Objective To evaluate the efficacy and technique of minimally invasive management for acute ureteral obstruction and severe infection caused by calculi.Methods A total of 51 patients with acute upper urinary tract obstruction and severe infection caused by calculi were enrolled in this study.When infection,sepsis,and electrolyte disorders were corrected,emergent drainage by retrograde ureteral catheterization using cystoscopy or B-ultrasonography-guided percutaneous nephrostomy were carried out.Ureteroscopic lithotripsy or extracorporeal shock wave lithotripsy(ESWL)were performed after the infection was controlled.Results Cystoscopic retrograde ureteral catheterization was completed in 8 cases,and the other 43 patients were treated successfully by B-ultrasonography-guided percutaneous nephrostomy.During the operations,purulent urine spurted out from the drainage tube.Ten patients had transient hematuria and lumbar pain postoperation.None of the patients developed pneumothorax,urinary extravasation,perirenal hematoma,or abdominal organ injuries,etc.In 3 cases,recauterization was done because the catheter dropped out.In all the patients,the body temperature and blood white blood cell counts returned to a normal range 3 to 7 days after the drainage.Among the cases,8 were treated with ESWL,35 received ureteroscopic lithotripsy,and 8 underwent ESWL after the ureteral stone being pushed upwards to the renal pelvis.No severe complications,such as ureteral perforation or tears,massive hemorrhage,or high fever occurred after lithotripsy.The stones were completely removed in all the cases in 3 weeks postoperation(in 1 week for 34 cases).The patients were followed up for 3 to 6 months,during which the renal function recovered to a normal level.Conclusions Retrograde ureteral catheterization using cystoscopy or B-ultrasonography-guided percutaneous nephrostomy combined with ureteroscopic lithotripsy or ESWL is efficient for patients with acute ureteral obstruction and severe infection caused by calculi.By using the method,ureteral infection can be controlled quickly without causing severe complications.

Objective To evaluate KISS1 expression, and its significance in the prognosis of GIST patients. Methods In this study, 137 GIST cases and 73 non-GIST sarcoma cases were evaluated for clinicopathological characteristics and immunohistochemistry for KISS1 antibodies. Result The expression rate of KISS1 was 40.9% (56/137) in GISTs,which was significantly correlated with tumor size, disease extent, cellularity, presence of pseudocapaule, Fletcher's risk stratification and metastatic status after resection (P＜0.05). Patients with positive KISS1 expression had significantly worse disease free survival and disease specific survival (P ＜ 0.05 ). Conclusions KISS1 expression was associated with some clinicopathological characteristics as well as malignant behaviors in patients with GISTs. KISS1 might be a predictor in prognosis for GIST patients.

Objective To explore the relationship between resveratrol and Notch 1 signalling pathway in podocytes.Methods Interference RNA (RNAi) and doxycycline (Dox) were used to inhibit the Sirtuin (SIRT) 1 expression in the wild-type and inducible SIRT1 shRNA (CAGGS) podocytes respectively.Recombinant mouse delta-like ligand 4 (DLL4) was used to activate Notch1 signalling.The message RNA of SIRT1,Notch1 downstream gene Hes1 and Hey2,as well as the key enzymes of Notch1 signalling pathway were detected by using real-time PCR.Western blotting was used to detect intracellular domain of Notch 1 (ICD1),SIRT1,and metalloprotease (ADAM) 10 and components of γ-secretase complex protein expression.Results In WT murine podoytes,resveratrol up-regulated ICD1 protein production,as well as the mRNA of Hes1 and Hey2 in a dose-dependent manner.Treatment with resveratrol resulted Nicastrin mRNA and protein increase in podocytes (P ＜0.05),as well as inhibit ADAM10 expression (P ＜ 0.05),but all these changes were prevented after the use of SIRT1 RNAi(P ＜ 0.05).DLL4 up-regulated the expression of mRNA of Hes1 and Hey2,as well as ICD1 protein production in a dose-dependent manner.Treatment with doxycycline resulted decrease of SIRT1 gene and protein expression in CAGGS podocytes after 24 h and 48 h respectively(P ＜ 0.05),which weakend the role of DLL4 significantly(P ＜ 0.05).Conclusion Resveratrol induces Nicastrin expression,as well as activation of Notch1 signalling pathway in a SIRT1-dependent manner.

Objective To determine the efficacy of retrovirus-mediated HSV-TK gene transfer and GCV in a BALB/c mice model with urinary bladder transitional cell carcinoma. Methods A replication defective retroviral vector containing HSV-TK gene was used. In vivo experimental animals were divided into 3 groups.In group A,7 tumors were induced in BALB/c mice by subcutaneous injection of MBT-2 transitional cell carcinoma (TCC);the virus was directly injected into the tumor and the animals received intraperitoneal GCV.In group B, 6 tumors were induced in BALB/c mice by subcutaneous injection of transferred HSV-TK gene TCC and the animals received intraperitoneal GCV.In group C,6 tumors were induced in BALB/c mice by subcutaneous injection of MBT-2 TCC and the animals received intraperitoneal normal saline.Tumor-volume measurement was performed in these 3 groups 10 d and 20 d after treatment, and the volume changes were compared among the 3 groups. Results In vivo experiment indicated that the mean tumor volume of group A [MBT-2 group, (55.37?4.52) mm3] and group B [MBT-2/HSV-TK group,(49.77?4.15)mm3] was reduced significantly compared with that of group C [control group,(146.27?10.46)mm3](P0.05).At 20 d after treatment, the mean tumor volume of group A [(186.75?8.14)mm3] and group B [(72.50?6.70)mm3] was also reduced compared with that of group C [(441.76?41.80)mm3] (P

Objective To study the effects of light at different intensities and an enriched environment (EE) on rats' level of voluntary exercise,and to explore the resulting benefits.Methods Thirty male SpragueDawley rats were tested successively under 4 different experimental conditions:EE + strong light,EE + dim light,open-field environment (OFE)+ strong light and OFE + dim light.Each rat's path in the different conditions was recorded using an automated tracking system.Distance moved (m),velocity (m/s),mobile duration (s),mobile frequency,moving duration (s) and moving frequency were recorded over a one-hour period. ResultsThe EE rats were significantly more active than the OFE rats in both strong and dim light.All rats were more mobile under dim light than under strong light.Conclusion Environment and light intensity are independent factors affecting rats' voluntary exercise levels,and they can exert their influence in synergy.

Objective·To explore effects of pCPT-cAMP on proteinuria and dedifferentiation of podocytes in adriamycin (ADR)-induced nephropathy mice. Methods·Male BALB/c mice were divided into three groups. The control group did not make any intervention, and the other mice were administrated with ADR in a dose of 10 mg/kg by intravenous injection (ADR group). Some ADR-injected mice were treated with pCPT-cAMP [50 mg/(kg·d)] by intraperitoneal injection everyday (A+P group). Albumin urine was detected by Coomassie blue stain. Urine creatinine concentration was estimated by ELISA. The expression of WT-1 was detected by immunohistochemical staining. Immunofluorescence staining and Western blotting were used to evulate the dedifferentiation of podocytes. Results·Compared with the control group, the ratio of urinary albumin/creatinine in ADR nephropathy mice was significantly increased. WT-1 immunohistochemical staining showed that the number of podocytes was significantly decreased, while immunofluorescence double staining of podocyte-specific protein synaptopodin and podocalyxin remarkably reduced, and the expression of desmin was increased. pCPT-cAMP intervention decreased the ratio of albumin/creatinine in ADR mice, elevated the quantity of WT-1 positive cells and the expression of synaptopodin and podocalyxin, while desmin expression decreased. Conclusion·pCPT-cAMP activates the PKA signaling and protects ADR nephropathy mice by preventing the loss of podocytes and ameliorating the urine albumin/creatinine ratio, which may be mediated by pCPT-cAMP-prevented dedifferentiation of podocytes.

Objective To compare the therapeutic efficiency of laparoscopic and open radical colorectal surgery in the treatment of colorectal carcinoma. Methods Clinical data of 77 cases undergoing laparoscopic colorectal surgery from September 2004 to October 2007 were compared with 90 patients treated by open surgery. Results Mean operating time was longer in the laparoseopic group than that in the open group [248 minutes vs. 225 minutes (t = -2. 11 ,P =0. 036)], blood loss was less in laparoscopic group [210 ml vs. 315 ml (t = 2. 82, P = 0. 005)]. Laparoscopic surgery was associated with lower rate of analgesia use [48% vs. 80% (x2 = 18. 69 ,P < 0. 01)], earlier recovery of bowel function [2. 9 days vs. 4. 3 days(t =5.59,P <0. 01)]and shorter hospital stay [12. 5 days vs. 15.5 days (t =2. 32,P=0. 039)]compared with open surgery. The number of removed lymph nodes [14. 2 vs. 15.3 (t = 1.04, P = 0. 3)]and length of reseeted bowel [18. 9 cm vs. 20. 0 cm, (t = 0. 88,P = 0. 383)]were not different between the two groups. The mean follow-up time of the two groups were 28 months, local recurrence rate, metachronous metastases rate and 3-year cumulative survival rate were not statistically different between the two groups. Conclusion Laparoscopic surgery is as effective as conventional open surgery in the treatment of colorectal carcinoma.

Objective To investigate the monitoring of the recurrent laryngeal nerve (RLN)function during thyroid surgery by recording the compound muscle action potential (CMAP) of lateral cricoarytenoid muscle(LCA) under block anaesthesia of the cervical plexus. Methods Nicolet Endeavor CR(Viasys Healthcare, USA) was applied for the intraoperative monitoring. A pair of needle electrodes were inserted into LCA to record CMAP, and a concentric electrode was used to intermittently stimulate the RLN for monitoring the RLN function during operation under block anaesthesia of the cervical plexus.Results In these 28 cases 31 RLNs were exposed during operation, CMAPs appeared with consistent latency when stimulation was applied at the exposed segment. The stimulating intensity threshold ranged from 0.2 to 1.6 mA. The average value was 0.96 mA. 25 of 31 showed CMAPs with consistent latency when stimulation was provided along the possible pathway of the unexposed segment. The stimulating intensity threshold ranged from 1.3 to 3.5 mA. The average value was 2. 03 mA. 6 of 31 did not evoked CMAP even though the maximal stimulating intensity was 5 mA. When these six nerves were exposured, compound muscle action potential were evoked consistently. All of the 28 patients had normal phonation function after surgery.Conclusions It is a safe, effective and feasible method to monitor the RL N function by recording the CMAP of lateral cricoarytenoid muscle under block anaesthesia of the cervical plexus.

Objective To compare the efficacy,toxicitis and side-effects of Casodex and Flutamide in the hormonal therapy of advanced prostate cancer patients.Methods One hundred and thirty-six advanced prostate cancer patients were treated with with hormonal therapy.The patients were divided into 3 groups,of which 52 patients (group A) used LHRHa and Casodex as intermittent hormonal therapy;60 patients(group B) used LHRHa and Flutamide as intermittent hormonal therapy;24 patients(group C) were treated with surgical castration only.The difference of clinical symptoms,serum PSA,disease progression risk,survival rate,toxicitis and side-effects of 3 groups were compared.Results The relief rates of group A and B were 80.8% (42/52)and 81.7% (49/60) respectively,higher than 70.8% (17/24) of group C.The mean serum PSA of group A and B decreased from 133.3 ng/ml(17.9-982.8 ng/ml) to 15.8 ng/ml(0.02-28.9 ng/ml),142.6 ng/ml (20.2-1001.0 ng/ml)to 16.1 ng/ml(0.07-53.8 ng/ml),respectively,both better than that of group C,which decreased from 142.3 ng/ml (27.1-988.0 ng/ml) to 27.6 ng/ml(6.0-62.1 ng/ml).The mean chemical recurrence rates of group A and B were 34.7% (18/52) and 36.7% (22/60),respectively,lower than 58.3% (14/24) of group C.The mean chemical recurrence time of group A and B was 22(5-52)months and 22(6-65)months,respectively,longer than 11(5-54)months of group C.The mortality rates of group A and B were 26.9% (14/52) and 31.7% (19/60),respectively,lower than 66.7%(16/24) of group C.88.5% (46/52)of group A were treated continuously,while group B had 66.7% (40/60).The side-effects rate of group A was lower than group B.Conclusions Both Cadosex and Flutamide are effective for prostate cancer,and decrease the disease progression risk.Casodex is more effective and safer as for the treatment of prostate cancer compared to Flutamide.

Objective To approach the clinical presentation,treatment and diagnosis of primary seminal vesicle carcinoma.Methods The records of 4 patients who diagnosed seminal vesicle carcinoma were retrospectively reviewed,including the symptoms signs and examination results as well as operation program,postoperative therapy.Considered to the literature reports.Bilateral seminal vesicles,bladder, prostate and rectum were totally removed in one case.Seminal vosiculectomy and partial cystoprostotectomy were performed in 2 cases,and the another one,bilateral lower ureterectomy and ileum substitute bladder was be done.Results Followed up for 3 months to 5 years,and no recurrence had been observed so far, one died of colon cancer after 2 years.Conclusions Early symptoms of primary seminal vesicle carcinoma are unobvious,so that early diagnosis of seminal vesicle carcinoma is difficult and the misdiagnosis is so usually.Thus,accurate recognition is important for early diagnosis.Radical surgery appears to offer the best chance and different approaches can be selected according to tumor stage and invasive condition of the circumambient organ.Comprehensive treatment like hormonal therapy,along with the 5-fluorouracil,paclitaxel,and oxaliplatin chemotherapy regimen appears to be effective against adenocarcinoma.