Background Superficial urothelial carcinoma （SUC） of the bladder is a common urinary tract tumor in China. There is a high recurrence rate of this tumor even after surgery and intravesical instillation. Previous rep...Background Superficial urothelial carcinoma （SUC） of the bladder is a common urinary tract tumor in China. There is a high recurrence rate of this tumor even after surgery and intravesical instillation. Previous reports have described a suppression of the immune system in cancer patients. Dendritic cells （DCs） play a pivotal role in the induction of an effective antitumor immune response. The aim of this study was to investigate the effects of surgery and epirubicin intravesical chemotherapy （IC） on peripheral blood DCs in subsets of patients with bladder SUC. Methods A total of 66 SUC patients and 38 healthy controls were enrolled in this study. All the patients had undergone transurethral resection （TUR） of their cancer and adjunctive IC after tumor removal. The patients were divided into a non-recurrence group （n=40） and a recurrence group （n=26） based on the presence or absence of tumor recurrence. Blood samples were taken preoperatively （PreOP）, on postoperative days （POD） 1 and 7, and at postoperative month （POM） 3. Flow cytometric analysis was used for the determination and quantitation of the surface markers CD80 and CD86 in circulating DC subsets. Results The preoperative percentages of myeloid dendritic cells （mDCs） and expression of CD80 and CD86 were impaired in SUC patients compared to healthy controls （P 〈0.05）. The percentages of mDCs and these surface markers decreased significantly on POD 1 and increased on POD 7, remaining higher than the preoperative values in POM 3 （P 〈0.05）. The percentages of mDCs, and CD80 and CD86 in the non-recurrence group on PreOP, POD 7, and POM 3 were higher than those in recurrence group. Conclusions Surgical removal of SUC and adjunctive IC were associated with improved circulating mDC counts and function. Persistent depression of mDC counts and function after treatment in recurrence patients indicated lower antitumor immunity that may lead to tumor recurrence.展开更多
Chromophobe renal cell carcinoma （CRCC） is a distinctive, but not rare, malignant renal neoplasm.Series studies have revealed that the incidence of CRCC is between 3.6% and 10.4% of all kidney neoplasms. In China, t...Chromophobe renal cell carcinoma （CRCC） is a distinctive, but not rare, malignant renal neoplasm.Series studies have revealed that the incidence of CRCC is between 3.6% and 10.4% of all kidney neoplasms. In China, the first CRCC case was described by our hospital in 1998; there have since been only a few case reports of CRCC in China and very few instances of long-term follow-up. To our knowledge, there is little information available regarding the clinical outcomes of patients with CRCC. In order to analyze the clinical and pathologic characteristics of CRCC and the prognosis in Chinese patients, we reviewed retrospectively the clinical data from cases of CRCC treated recently in our hospital.展开更多
Background Acute renal failure following coronary artery bypass grafting （CABG） surgery is associated with high morbidity and mortality. Approximately half of all patients who develop acute kidney injury （AKI） sub...Background Acute renal failure following coronary artery bypass grafting （CABG） surgery is associated with high morbidity and mortality. Approximately half of all patients who develop acute kidney injury （AKI） subsequently develop acute renal failure （ARF）. The purpose of the study was to compare early transient changes in renal function within the first post-operative week following CABG in patients that were either off-pump or on-pump. Methods Eight hundred and forty-nine consecutive patients with isolated CABG in a single institution between January 1990 and August 2006 were retrospectively analyzed, including 518 off-pump and 331 on-pump patients. A multivariate Logistic regression model was constructed to identify risk factors for the development of AKI. Results Sixty-one off-pump patients and 63 on-pump patients developed AKI. Risk factors for the development of post-operative AKI included an ejection fraction ≥50% or ≤30%, a pulse pressure ≥60 mmHg, peripheral vascular disease diabetes, emergent procedure, triple-vessel disease, body mass index, peri-operative and post-operative intra-aortic balloon pumping, NYHA class III and IV, and cardiopulmonary bypass. An ejection fraction ≥50% and peri-operative and post-operative intra-aortic balloon pumping were protective （OR 〈1）. Peak serum creatinine for post-operative AKI was noted 12 hours and 24 hours in the off-pump and on-pump patients, respectively. Serum creatinine kinetics revealed rapid recovery in the 24th to 48th hour （off-pump） and the 48th to 72nd hour （on-pump）. Conclusion Renal protection strategies are indicated from general anesthesia induction until 48 and 72 hours post-operatively in off-pump and on-pump patients, respectively.展开更多
文摘Background Superficial urothelial carcinoma （SUC） of the bladder is a common urinary tract tumor in China. There is a high recurrence rate of this tumor even after surgery and intravesical instillation. Previous reports have described a suppression of the immune system in cancer patients. Dendritic cells （DCs） play a pivotal role in the induction of an effective antitumor immune response. The aim of this study was to investigate the effects of surgery and epirubicin intravesical chemotherapy （IC） on peripheral blood DCs in subsets of patients with bladder SUC. Methods A total of 66 SUC patients and 38 healthy controls were enrolled in this study. All the patients had undergone transurethral resection （TUR） of their cancer and adjunctive IC after tumor removal. The patients were divided into a non-recurrence group （n=40） and a recurrence group （n=26） based on the presence or absence of tumor recurrence. Blood samples were taken preoperatively （PreOP）, on postoperative days （POD） 1 and 7, and at postoperative month （POM） 3. Flow cytometric analysis was used for the determination and quantitation of the surface markers CD80 and CD86 in circulating DC subsets. Results The preoperative percentages of myeloid dendritic cells （mDCs） and expression of CD80 and CD86 were impaired in SUC patients compared to healthy controls （P 〈0.05）. The percentages of mDCs and these surface markers decreased significantly on POD 1 and increased on POD 7, remaining higher than the preoperative values in POM 3 （P 〈0.05）. The percentages of mDCs, and CD80 and CD86 in the non-recurrence group on PreOP, POD 7, and POM 3 were higher than those in recurrence group. Conclusions Surgical removal of SUC and adjunctive IC were associated with improved circulating mDC counts and function. Persistent depression of mDC counts and function after treatment in recurrence patients indicated lower antitumor immunity that may lead to tumor recurrence.
文摘Chromophobe renal cell carcinoma （CRCC） is a distinctive, but not rare, malignant renal neoplasm.Series studies have revealed that the incidence of CRCC is between 3.6% and 10.4% of all kidney neoplasms. In China, the first CRCC case was described by our hospital in 1998; there have since been only a few case reports of CRCC in China and very few instances of long-term follow-up. To our knowledge, there is little information available regarding the clinical outcomes of patients with CRCC. In order to analyze the clinical and pathologic characteristics of CRCC and the prognosis in Chinese patients, we reviewed retrospectively the clinical data from cases of CRCC treated recently in our hospital.
文摘Background Acute renal failure following coronary artery bypass grafting （CABG） surgery is associated with high morbidity and mortality. Approximately half of all patients who develop acute kidney injury （AKI） subsequently develop acute renal failure （ARF）. The purpose of the study was to compare early transient changes in renal function within the first post-operative week following CABG in patients that were either off-pump or on-pump. Methods Eight hundred and forty-nine consecutive patients with isolated CABG in a single institution between January 1990 and August 2006 were retrospectively analyzed, including 518 off-pump and 331 on-pump patients. A multivariate Logistic regression model was constructed to identify risk factors for the development of AKI. Results Sixty-one off-pump patients and 63 on-pump patients developed AKI. Risk factors for the development of post-operative AKI included an ejection fraction ≥50% or ≤30%, a pulse pressure ≥60 mmHg, peripheral vascular disease diabetes, emergent procedure, triple-vessel disease, body mass index, peri-operative and post-operative intra-aortic balloon pumping, NYHA class III and IV, and cardiopulmonary bypass. An ejection fraction ≥50% and peri-operative and post-operative intra-aortic balloon pumping were protective （OR 〈1）. Peak serum creatinine for post-operative AKI was noted 12 hours and 24 hours in the off-pump and on-pump patients, respectively. Serum creatinine kinetics revealed rapid recovery in the 24th to 48th hour （off-pump） and the 48th to 72nd hour （on-pump）. Conclusion Renal protection strategies are indicated from general anesthesia induction until 48 and 72 hours post-operatively in off-pump and on-pump patients, respectively.
