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Objective: To evaluate the feasibility and clinical results of subsequent retroperitoneoscopic surgery for patients with previous ipsilateral retroperitoneal surgery through frank incision., Methods: A total of 10 patents were selected for subsequent laparoscopic surgery through retroperitoneal approach. Among them, there were recurrent renal cysts (n = 4) including a history of open surgery (n = 1) and retroperitoneal surgery (n = 3) and nonfunctional kidneys (n = 6) including open nephropyelopolasty (n = 3), retroperitoneoscopic nephropyelopolasty (n = 1) and retroperitoneoscopic ureterolithotomy (n = 2). The mean surgical duration was (12-85) 38.6 months. All patients underwent retroperitoneoscopy. Decortication was performed for renal cysts and nephrectomy for nonfunctional kidneys., Results: All operations were successfully performed with a mean surgical duration of 97 (40-185) minutes and a mean volume of blood loss 125 (20-460) ml. Among 4 cases with intraoperative peritoneal rupture, one case had renal cyst on ventral side. After enlargement, the procedure was performed through peritoneal cavity. The mean postoperative hospital stay was 5.6 (3-9) days. Nine patients received a mean follow-up period of 21.5 (3-47) months. All symptoms were relieved without any occurrence of postoperative complications., Conclusion: For patients with previous ipsilateral retroperitoneal surgery, retroperitoneoscopy may be feasible for properly selected cases.

Objective: To explore the expressions of urokinase-type plasminogen activator (uPA) and its receptor (uPAR) in vulvar tissues and elucidate the patterns., Methods: Thirty cases of vulvar neoplasms, 30 vulvar intraepithelial neoplasia (VIN) and 30 cases of normal epithelial tissue were harvested. And the expressions of uPA and uPAR in paraffin-embedded tissues were detected by immunohistochemistry. And the differential expressions of various vulvar tissues were observed. And the differences were compared in clinical stage and lymph node metastasis., Results: (1) The expressions of uPA and uPAR in normal tissues (0.422 ± 0.022, 0.431 ± 0.027), vulvar intraepithelial neoplasia (VIN) (0.462 ± 0.018, 0.467 ± 0.015) and vulvar neoplasms (0.508 ± 0.020, 0.510 ± 0.020) were significantly different (P < 0.01). (2) The expressions of uPA and uPAR in vulvar tissue significantly increased with a rising stage-level (P < 0.05). (3) Compared with those without lymph node metastasis, the patients with lymph node metastasis had significantly higher expressions of uPA and uPAR in vulvar tissue (P < 0.05)., Conclusion: Thus uPA and uPAR play an important role in the development process of vulvar neoplasms with an elevated expression in normal vulvar tissue, VIN and vulvar neoplasms. The invasiveness and prognosis of vulvar neoplasms may be evaluated through detecting the tissue expressions of uPA and uPAR.

Objective: To compare the clinical efficacy and safety of nephrectomy versus radical nephrectomy for renal cell carcinoma (RCC)., Methods: A total of 134 patients with renal carcinoma without metastasis in lymphatic system and distant sites were recruited. In random, 69 cases of renal cell carcinoma were elected for nephrectomy and the others radical nephrectomy. The operating time, blood loss, fasting time, postoperative hospital stay, information of tumor recurrence and metastasis, survival time without tumor, survival rate and perioperative complication were compared between two groups., Results: In cases of nephrectomy, the operating time ranged from 60 - 135 minutes and blood loss 70 - 100 ml. In 4 cases, membrana pleuro-peritonealis was damaged. The fasting time ranged from 6 - 24 hours and postoperative hospital stay 5 - 8 days; the staging of all 69 cases was detected; follow-up studies ranged from 5 - 15 years, finding 1 case tumor metastasis in adrenal body and 1 case recurrent tumor in cases of radical nephrectomy, operating time ranged from 105 - 185 minutes and blood loss 150 - 2000 ml. Membrana pleuro-peritonealis was breached in 3 cases. The fasting time ranged from 12 - 90 hours and postoperative hospital stay 8 - 12 days. The staging of all 65 cases was detected. Follow-up studies of 5 - 15 years revealed 1 case of tumor metastasis in brain and 1 case of recurrent tumor. There was no significant difference in perioperative complication, tumor recurrence, tumor metastasis and survival time without tumor between those two groups (P > 0.05). The blood loss, operating time, fasting and postoperative hospital stay were less than that in radical nephrectomy group (P < 0.05)., Conclusion: In patients without metastasis in lymphatic system and distant sites, nephrectomy is both effective and safe. It has the advantages of a short operating time, a short postoperative hospital stay and less damage and blood loss than radical nephrectomy.

Objective: To discuss the causes of common complications of ureteroscopy and how to prevent them., Methods: A total of 768 cases of common complications of ureteroscopy were retrospectively analyzed from February 2004 to February 2009., Results: The intra-operative complications were failed entry (n = 6, 0.78%), ureterostoma injury and ureterostoma submucosa pseudocana (n = 12, 1.56%), ureteral perforation (n = 16, 2.08%), stone displacement (n = 13, 1.87%) and ureteral mucosa evulsion (n = 3, 0.39%). And the post-operative complications were lumbago or renal colic (n = 11, 1.43%), infection (n = 9, 1.17%)and severe hematuria (n = 5, 0.65%)., Conclusion: Skillful operative techniques and strict indications are key to reducing complications of ureteroscopy.

Objective: To explore if PPARgamma agonist rosiglitazone could enhance the anti-atherosclerotic effects of mouse peroxisome proliferator-activated receptor gamma1 (PPARgamma1) gene transfer in apolipoprotein-knock out mice., Methods: Adult ApoE-knock out mice were fed a Western-diet for 20-weeks and then injected with PBS, Ad. PPARgamma1 (5 x 10(8)pfu) or Ad. GFP (5 x 10(8)pfu) via jugular vein. Another group of mice were intervened with rosiglitazone (dissolved in 0.5% cellulose acetate, 4 mg.kg(-1).d(-1), per gavage) 1 week before Ad. PPARgamma1 injection (n = 10, each group). Two weeks later, the lipid core and plaque composition were characterized with oil red O staining and Movat method respectively. The expression of PPARgamma, SM-actin, MOMA-2, MMP-9/TIMP-1, CD40/CD40L and TF antigens in aortic roots and plaques among four groups were compared semi-quantitatively using immunohistochemical technology., Results: All parameters were similar between AdGFP and PBS groups (P > 0.05). The area of plaque were significantly decreased and oil red O staining area significantly increased in AdPPARgamma1 [(0.86 +/- 0.12) mm(2), (150 +/- 35) x 10(3) microm(2)] and AdPPARgamma1 + RO [(0.79 +/- 0.15) mm(2), (270 +/- 49) x 10(3) microm(2)] treated mice compared with AdGFP group [(0.98 +/- 0.17) mm(2), (80 +/- 21) x 10(3) microm(2)] all P < 0.05. Elastic fiber, collagen and proteoglycan in plaques were also significantly increased in AdPPARgamma1 and AdPPARgamma1 + RO groups. Upregulation of PPARgamma, SM-actin, TIMP-1 antigen activity and downregulation of MOMA-2, MMP-9, CD40/CD40L and TF antigen activity in AdPPARgamma1 and most significantly in AdPPARgamma1 + RO group were observed (P < 0.05)., Conclusion: Anti-atherosclerotic effects of PPARgamma1 gene transfer in ApoE-knock out mice could be enhanced by PPARgamma agonist rosiglitazone.

Objective: To investigate the effect of PPARgamma1 gene overexpression on caveolin-1 mRNA and protein expressions in a murine macrophage cell line Raw264.7., Methods: Replication-deficient recombinant adenovirus expression vector of PPARgamma1 was constructed using the AdEasy system. Raw264.7 cells were randomly treated as follows: P group (PPARgamma1 gene overexpression), T group (Troglitazone 40 micromol/L in DMSO), PT group (PPARgamma1 gene overexpression and Troglitazone) and control group. Changes of PPARgamma1 and caveolin-1 at mRNA and protein levels were investigated., Results: Caveolin-1 expression can be detected by RT-PCR in Raw264.7, by immunocytochemistry method in cell and nuclear membrane but not by immunoblotting at protein level. Caveolin-1 expression at mRNA and protein levels in Raw264.7 were significantly higher in P, T and PT groups compared to control group and the expression was also significantly higher in PT group than that in P group and T group (P < 0.05). PPARgamma expression was significantly increased in PT group and P group where remained unchanged in T group compared to control group., Conclusion: PPARgamma1 overexpression can upregulate caveolin-1 expression in macrophages. Troglitazone upregulated caveolin-1 expression in the absence of increased PPARgamma1 expressions at mRNA and protein levels.