Objective To study the use of immunosuppressives for the patients with virus C hepatitis(HCV)after renal transplantation.Methods Twenty-five cases of HCV-RNA(+)and 30 cases of HCV-RNA(-)as control group were analyzed.All patients were divided into the Aza group(n=12),MMF group(n=8)and MP(MMF+Pred)group(n=5).Results Eight casGS revealed abnormal liver function in the Aza group and 2 in MMF group.After stopping the use of CsA and Aza,the liver function all revealed good outcome in the MP group.During one week 30 cases of HCV-RNA(-)recovered due to the readjustment of the dosage of immunosupprexsives(CsA,Aza)in the control group.Conclnsions The therapy of MMF+CsA+Pred is necessary for the patients with HCV-RNA(+)and the function of the renal and liver can be stabilized by MMF.

In order to compare the therapeutics of combined use of MMF with low dose of cyclosporine A (CsA) in renal transplantation, 16 cases were randomly divided into 3 groups:MMF 2.0g group receiving MMF 2.0g per day, MMF 1.5g group receiving MMF 1.5g per day,and Aza group. All the patients in the 3 groups were given the low dosage of CsA and steroid.The results showed that no patients in MMF 2.0g group experienced acute rejection. One patient (20%) in MMF 1.5g group occurred twice acute rejections. In Aza group 3 out of 5 patients (60%) experienced acute rejections. Six months after transplantation, serum Cr level and the used dose of CsA in MMF 2.0g group was obviously lower than that of Aza group. It was concluded that the combined use of 2.0g MMF per day with low dosage of CsA and steroid was safe and efficacy for renal transplanted patients. The clinical results of MMF 2.0g group were superior to those of Aza group.

Objective To elevate ability of diagnosing adrenal tumors. Methods B-ultrasonography were performed on 385 cases;CT scanning were on 385 cases;IVU were on 380 cases;MRI were on 180 cases;Doppler were on 63 cases;DSA were on 16 cases;MRA were on 28 cases;MIBG were on 34 cases;3 cases were performed tumors biopsy directed through CT. Results The accurate localization rate of APA,Cushing tumors,Pheo,myelolipoma with B-ultrasonography were 92.7%,88.3%,100.0%,100.0% respectively.The accurate qualitative rate of diagnosis were 83.2%,86.7%,83.4%,100.0% respectively.With CT scanning were 98.2%,98.7%,100.0%,100.0% and 90.5%,92.3%,83.4%,100.0% respectively.With MRI were 90.4%,96.5%,100.0%,100.0% and 72.8%?93.5%?85.8%?100.0% respectively. Conclusions The overall data of imaging is helpful in diagnosis of adrenal tumors.Correct localization of the tumors is the key step for the treatment.

Objective To evaluate the comprehensive treatment results of cystitis glandularis. Methods A total of 65 cases of cystitis glandularis underwent cystoscopy.The results showed follicular or villous changes in 39 cases,papillomatous in 15,chronic inflammation in 8 and no obvious change in 3.Transurethral electric resection or partial cystectomy were performed.After surgery all the cases received mitomycin-c bladder irrigation at high dose (40 mg once) regularly for 2 years.During the follow-up cystoscopy was periodically performed and the biopsy samples were pathologically examined with all the cases. Results The mean follow-up was 29 months (range,7 to 72 months).Of the 65 cases,60 fully recovered with transitional cell surface covering the bladder musoca gradually;4 had relapse;and 1 developed canceration (adenocarcinoma). Conclusions Transurethral resection of bladder tumors or galvanocautery is the essential therapy for cystitis glandularis.After surgery the bladder irrigation with mitomycin-c at high dose can be helpful for urothelium recover in histology.

Objective To probe into the diagnosis and treatment of pheochromocytoma of high risk. Methods The clinical data of 35 cases of pheochromocytoma of high risk underwent surgical extirpation from 1990 to 2000 were reviewed. Results The tumors were intraadrenal in 27 and extraadrenal in 8.The average diameter of the growth which could be successfully resected was 10 cm and the weight 350 g.Biopsy was undertaken in 2 because of the difficulty in extirpation of the tumor.Recurrence occurred in 4 and there were 3 cases being comfirmed to be malignant. Conclusions Adequate preoperative preparation and definite location of the tumor are the most important before surgery.Fluctuation of blood pressure have to be monitored during surgery and to be treated carefully and promptly.Hypoglycemia have to be awared of after the surgery.

Objective To evaluate the diagnostic significance of blood cells and electrolyte in preoperative diagnosis and surgical treatment of Cushing's disease (CD).Methods 116 csses of CD and 21 cases of adrenocortical adenoma (ACA) patients pathologically proven adrenocorticotropic hormone (ACTH) adenoma from Jan.2003 to Dec.2010 were enrolled into the study.They were given transsphenoidal surgery (TSS) and laparoscopic resection of adrenal adenoma (LRAA).Patients were divided into remission group ( group A),non-remission group (group B) and ACA group (group C) according to the remission criteria of CD.The preoperative and postoperative level of blood cells and electrolyte were determined.Results TSS treatment improved the abnormal level of blood cells and electrolyte in patients with CD.Group A had significant change in preoperative and postoperative level of blood cells and electrolyte,while group B and group C didn't.Conclusions Compared with the endocrine examination items which need huge expense and harsh conditions,the change of blood cells and electrolyte level is more superior in assessing diagnostic and cruative effects on CD patients.

AIM: To study the possibility that yellow wine improves the pathological changes of atherosclerosis in vivo. METHODS: Six weeks old LDL receptor knockout mice (n=48) on a high-fat and L-methionine diet developed plasma hyperhomocysteinemia and atherosclerosis. The animals were randomly divided into yellow wine group, red wine group, ethanol group and control group (n=12 in each group) and were sacrificed after 14 weeks. The levels of plasma lipids and homocysteine in serum were examined. The morphological changes of aorta artery and the atherosclerosis of aorta sinus were observed under microscope. The expression and activation of matrix metalloproteinase-2 (MMP-2) were determined by the method of immunohistochemistry. RESULTS: No significant difference of plasma total cholesterol, triglyceride or high density lipoprotein cholesterol among groups was observed. Plasma homocysteine was significantly decreased in yellow wine group as compared to other three groups (P<0.01). Compared to ethanol and control groups, use of yellow wine and red wine significantly reduced the atherosclerosis lesion area (P<0.01). However, no significant discrepancy between the yellow wine group and red wine group was found. Compared to control group, the expression of MMP-2 in yellow wine group, red wine group and ethanol group decreased by 26.3%, 27.6% (P<0.01) and 5.7% (P>0.05), respectively. The activity of MMP-2 in yellow wine group, red wine group and ethanol group decreased by 31.7%, 32.5% (P<0.01) and 6.7% (P>0.05), respectively. CONCLUSION: Yellow wine and red wine inhibit the expression of MMP-2 and improve the pathologic changes of atherosclerosis, indicating that they have benefic effects on cardiovascular system.

ObjectiveTo investigate the diagnosis and treatment of adrenocorticotropin-independent macronodular adrenal hyperplasia (AIMAH). MethodsThe clinical data of 14 cases of AIMAH from August 1972 to July 2010 were retrospectively analyzed.The cases included 5 males and 9 females with a mean age of 45 (range 26 to 58 ) years.Ten patients demonstrated typical Cushing's syndrome (CS) and 4 patients presented with weight gain,hypertension or diabetes mellitus without any signs of CS.The circadian rhythm of serum cortisol was abnormal.Low and high dose dexamethasone suppression tests failed to suppress cortisol secretion.CT scan showed bilateral enlargement of the adrenal glands with multiple macronodules.All patients underwent open surgery,including 5 cases of unilateral adrenalectomy,6 cases of adrenalectomy combined with contralateral subtotal adrenalectomy and 3 cases of bilateral adrenalectomy.ResultsIt was established by pathological examination that all patients had bilateral adrenal macronodular or adenomatoid hyperplasia.During the mean follow-up of 69 months (range 12 to 120 months),the clinical symptoms of CS disappeared after surgery in all cases.The 5 patients who received unilateral adrenalectomy had urinary free cortisol and serum cortisol within normal ranges and no further enlargement of the contralateral gland was noticed.Among the 3 patients who received bilateral adrenalectomy,1 case died of adrenal crisis on day seven post-operation.The remaining 2 cases presented with adrenal insufficiency but returned to normal after glucocorticoid replacement therapy.Nelson's syndrome was not observed in the other patients.ConclusionsAIMAH has unique endocrinological and pathological features,presenting as an independent etiology of CS.Unilateral adrenalectomy appears to be an effective and safe alternative treatment for AIMAH and long-term remission can be achieved.Bilateral adrenalectomy or unilateral adrenalectomy combined with contralateral subtotal adrenalectomy may be performed if the symptoms have not improved or recurred after unilateral adrenalectomy.

be diagnosed by imaging examination before operation.The ALT patients with large or symptomatic adrenal lipomatous lesions or preoperatively diagnosed teratoma should be given surgical treatment.

_ Objective_ To evaluate the efficacy of unilateral subtotal adrenalectomy in the treatment of bilateral adrenal solitary neoplasma causing Cushing's syndrome and to elaborate the therapeutic principle. Methods From 2007 to 2013, a total of ten patients were diagnosed with Cushing's syndrome caused by bilateral solitary adrenal neoplasma. We compared patients'clinical symptoms, hormone profiles, biochemical and metabolic parameters, and imaging data before and after the surgery. Five of them chose the optimal neoplasma based on the lateralization ratio of adrenal venous sampling result and the other 5 patients chose the optimal neoplasma based on the diameter of the mass reflected by the computed tomography result and were then operated. Results After the unilateral subtotal adrenalectomy,the24-hour urinary free cortisol decreased significantly(P<0.05)and the midnight serum cortisol level also significantly reduced(P<0. 01). Plasma adrenocorticotropic hormone level increased significantly(P<0. 01). Nine patients of them did not need contralateral adrenalectomy and one patient received contralateral adrelectomy because of the remnant of Cushingnoid symptoms. Conclusion Unilateral subtotal adrenalectomy is an effective and safe way to treat Cushing's syndrome caused by bilateral solitary neoplasma.