Systemic administration of platinum-based drugs has obvious limitations in the treatment of advanced bladder cancer (BC) owing to lower tumor accumulation and uncontrolled release of chemotherapeutics. There is an urgent need for advanced strategies to overcome the current limitations of platinum-based chemotherapy, to achieve maximal therapeutic outcomes with reduced side effects. In this study, self-polymerized platinum (II)-polydopamine nanocomplexes (PtPDs) were tailored for efficient chemo-photoimmunotherapy of BC. PtPDs with high Pt loading content (11.3%) were degradable under the combination of a reductive tumor microenvironment and near-infrared (NIR) light irradiation, thus controlling the release of Pt ions to achieve efficient chemotherapy. In addition, polydopamine promoted stronger photothermal effects to supplement platinum-based chemotherapy. Consequently, PtPDs provided effective chemo-photothermal therapy of MB49 BC in vitro and in vivo, strengthening the immunogenic cell death (ICD) effect and robust anti-tumoral immunity response. When combined with a PD-1 checkpoint blockade, PtPD-based photochemotherapy evoked systemic immune responses that completely suppressed primary and distant tumor growth without inducing systemic toxicities. Our work provides a highly versatile approach through metal-dopamine self-polymerization for the precise delivery of metal-based chemotherapeutic drugs, and may serve as a promising nanomedicine for efficient and safe platinum-based chemotherapy for BC.

目的:探讨浸润性膀胱癌(invasive bladder cancer,IBC)分子分型与预后的关系以及PD-L1在不同分子分型中的表达情况.方法:回顾性分析2016年1月—2018年12月内蒙古医科大学附属医院122例IBC患者的临床资料并进行了随访;采用免疫组织化学方法检测CK14、CK20在IBC中的表达,将IBC分为基底型(CK14+,CK20-)、管腔型(CK14-,CK20+)和双阴型(CK14—,CK20-)三种分子亚型;比较三组患者的临床病理特征;比较不同分子分型膀胱癌患者的生存率;分析PD-L1的表达与分子亚型的相关性.结果:122例患者中,基底型43例,管腔型56例,双阴型23例;与管腔型肿瘤比较,基底型和双阴型肿瘤的病理分期多在T2期以上;与管腔型、双阴型肿瘤患者比较,基底型肿瘤患者更易发生远处转移;管腔型膀胱癌患者的生存率显著高于基底型和双阴型膀胱癌患者(P＜0.05);与管腔型和双阴型比较,PD-L1在基底型IBC中高表达(P＜0.05).结论:与管腔型肿瘤患者比较,基底型和双阴型肿瘤患者预后较差;与管腔型和双阴型肿瘤相比,PD-L1在基底型肿瘤中高表达;提示PD-L1可能成为该型患者潜在的免疫治疗靶点.

目的 研究miRNA-196 a在膀胱癌中的表达与功能.方法 采用了实时定性的PCR方法,计算并比较了miRNA-196 a在膀胱癌细胞株(T24)和正常人膀胱细胞株(SV-HUC-1)中的表现.将miR-196 a模拟物、miR-196 a抑制剂以及阴性的对照物miRNA质粒经转染膀胱癌细胞系(T24)后,观察到癌基因(bcl2、e2 f3、cdk4、cdk6)的mRNA的表达状况.结果 miRNA-196 a在膀胱癌细胞系(T24)中的表达显著高于正常膀胱细胞(P<0.05),而转染miRNA-196 a模拟物的T24细胞中几种癌基因(bcl2、e2 f3、cdk4、cdk6)的mRNA表达显著高于阴性对照组和转染miR-196 a抑制剂的T24细胞(P<0.05).结论 由于MiRNA-196 a在膀胱癌中的高度表达,能够通过控制多种癌基因的表达从而在膀胱癌的发病及进展过程中发挥重要作用.

间充质干细胞可通过多种趋化因子被募集至前列腺癌组织中,是肿瘤微环境中重要的组成部分,通过多种信号通路的信号传导促进前列腺癌的发生发展,而前列腺癌细胞也可促进间充质干细胞的增殖并诱导其功能改变.阻断间充质干细胞与前列腺癌之间信号传导的关键信号分子或阻断间充质干细胞向前列腺癌的募集可能成为治疗前列腺癌的新方法 .近年来,研究者利用间充质干细胞向前列腺癌募集及其免疫抑制的特性,将间充质干细胞或其外泌体作为载体,从而精准地将治疗药物或治疗基因运送至前列腺癌组织中,为前列腺癌的治疗带来了新的见解.本文就间充质干细胞与前列腺癌发生发展的关系及间充质干细胞在前列腺癌治疗中的作用进行综述,以期为前列腺癌的治疗提供参考.

前列腺癌患者的预后与其被诊断的时间密切相关,虽然当前临床上已找到众多用于前列腺癌(PCa)早期诊断的各种分子标志物,但在使用时都会出现各自的局限性.前列腺癌在预防、诊断等方面仍然面临着许多不足,提高诊断效率、防止过度治疗依然为治疗前列腺癌的关键.本文介绍了前列腺癌在早期诊断中所面临的问题并对其进行分析,现就常见的前列腺癌实验室指标及筛查体系进行综述,为指导前列腺癌的早期诊断提供一定的科学理论依据.

目的 探讨超声造影对前列腺脓肿(PA)的诊断价值,总结PA超声造影的声像图特点.方法 回顾分析15例PA患者的27个病灶的超声造影资料,总结前列腺脓肿造影声像图特征.结果 15例患者中有7例病灶数目≥2个,8例患者为单发病灶;27个病灶造影后均表现为病灶壁快速环状增强及内部呈"空洞征",其中25个病灶表现为厚壁,9个病灶内见分隔;病灶壁的开始增强时间、达峰时间均早于周围正常前列腺组织,差异有统计学意义(P＜0.05),而脓肿壁的廓清时间与周围前列腺组织差异无统计学意义(P＞0.05).结论 PA典型超声造影表现为病灶厚壁且快速环状增强,内部呈"空洞征",经直肠腔内超声造影可以准确诊断PA.

研究表明,人类基因组中某些特定的非蛋白质编码区(Non-coding region)与肿瘤的发生、发展密切相关,其中最丰富的一类就是长链非编码RNA(lncRNA),它们与前列腺癌(PCa)的关系得到了越来越多的关注.本文对lncRNA PCa3、PCGEM1、SChLAP1、GAS5、PCAT1、MEG3在前列腺癌发生、发展中的功能和作用机制进行综述,并对lncRNA在前列腺癌早期诊断、预后及靶向治疗中的应用进行了展望.

长链非编码RNA是一种长度超过200个核苷酸RNA转录本,在生物体内起着重要的作用,参与转录前调控、转录调控及转录后调控等重要的细胞事件.本文将阐述lncRNA的功能、与肿瘤细胞的关系及与转移器官的关系,为进一步探索lncRNA在肿瘤中的作用提供基本资料.

肾细胞癌是泌尿系常见的恶性肿瘤,由于缺乏早期临床表现及特异性的肿瘤标志物,患者发现时常已发生局部进展或远处转移,错过治疗的机会,预后极差.为了深入了解长链非编码RNA(lncRNA)作为肾癌标志物的潜力,以期为肾癌的诊断及治疗提供新思路,本研究就目前肾癌肿瘤标志物在lncRNA领域的研究进展进行相关综述.

Objective To explore the effectiveness and safety of transurethral plasmakinetic resection of prostate(PKRP)and transure-thral plasmakinetic enucleation of prostate(PKEP)in treatment of benign prostatic hyperplasia. Methods A total of 60 patients with standard benign prostate hyperplasia(BPH)were randomly divided into two groups,30 cases in group A were applied with PKRP,and 30 cases in group B were applied with PKEP. The preoperative,intraoperative and postoperative parameters were compared between these 2 groups and followed - up for 3 months for statistical analysis. Results The conditions of patients in these 2 groups were generally similar,and the differnce was not statisti-cally significant( P > 0. 05). The difference in operating time,convertion to open surgery,transfusion for intraoperative blood loss,TURS,inci-dence of urinary incontinence,urinary tube replacement and urethral stricture between these 2 groups was not statistically significant( P > 0. 05). The bladder douche time,catheter indwelling time,postoperative hospitalization time in PKEP group were shorter than those of PKRP group( P <0. 05). The weight of resected specimens in PKEP group was greater than that of PKRP group( P < 0. 05). The incidence rates of capsular perfo-ration and bladder injury and postoperative bladder irritation in PKEP group were lower than those of PKRP group( P < 0. 05). The difference in Qmax,IPSS,QQL and PRV between these 2 groups in postoperative follow - up period of 3 months was not statisticallysignificant( P > 0. 05). Conclusion The application of PKRP or PKEP in treatment of BPH is safe and effective. The operating time,efficiency and duration for postoper-ative rehabilitation of PKEP are more efficient and shorter than those of PKRP.

目的 评价经尿道前列腺等离子剜除术(PKERP)与经尿道前列腺等离子电切术(PKRP)对前列腺增生患者术后性功能的影响.方法 搜索CNKI、万方及维普等中文数据库,以Meta分析法比较两种术式对前列腺增生患者术后性功能的影响.结果 纳入11篇文献,共1 189名患者.Meta分析结果提示:PKERP 与 PKRP 相比,PKERP术后ⅡEF-5评分高[SMD=1.109,95％CI (0.285,1.932),P=0.008]、逆行射精少[OR=0.516,95％ CI(0.317,0.838),P=0.007]、勃起功能障碍少[OR=0.592,95％CI (0.432,0.811),P=0.001].结论 与PKRP相比,PKERP能明显降低术后逆行射精、勃起功能障碍,并能提升ⅡEF-5评分.

Objective To discuss the expression levels and clinical significance of serum procalcitonin (PCT ) ,high sensitive C reactive protein (hs‐CRP) and interleukin‐6 (IL‐6) in patients with early burn associated septic disease .Methods The clinical data of 206 cases of patients with early burn treated in our hospital were retrospectively analyzed ,61 cases of them associated with sepsis patients as research group A ,the remaining 145 cases without sepsis patients as research group B .Another 76 cases of healthy vol‐unteers at the same age who underwent physical examination during the same period were selected as the control group .The serum levels of PCT ,hs‐CRP and IL‐6 were detected and compared in 3 groups ,and the differences of levels in different severity of sepsis were analyzed ,then the serum levels of different prognosis subgroups in the research group A were compared and researched .Re‐sults The differences were significant in the serum PCT ,hs‐CRP and IL‐6 levels among the 3 groups(P<0 .05) ,and the differ‐ences were also significant between each two groups (P<0 .05) .There were significant differences in the serum PCT ,hs‐CRP and IL‐6 levels among the three subgroups of sepsis ,severe sepsis and septic shock(P<0 .05) ,and the differences were significant be‐tween each two subgroups(P<0 .05) .The serum PCT ,hs‐CRP and IL‐6 levels in the good prognosis group were obviously lower than those in the poor prognosis group(P<0 .05) .Conclusion The serum PCT ,hs‐CRP and IL‐6 levels are abnormally increased in patients with early burn associated septic disease ,and the more serious illness ,the more significant increase degrees ,which has guid‐ing significance to the clinical treatment .

Stem cells are defined as cells that have the ability to self renew and differentiate themselves, so they rep-resent a great potential in the medical profession. Historically, stem cells have been divided into embryonic stem cells (ESC) and adult stem cells (ASC). Previously only that embryonic stem cells can maintain the ability to differentiate in-to any cell type, but only ASC has certain ability of embryonic cells. Recently, however, a large number of studies show that adult stem cells have the ability beyond its histogenesis. In this article, we list the use of bone marrow-derived stem cells and adipose tissue-derived stem cells in the treatment of erectile dysfunction in clinical trials, they reviewed one by one.

目的:探讨传统开放术式与微创后腹腔镜术式治疗肾上腺良性肿瘤近远期疗效及安全性的差异.方法:研究对象选取我院2012年1月～2015年5月收治肾上腺良性肿瘤患者共130例,采用随机区组法分为开放组(65例)和微创组(65例),分别采用传统开放术式与微创后腹腔镜术式治疗;比较两组患者围手术期临床指标、症状改善率及围手术期并发症发生率等.结果:微创组患者手术时间、术中出血量、术后首次排气时间、术后引流量、术后拔管时间及住院时间均显著优于开放组,差异有统计学意义(P＜0.05);两组患者ICU转入率比较差异无统计学意义(P＞0.05);两组患者症状改善率比较差异无统计学意义(P＞0.05);微创组患者围手术期并发症发生率均显著低于开放组,差异有统计学意义(P＜0.05).结论:相较于传统开放术式,微创后腹腔镜术式治疗肾上腺良性肿瘤可有效减轻术中创伤程度,加快术后康复进程,并有助于降低围手术期并发症发生风险.

目的 探讨缺氧诱导因子HIF-2α在前列腺癌中的表达及临床意义.方法 采用免疫组化法检测HIF-2α在前列腺癌组织中的表达,并评价HIF-2 α表达与临床病理及临床分期特征的关系以及HIF-2 α与血管内皮生长因子(VEGF)的相关性.结果 HIF-2 α在前列腺癌各病理分级的阳性表达率分别为高分化57.1％,中分化63.2％,低分化91.7％,高、中、低分化比较,差异有统计学意义,P＜ 0.05;临床分析方面,A+B期60.7％,C+D期82.4％,二者间比较,差异有统计学意义,P＜ 0.05.VEGF在前列腺癌各病理分级的阳性表达率分别为高分化42.9％,中分化68.4％,低分化75.0％,高、中、低分化比较,差异有统计学意义,P＜ 0.05;临床分析方面,A+B期53.6％,C+D期76.5％,二者间比较,差异有统计学意义,P＜ 0.05.HIF-2 α与VEGF表达呈正相关,r=0.258,P＜0.05.结论 HIF-2 α在前列腺肿瘤发生、发展中具有重要作用,对于前列腺癌病情的诊断和治疗具有重要临床意义.

Objective To discuss the significance of the application of neutrophil to lymphocyte ratio (NLR)combined with prostate specific antigen (PSA)in early diagnosis of prostate carcinoma.Methods 120 cases with surgery treatment of prostate carcinoma were selected as study group,and 120 healthy people were selected as control groups.The NLR and PSA were tested to diagnose the prostate carcinoma.The critical value of NLR in diagnosing prostate carcinoma was evaluated by ROC curves,and the advantages of combination of NLR and PSA were judged. Results By using ROC curves to evaluate the NLR in diagnosis,the critical value was 2.75.The susceptibility, specificity,Youden index,correct index were 0.79,0.85,0.65,0.72.The susceptibility,specificity,positive predictive value,negative predictive value,correct index of NLR combined with PSA in diagnosing the prostate carcinoma were 0.85,0.83,5.00,0.18,0.68.Conclusion The application of NLR has higher susceptibility and specificity to diagnose prostate carcinoma.NLR combined with PSA can improve the susceptibility and specificity of early diagnosis of prostate carcinoma.

Cell-based therapy and regenerative medicine offer a paradigm shift in regard to various diseases causing tissue or organ damage.Recently,many authors have focused their atte(n)tion on adipose-derived mesenchymal stem cells (ADMSCs) for their capacity to differentiate into many cell lineages.Acute kidney injury (AKI),as a common emergency,has high morbidity rate and relatively limited treatment.This review will summarize the mechanism of ADMSCs in treatment of acute kidney injury,and hope to lay a foundation for future research.

目的：探讨经皮肾镜及输尿管镜碎石取石术治疗肾及输尿管结石的手术疗效及安全性。方法：回顾性分析2011-07~2013-06经皮肾镜及输尿管镜碎石取石术治疗肾及输尿管结石63例病人的临床资料。结果：59例病人一期手术取得成功,结石取尽率(59/63)93.7%,手术时间30~100 min,平均45 min,1例输尿管结石因组织包裹转为开放手术取石,1例术后复查示结石残留行体外冲击波碎石,2例因残留的结石均<6 mm予以药物排石治疗。病人平均住院时间为7.5 d。1例病人术后出现菌血症,1例发生轻度肾周血肿,无其它严重并发症。结论：经皮肾镜及输尿管镜碎石取石术治疗肾及输尿管结石具有创伤小、碎石成功率高、并发症少的优点,是一种安全有效的方法。

AIM:Myeloid-derived suppressor cells (MDSCs) are a population of cells which negatively regulate immune response during tumor progression. In this study, we assessed the accumulation of MDSCs (CD33(+)CD11b(+)HLA-DR(-)CD14(-)) in patients with prostate cancer and its clinical relevance.METHODS:We tested the frequency of MDSCs in the peripheral blood of patients with prostate cancer or benign prostate hyperplasia and healthy donors. Serumal interleukin-8, -6 and -10 were analyzed. Effects of MDSCs on the T cell response were determined.RESULTS:MDSCs increased in cancer patients, and there was an association between MDSCs and cancer stages or overall survival. Elevated serumal interleukin-8 and -6 in cancer patients correlated with MDSCs. Moreover, accumulation of MDSCs was associated with defective T cell function.CONCLUSION:Our study showed an increased population of MDSCs in patients with prostate cancer. Interleukin-8 and -6 in serum may play a new important role companied with MDSCs in prostate cancer.

<正>泌尿外科腹腔镜基本技术在过去的几年里已经有了重大进步,使腹腔镜手术时间更短,也更安全。腹腔镜肾部分切除术作为一种有效治疗肾癌的手段,正逐渐取代开放性手术成为治疗早期肾癌的常规术式。2010年1月至2013年3月,我院采用腹腔镜技术治疗早期肾癌患者19例,手术效果良好,现报告如下。