Prolonged continuous infusion of teriparatide promotes bone metabolism in normal but not in castrated mice / 南方医科大学学报

OBJECTIVE@#To investigate the effects of continuous pumping of teriparatide (TPTD) on bone metabolism in ovariectomized and normal mice and provide experimental evidence for the selection of animal models for studying the effects of TPTD and its related peptides on osteoclasts.@*METHODS@#Twenty-four female C57BL mice (6-weeks old) were subjected to ovariectomy (OVX) or sham operation followed 7 days later by continuous pumping of TPTD or the solvent vehicle (VEH) a micropump (SHAM-VEH, SHAM-TPTD, OVX-VEH, and OVX-TPTD groups; =6). Two weeks later, the tibial and femoral bones were harvested for micro-CT scanning to measure the parameters of the tibia and the femoral cortical bone. Histopathological examinations of the tibial tissue were conducted using HE staining and TRAP staining and the number of osteoclasts and the growth plate thickness were determined. The serum Ca2 + levels of the mice were measured. The primary osteoblasts from the cranial bone were treated with estradiol (E2) and TPTD for 48 h, and the expressions of β-catenin and RANKL protein in the cells were analyzed.@*RESULTS@#The trabecular bone mass of OVX mice was significantly lower than that of sham-operated mice ( < 0.05). Continuous TPTD pumping significantly reduced tibial cancellous bone mass and femoral cortical bone area in the sham-operated mice, while in the castrated mice, TPTD pumping increased the cancellous bone mass without changing the cortical bone area. TRAP staining showed that cancellous osteoblasts in the tibia increased significantly in the castrated mice as compared with the sham-operated mice, and TPTD pumping significantly increased the number of cancellous osteoblasts in the sham-operated mice ( < 0.05). In the primary cultured osteoblasts, treatment with both E2 and TPTD obviously lowered the expression of β-catenin and increased the expression of RANKL as compared with TPTD treatment alone.@*CONCLUSIONS@#Continuous pumping of TPTD promotes bone resorption in normal mice but does not produce obvious bone resorption effect in the ovariectomized mice, suggesting that castrated mice are not suitable models for studying the effect of TPTD and the related peptides on the osteoclasts.

Distribution and drug resistance of pathogens isolated from upper and lower ureter of stone obstruction in patients with ureteral calculi / 中华全科医师杂志

Four hundred and twenty two patients with ureteral calculi undergoing surgical treatment from January 2016 to December 2016 were enrolled in the study.Urine samples were taken from upper and lower ureter of stone obstruction,pathogen examination and drug susceptibility tests were performed.Twenty nine strains of pathogens were isolated from the upper segment of ureter with a detection rate of 6.9%;22 strains were gram-negative bacteria(75.9%)and 3 strains were gram-positive bacteria(10.3%)and 4 strains were fungi(13.8%).Forty eight strains of pathogenic bacteria were isolated from the lower segment with a detection rate of 11.4%;37 strains were gram-negative bacteria(77.1%),11 strains were gram-positive bacteria(22.9%),no fungi was isolated.In 20 cases the positive results were obtained only from upper ureter urine samples, and in 39 cases the positive results were obtained only from lower segment samples.The same pathogens were detected from both upper and lower ureter of stone obstruction in 7 cases, and different pathogens were identified in 2 cases.The most common pathogens were Escherichia coli, followed by Proteus mirabilis, Klebsiella pneumoniae, Enterococcus faecalis and Enterococcus faecium.The resistance to quinolones in gram-negative bacteria was higher than that to cephalosporins.The resistance rate of Escherichia coli to cephalosporin was 36.7%-63.3%,that to ciprofloxacin and levofloxacin was 86.7%-100.0%; the resistance rate of Enterococcus to erythromycin was 100.0%.It is suggested that ureteral calculi obstruction may lead to negative culture results of conventional mid-stream urine samples.It is of clinical value to investigate the distribution and antibiotic resistance of pathogens both from upper and lower segments of ureter in patients with ureteral calculi.

Application of nerve stimulator for obturator nerve block in transurethral resection of bladder tumor / 中华全科医师杂志

Clinical data of 120 patients undergoing transurethral resection of the bladder sidewall tumors (TURBt) were retrospectively analyzed.Before TURBt the obturator nerve was blocked under the guide of the nerve stimulator in 46 cases (block group) and not blocked in 74 cases (unblock group).The incidence of obturator nerve reflex and bladder perforation in block group was significantly lower than that in unblock group(7％ vs.35％,P =0.000 and 0 vs.19％,P =0.002,respectively).The operation time and the duration of bladder continuous saline irrigation after operation in block group were shorter than those in unblocked group [(32.2 ± 12.5) vs.(43.2 ± 24.5) min,P =0.001 and (8.9 ± 6.4) vs.(13.3 ±10.8) h,P =0.013,respectively].The efficiency value of TURBt in block group was better than that in unblock group [(5.8 ±3.9) vs.(9.3 ± 7.0) min/cm2,P =0.001].The obturator nerve block guided by the nerve stimulator can improve the safety and the efficiency of TURBt.

Study on EDTA disk potentiation test for detecting metallo-β-lactamase of Acinetobacter baumannii / 国际检验医学杂志

Objective To research a method for detecting metallo-β-lactamase(MBL)to provide the basis for rationally selecting antibacterial drugs in clinic.Methods A total of 104 strains of imipenem-resistant Acinetobacter baumanmii(IRAB)were collected. The MBL phenotype was detected by using the EDTA disk potentiation test and the detection results were compared with the PCR detection results of MBL.Results Among 104 strains of tested IRAB,21 strains were the MBL gene positive by using PCR;24 strains were the MBL gene positive by using the EDTA disk potentiation test.Compared with the PCR detection results,the sensi-tivity of the EDTA disk potentiation test was 95.2% and the specificity was 95.1%.Conclusion The EDTA disk potentiation test for detecting MBL of Acinetobacter baumanmii is simple,credible in the detection results and cheap in cost,which is suitable for the preliminary identification of the MBL-producing Acinetobacter baumanmii in the clinical microbiology laboratory of the primary hos-pitals.

Efficacy and safety of TVT-Secur procedure for treatment of female stress urinary incontinence / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of the TVT-Secur procedure for female stress urinary incontinence (SUI). Methods Analyze retrospectively the preoperative, intraoperative and postoperative complications and follow-up data of 27 SUI patients from October 2008 to May 2010. 20 cases were simple SUI, and 7 cases were mixed SUI. The average age was 56.1 ± 10.7 years (range, 35-77), the average parity was 2.8-±- 1.4 (range, 1-6), the average body mass index was 25.6±2.5, and the average course of the disease was 6.8±7.2 yeas (range, 1-30). Two cases had past history of pelvic surgery without any anti-incontinence surgery. Mashall-marchett test was positive in all patients, with an average abdominal leak point pressure (ALPP) of 60.9±27.5 cm H2O (range, 27- 120 cm H2O). The mean International Consultation on Incontinence-Short Form (ICIQ-SF) score was 11.2 ± 1.8 (range, 7- 14) before surgery. Results 27 patients underwent TVT-Secur procedure, of which 19 cases underwent "U" procedure, and 8 cases underwent "H" procedure. The mean operation time was 15.3±1.4min (range, 13- 19 min). There were no intraoperative bladder or urethral injury, and no obturator vessel or nerve damage. The blood loss was 10 to 50 ml, and the maximum urinary flow rate was 25. 4±13. 1 ml (range, 4-50 ml). Three eases had mild dysuria(11. 1%), and 3 cases had wound effusion(11. 1%). Followed up for 12. 6 ±6. 7 months (range, 3-21 months). 10 cases complained of bladder overactivity symptoms such as frequency, urgency, and urge incontinence, and no case had vaginal erosion. Therapeutic efficacy: 15 cases were cured (56%), 8 cases were improved (30%), and 4 cases were ineffective (15%). Conclusions TVT-Secur procedure is a simple, safe and minimally invasive surgery, while the cure rate is low. The long-term efficacy needs great amount of clinical data and long-term follow-up to prove.

Transobturator tension-free vaginal tape technique procedure for the treatment of female stress urinary incontinence / 中国医师进修杂志

Objective To evaluate effectiveness and safety of the transobturator tension-free vaginal tape technique (TVT-O) for the treatment of female stress urinary incontinence(SUI). Methods Twenty-six cases of SUI patients with average (52.6±6.3) years old were included. Mean course of disease was (9.2± 2.3) years. Two cases were type Ⅱ ,23 cases were type Ⅱ/Ⅲ,and 1 case was type ID. One case had history of pelvic operation procedure,2 cases accompanied by urgent urinary incontinence. All cases were undergone TVT-0 procedure. The methods of this procedure and the outcomes and complications were closely analyzed. Results The average operating duration was (18.0 ±2.3) min (15-20 min) and average blood loss was (20.0±3.4)ml (10-40 ml). Twenty-four cases (92.3%) were cured, 2 cases (7.7%) were improved, 2 cases (7.7% ) had dysuria, 1 case improved after prolonged indwelling of catheter, 1 case was recovery with urethral dilations. Four cases (15.4% ) suffered pain of thigh skin around the wound, and relieved by analgesia. One case (3.8%) complained of frequency of micturition, and improved by medicine. Twenty-six cases were followed up of 8-16 months with no recurrence. Conclusion TVT-0 for the treatment of SUI is a simple optimal and reliable method with less complications and eusemia.

Clinical value of intravesical prostatic protrusion measured by transabdominal ultrasonography in judge-ment of benign prostatic obstruction / 中华泌尿外科杂志

Objective To assess the clinical value of intravesical prostatic protrusion (IPP) measured by transabdominal uhrasonography in judgement of benign prostatic obstruction (BPO). Methods According to pressure-flow study, 109 patients with benign prostatic hyperplasia were di-vided into 3 groups (non-obstruction, equivocal obstruction and obstruction). IPP was measured by transabdominal ultrasonography in all patients. The difference of IPP between different groups was studied and the correlation between IPP and the parameters reflecting BPO was analyzed. Results IPP value of the non-obstruction group, equivocal obstruction group and obstruction group was 2.7 ±1.2 mm, 2.9±1.4 mm and 15.4±6.5 mm. There was significant difference in IPP between the non-obstruction group, equivocal obstruction group and obstruction group (P<0.01). IPP was correlated with the parameters including Pdet. Qbeg, Pdet. Qmax, Pdet. Qend, Qmax and A-G number, Spearman's ratio was 0. 628, 0. 714, 0. 591, -0. 450 and 0. 729(P<0.01), respectively. The sensi-tivity and specificity of judging BPO were 89.9% and 97.5% if the cut-off was IPP≥10 mm. Con-clasion IPP measured by transabdominal ultrasonography could be a convenient and accurate method in diagnosis of BPO.

Application of multi-endoscopic technique in treatment of post-traumatic urethrostenosis in male patients / 中华创伤杂志

Objective To study the clinical efficacy and operative skill of multi-endoscopic technique in treatment of post-traumatic urethrostenosis in male patients.Methods A retrospective analysis was done on clinical data of 47 male patients with post-traumatic urethrostenosis treated with direct visional incision urethrotomy combined with transurethral resection of scar tissue and ureteroscopic incision.There were 29 patients with anterior urethral strictures and 18 with posterior urethral strictures.Results Of all,43 patients underwent successful endoscopic surgeries at the first time but one underwent secondary surgery because of unsuccessful endoscopic incision.These patients achieved satisfactory results without urinary incontinence,fistula or reoperation.The left three patients underwent open surgeries because of unsuccessful endoscopic incision,in which one patient could micturate at maximal flow rate of 9-12 ml/s,without therapeutic urethral dilation,one could micturate under regular therapeutic dilation and the other one could not micturate.Conclusions With the advantages of safety,high success rate and good long-term efficiency,multi-endoscopic technique can be used as an initial treatment for male patients with post-traumatic urethrostenosis and is worthy to be popularized.

Differentiation of helper T lymphocyte in type Ⅲ prostatitis / 中华泌尿外科杂志

Objective To investigate the differentiation of CD4+T helper cell in expressed prostatic secretions(EPS)in type Ⅲ prostatitis. Methods Seventy-six patients were studied,aged from 18 to 47(average 31.8).All patients presented with typical clinical symptoms for over 3 months.Cases were classified as type Ⅲ A(47 cases),type Ⅲ B(29 cases)and control group(16 cases)according to NIH classification system.Type Ⅲ A was also divided into group Ⅲ A1 with 26 cases(mild inflammation)and group Ⅲ A2 with 21 cases(severe inflammation).Th1 cytokine IFN-γ,Th2 cytokines IL-4 in EPS were detected by double antibody sandwich ELISA,and IFN-γ/IL-4 was determined.Results Compared with group control,IFN-γ in group Ⅲ A and Ⅲ B were significantly up regulated (134.78±43.67 pg/ml,109.82±30.09 pg/ml,P＜0.05),while IFN-γ level in group Ⅲ A was higher than in group Ⅲ B(P＜0.05).IL-4 in groupⅢ A was not changed(51.99±20.59 pg/ml,P＞0.05).IL-4 in group ⅢB was higher(76.40±17.99 pg/ml,P＜0.05).IFN-γ/IL-4 in group ⅢA was elevated significantly(2.94±1.12,P＜0.05),while IFN-γ/IL-4 in group ⅢB was not changed(1.49±0.48,P＞0.05).IFN-γ/IL-4 in group Ⅲ A2 was higher than in groupⅢA1 significantly(3.67±0.82vs 2.34±0.97,P＜0.05). Conclusions Th1 eell differentiation took the dominance in type Ⅲ A prostatitis.Th1/Th2 equilibrium was shifted to Th1.It is probably one of the pathogenies that Th1 dominant differentiation leads to local inflammation in prostate of type Ⅲ A prostatitis.

Intrasinusal pyelolithotomy for giant staghorn calculi / 中华泌尿外科杂志

Objective To evaluate intrasinusal pyelolithotomy for giant staghorn calculi. Methods The data of 22 cases treated with intrasinusal pyelolithotomy were analysed. Results Lithotomy was successful in all cases with the average operation time 116 minutes.Blood transfusion during the procedure was required in 8 cases with an everage of 550 ml.Postoperative examination of 12 cases with B ultrasound revealed residual calculus in 3,the diameters being less than 0.8 cm. Conclusions The procedure for giant staghorn calculi was easy,safe,and effective with renal parenchyma intact.

Inflammatory pseudotumor in anterovesical space(report of 4 cases) / 中华泌尿外科杂志

Objective To study the clinical features,etiology,misdiagnosis of inflammatory pseudotumor in anterovesical space. Methods Four cases of inflammatory pseudotumor in anterovesical space were retrospectively reviewed.Their clinical processes and features were analyzed based on literature. Results In all 4 cases,partial bladder wall was infiltrated.Two cases were misdiagnosed as bladder carcinoma.All tumors and partial walls of bladder were successfully resected.All 4 patients were followed up for 3 months to 6 years.No recurrence was observed. Conclusions Prior ligation of fallopian tube and infection are important etiological factors of inflammatory pseudotumor in anterovesical space.Misdiagnosis can be avoided by analysing the history,clinical condition and special examination.The operative therapy is effective.

Renal angiomyolipoma with spontaneous rupture(report of 23 cases) / 中华泌尿外科杂志

Objective To investigate the clinical features,diagnosis and treatment of spontaneous rupture of renal angiomyolipoma (RAML). Methods A total of 23 cases of spontaneous rupture of renal angiomyolipoma were studied retrospectively.The main clinical manifestations were summarized as follows.Sudden and unexpected lumbar and abdominal pain occurred in 21 cases and lumbar swollen pain in 2.Of them 3 cases concomitantly had hematuria.Nausea and vomiting occurred in 2 cases,shock in 3 and fever in 1.All cases underwent B-ultrasonic examination and 21 had CT examination. Results Diagnosis of RAML was established preoperatively in 16 cases,but 4 cases were misdiagnosed for carcinoma of kidney,1 case for renal infectious disease.Two cases were diagnosed by frozen-section sample during operation.Nephrectomy was performed in 10 cases and nephron sparing nephrectomy in 12,and digital subtraction angiography (DSA) embolization in 1. Conclusions Spontaneously ruptured RAML often changes its clinical symptoms and imaging features,which may result in a high misdiagnosis rate and subsequent nephrectomy.Comprehensive analysis of clinical manifestations and image findings can improve preopreative diagnosis rate,and frozen slice sample examination during operation can avoid unnecessary nephrectomy.

The diagnosis and management of renal angiomyolipoma / 临床外科杂志

Objective To inquire into the diagnosis and management of renal angiomyolipoma.Methods The 22 cases of RAML were studied restrospectively.Results The diagnosis accuracy was 54.5% for B ultrasound and 81.8% for CT,18 were diagnosed as RAML and 4 were misdiagnosed as renal cell carcinoma preoperatively,of which 3 were diagnosed as RAML based on intraoperative frozen section study.11 had been performed enuoleation,7 partial nephrectomy,3 nephrectomy and 1 radical nephrectomy. Conclusions CT is the first line imaging method for RAML.the cow fatty component,intratumor hemorrhage and small tumor are the main canse of misdiagnosis in RAML.careful analysis to clinical feature and imaging data,intraoperative frozen sect,ion study can avoid misdiagnosis.nephron sparing surgery is the best operative management.

Evaluation of urinary NMP_(22) in the detection of transitional cell carcinoma of bladder / 中国癌症杂志

0. 05) . The sensitivity and specificity of NMP-,2 in diagnosing transitional cell carcinoma of bladder were 85. 7% and 60% when the cut-off was set 10 u/ml, In contrast, the sensitivity and specificity of urinec cytology were 32. 1% and 100%. Conclusions: Urinary NMP22 can be used to screen and follow up transitional cell carcinomas of bladder with high sensitivity and high specificity.

Observation of the Therapeutic Effect of Pagosid on Prostatodynia / 中国药房

OBJECTIVE:To evaluate the therapeutic effect of pagosid on prostatodynia.METHODS:30patients with prostatodynia were evaluated;pagosid was taken orally1tablet t.i.d and NIH-CPSI was scored before treatment and q.w.4weeks after treatment.The results were evaluated.RESULTS:Effective rates from the first to the fourth week were16.7%,33.3%,40.0%,76.7%respectively.No obvious adverse reactions were found in the period of treatment.CONCLUSION:Pagosid has obvious effect on prostatodynia with pain as chief complaint,and few adverse reactions will develop.However it is slower to take effect,and therefore nonsteroid analgesic is recommended in the early stage of treatment.