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Objective:To explore the effect of comprehensive gastrointestinal training on the recovery of gastrointestinal function after radical cystectomy (Bricker′s operation).Methods:Seventy-one elderly bladder cancer patients who had undergone Bricker′s operation were randomly divided into a control group of 34 and an observation group of 37. Both groups were given routine treatment, while the observation group was additionally provided with comprehensive gastrointestinal training immediately after the operation. Plasma gastrin was measured before the operation and on the 1st and 3rd day afterward. The return of peristaltic sounds, the exhausting and defecation time, the incidence of intestinal obstruction and the average hospital stay were recorded. On the 7th, 14th, 21st and 28th day after the operation, both groups′ gastrointestinal functioning was scored by using Gastrointestinal Symptom Rating Scale (GSRS).Results:The levels of plasma gastrin in the observation group were significantly higher than before the surgery and significantly higher than those in the control group on the 1st and 3rd day after the surgery, though there had been no significant difference between the two groups before the operation. Compared with the control group, peristaltic sounds returned significantly earlier in the observation group (after 1.22±0.15d), and the group′s exhaust time (1.88±0.22d) and first defecation time (2.95±0.19d) were also better. The incidence of intestinal obstruction (23.53%) was significantly lower in the observation group as well. The observation group recorded lower average GSRS values than the control group throughout the observation and follow-up periods, and their average hospital stay was significantly shorter.Conclusion:Comprehensive gastrointestinal training can effectively promote recovery after radical bladder cystectomy.
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BACKGROUND:Now it has cooperation and facilitative effete between myogenic regulatory factors through a long time study. So, gene therapy of double genes of Myod1 and Myog can obtain better effect, and can provide a new way for preventing denervated skeletal muscle atrophy. OBJECTIVE:To construct eukaryotic co-expression vector carrying Myod1 and Myog genes. METHODS:Ful-length Myod1 gene and Myog gene cDNA were amplified by reverse transcription PCR, and then inserted into pVAX1 vector after digested to establish the recombined Myod1 and Myog eukaryotic co-expression vector pVAX1-Myod1-IRES2-Myog-IRES2-EGFP, and then identified with gene sequencing. The in vitro cultured 3T3 cel s were transfected with pVAX1-Myod1-IRES2-Myog-IRES2-EGFP, and the expressions of Myod1 and Myog genes in the 3T3 cel s were detected with western blot assay in order to identify whether the 3T3 cel s could express the target protein correctly. RESULTS AND CONCLUSION:The sequencing results showed that the sequence length and base sequence of Myod1 and Myog cDNA in eukaryotic co-expression vector pVAX1-Myod1-IRES2-Myog-IRES2-EGFP were identical with the reported sequences. Myod1 and Myog protein band expressions were detected in 3T3 cel s by western blot after transient transfection. The pVAX1-Myod1-IRES2-Myog-IRES2-EGFP, a eukaryotic co-expression vector of Myod1 gene and Myog gene is successful y constructed.
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Objective To find the differences of bladder and urethra dysfunction between sacral spinal cord injury and Thoracolumbar spinal cord injury.Methods According to the criteria of inclusion and exclusion, we collected 30 patients in the study group.There were 22 males and 8 females, aged 17 -74 ( mean, 47 ) years, with duration between 7 - 36 ( mean, 18) months.There were nineteen cases of thoracolumbar spinal cord injury and 11 cases of sacral spinal cord injury in the study group.We conducted a retrospective analysis of the urodynamic data of the 30 patients in the group.They were divided into a sacral spinal cord injury group and a thoracolumbar spinal cord injury group according to the location of the site of injury.The urodynamic findings of the two groups were comparable.SPSS 16.0 was used to compare the differences between the groups by ANOVA/rank sum test.Results We measured the free flow rate parameters between thoracolumbar and sacral spinal cord injury groups.The maximum free flow rate was ( 13.0 ±5.1 ) vs ( 13.0 ±5.8) ml/s, the free flow rate at 2 s was (6.5 ±5.1 ) vs (6.9 ±6.4) ml/s, the mean free flow rate was (5.4± 2.4) vs ( 3.4 ± 0.5 ) ml/s, urine output volume was ( 279.1 ±131.1 ) vs (450.0 ± 26.6) ml and the residual urine volume was (209.5 ± 180.7 ) vs (434.0 ± 215.0) ml.The residual urine volume and urine output volume of sacral the spinal cord injury group was higher than the thoracic spinal cord injury group (P ＜ 0.05).We also measured the the cystometric parameters.The maximum urinary flow rate was (16.0±23.3) vs (7.1 ±3.3) ml/s, average flow rate was (4.6 ±2.3) vs (3.9 ± 2.3) ml/s, the flow rate after voiding 2 s was (4.6 ± 3.1 ) vs (2.2 ± 3.2) ml/s, urine output volume was (268.4 ± 113.9) vs ( 129.0 ± 97.9) ml, detrusor pressure of maximum flow rate was (58.8 ± 22.0) vs (56.5 ± 14.5) cm H2 O, flow rate of maximum detrusor pressure was (4.8 ± 2.0) vs (4.8 ± 4.4) ml/s,the maximum detrusor pressure was (68.0 ± 31.0) vs (54.6 ± 20.2) cm H2O and the average pressure of voiding period was (47.4 ±20.0) vs (42.6 ± 13.9) cm H2O.The urine output volume of the thoracolumbar spinal cord injury group was lower than sacral spinal cord injury group ( P ＜ 0.05 ).There were no significant differences in bladder sensation and coordination of bladder/urethra between the thoracolumbar spinal cord injury group and the sacral spinal cord injury group (P ＞ 0.05).The incidence of low compliance bladder in the thoracolumbar spinal cord injury patients (4/11) was higher than the sacral spinal injury group, the incidence of high compliance bladder in the sacral spinal cord injury patients (11/19) was higherthan the thoracolumbar group.Conclusions The urodynamics' difference between the sacral spinal cord injury group and thoracolumbar spinal cord injury group was observed in bladder compliance and bladder detrusor contractility changes.Relatively, the incidence of decreased detrusor contractility and high compliance bladder in sacral spinal cord injury patients was higher, and the cidence of detrusor hyperreflexia and low compliance bladder in thoracolumbar spinal cord injury patients was higher.
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The changes in excitability and autorhthmicity of bladder detrusor in experimental non-insulin dependent diabetes mellitus (NIDDM) rats were observed. Sixty-nine NIDDM rats as NIDDM group and 69 normal rats as control group were enrolled into this experimental study. At 6th, 10th, 14th, 18th, 22nd and 26th week after the rats were injected last time, the changes in the excitability and autorhthmicity of detrusor strips in vitro were observed. The results showed that the threshold of the tension which made the detrusor strips contract was significantly higher in NIDDM group (0.716 +/- 0.325 g) than in control group (0.323 +/- 0.177 g) (F = 59.63, P < 0.001). At different stages, the threshold of the tension resulting the contract of the detrusor strips in NIDDM group was also higher than in control group. At 18th week after STZ injection, the frequency of spontaneous contract of the detrusor strips in NIDDM was significantly higher than in control group (P < 0.05), whereas at 22nd week, that in NIDDM group was significantly lower than in control group (P < 0.05). It was concluded that the decreased excitability of the bladder detrusor was the earliest and most obvious changes in bladder function in diabetes rats and the autorhthmicity had also changed at the early stage of diabetic bladder.
Subject(s)
Diabetes Mellitus, Experimental/physiopathology , Diabetes Mellitus, Type 2/physiopathology , Muscle Contraction/physiology , Muscle Relaxation/physiology , Rats, Wistar , Urinary Bladder/physiopathology , Urinary Bladder Diseases/etiology , Urinary Bladder Diseases/physiopathologyABSTRACT
The changes in excitability and autorhthmicity of bladder detrusor in experimental noninsulin dependent diabetes mellitus (NIDDM) rats were observed. Sixty-nine NIDDM rats as NIDDM group and 69 normal rats as control group were enrolled into this experimental study. At 6th,10th, 14th, 18th, 22nd and 26th week after the rats were injected last time, the changes in the excitability and autorhthmicity of detrusor strips in vitro were observed. The results showed that the threshold of the tension which made the detrusor strips contract was significantly higher in NIDDM group (0.716±0.325 g) than in control group (0.323±0.177 g)(F=59.63, P＜0.001). At different stages, the threshold of the tension resulting the contract of the detrusor strips in NIDDM group was also higher than in control group. At 18th week after STZ injection, the frequency of spontaneous contract of the detrusor strips in NIDDM was significantly higher than in control group (P＜0.05), whereas at 22nd week, that in NIDDM group was significantly lower than in control group (P＜0.05). It was concluded that the decreased excitability of the bladder detrusor was the earliest and most obvious changes in bladder function in diabetes rats and the autorhthmicity had also changed at the early stage of diabetic bladder.
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<p><b>OBJECTIVE</b>To analyze the value of the diagnostic criteria for bladder outlet obstruction in benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>A total of 358 patients with BPH were divided into 3 grades according to fibrous urethrocystoscopy information on the severity of obstructions, which were classified as Grade 1 (slight), Grade 2 (moderate), and Grade 3 (severe). By Schäfer's graph they were divided into 7 grades, represented by 0 to VI. We analyzed the volume of prostate, maximum flow rate (Qmax), residual urine volume, International Prostatic Symptom Score (IPSS) and detrusor instability. Statistical analysis ANOVA (analysis of variance) was made, spearman correlation evaluated and the coefficient of determination measured.</p><p><b>RESULTS</b>Of all the patients, 27 were classified as Grade 1, 236 as Grade 2 and 95 as Grade 3. Eighty-four patients had detrusor instability. The volumes of the prostate ranged from 16 ml to 145 ml, averaging (47.04 +/- 15.61) ml. The mean maximum flow rate was (10.02 +/- 2.12) ml/min and the mean residual urine volume was (84.06 +/- 36.50) ml. With the increase of the severity of obstruction, the volume of the prostate increased (F = 4.216, P < 0.05), IPSS rose (F = 8.408, P < 0.001), the maximum flow rate decreased (F = 22.43, P < 0.001), the residual urine volume rose (F = 163.232, P < 0.001), the incidence of detrusor instability increased (F = 23.637, P < 0.001) and Schäfer's grades were elevated (F = 202.897, P < 0.001). The volume of the prostate, the maximum flow rate (Qmax), residual urine volume, IPSS detrusor instability and Schäfer's grades were all correlated significantly with the severity of the obstruction. The correlation index and coefficient of determination were r = 0.29, R2 = 0.08; r = 0.35, R2 = 0.12; r = -0.69, R2 = 0.47; r = 0.60, R2 = 0.36; r = 0.33, R2 = 0.11; r = 0.72, R2 = 0.52; respectively. The correlation between the urethrocystoscopy information and Schäfer's graph on the severity of the obstruction were the best criteria of all.</p><p><b>CONCLUSION</b>The severity of the obstruction at urethrocystoscopy correlates well with that at urodynamic investigation. Such criteria could improve the sensitivity and specificity of the diagnosis of bladder outlet obstruction.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Prostatic Hyperplasia , Diagnosis , Retrospective Studies , Urinary Bladder Neck Obstruction , Diagnosis , UrodynamicsABSTRACT
Objective To explore the role and significance of free radicle in the pathophsiological mechanisms of diabetic cystopathy(DCP).Methods The detrusor strip contraction experiments were performed and observed in the group of type 2 diabetes mellitus(T2DM) rats at different time stages and the control group.The bladder tissue samples was made into homogenate,and the activities of superoxide dismutase(SOD) and the contents of malondialdehyde(MDA) were determined.Results The minimum stretch forces to induce the detrusor contractions in T2DM group were larger than the control group.Compared with the control group,the detrusor contractive frequency was higher in the period of 0 to 16 weeks,but was lower after the 20th week.The maximum detrusor contractive forces in the T2DM group showed a descended tendency with the elapse of the experiment time.In the bladder homogenate of the control group,the activities of SOD was declined after reaching the peak at the stage of 8th week,and then escalated at the stage of 24th week.As for the T2DM group,the activities of SOD became higher in the 4th week,than descended at the stage of 8th and 24th weeks.The contents of MDA in both groups showed descended tendency.In T2DM group,MDA became even lower than the control group in the 4th week and became higher than the control group in the 8th week.The ratio of SOD/ MDA in T2DM group was lower than the control group.In details,the ratio of SOD/MDA in T2DM group rose significantly in the 4th week,while declined in the 8th week.There was a negative correlation between the maximum detrusor contractive force and detrusor contractive frequency,and a positive correlation between the maximum detrusor contractive force and the contents of MDA.Conclusion The destrusor functions are impaired by Diabetes Mellitus.In the initial stage of DCP,the bladder functions are normal,because the detrusor had a high ability to remove the free radicle.In the progression stage of DCP,the bladder functions become decompensation,because the organism is seriously injured by the free radicle.So the impairment by free radicle is one of important mechanisms of destrusor impairment of diabetic cystopathy.
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Objective To analyze the relationship between bladder trabeculation degrees and the urodynamic findings in patients with benign prostatic hyperplasia (BPH). Methods A total of 358 patients with BPH were included.Based upon the urethrocystoscopy, the bladder trabeculation degree was divided into 4 grades:Grade 0-no bladder trabeculation;Grade 1-mild to moderate;Grade 2-severe;Grade 3-severe with formation of pseudo-diverticula.We analyzed the relationship between the bladder trabeculation found by fiber urethrocystoscopy and the urodynamic findings such as maximum flow rate (Qmax),P Qmax.Watte factor,compliance and residual urine volume.For statistical analysis AVOVA (analysis of variance) and Spearman correlation were used. Results In the 358 cases,the bladder trabeculation degrees were as follows:Grade 0,21 cases;Grade 1,228 cases;Grade 2,82 cases and Grade 3,27 cases.A significant correlation was found between bladder trabeculation and the urodynamic findings.As the degree of bladder trabeculation increased,Qmax decreased (Grades 0 to 3:11.50?1.13,10.28? 2.29,9.80?0.98,7.36?1.37 ml/s,respectively;F=22.43,P
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150 ml in 22 patients (31%).Ten patients (14%) had detru-sor instability.Six patients were incapable to void during the test. The volume of first bladder sensation was(203.25?107.53)ml (range,125 -630 ml) in the diabetes patients.The bladder capacity was (428.09?227.89)ml (range,220 -1350 ml).The maximum flow rate was (10.70?3.27) ml/min.The residualurine volume was (100.57?108.08) ml.In early stage group the volume of first bladder sensation was(151.67?24.07) ml;while in progressive stage group it was (268.16?13.90)ml,and bladder capacitywas (592.97?252.51)ml.The maximum flow rate was (8.61?2.04) ml/min. PQmax was (33.16?19.81)cm H2O (1 cm H2O=0.098 kPa).The residual urine volume was (169.03?137.25) ml. Theseparameters were all abnormal. In the detrusor strips test,the threshold of the tension which made the detrusorstrips contract was significantly higher in T2DM rats [(0.72?0.33) g] than in control rats [(0.32?0.18)g] (F=59.63,P