Objective To study the diagnosis and treatment of renal cell carcinoma. Methods 369 cases of renal cell carcinoma were reviewed for their incidence,diagnosis,treatment and prognosis. Results 281 cases(76.2%) were clear cell carcinoma ,39 cases (10.6%) of granular cell carcinoma,42 cases(11.4%) being a combination of the above two varieties and 7 cases being of other cell types. Radical nephrectomy was performed for 301 cases (81.6%) and other procedures for 45 cases. 297 cases have been followed up:three-year,five-year and ten-year survival rates were 74.6%、56.2% and 28.2% respectively. Conclusions B type ultrasonography and computerized tomography (CT) are important means in the diagnosis of renal cell carcinoma.The most effective treatment is radical nephrectomy at early stage,wherea sbiological treatment works in certain degree.

Objective To evaluate a modified pyelo-u re teroplasty in treating long segment of ureteropelvic junction (UPJ) stenosis. Methods 26 cases were treated with the designed pyelo-ur eteroplasty,on which the dilated pelvic was incised vertically and the pelvic fl ap was turned down to form a new infundibulas tube with running suture and was a nastomosed to the ureter stem,the long stenosis segment being cut off. Results The symptoms vanished in the follow-up period of 1～3 ye ars.It was showed by B-ultrasonography,IVU and RP (retrograde pyelography)that the anastomosis site in all the cases was smooth.3～12 months after operation,G FR(glomerulus filtration rate) was found to be improved markedly,and 20 minutes excretive rate in the operated kidneys was all above 50%. Conclusio ns The troublesome hydronephrosis due to complicated long stenosis o f UPJ and upper ureter can be effectively treated by the modified pyelo-uretero plasty.

Objective To evaluate the role of detecting circulating UP Ⅱ mRNA positive cells in patients with transitional cell carcinoma (TCC). Methods Expression of UP Ⅱ mRNA was examined with nested reverse transcriptase polymerase chain reaction (RT PCR) assay. Results UP Ⅱ mRNA positive cells were detected in 0% (0/26) of patients with superficial urothelial cancers (pT a～1 N 0M 0), 20.8% (5/24) of patients with invasive cancers (pT 2～4 N 0M 0), 50.0% (1/2) of regional node positive patients (pN 1～2 M 0),and 100.0% (2/2) of patients with distant metastases. Positive rates increased with tumor extension ( P

Objective To investigate the effects of Nrf2/ARE pathway activator upregulating the expression of phase Ⅱ detoxifcation enzymes and antioxidant enzymes in islet B cell on its morphological structure in type 2 diabetic rats.Methods Type 2 diabetic rats were divided into diabetes model group (DM group),and tertiary-Butylhydroquinone intervention group(tBHQ group).At the same time,the normal control group (NC group)was set up.All rats were killed after eight-week continuous intervention.Fasting blood glucose (FBG) and fasting insulin (FINS) level were determined.Morphological structure of islet cells and apoptosis were observed.ELISA was used to determine MDA,TNF-α and T-SOD levels in serum and pancreatic tissues and Western blot was used to detect the protein expression levels of total Nrf2 and nulear Nrf2 in pancreatic tissues.Results Compared with NC group,FBG and FINS levels significantly increased and decreased in DM group respectively (all P=0.000).Compared with DM group,FBG and FINS levels significantly decreased and increased in tBHQ group respectively (all P=0.000).Compared with NC group,the number of islet cells significantly decreased and swelling,necrosis and apoptosis occurred in DM group.Islet cells in tBHQ group were significantly better than those in DM group.Compared with NC group,MDA and TNF-α levels in serum and pancreatic tissue significantly increased and TSOD levels significantly decreased in DM group (all P=0.000).Compared with DM group,MDA and TNF-α levels in serum and pancreatic tissue significantly decreased and T-SOD levels significantly increased in DM group(all P=0.000).Total Nrf2 and nulear Nrf2 in protein expression in DM group were significantly lower of than those in NC group (P()=0.000,P nulear Nrf2=0.006).Rats in tBHQ group had significantly higher protein expression of total Nrf2 and nulear Nrf2 than in DM group (all P=0.000).Conclusions Activating Nrf2/ARE pathway can reduce injury of oxidative stress and chronic inflammation on islet B cells further through upregulating the expression of phase Ⅱ detoxifying enzymes and antioxidant enzymes in islet B cells.

Objective To study the significance of microvascular invasion to the neogrow in clinically nonmetastatic renal cell carcinoma (RCC). Methods Between 1989 and 1996,70 patients (mean age 54) were followed up for 1 to 7 years after radical nephrectomy for clinically localized RCC. Among them,there were 5 PT 1,50 PT 2,14 PT 3 and 1 PT 4 and histologically 7 G 1,38 G 2,19 G 3 and 6 G 4.The mean tumor diameter was 7.2 cm.The slides were stained with hematoxylin and eosin,elastin stains and periodic acid Schiff. then,the presence or absence of clinically inapparent vascular invasion,the relevance of microscopic vascular invasion to conventional tumor stage,grade and tumor diameter,et al were studied. Results Of the 70 patients analyzed,24(34.3%) had microvascular invasion,while 46 had none on microscopic examination.Of the microscopic vascular invasion group (11/24,45.8%),7 subsequently died of cancer recurrence,2 noncancer related death,4 alive with metastatic disease while only 4/46(8.7%) without microscopic vascular invasion presented with disease progression.Chi-square test showed statisticaly significant difference between stage,grade,tumor diameter and presence or absence of microscopic vascular invasion. A multivarite analysis was performed considering the impacts of age,PT stage,tumor grade,tumor diameter and microscopic vascular invasion on disease progression,an increase in statistical significance was confirmed with Coxs proportional hazards model(P=0.0062,RR=0.378). So, microscopic vascular invasion seems to be the most important predictor of progression in RCC. Conclusions In patients underwent radical nephrectomy for clinically nonmetastatic RCC,microvascular invasion may be another important prognostic marker and this makes us considering the presence of microscopic vascular invasion in RCC might be another pathological subcategory to predict the prognosis of RCC and can be used to choose whether early adjuvant therapy is necessary.

Objective To investigate the expression of Uroplakin Ⅱ (UPⅡ) gene together with other conventional parameters in the patients with transitional cell carcinoma(TCC). Methods Total RNAs extracted from solid tumor tissues and blood samples of patients with TCC were reverse transcribed and subjected to polymerase chain reaction amplification (RT PCR).The products of RT PCR were analyzed by agarose gel electrophoresis. The expressions in solid tissues of other kinds of tumors and blood samples of non neoplasm patients served as controls. Results UPⅡ gene were expressed in all the solid tumor tissues of TCC(100%) and in the blood samples of 5 patients of T 3～T 4 neogrowth(39%), 2 of the 5 cases had hematogenous metastasis which became nondetectable after chemotherapy; UPⅡ gene has not been detected in the blood samples of T 1～T 2 TCC patients, the non neoplasm patients and other kinds of solid tumor tissues. Conclusions UPⅡ is one of the specific markers of urothelium.It can be found in TCC patients of stage T 3～T 4 and in patients with metastasis. The detection of UPⅡ in the blood sample might serve as a marker for chemotherapeutic efficacy.

AIM: To screen the lentiviral vector carrying siRNA with higher efficiency of suppressing the sphingosine-1-phosphate receptor 2 (S1P2) gene expression in the primarily cultured corpus cavernosum smooth muscle cells of spontaneously hypertensive rats (SHR).METHODS: SHR and SD rats (n=5 each) were used for primarily culturing corpus cavernosum smooth muscle cells.The cells were randomly divided into 6 groups: SHR siRNA-1, SHR siRNA-2, SHR siRNA-3, SHR GFP, SHR control (SHR non-transfection group), and SD control (SD rat control group).Each group had 5 samples with 1.0×105 cells of each sample.At 72 h after transfection (MOI=60) with lentiviral vectors carrying S1P2 siRNA into the SHR corpus cavernosum smooth muscle cells, the expression of GFP was observed under fluorescence microscope.The protein expression of S1P2, ROCK1, ROCK2 and eNOS in the corpus cavernosum smooth muscle cells, and the mRNA expression of S1P2, ROCK1 and ROCK2 were determined by by Western blot and RT-PCR.RESULTS: The transfection efficiency of the corpus cavernosum smooth muscle cells in SHR siRNA-1, SHR siRNA-2, SHR siRNA-3 and SHR GFP groups were>80%.Compared with SHR control group, the mRNA levels and the protein expression of S1P2, ROCK1 and ROCK2 in SHR GFP group showed no remarkable changes, while those in SHR siRNA-1, SHR siRNA-2, SHR siRNA-3 and SD control groups were significantly lower than those in SHR control group (P<0.05).The protein expression of eNOS in SHR siRNA-1, SHR siRNA-2, SHR siRNA-3 and SHR GFP groups were not significantly changed as compared with SHR control group, but that in SD control group was significantly higher than that in SHR control group.CONCLUSION: Three groups of siRNA lentiviral vectors targeting S1P2 inhibit the expression of S1P2 in the corpus cavernosum smooth muscle cells of SHR, and by silencing the S1P2 expression, the expression of ROCK1 and ROCK2 is inhibited.Among them, siRNA-1 has the highest inhibitory efficiency.