Objective To study the clinical features,pathological characteristics and prognosis of renal cell carcinoma(RCC)in young adults,and to improve the recognition of RCC in young population. Methods The data of 35 young patients with RCC under the age of 35 years from August 1983 to June 2005 were analyzed retrospectively.There were 22 males and 13 females with a mean age of 31 years(age range, 19-35 years).The clinical presentations were as follows:painless hematuria in 12 cases(34%),low back pain in 12(34%),abdominal mass in 2(6%),fever in 3 and Stauffer syndrome in 1.The tumor size was 1.2-13.8 cm in diameter(mean,6.0cm).AJCC staging showed stage I tumor in 8 cases,stageⅡin 4, stageⅢin 18 and stageⅣin 5.Of the 35 cases,28 underwent radical nephrectomy(including simultaneous extraction of the vena cava emboli in 3 cases and extraction with pulmonary lobectomy in 1);5 cases under- went partial nephrectomy;and 2 cases lost the chance of operation(1 of them had biopsy).Results The operations were successful.The postoperative pathologic diagnoses consisted of clear cell carcinoma in 23 ca- ses,mixed cell carcinoma in 5,papillary cell carcinoma in 2,and chromophobe cell carcinoma in 2,low-dif- ferentiated and undifferentiated cell carcinoma each in 1.Of them,26 cases were followed for 12-148 months(mean,56 months).Postoperative 3-and 5-year survival rates were 65% and 50%,respectively. Conclnsions In young population,RCC is difficult to diagnose because of occult symptoms at early stage and lack of tumor specificity,which leads to relatively late clinical staging at diagnosis.RCC is characterized by higher malignancy,easy invasion to surrounding tissues and metastasis,and thus poor prognosis.

Objective To explore the value and the most reasonable procedure of EN by naso-intestinal tube in digestive tract disease after operation.Methods Data of 25 cases of indigestive tract disease subject to EN through a naso-intestinal tube after operation were reviewed and analysed.Results Insertion of naso-intestinal tube was completed in all cases.Nasal feeding could be completed in 24 cases;postoperative complications included 1 case of leakage,1 case of arrhythmia and heart failure and 4 cases of fat liquefication.Conclusion EN by naso-intestinal tube in digestive tract disease was favorable for reduction of postoperative risk.It could be applied in almost all pa- tients when the doctor had grasped the technique skillfully.

Objective To evaluate the feasibility and efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL)in the lateral position.Methods A total of 48 patients with staghorn(12 cases,2.2 to 5.8 cm in diameter)or multiple renal calculi(31)or upper ureteral stones(5)were treated with MPCNL in our hospital between July 2004 to October 2007.The patients were placed in a lateral position with the head 10? lower and the feet 20? lower.The puncture was made under the guidance of X-ray or ultrasonography,and then Holmium laser or EMS lithotripter was used for stone fragmentation.The stone debris was removed by irrigation.Results The procedure was completed in all of the 48 patients except one,who was converted to a supine position because of the difficulty in puncture.Among the 47 cases,41 were cured with the first operation,the other 6 received catheterization in the first procedure,and then underwent calculi removal in a second-stage operation.None of the patients were converted to open surgery.The mean operation time in this series was(137.5?39.6)min.The one-stage cure rate in our patients was 82.9%(34/41).None of the cases had massive blood loss,or injuries to the pleura and other organs.Follow-up was available in 21 cases for 1 to 3 months.During the period,among the 17 patients who had hydronephrosis,11 were cured and 6 were improved;and among the 4 who had residual stones,1 received ESWL in 1 months after the first operation and was cured afterwards;the other 3 were treated by traditional Chinese medicine,2 of them were cured.Conclusions The MPCNL performed on the patients in the lateral position is an effective alternative for renal calculi,and favorable to intra-operative anesthesia monitor.

The paper introduced the organization culture building of a private hospital, in creating the Aikang hospital as your home culture and Aikang values for building a harmonious workplace for the hospital. The management system reform features the separation between regulations and management,building of the supporting system and operating system, for better quality of care with advanced management practice. The social rewards feature great efforts in supporting the disadvantageous population, and undertaking public health service and charity activities. These care and love to the community help the hospital to fulfill its social responsibilities.

Objective To investigate therapeutic effects of muscle sliding operation treating Volkmann ischemic contracture of the forearm. Methods 32 cases Volkmann ischemic contracture were classified two types: the single type and the complex type. Three approaches were employed to treat different types which were single muscle sliding operation, muscle sliding plus skeletal operation, muscle sliding operation plus neurolysis.Results 29 cases were followed up, which excellent and good was 93.7 percent.Conclusions Muscle sliding operation was effective management for Volkmann ischemic contracture, and the skeletal operation or neurolysis could managed for the complex type in the meantime.

Objective To evaluate the clinical diagnostic value and limitation of MRI and contrast enhancement MRA (CE-MRA) in congenital heart disease of children. Methods Three hundred patients with congenital heart disease underwent CE-MRA. 173 were confirmed by operation. The results of MRA and CE-MRA were compared with operation data. Results 196 (86.0%) intracardiac malformation including septal defect and valve anomaly were diagnosed correctly by MRI within 228 abnormalities which were confirmed by operation. 101 (96.2%) extracardiac malformation including great vessels stenosis and anomalous connection were diagnosed correctly by MRI and MRA within 105 abnormalities which were confirmed by operation. Conclusion MRI and CE-MRA are very accurate diagnostic method for extracardiac malformation. CE-MRA is the best sequence for congenital heart disease.

Objective To report 6 cases of congenital heart disease with high origin of coronary artery and to evaluate the imaging method for diagnosis of congenital high origin of coronary artery. Methods Six patients with congenital high origin of coronary artery underwent angiocardiography ,echocardiography ,and 2 patients also underwent magnetic resonance examination. All 6 cases were confirmed by operation. Results All 6 cases were congenital high origin of right coronary artery. Angiocardiography made correct diagnosis in all 6 cases; MRI made the correct diagnosis in 1 of the 2 cases; echocardiography made 1 correct diagnosis. Conclusion Correct diagnosis of congenital high origin of coronary artery was very important for patients with congenital heart disease. Angiocardiography was a very reliable imaging method and MRI can play an important role in preoperative diagnosis of congenital high origin of coronary artery.

Abstract?AlM: To assess the efficacy and safety of trypan blue and indocyanine green ( lCG ) for continuous curvilineal capsulorrhexis ( CCC ) in mature or hypermature phacoemulsification.?METHODS: A total of 122 eyes of 122 cases with cataracts in mature and hypermature were randomly divided into three groups, trypan blue staining group was 46 eyes of 46 cases as group A, lCG staining group was 40 eyes of 40 cases as group B, control group was 36 eyes of 36 cases as group C. Staining groups were used to 0. 2mL trypan blue or lCG injected into the anterior chamber during operation, respectively. The success rate of CCC, lens posterior capsule rupture and implanted intraocular lens pouch were observed and compared during operation. Anterior chamber inflammation was observed after operation, and compared with the control group to observe and analysis.? RESULTS: The success rate of CCC, implanted intraocular lens pouch were statistically significant difference in trypan blue staining group ( group A ) than that in control group (group C) (P<0. 05). lmplanted intraocular lens pouch was statistically significant difference in lCG group ( group B ) than that in control group ( group C ) ( P<0. 05 ) . The rate of lens posterior capsule rupture was no statistically significant difference in all three groups ( P > 0. 05 ) . Anterior chamber inflammation was no significant difference in the postoperative reaction among the three groups.?CONCLUSlON:The application of trypan blue or lCG for lens capsule staining before CCC in lack of red reflective mature and hypermature cataracts is safe and effective, both results are comparable. lt guarantees a complete CCC and improves the success rate of phacoemulsification.

Objective To observe the preventive effect of salmeterol xinafoate and fluticasone propionate aerosol on radiation pneumonia in patients with local advanced non-small cell lung cancer (NSCLC) after radiotherapy.Methods Sixty-four patients with local advanced NSCLC were randomly divided into the study group and the control group.Both groups were treated with intensity modulated radiation therapy treatment and routine interventions.Salmeterol xinafoate and fluticasone propionate aerosol were given to the study group from the first day of radiation therapy at both the morning and evening time.Clinical symptoms,chest CT,Karnofsky score and tumor necrosis factor-α (TNF-α) levels in the two groups were analyzed at the time before radiotherapy and three months after radiotherapy.Results The radiation pneumonia incidence of the study group was lower than that of the control group [21.9 ％(7/32) vs 46.9 ％(15/32)].The plasma TNF-α content after radiotherapy of the study group was lower than that of the control group [(9.18±3.45) ng/ml vs (13.38 ± 2.75) ng/ml].Moreover,the Karnofsky score of the study group was higher than that of the control group [(81.67 ± 7.18) scores vs (75.00+ 6.74) scores].The differences between the two groups were statistically significant (all P＜ 0.05).Conclusion Salmeterol xinafoate and fluticasone propionate aerosol can reduce the radiation incidence of the patients with local advanced NSCLC,improve patients' quality of life after radiotherapy and prevent the radiation pneumonia.

Objective To study the changes of lipid levels and body weight during the treatment of bipolar disorder by lithium carbonate combined with olanzapine or lithium. Methods Lipid and body weight was measured in forty-six patients with bipolar disorder in the first six months (treated by lithium carbonate combined with olanzapine) and in the second six months (treated by lithium only). Then the results were compared with the data before the treatment. Results When the first six months was over,the levels of the total cholesterol, triglyceride and apolipoprotein B increased(P＜ 0.05 ) ,and when the second six months was over,the levels of the total cholesterol,triglyceride,low density lipoprotein cholesterol (LDL-C),and apolipoprotein B increased Significantly (P ＜ 0.05 ). The levels of the total cholesterol, triglyceride, LDL-C were more than the normal level,but apolipoprotein B didn't exceed the normal level. When the first six months was over, the body weight was higher than that before treatment [ (68.70 ± 8.35 ) kg vs. (64.85 ±7.52 ) kg, P ＜ 0.05 ]. When the second six months was over, the body weight [ (71.72 ± 7.96 ) kg ] was higher than that at the end of the first six months (P ＜ 0.05 ). Gender difference showed non-statistical significance.Conclusions The lipid levels and body weight will both increase whether treated with lithium carbonate combined with olanzapine or with lithium only. The lipid level changes apparently in treatment with lithium separately, and the risk of coronary heart disease will increase.