Objective To explore the efficacy of outpatient treatment for residual ureteral calculi after minimally invasive percutaneous nephrolithotomy(MPCNL).Methods The treatments were conducted in an outpatient setting.The patients with residual ureteral calculi(

Objective To perspectively compare the clinical outcomes of China-and Germany-made electromagnetic lithotripters in the treatment of upper urinary tract calculi.Methods Between January 2005 and August 2005,60 cases of upper urinary tract calculi were randomly divided into two groups:China-made and Germany-made groups(30 in each).Extracorporeal shock wave lithotripsy(ESWL)was performed by a same group of surgeons.Results The stone-free rate was 73%(22/30)in China-made group,and was 90%(27/30)in Germany-made group 3 weeks after ESWL(?2=2.283,P=0.095);and was 100% in both the groups 3 months postoperation.The retreatment rate was 27%(8/30)in China-made group,and 10%(3/30)in Germany-made group(?2=2.283,P=0.095).The rate of auxiliary procedure in both the groups was 0.The efficacy quotient(EQ)was 0.79 in China-made group,and was 0.91 in Germany-made group.Totally,39 ESWLs were performed on the patients in China-made group,while 33 ESWLs were carried out in Germany-made group.The rates of macroscopic hematuria,skin injury,and renal colic were 87%(34/39),64%(25/39),and 8%(3/39)respectively in China-made group,and were 91%(30/33),6%(2/33),and 6%(2/33)in Germany-made group(?2=0.016,P=0.900;?2=25.693,P=0.000;and ?2=0.000,P=1.000;respectively).One patient in China-made group developed fever after ESWL,while no one in Germany-made group had the symptom.In both the groups,no patients had hematuria,renal edema,or subcutaneous perinephric hemorrhage.Conclusion Both China-and Germany-made electromagnetic lithotripters are effective,safety,and non-invasive.

Objective To compare the efficacies of mini-incision dismembered pyeloplasty assisted by retroperitoneal laparoscopy and routine retroperitoneal laparoscopic dismembered pyeloplasty for ureteropelvic junction(UPJ) obstruction.MethodsThe clinical data of 47 patients with UPJ obstruction,who underwent dismembered pyeloplasty from January 2004 to November 2006 in our hospital,were retrospectively analyzed.Of the patients,22 were treated by mini-incision dismembered pyeloplasty assisted by retroperitoneal laparoscopy(group A),in whom a 4-cm incision was made under the costal margin at the posterior axillary line;and the other 25 cases underwent retroperitoneal laparoscopic dismembered pyeloplasty(group B).The clinical data of the two groups,including the operation time,blood loss,average airway resistance and partial pressure of carbon dioxide,recovery of intestinal function,length of drainage and hospital stay,incidence of urinary leakage,and remission rate of hydronephrosis and improvement of GFR,were statistical analyzed by SPSS 13.0.ResultsNo intra-operative complications occurred in either group.Compared with Group B,Group A had shorter operation time [(92.9?16.3) min vs(155.8?18.6) min,t=-12.251,P=0.000],more blood loss [(18.9?6.3) ml vs(13.6?6.7)ml,t=2.782,P=0.008],lower average airway resistance [(15.6?2.6) cm H2O vs(26.9?4.3) cm H2O,t=-10.715,P=0.000] and partial pressure of carbon dioxide [(36.0?6.9) cm H2O vs(51.6?6.7) cm H2O,t=-7.855,P=0.000].No statistical differences were detected in the recovery of intestinal function,postoperative length of drainage and hospital stay,incidence of urinary leakage,and remission rate of hydronephrosis and improvement of GFR.ConclusionMini-incision dismembered pyeloplasty assisted by retroperitoneal laparoscopy is a safe,effective,and minimally invasive therapy for UPJ obstruction.

Objective To look for a standard way to cure uric acid calculi in transplanted kidney with medicine.Methods Under the guide of the standard and widespread metabolic evaluation, citrate and allopurinol were used to treat 4 patients with uric acid calculi after kidney transplantation. These two kinds of medicines were used in the long term together with other conservative treatment to prevent the recurrence of calculi.Results In these 4 cases, all clinical syndromes disappeared and all the calculi dissolved. After follow-up for 1～2 years, no recurrence of calculi was found. Conclusion Citrate should be used to dissolve uric acid calculi in transplanted kidney and to prevent the recurrence of calculi under the guide of the standard metabolic evaluation.

Objective To evaluate the efficacy and safety of prostat in the treatment of chronic nonbacterial prostatitis (CNP). Methods A multicentral open clinical trial was conducted.A total of 115 CNP patients were enrolled in the trial.For each patient 1 tablet of prostat (70 mg P5+4 mg EA10) was orally administered twice a day. Results After 4- and 8- week therapy,NIH-CPSI overall scores were averagely decreased 7.1 (29.5%) and 11.9 (49.4%),respectively.Symptom rating scores were averagely decreased 5.0 (32.1%) and 8.2 (52.5%),respectively.Quality of life scores were averagely decreased 2.1 (24.6%) and 3.7 (43.9%),respectively.WBC counts in prostate massage fluid were averagely decreased 8.8/HP (39.3%) and 13.9/HP (61.9%),respectively.The total effective rate was 82.1% after 8 week therapy.No adverse reaction associated with medication was observed. Conclusions Prostat is effective and safe in relieving the subjective symptoms and improving the objective evaluation in the treatment of CNP patients.

Objective To evaluate the improvement of diagnosis and treatment of hypercatecholaminism. Methods A total of 95 cases of hypercatecholaminism were reviewed.Of them 74 cases were of pheochromocytoma and 21 cases were of adrenal medullary hyperplasia (AMH).In pheochromocytoma group,67 cases (90.5%) had symptom of hypertension.Increase in 24 h urinary VMA occurred in 62 cases (83.8%) and elevated urinary catecholamine level in 67(90.5%).All thses had positive findings of ultrasound,CT scan and MRI.In AMH group,all the patients were hypertensive and their 24 h urinary VMA was increased.Most of them (15/16) had higher urinary catecholamine level than normal;14 out of the 21 cases had positive findings of B-ultrasound examination. Results Surgical operations were performed in the 74 patients with pheochromocytoma including 9 cases of extra-drenal pheochromocytoma.Of them 5 cases were confirmed as malignant pheochromocytoma.In the 21 cases of AMH,18 undewent surgical operation.Of them 12 received unilateral resection and 6 received bilateral resection of adrenal gland.The pathological examination confirmed the diagnosis of AMH. Conclusions The diagnosis of pheochromocytoma should be focused on endocrinological examination,ie,qualitative examination,whereas it is diffucult to localize the lesion in AMH compared with pheochromocytoma.The establishment of notion of AMH as an isolated clinicopathological entity broadens and perfects the theory of hypercatecholaminism.

Objective To evaluate the clinical and pathological features of eosinophilic cystitis (EC),and to discuss its diagnosis and treatment.Methods The clinical and pathological data of one case of eosinophilic cystitis were reported.An 86-year-old male with gross hematuria and urinary urgency for 15 days was admitted on 16 March 2015.A computed tomography scan showed uneven thickening of the bladder wall and a nodular soft tissue on the anterior wall protruding into the bladder cavity.Results Cystoscopic examination showed diffuse thickening of the bladder with polypoid red lesions on the anterior wall.Transurethral biopsies revealed infiltrating eosinophils,which was consistent with the diagnosis of EC.The patient was then treated with anti-inflammatory drugs,corticosteroids and anti-histamine drugs.At 6 months of follow-up,the patient was asymptomatic and had no evidence of local recurrence by ultrasonography.Conclusions Eosinophilic cystitis is a rare disease without specific clinical and imaging features,which can mimic bladder tumor.The final diagnosis of this disease depends on the pathology.Transurethral resection of the lesion along with postoperative hormone and antihistamines administration are the main choices of treatment.

Objective Castleman′s disease ( CD) is a rare lymphoproliferative disorder, which has a very high misdiagnosis rate according to its lack of clinical and imaging specificity.The study was to improve the recognition, diagnosis and management of this disease by analyzing the clinicopathological characteristics and concluding diagnosis and treatment as well as literature review. Methods Retrospective analysis was conducted on clinical data of 31 CD patients (13 males and 18 females) who were hospitalized in the Affiliated Drum Tower Hosipital to Medical college of Nanjing University from January 2006 to Feburary 2014.Their mean age was (47.4 ±13.3) years.There were 24 cases with unicentric Castleman′s disease (UCD) and 7 cases with multicentric Castleman′s disease ( MCD) .UCD tended to be present in the form of an enlarged and painless mass which generally remained asymptomatic by accidental touch or regular physical examination.MCD was usually associated with constitutional symptoms.All the 24 patients with UCD underwent complete surgical resection.7 patients with MCD received different treatment methods, such as surgical resection, ste-riod and rituximab in combination with chemotherapy ( CHOP) . Results Postoperative pathology confirmed 23 cases were hyaline vascular type while 8 were plasma cell type.25 cases had been followed up (46.3 ±32.3) months after operation, among which 1 UCD case died of pancreatic head carcinoma 13 months after operation, 1 case with MCD plus pemphigus died 2 months after surgical resection of retroperitoneal lymphadenectasis, another MCD case died in 1 month without any treatment.The remaining 22 cases were alive. Conclusion CD is lack of clinical specificity and its diagnosis should be made by pathology.Each subtype differ greatly in prognosis, therefore different treatments should be taken after definitive subtype diagnosis.

Objective To investigate whether the Serum Ig is help to choose the optimal treatment in patients with immune thrombocytopenia(ITP) .Methods 128 ITP patients were collected for 3 years .All of ITP patients were treated with the step-style protocol including glucocorticoid(CsA)lombied IVIG ,Ciclosporin A and TPO receptor agonist lombied rituximab .The treatment re-sponse were evaluated according the comparison between the two groups namely ≤IgG ,IGM ,IgA median and > median groups . Results There was no relationship between the bleeding and IgA 、IgM、IgG level .Low IgM level was associated with first line treatment resistance and showed the response to CsA and TPO receptor agonist lombied rituximab .High IgA level was associated with the resistance of first line and CsA treatment ,but showed no response to TPO receptor agonist lombied rituximab .Conclusion Serum Ig level is helpful for the choice of optimal treatment strategies in adult IT P patients .

Objective To evaluate the advantages of transrectal contrast-enhanced ultrasound assis-ted prostate biopsy by comparing with systemic prostate biopsy . Methods From Jan.2010 to Dec.2011, 213 cases were selected randomly.Patient's mean age was 71.0±8.9 (54-83) years.Their PSA level was 22.5±19.4 (4.1-150.0) μg/L.The positive rates of DRE and transrectal ultrasound were 55.9%( 119/213) and 37.6%(80/213).This group of patients were biopsied according to transrectal contrast-enhanced ultrasound assisted prostate biopsies ( experimental group ) .During the same period , another 218 cases were selected randomly.Patient′s mean age was 65.0±9.1 (36-94) years.Their PSA level was 23.3±18.9 (4.6-147.0) μg/L.The positive rates of DRE and transrectal ultrasound were 57.3%( 125/218 ) and 38.1%(83/213).This group of patients were biopsied according to systemic prostate biopsy (control group).The data of two groups were compared to find out the advantages and disadvantages of transrectal contrast -en-hanced ultrasound assisted prostate biopsy . Results Comparing these two groups , the positive rates of prostate cancer in experimental group and control group were 38.0%(81/213) and 34.9%(76/218), with no statistically significance ( P>0.05); the numbers of cores were 9.5 and 12.0, with statistically signifi-cance (P<0.05);the positive rates of single needle were 18.2%(369/2 025) and 11.5%(301/2 616), with statistically significance (P<0.05); and the mean Gleason scores were 7.1 and 6.6, with statistically significance (P<0.05). Conclusions The efficiency of transrectal contrast-enhanced ultrasound assisted prostate biopsy is higher than systemic prostate biopsy .Transrectal contrast-enhanced ultrasound assisted prostate biopsy can be considered as a new option for prostate biopsy .