SUMMARY Intravesical bacillus Calmette-Guérin ( BCG) was a common treatment for non-muscle inva-sive urothelial carcinoma of the bladder. The complication of prostatic abscess was rare. We reported a case of tuberculous prostatic abscess after BCG therapy. A 65-year-old man was diagnosed as bladder cancer and accepted transurethral resection of bladder tumor ( TURBT) treatment. He received a 6-week induction course without any infection complication. Following the second BCG maintenance instillation, he complained of fever and dysuria. Transrectal ultrasound ( TRUS) demonstrated a well-defined complex mass in the right lobe of his prostate. The diagnosis of tuberculous prostatic abscess was considered after excluding other bacterial infection. The patient was treated with an anti-tuberculous regimen of isoniazid, rifampicin, and ethambutol. The symptoms were relieved after 4 weeks of anti-tuberculous therapy. Be-cause of the good response to the medicine, no further aspiration or drainage of prostatic abscess was car-ried out. The anti-tuberculous therapy had to be stopped for serious drug induced liver injury after 6 weeks of anti-tuberculous therapy. Eight weeks later of stopping anti-tuberculous therapy, the follow-up TRUS showed the disappearance of the prostatic abscess and the test of his liver function was normal. Considering the virulence of BCG is weaker than that of common tuberclebacillus, the shorter course of anti-tuberculous therapy maybe an alternative choice, and surgical drainage is not always necessary.

Cardio-Renal Syndrome ; physiopathology ; therapy ; Humans

Objective To investigate the expression of a novel imprinted gene,PEG10,in human gastric adenocarcinoma,and the effect of PEG10 on cell growth and proliferation of gastric cancer cells.Methods The PEG10 mRNA expressions in 40 human gastric adenocarcinoma,the corresponding adjacent normal tissues and 6 nomal gastric tissues were detected by RT-PCR.The expression vectors of PEG10 were constructed and transfected into gastric cancer cell line MKN45 which had no endogenetic PEG10 expression.Cell growth ability was measured by MTT assay.Results High PEG10 mRNA expression level was detected in 9 of 20(45.0%) human gastric adenocarcinoma which was significantly higher than those of the matched normal tissues(10.0%)(P

0.05). At day 30 after operation,half-pipe blockage occurred,and some yellow-green sediments were observed on the pipe wall in the straight tube group; a few of yellow-green sediments were found at top of wall,and some white floc sediments were observed in lumen but nothing was observed on valve in the venous valve tube group; a few of yellow-green sediments were found on pipe wall near the living valve,and some white floc sediments were observed in bile in the living valve tube group. At day 30 after operation,epithelium of mucous membrane was not intact,and gland proliferated lightly in the straight tube group; epithelium of mucous membrane was generally intact,and proliferation of gland was not found in the venous valve tube group; epithelium of mucous membrane was exactly intact,and glandular epithelial cells were not heteromorphism in the living valve tube group. CONCLUSION:The artificial bile ducts with a valve structure and living value structure has a good patency and plays an effective role of anti-reflux after a short-term observation,suggesting that a valve structure acts as a similar function to Oddis sphincter.

Objective To detect the expressions of enhancer of zeste homology 2 (EZH2) and signal transducer and activator of transcription 3 (STAT3) in gastric cancer tissues,and analyze the relationship between their expressions and clinicopathological factors and prognosis of patients.Methods The clinical data of 67 patients with gastric cancer who were admitted to the People's Hospital of Peking University from May 1999 to April 2000 were retrospectively analyzed.Gastric cancer tissues and adjacent normal tissues were harvested and fixed in 4％ formaldehyde,and then to make the tissue chips.The protein expressions of EZH2 and STAT3 were detected by immunohistochemical staining,and the relationship between the expressions of EZH2 and STAT3 and the prognosis of patients was analyzed.The correlation between the protein expressions of EZH2 and STAT3 in the gastric and colorectal tissues and the clinicopathological parameters was analyzed using the paired chi-square test.The survival curve was drawn by Kaplan-Meier method,and the survival rate was analyzed by using the Logrank test.The relationship between the clinicopathological factors and the prognosis of patients was analyzed using the COX proportional hazard model.Results The positive protein expression rates of EZH2 and STAT3 in the gastric cancer tissues were 73.1％ (49/67) and 67.2％ (45/67),which were significantly higher than 32.8％ (22/67) and 37.3％ (25/67) in the adjacent normal tissues (x2=21.839,11.964,P ＜0.05).The protein expression of STAT3 was correlated with the age,TNM staging,lymph node metastatic status (x2=5.475,9.998,5.475,P ＜ 0.05).The protein expression of EZH2 was correlated with TNM staging and lymph node metastatic status (x2=11.573,5.902,P ＜ 0.05).The co-expression rate of EZH2 and STAT3 proteins was 73.1％ (49/67),EZH2 and STAT3 had the common expression trend (r =0.397,P ＜ 0.05).The co-expression rate of EZH2 and STAT3 was increased as the increase of TNM stages,and the co-expression of EZH2 and STAT3 in the gastric cancer tissue was correlated with the TNM stages (x2 =6.997,P ＜ 0.05).The 5-year survival rate of patients with low protein expression of EZH2 was significantly higher than those with high protein expression of EZH2 (x2=7.386,P ＜ 0.05).The 5-year survival rate of patients with low proteins expression of STAT3 was significantly higher than those with high proteins expression of STAT3 (x2=12.253,P ＜ 0.05).The 5-year survival rate of patients with low co-expression of EZH2 and STAT3 protein was significantly higher than those with high co-expression of EZH2 and STAT3 proteins (x2 =8.765,P ＜ 0.05).The results of univariate analysis showed that age,TNM staging,EZH2 and STAT3 expression,lymph node metastasis and distal metastasis were the factors influencing the survival of patients with gastric cancer (RR =2.136,3.452,3.179,8.341,11.773,6.873,P ＜0.05).The results of multivariate analysis showed that TNM staging and STAT3 expression were independent factors influencing the prognosis of patients with gastric cancer (RR =2.453,7.535,P ＜ 0.05).Conclusions There is significant correlation between EZH2 and STAT3 protein expressions in gastric cancer tissues,and co-expression of EZH2 and STAT3 is associated with the TNM staging and the prognosis of the patients with gastric cancer.

Objective: Testicular mixed germ cell tumor is mixed with embryonal carcinoma, choriocarcinoma, yolk sac tumor, teratoma, seminoma and other two or more components of the testicular tumor, the clinical is relatively rare and high degree of malignancy, this article will summarize its clinical features and optimize its treatment.Methods: A retrospective analysis of the clinical data of 22 patients with testicular tumor mixed germ cell in Peking University Third Hospital from May 1994 to November 2016 was conducted using a combination of statistical analysis and discussion of the relevant literature.Results: The mean age of the 22 patients was (30.8±10.4) years and the rate of cryptorchidism was 13.6%.The maximum diameter of the tumor was (5.1±2.7) cm.The pathological results suggested that 12 cases (54.5%) contained two different germ cell tumor components, 7 cases (31.8%) contained 3 different tumor components, 2 cases (9.2%) contained 4 different tumor components, and 1 case (4.5%) contained 5 different tumor components.Tumor constituent analysis included yolk sac tumors(16 cases, 72.7%), mature teratoma (7 cases, 31.8%), immature teratoma (5 cases, 22.7%), embryonal carcinoma (17 cases, 77.3%) , choriocarcinoma (4 cases, 18.1%) and seminoma (6 cases, 27.3%).American Joint Committee of Cancer tumor staging indicated 19 cases of stage Ⅰ a tumor, 2 cases of stage Ⅱa tumor and 1 case of stage Ⅲa tumor.The mean values of human chorionic gonadotropin, alpha-fetoprotein and lactate dehydrogenase were 414.50 MIU/mL, 242.95 μg/L, 196.95 U/L (preoperative) and 17.20 MIU /mL, 90.20 μg/L, 183.70 U/L (postoperative within a year), and the comparison of the P values between the preoperative and the postoperative within a year were 0.079, 0.043 and 0.624.Fourteen patients underwent retroperitoneal lymph nodes dissection.Most patients lived with long-term survival (94.4%) after operation.Conclusion: Comprehensive treatment of radical orchiectomy with retroperitoneal lymphadenectomy combined with necessary radiotherapy or chemotherapy might help to control the tumor and achieve long-term survival for most patients with testicular mixed germ cell tumor.

Objective To investigate the effects of Houpupaiqi mixture on the recovery of gastrointestinal function after open gastrointestinal surgery,and evaluate the efficacy and safety of Houpupaiqi mixture.Methods A total of 144 selected patients who underwent open gastrointestinal surgery were enrolled into the multi-center prospective randomized double-blind controlled clinical trial from October 2010 to September 2011.Of the 144 patients,66 were from People's Hospital of Peking University,72 were from Beijing Friendship Hospital of Capital University of Medical Sciences,and 6 were from People's Hospital of Guangdong Province.All the patients were randomly divided into 2 groups (test group:96 patients,control group:48 patients) at the ratio of 2∶1 according to the random number table.Five patients who did not meet the criteria were excluded from the study,and then there were 92 patients in the test group and 47 patients in the control group.The study was assessed by the ethics committees,and all the patients signed the informed consent form.Houpupaiqi mixture (50 ml) or placebo (50 ml) were administered in the test group and control group at postoperative 16 and 20 hours,respectively.Parenteral and enteral nutritional support were given after pulling out of gastric tube.A standard intravenous analgesia was applied in the 2 groups,and agents which stimulate or suppress gastrointestinal motility were prohibited.The time for the recovery of regular bowel sounds,the first exhaust and first defecation time,and the time of first solid food intake of the 2 groups were recorded.Vital signs were recored before operation and after drug administration.Blood and urinary routine test,hepatic and renal function test,electrocardiogram examination,record of adverse drug event were carried out at postoperative day 6.The time for the indexes above and relevant frequencies were calculated,and the survival curve were drawn by Kaplan-Meier method.All the time points were analyzed using the Log-rank test.The measurement data were analyzed using the t test or rank-sum test,and the enumeration data were analyzed using the chi-square test or Fisher exact probability.Results The median time for the recovery of regular bowel sounds,median time for first exhaust and defecation were 21.4 (20.0,23.7)hours,45.0 (40.0,54.0) hours and 65.5 (54.7,74.0) hours in the test group,and 47.5 (44.0,56.5) hours,91.0 (87.0,93.8)hours,98.0 (94.0,113.5)hours in the control group,there were significant differences between the 2 groups (Log-rank values =21.67,53.15,11.81,P＜0.05).The median time of first solid food intake were 72.5 (66.2,110.5) hours of the test group and 116.3 (114.8,117.3) hours of the control group,with no significant difference between the 2 groups (Log-rank value =13.70,P ＞ 0.05).There were no significant differences in the body temperature,respiration,heart rate,systolic blood pressure and diastolic blood pressure before and after medication between the 2 groups (Z =0.03,0.68,0.97,0.22,0.72,P ＞ 0.05).There were no significant differences in the number of patients with abnormal results of blood test,hepatic function,renal function and electrocardiogram between the 2 groups (P ＞ 0.05).No severe adverse event was observed in the clinical trial.Conclusion Houpupaiqi mixture significantly promotes the recovery of gastrointestinal function of the patients who underwent open gastrointestinal surgery with relatively low adverse events.

Objective:To compare the efficacy and safety of tubeless percutaneous nephrolithotomy ( tubeless-PCNL) and ureteroscopic lithotripsy ( URL) in treatment of impacted upper-ureteral calculi ≥1.5 cm in size.Methods:Patients with ureteral stones sized ≥1.5 cm and lodged above the fourth lum-bar vertebra who were treated between September 2009 and July 2013 in Peking University People ’ s Hos-pital were retrospectively analyzed .In the study , 182 patients underwent tubeless-PCNL or URL treat-ment respectively , and the operation success rates were compared .The duration of operation , intraopera-tive blood loss ( average hemoglobin decrease ) , complications , mean hospital stay and residual stone rates were also compared.Results: Fifty-four patients underwent tubeless-PCNL treatment,the average stone size was (1.9 ±0.4) cm,nephrostomy tubes were placed in two patients ,and the operation success rate was 96.3%(52/54).In the rest of the 52 patients,and the mean operation time was (30.1 ±14.8) minutes with an average postoperative hemoglobin decrease of (10.2 ±6.1) g/L, and the mean hospital stay was (3.0 ±1.4) days.Only one of the patients had residual fragments (2%).The main complica-tions included minor perirenal hematoma in 1 patient, fever in 2 patients, elevated blood WBC in 11 patients,and analgesics requirement in 3 patients.In the study, 128 patients were treated with URL,the average stone size was (1.7 ±0.3) cm.19 procedures failed,and 10 patients were converted to PCNL, extracorporeal shock wave lithotripsy was executed subsequently after double -J stent placement in 5 patients,and migration of calculi or stone fragments happened in 4 patients.The mean operative time was (51.3 ±25.5) minutes for the remaining 109 patients with a hemoglobin reduction of (5.2 ±7.2) g/L. The mean hospital stay was (2.9 ±1.3) days, and residual stones were found in 13 of the 109 patients (11.9%).The main complications included fever in 3 patients, elevated blood WBC in 42 patients, an-algesics requirement in 13 patients because of pain in the urethra or flank .The size of the stones between the two group didn ’ t show significant difference ,but the success rate of the tubeless-PCNL procedure was significantly higher .Except that hemoglobin decrease was slightly higher in the tubeless-PCNL group ,the mean operative time , the rate of residual stones and rate of complications of the tubeless-PCNL group were lower significantly.Conclusion:Treating stones above 4th lumbar vertebra larger than 1.5 cm were challenging .It is difficult to treat these stones with URL because of a high probability to fail , but on the contrary, tubeless-PCNL was more likely to be performed successfully .For surgeons experienced with the PCNL technology, treating stones≥1.5 cm with tubeless-PCNL procedure may turn out to be more effi-cient and with a higher operation success rate , and the risk of complications was lower without lengthe-ning the postoperative hospital stay .

ObjectiveTo report our experience and assess the safety and efficacy of ultrasound-guided percutaneous nephrolithotomy (PCNL) with ultrasonic and pneumatic lithotripters for complete renal staghorn stones.MethodsFrom Jan 2006 to Jan 2015, 128 patients (142 kidneys) with complete staghorn stones underwent PCNL, included 14 patients with bilateral renal complete stones,13 patients with solitary or founctional solitary kidney, 22 patients with renal insufficiency, 25 patients with renal empyema, 4 patients with spine malformation, ultrasound-guided PCNL were performed. Stones were fragmented and cleared using a combination of ultrasonic and pneumatic lithotripters.ResultsAll PCNL procedures were successful. Successful access to the collecting system was 100%. Mean operation time was 64.5±39. 1min (range 30–150). The primary stone-free rate of PCNL was 76.8%(109/142). Most of the renal stones(63.4%, 90/142)were managed satisfactorily by a single tract,a second tract was used in 25 renal stones(17.6%, 25/142). There were 36 auxiliary procedures (24 second PCNL and 3 third PCNL and 9 extracorporeal shock wave lithotripsy). One month after treatment, the overall stone-free rate was 85.2%(121/142). Six patients (4.2%) received blood transfusion,three patients(2.1%) received angiography and embolization . Three patients (2.1%) with infective shock were cured by intravenous antibiotics and antishock treatments. Three patients with temporary renal function receded were observed in solitary kidney for two tracts PCNL. No other severe complications occurred. The mean postoperative stay was 5.2 days (range 2–12). Conclusion: Ultrasound-guided Percutaneous Nephrolithotomy with ultrasonic and pneumatic lithotripters for management of renal complete staghorn stones is safe, effective, and worthy of wider use in clinical practice.

AIM: To construct human Egr-1 promoter luciferase reporter system and study its activity induced by i-onizing radiation. METHODS: Egr-1 promoter was obtained by human genomic PCR and cloned into pGL3-basic vector. After transfection of recombinant plasmid into human tumor cells, the Egr-1 promoter activity induced by ionizing radiation was detected by luciferase reporter assay. RESULTS: The luciferasy reporter system of Egr-1 promoter was successfully constructed. The activity of Egr-1 promoter was substantially increased after different doses of IR and reached to the peak at the time point of 48h after IR. CONCLUSION: The Egr-1 promoter was constructed in this study showed IR inducible activity in tumor cells, laying foundation for the research of radiation, mediated gene therapy.