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Upper urinary tract damage secondary to voiding dysfunction is an important reason for the end stage of renal diseases. We evaluated clinical manifestations and outcomes of various treatments, and analyzed underlying mechanism in order to improve guidance for their therapy. Two hundred seventy one patients suffering from upper urinary tract damage caused by voiding dysfunction diseases from Jan. 1999 to Oct. 2009 were enrolled and data of urodynamics, urinary imaging and renal functions before and after treatments were retrospectively analyzed. Bladder pressure was over 40 cm H[2]O in 78.2% of the patients, and among them, the average pressures for the first voiding desire was 42.3 +/- 6.0 cm H[2]O with the maximum bladder pressure of 67.3 +/- 5.8cmH[2]O in 271 patients. In 157 patients the residual urine bladder volume was 100ml, but smaller and moderate residual urine volume was occurring in 37.9% of the upper urinary tract damage patients, which implied that residual urine is not an appropriate indicator. 89.3% of the patients exhibited bladder outlet obstruction and 95.2% of those suffered moderate to severe LUTS. After the relief of obstruction treatment and resulting intravesical pressure reduction, 264 patients showed a good recovery and in 202 of them hydronephrosis have disappeared and their renal function returned to normal, due to reduced bladder pressure. We found that high bladder pressure is the main reason of upper urinary tract damage caused by voiding dysfunction. Thus, attention should be paid in order to achieve and maintain reduced bladder pressure below the safety line
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Objective To investigate the therapeutic effect of post-traumatic complex posterior urethral stricture in the male patients.Methods Clinical data of 479 male patients with post-traumatic complex posterior urethral stricture were reviewed.One-stage resection of the stenosis and end-to-end anastomosis was performed in 422 patients and scrotal flap with blood pedicle posterior urethroplasty in 57.Results The mean operation time was 115 minutes(range,90-140 minutes).The mean blood loss was 225 ml(range,100-300 ml).No intraoperative blood transfusion was needed.The mean follow-up time was 15 months(range,12-24 months).Among the 422 patients performed end-to-end anastomosis,386 patients had good voiding and 36 had dysuria because of the formation of anastomotic stoma valve(21 patients)or stricture ring(15 patients).The problem was resolved by transurethral valve/stricture ring resection.Among 57 patients undergone posterior urethroplasty,45 patients had good voiding nine patients were found with anterior urethra-skin tube anastomotic stoma stricture,of which four patients were treated by urethral dilatation and five by endourethrotomy; three patients were found with posterior urethra-skin tube anastomotic stoma stricture,of which one patient was treated by urethral dilation and two by endourethrotomy.Conclusions One-stage resection of the stenosis and end-to-end anastomosis is the main treatment for post-traumatic complex posterior urethral stricture.If the condition of the patients does not allow the end-to-end anastomosis,posterior urethroplasty can be an alternative.
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Objective To investigate the effects of HO-1 on renal allografts after HO-1 gene transfection in rat chronic allograft nephropathy model. Methods Twenty F344 and twenty-six Lewis rats were included in this experiment. They were divided into 3 groups at random. Six Lewis rats were in pseudo-operation group, 10 Lewis were in empty carrier group (transfected with adenovirus) and 10 Lewis were in the gene transfection group (transfected with Ad-HO-1 adenovirus). The expression of HO-1 protein was detected by WB at the 1st ,2nd,3rd and 4th week. The content of creatinine in blood was assayed at the 4th,8th, 12th and the 16th week. The weight of rat, the value of patholiogical changes and the expression of ?-SMA,TGF-?1 and PDGF-B were analysized at the 16th week. Results The weight of rats in 3 groups had not any changes at 16th week. The content of creatinine in blood of gene transfection group were lower than those in the empty carrier group. The expression of HO-1 protein were very high in the 1st and 2nd week and decreased at 3rd and 4th week. The Banff value of kidney in the gene transfer group was better than that of the empty carrier group at the 16th week. The level of ?-SMA, TGF-?1 and PDGF-B in the gene transfection group were significantly lower than those in the empty carrier group. Conclusions Ad-HO-1 could efficiently transfer HO-1 gene into rat donor kidney. The prevention of chronic allograft nephropathy may have relationship with the decreasing expression of ?-SMA, TGF-?and PDGF-B.
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@# ObjectiveTo identify the relationship between urodynamic parameters and vaginal deliveries in women with genuine stress urinary incontinence(GSI).Methods56 women with vaginal delivery history who were diagnosed as stress urinary incontinence underwent urodynamic tests.Their abdominal leak point pressures(ALPP),maximum urethral closure pressure(MUCP) and functional urethral length(FUL) were recorded,and their Correlation to vaginal deliveries was tested using linear correlation coefficient.ResultsCorrelation between vaginal deliveries and ALPP showed a significant relationship(r=-0.349,P<0.05).Neither MUCP nor FUL showed a close relationship with vaginal deliveries(r=-0.219 and r=-0.178 respectively,P>0.05).ConclusionVaginal delivery plays an important role in the pathogenesis of GSI.The more vaginal deliveries,the more serious GSI.
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We have constructed the immune microsphere against tumor necrosis factor-alpha (TNF-alpha) prospectively, hoping to establish the experiment groundwork in more researches which could be used in specific elimination of the TNF-alpha by blood purification method for the future. The recombinant human tumor necrosis factor-alpha monoclonal antibody (rHTNF-alpha McAb) was wrapped on the polystyrene microsphere (PSM) carrier connecting poly-L-lysine (PLL) beforehand. They were earmarked by the fluorescein isothiocyanate (FITC) respectively. The packing conditions were examined using the inversted and fluorescence microscopes and the spectrophotometer. The results showed that the best conditions for wrapping were 20 degrees C, pH9.5 and 60 minutes. The PLL content was not changed in the washing fluid after coating, which indicated the wrapping was quite firm. At the same temperature and same coating time, the rHTNF-alpha McAb coated on the PLL was obviously substantial when the concentration of glutaraldehyde solution was 0.2%. The findings demonstrated that the built immune microsphers can be used as a novel adsorption material. This method is simple and economic, and it offers a new approach to the related studies.
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Humans , Antibodies, Monoclonal , Allergy and Immunology , Fluorescein , Chemistry , Microspheres , Polylysine , Chemistry , Polystyrenes , Chemistry , Recombinant Proteins , Allergy and Immunology , Tumor Necrosis Factor-alpha , Allergy and ImmunologyABSTRACT
Objective To study the different mRNA expressions of big and small conductance calcium activated potassium channels (Bkca and Skca), and calcium activated chloride channels (Clca) in normal and instable detrusors. Methods Model of bladder outlet obstruction (BOO) of female Wistar rats was prepared by ligating the proximal urethra in the perineum. Detrusor instability (DI) was confirmed by conscious cystometry. The mRNA was extracted from the detrusors of normal and DI rats for the detection of the expressions of Bkca, Skca2, Skca3, and Clca by RT PCR. The different channel expression between normal and instable detrusors was identified by gel imaging. Results The incidence of DI in BOO rats was 76.17%. Bladder capacity and the maximal detrusor pressure increased significantly ( P
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Objective To explore the therapeutic mechanisms of nitric oxide donor (SIN 1) in ischemic acute renal failure (IARF). Methods The effects of SIN 1 on intercellular adhesion molecule 1 (ICAM 1) expression and inflammatory cell infiltration in rat kidney after ischemia/reperfusion (I/R) injury were examined using ICAM 1, ?2 integrin polyclonal antibody, and immunohistochemistry. The renal functions were measured simultaneously. Results Progressive increased expression of ICAM 1 was found in kidneys, especially in vasa recta, after IR injury. ?2 integrin positive cells increased simultaneously in the outer medulla. The two indexes reached the peak values at 24 h after I/R injury. SIN 1 infusion at the beginning of reperfusion could remarkably inhibit the enhanced ICAM 1 expression, reduce the local infiltration of inflammatory cells, and ameliorate the renal functions. Conclusion NO donor can inhibit the renal expression of ICAM 1 and the infiltration of leukocytes after ischemia reperfusion injury, which may play an important role in the treatment of ischemic acute renal failure.
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Objective To elucidate the neurological mechanism of the referred pains in pelvic floor associated with the prostate. Methods The rat prostate was electrically stimulated, then the elicited action potentials (AP) of the lumbar and sacral nerves and the compound muscle action potentials from the external sphincter muscle of anus were detected. Results Action potentials from the iliohypogastric, genitofemoral, lateral femoral cutaneous, femoral, sciatic nerves compound muscle action potentials (CMAP) from the anal external sphincter were recorded. Conclusion Electric stimulation of the prostate can induce action potentials of the lumbar and sacral efferent nerves through the spinal reflex, resulting in referred pains in the perineal and pelvic areas due to muscle contraction.
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Objective To explore the functional changes of gap junctional intercellular communication(GJIC) in bladder smooth muscle. Methods The functions of GJIC in bladder smooth muscle were detected by fluorescence recovery after photobleaching(FRAP). The mean fluorescence recovery rates of the bladder smooth muscle cells in the experimental group and the control group were compared. Results The mean fluorescence recovery rate of the experimental group was significantly higher than that in the control group( P
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Objectives To observe the changes of the detrusor excitability and contractility and to study the mechanism of the unstable bladder. Methods Detrusor strips were obtained from prostectomy patients with benign prostatic hyperplasia. According to the results of urodynamic examination, patients were divided into detrusor instability (DI) and detrusor stability group(DS). Test of mechanical tension and stimulations with electricity and carbachol were performed on the excitability and contractility of the detrusor strips from 8 patients selected from each of the groups in vitro . Results The minimum tension of the detrusor strips when contraction occurred in DI and DS was (0 324?0 132)g and (0 822?0 216)g, respectively. There was significant difference between DI and DS ( P
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Objective To observe the inhibitory effect of endogenous angiogenesis inhibitor endostatin on the growth of bladder transitional cell carcinoma. Methods Recombinant mouse endostatin expressed by E. coli was purified with Ni NTA affinity chromatography and was administrated into mice bearing T739 bladder transitional cell carcinoma via subcutaneous injection at the dose of 20 mg?kg -1 ?d -1 . The tumor growth and angiogenesis were observed 10 days later. Results Tumors in mice treated with endostatin grew slowly and the inhibition rate reached 81 4%. Microvessel density(MVD) of tumor in treated group was significantly lower than that in the control group( P
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Objective To provide experimental basis for further study of the mechanism of urinary storage dysfunction of diabetic cystopathy (DCP). Methods Steptozotocin(STZ) induced and sucrose induced diabetic rats were employed as DCP and diuresis models. Normal rats served as the control. The changes of calcitonin gene related peptide(CGRP) were analyzed by immunocytochemical method and computer assisted image analysis software. Compliance of the whole bladder prepared in vitro was evaluated by bladder irrigation. The messenger molecule cAMP of detrusor relaxation was determined by radioimmunological assay. Results Compared with those in other groups, the CGRP immunoreactive positive nerve fibers and content of this neurotransmitter significantly decreased in the bladder wall, especially in the submucosa. Significantly higher bladder compliance was observed( P
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Objective To establish a stable animal model of bladder outlet obstruction(BOO) and to clarify the effects of BOO on the biomechanical properties of detrusor and the mechanisms. Methods BOO animal model was established by partial ligation of the proximal urethra of male Wistar rats forming, a urethra stricture with internal diameter of 1 mm. The active contraction of detrusor muscle stripes to carbachol was recorded with transfusor and organ bath tube. The compliance and maximum volume of bladder were examined by filling cystometry. Results The bladders demonstrated tropical post obstruction alterations at week 2 after partial ligation of the proximal urethra. The maximum volume (3 3?1 9) ml and bladder wet weight (10 4?2 8) g increased significantly in BOO group as compared with those in sham operation group [(1 6?0 8)ml and (7 2?3 5)g]. The detrusor contractile force of detrusor instability(DI) group was significantly lower than that in the control group. However, the contractile force in detrusor stability (DS) group was higher at week 2 but lower at week 4 after BOO than that in the sham operation group. Conclusion BOO animal model established by partial ligation of the proximal urethra of adult rats is simple and can give high survival rate and good stability, suitable for the studies of bladder outlet obstruction. There are two types of the detrusor contraction after BOO: DI group with impaired contraction and DS group with bidirectional change which was higher at early stage(week 2) but lower at later stage(week 4). The changes of bladder compliance are related to the stability of bladder, decrease in DI but increase in DS.
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Objective To study the modulation alterations of calcium activated potassium channel (Kca) and calcium activated chloride channels (Clca) on detrusor instability(DI) and their roles in DI. Methods The detrusor instability (DI) animal model was established using female Wistar rats. Detrusor strips were obtained from normal and DI rats. The contraction frequency and amplitude of the strips were measured by an in vitro tension test. The actions of channel openers and blockers were studied. Results Spontaneous contraction frequency and amplitude of DI increased significantly. The block of big conductance calcium activated potassium channel(Bkca) by Iberiotoxin resulted in decrease of frequency but increase of amplitude in the control, but only increase of frequency in DI. The opener, NS1619, resulted in decreases of frequency and amplitude in the control, but only decreases of frequency in DI. The block of small conductance Kca (Skca) by apamin resulted in increases of frequency and amplitude in both control and DI groups, but the opener, Chlorzoxazone, resulted in decreases of frequency and amplitude in the control, but only decrease of frequency in DI. The contraction alterations of DI were significantly lower than those of the control no matter Kca was blocked or opened. NFA, a selective Clca blocker, resulted in no significant frequency and amplitude alteration in the control, but significant decrease in DI. Conclusion These results suggested that Kca and Clca play a critical role in the modulation of detrusor contraction, and the down regulation of Kca and up regulation of Clca suggests that disorder of calcium related regulation may play an important role in DI.
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Objective To explore the mechanism of the referred pains in pelvic pain due to chronic prostatitis and the relation between pain due to prostatitis and pelvic floor muscle dysfunction. Methods The retrograde fluorescent double labeling and immunohistochemistry were used. A total of 24 Wistar rats were divided two groups, 12 in each group. In the first group, Propidium Iodide(PI) was injected into the prostate, Bisbenzimide(Bb)into the external anal sphincter. In the second group, PI was injected into the prostate, Bb into genitofemoral, iliohypogastric, ilioinguinal, femoral and lateral femoral cutaneous nerves. Results The fluorescent double labeled cells were found in the L 1 L 2 and L 6～S 3 dorsal root ganglia(DRG) and some of them were confirmed to contain calcitonin gene related peptide(CGRP) and P substance (SP) by immunohistochemistry. Conclusion The findings confirm that the peripheral process of DRG cells dichotomizes into prostate, external anal sphincter and somatic parties, and some of these cells contain CGRP and SP, which indicates the referred pains in pelvic floor may be caused by axon reflex in the peripheral process of DRG cells. Meanwhile, neurogenic inflammation might play an important role in this persistent pain status. Pain due to prostatitis is correlated with pelvic floor muscle dysfunction.
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Objective To investigate the changes of androgen receptor (AR) and AR mRNA of the ventral lobe, lateral lobe part 1(LP1) and lateral lobe part 2 (LP2) in the Wistar rat prostate after androgen manipulation. Methods Healthy adult male Wistar rats were randomly divided into 3 groups: control group(N), castration group(C) and androgen replacement group (T). In castration group, orchiectomy was performed through the scrotum. In androgen replacement group, testosterone propionate (2 5 mg/d) was injected subcutaneously for 14 d after castration. Expressions of AR and AR mRNA in the separate lobes of the adult Wistar rat prostate after androgen ablation and replacement were determined by immunohistochemistry and semi quantitative PCR. Results Different autoregulation of AR protein and mRNA was observed in the ventral lobe, LP1 and LP2 of rat prostate after androgen manipulation. In the ventral lobe and LP1, immunoreactive nuclear AR markedly decreased in staining intensity in the glandular epithelium 2 d after castration compared to that in the intact rats. Epithelial immunostaining continued to decline and was absent at day 7 and returned to normal level 3 d after testosterone replacement. There was a transient increase in AR mRNA demonstrated by RT PCR within 3 d and returned to control level within 7 d after castration in the ventral lobe and LP1 of rat prostate. In contrast, in LP2, the epithelial cells showed continued expressions of both AR protein and mRNA 14 d following androgen withdrawal. Conclusion These results suggest that there might be a different regulation of AR mediated by androgen in ventral lobe, LP1 and LP2 of rat prostate.
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Objective To explore the effects of aging on NO cGMP pathway and sexual hormone in penile tissue of different age rats. Methods The nitric oxide(NO) and cyclic guanosine monophosphate(cGMP) contents, nitric oxide synthase(NOS) activity in penile tissue and testosterone(T) and luteinizing hormone(LH) contents in blood of rats of different ages(2, 8, 16 and 24 months) were detected. Results With age increasing, ① The NO content of penile tissue firstly rose(8 months, the highest ) then dropped (24 months, the lowest), being the same as the variation of NOS( P
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Objective To promote the cure rate of operation and to decrease the operative complications in patients with upper urinary tract stone Methods The data of 962 patients with upper urinary tract stone operatively treated in our department from 1975 to 2002 were reviewed and analyzed Results Residual stones were found in 109 out of 673 patients (11 3 %) Of the 109 cases, conservative treatment, nephrectomy and various methods of treatment were performed in 21, 12 and 76 cases, respectively Conclusion Strict control of operative complication, proper selection of the operation type and reasonable management of the complication are the important measures to improve the cure rate of upper urinary tract stone, to greatly decrease the occurrence of residual stones and to reduce the possibility of nephrectomy
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Objective To observe the cytotoxicity of Ad-HO-1 and its capacity of mediating the expression of HO-1 in cultured HK-2 cells. Methods The HK-2 cells were infected by Ad-HO-1 with 100, 200 and 400 MOI for 3 h, followed by the green fluorescence observation 2 days later. The live cells ratio was detected 2 and 4 days later. The expression of HO-1 and GFP in HK-2 were detected under laser scan confocal microscope. The expression of HO-1 was detectee by Western blot analysis. 3H-TdR was used to assay the ability of HO-2 cells infected with Ad-HO-1 to inhibit the PBMC proliferation. Results Over 90% HK-2 cells expressed green fluorescence after infected by Ad-HO-1 (MOI 200) for 2 days. The live cell ratio at 2 and 4 days had not any difference from those of the control group. The expressions of HO-1 and GFP in the Ad-HO-1 transfected HK-2 cells were determined under laser scan confocal microscope. The locations of these two proteins were the same. HK-2 cells infected by Ad-HO-1 had protein immune blot strap combined with HO-1 antibody. When the MOI of Adv-HO-1 was 0.01, 0.1, 1 and 10, the proliferative capacity of PBMC was inhibited significantly. Conclusion The stable expression of HO-1 mediated by Ad-HO-1 in cultured tubular epithelial cells can inhibit the cell proliferation of PBMC.
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Objective To isolate and identify advanced oxidation protein products from human serum albumin (AOPP-HSA), expecting to search for a method of preparing highly purified and bioactive AOPP-HSA. Methods AOPP-HSA crude products were prepared in vitro by exposing HSA to HOCl. AOPP-HSA was isolated by gel chromatography and ion-exchange HPLC. Its structural features and biological activities were characterized by UV and fluorescence spectrum, SDS-PAGE, and the experiment of TNF-? release from monocytes. Results The isolated protein was purified up to 99.4% and was dityrosine-containing protein cross-linking products with molecular weight of 700?10 3. It possessed the ability of triggering the considerable release of TNF-? from monocytes. Conclusion Highly purified and bioactive AOPP-HSA can be successfully prepared by above-mentioned two-step chromatography from AOPP-HSA crude products, which builds a basis for further study of AOPP.