Background and purpose:Regular physical exam became the main means to discover the population with early stage RCC. So far, there have been no reports with large sample that have been published about the biomarkers as predictor for the metastasis of the postoperative patients with stage T_(1-3)N_0M_0 (RCC) in China. Furthermore, the underlying mechanism of metastasis of RCC is not clear. This research was carried out in order to study the correlation between delayed metastasis of early stage renal cell carcinoma after surgical operation and expressions of KAI-1、Ki-67 and HER-2/neu on RCC. Methods:Two hundred and forty-one patients with RCC underwent surgical operations and were pathologically diagnosed as T_(1-3)N_0M_0 stage. Twenty-four patients were found to have metastases after long-term follow-up and their clinical data were reviewed (metastasis group). One hundred and ninety-four patients without postoperative metastases were taken as control group. Twenty three patients were excluded from this study because they were lost to follow-up. The expressions of KAI1、 Ki-67 and HER-2/neu in the samples of the two groups were tested with immunohistochemical staining by PowerVision or EnVision two-step procedure. Significant difference was calculated with Chi square test.Results:The positive expression rates of KAI1、HER-2/neu and Ki-67 in 218 RCC were 82.6%、27.5% and 83.5%, respectively. Both mild (20.8%) and strong positive rates (4.2%) of KAI1 in metastasis group were dramatically less than that in control group (90.2%, 73.7%, P

Objective To study the diagnosis and treatment of testicular cancer in cryptorchids. Methods The data of 10 patients with cryptorchid tumor treated at our hospital between 1986 and 2003 were retrospectively analyzed.Their average age was 40 years (range,32~55 years).Of these patients,1 had the testis in the inguinal area;3,in the scrotum (with a history of inguinal cryptorchidism) and 6,in the abdomen.Cryptorchidism occurred on the left in 2 cases,on the right in 5 and bilaterally in 3.Three patients presented with stage Ⅰ A disease,5 with stage Ⅰ B,and 2 with stage Ⅱ D. Results All the 10 patients received surgical treatment including radical tumor resection,radical tumor resection with retroperitoneal lymph node dissection (RPLND),and palliative operation.Pathology showed that 9 cases had seminoma and 1 had seminoma accompanied by embryonic carcinoma.Radiotherapy was performed in 8 cases,and radiotherapy plus chemotherapy,in 2 (including 1 with embryonic carcinoma).Postoperatively,6 patients were followed up for 6 months to 14 years with a mean of 5.2 years;these patients showed no evidence of tumor recurrence and metastasis. Conclusions Cryptorchid testes have a greater risk of malignant change than do normally descended testes,and early intervention is advocated to prevent malignant canceration.Even treated with orchidopexy or orchiectomy,the patient should be followed up lifelong.Most of cryptorchid tumors are seminomas, and the ideal treatment strategies are tumor resection and radiotherapy.

Objective To evaluate the safety and efficacy of the trieyelic antidepressant amitrip tyline in the treatment of patient with interstitial cystitis (IC). Methods Fifty-four patients diagnosed with IC were recruited in this prospective three-month clinical trial. The average course of patient's history was (40. 75±11.6)months, ranging from 19-72 months. All the 54 patients received oral administration of amitriptyline for 3 months. The initial dosage of amitriptyline was 25 mg per night. After 1 week, the dosage would be increased to 50 mg if the symptom didn't relief. After another 1 week, the dosage would be increased to 75 mg if the symptoms were still exist. The patients were kept on a minimum dosage which could relief patient's IC symptoms. Clinical symptoms, such as frequency per day, maximal voiding volume and odynuria degree score, O'Leary-Sant IC symptom and problem index and quality of life score were recorded and assessed at the beginning of the study and 3 months after the treatment. Results After 3 month treatment, the pre-treatment vs post-treatment parameters of frequency per day was 28.5±8. 4 vs 15.6±3.3, odynuria degree score was 6.4± 1.5 vs 2.2±1.5 and maximal voiding volume was 108.7±62.2 ml vs 171.0±53.9 ml respectively. There was significant improvement in all the above parameters comparing between the baseline and 3 months after the treatment. At the 3 months after treatment, the pre-treatment vs post-treatment O'Leary-Sant IC symptom and problem index and quality of life score was 26.9±4.0 vs 13.7±5.7 and 5.5±0. 5 vs 2.5±0. 6, receptively. There were significant decreases compared with the baseline. There was no serious adverse event after taking amitriptyline. Drowsiness occurred in 45 of the 54 patients at the first month administration. Of the 45 patients, 43 patients relieved and 2 patients quitted from the study. Mild weight increase was noted in 10 patients. Mild constipation was recorded in 11 patients. Mouth dryness was recorded in 9 patients. Three patients quitted because of suffering dysuria. Conclusions Oral administration of amitriptyline can effectively relieve clinical symptoms of IC and improve IC patients" quality of life. The side effects are well tolerated.

Objective To evaluate the PDCA cycle on the rehabilitation of postoperative patients with anal fistula, aiming at improving the recovery of patients and preventing recurrence. Methods 144 postoperative patients of anal fistula were randomly divided into the observation group and the control group with 72 cases in each group. The observation group received intervention based upon the PDCA cy-cle, and the control group was given the traditional oral propaganda. The recovery time, recurrence rate, mastering of education content and self-control ability were compared in the two groups using t test and χ2 test. Results The mastering level of education content and the self-management skills in the observation group were superior to those of the control group. After 3 to 24 months of follow-up, the observation group showed shorter recovery time and less recurrence rate than that of the control group. Conclusions Nurs-ing intervention based upon PDCA cycle can strengthen the patients' mastering of related knowledge, pro-mote the recovery, reduce recurrence rate and improve the patients' quality of life.