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Background: Vascular endothelial growth factor-targeted agents are standard treatments in advanced clear-cell renal cell carcinoma (ccRCC), but biomarkers of activity are lacking. The aim of this study was to investigate the association of Von Hippel-Lindau (VHL) gene status, vascular endothelial growth factor receptor (VEGFR) or stem cell factor receptor (KIT) expression, and their relationships with characteristics and clinical outcome of advanced ccRCC. Methods: A total of 59 patients who received targeted treatment with sunitinib or pazopanib were evaluated for determination at Cancer Hospital and Institute, Chinese Academy of Medical Sciences between January 2010 and November 2012. Paraffin-embedded tumor samples were collected and status of the VHL gene and expression of VEGFR and KIT were determined by VHL sequence analysis and immunohistochemistry. Clinical-pathological features were collected and efficacy such as response rate and Median progression-free survival (PFS) and overall survival (OS) were calculated and then compared based on expression status. The Chi-square test, the Kaplan-Meier method, and the Lon-rank test were used for statistical analyses. Results: Of 59 patients, objective responses were observed in 28 patients (47.5%). The median PFS was 13.8 months and median OS was 39.9 months. There was an improved PFS in patients with the following clinical features: Male gender, number of metastatic sites 2 or less, VEGFR-2 positive or KIT positive. Eleven patients (18.6%) had evidence of VHL mutation, with an objective response rate of 45.5%, which showed no difference with patients with no VHL mutation (47.9%). VHL mutation status did not correlate with either overall response rate ( P = 0.938) or PFS ( P = 0.277). The PFS was 17.6 months and 22.2 months in VEGFR-2 positive patients and KIT positive patients, respectively, which was significantly longer than that of VEGFR-2 or KIT negative patients ( P = 0.026 and P = 0.043). Conclusion: VHL mutation status could not predict the efficacy of sunitinib or pazopanib. Further investigation of VHL/VEGFR pathway components is needed.

The energy-saving management system of major projects in implementation has always been in a state of imperfect. On the basis of combining energy-saving management status of major projects in implementation, referring to the research results of the management mechanism design theory at home and abroad, this paper aims at the primary interest-related subjects of the major projects energy-saving, uses economic mechanism designing theory and incentive theory, designs the energy-saving management mechanism; It does the theoretical analysis of the government and major projects owner with the complete information dynamic game model, then, provides decision evidence for the government to formulate the rational management intensity and maximize the interests of all parties. At last, the paper provides the suggestions to solve the existing problems of major projects energy-saving management.

At present, the difficulty of wind power integration has resulted in a large number of wind curtailment phenomena and wasted a lot of renewable energy. Due to the significant instability, anti-peak-regulation and intermittency of wind power, wind power integration needs an accurate prediction technique to be a basis. ARMA model has the advantage of high prediction accuracy in predicting short-term wind power. This paper puts forward the method for short-term wind power prediction using ARMA model and carries out empirical analysis using the data from a wind farm of Jilin province, which shows the science and operability of the proposed model. It provides a new research method for the wind power prediction.

Due to the significant instability, anti-peak-regulation and intermittency of wind power, wind power integration needs an accurate prediction technique to be a basis. At present, the difficulty of wind power integration has resulted in a large number of wind curtailment phenomena and wasted a lot of renewable energy. Grey prediction model has many advantages such as requiring little historical data and the simple model, with high prediction accuracy and convenient calculation, and without regard to regularities of distribution, etc. This paper puts forward the method for short-term wind power prediction using gray model GM (1, 1) and carries out simulation study and empirical analysis using the data from a wind farm of Jilin province, which shows the science and operability of the proposed model. It provides a new research method for the wind power prediction.

In this paper, according to the mechanics balance equation, the law of conservation of mass and the relationship between parameters including coal seam permeability, porosity and volume strain, we build a gas-solid coupling model of hydraulic flushing borehole in the coal roadway floor, and use the model to investigate the relationship between ejected coal amount and effective influence radius. The numerical simulation results indicate that the effective radius of hydraulic flushing borehole increase as the drainage time and the ejected coal amount, and the effective influence radius is 5.8m when the ejected coal mass is 1t/m, which indicate the pressure release and permeability enlarging effect is remarkable.

Low-grade myofibroblastic sarcoma is a recently characterized tumor showing features of myofibroblastic differentiation that is part of the spectrum of malignant mesenchymal tumors. This extremely rare type of tumor occurs most commonly in superficial locations. The case we describe herein is that of a 60-year-old man with two large hepatic masses. The patient’s tumor was removed radically through an incision due to the inconclusive imaging findings. Follow-up computed tomography showed no recurrence and metastasis after 37 months, suggesting that enucleation was adequate for tumor eradication. To our knowledge, this is the first reported case of low-grade myofibroblastic sarcoma in the liver in the English language literature.

Objectives:The aim of this article was to evaluate the clinical and pathologic characteristics, therapy, and prognostic factors of vulvar sweat gland carcinoma.Materials:Clinical and pathologic data for 12 patients with vulvar sweat gland carcinoma treated at our institution from January 1958 to April 2009 were retrospectively analyzed. Of the 12 cases, 7 cases were vulvar sweat gland carcinoma, 3 cases were vulvar Paget disease with underlying sweat gland adenocarcinoma, 1 case was vulvar apocrine adenocarcinoma, and 1 case was adenoid cystic carcinoma of the vulvar sweat gland. Two patients were treated with simple vulvar tumor excision at other medical institutions without adjuvant therapy. Among the other 10 patients, 6 underwent radical vulvectomy; 3, wide local excision of the vulva; and 1, a simple vulvectomy. For 5 of the 12 patients, bilateral or unilateral inguinal lymph nodes excision and biopsy were performed. For 1 patient with bulky inguinal lymph nodes, only a biopsy was performed, and the patient received radiotherapy after vulvar surgery.Results:A follow-up for 11 patients was conducted until death or April 1, 2009. Five of the 11 patients had recurrences after primary treatment. For 2 of these patients, recurrence was local 6 and 48 months after treatment. For 3 patients, distant metastasis was found 18, 5, and 31 months after surgery at our institution. Five of 11 patients died, 1 of whom died of irrelevant disease and 4 of tumor progression. The total survival periods of the 4 patients who died of tumor progression were 24, 36, 44, and 203 months. The other 6 patients have survived for more than 5 years without local failure. In total, there are 7 patients who have survived for 5 years or more.Conclusions:Vulvar sweat gland carcinoma is a very rare entity. Surgery is the primary treatment modality, and the function of radiotherapy and chemotherapy is uncertain. The vulvar tumor size and inguinal lymph nodes metastasis will influence the prognosis, with pathologic differentiation and surgical margin status being the probable prognostics factors.

Objective To investigate the clinical and pathological characteristics, treatment methods, and prognosis of synchronous primary cancer of the endometrium and ovary.

To discuss the optimal treatment options for stage I patients with endometrial stromal sarcoma (ESS).We reviewed hospital records and pathology of 53 patients with ESS at stage I. Statistical analysis was performed using SPSS 12.0 software, and Chi-square test, t-test and log rank test were adopted.Among 53 patients, 37 had low-grade tumors, 11 had undifferentiated endometrial sarcoma (UES) and 5 had unclassified ESS. The median follow-up time was 66 months, and 48 cases were still alive. The overall 2-year and 5-year survival rates were 91.5% and 85.9%, respectively. The recurrence rate of the patients with preserved ovarian function was remarkably higher than that of patients without (100% vs. 22.7%, P0.001). The patients who received adjuvant whole pelvic radiation (Dt 40 approximately 45 Gy) had obviously higher local control rate than the patients who did not (93.8% vs. 57.1%, P=0.007), but they had similar survival (P=0.963). Among 7 of the 11 UES patients without distant recurrence, 5 received the adjuvant chemotherapy with IAP (ifosfamide 1.0 g, d1-4; epirubicin 25 mg/m2, d1-2; cisplatin 20 mg, d1-5; mensa 0.2 g, 0, 4, 8 h from the application of ifosfamide, d1-4, q 28 days) or VAD (vincristine 1.2 mg/m2, d1; adriamycin 20 mg/m2, d1-3; dacarbazine 250 mg/m2, d1-5, q 28 days), and none of the other 4 cases recurring distantly received the chemotherapy with IAP or VAD.Surgeries not preserving ovarian function were helpful to decrease the risk of recurrence compared with those surgeries sparing ovarian function. Adjuvant radiotherapy could improve local control but not survival. Adjuvant chemotherapy with IAP or VAD seemed to be beneficial to UES patients.

Background and Objective: Diffuse large B-cell lymphoma (DLBCL), the most common type of non-Hodgkin's lymphoma (NHL), is heterogeneous on molecular and clinical levels, therefore, its prognosis is difficult to predict. This study aimed to evaluate the value of Blimp-1 protein and Hans classification in predicting the prognosis of DLBCL and their interrelation. Methods: The clinical records of 136 patients with DLBCL were reviewed. The patients were followed up for 5-80 months (median, 39 months). Immunohistochemical staining for CD10, MUM1, Bcl-6, and Blimp-1 were performed on paraffin-embedded tumor tissues from the 136 patients. The correlations of Blimp-1 protein and Hans classification in prognosis of DLBCL and their interrelation were analyzed. Results: Blimp-1 was detected in 38 (30.0%) patients, and was associated with a significantly shorter overall survival (OS) (P=0.030). Using the Hans classification based upon the expression of CD10, Bcl-6, and MUM1, 54 patients had germinal center B-cell (GCB) phenotype and 82 had non-GCB phenotype. The 5-year OS rate was 75% in the GCB group and 52% in the non-GCB group (P=0.020). The positive rate of Blimp-1 was 22.2% in the GCB group and 31.7% in the non-GCB group (P=0.329). The Cox regression multivariate analysis showed that international prognosis index (IPI) and Hans classification had independent prognostic significance, whereas Blimp-1 was not an independent prognostic factor. Conclusions: The patients with GCB subtype of DLBCL had better prognosis than the non-GCB subtype. High level of Blimp-1 expression in the patients with DLBCL implies a shorter survival, but it is not associated with Hans classification.

We presented an unusual case with coexistence of carcinoid, signet-ring cell carcinoma (SRC) and heterotopic pancreatic tissue in stomach. Gastroscopic examination of this 63-year-old male patient showed multiple protrusions in gastric corpus near the greater curvature, identified by subsequent biopsy as carcinoid. Distal subtotal gastrectomy was performed. Histological and immunohistochemical examinations showed a carcinoid tumor in gastric corpus near the greater curvature, an intramucosal SRC at the lesser curvature of corpus and heterotopic pancreatic tissue in muscularis propria of the antrum at the lesser curvature with hyperplasia of peripheral endocrine cells producing multiple pancreatic hormones. We reviewed the literatures on clinicopathological characteristics and the differential diagnosis of the above three abnormalities, and concluded that the carcinoid in corpus near the greater curvature and SRC in the lesser curvature are independent lesions; the foci of endocrine cells in the muscularis propria and serosa are hyperplastic lesions from the heterotopic pancreatic tissue, rather than dissemination of carcinoid in corpus.

e14502 Background: Recurrent or metastatic esophageal cancer has poor prognosis. Currently, the standard of care for esophageal cancer includes treatment with triweekly cisplatin-based chemotherapy. However, not all patients benefit from the treatment. To improve the response and identify specific marker for patient-personalized treatment, we designed this study to assess the efficacy and safety of biweekly paclitaxel and cisplatin combination for patients with recurrent or metastatic esophageal squamous cell carcinoma. The excision repair cross-complementation group 1 (ERCC1) expression to predict response is also assessed. Methods: Forty-six eligible patients were enrolled. Paclitaxel was given at 150 mg/m2 over 3 hours on day 1 and cisplatin was given at 50 mg/m2 on day 2, every 2 weeks as one cycle. ERCC1 protein expression was assessed by immunohistochemistry staining. Results: The overall response rate was 56.5% (26/46, 95% CI 42.2 %- 70.8%). Progression-free survival was 5.6 months (95% CI, 2.8-8.4 months) and the median actuarial survival time was 17.0 months (95% CI, 12.3-21.7months). There was a significant difference in median actuarial survival between the patients with a response compared to the non-responders (22.8 months vs. 7.4 months, p