Objectives:To determine the feasibility of routinely performing internal urethrotomy for anterior urethral stricture under intracorpus spongiosum anesthesia in an outpatient setting.Methods:In a consecutive series of 18 patients with anterior urethral stricture,a dosage of 2~3 ml of 1%~2% lidocaine was slowly injected into the glans penis.Next,optical urethrotomy was performed immediately with a cold-cutting knife.According to pain scale,the effect of this anesthetic technique was assessed by questionnaire.Results:Internal urethrotomy was successfully completed in all the patients.All patients had no pain or discomfort.All the minor procedures varying from 15 to 45 minutes in duration were successfully completed under the new local anesthesia without any additional IV sedation.The anesthesia was very satisfactory without any complications.Conclusions:Under intracorpus spongiosum anesthesia,optical urethrotomy can be routinely performed in an outpatient setting.With this new local anesthesia,internal urethrotomy is a safe,effective,simple,and inexpensive procedure for treatment of anterior urethral stricture.

Objectives:To evaluate the operative treatment for ureteropelvic junction(UPJ)stricture.Methods:A total of 58 cases of UPJ stricture had double-J tubes placed intraoperatively during Anderson-Hynes pyeloplasty.Urethral catheterization was maintained for 5~7 day,and the double-J tube was removed on cystoscopy 4 to 8 weeks after operation.The outcome was evaluated with ultrasonography or intravenous urography in 3 to 12 months postoperatively.Results:Success rate of management was 100%,stricture was relieved successfully in all patients,and hydronephrosis improved.Only 5 cases had complication in the near future.During follow-up of 6 months to 2 years,long-term complications,like stricture of the anastomotic mouth,and worsened kidney hydrocele,were not observed.all patients have been with satisfactory long-term results.Conclusions:Anderson-Hynes pyeloplasty was an effective method for the treatment of UPJ stricture.A double-J tubes in the operation could reduce the incidence of anastomotic mouth stricture and promote the success rate of operation.

Objective:To explore the application value of anti-intrarenal artery spasm(IRAS) in renal allografts with unknown ischemia during kidney transplantation. Methods:1. Hot compression:45℃ normal saline gauze was compressed over the grafted kidney and the renal surface was gently rubbed with the fingers;2. Vasodilator:Anisodamine hydrochloride(10～20mg) was injected rapidly into the renal artery. The injection could be repeated one or two times if the blood perfusion of the graft improved;3. Blockage:The adventitia of the renal artery was blocked with 1% lidocaine;4.Dopamine(20～40mg),papaverine(15～30mg) hydrochloride and 5% glucose in normal saline(500ml) were administered intravenously for three to five days after transplantation. Results:Ischemia disappeared in 8 cases with unknown ischemia reason and the cause was confirmed to be IRAS. Serum creatinine in 8 cases gradually decreased to the normal level on the third to the fifth postoperative days. Conclusion:Anti-IRAS is essential for those with unknown renal ischemia during kidney transplantation,especially for the diagnosis and treatment of IRAS.

Objective:To enhance the recognition of pyeloureteric junction(PUJ)obstruction and improve the diagnosis of its cause.Methods:Thirty-eight patients with pyeloureteric junction obstruction underwent intravenous urography(IVU),retrograde urography(RGU) and CT examinations.X-ray and CT findings in all patients were analyzed retrospectively.Results:On X-ray and CT images in all patients the morphologic features and hydronephrosis state of pyeloureteric junction obstruction were clearly visualized.Conclusion:Urography combined with CT examination can judge obstructive position and renal function,and it is a most efficient diagnostic method for obstructive disease in PUJ.

Objective:To explore the expression and significance of cyclooxygenase-2 in human transitional cell carcinoma of bladder.Methods:A total of 42 samples of paraffin-embedded TCC tissue and 8 normal bladder sample were stained by SP immunohistochemical method with specific anti COX-2 antibody.The correlation between the positive expression rates and grades of tumor was analyzed.RT-PCR studied the expression of COX-2 in bladder carcinoma tissue.Results:Expression rate of COX-2 protein was significantly correlated to the tumor grades and their invasiveness.Expression rate of COX-2 protein in TCC was 61.9%,statistically higher than those in the normal samples(P

Objective:To establish a suicide gene therapy system HSV-tk/GCV for bladder cancer,a treatment in vitro as well as in vivo and to test its efficacy.Methods:Mouse bladder cancer cell line (T739) was transfected with retroviral vector HSV-tk gene.The sensitivity of T739-TK cells to GCV was detected in vitro.In the mouse model of bladder tumor,T739 or T739-TK was implanted beneath the peritoneum of syngeneic mice.When tumors grew to the size of 0.5～0.8cm,intraperitoneal administration of GCV was carried out for 6 days.Changes of tumor size and survival rate of mice were observed.Results:RT-PCR showed that TK gene was transferred into the T739 cell and expressed successfully. In vitro,T739-TK cells became sensitive to low concentrations of GCV.In vivo studies showed similar result.Significant tumor inhibition was found in the T739-TK group after administration of GCV,and the survival time of mice was prolonged.Conclusion:Tumor cells expressing HSV-tk gene were eradicated by administration of GCV in vitro as well as in vivo.

2*!cm. Conclusions Large invasive and metastatic carcinoid tend to be malignant, and the prognosis is usually poor, with which a radical resection may help.

Objective To investigate the effects of the HyTK gene transduction on murine bladder carcinoma cells in vitro . Methods The retroviral vector plasmid PL(HyTK)SN was transfected into packaging cell line PA317 using the liposome method. The obtained recombinant retroviral supernatant fluid was used to infect murine bladder cancer cell line T739 cells. B resistant colonies, named as T739 TK, were obtained after hygromycin B selection. The integration and expression of HyTK gene in T739 TK cells were identified by RT PCR. The in vitro killing effects of GCV on T739 TK cells were observed. Results RT PCR showed that HyTK gene was inserted into T739 cells successfully and there was mRNA expression of HyTK gene. In vitro , T739 TK cells expressed the killing effects after treatment with GCV of different concentrations. However, T739 cells grew well at different doses of GCV. Conclusion GCV has obvious killing effect on HyTK gene transfected T739 cells in vitro .

Objective To determine the bystander effect of therapy with herpes simplex virus thymidine kinase ( HSVtk ) gene combined with ganciclovir (GCV) on mouse bladder cancer. Methods Mouse bladder cancer cell line (T739) was transfected with retroviral vector HSVtk gene. The sensitivity of T739TK cells to GCV was detected in vitro . Bystander effect in vitro in co cultured mixtures of T739TK and T739 cells at different ratios or at the same ratio in culture bottles of different size was determined. In the mouse model of bladder tumor, mixtures of T739 and T739TK cells were implanted beneath the peritonea of syngeneic mice. When tumors grew to the size of 0 5-0 8 cm, intraperitoneal administration of GCV was carried out for 6 d. Changes of tumor size and survival rate of mice were observed. Results T739 cells retrovirally transfected with the HSVtk gene became sensitive to low concentrations of GCV. Analysis by RT PCR confirmed HSVtk expression in the transfected T739TK cells. An absolute bystander effect was observed in the mixed culture of cells in vitro when the HSVtk gene transferred cells were at the ratio of above 10%. The tumor growth in the animal model was significantly inhibited by GCV, demonstrating the existence of bystander effect in vivo . The survival time of mice was prolonged after administration of GCV. Conclusion The in vitro and in vivo bystander effects exist in mouse bladder cancer transfected with HSVtk gene, enhancing the role of HSVtk /GCV system for the treatment of bladder carcinoma.

Objective To investigate dynamic changes and clinical significance of the high-sensitive Creactive protein(hs-CRP) level in acute cerebral infarction patients with different etiological types.Methods 136 patients with acute cerebral infarction were recruited.These patients were classified into five subtypes based on Trial of Org 10172 in Acute Stroke Treatment(TOAST) criteria.Serum hs-CRP levels on the 1st,3rd,5th,7th,14th day after onset from patients and 42 healthy controls were measured with immunoturbidimetry.The neurologic impairmentscore was determined with NIHSS.Results Serum hs-CRP levels is higher on the 1th,3rd,5th,7th,14th day than that of the control group ( (4.26 ± 1.31 ),( 12.57 ± 6.29 ),( 10.23 ± 4.49 ),(7.54 ± 2.33 ),(4.25 ± 1.77) mg/Land (2.56 ± 0.86) mg/L,t = 7.89,10.26,10.99,13.55,5.97,P ＜ 0.05 ).Among 5 subtypes,serum hs-CRP was the highest in large-artery atherosclerosis group after acute ischemic stroke,and cardioembolism group was the next.Serum hs-CRP reached the highest on three or five days after disease onset and decreased slowly.High levels of hs-CRP in large-artery atherosclerosis group indicated severe neurologic functional impairment and worsen prognosis.Conclusions ACI is closely related to serum hs-CRP level,which can be used as an subjective index for severity and prognosis with the lasting,high levels of hs-CRP levels predict poor prognosis.