Papillary renal cell carcinoma: 14 case report with literature review / 中华泌尿外科杂志

Objective To study the characteristics of different papillary renal cell carcinoma (PRCC)subtypes and their prognosis after nephrectomy.Methods Clinical data of 14 PRCC patients(7 males,7 females)with ages ranging from 20-77 in our institute from 2005 to 2011 were retrospectively reviewed.There were 5 tumors in the left kidney and 9 tumors in the right kidney.The average maximum tumor diameter was 3.8(1.6-7.8)cm.Patients presented with gross hematuria(n =3),flank pain(n =3),palpable abdominal mass(n =1)or asymptomatic(n =7).The TNM stages were 8 T1aN0M0,2 T1bN0M0,1 T1aN0M1,1 T2aN0M0,1 T3aN0M0 and 1 T3aN1 M0.Six patients were treated with radical nephrectomy,8 cases were treated with partial nephrectomy.Results There were 6 type Ⅰ and 8 type Ⅱ PRCCs cases.In pathology,type Ⅰ PRCC showed papillae covered by small cells with scanty basophilic cytoplasm,and arranged in a single layer on the papillary basement membrane with low nuclear grade.Type Ⅱ PRCC was composed of cells with higher nuclear grade,abundant eosinophilic cytoplasm,and pseudostratified nuclei on papillary cores.There were 12 well-differentiated cases,2 moderate-differentiated cases and no poorly differentiated case.Follow-up was carried out from 12to 80 months.During the follow-up,1 patient with type Ⅰ PRCC developed multiple lung metastases 26 month after surgery and deteriorated into hepatic and bone metastases at 34 month after surgery.We offered the patient with targeted therapy and the patient was still alive.There was 1 type Ⅱ PRCC patient died with multiple metastases at 42 month after surgery.Others were still alive without local recurrence and metastasis.Conclusions PRCC is not a common subtype of renal cell carcinoma in China.Early stage PRCC patient would achieve good prognosis after treated with nephrectomy.Targeted therapy is a good treatment option for metastatic papillary renal cell carcinoma patients.

Clinical efficacy of tolterodine tartrate combined with transcutaneous electrical nerve stimulation in the treatment of elderly female patients with overactive bladder / 中华老年医学杂志

Objective To study the clinical efficacy of tolterodine tartrate combined with transcutaneous electrical nerve stimulation(TENS)in the treatment of elderly female patients with overactive bladder(OAB).Methods 30 patients with OAB were randomly divided into single treatment with tolterodine tartrate and combination treatment of tolterodine tartrate and TENS for 10d.The efficacy was evaluated by overactive bladder symptom score(OABSS),patient perception of bladder condition(PPBC),quality of life(QOL),visual analogy scale(VAS)and 5 grade pain scores.Results The post-treatment symptoms of urgent urination and urinary incontinence,OABSS,PPBC,QOL,VAS and 5 grade pain scores in single treatment group[(1.67±1.45)times /d,(1.53±1.25)times /week,(6.67±2.55)scores,(2.07±0.96)scores,(2.07±1.03)scores,(3.67±0.90)scores and(4.07±0.80)scores]were improved as compared with pre-treatment[(6.40±1.45)times /d,(3.93±1.03)times/week,(13.00±1.00)scores,(4.20±0.68)scores,(3.80±0.68)scores,(7.13± 1.19)scores and(9.40± 1.55)](t=8.94,5.74,8.94,7.03,5.44,9.01 and 11.85,all P＜0.01).The above indexes in combination treatment group after treatment[(1.27±0.80)times/d,(1.20±0.77)times/week,(5.33±1.72)scores,(1.67±0.62)scores,(1.47±0.52)scores,(2.93±0.80)scores and(3.40±0.99)scores]were also improved as compared with pretreatment[(6.20±1.26)times/d,(4.00±1.25)times/week,(12.73±1.03)scores,(4.07±0.80)scores,(4.00±0.65)scores,(7.47±0.74)scores and(9.67±1.35)scores](t=12.77,7.36,14.29,9.21,11.77,16.09 and 14.55,all P＜0.01).The VAS and 5 grade pain scores were higher in combination treatment group than in single treatment group(t=4.879 and 2.746,P＜0.01).Conclusions Tolterodine tartrate combined with TENS is safe and effective for the treatment of elderly female patients with OAB,and may alleviate pain and improve quality of life.

Urodynamics parameters in female urinary incontinence patients with pelvic organ prolapse / 中华泌尿外科杂志

Objective To compare the urodynamic parameters in female patients with incontinence with or without pelvic organ prolapse. Methods The urodynamic data from 140 patients diagnosed urinary incontinence and another 42 patients coexisted with pelvic organ prolapse were reviewed and analyzed. The urodynamics parameters were compared in perfusion, urination, bladder compliance, maximum urinary flow rate (Qmax), detrusor muscle pressure of maximum urinary flow rate (Pdet,Qmax), minimum urinary flow rate(Pdet, Qmax), urethral resistance factor (RUA), obstruction of bladder index (OBI) and normalized detrusor contractility. The influence of pelvic organ prolapses with incontinence on bladder filling and voiding function was evaluated also.Results There were no significant differences between 140 patients of urinary incontinence and 42 patients coexisted with pelvic organ prolapse in perfusion (P=0.142), bladder compliance (P=0.273), Qmax(P=0.192),Pdet (P=-0. 629), Qmin (P=0.365) and normalized detrusor contractility (P=0.380). There were significant differences in age(P=2.2×10-5), urination(P=0.034), Pdet.Qmax(P=0.045), RUA(P=0.018), OBI (P=0.017). Conclusions There is not clinically significant change in urine storage function of bladder in patients with pelvic organ prolapse, but the parameters of voiding function of bladder may existe difference. The increased bladder outlet resistance and postvoid residual urine are noticed in patients with pelvic organ prolapse.

Comparison of identity between the clinical staging and the pathological staging for prostate cancer in radical prostatectomy / 中华老年医学杂志

Objective To explore the significance of clinical staging methods for prostate cancer before radical prostatectomy in the prediction of pathological stage, the selection of therapy, judgement of efficacy and the evaluation of prognosis. Methods Thirty-four patients with organ confined prostatic cancer were reviewed to compare the serum prostate specific antigen(PSA), Gleason score staging by biopsies, percentage of positive prostate biopsies staging, digital rectal examination(DRE) staging and magnetic resonance imaging(MRI) staging with the pathological staging results after radical prostatectomy. Results Pathological diagnosis by radical prostatectomy showed that 20 of 34(58.8%) patients with prostate cancer were in stage B, and 12 (35.3%) in stage C and 2 (5.9%) in stage D. All methods for cancer staging were significantly correlated with the pathological staging results ( P

Clinical Significance of Correlation Factors on Serum PSA Concentration / 中国医师杂志

0 05). 70 of 138 patients had serum PSA concentration remarkable elevation after prostate biopsy (P

Treatment of elderly female stress urinary incontinence with tension-free vaginal tape procedure: a report 6 cases / 中华老年医学杂志

Objective To evaluate the clinical significance of tension-free vaginal tape(TVT) procedure in the treatment with elder female stress incontinence(SUI). Methods Six patients with proven SUI were undergone the TVT with SPRAC. Results Six patients were operated under low spinal anesthesia. Mean operation time was 31.6 minutes and the mean blood loss was 36.2 ml. Five patients were able to micturate spontaneously within 24 hours after operation. One patient with fatty and vaginal colpoptosis was in-dwelling catheter for one week. Patients were followed-up for 10-28 months. Five patients were completely cured and one patient was failed after operation three months. Two patients were de novo urgency. One patient complained of persistent suprapubic discomfort. Conclusions The tension-free vaginal tape operation is a safe and effective surgical procedure for the treatment of urinary stress incontinence with fatty vaginal colpoptosis in elderly females.

Evaluation of combining clinical parameter staging and MRI staging for prostate cancer before radical prostatectomy / 中华泌尿外科杂志

Objective To evaluate the clinical significance of combining clinical parameter staging and magnetic resonance imaging (MRI) staging for prostate cancer before radical prostatectomy. Methods The data of 53 patients with organ confined prostate cancer were reviewed to assess the accuracy of combining clinical parameter staging and MRI staging in correlation with pathological staging results after radical prostatectomy. Results Of the 53 prostate cancer cases,20 were of stage T 2 preoperatively,but 5 (25%) of the 20 were pathologically diagnosed as stage T 3 after prostatectomy when serum PSA