Objective To investigate the protective effect of Fas ligand (FasL) gene transfer to renal allografts in rats. Methods FasL recombinant adenovirus vector was contruccted and transduced into rat renal allografts by renal artery perfusion. RT-PCR and immunohistochemistry were use d to detect the expression of exogenous FasL gene. Electronic microscopy was use d to observe the changes in the ultra-structure. At the same time, mean surviva l of animals and the level of serum creatinine were observed. Results FasL mRNA and protein were positively expressed in FasL gene transduced renal al lografts. FasL protein mainly distributed in renal small artery, glomerular and proximal tubues. FasL transduced allografts had less renal graft rejection and c hange in the ultra-structure, and prolonged allograft survival and lower serum creatinine as compared to control animals (P

Objective To elucidate the entity of single ectopic ureter and improve efficacy of its clinical treatment and to explore the correlation between the site of the ectopic orifice and the degree of the dysplastic kidney it drains. Methods The clinical data of 19 cases with single ectopic ureter were closely studied.And the correlation between the site of the ectopic orifice and the size of the kidney was analyzed. Results Thirteen of the 19 dysplastic kidneys were detected by combined use of ultrasound and IVU.The site of the ectopic orifice had no correlation with the degree of the dysplastic kidney.All patients were cured by means of one procedure. Conclusions The epidemiology and clinical features of single ectopic ureter have racial and regional differences.Appropriate intervention can obtain an excellent outcome.

Objective To investigate the change of quality of life and urodynamics after the enterocystoplasty combined with clean intermittent self-catheterisation (CISC) in nonparalytic spinal cord dysfunction (NSCD) patients with neurogenic underactive bladder by the Medical Outcomes study 36-item short-form general health survey (SF-36). Methods The quality of life of 72 NSCD patients with NUB were measured by SF-36 questionnaire, who had been taken enterocystoplasty combined with CISC or only CISC according to urodynamic results. In total, 58(81% ) patients were successfully followed for one year by SF-36 questionnaire and urodynamic examination, including 30 men (mean age 27±5 year) and 28 women (mean age 26±4 year). The normal volunteers without lower urinary tract symptom were set as control group, including 20 men (mean age 28 ± 4 year) and 20 women (mean age 29±4 year). Results At the follow-up, physical role, vitality and social function of men and women were 55±14 and 45±15, 76±19 and 74±15, 52±19 and 59±13 respectively, significantly higher than those before the treatment (35 ± 10 and 32 ±11, 27 ± 18 and 33 ± 17, 40 ±12 and 34 ±15). The bladder compliance and maximum cystometric capacity were (320 ± 44 ) ml and ( 338 ±50)ml,(55±15)cm H2O and (60±17)cm H2O respectively, also significantly higher than those before the treatment (131±30ml and 140±35ml,5±3 cm H2O and 6±4 cm H2O). However, detrusor leakage point pressures were (6±2)cm H2O and (6±3)cm H2O respectively, significantly lower than those before the treatment (28 ±9 cm H2 O and 25 ± 6 cm H2O). Except for physical function and bodily pain, the all domains of quality of life in both men and women patients were significantly lower than those in control group. Only 17 % of men and 7 % of women believed "their health is better than that one year ago". There was no significant difference in the remission rate between men and women (89% vs 76%) in the patients with RUUTD before treatment. Conclusions It is suggested that urodynamic parameters are significantly improved. Many domains of quality of life were not improved and the reduced quality of life still occurred in NSCD patients with NUB using enterocystoplasty and CISC.

Objective To explore the influence on the expression of elF4E and heparanase by antisense oligodeoxyribonucleotides (ASODN) transfection in human bladder carcinoma BIU-87 cells.Methods After transfecting the 2.5,5.O,7.5 μg/ml eIF4E ASODN into BIU-87 cells,at 24 h,48 h and 72 h,a cell control group (no transfection),a blank control group (empty liposomes) and a non-sense control group (transfected with non-sense ASODN) were established.The expression of eIF4E,HPA and mRNA were detected by in situ hybridration.The expression of eIF4 and HPA protein were detected by immunocytochemistry.SPSS 13.0 statistical software was used for statistical analysis.Results The expression quantity of eIF4E protein and mRNA were lower in the experimental groups ( protein:2.5 μg/ml ASODN treated 24 h,48 h,72 h were:3.55 ±0.52,3.52 ±0.51,3.22.±0.44 respectively; 5.0 μg/ml group:3.43 ±0.47,3.41 ± 0.46,3.19 ± 0.41 respectively ; 7.5 μg/ml group:2.36 ± 039,2.33 ± 0.37,2.05 ± 0.30 respectively.mRNA:2.5 μg/ml treated 24 h,48 h,72 h were:3.19 ±0.41,3.13 ±0.39,2.90 ±0.38 respectively ; 5.0 μg/ml group:3.07 ± 0.39,2.94 ± 038,2.27 ± 0.37 respectively ; 7.5 μg/ml group:2.22 ± 037,2.06 ± 0.30,1.95 ± 0.29 respectively.All data were less than those in the control groups (P ＜0.05).The expression quantity of HPA protein and mRNA were lower in experimental groups (protein:2.5 μg/ml ASODN treated 24 h,48 h,72 h were:4.44 ±0.55,4.40 ±0.54,3.99 ±0.52 respectively; 5.0 μg/ml group:4.41 ±0.55,4.21 ±0.53,3.77 ±0.50 respectively; 7.5 μg/ml group:4.02 ±0.52,3.98 ±0.52,2.32 ±0.37 respectively.mRNA:2.5 μg/ml treated 24 h,48 h,72 h were:4.12 ±0.51,3.75 ± 0.50,3.63 ± 0.45 respectively ; 5.0 μg/ml group:4.00 ± 0.51,3.71 ± 0.50,3.54 ± 0.44respectively ; 7.5 μg/ml group:3.87 ± 0.52,3.61 ± 0.49,2.08 ± 0.30 respectively).All data were less than in control groups ( P ＜ 0.05 ).There was a positive correlation on expression of HPA protein and eIF4E protein by inhibitory effect of eIF-4E ASODN (protein r=9.23,mRNA r=9.59,P ＜0.01).Conclusion eIF-4E ASODN might be used to inhibit the expression of eIF-4E gene and HPA gene in bladder cancer BIU-87 cells.

Objective To study the anti-tumor effects of SFPS against human colon cancer cells.Methods Inhibition of the cell proliferation was measured by MTT assay.SFPS induced apoptosis of lovo and RKO cells was observed by electron microscopy and flow cytometry.The potential of SFPS in inhibiting lovo and RKO cells viability was assessed by MTT assay.Results SFPS significantly exhibited antiproliferative activity which depended on dosage.Morphological examination showed chromosomal condensation, karyotheca margination,cell shrinkage and the presence of apoptosis bodies.The overall effect of SFPS on the cell cycle distribution was examined by flow cytometry.However,it was also found that SFPS arrested the human colon cancer cell line RKO at G0/G1 phase,and the RKO cells at S phase decreased significantly,while no change in cell cycle distribution from SFPS treated lovo cells was observed.Conclusion SFPS may induce the apoptosis of lovo and RKO cells in vitro through anti-tumor proliferation.

Objective To investigate the short-term efficacy of pelvic floor electrical stimulation (PFES) and pelvic floor training (PFT) for female with idiopathic detrusor overactivity (IDO) and stress urinary incontinence (SUI). Methods PFES and PFT were performed on 70 women (average age 40±7 years old) with IDO and SUI for twelve weeks. Urinary diary, International Continence In-quiring Committee's Questionnaire (ICI-Q-SF) scores were recorded and urodynamic study was per-formed before and after the treatment. Results Fifty women (71%) finally completed treatment for twelve weeks. Urinary incontinence disappeared in 8 (16%), detrusor overactivity disappeared in 10 (20 %). The leakage was not found in 6 (12 %) in leakage point pressure measurement. Moreover, the frequency of voiding (28±5 times/72 h), frequency of leakage (10±5 times/72 h), total scores of ICI-Q-SF(10±3), max detrusor uninhibited contraction pressure (18±8 cmH20) and detrusor unin-hibited contraction duration (8±3 s) were significantly lower than those before treatment (43±8 times/72 h, 20±6 times/72 h, 17±3, 27±9 cm H2O and 13±6s,P<0.01). Maximal voided vol-ume(225±48 ml), normal desired cystometric capacity (210±48 ml), maximal cystometric capacity (247±48 ml), Valsalva leak point pressure (94±11 cm H2O) and maximal urethral closure pressure (59±8 cm H2O) were significantly higher than those before treatment (159±37 ml, 141±39ml, 178±36ml, 81±15 cm H2O and 55±8 cm H2O, P<0.01). The effective rate during three months follow up was 60%, similar to time after treatment (P>0.05). Conclusions Pelvic floor electrical stimulation and pelvic floor training could be a useful therapy to treat women with IDO and SUI. It is both convenient and economical.

Objective To investigate the clinical efficacy of pedicled adrenal transposition for the treatment of adrenocortical and medullary hyperplasia, Methods Twenty cases of adrenal hyperpla-sia (6 men and 14 women; mean age,36 years ) had history of hypertension from 0.5 to 5 years. Of all cases, 15 had centripetal obesity and purple striae, 2 had weakness and polyuria, 3 had durative hypertension. Serum potassium and aldosterone were increased in 4 and 3 cases, respectively. Urinary 17-OH and 17-KS were increased in 15 cases. Epinepgrine, norepinephrine and dopamine increased in 3 cases, VMA increased in 4 cases. CT scan and MRI revealed adrenal diffuse enlargement with in-creased thickness or nodules in 18 and 3 cases, respectively, 131I-MIBG scan showed positive in 3 ca-ses. Preoperative diagnoses were Cushing's syndrome in 11 cases, hyperaldosteronism in 2 cases, pheochromocytoma in 1 case, adrenomedullary hyperplasia in 2 cases, Cushing's syndrome-cate-cholamine syndrome in 4 cases. All cases were treated with transposition of pedicled adrenal gland into the subcutaneous tissues. Results All operations were successful. The average operation time was 120 min, the average blood loss was 40 ml and the average hospital stay was 10 d. No obvious surgical complications occurred. Pathological studies of all the cases revealed the coexistence of adrenocortical and medullary hyperplasia. Seventeen cases were followed up for 0.5-8 years. Thirteen cases had no symptom and normal biochemical results. Four cases still had hypertension and abnormal biochemical results. They were recovered after adrenal operation of the ther side. Conclusion Transposition of pedicled adrenal gland could be an available option to treat patients with adrenocortical and medullary hyperplasia.

Objective To assess the safety and efficacy of percutaneous nephrolithotripsy withpneumatic and ultrasonic power in pediatric renal calculi. Methods The clinical data of 44 patientstreated with combination of pneumatic and ultrasonic power during pereutaneous nephrolithotripsywere retrospectively analyzed. The 44 patients had 49 renal calculi. The patients were all under 14years old. The average age was 11 years (range 7-14 years). There were 39 unilateral and 5 bilateralcalculi. Among the 44 patients,metabolic disturbance occurred in 19 cases (43.2%),anatomical dys function occurred in 15 cases (34.1%),urinary tract infection occurred in 14 cases (31.8%). Ante grade percutaneous access was established under ultrasound guidance,a combination of pneumatic andultrasonic lithotripsy were used. The effect was evaluated by postoperative KUB and ultrasonic. Re suits The access was successfully established in all patients. Complete stone clearance was achievedin 36 kidneys in phase Ⅰ,stones from 9 kidneys were completely removed with second lithotripsy.Leftover stone in 2 kidneys were treated by ESWL. Open surgery was performed in 2 kidneys due toexcessive bleeding. The operative time ranged from 52 132 min,average time was 79 min. Two pa tients needed blood transfusion. No severe complications occurred in all patients. Thirty seven pa tients were followed up for 3 18 months. The renal function was not worsened and hydronephrosiswas not aggravated in these patients. Conclusion The percutaneous nephrolithotripsy with pneumatic and ultrasonic power is a safe,effective treatment for pediatric renal calculi.

Objective To evaluate the impact of age on the bladder-urethral function and the outcome of transurethral resection of the prostate (TURP) in the elderly men with benign prostatic hyperpiasia (BPH). Methods The elderly men with BPH undergoing TURP were divided into young elderly group [n=158, mean age of 68 + 4 years] and elderly group [n=47, mean age of 80± 3 years]. All patients were evaluated by International Prostate Symptom Score (IPSS). Quality of life (QOL). transrectal ultrasound and urodynamic examination one week before TURP, and they were followed by IPSS, QOL. free uroflowmetry and postvoid residual urine volume (PVR) measurement at 3 months after TURP. Results The incidence rates of detrusor overactivity, low compliance bladder, detrusor underactivity and benign prostatic obstruction in elderly group were 70%, 34%, 19% and 77% respectively, and they were significantly higher than in young elderly group (42%, 18%, 6.3% and 58%,x2 =10.623, 4.328, 5.637,4.771,P<0.05). However, the mean max detrusor voided pressure [62±29) cm H2O] was significantly lower in elderly group than in young elderly group [(76±22) cm H2O,t =3.265, P<0.05]. Moreover, the mean prostatic length, static functional length and bladder neck pressure were (52±8) mm, (63±11) mm and (36 15) cm H2O respectively, they were significantly higher in elderly group than in young elderly group [(47±7)mm, (59±6) mm and (25±13) cm H2O, t=4.157, 3.388 and 4.912,P<0.05]. The IPSS, QOL and PVR were significantly lower after TURP than beforeTURP, and the max flow rate (MFR) was significantly higher after TURP than before TURP in both groups (tyoung elderly group= 19.744, 64.671, 23.342 and 27.504;t elderly group= 27.308, 19.311,9.694 and 11.671, P<0.05). However, the MFR was significantly lower in elderly group than in young elderly group, and PVR and QOL were significantly higher in elderly group than in young elderly group after TURP (t=3.493, 15.245 and 10.750, P<0.05). Conclusions The risk of bladder-urethral dysfunction is increased and the therapeutic effects of TURP is decreased with ageing in the elderly men with BPH. It would be beneficial to have an urodynamic study for their treatment.

Objective To report our experience of retroperitoneal laparoscopic extravascular stent placement for nutcracker syndrome.Methods The clinical data of 12 nutcracker syndrome patients (10 males and 2 females;mean age 26 years) who underwent retroperitoneal laparoscopic extravascular stent placement from March 2014 to Febuary 2016 were retrospectively reviewed.The main symptoms were gross hematuria in 8 patients(one with proteinuria)and flank pain was noted in 1 patient.Three male patients had left-sided secondary varicoceles.Ultrasonography and computed tomography showed the left renal vein clamped by the superior mesenteric artery and the aorta.The anteroposterior diameter of the left renal vein in the renal hilum was three-fold than the aortomesenteric area,and the peak velocity ratio of the aortomesenteric area was much faster than the renal hilum.Twelve patients underwent laparoscopic extravascular stent placement under general anesthesia.The preaortic fibrous tissue between the aorta and the superior mesenteric artery was released intraoperatively.Renal vein became fiat when the superior mesenteric artery was elevated.The 6-8 cm extravascular stent was set on the surface of the renal vein to prevent the compression.Results Stenting was successfully accomplished in all 12 patients.Mean operative time was 62 min (50-125 min),estimated blood loss was 35 ml(20-100 ml),and the hospital stay after operation was 8 days (6-12 days).Three patients had a transient orthostatic intolerance,and they were cured by conservative treatment.With a mean follow up of 14 months (5-30 months),symptoms of hematuria and flank pain resolved in 7/8 and 1/1,respectively.Varicoceles were cured in all three patients.One case got partial relief because of recurrent hematuria due to excessive exercise.Ultrasonography showed that extravascular stent was in the right place,and the angle between abdominal aorta and superior mesenteric artery became normal.The inner diameter of left renal vein was decreased,and the narrow segment was diminished in diameter meanwhile the blood outflow was smooth.Conclusions Retroperitoneal laparoscopic extravascular stent placement in the renal vein is a safe and effective approach for nutcracker syndrome.