[Tuberculous prostatic abscess following intravesical bacillus Calmette-Guerin immunotherapy: a case report].

Intravesical bacillus Calmette-Guerin (BCG) was a common treatment for non-muscle invasive 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. Because of the good response to the medicine, no further aspiration or drainage of prostatic abscess was carried 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.

[Treatment of upper urinary calculi through novel modular flexible ureteroscope: a report of 36 cases].

OBJECTIVE: To evaluate the feasibility and efficacy of novel modular flexible ureteroscope in the treatment of upper urinary calculi. METHODS: From Nov. 2013 to Jul. 2014, 36 cases of upper urinary calculi were treated with holmium laser lithotripsy through novel modular flexible ureteroscope. The clinical data including the location and diameter of the calculi, time of operation, stone-free rate, complications and hospital stay after operation were analyzed retrospectively. RESULTS: The operation was performed successfully in 34 cases, the average time of operation was 108.5 min (70-145 min), the post-operation hospital stay was 2-5 d (average 2.3 d), and the stone-free rate was 83.33%. No serious complications occurred except postoperative fever in 2 cases and haemorrhage in 1 case. CONCLUSION: The novel modular flexible ureteroscope is a safe and effective medical instrumentation for treatment of upper urinary calculi.

[Percutaneous renal puncture guide by a novel real-time needle-tracking ultrasound system for percutaneous nephrolithotomy: analysis of 16 cases].

OBJECTIVE: To evaluate the feasibility and efficacy of percutaneous renal puncture in percutaneous nephrolithotomy guided by novel needle-tracking ultrasound system. METHODS: From may to october 2013, 16 cases of percutaneous nephrolithotomy were performed under the guidance of ultrasound system. The clinical data including the time of completing percutaneous renal puncture, the color of urine sucked out from the kidney calices, and the complications were analyzed retrospectively. RESULTS: Of the 16 patients, 18 percutaneous renal access were established guided by ultrasound system. All of them were successtul for the first time, and the average time of completing percutaneous renal punctures was (26.90 ± 11.37) s (15 to 54 s). After the operation, the hemoglobin decreased by (9.56 ± 5.27)%(1.41% to 24.06%), and no complications occurred except for postoperative fever in 2 case. CONCLUSION: The novel ultrasound system is a safe and effective technique that can reduce the technical difficulty of percutaneous renal puncture in percutaneous nephrolithotomy.

[Balloon dilation by B ultrasound monitoring for treatment of urethral stricture: 5 case reports].

Urethral stricture is a common urologic disease and there are many therapeutic methods for it. Here we investigated the application of balloon dilation under B-mold ultrasound monitoring in the treatment of urethral stricture. Five male patients suffering from urethral stricture were treated with balloon dilation under B-mold ultrasound monitoring.Their urination was assessed after operation. All the patients underwent the operation successfully, without serious complications. The urinary catheter was removed 3-4 weeks after operation. The patients were followed up for 8 to 15 months. Four patients were voiding well and one improved. Balloon dilation under B-mold ultrasound monitoring in the treatment of urethral stricture was intuitive, safe and effective.

Digital measuring the ocular morphological parameters of guinea pig eye in vivo with Python.

AIM: To quantitatively measure ocular morphological parameters of guinea pig with Python technology. METHODS: Thirty-six eyeballs of eighteen 3-week-old guinea pigs were measured with keratometer and photographed to obtain the horizontal, coronal, and sagittal planes respectively. The corresponding photo pixels-actual length ratio was acquired by a proportional scale. The edge coordinates were identified artificially by ginput function. Circle and conic curve fitting were applied to fit the contour of the eyeball in the sagittal, coronal and horizontal view. The curvature, curvature radius, eccentricity, tilt angle, corneal diameter, and binocular separation angle were calculated according to the geometric principles. Next, the eyeballs were removed, canny edge detection was applied to identify the contour of eyeball in vitro. The results were compared between in vivo and in vitro. RESULTS: Regarding the corneal curvature and curvature radius on the horizontal and sagittal planes, no significant differences were observed among results in vivo, in vitro, and the keratometer. The horizontal and vertical binocular separation angles were 130.6°±6.39° and 129.8°±9.58° respectively. For the corneal curvature radius and eccentricity in vivo, significant differences were observed between horizontal and vertical planes. CONCLUSION: The Graphical interface window of Python makes up the deficiency of edge detection, which requires too much definition in Matlab. There are significant differences between guinea pig and human beings, such as exotropic eye position, oblique oval eyeball, and obvious discrepancy of binoculus. This study helps evaluate objectively the ocular morphological parameters of small experimental animals in emmetropization research.

[Tea polyphenol protects against HK-2 cell injury induced by oxalate and calcium oxalate monohydrate crystals].

OBJECTIVE: To test whether the antioxidants tea polyphenol (TP) can provide protection against oxalate and calcium oxalate monohydrate (COM) crystals toxicity in HK-2 cells. METHODS: Four groups were chosen for the study: Negative control group, positive control group (COM+oxalate), TP group (TP+COM+oxalate), VitE group (vitamin E+COM+oxalate). HK-2 cells were exposed for 4, 8, 12 and 24 h. The viability of the cells was assessed by MTT. The cellular injury was assessed by the concentration of lactate dehydrogenase (LDH), hydrogen peroxide and viability of Na+/K+ ATP enzyme. The peroxidation level was assessed by malondialdehyde (MDA) content and viability of superoxide dismutase (SOD). The morphological changes of HK-2 cells after being exposed for 4 and 12 h in each group were observed by transmission electron microscope (TEM). RESULTS: The effects of TP and vitamin E on oxalate and COM exposed cells were tested. The HK-2 cells exposed to oxalate and COM showed a significant reduction in viability of cells, Na+/K+ ATPase and SOD. LDH release, MDA content and concentration of H2O2 were significantly increased. In TP group, the addition of TP significantly increased viability of cells, activity of Na+/K+ ATPase and SOD while LDH release, MDA content and concentration of H2O2 were significant decreased compared with the positive control group. In the Vitamn E group, compared with the positive control group, viability of cells, and activity of Na+/K+ ATPase were not significantly changed and after addition of vitamin E, SOD activity was restored, LDH release, MDA content and concentration of H2O2 were significant decreased compared with the positive control group. The morphological changes of HK-2 cells were observed by TEM in the positive control group, TP group and VitE group. In the VitE and TP groups, the amount of the cells with vacuoles formed in kytoplasms, mitochondria swelling, karyotheca dissolved and nucleolus disappearing were less than in the positive group. The morphological changes in the TP group were less than in the VitE group. CONCLUSION: TP and vitamin E administration may prevent oxalate and COM mediated peroxidative injury and restore intracellular antioxidant enzyme activity. The protection rendered by TP was greater than that of vitamin E.

[Clinical efficacy and safety of percutaneous nephrolithotomy for upper urinary tract calculi patients with metabolic syndrome].

OBJECTIVE: To investigate the efficacy and safety of percutaneous nephrolithotomy (PCNL) for upper urinary tract calculi patients complicated with metabolic syndrome (MS). METHODS: The clinical data of 66 PCNL cases with upper urinary tract calculi from March 2010 to February 2011 were retrospectively reviewed. Patients were divided into two groups according to 2004 Diagnostic Criteria of Metabolic Syndrome by the Chinese Diabetes Society (CDS). Twenty six upper urinary tract calculi patients complicated with metabolic syndrome were defined as case group (average aged 52.4 years, 16 males and 10 females). The other 40 cases without MS served as control group (average aged 45.9 years, 21 males and 19 females). The stone burden was (7.2 ± 1.8) cm(3) in case group and (6.4 ± 1.3) cm(3) in control group (P=0.712). The stone free rate, operative time, drop in hemoglobin level and fever were compared between the two groups. RESULTS: The operation time was (87.1 ± 9.0) min in case group and (87.6 ± 6.0) min in control group (P=0.963). The stone free rate was 76.9% (20/26) vs. 75.0% (30/40), P=0.859. The drop in hemoglobin level was (8.4 ± 1.6) g/L vs. (9.1 ± 1.4) g/L, P=0.739. The incidence of post-operative fever was 38.5% (10/26) vs. 45.0% (18/40), P=0.599. CONCLUSION: MS will neither increase the difficulty of surgery, nor reduce the stone free rate of PCNL for upper urinary tract calculi. And it will not raise the incidence of postoperative complications.

[Intravesical laparoscopic repair of vesicovaginal fistula].

OBJECTIVE: To introduce a new technique to treat vesicovaginal fistula (VVF) with intravesical laparoscopic repair, and assess its safety and efficacy. METHODS: Four female patients with iatronic VVF were treated with intravesical laparoscopic method between October 2008 and March 2010. The second case underwent open surgery repair four months ago. All the fistulae were in posterior wall of bladder,with 0.8 cm, 1.0 cm, 1.2 cm and 0.5 cm in size respectively. One 10 mm superpubic trocar and 2.5 mm lateral trocars were placed in surgery. Carbon dioxide gas was used to distend the bladder. RESULTS: Four operations were completed successfully. The operative time was 80-140 min, and the blood loss was 50-100 mL. The indwelling catheter was removed after 4 weeks. All the patients were followed up for 1-8 months. Three patients showed no recurrence of fistula and had normal urination. One patient developed urinary leakage through the vagina again after 1 month. CONCLUSION: Intravesical laparoscopic technique is a safe and effective treatment with micro-trauma for iatrogenic VVF, but more clinical files are needed for further evaluation.

Measuring the Ocular Morphological Parameters of Guinea Pig Eye with Edge Detection and Curve Fitting.

AIM: To identify the guinea pig eyeball with edge detection and curve fitting and devise a noncontact technology of measuring ocular morphological parameters of small experimental animal. METHODS: Thirty-nine eyeballs of guinea pig eyeballs were photographed to obtain the anterior and posterior surface; transverse and sagittal planes after the eyeballs were eviscerated. Next, the eyeball photos were input into digital image analysis software; the corresponding photo pixels-actual length ratio was acquired by a proportional scale. The contour lines of the eyeballs were identified by edge detection technology; conic curve fitting was applied to fit the contour line of the eyeball. The maximum and minimum diameters, the horizontal and vertical diameters, eccentricity, tilt angle, cross-sectional area, equatorial circumference, retrobulbar equatorial maximum length, corneal radius of curvature (CRC) in central region, and the whole cornea were calculated according to the geometric principles. The corneal data of in vitro study were compared with the in vivo results. RESULTS: The contour line of the selected guinea pig eye was identified correctly by edge detection. There were no significant differences between anterior and posterior surfaces of one eyeball in the maximum diameters, eccentricity, cross-sectional area, equatorial circumference, and tilt angle (P > 0.01). There were significant differences of eccentricity and CRC between central region and the whole cornea (P < 0.01). There were no significant differences between keratometer in vivo and cornea in vitro. CONCLUSION: It was feasible to measure an experimental animal eye in a noncontact way. Edge detection and curve fitting technology could accurately evaluate the ocular morphological parameters.

[Comparative assessment of visual quality after combined implantation of multifocal intraocular lens].

OBJECTIVE: To evaluate the visual quality after combined implantation of refractive and diffractive multifocal intraocular lenses (IOL) in both eyes. METHODS: Prospective, nonrandomized study. Age-related cataract patients were divided into multifocal IOL group (MIOL group) and monofocal IOL group (SIOL group) and received phacoemulsification. In MIOL group, a ReZoom NXG1 IOL and a Tecnis Z M900 IOL were implanted into the dominant eye and the fellow eye, respectively. In SIOL group, Sensar AR40e IOLs were implanted into both eyes. Monocular or binocular test was performed one month after surgery, including wavefront aberration, contrast sensitivity with or without glare and near stereoacuity. RESULTS: The root mean square of spherical aberration at pupil diameter of 5 mm was 0.058 +/- 0.159 microm in NXG1 eyes and 0.005 +/- 0.169 microm in ZM900 eyes, both of them were significantly lower than 0.408 +/- 0.160 microm achieved in AR40e eyes (F = 11.734; P = 0.001, 0.000). There was no significant difference in the total ocular aberration, contrast sensitivity and high-order aberration among eyes with these different IOLs. The uncorrected near stereoacuity in MIOL group was (45.60 +/- 35.04) seconds of arc, which was significantly better than (110.00 +/- 41.23) seconds of arc achieved in SIOL group (F = 2.923; P = 0.010). CONCLUSION: Combined implantation of multifocal ReZoom NXG1 IOL and Tecnis ZM900 IOL provides a good visual quality with reduced spherical aberration and satisfactory near stereoacuity.

[Comparative assessment of individualized multifocal intraocular lens implantation].

OBJECTIVE: To evaluate the visual quality after combined implantation of refractive and diffractive multifocal intraocular lens (MIOLs) in both eyes (CustomMatch pattern). METHODS: Prospective, nonrandomized study. Zhongshan Ophthalmic Center, Sun yat-sen university, P.R. China. Age-related cataract patients, selected according to the inclusion criteria and divided into MIOL group and monofocal intraocular lens (SIOL) group, received phacoemulsification and were implanted with combined a ReZoom NXG1 IOL in the dominant eye and a Tecnis ZM900 IOL in the fellow eye or bilateral Sensar AR40e IOLs. Monocular and binocular testing one month after surgery included uncorrected and best-spectacle corrected visual acuity at far, intermediate and near distances under 100 cd/m(2) and 6 cd/m(2), reading visual acuity and reading speed, defocus curve, and subjective vision-related quality of life using questionnaire. RESULTS: Under 100 cd/m(2) and 6 cd/m(2), binocular mean uncorrected visual acuity at 500 cm in MIOL group was logMAR 0.013 +/- 0.149 and logMAR 0.163 +/- 0.220 and binocular mean best-spectacle corrected visual acuity was logMAR -0.027 +/- 0.092 and logMAR 0.109 +/- 0.175 respectively. The mean refraction spherical equivalent for best distance corrected visual acuity was (-0.18 +/- 0.85) D and (-0.32 +/- 0.90) D respectively. Under 100 cd/m(2), better uncorrected visual acuity (decimal 0.63) at 40 cm, 63 cm and 100 cm was achieved in MIOL group. Under 6 cd/m(2), the uncorrected visual acuities in MIOL group at 40 cm and 63 cm distance were significantly higher than those in SIOL group although there were no statistically difference at 100 cm. Uncorrected reading visual acuity and reading speed in MIOL group were better than those in SIOL group, while the results in reading ability were similar when MIOL group without correction compared with SIOL group with correction. The depth of focus was 5.5 diopter in MIOL group. No patient in both groups wore glasses for distance and 70% patients in MIOL group did not need to wear glasses for intermediate and near distances after surgery. CONCLUSION: CustomMatch pattern could provide a satisfactory vision at a full range of near, intermediate and far distance and improve the life quality to a certain extent.

Targeting silencing androgen receptor gene by shRNA with low-intensity focused ultrasonic irradiation inhibits growth of prostate cancer xenografts in nude mice.

The androgen receptor (AR) plays a pivotal role in prostate cancer, making it a potential therapeutic target. Short-hairpin RNA (shRNA) inhibits gene expression and offers a novel strategy to eradicate disease. Ultrasound-mediated gene transfection is a promising gene delivery method. This study sought to determine whether targeting silencing androgen receptor gene by shRNA with low-intensity focused ultrasonic irradiation could be used as effective therapy for prostate cancers in vivo. A plasmid-based short-hairpin RNA combined with low-intensity focused ultrasonic irradiation approach was used to specifically knock down the expression of AR in prostate cancer 22RV1 cells in vivo. The growth of 22RV1 tumors that had been subcutaneously xenografted was evaluated and expression level of AR was determined by immunohistochemical staining. The proliferative index (PI) and the apoptotic index (AI) were respectively derived from the percentage of positive cells by Ki-67 immunohistochemical staining and TUNEL assay. The plasmid-based AR shRNA administrated intravenously significantly inhibited the tumor growth and AR expression. These inhibitory effects of AR shRNA were augmented when the region of tumor received low-intensity focused ultrasound irradiation. Immunohistochemical staining and TUNEL assay confirmed AR shRNA with low-intensity focused ultrasonic irradiation exhibited growth-inhibitory, antiproliferative, and apoptotic effects on prostate cancer xenografts. The authors showed for the first time that the knockdown of AR expression by plasmid-based AR shRNA with low-intensity focused ultrasonic irradiation significantly suppressed the tumor growth of prostate cancer in vivo.

Treatment of hyperhomocysteinemia and endothelial dysfunction in renal transplant recipients with B vitamins in the Chinese population.

PURPOSE: We studied the efficacy of B vitamins as a treatment for hyperhomocysteinemia and endothelial dysfunction in renal transplant recipients in the Chinese population. MATERIALS AND METHODS: A total of 36 stable renal transplant recipients with hyperhomocysteinemia were randomly assigned to folate treatment (5 mg folic acid per day, 50 mg vitamin B6 per day and 1,000 microg vitamin B12 per day) or to the control group (placebo only) for 6 months. All subjects underwent tests for creatinine, creatinine clearance rate, average blood pressure, total cholesterol, triglyceride and fasting homocysteine. Endothelial function was evaluated using high resolution vascular ultrasound. RESULTS: Homocysteine significantly decreased in those with folate treatment after intervention compared with baseline (12.6 +/- 3.9 vs 20.1 +/- 5.4 micromol/l, t = 5.3, p <0.01), whereas no significant changes were observed in controls. In the folate treatment group endothelium dependent and independent vasodilatation responses significantly increased after intervention (12.2% +/- 4.6% vs 8.8% +/- 5.2%, t = 2.9, p <0.01 and 17.6% +/- 3.9% vs 12.2% +/- 4.7%, t = 3.4, p <0.01, respectively). However, no significant changes were observed in controls. Endothelium dependent and independent vasodilatation responses were significantly lower in controls compared to levels in the folate group after treatment (8.7% +/- 6.3%, t = 2.8, p <0.01 and 12.2% +/- 5.3%, t = 3.5, p <0.01, respectively). CONCLUSIONS: Based on these data B vitamin supplementation may decrease blood homocysteine and improve endothelial function in renal transplant recipients with hyperhomocysteinemia.

Clinical features and surgical treatment of double elevator palsy in young children.

AIM: To describe the clinical features of congenital double elevator palsy (CDEP) and to evaluate various surgical outcomes between the standard Knapp and augmented Knapp procedures, based on improvements in primary eye position and ocular motility. METHODS: Twenty-two patients with CDEP at Shanghai Children's Hospital were enrolled from July 2014 to January 2018. The forced duction test (FDT) was negative in 21 patients, aged 8mo to 12y (mean 5.4y). Patients were divided into two treatment groups: 16 patients underwent the standard Knapp procedure (group A), with or without horizontal squint procedure; and 5 patients underwent the augmented Knapp procedure (Foster procedure; group B). One patient underwent inferior rectus recession in the affected eye and superior rectus recession in the sound eye because of a positive FDT. The pre- and postoperative vertical deviations in the primary position and ocular motility were compared in the two groups. RESULTS: Twenty-one eyes of the 22 patients (95%) were aligned within 10 prism diopters (PD), and all patients (100%) reached ≥25% elevation improvement after surgery. The average corrected vertical deviation in group B was statistically better than that of group A. For group A, the vertical deviation in the primary position decreased from 24.75Δ±8.35Δ to 4.56Δ±8.07Δ after surgery, for an improvement of 23.06Δ±6.51Δ (P<0.05). In group B, the decrease was from 35.00Δ±5.00Δ (range 30Δ-40Δ) to 1.00Δ±2.24Δ, for an improvement of 34.00Δ±4.18Δ (P<0.05). There were significant differences between the pre- and postoperative elevation in each group (group A, P<0.05; group B, P<0.05). The average scale of improved elevation in group B (1.80±0.45) was not significantly better than that of group A (1.69±0.87; Z=-0.732, P=0.548). The average follow-up periods lasted 21mo in group A and 18mo in group B. CONCLUSION: For vertical deviations <30Δ, the standard Knapp procedure can be chosen. For deviations greater than 30Δ-40Δ, the Foster procedure should be chosen. Because of our early interference, the inferior rectus (IR) muscle did not show mechanical restriction. Monocular elevation deficiency (MED) should be diagnosed early so that complications will be reduced and the procedure will be easier for the surgeon.

[Detection and significance of 16S rDNA in the prostatic secretions of patients with chronic prostatitis].

OBJECTIVE: To evaluate the expression and significance of 16S rDNA in prostatic secretions (EPS) of chronic prostatitis. METHODS: 16S rDNA was detected in EPS of 116 patients with chronic prostatitis by PCR. RESULTS: 16S rDNA were positively expressed in all 29 cases of II type chronic bacterial prostatitis and 71 out of 87 cases of III type chronic prostatitis (82%). The positive rates were 94% (45/48) and 67% (26/39) in lIIA and IIIB chronic prostatitis respectively. There was a statistical difference in 16S rDNA positive rate between IIIA and IlB chronic prostatitis (P < 0.01). CONCLUSION: Detection of 16s rDNA may be a useful index for the diagnosis and classification of chronic prostatitis.

Enhanced sensitivity to mitomycin C by abating heat shock protein 70 expression in human bladder cancer cell line of BIU-87.

BACKGROUND: Bladder cancer is a relatively common tumor in the urinary system, in which mitomycin C (MMC)-based chemotherapy or combination chemotherapy has been mainly used to treat patients with advanced bladder cancer. The prognosis of patients with advanced bladder cancer is still extremely poor in spite of recent therapeutic advances. To improve the prognosis, the sensitivity of tumor cells to mitomycin C by the induction of apoptosis with the abating heat shock protein 70 (HSP70) expression in human bladder cancer cell lines of BIU-87 was investigated. METHODS: HSP70 expression was abated in BIU-87 cells by HSP mRNA antisense oligomers. MTT assay and the clone-forming test were used for evaluating the sensitivity of cells to MMC. Apoptosis was assessed using both fluorescent microscopy after staining the cells with Hoechst 33258 and DNA fragment ladder agarose electrophoresis. Thirty-two male six-week-old BALB/c nude mice, at the beginning of the experiment, were used to evaluate the effect of antisense oligomers (ASO) on the tumor formation in vivo. RESULTS: HSP70 expression in BIU-87 was effectively abated by HSP70 mRNA antisense oligomers. The percentage of apoptotic cells in ASO group was greater than in sense oligomers (SO) [P < 0.05, (18.31 +/- 2.89)% vs (1.89 +/- 0.74)%], nonsense oligomers (NO) [P < 0.05, (18.31 +/- 2.89)% vs (1.78 +/- 0.92)%] and blank groups [P < 0.05, (18.31 +/- 2.89)% vs (1.87 +/- 0.84)%], while the sensitivity of tumor cells to mitomycin C was enhanced. The in vivo tumor inhibition rate of ASO plus MMC (> 50%) was more than that of ASO or MMC group alone (all P < 0.05). CONCLUSIONS: The abating level of HSP70 expression can strengthen the sensitivity of BIU-87 to MMC. One of this effect might be related to the induction of apoptosis by abating HSP70 expression.

[Inhibitory effect of doxazosin on the growth of transplanted tumor of prostate cancer cell PC-3 in nude mice].

OBJECTIVE: To investigate the effects of alpha1 adrenoceptor antagonist doxazosin on the growth of androgen-independent prostate cancer cell PC-3 transplanted in nude mice. METHODS: PC-3 cells xenografts were transplanted (s.c.) in nude mice, and thirty xenografts were established successively. They were then randomly divided into 5 groups: A (control group), B (doxazosin 3 mg/kg), C (doxazosin 10 mg/kg), D (doxazosin 30 mg/kg), and E (doxazosin 100 mg/kg). Seven days after implantation, doxazosin was administered in sterile water by oral gavage, and the volumes of the transplanted tumors were measured during the therapy twice a week. All the mice were sacrificed after two weeks of doxazosin administration; the tumors were resected to do the following research. Immunohistochemistry of Ki67 and terminal deoxynucleotidyl transferase-mediated dUTP biotin nick end labeling (TUNEL) was done to study the effects of doxazosin on the proliferation and apoptosis of prostate cancer cells; moreover, we also used Western blotting to study the protein expression of Smad-4 and IkappaB alpha. RESULTS: Nude mouse experiments showed that the in vivo doxazosin administration induced a notable decrease in the volumes of prostate cancer xenografts compared with the control group, and the tumor weights were also decreased. Interestingly enough, administration of doxazosin at higher concentrations (10, 30, 100 mg/kg) did not have further effect on tumor suppression. The percentage of PC-3 TUNEL positive cells was significantly higher than that of the control group; while the doxazosin treated groups and the control group did not have statistical difference on the percentage of Ki67 positive cells. In doxazosin treated groups Smad-4 and IkappaB alpha expressions were higher than that of the control group. CONCLUSION: Doxazosin can inhibit the growth of the prostate xenografts in the nude mice by inducing apoptosis without affecting the cell proliferation. Activation of transforming growth factor beta1 (TGF-beta1) signaling pathway may be the mechanism underlying doxazosin-mediated apoptosis.

[Treatment of hyperhomocysteinemia and endothelial dysfunction in renal-transplant recipients with vitamin B].

OBJECTIVE: To study the effect of vitamin B on treatment of hyperhomocysteinemia and endothelial dysfunction in renal-transplant recipients. METHODS: Thirty-six stable hyperhomocysteinemic renal-transplant recipients were randomly assigned to vitamin treatment (group A, n = 18, folic acid 5 mg/d, vitamin B(6) 50 mg/d, B(12) 1000 microg/d) or controlled group (group B, n = 18) for 6 months. All subjects underwent assessment of levels for creatinine, creatinine clearance, average pressure, total cholesterol, triglyceride and fasting homocysteine. Endothelial function was evaluated using high-resolution vascular ultrasound. RESULTS: The levels of homocysteine markedly decreased in group A [(13 +/- 4) micromol/L vs (20 +/- 5) micromol/L, t = 5.3, P < 0.01] after treatment, whereas no significant changes were observed in group B. In group A, endothelium dependent [(12 +/- 5)% vs (9 +/- 5)%, t = 2.9, P < 0.01] and independent [(18 +/- 4)% vs (12 +/- 5)%, t = 3.4, P < 0.01] vasodilatation responses significantly increased after treatment, no significant changes were observed in group B. Endothelium dependent [(9 +/- 6)%, t = 2.8, P < 0.01] and independent [(12 +/- 5)%, t = 3.5, P < 0.01] vasodilatation responses of group A were significantly lower than that of group B after treatment. CONCLUSIONS: Vitamin B supplementation can reduce the levels of homocysteine and improve the endothelial function in hyperhomocysteinemic renal-transplant recipients.

[Analysis of eleven cases of severe pneumonia in kidney transplant recipients].

OBJECTIVE: To analyse retrospectively the diagnosis and treatment of severe pneumonia in kidney transplantation recipients. METHODS: Between January 1999 and December 2003, 172 adult patients underwent kidney transplantation at our department. In all severe pneumonia cases, empirical therapy was initiated with aztreonam, erythromycin and ganciclovir. And the therapy was switched to proper antibiotics according to the results of sensitivity testing. Responsible pathogen was detected by study of BAL (bronco-alveolar-lavage), sputum and blood specimen. Analyses included cell differential count, cytopathologic examination and cultures for bacteria, fungi and viruses. The immunosuppressive therapy was drastically reduced. Hypoxia was relieved by BiPAP (Bi-level Positive Airway Pressure) or mechanical ventilation if necessary. RESULTS: Seventeen cases (9.9%) of pneumonia were observed in the 172 recipients, only 11 (65%) patients experienced severe pneumonia, 1 (9%) of them died. Fever was the most common symptom on presentation (82%). On presentation 46% of the patients presented with classical clinical syndrome of fever accompanied by cough and dyspnea. Positive rate of BAL and blood culture were 100% and 46% respectively. BiPAP and mechanical ventilation were required in 6 and 2 cases respectively. CONCLUSION: BAL is preferred for early detection of responsible pathogen. A combination of drastic reduction of the immunosuppressive regimen, implementation of appropriate empirical antibiotics, proper BiPAP or mechanical ventilation are important.

Electron paramagnetic resonance in monitoring of nitric oxide production after kidney transplantation in rats.

BACKGROUND: Much research has been focused on ischemia/reperfusion injury (IRI) to the transplanted organs. As a free radical, nitric oxide (NO) plays an important role in IRI. In this study, the production of NO and its functions during IRI were monitored in rat models after allotransplantation of kidney grafts. METHODS: Of 75 male LEW rats, 30 served as donors, and the remaining 45 rats were divided into three groups (15 rats in each group): controls (group 1), kidney allotransplantation followed by bilateral nephrectomy during reperfusion (group 2), 2 hours before operation, donors and recipients were treated with N(G)-nitro L-arginine methyl ester (L-NAME), a NO synthase inhibitor, at a dose of 30 mg/kg (group 3). Bilateral nephrectomies were performed while kidney grafts were reperfused. The kidney grafts were hypothemically stored for 24 hours. The production of NO before and after reperfusion was measured by electron paramagnetic resonance (EPR). The creatinine level, the glomerular filtration rate (GFR) and the protein carbonyl content in tissue samples were recorded on the first and the fifth day after operation. The data were evaluated by one-way analysis of variance. Differences were considered to be statistically significant when a P value was less than 0.05. RESULTS: After reperfusion for 15 minutes, the production of NO increased remarkably and kept increasing till 120 minutes, after which the level returned to normal. In group 3, which was pretreated with L-NAME, creatinine levels were higher than those in group 2 at the 24th hour (4.10 +/- 0.50 mg/dl vs. 3.77 +/- 0.42 mg/dl, P < 0.05) and the 120th hour (3.19 +/- 0.79 mg/dl vs. 2.22 +/- 0.53 mg/dl, P < 0.05). GFR levels in group 3 were lower than those in group 2 at the 24th hour (0.50 +/- 0.12 ml/min vs. 0.71 +/- 0.19 ml/min, P < 0.05) and the 120th hour (0.59 +/- 0.38 ml/min vs. 1.27 +/- 0.23 ml/min, P < 0.01). The content of protein carbonyl in tissue samples of group 3 was lower than that in group 2 at the 24th hour (29.01 +/- 7.02 nmol/mg protein vs. 49.39 +/- 13.13 nmol/mg protein, P < 0.05), but was higher than that at the 120th hour (75.71 +/- 16.74 nmol/mg protein vs. 57.93 +/- 15.32 nmol/mg protein, P < 0.05). CONCLUSIONS: After transplantation of hypothemically stored kidney grafts, the increased NO production in the early stage has protective effects on the transplanted kidney. Application of L-NAME to inhibit NO production is harmful to the recovery of the renal functions of kidney grafts.