Application progress of imaging examination in the diagnosis of urethral stricture / 现代泌尿外科杂志

Urethra stricture is one of the most common diseases of the urinary system. Accurate imaging diagnosis is key to the selection of surgical approach. At present, X-ray urethral imaging can show the form of urethra cavity, but not the tissues around the urethra. Sonourethrography (SUG) can dynamically identify the urethral cavity and the surrounding tissues without radiation exposure. Multi-layer spiral CT urethrography (CTU) has advantages of no need to adjust the position, quick scanning and reconstruction of the three-dimensional image, which can accurately show the location, length and degree of urethral stricture, and the spatial relationship with the surrounding tissues. Magnetic resonance urethrography (MRU) can provide useful information of the urethral stricture and soft tissues around the urethra, especially in urethral strictures caused by pelvic fractures and complex urethral stenosis. The choice of imaging method should be based on the etiology, anatomy, types of urethral injury and the general situation of patients. Appropriate imaging method can improve the diagnostic accuracy.

Causes and management for male urethral stricture / 中南大学学报(医学版)

Objective:To explore the etiology of male urethral stricture,analyze the therapeutic strategies of urethral stricture,and summarize the complicated cases.Methods:The data of 183 patients with urethral stricture were retrospectively analyzed,including etiology,obstruction site,stricture length,therapeutic strategy,and related complications.Results:The mean age was 49.7 years,the average course was 64.7 months,and the constituent ratio of51 to 65 years old patients was 38.8％ (71/183).The traumatic injury of patients accounted for 52.4％ (96/183),in which the pelvic fracture accounted for 35.5％ (65/183) and the straddle injury accounted for 16.9％ (31/183).There were 54 cases of iatrogenic injury (29.5％).The posterior urethral stricture accounted for 45.9％ (84/183),followed by the anterior urethral stricture (44.8％,82/183) and the stenosis (6.6％,12/183).A total of 99 patients (54.1％) received the end to end anastomosis,and 40 (21.9％) were treated with intracavitary surgery,such as endoscopic holmium laser,cold knife incision,endoscopic electroknife scar removal,balloon dilation,and urethral dilation.In the patients over 65-years old,the urethral stricture rate was 14.8％ and the complication rate (70.4％) for transurethral resection of the prostate (TURP) was significantly higher than that of all samples (P＜ 0.01).Conclusion:Both the etiology of male urethral stricture and the treatment strategy have changed and the incidence of traumatic and iatrogenic urethral stricture has increased in recent 3 years.The main treatment of urethral stricture has been transformed from endoscopic surgery into urethroplasty.

Effect of calcium channel blockers on primary cultured human urethra scar fibroblasts / 中南大学学报(医学版)

To investigate effects of verapamil on primary cultured human urethral scar fibroblasts (USFs) and to provide basis for protecting the formation of urethra scar.
 Methods: The cell proliferation was evaluated with the cell counting kit (CCK)-8 method after USFs were incubated various verapamil concentrations (50, 100, 150, 200, or 250 μmol/L) or solvent for 12, 24, or 48 h. The protein level of matrix metalloproteinase (MMP) was evaluated with ELISA after cells were incubated with verapamil (100 μmol/L) or solvent (control cells) for 24 h.
 Results: The proliferation of USFs was obviously suppressed after verapamil treatment, which was in a dose-dependent and time-dependent manner. Meanwhile, the protein levels of MMP-2 and MMP-9 in the verapamil treatment group increased obviously compared with those of the control groups (P<0.05).
 Conclusion: Calcium channel blockers may prevent the excessive formation of urethra scar by inhibiting the proliferation of urethral scar fibroblasts and enhancing the activity of MMP.

Analysis of influential factors for prostate biopsy and establishment of logistic regression model for prostate cancer / 中南大学学报(医学版)

OBJECTIVE@#To establish logistic regression model for prostate cancer and provide basis for prostate biopsy.
@*METHODS@#A total of 117 cases of prostate biopsy were retrospectively analyzed in chronological sequence. All cases were assigned into a model group (n=78) and a validation group (n=39). Logistic regression model was established and its value was estimated by receiver operating characteristic (ROC) curve. 
@*RESULTS@#Digital rectal examination(DRE), transrectal ultrasound(TRUS), MRI, prostate-specific antigen density (PSAD), and free PSA/total PSA (fPSA/tPSA) were the influential factors for prostate biopsy (P<0.01). The established logistic regression model for prostate cancer by regression coefficient was: logit P=-2.362+2.561×DRE+1.747×TRUS+2.901×MRI+1.126×PSAD-
2.569×fPSA/tPSA and area under curve was 0.907. When the cutoff aimed at 0.12, the sensitivity and specificity were 81.80% and 89.30%, respectively.
@*CONCLUSION@#Logistic regression model for prostate cancer can provide sufficient basis for prostate biopsy. Prostate biopsy should be performed when P value is more than 0.12.

A preliminary study on mechanisms for urinary system disorders before and after ketamine withdrawal in rats / 中南大学学报(医学版)

OBJECTIVE@#To explore the mechanisms for urinary system disorders before and after ketamine withdrawal in rats and to evaluate the recovery degree of the urinary system damage after ketamine withdrawal.@*METHODS@#Fifteen male healthy Sprague-Dawley rats were randomly divided into 3 groups: A control group, an experimental group, and a withdrawal group. The rats in the control group were given normal saline. The rats in the experimental group were given ketamine 30 mg/(kg.day) for 30 days. The rats in the withdrawal group were treated as the experimental group except for drug withdrawal for 2 weeks. In the experimental period, we randomly selected 1 rat of kidney, ureter, and bladder from each group to perform HE staining. The bladder tissues in each group were used to detect mRNA expression by quantitative real-time polymerase chain reaction (qRT-PCR).@*RESULTS@#1) The behavior of ketamine-injected rats was obviously changed, but the weight of ketamine-induced rats was not changed. 2) As compared with the control group, the experimental and withdrawal groups showed infiltration of mononuclear inflammatory cells in the kidney tissues, the thinner epithelium of bladder and infiltration of submucosal mononuclear inflammatory cells under the optical microscope. 3) As compared with the control group, the expression of H1R mRNA was increased in the experimental group (P<0.05). As compared with the experimental group, H1R mRNA expression was significantly decreased in the withdrawal group (P<0.05).@*CONCLUSION@#Ketamine abuse could induce behavior changes in rats. The infiltration of mononuclear inflammatory cells in kidney and bladder, the thinner bladder epithelial layer, and the increased H1R gene mRNA expression in bladder might be an important pathogenesis of KAUD. Ketamine withdrawal may effectively reverse the pathogenic process of KAUD.

Clinical study on the effectiveness and safety of terazosin in the treatment of benign prostatic hyperplasia patients with concomitant hypertension / 中国综合临床

Objective To evaluate the effectiveness and safety of terazosin in the treatment of benign prostatic hyperplasia (BPH)patients with concomitant hypertension.Methods A singlecenter prospective clinical observational study was conducted from March,2006 to March,2010 in our center.The main endpoints were the changes of IPSS total score,diastolic and systolic blood pressures at the end of 4 weeks and 3 monthes compared with the baseline,The second endpoints were Qmax value at the end of 4 weeks and 3 monthes compared with the baseline,Safety was assessed by adverse events.Results There were 212 patients in the study recruited,and 189 patients completed the study.All patients had BPH combined with hepertension.All patients were randomly devided into two statistical analysis group,blood pressure well controled and not well controled group,In the well controlled group,the IPSS socre reduced from 22.31 ± 5.18 at baseline to 15.64 ±3.91 at the end of the 4th weeks and 13.16 ± 3.53 at the end of 3rd monthes in the blood pressure well controled group populatin( P ＜ 0.01 ).The Qmax were improved significantly from (7.87 ± 2.41 ) ％ at baseline to (14.19 ±2.64)％ at the end of the 4th weeks and (15.69 ±2.77)％ at the end of3rd monthes in the blood pressure well controled group populatin( P ＜ 0.01 ).Terazosin had moderate effect in blood pressure decreasing (P ＜ 0.05 ),and all patients were within normal blood pressure range.In the uncontrolled group,the IPSS socre reduced from 21.55 ± 4.82 at baseline to 15.44 ± 3.66 at the end of the 4th weeks and 12.96 ± 3.11 at the end of 3rd monthes in the blood pressure well controled group populatin (P ＜ 0.01 ).The Qmax were improved significantly from ( 8.27 ± 2.27 ) ％ at baseline to ( 14.26 ± 2.87) ％ at the end of the 4th weeks and ( 15.51 ±2.92) ％ at the end of 3rd monthes in the blood pressure well controled group populatin( P ＜ 0.01 ).Terazosin decreased BPH patient blood pressure with controlled patients and unctrolled patients additionaly to other blood pressure medicine (P ＜ 0.05 ),and no severe side effect occured.At the end of the study,all patients were taking drug continuously and were followed.Conclnsion Terazosin can significantly improve the symptoms and quality of life in BPH patients with hypertension with good safety and compliance.