Objective To evaluate the clinical efficacy of retroperitoneal laparoscopic ureterolithotomy.Methods A total of 34 cases(38 sides) of middle(5 sides) or upper(33 sides) ureteral calculus were treated by retroperitoneal laparoscopic ureterolithotomy.The stones were(0.8 cm?1.0 cm)~(1.5 cm?3.0 cm) in size.Twenty cases had been previously treated by unsuccessful extracorporeal shock wave lithotripsy(ESWL).Results The operation was successfully completed in 33 cases and a conversion to open surgery was required in 1 case because of extensive adhesion and blood oozing.The operating time was 45~190 min(mean,85.5 min),the intraoperative blood loss was 10~50 ml(mean,20.6 ml),and the postoperative hospitalization,3~7 d(mean,4.3 d).Postoperative recovery was uneventful.No complication was observed during a 3~24 months(mean,9.7 months) of follow-up.Conclusions Retroperitoneal laparoscopic ureterolithotomy is micro-invasive,simple to perform,and safe.

ObjectiveTo evaluate transcatheter arter ia l embolization(TAE) on congenital renal arteriovenous malformation(RAVM).MethodsFive cases of RAVM,diagnosed on digital substraction a ngiography have been treated between March 1995 and May 2002 by transarterial em bolization (TAE) with different embolic agents (ethanol,iodised oil,gelform part icles or metalic coils).The efficacy was evaluated.ResultsIn all the 5 cases,gross hematuria was controlled immediately after TAE,th e urine turned clear in 24 h and urinalysis became normal in 7 days.The patients have been followed up for 6～12 months with an average of 10 months with hematu r ia well controlled in all.There has been no hypertension or apparent renal funct ion damage.Bilateral renal emission computed tomography (ECT) reveated only some local loss of the renal cortical function on the concerned side.ConclusionsAt present renal arteriography is still the most reliable method in the diagnosis of RAVM.TAE has the benefits of less inva sive, a low incidence of complications, early resumption of normal activities an d shorter hospital stay,and can avoid renal resection and correlative surgical c omplications.The renal function could be well protected from harm.

Objective To study the therapeutic effects of pedicled greater omentum displacement for complex posterior urethral stricture. Methods This study included 6 cases (all males) of complex posterior urethral stricture.Their age ranged from 14 to 45 years with a mean of 26 years.In these cases,traffic accident injury occurred in 5 and falling injury in 1.The course of diseases ranged from 6 months to 5 years with a mean of 2.5 years.The length of stricture segment was from 3.0 to 5.5 cm.All cases were surgically treated via transpubic approach and pedicled greater omentum displacement. Results Good operative results were achieved in all 6 cases.Each of them could urinate when the catheter was taken out 4 weeks later,and no urinary incontinence,urinary tract infection were observed.All were followed up for a median period of 26 months (ranged from 6 to 38 months).4 patients had normal micturition with no need of urethral dilatation and 2 patients reencountered dysuria in 3 months and were all cured by the administration of urethral dilatation for 3 to 24 months. Conclusions This procedure has a higher success rate.It is suitable for those with complicated posterior urethral stricture,such as longer posterior urethral stricture,urethra-rectal fistula, false passage, and especially those having experienced failure of urethra repair via perineal approach. It can be regarded as one of the ideal and effective therapeutic methods for complex posterior urethral stricture.

Objective To improve the differential diagnosis between benign renal mass and renal cell carcinoma(RCC) so as to lower the misdiagnosis rate. Methods This study included 12 cases of renal mass,whose age ranged from 35 to 69 years with a mean of 52 years.Among the 12 cases,flank pain occurned in 9,2 of whom had gross hematuria.Three clinically asymptomatic cases were detected incidentally by ultrasound in physical examination.All the 12 cases underwent imaging examinations such as B-ultrasound and CT scan,and all of them were preoperatively diagnosed as RCC. Results All the cases were surgically treated.Seven underwent enucleation or simple nephrectomy because of the diagnosis of benign renal mass by intraoperative frozen section.Five underwent radical nephrectomy.None developed recurrence during follow-up of 1 to 3 years. Conclusions Clinicians should not overestimate the diagnostic significance of imaging examinations such as CT and ultrasonography.For cases who have no definite diagnosis,surgical exploration can be performed.Intraoperative frozen section by pathologic study can increase correct diagnostic rate. Most of the misdiagnosed benign renal masses have different imaging features from those of RCC.

Objective To improve the prevention and treatment level of child traumatic posterior urethral stricture. Methods This series included 22 male children (mean age 9 years) with pelvic fracture complicated by posterior urethral disruption.A medical nylon string was indwelled after uretheral reunion operation.Urethral stricture recurred in 9 patients 3 months after the operation,and they were all cured by performance of urethra dilatation with self-designed single J tube under the guidance of the medical nylon string. Results All of the 9 were doing well during the operation.The medical nylon string was not taken out until dysuria disappeared completely.The cure rate was 100%.All the cases were followed up for a mean period of 15 months(range,3 to 24 months).All had normal urination. Conclusions Application of self-designed single J tube and medical nylon string is effective,simple and economical for the treatment of child traumatic posterior urethral stricture.It is easy both for the doctors' training and for the children's cooperation.Thus,it provides a new approach for the prevention and treatment of child traumatic posterior urethral stricture.

Objective To call attention to the diagnosis and treatment of prostate sarcoma. Me thods From Jan 1984 to May 2000,7 cases of prostate sarcoma were treated,2 cases by radical cystoprostatectomy and detenia cecocolon continent urinary reservoir,1 case by suprapubic prostatectomy,3 cases by radiotherapy whereas 1 case underwent needle biopsy only. Results Of the 2 cases underwent radical cystoprostatectomy,one has been still surviving after 5 years whereas the other one died of lung metastases after 9 months.The other 5 patients all died within 13 months. Conclusions Early dignosis and radical cystoprostatectomy are mandatory to prolong survival.

0.05). Conclusions Carbon dioxide pneumoperitoneum during retroperitoneoscopy has no obvious influence on hepatic functions, renal functions and myocardial enzymogram. It may not cause significant damage to patients with normal heart, hepatic, and renal functions.

Clinical practice is quite important transition phase for medical students to become qualified doctors,and development of surgerical skills is the diffficult and key point in the clinical practice.Intensive training of surgerical skills before clinical practice can enhance the confidence and efficiency of medicine students during the course of clinical practice.Whihin limited time,the key of intensive training of surgerical skills is the training of aseptic technique and basic skills of surgery,and during the course of training,attention should be paid to both principle and details.

Objective To report the cloning, expression and identification of the tumor-associated antigen G250/MN/CA Ⅸ. Methods The total RNA was extracted from renal cell carcinoma tissue samples from 54 male patients. Gene fragments encoding G250 was obtained by RT-PCR,and was cloned into prokaryotic expression vector pET22b(+) and expressed in E.coli BL21(DE3);and the results were examined by SDS-PAGE gel electrophoresis. The recombinant protein was studied by Western blot test. Results DNA sequence analysis showed that the obtained sequence was the same as that showed in GenBank.Gene of G250 was expressed in E.coli BL21 successfully. Western blot analysis showed that the recombinant protein could be specially recognized by monoclonal antibody. It had better antigenicity and specificity. Conclusions This study provides experimental basis for the purification of G250/MN/CA Ⅸ protein and the further study of G250/MN/CA Ⅸ function and preparation of antibody.

Objective:To investigate the inhibitory effect of adenovirus-mediated herpes simplex virus-thymidine kinase (TK) gene combined with ?-IFN on renal clear-cell carcinoma. Methods: Adenovirus containing suicide gene TK, in combination with GCV or ?-IFN, was used to treat human renal clear-cell carcinoma cell line 786-0, and the in vitro cytotoxic effects against 786-0 were evaluated using MTT method. The subcutaneous transplantation model of 786-0 cells was established with nude mice. Adenovirus containing TK gene was injected intratumorally and the GCV (50 mg/kg) was injected intraperitoneally; ?-IFN (104 U/L) was injected intratumorally in combined therapy. The growth of tumors was observed after treatments. Results: The survival rate of 786-0 cells was (35.07?1.43)% in the TK+GCV+?-IFN group, (68.57?1.41)% in the TK+GCV group and (68.65?1.45)% in the ?-IFN group ( P=0.000). There was an obvious synergic effect between Ad-TK and ?-IFN in inhibiting 786-0 cells. Ad-TK combined with GCV and ?-IFN significantly suppressed the growth of 786-0 cells growth in nude mice model.Conclusion: Adenovirus-mediated TK plus prodrug GCV combined with ?-IFN has obvious therapeutic effect in treatment of human renal clear-cell carcinoma.