Objective To explore the diagnostic and therapeutic methods for hemangioma in different parts of the urinary system. Methods Twenty patients with urinary hemangiomas were enrolled in this study.Of them 5 cases had hemangiomas in the kidney,2 in the ureter,10 in the bladder and 4 in urethra.Three cases (15%) had multiple hemangiomas in different parts of the body,of whom 1 case had hemangiomas concomitantly in the bladder and urethra,1 case in the bladder and neck,and 1 case in the urethra and perineum.Modalities of diagnosis before operation included B ultrasound,CT,IVU,endoscopy,et al.Surgical operations were the major treatment(95%),and only 1 patient with urethral hemangioma underwent lasar therapy. Results The pre-operation confirmed diagnosis was 0、1、9 and 4 cases for hemangiomas in kidney,ureter,bladder and urethra,respectively.For pathologic classification 13 cases were of cavernous hemangiomas,6 of capillary and 1 of racemose.With follow-up of 9 months to 16 years,recurrent bladder hemangioma was found in one patient. Conclusions The diagnoses of urinary hemangiomas mainly rely on endoscopy,but for the diagnosis of parenchyma or surface hemangioma of kidney conventional imaging examination is essential.Surgical operations were the major treatment for urinary hemangiomas,but different modalities of treatment are needed for different sites and nature of hemangiomas.

Objective To investigate the effects of partial prostatic capsula and surrounding striated sphincter sparing surgery on the function of intestinal orthotopic neobladder. Methods Total cystectomy and orthotopic intestinal neobladder was performed in 23 male patients with invasive bladder cancer. The patients were divided into classical cystectomy group (n=10) and modified cystectomy group (n=13).In the classical group the prostate was removed completely and the residual urethra was anastomosed with the neobladder using interrupted suture.In the modified group transurethral resection of the prostate preceded the cystectomy,and the prostatic capsula below the verumontanum with its surrounding striated urethral sphincter was retained.The neobladder was anastomosed with the residual capsula using continuous suture.The function of the neobladder in the 2 groups was evaluated and compared. Results The pathological classification of the 23 patients was as follows:T 2aN 0M 0,13 cases;T 2bN 0M 0,6;T 1N 0M 0,1;T 3aN 0M 0,1;T 3bN 1M 0,1;T 4aN 0M 0,1.The patients were followed up for 3 to 40 months(mean,15.7 months).In modified group,11 patients survived disease-free and 2 survived with metastasis.All the 13 patients voided well with residual volume of 0 to 70 ml.Complete urinary continence was achieved in 12 patients and the remaining one had nocturnal incontinence.In classical group,10 patients survived disease-free;of them 7 voided well with residual volume of 10 to 100 ml and the other 3 needed intermittent catheterization because of their residual urine being up to 100 to 250 ml.Complete continence was achieved in 7 patients and the other 3 were incontinent(1 with incontinence day and night,2 with nocturnal incontinence). Conclusions Partial prostatic capsula and its surrounding striated sphincter sparing surgery can improve the continence and voiding of the orthotopic neobladder.$$$$

Purpose:The aim of this study was to evaluate the clinical efficacy and toxicity of treatment with gemcitabine and cisplatin for hormone independent prostate cancer.Methods:18 cases of advanced hormone independent prostate cancers who received castration and antiandrogen medicines were confirmed to have multiple bone metastatic carcinomas by emission computed tomography(ECT), and hepatic , adrenal and intracranial metastasis were found respectively each in 1 patient, and the value of PSA(prostatic special antigen) had on ascending trend in all patients. Gemcitabine 1000 mg/m~(2) +NS 100 ml was administered by intravenous drip on days 1,8 and cisplatin 100 mg/m~(2) +NS 500 ml was administered by intravenous drip on day 1 or cisplatin 30 mg/m~(2) +NS 250 ml was administered by intravenous drip on days 1 to 5 in each 28-day cycle.Results:Levels of PSA descent to normal titer(

Objective To study the cellular apoptosis and telomerase activity in bladder cancer before and after treatment with cell wall skeleton of bacillus Calmett Guerin(BCG CWS) and interleukin 2(IL 2). Methods The cellular apoptosis and telomerase activity of 33 cases of bladder cancer tissues were detected by terminal deoxynucleotidyl transferase mediated dUTP biotin nick end labeling(TUNEL) and telomeric repeat amplification protocol(TRAP) assay both before and after treated with BCG CWS and IL 2. Results The apoptosis index for bladder cancers before and after treatment with BCG CWS and IL 2 was (35.6?12.7)% and (79.1?11.3)% respectively, the apoptosis index being obviously increased after the treatments, P

Objective:To investigate the clinical characteristics of adrenal incidentaloma and explore the management strategies for this disease. Methods:The clinical data of adrenal neoplasm patients admitted in The First Affiliated Hospital and Cancer Center of Sun Yat-sen University from January 2001 to January 2013 were analyzed retrospectively. Results:The data of 667 patients with adre-nal incidentaloma were analyzed. Adenoma was the most common tumor in 511 cases with pathological results (240/511, 47%). Fur-thermore, the pathologic results indicated that 18%(90/511) of these cases were pheochromocytoma and 8%(41/511) were adreno-cortical carcinoma. Of the 511 cases, 266 had≤4 cm tumors, and 245 had>6 cm tumors. In cases with≤4 cm tumors, 260 (98%) had benign tumors, and 183 of these cases underwent laparoscopic adrenalectomy. In cases with>6 cm tumor, 91 cases (37%) had malig-nant tumors, and 162 of these cases underwent open adrenalectomy. Conclusion:The suggested cut-off size for adrenal incidentalo-ma diagnosis is 4 cm. Laparoscopic adrenalectomy is the recommended management strategy for small (≤4 cm) and nonfunctional ad-renal incidentaloma.

Objective To verify whether the concomitant performance of modified radical inguinal lymphadenectomy and penectomy may increase complications and compromise oncological effectiveness.Methods From June 2002 to June 2010,a total of 110 simultaneous inguinal lymphadenectomies were performed on 55 patients (mean age 49 years),including 107 modified radical lymphadenectomies,2 radical lymphadenectomies and 1 lymphadenectomy before which the sapheous vein was resected.The records of all patients were reviewed.Results Of 107 simultaneously modified radical inguinal lymphadenectomy,only 1 (0.9％) had wound infection.There were 18 ( 16.8％ ) leg lymphedema and 6 (5.6％) skin flap necrosis,postoperatively.The average number of inguinal lymph nodes dissected was 11 (3 -23 ).Overall 3-year survival was 84％.Conclusions Penile surgery combined with simultaneously modified radical inguinal lymphadenectomy could be feasible,which may have oncological control without increasing the risk of surgical complications.

Objective To report a modified radical inguinal lymphadenectomy the aim of which is to reduce the incidence of the complication of skin necrosis.Methods One hundred and twenty-six modified radical inguinal dissections were performed in 63 patients with penile carcinoma from June 2002 to June 2010.A modified radical inguinal dissection characterized by an S-shaped incision and precisely separating layers using an anatomical mark was performed.The boundaries of dissection were the same as classic radical inguinal lymphadenectomy.The incidences of complications of skin flap necrosis were retrospectively analyzed.Results The follow-up time ranged from 12 to 93 months.A total of 37 complications occurred,including 7 minimal skin necroses (5.6％),3 wound infections (2.4％),19 lymphedemas (15.1％),2 seroma formations (1.6％),5 lymphocele (4.0％),and 1 deep venous thrombosis (0.8％).There were no complications in 106 dissections (84.1％ ),and 20 dissections had one or two minor complications ( 15.9％ ).Conclusions The complication of skin necrosis related to groin dissection in patients with penile carcinoma could be reduced by using this modified inguinal dissection technique,which characterized by an S-shaped incision and precisely separating layers with using an anatomical landmark.

Objective: To analyze the prognostic factors of non-Hodgkin's lymphoma(NHL)and to investigate the prognostic value of peripheral blood absolute lymphocyte count(ALC)at admission for patients with NHL. Methods: Clinical features and follow-up data of 108 patients with pathologically confirmed NHL seen in our hospital between January 2000 and January 2008 were reviewed.SPSS14.0 package was used for statistical analysis.Kaplan-Meier was applied to assess the survival probability.All parameters statistically significant concluded by univariate analysis were then computed as co-variates for multivariate analysis with Cox regression model. Results: The ratio of males to females was approximately 1.5:1.The median age of patients was 48 years.Before treatment.the Ann Arbor clinical classification showed that 61.1% of the cases were of stage Ⅰ and Ⅱ.Approximately 93%of the patients had ECOG performance status(PS)score of 0-1 and 19.2%of the cases had elevated serum lactate dehydrogenase(LDH).According to intemational prognosis index score.80.6%of the patients were in a low risk group.At admission，35.2%of the cases had ALC≤1×10~9/L.Hemoglobin (Hb)≤110g/L and B symptoms were seen in 29.6%and 26.9%of the patients.The mean Hb was 129.2±17.5g/L in cases with ALC>1×10~9/L(n=70)and 98.1±20.6g/L in cases with ALC≤1×10~9/L(n=38),with a statistically significant difference between the two groups(P<0.05).With a median follow-up duration of 2 years，the median overall survival(OS)time was 2.3 years for all patients.The 2-year and 5-year OS rates were 73.2%and 39.6%，respectively.ALC≤1×10~9/L,Hb≤110g/L,B symptoms and intemational prognostic index(IPI)≥2 were statistically significant unfavorable prognostic factors for NHL revealed by univariate analysis.Multivariate analysis showed that ALC≤1×10~9/L,B symptoms and IPI ≥2 were statistically significant unfavorable prognostic factors for NHL. Conclusion: ALC and B symptoms may be prognostic factors independent of IPI for NHL.Evaluation of the prognosis with IPI,ALC，and B symptoms is of clinical value for individualized therapy of NHL patients.

Objective To analyze the outcome of intra-artery chemotherapy for T1G3 bladder cancer , and its effectiveness and safety. Methods From June 2003 to May 2014, 39 patients with T1G3 bladder cancer chose intra-artery chemotherapy (Gemcitabine plus cis-platin), and close follow-up was required after 2 cycles of chemotherapy. During the follow-up, transurethral resection of bladder tumor was performed for non-muscle invasive bladder cancer, and cystectomy was performed for muscle invasive tumor. Results Of all patients, 32 were male and 7 were female. The median age was 56 years old (range: 32-82 years), and median follow-up time was 56 months (range: 12-136 months). Nineteen patients were primary bladder cancer, and 20 were recurrent tumor. During the follow-up, 17 patients developed recurrent tumors, including 8 progressed tumors and 3 died from tumor. Two-year and 5-year progressed-free survival were 88% and 74%, and 2-year and 5-year cancer-specific survival were 97% and 89%, respectively. During 5 years′ follow-up, 81% survivor preserved intact bladder, and only 1 patient cancelled chemotherapy for adverse effect. Conclusions Intra-artery chemotherapy (GC regimen) is a choice for T1G3bladder cancer, preventing from disease progression with good tolerance.

Objective To estimate the feasibility of QOL score in functional assessment of or-thotopic neobladder after radical cystectomy. Methods Questionnaire survey,QOL score sheet and urodynamic examination were done in 22 patients with orthotopic neobladder.Investigations were fo-CUS on the micturition interval during daytime and nighttime.Micturition time,degree of incontinence and their relationship with QOI.scores and urodynamic parameters wete also analyzed. ResuIts There were 3,6,7,1,2,3 and 0 cases which QOI.score were 0 to 6 accordingly.In the dav time,2 patients complained a light incontinence while 1 patient of moderate incontinence.In the nighttime.3 patients had the complaint of moderate incontinence while 4 patients of light incontinence.The average daytime mlcturltlon interval was 136 min(45-210 rain).The average maximum urinary flow rate,maximal urethral closure pressure and postvoid residual were 12.9 ml/s(2.7-22.1 ml/s),69.3 cm H2O(33-114 em H20)and 91.8 ml(5-300 m1)respectively.QOL scores had D.sitive correlation with the degree of incontinence during daytime and nighttime(daytime:r-0.510,P=0.015,night time:r=0.911,P<0.001).The QOL scores had negative correlation with daytime micturition inter-val(r=-0.749,P<0.001).The factors which influenced the QOL scores included the maximaI ure-thral closure pressure,postvoid residual and the maximum urinary flow rate. Conclusions QOL score reflects the patients"continent ability,subjective feelings on quality of life.It is correlated with the common urodynamic parameters.QOI.score might be used as a new index to estimate the function of orthotopic neobladder.