Objective To discuss hemodynamic and electrolyte changes associated with irrigation fluid absorption during percutaneous nephrolithotripsy(PCNL). Methods Eithty nine upper urinary tract lithiasis patients underwent PCNL assisted with pressure irrigation. Sixty five cases were with renal calculi and 24 cases were with ureteral calculi. There were 62 males and 27 females. Nor mal saline was used as irrigation fluid. Heart rate(HR),central venous pressure(CVP),cardiac out put(CO),stroke volume(SV),systemic vascular resistance(SVR),thoracic fluid content(TFC) wererecorded before operation and every 30 min during irrigation. Serum Na+,K+,CI ,Ph,BE weredetected before and after irrigation. One way ANOVA,linear correlation and paired t test were usedas statistic analysis. Results The mean irrigation time was 105 min. Mean irrigation fluid volumewas 18 391 ml and mean irrigation velocity was 174.46 ml/min. HR,CO,SV,SVR and blood Na+ ,K+,C1 did not change significantly during and after irrigation. CVP and TFC significantly increasedduring irrigation. The increasing of CVP and TFC were correlated with irrigation time, volume andvelocity. CVP and TFC increased rapidly in 5 patients with calyx laceration and recovered after diuret ic injection. No serious complication was detected. Conclusions Irrigation fluid absorption is observed during PCNL with pressure irrigation. Generally, no significant changes in hemodynamic andelectrolyte balance are found in patients with normal cardiac and renal function.

Objective To compare the characteristics of hMPV infection in BALB/c and SCID mice.Methods BALB/c and SCID mice were infected intranasally with GFP-rhMPV,and sacrificed on day 3,5,7,9 and 14 post inoculation.Heart,liver,spleen,lungs,kidneys and brain of the animals were used for viral isolation,titration,pulmonary histopathology and detection of GFP-hMPV mRNA expression by RT-PCR and real-time PCR.Results Live viruses were successfully isolated from the lungs of infected mice.Viral titers peaked on the 5th day post inoculation.Viruses remained to be detectable on the 14th day post inoculation in SCID mice,but not in BALB/c mice,whereas genomic RNA of GFP-rhMPV was detectable by PCR targeting F gene in infected BALB/c mice.Live viruses were not able to be isolated from heart,liver,spleen,kidney and brain,neither was genomic RNA of hMPV able to be detected on the 5 th day post inoculation by RT-PCR and real-time PCR.Histopathology of lungs was characterized by interstitial pneumonia on 5 days post inoculation.Lung pathology score of BALB/c mice group was slightly lower than SCID,and the difference was not statistically significant.Conclusion GFP-rhMPV can only replicate in the immunocompetent and immunodeficient mouse lungs,but not in other organs.As compared to that in BALB/c mice,the viral replication appears to be more efficiently and for longer time in SCID mouse lungs probably due to the absence of host cellular and humaral immunity,but this does not necessarily result in more severe pathological lesion.

Objective To discuss the clinical application and significance of non-enhanced computed tomography axis rotating movie imaging technique in PCNL for complex renal calculi. Methods Thirty-one cases unilateral and 2 cases bilateral multiple and staghorn renal calculi with mild or mediurn hydronephrosis patients were performed bilateral kidneys non-enhanced CT scanning,three dimensional reconstruction and the axis rotating movie composition were carried on by computer software,PCNL accesses were designed and the residual stone were predicted referred to the access-calyces angle measured in axis rotating movie image,PCNL were performed after while.Comparing between preoperation accesses design and residual stone prediction with in-operation practice were carried out.Results The first PCNL access was constructed via posterior middle upper minor calyces in 22 renal units and via posterior middle lower minor calyces in 13 renal units,which was consistent with pre-operation design according to CT axis rotating movie image.The second PCNL accesses were constructed via lower calyx posterior upper minor calyces in 9 renal units and via lower calyx posterior lower minor calyces in 5 renal units,nephrolithotomy were performed in the same operation,clinical stone clearance rate was 80%(28/35),other 7 cases with residual stone were consistent with pre-operation prediction,No blood transfusion was necessary and no severe complication happened in all 33 cases.Conclusions Non-enhanced CT axis rotating movie imaging provided the detail three dimensional shape and spatial structure of complex renal calculi intuitively) that was benefit for designing appropriate PCNL accesses for complex renal calculi patients, guiding for searching stone fragments in operation, predicting residual stone, and ensuring operation safety.

Objective To evaluate the feasibility of European Organization for Research and Treatment of Cancer (EORTC) risk tables in non-muscle invasive bladder cancer in Chinese patients.Methods A retrospective analysis was performed on the data from 185 patients with non-muscle invaaive urothelial bladder cancer from January 2003 to February 2009. Among the 185 patients, 128 patients were stage Ta compared with 57 patients who were stage T1. There were 87, 53 and 45 patients with grade G1, G2 and G3 respectively. Transurethral resection of the bladder tumor was performed on all the patients and all the patients received routine post-operative intravesical instillation. A telephone interview follow-up was conducted on all the patients, and the average follow-up period was 36 months. EORTC risk tables were used to calculate risk scores for recurrence and progression for each patient. The recurrence and progression rates of different risk groups were recorded and compared with the estimated rates by EORTC risk table. Statistical analysis was used for comparison. ResultsTotal 1-year recurrence rate and progression rate for these patients were 25.9% and 3.8% respectively. According to calculated values of the patients, the 1-year recurrence rates of Group 0, Group 1-4, Group 5-9, Group 10-17 were 10.4%(5/48), 21. 5%(14/65), 35. 2% (19/54), 55.6%(10/18), respectively. The 1-year progression rates of Group 0, Group 2-6, Group 7-13, Group 14-23 were 0% (0/43), 1.5% (1/67), 6. 7% (4/60), 13. 3% (2/15). There was no significant difference between the real rates and estimated rates of the EORTC risk tables (P＞0. 05). However,the 1-year recurrence and progression rates between the low risk group, the medium risk group and the high risk group showed significant differences respectively (P ＜ 0. 05 ). Conclusions The EORTC risk tables are feasible to evaluate the recurrence and progression risk of non-muscle invasive bladder cancer in the present cohort. Nevertheless, the long term value and feasibility need more research to confirm.

ObjectiveTo investigate the difference of pathogenicity between the two genotypes of human metapneumovirus(hMPV) for the further research.MethodsAt various time after hMPV infection in BALB/c mice,viral titers of lung tissue were measured by real-time RT-PCR,pathology was assessed by a histopathological scoring system,airway responsiveness was assayed by animal lung function monitoring equipment.Pathogenicity was then measured by detailed evaluation through the results above.Results There is no significant difference in weight of mice between control group and experimental group through dynamic monitoring ; though the difference was exists in airway responsiveness and pathological changes of mice between control group and experimental group,the differences were not statistically in airway reaction,pathological changes and virus drops among the three groups of experimental group.ConclusionThere is no difference in pathogenicity between the two subtypes of hMPV in infection of BALB/c mice,viral genotype do not appear to be associated with pathogenicity.

OBJECTIVETo evaluate the clinical value of the four regions 12-core systemic prostate biopsy.

METHODSNinety-one patients suspected of prostate cancer received four regions 12-core systemic prostate biopsy, and the detection rate and complications were compared with those of the sextant method.

RESULTSMore positive results were obtained in detecting prostate cancer with the four regions 12-core method, and the complications were similar to those of the sextant biopsy.

CONCLUSIONThe four regions 12-core biopsy was suggested for patients suspected of prostate cancer with enlarged prostate gland above 40 ml.

Aged ; Aged, 80 and over ; Biopsy, Needle ; adverse effects ; Humans ; Male ; Middle Aged ; Prostate ; pathology ; Prostatic Neoplasms ; diagnosis ; pathology

Objective To compare WHO 2004 and WHO 1973 pathological grading methods of non-muscle invasive urothelial neoplasms. Methods The clinical pathological features of 160 non-muscle invasive urothelial neoplasms patients, treated in our hospital from February, 1998 to Decem-ber, 2008, were re-graded according to WHO 2004 and WHO 1973 classification system. To evaluate recurrence and progression of all the patients during the follow up period, we used statistical method to analyses the differences between two classification system. Results There were 160 patients, ac-cording to WHO 1973 classification methods: 5 cases of papilloma, 52 cases of grade 1 tumors, 83 ca-ses of grade 2 and 20 cases of grade 3;By WHO 2004 classification method: 7 cases of papilloma, 31 cases of low-grade malignant potential of urothelial papilloma, 99 cases of low-grade papillary urotheli-al carcinoma and 23 cases of high-grade papillary urothelial carcinoma. There was no difference in re-currence among the grades of WHO 2004 and WHO 1973 pathological grading system (both P>0.05). Regarding the progress of non-muscle invasive papillary urothelial neoplasms, no significant difference was found among grades of WHO 1973 classification system(P>0.05)while difference exis-ted among grades of WHO 2004 pathological grading system (P<0.05), especially between papillary neoplasm of low malignant potential (PNLMP) and high grade papillary urothelial carcinomas(HG-PUC) (P<0.01). Moreover, HGPUC grade had more progression rate (30.4%) than G_3 grade (15.0%). Conclusions Compare to G_3 grade, HGPUC grade was more easily to make progress in pa-tients,due to this grade include more high malignant papillary urothelial carcinomas. Therefore, it is necessary for urologists to use a more rigorously follow up and therapy method in connection with HG-PUC grade of new classification system.