There is remarkable heterogeneity in the history of the bladder cancer,which makes it essential to evaluate individualized prognosis risk of each patient.The Nomograms model is more convenient and accurate than other prognostic models,can provide significantly accurate individualized risk estimations that facilitate management decisions.The Nomograms model has been regarded as the most accurate and discriminating prognosis model to the patient of bladder cancer,and its development has a bright future.While the Nomograms Model has several weakness itself,which would be remedied through more researches and new predictors.Before Nomograms Model can be accepted in practice,we really need better evidence that they improve patient care and outcomes.

Recently,some researches have been focused on prostate stem cell antigen and related cancers.Researches have reveled that prostate stem cell antigen is overexpressed in prostate cancer,bladder cancer and some malignant tumors in digestive system,and is highly associated with tumour genesis and progress.This review is to show the recent researches on association between prostate stem cell antigen and bladder cancer.

Objective To evaluate the different expression level of prostate cell carcinoma antigen (PSCA)mRNA in bladder transitional cell carcinoma(BTCC) and normal bladder tissue,additionally analyse the relationship between PSCA mRNA expression level in BTCC and different rs2294008 (C ＞ T) genotypes and various clinicopathological features,including stage and grade.Methods Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) was performed on 80 BTCC samples and 38 samples of normal bladder mucosal to measure the expression of PSCA mRNA.Genomic DNA were extracted from tumour tissue to sequence to determine the rs2294008 (C ＞ T) genotypes.Results PSCA mRNA expression was detected in all samples (100％).Tumor samples had significantly higher PSCA expression (M =0.22) than normal samples (M =0.12) (P =0.038).PSCA mRNA expression level was positively correlated with advanced histological grade (G1-2 vs.G3,P =0.001).However no significant difference was detected between patients with superficial tumors (Ta or T1) and those with (≥ pT2)muscle-invasive tumors (P =0.250).There was significantly higher PSCA mRNA expression in T allele carriers than CC homozygous (P =0.001).Conclusions PSCA mRNA expression is related to the BTCC and tumor histological grade,however it is unrelated to tumor stages.PSCA mRNA expression level is higher in patients with T allele carriers than CC homozygous,suggesting T allele may increase PSCA mRNA' s expression.

Objective To study the correlation between GSTM1 genetic polymorphism and bladder cancer susceptibility. Methods In a case control study, the GSTM1 genotype was assessed by a PCR based method. 69 patients with transitional cell carcinoma of the bladder and 88 controls matched for age and sex were studied. Results The frequency of GSTM1 null genotype among the bladder cancer patients was 58% compared with 41% among controls(OR=2.0, 95%CI=1.05～ 3.79 ,? 2=4.51, P

Objective To study the clinicopathological features,diagnosis and treatment of carcinoid tumors of the urinary bladder. Methods The clinical,histopathologic data of 4 carcinoid tumors of the urinary bladder were retrospectively analysed.The bladder carcinoid was diagnosed in 3 male patients and 1 female patient with age from 54 to 79 years.All patients were presented with gross hematuria,but with no clinical manifestations of the carcinoid syndrome such as flush,tachycardia,diarrhea.Cystoscopies showed 5 mm?5 mm to 25 mm?30 mm sessile polypoid masses. Results One patient received radical cystectomy followed by radiotherapy,3 patients received partial cystectomy.Two patients died of the tumor metastasis at survival interval 5 years and 3 months,respectively;other 2 patients were still alive 19 years and 8 months following the surgical treatment.Two cases were stage Ⅱ,and other 2 cases were stage Ⅲ.Histologically,tumor cells exhibited strong argyrophilia and electron microscopy revealed characteristic dense-core granules. Immunohistochemical testing showed the cancer cell was positive for chromogranin A and keratin. Conclusions Carcinoid of the urinary bladder is uncommon,the diagnosis depends on histopathological and immunohistochemical tests.Based on the degree of infiltration,size,location,lymph node metastasis,different surgical intervention can be choosed.

Objective To report the author' s experience with the laparoscopic radical nephrectomy and eraluate it's saftey and therapy.Methods The retrospective analysis was performed on 600 consecutive patients undergoing laparoscopic radieal nephrectomy in the author' s institute from March 2004 to March 2012.There were 380 male and 220 female patients with the average age of 55 years (16-84 years).Five hundred and sixty cases and 40 cases underwent retroperitoneal and transperitoneal surgery respectively.The operative time,estimated blood loss,postoperative hospital stay,complications and the time of complete convalesceuce were recorded.Results Thirteen cases were converted to open surgery due to severe adhesion and severe bleeding.The mean operative time was 110 min(70-320 min).The medium estimated blood loss was 90 mL(30-830 mL) and 15 cases required blood transfusion.The mean drainage time was 50 h(36-72 h),the mean time to first oral intake was 23 h (19-43 h) and the mean postoperative hospital stay was 7 d(5.5-10 d).There were 4 patients with severe complication.Conclusion Laparscopic radical nephrectomy is safe and effective.It has been the standard therapeutic modality for localized renal cell carcinoma.

Objective To investigate the risk factors of sexual dysfunction in male patients with obstructive sleep apnea and hypoventilation syndrome (OSAHS).Methods One hundred and twenty-one OSAHS male patients aged 22-50 years were stratified into two groups based on scores on the rating scales of international index of erectile function-5 (IIEF-5).Patients' characteristics and polysomnography data of the sexual dysfunction group (n =56) were compared with that of the normal group (n =65).Continuous positive airway pressure(CPAP) treatment was carried out in some patients with abnormal sexual function.Results There were significant differences between the two groups in body mass index (BMI),history of hypertensive disease and diabetes mellitus,the rise of morning blood pressure,respiratory disturbance index (RDI),the longest apnea time(Tmax),the lowest oxygen saturation(LSpO2),percentage of recording time with oxygen saturation of 90％ or less(T90％),slow wave sleep(S1 + S2) over total sleep time(TST),rapid wave sleep (S3 + S4) time over TST,and rapid eye movement (REM) sleep time over TST in bivariate analysis (P ＜ 0.05).There were statistical significance of the history of diabetes mellitus,slow wave sleep (S1 + S2) over TST,RDI,and LSpO2shown in Logistics regression analysis,and ORs were 2.10 (1.17-5.01),3.52 (1.33-5.97),1.45 (1.08-2.95),and 0.86 (0.67-0.93) respectively (P ＜ 0.05).Moreover,20 OSAHS patients with sexual dysfunction were revaluated after the CPAP treatment in two months,and 14 patients returned to the normal scores.Conclusion The history of diabetes mellitus,slow wave sleep (S1 + S2) over TST,RDI,and LSpO2 were independent risk factors for sexual dysfunction in male patients with OSAHS,and treatment with CPAP could significantly improve sexual function in male patients.

Objective To develop a nomogram which can accurately predict the disease recurrence risk after the transurethral resection of bladder tumor (TURBT) in patients with non-muscle invasive bladder urothelial carcinoma.Methods There were 317 patients in total with newly diagnosed non-muscle invasive bladder urothelial carcinoma from 1998 to 2007 enrolled in this study.The patient's gender,age,smoking history,drinking history,comorbidity of renal failure,time from diagnosis to operation,tumor size,tumor number,tumor grade,and intravesical therapy served as the predictors of the disease recurrence.Every prognosis factor were analyzed and screened through univariate and multivariate Cox proportional hazard regression statistical analysis,and the nomograms that could be used to predict the 3-year and 5-year recurrence probability after the surgery were developed.And the prediction accuracy of the nomogram had been internal validated and calibrated as well.Results Of the 317 patients,the three-year and five-year disease recurrence rates were 36.9％ (117/317) and 43.5％ (138/317),respectively.The patient's gender (RR=0.617,P=0.011),age (RR=1.369,P=0.088),tumor size (RR=1.474,P=0.030),tumor number (RR =1.663,P =0.002),tumor grade (RR =1.880,P =0.000),and comorbidity of renal failure (RR =3.646,P =0.000) had been proved to be the prognosis factors with significantly statistical difference.The predictive accuracy of the nomograms predicting the 3-year and 5-year disease recurrence after the surgery was 75.2％ and 68.3％,respectively.Conclusion The nomograms can provide individualized accurate risk estimations for patients,and therefore it can provide assured proof to formulate the individualizing treatment and follow-up protocol in clinic.

Objective To explore the diagnosis and treatment features of tuberous sclerosis complex associated renal cell carcinoma.Methods A 22-year-old boy with a childhood history of epilepsy and mental retardation presented with a complaint of intermittent painless gross hematuria for the past 2 years.After superselective left renal artery embolization was done twice in the past year, painless gross hematuria was still repeated with 6- 10 months intervals.Physical examination showed retarded face, obesity, visible facial angiofibroma and a ditch fibroma.CT scan showed irregular lesions.The largest cross-section 14.2 cm × 9.0 cm in the left kidney was inhomogeneous enhanced from 45 - 54 HU in the plain phase to 60 - 78 HU in the contrast phase.Filling defect in the left renal vein and multiple fat-density lesions (CT value of -25 - -38 HU) with the largest cross-section 7.2 cm× 5.7 cm in the right kidney were also found in contrast CT scan.The PUBMED and CBM database were reviewed.Results Open retroperitoneal radical left nephrectomy was performed.Pathology showed renal clear cell carcinoma and renal vein thrombosis.There was no tumor recurrence or distant metastasis at 4-month follow-up.Conclusions Tuberous sclerosis complex associated renal cell carcinoma is rarely reported.Timely nephron-sparing surgery is necessary when the diagnosis is established, or radical nephrectomy is also necessary if nephron-sparing surgery is impossible.

Objective To discuss the feasibility of laparoscopic renal surgery following kidney rupture.Methods Two patients with left kidney rupture were treated laparoscopiclly at our institution in the last 4 years. 1 operated 7 days after hemorrhage and another operated immediately. Both of them performed retroperitoneal laparoscopic nephrectomy. Results The operations succeeded, the operating time being 100～120 min, the blood loss 200～300 mL. There were no postoperative complications in all cases. Conclusion Laparuscopic exploration and extirpation offer a viable measure to treat kidney rupture.