Objective To investigate the surgical technique and clinical effectiveness of retroperitoneal laparoscopic nephroureterectomy with transurethral bladder-cuff excision and open nephroureterectomy in pelvis carcinoma. Methods We retrospectively analysed the records of all 62 patients who underwent retroperitoneal laparoscopic or open nephroureterectomy in Tianjin Dagang Hospital or the Second Affiliated Hospital of Tianjin Medical University from July 2001 to July 2009. Variables analyse were compared including operative time, blood loss, turning to open operation, complications, length of stay, tumor recurrence and metastasis. Groups were compared using Student's t-test, and a probability (P) value of less than 0.05 was taken to indicate statistical significance. Results The respective mean operative duration [(47.34±39.16) vs (118.17±44.65) ml], length of hospital stay [(9.15±2.19) vs (11.64±3.71) d], time to ambulation [(3.58±0.79) vs (5.67±1.24) d]and blood loss [(70.64±27.33) vs (118.17±44.65) ml]in retroperitoneal laparoscopic nephroureterectomy with transurethral bladder-cuff excision group was significantly reduce to open nephroureterectomy group (t = 3.3167, 2.0587, 8.0494, 5.1777, P ＜0.05). There was no significantly difference between two groups in complication of during operation and post operation [4.8 % (2/42) vs 5.0 %(1/20), 0 vs 0, respectively](P ＞0.05). 4 cases were failed and conversed to open surgery in retroperitoneal laparoscopic nephroureterectomy group. During the follow up period range from 8-48 months, there was no significantly difference between two groups in tumor recurrence and metastasis [4.8 % (2/42) vs 5.0 % (1/20),2.4 % (1/42) vs 5.0 % (1/20), respectively](P ＞0.05). Conclusion Retroperitoneal laparoscopy in upper urinary tract transitional carcinoma uses a small incision, incurs less blood loss, and allows for a more rapid recovery, suggesting it is a safe and effective method for treating patients with renal and pelvis cancer.

Objective:To research the relationship of urinary cytology positive rate with the grade and stage of primary ureter uroepithelium cancer.Methods:A total of 104 cases of primary ureter uroepithelium cancer were recruited in this study.The urine of all paitents was collected for preoperative urinary cytology de-tection.The urinary cytology detection rates were compared among different grades and stages of primary ureter uroepithelium cancer.Results:The overall unnary cytology positive rate of primary ureter uroepithelium cancer was 34.26%.The overall urinary cytology positive rate was 43.59%in the advanced stage group and 11.54%in the low stage group,with a significant difference(X2=8.740, P=0.003).The difference in positive rate between the advanced stage group and the low stage group in the high grade with inferior segment group of primary ureter uroepithelium cancer was statistically significant(X2=10.628,P=0.001).The difference in positive rate between the advanced stage group and the low stage group in the high grade group of primary ureter uroepithelium cancer was statistically significant(X2=5.678,P=0.01 7).The difference in positive rate be-tween the high grade group and the low grade group in low stage group of primary ureter uroepithelium can-cer was statistically significant(X2=12.860,P=0.001).Conclusion:The unnary cytology positive rate of primary ureter uroepithelium cancer of high grade and low stage is higher.

Prostate cancer is one of the life threatening disorders for human being, which has a high incidence over the world. At present, treatments include surgery, radiation therapy, cryosurgery, chemotherapy and hormonal therapy etc. Also, dietary modifications may decrease incidence of developing prostate cancer. This article summarizes current treat-ments, which may be helpful to prevent life threatening disease.

Objective To compare the transurenthral resection to radical cystectomy on muscle invasive bladder cancer, and to explore the factors affecting the prognosis. Methods Data of 74 patients with muscle invasive bladder can?cer were retrospectively analyzed. There were 38 cases underwent radical cystectomy (group A), and were treated with intra?venous chemotherapy after operation. There were 36 cases underwent transurenthral resection (group B), and were treated with intravenous and urinary bladder irrigation chemotherapy. All patients were followed up 61 (5-91) months. Data were compared between two groups including duration of surgery, intraoperative blood loss, the cumulative length of hospital stay, cancer recurrence rate and 5-year survival rate . The factors may affecting the prognosis in patients were collected and ana?lyzed by the Log-rank univariate and Cox multivariate analyzed. Results The values of operation time, intraoperative blood loss and the cumulative length of hospital stay were significantly lower in group B than those of group A ( P<0.01). There were no significant differences in cancer recurrence rate and 5-year survival rate between two groups (P>0.05). Results of the Log-rank univariate analysis showed that the tumor size≥5 cm and T3 stage were the important factors of 5-year relapse-free survival rate and 5-year overall survival rate. Results of the Cox multivariate analysis showed that the tumor size≥5 cm (RR=3.687, 95%CI:1.913-7.105, P<0.001) was the important factor of recurrence in patients after operation. T3 stage (RR=3.325, 95%CI:1.437-7.695, P=0.005) and tumor size≥5 cm (RR=5.017, 95%CI:2.440-10.317, P=0.002) were the risk fac?tors of the 5-year overall survival rate. Conclusion The transurenthral resection with intravenous and urinary bladder irri?gation chemotherapy deserves recommendation for the treatment of muscle invasive bladder cancer. Tumor size ≥5 cm and T3 stage are the important factors for the prognosis.

Objective To investigate the indication to retain the involved kidney in the surgical treatment of upper urinary tract stone accompanied by renal insufficiency in children. Methods 118 cases of upper urinary tract stone accompanied by renal insufficiency in children were retrospectively studied. Results 118 children with kidney or upper segment ureteral stone accompanied by renal insufficiency underwent lithotomy and nephrostomy,115 of them have been cured of the disease ( 97.5 %).3(2.5%) died.No upper urinary tract stenosis has been observed. Conclusions Early diagnosis and prompt relief of the obstruction are the key points to protect and retain the involved kidney.Clinical history and physical sign,the thickness of the renal cortex and the renal function,complicated by infection or not are the cardinal factors to be considered in order to achieve a success in retaining the involved kidney.

Objective To review the clinical and pathologic features of xanthogranulomatous cystitis (XC). Methods The clinical and pathologic data of 3 patients (2 females and 1 male, mean age, 37.3 year, age range, 24-50 year) with XC were reported in combination with review of the relevant literature. All 3 cases had recurrences cystitis-like symptoms, 2 cases had lower abdominal pain.1 case found low abdominal palpable mass during physical examination. Ultra sonography and CT revealed solid mass at the dome of the bladder. Partial cystectomy was performed on 2 patients, the rest 1 was case treated as urachal carcinoma.Results Postoperative pathology confirmed XC. Pathological features were as follows: xanthoma cells (lipidladenmacrophages), multinucleated giant cells and cholesterol clefts. With 12-36 (mean 28) months follow-up, there was no recurrence and cystitis-like symptoms on these patients. Conclusions XC is a rare disease. XC is usually identified by pathology. The presence of a concomitant neoplasm should be considered when the diagnosis of XC is made.Surgical resection could be a curative treatment.

OBJECTIVETo discuss the influence of setup errors on the accuracy of pelvic cancer in IGRT, analysis setup errors and determine the CTV-to-PTV margins.

METHODS60 pelvic cancer patients treated with Varian 23IX, all of them were performed by CBCT before and after-correction three times in the first week and after that once a week. Then, to measure the setup errors at X(left-right), Y(superior-inferior), Z(anterior-posterior) axis and E(coronal), F(sagittal), G(axial) rotation directions.

RESULTS530 scans obtained in all, the setup errors in X, Y, Z, E, F, G were (-0.52 ± 4.18) mm, (0.73 ± 4.86) mm, (-0.36 ± 3.62) mm, (0.14 ± 1.20)degrees, (0.13 ± 1.34)degrees, (0.21 ± 1.73)degrees respectively and were much lower after correction at X, Y, Z axis, besides, CTV-to-PTV margins decrease a lot.

CONCLUSIONThe accuracy of radiotherapy can be highly increased with the use of IGRT in pelvic cancer.

Objective: To construct siRNA plasmid expression vector in order to knockdown E2F-3 activity. Methods: Sixty-four base-pair oligos for hairpin RNA expression, which targeted E2F-3 gene, were chemically synthesized and annealed. The pRNAT-U6.1/Neo vector was linearized with Bam HI and HindⅢ. Finally, the annealed oligos were inserted into the lined pRNAT-U6.1/Neo to construct RNAi plasmid(pRNAT-U6.1-E2F-3/Neo). The reconstructed RNAi plasmids were i-dentified by electrophoresis after digestion with BamHI and Hind Ⅲ, and were confirmed by sequencing analysis. Results: The recombinant pRNAT-U6.1-E2F-3/Neo vector was identified by polymerase chain reaction, and confirmed by sequencing analysis. The results demonstrated that 64 bp had been inserted into the expected site. Furthermore, the insertion sequence was exactly correct and no mutation site was found. Conclusion: The pRNAT-U6.1-E2F-3/Neo RNAi system was constructed successfully. This will facilitate the study of E2F-3 in bladder cancer cell lines.

ObjectiveTo examine the effects of temsirolimus, an inhibitor of mammalian target of rapamycin, on bladder cancer cell lines T24 and BIU-87 in vitro and in vivo for purpose of evaluating the probability of mTOR targeted therapy for bladder cancer.MethodsAfter being treated by a different concentration of temsirolimus, T24 and BIU-87 cells were tested by MTT assay for cell proliferation activity.Cell cycle and apoptosis analysis were performed with flow cytometer. Wound scratch assay was used for cell migration activity and transwell motility assay. Western blot analysis was used to test the mTOR phosphorylation. Subcutaneous inoculation of 6-week-old nude mice was performed using 1 × 106 T24 cells in 50％ matrigel for both control (n = 10) and temsirolimus (n = 10) groups. The volume of tumors was examined and then the expression of Ki-67 was detected by immunohistochemistry.ResultsTemsirolimus significantly inhibited proliferation of T24 and BIU-87 cells in a dose- and time-dependent manner. After administration of temsirolimus on T24 and BIU-87 cell lines for 24 h, the rate of wound healing in 0 nmol/L groups were (88.9 ± 14. 1 ) ％ and ( 83.6 ± 16.3)％ , which were higher than in the 5 nmol/L groups, which were (42.7 ± 11.6) ％ and ( 36.9 ± 9.7 ) ％ ( P ＜ 0.05 ). In the transwell motility assay, the number of cells in the 0 nmol/L group was 26.5 ± 5.8 and 28.2 ± 4.6, which was higher than in the 5 nmol/L group ( 19.0 ±3. 8 and 21.3 ± 5.1, respectively) (P ＜ 0. 05). When temsirolimus was administered on T24 and BIU-87 cell lines for 48 h the percentages of cells delayed in phase G0/G1 in 5 nmol/L group were ( 77.46 ±6.11)％ and (73. 39 ± 4. 94)％ respectively, and higher than in the 0 nmol/L group, which were (65.99 ±5.01 )％ 、(60.15 ±3.98)％ (P ＜0.05). There was no statistically significant difference in the apoptosis rate between the two groups (P ＞ 0.05 ). In Western blot analysis, the ratios of p-mTOR/β-actin were 0.92 ±0.09 and 1.01 ± 0.08 in 0 nmol/L group, and higher than in the 5 nmol/L group (0.47 ±0.05、0.04 ±0. 01 ) (P ＜ 0.05 ). After administration of temsirolimus for 21 days, the tumor volume in nude mice in the control group were 351.1 ± 139.9 mm3 , which was larger than 351.1 ± 139.9 mm3 in the temsirolimus group ( P ＜ 0.05 ). The positive rate of Ki-67 expression was ( 67.3 ± 8.4 ) ％ in the control group, which was higher than in the temsirolimus group ( 35.5 ± 6.7 ) ％ ( P ＜ 0.05 ).ConclusionsThis study provides in vitro and in vivo evidence that temsirolimus may inhibit the viability of bladder cancer cells and temsirolimus could be exploited as a potential therapeutic strategy in bladder cancer.

Objective:To establish the quality standard for two effective components in extractum glycyrrhizae capsules. Methods:Radix glycyrrhizae was identified by a TLC method. The contents of liquiritin and ammonium glycyrrhizinate in extractum glycyrrhizae capsules were determined by HPLC. An Inertsil C18 (150 mm × 4. 6 mm, 5μm) column was used. The mobile phase consisted of ace-tonitrile (A)-0. 2％ phosphoric acid (B) (0-8 min: 20％A-20％A;8-34 min: 20％A-50％A;34-35 min: 50％A-100％A;35-40 min:100％A-20％A) at a flow rate of 1. 0 ml·min-1 . The detection wavelength was at 237 nm under 25℃. Results: The spots in TLC were clear. Liquiritin showed a good linear relationship within the range of 0. 0020-0. 1000 mg·ml-1(r=0. 9995). The aver-age recovery was 100. 29％, and the RSD was 2. 94％(n=6). Ammonium glycyrrhizinate showed a good linear relationship within the range of 0. 0020-0. 1000 mg·ml-1(r=0. 9998). The average recovery was 101. 46％, and the RSD was 2. 33％(n=6). Conclu-sion:The method is simple,reliable and reproducible, which can be used for the quality control of the preparation.