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Objective@#To analyze the computed tomography(CT) features and clinical outcomes of renal epithelioid angiomyolipoma(EAML).@*Methods@#From January 2004 to June 2015, 17 patients with EAML in the Second People′s Hospital of Lianyungang and Nanjing Drum Tower Hospital were included in the study.All patients underwent CT examination.The patients' general data, imaging characteristics and pathologic features were determined by chart review.@*Results@#Nine patients underwent radical nephrectomy, and 8 patients underwent partial nephrectomy.The mean maximal tumor diameter was 6.1 cm (ranged 1.2-12.5 cm). The fat component of one lesion was detected by CT.On unenhanced CT, the intratumoral attenuations were hyperattenuating in 9 patients, isoattenuating in 1 patient and hypoattenuating in 7 patients.The contrast enhancement degree was mild in 1 patient, moderate in 6 patients and marked in 10 patients.The contrast enhancement pattern was homogeneous in 8 lesions and heterogeneous in 9 lesions.All patients were positive for melanoma(12 cases were positive for HMB-45, 3 cases were positive for melan A, and 2 cases were positive for both). The mean follow-up period was 28.5 months (ranged 2-126 months), and 15 patients were alive with no evidence of disease at the time of the last follow-up, 1 patient exhibited local recurrence and lung metastases, and another 1 patient developed distant metastasis.@*Conclusion@#Renal EAML has a range of imaging appearances.Our data suggested that the majority of the tumors (size 10 cm) were solid and had a tendency to be hyperattenuating on unenhanced CT images.Hemorrhaging or necrosis was observed in tumors with sizes≥10cm with heterogeneous enhancement.In contrast to classic AML, which is benign, EAML is potentially malignant and exhibits aggressive clinical features, including local recurrence and distant metastasis.
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Objective To study the correlation between ABCC3 gene and bladder cancer cell proliferation,drug resistance and aerobic glycolysis.Methods Lipofectamine 2000 reagent was used for small interfering RNA (siRNA) transfection.Human ABCC3 siRNA and negative control siRNA were transfected into UMUC-3 and 5637 cells separately,and bladder cancer cells were divided into siABCC3-1 group,siABCC3-2 group and control group.Western blot assay was used to evaluate the ABCC3 expression levels.Quantitative real-time polymerase chain reaction (PCR) was performed to determine the ABCC3 mRNA expression levels.The effect of ABCC3 on bladder cancer cell growth was determined by colony formation assay.We also analyzed the sensitivity of cance cells to cisplatin by MTT assay.The effect of ABCC3 on aerobic glycolysis were detected by measuring LDHA protein levels,lactate production and glucose consumption.The measurement data were expressed as ((x) ± s) tandard deviation.The difference between the groups was analyzed by single factor analysis of variance and LSD.Results Both protein and mRNA levels of ABCC3 were significantly decreased after si-ABCC3 transfection.Bladder cancer cells treated with si-ABCC3 exhibited significantly lower colony numbers than that of the control group.5637 cells treated with siABCC3-1 and siABCC3-2 were 4.02 μg/ml and 3.91 μg/ml,respectively.The IC50 values of cisplatin after UMUC-3 cells siABCC3-1 and siABCC3-2 were 2.54 μg/ml and 2.49 μg/ml,respectively.The expression of lactate dehydrogenase A protein in bladder cancer cells was down-regulated and the expression of ABCC3 was positively correlated with the expression of LDHA (P =0.0362).siABCC3-1 and siABCC3-2 were transfected into 5637 cells,respectively.The glucose consumption decreased by 43.2％ and 43.7％ respectively.The lactic acid production was reduced by 31.3％ and 29.7％,respectively.After transfection of UMUC-3 cells with siABCC3-1 and siABCC3-2,glucose consumption decreased by 33.4％ and 37.5％,respectively,and lactic acid production decreased by 24.7％ and 25.2％,respectively,compared with the control group,the difference was statistically significant (P ＜ 0.001).Conclusions ABCC3 is an important oncoprotein involved in cell proliferation,glycolysis and drug resistance.It could be a promising predictive biomarker and potential therapeutic target for bladder cancer.
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Objective To compare the safety and efficacy of 1 470 nm diode laser vaporization of the prostate with transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH).Methods From July 2014 to July 2015,82 patients diagnosed as BPH were randomly divided into two groups.Forty cases of them underwent 1 470 nm diode laser vaporization and 42 cases for TURP.The operation time,hemoglobin decrease,serum sodium decrease,bladder irrigation time,duration of bladder catheterization and postoperative complications were recorded.The international prostate symptom score (IPSS),maximum flow rate (Qmax) and post-voiding residual volume (PVR) before and after operation were compared.Results No differences were found between the two groups in basic preoperative characteristics,such as:age,prostate volume,IPSS,PVR and Qmax(P＞0.05).The mean operative time in the diode laser group was (64.8±14.6) min,slightly longer than tin he TURP group ((59.3 ± 14.5) min,P＞0.05).The hemoglobin decrease,the serum sodium decrease,the time of bladder irrigating and the time of catheterization of 1470 nm diode laser group were all less than that in TURP group,the differences were significant between the two groups((2.06±1.43) g/L vs.(6.07±1.68) g/L,(1.16±0.67) mmol/L vs.(4.09±3.78) mmol/L,(5.08±2.80) h vs.(25.8±12.7) h,(3.38±1.17) d vs.(4.88± 1.42) d,respectively;t =-11.615,-4.845,-10.337,-5.232;P＜0.001).The complications in 1470nm diode laser group were less than that in TURP group,but the differences were not significant between the two groups(P＞0.05).All patients were followed up for 3-12 months,the IPSS,PVR and Qmax of 3 months after surgery in 1 470 nm diode laser group and TURP group were all improved significantly compared with that of preoperative in both groups,but no statistical differences could be found between the two groups(IPSS:F inner grouP=527.65,P＜0.001;F between groups=0.099,P=0.753;F across groups=0.040,P=0.843,PVR:F inner grouP =509.57,P＜ 0.001;F between groups =2.817,P =0.097;F across groups =1.02,P=0.315;Qmax:inner grouP=60.06,P＜0.001;F between groups =0.30,P=0.585;F across groups =0.394,P=0.532).Conclusion 1 470 nm diode laser vaporization of the prostate can significantly improve the patient's lower urinary tract obstruction symptoms,which show similar short-term effects with TURP.It also has advantages of less bleeding,shorter catheter indwelling time and rapid postoperative recovery compared with TURP,suggesting that it is a safe and effective operation for BPH treatment.
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Objective To assess the efficacy and safety of combining rociverine tablets with Suoquan cap-sules in the treatment of female patients with overactive bladder(OAB).Methods 152 female patients with OAB were randomly divided into three groups.Patients in rociverine group were administered rociverine tablets 10mg three times a day for 4 weeks.Patients in Suoquan capsule group were administered Suoquan capsules 1.8g three times a day for 4 weeks.Patients in combination group were administered rociverine tablets 10mg and Suoquan capsule 1.8g three times a day for 4 weeks.Each group of patients had to complete 3d voiding diary before and after treatment to record daily frequency of micturition,urgency,urgency incontinence,nocturia and avoiding volumes,OABSS score and drug side effects were also observed.All the data were analyzed to assess the efficacy and safety of treatment.Results There were significant differences in daily frequency of micturition,urgency,urgency incontinence,nocturia,avoiding volumes and OABSS score of patients in each group before and after treatment(all P 0.05).The incidence rates of adverse events of rociverine and combination group were 7.8% and 22.6%,respectively,there was significant difference between the two groups(χ2 =4.372,P =0.032). Conclusion Combining rociverine tablets with Suoquan capsules in the treatment of female patients with OAB was effective and safe.
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<p><b>OBJECTIVE</b>To study the safety and effectiveness of laparoscopic radiofrequency ablation for centrally located renal tumors.</p><p><b>METHODS</b>From January 2009 to April 2013, thirteen patients who diagnosed as centrally located renal tumors were treated with laparoscopic radiofrequency ablation in the Department of Urology of Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School. All of the cases were T1aN0M0 stage, 9 patients were male, 4 were female, the mean age was 56 years (range, 38-73 years). All tumors were unilateral, eight lesions were in the left kidney and five in the right kidney. Intraoperative real-time ultrasound and temperature probes were used to guide the range of radiofrequency ablation. Ice saline was injected through ureteral catheter for cooling the collecting system. The postoperative serum creatinine and glomerular filtration rate (GFR) data were collected,all patients were followed up with enhanced CT or MRI.The pre- and post-operative date were compared by paired t test.</p><p><b>RESULTS</b>All patients underwent laparoscopic radiofrequency ablation successfully. The mean operation time was (113±13) minutes and the mean blood loss was (99±23) ml. The mean pre- and post-operative serum creatinine was (71±11) µmol/L and (74±11) µmol/L, the mean pre- and post-operative GFR was (49±8) ml/min and (45±7) ml/min. There was no significant statistic difference between pre-operation and post-operation (t=-1.371 and 1.986, P>0.05). The mean follow-up was 37 months, range 12-63 months. No evidence of local recurrence or distant metastasis was found.</p><p><b>CONCLUSIONS</b>Laparoscopic radiofrequency ablation for T1aN0M0 centrally located renal tumors could be performed safely with good outcomes. Intraoperative real-time ultrasound and temperature probes are helpful to control the range of radiofrequency ablation. Physical cooling of renal collecting system could reduce the occurrence of postoperative hydronephrosis and leakage of urine.</p>