Analysis of urethral blood flow by high-resolution laser speckle contrast imaging in a rat model of vaginal distension.

OBJECTIVE: To investigate the feasibility of laser speckle contrast imaging (LSCI) for monitoring urethral blood flow (UBF). MATERIALS AND METHODS: In this study, 18 healthy, virgin female Sprague-Dawley rats aged 8-week-old were used. The animals were divided into the sham group (n = 9) and the vaginal distension (VD) group (n = 9). The sham group underwent one catheterization of the vagina without distension and the VD group underwent one VD. Following the VD or sham treatment for one week, LSCI assessment of urethral blood flow was performed during bladder filling and leak point pressure (LPP) process. RESULTS: During the LPP process, in the VD group, the mean LPP was significantly lower than in the sham group (p < 0.05) and the mean UBF level was also significantly lower than in the sham group (p < 0.05) in the LPP condition. The mean relative change of UBF (Δ Flow) was significantly different between the sham group and VD group. The value was 0.646 ± 0.229 and 0.295 ± 0.19, respectively (p < 0.05). During the bladder filling process, the VD group had a significant lower mean UBF level than the sham group under full bladder conditions (p = 0.008). The mean ΔFlow was also significantly lower than in the sham group. The value was 0.115 ± 0.121 and 0.375 ± 0.127, respectively (p = 0.016). CONCLUSIONS: The results confirmed that LSCI was able to determine UBF in female rats. The VD group had lower baseline UBF and lower increases in UBF during bladder filling and LPP process compared with the sham group.

Morphological and histological changes in the urethra after intraurethral nonablative erbium YAG laser therapy: an experimental study in beagle dogs.

The purpose of this study was to investigate the morphological and histological changes in the urethra in beagle dogs after intraurethral Er:YAG laser irradiation in nonablative mode to confirm the safety of this therapy. Six 2-year-old healthy female virgin beagle dogs (13 ± 1.51 kg) were used in this study. The animals were divided into 2 groups: the sham group, which received sham treatment (n = 3) involving insertion of an intraurethral cannula and laser delivery handpiece into the urethra without laser irradiation, and the experimental group (n = 3), which received intraurethral Er:YAG laser irradiation. The laser irradiation parameters were set according to clinical criteria (4 mm spot size, 1.5 J/cm2, 1.4 Hz, and 4 pulses) in nonablative mode. All animals received three sequential sessions at 4-week intervals. Urethrography and urethroscopy were performed in the 12th week and 13th week, respectively, after the first treatment. After urethroscopy, the animals were sacrificed, and urethral tissue was harvested for histological investigations. All procedures were performed under general anesthesia (40 mg/kg 3% sodium pentobarbital, i.v.). Transforming growth factor ß1 (TGF-ß1) and α-smooth muscle actin (α-SMA) expression levels were measured to evaluate the biochemical characteristics of the scar. Urethral stricture was not found by urethrography or urethroscopy in either group. Urethral epithelium thickness and collagen expression under the urethral mucosa were significantly increased in the experimental group compared with the sham group. However, there were no significant differences in TGF-ß1 and α-SMA expression between the experimental group and sham group (p > 0.05). Urethral stricture is not found in beagle dogs after clinically relevant intraurethral nonablative mode Er:YAG laser irradiation. Proliferation of urethral collagen and the urethral mucosa may be one of the mechanisms by which urine leakage symptoms can be improved.

Prophylactic Antibiotics for Urinary Tract Infections after Urodynamic Studies: A Meta-Analysis.

AIM: We aimed to perform a meta-analysis to determine whether antibiotic prophylaxis reduces the incidence of urinary tract infections (UTIs) after urodynamic studies (UDS). METHODS: We conducted a systematic search of PubMed, Web of Science, Ovid, Elsevier, ClinicalKey, Embase, Cochrane Library, Medline, and Wiley Online Library. Randomized controlled trials (RCTs) comparing the effectiveness of prophylactic antibiotics with placebo or no treatment in preventing UTI after UDS were included. Two reviewers extracted data independently, and RevMan 5.3 software was used to analyze relative risk (RR) with 95% confidence intervals (CI). Heterogeneity was assessed by the Q test and I 2 test. RESULTS: The final meta-analysis included 1829 patients in 13 RCTs. Compared with the placebo or no treatment group, prophylactic antibiotics could significantly reduce the risk of bacteriuria (RR = 0.42, 95% CI: 0.30-0.60) and the risk of symptomatic UTI (RR = 0.65, 95% CI: 0.48-0.88). In addition, there was no statistically significant difference in the risk of adverse events (RR = 4.93, 95% CI: 0.61-40.05). No significant heterogeneity or publication bias was found in this study. CONCLUSIONS: Current evidence showed that prophylactic antibiotics could reduce the risk of asymptomatic bacteriuria and symptomatic UTI after UDS without increasing the incidence of adverse events.

Verification and Defined Dosage of Sodium Pentobarbital for a Urodynamic Study in the Possibility of Survival Experiments in Female Rat.

OBJECTIVES: To evaluate the effects of pentobarbital dosages on lower urinary tract function and to define an appropriate dosage of sodium pentobarbital that would be suitable for urodynamic studies in which recovery from anesthesia and long term survive were needed for subsequent experiment. METHODS: Twenty-four 8-week-old, female, virgin, Sprague-Dawley rats (200-250 g) were used in this study. Rats in study groups received gradient doses of pentobarbital intraperitoneally, and those in the control group received urethane intraperitoneally. External urethral sphincter electromyography (EUS-EMG) was recorded simultaneously during cystometry and leak point pressure tests. The toe-pinch reflex was used to determine the level of anesthesia. RESULTS: Micturition was normally induced in both the urethane group and 32 mg/kg pentobarbital group. However, in groups of 40 mg/kg or 36 mg/kg pentobarbital, micturition failed to be induced; instead, nonvoiding contractions accompanied by EUS-EMG tonic activity were observed. There were no significant differences in leak point pressure or EUS-EMG amplitude or frequency between the urethane and 32 mg/kg pentobarbital groups. CONCLUSIONS: This study confirmed significant dose-dependent effects of pentobarbital on lower urinary tract function and 32 mg/kg pentobarbital as an appropriate dosage for recovery urodynamic testing, which enable the achievement of expected essential micturition under satisfactory anesthesia in female rats.

ERα Gene Promoter Methylation in Cognitive Function and Quality of Life of Patients With Alzheimer Disease.

OBJECTIVE: Alzheimer disease (AD) has been recognized as a progressive neurodegenerative disorder. This study aims to investigate the effects of estrogen receptor α (ERα) gene promoter methylation on the cognitive function and quality of life (QOL) of patients with AD. METHODS: A total of 132 patients with AD and 135 healthy individuals were recruited for this study. The DNA in the peripheral blood was extracted and treated with bisulfite; then methylation-specific polymerase chain reaction and reverse transcription quantitative polymerase chain reaction were performed to determine the methylation status of ERα and ERα messenger RNA (mRNA) expression, respectively. Mini-Mental State Examination (MMSE), activities of daily living (ADL), and Quality of Life-Alzheimer Disease scale were employed to evaluate the cognitive functions, ADL, and QOL of the participants. RESULTS: The methylation group showed a decrease in ERα mRNA expression. The MMSE and ADL scores were indicative of a worse cognitive function in the methylation group. The ERα promoter methylated patients showed a higher rate of abnormal ADL score, while patients in the nonmethylation group enjoyed a better QOL. CONCLUSIONS: The ERα promoter methylation is related to impaired cognitive function and QOL of patients with AD by inhibiting ERα mRNA expression and transcription.

Genetic polymorphisms in tumor necrosis factor alpha and interleukin-10 are associated with an increased risk of cervical cancer.

Most cases of cervical cancer are the result of infection with specific high-risk types of human papillomavirus (HPV). Investigating the genetic basis of the host immune response, particularly cytokine function, could help further characterize the progression of cervical HPV infection into neoplasia. Prior studies have demonstrated a correlation between genetic variants of tumor necrosis factor alpha (TNF-α, TNF gene) and/or interleukin-10 (IL-10, IL10 gene) and cervical cancer susceptibility. However, some of the results have been contradictory. We sought to resolve these discrepancies by carrying out our study in a large cohort of Chinese women. In order to assess the association of TNF and IL10 genotypes with cervical cancer susceptibility, the polymorphisms in TNF (-238 G/A, -308 G/A) and IL10 (-592 C/A, -819 C/T, -1082 A/G) were genotyped and odds ratios for the genotype and allele frequencies between cervical cancer patients and healthy controls were calculated. Also, the functional relevance of these polymorphisms was evaluated using enzyme-linked immunosorbent assays (ELISAs) and in vitro lymphocyte proliferation assays. The TNF-238 AA genotype frequency was lower in patients than in controls (p < 0.05). TNF-308 AA, IL10-592 CA/AA, and IL10-819 CC/CT genotype frequencies were higher in cervical cancer patients than in controls (p < 0.05). The frequency of the TNF-238 A allele was significantly lower in patients, while the frequency of the -308 A allele was significantly higher (p < 0.05). No significant differences between patients and controls were found in the genotype or allele frequencies of IL10-1082 A/G (p > 0.05). Furthermore, the combinations of TNF-238 GA or GG and IL10-592 CC; TNF-238 GA or GG and IL10-592 CA or AA; TNF-308 AA and IL10-592 CC; and TNF-308 AA and IL10-592 CA or AA in cervical cancer patients were statistically significant (p < 0.0167). Upon stimulation with PHA, peripheral blood mononuclear cells (PBMCs) with the TNF-308AA genotype exhibited significantly higher proliferation rates, elevated IL-4, TGF-ß levels, and lower IL-2 levels (p < 0.05). For IL10-592C/A, the AA and CA genotypes were significantly associated with higher proliferation rates, elevated IL-4 and IL-10 levels (p < 0.05). We also found that for TNF-308 G/A or IL10-592 C/A variants, the combination of TNF-308 GG or GA with IL10 CA or AA had an association with the severity of cervical cancer. Taken together, these results suggest that TNF-308 AA and IL10-592 CA/AA genotypes may increase susceptibility to cervical cancer by altering the immune response of an individual.

[Transformation and Migration of Sulfur Speciation in the Rhizosphere and Bulk Soil of Paddy Soil].

A pool culture experiment was carried out to investigate the influence of different forms of sulfur fertilizers (sulfur and gypsum) on the transformation and migration of sulfur speciation in the rhizosphere and bulk soil of unpolluted and polluted paddy soils.The results showed that the redox potential (Eh) was about 93-283 mV and 83-254 mV, respectively, the soil solution pH was 7.5-8.4 and 7.7-8.4, respectively, and pe+pH was 9.1-13.2 and 9.1-12.5, respectively, in the bulk and bulk soil.Solution Eh values in Rhizosphere soil were generally higher than those in bulk soil, and solution pH in the former was generally lower than that in the latter.The different forms of inorganic sulfur followed the order of water-soluble sulfur (41%-81% of total inorganic sulfur, similarly hereinafter)>>sulfur adsorption (9%-34%)>hydrochloric acid soluble sulfur (8%-24%)>hydrochloric acid volatile sulfide (2%-8%) in the rhizosphere.In tillering and earing flowering,the concentrations of water-soluble and absorbed sulfur by application of gypsum were significantly higher than those using elemental sulfur.And its content in unpolluted paddy soil was significantly higher than that in polluted paddy soil. In the bulk soil,the forms of inorganic sulfur followed the order of water-soluble sulfur (40%-69%)>>hydrochloric acid soluble sulfur (18%-41%)>hydrochloric acid volatile sulfide (6%-16%)>adsorbed sulfur (0.7%-7.5%).The mass fractions of inorganic sulfur, organic sulphur and the total sulfur in the rhizosphere soil were in the range of 223-738 mg·kg-1, 574-1647 mg·kg-1 and 825-2287 mg·kg-1,respectively,and the corresponding fractions were in the range of 68-128 mg·kg-1, 108-391 mg·kg-1 and 200-477 mg·kg-1 in the bulk soil,respectively.Inorganic sulfur and organic sulfur of total sulfur in the rhizosphere were 20%-40% and 60%-80%, respectively, and those in the bulk were 18%-46% and 54%-82%, respectively.Total sulfur. organic sulfur and water-soluble sulfur and adsorbed sulfur and hydrochloric acid soluble sulfur in the rhizosphere were 3-11 times, 3-5 times, 5-7 times, 12-20 times, and 2-3 times of those in the bulk soil, respectively, whereas the hydrochloric acid volatile sulfur in the rhizosphere was lower than that in the bulk soil.

[Adsorption Characteristics of Arsenite on Goethite by Flow Stirring Method].

Adsorption characteristics of arsenite on goethite under the effects of the solution pH, concentration and temperature were investigated using a flow-stirring dynamic device. The results showed that the adsorption process of arsenic could be divided into rapid and slow reactions under different conditions.The maximum of arsenite adsorption fitted by the first order equation remarkably decreased with increase in the solution pH, for example, 246.9 mg·kg-1 at pH 3.0 and 99.8 mg·kg-1 at pH 7.0, respectively. The rate constant(k')of the apparent adsorption increased gradually along with the increase of solution pH, and so the half reaction time(t1/2)was smaller, and the equilibrium time of arsenic adsorption was shorter. At the same time, the b values of diffusion rate constant were reduced gradually. With the increase of arsenic concentration, the amounts of arsenic adsorption and the k' values increased gradually. The maximum amount of adsorption of arsenic was 96.5 mg·kg-1 and 249.1 mg·kg-1 when the arsenic concentration was 0.10 mg·L-1 and 1.00 mg·L-1, respectively. Adsorption constant(Kf)by the Freundlich equation decreased gradually with the extension of the reaction time and its ability of adsorption was gradually weakened. Distribution factor(RL)by Langmuir equation was between 0-1, and the adsorption of arsenic on goethite was accounted for the preferential adsorption. With the increase of temperature, the maximum amount of adsorption of arsenic was increased, for example, 241.1 mg·kg-1 at 298 K and 315.6 mg·kg-1 at 313 K, respectively. And the k' values of the apparent adsorption rate constant gradually rose in the meantime. The false thermodynamic constants were calculated using the b values of the diffusion rate by the parabolic diffusion equation. The reaction activation energy(Ea*)of Arsenic adsorption was 14.60 kJ·mol-1. The change of arsenic diffusion activation enthalpy(ΔHθ)decreased with the increase of temperature, and ΔHθ was positive in values and on behalf of the endothermic process. So the rising temperature was beneficial to the diffusion of arsenic. ΔGθ of activation free energy was increased as the temperatures rose, and helpful to accelerate the diffusion process. Entropy of activation(ΔSθ)was negative in all cases, suggesting that the system could improve its degree of order.

[Influence of Sulfur on the Formation of Fe-Mn Plaque on Root and Uptake of Cd by Rice (Oryza sativa L.)].

A pool culture experiment using exogenous Cd-polluted paddy soils was carried out to investigate the influence of different forms of sulfur fertilizers (sulfur and gypsum) on the formation of Fe-Mn plaque on rice root and the uptake of Cd by rice. The results showed that the redox potential ( Eh) was about--200-100 mV, the pH was 6.9-7.9 and the pe + pH was 4-10 in different growth periods of rice. The mass fractions of Fe and Mn plaque on rice root were 5000-13,000 mg · kg(-1) and 170-580 mg · kg(-1), respectively. The high sulfur treatment led to the formation of more Fe plaque than the low sulfur treatment, and the mass fractions of Fe plaque in both treatments were 9400 mg · kg(-1) and 8600 mg · kg(-1) respectively in the boot stage. Contents of Mn plaque, significantly different in the tiller stage by elemental sulfur treatment and gypsum treatment, were 600 mg · kg(-1) and 400 mg · kg(-1), respectively. The elemental S treatment led to the formation of more Mn plaque on rice root than the gypsum treatment. The excessive intake of Fe2+ might be prevented by the formation of the plaque which had little significant influence on the uptake of Mn2+. The mass fractions of Cd adsorbed by rice roots surface plaque were 78.8-131.1 mg · kg(-1) in tiller stage, 16.6-21.1 mg · kg(-1) in boot stage, and 3.0-9.2 mg · kg(-1) in mature stage. The high sulfur treatment led to higher adsorption of Cd by the plaque than the low sulfur treatment in the tiller stage and the boot stage, while opposite result was observed in the mature stage. The values of Cd on the plaque measured by ACA could not truly show its actual contents adsorbed. The mass fractions of Cd in the different parts of rice followed the order of roots > stem leaf > grain. The sulfur fertilizers applied significantly reduced the mass fractions of Cd uptake in different parts of rice, and the elemental sulfur treatment had better effects than the gypsum treatment before the mature stage in roots and stem leaf, and the gypsum sulfur treatment was better for grain. A certain amount of sulfur fertilizers could effectively prevent the migration of Cd from roots to stem and grain. The transfer coefficients of Cd from roots to stem leaf in the elemental sulfur treatment and the gypsum treatment were 0.13 and 0.25 in the boot stage, respectively, and the difference was significant. Elemental sulfur was more effective to prevent the Cd migration from roots to stem leaf, and the gypsum treatment was more active from roots to grain.

[Influence of photoselective vaporization of prostate on erectile function in patients with benign prostatic hyperplasia].

OBJECTIVE: To assess the influence of photoselective vaporization of the prostate (PVP) on the erectile function of the patient with benign prostatic hyperplasia (BPH). METHODS: Using IIEF-5, we conducted a questionnaire investigation among 210 BPH patients before and after treated by PVP (n = 80) and transurethral resection of the prostate (TURP, n = 130). We also reviewed the clinical data and compared the pre- and post-operative penile erectile function between the two groups of patients. RESULTS: Follow-up was completed in 76 cases of PVP and 123 of TURP. The baseline data showed no statistically significant differences between the two groups in age, prostate volume, IPSS, QOL, Qmax, post void urine residual volume and IIEF-5 scores (P>0.05). Compared with the IEFF-5 score at the baseline (21.88 +/- 2.46), those at 3, 6 and 12 months after PVP were 16.72 +/- 3.17, 19.34 +/- 2.46 and 19.29 +/- 2. 18, respectively, significantly decreased at 3 months (P = 0.042), but with no remarkable difference at 6 and 12 months (P >0.05). Nor were there significant differences in the IIEF-5 score between the PVP and TURP groups at any time points (P>0.05). At 6 months after surgery, the incidence rates of erectile dysfunction were 11.7% and 13.7% in the TURP and PVP groups, respectively (P>0.05). CONCLUSION: PVP may reduce erectile function in some cases in the early stage after surgery, but this adverse effect does not last long and is basically similar to that of TURP.

[Value of spermatic cord sonography in the early diagnosis and treatment of testicular torsion].

OBJECTIVE: To improve the early diagnosis and therapeutic outcomes of testicular torsion. METHODS: We retrospectively reviewed the clinical data of 49 cases of testicular torsion along with the results of their intratesticular color Doppler flow imaging (CDFI) and spermatic cord sonography. RESULTS: Of the 49 cases, 42 showed abnormal intratesticular blood flow, including 3 cases of increased blood flow, while the other 7 presented no obvious abnormality. Morphological abnormality of the spermatic cord was found in 47 cases. Twenty-eight cases underwent testis removal, and the other 21 received detorsion and orchidopexy, in which 12 testes were preserved with normal size and blood flow. CONCLUSION: Spermatic cord sonography and intratesticular CDFI play an important role in the early diagnosis of testicular torsion. And early surgical exploration contributes to the preservation of the testis.

[The effect of cell killing by ABT-737 synergized with docetaxel in human prostate cancer PC-3 cells].

OBJECTIVE: To investigate the synergistical killing effect of docetaxel combined with ABT-737 on human prostate cancer cell line PC-3 by inducing apoptosis and further to determine the mechanism underlying such effect. METHODS: PC-3 cells were treated with various concentrations of docetaxel or (and) ABT-737. Cell viability was determined using MTT assay. Apoptosis was assessed by fluorescence microscopy analysis of cells with condensed and segmented nuclei following staining with 4',6-diamidino-2-phenylindole (DAPI). Cellular DNA was stained with propidium iodide and flow cytometric analysis was performed to analyze the cell cycle distribution. Bcl-2, Bax, Bcl-xL and Mcl-1 protein changes were detected by Western blot. The activity of caspase-3 was measured using a colorimetric assay. RESULTS: Docetaxel (20 nmol/L) combination with ABT-737 (400 nmol/L) for 48 hours, the cell viability was decreased to 19.7% ± 3.2% to compare with 44.2% ± 4.4% (t = 4.45) of docetaxel and 93.2% ± 1.8% of ABT-737 separately and there was a synergistic effect between the two drugs (CI = 0.8). Apoptosis rate of the combination group was higher than other two drugs. Docetaxel increased the cell number arrested in G(2)/M phase compared with control group (P < 0.05), but the combination treatment resulted in a significant arrest in the G(0)/G(1) phase. The combination treatment could significantly reduced the Bcl-2, Bcl-xL and Mcl-1 expression (F = 369.53, 57.89 and 32.77, all P < 0.05) and enhanced the activity of caspase-3 (419.7% ± 15.6%) (F = 207.33, P < 0.05). CONCLUSIONS: The combination of ABT-737 with docetaxel can synergistically inhibit the proliferation of PC-3 cells through inducing apoptosis, which may be associated with cell cycle arrest, down-regulation of Bcl-2, Bcl-xL and Mcl-1 expression and activation of caspase-3.

Morphological and molecular evidence for natural hybridization in sympatric population of Roscoea humeana and R. cautleoides (Zingiberaceae).

The sympatric occurrence of some species in Roscoea is very common, but little information is available on natural hybridization. However, some intermediate individuals were found on the sympatric population of Roscoea humeana and R. cautleoides at Ganhaizi population in northwestern Yunnan Province, China. We suspected that these intermediate individuals were the hybrids of R. humeana and R. cautleoides from the previous evidence, but could not confirm them. In this study, morphometric analysis was followed by examination of HAT-RAPD polymorphisms to determine the occurrence of natural hybridization between sympatric R. humeana and R. cautleoides. The results showed that most morphological characters of the putative hybrids were found to be intermediate between those of R. humeana and R. cautleoides. Meanwhile, molecular analysis confirmed that the morphological intermediates were derived from hybridization between the two species. From the analysis of the NewHybrids, the hybridization individuals were mainly F1s. These results indicated that interspecific hybridization between R. humeana and R. cautleoides indeed occurred in sympatric population.

Comparison of three kinds of mid-urethral slings for surgical treatment of female stress urinary incontinence.

AIMS: A study was conducted to compare the efficacy and complications of tension-free vaginal tape (TVT), transobturator vaginal tape inside-out TVT-O and transobturator vaginal tape out-inside (TOT) procedures for the surgical treatment of female stress urinary incontinence SUI. METHODS: This study is a prospective randomized trial involving 187 women with primary SUI; 77 received TVT, 65 received TVT-O, and 45 patients were treated with TVT-O between June 2002 and December 2009. Before the operation, a complete medical history was taken and a gynecologic examination was performed, including subjective symptoms, history and urodynamic studies. Postoperative data included mean operation time, days of hospitalization, postoperative complications and efficacy evaluation. Therapeutic effect was assessed by presence or absence of incontinence when abdominal pressure increased. RESULTS: The history, physical examination and urodynamic studies among the three groups have no significant difference (P>0.05). The total cure rate was 91.4%. The cure rate in TVT, TVT-O and TOT groups were 90.9%, 92.3% and 91.1%, respectively. There was no significant difference (P>0.05). Mean operative time showed no significant difference between TVT-O and TOT groups, but both were significantly shorter than TVT group (26.90±16.80, 20.00±13.50 vs 48.20±21.90). The mean postoperative hospital stay showed no significant difference between TVT and TVT-O groups, but both groups were significantly longer than TOT group. Mean postoperative hospital stay of TVT, TVT-O and TOT were 5.00±2.40 days, 4.00±2.20 days and 2.30±0.80 days, respectively. The complication rate in TVT, TVT-O and TOT groups was 15.60%, 9.20% and 8.90%, respectively. In TVT group, 4 patients experienced bladder perforation, postoperative dysuria or retention occurred in 7 cases and was cured by urethral dilation, hematomas of retropubic space in 1 patient. No bladder injury occurred in TVT-O and TOT group, 3 patients had postoperative dysuria or retention and 3 patients had transient dysfunction of both lower limbs postoperatively in TVT-O group, 2 patients had postoperative dysuria or retention and 2 patients had transient dysfunction of both lower limbs postoperatively in TOT group. SUMMARY: The three tension-free urethral suspension techniques have similar efficacy, all of them are safe and effective procedures for the treatment of female SUI. Compared with TVT, TVT-O and TOT are simpler, less invasive and have fewer complications.

[The urodynamic diagnosis of benign prostatic hyperplasia with coexisting overactive bladder].

OBJECTIVE: To investigate the urodynamic features in patients of benign prostatic hyperplasia (BPH) with coexisting overactive bladder (OAB). METHODS: Clinical data of 235 patients with symptomatic BPH who underwent urodynamic examination during January 2009 to May 2010 were retrospectively analyzed. Patients were divided into group of pure BPH, BPH with detrusor overactivity (DO), BPH with coexisting OAB without DO and BPH with coexisting OAB with DO. The difference of age, International Prostate Symptom Score (IPSS), transrectal ultrasound (TRUS)-volume, maximum flow rate, residual urine volume, bladder volume of first sensation, bladder volume of strong sensation, bladder outlet obstruction index (BOOI) and the prevalence of decreased detrusor contractility were compared between these groups. The urodynamic characteristics of DO between group of BPH with DO and group of BPH coexisting OAB and DO were analyzed. RESULTS: A total of 219 cases were included in the final analysis, with mean age of (66 ± 8) years, mean TRUS-volume was (35 ± 24) ml, mean maximum flow rate was (11 ± 6) ml/s. Of the 219 patients, 93 patients (42.5%) had pure BPH, 11 patients (5.0%) had BPH with DO, 52 patients (23.7%) had BPH coexisting OAB without DO, 63 patients (28.8%) had BPH coexisting OAB and DO. Comparing to group of BPH (n = 104), patients with BPH and OAB (n = 115) were older, had higher IPSS, bigger TRUS-volume, less bladder volume of first sensation and strong sensation, higher BOOI and higher prevalence of decreased detrusor contractility. Comparing to group of BPH with coexisting OAB without DO patients, patients of BPH with coexisting OAB and DO had higher IPSS score (19 ± 12 vs 17 ± 10), bigger TRUS-volume [(51 ± 33) ml vs (43 ± 27) ml], higher BOOI (49 ± 18 vs 37 ± 14). Comparing to patients pure BPH, patients of BPH with DO had less bladder volume of first sensation and bladder volume of strong sensation [(82 ± 41) ml vs (118 ± 35) ml;(335 ± 67) ml vs (419 ± 53) ml]. Comparing to group of BPH with DO, patients of BPH with coexisting OAB and DO had higher maximum DO pressure [(45 ± 36) cmH2O vs (39 ± 30) cmH2O (1 cmH2O = 0.098 kPa)] and longer DO time [(7 ± 4) s vs (6 ± 4) s]. CONCLUSIONS: The urodynamic features in patients with BPH differ greatly and these information should be helpful in making choice of treatment and in predicting treatment outcomes.

[Cloning and expression of atp6 and atp9 genes from ramie (Boehmeria nivea (L.) Gaud.) and their relationship with cytoplasmic male sterility].

The atp6 and apt9 gene fragments associated with cytoplasmic male sterility (CMS) were cloned from the mitochondrial DNA of a ramie (Boehmeria nivea (L.) Gaud.) cytoplasmic male sterile line and its maintainer and restorer lines using PCR and degenerated primer strategy. The primers were designed according to the reserved sequences in the encoding region of mitochondrial genes atp6 and atp9 of some dicotyledons from GenBank. These fragments did not have complete encoding region but showed the homology of 94% and 85% with atp6 and atp9 genes from the referred dicotyledons in GenBank. The complete atp6 and atp9 genes including the complete open reading frames were cloned by means of amplifying the 3' and 5'end unknown sequences of these gene fragments using DNA Walking method. The atp6 gene showed no difference among ramie male sterile line, maintainer and restorer lines at mtDNA sequence, transcription and translation control and protein level. However, compared to the maintainer and restorer lines, the atp9 gene of the male sterile line was different and deletion in several bases at the 3' end of the encoding region. An abnormally high expression of atp9 gene in the male sterile line at the budding stage and full-bloom stage was analyzed by RT-PCR analysis. These results indicated that the variation in DNA sequence and/or abnormality in expression of atp9 gene in the male sterile line maybe closely related to ramie CMS.

[A multicenter study of mid urethral sling procedures in treatment of female stress urinary incontinence].

OBJECTIVE: To investigate the clinical efficacy, surgical indications and postoperative complications of mid urethral sling procedures in treatment of female stress urinary incontinence. METHODS: A multicenter clinical trial was conducted from April 2002 to April 2008 in five hospitals, 304 cases of genuine stress urinary incontinence and 8 cases of mixed incontinence were included. TVT procedures were carried out in 134 patients, TVTO procedures in 167 patients, Monarc procedures in 11 patients. Perioperative evaluations included: operating time, bleeding volume, and perioperative complications. Operative efficacy was classified into three categories: cure, improved and failure and evaluated before discharge, 3 months after surgery and then every year. RESULTS: TVT group had longer operating time [(18.5 + or - 9.6) min] and more bleeding volume [(32.2 + or - 12.6) ml] than those in TVTO group [(11.5 + or - 3.1) min, (12.8 + or - 8.5) ml] and in Monarc group [(11.1 + or - 2.6) min, (12.3 + or - 3.5) ml] with P < 0.05. Monarc and TVTO procedures had higher cure rates and improve rates comparing with TVT, but the differences were of no significance. The cure rate (95.7%) in patients with genuine stress incontinence were significantly higher than that in patients with mixed incontinence (37.5%). No significant differences of total intra- and postoperative complications were noted for all of the three procedures. However, bladder injury tended to occur in TVT group and obturator nerve injury and vaginal injury tended to occur in TVTO group. Transient voiding dysfunction and urinary retention were the most common complications. CONCLUSIONS: Mid urethral sling procedures have excellent clinical outcomes in the treatment of female stress urinary incontinence.

[Hyperlipidemia and erectile dysfunction].

Hyperlipidemia is one of the risk factors leading to erectile dysfunction (ED), a common disorder in men, especially in old men. Epidemiological studies have found that the decrease in high density lipoprotein (HDL) and elevation of total cholesterol/high density lipoprotein (TC/HDL) are correlated with ED. Studies have also shown that arterial stenosis and occlusion caused by hyperlipidemia could be attributed to the advanced-stage mechanism of ED induced by hyperlipidemia. Hyperlipidemia may damage man's erectile function at an early stage by affecting the endothelial cells and smooth muscles of the penis and the peripheral nerves for penile erection. Apart from dietary therapy and drug therapy aiming at hyperlipidemia, the traditional Chinese medicine therapy and gene therapy are two promising approaches to the treatment of ED caused by hyperlipidemia.

[Correlation between abnormal serum lipid and erectile dysfunction].

OBJECTIVE: To achieve the correlation between abnormal serum lipid and male erectile dysfunction (ED). METHODS: Randomly selected were 200 male patients abnormal at least in one of the four laboratory items: total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL). Their erectile function was evaluated by IIEF-5, and the correlation was studied between abnormal serum lipid and ED. RESULTS: The incidence of ED was 47% in these patients. Age, coronary heart disease (CHD), high serum glucose, benign prostatic hyperplasia (BPH), drug, hypertension were negatively, while HDL was positively correlated with erectile function. Age, CHD, BPH and TC/HDL ratio were risk factors of ED, while HDL was a preventive one. CONCLUSION: Hyperlipidemia is an important factor of ED. HDL and TC/HDL ratio are good predictors of ED.

Biofeedback therapy for chronic pelvic pain syndrome.

AIM: To evaluate the efficacy of biofeedback therapy in patients with chronic pelvic pain syndrome (CPPS). METHODS: From November 2001 to April 2002, patients visiting the Urological Outpatient Clinic of this Hospital were evaluated by means of the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and classified by the NIH classification standard. Sixty-two patients of CPPS category III were involved in this study. All patients had been treated by conventional approaches such as antibiotics and alpha-blockers for more than half a year without any improvement. The expressed prostatic secretion results were as follows: WBC 5 to 9/high power field, lipid + approximately +++ and bacterial culture negative. Their NIH-CPSI were 12 approximately 40. All the 62 cases complained of micturitional irritation (frequency, urgency, splitted stream and sense of residual urine), 32 cases, of pain or discomfort at the testicular, penile, scrotal, pelvic or rectal region and 13 cases, of white secretion-dripping. The patients were treated by the Urostym Biofeedback equipment (Laborie Co., Canada) 5 times a week for 2 weeks with a stimulus intensity of 15 mA approximatley 23 mA and duration of 20 minutes. RESULTS: Sixty patients were significantly improved or cured, while no significant improvement in the remaining 2. No apparent side effect was observed. The NIH-CPSI dropped to 6 to 14 with an average reduction of 21 (P<0.01). In the 60 improved cases, pain was relieved after 2 approximately 3 treatment courses and other symptoms disappeared after 4 approximately 5 courses. CONCLUSION: Biofeedback therapy is a safe and effective treatment for CPPS. Large randomized clinical trials are needed to confirm its efficacy and to explore the mechanism of action.