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Objective To evaluate the urodynamic and functional characteristics of 26 patients who had underwent orthotopic contient globular ileal neobladder. Methods The clinical date of 26patients who underwent radical cystectomy were reviewed. The neobladder pressure, capacity, urethral pressure and urinary flow rate were collected at 3-12 months after operation. Results The neobladders average pressure was less than 15 cm H2O when the volume was 400 ml. The pressure was 22.4 cm H2O at 100% capacity. The mean pressure of contractions was less than 40 cm H2O. The mean filling pressure after operation was relative stable while the difference between 3 months and 6 months was statistically significant. The difference between 6 and 9 and 12 month showed no statistical significance. The mean post-void residual was 42 ml. A mean voiding flow rate of 19. 6 ml/s could be obtained by Valsalva. Conclusion The neobladder not only could offer adequate capacity at low pressures but also could give a satisfied continent.
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Objective To discuss the value of Fisher discriminant analysis of serum progesterone and the growing rate of β-human chorionic gonadotropin in the prediction of early ectopic pregnancy. Methods 66 patients with ectopic pregnancy (11 cases were successfully treated expectantly and 55 cases were treated surgically including 40 cases of rupture of fallopian tube and 15 cases of tubal abortion) and 55 patients with intrauterine pregnancy and 50 patients with threatened abortion were chosen. Serum progesterone,β-HCG,48 hβ-HCG and the 48 h growing rate of β-HCG in each group were measured and a Fisher discriminant analysis was used. Results The serum progester-one was (30.27± 18.20) nmol/L in ectopic pregnancy group,( 108.44±23.27 ) nmol/L in intrauterine pregnancy group and (91.68±34.90) nmol/L in threatened abortion group. The first β-HCG was ( 3767.63 ± 3530.38 ) U/L in ectopie pregnancy group,(29 028.65 ± 10 874.01 )U/L in intrauterine pregnancy group and (13 457.47±16 367.65)U/L in threatened abortion group. The second β-HCG was (4349.24±3536.22)U/L in ectopic pregnancygroup,(56 139.46 ± 23 296.87 ) U/L in intrauterine pregnancy group and (23 270.63 ± 23 811.68 ) U/L in threat-ened abortion group. The growing rate of β-HCG ( β-HCG/the first serum β-HCG) was 1.29 ± 0.28 in ectopic preg-nancy group,1.93 ± 0.36 in intrauterine pregnancy group and 1.97±0.28 in threatened abortion group. There was significant difference in serum progesterone,the first β-HCG and the second β-HCG as well as the growing rate of β-HCG among the groups(P<0.05 or <0.01). Fisher discriminant analysis of combing progesterone and the growing rate of β-HCG were connected with diagnosis of ectopic pregnancy,however,the only one serum β-HCG was not con-nected with diagnosis of ectopic pregnancy. 98.5% of ectopic pregnancy,65.6% of intrauterine pregnancy and 64.0% of threatened abortion were correctly classified in the Fisher discfiminant analysis,with overall correct rate of 77.8%. Conclusion Fisher discriminant analysis of combing progesterone and the growing rate of β-HCG can bet-ter predict the early ectopic pregnancy.
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Objective To evaluate the clinical application of female orthotopic ileal neobladder.Methods Modified radical cysteetomy plus orthotopic ileal neobladder was performed on 19 female pa-tients with bladder cancer from June 1999 to January 2008.The mean age of the patients was 52(45-66) years,mean course of disease was 4.4 months (16 days-1.9 years).Of all the patients,there were 10 cases with grade 1,7 cases with grade 2 and 2 cases grade 3.According to the UICC stage system,5 patients were T1 stage,12 T2 and 2 T3a.All the patients received modified radical cystecto-my without resection of uterus and anterior vagina,meanwhile the nerves around urethra were protec-ted.0.8-1.2 cm proximal end of the urethra was excised and 30 cm distal ileum was used for the re-construction of the neobladder.Results Sixteen cases were followed up for 6-102 months,mean 71 months.Fifteen patients survived without disease recurrence,1 patient died of myocardial infarc-tion 17 months postoperation.The daytime and night continent rate was 100$,93% at 9 months postoperative.The average voiding volume of the 15 patients was 519.0 ml.The average residual vol-ume was 29.2 ml,and Qmax was 18.6 ml/s.The average filling and voiding pressure was 16.7 cm H2O and 53.0 cm H2O.Intravenous urography showed slight hydronephrosis in 1 case.Conclusion Female orthotopic ileal neobladder could be a good choice because of the continence,fewer complica-tions,lower pressure and enough bladder capacity.
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Objective To study the role of bcl 2 gene expression in human prostate. Methods The level of bcl 2 gene mRNA expression were investigated by in situ hybridization in 11 cases of fetal prostates, 27 cases of adult (specimens obtained from autopsy)and 60 cases of hyperplastic prostates. Results In fetal prostates, positive signals were detected in all epithelial cells of the prostate buds, while in adult and hyperplastic specimens, positive signals were predominantly concentrated to the basal cell layer of the epithelium, with little involvement of the secretory epithelial cells. The expression in hyperplastic prostates was significantly higher than in normal ones and that of the basal epithelial cells was significantly higher than the secretory ones in both the normal prostates and the hyperplastic ones. Conclusions Bcl 2 gene may play an important role in regulating the apoptosis of the basal cells while if plays a secondary role in the secretory cells of the prostate.