The article briefly reviews the aged lung cancer in epidemiology, physical and pathologic traits, and treatments. It includes the matters needing attention of operation with elder lung cancer patients; matters about the radiotherapy; choice of chemotherapeutics or dosage; situation of targeted drug and treatment of Chinese Medicine. Goals of treatment with elder lung cancer patients are prolonging lifetime, improving quality of life. Patients should be treated individually according to their state of illness and constitutions.

Objecitve To conclude the clinical manifestation of Fournier's gangrene (FG) and its emergency treatment.Methods From 2006 to 201 1,12 patient were involved in the study,all had received debridement,wide spectrum antibiotics and support therapy,the clinical manifestation,treatment choice and prognosis were analyzed retrospectively.Results All patients were male with 67.7 year-old mean age.Initial lesions were all in scrotal skin,an average procedures of each patient was 3.5,mean hospitalization days was 29.7 days.Surgical wound was healed by left scrotal skin in all cases,2 cases with huge urethra defect were received perineostomy.Ten cases were survived with 57-months follow-up and mortality was 16.7％.Conclusions Fournier is one of emergency disease of Urology.Its mortality is still high.Intensive care and appropriate anti-biotic therapy combined with surgical treatment is the key of FG's management.

Objective Concluding the clinical feature and prognosis of primary testicular lymphoma to improve the understanding of this disease.Methods During 1995 and 2010,17 cases of primary testicular lymphoma treated in Beijing Friendship Hospital of Capital Medical University were retrospectively analyzed of its clinical features,diagnosis,treatment and prognosis.Results Seventeen patients with a mean age of 68 years complained the testicular sohd mass as their first symptoms.The mean tumor diameter was 4.7 cm,and all patients underwent orchidectomy,and testicular non- Hodgkin's lymphoma was confirmed by pathologic examination.Fourteen cases were diffuse large B cell type and 3 cases were anaplastic large cell type.The clinical stage of all the patients was IE.Fourteen cases were followed up (3 cases were lost)with mean follow-up time of 37.8 months by outpatient interview and telephone,all patients were treated with CHOP chemotherapy,and some of them were combined with rituximab and preventive lowdose pelvic radiotherapy.Five cases died of other chronic medical complications,1 case with contralateral testicular metastasis received surgery again.There were 9 tumor free survival cases in total.Conclusion Primary testicular lymphoma is rare and more common in older men.Postoperative pathologic diagnosis is gold standard.The systemic treatment and individual therapy is the first choice for primary testicular lymphoma.

Objective To evaluate whether the unidirectional barbed suture is safety and efficiency enough for laparoscopic partial nephrectomy.Method From March 2013 to March 2014,27 patients with renal mass have been involved into this study and divided into 2 groups wsing a lottery.Group A used Coated Vicryl in renorrhaphy after LPN,and group B used unidirectional barbed suture.All patients underwent LPN preformed by single group of surgeons.Perioperative and postoperative indicators were compared in two groups.Result It is identical in age,BMI,tumor size,R.E.N.A.L nephrometry scoring system between 2 groups.However,using barbed suture has significantly shortened in warm ischemia time (WIT).The postoperative indicators,such as blood loss,hospital stay and surgery complication has no significantly difference in two groups.Conclusion The unidirectional barbed suture is safety and efficiency using in LPN which can shorten WIT significantly.

Objective To explore the different operation modes for treating native renal pelvic and ureteral neoplasms occurring at the same side of transplanted kidney.Method A retrospective analysis was performed on 48 cases of native renal pelvic and ureteral neoplasms occurring at the same side of transplanted kidney,including 14 cases receiving open surgery (open surgery),22 cases receiving laparoscopic radical nephroureterectomy with bladder cuff resection through a lower abdomen oblique incision (oblique incision group) and 12 cases receiving modified endoscope assisted Plunk technique (Plunk group).The operating time,amount of bleeding and blood transfusion during operation,recovery of intestinal function,time of indwelling drainage tube and wound suture,the total cost of hospitalization,the hospital stay and the incidence of complications were comparatively analyzed.Result The operating time in open group was shortest.Group of Pluck is better than other groups in the aspects of Time of wound suture and intestinal function time in shorter in Plunk group than the rest two group (P＜0.05),and amount of bleeding and incidence of complication in Plunk group were higher than oblique incision group (P＜0.05).The incidence of complications and amount of bleeding were decreased significantly as compared with the rest groups (P＜0.05).Conclusion The mode of the laparoscopic radical nephroureterectomy with bladder cuff resection through a lower abdomen oblique incision has the advantages of high security,minimal invasion and satisfactory treatment effect.It is especially suitable for treating native renal pelvic and ureteral neoplasms occurring at the same side of transplanted kidney.

Objective To evaluate the efficacy and safety of modified technique of ureteral stent placement during transurethral resection of bladder tumor.Methods Seventeen patients with muscle invasive bladder cancer invading the ureteral orifice from March 2014 to June 2016 in Beijing Friendship Hospital were randomly divided into two groups.In the modified technique group (group A,n =10),tumor was resected until the ureteral orifice was exposed.Then,a guide wire was placed through the tunnel of Electrode loop and the ureteral stent was placed along the guide wire.In control group (group B,7 cases),after ureteral orifice exposed,the guide wire and ureteral stent was placed with cystoscopy.The demographic,oncological baseline and operative factors were evaluated between two groups.Results There was no difference in tumor grade and maximum diameter between two groups (P ＞ 0.05).The operation time in group A was significantly shorter than that in group B [(39.5 ± 14.8)min vs (59.3 ± 16.2) min,P =0.020],and the intraoperative vision clarity score was better in group A as well [(7.7 ± 1.3) vs (5.9± 1.2),P =0.010].There was no statistical difference between the two groups in the complication.Conclusions The modified technique can improve the efficiency of ureteral stent placement during transurethral resection of bladder tumor without any risk enhancement.

Tumor-associated macrophage (TAM) is a macrophage infiltrating around tumor cells, which can be divided into two categories including classical activated macrophages (M1) and alternately activated macrophages (M2). On the whole, it shows the phenotype of M2 macrophages that promote immune escape of tumor cells. With the in-depth study of the immune function of the body, the studies have indicated that TAM is highly malleable and can be transformed into each other with the change of tumor microenvironment. TAM plays a very important role in tumor occurrence, development, invasion and metastasis, and its classification and quantity may also be used as an index to judge the prognosis of tumors. Therefore, TAM is a feasible potential target for the treatment of cancer. This paper reviews the role of TAM in tumorigenesis and development.

Objective To investigate the clinical characteristics and treatmentof ureteral endometriosis.MethodsA retrospective analysis was made on the clinical data of 16 cases of ureteral endometriosis of the Department of Vrology,Beijing Friendship Hapital,Affiliated to Copital Medical Universty from January.1991 to Augest.2011.ResultsSixteen cases were pathologically confirmed endometriosis,including 11 cases of outer lumen type,5 cases of lumen type ; endomctriosis lesions were all located in the lower ureter.Ureteral stricture length was 1.0-4.0 cm.During 12 months to 20 years follow-up,hydronephrosis detected by ultrasonography in 15 patients was released significantly,and no recurrence occurred except one case who was found hydronephrosis 3 years later.Ureter anastomosis was undergone later.ConclusionsUreteral endometriosis onset is undetectable which could impact renal function.Renal ultrasonography can reduce misdiagnosis.The principle of treatment is to remove the obstruction and protect renal function,and well follow-up to prevent recurrence.

Objective To evaluate the postoperative quality of life of donors in living donor renal transplantation patients.Methods One hundred and seventeen donors were involved in present study from 2006-2008.A crosssectional survey was performed with questionnaire research to all the donors who received living donor nephrectomy during this period.The questionnaire included sociodemographic characteristics,surgical complications,economic status,donors awareness status,family support,the health care,social welfare and daily exercise after surgery.The Chinese version of SF-36 was used as the measurement of quality of life.The statistic analyze include T test,analysis of variance and stepwise regression analysis.Results The donors' mental health status was better than the healthy population (P ＜ 0.05).The difference of quality of life and scores of other dimensions compared with the healthy population was not statistically significant (P ＞ 0.05).In univariate analysis,four kinds of fields such as age,education level,economic status and physical exercise were associated with quality of life.In further multivariate analysis,with exclusion of the interaction between various factors,the main factors for postoperative quality of life are the cultural,economic status and physical activity (P ＜ 0.05).Conclusions Social and psychological factor should be concerned in donor's preoperative screening.Good social psychological background,the necessary psychological intervention and postoperative follow-up maybe play an important role to improve the postoperative quality of life in living donor renal transplantation.

Objective To explore the efficacy and safety of Gemcitabine and Cisplatin combination chemotherapy in treatment of muscle-invasive urothelial cell carcinoma.Methods Analyse of 72 cases of patients with muscle-invasive urothelial cell carcinoma receiving chemotherapy from September 2010 to September 2012,including 47 male and 25 female,the avarage age was 65 (86-33).All patients were received GC chemotherapy (Gemcitabine 800-1 000 mg/m2,ivgtt,dl,d8,d15; Cisplatin 70 mg/m2,ivgtt,d2).Efficacy was reviewed after 1 cycle of chemotherapy.Results Fifty-one cases in all the patients completed two or more chemotherapy cycles and CR 10 cases,PR 27 cases,total effective rate was 51.39％ (37/72).The main toxic reactions included nausea,vomit,myelosuppression,and then damage of liver and renal function.Cconclusion GC regimen is a good choice for urothelial cell carcinoma.Close follow-up and the usage of adjuvant drugs can contribute to reduce the side effect of chemotherapy.