Objective To explore the risk factors, di ag nosis and treatment of renal pelvis and ureter cancer after surgery of bladder c ancer. Methods The clinical data of 13 patients (9 males and 4 females) with renal pelvis and ureter cancer after surgical operation of bladder cancer were retrospectively analyzed.Among them renal pelvis cancer was diagnosed in 9 cases;ureter cancer in 4.Clinical manifestations consisted of gro ss hematuria with flank pain in 11 cases,suspected renal pelvis cancer by ultras ound (US) in 2. Results Among the 13 patients,US,intrave nous urography (IVU) and CT located the focus exactly in 10,8 and all the 13 cas es,respectively.Upper urinary obstruction was diagnosed by US and IVU in 13 and 8 cases,respectively.No image was developed by IVU in 5 cases.CT located the foc us exactly in all the 13 cases;of them 11 cases were definitely diagnosed.Overal l,13 cases were cured and alive during the follow-up period. No recurrence or m etastasis developed.Renal dysfunction occurred in only 1 case (Cr,285 ?mol/L) d ue to the contralateral renal stones. Conclusions Multif ocal bladder cancer and cancerogenic tendency of urothelium may be the risk fact ors of this disease.IVU combined with US is the main diagnostic method for the d isease.CT is recommended for the further examination.Nephroureterectomy is the p referred treatment choice for this disease.

Objective To explore the continuous care needs of stroke patients when discharge,and analyze the related influenced factors.Methods One hundred and twenty cases with first stroke attack were selected,and their continuous care needs were investigated by methods of filling in questionnaires when discharged.The National Institutes of Health Stroke Scale and Barthel Index were applied to assess the severity of acute stroke and their ability of daily life when cases were admitted and discharged,respectively.We investigated the continuous care needs of stroke patients,and analyzed the relationship of that with the severity of acute stroke and their ability of daily life.Results The top five continuous care needs were knowledge of stroke,safety administration,methods of rehabilitation,self control and monitoring blood pressure,and diet direction.Those ratios of needs ranged from 87.25%to 94.12%.The score of continuous care needs had a positive relationship with that of NIHSS(r=0.271,<0.05),and had a negative relationship with that of BI both at the time of discharge(r=-0.226,<0.05).Conclusion The various continuous care needs are very common in patients with first stroke attack for varied reasons.More serious the neurological dysfunction and lower ability of daily life,higher the level of needs for continuous care.

Objective To compare WHO 2004 and WHO 1973 pathological grading methods of non-muscle invasive urothelial neoplasms. Methods The clinical pathological features of 160 non-muscle invasive urothelial neoplasms patients, treated in our hospital from February, 1998 to Decem-ber, 2008, were re-graded according to WHO 2004 and WHO 1973 classification system. To evaluate recurrence and progression of all the patients during the follow up period, we used statistical method to analyses the differences between two classification system. Results There were 160 patients, ac-cording to WHO 1973 classification methods: 5 cases of papilloma, 52 cases of grade 1 tumors, 83 ca-ses of grade 2 and 20 cases of grade 3;By WHO 2004 classification method: 7 cases of papilloma, 31 cases of low-grade malignant potential of urothelial papilloma, 99 cases of low-grade papillary urotheli-al carcinoma and 23 cases of high-grade papillary urothelial carcinoma. There was no difference in re-currence among the grades of WHO 2004 and WHO 1973 pathological grading system (both P>0.05). Regarding the progress of non-muscle invasive papillary urothelial neoplasms, no significant difference was found among grades of WHO 1973 classification system(P>0.05)while difference exis-ted among grades of WHO 2004 pathological grading system (P<0.05), especially between papillary neoplasm of low malignant potential (PNLMP) and high grade papillary urothelial carcinomas(HG-PUC) (P<0.01). Moreover, HGPUC grade had more progression rate (30.4%) than G_3 grade (15.0%). Conclusions Compare to G_3 grade, HGPUC grade was more easily to make progress in pa-tients,due to this grade include more high malignant papillary urothelial carcinomas. Therefore, it is necessary for urologists to use a more rigorously follow up and therapy method in connection with HG-PUC grade of new classification system.