Objective To study whether CK20 expression could be served as a noninvasive test for detecting and monitoring bladder cancer. Methods Reverse transcriptase polymerase chain reaction (RT PCR) was used to determine the expression of CK20 in cells collected from the urine of 10 healthy volunteers,41 patients with bladder cancer and in 20 hematuria patients with bladder cancer excluded. Results CK20 amplification band (370bp) was obtained with mRNA extracted from TCC cells of bladder cancer. Of 41 patients with bladder cancer, 37 specimen were positive.No false positive cases were found in the 10 healthy controls and only in 3 of the 20 hematuric cases.Of the 3 false positive, 2 had pelvic cancer and 1 chronic inflammation. CK20 was positive in 23 of the 25 G 1 patients,in 8 of the 9 G 2 patients,and in 6 of the 7 G 3 patients. Conclusions The preliminary results showed that CK20 might be a potential biomarker for the noninvasive detection of bladder cancer by means of assaying urothelial cells from the voided urine specimen with RT PCR.

Objective To investigate the efficacy of clinical case-based PBL in clinical practice in department of urology.Methods Medical students admitted by our clinical medical school in 2006 and 2007 were involved.Fifty-six students of 2007 grade were chosen as study group while 49students of 2006 grade as control group.Students in study group were taught by clinical case-based PBL method while those in control group by traditional method.All results were analyzed by SPSS 11.0.Results The scores in study group were higher than those in control group with statistical differences (82.84 ± 12.35 vs.72.95 ± 11.13 ; t =4.29,P ＜ 0.01).Students in study group showed more interests in practice lessons.Teachers were more satisfied with the overall performance of students in study group.Conclusions Clinical case-based PBL can increase students' overall performance such as better coordination,better clinical skills and better open-minded clinical case solution.

Objective　To study the malignant or benign characters of lung mini nodules for diagnosis and treatment.Methods　A retrospective analysis was performed on 80 post-operative cases with pathologically confirmed malignant or benign lung mini-nodules.Results　Lung mini-nodule resection cases accounted for 17.7%(80) out of a 451-cases group.Malignant cases accounted for 73.7%(59/80)，benign cases 26.3%(21/80).Most of the malignant cases were squamous cell carcinoma and adenocarcinoma,while most of the benign cases were tuberculosis and inflammatory pseudo-neoplasms.As for pTNM staging in malignant cases,there were 28 in pT1N0M0，19 in pT1N1M0,1 in pT1N1M1,10in pT1N2M0 and 1 in pT1N2M1;the average survival time was 29.4 months.The accurate rate of pre-operative X-ray and CT scan was 45% and 76.2% respectively.Conclusion　For patients with lung mini-nodules ＜2 cm CT value at 37HU,and the nature unknown ,resection is suggested.

Objective To evaluate the effect of ImmunoCyt on the early diagnosis of bladder cancer by comparing the result of cystoscopy with that of cytology. Methods Eighty-six consecutive patients with bladder cancer (mean age,63 years) were included in this group.Among them 38 had undergone transurethral resection of superficial transitional cell carcinoma and had been followed up and 48 had hematuria.These patients were evaluated with standard cytology and ImmunoCyt test.Then all the patients underwent cystoscopy and suspected lesions were biopsied. Results Transitional cell carcinoma of bladder was confirmed pathologically in 28 cases.The sensitivity of ImmunoCyt (82%) was superior to that of cytology (39%, P

Objective To evaluate the effect of technical improvement of radical retropubic prostatectomy (RRP) for patients with localized prostatic cancer. Methods RRP was performed in 32 cases (mean age,68 years) of prostatic cancer at clinical T 1 and T 2 stages.Technical improvements included extensive lymph node clearance,protection of the neurovascular bundle,suture and ligation of the dorsal vein complex,preservation of the distal prostatic urethra,and intussusception of the bladder neck. Results The mean operative time was 3.5 h.The mean blood loss was 450 ml;blood transfusion was conducted in 17 cases.Postoperative pathologic findings revealed tumor confined disease in 30 cases,positive surgical margin in 1, and lymph node metastasis in 1.All the patients survived and were followed up for a mean of 22 months (range 8 to 48 months),with PSA

Objective To evaluate the clinical value of cystectomy with prostate capsule sparing in orthotopic bladder replacement for bladder cancer. Methods A total of 56 male patients (mean age,62 years) with bladder cancer were included.Of them 40 cases were of primary tumors and 16 were of recurrent ones.Pathology by cystoscopy and biopsy showed transitional cell carcinoma in 53 cases and squamous cell carcinoma in 3.According to the analysis of B ultrasound,CT,MRI and cystoscopy, they were clinically diagnosed as recurrent multiple superficial tumors (n=27) and invasive tumors (n=29).Radical cystectomy with prostate capsule sparing was performed on them.Detubularized ascending colon (20 cases) or ileal segment (36 cases) was used to form a neobladder,which was anastomosed with distal portion of prostate capsule. Results Mean operative time of ascending colonic neobladder and ileal neobladder was 5 h 50 min and 6 h 20 min,with blood loss of 580 ml and 540 ml,respectively.Pathology showed pT 1N 0 in 28 cases,pT 2N 0 in 25 and pT 3N + in 3.During the follow up of 4 to 102 months (mean,42 months) 3 patients of pT 3N + died of bladder cancer and 5 died of other diseases.The cancer specific 5 year survival was 94% in cases of T 1N 0,83% in T 2N 0.At 1 year follow up,17 out of 18 patients (94%) with ascending colonic neobladder and 30 out of 30 patients (100%) with ileal neobladder were fully continent during the day,and 46 (96%) voided 1 to 2 times at night and could stay dry.Of 31 patients with preoperative adequate sexual function, 23 (74%) maintained potency postoperatively. Conclusions Radical cystectomy with distal prostate capsule sparing and reconstruction with an orthotopic neobladder is a relatively safe and reliable surgical procedure.It can improve the continence and potency without compromising the principle of tumor control.

Objective To investigate the value of MR perfusion-weighted imaging(PWI)in the evaluation of therapeutic effect of brain metastases with gamma knife.Methods Treatment by gamma knife before and after that 3 months or 6 months PWI studies were penformed respectively in 22 patients with brain metastases .Maps of relative regional blood volume(rCBV)and mean transit time(MTT)were obtained.The ratios of rCBV and MTT of lesions were analyzed.Results rCBV of tumors in 22 cases was increased.The ratios of maximum rCBV of the lesions and opposite side were 6.16?3.12 and 1.18?0.17 respectively.The ratios of MTT of the tumors was 1.44?0.53.After gamma knife treatment,9 of 22 cases appeared decreased rCBV,but the ratios of MTT were no changing,of them,3 cases presented cerebral necrosis.13 of 22 cases,the ratios of rCBV were increased in varied degree after treatment by gamma knife,and 6 cases presented brain radionecrosis.Conclusion PWI is a significant method in evaluating the therapeutic effect of brain metastases with gamma knife

Objective To explore the role of mitogen-activated protein kinase(MAPK)in lipopolysaccharide(LPS)-induced iNOS expression and NO production in rat Schwann cells by the use of inhibitors PD98059 selective for extracellular signal-regulated kinase 1/2(EPK1/2), SB202190 for P38 MAPK and SP600125 for the c-Jun NH_2-terminal kinase (JNK). Methods Schwann cells were pretreated with PD98059 (30, 50, 70?mol/L), SB202190 (10, 20, 40?mol/L) and SP600125 (10, 30, 50?mol/L) at the indicated concentrations for 1 hour before the stimulation with LPS (10mg/L) for 4 hour. The estimation of iNOS mRNA, IL-6 mRNA and TNF-? mRNA was performed by RT-PCR; the changes of iNOS protein expression were investigated by Western blotting. The NO level was observed with measurement of nitrite in the cell culture medium. Results LPS could significantly activate MAPK signal pathway and lead to the expression of iNOS and NO production. The iNOS expression and NO production induced by LPS stimulation were significantly inhibited by the three highly specific inhibitors of MAPK. In addition, the inhibitors decreased LPS-induced the expression of IL-6 mRNA and TNF-? mRNA. Conclusion Activation of MAPK pathway is involved in iNOS expression and NO production in rat Schwann cells, and the inhibition of the signal transduction pathway can be effective to reduce the production of iNOS and NO, which may be a useful strategy against inflammatory and immune reaction after peripheral nerve injury.

OBJECTIVE: To explore the mechanism, clinical characterization, diagnosis and therapeutic approach of vocal process granuloma(VPG) induced by gastroesophageal reflux. METHOD: We performed a retrospective review of 4 cases. RESULT: In 4 male cases, 3 cases had no obvious symptoms of stomach and esophagus and 1 case had symptoms of bloating and acid reflux. Additionally, 4 cases in which lesions were all located to the left side were diagnosed by trial therapy with proton pump inhibitors (PPIs) with good responding. 2 of 4 cases were relapsed after operations. Meanwhile 4 patients were treated by Rabeprazole for acid suppression therapy and 3 cases were cured and 1 invalid case was cured by Pantoprazole. All patients were followed up for 4-48 months with no recurrence. CONCLUSION Gastroesophageal reflux is an important pathogenic factor to the VPG. The majority of patients with VPG do not have gastroesophageal reflux symptoms. Besides, most lesions located in the left are associated with sleeping position. The diagnosis is mainly based on the laryngoscope examination and trial of acid suppression therapy. Moreover, recurrence risk is high-with simple operation in VPG therefore the main treatment is a antireflux and it is also valid by replacing byother PPI treatment. The treatment must be long enough. Meanwhile, the comprehensive treatment should be noticed.
2-Pyridinylmethylsulfinylbenzimidazoles ; therapeutic use ; Arytenoid Cartilage ; pathology ; Gastroesophageal Reflux ; complications ; drug therapy ; Granuloma ; etiology ; Humans ; Male ; Pantoprazole ; Proton Pump Inhibitors ; therapeutic use ; Retrospective Studies ; Treatment Outcome

Objective To investigate treatment effect of the type of foot drop in patients with lumbar disc herniation.Methods Clinical data of 34 patients with foot drop in lumbar disc herniation who were treated in Spinal Surgery Department of Shunyi District Hospital of Beijing from January 2006 to December 2013 were retrospective analyzed,all patients were treated by operation.After 24 months of follow-up,the effect was observed,the prognosis and related factors were analyzed.Results Two years after operation,the recovery of the patients was excellent in 4 cases and good in 19 cases,common and poor in 11 cases,and the excellent and good rate was up to 67.6%(23/34).Analysis results showed that after 3 to 24 months after surgery,the anterior tibial muscle strength grades(grade 0-5) corresponding score were 28 points preoperatively,59 points at 3 months after surgery,69 points at 6 months after surgery,92 points 1 year after surgery,reached 95 points 2 years after surgery.Muscle strength score of patients with an increasing trend,especially after 3 months to 12 months after the operation.Conclusion The drop occurred should be operated as soon as possible,recommendations for open surgery,complete decompression,avoid injury.Three months to 1 years after operation is the key period of recovery.