The surgical technique of total bladder replacement orthotopic intestinal neobladder has already been a well accepted method for urinary tract reconstruction after cystectomy in woad wide medical center in past 20 yeas.In this review,the update advance and viewpoint in some critical aspects of patients selection,reflux prevention,upper tract safety,continence,oncology safety,specific complications and quality of life were evaluated in the orthotopic bladder replacement.It is possible that the orthotopic bladder replacement become a new gold standard in urinary diversion after radical cystectomy.

Objective To explore the expression of heparanase(HPA)and its correlation with the clinical pathological features and angiogenesis in bladder transitional cell carcinoma.Methods HPA mRNA level was detected with RT-PCR and its protein level was determined by immunohistochemical staining in 68 cases of bladder cancer and 24 cases of adjacent tissues of bladder cancer.Results The positive rate of HPA mRNA was 60.3%(41/68)in bladder cancer,4.2%(1/24)in the adjacent tissues of bladder cancer.The expression of HPA mRNA had statistically significant correlation with pathological stage,clinical staging and lymphonode metastasis(P

Objective To investigate the effect of paliperidone extended-release combined with modified electric convulsive therapy(MECT) on cognitive function in patients with refractory schizophrenia. Methods 30 patients were reviewed with the Wisconsin Card SortingTest (WCST), the Trail Making Test A and B, Digit Span Test (DST), Digit Symbol Substitution Test (DSST) and the Clinical MemoryScale (CMS). Results The time shortened after treatment in the Trail Making Test A and B (P<0.05). There was no significant difference beforeand after the treatment in the other tests. Conclusion Paliperidone combined with modified electric convulsive therapy may inmprovethe memory and attention in schizophrenics.

BACKGROUND: Muscarine receptor plays a key role in adjusting contraction of detrusor muscle cell, and M3R, isoforms of its receptor, can mediate contraction of detrusor muscle cell directly. Ca2+ is the direct factor in stimulating contraction of detrusor muscle cell. Of several 10 kinds of Ca2+conjugable receptors protein, Ca2+ conjugated with different receptor proteins can adjust various reactions.OBJECTIVE: To investigate the effect of Ca2+-calmodulin (Ca2+-CaM) on contraction of M3R-mediated detrusor muscle cell.DESIGN: Compared observation .on the basis of detrusor muscle cell.SETTING: Ourological Center of Southwest Hospital of the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was completed at Central Laboratory of Southwest Hospital of the Third Military Medical University of Chinese PLA. Healthy Wistar rats were selected in this study.METHODS: The primary cultured detrusor muscle cells were divided into experimental group and control group. Cells were inoculated in 6-well plate, and 10-4 mmol/L carbachol and M2R antagonist were added to cells of the experimental group during 70% confluence to block M3R and M2R respectively. Ca2+ concentration and CaM activity were detected by Ca2+ test kit and CaM test kit respectively.MAIN OUTCOME MEASURES: Changes of [Ca2+]I concentration and CaM activity of cells in both groups.RESULTS: The mean channel fluorescence values (log) of [Ca2+]I and CaM were higher in the experimental group than those in the control group(3.26±0.38, 2.06±0.12; 2.87±0.34, 2.14±0.24, P ＜ 0.05).CONCLUSION: Results in this study suggest that Ca2+-CaM participates in adjusting contraction of M3R-mediated detrusor muscle cells through signal transduction.

Objective To study the safety and efficacy of transurethral resection of bladder tumor(TURBt)under block anesthesia of bilateral obturator nerves.Methods Seventy-seven patients were chronologically divided into two groups.Forty-six of patients with lateral,bilateral or multiple tumors in the bladder,which underwent transurethral resection of bladder tumor under epidural anesthesia from April 2003 to October 2004,were chosen as the Control Group.Thirty-one patients whom were administrated with epidural anesthesia plus bilateral block of the obturator nerve from October 2004 to July 2005 served as the Study Group.Incidences of bladder perforation and obturator nerve reflex were compared between the two groups.Results In the Control Group,obturator nerve reflex occurred in 25 patients(including intense reflex in 11 patients),giving an incidence of 54.3%(25/46),and bladder perforation resulted from the reflex was observed in 8 patients,with an incidence of 17.3%(8/46).In the Study Group,slight obturator nerve reflex happened in 3 patients(9.9%,3/31)and bladder perforation was found in 1 patient(3.2%,1/31).A significant higher rate of obturator nerve reflex was noted in the Control Group than in the Study Group(?2=15.970,P=0.000),but no statistical difference was seen in bladder perforation rate between the two groups(?2=2.359,P=0.125).Conclusions Bilateral block of the obturator nerve can improve the safety remarkably during transurethral resection of bladder tumor,especially when the tumor was located in the lateral bladder wall.

Objective:To establish a simple and efficient clinical prediction model of moderate and severe obstructive sleep apnea hypopnea (OSAHS) in snoring patients based on the clinical data and morphological measurement data in order to increase the early diagnosis and then early intervention of OSAHS. The prediction model is evaluated by external validation.Methods:A total of 299 subjects from January 2015 to December 2018 were selected to perform polysomngraphy (PSG) in Yangpu Hospital, Tongji University School of Medicine. According to the PSG results, they were divided into moderate and severe OSAHS groups (143 cases) and control groups (156 cases). Clinical complications data and morphological measurement data were collected. The regression equation and ROC curve were established according to the Logistic regression method. Then, another 110 subjects from January 2019 to October 2019 were chosen as verified data group, and used to verify the accuracy of the prediction model. The data of 110 subjects were put into the equation according to risk factors and assignment. The ROC curve was drawn and the area under the curve was calculated. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated.Results:The predicted equation was: y = -10.707 86+0.589 60 × sex+ 0.141 61 × BMI+ 1.281 62 × tonsil size degree+ 1.807 43 × modified Mallampati degree′tongue position. The AUC of the ROC curve of prediction model in training set was 0.851(95% CI 0.807-0.895), the sensitivity was 83.9%, the specificity was 79.5%, and the cut-off value was 0.634.The AUC of the ROC curve in validation set was 0.827(95% CI 0.751-0.904) with a sensitivity of 73.3% and a specificity of 86.0%, and an accuracy of 79.1%. Its positive predictive value was 5.238, and negative predictive value was 0.310. Conclusions:The predictive model constructed by the combination of clinically accessible data (sex) and morphological measurement (BMI, tonsil size degree, modifiedMallampatidegree) has a relatively high predictive efficiency for screening snoring patients with moderate and severe OSAHS. The predictive model is proved with good forecast accuracy by the external verification method.

OBJECTIVETo study the effects of tunicamycin (a glycosylation inhibitor) combined with cisplatin on the proliferation and apoptosis of human nasopharyngeal carcinoma cells and explore the molecular mechanism.

METHODSNasopharyngeal carcinoma CNE-1 and CNE-2 cells cultured in vitro were treated with different concentrations of tunicamycin with or without cisplatin. The inhibition of cell proliferation was examined using MTT assay and colony formation assay, and the cell apoptosis was analyzed using flow cytometry with propidium iodide staining. The expressions of Bax, Bcl-2, and GRP78 in cells treated with 3 µmol/L tunicamycin with or without 6.00 µmol/L cisplatin were measured with Western blotting.

RESULTSTreatment with tunicamycin or cisplatin obviously inhibited the proliferation of CNE-1 and CNE-2 cells. Treatment with 3 µmol/L tunicamycin for 24, 36 and 48 h resulted in a viability of 72.13%, 51.97%, and 37.56% in CNE-1 cells and 85.61%, 56.95%, and 43.66% in CNE-2 cells, respectively, and the combined treatment with 6 µmol/L cisplatin lowered the cell viability to 67.97%, 47.76%, and 34.68% in CNE-1 cells and 56.89%, 37.05%, and 29.30% in CNE-2 cells, respectively. Tunicamycin at 0.3 µmol/L combined with 0.6 µmol/L cisplatin showed an obviously enhanced inhibitory effect on colony formation of CNE-1 and CNE-2 cells. Tunicamycin treatment (3 µmol/L) of CNE-1 and CNE-2 cells for 48 h induced an apoptosis rate of only 8.89% and 8.67%, but when combined with 6 µmol/L cisplatin, the cell apoptosis rate increased to 37.02% and 32.25%, significantly higher than that in cells with cisplatin treatment alone (7.25% and 6.36%, respectively). Compared with tunicamycin and cisplatin alone, the combined treatment significantly increased Bax expression and decreased Bcl-2 expression in the cells; tunicamycin up-regulated the expression of GRP-78 and enhanced the activity of caspase-3.

CONCLUSIONTunicamycin can inhibit the proliferation of CNE-1 and CNE-2 cells and enhance cisplatin-induced cell death, the mechanism of which may involve excessive endoplasmic reticulum stress response and increased activity of caspase-3.

Apoptosis ; drug effects ; Carcinoma ; Caspase 3 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cisplatin ; pharmacology ; Endoplasmic Reticulum Stress ; drug effects ; Heat-Shock Proteins ; metabolism ; Humans ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Tunicamycin ; pharmacology ; bcl-2-Associated X Protein ; metabolism

OBJECTIVETo investigate the effect of low-molecular-weight heparin (LMWH) combined with paclitaxel (PTX) on the invasiveness and migration of nasopharyngeal carcinoma cells and explore the molecular mechanisms.

METHODSMTT assay was used to detect the growth inhibition induced by LMWH and PTX in CNE1 and CNE2 cells. Wound healing assay and Transwell migration assay were employed to assess the effects of the drugs on the cell migration, and Transwell invasion assay was used to evaluate the cell invasiveness. The cellular expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) were analyzed by Western blotting. ELISA was used to determine the expression of heparanase (HPA) in the culture medium of the cells.

RESULTSMTT assay showed an obvious suppression of CNE1 and CNE2 cell proliferation in response to LMWH and PTX treatments. Treatment with 200 U·ml LMWH combined with 0.1 µmol·L PTX for 24 h resulted in the inhibition rates of migration of 66.70% and 70.53% in CNE1 and CNE2 cells, respectively significantly higher than the rates in cells with PTX treatment alone. The combined treatment with LMWH and PTX for 24 h also caused a significantly higher inhibition rate of cell invasion than LMWH and PTX alone. LMWH enhanced the down-regulation of MMP-9 and HPA induced by PTX.

CONCLUSIONLMWH can enhance the inhibitory effect of PTX on the migration and invasion of nasopharyngeal carcinoma cells, the mechanism of which may involve the down-regulation of MMP-9 and HPA expressions.

Carcinoma ; Cell Line, Tumor ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Glucuronidase ; metabolism ; Heparin Lyase ; metabolism ; Heparin, Low-Molecular-Weight ; administration & dosage ; pharmacology ; Humans ; Matrix Metalloproteinase 9 ; metabolism ; Nasopharyngeal Neoplasms ; pathology ; Paclitaxel ; administration & dosage ; pharmacology ; Tissue Inhibitor of Metalloproteinase-1 ; metabolism

Objective To investigate the therapeutic effect of post-traumatic complex posterior urethral stricture in the male patients.Methods Clinical data of 479 male patients with post-traumatic complex posterior urethral stricture were reviewed.One-stage resection of the stenosis and end-to-end anastomosis was performed in 422 patients and scrotal flap with blood pedicle posterior urethroplasty in 57.Results The mean operation time was 115 minutes(range,90-140 minutes).The mean blood loss was 225 ml(range,100-300 ml).No intraoperative blood transfusion was needed.The mean follow-up time was 15 months(range,12-24 months).Among the 422 patients performed end-to-end anastomosis,386 patients had good voiding and 36 had dysuria because of the formation of anastomotic stoma valve(21 patients)or stricture ring(15 patients).The problem was resolved by transurethral valve/stricture ring resection.Among 57 patients undergone posterior urethroplasty,45 patients had good voiding nine patients were found with anterior urethra-skin tube anastomotic stoma stricture,of which four patients were treated by urethral dilatation and five by endourethrotomy; three patients were found with posterior urethra-skin tube anastomotic stoma stricture,of which one patient was treated by urethral dilation and two by endourethrotomy.Conclusions One-stage resection of the stenosis and end-to-end anastomosis is the main treatment for post-traumatic complex posterior urethral stricture.If the condition of the patients does not allow the end-to-end anastomosis,posterior urethroplasty can be an alternative.

Objective To observe the effect and safety of the aversion therapy with furazolidone on patients with alcohol dependence.Methods 90 patients with alcohol dependence were randomly divided into the aversion therapy group and the control group with 45 cases in each group. The cases of the aversion therapy group were treated by aversion therapy with furazolidone and those of the control group were treated with routine therapy. The changes of the blood pressure, pulse and respiratory rate before and after drinking were observed and the rate of successful abstinence in one year was investigated.Results The effect of the aversion therapy group treated with furazolidone was significantly better than that of the control group ( P<0.05). The aversion therapy was safe.Conclusion The aversion therapy with furazolidone is more effective and safe.