Objective To analyze the complication rates in 210 patients undergoing transrectal ultrasound-guided 24-core transperineal prostate biopsy.Methods Clinical data of 210 patients who underwent transrectal ultrasound-guided 24-core transperineal prostate biopsy from 2010 to 2012 were collected.A retrospective analysis of complications after prostate biopsy was conducted.Results The main postoperative complications were hematuria,bloody stool,dysuria,urinary retention,fever (＞38℃),urinary infection,vasovagal syncope,and their complication rates were 43.3 ％ (91/210),10.9％ (23/210),23.3％ (49/210),25.2％ (53/210),14.8％ (31/210),21.9％ (46/210),0.48％ (1/210) respectively.In addition,5 patients (2.5％) were hospitalized due to biopsy related complications.Conclusions Transrectal ultrasound guided 24-core transperineal prostate biopsy is an relatively safe and effective puncture method with common minor complications and less severe complications.Adequate attentions should be paid to its complications.

Seven cases of renal tumor treated at our hospital from May 2009 to November 2011 were assigned to undergo laparoscopic ultrasonography assisted laparoscopic partial nephreetomy.The mean operative duration was 109 minutes (range:102-121).And the mean volume of blood loss was 82 ml (range:60-120).All patients had confirmed negative margins.Renal clear cell carcinoma was definitely diagnosed in all cases.Laparoscopic ultrasonography could provide more precise information of renal tumor within renal capsule.Thus it may be used to guide the operation so that tumors are excised more completely,residual tumor tissues avoided and normal renal tissues protected.

A retrospective analysis was conducted for male Han patients aged 46 years or above undergoing serum test of total prostate specific antigen (tPSA) at our hospital from 2007 to 2009.Among them,there were 109 patients with complete clinical data (including a history of hypertension and dyslipidemia),including 36 type 2 diabetics and 73 non-diabetics.For type 2 diabetes and non-diabetes groups,the median values (lower quartile,upper quartile) of serum tPSA test results were 1.01 (0.44,3.43) μg/L and 2.26 (1.04,5.48) μg/L (t =-2.65,P ＜0.01) respectively.The serum level of tPSA in type 2 diabetics was significantly lower than that in non-diabetics.

Objective To explore the diagnosis and treatment features of tuberous sclerosis complex associated renal cell carcinoma.Methods A 22-year-old boy with a childhood history of epilepsy and mental retardation presented with a complaint of intermittent painless gross hematuria for the past 2 years.After superselective left renal artery embolization was done twice in the past year, painless gross hematuria was still repeated with 6- 10 months intervals.Physical examination showed retarded face, obesity, visible facial angiofibroma and a ditch fibroma.CT scan showed irregular lesions.The largest cross-section 14.2 cm × 9.0 cm in the left kidney was inhomogeneous enhanced from 45 - 54 HU in the plain phase to 60 - 78 HU in the contrast phase.Filling defect in the left renal vein and multiple fat-density lesions (CT value of -25 - -38 HU) with the largest cross-section 7.2 cm× 5.7 cm in the right kidney were also found in contrast CT scan.The PUBMED and CBM database were reviewed.Results Open retroperitoneal radical left nephrectomy was performed.Pathology showed renal clear cell carcinoma and renal vein thrombosis.There was no tumor recurrence or distant metastasis at 4-month follow-up.Conclusions Tuberous sclerosis complex associated renal cell carcinoma is rarely reported.Timely nephron-sparing surgery is necessary when the diagnosis is established, or radical nephrectomy is also necessary if nephron-sparing surgery is impossible.

The perivascular epithelioid cell (PEC) is a cell type constantly present in a group of tumors called PEComas(perivascular epithelioid cell tumors). PEC expresses myogenic and melanocytic markers,such as HMB45. PEComa is a widely accepted entity now. PEComas are related to the genetic alterations of tuberous sclerosis complex (TSC), an autosomal dominant genetic disease due to losses of TSC1 or TSC2 genes. PEComas are rare in the urinary system and there are some open questions about PEComas regarding its histogenesis, the definition of epithelioid angiomyolipoma and the identification of the histological criteria of malignancy. This review provides an update on PEComas of the urinary system.

Objective To investigate the curative effect of RevoLix 2 micron continuous wave laser va-poresection for treatment of elderly and high risk benign prostatic hyperplasia patients. Methods Clinical data of 36 benign prostatic hyperplasia patients with medical complications aging 70 -82 years were retro-spectively analyzed. Operations were done after their complications were controlled. The RevoLix 2 μm laser system with output power of 70 W was used, and normal saline was used as rinse solution. Operations were started after positions of seminal colliculns and distances to neck of bladder were confirmed. Results Oper-ation time varied from 65 to 135 rain with a mean time of (83.6±10. 6) rain. Occasional venous hemor-rhage occurred during operation but no arterial hemorrhage was observed. No blood transfusion necessitated and no TURP syndrome was observed. Catheter was removed 2-4 days after operation. All the patients could urinate freely. No urinary incontinence was found during follow-up except 2 patients with temporary urinary incontinence. A 3-6 months follow-up showed that IPSS decreased from 24. 26 ±2. 70 to 8.47±4. 32, QOL dropped from 4. 51±0. 56 to 1.34 ± 0. 53, and Qmax increased from (6. 37 ± 1.31) mL/s to (17.24± 2. 32) mL/s. Conclusions RevoLix 2 micron continuous wave laser vaporesection is a safe and effective method with less trauma and fast recovery for treating elderly and high risk benign prostatic hyperplasia pa-tients.

Objective To discuss the feasibility of laparoscopic renal surgery following kidney rupture.Methods Two patients with left kidney rupture were treated laparoscopiclly at our institution in the last 4 years. 1 operated 7 days after hemorrhage and another operated immediately. Both of them performed retroperitoneal laparoscopic nephrectomy. Results The operations succeeded, the operating time being 100～120 min, the blood loss 200～300 mL. There were no postoperative complications in all cases. Conclusion Laparuscopic exploration and extirpation offer a viable measure to treat kidney rupture.

Objective To evaluate the safety and feasibility of minimally invasive percutaneous nephro-lithotomy (mPCNL) with U100plus laser for the treatment of renal calculi. Methods From October 2006 to December 2008 ,mPCNL was performed on 133 patients suffering from renal calculi by using Wolf 8/9. 8 rig-id ureteroscope and U10Oplus laser. Results mPCNL was completed in all the 133 cases. Residual calculi were found in 7 cases after operation and use medical drags to treat. The most residual calculi were removed after 1 month and a few stones being survived. 5 cases with residual calculi were treated by ESWL. The total stone clearance was 91.0%. The operation time was 38 -65 min(mean 46 min). Nephrostomy tube was kept for a mean of 1 -2 d. The mean postoperational hospital stay was 2 -4 d. Among the patients, 133 were followed up for 1-16 months (mean 8. 3 months) , during which no recurrent renal stones were found by B ultrasonngraphy or X ray. Conclusion By using mPCNL with U100plus laser, patients with renal calculi can be treated safely and effectively.

Interleukin-22 (IL-22) is a new kind of eytokine discovered in 2000. The major sources of IL-22 are activated T1 -cells and NK-cells. Tissue cells at outer body barriers, i.e. of the skin, kidney, the di-gestive and respiratory systems all highly express IL-22R or respond to IL-22. IL-22 functions by promoting the anti-microbial defense, inducing phase reactants, protecting against damage and enhancing natural immu-nity. Furthermore, IL-22 mediates the proliferation, differentiation and apoptesis in cancer cells, that gives us a new idea about tumor therapy.

Objective To evaluate the feasibility of using pure laparoscopic radical nephrectomy and thrombectomy to treat renal tumor with renal vein and vena caval thrombus. Methods Two ca-ses o{ right renal tumor with renal vein and vena caval thrombus were reported. Contrast-enchanced CT showed renal tumor extended into renal vein and vena cava in 1 case, and filling defect was found in right renal vein and extended to vena cava in the other. Both patients received pure laparoscopic ra-dical nephrectomy and thrombectomy through retroperitoneal approach. Four trocars were placed du-ring the operation, and the renal artery was dissected before the vena cava was mobilized circumferen-tially above and below the renal vein, a faparoscopic vessel blockage clamp was used to partly occlude the vena cava containing the thrombus. The vena cava was repaired after the intact tumor thrombus was extracted. Results The tumor thrombus extended 0.3 cm and 1.0 cm above the renal vein, re-spectively. Both patients were discharged 5 d after operation. Pathological examinations showed that tumors were epithelioid renal angiomyolipoma and grade Ⅰ-Ⅱ clear cell carcinoma separately. Both patients were free of local recurrence and metastasis 5 months after operation. Conclusion Pure la- paroscopic radical nephrectomy and thrombectomy for renal tumor with vena caval and renal vein thrombus is feasible in carefully selected patients.