Zhi-song He

Peking University, Beijing, Beijing Shi, China

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Publications (31)21.07 Total impact

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    ABSTRACT: There is currently no consensus about the pattern and risk factors of bladder recurrence after nephroureterectomy, especially in the Chinese population. We evaluated the pattern and risk factors based on data from a large Chinese center. The clinical and pathological data of 438 patients with upper tract urothelial carcinoma (UTUC), who underwent nephroureterectomy at Peking University First Hospital, Beijing, China between 2000 and 2010, was retrospectively analyzed. Univariate analysis by log-rank test and multivariate analysis by Cox proportional hazards regression model were used to determine the independent risk factors. A total of 135 patients (30.8%) developed intravesical recurrence within a median follow-up of 45 months (range: 12-144 months). The median interval of bladder recurrence was 15 months (range: 2.0-98.0 months), and the two peaks for recurrence were 4-6 months and 17-19 months. Lower tumor grade, tumor multifocality, concomitant carcinoma in situ (CIS) and tumors located in the lower ureter were significant risk factors by univariate and multivariate analysis. A risk-scoring system was developed and a significant difference was found between different risk evaluations. Patients with concomitant CIS tended to develop a late bladder recurrence. One hundred and eighteen patients (87.4%) received transurethral resection after bladder tumor recurrence. Lower tumor grade, tumor multifocality, concomitant CIS and tumors located in the lower ureter tend to be predictive for bladder recurrence after nephroureterectomy, although the underlying mechanism is not fully elucidated, and the scoring system could help risk stratification. Most recurrent tumors could be treated by transurethral resection and there were two peaks for recurrence, which is probably related to the mechanisms and may be unique to the Chinese population.
    Journal of the Formosan Medical Association 12/2013; · 1.00 Impact Factor
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    ABSTRACT: To evaluate the prevalence of baseline chronic kidney disease (CKD) in a large cohort of patients with renal masses in a single Chinese institution. Estimated glomerular filtration rate (eGFR) and CKD stage are more clinically relevant to predict the risk of morbidity and mortality in patients after nephrectomy. But, sCr reflects renal function poorly. We retrospectively identified patients undergoing kidney surgery between January 2002 and June 2012. eGFR was calculated using the modification of diet in renal disease formulas modified based on Chinese people. CKD stages I-V were defined using the National Kidney Foundation definitions. A total of 2769 patients had adequate data available to calculate a preoperative eGFR (mL/min/1.73m(2)) with renal cancer confirmed by pathology. Of all patients, 97.7 % awaiting surgery at our institution had a "normal" baseline sCr (≤1.4 mg/dL), and 3.2 % of patients had CKD stage III or worse. Of the 401 patients ≥70 years old, 16.7 % (67/401) had CKD stage III. Many patients with a seemingly normal sCr have CKD stage III or worse, especially in patients over 70 years old. Given the high prevalence of baseline CKD in patients with renal cancer, it is important to preserve renal parenchyma when treating them surgically.
    World Journal of Urology 10/2013; · 2.89 Impact Factor
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    ABSTRACT: Objective: To compare the treatment outcome of laparoscopic versus open surgery for renal masses with infrahepatic (levels I and II) tumor thrombus and analyze the largest series of retroperitoneal experience in such cases from China. Materials and Methods: 49 patients with renal masses with infrahepatic tumor thrombus were analyzed retrospectively between January 2009 and January 2013 at our institution. The diagnosis was confirmed by the computed tomography and/or magnetic resonance imaging preoperatively. They were divided into 2 groups based on the detailed surgical approach applied. Group 1 (A, pure laparoscopic; B, laparoscopic nephrectomy with open thrombectomy) consisted of 17 patients (34.7%) and group 2 (pure open) consisted of 32 patients (65.3%). Results: The two groups were comparable with regard to all of the patients' baseline characteristics. All operations were performed successfully without severe complications. In group 1, the mean operative time was 208.5min, the mean estimated blood loss was 147.1ml, the mean postoperative hospital stay was 5.8d, and only 2 patients (11.8%) accepted blood transfusion with a mean quantity of 300ml. In group 2, the figures were 268.3min, 1345.3ml, 12.5d respectively and a total of 17 patients (53.1%) received transfusion with a mean quantity of 1488.2ml. The differences of all these parameters were statistically significant between both groups (p<0.05). However, comparisons between the group 1A and 1B in all of the perioperative characteristics were not statistical significant. During a mean follow-up of 18.2 months, 13 patients in group 1 and 26 in group 2 survived. The difference of cancer-survival rates between both groups was not statistically significant. Conclusions: Although it remains technically complex, demanding and challenging for renal masses with infrahepatic tumor thrombus, the laparoscopic surgery in retroperitoneal approach can make favorably perioperative results and comparable survival rates in selectively less complex patients compared with the traditional open surgery.
    Journal of endourology / Endourological Society 09/2013; · 1.75 Impact Factor
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    ABSTRACT: Introduction: Intravesical recurrence after treatment of primary upper urinary tract urothelial carcinomas (UUT-UCs) is common. While intravesical instillation is widely used to prevent recurrence after transurethral resection for primary bladder tumors, there is still no consensus on the prophylactic capability of intravesical chemotherapy in preventing bladder tumor recurrence after surgery for UUT-UCs. Methods: A meta-analysis of the published results of clinical trials was performed to compare radical surgery alone or surgery plus postoperative intravesical chemotherapy. The primary end point was to determine the percentage of patients with recurrence in the different groups. Results: Our study includes five trials with recurrence information on 614 patients. During follow-up, 55 of 268 (20.5%) patients who received postoperative instillation had bladder recurrence compared to 127 of 346 (36.7%) patients who had no adjuvant treatment - a decrease of 41% in the odds of recurrence with chemotherapy (odds ratio 0.48, 95% confidence interval 0.33-0.69, p = 0.0001). No serious adverse events were reported. Subgroup analyses were temporarily unavailable. Conclusions: Postoperative intravesical chemotherapy significantly decreases the risk of bladder recurrence after nephroureterectomy for primary UUT-UCs. Postoperative intravesical instillation is considered the treatment of choice after nephroureterectomy. © 2013 S. Karger AG, Basel.
    Urologia Internationalis 08/2013; · 1.07 Impact Factor
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    ABSTRACT: Sunitinib has been proved an effective new option for treatment of metastatic renal cell carcinoma (mRCC). Analysis of clinical data of 22 patients, who were exposed to sunitinib for at least 1 year, was conducted to evaluate the long-term efficacy and safety of sunitinib for the treatment of mRCC. A total of 54 patients with mRCC were treated with sunitinib malate, 50 mg/d orally, on a 4-weeks-on and 2-weeks-off dosing schedule in Peking University First Hospital. Treatment continued until disease progression, unacceptable adverse events (AEs), or death. Among them, 22 patients continued treatment for at least 1 year. The clinical data of these 22 patients were prospectively collected for analysis. AEs were assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events, Version 3.0. Tumor response was evaluated in accordance with the Response Evaluation Criteria in Solid Tumors. Median progression-free survival was 19.5 months until last follow-up. The best efficacy results achieved were complete response, partial response, and stable disease for 2, 9, and 11 patients, respectively. Objective response rate was 50%. The most common AEs were hand-foot syndrome (95%) and hypertension (91%). Other common AEs were thyroid-stimulating hormone elevation (82%), platelet decrease (77%), and loss of appetite (77%). Only one patient withdrew from treatment for cardiac infarction. Another nine patients experienced dose modifications or short-term suspensions. Long-term exposure to sunitinib malate showed encouraging efficacy in the treatment of mRCC. At the same time, the tolerability was good.
    Chinese medical journal 08/2013; 126(15):2826-9. · 0.90 Impact Factor
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    ABSTRACT: To analyse the predictive factors for worse pathological outcome (muscle invasive pT2+, non-organ-confined pT3+ or N+ and histological Grade 3) of upper tract urothelial carcinoma (UTUC) in a Chinese population from a nationwide high-volume centre in China. Predictors were studied by retrospectively reviewing the clinicopathological data of 729 consecutive patients with UTUC treated in our centre from January 2002 to December 2010. Univariate and multivariate logistic regression analyses were used. There were more female patients (56.4%) than males and more tumours were located in the ureter (52.7%) than in the pelvis. In multivariate analysis, male gender (hazard ratio [HR] 1.898, P = 0.001), sessile architecture (HR 3.249, P < 0.001), high grade (HR 5.007, P < 0.001), ipsilateral hydronephrosis (HR 4.768, P < 0.001), renal pelvis location (HR 2.620, P < 0.001) and tumour without multifocality (HR 1.639, P = 0.028) were predictive factors for muscle-invasive UTUC. Male gender (HR 2.132, P < 0.001), renal pelvis location (HR 3.466, P < 0.001), tumour without multifocality (HR 2.532, P = 0.001), sessile tumour architecture (HR 3.274, P < 0.001), and high grade (HR 3.019, P < 0.001) were predictive factors for non-organ-confined disease. Chronological old age (HR 1.047, P < 0.001), sessile tumour architecture (HR 25.192, P < 0.001), ipsilateral hydronephrosis (HR 1.689, P = 0.024), and positive urinary cytology (HR 1.997, P = 0.006) were predictive factors for histological Grade 3 UTUC. There was a predominance of female patients and ureteric tumours in UTUCs of this Chinese population. Male gender, sessile architecture, tumour location, tumour without multifocality, high histological grade and preoperative ipsilateral hydronephrosis were independent predictive factors for worse pathological outcome of UTUCs.
    BJU International 07/2013; · 3.05 Impact Factor
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    ABSTRACT: Benign prostatic hyperplasia often causes intravesical obstruction in elderly men; however, the processes of aging and bladder outlet obstruction independently evoke alterations in the structure and function of the bladder. These changes lead to lower urinary tract symptoms; however, it is difficult to separate the effects of prostatic obstruction on the bladder from those of aging. Nevertheless, few studies have focused on elucidating the pathophysiological mechanisms in the aged bladder. Bladder dysfunction due to detrusor instability (caused by old age) is considered to be associated with chronic ischaemia and inflammation. The aim of this study was to explore the role of tumour necrosis factor (TNF)-like ligand 1A (TL1A) and death-domain receptor (DR)3 in the ischaemic and inflammatory process of aged bladder dysfunction. Sixteen bladder tissue samples collected from patients with urothelial tumours of the bladder were divided into two groups according to age: group 1 (controls, n=8) and group 2 (aged group, n=8). Urodynamic examinations were preformed before radical cystectomy. The full-thickness bladder tissues were obtained at least 5 cm away from the margin of the tumours. The mRNA expression levels of TL1A, DR3, von Willebrand factor (vWF), interleukin (IL)-6 and nerve growth factor (NGF) in the two groups were determined using real-time reverse transcription-PCR and the protein expression levels of TL1A, DR3 and p65 were determined by western blot analysis. The TL1A and DR3 mRNA and protein expression levels of the aged bladders were upregulated compared to the control group (p<0.05). Compared to the control, the mRNA expression levels of vWF in the aged bladder tissues were markedly lower (p<0.01); however, the mRNA expression levels of IL-6 were significantly higher in the aged bladder tissues (p<0.01) compared to the control. No significant difference in NGF mRNA expression between the two groups was detected (p>0.05). In conclusion, the aged bladder was associated with ischaemic and inflammatory alterations in comparison to the control group. TL1A and DR3 may play an important role in the pathophysiological process of the aged bladder.
    Molecular Medicine Reports 05/2012; 6(2):434-8. · 1.17 Impact Factor
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    ABSTRACT: To discuss the pathological and clinical characteristics, treatments and prognosis of chromophobe renal cell carcinoma (CRCC). We developed a database that contained 1,870 patients who were diagnosed with renal cell carcinoma (RCC) and who underwent surgery in our hospital between 2002 and 2010. Afterward, the clinical and pathological data of 53 CRCC cases were extracted and analyzed. The mean age of the 53 patients at diagnosis was 50.2 years (range, 21-88 years), and the ratio of male to female was 1:1. All tumors were unilateral and a majority of them (69.8%) were discovered incidentally. The mean tumor size was 5.8 ± 3.2 cm (range, 2-20 cm). Stage T1, T2, and T3 tumors, in accordance with 2004 TNM classification, accounted for 75.5, 13.2 and 11.3% of all cases, respectively. By histologic grading, 11.3, 73.6 and 15.1% of the tumors were G1, G2, and G3, respectively. Forty-one (77.4%) patients underwent radical nephrectomy, 12 (22.6%) underwent partial nephrectomy. Forty-five (84.9%) patients with follow-up results were alive after a mean follow-up of 34 months (range, 4-79 months). Tumor metastasis was discovered in 2 patients: one tumor metastasis was found in the liver 4 months postoperation, and the other was found in the lumbar vertebrae 47 months postoperation. No local recurrence was found. The overall survival rate was 100%. CRCC is an uncommon subtype of RCC, with a favorable prognosis. Chinese patients are seemingly younger at diagnosis. Prediction of prognosis is still difficult.
    Journal of Cancer Research and Clinical Oncology 12/2011; 138(3):451-4. · 2.91 Impact Factor
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    ABSTRACT: Few studies have evaluated the growth pattern of renal cell carcinoma (RCC) in patients with delayed treatment. This report investigated the growth rate and stage progression of incidentally discovered RCC following a long period of active surveillance. Thirty-two patients who did not receive immediate surgical treatment for renal solid masses that later proved to be RCC were reviewed retrospectively. Annual tumor growth rates were calculated according to changes in the maximal diameter on CT or MRI. Clinical and pathological characteristics associated with tumor growth rate and stage progression were analyzed. The median tumor size grow from 2.14 (range, 0.30-6.70) cm to 4.33 (range, 1.40-8.80) cm after a median 46.0 months observation period. The average tumor growth rate was 0.80 (range, 0.16-3.80) cm/year. Clear cell carcinoma (0.86 cm/year) tended to grow faster than papillary cell carcinoma (0.28 cm/year) (P = 0.066). The mean growth rate of grade 2 tumors (0.88 cm/year) was faster than that of grade 1 tumors (0.36 cm/year) (P = 0.041). Thirteen tumors (40.6%) were upstaged at a median 48 months after initial presentation. Cox regression analysis revealed initial tumor size as the only risk factor for upstaging (P = 0.018). No local and systemic recurrences were noted in our cohort after the intervention at a median of 47 (range, 6-248) months of follow-up. RCCs were found to be slow growing in a group of untreated renal cell carcinoma patients. However, some tumors progressed in stage under observation. The growth rate of RCC tended to correlate with histologic grade and histologic subtype.
    Journal of Cancer Research and Clinical Oncology 11/2011; 138(2):269-74. · 2.91 Impact Factor
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    ABSTRACT: The tyrosine kinase inhibitors (TKIs) sunitinib, the first targeted agent for the first line treatment of metastatic renal cell carcinoma (RCC), targets the vascular endothelial growth factor (VEGF) pathway. The objective of this study was to investigate the efficacy and safety of sunitinib in treating metastatic clear-cell RCC and to confirm if hypertension is an effective predictive factor. A total of 36 patients with metastatic RCC were enrolled between June 2008 and December 2010. Among them 29 cases were first line therapy and 7 cases were in progression on first-line cytokine or sorafinib therapy. The pathology of all patients was confirmed predominant in clear cell type. Sunitinib mono-therapy was administered in repeated 6-week cycles of daily oral therapy for 4 weeks, followed by 2 weeks off in 34 patients; and 3 patients were administered with 37.5 mg/d continuously until disease progression or unacceptable toxicities occurred. Overall response rate and safety were evaluated. We divided patients into Group A and Group B according to the blood pressure level. The median follow-up was 15 months (10 cycles, range 1.5 - 30.0 months (1 - 20 cycles)). Ten patients (29.4%) achieved partial responses (PR); 23 patients (67.6%) demonstrated stable disease (SD) lasting ≥ 2 cycles. Seventeen patients (50%) developed progressive disease (PD) during follow-up. The median progression-free survival (PFS) was 15 months (range 3.0 - 28.5) months. A total of 9 patients died; the overall survival has not been reached; the median survival time of the deceased patients was 13 months (range 7 - 24) months. The most common adverse events were hand-foot syndrome (77.8%), thrombocytopenia (75.0%), hypertension (61.1%) and diarrhea (46.0%). Most adverse events were reversible by treatment interruption. Twenty-two patients (61.1%) developed hypertension; and hypertension was associated with a long time to disease progression and long overall survival (P = 0.004, 0.000, respectively). The results of this study demonstrate the efficacy and manageable adverse event profile of sunitinib as a single agent in first- or second-line therapy for patients with metastatic clear cell RCC. Further, sunitinib-associated hypertension may be a strong predictive marker for treatment efficacy in metastatic RCC.
    Chinese medical journal 09/2011; 124(18):2920-4. · 0.90 Impact Factor
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    ABSTRACT: To summarize the clinical outcome and adverse events of estrogen therapy for hormone refractory prostate cancer. A total of 32 patients with hormone refractory prostate cancer received diethylstilbestrol (DES) 2 mg daily at our institute. The data of PSA (prostate-specific antigen) change, time to progression, overall survival rate, disease-specific survival rate and adverse events were collected and analyzed. The data of 29 patients were complete. The mean duration of DES dosing was 8.6 ± 0.9 months. Among them, 8 (27.5%) patients achieved a PSA response with a 50% decrement of PSA or more. Seven (24.1%) patients had a stable level of PSA (50% < PSA < 125%) while 14 of 29 (48.3%) maintained a PSA progression with a 25% increment of PSA or more. The overall median time to progression was 4 (1 - 12) months. And the median time to progression was 6 (5-12) months in the PSA response group. The overall survival rate was 48.3% and disease-specific survival rate 55.2%. The main adverse events were gynecomastia (10/29, 34.5%) and deep vein thrombosis (3/29, 10.3%). When used for the treatment of hormone refractory prostate cancer, diethylstilbestrol at a daily dose of 2 mg can achieve a PSA response in 27.5% patients and a PSA stability in 24.1% patients. And the median time to progression is 4 months. Estrogen is efficacious for the patients with hormone refractory prostate cancer.
    Zhonghua yi xue za zhi 08/2011; 91(32):2247-9.
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    ABSTRACT: To discuss the feasibility and safety of laparoscopic transperitoneal and transmesenteric pyeloplasty for recurrent ureteropelvic junction obstruction (UPJO). From May 2006 to June 2008, we admitted 5 cases of recurrent UPJO who had received open retroperitoneal pyeloplasty with 3 males and 2 females. They were 19 to 32 years old with the average of 24.5 years and suffered from recurrent UPJO 3 to 16 years with the average of 7.8 years after operation. They felt discomfort in the lumbar region to different extent and their intravenous pyelography (IVP) or computerized tomography for urinary system (CTU) showed typical UPJO. The nucleotide renal scan (NRS) revealed that the renal excretion was slow, even after intravenous injection of diuretics. The laparoscopic transperitoneal and transmesenteric pathway was done in such a way that the incision was longitudinal at the mesentery of small intestine near the affected ureteropelvic junction (UPJ). The UPJ was isolated to avoid injuring the intestine and the mesenteric blood vessels. The UPJO was removed with the routine Anderson-Hynes technique and the anastomosis between pelvis and ureter was carried out by 2 separate and running sutures. The operating time was 105-230 min with the average of 165 min and the estimated blood loss was 50 to 120 mL with the average of 75 mL. Patients left bed on the first day and the drainage tube was taken out on the 4th to 5th day after the operation. There were no other injuries and complications. By October of 2008, they had been followed up for 33 to 49 months with the average of 37.5 months and IVP or CTU and the diuretic NRS showed smooth excretion of the operated UPJ. As for experienced hands, the laparoscopic transperitoneal and transmesenteric pyeloplasty is feasible and safe for recurrent UPJO, but it's not recommended to the beginners of laparoscopic procedures.
    Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 08/2011; 43(4):540-3.
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    ABSTRACT: To discuss the surgical skills and clinical value of complete transperitoneal laparoscopic nephroureterectomy. We collected and analyzed the clinical data of 25 patients (14 renal pelvic carcinoma and 11 carcinoma of ulreter, right side 15 and left side 10) who underwent complete transperitoneal laparoscopic nephroureterectomy for the upper urinary tract urothelial carcinoma (UUT-UC) in Peking University First Hospital from May 2010 to April 2011. All the operations were successfully done by one surgeon with standard 4 or 5 trocars technique. The mean operative time was 150 min (120-180 min), the blood loss about 20-100 mL (mean 40 mL) and no severe complications observed. The postoperative hospital stay was 4-6 days with an average length of 5.5 days. The mean follow-up was 5.5 (1-11) months. One of 19 patients underwent trans urethral resection of bladder tumour (TURBT) for recurrent non-muscle invasive bladder tumor. Complete transperitoneal laparoscopic nephroureterectomy is a minimally invasive, safe and effective way to treat UUT-UC. The patients recover soon and have a shorter length of stay.
    Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 08/2011; 43(4):531-4.
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    ABSTRACT: NSBP1 is a recently identified member of the HMGN protein family which binds to nucleosomes and regulates gene transcription through chromatin remodeling. In this study, we aimed to investigate the potential role of NSBP1 in human bladder cancer. We examined NSBP1 expression in 114 surgically removed bladder cancer specimens as well as 11 human bladder cell lines by immunohistochemistry and Western blot analysis, and found that NSBP1 level was correlated with the increased tumor grade and pathologic stage, and lymph node metastasis. RNAi-mediated knockdown of NSBP1 in EJ cells, a bladder cancer cell line that overexpressed NSBP1, resulted in moderate decrease of cell viability, moderate blockage of cell cycle at G2/M phase, and decreased cyclin B1 expression, but had no effects on apoptosis. Moreover, NSBP1 knockdown led to reduced activity of MMP-9 but not MMP-2. Taken together, these results suggest that NSBP1 promotes the viability of bladder cancer cells through increased cell proliferation but not decreased apoptosis, and increases the invasion ability of metastatic bladder cancer cells through the upregulation of MMP-9 activity. Our findings not only provide a molecular understanding of the role of NSBP1 in bladder cancer, but also suggest NSBP1 RNAi as a novel therapeutic approach for bladder cancer.
    Tumor Biology 06/2011; 32(5):931-9. · 2.52 Impact Factor
  • Journal of Urology - J UROL. 01/2011; 185(4).
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    ABSTRACT: To assess the clinical utility of a fluorescence in situ hybridization (FISH) assay as a non-invasive method for diagnosing and monitoring urothelial carcinoma (UC) in the upper urinary tract (UUT). Urine specimens from 63 consecutive patients with UUT-UC and 69 controls with benign disease were analyzed by means of cytology and FISH. For FISH analysis, labeled probes specific for chromosomes 3, 7, and 17 and for the p16 (9p21) gene were used to assess chromosomal abnormalities indicative of malignancy.Sensitivity and specificity of both techniques were determined and compared. The frequency of chromosomal aberrations of malignant cells from UUT-UC was also determined. Of 63 patients with UUT-UC, FISH affords an overall sensitivity of 84.1% (53/63), the figure being 71.4% (20/28) for PTa and PT1 tumors,94.3% (33/35) for PT2-4 tumors. The sensitivities of urine cytology were 35.7% (10/28) for PTa and PT1 tumor,45.7% (16/35)for PT2-4 tumors,with an overall sensitivity of 41.3% (26/63). The sensitivities of the two methods for the low grade tumors were 80% (20/25) and 44% (11/25), and for high grade tumors were 86.8% (33/38) and 39.5% (15/38), respectively. Specificities for FISH and urine cytology were 91.3% (63/69) and 94.2% (65/69)respectively. According to the results,the sensitivity of FISH for the detection of UUT-UC is superior to that of urine cytology and the specificities of FISH and urine cytology are not significantly different. FISH can promote the diagnosis of UUT-UC, especially for the low stage and low grade cases,it may be a new promising non-invasive method for the diagnosis of UUT-UC.
    Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 08/2010; 42(4):381-5.
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    ABSTRACT: To investigate the effect of intermittent hormonal therapy (IHT) for patients with different stage/grade prostate cancer (PCa). The number of cycles and the duration of ON/OFF therapy for 45 PCa patients receiving IHT were observed. Maximal androgen blockade (MAB) therapies were used for six to nine months, and then stopped until the serum prostate specific antigen (PSA) was decreased below 0.2 microg/L, which lasted for three months. It was decided whether MAB went on according to the level of PSA. The average follow-up time was 40.7+/-13.4 months. Forty-one patients started the second cycle of treatment, of whom, 8 became androgen-independent and 7 were at T3-4M0 or M1 stages and the Gleason scores were above 8. Sixteen patients entered the third cycle, of whom, 14 were at lower than stage III and 13 had the Gleason scores below 7. From the first to the fourth courses of treatment, the average intervals were 8.7+/-5.4 (47.1%), 8.4+/-4.9 (49.3%), 7.0+/-3.4 (43.7%), and 3.7+/-0.6(42.5%) months respectively. Five patients developed bone metastasis. No one died up to now. According to the evaluation criteria, patients were divided into tolerance (n=16) and intolerance groups (n=29). Compared with the intolerance group, the patients who tolerated the treatment well had lower Gleason scores (P=0.002), lower PSA levels (P=0.053) and lower tumor stages (P=0.001). There was no evidence that age, lymph node metastasis, bone metastasis and the state of recurrence were associated with an increased risk of the outcome. Non-conditional Logistic regression analysis showed that the proportion of patients at stage IV was the only independent risk factor for the tolerance of the treatment (OR=12.113, 95%CI 1.330-110.312, P=0.027). Intermittent hormonal therapy is more effective and proper for the patient with highly differentiated tumor and at lower stages (< or = III). The patients who progressed to hormone-independence are mostly at stage IV with poorly differentiated tumor. Intermittent hormone therapy could be more adaptive for the patients at lower than stage III.
    Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 08/2010; 42(4):396-9.
  • Cui-jian Zhang, Zhi-song He, Li-qun Zhou
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    ABSTRACT: To investigate changes of the stage, age of onset, and prostate specific antigen (PSA) level of prostate cancer with socioeconomic development and medicare promotion. The medical records of 784 inpatients with prostate cancer were analyzed retrospectively, who were diagnosed in Peking University First Hospital from 1997 to 2007. According to the time of diagnosis, all the patients were sorted into three groups: earlier group (1997-2001), intermediate group (2002-2004), and contemporary group (2005-2007). The tumor stages, ages, Gleason scores, and PSA levels of each group and of the three groups were compared to determine whether the discrepancies were significant. The discrepancies of ages, Gleason scores, and stages between earlier and intermediate groups were not significant. The differences of ages and stages between intermediate and contemporary groups were not significant, but the change of Gleason scores was significant. The discrepancies of Gleason scores and stages between earlier and contemporary groups were meaningful, but the change of ages was not significant. As time passes, PSA levels and tumor stages of prostate cancer patients show a descending trend, but the discrepancy of ages between the three groups is meaningless. The weight of low risk and intermediate risk groups in localized prostate cancer is becoming heavy.
    Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 08/2010; 42(4):404-8.
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    ABSTRACT: To describe our diagnostic and therapeutic experience of patients with urinary tract endometriosis. We performed a retrospective analysis of 22 cases of urinary tract endometriosis with histopathological results from 2001 to 2007. The mean patient age was 36.0 years. Of the 22 patients, 4 had bladder involvement and 18 ureteral involvement. In those with bladder endometriosis, the diagnosis was made by cystoscopy and biopsy in 4 patients. The treatments consisted of partial cystectomy in 3 patients and transurethral resection of the bladder in 1 patient. One of the patients who underwent transurethral resection of the bladder experienced 1 relapse. The relapse was treated with partial cystectomy. In the patients with ureteral endometriosis, the diagnosis was mainly established by ultrasound (18 cases), intravenous urography (11 cases), retrograde pyelography (7 cases), CT (14 cases) and MRI (5 cases). The treatments consisted of ureterolysis in 1 patient,ureteroneocystostomy in 4, and ureteral resection and end-to-end anastomosis in 13 of them. All the patients pathologic results were of endometriosis. Urinary tract endometriosis is an uncommon disease. Partial cystectomy should be considered as the therapeutic option for bladder endometriosis . For cases of ureteral endometriosis, the first technique depends on the location, extent and depth of the lesion.
    Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 08/2010; 42(4):461-4.
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    ABSTRACT: To compare the safety and efficacy of laparoscopic and open partial nephrectomy for small renal cell carcinoma. To collect and analyze the data such as operation time, warm ischemia time, complications, recovery and surgical margins of 110 patients of small renal carcinoma (T1aN0M0) from January 2004 to March 2009, 52 of which underwent laparoscopic partial nephrectomy (LPN) and the other 58 patients underwent open partial nephrectomy (OPN). The mean operation time of LPN group and OPN group were 177.8 min and 126.7 min (t = 3.973, P < 0.01), respectively. The warm ischemia time of the two groups were 28.3 min and 21.9 min (t = 4.627, P > 0.05), respectively. Two cases in LPN group and 1 case in OPN group (3.8% vs 1.7%, chi(2) = 0.010, P > 0.05) needed blood transfusion. The increment of creatine after operation were 4 micromol/L in LPN group and 6 micromol/L in OPN group (t = -2.018, P > 0.05). Six cases (11.5%) in LPN group and 8 cases (13.8%) in OPN group needed collection system repairing (chi(2) = 0.130, P > 0.05)and the same data of hematuria after operation was observed. There was no urinary fistula or other severe complications in all patients. The hospital stay after operation was 10.6 d and 12.9 d (t = -3.244, P < 0.01) in the two groups, respectively. All surgical margins were negative. LPN and OPN have the same safety and efficacy, LPN primary treatment can be used for selected patients of T1aN0M0 renal cell carcinoma because of its fast recovery.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 03/2010; 48(5):372-4.

Publication Stats

66 Citations
21.07 Total Impact Points

Institutions

  • 2006–2013
    • Peking University
      • Institute of Urology
      Beijing, Beijing Shi, China
  • 2005–2013
    • Beijing Medical University
      • Institute of Urology
      Peping, Beijing, China