Objective To summarize the experience of the diagnosis and treatment of pulmonary hamartoma.Methods Bronchoscopic enucleation of tumor was conducted in 1 case of endobrochial hamartoma, while video-assisted thoracoscopic surgery was performed in 42 cases(consisting of 40 cases of pulmonary wedge resection,1 case of lobectomy,and 1 case of bilateral lesion biopsy).Results Pathological examinations revealed hamartoma in all the 43 cases,including 1 case of multiple lesions and 1 case of hamartoma complicated with lung cancer.The diagnostic accordance rate was 11.6%(5/43).Follow-up in 37 cases for 4 months~ 11 years(mean,41.2 months) showed no recurrence or malignant change.Conclusions Pulmonary hamartoma is difficult to be confirmatively diagnosed preoperatively.Endoscopic operations can give an accurate diagnosis and a thorough removal of the lesion,with minimal invasion and rapid recovery.

Objective To study the characteristics and diagnosis of renal sinus lipomatosis (RSL) complicated with renal staghorn calculi, and report our preliminary experience on percutaneous nephrolithotripsy for the disease. Methods A total of 547 patients with complex renal calculi were admitted to our hospital from January 2005 to June 2007. In 2 of them, RSL complicated with renal staghorn calculi was diagnosed by B-ultrasonography, CT, and MRI. Both the patients were female, aged 42 and 82 years respectively. B-ultrasonography-guided percutaneous nephrolithotripsy was performed on the two patients without removing the kidneys.Results Totally, 7 ml and 5 ml of stones were removed respectively from the two patients by percutaneous nephrolithotripsy. No retained calculi were found by KUB performed one week postoperation. Biopsy of the submucosal fat obtained from the renal pelvis during the operation showed hyperplasia and fibrosis of fatty tissues and inflammatory effusion. The patients were followed up for half a year, during which no recurrence of renal calculi occurred, and no abnormal fatty tissues were found at the renal sinus or surrounding the kidney. Conclusions Imaging examination is valuable for the diagnosis of RSL. B-ultrasonography-guided percutaneous nephrolithotripsy is safe and effective for RSL complicated with renal calculi.

Objective To explore an effective treatment for benign prostatic hyperplasia complicated with bladder stones.Methods Swiss LithoClast Master and transurethral resection of the prostate(TURP)were performed on 33 patients with benign prostatic hyperplasia complicated with bladder stones.Results The operations were completed successfully in all the cases with a mean lithoclasty time of 35 min(15-65 min),and mean TURP time of 85 min(50-110 min).No blood transfusion,TUR syndrome,bladder perforation,or residual stone occurred during and after the operations.Urethral catheter was withdrawn 5 days postoperation,none of the patients had urinary incontinence or dysuria.The diagnosis of benign prostatic hyperplasia was confirmed by pathology examination.Three months after the operations,IPSS decreased from 23.4?5.2 to 7.4?1.2(t=3.732,P=0.000);maximum urinary flow rate increased from(5.4?1.5)ml/s to(18.6?3.2)ml/s(t=2.491,P=0.015);and QOL decreased from 3.9?1.2 to 2.0?0.7(t=2.454,P=0.014).Conclusions EMS LithoClast Master combined with TURP is an effective treatment for benign prostatic hyperplasia complicated with bladder stones.

Objective To evaluate the efficacy and safety of standard percutaneous nephrolithotomy(PCNL)guided by ultrasonography for calculi within horseshoe kidneys.Methods From September 2005 to January 2008,44 patients with calculi within horseshoe kidneys(51 sides)underwent ultrasonography-guided F24-tract PCNL in our hospital.Among the cases,single calculus was found in 24 kidneys,multiple calculi were detected in 18,and staghorn calculi in 9.The stones sized(24.4?5.8)mm in length.Results All the operations were completed in one session,single tract was established in 49 kidneys,while double tracts were used in the other 2;31 of the tracts were made through the upper calyx,20 via the middle calyx,and 2 through the lower calyx.The mean operation time was(48.4?11.9)min.The stone-free rate after one-session operation was 88.2%(45/51),3 cases received a second-session PCNL to remove the residual calculi.After the operation,the hemoglobin decreased by(11.3?3.7)% in the patients,none of them received blood transfusion.Postoperative rate of surgery-related infection was 5.9%(3/51).No pleural or abdominal injury occurred.44 patients were followed up for 11.4 months,during the period one of the 3 patients who received the second-session surgery achieved stone-free.The rate of recurrence at 6 months was 2.0%(1/51),and 6.5% at 1 year(3/46).Conclusions Ultrasonography-guided standard PCNL is effective and safe for calculi within horseshoe kidneys.

Objective To evaluate the clinical effects of endobronchial ultrasound - transbronchial needle aspiration (EBUS-TBNA) in the evaluation of staging of lung cancer.Methods Between July 2008 to March 2010,the first 128 patients selected by CT or PET/CT scanning with lung cancer in whom metastatic carcinoma in the hilar and/or mediastinal lymph nodes underwent EBUS-TBNA and were clinically followed up.There were 102 males and 26 femals with the age of 37 - 85 years,average 60.1 years.Review the performance in check and the result of biopsy.Results From 128 patients of mean age 60.1 years ( range 37 - 85 ),189 lymph nodes were punctured.The mean diameter of the nodes was 12.3 mm and the range was 6-16 mm.There were no procedural complications.Accuracy,sensitivity,and specificity for EBUS-TBNA were 98.53％,98.50％,and 100％,respectively.Conclusion EBUS-TBNA allows real-time visualization of mediastinal and hilar lymph nodes,allowing sampling safely and efficiently.It has great potential for diagnosis of staging of lung cancer.

Objective　To modify the Guy's stone score system and evaluate the validation of the modified score system in grading the complexity of percutaneous nephrolithotomy (PCNL) and predicting the stone-free rate after PCNL.　Methods　The modified system comprises 4 grades:grade Ⅰ,solitary stone in mid/lower pole or solitary stone in the pelvis with simple anatomy; grade Ⅱ,solitary stone in upper pole or multiple stones (located in 2 or more 2 calyces) in a patient with simple anatomy or a solitary stone in a patient with abnormal anatomy; grade Ⅲ,multiple stones in patients with abnormal anatomy or stones in a caliceal diverticulum or partial staghorn calculus; grade Ⅳ,staghorn calculus or any stone in a patient with spinal injury or spine malformation ( e.g.spina bifida,scoliosis,lordosis) ; kidney dysplasia ( e.g.duplex kidney,horseshoe kidney).It was validated on a database of 145 PCNL procedures performed by a single surgeon in a stone center.The clinical outcomes were retrospectively assessed with multivariate analysis.Results Of the 145 PCNL patients,according to Guy's stone score system and the modified score system,there were 22 G1 cases (15.2％) and 22 SFR cases (100.0％) ; 27 G2 cases (18.6％) and 25 SFR cases (92.6％); 36 G3 cases (24.8％) and SFR(31,86.1％); 60 G4 cases (41.4％) and 49 SFR cases ( 81.7％ ).Showing that the modified Guy's stone score was more accurate in predicting stone-free rate after PCNL ( P ＜ 0.05 ).　Conclusions　The modified Guy' s stone score system can accurately predict the stone-free rate after PCNL than the old system.

Objective To discuss the clinical features and significance of the difference between the preoperative plan and the actual procedure of the treatment of staghorn calculi with standard access PCNL under ultrasound guidance.Methods From Feb 2011 to May 2011,56 patients withsimple staghorn calculi after standard PCNL under ultrasound guidance were enrolled.The same urologist made the operation plan preoperatively and performed the procedure.The difference between the preoperative plan and the actual procedure were analyzed.The factors leading to the difference were evaluated.Results First puncture calyx,the number of access and stage were changed in 9 (16.1％),15 (26.8％),and 10 (17.9％) patients,respectively.The factors leading to the changes include:flexible,compliance,local inflammation of calyx and texture of stone,efficiency of fragmentation.Conclusions The factors which cannot be clearly known preoperatively may change the procedure of PCNL,which is important to know the clinical features and significance of these factors.

Objective:To evaluate the efficacy and morbidity of 24F-tract percutaneous nephrolithotomy(PNL) accessed by two-step dilation.Methods:A total of 3 052 patients with 3 366 kidneys or upper ureter calculi underwent 24F-tract PNL accessed by two-step dilation between Aug.,2003 and Jan.,2008,including 108 patients with solitary kidney,68 with kidney cysts,44 with horseshoe kidney,26 with vertebral column deformity,24 with medullary sponge kidney and 1 transplanted kidney.Stone burdens were(47.2?35.6) mm in length.Results:99.4% of 3 740 operations were successful in one-session access,in which 3 348 PNLs were accessed by single tract(89.5%),366 by double tracts(9.7%) and 26 by triple tracts(0.7%).The mean operating time was(68.4?30.9) min,the mean first accessing time were(17.6?11.1) min.and the mean calculi-dealing time were(35.0?55.3) min.The stone-free rate after one session operation was 100% for single calculus and 72.3% for multiple or staghorn calculi.of all the kidneys,374(11.1%) accepted another PNL to remove the residual calculi,and the last stone-free rate of PNL was 88.6%.During and after operation,52 cases(1.4%)needed transfusion,12(0.3%)underwent selective embolization of renal artery and 1(0.03%)accepted nephrectomy for bleeding control.No injury of organs occurred except for 3 cases with pneumatothorax and 19(0.5%)with urinary extravazation.No septic shock occurred.Conclusion:24F-tract PNL accessed by two-step dilation wtih ultrasound-guided puncture is effective and safe.

[ Objective ] To investigate the therapeutic effect of Tonglieshu capsules (mainly composed of Radix Linderae, Semen Litchi, Semen Vaccariae, Rhizoma Corydalis, Rhizoma Sparganii, Rhizoma Curcumae, Herba Taraxaci, etc. ) for nonbacterial prostatitis. [Methods] Forty SD rats were randomized to 4 groups: normal control group (group A) , model group (group B), Qianlietong group (group C) and Tonglieshu, Capsules (group D). Except those in group A, rats in other groups were injected with Xiaozhiling Injection directly into the prostatic glands to establish nonbacterial prostatitis. After treatment with Tonglieshu capsules for 4 weeks, white blood cells counting, density of lecithin corpuscle and inflammatory cells infiltrating into interstitium and glandular lumen of prostatic tissues were observed. [Results] WBC counting was decreased and density of lecithin corpuscle increased in group D (P 0.05) . [Conclusion] Tonglieshu capsules has an effect in treating chronic prostatitis by decreasing the WBC counting, reducing infiltration of inflammatory cells and increasing the density of lecithin corpuscle in prostatic tissues.

Objective:To evaluate the diagnostic accuracy of 64-channel multislice spiral computed tomography(MSCT) in subjects with presentations suggestive of stable angina or acute coronary syndrome. Methods: Subjects received both 64-channel MSCT and coronary angiography, from Feb. 2006 to Feb. 2007, were enrolled for retrospective analyses. Results of the quantitative coronary angiography were used as the "Golden criteria", accuracy of 64-channel MSCT were evaluated in the overall sample, as well as in subjects suspected of stable angina and acute coronary syndrome. Results: A total of 120 subjects were enrolled in the analyses. On the patient level, the sensitivity, specificity, and accuracy of 64-channel MSCT in detecting significant stenoses were 92.5%, 50%, and 87.5%, respectively. The overall ROC area under curve was 0.71. On the artery level, sensitivity, specificity, positive predictive value, negative predictive value, and ROC area under curve of 64-channel MSCT were 69.9%, 83.8%, 81.1%, 73.7%, and 0.77, respectively. Further analyses showed the sensitivity, specificity, positive predictive value, negative predictive value, and ROC area under curve of 64-channel MSCT in subjects presenting as stable angina and in subjects presenting as acute coronary syndrome were as follows: 70.2% vs 69.2%, 76.2% vs 86.0%, 74.7% vs 85.6%, 71.9% vs 69.9%, and 0.73 vs 0.78. Conclusion: The accuracy rates of 64-chanel MSCT in subjects presenting as stable angina and in subjects presenting as acute coronary syndrome were similar.