Influence of matrine on Th17/Treg balance in rats with inflammatory bowel disease by regulating IL-6/STAT3/NF-κB signaling pathway / 西安交通大学学报(医学版)

【Objective】 To investigate the influence of matrine (MT) on the balance of T helper cell 17 (Th17)/regulatory T cells (Treg) in rats with inflammatory bowel disease by regulating interleukin-6 (IL-6)/signal transducer and activator of transcription 3 (STAT3)/nuclear transcription factor-κB (NF-κB) pathway. 【Methods】 SD rats were grouped into control check group (CK group), model group, low-dose MT group (MT-L group, 50 mg/kg), medium-dose MT group (MT-M group, 100 mg/kg), high-dose MT group (MT-H group, 200 mg/kg), mesalazine group (MSLM group, 0.42 g/kg), and MT-H+rIL-6 (IL-6 activator) group (200 mg/kg+0.05 mg/kg) according to the random number table method, with 18 in each group. Except for the CK group, the rats in other groups all received with 5% trinitrobenzenesulfonic acid (20 mg/kg) buffer solution mixed with 50% ethanol at a ratio of 1∶1 and then enema to construct a rat model of inflammatory bowel disease. After the successful modeling, they were treated with drug administration once a day for 7 weeks. The body weight of rats was measured at 1, 3, 5, and 7 weeks of administration; the changes of colon length of rats in each group were compared; HE staining was used to detect the pathological damage of rat colon tissue; the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-17 and IL-10 in serum of rats were detected by ELISA; the proportions of Th17 and Treg cells in peripheral blood of rats were detected by flow cytometry; Western blottingt was performed to detect the protein expression of retinoic acid-related orphan receptor γt (RORγt), forkhead box protein P3 (Foxp3), IL-6, p-STAT3, and p-NF-κB p65 in rat colon tissue. 【Results】 Compared with the CK group, the colon tissue of the model group was severely damaged by pathology, and the body weight (at 3, 5, and 7 weeks), the level of IL-10, the proportion of Treg cell, and the expression of Foxp3 protein were decreased, the colon length shortened, the levels of TNF-α, IL-17, the proportions of Th17 cell, Th17/Treg ratio, and the protein expression of RORγt, IL-6, p-STAT3, and p-NF-κB p65 increased (P<0.05). Compared with the model group, the corresponding indicators of the MT-L group, MT-M group, MT-H group, and MSLM group had the opposite trends (P<0.05); rIL-6 attenuated the promoting effect of high-dose MT on Th17/Treg balance in inflammatory bowel disease rats. 【Conclusion】 MT may promote Th17/Treg balance in inflammatory bowel disease rats by inhibiting IL-6/STAT3/NF-κB signaling pathway.

Pathogenic risk of Vibrio parahaemolyticus infection in raw aquatic products of animal origin by using sQMRA / 公共卫生与预防医学

Objective To evaluate the risk of disease of Vibrio parahaemolyticus in aquatic products of raw food animals for population in guangzhou,and determine risk management points. Methods VP quantitative detection was carried out in aquatic products of raw food animals sold in Guangzhou from 2009 to 2022.sQMRA was applied to assess Vibrio parahaemolyticus risk of aquatic products of raw food animals. According to stratified analysis based on the pollution of Vibrio parahaemolyticus and evaluation results,carry out risk management and analysis. Results Among the 98 samples were detected positive of VP from 1 343 samples from 2009 to 2022 , with an overall positive rate of 7.30%.The number of Vibrio parahaemolyticus infection cases caused by eating aquatic products of raw food animals in Guangzhou was 3012. If the proportion of raw food is reduced , the number of Vibrio parahaemolyticus infection cases will be significantly reduced. The number of cases caused by eating raw fash will be reduced from 2128 to 217.The detection rate of Vibrio parahaemolyticus in raw fresh water products was much higher than that in marine products. The probability of infection in the population was higher. The number of cases caused by eating raw fash was the highest.The detection rate of Vibrio parahaemolyticus was higher in raw crustaceans and molluscs. The incidence of Vibrio parahaemolyticus infection cases caused by eating raw fash in the four quarters varied from high to low as such sequence ,4.93×10-5 in the three quarters , 2.53×10-5 in the second quarter , 2.40×10-5 in the first quarter ,1.77×10-5 in the fourth quarter . Conclusion The risk of disease of Vibrio parahaemolyticus in aquatic products of raw food animals was higher. The public health education should be done well. Aquatic products should be cooked thoroughly before eating . Reduce the intake of raw aquatic products and avoid cross contamination. Focus on the risks of summer and autumn seasons and seafood such as crustaceans and molluscs. Concentrate on scientific research on Vibrio parahaemolyticus pollution of fresh water products.

Long-term efficacy of AdVance obturator sling and artificial urethral sphincter in treatment of male stress urinary incontinence / 中华泌尿外科杂志

Objective:To evaluate the long-term efficacy of AdVance sling bulbar urethral suspension and artificial urethral sphincter (AUS) implantation in the treatment of moderate to severe male stress urinary incontinence.Methods:The clinical data of 12 male patients with urinary incontinence who underwent surgical treatment in Peking University People's Hospital from June 2011 to June 2017 were retrospectively analyzed. The median age was 75(64-80) years. There were 9 cases after radical prostatectomy and 3 cases after transurethral prostatectomy. Patients had a median history of urinary incontinence of 3(1-9) years, and needed an average of 8(5-10) pads per day. Among them, 5 patients had moderate urinary incontinence and 7 patients had severe urinary incontinence. All patients underwent urinary incontinence surgery for the first time. Among the 12 patients, 6 received AdVance sling ball urethral suspension (AdVance group), and 6 received AUS implantation (AUS group). The median age of the AdVance group was 72 (64-73) years. The median number of pads used daily was 6 (5-8) tablets. Urinary incontinence Quality of Life questionnaire (I-QOL) score was (15.0±5.4). Five patients had moderate urinary incontinence and one patient had severe urinary incontinence. In the AUS group, the median age was 78(76-80) years old, the median daily pad use was 8(6-10) tablets, and the I-QOL score was (16.7±5.1), all of which were severe urinary incontinence. The daily pad usage, I-QOL and postoperative complications were recorded at 1 and 5 years after operation.Results:All patients completed the operation successfully. The postoperative follow-up was 5-7 years (mean 5.5 years). In AdVance group, 1 patient with severe urinary incontinence had no significant improvement in postoperative symptoms at 1 year after operation. The other 5 patients showed significant improvement in urinary incontinence symptoms. In the AdVance group, the median number of pads used per day was 2.5 (1-10), and the I-QOL score was (75.0±28.1), which were all significantly improved compared with that before operation ( P<0.05). The median number of pads used per day in the AdVance group 5 years after operation was 2.5(1-10), and the I-QOL score was (78.3±29.3), which were significantly improved compared with those before operation (all P<0.01). In the AUS group, no pad was needed at 1 year after operation, which was significantly improved compared with that before operation ( P<0.01). Urethral erosion occurred in 2 cases 3 years after operation, and the AUS was removed. Urinary incontinence recurred and returned to the preoperative state without reoperation. The other 4 cases did not need to use the pad 5 years after operation. In AdVance group, 3 patients had perineal pain within 3 months after operation, which was related to activity and relieved spontaneously. No wound infection, urethral erosion and other complications occurred. Urethral erosion occurred in 3 cases in AUS group. Conclusions:AdVance sling ball urethral suspension is effective for patients with moderate stress urinary incontinence and has fewer complications. AUS implantation is effective for patients with severe male stress urinary incontinence. However, the long-term complications of this operation may affect the postoperative efficacy.

Management of cardiovascular health in prostate cancer patients with androgen deprivation therapy / 中华泌尿外科杂志

Androgen deprivation therapy is one of the main treatments for prostate cancer patients. In recent years, many studies have revealed that androgen deprivation therapy increases the risk of cardiovascular disease, which leads to the cause of death alongside tumor-related deaths. The mechanism may be related to the elevation of testosterone levels, follicle-stimulating hormone levels and unstable atherosclerotic plaque. Standardized cardiovascular disease management in this population is a key issue to improve survival and prognosis. This paper summarizes a management plan covering 5 areas, including history collecting and data examination, assessment, referral, health education, and regimen selection.

Impact of warm ischemia time during partial nephrectomy on laparoscopic postoperative renal function / 中华泌尿外科杂志

Objective:To assess the association between warm ischemia time (WIT) and renal function in patients undergoing laparoscopic partial nephrectomy.Methods:A total of 344 patients treated with laparoscopic partial nephrectomy in Peking University People’s Hospital were included. There were 240 males (69.8%) and 104 females (30.2%) with a median age of 57 (23-89) years.The median BMI was 25.6 (16.7-36.0) kg/m 2.213 cases (61.9%) were associated with hypertension.There were 66 (19.2%) patients with diabetes mellitus. There were 92 cases (26.7%) with smoking history. The median preoperative creatinine was 73 (32-170) μmol/L. The median preoperative estimated glomerular filtration rate (eGFR) was 95 (33-142) ml/(min·1.73m 2). The maximum diameter of the tumor was 2.5 (7-9) cm.314 (91.3%) patients with renal cancer stage T 1. All patients underwent warm ischemia during the operation. The patients were divided into three groups for analysis. Restricted cubic spline regression analysis was used to assess the association between WIT as a continuous variable and percentage change of eGFR. Analysis of covariance was used to compare postoperative eGFR among the three groups, and to adjust for preoperative eGFR and tumor diameter. Results:There were statistically significant differences in the percentage change of postoperative eGFR ( P=0.009) and tumor diameter ( P<0.001) among the three groups. Restricted cubic spline regression analysis showed that with the prolongation of WIT, the percentage change of postoperative eGFR gradually decreased, and the curve began to stabilize after 30 minutes (R 2=0.044, P=0.015). The results of covariance analysis showed that after adjusting for baseline preoperative eGFR and tumor size, the effect of WIT on postoperative eGFR was significantly different among the three groups ( F=3.864, P=0.022). The postoperative eGFR in the WIT<20 min group was significantly higher than that in 20 min≤WIT<30 min group( P=0.009) and WIT≥30 min group( P=0.017). There was no significant difference in postoperative eGFR between the two groups with longer WIT( P=0.806). Conclusions:In partial nephrectomy, patients with WIT less than 20 minutes had higher postoperative eGFR levels than those with WIT greater than 20 minutes. However, when WIT exceeded 20 minutes, prolonged ischemia time did not lead to further decline in renal function.

Establish the urodynamic classification of male patients with benign prostatic obstruction and analysis of the effect of transurethral resection of the prostate on different classifications / 中华泌尿外科杂志

Objective:To establish the urodynamic classification of middle-aged and elderly men with benign prostatic obstruction(BPO), and to analyze the efficacy of transurethral resection of the prostate(TURP) on various types of patients.Methods:A retrospective analysis of middle-aged and elderly male patients with non-neurogenic lower urinary tract symptoms(LUTS) who underwent urodynamic tests from January 2010 to December 2018, including 793 patients with BPO. Urodynamics examination of detrusor without contraction needs to complete cystoscopy to diagnose BPO. During urodynamic examination, the detrusor uninhibited contraction induced by spontaneous or stimulation during the bladder filling period is diagnosed as overactivity of the bladder detrusor(DO), and the LinPURR chart indicates the detrusor underactivity(DU). Based on the persistence of BPO leading to DO, DU, and decreased bladder compliance, 793 male patients with BPO with LUTS were divided into four types, including type Ⅰ(BPO: n=164, 20.7%), type Ⅱ(BPO combined with DO: n=333, 42.00%), type Ⅲ(BPO combined with DU: n=267, 33.7%), type Ⅳ(BPO combined with decreased bladder compliance: n=29, 3.7%). The preoperative comparison between groups showed that the age of type Ⅰ-Ⅳ gradually increased, and the age of type Ⅰ was significantly smaller than other types [(67.3±8.2)years, (69.7±7.7)years, (71.5±7.9)years, (72.4±7.1)years, P<0.05]. Compared with other types, the type Ⅰ’s IPSS-S[(9.1±3.6)points vs.(10.4±3.1) points, (9.2±3.3) points, (10.4±3.1)points, P<0.05], IPSS-V[(13.5±3.4) points vs. (14.2±3.5)points, (14.0±3.5)points, (14.2±2.9)points, P<0.05], IPSS scores[(22.6±5.4)points, (24.7±4.9)points, (23.1±5.3)points, (24.6±4.7)points, P<0.05] were significantly lower than other groups, the maximum bladder capacity [(332.6±83.2)ml vs.(221.4±80.8)ml, (286.7±108.2)ml, (242.3±103.4)ml, P<0.05], the functional bladder capacity was significantly higher than other types[(215.2±90.0)ml, (148.5±76.0)ml, (154.9±87.2)ml, (121.2±72.9)ml, P<0.05]. Type Ⅱ’s IPSS-S[(10.4±3.1)points vs.(9.1±3.6)points, (9.2±3.3)points, P<0.05], nocturia frequency[(3.7±1.8)times vs.(3.2±1.8)times, (3.2±1.6)times, P<0.05], IPSS score[(24.7±4.9)points vs.(22.6±5.4)points, (23.1±5.3)points, P<0.05], quality of life scores [(4.9±0.9) points, (4.6±0.9)points, (4.6±0.9)points, P<0.05] was significantly higher than type Ⅰ and type Ⅲ ( P<0.05). Type Ⅲ and Ⅳ had higher residual urine than type Ⅱ[(121.3±96.4)ml, (121.3±96.4)ml vs.(71.2±73.5)ml, P<0.05]. Type Ⅳ’s IPSS-S[(10.4±3.1)points vs. (9.1±3.6)points, (9.2±3.3)points, P<0.05], IPSS-V[(14.2±2.9) points vs.(13.5±3.4)points, (14.0±3.5)points, P<0.05], the frequency of nocturia[(3.8±1.9)times vs.(3.2±1.8)times, (3.2±1.6)times, P<0.05] was significantly higher than that of type Ⅰ and type Ⅲ, and the quality of life score was higher than type Ⅰ and type Ⅲ[(4.3±0.8)points vs.(4.7±0.9)points, (4.6±0.9)points, P<0.05]. type Ⅱ and type Ⅳ’s bladder compliance[(21.4±24.2)ml/cmH 2O, (11.0±11.4)ml/cmH 2O vs.(33.9±23.7)ml/cmH 2O, (33.1±32.7)ml/cmH 2O, P<0.05], maximum bladder capacity[(221.4±80.8)ml, (242.3±103.4)ml vs.(332.6±83.2)ml, (286.7±108.2)ml, P<0.05], functional bladder capacity[(148.5±76.0)ml, (121.2±72.9)ml vs.(215.2±90.0)ml, (154.9±87.2)ml, P<0.05] were significantly less than type Ⅰ and type Ⅲ( P<0.05). From November 2016 to November 2018, 60 middle-aged and elderly male patients with confirmed BPO and TURP were selected, including type Ⅰ( n=17, 28.3%), type Ⅱ ( n=23, 38.3%), and Ⅲ type ( n=11, 18.3%), Ⅳ type( n=9, 15.1%). Type IV patients are significantly older than other types ( P<0.05), bladder compliance is significantly worse than other types( P<0.05), the maximum bladder capacity is smaller than other types( P<0.05). The follow-up started 3 months after the operation. The content of the follow-up included IPSS, IPSS-S, IPSS-V, nocturia frequency, undisturbed sleep time, nocturia quality of life score, and life quality score. Results:The IPSS scores of type Ⅰ, type Ⅱ, and type Ⅲ after TURP were significantly improved compared with preoperative(19.8±6.2 vs.3.4±1.8; 21.9±5.2 vs.4.6±2.6; 21.5±6.2 vs.5.7±4.6, P<0.05), type Ⅳ urine storage symptom score (9.1±4.1 vs.4.3±3.7), nocturia frequency(3.6±1.5vs.2.3±1.6), nocturia quality of life score (25.3±6.9 vs.31.4±13.7) Compared with preoperatively, there was no significant improvement( P>0.05). The quality of life score improvement of type Ⅳ patients was significantly lower than that of type Ⅰ, type Ⅱ, and type Ⅲ (10.9±9.1 vs.12.2±9.0, 14.4±5.7, 12.7±5.8, P<0.05). The IPSS score of type Ⅳ patients was significantly higher than that of type Ⅰ(7.0±5.8 vs.3.4±1.8), and the nocturia quality of life score was significantly lower than that of each group (31.4±13.7 vs.37.5±4.2, 38.7±3.5, 37.8±3.8, P<0.05). Conclusions:For middle-aged and elderly men with BPO, we divide them into four types based on the results of urodynamic examinations, type Ⅰ(simple BPO), type Ⅱ(BPO combined with DO), type Ⅲ(BPO combined with DU), type Ⅳ(BPO combined with bladder compliance decline). Type Ⅰ patients have the best bladder function, and TURP has the best effect; type Ⅱ has a high symptom score and poor quality of life, and can benefit after TURP; type Ⅲ bladder function is poor, and surgery should be performed as soon as possible to prevent further deterioration of bladder function; type Ⅳ bladder function is the best poor, IPSS score and quality of life score are high, TURP surgery is not effective.

The clinical effect of TURP in patients with detrusor underactivity: a short-term follow-up / 中华泌尿外科杂志

Objective:To investigate the effect of transurethral prostatectomy (TURP) on patients with detrusor underactivity (DU).Methods:From January 2015 to January 2019, 72 male patients from Peking University People’s hospital who underwent TURP treatment were retrospectively analyzed. The age of all patients range from 51 to 89, with an average age of 72 years old. All patients underwent urodynamic examination before surgery. The patients were divided into three groups according to BCI and P detQmax. DU group(BCI<100 and P detQmax≤40 cmH 2O) consisted of 31 patients. Then DU patients were divided into two groups according to the P detQmax: Group A, P detQmax≤20 cmH 2O, involving 9 patients; Group B, 20 cmH 2O<P detQmax≤40 cmH 2O, involving 22 patients. Non-DU group(BCI≥100 and 40 cmH 2O<P detQmax≤60 cmH 2O), also named the control GroupC, included 41 patients. There was no statistically significant difference in term of age and duration of disease among the three groups ( P<0.05). Preoperative international prostate symptom scores(IPSS)of the three groups were(26.40±5.54), (21.04±4.61)and(18.53±4.41), respectively. The quality of life score (QOL) were(4.70±1.34), (3.37±1.11)and(3.49±1.34), respectively. The Q max were(4.60±2.63), (8.48±2.47)and(11.38±4.00)ml/s, respectively. The residual urine volume (PVR) were(152.90±75.26), (90.78±51.97)and(53.23±38.98)ml, respectively. The preoperative IPSS and QOL of patients in group A were significantly higher than those in group B and group C, and the difference was statistically significant ( P<0.05), whereas the difference between group B and group C was not statistically significant ( P>0.05). The preoperative Q max of group A was significantly inferior than that of group B and C, with statistically significant difference ( P<0.05) and group B was significantly inferior than group C, with statistically significant difference ( P<0.05). The preoperative PVR of group A was significantly higher than that of group B and group C, with statistically significant difference ( P<0.05)and group B was significantly higher than group C, with statistically significant difference ( P<0.05). The above indicators were followed up to compare the improvement for the three groups of patients. Seventy-two patients were followed up for free Q max(fQ max) PVR, IPSS and QOL score from March 2019 to June 2019. Results:The 72 patients were followed up for 3 to 52 months, with an average of 31.1 months. Postoperative IPSS of the three groups were(25.50±2.84), (16.78±4.04)and(14.98±3.41), respectively. The QOL were (2.90±1.29), (2.67±0.88)and(2.53±0.92), respectively. The fQ max was (5.44±2.60), (10.30±3.68)and(13.07±3.51) ml/s, respectively, and PVR was(104.00±46.00), (76.81±46.74)and(35.64±26.17)ml, respectively. Compared with the preoperative parameters, QOL in group A was significantly improved, with statistically significant difference ( P<0.05) and the IPSS, fQ max and PVR in group A were improved, but the difference was not statistically significant ( P>0.05). The IPSS, QOL, fQ max and PVR in group B and C were significantly improved compared with the preoperative parameters, and the difference was statistically significant ( P<0.05). Conclusions:The subjective and objective indicators of DU patients can be improved after TURP, while for those patients whose P detQmax≤20 cmH 2O, only QOL can be improved significantly, and the other indicators can not be improved. Therefore, adequate communication should be made before surgery to inform reasonable expectations for the DU patients.

Effect of transurethral resection of the prostate on nocturia and sleep quality in men with benign prostatic hyperplasia / 中华泌尿外科杂志

Objective:To evaluate the effect of transurethral resection of the prostate on nocturia and sleep quality in men with benign prostatic hyperplasia.Methods:This retrospective study included 122 patients who underwent TURP(transurethral resection of the prostate) for BPH(benign prostatic hyperplasia)from December 2016 to December 2018.The age was(69.7±7.9)years old. There was 20 cases with diabetes and 40 cases with hypertension. The preoperative mean prostate volume was (64.4±41.2)ml and mean BMI was (24.3±2.7)kg/m 2. The preoperative IPSS score was (20.5±5.5) points, the number of nocturia events(assessed by the seventh question of IPSS) was (4.4±1.9) times, hours of undisturbed sleep (HUS) was (1.7±1.0) h, 110 cases with HUS <3 h; nocturia quality-of-life questionnaire (N-QOL) was (24.9±6.3) points, quality of life (QOL) was (4.4±0.9) points. 111 patients had the urodynamic examination done. The maximum urine flow rate was (6.4±3.1) ml/s, the maximum bladder volume was (318.5±83.6) ml, the residual urine volume was (153.9±158.9) ml, and the maximum detrusor pressure was (78.4±35.5)cmH 2O.Detrusor muscle strength decreased in 27 cases, 18 cases had OAB, 9 cases of effective bladder capacity declined and 60 cases had bladder outlet obstruction. 42 cases had an effective bladder volume <200 ml, of which 33 had a maximum bladder capacity >200 ml with nocturia (4.5±1.9) times, 9 cases had a maximum bladder capacity ≤200 ml with nocturia (4.7±1.7) times. All 122 patients were treated with TURP. Result:122 patients were followed up for 3-20 months. After operation the number of nocturia significantly decreased to (1.9±1.23) times ( P<0.05), HUS significantly improved to(3.4±1.3) h ( P<0.05), and 91 cases had HUS ≥3 with 82.7% remission rate; N-QOL significantly improved to (37.3±6.7) points ( P<0.05), IPSS significantly decreased to (4.9±4.2) points ( P<0.05), and QOL significantly decreased (0.8±0.9) points ( P<0.05). 121 patients had nocturia ≥2 voids before surgery, and 96 patients had improved (≥50% reduction of nocturnal frequency). There were 68 patients with nocturia ≥2 voids after operation with total score of preoperative IPSS (21.8±5.3), and 54 patients with nocturia <2 voids with total score of preoperative IPSS (19.2±5.5)( P<0.05). Patients with a effective bladder capacity less than 200 ml were divided into a group with a maximum bladder volume ≤200 ml and a group with a maximum bladder capacity>200 ml. The nocturia did not improve significantly after surgery ( P>0.05) in the group with a maximum bladder volume ≤200 ml, and the nocturia in the group with a maximum bladder capacity >200 ml had significantly improvement ( P<0.05). The group with a maximum bladder capacity ≤200 ml had nocturia (3.4±1.5) times after surgery, which was no significant different from that before surgery ( P=0.12); nocturia (1.9±1.1) times after operation in the group with maximum bladder volume>200 ml, and there was significant difference compared with before surgery ( P<0.05). Conclusion:TURP can significantly prolong the HUS of BPH patients with nocturia, and improve the life and sleep quality of patients. TURP partly reduces the number of nocturia, but some patients still suffer from nocturia after operation. The high total score of IPSS before operation and the maximum bladder volume ≤200 ml are the risk factors for nocturia after operation.

Urodynamic classification of female patients with symptoms of overactive bladder and the outcome analysis / 中华泌尿外科杂志

Objective To introduce a urodynamic classification of female patients with symptoms of overactive bladder(OAB) and discuss its clinical significance.Methods From January 2015 to January 2017,62 female patients from Peking University People's Hospital who diagnosed clinically with OAB and underwent preoperative urodynamic test were involved in this study.Female OAB patients can be stratified into four groups based on the chief complaints and the urodynamic test,including type Ⅰ-no evidence of detrusor overactivity(DO) on urodynamic test,patients can feel urgency and have no urinary incontinence,type Ⅱ-involuntary detrusor contraction present,patients aware and able to abort them and have no urinary incontinence,type Ⅲ-involuntary detrusor contraction present,patients aware and able to contract the sphincter but can not abort contractions and have urinary incontinence and type Ⅳ-contractions present,and patients unaware and unable to contract the sphincter or abort contractions and have urinary incontinence.According to the classification,the amount of the four types of OAB patients were 8,22,25 and 7,respectively.The data of height,age,weight showed no statistical significance (P ＞ 0.05).The amount of the concomitant diseases of the type Ⅰ,Ⅱ and Ⅲ showed no obviously difference (P ＞ 0.05),but the type Ⅳ was higher than the other three types(P ＜ 0.05).The preoperative OABSS(6.38 ± 1.51 vs.6.41 ± 1.76,P ＞ 0.05) and AUASS scores (16.38 ± 5.26 vs.16.59 ± 5.11,P ＞ 0.05) of the type Ⅰ and Ⅱ have shown no obviously difference.The preoperative OABSS(9.00 ± 2.35 vs.9.71 ± 3.04,P ＞ 0.05) and AUASS(20.59 ± 3.95 vs.22.00 ± 4.97,P ＞ 0.05) scores of the type Ⅲ and Ⅳ have shown no obviously difference.The preoperative scores of the OABSS scores and AUASS scores of the type Ⅲ and the type ⅣV were obviously higher than that of the type Ⅰ and the type Ⅱ (P ＜ 0.05).In this study,16 of the 62 patients were treated with tolterodine,46 patients were treated with solifenacin,with the average duration of drug therapy of 3.4 months (0.5-20.0 months).The postoperative scores of the OABSS and AUASS were followed up.The treatment outcomes among different OAB types were compared.Results The 62 patients were followed up from 6 to 20 months,with an average of 11.2 months.The improvement of the OABSS scores of the type Ⅰ and Ⅱ(3.63 ± 0.74 vs.3.86 ± 0.89,P ＞ 0.05) have shown no obviously difference.The improvement of the OABSS scores of the type Ⅲ (6.40 ± 1.17) were obviously higher than the type Ⅰ,Ⅱ and Ⅳ (1.71 ± 1.38) (P ＜ 0.05).The improvement of the OABSS scores of the type Ⅳ were obviously inferior to the type Ⅰ,Ⅱ and Ⅲ (P ＜ 0.05).The improvement of the AUASS scores of the type Ⅰ and Ⅱ (11.75 ± 4.33 vs.12.30 ±5.34,P ＞0.05)have shown no obviously difference.The improvement of the AUASS scores of the type Ⅲ (15.28 ± 4.32)were obviously higher than the type Ⅰ,Ⅱ and ⅣV (8.14 ± 4.34) (P ＜ 0.05).The improvement of the AUASS scores of the type ⅣV were obviously inferior to the type Ⅰ,Ⅱ and Ⅲ (P ＜ 0.05).Conclusions The type Ⅳ OAB presented with the worst outcome and the type Ⅲ OAB presented with the best among the four types of OAB.The classification system will have a suggestive significance to predict the prognosis and the therapeutic effect of the patients with OAB.

Determination of Main Components and Related Substances in Phenzolzine Capsules by HPLC / 中国药房

OBJECTIVE： To establish a method for content determination of main components and its related substances in Phenzolzine capsules. METHODS： HPLC method was adopted for content determination of main components. The contents of related substance （known impurity 1， known impurity 2， total impurity） were calculated with principle component self-control method. The determination was performed on Inertsil ODS-2 C18 column with mobile phase consisted of acetonitrile-water （55 ∶ 45， V/V）at the flow rate of 1.0 mL/min. The detection wavelength was set at 223 nm， and column temperature was 25 ℃. The sample size was 20 μL. RESULTS： The main component phenzolzine and other impurity peaks were well separated. The liner range of phenzolzine was 20.04-60.12 μg/mL （r＝1.000 0）. RSDs of precision， stability （24 h） and reproducibility tests were all ≤0.5％ （n＝6）. Average recovery was 97.50％ （RSD＝0.36％， n＝3）. The detection limit and quantification limit of phenzolzine were 0.91 ng and 3.04 ng. In 3 batches of samples， average value of phenzolzine， known impurity 1， known impurity 2 and total impurity were 106.68％， 0.002 1％， 0.044 0％ and 0.046 2％， respectively. CONCLUSIONS： Established method is simple， specific， sensitive and accurate for content determination of main component and related substance in Phenzolzine capsules. It is suitable for quality control of Phenzolzine capsules.

Effect of traditional Chinese medicine syndrome differentiation and standard bundle therapy in patients with septic shock / 中华危重病急救医学

Objective To evaluate an effective and feasible quantitative evaluation table of traditional Chinese medicine (TCM) syndrome differentiation, and to observe the effect of combination of TCM syndrome differentiation and standard bundle therapy in patients with septic shock. Methods A prospective randomized controlled trial was conducted. The septic shock patients with acute deficiency syndrome admitted to department of critical care medicine of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 1st, 2016 to December 31st, 2017 were enrolled. The patients were randomly divided into control group and Shenfu group. The patients in both groups received early application of standardized bundle therapy; those in Shenfu group received 60 mL Shenfu injection infusion in addition for 7 days. The TCM syndrome score was evaluated by classification and scoring method of TCM symptoms. The circulation and tissue perfusion, severity of disease, organ function, inflammation response, adjuvant treatment and 28-day mortality were compared between the two groups. Results A total of 50 patients with septic shock were enrolled in the analysis, 25 in control group and 25 in Shenfu group. The markedly effective rate of TCM symptoms score in Shenfu group was significantly higher than that in control group [60.0% (15/25) vs. 16.0% (4/25), P < 0.01]. There was no significant difference in all parameters before treatment between the two groups. After treatment, the observation indexes of both groups were improved. Compared with control group, the mean arterial pressure (MAP) in Shenfu group increased more significantly [mmHg (1 mmHg = 0.133 kPa): 13.0 (2.5, 28.5) vs. 6.0 (0, 13.5)], the lactate (Lac) and procalcitonin (PCT) decreased more significantly [Lac (mmol/L): 0.8 (0.1, 3.7) vs. 0.5 (-0.6, 1.7), PCT (μg/L): 2.0 (0.7, 32.3) vs. 0 (-1.8, 3.8)], activated partial thromboplastin time (APTT) was shortened more significantly [s: 8.5 (0, 12.9) vs. 0 (-7.2, 10.0)], and interleukins (IL-2 receptor and IL-6) levels decreased more significantly [IL-2 receptor (ng/L):1 031.0 (533.0, 1 840.0) vs. 525.5 (186.0, 1 166.8), IL-6 (ng/L): 153.1 (21.4, 406.8) vs. 35.1 (16.3, 110.1)] with significant differences (all P < 0.05). There was no significant difference in the use time of vasoactive drugs, duration of mechanical ventilation, severity of the disease or 28-day mortality between the two groups. However, the use time of vasoactive drugs in Shenfu group was shorter than that in control group (days: 5.48±4.81 vs. 8.28±7.83), and the 28-day mortality was decreased [8.0% (2/25) vs. 20.0% (5/25)]. Conclusions TCM syndrome score is helpful to evaluate the effect of TCM syndrome differentiation and treatment, and it is effective and feasible in clinical application. Septic shock patients treated with TCM syndrome differentiation and treatment combined with standard bundle therapy were significantly improved in circulation, tissue perfusion, coagulation function and inflammation reaction.

A retrospective cohort study on treatment ofTiaogan-Bushen-Xiaoji recipe for the patients with advanced breast cancer / 国际中医中药杂志

Objective To explore the efficacy ofTiaogan-Bushen-Xiaoji recipe (TGBSXJ Recipe) on overall survival and progression free survival (PFS) in patients with advanced breast cancer.Methods A total of 105 patients with advanced breast cancer, who received the first-line treatment, were divided into two groups, 56 cases in the control group and 49 in the experimental group. The control group received standard therapy according to guidelines, including chemotherapy, targeted therapy, endocrine therapy and treatment of bisphosphonates.The experimental group received the treatment of TGBSXJ Recipe besides the standard therapy. The overall survival (OS), progression-free survival (PFS) and Karnofsky (KPS) of the patients in two groups were observed and compared. The treatment ended with the sighs of the observation ending, the second progress for the disease or death.Results The overall survival of the experimental group was significantly higher than that of the control group [OS: 58.2(50.7-65.8)/monthsvs. 43.8(30.6-51.6)/months,P=0.040]. The PFS of the experimental group was significantly higher than the control group [PFS: 30.7(23.8-37.7)/monthsvs. 15.2(11.3-19.1)/months,P=0.001]. The KPS of the experimental group was significantly higher than the control group (88.6 ± 10.0vs. 80.5 ± 19.0,t=2.654). The PFS of the triple negative breast cancer (TNBC) in the experimental group was significantly higher than control group [(25.1(12.1-38.0)/monthsvs. 9.9(4.7-15.0)/months,P=0.038].Conclusions The TGBSXJ recipe could extend the OS and PFS and improve the life quality of the patients with advanced breast cancer. In this study, no severe adverse effects had been found in the experimental group.

The value of the prostate imaging reporting and data system version 2 for the diagnosis of prostate cancer / 中华泌尿外科杂志

Objective To evaluate the value of the prostate imaging reporting and data system version 2 (PI-RADS version 2) for the diagnosis of prostate cancer.Methods A total of 243 patients who underwent multiparametric 3T prostate MRI followed by prostate biopsy or radical prostatectomy were included.111 patients were in PSA gray zone(4.0-10.0 ng/ml).PI-RADS version 2 scores for each patient was assigned by two readers independently.Reference standard was obtained by histopathology.Positive predictive value (PPV) for prostate cancer and clinically significant cancer were compared among patients with different PI-RADS Version 2 scores using chi-square trend test.Receiver operating characteristic (ROC) curve was performed to assess diagnostic accuracy of the PI-RADS version 2 scores for prostate cancer detection,and evaluate the difference in diagnostic efficiency between transition zone and peripheral zone.Results Two hundred and eighty five suspicious foci from the 243 patients were finally recruited to this study,131 of which were diagnosed as prostate cancer according to pathology.There was significant difference in PPV for prostate cancer and clinically significant cancer among patients with different PI-RADS version 2 scores (score 1:8.0％;score 2:10.1％;score 3:49.2％;score 4:61.1％ score 5:87.9％,P＜0.01),(score 1:0;score 2:5.1％;score 3:31.1％;score 4:59.3％ score 5:88.9％,P ＜ 0.01).When PI-RADS version 2 score was 3,Youden index was maximum (0.53),the sensitivity was 92.4％ and the specificity was 61.0％.The ROC analysis revealed that the area under the curve (AUC) of prostate cancer incidence in transition zone was similar to that in peripheral zone with 0.86(95％ CI 0.78-0.95) vs.0.83(95％ CI 0.77-0.89).There were 111 patients in PSA gray zone,33 of whom were diagnosed as prostate cancer.If we used PI-RADS version 2 score 3 as the cut-off point,47 out of 111 patients would avoid unnecessary prostate biopsies with 4 misdiagnosed nonsignificant prostate cancer.Conclusions The value of PI-RADS version 2 score is positively associated with PPV for prostate cancer.PI-RADS version 2 seems to have good diagnostic accuracy in prostate cancer detection.Clinical application of PI-RADS version 2 may help to reduce the number of unnecessary biopsy.

Analysis of outcomes of tension-free mid-urethral sling procedure in women with mixed urinary incontinence / 北京大学学报(医学版)

Objective: To evaluate the medium and long term outcomes of tension-free mid-urethral sling in the treatment of female patients with mixed urinary incontinence (MUI).Methods: Twenty-six patients who underwent the tension-free mid-urethral sling procedure for MUI from April, 2010 to September, 2016, were followed up.Four of the 26 patients underwent retropubic tension free mid-urethral sling (TVT), and 22 of them underwent transurethral middle obturator sling (TOT).Scales were used in the follow-up, such as urinary incontinence severity score (UISS), detrusor instability score (DIS), incontinence quality of life scale evaluation (I-QOL), Urogenital Distress Inventory short form (UDI-6), and the outcomes before and after the procedure were compared.Results: The mean age was 62 years, with a range of 42-80 years.The mean body mass index (BMI) was 26.82 kg/m2, with a range of 21.48-31.14 kg/m2.The mean follow-up time was 26 months, with a range of 8-69 months.Twelve patients never took M-blockers and the rest 14 patients took M-blockers within two weeks.None of the pa-tients had complications, including dysuria, injury of bladder, urethra, obturator vessel or nerve during the surgery.After pulling out the catheter, no one suffered moderate or severe pain or difficulty of urination.The overall cure rate for stress urinary incontinence (SUI) was 96.15% with 25 patients cured, and for urge urinary incontinence (UUI) was 76.92% with 20 patients cured.The patients'' life quality also improved significantly (P<0.05).Conclusion: Ten of the 26 patients showed an overactive bladder according to urodynamic study, from whom all of the six failed patient were.And 16 patients didn''t show an overactive bladder, which may due to two reasons.One is that their sense of urge is not so serious, the other one is that their sense of urge is from urethra.Proximal urethra is full of nerve, which plays a role in sense and urine control.The sense of urge may come from urethra instead of bladder.Tension-free mid-urethral sling procedure is an effective treatment for women with mixed urinary incontinence.Even without taking the M-blockers, the cure rate for urge incontinence reached 76.92%.The efficacy of surgery remained stable in medium and long term, and the patients'' quality of life improved significantly.

Trends in Gleason scores of Chinese prostate carcinoma from 1995 to 2014 / 北京大学学报(医学版)

Objective:To assess the changing trends in Gleason score (GS)of Chinese prostate carci-noma (PCa)from January 1995 to December 2014.Methods:In the study,875 patients admitted to hospital from January 1995 to December 2004 (1995 -2004)and from January 2005 to December 2014 (2005 -2014)were divided into two groups.The mean levels and proportions of GS,primary and se-condary grades were studied.The patients were divided into four groups according to age: <60,60 -69,70 -79 and ≥80 years.Types of specimen included needle biopsy (NB),transurethral resection of the prostate (TURP)and radical prostatectomy (RP).Histological types were made up by acinar carci-noma and other types (including atrophic,pseudohyperplastic,foam,signet ring cell and ductal carcino-ma,and so on).The total prostate-specific antigen (tPSA)involved groups of <20.0 μg/L and ≥20.0 μg/L.We observed the mean levels and proportions of GS in age,types of specimen,histological types and total prostate-specific antigen in different periods,and used SPSS 17.0 software for statistical analysis.Results:Compared with 1995 -2004,the mean levels of GS,primary and secondary grades decreased 0.32 (P =0.003),0.19 (P =0.001)and 0.12 (P =0.016)in 2005 -2014,respectively. The proportions of ≤6 in GS increased 10.9% (P =0.003),and ≥8 decreased 14.0% (P <0.001). The difference of GS 7 was not statistically significant.In the primary grade,the ratio of grades≤3 in-creased 12.8% (P =0.001 ),and grade 4 decreased 7.4% (P =0.037),grade 5 decreased 5.5%(P =0.007).The ratio of secondary grades≤3 increased 7.6% (P =0.037).The difference of grades 4 and 5 was not statistically significant.Conclusion:GS in Chinese patients with PCa showed a down-ward trend,which is one of the notable features in the past 20 years in China.The types of specimen and age are important factors in GS,while the histological types and tPSA have less impact on the GS.

Effect of age on urodynamic parameters of women with urinary incontinence / 北京大学学报(医学版)

Objective:To investigate age related changes in urodynamic parameters of women with uri-nary incontinence.Methods:From May 2008 to October 2015,a total of 214 patients diagnosed with urinary incontinence in Peking University People’s Hospital was involved in this study.Average age was (56.97 ±10.68)years,ranging from 30 to 82 years,and average history was (8.44 ±8.85)years, ranging from one month to 50 years.Urodynamic examinations of each patient were taken before operation routinely in Department of Urology,Peking University People’s Hospital.The urodynamic study was composed of non-invasive and invasive procedures.Analysis included maximal flow rate (Qmax ),average flow rate,time to Qmax ,voiding time,detrusor pressure at Qmax ,maximal detrusor pressure,voided volume,post-void residual urine volume (PVR),the total capacity of bladder,first-,strong-,and urge-desire to void,cough leak point pressure (CLPP),and Valsalva leak point pressure (VLPP).Patients were divided into four groups according to age,Kolmogorov-Smirnov test and one-way ANOVA were used for data analysis.Results:A total of 214 patients were enrolled in this study.The data of Qmax ,average flow rate,voided volume,and total capacity of bladder decreased with statistical significance.The value of residual urine volume and voiding time increased without statistical significance,while the value of maximal detrusor pressure decreased.Conclusion:Urodynamic examination data of females with urinary incontinence changes along with the elapse of age,which was mainly observed as age ascends,and the changes in urodynamic parameters of women with urinary incontinence suggest that the value of Qmax , average flow rate,voided volume,and total capacity of bladder decreased significantly,while the value of PVR and the voiding time increased and the value of maximal detrusor pressure decreased.

A prospective randomized study of TOT and TVT procedure for female intrinsic sphincter deficiency(ISD) / 中华泌尿外科杂志

Objective To compare the outcomes of TOT and TVT procedure treating female intrinsic sphincter deficiency (ISD).Methods From May 2010 to September 2015,42 stress urinary incontinence (SUI) patients whose abdominal leak point pressure was less than 60 cmH2O were enrolled in this study.Thirty-five patients were followed up.The mean age was (56.8 ±10.5) years,with a range of 30-80 years.The mean history was(10.5 ± 9.1)years,with a range of 4 months to 30 years,with 26 (74.3％) of them being postmenopausal,5 (14.3％) having a history of pelvic surgery,and no pelvic organ prolapsed or hormone replacement.All of them were randomly divided into 2 groups to undergo either TVT operation (13 cases) or TOT operation (22 cases).The baseline characteristics of the two groups including age,length of history,urodynamic parameters and scale scores showed no significant difference.The scales including urinary incontinence severity score (UISS),detrusor instability score (DIS),Quality of Life Scale Evaluation (I-QOL),lower urinary tract symptoms affect score (UDI-6) were used.The outcomes between TVT group and TOT group were compared.Result After procedure,patients in TVT group got a lower UISS score than TOT group(17.2 ± 2.2 vs.17.7 ± 3.1),and their severity of urinary incontinence improved significantly (P ＜ 0.05).Patients from TVT group got a lower DIS score than TOT group (12.6 ± 4.2 vs.14.2 ± 3.5),and their detrusor instability symptoms improved more significantly (P ＜ 0.05).Patients from TVT group got a higher I-QOL score than TOT group(17.5 ± 14.5 vs.16.1 ± 13.0),and their quality of life improved more significantly (P ＜ 0.05).Patients from TVT group got a lower UDI-6 score than TOT group (10.1 ± 3.0 vs.11.2 ± 3.4),and their lower urinary tract symptoms improved more significantly (P ＜ 0.05).Conclusion Urinary incontinence of female ISD patients were improved greater by TVT than TOT procedure.

Significance of preoperative urodynamics for clinical diagnosis of female patients with stress urinary incontinence / 北京大学学报(医学版)

Objective:To investigate the impact of preoperative urodynamic study on the diagnosis and treatment for female patients with clinical diagnosis of stress urinary incontinence by studying their diag-nosis and treatment database,and to assess its clinical significance of urodynamic study.Methods:From April 2011 to December 2015,196 female patients diagnosed clinically with stress urinary incontinence underwent preoperative urodynamics study,after excluding pelvic organ prolapse.The preoperative uro-dynamic data of these 196 cases were analyzed and the clinical significance of urodynamics on differential diagnosis and treatment for the female patients with stress urinary incontinence was evaluated.Results:In this study,23 cases (11.73%)changed or amended their diagnoses by the urodynamic study,which were inconsistent with the previous clinical diagnoses concluded by the symptoms,physical examinations, and lab tests.A total of 10 cases underwent a different surgery or conservative treatment instead of the original treatment according to urodynamic study.Of them,3 were diagnosed as detrusor overactive and undertook conservative treatment;3 were diagnosed as bladder outlet obstruction plus stress urinary in-continence and were undertaken the transurethral resection of the bladder neck (TURBN)plus tension free vaginal tape (TVT);2 were diagnosed as bladder outlet obstruction plus stress urinary incontinence and were undertaken TURBN alone;1 was diagnosed as bladder outlet obstruction plus stress urinary in-continence and was undertaken TURBN plus tension free vaginal tape obturator (TOT);1 was found no abnormal bladder function turned out to be interstitial cystitis and went for a bladder instillation of drug. The changed treatments avoided the risk of dysuria or residual urine increased after operation due to inap-propriate surgical methods.Conclusion:In order to make a correct diagnosis and suitable treatment for female patients with stress urinary incontinences,the preoperative urodynamic study is necessary besides detailed medical history,physical examination,and laboratory tests.With the help of the urodynamic study,the concomitant diseases of patients with stress urinary incontinence may be detected,the individualized treatment regimen can be developed,and more importantly,the inappropriate surgical de-cision can be avoided.

Study on Distribution and Targeting of Gardenia jasminoides Extract Niosomes in Rats / 中国药房

OBJECTIVE:To study distribution and targeting of Gardenia jasminoides extract niosomes in rats. METHODS:G. jasminoides extract niosomes were prepared by modified thin film dispersion method. 30 rats were randomly divided into G. jasmin-oides extract group(57 mg/kg)and G. jasminoides extract liposome group(131 mg/kg)according to their weight. They were given relevant medicine intragastrically,once a day,for consecutive 7 days. 1 h after last administration,heart,liver,spleen,lung and kidney tissue were isolated,and HPLC method was adopted to the contents of active ingredients gardenoside in them. The targeting of G. jasminoides extract niosomes was evaluated by DTI quantitatively. RESULTS:Compared with G. jasminoides extract group, the contents of gardenoside in heart,spleen and brain tissue of rats increased significantly in G. jasminoides extract niosomes group (P<0.01),and DTI were 1.718,1.972 and 13.071;the contents of gardenoside in liver and kidney decreased significantly (P<0.01),and DTI were 0.431 and 0.467,respectively. CONCLUSIONS:G. jasminoides extract niosomes change the distribution of gardenoside in rats,showing brain targeting effect and decreasing first pass effect for liver.

Synthesis and investigation on antidiabetic activity of 4-(1-aryl-3-oxo-5-phenylpentylamino) benzenesulfonamide / 药学学报

Searching for new antidiabetic lead compound, 4-(1-aryl-3-oxo-5-phenylpentylamino) benzenesulfonamides were designed and synthesized directly by three component one-pot condensation of 4-phenyl-2-butanone and sulfanilamide with some aromatic aldehydes at an yield of 23%-97%. The chemical structures of the twelve new Mannich bases were confirmed by 1H NMR, 13C NMR, FTIR, ESI-MS and HR-MS. The screening results of antidiabetic activity indicated that most of these title compounds possess alpha-glucosidase inhibitory activity, among which compound le is the strongest one. And compound 11 possesses good peroxisome proliferator-activated receptor response element (PPRE) agonist activity. The structure-activity relationship of these new beta-amino ketones containing benzenesulfonamide unit was also discussed preliminarily.