The recovery of affected side kidney function after upper urinary tract obstruction was relieved, a retrospective study / 中华泌尿外科杂志

Objective To investigate the recovery of affected side kidney function after upper urinary tract obstruction was relieved Methods 78 patients who had been diagnosed with upper urinary tract obstruction were enrolled from January to December of 2015 in our hospital.All patients received the surgery to relieve the obstruction.GFR of the affected side kidney was done after one months of the surgery.The average age was(51.3 ± 12.8)years old.The reason of obstruction was upper urinary tract calculi (72 cases) and upper urinary tract stenosis (6 cases) respectively.All the patients received CT and ECT before and after operation.All the patients was divided into 3 groups by the decreased degree of affected side kidney function,including moderately decreased group [15 rnl/min ≤ GFR ＜ 30 ml/min,n =43,mean value =(23.1 ±5.0) mL/min],severely decreased group [7.5 rnL/min≤ GFR ＜ 15 ml/min,n =23,mean value =(11.2 ± 2.3) ml/min],and extreme severely decreased group [GFR ＜ 7.5 ml/min,n =12,mean value =(4.3 ± 2.9)ml/min].Linear correlation analysis was used to analysis the relationship analysis between the GFR value (pre-operation,post-operation) and the renal cortical thickness.The follow up time of extreme severely decreased group extended to 8-12 months.Results The GFR of moderate decreased group recovered to(30.6 ± 8.5) ml/min,regained averagely (7.56 ± 7.62) ml/min;the severely decreased group recovered to (13.1 ± 4.5) ml/min,regain (1.94 ± 3.38) ml/min.Extreme severely decreased group recovered to (11.1 ± 3.4) ml/min,regained averagely (6.75 ± 4.76) rnl/min,the GFR mean value after operation 8-12 months recovered to (12.7 ± 3.6) ml/min.All groups got significant recovery of kidney function of the affected side.The correlation coefficient between GFR value and the renal cortical thickness was 0.59 (before the surgery) and 0.70 (after the surgery) respectively (P ＜ 0.05).Conclusions Most of affected side kidneys got different degree of recovery.Obstruction influenced the accuracy of ECT at the time of evaluating the actual renal function before operation.The kidneys which had been supposed should be resected in presurgical evaluation could recover to the level of kidney reserve after the surgery.

Endovascular treatment of ureteral stenosis:a report of 628 cases / 局解手术学杂志

Objective To summarise and analyze the clinical effecacy of endovascular treatment(internal holmium laser incision,bal-loon dilation,ureter dilator,rigid ureter dilation)for ureteral stricture.Methods The clinical data of 628 patients from January 2010 to Jan-uary 2015 in our hospital were analyzed.The relevant operation indicators,postoperative complications and recovery condition were recorded and analyzed.Results The operation time was 5.5 to 29 minutes,with average time of 16.5 minutes,no ureteral avulsion,ureteral fragmen-tation and massive haemorrhage happened.All patients were followed up for 6 to 36 months,591 cases(94.1%)were cured,29 cases (4.6%)of postoperative stricture recurrence received endovascular treatment again,8 patients(1.3%)conversion to open ureterolithotomy. Conclusion Endovascular treatment of ureteral stricture is diversified within holmium laser incision,it has the advantages of shorter opera-tion time,fewer complications,less trauma,repeatability and so on,which is an effective and safe treatment method.

Expression and clinical significance of URAT1 in renal tissue of patients with uric acid nephrolithiasis / 局解手术学杂志

Objective To investigate the metabolic profile of uric acid and the significance of the altered renal expression of urate trans-porter 1(URAT1) in patients with uric acid nephrolithiasis. Methods The data of 24 patients in our hospital from January 2012 to October 2013 were analyzed retrospectively. Participants in the research were divided into three groups:patients with uric acid nephrolithiasis,other patients with nephrolithiasis and normal participants. The basic clinical data and the related data of uric acid metabolition of participants were collected,URAT1 gene expression in renal tissures of three groups was detected by Real-time PCR technique. All data were statistically ana-lyzed and compared between these groups. Results Uric acid levels in plasma,body mass index and age were significantly higher in patients with uric acid nephrolithiasis than other two groups (P0. 05). The result of Real-time PCR suggested that the URAT1 renal expression was significantly higher in patients with uric acid nephrolithiasis than other two groups (P<0. 05). Conculusion Patients with uric acid nephrolithiasis are closely related with hyperuricemia,but unrelated with renal over-ex-cretion of uric acid. The upregulated URAT1 expression in the kidney may be an important molecular mechanism of the clinical features.

Outcomes of metallic ureteral stents for malignant ureteral obstruction and chronic benign ureteral obstruction / 局解手术学杂志

Objective To evaluate the curative effect of metallic stent placed for malignant and chronic benign ureteral obstruction. Methods From October 2013 to April 2014, 10 patients were given placement of the metallic stents for treatment of malignant ureteral ob-struction and chronic benign ureteral obstruction in our institutionl. ECT was performed to test split kidney function after metallic stents placement. Results After the mean follow-up time of 4 months ( ranged from 1 to 7 months) , unilateral renal function improved in 11 cases. And there was no decrease of kidney function among all the patients who were given placement of the metallic stents. Conclusion Metallic stent is a valuable treatment for releasing the malignant and chronic benign ureteral obstruction.

Curative observation of polyscope modular flexible ureteroscope combined with Holmium laser lithotripsy in the treatment of renal calculi / 局解手术学杂志

Objective To evaluate the curative effect of polyscope modular flexible ureteroscope combined with Holmium laser lithotrip-sy in the treatment of renal calculi. Methods 53 patients with renal calculi were performed CTU to detect the position of renal calculi before operation. The patients were treated with polyscope modular flexible ureteroscope combined with Holmium laser, and the double J tube were routinely indwelled 4 to 12 weeks after surgery. Results All the 52 patients has successfully completed the operation in the frist stage. The mean operative time was about 38 minutes. 6 patients were treated with flexible ureteroscope for second stage operation. One week after oper-ation, the review showed that there were residual calculi existed in 24 cases and there were 56 cases of post-operative infection, including 17 cases of sepsis or sepsis shock. Conclusion Polyscope modular flexible ureteroscope can be used for all kinds of kidney stones surgery and is characterized by safety and mild tissue injury. But we should pay more attention to the post-operative infection especially urosepsis.

Clinical efficacy of physical vibration lithecbole / 局解手术学杂志

Objective To analyze the clinical efficacy of physical vibration lithecbole in treatment of urinary calculi. Methods Ana-lysed the efficacy of 80 patients who underwent physical vibration lithecbole only or combination therapy with surgery in urinary calculi in our hospital from February 2014 to July 2014. Result There were 1 to 4 times calculi discharge among the 80 patients. One month after the sur-gery, the calculi discharge rate was 33. 3% and the calculi clean rate was 22. 2% in the upper ureteral; the calculi discharge rate was 16. 7%and the calculi clean rate was 50. 0% in the distal ureteral; the calculi discharge rate was 40. 0% and the calculi clean rate was 23. 3% in the upper renal calyx;the calculi discharge rate was 27. 7% and the calculi clean rate was 38. 8% in the middle renal calyx;the calculi discharge rate was 60. 0% and the calculi clean rate was 20. 0% in the lower renal calyx. One month after the surgery of physical vi-bration lithecbole combined with Holium laser lithotripsy, the calculi discharge rate was 52. 1% and the calculi clean rate was 39. 1%. Con-clusion Physical vibration lithecbole is a noninvasive treatment for urinary calculi. It has good efficacy in calculi discharge and it can relieve the pain caused by calculi.

Holmium laser incision under ureteroscopy for refractory hemospermia / 局解手术学杂志

Objective To analyse the effect of holmium laser incision through ureteroscopy and simple ureteroscopy treatment for refrac-tory hemospermia. Methods From December 2003 to April 2013,the data of 67 cases with refractory hemospermia were retrospectively ana-lyzed. All the patients underwent semen analysis,transrectal ultrasonography,seminal vesicle ultrasonography,some patients underwent pelvic CT or MRI. Results Simple ureteroscopy were done for 24 cases,holmium laser incision through ureteroscopy were done for 43 cases. Var-ying degrees of ejaculatory duct stenosis or obstruction were observed. Postoperative follow-up was from 6 months to 8 years,in 24 cases of simple ureteroscopy,2 cases experienced recurrence 6 or 8 months later. The ejaculatory duct narrow were found when they received reopera-tion,with holmium laser incision,hemospermia disappeared. No complications such as retrograde ejaculation,urinary incontinence or rectal injury occurred postoperatively. Conclusion The effect of holmium laser incision through ureteroscopy for refractory hemospermia is better than simple ureteroscopy,which is worthy of clinical application needs further observation and summary.

Clinical analysis of temporary urinary incontinence after transurethral resection of the prostate for the treatment of benign prostatic hyperplasia / 重庆医学

Objective To evaluate the clinical effect of the transurethral resection of the prostate (TURP) reserving anterior lobe of the prostate .Methods A total of 736 cases of benign prostatic hyperplasia (BPH ) patients from Guizhou Aerospace Hospital were averagely randomly divided into the observation group and control group .Control group was treated with traditional TURP with the anterior lobe reseated ;while observation group was treated with the similar method to the control group ,but retained the anterior lobe .The clinical therapeutic effects and postoperative complications were observed .Results The maximum flow rate ,re-sidual urine volume and the international prostate symptom score in observation group did not show any statistical significance com -pared with that in control group after surgery (P> 0 .05) .The prevalence rate of temporary incontinence in observation group (1 .09% ) was lower than that in control group(5 .16% ) ,with significant difference(P0 .05) .Conclusion TURP reserving the anterior lobe can effectively reduce the incidence of temporary urinary incontinence ,there-fore ,this method could be spread in the clinical practice .

Surgical treatment of post-traumatic complex posterior urethral stricture in male patients / 中华创伤杂志

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.

Clinical observation of tamsulosin in the treatment for lower ureteral calculi(216 caces report) / 重庆医科大学学报

Objective:To observe and assess the effect of Tamsulosin in the treatment for lower ureteral calculi. Methods: 378 patients with ureterolithiasis in the lower ureter were randomly divided into two groups: The contral group(n=162) was subjected to the regular treatment(Dang Shipian 1.8g Tid for 4 weeks and with drinking water over 2 000 ml per day); The treatment group(n=216) was regular treatment combined with Tamsulosin (0.2 mg Bid for 4 weeks). Results: In treatment group, 86.1% (186 of 216) of the patients expelled the calculi and was higher than 38.3%(62/162) in contral group. The mean time discharged calculis in treatment group was more shorter than the contral group. Conclusion: The treatment of Tamsulosin could accelerate calculi discharge from lower ureter and increase the discharge rate of calculi.

Determination of stress leak point pressure in the diagnosis of female genuine stress urinary incontinence / 中国组织工程研究

BACKGROUND: Urinary incontinence can be divided into stress, urgent and mixed types, they can not be easily distinguished only basing on clinical experience, which often result in misdiagnose or improper treatment OBJECTIVE: To discuss the value of urodynamical inspection, especially stress leak point pressure (SLPP) determination in the diagnose of female stress urinary incontinence.DESIGN: Retrospective paralleled comparison observation.SETTING: Center of General Urology Department, Southern Hospital,Third Military Medical University of Chinese PLA PARTICIPANTS: Totally 120 female patients who received medical treatment in the uropoiesis surgical department of the Southwest hospital due to urinary incontinence between January 1996 and May 2002 were enrolled in this experiment.gle was determined and considered as normal if it was ＜100° and abnormal if ＞ 100°. Urethral tilt angle is judged as normal if ＜ 45° and abnormal if ＞45°; Urethrovesical junction (when static state) was judged as normal if not tion: including fulling urinary bladder pressure measurement, static urethral Cystourethrography classification standard: type Ⅰ refers to posterior urethrovesical angle vanished with urethral tilt angle＜45° and the biggest urethra closure pressure＞20 cmH2O; type Ⅱ: refers to posterior urethrovesical angle vanished with urethral tilt angle＞45° and the biggest urethra closure pressure＜20 cmH2O; type Ⅲ refers to normal posterior urethrovesical angle with urethral tilt angle＜45° and the biggest urethra closure pressure ＞20 cmH2O. SLPP classification standard: typeⅠ: SLPP ＞120 cmH2O; type Ⅱ: SLPP of 90- 120 cmH2O; type Ⅲ: SLPP ＜ 60 cmH2O;type Ⅱ/Ⅲ: SLPP of 60 - 90 cmH2O.compared with that of cystourethrographic classification.RESETS: Totally120 patients all remained in the final result analysis.stress urinary incontinence, 64 cases as symptomatic stress urinary incontinence including 28 cases of unstable bladder and 36 cases of low compliclassification: of the 56 genuine stress urinary incontinence, 20 cases were diagnosed as type Ⅰ; 16 cases as type Ⅱ and 10 cases as type Ⅱ/Ⅲ; 10cases as type Ⅲ. Two classification was proved of 100% consistency in type Ⅰ and Ⅲ, and 94.1% and 90.1% in type Ⅱ and type Ⅱ/Ⅲ respectively, difference was not remarkable (P＞0.05).CONCLUSION: SLPP determination can be used to make accurate classification of female genuine stress urinary incontinence, possessing important instructive significance for the treatment.

Expressions of NSE and nNOS of interstitial cells of Cajal in vitro from guinea pigs / 第三军医大学学报

Objective To explore the expression of neuron specific enolase(NSE)and neuronal nitric oxide synthase(nNOS)in the interstitial cells of Cajal(ICCs)in vitro from guinea pigs.Methods The ICCs of bladder were primary cultured from guinea pigs by collagenase digestion.The control group was smooth muscle cell(SMC)of bladder primary cultured from guinea pigs.The expression of c-kit and smooth muscle actin(SMA)were detected by immumofluorescence.RT-PCR and Western blotting were used to detect the mRNA level and protein content of NSE and nNOS at 1,3 and 5 d after primary culture.Results The expression of c-kit was positive in the ICCs of bladder but negative in the control group,while the expression of SMA was negative in the ICCs of bladder but positive in the control group.Both NSE and nNOS of the ICCs of bladder were high in the mRNA and protein content,but were negative in the control group.Conclusion NSE and nNOS were expressed stably in the ICCs of bladder in vitro,indicating that the ICCs of bladder may be involved in the regulation of bladder function.

Connexin 43 expression in cultured interstitial cells of Cajal from guinea pigs / 第三军医大学学报

Objective To explore the expression of connexin 43 in the interstitial cells of Cajal (ICCs) from guinea pig bladder in vitro. Methods Bladder ICCs were primarily cultured from guinea pigs by collagenase digestion method. Primarily cultured bladder smooth muscle cells (SMCs) from guinea pig were taken as control. The expressions of c-kit and smooth muscle actin (SMA) were detected by immunofluorescent method. Immumofluorescent method and Western blotting were used to detect the expression of Connexin 43 in 2 groups of cells. Results The expression of c-kit was positive in ICCs but negative in the control group. On the contrary, the expression of SMA was negative in ICCs but positive in the control group. Connexin 43 expression was significantly higher in ICCs than that in the control group (P

Heparanase expression in bladder transitional cell carcinoma and its correlation with clinical pathological features / 第三军医大学学报

Objective To explore the expression of heparanase(HPA)and its correlation with the clinical pathological features and angiogenesis in bladder transitional cell carcinoma.Methods HPA mRNA level was detected with RT-PCR and its protein level was determined by immunohistochemical staining in 68 cases of bladder cancer and 24 cases of adjacent tissues of bladder cancer.Results The positive rate of HPA mRNA was 60.3%(41/68)in bladder cancer,4.2%(1/24)in the adjacent tissues of bladder cancer.The expression of HPA mRNA had statistically significant correlation with pathological stage,clinical staging and lymphonode metastasis(P