial levels was higher than that of the non-obtained group (P＜0.05),and the average time interval between the groups after returning home was less than that of the non-obtained group (P＜0.05).Conclusions The hospital-level initial funding for overseas returnee can obviously improve the quality and speed of the subsequent projects of the young talents in the hospital,and have a significant positive effect on mobilizing the enthusiasm for scientific research,improving their scientific re search ability,and improving the overall scientific research level and competitiveness of the hospital.

Analysing pathologic characteristics of early onset renal cell carcinoma in Asian population on the basis of SEER and Renji database / 中华泌尿外科杂志

Objective To identify clinicopathologic features of early onset RCC in Asian population.Methods Surveillance,Epidemiology,End Results Registry (SEER) database were queried for cases diagnosed as RCC in Asia or pacific islander between 2010 and 2015.Patients diagnosed with RCC in Renji hospital during 2014-2018 were reviewed.All Patients was divided into two group,including early onset group (≤46 years) and control group (＞46 years).There were 3 023 patients with average age of 61 years old,ranging from 10-93 years old in SEER cohort and 2 702 patients with average age of 57 years old,ranging from 15-89 years old in Renji cohort.Early onset group took up 13.4％ (406/3 023) in SEER cohort and 20.2％ (546/2 702) in Renji cohort.Clinicopathologic characteristics were compared between groups in both cohorts.Results The histologic spectrum of early onset group was significantly different from control group comprising fewer clear cell renal cell carcinoma(76.8％ vs.84.8％ in SEER cohort;84.3％ vs.88.5％ in Renji cohort),more chromophobe renal cell carcinoma(12.1％ vs.6.2％ in SEER cohort;11.2％ vs.4.8％ in Renji cohort) (P ＜ 0.01 in both cohorts).21 cases of Xp 11 translocation RCCs were identified in Renji cohort taking up 3.8％ (21/546) of early onset group which was higher than that in control group (0.3 ％,7/2 156),Von Hippel-Lindau syndromes took up 2.0％ (11/546) of early onset group larger than control group (0.3％,7/2 156).In addition,early onset RCC was more likely to be classified into lower pathological T stage(85.5％ vs.78.1％ P =0.037 in SEER cohort;96.1％ vs.91.2％ P ＜ 0.01 in Renji cohort)containing more low-grade tumors (58.1％ vs.53.4％,P =0.043 in SEER cohort;85.2％ vs.79.4％,P ＜0.01 in Renji cohort).The overall follow-up rate of SEER cohort was 96.0％ (2 901/3 023),follow-up time ranges from 1 to 71 months with a median of 26 months.The 1-year,3-year and 5-year overall survival rate were 94.0％ 、92.1％ 、92.1％ in early onset group and 89.7％、81.1％ 、74.2％ in control group,the differences were significant in statistics (P ＜ 0.01).Conclusions Asians who developed early onset RCC present with more ChRCC and fewer ccRCC compared to the older patients.Xp 11 translocation RCCs and VHL disease frequently occurred in younger group rather than the old counterparts.Younger patients diagnosed with RCC usually manifest lower T stage and tumor grade with a favorable prognosis.

Reform and explorations on appraisal and incentives mechanism for senior medical professionals at hospitals / 中华医院管理杂志

The paper presented the " Professors Evaluation System" initiated by the hospital since July 2009, which was designed for quantitative assessment of senior medical professionals of non-management category in terms of their performance in medical, teaching, research and management work. Seven periods of appraisal have witnessed a significant elevation of the rate of excellence among such professionals, proving that such a system can motivate and guide these professionals to continuously improve their competence in medical, teaching, research and management work.

Application of modified laparoscopy in repair of high complex vesical vagina fistula / 中华泌尿外科杂志

Objective To evaluate the efficacy of modified abdominal laparoscopy in the repair of complex vesical vaginal fistula after total hysterectomy.Methods The clinical data of 58 cases of urinary bladder and vagina fistula in our hospital from April 2014 to December 2017 were retrospectively analyzed,of which 32 cases were repaired by ordinary abdominal laparoscopy from April 2014 to February 2016 and 26 cases were repaired by modified abdominal laparoscopy from March 2016 to June 2017.On the basis of the original laparoscopy,the modified transabdominal laparoscopy enlarged the free range between the vaginal stump and the bladder,separated the anterior vaginal wall from the bladder completely and dissociated the retrovaginal peritoneum,wrapping around the vaginal stump to make the peritoneum.The median age of ordinary group was 52 (range:33-67)years old,the median course of disease was 12 (range:3-40) months,and the size of fistula was (25.5 ± 10.3) mm.The median age of modified group was 50 (range:37-65) years,the median course of disease was 11.5 (range:3-36) months,and the size of the fistula was (26.3 ± 9.1) mm.The operation time,bleeding volume,the time of hospitalization,the rate of complications and the success rate of the operation were compared.Results The operation time of the two groups was successfully completed.The operation time of the modified group [(164.2 ± 21.2) min] was significantly shorter than that of the common group [(201.4 ± 25.8) min],and the difference was statistically significant (P ＜ 0.01).In the modified group,the cure rate (100.0％,26/26) was higher than that in the normal group (84.4％,27/32,P ＜ 0.05).There was no significant difference in the amount of intraoperative bleeding[50 (10-100) ml vs.55 (5-110) ml],hospitalization time [(9.1 ± 1.7) d vs.(10.0 ± 1.8) d],postoperative infection [19.2％ (5/26) vs.15.6％ (5/32)],urinary incontinence [7.7％ (2/26) vs.9.4％ (3/32)],urinary frequency [15.4％ (4/26) vs.21.9％ (7/32)],intestinal obstruction [3.8％ (1/26) vs.9.4％ (3/32)] between the modified group and common group (P ＞ 0.05).Conclusions The modified transabdominal laparoscopic mode shortens the operation time,and improves the cure rate of the operation.Satisfactory results are recommended for the repair of high complex bladder vagina fistula.

Application of the "four-quadrant" tumor target-artery positioning in retroperitoneal laparoscopic partial nephrectomy / 中华泌尿外科杂志

Objective To evaluate the safety,feasibility of the application of "four-quadrant" tumor target-artery positioning in "zero-ischemia" retroperitoneal laparoscopic partial nephrectomy.Methods A retrospective study was conducted on 25 patients who underwent retroperitoneal laparoscopic partial nephrectomy from November 2016 to March 2017 by single surgeon.There were 15 males and 10 females with a mean age of (52.6 ± 11.9) years old.The mean diameter of the tumor was (3.8 ± 0.5) cm.The mean R.E.N.A.L.score was (9.0±1.3).The mean GFR of the operation side was (49.2±11.4) ml/(min · 1.73 m2) before the operation.All 25 patients underwent 3 Dimentional CT for the reconstruction of their renal models.The tumor target-artery was located in "four-quadrant" system,which based on the boundary between tumor and renal parenchyma.Perioperative outcomes including the estimated blood loss (EBL),operation time,complications and oncological outcomes were carefully collected and analyzed.Results Of all the 25 patients,21 patients underwent "zero-ischemia" retroperitoneal laparoscopic partial nephrectomy,the mean operation time was (106.1 ± 18.8) min,the mean EBL was (162.2 ±68.0) ml with no transfusion case.4 patients converted to conventional retroperitoneal laparoscopic partial nephrectomy,the operation time was 110-140 min,the EBL was 350-500 ml and the warm-ischemia time was 12-20 min respectively.The pathological outcome shows renal cell carcinoma in 24 patients and papillary renal cell carcinoma in 1 patient with all negative margins.The mean GFR of the operation side was (45.1 ± 10.2) ml/(min · 1.73 m2) after three months of the surgery and shows no statistical difference (P =0.268).Conclusion The application of the "four-quadrant" tumor target-artery positioning in " zeroischemia" retroperitoneal laparoscopic partial nephrectomy is a safety and feasible method in terms of accurate location of the target-artery,better postoperative renal function,low EBL and reasonable oncological outcomes.

Surgical treatment of patients with non-hepatitis B and non-hepatitis C hepatocellular carcinoma / 中华肝胆外科杂志

Objective To determine the relative and independent risk factors of survival in patients with non-hepatitis B and non-hepatitis C hepatocellular carcinoma (NBNC-HCC).Methods The clinical records of 109 patients who underwent surgical resection for NBNC-HCC at Tianjin Medical University Cancer Institute & Hospital between January 2010 and January 2013 were retrospectively analyzed.The risk factors influencing disease-free survival (DFS) and overall survival (OS) were used as primary outcome measures.Univariate analysis was conducted to determine the relative risk factor predicting prognosis of NBNC-HCC,and the Cox proportional hazards model was used to determine independent risk factors of DFS and OS.Results For the 109 NBNC-HCC patients,the 1-,2-,3-year overall survival rates were 90.8％,78.0％ and 65.1％,respectively.The compounding disease-free survival rates were 74.0％,63.3％ and 55.8％,respectively.Univariate analysis showed the AFP level,ascites,and TNM staging were the risk factors of OS (all P ＜ O.05).The AFP level,ascites,BCLC stage,TNM staging were related with DFS (all P ＜ 0.05).Multivariate analysis demonstrated AFP and ascites to be the independent risk factors of OS and DFS.Conclusions AFP and ascites were independent risk factors of OS and DFS.For the NBNC-HCC patients,a strong positive AFP with ascites indicated poor prognosis.

Evolvement of the expression of fourteen-meridian-acupoint verse and its content / 中国针灸

Through summarizing the meridian verses and acupoint verses of fourteen meridians, in views of the expression mode and content evolvement, the academic characteristics of fourteen-meridian-acupoint verse were discussed. Regarding the expression mode, three are the meridian based verse and the location-meridian based verse. Regarding the content evolvement, the changes in the basic content, the numbers of meridian points and the sequence of points distribution were reflected at different stages during the development of meridian and point theory. The fourteen-meridian-acupoint verse is easily to be recited due to its language characteristics. It plays an active role in the promotion of the verse during the development of meridian and point theory and provides the reference to the study on the meridian and point theory and acupuncture education.

Current update on combined hepatocellular and cholangiocarcinoma / 天津医药

Combined hepatocellular and cholangiocarcinoma (HCC-CC) is a rare primary hepatic neoplasm (PHN) with features of both hepatocellular and biliary differentiation. Hepatitis B and hepatitis C are the major causes of HCC-CC. Surgical treatment is the main therapeutic method for HCC-CC. For patients with unresectable lesions, curative or palliative locoregional therapy is applied, including radiofrequency ablation (RFA), transarterial chemoembolization (TACE) and supportive treatment. Because of the rare occurrence and ambiguous clinical features of HCC-CC, it is most often misdiagnosed with the other two types of primary liver cancer. Thus, the realization of the current progress of combined hepatocellular and cholangiocarcinoma is particularly important for us. This article aims to summarize the epidemiology and clinical futures, the treatment and prognosis, the progress of genetics and molecular analysis of HCC-CC.

Discoidin domain receptor 2 and its expression and role in tumor / 国际肿瘤学杂志

Discoidin domain receptor 2 (DDR2) is a receptor tyrosine kinase (RTK) that can be activated by fibrillar collagens (Ⅰ-Ⅲ,X).Recently researchers show that the DDR2 is expressed differently in many cancers,which suggests DDR2 is probably correlated with tumorigenesis and cancer development,and it may become a promising cancer therapeutic target.

Application of the job embedded scale in the dropout prediction of medical workers at a tertiary hospital / 中华医院管理杂志

Objective Introducing the job embedded scale to explore the dropout intention of medical workers at tertiary hospitals.Methods Correlation analysis, analysis of variance and regression analysis were used to analyze with a job embedded scale, the dropout intention of medical workers of a Beijing hospital.Results There was a significant negative correlation between job embedding and dropout intention of such people(r=-0.223).The predictive ability of on-the-job embeddedness is better than off-the-job embeddedness.Fit-organizational, sacrifice-organizational, fit-community and sacrifice-community were significantly negatively correlated with dropout intention.There are differences in the relationship between job embedding and dropout intention of medical workers of different individual attributes.Conclusion Job embedded scale can effectively predict the dropout intention of medical workers, offering a usable tool to predict the dropout of these people.

Clinical outcome comparison of retropubic radical prostatectomy and standard laparoscopic radical prostatectomy / 中华泌尿外科杂志

Objective To compare the clinical outcome between open retropubic radical prostatectomy (RRP) and standard laparoscopic radical prostatectomy (SLRP).Methods From January,2008 to December,2014,643 cases of RRP and 161 cases of SLRP were retrospectively reviewed.No significant difference was found in age,body mass index,preoperative prostate specific antigen and pathological results of biopsy between the 2 groups (P ＞ 0.05).The operating time,blood loss,transfusion rate,hospital stay,positive surgical margin rate,urine leakage rate,urethra stricture rate,urinary continence recovery at 6 months and 12 months,2-year biochemical recurrence and median biochemical recurrence of the 2 groups were compared.Results The mean operating time was 131.6 ± 34.5 min in RRP group while 171.3 ±35.1 min in SLRP group (P =0.000).The blood loss was 385 ± 142 ml in RRP group and 194±87 ml in SLRP group (P =0.000),respectively.For the transfusion rate,the RRP group was 3.4％ (22/643) while the SLRP group was 2.5 ％ (4/161),there was no significant difference between the 2 groups (P =0.548).The urine leakage rates were 12.8％ (82/643) in RRP group and 6.2％ (10/161) in SLRP group (P =0.020).The average hospital stay in SLRP group was 6.7 ± 1.5 d,which was significantly shorter than 7.5 ± 1.3 d in RRP group (P =0.000).A pad-free continence was achieved in 68.7％ (442/643) of the cases in RRP group and in 78.9％ (127/161) of the cases in SLRP group at 6 months after surgery (P =0.011).However,there was no significant difference in pad-free continence between the 2 groups at 12 months after surgery (P =0.376).In RRP group,complete continent rate was 94.6％ (608/643),while in SLRP group,it was 96.3％ (155/161).For the positive surgical margin rate,early biochemical recurrence rate and median biochemical recurrence free survival time,no significant difference was found between the 2 groups (P ＞ 0.05).Conclusions Compared to classical RRP,the blood loss during the surgery,urine leakage rate and hospital stay could be significantly reduced in SLRP.Although the patients undergone SLRP could get quicker urinary continence recovery at 6 months after surgery,the urinary continence recovery at 12 months is identical between the 2 groups.RRP and SLRP could achieve nearly the same oncologic outcome.

Clinicopathological characteristics and prognosis of 11 patients with renal mucinous tubular and spindle cell carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the clinicopathological features, treatment and prognosis of renal mucinous tubular and spindle cell carcinoma (MTSCC).</p><p><b>METHODS</b>The clinicopathological data of eleven patients of pathologically confirmed renal MTSCC were reviewed retrospectively. Among the 11 patients, there were 4 males and 7 females with a mean age of 51.6 years (range, 24 to 81 years). Two patients presented with hematuria, one presented with lumbago and others were asymptomatic.</p><p><b>RESULTS</b>The renal MTSCC was of hypovascular tumor in enhanced CT scan. Seven cases were treated with radical nephrectomy, and the other four with partial nephrectomy. The mean diameter of tumors was 4.4 cm. The TNM stages were as follows: pT1aN0M0 in 6, pT1bN0M0 in 3, pT2N0M0 in 2 cases. Histological examination of the tumors showed that they consisted of spindle cells arranged in tubular and trabecular patterns embedded in a myxoid stroma. No recurrence or metastasis was observed during the follow-up (median 41 months).</p><p><b>CONCLUSIONS</b>MTSCC is a rare low-grade renal epithelial carcinoma with a relatively good prognosis. Preoperative CT scan is partly helpful for diagnosis and guiding decision making. Nephron-sparing surgery is recommended in most cases, especially in patients with small tumors.</p>

Expression of N-cadherin protein in urothelial bladder cancer and its relation to prognosis / 中华泌尿外科杂志

Objective To explore the expression and significance of N-cadherin in urothelial bladder cancer and analyse its relation to clinicpathologic and prognosis of bladder cancer.Methods The expression of N-cadherin in 145 urothelial bladder cancer and 25 normal bladder tissues was detected by immunuhistochemisty,and correlations between N-cadherin and clinicopathologic features were analysed.Results The positive rate of N-cadherin protein was significantly higher in bladder cancer than in normal bladder tissue (P＜0.01).The positive rate of N-cadherin protein was 38.6％ in G1 bladder cancer,58.4％ in G2-G3 bladder cancer,and its difference was significant (P =0.028).The expression was significantly lower in non-muscle-invasive bladder cancer than in muscle invasive bladder cancer (45.7％ vs 64.7％,P=0.029).The muscle-invasive bladder cancer patients were followed up 4-103 months.Among those,the overall survival with positive expression of N-cadherin protein was 24.2％ (8/33),and the overall survival with negative expression of N-cadherin protein was 66.7 ％ (12/18).Kaplan-Meier analysis showed the positive expression of N-cadherin was significantly associated with overall survival of patients with muscle-invasive-bladder cancer (P=0.002 2).Multivariate Cox analysis showed that N-cadherin expression was an important prognostic factor.Conclusions The expression of N-cadherin protein was high in bladder cancer.The detection of the expression of N-cadherin protein is associated with the diagnosis and prognosis of bladder cancer.