Individual strategy of retroperitoneoscopic nephrectomy for benign non-functioning kidneys (84 cases) / 中国内镜杂志

Objective To explore the technique and clinical efficacy of retroperitoneoscopic nephrectomy (RN) at different anatomical plane for benign non-functioning kidneys. Method We retrospectively reviewed the clinical data of 84 patients who underwent RN for benign non-functioning kidneys from February 2010 to November 2016. Various anatomical plane was performed for differing etiology, image and plane, included radical nephrectomy (A group, n = 35), simple nephrectomy (B group, n = 27) and subcapsular nephrectomy (C group, n = 22). Clinical data and preoperative information was collected and analyzed. Result Nephrectomy was performed successfully in 84 patients. There are significantly longer mean operative time and more estimated blood loss in the C group than that in A group and B group (P < 0.05), however, postoperative hospital stay, complications and recovery time were significantly less in the three groups. There was longer mean operative time and more estimated blood in specific and nonspecific infection group compared with the other two groups (P < 0.05). Conclusion Retroperitoneoscopic nephrectomy, although challenging, is safe, reliable, and successful for treatment of benign non-functioning kidneys.Anatomical plane of avascular zone should be offered as the choice of modality to all patients with benign non-functioning kidney.

Establishment and application of Chinese Pediatric Evaluation of Disability Inventory norms in Chongqing, China / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To establish the Chinese Pediatric Evaluation of Disability Inventory (PEDI) norms in Chongqing, China.</p><p><b>METHODS</b>PEDI (English version) was translated into Chinese and proof read by back-translation. A total of 1 140 children stratified by age were randomly selected from Chongqing and evaluated by the Chinese version of the PEDI. The obtained data were statistically analyzed.</p><p><b>RESULTS</b>Of 1 140 questionnaires, 1 075 (94.3%) were valid. The data showed that the raw and scale scores of PEDI increased with age, but the standard scores did not increase with age. The raw, scale, and standard scores on self-care and social function scales were significantly lower than American PEDI norms in some age periods (P<0.05), but the raw, scale, and standard scores on mobility scale were not significantly different from American norms (P>0.05).</p><p><b>CONCLUSIONS</b>The PEDI norms in Chongqing have been successfully established, and can be used to assess the daily function in children, judge the degree of daily function impairment, evaluate the effect of rehabilitation training, and make the rehabilitation plan for disabled children.</p>

Diagnosis and treatment of xanthogranulomatous prostatitis: a case report and review of the literature / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the diagnosis and treatment of xanthogranulomatous prostatitis.</p><p><b>METHODS</b>A 75-year-old man presented with a 3-month history of difficult urination and frequent micturition, which was exacerbated for 2 days. Digital rectal examination indicated an enlarged prostate size of II degrees with hard texture but no tenderness. Serum total PSA was 172.5 microg/L. TRUS revealed 200 ml of post-micturition residual urine, thickened bladder wall, prostate size of 4.3 cm x 3.8 cm x 5.0 cm and no isochrones. MRI showed an enlarged prostate gland, with marked enlargement of the central zones and low-signal intensity of the peripheral gland, part of the prostate gland protruding to the bladder with no clear dividing line. It was diagnosed as prostate cancer initially, and confirmed by needle biopsy.</p><p><b>RESULTS</b>Histopathological examination revealed large numbers of "foamy macrophages" in the lesion, with a few multinucleated giant cells, leukocytes, mononuclear, plasmocytes and fibroplasia. Immunohistochemistry showed CD68 (+) and PSA (-). The patient was treated with oral Tamsulosin and glucocorticoid and by temporary catheterization, and followed up for 20 months. Urination symptoms began to alleviate and serum PSA to decrease at 4 months. The PSA level was 9.2 microg/L at 13 months and 3.6 microg/L at 17 months.</p><p><b>CONCLUSION</b>Xanthogranulomatous prostatitis is a rare clinically, which can be confirmed by histopathological examination. It is treated mainly by supportive therapy and, for the cases with severe lower urinary tract obstruction, TURP can be employed. Follow-up must be performed by possible examination of PSA and necessary needle biopsy of the prostate.</p>

Retroperitoneal laparoscopy combined with urethral resection for treatment of renal pelvic carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The purpose of this study is to explore the operation method and efficacy through retroperitoneal laparoscopy combined with urethral resection for treatment of renal pelvic carcinoma.</p><p><b>METHODS</b>Total nephroureterectomy with excision of bladder cuff by retroperitoneal laparoscopy plus urethral resection was performed in 18 patients with pathologically confirmed pelvic transitional cell carcinoma (II-III, T1N0M0-T2N0M0). The operation was performed using Olympus celioscope (30 degrees or 0 degree) under general anesthesia. First, a 10 mm incision was made at the intersection of midaxillary line and superior border 2 cm from crista iliaca, then a self-made hyponome filled with 250-300 ml water was put through the small incision in order to open the retroperitoneal space, followed by getting the hyponome out and perfusing CO2 into the retroperitoneal space to make a pneumoretroperitoneum. Finally, the celioscope was put into the retroperitoneal space to operate. During the operation, electric coagulation was used to stop bleeding and the bladder was not irrigated.</p><p><b>RESULTS</b>The operation was successfully performed in 18 patients without any complication. The operative time ranged from 150 to 190 min with a mean of 160 min. The hospital stay after operation was 7 to 10 days. There was no tumor recurrence or metastasis or implantation in all these patients after follow-up of 1-19 months.</p><p><b>CONCLUSION</b>Compared with regular operation mode, retroperitoneal laparoscopy plus urethral resection for treatment of renal pelvic carcinoma is a minimally invasive treatment with less bleeding and quick recovery.</p>

Heme oxygenase-1 gene transfer protects rat kidney transplant from ischemia/reperfusion injury / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the protective effect of Heme oxygenase-1 (HO-1) gene transfer on rat renal autograft against ischemia/reperfusion injury.</p><p><b>METHODS</b>HO-1 recombinant adenovirus vectors were constructed and transduced into rat renal autograft by renal arterial perfusion. The renal autografts were transplanted orthotopically after store at 4 degrees C for 24 h, followed by contralateral native nephrectomy 5 d after transplantation. There were 25 rats in the control group. 5 h and 3 d after transplantation, reverse transcriptase polymerase chain reaction (RT-PCR) and immunohistochemistry were used to detect the expression of HO-1 gene; enzyme-labeled immunosorbent (ELISA) was used to measure HO-1 protein content in the homogenate of renal autograft.</p><p><b>RESULTS</b>The intensity of HO-1mRNA expression at 3 h and 3 d after transplantation were 0.65 +/- 0.11, 0.86 +/- 0.17 in the experimental group and 0.09 +/- 0.01, 0.15 +/- 0.02 in the control group respectively. The differences between the two groups were significant (t = 14.38, 11.73, P < 0.05). HO-1 protein content at 3 h and 3 d after transplantation were significantly increased in the experimental group, as compared with the control group [(297 +/- 61) ng/g and (468 +/- 51) ng/g versus (98 +/- 30) ng/g and (155 +/- 31) ng/g; t = 8.27, 14.83, P < 0.05]. HO-1 transduced autografts had less renal ischemic injury and lower serum creatinine level compared with control animals (P < 0.05).</p><p><b>CONCLUSION</b>Adenoviral vector can successfully transduce rat kidneys with the HO-1cDNA, which can protect rat renal autografts from ischemia/reperfusion injury.</p>