Objective The diagnosis and treatment of renal angiomyolipoma were studied. Methods A total of 72 cases of renal angiomyolipoma encountered and treated from Jan. 1983 to Dec. 1999 were reviewed. Results Of the 72 cases, 13 were misdiagnosed preoperatively.The positive diagnosis rate of ultrasonography was 73.6%(53/72) and that of CT 81.9%(59/72).10 cases( 13.9 %) had been misdiagnosed preoperatively with the combined use of ultrasonography and CT.Tumors smaller than 4 cm had a significantly higher misdiagnosis rate( P

Objective:To investigate changes of the stage,age of onset,and prostate specific antigen(PSA) level of prostate cancer with socioeconomic development and medicare promotion.Methods:The medical records of 784 inpatients with prostate cancer were analyzed retrospectively,who were diagnosed in Peking University First Hospital from 1997 to 2007.According to the time of diagnosis,all the patients were sorted into three groups:earlier group(1997-2001),intermediate group(2002-2004),and contemporary group(2005-2007).The tumor stages,ages,Gleason scores,and PSA levels of each group and of the three groups were compared to determine whether the discrepancies were significant.Results:The discrepancies of ages,Gleason scores,and stages between earlier and intermediate groups were not significant.The differences of ages and stages between intermediate and contemporary groups were not significant,but the change of Gleason scores was significant.The discrepancies of Gleason scores and stages between earlier and contemporary groups were meaningful,but the change of ages was not significant.Conclusion:As time passes,PSA levels and tumor stages of prostate cancer patients show a descending trend,but the discrepancy of ages between the three groups is meaningless.The weight of low risk and intermediate risk groups in localized prostate cancer is becoming heavy.

Objective To analysis the impact of ? blocker therapy on symptoms of benign prostatic hyperplasia(BPH). Methods 148 cases of BPH patients had been treated with ? blocker for 4 weeks. Symptom score, uroflowmetry and post voiding residual urine were recorded and analyzed. Results After 4 weeks of treatment, the IPSS, uroflowmetry and residual volume were improved significantly, P 0.1. Conclusions Reduction of symptoms and improvements of uroflowmetry in BPH patients treated with ? blocker.might be initiated through different mechanisms.

AIM: To investigate the expression of midkine in bladder transitional cell carcinoma and to analyze its relationship with the features of clinical pathology and prognosis.METHODS: The expressions of midkine protein in 50 cases of bladder transitional cell carcinoma samples were detected by SP immunohistochemical method using polyclonal antibodies against human midkine.Survival time of 40 cases was recorded.RESULTS: The protein expression of midkine was found in cytoplasm of tumor cells.The overall positive rate of midkine in 50 cases of bladder carcinoma was 90%(45/50).The positive degree of midkine showed a trend of increasing in grade and stage.There was statistically significant difference among them(P0.05).Patients with high expression of MK predicted a poor clinical outcome.CONCLUSION: Midkine is overexpressed in bladder transitional cell carcinoma than that in normal bladder.MK expression in bladder cancer is higher in less differentiated and deeper invaded cases,but it has no correlation with age,sex,treatment,tumor number and size.Patients with higher MK expression have shorter survival time than those with lower MK expression.

Objective To validate the Partin table 1997,2001 and 2007 for their accuracy in predicting pathologic stage in Chinese prostate cancer patients.Methods From January 1997 to June 2007,109 consecutive patients with clinically localized prostate carcinoma underwent open retropubic or laparoscopic radical prostatectomies and met all inclusion criteria well enrolled.Receiver operating characteristic(ROC)analysis was performed tO test the predictive accuracy of organ confined disease (0CD),extraprostatic extension(EPE),seminal vesicle involvement(SVI)and lymph node involvement(LNI). Results OCD,EPE,SVl and LNl were noted in 70%,17%,13%and 0%of cases respectively.The area under curve(AUC)of ROC for Partin table 1997 was 0.727,0.654 and 0.811for 0CD.EPE and SVl respectively,and was 0.693,0.633 and 0.835 for Partin table 2001 and 0.669.0.611 and 0.778 for Partin table 2007.Conclusions Partin tables 1997,2001 and 2007 are able to accurately predict the pathologic feature of seminal vesicle involvement.However,only Partin table 1997 can more accurately predict organ confined disease in this external validation for Chinese patients.

Objective:To describe our diagnostic and therapeutic experience of patients with urinary tract endometriosis.Methods:We performed a retrospective analysis of 22 cases of urinary tract endometriosis with histopathological results from 2001 to 2007.Results:The mean patient age was 36.0 years.Of the 22 patients,4 had bladder involvement and 18 ureteral involvement.In those with bladder endometriosis,the diagnosis was made by cystoscopy and biopsy in 4 patients.The treatments consisted of partial cystectomy in 3 patients and transurethral resection of the bladder in 1 patient.One of the patients who underwent transurethral resection of the bladder experienced 1 relapse.The relapse was treated with partial cystectomy.In the patients with ureteral endometriosis,the diagnosis was mainly established by ultrasound(18 cases),intravenous urography(11 cases),retrograde pyelography(7 cases),CT(14 cases) and MRI(5 cases).The treatments consisted of ureterolysis in 1 patient,ureteroneocystostomy in 4,and ureteral resection and end-to-end anastomosis in 13 of them.All the patients pathologic results were of endome-triosis.Conclusion:Urinary tract endometriosis is an uncommon disease.Partial cystectomy should be considered as the therapeutic option for bladder endometriosis.For cases of ureteral endome-triosis,the first technique depends on the location,extent and depth of the lesion.

Objective To review the experience in diagnosis and treatment of pheochromocytoma in a single center. Methods A total number of 142/145 pheochromocytoma cases treated surgically in our institute from August 2002 to February 2010 were retrospectively reviewed. The mean diameter of tumor was 5.9 cm (1.3- 18. 0 cm). The majority of the tumors (92.9%) were adrenal pheochromocytomas. Ninety-eight patients (69.0 % ) presented initially with hypertension, whereas 44 patients (31%)presented with adrenal incidentaloma. A specific anti-hypertensive pre-surgery preparation with phenoxybenzamine or doxazosine mesylate was started over 1 week before the operation.Of the 142 patients, 91 accepted open surgery, 54 accepted laparoscopic surgery, of which, 5 converted from laparoscopic surgery to open surgery. Results Histopathological results showed that all the cases were pheochromocytoma, while 83 cases were benign, 23 cases were malignant and 37 cases were suspected malignant. Sudden rising of blood pressure during operation was related to the preoperative serum level of catecholamine. Eighty-seven of 98 patients with preoperative hypertension had normal postoperative blood pressure; the remaining 11 patients reduced the dosage of anti-hypertension medication postoperatively. During the follow-up of 3-96 months (median 46 months), 10 of 91patients had a recurrence or metastasis. Six patients died of recurrences or metastasis within 5 years.Conclusions The procedures of qualitative and locative diagnosis of phechromocytoma include clinical manifestations, biochemical tests and imaging investigation. Surgical excision is the fundamental treatment for cure. Patients with high serum level of catecholamine tend to have a sudden rising of blood pressure during operation. Preoperative management is extremely important for the safety of the patient. Intensive follow up is necessary.

Objective:To assess the clinical utility of a fluorescence in situ hybridization(FISH) assay as a non-invasive method for diagnosing and monitoring urothelial carcinoma(UC) in the upper urinary tract(UUT).Methods:Urine specimens from 63 consecutive patients with UUT-UC and 69 controls with benign disease were analyzed by means of cytology and FISH.For FISH analysis,labeled probes specific for chromosomes 3,7,and 17 and for the p16(9p21) gene were used to assess chromosomal abnormalities indicative of malignancy.Sensitivity and specificity of both techniques were determined and compared.The frequency of chromosomal aberrations of malignant cells from UUT-UC was also determined.Results:Of 63 patients with UUT-UC,FISH affords an overall sensitivity of 84.1%(53/63),the figure being 71.4%(20/28)for PTa and PT1 tumors,94.3%(33/35) for PT2-4 tumors.The sensitivities of urine cytology were 35.7%(10/28)for PTa and PT1 tumor,45.7%(16/35)for PT2-4 tumors,with an overall sensitivity of 41.3%(26/63).The sensitivities of the two methods for the low grade tumors were 80%(20/25)and 44%(11/25),and for high grade tumors were 86.8%(33/38)and 39.5%(15/38),respectively.Specificities for FISH and urine cytology were 91.3%(63/69)and 94.2%(65/69)respectively.Conclusion:According to the results,the sensitivity of FISH for the detection of UUT-UC is superior to that of urine cytology and the specificities of FISH and urine cytology are not significantly different.FISH can promote the diagnosis of UUT-UC,especially for the low stage and low grade cases,it may be a new promising non-invasive method for the diagnosis of UUT-UC.

Objective To evaluate the impact of preoperative renal artery embolization in renal cell carcinoma patients with venous tumor thrombus.Methods A total of 249 RCC patients with venous tumor thrombus underwent radical nephrectomy and thrombectormy in our hospital.Seventy-four patients received preoperative renal artery embolization while other 175 patients did not.The related items were analyzed.The tumor thrombus level was divided into 5 groups with American Mayo clinic classification system.Considering the significant difference in tumor situation and treatment strategies, we took the hepatic vein as a cut-off line, dividing patients into two subgroups, the early and advanced tumor thrombus groups.There were 208 patients in the early tumor thrombus group and 41 patients in the advanced group.The related items were analyzed respectively.Results Patients in the embolization group tended to have larger tumors and higher percentage of advanced tumor thrombus.For all patients, the embolization group had longer operation time [(4.8 ±2.1) h vs.(4.1 ±2.2) h ,P <0.05] and greater median blood loss (900ml vs 500 ml,P <0.05), compared to the non-embolization patients, and RAE did not show benefits on perioperative outcomes seemingly.However, subgroup analysis of patients with advanced tumor thrombus ( above hepatic vein) , in spite of the larger size of tumor, preoperative RAE showed significant benefits on reducing operation time [(7.0 ±1.7)h vs.(8.2 ±1.8)h, P<0.05)] and intraoperative blood loss (2 000 ml vs.3 000 ml, P<0.05) and decreasing blood transfusion (1 525 ml vs.2 050 ml ,P>0.05).Conclusion Preoperative RAE may be more appropriate for patients with advanced tumor thrombus because of its benefits in reducing operation time, intraoperative blood loss and elevating the operative security.

Objective To analyze the clinical characteristics of renal cell carcinoma (RCC) and unveil the current status of diagnosis and treatments. Methods The registry data from 23 medical centers cover different areas of China. A total of 2030 new cases of RCCs in the 23 centers from Au-gust 2007 to October 2008 were collected, in which 1975 cases had integrated data for analysis. The symptoms, diagnostic techniques, pathology features, and therapeutic selection were analyzed. Re-sults A total of 1975 new cases were reviewed, with 1329 males and 634 females. The male and fe-male ratio was about 2.1 : 1.0. Of all cases, 1238 patients (62.7%) were asymptomatic and detected by examination, while 711 patients (36.0%) were symptomatic. 1260 patients (63.8%) were clinical stage Ⅰ , most of them were asymptomatic. 1844 patients were treated surgically, 1500(81.3%) un-derwent radical nephrectomy, 325 (17. 6%) underwent partial nephrectomy. Among the operations, open operation was performed in 1493 cases(81.0%), laparoscopic procedure in 351 cases(19.0%). There were 1522(84.5%) clear cell carcinomas, 98 (5.44%) papilliform renal cell carcinomas. Con-clusions Routine health examination could be an important way to diagnose early stage RCC. Open radical nephrectomy is the most often used surgical technique among the centres of present study.