Objective: To investigate the differential expression of matrix metalloproteinases-1 / tissue inhibitor of metalloproteinase-1 (MMP-1/TIMP-1) between normal kidney,kidneys of patients with autosomal dominant polycystic kidney disease(ADPKD),and the original kidneys after renal transplantation(OKRT).Methods: DNA microarray technique was used to analyze the differential gene expression in the above 3 tissues.Semi-quantitive RT-PCR was performed to verify the differentially expressed genes.Results: There were 463 differentially expressed genes between normal kidney and ADPKD tissues and 130 differentially expressed genes between ADPKD and the OKRT tissues.Expression of MMP1/TIMP1 in the ADPKD and the OKRT tissues were significantly higher than that in the normal kidney tissue(P

Objective:To investigate the influence of sirolimus on the disease progression of a rat model of autosomal dominant polycystic kidney disease(ADPKD)-HanSPRD with chronic renal insufficiency.Methods: Twenty 6-month-old male ADPKD heterozygous(Cy/+) rats with chronic renal insufficiency were divided into 2 groups at random(n=10).Rats in experimental group received intragastric administration of sirolimus(0.2 mg?kg~(-1)?d~(-1)) for 45 days and those in control group were bred routinely.The general state and renal function of rats were monitored throughout the treatment.The rats were sacrificed 45 days later and both kidneys were harvested,weighed;and the 2-kidney/total body weight(2K/TBW) ratio was determined.Then the kidneys were subjected to immunohistochemistry examination and the numbers of cells positive of proliferating cell nuclear antigen(PCNA) were counted.Results: There was no death in the 2 groups and all rats gained weights,with no significant difference between the 2 groups.Blood urea nitrogen(BUN) increased progressively in both groups,with the increase in experimental group lower than that in the control group by 12.5% on 45 days after administration(P

Problem-based learning(PBL) teaching mode was applied in Urology practice of the medical students.The externs were organized to analyze and discuss a real case,having grasped enough knowledge of relative diseases,and to provide their advice about the diagnosis and treatment,changing question mark into a full stop.And then their conclusions were verified by post-operational follow-up.PBL teaching mode can increase the students'study motivations and interests and the ability to resolve practical problems,master medical knowledge,train their clinical thinking and enhance the quality of teaching and thus it is an effective teaching mode.

Objective To study the anatomic relationship between the thoracic transverse process and adjacent bony structures and its clinical significance for thoracic screw fixation.Methods The present anatomic measurement used 45 dry cadaveric specimens of the normal adult thoracic vertebrae.We measured the distances from the horizontal midline of the transverse process to the superior,middle and inferior margius of the pedicle,the height of the anterolateral transverse process sheltered by ribs,and the position at the horizontal midline of the transverse process corresponding to the vertebral body.Results The horizontal midlines margius of the transverse processes of T1 to T10 are localized in the plane ranging from the superior to the inferior margins of the pedicle.The midlines of the transverse process are closer at T6 and T7 while more apart at T9 and T10.From T1 to T8,the anterolateral transverse process is totally or mostly sheltered by ribs,but the shelter is much less at T9 and T10.The horizontal midline of the transverse process corresponds to the upper 1/3 or middle 1/3 of the vertebral body.Conclusion Thoracic screw fixation across the transverse process to the vertebral body is safe,reliable and feasible in clinic.

Objective:To prepare pioglitazone hydrochloride ( PGH) sustained-release pellet capsules and study the in vitro disso-lution. Methods:The preparation was prepared with a bottom spray fluidized bed, and the formula and technology were optimized by orthogonal test. Results:The method was simple and easy to operate, the reproducibility of the formula and technology was good, and the pellets had obvious sustained-release property. Conclusion:The formula and technology are easy and controllable, and the stability of sustained release pellets is good.

Objective To evaluate the efficacy of retroperitoneoscopic radical nephrectomy.Methods From October 2001 to September 2006,a total of 108 patients underwent retroperitoneoscopic radical nephrectomy in our department.The tumors sized 1.0-8.0 cm in diameter with a mean of(4.3?2.9)cm.Before the operation,42 patients were in stage T1N0M0,54 in stage T2M0N0,and 12 in stage T3aN0M0.Results The operation time was 35-180 min with a mean of(63.5?30.3)min,and the blood loss was 20-1500 ml [mean,(75?23)ml].Totally 3 patients were converted to open surgery.The intra-and postoperative complications included hemorrhage caused by the injury of the inferior vena cava or renal artery(4 cases),wound infection(3 cases),and hypercapnia(8 cases).The patients were followed up for 6-36 months(over 12 months in 61 cases),during which 2 patients died of pulmonary metastasis one year after the surgery,1 patent died of liver metastasis 7 months after postoperation,the other 105 patients survived without tumor.The 1-year survival rate was 98.4%(60/61);and 3-year survival rate was 85.7%(18/21).Conclusions Retroperitoneoscopic radical nephrectomy is mini-invasive and effective for renal carcinoma.The patients recover quickly after the surgery.The procedure is worth being wildly used.

Objective:To study the differential gene expression pattern between autosomal dominant polycystic and normal kidney tissue,and to deduce the etiological factor and treatment for autosomal dominant polycystic kidney disease(ADPKD).Methods: The cDNA probes were prepared by labelling normal kidney tissue mRNA and ADPKD tissue mRNA with Cy3-dUTP and Cy5-dUTP separately through reverse transcription.The probes were then hybridized with the DNA microarrays(PCR products of(4 096) human cDNAs onto specially treated glass slides) and the fluorescent signals were scanned with ScanArray 4000 scanner.Semi-quantitive RT-PCR was performed to test the expression level of 4 related genes.Results: Of the 4 096 genes screened,463 genes showed obvious changes.Expression of 206 genes was upregulated in the polycystic kidney tissue,especially cyclin D_(2),MMPs,TIMP1 and fibroblast activation protein;expression of 257 genes was downregulated,especially phosphatase 1A and acid phosphatase 1.The expression of genes tested by RT-PCR was in accordance with those detected by cDNA microarray.Conclusion: ADPKD may be related to the upregulation of cyclin,MMPs,and various kinds of growth factors,and drugs like inhibitors of CaM and MMPs might have therapeutical effects on ADPKD.

ObjectiveTo study the outcome of renal transplantation in polycystic kidney disease (PKD) and its influencing factors.MethodsFrom 1978 to 2002, 46 PKD patients undergoing renal transplantation (PKD group) and 46 cases of other diseases (non-diabetic nephropathy;control group) were retrospectively analyzed. Patient/renal survival rate (1, 3 and 5 years after re nal transplantation) and postoperative complications were evaluated.ResultsA comparable overall patient (1, 3 and 5 years: 95.7?% , 91.3?% , 91.3 ?% PKD vs 97.8?% , 95.7?% , 93.5?% controls) and transplant sur vival rate (1, 3 and 5 years: 93.5?% , 89.1?% , 87.0?% PKD vs 95 .7?% , 89.1?% , 87.0?% controls) was found in both groups. Infectious complications with the exception of urinary tract infections (UTIs: PKD 43.4 ?% vs 10.9?% ) were diagnosed in similar frequency in the graft recipien ts. PKD patients were significantly more affected by UTIs than the control group (P

BACKGROUND:Pathological examination and MRI have been widely used in clinic, but their combination is rarely reported in discrimination of early spine infections.
OBJECTIVE:To determine the accuracy of pathology and MRI for discrimination between early pyogenic spondylitis and brucella spondylitis.
METHODS:Twenty-two patients with pyogenic spondylitis and 20 patients with brucella spondylitis who had CT-guided percutaneous biopsy and MRI of the spine were retrospectively reviewed. Pathological observations included structure and activity of bone lesions, tissue cells and their main components;MRI observations included signal and sign changes at lesion sites. Statistical analysis was performed with the chi-square test.
RESULTS AND CONCLUSION:The patients with pyogenic spondylitis had a significantly higher incidence of pathological and MRI findings as fol ows (P<0.05):neutrophil infiltration;intervertebral disc abnormal signal, location of vertebral body lesions anterior+posterior, obviously shape change in the vertebral body, paraspinal abnormal signal, presence of intraosseous or paraspinal abscess. Pathological and MRI examination was accurate for early differentiation of pyogenic spondylitis from brucella spondylitis.

BACKGROUND:The reasons for spinal imbalance include spinal deformity, spinal degenerative disease osteoporotic vertebral compression fractures. We believe that the power factor (back muscle) plays a key role in spinal sagittal imbalance. OBJECTIVE:To analyze the reasons for spinal sagittal imbalance by observing clinical manifestations and therapeutic outcomes in patients with osteoporotic vertebral compression fractures. METHODS:A total of 41 patients with osteoporotic compression fractures combined with spinal sagittal imbalance were retrospectively analyzed from January 2012 to May 2013. Al patients were subjected to percutaneous bal oon vertebroplasty under local anesthesia. Before treatment, they received bone density, standing ful-spine lateral X-ray, CT and MR imaging with injured vertebrae as the center. Using standing ful-spine radiographs, the height of anterior border of the injured vertebrae, Cobb angle of kyphosis and improved angle, wedging angle of the injured vertebrae and improved angle were measured. The patients underwent weight loading test and walking test. Preoperative and postoperative data were compared. RESULTS AND CONCLUSION:The patients affected spinal sagittal imbalance symptoms, so the walking distance was significantly shorter than that postoperatively (P<0.05). Moreover, the time of weight loading test was significantly shorter than that postoperatively (P<0.05). In standing ful-spine radiographs, the average difference of Cobb angle was (10.01±0.76)°. The mean difference of vertebral wedging improvement was (4.84±0.40)° (P<0.05). Al patients were fol owed up. Low back pain and sagittal imbalance symptoms were relieved. No severe complications appeared after percutaneous bal oon vertebroplasty. Results indicated that patients with osteoporosis compression fractures can affect the symptoms of spinal sagittal imbalance, which is not only induced by wedging of the injured vertebra. In addition, after percutaneous bal oon vertebroplasty, imbalance symptoms are apparently improved, suggesting that back pain after spinal fracture limits back muscle strength and is an important cause for spinal sagittal imbalance.