Objective To investigate the clinlic therapeutic result of detenial sigmoid neobladder after radical cystectomy. Methods 50 patients with bladder cancer (41 males and 9 females;age range from 35 to 82 years) were admitted and underwent radical cystectomy and detenial sigmoid neobladder. Results All the 50 patients were followed up for a mean of 18.6 months(range from 6 to 29 months).The blood Cr and BUN levels were both in the normal range without acidosis in all the cases.Only 2 had unilateral ureteral urine reflux during cystography.Of the 50 patients 45 cases(90%) achieved continence during daytime;10 cases(20%) were incontinent at night,but 8 of the 10 cases could control urination by being woken up at night.The capacity of the neobladder was 220 to 550 ml with a mean of 350 ml and the maximal pressure of the neobladder during filling was 15 to 55 cmH 2O(1 cmH 2O=0.098 kPa) with a mean of 35 cmH 2O. Conclusions As a simple operation the detenial sigmoid neobladder can be performed easily with less complications and more reliable results.This operation may be generally applied in clinical practice.

BACKGROUND: At present, there is little related report about producing a whole-kidney acellular matrix (ACM) scaffold in rats using perfusion. The cellular biocompatibility of the ACM is poorly understood. OBJECTIVE: To produce a whole-kidney ACM scaffold in rats by perfusion, to evaluate the cytocompatibility of ACM with the L929 cells in vitro, and to assess the possibility of ACM as the cytoskeleton and tissue-engineered urinary organ construction. DESIGN, TIME AND SETTING: An in vitro observation was performed at the Central Laboratory of Zhujiang Hospital, Southern Medical University from February to May 2009. MATERIALS: Kidneys were obtained from 12-week-old Whista rats, while ureter, renal veins and renal artery were reserved. Intravenous catheters were inserted through renal arteries to establish channels for perfusion. Whole-kidney retrograde perfusion was performed with successively heparinized PBS, 1% SDS, deionized water, 1% TritonX-100 and antibiotic-containing PBS under a pressure of 9.81 kPa to prepare whole-kindney acellular matrix scaffolds. METHODS: ① Samples were randomly divided into blank group (without any cells), negative control group (culture media), experimental group (rat kidney ACM leaching liquor), and positive control group (culture media containing 0.64% phenol). L929 cells in the logarithmic phase were seeded in 96-well plates at the density of 4×10~3/well, with 5 wells in each group. At 24, 72, and 120 hours after incubation, cells were stained with MTT method to detect absorbance at 490 nm and calculate relative growth rate. ② Control group (culture medium), experimental group (rat kidney ACM leaching liquor), and positive control group (culture media containing 0.64% phenol) were set up to detect cell apoptosis at 48 hours after culture using flow cytometry. MAIN OUTCOME MEASURES: Microstructure of the scaffold, cytotoxicity and cell apoptotic rate. RESULTS: After SDS and TritonX-100 union processing, reticulate structures made of basilar membrane and collagen were shown under scanning electron microscope rather than normal structures of cells. At every time intervals (24, 72, and 120 hours), there was no significant difference in the absorbance between experimental group and negative control group (P > 0.05). The grade of the cytotoxicity of the ACM was .0-1. There was no significant difference in cell apoptotic rate between experimental group and negative control group (P > 0.05). CONCLUSION: The whole-kidney acellular matrix scaffolds in rat by perfusion have good biocompatibility.

Objective:To explore the relationship of lymphocyte function-associated antigen 3 (LFA-3, CD58) expression in glioma with clinical features and its role in clinical prognosis. Methods:Clinical data and mRNA microarray data of 514 patients with glioma were obtained from The Cancer Genome Atlas and were used to study the expression of LFA-3 (CD58). Cox regression was used to analyze the relationship between CD58 expression and survival of patients with glioma. Multivariate analysis of variance was used to further analyze the relationship of CD58 with age, sex, and pathological grade of glioma. Results:The results of the stratified χ2 test of CD58 expression and tumor grading were shown, considering tumor type, gender and age of diagnosis (all P<0.05). CD58 expression was sig-nificantly correlated with overall survival (OS) and disease-free survival (DFS) of patients with glioma. Patients with high CD58 expres-sion presented short OS and DFS (P<0.0001). Conclusion:CD58 possibly promotes tumorigenesis in gliomas and thus can serve as a potential tumor diagnostic marker and individual therapeutic target.

Objective:To investigate the changes and clinical significance of prothrombin time (PT) during chemotherapy for non-Hodgkin lymphoma (NHL) in high-altitude area and low-altitude area, and understand the relationship between NHL and PT.Methods:From August 2018 to September 2019, data of 68 cases of NHL patients in the Fifth People′s Hospital of Qinghai Province in the high-altitude area (average altitude: 2 261 m) and the Tianjin Fourth Central Hospital in the low-altitude area (average altitude: 1.3 m) were collected and compared with those of 20 subjects from health examination. The patients were divided into groups according to the NHL classification, stage and grade (international prognostic index, IPI score), the PT at initial diagnosis was compared. The PT changes before and after chemotherapy (6 cycles) were compared between high-altitude area and low-altitude area.Results:The PT in healthy subjects and PT at initial diagnosis in NHL patients in low-altitude area were lower than those in high-altitude area: (12.3 ± 1.3) s vs. (13.4 ± 1.9) s, (12.2 ± 0.8) s vs. (13.7 ± 1.1) s, and there was statistical difference ( P<0.05). There was no significant difference between NHL patients and healthy patients in the same area ( P>0.05). In NHL patients in high-altitude area and low-altitude area, PT of different NHL classification, stage and grade were statistically significant ( t = 4.611, 8.202, 6.893, 5.345, 3.121, 5.397, 2.838 and 3.720, P<0.05). In the same altitude area, NHL classification, stage and grade of NHL patients had no significant effect on PT, and there were no statistically significant difference ( P> 0.05); in NHL patients, there were statistically significant differences in PT before and after chemotherapy between high-altitude area and low-altitude area: (13.7 ± 1.1) s vs. (12.2 ± 0.8) s, (13.4 ± 1.4) s vs. (12.0 ± 1.3) s, and there were statistical differences ( P<0.05), and no significant changes in PT before and after chemotherapy in the same altitude area ( t = 1.377 and -1.222, P>0.05). Conclusions:PT of NHL patients in low-altitude area is lower than that in high-altitude area, and there is no significant correlation with NHL classification, stage, grade and chemotherapy in NHL patients.

Objective To present our initial experience of pure laparoendoscopic single-site surgery (LESS) for radical cystectomy and bilateral pelvic lymph node dissections. Methods 10 patients with pathology confined bladder urothelial carcinoma underwent laparoendoscopic single-site radical cystectomy, including 9 males and 1 female. After a 3-4 cm lower median abdominal incision was made, quadport or homemade single multichannel port was inserted, and conventional and prebent laparoscopic instruments were utilized. The surgical procedure included bilateral pelvic lymphadenectomies, radical cystectomy and building with a sigmoid orthotopic neobladder by open surgery.Results No extra port needed, neither conversion to open or conventional laparoscopic surgery. The time of LESS procedure ranged from 130 to 330 min (mean 243 nin). Estimated blood loss ranged from 50 to 600 ml (mean 270 ml). 5 patients needed blood transfusion of 2 to 4 units. The pathologic evaluation revealed bladder urothelial carcinoma, negative margins and negative pelvic lymph node involvement. No mortality or severe complications were observed perioperatively. After followup of more than 6 months, all revealed controllable urination at daytime, while 4 revealed nocturnal incontinence and needed one or two pads during nighttime. No evidence of recurrent or metastatic disease was detected. Conclusions LESS radical cystectomy and bilateral lymphadenectomies was safe and feasible, and short-term follow-up showed good tumor control outcomes. Homemade single multichannel port made of two elastic ring and glove was simple and effective.

Objective To discuss the feasibility of percutaneous nephrolithotomy (PCNL) for treating upper urinary calculi under local anesthesia.Methods One thousand three hundred and sixty-three patients who suffered with upper urinary calculi were treated with PCNL, the puncture and tracts were created using local anesthesia and guided through ultrasound.Of the 1363 patients, 475 patients had complicated renal caluli, 520 patients had kidney pelvic calculi and 368 had upper uretere calculi.Results All of the patients successfully received PCNL under the local anesthesia.Of the 1363 patients five tracts were used in two patients, four tracts were used in four patients, three tracts were used in nine patients, double tracts were used in 25 patents and one tract was used in the remaining patients.The stone-free rate was 96.0% in the kidney pelvic calculi patients, 100.0% in the upper uretere calculi patients, and 90.1% in the complicated renal caluli patients.90.0% patients were find well throught the operation, 10.0% patients find a little pain and solved by another more 5 - 10 ml lidocaine local injection or 50 - 75 mg pethidine hydrochloride intramuscular injection.No case stop operation because of pain or position changed.All without any severe complications such as damaged of liver, spleen, thorax and intestine.Conclusion The PCNL handled under local anesthesia was simple safe and effective, deserved clinical popularizing use.

OBJECTIVETo summarize our initial experience with laparoendoscopic single-site (LESS) retroperitoneal lymph node dissection (RPLND) for treatment of nonseminomatous testicular cancer.

METHODSFrom September 2010 to June 2011, 3 patients (aged 19-27 years) with right testicle enlargement and elevated alpha-fetoprotein level underwent right radical orchidectomy. Histopathological analysis revealed nonseminomatous germ cell tumor. LESS-RPLND was performed 3 weeks after orchiectomy. The homemade port was inserted through a 3-cm right pararectal incision in the right lower quadrant for unilateral RPLND using nerve-sparing technique and modified right-sided template removal similar to those in open RPLND.

RESULTSThe operation was successfully performed with a mean operative time of 240 min and a mean estimated blood loss of 50 ml. No conversion to open or conventional laparoscopic surgery was required. No major perioperative complications were observed. For the first case, the number of lymph nodes obtained for final histopathological examination was 11, and two positive nodes were detected. For the other 2 cases, no positive nodes were detected. Chemotherapy was administered in the first case. Alpha-fetoprotein level decreased close to the baseline one week postoperatively and no relapse occurred in these cases 3 month after RPLND. Follow-up at 1 year after the surgery showed good tumor control and preservation of the sexual function.

CONCLUSIONLESS-RPLND is safe and feasible for treatment of nonseminomatous testicular cancer, and the pararectal incision provides an ideal surgical approach with good cosmetic result, but the long-term effect needs to be tested by further large population-based study.

Adult ; Follow-Up Studies ; Humans ; Laparoscopy ; methods ; Lymph Node Excision ; methods ; Male ; Neoplasms, Germ Cell and Embryonal ; surgery ; Orchiectomy ; Retroperitoneal Space ; surgery ; Testicular Neoplasms ; surgery ; Young Adult

OBJECTIVETo investigate the effect of docetaxel on the interaction between C-jun and androgen receptor (AR) in prostate cancer LNCaP cells and its androgen-independence subtype LNCaP-bic cells.

METHODSLNCaP and LNCaP-bic cells were treated with docetaxel and the changes in AR and AP-1 expression were evaluated using luciferase assay. Western blotting and immunoprecipitation assay were employed to analyze the effects of docetaxel on the expressions of C-jun and AR and their interaction.

RESULTSLuciferase assay showed that LNCaP and LNCaP-bic cells expressed higher levels of AR and C-jun after docetaxel treatment. Docetaxel induced a higher level of p-c-jun expression in LNCaP-bic cells than in the parental LNCaP cells. Western blotting showed a strong PSA protein expression in LNCaP-bic cell after docetaxel treatment. Docetaxel caused a stronger interaction between AR and C-jun in LNCaP-bic cells.

CONCLUSIONDocetaxel activates ligand-independent AR transcription, and the interaction between AR and C-jun may affect the outcome of docetaxel chemotherapy.

Cell Line, Tumor ; Humans ; Male ; Prostate ; metabolism ; Prostatic Neoplasms ; metabolism ; Proto-Oncogene Proteins c-jun ; metabolism ; Receptors, Androgen ; metabolism ; Taxoids ; pharmacology

OBJECTIVETo construct three-dimensional (3D) models of renal stones and perform percutaneous nephrolithotomy (PCNL) virtual surgery simulation. Methods CT images were obtained from 8 patients with renal stones. Images segmentation and reconstruction were performed using MIMICS 10.0 software to construct the 3D model of the renal stones, which provided the anatomical relationships between the kidney and the adjacent organs. The optimal PCNL virtual surgery simulation for each individual case was performed using FreeForm Modeling System on the basis of the 3D model.

RESULTSEight 3D models of renal stone were constructed. The 3D model of the renal stones represented the interrelationships of the stones, intrarenal vessel, and the collecting system with the adjacent anatomical structures. Individualized PCNL virtual surgery simulations including percutaneous puncture, dilatation and pneumatic lithotripsy were performed successfully in all the 8 3D models.

CONCLUSIONDigital 3D model of renal stone provides the reliable and comprehensive imaging information for surgical design, and PCNL virtual surgery simulation has important clinical significance to improve the stone clearance rate and reduce the surgical complications.

Adult ; Female ; Humans ; Imaging, Three-Dimensional ; Kidney Calculi ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Nephrostomy, Percutaneous ; methods ; Software ; Tomography, Spiral Computed ; User-Computer Interface

Objective To summarize and evaluate the clinical effect of extraco-rporeal membrane oxygenation(ECMO) support for critically ill patients after heart surgery,and to explore the factors that influenced the prognosis of ECMO.Methods The clinical data of 67 patients undergoing ECMO admitted to the Second Hospital of Jilin University from August 2013 to July 2017 were retrospectively analyzed.The patient's age ranged from 22 months to 78 years,including 3 infants aged 22,24,30 months and 64 adults ranged from 32 to 78 years,the mean age was(56.52 ± 10.99) years.Results The average ECMO support time was (235.79 ± 123.87) h,the mean mechanical ventilation time was (166.11 ± 148.31) h.49 patients weaned off successfully from ECMO,38 of them were discharged and 11 died within 28 days.18 patients gaved up treatment.42 patients suffered the complications.Conclusion VA-ECMO is a significant supportive method for preoperative intensive care in patients undergoing cardiovascular surgery.The keys to optimal results are grasping the indications of ECMO,earlier stopping mechanical ventilation,cluster curing(which involves reasonable anticoagulation,protection of organ function,prevention of hemorrhage,infection and limb distal ischemia).