Objective To study the juxtaglomerular cell tumor. Methods The clinical characteristics,diagnosis,surgical teratment and the prognosis of 5 patients were retrospectively studied with review of the literature. Results All the patients had hypokalemia.Peripheral serum renin levels were recorded in 4 patients and 3 of them had high levels of peripheral serum renin activity and hyperaldosteronism while these were normal in the other 1.1 patient had been preoperatively diagnosed as a right adrenal tumor with a concurrent right kidney tumor while the post-operative histopathological studied revealed normal adrenal tissue and a juxtaglomerular cell tumor of the right kidney.All patients underwent simple tumor resection.The peripheral serum renin activity,hyperaldosteronism,hypokalemia,and hypertension became normal after the tumor resection.At a mean follow-up of 58 months (range 15 to 120 months ) no tumor recurrence and hypertension has been documented. Conclusions Juxtaglomerular cell tumor is a begin tumor of kidney,being a rare, curable cause of high levels of peripheral serum renin activity,hyperaldosteronism, hypokalemia and hypertension.Differential diagnosis includes primary hyperaldosteronism and renal artery stenosis.The prognosis is good with tumor resection.

Interleukin-22 (IL-22) is a new kind of eytokine discovered in 2000. The major sources of IL-22 are activated T1 -cells and NK-cells. Tissue cells at outer body barriers, i.e. of the skin, kidney, the di-gestive and respiratory systems all highly express IL-22R or respond to IL-22. IL-22 functions by promoting the anti-microbial defense, inducing phase reactants, protecting against damage and enhancing natural immu-nity. Furthermore, IL-22 mediates the proliferation, differentiation and apoptesis in cancer cells, that gives us a new idea about tumor therapy.

Objective To evaluate the diagnostic significance of B-ultrasound and CT in small renal tumor (≤3 cm). Methods The clinical data of 48 patients (29 men and 19 women) with small renal tumor were reviewed.Their mean age was 49 years.Of them,43 cases were asymptomatic,while 2 complained of hematuria,2 of lumbago and 1 of hematuria with lumbago.B-ultrasound, conventional CT,helical CT thin scan and intraoperative frozen section were evaluated. Results Of the 48 cases,36 of renal cell carcinoma (RCC),7 of renal angiomyolipoma (RAML),4 of oncocytic adenoma and 1 of metanephric adenoma were diagnosed by pathology after surgery.The diagnostic accuracy was 75%(36/48) for B-ultrasound,81%(39/48) for conventional CT,91%(20/22) for helical CT thin scan and 95%(19/20) for intraoperative frozen section,respectively. Conclusions Small renal tumor has high incidental rate as well as high benign rate.As the tumor is relatively smaller, it is difficult to differentiate between benign and malignant nature of the tumor by B-ultrasound and conventional CT.Helical CT thin scan and intraoperative frozen section are helpful for accurate diagnosis of the tumor.

Objective To evaluate the clinical value of transrectal ultrasound guided systematic 12-sample needle biopsy in patients with elevated serum prostate-specific antigen and/or abnormal digital rectal examination findings. Methods The data of 220 patients who underwent 12-sample transrectal ultrasound guided needle biopsy (comprising conventional 6 biopsies and 3 biopsies in each lateral peripheral zone) of the prostate were retrospectively analyzed. Results Of the 220 patients,73 (33.2%) had prostate cancers on biopsy;the clinical stages were as follows:4 cases of stage T 1,21 of T 2,15 of T 3 and 33 of T 4.If the conventional 6-core biopsy alone was performed, the detection rate would be 31.4%,4 cases (3 of stage T 1 and 1 of stage T 2,all with tumor volume less than 0.5 ml) would be missed. The improvement by 12-core biopsy was marked in patients with stage T 1-T 2 prostate disease (16%,4/25).No serious complications were observed in patients with transrectal ultrasound guided systematic 12-core biopsy of the prostate. Conclusions The 12-sample procedure can improve the cancer detection rate of the early stage prostate cancer and tumor with volume less than 0.5 ml.Therefore,more attention should be paid to the lateral peripheral zone biopsy.

Objective To evaluate the effect of surgical treatment on patients with retroperitoneal fibrosis. Methods The medical records of 24 retroperitoneal fibrosis patients (19 men and 5 women;mean age,52 years) who had been surgically treated from January 1985 to December 2003 were retrospectively analyzed.The initial clinical presentations included low back and abdominal pain in 11 cases,acute anuresis in 5 and incidental bilateral hydronephrosis in 8.Double-J inter-ureter drainage was performed in 11 cases, among whom the procedure failed in 4 cases, and then they underwent pricking pyelostomy.After their general condition improved,ureterocutaneostomy and ureterolysis were performed in 2 cases and 1 case, respectively.Of them 1 case died of acute myocardial infarction 3 months later.Thirteen cases who had good general condition at diagnosis underwent ureterolysis. Results One patient developed renal function failure due to repeated urinary infection 3 years after operation.One died of acute myocardial infarction 3 months after operation.The other 22 patients recovered well,and their mean creatinine level decreased from 450.9?mol/L before operation to 318.2 ?mol/L (1 month) and 265.2 ?mol/L (3 months),respectively,after operation. Conclusions Prompt and appropriate relief of urinary obstruction with surgical treatment can effectively protect the renal function in patients with retroperitoneal fibrosis.

Background and purpose:Surface enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS) is useful in helping to identify the molecular changes closely related to renal cell carcinoma. We explored the different expression of sera protein between human renal cell carcinoma patients and normal to screen renal cancer-specific biomarkers. Methods:The protein mass spectrometry of 28 cases with renal cell carcinoma and 28 normal persons were detected by WCX2 protein chip combining with SELDI-TOF-MS technique for screening the different proteins. Serum samples from 28 patients with clear renal cell carcinoma and 28 normal persons were used to detect biomarkers for clear renal cell carcinoma by SELDI-TOF-MS technique with WCX2 Proteinchip. Results:170 effective protein wave crests between 1.5?103-30?103(1.5-30 kD) were detected. Seven proteins were specifically detected in sera of patients with clear renal cell carcinoma, but not in normal donor. The proteins with MW 4.098,5.917,6.643 ?103 were down-regulated ,and four proteins with MW 5.572,6.344,6.529,8.518 ?103 were up-regulated. Conclusion:Detection of specific protein in human renal cell carcinoma sera is significant both for determination of clinical specific biomarkers and study of cancer development mechanism.

Objective To evaluate the clinical outcomes of a reformed endoscope assisted ureteral stripping technique in post renal transplant patients with renal pelvic tumor of the graft homonymy primitive kidney.Methods Seven post renal transplant patients with renal pelvic tumor of the graft homonymy primitive kidneys(2 males and 5 females)with average age of 54 years old were recruited.Standard retroperitoneal laparoscopic nephrectomies were performed for all patients after placement of a 5 F ureteral stent as the ureteral stripper. After the closure of the ureter at the lower kidney pole level with metal clips, the distal ureter was separated and the ureteral muscle layer and serous membrane layer were split. The ureter muscle layer was then tied tightly to the ureteral stent tip. The ureter and the stent were pulled out through urethra. Transurethral resection around the everted ureteral orifice was performed and the ureter was removed afterwards. The graft function, operation time,complication and estimated blood loss were recorded.Results All the 7 patients successfully underwent the operations and no major complication such as ureteral disruption, stripping embarrassment and converting to open operation happened. The mean operation time was 126 min (ranging from 105 to 160 min) and the mean blood loss was 124 ml (ranging from 80 to 160 ml). Introvesical chemotherapy with farmorubine hydrochloride was performed 3 weeks after surgery. The mean preoperation and 6 months post-operation creatinine and urea nitrogen levels were 136.5μmol/L, 138. 6μmol/L and 7.42 mmol/L, 7.80 mmol/L respectively and there was no statistical difference. There was no tumor recurrence during 6 month follow-up except one case having simultaneous bladder cancer had bladder cancer relapse 3 months after operation and required another TURBt.Conclusion The reformed endoscope assisted ureteral stripping technique is minimally invasive and convenient in the treatment of post renal transplant patients with renal pelvic tumor of the graft homonymy primitive kidney.

Objective To study the factors associated with post-operattve renal function injury after laparoscopic nephron-sparing surgery(LNSS)for tumors. Methods Fifty consecutive patients were enroned in a prospective protocol and underwent LNSS.Preoperative and postoperative renal scintigraphic scan was performed in all patients. 99 Tcm-diethylenetetraminepentacetic acid scan was performed in all patients.Linear correlation and multivariate regression model were used to analysis the factors associated with postoperative renal damage.Twenty consecutive patients associated with risk factors were followed-up.These data in GFR were monitored at the preoperative,1 week and 3 months after operation.The duration Warm ischemia was recorded. Results In selected patients,assessed by renal scintigraphy,the function of the operated kidney was reduced by a mean of 24%.Linar correlation analysis showed that there was positive correlation between the age,tumor size,duration of warm ischemia and postoperative renal function injury.Furthermore,multivariate Legression analysis revealed that the duration of warm ischemia was the independent risk factor of postoperative renal damage.Twenty consecutive patients were included in this protocol.There was a significant difference between vessel clamp time≤30 min and vessel clamp time＞30 min.Renal scan data did not reveal any significant decrease in GFR in the affected kidney at 3 months after surgery for the patients whose yesscl clamp time less than 30 min.Renal function damage could not recover in the patients over 70 years with longer than 30 min warm ischemia or with longer than 60 min warm ischemia. Conclusions This paper evaluated renal function on the affected side before and after surgery by measuring renal function with renal scintigraphy using99 Tcm-DTPA.Risk factors for renal dysfunction in the affected kidney after LPN are age over 70 years with more than 30min warm ischemia time,and a warm ischemia time longer than 60 min.

Objective To understand the ultrastructure of detrusor musculature in areflexia neurogenic bladders. Methods The detrusor secured from the anterior wall of bladders was studied and compared by means of transmission electron microscope in 11 patients with areflexia neurogenic bladder during cystomyoplasty with musculus rectus abdominis and in 7 accidentally deceased young men in autopsy. Results Ultrastructural changes of de differentiation of detrusor cells were observed in areflexia neurogenic bladders,such as inconsistent contours,malalignment and disarray.Wide separation between muscle cells with reduction of intermediate cell junction and with abundant collagen fibrils and irregular dense structures between individual cells were noted.There were also such changes as reduction of pinocytotic vesicle and mitochondria,disarray of myofilaments and malalignment of dense body,etc.,in detrusor cells.By contrast normal detrusor cells were well arranged and well distributed with consistent contours and size.The distance between muscle cells was much smaller than the abnormal specimens with proper intermediate junction.Caveolae and dense area were evenly distributed among the sarcoplasm.Organelles,myofilament and dense body were well organized in the smooth muscle cells. Conclusions The ultrastructural changes of detrusor in areflexia neurogenic bladders may be associated with relative increment of bladder outlet obstruction,which is probably due to detrusor debility from diseased nerve and sequential disequilibrium between normal detrusor and sphincter muscle of the urethra.Prophylactic management of lower intra bladder pressure may be beneficial to the prevention of ultrastructural deterioration in detrusor cells.

Objective To analyze the complication rates in 210 patients undergoing transrectal ultrasound-guided 24-core transperineal prostate biopsy.Methods Clinical data of 210 patients who underwent transrectal ultrasound-guided 24-core transperineal prostate biopsy from 2010 to 2012 were collected.A retrospective analysis of complications after prostate biopsy was conducted.Results The main postoperative complications were hematuria,bloody stool,dysuria,urinary retention,fever (＞38℃),urinary infection,vasovagal syncope,and their complication rates were 43.3 ％ (91/210),10.9％ (23/210),23.3％ (49/210),25.2％ (53/210),14.8％ (31/210),21.9％ (46/210),0.48％ (1/210) respectively.In addition,5 patients (2.5％) were hospitalized due to biopsy related complications.Conclusions Transrectal ultrasound guided 24-core transperineal prostate biopsy is an relatively safe and effective puncture method with common minor complications and less severe complications.Adequate attentions should be paid to its complications.