Comparison between renal pelvic and ureteral tumors in muscle-invasive upper tract urothelial carcinoma.

Although renal pelvic and ureteral urothelial carcinoma share similarities in their origins, disparities on a genetic and clinical level make them divergent entities. Clinical information from the Surveillance, Epidemiology, and End Results (SEER) database was used to validate the characteristics and molecular subtypes using single-center data, which were compared between the two types of muscle-invasive tumors. Simultaneously, to expand the sample size for further verification, we explored a deep learning algorithm to correctly classify molecular subtypes from H&E histology slides. We suggested that the renal pelvic group might have a proclivity towards luminal and the ureter towards basal and P53-like. Furthermore, we explore the heterogeneity of matrix and immune tumor microenvironment, and the ureteral group had more immune cell infiltration and higher stiffness. Collectively, these results showed that muscle-invasive upper tract urothelial carcinoma exist in distinct properties of clinical characteristics, molecular subtype, and tumor microenvironment.

Clinical research of holmium laser therapy in extramammary Paget's disease.

This study aims to investigate the safety and efficiency of the holmium laser therapy in extramammary Paget's disease. The clinical data of 61 patients was collected since 2002 to 2012, confirmed as non-subcutaneous invasive extramammary Paget's disease by biopsy and underwent surgery. All patients were divided into two groups. Group A included 30 patients who underwent the holmium laser therapy. Group B included 31 patients who underwent the traditional surgical therapy. The clinical data of all patients included preoperative, intraoperative, and postoperative management and follow-up records. Compared with the traditional operation group, the holmium laser group had a shorter operation time and was easier to perform. There were no significant differences between the two groups in cases of intraoperative and postoperative complications, the recurrence-free survival, and the disease-specific survival. But the holmium laser group had a longer recovery time than the traditional operation group in large and deep nidus. Multiple-factor analysis of prognostic parameters of 61 patients confirmed that any of these two methods chosen was not a prognostic parameter for recurrence-free survival. The holmium laser therapy might prove to be a preferable alternative to the traditional operative therapy of extramammary Paget's disease. However, the holmium laser therapy did not demonstrate to have an obvious advantage over traditional operative therapy in the recurrence-free survival and the disease-specific survival.

Comparison of the Efficacy of Desloratadine Citrate Disodium and Acrivastine Decremental Therapy in the Treatment of Chronic Urticaria / 中国药房

OBJECTIVE:To compare the efficacy and safety of desloratadine citrate disodium and acrivastine decremental thera-py in the treatment of chronic urticaria. METHODS:132 patients with chronic urticaria were randomly divided into group A(62 cases)and group B(70 cases). Group A was orally given 8.8 mg Desloratadine citrate disodium tablet in 12 2 weeks,once a day;8.8 mg in 3-4 weeks,once every 2 days;8.8 mg in 5-6 weeks,once every 3 days;8.8 mg in 7-8 weeks,once every 4 days;and 8.8 mg in 9-10 weeks,once every 5 days. Group B was orally given 8 mg Acrivastine capsule in 12 2 weeks,3 times a day;8 mg in 3-4 weeks,twice a day;8 mg in 5-6 weeks,once a day;8 mg in 7-8 weeks,once every 2 days;and 8 mg in 9-10 weeks, once every 3 days. The treatment course for both groups was 10 weeks. Clinical efficacy,and plasma histamine levels and total scores of signs and symptoms before and after treatment in 2 groups were observed,and recurrence and incidence of adverse reac-tions after 4 weeks of stopping drugs in 2 groups were followed-up. RESULTS:There were no significant difference in the total ef-fective rate and incidence of adverse reactions between 2 groups(P>0.05). After treatment,the total scores of signs and symptoms in 2 groups were significantly lower than before,the difference was statistically significant(P0.05). The recurrence rate in group A was significantly lower than group B,the difference was sta-tistically significant(P<0.05). CONCLUSIONS:Both efficacy and safety of desloratadine citrate disodium and acrivastine decre-mental therapy in the treatment of chronic urticaria are good,however,desloratadine citrate disodium is better than acrivastine in re-ducing recurrence rate.

Comparing the safety and efficiency of conventional monopolar, plasmakinetic, and holmium laser transurethral resection of primary non-muscle invasive bladder cancer.

PURPOSE: To compare the safety and efficiency of conventional monopolar, plasmakinetic and holmium laser transurethral resection of bladder tumor (CM-TURBT, PK-TURBT and HoL-TURBT) while managing primary non-muscle invasive bladder cancer. PATIENTS AND METHODS: From 2005 to 2009, 173 patients with primary non-muscle invasive bladder cancer underwent endoscopic surgery. Among them, 51 patients underwent CM-TURBT, 58 patients underwent PK-TURBT, and 64 patients underwent HoL-TURBT. All patients were divided into three risk groups (low, intermediate, and high) based on the European Association of Urology guidelines and prognostic factors of recurrence. Clinical data, included preoperative, operative, and postoperative management and follow-up, were recorded. RESULTS: Patient demographics and tumor characteristics in all three groups were compared before surgery. There was no significant difference in operative duration among the three groups. Compared with the CM-TURBT group, both PK-TURBT and HoL-TURBT groups had less intraoperative and postoperative complications, including obturator nerve reflex, bladder perforation, as well as bleeding and postoperative bladder irritation. There were no significant differences among the three groups in the transfusion rate and occurrence of urethral strictures. Patients in the PK-TURBT and HoL-TURBT groups had less catheterization and hospitalization time than those in the CM-TURBT group, and there were no significant differences in each risk subgroup as well as the overall recurrence rate among the CM-TURBT, PK-TURBT and HoL-TURBT groups. CONCLUSIONS: Both PK-TURBT and HoL-TURBT might prove to be preferable alternatives to CM-TURBT management of non-muscle invasive bladder cancer. PK-TURBT and HoL-TURBT, however, did not demonstrate an obvious advantage over CM-TURBT in tumor recurrence rate.

Solitary kidney with renal artery aneurysm : one case report with literature review / 中华泌尿外科杂志

Objective To summarize the treatment experience of the solitary kidney with renal artery aneurysm.Methods Clinical data of 1 solitary renal artery aneurysm patient treated in our hospital in May.2012 was retrospectively analyzed.The 48 yrs man with a history of hypertension for 10 years,but responded to medical treatment poorly.The highest blood pressure was up to 180/100 mmHg (1 mmHg =0.133 kPa).Preoperative check found that the serum creatinine was 64 μmol/L.Color Doppler ultrasound showed no detection of left kidney,the renal artery enlarged to the range of 21 mm× 14 mm.CT scan showed that the right renal artery locally enlarged,suggesting artery aneurysm.Renal computerized tomography angiography showed that left renal agenesis,right renal with artery aneurysm close to the renal hilum with size of 17.1 mm× 19.1 mm,was located on the distal renal artery bifurcation,involving 2 artery branches.The diagnosis was right solitary kidney with renal artery aneurysm.Renal aneurysm clip occlusion was performed under general anesthesia,blood pressure was controlled to 70/40 mmHg during the procedure.After exposing the renal artery,the renal artery was visible with a diameter of 25 mm and with a basement width about 19 mm,which located in the main renal artery and overrode the branches of the two renal arteries.After the clamp of the artery aneurysm from two sides to center and the middle part of it was overlapped,the artery aneurysm reduced obviously,and clipped the aneurysmal wall with noose suture.When loosen the clamp of main renal artery,the artery aneurysm was not enlarged,blood pressure up to 120/80 mmHg.Results The operation was successful,operation time was 75 min,intraoperative blocking time was 15 min,intraoperative blood loss was 50 ml,and there was no intraoperative and postoperative complication.Postoperatively immediate and the first postoperative day serum creatinine were 95 μmol/L and 150 μmol/L.2 week after surgery the index decreased to 74 μmol/L.After operation the blood pressure was control successful,and kept at 130/80 mmHg.Conclusions Solitary kidney with renal artery aneurysm is rare.Renal aneurysm clip occlusion is a safe,effective and feasible treatment option,especially for the patients with solitary kidney.

The dual incision lock type golf combined with support plate in the treatment of 40 patients with tibial plateau fracture / 中国基层医药

Objective To investigate the methods and effect of the dual incision lock type golf combined with support plate in the treatment of tibial plateau fracture.Methods 80 cases with comminuted fracture of the tibial plateau were randomly divided into two groups.40 cases in the observation group were given the dual incision lock type golf combined with support plate.and the control group used traditional single incision T-shaped steel treatment.The clinical efficacy was compared between the two groups.Results 80 patients were followed up.Excellent rate of the observation group was 67.5％,which was significantly higher than 45.0％ of the control group.The incidence rate of complication in observation group was 2.5 ％,which was significantly lower than 22.5 ％ in the control group (P ＜ 0.05).The reset extent of patients,healing time,loading time,HSS score of the observation group were significantly better than those of the control group (P ＜ 0.05).Conclusion The dual incision lock type golf combined with support plate in the treatment of tibial plateau fracture has less trauma,reliable fixation,early functional exercise andfewer complications.

Expression of X-linked inhibitor of apoptosis protein in transitional cell carcinoma and the clinical significance / 中华泌尿外科杂志

Objective To study the relationship between X-linked inhibitor of apoptosis protein (XIAP) expression and transitional cell carcinoma(TCC) development. Methods Forty-three TCC tissues and 12 normal transitional epithelial tissues were applied to detect XIAP expression by semi-quantitative RT-PCR, immunohistochemistry and western blot. The data were statistically analyzed by using SPSS11.5 according to the 2 groups (TCC and normal transitional epithelial) as well as the dif-ferent subgroups (tumor stage, grade, single or multiple tumor, primary or recurrence tumor). Results XIAP expression in TCC tissues was higher than in normal transitional epithelial tissues(im-munohistochemistry: 22±5 and 16±2, Western blot:1.21±0. 15 and 0. 61±0.24, mRNA: 1.17± 0. 30 and 0. 75±0. 17, P<0. 05). In the bladder tumors group, XIAP expression in recurrence tumors was higher than in primary tumors(immunohistochemistry: 24±3 and 20±3, Western blot: 1.66±0.28 and 1.10±0. 23, mRNA: 1.44±0. 27 and 1.05±0. 23, P<0. 05). However, there were no significant differences according to the tumor stage and tumor grade as well as tumor multi-plicity or not. Conclusion XIAP expression might serve as a biomarker in TCC diagnosis and recur-rence prediction.