[Clinical study of resiniferatoxin on neurogenic bladder].

OBJECTIVE: To understand the effect of resiniferatoxin on neurogenic bladder by intravesical filling. METHODS: Twenty-four male spinal cord injury patients with an obviously low cystometric capacity, 2 incomplete cervical cord injury, 5 complete thoracic cord injury, 4 incomplete thoracic cord injury, 5 incomplete lumbar cord injury and 8 complete lumbar cord injury were examined. The age range was 24 - 58 years old and the course of disease 1 - 6 years. There were 0.0063 mg/4 ml RTX in each bottle, it was dissolved in 50 ml physiologic saline and was infused into bladder slowly, kept 30 min, then was discharged by intermittent catheterization (IC). During the process, the patients were requested to fill a micturition chart and conduct urodynamic examination before and after the infusion. We regulated that it was utility when the amount of increased maximal cystometric capacity (MCC) exceeded or was 100 ml, otherwise it was invalid. RESULTS: The urodynamic examination before intravesical filling and 1 week after intravesical filling showed that the average MCC were (210 ± 23) ml and (360 ± 30) ml respectively, the average bladder compliance were (17 ± 3) ml/cm H2O and (24 ± 5) ml/cm H2O, there were statistic difference between them (both P < 0.01). The overall effective rate was 62.5%. It lasted 1 - 4 months. CONCLUSION: Resiniferatoxin is effective to increase the cystometric capacity and booster the bladder compliance.

[Clinical differential diagnosis of type III prostatitis and interstitial cystitis].

OBJECTIVE: To investigate the differential diagnosis of type III prostatitis and interstitial cystitis so as to improve the efficiency of diagnosis and treatment of the two diseases. METHODS: Based on the clinical data of 4 cases of type III prostatitis and 3 cases of interstitial cystitis, we analyzed the characteristics of the two diseases in such aspects as clinical symptomatology, urodynamics, prostatic fluid microscopy, microbiology and treatment. RESULTS: The common clinical characteristics of type III prostatitis and interstitial cystitis were indisposition or pain in the subabdomen and/or pelvic floor, but their differences were quite obvious. In interstitial cystitis, longer urine accumulation could cause worse pain in the subabdomen, which could be relieved after micturation, and the bladder capacity was obviously decreased, but with normal prostatic fluid and negative result of microbial culture. It responded to behavior therapy, resiniferatoxin, sodium hyaluronate and water dilation of the bladder under anaesthesia. While type III prostatitis, with white blood cells > 10/HP or < or = 10/HP in the prostatic fluid and negative result of microbial culture, did not respond to the above therapeutic methods that were effective for interstitial cystitis. CONCLUSION: Type III prostatitis and interstitial cystitis, although clinically confusable, can be definitely differentiated from each other according to their characteristic causes and locations.

[Experimental study on effect of Bailing Cpsule on dendritic cells in mice].

OBJECTIVE: Comparing with the classic immuno-supressors, to probe in the in vitro effect of Cordyceps Sinensis (CS) on the differentiation, maturation and function of dentritic cells (DCs), and further to explore its mechanism. METHODS: Mice myeloid DCs were cultured respectively with extraction of Bailing Capsule (CSE), a Chinese medical preparation made of CS, Rapamycin and Tacrolimus, and the effect of various drugs on phenotype of DCs was analyzed with flow cytometer. Then, using as the stimulator, the DCs cultured with different drugs were mixed and cultured with heterogenous lymphocytes for observing the stimulating capacity of DCs on cell proliferation. RESULTS: CSE showed no in vitro effect on phenotype markers and co-stimulation molecules of DCs, the difference between CSE and Tacrolimus was insignificant, while Rapamycin could reduce the two parameters. CSE showed a marked suppressive effect on DCs in stimulating leucocyte proliferation in a dose-dependent manner. CONCLUSION: CSE could affect the stimulating capacity of DCs on cell proliferation, which is probably by means of inhibiting the function of antigen presentating cells to block the presentation of extrinsic signal, and make the low immune response condition, thus to obtain the effect of immunosuppression.

[Submucosal injection of anti-tumor drug on the prevention of Post-TUR-Bt recurrence].

OBJECTIVE: To study a new and practical method to prevent the superficial bladder tumor recurrence after transurethral resection of bladder tumor (TUR-Bt). METHODS: We had chosen 68 patients with superficial bladder tumor randomly. After TUR-Bt, we inserted special stainless steel injection needle through the operation hole, and then injected anti-tumor drugs (pirarubicin) submucously; in the control group, 74 patients were given traditional perfusion therapy for carcinoma in bladder with the same anti-tumor drug (pirarubicin) after TUR-Bt. The effects were evaluated according to recurrence ratio. RESULTS: The recurrence rate of injection group was 11.8% (8/68), and that of the control group was 29.7% (22/74). There is a very significant difference between the two groups (chi(2) = 0.013, P < 0.01). The overall median recurrence interval period of injection group was obviously longer than that of the control group, but there was no significant difference about single and multiple occurrences between the two groups (chi(2) = 0.719, P > 0.05). CONCLUSIONS: The injection method used to prevent tumor recurrence after TUR-Bt has the following virtues: simple and safe, less side effect, more economical. We demonstrated that submucosal injection is a practical method to prevent tumor recurrence and is worth popularizing.

Influence of bladder outlet obstruction and detrusor contractility on residual urine in patients with benign prostatic hyperplasia.

OBJECTIVE: To study the relationship between the degree of bladder outlet obstruction (BOO), detrusor contractility and residual urine in patients suffering from benign prostatic hyperplasia (BPH). METHODS: In 181 patients with BPH, degree of BOO, detrusor contractility, residual urine caculated from cathetering combined with the difference between the filling and the voiding were recorded and analysized statistically using urodynamic technique. RESULTS: Residual urine increased when the detusor contractility was weakened (F = 12.134, P = 0.001). In patients wih severe BOO, there was no significant difference in residual urine (F = 2.386, P = 0.071). CONCLUSIONS: Increased residual urine is mainly resulted from decreased detrusor contractility. BOO has no significant influence on residual urine. Some patients with normal or weakened detrusor contractility may have more residual urine.

Surgical repair of spontaneous renal allograft rupture: a new procedure.

BACKGROUND: The purpose of the present paper is to introduce a new surgical procedure using the external oblique aponeurosis (EOA) for repair of spontaneous renal allograft rupture. METHODS: Thirty-eight cases with spontaneous renal allograft rupture were encountered in 1000 consecutive kidney transplants between April 1991 and August 2000. Thirty-three cases underwent surgical exploration with two grafts undergoing nephrectomy, while a further 31 were repaired using the new surgical procedure. The external oblique aponeurosis (EOA) from the incision was trimmed into 1 cm x 1 cm square pieces. A 2/0 Dexon suture was placed through each piece of the EOA, then through the parenchyma of the kidney perpendicular to the rupture. Each suture was then placed through another piece of EOA and tied. RESULTS: Two repaired grafts were removed on day 7 and day 10, one due to graft re-rupture and another with ischaemia secondary to irreversible acute rejection. The graft function of 29 cases had recovered completely at 30 days following surgical repair with one graft improving rapidly. Thirteen grafts were diagnosed as undergoing mild to moderate acute rejection, whereas a further 20 cases were considered to have acute tubular necrosis on histopathology. The allograft survival rate at 1 year and 5 years post grafting was 86% and 64%, respectively. No patients died from postoperative complications following repair using this procedure. CONCLUSIONS: Spontaneous renal allograft rupture is a relatively common post-transplant complication secondary to either acute tubular necrosis or acute rejection. This new surgical procedure is proposed as a reliable and practical method of repair following graft rupture. Preservation of graft function and viability following rupture appears achievable both in the medium and long-term.

[Non-improvement after different procedures of prostatectomy].

OBJECTIVE: To analyze the causes of non-improvement after different procedures of prostatectomy. METHODS: Using the urodynamics and other techniques, we examined 84 non-improved patients who had undergone different procedures of prostatectomy. RESULTS: In the TURP group, the main causes of non-improvement included bladder outlet obstruction (84.9%), weak contractility of the detrusor (30.4%), and detrusor instability (DI) (18.2%). In the open group, however, the main causes of non-improvement included detrusor weak contractility (52.9%), DI (35.2%), and bladder outlet obstruction (33.3%). There was significant difference between the two groups according to the Pearson Chi-square test (P = 0.000). The re-obstruction rate in the TURP group was much higher than that in the open group, suggesting that the level of the TURP should be improved. CONCLUSIONS: Different operative procedures yield different non-improvement after prostatectomy gradually. When BPH patients are diagnosed with detrusor weak contractility and DI, prostatectomy should be carefully considered.

[The relationship between the peripheral blood of CD61, CD63, PAC-1 and the transplant kidney function].

OBJECTIVES: To explore the relationships between the peripheral blood levels of CD61, CD63, PAC-1 and the incidence of acute rejection and tubular necrosis after renal transplantation, and recovery of the graft function. METHODS: The peripheral blood levels of CD61, CD63, and PAC-1 of 86 patients with uremia in different stages before and after transplantations were analyzed by flow cytometry. The patients were divided into three groups: (1) twenty-nine patients with normal grafts function, (2) hirty with acute rejection and (3) twenty-seven with acute tubular necrosis. The patients with acute rejection were randomly divided into treatment group with anticoagulants and cntrol group. RESULTS: The peripheral blood levels of CD61, CD63 and PAC-1 significantly increased (P < 0.05) in the patients with acute rejection, in comparison with those with normal grafts function and those with acute tubular necrosis. The peripheral blood levels of CD61, CD63 and PAC-1 in patients with acute rejection in anticoagulants therapy was lower, recovery time of the grafts function was shorter, one-year survival rates of patients and grafts were higher, as compared with those of controls. CONCLUSIONS: The patients with acute rejection have significantly high peripheral blood levels of CD61, CD63 and PAC-1 before transplantation, however, these values in patients with acute tubular necrosis are not high, this suggesting that acute rejection might relate to platelet activation, while acute tubular necrosis might not relate to it. After anticoagulants therapy in patients with acute rejection, the grafts function might recover faster and their one-year survival rates and grafts might be higher in those with CD61, CD63 and PAC-1 decreasing remarkably.

Urodynamic analysis of non-improvement after prostatectomy.

OBJECTIVE: To study the factors that affect the prognosis of the patients with benign prostatic hypertrophy (BPH) after prostatectomy. METHODS: Using urodynamic methods, we studied 50 BPH patients with embarrassing outcomes after prostatectomy. RESULTS: Detrusor instability (Dl) appeared in 20 (40%) patients. Twelve (24%) patients suffered from weak contractility of the detrusor and 18 (36%) patients had bladder outlet obstruction. CONCLUSIONS: Dl, weak contractility of the detrusor and bladder outlet obstruction are the most frequent causes affecting the prognosis of BPH patients after prostatectomy. Urodynamics may play a significant role in the identification of the causes of unsatisfied prognosis of BPH patients.

Magnetic resonance urography in the diagnosis of urinary tract obstruction after renal transplantation.

OBJECTIVE: To evaluate magnetic resonance urography (MRU) in the diagnosis of urinary tract obstruction after renal transplantation. METHODS: A total of 31 patients with suspected urinary tract obstruction after renal transplantation were examined, and the results were compared with those from surgery and B-ultrasound examination. RESULTS: The urinary tract after renal transplantation was clearly shown using MRU, and all patients were clearly diagnosed by MRU. Imaging results were consistent with those from surgery. CONCLUSIONS: MRU is suitable for detecting urinary tract obstruction after renal transplantation. It is a alternative method for IVP and CT in patients with renal function impairment and uremia.

[Expression of vascular endothelial growth factor in colorectal cancer and its clinical significance].

OBJECTIVE: To evaluate the relationship between vascular endothelial growth factor (VEGF) and colorectal cancer. METHODS: Samples of cancer and adjacent normal mucosa were taken from 34 patients with colorectal cancer. The percentage and average fluorescence intensity pf VEGF positive cells in these samples were examined by using flow cytometry. RESULTS: The percentage of VEGF positive cells was 57% +/- 29% in cancer tissue and 42% +/- 24% in normal tissue (P < 0.05). The average fluorescence intensity of VEGF positive cells was 24% +/- 11% in cancer tissue and 16% +/- 7% in normal tissue (P < 0.01). The percentage of VEGF positive cells was 30% +/- 22% in cancer of Dukes stage B and 72% +/- 18% in cancer of Dukes stage C (P < 0.01). The average fluorescence intensity was 18% +/- 25% in cancer of Dukes stage B and 27% +/- 12% in cancer of Dukes stage C (P < 0.01). CONCLUSION: VEGF is associated with the development and prognosis of colorectal cancer. Its relation with degree of differentiation of colorectal cancer remains to be studied.