Objective To evaluate intrasinusal pyelolithotomy for giant staghorn calculi. Methods The data of 22 cases treated with intrasinusal pyelolithotomy were analysed. Results Lithotomy was successful in all cases with the average operation time 116 minutes.Blood transfusion during the procedure was required in 8 cases with an everage of 550 ml.Postoperative examination of 12 cases with B ultrasound revealed residual calculus in 3,the diameters being less than 0.8 cm. Conclusions The procedure for giant staghorn calculi was easy,safe,and effective with renal parenchyma intact.

Objective To study the effect of anisodamine (654-2) combined with exogenous pulmonary surfactant (PS) on tumor necrosis (TNF- ?) ,structure of lung tissue changes during pig's lung ischemic-reperfusion injury. Methods 24 pigs ,approximately 45-day-old, were randomly divided into four groups: a control group,a 654-2 group,a PS group and a 654-2 plus PS group. The TNF-? concentration of every lung was analysed with ELISA methods at the point of pre-clamping right pulmonary aortery,post-clamping 60',90'(opening),post-unclamping 60',90',120'.Finally ,we examined the pathologic changes of the lungs. Results After clamping right pulmonary artery , TNF-? concentrations in every experimental groups were significantly lower than that of the control group (all P

0. 05) . The sensitivity and specificity of NMP-,2 in diagnosing transitional cell carcinoma of bladder were 85. 7% and 60% when the cut-off was set 10 u/ml, In contrast, the sensitivity and specificity of urinec cytology were 32. 1% and 100%. Conclusions: Urinary NMP22 can be used to screen and follow up transitional cell carcinomas of bladder with high sensitivity and high specificity.

Objective To investigate the clinical features,diagnosis and treatment of spontaneous rupture of renal angiomyolipoma (RAML). Methods A total of 23 cases of spontaneous rupture of renal angiomyolipoma were studied retrospectively.The main clinical manifestations were summarized as follows.Sudden and unexpected lumbar and abdominal pain occurred in 21 cases and lumbar swollen pain in 2.Of them 3 cases concomitantly had hematuria.Nausea and vomiting occurred in 2 cases,shock in 3 and fever in 1.All cases underwent B-ultrasonic examination and 21 had CT examination. Results Diagnosis of RAML was established preoperatively in 16 cases,but 4 cases were misdiagnosed for carcinoma of kidney,1 case for renal infectious disease.Two cases were diagnosed by frozen-section sample during operation.Nephrectomy was performed in 10 cases and nephron sparing nephrectomy in 12,and digital subtraction angiography (DSA) embolization in 1. Conclusions Spontaneously ruptured RAML often changes its clinical symptoms and imaging features,which may result in a high misdiagnosis rate and subsequent nephrectomy.Comprehensive analysis of clinical manifestations and image findings can improve preopreative diagnosis rate,and frozen slice sample examination during operation can avoid unnecessary nephrectomy.

Objective To study the clinical features,etiology,misdiagnosis of inflammatory pseudotumor in anterovesical space. Methods Four cases of inflammatory pseudotumor in anterovesical space were retrospectively reviewed.Their clinical processes and features were analyzed based on literature. Results In all 4 cases,partial bladder wall was infiltrated.Two cases were misdiagnosed as bladder carcinoma.All tumors and partial walls of bladder were successfully resected.All 4 patients were followed up for 3 months to 6 years.No recurrence was observed. Conclusions Prior ligation of fallopian tube and infection are important etiological factors of inflammatory pseudotumor in anterovesical space.Misdiagnosis can be avoided by analysing the history,clinical condition and special examination.The operative therapy is effective.

Objective To inquire into the diagnosis and management of renal angiomyolipoma.Methods The 22 cases of RAML were studied restrospectively.Results The diagnosis accuracy was 54.5% for B ultrasound and 81.8% for CT,18 were diagnosed as RAML and 4 were misdiagnosed as renal cell carcinoma preoperatively,of which 3 were diagnosed as RAML based on intraoperative frozen section study.11 had been performed enuoleation,7 partial nephrectomy,3 nephrectomy and 1 radical nephrectomy. Conclusions CT is the first line imaging method for RAML.the cow fatty component,intratumor hemorrhage and small tumor are the main canse of misdiagnosis in RAML.careful analysis to clinical feature and imaging data,intraoperative frozen sect,ion study can avoid misdiagnosis.nephron sparing surgery is the best operative management.

OBJECTIVE:To evaluate the therapeutic effect of pagosid on prostatodynia.METHODS:30patients with prostatodynia were evaluated;pagosid was taken orally1tablet t.i.d and NIH-CPSI was scored before treatment and q.w.4weeks after treatment.The results were evaluated.RESULTS:Effective rates from the first to the fourth week were16.7%,33.3%,40.0%,76.7%respectively.No obvious adverse reactions were found in the period of treatment.CONCLUSION:Pagosid has obvious effect on prostatodynia with pain as chief complaint,and few adverse reactions will develop.However it is slower to take effect,and therefore nonsteroid analgesic is recommended in the early stage of treatment.

Objective To study the clinical effect of qi supplementation combined with rehabilitation on the severity of fatigue after ischcmic stroke in patients with qi deficiency. Methods Ninety ischemic stroke patients with qi deficiency were randomly divided into 3 groups of 30. The treatment group was treated with an oral decoction of qi-supplementing Chinese medicine and also rehabilitation. The Western medicine control group was treated with a Chinese medicine placebo, Western medicine and rehabilitation. The blank control group was treated with the Chinese medicine placebo and rehabilitation. All groups were evaluated using a stroke-specific quality of life scale ( SSQOL) and a fatigue severity scale (FSS) before and 4 weeks after treatment. Results After treatment, the average SS-QOL and FSS scores had improved significantly compared with those before treatment, especially in the two treatment groups. There was a significant difference between the treatment group and the Western medicine control group,and between the treatment group and the blank control group on both scales. There was also a significant difference between the Western medicine control group and the blank control group in terms of SS-QOL scores, but not FSSscores. Conclusion All 3 treatments alleviated fatigue in ischemic stroke patients with a qi deficiency. Qi supplementation combined with rehabilitation was the most effective, followed by Western medicine combined with rehabilitation.

OBJECTIVE: Some studies have documented that living donor kidney transplantation has a better clinical results than cadaveric donors, however, it is poorly understood whether different living-related donors has different effects on kidney transplantation. The aim of this study is to discuss the clinical results of different living-related donors on kidney transplantation, in addition, to analyze the related problems including the donor selection, and relation of type matching with transplantation results. METHODS: Donors comprise 36 males and 58 females, aged (42.6±8.8) years. There were 72 males and 22 females received kidney transplantation, aged (33.9±8.7) years. Except for 6 cases being donated by spouse, 35 cases were donated by parents and 53 cases were donated by brothers and sisters. As to human leucocyte antigen (HLA) matching, 18 cases were full matched, 2 cases shared one-haplotype mismatched, 5 cases with 2-haplotype mismatched, 2 cases with 3-haplotype mismatched, 2 cases with 4-haplotype mismatched, and 1 case with 5-haplotype mismatched, 10 cases with full mismatched. Totally 85 cases had identical blood type, 9 cases had blood type compatibility. All recipients were negative for panel reaction antibody with smaller than 10% of lymphocytotoxicity tests prior to transplantation. RESULTS: All donors recovered well. Acute rejection episodes occurred in 8 patients, 4 cases donated by parents, 3 cases donated by siblings and 1 case donated by spouse. One recipient donated by spouse suffered accelerated rejection and delayed graft function recovery occurred. The renal function recovered in 5 weeks post-operation. All cases were reversed successfully by high intravenous dose of methyl-prednisolone or polyclonal anti-T-cell antibodies. A 6 month to 10 years follow-up showed all the donors kept normal kidney function without impairment of life quality, and 92 recipients with 92 grafts survived yet. Two recipients were dead: one due to serious pulmonary infection, and the other due to heart failure. 2 recipients underwent chronic allograft nephropathy. CONCLUSION: Living-related donor kidney transplantation has optimal HLA matches, low incidence of acute rejection and long-term surviving ratio and blood relative, which is better for renal transplantation.

Objective To contrast the efficacy of mechanical stapler and hand suture for cervical esophagogastrostomy in the treatment of esophayeal cancer.Methods From January 2001 to August 2007,217 cases of cervical esophagogastrostomy were done in esophageal carcinoma.Among them.136 cases were treated by mechanical stapler and 81 cases by hand.Results The incidence of anastomotic fistula was 2.2%(3/136)in mechanical stapler group and 11.1%(9/81)in the group by hand.There was significant difference between the two groups(P＜0.95).The incidence of cervical incision infection was 2.9%(4/136)in mechanical stapler group and 14.8%(12/81)in the group by hand.There was significant difference between these two groups(P＜0.05).There was no significant difference between these two groups about pulmonary infection,arrhythmia,chylothorax and laryngeal nerve injury.Conclusion The incidence of anastomotic fistula and cervical incision infection was reduced by mechanical stapler which was displayed to advantage in esophagogastrostomy.