Resection of a giant renal angiomyolipoma in a solitary kidney with preoperative arterial embolization / 中华医学杂志(英文版)

Renal angiomyolipoma is a type of benign tumor that occurs sporadically in addition to being associated with tuberous sclerosis. Preoperative embolization of large tumors is important to avoid excessive blood loss during surgery. We reported a patient with a 5505-g giant renal angiomyolipoma in a solitary kidney. The patient was treated with preoperative embolization and radical nephrectomy without complications. This type of treatment for an enormous angiomyolipoma can reduce the risk of uncontrolled hemorrhage caused by rupture of the tumor during the operation and should be considered for the treatment of similar tumors.

Correlation between activation of L5-S2 spinal cord astrocytes and effect of substance P in chronic prostatitis pain / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the expressions of the substance P (SP) mRNA and neurokinin-1 receptor (NK-1R) in the posterior horn of the L5 - S2 spinal cord in the rat model of chronic prostatitis pain, and to investigate the changes in the activation of astrocytes and influence of SP on this activation in rat spinal cord astrocytes cultured in vitro.</p><p><b>METHODS</b>The rat model of chronic prostatitis pain was established by injection of complete Freund's adjuvant (CFA) and assessed by the tail flick threshold test, the control rats injected with sodium chloride and all observed at 0, 14 and 28 days. Changes in the expressions of SP mRNA, NK-1R, glial fibrillary acidic protein (GFAP), tumor necrosis factor-alpha (TNF-alpha) and inducible nitric oxide synthase (iNOS) in the posterior horn of the L5 - S2 spinal cord were detected by RT-PCR and Western blot. Rat spinal cord astrocytes were cultured in vitro and divided into a control group, cultured with ITS cell culture fluid, and two experiment groups, with Group 1 stimulated with SP at the concentration of 10(-9) - 10(-6) mol/L for 12 hours followed by determination of the expressions of TNF-alpha, IL-1beta, NO and NOS by ELISA and nitrate reductase and colorimetric methods, and Group 2 at 10(-7) mol/L for 0, 24, 48 and 72 hours followed by detection of the GFAP expression by Western blot.</p><p><b>RESULTS</b>The expressions of SP mRNA, NK-1 R, GFAP, TNF-alpha and iNOS in the posterior horn of the L5 - S2 spinal cord were obviously higher in the rat prostatitis pain models than in the controls, successively higher at 28 than at 14 and 0 d (P < 0.01), and so was the expression of GFAP at 28 than at 14 d in the experiment groups (P < 0.05). SP induced a gradual increase at 10(-7) mol/L in the expression of GFAP in the spinal cord astrocytes at 0 -72 h, significantly different from that of the control group (P < 0.01), and it promoted the excretion of TNF-alpha and IL-1beta and the activity of NO and NOS at 10(-9) - 10(-6) mol/L at 12 h in a concentration-dependent manner, with marked differences between the experiment and control groups (P < 0.01, P < 0.05). But a decreased excretion of IL-1 beta was observed in the 10(-6) mol/L group, though with no significant difference from the control (P > 0.05).</p><p><b>CONCLUSION</b>Chronic prostatitis pain could upregulate the expressions of the excitatory transmitter SP and receptor in the L5 - S2 spinal cord, and result in the activation of astrocytes and increased excretion of proinflammatory cytokines, which may be associated with the persistence and generalization of prostatitis pain.</p>

Operative techniques of anastomotic posterior urethroplasty for traumatic posterior urethral strictures / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To elucidate the details of operative technique of anastomotic posterior urethroplasty for traumatic posterior urethral strictures in attempt to offer a successful result.</p><p><b>METHODS</b>We reviewed the clinical data of 106 patients who had undergone anastomotic repair for posterior urethral strictures following traumatic pelvic fracture between 1979 and 2004. Patients'age ranged from 8 to 53 years (mean 27 years). Surgical repair was performed via perinea in 72 patients, modified transperineal repair in 5 and perineoabdominal repair in 29. Follow-up ranged from 1 to 23 years (mean 8 years).</p><p><b>RESULTS</b>Among the 77 patients treated by perineal approaches, 69 (95.8%) were successfully repaired and 27 out of the 29 patients (93.1%) who were repaired by perineoabdominal protocols were successful. The successful results have sustained as long as 23 years in some cases. Urinary incontinence did not happen in any patients while impotence occurred as a result of the anastomotic surgery.</p><p><b>CONCLUSIONS</b>Three important skills or principles will ensure a successful outcome, namely complete excision of scar tissues, a completely normal mucosa ready for anastomosis at both ends of the urethra, and a tension-free anastomosis. When the urethral stricture is below 2.5 cm long, restoration of urethral continuity can be accomplished by a perineal procedure. If the stricture is over 2.5 cm long, a modified perineal or transpubic perineoabdominal procedure should be used. In the presence of a competent bladder neck, anastomotic surgery does not result in urinary incontinence. Impotence is usually related to the original trauma and rarely (5.7%) to urethroplasty.</p>

Activation of astrocytes effects changes of substance P in cornu dorsal medullae spinalis in chronic prostatitis rats / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the changes of substance P in cornu dorsal medullae spinalis effected by activation of astrocytes in rats with pain from chronic prostatitis.</p><p><b>METHODS</b>Sixty SD rats were randomized into three groups: the control group (n=20), the chronic prostatitis pain model group (n=20) and the interference group (n=20). The model was induced by injection of complete Freund adjuvant and 3% carrageenan into the prostate. Propentofylline was given with PE-10 in the spinal cord of the rat models. The activation of astrocytes and the distribution of substance P in the spinal cord were detected with immunofluorescence and the changes of substance P observed by radioimmunoassay.</p><p><b>RESULTS</b>The activation of astrocytes was significantly increased in the models compared with controls, but significantly reduced in interfered group in comparison with the pain model group (P < 0.01), and such was the case with substance P (P <0.01).</p><p><b>CONCLUSION</b>The activation of astrocytes was one important reason for the changes of substance P excreted from cornu dorsal medullae spinalis in the chronic prostatitis rats.</p>