Objective To evaluate the effects of exog en ous adenovirus-mediated gene transfer of human tumor suppressor gene PTEN (phos phatase and tensin homology deleted on chromosome 10) on cell prolifiration and invasive ability of human prostate cancer cell lines LNCaP and DU-145. Methods mRNA and protein expressions of PTEN in human prostate c ancer LNCaP and DU-145 cells infected with AdPTEN were detected by RT-PCR and Western blot.MTT assay was used to assess the effect of PTEN on cell proliferati on.The change of cell cycle and apoptosis were measured by flow cytometry and th e invasion abilities in vitro detected by Boyden chamber.Ad-X-TRE-?gal v irus was used as control. Results RT-PCR and Western bl ot analysis showed that LNCaP and DU-145 cells express high level of PTEN after its infected with Ad-PTEN. The growth of LNCaP and DU-145 cells treated with Ad-PTEN was significantly more inhibited than that with a control adenovirus.Ad -PTEN-infected LNCaP and DU-145 cells showed a significant increase in G 0～ G 1 phase and PTEN-induced apoptosis in comparison with the control.The invasiv e ability of prostate cancer cell lines was inhibited by expression of PTEN effe ctively. Conclusions Adenoviral-mediated expression of human tumor suppressor gene PTEN has inhibitory affect on proliferation and inva sive ability of human prostate cancer cell lines LNCaP and DU-145.This study pr ovides an idea for the further development of Ad-PTEN as a potential therapeuti c vector in the gene therapy of prostate cancer.

Objective　To evaluate the status of urological laparoendoscopic single-site surgery (LESS) technique in China.　Methods　We had conducted a systematic review of literatures of urological laparoendoscopic single-site surgery published from Chinese institutions using WanFang,CNKI,VIP,CBM,GoogleScholar and MEDLINE databases.All relevant articles were selected with consensus and analyzed according to the inclusion and exclusion criteria.　Results　Overall,205 articles from 66 different centers all over China published between January 2009 and June 2012 were included in the analysis. Of which,there were 26 articles of science citation index papers and 179 articles from Chinese academic journals.The included literature was mainly composed of case series reports ( 133 articles,64.9％ ),comparison studies (13 articles,6.3％ ),reviews or comments (20 papers,9.8％ ),nursing related papers (28 pieces,13.7％ ),animal surgery studies (6 articles,2.9％ ),and training (5 articles,2.4％ ).A total of 1790 clinical cases were reported during the study period,56.9％ of these were procedures done in the upper urinary tract,only 5.8％ were in the lower urinary tract,and 37.3％ were genital or other procedures.Procedures of tumor-related and reconstruction required accounted for 18.8％ and 18.7％,respectively.Pure single-port technique was applied on 58.3％ of cases.In cases of a single-port platform used,45.6％ used the commercially available devices and 54.4％ used homemade devices.Transperitoneal accesses were adopted in 59.5％ of cases and the other 40.5％ were performed through extraperitoneal approaches.The umbilicus was used as the site of access in 58.5％ of cases.A total of 25 indications were reported,including adrenalectomy,nephrectomy and ureterolithotomy,etc. in the upper urinary tract,radical cystectomy,radical prostatectomy and transvesical enucleation of the prostate,etc.in the lower urinary tract,and varicocelectomy,orchidopexy and others. The three most often done procedures were varicocelectomy (601　cases,33.6％ ),renal cyst decortication (408 cases,22.8％ ) and adrenalectomy ( 179 cases,10.0％ ).The overall conversion rate was 5.5％,and complications were encountered in 3.4％ of cases.　Conclusions Laparoendoscopic single-site surgery has been widely adopted by Chinese urologists and largely covered the spectrum of conventional urologic laparoscopic procedures,with most of these being non-reconstructive operations for the treatment of benign diseases.In large,we are still under the initial stage of LESS application in urology.And more work on creative innovation and well-designed studies are needed to further evaluate its role in the urological minimally invasive surgery.

Laparoscopic partial nephrectomy is gaining more and more popularity in treating patients with early renal carcinoma in recent years.Compared with radical nephrectomy,laparoscopic partial nephrectomy is a mini-invasive,safe method with satisfactory postoperative survival rate.However, there were still limited laboratory and clinical data about laparoscopic partial nephrectomy,and the experimental data of traditional laparoscopic surgery and open surgery were still used.Based on the existing data and the authors' experience,this article proposes three hypotheses for the problems puzzling urologic surgeons;the authors hope to verify the hypotheses through basic or clinical research.

Lower urinary tract symptoms (LUTS),consisting storage,voiding and postmicturition symptoms,is a comprehensive definition involving multiple organs.There has been an increasing emphasis on the integrated management of non-neurogenic male lower urinary tract symptoms.Instead of focusing on the enlarged prostate,the current treatment has paid more attention on the entire urinary tract as well as multiple organ factors.Therefore,we provided a literature review and summarized the key points during the management of male LUTS as 3B,namely beyond prostate,beyond surgery and beyond urology.

Objective To probe into the clinical and urodynamic features of primary bladder neck obstruction(PBNO) in females. Methods A retrospective analysis was made with comprehensive urodynamic evaluation in 61 cases with PBNO and 32 cases with genuine stress incontinence. Results According to the modified phentolamine UPP tests,there were 41 cases of internal sphincter spasticity(ISS)and 20 cases of bladder neck obstruction(BNO).The success rate of P Q plot analysis in the ISS group was lower than those of BNO and the control(49%vs 80% and 81%).94% of both ISS and BNO patients had a Lin PURR grading of ≥grade Ⅱ,whereas 99% of the control group were of grade 0 of I.There were a significant difference in such parameters as PVB,A G number(Pdet Qmax -2Qmax),post voiding residual,and maximum urethral closure pressure between the obstructed groups and nonobstructed group. Conclusions The meaningful diagnostic parameters for PBNO are Lin PURR grading(≥grade Ⅱ),PVB and A G number.The modified phentolamine UPP test is a reliable index for the assessment of internal sphincter sphincter functional obstruction.

Objective To study the mechanism of occurrence of the multifocal bladder cancers. Methods The expressions of p21,p53 and EMA in twenty specimens from 5 cases of multifocal bladder cancers were studied by means of immunohistochemistry. Results In 4 of 5 cases, the expressions of p21 and p53 were correspondent in scattering specimens from the same patient. In all the 5 cases, the expressions of EMA were correspondent in scattering specimens from the same patient. Conclusions Multifocal bladder cancer may originate from the same monocolone.

Objective To investigate the expression level of MMP 1 and MMP 2 in the bladder transitional cell carcinoma (BTCC) and to analyse the location feature of expression and to provide a useful marker for judging the invasion. Methods From March 1998 to December 1999,62 cases of BTCC specimens were collected.The expression level of MMP 1 and MMP 2 of the specimens was detected by in situ hybridization technique. Results MMP 1 and MMP 2 were expressed in a small amount in the normal bladder walls.They were expressed mainly in cytoplasm of tumor cells and stromal cells. The positive rate of MMP 1 mRNA was 43.5%,and had no association with cell grade and TNM stage.The positive rate of MMP 2 mRNA was 59.6%.The expression level closely correlated with the cell grade and TNM stage ( P

Objective To evaluate the clinical effect of Ho:YAG laser with flexible ureteroscope on the treatment of renal calculi. Methods Fifty one cases of renal stone burdens were treated with Versa Pulse Select Ho:YAG lithotriptor through flexible ureteroscope. Results The successful rate of stone fragmentation after single session was 90%(45/51).Mean operation duration was 45 min (30～78 min).Mean duration of post operation in hospital was 2.4 days (1～6 days).Stone free time was 3～6 weeks,with a mean of 4 weeks.No ureteral perforations or pyonephrosis occurred. Conclusions Ho:YAG laser lithotripsy through flexible ureteroscope is a safe, effective treatment for renal calculi.

ObjectiveTo evaluate the efficiency of reversed vesical muco-muscular flap in the treatment of vesicoureteral reflux.MethodsFrom 1999 to 2000,a new anti-reflux operation was performed for 4 cases of vesicoureteral reflux (one with grade Ⅲ and three with grade Ⅳ) using reversed vesical muco-muscular flap.The vesicoureteral reflux was primary in 2 patients and secondary to ureteromeatotomy for the management of intramural ureteral calculi in the other 2.ResultsAll the 4 patients were successfully treated with this new technique.2 patients exhibited bladder irritation and spasm after operation,which were palliated in one month and vanished in three months.The lumbodynia and distending pain vanished during the follow-up (mean 22 months). Intravenous urography revealed normal renal function of the involved kidney.Hydronephrosis and ureteric dilatation were cured in 3 patients and significantly improved in 1.Voiding cystography demonstrated no reflux.The reconstructed ureteral orifice was labiate under cystoscopic view.ConclusionsThe anti-reflux operation is simple,convenient and effective in the treatment of vesicoureteral reflux.The postoperative bladder irritation is transient and shortcoming.

Objective To evaluate Ho:YAG laser in the treatment of superficial bladder tumors. Methods 30 patients with superficial bladder tumors underwent endoscopic holmium laser resection with postoperative intravesical instillation therapy.There were 25 male patients and 5 famale with an average age of 54.The growth has been single in 15 and multiple in 15.The diameter of the tumor was 0.2～3.5 cm with the pathology grade G 1～G 2 and clinical stage T 1～T 2. Results The procedure has been successful in all and cold cup biopsies of the tumor base and incisal margin were negative.The mean resection time was 18 minutes,the mean volume of bleeding was less than 15 ml and no intraoperative bladder perforation or secondary hemorrhage occurred.All patients have been followed up for 3 to 14 months with a mean of 7.5 months.One patient (3%) had out-of-field recurrence. Conclusions Ho:YAG laser resection of bladder tumor (HoLRBt) provides an useful clinical therapeutic method that has the advantages of precise resection,simple technique,as well as no serious intraoperative or delayed complications.