Genotypes and serotypes of avian infectious bronchitis viruses isolated during 2009-2011 in Guangxi, China / 病毒学报

In order to investigate the prevalence and track genetic and antigenic evolutions of infectious bronchitis virus (IBV) and their prevalence in Guangxi, China since 1985, gene amplification and sequencing and virus neutralization (VN) test on chicken embryo tracheal organ cultures were used in genotyping and serotyping of 28 IBV isolates during 2009-2011 in Guangxi. The results of N gene sequencing and comparison showed that the 28 isolates and reference strains were classified into three groups, and most isolates belonged to group Ill, while the isolates in 1985-2008 belonged to groups IV and II. The data of VN test indicated that the 28 isolates belonged to 6 serotypes; among them, 71. 4% belonged to serotypes 1, 2, and 3, and 11 (39.3%) shared the same serotype with the current vaccine strains. Given the data of our previous study, it is found that prevalent serotypes and their proportions varied in different areas of Guangxi and during different periods. These data lay a good foundation for developing an oil-emulsified inactivated polyvalent vaccine containing local dominant serotypes for the effective prevention and control of infectious bronchitis.

Identification of lower urinary tract voiding dysfunction in females by using video-urodynamic study / 中华外科杂志

<p><b>OBJECTIVE</b>To assess the value of video-urodynamic study (VUD) in the identification of lower urinary tract voiding dysfunction in female.</p><p><b>METHODS</b>A total of 126 female patients with sign and symptoms of lower urinary tract voiding dysfunction underwent VUD from December 2008 to January 2011 in Beijing Chaoyang Hospital. The causes of voiding dysfunction were analyzed based on VUD findings.</p><p><b>RESULTS</b>Neurogenic voiding dysfunction was found in 30 patients (23.8%), non-neurogenic voiding dysfunction was found in 96 patients (76.2%). The 72 patients suffered from recurrent urinary tract infection (57.1%) and 23 patients suffered from hydronephrosis (18.3%). Based on special characteristics of video-urodynamic study, a total of 126 patients were classified as: (1) Bladder outlet obstruction (BOO) was found in 65 patients. Of them, bladder neck obstruction in 40 patients (61.5%), their VUD showed "high pressure-low flow" obstructive curve and synchronic image showed bladder neck did not open in a funnel shape and no contrast was found in urethra. Distal urethral stricture in 22 patients (33.8%), VUD showed "high pressure-low flow" obstructive curve and synchronic image showed bladder neck open in a funnel shape, proximal urethra dilated and no contrast was found in distal urethral. Urethral sphincter obstruction in 3 patients (including detrusor-sphincter dyssynergia in 1 and sphincterismus in 2 patients), VUD showed "high pressure-low flow" obstructive curve and synchronic image showed bladder neck open in a funnel shape, sphincteric urethra did not open, proximal urethra dilated and no contrast was found in distal urethral. (2) Detrusor areflexia (DA) was found in 39 patients (2 patients with hydronephrosis), the VUD finding was: no voluntary detrusor contraction in voiding phase, and abdominal pressure voiding pattern. (3) OAB was found in 3 patients, which VUD findings was frequent involuntary detrusor contraction at storage period with or without urine leakage. (4) Low compliance bladder was found in 17 patients (13.5%), 16 patients with hydronephrosis, the VUD showed that increased bladder storage pressure with significantly decreased bladder safe capacity and compliance, appearance of the bladder as "Christmas tree", with or without ureteral reflux. (5) And stress urinary incontinence (SUI) was in 2.</p><p><b>CONCLUSIONS</b>The main causes of female BOO may be non-neurogenic conditions or organic obstruction. VUD would offer valuable information for confirmed diagnosis of voiding dysfunction in female patients.</p>

Video-urodynamics study on female patients with bladder neck obstruction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pressure-flow study combined with cystourethroscopy were used as the major method to define female bladder neck obstruction in China. However, the definition of urodynamics for female bladder outlet obstruction (BOO) is not clear so far. Video-urodynamic study (VUDS) would provide more information to define the female BOO, but it is not used commonly due to the limitation of video-urodynamic equipment in China. We attempted to find a better way for diagnosis of female BOO by performing VUDS.</p><p><b>METHODS</b>VUDS and cystourethroscopy were performed in 38 women with signs and symptoms of difficult voiding from March 2008 to April 2010 in Beijing Chao-Yang Hospital. Bladder neck obstruction was defined by radiological evidence of narrowing bladder neck, voiding pressure greater than 20 cmH2O and maximum flow rate (Q(max)) less than 12 ml/s. Transurethral incision of bladder neck was then performed on those patients. Follow-up examination (Q(max) and residual urine) was recorded 3 months after operation.</p><p><b>RESULTS</b>The mean time from its onset to diagnosis was (18.1 ± 9.1) months in 38 patients. Average patient age was 36.1 years (range from 19 to 79 years). The mean Q(max) was (10.6 ± 4.7) ml/s and residual urine was (81.5 ± 42.4) ml. Three out of 38 patients had obvious distal urethral stricture, eight of them suffered from definitely bladder neck contracture and the remaining 27 patients did not show obvious abnormalities measured by cystourethroscopy examination. For the 35 patients without urethral stricture, the most frequent findings of VUDS were high-voiding pressure plus low-flow rate and narrow bladder neck during voiding on simultaneous fluoroscopy examination. With video-urodynamics definition, 32 patients were diagnosed as bladder neck obstruction with mean Q(max) of (10.8 ± 3.7) ml/s, residual urine of (76.9 ± 32.7) ml and detrusor pressure at maximum flow (P(det Q(max))) of (50.7 ± 19.1) cmH2O. Other three patients were suffered from detrusor hypocontractility. All 32 patients including eight with definitely bladder neck contracture and 24 with primary bladder neck obstruction received transurethral bladder neck incision. The symptom of difficult voiding was relieved. The postoperative follow-up showed that Q(max) was (21.7 ± 7.6) ml/s (P < 0.01) and the residual urine was (23.2 ± 17.6) ml (P < 0.01).</p><p><b>CONCLUSIONS</b>The real cause of the obstruction for female patient with difficult voiding might be various. A full VUDS would give us valuable information for correct diagnosis in female patients with bladder neck obstruction.</p>

Diagnosis of lower urinary tract voiding dysfunction with video-urodynamic studies / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the role of video-urodynamics (VUD) in the diagnosis of lower urinary tract voiding dysfunction.</p><p><b>METHODS</b>From December 2008 to March 2010, 115 patients with lower urinary tract voiding dysfunction were included in our study. All patients underwent VUD studies.</p><p><b>RESULTS</b>Neurogenic bladder was found in 37 patients, including 25 male patients and 12 female patients. Among these patients, 18 patients were detrusor areflexia (DA), 2 patients were overactive bladder (OAB), 10 patients were low compliance bladder with hydronephrosis and 7 patients were detrusor-external sphincter dyssynergia. Non-neurogenic voiding dysfunction was found in 59 patients, including 34 male patients and 25 female patients. Among these patients, bladder outlet obstruction was found in 33 patients, OAB in 4 patients, urethra stricture in 4 patients and sphincterismus in 3 patients. Seven patients receiving augmentation of bladder took second VUD examination, including 4 male patients and 3 female patients. One patient receiving Indiana pouch and one patient receiving ureter reimplantation all took VUD examination. Ten patients had basic normal bladder urethra function from VUD examination, including 6 male patients and 4 female patients.</p><p><b>CONCLUSION</b>From combination of pressure-flow figure and real time image, VUD examination provides precise evidence of diagnosis and treatment for lower urinary tract voiding dysfunction.</p>

Applying bladder outlet obstruction number to predict bladder outlet obstruction of benign prostatic hyperplasia / 中华外科杂志

<p><b>OBJECTIVE</b>Applying bladder outlet obstruction number (BOON) to predict bladder outlet obstruction (BOO) of benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>Seventy-six male who were suspected to suffer from BOO due to BPH with lower urinary tract symptoms were evaluated. The data included prostate volume (by transrectal prostate ultrasound), maximum urine flow rate (Qmax) and mean voided volume to calculate the BOON by simple algorithm: prostate volume (cm(3))-3 x Qmax (ml/s)-0.2 x mean voided volume (ml). Pressure-flow study was also performed on each patient to get AG number and Schäfer obstruction grade. Correlation between traditional parameters, BOON and AG number was calculated to evaluate the price of using BOON to predict BOO.</p><p><b>RESULTS</b>Parameters such as age, prostate volume, maximum urine flow rate, residual urine and BOON were used as independent and AG was used as dependent to calculated the multiple linear regression. Data expressed the entire regression equation's R = 0.542 (P = 0.000), and result showed BOON had the strongest relationship with AG (P = 0.000). Eighteen patients' BOON number were greater than -10, by AG number and Schäfer obstruction grade proving, all these patients were suffered from BOO, the sensitivity and the specificity of judging BOO by BOON were 31% and 100% respectively. While take BOON as -20, the sensitivity and the specificity were 42.4% and 88.2%, when take BOON as -30, the sensitivity and the specificity were 66.1% and 82.4%, respectively. Fifty-two persons' BOON were greater than -40, 46 patients suffered from BOO, the sensitivity and the specificity were 77.9% and 64.7%, the specificity and the opportunity of having BOO decreased significantly. The data showed that: taking BOON = -30 as critical point can predict BOO with higher sensitivity and specificity, greater BOON means greater possibility of BOO.</p><p><b>CONCLUSIONS</b>Using BOON which is deduced from prostate volume, maximum urine flow rate and mean voided volume, the point -30 as critical point, can predict the probability of BOO with higher sensitivity and specificity.</p>

Length and volume of intravesical prostatic protrusion closely correlated with bladder outflow obstruction in BPH patients / 中华男科学杂志

<p><b>OBJECTIVE</b>To analyze the correlation of the length and volume of intravesical prostatic protrusion (IPP) with bladder outflow obstruction (BOO) in patients with BPH and to find a simple method for the diagnosis of the disease.</p><p><b>METHOD</b>The length and volume IPP were measured by transrectal ultrasound for 87 patients with BPH, the diagnosis of BOO was made by urodynamic tests and the correlation of the length and volume of IPP with BOO was analyzed, and reanalyzed 3 months after oral medication of a-blocker. The length and volume of IPP were measured again during the operation in 54 of the cases to confirm the ultrasound findings.</p><p><b>RESULTS</b>BOO was diagnosed in 51 of the patients. The coefficient of correlation between the length of IPP and BOO and that between the volume of IPP and BOO were 0.53 and 0.47 (P < 0.01). Not considering the dynamic factors, they were 0.69 and 0.62 (P < 0.01), respectively. BOO was confirmed in patients with the length of IPP > 1.0 cm or the volume > 1.5 ml. There was no significant difference between the results of transrectal ultrasound and the findings during the operation concerning the length and volume of IPP (P > 0.05).</p><p><b>CONCLUSION</b>There is a close correlation between the length and volume of IPP and BOO, which can be conveniently applied to the diagnosis of BOO in BPH patients.</p>

Non-improvement after different procedures of prostatectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the causes of non-improvement after different procedures of prostatectomy.</p><p><b>METHODS</b>Using the urodynamics and other techniques, we examined 84 non-improved patients who had undergone different procedures of prostatectomy.</p><p><b>RESULTS</b>In the TURP group, the main causes of non-improvement included bladder outlet obstruction (84.9%), weak contractility of the detrusor (30.4%), and detrusor instability (DI) (18.2%). In the open group, however, the main causes of non-improvement included detrusor weak contractility (52.9%), DI (35.2%), and bladder outlet obstruction (33.3%). There was significant difference between the two groups according to the Pearson Chi-square test (P = 0.000). The re-obstruction rate in the TURP group was much higher than that in the open group, suggesting that the level of the TURP should be improved.</p><p><b>CONCLUSIONS</b>Different operative procedures yield different non-improvement after prostatectomy gradually. When BPH patients are diagnosed with detrusor weak contractility and DI, prostatectomy should be carefully considered.</p>