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 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 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 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 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

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 study the clinical significance of the mRNA expression level of a novel gene which encodes a kind of transmembrane prostate protein induced by androgen-PMEPA1, as it may predict the progress of prostate cancer from hormone-dependent to hormone-independent. Methods We used Real-time PCR to detect the mRNA expression of PMEPA1 and GSTP1 in prostate cancer cell lines (LNCaP, PC-3), epithelia cells of benign prostatic hyperplasia and tissues from 33 patients with prostate cancers and 16 cases of prostatic hyperplasia. Results We found the mRNA expression of GSTP1 and PMEPA1 were both down-regulated in prostate cancer cell lines. The mRNA expression of GSTP1 was up-regulated in 6.1% of cases, down-regulated in 81.8%, and showed no difference in 12.1%. While PMEPA1 was highly expressed in 27.3% of cases, lowly expressed in 27.3%, and not differently expressed in 45.4%. Statistical analysis showed that the mRNA expression of GSTP1 was relevant to ages, but had no relationship with PSA, TNM stage, osseous metastasis or tumor differentiation, while the mRNA expression of PMEPA1 was relevant to osseous metastasis and tumor differentiation, but had no relationship with age, PSA or TNM stage. Conclusions PMEPA1 is possibly a useful biomarker, as it can identify patients with unfavourable prognosis, however, this hypothesis needs to be further studied with large samples.

BACKGROUND: Allogeneic hematopoietic stem cell transplantation(allo-HSCT)is an effective method for treating multiple malignant hematological diseases and hereditary diseases.However,systematic internal organs disorders,especially pulmonary complications,are commonly following allo-HSCT,How to correctly diagnose and treat the coexistence of pulmonary infectious complications and pulmonary noninfectious complications has great importance.OBJECTIVE: To report a case suffered from pulmonary Aspergillus infection coexisted with obliterative bronchiolitis at 1 year following allo-HSCT,and to discuss the prevention,clinical manifestation and treating method by reviewing related literature.METHODS: At 373 days after allo-HSCT,the patient developed fever,dry cough,shortness of breath and dyspnea on exertion A high-resolution computed tomography of chest demonstrated that there were alveolar infiltrating in the upper,middle and lower lobe of the right lung,and the focus of infection was performed further biopsy.RESULTS AND CONCLUSION: The histopathological examination of the sample showed alveolus dilatation,epithelial cells hyperplasia,fibrinous obliteration in alveolar space and peribronchiolar lymphocytes inflammation,which were CD3(+),CD45RO(+),CD20(-),CD79a(-),MPO(-),CD34(-).Aspergillus fumigatus could be seen in the cultured biopsied tissue specimen.Pulmonary function test showed that,air flow obstruction with reduction of forced expiratory volume in one second was 59.27%.The patient was diagnosed as invasive pulmonary Aspergillus infection combined with bronchiolitis obliterans and was treated by caspofungin combined with intravenous voriconazole for invasive aspergillosis,methylprednisolone,azathioprine,intravenous immunoglobulin and azithromycin for bronchiolitis obliterans.At 40 days after treatment,the CT examination showed the focus was absorbed completely.

Objective To compare the diagnostic efficacy and complications of transperineal prostate biopsy for<10 cores biopsy vs≥10 cores biopsy. Methods Nine hundred transrectal ul-trasound-guided transperineal prostate biopsies were performed. Patients were divided into 2 groups, <10 cores group and ≥10 cores group. Patient numbers of the 2 groups were 759 and 141, respec-tively. Cancer positive rate and complications were compared between the 2 groups retrospectively. Results Cancer positive rates were 41.6%(316/759) and 51.8%(73/141) in 2 groups (P<0.05). In patients of PSA≤10.0 ng/ml, cancer positive rates were 6.8% (16/235) and 17.8% (8/45) in 2 groups (P<0.05). Gross hematuria was the most common complication associated with biopsy. There was no statistical difference between the 2 groups in post-biopsy gross hematuria rate. Conclu-sions The diagnostic efficacy is higher in≥10 cores prostate biopsy than that in <10 cores prostate biopsy, There is no difference in biopsy related complications regarding biopsy core numbers.