ABSTRACT
OBJECTIVE@#To study the inhibitory effect of matrine on bladder cancer cell growth and invasion in vitro through PI3K/AKT signaling pathway.@*METHODS@#Human T24 bladder cancer cell lines were cultured and treated with different doses of matrine (0.25 mg/mL, 0.5 mg/mL and 1.0 mg/mL) as well as 20 μmol/L PI3K inhibitor LY294002 for 24 h, and the cell proliferation activity, the number of invasive cells as well as the expression of p-PI3K, p-AKT, proliferation genes and invasion genes were determined.@*RESULTS@#Different doses of matrine could decrease the cell viability value, the number of invasive cells as well as the expression of p-PI3K, p-AKT, MMP2 and MMP9, and increase the expression of p16, p21 and p27 in dose-dependent manner; p16, p21 and p27 expression in cells of 20 μmol/L LY29002 group were significantly higher than those of 0 μmol/L LY29002 group while MMP2 and MMP9 expression were significantly lower than those of 0 μmol/L LY29002 group (P < 0.05).@*CONCLUSIONS@#Matrine can inhibit bladder cancer cell proliferation and invasion in vitro and regulate the expression of cell cycle-inhibiting molecules and invasion-related genes through PI3K/AKT signaling pathway.
ABSTRACT
Objective@#To investigate the effects of down-regulation of PTTG1 expression on the proliferation, invasiveness and apoptosis of androgen-independent human prostate cancer LNCaP-AI cells and their sensitivity to androgen antagonists.@*METHODS@#Human prostate cancer LNCaP-AI cells were transfected with siRNA targeting the PTTG1 gene using the Lipofectamine 2000 transfection reagent. The proliferation, invasiveness and apoptosis of the cells were detected by MTT, Transwell assay and flow cytometry, respectively. The protein expressions of PTTG1, p-Akt, and p-ERK were determined by Western blot and the mRNA expression of PTTG1 measured by agarose gel electrophoresis.@*RESULTS@#The siRNA expression vector markedly down-regulated the expression of PTTG1, which effectively suppressed the proliferation of the LNCaP-AI cells, with the inhibition rates of (19.47 ± 2.12), (24.01 ± 2.13) and (48.02 ± 2.22)% at 24, 48 and 72 hours, respectively, after transfection, with statistically significant differences among the three groups (P <0.05). The number of the cells passing through the polycarbonate film was remarkably decreased at 24, 48 and 72 hours (74.67 ± 9.85, 56.44 ± 8.66 and 37.33 ± 6.14) as compared with the baseline (111.11 ± 13.47) (P <0.01), while the apoptosis rate of the cells was significantly increased at 24, 48 and 72 hours (18.32 ± 0.94), (19.94 ± 1.30) and (21.73 ± 1.88)% in comparison with the baseline ([2.17 ± 0.49]%), (P <0.05). PTTG1 siRNA combined with androgen antagonist flumatide exhibited even more significant effects in inhibiting the proliferation and promoting the apoptosis of the LNCaP-AI cells than either used alone, and in a flumatide dose-dependent manner. The inhibition and apoptosis rates of the LNCaP-AI cells treated with 50 nmol/L flumatide were (27.13 ± 3.52) and (3.94 ± 0.48)%, and those treated with siRNA + 50 nmol/L flumatide were (67.51 ± 5.13) and (19.93 ± 1.72)%, respectively, both with statistically significant differences between the two groups (P <0.05). The inhibition and apoptosis rates of the cells treated with 100 nmol/L flumatide were (43.72 ± 3.90) and (5.33 ± 0.66)%, and those treated with siRNA + 100 nmol/L flumatide were (73.19 ± 4.78) and (23.43 ± 1.76)%, respectively, both with statistically significant differences between the two groups (P <0.05).@*CONCLUSIONS@#The siRNA expression vector can down-regulate the expression of PTTG1, which can inhibit the proliferation and invasiveness of LNCaP-AI cells, promote their apoptosis, and increase their sensibility to androgen antagonists. Suppressing the expression of PTTG1 may enhance the effect of androgen-deprivation therapy on advanced prostate cancer.
Subject(s)
Humans , Male , Androgen Antagonists , Pharmacology , Apoptosis , Cell Line, Tumor , Cell Proliferation , Down-Regulation , Neoplasm Invasiveness , Prostatic Neoplasms , Drug Therapy , Metabolism , Pathology , RNA, Small Interfering , Metabolism , Securin , Genetics , Metabolism , Time Factors , TransfectionABSTRACT
Objective To study the inhibitory effect of matrine on bladder cancer cell growth and invasion in vitro through PI3K/AKT signaling pathway. Methods Human T24 bladder cancer cell lines were cultured and treated with different doses of matrine (0.25 mg/mL, 0.5 mg/mL and 1.0 mg/mL) as well as 20 μmol/L PI3K inhibitor LY294002 for 24 h, and the cell proliferation activity, the number of invasive cells as well as the expression of p-PI3K, p-AKT, proliferation genes and invasion genes were determined. Results Different doses of matrine could decrease the cell viability value, the number of invasive cells as well as the expression of p-PI3K, p-AKT, MMP2 and MMP9, and increase the expression of p16, p21 and p27 in dose-dependent manner; p16, p21 and p27 expression in cells of 20 μmol/L LY29002 group were significantly higher than those of 0 μmol/L LY29002 group while MMP2 and MMP9 expression were significantly lower than those of 0 μmol/L LY29002 group (P < 0.05). Conclusions Matrine can inhibit bladder cancer cell proliferation and invasion in vitro and regulate the expression of cell cycle-inhibiting molecules and invasion-related genes through PI3K/AKT signaling pathway.
ABSTRACT
The aim of this study was to compare cell proliferation and function of the T cells acquired under various culture conditions for establishing a simple, safe and efficient cell expansion protocol in vitro. The peripheral blood mononuclear cells (PBMNC) were isolated and stimulated with autologous dendritic cells (DC) and EBV-transformed B lymphoblastoid cell line (BLCL) weekly. The cell proliferation test, flow cytometry with PI and Annexin V double staining, Cr release test and ELISPOT test were used to detect the cell expansion level, frequency of IFN-γ producing T cells, killing activity of antigen-specific T cells, cell apoptotic status and cell differentiation potential, respectively. The results indicated that use of IL-2 combined with IL-7 and IL-15 resulted in the highest cell expansion comparing to the use of IL-2 alone and the use of CD3/28 Microbeads. Also the cells obtained under cultivating with IL-2, IL-7 and IL-15 together showed high frequency of IFN-γ producing cells, strong killing activity, high viability and high differentiation potential with large portion of CD3(+)CD8(+) population among the T cells. It is concluded that a protocol is established in which the use of IL-2 combined with IL-7 and IL-15 induces the biggest cell expansion, expanded cells show high viability, strong differentiation potential, high frequency of IFN-γ producing cells and strong killing activity.
Subject(s)
Humans , Cell Line, Transformed , Cell Proliferation , Cell Separation , Dendritic Cells , Cell Biology , Metabolism , Interleukin-15 , Pharmacology , Interleukin-2 , Pharmacology , Interleukin-7 , Pharmacology , T-Lymphocytes , Cell Biology , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To analyze the influence of benign prostatic hyperplasia (BPH) drugs on incidence and pathology grading of prostate cancer in China.</p><p><b>METHODS</b>Retrospectively investigated the history of drug treatment in 1029 cases of BPH in patients from February 1998 to December 2004. According to the history of drug use, the patients were divided into 4 groups: finasteride group, alpha-receptor inhibitor group, finasteride and alpha-receptor inhibitor combination group and control group (untreated group). We gathered pathology sections of patients in all groups, and gave Gleason Score to each. The difference of incidence and pathology grading of prostate cancer were analyzed by Stata 7.0.</p><p><b>RESULTS</b>The incidence of prostate cancer in the population of our study was 13.5%; The incidence in finasteride group, alpha-receptor inhibitor group, combination group and control group was 9.8%, 16.0%, 10.3% and 18.6%, respectively. There was significant difference between the two groups with the use of finasteride and the two groups without it (P < 0.05). In our study, the ratio of middle or high level pathology grading (Gleason ≥ 7) in prostate cancer patients was 58.3%, the ratio of middle or high level pathology grading prostate cancer patients in the four groups was 71.4%, 59.6%, 67.7% and 40.0%, respectively. In the comparison of composition ratio of middle or high level prostate cancer, there was significant difference between the two groups with the use of finasteride and the two groups without it (P < 0.05).</p><p><b>CONCLUSIONS</b>Finasteride can lower the risk of prostate cancer, but increase the pathology grade of the prostate cancer which has occurred in the same time. The alpha-receptor inhibitor does not have the same effect.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Adrenergic alpha-Antagonists , Therapeutic Uses , Finasteride , Therapeutic Uses , Incidence , Prostatic Hyperplasia , Drug Therapy , Prostatic Neoplasms , Epidemiology , Pathology , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To present the technique and experience of robotic-assisted laparoscopic radical cystectomy (RARC) by da Vinci surgical system.</p><p><b>METHODS</b>From December 2007 to September 2008, 4 patients underwent RARC and urinary diversion. The age of patients was 44 to 63 years old. The body mass index was 22.8 to 27.7. All their clinical stages were lower than T2N0M0. The technique for RARC involving ureters dissection, posterior dissection, lateral pedicle control, anterior dissection, dorsal vein complex control, neurovascular bundles sparing, lymphadenectomy, ureter-ileal anastomosis, urethra-neobladder anastomosis to either ileal conduit urinary diversion or neobladder reconstruction performed extracorporeally.</p><p><b>RESULTS</b>All the operations were accomplished successfully. The urinary diversion of 2 case was ileal conduit and others was ileal orthophoria neobladder. The operation time was 300 to 450 min. The time of radical cystectomy was 150 to 180 min. The estimated blood loss was 100 to 500 ml. The postoperative hospital stay was 9 to 35 d. The bed rest time was 4 to 9 d. There was 1 patients who had incomplete intestinal obstruction at 8th postoperative day cured by conservative therapy. The patients were followed up for 3 to 12 months, all patients survived without tumor recurrence. The patients have satisfied urinary continence and normal renal functions without hydronephrosis after the operation.</p><p><b>CONCLUSIONS</b>RARC is small incision and safe, the results are definite. It is one of the direction of minimally invasive urologic surgery.</p>
Subject(s)
Adult , Humans , Male , Middle Aged , Cystectomy , Methods , Follow-Up Studies , Laparoscopy , Methods , Retrospective Studies , Robotics , Urinary Diversion , MethodsABSTRACT
<p><b>OBJECTIVE</b>To study the expression of Livin, an apoptosis inhibitor gene, in prostate cancer, and to investigate its clinical and pathological implications.</p><p><b>METHODS</b>The expressions of Livin were detected in 62 cases of neoplastic prostate tissues and 10 cases of normal prostate tissues by RT-PCR and immunohistochemistry (SP method).</p><p><b>RESULTS</b>The Livin gene was highly expressed in neoplastic prostate tissues, but not in normal ones. Positive expression of Livin proteins was observed in 37 of the 62 (59.7%) tumor samples and accounted for 28.6%, 60.0% and 83.3% in the high, middle and low differentiation prostatic carcinoma groups respectively, with significant difference between the high and low groups. Livin positivity was also significantly correlated with tumor stages, increasing with tumor progression.</p><p><b>CONCLUSION</b>Livin may play an essential role in prostate carcinogenesis and serve as a marker for the prognosis of prostate cancer.</p>
Subject(s)
Aged , Humans , Male , Middle Aged , Adaptor Proteins, Signal Transducing , Genetics , Disease Progression , Gene Expression Regulation, Neoplastic , Immunohistochemistry , Inhibitor of Apoptosis Proteins , Genetics , Neoplasm Proteins , Genetics , Neoplasm Staging , Prognosis , Prostatic Neoplasms , Genetics , Metabolism , Pathology , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
<p><b>OBJECTIVE</b>To investigate the role of the tumor suppressor gene BRCA1 in response to DNA damage and to confirm that the function of the BRCA1 protein is regulated by a variety of mechanisms including transcriptional control, phosphorylation and protein-protein interaction.</p><p><b>METHODS</b>With the human breast cell line MCF7 as the positive control, we determined the subcellular distribution of BRCA1 in the prostate cancer cell lines LNCaP, DU145 and PC3 by immunohistochemical staining and Western blotting analyses.</p><p><b>RESULTS</b>BRCA1 was present in the prostate cancer cell lines LNCaP, DU145 and PC3. Ionizing radiation induced BRCA1 nuclear export, increasing from 14% to 40% in the cytoplasma (P < 0.01) and decreasing from 46% to 21% in the nuclei (P < 0.01). This DNA damage-induced BRCA1 nuclear export occurred only in the p53 wild-type but not in the p53 mutant cell line. The apoptosis rate of LNCaP cells was as high as 40% after nuclear export, with an obvious increase of cleaved caspase-3, which was correlated with BRCA1 nuclear-cytoplasmic shuttling.</p><p><b>CONCLUSION</b>Cytoplasmic relocalization of the BRCA1 protein may be a mechanism whereby the BRCA1 function is regulated in response to DNA damage. Its induction of a higher rate of cell apoptosis indicates BRCA1 to be another good biomarker for the treatment of prostate cancer.</p>
Subject(s)
Humans , Male , BRCA1 Protein , Metabolism , Blotting, Western , Cell Line, Tumor , DNA Damage , Immunohistochemistry , Prostatic Neoplasms , Genetics , Metabolism , Pathology , Tumor Suppressor Protein p53 , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To improve the treatment of renal neoplasm with tumor thrombus in the inferior vena cava.</p><p><b>METHODS</b>From May 2005 to May 2006, 9 cases of renal neoplasm with tumor thrombus were treated with balloon catheters to block inferior vena cava under the level of liver vena during the operations. Among the patients, 6 were male and 3 were female. The patients were from 20 to 76 years old (average 53).</p><p><b>RESULTS</b>All cases were succeed by transabdominal incisions. The average length of tumor thrombus was 5.0 cm (3.0 - 6.7 cm). The blood pressure and heart rate were stable during operations. No intraoperative or postoperative complications occurred. The follow up ranged from 6 to 18 months. One patient died at 6 months after surgery. The others lived well.</p><p><b>CONCLUSION</b>The use of balloon catheter during surgical treatment of renal neoplasm with inferior vena cava thrombus is suitable for type II and III tumor thrombus.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Balloon Occlusion , Embolectomy , Methods , Embolism , General Surgery , Follow-Up Studies , Kidney Neoplasms , General Surgery , Liver , Pathology , General Surgery , Nephrectomy , Treatment Outcome , Vena Cava, InferiorABSTRACT
<p><b>OBJECTIVE</b>To investigate the usefulness of percentage of free prostate specific antigen (FPSA/TPSA) in serum/PSA density [(F/T)/PSAD] in the diagnosis of prostate cancer.</p><p><b>METHODS</b>Two hundred and four patients who had been carried out transrectal ultrasound guided prostate biopsy, were involved in this study. Among them, 90 patients were proved to be suffering from prostate cancer, and other 114 patients were identified as benign prostate hypertrophy. The effect of total serum PSA level, FPSA/TPSA, PSAD and (F/T)/PSAD in the diagnosis of prostate cancer were investigated, and at the same time, selecting patients who should be carried out a prostate biopsy.</p><p><b>RESULTS</b>The mean values of (F/T)/PSAD were significantly lower for patients with prostate cancer in different PSA levels (<4.0, 4.0-, 10.1-, >20.0 microg/L), when compared with benign prostate hypertrophy patients. This difference has arrived statistical significance (P < 0.05). (F/T)/PSAD could provide higher specificity for diagnosing prostate cancer than FPSA/TPSA or PSAD. Among all patients, at the same higher sensitivity (about 90%), the specificity of FPSA/TPSA, PSAD and (F/T)/PSAD was 31.6%, 45.6% and 64.0%, respectively. At the same time, it was suggested that clinicians use different cutoffs for (F/T)/PSAD in different PSA level. When PSA level of patients was no more than 4.0 microg/L, 2.5 as the commended cutoff for (F/T)/PSAD was preferred; if PSA level was between 4.0 microg/L and 20.0 microg/L, 0.8 was a more suitable cutoff; 0.5 also could be taken as an appropriate cutoff in case of PSA level being higher than 20.0 microg/L.</p><p><b>CONCLUSIONS</b>Keeping high sensitivity, using of (F/T)/PSAD can improve the diagnostic specificity of prostate cancer significantly.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Biopsy , Prostate , Pathology , Prostate-Specific Antigen , Blood , Prostatic Neoplasms , Blood , Diagnosis , Pathology , Retrospective Studies , Sensitivity and SpecificityABSTRACT
<p><b>OBJECTIVE</b>To evaluate the detection of prostate cancer in different prostate specific antigen (PSA) level and the predict value of PSA, digital rectal examination (DRE), transrectal ultrasound scan (TRUS) and PSA density (PSAD).</p><p><b>METHODS</b>The clinical data of 634 cases who had underwent transrectal ultrasound guided systematic sextant prostate biopsies between April 1996 to December 2002 due to being suspicious of prostate cancer were retrospectively analyzed. The detection of prostate cancer in different PSA groups, namely PSA < or = 4.0, 4.1-, 10.1-, > 20.0 microg/L, and the predict values of PSA, DRE, TRUS and PSAD were statistically analyzed using t test, chi2 test and logistic regression analysis.</p><p><b>RESULTS</b>The rates of prostate cancer detection in different PSA groups were 11.6%, 26.8%, 39.8% and 68.6%, respectively. The higher the PSA, the higher the rate of prostate cancer detection, the same was the positive predictive value of DRE and TRUS. The sensitivity and specificity of PSA > 4.0 microg/L were 93.0% and 33.0%, and the efficiency of DRE and TRUS were very low. Logistic regression analysis indicated that PSAD was the most risk factor of prostate cancer in the group of PSA 4.1-20.0 microg/L (OR = 687.09 +/- 646.96, P = 0.000).</p><p><b>CONCLUSIONS</b>The rates of prostate cancer detection in different PSA groups are different compared with other countries. The screening roles of DRE and TRUS are dependent on PSA level. Utilization of the screening protocol which to stratify cases into three PSA groups, namely PSA < or = 4.0, 4.1 - 20.0, > 20.0 microg/L, can elevate the positive rate of prostate biopsies without sacrificing cancers detected.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Biopsy, Needle , Methods , Digital Rectal Examination , Methods , Early Diagnosis , Endosonography , Logistic Models , Mass Screening , Predictive Value of Tests , Prostate , Diagnostic Imaging , Pathology , Prostate-Specific Antigen , Blood , Prostatic Neoplasms , Blood , Diagnosis , Pathology , Retrospective Studies , Ultrasonography , MethodsABSTRACT
<p><b>AIM</b>To explore the feasibility and safety of greenlight photoselective vaporization of the prostate (PVP) on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH) and to evaluate their clinical and voiding outcome.</p><p><b>METHODS</b>A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80 W potassium-titanyl-phosphate laser, which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope. Operative time, blood loss, indwelling catheterzation, international prostate symptom score (IPSS), quality of life score (QoL), uroflowmetry, postvoid residual urine volume and short-term complication rates were evaluated for all patients.</p><p><b>RESULTS</b>All patients got through the perioperative period safely. The chief advantages of PVP were: short operative time (25.6 +/- 7.6 min), little bleeding loss (56.8 +/- 14.3 mL) and short indwelling catheterization (1.6 +/- 0.8 d). The IPSS and QoL decreased from (29.6 +/- 5.4) and (5.4 +/- 0.6) to (9.5 +/- 2.6) and (1.3 +/- 0.6), respectively. The vast majority of patients were satisfied with voiding outcome. The mean maximal urinary flow rate increased to 17.8 mL/s and postvoid residual urine volume decreased to 55.6 mL. These results are significantly different from preoperative data (P < 0.05). No patient required blood transfusion or fluid absorption. There were few complications and very high patient satisfaction after operation.</p><p><b>CONCLUSION</b>PVP has a short operative time and high tolerance, and is safe, effective and minimally invasive for high-risk patients, therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Laser Therapy , Phosphates , Prospective Studies , Prostatic Hyperplasia , General Surgery , Titanium , Treatment Outcome , Urination Disorders , EpidemiologyABSTRACT
<p><b>BACKGROUND</b>The treatment of symptomatic benign prostatic hyperplasia (BPH) remains a challenge for most urologic surgeons. We studied a cumulative cohort of patients with symptomatic benign prostatic hyperplasia (BPH) who underwent photoselective vaporization of the prostate (PVP) and evaluated the efficacy and safety of this procedure.</p><p><b>METHODS</b>A total of 196 patients with lower urinary tract obstruction symptoms secondary to BPH were treated using laser vaporization of the prostate under sacral canal anesthesia at our institutions. The therapeutic results were assessed using following variables: the safety and efficacy of sacral anesthesia, blood loss, operative time, indwelling catheterization. Preoperative and perioperative parameters were evaluated in the international prostate symptom score (IPSS), quality of life score (QoL), maximal urinary flow rate (Qmax), post-void residual urine volume (PVR) and the change of sexual function. Patients were also assessed for 3-month follow up.</p><p><b>RESULTS</b>PVP was performed successfully for all patients. There were 195 patients under sacral anesthesia and 1 patient under epidural anesthesia. Mean operative time was (45.2 +/- 18.5) minutes. The mean IPSS decreased from (26.6 +/- 3.2) to (5.6 +/- 1.4) and the QoL score decreased from (5.7 +/- 0.4) to (1.6 +/- 0.5), respectively (P < 0.05), while mean Qmax increased from (6.7 +/- 2.5) ml/s preoperatively to (19.6 +/- 2.4) ml/s, PVR decreased from 158.4 to 25.8 ml, respectively (P < 0.05). Average catheterization time was (1.8 +/- 0.9) days. There was no significant blood loss or fluid absorption during the period of PVP. Complications consisted of transient dysuria in 3 patients (1.5%), delayed gross hematuria in 5 patients (2.5%), respectively. Significant improvement in clinical outcomes were noted as early as 3 months after PVP treatment.</p><p><b>CONCLUSIONS</b>PVP is considered as a high satisfaction rate by patient and a minimal postoperative complication. Hence, PVP is a novel, safe, effective and minimal invasive treatment for patients with symptomatic BPH.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Laser Therapy , Patient Satisfaction , Prostatectomy , Methods , Prostatic Hyperplasia , General Surgery , VolatilizationABSTRACT
<p><b>OBJECTIVE</b>To evaluate CT virtual endoscopy (CTVE) based on spiral CT in the staging diagnosis of bladder neoplasms and its clinical application.</p><p><b>METHODS</b>Forty patients with bladder neoplasms and 10 normal patients underwent volume scanning using spiral CT. All images with thin collimation and overlapping reconstruction were transferred to computer workstation to obtain the images of CTVE. The results of all CTVE findings were compared with those of conventional CT, cystoscopy, operation and pathological data.</p><p><b>RESULTS</b>CTVE showed the normal anatomical structure of bladder as actual cystoscopy. The size, configuration, location and extension of bladder neoplasms was detected by CTVE scans agreed with that of actual cystoscopy. CTVE revealed the structure of trigone of urinary bladder that were not available in actual cystoscopy, and they were confirmed operatively and compared with the pathological results according to the TNM classification of malignant neoplasms. The sensitivity of CTVE for bladder tumors and accuracy in preoperative neoplasms staging was 98% (39/40) and 85% (33/39), respectively. The sensitivity of mass detection of diameter > or = 0.5 cm was 100%. The results were studied in a blind way.</p><p><b>CONCLUSIONS</b>CTVE is a noninvasive, safe and reliable procedure in the staging diagnosis of bladder neoplasms. CTVE can well show bladder neck anatomy and serve as an important complementary method to conventional cystoscopy. The limitation of CTVE is that it can not observe change of mucosal appearances and perform biopsy.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Neoplasm Staging , Methods , Sensitivity and Specificity , Tomography, Spiral Computed , Methods , Urinary Bladder Neoplasms , Diagnostic Imaging , PathologyABSTRACT
Objective To elucidate the deleterious diabetogenic effect of tacrolimus on Chinese Han people.Methods According to patients' whole blood trough levels,the concentration of tacroli- mus was 5,15 and 25?g/L.Human islet cells cultured in vitro were exposed to various concentra- tions of tacrolimus for 72 h respectively,then stimulated by glucose at low (2.8 mmol/L) and high (16.7 mmol/L) levels.Glucose-stimulating insulin secretion during subsequent static incubation was measured using the ultrasensitive human insulin ELISA kit.The assessment of islet cell viability was studied with acridine orange (AO)-propidium iodide (PI).According to fasting plasma glucose,461 subjects were divided into normal glucosetolerance group (FPG<5.55 mmol/L),impaired fasting glu- cose group (5.55 mmol/L<FPG<6.88 mmol/L) and posttransplant diabetes mellitus group (FPG≥6.89 mmol/L).A retrospective review of 461 non-diabetic kidney recipients completing at least 12 months of follow-up was performed to determine risk factors,incidence,and characteristics of post- transplant diabetes mellitus (PTDM).Results In vitro,lower tacrolimus concentration had not dele- terious effect on insulin secretion and viability of islet;high tacrolimus impaired?-cell survival as well as insulin secretion.Of the 461 patients with no history of diabetes at transplantation over the study period of 12 months,123 received tacrolimus and 338 received cyclosporine A (CsA).For patients receiving tacrolimus the cumulative incidence of PTDM was 13.8%,compared with 7.7% for pa- tients receiving CsA,showing no significant difference between them.The reduced tacrolimus level within the therapeutic window resulted in an increase in better glucose metabolism.Older age,family history of diabetes,acute rejection episodes and pre-transplant impaired fasting glucose were identified as risk factors for PTDM.Conclusion The diabetogenic effect of TAC is dose-dependent,and in the majority is reversible.Low initial doses,more rapidly tapering and lower maintenance levels of tacroli- mus decrease the incidence of PTDM in patients receiving tacrolimus.
ABSTRACT
Objective:To investigate the therapeutic efficacy of double-J catheter in treatment of renal tuberculosis(TB)and in rescuing the structure and function of the kidney.Methods:Thirty-four patients with renal TB(22 combined with single side hydronephrosis)were divided into 2 groups randomly.Group A were treated with antituberculous therapy and group B with antituberculous therapy combined with pre-treatment with double-J catheter.All 34 patients were followed up for 3 months and were re-examined.Results:The results of B ultrasound,intravenous urogram(IVU),CT and isotope nephrogram were comparable between the 2 groups before treatment,and the results were significantly different between the two groups after 3 months'drug treatment(P