Objective To investigate the effect of different instillation methods on recurrence of superficial bladder carcinoma after surgical operation by meta-analysis.Methods Literatures in the relationship between different instillation methods and recurrence of superficial bladder carcinoma issued from January 1989 to February 2005 were retrieved and the effects were quantitatively estimated with fixed-effect model and random-effect model by meta-analysis.Results Forty-three copies of related literatures were included in the analysis.Combined OR of the instillation methods excluding BCG,only BCG instillation and combined instillation of BCG and other drugs for the recurrence of bladder carcinoma after surgical operation was 0.55(95%CI:0.40~0.74),0.32(95%CI:0.06~1.64) and 0.43(95%CI:0.33~0.57),respectively.Funnel plot showed symmetrically distributed studies,indicating little publication bias and reliable conclusions.Conclusions Only BCG instillation and combined instillation of BCG and other drugs could effectively lower recurrence of superficial bladder carcinoma after surgical operation.

Objective To provide evidence for decision-making on bladder cancer prevention through investigating the main risk factors related to the incidence of bladder cancer in Chinese population.Methods Using the search terms "bladder neoplasm" and "smoking", the literature from January 1979 to June 2005 on the relationship between risk factors and bladder carcinoma was searched from MEDLINE database and PubMed database,and was studied by Meta-analysis.At the same time,ORs of randomized model and fixed model were calculated to evaluate the sensitivity.Results Totally,23 epidemiological studies on risk factors of bladder cancer were analyzed synthetically by Meta-analysis.The cumulative cases and controls were 7 600 and 5 002,respectively.The pooled odds ratio(OR) values and 95% CIs were as follows:smoking,1.38(1.22-1.57);contacting chemicals,1.95(1.74-2.19);drinking alcohol,2.53(1.60-4.00);drinking coffee,1.31(1.04-1.64);family history of bladder cancer,4.43(3.54-5.53);and gender,4.12(3.71-8.14);respectively(P

Objective Measure the cytokines including hIFN-?、hIL-12 and hTNF-? which secreted by PBMC stimulated with recombinant BCG, and research how recombinant BCG influence the expression of cytokines and improve the immunologic response. Methods In the experiment, Recombinant hIFN-?-2b-BCG group and wild-type BCG group stimulate peripheral blood monocytes(PBMC) with different density in vitro, which is 0.1 OD and 0.01 OD (1 OD=2.7?107CFU). In third group, we put IFN-?-2b into wild-type BCG so that we can compare it with recombinant BCG. All these components foster with PBMC(4?106/ml), then collect the supernatant in 12 hours, 24 hours, 48hours, 72 hours, 5 day, 7day, and detect hIFN-?、hTNF-?, hIL-12 by an enzyme-linked immynosorbent assay(ELISA), compare the results. Results We can learn from the result, compared with the other groups, recombinant BCG can induce higher density cytokines than wild-type BCG’s and combination group’s(P

Objective To evaluate the prognostic factors for survival in patients with renal pel-vic and ureteral carcinoma. Methods The clinical data of 220 patients with renal pelvic and/or ure-teral carcinoma were retrospectively analyzed. One hundred and forty-six cases were males and 74 ca-ses were females. Age ranged from 38 to 84 years. One hundred and three cases were renal pelvic car-cinoma, 84 cases were carcinoma of ureter, 13 cases were renal pelvic carcinoma with carcinoma of u-reter, 5 cases were renal pelvic carcinoma with bladder cancer, 11 cases were carcinoma of ureter withbladder carcinoma, and 4 cases were renal pelvic carcinoma with carcinoma of ureter and bladder carci-noma. For TNM stage, there were 2 cases in T., 116 cases in T1, 48 cases in T2,37 cases in Ta and 17 cases in T,. For WHO grade, there were 5 cases with grade Ⅰ tumor, 87 cases with grade Ⅱ tumor and 128 cases with grade Ⅲ. Multivariate analyses were done using logistic analysis and Cox proportional hazards regression model with Kaplan-Meier method, Log-rank test and Gehan test, re-spectively. Results The 5-year survival rates of Ta--T1,T2,T3,T4cases were 80.5%(95/118), 70.8%(34/48), 45.9%(17/37) and 17.6%(3/17), respectively. Survival rates were significantly different in patients with tumor stage Ta-T1,T2and patients with tumor stage T3-T4 (u=9.429, P=0.002). There was no significant difference between survival o{ ureterorenoscopic surgery group and other operation group(x2=0.217,P=0.641). The factors affected survival were age (RR= 1.639,P=0.027), time of initial symptoms to operation (RR=1.279, P=0.019) and clinical stage of the tumor (RR=1.373,P=0.011). Logistic regression analysis showed that the factors influencing the recurrence of bladder carcinoma ineluded multi-site growth(RR=11.292,P=0.003)and coexisting bladder careinoma (RR=8.780,P=0.001). Conclusions Age, time of initial symptoms to opera-tion and the stage of the tumor are the important predictors affecting the prognosis of the renal pelvic and ureteral carcinoma. Multi-site growth and coexisting bladder carcinoma are important risk factors having impact on the recurrence of bladder carcinoma.

Objective To study the therapeutically effect of rAAV-TIE model in vivo. Meth-ods Cell suspensions of T24 cells were injected into the subcutaneously of right scapular region of nude mice. The nude mice were raised under SPF condition and the xenograft tumor growth was ob-served. Bearing tumor nude mice were randomly divided into 5 groups: rAAV-MCS group, rAAV-Tk group, rAAV-ES group, rAAV-TIE group and control group. Four weeks later of treatment, the nude mice were sacrificed. The xenografts tumors were fixed for HE staining. The liver tissue and ne-phridial tissue were also fixed for HE stain. The blood sample and endostatin concentration was as-sayed by ELISA. Results After 3 weeks of injected with T24 cells on nude mice, 25 showed visible tumor on the injected location. The rate of tumor formation was 93%. After 9 days injected by rAAV-ES, rAAV-TK, rAAV-TIE, the tumor volume were: rAAV-ES group(0.75±0.08)cm3 , rAAV-TK group(0.71±0.11)cm3 , rAAV-TIE group(0.52±0.09)cm3 , rAAV-MCS group(1.27±0.13)cm3 and control group (1.24±0.17)cm3. The microvessel density in the different groups were as follow-ings: rAAV-ES group(18.72±2.53)/HP, rAAV-TK group(21.74±4.62)/HP, rAAV-TIE group (12.73±1.78)/HP, rAAV-MCS group(52.38±6.46)/HP and control group(49.94±7.17)/HP. The endostatin concentration in the diffcrent groups were as followings: rAAV ES group(38.52 6.53)μg/L and rAAV-TIE group(40.33±7.48)μg/L. HE staining confirmed the tumor. The liver tissue and kidncy tissue of each group had no obviously cell degeneration or necrosis. Conclusion The rAAV-TIE could inhibit tumor induced angiogenesis and suppress both the initiation and the subse-quent growth of human bladder cancer in nude mice model.

Objective To discuss whether potassium sensitivity test(PST) is correlated with PUF in Interstitial Cystitis (IC). Methods The data of 14 IC patients (female 13, male 1) were an-alyzed. The mean age was 48 years (range 35-67 years). The clinical symptoms included urinary fre-quency, urgency, pelvic and peritoneal region pain after bladder filling. All the patients met the diag-nostic criteria of NIDDK for IC. Dilatations by hyponome were performed, medicine including heparin-sodium, lidocaine, NaHCO3 were used by intravesical instillation. PST and the pelvic pain and urgen-cy/frequency patient symptom (PUF) were used for evaluation. The relationship of the PST and PUF was assessed by statistics. Results PST median decreased from 4.0 to 1.0 (P<0.01). PUF medi-an decreased from 27.5 to 13.5(P<0.01). PST was directly correlated with PUF (rs=0. 868, t= 4.418, P= 0.001 before treatment, rs = 0.779, t=4.300, P = 0.001 after treatment). Conclusions PST and PUF are correlated. Both can be used as index in diagnosis, differential diagno-sis, symptom severity and treatment effectiveness evaluation of IC.

Objective To investigate possible disturbance of Th1/Th2 immunoregulation of blood serum and bladder mucosa in patients with interstitial cystitis(IC). Methods Blood serum and bladder mucosal specimens were collected from 16 female patients with IC and 16 female normal controis.The age of IC patients was 51.3±10.2 years.The age of normal controls was 53.1±9.6years.The expressions of Th1(IFN-γ,IL-2)and Th2 cytokines(IL-4,IL-10)were determined by enIFN-γ and IL-2 in IC blood serum were(4.57±2.92),(17.52±7.52)pg/ml and in normal blood serum were(4.11±2.27),(20.99±5.09)pg/ml.Such two factors had no significant differences in these two groups.The expressions of IL-4 and IL-10 in IC blood serum were(0.34±0.22),(4.37±2.34)pg/ml and in normal blood serum were(O.14±O.07),(1.18±0.61)pg/ml.Such two factors had sighad no significant differences with normal bladder tissues(IFN-γ:χ2＝1.900,IL-2:χ2＝0.514).The expressions of IL-4 and IL-10 in IC bladder tissues had significant differences with normal bladder tiswere(0.16±0.11)and(2.42±1.27)pg/ml but in high PUF group were(0.53±0.12)and(6.31±1.21)pg/ml.The expressions of these two factors had significant correlations with the degree of PUF,which intensified in the IC of high PUF. Conclusion The expression of Th2 type eytokines is predominant in IC blood plasm and bladder tissues,the expression of Th2 type cytokines in IC blood plasm and bladder tissues has positive correlation with the degree of PUF.

Objective To review the clinical manifestation,pathological characteristics,treatment and prognosis of borderline phyllodes tumor of the prostate. Methods A case of borderline phyllodes tumor of the Prostate was reported and relative literature was reviewed. Results A 32-year-old man was admided to hospital with a history of aggravated dysuria 2 weeks and urinary retchtion one day. The enlarged prostate was palpated softly and smoothly by DRE.The serum PSA was 20.62 ng/ml.Transrectal ultrasonography and MRI revealed a well-demarcated poly-cystiform tumor which compressed the right lobe of the prostate to flattening.The diagnosis of benign stroma tumor which was not differentiated maturity obtained after transrectal sextant needle biopsy,and the transvesical enucleation was performed under epidural anesthesia.The tumor was histologically diagnosed as borderline phyllodes tumor of the prostate. Microscopic examination showed the tumor was composed of epithelial and stroma cells.The stroma cells proliferated obviously with atypia and mitosis,and the epithelial cells propagated without atypia.Immunohistochemical staining was performed.Vimentin was typically positive,PSA and PAP was positive,and SMA was negative.Forty days after the enucleation,the tumor recurrenced then radical prostatectomy was performed.The diagnosis of low potential malignant phyllodes tumor of the prostate was made.The tumor was limited in tegument and the cross-section of urethra was infiltrated.The patient received external radiation to the whole pelvis(66 Gy)1 month postoperatively.At 6 months'follow up,the patient was asymptomatae. Conelusions The right diagnosis can not be obtained by needle biopsy because hyperptastic epithelial cells can not get and the recurrences of phyllodes tumor increase malignant potential.Radical prostatectomy is the most reliable method of treatment at present.

Objective To compare the mast cells' property and the level of pelvic pain, urgency and frequency (PUF) scale in urinary bladder between interstitial cystitis (IC) patients and controls.Methods Eighteen cystoscopy biopsy specimens of interstitial cystitis patients and 12 controls were stained with 0.5% toluidine blue and immobilizated with Osmic Acid. Then the mast cells were observed and counted with light microscope and transmission electron microscope. The PUF scale and the number of mast cells between the 2 groups were compared. Results The mast cell's number of the interstitial cystitis samples(28-76 pieces/mm2) was significantly higher than that of the non IC persons' bladder tissues(7-15 pieces/mm2) (Z=3.927,P＜0.01). 75.3% mast cells were in a state of being activated degranulation. The PUF scale of IC patients( 17-35 scores)was significantly higher than that of the non IC persons' (0-8 scores) (t=14.736,P＜0.01). The PUF scale of the patient group did not have a linear IC relation with the mast cell's infiltrated number among the specimens (rs=-0.618,P=0.601). Conclusions Mast cell infiltration may be one of the characteristic pathological manifestations of IC. The association of mast cell infiltration and the PUF scale may be a new diagnosis criteria for IC.

Objective To improve the level of diagnosis and treatment of non-specific ureteritis. Methods The clinical data of 11 cases of non-specific ureteritis (6 men and 5 women) were retrospectively analyzed. Their mean age was 48 years (range,24～67 years).The lesions were detected in upper part of the ureter in 1 case,in middle part in 3,and in lower part in 7.All the lesions were unilateral strictured;of them unifocal strictures were found in 9 cases and multifocal strictures in 2.Open surgery was performed in 7 cases,biopsy and double J stent insertion in 4;of the 4 cases balloon dilation was performed in 1. Results Pathological findings confirmed the diagnosis of non-specific ureteritis.During follow-up of 6 months to 2.4 years (mean,1.6 years) for 10 cases,hydronephrosis was cured in 3 cases,alleviated in 6,unchanged in 1.Of these cases,2 underwent nephroureterectomy.No recurrence and canceration were found in the ureters of all cases. Conclusions Clinically,exploratory operation and biopsy are very important for suspected disorders of ureter before performing nephroureterectomy.