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Objective To explore the clinical value of urethral dilation in treatment of female bladder outlet obstruction. Methods Thirty-five female bladder outlet obstruction patients were selected, and all the patients failed for more than 1 month inαreceptor blocker treatment. The patients underwent urethral dilation under local anaesthesia, once a week, for a total of 12 times. The international prostate symptom score (IPSS), quality of life score (QOL) and residual urine volume before and after treatment were examined. Results The IPSS, QOL and residual urine volume after treatment were significantly lower than those before treatment: (10.23 ± 6.31) scores vs. (21.41 ± 3.71) scores, (2.31 ± 0.65) scores vs. (5.43 ± 0.60) scores and (20.73 ± 10.59) ml vs. (85.23 ± 12.15) ml, and there were statistical differences (P<0.01). Conclusions The urethral dilation is one of the effective treatments for female bladder outlet obstruction patients who fail in αreceptor blocker treatment. It can make a part of patients avoid invasive examination and surgery, and it is worth to be popularized in clinic and primary hospital.
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The occurence and progress of hepatocellular carcinoma(HCC)is a complex network inter-action process connected by multiple signaling pathways involving genes,cells and various active molecules. The effects and functions of biological molecular markers also vary among different pathways. Moreover,wheth-er the molecular markers have prediction effects for the prognosis of HCC remains unclear,and studies investing this issue are still insufficient. The current studies reveal that molecular markers involves in multiple pathways including gene expression,gene regulation,cell cycle regulation,cancer stem cell proliferation and differentia-tion. These processes are intimately associated with the occurrence and prognosis of HCC. The relevant gene or molecular that may indicate the prognosis of HCC includes p53 gene,long non-coding RNA,cell cycle regula-tors,liver cancer stem cell surface-associated molecules,etc.
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Symptomatic venous thromboembolism (VTE) has a six-to seven-fold risk of occurring in cancer patients compared with non-cancer patients. VTE is the second most common cause of death among patients with cancer, and cancer-associated VTE is be-coming increasingly prevalent. Therefore, early diagnosis and treatment of cancer-associated VTE is particularly important. This study presents a pancreatic cancer-associated deep vein thrombosis (DVT) patient who engaged in a multidisciplinary comprehensive discus-sion in the Interventional Therapy Department, Tianjin Medical University Cancer Hospital to enhance concern, interdisciplinary com-munication, and cooperation in terms of cancer-associated VTE diagnosis and treatment strategies.
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Base on the Kawakita powder compression equation, a general theoretical model for predicting the compression characteristics of multi-components pharmaceutical powders with different mass ratios was developed. The uniaxial flat-face compression tests of powder lactose, starch and microcrystalline cellulose were carried out, separately. Therefore, the Kawakita equation parameters of the powder materials were obtained. The uniaxial flat-face compression tests of the powder mixtures of lactose, starch, microcrystalline cellulose and sodium stearyl fumarate with five mass ratios were conducted, through which, the correlation between mixture density and loading pressure and the Kawakita equation curves were obtained. Finally, the theoretical prediction values were compared with experimental results. The analysis showed that the errors in predicting mixture densities were less than 5.0% and the errors of Kawakita vertical coordinate were within 4.6%, which indicated that the theoretical model could be used to predict the direct compaction characteristics of multi-component pharmaceutical powders.
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Objective To investigate the clinical significance of (CAG)n repeats length of androgen receptor (AR) among the patients with metastatic prostate cancer (TxNxM1),and to analyze their relevance to survival.Methods This study retrospectively investigated fifty-three metastatic prostate cancer patients aged 65 years (range 45-87) who were initially treated with endocrine therapy.The length of the (CAG) n repeats of blood samples was determined by both PCR sequencing and fragment analysis.The clinical significance of (CAG)n repeats and its correlation with biochemical progression free survival (bPFS)and overall survival (OS) were investigated.Results The median length of CAG repeats was 21,ranged from 14 to 32.According to the median (CAG)n repeats length,two groups were divided as (CAG)n ≤ 21and(CAG) n≥ 22.The median follow-up was 36 months.Patients with (CAG)n ≤ 21 had significantly shorter OS and bPFS than those with (CAG)n ≥ 22 (P ＜0.05).Shorter CAG repeats remained significant bPFS (HR 2.820,95％CI 1.466-5.427,P=0.002) and OS (HR 5.245,95％CI 1.293-21.27,P=0.020) predictor in multivariate analysis.Conclusions The efficacy of endocrine therapy for metastatic prostate cancer patients maybe influenced by the AR-CAG repeats length,and short (CAG) n repeats predict bad prognosis.
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Objective To evaluate the therapeutic efficacy of ureteroscopic pneumatic lithotripsy for treatment of complicated ureteral calculi. Methods Clinical data of 56 cases with complicated ureteral calculi who were treated with ureteroscopic pneumatic lithotripsy was reviewed. Among them 15 cases were proximal ureteral calculi,41 cases were middle and distal ureteral calculi. Treatment by extracorporeal shockwave lithotripsy (ESWL) failed in 25 cases,8 cases complicated with fever. Results In 41 cases with middle and distal ureteral calculi, successful lithotripsy was achieved after the first treatment session,the success rate was 100.0% (41/41). In 15 cases with proximal ureteral calculi ,successful lithotripsy was achieved in 10 cases after the first treatment session,the success rate was 66.7%(l0/15). Calculi migrated to kidney in 3 cases who treated by ESWL for 1-2 times. The failure was due to ureteral kink in 1 case and due to ureteral perforation that required surgical repair in another case. Forty-nine cases were calculi-free after 4 weeks,the calculi-free rate was 87.5%(49/56). Emergency operation was performed in 8 cases complicated with fever. Successful lithotripsy was achieved after the first treatment session in 7 cases. In one patient,calculi migration occurred. Within all 8 cases obstruction was released and fever was allayed after operation.The complication rate was 1.8% (1/56). Conclusion Ureteroscopic pneumatic lithotripsy for treatment of complicated ureteral calculi is a safe and effective method.
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Objective To summarize the clinical experiences of mini-incision urological surgery.Methods The clinical data of 43 patients who received mini-incision surgery were reviewed retrospectively.The subjects included 5 adrenal tumor excisions,9 nephrectomy,13 unroofing of solitary renal cyst,4 pyeloplasty.12 pyelolithotomy and ureterolithotomy.Results All surgical procedures were successful in the 43 cases.The length of the incision ranged from 3 to 8 cm.The average operation time was 80 minutes and average blood loss was 100 ml. No patients needed blood transfusion during the operation.No serious complications such as the surrounding organ damage happened.The postoperative hospitalization was 5-7 d. Conclusion Mini-incision approach for urological operation has the advantages of minimal invasion,safety,rapid recovery and no requirement for special equipments.Its easy to be popularized in the primary hospital.
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Non-surgical method plays a very important role in the treatment of hepatocellular carcinoma(HCC). The related evidence-based medical research findings such as the therapeutic effect differences in different technical methods, materials of ablation therapy and interventional therapy, and in the survival benefits of differential anti-tumor drugs etc, have attracted more and more attention.
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Objeetive To investigate the effect of alteration of blood flow in the hepatic artery on the therapeutic effect of cryoablation in VX2 hepatic tumor rabbit model.Methods Thirty rabbits with VX2 hepatic tumor were divided into three groups according to hepatic artery blood flow:complete occlusion of the hepatic artery(group A),paaial occlusion of the hepatic artery(group B),and no occlusion of the hepatic artery(group C).With conventional CT scau and perfusion scan,the values of blood flow(BF)and blood volume(BV)of VX2 tumor were computed and the differences among the three groups were analyzed.After cryoablation,the animals were euthanized and the livers were removed.The hepatic tissue from the cryoablation area and surrounding area underwent both methyl thiazolyl tetrazolium(MTT)diaphorase staining and triphenyl tetrazolium chloride(TTC)staining.The gross pathology and histopathological 3.14)ml/100 g in group C,respectively.There were significant differences among the three groups in the BF and BV(F value was 452.16 and 421.33 in the BF and BV,respectively,P＜0.01);(2)The maximum diameter of cryoablation-induced necrosis was(2.3±0.3)cm in group A,(1.5±0.2)cm in group B,and(0.8±0.1)cm in group C,respectively.The difference was significant among the groups (F value was 315.32,P＜0.01).(3)There were well-defined frozen areas.bordering areas and normal surrounding areas in MTT staining.In group C,positive staining around some blood vessels could be seen.Conclusion Alteration of the blood flow in the hepetatic artery can affect the cryoablation efficacy.With the decrease of hepatic artery blood flow,the efficacy of cryoablation on liver tumor increased.
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Objective To evaluate the effectiveness and safety of rectal ultrasound-guided agon- hilium percutaneous cryoablation in treatment of patients with median and or late-stage prostate cancer patients. Methods Retrospectively analysis of 42 cases of with stage C and D prostate cancer patients treated by rectal ultrasound-guided argon&ilium percutaneous cryoablation during the follow-up of 1--12 months. The prostate specific antigen (PSA), biochemical progression-free survival (bPFS), PSA objective response, transrectal ultrasound of the prostate (TRUS), TRUS-guided biopsy of the prostate, the maximum urinary flow rate(MFR), MRI examination at before, and 3,6,12 months after cryoablatian were recorded and evaluated. The results were statistically evaluated by using variance analysis. Results The PSA value at before and 3, 6, 12 months after cryoablation were (4.48±1.35), (3.54±1.67), (3.18±1.76), (2.87±1.89) ug/L, respectively; TRUS-messured prostate volumes at before and 3, 6,12 months after cryoablation were (59.7± 8.2),(46.9±8.3),(26.2±3.9),(25.9±3.7)mm3, respectively; MFR before and 3, 6,12 months after cryoablation were (10.4±0.8), (14.3±1.2), (18.3±1.3), (18.9±1.3) ml/s, respectively; Compared with before cryoablation, the differences between before and after cryoablation was statistically significant( F = 53.93,747.92,3843.03,respectively, P<0.01). The bPFS rates in 3 months,6 months and 12 months were 95.2% (40/42), 95. 2% (40/42), and 90.5% (38/42), respectively. According to the PSA response, the total effective rate (CR 16 cases, PR 15 cases) at 12 months was 73. 8%, and SD was 16.7% (7/42), PD was 9.5% (4/42). Complications included temporary incontinence 2.4% (1/42), Penile tingling/numbness 2.4% (1/42), pelvic pain 4.9% (2/41) and Scrotum Edema 2.4% (1/42). There was no case with severe complications such as severe infection or urethrorectal fistula, etc. Condusions Rectal ultrasound-guided agon-hilium percutaneous cryoablation showed is a well tolerated and has better early clinical efficacy to the treatment of stage C and D prostate cancer.