Clinical application of a novel urinary cytology detection system for bladder cancer / 现代泌尿外科杂志

【Objective】 To investigate the diagnostic efficacy of a novel bladder cancer detection system utilizing a urine cell processing kit for urine sample preservation and detection. 【Methods】 Patients with primary persistent gross hematuria and high recurrence risk of bladder cancer after transurethral resection of bladder tumor were prospectively enrolled between Dec.2021 and Mar.2022. Urine specimens were either added to (experimental group) or not added to (control group) the urine cell processing kit and were fixed on Day 0, Day 3 and Day 7. The sensitivity and specificity of the two groups were compared after the cells were fixed, produced, stained and read with body fluid cytology total staining technique. 【Results】 The sensitivity and specificity of the experimental group on Day 0 were 82.50% (33/40) and 87.50% (14/16), respectively; those of the control group were 79.49% (31/39) and 82.35% (14/17), respectively. On Day 3, the sensitivity and specificity of the experimental group were 76.32% (29/38)and 81.25% (13/16), respectively; those of the control group were 52.78% (19/36) and 78.57% (11/14), respectively. On Day 7, the sensitivity and specificity of the experimental group were 71.43% (25/35) and 72.22% (13/18), respectively; those of the control group were 35.71% (10/28) and 60.00% (9/15), respectively. The sensitivity of the experimental group on Day 3 and Day 7 was significantly higher than that of the control group (P<0.05). 【Conclusion】 This bladder cancer urine cytology detection system provides clear diagnostic advantages and can be used as an auxiliary examination before cystoscopy for patients with hematuria and those at high risk of bladder cancer recurrence. It can also be used as a bladder cancer screening tool for pre-screening a large sample of people in order to achieve early diagnosis and treatment of bladder cancer.

Advances in the biosynthesis of natamycin and its regulatory mechanisms / 生物工程学报

Natamycin is a polyene macrolide antibiotics with strong and broad spectrum antifungal activity. It not only effectively inhibits the growth and reproduction of fungi, but also prevents the formation of some mycotoxins. Consequently, it has been approved for use as an antifungal food preservative in most countries, and is also widely used in agriculture and healthcare. Streptomyces natalensis and Streptomyces chatanoogensis are the main producers of natamycin. This review summarizes the biosynthesis and regulatory mechanism of natamycin, as well as the strategies for improving natamycin production. Moreover, the future perspectives on natamycin research are discussed.

Effect of modified Zhuyujingkang decoction combined with glucosamine sulfate in the treatment of cervical spondylosis and its influence on the serum level of TBX 2 / 中国基层医药

Objective:To investigate the therapeutic effect of modified Zhuyujingkang decoction combined with glucosamine sulfate on cervical spondylosis and its influence on the serum level of thromboxane B2(TBX 2). Methods:From June 2017 to June 2019, 82 patients with cervical spondylosis in the Maternal and Child Health Hospital of Zhoushan were selected, and they were divided into control group and observation group according to the random digital table method, with 41 cases in each group.The control group was treated with glucosamine sulfate, and the observation group was treated with modified Zhuyujingkang decoction on the basis of the control group.The course of treatment in both two groups was 4 weeks.The therapeutic effects of the two groups were compared.The changes of VAS, NDI and TBX 2 before and after treatment were compared. Results:The total effective rate of the observation group was 92.68%, which was higher than 70.73% of the control group(χ 2=6.609, P<0.05). After treatment, the VAS score of the observation group was (3.82±0.42)points, which was lower than (4.52±0.38)points of the control group( t=8.479, P<0.05). The NDI score of the observation group was (22.31±2.68)points, which was lower than (27.39±1.89)points of the control group( t=9.919, P<0.05). The serum level of TBX 2 in the observation group was (57.84±3.19)ng/L, which was lower than (65.74±2.48)ng/L in the control group( t=12.519, P<0.05). Conclusion:The therapeutic effect of modified Zhuyujingkang decoction combined with glucosamine sulfate on cervical spondylosis is good.It can reduce the pain, improve the related function of neck and shoulder, and reduce the level of TBX 2, which is worthy of clinical reference.

Analysis of the necessity of extraperitonealization in ileal conduit surgery after radical cystectomy / 中华泌尿外科杂志

Objective To discuss the necessity of closing the peritoneum during the operation of ileal conduit after the radical cystectomy.Methods We retrospectively analyzed the clinical data of 395 patients with bladder cancer who received radical cystectomy from Jan.2014 to Sep.2016.The amount of male was 327,female was 68.The mean age was (65.8 ± 9.7) years old.Patients were divided into four groups according to the surgical method of cystectomy and urinary diversion.In group A,patients,including 78 males and 9 females,were received open radical cysectomy (ORC) with extraperitoneal ileal conduit.The mean age was (67.8 ± 9.2) years old.In the preoperative clinical staging,66 cases were less than T2 and 21 cases were more than T2.Preoperative pathological grade in 83 cases and low grade in 4 cases.In group B,patients,including 31 males and 2 females,were accepted ORC with ileal conduit without peritoneum closure.The mean age was (67.3 ± 8.7) years old.Preoperative clinical staging showed less than T2 in 25 cases,more than T2 in 8 cases,The preoperative pathological grade showed high grade in 33 cases.In group C,patients,including 112 males and 27 females,were accpeted LRC with ileal conduit without peritoneum closure.The mean age was (64.3 ± 10.5)years old.The preoperative clinical staging showed less than T2 in 107 cases and more than T2 in 32 cases.The preoperative pathological grade showed high grade in 135 cases and low grade in 4 cases.In group D,patients,including 106 males and 30 females,were accepted RARC with ileal conduit without peritoneum closure.The mean age was (65.9 ±10.0)years old.Preoperative clinical staging showed less than T2 in 103 cases and more than T2 in 33 cases.The preoperative pathological grade showed high grade in 132 cases and low grade in 4 cases.Ileal conduit without peritoneum closure means completely open the peritoneum after anastomosis of the ureter and intestine in the urinary diversion surgery without shutting down the peritoneum,which is different from the extraperitoneal ileal conduit.The operating time,blood loss,blood transfusion rate,recovery time of intestinal function and perioperative complications and rate of hydronephrosis were analyzed.Results The 395 cases completed operation successfully,no LRC or RARC had been converted to ORC.The operative time was (280.1 ± 92.3) min,(233.6 ± 99.4) min,(304.8 ± 108.9) min,(364.6 ± 86.4) min in four groups,respectively (P ＜ 0.05).The blood loss in four groups were (489.1 ± 285.6) ml,(431.8 ± 233.1) ml,(373.0 ±213.7) ml,(205.6 ± 137.8) ml,respectively (P ＜0.05).The transfusion rate in four groups were 18 (20.7％),16 (48.0％),15 (10.8％),14 (10.3％),respectively (P ＜ 0.05).The mean time to flatus in four groups were (3.7 ±1.8)d,(3.6±1.0)d,(3.5±1.2)d,(2.2±1.7)d,respectively (P ＜ 0.05).While ileal obstruction rate had no statistical difference in four groups [group A 17 cases(19.5％),group B 6 cases(18.2％),group C 27 cases(19.4％),group D 19 cases(14.0％),P =0.678].Urine leakage,intestinal leakage,lymphocyst were only occurred in group A [7 cases (8.0％),2 cases (2.3％),2 cases (2.3％)].Pyelonephritis was noticed in each group,including 14 cases(16.1％)in group A,2 cases(6.1％)in group B,9 cases (6.5％)in group C,6 cases(4.4％)in group D (P ＜ 0.05).Hydronephrosis 6 months after surgery was observed in four groups,including 15 cases(17.2％)in group A,3 cases(9.1％)in group B,7 cases(5.0％)in group C,5 cases(3.7％)in group D (P ＜ 0.05).Conclusions Ileal conduit without peritoneum closure would not increase the incidence of complications,on the contrary,it would relieve the tension of anastomosis,and reduce the occurrence of complications such as urine leakage.

Retrospective study of the safety and effectiveness of transurethral resection of the prostate for be-nigh prostatic hyperplasia in large prostates / 中华泌尿外科杂志

Objective To discuss the safety and effectiveness of transurethral resection of the prostate (TURP) on large-size (≥ 80 ml) benign prostatic hyperplasia (BPH).Methods Retrospective analysis of 958 BPH patients in Southwest Hospital during January 2010 to January 2013 was conducted.The patients were grouped into ≥80 ml prostate group (Group A) and ＜80 ml prostate group (Group B) according to the volume of prostate.Comparison was made between the 2 groups on the safety and effectiveness of TURP.Results There were 276 patients in Group A and 682 in Group B.No significant differences were shown in average age and preoperative American society of anesthesiology score of Group A and B.Compared with Group B,decrement in hemoglobin level and blood Na+ concentration of Group A was more significant (P＜0.01).There were more prostate tissues excised and duration of the operations was longer (P＜0.01).No significant difference was observed in peri-operative complications graded by the modified Clavien classification system,catheter durations and durations of hospital stay between the 2 groups (P＞0.05).At 6 months after the surgery,average maximum urinary flow rate (Qmax) increased from 5.9±2.9 ml/s to 17.1±8.2 ml/s for Group A and 6.1±3.0 ml/s to 17.5±6.4 ml/s for Group B,both groups showed significant increase in Qmax after surgery(P＜0.01).Six months after surgery,international prostate symptom score (IPSS) of Group A decreased from 23.7±6.1 to 5.9±4.9 while IPSS of Group B decreased from 23.1±5.5 to 6.2±4.4,both groups showed a significant decrease (P＜0.01).No significant difference was shown in IPSS,quality of life,Qmax,postvoid residual urine volume and occurrence rate of long-term complications after 6 months between the 2 groups (P＞0.05).Conclusion TURP is as safe and effective in treating large-size BPH as treating medium and small-size BPH.

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.

Diagnosis and treatment of 138 hermaphroditism cases / 第三军医大学学报

Objective To improve the diagnosis and treatment of hermaphroditism.Methods The data of 138 cases of hermaphroditism who were hospitalized in our department between March 2005 and April 2008 were reviewed and and analyzed to summarize our experience in the diagnosis and treatment.Results Among the 138 cases with a age ranging from 2 to 36(mean 17 years old),42 were socially male and 96 were socially female.With the help of medical examination,,laboratory examination,ultrasonic examination,radiological examination and pathologic diagnosis,54 patients were diagnosed as female pseudohermaphroditism,66 as male pseudohermaphroditism,10 patients as true hermaphroditism,2 patients as pure gonadal dysgenesis,2 as testicle degeneration,and the left 4 patients as Klinefelter syndrome.Among the 138 patients,132 patients were received surgery operation,including 76 of them receiving laparoscopy.After operation,121 patients were maintained female sex,11 patients were maintained male sex.Female pseudohermaphroditism were all maintained female sex.Fifty-nine patients of male pseudohermaphroditism were maintained female sex.There were 4 patients being maintained male sex,and 3 patients having not received operation.Of the cases of the true hermaphroditism,8 patients were maintained female sex and 2 patients were maintained male sex.Conclusion Early accurate diagnosis is very important to the treatment of hermaphroditism.Etiologic diagnosis is useful in the course.Although it is good for the hermaphroditism to maintain female sex,the decision of the patients and the family should be considered.

Evaluation of short-term efficacy of holmium laser enucleation of the prostate in the treatment of BPH / 中华泌尿外科杂志

0.05 ).Fifty five patients of HoLEP group (78.6%,55/70) and 58 patients of TURP group(82.9%,58/70) were followed up at the third and sixth month postoperatively.In TURP group,6.9% of the patients(4/58) needed blood transfusion and 3.4%(2/58)developed TURS.In HoLEP group, no one needed blood transfusion or developed TURS. The differences were significant between the 2 groups ( P