Objective To compare the clinical outcomes of urethral resectoscopy and retroperitoneal laparoscopic nephroureterectomy with open surgical nephroureterectomy. Methods A total of 44 patients with renal pelvic and ureteral neoplasms were included.Urethral resectoscopy and retroperitoneal laparoscopic nephroureterectomy were performed in 15 cases (Group A) and open surgical nephroureterectomy in 29 cases (Group B).The therapeutic effectiveness,postoperative recovery,relevant cost and complications were compared between Group A and Group B. Results The analysis showed that the intra-operative bleeding volum [(75.1?29.5)ml],the postoperative intesinal function recovery [(24.1?12.6)h],time to ambulation [(24.3?10.5)h],use of antalgesic [(3.0?0.8)d],intravenous antibiotic [(7.2?3.1)d],hospital stay [(6.3?1.2)d],convalescene of normal activities [(28.0?7.8)d] and incidence of complications with Group A were significantly superior to those with Group B(P

Objective To summarize the clinical experience of retroperitoneal and transperitoneal laparoscopic adrenalectomy for adrenal tumors.Methods Laparoscopic adrenalectomy was carried out in 56 cases of adrenal tumors via transperitoneal(10 cases) or retroperitoneal(46 cases) approaches.For transperitoneal laparoscopic adrenalectomy,the operation was performed through 3 abdominal trocars.After the peritoneum and the Gerota's fascia were opened,the adrenal gland or tumor were disconnected near the upper polar of the kidney.Then the tumor was removed by using the LigaSure system and a harmonic scalpel.For retroperitoneal laparoscopic adrenalectomy,a self-made balloon was used to dilate the retroperitoneal space.Then the Gerota's fascia was opened and the tumor was removed by using the LigaSure system and a harmonic scalpel. Results Of the 10 cases of transperitoneal adrenalectomy,conversions to open surgery were required in 3 cases because of extensive abdominal adhesion;of the 46 cases of retroperitoneal adrenalectomy,a conversion to open surgery was needed in 1 case because of massive hemorrhage of the inferior vena cava.Of the remaining 52 cases,the intraoperative blood loss was 20~200 ml(mean,70 ml) and no blood transfusion was needed.The operation time was 40~200 min(mean,110 min).The postoperative hospital stay was 3~8 d (mean,5.4 d).Follow-up for(6~36) months(mean,8 months) in 52 cases showed no tumor recurrence and metastasis.Conclusions Laparoscopic adrenalectomy has advantages of reliable effects,minimal invasion,rapid recovery,and short hospital stay.This procedure can be used as the first choice for the treatment of adrenal tumors.

Objective To explore the factors imfluencing the prognosis of patients with renal cell carcinoma after laparoscopic partial nephrectomy.Methods Clinical data from 593 renal cell carcinoma patients underwent laparoscopic partial nephrectomy in our institution from December 2010 to December 2015 were retrospectively collected..Tbere were 396 males and 197 females,aged 35 to 72 years old(mean 55.4 years).There were 181 cases of smoking history,206 cases of hypertension and 105 cases of diabetes.Before operation,98 cases of liver function were damaged and 122 cases were anemia.There were 521 cases with PLT ＜ 450 × 109/L,72 cases PLT≥ 450 × 109/L.Thc tumor of 292 cases on the left and 301 cases on the right.The Kaplan-Meier method log-rank test was used for survival analysis.Univariate analysis and factors which were significantly associated with survival in the univariate analysis were conducted into the multivariate analysis with Cox proportional hazards model.Results The operative time was 88.0-120.6 min,mean 104.3 min,the blood loss during operation was 47.2-157.8 ml,mean 102.5 ml. Pathological tumor stage revealed that 398 cases were T1 and 195 cases were T2 . Fuhrman classification revealed that 29 cases were grade Ⅰ,411 cases were grade Ⅱ,150 cases grade Ⅲ,3 cases grade Ⅳ . The median follow-up time was 36 months(ranged 6 to 99 months) . Five cases (1.3％) in the T1 patients relapsed,recurrencefree survival (RFS) rate was 98.7％;In the T2 patients,7 cases (3.6％) relapsed,1 of them had local recurrence and died of lung metastasis,and the RFS rate was 96.4％.Univariate analysis revealed that T stage,Fuhrman grade,tunor necrosis,tumor pseudocapsule,lymphovascular invasion,collection system violation,anemia,and high platelet were significantly associated with RFS of patients.Multivariate analysis found that T stage (HR =1.524,95 ％ CI 1.326-1.926,P =0.001),Fuhrman grade (HR =1.600,95 ％ CI 1.035-2.364,P =0.022),tumor necrosis (HR =2.315,95％ CI 1.523-3.624,P =0.001) were independent risk factors for the RFS of patients with renal cell carcinoma after retroperitoneal laparoscopic partial nephrectomy.Conclusion High T stage,high Fuhrman grade and tumor necrosis were independent risk factors for the RFS of patients with renal cell carcinoma after retroperitoneal laparoscopic partial nephrectomy.

Objective　To study the roles of P-selectin and nitric oxide (NO) on the etiology of pregnancy induced hypertension (PIH). Methods　The levels of plasma P-selectin and nitrite and nitrate (NO2-/NO3-) were determined in 36 patients with PIH. The data were compared with those of normal pregnant group (n=18) and healthy non-pregnant group (n=19). The levels of plasma P-selectin were measured by means of enzyme-linked immunosorbent assay (ELISA) and levels of plasma NO2-/NO3- were measured by Griess reaction after the nitrate was reduced by a Cadmium-reduction method. Results　 The results showed: （1）The level of P-selectin in the normal pregnant group (48.92±15.16) μg/L was higher than that in non-pregnant group ［(30.16±8.42) μg/L, P<0.001］. There was no significantly statistical difference in the levels of P-selectin between the normal pregnant group and the mild PIH group (P>0.05). The levels of P-selectin in the moderate and severe PIH group (70.11±17.65) μg/L were higher than those in the mild PIH group ［(47.33±17.95) μg/L, P<0.01］ and the normal pregnant group (P<0.001). （2）The concentration of NO2-/NO3- in normal pregnant group was higher than that in non-pregnant group (P<0.01). The concentration of NO2-/NO3- in PIH group were lower than was in normal pregnant group (P<0.001). The NO2-/NO3- in mild group was lower than that in normal pregnant group (P<0.001). The Plasma concentration of NO2-/NO3- in moderate and severe PIH group was lower than that of mild group (P<0.05). （3） There was a negative correlation between the plasma concentration of P-selectin and NO2-/NO3- in the PIH group. Conclusion　The changes of plasma levels of P-selectin and NO are related to the occurrence and development of PIH.

ObjectiveTo valuate the clinical effect of maintence of arteriovenous fistula by Songling Xuemaikang capsule.Methods40 cases were obtained from patients with chronic renal failure had received arterio-venous fistula operation,24 cases were observed with the combination treatment and 16 cases were served as control group,Hemorheology and difference value of vein diameter before and after treatment,blood flow of native arteivenous fistula and primary using time were observed.ResultsThe improvement degree of high shear rate and low shear rate were significantly as compared with that in the control group (P =0.000,P =0.001 ),while the blood flow after fistula maturation and ifference value of vein diameter were better than that in the control group( P =0.0356),primary using time between two groups were no significant differences ( P =0.056).ConclusionSonglinxuemaikang capsule was an effective drug for prevention high blood caogulation state,increasing blood flow of native arteivenous fistula,and enlargment vein diameter after arterio-venous fistula operation,which had certain value in clinical application.

Objective　To study the association of plasma von willebrand factor (vWF) and endothelin-1(ET-1) levels in patients with pregnancy induced hypertension (PIH). Methods　Plasma vWF and ET-1 were studied by ELISA method and immunoradiological method respectively in 36 patients with PIH, 18 normal pregnant women and 19 normal non-pregnant women. Results　Circulation levels of vWF and ET-1 were increased with increasing severity of the PIH. In mild PIH patients, the levels of plasma vWF ［(135.9±30.9)%, （P>0.05)］ weren′t significantly higher than those in healthy pregnant women ［(131.6±39.2)%,（P>0.05)］，but the levels of ET-1 ［(63.7±4.8) pg/L］ were significantly higher than those in healthy pregnant women ［(47.1±4.7) pg/L,（P<0.01)］. There were significant differences between groups of moderate-severe PIH ［vWF (174.4±35.4)%, ET-1 (92.6±19.1) pg/L］. There was a positive correlation between the plasma vWF level and ET-1 level. Conclusion　The results suggested that plasma vWF and ET-1 concentration could be used as indicators for the severity of PIH.

Objective To explore the curative effect of the pressure sore treated by iodophors associating with oxygen and peptide. Method 36 cases with pressure sore in stage Ⅲ and stage Ⅵ were randomly divided into the observation group and the control group. After ebriding was carried out in both groups, the control group was trea-ted with the rout change dressing and the other group was treated by iodophors associating with oxygen and peptide es-pecially. Result The cicatrization time of the observation group was remarkablely shorter than the control group. Conclusion Treating the pressure sore by iodopbors associating with oxygen and peptide has the advantage of less passion, shorter course of treatment, better curative effect, economy and mote convenience which is worth for the pro-moting of clinical usage.

Objective To analyze the pathogenesy and mutation of X-linked juvenile retinoschisis (XLRS) 1 gene in XLRS families, and to provide the theory basis in directing gene diagnosis. Methods The mutation of XLRS1 gene code in two XLRS families were detected and screened by polymerase chain reaction (PCR) and DNA direct sequence determination. Results Pro193Ser mutation was detected in family 1. Conclusion Pro193Ser mutation could be found in XLRS families, which can be used for genetic consultation and prenatal gene diagnosis.

Objective To evaluate the use of isoptin in kidney transplants recipients. Methods The graft acute rejection rate,the cyclosporin A daily dose and its trough level and toxicity,the blood pressure and cardiovascular complications,the serum creatinine and blood sugar were studied in cadaveric kidney transplant recipients both with and without the additional use of isoptin. Results With the additional use of isoptin in 44 cadaveric kidney transplant recipients,the acute rejection rate has not increased.After using isoptin for 2 weeks,CsA blood level has been increased 25.5% whereas the CsA dose been cut down 32.6 %.So,drug expense dropped about 30.0% and CsA toxicity (hand tremble,insomnia) was slightly decreased. Conclusions Isoptin does not inecease the graft acute rejection rate yet makes the CsA dose and its toxicity less.

Objective To investigate the effect of acute hyperventilation on the cerebral function of dogs with acute intracranial hypertension.Methods A total of 16 dogs with acute epidural hematoma were randomly divided into four groups.Group A,the group control,were ventilated and PETCO2 was maintained at 35-45mmHg.Groups B,C and D were hyperventilated and PETCO2 was maintained at 28-35,20-27 and below 20mmHg,respectively,for 1h.Jugular vein blood was taken to determine S100B and CRP content at preoperation(T1),2h(T2) post-ventilation,6h(T3),12h(T4),24h(T5) and 48h(T6).Results S100B and CRP contents in experimental group dogs increased,with a significant difference from that before operation(P