Objective To experiment the use of allodecellular skin extracellular matrix for the replacement of urethral. Methods Skin extracellular matrix was obtained from 2 dogs by decellularization process.18 experimental dogs were used and a 4 cm segment of urethral was resected in each.In the experimental group of 15 dogs,the resected urethral was replaced by the allo skin ECM.In the control group of 3 dogs,the resected urethral was replaced by allograft transplantation of untreated skin.The neourethral segment was studied with ecectronmicroscopy and immunohistochemical procedures. Results In the experiment animals,urothelial and monocytes could be seen in the ECM area and fully filled up the area after 6 weeks.The histological structure was not much different with a normal urethra.In the control group with allograft transplantation,rejection and necrosis occurred 8～10 days after the transplantation.On the basis of the experiment,skin ECM has been successfully used in clinical practice for 2 patients. Conclusions Alloskin ECM may be an ideal tissue engineering material for the replacement of urethral.

Objective To study the histopathological features of injured urethra managed by urethral realignment or suprapublic cystotomy and to sum up the experience on its treatment. Methods Urethral realignment or suprapublic cystotomy were carried out for 20 dogs as the instant management;tissue specimens from the two groups were studied using hematoxylin and eosin stain,immunohistochemistry and electron microscopy and the result has been studied. Results Regeneration of urethra was demonstrated in the urethral realignment group at 8 weeks after urethral injured whereas regeneration has been in the suprapublic cystotomy group.The average length of urethral emphraxis was 3.8 cm in the suprapublic cystotomy group whereas that of urethral stricture only 2.5cm in the urethral realignment group at 32 week. Conclusions Urethral realignment might be the treatment of choice for the instant managerment of urethral disruption as compared with suprapublic cystotomy.

Objective To evaluate the application of urine diversion in prostatectomy for hemostasis. Methods In 86 cases underwent suprapubic prostatectomy urine diversion was carried out.The prostatic bed was compressed by the inflated baloon of the urethral catheter.The operation time was recorded and the amount of blood loss both during and after the operation were measured.Postoperative blood hemoglobin and urodynamic parameters were compared with those before operation. Results The average operation time for the 86 patients was 45 min.The average blood loss during the operation was 140 ml and the average postoperative drainage 190 ml.Blood transfusion is not needed in all.The ureteral catheters for urine diversion were maintained for an average of 7.2 days and the urethral catheter for 8.6 days.Normal micturation was noted right after the removal of urethral catheter in all the 86 patients.Postoperative blood routine and biochemical assays were not significantly different from those before operation.The average maximum urine flow rate was 21.5ml/s.2 of the patients have experienced difficulty in micturation.Normal micturation was resumed on endoscopic urethrotostomy.No secondary bleeding or upper urinary tract infection has been noted. Conclusions The application of urine diversion is an effective means of hemostasis in prostatectomy.

Objective To understand the histologic changes of prostatic carcinoma's bone metastases and other associated observations,and to provide histopathological basis for clinical therapy. Methods Seven patients with prostatic carcinoma bone metastases,whose needle biopsy of prostate and bone metastases was positive,were treated by hormone castrative therapy.The changes of prostatic primary carcinoma,bone metastases and correlated examinations were observed,and the results were compared with those before treatment. Results The prostatic tumors of 7 patients disappeared in 2 months after treatment.The prostate specific antigen (PSA) level of 5 patients returned to normal within 2 months.Two patients had orthopedics surgery because of spinal epidural compression symptom,and their pathologic examination of bone metastases showed that the transparent cells disappeared,the number of tumor bone trabecula reduced and immunohistochemical stains of PSA was negative.Another 2 patients had bone excision because of the development of bone metastases.Transparent acinose cells,mixed with many tumor-like bone tissues,could be found in the focus,with immunohistochemical stains being positive compatible with the changes of focal bone,PSA and imageology examination showed corresponding results. Conclusions Castration therapy can make carcinoma cells of the prostate and bone metastases,partially or completely,disappear.However,part of bone metastases changes may not be consistent with those of primary carcinoma.PSA and imageology examination may show the correlated changes of bone metastases,and provide exact basis for the clinical treatment.

Objective To introduce an optimal incision technique in the endourethral surgery for urethratresia. Methods Sixteen patients suffering from urethratresia were managed by endourethral surgery,2 of them treated with rotator incision and the other 14 with rotator incision plus transurethral scar electrosectomy.The efficacy of the treatment was evaluated by Qmax. Results Successful incisions were achieved in all patients,the duration of procedure being from 18 to 33 min,with a mean of 25 min.Two patients with rotator incision had dysuria (Qmax 9 and 7 ml/s) after the surgery and accepted transurethral resection of scar again.The other 14 patients with rotator incision plus transurethral scar electrosectomy had good voiding.Qmax was more than 16 ml/s in all patients after operation. Conclusions Rotator incision is a safe,simple,efficacious incision technique in the endourethral surgery for urethratresia,and scar electrosectomy is essential for successsful outcome.

Objective To study the clinical features of penetrating renal trauma. Methods From March 1996 to November 2002,28 patients (male,mean age 31) with penetrating renal trauma were treated,the clinical data of these were studied and reviewed. Results Nonoperative treatment was carried out in 6 patients of grade Ⅱ injuries were reconstructed and the other 2 patients were managed by embolization with an excellent renal salvage rate.In 12 patients with grade Ⅳ injuries,6 underwent embolization successfully,2 were successfully managed reconstruction,4 required nephrectomy.3 patients were of grade Ⅳ injuries,2 of whom underwent nephrectomy and 1 was died. Conclusions The condition of vascular injury should be considered in treatment of penetrating renal trauma.Emblization is a ideal treatment for the grade Ⅲ-Ⅳ penetrating renal trauma.

Objective To study the macrophage immune response after the percutaneous microwave coagulation therapy (PMCT) under the ultrasound guide. Methods Eighty-nine cases of primary hepatic carcinoma patients were treated by PMCT. At the time of the fourth week after PMCT and before PMCT, the patients were given percutaneous biopsy under ultrasound guide. And the samples were stained by immunohistochemical methods. Then the infiltration of macrophage on local treatment areas were compared before and after the treatment. Moreover the function of immunocytes were observed by electronic microscope. Results The infiltration of macrophage increased significantly in post-PMCT as compared with that in pre-PMCT. And there were more protuberance from the macrophage and much more lysosome and endoplasmic reticulum and mitochondrium observed by electronic microscope. Conclusion The local macrophage cellular immunity can be more improved after the primary hepatic carcinoma treated by PMCT.

Background and purpose:Tumour cell is recognized and rejected by immunocytes.The local infiltration of immunocytes and the clinical curative effect after the percutaneous microwave coagulation therapy(PMCT) is worthy of further study.We investigated the local immune response after PMCT under ultrasound guidance and evaluated if the local immune response had any influence on the prognosis of patients.Methods:89 cases of patients with hepatocellular carcinoma were treated by PMCT.At the time of the fourth week after PMCT and before PMCT,the patients were given percutaneous biopsy under ultrasound guidance.And the samples were stained by immunohistochemical methods.Then the infiltration of CD4+、CD57+ and CD68+ of local treatment areas were compared before and after the treatment of PMCT.Meanwhile,the patients underwent follow-up to survey the possibility of recrudescence.Moreover,the authors analyzed the relation between the infiltration of immunocytes and recrudescence.Results:A few CD4、CD57 and CD68 positive cells were observed in the cancer stoma and tissues surroundings the liver before PMCT.After PMCT,the immunocytes of CD4、CD57 and CD68 positive cells were significantly increased both in the cancer and the adjacent liver tissue.These immunocytes were enlarged in size.The infiltration of CD4+、CD57+ and CD68+ increased significantly in post-PMCT as compared with those of pre-PMCT(P

Objective To study osteoporosis in patients after orchiectomy for prostate cancer. Methods 64 patients were divided into two groups.In the first group,31 patients with prostate cancer treated by orchiectomy.The other 33 patients were taken as contrast(second group) which were benign prostate hyperplasia (BPH) treated by finasteride.BMD,X ray,serum testoterone and parameters of bone metabolism were measured both before and 6 months after treatment for both groups.Osteoporosis was defined according to WHO criteria. Results A significant reduction of BMD and serum testoterone were observed in the first group 6 months after orchiectomy ( P 0.05).All the patients in first group were classified as osteoporosis 6 months after orchiectomy. Conclusions It is suggested that androgen deprivation would induce osteoporosis which should be treated in early stage.

Objective To evaluate the effect of 5? reductase inhibitor on vascularity of benign prostatic hyperplasia (BPH). Methods Sixty male adult rats were randomly divided into 4 groups (15 per group): normal control, BPH control group, the group of 5? reductase inhibitor treatment during hyperplasia and the group of treatment after hyperplasia. Immunohistochemistry combined with computer assisted image analysis system were performed to examine the expression of factor Ⅷ related antigen, PCNA and VEGF in the prostatic tissue for all rats. Results The microvessel density(MVD) and the expressions of PCNA and VEGF were much less in treatment during hyperplasia and treatment after hyperplusia than that in BPH control group( P