Objective To discuss the diagnosis and outcome of multilocular cystic renal cell car-cinoma. Methods The clinic data of 1 case of multilocular cystic renal cell carcinoma were reviewed with its clinical manifestation, imaging, pathology and therapy in our hospital. The male patient aged 49 was incidentally found to have a right renal tumor. The CT scan showed a multiloeular cystic tumor in the low pole of the right kidney with a clear outline. The thin septa were found in the tumor, which were enhanced in the enhancement CT scan. The enhancement MRI showed the cystic wall was en-hanced. Results The patient received a partial nephrectomy as his treatment. The pathological char-acteristics were as following: the multilocular cystic tumor was about 3 cm×2 cm×2 cm with clear serosity in it. The cystic wall was smooth with the width of 0.1-0.2 cm. Most of the cystic cavities were covered by monostratified or stratified cubic clear cells, and some were covered by squamous epi-thelium or no epithelium at all. The septum was composed of collagen fiber, and clear cells were found in it. The clear cells form small collections but do not form expansile nodules. The final pathological diagnosis was multilocular cystic renal cell carcinoma. The follow-up was 20 months, without local re-currence or distant metastasis was found. Conclusions Multilocular cystic renal cell carcinoma (MCRCC) is a rare variant of renal cell carcinoma with a good prognosis. MCRCC is an uncommon tumor of the kidney composed of multiple cysts with clear cells in the septa indistinguishable from grade I renal cell carcinoma. Most patients are asymptomatie and the tumors are discovered inciden-tally. The preoperative diagnosis of MCRCC immediately depends on imaging studies. Pathology is the key to diagnosis.

Objective To discuss the diagnosis and outcome of adult endodermal sinus tumor oftestis.Methods The clinic data of 6 cases of adult endodermal sinus tumor of testis were reviewed.The patients' average age was 28 years.Five patients complained of an asymptomatic scrotal mass and1 patient complained of the pain of cryptorchidism.All patients received radical orchiectomy as initialtreatment.Pathology results suggested 2 patients with stage Ⅰ disease,3 patients with stage Ⅱ diseaseand 1 patient with stage Ⅲ disease.All were treated with chemotherapy or radiotherapy following rad ical orchiectomy.Retroperitoneal lymph node dissection(RPLND)was performed in Ⅰ case with stageⅡ disease.Results Six cases of adult endodermal sinus tumor of testis were confirmed by patholo gy.Five patients were followed up for 1.5 year to 8 years,no local recurrence and distant metastasiswere found.Conclusions Adult endodermal sinus tumor is a rare neoplasm of the germinal cell line.Pathological examination is the key to diagnosis.Postoperative combination chemotherapy and radio therapy are the most common means of this disease.

Objective To investigate the preoperative design and application of the minimum foveolar translocation distance and angle of macular translocation. Methods The fundus fluorescein and indocyanine green angiographies were performed on 53 eyes of 53 patients with classic subfoveal choroidal neovascularization (SCNV), including 42 with exudative age-related macular degeneration and 11 with high myopic macular degeneration. The actual area of macular SCNV and the minimum foveolar translocation distance and angle were analyzed. Results The actual area of SCNV was 0.39~18.00 mm 2 with the mean of (3.08?3.22) mm 2. The designed minimum superior translocation distance was 67~2 240 ?m with the mean of (845.72?425.23) ?m;the minimum designed minimum inferior translocation distance was 53~ 2 430 ?m with the mean of (912.17?547.77) ?m. The minimum designed superior translocation angle was 1~32? with the mean of (13.23?6.68)?;the minimum designed inferior translocation angle was 1~35? with the mean of (14.06?8.46)?. The individual difference of the minimum designed superior and inferior translocation distance was more than 500 ?m in 16 eyes (30.19%), and the difference of translocation angle was more than 10? in 11(20.75%). Conclusion Preoperative design of minimum translocation distance and angle of macular translocation may be helpful to choose the operation program.

Objective To observe the characteristics of indocyanine green angiography and fundus fluorescein angiography (ICGA& FFA) in anterior ischemic optic neuropathy ( AION ) , and to investigate the etiology of AION and the value of ICGA and FFA in the diagnosis and study of AION. Methods Simultaneous ICGA and FFA were performed on 32 eyes of 31 AION patients and 38 eyes of 38 non AION patients. Results The eyes that all or a part of the optic disc lies in the watershed zones of the choroidal blood supply were significantly more in the AION group than those in the non AION group (P

Objective To investigate the incidence of renal dysfunction among patients received radical nephrectomy during 5-year follow-up and to discover the risk factors for chronic kidney dysfunction (CKD).Methods Data of 339 patients who underwent radical nephrectomy for renal cell carcinoma between Jan.2006 to Dec.2007 were investigated,and those who suffered renal dysfuntion before surgery or lost follow-up were excluded.Finally,148 patients were enrolled in this retrospective study.GFR after surgery were replaced by eGFR which were calculated with the abbreviated equation of MDRD.It will be defined as CKD when eGFR was less than 60 ml/(min · 1.73 m2).Postoperative occurence rate of CKD was estimated using the Kaplan-Meier methods.Rank sum test and chi-square test were used for the univariate analysis in term of CKD between groups.Multivariate Logistic regression analysis was used to judge the independent risk factors for CKD.Results Patients were followed up for 42-60 months.CKD occurred in 58 cases,and the 5 year cumulative incidence of CKD was 42.7％.As many as 17.4％ of the patients with a normal eGFR during the first 3 months follow-up would progress to CKD 5 years later.Clinical characteristics,including age at surgery,weight,body mass index,hypertension,preoperative total GFR and contralateral GFR,complications,size of tumor,pathologic type,eGFR calculated shortly after operation,were significantly different between the CKD group and the normal group (P＜0.05).Multivariate Logistic regression analysis shows that age at surgery (P =0.016,OR =1.106),size of tumor (P =0.048,OR =0.680) and eGFR calculated within one week postoperatively (P=0.002,OR=0.874) were the independent risk factors for postoperative CKD.Conclusions The incidence of CKD after radical nephrectomy in patients with renal cell carcinoma is not uncommon.The of age at surgery,size of tumor and eGFR value calculated within one week postroperatively have a close relation with the incidence of postoperative CKD.

Objectiye To improve the diagnosis and treatment of chromophobe renal cell carcinoma(CRCC). Methods The clinical dota of 25 patients of CRCC were reviewed.Thirteen were xmales and 12 were females and thirteen on the left and twelve on the right.The mean age was 51 years.Sixteen(64%)patients were asymptomatic.Gross hematuria,low back pain and discomfort and fever occurred in the other 9 patients.Laboratory investigations showed 1 patient had raised alanine aminotransferase and 1 had high erythrocyte sedimentation rate. Results B-ultrasound was mainly characterized by low echo renal mass with intact capsule and low blood flow signals.CT and MR of CRCC were typically well circumscribed,homogeneous(unenhanced CT was 70%,MR was 73%)with no necrosis and hemorrhage,homogenous enhancement(CT was 65%,MR was 67%)and mild enhanced(CT was 65%,MR was 67 %)renal mass.Twenty-two patients with tumors＞4.0 cm had radical nephrectomy and three with tumors≤4.0 cm had partial nephrectomy.The average diameter of tumors was 7.6 cm.The cross-sections of the tumors were grossly homogeneous,pale or dark brown solid.Light microscopy showed that the tumors were composed of trabeculae or sheets with voluminous cells in pale or eosinophilic cytoplasm.Immunohistochemical assay was positive of CK8 and negative of Vimentin.The pathologic TNM stages were 8 with T1a,9 with T1b,6 with T2 and 2 with T3a.Twenty-three patients were followed up.After mean follow-up of 28 months,22 cases were tumor free.One patient had pulmonary metastasis 58 months after operation and had no reaction to interferon-α and chemotherapy and died. Conclusions The majority of CRCC patients are asymptomatic and usually with low-stages.There are some features in CT and MR appearance of CRCC such as well circumscribed and homogenous.Surgical treatment should follow the treatment principles of renal cell carcinoma and carries an excellent prognosis for most localized tumors but there has been no effective measures to treat metastasis disease.The interval between operation and metastasis is relatively long and the time of follow-up should be prolonged in CRCC.

Objective To discuss the characteristics of renal cell carcinoma with regional lymph node metastasis at diagnosis. Methods The data of 19 patients diagnosed with renal cell carcinoma with regional lymph node metastases at diagnosis from January 2004 to December 2008 were reviewed.The median age was 57 years (29-77).The study group included 15 males and four females.The primary tumor was located in the left kidney in 12 patients and fight in seven patients.The median maximam diameter of retroperitoneal lymph nodes was 2.8 cm(1.5-5.0).The lymph nodes in four patients were not detected by the preoperative image examination,but were confirmed by intraoperative exploration.Eleven cases had enlarged retroperitoneal lymph nodes resected and eight had regional lymph nodes dissected. Results The patients with regional lymph node metastases at diagnosis of renal celI carcinoma accounted for 1.6% (19/1213) of the total renal cell carcinoma cases.With a median follow-up of 34 months,six patients were survival without progression,and seven were survival with progression.giving a 5-year survival rate of 68.4%.The survival and recurrence rates after surgery were not significantly different by Fisher test(P=0.644 and 0.319 respectively) between the patients who underwent retroperitoneal regional lymph node dissection and those who underwent enlarged lymph node resection. Condmiom Renal cell carcinoma with regional lymph node metastasis at diagnosis is uncommon.Some patients may achieve long-term tumor-free survival through regional lymph node dissection or enlarged Iymph nodes resection.

Objective] To determine the nucleotide sequence of the 3′\|termal of the RESA gene Plasmodium falciparum isolate FCC1/HN, and find out the differences of the sequences of RESA gene among isolate FCC1/HN,FC27,NF7 and Palo Alto. [Methods] 3′\|terminal fragment of RESA gene of P.falciparum isolate FCC1/HN was amplified by PCR method, then was cloned into pMD18\|T vector. The recombinant was screened and identified by BamHI+XhoI and PCR technique. The nucleotide sequence of the 3′\|terminal of the RESA gene was determined by the dideoxy chain termination method. DNASTAR and BLAST software were used to compare and analyze the RESA gene sequences among the different isolates. [Results] The 3′\|termal fragment of the RESA gene with about 846 bp was specifically amplified by PCR, the recombinant pMD18\|T\|RESA was successfully constructed. Different degrees of diversity of the RESA gene sequences were found among P.falciparum isolates FCC1/HN、FC27,NF7 and Palo Alto. [Conclusion] There were differences in the sequences of RESA gene among the P.falciparum isolate FCC1/HN and three other isolates (FC27,NF7 and Palto alto).

Object To investigate the effect of total flavone in Sanguis Draconis (tFSD) on platelet aggregation, thrombus formation and myocardial ischemia in rat and rabbit. Methods Adopting the experimental models including in vitro platelet aggregation in rat and rabbit, in vivo thrombus formation in rat internal vein, and acute myocardial ischemia by ligating the coronary artery. Results In vitro, tFSD could, to a certain degree, inhibit the platelet aggregation induced by ADP and PAF. Moreover, tFSD could markedly restrain artificial thrombus formation in rat internal vein and the area of acute myocardial ischemia after ligating the coronary artery. Conclusion tFSD has the function of promoting blood circulation and removing blood stasis, anti thrombosis, together with platelet aggregation inhibition.

ObjectiveTo measure the displacement parameters of the femoral head in space through CT three-dimensional reconstruction so as to re-understand impacted femoral neck fractures.MethodsFifty patients with impacted femoral neck fractures were included in the study.There were 17 males and 33 females.Bilateral proximal femurs of each patient were scanned by spiral CT preoperatively.Then these primitive CT data were reconstructed by Mimics 10.01 software.Registered the normal femur and fracture mirror model,the registered mirror model was generated a new mask in the CT cross-sectional images,marked key points in the masks and measured the displacement parameters of femoral head with three-dimensional measurement technology.ResultsIn the impacted femoral neck fractures,the femoral head displacement angle was 17.17°±10.40°,70％(35/50) of the patients had femoral head rotation angle was at 10° to 35°,and 30％(15/50) of the patients had femoral head space displacement more than 20°.The average displacement distance of femoral head center and the deepest point of fovea capitis were(6.49±3.60) mm and(10.42±5.92) mm,respectively.A high proportion of the impacted femoral neck fractures had a large of displacement in the three-dimensional space.It is not scientific to equal impacted femoral neck fractures to undisplaced fractures.ConclusionThree-dimensional reconstruction and digital measurement is a precise,efficient and convenient method for the measurement of femoral head displacement parameters in femoral neck fracture patients.The classic Garden classification for impacted femoral neck fractures has certain defects and limitations.Clinicians should re-understand impacted femoral neck fractures and choose more reasonable treatment.