Self-pulsing and dual-mode lasing in a square microcavity semiconductor laser.

Self-pulsing and dual-mode lasing in a square microcavity semiconductor laser are studied experimentally. Self-sustained pulses originating from undamped relaxation oscillation induced by a two-mode interaction are obtained, as the injection current is slightly above the laser threshold. A repetition frequency of 4.4 GHz and a pulse width of 30-40 ps are obtained at a current of 8 mA. The laser switches to continuous-wave operation when the injection current is higher than a certain value, and dual-mode lasing with 30.7 GHz at 16 mA and 10.7 GHz at 27 mA are observed in the lasing spectra. Furthermore, the relative intensity noise spectra are presented to reveal the relationship between the lasing states and the dynamics induced by relaxation oscillation and mode beating.

Wideband chaotic tri-mode microlasers with optical feedback.

A tri-mode micro-square laser under optical feedback is proposed and demonstrated to generate chaos with the broadband flat microwave spectrum. By adjusting lasing mode intensities, frequency intervals, and optical feedback strength, we can enhance the chaotic bandwidth significantly. The existence of two mode-beating peaks makes the flat bandwidth much larger than the relaxation oscillation frequency. Effective bandwidth of 35.3 GHz is experimentally achieved with the flatness of 8.3 dB from the chaotic output spectrum of the tri-mode mode laser under optical feedback.

Construction of an immune-related LncRNA signature with prognostic significance for bladder cancer.

Bladder cancer (BLCA) is one of the most common urological cancer with increasing cases and deaths every year. In the present study, we aim to construct an immune-related prognostic lncRNA signature (IRPLS) in bladder cancer (BLCA) patients and explore its immunogenomic implications in pan-cancers. First, the immune-related differentially expressed lncRNAs (IRDELs) were identified by 'limma' R package and the score of IRPLS in every patient were evaluated by Cox regression. The dysregulation of IRDELs expression between cancer and para-cancer normal tissues was validated through RT-qPCR. Then, we further explore the biological functions of a novel lncRNA from IRPLS, RP11-89 in BLCA using CCK8 assay, Transwell assay and Apoptosis analysis, which indicated that RP11-89 was able to promote cell proliferation and invasive capacity while inhibits cell apoptosis in BLCA. In addition, we performed bioinformatic methods and RIP to investigate and validate the RP11-89/miR-27a-3p/PPARγ pathway in order to explore the mechanism. Next, CIBERSORT and ESTIMATE algorithm were used to evaluate abundance of tumour-infiltrating immune cells and scores of tumour environment elements in BLCA with different level of IRPLS risk scores. Finally, multiple bioinformatic methods were performed to show us the immune landscape of these four lncRNAs for pan-cancers. In conclusion, this study first constructed an immune-related prognostic lncRNA signature, which consists of RP11-89, PSORS1C3, LINC02672 and MIR100HG and might shed lights on novel targets for individualized immunotherapy for BLCA patients.

Manipulation of lasing modes in a circular-side octagonal microcavity laser with a spatially distributed current injection.

We propose and demonstrate a circular-side octagonal microcavity (COM) semiconductor laser with a spatially distributed current injection for manipulating the lasing modes. There are two types of high-quality-factor whispering-gallery (WG) modes with distinct field patterns in a COM: the four-bounced quadrilateral modes and the eight-bounced octagonal modes. By designing two separated p-electrodes, the COM laser is divided into two regions that are pumped independently to select specific modes for lasing. The two types of WG modes lase simultaneously when the two regions are injected with equivalent currents. Degeneracy removal of the quadrilateral modes is observed in both simulation and experiment when the two regions are injected with inequivalent currents. The quadrilateral modes are suppressed when one of the two regions is un-injected or biased with a negative current, and single-octagonal-mode lasing is realized. The results show that the lasing modes can be efficiently manipulated with the spatially distributed current injection considering the distinct field patterns of different WG modes in the microcavities, which can promote the practical application of the microcavity lasers.

Comparison of single- and dual-mode lasing states of a hybrid-cavity laser under optical feedback.

In this Letter, we design and realize a hybrid-cavity laser with single- or dual-mode lasing states and study the nonlinear states of the laser under external optical feedback (EOF). The laser at a dual-mode state easily and directly enters the chaotic state without periodic oscillation states and display chaos for a much wider range of the EOF magnitude than the laser at a single-mode state. A flat chaotic signal is obtained for the laser at a dual-mode lasing state under a weak EOF benefitting from the low-frequency energy enhancement caused by mode competition between the dual modes.

Numerical simulation of all-optical logic gates based on hybrid-cavity semiconductor lasers.

All-optical switch and multiple logic gates have been demonstrated using a hybrid-cavity semiconductor laser composed of a square microcavity and a Fabry-Perot cavity experimentally. In this paper, two-section tri-mode rate equations with optical injection terms are proposed and applied to study all-optical logic gates of NOT, NOR, and NAND operations utilizing the hybrid-cavity laser. Steady-state and dynamical characteristics of all-optical multiple logic gates are simulated, taking into account the influence of mode frequency detuning, gain suppression coefficients, mode Q factor, injection energy, and biasing current. All-optical logic NOT, NOR, and NAND gates up to 20, 15, and 20 Gbit/s are obtained numerically with dynamic extinction ratios of over 20, 20, and 10 dB, respectively, which are potential response speeds of the all-optical logic gates based on the hybrid-cavity semiconductor lasers.

Mode control through anti-Hermitian coupling in regular-polygonal microcavities with non-uniform gain and loss.

We theoretically and numerically study optical modes in regular-polygonal microcavities with non-uniform gain and loss, where high quality (Q) whispering-gallery-like modes typically appear as superscar states. High Q superscar modes can be described by the propagating plane waves in an effective rectangle formed by unfolding the periodic orbits and exhibit regular and predictable spatial field distributions and transverse-mode spectra. With non-uniform gain and loss, anti-Hermitian coupling between the transverse modes with close frequencies occurs according to the mode coupling theory, which results in novel mode properties such as modified mode spectra and field patterns, and the appearance of exceptional points. Numerical simulation results are in good agreement with the theoretical analyses, and such analyses are also suitable for other kinds of high Q microcavities with non-uniform gain and loss. These results will be highly useful for studying non-Hermitian physics in optical microcavities and advancing the practical applications of microcavity devices.

Extended versus non-extended lymphadenectomy during radical cystectomy for patients with bladder cancer: a meta-analysis of the effect on long-term and short-term outcomes.

BACKGROUND: Pelvic lymphadenectomy (PLND) is an integral part of curative surgery for high-risk non-muscle invasive and muscle-invasive bladder cancer. The therapeutic value of extended PLND is controversial. METHODS: We conducted a comprehensive online search in PubMed, EMBASE, and the Cochrane Library databases for relevant literature directly comparing extended PLND (e-PLND) with non-extended PLND (ne-PLND) from database inception to June 2019. We performed the meta-analysis to evaluate the impact of PLND templates on recurrence-free survival (RFS), disease-specific survival (DSS), overall survival (OS), rates of postoperative major complications, and mortality within 90 days of surgery. RESULTS: A total of 10 studies involving 3979 patients undergoing either e-PLND or ne-PLND were included. The results showed that e-PLND was significantly associated with better RFS (HR 0.74, 95% CI 0.62-0.90, p = 0.002) and DSS (HR 0.66, 95% CI 0.55-0.79, p < 0.001). However, no correlation was found between e-PLND template and a better OS (HR 0.93, 95% CI 0.55-1.58, p = 0.79). Postoperative major complications were similar between e-PLND group and ne-PLND group, as was mortality within 90 days of surgery. CONCLUSION: e-PLND template is correlated with favorable RFS and DSS outcomes for patients with bladder cancer. e-PLND did not have more postoperative major complications than did ne-PLND.

Tumor growth velocity: A modified tumor growth rate defining tumor progression during sorafenib treatment in patients with metastatic renal cell carcinoma.

OBJECTIVES: To investigate the role of tumor growth velocity in defining tumor progression in metastatic renal cell carcinoma patients treated with the vascular endothelial growth factor tyrosine kinase inhibitor, sorafenib. METHODS: A modified calculation for tumor growth velocity was introduced to evaluate the tumor growth velocity, before and after sorafenib withdrawal. Known prognostic factors together with tumor growth velocity before drug withdrawal and tumor growth velocity after drug withdrawal were compared using a χ2 -test from a contingency table, and partial likelihood test from a Cox regression model for overall survival. RESULTS: A total of 114 patients who reached progressive disease and withdrew from sorafenib were enrolled after a median follow-up period of 107.8 months. Tumor growth velocity before drug withdrawal was 7.347 ± 4.040, and tumor growth velocity after drug withdrawal was 11.647 ± 5.937 (P < 0.001). Higher tumor growth velocity before drug withdrawal was correlated with a higher risk Memorial Sloan Kettering Cancer Center score (P = 0.022), Karnofsky Performance Status <80 (P = 0.028), non-clear cell carcinoma (P = 0.037), higher tumor nucleus grade (P < 0.001) and best treatment response (P < 0.001). Patients with tumor growth velocity before drug withdrawal >5.0 had shorter overall survival (P < 0.001). On multivariate analysis, factors associated with overall survival were high/intermediate Memorial Sloan Kettering Cancer Center risk score (hazard ratio 2.119, P = 0.006), non-clear histological subtype (hazard ratio 1.900, P = 0.031), tumor growth velocity before drug withdrawal ≥5.0 (hazard ratio 2.758, P < 0.001) and progressive disease as best response (hazard ratio 2.069, P = 0.001). CONCLUSIONS: Significantly faster tumor growth can be observed if sorafenib is discontinued in the case of disease progression. Thus, we suggest not to withdraw targeted agents until tumor growth velocity is >5.0.

Nephrometry score-guided off-clamp laparoscopic partial nephrectomy: patient selection and short-time functional results.

BACKGROUND: Laparoscopic partial nephrectomy (LPN) is not a novel but a relatively technically challenging surgical procedure. Off-clamp LPN with zero ischemia can completely eliminate ischemic reperfusion injury to the kidney. The purpose of this study was to evaluate the safety and functional outcome of nephrometry score-guided off-clamp technique in LPN. METHODS: A total of 44 patients underwent LPN between January 2015 and July 2015 for renal mass with radius, exophytic/endophytic, nearness to sinus, anterior/posterior location (RENAL) score 4 were enrolled. Twenty-two of them underwent off-clamp LPN with zero ischemia, and the other 22 received standard LPN with common renal artery clamp. Estimate blood loss (EBL), total operation time, resection time, renorrhaphy time, preoperative estimated glomerular filtration rate (eGFR), postoperative eGFR, eGFR change, and drainage after surgery were compared between these two groups using t test. RESULTS: Patients' characteristics including gender, age, BMI, tumor size, and RENAL score were balanced between the two groups. Average EBL was more in the off-clamp group than in the on-clamp group (134.32 versus 70.23 ml, p = 0.001). Average eGFR change was less in the off-clamp group than in the on-clamp group (-1.56 versus -6.45, p < 0.001). Average drainage after surgery was 203.41 ml for the off-clamp group and 145.46 ml for the on-clamp group, p = 0.062. No urinary leakage and hematuria occurred in both groups. There were no statistical difference in total operation time, resection time, renorrhaphy time, preoperative eGFR, and postoperative eGFR between the two groups. CONCLUSIONS: Off-clamp LPN is a safe and feasible approach to excise certain kidney tumors with RENAL score 4. This technique can better preserve kidney function without ischemic reperfusion injury.

Visceral fat accumulation is associated with different pathological subtypes of renal cell carcinoma (RCC): a multicentre study in China.

OBJECTIVE: To investigate whether visceral obesity is associated with certain histological subtypes of renal cell carcinoma (RCC) ina multicentre Chinese cohort. PATIENTS AND METHODS: A kidney tumour database was created using three tertiary centres in China; 487 patients were enrolled presenting with localised RCC and complete computer tomography(CT)/magnetic resonance imaging (MRI) information. A single-slice CT image was used to measure the area of visceral and subcutaneous adipose tissues in each patient. Statistical methods were used to analyse clear-cell RCC (ccRCC) and non-clear-cell RCC (non-ccRCC) as they relate to visceral fat area (VFA) and other risk factors, such as age, gender, tumour size, diabetes, hypertension, total fat area (TFA) and body mass index (BMI). RESULTS: In all, 418 patients had a ccRCC subtype and 69 had a non-ccRCC subtype. For all the patients with RCC, the mean VFA was 102 cm2, while mean BMI was 24 kg/m2. The mean VFA was greater in ccRCC than non-ccRCC patients by 25 cm2. There were significant differences in the mean VFA and TFA between patients with ccRCC and those with non-ccRCC.Multivariate analysis showed that the presence ofVFA was more important than the effects of BMI and Type 2 diabetes on pathology prediction. In patients with a normal BMI, those with a higher quartile of VFA were more likely to develop ccRCC than those with a low VFA. CONCLUSIONS: Increased visceral fat was found to be associated with ccRCC and the significance of VFA outweighed the effects of BMI and Type 2 diabetes for the prediction of RCC pathology in multivariate analyses. As a result, VFA could constitute a primary explanation for the link between obesity and ccRCC.

A Phase II trial of dosage escalation of sorafenib in Asian patients with metastatic renal cell carcinoma.

AIM: To investigate the role of sorafenib dosage escalation in Asian patients with metastatic renal cell carcinoma that had progressed after routine dosages. PATIENTS & METHODS: Sorafenib dosage escalation to 600 or 800 mg twice a day was offered to 41 patients with metastatic renal cell carcinoma who had progressed on normal dosages. Clinical outcome, toxicity and favorable clinical covariables for progression-free survival (PFS) were evaluated. RESULTS: The median PFS with dosage-escalated therapy was 7 months. Drug-related adverse events were tolerable. The pre-escalation Karnofsky performance status, serum calcium concentration, neutrophil/lymphocyte ratio, PFS and the highest toxicity grade at the routine dosage were associated with a longer PFS in the dosage-escalation period. CONCLUSION: Sorafenib dosage escalation was efficacious and tolerable in Asian patients. TRIAL REGISTRATION: Chinese Clinical Trial Registry (no. ChiCTR-ONRC-12002088).

[Hematologic adverse effects in patients with renal cell carcinoma treated with sunitinib].

OBJECTIVE: To explore the hematologic adverse effects in patients with renal cell carcinoma treated with sunitinib. METHODS: A total of 136 patients with advanced renal cell carcinoma were treated with sunitinib at our hospital from 2008 to 2011. There were 91 males and 45 females with an average age of 55.5 years. They received sunitinib in repeated 6-week cycles consisting of 4 weeks of sunitinib 50 mg per day followed by 2 weeks of treatment (schedule 4/2). The hematologic toxicities, collected at baseline and 14, 28, 42 (after a 2-week rest period) days, were graded according to the National Cancer Institute common terminology criteria for adverse events version 3.0. The paired Wilcoxon test was used to evaluate the kinetics of hematologic adverse effects at days 14, 28, and 42 post-treatment. RESULTS: The hematologic toxicities included leukopenia (n = 91, 66.9%), neutropenia (n = 95, 69.8%), lymphopenia (n = 58, 46.2%), thrombopenia (n = 89, 65.4%) and hypohemoglobinemia (n = 48, 35.3%). Among them, 31 cases (22.8%) had the high-grade (including grades 3 and 4) toxicity of thrombopenia. There were depressions in hematopoietic cell populations including leukocytes, neutrophils, and platelets at days 14, 28 and 42 versus the baseline level (all P < 0.05). The median hemoglobin level transiently increased at days 14 and 28 (both P < 0.01) and returned to the level of baseline at days 42 (P = 0.754). CONCLUSIONS: The incidence of hematologic adverse effects of sunitinib slightly varies with what have been observed in previous studies. And the incidence of high-grade toxicity of thrombocytopenia is higher than that reported in studies conducted in the US and Europe.

[Exploratory analysis of the effect of toxicity of sunitinib on the clinical outcome of patients with advanced renal cell carcinoma].

OBJECTIVE: To explore the effect of toxicity of sunitinib on the clinical outcome of patients with advanced renal cell carcinoma (RCC) . METHODS: A total of 136 patients with advanced RCC were treated with sunitinib from 2008 to 2011. There were 91 males and 45 females with an average age of 56 years. Their 6-week therapy cycle was 4 weeks of sunitinib 50 mg daily followed by 2-week off-treatment (schedule 4/2). The median follow-up time was 15 months. Correlation between toxicities and overall survival (OS) was evaluated in a Cox model using log-transformed levels after adjusting for MSKCC model.Log-rank test and Cox proportional hazard model were used to assess the value of drug toxicity as the prognostic factors. RESULTS: The increased hemoglobin on cycle 1 day 14 (HR:0.950, 95%CI:0.923-0.978) and the increased lymphocytes on cycle 1 days 28 and 42 (HR:0.405, 95%CI:0.203-0.809, HR:0.394, 95%CI:0.179-0.867) were significantly associated with OS (P adj = 0.001, 0.014 and 0.022 respectively). Hypertension class III/IV (HR:0.066, 95%CI:0.008-0.582), and the number of neutrophils screening and lymphocyte count ratio (HR:2.537, 95%CI:1.182-5.404) were the survival prognosis independent predictors. CONCLUSION: Early hematopoietic toxicities may potentially predict the outcomes of advanced RCC after a therapy of sunitinib.

[Efficacy of low dose ketoconazole therapy for Chinese patients with castration resistant prostate cancer].

OBJECTIVE: To assess the efficacy of low dose ketoconazole therapy for Chinese patients with castration resistant prostate cancer (CRPC) and explore possible prognosis factors. METHODS: From August 2006 to August 2011, 71 patients with CRPC were analyzed retrospectively, who received oral ketoconazole 200 mg, three times a day with prednisone 5 mg, twice a day. Prostate specific antigen (PSA) response rate was defined as the percentage of patients with PSA decline ≥ 50% compared to baseline PSA level during low dose ketoconazole therapy. Multivariate Logistic regression analysis and receiver operating characteristic curve were used to assess the prognostic factors and their accuracy. RESULTS: The mean initial serum PSA level was (205 ± 38) ng/ml for these patients with mean age (69 ± 1) years old. After first androgen deprivation therapy failure, the prostate cancer progressed into castration resistant stage. The baseline PSA was (93 ± 24) ng/ml and the baseline serum testosterone was (0.13 ± 0.02) ng/ml. During the low dose ketoconazole therapy, 31 patients (43.7%) had PSA decrease and 22 cases (31.0%) were effective with PSA decline more than 50%. PSA doubling time and baseline serum testosterone were positive correlation with PSA response rate by multivariate Logistic regression analysis. Patients with PSA doubling time of ≥ 3.0 months had a PSA response rate of 64.3% and the PSA response rate in those with < 3.0 months decreased to 22.8%, hazard rate (HR) = 0.149 (95% confidence interval [CI] 0.029 - 0.766), P = 0.023, area under the curve (AUC) = 0.707. The PSA response rate for patients with baseline serum testosterone ≥ 0.1 and < 0.1 µg/L were 55.6% and 5.7%, respectively, HR = 0.068 (95%CI 0.012 - 0.380), P = 0.002, AUC = 0.749. The common adverse reactions included liver dysfunction (17.9%), renal dysfunction (16.4%), fatigue (11.9%), nausea (6.0%) and anorexia (4.5%) and so on. CONCLUSIONS: Low dose ketoconazole therapy was a moderate, low toxicity hormonal therapy option for patients with CRPC. PSA doubling time ≥ 3 months and baseline serum testosterone ≥ 0.1 µg/L were predictors of desired effect for low dose ketoconazole therapy.

Chaotic microlasers caused by internal mode interaction for random number generation.

Chaotic semiconductor lasers have been widely investigated for generating unpredictable random numbers, especially for lasers with external optical feedback. Nevertheless, chaotic lasers under external feedback are hindered by external feedback loop time, which causes correlation peaks for chaotic output. Here, we demonstrate the first self-chaotic microlaser based on internal mode interaction for a dual-mode microcavity laser, and realize random number generation using the self-chaotic laser output. By adjusting mode frequency interval close to the intrinsic relaxation oscillation frequency, nonlinear dynamics including self-chaos and period-oscillations are predicted and realized numerically and experimentally due to internal mode interaction. The internal mode interaction and corresponding carrier spatial oscillations pave the way of mode engineering for nonlinear dynamics in a solitary laser. Our findings provide a novel and easy method to create controllable and robust optical chaos for high-speed random number generation.

Comparison of accuracy among three generations of Partin tables in a Chinese cohort.

INTRODUCTION: To perform a head to head comparison among three generations of Partin tables, namely from 1997, 2001 and the last updated version of 2007, in a Chinese cohort of prostate cancer. MATERIAL AND METHODS: Clinical and pathological data of 198 consecutive Chinese patients were retrospectively analyzed, who underwent radical prostatectomy for clinically localized prostate cancer between January 2005 and May 2010. Three versions of the Partin tables were compared for their accuracy and performance to predict final pathological stage using receiver operating characteristic (ROC) curve. RESULTS: Of the whole cohort 58.6% were presented with organ-confined disease (OCD), 10.1% had lymph node involvement (LNI), and 31.3% had locally advanced disease (LAD), while 21.2% had extraprostatic extension (ECE) and 10.1% showed seminal vesicle involvement (SVI). The area under the ROC curve (AUC) of the Partin Tables 1997, 2001 and 2007 was 0.732, 0.722 and 0.695 for OCD; 0.647, 0.594 and 0.577 for LAD; 0.856, 0.872 and 0.829 for LNI, respectively. CONCLUSION: All three generations of the Partin tables showed a good accuracy to predict OCD, and LNI. However, the predictive accuracy for LAD was more limited. Overall, the newer versions of the Partin tables could not exceed the version of 1997 in their predictive accuracy for the present Chinese cohort. Our results suggest caution when using newly introduced predictive tools that are not supported by population-specific accuracy tests.

Involvement of microRNA-21 in mediating chemo-resistance to docetaxel in androgen-independent prostate cancer PC3 cells.

AIM: To investigate whether microRNA-21 was involved in mediating the chemoresistance of prostate cancer cells to docetaxel. METHODS: A microarray technique was used to determine the miRNA profile in docetaxel-resistant PC3 cells. Real-time PCR was used to confirm the array results. miR-21 mimics and inhibitors were synthesized and introduced to cells using Lipofectamine 2000. Cell proliferation was examined with the CCK-8 assay. Luciferase reporter containing PDCD 3'UTR was constructed and the activity was detected by a dual luciferase assay. PDCD4 protein expression was evaluated using Western blot. RESULTS: A docetaxel-resistant prostate cancer PC3 cell line (PC3R) was established . Using microarrays, miR-21 was found to be up-regulated in PC3R cells. Ectopic expression of miR-21 increased the resistance to docetaxel in PC3 wild type cells. In contrast, silencing of miR-21 in PC3R cells sensitized the cells to docetaxel. The IC(50) values for miR-21-silencing cells and control cells were 28.31 and 35.89 nmol/L, respectively. PDCD4, a direct target gene of miR-21, could mediate chemoresistance to docetaxel in PC3 cells. CONCLUSION: Our findings suggest that miR-21 contributed to the resistance of PC3 cells to docetaxel, and that targeting miR-21 may offer a promising therapeutic approach in sensitizing prostate cancer to docetaxel treatment.

[Establishment of regression model predicting the probability of the capsular penetration of prostate cancer].

OBJECTIVE: To establish the regression model predicting the probability of the capsular penetration according to the Chinese prostate cancer samples. METHODS: Men enrolled in the Fudan University Shanghai Cancer Centre and undergoing radical prostatectomy between January 2006 and April 2010 were used to establish the predicting model. According to the pathology after radical prostatectomy, all cases were divided into two groups: organ confined disease group and locally advanced disease group, the difference of which were whether had the capsular penetration. The cases with regional lymph node metastasis were excluded. Serum prostate specific antigen level, Gleason grade, clinical stage were collected. Multiple Logistic regression model was established according to preoperative clinical data and postoperative pathological data to predict the incidence of capsular penetration. Receiver operating characteristic curve was used for the internal validation of the model. RESULTS: 83 Chinese men were identified in the organ confined disease group with the age of 66.8 ± 5.8 years, and 36 in the locally advanced disease group with the age of 66.0 ± 6.8 years. The difference of the age between the two groups were of no statistic significance (t = 0.650, P = 0.517). The serum prostate specific antigen level (Wilcoxon W = 4562.0, P = 0.016), Gleason score (Wilcoxon W = 4586.5, P = 0.016), and clinical stage (Wilcoxon W = 4444.5, P = 0.001) of the locally advanced disease group were higher than the other group. The equation of the multiple Logistic regression model was Logit P = 0.488 × Gleason score + 0.104 × clinical stage -6.187, with the freedom degree of two and the likelihood ratio χ(2) test of 11.263 (P = 0.001). The area under the ROC curve (AUC) for capsular penetration was 0.696 (P = 0.001), with the 95% confidence interval of 0.598 - 0.793. CONCLUSION: The multiple Logistic regression model based on the Chinese population can accurately predict the probability of capsular penetration of the prostate cancer and work on well with high internal accuracy when clinical decisions are made.

[Experiences of open transperitoneal radical nephrectomy for large renal masses].

OBJECTIVE: To evaluate the effect of technical improvements of transperitoneal radical nephrectomy on the patients with large renal cell carcinoma. METHODS: From May 2002 until May 2009, 45 patients with large (> 12 cm) renal cell carcinoma underwent transperitoneal radical nephrectomy. A subcostal incision was selected to expose the extraperitoneal area. The modified operative methods included exposing the operative field via a liver retractor and initially ligating renal artery to block the blood supply of kidney and tumor. The method of tumor-free tissue dissociation was applied. Hem-o-lock was employed for clipping so as to avoid hemorrhage. This modified technique was evaluated in respects of operating time, estimated blood loss, intra-operative complications, postoperative complications, length of hospital stay and pathological diagnoses. RESULTS: The tumor diameter was from 12.2 cm to 28.3 cm with a mean of 14.5 cm. The mean operative time was (150 +/- 58) min and the average estimated blood loss (350 +/- 180) ml. Three cases received blood transfusion. The average length of hospital stay was (12 +/- 6) days. Three cases developed complications, including spleen injury in 2 and pancreatic injury in 1. The treatment modalities were splenectomy and resection of pancreatic tail respectively. The pathological diagnoses were all of renal cell carcinoma. The pathological stage included T(2)N(0 approximately 1)M(0 approximately 1)(n = 13), T(3)N(0 approximately 1)M(0 approximately 1)(n = 23), T(4)N(0 approximately 1)M(0 approximately 1)(n = 9). After a follow-up period of 3 - 63 months, 3 cases of tumor recurrence were found in primary renal clutch. CONCLUSION: Improved radical nephrectomy is feasible for large renal cell carcinoma. And it can reduce the volume of blood loss and decrease the occurrence of complications.