Objective To study the causes of misdiagnosis between renal cell carcinoma (RCC) and renal angiomyolipoma (RAML). Methods Since 1990, 228 cases of RCC and 62 RAML were surgically treated.13 of them,4 RCC and 9 RAML were incorrectly treated because the misdiagnosis on imaging examination or intraoperative frozen section study. The causes were analyzed. Results 4 RCC underwent enucleation or simple nephrectomy because of the frozen section diagnosis of RAML.None have developed recurrent RCC with 1～4 years of follow up.Of the 9 RAML cases,6 have been misdiagnosed as RCC on imaging procedures.The other 3 patients that failed to reach a proper diagnosis on imaging examination were submitted to intraoperative frozen section studies.1 was diagnosed as RCC and the other 2 remained uncertain. Radical nephrectomy have been performed for 9 patients. Conclusions Difficult interpretation due to poor quality of frozen sections is a potential cause of diagnosis error.RCC might be confused with RAML when the specimens contained highly vascular tissue. The content and distribution of fat is the main cause of imaging misdiagnosis.

Objective To determine whether antibiotic prophylaxis can reduce the risk of postoperative infective complications in patients undergoing TURP who have sterile preoperative urine. Methods MEDLINE,EMBASE,CBMA and the Cochrane Library were searched for RCTs comparing antibiotic prophylaxis with placebo/blank controls for patients undergoing TURP with preoperative sterile urine.The search strategy was made according to the Collaborative Review Group search strategy.Data were extracted by two reviewers using the designed extraction form. The software RevMan was used to review management and data analysis.The results were expressed as RR and 95% confidence intervals (CI) for categorical outcomes and weighted mean difference (WMD) and 95%CI for continuous outcomes. Results 53 relevant RCTs were searched, of which 27 were included and 26 were excluded.Antibiotic prophylaxis significantly decreased the rate of post-TURP bacteriuria,post-TURP fever,post-TURP bacteremia and the rate of continuous antibiotic use.The corresponding pooled relative risk (RR) and 95%CI was 0.36 (0.28 to 0.46),0.83 (0.71 to 0.97),0.43 (0.22 to 0.86) and 0.26 (0.20 to 0.33),respectively.However,the available data failed to prove that antibiotic prophylaxis shortened the duration of hospitalization (WMD, -0.31;95% CI , -0.78 to 0.35). Conclusions Prophylactic antibiotics can significantly decrease the incidence of post-TURP bacteriuria,fever,bacteremia and continuous antibiotic treatment,but cannot significantly shorten the duration of hospitalization.Antibiotics should be used in patients undergoing TURP.

Background Diabetic retinopathy (DR) is one of the most important microvascular complications of diabetes,which has become one of the leading causes of blindness.Neovascularization is the main pathological manifestations of DR,but its mechanism is unknown.There is a clear need to investigate its pathogenesis which can offer potential therapeutic targets.Objective The aim of this study was to investigate the expression and distribution of visfatin and vascular endothelial growth factor (VEGF) in diabetic model rats.Methods This study was approved by Animal Ethic Committee of Inner Mongolia Medical University.Sixty SPF 8-week-old male SpragueDawley rats were randomized into the diabetic group and control group.The rats were housed under a condition that alternated between 12 hours of light and darkness,with free access to rat food and water.Diabetes was induced by intraperitoneal injection of 60 mg/kg (0.60 ml/100 g) of streptozotocin (STZ) and control rats received equivalent volume of buffer.The models were regarded as successful when blood glucose was ≥ 16.7 mmol/L.Rats were sacrificed 12 weeks after the injection of STZ and retinal specimens were prepared to detect the expression of visfatin and VEGF.Total retinal protein was isolated from the retinas of experimental and control eyes,and the expression of visfatin and VEGF was assessed by Western blot.Frozen cross sections of retinas of 5 μm thickness were used to perform double immunofluorescence staining with anti-visfatin and anti-VEGF antibodies.Results Mean body weight of the diabetic rats was (189.02±11.34) g and that of the control rats was (489.57 ± 14.48) g at 12 weeks post-injection,showing a significant difference between them (t =5.236,P =0.003).Mean blood glucose level was (29.25±3.86) mmol/L in the diabetic group and (5.32±1.01) mmol/L in the control group,demonstrating a significant difference (t =11.778,P =0.000).Double immunofluorescence staining showed reduced expression of visfatin and VEGF in the retinal nerve fibrous layer and glial cells in the control rats.A stronger staining for visfatin and VEGF was found in the various layers of the retina in the diabetic rats,with an expression level of visfatin (A value) of 346.26±41.23,which was considerably higher than that of the control group (102.07±65.01) (t =8.291,P =0.000) in 12 weeks after injection.Furthermore,the expression of VEGF in the retina was elevated in the diabetic group compared with the control group (A value) (415.88±92.15 vs.113.06±32.06) (t=10.067,P=0.000).Conclusions Visfatin might contribute to the pathologic progression of diabetic retinal,neovascularization and it might play a synergistic role with VEGF in the pathophysiology of DR.

Objective To develop a high performance liquid chromatography (HPLC) for the determination of fourteen dyes in hair dying formulations.Methods Dyes were separated on a amide bonded C_(16) silica column (250 mm?4.6 mm,5?m),the target analytes were ion-paired prior to HPLC analysis with elution employing methanol-0.025 mol/L phosphate buffer (pH=6.0) containing 1 g/L 1-heptanesulfonic acid sodium salt as mobile phase and detection by a photodiode array detector with the detection wavelength of 230 nm and 280 nm.The flow rate was 1.0 ml/min and the column temperature was 25℃.Results The linear range were 10-500 mg/L,the detection limits were 0.3-2.0 mg/L,the coeffieients of variation were less than 10%(except 2-amino-6-chloro-4-nitrophenol at low concentration) and the recovery rates were 71.3%-118.5%.Conclusion The methods of high performance liquid chromatography introduced in this paper is simple,rapid,accurate and is applicable to the analysis of various hair dyes.

Objective To evaluate the efficacy and safety of dorsal onlay buccal mucosa urethro-plasty for the treatment of long anterior urethral stricture. Methods From October 2005 to SeDtem-ber 2007,57 patients(17-52 years old)underwent buccal mucosal dorsal onlay urethroplastv for the treatment of anterior urethral stricture.The mean urethral stricture length was 3.0cm(2.5-7.0 cm).Previously,29(51%)patients had experienced one direct vision internal urethrotomy(DVIU),20(35%)patients had accepted twice DVIU and 8(14%)patient had 3 times DVIU for the treatment of urethral stricture.All patients recurred urethral stricture after DVIU.The length of urethral stric-ture was measured by combined retrograde urethrography and voiding cystourethrography before ure-throplasty.All patients accepted urethroplasty at more than 6 months after last failed surgery.Buccal mucosa was harvested from right cheek.The urethra was exposed and dors'al side was rotated to out-side. A longitudinal incision was made on urethra. Buccal mucosal free grafts were sutured to the open edges of urethra with 6-0 absorbable suture. 1 8 F silicon fenestrated urethral catheter was Dlaced and kept for 4 weeks. Urethrography was used at 4 weeks and 3 months after the urethroplastv,and thenevery 6 months to evaluate the urethral recovery.Dysuria and urethral caliber less than 1 6 F which was confirmed by urethrography and urethroscopy were regarded as stricture recurrence. Resuits The mean fellow-up time were 11.2 months(1-23 months).Fifty-four(95%) patients remained stricture free.Three(5%)patients recurred at the 2 to 3 months after the operation and were treated with DVIU.Three patients had wound infection and recovered without other complication.There was no fistula,diverticulum in all patients.The pain of cheek lasted for 2 5 days(average 2.3 days).No case had hypoesthesia of cheek,obstruction of stenseffs duct or cheek scar.Conclusions Dorsal on-1ay buccal mucosal urethroplasty for long anterior urethral stricture provides stable results with few and acceptable complications.

Adolescent ; Humans ; Male ; Neurofibromatosis 1 ; Neurofibromatosis 2

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Bloodletting ; Female ; Headache ; therapy ; Humans ; Male ; Young Adult

Humans ; Nasal Obstruction ; Nose Diseases ; Syndrome

Child ; Cross Infection ; Humans ; Pneumonia

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; Female ; Homeodomain Proteins ; biosynthesis ; genetics ; Humans ; Middle Aged ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; RNA, Messenger ; biosynthesis ; genetics ; Receptors, Estrogen ; metabolism ; Transcription Factors ; biosynthesis ; genetics