New endocrine therapy with abiterone for metastatic hormone sensitive prostate cancer: a case report and literature review / 中华泌尿外科杂志

To investigate the clinical characteristics of metastatic hormone sensitive prostate cancer and explore the strategy of combination of new endocrine drugs.In April 2019, an 69-year-old man was admitted to the First People’s hospital of Changzhou with "gross hematuria" . Physical examination showed prostatic hyperplasia with an unsmooth hard surface. CT showed a mass in bladder and possible metastasis in right lung. Diagnostic TUR-Bt pathology showed prostatic acinar adenocarcinoma, and PET-CT showed malignant lesion of prostate with bladder invasion, multiple pelvic lymph node metastasis and lung metastasis. The diagnosis of mHSPC with lymphatic and lung metastasis was considered. The patient was treated with bicalutamide and then switched to goserelin plus acetate abiraterone with prednisone. Total prostate specific antigen (tPSA) decreased to 0.705 ng/ml after 1 month of ADT+ AAP treatment, and decreased to 0.007 ng/ml after 4 months, and then maintained at 0.003 ng/ml until January 2021. Serum testosterone decreased to 0ng/dl and maintained the whole follow-up period. After 3 months of treatment, the pulmonary metastasis was not obvious. Till the last follow-up at January 2021, the patient reported good quality of life with no serious adverse events. The efficacy of ADT combined with acetate abiraterone in the treatment of mHSPC with lung cancer was significant.

A case report of varicella pneumonia, hepatitis and pancreatitis secondary to kidney transplantation / 中华泌尿外科杂志

A case of varicella pneumonia, hepatitis and pancreatitis after kidney transplantation was retrospectively analyzed. One week after kidney transplantation, the patient had a papule with pruritus, which was diagnosed as varicella by dermatologist as well as high-throughput sequencing. The patient was found to have pneumonia, hepatitis and pancreatitis. The individualized treatment regimen was used, including the dosage reduction of immunosuppressive agents, the blood drug concentration monitoring, antiviral therapy, anti-infection therapy, supportive treatment, and symptomatic alleviation for complications. The treatment was adjusted according to the indicators'variation. The timely review of the indicators and immunosuppressant blood concentration were performed to protect the transplanted kidney function, and the patient recovered in time. This rare case of postoperative complications of kidney transplantation were summarized and analyzed in order to accumulate clinical experience for the treatment of renal transplantation.

Analysis on application of regulatory dendritic cell in renal transplantation / 器官移植

How to reduce the use of immunosuppressant is one of the difficult problems to be solved in the field of organ transplantation. Cell therapy is considered as an effective solution to replace immunosuppressant with a promising clinical application. Regulatory dendritic cell (DCreg) has attracted widespread attention due to its ability to induce immune tolerance. Kidney is a solid and non-immune organ. Whether the particularity of body and the local microenvironment of recipients after renal transplantation affects the application of DCreg is the focus of research. In this article, the application of DCreg in renal transplantation was analyzed from the perspective of renal immunity.

Prognostic value of preoperative C-reactive protein/albumin ratio in patients with clear cell renal cell carcinoma / 中华泌尿外科杂志

Objective To assess the prognostic value of C-reactive protein/albumin (CRP/Alb) ratio in patients with clear cell renal cell carcinoma (ccRCC).Methods The study comprised 406 ccRCC patients undergoing nephrectomy between January 2003 and December 2012 in our hospital.There were 253 males and 153 females,aged 24-80 years,with a median age of 58 years.There were 355 cases with TNM Ⅰ stage,38 cases with Ⅱ stage,30 cases with Ⅲ stage,3 cases with Ⅳ stage.There were 376 cases with tumor necrosis and 40 cases without tumor necrosis.There were 395 cases of vascular invasion,21 cases without vessel invasion.The correlations among the pretreatment CRP/Alb ratio,clinicopathological parameters,and overall survival (OS) were evaluated.We compared the prognostic value of the CRP/Alb ratio with GPS and mGPS using the area under the curve (AUC).Results CRP/Alb ratio was associated with age at surgery (P =0.007),TNM stage (P ＜ 0.001),tumor necrosis (P ＜ 0.001) and lymphovascular invasion (P ＜ 0.001),and OS (P ＜ 0.001).The multivariate analysis confirmed that the CRP/Alb ratio independently predicted the OS of patients with ccRCC (P ＜ 0.001),the Glasgow prognostic score (GPS) (P =0.001) and modified GPS (mGPS) (P =0.019) were also independent prognostic factors.For predicting 3-year survival,the AUC values for CRP/Alb (continuous),CRP/Alb (categorical),GPS and mGPS were 0.88,0.84,0.85,0.80.For predicting 5-year survival,the AUC values for CRP/Alb (continuous),CRP/Alb (categorical),GPS and mGPS were 0.80,0.79,0.76,0.72.The CRP/Alb ratio was superior to GPS and mGPS in predicting the 3-or 5-year survival rate of ccRCC patients.Conclusions The CRP/Alb ratio could be an independent prognostic factor in ccRCC patients.The CRP/Alb ratio could take the place of the GPS and mGPS in terms of predicting prognosis in ccRCC.

Combinations of intra-artery chemotherapy and bladder-preserving resection for primary T1G3 bladder cancer / 肿瘤研究与临床

Objective To evaluate the feasibility and effectiveness of bladder-preserving local resection combined with intra-artery chemotherapy for patients with T1G3 bladder cancer.Methods Thirty five cases with T1G3 bladder cancer were analyzed retrospectively. Patients were all treated by bladder-preserving local resection combined with intra-artery chemotherapy. Results Thirty five cases were followed up. The time of follow-up ranged from 7 to 116 months,and mean time was(66.0±18.3)months.The 5 year recurrence and bladder-preserving rate were 48.6 ％(17/35)and 68.6 ％(24/35),respectively.The overall and tumor specific survival at 5 years was 77.1％ (27/35)and 82.9 ％ (29/35).The effect of bladder-preserving local resection plus intra-artery chemotherapy was satisfactory. Moreover, intra-artery chemotherapy had no obvious side effects.Conclusion Bladder-preserving local resection combined with intra-artery chemotherapy not only can retain normal bladder function, decrease in the recurrence, but also does not reduce the survival rate. It is an effective treatment for some patients with T1G3 bladder cancer instead of cystectomy over-treatment.

Applied value of muitislice CT in selecting living donor kidneys and excision methods / 中华器官移植杂志

Objective To evaluate the applied value of multislice CT (MSCT) in the selection of living donor kidneys and excision methods.Methods Ninety living renal donors underwent MSCT assessment.The nonenhanced,arterial,venous and excretory phase examinations were performed.Using maximum intensity projection and volume rendering techniques for vascular imaging,two blinded radiologists independently analyzed and evaluated all MSCT images.According to the CT reconstructive images,radiologists and physicians selected the left renal or the right renal donors,and chose laparoscopic or open live donor nephrectomy.Results On the 90 cases of donors,78 donors underwent nephrectomy in the left kidney.Seventy-one left kidney donors having no significant variation received the routine laparoscopic live donor nephrectomy.Seven left kidney donors on both sides had relatively obvious anatomical variations such as accessory renal artery,multi-branch renal vein and renal vein in the back of the abdominal aorta,and they were subjected to the left kidney open donor nephre.ctomy.Other 12 donors having significant variation in the left kidney were given nephrectomy in the right kidney,and all of them received hand-assisted laparoscopic live donor nephrectomy.All intraoperative records of urine collection system and renal vascular anatomy were consistent with the preoperative evaluation of MSCT,and the accuracy was 100 ％.Two imaging experts in the evaluation of renal artery,renal vein and urine collection system showed good consistency.Nephrectomy was successfully performed on 90 cases of donors,and.postoperative recipients had no renal vein thrombosis and other vascular complications.Conclusion MSCT can provide accurate and valuable information for the selection of living donor kidneys and excision methods as a “one-stop” technique for the preoperative evaluation of living renal donors.

Paraganglioma of urinary bladder (two cases reports and review of literatures) / 中华泌尿外科杂志

Objective To study the clinical,histopathological,immunohistochemical features and the diagnosis and treatment of paraganglioma of urinary bladder. Methods Two cases of paraganglioma of urinary bladder were treated. The first case was a male with painless haematuria. The abdominal ultrasonography and CT scan showed a 2.5 cm× 2.0 cm mass in the right anterior wall of the bladder, and urine vanillylmandelic acid elevated to 17. 9- 31. 3 μmol/24 h (normal range 10- 35 μmol/24 h). The second case was a female who presented with 8 years history of headache and palpitation after voiding. Abdominal ultrasonography and CT scan showed a 2. 6 cm× 1.5 cm mass in the left wall of the bladder, and her urine vanillylmandelic acid was 35.3-43.3 μmol/24 h. Results One patient underwent transurethral resection (TURBT) and the other underwent partial cystectomy.The two cases were diagnosed as bladder paraganglioma by pathological examination. Immunohistochemically, the tumor cells were positive for CgA, Syn, NSE and S-100. No evidence of recurrence was detected during follow-up at 3 months and 3 years. Conclusions Paraganglioma of urinary bladder should be considered as a low grade malignancy. Partial cystectomy should be recommended. The diagnosis depends on clinical symptoms, pathological and immunohistochemical results.

Comparative genomic hybridization technique detects the chromosomal aberration in renal carcinoma / 基础医学与临床

Objective To detect the chromosomal aberration in the cells of renal carcinoma and to evaluate the rela-tionship between the chromosomal aberration and development of renal carcinoma.Methods CGH technology was used to analyze the global genomic aberration in cancer cells from 12 patients with renal carcinoma.Results All of 12 cases deeeted by CGH showed chromosomal aberrations.The common extension regions of renal carcinoma were 1p,4p,5q,7p,9p and 16p.The common deletion regions of renal carcinoma were 3q,4q,6q,9q,14q and 18q.Conclusion The hereditary material of renal carcinoma is unbalanced.The extension and/or deletion of chro-mosome may facilitate the occurrence of renal carcinoma.

Clinical value of 16-row multislice CT in the preoperative assessment of live kidney donor / 中华泌尿外科杂志

Objective To analyze the clinical value of 16-row multislice CT in the live kidney donor preoperative assessment. Methods Thirty-six kidney donors underwent 16-slice CT preopera-tive assessment. The non-enhanced, arterial phase, venous phase and excretory phase examinations were performed. Two radiologists independently studied renal vessels and urinary system of each case by maximum intensity projections and volume rendering techniques. The specificity and accuracy of 16-row muhislice CT in the evaluation o{ renal vessels and urinary system were calculated after comparing with surgical findings as reference. Results 16-row muhislice CT found 7 variant renal arteries. One variant artery confirmed in surgery was missed in the CT study. 16-row muhislice CT made cor-rect diagnosis of all variant anatomy of renal veins and ureters which were confirmed in surgery. For i-dentification of variant anatomy of renal arteries, veins and ureters, the specificity of 16-slice CT was 100% (29/29), 100% (32/32), and 100% (35/35), the overall accuracy was 97%(36/37), 100% (36/ 36), and 100%(36/36), respectively. Conclusions 16-row muhislice CT shows excellent value in the evaluation of renal vessels and urinary system in live kidney donors. 16-row multislice CT is suit-able for the noninvasive examination in live kidney donor preoperative assessment and provides all sup-portive and relevant information required by the surgeons.

Primary adrenal non-Hodgkin's lymphoma: report of 7 cases / 中华泌尿外科杂志

Objective To discuss the diagnosis and treatment of primary adrenal lymphoma. Methods The clinical data of 7 adrenal primary lymphoma cases were retrospectively analyzed. Five cases were male,2 were female. Age ranged from 33 to 62 years,mean 48 years. Two cases presented with unilateral and 5 cases with bilateral masses. Two cases were found by regular health examination. Two cases had fever and weakness, with body weight loss for 3-4 months. One case had enlarged testis for 1 month. Two cases had lumbar pain accompanied by enlarged spleen. Abdominal ultra-sonography and CT showed adrenal neoplasms. All 7 cases had elevated serum lactate dehydrogenase (367-568 U/L, normal range 100-245 U/L) and β2 microglobulin (5.9-6.3 mg/L, normal range 2.4 mg/L). The CT showed irregular,inhomogeneous adrenal mass which was mildly enhanced. Results Four of the 7 patients were misdiagnosed before operation. Two patients were diagnosed as adrenal lymphoma by biopsy. One patient was diagnosed by testicular biopsy. One was T cell non-Hodgkin's lymphoma. Six cases were diagnosed as diffuse large B cell non-Hodgkin's lymphoma by pathology. Immunohistochemieally,the tumor cells were positive for CD3,CD45-RO, L26 and CD79a. Four patients had their adrenal mass removed and received chemotherapy afterwards. As follow-up of 2 years, 1 patient had no evidence of recurrence. Three patients died after 2,6,20 months after opera-tion. Three cases took chemotherapy and radiation therapy after diagnosed. They died 19,32, 38 months during follow up. Conclusions Because adrenal mass as the primary representation of prima-ry adrenal lymphoma has no characteristic clinical appearance, diagnosis could not be made preopera-tively. The principal treatment consists of adrenalectomy and adjuvant combination chemotherapy.

Comparative study of vaginal wall suspension via percutaneous puncture and tension-free vaginal tape on female stress urinary incontinence / 中华泌尿外科杂志

Objective To compare the therapeutic effect,advantages and disadvantages of 2 different methods on female stress urinary incontinence(SUI),vaginal wall suspension via percutaneous puncture(VWS-PP)and tension-free vaginal tape(TVT).Methods Fourteen SUI cases were treated by VWS-PP and 12 SUI cases were treated by TVT.The patients'age and course in 2 treatment groups were similar,and they were followed up 6 weeks,6 months and 1 year post-operatively.Therapeutic effect was evaluated by presence or absence of urinary incontinence when abdominal pressure increased.Meanwhile,operation time and complication were also compared.Results The therapeutic effect in VWS-PP group resembled as in TVT group,but the complication in VWS-PP was much less than that in TVT.The mean operation time of the VWS-PP group was 80 min(range from 60 to 90 min).while that of TVT group was 35 min(range from 25 to 50 min).The difference between 2 groups was statistically significant(P＜0.01).Conclusions The VWS-PP method is an effective,safe and mini-invasive operation for SUI.similar to TVT.Although the operation time in VWS-PP group is much longer than that in TVT group,the trauma is tinier and the surgeon can observe the anatomy reset by ultrasonic wave.

Experience with 1210 cases of cadaveric renal transplantation / 中华泌尿外科杂志

Objective To summarize the experience with cadaveric renal transplantation for improving the long-term survival rate of the recipients.Methods The clinical data of 1210 cases(773 men and 437 women;age range,6-75 years) of cadaveric kidney transplantation from 1986 to 2003 were analyzed retrospectively,including the resection of the donor's kidneys,surgical techniques,use of immunosuppressants,and complications.The 1210 patients underwent renal transplantation for most of them(1047 cases) suffered from chronic glomerulonephritis.Lymphocytotoxicity test was performed in 1210 cases with all