[Show abstract][Hide abstract] ABSTRACT: Objectives:
To investigate the learning curve of percutaneous nephrolithotomy under total ultrasound guidance.
One hundred and twenty consecutive PCNL operations under total ultrasound guidance performed by a novice surgeon in a tertiary referral center were studied. Operations were analyzed in cohorts of 15 to determine when a plateau was reached for the variables such as operation duration, ultrasound screening time, tract dilation time, stone-free rate and complication rate. Comparison was made with the results of a surgeon who had performed more than 1000 PCNLs. Fluoroscopy was not used at all during procedure.
The mean operation time dropped from 82.5 min for the first 15 patients to a mean of 64.7 min for cases 46 through 60(P = 0.047). The ultrasound screening time was a peak of 6.4 min in the first 15 cases, whereas it dropped to a mean of 3.9 min for cases 46 through 60(P = 0.01). The tract dilation time dropped from 4.9 min for the first 15 patients to a mean of 3.8 min for cases 46 through 60(P = 0.036). The senior surgeon had a mean operating time, screening time and tract dilation time equivalent to those of the novice surgeon after 60 cases. There was no significant difference in stone free rate and complication rate.
The competence of ultrasound guided PCNL is reached after 60 cases with good stone free rate and without major complications.
[Show abstract][Hide abstract] ABSTRACT: To evaluate the application of shear wave elastography (SWE) combined with transition zone biopsy in the detection of prostate cancer (PCa).
A total of 489 patients with suspected PCa underwent transrectal ultrasonography (TRUS) and SWE-guided prostatic biopsy. We evaluated the role of SWE combined with transition zone biopsy in promoting the detection rate in comparison with the results of biopsy pathology.
The pathological results confirmed 221 malignant and 268 benign cases. Based on systematic biopsy, SWE combined with transition zone biopsy achieved a detection rate of 45. 19% , significantly higher than that of systematic biopsy alone (33.13%) (P < 0.05). The diagnostic sensitivity, specificity, and accuracy of SWE were significantly better than those of TRUS (P < 0.05). The mean elasticity (Emean) of SWE was remarkably higher for malignant than for benign lesions ([40.1 ± 9.5] vs [21.6 ± 8.3] kPa, P < 0.05). With 28.5 kPa as the threshold of the Emean value, the area under the ROC curve was 0. 899, and the diagnostic sensitivity and specificity were 88.71% and 86.23%, respectively.
SWE combined with transition zone biopsy could significantly improve the detection rate of prostate cancer.
No preview · Article · Jul 2015 · Zhonghua nan ke xue = National journal of andrology
[Show abstract][Hide abstract] ABSTRACT: Despite recent advances in the understanding of the biology of renal cell carcinoma (RCC), successful surgical treatment and implementation of novel‑targeted therapies, the prognosis for RCC patients remains poor. Late presentation, tumor heterogeneity and in particular the lack of molecular biomarkers for early detection, classification and the surveillance of RCC treatments are major obstacles. The increasing knowledge regarding the functional role of microRNAs (miRNAs) in pathophysiological processes may provide an important link to the identification of suitable therapeutic targets and diagnostic/prognostic biomarkers for RCC. The aim of this review was to provide new insight into the function of miRNAs in the pathogenesis of RCC and to emphasize their potential as diagnostic and prognostic markers, as well as therapeutic targets.
[Show abstract][Hide abstract] ABSTRACT: This study aimed to evaluate the expression of DNA methyltransferase (DNMT) family proteins in renal cell carcinoma (RCC) and to assess the clinical significance and prognostic value of their expression patterns.
A total of 97 renal cell carcinoma and 52 no-tumor tissues were recruited for immunohistochemical analysis of their expression.
DNMT1, DNMT3A and DNMT3B proteins were highly expressed in clear cell RCC, papillary RCC and chromophobe RCC tissues than that of no-tumor tissues (all P < 0.05). DNMT1, DNMT3A and DNMT3B expression was significantly associated with tumor size (P=0.003, 0.001 and 0.003, respectively), tumor pathology stage (P=0.039, 0.034 and 0.037, respectively), histopathological grading (P=0.042, 0.026 and 0.031, respectively), lymph node metastasis (P=0.022, 0.030 and 0.020, respectively) and vascular invasion (P=0.042, 0.031 and 0.044, respectively). The Kaplan-Meier survival analysis demonstrated that expression of DNMTs protein in RCC was significantly associated with shorter over all survival and disease-free survival (all P < 0.05). Furthermore, multivariate analysis showed that the expression of DNMT1 was an independent prognostic factor for overall survival (OS) (P=0.036), and the expression of DNMT3A or DNMT3B was an independent prognostic factor for disease-free survival (DFS) in the patients (P=0.031 and P=0.023, respectively).
DNMTs were higher expressed in RCC than no-tumor tissues, and the expression of DNMTs were strongly associated with RCC tumor size, tumor pathology stage, histological grading, lymph node metastasis, vascular invasion, recurrence, and prognosis. DNMTs may thus serve as prognostic markers and novel therapeutic targets for RCC patients.
No preview · Article · Dec 2014 · International journal of clinical and experimental pathology
[Show abstract][Hide abstract] ABSTRACT: Objective:
To evaluate the safety and efficacy of single-stage multiple-tract percutaneous nephrolithotomy (PCNL) in the treatment of staghorn stones solely guided by ultrasonography (US).
Patients and methods:
From May 2007 to July 2012, 55 single-stage multiple-tract PCNL procedures were performed (53 patients, of whom 2 had bilateral stones). Caliceal puncture and dilatation were performed under US guidance in all cases. The procedure was evaluated for access success, length of postoperative hospital stay, complications (modified Clavien system), and stone clearance.
The mean (±SD) operating time was 84.87 ± 24.9 min, with a mean (±SD) postoperative hospital stay of 5.2 ± 1.31 days. The patients experienced a mean (±SD) decrease in hemoglobin level of 8.23 ± 2.39 g/l and the stone-free rate after single-stage surgery was 78.18%. Extracorporeal shock wave lithotripsy was indicated in 2 cases as an auxiliary treatment. There were 10 grade 1 (62.5%) and 6 grade 2 (37.5%) complications; however, there were no complications above grade 3.
Total US-guided single-stage multiple-tract PCNL for treating staghorn calculi in selected cases is safe, feasible, and may be performed with an acceptable morbidity and with the advantage of preventing radiation hazards and damage to adjacent organs.
No preview · Article · Aug 2014 · Urologia Internationalis
[Show abstract][Hide abstract] ABSTRACT: Objective:
To better understand the contribution of dysregulated DNA methyltransferase 1 (DNMT1) expression to the progression and biology of clear cell renal cell carcinoma (ccRCC).
We examined the differences in the expression of DNMT1 in 89 ccRCC and 22 normal tissue samples by immunohistochemistry. In addition, changes in cell viability, apoptosis, colony formation and invading ability of ccRCC cell lines (786-0 and Caki-1) were assessed after transfection with DNMT1 siRNA.
We found DNMT1 protein was significantly higher expressed in ccRCC than that of in no-tumor tissues (56.2% and 27.3%, respectively, P=0.018). The expression of DNMT1 was strongly associated with ccRCC tumor size, tumor pathology stage, histological grading, lymph node metastasis, vascular invasion, recurrence and prognosis. Moreover, knockdown of DNMT1 expression significantly inhibited ccRCC cell viability, induced apoptosis, decreased colony formation and invading ability.
Expression of DNMT1 protein is increased in ccRCC tissues, and DNMT1 expression is associated with poor prognosis of patients. Experiments in vitro further showed DNMT1 played an essential role in proliferation and invasion of renal cancer cells. Moreover, targeting this enzyme could be a promising strategy for treating ccRCC, as evidenced by inhibited cell viability, increased apoptosis, decreased colony formation and invading ability.
No preview · Article · Aug 2014 · Chinese Journal of Cancer Research
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVE: To review the management of problematic ureteral calculi in pregnancy and to compare efficacy among 3 treatments: ureteroscopic lithotripsy, ureteral stent insertion, and percutaneous nephrostomy. METHODS: In a retrospective study at Sheng Jing Hospital, Shenyang, China, data were analyzed from 54 consecutive pregnant patients who required medical intervention for urolithiasis between April 2001 and July 2012. The patients were divided into 3 groups based on whether they had ureteroscopic lithotripsy (group 1, n=21), nephrostomy (group 2, n=16), or ureteral stent insertion (group 3, n=17). Statistical significance was evaluated by Student t test and χ2 test. RESULTS: In group 1, 18 of 21 patients had complete calculi fragmentation. In group 2, nephrostomy was carried out successfully for all 16 patients. The insertion of a ureteral stent was possible for 12 of 17 patients in group 3. The ureteroscopic lithotripsy procedure took longer than the other 2 procedures (P<0.005). Patients in the stent insertion group had the highest rate of complications (52.9%) and lowest rate of success (70.6%). CONCLUSION: Ureteroscopic lithotripsy was found to be an effective intervention during pregnancy. However, the choice of treatment depends on the individual situation.
No preview · Article · Mar 2013 · International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
[Show abstract][Hide abstract] ABSTRACT: The aims of this study were to determine the methylation and expression status of secreted Frizzled-related protein 1 (SFRP1) in bladder cancer, to explore the mechanisms involved and to study the role of SFRP1 in the pathogenesis of bladder cancer. SFRP1 mRNA was detected by reverse transcription PCR (RT-PCR). The DNA methylation status was determined by methylation-specific PCR and protein was detected using western blotting. The results of the present study demonstrated that SFRP1 was methylated in the bladder cancer cell lines T24 and 5637, but not in SCaBER cells. After treating T24 and 5637 cells with a demethylating agent, the cells expressed SFRP1 mRNA and protein. Among the 45 patients with bladder cancer, methylation of SFRP1 was detected in 28 patients (62.2%). Of the matched cancer-adjacent tissues, 6 (13.3%) were found to have methylated SFRP1. The result is statistically significant (P<0.01). In conclusion, SFRP1 is downregulated in certain bladder cancer patients as a consequence of methylation. SFRP1 methylation may be involved in the pathogenesis of bladder cancer via excessive activation of the Wnt signaling pathway.
No preview · Article · Aug 2012 · Oncology letters
[Show abstract][Hide abstract] ABSTRACT: It has been reported that expression of glucose transporter member 3 (GLUT3) is up-regulated in bladder cancers. However, the regulating mechanism remains unknown. Here, we assessed whether microRNAs (miRNAs) regulate GLUT3 expression in bladder cancers. In our study, miR-195-5p was identified to directly targeted GLUT3 3'-untranslated region (UTR) in bladder cancer T24 cells. Small interfering RNA (siRNA)- and miR-195-5p-mediated GLUT3 knockdown experiments revealed that miR-195-5p decreased T24 cells glucose uptake, inhibited cell growth and promoted cell apoptosis through suppression of GLUT3 expression. Therefore, miR-195-5p is a novel and also the first identified miRNA that targets GLUT3, and the aberrant decreased expression of miR-195-5p and consequent GLUT3 up-regulation may contribute to bladder carcinogenesis.
[Show abstract][Hide abstract] ABSTRACT: The aims of this study were to evaluate the efficacy of retrograde ureteral stenting and to identify the predictive factors for potential failure of this technique in women with advanced gynecologic malignancies.
From 2006 to 2010, a retrospective analysis was performed on a total of 75 patients with ureteral obstruction due to gynecologic malignancies. This population was divided into group 1 (n = 50) in which retrograde stent placement was successful, and group 2 (n = 25) in which stent placement failed and subsequent percutaneous nephrostomy tube placement was required. Multivariate analysis was done to identify predictors of the failure of ureteral stent insertion.
Multivariate analysis revealed that mean preprocedureal serum cystanin C greater than 2.5 mg/L and length of the ureteral obstruction greater than 3 cm were significant predictors of stent failure. Neither the causes nor location of obstruction predicted the need for percutaneous nephrostomy (PCN). No statistical significance was detected among the subgroups of patients with different degrees of hydronephrosis. Statistical significant differences were found between the 2 groups in procedural time, average cost, and mean interval of stent/catheter replacement. However, no statistically significant difference was found in the median survival time and overall stent-related or catheter-related complications between the 2 groups.
Retrograde ureteral stenting is a first-line option for managing ureteral obstruction caused by gynecologic malignancies. However, in cases where the preprocedureal mean serum cystanin C is greater than 2.5 mg/L and the length of the ureteral obstruction segment is greater than 3 cm, these patients may be better served by percutaneous drainage.
No preview · Article · Feb 2012 · International Journal of Gynecological Cancer
[Show abstract][Hide abstract] ABSTRACT: Unstable, gene-rich pericentric regions have been associated with various structural aberrations including small supernumerary marker chromosomes (sSMCs). We hereby report on a complex pure mosaic sSMCs derived from chromosomes 11 and 19 in a child featuring multiple congenital anomalies. As indicated by microarray analysis, the sSMCs have involved materials from 11p11.12 → q12.1 and 19p12 → q12 in complex forms (with four cell lines harboring from 1 to 4 sSMCs) in all peripheral blood lymphocytes. The patient featured facial dysmorphism, generalized hypotonia, cryptorchidism, transverse palmar creases, cerebral hemorrhage, atrial septal defect secundum, strabismus, epilepsy, immunodeficiency, and severe cognitive and motor impairment. Literature review indicated this to be a unique sSMCs case simultaneously involving chromosomes 11 and 19, with one sSMC containing materials from the both chromosomes. We propose that the involved chromosomal regions may contain dosage-sensitive genes which are important for the development, and that the sSMCs derived from multiple origins have formed by a complex mechanism.
No preview · Article · Dec 2011 · American Journal of Medical Genetics Part A
[Show abstract][Hide abstract] ABSTRACT: To investigate the influence of chronic prostatitis/chronic pelvic pain syndromes (CP/CPPS) on male health.
We conducted investigations among 200 cases of CP/CPPS, aged 20 -59 years and randomly selected from 650 out-patients, using an anonymous questionnaire including such items as the patients'age, height, body weight, disease duration and treatment, the results of EPS and semen determinations, and the scores on NIH-CPSI, IIEF-5 and Symptom Checklist (SCL-90).
According to the 198 valid questionnaires collected, CPSI scores showed 56 (28.3%) cases to be mild, 98 (49.5%) moderate and 44 (22.2%) severe. Sperm density and motility (grade a + b) were reduced in 38 (19.2%) and 47 (23.7%) cases, respectively. IIEF-5 revealed ED in 41 (20.7%) cases, of which 58.5% were mild. Psychological abnormality was found in 94 (47.5%) cases, including anxiety, depression, sensitiveness and so on. NIH-CPSI scores were positively correlated with psychological symptoms and ED (r = 0.25, P < 0.05; r = 0.12, P < 0.05), but not significantly related with sperm density and motility (P > 0.05).
The influence of CP/CPPS is obvious on male psychology but mild on penile erection and not significant on semen. Integrated physiological and psychological therapy is recommended for the treatment of CP/CPPS.
No preview · Article · Dec 2009 · Zhonghua nan ke xue = National journal of andrology
[Show abstract][Hide abstract] ABSTRACT: To improve the diagnosis and the treatment of tuberculous epididymitis.
Retrospective studies were made of 20 cases of isolated epididymal tuberculosis defined as "tuberculosis infection affecting the epididymis without evidence of renal involvement as documented by the absence of acid fast bacilli in the urine sample and on imaging" among 35 patients with epididymal tuberculosis. Two weeks after the intensified anti-TB treatment by the combined therapy of Isoniazid + Rifampicin + Streptomycin or Ethambutol, all the patients underwent surgical removal of the tuberculous lesion, followed again by the combined therapy for 6-9 months.
Of the 20 cases, 16 experienced no recurrence and complications within 0.5-5 years after the surgery, 3 were found with urinary tuberculosis at 3, 3.5 and 5 years, and 1 developed tuberculous epididymitis of the other side at 3.5 years.
Isolated tuberculous epididymitis may be the sole or the initial presentation of genitourinary tuberculosis, for which timely surgery is the best option and has a good prognosis.
No preview · Article · Nov 2008 · Zhonghua nan ke xue = National journal of andrology
[Show abstract][Hide abstract] ABSTRACT: To evaluate the effect of the modified urethral pull-through procedure in the surgical treatment of posterior urethral stricture or obliteration caused by trauma.
From January 2001 to June 2005, modified urethral pull-through procedures were performed in 36 patients with post-trauma posterior urethral stricture or obliteration, 25 of them with post-operation urethral stricture or obliteration after urethral realignment by traction and the other 11 treated by cystostomy at the time of initial injury. The length of the urethral stricture segment was 1.0-4.5 cm, mean 2.2 cm. The patients were aged from 17 to 59 years (mean 44.5 years).
All the patients were followed up for at least 1 year. Success was achieved in 34 patients, among whom 25 had good voiding and no need of dilation, 6 were cured after 3 - 6 post-operative dilations, 3 required dilation every 2 or 3 months for over a year and 2 failed. No blood transfusion was needed during the operation, and no erectile dysfunction or incontinence occurred after it.
The modified urethral pull-through procedure is effective and simple in the surgical treatment of post-trauma posterior urethral stricture or obliteration, with few complications and no consequent erectile dysfunction or incontinence.
No preview · Article · Nov 2007 · Zhonghua nan ke xue = National journal of andrology
[Show abstract][Hide abstract] ABSTRACT: To assess the outcome of prostatectomy simultaneously with suprapubic punctual cystostomy for BPH patients with impaired detrusor contractility.
Twelve cases of BPH with impaired detrusor contractility were diagnosed by urodynamic examination from 2002 to 2005. The patients underwent prostatectomy simultaneously with suprapubic punctual cystostomy and were followed up for a year.
Nine of the patients, at the average age of 69.00 +/- 5.13 years and with a short history of LUST, were restored to normal bladder function, while the other 3, older than 78 years and with a longer LUST history, failed to respond to the treatment.
BPH patients with impaired detrusor contractility that are younger and have a shorter LUST history could benefit from prostatectomy simultaneously with suprapubic punctual cystostomy, but the older ones with a longer LUST history should be treated by suprapubic punctual cystostomy alone.
No preview · Article · Oct 2007 · Zhonghua nan ke xue = National journal of andrology