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Objective To investigate the clinical effect of five-step sequential method for hemorrhagic radiation cystitis.Methods From April 2015 to April 2018,512 cases of hemorrhagic radiation cystitis patients in 6 provincial tumor hospital were retrospectively analyzed.12 cases were male patients,and 497 cases were female.Patients'average age was (60.1 ± 8.2) years (53-71 years).Hematuria appeared in 2.9 years on average after radiotherapy(ranged 0.5 to 13 years).According to the severity of hematuria,480 patients were classified as mild and 32 patients as severe.The step 1 was drug conservative symptomatic treatment.Thrombin solution or sodium hyaluronate was used for bladder perfusion in step 2.The step 3 was transurethral electrocoagulation.The step 4 was interventional embolization.The step 5 was hyperbaric oxygen therapy.Mild patients were treated from the first step,and the severe patients were treated rom step 3,and combined with step 1.Overactive bladder symptom score (OABSS) was used to assess the improvement of patients'symptoms.Results No obvious complications occurred in step 1,2,3,5.Mild hip pain occurred at step 4.Recurrent hemorrhage rate were 6.7％ (2/30) in mild patients group and 10.5％ (2/19) in severe respectively in step 4.The total effective rate of step 1 in mild patients group was 65.2％ (313/480),step 1 + 2 was 84.2％ (404/480),step 1 + 2 + 3 was 95.6％ (459/480),step 1 + 2 + 3 + 4 was 98.3％ (472/480),and step 1 +2 +3 +4 +5 was 100％ (480/480).The effective rate of step 3 + 1 treatment was 59.4％ (19/32) in severe patients group,step 3 + 1 + 4 was 68.8％ (22/32),and step 3 + 1 +4 +5 was 100％ (32/32).The OABSS scores of mild and severe patients decreased after treatment (P＜0.01).Condusion Five-step sequential therapy could be an effective method for the treatment of hemorrhagic radiation cystitis.
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Objective To evaluate the clinical efficacy and safety of gemcitabine combined with cisplatin in the treatment of bladder cancer.MethodsFrom October 2012 to August 2015, 92 patients with bladder cancer were enrolled in our hospital.Patients were divided into observation group and control group by random number table method.On the basis of routine nutrition support and symptomatic treatment, cisplatin was administered by intravenous infusion of cisplatin 70mg/m2 in the first 3d in control group.On the 1d and 8d, gemcitabine 1000mg/m2 was intravenously infused in observation group and 21 days treatment was taken continuous for 2 courses.Curative effect, IL-17, IL-18, transforming growth factor-β (TGF-β), vascular endothelial growth factor (VEGF) and urinary TGF-β1 levels and adverse reactions of two groups were comparatively studied.ResultsThe total effective rate in the control group (63.05%) was significantly lower than that in the observation group (76.09%) (P<0.05).After treatment, the levels of serum IL-17, IL-18, TGF-β1 and VEGF in the two groups were significantly decreased and with significant difference between two groups (P<0.05).The levels of urinary TGF-β1 were significantly increased and with significant difference between two groups (P<0.05).The incidence of adverse reactions in the control and observation groups was 15.22% and 6.52%, respectively.There was no significant difference between the two groups.ConclusionGemcitabine combined with cisplatin has a significant clinical efficacy and safety in the treatment of bladder cancer.
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Objective To evaluate the efficacy of partial cystectomy in treatment of localized muscle invasive bladder cancer.Methods From 1999 to 2005,data from 71 patients with muscle invasive bladder cancer(MIBC) were reviewed.There were 47 patients underwent partial cystectomy (PC) and 24 underwent total cystectomy (TC).The overall survival and disease-free survival in patients with MIBC with PC or TC were compared.All patients had pathologic T2-T3.Matched Kaplan-Meier survival analyses compared the effect of PC vs.TC on overall survival and disease-free survival.Univariate (log rank) and multivariate (Cox' proportional hazard model) analyses were used to test the statistical significance of several potential prognostic factors for survival rate.Results In the entire cohort,the overall survival rate and disease-free survival rate estimated at 5 years were 57％ and 50％ for PC patients,53％ and 46％ for TC patients,respectively (P＞0.05).On univariate analysis,T stage (include vessel tumor embolus) and whether the tumor was pedunculated were the significant predictors of tumor recurrence.Age,gender,tumor quantity,tumor size and histology category were not associated with prognosis.Cox proportional hazard regression model confirmed that the independent prognosis factors of tumor was T stage (EXP(B)=1.64,P＜0.05).Conclusions PC might not undermine cancer control in appropriately selected patients with MIBC.
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ObjectiveTo investigate the etiology and management of male urethral stricture at 8 medical centers in China during the period from 2004 to 2009 years,and to investigate whether there were any changes in etiology and management of urethral stricture with time change.MethodsThe database on 3455 male patients with urethral stricture who underwent treatment at 8 medical centers in China between January 2004 and December 2009 were prospectively collected.The databases were analyzed for possible cause of stricture and treatment techniques for urethral stricture,and for the changes in etiology and management with time change.ResultsThere were 3455 operations for urethral stricture during the study period.The main causes of urethral strictures were traumas in 1833 patients (53.05％),among which pelvic fractures were in 1327 (38.41％) and perineal trauma in 506 (14.65％).The second cause was iatrogenic causes in 1181 patients (34.18％ ),among which transurethral operations or examinations were in 602 (17.42％),hypospadias surgery in 291 (8.42％) and urethral catheterization in 164 (4.75％ ).Less common causes were urethritis in 201 patients (5.82％),lichen sclerosus in 149 (4.31％),undefined in 91 (2.63％).The treatments of urethral strictures were endourological surgery including internal urethrotomy and dilation and open urethroplasty including end-to-end urethroplasty and the substitude urethroplasty etc.The ratios of using various techniques in total number of patients were obviously different by time.The most application technique for treatment of urethral stricture was endourological surgery ( 709 ) during 2004 -2006 and occupied 52.67％ in total number of patients.It was gradually decreased during 2007 -2009 (726) and only occupied 34.42％ (P ＜0.01 ).Open urethroplasty gradually increased during 2007 -2009 ( 1243,58.94％ ) compared with the first three years (563,41.83％ ) (P ＜ 0.01 ). Conclusions During the recent years there was an increase in the incidence of urethral stricture being trauma and iatrogenic causes.The main treatments of urethral strictures were endourological surgery and open urethroplasty.Endourological surgery was significantly decreased in total number of patients,while open urethroplasty were significantly increased during the late three years.
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Objective To confirm that rat bone marrow mesenchymal stem cells (MSC) transfected with nerve growth factor (NGF) gene in the bladder tissue of diabetic rats bladder tissues can survive and stably express NGF. Methods A diabetic rat model was constructed. The BrdU-labelled MSC transfected with NGF gene were transplanted into the diabetic rats bladder tissues. BrdUlabelled immunohistochemistry was used to observe the growth of MSC transfected with NGF gene in the diabetic rats bladder tissues. The expression of NGF mRNA and protein were checked by RT-PCR and ELISA. Results A diabetic rat model was successfully built by a single intraperitoneal injectionof STZ. The blood glucose was still high after 8 weeks. NGF gene modified MSC could be detected in the bladder of diabetic rats by BrdU-labelled immunohistochemistry. The concentration of NGF in the control group, disease group and treatment group were ( 114 ± 3), ( 70 ± 2), ( 110 ± 2) pg/ml by ELISA and mRNA quantity by RT-PCR were 0. 183±0. 004, 0. 032±0. 139, 0. 130±0. 165, respectively. Compared with the control group, the expression of NGF gene was decreased (P＜0. 05) in the incidence group. The expression of NGF gene was increased (P＜0. 05) in the treatment group compared with the disease group. Conclusions The NGF gene-modified MSC could survive in diabetic rats bladder tissues. The NGF gene in MSC could stably express in diabetic rats bladder tissues.
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Objective To investigate the effects of nordihydroguaiaretic acid(NDGA), a general lipoxygenase inhibitor, on the proliferation and apoptosis of human prostate cancer PC-3 ceils and ex-plore the mechanism. Methods The cultured PC-3 ceils were exposured to NDGA at the different concentrations of 0 (control group), 20, 40, 80 and 160 μmol/L, respectively. The effect of NDGA on growth inhibition and apoptosis inducement were measured with morphometry, MTT and TUNEL as-say. The activity of caspase-3 was determinated with flow cytometry. Results The survival rate of PC-3 cell decreased significantly after treated with 40, 80, 160 μmol/L NDGA. The apoptosis indices of PC-3 cell dealt with 0, 20, 40, 80 and 160 μmol/L NDGA for 48 h were (2.9±0.2)%, (3.2±0.3)%, (68.5±0.8)%, (86.2±0.3)% and (86.9±0.6)%, respectively. When PC-3 cells were treated with 0, 20, 40, 80, 160 μmol/L NDGA for 48 h, the positive rates of activated caspase-3 were (3.9±0.0)%, (4.15±0.1)%, (55.5±0.8)%, (75.1±0.3)%, and (76.3±0.7)%, respectively. Compared with the control group, the apoptosis indices and positive rates of activated caspase-3 in the groups of 40, 80, and 160 μmol/L NDGA increased significantly(P<0.05). Conclusions NDGA can inhibit the growth and induce apoptosis of PC-3 cells. The mechanism may be related with intra-cellular activation of caspase-3.
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Objective To compare the efficacy and side effects of intermittent androgen depriva-tion (IAD) versus continuous androgen deprivation (CAD) in prostate cancer. Methods Forty-four patients with prostate cancer were divided into 2 groups. Twenty-one cases (group IAD) received IAD therapy. Of them, TNM staging showed T2 in 7 cases, T3 in 9 cases, T4 in 5 cases. The patients were treated by maximum androgen blockage until the serum PSA decreased to less than 0.2 ng/ml and maintained for 2 months. The treatment was resumed when the serum PSA increased up to 10.0 ng/ml or the symptoms occurred progress. Twenty-three cases (group CAD) underwent CAD therapy. Of them, TNM staging showed T2 in 7 cases,T3 in 12 cases,T4 in 4 cases. The time to prostate cancer progression,quality of life and side effect rate were compared between the 2 groups. Results The median time to disease progression was (36±4) months in group IAD and (30±4) months in group CAD,respectively. There was no significant difference between the 2 groups (P=0.132). The mean cycle length was (15.9±2.3) months, among them time on treatment and time off treatment were(8.8±1.5) months and (7.3±0.8) months, respectively. The symptom scores related to treatment in the treatment period and intermission of IAD group were 55.9±16.8 and 47.9±19.7, respective-ly, there was significant difference between them(P=0.007). But the differences between the treat-ment period and intermission in bone pain,urinary and intestinal symptoms were not significant (P> 0.05). The urinary symptom scores after 5 months of continuing treatment in groug CAD was signifi-cantly higher than the basis reference value which was obtained in the sixth month of initial treatment(P=0. 023), but there was no significant changes in the scores of bone pain, intestinal symptoms and symptoms related to treatment(P>0.05). The incidences of hot flash and gynecomastia were 28.6% (6/21) and 19.0%(4/21) in group IAD, 60.9%(14/23) and 52.2%(12/23) in group CAD, respec-tively. There were significant differences between the 2 groups(P<0.05). Conclusions IAD thera-py can alleviate the side effects of androgen deprivation therapy and improve the life quality. The effica-cy of prolonging the time to androgen independence of IAD therapy is similar to CAD therapy.
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BACKGROUND:There is few mesenchymal stem cells(MSCs) in the bone marrow,about one BMSC in 1?104-1?105 monocytes.Following in vitro isolation,purification and amplification,it is satisfactory for in vivo requirement.OBJECTIVE:To observe biological characteristics and potentiality of multi-directional differentiation of BMSCs in vitro.DESIGN,TIME AND SETTING:The cytological in vitro study was performed at the Institute of Urinary Surgery,Union Hospital Affiliated to Fujian Medical University from October 2007 to December 2008.MATERIALS:A total of 30 clean male Sprague Dawley rats of inbreeding line were supplied by Silaike,Shanghai,China.METHODS:BMSCs from rats were isolated and cultured in vitro by using the whole bone marrow adherence method.When 80%-90% confluency,BMSCs were digested by trypsin.At the third passage,BMSCs were induced to differentiate into osteoblasts and adipocytes.MAIN OUTCOME MEASURES:Cell morphology was observed under the inverted phase contrast microscope.BMSCs surface markers were detected using flow cytometry.Osteogenic ability was examined by alizarin red staining.Adipogenic ability was measured by Oil red O staining.RESULTS:The primary cells and the passage cells were mostly fusiform in shape,to be similar to fibroblasts.Cell still kept a high potential of growth and amplification following over 10 subcultures.At the third passage,BMSCs were positive for CD44,CD90,CD106,but negative for CD34,CD45,CD11b.Following 21 days of osteogenic induction,cell alizarin red staining showed that alizarin red was positive in osteoblasts.Following 2 weeks of adipogenic induction,oil red O staining showed that red lipid droplet existed in adipocytes.CONCLUSION:Whole bone marrow adherence method can isolate,purify and amplify BMSCs in vitro.The obtained cells have general biological characteristics of MSCs,and also have potentiality of multi-directional differentiation.
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Objective To evaluate the clinical value of laparoscopy in adrenal surgery.Methods From December 2000 to May 2006,86 cases of adrenal space-occupying lesion received laparoscopic adrenalectomy via transperitoneal(n=1),retroperitoneal(n=81) and hand-assisted transperitoneal(n=4) approach,respectively.Results All the operations were successful without conversion to open surgery and severe complications.The mean operative time was 72 min(range,50-175 min).The mean blood loss was 54 ml(range,15-120 ml).The postoperative hospital stay was 6.3 d(range,5-8 d).Imaging examinations revealed no tumor recurrence and metastasis during the mean follow-up period of 26.5 months(range,2-65 months)in 86 patients.The symptoms of patients with functional tumor was alleviated or disappeared.Conclusions Laparoscopic adrenalectomy has advantages of minimal invasion,less blood loss,and quicker recovery,and it should be the fist choice for most adrenal space-occupying lesions.
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<p><b>OBJECTIVE</b>To evaluate prostate specific antigen (PSA) and transition zone index (TZI) as predictors of acute urinary retention (AUR) in men with benign prostate hyperplasia(BPH).</p><p><b>METHODS</b>The complete data of 602 cases of BPH were reviewed and analyzed.</p><p><b>RESULTS</b>Mean serum PSA and TZI were (6.60 +/- 3.4) microgram/L and (0.71 +/- 0.14) in AUR group, (3.51 +/- 2.3) microgram/L and (0.46 +/- 0.21) in non-AUR group, respectively. There were significant differences in serum PSA and TZI between the two groups(P < 0.05). The difference in incidence of AUR between serum PSA < 4.0 micrograms/L, 4.0-10.0 micrograms/L and PSA > 10.0 micrograms/L was significant (P < 0.05). There was significant positive correlation between serum PSA and TZI(r = 0.213, P < 0.01).</p><p><b>CONCLUSION</b>Serum PSA and TZI were powerful predictors of the risk of AUR in men with BPH.</p>