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 make early diagnosis of occupational bladder cancer in benzine-exposured worker in China. Methods An epidemicological investigation was made for a total of 1 796 benzidine-exposured worker.All the urine sample were tested for cytology,DNA G-Actin and M344 tumor associated antigen by PaP and QFIA methods.Clinical studies were then carried out for the high risk workers. Results 30 cases of bladder cancer and 1 pelvic cancer were found(1.73%),all of which were transitional cell carcinoma.There were 3 grade Ⅰ tumors,10 grade Ⅱ,18 grade Ⅲ.For the high risk workers,the time elapsed for the occurrence of clinical cancer was 18 months in average and the average patent time of occupational bladder cancer was 21.2 years (5～30 years). Conclusions Pap cytology and QFIA are beneficial to the early diagnosis and screening of occupational bladder cancer.

Objective To investigate the preoperative preparation for pheochromocytoma. Methods The data of 286 cases of pheochromocytoma, who were treated in our hospital from 1980 to 2002,were collected and reviewed on the preoperative preparation.Phenoxybenzamine was given to 207 cases and urapidil to 78 during preoperative period, lasting for 2～9 weeks with a mean of 6 weeks.The remaining 1 underwent emergent surgery without use of ?-adrenergic blockers.In 28% of the cases,?-adrenergic blocker was given for control of heart rate. Results In 254 cases,blood pressure remained stable at the level of 120/80 mm Hg (1 mm Hg=0.133 kPa) or so.No paroxysmal hypertension,palpitation and sweating occurred after use of ?-blockade.The heart rate remained 80～85 times/min.No arrhythmia occurred.Peri-microcirculation was obviously improved.The tumor size (range,3～12 cm in diameter;mean,5.2 cm) was not related to the function and length of preoperative use of the medications.Hypertensive crisis occurred in 32 cases 2 weeks before operation. In most cases (96%), blood pressure fluctuated (reaching up to 280/180 mm Hg) when they experienced anesthesia induction and tumor crush during operation.However,it was easy to control.Postoperative blood pressure remained stable. Conclusions The full preoperative preparation for patients with pheochromocytoma is essential for the safety and success of anesthesia and operation.

Objective To explore the possible association of oxidative stress reaction with the mRNA expression of podocin in rats with adriarnycin(ADR)-induced nephrotic syndrome.Methods mRNA expression of podocin in renal cortex were investigated by in situ hybridization staining and semi-quantitative RT-PCR in ADR-induced nephrotic rats,the level of malondialdehyde(MDA), superoxide dismutase(SOD)and total antioxidative capacity(T-AOC) in renal cortex were measured, then the relationship between them was evaluated.Results In ADR rats, MDA increased at d7 and reached a significant higher level at d14 and d21;SOD decreased at d14 and persisted to d21; T-AOC decreased at d21.The podocin mRNA mostly expressed in cytoplasm of glomerular cells. Both the number and the intensity of positive cells increased notably as time progressed in ADR rats.The level of podocin mRNA expression showed no obvious changes at d7, while prominently increased at d14 and pesisted to d21 in ADR rats.There was significant correlativity between the mRNA expression of podocin and the level of MDA,SOD,T-AOC.Conclusion The mRNA expression of podocin is correlated with oxidative stress reaction in rats with ADR-induced nephrotic syndrome.

This study was to investigate the role of urethral catheter balloon dilatation(F16)in the treatment of intrauterine adhesion after hysteroscopic surgery.A total of 523 patients with severe intrauterine adhesion(IUA)following hysteroscopic surgery underwent urethral catheter balloon dilatation during April 2000 and December 2005.During 3～15 months'follow-up,normal menses were seen in 340 patients (65.0％),nearly normal menses in 165 patients(31.5％),and menoschesis in 18 patients(3.4％).302 patients showed normal uterine cavity with no recurrent endometrial adhesion,203 patients(38.8％)were found slight IUA,and only 18 patients(3.4％)still presented with severe adhesion.No operative complication was reposed.and the pregnant rate was 47.6％.In summary.urethral catheter balloon dilatation.based therapeutic strategies is safe.effective and beneficial.

Objective To compare two different gastric tube insertion methods on neonatal pain responae.Methods From April to July 2010,47 neonatal patients underwent gastric tube insertion in the neonatal department of our hospital were randomly classified into two groups:the nasal gastric tube insertion group(28 cases) and the oral gastric tube insertion group( 19 cases).Neonatal pain score and incidence of complications during gastric tube insertion between both groups were compared.Results The mean rank of pain scores were significantly higher in the nasal gastric tube insertion group than in the oral gastric tube insertion group.The incidence of pain and complications were higher in the nasal gastric tube insertion group than in the oral gastric tube insertion group.Conclusions The impact of oral gastric tube insertion on neonatal pain response is not significant,and few complications occur during oral gastric tube insertion,so it is worthy of clinical application.

Adenocarcinoma, Clear Cell ; pathology ; Humans ; Kidney Neoplasms ; pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Thyroid Neoplasms ; secondary

Objective To investigate the effect of tramadol combined with sufentanil on postop-erative analgesia in patients received upper-abdominal surgery.Methods One hundred and fifty pa-tients scheduled for selective upper-abdominal operation were randomly divided into five groups (n=30 each):Tramadol group (T);large dose sufentanil combined small dose tramadol group (TS1 );balanced tramadol and sufentani group (TS2 );small dose sufentanil combied large dose tramadol group (TS3);sufentanil group (S).Postoprative VAS scores were recorded respectively at 1,4,8, 12,24,36,48 h when be in quiet and turning 90 degree,Ramsay sedation score,analgesia pump pressing times and side effects were also recorded.Results VAS scores in group TS2,group TS3 and group S at each time point both be in quiet and turning 90 degree were significantly lower than that of group T and group TS1 (P <0.05).Group S sedation score significantly higher than group T (P <0.05).No significant difference in other groups.Conclusion Balanced tramadol and sufentanil group has best analgesic effect and least side effects.With the increasing doses of sufentanil,its analgesic effect was not obvious enhancement.

Objective To investigate the clinical value of the combination of hysterescope and laparoecope in the treatment of tubal obstruction infertility.Methods Two hundred and sixty-slx infertile women managed by the combination of hysteroscope and laparoecope from August 2003 to December 2006 were enrolled.The postoperation tubal recapalization extent and pregnancy rate were analyzed.Results The recanalization rate of the umbrella and ampulla portion was higher (86.9%) than that of other sites (interstitial portion was 33.8%,isthmic portion was 35.5% ),and the pregnancy rote of patients with one tubal recavalization was signifieenfly higher than that of patients with bilateral tubal obstruction.The pregnancy rate was 48.0% in 12 months,little higher than 41.0% in 6 months after operation.Conclusion The combination of hysterecope and laparescope in treatment of tubal obstruction infertility has ideal effect and clinical application value.

BACKGROUND:Finite element method is widely used in the femoral neck fracture, but the study concerning different fixation methods of femoral neck fracture is not much. OBJECTIVE:To analyze biomechanical properties of different fixation methods for femoral neck fracture using finite element analysis. METHODS:The femur of voluntters was scanned with CT, at thickness 0.6 mm, from the site above the greater trochanter of the femur. Scanning data were saved in .DICOM format. Data of right proximal femur were imported into Mimics software. Osteotomy was performed according to Pauwels I type fracture. Models of two tensile force screws, ful y threaded hol ow screw and proximal femoral locking plate were established. Three-dimensional finite element method was used to analyze stress distribution, stress concentration position, displacement distribution and maximum displacement in different models of femoral neck fracture with different internal fixation methods. RESULTS AND CONCLUSION:(1) The maximum stress value of two lag screws model was biggest. The maximum stress value of ful y threaded hol ow screw model was minimized. The maximum stresses of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al were concentrated in the fixed end of fractures. (2) The femoral maximum stress of two lag screws model was biggest. The femoral maximum stress value of proximal femoral locking plate model was minimized. The femoral maximum stresses of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al were concentrated in the medial femoral smal rotor near and medial femoral and fixation contact points. (3) The maximum displacement of two lag screws model was biggest. The maximum displacement of ful y threaded hol ow screw model was minimized. The maximum displacement of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al was in the femoral head. (4) The maximum displacement value of two lag screws model fixed place was biggest. The maximum displacement value of ful y threaded hol ow screw model fixed place was minimized. The maximum displacement value of two lag screws model was biggest at femoral head. The maximum displacement value of ful y threaded hol ow screw model was minimized at femoral head. (5) Results showed that the treatment effect of ful y threaded hol ow screw on Pauwels I fractures was better than other two fixation methods.