BACKGROUND: Studies on substitute cells of bladder smooth muscle cells are in the early period at present. Mesenchymal stem cell transplantation is an ideal method. Human amniotic mesenchymal cells can differentiate into cardiomyocytes and nerve growth factor and promote local structure repair. OBJECTIVE: To investigate the differentiation of human amniotic mesenchymal cells into smooth muscle cells following transplantation, and the effects on bladder muscle layer. DESIGN, TIME AND SETTING: The cytology in vitro study was performed at the Japan Xinzhou University from October 2006 to April 2007. MATERIALS: Human amnion was obtained from healthy full-term puerperal. A total of 18 clean female Sprague Dawley rats were randomly and equally assigned into normal bladder cell transplantation group, frostbite bladder control group, and frostbite bladder cell transplantation group. METHODS: Amnion was cut and mixed in DMEM containing trypsin. Epithelial cells were removed prior to tissues were incubated in DMEM, supplemented with collagenase and DNA enzyme. Human amniotic mesenchymal cells were harvested for use. Posterior vertex of urinary bladder was frozen using a -70 ℃ iron rod in rats of the frostbite bladder control group and frostbite bladder cell transplantation group. Hematoma appeared at the frostbite region of the bladder three days later. 100 ?L DMEM was injected into the hematoma of the rats of the frostbite bladder control group, while an equal volume of human amniotic mesenchymal cell suspension (105 cells) was injected into the hematoma of the rats of the frostbite bladder cell transplantation group. Human amniotic mesenchymal cell suspension was implanted into the normal rat bladder in the normal bladder cell transplantation group. After three weeks, the bladder tissue including partial urethra was used for bladder sample preparation. MAIN OUTCOME MEASURES: Bladder smooth muscle repair was observed using hematoxylin-eosin staining. The differentiation of human amniotic mesenchymal cells in the wall of urinary bladder was detected using fluorescence immunohistochemistry. RESULTS: Compared with the normal bladder cell transplantation group, normal wall structure of urinary bladder, few fibrosis and good proliferation of smooth muscle cells were detected in the frostbite bladder cell transplantation group, while the wall of urinary bladder was slowly repaired, and disorder muscle structure, fibrosis, scar-like shape, and inflammatory cells were found in the frostbite bladder control group. Three weeks later, human amniotic mesenchymal cells were not seen in the normal bladder tissue. A large number of human amniotic mesenchymal cells was lived and some of them had differentiated into the smooth muscle cells in the frostbite bladder cell transplantation group. CONCLUSION: Human amniotic mesenchymal cells had the potential to differentiate into bladder smooth muscle cells and promoted self-repair of the wall of urinary bladder.

Objective To explore the relationship between dyslipidemia and urinary stone formation.Methods The clinical data of 427 patients diagnosed with urolithiasis in our hospital during January 2015 to May 2016 were collected.Among them,272 men accounting for 63.7%,155 women account for 36.3%.The average age were 53 (43-63).218 cases were kidney stones,accounting for 35.6%;158 cases were ureteral calculi, accounting for 25.8%; 23 cases were kidney stones with ureteral calculi, accounting for 3.8%;28 cases were bladder calculi, accounting for 4.6%.At the same time,950 age and gender matched healthy controls were collected.Among them,570 men accounting for 60%, 380 women account for 40%.The average age were 53 ( 48-60 ).All of them had undergone renal ultrasound to excluded urolithiasis.The difference between lipid level and incidence of dyslipidemia in patients with urolithiasis were observed. The relationship between lipid level and serum UA, urine pH and stone composition was evaluated and analyzed with logistic regression.Results The average serum TC,TG,HDL-C levels of patients with urolithiasis were 4.34mmol/L, 1.38mmol/L, 1.25mmol/L, which levels were 4.32mmol/L,1.09mmol/L,1.40mmol/L in healthy controls.Significant difference were seen between the two groups ( P <0.05 ).The average serum LDL-C was 2.63mmol/L in patients with urolithiasis and 2.65mmol/L in healthy controls.No difference were seen between the two groups ( P=0.241).31.6% of patients with urolithiasis had different degree of dyslipidemia.The average serum UA levels,urine pH value of patients with dyslipidemia were 392μmol/L and 5,which were 339μmol/L and 6 in patients with normal lipid level.Significant difference were seen between the two groups ( P<0.05 ).Among 193 patients who had stone composition analysis, 130 cases had normal lipid level, accounting for 67.4%; 63 cases had dyslipidemia, accounting for 32.6%.In 63 patients with calculi who had dyslipidemia,31 cases had uric acid calculi,accounting for 49.2%.In 130 patients with calculi who had normal lipid level,40 cases had uric acid calculi, accounting for 30.8%.Significant difference were seen between the two groups ( P =0.013 ).Multivariate logistic regression showed TG was the independent risk factor of urinary stone formation ( P=0.001).Conclusion Dyslipidemia is closely related to urinary stone formation,especially concerning the for hypertriglyceridemia.

Objective To compare the efficacy of tamsulosin and tolterodine for the adjunctive expulsive therapy in patients with lower ureteral stones.Methods A total of 160 patients with lower ureteral stones(4-10 mm)were included in the study.The patients were divided into 4 groups by block randomization.Group Ⅰ patients received tamsulosin 0.4 mg/d;group Ⅱpatients received tamsulosin 0.4 mg/d plus tolterodine 2 mg(twice a day);group Ⅲ patients received toherodine 2 mg(twice a day);and group Ⅳpatients served as controls.All patients were observed for 2 weeks.Remits The stone expulsion rate of group Ⅰ,Ⅱ,Ⅲ,Ⅳ was 76.9%(30/39),70.0%(28/40),46.2%(18/39)and 42.1%(16/38),respectively.The stone expulsion rate in group ⅠandⅡwas,higher than that in group Ⅲand Ⅳ(P＜0.05).The expulsion time of group Ⅰ,Ⅱ,Ⅲ,Ⅳ was(5.3±2.5),(6.4±2.2),(10.7±1.8),(12.8±3.4)d,respectively,with significant differences between group Ⅰ,Ⅱ andⅢ,Ⅳ,between groupⅢand Ⅳ(P＜0.05).Almost all of the patients tolerated the expulsive therapy and only 4 patients withdrew from treatment.No obvious side effect occurred.Conclusion The use of tamsulosin for the expulsion of lower ureteral stones is effective and safe;however,the use of tolteredine provides no additional advantages.

Objective To construct survivin-targeting siRNA-expressing plasmid.Methods DNA sequence correspond to siRNA targeting survivin was designed and synthesized,and cloned into plasmid pRNAT-U6.1/Neo to produce surviving-targeting plasmid.Two oligos in the template with cohesive BamHⅠ and HindⅢ sites were prepared and annealled to form the insert fragment for siRNA vector.The vector was cut with BamHⅠ and HindⅢ and ligated with the insert fragment using T4 ligase.The recombinant vector was confirmed by restriction digestion and DNA sequencing,and then was transfected into T24 cells with Lipofectamine TM2000 and the expression of survivin was detected by real-time quantitive PCR.Results DNA sequencing for the PCR product showed that the recombinant vector pRNAT-U6.1/Neo-survivin was successfully constructed without any base pair mutation.The plasmid pRNAT-U6.1/Neo-survivin could efficiently reduce the expression of survivin and confer G-418 resistance in T24 cells.Conclusion The siRNA-expressing plasmid which were successfully constructed and transfected into T24 cells in this study may facilitate the application of RNA interference technique,and lay foundation for further studies on the function of survivin.

Objective To improve the diagnosis and treatment of upper urinary tract hematuria. Methods A total of 121 patients with hematuria who had undergone B-utrasonography,KUB plus IVU,CT and cystoscopy were suspected of hematuria from upper urinary tract.For these cases ureterorenoscopy was performed to establish the diagnosis and to conduct specific therapies. Results The diagnostic accordance rate was 92%(111/121).Among these cases,ureteral small stones in middle and lower segments were found in 45 cases;renal pelvis and ureteral tumors in 32 cases;renal hemorrhagic diseases in 19 cases and ureteral polyps in 15 cases.19 cases who had renal hemorrhagic diseases and 10 who had no definite lesions received specific therapies were followed up for 6 to 8 months.The long-term successful rate was 79%(23/29). Conclusions The application of ureterorenoscopy for the management of upper urinary tract hematuria is quite effective and worthy of widespread application.

BACKGROUND:In recent years, with the use of new immunosuppressive agents, the survival rate of renal graft is greatly improved, but accompanied by lots of side effects and unchanged long-term graft survival. Mesenchymal stem cel s (MSCs) have aroused people’s great interest, while their efficacy in kidney transplantation remains controversial.
OBJECTIVE:To evaluate the efficacy of MSCs transplantation on post-transplant renal graft function with a systematic review.
METHODS:PubMed, EMBASE, the Cochrane Library database, the Cochrane Central Register of Control ed Trials, Wanfang database and China National Knowledge Infrastructure (CNKI) were searched until November 2015. Revman 5.3 was used for statistical analysis.
RESULTS AND CONCLUSION:A total of 6 randomized control ed trials were included, including 1 166 patients. Meta-analysis results showed that at 1, 2 weeks and 1 month after kidney transplantation, the posttransplantation estimated glomerular filtration rates in the MSC-treated group were significantly higher than those in the control group (P<0.05). At 1, 3, 6, 12 months after kidney transplantation, the posttransplantation serum creatinine levels showed no significant difference between the MSC-treated group and the control group (P>0.05). To conclude, MSC-based immunosuppression regimen is superior to current standard immunotherapy in improving renal graft function in the early stage after kidney transplantation, but the clinical efficacy is diminished in the later period. Therefore, further investigation using large-scale randomized control ed trials is warranted.

Objective To investigate the relationship between body mass index (BMI), blood lipid level and cancer de?tection in prostate biopsy. Methods A total of 214 patients undergoing a prostate biopsy during 2013.2—2014.8 were re?viewed retrospectively. They were divided into prostate cancer and non-cancer groups by biopsy results. The differences of age, prostate-specific antigen (PSA) level, prostate volume (PV), blood lipid level and BMI were analyzed between two groups. Risk factors for cancer detection of biopsy were also analyzed. Results Compared with non-cancer patients, pros?tate cancer patients were older, had higher level of PSA and BMI, but smaller PV and lower level of HDL-C ( P<0.05). Lo?gistic regression analysis showed that older, higher level of PSA and BMI were risk factors for prostate biopsy positive, but larger PV and higher level of HDL-C were protective factors (P<0.05). Conclusion Comprehensive assessment of BMI and blood lipid levels can provide important reference for prostate cancer screening at early time and establishment of pros?tate biopsy scheme, which also provide significant evidence for the prevention, diagnosis and treatment of prostate cancer at early stage for high risk population.

Objective To evaluate diagnostic value of transrectal gray scale contrast enhanced ultrasound (CEUS) in distinguishing benign from malignant nodes of prostate. Methods Thirty-three patients with 38 prostate nodes underwent real-time transrectal gray scale CEUS with SonoVue and contrast pulsed sequence (CPS). Contrast enhancement pattern of the prostate nodes were recorded and time-intensity curves (TIC) were drawn to calculate the parameters and difference between benign and malignant nodes. Results Twenty benign nodes (17 in inner gland) and 18 malignant ones (14 in external gland) were confirmed by pathology. Compared with normal peripheral zone, malignant lesions showed significantly earlier time to enhancement. The time to peak (TTP), accelerating time (ACT) and peak intensity (PI) of malignant lesions were lower than those of benign lesions (P<0.05).There was no significance in arrival time (AT) between the two groups (P>0.05). Conclusion Of all parameters in CEUS, TTP, ACT and PI are different between prostate benign and malignant lesions, and thus contribute to discriminate prostate cancer from benign diseases.

Objective To research the consistency of testing results with three different antimajor histocompatibility complex class Ⅰ-related chain A(MICA) specific antibody reagents in order to evaluate their clinical application's value.Method An collaborative study of 18 laboratories was undertaken at the 16th International HLA and Irnmunogenetics Workshop.Total of 16 sera(4 batchs)were tested for anti-MICA antibodies by Luminex method with three different reagents (Kit-A,-B and -C).Result Anti-MICA antibodies were found in 15 sera,except one sera(no.S04) ; No.S10 sera showed positive results in all the laboratories.The anti-MICA antibodies were divided into MICA-G1 group (MICA01,02,07,12,17 and 18) and MICA-G2 group (MICA 04,06,08/27,09 and 19).MICA-G1 group specific antibodies were detected in 5 sera with Kit-A and-B reagent; but there were false-positive results of anti-MICA08/27 and MICA19 antibodies in this 5 sera with Kit-C.MICA-G2group specific antibodies can be detected in other 5 sera with Kit-A and-B,But the MICA specific antibodies testing gave different results with Kit-A,-B and-C in all the last 5 sera samples.Testing of MICA08/27 showed highest consistency results (86.67％,13/15) with Kit-A,-B and-C; and testing of MICA19 showed lowest consistency results (40％,6/15) with this 3 reagents.There were 80％ consistency results of anti-MICA specific antibodies in 13 sera with Kit-B.Conclusion There are the same effect to judgment positive or negative result for anti-MICA antibodies with 3 different reagents,but the results of anti-MICA specific antibodies are not the same.Therefore,it's better to use two or more reagents to test anti-MICA specific antibodies,or choose reagent with wide detection range.

Objective To investigate the approach and safety of minimally invasive surgical procedures treating symptomatic caliceal diverticular calculi. Methods Clinical data of 21 cases with symptomatic caliceal diverticular calculi were retrospectively reviewed. Twelve females and 9 males aged 22 to 57 years old. The average diameter of caliceal diverticulum was 3.7 cm (2.5-7.0 cm) and average diameter of calculi was 2.3 cm (0.8-3.5 cm). The patients underwent flexible ureteroscopic lithotripsy, PCNL or mPCNL, laparoscopic techniques and laparoscopy-assisted transperitoneal PCNL, respectively. Four cases underwent flexible ureteroscopic lithotripsy. PCNL (2 cases) or mPCNL(5 cases)were performed in 7 cases. Nine cases underwent laparoscopic techniques. Laparoscopyassisted transperitoneal PCNL was performed in 1 case. Results The operations were performed successfully in 21 cases. No case need to transfer to open surgery during the operation and no major complications like perforation or organic injury were noted. One case with iatrogenic arteriovenous fistula of the kidney after 1 week postoperative was cured by delayed hemorrhage 2 days later, while clinical symptoms of 2 cases with residue calculi relieved. 19 cases without residue calculi were followed up for 6 to 12 month without recurrence. Conclusions After handling indication of treatment efficiently and creating advisable therapeutic decision-making, minimally invasive surgical procedures treating symptomatic caliceal diverticular calculi appears to be effective and safe.