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BACKGROUND:Studies have shown that mesenchymsi stem cells (MSCs) participate in tumor stroma remodeling,but the mechanism is not clear.However,myofibroblast is related with tumor strema remodeling.OBJECTIVE:To investigate whether MSCs can differentiate into myofibroblast under the induction of tumor microenvironment.DESIGN,TIME AND SETING:This in vitro observation and in vivo transplantation cytology experiment was performed at institute of Low Temperature Medicine,Qilu Hospital of Shandong University from June 2006 to December 2007.MATERIALS:Twelve male New Zealand white rabbits,with 3-month-old,were purchased from Shandong Academy of Agricultural Sciences.METHODS:MSCs were obtained through bone marrow aspirates in male New Zealand rabbits and cultured by density gradient method.The 2~(nd) passage of MSCs were labeled with DAPI,and adjusted cell density to 5×10~(10) /L.The cells were assigned into experimental and control groups.For the experimental group,the passage two MSCs were cultured in low-glucose DMEM containing 10% fetal bovine serum and 30% VX2-cultured supernatant.For the control group,passage two MSCs were cultured in low-glucose DMEM containing 10% fetal bovine serum.Also,DAPI labeled self passage 2 MSCs of avery animal were delivered uniformly via direct surgical intratumoral injection to observe the differentiation of MSCs in tumor tissue.MAIN OUTCOME MEASURES:Immunofluorescense and RT-PCR were used to test the expression of α-SMA and Vimentin in MSCs of both groups 14 days later.At 3 weeks after VX2.intratumoral injection,Immunofluorescence was used to observe the distribution and differentiation of MSCs in tumor tissue.RESULTS:After stimulated with 30% VX2-cultured supematant for 2 weeks,Cy3 immunofluorescance showed that the expressions of α-SMA and Vimentin were strongly expressed in the experimental group,which was weakly expressed in the control group.Compared to the control group,the levels of α-SMA and Vimentin mRNA were obviously increased in the experimental group (P ＜ 0.01,P ＜ 0.05).At 3 weeks after MSCs intratumoral injection,these MSCs mainly distributed in tumor stroma and the expression of α-SMA and Vimentin in MSCs were also obviously increased,which demonstrated that the MSCs had differentiated into myofibroblasts.CONCLUSIONS:Under the induction of tumor microenivironment,MSCs can differentiate into myofibroblast,accordingly,accelerate the growth of tumor.

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Objective To study a noninvasive method in evaluating the bladder outlet obstruc-tion (BOO) and bladder function in patients with benign prostatic hyperplasia (BPH) based on the transabdominal ultrasonic measurement of intravesical prostatic protrusion (IPP). Methods The da-ta of 206 first visit BPH patients with lower urinary tract symptoms (LUTS) were retrospectively re-viewed. Patients were divided into 2 groups based on the degree of IPP: the research group with IPP greater than 10 mm(n=78) and control group with IPP 10 mm or less(n=128). Clinical data and uro-dynamic findings of the 2 groups were analyzed to find the clinical significance of IPP. Resells In-creased prostate volume(73.7±35.9 ml vs 62.8±36.5 ml), serum prostate specific antigen(1.81± 0.67 ng/ml vs 1. 64±0.36 ng/ml), post-voiding residual urine volume (PVR)(290.2±217.2 ml vs 228.2±167.9 ml), incidence of acute urine retention(33.3% vs 18.0%)and bladder trabeculation (23.1% vs 11.7%)had signicant differences between the 2 groups (P<0.05). Positive correlation was found between IPP and prostate volume as well as PVR (r=0.401 and 0.342, respectively). In the urodynamic study, significantly lower peak flow rate (Qmax) (7.6±4.1 ml/s vs 9.1±3.6 ml/s), higher incidence of detrusor overactivity (82.1% vs 17.2%) and low bladder compliance (35.9% vs 12.5%)were found in research group (P<0.01). In addition, maximum detrusor pressure(109.8± 84.9 cm H2O vs 84.9±44.1 cm H2O) and BOO index (BOOI) (75.2±27.1 vs 65.9±34.6) were significantly higher in the research group (p<0.05). The correlation study showed that r between IPP and Qmax, Pdet. max and BOOI was-0.284, 0.252 and 0.456, respectively. The incidence of acute urinary intention recurrence was higher in research group than in control group (64.3% vs 23.5%) (P<0.05). Conclusions IPP is a useful predictor in evaluating BOO and detrusor function. BOO and impaired detrusor function in obvious IPP patients are more severe. The obvious IPP pa-tients, especially those presenting with acute urine retention, may benefit more from early surgical in-tervention.

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OBJECTIVES: We evaluated a noninvasive method to predict bladder outlet obstruction (BOO) and bladder function in patients with benign prostatic enlargement (BPE) based on intravesical prostatic protrusion (IPP) using transabdominal ultrasound. METHODS: The records of 206 first-visit patients with BPE were reviewed. We divided patients into two groups based on the degree of IPP: the significant IPP group (greater than 10 mm) and the no significant IPP group (10 mm or less). We analyzed clinical data and urodynamic findings of the two groups to define the clinical significance of IPP. RESULTS: In the clinical data, increased prostate volume, serum prostate specific antigen, postvoiding residual urine volume (PVR), incidence of acute urine residual (AUR), and bladder trabeculation appeared more often in the significant IPP group (P <0.05). Positive correlation was found between IPP and prostate volume as well as PVR (Spearman's rho = 0.401 and 0.342, respectively). In the urodynamic findings, significantly lower peak flow rate (Qmax) and higher incidence of detrusor overactivity and low bladder compliance both existed in the significant IPP group (P <0.0l). In addition, maximum detrusor pressure (Pdet.max) and BOO index (BOOI) were significantly higher in the significant IPP group (P <0.05). The correlation coefficient (Spearman's rho) between IPP and Qmax, Pdet.max, and BOOI was -0.284, 0.252, and 0.456, respectively. CONCLUSIONS: Intravesical prostatic protrusion is a useful predictor for evaluating BOO and detrusor function. BOO and impaired detrusor function in significant IPP patients are more severe. The significant IPP patients, especially those presenting with AUR, may benefit from early surgical intervention.

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AIM: To study the association between age and clinical characteristics of renal cell carcinoma in adult patients. METHODS: Three hundred and ten patients with renal cell carcinoma were classified into three groups: or=60 years group. The clinical characteristics of the three groups were compared to define the association. RESULTS: The male/female ratio was 1.3/1, 2.0/1, 3.3/1 in the three groups, respectively, and a significant difference appeared when comparing the or=60 years group (P=0.010). The respective percentage of incidental renal cell carcinoma was 27.9%, 43.2%, 31.2%, and it was significantly higher in the 41-59 years group than the >or=60 years group (P=0.047). The incidence of poorly differentiated renal cell carcinoma decreased with age increasing (11.6% vs 5.2% vs 2.7%), and there was significant difference between the or=60 years group (P=0.038). In the

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Objective To evaluate advantages and disadvantages of three procedures-percutaneous ethanol injection,small incision unroofing,and laparoscopic unroofing-in the treatment of renal cysts.Methods Clinical data of 106 cases of renal cysts from January 2001 to November 2004,treated either by percutaneous ethanol injection(Percutaneous Group),or small incision unroofing(Small Incision Group),or laparoscopic unroofing (Laparoscopic Group),were reviewed.The operation time,intraoperative blood loss,hospitalization costs,and cure rate were compared among the three procedures.Results The Percutaneous Group presented the least hospitalization costs(3 261.8?779.2 yuan),the lowest cure rate(78.6%,22/28),and the highest recurrence rate(21.4%,6/28).The Small Incision Group had the shortest operation time(44.1?5.7 min),and the Laparoscopic Group had the highest hospitalization costs(9 050.9?1 116.2 yuan).There were significant differences in these parameters among the three groups(P0.05).Conclusions The three procedures,with each having its own advantages,should be selected depending on individual conditions.For patients with a simple renal cyst

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Female urethral syndrome is very common, but its etiology is not yet known completely and its management is somehow difficult. Up to now, there have been quite a number of reports about the female prostate, whose inflammation is possibly the major cause of female urethral syndrome.

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Objective To evaluate the long term outcome of the continent urinary reservoir constructed with ileocecum appendix. Methods From 1985 to 1992,continent urinary reservoir was constructed by using ileocecum appendix after radical cystectomy for 56 patients,of which 11 have been followed up for over ten years. Results The daytime continence rate was 90% and the night continence rate 80%.The average capacity of the urinary pouch has been 388 ml,and the mean pressure 28 cm H 2O.The average urine flow rate is 9.6 ml/s.No evidence of ureteral reflux and no hyperchloremic acidosis have been observed.Stone formation in the pouch occurred in 1 patient,pseudo valve in the posterior urethra in 2 and stricture of the posterior urethra in 1. Conclusions Continent ileocecum appendix pouch might be considered as an ideal form of urinary diversion,characterized by low pressure,large capacity,continent and in situ urination.

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Objective To study the clinical effects of intra internal iliac arterial chemotherapy for invasive bladder cancer after operation. Methods From February 1997 to June 2000,32 cases of invasive bladder cancer underwent partial cystectomy and arterial infusion pump implanted into the intra internal iliac artery, for postoperative chemotherapy. Results The patients have been followed up for 5～42 months, with a mean of 26 months,27 of the 32 patients have been free from the tumor,metastasis to lung and liver was noted in 2.Recurrence occurred in 3?10?16?30 months after operation respectively.Few side effects were noted. Conclusions Intra arterial chemotherapy might serve as an adjuvant therapy for invasive bladder cancer after operation.

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Objective To evaluate the surgical treatment of pheochromocytoma. Methods A total of 151 cases of pheochromocytoma were studied in regard to the preoperative preparation,anesthetic management,operative technique and postoperative treatment. Results Of the 151 cases 132 underwent total tumor excision,12 cases intracapsular excavation and 7 cases partial cystectomy.Only 1 patient died during the course of operation.Pathological examination showed that 137 cases were of benign pheochromocytoma and 14 cases of malignant.After operation 136 cases had normal blood pressure and 15 cases were treated with hypotensor to maintain normal blood pressure.Of the 137 cases of benign pheochromocytoma 9 experienced relapse.Of the 14 cases of malignancy 10 died of metastasis within 5 years. Conclusions Surgical excision is the fundamental approach for cure,and correct preoperative diagnosis and proper perioperative management are extremely important.

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0.05). Conclusions TVT is a safe, effective and minimally invasive surgical procedure for treatment of female stress urinary incontinence.

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60 years group was 26.6%, which was significantly higher than those in the other 2 groups (P≤0.001).The 60 years group (P=0.019).There were significant differences when the component ratios of clinical stages were compared among the 3 groups (P≤0.011).In

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0.05 ). Conclusion The NPT test is simple and practical, and its diagnostic accuracy is comparable to that of the combined test. The NPT test should be used as an examination of choice for the primary etiological diagnosis in ED after trauma.