Objective To study the diagnosis and treatment of coincident vesical transitional cell carcinoma and prostatic cancer. Methods 8 cases of coincident vesical transitional cell carcinoma and prostatic cancer were evaluated clinically. Results All the 8 were diagnosed as vesical transitional cell carcinoma on cystoscopy and biopsy.Whereas on needle biopsy of the prostate,prostatic cancer was diagnosed in 7 and BPH in 1 but turned to be prostatic cancer on pathological study after cystoprostatectomy.4 patients underwent transurethral resection of the bladder cancer and bilateral orchiectomy with bladder instillation of MMC or BCG and oral flutamide for prostatic cancer.1 patient underwent partial cystectomy,bilateral orchiectomy and external radiotherapy for prostatic cancer.3 underwent radical cystoprostatectomy.2 cases were lost to follow up.In the other 6,3 survived less than 1 year because of wide metastasis.The other 3 have been followed up for 1.5 to 4.0 years,remained well and tumor free. Conclusions PSA detection together with rectal palpation,biopsy,transrectal ultrasonography and cystoscopy played the important role in the diagnosis of coincident vesical transitional cell carcinoma and prostatic cancer.Radical cytoprostatectomy yields a better outcome.

Objective To evaluate intravesical instillation of mitoxantrone(MTZ) for the prevention of postoperative recurrence of bladder cancer. Methods Intravesical instillation of 12 mg MTZ dissolved in 50 ml normal saline and retained in bladder for 2 hours were given to bladder cancer patients postoperatively once a week for 8 weeks and subsequently once a month for 12 months.Kidney and liver function,blood counting,urinalysis and cystoscopy were taken periodically.The systemic and local reactions were recorded every time after the intravesical instillation. Results All of the 98 cases were followed up for 6 to 24 months with a mean of 13 months.The recurrence rate was 6.2%.There was no generalized side effect. Conclusions Intravesical instillation of MTZ was efficacious for the prevention of postoperative recurrence of superficial bladder cancer with safety and less side effect.So it can be widely used in such patients.

Objective To investigate radiation dose to the patients undergoing interventional radiology and make radiation risk assessment.Methods Data was collected on 198 instances of 10 interventional radiology procedures by using Philips Allura Xper FD20 DSA, which was equipped with the transparent ionization chamber system in compliance with IEC 60601-2.Patient peak skin dose and effective dose were estimated.Results Cumulative fluoroscopy time was 2.1 - 80.9 min, and number of images monitored for PSD were above 1 Gy and 79 cases monitored for E were above 20 mSv.Conclusions Substantial number of cases exceeded the dose threshold for erythema.Due attention should be paid to radiation protection of patients.

Objective To investigate the effects of prostaglandin E1(PGEl)in improving proteinuria and albuminuria in the elderly people with diabetic nephropathy(DN). Methods Patients including stage Ⅲ,stage Ⅳ and stage Ⅴ were divided into four groups:conventional therapy group,PGE1 group,PGE1+ACEI group and ACEI group.Proteinuria and albuminuria were measured before and after treatment for 15 days,3 months,6 months. Results (1)In the DN patients in stage Ⅲ and stage Ⅳ (proteinuria＜2.5 g/d),the proteinuria and albuminuria descended markedly in PGE1+ACEI and PGEl group(P＜0.01).It was better than that in eonventionaI therapy and ACEI group.(2)In the DN patients in stage Ⅳ(proteinuria＞2.5 g/d),proteinuria and albuminuria were not changed significantly after 3 months and 6 months in PGE1+ACEI and PGE1 group,but they were increased in conventional group(P＜0.05).(3)In the DN patients in stage Ⅴ,the proteinuria and albuminuria were not changed much after 1 5 days,3 months and 6 months(P＜0.05).The proteinuria and albuminuria were increased by more than 10 percent(P＜0.01)in the conventional group after 3 and 6 months. Conclusions The therapeutic effects of PGE1 are obvious.Early treatment of nephropathy will get a better improvement in patients with diabetic nephropathy.

Objective To report the preliminary results of placing metallic stent and ~(125)Ⅰ seed strand combined with transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC) with inferior vena cava (IVC) obstruction. Methods From March 2009 to June 2009, implantation of radioactive ~(125)Ⅰ seed strand and metallic stent combined with TACE treatment was performed in 8 cases of HCC with malignant IVC obstruction. All patients were males with a mean age of (60.6 ± 9.6) years, ~(125)Ⅰ seed strand and Z-type soft-expandable metallic stent were placed in the obstructive segment of IVC, which was followed by TACE. Before and after the treatment, the diameter of the obstructive segment of IVC, the pressure gradient between right atrium and distal end of obstructive segment of IVC, and the symptoms related to the obstruction were estimated and recorded, the results were compared individually. Clinical follow-up was conducted in all patients. Results A total of 8 stents and 10 ~(125)Ⅰ seed strands were placed in the obstructive segment of IVC. Altogether 138 ~(125)Ⅰ seeds were implanted in 8 patients. Obvious clinical improvements were obtained after therapy. No complications occurred in all patients except one patient who experienced acute renal dysfunction at the second day after therapy. During a mean of (2.1 ± 0.6) months follow-up, occlusion of IVC stent was detected in 1 patient. The remaining stents remained patent. Conclusion Our initial results indicate that placement of ~(125)Ⅰ seed strand and metallic stent combined with TACE is a safe and feasible therapeutic option for advanced HCC with malignant IVC obstruction.

Objective To study the action and mechanism of staphylococcal exfoliative toxin A(E-TA)on pemphigus foliaceus antigen(PFA)and pemphigus vulgaris antigen(PVA)expressed on cultured human keratinocytes.Methods Stratified human keratinocytes were incubated with ETA and then stained with sera from patients with pemphigus foliaceus or pemphigus vulgaris as the first antibodies and FITC-la-beled sheep anti-human IgG as the second antibody.Total protein was harvested from the cells pretreated with ETA and run on SDS-PAGE for Western blot with the same antibodies.Simultaneously,supernatants of the keratinocytes before and after ETA treatment were collected for detection of the levels of IL-1?,IL-6with ELISA kits.The caseinolytic activities of the supernatants were tested by spectrometry in which casein was used as a non-specific substrate.Results Down-expression of PFA was shown after ETA treatment while no change of PVA expression was found.The high intensity and continuous linear appearance of fluo-rescent staining before ETA treatment became weak and discontinuous after ETA treatment,which were re-covered gradually in24hours.The degradation of proteins recognized by PF sera after ETV treatment was revealed by Western blot.The decreasing tendency of IL-1?concentration was found in the supernatants of cell culture after ETA treatment,but IL-6level was too low to be detected.Increased caseinolytic activities were found in the supernatants,and declined36hours after ETA treatment.Conclusions ETA acts on PFA expressed on keratinocytes in vitro,which is reversible along with withdrawal of ETA.The mechanism of E-TA act on PFA may be related to proteolytic action instead of promoting cytokine secretion.

Objective To retrospectively analyze the mid-term clinical results of direct intrahepatic portosystemic shunt (DIPS) in treating patients with portal hypertension. Methods DIPS were created in 23 patients with portal hypertension. Both preoperative and postoperative portal systemic pressure gradient (PPG), liver function and clinical symptoms were recorded and compared. Shunt patency was checked by color Doppler ultrasonography and the data were statistically analyzed by Kaplan-Meier method. Results DIPS creation was successfully accomplished in all 23 patients. No serious complications occurred after DIPS except for hemorrhagic ascites (n = 1) and mild hepatic encephalopathy (n = 3). Mean PPG significantly decreased from preoperative (32.6 ? 5.3) mmHg with a range of (23 - 43) mmHg to postoperative (10.1 ? 2.7) mmHg with a range of (5-14) mmHg (P

Objective To report the preliminary results of placing metallic stent and 125I seed strand combined with transcatheter arterial chemoembolization(TACE) for the treatment of hepatocellular carcinoma(HCC) with inferior vena cava(IVC) obstruction.Methods From March 2009 to June 2009,implantation of radioactive 125I seed strand and metallic stent combined with TACE treatment was performed in 8 cases of HCC with malignant IVC obstruction.All patients were males with a mean age of(60.6 ? 9.6) years.125I seed strand and Z-type self-expandable metallic stent were placed in the obstructive segment of IVC,which was followed by TACE.Before and after the treatment,the diameter of the obstructive segment of IVC,the pressure gradient between right atrium and distal end of obstructive segment of IVC,and the symptoms related to the obstruction were estimated and recorded,the results were compared individually.Clinical follow-up was conducted in all patients.Results A total of 8 stents and 10 125I seed strands were placed in the obstructive segment of IVC.Altogether 138 125I seeds were implanted in 8 patients.Obvious clinical improvements were obtained after therapy.No complications occurred in all patients except one patient who experienced acute renal dysfunction at the second day after therapy.During a mean of(2.1 ? 0.6) months follow-up,occlusion of IVC stent was detected in 1 patient.The remaining stents remained patent.Conclusion Our initial results indicate that placement of 125I seed strand and metallic stent combined with TACE is a safe and feasible therapeutic option for advanced HCC with malignant IVC obstruction.

Objective To discuss the application of C-arm CT scanning technology in performing transcatheter arterial chemoembolization for hepatic cancer.Methods Seventy-seven patients of hepatic cancer were treated with selective transcatheter arterial chemoembolization(TACE),which was followed by C-arm CT scanning to observe the embolization effect.C-arm CT scanning was also performed before TACE in 13 cases.Three-dimension reconstruction of the images was carried out on Integris 3D-RA workstation.The therapeutic results were evaluated.Results The embolization state of both the peripheral margin and the body of the tumor could be clearly displayed on CT scans in all 77 patients.Some tiny liver lesions were also detected in 3cases.Conclusion C-arm CT scanning technology is a newly-developed high-tech examination.This examination is very helpful for making the proper operation scheme and for evaluating the curative effect of intravascular intervention.Compared to the traditional CT scanning,C-arm CT scanning can provide more accurate information and stereoscopic image of the lesions,therefore,the whole course of the interventional procedure can be entirely under the operator's control and the curative effect can be evaluated at any time during the operation.C-arm CT scanning can be effectively employed in interventional therapy for multisystemic disorders.

Percutaneous transhepatic biliary drainage(PTBD) is an effective therapeutic option for obstructive jaundice.With various novel puncture instruments being created,the manipulating technique being improved and medical idea being updated,PTBD has been widely employed in clinical practice for alleviating the biliary tract obstruction.In order to standardize this technique this paper aims to make some suggestions for the PTBD guidelines concerning the indications,contraindications,operative skill,postoperative management,complications and their preventions,points for attention,etc.