Objective To investigate the clinical significance of the rate of spontaneous apoptosis and the expression of p27kip1 in transitional cell carcinoma of bladder (BTCC). Methods Immunohistochemical analysis of p27kip1 was performed on paraffin embedded tissue sections in 50 cases of BTCC, by immunohistochemical method S-P. The terminal deoxynucleotidyl transferase- mediated dUTP- biotin nick end labeling (TUNEL) was used to examine the level of apoptotic cells in 50 cases of BTCC. Results In BTCC, the spontaneous apoptosis index AI was (3.0?1.5)%, the positive rate of p27kip1 was 58.0 %(29/50). Both of them decreased with the escalation of the clinicopathologic grade and stage. The positive expression of p27kip1 protein were significantly associated with higher spontaneous apoptosis (P

Micrometastasis are frequently accompanied by the majority of cases of invasive malignant tumor, being a compacted relationship with the prognosis of patients. We should pay more attentions to the occurrence of micrometastasis in the diagnosis and management of carcinoma of urinary bladder, which is the most commonly diagnosed malignancy in urinary system and a significant cause of morbidity and mortality.This article introduces the diachronic concept of micrometastasis and the major methods for the detections of micrometastasis, moreover,it reviews recent advances about the detection of micrometastasis in bladder cancer, and about the benefits that patients of the disease might have received in the treatment of micrometastasis.

Objective To evaluate transurethral endosco pic management of 15 cases of ureterocele encountered between 1990 and 2000. Methods All the medical documents were reviewed and analyse d. Results The diagnosis of all the cases was establishe d on IVU,ultrasonography and endoscopy.Transurethral incision of ureterocele was undertaken for 6 cases,and transurethral unroofing for 9.All the patients have been followed up for 6～36 months with the hydronephrosis abated.No vesicoureter al reflux has been noted. Conclusions Transurethral inte rvention of ureterocele is simple and effective rendering minimal trauma to the patients.Transurethral unroofing is an effective means to treat ureterocele.

Objective To make the surgical therapy of urethral stricture and occlusion more effective. Methods 154 patients treated in our hospital were included in this retrospective study,of these cases,40 cases were in anterior urethra and 114 in posterior part.Based on etiology,106 cases were from trauma,15 from infection and 33 from idiopathic causes.Open surgery was performed on 34 cases and endoscopic therapy on 120 cases. Results All of the anterior urethral cases were treated successfully,among them,18 cases were with open surgery and 22 with endoscopic surgery.Normal urination was achieved on the follow-up from 6 months to 12 months.Within posterior urethral stricture and occlusion situation,open surgery was in 16 cases with 10 cases of normal urination and endoscopic surgery in 98 cases with 92 cases of normal urination.6 cases with open surgery and 5 cases with endoscopy resulted in postoperative dysuria or anuria.Urethral stricture and occlusion were shown in all these unsuccessful operation according to our urethrogram. Conclusions Good result can be achieved by both open and endoscopic surgery in anterior urethral stricture.In case of posterior urethral condition,endoscopic procedure is the best choice.

Objective To evaluate the efficacy of preoperative and postoperative intravesical instillation of pirarubicin for the prevention of postoperative recurrence of non-muscle invasive bladder cancer (NMIBC). Methods From September 2012 to March 2014, 120 patients who were diagnosed as NMIBC and accepted trans-urethral resection of bladder tumor (TUR-Bt) were collected and randomly divided into two groups, including treatment group (60 cases) and control group (60 cases). 30 minutes before the operation, instillation of pirarubicin (40 mg) was performed in the treatment group, then pirarubicin perfusion was given within 24 h after operation, once a week for 8 weeks, and once a month for 10 months after operation. In control group, instillation of pirarubicin (40 mg) was given within 24 h after operation, and other treatments were the same as the treatment group. The differences of lesion detection probability, the 2-year recurrent rate and the adverse reaction rate were compared between the two groups. Results The lesion detection rates were 42.70 % (38/89) and 1.85 % (2/108) in the treatment group and control group, respectively (χ2=50.303, P<0.05). 119 patients were follow-up for 24 months. The 2-year recurrence rates were 8.47%(5/59), 21.67% (13/60) in treatment group and control group respectively (χ2= 4.033, P< 0.05). The adverse reactions mainly included hematuria (3 cases in treatment group, 3 cases in control group), urinary tract irritation (3 cases in treatment group, 2 cases in control group) and urethral stricture (1 case in treatment group, 1 case in control group). The difference of the adverse reaction incidence between the two groups was not significant statistically [11.86 % (7/59) vs. 10.00 (6/60), χ 2 = 0.106, P > 0.05]. Conclusions The preoperational intravesical instillation of pirarubicin can fix and diagnose malignant lesions in the bladder without adverse reactions, which will improve the rate of tumor resection and prevent postoperative recurrence of tumors.

Objective To investigate the safety and feasibility of barbed absorbable suture line in retroperitoneoscopic partial nephrectomy. Methods 45 patients who were suitable for retroperitoneoscopic partial nephrectomy from February 2013 to February 2014 were collected and randomly divided into V-Loc group and the control group. 23 cases of V-Loc barbed absorbable suture line were chosen by suture kidney in V-Loc group.There were 22 cases of coated vicryl plus antibacterial suture and Hem-o-lok clip in the control group. The differences of operative time, blood loss, warm ischemia time, suture time, hospital stay and suture material costs were compared respectively between the two groups. Results All 45 cases of retroperitoneoscopic partial nephrectomy were successfully performed, without conversion to open surgery and important intraoperative complications. Postoperative pathology report showed that there were 37 cases with renal clear cell carcinoma, 3 cases with papillary renal cell carcinoma, 2 cases with chromophobe renal cell carcinoma with negative surgical margin, 3 cases with renal angiomyolipomas. In the V-Loc group and the control group, the average operative time were (90.8±9.6) and (96.9±9.1) min (P>0.05), the mean blood loss were (80.4±24.2) and (99.5±24.8) ml (P>0.05), the mean warm ischemia time were (21.5±3.4) and (25.3±1.9) min (P<0.05), suture time were (10.8±1.7) and (16.8±3.1) min (P<0.05), respectively, postoperative hospital stay were (5.7±1.7) and (7.1±1.9) d (P>0.05), the average cost of renal parenchymal suture material were (1 215.5±101.4) and (2 073.5±301.8) yuan (P<0.05). The warm ischemia time,suture time and suture material costs in the V-Loc group were significantly lower than those in the control group (all P<0.05). Conclusion The application of barbed absorbable suture line in retroperitoneoscopic partial nephrectomy can shorten warm ischemia time and suture time, and save hospitalization costs, with favorable safety and feasibility.

Objective To evaluate the efficacy and feasibility of 125I radioactive seed interstitial implantation for the local advanced urinary tract epithelial carcinoma without total resection.Methods The clinical data of 21 patients with local advanced urothelial carcinoma without completely surgical resection who were treated by 125I radioactive particles implantation were retrospectively analyzed.The patients were divided into two groups and received preoperative plan.In group A, 14 patients received implants during operations, including 7 bladder transitional cell carcinoma patients who underwent a transurethral resection surgery or partial bladder resection and another 7 ureteral carcinoma cases who underwent semi urine road resection.After these operations, all of patients had tumor residues.After furthest resection of the tumor, the 125I seeds were implanted at the residual suspicious tumors and their surroundings.In group B, 7 patients were implanted under the guidance of color ultrasound or CT.According to the evaluation criteria of solid tumor in 2009, the tumor remission rate, survival rate, distribution and the mobile information of the particles were observed.Results The operations were successfully completed in all of 21 patients, and serious complications did not appear during the operation.Particle distribution and lesions were basic coincidence.A total of 2 particles displaced, but every patient had no adverse reactions.There were 2 patients with local fever after operation within 4 months, while the rest of patients had no adverse reactions.After median follow-up for 36 months (3-75 months) , the 1-year survival rate was 100.0 ％ (21/21), the 2-year survival rate was 90.5 ％ (19/21), and the 3-year survival rate was 61.9 ％ (13/21).The tumor remission rate of group A was 85.7 ％ (12/14) after 6-9 months, and was 42.9 ％ (6/14) after 12 months.The bladder was preserved in 7 cases with bladder tumors with the 2-year survival rate of 100.0 ％ (7/7) and the 5-year survival rate of 71.4 ％ (5/7).The tumor remission rate of group B after 6-9 months was 71.4 ％ (5/7), and was 42.9 ％ (3/7) after 12 months.Conclusion 125I seed implantation is a good choice for locally advanced urothelial carcinoma with high local tumor control rate, which is expected to be applied in the individual treatment of advanced urothelial cancer.

Objective To observe hematoxylin's cytocidal and apoptosis-inducing effects on human urinary cancer cell-T24,and its cytocidal mechanism to the target cell.Methods Target cells were incubated in the medium 1640 for 24h,which contained hematoxylin in dosage of zero(blank),12.5,25,50,100,200μg/ml,respectively;under inverted microscopy to observe target cells'morphologic change,and then harvest them;by trypan blue tmpochrome method to determine hematoxylin's cytocidal activity to the target cells;by flow cytomelry to detect the effects of hematoxylin in its different levels on target cells'apoptosis.Results The control group(without hematoxylin)showed their target cells in a fusiform adherent growth,plump,close-arranged,and with a good transparence.With the addition and increment of hematoxylin,target cells turned round,not adherent,pyknotic,with a bad transparence,as well as chromatin condensation,the cells clumped.Cell death rate of control group was(2.63±0.29)%,with the increased dosage of hematoxylin the cell death rate of test groups was(10.00±4.82)%,(21.88±3.42)%,(76.41±4.82)%,(92.27±6.54)%,and(96.34±8.70)%respectively.Flow cytometry showed cell apoptosis rate in control group was 0.47%(occurred spontaneously),but hematoxylin in dose of 50μg/ml made the apoptosis rate increased markedly,to 43.1 8%,dead cell rate 48.47%,and survival cell rate 8.35%.With the increased hematoxylin dose,cell apoptosis rate decreased gradually,while dead cell rate increased.Conclusion Hematoxylin can inhibit the target cell by two routes:to induce apoptose or kill it.In a lower dose it is able to induce target cell to apeptose;hematoxylin in a dose over 100μg/ml can directly kill the target cell.Making this trial for checking the cell's morphologic changes benefits determining the optimal dosage level and optimal acting duration for the apoptosis induction.

Objective To evaluate the clinical value of transrectal ultrasound-guided 10 cores plus fixed-point prostate biopsy for diagnosing prostate cancer.Methods The serum PSA level of 181 patients were determined with ELISA.AU the patients underwent 10 cores plus fixed-point prostate biopsy under the guidance of transrectal ultrasound.Resuits 80 cases with prostate cancer(44.2%),63 cases with benign prostatic hypertrophy (34.8%),36 cases with prostatitis(19.9%),1 cage with tuberculosis(0.6%),and 1 cage with prostate leiomyoma(0.6%).When PSA WaS more than 20 μg/L,the incidence rate of prostate cancer was significantly higher than other PSA levels.Meanwhile,Gleason scores were increased with the advance of PSA levels (P＜0.001).Conclusion Transrectal ultrasound-guided systematic 10 cores plus fixed-point prostate biopsy could significantly enhance the prostate cancer detection rate, and it was important in diagnosing prostate cancer for patients,especially when PsA was more than 20 μg/L.

Objective To study the expression of NF-κB and COX-2 protein in renal cell carcinoma, and to investigate the clinical value of it in the occurrence, progression and metastasis of renal cell carcinoma as well as the prognosis of patients. Methods 48 cases of renal cell carcinoma tissues and 5 cases of normal renal tissues were detected by using immunohistochemical method, and following up the patients who were included in the study. Then we analyzed the relationship between NF-κB and COX-2 protein level and clinic pathological parameters as well as the prognosis of patients. Resalts The expression of NF-κB and COX-2 protein were increasing in renal cell carcinoma, the protein levels were significantly different compared with that in normal renal tissues(P <0.05). There were significantly positive correlation between the expression of NF-κB protein and the clinic stages of renal cell earcinoma(P <0.05), but no correlation between the expression of COX-2 protein and them(P >0.05). There were significantly negative correlation between the expression of COX-2 protein and the pathological grades of renal cell careinoma(P <0.05), but no correlation between the expression of NF-κB protein and them (P>O.05). The survival rate of these patients whose expression of NF-κB protein were positive was significantly lower than those of negative expression of NF-κB protein(P <0.05), and there was opposite result for COX-2, but not significanfly(P >0.05). The expression of NF-κB and COX-2 protein in renal cell carcinoma had no significant correlation (P >0.05). Conclusion There may be relationship between the expression of NF-κB and COX-2 protein and the occurrence, progression of renal cell carcinoma, the expression of NF-κB may also have association with metastasis of renal cell carcinoma as well as the prognosis of patients. Detecting the expression of NF-κB and COX-2 protein may be useful in early diagnosis of renal cell carcinoma as well as prognosis evaluation of patients.