Objective To evaluate the efficacy of retroperitoneoscopic radical nephrectomy.Methods From October 2001 to September 2006,a total of 108 patients underwent retroperitoneoscopic radical nephrectomy in our department.The tumors sized 1.0-8.0 cm in diameter with a mean of(4.3?2.9)cm.Before the operation,42 patients were in stage T1N0M0,54 in stage T2M0N0,and 12 in stage T3aN0M0.Results The operation time was 35-180 min with a mean of(63.5?30.3)min,and the blood loss was 20-1500 ml [mean,(75?23)ml].Totally 3 patients were converted to open surgery.The intra-and postoperative complications included hemorrhage caused by the injury of the inferior vena cava or renal artery(4 cases),wound infection(3 cases),and hypercapnia(8 cases).The patients were followed up for 6-36 months(over 12 months in 61 cases),during which 2 patients died of pulmonary metastasis one year after the surgery,1 patent died of liver metastasis 7 months after postoperation,the other 105 patients survived without tumor.The 1-year survival rate was 98.4%(60/61);and 3-year survival rate was 85.7%(18/21).Conclusions Retroperitoneoscopic radical nephrectomy is mini-invasive and effective for renal carcinoma.The patients recover quickly after the surgery.The procedure is worth being wildly used.

Objective:To investigate the clinicopathologic features of intraspinal ganglioneuroma.Meth-ods:We collected 1 2 cases of diagnosed ganlioneuroma arising from the spine and one case of ganlioneuro-ma arising from mediastinum as the control.Clinical and radiographic features were reviewed.The pathologi-cal parameters of these cases were analyzed with routine and immunohistochemical stainings of neural fiber (NF),S-100 protein(S-100),myelin based protein(MBP),peripheral myelin protein 22(PMP22),smooth mus-cle actin(SMA),glial fibrilary acidic protein(GFAP)and Ki-67.Results:The disease was likely to occur in pa-tients aged 30-40 years old and more common in female.These cases were all intral cervical spinal tumors and presented with radicular neuralgia and mass effects of cervical spinal cord compression.Ganglioneuro-mas which occasionally contained normal spindle shaped cells were composed of mature or degenarative ganglion cells and neoplastic Schwannian stroma.Ganglion cells appeared positive for NF.Schwannian stro-ma as well as satellite cells around ganglion showed immunoreactivity for S-100.more intense than neurofi-bro-stroma.Mature spindle shaped cells showed immumoreactivity for MBP.Ki-67 labeling indices were usual-ly 0-1%while in Schwannian stroma areas were 3%.No blood vessel endothelium proliferation was ob-served.Conclusion:Intraspinal ganglioneuromas are rare benign tumors(WHO grand I),causing radicular neuralgia.It is jmportant to distinguish ganglioneuroma with spinal root encircled from Schwannoma or neuro-fibroma in the same anatomic location.The optimal treatment is surgical total resection.

Objective: To discuss the procedure and clinical effect of retroperitoneal laparoscopic nephropexy (RLN).Methods: From August 2001 to June 2006, RLN was performed on 28 female patients aged 26-45 years old (mean, 34±2.5) with symptomatic nephroptosis, including 15 with the right kidney, 12 with the left, and 1 with both. The preoperative complaint of patients included subjective symptoms (constant and recurring pain in 28 patients) and objective symptoms (upper urinary infections in 16, hematuria in 12, and upper tract obstruction in 12). One patient underwent nephropexy via the transperitoneal approach and the others underwent nephropexy via the retroperitoneal approach. A retroperitoneoscopic procedure was performed after positioning the patients in the flank position. Digital preparation of the retroperitoneal space was made and standardized trocar was placed. The key step of the surgery was complete exposure of the kidney within Gerota' fascia, which was aimed to separate the potential adhesions between the colon and kidney or between the inferior blood vessels of the kidney. Nephropexy was performed between the fibrous capsule at the lower pole of the kidney and the dissected psoas muscle, using three sutures placed by intracorporeal technique or the percutaneous needle both for introduction and removal of the suture; the sutures were separately tied over the sacrospinalis fascia. Results: The mean operative time was (125±9) min (ranging 115-240 min); the mean postoperative hospital stay was (9±1.2) days, largely owing to the required 5-12 days' bed rest. During a mean follow-up of (24±4.2) months(ranging 3 to 70 months), 3 patients had paresthesia, 5 had constant and recurrent ache, 20 were completely free of pain, and 4 had micro-hematuria. One patient had further episodes of pyelonephritis and upper tract obstruction after operation. Intravenous pyelogram(IVP) revealed that the ptosis incorporated into more than one vertebral body in 2 patients. Postoperative renal function test showed an improvement in renal function. Conclusion: RLN is mini-invasive and has less complication. The procedure should be considered as one of the optimal therapy for nephroptosis.

Objective To investigate the expressions of Ki67,p53,CKL,EMA,S-lOO,NSE,CgA,Syn,CEA and nm23 in adrenal tumors and their clinical significance.Methods Clinical data from 157 cases of adre-nal tumor patients were retrospectively reviewed including the clinical informa-tion and pathology data.Expressions of Ki67,p53,CKL,EMA,S-100,NSE,CgA,Syn,CEA and nm23 proteins were studied by immunohistochemistry(SP method)using monoclonal antibodies,and the relationship of their expressions with histopathologic type and clinical imformation was analyzed with SAS v6.12 software.A P value of＜0.05 was considered statistically significant.Results A increase of the expression rate of CKL,S-100,NSE,CgA,Syn and nm23 in adrenal tumors was obsered(P＜0.05).For univariate analysis,the expression of S-100,CgA,Syn was in connection with histopathologie types(P＜0.05).The expression of S-100,CgA,Syn had positive correlation with each other.The expression of CKL,S-100,NSE,CgA,Syn,nm-23 was no difference between adrnalbenign tumors and malignant tumors(P＞0.05),but it was much higher than in normal adrenal tissues(P＜0.05).The expression of Syn in adrenal cortical adenomaa was higher than in adrenal cortical cancers(P＜0.05),the expression of Ki67 in adrenal cortical adenomas was much lower than in adrenal cortical cancers(P＜0.05).The expression of EMA、CKL in adrenal cortical tumors were higher than in adrenal medullary tumors(P＜0.05),the expression of S-100,Syn,NSE,CgA in adrenal cortical tumors were lower than in adrenal medullary tumors(P＜0.05).Conclusions CKL,S-100,NSE,CgA,Syn and nm23 were good markers for adrenal tumors,they could be use for the adrenal tumors diagnosis.Detect Syn and Ki67 simutaneously was helpful to the diagnosis of adrenal cortical tumors.Detect EMA,CKL,S-100,Syn,NSE and CgA simultaneously and combine with clinical data was helpful to diagnosis between adrenal cortical tumors and adrenal medullay tumors.In malignant tumors,blood pressure had positive correlation with the expression of CgA,the size of tumor had neg-ative correlation of blood pressure,no prognostic factor was found.

Objective:To study the indicators and operative method of retroperitoneal laparoscopic nephropexy.Methods: From August2001to June2003,8patients with nephroptosis underwent retroperitoneal laparospic nephropexy.All cases were women with an average age of34years(range26-45years).Five cases involved the right kidney,2on the left and1on the both.The presurgical symptoms included constant and recurring pain in8cases,upper urinary infections in6,hematuria in 5,upper tract obstruction in4.A retroperitoneoscopic procedure was performed after positioning the patient in the flank posi-tion.The decisive part was complete exposure exposure within Gerota'fascia to mobilize potential adhesions or the colon,espe-cially to pull inferior blood vessel of the kidney.Nephropexy was performed between the fibrous capsule of the lower pole of the kidney and the dissected psosa muscle using3sutures placed by intracorporeal or extracorporeal technique.Results:The mean operative time was125min(range115-240min);the mean post-operative hospital stay was9d,and the mean bedrest time was7d.During a mean follow-up of12months(range3-20months),1patient complained of recurrent pain,and there was1hematuria.No patient had further episodes of pyelonephritis or upper tract obstruction.IVP revealed kidneys in the af-fected part were in the normal region and greatly improved.Conclusion:Retroperitoneal laparoscopic nephropexy has less trauma,less post-operative discomfort and quicker recovery.It should be considered as the first choice for nephroptosis.[

Objective:To compare the clinical outcomes of laparoscopic nephrectomy and open nephrectomy for radical treatment of renal cancer.Methods: Fifty-three patients with renal cell carcinoma(due to receive radical renal tumor resection) were randomly allocated into 2 groups: retroperitoneal laparocopic(RL) group(n=27) and open approach(OA) group(n=26).The operation time,hospital stay,use of painkiller,fasting period after operation,and blood loss during operation were analyzed and compared.All the cases were followed up for 6-12 months and the survival rates,wound healing,and carcinoma metastasis were recorded.Results: Patients in both groups were all successfully treated and their sexes,clinical stages,ages,and tumor sizes were all comparable.The (operation) time was similar in the 2 groups,with that of RL group being(66.66?10.37) min and of OA group being((69.08?)(11.22) min.)The fasting period in RL group([1?0.36] d) was significantly shorter than that in the OA group([2?0.68] d,P

Objective To evaluate the clinical efficacy and safety of laparoscopic nephron sparing surgery in the treatment of T1 renal cell carcinoma. Methods Thirty-two patients (24 males and 8 females) were diagnosed with T1 N0 M0 renal cell carcinoma by ultrasound, CT or MRI and un derwent laparoscopic nephron sparing surgery. The mean age was (49±2)years old (from 31 to 72 years old). The mean tumor diameter was (2.8±0.8)cm. There were 21 tumors in left kidney, 11 in right kidney. Of them, 10 tumors were in upper pole, 13 in lower pole, 5 in kidney center, 4 close to renal hilum, 18 in dorsal side and 14 in ventral side of the kidney. Tumor masses were resected with the surgical margin of 0. 5 cm. Twenty-five cases were done through retroperitoneal approach and 7 cases was done through transperitoneal approach. The pathological results showed that there were clear cell renal carcinoma in 28 cases, granule cell renal carcinoma in 3 cases and oncocytoma in 1 case. Renal function was examined by ECT before and after the surgery. Results Thirty-one cases under went laparoscopic nephron sparing surgery successfully and only one case converted to open surgery due to excessive intra-operative bleeding. The mean renal pedicle blocking time was (24±4)min (from 19 to 52 min). There were 3 cases having blocking time longer than 30 min (38 min, 45 min and 52 min) and accepted secondary blockage during the procedure. The mean operative time was (105 ± 15) rain. The mean estimated blood loss was (120±22)ml. Only 6 cases accepted 400 ml blood transfusion. D-J stents were placed in 5 eases with the tumor in kidney center before operation. In 3 cases with intra-operative exposure of renal calyx, D-J stems were placed after operation. Urine leakage in 2 eases were noted at 2 and 3 days and recovered at 15 and 21 days after operation. The mean hospital stay was (9±2)days. There was no recurrence in a mean follow-up time of (23±5)months. There were 3 cases with local hematoma (1 case of 4 cm × 3 cm, 2 cases of 2 cm×3 cm) in the surgical site confirmed by ultrasound or CT scan 1 month after surgery and they disappeared 3 months after the operation. Serum creatinine and urea nitrogen were all in normal range after operation. Compared with renal blood flow of the operated kidney before operation, there were 9 cases decreased by 10 %- 15 and 3 cases decreased by 20% at 15 days, 7 cases decreased by 10%-15% at 1 month and 3 cases decreased by 10%- 15% at (23 ± 5) months after operation. Conclusion Laparoscopic nephron sparing surgery is one of feasible and safe options for the treatment of T1 renal cell carcinoma.

Objective To explore the effects of microRNA(miR)-1283 on invasion,proliferation and apoptosis of HTR 8/SVneo cell line derived from human-trophoblast cells.Methods HTR-8/SVneo cells were divided into three groups,as-miR 1283 group was transfected with miR 1283 analogues,anti-miR-1283 group was transfected with miR-1283 inhibitors,and negative control group was transfected with non functional sequence.The levels of miR 1283 expression were detected by fluorescence quantitative polymerase chain reaction at 24 hours after transfection.The cell proliferation was measured by 3-(4,5)-dimethylthiazol-2-yl-(2,5)-diphenyl tetrazolium bromide assay at 24,48 and 72 hours after transfection.Apoptosis was evaluated by propidium iodide staining and flow cytometry at 48 hours after transfection.Transwell experiments were performed to evaluate cellular invasion abilities at 24 hours after transfection.Analysis of variance and Bonferroni method were applied as statistical methods.Results The level of miR 1283 in as miR 1283 group was higher than that in the negative control group with statistically significant difference (14.85±0.57 vs 7.08±0.20,P＜0.01).At 24,48 and 72 hours after transfection,the inhibitory rate of cell proliferation in as-miR-1283 group was (8.04 ± 0.27) ％,(32.47 ± 0.24) ％ and (9.23± 0.17) ％,higher than those in the negative control group [(0.72 ± 0.06) ％,(1.17 ± 0.04) ％ and (0.53 ± 0.05) ％] (P ＜ 0.01,respectively).Cell apoptosis rate was higher in as-miR 1283 group than in negative control group [(16.33 ± 0.40) ％ vs (9.39± 0.58) ％,P＜0.01].The transmembrane cell number was lower in as-miR-1283 group as comparing with the negative control group (7.25 ± 1.83 vs 16.33 ± 2.08,P＜0.01).miR-1283 expression,apoptosis and transmembrane cell number in anti-miR-1283 group had no statistical difference as compared to the negative control group (all P ＞ 0.05).Conclusions Up-regulated levels of miR-1283 could inhibit HTR-8/SVneo cell proliferation and invasion,but promote the cell apoptosis.

Objective: To understand the etiology, genotype and molecular characteristics of acute viral gastroenteritis in Quanzhou from 2014 to 2017. Methods: Specimens from 15 outbreaks of acute viral gastroenteritis in Quanzhou area from 2014 to 2017 were collected and real-time fluorescence quantitative PCR was used to detect norovirus GI and GII, sapovirus, astrovirus and rotavirus, and the result were statistically analyzed. Furthermore, specimens positive for norovirus was further subjected to the amplification and sequencing of polymerase and VP1 genes of norovirus, and sequences were analyzed using DNAstar and MEGA7.0 software. Results: In this study, 96 specimens from 15 outbreaks of acute viral gastroenteritis were collected, and norovirus was detected in 30 specimens with a positive rate of 31.25%, among which 23 specimens were genotype GII and 7 specimens genotype GI. Meanwhile, 10 specimens were randomly selected for nucleic acid sequence analysis. The result showed that 9 of them were GII.P16/GII.2 and 1 was GI.6. The phylogenetic analysis showed that the new recombinant norovirus subtype GII.P16/GII.2 was highly homologous to the same subtype detected in outbreaks home and abroad recently. Conclusions The main pathogens caused the outbreak of acute viral gastroenteritis in Quanzhou from 2014 to 2017 were norovirus belonging to subtype GII.P16/GII.2 and subtype GI.6, and subtype GII.P16/GII.2 was the predominant strain which was found for the first time in Quanzhou.

Objective: To probe into the etiology of the sever e post-renal transplantation infection and its diagnosis and t reatment. Methods: A retrospective analysis was made on the seve re infected cases among 1 504 renal transplantation cases. Results: (1)The infected rate in the whole group was 23.74%,and 14.01% of the infecti on cases was severely involved. (2) About 86% of the severe infection occurred within 6 months after operation and as high as 82% of the patients were successf ully rescued by various etiological treatment. (3) The main etiological causes according to their frequency and type were: Bacteria(Mycobacterium tub erculosis, Pseudomonas, Aureus staphylococcus, Bacillus cloacae, etc.); Fungus (Candida albians, Candida tropicals, Penicillum patulum). Cytomegalo virus also often appeared. Conclusion: (1) Infection is one of t h e common complications after renal transplantation and severe infection is an im portant cause of death. (2) Correct diagnosis and combined therapy in time may improve its success rate. (3) Characterized germ spectrum exists in severe post -renal transplantation infection and its role is of great importance to clinica l management.