Objective To evaluate the efficacy of retroperitoneal laparoscopic renal cystectomy.Methods A total of 80 patients with renal cyst were enrolled in this study.Under general anesthesia,the retroperitoneal cavity was established by using water-filled balloon.The renal cyst were exposed by identifying the psoas major muscle.The cysts were unroofed at 5 mm from the edge of the renal parenchyma with electrical claw.Results The operation was completed in all the cases without severe complications.The operation time was 20-100 min(mean 39 min),blood loss was 5-65 ml(mean 20 ml),and hospital stay was 4-11 d(mean 5.6 d).Postoperative pathological examination showed that all the cysts were simple renal cysts.The 80 patients were followed up for 2-24 months(mean 11 months),3 of them were diagnosed as having residual cyst at 2 months after the operation.Conclusion Retroperitoneal laparoscopic renal cystectomy is safe and effective and is superior in mild surgical trauma,quick recovery,and short hospitalization.

Objective To assess the outcomes of modified spiral ileal orthotopic neobladder.Methods From January 1998 to January 2008, 32 patients (all male) underwent radical cystectomy and spiral ileal orthotopic substitution for muscle invasive bladder cancer. A segment of 40 to 45 cm ileal loop was isolated, detubularized, and reconfigured in spiral shape to form a pouch. Bilateral ureters were reimplanted by inserting the 1 cm distal segment into the pouch to form a Split-Cuff nipple.The bottom of the pouch was opened and anastomosed with the urethra (4 stitches). Results There were no perioperative deaths. The mean operative time was 281.2±48.7 min. Blood loss was 545.4±181.9 ml. Twenty cases required a blood transfusion, the mean volume of intraoprative blood transfusion was 430.8±235.9 ml. The average hospital stays were 26.8±9. 7 days. Rate of daytime continence was 93. 7% (30/32) while nighttime continence was 81.3% (26/32). Urodynamic studies were carried out in 23 cases 6 months after surgery. Neobladder capacity at first desire to urinate was 315.0± 33.4 ml(270-420 ml). The maximum neobladder capacity was 490. 3±39.7 ml(350-600 ml).The maximum flow rate (Qmax) was 16.5 ± 5.9 ml/s. Full resting pressure was 22. 5 ± 11.8 cm H2O. Peak voiding pressure was 78.3 ± 14.7 cm H2O. After mean 58. 4 months' follow up (range 22 to 132), 4 cases died of metastasis of bladder cancer. Conclusion Modified spiral ileal orthotopic neobladder is a reasonable option for treating invasive bladder cancer.

AIM: To study the effect of caffeine on the large conductance calcium activated potassium (K_(Ca)) channels by patch-clamp technique on smooth muscle cells enzymatically isolated from the porcine coronary artery (PCASMC),and to investigate the effect of ryanodine on K_(Ca) being activated by caffeine.METHODS: Using the single channel patch-clamp technique,single PCASMC was isolated by collagenase,the activity of single K_(Ca) channel was recorded in porcine coronary artery smooth muscle cells.RESULTS: Caffeine (0.1-10 mmol/L) enhanced the open probability (Po) of K_(Ca) channels in a dose-dependent manner in the intracellular side of inside-out patches and its effect was almost completely abolished by washout. Caffeine decreased the mean close time markedly,but had no effect on the amplitude of K_(Ca) channels. However,ryanodine (10-40 μmol/L) decreased Po of K_(Ca) channels activated by caffeine in a dose-dependent manner in cell-attached patches. The mean open time also decreased.CONCLUSION: Caffeine directly activates K_(Ca) channels of porcine coronary artery smooth muscle cells in inside-out patches,the activity of single K_(Ca) channel is inhibited by ryanodine indirectly in cell-attached patches.

AIM:To study the effect of caffeine on the large conductance calcium activated potassium (KCa) channels by patch-clamp technique on smooth muscle cells enzymatically isolated from the porcine coronary artery (PCASMC),and to investigate the effect of ryanodine on KCa being activated by caffeine.METHODS:Using the single channel patch-clamp technique,single PCASMC was isolated by collagenase,the activity of single KCa channel was recorded in porcine coronary artery smooth muscle cells.RESULTS:Caffeine (0.1-10 mmol/L) enhanced the open probability (Po) of KCa channels in a dose-dependent manner in the intracellular side of inside-out patches and its effect was almost completely abolished by washout. Caffeine decreased the mean close time markedly,but had no effect on the amplitude of KCa channels. However,ryanodine (10-40 ?mol/L) decreased Po of KCa channels activated by caffeine in a dose-dependent manner in cell-attached patches. The mean open time also decreased.CONCLUSION:Caffeine directly activates KCa channels of porcine coronary artery smooth muscle cells in inside-out patches,the activity of single KCa channel is inhibited by ryanodine indirectly in cell-attached patches.

ObjectiveTo investigate the serum prostate-specific antigen (tPSA),serum free PSA to total PSA ratio (f/tPSA),prostate volume (PV) and prostate-specific antigen density (PSAD) in early prostate cancer (PCa) diagnosis.MethodsRetrospective analysis was performed on serum PSA values and related test results from 252 cases of BPH patients and 49 patients with PCa.Prostate volume (PV) was measured by transrectal ultrasound (TRUS),and the f/tPSAand PSAD values were calculated.The differences of serum tPSA,f/tPSA,PV,and PSAD between BPH and PCa group were compared,the area under the ROC curve was used to evaluate these four indicators for its diagnostic sensitivity and diagnostic specificity.ResultsThe values of tPSA,PSAD in PCa group were significantly higher than BPH group ( P ＜0.05),while the values of f/tPSA,PV in PCa group were significantly lower than BPH group ( P ＜0.01orP ＜0.05).The ROC area showed that serum tPSA(0.8013),f/tPSA(0.7390),PV(0.5613) had lower diagnosis value than PSAD(0.9214) in early prostate cancer ( PSAD ＞ tPSA ＞ f/tPSA ＞ PV).When the upper limit of normal PSA was set to take 4ng/ml,the sensitivity was 91.49％,diagnostic specificity was 51.05％.When the f/tPSA threshold set to 0.16,the diagnostic sensitivity was 57.78％,diagnostic specificity was 78.72％.When PSAD threshold was set to 0.15,diagnostic sensitivity was 88.24％,diagnostic specificity was 81.52％.ConclusionsPSA,f/tPSA and PSAD are indicators for biopsy or followup in early diagnosis of prostate cancer.In particular,the diagnostic value of PSAD has higher sensitivity and specificity than PSA and f/tPSA in the diagnosis of prostate cancer.