Objective To discuss the need for performing intravenous urography(IVU) in patients with non-muscle invasive bladder cancer before surgery. Methods From 1997 to 2008,1968patients were diagnosed as non-muscle invasive carcinoma of the bladder with pathological confirmation. All patients underwent ultrasonography, cystoscopy and IVU prior to surgrey. The x2 test was used for statistical analysis. Results The incidence of upper urinary tract urothelial tumors (UUTUT) was 11. 0% (216 cases). Two hundred and fifteen (13. 6%) suffered simultaneous UUTUT detected by IVU in 1528 patients with bladder cancer who had intermittent painless gross hematuria, while only 1 (0.3 %) suffered simultaneous UUTUT in 386 non-symptomatic patients (P＜0.01). Among 120 patients with bladder cancer whose upper tract was abnormal detected by ultrasonography,120 (100. 0%) suffered simultaneous UUTUT detected by IVU, and of 1848 patients who were normal in upper tract by ultrasonography, 96 (5. 2%) suffered simultaneous UUTUT detected by IVU (P＜0. 01). Of the patients with no abnormalities in upper tract by ultrasound, 37(3. 0%) suffered simultaneous UUTUT detcted by 1VU in 1247 patients with single bladder tumor,and 59 (9.8%) suffered simultaneous UUTUT in 601 patients with multiple bladder tumors (P＜0.01). Of the patients with single bladder tumor who had no abnormalities in upper tract by ultrasonography, 2 (0.2%) suffered simultaneous UUTUT detected by IVU in 822 patients with the diameter of the tumor＜1.0 cm, and 35 (8. 2 %) suffered simultaneous UUTUT in 425 patients with the diameter≥1. 0 cm (P＜0.01). Of the 1541 patients with histological G1, 48 (3.1%) suffered simultaneous UUTUT detected by IVU, and of the 427 patients with histological G2- G3, 168 (39. 3%)suffered simultaneous UUTUT (P ＜ 0. 01 ). Conclusion Patients with the following characters should undergo IVU before surgery: hematuria, abnormal upper urinary tract by ultrasonography,multifocal tumours, the diameter of the single bladder tumor≥1. 0 cm and high gradc tumors.

Objective To investigate the levels of specific urine growth factors in interstitial cystitis (IC). Methods ELISA was used to determine levels of epidermal growth factor (EGF), insulin-like growth factor 1(IGF1), insulin-like growth factor binding protein 3 (IGFBP3) and heparin binding epidermal growth factor-like growth factor (HB-EGF) in urine specimens from women with IC and in asymptomatic controls. Results Urine HB-EGF in IC patients was (2.17?0.21)ng/ml and that of asymptomatic controls (6.59?0.97)ng/ml( P

Objective To evaluate the affect of Smad 4 in bladder cancer. Methods Immunohistochemical methods were used to study the Smad 4 expression in BBN induced bladder cancer in big rats. Results The positive expression rate of Smad 4 in the hyperplastic bladder mucosa was 24%(5/21),and in the bladder cancer 53%(17/32), P

Objective To study the diagnostic and therapeutic means of kidney cortex suppurative infection. Methods 27 cases of kidney cortical suppurative infection were studied retrospectively. Results 14 cases of acute bacterial nephritis and 7 cases of renal cortical abscess were cured on antibiotics therapy.Nephrectomy was performed for 2 patients with acute bacterial nephritis and 4 cases of renal cortical abscess greater than 5 cm in diameter were cured by surgical intervention. Conclusions These two diseases can be diagnosed by comprehensive evaluation of clinical manifestation,auxialliary examination and treatment trials.CT and B ultrasonography both play an important role.Renal cell carcinoma should be excluded in diagnosis because these two likewise show a mass on imaging.Antibiotics can be used in acute bacterial nephritis and in renal cortical abscess less than 5 cm in diameter whereas in abscess larger than 5 cm, surgical intervention is needed.

ObjectiveTo investigate the cause, treatment and prevention of splenic injury in radical nephrectomy for left renal cell carcinoma.MethodsThe clinical data of 27 cases of splenic injury in 458 cases of radical nephrectomy for renal cell carcinoma were retrospectively analyzed.ResultsThe injured spleen was saved in 21 cases (18 gradeⅠ injury,3 grade Ⅱ).The injured spleen was sewed up and pressed with hemostatic ganze in 7,pressed with medical sponge laid with spurting argon on biological glue in 11 and the same was carried out in 3 grade Ⅱ injury.Spleenectomy was conducted in the other 6 cases (4 grade Ⅱ injury,2 grade Ⅲ).The patients have been followed up for 6 months to 5 years.The outcome has been good in all except 1 patient died of tumor recurrence 1 month after operation.No late bleeding or adverse side effects has been noted.Conclusionssplenic injury may occur in radical nephrectomy for renal cell carcinoma especially the tumor is lasge or adhered to spleen in the upper past of left kidney.The occurrence of splenic injury is also related to the tumor stage.Attention should be called to the mentioned surgical complication.

ObjectiveTo study the expression of three protein kinase C subforms in renal cell carcinoma.MethodsThe expression of cPKC?,cPKC? Ⅱ and aPKC? in renal cell carcinoma were detected by immunohistochemical method(S-P method) and by in situ hybridization.ResultsPositive rate of cPKC? ?cPKC? Ⅱ and aPKC? was 68.4%,34.2% and 44.7% respectively in renal cell carcinoma.Positive rate of cPKC? in stage T 2～T 4 tumors was 80.9%(17/21) and 52.9%(9/17) in T 1(P 0.05).The positive expression of cPKC? in deadly cases was significantly higher than in survivers (P

Objective To study the diagnosis and management of extra-adrenal pheochromocytoma. Methods Eighteen patients with extra-adrenal pheochromocytoma were analyzed retrospectively.Among the 18 patients 13(72%) were men.The mean age at diagnosis was 30 years,with a range from 15 to 65 years.All the patients presented with hypertension.Other typical symptoms included headache and dizziness(67%),palpitation and sweating(44%),blurred vision (33%) and hematuria (28%).Of all the patients 89% were diagnosed with urine CA and VMA.Most of the tumors were located at the bladder (39%),para-aorta (28%) and renal hilus(22%). Results All the patients were treated with surgical operation including 14 total resection of tumor,1 simple resection of tumor and 3 biopsy.Two of the 18 cases were malignant according to the post-operative pathologic diagnosis.Five patients recurred 3 months to 10 years after operation. Conclusions The determination of CA and VMA in urine is valuable for the diagnosis and monitoring of postoperative recurrence.Ultrasonography and CT scanning are effective means for tumor localization.The perioperative management of controlling blood pressure and expansion of the blood volume are very important.Surgical extirpation is a good method for the effective treatment.Postoperative long-term follow up is necessary.

Objective To present the clinical and pathological features of carcinosarcoma of ureter and renal pelvis. Methods Three cases of carcinosarcoma of ureter and renal pelvis were reviewed. Results The clinical symptoms of carcinosarcomas of ureter and renal pelvis are hematuria and flank pain.The neoplasm consists of an admixture of malignant epithelial and mesenchymal elements on histological studies.The immunohistochemical studies demonstrated obvious epithelial and mesenchymal reactivity.Three patients died of the disease 8 months,14 months and 2.5 months after operation. Conclusions Carcinosarcoma of ureter and renal pelvis is a rare occurrence and is usually associated with a poor prognosis.It is sometimes difficult to make certain the diagnosis and the immunohistochemical studies are essential in pathological examinations.This lesion should be differentiated from sarcomatoid carcinoma.

Objective To understand the pathogenesis and the clinical features of the bladder soft calculi. Methods A case of bladder soft calculi with emphysematous cystitis was reported.The patient,who had underwent partial cystectomy for bladder cancer,was 53 years old with diabetes and prostate hyperplasia. E.coli was found in his urine.KUB showed negative result.B-us and cystoscopy showed bladder mass.Some of other cases were also reviewed. Results The patient underwent surgical operation,and during the procedure a multilamellar yellow/brown internal structure of the calculi was observed.It presented as something like cellulose in the pathological study.The patient received antibiotic therapy after operation for two weeks,and recovered very well. Conclusions The formation of soft calculi is typically associated with urinary infection caused by proteus species.Diabetes mellitus is believed to be the most important predisposing factor for the formation of soft calculi.In most cases, surgical manipulation is required for their removal because they are not dissolved by any means yet known, and the antibiotic therapy is necessary too.

Objective To evaluate the expression of multidrug resistance-related markers in renal pelvic and ureteral carcinoma. Methods The immunohistochemical expression of P-glycoprotein (P-gp), multidrug resistance-associated protein (MRP), lung-resistance protein (LRP) and glutathione S-transferase Pi (GST-?) were examined in 51 patients with renal pelvic or ureteral carcinoma.The correlation between the expression and some clinicopathological parameters was analyzed. Results The positive expression rate of P-gp、MRP、LRP and GST-? in renal pelvic or ureteral carcinoma was 35.3%(18/51),39.2%(20/51),58.8%(30/51) and 43.1%(22/51) respectively.The rate of P-gp positive staining was increased with the advance of tumor grade (P