Delayed decompression for cauda equina syndrome secondary to lumbar disc herniation: long-term follow-up results / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the impact of delayed decompression on long-term neurological and bladder function recovery in patients with cauda equina syndrome (CES) secondary to lumbar disc herniation (LDH).</p><p><b>METHODS</b>The clinical data of 35 patients receiving delayed decompression surgery for CES secondary to LDH were reviewed. The bladder empty function, bowel control, sexual ability and neurological functions of the lower limbs were evaluated after the operation, and the urodynamic changes were assessed in 6 patients with urodynamic data before and after the operation.</p><p><b>RESULTS</b>Surgical decompression was performed at 4.1∓3.9 weeks in 12 patients with complete CES and at 5.5∓7.6 weeks in 23 patients with incomplete CES after the onset of symptoms. The patients were followed up for a mean of 43.0∓28.9 months (3-110 months). In the 23 patients with incomplete CES, 19 obtained full recovery, 4 had slight sensory alterations in the saddle area or the lower limbs. In the 12 patients with complete CES, 2 had full recovery, 4 reported slight sensory alterations in the saddle area or the lower limbs (including 2 with occasional constipation); 6 still had sense deficit in the saddle area and difficulties in bladder or bowl emptying, but they all reported significant improvements compared to the condition before operation. Urodynamic analysis in the 6 patients with pre- and postoperative urodynamic data showed increased abdominal pressure when voiding with significantly reduced residual urine in all the 6 patients; 4 patients with abnormal first desire volume before operation reported recovery after the operation.</p><p><b>CONCLUSION</b>Patients with LDH-induced CES who missed the chance of early decompression can still expect favorable functional recovery in the long term. The improvement of bladder function following decompression is probably a result of recovery of bladder sensation and the compensation by increased intra-abdominal pressure. The key strategy to promote bladder function recovery in these patients is to promote the detrusor recovery.</p>

Expressions of inflammatory and fibrogenic factors in perinephric and subcutaneous adipose tissues of patients with adrenocorticotropic hormone-independent Cushing's syndrome / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the expressions of inflammation- and fibrosis-related genes in perinephric and subcutaneous adipose tissues in patients with adrenocorticotropic hormone (ACTH)-independent Cushing's syndrome.</p><p><b>METHODS</b>The perinephric and subcutaneous adipose tissues adipose tissues were obtained from 8 patients with ACTH-independent Cushing's syndrome undergoing laparoscopic retroperitoneal adrenalectomy. Real-time PCR was used to detect the mRNA expression levels of interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), matrix metallopeptidase 2 (MMP-2), TIMP metallopeptidase inhibitor 1 (TIMP-1), early growth response 1 (EGR1), CCAAT/enhancer binding protein β(CEBPβ), uncoupling protein 1(UCP-1), PPARγ coactivator 1 alpha (PGC1α) and cell death-inducing DFFA-like effector a (CIDEA).</p><p><b>RESULTS</b>The mRNA level of CIDEA was significantly higher in the perinephric adipose tissue (peri-N) than in the subcutaneous adipose tissue (subQ) (P<0.05). The expressions of CEBPβ, UCP-1, and PGC1α mRNA in the peri-N were similar with those in the subQ. The expressions of IL-6, TIMP1 and EGR1 mRNA in the subQ were significantly higher than those in the peri-N (P<0.05). No significant difference in TNF-α and MMP-2 mRNA levels was found between peri-N and subQ.</p><p><b>CONCLUSION</b>The expression levels of the inflammation- and fibrosis-related genes are higher in the subQ than in the peri-N of patients with ACTH-independent Cushing's syndrome, suggesting that chronic exposure to endogenous hypercortisolism may cause adipose tissue dysfunction.</p>

Detection of Skp2 and p27kip1 expression in human renal cell carcinoma using tissue chip technique / 南方医科大学学报

<p><b>OBJECTIVE</b>To detect the expression of skp2 and p27kip1 in human renal cell carcinoma (RCC) using tissue chip technique, and evaluate the relationship between the proteins and the biological behavior of RCC.</p><p><b>METHODS</b>Tissue chip technique and immunohistochemical SP method was used to detect the expression of skp2 and p27kip1 in normal and tumor tissues.</p><p><b>RESULTS</b>The positivity rate of Skp2 in RCC was significantly higher than that in normal renal tissues (P=0.025). The positivity rate of Skp2 expression in RCC was significantly correlated to poor differentiation of the tumor (P=0.002), and was not associated with the patients gender, age, tumor size, lymph node metastasis and stages of RCC (P>0.05). The positivity rate of p27kip1 in RCC was significantly lower than that in normal renal tissues (P=0.007). The positivity rate of p27kip1 expression was inversely correlated to the malignancy and stage of RCC (P<0.05), but not with the patients' age, gender, lymph node metastasis and tumor size (P>0.05). An inverse correlation was noted between Skp2 and p27kip1 expressions (r= -0.273, P=0.014).</p><p><b>CONCLUSION</b>Overexpression of Skp2 protein may lead to decreased p27kip1 level in RCC, indicating its involvement in the carcinogenesis and development of RCC.</p>

Effects of transurethral catheterization on uroflow rate in the pressure-flow study of patients with benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effects of transurethral catheterization on the uroflow rate in the pressure-flow study of patients with benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>Thirty-nine men with BPH underwent free uroflowmetry and pressure-flow analysis respectively. With an 8 F urethral catheter, the standard pressure-flow variables such as the maximum flow rate, detrusor pressure at the maximum flow rate and so on were recorded. The free maximum flow rate and the maximum flow rate with transurethral catheterization were statistically analyzed.</p><p><b>RESULTS</b>The maximum voided volumes of the free uroflowmetry group and the pressure-flow study group were (209.23 +/- 56. 56) ml and (210.33 +/- 62.02) ml respectively (P > 0.05). The free maximum flow rate was (8.61 +/- 2.80) ml/s, and the maximum flow rate with transurethral catheterization-was (7.39 +/- 3.01) ml/s (P < 0.05). When the patients were divided into seven grades of bladder outlet obstruction (BOO) according to the Schäfer nomogram, the free maximum flow rate and the maximum flow rate with transurethral catheterization with Grade 0-I of BOO were (12.56 +/- 1.57) ml/s and (10.95 +/- 2.51) ml/s, and those of Grade II were (9.35 +/- 0.76) ml/s and (8.41 +/- 1.23) ml/s respectively. For Grades III, IV and V-VI , the two maximum flow rates were (7.88 +/- 1.21) ml/s and (6.37 +/- 0.59) ml/s, (6.54 +/- 1.93) ml/s and (5.55 +/- 2.48) ml/s, and (6.01 +/- 2.10) ml/s and (4.84 +/- 2.89) ml/s, respectively, all with significant difference in between (P < 0.05).</p><p><b>CONCLUSION</b>The 8 F urethral catheter has a significant effect on the maximum uroflow rate in the pressure-flow study and this effect is correlated with the grade of BOO.</p>