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【Objective】 To investigate the risk factors and clinical significance of incidental prostate cancer (IPCa) in patients undergoing radical cystoprostatectomy (PCR). 【Methods】 The clinicopathological data of 260 patients undergoing RCP in our hospital during Jan. 2010 and Jan. 2022 were retrospectively analyzed, including 39 cases of IPCa detected with postoperative pathology, and 221 non-IPCa cases. 【Results】 The detection rate of IPCa was 15%. Univariate logistic regression analysis showed age (P<0.001), smoking (P<0.05), T stage (P<0.05), number of tumors (P<0.05), involvement of trigone (P<0.05), prostate volume (P<0.05), and preoperative total prostate-specific antigen (tPSA) (P<0.05) were influencing factors of prostate cancer. Multivariate logistic regression analysis showed that age (OR=1.061, 95%CI: 1.021-1.107, P=0.004), smoking (OR=2.852, 95%CI: 1.296-6.677, P=0.012), involvement of trigone(OR=2.967, 95%CI: 2.365-3.657, P=0.019) and preoperative tPSA (OR=1.109, 95%CI: 1.011-1.223, P=0.030) were independent risk factors of IPCa. 【Conclusion】 Advanced age, smoking, bladder tumor in trigone and preoperative PSA abnormality are risk factors for incidental prostate cancer in bladder cancer patients.
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Objective:To assess the evidence for relevant factors associated with mortality in COVID-19 kidney transplantation recipients(KTR) through Meta-analysis.Methods:A complete search of PubMed, Web of Science, Medline, Scopus, Cochrane Library, CNKI and Wanfang Database were performed to search for eligible studies on 18 August 2022.Results:twenty-nine studies involving 7 978 Cases were included in our Meta-analysis.Patients with mean age ≥60 years( OR=1.09, 95% CI: 1.06-1.13), Comorbidities including diabetes mellitus( OR=1.49, 95% CI: 1.26-1.76), cardiovascular disease( OR=1.88, 95% CI: 1.33-2.65), and acute kidney injury( OR=3.46, 95% CI: 1.35-8.89) significantly increased mortality risk.KTR with dyspnea ( OR=2.17, 95% CI: 1.38-3.42), higher Hemoglobin ( OR=1.09, 95% CI: 1.00-1.19), Use of mycophenolic ( OR=1.18, 95% CI: 1.02-1.37) and Antibiotics( OR=7.26, 95% CI: 2.11-25.07) at presentation were at higher mortality risk, while diarrhea( OR=0.57, 95% CI: 0.34-0.96) and higher eGFR( OR=0.95, 95% CI: 0.92-0.98) decreased the risk.Overall in-hospital mortality in COVID-19 KTR was 19%, 95% CI: 15%-23%. Conclusions:Our systematic review and -analysis results suggest that overall in-hospital mortality in COVID-19 KTR declined progressively over time.KTR with these risk factors should receive more intensive monitoring and early therapeutic interventions to optimize health outcomes.
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In this study, a new ileal orthotopic bladder (Urumqi Bladder) modified by our center based on the ileal "W" type orthotopic bladder and Studer bladder was used on 8 patients with invasive bladder cancer. All of patients were male and aged between 54 and 66 years. The history of disease ranged from 1 month to 3 years, including 5 patients with initial onset, 3 patients with ≥2 TURBT history. 6 patients had multiple tumors, tumor size from 0.5 cm to 2.5cm. There were 2 patients with single tumor. Preoperative PET-CT examination showed no distant metastasis and pelvic lymph node enlargement, no urinary tract hydronephrosis, and cystoscopy showed no suspected tumor in the urethra. Preoperative pathological results: high-grade invasive urothelial carcinoma was found in 6 cases and muscular invasive urothelial carcinoma in 2 cases. In 8 patients, 50cm ileum was taken from 15cm away from ileocecum after radical cystectomy, which was crimped clockwise inward from the right end into a nearly circular shape, with 10cm left at the left end. The remaining 40cm ileum was formed into 3 sections of about 13cm each, which were decanted to form a storage capsule. The last 10cm intestinal tube was crossed from the front of sigmoid colon. The end of intestine was anastomosed with the left ureter. The right ureter was anastomosed with the top of the right intestine pouch, and the urethra was anastomosed with the pouch to complete the diversion of urine flow. During 3-12 months of postoperative follow-up, 4 patients had short-term mild urinary incontinence. All had complete urinary control at 12 months. 1 patient still had mild left ureter reflux 12 months after surgery, and the other 7 patients had no ureter reflux. In this group of 8 patients, postoperative excretory cystography showed satisfactory effect of bladder voiding, residual, and bladder capacity. Follow-up review of chest CT, urinary CT and abdominal ultrasound showed no hydronephrosis, and no tumor recurrence or distant metastasis.
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Objective:To discuss the clinical features, treatment and prognosis of renal mesenchymal malignancy.Methods:Retrospective analysis was performed on the clinical data of 48 patients with renal mesenchymal malignancies admitted from January 2005 to June 2019.The patients' age ranged from 16-79 years, including 29 males and 19 females. There were 21 cases of Han nationality and 27 cases of ethnic minorities. The main complained of lumbago were 31 cases, bloating 8 cases, blood urine 2 cases, and 6 cases by physical examination. And one case was seen in orthopedics due to upper arm pain. The patient's completion of the examination indicated a tumor of kidney origin. CT examination mostly showed renal space-occupying lesions. After enhancement, the tumor was irregularly enhanced, with unclear edges, which was difficult to distinguish from renal carcinoma. The tumors were on the left in 30 cases and on the right in 18 cases. All patients perfected preoperative blood routine, biochemical, coagulation and other examinations. Prothrombin time was normal in 39 cases. Clinical staging was conducted according to the imaging results at the time of initial diagnosis. 7 were in clinical Stage T 1, 16 were in Stage T 2, 20 were in stage T 3, and 5 were in stage T 4.Distant metastases were found in 8 cases, including 4 lung metastases, 2 retroperitoneal metastases, and 2 bone metastases. 13 patients underwent needle biopsy to confirm the diagnosis. Among the 48 cases in this group, 29 cases were diagnosed as renal tumor, 12 cases were diagnosed as renal space occupying lesions, and 7 cases were diagnosed as retroperitoneal space occupying. 17 underwent radical nephrectomy, 22 underwent partial nephrectomy, and 9 did not receive surgical treatment after needle biopsy. Results:Among the 48 patients, Conventional pathology confirmed 17 cases as leiomyosarcoma, 17 cases as liposarcoma, and 14 cases as other types of mesenchymal malignancies. Follow-up ranged from 7 to 180 months, with an average follow-up of 38.8 months. Thirty patients died, and the average survival time was 39 months. The 5-year survival rates of leiomyosarcoma, liposarcoma and other types of tumors were 18.2%, 30.8% and 50.1%, and the difference was statistically significant ( P=0.047). The 5-year survival rates of patients with normal and abnormal prothrombin time were 36.8% and 11.0%, the difference was statistically significant ( P=0.018). The 5-year survival rates of radical surgery and partial nephrectomy were 44.6% and 29.8%, and the difference was statistically significant ( P<0.05). The 5-year survival rates of T 1, T 2, T 3 and T 4 patients were 40.0%, 31.6%, 35.4% and 0, and the differences were statistically significant ( P=0.020). Multivariate analysis showed that preoperative prothrombin time ( P=0.013), clinical T stage ( P=0.030) and surgical method ( P=0.006) were independent factors affecting the prognosis of patients with RMM. Conclusions:Renal mesenchymal malignant tumor is rare, and highly malignant. Preoperative needle biopsy did not affect the prognosis of RMM. Patients with normal prothrombin time, early clinical staging and radical surgery had better prognosis. Renal liposarcoma has a better prognosis than renal leiomyosarcoma.
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Objective To compare the efficacy of extended pelvic lymph node dissection (ePLND) and standard pelvic lymph node dissection (sPLND) in open radical cystectomy.Methods We retrospectively analyzed the clinical data of 139 patients with bladder cancer cases in our hospital from January 2007 to January 2017,who underwent open radical cystectomy and pelvic lymph node dissection performed by the same group of surgeons.There were 117 males and 22 females,aged from 20 to 84 years old,with an average of (64.6 ± 11.7) years,91 patients were underwent ePLND group and 48 patients were underwent sPLND group.The preoperative anemia-free patients was compared between the ePLND group and the sPLND group [24 (50.0％)] vs.58 (54.9％),respectively],the patients with anemia were [24 (50.0％) vs.41 (45.1％)].The range of ePLND is:sway to the common iliac artery and the lower aortic (unreaching the inferior mesenteric artery);the lateral boundary to the reproductive femoral nerve;the distal end of the iliac artery at the groin level,the posterior border to the iliac vessels and closure,which contains the anterior tibial lymph nodes between the two sides.The range of sPLND is below the level of the common iliac artery bifurcation,and the rest of the range is the same as ePLND.The average operative time,average intraoperative blood loss,intraoperative blood transfusion,intraoperative and postoperative complications,postoperative eating time,postoperative activity time,postoperative exhaust time,postoperative hospital stay,mean gastric tube indwelling time,average pelvic drainage tube indwelling time,lymph nodes positive rate,lymph node density,and cancer-free survival were evaluated.Results All 139 patients underwent surgery successfully.The average operative time in the ePLND group and the sPLND group were [(351.2 ±79.5)min vs.(342.5 ± 69.3) min],average intraoperative blood loss [(314.6 ± 120.6) ml vs.(298.3 ± 126.3)ml],intraoperative blood transfusion [(702.9 ± 645.7) ml vs.(936.9 ± 818.1) ml],no intraoperative complications,postoperative complications [29 cases (31.9 ％) vs.18 cases (37.5 ％)],postoperative eating time [(5.4 ± 1.9) d vs.(4.8 ± 2.1) d],postoperative activity time [(2.1 ± 0.9) d vs.(1.9 ± 0.8) d],postoperative exhaust time [(3.8 ± 0.9) d vs.(3.6 ± 1.0) d],postoperative hospital stay [(14.9 ± 7.8) d vs.(15.5 ± 6.9) d],average gastric tube indwelling time [(4.8 ± 2.6) d vs.(4.53 ± 1.9) d],average pelvic drainage tube indwelling time [(11.1 ± 4.9) d vs.(10.9 ± 4.9) d],the difference was not statistically significant (P ＞ 0.05).A total of 2 359 lymph nodes were dissected from the two groups.The number of lymph nodes dissected in each of the ePLND group and the sPLND group was [(20.3 ± 3.8) vs.(10.6 ± 3.1),P ＜ 0.01],and the average number of positive lymph nodes was [(0.6 ± 1.3) vs.(0.3 ±1.0),P =0.034],the ratio of lymph node positive patients was [33 (36.3％) vs.9 (18.8％),P =0.026],and the lymph node density was [7.9％ (146/1848) vs.4.1％ (21/511)],the difference was statistically significant (P ＜ 0.05).In regard to prognosis,the disease-free survival rate (DFS) of ePLND group was 94.5％,91.0％,84.4％,81.1％,75.3％ at 1,2,3,4 and 5 years follow-up respectively.The other group was 70.5％,63.5％,57.8％,51.4％,41.1％ respectively.DFS of ePLND group tended to be higher than that of sPLND group in lymph node positive subgroups.The difference between the two groups was statistically significant (P ＜ 0.001).Conclusions In open radical cystectomy,ePLND and sPLND have similar surgical safety,but expanded lymph node dissection can improve disease-free survival in patients and improve the prognosis by increasing the detection range of positive lymph nodes.
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Objective To analyze the clinicopathological features and prognostic factors of common subtypes of non-transparent renal cell carcinoma.Methods Retrospective analysis of 115 patients with pathologically confirmed non-transparent renal cell carcinoma from January 2003 to December 2017,including 67 males and 48 females,with a male to female ratio of 1.4∶ 1.The average age is (51.2 ± 13.4)years old.71 cases were asymptomatic renal cancer,44 cases had clinical symptoms,including 10 cases of gross hematuria,28 cases of low back pain,4 cases of hematuria with low back pain,and 2 cases of abdominal mass.There were 49 open surgery and 66 laparoscopic surgery.58 patients underwent radical nephrectomy and 57 underwent partial nephrectomy.Of the 115 patients,17 (14.9％) had abnormal hemoglobin (Hb),22 (19.1％) had abnormal platelet (PLT) count,18 (15.7％) had abnormal alkaline phosphatase,and abnormal lactate dehydrogenase 16 cases (13.9％).The Kaplan-Meier survival analysis method was used to calculate the survival rate of patients,and the Cox proportional regression risk model was used to analyze the prognostic factors.Results The postoperative pathological stage was 57 cases in T1a stage,38 cases in T1b stage,12 cases in T2a stage,8 cases in T2b stage,2 cases of regional lymph node positive,and 113 cases negative;no distant metastasis.Pathological types:42 cases of renal chromophobe cell carcinoma,37 cases of papillary renal cell carcinoma type Ⅰ,36 cases of type Ⅱ.The average follow-up time was 38.6 months,and the rate of loss of follow-up was 3.5％ (4/115).The 1,3,and 5 year overall survival rates of 115 patients with common subtypes of non-transparent renal cell carcinoma were 99.1％,95.8％,and 81.1％,respectively.Multivariate Cox regression analysis found that the pathological type (OR =4.625,P =0.014),four indicators ≥ 3 abnormalities (OR =30.853,P =0.024),lymph node metastasis (OR =35.663,P =0.006) were the group.An independent factor in the survival time of patients with common subtypes of non-transparent renal cell carcinoma.Conclusions Compared with papillary renal cell carcinoma type Ⅰ and renal chromophobe cell carcinoma,papillary renal cell carcinoma type Ⅱ has a higher degree of malignancy and a poor prognosis.The pathological types of the common subtypes of nontransparent renal cell carcinoma,four indicators (Hb,PLT count,alkaline phosphatase,and lactate dehydrogenase) ≥3 abnormalities and lymph node metastasis are independent prognostic factors for overall survival.
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BACKGROUND: Little is reported on human urine derived stem cells, and there is still no stable and efficient culture method until now. OBJECTIVE: To compare the effects of three kinds of culture media on the growth and proliferation of human urine derived stem cells, and to optimize the culture methods. METHODS: Human urine derived stem cells were isolated and purified using centrifugation method, and then cultured using adherent method in keratinocyte serum-free medium, progenitor cell culture medium, and urinary cell culture medium (equal-proportion mixture of keratinocyte serum-free medium and progenitor cell culture medium). Cell morphology was observed, and cell proliferation was detected by MTT method to draw a cell growth curve.RESULTS AND CONCLUSION: Human urine derived stem cells could be successfully cultured in these three kinds of culture media, which grew slowly in the keratinocyte serum-free medium, grew rapidly in the progenitor cell culture medium, and grew best in the urinary cell culture medium. To conclude, the urinary cell culture medium which can rapidly and efficiently culture target cells is the best choice for the growth of human urine derived stem cells.
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Objective To investigate the surgical technique and the curative effect of the intact ectocystectomy for renal hydatid cyst.Method Totally 7 cases of renal echinococcosis patients treated by the intact ectocystectomy of renal hydatid complete at Urology,the First Affiliated Hospital of Xinjiang Medical University from Mar 2007 to Dec 2015 were analyzed by retrospective analysis,the surgical procedure,postoperative pathologic results and efficacy were summarized.Results Visible in the operation of renal parenchyma and hydatid cysts,along a detachable gap between the gaps,renal hydatid capsule could be completely removed.The renal wound was smooth grossly,without much blood,hydatid ectocyst was removed completely,with smooth wall,pathology inspection for the attached results confirmed the capsule wall collagen fiber tissue,a small amount of renal parenchyma.Totally 7 cases of surgical success,with no liquid capsule rupture overflow,and they were followed up for 1-36 months,no recurrence and residual cavity formation and other complications occurred.Conclusion The results have indicated that the intact ectocystectomy is a radical therapy for renal echinococcosis and retain renal parenchyma.
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Objective To introduce a new trocar position in the posterior laparoscopic for the treatment of retrocaval ureter.Methods From August 2011 to October 2014,5 cases with retrocaval ureter treated with posterior laparoscopic were retrospectively analyzed,including 3 males and 2 females,aged from 15 to 46 years(mean 34 years).The history of disease ranged from 1 to 10 months,with 3 cases presented with low back pain,and 2 cases being detected uronephrosis by check-up.Results All the operations were successfully completed,with the operation duration ranged from 75-125 min (mean 90min),and blood loss ranged from 20ml to 50 ml(mean 35 ml).The average hospital stay was 6 days(5-7d).There was no wound infection or urine leakage.Ureteral double-J tubes were removed 4 weeks after surgery.Postoperative followup ranged from 2 weeks to 6 months (mean 30 months).There was no anastomotic stricture,and the hydronephrosis relieved.Conclusions Trocar position adjustment of posterior laparoscopic in treatment of retrocaval ureter is convenient to operate,which also shortened the time of operation,reduced the difficulty of operation and the surgeons' fatigue.
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Objective To detect the circulating miR-106a levels in serum before and after surgery in patients with renal clear cell carcinoma,and to explore its relationship with clinical-pathological parameters.Methods 30 serum samples from patients with renal clear cell carcinoma were collected before and after surgery during February 2013 to July 2014.This study included 30 normal controls.All serum miR-106a levels were detected using the real-time PCR.Results The serum miR-l06a levels in patients with renal clear cell carcinoma pre-operatively wcre significantly greater than normal controls (Z =-4.251,P =0.0001).The serum miR-106a levels in patients post-operatively had no significant differences compared to normal controls (Z =-0.244,P =0.807).The serum miR-106a levels in post-operative samples were significantly lower than the pre-operative samples (Z =-4.229,P =0.0001).Serum miR-106a levels and other clinical-pathological parameters had no correlation in patients with renal clear cell carcinoma(tumor size:Z =-0.775,P =0.439;Fuhrman grade:Z =-1.694,P =0.090).The receiver operating characteristic curve was used to distinguish pre-operative samples and normal controls,its AUC was 0.819 (95％ CI:0.710-0.929,P =0.0001) with 86.7％ sensitivity and 70.0％ specificity.Conclusions The serum miR-106a levels in patients with renal clear cell carcinoma pre-operatively were significantly greater than post-operatively with no correlation in tumor size and Fuhrman grade.The outcome suggested that serum miR-106a can be regarded as a potential molecular marker in renal clear cell carcinoma.
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BACKGROUND:Hair folicle stem cels have been confirmed to have stronger proliferative ability than interfolicular epidermal stem cels, which have been an issue of concern in seed cel research. OBJECTIVE:To compare the biological characteristics of rat hair folicle stem cels cultured by tissue explant method and enzymatic digestion method. METHODS: Under stereomicroscope, hair folicles were isolated from the rat whiskers, and then tissue explant method and two-step enzymatic digestion method were employed to culture hair folicle stem cels. Cels were purified using repeated differential adhesion method, and cel growth and morphology were observed periodicaly. Flow cytometry was used to detect the expression of CD34 and β1 integrin in passage 3 hair folicle stem cels. RESULTS AND CONCLUSION:Cels cultured by two-step enzymatic digestion method grew faster with more amount than those cultured by tissue explants method. Flow cytometry showed that the expressions of PE-CD34 and FITC-β1 were (39.52±19.57)% and (93.46±4.73)% for the two-step enzymatic digestion group, and (19.20±11.53)% and (363.57±14.42)% for the tissue explant method, respectively. There was a significant difference between the two methods. In conclusion, these two methods are able to culture high-activity hair folicle stem cels, which can be chosen according to different experimental requirements.
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<p><b>OBJECTIVE</b>To investigate the indications and clinical effect of using oral mucosa as the graft in hypospadias repair.</p><p><b>METHODS</b>We performed hypospadias repair using oral mucosa for 19 patients, 10 with the urethral opening at the root of the penis, 7 at the scrotum and 2 at the perineum. Of these patients, 8 had received urethroplasty once, and 6 twice, unsuccessfully, and 7 of them were complicated by penile chordee. The lower lip mucosa was used as the graft for 14 cases, and the buccal mucosa for the other 5. Fifteen cases received autologous oral mucosa onlay for repair, with the new urethra covered by the dartos coat of the dorsal skin. For the other 4 cases, whose urethral plates had been damaged in the previous operations, oral mucosa strips were used to substitute the urethral plates to get the penis straightened, followed by urethroplasty 6 months later.</p><p><b>RESULTS</b>Of the 19 patients, 17 (89.5%) achieved satisfactory results, with a desirable shape of the penis and a vertical slit-like meatus at the tip of the glans. Chordee was corrected in all the patients. No urethral stricture was found during the 3 - 18 months follow-up. Urethral fistula occurred in 2 cases because of infection, but cured by surgical repair 6 months later.</p><p><b>CONCLUSION</b>Using oral mucosa as the graft is an effective surgical option for hypospadias repair.</p>