Objective To evaluate the diagnosis and treatment of pheochromocytoma in children. Methods Eighteen children with pheochromocytoma were diagnosed and treated from 1980 to 2000.The primary clinical manifestations included severe headache,blurring of vision,palpitation,excessive perspiration.Sustained hypertension occurred in 10 cases,sustained hypertension accompanied by episodic exacerbation in 7 and episodic hypertension in 1.The mean blood pressure was 185/130 mmHg(1 mmHg=0.133 kPa),with the highest up to 260/190 mmHg.VMA was increased in 89% (16/18) of the cases,and blood and urinary catecholamine was increased in 92% (12/13).Retroperitoneal pneumography was performed in 3 cases,CT in 14 cases and MRI in 2 cases,with all positive findings.B-ultrasonography showed positive in 94%(15/16). Results This series of 18 cases accounted for 11.6% of the pheochromocytoma cases admitted homochronously (18/155).All the 18 cases underwent surgery with the help of proper peir-operative management.The pheochromocytomas (comfired by pathology) were successfully extirpated with the tumor weight ranging from 40 to 150 g.All the cases were followed up for 1 to 20 years.Their blood pressure returned to normal in 94%(17/18).Only 1 case had relapse 2 years later with diagnosis of malignancy,and died in the following year. Conclusions Since the clinical manifestations of pheochromocytoma in children are atypical,endocrinological and imaging examinations are necessary to children with hypertension.Surgical excision is the best option,and oppropriate perioperative management is extremely important.The outcome of surgical management in children is better than that in the adults.

0.05. Conclusions Radical nephrectomy remains the cardinal method for the treatment of primary renal cell carcinoma. Extensive retroperitoneal lymphadenectomy does not improve the survival.

Objective:To study the expression and significance of cyclinD 1 in 45 cases of transitional cell carcinoma of bladder.Methods:The expression of cyclinD 1 was detectde by immunohistochemistry(SP).Results: Expression of cyclinD 1 was found in 55.56% of TCCs and none of controls,and 78.57% of T a～T 1,11.76%of T 2～T 4.Approximately,85% of G 1,46.67% of G 2 and 10% of G 3 with the progress of tumors clinical stages and grades ,and the positive rates of cyclinD 1 expression decreased. There was no significant correlation between cyclinD 1 expression and number of lesions and postoperative reccurance.Conclusions: CyclinD 1 overexpression can play an important role in the early stage of bladder tumorgenesis.There was significant relativity between cyclinD 1 expression and the biological behaviour of bladder TCCs.

Objective To study the effect of tranilast on cyclosporine A (CsA)-induced epithelial-to-mesenchymal transition in human renal tubular epithelial cells, and investigate the mechanism of its antifibrotic effect. Methods Cultured HK-2 cells were divided into four groups: (1)In the control group, cells were treated without any medicine; (2) The cell were treated with CsA (4. 2μmol/L) for 72 h; (3) The cells were treated with a combination of CsA (4. 2 μmol/L) and tranilast (100μmol/L); (4) The cells were treated with tranilast (100 μmol/L) alone for 72 h.Morphological changes of the cells were assessed by phase-contrast microscopy. The immunofluorescence and Western blotting were adopted to detect the expression of E-cadherin, α-SMA and OPN mRNA and proteins respectively. Results Tranilast could markedly ameliorate the morphological changes of HK-2 cells stimulated by CsA. The irmmunofluorescence staining revealed the expression of E-cadherin was markedly decreased in HK-2 cells stimulated with CsA for 72 as compared with the control group, while the expression of α-SMA and OPN was significantly higher in CsA group than the control group. The expression of E-cadherin in the CsA + Tranilast group was higher than the CsA group, while the expression of α-SMA and OPN in the CsA + Tranilast group was lower than the CsA group. Western blotting showed that protein expression level of E-cadherin in CsA group was dramatically lower than that in the control group (P＜0. 05), while that of α-SMA and OPN in CsA group was significantly higher than in the control group (P＜0.05). The protein expression level of E-cadherin in HK-2 cells in the CsA + Tranilast group was markedly higher than in the CsA group (P＜0.05), and that of α-SMA and OPN in CsA + Tranilast group was significantly lower than in the CsA group (P＜0. 05). Conclusion Tranilast can block the CsA-induced epithelialto-mesenchymal transition in HK-2 cells probably by suppressing the expression of OPN.

Objective To present the experience of laparoscopic extraperitoneal radical prostatectomy and evaluate its safety and efficacy. Methods A total of 91 patients diagnosed with localized prostate carcinoma were admitted from February 2003 to June 2008. The level of serum PSA ranged from 7. 5 - 47. 0 ng/ml(mean 14. 0 ng/ml). The volume of the prostate ranged from 35 - 75 ml(mean 52 ml). Biopsy was performed before the operation and the pathological results revealed prostate carcinoma with Gleason score no more than 8. CT, MR and ECT revealed there was no lymph node or seminal vesicle involvement and there was no bone metastasis. The procedures were performed with an-tegrade techniques and pelvic lymphadenectomies were performed in 32 cases and nerve-sparings were performed in 11 cases. Results The operation duration ranged from 105 - 270 min (mean 173 min). Intraoperative blood loss was 110 - 1200 ml(mean 315 ml). Incontinence occurred in 19 cases in early stage and 18 cases recovered within 3 months. Positive surgical margin occurred in 11 cases. There was no complication of urethra stricture during 3 - 30 months' follow-up. No lymph node was involved in 32 cases with pelvic lymphadectomy. Five of the 11 cases received nerve-sparing prostatectomy had normal erectile function during the follow-up. Conclusions Laparoscopic extraperitoneal radical prostatectomy is a safe, effective and efficient surgical procedure with the minimal invasion, less morbidity and rapid recovery. Laparoscopic radical prostatectomy is emerging as an alternative to open radical prostatectomy.

Objective To report the modified liver mobilization technique in management of renal cell carcinoma with intrahepatic inferior vena cava thrombus. Methods 10 cases (7 men and 3 women at the average age of 49 years) of renal cell carcinoma with intrahepatic inferior vena cavs thrombus were reviewed.The operations were carried by using father clamp to control inferior vena cava,combined with hepatic portal blocking. Results There was no postoperative complication.The average blood loss was 800 ml.The mean hospital stay was 13 days.The time of follow-up ranged from 1 to 48 months. Conclusions The technique of using father clamp to control suprahepatic inferior vena cava combined with hepatic portal blocking is feasible for the treatment of the renal cell carcinoma with intrahepatic inferior vena cava thromhosis.