Objective To study the clinical efficacy and advantages of tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy for the treatment of impacted upper ureteral calculi.Methods We retrospectively analyzed 75 cases of impacted upper ureteral calculi treated in our hospital between September 2015 and December 2017.There were 45 males and 30 females,aged from 35 to 65 years,mean (42.5 ± 3.5)years.All patients were diagnosed by B-ultrasound and CT with impacted upper ureteral calculi.The mean stone diameter was (1.6 ± 0.3) cm.The CT value of stone was (1 025.3 ± 215.4) HU.Tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy were performed in all of the cases,which were under general anesthesia with lithotomy position,to observe the successful rate of lithotripsy,operation time,intraoperative and postoperative complications,postoperative hospitalization time and stone-free rate.Results All 75 cases were successfully operated.The operation time was (38.5 ± 11.2) min.Three cases had postoperative fever.No severe perioperative complications such as septic shock,ureteral perforation or avulsion occurred.The mean hospital stay of the patients was (2.7 ± 0.4) d.A follow up by non-contrast CT scan was done 4 weeks after the procedure to evaluate the result.Sixty seven cases had stone clearances at the primary operation and the stone clearance rate was 89.3％ (67/75).Eight cases undergone ESWL and physical vibration lithecbole,the CT examination showed that the stones were cleared after 1 month.Conclusions Tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy in the treatment of impacted upper ureteral calculi had a definite effect,safe and comfortable for doctors.

Objective:To investigate the clinical, imaging, and pathological characteristics of renal oncocytoma, and to improve the understanding, diagnosis, and treatment of renal oncocytoma.Methods:The imaging and pathological data of two patients misdiagnosed with renal cell carcinoma in the 970 Hospital of PLA Joint Logistics Support Force from January to March 2021 were retrospectively analyzed. The relevant literature was reviewed and discussed.Results:The tumors were located in the left kidney of two patients, with diameters of 2.7 cm and 3.2 cm respectively. The patients underwent retroperitoneal laparoscopic removal of partial left kidney and retroperitoneal laparoscopic removal of the whole left kidney separately. The pathological results confirmed the diagnosis of renal oncocytoma.Conclusion:Renal oncocytoma is a rare benign renal cell tumor which is difficult to be diagnosed before surgery. Contrast-enhanced CT can provide evidence for the identification of renal oncocytoma. Its final diagnosis depends on pathological results.

Objective To evaluate the effect of the different Child-Pugh classification on the recurrence and survival of hepatocellular carcinoma (HCC) recipients after liver transplantation. Methods Clinical data of 125 HCC recipients undergoing liver transplantation were retrospectively analyzed. The 3-year disease-free survival (DFS) and overall survival (OS) rates were calculated by Kaplan-Meier survival curve. The independent risk factors probably affecting the recurrence and survival of HCC recipients after liver transplantation were identified by using Cox's proportional hazards regression model. Results The median follow-up time was 25.6 months. The 3-year DFS and OS rates were 68.4% and 65.7% for all patients. The 3-year DFS and OS rates in 113 patients with Child-Pugh class A/B HCC were 68.6% and 66.2%, whereas 66.7% and 65.6% for 12 patients with Child-Pugh class C HCC with no statistical significance (all P>0.05). Cox's proportional hazards regression model demonstrated that vascular invasion (P=0.001)and the number of tumors>3 (P=0.025) were the independent risk factors for the postoperative recurrence of HCC in recipients undergoing liver transplantation. Alpha fetoprotein (AFP)>400μg/L (P=0.035), vascular invasion (P=0.031) and number of tumors>3 (P=0.008) were the independent risk factors affecting the survival of HCC patients. Conclusions The postoperative prognosis does not significantly differ between Child-Pugh class C and A/B HCC patients after liver transplantation. AFP, vascular invasion and number of tumors are the risk factors affecting the clinical prognosis of HCC patients after liver transplantation. Liver transplantation is an efficacious treatment for HCC patients with Child-Pugh class C.

Objective To investigate the expression of apolipoprotein (Apo) F in hepatocellular carcinoma (HCC) and its application value in the prognosis of patients with HCC. Methods 50 HCC samples were procured from patients undergoing surgical resection in the Third Affiliated Hospital of Sun Yat-sen University between September 2015 and September 2016, and all the samples were confirmed by postoperative pathological examination. The informed consents of all patients were obtained and the local ethical committee approval was received. There were 37 males and 13 females, aged from 31-67 with a median age of 53 years old. The expression of ApoF mRNA in HCC tissues was detected by RT-PCR. The expression profile was analyzed by using data from the Gene Expression Omnibus (GEO). The expression of ApoF between two groups were compared by t test. Correlation analysis of clinical related parameter was conducted by Chi-square test, and survival prognosis was analyzed by Kaplan-Meier test and Log rank test. Results The average relative expression of ApoF mRNA in HCC tissues was 0.15±0.07, significantly lower than 0.55±0.09 in the adjacent tissues (t=-6.26, P<0.05). GEO online analysis showed that expression of ApoF was significantly correlated with the status of liver cirrhosis, and most HCC patients with liver cirrhosis presented low expression of ApoF (χ2=4.626, P<0.05). The 5-year disease-free survival was respectively 55.9% and 32.0% in ApoF high expression group and low expression group, where significant difference was observed (χ2=3.939, P<0.05). Conclusions Low expression of ApoF exists in HCC tissues, and it is related to the liver cirrhosis status of patients. Patients with low ApoF expression present poorer prognosis. ApoF plays a role in inhibiting the cancer.