1.Transurethral Plasmakinetic Resection for Bladder Tumor Complicated with BPH:Report of 41 Cases
Changxing KE ; Delin YANG ; Jiansong WANG
Chinese Journal of Minimally Invasive Surgery 2005;0(10):-
Objective To evaluate the efficacy and safety of transurethral plasmakinetic resection for patients with superficial bladder tumor(SBT) complicated with benign prostate hyperplasia(BPH).Methods A total of 41 patients with SBT complicated with BPH were treated by transurethral plasmakinetic resection in our hospital.Various procedures were selected basing on the location,size,quantity of the bladder tumors,size of the prostate,and degree of adhesion around the gland.Results The opertion was completed in all of the 41 cases.The mean operation time was(67.2?25.3) min for resection of the bladder tumors and(72.3?23.2) min for the prostate.During the surgery,7 cases showed obturator nerve reflex and 2 developed bladder perforation.No patients died or had transurethral resection syndrome or rectal perforation.Six months after the operation,reexamination showed a mean IPSS of 6.2?3.7 and Qmax of(20.1?4.2) ml/s,which were significantly imporved compared with those detected before the surgery [25.3?4.1,(8.9?4.1)ml/s,t=22.209 and -12.174 respectively;and both P=0.000].The patients were followed up for 1 to 4 years,during which 9 cases showed recurent bladder tumor.Conclusions Transurethral plasmakinetic resection is safe and effective for patients with SBT complicated with BPH.The surgical procedure should be determined accordingly.
2.Clinical application of selective renal artery embolization in treating kidney diseases
Jiaping WANG ; Changxing KE ; Yingchun LI ; Shuguang YUAN ; Dong YAN ; Jiansong WANG ; Yuyun TONG ; Quansheng ZHU
Chinese Journal of Postgraduates of Medicine 2009;32(11):44-47
Objective To evaluate the clinical application of selective renal artery embolization (SRAE) for the treatment of kidney diseases. Methods Seventy-four cases of renal carcinomas, 11 cases of renal angiomyolipomas (RAML) and 72 cases of traumatic renal haemorrhages were first demonstrated by renal arteriography under Seldinger technique to ensure a site, range and neighbouring relation of lesions and then followed by percutaneous catheterized selective renal arterial embolization with embolic agents. Results The edema around the carcinomas and abscesses became obvious, and bleeding were reduced, which were convenient for operation after SRAE for the preoperative adjuvant treatment of renal carcinomas. The clinical symptoms were improved obviously in 9 eases with advanced renal carcinoma after palliative treatment. The tumour volumes of 11 RAML were decreased evidently by 15 %-65 % with the average of 42 %. The bleeding in 68 cases of traumatic renal haemorrhage were ceased completely in 1-4 days after embolism, 2 cases with serious renal fragmented injury and huge perirenal hematoma combined with shock received successful operation after SRAE, 2 cases bleeding again after SRAE were cured by the second SRAE. No severe complications occurred after embolization in all the patients. Conclusions As a minimal invasive technique,selective renal artery embolization is a safe, effective method with less complications and an adjuvant pre-op-erative therapy for renal carcinoma or a palliative treatment for advanced carcinoma and an effective treatment for RAML and traumatic renal haemorrhage.
3.Minimally invasive percutaneous nephrolithotomy for lower caliceal stone
Changxing KE ; Delin YANG ; Yigang ZUO ; Jiansong WANG ; Ruping YAN ; Wei WANG
Chinese Journal of General Practitioners 2008;7(3):192-193
Clinical data of 53 patients with lower caliceal stone during August 2005 and March2007 were analyzed retrospectively.The stones were 11-35 mm in diameter.Under the guidance of X-ray.single renal tract parallel to the lower caliceal for percutaneous nephrolithotomy was established.The procedures were successful in all the patients.Fifty patients were stone free after first minimally invasive pereutaneous nephrolithotomy(MPCNL),2 were stone free following second MPCNL,1 saw residual small stones clear off spontaneously during the follow-up period.Operative time was 65-162 minutes.and blood loss was 10-200 ml.No severe complications or death occurred.MPCNL may be related with minimal invasion and fewer complications,thus provides an effective and safe way of lower caliceal stone treatment.
4.Distributional Difference of CD3+T Lymphocyte in Tissue of Bladder Cancer and Epithelium of Paracancer Area
Hui ZHAN ; Jiansong WANG ; Chengchuang WU ; Haifeng WANG ; Mingxia DING ; Changxing KE
Journal of Kunming Medical University 2014;(1):28-31
Objective The purpose of this study was to observe the distribution of CD3+T lymphocyte in the tissue of bladder cancer and epithelium of paracancer area, and analyze the significance. Methods Biopsy was performed in 28 patients with bladder cancer, and the distribution and number of CD3+T lymphocyte in tissue of bladder cancer and epithelium of paracancer area were observed and compared using immunohistochemistry. Results Many of CD3+T lymphocytes could be observed in the epithelium of paracancer tissues, but CD3+T lymphocytes in cancer nests was few. The average number of CD3+T lymphocytes in every 5 typical microscope visual fields of paracancer tissues and cancer nests was 15 ±4.5 and 4 ±2.2, respectively, and the difference was significant ( <0.05) . Conclusion Distribution of CD3+T lymphocytes in bladder cancer nests and paracancer tissues was different, which may be related to the immune escape and prognosis of bladder cancer. It is worthy of further research.
5.Minimally Invasive Percutaneous Nephrolithotomy in Treatment of Impacted Proximal Ureteric Calculi
Yigang ZUO ; Changxing KE ; Delin YANG ; Jiansong WANG ; Mingxia DING ; Jingyu LIU
Journal of Kunming Medical University 1986;0(04):-
Objective To evaluate the surgical method and curative effect of minimally invasive percutaneous nephrolithotomy(MPCNL) in treatment of impacted proximal ureteric calculi.Methods 45 cases of proximal ureteric calculi treated with MPCNL were studied retrospectively.Percutaneous nephrostomy was established under the guide of X-ray,B-ultrasound and naked eye,and the nephropathy was extended to F16 through invasive percutaneous.Stones were taken out by ureteropyeloscopic pneumatic lithotripsy with help of hydraulic perfusion pump.Results The surgical time was 15~110 min with the average of 42 min after percutaneous nephrostomy.The average blood loss volume was 30 mL;no severe complications were occurred in the intra-or post-operative time.The rate of complete clearance of stones was 100% in first attempt.The mean hospital stay was 9 d,and the mean postoperative hospital stay was 3.5 d.Conclusion MPCNL used to treat the impacted proximal urethral calculi have satisfied effects and a lot of merits.
6.Study on Reduction of Complications in Radical Retropubic Prostatectomy of 22 Cases
Changxing KE ; Jiansong WANG ; Yongfu SHI ; Yigang ZUO ; Delin YANG ; Hongyi XU
Journal of Kunming Medical University 1989;0(01):-
Objective To evaluate the effect of technical improvement of radical retropubic prostatectomy(RRP) for patients and reduction of complications.Methods 22 patients with clinically prostate cancer(mean age 67 years,stage B 19 cases,stage C 3 cases) underwent radical retropubic prostatectomy.During operation the dorsal vein complex,puboprostatic ligament,puborectalis sling,the neurovascular bundle,external urethral sphincter,reconstruction of the bladder neck were carefully managed.Results All the patients recovered uneventful except 2 deaths,and they survived and were followed up for a mean time of 16 months(range 1~4 years).The mean operative time was 140 minutes(range 90~220minutes) and the mean blood loss was 600mL(range 250~1500mL).16 cases received blood transfusion for 300~1200mL and no ureteral or rectal injury occurred.The urinary catheters were removed 2~3 weeks after operation.2 cases had stress incontinence 3 months later,1 case encountered urethral stricture and became well after urethral dilation,15 cases had satisfactory erectile function after operation and 3 patients had biochemical failure and endured continually chemotherapy during follow-up.Conclusions Accurate maneuver is handled according to correct anatomy can protect the apex of prostate and its surrounding tissue and reconstructing the bladder neck is helpful to reduce complications and achieve better outcome.
7.Minimally Invasive Percutaneous Nephrolithotomy in Treatment of Proximal Ureteric Calculi by Non-Imaging in Localization:A Report of 52 Cases
Delin YANG ; Changxing KE ; Yigang ZUO ; Jiansong WANG ; Mingxia DING ; Hongyi XU
Journal of Kunming Medical University 1986;0(04):-
Objective To evaluate the surgical method and curative effect of minimally invasive percutaneous nephrolithotomy(MPCNL) in treatment of impacted proximal ureteric calculi and giant renal pelvic calculi with moderate or severe hydronephrosis by non-imaging in localization.Methods 52 cases of calculi treated with MPCNL were studied retrospectively.Percutaneous nephrostomy was established by non-imaging in localization(naked eye) according location of kidneys,length of 12th ribs,degree of hydronephrosis and condition of calculi,and the nephropathy was extended to F16 through invasive percutaneous.Stones were taken out by ureteropyeloscopic pneumatic lithotripsy with the help of hydraulic perfusion pump.Results The operative time was 32~140min with the average of 112min.The average blood loss volume was 45mL.No severe complication occurred in the intra-or post-operative time.The rate of complete clearance of stones was 96 % in first attempt,and the residual stones passed out by themselves after the double "J" tube was pulled out in cases.The mean hospital stay was 9 days,and the mean postoperative hospital stay was 4.2 days.Conclusion To treat the impacted proximal ureteric calculi and giant renal pelvic calculi with moderate hydronephrosis or severe hydronephrosis,some skilled doctors can appropriately use the method of MPCNL by non-imaging in localization,since the method can reduce the harm by X-ray,and save medical expenses.
8.Analysis of the correlation between rs8444 polymorphisms located within LASS2-3′-UTR and susceptibility of bladder cancer
Yujin CHEN ; Haifeng WANG ; Ruping YAN ; Changxing KE ; Mingxia DING ; Ting LUAN ; Renchao ZOU ; Jiansong WANG
Chinese Journal of Clinical Oncology 2017;44(3):107-111
Objective:To explore the correlation between single nucleotide polymorphisms (SNPs) in Homo sapiens longevity assur-ance homologue 2 (LASS2) gene 3′-untranslated regions (UTR) and susceptibility of bladder cancer among residents of Yunnan, China. Methods:A total of 105 bladder cancer patients (bladder cancer group) and 100 nonbladder cancer patients (control group) were se-lected. PCR method and sequence for LASS2-3′-UTR were performed to identify the SNPs correlated with bladder cancer. The relation-ships between the LASS2-3′-UTR polymorphisms and bladder cancer risk were analyzed. Results:An SNP (rs8444) was identified in LASS2-3′-UTR, and the T/C allele frequencies and genotype distributions of rs8444 largely differed between the bladder cancer and control groups (χ2=10.267, P=0.006;χ2=10.634, P=0.001). Individuals that carry the rs8444 C allele or CC genotype had a remarkably lower risk of bladder cancer compared with those that carry the T allele or TT genotype (OR=0.489, 95%CI:0.309-0.772, P=0.002;OR=0.258, 95%CI:0.081-0.827, P=0.023). No significant correlations were observed between the T/C allele frequencies and genotype distri-butions of rs8444 and TNM stage, as well as histological grade and distant metastasis in bladder cancer (P>0.05). Conclusion: The rs8444 C allele or CC genotype located within LASS2-3′-UTR can lower the susceptibility of bladder cancer among the residents of Yun-nan, China. However, it is not associated with the TNM stage, histological grade, and distant metastasis.
9.3D/2D laparoscopic radical prostatectomy:A single center experiences
Qinrong PING ; Haifeng WANG ; Ruping YAN ; Jian CHEN ; Yigang ZUO ; Changxing KE ; Mingxia DING ; Hui ZHAN ; Wei WANG ; Jiansong WANG
China Journal of Endoscopy 2016;22(12):1-5
Objective To compare the clinical effect of 2D and 3D laparoscopic radical prostectomy and summarize surgical experience of laparoscopic radical prostectomy of early prostate cancer.MethodsThe clinical data of 34 cases of prostate cancer treated in our institute from November 2015 to April 2016 were collected and analyzed retrospectively. The patients in observation group (11 cases) were treated by 3D laparoscopic radical prostectomy, while those in control group (23 cases) were given 2D laparoscopic radical prostectomy. The operation time, intraoperative bleeding volume, postoperative drainage time, quantity of drainage fluid within 24 hours postoperatively, indwelling catheter time, hospital time, positive surgical margin rate, potence rate, 30d-urinary continence rate and complications were compared between the two groups.Results All operations were successfully performed. There were no signiifcant differences in operation time, intraoperative bleeding volume, postoperative drainage time, quantity of drainage lfuid within 24 hours postoperatively, indwelling catheter time, hospital time, positive surgical margin rate, potence rate, 30d-urinary continence rate and complications between the two groups (P > 0.05). In observation group, the operation time was (153.52 ± 30.47) min and the potence rate was 50.0 %, 4 cases with uroclepsia (36.4 %), 1 case with urine leakage (9.1 %), no patient had urethral stricture or positive surgical margin, the 30d-urinary continence rate was 72.7 %. In control group, the operation time was (164.73 ± 28.65) min and the potence rate was 38.9 %, 13 cases with uroclepsia (56.5 %), 4 cases with urine leakage (17.4 %), 1 case with urethral stricture (4.3 %), 2 cases with positive surgical margin (8.7 %), 30d-urinary continence rate was 60.9 %.ConclusionLaparoscopic radical prostectomy is a safe, effective and less invasive method for treating early prostate cancer patients. Also 3D laparoscopic radical prostectomy play the similar functional results compared with 2D laparoscopic radical prostectomy, but 3D laparoscopic has the advantage in three dimensions space sense and accurate operation, it is worthy of promoting clinical application.
10.Expression and potential role of miRNA-20a in bladder cancer
CHEN YUJIN ; WANG JIANSONG ; YAN RUPING ; KE CHANGXING ; DING MINGXIA ; LUAN TING ; ZOU RENCHAO ; WANG HAIFENG
Chinese Journal of Clinical Oncology 2017;44(20):1014-1018
Objective:To investigate microRNA-20a (miRNA-20a) expression in bladder cancer and its potential mechanism. Methods:MiRNA-20a expression was examined using quantitative reverse-transcription polymerase chain reaction (qRT-PCR) in human bladder cancer tissues and the paired adjacent non-tumor bladder tissues of 96 patients. The target gene of the miRNA-20a was predicted and validated using bioinformatics analysis and reporter gene assay, respectively. The mRNA or protein expression of the target gene in bladder cancer T24 and J82 cells transfected with miRNA-20a mimic or negative control (NC) mimics was detected via qRT-PCR, West-ern blot analysis, and cell immunofluorescence. CCK-8, Transwell chamber, and wound-healing assays were applied to test the prolifer-ation, migration, and invasion of T24 cells after miRNA-20a over-expression in vitro. Results:MiRNA-20a expression significantly in-creased in bladder cancer tissues compared with those in corresponding adjacent non-tumor tissues. High miRNA-20a expression in bladder cancer tissues was closely related to aggressive tumor phenotype, such as high histological grade, poor TNM stage, lymph node invasion, distant metastasis, and tumor recurrence (all P<0.001). Dual-luciferase reporter assay confirmed that miRNA-20a can di-rectly bind to the 3'-untranslated region (3'-UTR) of Homo sapiens longevity assurance homologue 2 (LASS2). Transfection with miRNA-20a mimics significantly inhibited mRNA and protein expression of LASS2 in T24 and J82 cells (all P<0.01) and promoted T24 cell prolif-eration, migration, and invasion in vitro. Conclusion:MiRNA-20a is highly expressed in bladder cancer tissues. MiRNA-20a enhances cell migration as well as proliferation and acts as an oncogene in bladder cancer because of the targeted inhibition of LASS2 expression.