Objective To evaluate the efficacy of post-operative radiotherapy and prognosis of renal cell carcinoma(RCC). Methods Between 1981 and 1998 , 90 s uch patients with disease limited to the kidney underwent nephrectomy at our ins titution. According to TNM classification(UICC,1997) the pathological stage was: Ⅰin 27 patients(30%),Ⅱ in 18 (20%), Ⅲ in 35(38.9%), and Ⅳ in 10(11.1%).Post - operative irradiation, with a median dose of 50?Gy in 25 fractions over 5 weeks w as given to 52 patients in 3～5weeks after surgery, using AP-PA opposing portal s or oblique portals. Results The 5- and 10-year survival rates in the irradiate d patients(S+Rt) were 75% and 60%,respectively, but in the non-irradiated patien t s(S) 50% and 40%, respectively.This difference is statistically significant. 5- y ear survival rates by TNM stage in the two groups were as follows: stageⅠ:S 67 %,S+Rt 100%;stageⅡ: S 55%,S+Rt 71%;stageⅢ: S 47%,S+Rt 65% (P=0 .010);stageⅣ: S 0%, S+Rt 43%.Diseases recurred locally in a total of 12 patients: 3 had tumo r b ed recurrence and 6 had regional lymph node recurrence and 3 had both. Local rec urrence in S was 29% and that of S+R was 2% (P=0.001). and local recurrence by T NM stage:Ⅲ were 33% and 5%, respectively. One patient developed radiation-indu c ed small bowel obstruction which necessitated surgical intervention, but no pat i ent died from radiotherapy-induced complications. By multivariate analysis: per f ormance status, symptomatic presentation, lymph node involvement, post-operativ e radiation and post-operative residual were all independent predictors of overa l l survival in the RCC patients. Conclusions In renal cell carcinoma, radiothera py is beneficial in reducing the locoregional recurrence. Radiotherapy has a sup prisingly positive effect on both local control and survival in TNM stage Ⅲ pat ients. Performance status, symptomatic presentation, lymph node involvement, pos t-operative radiation and post-operative residual are prognostic indicators of RCC. TNM staging is superior to Robson staging in predictive values .

BACKGROUND: Urinary incontinence can be divided into stress, urgent and mixed types, they can not be easily distinguished only basing on clinical experience, which often result in misdiagnose or improper treatment OBJECTIVE: To discuss the value of urodynamical inspection, especially stress leak point pressure (SLPP) determination in the diagnose of female stress urinary incontinence.DESIGN: Retrospective paralleled comparison observation.SETTING: Center of General Urology Department, Southern Hospital,Third Military Medical University of Chinese PLA PARTICIPANTS: Totally 120 female patients who received medical treatment in the uropoiesis surgical department of the Southwest hospital due to urinary incontinence between January 1996 and May 2002 were enrolled in this experiment.gle was determined and considered as normal if it was ＜100° and abnormal if ＞ 100°. Urethral tilt angle is judged as normal if ＜ 45° and abnormal if ＞45°; Urethrovesical junction (when static state) was judged as normal if not tion: including fulling urinary bladder pressure measurement, static urethral Cystourethrography classification standard: type Ⅰ refers to posterior urethrovesical angle vanished with urethral tilt angle＜45° and the biggest urethra closure pressure＞20 cmH2O; type Ⅱ: refers to posterior urethrovesical angle vanished with urethral tilt angle＞45° and the biggest urethra closure pressure＜20 cmH2O; type Ⅲ refers to normal posterior urethrovesical angle with urethral tilt angle＜45° and the biggest urethra closure pressure ＞20 cmH2O. SLPP classification standard: typeⅠ: SLPP ＞120 cmH2O; type Ⅱ: SLPP of 90- 120 cmH2O; type Ⅲ: SLPP ＜ 60 cmH2O;type Ⅱ/Ⅲ: SLPP of 60 - 90 cmH2O.compared with that of cystourethrographic classification.RESETS: Totally120 patients all remained in the final result analysis.stress urinary incontinence, 64 cases as symptomatic stress urinary incontinence including 28 cases of unstable bladder and 36 cases of low compliclassification: of the 56 genuine stress urinary incontinence, 20 cases were diagnosed as type Ⅰ; 16 cases as type Ⅱ and 10 cases as type Ⅱ/Ⅲ; 10cases as type Ⅲ. Two classification was proved of 100% consistency in type Ⅰ and Ⅲ, and 94.1% and 90.1% in type Ⅱ and type Ⅱ/Ⅲ respectively, difference was not remarkable (P＞0.05).CONCLUSION: SLPP determination can be used to make accurate classification of female genuine stress urinary incontinence, possessing important instructive significance for the treatment.

Objective To find an appropriate r3diobiological model for analyzing the biological effect of the radiotherapy for breast cancer by comparing different results computed by various types of radiobiological models. Methods DVHs database simulating breast conserving radiotherapy was set up,based on clinical DVHs data of the heart.the lung and PTV of 22 patients with early breast cancer given conventional tangential radiotherapy.Two models assessing NTCP of radiation pneumonitis and cardiac mortality and four models assessing TCP were compared by analyzing the effects of the parameters and DVH database input methods on the results. Results When mean irradiation dose of the whole lung was 30 Gy.the incidence of radiation pneumonitis was 32%and 54%predicted by NTCP-RSM model and NTCP-Lyman model,respectively.When 1%cardiac mortality of radiation was assumed,28 Gy and 40 Gy isodose should cover the heart assessed by the two models.The mean TCP were 21.1%.80.8%.38.4%and 41.0%when assessed by LQ-Poisson-TCP,Zaider-TCP,Poisson-TCP and Logit-TCP models,respectively.Setting various differential DVH(dDVH)bins had very few effect on the NTCP/TCP results in a certain model.Adopting physical dose or LQED2 affected the results with greater resu]ts for physical dose.Variation in α or β value,tumor cell density and D50 had significant effect upon TCP results in LQ-Poisson-TCP(P:0.000). Conclusions NTCP-Lyman model is better for predicting the incidence of radiation pneumonitis while NTCP-RSM model is better for predicting radiation-induced cardiac mortality.LQ-Poisson-TCP is the best TCP model for clinical application.Parameters selected for model can significantly affect the results.It is imporrant to understand the distinct characteristics of different models.

Objective To investigate the recovery of affected side kidney function after upper urinary tract obstruction was relieved Methods 78 patients who had been diagnosed with upper urinary tract obstruction were enrolled from January to December of 2015 in our hospital.All patients received the surgery to relieve the obstruction.GFR of the affected side kidney was done after one months of the surgery.The average age was(51.3 ± 12.8)years old.The reason of obstruction was upper urinary tract calculi (72 cases) and upper urinary tract stenosis (6 cases) respectively.All the patients received CT and ECT before and after operation.All the patients was divided into 3 groups by the decreased degree of affected side kidney function,including moderately decreased group [15 rnl/min ≤ GFR ＜ 30 ml/min,n =43,mean value =(23.1 ±5.0) mL/min],severely decreased group [7.5 rnL/min≤ GFR ＜ 15 ml/min,n =23,mean value =(11.2 ± 2.3) ml/min],and extreme severely decreased group [GFR ＜ 7.5 ml/min,n =12,mean value =(4.3 ± 2.9)ml/min].Linear correlation analysis was used to analysis the relationship analysis between the GFR value (pre-operation,post-operation) and the renal cortical thickness.The follow up time of extreme severely decreased group extended to 8-12 months.Results The GFR of moderate decreased group recovered to(30.6 ± 8.5) ml/min,regained averagely (7.56 ± 7.62) ml/min;the severely decreased group recovered to (13.1 ± 4.5) ml/min,regain (1.94 ± 3.38) ml/min.Extreme severely decreased group recovered to (11.1 ± 3.4) ml/min,regained averagely (6.75 ± 4.76) rnl/min,the GFR mean value after operation 8-12 months recovered to (12.7 ± 3.6) ml/min.All groups got significant recovery of kidney function of the affected side.The correlation coefficient between GFR value and the renal cortical thickness was 0.59 (before the surgery) and 0.70 (after the surgery) respectively (P ＜ 0.05).Conclusions Most of affected side kidneys got different degree of recovery.Obstruction influenced the accuracy of ECT at the time of evaluating the actual renal function before operation.The kidneys which had been supposed should be resected in presurgical evaluation could recover to the level of kidney reserve after the surgery.

Chronic obstructive pulmonary (COPD) has significant extra pulmonary effects, which could induce atrophy of peripheral skeletal muscle and respiratory muscles, and significantly influence the respiratory function and quality of life. Muscle nuclear factor (NF)-κB activation plays a key role in the skeletal muscle atrophy. This article discussed the potential mechanisms on how NF-κB signaling pathway increasing protein breakdown and reducing muscle regeneration. On this basis, we explored the role of NF-κB in skeletal muscle at-rophy in patients with COPD during exercise.

Objective To evaluate the value of using ultraharmonic contrast imaging(UHCI) and acoustic densitometry(AD) technique to quantify cortex blood perfusion of acute rejection in renal allograft.Methods The canine models with acute renal allograft rejection were established. The examinations of renal allograft were performed by intravenous contrast ultrasound and AD technique on the days 1,3,5,7,9,11 after transplantation,some parameters related to perfusion such as peak intensity(PI),the area under the curve(AUC),the half time of descending(HT) and the mean transit time(MTT) of renal cortex were measured,and the graft biopsies were done simultaneously.Results The cortex of renal allograft with acute rejection showed nonenhancing defects after contrast agent injection. From 5 to 11 days after transplantation,the PI,AUC,HT,MTT of renal cortex were increasingly decreased,and the 50% wash-out slope was increasingly increased; furthermore,there were significant differences between those of the first day of post-operation(P

0 05). SLPP determation is helpful in the assessment of the type of genuine female stress urinary incontinence and is therefore valuable in its management.

Objective To investigate the learning styles of students for rehabilitation therapy. Methods 265 students of 4 grades were investigated with VARK Questionnaire (version 7.0). Results and Conclusion The maximums distributed mainly in the K dimension, with multi-style, mild tendency. For those with single-style, it was tended to K. The learning styles of the students transferred from mainly multi-style (quaternity the most) to single-style with the grades.

Objective To analyse the effect of holmium laser incision through ureteroscopy and simple ureteroscopy treatment for refrac-tory hemospermia. Methods From December 2003 to April 2013,the data of 67 cases with refractory hemospermia were retrospectively ana-lyzed. All the patients underwent semen analysis,transrectal ultrasonography,seminal vesicle ultrasonography,some patients underwent pelvic CT or MRI. Results Simple ureteroscopy were done for 24 cases,holmium laser incision through ureteroscopy were done for 43 cases. Var-ying degrees of ejaculatory duct stenosis or obstruction were observed. Postoperative follow-up was from 6 months to 8 years,in 24 cases of simple ureteroscopy,2 cases experienced recurrence 6 or 8 months later. The ejaculatory duct narrow were found when they received reopera-tion,with holmium laser incision,hemospermia disappeared. No complications such as retrograde ejaculation,urinary incontinence or rectal injury occurred postoperatively. Conclusion The effect of holmium laser incision through ureteroscopy for refractory hemospermia is better than simple ureteroscopy,which is worthy of clinical application needs further observation and summary.

Objective To investigate the metabolic profile of uric acid and the significance of the altered renal expression of urate trans-porter 1(URAT1) in patients with uric acid nephrolithiasis. Methods The data of 24 patients in our hospital from January 2012 to October 2013 were analyzed retrospectively. Participants in the research were divided into three groups:patients with uric acid nephrolithiasis,other patients with nephrolithiasis and normal participants. The basic clinical data and the related data of uric acid metabolition of participants were collected,URAT1 gene expression in renal tissures of three groups was detected by Real-time PCR technique. All data were statistically ana-lyzed and compared between these groups. Results Uric acid levels in plasma,body mass index and age were significantly higher in patients with uric acid nephrolithiasis than other two groups (P<0. 05),but urine PH value was significantly reduced in patients with uric acid neph-rolithiasis. Urine and uric acid output of 24 hours urine were no significant difference among the three groups (P>0. 05). The result of Real-time PCR suggested that the URAT1 renal expression was significantly higher in patients with uric acid nephrolithiasis than other two groups (P<0. 05). Conculusion Patients with uric acid nephrolithiasis are closely related with hyperuricemia,but unrelated with renal over-ex-cretion of uric acid. The upregulated URAT1 expression in the kidney may be an important molecular mechanism of the clinical features.