Objective To observe the efficacy of radical nephrectomy plus embolectomy for the treatment of renal cell carcinoma with renal vein or inferior vena cava involvement. Methods Clinical and pathologic data of 8 patients with renal cell carcinoma extending into renal vein or inferior vena cava were summarized.The operative essentials were introduced,and survival periods were followed up. Results A total of 8 patients underwent radical nephrectomy plus embolectomy.One patient died during the operation after embolectomy with exhausted respiration and cardiovascular function.Three patients survived for 2,4 and 22 months respectively,but all died of distal metastasis later.Four patients were alive for 2,14,25 and 47 months respectively after operations till writing of this article. Conclusions Radical nephrectomy plus embolectomy is a valuable method for the treatment of renal cell carcinoma with renal vein or inferior vena cava involvement.

Objective To evaluate the efficacy of repeated internal urethrotomy as the treatment for male urethral stricture. Methods A total of 296 patients with proved urethral stricture was treated with optical internal urethrotomy and the value of repeated internal urethrotomy has been analysed. Results Of the 296 patients internal urethrotomy has been successful in 261 (88.2%),217 patients with single operation,twice or three times with successful outcome in 32 and 12 patients respectively.35 patients (11.8%) failed with more than three times internal urethrotomy,of which 26 patients was then treated with stents and 9 required open surgery. Conclusions Internal urethrotomy is an efficacious treatment for male urethral stricture,but repeated operation is of limited value especially when the course of the disease is longer than 1 year.

Objective To evaluate diagnostic methods and long-term curative effects for recurrent urethral stricture with false passage. Methods Among a total of 620 cases of urethral stricture or atresia treated from March 1987 to March 2005 in this hospital,false passage was present in 40 cases(6.4%).Diagnostic methods included urethrography,sonourethrography,injection of methylene blue into the bladder by cystostomy,CT and/or MRI examinations,or exploration by vesicotomy.Surgical methods included insertion of a memory metallic stent after urethrotomy in 10 cases,electrotomy in 7 cases,urethral reunion in 4 cases,hydroelectric shock wave therapy in 8,posterior pull-through urethroplasty in 4,patient self-administered urethral dilation in 5,excision of false passage in 1,and perineourethrostomy in 1.Results All the 40 cases were followed for 1~15 years(mean,9 years).The urethral stricture was cured in 32 cases(80.0%),and therapeutic failure was observed in 8 cases(20.0%),including 4 cases of unstable pelvic fracture.Conclusions Sonourethrography is the most accurate noninvasive method of staging urethra strictures.It is simple to perform,requires no radiation,and offers a dynamic three dimensional measurement.

Objective To assess the outcome of internal urethrotomy for the treatment of urethral stricture. Metho ds In the past 10 years, a total of 203 patients with proved urethra l strictures were treated by optical internal urethrotomy.Follow-up studies wer e carried out for 157 patients. Results Of the 203 patie nts 194(96%) have undergone successful internal urethrotomy, 9 patients(4%) with long stricture more than 3 cm failed on repeated internal urethr otomy and required open surgery. Internal urethrotomy was carried out twice for 9 patients and thrice for 5 with successful outcome. Of the 194 patients 157 wer e followed up for 6 months to 8 years, in whom 143 have had satisfactory voiding and 14 needed intermittent dilation. Conclusions Endosc opic treatment shoud be considered as the procedure of first choice for the tr eatment of urethral strictuer, however repeated urethrotomy should be avoided.

Objective To investigate the feasibility of tissue-specific gene therapy for bladder cancer using human UroplakinⅡ(UPⅡ) promoter. Methods The recombinant adenoviruses,Ad-hUPⅡ-TNF carrying tumor necrosis factor (TNF-?) under control of the hUPⅡ,were generated.ELISA showed the production and secretion of TNF by bladder cancer cells infected with Ad-hUPⅡ-TNF.The level of TNF in urine was identified with ELISA. Results ELISA showed that production and secretion of TNF by bladder cancer cells infected with Ad-hUPⅡ-TNF was distinctly higher than by non-urothelium cells infected with Ad-hUPⅡ-TNF and MTT showed that proliferation of bladder cancer cells was obviously inhibited.Conditioned medium from bladder cancer cells apparently inhibited cells of L929 proliferation,compared with conditioned medium from non-bladder cells by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.Intravesical inoculation of Ad-hUPⅡ-TNF also caused decreased tumor growth in orthotopic human bladder cancer model.The sustained high level of TNF in urine could be identified with ELISA. Conclusions TNF driven by hUPⅡ promoter has effective active in the inhibition of bladder cancer growth both in vivo and in vitro.These will undoubtedly yield a new approach of therapy for bladder cancer.

Objective To explore regional anatomical features of fascia and spaces related to complete mesocolic excision (CME)dur-ing laparoscopic right hemicolectomy.Methods Observe and describe the regional anatomical features of related mesenterium,fascia and spaces through autopsy and somatoscopy.Results Superior mesenteric vein is the anatomic landmark in CME with medial access for laparo-scopic right hemicolectomy.Right mesocolon and ileal mesentery are the main mesenterium,and the fascia contains the prerenal fascia and the pancreatic fascia.The right retrocolic space and the colon transversum space are two important anatomical spaces,and their fusion fascia space served as a natural surgical plane.Conclusion There is a natural surgical plane which made of mesenterium,fascia and spaces be-tween mesocolon and prerenal fascia in CME during laparoscopic right hemicolectomy,and the surgery is feasible.

BACKGROUND: The effective method to obtain neural stem cells through in vitro culture that deserves to pay more attention in experimental studies of stem cells.OBJECTIVE: To investigate the effective methods to culture neural stem cells in vitro using culture medium containing different growth factors.DESIGN: Single sample observation.SETTING: Laboratory of Cell Biology, College of Life Science, Sichuan University.MATERIALS: Ten SD rats which were pregnant for 14 days, DMEM/F12 1:1, basic fibroblasts growth factors, epidermal growth factor; nestin antibody IgG , β- microtubule protein Ⅲ antibody IgG , glial fibrillary acidic protein antibody IgG, biotin labeled second antibody and third antibody and fluorescinisothiocyate (FITC)-labeled second antibody were used in this experiment.METHODS: This experiment was carried out at the Laboratory of Cell Biology, College of Life Science, Sichuan University from 1999 to 2001. ① Brain tissue was taken out from the procerebrum of fetal rat, then primary neural stem cell clone was obtained through enzymatic digestion, mechanical treatment, centrifugation and culture. ② Neural stem cells were inoculated and cultured at 2×108 L-1 and divided into 4 groups with 6 bottles of cells in each group. DMEM/F12 (1:1 )culture medium containing 0.1 volume fraction of fetal bovine serum was added , serving as DMEM/F12 group; culture medium containing 20 μg/L basic fibroblast growth factor was added , serving as basic fibroblast growth factor group; culture medium containing 30 μg/L epidermal growth factor was added , serving as epidermal growth factor group; Culture medium containing basic fibroblast growth factors was added to culture for 2 hours, then culture medium containing epidermal growth factors was used for further culture, serving as basic fibroblast growth factor+ epidermal growth factor group. Culture flask was change after 24-hour culture; another 14 days later, primary clone number was counted under the microscope, and expressions of specially labeled albumen nidogen of stem cells were detected with immunohistochemistry.MAIN OUTCOME MEASURES: ① Primary clone of neural stem cells.② Clone culture result of unicell. ③ Induction and differentiation results.RESULTS: ① The cells isolated from the brain of fetal rats possess the ability to consecutively passage and form clone , and immunofluorescent staining showed cell nidogen expression positive in the cell sphere. ②Clone rate of neural stem cells was the highest (0.630%)using ordinal culture of basic fibroblast growth factor and epidermal growth factor. ③ The cultured neural stem cell clone can be induced and differentiated neurons and glinl cells.CONCLUSION: ① The results proved that the cultured and isolated cells are neural stem cells. ②Ordinal treatment of basic fibroblast growth factor and epidermal growth factor is an effective method to obtain neural stem cells.

Objective:To investigate the effects of early postoperative enteral nutrition on recovery of patients with gastric cancer.Methods:Sixty-five cases of patients with gastric cancer were randomized into early enteral nutrition (EEN) group and enteral nutrition (EN) group.Serum total protein (TB),albumin(ALB),Prealbumin,white blood cell count (WBC),C-reactive protein (CRP),immunoglobulin,peripheral T-lymphocyte subsets,gastrointestinal recovery time,hospital stay and cost were recorded.The nutritional and cellular immunity parameters of the EEN group on 7th day after operation were higher than those of the EN group.Inflammatory response of the EEN group on 3th day after operation was lower than EN group.EEN group showed better immunological response and clinical recovery than the EN group (P ＜ 0.05).Conclusion:Early enteral nutrition in postoperative gastric cancer patients can improve early postoperative nutritional status and immune function,alleviate inflammatory response,promote the recovery of intestinal function and shorten hospital stay.

Objective To evaluate smooth muscle protein of 22 kDa (SM22) in the diagnosis of acute intestinal ischemia.Methods 96 healthy adult SD rats were evenly divided into experimental group and control group,with each group subdivided into 6 subgroups,subject respectively to superior mesenteric artery ligation or sham operation.The venous blood samples were extracted from each group rats' right heart atO.5,1,2,4,8,12 h after the operation,for SM22 testing and small intestines tissues for direct immunofluorescence staining of SM22.Results The serum SM22 concentration reached a peak at 4 h (265 ± 15) mg/L,then gradually decreased (P ＜ 0.05).The I-FABP was mainly expressed in the epithelium of intestinal mucosa.During the 4 hours of intestinal ischemia,The number of SM22 positive particles did not change.After 4 hours,the number of SM22 positive granules had gradually decreased compared with the control group (all P ＜ 0.05).Conclusion SM22 mainly exists in the smooth muscle of intestinal,during the ischemic necrosis of the intestinal muscle layer SM22 leaks into blood stream,resulting in high serum levels of SM22 facilitating early diagnosis of acute intestinal ischemia.