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Objective To investigate the clinicalmanifestations,imaging features,diagnosis and differential diagnosis,treatment and prognosis of renal malignant solitary fibrous tumor(SFT).Methods The clinical data in 1 case of rare renal malignant SFT were retrospectively analyzed.Referring to related literatures,the histological origin,pathological features,differential diagnosis,treatment and follow-up of renal malignant SFT were analyzed.Results The patient was preoperatively diagnosed as right renal clear cell carcinoma.Postoperative pathological examination diagnosed as low grade malignant SFT of right kidney.And immunohistochemistry indicated CD34+,BCL-2 +,CD68+,CD99+,vimentin,Ki-67 5％ +,SMA focal weakly positive.No recurrence or metastasis occurred after 4-month follow-up period.Conclusion Malignant SFT of the kidney is very rare,its diagnosis and differential diagnosis depend on postoperative pathological and immunohistochemical examination.Radical nephrectomy is the main option for malignant SFT of the kidney with good prognosis.
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Objective To explore the effect influencing factors of ureteroscopic holmium laser lithotripsy in treating ureteral calculus.Methods A total of 274 cases of ureteral calculus in our hospital from February 2012 to December 2015 were selected.The treatment effects and complications were observed,and the relationship between clinical parameters and operation success rate was analyzed.Results The one-time successful rate of ureteroscopic holmium laser lithotripsy was 95.25％,no serious complications occurred.Among 274 cases,there was correlation in the aspects of whether complicating polyps,calculus size,whether complicating ureteral stenosis,hospitalization duration,operation time and postoperative indwelling catheter time in the success group and non-success group (P＜0.05).Conclusion The ureteroscopic holmium laser lithotripsy in treating ureteral calculus has good effect and high successful rate.
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Objective To explore the effect influencing factors of ureteroscopic holmium laser lithotripsy in treating ureteral calculus.Methods A total of 274 cases of ureteral calculus in our hospital from February 2012 to December 2015 were selected.The treatment effects and complications were observed,and the relationship between clinical parameters and operation success rate was analyzed.Results The one-time successful rate of ureteroscopic holmium laser lithotripsy was 95.25％,no serious complications occurred.Among 274 cases,there was correlation in the aspects of whether complicating polyps,calculus size,whether complicating ureteral stenosis,hospitalization duration,operation time and postoperative indwelling catheter time in the success group and non-success group (P＜0.05).Conclusion The ureteroscopic holmium laser lithotripsy in treating ureteral calculus has good effect and high successful rate.
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Objective To decrease the error and missed diagnosis of xanthogranulomatous cystitis(XC) .Methods Combined with laboratory and imaging examnation ,we considered the diagnosis of urachal carcinoma complicated by urinary track infection . Anti-infection treatment before surgery ,we removaled of the pathological tissues ,and the final diagnosis was XC .Results The clin-ical symptoms of XC was not typical ,and this case was similar to that of urachal carcinoma .Cystoscope and imaging examination had no specificity .There were not frequent micturition ,the the urgency of urination and low back pain of patiut of the patient by one year follow-up .Conclusion XC is very rarely ,and it is hard to differentiate from other bladder diseases ,tumor of the urachus .The final diagnosis may still depends on histopathological examination .
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Objective To summary the experience of laparoscopic cystectomy ileal conduit (Bricker) and orthotopic ileal neo‐bladder (Hautmann) and compare the short‐term efficacy of the two types of urinary diversion for invasive bladder cancer . Methods Retorspective analysis of the patients in our hospital who accepted laparoscopic radical cystectomy from 2010 to 2014 was performed ,74 of them accepted ileal conduit ,and 30 of them accepted orthotopic ileal neobladder .The general clinical data ,postop‐erative recovery ,postoperative complications and Oncology feature were analyzed and compared between the two groups .Results There was no demonstrable difference was found in operation time ,blood loss ,intraoperative blood transfusion rate ,the number of removed lymph node ,average hospital stay ,specimens positive margin rate and postoperative pathology results between the two groups (P>0 .05) .But there were significant difference in postoperative intestinal function recovery time[(4 .2 ± 1 .4)d ,(5 .3 ± 2 .2)d] ,(P=0 .002) ,and the complication rates 31 .9% (23 cases)vs .53 .3% (16 case) ,P=0 .043 .After 6 months ,the daytime and nighttime urinary control were 76 .9% ,57 .7% ,after 12 months ,the daytime and nighttime urinary control increased to 90 .9% , 81 .8% .2 cases(7 .7% ) were diagnosed with recurrence or metastasis during follow‐up in Hautmann group ,while 9 cases(14 .1% ) were diagnosed with recurrence or metastasis in Bricker group .Conclusion Two kinds of surgical procedures both have the similar therapeutic effect ,but the postoperative quality of life is better for Hautmann orthotopic neobladder patients .
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Objective:To evaluate the function of bladder after gastrocystoplasty.Methods:38 patients after gastrocystoplasty were analyzed by observing the micturition and examination of urodynamics and to investigate the function of bladder during the filling and the micturition.Results:In the 38 patients,voiding interval time was 3.2?1.7hours;unirary output was 320?110ml;maximual flow rate was 19?7.2 ml per second;intravcsical pressure during filling was 11.2?8.2 cmH 2O;maximual intravesical pressure during voiding was 58?21 cmH 2O;and maximual pressure of detrusor was 28?12 cmH 2O.In total 38 cases,residual urine was observed in 11 cases,and residual volume was 55?34ml.12 cases developed uracratia or enuresis.Conclusion:Filling function of bladder is satisfactory after gastrocystoplasty,the micturition is carried out mainly by the action of intra-abdominal pressure.The disturbance of function of the sensation of bladder and the urethral sphincter is possibly the common cause for uracratia or enuresis.
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Objective To explore the feasibility of detecting the cytokeratin 20 (CK-20) mRNA in exfoliated urothelial cells for the diagnosis of bladder carcinoma. Methods Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect the expression of CK-20 mRNA in cells collected from the urine of 45 cases of bladder cancer, 15 cases of cystitis accompanied by hematuria, 10 healthy volunteers, and 7 different cell lines, including bladder cancer cell line T24, kidney cancer 786-0 and GRC-1, breast cancer MCF-7 and MDA-MB-435, and ovary cancer SKOV 3 and 3AO. Results CK-20 mRNA expression was detected in 36 of 41 cases of bladder transitional cell carcinoma (87.80%), in 18 of the 21 GⅠ patients (85.71%), in 11 of the 13 GⅡ patients (84.62%), in 7 of the 7 GⅢ patients (100%), in 20 of the 22 T a-1 patients (90.91%), and in 16 of the 19T 2-4 patients (84.21%). Sensitivity of the method was found to be 87.80%, whereas specificity was 73.33%. In 15 patients with hematuria, there were 4 cases of false positive: 1 case of BPH, 1 case of atypical hyperplasia, 1 case of chronic inflammation, and 1 case undergoing TURP previously. CK-20 amplification band was also obtained in all of 19 cases of bladder transitional cell tumor tissues and bladder cancer cell line T24, but not in 4 patients with non-transitional cell carcinoma and 6 other tumor cell lines. No false positive cases were found in the healthy control group. Conclusion These results suggest that CK-20 might be a useful tumor marker for early noninvasive diagnosis and follow-up of bladder cancer by detecting CK-20 mRNA expression of uroepithelial cells from the voided urine specimen by RT-PCR.
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A new technigue of the macroscopic vasovasostomy has been reported. The procedure was carried out by suturing only tunic of the both ends of the vas with catgut to splint and reduce tension(Group 1 ).In animal experiment, this technigue was compared with following methods of vasovasostomy. ( 1 ) .tunic-muscular layer anastomosis without splint(Group 2),(2).whole layer anastomosis with stainless steel splint (Group 3) and (3).whole layer anastomosis without splint. Among all dogs,the operative procedure was performed without the aid of optical magnification nor any special instruments. The four technigues were tested in 60 dogs (120 vasa) in which each of them used 15 dogs (30 vasa). The results of the dog experiments showed that the anatomical patency rates of the Group 1,2,3 and 4 after operation were 63.3%, 66.7%, 23.3%and 10%.Our studies indicate that the use of absorble catgut as an intravasal splinting and reducing tension in vasovasostomy is feasible in dogs.Gross as well as microscopic evaluation of the anastomotic area demonstrated that the intraluminal material was substantially absorbed with nosignificant reaction after operation.As compared with other macroscopic vasovasostomies, this technic is claimed to be simpler, easier, less traumatic, effective and feasible