Non-small cell lung cancer has a poor prognosis. Many patients who were proved to have none lymph node metastasis still relapse after operation. It may be caused by micrometastases which can′t be detected by conventional pathologic technique. Recently immunocytochemistry and moleculer methods are used to detect micrometastases in the peripheral blood, bone marrow or lymph node near the tumor. But the standard and reliable methods need to be developed and the clinical significance of micrometastases need to be discussed.

100 g).The catheters were removed 1 to 5 days after operation,with transient retention occurring in 5 patients and transient frequency and urgency of urination in 5.At one-month follow-up,the mean IPSS decreased to 11, and mean Qmax increased to 17.8 ml/s. Conclusions The results demonstrate that PVP is safe,efficacious and minimally invasive for patients with obstructive BPH,especially for those of advanced age or at high risk.

Objective To evaluate the risk factors,diagnostic index of the restrictive right ventricle physiology(rRV) and the impact of the mid-term outcome of the patients.Methods Eighty patients(30 in rRV group and 50 in non-rRV group) undergoing TOF repair admitted in our department from Oct 2011 to May 2012 were studied.Perioperative clinical data were collected and echo data were recorded after operation.Mixed linear regression for repeated measures was used to compare the variables and analyze the correlations.Results Patients in rRV group were younger with longer cardiopulmonary bypass(CPB) time,aortic cross clamp time,ventilation time,intensive care unit and hospital stay compared with those in non-rRV group(P<0.01,respectively).The younger patients with longer CPB time had high risk of rRV by logistic regression analysis.Within 7 days post operation,the increase of saturation of venous oxygenation and decrease of oxygen extraction ration were slower in rRV group than those in non-rRV group(P<0.05,respectively).Lactate decreased in both groups,but was higher in rRV group throughout the 7 days(P=0.03).NT-proBNP was higher in rRV group throughout the 7 days than that in non-rRV group.NT-proBNP≥4750pg/ml often indicated the patients in the state of rRV.CRP slightly increased in 1-2 days post operation,and decreased thereafter,and the decrease was slower in rRV group(P=0.08).With regard to the mid-term outcome,there was no significant differences in the incidences of the obstruction of the right ventricle outflow and main pulmonary artery,the stenosis of the branch of pulmonary artery and the degree of the pulmonary valve regurgitation.Conclusion rRV is associated with significantly higher levels of NT-proBNP and CRP.The incidence of rRV correlates with age on operation and positively correlates with CPB time.NT-proBNP would be regarded as an indicator of the incidence of rRV.The study indicated the rRV would have impact on the early outcome of the patients but there was no significant effect on mid-term outcome.

Objective To study the value of flexible cystoscopy in diagnosing posterior urethral strictures resulting from pelvic fracture and the pain score of the examination. Methods Between 2014 and 2015, 120 male patients with pelvic fracture urethral distraction defect were evaluated by cystoscopy before surgery. In this study, flexible cystoscopy was used in 87 patients, 33 patients received conventional rigid cystoscopy. The cystoscopy was introduced into the posterior urethra and the area was evaluated for the length of the proximal urethra and any possible fistulas, false passages, calculi or displacement of the posterior urethra. The patient’s pain feeling was recorded during the examination, 24 hrs after cystoscopy examination. The pain feeling result was achieved by visual analogue pain scale. Results Severe allergic reaction or obvious discomfort did not occur in any patients after cystoscopy. By comparing the data obtained from lfexible cystoscopy to those from conventional urethrography, the rate of detection in other abnormalities was higher in lfexible cystoscopy than in conventional urethrography. 21, 5, 7 and 5 patients were detected with calculus, posterior urethral structure damage, false passage and ifstula respectively. In comparison, the abnormalities were only observed in 3, 2, 3 and 1 patients respectively through conventional urethrography imaging. However, the pain feeling of the flexible cystoscopy is better than the convenional rigid cystoscopy. The statistical difference was found in the pain feeling score during the examination and later after the examination. Conclusions Flexible cystoscopy is a safe and valuable procedure in the evaluation of the posterior urethra in patients with pelvic fracture urethral distraction defect before surgery.

Objectives: To evaluate the efficacy, toxicity and side effects of CAP (cytoxan, adriamycin, cisplatin), NP(navelbine, cisplatin), GP(gemcitabine, cisplatin) in the treatment of patients with non small cell Lung cancer(NSCLC). Methods:146 patients with NSCLC diagnosed by pathology or cytology were treated with CAP, GP or GP regimen. Results:The overall response rate of the three groups (CAP, NP, GP)were 33.33%, 46.43% and 47.92% respectively. The major toxicity and side effects was bone marrow inhibition and the gastrointestinal reaction. Grade Ⅲ-Ⅳ side effects of CAP group were significant higher than the others. Conclusions:The regimen of navelbine and cisplatin or gemcitabine and cisplatin was more effective and less toxic than cytoxan, adriamycin, cisplatin and cisplatin.

ObjectiveTo improve the recognition of lichen sclerosus (LS) involving the anterior urethral strictures and to investigate the outcome of urethroplasty using free mucosal grafts for the treatment of urethral strictures caused by LS. MethodsFrom January 2007 to December 2010,36 patients with anterior urethral strictures caused by LS were treated using oral mucosal grafts or colonic urethroplasty.The mean age was 41 years (range,27 -75) and the mean anterior urethral stricture length was 11.5 cm (range,5.0 -20.0 cm).Of the 36 patients,27 patients underwent dorsal lingual mucosal graft or combined buccal mucosal graft urethrography.Eight patients underwent colonic mucosal urethrography according to the length and seriousness of urethral strictures,and the remaining patient underwent anterior urethral split.Biopsies were taken from the glans,urethral meatus and urethra before urethroplasty. ResultsThe urethral silicone stent was removed 21 d post-operatively and all the patients voided well.An epithelial-stromal lesion characterized by hyperkeratosis,thinned epithelium and diffuse perivascular lymphocyte infiltrate was seen upon histological examination of the biopsied areas.The mean follow-up was 22 ( range,6 - 50) months post-operatively.Meatal stenosis developed in 2 patients undergoing oral mucosas urethroplasty and 1 patient with colonic urethroplasty,the patients voided very well after re-operation.The other patients voided well and the urinary peak flow rates ranged from 17.2 to 47.0 mL/s ( mean,23.4). ConclusionsFree mucosal grafts urethroplasty can obtain good results for the treatment of urethral strictures caused by LS.But there is a risk of recurrence of urethral stricture and closing follow-up is required,especially for meatal stenosis.

ObjectiveTo evaluate the efficacy of using oral mucosal grafts (buccal mucosa and lingual mucosa) for urethroplasty in the treatment of anterior urethral strictures. Methods Between Jan 2001 and Dec 2010,255 patients with urethral strictures (length ranging from 3 cm to 18 cm,mean 6 cm)underwent one-stage onlay oral mucosal grafts urethroplasty.Two different techniques were used for urethral reconstruction.The first technique involved tubularized dorsal lingual mucosa graft (LMG) augmentation of urethral plate ; the second technique used dorsal patch graft urethroplasty.Of the 255 patients,49 patients with long-segment urethral strictures ( ≥ 8 cm) underwent dual buccal mucosal graft ( BMG),dual LMG,combined LMG and BMG or long-strip LMG urethroplasty. ResultsThe patients were followed up for 8 -120 months postoperatively ( mean 37 months).Of the 255 cases,230 cases voided well and the urinary peak flows ranged from 16 to 51 ml/s (mean 26 ml/s).The overall success rate was 90.2％.Seventeen cases developed a recurrence of urethral stricture.Among these patients,15 underwent BMG urethroplasty again and 2 underwent direct vision internal urethrotomy,after which the patients voided well.Eight cases presented with urethrocutaneous fistula,these patients underwent a second operation,after which,the urethrocutaneous fistulas were cured. Conclusions The buccal mucosa and lingual mucosa are excellent sources of graft materials for the repair of anterior urethral strictures.Combined two oral mucosal grafts substitution urethroplasty is an effective technique for the treatment of long-segment urethral strictures.

OBJECTIVETo investigate the possibility of urethral reconstruction with colonic mucosa for the treatment of complex longer urethral stricture (>/= 10 cm).

METHODSFrom October 2000 to September 2001, 6 patients with complex longer urethral stricture were treated with colonic mucosal graft urethroplasty. They had under gone 3 previous unsuccessful urethral repairs on average. Urethral reconstruction with a free graft of colonic mucosa ranged from 10 to 15 cm (mean 12.17 cm). Follow-up included retrograde urethrography, urethroscopy, and uroflowmetry.

RESULTSThe patients were followed up 3 - 14 months postoperatively (mean 7.8 months). Meatal stenosis developed in one patient 3 months after operation needed reoperation. The patient voided very well with urinary peak flow 28.7 ml per second duing follow-up for 12 months postoperatively. The other patients voided well with urinary peak flow greater than 15 ml per second. At urethroscopy, colonic mucosa was macroscopically difficult to distinguish from normal original urethral mucosa in 4 patients over 6 months after the operation.

CONCLUSIONSColonic mucosa graft urethroplasty is feasible for the treatment of complex longer anterior urethral stricture. The technique is useful for urethral reconstruction when penial skin and bladder mucosa are not available.

Colon ; Humans ; Intestinal Mucosa ; Treatment Outcome ; Urethra ; Urethral Stricture ; Urologic Surgical Procedures, Male

OBJECTIVETo explore whether bulbourethral suspension procedure is effective for the treatment of male urinary incontinence of post-prostatectomy and posterior urethroplasty.

METHODSTwelve male patients with urinary incontinence undergone bulbourethral suspensive operation were reviewed and analyzed with regard to the operation method, postoperative urinary dynamics and clinical results.

RESULTSTen patients resumed complete control of urination and 1 was improved. In one patient, postoperative difficulty occurred in voiding but corrected by transurethral bladder neck revision for free passage of urine and continence. Urodynamic study showed that the maximum urethral pressure ranged from 85 to 115 cm H(2)O (mean 98 cm H(2)O, 1 cm H(2)O = 0.098 kPa). The functional urethral length ranged from 3.5 to 4.5 cm (mean 3.75 cm).

CONCLUSIONBulbourethral suspension procedure is effective in the treatment of male urinary incontinence after prostatectomy and posterior urethroplasty.

Adult ; Aged ; Humans ; Male ; Middle Aged ; Prostatectomy ; adverse effects ; Suture Techniques ; Urethra ; surgery ; Urinary Incontinence ; etiology ; surgery

BACKGROUNDDendritic cells (DCs) are the unique antigen-presenting cells that can activate naive T lymphocytes. This function is critical for inducing specific immune response. DCs-based vaccines have been used broadly in immunotherapy for many carcinomas. Constructing vaccines by transfecting total tumor RNA into DCs can be done with a few tumor tissues and need not to identify tumor antigens, so it is especially suitable for lung cancer which lacks tumor-specific antigens but has great heterogenicity and weak immunogenicity. Currently, the best transfection stage and method are still indefinite. So, the objective of this study is to explore the best condition of transfecting total RNA extracted from lung cancer tissues into DCs.

METHODSTen patients with lung cancer were enrolled whose tumor tissues were CEA and MUC1 positive in immunohistochemical staining. Total tumor RNA were extracted by one-step method. Then DCs and T cells were separated and cultured from peripheral blood monocytes and the RNA was transfected into the DCs in different stages with different methods. CEA and MUC1 expression in the transfected DCs were measured by flow cytometry analysis and T cells' proliferation was examined by mixed lymphocyte reaction (MLR).

RESULTSThe expression of CEA and MUC1 protein in immature DCs (11.33±2.64, 39.68±7.25) was remarkably higher than that in mature DCs (5.46±1.63, 27.17±4.16) after transfection with total RNA of lung cancer tissues (P < 0.01), and the DCs presented more powerful effects on T cell proliferation. The CEA and MUC1 expression on DCs were significantly higher in electroporation transfection group (20.53±3.64, 65.39± 9.33) than that in lipofection group (11.33±2.64, 39.68±7.25) and passive pulsing transfection group ( 0.91±0.27,18.53±3.26)(P < 0.01), and the DCs in electroporation transfection group presented more powerful effects on stimulating T cell proliferation than the other two groups did.

CONCLUSIONSTransfecting total tumor RNA into immature DCs by using electroporation is a good way to construct DCs-based vaccines for lung cancer and to achieve a higher activity to stimulate T cell proliferation.