Endourology has developed very quickly during the past decades. For transurethral therapy of diseases of lower urinary tract, it has been gradually accepted by both urologists and patients for plasmatic electrocautery resection, holmium laser and electrochemical enucleation of benign prostatic hyperplasia. Flexible ureteroscope has been widely used for examination of upper urinary tract for unknown urinary bleeding and micronephrostomy has achieved great success for percutaneous nephrolithotripsy. Laparoscope has become very popular and can be used to perform most of the operations in the field of urology.

Objective To study the expression of DDH and VEGF in esophageal carcinoma and their relationship, and their prognostic significance for patients of esophageal carcinoma.Methods The expression of DDH and VEGF in 61 esophageal carcinoma tissues and border areas were detected by immunohistochemistry SABC method.Results The positive rate of DDH and VEGF in esophageal carcinoma tissues are higher than those in border areas,both of their expression were correlated with TNM stages,grades of cell differentiation and lymph node metastasis.Patients expressing DDH and VEGF seemed to have a poor prognosis.The expression of DDH was found in a positive correlation with VEGF. Conclusion DDH and VEGF were correlated with the tumorigenesis and progression of esophageal carcinoma patients.

Objective To investigate the role of GST-? mRNA in the development and pathogenesis of esophageal cancer. Methods Twenty two matched pairs of esophageal cancerous and noncancerous tissues were obtained from 22 patients with esophageal cancer in an endemic region. AP-PCR was used for determining the differential gene fragments and RT-PCR for detecting the expression of GST-? mRNA. Results Differential random amplified fragments were found in 6 cancerous tissues, and none of the noncancerous tissues. The 5T differential gene fragments were of 1.0 kb, and by cloning, sequencing, and sequence homology analysis, no homologous sequence was found in the gene library. The expression rates of GST-? mRNA in cancerous and noncancerous tissues were 54.5%(12/22) and 18.2%(4/22), respectively. Conclusions Whether the 5T differential gene fragment is a new gene candidate or is a marker of oncogene remains to be further studied. The expression of GST-? mRNA in esophageal cancerous tissue was markedly enhanced.

AIM: To study the effect of sesamin on expression of inducible nitric oxide synthase(iNOS)and nitrotyrosine(NT)in rat liver tissue with metabolic syndromic hepatic steatosis. METHODS: The rat model of metabolic syndromic hepatic steatosis was induced by operation of two kidneys with one clip(2K1C)and high-fat. The rats taken from that successful model were randomly divided into model group and sesamin(120, 60, and 30 mg·kg~(-1)·d~(-1))groups. In addition, the sham-operated group was set up. The rats in treated group were given sesamin intragastrically everyday for 8 weeks. The levels of blood lipids(TC, TG and FFA)in serum were detected. The activity of SOD and MDA level in the liver homogenate were determined. The expressions of iNOS and NT proteins were detected by Western blotting analysis. The histopathological changes were observed by HE staining in the liver tissues. RESULTS: Compared to model groups, sesamin(120, 60 mg·kg~(-1))significantly inhibited the elevation of serum TC, TG, FFA, and MDA in liver homogenate(P<0.05), and increased the activity of SOD(P<0.05). It also decreased the protein expression of iNOS and NT(P<0.05), and ameliorated the degree of hepatic steatosis. CONCLUSION: Sesamin prevents and cures the metabolic syndromic hepatic steatosis. The mechanism is probably mediated through decreasing the protein expression of iNOS and NT, and alleviating the oxidative stress in addition to regulating the lipid metabolism.

Objective To explore the clinical features of adrenocortical oncocytoma for better understanding. Methods A total of 586 patients with adrenal cortical adenoma were retrospectively analyzed in our hospital from January 1993 to November 2009, in which 18 were diagnosed as adrenal cortical oncocytoma pathologically, with 7 male and 11 female, aged ( 45.5 ± 15.9 ) years, and the disease course of( 13.3 ± 13.1 )months. Results 6 patients suffered from Cushing's syndrome, 2 primary hyperaldosteronism, 1 had clinical features of both Cushing's syndrome and primary hyperaldosteronism, and 9 were nonfunctional. 4 cases were misdiagnosed as pheochromocytoma preoperatively. All 18 patients were diagnosed by B-mode ultrasound and operation ( 13 by laparoscopy, 5 by laparotomy). 11 tumors were located in the left adrenal while 7 in the right, with the average tumor size of 5.6 cm in diameter. Histopathologically, 1 was oncocytic adrenocortical carcinoma, while 17 were adrenocortical oncocytoma, in which 5 were potentially malignant and 12 were benign. 11 patients were followed up for 20.5±20.1 months. 2 patients were dead, and 9 were alive with tumor recurrence in 1 case.ConclusionsAdrenocortical oncocytoma is a pathological diagnosis and the clinical manifestations are various. The tumors are usually large in size, and can easily be found by ultrasound, but may be wrongly diagnosed as pheochromocytoma.Being different from previous reports, the majority of these patients present with endocrine dysfunction. Most of these cases are benign, but malignant potential is obvious. Therefore,follow-up is very important.

Objective To investigate the effect and safety of duct-to-mucosa anastomosis technique for pancreaticoduodenectomy(PD).Methods The clinical data,including pancreatic fistula and other complications,of 189 patients underwent PD with end-to-side pancreaticojejunostomy at our institution from Jan 2001 to Jan 2009 were analyzed retrospectively.The definition of pancreatic fistula was threefold increase over the serum amylase level 7 days after operation,and draining volume was more than 50 ml per day.Results Totally 177 Whipple procedures were performed,while 12 pylorus-preserving pancreateduodenectomy procedures were performed.Five patients developed pancreatic fistula with a incidence of 2.65%(5/189).In which 3 were mild Cases,who fully recovered after conservative management,and the other 2 cages were cured by surgical intervention.Other complications included 9 cases of wound infection(4.76%,9/189),11 cases of empty dysfunction(5.82%,11/189),5 Cases of delayed hemorrhage(2.65%,5/189),and 4 cases of intra-abdominal infection(2.12%,4/189),and 2 patients died due to severe intra-abdominal infection and acute pulmonary infarction.Conclusions Duet-to-mucesa anastomosis technique resembles physiological state with low incidence of pancreatic fistula and delayed anastomosis hemorrhage.It may be used for different kinds of anastomosis for pancreatic stump.

Aim To investigate the difference of aortic function between renal hypertension rat(2K1C) and renal hypertensive-hyperlipidemia rat(RHHR).Methods Animals were divided into 3 groups: the sham-operated group,RHHR and 2K1C model groups.The vascular function test was performed in vitro.The response of aortic ring to phenylephrine(PE),acetylcholine(ACh) and sodium nitroprusside(SNP) was measured.Then aortic ring was incubated with nitricoxide synthase inhibitor N-nitro-L-arginine-methyl-ester(L-NAME) and its response to Ach was observed.Results The contraction in response to PE was augmented in the two model groups.ACh-induced vasorelaxation was reduced in both model groups,and such relaxation was more depressed in RHHR than that in 2K1C.The ability of relaxation evoked by NO was impaired in two model groups.SNP elicited complete relaxation in three groups,but the sensitivity to SNP was more decreased in RHHR than those in sham-operated and 2K1C groups.Conclusion These findings suggest that the vasodilation function of aorta is more impaired in RHHR than that in 2K1C group.The decrease in utilization of vascular smooth muscle to NO induced by hyperlipidemia may contribute to the main cause.

The means of survival of genomic dsRNA of reoviruses from dsRNA-triggered and Dicer-initiated RNAi pathway remains to be defined.The present study aimed to investigate the effect of Grass carp reovirus (GCRV) replication on the RNAi pathway of grass carp kidney cells (CIK).The dsRNA-triggered RNAi pathway was demonstrated unimpaired in CIK cells through RNAi assay.GCRV-specific siRNA was generated in CIK cells transfected with purified GCRV genomic dsRNA in Northern blot analysis; while in GCRV-infected CIK cells,no GCRV-specific siRNA could be detected.Infection and transfection experiments further indicated that replication of GCRV correlated with the increased transcription level of the Dicer gene and functional inhibition of in vitro synthesized egfp-siRNA in silencing the EGFP reporter gene.These data demonstrated that although only the genomic dsRNA of GCRV was sensitive to the cellular RNAi pathway,unidentified RNAi suppressor protein(s) might contribute to the survival of the viral genome and efficient viral replication.

Objective To investigate the prognosis of patients with primary liver cancer in different pathological types after hepatectomy,and to analyze the effects of clinicopathological factors on the survival.Methods The clinical data of 567 patients with primary liver cancer who received hepatectomy at the Affiliated Hospital of Qingdao University from January 1997 to December 2008 were retrospectively analyzed.All patients were divided into hepatocellular carcinoma (HCC) group,cholangiocarcinoma (CC) group and combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) group.The survival and risk factors of the patients were analyzed.All data were analyzed by using the chi-square test,t test,analysis of variance.The survival curve was drawn by the Kaplan-Meier method and the survival of the 3 groups was compared by the Log-rank test.The risk factors were analyzed by the one-way analysis of variance and COX regression model.Results The results of pathological examination confirmed that 92.9％ (527/567) patients were with HCC,4.6％ (26/576) with CC and 2.5％ (14/567)with cHCC-CC.The median cumulative survival time of patients with HCC was 48 months,which was significantly longer than 19 months of patients with CC and 14 months of patients with cHCC-CC (Log-rank value =4.354,8.847,P ＜ 0.05).The median tumor-free survival time of patients with HCC was 26 months,which was significantly longer than 9 months of patients with CC and 9 months of patients with cHCC-CC (Log-rank value =6.479,7.708,P ＜ 0.05).The tumor recurrence rate within 1 year of patients with HCC was 28.8％ (152/527),which was significantly lower than 57.7％ (15/26) of patients with CC or 9/14 of patients with cHCC-CC (F =17.046,P ＜ 0.05).No vascular thrombosis was detected in patients with CC,but the regional lymph node metastasis rate was 19.2％ (5/26),which was significantly higher than 2.8％ (15/527) of patients with HCC (x2 =19.082,P ＜ 0.05).Level of alpha-fetoprotein,TNM staging,tumor diameter,multiple foci,liver capsule invasion,satellite foci and lymph node metastasis were risk factors for the survivals of patients with primary liver cancer after hepateetomy (x2 =8.648,118.786,59.548,7.639,13.200,43.842,15.540,P ＜ 0.05).Vascular tumor thrombosis and Child-Pugh classification were the risk factors for the survivals of patients with HCC or cHCC-CC (x2 =70.446,6.230,P ＜ 0.05).TNM staging,tumor diameter,satellite foci and vascular tumor thrombusis were the independent risk factors for the survivals of patients with primary liver cancer (RR =1.420,1.050,1.513,1.899,P ＜ 0.05) ; TNM staging,tumor diameter and vascular tumor thrombosis were the independent risk factors for the survivals of patients with HCC (RR =1.432,1.888,1.052,P ＜ 0.05).TNM staging and tumor diameter were the independent risk factors for the survivals patients with CC (RR =1.473,1.503,P ＜ 0.05).Conclusion Although CC and cHCC-CC take small proportion in the primary liver cancer,the tumor recurrence rate is higher and the survival rate is lower when compared with patients with HCC.

Objective To summarize the experience in the diagnosis and treatment of mucinous cystic neoplasms (MCN) of the pancreas. Methods The clinical data of 20 cases who were diagnosed as MCN of the pancreas in the affiliated hospital of Qingdao university from January, 2003 to June, 2008 were collected, data including clinical manifestations, pathological features, treatment and survival were analyzed retrospectively. Results The clinical manifestations mainly included abdominal pain or discomfort, nausea, vomiting; 11 patients had abdominal tenderness, 6 patients had palpable abdominal mass. All the patients underwent ultrasound and CT scan examinations, 13 patients were diagnosed as having benign MCN of the pancreas, 4 were serous cystadenoma, 3 were mucinous cystadenocarcinoma. The tumors were located in the body and tail of the pancreas, with a mean diameter of 4 - 14 cm. All the 20 cases received surgical treatment. The procedures mainly included pancreaticoduodenectomy and resection of pancreatic body and tail. Pathological examinations confirmed there were 10 patients with benign MCN of the pancreas, 3 were borderline mucinous cystadenomas and 7 mucinous cystadenocarcinomas. After a mean follow-up of 26 months, patients with benign MCN of the pancreas or borderline mucinous cystadenomas were still alive without recurrence, the three year survival of patients with mucinous cystadenocarcinomas was 50%. Conclusions MCN of the pancreas mainly occurred in female, and there was no specific clinical features, preoperative ultrasound and CT scan examinations could help to diagnose this disease. Surgical resection was the only effective method to cure MCN with good prognosis.