To discuss pathological factors which affection the prognosis of patients with esophageal cancer.We ex plored and compared the main pathological factors affecting the prognosis of esophageal cancer patients by analyzing their clinical data:the extent of tumor invasion,lymph nodes shift,distant organ metastasis,as well as stages of tumor.And the prognosis associated with the following independent factors:tumor histological type and degree of dif ferentiation tumor mierometastases,vascular tumor thrombus formation,and stromal tumor-infiltrating lymphocytes. The authors think the pathological stage of esophageal cancer patients need to be improved.

Objective To assess the clinical walue of 3D retroperitoneal laparoscopic renal pedicle disconnection by comparing its clinical effects with those of traditional 2D laparoscopic.Methods Clinical data about 49 cases from our department with chyluria respectively treated by 3D retroperitoneal laparoscopic and 2D laparoscopic renal pedicle disconnection were analyzed retrospectively.They were divided into 3D group(26 cases)and 2D group(23 cases),and operated by the same salty doctor.The operation time,intraoperative blood loss,postoperation hospital stay and recurrence rate of the two group were compared.Results The operation time in 3D group[(95.2±30.3)min] was shorter than 2D group[(120.4±25.8)min,P<0.05].The intraoperative blood loss in 3D group[(30.0±12.7)ml] was less than 2D group[(55.0±21.7)ml,P<0.05].There were no difference in postoperation hospital stay between the two groups.All of the cases were not recurred.Conclusion 3D Retroperitoneoscopic renal pedicle lymphatic disconnection for treatment of chyluria is safty and feasible.3D laparoscopy provides high-quality 3D endoscopic view and facilitates precise manipulation during surgery,resulting in shorter operation time and intraoperative blood loss compared with 2D laparoscopy.

Objective To study the effect of flushing the pelvis with normal saline at constant pressure on renal function to provide a theoretical basis of pathogenesis of renal injury during endoscopic procedures. Method Fifty rabbits underwent tube ureterocutaneostomy as a method of urinary diversion, the flushing group perfused immediately after ureterocutaneostomy, and the intrapelvic pressure is 60, 80, 100, 120cmH_2O, but the sham-operated group didn′t flush. Urinary protein excretion were examined every day after operation,we also got pathological examination of nephridial tissue continually. The urinary protein include immunoglobulin G, microalbuminuria and ?_2-microglobulin. Result All the flushed rabbits had the change of urinary protein, the difference of urinary protein was of statistical significance between the before and the first day after treatment(P

In order to investigate the influence of bleeding tendency on emergent treatment of postrenal renal failure patients, we retrospectively studied the methods and complications of emergent treatment in 86 renal failure patients induced by postrenal obstruction hospitalized from March 1988 to December 2000. Fourteen patients were treated by emergent open operation, in whom one died after operation because of severe bleeding,and 3 with total bleeding volume more than 1000ml. Thirty nine patients were treated with percutaneous nephrostomy, in whom 2 died after operation and 3 had to undergo mephrectomy.32 patients were treated with retrograde indwelling ureteral stent and one with transureteroscopic lithotomy (TUL),without the occurrence of complications. Emergent open operation and percutaneous nephrostomy for renal failure patients induced by postrenal obstruction may induce uncontrolled renal bleeding,resulting in patient death or kidney loss because of bleeding tendency.The retrograde ureteral catheterization for drainge is recommended as the first option for emergent treatment of renal failure patient induced by postrenal obstruction.

Objective To observe the effect of unilateral ureter obstruction(UUO) on the expression of complement 5a receptor(C5aR) in rat renal tissue,and to investigate the roles played by C5aR in the development of renal intersititial fibrosis.Methods Thirty six male Sprague Dawley rats were randomly assigned into two groups(18 each): sham-operated group and UUO group.The left ureter of the rats in UUO group was obstructed,while in sham-operated group the left ureter was not.Six rats in each group were executed respectively on the 5th,10th and 15th day after surgery.Histological changes in renal tubular interstitium were observed with H.E.and Masson staining,and the expression of C5aR in renal tissues was detected by iminunohistochemical ELiVisionTM plus at each time point.Results Renal tubular dilatation and partial interstitial cells degeneration were found in UUO group on the 5th day after surgery.Necrosis of the interstitial cells was found in renal tubule,and the interstitial fibrosis was found on the 10th day.On the 15th day after surgery diffuse thickening and shrinkage of renal tubular basement membrane and obvious fibrosis were found(P0.05).Conclusion The C5aR expression in renal tissue increases significantly at the early stage of UUO,while the process is slowed down in the later stage.C5aR may take part in the process of renal intersititial fibrosis at the early stage.

Objective To investigate the expression and clinical significance of H1 receptor in kidney and bladder tissue of rats after long term ketamine intraperitoneal injection.Methods This study was conducted from May 2012 to December 2012.Sixty male 2-month-old SD rats,weighted (200±10) g,were randomly divided into Group A and Group B.Each group concluded 30 rats.In the Group A,Ketamine (100 mg/kg) was given as intraperitoneal injection every other day,while normal saline (100 mg/kg) was given in Group B.The dosage was adjusted every week according to the weight of rats.After 2,4 and 6 months,10 rats from each group were randomly chosen.First,the micturition number during 2 h was recorded.Then,urine samples over a 24 h period were collected and the content of Na+ and K+ were determined.Finally,the blood samples were obtained from the apex of heart for the creatinine determination.The kidneys and bladders were harvested after the rats were sacrificed.HE staining was conducted on all the tissues.Immunohistochemical S-P method was used to detect the expression of H1 receptor in the bladder and kidney tissues from Group A and Group B.The average optical density (A Value) in each group was separately calculated by Imagepro-plus 6.0 software.All the parameters,mentioned above,were carefully compared.Results The successive rate of establishing rats model was 90％ (9/10),according to the pathological result after 6 months injection.The urine volume of 24 h in group A and B were (15.9±1.3) and (10.1±0.8) ml,respectively.Micturition frequency during 2 hours in group A and B were (6.9±1.4) and (3.0±0.5) times.The urine volume of 24 h and micturition frequency during 2 hours were significantly increased in group A (P＜ 0.05).The urine sodium within 24 h in group A was (1.7±0.1) mmol,which is increased significantly than that in group B (1.0±0.1 mmol).While the urine potassium was less in group A (1.1±0.1 mmol/d) than in group B (2.6±0.1 mmol/d) (P＜0.05).But the serum creatinine level were (60.5±6.8) and (58.1± 3.9) μmol/L in group A and B,which had no difference between the two groups (P＜0.05).The expression of H1 receptor in kidneys and bladder in group A was significantly raised compared with group B (P＜0.05).In the group A,the expression of H1 receptor level in kidney was 0.008±0.001,0.016±0.001,0.023±0.004 after 2,4 and 6 months drug used.The expression level in group A were significantly difference than that in group B (0.003±0.001,0.004±0.002,0.003±0.001) (P＜0.05) and goes up with prolonging the drug using.While in the bladder tissue,the level of H1 receptor expression was 0.017±0.006,0.031±0.012,0.036±0.007 in group A and 0.015±0.007,0.016±0.005,0.016±0.004 in group B,which could be noticed a significantly increasing in group A (P＜0.05).In 4 and 6 months,the H1 receptor expression level significantly raised than that in 2 months (P＜0.05).Conclusions Long term ketamine addiction exerts toxicity not only on the bladder but also on the kidney.The increased expression of H1 receptor in rats' kidney and bladder tissues of group A indicates that H1 receptor may be related to the ketamine-associated urinary system dysfunction.The urine sodium and potassium within 24 h may be a sensitive index for the assessment of degree of kidney damage in the early stage of ketamine-induced dysfunction than serum creatinine.

Objective To explore the correlation of peritumoral brain edema( PTBE)size,histologi-cal grades and the expression rate of Ki-67 in gliomas. Methods The data and specimens about 74 cases of gliomas in People's Hospital of Xinjiang Uygur Autonomous Region during 2010-2013 were collected. All cases were confirmed by surgery and pathology. According to preoperative MRI,PTBE was graded. Immunohisto-chemical discriminate the expression of Ki-67. HE coloration distinguish the histological grades. Results In this study,90. 54%(67/74)patients occured PTBE,the incidence of PTBE inⅠ,Ⅱ,Ⅲ,Ⅳlevel of groups were 100%(3/3),78. 95%(15/19),83. 33%(15/18),100%(34/34). Ki-67 expression was positive in 75. 68%(56/74)patients,and the rates were 0,36. 84%(7/19),94. 44%(17/18),94. 12%(32/34) in Ⅰ,Ⅱ,Ⅲ,Ⅳ level of groups. The expression rate of Ki-67 was 57. 14%(4/7),60. 00%(6/10),and 80. 70%(46/57)in normal group,Ⅰ-level groups of PTBE,Ⅱ-level groups of PTBE. The result of Kruskal-Wallis H showed that the PTBE from different grades was statistically significant(H=11. 304,P=0. 010). The expression rate of Ki-67 in different grade gliomas was statistically significant(H=38. 530,P﹤0. 05), The difference of expression Ki-67 in gliomas of different PTBE was statistically significant( H=6. 478,P=0. 039). The result of Spearman rank correlation analysis showed that the PTBE level increased with the histo-logical grade up in gliomas(r=0. 385,P=0. 001). The expression rate of Ki-67 increased with the histologi-cal grade up in gliomas(r=0. 692,P﹤0. 05),and the expression rate of Ki-67 increased with the degree of PTBE up in glomas( r =0. 256,P =0. 028 ). Conclusion Accorrding to the PTBE size,the histological grades and proliferation ability of glioma can be judged pre-operation. Ki-67 can be used as the indicator of pro-liferation activity of tumor,and also be used as the important basis of histological grades.

Objective To explore the ultrasound imaging and the clinical analysis of eosinophilic cystitis in children and to improve the understanding of this very rare clinical disease.Methods The ultrasound imaging of 9 patients who were diagnosed as eosinophilic cystitis in Nanjing Children's Hospital Affiliated to Nanjing Medical University from Jul.2007 to May 2013 were analyzed retrospectively,and the relevant literatures were reviewed.Results The ultrasound imaging of the 9 patients were described as follows:4 cases showed a diffuse thickening bladder wall,2 cases showed a localized mass-like thickening bladder wall,and 3 cases showed a markedly thickening anterior bladder wall and bilateral bladder wall.Laboratory studies showed that all the patients were presented with eosinophilia.Six patients underwent cystoscopy that showed an erythematous,and velvety appearance of the bladder mucosa.Histopathology disclosed a bladder mucosal tissue with dense interstitial eosinophilic infiltration consistent with eosinophilic cystitis.Three patients had clinical resolution under the treatment of anti-infections and urine alkalinization.Other 6 patients received prednisone at 0.5-1.0 mg/kg and an antihistamine treatment.Prednisone was eventually tapered off after 2-week reemission.Regular follow-up by urinary bladder ultrasound and urine routine did not show any disease recurrence in 9 children.Conclusions The combination of bladder wall thickening and peripheral eosinophilia may suggest the likely diagnosis of eosinophilic cystitis.Cystoscopy with bladder biopsy is the most important step in the diagnosis of eosinophilic cystitis.Anti-histamines and corticosteroids can be used as the primary management and have good results.

This paper presents the components and the principles of an internal electrohydraulic lithotripter.Cooperating with the cystoscope,the lithotripter introduces the high-pressure discharge pulse into the bladder through the microelectrode.Then the little,easily-moved stone is targeted,and the re-discharge of the lithotripter 5mm away from the stone results in the shock wave to perform lithotritization.

Objective: To investigate the prospect of applying technology of ultra fine powder (UFP) to TCM powders for external use. Methods: The morphocytology between UFP of Cortex cinnamomi , compared with its common powder, was observed; physical parameters of the UFP particles and the penetrating amount of cinnamaldehyde, through rat skin in vitro was determined with an improved Franz diffuse cell. Results: The diameter of the UFP particles detected was small (D 50 =12.72?m). and a typical microscopic characters of Cortex cinnamomi powder was not observed. The Cortex cinnamomi UFP have good transdermal effects. There existed the linear relationship between penetrating amount of cinnamaldehyde and penetrating time. The highest penetrating rate (0.25mg/cm 2/h) was within the first hour in the beginning, and then the rate became lower and sustained. The accumulating transdermal amount of the UFP was 1.0mg/cm 2 totally in 8 hours. Conclusion: It indicated that UFP might have a fine respect, applied in cosmetic or drug preparations for external use.