Objective:To optimize the extraction conditions of gallic acid inWudang pineneedle tea and establish the assay meth-od. Methods:The content of gallic acid was determined by RP-HPLC-DAD. Orthogonal test was used to optimize the extraction condi-tions of gallic acid in Wudang pineneedle tea on the base of single factor tests. The optimal extraction conditions were as follows:adding 50-fold amount of water, and ultrasonic extracting for 60 min under 200W ultrasound power. Results:The linear range of gallic acid was 5. 10-51. 00 mg ·L-1(r=0. 9993), and the average recovery was 98. 7% (RSD=1. 93%, n=6). The average content of gallic acid in the samples was 0. 35 mg·g-1 . Conclusion: The optimal extraction conditions are simple and feasible, and the assay method is stable and reliable, which can be used for the extraction and content determination of gallic acid in Wudang pineneedle tea.

Objective To introduce our experience of performing posterior or anterior renal lip incision for partial nephrectomy in the treatment of renal hilum endophytic renal cell carcinoma.Methods From Jan.2010 to Jan.2014,five female patients with renal hilum tumors were treated in our institute.The median age was 54 (51-72) years.The median tumor diameter was 4.0 (2.8-4.8) cm.The median preoperative creatinine was 53.9 (52.6-75.4) μmol/L.One of them was solitary kidney with absolute indication; three cases had basic disease with relative indication; one was with selective indication.The patients were put in supine or lateral position.After general anesthesia,we preformed partial nephrectomy by cutting posterior renal lip in 3 cases and the anterior lip in 2 cases.We clamped the renal artery,opened the renal posterior or anterior lip,then dissected the tumor beside the pseudo-capsule.After removing the tumor,we used 3-0 absorption suture to control bleeding and repair the opened collecting system.Finally,we used 2-0 absorption suture to close the renal defect.Results The median operation time was 195 (155-215) min; the median renal warm ischemia time was 35 (15-70) min; the median postoperative hospital stay was 8 (7-9) d.There was no secondary bleeding and urine leakage happened.The pathological results showed that 3 cases with clear cell carcinoma,1 with papillary carcinoma and 1 with renal medullary interstitial cell tumor.All patients showed normal kidney shape.The median postoperative creatinine was 63.0 (59.4-75.4) μmol/L.After a median follow up of 24.2 mon,all patients survive without tumor recurrence.Conclusions The short-term result of posterior or anterior renal lip incision partial nephrectomy in treating endophytic renal hilum endophytic renal cell carcinoma is safe and feasible.

Objective The aim of this study is to summarize the clinicopathologic characters and factors associated with prognosis of papillary renal cell carcinoma.Methods We treated 72 papillary renal cell carcinoma by surgery from August 2001 to February 2013,which account for 7.2％ of all renal cancer patients (72/1005 cases).There were 60 male and 12 female patients included in this study,with a median age of 50 (ranging from 21-75).The median tumor diameter was 5.8cm (ranging from 4 to 8cm).Fifth-two patients were asymptomatic,14 patients presented with hematuria and 6 presented with backache.In the 72 patients,63 received (87.5％) open surgery and 9 cases (12.5％) underwent laparoscopic surgery.Fortyeight patients (66.7％) were treated with radical nephrectomy and 24 patients (33.3％) were treated with partial nephrectomy.In the current study,we summarized the clinical and pathological records and follow-up data.Cox regression analysis were performed to identify the independent predictors for cancer specific survival.Results Local lymph nodes were involved in 16 cases and distal metastasis was found in 2 cases.There were 11 cases (15.3％) of type Ⅰ papillary renal cell carcinoma and 61 cases (84.7％)of type Ⅱ.All type Ⅰ cases were determined as Fuhrman grade Ⅰ and all type Ⅱ tumor were determined as Fuhrman grade Ⅱ-Ⅳ,including grade Ⅱ in 36 cases,grade Ⅲ in 15 cases and grade Ⅳ in 30 cases.With a median follow-up duration of 35 months (ranging from 7 to 146 months),10 patients died due to renal cancer,1 died due to heart failure and the rest 61 was alive.The cancer specific survival at five years for the whole group was 78.6％ (100.0％ in type Ⅰ and 75.5％ in type Ⅱ).The 5 year cancer specific survival rate for patients with Fuhrman grade Ⅰ-Ⅳ was 100.0％,83.5％,78.8％ and 31.3％,respectively.Cox regression analysis revealed that tumor diameter (hazard ratio 1.141,P =0.019) and Fuhrman grade (hazard ratio 3.034,P =0.004) were independent prognostic factors for cancer specific survival.Conclusions Type Ⅱ papillary renal cell carcinoma has more aggressive characters and poorer prognosis compared with type Ⅰ.Tumor diameter and Fuhrman grade were independent prognostic factors for cancer specific survival.

Objective To explore if it is essential to excise ipsilateral adrenal gland in radical nephrectomy.Methods Two hundred and sixty-three patients underwent radical nephrectomy were analyzed retrospectively.The duration of operation,bleeding volumn,complications and survival rates were compared between the adrenalectomy and adrenal preserved groups.The clinical data of the patients with adrenal gland involvement were analyzed as well.Results There were 214 clinical localized(T_(1-2)N_0M_0 )renal cell carcinoma (RCC) patients,26 local advanced RCC(T_(3-4)N_(0-2)M_0 ) patients and 23 metastatic RCC(T_(1-4)N_(0-2)M_1) patients in this study.In the 263 patients,146 cases received ipsilateral adrenal gland excisions,while 117 cases had the ipsilateral adrenal glands preserved.The duration of operation,estimated blood loss and the complications did not differ significantly between these two groups.Only 8 patients had adrenal gland involvement.The mean size of the 8 tumors was 9.7 cm and 5 of them had a diameter ≥8 cm.In the 8 patients,6 had the tumor in the upper pole and 2 had the whole kidney involved.One hundred and twenty-nine clinical stage Ⅰ and Ⅱ patients had ipsilateral adrenal excised,while only 4 (3.1%) had adrenal gland involvement.Seventeen clinical stage Ⅲ and Ⅳ patients had ipsilateral adrenal excised,and 4 (23.5%) had adrenal gland involvements.The clinical stages of these 8 patients were stage Ⅲand Ⅳ.The patients were followed up for 28 months (3-102 months).There was no significant difference of 5-year survival rates between the ipsilateral adrenal gland excised and preserved patients categorized according to pathological stage.Conclusion For patients with renal cancer larger than or equal to 8 cm,localized in upper pole of kidney or with the whole kidney involve and with a clinical stage higher or equal to Ⅲ,it is essential to excise ipsilateral adrenal gland in radical nephrectomy,otherwise the ipsilateral adrenal can be preserved.

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.

Objective To investigate the techniques of laparoscopic retroperitoneal lymph node dissection(LRPLND)through extraperitoneal approach. Methods Seven non-seminomatous germ cell testicular tumor(NSGCT)patients of clinical stage Ⅰ underwent LRPLND through extraperitoneal approach.The average age was 31(27-39 years old),the average weight was 62 kg(weight 58-72 kg).Pathological examination revealed 2 testis mixed carcinoma(major of embryonal carclnoma and seminoma),2 yolk sac tumor,1 ehoriocarcinoma,2 teratoma with seminoma.Two of them were in right side,and 5 in left.All the chest X-ray,abdominal CT and bone scanning of them were normal before operation.All patients were general anesthetized.Three or 4 trocars were placed,from 2 of them two gasbags were used to expand the retroperitoneal space at volume of 800-900 ml.The retroperitoneal fat was cleared off from the surface of Gerota's fascia to iliac fossa and the plane spance betwwwn anterior rena fascia and posterior peritoneum was separated In the same way the Plane between dorsal renal and the surface of psoas major and quadratus lumborum unto iliae lossa was exposed.Abdominal aorta or vena cava was exposed,then divided and dissected free from surfaee of psoas maior.The conflux of renal vein and testicular vein at the deep face of renal artere(left)was exposed,then testicular vein was ligated and divided it at its end.Fat and lymph tissue between ureter and vessels was dissected to the crotch of abdominal aorta or inferior vena cava.The primary inguinal incision of testectomy was then excided.Normal antegrade ejaculation recovered in 1 month postoperatively. Results The initial 2 operations were converted to open way as the peritoneum were penetrated largely.The other 5 operations were successful.The average operating time was 285 min(245-350 min),intraoperative blood loss was 100-250 ml.Four patients'pathologic results accorded with clinical staging,and 2 positive lymph nodes were found in the other one.The average number of lymph node resected was 25.6 counts(22-31).Follow-up for 3-20 months,chest X-ray and abdominal CT revealed no evidence of recurrence or distant metastasis,and serum tumor markers were in normal range.Normal antegrade ejaculation recovered in 1 month postoperatively. Conclusions The technique through extraperitoneal approach could be applied for LRPLND.It might be an approach for diagnosis and treatment of stage Ⅰ NSGCT.

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 evaluate the efficacy and application value of retroperitoneal laparoscopic nephroureterectomy for localized and poor differentiated renal pelvic carcinoma by comparing with open nephroureterectomy.Methods Thirty-three pelvic carcinoma patients underwent radical nephroureterectomy were retrospeetively analyzed.All tumors were confirmed to be localized,stage T1-T3 and grade 3.Retroperitoneal laparoscopic nephroureterectomy was performed in 12 patients,the ureteral orifice was resected in traditional way through a small incision in lower abdomen.Open radical nephroureterectomy was performed in 21 cases.Clinical outcomes of the patients were compared between the 2 surgery groups.Results Mean operative time was 232 vs 212 min(P=0.100)and blood loss volume was 162 vs 233 ml(P=0.001)in the laparoscopic and open nephroureterectomy groups.Mean postoperative hospitalization was 7.6 vs 9.8 d(P＜0.001)for the laparoscopic and open groups.During the followup for 7-67 months,all the 33 patients survived.There was no recurrence or metastasis in laparoscopic group.While there was 1 retroperitoneal recurrence,and 3 cases suffering from superficial bladder cancer in open surgery group.Conclnsion Retroperitoneal laparoscopic nephroureterectomy may be performed safely in local renal pelvic carcinoma patients with poor differentiated tumors,with less intraoperative blood loss and early recovery.

Objective To explore the risk factors of inguinal metastasis in squamous cell carcinoma of the penis, screening lymph node metastasis high-risk patients. Methods The clinical and pathological data of 81 consecutive patients with squamous cell carcinoma of the penis were analyzed retrospectively. Age at presentation ranged from 27 to 81 years with a median of 49 years. Course of disease within one year of patients with 46 cases (56.8%), 1 year above 35 eases (43.2 %). Seventyfive patients underwent bilateral inguinal lymph node dissection, and 6 patients had unilateral inguinal lymph node dissection. Clinical stage of the primary tumor was assigned according to the 2002 TNM staging system. Variables included patients' age, redundant prepuce and/or phimosis, tumor site,size, number, macroscopic growth pattern, histological grade, inguinal physical examination and the size of inguinal lymph nodes. Results Of the 81 patients, 42 (51.9%) were staged as pN+ and 39 (48. 1%) as pN0. Metastases occurred in 32.0% (16/50) of G1, 78.3% (18/23) of G2 and 100. 0%(8/8) of G3 cases, with significant differences among them (P= 0. 015). According to the inguinal lymph node physical examination results, 63 were staged as clinically node-positive (cN+) and 18 as clinically node-negative (cN0). Metastases occurred in 63. 5% (40/63) of cases of cN+, as compared with 11.1% (2/18) of cases of cN0(P=0. 012). At a median follow up of 40 months (ranged 2-127 months), the 5-year disease free survival rates for positive and negative inguinal lymph nodes metastasis were 71.4% and 92.3%, respectively (P=0. 005) , and the 5-year cancer specific survival rates were 79.0% and 91.4%, respectively (P=0.001). Conclusions Inguinal physical examination and histological grade were the strongest predictors of inguinal metastasis. The patients with inguinal lymph nodes metastasis have lower 5-year disease free survival rates and cancer specific survival rates,and should receive positive treatment measures.

ObjectiveTo analyze the epidemiological characteristics of newly diagnosed occupational welder's pneumoconiosis (OWP) in the shipbuilding industry in Guangzhou City from 2006 to 2022. Methods Data on newly diagnosed OWP cases in the shipbuilding industry in Guangzhou City from 2006 to 2022 was collected and ananlyzed from the Health Hazard Monitoring Information System subsystem of the Chinese Disease Prevention and Control System. ResultA total of 250 cases of new welder's pneumoconiosis were diagnosed in the shipbuilding industry in Guangzhou City from 2006 to 2022. The number of new cases per year showed an initial increase followed by a rapid decline, reaching a peak in 2013 (65 cases). Most of the cases were male, accounted for 99.2%. There were 220 cases reported the OWP stage, with the stage Ⅰ and stage Ⅱ cases accounted for 93.6% and 6.4%, respectively, but no stage Ⅲ cases were reported. The median (M) age and the 25th and 75th percentiles (P₂₅, P₇₅) at diagnosis was 43.0 (39.0, 47.0) years and the dust exposure years M (P₂₅, P₇₅) was 11.2 (8.1, 14.7) years. The M of age at diagnosis of new OWP cases in 2015-2018 and 2019-2022 were higher than those in 2006-2010 and 2011-2014, respectively (all P<0.05). The M of dust exposure duration of new OWP cases from 2006-2010 and 2019-2022 was higher than that in cases from 2015-2018 and 2011-2014, respectively (all P<0.05). Most of the small shadows of the cases were circular small p shadows and distributed in the bilateral middle and lower lung zones, with a density mostly of 1/1, according to the X-ray chest films. Conclusion The hazard of welding fumes in the shipbuilding industry in Guangzhou City has been controlled, but the prevention and control of OWP among welders remains severe.