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 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 investigate the short and long term therapeutic effects of prostaglandin E1 (PGEl) on diabetic nephropathy (DN). Methods Patients with DN in stage Ⅲ to Ⅴ according to Mogensen criteria were randomly assigned to four groups of PGE1, angiotensin-converting enzyme inhibitor (ACEI), PGE1 + ACEI and control drug. The levels of proteinuria and albuminuria were measured before and 15 days, 6 months and 18 months after treatment. Patients with DN in stage Ⅳ were subdivided into three groups according to proteinuria: early stage IV (protienuria was less than 1.5 g/d), middle stage Ⅳ (protienuria was between 1.5 g/d and 2.5 g/d) and late stage Ⅳ (protienuria was larger than 2.5 g/d). Results Fifteen days after treatment, the levels of proteinuria and albuminuria were significantly decreased compared with pre-treatment in PGE1 and PGE1 + ACEI groups (P<0. 01), and the therapeutic effect was better in PGE1 + ACE1 group than in ACEI group (P<0. 01). Six months after treatment, there were still significant differences in above parameters in patients with DN in stage Ⅲ and Ⅳ between PGE1 + ACEI and PGE1 groups. And for the patients in stage Ⅴ, statistic significance between pre-and post-treatment existed only in PGE1 + ACEI group (P<0. 05). but not in PGE1 and ACEI groups (both P>0. 05). Eighteen months atter treatment, the levels of proteinuria and albuminuria were significantly decreased in patients in stage HI and early stage IV in all treatment groups (P<0. 01). For patients in middle stage IV and late stage Ⅳ , the significant differences still occurred between pre-and post-treatment in PGE1 + ACEI group (P<0. 01 or P<0. 05), and were significantly better than in ACEI group (P<0. 01 or P<0. 05). However, the proteinuria of patients in late stage IV elevated in PGE1 group in post-treatment versus pre-treatment (P<0. 05). Conclusions The short term therapeutic effect of PGE1 is quick and good in patients with DN. The therapeutic effect is much better in patients in stage Ⅲ compared with stage Ⅴ. The combination of PGE1 and ACEI will get better best therapeutic effect than PGE1 or ACEI alone in long term.

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.

Purpose:To improve the clinical diagnosis of prostatic cancer. Methods:161 prostatic neoplasms were evaluated retrospectively according to the clincial manifestations, transrectal palpation, CT scanning, MRI of prostate, blood PSA findings and skeletal scintigraphy.Results:As to the clincial manifestations dysuria occurred in 154(95.6%), retention of urine in 30 (18.6%), hematuria in 56(34.8%), paralyses in 2 (1.3), bone pain or weight loss were noted in 8 (4.9%). On transrectal palpation glandular induration was found in 127(78.9%), irregularity of the prostatic surfase in 47(37.1%) and elevated nodules in 129(73.9%). Ultrasonography showed a prostatic enlargement in 27 (21.1%) high echo in 14 (10.9%), low echo in 58(45.3%). vesical infiltration in 14 (10.9%) and seminal invasion in 11(8.6%); 46 patients underwent prostate biopsy guided by transrectal ultrasound,positive results were found in 42(91.3%). 93 serum PSA findings revealed less than 4 ?g/L in 10 (10.8%), 4～10 ?g/L in 9(9.7%), 10～100 ?g/L in 41(44.1%),more than 100 ?l in 33(35.5%). 108 skeletal scintigraphy revealed normal bone scanning in 22 (20.4%), multiple metastases in 81(75.0%), single suspected lesion in 5 (4.6%). Conclusions:The clinical manifestations together with the imaging, PSA finding, bone scanning etc, all played an important role in the clinical diagnosis of prostatic cancer.

Objective To analyze left ventricular(LV) and right ventricular(RV) myocardial function in fetuses,quantitative tissue velocity imaging (QTVI) was used to detect myocardial performance index (Tei index).Methods The study group consisted of 77 second and third trimester conceived normal fetuses.The isovolumic relaxation time (IRT) + isovolumic contraction time (ICT) and ejection time (ET) of LV,RV and internal ventricular septum were obtained by QTVI.Tei indexes were calculated using the formula (IRT+ICT)/ET.Results The fetal IRT+ICT,ET and Tei index can be easily obtained in all fetuses.There was no significant difference for LV and RV Tei index (LV: 0.49 ? 0.10 ;RV: 0.50 ? 0.13 ).The IRT + ICT and ET were inversely proportional to fetal heart rate.The Tei index,however,appeared to be independent of fetal heart rate and of gestation age.Conclusions QTVI provides a new,easily obtainable and reproducible measure to assess fetal ventricular function.

A special method of clinical tumor radiation therapy,namely 3DCRT& IMRT,is described in this paper,including its design and clinical application.

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.