【摘要】 目的 評價螺旋CT對原發性膀胱移行細胞癌（TCC）分期的準確性。 方法 對2000年9月-2009年9月診治的73例原發性TCC患者，手術前行螺旋CT臨床分期與手術后病理分期進行比較。 結果 TCC患者手術前螺旋CT臨床分期與手術后病理分期相符率為90.5%。7例分期不符的患者中，4例螺旋CT分期低于病理分期，3例高于病理分期。 結論 螺旋CT對TCC的手術前臨床分期較準確；螺旋CT分期誤差產生的主要原因是不能確定腫大的淋巴結是否是癌轉移。【Abstract】 Objective To investigate the value of contrast helical CT in Neopl-asm staging in patients with transitional cell carcinoma (TCC) of bladder. Methods Total 73 patients with TCC of bladder treated from september 2000 to September 2009 was analysed to compare preoperative helical CT examination with postoperative pathological diagnosis. Results The coincident staging of helical CT and pathological finding of TCC of bladder was found to be 90.5%. In the remaining seven patients, four patients were of overstaging and three patients were of understaging respectively. Conclusion The early enhancing phase of helical CT is helpful in the evaluation of the staging in patients with TCC of bladder.The cause of incorrecting staging by preoperative CT was usualy due to the difficulty in determing if lymph nodemetastasis occurs.
ObjectiveTo investigate the potential causal relationships between blood metabolites and diabetic kidney disease (DKD) in East Asian populations and to identify ethnicity-specific metabolic risk factors. MethodsWe utilized summary-level data from genome-wide association studies (GWAS) comprising 112 blood metabolites in a Chinese population and DKD in an East Asian population. Genetic variants significantly associated with metabolites were selected as instrumental variables. We performed bidirectional two-sample Mendelian randomization (MR) analyses, with primary causal estimates derived using the inverse variance weighted (IVW) method. Sensitivity analyses included MR-Egger, weighted median, and Bayesian-weighted MR (BWMR). Metabolites showing suggestive evidence of association were further investigated using multivariable MR and colocalization analysis. Robustness of findings was assessed via Cochran’s Q test for heterogeneity, the MR-Egger intercept test for horizontal pleiotropy, and leave-one-out analysis. ResultsForward MR analysis identified suggestive associations between elevated levels of tyrosine, glutamine, leucine, and the albumin-to-globulin ratio with DKD risk. In multivariable MR analysis, leucine (OR=0.084, P=0.026) and the albumin-to-globulin ratio (OR=0.161, P=0.048) retained statistically significant independent protective effects against DKD, whereas the associations for tyrosine and glutamine were attenuated. Colocalization analysis did not support the presence of shared underlying causal genetic variants between the identified metabolites and DKD. Sensitivity analyses revealed no significant evidence of heterogeneity or horizontal pleiotropy. Reverse MR analysis did not suggest the presence of reverse causation. ConclusionOur findings suggest that leucine and the albumin-to-globulin ratio may act as independent protective factors against DKD in East Asian populations. These results provide new genetic insights into the ethnicity-specific metabolic mechanisms contributing to DKD.