Objective To study the diagnosis and treatment of renal tuberculosis (TB). Methods A retrospective study was made on 281 cases. Results Irritation symptoms, hematuria and lumbodynia were the most common symptoms. The positive result of acid-fast stains, urinary TB-PCR, PPD-IgG were 44.5%, 44.1% and 62.5% respectively. The diagnostic accuracy of urography, CT and B-type ultrasonography were 69.1%, 84.3% and 28.3%.105 of the 128 cases have been cured on medicine ( INH + RFP + PZA for 6～8 months ). Nephro-ureterectomy was performed for 145 out of 153 cases (94.8%). Conclusions Combined use of different means of diagnostic technique would help to assess the diagnosis of renal TB especially in atypical cases.IVU is still the first choice for diagnosis and CT scan is helpful.INH,REP and PZA used combinedly yiels satisfactory outcome for early cases.When nephro-ureterectomy is indicated,the involved ureter should be excised as much as possible.

Objective: To summarize experiences in 136 cases of retroperitoneal laparoscopic surgery. Methods:From April 1997 to May 2002, retroperitoneal laparoscopic surgery were performed for 136 cases of adrenal dis-eases. There were 63 aldosterone- producing adenoma, 22 adrenalcortical adenoma, 39 nonfunctional adrenal tu-mor, 7 adrenal cyst and 5 phenochromocytoma. Results: Except for one case converts to open surgery, success hasbeen achieved in all cases without major complications. Intraoperative blood loss was 76 + 32ml without blood trans-fusion. Postoperative hospital stay was 6 + 3 days. There were statistical differences among these indices when com-paring to those of open surgery for 126 cases with adrenal diseases( P ＜ 0.05). But operative time was little longer inlaparoscopic group than in group of open surgery(P＜0.05) ,whereas it has been changed to similar in those recentcases. Conclusion:Retroperitoneal laparoscopic surgery was less traumatic to the patients, with less postoperative dis-comfort and quicker recovery and should be considered the first choice of therapy for adrenal disorders.

Objective To determine the effects of pub op rostatic ligament and puborectalis sling sparing on postoperative complicationgs after radical retropubic prostatectomy. Methods A total of 16 men(mean age 67,stage B 14 cases,stage C 2 cases) with clinically prostat e cancer were managed with radical retropubic prostatectomy.Puboprostatic ligame nt and puborectalis sling sparing technique were used in all patients. Results All patients recovered from the operation.During 1 to 4 y ears,follow-up,none had long term incontinence or dysuria.PSA declined to 0.00 ng/ml and stayed 0.00 ng/ml in 9 cases within follow-up period.PSA were bellow

Objective To evaluate the safety and feasibility of retroperitoneal laparoscopic excision of pheochromocytoma. Methods Retroperitoneal laparoscopic excision of pheochromocytoma was performed on 20 patients with pheochromocytoma (group A).At the same period, 20 patients with pheochromocytoma undergoing open surgery served as controls (group B).Intraoperative blood pressure, heart rate, plasma noradrenalin (NE) concentration,operative time, volume of blood loss, cases receiving blood transfusion, postoperative activity out of bed days, postoperative hospital stay,were compared between the 2 groups.The NE concentration was determined using RP-HPLC-ECD. Results The operations were successful in all the patients. Intraoperatively,3 cases (15.0%) in group A and 12 cases (60.0%) in group B experienced acute fluctuation in blood pressure,heart rate and pulse [maximum blood pressure,220/110 mm Hg(1 mm Hg=0.133 kPa) vs 210/115 mmHg; minimum blood pressure,88/57 mm Hg vs 85/60!mm Hg;maximum heart rate,122/min vs 120/min, respectively].The NE concentratioo correspondingly fluctuated from the maximum 16.82 ng/ml to the minimum 6.28 ng/ml (normal reference,0.32 ng/ml) (P

Objective To discuss hemodynamic and electrolyte changes associated with irrigation fluid absorption during percutaneous nephrolithotripsy(PCNL). Methods Eithty nine upper urinary tract lithiasis patients underwent PCNL assisted with pressure irrigation. Sixty five cases were with renal calculi and 24 cases were with ureteral calculi. There were 62 males and 27 females. Nor mal saline was used as irrigation fluid. Heart rate(HR),central venous pressure(CVP),cardiac out put(CO),stroke volume(SV),systemic vascular resistance(SVR),thoracic fluid content(TFC) wererecorded before operation and every 30 min during irrigation. Serum Na+,K+,CI ,Ph,BE weredetected before and after irrigation. One way ANOVA,linear correlation and paired t test were usedas statistic analysis. Results The mean irrigation time was 105 min. Mean irrigation fluid volumewas 18 391 ml and mean irrigation velocity was 174.46 ml/min. HR,CO,SV,SVR and blood Na+ ,K+,C1 did not change significantly during and after irrigation. CVP and TFC significantly increasedduring irrigation. The increasing of CVP and TFC were correlated with irrigation time, volume andvelocity. CVP and TFC increased rapidly in 5 patients with calyx laceration and recovered after diuret ic injection. No serious complication was detected. Conclusions Irrigation fluid absorption is observed during PCNL with pressure irrigation. Generally, no significant changes in hemodynamic andelectrolyte balance are found in patients with normal cardiac and renal function.

【Objective】To observe the effects of bamboo leaf extract(BLE)on cerebral ischemia.【Methods】 Effect of BLE(at the concentrations of 10,20 and 40 mg/kg respectively,iv)on rabbit carotid thrombus induced by cotton thread was observed.Meanwhile,the effects of BLE(at the concentrations of 15,30 and 60 mg/kg respectively,iv)on neurological deficit and cerebral infarct size in rats with middle cerebral arterial obstruction(MCAO),as well as the effects of BLE(at the concentrations of 22.5,45,and 90?mg/kg respectively,iv)on mice stroke index,grasping time of decapitated mice and survival time of mice subjecting to bilateral carotid ligation were also observed.【Results】BLE inhibited rabbit carotid thrombosis,improved neurological deficit and reduced cerebral infarct size in MCAO rats(P

Objective To discuss the feasibility and safety of retroperitoneal laparoscopic nephrectomy for treatment of kidney tuberculosis. Methods From March 2005 to February 2009, 28 patients with kidney tuberculosis underwent retroperitoneal laparoscopic nephrectomy. The patients′ data were reviewed and analyzed. Results There were 18 men and tencwomen with an average age of 36 (26-51) in the cohort. Sixteen patients had lesions on the left kidney and 12 on right kidney. All patients had a normal renal function on the contra lateral side. The severely impaired renal function of the lesion side was confirmed before operation. Anti-tuberculosis chemotherapy was administered to patients for two weeks to six months in advance of the surgery. No active lesion of tuberculosis was found and ESR level was normal before operation. All the operations were successfully performed without switching to open surgery. The average operative time was 170 (121-258) minutes, blood loss was 110 (70-250) ml and average postoperative hospital stay was 5.7 (5-14) days. Peritoneum injury was seen in three patients and incision infection in two patients. No severe complications were observed. Anti-tuberculosis chemotherapy was continued for three months. Twenty-four patients were followed-up, and the average follow-up time was 12.5 (6-20) months. All patients recovered without any lesion remaining. Conclusions Retroperitoneal laparoscopic nephrectomy could be a safe and reliable method for the treatment of non-functioning kidney due to tuberculosis.

ObjectiveTo evaluate the clinical effect of post bladder sparing surgery intra-arterial chemotherapy combined with intravesical chemotherapy for the treatment of T1G3 bladder urothelial carcinoma.MethodsSeventy-four T1G3 bladder cancer patients were enrolled in this study.After bladder sparing surgery,22 patients received intra-arterial chemotherapy combined with intravesical chemotherapy,while the other 52 patients were treated with intravesical chemotherapy only.There was no significant difference between the 2 groups in sex,age,the size and number of bladder tumor and newly diagnosed cases (P ＞0.05).Twenty-two patients were treated with intra-arterial chemotherapy of piarubicin or epirubicin (40 -60 mg)+ cisplatin (60 -80 mg) 2 or 3 weeks after bladder sparing surgery,3 times as a cycle,repeat every 4 - 6 weeks.All the patients received the same protocol of intravesical chemotherapy.With a median follow-up of 32 months,effects of combination therapy group were compared with intravesical chemotherapy group in the aspects of tumor-specific death rates,recurrent rate,progressive rate,recurrent interval and the adverse reactions.ResultsThe tumor-specific death rates of combination therapy group and intravesical chemotherapy group were 0％ (0/22) and 13.5％ (7/52),respectively.There was no difference between the 2 groups (P =0.096).The recurrent rates were 13.6％ (3/22) and 46.2％ ( 24/52 ) ； The progressive rates were 0％ (0/22) and 21.2％ (11/52).There were significant differences between the 2 groups in recurrent rate (P =0.000) and progressive rate (P =0.048 ).The recurrent intervals of the 2 groups were 15 months and 6.5 months.During the interval of intra-arterial chemotherapy cycle,12 patients suffered 1 -2 degree nausea and vomit,2 patients suffered hypoleukemia,2 patients suffered neutropenia,4 patients'liver function was impaired and 1 patient's renal function was impaired.All the adverse reactions were minimal and reversible.ConclusionsIntra-arterial chemotherapy combined with intravesical chemotherapy is effective in preventing T1 G3 bladder cancer from recurrence and metastasis after bladder sparing surgery.The adverse reactions of this protocol were minimal and reversible.

Objective To evaluate the feasibility of European Organization for Research and Treatment of Cancer (EORTC) risk tables in non-muscle invasive bladder cancer in Chinese patients.Methods A retrospective analysis was performed on the data from 185 patients with non-muscle invaaive urothelial bladder cancer from January 2003 to February 2009. Among the 185 patients, 128 patients were stage Ta compared with 57 patients who were stage T1. There were 87, 53 and 45 patients with grade G1, G2 and G3 respectively. Transurethral resection of the bladder tumor was performed on all the patients and all the patients received routine post-operative intravesical instillation. A telephone interview follow-up was conducted on all the patients, and the average follow-up period was 36 months. EORTC risk tables were used to calculate risk scores for recurrence and progression for each patient. The recurrence and progression rates of different risk groups were recorded and compared with the estimated rates by EORTC risk table. Statistical analysis was used for comparison. ResultsTotal 1-year recurrence rate and progression rate for these patients were 25.9% and 3.8% respectively. According to calculated values of the patients, the 1-year recurrence rates of Group 0, Group 1-4, Group 5-9, Group 10-17 were 10.4%(5/48), 21. 5%(14/65), 35. 2% (19/54), 55.6%(10/18), respectively. The 1-year progression rates of Group 0, Group 2-6, Group 7-13, Group 14-23 were 0% (0/43), 1.5% (1/67), 6. 7% (4/60), 13. 3% (2/15). There was no significant difference between the real rates and estimated rates of the EORTC risk tables (P＞0. 05). However,the 1-year recurrence and progression rates between the low risk group, the medium risk group and the high risk group showed significant differences respectively (P ＜ 0. 05 ). Conclusions The EORTC risk tables are feasible to evaluate the recurrence and progression risk of non-muscle invasive bladder cancer in the present cohort. Nevertheless, the long term value and feasibility need more research to confirm.

Objective]To explore the diagnostic value of magnetic resonance imaging(MRI)combined transrectal ultrasound (TRUS)to guide prostate cancer detection at different serum prostate-specific antigen(PSA)levels.[Methods]Totally 278 patients who underwent a systematic biopsy were collected in our hospital from November 2014 to June 2016. Preoperative tests of PSA , MRI,TRUS were performed in all the included patients. According to the PSA level of 4~10 ng/mL,10~20 ng/mL,over 20 ng/mL, 278 cases were divided into three group of A ,B ,C. Retrospective analysis was performed within the three groups of diagnostic accuracy.[Results]In Group A,the areas under ROC for MRI+TRUS and TRUS were 0.73 and 0.59,respectively(P = 0.02). In Group B ,the areas under ROC for MRI+TRUS and TRUS were 0.68 and 0.56 ,respectively (P < 0.001). In Group C ,the area under ROC for MRI+TRUS and TRUS were 0.74 and 0.63,respectively(P < 0.001). There is more significant statistical difference in Group B and C.[Conclusion]MRI combined TRUS has higher diagnostic value in cancer detection than TRUS before biopsy between different PSA levels ,which Indicates that MRI combined TRUS is an effective method for the improvement of prostate cancer detection.