Objective To study the clinical and pathological features, diagnosis and treatment of malig-nant mesothelioma of the tunica vaginalis testis. Methods One case of malignant mesothelioma of the tuni-ca vaginalis testis was reported. The patient was a 73 years old man, presented with a history of aggravated hydrocele for 1 year. B-ultrasound showed 7.5 cm×4.1 cm liquid anechoic area around the testis. The Pubmed and CBM databases were searched for related articles, and the clinical data were reviewed. Results An operation was performed to incise the tunica vaginalis. The pathology showed fecal caneeration in the tunica vaginalis testis and the immunohistology showed CK5/6, Calretinin and E-cadlberin positive. Right or-chiectomy was performed after three weeks. Local tumor recurrence and inguinal lymph nodes metastasis were found 11 months after operation, and local tumor and lymph nodes were resected. The tumor was diagnosed as malignant mesothelioma of the tunica vaginalis testis and CK5/6 and Calretinin fecal positive. Conclu-sions Malignant mesothelioma of the tunica vaginalis is a rare disease of the testis with potentially aggres-sive behavior. Due to the lack of tumor markers and characteristic symptoms, correct preoperative diagnosis is extremely difficult. Radical surgical treatment is of major importance to the survival of the patients. Life-long follow-up should be offered to patients with malignant mesothelioma of the tunica vaginalis.

Objective To evaluate the diagnostic significance of B-ultrasound and CT in small renal tumor (≤3 cm). Methods The clinical data of 48 patients (29 men and 19 women) with small renal tumor were reviewed.Their mean age was 49 years.Of them,43 cases were asymptomatic,while 2 complained of hematuria,2 of lumbago and 1 of hematuria with lumbago.B-ultrasound, conventional CT,helical CT thin scan and intraoperative frozen section were evaluated. Results Of the 48 cases,36 of renal cell carcinoma (RCC),7 of renal angiomyolipoma (RAML),4 of oncocytic adenoma and 1 of metanephric adenoma were diagnosed by pathology after surgery.The diagnostic accuracy was 75%(36/48) for B-ultrasound,81%(39/48) for conventional CT,91%(20/22) for helical CT thin scan and 95%(19/20) for intraoperative frozen section,respectively. Conclusions Small renal tumor has high incidental rate as well as high benign rate.As the tumor is relatively smaller, it is difficult to differentiate between benign and malignant nature of the tumor by B-ultrasound and conventional CT.Helical CT thin scan and intraoperative frozen section are helpful for accurate diagnosis of the tumor.

Objective To study the clinical and pathologic features of chromophobe cell renal carcinoma and to improve the diagnosis and treatment of the disease. Methods The clinical and pathologic data of 19 patients (10 men and 9 women;mean age,53 years) with chromophobe cell renal carcinoma (9 on the left and 10 on the right) were analyzed.Of the 19 cases,12 were incidentally diagnosed of renal tumor during physical examination.Gross hematuria,low back pain and discomfort and abdominal mass occurred in 7 cases. Results B-ultrasound was mainly characterized by low echo of mass with intact capsule.CT scan revealed that most of the tumors were homogeneous hypodense solid masses,which were well circumscribed.The tumors averaged 8.2 cm in diameter.By TNM staging,8 cases had T_1N_0M_0 stage tumors and 11 cases had T_2N_0M_0 stage tumors.Radical nephrectomy was performed in 17 cases,and partial nephrectomy,in 2 cases.Follow-up was available for 16 patients (mean,4.8 years;range,3 months to 16 years)who were alive without recurrence and metastasis.Pathological features were as follows.①The cross-sections of the tumors were grossly homogeneous, dark brown and solid. One case had fibrous bands coalescence in the center of the tumor.②Microscopically the tumors were composed of 2 types of cells, typical and eosinophilic types,with very distinct borders.③Immunohistochemical assay was positive for CK8 and negative for Vimentin, and Hale colloidal iron staining was positive for the carcinoma cells.④Electron microscopy showed large numbers of vesicles within the cytoplasm. Conclusions Chromophobe cell renal carcinoma is a morphologically distinctive neoplasm with no specific findings on B-ultrasound and CT examinations.The tumors are larger in most cases but usually at early TNM stages with a favorable prognosis.

Radiotherapy and chemotherapy have little or no effect on advanced renal cell carcinoma, leading to a poor prognosis. Several factors couLd affect the survival rate of RCC. Some RCC patients could partly respond to immunotherapy.The newly emerging targeted therapy has a dramatic tuning point in improving outcomes for RCC. Further understanding of the anti-RCC mechanisms involves in chemokine-mediated angiogenesis and RCC cell proliferation. These new agents include Sorafenib, Sunitinib, Temsirolimus, Bevacizumab, etc. Combination treatment with immunotherapy may lead to improved outcomes in this disease.

Objective To investigate the curative effect of RevoLix 2 micron continuous wave laser va-poresection for treatment of elderly and high risk benign prostatic hyperplasia patients. Methods Clinical data of 36 benign prostatic hyperplasia patients with medical complications aging 70 -82 years were retro-spectively analyzed. Operations were done after their complications were controlled. The RevoLix 2 μm laser system with output power of 70 W was used, and normal saline was used as rinse solution. Operations were started after positions of seminal colliculns and distances to neck of bladder were confirmed. Results Oper-ation time varied from 65 to 135 rain with a mean time of (83.6±10. 6) rain. Occasional venous hemor-rhage occurred during operation but no arterial hemorrhage was observed. No blood transfusion necessitated and no TURP syndrome was observed. Catheter was removed 2-4 days after operation. All the patients could urinate freely. No urinary incontinence was found during follow-up except 2 patients with temporary urinary incontinence. A 3-6 months follow-up showed that IPSS decreased from 24. 26 ±2. 70 to 8.47±4. 32, QOL dropped from 4. 51±0. 56 to 1.34 ± 0. 53, and Qmax increased from (6. 37 ± 1.31) mL/s to (17.24± 2. 32) mL/s. Conclusions RevoLix 2 micron continuous wave laser vaporesection is a safe and effective method with less trauma and fast recovery for treating elderly and high risk benign prostatic hyperplasia pa-tients.

Objective To evaluate the safety and feasibility of minimally invasive percutaneous nephro-lithotomy (mPCNL) with U100plus laser for the treatment of renal calculi. Methods From October 2006 to December 2008 ,mPCNL was performed on 133 patients suffering from renal calculi by using Wolf 8/9. 8 rig-id ureteroscope and U10Oplus laser. Results mPCNL was completed in all the 133 cases. Residual calculi were found in 7 cases after operation and use medical drags to treat. The most residual calculi were removed after 1 month and a few stones being survived. 5 cases with residual calculi were treated by ESWL. The total stone clearance was 91.0%. The operation time was 38 -65 min(mean 46 min). Nephrostomy tube was kept for a mean of 1 -2 d. The mean postoperational hospital stay was 2 -4 d. Among the patients, 133 were followed up for 1-16 months (mean 8. 3 months) , during which no recurrent renal stones were found by B ultrasonngraphy or X ray. Conclusion By using mPCNL with U100plus laser, patients with renal calculi can be treated safely and effectively.

Objective To study the clinical features,diagnosis and treatment of bladder leiomyoma.Methods The clinical data of eight patients(3 men and 5 women)with bladder leiomyoma were analyzed retrospectively.Results The median age was 42 years ( range,27 -71 years).Three patients were treated with transurethral resection of bladder tumor( TURBT),two patients underwent partial cystectomy,two patients underwent enucleation of leiomyoma,and one patient underwent laparoscopic enucleation of leiomyoma of the bladder.The patients were well with no evidence of recurrent tumor after follow-up from 10 to 75 months.Conclusion Bladder leiomyoma is rare,surgery is the treatment of choice and technique depends on tumor size and localization.The laparoscopic approach seems to be an effective alternative in this group of tumors.

Objective To observe the anti-proliferation effects of rapamycin and paclitaxel of different hu-man prostate cancer cells in vitro. Methods The methods of MTr and flow cytometry were respectively ap-plied to observe the effect of rapamycin, paclitaxel and rapamycin+paclitaxel on proliferation and apoptosis of different prostate cancer cell lines (LNCaP-C4, LNCaP-C4-2, PC-3). Results When the concentration of rapamycin was 0.01 μmol/L, the impressive effect showed a remarkable difference in contrast to the con-trol. While in group LNCaP-C4-2 and PC-3, the goal concentration of rapamycin was 0.001μmol/L. When the concentration of paclitaxel was 0. 2 ng/mL, the impressive effect showed a remarkable difference in con-trast to the control. In group rapamycin (10 nmol/L) and in group paclitaxel (1 ng/mL) there were signifi-cant differences in growth inhibition, compared with control. While in group rapamycin(5 nmoL/L)+pacli-taxel(0.5ng/mL) there was significant difference in growth inhibition, compared with rapamycin (10 nmol/L) and paclitaxel (1 ng/mL) respectively. After cultured with rapamycin or paclitaxel alone, more tumor cells induced apoptosis than control. While after cultured with rapamycin and paclitaxel simultaneously, more tumor cells induced apoptosis than with rapamycin or paclitaxel alone. Conclusions Both rapamycin and paclitaxel had a good impressive effect on the three prostate cell lines (LNCaP-CA, LNCaP-C4-2, PC-3) with dose-dependent manner. After cultured with rapamycin and paclitaxel simultaneously, more tumor cells were induced apoptosis than with rapamycin or paclitaxel alone.

Stenosis and occlusion caused by carotid atherosclerosis is an important cause of ischemic stroke. In recent years, with the continuous development of magnetic resonance imaging (MRI) technology and the introduction of complex network theory, brain network analysis can be used not only to explain the clinical symptoms and cognitive dysfunction in patients with carotid stenosis caused by changes in network topological properties of different brain regions, but also to explore the imaging markers of carotid stenosis, thus providing important reference data for the diagnosis of early asymptomatic carotid stenosis, the selection of individualized intervention programs, and the assessment of efficacy. Brain network analysis has been used as a powerful tool. In this paper, we review the studies of structural and functional brain networks in patients with carotid stenosis, and introduce the definitions of brain network nodes and edges and important topological properties of complex networks. We also analyze the current research on brain network in patients with carotid stenosis, and discuss the challenges and outlook of existing imaging techniques and network construction methodologies in this field.