Objective To explore the safety and clinical efficacy of radical transurethral photoselective vaporization of bladder tumours (RPVBT) combined with chemotherapy in the treatment of muscle invasive bladder cancer.Methods Collected during Sept.2010 to Sept.2012,a total of 34 patients with muscle invasive bladder cancer who refuse or older,merge the heavier medical disease,difficult to tolerate radical cystectomy.Using RPVBT,vaporization resection to the bladder wall fat layer,postoperatively systemic chemotherapy of gemcitabine combined cisplatin and bladder perfusion chemotherapy of pharmorubicin.The operation time、the first recurrent time and recurrent rate,and the survival rate were measured.Results Operation are completed smoothly,operating time is 30.5-69.0 min and average 49.2 min,intraoperative rinses quantity is 5.9-10.7 L and average 8.3 L.Intraoperative no obvious bleeding,intraoperative no serioue complications,postoperative pathological diagnosis is invasive epithelial cell carcinoma of the urinary tract,pathology classification:low level 15cases,the high level 19 cases.Followup of 12 to 36 months,an average of 21 months,9 cases of recurrence,2 cases underwent radical cystectomy,7 cases again RPVBT,the first tumor recurrence time 3-20 months,11 months and the median time to relapse recurrence rate 26.5％ (9/34),3 cases of relapses diedof bladder cancer metastasis,31 cases of survival.Conclusion Treatment of RPVBT combination chemotherapy in patients with locally invasive bladder cancer,small trauma,less bleeding,high safety,have certain curative effect,It could be a effective treatment strategy for patients of high-risk elderly or unwilling to accept Radadical cystectomy.

Objective To evaluate the efficacy and safety of application of F 16 single-tract minimally invasive percutaneous nephrolithotomy ( MPCNL) combined with flexible ureteroscopy for the treatment of complex renal staghorn calculi . Methods From May 2009 to September 2012, 35 patients with complex renal staghorn calculi were treated by F 16 single-tract MPCNL combined with flexible ureteroscopy in this hospital .All the patients underwent MPCNL at the first-stage, and 5-7 days afterwards a second-stage operation was performed by using flexible ureteroscopy .The fragments of stones were removed from the MPCNL tract .For patients diagnosed as having residual stones , a third-stage reoperation of MPCNL combined with flexible ureteroscopy was given . Results Twenty-one patients were stone-free after the second-stage operation , 12 patients were stone-free after the third-stage operation , and the remaining 2 patients with residual stones were given drug administration for stone removal and were clarified as stone -free within 1 month of follow-up.No serious intraoperative or postoperative complications such as hemorrhage or infectious shock occurred .Follow-up reviews for 3 -6 months in the 35 patients found no residual stones or recurrence . Conclusion F16 single-tract MPCNL combined with flexible ureteroscopy is an effect and safe procedure for complex renal staghorn calculi .

Objective To evaluate the efficacy of perioperative antibiotic prophylaxis for tension-free repair of inguinal hernia. Methods A randomized, prospective double-blind control trial was performed to evaluate the efficacy of perioperative antibiotic prophylaxis for tension-free mesh repair in 180 cases of inguinal hernia from March 2007 to March 2008. Intravenous cefuroxime ( 1.5 g ) was given immediately before the surgery in two groups followed by postoperative administration of cefuroxime 1.5 g twice a day for 3 days in test group compared with NS infusion in the control group. Postoperatively 16 patients (8. 89 per cent) could not be contacted at any point, giving a response rate of91. 11%. The total number of subjects for per- protocol (PP) analysis was 180, 84 cases in test group and 80 cases in control group. Results Complete data were available for 164 patients, 3 ( 1.83 per cent) developed surgical site infection (SSI) including 2 cases of surgical site infection in test group and 1 case of superficial incision surgical site infection in control group. The differences were not statistically significant. The time to follow up was 12 -29 months, the mean follow up time in test group was (15.6 ±2.2) months and (18 ±3)months in control group respectively. 93.33% patients in test group were followed up and 88. 89% patients in control group. There were not hernia recurrence and side effect of antibiotics reported in the two groups.Conclusions To prevent SSI, it is necessary to use preoperative antibiotics prophylaxis just one time for inguinal hernia repair.

Objective To evaluate the repair of abdominal complicated incisional hernia using acellular dermal matrix (ADM).Methods Retrospective analysis was made on 7 cases with abdominal complicated incisional hernia treated by ADM in our hospital from January 2008 to June 2010,among them there were 4 males and 3 females.Age ranged from 43 to 83 years and the median age was 53 years.Two concurrent indirect inguinal hernia cases were repaired and concurrent gastrointestinal tract problems including 2 small bowd fistulas were operated one stage in 5 cases.Mean diameter of hernia ring was ( 11.6 ± 2.8 ) cm,ranged from 9.2 to 16.5 cm.5 cases were repaired by using intraperitoneal onlay mesh,others using total extraperitoneal prothesis.Results All patients were operated on successfully.Average time was (33 ±12) min.Blood loss was (16 ±4) ml.Hospital stay was 7 - 12 d.7 patients repaired by ADM fully recovered.There were no chronic pain,paresthesia,pneumonia and urinary tract infection cases,no incision swelling,seroma or infection.All patients were followed up with median time of 14 months,ranging from 5 to 26 months.There were not hernia recurrence,nor surgical site infection during follow-up period.Conclusions For the repairing of abdominal complicated incisional hernia,the application of acellular dermal matrix is safe and effective method especially in those of incisional hernia complicated by infection.

Objective To study the relationship of soluble LAIR (sCD305 and CD3060) expression in recipient serum with cytomegalovirus (CMV) pneumonitis after renal transplantation. Methods Nineteen serum specimens from recipients were divided into CMV pneumonitis group (n=10) and control group (n=9). Then the concentrations of sCD305 and CD3060 were quantitated with sandwich ELISA. The data were analyzed by using student t test. Results sCD305 was skewness distributed in both 2 groups, was 0.000-3.039 μg/L in CMV pneumonitis group and 0.000-8.375 μg/L in con-trol group. CD3060 was skewness distributed in CMV pneumonitis group and the concentration was 0.000-0.017μg/L. CD3060 was mormally distributed in control group and the concentration was 0.046±0.035 μg/L. There was significant difference of CD3060 (P=0.000) concentrations and no sig-nificant difference of sCD305(P=0.316) concentrations in 2 groups, respectively. Conclusions The concentration of CD3060 is low in CMV pneumonitis patients. The combination of CMV PP65 antigen detection and CD3060 detection is helpful for the early and precise diagnosis of CMV pneumonitis in renal transplantation patients.

Objective To investigate ideal solution of neoadjuvant hormomal therapy (NHT) for locally advanced prostate cancer.Methods 60 patients diagnosed with locally advanced (T3-4N0M0) prostate cancer were treated with NHT.They were randomly divided into 3 groups of 20 cases.A group:NHT 2 weeks,B group:NHT 3 months,C group:NHT 6 months.Results The median PSA of A,B and C group after NHT were 24.88 (6.62-55.86),0.20 (0.05-12.07) and 0.07 (0.01-2.01) ng/ml,respectively.There was statistically significance compared with those in untreatment ( all P =0.00).There was statistically significant (P =0.00)among groups.The prostate volume of A,B and C group were (49.50+14.19),(47.35±17.99) and (36.15±7.17)ml,respectively.There was statistically significance in the B and C group compared with that in untreatment (P =0.04,0.00).There was statistically significant between A and C group and between B and C group (P =0.00,0.01).The Qmax of A,B and C group were (8.75±2.15),(11.7±2.81) and (14.45±2.61) ml/s,respectively.There was statistically significance in the B and C group compared with untreatment (both P =0.00).There was statistically significance among groups (all P =0.00).Conclusion The NHT time should last at least 3 months in order to reduce PSA and prostate volume and to increase the Qmax.

ObjectiveTo investigate the ideal method of neoadjuvant hormonal therapy (NHT) for locally advanced prostate cancer.MethodsSixty cases of patients diagnosed with locally advanced ( T3 -T4 N0M0) prostate cancer were treated with NHT combined with intensity modulated radiotherapy (IMRT),They were randomly divided into 3 groups with 20 cases in each group.Group A with NHT 2 weeks,Group B with NHT 3 months,Group C with NHT 6 months.Endocrine duration began with NHT until 12 months after the end of IMRT.The PSA and prostate volumes were detected by transrectal ultrasound and Qmax was tested after NHT and every 3 months after IMRT.Results After NHT,the median PSA of different groups were decreased to 24.88,0.20 and 0.07 μg/L,respectively.There was significant difference ( P ＜ 0.05 ).The prostate volume in groups B and C reduced significantly ( P ＜ 0.05 ).The group B reduced 20.8％ and the group C reduced 39.5％.The Qmax of group B and C were ( 11.70 ± 2.81 ) and ( 14.45 ±2.61 ) ml/s respectively.After 12 months of endocrine combined with IMRT:(①)PSA.There was significant difference (P ＜0.01 ) with group C ＜ group B ＜ group A.②The prostate volume.The reducing of groups B and C were more obvious than group A ( P ＜ 0.01 ).There was no significant difference between group B and group C ( P ＞ 0.05).③Qmax.There was significant difference (P ＜ 0.01 ) among the 3 groups with group C ＞ group B ＞ group A.ConclusionsNHT combined with IMRT is an ideal method for locally advanced prostate cancer.The NHT time before IMRT treatment should last at least 3 months.

To further explore the molecular mechanism of triterpenoid biosynthesis and acquire highvalue strain of Sanghuangporus baumii , the Agrobacterium tumefaciens-mediated transformation (ATMT) system was studied. The key triterpenoid biosynthesis-associated gene isopentenyl diphosphate isomerase (IDI) was transformed into S. baumii by ATMT system. Then, the qRT-PCR technique was used to analyze gene transcript level, and the widely targeted metabolomics was used to investigate individual triterpenoid content. Total triterpenoid content and anti-oxidant activity were determined by spectrophotometer. In this study, we for the first time established an efficient ATMT system and transferred the IDI gene into S. baumii. Relative to the wild-type (WT) strain, the IDI-transformant (IT) strain showed significantly higher transcript levels of IDI and total triterpenoid content. We then investigated individual triterpenoids in S. baumii, which led to the identification of 10 distinct triterpenoids. The contents of individual triterpenoids produced by the IT2 strain were 1.76–10.03 times higher than those produced by the WT strain. The triterpenoid production showed a significant positive correlation with the IDI gene expression. Besides, IT2 strain showed better anti-oxidant activity. The findings provide valuable information about the biosynthetic pathway of triterpenoids and provide a strategy for cultivating high-value S. baumii strains.

Objective To study the changes of hippocampal caspase-3 and PSD-95 expression levels in the mice exposed to ketamine 30 mg/(kg·d)for three months. Methods Forty C57BL/6 mice were randomly divided into two groups,and the chronic ketamine addiction model was established by giving mice a three month course of daily intraperitoneal injections of ketamine. Immunohistochemical study and Western blot-ting were applied to observe the expression of caspase-3 and PSD-95 protein. Results There were more expression of caspase-3 and less of PSD-95 in ketamine group as detected by immuohistochemistry. Western blotting results showed caspase-3 active fragment level significantly increased com-pared to saline group,but PSD-95 protein level was decreased. Conclusion The increased level of caspase-3 protein and reduced expression of PSD-95 are observed after long-term ketamine administration. These findings may provide an evidence for the neurotoxicity in mouse hippocampus of chronic ketamine addition as a recreational drug.

Objective To assess the role of 68Ga-N,N′-bis(2-hydroxy-5-(carboxyethyl)benzyl) ethylenediamine-N,N′-diacetic acid(HBED-CC)-(Ahx)Lys-CO-Glu(PSMA-11) PET/CT on the detection of metastatic lesions from castration-resistant prostate cancer (CRPC).Methods Sixteen patients with CRPC who underwent 68Ga-PSMA-11 PET/CT between January 2015 and November 2015 were recruited in this study.Mean age of patients was (72±9) years.The PSA levels were 4-12 356 μg/L, Gleason score was 7-10.PET/CT was performed at 1 h postinjection of 68Ga-PSMA-11.Patient-based analysis and lesion-based analysis were performed.ROI analysis was used to calculate the tumor uptake (SUVmax).Final diagnosis was based on histopathology and results of other imaging examinations(99Tcm-MDP imaging, MRI).χ2 test was used to compare the diagnostic efficiencies of PET and CT.Results No adverse effects were observed in patients.68Ga-PSMA-11 PET/CT showed moderate physiologic uptake in salivary glands and proximal small intestine, with predominant tracer clearance by the kidneys.All patients were positive on 68Ga-PSMA-11 PET/CT.Bone metastasis was found in 16 patients, liver metastasis in 2 patients (5 lesions), and lymph node metastasis in 4 patients (26 lesions).The SUVmax of liver, lymph node and bone metastases were 15.06±2.77, 7.54±5.20, 19.01±16.96, respectively.The diagnostic sensitivity, specificity and accuracy on bone metastasis with 68Ga-PSMA-11 PET and CT were 96.30%(52/54) vs 61.11%(33/54), 3/3 vs 1/3, 96.49%(55/57) vs 59.65%(34/57).The sensitivities and accuracies of the two modalities were significantly different(χ2=19.943, 22.593, both P<0.01).Conclusions 68Ga-PSMA-11 PET/CT could precisely detect both primary and metastatic lesions of CRPC, suggesting that it is of great value for the clinical management and treatment.