Objective:To identify the safety and efficiency of polymer clip (Hem-o-lok) for routine control of renal artery and vein during retroperitoneal laparoscopic nephrectomy (RLPN). Methods: From June 2007 to June 2009, 34 patients underwent RLPN, Of which 21 cases of renal cell carcinoma, 5 cases of renal pelvis/ureter cancer, 3 cases of non-functioning kidney and renal atrophy, 5 cases of renal tuberculosis. Renal arterial and venous control were achieved solely by the Hem-o-lok clips where at least two clips were applied on the patient side. Results: 31 cases of RLPN were successful, because 2 cases due to severe adhesions and bleeding, 1 case due to equipment failure during laparoscopic procedure, diverted open nephrectomy. Renal arterial and venous control using the Hem-o-lok clips were successful without any slipping of clips or uncontrolled bleeding. The mean Operating time was 100 minutes (60~150 minutes), the mean blood loss was 90 ml (50~200 ml) without blood transfusion. Follow-up was carried out for 1-24 months, no recurrence found in any patients with renal tumor or ureter tumor; 5 cases of renal tuberculosis recovered smoothly by further anti-tuberculosis treatment; one patient suffered from serious retroperitoneal inflammation, recovered smoothly after close anti-sepsis; a sense of wound pain, numbness in 3 patients, disappeared after 6 months. Conclusion: The Hem-o-lok clip is a safe, convenient and economical device for vascular control in RLPN. RLPN with minimal invasion is expected to become the first choice for nephrectomy.

Objective:To explore the mechanisms of angiogenesis,invasion and metastasis inhibited by arsenic trioxide(As2O3)in human renal cell carcinoma 786-0 cells.Methods:The changes of VEGF,nm23,MMP-9,and TIMP-1 protein expression were studied by immunocytochemistry,and TGF-?1,T?R-I and T?R-II mRNA were analysed by reverse transcription polymerase chain reaction in 786-0 cells treated with As2O3.Results:2?mol/L As2O3 effectively inhibited the protein expression of VEGF and MMP-9 in 786-0 cells(P

Objective:To explore the influence of arsenic trioxide on cell cycle,cyclin and cyclin-dependent kinase inhibitor(CDKI) of human renal cell carcinoma 786-0 cells.Methods:The change of cell cycle was measured by flow cytometric assay(FCM),and its mechanism was analyzed by immunocytochemistry and reverse transcription polymerase chain reaction. Results: Treatment with As2O3 of 2?mol/L or 5?mol/L for 24h,48h and 72h, notably induced a G2/M and G0/G1 cell cycle arrest in 786-0 cells,decreased expression of cyclin A,B1,D1,E(P

Objective:To explore the correlation of NF-K B signal fractions and RCC onset and development,and influence of As_2O_3 on NF-K B signal transduction in RCC 786-0 cell.Methods:NF-K B DNA binding activity,p65 mRNA,p65,IK- K?/?,I K B?and ICAM-1 protein were investigated in 15 RCC tissues and 10 normal renal tissues,and human RCC 786-0 cell by ICC,ISH,Western blot and EMSA.Results:In RCC tissues,NF-K B DNA binding activity,p65,IKK?/?and I- CAM-1 protein were increased,compared to normal renal tissues(P

This paper introduces the advantages of evidence-based medicine model and disadvantages of traditional urology education model,in the mean time,elucidates the important significance and corresponding measures of evidence-based medicine.

The renal cell cancer stem cells determine the growth and proliferation of renal cell carcino-ma.So far some possible markers have been identified in renal cell carcinoma,including octamer binding factor 4 (Oct4),CD133,CD105,ATP-binding cassette subfamily B member 1 transporter gene (ABCB1),CXC chemokine receptor 4 (CXCR4),but these markers are still controversial.Therefore,for the more effective treatments of metastatic renal cell carcinoma,studying a generally applicable marker for renal cell carcinoma is necessary.

In recent years, there is some new recognition about the origin of prostatic carcinoma, prostatic carcinoma has been considered as a stem cell disease. Prostate cancer stem cells have close relationship with prostatic carcinoma formation, advancement, relapse, metastasis and drug resistance. As the development of science and technology continues, studies on the isolation and correlated phenotype identification of prostate cancer stem cells have lead us to further recognize prostate cancer stem cells, as well pave a new way for the diagnosis and therapy of clinical prostatic carcinoma.

Objective To explore the expressions and significance of Yes-associated protein (YAP) and large tumor suppressor gene 1 ( LATS1 ) in renal clear cell carcinoma (RCCC).Methods There are 30 cases of RCCC,15 males and 15 females.The median age was 63 (36 - 77) years.There were 17 cases of stage Ⅰ - Ⅱ,13 cases of stage Ⅲ - Ⅳ.There were 8 cases well differentiated,13 cases moderately differentiated and 9 cases low differentiated.The expressions of YAP,LATS1 mRNA and proteins in 30 cases of RCCC and normal renal tissues were tested by RT-PCR and immunohistochemistry,and were analyzed with clinical data.ResultsThe expression level of YAP mRNA in RCCC was higher than that in normal renal tissues (0.569 ± 0.066 vs 0.515 ±0.068,P =0.003 ),and the level of LATS1 mRNA in RCCC was lower than that in normal renal tissues (0.454 ± 0.115 vs 0.514 ± 0.093,P =0.029 ).Thepositive rate of YAP proteins in RCCC was obviously higher than that in normal renal tissues (63.3％ vs 33.3％,P =0.020),and the positive rate of LATS1 proteins in RCCC was lower than that in normal renal tissues (46.7％ vs 76.7％,P =0.017).The positive rate of YAP proteins was 33.3％ in well differentiated tissues,61.5％ in moderately differentiated tissues and 88.9％ in low differentiated tissues ( P =0.018),and the positive rate of LATS1 proteins was 75.0％ in well differentiated tissues,53.8％ in moderately differentiated tissues and 11.1％ in low differentiated tissues (P =0.024).The positive rate of YAP proteins was 47.1％ in stage Ⅰ - Ⅱ and 84.6％ in stage Ⅲ - Ⅳ ( P =0.034 ),and the positive rate of LATS1 proteins was 64.7％ in stage Ⅰ - Ⅱ,23.1％ in stage Ⅲ - Ⅳ ( P =0.024 ).ConclusionYAP and LATS1 play important roles in the development of renal clear carcinoma,and may become new targets in the treatment of RCCC.

Objective To evaluate the clinical significance of retroperitoneal laparoscopic adrenalectomy for benign adrenal tumors.Methods A total of 81 cases of retroperitoneal laparoscopic adrenalectomy from March 2002 to October 2005 was retrospectively analyzed,including 21 cases of Cushing's syndrome,57 cases of aldosterone-preducing adenoma,2 cases of adrenal pheochromocytoma,and 1 case of bilateral adrenocortical hyperplasia.Three trocars were introduced at the lumbar part and a retroperitoneal space was established by blunt dissection with the camera assembly.The tumor was removed by using a harmonic scalpel.Results The procedure was successfully completed in all the 81 cases,with an operation time of 20~140 min(mean,60 min) and an intraoperative blood loss of 20~100 ml(mean,45 ml).There was no need of blood transfusion intra-and post-operatively.Retroperitoneal hematoma occurred in 1 case post-operatively.Follow-up examinations in 37 cases for 3~18 months(mean,11 months) showed normal blood pressure,stature and laboratory findings.Conclusions Retroperitoneal laparoscopic adrenalectomy has advantages of minimal invasion,little blood loss,quick post-operative recovery,and low complication incidence.It should be considered as the first choice for treating benign adrenal tumors.

This paper introduces the disadvantages of traditional surgeon training model,discusses the significance and urgency of founding training center of surgical techniques and skills,and explores the details on how to found training center of surgical techniques and skills and its function and application in surgeon training.