Objective To investigate essentiality of bone scintigraphy in patients with renal cellcarcinoma.Methods The clinical data of 152 patients with confirmed renal cell carcinoma from Jan uary 1999 to June 2007 were retrospectively analyzed.There were 106 men and 46 women with a meanage of 56 years (range 11-86 years).The tumor size was 1.5-20.0 cm (mean 6.0 cm).Accordingto the TNM and AJCC staging classification,88 patients had stage I,included of T1a in 47 cases,T1bin 41; 38 had stage Ⅱ; 16 had stage Ⅲ,included of T3a,in 10 cases,T3b in 6; and 10 had stage Ⅳ.Histological grade was well differentiated in 90 cases,moderately in 43,poor in 19.Ten clinical pa thology factors were evaluated by Logistic analysis to present the significant factors related to osseousmetastatic lesions.Results Overall osseous metastatic lesions were present in 22 of the 152 patients(14.5%).Of the 126 patients with clinically localized,11 cases (8.7%) had osseous metastatic le sions.Of the 16 patients with clinically advanced,5 eases (31.2%) had osseous metastatic lesions.Ofthe 10 patients with metastasis,6 cases(60%) had osseous metastatic lesions.Clinical stage was re lated to osseous metastatic lesions by Logistic analysis.The incidence of osseous metastatic lesionswas 40.9% in localized renal cell carcinoma patients with bone pain.Conclusions Bone seintigraphymay be omitted in patients with clinically localized renal ceil carcinoma(stage Ⅰ,Ⅱ) unless bone pain is pres ent.Bone scintigraphy should be performed in patients with stage Ⅲ or Ⅳ regardless of symptoms.

Object To study chemical constituents of the root of Isatis indigotica Fort Methods The powdered plant material was percolated with 95% ethanol, the percolate was extracted with different solvents, the extract was subject to chromatography on silica gel column and macroporous resin column. The compounds were identitfied by their physicochemical properties and spectral data (MS, 1HNMR, 13 CNMR, UV and IR) Results Two compounds were obtained from the ethanol extracts of the plant root They are 3 (2′ hydroxyphenyl) 4(3H) quinazolinone and isaindigodione respectively Conclusion The two compounds were obtained from I. indigotica for the first time

Objective To investigate the relationship between non muscle-invasive bladder can-cer and polymorphisms of DNA repair genes among Han nationality in Shanghai. Methods From January 2006 to June 2008, 94 patients with non muscle-invasive bladder cancer and 304 controls were enrolled. Known single nucleotide polymorphism(SNP) in the XPC, XPG, XRCC1 genes were detec-ted by TaqMan real-time PCR. After adjusted for age, sex, and smoking, interaction effects of the genotypes and non muscle-invasive bladder cancer risk, genotypes and clinical and pathological features of bladder cancer were analyzed using unconditional Logistic regression. Results After adjusted for age, sex, and smoking, the XPC 939 Lys/Gln, XPC 939Gin/Gin genotype and XPG 1104 Asp/His, XPG 1104 His/His genotype were more frequent in patients with non muscle-invasive bladder cancer, adjusted OR=1.89, 95%CI 1.14-3. 23 and OR=1.07,95%CI 0.86-1.87, respectively. The XRCC1 Arg399Gln polymorphisms were not significantly associated with non muscle-invasive bladder cancer, adjusted OR= 1.15, 95% CI 0.55-2.40. There were no significant associations between tumor clinical and pathological features in patients who possessed either the XPC or XPG polymor-phisms (P>0.05). Conclusion XPC Lys939Gln and XPG Asp1104His may modulate non muscle-invasive bladder cancer risk among Han nationality in Shanghai.

Objective To investigate the expression of Kruppel like factor 8(KLF8)in human renal cell carcinoma(RCC)specimens and clinical significance.Methods RT-PCR and immunohistochemistry were used to detect the KLF8 mRNA and protein expression respectively in RCC cell strain 786-0,OS-RC-2 with 37 RCC specimens and adjacent normal tissues of the same patients.Results The expression of KLF8 mRNA was high in RCC cell strain 786-0,OS-RC-2,was 0.80±0.28 and 0.41±0.11 in the RCC specimens and normal tissues respectively(P＜0.01).The level of KLF8 protein expression of 37 RCC specimens(17 was expressed at++-+++)was significantly higher than that of the normal tissues(29 was expressed at--+)(P＜0.01).KLF protein was high expressed in RCC cell strain 786-0,OS-RC-2.The levels of KLF8 mRNA and protein expression were positively correlated with the tumor size,cell differentiation,clinical stage,but not correlated with the patients sex and age.Conclusions The KLF8 mRNA and protein expressions are elevated in the human RCC.KLF8 may be involved in the development and progression of RCC.

Object To extract and separate the chemical constituents from the root of Isatis indigotica Fort (Cruciferae) Methods The root of I. indigotica was percolated with 95% ethyl alcohol, partitioned in solvents of different polarities and finally isolated on silica gel and macroporous resin columns The purified compounds obtained were identified and structurally elucidated by their physicochemical properties and spectral analysis Results Two compounds were obtained and named as isaindigotidione (Ⅰ) and (E)-3-(3′, 5′-dimethoxy-4′-hydroxybenzylidene)-2-indolinone Conclusion The two compounds were new

Objective To evaluate the surgical technique,urinary continence and clinical efficacy of extraperitoneal laparoscopic radical prostatectomy for prostate cancer. Methods This series included 28 cases of prostate cancer aged 60 -75 years (mean,68 years). The PSA level ranged from 0. 7 ng/ml to 23. 6 ng/ml. TNM classification showed T1N0M0 tumor in 11 cases, T2N0M0 tumor in 15 and T3aN0M0 tumor in 2. All cases underwent extraperitoneal laparoscopic radical prostatectomy. The functional reconstructive technique consisted of preservation of the urethral and bladder outlet sphincter muscles, and reconstruction of the bladder neck. Results All the operations were successful. The operative time was 180 - 380 min( mean, 240 min) ,and the blood loss was 400 - 1200 ml( mean,800 ml) . All the catheter were removed 2 weeks after surgery. Mild urinary incontinence occurred in 3 cases, and it improved after supportive treatment. The PSA level was 0. 02 -0. 10 ng/ml 3 months after operation. No recurrence of prostate cancer was found during the follow-up of 1 month-2 years. Conclusions Extraperitoneal laparoscopic radical prostatectomy is safe and effiective for the treatment of prostate cancer. It can be widely applied in clinical practice.

Objective To find out about the current state of and need for general practice training in communities so as to provide basis for the formulation of relevant training strategies and methods. Methods A qualitative and quantitative investigation was made on the state of and need for general practice training at the community based health services centers or stations in the 3 cities of Chengdu, Shenyang and Shanghai. Results Of the 171 physicians surveyed, 39.8% once received general practice training; of the 162 nursing personnel surveyed, 12.3% once received general practice training; of the 67 preventive healthcare personnel surveyed, 35.8% once received general practice training. While the medical personnel who once received general practice training did not think highly of the training result, they did have high demands for general practice training. Conclusion It is suggested that centers for training general practitioners be established, training of community health services personnel strengthened, and their quality improved.

Objective To study the value of PSADT in predicting the prognosis and the possibility of disease progression for patients with prostate cancer after MAB therapy.Methods Based on the retrospective review of the history and the follow-up of 159 prostate cancer patients,who received MAB therapy in our department from January 1994 to December 2010,PSADT values were calculated and survival analysis was performed.The ages at diagnosis ranged from 54 to 90 years with a median of 74 years.The pretreatment PSA value ranged from 2.6 to 275.0 μg/L with a median of 46.8 μg/L.The patients of Gleason score ≤6,7 and ≥8 constituted 27.7％,42.1％ and 25.2％,respectively.Only 26.4％ of the patients were staged as T1N0M0-T2N0M0 and the others had locally advanced disease or metastasis.A multivariate analysis with a Cox's proportional hazard model was used and the disease progression rates in different PSADT groups were also compared.Chi-square test and Log-rank test were applied in statistic analysis.Results The 159 patients received follow-up with a median period of 28 months (6-126 m).The median PSADT of these 159 patients was 5.7 months (0.5-21.0 m).The 3-year and 5-year survival for the 71 patients,whose PSADT were not less than 6 months,were 89.4％ and 47.6％ respectively,compared with 49.8％ and 30.6％ for the other 88 patients whose PSADT were less than 6 months.The survivals were significantly different between the two groups (P ＜ 0.01).It was confirmed by a further multivariate analysis with a Cox' s proportional hazard model that PSADT was one of the predictive factors of the prognosis of these prostate cancer patients with a hazard ratio of 2.6 (P ＜ 0.01).Moreover,disease progression were found in 19.7％ of the PSADT≥6 m group during the follow-up compared with 63.6％ in the PSADT ＜6 m group.The disease progression rates were also significantly different (P ＜ 0.0 l).Conclusions PSADT can be used to predict the prognosis of patients with prostate cancer after the MAB therapy.The survival for the patients,whose PSADT are not less than 6 months,is higher than those whose PSADT less than 6 months.Meanwhile,PSADT can predict the possibility of disease progression after MAB treatment.

Objective To investigate if distribution of stone composition and onset age in the upper urinary tract changed during the past 12 years in China.Methods There were 1 878 urolithiasis patients of the upper urinary tract in our hospital from 2003 to 2014 enrolled in present cross-sectional study.There were 1 300 male and 578 female patients with a median onset age of 46 (6-95) years.Stone composition was measured by infrared spectrophotometry.All the patients were divided into 3 groups according to the onset year:Year 2003-2006,Year 2007-2010 and Year 2011-2014.The distributions of stone types were compared among the 3 groups.Age and gender were included as potential confounders.Chi square test,P trend test,Kruskal-Wallis test and logistic regression were employed in the statistical analysis.Results Calcium oxalate was the most common type with a dominant proportion of 78.1％ (1 466/1 878),while uric acid had a small proportion of 4.8％ (91/1 878).The proportions of uric acid in the 3 groups were 2.7％ (12/441),5.1％ (39/758) and 5.9％ (40/679),showing an increasing trend (P ＜0.05).Multivariate analysis showed that year group was independently correlated with the proportion of uric acid,with an OR of 1.385 (95％ CI,1.027-1.867).From 2003 to 2014,the proportion of uric acid calculus increased by 0.42％ (95％ CI,0.25％-0.59％) annually.The median ages of disease onset were 43,46 and 49 years respectively in those three groups,also showing an increasing trend with time (P ＜0.01).Conclusion From 2003 to 2014,the proportion of uric acid and onset age in patients of upper urinary tract calculi were increased in the present cohort.

Objective To investigate the proportion , risk factors and tendency of change of stone composition in recurrent urolithiasis .Methods Eighty-five recurrent urolithiasis patients from 2002 to 2014 were enrolled in this retrospective cohort study .There were 61 male and 24 female patients with a median age of 51 (21-89) years at initial events.Among those patients, 70 had two events, 12 had three events, and 3 had more than 3 events.Compositions of initial and recurrent stones were measured by infrared spectrophotometry.Stone type, recurrence interval and recurrence frequency were studied as potential risk factors for composition change . Chi square test and logistic regression analysis were employed in the statistical analysis.Results Stone composition changed during recurrence in 26 patients ( 30.6%) . Univariate analysis showed the risk ratio of composition change in the patients with recurrence interval of 1-5 years was 0.518 (95%CI, 0.277-0.967, P<0.05) when compared with those of less than 1 year or more than 5 years.Logistic regression analysis showed the odds ratio of recurrence interval of 1-5 years was 0.231 (95%CI, 0.075-0.707, P=0.010).The mutual conversion between calcium oxalate and infection stones was mostly observed when stone composition changed during recurrence .Twenty percent of calcium oxalate stones changed to infection stones and 29.2% of infection stones changed to calcium oxalate .
Conclusions Stone composition changes in about one third patients of recurrent urolithiasis .The mutual conversion between calcium oxalate and infection stones is the most common change .Recurrence interval is an independent risk factor to predict composition change .Repeated stone analysis should be suggested to patients with recurrent interval of less than 1 year or more than 5 years.