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Objective To investigate the expression of proline rich tyrosine kinase 2 (Pyk2) in non-muscle invasive bladder cancer,and analyze its correlation to clinicopathologic features and prognosis of non-muscle invasive bladder cancer.Methods 114 surgical specimens and 50 normal bladder mucosa specimens were collected from 114 non-muscle invasive bladder cancer patients who underwent TURBT at our hospital,from June 2013 to March 2018.Of the 114 patients,63 were male and 51 were female,aged 42-87 years,average age of (63.6 ± 13.8) years,73 cases of tumor ＜3 cm,41 cases of tumor ≥3 cm,83 cases were single and 31 cases were multiple tumor,53 cases were high grade and 61 cases were low grade,59 cases were Ta and 55 cases were T1 stage.Pyk2 protein expression was detected by immunohistochemistry and western blot.The correlation of the expression of Pyk2 with clinicopathologic features,including gender,age,tumor size,the number of tumors,histological grade and clinical stage were analyzed.Survival analysis was calculated by using the Kaplan-Meier method,and the difference in survival curve was analyzed by using the log-rank test.Association of Pyk2 expression with prognosis of non-muscle invasive bladder cancer analyzed by using the Cox proportional hazards regression model.Results Compared with normal bladder tissues,expression of Pyk2 protein was increased in bladder cancer tissue significantly(0.571 ±0.230 vs.0.253 ± 0.152,P ＜0.01).The expression of Pyk2 protein was closely related to clinical stage(P =0.027) and grade(P =0.010),rather than gender (P =0.275),age (P =0.419),tumor size (P =0.317),and tumor number(P =0.208).The recurrence rate in the Pyk2 positive group and negative group were 46.1％ (35/76)and 28.9％ (11/38)respectively.The progression rate in the Pyk2 positive group and negative group were 35.5％ (27/76) and 10.5 ％ (4/38) respectively.Survival analysis suggested expression of Pyk2 in non-muscle invasive bladder cancer had a significant relation to recurrence-free survival rate(P ＜0.001) and progression-free survival rate(P =0.003).In the multivariable Cox analysis,we found that Pyk2 protein was an independent predictor of recurrence-free survival rate(HR 0.245,95％ CI 0.078-0.768,P =0.016) and progression-free survival rate (HR 0.095,95％ CI 0.012-0.764,P =0.027).Conclusions The expression of Pyk2 in non-muscle invasive bladder cancer was significantly increased.The expression of Pyk2 has a significant relation to recurrence and progression of non-muscle invasive bladder cancer.High Pyk2 expression is an independent prognostic factor in non-muscle invasive bladder cancer.
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Objective To investigate the micro -channel percutaneous nephrolithotomy under ultrasound guidance in clinical studies of renal calculi in non -dilated collecting system.Methods Clinical data of 126 patients with renal calculi in non -dilated collecting system treated by ultrasound -guided percutaneous nephrolithotomy microchannel were retrospectively analyzed.Ureteroscopy up to the renal pelvis or ureter segment,zebra guide wire was placed along the guide wire indwelling ureteral catheter end connected to the blood transfusion needle while external saline suspension 100cm.Ultrasound -guided puncture target cup,established 16 -18F channel percutaneous nephro-lithotomy,ureteroscopy downlink percutaneous nephrolithotomy lithotripsy.The clinical data of operation time,stone clearance rate,blood loss,complications were analyzed.Results 124 patients with successful puncture,puncture fail-ure in two patients,conversion to open surgery.118 cases of successful implementation of a single -channel stone, nine cases of postoperative residual stones was found,again two stone surgery in 6 cases,3 cases refused surgery again;six cases were due to stones larger load,operation time exceeded 2h,to 2 stage of stone surgery in 4 cases, 2 cases changed to standard channel.Operation time was 30 -150min,average 78min.A stone clearance rate was 87.3%,summarize stone clearance rate was 95.2%(118 /124).Postoperative hemoglobin level decreased to (16.0 ± 7.6)g/L,7 patients with postoperative bleeding more blood transfusion 400 -800mL,none embolization.4 cases of postoperative fever,septic shock in 1 case,1 case of pneumothorax.Conclusion The micro -channel percutaneous nephrolithotomy under ultrasound guidance in the treatment of renal calculi in non -dilated collecting system is safe and feasible,it is the preferred method of treating renal calculi in non -dilated collecting system.
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Objective To compare the efficacy of three endoscopic surgery in impacted upper ureteral calculi treatment.Methods 218 patients with impacted upper ureteral calculi were treated with minimally invasive percutaneous nephrolithotomy (MPCNL),transurethral ureteroscope lithotripsy(URL)and retroperitoneal laparoscopic urerolithotomy (RLU)respectively.The operation safety,efficacy and complication were compared in the three groups.Results In the MPCNL group,URL group,RLU group one success rate of lithotripsy were 100.00%,85.19%,100.00% respec-tively.The mean operative time were (76.35 ±16.20)min,(46.26 ±15.30)min,(89.20 ±19.60)min respectively. Decreased hemoglobin values were (22.24 ±8.63)g/L,(4.15 ±1.89)g/L,(10.68 ±4.55)g/L respectively.The stone -free rates of one month postoperation were 96.32%,79.59%,100.00%.Length of hospital stay were (8.56 ± 2.13)d,(6.58 ±1.76)d,(9.79 ±2.14)d,respectively,the differences were statistically significant(t/χ2 =36.916, 27.629,all P <0.05).Conclusion MPCNL and URL for impacted upper ureteral calculi is safety and has good efficacy and less complications,but the MPCNL is recommended the first choice,some cases can try URL.
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OBJECTIVE@#To investigate the clinical characteristics of nasopharyngeal teratomas (NPT), improve the diagnosis and treatment of the disease.@*METHOD@#We reported a 14 years old girl with NPT, and reviewed the literatures.@*RESULT@#NPT was transorally expected under nasal endoscope, no recurrence was found over a 5 year follow-up.@*CONCLUSION@#NPT is rare,the diagnosis of the disease relies on clinical manifestations, imaging and pathological examination. Transoral endoscopic surgery is an effective method of treatment.
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Adolescent , Female , Humans , Nasopharyngeal Neoplasms , TeratomaABSTRACT
Aim:To compare the effect of cilazapril and metoprolol on the compliance o f brachial artery in essential hypertension(EH). Methods:Compliance of brachial artery was determined by Pulsed Doppl er techniques. Brachial artery diameter(Dd),flow velocity(Vm),volumic blood flow (Q) and the distensibility(Dis) increased markedly,the resistance(R) used as the indexes of compliance of brachial artery. Results:Sixty seven EH were divided into two groups(A,B) random ly. Group A were treated with Cilazaril,Group B with Metoprolol. Aft er 6 months treatment, BP in all the patients decreased. In Group A,the Dd,Vm,Q and Dis increased markedly,but R of brachial artery decreased obviously. In group B,no obvious changes of branchial artery were found. Conclusion:Cilazapril may improve the compliance of brachial artery partially.