Objective To study the effect of grape seed procyanidin extract(GSPE) on the cell cycle arrest in human bladder cancer BIU87 cells and investigate the underlying molecular mechanism.Methods BIU87 cells were treated with different concentrations of GSPE(50,100 and 200 ?g/ml) and cultured for 24 h.The untreated group served as control.Flow cytometry was used to evaluate the cell cycle,and RT-PCR and Western blotting were used to detect the mRNA and protein expressions of CyclinD1 and cyclin-dependent kinase 4(CDK4).Results GSPE inhibited the cell growth through cell cycle arrest at G1 phrase in a dose-dependent manner.Semi-quantitated RT-PCR and Western blot analyses indicated that GSPE decreased CyclinD1 and CDK4 expressions in a dose-dependent fashion(P

B7-H1, a recently described member of the B7 family of costimulatory molecules, is thought to be involved in tumor immune escape by inducing T-cell apoptosis. In order to investigate the relationship between B7-H1 and immune escape of bladder cancer, B7-H1 expression in 50 cases of bladder cancer was detected by using immunohistochemical method. Survival curves were constructed using the Kaplan-Meier method and independent prognostic factors were evaluated using the Cox regression model. Our results showed that the positive rate of B7-H1 immunostaining in normal bladder tissue and bladder cancer was 0 and 72% respectively. The expression of B7-H1 was strongly associated with the pathological grade, clinical stage and recurrence (P<0.05). The survival rate was significantly lower in patients with B7-H1 positive group than in those with B7-H1 negative group and multi-variable analysis revealed that B7-H1 could be regarded as an independent factor in evaluating the prognosis of bladder cancer. It is concluded that the expression of B7-H1 is strongly associated with neoplastic progression and prognosis of bladder cancer. The manipulation of B7-H1 may become a beneficial target for immunotherapy in human bladder cancer.
Antigens, CD/genetics ; Antigens, CD/*metabolism ; Antigens, CD80/genetics ; Antigens, CD80/*metabolism ; Prognosis ; Tumor Escape/*genetics ; Urinary Bladder Neoplasms/*immunology ; Urinary Bladder Neoplasms/metabolism

OBJECTIVE: To summarize advances in clinical application of ureter stent and its biocompatibility. METHODS: A computer-based online search of CNKI (1989/2009) and Medline (1989/2009) was performed with the key words of "ureter, biocompatibility, stent, treatment, complications" in Chinese and English respectively. A total of 51 articles were collected. and 21 were included. The treatment advances and its biocompatibility of ureter stent were summarized, and clinical application advances, biocompatibility and complication prevention of ureter stent were explored. RESULTS: Ureter stent includes polymerizer, metal and degradable material stents. As the common implants in treatment of upper urinary tract diseases, ureter stent functions as stent and internal drainage, and relieve ureteral obstruction, prevent leakage of urine postoperatively and ureterostenosis. Complications following ureter stent implantation include stent shifting, urine reflux, irdtative symptoms of bladder, fouling and stone formation as well as infection. However, these complications can be relieved through positive treatment. CONCLUSION: Ureter stent is an effective approach to treat urologic disease, but the biocompatibility required improvement. Rigorous operation during stent implantation and positive treatment of complication can effectively prevent complications.

Objective To evaluate the safety and efficacy of nephron sparing surgery for small renal tumor. Methods A total of 43 patients with small renal tumor underwent nephron sparing surgery (NSS). Of the 43 patients, 27 were male and 16 were female, with an average age of 46.0(21-79)years. The mean diameter of the tumors was 3.1 (1.2- 4. 0)cm. Eighteen cases received open NSS, other 25 cases received retroperitoneal laparoscopic NSS. The perioperative data and renal function, postoperative complications and tumor recurrence were evaluated. Results The procedure was successful in all 43 patients, though 2 cases occurred serious bleeding during operation. The average operating time was 158. 0(69- 277) and 150. 0(60-226) min in open NSS and laparoscopic NSS groups. The average warm ischemia time was 23. 2(20-31) and 25.8(23-35) min. The average blood loss was 590.8(120-3000) and 468. 5(50-1600) ml. The average pre-operation creatinine was (65.9±22. 8)and(68.4±25.0)μmol/L. The average creatinine at the end of follow-up was(82. 2±24.1)and(85. 3±25.9)μmol/L. The average hospital stay was 19.2(11-47) and 12.5(10- 16) (P＜0.05). The histological results showed 25 cases of renal cell carcinoma (RCC, Tla) and 18 cases of benign lesions. Sixteen cases(37%)of minor complications were observed. Comparing the open NSS versus laparoscopic NSS group, perirenal hematoma rate was 6 % vs 12 % (P＜0.05), flank numbness rate was 11.1% vs 0(P＜0.05). During the mean 25-60(37. 4±7.2)months follow-up, 1 case with RCC relapsed in 20 months and received radical nephrectomy. 1 case with harmatoma was found a new lesion apart from the original site in 6 months and CT scan confirmed harmatoma, and then received active surveillance. The 3-year recurrence-free survival for all tumors in 2 groups was 94%, 96%, and that for RCC was 100% and 93%, separately. Conclusions Comparing with open NSS, laparoscopic NSS for small renal tumor has a shorter hospital stay and lower flank numbness rate, though has higher perirenal hematoma rate. There was no significant difference in other complications between the 2 groups. No irreversible renal function damage was observed in two groups. The tumor recurrencefree survival and RCC recurrence-free survival were no significant difference between two groups.

Objective To investigate the diagnosis,treatment and prognosis of bilateral renal clear cell carcinoma in the elderly.Methods Clinical data from 38 cases of elder patients admitted with bilateral renal clear cell carcinoma in our department from 2010 to 2014 were retrospectively analyzed.Among the total 38 cases diagnosed by B ultrasound and CT,13 cases(A group)were treated with laparoscopic radical nephrectomy on one side,combined with microwave ablation on the other side;another 25 cases(B group)were treated with microwave ablation on bilateral sides.Patients were followed up for 24-36 months,with regularly checking by B ultrasound,CT and renal function.Results The operations were successful in total 38 cases (A +-B group),and no postoperative complications were found.All cases were diagnosed as pathologically proven bilateral renal clear cell carcinoma.Postoperative renal functions of the cases were decreased at different degrees as compared with preoperative renal functions,but not needing dialysis treatment.The microwave ablation on bilateral sides(B Group) versus A Group,significantly decreased the surgical time cost (P =0.012) and hospital stay(P =0.021).For both A and B group,postoperative renal function were declined in different degree.The damage extents of blood urea nitrogen,creatinine and creatinine clearance rate were less in group B than in group A at one week after surgery(P=0.008,0.009 and 0.006).Atpostoperative follow-up for 3 month,it was found that the damage extents of blood urea nitrogen,creatinine and creatinine clearance rate were less in group B than in group A (P =0.037,0.020 and 0.018).At postoperative follow-up for 30 months in average,no local recurrence or metastasis was found.Diagnosis of bilateral kidney clear cell carcinoma in the elderly mainly depended on B ultrasound,CT scan and MRI imaging.Conclusions As to the treatment of elderly patients with early renal clear cell carcinoma,considering both the general healthy condition of patients and tumor therapy and choosing microwave ablation might be good for efficiency and prognoses.

Objective To investigate the efficacy and safety of perioperative use of different hemostatic drugs in elderly patients undergoing transurethral resection of the prostate (TURP).Methods A total of 480 elderly patients with benign prostatic hyperplasia (BPH) admitted to the Departments of Urology and Gerontology of our hospital from January 2010 to October 2014 were selected and randomly divided into 6 groups (n =80,each).Patients in all groups were given preoperative oral finasteride for 1 week,with each of the non-control groups receiving perioperative heamocoagulase agkistrodon,mangabeys hemocoagulase,reptilase,ethylenediamine diaceturate,or dicynone + paraaminomethyl benzoic acid (PAMBA).Intraoperative bleeding,perioperative hematocrit,hemoglobin change,continuous bladder irrigation time,adverse reactions and other clinical parameters were recorded.Results Operations went smoothly with all patients.Changes in perioperative blood routine indexes,coagulation function,intraoperative bleeding volume and continuous bladder irrigation time had significant differences between the control group and the groups treated with hemostatic drugs (all P＜0.05).No significant differences in perioperative blood routine indexes,coagulation function,intraoperative bleeding volume and continuous bladder irrigation time were found between groups treated with heamocoagulase agkistrodon,mangabeys hemocoagulase and reptilase,or between groups treated with ethylenediamine diaceturate and dicynone+PAMBA (all P＞ 0.05).There were significant differences in the perioperative blood routine indexes,coagulation function,intraoperative bleeding volume and continuous bladder irrigation time between the groups with and without blood coagulation enzymes (all P ＜0.05).Fibrinolytic responses occurred in 2 patients in the heamocoagulase agkistrodon group and were mitigated after drug withdrawal and fibrinogen infusion.Conclusions A reasonable perioperative dose of a hemostatic drug has good clinical effects in elderly patients undergoing TURP.Hemostatic drugs such as blood coagulation enzymes have certain advantages including safety over other types of hemostatic drugs,but their doses should not be too large.

The safety and efficacy of retroperitoneoscopic microwave ablation (MWA) in the treatment of renal hamartoma were evaluated. From July 2007 to July 2009, a total of 16 cases of renal hamartoma were treated with retroperitoneoscopic MWA. Peri- and post-operative findings were observed. Middle-term efficacy was assessed by contrast-enhanced computerized tomography (CT) in follow-up period. All patients received MWA of 1-5 points. The mean operative time was 85 min and the mean blood loss was 65 mL. During a median follow-up of 16 months, no evidence of disease recurrence was observed despite of incomplete ablation in 1 case. Retroperitoneoscopic MWA is a relatively simple procedure with less impact to renal function and less complication. The outcome of middle-term follow-up is satisfactory. Thus, retroperitoneoscopic MWA appears to be a safe and effective technique for renal hamartoma in selected patients.

Immunotherapy which has been in practice for more than 20 years proves effective for the treatment of metastatic renal cell carcinoma (mRCC). Anti-angiogenesis-targeted therapy has recently been identified as a promising therapeutic strategy for mRCC. This study was aimed to evaluate the effectiveness of vascular endothelial growth factor (VEGF) pathway-targeted therapy for mRCC by comparing its effectiveness with that of immunotherapy. The electronic databases were searched. Randomized controlled trials (RCTs) on comparison of VEGF inhibiting drugs (sorafenib, sunitinib and bevacizumab) with interferon (IFN) or placebo for mRCC treatment were included. Data were pooled to meta-analyze. A total of 7 RCTs with 3451 patients were involved. The results showed that anti-VEGF agents improved progression-free survival (PFS) and offered substantial clinical benefits to patients with mRCC. Among them, sunitinib had a higher overall response rate (ORR) than IFN (47% versus 12%, P<0.000001). Bevacizumab plus IFN produced a superior PFS [risk ratio (RR): 0.86, 95% confidence interval (CI): 0.76-0.97; P=0.01] and ORR (RR: 2.19; 95% CI: 1.72-2.78; P<0.00001) in patients with mRCC over IFN, but it yielded an increase by 31% in the risk of serious toxic effects (RR: 1.31; 95% CI: 1.20-1.43; P<0.00001) as compared with IFN. The overall survival (OS) was extended by sorafenib (17.8 months) and sunitinib (26.4 months) as compared with IFN (13 months). It was concluded that compared with IFN therapy, VEGF pathway-targeted therapies improved PFS and achieved significant therapeutic benefits in mRCC. However, the risk to benefit ratio of these agents needs to be further evaluated.

The safety and efficacy of retroperitoneoscopic microwave ablation (MWA) in the treatment of renal hamartoma were evaluated. From July 2007 to July 2009, a total of 16 cases of renal hamartoma were treated with retroperitoneoscopic MWA. Peri- and post-operative findings were observed. Middle-term efficacy was assessed by contrast-enhanced computerized tomography (CT) in follow-up period. All patients received MWA of 1-5 points. The mean operative time was 85 min and the mean blood loss was 65 mL. During a median follow-up of 16 months, no evidence of disease recurrence was observed despite of incomplete ablation in 1 case. Retroperitoneoscopic MWA is a relatively simple procedure with less impact to renal function and less complication. The outcome of middle-term follow-up is satisfactory. Thus, retroperitoneoscopic MWA appears to be a safe and effective technique for renal hamartoma in selected patients.

Immunotherapy which has been in practice for more than 20 years proves effective for the treatment of metastatic renal cell carcinoma (mRCC).Anti-angiogenesis-targeted therapy has recently been identified as a promising therapeutic strategy for mRCC.This study was aimed to evaluate the effectiveness of vascular endothelial growth factor (VEGF) pathway-targeted therapy for mRCC by comparing its effectiveness with that of immunotherapy.The electronic databases were searched.Randomized controlled trials (RCTs) on comparison of VEGF inhibiting drugs (sorafenib,sunitinib and bevacizumab) with interferon (IFN) or placebo for mRCC treatment were included.Data were pooled to meta-analyze.A total of 7 RCTs with 3451 patients were involved.The results showed that anti-VEGF agents improved progression-free survival (PFS) and offered substantial clinical benefits to patients with mRCC.Among them,sunitinib had a higher overall response rate (ORR) than IFN (47％ versus 12％,P＜0.000001).Bevacizumab plus IFN produced a superior PFS [risk ratio (RR):0.86,95％ confidence interval (CI):0.76-0.97; P=0.01] and ORR (RR:2.19; 95％ CI:1.72-2.78; P＜0.00001) in patients with mRCC over IFN,but it yielded an increase by 31％ in the risk of serious toxic effects (RR:1.31; 95％ CI:1.20-1.43; P＜0.00001) as compared with IFN.The overall survival (OS) was extended by sorafenib (17.8 months) and sunitinib (26.4 months) as compared with IFN (13 months).It was concluded that compared with IFN therapy,VEGF pathway-targeted therapies improved PFS and achieved significant therapeutic benefits in mRCC.However,the risk to benefit ratio of these agents needs to be further evaluated.