Objective To evaluate the efficacy and safety of holmium laser lithotripsy for ureteral stones. Methods A total of 238 patients with ureteral stones (upper segment, 60 patients; middle segment, 93; lower segment, 85) received the holmium laser lithotripsy under a semi-rigid ureteropyeloscope. Results Stones were successfully fragmented on one session in 97.1% of patients (231/238). The success rate was 91.7% in patients with stones in the upper ureteral segment (55/60) and 98.9% in patients with stones in the!mid-lower ureteral segment (176/178). Five patients with bilateral ureteral stones associated with acute renal failure and anuria returned to normal rapidly. No complications such as perforation or severe trauma were encountered during the operation. The postoperative hospital stay of the 231 patients was 1~2 days (mean, 1.3 days). Follow-up for 0.5~12 months (mean, 4.1 months) revealed a stone-free rate of 98.7% (228/231). No stricture of the ureter was found. Conclusions Holmium: YAG laser lithotripsy is effective, mini-invasive and safe. It is indicated as the first choice in the treatment of ureteral stones, especially stones located in the mid-lower ureteral segment.

Objective To evaluate the efficacy and safety of holmium laser lithotripsy for the treatment of urinary calculi.Methods A total of 1216 cases of urinary calculi underwent ureteropyeloscopic and cyctocopic holmium laser lithotripsy.There were 1 006 cases of ureteral stones(302 cases of upper ureteral stones,364 cases of middle ureteral stones,and 340 cases of lower ureteral stones) and 210 cases of bladder stones.Results In 1 case of upper ureteral stones,failure to access the ureteral orifice due to enlarged prostate was encountered,and extracorporeal shock wave lithotripsy(ESWL) was employed.In 1006 cases of ureteral stones,the rate of successful fragmentation on single session was 95.5%(961/1 006),with 89.4%(270/302),96.4%(351/364),and 100%(340/340) for upper,middle,and lower ureteral stones,respectively.Ureteral perforation was encountered during lithotripsy in 6 cases.In 210 cases of bladder stones,the rate of successful fragmentation on one session was 100%(210/210).No bleeding or bladder perforation was observed during lithotripsy.Follow-up checkups for 0.5~40 months(mean,18.6 months) in 881 cases of ureteral stones showed that the stone-free rates were 91.1%(224/246),98.5%(318/323),and 100%(312/312) for upper,middle,and lower ureteral stones,respectively.The overall stone-free rate for all levels of ureteral stones achieved 96.9%((854/881)).Ureteral stenosis was found in 6 cases.Follow-up checkups for 0.5~31 months(mean,12.4 months) in 187 cases of bladder stones revealed a stone-free rate of 98.4%(184/187). Conclusions Holmium laser lithotripsy is a highly effective,minimally invasive,and safe therapy for urinary calculi.It is indicated as the first choice of treatment for patients with ureteral stones and bladder stones.

Objective To investigate the effect of a newly developed photosensitizer—chlorophyll derivative combined with irradiation of 650 nm laser for PC3, an androgen independent cell line in vitro. Methods PC3 was cultured and designed to 4 groups,including blank control,laser irradiation,medication of photosensitizer and medication of photosensitizer with laser irradiation (treated).The medicated concentration of chlorophyll was 0.1 g/L and irradation fluence of 650 nm semiconductor laser was 6 J/cm2.Intracellular distribution of photosensitizer and cellular morphological alterations were studied through light microscopy, electron microscopy and laser confocal microscopy. Results It showed the shrinkage, round-up and membrane integrity of treated PC3 under light microscopy.Sable deposits were observed in cytoplasm of cells in both photosensitizer and treated groups.Transmission electron microscopy showed the fragmentation of DNA and condensation of chromatin beneath the karyolemma in treated cells.In cytoplasm,the endoplasmic reticulum and mitochondria swell to form vesicles and vacuoles.It showed the strong red fluorescence in the cytoplasm of treat cells compared with the red fluorescence indifferent to the background through laser confocal microscopy. Conclusions Chlorophyll derivative based photodynamic therapy is able to induce apoptosis of PC3 in vitro.Mitochondria is presumed to be the primary target of photodynamic therapy and trigger the apoptotic pathway.

Objective To observe the therapeutic effect and adverse effect for chemthrombocytopenic of rhIL-11 in chemotherapy for acute myeloid leukemia. Methods We adopted a randomized, blank-control, crossover trial of rhIL-11 in 16 newly diagnosed patients with acute myeloid leukemia. The treatment group were accepted chemotherapy by DA or TA. rhIL-11 (25μg·kg-1·d-1, subcutaneously) was administered from 24 h after chemotherapy and continued for seven to fourteen days. The changes of platelet counts were observed. Results The group by chemotherapy had higher platelet counts than control after rhIL-11 treatment and platelet transfusion frequency was reduced. The adverse effect of rhIL-11 was light, including fatigue, muscular soreness and low-grade fever. Conclusion rhIL-11 is safe and effective in reducing chemotherapy thrombocytopenia.

Objective To evaluate the incidence of liver dysfunction and the relevant treatment in patients with prostate cancer with combined androgen blockade. Methods Twenty three patients (mean age,73 years;range,63-80 years) with histologically confirmed prostate cancer showed liver dysfunction during the course of combined blockade with bilateral orchiectomy and flutamide at a dose of 250 mg,3 times per day.After 6.2 months of therapy, ALT level was increased from pre treatment of (37?7.2)U/L to (63.5?7.53)U/L in 17 patients without jaundice and (87.2?7.34)U/L in 6 patients with jaundice.In the 17 patients without jaundice,herbal medicines were used together with vitamin C and vitamin B complex for 1-2 months (first line therapy).In the 6 severely disordered patients,flutamide was stopped, while glucurolactone at a dose of 1.2 g and (or) TAD of 0.6-1.2 g were administered intravenously per day for 4 weeks (second line therapy).Liver function was monitored every week. Results The 17 patients with mild liver dysfunction recovered after application of first line therapy for 1-2 months.The other 6 patients with relatively severe dysfunction had recovery or improvement with additional second line therapy.Of these patients,4 died of hepatic metastases after 2.1 years. Conclusions It is necessary to monitor liver function during the course of combined androgen blockade and to adopt liver protecting therapy for patients with prostate cancer who previously had hepatitis.

Objective To evaluate the efficacy and safety of ureteropyeloscopic lithotripsy with holmium:YAG laser for treatment of ureteral calculi. Methods We retrospectively reviewed the data of 186 patients (123 males and 63 females,with an average age of 51 years) who underwent ureteropyeloscopic lithotripsy using holmium:YAG laser with a semi rigid ureteropyeloscope. Among these patients,51 had stones in the upper,64 in the middle,and 71 in the lower ureter.The stones were 0.6 to 2.5 cm (mean 1.3 cm) in diameter. Results The success rates of fragmentation in a single procedure for the upper and mid lower levels of ureteral stones were 90% (46/51) and 99% (133/135), respectively.The overall rate of successful fragmentation for all levels of ureteral stones in a single procedure achieved 96% (179/186).The mean operative time was 28 min,and the mean postoperative hospital stay was 1.2 days.No complications such as perforation occurred during the operation.In 179 patients,the postoperative follow up of 2 weeks to 3 months revealed that the stone free rate was 99% (177/179) and the hydronephrosis was markedly improved from preoperative (3.6?0.7) cm to postoperative (1.5?0.4) cm according to B ultrasound,IVU or renogram ( P

vides com-parable efficacy with medical castration in regard of decreasing PSA level and reducing prostate vol-ume. It is a safe and well tolerated treatment option as well.

Pigment epithelium-derived factor (PEDF) is an antiangiogenic factor which is effective in tumour inhibition in a variety of tumours and has not yet been studied in bladder tumour before. In this study the expression of PEDF, interleukin-1α (IL-1α) and -8 (IL-8) in bladder tumours was investigated. Immunohistochemistry was performed on 64 bladder tumour and 23 normal uroepithelium samples. Expression change of the factors was compared with clinicopathological parameters. Correlations between PEDF, IL-1α and IL-8 were analyzed. None of the factors was in relation to gender, tumour occurrence, and size or onset pattern. PEDF (P=0.014) and IL-1α (P=0.049) expression was down-regulated with grade progression. PEDF expression was lower in normal uroepithelium than in papillary urothelial neoplasm of low malignant potential (PUNLMP) (P=0.000) and carcinoma (P=0.009) whilst IL-1α (P=0.000 and P=0.000 respectively) and IL-8 (P=0.000 and P=0.023 respectively) expression was higher in the same grouping. PEDF expression had a negative correlation with IL-8 in PUNLMP (P=0.049, r=-0.578) as well as in tumour grouping (P=0.033, r=-0.276). Deranged expressional change of PEDF, IL-1α and IL-8 could be in relation to loss of differentiation from normal uroepithelium to papillary lesion and eventually to carcinoma.

Objective: To explore the correlation of left descending anterior (LDA) myocardial bridge (MB) and atherosclerosis at proximal to a segment with MB in patients elderly than 60 years and to identify if LDAMB could become the independent risk factor of atherosclerotic stenosis at proximal to a segment with MB. Methods: A total of 986 patients with multi-slice spiral CT diagnosed coronary artery disease (CAD) were studied and 389 patients with 486 MB in left heart were found. General information as the age, gender, diabetes, hypertension, dyslipidemia and smoking conditions were collected, relationship between LDAMB and atherosclerotic stenosis at proximal to a segment with MB was studied by Logistic regression analysis. Results: There were 48/389 (12.3%) cases with MB at proximal segment of LDA, 254 (65.3%) cases with MB at middle segment of LDA, 51 (13.1%) cases with MB at distal segment of LDA, 19 (4.9%) cases with MB at the ifrst diagonal branch and 17 (4.4%) cases with MB at obtuse marginal branch respectively. Logistic regression analysis presented that age (OR=1.07, 95% CI 0.02-0.09,P<0.01), diabetes (OR=4.48, 95% CI 0.75-2.24,P<0.01) and MB at middle segment of LDA (OR=4.98, 95% CI 0.81-2.41, P<0.01) were related to atherosclerotic stenosis at proximal to a segment with MB; age (OR=1.08, 95% CI 0.04-0.12,P<0.01) and diabetes (OR=3.49, 95% CI 0.30-2.19,P=0.01) were related to the atherosclerosis at LAD middle segment; the MB at LAD middle segment was not related to atherosclerosis of middle and distal LAD segments,P>0.05. Conclusion: MB at middle segment of LDA was with the higher occurrence rate of atherosclerotic stenosis at proximal to a segment with MB in elderly patients, which could be used as an independence risk factor for clinical diagnosis.

Objective To study the role of Med19 in bladder cancer by analyzing the effects of lentivirus-mediated suppression of Med19 expression on T24 bladder cancer cells in vitro.Methods The lentivirus vectors containing a small hairpin RNA (shRNA) to target Med19 were constructed.After T24 bladder cancer cells were infected,real-time PCR and Western-blotting were used to study the Med19 expressions in the CON group (non-infected cells),the NC group (Lv-NC-infected cells) and the KD group (Lv-shMed19-infected cells).The influence of Med19 on the proliferation of bladder cancer cells were assessed using MTT,BrdU,colony formation assay and tumorigenicity experiment in mice.Cell cycle was analyzed with flow cytometry assay.Results Med19 relative mRNA level (0.35 ± 0.03) and Med19 protein expressing in the KD group were significantly inhibited (P ＜ 0.05).The KD group displayed an increased proportion of cells (77.50 ± 0.29)％ in the G0/G1 phase compared with the CON group (69.81 ± 0.81)％and NC group (67.53 ± 0.67) ％ (P ＜ 0.05).Compared with the CON group and the NC group,the KD group displayed a significant cell proliferation defect by MTT and BrdU assay and the number of colonies (91.33 ± 6.11) was significant decreased (P ＜ 0.05).On the day 24,the tumor volume (596.64 ± 485.36) mm3 and weight (0.57 ± 0.44) g of the KD group mice were decreased after inoculation into nude mice (P ＜ 0.05).Specific lentivirus-mediated knockdown of Med19 significantly impacted the cell cycle and proliferation of bladder cancer cells.Infected T24 cells nearly lost their tumorigenicity when being inoculated into nude mice.Conclusion Our results provide new evidence of an important role for Med19 in the development of bladder cancer,suggesting that lentiviruses delivering shRNA against Med19 may be a promising tool for bladder cancer therapy.