Surgical treatment of left-sided renal carcinoma with grade II inferior vena cava tumour thrombus: a report and review of the literature

The surgical removal of renal cancer,along with the thrombectomy of the inferior vena cava tumour thrombus,represents a remarkable milestone in urological surgery.This procedure is not only technically demanding but also requires a high level of surgical expertise.Managing renal cancer combined with a vena cava tumour thrombus poses significant challenges,especially when dealing with combined grade Ⅱ-Ⅳ inferior vena cava tumour thrombus.The complexity of these cases is further exacerbated by the delicate anatomical structures involved and the need to preserve critical vessels while effectively removing the tumour.The Upper Urethral Tumour Treatment Centre of Weifang People's Hospital successfully treated a challenging case of left renal tumour combined with grade II inferior vena cava tumour thrombus.The surgical team,led by experienced urological surgeons,meticulously planned and executed the procedure,ensuring minimal trauma to the patient and complete removal of the tumour.This achievement not only demonstrates the hospital's commitment to providing state-of-the-art surgical care but also highlights the importance of continued research and training in urological oncology.The successful outcome of this case is a testament to the expertise and dedication of the medical team and offers hope to patients facing similar complex surgical challenges.

Tongguan Liqiao acupuncture therapy improves dysphagia after brainstem stroke

Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in patients with brainstem infarction. Sixty-four patients with dysphagia following brainstem infarction were recruited and divided into a medulla oblongata infarction group（n = 22）, a midbrain and pons infarction group（n = 16）, and a multiple cerebral infarction group（n = 26） according to their magnetic resonance imaging results. All patients received Tongguan Liqiao acupuncture for 28 days. The main acupoints were Neiguan（PC6）, Renzhong（DU26）, Sanyinjiao（SP6）, Fengchi（GB20）, Wangu（GB12）, and Yifeng（SJ17）. Furthermore, the posterior pharyngeal wall was pricked. Before and after treatment, patient swallowing functions were evaluated with the Kubota Water Test, Fujishima Ichiro Rating Scale, and the Standard Swallowing Assessment. The Barthel Index was also used to evaluate their quality of life. Results showed that after 28 days of treatment, scores on the Kubota Water Test and Standard Swallowing Assessment had decreased, but scores on the Fujishima Ichiro Rating Scale and Barthel Index had increased in each group. The total efficacy rate was 92.2% after treatment, and was most obvious in patients with medulla oblongata infarction（95.9%）. These findings suggest that Tongguan Liqiao acupuncture therapy can repair the connection of upper motor neurons to the medulla oblongata motor nucleus, promote the recovery of brainstem infarction, and improve patient＇s swallowing ability and quality of life.

Effect of precipitate evolution on corrosion behavior of friction stir welded joints of AA2060-T8 alloy

Friction stir welding was used to join two AA2060-T8 plates,and then the effect of precipitate evolution on microstructure and corrosion behavior of the joint was investigated.The evolution of precipitates on the top surface of the joint was characterized by scanning electron microscopy and transmission electron microscopy.The corrosion behaviors of different regions in the joint were investigated by an electrochemistry method and an alternating salt spray exposure.The corrosion was mainly dependent on the nature of precipitates in each region of the joint.The shoulder affected zone had the worst corrosion resistance as a result of the re-dissolved ofθ′(Al2Cu),T1(Al2CuLi)andδ′(Al3Li)phases,the formation of intergranular precipitates and precipitate-free zones.However,the thermomechanically affected zone had a slightly improved corrosion resistance because it had no intergranular precipitates.The heat affected zone and base metal had the best corrosion resistance.

Kidney inflammatory myofibroblastic tumor masquerading as metastatic malignancy: A case report and literature review

BACKGROUND Inflammatory myofibroblastic tumor(IMT) is a rare mesenchymal tumor that is characterized by spindle cells differentiated from muscle fibroblasts and infiltration of various types of inflammatory cells. IMT can occur at any age and at any anatomic site. The most common location of IMT is the bladder in the genitourinary tract. Only scarce cases of kidney IMT have been reported in the literature.CASE SUMMARY A 77-year-old woman, with a history of bilateral renal calculus for 15 years, was admitted to the Department of Urology of our hospital complaining of recurrent painless gross hematuria for one month. The treatment with cephalosporin was ineffective. Computed tomography imaging showed a mixed density and slightly heterogeneously enhanced lesion in the middle pole of the left kidney and ipsilateral adrenal enlargement. The patient underwent surgical treatment by retroperitoneoscopic left radical nephrectomy plus adrenalectomy. A large number of typical spindle cells surrounded by plasma cells and lymphocytes were observed microscopically. Immunohistochemical analyses indicated that these spindle cells were positive for vimentin, cytokeratin(CK), Ki-67, CK7,CD34, and CD31 and were focally positive for CD10 and anaplastic lymphoma kinase(ALK-1). Thus, a diagnosis of IMT was made definitively. The patient recovered well after operation, and no recurrence or metastasis was noted during the 22-mo follow-up.CONCLUSION Since kidney IMT is very rare and lacks characteristic clinical manifestation, it is easily misdiagnosed as a malignant tumor before operation. Surgery remains the best choice for diagnosis and treatment, and such cases must be followed carefully because of the uncertain biological behavior of this tumor. This report suggests that renal calculus may be one of the causes of IMT, but further investigation is necessary to prove it.

Decreased expression of gastrokine 1 in gastric mucosa of gastric cancer patients

AIM: To investigate the expression of gastrokine 1 (GKN1) in normal gastric mucosa, precancerous lesions and gastric cancer tissues, and to analyse its correlations with tumour site and pathological pattern.

Letter to editor‘Non-invasive model for predicting high-risk esophageal varices based on liver and spleen stiffness’

predicting high-risk esophageal varices based on liver and spleen stiffness".Acute bleeding caused by esophageal varices is a life-threatening complication in patients with liver cirrhosis.Due to the discomfort,contraindications,and associated complications of upper gastrointestinal endoscopy screening,it is crucial to identify an imaging-based non-invasive model for predicting high-risk esophageal varices in patients with cirrhosis.

Improvement cues of lesion absorption using the adjuvant therapy of traditional Chinese medicine Qinbudan tablet for retreatment pulmonary tuberculosis with standard anti-tuberculosis regimen

Background:China is the second highest pulmonary tuberculosis(PTB)burden country worldwide.However,retreatment of PTB has often developed resistance to at least one of the four first-line anti-TB drugs.The cure rate(approximately 50.0–73.3%)and management of retreatment of PTB in China needs to be improved.Qinbudan decoction has been widely used to treat PTB in China since the 1960s.Previously clinical studies have shown that the Qinbudan tablet(QBDT)promoted sputum-culture negative conversion and lesion absorption.However,powerful evidence from a randomized controlled clinical trial is lacking.Therefore,the aim of this study was to compare the efficacy and safety of QBDT as an adjunct therapy for retreatment of PTB.Methods:We conducted a multicenter,randomized,double-blind,placebo-controlled clinical trial in China.People diagnosed with PTB were enrolled who received previous anti-TB treatment from April 2011 to March 2013.The treatment group received an anti-TB regimen and QBDT,and the control group was administered an anti-TB regimen plus placebo.Anti-TB treatment options included isoniazid,rifampicin,pyrazinamide,ethambutol,streptomycin for 2 months(2HRZES),followed by isoniazid,rifampicin,ethambutol for 6 months(6HRE),daily for 8 months.Primary outcome was sputum-culture conversion using the MGIT 960 liquid medium method.Secondary outcomes included lung lesion absorption and cavity closure.Adverse events and reactions were observed after treatment.A structured questionnaire was used to record demographic information and clinical symptoms of all subjects.Data analysis was performed by SPSS 25.0 software in the full analysis set(FAS)population.Results:One hundred eighty-one cases of retreatment PTB were randomly divided into two groups:the placebo group(88 cases)and the QBDT group(93 cases).A total of 166 patients completed the trial and 15 patients lost to follow-up.The culture conversion rate of the QBDT group and placebo group did not show a noticeable improvement by using the covariate sites to correct the rate differences(79.6%vs 69.3%;rate difference=0.10,95%confidence interval(CI):-0.02–0.23;F=2.48,P=0.12)after treatment.A significant 16.6%increase in lesion absorption was observed in the QBDT group when compared with the placebo group(67.7%vs 51.1%;rate difference=0.17,95%CI:0.02–0.31;χ2=5.56,P=0.02).The intervention and placebo group did not differ in terms of cavity closure(25.5%vs 21.1%;rate difference=0.04,95%CI:-0.21–0.12;χ2=0.27,P=0.60).Two patients who received chemotherapy and combined QBDT reported pruritus/nausea and vomiting.Conclusions:No significant improvement in culture conversion was observed for retreatment PTB with traditional Chinese medicine plus standard anti-TB regimen.However,QBDT as an adjunct therapy significantly promoted lesion absorption,thereby reducing lung injury due to Mycobacterium tuberculosis infection.Trial registration:This trial is registered at ClinicalTrials.gov,NCT02313610.

Study on Preparation and Properties of Polyether Polytriazole Elastomers

To explore the application of click chemistry in the field of elastomer materials, propargyl-terminated ethylene oxide-tetrahydrofuran copolymer （PTP（E-co-T）） was prepared from hydroxyl-terminated ethylene oxide-tetrahydrofuran copolymer （P（E-co-T）） by end-etherisation modification. FTIR and ^13C-NMR results indicate that P（E-co-T）-terminated hydroxyl was etherified thoroughly, yielding the target product PTP（E-co-T）, and the content of terminated alkynyl of PTP（E-co-T） was evaluated to be 0.428 mmol.g^-l. Using a polyazide compound as a cross-linker, polytriazole elastomers with various functional molar ratio （R） values were prepared from PTP（E-co-T） by virtue of the CuAAC reaction. Mechanical property tests indicate that with the increase in R, the modulus E and stress Orb of the polytriazole elastomers first increase and subsequently decrease, whereas the strain first decreases and later increases. The mechanical properties of the polytriazole elastomers show a parabolic dependence on the R value. Near the stoichiometric ratio, E and Orb show maxima and the strain εb shows a minimum. Swelling tests demonstrate that the apparent molecular weight of polytriazole elastomer strands also first decreases and subsequently increases. At the stoichiometric ratio, the network structure possesses strands with a minimum apparent molecular weight and a maximum apparent density. Dynamic mechanical analysis reveals that the polytriazole elastomers presented damping peaks at approximately -64℃, corresponding to the glass transition of copolyether strands, and the elastomer exhibited the lowest dissipation factor tanδ at the stoichiometric ratio. Thermal analysis suggests that the weight-loss process of the polytriazole elastomer is characteristic of one-step decomposition, and the elastomer begins to decompose from polyether strands, not triazole groups.

Expression of Dickkopf-like1 protein(Dkkl1) in mouse testis

Objective To investigate the expression and the distribution of Dickkopf-likel （Dkkll） protein during the development of mouse testis. Methods Testes eDNA samples from BALB/c mice in different postnatal days were hybridized with mouse whole genome affymetrix chip to screen the spermatogenesisrelated genes. The characteristics of the selected genes were analyzed by various bioinformatics tools. The mRNA expression of Dkkll at different stages of testis development and different tissues in mouse were analyzed by RT-PCR. The protein localization of Dkkll in mouse testis was assesed by immunohistoehemistry. Results By analyzing the gene chip signals of mouse testis aged 4 d, 9 d, 18 d, 35 d, 54 d and 6 months, Dkkll was identified with a differential expression in the develop- mental stages of testis. RT-PCR analysis showed that the expression of Dkkll mRNA was firstly detected on 15 d testis tissue and gradually upregulated during the testis developing to the adult stage. The Dkkll protein was predominantly located in spermatocytes and round spermatids in mouse testis. Conclusion The expression of Dkkll is gradually upregulated during the development of mouse testis and corresponds to the mouse spermatogenesis. It may play a critical role in male mammalian spermatogenesis.