Objective To improve the diagnosis and treatment of renal oncocytoma. Methods The clinical data of 3 cases with renal oncocytoma treated from 1999 to 2002 were retrospectively analyzed and discussed with literature reviewed. The 3 tumors’size was 7.6 cm?8.5 cm?6.8 cm,10.0 cm?11.5 cm?9.8 cm,10.0 cm?8.0 cm?6.8 cm,respectively.The clinical features were atypical.Renal oncocytoma was characterized by homogeneous attenuation with a central, margined stellate area on CT scan. Results The 3 cases underwent nephrectomy,and the resected tumors were examined by pathology.On light microscopy,there was strong eosinophilic cytoplasm with granules,the tumor cells being tubular or adenoid in pattern with no necrosis and very rare or no mitosis.Enormous mitochondria were noted on electron microscopy.The immunohistochemical staining was positive for cytokeratin and EMA,whereas it was negative for vimentin.The follow-up lasted for 16 to 30 months without recurrence or metastasis. Conclusions Renal oncocytoma is a type of benign,parenchymatous tumor,and it has no specific clinical feature.The diagnosis can be established on histopathologic,immunohistochemical and electron microscopic studies.

10 ng/ml). Results The diagnost ic rate of 3 groups was 44.5%,29.8%,57.4% respectivly. Conclusions The advantages of the procedure were correct acquiring of prastate ti ssue,more accurate approach and depth of the puncturing needle,avoiding injury t o the nearby tissue and raising the diagnosis rate of prostatic carcinoma.

Objective To construct a reliable and continent urinary reservoir,which is surgically simple. Methods (8 adult mongrel female dogs underwent a procedure in which an ileal segment was tapered as an efferent tube and a 1.5 cm in width of Dilurn polyester with a tension of 400g was used to suspend the efferent tube to enhanced the continent mechanism of the tapered ileum.) Urodynamic and radiological studies were carried out postoperatively in all. Results All the stomas could be easily catheterized with a 14 F catheter. The urodynamic study of the efferent tubes showed the maximum close pressure ranged from 117 cmH 2O to 157 cmH 2O,with a mean of 137 cmH 2O.Retrograde radiogram showed perfect canalization of the efferent tube without stenosis and pouchgram revealed no contrast medium in the efferent tube. Conclusions This study suggested that the continent mechanism of tapered ileum can be greatly enhanced by the suspension technique.

Objective To evaluate bulbourethral sling procedure in the treatment of post prostatectomy incontinence. Methods 5 patients with post prostatectomy incontinence underwent the bulbourethral sling procedure.Preoperatively 1 patient was completely incontinent and 4 patients required a mean of 3.5 pads per day.The mean duration of incontinence was 4.5 years. A sling tension of a mean of 500 g was used to correct incontinence. Results 4 patients have been completely dry,whereas postoperative difficulty in voiding occurred in the other patient and was corrected by subsequent transurethral bladder neck revision resulting in free passage of urine and continence. Conclusions The bulbourethral sling procedure is an effective means in the treatment of post prostatectomy incontinence.

Objective To elucidate the clinical features of nonspecific granulomatous prostatitis(NSGP). Methods From February 1994 to February 2002,26 cases of NSGP confirmed histologically were retrospectively analysed.Of them 20 cases were treated with anti-inflammatory therapy alone;4 cases with anti-inflammatory therapy plus ?-receptor blocker,and 2 cases who concomitantly had retention of urine underwent TURP. Results All the 26 patients were followed up for 6 to 42 months.The therapeutic results were satisfactory.The Qmax increased from 4.6～12.8 ml/s to 16～28 ml/s,and the hard prostate mass became soft,with reduction from 2.5 cm?3.5 cm to 0.5 cm?1.0 cm.The serum PSA decreased from 15.5～60.8 ng/ml to 1.5～10.6 ng/ml. Conclusions In clinical practice NSGP is often mistaken for prostatic carcinoma,so special attention should be paid to the differential diagnosis.The definite diagnosis depends on histopathological examination.

Objective To study the diagnostic value of 3-dimensional CT reconstruction in posterior urethral strictures or ankylurethria.Methods Thirty patients with strictures or ankylurethria of posterior urethra caused by pelvic fracture underwent helical CT scan and 3-dimensional reconstruction of the urethral canal as well as radiographic urethrography before and post open urethral reconstruction to observe the urethral anatomy,the length and position of the urethral strictures,the depth of periurethral scar.Results The mean stricture or ankylurethria length measured by radiographic urethrography was 4.0 cm (range from 1.0 cm to 7.0 cm),and the correlation coefficient of stricture or ankylurethria length was 0.92,21 (70%) patients were diagnosed accurately by radiographic urethrography.The mean stricture or ankylurethria length measured by 3-dimensional CT reconstruction was 4.3 cm (range from 1.2 cm to 7.6 cm),and the correlation coefficient of stricture or ankylurethria length was 0.96,there were 28(93%) patients diagnosed accurately by 3-dimensional CT reconstruction.The mean stricture or ankylurethria length measured by open urethral reconstruction was 4.2 cm (range from 1.5 cm to 7.5 cm).Five patients with urethrorectal fistula were also diagnosed accurately by 3-dimensional CT reconstruction rather than by radiographic urethrography.Conclusions 3-dimensional CT reconstruction of the urethral canal can accurately evaluate the urethral anatomy,the length and position of the urethral strictures,as well as the depth of periurethral scar after crush injury and provide useful information for operation that may not be provided by radiographic urethrography.3-dimensional CT reconstruction may become the most valuable means for detecting posterior urethra strictures or ankylurethria with urethrorectal fistula.

Objective To evaluate the efficacy of transpubie access using pedicle tabularized la-bial urethroplasty for urethral reconstruction in female patients with urethral strictures associated with urethrovaginal fistulas.Methods Eight cases of urethral strictures were treated using pedicle labial skin flaps for urethral reconstructions.All cases were the mid-urethral strictures associated with ure-throvaginal fistulas.A single face pedicle flap was obtained from the labia minus or majus in 5 women,and double face pedicle labial flaps were used in 3 patients.Results There were no serious complica-tions.Two patients complained of dysuria symptoms for 2 weeks and one patient experienced stress incontinence which resolved after 4 weeks.The patients were followed up for 6 to 130 months (mean 52) postoperatively.All patients had normal micturition following catheter removal with urinary peak flow greater than 15 ml/s(17.4-42.0 ml/s).Conclusion Pedicle labial urethroplasty might be a reliable technique for the management of complex urethral strictures associated with urethrovaginal fis-tulas.

Objective This study was to discuss various operative approaches for the repair complicated posterior urethral strictures. Methods 34 patients with posterior urethral strictures and associated ure-throrectal fistulas (URFs) were reviewed. The etiology of urethral strictures and fistula was due to pelvic fracture in 26 patients, iatrogenic in 6 cases and fall injury in the remaining 2 cases. The patients were treated by using a simple perineal approach (4 patients), a transperineal inferior pubectomy approach (21 patients) and combined abdominal transpubic perineal approach (9 patients) and URF repair and anastomotic urethroplasty were performed simultaneously in all cases. Results One-stage repair was successful in four patients (100%) using a simple perineal approach, in 19 of 21 (90. 48%) using the transperineal-inferior pubectomy approach and 7 of 9 (77. 78%) using the transpubic-perineal approach. Of the 34 patients, recurrent urethral strictures developed in two cases, recurrent URFs developd in two patients. Conclusions Surgical approaches for the special complex urethral strictures should be based on the location of the URF, its etiology and length of the urethral strictures, as well as a history of previous repairs. The transperineal-inferior pubic approach may be appropriate as a first-line procedure.

Objective To investigate the effect of electroacupuncture at point Zusanli (ST36) on gastric expression of heat shock protein 70 (HSP70) mRNA in rats with stress gastric ulcer and explore the molecular mechanism of its prevention and treatment of gastric ulcer. Method Fifty-one SD rats were randomly allocated to normal control (normal), stress gastric ulcer (model) and electroacupuncture at point Zusanli (electroacupuncture) groups. A model of stress gastric ulcer was made by cold restraint. From the second day after model making, the electroacupuncture group received electroacupuncture at point Zusanli 20 min once daily for three consecutive days, with left and right points Zusanli alternately needled; the model group, the same restraint treatment as in the electroacupuncture group; the normal group, no treatment. Gastric mucosal ulcer index (UI) was calculated using the GUTH’s method. The pathological morphology of gastric tissue was observed by HE staining. Gastric HSP70 mRNA expression was determined by RT-PCR. Result Different numbers and sizes of obvious gastric mucosal ulcers were observed, UI increased significantly (P<0.001) and HSP70 mRNA expression decreased significantly (P<0.05) in the model group compared with the normal group. The pathological change in gastric tissue improved somewhat, gastric mucosal UI decreased significantly (P<0.05) and HSP70 mRNA expression increased significantly (P<0.01) in the electroacupuncture group compared with the model group. Conclusion Electroacupuncture at point Zusanli can upregulate gastric HSP70 mRNA expression and promote the repair of gastric mucosa injuries in rats with stress gastric ulcer.

Objective To investigate the quality of life in young patients with hemodialysis and influencing factors .Methods Totally 128 young patients aged 18-44 years old with maintenance hemodialysis were performed the questionnaire investigation by using the self‐designed demographic information questionnaire ,Medical Outcomes Study Health Status Short Form (SF‐36) , Herth Hope Index(HHI)and Social Support Rating Scale(SSRS) .Results The mean total score of physical health in the hemodial‐ysis young patients was (202 .49 ± 53 .94) points and the mean total score of mental health was (190 .85 ± 77 .81) points .In the va‐rious dimensional scores of living quality ,the scores of physical functioning and bodily pain were highest ,while the scores of physi‐cal function and emotional function were lowest ,moreover the scores of various dimensions were lower the the national norm (P<0 .01) .The multiple regression analysis showed that the quality of life was significantly correlated with hope level ,social support and economic condition ,which could explained 62 .8% of living quality variation amount .Conclusion The quality of life in hemodi‐alysis young patients needs to be improved .The medical care workers formulate the intervention measures ,meanwhile should pay attention to enchance patients′hope leve and social support .At the same time it is appealed that the government helps to solve the patients′economic problem in order to better improve their living quality and promote them return to society .