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Liang S.,Anhui Provincial Childrens Hospital | Liang S.,Shanghai JiaoTong University | Zou Q.,Shanghai JiaoTong University | Han B.,Shanghai JiaoTong University | And 6 more authors.
Urologia Internationalis | Year: 2015

Purpose: To assess the efficacy of intra-arterial chemotherapy as a bladder-preservation treatment in patients with muscle-invasive bladder cancer (MIBC) following transurethral resection of bladder tumors (TURBT). Materials and Methods: From 2005 June to 2012 November, 46 patients diagnosed with MIBC (clinical stage T2-T3N0M0) underwent three courses of cisplatin-based intra-arterial chemotherapy as a remedial approach for bladder preservation after TURBT. All patients also received intravesical instillation of chemotherapy as a maintenance strategy. Results: All 46 patients completed the treatment with minor complications. The median follow-up time was 34.5 months (range, 8-87 months). Thirty-two patients (69.6%) demonstrated complete response. The three-year and five-year overall survival was 70.65 and 61.23%, and the disease-specific survival over the same periods was 78.03 and 67.62%, respectively. During the entire follow-up period, more than 80% preserved their bladder. Conclusions: Intra-arterial chemotherapy can be performed as a remedial treatment for MIBC patient following TURBT. Combined with TURBT, it offers an option for bladder preservation therapy on patients who are unable or unwilling to undergo radical cystectomy. © 2015 S. Karger AG, Basel.

BACKGROUND: The one-stage procedure for treatment of older developmental dislocation of the hip (DDH) is used widely. However, the best age group for this operation is still unknown. The aims of our study were to evaluate middle-term outcomes of one-stage surgical treatment of a large number of patients with late-diagnosed DDH, and to explore the best age group for treatment.METHODS: We retrospectively reviewed 652 patients with a total of 864 hip joints with DDH, all aged >18 months. All the hip joints were treated with one-stage procedures including open reduction, pelvic osteotomy, and femoral shortening. The patients were divided into three groups according to age at surgery: Group I: 1.5-2.5 years; Group II: 2.5-8 years; and Group III: >8 years. The latest clinical and radiographic outcomes, complications and avascular necrosis (AVN) of the femoral head were evaluated and compared among the three groups.RESULTS: The mean age at surgery was 5.8 years (range: 1.5-13.2 years). The average time of follow-up was 6.2 years (range: 3.2-8.9 years). A total of 79.4% of good or excellent outcomes were obtained for clinical functional evaluation according to the McKay classification. For radiographic outcomes, 732 hips (84.7%) were classified as good or excellent according to the Severin classification. A total of 27.4% of all hips had a poor outcome according to the Kalamchi and MacEwen classification for AVN. The poorest outcomes were observed for clinical, radiographic and AVN results in Group III (p < 0.001). Compared with Group I, the better results for clinical and AVN outcomes were found in Group II (p < 0.001). However, similar clinical outcomes were observed between Groups I and II (p > 0.05). A significantly higher incidence of redislocation and residual acetabular dysplasia was observed in Tonnis grade II and III hip dislocation (p < 0.001).CONCLUSIONS: One-stage treatment of late-diagnosed DDH had a good outcome in young and middle group. Younger patients achieved better results than older patients. However, the best age group was 2.5-8 years. Tonnis grade II and III DDH is a risk factor for redislocation and residual acetabular dysplasia after the one-stage operation.

Chen G.,Anhui University of Traditional Chinese Medicine | Liu H.,Anhui Provincial Childrens Hospital | Cheng F.,Anhui University of Traditional Chinese Medicine
Journal of Traditional Chinese Medicine | Year: 2013

OBJECTIVE: To investigated the effect and mechanism of Fangjihuangqi Tang (FHT) on lower urinary tract dysfunction induced by benign prostatic hyperplasia (BPH) in rats. METHODS: Male rats were randomly divided into seven groups: normal, model, finasteride (0.5 mg/kg), terazosin (0.5 mg/kg), and FHT (10, 5, 2.5 g/kg). Rats were administered testosterone (0.5 mg sc) for 6 weeks after orchiectomy, excluding the normal group. All rats were intragastrically administered assigned drugs for 4 weeks from the third week. Urodynamics were assessed in rats under anesthesia. Serum dihydrotestosterone (DHT) and prostatic acid phosphatase (PAP) were measured. The prostate index (PI), bladder index (BI), and pathological detection were evaluated. RESULTS: In the model group, the PI, BI, serum DHT, serum PAP, threshold pressure (TP), micturition pressure (MP), and residual urine volume (RV) were significantly higher. Moreover, inter-micturition duration (IMD) was significantly lower and the prostatic and bladder showed obvious pathological changes. The IMD was significantly higher, while BI, TP, MP, and RV were significantly lower and bladder pathological changes were alleviated in the FHT (10, 5 g/kg), finasteride, and terazosin groups. The PI, DHT, and PAP were significantly lower in the finasteride group, but they did not change significantly in the FHT (10, 5, 2.5 g/kg) and terazosin groups. CONCLUSION: FHT could relieve symptoms of lower urinary tract dysfunction in BPH rats but with no apparent effect on reducing the volume of the enlarged prostate itself. © 2013 JTCM. All rights reserved.

Xu Z.,Anhui Provincial Childrens Hospital | Zhang S.,Anhui Medical University | Zhou Q.,Anhui Medical University | Wang Y.,Anhui Medical University | Xia R.,Anhui Medical University
Molecular and Cellular Biochemistry | Year: 2014

Recent evidence indicated that endocan may be a potential cell marker and a new target for cancers including acute leukemia since the serum endocan level in patients with acute leukemia was associated with the status of the disease, i.e., endocan was higly expressed in untreated acute leukemia, but decreased after chemotherapy and increased again during bone marrow regeneration. The present study showed that there was high level expression of endocan in cytoplasm of bone marrow blasts of patients with acute myeloid leukemia or acute lymphoblastic leukemia. The expression level of endocan was significantly decreased when the patients underwent remission after chemotherapy and re-bounces back when the acute leukemia relapsed. No obvious change in expression of endocan was observed before and after chemotherapy if the patients showed no remission after chemotherapy. (N-(4-Hydroxyphenyl) retinamide), a potent anti-angiogenic agent, could not only down-regulate the expression of vascular epithelial growth factor, but also decrease endocan transcription and expression in NB4 cells, a human acute promyelocytic leukemia cell line. These observations suggest that endocan could act as a predictor for the severity and the prognosis of acute leukemia. The findings could be used as the basis for future targeted therapy directed against bone marrow angiogenesis in acute leukemia treatment. © 2014 Springer Science+Business Media.

Zhu Y.,Anhui Provincial Childrens Hospital | Dong Y.,Anhui Provincial Childrens Hospital | Xu D.-L.,Anhui Provincial Childrens Hospital | Jiang J.-Y.,Anhui Provincial Childrens Hospital
Chinese Journal of Contemporary Pediatrics | Year: 2013

Objective To observe the therapeutic effect of continuous blood purification (CBP) combined with hemoperfusion (HP) in children with hemolytic-uremic syndrome (HUS) and to investigate its possible mechanism. Methods Eight children with HUS received CBP combined with HP on the basis of internal medicine treatment in the acute stage. Before and after treatment, serum levels of interleukin-6 (IL-6), IL-8 and tumor necrosis factor-a (TNF-a) were measured by chemiluminescence method, and levels of blood urea nitrogen (BUN), serum creatinine (SCr), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK), creatine kinase MB (CKMB), hemoglobin (Hb), platelet (PLT) and C-reactive protein (CRP) were measured. Eight healthy children undergoing physical examination were used as controls. Results The 8 children with HUS all survived after CBP combined with HP and showe improve con itions. Theyha increase Hban PLTlevelsan ecrease serum levelsofIL-6 IL-8 TNF-c BUN, SCr, ALT, CK and CRP after treatment (P <0. 05). Conclusions CBP combined with HP can quickly remove pathogenic factors continualy eliminate inflammatory mediators and toxins and reverse multiple organ dysfunction and is one of effective methods for treating HUS in children. Copyright © 2004-2005 Chinese Journal Of Contemporary Pediatrics All rights reserved.

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