Application of self-retaining bidirectional barbed absorbable suture in retroperito- neoscopic partial nephrectomy.

OBJECTIVE: To investigate the safety and feasibility of self-retaining bidirectional barbed absorbable suture application in retroperitoneoscopic partial nephrectomy. MATERIALS AND METHODS: From Sep 2011 and Aug 2012, 76 cases of retroperitoneoscopic partial nephrectomy were performed at our hospital. The patients were divided into two groups: self-retaining barbed suture (SRBS) group (n = 36) and non-SRBS group (n = 40). There was no significant difference in age, sex, tumor size and location between the two groups. Clinical data and outcomes were analyzed retrospectively. RESULTS: All 76 cases of retroperitoneoscopic partial nephrectomy were successfully performed, without conversion to open surgery or serious intraoperative complications. In the SRBS group, the suture time, warm ischemia time and operation blood loss were significantly shorter than that of non-SRBS group (p < 0.01), and operation time and hospital stay were shorter than that of non-SRBS group (p < 0.05). CONCLUSIONS: The application of self-retaining bidirectional barbed absorbable suture in retroperitoneoscopic partial nephrectomy could shorten suture time and warm ischemia time, with good safety and feasibility, worthy of being used in clinic.

[Outcomes of renal transplantation with donor kidneys with multiple arteries].

OBJECTIVE: To compare the outcomes of renal transplantation with donor kidneys with multi-branched renal arteries. METHODS: The data about operation time, volume of intra-operational blood loss, postoperative complications, and post-operational renal function status of 251 recipients of donor kidneys with single-branched renal artery (Group A), 12 recipients of donor kidneys with double-branched renal arteries the diameter of one of which was < 2 mm or the estimated blood supply areas of one of which were < 10% (Group B), and 35 recipients of donor kidneys with renal arteries with 2 or more than 2 branches (Group C). RESULTS: The operation time was (115 +/- 34) min in Group A and was (120 +/- 31) min in Group B, both shorter than that of Group C [(133 +/- 55) min], however, not significantly. There were not significant differences in the intra-operational volume of blood loss, 1-year survival rate of patient/transplanted kidney, and post-operational creatinine level among these three groups. The complication rate was 7.6% (19/251) in Group A, 16.7% (2/12) in Group B, and 11.4% in Group C (4/35). CONCLUSION: There are not significant differences in the intra-operational status and post-operational outcomes among the operations of renal transplantation with donor kidneys with different amounts of renal arteries.

Inguinal incision as a successful route to extract the kidney during laparoscopic retroperitoneal live-donor nephrectomy.

OBJECTIVES: We sought to evaluate the advantages of an inguinal incision in extracting the kidney during retroperitoneal laparoscopic live-donor nephrectomy. MATERIALS AND METHODS: From May 2008 to June 2011, fifty-eight cases of retroperitoneal live-donor nephrectomy were performed at our hospital; all data were analyzed retrospectively. All donors were grouped in a test group (n=32, inguinal incision) or a control group (n=26, lumbar incision) according to the selected graft retrieval incision. Donors were compared with regard to operative time and warm ischemia time, operative blood loss, hospital stay, cosmetic satisfaction, and incision complications. RESULTS: All 58 cases of retroperitoneal live-donor nephrectomy were successfully accomplished, without donor death, serious complications, and conversion to open surgery. There were no differences in mean operative time, mean blood loss, mean warm ischemic time, graft function, and 1-year graft survival rate between the groups. However, in a test group, the mean hospital stay was shorter (P < .01), and the satisfaction with cosmesis was higher (P < .01). The incidence rates of abdomen asymmetry (9/28), incision hernia (4/28), wound infection (5/28), and wound faulty union (6/28) were higher in the control group than they were in the test group. CONCLUSIONS: Inguinal incision is a safe and practical graft retrieval incision in retroperitoneal laparoscopic donor nephrectomy and can be generally applied.

MicroRNA expression profile analysis reveals diagnostic biomarker for human prostate cancer.

Prostate cancer is a highly prevalent disease in older men of the western world. MicroRNAs (miRNAs) are small RNA molecules that regulate gene expression via posttranscriptional inhibition of protein synthesis. To identify the diagnostic potential of miRNAs in prostate cancer, we downloaded the miRNA expression profile of prostate cancer from the GEO database and analysed the differentially expressed miRNAs (DE-miRNAs) in prostate cancerous tissue compared to non-cancerous tissue. Then, the targets of these DE-miRNAs were extracted from the database and mapped to the STRING and KEGG databases for network construction and pathway enrichment analysis. We identified a total of 16 miRNAs that showed a significant differential expression in cancer samples. A total of 9 target genes corresponding to 3 DE-miRNAs were obtained. After network and pathway enrichment analysis, we finally demonstrated that miR-20 appears to play an important role in the regulation of prostate cancer onset. MiR-20 as single biomarker or in combination could be useful in the diagnosis of prostate cancer. We anticipate our study could provide the groundwork for further experiments.

[Study on severity, status of awareness and therapy regarding urinary incontinence in elderly people from rural areas in Jixian county, Tianjin].

OBJECTIVE: To understand the prevalence of urinary incontinence (UI) and its severity in rural elderly people, as well as to investigate the awareness on UI in the elderly and health-care service seeking behavior. METHODS: A cross-sectional study was carried out in two townships of Jixian county, Tianjin. A total of 743 people aged 60 years and over were selected under cluster sampling method. All the information was collected with a standardized structured questionnaire by face-to-face interview. Prevalence, severity, the awareness on UI in the elderly and their utilization of health-care service for its diagnosis and treatment were analyzed. RESULTS: Prevalence of UI was 33.38% among people aged 60 years and over in two townships of Jixian, higher in females than in males (43.15% vs. 22.75%, χ(2) = 34.70, P < 0.0001). The prevalence rates of UI in 60- age group, 65- age group, 70- age group, 75- age group, 80- age group, 85 - 95 age group were 28.64%, 32.12%, 34.08%, 35.45%, 47.76%, 30.00%, respectively, and increased with age (for trend χ(2) = 2.19, P = 0.029). Stress urinary incontinence (SUI) and urge urinary incontinence (UUI) were mild, while mixed urinary incontinence (MUI) were mainly moderate. The differences of severity of SUI, UUI, MUI between men and women did not show statistical significance (all P > 0.05). In 743 elderly people, more than half of the respondents had never heard of UI (50.20%, 373/743) and only 170(22.88%) elderly people considered UI as a disease. 630 (84.79%) and 665 (89.50%) elderly people in our research group did not know that such condition was curable and preventable. In 248 elderly people with UI, only 12 (4.84%) of them ever seeking community health-care services in the health-care centers or hospitals. For the ones who did visit the centers, the purpose was only to seek for drug treatment. CONCLUSION: Prevalence of UI appeared to be high among the elderly people in rural areas of Jixian county. Most of the elderly people were lack of knowledge about UI that hindered them from seeking for diagnosis and treatment in the clinics, plus the treatment program for UI was not standardized. Knowledge on UI and health care seeking behavior should be popularized and strengthened among elderly people living in the rural areas.

[Study on the prevalence of urinary incontinence and its related factors among elderly in rural areas, Jixian county, Tianjin].

OBJECTIVE: To understand the prevalence of urinary incontinence (UI) and its related factors so as to develop a three-tier program for prevention of the disease. METHODS: A cross-sectional study was carried out in two townships of Jixian county, Tianjin, during July to November 2007. A total of 743 people aged 60 years and over were selected under cluster sampling, and all information were collected with a standardized structured questionnaire by face-to-face interview. All the data were analyzed with multivariate logistic regression method to explore the related factors for UI in the elderly. RESULTS: The overall prevalence of UI was 33.38 percent among people aged 60 years and over in two townships. Risk factors for UI in men would include older age (OR = 1.39), occupation (OR = 5.00), awareness of UI (OR = 1.91), having in chronic respiratory diseases (OR = 2.23), prostate (OR = 11.47), neurological (OR = 11.76), or motor systems (OR = 2.48), while protective factors would include high educational level (taking primary school or below as control group), OR for the junior middle school group appeared to be 0.35, for senior middle school group it was 0.77, and of undergraduate group it was 0.53. Risk factors for UI in women would include older age (OR = 1.31), constipation (OR = 1.46), awareness of UI (OR = 1.94), increased body mass index (when normal weight group served as control group, OR in the overweight group was 1.03 and in the obesity group OR was 1.54), suffering from chronic respiratory diseases (OR = 4.84), diabetes mellitus (OR = 2.36), or motor system diseases (OR = 1.37), more gravidity (OR = 1.03), more parity (OR = 1.02), suffering from perinea laceration (OR = 1.72) and wound infection during delivery (OR = 1.65), while protective factors would include physical exercises (OR = 0.64). CONCLUSION: Prevalence of UI was higher among the elderly people in rural areas of Jixian county, Tianjin. UI in the elderly might have been influenced by various factors which suggesting the intervention strategy should be targeted at those related factors as well as focusing on primary prevention.