Needlescope is a laparoscopic equipment with a diameter of only 2 mm. It has been used in treatment of some general surgery and gynecology diseases. In urology .needlescopic techniques have also been applied in some procedures including adrenalectomy and pediatric orchiopexy. Although debates still exist about the definition of needlescopic surgery and the 2-mm instruments have their limitation,needlescopic technology has obvious advantages such as smaller traumas,superior cosmetic result, shorter hospital stay, and abbreviated convalescence. Needlescopic techniques represent a natural evolution of conventional laparoscopy.

Laparoscopic partial nephrectomy is gaining more and more popularity in treating patients with early renal carcinoma in recent years.Compared with radical nephrectomy,laparoscopic partial nephrectomy is a mini-invasive,safe method with satisfactory postoperative survival rate.However, there were still limited laboratory and clinical data about laparoscopic partial nephrectomy,and the experimental data of traditional laparoscopic surgery and open surgery were still used.Based on the existing data and the authors' experience,this article proposes three hypotheses for the problems puzzling urologic surgeons;the authors hope to verify the hypotheses through basic or clinical research.

0.3 g/L)promoted the growth of epithelial cells,and the promoting effect was significantly when the concentration of chitosan was 1.2 g/L(P

Objective To study chitosan's improving proliferation effect to the bladder epithelial cells,thus providing experlimental foundation for the treatment of interstitial cystitis.Methods Bladder epithelial cells were harested by the enzymatic digestion of the epithelium exposed by the eversion of reseeted New-Zealand hare's bladder.The cells were cultured in different concentrations(0.3、0.6、1.2、2.4、4.8 g/L)of chitosan group and control group,after 72 h,observing their growth and proliferation with optical microscopy;The effects of chitosan on proliferation of rabbit bladder epithelial cells were studied by NAG assay.EGFR mRNA was measured by PT-PCR.Results The growth of cells in the sample added chitosan is much better than that of in the control group.Chitosan could promote the proliferation of bladder epithelial cells at higher than 0.3 g/L of concentration in a dose dependent way.The optimum concentration to increase proliferation of eonjunctival epithelial cells was 1.2 g/L.The proliferative effect of EGFR mRNA increased with the elevated chitosan concentration after 72 h.Conclusions Chitosan can promote the growth of the bladder epithelial eell,which can provides a valuable evidence for further studies of interstitial cystitis's treatment.This proliferation effect is perhaps related to chitosan's promoting EGFR combinating specificity with EGFR.

Objective To study and evaluate the diagnostic procedures and the treatment strategy of adrenal tumors. Methods The accurate rate of localization and qualitative diagnosis of various imaging procedures for 117 cases of adrenal tumors were analyzed and the treatment efficacy studied. Results The accurate localization rate of the tumors was 84.6% for B ultrasonography,90.6% for CT,98.1% for MRI and the accurate qualitative diagnosis rate 39.2%,69.6% and 79.6% respectively.107 of the 117 cases were surgically cured,of which 30 were considered as large tumors with a volume exceeding 10 cm?5 cm?4 cm,the largest being 20 cm?15 cm?10 cm.9 patients underwent intervention therapy and no surgical procedure has been undertaken in 1. Conclusions Imaging procedures are very helpful for the localization and qualitative diagnosis of adrenal tumors.B ultrasonography can be used as a screening procedure.CT and MRI are high in accurate localization rate.As to the accurate qualitative diagnosis rate MRI is a little higher than CT.Accurate surgical incision is of prime importance for a surgical success.Adequate perioperative preparation can minimize complications to occur.Laparoscopic ultrasonography should be on schedule whenever laparoscopic adrenalectomy is contemplated.

Objective To observe the expression of FcRIIa and FcRIIb on the surface of several immune cells.Methods The expression of FcRIIa and FcRIIb on the surface of several immune cells were detected by RT-PCR and Western blot before and after IVIG incubation. The difference of Fc?RIIb expression on U937 and human peripheral blood mononuclear cells (PBM) after IVIG induction. was also analyze by FACS.Results Under normal conditions Fc?RIIa was mainly detected in macrophages/monocytes and B lymphocyte cells, while Fc?RIIb could not be detected. After IVIG administration, the expression of FcRIIb on the surface of U937 cells was quickly up-regulated (RT-PCR). FACS analysis revealed that the Fc?RIIb expression on U937 and human peripheral blood mononuclear cells (PBM) after IVIG induction was also increased. Conclusion The effect of immunoregulation of IVIG was partly achieved by up-regulation of the expression of FcRIIb on the surface of some immune cells.

Objective To investigate the influence of renal allograft donor cytokine and cytokine receptor gene polymorphisms on acute rejection after renal transplantation.Methods (1) 126 cases of cadaveric renal allograft recipients were divided into two groups according to the presence or absence of acute graft rejection.The distribution of 22 polymorphisms in 13 cytokine genes and production types of some cytokines were compared between donors of two groups as well as latent factors affecting acute rejection.(2) Based on the result of HLA-DR matching,all recipients were stratified into two conditions:0～1 locus HLA-DR mismatched and HLA-DR completely mismatched.Previous positive gene polymorphisms were compared between rejection group and no rejection group under two conditions.Results (1) Compared with no rejection group,the number of HLA-DR mismatched was significantly higher in rejection group.In the donors of rejection group,the genotype frequency of IL-1α-889 C/C,IL-1Rα msp I 11100 T/T,IL-4Rα+ 1902 A/A,TGF-β1 codon 10 C/C,IL-10-1082 A/A and lower production type frequency of IL-10 were significantly higher,whereas the genotype frequency of IL-12-1188 A/A,IL-2-330 G/G and IL-10 GCC/ATA was significantly lower.(2) With 0～1 locus HLA-DR mismatched,the genotype frequency of IL-1Rα msp I 11100 T/T,IL-4Raα+1902 A/A,IL-2-330 G/G,TGF-β1 codon 10 C/C and lower production type frequency of IL-10 showed significant difference between two groups,whereas with HLA-DR completely mismatched,the genotype frequency of IL-12-1188 A/A had significant difference.Conclusions This study verifies renal allograft donor genotype of IL-1α-889 C/C,IL-4Rα+ 1902 A/A,IL-1Ra msp I 11100 T/T,TGF-β1 codon 10 C/C,IL-10-1082 A/A and lower production type of IL-10 gene as the genetic safe factors for the development of acute allograft rejection and genotype of IL-12-1188 A/A and IL-2-330G/G as the major genetic risk factors for acute rejection after kidney transplantation Furthermore,the condition of HLA-DR mismatching might interfere with the action of these cytokine and cytokine receptor polymorphisms.

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 neuroendocrine properties of adrenalcortical tumors.Methods: We retrospectively reviewed the clinical data of 99 adrenalcortical tumor patients,who were treated in Changzheng Hospital form June 1999 to June 2005.Expression of neuron specific enolase(NSE),chromogranin A(CgA) and synaptophysin(Syn) proteins were examined by immunohistochemistry(S-P method) using monoclonal antibodies.The general data of patients,including the age,symptoms,laboratory findings,and pathological types,were collected and subjected to statistical analysis with SAS v6.12 software.Results: The expression of all the above 3 proteins was found in adrenalcortical adenoma tissues,with the positive rate of NSE being 80%,the positive rate of CgA being 48.9%,and the positive rate of Syn being 75.6%;the positive rates in the adrenalcortical carcinoma tissues were 77.8%,22.2%,and 77.8%,respectively;and those in the normal adrenal tissues was 20%,0%,and 10%,respectively.The positive rates of 3 proteins in adrenalcortical tumors was significantly higher than those in the normal adrenal tissues(P