Circumcision with no-flip Shang Ring technique for adult males: analysis of 168 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the clinical effects of the no-flip procedure with the Chinese Shang Ring when circumcising adult males with redundant prepuce or phimosis, and to discuss its advantages and disadvantages.</p><p><b>METHODS</b>Using the no-flip Shang Ring technique, we performed circumcision for 167 adult males aged 18 -72 (mean 27.8) years with redundant prepuce or phimosis, and analyzed the clinical data, including the operation time, postoperative complications, ring-removal time, and postoperative appearance of the penis.</p><p><b>RESULTS</b>Complete follow-up data of 94 cases (56.29%) were obtained. The mean operation time was (5.03 +/- 0.71) minutes and the average ring-removal time was (18.83 +/- 6.70) days. The primary postoperative complications were edema (35 cases [37.23%] at 2 weeks and 9 cases [9.57%] at 4 weeks), including 2 severe cases (2.13%), and infection (3 cases [3.19%]). The pain scores were 2.01 +/- 2.46 during the procedure and 4.52 +/- 2.53 at 24 hours postoperatively. Slipping of the outer ring occurred in 1 case, and delayed removal of the ring in 30 cases (31.91%).</p><p><b>CONCLUSION</b>Adult male circumcision with the no-flip Shang Ring technique is recommended for its short operation time, simple procedure, fewer postoperative complications, less pain, and better incision appearance.</p>

Chronic hypertension superimposed on preeclampsia at 13 gestational weeks: a case report with review / 中华医学杂志(英文版)

Preeclampsia is represented by hypertension and proteinuria in pregnancy. It usually occurs after 20 gestational weeks. There are few reports on preeclampsia before 20 gestational weeks. In this case, we report a patient with chronic hypertension superimposed with preeclampsia at 13 gestational weeks.

A novel bioreactor to simulate urinary bladder mechanical properties and compliance for bladder functional tissue engineering / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Bioreactors are pivotal tools for generating mechanical stimulation in functional tissue engineering study. This study aimed to create a bioreactor that can simulate urinary bladder mechanical properties, and to investigate the effects of a mechanically stimulated culture on urothelial cells and bladder smooth muscle cells.</p><p><b>METHODS</b>We designed a bioreactor to simulate the mechanical properties of bladder. A pressure-record system was used to evaluate the mechanical properties of the bioreactor by measuring the pressure in culture chambers. To test the biocompatibility of the bioreactor, viabilities of urothelial cells and smooth muscle cells cultured in the bioreactor under static and mechanically changed conditions were measured after 7-day culture. To evaluate the effect of mechanical stimulations on the vital cells, urethral cells and smooth muscle cells were cultured in the simulated mechanical conditions. After that, the viability and the distribution pattern of the cells were observed and compared with cells cultured in non-mechanical stimulated condition.</p><p><b>RESULTS</b>The bioreactor system successfully generated waveforms similar to the intended programmed model while maintaining a cell-seeded elastic membrane between the chambers. There were no differences between viabilities of urothelial cells ((91.90 ± 1.22)% vs. (93.14 ± 1.78)%, P > 0.05) and bladder smooth muscle cells ((93.41 ± 1.49)% vs. (92.61 ± 1.34)%, P > 0.05). The viability of cells and tissue structure observation after cultured in simulated condition showed that mechanical stimulation was the only factor affected cells in the bioreactor and improved the arrangement of cells on silastic membrane.</p><p><b>CONCLUSIONS</b>This bioreactor can effectively simulate the physiological and mechanical properties of the bladder. Mechanical stimulation is the only factor that affected the viability of cells cultured in the bioreactor. The bioreactor can change the growth behavior of urothelial cells and bladder smooth muscle cells, resulting in the cells undergoing adaptive changes in mechanically-stimulated environment.</p>

Risk factors of recurrence after transurethral resection of the prostate due to benign prostate hyperplasia / 中华外科杂志

<p><b>OBJECTIVES</b>To review the clinic data of benign prostate hyperplasia (BPH) cases, and to find the risk factors of recurrence in post transurethral resection of the prostate (TURP) patients.</p><p><b>METHODS</b>From November 2002 to November 2007, 1471 cases were reviewed, including 41 patients of recurrence after TURP. Record the data include onset age, course of disease, age of surgery, LUTS, PSA, blood serum creatinine, size of the prostate in transabdomen ultrasonography, data of urodynamic examination, weight of resected tissue, persistence time of the resection, length of stay, score of inflammation of the pathologic sample, experience of the operator, routine blood examination, routine urine examination and so on. Statistical analysis was performed using univariate and multivariate unconditional Logistic regression analysis for evaluation of the data.</p><p><b>RESULTS</b>In the univariate analysis, onset age (t = 2.292, P = 0.086), PVR (t = 2.181, P = 0.03), size of the prostate in transabdomen ultrasonography (t = -1.987, P = 0.047), experience of the operator (Z = 10.13, P = 0.0015) and the symptom that bladder does not feel completely empty right after urinating (chi(2) = 9.240, P = 0.002) had statistical significance. In the multivariate unconditional Logistic regression analysis, Odds ratio (OR) of the factors were investigated, the symptom that bladder does not feel completely empty right after urinating (OR = 0.557), the score for inflammation (OR = 0.905) and experience of the operator (OR = 0.393) had statistical significance.</p><p><b>CONCLUSIONS</b>The risk factors for elevating the incidence of post-TURP recurrence are the lower score for inflammation, younger onset age, having the symptom that bladder does not feel completely empty right after urinating, bigger size of prostate in transabdomen ultrasonography, lower post void residual urine volume and poor experience of the operator.</p>