膀胱癌是泌尿系统器官中最常见的恶性肿瘤之一，其病因及发病机制尚不十分清楚，且其具有发病率高、恶性程度高 以及术后易复发等特点，因此对其病因、发生发展的具体分子机制的研究及阐明，将有力地促进膀胱癌的诊断及治疗。长链非编 码RNA（long non-coding RNA，lncRNA）是细胞中一类转录本长度超过200个核苷酸的非编码RNA分子， 占RNA总量的98%。 lncRNA具有与mRNA相似的结构，经过转录后加工，也具有polyA尾巴和启动子结构，但是由于序列中缺少开放阅读框，而不参 与或很少参与蛋白质编码。近年来，随着二代测序技术的广泛应用，越来越多的研究发现lncRNA在多个层面上参与细胞分化和 个体发育等重要生命活动过程的调控，并与人类的重大疾病尤其是肿瘤密切相关。相关的研究表明，lncRNA参与靶基因的表达 调控，在肿瘤的发生发展中发挥着重要的作用。本文对lncRNA在膀胱癌方面的最新研究进展进行了文献综述。

Objective To review the clinical features of small cell neuroendocrine carcinoma of the prostate (SCPCa). Methods The ages of 4 cases were 25-77 years. Four cases had progressive dysuria with 2 cases had chronic urinary retention and 2 had upper urinary tract hydronephrosis. On admission, all cases were palpated a hard prostate mass in digital rectal examination. Serum tPSA were 0. 57-6.36 ng/ml with a ratio f/t PSA 0. 26-0.63. B ultrasound, CT and MRI detected 3.9 cm×3. 9 cm×1.6 cm-11.3 cm×7. 9 cm×9. 5 cm irregular shape mass in prostate. 2 cases had seminal vesicle involved, 2 cases had rectum involved, 2 had unilateral ureter involved, and 1 case had sacrum involved. Pelvic lymphonodes metastasis were seen in 3 cases. Bone scan detected multiple bone metastasis in 3 patients. Results The final diagnoses were accomplished by prostate biopsy. Under light microscope, tumor cells were orbivular-ovate or fusiform shape, small volume, and had little cytoplasm. The margin of tumor cells was not clear. Caryokinesis phase could be found with hyperchromatic chromatin. Immunohistochemistry showed positive ChA staining in 4 eases, positive NSE expression in 2 patients and negative PSA in 4 cases. 3 cases were given cisplatin-based chemotherapy, pelvic radiation, or chemotherapy plus radiotherapy. All patients appeared widespread metastasis quickly and died or lost visit within one year. Conclusions SCPCa is a rare, poor prognosis malignancy with early extensive metastasis. The diagnosis is based on pathology.

Objective To investigate the safety and efficacy of same session ureteroscopical lithotripsy as a valuable treatment for the bilateral upper urinary stones.Methods 32 cases with bilateral upper urinary stones were enrolled into this study from Jan 2013 to Dec,including 19 male and 13 female.The age ranged from 19 to 79 years old [mean (53.2 ± 14.2) years old].Ultrasound,CT and IVU were used to evaluate the details about the stone burden,number and location.The total stone burden was (23.7± 7.6)mm,ranged from 14 to 40mm.The kidney stone burden ranged from 0 to 37mm [mean (15.4 ±9.7)mm].and ureter stone burden ranged from 0 to 34 mm [mean (8.2 ±7.2)mm].Total stone number was 109,including 78 stones in kidney and 31 stones in ureter.23 (71.9％) patients had stents placed before the surgery.All the patients were treated with FURL and(or) URL by the same surgeon under general anesthesia,and C arm was used routinely to monitor the position of the guide wire,sheath and residual stones.The stents were placed for 2 to 4 weeks post-operatively.The ureteral catheters were placed for 24 to 48 hours.Stone-free rates(SFRs) were judged by KUB and(or)NCCT on the first day after the surgery and one month after withdraw the stent.The number of procedures,operative duration,hospital stay,SFRs in different time phase,serum creatinine,stone composition and complications were evaluated.All patients were divided into low burden group and high burden group,based on the borderline of stone burden (20mm).The SFR and complication was compared among those group.Results Among 32 cases,30 cases underwent the one stage procedure and 2 cases underwent two stage procedure.Operative time was (99.2 ± 32.5) mins.There was no significant difference of serum creatinines before and after the surgery.[(78.3 ± 15.0) μmoL/L vs.(77.9 ± 15.3) μmol/L,P =0.711].The overall SFRs aftcr 1,2 procedures were 84.0％ (27/32) and 91.0％ (29/32),respectively.The immediate SFRs for patients with a preoperative stone burden ≤20 and ＞20 mm showed significant difference(100％ vs.50％,P =0.002).Only 5 minor postoperative complications,including fever in 4 patients,hematuria in 1 were recorded.Longterm complication,such as ureteral stricture,was not noticed.Conclusions For selected cases with bilateral upper urinary stones,bilateral same-session ureteroscopy is effective and safe with little influence on the kidney function.For those whose stone burden less than 20mm,the immediate SFRs are much higher.

Objective To evaluate the efficacy and safety of prostat in the treatment of chronic nonbacterial prostatitis (CNP). Methods A multicentral open clinical trial was conducted.A total of 115 CNP patients were enrolled in the trial.For each patient 1 tablet of prostat (70 mg P5+4 mg EA10) was orally administered twice a day. Results After 4- and 8- week therapy,NIH-CPSI overall scores were averagely decreased 7.1 (29.5%) and 11.9 (49.4%),respectively.Symptom rating scores were averagely decreased 5.0 (32.1%) and 8.2 (52.5%),respectively.Quality of life scores were averagely decreased 2.1 (24.6%) and 3.7 (43.9%),respectively.WBC counts in prostate massage fluid were averagely decreased 8.8/HP (39.3%) and 13.9/HP (61.9%),respectively.The total effective rate was 82.1% after 8 week therapy.No adverse reaction associated with medication was observed. Conclusions Prostat is effective and safe in relieving the subjective symptoms and improving the objective evaluation in the treatment of CNP patients.

Objective To evaluate the efficacy and safety of Prostant TM and the patients’ compliance with the treatment of chronic prostatitis of different types. Methods A multi-central,randomized,double-blind,placebo-controlled clinical trial was conducted between June 2002 and December 2002.A total of 125 patients who had been diagnosed as chronic prostatitis and classified according to NIH classification system for prostatitis were divided into two groups: the trial group treated with Prostant TM anally one pill per night for 30 days and the control group given placebo in the same way.The efficacy was evaluated by the NIH chronic prostatitis symptom index (NIH-CPSI) and the WBC count in EPS after the treatment. Results Based on leukocyte and culture results,124 evaluable patients were stratified,with 48 cases of categories Ⅱ(38.7%),45 cases of Ⅲa(36.3%) and 31 cases of Ⅲb(25.0%)with chronic prostatitis.The overall NIH-CPSI scores were averagely reduced by 10.37 points in trial group and 6.65 in control group,and the symptom scores were averagely reduced by 7.34 in trial group and 4.72 in controll group,compared with pre-treatment.Significant differences of reduction were found between the two groups(P

Objective To study the efficacy and safety of naftopidil,a new ? 1-adrenoceptor antagonist for treatment of benign prostatic hyperplasia(BPH). Methods A randomized,double-blind,double-simulant,parallel-controlled,multicentral clinical trial was conducted in 224 patients with BPH.Patients of treatment group received naftopidil (25 mg,once a day) and the controls received tamsulosin (0.2 mg,once a day). Results After 6-week therapy,IPSS,quality of life (QOL) score,maximum urinary flow rate (Qmax) and average urinary flow rate(Qave) were significantly improved both in naftopidil group and tamsulosin (control) group.In naftopidil group,IPSS was averagely decreased by 11.03 (P0.05).The clinical adverse event rate was 2.68% in naftopidil group, which was significantly lower than that in tamsulosin group (8.93%,P

Objective Study the efficacy and safety of epristeride, a new uncompetitive 5?-reductase inhibitor, in the treatment of benign prostatic hyperplasia(BPH). Methods A multicentral opened clinical trial was conducted. 2 006 BPH patients were enrolled in the trial, in which 5mg epristeride was orally administered twice a day. Results After 4 months therapy, IPSS score was averagely decreased 6.12(28.8%) ( P

Objective To evaluate the short term and long term clinical effect of internal iliac arterial chemotherapy (IIAC) followed by surgery for invasive bladder cancer. Methods Fifty six patients with invasive bladder cancer were preoperatively treated by IIAC with cisplatin (100 mg/m 2) and adriamycin (30 mg/m 2).All the cases received IIAC twice with 3 to 4 weeks interval.Two weeks after the second chemotherapy,the patients were examined by ultrasound and cystoscopy.Bladder preserving operation or radical cystectomy was performed according to clinical stages and grades of the bladder cancer. Results Two weeks after IIAC,down staging was observed in 42 patients (75%),and no change or increase in volume and stage were observed in 14 patients (25%).After IIAC TURBt was performed on 21 patients,partial cystectomy on 5,and radical cystectomy on 28 depending on the rumor size and clinical stages.The 1 ,2 ,3 ,5 year disease free survival rate in evaluative 40 patients was 85.0%,70.0%,57.5%,50.0%,respectively. Conclusions IIAC as a neoadjuvant chemotherapy has the possibility of down staging the cancer,which provides the chance of bladder preserving operations for invasive bladder cancer, and the possibility of radical cystectomy for high stage (T 3b ～T 4) bladder cancer.IIAC followed by surgery can effectively improve the disease free survival rate for invasive bladder cancer.

Objective To validate the Partin table 1997,2001 and 2007 for their accuracy in predicting pathologic stage in Chinese prostate cancer patients.Methods From January 1997 to June 2007,109 consecutive patients with clinically localized prostate carcinoma underwent open retropubic or laparoscopic radical prostatectomies and met all inclusion criteria well enrolled.Receiver operating characteristic(ROC)analysis was performed tO test the predictive accuracy of organ confined disease (0CD),extraprostatic extension(EPE),seminal vesicle involvement(SVI)and lymph node involvement(LNI). Results OCD,EPE,SVl and LNl were noted in 70%,17%,13%and 0%of cases respectively.The area under curve(AUC)of ROC for Partin table 1997 was 0.727,0.654 and 0.811for 0CD.EPE and SVl respectively,and was 0.693,0.633 and 0.835 for Partin table 2001 and 0.669.0.611 and 0.778 for Partin table 2007.Conclusions Partin tables 1997,2001 and 2007 are able to accurately predict the pathologic feature of seminal vesicle involvement.However,only Partin table 1997 can more accurately predict organ confined disease in this external validation for Chinese patients.

Objective To investigate the effectiveness of Uromentor virtual reality simulator in flexible ureteroscopy training for catechumen.Methods Fifty-one catechumen were selected.After 1 hour training of basic operation in Uromentor virtual reality simulator, all trainees performed special-purpose exercise ( kidney inspection with flexible ureteroscopy ) for 3 hours. Using right kidney inspection, a preliminary assessment for each trainee was made before the special-purpose exercise and data such as total time, number of trauma from the scopes and tools, percentage of kidney surface examined and global rating scale ( GRS ) were recorded.The same assessment was performed once again after the special-purpose exercise ( secondary assessment ) , and data were recorded and compared to the preliminary assessment. Results Each trainee made a significant improvement in flexible ureteroscopic skill after the special-purpose training.The parameters such as total time, number of trauma from the scopes and tools, percentage of kidney surface examined and GRS of all trainees in preliminary assessment were 14.63 ±1.01 min, 8.62 ± 2.67, 51.05%±20.79%and 10.31 ±2.53, respectively;while in secondary assessment, parameters were 7.71 ±1.13 min, 1.67 ±1.23, 98.04% ±5.42% and 29.14 ±3.01, respectively.The differences between the preliminary assessment and the secondary assessment of each parameter were significant ( P<0.01).Conclusions The Uromentor virtual reality simulator can improve the trainee′s skills of flexible ureteroscopy.It is a good instrument of the flexible ureteroscopic training for catechumen.