目的 探讨新型自制气囊扩张装置在泌尿外科后腹腔镜手术建腔中的有效性及可行性.方法 纳入2016年2月至2017年2月间入院适宜行后腹腔镜手术的患者288例,抽签法随机分为两组:应用新型自制气囊扩张装置建腔144例(新型组)和应用传统自制气囊扩张方法建腔144例(传统组).分析比较两组建腔时间、建腔并发症的差异.结果 新型组的建腔时间为(3.8±1.2) min,明显少于传统组的建腔时间(5.9±1.1) min(P＜0.05),建腔并发症(明显出血、腹膜损伤、气囊破裂)发生率方面两组间差异无统计学意义.结论 该新型自制气囊扩张装置在泌尿外科后腹腔镜手术中建腔有效快捷、安全可行,能够明显缩短建腔时间,进而节省手术时间.

Objective To investigate the expressions of metallothionein-2A (MT-2A), E-cadherin, interleukin-6 (IL-6), cyclin E, proliferating cell nuclear antigen (PCNA) and bcl-2 in prostate cancer tissues and their correlation with biochemical recurrence of prostate cancer. Methods Tissue specimens from 128 cases of prostate cancer who underwent radical prostatectomy in Shanxi Dayi Hospital from October 2012 to October 2017 were processed and transferred into tissue microarrays, the clinicopathological parameters of patients were also recorded. The expression levels of MT-2A, E-cadherin, IL-6, cyclin E, PCNA and bcl-2 were detected by immunohistochemical avidin-biotin complex (ABC) staining. The correlation between different molecular markers and biochemical recurrence of prostate cancer was analyzed. Results The biochemical recurrence rate of 128 patients with prostate cancer was 30.5％ (39/128). The biochemical recurrence rates of low-risk, intermediate-risk and high-risk prostate cancer patients were 14.8％(8/54), 38.7％(24/62) and 58.3％ (7/12), respectively. The risk classification and pathological T stage of patients with prostate cancer were associated with the expressions of MT-2A, cyclin E, IL-6 and E-cadherin (all P< 0.05). Multivariate Cox risk model showed that the high risk classification (HR= 1.81, 95％CI 1.56-2.19, P=0.042), MT-2A positive expression (HR= 2.01, 95％CI 1.08-3.15, P= 0.005), cyclin E positive expression (HR= 1.79, 95％CI 1.08-2.21, P= 0.042) and E-cadherin negative expression (HR= 1.92, 95％ CI 1.22-2.45, P= 0.020) were the independent risk factors for biochemical recurrence of prostate cancer. Conclusion The expression of MT-2A, cyclin E and E-cadherin may serve as independent predictors for biochemical recurrence of prostate cancer.

目的 探讨肾脏原始神经外胚层肿瘤(PNET)的临床病理特征.方法 回顾性分析山西大医院收治的1例肾脏PNET患者的临床病理资料,并进行文献复习.结果 该患者临床表现和影像学检查无特异性,行根治性肾切除术,过程顺利.肉眼可见肿瘤切面呈灰红色,可区别于肾脏透明细胞癌;术后免疫组织化学提示为PNET、Vimentin(+)、CD99(+)、NSE(部分+)、CD117(部分+)、CD56(+)、Syn(+)、Fli-1(+)、Ki-67(30％+).术后21个月患者无复发及转移征象.结论 肾脏PNET临床罕见,预后相对较好,诊断依赖于组织病理学,早期手术治疗对改善预后有重要意义.

尿路上皮癌是泌尿系统常见的肿瘤之一,上尿路癌占原发性尿路上皮癌的5％～6％,其中原发性输尿管癌占尿路上皮肿瘤的1％[1].对于原发性输尿管癌,标准治疗是将肾输尿管膀胱袖套状切除.有报道对于低级别低分期的输尿管肿瘤或对于孤立肾输尿管癌、双侧尿路上皮癌,肾功不全患者,合并内科疾患难以承受标准手术患者,可行保肾手术治疗[2],目前仍有争议[3].2011-2014年本院共实施176例输尿管肿瘤手术,其中151例行标准术式,25例行保肾手术治疗,效果满意,现将保肾治疗病例及临床资料报告如下.

125I粒子植入术以其手术成功率高、并发症少、患者耐受性好等优势在老年前列腺癌患者中广泛应用[1].此外,为了提高放射性粒子植入治疗效果,125I放射性粒子植入的近距离内放射治疗联合内分泌治疗已开始应用于局限性前列腺癌的治疗. 因此,我们通过回顾性分析116例前列腺癌患者临床资料, 对比分析内分泌治疗和 125I粒子植入联合内分泌治疗两种方案的临床治疗效果和生化无进展生存率,进而为老年前列腺癌患者的治疗提供临床研究证据.

Objective To investigate the efficacy and safety of intravesical instillation with Sufuning (SFN) lotion for prevention of postoperative recurrence of bladder cancer. Methods A total of 240 bladder cancer patients who were diagnosed as bladder cancer and accepted trans-urethral resection of bladder tumor from January 2010 to June 2016 in Shanxi Provincial Cancer Hospital were randomly divided into the experimental group (120 cases) and the control group (120 cases) according to the envelope method. The patients in the experimental group were treated with SFN lotion for immediate intravesical instillation(250 mg for once), and the patients in the control group were treated with pirarubicin (THP) for immediate intravesical instillation (30 mg for once). The patients of two groups were treated with intravesical chemotherapy once a week for 8 times, and the chemotherapy was performed once a month for 1 year. The recurrence rate, progression-free survival (PFS) rate, overall survival (OS) rate and recent side effects were compared between the two groups. Results The patients were followed up for 6 to 60 months. The median follow-up time was 36.5 months.In the experimental group,6 patients were lost and 8 patients were lost in the control group.The experimental group, the total recurrence rate was 26.3 % (30/114). The control group, the overall recurrence rate was 25.0 % (28/112) (χ2= 0.142, P = 0.781). Five years of PFS rate in the experimental group and the control group was 73.7 % (84/114) and 75.0 % (84/112) respectively, and there was no significant difference between the two groups (χ2= 2.011, P= 0.615). Five years of OS rate in the experimental group and the control group was 95.6 % and 92.9 % respectively, and there was no significant difference between the two groups (χ 2= 1.611, P= 0.425). The major side effects included chemical cystitis and hematuria. The incidence of chemical cystitis and hematuria in the experimental group was significantly lower than that in the control group(χ2=5.991,P=0.018;χ2=4.925,P=0.036).There was a statistically significant difference of the hematological side effects (blood routine changes) between the two groups (χ 2= 4.891, P= 0.032). Conclusion It is safe and effective for intravesical instillation of SFN lotion to prevent the recurrence of bladder cancer.

Objective To evaluated the clinical efficacy of transurethral en bloc resection of bladder tumor with 2 μm laser in the high-risk elderly patients with bladder cancer under local anesthesia. Methods All of 64 high-risk elderly patients having underwent surgical treatment from April 2015 to October 2016 were divided into 2 groups,2 μm laser group(30 patients)and transurethral resection of bladder tumor(TURBT)group(34 group)according to surgical methods.The area and degree of pain was observed and recorded using visual analogue scales(VAS)during the 2 μm laser operation. The operation time,bladder irrigation time,catheter indwelling time,hospital stay,complications and 1-year cumulative recurrence rate were compared between 2 groups. Results The ASA grade in 2 μm laser group was higher than that in TURBT group and there was significant difference(P<0.05).During the 2 μm laser operation,the urethra pain was 53.33%(16/30),bladder pain was 20.00%(6/30), both urethra and bladder pain was 26.67%(8/30).The VAS scores were(2.50 ± 1.38)points,all the patients tolerated the pain in the 2 μm laser group.There was no significant difference in operation time between 2 groups(P>0.05).The bladder irrigation time,catheter indwelling time and hospital stay were shorter in 2 μm laser group than those in TURBT group:(40.00 ± 19.06)h vs.(56.47 ± 14.55)h,(4.33 ± 1.40)d vs. (5.65 ± 0.93) d,(4.13 ± 1.51) d vs. (6.24 ± 0.75) d,P<0.05 or<0.01. The overall incidence of complications was lower in 2 μm laser group than that in TURBT group:13.33%(4/30) vs. 64.71% (22/34),χ2=8.719,P=0.003.Compared with that of pre-treatment,the quality of life was higher after treatment in two groups,but there were no significant differences between the two groups.There were no significant differences in 1-year cumulative recurrence rate between the two groups after treatment (χ2= 0.496,P = 0.481). Conclusions Transurethral 2 μm laser treatment in bladder cancer under urethral surface anesthesia is safe and reliable for the high-risk elderly patients and complications are fewer than TURBT.The recent curative effect is satisfied.

This study aimed to investigate whether lidocaine, alone or in combination with other chemotherapeutic agents, inhibits the growth of human bladder cancer cells in vitro and orthotopically transplanted bladder tumors in vivo. The effects of lidocaine (1.25, 2.5 or 5 mg/mL), mitomycin C (MMC, 0.66 mg/mL), pirarubicin (0.75 mg/mL) and Su Fu’ning lotion (SFN, 0.0625 mg/mL) on the proliferation of human bladder cancer (BIU-87) cells were studied using the MTT assay. A Balb/c nude mouse model of bladder cancer was developed by orthotopic transplantation of BIU-87 cells, and the effects of intravesical instillation of lidocaine and MMC on bladder wet weight (a measure of tumor size) and survival (over 60 days) were studied. Lidocaine inhibited proliferation of BIU-87 cells in a concentration-dependent manner and (when given in combination) enhanced the actions of each of the other antiproliferative agents. In tumor-bearing mice, MMC alone had no effect on mean survival or bladder wet weight. However, the combination of 0.66 mg/mL MMC and 5 mg/mL lidocaine prolonged survival (from 34.62 ± 6.49 to 49.30 ± 6.72 days; n = 8, P < 0.05) and reduced bladder wet weight (from 68.94 ± 53.61 to 20.26 ± 6.07; n = 8, P < 0.05). Intravesical instillation of lidocaine combined with other chemotherapeutic agents potentially could be an effective therapy for bladder cancer.

Objective To evaluate the efficacy of preoperative and postoperative intravesical instillation of pirarubicin for the prevention of postoperative recurrence of non-muscle invasive bladder cancer (NMIBC). Methods From September 2012 to March 2014, 120 patients who were diagnosed as NMIBC and accepted trans-urethral resection of bladder tumor (TUR-Bt) were collected and randomly divided into two groups, including treatment group (60 cases) and control group (60 cases). 30 minutes before the operation, instillation of pirarubicin (40 mg) was performed in the treatment group, then pirarubicin perfusion was given within 24 h after operation, once a week for 8 weeks, and once a month for 10 months after operation. In control group, instillation of pirarubicin (40 mg) was given within 24 h after operation, and other treatments were the same as the treatment group. The differences of lesion detection probability, the 2-year recurrent rate and the adverse reaction rate were compared between the two groups. Results The lesion detection rates were 42.70 % (38/89) and 1.85 % (2/108) in the treatment group and control group, respectively (χ2=50.303, P<0.05). 119 patients were follow-up for 24 months. The 2-year recurrence rates were 8.47%(5/59), 21.67% (13/60) in treatment group and control group respectively (χ2= 4.033, P< 0.05). The adverse reactions mainly included hematuria (3 cases in treatment group, 3 cases in control group), urinary tract irritation (3 cases in treatment group, 2 cases in control group) and urethral stricture (1 case in treatment group, 1 case in control group). The difference of the adverse reaction incidence between the two groups was not significant statistically [11.86 % (7/59) vs. 10.00 (6/60), χ 2 = 0.106, P > 0.05]. Conclusions The preoperational intravesical instillation of pirarubicin can fix and diagnose malignant lesions in the bladder without adverse reactions, which will improve the rate of tumor resection and prevent postoperative recurrence of tumors.

Objective To investigate the efficacy of 125I radioactive particle implantation combined with surgery and chemotherapy in the treatment of locally advanced urinary tract urothelial carcinoma (UTUC).Methods The clinical data of 128 patients of locally advanced (T3,T4) UTUC treated with surgery with radioactive particle implantation plus postoperative GC chemotherapy (experimental group) and surgery plus postoperative GC chemotherapy (control group) were retrospectively analyzed.All the patients underwent complete resection of the tumor.The postoperative pathology was urinary tract epithelium cancer.In the experimental group,there were 45 (69.2％) males and 20 (30.8％) females,with median age 56.5 years.There were 39 (60.0％) patients diagnosed with renal pelvic cancer,including 13 (33.3 ％) patients with local lymph node metastasis;26 patients (40.0％) with ureteral cancer,11 patients (42.3％) with local lymph node metastasis.In the control group,there were 46 males (73.0％) and 17 females (27.0％),with median age 57.1 years.There were 40 (63.5％) patients with renal pelvic cancer,including 12 (30％) cases of local lymph node metastasis;23 patients with ureteral carcinoma (36.5％),including 10 patients (43.4％) with local lymph node metastasis.There was no significant difference in basehne data between the two groups (P ＞ 0.05).The recurrence and distant metastasis,recurrence-free survival,distant disease free survival(DDFS),disease-specific survival(DSS),overall survival (OS) and comphcations of two groups were compared.Results The follow-up time was 50.5 months (ranged 5 to 62 months).In experimental group,there were 2 cases,5 cases,11 cases,16 cases and 21 cases occurred recurrence and distant metastasis in 6 months,1 year,2 years,3 years and 5 years respectively,and the 5-year cumulative recurrence and distant rate was 32.3％ (21/65).In control group,there were 3 cases,5 cases,17 cases,21 cases and 32 cases,occurred recurrence and distant metastasis in 6 months,1 year,2year,3 year,5 year respectively,and the 5-year cumulative recurrence and distant rate was 50.8％(32/63).There was significant difference between the two groups (P =0.034).In the experimental group and the control group,the 5-year non-metastatic survival rates were 61.5％ (40/65)and 41.3％ (26/63),respectively.There was significant difference in 5-year non-metastatic survival rate between the two groups (P =0.033).The 5-year DSS rates were 69.2％ (45/65) and 50.8％ (32/63),respectively.The 5-year DSS rate of the two groups was significantly different (P =0.033).The 5-year OS rates were 53.8％ (35/65) and 36.5％ (23/63) respectively.There was significant difference in the 5-year OS rate between the two groups (P =0.049).Condusions Compared with surgery and chemotherapy,the use of 125I radioactive particle implantation combined with surgery and chemotherapy in the treatment of locally advanced stage (T3-T4) UTUC could achieve the total survival benefit,and less adverse reactions.

Objective To investigate the safety and feasibility of barbed absorbable suture line in retroperitoneoscopic partial nephrectomy. Methods 45 patients who were suitable for retroperitoneoscopic partial nephrectomy from February 2013 to February 2014 were collected and randomly divided into V-Loc group and the control group. 23 cases of V-Loc barbed absorbable suture line were chosen by suture kidney in V-Loc group.There were 22 cases of coated vicryl plus antibacterial suture and Hem-o-lok clip in the control group. The differences of operative time, blood loss, warm ischemia time, suture time, hospital stay and suture material costs were compared respectively between the two groups. Results All 45 cases of retroperitoneoscopic partial nephrectomy were successfully performed, without conversion to open surgery and important intraoperative complications. Postoperative pathology report showed that there were 37 cases with renal clear cell carcinoma, 3 cases with papillary renal cell carcinoma, 2 cases with chromophobe renal cell carcinoma with negative surgical margin, 3 cases with renal angiomyolipomas. In the V-Loc group and the control group, the average operative time were (90.8±9.6) and (96.9±9.1) min (P>0.05), the mean blood loss were (80.4±24.2) and (99.5±24.8) ml (P>0.05), the mean warm ischemia time were (21.5±3.4) and (25.3±1.9) min (P<0.05), suture time were (10.8±1.7) and (16.8±3.1) min (P<0.05), respectively, postoperative hospital stay were (5.7±1.7) and (7.1±1.9) d (P>0.05), the average cost of renal parenchymal suture material were (1 215.5±101.4) and (2 073.5±301.8) yuan (P<0.05). The warm ischemia time,suture time and suture material costs in the V-Loc group were significantly lower than those in the control group (all P<0.05). Conclusion The application of barbed absorbable suture line in retroperitoneoscopic partial nephrectomy can shorten warm ischemia time and suture time, and save hospitalization costs, with favorable safety and feasibility.

Objective:To discuss the diagnosis and treatment of primary urothelial carcinoma of the prostate by analysis of two cases.Methods:Case 1:A 76-year-old man was admitted with dysuresia for 3 months,and was taken with transurethral resection of the prostate(TURP).Case 2:A 77-year-old man who has been taken with TURP 2 months before was admitted with dysuresia for 2 weeks,and was managed with transurethral re-section of the prostate too.Results:case 1 was managed with TURP and interventional therapy because of recurrence after a year too.He was taken TURP after 4 months because of recurrence,and was managed with radiotherapy after 8 months as the same reason too,and died after 13 months. Case 2 recrudescent was managed with TURP.A lot of cancerous nodus was found in the capsula prostatica on operation.His dysuresia was improved. He was changed to the department of therapeutic radiology and accepted to further treat with.Conclusion:Primary urothelial carcinoma of the prostate is a rare disease.transurethral resection of the prostate can not improve the prognosis.

Objective To study the diagonsis value of urinary tissue polypeptide-specific anti-gen (TPS),nuclear matrix protein 22 (NMP22 ),CYFRA21-1 and carbohydrate antigen 1 9-9 (CA1 9-9)in urothelial carcinoma of renal pelvis. Methods The study was a retrospective analysis with clinical data of cases of urothelial carcinoma of renal pelvis in Shanxi Provincial Tumor Hospital from 2010 January to 201 5 December,including 238 urine samples from 63 cases with urothelial car-cinoma of the renal pelvis (group A),46 cases with urothelial carcinoma of the urinary bladder (group B),62 cases with other urological diseases (group C),47 cases with no recurrence after radi-cal resection from the renal pelvis group for at least 2 years (group D),20 volunteers from our hos-pital (group E).Voided urine samples were collected before cystoscopies or surgeries.NMP22, TPS,CYFRA21-1,CA1 9-9 were measured by chemiluminescent immunoassays.We evaluated their concentration of urine and draw receiver operating characteristic cutoffs curves,and calulated the are-as under the ROC curves for further statistical analysis.Results The urine concentration of NMP22 in group A was higher than that in group B,the difference was statistically significant (P =0.001).&nbsp;There was no significant difference in the urine concentrations of TPS,CYFRA21-1 and CA1 9-9 between group A and group B (P >0.05).The urine concentrations of CA1 9-9,NMP22,CYFRA21-1 and TPS in group A were higher than that in group C, group D and group E,and the differences were statistically significant (P <0.05).The urine concentrations of NMP22,TPS, CYFRA21-1 and CA1 9-9 in group B were higher than those in group C,group D and group E,and there were significant differ-ences (P <0.05).There was no significant difference in the urine concentrations of NMP22,TPS,CYFRA21-1 and CA1 9-9 a-mong the group C,group D and group E (P >0.05).The urine concentrations of NMP22,TPS,CYFRA21-1,CA1 9-9 in the group A were not statistically significant (P >0.05)between group of different pathological grades,clinical stages,tumor size, and whether there was hydronephrosis or not.The diagnostic accuracy of NMP22,TPS,CYFRA21-1 and CA1 9-9 were higher than that of urine cytology in group A by paired sample McNemar tests,and the differences were statistically significant (P <0.05).The areas under the ROC curves of the four tumor markers were all in 0.7-0.9,and the diagnostic efficacies were moder-ate,with the highest one was the combination of NMP22 and CYFRA21-1,which was 0.884. Conclusions NMP22,TPS, CYFRA21-1,CA1 9-9 in urine have moderate diagnostic value for patients with urothelial carcinoma of the renal pelvis.Howev-er more study should be performed for their value for prediction of tumor stage,and pathological classification,and prognosis.

目的:评价TURBt联合术前髂内动脉化疗栓塞术治疗直径≥3 cm的肌层浸润性膀胱癌的临床效果.方法:将45例直径≥3 cm的肌层浸润性膀胱癌患者(分期:T2-3N0M0)分为A、B两组,A组23例,单纯行TURBt,B组22例,行TURBt联合术前髂内动脉化疗栓塞.统计分析比较两组手术时间、出血量、生存率、复发率、不良反应发生率,并绘制生存曲线及复发率曲线.结果:A组手术时间为(61.2±8.3)min,出血量(55.8±3.7)ml,B组手术时间为(30±8.4)min,出血量(20.3±5.4)ml,两组比较差异有统计学意义(P＜0.05).3年生存率,A组为86.36％,B组为95.00％,两组比较差异无统计学意义(P＞0.05).3年复发率,A组为54.55％,B组为45％,两组比较差异有统计学意义(P＜0.05).两组不良反应发生率比较差异无统计学意义(P＞0.05).结论:TURBt术前髂内动脉化疗栓塞治疗直径≥3 cm的肌层浸润性膀胱癌有效降低了手术难度及术后复发率,近期效果满意.

Objective To evaluate the efficacy and feasibility of 125I radioactive seed interstitial implantation for the local advanced urinary tract epithelial carcinoma without total resection.Methods The clinical data of 21 patients with local advanced urothelial carcinoma without completely surgical resection who were treated by 125I radioactive particles implantation were retrospectively analyzed.The patients were divided into two groups and received preoperative plan.In group A, 14 patients received implants during operations, including 7 bladder transitional cell carcinoma patients who underwent a transurethral resection surgery or partial bladder resection and another 7 ureteral carcinoma cases who underwent semi urine road resection.After these operations, all of patients had tumor residues.After furthest resection of the tumor, the 125I seeds were implanted at the residual suspicious tumors and their surroundings.In group B, 7 patients were implanted under the guidance of color ultrasound or CT.According to the evaluation criteria of solid tumor in 2009, the tumor remission rate, survival rate, distribution and the mobile information of the particles were observed.Results The operations were successfully completed in all of 21 patients, and serious complications did not appear during the operation.Particle distribution and lesions were basic coincidence.A total of 2 particles displaced, but every patient had no adverse reactions.There were 2 patients with local fever after operation within 4 months, while the rest of patients had no adverse reactions.After median follow-up for 36 months (3-75 months) , the 1-year survival rate was 100.0 ％ (21/21), the 2-year survival rate was 90.5 ％ (19/21), and the 3-year survival rate was 61.9 ％ (13/21).The tumor remission rate of group A was 85.7 ％ (12/14) after 6-9 months, and was 42.9 ％ (6/14) after 12 months.The bladder was preserved in 7 cases with bladder tumors with the 2-year survival rate of 100.0 ％ (7/7) and the 5-year survival rate of 71.4 ％ (5/7).The tumor remission rate of group B after 6-9 months was 71.4 ％ (5/7), and was 42.9 ％ (3/7) after 12 months.Conclusion 125I seed implantation is a good choice for locally advanced urothelial carcinoma with high local tumor control rate, which is expected to be applied in the individual treatment of advanced urothelial cancer.

目的 评价舒尼替尼一线治疗转移性肾癌的疗效、安全性,并探讨其对不同转移灶的疗效.方法 2008年12月至2011年7月经病理确诊为转移性肾透明细胞癌的38例患者接受舒尼替尼治疗,男25例,女13例,中位年龄57(32～74)岁.曾行原发肿瘤姑息性切除术35例,行彩超引导下肿瘤穿刺活检术3例,组织学类型均为肾透明细胞癌.治疗方案为舒尼替尼50 mg/d,4/2方案34例,37.5 mg/d,持续口服方案4例.结果 中位随访时间13(3～34)月.36例患者治疗2周期以上,可进行疗效评估.根据标准进行疗效评价显示部分缓解(PR)6例(16.7％),疾病稳定(SD)28例(77.8％),疾病进展(PD)2例(5.6％),其中死亡1例.全组客观反应率16.7％(6/36),疾病控制率94.4％(34/36).主要不良反应包括乏力11例(30.6％)、脱发3例(8.3％)、血小板减少21例(58.3％)、甲状腺功能异常26例(72.2％)、白细胞减少20例(55.6％)、高血压16例(44.4％)、手足反应10例(27.8％)、腹泻4例(11.1％)等.大多数不良反应为1～2级,3级以上不良反应包括血小板降低2例(5.6％)和水肿1例(2.8％)等.13例(36.1％)患者在治疗过程中减量或停药,停药时间均小于2周.通过对症支持,减量或停药,不良反应可控制并耐受.缓解病例多为局部复发及肺转移病灶,进展病例为骨、肝、脑转移病灶.结论 舒尼替尼一线治疗晚期转移性肾透明细胞癌可取得较高的疾病控制率,不良反应可控、可逆,并且其对不同器官组织转移灶的疗效可能存在一定的差异.

Objective To study the expression of matrix metalloproteinases 9 (MMP-9) in bladder cancer and its clinical significance. Methods Meta analysis of relative literatures published In domestic Chinese journals from 1998 to 2014 ,bladder cancer tissues as cases, normal bladder mucous membrane tissues as control group;Odds ratio (OR) as the effect index. Then apply RevMan 5.2 software to statistical data , calculate merger OR values and 95%confidence interval, and draw the forest map of Meta analysis. Results 12 studies involving 792 patients that met the inclusion criteria, were included in the Meta analysis. OR values in bladder cancer tissue and normal bladder tissue group, superficial bladder cancer group and invasive bladder cancer group, low grade bladder cancer group and senior grade bladder cancer group were 58.99,0.17,0.29. The positive rate of MMP-9 in bladder cancer group were significantly higher than that in normal bladder tissue group, in invasive bladder cancer group were significantly higher than that of superficial bladder cancer group, in senior grade bladder cancer group were significantly higher than the low grade bladder cancer group. Conclusion The high expression of MMP-9 have a role in in bladder cancer occurrence and development; to detect the expression of MMP-9 contributes to the understanding of the biology of bladder cancer, and provide information for clinical treatment and prognosis.

Objective To study the expression and clinical significance of matrix metalloproteinase 2 (MMP-2) in chinese patients with bladder cancer. Methods The relevant original articles published in journals from 1998 to 2014 were selected. The ratio of the case group and the control group (OR value) regarded as an effect index. Then the original data were analyzed using Meta analysis software RevMan 5.0, the combined OR values and 95%confidence interval were calculated, and the forest map was draw. Results 13 studies involving 692 patients that met the inclusion criteria were included in the Meta analysis. The OR values of bladder cancer tissue group and normal bladder tissue group, superficial bladder cancer group and invasive bladder cancer group, and low grade bladder cancer group and senior bladder cancer group were 45.83, 0.22 and 0.31, respectively. The positive rates of MMP-2 in bladder cancer tissue group, invasive bladder cancer group and advanced bladder cancer group were significantly higher than those in normal bladder tissue group, superficial bladder cancer group and low grade bladder cancer group (all P< 0.05). Conclusions The high expression of MMP-2 has a certain effect in bladder cancer. The detection of MMP-2 contributes to the understanding of the biology of bladder cancer, and provides information for clinical treatment and prognosis.

目的:探讨前列腺平滑肌肉瘤的临床诊治和预后特点.方法:汇报1例39岁前列腺平滑肌肉瘤患者,以“进行性排尿困难2个月余,不能自主排尿15天”入院.超声检查提示:考虑为脓肿可能;前列腺MRI检查提示:前列腺异常信号,考虑为占位病变;膀胱镜检查示:前列腺不规则增生.于2013年3月18日在腰硬联合麻醉下行“经尿道前列腺诊断性电切术”,手术顺利.查阅相关文献复习讨论.结果:病理报告示:组织呈灰白、灰红色,HE染色可见短梭形细胞、核大小差异较大,细胞丰富、密集、呈浸润性生长、核异型性明显、可见核分裂象;免疫组化示:Vimentin(+++)、Desmin(+)、SMA(+)、Caldesmon(+++),病理诊断:低分化平滑肌肉瘤.结论:前列腺平滑肌肉瘤是一种罕见的前列腺肿瘤,其发病机制目前还不清楚,临床诊断常较为困难,确诊需依靠病理学组织学及免疫组化染色检查.治疗以手术切除联合放化疗为主,但其病情进展迅速,预后不佳.

Objective To systematically evaluate the efficacy and safety of solifenacin versus tolterodine, for treatment of overactive bladder (OAB). Methods Chinese and English literatures of randomized controlled trials us-ing solifenacin versus tolterodine for treatment of OAB were collected, and the references included in the literatures were searched. Statistical software, RevMan 5.0 was used for the meta-analysis. Results Eight studies, involving a to-tal sample size of 832 cases, were included for the meta-analysis, with the same examined baseline. By comparing five common parameters and adverse reactions after medication, meta-analysis found that there were no statistical differ-ences in improving OAB daily frequency of urgent urination, urinary incontinence, and nocturia between using solife-nacin and tolterodine. However, the effect of using solifenacin in improving daily frequency of urination and micturi-tion volume per voiding were better than those of using tolterodine, with statistically significant differences ( P<0.05). For adverse reactions, the dry mouth incidence of using solifenacin was 50%lower than that of using tolterodine, with statistically significant difference (P<0.05). There were no statistical differences in constipation, blurred vision, and dyspepsia between using solifenacin and tolterodine. Conclusion Both of solifenacin and tolterodine can improve symptoms of OAB, whereas the effects of using solifenacin in improving daily frequency of urination, micturition vol-ume per voiding, and dry mouth are better than those of using tolterodine. As the included literatures and sample size were limited, large sample size and long-term follow-up of high-quality clinical trial can provide better evidence-based findings.