The application of RoSCo score in the laparoscopic partial nephrectomy / 实用医学杂志

Objective To investigate the association between the RoSCo scoring system and the postopera tive complications of laparoscopic partial nephrectomy.Methods The clinical data of 127 patients with laparoscopic partial nephrectomy in our hospital from 2010 to 2015 were retrospectively analyzed.By studying all patients' preoperative clinical data,we give all the patients the RoSCo score,then divided all the patients into the RoSCo low group (3-4),RoSCo moderate group (5-6),RoSCo high group (7-8).Respectively study the association between the RoSCo score and Clavein score,operative time,intraoperative blood loss,warm ischemia time and length of hospital stay after laparoscopic partial nephrectomy.Results The RoSCo score was associated with postoperative complications of laparoscopic partial nephrectomy (P ＜ 0.05) and was more accurate than the RENAL score alone.There were significant differences in bleeding,warm ischemia time,hospital stay and operation time between the low,middle and high groups of RoSCo (P ＜ 0.05).Conclusion The RoSCo scoring system can be used to assess the complications of laparoscopic partial nephrectomy.

Preliminary analysis for risk factors of upper urinary tract dysfunction associated with ketamine abuse / 中华泌尿外科杂志

Objective To identify the risk factors of chronic ketamine-induced upper urinary tract dysfunction (KUUTD).Methods Medical records of 103 patients with ketamine-associated urinary dysfunction(KAUD) from Sep.2009 to Jul.2015 were retrospectively reviewed.All the patients were divided into the upper urinary tract dysfunction group(n =39)or the normal group(n =64)according to the diagnostic criteria.Indexes such as general features (age,gender,BMI),drug-abusing characteristics (abusing time,frequency,dose,abstinent period),duration of LUTS,pelvic pain and urgency/frequency symptom score(PUF score),serum parameters (WBC,ALT,AST,γ-GT),bladder diary (daytime inter-void interval,nocturia,average urine volume),urodynamic data (maximum cystometric capacity,post-void residual,maximum urethral closure pressure,maximum and average flow rate,instable contraction,bladder compliance) and imaging manifestations were compared between the two groups.Logistic regression analysis was performed for the evaluation of variables with statistical significance.Results There was significantly difference between the two groups in BMI (t =2.127,P =0.043),drug-abusing frequency (t =2.335,P =0.029),abstinent period (t =3.451,P =0.003),duration of LUTS (t =2.289,P =0.036),PUF score (t =3.030,P =0.004),γ-GT value(t =2.697,P =0.012),MCC(t =5.056,P ＜ 0.001),MUCP(t =3.015,P =0.008),BC (t =8.562,P ＜ 0.001) and imaging findings of bladder contracture (x2 =15.155,P ＜0.001).The multivariate Logistic regression analysis showed that drug-abusing frequency(OR =1.279,P =0.038),abstinent period(OR =0.394,P =0.028),γ-GT value (OR =1.007,P =0.032),MCC (OR =0.775,P =0.011)and BC (OR =0.013,P =0.008)were the key factors of KUUTD.Conclusion Consecutive and frequent drug abuse,combination with chronic obstructive cholangitis,reduced capacity and low compliance bladder are the risk factors of upper urinary tract dysfunction associated with ketamine abuse.

The staging evaluation of ketamine associated urinary dysfunction based on a scoring system / 中华泌尿外科杂志

Objective To establish the a staging system based on scoring of ketamine associated urinary dysfunction (KAUD) and evaluate its diagnosis performance and clinical value.Methods A retrospective analysis of 135 admitted KAUD patients from September 2009 to September 2015 was performed.All patients were classified into three stages according to bladder and upper urinary tract impairment, and treated with subsequent strategy.The behavioral modification and pharmacotherapy was performed in stage Ⅰ which image investigation was normal.Hydrodistension and intravesical perfusion was used if pharmacotherapy failed in stage Ⅱ patients who had bladder impairment in image or urodynamics.Augmentation cystoplasty or cystectomy with urinary diversion was optional if aforementioned treatment failed in stage Ⅲ who had upper urinary tract involvement and abnormal renal function.The voided volume, micturition interval, and nocturnal void frequency as recorded in their 3-day bladder diary, PUF, ICPI and ICSI score after treatment in one month, were compared with their baseline data prior to treatment.Ketamine abusing history, renal and liver function, bladder and upper urinary tract changes, urodynamics and radioisotope renography correlation with stages were analyzed.A scoring system was established and the concordance between the clinical staging and model staging of each patient was compared.Receiver operating characteristic curve was employed to testify the sensitivity and specificity.Results There were 39, 80 and 16 patients included in each stage respectively.After subsequent strategy of treatment, voided volume, micturition interval, and nocturnal void frequency, PUF, ICPI and ICSI were improved significantly.Age (P =0.018), ketamine abusing history (P =0.006), eGFR (P =0.001), ALT (P =0.037), γ-GT (P ＜ 0.001), bladder (P =0.013) and ureteral changes (P ＜ 0.001), hydronephrosis (P ＜ 0.001) and radioisotope renography abnormality (P =0.01) were correlated with clinical stages.In total, 107 cases' stages based on scoring were accordant with clinical stages (30, 65 and 12 cases in each stage respectively).AUC of the scoring model ROC was 0.922 on cut point between Ⅰ and Ⅱ stages and AUC of the scoring model ROC was 0.978 on cut point between Ⅱ and Ⅲ stages.Conclusions We presented a scoring staging system of KAUD based on ketamine abusing history, laboratory test results, and imaging findings.It might be helpful to evaluate the progression on bladder and upper urinary tract, and provide a reference for treatment.This staging system based on scoring still needs further validation and improvement.

Overactive bladder symptom score to evaluate efficacy of solifenacin for the treatment of overactive bladder symptoms / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Overactive bladder (OAB) is a series of symptoms with high prevalence in elderly people. This study was conducted using the overactive bladder symptom score (OABSS) to evaluate the efficacy of solifenacin succinate for the treatment of OAB.</p><p><b>METHODS</b>This was a prospective, multicenter, single-arm, 12-week study that enrolled 241 OAB patients. The patients received 5-10 mg/day solifenacin. Changes in OABSS, symptoms from voiding diary, perception of bladder condition (PPBC) score, international prostate symptom score (IPSS) and quality of life (QOL) were evaluated at weeks 0, 4, and 12. The relationship between OABSS and PPBC score or parameters of voiding diary was also evaluated.</p><p><b>RESULTS</b>At baseline, the mean OABSS for all patients was 9.41 ± 2.40, and was reduced significantly at week 12 (-3.76 points; 61.21%, P < 0.0001). The OABSS subscore, PPBC score, IPSS, and QOL were also significantly reduced during the study (P < 0.0001). The overall incidence of adverse events was 19.91% (44 cases). The gastrointestinal system was the most commonly affected (11.31%). Around 5.88% of the cases had adverse events related to the genitourinary system. There was a strong correlation between OABSS and urinary symptoms that was recorded in the 3-day voiding dairy.</p><p><b>CONCLUSIONS</b>We showed that solifenacin was clinically effective for relieving OAB symptoms, considering the balance between efficacy, patients' well-being, and tolerability. OABSS integrates four OAB symptoms into a single score and can be a useful tool for research and clinical practice.</p>

Imaging features of urinary dysfunction associated with ketamine abuse / 南方医科大学学报

<p><b>OBJECTIVE</b>To summarize the imaging features of urinary dysfunction associated with ketamine abuse (KAUD) for imaging diagnosis of KAUD.</p><p><b>METHODS</b>We analyzed the imaging findings in 45 patients with KAUD, all having a history of ketamine abuse and presenting with severe lower urinary tract symptoms. The patients underwent imaging examinations with ultrasonography (n=45), X-ray (n=38), computed tomography (n=28), magnetic resonance imaging (n=10) or single photon emission computed tomography (n=25), and the results were classified and evaluated to identify the common imaging findings.</p><p><b>RESULTS</b>The imaging changes of KAUD were found primarily in the urinary and biliary system. The most common imaging characteristics included thickening of the bladder wall, contracture and decreased functional volume of the bladder, dilation of the ureter and hydronephrosis, stricture of the upper ureter, renal impairment, dilation of the biliary system, and inflammation or swelling of the adjacent organs and lymph nodes</p><p><b>CONCLUSION</b>KAUD presents with typical imaging changes. Radiologists should be aware of KAUD if the typical imaging features are detected, especially in cases with a history of ketamine abuse.</p>

Clinical value of urinary potassium measurement in ketamine-associated cystitis / 中华泌尿外科杂志

Objective To investigate the relationship of 24 h urinary potassium (K) measurement and the symptoms change in ketamine-associated cystitis.Methods Forty-three ketamine-associated cystitis patients (29 male cases,14 female cases) were analyzed.The average age was 22 (17-29) years.Thirty-two patients without indwelling urinary catheter were categorized as group A,while the other 11 patients with indwelling urinary catheter were in group B.The therapy regimes consisted of anti-inflammatory,antioxidant,relieving spasm and pain,improving the microcirculation and repairing the bladder epithelium barrier.Thirty healthy adults were selected as the controls.Urinary K,sodium (Na) and creatinine (Cr)were determined in 24 h urine samples from all patients and controls before and after treatments.24 h urinary Cr was used as the internal standard.24 h urinary K and Na concentrations of the patients were calculated as relative to the Cr concentrations.The pelvic pain and urgency/frequency symptom (PUF) was used for evaluation before and after the treatments.The differences of urinary K were compared within each group and between groups before and after treatments.In addition,relationship of urinary K and PUF were assessed.Results Urinary Cr concentrations in all groups were not significantly different (P ＞ 0.05).Patients in group A had lower average K-to-Cr ratios than those patients in group B and controls (A 1.80 ± 0.67 vs.B 6.22±0.92 mmolK/mmol Cr,P=0.0001; A 1.80±0.67 vs.controls 6.47 ±0.97 mmol K/mmol Cr,P =0.0001) before treatments.But the ratios of K-to-Cr in group A were not significantly different with group B and controls after treatments (A 6.23 ± 1.42 vs.B 6.02 ± 0.98 mmol K/mmol Cr,A 6.23 ± 1.42vs.controls 6.47 ±0.97 mmol K/mmol Cr,F =0.698,P =0.472).PUF in both groups was not significantly different before treatments.For group A,PUF was negatively correlated with urinary K before and after treatments (before: r=-0.637,P=0.0001; after: r=-0.427,P=0.015).For group B,PUF had no correlation with urinary K before treatment (r=0.581,P =0.188),while there was a negative correlation between them after treatments (r =-0.779,P =0.005).PUF scores in all patients (group A + B)were significantly decreased after treatments when compared to those before treatments (18.12 ± 2.83 vs.22.77 ± 3.63,P =0.0001).Conclusion Urinary potassium measurement may have a role in evaluating the disease status and efficacy of treatments of patients suffered from ketamine-associated cystitis.

A model for predicting the success rate of a single extracorporeal shock wave lithotripsy session for single renal calculus / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the factors affecting the efficacy of extracorporeal shock wave lithotripsy (ESWL) and establish a model for predicting the success rate of a single ESWL session in the treatment of single renal calculus.</p><p><b>METHODS</b>Between January 2008 and February 2010, 325 patients underwent ESWL monotherapy and were followed up for at most 3 months. The correlations between the outcome of a single ESWL session and the patients' age, gender, body mass index (BMI), disease duration, pretreatment renal colic, hematuria, urinary irritation symptoms, stone location, stone laterality, stone length and stone width were analyzed. The statistically significant factors identifies were further analyzed by multivariate logistic regression, and the predictive model was established.</p><p><b>RESULTS</b>The stone-free rate of ESWL was 76.9%. Univariate analysis found that the patients' age, stone laterality, stone location, disease duration, pretreatment hematuria, stone length and width all significantly affected the outcome of the treatment. Logistic regression analysis indicated the factors including disease duration, pretreatment hematuria, stone length and stone width determined the success rate of the treatment. Hosmer and Lemeshow Test showed a good fitting of the predictive model (Χ(2)=18.144, df=8, P=0.168) with an overall accuracy of 87.4%.</p><p><b>CONCLUSION</b>Disease duration, pretreatment hematuria, stone length and width are independent factors affecting the outcome of a single ESWL session for single renal calculus.</p>

Clinical analysis of squamous cell carcinoma of renal pelvis / 中华泌尿外科杂志

Objective To review the diagnosis and treatment of squamous cell carcinoma of renal pelvis. Methods The clinical data from October 1991 to May 2009 of eight cases of squamous cell carcinoma of renal pelvis were reviewed and analyzed retrospectively. The symptoms of the patients were hematuria (eight cases), pain (seven cases) and abdominal mass (one case). All patients underwent B-ultrasound and IVU examination and four cases underwent CT scan. Three cases were diagnosed as having a tumor before surgery. Five cases were diagnosed as renal calculus, two of the five cases were diagnosed by intraoperative frozen section. Radical nephroureterectomy were performed in four cases, nephrectomy in three cases and palliative resection in one case. Results Histological classification revealed that six cases were moderately differentiated, one case was well differentiated and one case was poorly differentiated. Two cases had stage pT1/pT2 and six cases had stage pT3/pT4. 2 cases had regional lymph nodes metastasis. Seven cases were followed-up. All patients died of tumor recurrence or metastasis. The median tumor specific survive time was six months (range from two months to 42 months). Conclusions Squamous cell carcinoma of renal pelvis is often occurs concurrently with urolithiasis which could lead to difficulty in diagnose before operation. As the most of the patients were diagnosed with advanced stage disease, squamous cell carcinoma of renal pelvis tended to early recurrence and metastasis and the prognosis was very poor.

Experimental study of transfecting adenovirus carrying G250 antigen gene to dendritic cells and to activate immune effector cells in kidney cancer treatment / 中华泌尿外科杂志

Objective To investigate T cell-mediated effects of dendritic cells(DC)transfected with kidney associated antigen G250 gene using adenovirus(Ad)as vector in the treatment of kidney cancer. Methods Peripheral blood mononuclear cells(PBMC)were isolated by standard FicollPaque density gradient centrifugation of heparinized blood obtained from healthy donors.After removal of the nonadherent ceils,the adherent cells were divided into gene transfer group,protein pulsed group and control group.The gene transfer group was infected with Ad/G250 virus;the protein pulsed group was added with G250 protein; the control group was added with PBS.The DCs were cultured and proliferated in vitro using recombinant human granulocyte macrophage colony stimulating factor and inlerleukin-4.The autologous T cells were added into the 3 DC groups(responders:dendritics,20:1).After 5 d co-culture,3 eytotoxic T lymphocyte(CTL)groups were collected.TheG250 mRNA expression was detected in transduced DCs using RT-PCR.The G250 protein translation products and cell surface marker of DCs were analyzed by flow cytometry.The specific cytolytic activities of CTL to different target cells(renal carcinoma 786-0 cell line and lung cancer A549 cell line)were assessed by MTT method. Results Ad/G250 transfected DC successfully and the G250 expression was confirmed by RT-PCR. The expression levels of CD_(80), CD_(83). HLA-DR and CD_(86) in the Ad/G250 group were higher than those in the other 2 groups. The cytotoxicity to 786-0 of T lymphocytes activated by Ad/G250 transfecting DCs(83. 4±2. 8)% was greater than those of T lymphocytes in the protein pulsed group(79. 6±2. 4)% and control group(77. 3±2. 1)%. There were no significant differences of the cytotyxicities to A549 among the 3 cytotoxic T lymphocyte groups(F=0. 373.P=0.693). Conclusions Ad-loading DCs may be useful for immunotherapeutic protocols against self-antigens for the kidney cancer.

A case report of extensively ossification renal cell carcinoma and review of literature / 中华泌尿外科杂志

Objective To review the pathogenesis, pathology, diagnosis and prognosis of calci-fication or ossification renal cell carcinoma with 1 case report. Methods A 48-year-old man was re-ferred for evaluation of an incidental mass found on the upper-middle right kidney, and computed tomography showed a 7 cm tumor with extensively calcification. PET-CT found an extensively calci-fied and ossification mass without high-function in the upper-middle right kidney. Under the diagnosis of renal cell carcinoma, a transabdominal radical right nephrectomy was performed. Results During the operation, a 7.5 crux 5.0 cm well-circumscribed, encapsulated heterogeneous mass was found on the upper-middle right kidney. The patient underwent an partial nephrectomy. Frozen section diagno-sis was renal cell carcinoma with heterotopic bone formation. Then a transabdominal radical right ne-phrectomy plus regional lymph node dissection were performed. Paraffin sections showed renal cell carcinoma with heterotopic bone formation(clear cell carcinoma, pT2b No M0 ). There was neither me-tastasis nor recurrence during the 8 months follow-up. Conclusions Renal cell carcinoma with ossifi-cation is extremely rare. Renal mass with obvious substantive calcification ossification should be trea-ted as malignant mass before operation. The prognosis of renal cell carcinoma associated with ossifica-tion is relatively good.

Clinical characteristics of adult Wilms' tumor / 中华泌尿外科杂志

Objective To investigate the clinical characteristics of adult Wilms'tumor in Chinese adults and to improve the recognition of adult Wilms'tumor.Methods The clinical data of 6 Wilms'tumor patients treated in our hospital were reviewed. Of them, there were 4 male patients and 2 female patients with mean age of 31 years old. Four patients with abdominal and flank pain and 2 patients with abdominal masses were the main clinical manifestations. One case accompanied with hematuria and another one had fever.Tumor masses were palpable by physical examination in 4 patients. Five patients had percussion tenderness over kidney region and 1 case had abdominal tenderness. Six cases underwent urinalysis and red blood cell was positive in 2 cases. There were no abnormal results in other laboratory tests. Chest X-ray was routinely performed before operation. Six patients underwent ultrasonography and all showed hypoechoic masses (5.0cm×5.0 cm-22.0 cm×25.0 cm) with clear margin. Four cases examined by CT and all had solid masses with inhomogeneous density and clear margin. On enhanced CT scan, 1 of 4 cases demonstrated irregular enhancement of the mass with local hemorrhagic necrosis area. The CT value ranged from 11-40 HU, with an average value of 22.5 HU, and increased to 35-78 HU, with an average value of 63.5 HU after administration of contrast. Two cases of MRI revealed solid mass defects.Three cases underwent IVU examination and showed the enlargement of renal umbra as well as thinning of renal calices caused by the compression of tumor and 1 case showed hydronephrosis.Thus, 5 cases were diagnosed with renal tumor and 1 case was diagnosed with cavitas pelvis tumor before operation. Five patients successfully underwent nephrectomies and 1 patient accepted oophorotomy with no subsequent complication.Retroperitoneal lymph node dissection(RPLND) was performed at the time of radical nephrectomy or oophorotomy in all patients. The tumor was found to be about 5-25 cm in size during operation. One of the tumors had invaded pancreas tail, one had invaded to the lateral abdominal wall and one had invaded into the inferior caval vein. Renal hilar lymph node was found to be exceeded 1.5 cm×1.5 cm in 2 patients. The post-operative incisal surface of the tumor presented with gray-yellow color. Capsule was intact in 4 patients. Three cases had hemorrhagic necrosis in tumor center. All the specimens sent for the pathological examination. None received adjuvant therapy before operation. Four patients received chemotherapy plus radiotherapy after surgery and other 2 patients received chemotherapy only. All patients were followed up with routine lab tests, ultrasonography and chest X-ray.Results Six patients were staged according to the National Wilms'Tumor Study staging system as follows: 1 case in stage Ⅰ, 2 cases in stageⅡ, 2 cases in stage Ⅲ and 1 case in stage Ⅳ. Nephrectomies or oophorotomy were performed in all patients successfully. Tumor diameters were from 4.5-25.0 cm, in average 11.8 cm.All cases had pathological diagnosis of Wilm's tumor. Five cases were classified into favorable histologic type and 1 case was in unfavorable histologic type. Two patients with lymph node metastasis and 3 patients with local invasion were observed. One patient with pulmonary metastasis was recorded. Six patients were followed up for 1-7 years. Five patients survived with no evidence of cancer recurrence. One patient died of pulmonary metastasis 2 years after surgery.Conclusions The majority of adult Wilms'tumors are found with local invasion and metastasis. The incidence of hematogenous metastasis in adult Wilms'tumor is higher than other types of renal tumor as well. The early diagnosis and radical surgical treatment and adjuvant chemoradiotherapy could improve the survival rate.

"Street ketamine" associated urinary system dysfunction / 中华泌尿外科杂志

Objective To investigate the clinical, pathology, diagnosis and treatment of the lower urinary system dysfunction among chronic recreational ketamine abusers. Methods From 2000-2008, 20 ketamine abusers(14 men and 6 women; mean age, 22.3 years), from 3 hospitals in Guangzhou and Hongkong, and suffering from lower urinary tract dysfunction was reported. All of them had abused ketamine for 1 to 4 years, and presented with severe lower urinary tract symptoms. Complaint of severe frequency, urgency, urge incontinence, and painful haematuria was common. Urine cultures were negative. Six men suffered from severe dysuria. B ultrasound examination of 16 cases demonstrated the presence of bilateral hydronephrosis. Fourteen IVU and 10 CT investigations demonstrated the presence of bilateral hydronephrosis, bladder contraction, and 1 case showed papillary necrosis of the kidney. Different levels of abnormal liver function and chronic/acute renal failure were observed. All of the patients were required to withdraw the narcotics and the experimental medicine were given. Results The biopsies of 6 cases demonstrated the cystitis. Twelve cases' symptoms were reversible after these patients stopped or reduced the frequency and amount of ketamine abuse. Pentosan polysulfate sodium and sodium hyaluronate solution relieved the symptoms of 6 patients. Conclusions "Street ketamine" associated urinary system dysfunction might be a kind of in flammatory process involving the upper and lower urinary tract. Underlying aetiology and treatment methods necessitate further study.

Experience of intensive training of surgerical skills before clinical practice / 中华医学教育探索杂志

Clinical practice is quite important transition phase for medical students to become qualified doctors,and development of surgerical skills is the diffficult and key point in the clinical practice.Intensive training of surgerical skills before clinical practice can enhance the confidence and efficiency of medicine students during the course of clinical practice.Whihin limited time,the key of intensive training of surgerical skills is the training of aseptic technique and basic skills of surgery,and during the course of training,attention should be paid to both principle and details.

AN ANIMAL EXPERIMENTAL STUDY OF NITRERGIC INNERVATION IN URINARY BLADDER AFTER SPINAL CORD INJURY / 解放军医学杂志

This study was undertaken to examine ncNOS IR in bladder after spinal cord injury (SCI). In the meantime, we determine rats bladder ncNOS IR following intravesical instillation of capsaicin after SCI. Adult Sprague Dawley rats and guinea pigs were randomly divided into normal group, sham injury group, spinal cord injury group (4～5weeks after T 8～9 transection). A dose of 1mmol/L intravesical capsaicin was instilled in a part of SCI rats. Bladders of all animals were divided into three tissue pieces: bladder base, bladder body and bladder dome,in which the distribution of ncNOS IR was examined. Spinal transection induced a significant ncNOS IR increase in guinea pig bladder base. In rats, the quantity of ncNOS IR did not differ between the two groups. Instillation of intravesical capsaicin can cause significant up regulation of rat bladder ncNOS IR after SCI. The increase of ncNOS IR in SCI animals bladder indicates that NO may play an important role in the regulation of micturition reflex after SCI. In SCI rats, ncNOS IR can significantly be up regulated by intravesical capsaicin instillation, suggesting that NO may act as a factor in the action of capsaicin.

Analysis of correlation between erythrocyte sedimentation rate and tumor size/stage in renal cell carcinoma patients / 中华泌尿外科杂志

100 mm/h, group D).The tumor size/stage of the 4 ESR groups were analyzed by means of SPSS10.0. Results There were 89 cases with normal ESR,18 cases in group A,49 cases in group B,14 cases in group C and 3 cases in group D.For the correlation of ESR and tumor size,the analysis resulted in ?2 =13.621,P=0.003;Spearman correlation analysis results were:correlation coefficient of 0.341,P=0.002.For the correlation of ESR and tumor stage, the analysis resulted in ?2 =5.959 and P=0.114;Spearman correlation analysis results were:correlation coefficient of 0.208,P=0.057. Conclusions These results suggest that ESR is positively correlated with the size of renal cell carcinoma;however,there is no association between ESR and tumor stages.

Self-designed single J tube and medical nylon string for the prevention and treatment of child traumatic posterior urethral stricture / 中华泌尿外科杂志

Objective To improve the prevention and treatment level of child traumatic posterior urethral stricture. Methods This series included 22 male children (mean age 9 years) with pelvic fracture complicated by posterior urethral disruption.A medical nylon string was indwelled after uretheral reunion operation.Urethral stricture recurred in 9 patients 3 months after the operation,and they were all cured by performance of urethra dilatation with self-designed single J tube under the guidance of the medical nylon string. Results All of the 9 were doing well during the operation.The medical nylon string was not taken out until dysuria disappeared completely.The cure rate was 100%.All the cases were followed up for a mean period of 15 months(range,3 to 24 months).All had normal urination. Conclusions Application of self-designed single J tube and medical nylon string is effective,simple and economical for the treatment of child traumatic posterior urethral stricture.It is easy both for the doctors' training and for the children's cooperation.Thus,it provides a new approach for the prevention and treatment of child traumatic posterior urethral stricture.

Sarcoma of prostate (report of 7 cases) / 中华泌尿外科杂志

Objective To call attention to the diagnosis and treatment of prostate sarcoma. Me thods From Jan 1984 to May 2000,7 cases of prostate sarcoma were treated,2 cases by radical cystoprostatectomy and detenia cecocolon continent urinary reservoir,1 case by suprapubic prostatectomy,3 cases by radiotherapy whereas 1 case underwent needle biopsy only. Results Of the 2 cases underwent radical cystoprostatectomy,one has been still surviving after 5 years whereas the other one died of lung metastases after 9 months.The other 5 patients all died within 13 months. Conclusions Early dignosis and radical cystoprostatectomy are mandatory to prolong survival.

Intervening embolization for congenital renal arteriovenous malformation / 中华泌尿外科杂志

ObjectiveTo evaluate transcatheter arter ia l embolization(TAE) on congenital renal arteriovenous malformation(RAVM).MethodsFive cases of RAVM,diagnosed on digital substraction a ngiography have been treated between March 1995 and May 2002 by transarterial em bolization (TAE) with different embolic agents (ethanol,iodised oil,gelform part icles or metalic coils).The efficacy was evaluated.ResultsIn all the 5 cases,gross hematuria was controlled immediately after TAE,th e urine turned clear in 24 h and urinalysis became normal in 7 days.The patients have been followed up for 6～12 months with an average of 10 months with hematu r ia well controlled in all.There has been no hypertension or apparent renal funct ion damage.Bilateral renal emission computed tomography (ECT) reveated only some local loss of the renal cortical function on the concerned side.ConclusionsAt present renal arteriography is still the most reliable method in the diagnosis of RAVM.TAE has the benefits of less inva sive, a low incidence of complications, early resumption of normal activities an d shorter hospital stay,and can avoid renal resection and correlative surgical c omplications.The renal function could be well protected from harm.

Effect of estradiol on expressions of transforming growth factor ? and smoothelin in human prostatic stromal cells / 中华泌尿外科杂志

Objective To investigate the relationships among estrogen,transforming growth factor ?(TGF?) and smooth muscle cells in human prostatic tissue by cell experiment. Methods Eleven strains of prostatic stromal cells were cultured successfully from BPH patients,and stimulated by estradiol(E 2).Cell proliferations were observed by MTT,and mRNA expressions of TGF? 1,TGF? 2 and smoothelin were observed by RT-PCR. Results E 2 could not influence TGF? 1 expressions in prostatic stromal cells,but could upregulate expressions of TGF? 2 and smoothelin;and expression values of TGF? 2 and smoothelin had a positive correlation. Conclusions E 2 can influence growth and differentiation of prostatic smooth muscle cells through induction of TGF? 2 expression.

An experimental study of nitrergic innervation in urinary bladder after spinal cord injury / 中华泌尿外科杂志

Objective Rats bladder ncNOS IR following intravesical instillation of capsaicin after chronic spinal cord injury(SCI) was studied to investigate the mechanism of ncNOS IR in pathological bladder. Methods 44 adult Sprague Dawley rats were randomly divided into normal group,sham injury group and spinal cord injury group(4～5 weeks after T 8～9 spinalization).A dose of 1 mmol/L capsaicin was instilled in part of SCI rats.the distribution of ncNOS IR in bladder base,bladder body and bladder dome of all rats were examined. Results In rats,the ncNOS IR did not differ between the normal group (11.1?0.9) and the SCI group (12.8?1.3).Intravesical instillation of capsaicin significantly up regulated ncNOS IR in rat bladder of SCI group (26.1?2.7, P