Objective To investigate the levels of inflammatory cytokines in children with low absolute lymphocyte count (ALC).Methods 56 patients with low ALC as the patients group and 20 children with healthy physical examination as the control group were enrolled.Several inflammatory cytokines,namely IL-1,IL-6,IL-8 and TNF-βwere measured with enzyme linked immu-nosorbent assay(ELISA)kits.High sensitive C reactive protein(Hs-CRP)was measured by the immunoturbidimetry(ITM)kit with the automatic biochemical analyzer.Results The concentrations of IL-1,IL-6,IL-8 and TNF-βin the patients were(0.096±0.012) ng/mL,(0.118±0.026)ng/mL,(0.388 ±0.069)ng/mL and(1.256 ±0.245 )ng/mL respectively,which had no statistical differ-ences as compared with the control group(P >0.05);the concentration of HsCRP in the patients group was(5.7±2.8)mg/L,while which in the control group was(4.8±2.6)mg/L,showing no statistically significant difference between them(P >0.05).Conclusion The levels of the cytokines in low ALC patients are not increased,which may be related with the other factors.Actively using tra-ditional Chinese medicine treatment is beneficial to the recovery of disease.

The improving brain circulation is the most important aspect in protecting brain from the ischemic trauma. This frauma on pathophysiology includes the two stages which are related to different treatments. The paper induced some therapeutic progress, such as thrombolytic therapy, the use of anticoagulation agents, antiplatelet drugs, neuroprotectine agents, intracerebral transplantation, antiedama, and reducing intracranieal pressure.

Objective To highlight the diagnostic and t herapeutic procedures for extra-adrenal pheochromocytoma. Methods Thirty-eight cases of extra-adrenal pheochromocytoma proven patholo gically from 1998 to 2002 were reviewed and studied.Hypertension was observed in 34 cases and intermittent macrohematuria in 4 patients.Another 2 cases were adm itted to hospital with abdomen masses through routinely physical examination.Uri nary VMA,serum and urinary catecholamine were measured in 33 cases.38 cases had B-model ultrasound examination and 34 cases took CT scan.The level of urine VMA elevated in 30 cases(91%) and serum or urinary catecholamine were elevated in 2 8 (85%).The positive rates of localization of B-ultrasound and CT were 92% and 100%,respectively.29 cases took ?-receptor blocker for at least 2 weeks preope ratively.There were 6 cases operated under epidural anesthesia and 32 general an esthesia.Six cases were operated transvesical.10 cases with lumber incision and 19 with abdominal incision.The other 3 cases operated laparoscopically. Results Tumor location,6 cases in bladder wall,7 in renal hilum, 9 in upper pole of kidney,4 in low pole,10 in anterio-lateral to the adrenal gl and,and 2 cases of multifoci.The specimens were from 2 to 9 cm in size.Among 34 cases with hypertension,the blood pressure of 26 patients return to normal and 2 cases were still hypertensive.10 cases were assayed as malignant pheochromocyto ma.There were 9 cases of recurrence or metastases and 5 patients died during fol lowed-up from 13 months to 10 years. Conclusions Urine VMA level is a useful marker to detect extra-adrenal pheochromocytoma and CT sc an is the most reliable in localizing the lesions. 131I-MIBG scintigra phy is of great value for the localization and quantitative for extra-renal phe ochromocytoma with high sensitivity and accuracy.It may be also used as a therap eutic method.Surgical manipulation of the tumor is the best management and metic ulous perioperative management is extremely important.Measuring the level of uri nary catecholamine can monitor the recurrence or metastasis of the tumor.

Objective To evaluate the occurrence of antiandrogen withdrawal syndrome in patients with advanced prostate cancer treated with combined androgen blockade. Methods 24 cases of advanced prostate cancer (10 in stage C and 14 in stage D) were retrospectively studied. All the patients have been treated with combined androgen blockade (bilateral orchiectomy and flutamide). After initial beneficial response to hormonal therapy (duration 7 to 36 months), the disease became progressing.Flutamide was then discontinued. Serum prostate specific antigen (PSA) levels and symptoms alterations were observed. Results Following withdrawal of flutamide, 8 patients showed a decline in PSA (mean 75%).In 6 the PSA declined more than 50%. Clinical symptoms improved in 4 patients and the prostate mass became smaller in 2. The mean duration of improvement was 4.3 months. Conclusions In patients with hormone refractory prostate cancer after initial combined androgen blockade, a trial of "antiandrogen withdrawal" is a reasonable therapeutic management prior to other more toxic therapies.

Objective To evaluate parathyroidectomy combined with parathyroid tissue transplantation in forearm in the treatment of severe secondary hyperparathyroidism (SHP). Methods 9 cases treated with the procedure were reviewed.The diagnosis,operation indication and peri operative management were discussed. Results Thirty five hypertrophic parathyroids were resected from the 9 cases with SHP,and a left thyroidectomy was carried out for one case.Some parathyroid tissue has been grafted into the forearm for every patient.All of those grafts have survived.The symptoms va nished in all and the relevent laboratory tests recovered to normal after the surgery. Conclusions This surgical strategy is safe and effective for SHP not benefited from medical therapy.

0.05. Conclusions Radical nephrectomy remains the cardinal method for the treatment of primary renal cell carcinoma. Extensive retroperitoneal lymphadenectomy does not improve the survival.

Objective To study the relationship between urinary heparin and human bladder transitional cell carcinoma(BTCC) Methods Reverse polarity capillary electrophonesis(RPCE)in a phosphate buffer was used to determine the value of urinary heparin in 19 patients with BTCC and in 9 normal individuals. Results The value of urinary heparin was (2.37?1.06)?g/L in 9 normal subjects,(1.11?0.45)?g/L in 9 patients with Ta～T 1 BTCC and (0.41?0.13)?g/L in 10 patients with T 2～T 4 BTCC. Conclusions Falling of urinary heparin in BTCC plays an important role in the occurrence and invasiveness of BTCC.

Objective To study the diagnosis accuracy and the treatment sequelae of adenocarcinoma of urinary bladder. Methods 41 cases of urinary bladder adenocarcinoma have been encountered from 1980 to 2000,all of them had undergone operation and the diagnosis being assessed on histopathology studies.There are 18 cases of primary bladder adenocarcinoma,among which 8 had undergone radical cystectomy and 10 partial cystectomy.Among 12 cases of urachal adenocarcinoma extending to the bladder,11 received extended resection.All the 11 patitents with metastatic focus in the bladder underwent local ablation. Results Urinary bladder adenocarcinoma comprised 3.2% of the bladder cancer.Thirty seven patients have been followed up for five months to ten years.The 1 year survival rate was 51.3%(19 cases),the 2 year survival rate 43.2%(16 cases) and the 5 year survival rate 21.6%(8 cases). Conclusions Radical total cystectomy is the treatment of choice for primary adenocarcinoma of bladder and extended partial cystectomy seems to be the best for urachal adenocarcinoma. Comprehension therapy should be undertaken for patients with metastatic adenocarcinoma or tumor recurrence so as to improve the survival rate.

Objective To evaluate the modified Stamey bladder neck suspension for female stress urinary incontinence. Methods 52 cases with an average age of 46 and an average stress incontinence history of 7.5 years underwent the modified Stamey procedure,18 cases being degree Ⅰ,21 degree Ⅱ and the other 13 degree Ⅲ. Results 32 cases were treated before 1994 and the outcome was evaluate at 3.6 years and 9.6 years postoperatively.There were 3 failures because of operative complication.The cure rates and failure rates at 3.6 and 9.6 years were 87.5%,68.8% and 6.2%, 21.9%,respectively.20 cases were treated after 1994 with a follow up of 4.3 years.The cure rate has been 90.0%. Conclusions The Stamey procedure yields high initial cure rates yet the latter declines with time.

ObjectiveTo study the diagnosis and therapy of circumcaval ureter.MethodsFifteen cases of circumcaval ureter were studied retrospectively.The cardinal symptoms include discomfort over the back and loins,nephrocolic and bloody urine.The diagnosis mainly depends on IVU and retrograde urography.12 patients underwent ureteroureterostomy,2 ureteropyeloneostomy and 1 nephrectomy.ResultsAll the patients have been follewed up from 1 to 15 years by IVU and ultrasonography,and no nephrohydrosis or stenosis of the anastomosis site has been noted.All the patients have been free from any complaints.ConclusionsIVU and retrograde urography are the cardinal means for the diagnosis of circumcaval ureter,and operation is indicated in order to improve the renal function.It is important to choose a proper time and an adequate surgical technique.