Objective To identify various arteriographic manifestations and the curative effects of emergency embolization of renal hemorrhage after percutaneous nephrolithotomy.Methods Emergency arteriography was performed in 21 patients of renal hemor-rhage after percutaneous nephrolithotomy.Emergency embolotherapy was conducted by using different embolic agents such as gelat-in sponge,polyvinyl alcohol (PVA)particles and coils after bleeding arteries were identified.The arteriographic manifestations and the curative effects of the treatment for renal hemorrhage were retrospectively analyzed.Results Contrast extravasations were con-firmed in 21 patients,among them,4 contrast extravasations with arteriovenous fistulas(AVF)of renal artery;3 pseudoaneurysms of renal artery.The hemorrhage completely stopped after emergent embolotherapy in 21 cases.During follow-up,no rebleedings and severe complications occurred.Conclusion Emergency arterial embolization for renal hemorrhage after percutaneous nephrolithotomy is a safe and effective treatment.The key to successful treatment is to select embolization agent reasonably and embolize the bleeding arteries thoroughly and completely.

Objective:To investigate the therapeutic efficacy of double-J catheter in treatment of renal tuberculosis(TB)and in rescuing the structure and function of the kidney.Methods:Thirty-four patients with renal TB(22 combined with single side hydronephrosis)were divided into 2 groups randomly.Group A were treated with antituberculous therapy and group B with antituberculous therapy combined with pre-treatment with double-J catheter.All 34 patients were followed up for 3 months and were re-examined.Results:The results of B ultrasound,intravenous urogram(IVU),CT and isotope nephrogram were comparable between the 2 groups before treatment,and the results were significantly different between the two groups after 3 months'drug treatment(P

Radical retropubic prostatectomy (RRP) has been one of the most effective treatments for prostate cancer.This study is designed to identify the related predictive risk factors for complications in patients following RRP.Between 2000 and 2012 in Department of Urology,Fudan University Shanghai Cancer Center,421 cases undergoing RRP for localized prostate cancer by one surgeon were included in this retrospective analysis.We reviewed various risk factors that were correlated with perioperative complications,including patient characteristics [age,body mass index (BMI),co-morbidities],clinical findings (preoperative PSA level,Gleason score,clinical stage,pathological grade),and surgeon's own clinical practice.Charlson comorbidity index (CCI) was used to explain comorbidities.The total rate of perioperative complications was 23.2％ (98/421).There were 45/421 (10.7％),28/421 (6.6％),24/421 (5.7％) and 1/421 (0.2％) in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ respectively,and 323/421 (76.8％) cases had none of these complications.Statistical analysis of multiple potential risk factors revealed that BMI ＞30 (P=0.014),Charlson score ≥1 (P＜0.001) and surgical experience (P=0.0252) were predictors of perioperative complications.Age,PSA level,Gleason score,TNM stage,operation time,blood loss,and blood transfusion were not correlated with perioperative complications (P＞0.05).It was concluded that patients' own factors and surgeons' technical factors are related with an increased risk of development of perioperative complications following radical prostatectomy.Knowing these predictors can both favor risk stratification of patients undergoing RRP and help surgeons make treatment decisions.

Adult ; Coronary Aneurysm ; complications ; Endocarditis, Bacterial ; complications ; Fistula ; complications ; Humans ; Male

OBJECTIVETo summarize and analyze the clinical features of bladder tumor patients who received transurethral partial cystectomy by 2 microm continuous wave laser, in 1 year post operation follow-up visits.

METHODSFrom December 2007 to May 2008, 47 bladder carcinoma patients were treated with 2 microm laser transurethrally under sacral block. Operation characteristics, operation time, intraoperative hemorrhages and postoperative complications, and pathology staging of the tumor were observed and postoperative follow-up visits were performed.

RESULTSAll of the operation procedures were successful. The surgery time was 5 to 15 minutes. Blood loss in the operation was minimal. There was no obturator nerve reflection, and no hemorrhaging was detected after the operation. The pathological stages can be judged correctly with the obtained specimens. There was one case with peritoneum perforation. The patients received 12 to 17 months of postoperative follow-up visits, and there was no recurrence at the resection site. The survival rate was 100%.

CONCLUSIONSTransurethral partial cystectomy in the treatment of bladder tumor by 2 microm continuous wave laser is a safe, efficient and effective method. The tumor and all the basal part of bladder wall could be excised completely and the pathological stages can be judged correctly using these specimens to fulfill partial cystectomy for the treatment of bladder carcinoma.

Adult ; Aged ; Aged, 80 and over ; Cystectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Laser Therapy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Urinary Bladder Neoplasms ; surgery

OBJECTIVESTo observe the vaporesection efficiency of the 2 micron laser to the prostatic gland in benign prostatic hyperplasia, and investigate the method of estimating the amount of the vaporesected prostatic tissues during transurethral vaporesection of the prostate using the 2 micron laser system in the treatment of benign prostatic hyperplasia.

METHODSTotal 9 fresh prostatic gland specimens were obtained from patients with BPH under open surgical procedures, and vaporesected under a simulated transurethral environment with the 2 micron laser system immediately after weighted. Energies and time consumptions were noted, collections of vaporesected tissue specimens and the remnants of the prostatic glands were weighted after the procedures. The ratios of the vaporized tissues and the collected tissues to the whole vaporesected tissues were calculated respectively. The vaporesection efficiency of the 2 micron laser to the prostatic tissues was also calculated.

RESULTSAmong the total lost tissues, about (65.6 +/- 1.5) percent of which were that of vaporized, and nearly (34.5 +/- 1.5) percent were resected. Linear correlation between the weight of collected prostatic tissue(x) and the weight of prostatic gland specimens(y) could be defined as a formula of [y = 3.245x - 6.475 (t = 15.097, P = 0.000)].

CONCLUSIONThe amounts of the whole prostatic tissues removed by the 2 micron laser could be calculated from the collected resected prostatic specimens under a simulated transurethral surgical procedure.

Humans ; In Vitro Techniques ; Laser Therapy ; methods ; Lasers ; Male ; Prostate ; surgery ; Prostatic Hyperplasia ; surgery ; Transurethral Resection of Prostate ; methods

OBJECTIVETo explore the effect of anti-VEGF hairpin ribozyme gene on the tumor cell growth and tumor angiogenesis in nude mice.

METHODSThe recombinant eukaryotic expression plasmid pcDNA-RZ containing anti-VEGF hairpin ribozyme gene and the empty vector plasmid pcDNA were introduced separately into K562 cells by lipofectamine mediation and positive clones were screened by G418. Ribozyme gene in K562 cells was confirmed by PCR. Fluorescent real time RT-PCR and Western blot were used to detect the expression of VEGF mRNA and protein in the leukemia cells. The tumorigenicity of transfected K562 cells were transplanted in nude mice and tumor microvascular density (MVD) were observed by morphology and vWF immunohistochemistry stain.

RESULTSStable expression of the ribozyme gene in K562 cells was confirmed by PCR. The level of VEGF mRNA and protein decreased dramatically in K562/RZ cells when compared with K562 or K562/PC (K562 cells transfected with empty vector) cells. The tumor volumes were (4.43 +/- 0.87), (3.96 +/- 0.94), (2.24 +/- 0.56) cm3; tumor weight was (4.43 +/- 0.87), (3.96 +/- 0.94), (2.24 +/- 0.56)g; and tumor microvascular density was 4.70 +/- 1.25, 4.67 +/- 1.31, 1.80 +/- 1.55 in K562, K562/PC and K562/RZ cell groups, respectively.

CONCLUSIONTransfection with anti-VEGF ribozyme gene can inhibit tumor growth and vessel formation by down-regulating the VEGF gene expression in K562 cells.

Animals ; Humans ; K562 Cells ; Mice ; Mice, Nude ; Neovascularization, Pathologic ; prevention & control ; RNA, Catalytic ; genetics ; Transfection ; Vascular Endothelial Growth Factor A ; biosynthesis ; genetics

OBJECTIVETo study the feasibility and cost-effectiveness of a case-finding program on tuberculosis (TB) in richer rural areas.

METHODSScreening was implemented every three months for a total period of 9 months, in rural areas with high case notification rates. Three villages, each with ten thousand population, were selected to carry out a household screening program. A suspect was defined as who coughed for more than 3 weeks. The suspect was then referred to further diagnosis in county TB dispensary to undergo chest X-ray and sputum test.

RESULTSOf the 86,168 community population screened, 26 TB patients were identified with 7 of them were smear positive. The ratio of effectiveness vs. cost decreased on the second but slightly increased on the third screening program. The direct costs for the 3 screening programs were 6,312,397 and 1637 RMB respectively. Of total direct cost, 5.9% was paid by TB patients, whereas 35.9% was through financing of the county itself.

CONCLUSIONThe community household screening program could achieve higher case detection rate than passive case-finding approach which could be used in richer areas with low case detection rate in China.

China ; Chronic Disease ; Cost-Benefit Analysis ; Cough ; etiology ; Family Characteristics ; Humans ; Mass Screening ; economics ; Radiography, Thoracic ; Rural Health ; Sputum ; microbiology ; Tuberculosis ; complications ; diagnosis

OBJECTIVETo summarize the 5-year follow-up to 2 micron continuous wave laser vaporesection for the treatment of patients with low urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), and evaluate the safety and clinical effects of the treatment.

METHODSFrom October 2006 to September 2007, 236 cases with low urinary tract symptom secondary to BPH were treated transurethrally under epidural or general anesthesia using the 70 Watt 2 micron laser system. Vaporesection of the prostate was performed with the traditional "U" or the "dividing" method. The 210 cases who met the inclusion criteria in this study were selected for further observation. Baseline and perioperative data were recorded and evaluated in resection time, transfusion rate, catheter-time, improvements in maximal urinary flow rate (Qmax), international prostate symptom scores (IPSS), quality of life (QoL), and post voiding residual volume (PVR).

RESULTSOut of the 210 cases, 179 cases were followed up to 5 years finally. All the surgical procedures were successfully conducted under epidural or general anesthesia. Mean operation time was (80 ± 22) minutes, and mean retrieved prostatic tissue was (24.9 ± 4.2) g. Resected prostatic tissues could be easily flashed out of the bladder. There were no significant differences in serum sodium concentrations and hemoglobin levels before and after the surgery. Mean catheter time and hospital stay was (114 ± 35) hours and (5.7 ± 1.9) days respectively. Only one postoperative secondary hemorrhage was found and treated with blood transfusion. During the 5-year follow-up, Qmax increased from (8.6 ± 3.5) ml/s preoperatively to (23.6 ± 4.2) ml/s by the end of the follow-up (P < 0.01), IPSS and QoL-Score improved from 25.3 ± 5.2 and 4.1 ± 1.3 to 6.1 ± 3.0 and 1.4 ± 0.8 respectively (P < 0.01), and PVR decreased from (248 ± 89) ml to (15 ± 13) ml. The 3 patients developed urinary incontinence and recovered 3 months later through functional exercises with the help of acupuncture. Five patients were found to have urethral stricture 3 months after the surgery and recovered with the treatment of urethral dilatation (3 cases) or internal urethrotomy (2 cases) respectively.

CONCLUSIONSTransurethral vaporesection of prostate using the 2 micron continuous wave laser system is a safe and effective treatment for benign prostatic hyperplasia with obvious improvements in subjective and objective voiding parameters, which were evident at 3 months after the surgery and were sustained throughout the 5-year long-term follow-up.

Aged ; Aged, 80 and over ; Follow-Up Studies ; Humans ; Laser Therapy ; Male ; Middle Aged ; Postoperative Complications ; Prostatic Hyperplasia ; surgery ; Transurethral Resection of Prostate ; methods