Purpose：To evaluate the use of transrectal ultrasonography in diagnosis of prostate cancer.Methods：A high-frequency probe was used to examine 56 cases of prostate cancer transrectally and the sonographic features were analyzd. Results：On Trus image lesions were located in peripheral zone in 48(76.8%), transition zone in 8 (14.3%),and central zone in 5 (8.9%). 45 cases (80.4%) of the prostate cancer were hypoechoic,4(7.1%) were hyperechoic, 5(8.9%) had mixed echogenicity and 2 (3.6%)showed isoechoic appearance. Indirect signs represented prostatic asymmetry,intermittent capsular and dilation or disappear of the seminal vesicles.Conclusions：TRUS is imperative in the diagnosis and staging of prostate cancer.

Objective To investigate the prophylactic treatment of cytomegalovirus (CMV) infection in renal transplant patients.Methods Fifty-five patients were divided into two groups. Group A (n=27) was administered with ganciclovir (5 mg/kg every day) intravenously for 30 days. Group B(n=28) was the control group. According to donor (D) or recipient (R) CMV antibody categories,each group had D+/R-,D-/R+,D+/R+ three subgroups. All patients were followed up prospectively for 6 months with measurements of CMV antibody,CMV-DNA antigen,acute rejection for monitoring activity of CMV infections.Results The rate of CMV infection and disease was similar in both groups. The delay between transplantation and CMV infection was significantly longer in the ganciclovir group than in the control group (70.1?14.9 vs 50.2?9.8,P

Objective To review the clinical features,diagnosis,management and prognosis of patients with nonfunctional malignant adrenal tumors. Methods 12 patients admitted with nonfunctional malignant adrenal tumors from 1990 to 2000 were reviewed.Among them 6 cases had symptoms of fever,ostealgia,etc.The tumor measured 3 cm in 1 case,5 to 10 cm in 9 cases and more than 10 cm in 2 cases.Ten cases developed local invasion and (or) matastasis. Results Five cases underwent tumor excision or enucleation and 5 underwent biopsy only.Of these 10 cases,4 were pathologically diagnosed as cortical adenocarcinoma,4 as metastatic carcinoma,1 as mucous liposarcoma and 1 as lymphoma.The remaining 2 cases had no operation.One case died during hospital stay.Ten cases died within 2 years.One case of adrenocortical carcinoma experienced relapse 3 years after initial operation and died next year. Conclusions Nonfunctional malignant adrenal tumor is rare and difficult to diagnosis in early stage,indicating an extremely poor prognosis.Tumor diameter is an important factor to be considered regarding surgical indication.

Objective To study the diagnosis and treatment of coincident vesical transitional cell carcinoma and prostatic cancer. Methods 8 cases of coincident vesical transitional cell carcinoma and prostatic cancer were evaluated clinically. Results All the 8 were diagnosed as vesical transitional cell carcinoma on cystoscopy and biopsy.Whereas on needle biopsy of the prostate,prostatic cancer was diagnosed in 7 and BPH in 1 but turned to be prostatic cancer on pathological study after cystoprostatectomy.4 patients underwent transurethral resection of the bladder cancer and bilateral orchiectomy with bladder instillation of MMC or BCG and oral flutamide for prostatic cancer.1 patient underwent partial cystectomy,bilateral orchiectomy and external radiotherapy for prostatic cancer.3 underwent radical cystoprostatectomy.2 cases were lost to follow up.In the other 6,3 survived less than 1 year because of wide metastasis.The other 3 have been followed up for 1.5 to 4.0 years,remained well and tumor free. Conclusions PSA detection together with rectal palpation,biopsy,transrectal ultrasonography and cystoscopy played the important role in the diagnosis of coincident vesical transitional cell carcinoma and prostatic cancer.Radical cytoprostatectomy yields a better outcome.

Objective To evaluate intravesical instillation of mitoxantrone(MTZ) for the prevention of postoperative recurrence of bladder cancer. Methods Intravesical instillation of 12 mg MTZ dissolved in 50 ml normal saline and retained in bladder for 2 hours were given to bladder cancer patients postoperatively once a week for 8 weeks and subsequently once a month for 12 months.Kidney and liver function,blood counting,urinalysis and cystoscopy were taken periodically.The systemic and local reactions were recorded every time after the intravesical instillation. Results All of the 98 cases were followed up for 6 to 24 months with a mean of 13 months.The recurrence rate was 6.2%.There was no generalized side effect. Conclusions Intravesical instillation of MTZ was efficacious for the prevention of postoperative recurrence of superficial bladder cancer with safety and less side effect.So it can be widely used in such patients.

Purpose:To improve the clinical diagnosis of prostatic cancer. Methods:161 prostatic neoplasms were evaluated retrospectively according to the clincial manifestations, transrectal palpation, CT scanning, MRI of prostate, blood PSA findings and skeletal scintigraphy.Results:As to the clincial manifestations dysuria occurred in 154(95.6%), retention of urine in 30 (18.6%), hematuria in 56(34.8%), paralyses in 2 (1.3), bone pain or weight loss were noted in 8 (4.9%). On transrectal palpation glandular induration was found in 127(78.9%), irregularity of the prostatic surfase in 47(37.1%) and elevated nodules in 129(73.9%). Ultrasonography showed a prostatic enlargement in 27 (21.1%) high echo in 14 (10.9%), low echo in 58(45.3%). vesical infiltration in 14 (10.9%) and seminal invasion in 11(8.6%); 46 patients underwent prostate biopsy guided by transrectal ultrasound,positive results were found in 42(91.3%). 93 serum PSA findings revealed less than 4 ?g/L in 10 (10.8%), 4～10 ?g/L in 9(9.7%), 10～100 ?g/L in 41(44.1%),more than 100 ?l in 33(35.5%). 108 skeletal scintigraphy revealed normal bone scanning in 22 (20.4%), multiple metastases in 81(75.0%), single suspected lesion in 5 (4.6%). Conclusions:The clinical manifestations together with the imaging, PSA finding, bone scanning etc, all played an important role in the clinical diagnosis of prostatic cancer.

BACKGROUND: Rats model of kidney transplantation are common used in the research of organ transplantation and kidney associated diseases. However,the existed modeling methods have various problems in transplanting time or transplantation effect. OBJECTIVE: To establish a lateral kidney transplantation model with simplity,safty,and high success rate. DESIGN,TIME AND SETTING: The analysis experiment of animal model was performed at the Department of Urology,Fudan University between March and June,2008. MATERIALS: 60 Wistar rats and 60 Sprague Dawley rats were selected as donors and recipients,respectively. METHODS: The left kidney graft was transplanted heterotopically into the left infrarenal position,to perform donor abdominal aorta and left renal vein end-to-side anastomoses to the recipient abdominal aorta and inferior vena cava. The ureter of kidney allograft was inserted into bladder traced by 5-0 needle. Bilateral native kidneys nephrectomy of the recipient was performed immediately. The operation time and survival rate were measured. MAIN OUTCOME MEASURES: Transplanting time,warm ischemia time,cold ischemia time,arteriovenous anastomosis and operation time,graft failure rate and reason,survival rates. RESULTS: The operation cost 100-140 minutes. The warm ischemia time was about 8-10 seconds,while the cold ischemia time was 40-60 minutes. Operation achievement ratio is 85%. Reasons of failures were analysed as follows: stenosis of the anastomotic stoma and thrombosis (6.67%),hemorrhage of the anastomotic stoma (5%),infection (1.67%),and unknown reason (1.67%). CONCLUSION: The establish method with advantages of convenience and reliability,which can notably shortened time of warm ischemia of the graft and urinary tract reconstruction and decreased complications.