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【Objective】 To compare the outcomes of robot-assisted laparoscopic transperitoneal and retroperitoneal operation for huge (>6 cm) adrenal tumors. 【Methods】 The clinical data of 45 patients with huge adrenal tumors who underwent robotic surgery during Jan.2017 and Dec.2021 were retrospectively analyzed, including 28 cases via the transperitoneal approach and 17 cases via the retroperitoneal approach. 【Results】 No patients were converted to open operations. There were no significant differences in postoperative drainage time (2.24±0.44 vs. 2.36±0.49) d, operation time (130.88±5.96 vs. 136.61±8.39) min, blood loss (189.41±13.91 vs. 192.5±12.36) mL and postoperative hospital stay (7.06±0.56 vs. 7.46±0.69) d between the retroperitoneal and transperitoneal approaches. Retroperitoneal approach was better than transperitoneal approach in early postoperative feeding [(38.82±6.75 vs. 74.14±6.57) h, P<0.01] . 【Conclusion】 Robotic surgery is safe and effective in the treatment of large adrenal tumors. The choice of surgical approach should be based on patients’ condition, tumor volume and location.
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Objective To discuss the opportunity of transurethral resection of prostate (TURP) after transrectal prostate biopsy.Methods We analyzed 60 cases of benign prostatic hyperplasia(BPH) who underwent TURP after transrectal prostate biopsy from September 2013 to September 2015.All the patients were divided into either group A or group B in chronological order, with 30 cases in each group.There were no significant differences in age, prostate specific antigen (PSA), prostate volume, hemoglobin level, and international prostate symptom score (IPSS) between the two groups.The group A and group B were treated by TURP at 1 week and 4 weeks after transrectal prostate biopsy, respectively.The parameters including operation time, excised prostate weight, intraoperative total blood loss, bladder irrigation time, and IPSS at 3 months after operation were recorded.Results The operation time, intraoperative total blood loss, bladder irrigation time, and IPSS in the group B were significantly lower than those in the group A [(58.3±6.0) min vs.(62.0±3.3) min, t=2.952, P=0.005;(154.1±15.8) ml vs.(167.4±29.5) ml, t=2.181, P=0.035;(19.2±0.8) h vs.(20.6±2.3) h, t=3.034, P=0.004;(18.3±2.5) points vs.(20.3±2.0) points, t=3.419, P=0.001].The excised prostate weight in the group B was significantly higher than that in the group A [(37.1±4.0) g vs.(33.3±7.8) g, t=-2.341, P=0.024].Conclusions TURP performed at 4 weeks after transrectal prostate biopsy can significantly increase the excised prostate weight, reduce intraoperative total blood loss volume, shorten the operation time and postoperative bladder irrigation time, and improve urinary symptoms.In brief, we recommend that TURP be executed at 4 weeks after transrectal prostate biopsy.
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It has been widely verified by various sorting methods that cancer stem cells (CSCs) exist in different types of tumor cells or tissues. However, due to lack of specific stem cell surface markers, CSCs are very difficult to be separated from some cancer cells, which becomes the key barrier of functional studies of CSCs. The sorting method by side population cells (SP) lays a solid foundation for in-depth and comprehensive study of CSCs. To identify the existence of SP in prostate cancer cell lines, we applied flow cytometry sorting by SP to cultures of prostate cancer cell lines (TSU, LnCap, and PC-3), and the cancer stem-like characteristics of SP were verified through experiments in vitro and in vivo. The proportion of SP in TSU cells was calculated to be 1.60%±0.40% [Formula: see text], and that in PC-3 and LnCap cells was calculated to be 0.80%±0.05% and 0.60%±0.20%, respectively. The colony formation assay demonstrated that the colony formation rate of SP to non-SP sorted from TSU via flow cytometry was 0.495±0.038 to 0.177±0.029 in 500 cells, 0.505±0.026 to 0.169±0.024 in 250 cells, and 0.088±0.016 to 0.043±0.012 in 125 cells respectively. In the in vivo experiments, tumors were observed in all the mice on the 10th day after injecting 50 000 cells subcutaneously in SP group, whereas when 5×10(6) cells were injected in non-SP group, tumors were developed in only 4 out of 8 mice until the 3rd week before the end of the experiment. Our results revealed that prostate cancer cells contain a small subset of cells, called SP, possessing much greater capacity of colony formation and tumorigenic potential than non-SP. These suggest that SP in prostate cancer cells may play a key role in the self-renewal and proliferation, and have the characteristics of cancer stem-like cells. Dissecting these features will provide a new understanding of the function of prostate CSCs in tumorigenicity and transformation.
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Objective To discuss the early diagnosis and interventional therapy of acute renal infarction.Methods The diagnosis and therapy of 5 cases of acute renal infarction were retrospectively analyzed.There were 4 male and 1 female patients,aged 38-68 years.The symptoms were severe back pain or upper abdominal pain,with or without nausea and vomiting and the time to hospital was 1 to 16 h.Four cases had rheumatic heart disease and 4 cases had artrial fibrillation history.The lab assay results: WBC 8.9-15.8 × 109/L,urine RBC-to + + +,albumin + to + + +,serum creatinin 66-216 μmol/L,serum LDH 350-920 U/L.The doppler ultrasound and CT scan showed large infarction in 3 cases and focal infarction in 2 cases.Percutaneous arteriography,thrombolytic therapy and thrombosuction via catheter were applied promptly.Results The 5 cases were diagnosed and treated timely and effectively.The emboli were cleared.Four patients were followed up for 3-12 months.The creatinin recovered to 53-122 μmol/L,and the blood perfusion of the infarction lesion was satisfactory.Conclusions Early diagnosis and interventional therapy is important for achieving satisfactory recovery of the acute renal infarction.Three dimensional CT angiography could conduce to early diagnosis and follow-up.Thrombosuction via catheter plus thrombolytic therapy is efficient for greater embolus.
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ObjectiveTo evaluate the effect of increasing doses of tamsulosin in lower urinary tract symptom (LUTS) of benign prostatic hyperplasia (BPH).MethodsA prospective self-controlled clinical trail was performed.Two hundred and sixty-one patients who had LUTS of BPH were enrolled in this prospective 4 weeks study of tamsulosin.The patients were randomly divided into 2 groups:took tamsulosin 0.2 mg QN (n =126,group A) and 0.4 mg QN (n =135,group B) respectively.The IPSS score and maximum flow rate before and after treatment were compared between the 2 groups.ResultsThe IPSS score of group A decreased from 17.72 ± 2.50 to 10.21± 1.95,average decreased 7.59 ± 2.74 ； maximum flow rate was elevated from (8.78 ± 3.70) ml/s to ( 12.74 ± 2.99 ) ml/s,average increased (4.31 ± 3.01 )ml/s.The IPSS score of group B decreased from 19.24 ± 3.22 to 11.21 ± 3.02,average decreased 8.49 ±3.73； maximum flow rate was elevated from (7.74 ± 1.97) ml/s to ( 12.04 ± 2.46) ml/s,average increased (4.73 ± 2.97) ml/s.There was no significant difference of the changes of IPSS score between the 2 groups ( P ＞ 0.05 ),but there was a significant difference of the changes of maximum flow rate between the 2 groups ( P ＜ 0.05 ).The results was further analyzed by sub grouped ( by patient body weight,divided into ≤55.0 kg,55.1 -65.0 kg,65.1 -75.0 kg,＞75.0 kg group).There were significant differences of the changes of IPSS score and maximum flow rate between the 2 groups in 65.1 - 75.0 kg and ＞ 75.0 kg subgroups ( P ＜ 0.05 ).The incidence of side effects between the 2 groups was not significantly different (P ＞ 0.05).ConclusionsFor most patients,the use of high-dose tamsulosin in improving LUTS caused by BPH can not bring significant benefits.But if the patient's weight is more than 65.0 kg,increasing the dose of tamsulosin is suggested for consideration.
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It has been widely verified by various sorting methods that cancer stem cells (CSCs) exist in different types of tumor cells or tissues. However, due to lack of specific stem cell surface markers, CSCs are very difficult to be separated from some cancer cells, which becomes the key barrier of functional studies of CSCs. The sorting method by side population cells (SP) lays a solid foundation for in-depth and comprehensive study of CSCs. To identify the existence of SP in prostate cancer cell lines, we applied flow cytometry sorting by SP to cultures of prostate cancer cell lines (TSU, LnCap, and PC-3), and the cancer stem-like characteristics of SP were verified through experiments in vitro and in vivo. The proportion of SP in TSU cells was calculated to be 1.60%±0.40% [Formula: see text], and that in PC-3 and LnCap cells was calculated to be 0.80%±0.05% and 0.60%±0.20%, respectively. The colony formation assay demonstrated that the colony formation rate of SP to non-SP sorted from TSU via flow cytometry was 0.495±0.038 to 0.177±0.029 in 500 cells, 0.505±0.026 to 0.169±0.024 in 250 cells, and 0.088±0.016 to 0.043±0.012 in 125 cells respectively. In the in vivo experiments, tumors were observed in all the mice on the 10th day after injecting 50 000 cells subcutaneously in SP group, whereas when 5×10(6) cells were injected in non-SP group, tumors were developed in only 4 out of 8 mice until the 3rd week before the end of the experiment. Our results revealed that prostate cancer cells contain a small subset of cells, called SP, possessing much greater capacity of colony formation and tumorigenic potential than non-SP. These suggest that SP in prostate cancer cells may play a key role in the self-renewal and proliferation, and have the characteristics of cancer stem-like cells. Dissecting these features will provide a new understanding of the function of prostate CSCs in tumorigenicity and transformation.
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Humanos , Masculino , Linhagem Celular Tumoral , Células-Tronco Neoplásicas , Patologia , Neoplasias da Próstata , Patologia , Células da Side Population , PatologiaRESUMO
Objective To evaluate the clinical characteristics, surgical treatment effect and prognostic factors of post-operative hypertension in the 2 subtypes of primary aldosteronism (PHA),aldosterone adenoma (APA) and unilateral adrenal hyperplasia (UNAH). Methods In the collection of surgical treatment of PHA from 2002-2009, 135 cases, 68 males and 67 females, with age of 26-79 years (mean, 51 years) were analyzed. Of them, there were 83 APA patients, 52 UNAH cases. All the cases with PHA were with hypertension symptoms and met the preoperative diagnosis criteria. All the patients were performed preoperatively blood biochemical and hormonal tests and CT scans. The diagnosis was confirmed by pathology. All cases undergone adrenal reserved surgery (ASS) and followed-up. According to the postoperative recovery of blood pressure was normal or still in hypertension, Logistic regression analysis and comparison between the 2 groups were carried out,the clinical data of various factors in predicting the role of postoperative blood pressure were considered. Results One hundred and thirty-five patients were operated successfully. The mean follow up was 2. 5± 1.6 years (1-7 years). There were significant decreases in both systolic blood pressure and diastolic blood pressure at final follow up compared with those before surgery. Antihypertensive requirement was decreased at final follow-up. Serum aldosterone levels, plasma renin activity and potassium levels were improved significantly. Overall, blood pressure returned to normal in 51 cases(37.8%). Other 84 cases (62.2%) continued with high blood pressure, of whom 58 cases reduced antihypertensive drug use. Patient's age over 49.5 years, hypertension duration over 6. 5 years, family history of hypertension were higher risks of postoperative continuous high blood pressure. Conclusions APA and UNAH are 2 types of PHA with similar performance of patients, surgical treatment effect. ASS can be used in the treatment of these 2 types of disease. Age, hypertension duration, family history of hypertension are independent factors predicting sustained hypertension after surgery.
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To study the expression of beta-human chorionic gonadotropin (beta hCG) genes in renal cell carcinomas (RCC) and benign renal disease tissues, nested reverse transcription-polymerase chain reaction (RT-PCR) and restriction endonuclease analysis were employed to detect the expression of beta hCG genes in 44 cases of RCC tissues and 24 cases of benign renal disease tissues. It was found that 52% RCC samples revealed positive for beta hCG mRNA expression. Positive rate in advanced stage and poorly differentiated RCC was higher, but there was no significant difference. The positive rate of beta hCG mRNA expression was 54% in 24 cases of benign renal tissues, including 3 cases out of 6 polycystic kidneys, 7 cases out of 13 renal atrophies, 2 cases out of 2 oncocytomas and 1 case out of 2 pyonephrotic kidneys. beta 7 was most frequently transcribed subtype gene independent on the histology. These findings suggested beta hCG gene transcription is not only involved in RCC but also in benign renal diseases.
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Adulto , Humanos , Biomarcadores Tumorais , Carcinoma de Células Renais , Genética , Metabolismo , Gonadotropina Coriônica Humana Subunidade beta , Genética , Rim , Metabolismo , Nefropatias , Genética , Metabolismo , Neoplasias Renais , Genética , Metabolismo , Doenças Renais Policísticas , Metabolismo , RNA Mensageiro , Genética , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
Objective To investigate the surgical managements and effects of congenital islated penile curvature. Methods The degloving of penile shaft,penile dorsal tunical plication,urethral division and urethroplasty were performed in 23 patients with this entity including 2 cases of type Ⅰ,11 cases of type Ⅱ,6 cases of type Ⅲ,4 cases of type Ⅳ,mean age 7 years (age 1 to 21 years). Results Of all 23 patients 17 cases of type Ⅱ and Ⅲ were succesfully repaired by degloving of penile shaft;1 case of type Ⅰ,by degloving of penile shaft and dorsal tunical plication;1 case of type Ⅰ and 2 cases of type Ⅳ,by degloving of penile shaft,dorsal tunical plication and urethral division;2 case of type Ⅰ and Ⅳ,by urethroplasty.One case was complicated with urethrocutaneous fistula after urethroplasty,which was succesfully repaired 8 month later;16 cases were followed up average 24 months (range 7 months to 57 months),15 cases showed complete straight penis beside one case with mild curvature less than 15 degree. Conclusions The abnormalities of skin,dartos and Buck's fasciae are main causes of congenital islated penile curvature.Penile degloving,dorsal plication are main surgical methods with minimal complications.
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Objective To investigate the relationship between ?hCG genes expression and the clinicobiological behavior of bladder cancer. Methods RT-PCR method combined with restriction endonuclease analysis was adopted to detect the expressions of ?hCG mRNA and its subtypes in 37 cases of bladder cancer tissues. Results 26 of 37 cancer tissues (70%) were positive for ?hCG mRNA expression. The positive rate was higher in invasive tumor (T 2～T 4,13/14) compared with that in superficial tumor (Ta～T 1,13/23) ( P 0.05). Most of superficial tumors only expressed ?7 gene, while invasive tumor expressed ?7,?5, ?3, or ?8 . Conclusions The positive rate of ?hCG mRNA expression is related to tumor stage. The expression of hCG gene ?5, ?3 or ?8 in addition to ?7 indicates a worse differentiated or advanced bladder tumor.
