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Objective To explore the effectiveness and compliance of ketogenic-diet(KD) treatment for infantile spasm(IS).Methods Ninety-eight IS patients who were treated with KD in Wuhan Children's Hospital from March 2009 to June 2015 were analyzed by using retrospective case-control study,the patients were divided into 4 groups:newly diagnosed IS patients group (group A,including 24 patients),one antiepileptic drug (AEDs) failure IS patients (group B,including 28 patients),two and more AEDs failure IS patients (group C,including 29 patients),and two or more AEDs combined with ACTH failure IS patients(group D,including 17 patients).The spasm-free andretention rates after 3,6 and 12 months KD treatment were compared among these groups.Results Overall retention rate was 80.6％ (79/98 cases),69.4％ (68/98 cases),and 42.9％ (42/98 cases)at 3,6,12 months,respectively.The 3-month retention rate in group A,B,C and D was 83.3 ％ (20/24 cases),78.6％ (22/28 cases),82.7％ (24/29 cases) and 76.4％ (13/17 cases) respectively,and there was no significant difference among these groups (P ＞ 0.05).The 6-month retention rates in each group was 75.0％ (18/24 cases),67.9％ (19/28 cases),68.8％ (20/29 cases) and 65.0％ (11/17 cases) in sequence,and there was also no significant difference among these groups(P ＞0.05).The 12-month retention rate was 54.2％ (13/24 cases),21.4％ (6/28 cases),48.3％ (14/29 cases) and 52.9％ (9/17 cases) in group A,B,C and D in sequence,the 12-month retention rate of group B was significantly lower than that of other 3 groups,and the differences were statistically significant(x2 =5.973,4.508,4.727,all P ＜ 0.05),and there was no significant difference among the A,C,D groups (all P ＞ 0.05).The spasm-free rate at 3,6,12 months of KD treatment was 19.4％ (19/98 cases),20.4％ (20/98 cases),30.6％ (30/98 cases).The 3-month spasm-free rate in A,B,C,D groups were as follow:41.7％ (10/24 cases),14.3％ (4/28 cases),10.3％ (3/29 cases),11.8％ (2/17 cases),respectively.The 3-month spasm-free rate in group A was significantly higher than that of other 3 groups,and the differences were statistically significant (x2 =10.238,9.219,6.697,all P ＜ 0.05),but there was no significant difference among the B,C,D groups (all P ＞ 0.05).The 6-month spasm-free rates were 41.7％ (10/24 cases),14.3％ (4/28 cases),13.8％ (4/29 cases),and 11.8％ (2/17 cases) in group A,B,C and D in order,and the spasm-free rate in group A was significantly higher than that of other 3 groups,and the differences were statistically significant(x2 =4.924,5.249,4.298,all P ＜ 0.05),but there was no significant difference among the A,C,D groups (all P ＞ 0.05).The 12-month spasm-free rates were 54.2％ (13/24 cases),21.4％ (6/28 cases),24.1％ (7/29 cases),and 23.5 ％ (4/17 cases) in group A,B,C and D,and the spasm-free rate in group A was significantly higher than that in other 3 groups,and the differences were statistically significant(x2 =8.354,7.923,4.364,all P ＜ 0.05),but there was no significant difference among the A,C,D groups (all P ＞ 0.05).Conclusions The spasm-free rate of KD therapy for newly-diagnosed IS is higher than that of IS patients whose drug-therapy failed.KD therapy may be the top priority for IS patients and part of those patients whose drug-therapy failed can still get seizure-free with KD diet.
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Objective To investigate the incidence and risk factors of urinary incontinence of the adult women in two communities in Kunming so as to obtain basic epidemiological data,draw epidemiological regularity of adult women urinary incontinence in this two communities.Methods International Consultation on Inconvenience Questionnaire Short Form (ICQ-SF) survey was conducted among adult women Shuanglongqiao community and Zongshuying community during April 2012 to April 2013.Results (1) The prevalence rate of urinary incontinence among adult women was 16.84％.The constituent ratio of stress urinary incontinence was 42.6％,mainly with mild occurrence.Women over 41 years old were found with moderate and severe urinary incontinences.(2) The prevalence of urinary incontinence increased with age,especially the middle-aged and elderly women.The incidence was related to educational background,occupation,marriage and pregnancy status,and history of pelvic surgery (P＜ 0.05).Conclusion Urinary incontinence affects middle-aged and elderly women.There are differences of the prevalence of urinary incontinence among adult women with different nationality,occupation,educational background,marriage and pregnancy status,and history of pelvic surgery.
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Female stress urinary incontinence (FSUI) is a common disease of women in department of urology, which severely affects elderly physical and mental health of women. The molecular mechanism of FSUI is still unclear. Nitric oxide synthase (NOS), cyclooxygenase (COX) and their respective products nitric oxide (NO) and prostaglandin (PG) are closely related with FSUI. In this paper, the distribution of NOS and COX in female lower urinary tract and the research development of NOS, COX and their products with FSUI are summarized.
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Skeletal muscle is an important tissue of the human body .Besides the roles in the motion system , the respiratory system, and the circulatory system , skeletal muscle also can be a secreting tissue and participate in signal transduction .As the finding of satellite cell and its muscle formation , the viewpoint that skeletal muscle′s injure is irreversible has becoming an history .Using sat-ellite cells to form muscle can be used to treat injury of skeletal muscle .However , the process is affected by many factors , such as ex-tracellular matrix, regulation factors, age, disease, epigenetic and so on.This paper summarizes the latest study progress of satellite cell muscle formation .
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Inducible nitric oxide synthase (iNOS), cyclooxygenase 2 (COX-2) and iNOS/COX-2 signal transduction path-ways are closely related to occurrence and development of diseases , such as tumor, immunity, inflammation, hypoxia, ischemia, injury and so on.iNOS/COX-2 controls the physiological and pathological activities of human lower urinary tract .This article summarizes the role and mechanism of iNOS/COX-2 signal transduction pathways in related diseases .It not only provids an important target for treat-ment of disease and but provides a theoretical basis and research ideas for the development and research of new drugs .
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Objective To raise the awareness of the glandularis ureteritis. Methods Five cases with glandularis ureteritis confirmed by pathological examination from Jan 2001 to Jun 2012 were reviewed. The diagnosis was assessed on histopathologic studies in all. The clinical manifestations, the diagnosis and treatment were discussed. Results Resections of the affected ureter and ureteroplasty were undertaken for 2 patients. Ureteronephrectomy was performed for 2 patients because of serious hydronephrosis due to obstruction. Electrofulguration via-ureteroscopy was carried out for another patient. All patients have been well and without recurrence on following up for 15 to 152 months, with an average of 86.6 months. Conclusion Glandularis ureteritis is not frequently seen and the etiopathogenesis is not yet clear. Biopsy is very important for suspected neoplasm of ureter before performing nephrectomy.
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Clinical bilingual education is an effective method to educate modern senior medical talents.In order to cultivate a group of medical talents with good clinical competence,high professional standard of English,the model of “Bilingual teaching,goal-directed motion and learning by using binding” in combination with modern advanced teaching means is worth discussing.
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Objective To discuss the long term clinical effect of ileal orthotropic neobladder.Methods From 1991 to 1998,79 patients,mean age 55(41～75)years,male 74,female 6,were followed up.The serum creatinine and urea,electrolytes,blood routine,B ultrasonic scan of the neobladder residual urine and IVU or MRU of the patients were followed up.The max transverse diameter of renal pelvis and the max verticaI/level diameter of neobladder were measured in 5,10 to 14,15 years of postoperative when IVU or MRU.All results of different time were compared by the multiple comparisons.The local or distant cancer recurrence and the complications of the operation Were evaluated. Results Sixty-four cases,58 male,6 famle,were long term followed up:mean time was 167 (range,121～216)months.Seven cases died of other diseases.Seven cases had pelvic recarrence.Two cases had urethral recurrence.Three cases died of tumor metastasis.One case had ureter recurrence.Forty-eight patients were alive more than 10 years.The value of the serum creatinine,urea,electrolytes and bloods routine of the patients were normal after 5,10 to 14 and 15 vears postoperative (P＞0.05).The max transverse diameter of the renal pelvis in 5,10 to 14 and 15 years Dostoperative were 14.0 mm,14.1 mm and 13.7 mm,respectively,P＞0.05.The max vertical/level diameter of the neobladder in 5,10 to 14,15 years of postoperative were 110.4 mm/90.4 mm,111.5 mm/95.3mm and 127.0 mm/97.0 mm,respectively,P＞0.05.The residual urine of 5 cases was more than 50 ml and had not increased during follow up.Eight cases with neobladder stone were cured by the intracavitary lithothrypsis.Two cases with uretheral stricture were cured by the intracavitary therapy.Twelve cases of 14 cases with inguinal hernia were cured by reoperation,2 cases accepted conservative treatment.Only 17 cases had no complication involve of the cancer and the operation. Conclusion The upper urinary tract and neobladder of the ileal orthotopic neobladder could be stable for long time,the cure rate of tumor is satisfactory and the lifetime follow up is necessary.
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Objective To study the effect of angiotensin converting enzyme inhibitory peptides (ACEIP) on blood pressure of spontaneously hypertensive rats.Methods One hundred and four spontaneously hypertensive rats(SHR) were randomized to thirteen groups (n= 8,each group) and received one of following approaches:saline,captopril (10 mg/kg),low-dose (200 ?g/kg),medium-dose(400 ?g/kg) and high-dose (800 ?g/kg) of the three ACEIPs:VLPVP,KVLPVP,VLPVPR respectively.Thirty-two WKY rats were randomized to 4 groups(n=8 in each group),VLPVP,KVLPVP,VLPVPR (800 ?g/kg by gavage) and saline were administrated.The systolic blood pressure was measured before and after the administration of ACEIP.Results Compared with the control group,medium-dose and high-dose of VLPVP,KVLPVP and VLPVPR reduce blood pressure in hypertensive rats and the effect can last for above 6 hours [decline of blood pressure:high-dose:(40.9?15.7),(38.0?21.3) and (43.2?12.6) mmHg;medium-dose:(28.3?23.0),(24.7?21.5) and (26.2?9.9);control:(8.5?5.1),(6.2?4.1) and (7.1?5.5)mmHg;all P0.05].Conclusion Recombinant ACEIP acutely reduce high blood pressure in SHR,the antihypertensive effects persist for at least 6 hours,with no effect on normotensive WKY rats.
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Objective To investigate the therapeutic effects of orthotopic urinary diversion in women. Methods From September 1995 to December 2003,34 female patients (mean age,58 years;range,53-64 years) with bladder cancer were included.Of them,30 cases were of primary tumors and 4,of recurrent ones.Pathology showed transitional cell carcinoma in 30 cases,bladder adenocarcinoma in 3 and squamous cell carcinoma in 1.Radical cystectomy was performed in all the 34 cases;and the technique of cystectomy with nerve-sparing was performed in 24 of them. Intraoperative frozen section of the distal urethra surgical margin showed no evidence of tumor,and ileal neobladder was formed in all.The clinical therapeutic effects were analyzed retrospectively. Results The mean operative time was 360 min(range,280-420 min),and mean blood transfusion was 600 ml(range,300-1000 ml).Thirty cases were followed up for a mean of 61 months(range,6-108 months).At 6 months after surgery the continence rate was 90%(27/30) during the day and 86%(26/30) at night.Twenty-three cases could empty the neobladder one time and 2 needed intermittent catheterization due to hyper-continence; the other 5 needed pushing the abdomen to empty the neobladder. Twenty-three patients had good urodynamic findings;the vesical capacity ranged 300-520 ml and maximum intravesical pressure were
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Objective To study the methods and efficacy of selective or superselective renal artery embolization for renal neoplasms,abcesses and bleeding. Methods Sixty cases of renal carcinomas and 4 cases of abcesses were all treated with selective renal artery embolization before surgery,and 3 cases of advanced renal carcinomas were treated with selective renal artery embolization alone.Embolization materials for carcinoma and abcesses were mainly gelfoam.Nine cases of renal angiomyolipomas,23 of traumatic renal hemorrhages,1 undergoing extracorporeal shock-wave lithotripsy (ESWL) and 2 nephrolithotomy,all of whom had severe hematuria,were treated with selective or superselective renal segment artery embolization.Embolization materials for hemorrhages were mainly self-blood clots and(or) gelfoam,and the materials for angiomyolipoma were pure alcohol and(or) gelfoam. Results The sizes of carcinomas and abcesses were decreased in all of the 60 cases of renal carcinomas and 4 cases of renal abcesses.The edema around the carcinomas and abcesses became obvious,and bleeding was reduced,which were convenient for operation and prolonged survivals.All the renal bleeding were cured with selective or superselective renal artery embolization except for one traumatic case treated by operation for continuous bleeding.All these cases were followed up for 1 month to 18 years.One case had mild atrophy of kidney and in one case IVU didn't develop.All the others were in good condition. Conclusions Selective or superselective renal artery embolization is a safe,effective approach with less complications and most probability to preserve the diseased kidney. Renal artery embolization as a valuable treatment should be studied and widely applied.
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Modern medicine has a double characteristics of techniques and humanity in clinics especially in urology for new techniques and materials can be simply utilized by means of physical channel of urinal system.In the clinical practice of Uuology,we should consciously practice the medical ethics,such as autonomy right and respecting right,and offer humane care to patients indeed.These contributes to improving the quality of medical service,alleviating the contradictions between docters and patients,reducing medical disputes.
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Objective To investigate the applied perineal anatomy of the pudendal nerve of female and its direction to perineal operation.Methods The gross anatomy were done on 20 female cadaver(ensuring the pelvic,the hip and the perineum were intact).In each cadaver,the dissection proceeded from intrapelvic,the pudendal canal(Alcock'canal) and the ischiorectal fossa.The composition,track,abut,ramus and domination area of female pudendal nerve were examined.Results The gross anatomy showed that the pudendal nerve was composed of the ventro-branches of sacral nerve 2~4(S_2~S_4).The pudendal nerve sends off anal branch at level of the ischial spine.And the trunk courses in the internal pudendal canal forwardly and inwardly send off the perineal nerves and dorsal nerve of clitoris.The perineal nerves sends off branches to back lunar labium,muscle and urethra.The dorsal nerve of clitoris sends off the nerve to skin of clitoris,and some to the urethra simultaneously.The pudendal nerve has different abut in different anatomical position.Conclusions The perineal anatomy of the pudendal nerve has the meaningful direction to the perineal operations.