Objective To evaluate intravesical epirubicin instillation for preventing the recurrence of superficial bladder tumors after surgical management. Methods From Aug.1998 to Aug.1999, 32 cases of superficial bladder tumors after TURBt or partial cystectomy, received early single intravesical epirubicin instillation and the patients have been followed up for 12～24 months with cystoscopy. Results The patients followed up from 12～24 months after surgery(average time was 18 months).In 4 patients the tumor recurred 3, 6, 7 and 8 months after surgery.No side effect and complication was observed either during or after the instillation. Conclusions Early single intravesical epirubicin instillation is markedly effective for preventing the recurrence of superficial bladder tumors after surgical management. Its toxic side effects are mild. This method is of high clinical value.

Objective To evaluate the efficacy of retroperitoneal laparoscopic renal cystectomy.Methods A total of 80 patients with renal cyst were enrolled in this study.Under general anesthesia,the retroperitoneal cavity was established by using water-filled balloon.The renal cyst were exposed by identifying the psoas major muscle.The cysts were unroofed at 5 mm from the edge of the renal parenchyma with electrical claw.Results The operation was completed in all the cases without severe complications.The operation time was 20-100 min(mean 39 min),blood loss was 5-65 ml(mean 20 ml),and hospital stay was 4-11 d(mean 5.6 d).Postoperative pathological examination showed that all the cysts were simple renal cysts.The 80 patients were followed up for 2-24 months(mean 11 months),3 of them were diagnosed as having residual cyst at 2 months after the operation.Conclusion Retroperitoneal laparoscopic renal cystectomy is safe and effective and is superior in mild surgical trauma,quick recovery,and short hospitalization.

Objective To investigate the histologic basis of imaging manifestations on adrenal myelolipoma and evaluate the value of various imaging modalities in diagnosing the tumor.Methods The imaging manifestations and pathological features of 21 cases of adrenal myelolipoma proved by postsurgical pathology were retrospectively analysed.Results Histologically,the myelolipoma presented hematopoietic elements amidst fatty tissue and showed indefinite border.The myeloid tissue was well vascularized and were adherent closely to normal adrenal gland.Both CT and MRI detected a single mass with irregular plaque or streak of bone marrow tissues between fatty components.The capsule of the tumor was not apparent,but rarely it presented an irregular local “capsule”which was composed of adrenal tissue with compression surrounding the tumor.Enhanced-scan found foggy enhancement in fatty tissue and enhancement of bone marrow tissue which made myeloid plaque enlarged and the edge misted.Ultrasonography demonstrated highly echogenic fat-containing ball of adrenal,while intravenous urography only showed translocation and renal axis alteration of homolateral kidney.Conclusion CT scan appears to be the most accurate qualitative modality to demonstrate adrenal myelolipoma while coronal and sagittal section scanning on MRI can make its localization more exact.Ultrasonography is also an important way in detecting the mass whereas intravenous urography and abdominal plain film should not be used to be the qualitative criterion.

Objective To explore the expressions of interleukin (IL)-17A and its receptor IL-17RA in different degrees of malignant gliomas. Methods Fifty patients with glioma were collected in this study. Accordance to the World Health Organization Classification System, patients were classified by malignancy grade, including gradeⅠ(n=12), gradeⅡ(n=18), gradeⅢ(n=13) and gradeⅣ(n=7). The glioma tissue and peripheral blood samples of patients were obtained for detecting the expression levels of IL-17A and IL-17RA mRNA by using immunohistochemistry, quantitative real-time PCR. Western blot assay was used to detect expressions of IL- 17A and IL- 17RA in both the macroscopic (immunohistochemistry) and molecular levels (mRNA and protein). Results Immunohistochemical staining showed that the expression levels of IL-17A and its receptor IL-17RA increased with the increase of the malignant degree of gliomas. The mRNA levels of IL-17A and IL-17RA receptors in peripheral blood were up-regulated with the increasing malignancy grade of glioma (F=8.96, P<0.05;F=10.34, P<0.05). The mRNA levels of IL-17A and IL-17RA in glioma tissues were up-regulated with the increasing malignancy grade of glioma (F=11.21, P<0.05;F=14.11, P<0.05). The protein levels of IL-17A and IL-17RA in peripheral blood and glioma tissues were also up-regulated with the increasing malignancy grade of glioma (in peripheral blood:F=9.90, P<0.05;F=11.80, P<0.05;and in gliomas tissues:F=8.15, P<0.05;F=14.46, P<0.05). Conclusion The expressions of IL-17A and IL-17RA receptor are positively correlated with malignancy grade of glioma. These results provide some reference for clinical diagnosis of malignant gliomas.

Objective To assess the outcomes of modified spiral ileal orthotopic neobladder.Methods From January 1998 to January 2008, 32 patients (all male) underwent radical cystectomy and spiral ileal orthotopic substitution for muscle invasive bladder cancer. A segment of 40 to 45 cm ileal loop was isolated, detubularized, and reconfigured in spiral shape to form a pouch. Bilateral ureters were reimplanted by inserting the 1 cm distal segment into the pouch to form a Split-Cuff nipple.The bottom of the pouch was opened and anastomosed with the urethra (4 stitches). Results There were no perioperative deaths. The mean operative time was 281.2±48.7 min. Blood loss was 545.4±181.9 ml. Twenty cases required a blood transfusion, the mean volume of intraoprative blood transfusion was 430.8±235.9 ml. The average hospital stays were 26.8±9. 7 days. Rate of daytime continence was 93. 7% (30/32) while nighttime continence was 81.3% (26/32). Urodynamic studies were carried out in 23 cases 6 months after surgery. Neobladder capacity at first desire to urinate was 315.0± 33.4 ml(270-420 ml). The maximum neobladder capacity was 490. 3±39.7 ml(350-600 ml).The maximum flow rate (Qmax) was 16.5 ± 5.9 ml/s. Full resting pressure was 22. 5 ± 11.8 cm H2O. Peak voiding pressure was 78.3 ± 14.7 cm H2O. After mean 58. 4 months' follow up (range 22 to 132), 4 cases died of metastasis of bladder cancer. Conclusion Modified spiral ileal orthotopic neobladder is a reasonable option for treating invasive bladder cancer.

Objective To research the effect of GGCX gene on MMP13 in rabbit osteoarthritis cartilage cells and investigate its effect on osteoarthritis cartilage degeneration.Methods Six Japanese big ear rabbits weighted (2.0±0.2)kg were randomly di vided into three groups,each group seted a rabbit as control.Anterior cruciate ligament transection method was used to build osteoarthritis cartilage degeneration model at second,forth,sixth week.Articular cartilage was separated successfully after the model were built,cartilage cells were divided from articular cartilage and cultured in 6-well cell culture plate.Cartilage cells were divided into blank group,negative control group and transfection group.PCR method and Western blot were conducted to detect GGCX and MMP13 expressed at the level of mRNA and protein.Results Compare with blank group and negative control group,the expressin level of GGCX incresed,while the MMP13 expression level dcresed(P＜0.05).Conclusion Over expression of GGCX gene can ob viously decrease the expression of MMP13,it provide experimental basis for osteoarthritis of the in vitro gene therapy.

Objective To investigate the effects of fasudil on expressions of Bcl-2 and Bax in cerebral cortex of model rats with subarachnoid hemorrhage (SAH). Methods Thirty rats were divided into sham operation group, SAH group and SAH+fasudil group, 10 rats in each group. Double injection of blood into occipital cistern method was used for SAH model in SAH group and SAH+fasudil group. In the sham operation group, the blood injection was instead by normal saline. In the SAH+fasudil group, at 30 min after the second injection of blood, rats were administrated with intraperitoneal injection of fasudil at a dose of 3 mg/kg. The general situation, neurological score, TUNEL staining for cortex cell apoptosis, immune histochemical staining and Western blotting assay for Bcl-2 and Bax protein expression were compared 24 h after the operation between the three groups. Results Compared with the sham operation group, rats in SAH group and SAH +fasudil group appeared obvious neurological deficits. The neurological score was significantly lower in SAH group ( 2.68 ± 0.31) than that of sham operation group (5.00±0.00). The neurological score was significantly higher in SAH+fasudil group (3.27 ± 0.35) compared with that of SAH group (2.68 ± 0.31, P<0.05). There was obvious cell apoptosis in SAH group and SAH+fasudil group, and the apoptosis was less in SAH+fasudil group than that of SAH group (P<0.05). The level of Bcl-2 expression was significantly lower in SAH group than that of sham operation group, and Bax expression was significantly higher in SAH group than that of sham operation group (P<0.05). The level of Bcl-2 expression was significantly higher in SAH+fasudil group than that of SAH group, but Bax expression was significantly lower in SAH+fasudil group than that of SAH group (P<0.05). Conclusion Fasudil can improve the neurological damage in rats with SAH, which may be related with the regulation of apoptosis related proteins Bcl-2 and Bax.

The composite material PLGA compounded with β-tricalcium phosphate (β-TCP) was prepared by melt blending method, and the absorbable interface screw was prepared by injection molding process. Prepare PBS buffer that simulates human body, conduct in vitro degradation experiments on interface screws according to relevant national and industry standards, then test and characterize interface screws at different time points for degradation of intrinsic viscosity, average molecular weight distribution, mass loss, mechanical properties and thermal properties. According to the degradation performance-time curve, determine the time node at which the interface screw loses the mechanical properties. In this paper, the in vitro degradation behavior of interfacial screws prepared from PLGA and β-TCP composites was studied in detail, providing a reference and basis for the degradation behavior of absorbable products prepared from PLGA and β-TCP composites.
Humans ; Polyesters ; Materials Testing ; Calcium Phosphates ; Absorbable Implants

ObjectiveTo investigate the serum prostate-specific antigen (tPSA),serum free PSA to total PSA ratio (f/tPSA),prostate volume (PV) and prostate-specific antigen density (PSAD) in early prostate cancer (PCa) diagnosis.MethodsRetrospective analysis was performed on serum PSA values and related test results from 252 cases of BPH patients and 49 patients with PCa.Prostate volume (PV) was measured by transrectal ultrasound (TRUS),and the f/tPSAand PSAD values were calculated.The differences of serum tPSA,f/tPSA,PV,and PSAD between BPH and PCa group were compared,the area under the ROC curve was used to evaluate these four indicators for its diagnostic sensitivity and diagnostic specificity.ResultsThe values of tPSA,PSAD in PCa group were significantly higher than BPH group ( P ＜0.05),while the values of f/tPSA,PV in PCa group were significantly lower than BPH group ( P ＜0.01orP ＜0.05).The ROC area showed that serum tPSA(0.8013),f/tPSA(0.7390),PV(0.5613) had lower diagnosis value than PSAD(0.9214) in early prostate cancer ( PSAD ＞ tPSA ＞ f/tPSA ＞ PV).When the upper limit of normal PSA was set to take 4ng/ml,the sensitivity was 91.49％,diagnostic specificity was 51.05％.When the f/tPSA threshold set to 0.16,the diagnostic sensitivity was 57.78％,diagnostic specificity was 78.72％.When PSAD threshold was set to 0.15,diagnostic sensitivity was 88.24％,diagnostic specificity was 81.52％.ConclusionsPSA,f/tPSA and PSAD are indicators for biopsy or followup in early diagnosis of prostate cancer.In particular,the diagnostic value of PSAD has higher sensitivity and specificity than PSA and f/tPSA in the diagnosis of prostate cancer.

Objective To evaluate the feasibility and clinical efficacy of retroperitoneal laparoscopic partial nephrectomy (RLPN) with individual operation plan in treatment of small renal cell carcinoma (RCC). Methods 98 patients with small RCC who was treated by RLPN from June 2012 to June 2016 were retrospectively analyzed. There were 57 males and 41 females with a mean age of 52 years old (ranging 28 ~ 75 years old). 52 cases were located on the right side while 46 cases were left. The mean tumor size was 3.1 cm in diameter (ranging 0.8 ~ 4.5 cm). 87 patients (A group) were underwent standard RLPN with clamping main renal artery. 7 patients (B group) with exophytic RCC were performed without clamping renal artery, but with separating main renal artery and prepared for possible clamping. 4 patients (C group) with endophytic RCC were performed with clamping renal artery under ultrosound monitoring. The feasibility and outcomes were evaluated by surgical and oncological outcomes. Results 84 cases among A group were underwent standard RLPN successfully, with 2 cases converted to open surgery and 1 case failed to excising tumor completely and converted to laparoscopic radical nephrectomy. The amount of bleeding during operation was 30 ~ 350 ml, average 93 ml, operation time was 70 ~ 245 min, average 127 min, warm ischemia time 20 ~ 42 min, average 26 min. 6 cases among B group were performed successfully without clamping renal artery with 1 case converted to clamp renal artery for 15 min during the operation because of obvious bleeding. The amount of bleeding was 160 ~ 380 ml, average 220 ml, operation time was 85 ~ 215 min, average143 min. 4 cases of C group were all performed successfully, The amount of bleeding was 35 ~ 250 ml, average 85 ml, operation time was 110 ~ 235 min, average 175 min, warm ischemia time 25 ~ 40 min, average 28 min. With a mean follow up of 28 months (ranging 18 ~ 42 months), there was only 1 case of A group occured local recurrence and lung metastases and accepted molecular targeted therapy with Sorafenib. Conclusion RLPN with individual operation plan in treatment of small RCC is safe and effective, the long-term effect of the procedure needs further investigation.