Objective To present the diagnosis and treatment of functional bladder outlet obstruction and to assess the results of transurethral bladder neck incision and alpha-blockers with regard to symptoms and urodynamic findings. Methods From October 1995 to October 2002,39 male patients (age range from 24 to 48 years,with a mean of 37 years) who had dysuria and underwent urodynamic examination,cystourethrography and urethral exploration were diagnosed with functional bladder outlet obstruction.The mean IPSS was 22.5.The mean maximum urinary flow rate was 10.2 ml/s and the mean residual volume was 124 ml.All the patients were treated with transurethral incision of bladder neck and alpha blockers. Results The mean operative duration was 15 min;mean blood loss was 50 ml;mean postoperative hospital stay was 3.5 d.During 1-year follow-up,most of the patients were satisfied with the treatment results.Subjective assessment showed a statistically significant reduction of the voiding complaints.The mean IPSS was 10.1 .The mean maximum urinary flow rate was 22.1 ml/s (range,12.7 to 42.1 ml/s) and the mean residual volume was 49 ml (range,0 to 84 ml). Conclusions Urodynamic examination,voiding cystourethrography and urethral exploration with dilator facilitate the diagnosis of functional bladder outlet obstruction.Treatments with transurethral incision of the bladder neck and alpha-blockers are effective and safe for functional bladder outlet obstruction.

Objective To evaluate the clinical features,diagnosis and treatment of metastatic adrenal carcinoma. Methods The data of 11 cases of metastatic adrenal carcinoma who were admitted from December 1993 to March 2003 were reviewed,including 4 cases of lung carcinoma,5 cases of hepatocellular carcinoma,1 case of bile duct carcinoma and 1 case of renal cell carcinoma.The main clinical manifestations were waist pain in 3,fatigue and weight loss in 3,hematuria in 1 and no symptom in 4.All the 11 cases underwent B-ultrasonography and CT scan,of whom 2 underwent positron emission tomography (PET).All patients were treated by surgical operation,including 9 cases by total adrenalectomy,1 case by palliative adrenalectomy and 1 bilateral metastatic case by left-adrenalectomy alone. Results In 5 cases by total adrenalectomy the survival time was 6 to 63 months with a mean of 34 months.Two cases were followed up for 2 to 16 months and 2 cases were lost with follow-up.One case by palliative adrenalectomy survived for 3 months.One bilateral metastatic case by left-adrenalectomy survived for 4 months. Conclusions Ultrasonography and CT are important in the diagnosis of metastatic adrenal carcinoma,and PET is of greater value in clinical practice.Complete adrenalectomy may be the best treatment choice to prolong the survival time.

Objective To discuss the safety of nephron sparing surgery for central renal tumors. Methods Thirty-eight cases of partial nephrectomies for central type renal masses were performed.One hundred and seventeen cases of partial nephrectomies with peripheral type renal tumors were compared. Results For the patients with central renal tumors,mean operative time was 118 minutes.Mean isehemic time was 34 minutes.Mean blood loss was 150 ml.The major postoperative complication included leakage of urine(1 case).For the patients with peripheral based tumors,mean operative time was 95 minutes.Mean ischemic time was 21 minutes(only renal artery clamped)and 17 minutes(complete block).Mean blood loss was 250 ml(only renal artery clamped)and 100 ml(complete block).The major postoperative complication included postoperative bleeding(4 cases). Conclusion According to the standard operative procedure,the nephron sparing surgery for central renal tumors is a safe procedure.

Objective To study the feasibility of renal hypothermia achieved by retrograde icecold saline infusion with perfusion pump. Methods Twenty-one patients who received the open radical nephreetomy were divided into three groups,A group with ice-slush renal hypothermia,B group with gravitational retrograde ice-cold infusion,C group with retrograde ice-cold infusion by perfusion pump.After the kidney was dissected and the ureter was divided,the renal vasculars were clamped.The kidney was cooled by three methods respectively.The temperature of renal parenchyma was monitored for 15 min. Results Fifteen minutes later,the temperature of renal parenchyma of A group declined from 34.4℃ to 5.4℃,B group from 34.8℃ tO 23.8℃,C group from 35.1℃ to 22.3℃.Coneiusions Renal hypothermia can be achieved by retrograde cold saline infusion and the perfusion pump may accelerate the speed of cooling.

A new method to revel RFLPs is presented. The human genomic DNAwas purified by saturatedNaCl solution and the pAW101 probe labelled with digoxigenin-dUTP. The relationships of RFLPsand genetic patterns of PGM1 (phosphoglucomutase),EsD (esterase D),GLO1 (glyoxalase)and ACP(acid phosphatase ) between the fillal generation and parental generation were detected in 15 families(among them 11 cases were aborted fetuses). The probability of paternity (w)was caculated accor-ding to Essen - Moller's formula, each w vlua was over 99. 73 %, reached the standard of incladingpaternity. An effective,rapid, and non-toxic RFLPs technique was established, which is easy to man-age in common lab oratories.

Objective:To investigate the role of SDF-1/CXCR4 in metastasis of renal cell carcinoma and to observe the intracellular location of different CXCR4 segments in renal carcinoma cells.Methods:The potential nuclear localization sequences of different CXCR4 were discovered by nuclear localization software and experiments.Full length and truncated forms of CXCR4 were fused with green fluorescent protein pEGFP-N1 and their influence on subcellular localization was examined by confocal microscopy after transfecting them into renal carcinoma cell line A498.Results:Analysis with PSORT Ⅱ Prediction revealed that the nuclear localization sequence region of CXCR4 was located between amino acids 146 and 149(RPRK).Expression products of the recombinant plasmids with SDF-1 stimulation,including EGFP-CXCR4(1-510 bp),EGFP-CXCR4(1-765 bp) and wild-type EGFP-CXCR4,were mainly located in the cell nuclei.However,expression product of EGFP-CXCR4(1-267 bp) with SDF-1 stimulation was mainly located in the renal cell cytoplasm.Expression product of wild-type EGFP-CXCR4 full length plasmid without SDF-1 stimulation was mainly located in the cell cytoplasm;these results accorded with the results of bioinformatics analysis.Conclusion:Nuclear localization sequence of CXCR4 is located in the amino acids 90 to 170,which provides a theoretical basis for further clarifying the nuclear localization sequences of CXCR4 in renal cell carcinoma cells and for finding new potential target for inhibiting the metastasis of renal cell carcinoma.

Objective:To study the inhibitory and apoptosisinducing effect of vitamin E succinate(VES) on androgen-independent prostate cancer cell line PC-3 in vitro.Methods: VES was dissolved with ethanol to obtain VES solution.PC-3 cells of logarithmic growth phase were treated with various concentrations of VES solution(25,50,75,100,and 125mg/L);cells in control group were treated with 1.25% ethanol.MTT method was used to measure the viability and inhibitory rate of cells in each group 24h,48h and 72h after VES treatment;flow cytometry was employed to determine the apoptosis rate of the PC-3 cells.Results: The viability of cells in the experimental groups was significantly lower than that in the control group(P

Objective To evaluate the diagnostic value of tracking movement of normal patellar using volume scan on sensation 320 CT. Method Data of dynamic scans of 30 knees was collected using the motor function of 320 CT and retrospectively analyzed. The data of movement of the patellorfemoral joint was obtained during flexion (from 0° to 120°) within 10-sec by 320 CT from all volunteers. The 3D coordinate of the center of patella was recorded to investigate the dispose relation of patellofemoral joint.Result With the knee angle changed from 0° to 90°, the patella moved rapidly along the Y-axis direction ( sagittal plane) down about (53.87 ± 0. 45 ) mm, and then entered the plateau phase with little change.When the knee flexion reached 10°-30° ,the patellar movement along the X-axis reached the largest range of (2. 31 ±0. 52)-(3.36 ± 0. 43 ) mm, and subsequently moved to the opposite lateral direction with the maximum about (8. 53 ± 0. 44 ) mm at 120°. In the Z axis, the track initially showed plateau, and then presented a rapidly downward trend after 30°. The patellar tracking is like an outward arc during the whole knee flexion. Conclusion The motor functional imaging of 320 CT can pinpoint the patelar tracking in a fast, painless way.

0.05).In the 3 recipients who developed acute rejection,the levels of P and GB relative expression were 1 923?326 and 489?57 respectively,which were significantly higher than those before rejection ( P

Objective To compare the clinical outcomes of retroperitoneal laparoscopic and open radical nephrectomy in patients with T1 renal cell carcinoma (RCC). Methods 352 patients under-went radical nephrectomy for T1 RCC, 185 by retroperitoneal laparoscopic radical nephrectomy(group A) and 167 by open radical nephrectomy through an extraperitoneal flank incision(group B). The op-eration time, blood loss during operation, hospital stay and complication after surgery were analyzed and compared. All the cases were followed up for 6-42 months(median, 25 months) and the survival rates were recorded. Results The operation time of group A, B was 55-130(75.6±11.2)min vs. 50-140(68.0±10.6)min(P0.05). Blood loss was 50-1200(110.6±32.3)ml vs. 50-1500 (160.8±38.1)ml(P<0.05). Eight cases of group A and 132 cases of group B took analgesic after surgery(P<0.05). The fasting period was 1-2(1.3±0.5)day vs. 2-5(2.9±1.2)d of group B (P<0.05)ilengthof hospital stay was 3-7(4.6±1.2)d vs. 7-14(8.9±1.6)d(P<0.05). The survival rate was 85.4 % vs. 86.2% (P0.05). Conclusions Compared with open radical nephrec-tomy, retroperitoneal laparoscopic radical nephrectomy is associated with lower blood loss, narcotic requirement and complications, a shorter hospital stay and earlier resumption of routine activities. Retroperitoneal laparoscopic radical nrphrectomy has become a gold standard therapy in T1 renal cell carcinoma.