Objective To determine whether antibiotic prophylaxis can reduce the risk of postoperative infective complications in patients undergoing TURP who have sterile preoperative urine. Methods MEDLINE,EMBASE,CBMA and the Cochrane Library were searched for RCTs comparing antibiotic prophylaxis with placebo/blank controls for patients undergoing TURP with preoperative sterile urine.The search strategy was made according to the Collaborative Review Group search strategy.Data were extracted by two reviewers using the designed extraction form. The software RevMan was used to review management and data analysis.The results were expressed as RR and 95% confidence intervals (CI) for categorical outcomes and weighted mean difference (WMD) and 95%CI for continuous outcomes. Results 53 relevant RCTs were searched, of which 27 were included and 26 were excluded.Antibiotic prophylaxis significantly decreased the rate of post-TURP bacteriuria,post-TURP fever,post-TURP bacteremia and the rate of continuous antibiotic use.The corresponding pooled relative risk (RR) and 95%CI was 0.36 (0.28 to 0.46),0.83 (0.71 to 0.97),0.43 (0.22 to 0.86) and 0.26 (0.20 to 0.33),respectively.However,the available data failed to prove that antibiotic prophylaxis shortened the duration of hospitalization (WMD, -0.31;95% CI , -0.78 to 0.35). Conclusions Prophylactic antibiotics can significantly decrease the incidence of post-TURP bacteriuria,fever,bacteremia and continuous antibiotic treatment,but cannot significantly shorten the duration of hospitalization.Antibiotics should be used in patients undergoing TURP.

Objective To isolate and clone novel O-superfamily conotoxin genes of Conus capitaneus Linnaeus collected from Hainan,which would provide the initial drug leads to investigate and develop Conus capitaneus conotoxins.Methods 3'-RACE(Rapid Amplification of cDNA Ends) was used for cloning the novel O-superfamily conotoxins.The specific amplified cDNA fragments were sequenced and analyzed,as well as the genetic diversity of the O-superfamily conotoxins.Results The full-length cDNA(CaHr91N) of a new O-superfamily conotoxin(CaHr91) was cloned and sequenced from Conus capitaneus Linnaeus.The novel conotoxin precursor CaHr91P with 77 amino acids(aa) encoded by the cDNA consists of three typical regions of signal with 21aa, pro-peptide with 22aa and mature peptide with 34aa.Predicted sequence of the toxin region CaHr91M is "ECREQSQGC TNTSPPCC SGLRC SGQSQGGVC ISN" with a common O-superfamily cysteine pattern C-C-CC-C-C.Percent identities between CaHr91P and other published homologue O-superfamily sequences were compared systematically,as well as research status on conopeptides from C.capitaneus.Conlusion The elucidated cDNA of the novel CaHr91P conotoxin will be the basis for a better understanding of its bioactivity and application,as well as finding more novel conotoxins from C.capitaneus.

Objective To discuss the efficacy of application combination Of minimal immunosuppressive drugs in chronic allograft nephropathy after renal transplantation. Methods Data were drawn from the First Hospital of Tsinghua University.From September 1,2004 to July 1,2006,31 cadaver kidney transplantations were performed using triple immunosuppression with tacrolimus(n=31)and MMF plus steroids before using new strategy.The new strategy is Rapamycin+tacrolimus+MMF+Prednisone.The serum ereatinine,GFR(ml/min/1.73 m2)and 24-hours urine protein before and after 12 months of using lOW dose combination of calcineurin inhibitors,MMF,Rapamune,Predsone and Q80 were recorded.During this time,the concentration of tacrolimus,rapamune were monitored as well. Results After 12 months follow-up,the serum creatinine of 28 patients were decreased from(300±21)μmol/L to(215±38)μmol/L.GFR(ml/min/1.73m2)was elevated from 42.54±2.95 to 49.98±3.05.Three patients whose serum creatinine was 416-464μmol/L had to take hemodialysis.The 24-hours urine protein(g)of 31 patients below 0.8 g did not increase urine protein during follow-up.One patient's 24-hours urine protein(g)increased from 0.95 to 1.29.The patient and graft survival rate was 100%(31/31),90.3%(28/31)respectively.The rapamune main side effect was hyperlipidemia. Conclusions Rapamune and low dose Tacrolimus+Myeophenolate Mofetil+Corticosteroid could be a safe treatment.It may improve renal function in chronic allograft nephropathy.

Objective:To explore the expressions of endogenous hydrogen sulfide (H2 S)and its synthases cystathionine beta synthase (CBS)and cystathionine gamma lyase (CSE)in the cell lines of normal bladder and bladder cancer,and to clarify their mechanism in the development of bladder cancer.Methods:The bladder cancer cell lines (5637,T24,UM-UC-3,EJ)and human bladder epithelial cell line SV-HUC-1 were selected.The expressions of CBS and CSE in bladder cancer and normal cell lines were analyzed by Western blotting assay and the productivities of H2 S in cell lines were detected by sensitive sulphur electrode assay.The EJ cells were selected based on the previous experimental results and divided into groups as follows:① 10 μmol· L-1 NaHS group, 50 μmol·L-1 NaHS group,100 μmol·L-1 NaHS group and control group.After drug treatment,the cell survival rate was measured by MTT assay at 24 and 48 h.② 5 μg·L-1 cisplatin group,cisplatin (5 μg·L-1 )+ NaHS (100 μmol·L-1 )group and control group.After medicine treatment,the cell survival rate was measured by MTT assay and the cell apoptotic rate was detected by flow cytometry at 48 h. Results:Compared with the normal bladder cells (SV-HUC-1),the expression levels of CBS and CSE and the productivity of H2 S in the bladder cancer cell lines (5637,T24,UM-UC-3 and EJ)were increased obviously (P <0.05 or P <0.01).Compared with control group,exogenous H2 S promoted the cell proliferation of EJ cells.The cell survival rates were increased with the increase of drug dose (P <0.05),which showed a dose-dependent effect.The cell survival rates were increased with the prolongation of time (P <0.05),which showed a time-dependent effect.After medicine treatment,compared with cisplatin group,the cell viability in cisplatin+NaHS group was increased (P <0.05)and the apoptotic rate was decreased (P <0.05).Conclusion:Endogenous H2 S and its synthases CBS and CSE have an increased expression level in bladder cancer cell lines compared with the normal bladder cells.H2 S can enhance the proliferation of bladder cancer cells and decrease the apoptosis induced by cisplatin.

Objective:To construct the rat models of orthotopic bladder cancer induced by N-methyl-nitrosourea (MNU),and to evaluate the value of magnetic resonance imaging (MRI)in the noninvasive diagnosis of the bladder cancer model.Methods:Sixty femail SD rats were divided into experiment group (n=45)and control group (n=15).The rats experiment group were induced with MNU (2 mg per rat)by intravesical administration every other week,for 4 times.Meantime,the rats in control group were treated with normal saline (0.2 mL per rat)by intravesical administration.At the end of the 14th week,all rats were examined by MRI and the pathological changes of bladder tissue were detected.Results:In experiment group,43 rats were alived and 2 rats were died at the end of the 14th week;the survial rate was 95.6% and the death rate was 4.4%;the abnormal signals were found in each of 43 rats by MRI which manifested as bladder tumor, and the same results were identified by pathology;the tumor formation rate was 100%.In control group,14 rats were alived and 1 rat was died at the end of the 14th week;the survival rate was 93.3%,and the death rate was 6.7%;there was no abnormal signal in the MRI examination and no bladder cancer in the pathological examination;the tumor formation rate was 0.The tumor formation rates of bladder cancer of the rats in two groups had significant difference (P <0.05),and the death rate had no significant difference (P >0.05).Conclusion:The method to establish the rat models of orthotopic bladder cancer induced by MNU is simple and reliable;the results of MRI are consistent with the pathological results and MRI examination is a reliable diagnostic method concerning this model.

Objective To develop an ideal substitution material for bladder defect ,which can reduce serious complications of urinary intestinal diversion ,we establish experimental rabbit model of reconstruction the new bladder by ileal seromuscular with transplantation of autologous peritoneum .This animal research provides the basical ground for the experimental model and further clinical application of replacement bladder .Methods Randomly ,seven experimental female rabbits were chosen ,and their body weight was 4 .0-5 .0 kg .By intravenous anesthesia ,the bladder substitute operation was carried out (to transplant the peritoneum to an ileum segment which mucosa had been removed .These flaps were used to mend and reconstruct the bladder by composite cys‐toplasty) .Animals were euthanized at 4 ,8 weeks for routine pathology and immunohistochemistry .Results Seven rabbits under‐went reconstruction ,but three were lost to complications .The length of ileum was 4 .0 cm ,and the area of substitute peritoneum was 4 .0 cm × 2 .5 cm .Voiding behaviour was normal ,and urine was clear in the remainder .At autopsy ,reconstructed bladders were healthy .Pathological examination showed that the technique was successful in creating seromuscular segments with no epithelial remnants .When applied surgically ,the seromuscular flaps with peritoneum survived at 4 weeks and the peritoneum was substituted by transitional epithelium at 8 weeks .Conclusion In this experimental rabbit model ,reconstruction bladder by autologous peritone‐um and seromuscular segment is an ideal approach for which can prevent regrowth by ileal epithelial cells and overcome the compli‐cations of conventional enterocystoplasty .Voiding behaviour is normal in the remainder .This animal study provides the basical ground for the large experimental model and further clinical application of the new enterocysplasty .

Exosomes derived from prostate cancer cells can directly or indirectly promote the growth and metastasis of prostate cancer cells. It was found that it can be used as a marker for diagnosis and prognosis evaluation of prostate cancer, and participate in the clinical treatment of prostate cancer, such as targeted therapy, drug resistance assessment, tumor vaccine preparation, etc. With the development of various studies and technological progress, exosomes will play a huge role in the diagnosis and treatment of prostate cancer.

Objective To observe the clinical effect of traditional Chinese medicine (TCM) characteristic lung rehabilitation in treatment of patients with chronic obstructive pulmonary disease (COPD) and TCM syndrome of lung and kidney qi deficiency at stable period. Methods Sixty patients with stable COPD and lung and kidney qi deficiency syndrome admitted to the First Affiliated Hospital of Anhui University of Chinese Medicine from June to August 2017 were enrolled, and they were divided into routine treatment group and lung rehabilitation treatment group according to the random number table method, each group 30 cases. The routine treatment group was given Seretide (serevent/futicasone) dry powderi nhalation therapy; on the basis of therapy in the routine treatment group, the lung rehabilitation treatment group was treated with TCM characteristic lung rehabilitation technology (acupoint application + Chinese medicine ionic induction + oral administration of Chinese medicine Liuweibuqi granules, delivery at appropriate intervals); both groups were treated for 2 months. The changes of TCM syndrome score, western medicine symptom score, the times of acute exacerbation of COPD, COPD assessment test (CAT) score, lung function indexes: forced expiratory volume in one second (FEV1), FEV1/forced vital capacity (FVC) were observed before and after treatment in two groups. Results After treatment, TCM syndrome score, western medicine symptom score, CAT score, and after treatment the times of acute exacerbation of COPD in both groups were significantly lower than those before treatment, and the above indexes in the lung rehabilitation treatment group were markedly lower than those in routine treatment group [TCM syndrome score:11.93±1.80 vs. 14.27±2.88, western medicine symptom score: 14.20±2.75 vs. 11.93±4.23, CAT score: 14.87±2.60 vs. 16.23±4.39, the times of acute exacerbation of COPD (times): 0.63±0.49 vs. 0.95±0.83, all P < 0.05]. The improvement of FEV1 in the two groups was not significant; but FEV1/FVC in lung rehabilitation treatment group was obviously higher than that before treatment, FEV1/FVC in lung rehabilitation treatment group was significantly higher than that in the routine treatment group [(57.93±7.27)% vs. (52.49±6.61)%, P < 0.05]. Conclusion The application of TCM characteristic lung rehabilitation in the treatment of COPD patients with stable lung and kidney qi deficiency syndrome based on bronchodilators and glucocorticoids can reduce the number of acute exacerbation, improve the patients' clinical symptoms and living quality, but the improvement of lung function is not significant.