Objective To investigate the efficacy and safety of transrectal ultrasound guided transurethral balloon dilation of the prostate (TUDP) for the treatment of benign prostatic hyperplasia (BPH).Methods A total of 23 men with BPH who had undergone TUDP were retrospectively analyzed,including 16 men with indwelling urinary catheters before the operation.During the TUDP,the prostatic apex and membranous urethra were dilated by inner balloon,and the prostatic urethra and bladder neck were dilated by outer balloon.The patients were followed up at the 1st,3rd,6th and 12th month after the operation,and the observation parameters included subjective symptoms,such as international prostatic symptom score (IPSS) and quality of life (QOL) score,and objective parameters,such as maximum flow rate (Qmax) and post-void residual (PVR).Results The operation time was 30-165 min,and the intraoperative hemorrhage volume was 5-50 ml.The IPSS scores at 1st,3rd,6th and 12th month after the operation were 10.4± 4.2,8.7±3.2,9.5±4.6 and 8.3±1.5 respectively,which were significantly decreased in comparison to the IPSS score (22.0±7.2) before the operation (P＜0.05).The QOL scores at 1st,3rd,6th and 12th month after the operation were 2.1±1.1,1.6±1.0,1.8±1.1 and 1.6±1.0 respectively,which were significantly improved in comparison to the QOL score (4.9±0.9) before the operation (P＜0.05).The Qmax at 1st,3rd,6th and 12th month after the operation were (10.5±3.4),(12.4±4.2),(10.9±3.9) and (12.7±4.6) ml/s respectively,which were significantly increased in comparison to the Qmax(1.9± 1.9 ml/s) before the operation (P＜0.05).There were 5,4,2 cases of urinary incontinence at the 1st,2nd and 3rd month after the operation,but they recovered at the 4th month follow-up.Besides,there were 3 cases suffered from epididymitis.Conclusion Transrectal ultrasound guided TUDP is a safe,effective and cheap option for the treatment of BPH,especially for the primary hospitals.

Objective: To observe the efficacy and safety of analgesic drugs in the standardized treatment of cancer pain patients at the pain clinic. Methods: The data of 787 cancer pain patients and their corresponding prescriptions for cancer pain were collected from April, 2012 to April, 2013 at the pain clinic. The obtained information comprise of diseases that lead to cancer pain, cause of pain, pain intensity, and efficacy and side effects of medications. Diseases that caused cancer pain include 658 cases with primary malignant lung cancer. Results: Pain was mainly caused by primary lung cancer in 787 cancer-related patients. An analgesic drug, namely, oxycodone hydrochloride, was administered in 54.6% via single drug therapy. The daily dosage range of this drug was 20 to 90 mg/d in 280 cases. About 35.6% of the studied patients with a daily dosage of 90 mg/d or lower had their pain effectively managed. After the treatment, the number of cases with moderate to severe pain was reduced from 437 (55.5%) to 248 (31.5%). The oral administration of opioid oxycodone hydrochloride tablets ranked first among the prescribed drugs for cancer pain, and single-drug therapy was the choice of medication. The majority of patients had satisfactory pain-relief with a daily dosage of less than 90 mg/d upon the administration of oxycodone hydrochloride sustained-release tablets and morphine sulfate controlled-release tablets. Side effects included mild constipation, nausea, vomiting, dizziness, loss of appetite, urinary retention, somnolence, and so on. Intervention treatment was needed in most of the patients. Conclusion: Pain clinic is critical in the administration of standardized treatment for cancer pain in hospitals. The establishment of pain clinic ensures the standardized treatment of cancer pain.

Objective: To assess the diagnostic rate, safety and clinical application of percutaneous renal masses biopsy for advanced renal cell carcinoma patients.Methods: In this retrospective study, we collected the data of renal masses from the patients who underwent renal masses biopsy under ultrasound from April 2001 to December 2014 in Peking University First Hospital.A total of 75 patients who were undiagnosed or diagnosed with advanced renal cell carcinoma by the imageological method were enrolled in this study.The patient and lesion characteristics such as tumor size, pathology of tumor, histologic subtype, pathological grade, biopsied location and biopsied cores were recorded and analyzed.Results: Among all the 75 patients, biopsy was diagnostic in 64 cases (85.3%) and non-diagnostic in 11 cases (14.7%).Of the 64 diagnostic biopsies, 60 were malignant, including 37 (61.7%) renal cell carcinoma (RCC), 13 (21.7%) urothelial carcinoma and 10 (16.7%) other malignant masses.Of all the RCC subjects, 24 suffered from clear cell RCC, 5 papillary RCC, 3 collecting duct carcinomas, 1 unclassified RCC and 4 unknown subtypes.The 11 non-diagnostic biopsied samplings included inflammatory, blood and extrarenal tissue and normal renal tissue.The proportion of collecting duct carcinoma in RCC was 10.8% and the proportion of squamous carcinoma in urothelial carcinoma was 23.1%, which were both higher than the previous research findings.For the male and female groups, non-diagnostic yields were 6.5% and 30.4%, respectively (P=0.022).Of all the 75 patients, 13 renal cell carcinoma patients underwent the surgical treatment and got the results of postoperative pathology.Comparing preoperative biopsy pathological diagnosis with postoperative pathological diagnosis, we found the diagnostic correct rates for benign and malignant lesions, pathological subtype and pathological grade were 100%, 81.8% and 60%, respectively.Mild macroscopic hematuria occurred in 1 case after RMB and there were no serious complications in all the cases.Conclusion: Percutaneous renal masses biopsy under ultrasound with a high diagnostic rate which can define the histologic subtype of renal cell carcinoma.With targeted therapy, more and more patients whose evaluation suggests local advanced disease or metastatic tumors adopt renal tumor biopsy to define the histologic subtype, which could avoid unnecessary surgical treatment.

Objective: To observe the safety and efficiency of face-lift combined with fat grafting in facial rejuvenation. Methods: We performed a retrospective study, which included 23 patients. SMAS suspension and multi-site suspension were combined to correct the nasolabial fold, mid-cheek aging and malar mounds. Structural fat grafting was performed to treat the volume loss in mid-face. Results: All patients demonstrated a significant improvement in midfacial appearance. No infection or nerve injury were found in this study. Only three patients did not get primary healing in temple region, which led to temporal hair loss from secondary healing. Conclusions This study demonstrates that fat grafting and multiple layers face-lift are efficient method for facial rejuvenation. These approaches appear to be very promising for facial anti-aging techniques.

Objective: To investigate the clinical pathological features, pathological diagnosis and differential diagnosis of hybrid schwannoma/perineurioma. Methods: The clinicopathological data of 35 cases were collected at Fudan University Shanghai Cancer Center, from October 2010 to August 2017; morphological observation and immunohistochemical staining were performed, and the literatures were also reviewed. Results: There were 7 males and 28 females (male∶female=1∶4), patients with onset age ranging from 3 to 81 years(mean=36 years). Of 35 tumors, 11 cases occurred in the head and neck, 10 in the extremities, 9 in the trunk, 4 in the intestine, and 1 in the labiamajora, respectively. Clinically, most patients presented as a slowly growing dermal nodule, sometimes associated with pain. The duration of symptoms ranged from 1 month to 20 years before excision. Tumor size ranged from 0.8 cm to 6.0 cm (mean=2.6 cm). Microscopically, the tumors were usually well circumscribed but unencapsulated. At low power, most tumors were located in the dermis or subcutis, and several cases in the submucosal tissues. The tumors were composed of fascicular, storiform or whorled growth of closely intermixed plump spindle cells and slender spindle cells. The plump spindle cells had ill-defined eosinophilic cytoplasm with larger tapered or wavy nuclei, whereas the slender spindle cells had comparatively delicate nuclei with elongated cytoplasmic processes. Tumor cells had no obvious atypia, and mitoses were rare. Scattered large cells with degenerative nuclear atypia were seen in some cases. By immunohistochemistry, most of plump spindle cells showed strong staining of S-100 protein(35/35) and SOX10(8/9), whereas slender spindle cells stained variably for epithelial membrane antigen(31/35), CD34(32/33), Claudin-1 (15/15) and GLUT-1(8/8). Ki-67 proliferation index were all less than 5%. Follow-up data available in 16 patients (range 4 to 72 months; mean=46 months) were all free of disease, and one case developed local recurrence. Conclusions Hybrid schwannoma/perineuriomaisa benign nerve sheath tumor that typically manifests as a dermaland subcutaneous tumor, less frequently may affect uncommon sites such as the nasal cavity, the gastro-intestinal tract, and the external genital areas. The tumors consisted of intimately admixed plump-spindled schwannian cells and slender-spindled perineurial cells showing dual differentiation of strong S-100 protein and SOX10 expression in the former component and variable immunoreactivity of epithelial membrane antigen, Claudin-1 and CD34 in the latter. It should be aware of the possibility of potentially misinterpretation of hybrid schwannoma/perineurioma as dermatofibrosarcoma protuberans and solitary fibrous tumor and so on.