·AIM: To investigate the efficacy and security of the silicone membrane implant through observing intraocular pressure, filtering blebs and histopathologic results.·METHODS; Forty rabbits were randomly divided into 4 groups. Each group consisted of 10 rabbits. Trabecu-lectomy and silicone membrane implantation were performed in one eye of each rabbit, while the other eye was only performed trabeculectomy as control. The change of intraocular pressure, filtering blebs were observed postoperatively. And each eye had undergone histopathologic examination.·RESULTS:The duration of low intraocular pressure and existence of filtering blebs in implanted eyes was longer than that in controlled eyes. Light microscopy revealed that patent drainage tract and biting site could be seen in silicone membrane implanted eye. The activity and regularity of fibroblast proliferation in implanted eyes and controlled eyes were similar. Excessive expression of fibroblast proliferation was not induced by silicone membrane.·CONCLUSION: Characterized by safety, effectiveness and simplicity, silicone membrane implantation can act as a new drainage surgery.KEYWORDS: silicone membrane; drainage surgery;intraocular pressure

AIM:To observe the efficacy of intravitreal conbercept injection for chronic central serous chorioretinopathy (CSC).METHODS: Nine eyes of 9 patients diagnosed as chronic CSC between October 2015 to May 2016 were treated with an intravitreal injection of conbercept (0.5mg/0.05mL) (six patients were given the same does of intravitreal injection again at 1mo after the first injection).Follow-up observation was at 1, 2, and 6mo after injection.Observed indicators included best-corrected visual acuity (BCVA), intraocular pressure, optical coherence tomography (OCT), fundus fluorescein angiography (FFA), choroidal indocyanine green angiography (ICGA), macular fovea thickness (CMT), subfoveal choroidal thickness (SFCT).RESULTS:Seven of the 9 patients responded significantly to the drug, while 2 patients had no response.The CMT was 373.12±72.43μm at baseline, which decreased significantly to 332.05±67.13μm, 282.24±62.30μm and 225.56±71.08μm at 1, 2 and 6mo after the intravitreal injection.The mean thickness of SFCT was 422.11±64.82μm before treatment.The choroidal thickness of non-responsive patients before treatment was below average, respectively 353μm and 365μm.The SFCT of 1, 2, and 6mo after treatment was 391.45±75.24μm, 365.53±63.07μm, 355.40±66.65μm.Before treatment and 1mo after, there was no significant difference (P=0.074), but there was statistically significant (P<0.01) between those of before and 2mo and 6mo after.The mean BCVA of the prior treatment was 0.53±0.32, the after treatment was 0.65±0.20, there was no different between the two(P>0.05).CONCLUSION: Intravitreal conbercept injection in chronic CSC may have some effect in accelerating subertinal fluid resolution and decreasing the CMT.The SFCT within 6mo after treatment was significantly lower than pretreatment.The SFCT may be an indicator of whether patients respond.

Objective To investigate the clinical presentations, pathologic features, and the di-agnosis and treatment of prostate sarcomatoid carcinoma. Methods Two cases of prostate sarcoma-told carcinoma were analyzed with review of the relevant literature. Case 1, a 51-year-old man com-plained of dysuria and perineal discomfort for 2 months, was admitted because of acute urinary reten-tion. His serum PSA was 2.31 ng/ml. Heterogeneous density of the prostate left lobe and bladder neck involvement was shown on CT scan. Prostate sarcomatoid carcinoma was confirmed by transrec-tal prostate biopsy, and patient accepted radical cystoprostatectomy and ideal conduit followed with lo-cal radiotherapy and hormonal therapy. Case 2 was a 54-year-old male. This ease was admitted with a history of dysuria and intermittent gross hematuria for 1 month. Hypoechoic lesion was found by ul-trasonography,and heterogeneous density of the prostate was shown on CT scan. His serum PSA was 2.61 ng/ml. The prostate biopsy result showed prostate sarcoma. Radical cystoprostatectomy and ide-al conduit was performed on this case. Results The diagnosis of prostate sarcomatoid carcinoma in the 2 cases was confirmed by postoperative pathology. Under microscope, the neoplasm was mainly composed of epithelial and sarcomatoid mesenchymal cells,with a transitional region of these cells. Im-munohistochemical staining showed that the cells were positive for cytokeratin and epithelial membrane antigen. Vimentin was negative in the epithelial cells, but was positive in the majority of sarcomatoid cell. Both patients died of multi-metastasis at 43 and 19 months after surgery respectively. Conclu-sions Sarcomatoid carcinoma of the prostate is extremely rare with a high grade of malignancy,and its prognosis is poor. The diagnosis depends on pathological features and immunohistochemical studies. Radical resection combined with endocrine therapy and radiotherapy is considered to be the most relia-ble treatment so far.

ObjectiveTo investigate the diagnosis and the treatment of male interstitial cystitis (IC) to improve the efficiency.MethodsEighteen cases of IC male patients treated from Jan 2010 to Dec 2010 who suffered from suprapnbic pain urinary frequency and urgency were analyzed retrospectively.All these patients were misdiagnosed as category Ⅲ chronic prostatitis.According to the NIDDK diagnostic criteria of IC,Pelvic Pain and Urgency Frequency (PUF) scoring,potassium sensitivity test (PST),and cystoscopy under anaesthesia were used to establish the diagnosis of IC.24 h urinary diary,routine uronoscopy,prostate fluid routine and bacterial culture examination were taken before the treatment of hydrodistention and intravesical instillation of heparin.ResultsAfter the follow-up 12 to 25 months ( average,19 months),the symptoms improved distinctly.The PUF scoring was 19.2 ±4.1 before treatment and 13.6 ±2.4 after treatment respectively ( P ＜ 0.01 ).24 hours' frequency and amount of urination were (7.5 ± 4.3)times and (241.7 ±45.3) ml after treatment compared with (11.5 ±3.9) times and (159.5 ±30.8) ml before treatment ( P ＜ 0.01 ).ConclusionsThe male IC and chronic prostatitis share the same symptoms.They can be differentiated by the IC diagnosis.The treatment of hydrodistention alone with oral tolterodine tartrate sustained release tablets and intravesical instillation of heparin can evidently improve the symptoms of the male IC patients.

One hundred and twenty five patients, who underwent cystoscopic examination, were randomly divided into two groups: the control group ( n = 62) received conventional cystoscopy, and the treatment group (n = 63) received rociverine 20 mg 1 h before cystoscpy.The pain levels were evaluated using numeric rating scale (NRS) in all patients.The average NRS during examination was 2.1 ±0.9 and 3.6 ± 1.8 in treatment group and control group respectively( P ＜0.01 ).The pain scores in control g roupwere still higher than those in treatment group 15 min and 1 d after procedure ( P ＜ 0.01 or 0.05,respectively).

Objective To discuss the techniques and clinical efficacy of laparoscopic partial cystectomy with bilateral pelvic lymphadenectomy for urachal adenocarcinoma. Methods From July 2006 to April 2008, 4 patients with urachal adenocarcinoma were managed by the laparoscopic procedure. Three patients were male, the other one was female, with a median age of 51 (range 42 to 66)years. The mean size of tumors was 3.4(rang 1.9 to 5.4)cm in diameter. Three of them were diagnosed as mucinous adenocarcinoma, the other one was adenocarcinoma. There was 1 patient at stage Ⅱ , and the other three as stage Ⅲ according to Sheldon Stage. Four patients were performed by transperitoneal approach. The boundaries of resection were similar to the open surgery, including resection of the tumor with normal margins, the peritoneum lateral to the two medial unbilical ligaments,the posterior sheath of the rectus muscle and the muscle fibers of the rectus muscle below it, and bilateral pelvic lymphanodes. Results The procedure was successfully in all 4 patients, with a mean operative time of 220(range 150 to 350)min, a mean estimated blood loss of 180 (range 120 to 290)ml.No significant intraoperative or postoperative complications occurred, except for an inferior epigastric artery injury in 1 case. The mean postoperative in-dwelling urinary catheter time was 6 (range 5 to 7)d, and the mean postoperative hospital stay was 6 (range 5 to 8)d. All 36 resected lymph nodes (range 8 to 11) were negative. At a median follow-up of 25(range 15 to 36) months, there was no evidence of recurrent disease by radiologic or cystoscopic evaluation. ConclusionLaparoscopic partial cystectomy and bilateral extended pelvic lymphadenectomy in selected patients with urachal tumors could be a safe, feasible, minimally invasive procedure.

Objective To investigate the clinical,pathological and histopatholo(g)ical features of primary bladder clear cell carcinoma and discuss the diagnosis and treatment of the disease. Methods The clinical and pathological features of one primary bladder clear cell carcinoma case retrospectively were analyzed,with the combination of reviewing reported literatures. Results The patient came to hospital with the chief complaint of urinary tract symptom and gradually developed gross hematuria.The tumor was located in the left wall of the bladder and was confirmed to be clear cell carcinoma by preoperative biopsy.Partial cysteetomy,ureteroneocystostomy and hysterectomy plus bilateral adnexectomy were performed.The patient received chemotherapy postoperatively and was tumor free 6 months post operatively. Conclusions Primary clear cell carcinoma of the bladder is a rare type of bladder adenocarcinoma.The diagnosis depends on the clinical and pathological study.Surgical operation is effective and the outcome of the disease is better than other non-urothelium carcinoma.

This article is report the study of the pharmacokinetics and metabolic disposition of exogenous phosphocreatine (PCr) in rats by means of an ion-pair HPLC-UV assay. PCr and its metabolite creatine (Cr) and related-ATP in rat plasma and red blood cell (RBC) were simultaneously determined. A blank plasma and RBC were initially run for baseline subtraction. Plasma and RBC samples were deproteinized with 6% PCA prior to HPLC. Following i.v. administration of PCr 500 mg x kg(-1) and 1 000 mg x kg(-1) the C-T curve could be described by the two-compartment model with t1/2beta 22.5-23.3 min, V(d) 0.956 4-0.978 6 L x kg(-1), CL 0.029 L. kg(-1) x min(-1). The Cr as PCr degraded product appeared as early as 2 min post i.v. dosing with t(max) 20 min, t1/2kappa (m) 40.6-42.7 min and f(m) 60%-76%. After po administration of PCr, the parent drug in plasma was undetectable, but the metabolite Cr was detected with t(max) 65-95 min, t1/2kappa (m) 56.0-57.7 min, metabolite-based bioavailability F(m) 55.02%-62.31%. PCr i.v. administration resulted in significant elevation of ATP level in RBC but not in plasma, the related-ATP in RBC was characterized by t(max) 68-83 min, t1/2kappa 49-52 min. In RBC no exogenous PCr was found but Cr was detected following i.v. administration of PCr, with the t(max) 120 min and t1/2k (m) 70 min for Cr. The above results indicate that PCr eliminates and bio-transforms in body very rapidly; K > K(m) confers ERL, instead of FRL, type upon the metabolic disposition of Cr. Following po administration of PCr, the degraded product Cr is absorbed but not the parent drug PCr. The formed Cr can be accounted for by most of i.v. and po PCr. Intravenous dosing leads apparently increased and sustained Cr and related-ATP concentration in RBC.
Adenosine Triphosphate ; blood ; pharmacokinetics ; Administration, Oral ; Animals ; Area Under Curve ; Biological Availability ; Biotransformation ; Cardiotonic Agents ; administration & dosage ; blood ; pharmacokinetics ; Creatine ; administration & dosage ; metabolism ; pharmacokinetics ; Erythrocytes ; metabolism ; Injections, Intravenous ; Male ; Phosphocreatine ; administration & dosage ; blood ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo evaluate the relationship between peroxisome proliferator-activated receptor-γ2 (PPARγ2) Pro12Ala polymorphism and type 2 diabetes mellitus (T2DM) in Chinese Han population.

METHODSPubMed, Chinese Biomedicine Database (CBM), China National Knowledge Infrastructure (CNKI) and Wanfang database were searched for all relevant articles investigating the association between PPARγ2 Pro12Ala polymorphism and T2DM that were available from January, 1990 to June, 2011. A total of 29 relevant articles were selected. A Meta-analysis was performed to estimate heterogeneity and the pooled odds ratio (OR) to evaluate the relationship between PPARγ2 Pro12Ala polymorphism and T2DM. The sensitivity analysis was also assessed.

RESULTSA total of 21 qualified articles including 3870 patients with T2DM and 3333 healthy controls were analyzed in the study. The frequencies of the allele Ala12 in T2DM and control groups were 4.13% (320/7740) and 4.56% (304/6666), respectively. There were not heterogeneity (χ(2) = 25.96, P = 0.17) among the 21 qualified articles. The pooled OR (95%CI) value of the frequencies of the PPARγ2 genotype (PA + AA)/PP calculated by fixed effects model was 0.96 (0.81 - 1.14) (P = 0.64). There was not heterogeneity among the remaining articles after excluding the article with the largest weight and the article with larger frequencies of the allele Ala12 respectively (χ(2) values were 24.23, 16.87 respectively, both P values > 0.05). The pooled OR (95%CI) value of the frequencies of the PPARγ2 genotype (PA + AA)/PP of the remaining articles were 1.01 (0.84 - 1.21) and 1.07 (0.89 - 1.28) after excluding the article with the largest weight and the article with larger frequencies of the allele Ala12 (both P values > 0.05).

CONCLUSIONPPARγ2 Pro12Ala polymorphism was not associated with type 2 diabetes mellitus in Chinese Han population.

Alleles ; Asian Continental Ancestry Group ; genetics ; China ; Diabetes Mellitus, Type 2 ; genetics ; Gene Frequency ; Genotype ; Humans ; PPAR gamma ; genetics ; Polymorphism, Single Nucleotide

OBJECTIVETo detect the expression of Toll-like receptor 9 (TLR9) in ovarian cancer, and to explore their clinical significance.

METHODSWestern blot method and immunohistochemical staining were used to examine the expression of TLR9 in the ovarian cancer, paracancerous tissues and normal ovarian tissues, obtained during operation from 30 ovarian carcinoma patients and 30 normal non-tumor patients. The relationships of TLR9 with pathological grade, clinical stage, and metastasis of ovarian cancer were statistically analyzed.

RESULTSThe percentage of positive cells expressing TLR9 protein in human ovarian cancer tissues, paracancerous tissues and normal ovarian tissues were 80.0%, 36.7% and 20.0%, respectively. The protein expression level of TLR9 was gradually descending (P < 0.01). The highly expressed TLR9 significantly correlated with the degree of tumor differentiation, an advanced FIGO stage and lymph node metastasis. The Western blot results showed that TLR9 protein expression in ovarian cancer, paracancerous tissues and normal ovarian tissues were 0.803 ± 0.072, 0.411 ± 0.087 and 0.113 ± 0.065, respectively. The expression of TLR9 in ovarian cancer was significantly higher than that in normal tissue and paracancerous tissues (P < 0.01).

CONCLUSIONSTLR9 has a higher expression in ovarian cancer tissues. TLR9 expression has a close relationship with pathological grades of ovarian cancer, suggesting that TLR9 plays an important role in the development and progression of ovarian cancer through immunologic mechanisms.

Adult ; Blotting, Western ; Carcinoma, Endometrioid ; metabolism ; pathology ; Case-Control Studies ; Cystadenocarcinoma, Mucinous ; metabolism ; pathology ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Neoplasm Staging ; Ovarian Neoplasms ; metabolism ; pathology ; Ovary ; metabolism ; Toll-Like Receptor 9 ; metabolism